[Ectodermal dysplasia and exocrine pancreatic insufficiency--a familial syndrome]. A syndrome was observed in two sisters which was characterized by a median defect of the hair of the head, hypoplasia of the ala nasi, absence of the permanent teeth, microdontia of the deciduous teeth, and exocrine insufficiency of the pancreas. This syndrome is probably autosomal regressive; the symptoms are similar to those of Johanson-Blizzard syndrome.


[Reproducibility of plaque formation in the dento-gingival region. 4]. The reproducibility of plaque was quantitatively determined in three twelve-day examination periods. The periodontium of the subjects was healthy; tendencies for plaque formation were extreme or slight. Plaque formation was studied on teeth 33 to 43; the vestibular surface was divided into 1,600 areas, according to topographic factors. The absence and appearance of plaque three times tends to indicate a causal event in that particular area. The results were as follows:1) The reproducibility of plaque formation with "slight" plaque patterns is no lower than with "severe" plaque patterns. 2) The dominating influence of the microrelief (surface roughness) compared with the macrorelief (form of the tooth, tooth position) and other factors holds true for subjects with a tendency for severe and slight plaque formation. 3) Plaque may be formed by several different factors; these factors will affect various topographic zones of the tooth surface differently. Many other differences were reported in subjects with severe or weak plaque formation. 4) Terms of preventive dentistry, the evaluation of surface roughness of the teeth, particularly with adolescents, is necessary in each dental practice.


[The Silcadraht adhesive splint--a new methods for the treatment of luxated teeth]. Splints for the immobilization of dislocated teeth have been attached to teeth with the enamal-cauterization-cement technique for the last six years at the Innsbruck Hospital. Semicircular silica wires proved to be so satisfactory with 92 patients that this method has now replaced the traditional splinting methods at our hospital. The secondary advantages are the simple production of the splint, painless application and removal, and complete protection of the periodontium. Occlusal disturbances are avoided, because the splints do not cover any of the occluding tooth surfaces.


[The necessity of bite wing registration for the diagnosis of caries]. This study points out the importance of the radiograph, particularly bitewing films, for diagnosing caries in interproximal regions. The assertion that interproximal caries may be optimally diagnosed without radiographs was investigated. Two clinical examinations of the same patient were compared with two evaluations of the bitewing film.


[The patient's motivation for oral hygiene--a psychological consideration]. The kernel of the patient's motivation for oral hygiene should be the conversation which the dentist has with his patient. He should conduct this conversation factually, carefully, without loud or shrill tones. The patient must be told: concerns your own personal interest. The necessary detailed information and technical hints may be left to the assistant or the dental technicians, additional leaflets and even audiovisual aids may supplement the patient's information. The members of the practice must be in agreement on the questions of motivation and information of the patient, so that one does not destroy what another has built up.


[Pathology of the bone pocket].

[Pathology of the bone pocket]. Inflammatory periodontal destruction includes periodontal bone destruction. In addition to etiologic factors which contribute to the formation of gingival pockets, cell-mediated immune reactions apparently play a special role in osteoclastic processes. Apart from coincidental events, the form of osteoclasia is influenced in the beginning by the form and position of the tooth. Vertical osteoclasia, a variant form, is more frequently observed in connection with juvenile periodontitis. Occlusal periodontal trauma and general primary diseases may possibly also influence the pattern of periodontal bone destruction.


[Possibilities of healing of periodontal injuries in the apical region--an animal experimental study]. A histologic study of the healing of periodontal injuries in the area of the roots was carried out using beagle dogs. Mucobuccal injuries were inflicted in the dentoaveolar region with a saw. Polychromatic fluorescence labeling was selected to observe the reparative processes. Combined with polarization, it was possible to obtain a good evaluation of the unstained microsection. The course of healing was favorable, and the original condition was completely restored. When pure saw injuries were limited to the periodontium, we found that saw cuts extending into the dentin always left defects in the hard substance which, under favorable conditions, functionally adapted to the attachment apparatus of the teeth.


[Nomenclature of regional tissue changes in periodontal diseases]. The nomenclature of periodontal diseases has undergone repeated alterations in the course of time. An important reason for this was the difficulty of reconciling the clinical symptomatology, which must always be the basis of a classification, with the nature of the tissue changes, i.e. with the pathogenetic principles underlying them.


[The Edlan-Mejchar modified surgical method]. In addition to free grafts of mucosa, the method for widening attached gingiva developed by Edlan and Mejchar appears to be the most successful of all operative procedures described during the last 25 years. Of all known procedures, it has the lowest percentage of recurrence. Over a period of years, my coworkers and I modified the procedure described by these two authors so that it is now a feasible procedure for the daily dental practice which, with a little practice, can easily be carried out without risk. It is well tolerated by all patients. This method is most frequently employed in the context of periodontal treatment, but it also lends itself well as an effective preprosthetic procedure.


[The coronal flap with integrated gingival graft for the covering of receded gingiva]. Surgical correction (50 operations) was carried out for 113 recurrences using the two-phase operative procedure described. Follow-up examinations one month after surgery indicated that--the initial average depth of recurrence was reduced from 2.67 to 0.56 mm; --maximal coverage success was 5 mm; --sixty-two recurrences of various depths were covered 100%.


[Comparative clinical and histological studies on keratinized and non-keratinized tissues transplanted onto the periosteum and the denuded alveolar bone]. Our clinical and histological investigations in humans and beagle dogs in a unilateral trial with free and pedicled grafts applied to the periosteum and to exposed alveolar bone established that from the clinical aspect it is better to place the graft on the exposed bone to obtain a firmly fixed base instead of a movable periosteal one.


[Comparative studies of the hardness of dental calculus after the use of 2 dentifrices]. A method was described for recording the mechanical characteristics of tartar using objectively comparable test data. This method was used to study tartar which had formed when different tooth pastes were used. The results of this study indicate that 1. Tartar formed when different tooth pastes are used may exhibit different characteristics; 2. The dynamic measurement of indentation is suitable for quantitative determination of the mechanical characteristics of tartar. These mechanical characteristics have not been ascertainable until now.


[Retrograde movement of upper incisors]. Labial stress of 1 to 8 n(102-815 Pond) was exerted on free-standing upper incisors, both healthy teeth and teeth damaged by progressive marginal periodontitis, until all creeping movement subsided and constant guidance was achieved. The teeth were then freed, and the resetting movements were measured without inertia and free of effect. The dampening characteristics of healthy and diseased teeth differed qualitatively in the first few milliseconds. Construction of a diagnostic device of determination of periodontal disease suitable for the general practice therefore ought to be possible.


[Functional aspects of injuries to the incisors]. A demonstrable causal relationship between occlusal and articular interference was established for periodontal and pathologic symptoms of the maxillary anterior teeth. The study was based on the localization of the periodontal pathology, marking of occlusal interference, and analysis of the sequences on the repantographs with occlusal and articular guidance.


[The value of functional analyses for systematic periodontal treatment (clinical study)]. The relationship between periodontal disease and dysfunction of the stomatognathic system was examined with the usual analysis of function in the context of a clinical study. In addition to neuromuscular incoordination, premature centric contacts deflect the mandible from a muscularly stable contact position and traumatize the periodontium mechanically. After suitable treatment, the causes of functional damage to the tooth attachment apparatus may be demonstrated in connection with an exact clinical registration of the findings by a simple instrumental analysis of function. This analysis may be adequately carried out with a semiadjustable articulator together with a rapidly transmitted curve.


[The use of periodic forces of various frequencies for the study of the visco-elastic properties of the gingiva]. The examination of interdental papilla using the turgometric procedure with forced oscillations in the frequency range between 30 Hz and 330 Hz provides diagnostically valuable information. With a relatively simple evaluation procedure, a quantitative value for the degree of inflammation in each interdental papilla can be obtained directly.


[The effect of vascular injuries on the healing of experimental gingival wounds]. Following experimental infliction of stab wounds, the blood circulation in mandibular gingiva attached to the labium was studied in 31 subjects with fluorescence angiography. Ischemic circulatory disturbances six hours after infliction of the wound and enlargement of the wound three days post operationem were all directed cranially. Blood flow in this area of the gingiva seems to have a strictly caudocranial orientation; the ability to develop collateral circulation is also limited. Ischemia was significantly increased in the stab wounds set axially over the roots of the incisors. Three and seven days later, the wound surface was considerably larger than that of papillar wounds inflicted at the same level. The attached gingiva appears to be more susceptible to injury over the roots of the lower incisors than in the neighboring papillary regions.


[The presentation of the periodontal blood vessels. Histological studies in perfused rats]. Unbroken series of sections taken from various areas of the periodontium of vitally fixed rats were prepared as the basis for constructing a model for the morphology of the vessels and for planimetric evaluation. Using this material, we were successfully able to validate a technique for localization, course, and distribution of vessels and of capillary anastomoses.


New developments in the clinical application of evoked potentials. The introduction of the pattern-evoked response and of far field recording of the auditory and somatosensory short latency responses has provided to major advances in the clinical application of evoked potentials. The sensitivity of the pattern response in the detection of minimal lesions of the visual pathways is now well established, and makes the test of particular value in the diagnosis of demyelinating disease and in the early detection of compressive lesions. The short latency auditory and somatosensory responses also show a high incidence of abnormalities in demyelinating disease. The technique will not compete directly with such well established methods as audiometry and perimetry, but it can provide valuable additional information, not accessible to these methods, particularly where the lesions are clinically silent or inconspicuous.


Computed EEG topography.

Computed EEG topography. Using the method of sequential analysis, clinical EEGs are transformed into a temporal sequence of individual events with specification of amplitude, wave or segment interval, channel of origin and paroxysmal character in relation to background activity. These data can be viewed immediately in graphic form and stored for subsequent display or numerical analysis. The speed, format, and high information content of this method of data reduction allow real time topographic display of individual background and paroxysmal events - computed EEG topography (CET). Alpha asymmetry, slow activity, paroxysmal events and bilateral spike-wave activity are vividly represented and distinguished. There appears to be a close correlation between the usual method of EEG interpretation and the independent interpretation of a very compact quasi-anatomic CET with respect to nature and localization of normal and abnormal EEG activity. Initial observations suggest particular value of the CET in defining the extent of functional disturbance related to an anatomical lesion and in communicating this information to the electroencephalographer and to the clinician.


Spectral analysis of alpha rhythm during Schultz's autogenic training. A tentative approach to rapid visualization. The records from experimental sessions including autogenic standard exercises and other conscious states, in two long-term trainees, were treated by using a frequency analysis programme. Starting from a synoptic reduced representation of the data and selecting sequences for the building of histograms of averaged energy levels in limited frequency bands, the authors describe the progressive spread of a dominant alpha band all over the scalp during autogenic training.


Recent advances in EEG data processing.

Recent advances in EEG data processing. It is argued that the most interesting advances in EEG signal processing are with methods based on descriptive mathematical models of the process. Formulation of auto-regressive (AR) and mixed autoregressive and moving average (ARMA) models is reviewed for the scalar and the multidimensional cases and extensions to allow time-varying coefficients are pointed out. Data processing with parametric models, DPPM, involves parameter estimation and a large number of algorithms are available. Emphasis is put on those that are simple to apply and require a modest amount of computation. A recursive algorithm by Levinson, Robinson and Durbin is well suited for estimation of the coefficients in the AR model and for tests of model order. It is applicable to both the scalar and multidimensional cases. The ARMA model can be handled by approximation of an AR model or by nonlinear optimization. Recursive estimation with AR and ARMA models is reviewed and the connection with the Kalman filter pointed out. In this way processes with time-varying properties may be handled and a stationarity index is defined. The recursive algorithms can deal with AR or ARMA models in the same way. A reformulation of the algorithm to include sparsely updated parameter estimates significantly speeds up the calculations. It will allow several EEG channels to be handled simultaneously in real time on a modern minicomputer installation. DPPM has been particularly successful in the areas of spectral analysis and detection of short transients such as spikes and sharp waves. Recently some interesting attempts have been made to apply classification algorithms to estimated parameters. A brief review is made of the main results in these areas.


Neuroelectric measures of lateral specialization in relation to performance. Four experiments were undertaken to study EEG asymmetry in relation to cognitive specialization of the hemispheres of the human brain and in relation to the proficiency of behavioral performance. Individual differences in the functional significance of alpha lateralization were noted, but there were, within subjects, consistent indications of lateral specialization and of the influence of alpha asymmetry on reaction time. Simultaneous demands for both input processing and motor output control by a given hemisphere caused a decrement in reaction time performance. The decrement appeared to involve impaired perceptual processing, as indicated by factor analysis of the evoked potential. A factor identified as P300 was least represented in the wave forms associated with conditions leading to long reaction times.


Ionic changes during experimentally induced seizure activity. Changes in intra- and extracellular ionic activity and their relation to generation and termination of seizure phenomena can be studied with the help of ion-selective microelectrodes. Transient changes in extracellular potassium activity (aK) of the cortex regularly accompany paroxysmal activity induced by electrical stimulation and pentylenetetrazol injections or occur within active penicillin and aluminum foci. A rise of aK from baseline levels of about 3 mmoles/l up to ceiling levels of 8--12 mmoles/l, followed by subnormal K activity, is typically found during seizure discharge. Extracellular K accumulation during seizures facilitates the spread into extrafocal regions. Ceiling levels of extracellular aK are characterized by pronounced K reabsorption which is probably a limiting mechanism for the rise in extracellular aK. It may be a consequence of a simultaneous rise in intracellular Na activity that an electrogenic Na--K exchange process is involved in the termination of ictal activity. Seizures are also accompanied by significant reductions in extracellular Ca2+ activity (aCa) to as low as 0.7 mmoles/l (resting aCa 1.25 mmoles/l). There is no critical level of lowered aCa at which a seizure ultimately results. However, unlike changes in aK reductions in aCa can precede ictal activity. Thus, a fall of aCa occurs before the onset of paroxysmal periods during cyclical spike driving in a penicillin focus and before seizures induced by pentylenetetrazol. Ca2+-dependent mechanisms may contribute to seizure generation. In addition to changes in aK and aCa, intracellular chloride activity (aCl) can increase during seizure activity, as a result of an impaired chloride extrusion mechanism, which would lead to a reduced efficacy of inhibitory synaptic transmission and, therefore, to facilitation of seizure generation.


EEG synchronization in seizures: facts and models. In topographic studies of seizure patterns in the rabbit, the phenomenon of synchronization has turned out to be characterized by regular propagation of the potential fields underlying the raphoelements observed in the EEG: in most cases these potential fields describe circular paths within the cortex. Moreover, a multielectrode was developed to explore the different layers of the cortex simultaneously. Both approaches brought enough material to put forward a hypothesis on the origin and the maintenance of so-called synchronized activities.


EEG and psychopharmacology.

EEG and psychopharmacology. The waking EEG bears direct relations to chemical changes in the brain induced by drugs. The waking EEG is responsive to the unique characteristics of psychoactive drugs. Their EEG signatures are predictive of their short-term behavioral effects and of their clinical efficacy. This association has led to the development of cerebral electrometry - a technique to predict a drug's clinical profile from experimental trials in normal volunteers. The technique is also useful in pharmacodynamic studies. Cerebral electrometry depends on careful control of behavioral variables, quantification of EEG effects and statistical processing of the data. The EEG-behavioral associations do not depend on a single method of quantification. Behavioral association is predicted for animal studies as well. Lacking, however, are studies in animals with adequate behavioral controls, clinical correlations of direct use to the individual patient and robust tests of this association hypothesis. The past decade has shown the utility of quantitative EEG studies and improved the methodology to a practical art. The next decade should see the techniques used by classical pharmacologists, mindful of the restraints inherent in animal models of the mental aspects of behavior.


Kinesiology: with special reference to electromyographic kinesiology. A brief review of kinesiological research with special reference to electromyographic kinesiology is presented. The review deals with, among other things, the use of electromyography in functional anatomical studies, in biomechanical studies on muscular force, in neurophysiological studies on muscular fatigue, in applied kinesiologic studies and in vocational studies.


Biochemical relationships between muscle and erythrocyte membrane. Interpretations with respect to Duchenne muscular dystrophy. Whether Duchenne muscular dystrophy (DMD) is a disease of primary myogenic, secondary neuropathic, vascular or membrane etiology is the subject of some debate. Using the erythrocyte membrane as a biopsy tissue we present biochemical data that support the possibility of a defect in myosin as the genetic defect in DMD. Peptide analysis of hydrolyzed erythrocyte spectrin supports previous data demonstrating an alteration in DMD spectrin. The biochemical and biophysical similarities between spectrin and myosin can be tested with available technology. The hypothesis that a defect in myosin may be responsible for DMD is attractive because it is testable.


Structure and function of the motor unit. Effects of immobilization, monoparesis or paraplegia. Single motor units have been studied in the medial gastrocnemius muscle in cat following acute or chronic unilateral hind limb immobilization or antero-lateral spinal cord section. Immobilization produces muscle atrophy by 5 weeks and in the chronic phase (4-6 months) is characterized functionally by reduced twitch and tetanus tensions and structurally by fiber atrophy without type grouping or preponderance. Antero-lateral cord section with minimal motor dysfunction does not produce muscle atrophy or change in tension but in the chronic animals there is a slight decrease in twitch-tetanus ratios. Changes in the functional properties of motor units reflect changes in structure and both may result from secondary effects (i.e., type and amount of muscle activity, muscle length, pain, etc.) of a neuromuscular disease on muscle.


Diagnostic value of quantitative electromyography. Its scope and limitations. On the evidence of 951 cases of the 10,500 investigated with the aid of quantitative electromyography the author shows the value of the method for diagnosing muscle activity. Statistical analysis was applied to check the diagnostic value of EMG parameters separately and jointly in the identification of the pathology and its classification as either neurogenic or myogenic. Also surveyed are the sources of the discrepancies between the electromyographic and the histopathological results in very early and very advanced cases. Examples are given that show electromyographic findings as nosologically non-specific and the method as inferior to the morphological in this respect. On the other hand the method is stressed as one that permits it to (a) tell a malignant and rapid process from a slow one, (b) obtain evidence of repair and (c) prove generalization of processes considered to be local or the progressive character of processes considered to be non-progressive. The author also refers to the added scope given to electromyography by such developments as automatic recording, SFEMG, and determination of motor unit territory with the aid of multielectrodes.


Modifications of ongoing tremors and locomotion by sensory feedback. In principle tremors can be produced by (1) mechanical oscillators (combination of masses and springs), (2) reflex oscillators arising from sensory feedback pathways, or (3) central oscillators generated by single "pacemaker" neurones or interconnected networks. Recent studies supporting each of these mechanisms under certain conditions are discussed. Differences between these mechanisms are clarified by recent studies in Edmonton on the premammillary cat. This preparation shows a prominent reflexly-induced tremor which can be modified by mechanical loading and electrical stimulation. It also shows spontaneous stepping on a treadmill which is known to be produced by a spinal "stepping generator", but can be modified in interesting ways by sensory perturbations. The applicability of these animal studies to human tremors is considered in relation to preliminary studies in Calgary on patients with Parkinson's disease or essential tremor. We have attempted to modify these tremors by application of torque pulses applied to the wrist. The results are described in terms of a normalized "resetting" index which has a high value (greater than 0.6) for all essential tremor patients studied, and a wide range of values for different parkinsonian patients. The resetting index may be useful in determining the relative importance of peripheral and central factors in producing tremor in a variety of patients.


Reciprocal Ia inhibition in spastic paralysis in man. Reciprocal reflex connections were studied in capsular hemiplegia and spastic paresis with spinal cord lesions, using Lloyd's technique. Effects of conditioning stimulation of the tibial or peroneal nerve on the H reflex in the antagonists were examined. Stimulus intensity was controlled with reference to the threshold of the M wave. Weaker stimulation than this threshold was regarded as stimulation of group I afferents. It aroused no subjection sensation in intact subjects. Early and strong inhibition, comparable to Ia inhibition in the cat (Lloyd 1946), was observed from weak stimulation of the tibial nerve on the pre-tibial (flexor) H reflex, but not from the peroneal nerve on the triceps surae (extensor) H reflex in capsular hemiplegia. Alcohol block of extensor motor points resulted in reduction of spasticity without further paralysis in the blocked muscle and a remarkable increase in strength of the antagonist pre-tibial muscles. These results suggest that an extensor spasticity withe flexor weakness, which is common in capsular hemiplegia, may be due to an imbalance of reflex activities via Ia muscle afferents, and that a part of flexor weakness can be restored by "disinhibition' by reduction of Ia inflow from extensor muscles. Ia inhibition was also observed in one third of cases with spinal cord lesions at rest. It returned to normal after recovery from spastic paresis by radical therapy in some cases.


Muscle membrane chloride conductance and the myotonic syndromes. The myotonic syndrome of delayed relaxation in striated muscle associated with repetitive membrane electrical activity is characteristic of a number of hereditary disorders in animals and man. This state of pathologic membrane hyperexcitability is also seen as a consequence of intoxication with several classes of chemicals. In most of these states an increase in muscle membrane resistance due to a specific reduction in sarcolemmal GCl can be demonstrated. Computer simulations have indicated that such a reduction in GCl alone could account for the observed repetitive electrical activity. Controlled reduction of GCl in normal muscle, using aromatic monocarboxylic acids, produces a myotonic syndrome. This myotonia resembles that seen in hereditary disease in its contractile characteristics, its intracellular electrical behavior and its response to diphenylhydantoin and procainamide. The effects of variations in temperature and divalent cation concentration seen in this system parallel those predicted by computer models of myotonia based on the chloride hypothesis. Comparison of the behavior of this and similar model systems with the hereditary myotonias of man and goat allow conclusions to be drawn concerning the underlying pathophysiologic mechanisms at work in the hereditary disorders. The concept of an abnormally reduced GCl as the final common factor in many of these disorders emerges as the most tenable hypothesis, although the mechanism by which this conductance is altered may be unique in each case.


Models of the dynamics of neural populations. Three requirements are posed for constructing models to simulate EEG dynamics. The element of the model should be an interactive ensemble of neurons and not single neurons. The observations must be statistical, such as EEG waves and averages of unit activity over time and over local neighborhoods containing neural subsets. The state variables and operations of the model must be clearly related to behavioral functions such as sensory reception and perception. A model is presented that exemplifies these requirements. Its key feature is the dependence of its levels of interaction on the level of its input, so that with each burst of input the model switches from an equilibrium state to a limit cycle state. A mechanism is described for coding sensory input into the spatial modulation of the limit cycle activity viewed as a carrier. It is suggested that sensory recepts and percepts exist at different hierarchical levels in the brain, recepts at the level of single neurones, and percepts at the level of neural ensembles, the latter being possibly manifested in the EEG.


Communicating hydrocephalus in treated leukemic patients. 7 brains out of a series of 124 necropsies of treated leukemic patients show a communicating hydrocephalus, without invasion of the central nervous system by the malignant blood cells. In 4 cases it is proven that the hydrocephalus is due to obstruction of the liquor drainage at the level of the arachnoidal villi and dural sinuses, by the leukemic invasion of these structures. It is shown that, even in case of preventive brain irradiation and intrathecal-administered cytotoxic drugs, these structures remain areas, in which the leukemic cells are difficult to destroy.


Centric relation. Its effect on occluso-muscle harmony. The most common cause of pain in the region of the temporomandibular joint is occluso-muscle imbalance. This results most often from disharmony between the articulation of the teeth and the centric relation of the condyles. Muscle tenderness of palpation indicates that muscle is involved. An examination must then be done to determine the cause of the muscle tenderness. Before the condyle-occlusion relationship can be evaluated, an accurate centric relation must be determined and verified. The condyles are in centric relation when they are in the most superior position possible in the fossae. From that apex of force position, the condyle can travel neither forward nor backward without moving downward. This position can be located with careful bilateral manipulation and then verified if it can resist firm pressure with no tension or tenderness. Until this correct centric relation is located and verified, it is not possible to properly evaluate the occlusal relationship to the temporomandibular joints. If the occlusion is harmonized to a centric related condyle that can resist firm pressure with pressure with no discomfort, there will be no reason for the muscles to protect either the teeth or the joints. If an occlusion is adjusted to a malrelated condylar position, the occluso-muscle imbalance will be perpetuated and often intensified. Centric relation is the starting point of occlusal contact. Incline interferences in excusive movements must also be eliminated and the occlusion must be harmonized to the envelope of function for each patient. If centric relation is not properly located, occlusal interferences will remain regardless of what procedures are used to record or adjust excursive movements.


Mandibular movement recordings and articulator adjustments simplified. Research data from several hundred patient recordings using the Lee method have been utilized to design a simplified jaw movement analyzer and articulator. The study also shows that most patient's movement characteristics can be satisfied with standard preformed articulator controls.


The Denar system and its application in everyday dentistry. The Denar System is far more than just a pantograph and a fully adjustable articulator. These are just a small portion of the system. Today and system includes instruments for occlusal treatment, educational programs, protocol for dentist-laboratory relations, and laboratory support. Prior to the Denar System, effective occlusal treatment was available only to a select few and it was rendered with the expenditure of considerable time and expense by those few dentists who, after many years of concentrated effort, developed the required skills and eventually overcome the obstacles to providing this service. Today, the Denar System provides the profession not only with the tools but also with the means to acquire, in a few short months, basic occlusal treatment and management skills that took predecessors many years of concentrated effort to develop. Because of the continuing efforts of many of our colleagues in dental education there is currently an increasing level of awareness of the role of occlusion in modern dental practice. These significant educational activities can now be supported by commercial organizations, such as the Denar Corporation, who possess the resources needed to develop whatever instruments or services are required to enable more dentists to implement principles of occlusion in their treatments on a routine basis and to enable them to do so within the economic framework of a modern dental practice.


[Possible mechanism of morphine-induced Straub tail reaction (STR) (author's transl)]. Mechanical contraction of the dorsal sarco-cocygeus muscle and electrical stimulation of spinal cord elicited tail elevation such as straub tail reaction (STR). When morphine, 0.25 approximately 0.5 microgram, was injected into the lumbothecal space, STR was produced dose-dependently and such was the same as that produced by systemic injection of morphine. STR was not observed, when morphine was injected into the lumbo-thecal space in spinal mice. STR was antagonized by tubocurarine given subcutaneously and by naloxone injected into the lumbothecal space. STR was not antagonized by the right, left or both dorsal spinal lesion at C5 approximately 6 as well as by the right or both dorsal spinal lesion at T11 approximately 12. However, STR was antagonized by the spinal transection at T11 approximately 12. The lesion of spinal serotonergic neurons enhanced STR. These results suggest that morphine acts on both the lumbo-sacral nerve cell bodies and the nerve terminals descending via the spinal ventral horn, by which the morphine-induced contraction of dorsal sarco-coccygeus muscle tendons produce STR.


Cell surface glycoprotein analysis: a diagnostic tool in human leukemias. We have radiolabelled surface glycoproteins of different types of leukemic cell. The labelled proteins were separated by polyacrylamide slab gel electrophoresis and visualized by fluorography. Surface glycoprotein patterns discriminatory for acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) were found. We conclude that the analysis of the surface glycoprotein profile provides a useful method for the classification of leukemic cells according to cell type and stage of differentiation.


Extra-osseous osteosarcoma: a clinical and histopathological study of four cases. Four cases of extra-osseous osteosarcoma were found among 242 cases recorded as osteosarcoma in the Swedish Cancer Registry during the years 1958 to 1968. The tumours occurred in middle-aged and elderly patients. Three of the tumours were situated in the proximal part of the thigh and one in the scapular region. Histopathologically, all tumours were subclassified as osteoblastic osteosarcomas. The patients were treated by primary local excision which in one case was followed by a radical en bloc excision of the entire tumour bed. All cases subjected to simple excision died of metastatic disease five to twenty-four months after diagnosis. The patient treated by en bloc excision is alive and apparently free from disease fourteen years after diagnosis.


The effect of biopsy on survival of patients with osteosarcoma. A retrospective study of patients with osteosarcoma was undertaken to determine whether there was a relationship between biopsy and survival. Fifty-seven patients treated at the Karolinska Hospital, Stockholm, between 1938 and 1959 were included in this study, all of whom were less than thirty years old, had a metaphysial osteosarcoma in a long bone but had no pulmonary metastases at the time of diagnosis; all were treated by amputation. No clinical variants of osteosarcoma were included. Twenty-four of the fifty-seven patients had an amputation without a prior biopsy; the others had biopsies before amputation. These two groups were fairly closely matched in age, sex, site and size of tumour, and in the level of amputation; some patients in each group received radiation before operation. Evaluation of these two groups of patients revealed that the performance of a biopsy, with or without a delay of not more than thirty days between the biopsy and the definitive operation, had no adverse effect on survival.


Periodic acid-Schiff reaction and prognosis in lymphoblastic leukaemia. Diagnostic bone marrow smears from 132 patients with acute lymphoblastic leukaemia, (ALL) were stained simultaneously by the periodic acid-Schiff (PAS) reaction, and the blast cell positivity was assessed quantitatively. The patients fell naturally into two unequal groups: those with more than 20% PAS-positive blast cells (44 patients) and those with less (88 patients). There was no relation between the degree of positivity and age, sex, or presenting leucocyte count. Actuarial survival studies showed that the group with more than 20% PAS-positive blast cells survived longer, but that this difference assumed statistical significance only after the exclusion of patients over 14 years old and those with high white cell counts at the time of diagnosis. It appears that the PAS reaction can identify long survivors among patients with ALL, but not in the absence of features strongly associated with a poor prognosis.


The effect of instruction and supervised toothbrushing on the reduction of dental plaque in kindergarten children. Based upon the present study the following conclusions were reached: Supervised toothbrushing with instruction for preschool children significantly and consistently decreased dental plaque scores, when compared to the control group of the same children who had only supervision. While those subjects receiving toothbrushing instructions and supervision had significant plaque reductions, at no time did the plaque scores reach zero. A symmetrical but nonuniform distribution of dental plaque prior to toothbrushing was noted as follows: Posterior teeth had higher dental plaque scores than anterior teeth. More dental plaque was present on the buccal surfaces of the maxillary teeth than on the lingual surfaces. More dental plaque was present on the lingual surfaces of the mandibular teeth than on the buccal surfaces. The distribution of dental plaque following toothbrushing remained the same as the prebrushing pattern, but the amount of dental plaque was reduced by 31 percent. Constant reinforcement is necessary to maintain effective plaque control in pre-school children.


An evaluation of the behavioral aspect of a prevention-oriented oral health program. The teaching and learning program is not effective in the behavioral dimension, given the data of this evaluation. The Navy Plaque Index was shown to be an unreliable instrument, when utilized with a relatively large number of upper elementary level students by more than one dentist, due to differences in the level of plaque recorded by the dentists.


Personality characteristics of patients with myofascial pain-dysfunction (MPD) syndrome unresponsive to conventional therapy. The composite MMPI profiles of 42 successfully-treated and 42 unsuccessfully-treated female patients with MPD syndrome were compared statistically. The profiles did not differ in configuration, but that of the unsuccessful patients was significantly higher than that of the successful group, indicating a greater degree of emotional distress. The pattern of deviation from normal for both groups was diagnostic of a psychophysiological disorder marked by repression and somatization.


Relation between integrated electromyographic activity and biting force during voluntary isometric contraction in human masticatory muscles. The relation between integrated electromyographic activity and computed biting force during voluntary isometric contraction was evaluated in the masticatory muscles of healthy subjects. The slopes of the curves relating integrated electromyographic activity to computed biting force in masseter muscles were steeper on the non-preferred chewing side than on the preferred chewing side, and they progressively became steeper during the course of continuous isometric contraction of a given biting force.


Color stability of a pigmented elastomer for maxillofacial appliances. The color stability of a series of eleven maxillofacial pigments was determined after accelerated aging using reflection spectrophotometry. The results indicate that seven of the pigments demonstrated good to excellent color stability, while four of the pigments were less promising for clinical use.


Stain resistance of maxillofacial materials. The resistance of three silicone and one polyvinyl chloride maxillofacial materials to staining by tea, lipstick, and disclosing solution was measured by reflectance spectrophotometry. Changes in color caused by staining were larger than changes caused by color instability of the base elastomers or pigments under conditions of accelerated aging.


A new type of hydraulic dental cement.

A new type of hydraulic dental cement. A new type of hydraulic cement has been developed. This cement consists of a mixture of cement powder and setting agent powder and therefore has only to be kneaded with a little amount of water when being used.


The uptake of sugars by isolated rat parotid acinar cells. This study presents the basic transport mechanisms of the uptake of D-glucose and 3-0-methyl-D-glucose by isolated rat parotid acinar cells. The transport characteristics were studied in vitro using 14C-labeled isotopic analogues of these sugars.


Avoiding perforation during endodontic access. Planning for endodontic access should be as precise as possible and the dentist should consider several factors in his preoperative evaluation of teeth to avoid perforations. Anatomical characteristics of teeth can be helpful in establishing endodontic access, and valid and invalid points for orientation have been discussed. Seven suggestions have been offered for the establishment of access on difficult teeth. The ideal in establishing endodontic access can only be achieved by the deliberate, conscious application of a thorough knowledge of dental anatomy, and of possible variations from the norm, coupled with a thorough preoperative examination of the tooth. Although a casual approach may not be unsuccessful, precision will certainly yield a higher percentage of successful cases.


Medications and health histories: a survey of 4,365 dental patients. Dental patients were surveyed to determine the medications they were using and to compile information on their medical histories. Complete survey forms were obtained from 4,365 patients who were seen for emergency treatment or for diagnosis and treatment planning between August 1975 and July 1976. Of the patients surveyed, 1,833 (42%) were taking medications. The frequency of intake of different drug groups was: analgesics, 14.2%; oral contraceptives, 12.1%; antihypertensives, 9.4%; miscellaneous (vitamins, antacids, anorectics, nonprescription cold remedies), 9.4%; psychotherapeutic agents, 7.6%; hormones, 6.6%; antibiotics, 4.9%; antihistamines, 3.8%; cardiac agents, 3.1%; hypoglycemics, 2.0%; anticonvulsants, 0.9%; antiasthmatics, 0.6%; and anticoagulants, 0.2%. At least one significant medical problem was reported by 2.989 patients (68.5%). The frequency of positive responses in the various groups was: hospitalizations, 40.5%; genitourinary problems, 19.8%; allergies, 19.2%; respiratory problems, 17.9%; gastrointestinal problems, 15.5%; cardiovascular disorders, 15.1%; musculoskeletal disorders, 12.6%; eye and ear afflictions, 8.3%; endocrine disorders, 6.5%;  serious illness, 6.5%; disorders of the central nervous system, 5.9%; and disorders of integument, 4.9%


Surgical-orthodontic management of an unerupted maxillary incisor. Satisfactory functional and esthetic results were attained, with proper consideration of surgical, periodontal, and orthodontic principles in the treatment of a patient with an unerupted maxillary central incisor. Gingival attachment was maintained and integrity of the dental arch was restored.


Eleven-year follow-up of tooth replantation. An 11-year clinical and radiographic follow-up of an avulsed tooth, replanted within 15 minutes, has been presented. The periodontal membrane can be traced around the replanted central incisor, indicating the tooth is not ankylosed and is functionally attached. It is not anchored immutably to the bone. The tooth has responded dynamically to growth and development of the maxilla and now abuts and aligns well with the other teeth in the arch.


Aspirin idiosyncrasy.

Aspirin idiosyncrasy. Aspirin idiosyncrasy is infrequently discussed in the dental literature. The severity of the case described illustrates the importance of complete familiarity with the syndrome. Because the patient who is sensitive to the drug may not volunteer this information, the dentist must include specific questions about asthma, nasal polyps, and adverse clinical reaction to aspirin in the initial interview of the patient. Suspicion of this idiosyncrasy will result in avoidance of aspirin; this may well prevent a life-threatening reaction. Acetaminophen is a safe alternative analgesic agent for such patients.


The Oregon lesson: results of postelection research. Bureau of Economic and Behavioral Research. Definite issues are involved in the denturism controversy, such as consumerism/economics, sympathy for the elderly population, freedom of choice, and acceptance of paraprofessionals. The dental profession must deal with these issues. Its concern for oral health and quality of training can only be presented (and accepted) if it is placed within the context of the issues as the public sees them.


Reimplantation of the mandibular condyle in cases of intraoral resection and reconstruction of the mandible. A new technique for the reconstruction of the disarticulated ramus is presented. From an intra-oral approach the mandible is resected, and if the posterior part of the ramus and the neck of the condyle are not involved by the tumour, this part is preserved. It is then fixed to the bone graft from the iliac crest bridging the remaining defect. The procedure is outlined, based on the experience of 4 cases which have been successfully operated on according to this technique. The earliest of them has been followed-up for seven years.


Reconstruction of labial commissure by a sliding U-shaped cheek flap. Repair of the labial commissure following tumour removal is performed with a U-shaped posteriorly based cheek advancement flap. With such a method a very good reconstruction of this delicate area can be achieved and it has no tendency to dehiscence or scar contracture at the vermillion border of the lip. Best results are of course obtained when reconstruction is performed in three layers (skin, muscle, mucosa).


Carcinoma of the oral cavity: on the prognostic significance of the primary tumour site (by levels and areas). The prognostic significance of primary tumour site in carcinomas of the oral cavity was investigated in a series of 585 cases. For the subsamples (levels and areas of oral cavity) studied, the numerical distribution of TNM categories, life tables and life table comparisons were computed. This produced the following results: Given an identical extension and analogous metastazising rate, there is no computationally demonstrable difference in prognosis between primary tumours sited at different levels and areas of the oral cavity. The exception are the T1Nx categories, for which a difference exists between precanine and retromolar sites. These results should be re-examined on the basis of a larger series.


Branchiogenic carcinoma -- fact or fallacy? The ongoing debate concerning the existence of malignant transformation of branchial cleft cysts has been analyzed, with the aid of previous reports and reviews in the literature. Six new cases are presented and illustrated. These occurred in 4 male and 2 female patients, having an average age of 60 years. Two of the lesions were within the parotid salivary gland. The longest period of survival was 3 1/2 years. New criteria for the acceptability of tumors as primary branchiogenic cancers are proposed. We believe that, using these strict criteria, rare examples of primary branchiogenic carcinomas do exist; their treatment should include whide local excision, followed by ipsilateral radical neck dissection.


Two-stage closure of cleft palate (progress report). In order to achieve palatal closure with the least possible impediment to maxillary growth, the two-stage repair seems to be the best procedure in our hands. The technique and timing of closure of soft and hard palate are described. For soft palate closure a modification of Widmaier's (1959) technique is used. Of the 216 cases operated upon this manner, usually at the age of 18 months (total and partial clefts included), the great majority show a soft palate of sufficient length and good elevation, a definite improvement in comparison with the one-stage procedure used formerly. Hard palate closure is postponed until between 5 and 8 years, the timing of surgery is chosen individually on the assessments of speech and dento-maxillary development.


A morphological substantiation of mental fractures. Clinical and experimental study. The clinical impressions and the study performed in connection with them on cadaveric material with a view to clarifying morphologically the "mental fracture" concept is reported. Mental fractures are classified on the basis of muscle interaction on the fragments, used as an objective criterion for fracture classification. Against the background of the data obtained a morphologically substantiated definition of mental fractures is proposed.


Reconstructive surgery of the mandible by means of metal plates. Reconstructive operations for defects of the mandible arising as a consequence of tumour operations and after trauma, add considerably to the improvement of aesthetics and masticatory function. Here, we have found methods of stable osteosynthesis for transplant fixation to be very useful. The most favourable results were achieved by the application of special mandibular plates. Only homologous spongy bone of the crest of filium was used as the transplant material. The primary temporary bridging of the defect by alloplastic material after mandibular resection in cancer therapy proved very advantageous. The results of treatment permit practical conclusions.


Unilateral condylar hyperplasia and acromegaly (case report). A case of a 57-years-old caucasian male with unilateral condylar hyperplasia and proven acromegaly is presented.


The alveolar flap for the repair of the cleft alveolus -- related to the development of the upper jaw. A new method for the repair of the cleft alveolus employing the alvolar flap, was carried out in 33 patients with a unilateral total cleft. Alternating primary osteoplastic repairs were performed in in aqual number of patients. The postoperative interval varies between 8 and 9 years. The patients were followed up with attention beng paid to the further growth of the upper jaw.


Behavioral treatment of night terrors in a child with acute leukemia. A 3-year-old girl diagnosed with acute lymphocytic leukemia presented with a 1-month history of recurrent nightmares. Symptoms of the disturbance conformed to a clinical picture of slow wave arousal night terrors, or pavor nocturnus. Behavioral treatment aimed at reducing anxiety related to maternal separation and medical procedures, and at reinforcing appropriate sleep patterns was effective in reducing and eventually eliminating the symptoms. Follow-up revealed no return of nightmares or existence of new problems. A brief review of descriptive, etiological and treatment aspects of night terrors is presented and the hypothesis is put forth that such episodes represent a psychological reaction to trauma. The importance of being aware of age variables in the expression of children's anxiety is noted as is the value of careful tabulation of outcome data.


Short term evaluation of counselling and occlusal adjustment in patients with mandibular dysfunction involving the temporomandibular joint. The effect of counselling and occlusal adjustment was investigated in thirty patients with mandibular dysfunction involving the temporomandibular joint (TMJ). The patients were examined at three visits 6 weeks apart. At the first visit all patients received counselling. At the second visit they were divided into two groups, one receiving occlusal adjustment and the other not receiving treatment. The degree of mandibular dysfunction was assessed by the patients according to a five grade scale and by the clinical dysfunction index according to Helkimo (1974a). The score of subjective dysfunction was reduced significantly during the period following counselling and 60% of the patients improved. No effect was found on the clinical dysfunction score. The score of clinical dysfunction was reduced significantly during the period following occlusal adjustment and 67% of the patients improved. No further effect could be detected on the subjective dysfunction score. The correlation between changes in subjective and clinical dysfunction was poor, but changes in the subjective score were generally associated with changes in the clinical score. It was concluded that counselling may reduce the subjective symptoms; and occlusal adjustment the clinical signs of mandibular dysfunction involving the TMJ, but that the individual variation in response is substantial.


Some subjective-experiential parameters in experimental tooth clenching in man. Experimental tooth clenching was performed by fourteen human subjects in order to determine the onset of the subjective sensations of jaw muscle fatigue and jaw muscle pains, the ability to endure jaw muscle pains, and other discomforts. During production of maximal voluntary isometric tension by the elevator jaw muscles the fatigue threshold (x = 31 s), the pain threshold (x = 55 s), and the pain tolerance (x = 118 s) of tooth clenching did not vary significantly intraindividually, whereas this was so interindividually. There might have existed psychological relationships between the three parameters, but they might also have been influenced by the same physiological cause. The weak to intense discomforts were localized to the face, and primarily to the jaw muscles, and after determination of the pain tolerance they disappeared in about 90 s.


Diametral tensile strength of twenty-three hardened commercial amalgams. In view of the ever increasing number of high copper alloys, it was the aim of this study to investigate the tensile strength property of some of the new alloy systems. The factors alloy system and heat treatment were investigated in relation to the tensile strength. The factors alloy system as well as the heat treatment turned out to be significant. The study suggests that the introduction of "dispersion" alloys did not change the dental picture as to the property of the tensile strength. The selection of strength values in the range of 35-55 MN/m2 for the diametral tensile strength probably have no clinical relevancy as to the prevention of bulk fractures of amalgam restorations under oral conditions.


Oral temperatures in young and old people. Oral temperatures were measured in ten young females and ten young males, and compared to oral temperatures measured in ten elderly females and ten elderly males. Each subject had a complete natural dentition. When analysed by sex, it was found that the temperatures in elderly males were lower than in young males (P less than 0.001), while temperatures in young and elderly females did not differ. Concerning sublingual temperatures, a difference of approximately one-third of a degree centigrade was demonstrated between the two age groups (P less than 0.005).


The sagittal condylar movements of the clicking temporomandibular joint. An analysis of the sagittal condylar pathways in patients with clicking temporomandibular joints is presented in relation to the mechanism of this symptom which is still hypothetical. The condylar movements of five healthy subjects are compared with the pathways of five patients with unilateral or bilateral clicking joints. The results indicate that in the latter group there are clearly perceivable deviations from the movement pattern as found in the group of the healthy subjects.


A comparison of dentine abrasion data generated by radiotracer and surface profilometer methods. Six toothpastes were despatched to two research stations where a radiotracer method of dentine abrasion measurement is used (British Standards, 1974: Hefferren, 1976) and three research stations where a surface profile method is used (Ashmore, Van Abbé & Wilson, 1972). Each station measured the abrasivities of the pastes with respect to dentine by their own method. The ranges of abrasion data were found to be wider from the surface profile method than from the radiotracer method.


Qualitative changes in dental plaque formation related to removable partial dentures. A study was performed on the microbial composition of dental plaque developing on fifteen abutment teeth in nine partially edentulous subjects. Bacteria were counted in samples of plaque which had formed on vestibular surfaces, and on proximal surfaces facing edentulous spaces, during a period  when dentures were not worn, and then for a period when dentures were being worn. It was found that the presence of removable partial dentures favoured a proliferation of spiral organisms.


Comparison of recovery tests after intravenous sedation with diazepam-methohexital and diazepam-methohexital and fentanyl. A model for the assessment of recovery to street fitness from two commonly used techniques for intravenous sedation is described. Well-known psychometric research methods and simple paper-and-pencil tests that could be given by interested clinicians were used. The speed of recovery from diazepam-methohexital, and diazepam-methohexital and fentanyl (with naloxine reversal), did not differ significantly. Psychomotor skills were recovered before both perceptual and cognitive functions. Two simple paper-and-pencil tests easily identified perceptual and cognitive deficits at least three hours postoperatively.


Collateral circulation in the rabbit tongue after common carotid ligation. A study was undertaken to ascertain the microvascular pattern of the collateral circulation of the tongue after unilateral ligation of the common carotid artery. The right common carotid artery was ligated in 25 New Zealand White male rabbits. These animals were killed in groups of five at intervals of an hour, six hours, 24 hours, one week, and two weeks. The vasculature in the head and neck of these animals was flushed with heparinized saline solution and perfused with latex. The results show that circulation was present but signifincatly reduced in the one-hour group, slightly reduced in the six-hour and 24-hour groups, and normal in the one- and two-week groups. This study indicates that the collateral circulation of the tongue is extensive and that a normal vascular pattern returns within a week after unilateral ligation of the common carotid artery.


The bacteriology of perimandibular space infections. The bacteriology of 21 perimandibular clised-space infections was studied prospectively using optimal bacteriological techniques to collect, transport, and process specimens. There was an average of six microbial species per specimen, including approximately four anaerobes and two aerobes. The predominant aerobes were alpha-hemolytic and non-hemolytic streptococci; the predominant anaerobes were peptostreptococci, Bacteroides melaninogenicus, and Fusobacterium nucleatum. These findings indicate that most perimandibular space infections involve a polymicrobial flora in which anaerobic bacteria are the dominant isolates. Antimicrobial decisions should account for these observations, particularly in cases where cultural data are not available or when anaerobic cultures are not performed with optimal techniques.


Immediate mandibular reconstruction after resection using a modified Kirschner wire splint. The use of a modified Kirschner wire splint is described and our experience with this procedure in 25 patients is reviewed. The splint is intended to be a temporary method of maintaining bone fragments in the correct position while intraoral seal is established. After sufficient healing has occurred, a final reconstruction is done by bone grafting.


Median mandibular cyst.

Median mandibular cyst. A case of median mandibular cyst in a 22-year-old man is presented and various aspects of its pathogenesis are discussed. Five points which should be taken into account when a lesion is diagnosed as median mandibular cyst are suggested.


Prolonged apnea of an oral surgery patient after administration of succinylcholine. To properly diagnose the presence of a genetic pseudocholinesterase variation, the family history is important. Furthermore, the DN and pseudocholinesterase tests are most useful, but if facilities for these are not available, one should be wary of patients with abnormal liver function tests. Certainly medical history, family medical history, laboratory evaluation, and knowledge of the disease processes should avoid unnecessary complications.


Ameloblastic sarcoma of the mandible: report of case. A case of ameloblastic sarcoma of the mandible in a 19-year-old man is presented. Pain, paresthesia, and rapidity of growth were features of the lesion. Successful excision was followed by death from secondary hemorrhage.


The office emergency cart.

The office emergency cart. Two mobile emergency resuscitative carts have been described. One, in use in a major dental school in the United States, has been estimated to cost $8,000 to $10,000. The second, with essentially the same equipment and drugs, costs about $2,800 and is feasible for an office situation. It helps to solve two problems. First, it provides a ready, compact, and organized method for the storage and maintenance of emergency resuscitative drugs and equipment. Second, it provides a vehicle by which the medical emergency resuscitative expertise of the oral and maxillofacial surgeon may be extended and utilized.


Sickle cell hemoglobinopathies: a protocol for management. Two cases have been presented: one shows complications when a latent form of sickle cell disease was manifested after orthognathic surgery; the other illustrates a protocol for management of patients with abnormal hemoglobins who are candidates for orthognathic surgery. The protocol includes an initial screening test for all black patients who are hospitalized for elective orthognathic surgery. When the screening test is positive, afollow-up hemoglobin electrophoresis is obtained to identify the specific hemoglobinopathy. Transfusions, when indicated, are given to alter the percentages so that the patient has no greater than 40% abnormal hemoglobin. Precautions are taken during anesthesia and after surgery to ensure that the patient is well oxygenated and is not in a hypothermic state. Serial electrophoreses are performed and transfusions, if indicated, are given during the postoperative and healing phases according to the postoperative status.


Physiologic dimensions of the periodontium significant to the restorative dentist. When treating patients, the objectives of restorative therapy must be clear. The first and most basic objective is preservation of the teeth. The attainment of this objective would be far less complex if it could be considered independent of restoration of function, comfort and esthetics, but such is not the case. The latter objectives usually require sophisticated restorative dentistry and often include restorations with intracrevicular margins. Although it is widely accepted that the best restorative margin is one that is placed coronal to marginal tissue, most restorations have margins in the gingival crevice, and permanent tissue damage is common. In attempting to reach his objective, the restorative dentist must remember the fundamental precept of the health professions, which is: Do no harm. Daily observation of the three physiologic dimensions permits the therapist to restore teeth with minimal injury to the periodontium.


Fiber glass splints.

Fiber glass splints. Temporary splints to immobilize periodontally diseased teeth were made by fiber glass bonded and attached to the teeth with acid-etch technique with BIS-GMA resin. Twenty-one splints were made. Observation time ranged from 4 to 14 months. During the observation only one splint fractured and was repaired while the others functioned without failure.


Bone defects repaired with dentin matrix. The results of this study summarized in the Table 1 indicate that both allogenic and xenogenic dentin matrix stimulated sufficient new bone formation to bridge the gap between the two cut ends of a bone (rat fibula). Allogenic bone grafts appeared to be successful in restoring resected bone more often than did xenografts.


Effects of subgingival restorations in beagle dogs. Part II: Gingivitis. For the materials and time period used in this study it was found that: 1. At the end of the study there were no significant differences recorded between the restored teeth with either the gingival index or the histologic inflammation index. 2. The gingival index showed that during the study the overall gingival health of the control teeth had improved significantly, while the overall gingival health of the restored teeth had improved only slightly. 3. At the end of the study the histologic inflammation index, but not the gingival index, showed significantly more gingivitis overall for the restored teeth than for the control teeth. 4. A comparison of the gingival, histologic inflammation, and microorganism (from Part I) indices, used to assess either the gingival condition or the amount of subgingival plaque on the restored teeth, showed no association between any of them. 5. In general, the degree of clinical and histologic gingivitis associated with the restored teeth was slight.


Fluoride treatment and microhardness of dentin. Effects of various fluoride treatments on the microhardness of human dentin were determined. Treatment with acidulated phosphate-fluoride at pH 3.0 induced a significant (p less than .05) softening when compared to treatment with water. APF at pH 4.0 did not bring about a significant change. Response to treatment with 0.4% SnF2 did not differ significantly from water treatment. Sequential treatment with APF (pH 4.0) followed by SnF2 produced significant (p less than .05) hardening of dentin. This hardening with APF-SnF2 differed at a high level of significance (p less than .001) from the softening produced by the pH 3.0 APF. A similarly significant difference was found between this single APF treatment and the single SnF2 treatment. When hardening of exposed dentin surfaces is desired, the sequential treatment method should be employed.


Iatrogenic TMJ difficulty: cervical traction may be the etiology. Patients in cervical traction for the treatment of cervical spine syndromes frequently complain that the traction makes them worse. It is possible that such patients may be suffering from TMJ symptoms. The physician treating a patient with cervical traction should consider prescribing an occlusal splint for patients without posterior teeth. The splint should be designed to distribute the stresses through the mandible to the maxillae via the teeth, splint, and TMJ.


Accessory retention for a facial prosthesis. A possible means of retaining a nasal prosthesis by utilizing newly designed eyeglass frames has been proposed. In many situations, this procedure can enhance the successful rehabilitation of a patient by the maxillofacial prosthodontist.


Inferior joint space arthrography and characteristics of condylar paths in internal derangements of the TMJ. Inferior joint space arthrography and measurements of the condylar path provide scientific documentation of derangement of the TMJ disc and condyle. These derangements are described as an anterior displacement of the disk associated with posterior-superior displacement of the condyle when the teeth are closed into the intercuspal position. Clinical studies demonstrate that approximately 70% of a TMJ patient population present with some type or stage of these derangements. These observations have far-reaching implications regarding contemporary dental curriculum, particularly concerning exegesis of the MPD syndrome theory and concepts of dysfunctional dental occlusion.


The reproducibility of pantographic tracings on medicated and nonmedicated subjects. Tracings were made on three patients using a modified pantographic device. The tracings were made on glass flags with wax, etched, and superimposed. The effects of body position and modification were investigated. From this research project the following can be concluded: 1. A precise method has been developed which permits superimposition of pantographic tracings for analysis. 2. There is a significant difference in reproducibility between medicated and nonmedicated subjects. 3. The percentage coincidence of border tracings increases significantly when the patient is pantographed while under the influence of medication (Valium). 4. The angulation of the body does not appear to be significant for reproducing border tracings. 5. There appears to be no significant difference in the reproducibility of the border tracings relative to time (1, 1 1/2, 2, and 2 1/2 hours) after medication. 6. The lateral side shift of the jaw cannot always be reproduced accurately. 7. The neuromusculature appears to be the overriding factor governing border movements.


Multisectional mold for fabrication of prosthetic ears. The use of a multisectional stone mold is advocated for the fabrication of prosthetic ears. Less force is required in the deflasking procedure with this technique, reducing the risk of fracturing the mold or tearing the prosthesis. This technique requires more time and care in the flasking procedure. Convergence of the sections is of particular importance. The potential for multiple section lines may result in a need for more surface finishing of the prosthesis.


Posterior maxillary osteotomies: an aid for a difficult prosthodontic problem. Patients who have supereruption of posterior dentoalveolar segments provide an interesting challenge to the dentisr. The severe problems require a team approach to achieve the best results. Factors influencing the treatment include the periodontal status of the involved teeth as well as the concern of the patient. The posterior maxillary osteotomy provides the chance to maintain the vital functional teeth in an otherwise difficult situation. It must be emphasized that the patient must wear an opposing splint or prosthesis following surgery to prevent relapse. This conservative approach maintains the teeth and their vitality and anatomically repositions the supererupted segment to an improved functional position.


Variations in organic occlusion.

Variations in organic occlusion. The principles of organic occlusion were illustrated and described as neutroclusion. Variations of occlusion in a mesial and distal position were described as distoclusion and mesioclusion. The potential areas of conflict in these variations were described, and the methods for correction were shown so that the principles of organic occlusion would not be compromised even in these variations.


Reflectance spectra of composite resins on liners. The reflectance spectra of two types of composite resins were determined on various backgrounds. It was found that the shade differences caused by different "whitish" liners were perceptible only for thin resin specimens and were smaller than those caused by varying the resin type and thickness. Employing a light brown liner gave rise to a difference in shade which was also perceptible on resin specimens of 2.5 mm thickness. Shade differences due to varying the thickness of the specimens were more pronounced on white than on black backgrounds. The clinical significance and the qualitative physical interpretation of the results were discussed.


Simplified Class V matrix for resin restorations. A matrix technique and its modifications to assist in the restoration of Class V lesions occurring in the gingival third of the teeth are described. This technique is applicable for filled and unfilled restorative resins.


A technique for the removal of provisionally placed cast restorations. A technique has been described to quickly and safely remove castings following the initial trial evaluation or provisional cementation.


Changing incidence of thyroid cancer.

Changing incidence of thyroid cancer. The incidence of thyroid cancer was examined temporally and geographically by age and sex from data provided by tumor registries in the United States and abroad. The temporal trends in Connecticut showed an increase in annual incidence after 1945, with an especially sudden increase in incidence in females. The increase occurred predominantly in older males and younger females. The increase in young females was confirmed by cohort analysis. The rates rose with age in both sexes, but recently females have developed a secondary peak in the fourth decade of life. The same phenomenon was observed in other U.S. data but not as clearly in data from ten foreign registries. These observations are consistent with the hypothesis that X-radiation therapy for benign conditions of the head and neck in childhood was a factor in the increased incidence of thyroid cancer in U.S. females, but some other etiologic or modifying factor should be sought to explain the increased incidence in U.S. males.


Sister chromatid exchange and cell cycle progression in cultured lymphocytes from patients with chronic lymphatic leukemia. Sister chromatid exchange (SCE) was significantly increased in patients who had chronic lymphatic leukemia (CLL) and who had received therapy compared with untreated patients and normal controls. Elevated SCE appeared to be a function of the therapy and not the leukemia. Differential chromatid staining was used to identify successive cell reproduction cycles. In comparison to normal lymphocytes, the cells responding to phytohemagglutinin in CLL cultures showed no evidence of retarded progression through successive cell cycles.


Cytogenetic study of a European Burkitt's lymphoma cell line. The chromosomes of an Epstein-Barr virus-negative European Burkitt's lymphoma cell line were studied. All the cells carried the t(8;14) translocation. One clone had 51 chromosomes and was (+1,+7,+16,+15,+21), whereas another clone also had 51 chromosomes but was (+1q+,+7,+16,+15,+21). A third clone had 46 chromosomes (4q+/-).


Offspring of patients treated for cancer in childhood. Genetic effects of cancer in childhood were examined among offspring of patients enrolled in the tumor registries of the Sidney Farber Cancer Institute and the Kansas University Medical Center. For 146 patients, 84 women and 62 men, 293 pregnancies were reported after cessation of treatment of diverse neoplasms. The outcomes of 286 completed pregnancies were as follows: 242 live births (1 set of twins), 1 stillbirth, 25 spontaneous abortions, and 19 therapeutic abortions. Seven live-born infants died during the first 2 years of life, a frequency in accord with expectation. Two offspring have developed cancer. One girl and her father had bilateral hereditary retinoblastoma. A second girl developed acute myelocytic leukemia; her mother had received radiotherapy during childhood for a brain tumor. Compared with their cousins and with published figures for the general population, the study progeny had no excess of congenital anomalies or other diseases. Chromosome and immunoglobulin studies of a few offspring did not reveal damage from preconception exposure to cancer chemotherapy and radiotherapy. Findings indicated that large collaborative studies are needed to monitor the offspring of childhood cancer survivors for inherited traits associated with the parental tumors and for mutagenic effects of therapy, particularly intense multimodality treatments.


Comparison and evaluation of some experimental designs for use in carcinogen screening. The development and evaluation of experimental designs for routine in vivo screening of chemicals for potential carcinogenic activity were considered. Such designs have played an important role in the Carcinogenesis Bloassay Program of the National Cancer Institute (NCI). In particular, the current one-stage 50-animal/group screen used by the NCI was considered. A specific two-stage alternative was proposed in which 35 animals/group were used; this alternative allowed for retesting of equivocal compounds. The proposed designs were evaluated in terms of sensitivity, specificity, and throughout. Despite the large number of tests made for each compound, the false-positive rate was found to be less than 0.07 for the current screen and less than 0.05 for the proposed two-stage alternative. The power of the one-stage and two-stage screens was comparable. The two-stage screen was shown to make about 30% more decisions per test period with a savings of around 28% in the expected number of animals needed per compound tested.


Entry of metastatic malignant cells into the circulation from a subcutaneously growing myelogenous tumor. The initial stage of metastasis formation, i.e., the entry of metastatic cells from a malignant subcutaneously growing myelogenous tumor into the circulation, was observed by means of transmission electron microscopy and scanning electron microscopy in Long-Evans rats. The transmural passage of malignant cells occurred through the walls of intact venules within the tumor. The malignant cell penetrated the endothelial cell body by making a temporary migration pore. The migration pore closed after the malignant cell entered the vascular lumen. The endothelial vascular lining remained continuous. The entry of malignant cells into the circulation was not the result of the general invasive and destructive properties of malignant tumor cells, but the consequence of a specific action of the tumor cells on the abluminal plasma membrane of the endothelium.


A tumor-associated organ-specific antigen characteristic of spontaneously metastatic rat mammary carcinomas. An organ-specific tumor-associated antigen (TAA) was present in several metastatic and nonmetastatic mammary carcinomas induced in WF female rats by 3-methylcholanthrene. The level of TAA was high in 2 metastatic carcinomas tested (TMT-081 and SMT-2A) and much lower--by a factor of 50--200--in 2 nonmetastatic mammary carcinomas (MT-100 and MT-W9B). The TAA in the 2 metastatic tumors was identical, as demonstrated by immunodiffusion and supported by cross-reactivity with antibody against TAA from TMT-081 in a binding inhibition radioimmunoassay. The TAA was shed in relatively large amounts by the metastatic tumors maintained in short-term organ culture. The high level and shedding of TAA thus appeared to be characteristics of the metastatic tumors but not of the nonmetastatic ones. This suggests that TAA on the cell membrane or in the circulation may be involved in the metastatic process as a factor blocking potentially cytotoxic cells or in other ways leading to suppression of the immune response against the tumor.


Enhancement of erythroid target cells for Friend murine leukemia virus by intravenous pyran treatment. Male BALB/c mice that received prophylactic iv treatment with pyran had significantly enhanced splenomegaly, an increased number of splenic foci induced by the spleen focus forming virus (SFFV) in the Friend murine leukemia virus (F-MuLV) complex, and a slightly decreased mean survival time as compared with untreated controls infected with F-MuLV. A corresponding increase in the lymphatic leukemia virus component of the F-MuLV complex was not observed, which suggests that the enhancement of the disease was due primarily to a selective increase in the SFFV component of the F-MuLV complex. That the enhancement was related to an increased number of target cells for SFFV was substantiated by data concerning erythropoiesis in iv pyran-treated animals. Increases in splenic hematocrits and in uptake of 59Fe in the spleens of animals treated iv with pyran provided quantitative evidence for the histologic finding of increased erythroid precursors in the spleens.


In vitro inhibitory effects of polymer-linked methotrexate derivatives on tetrahydrofolate dehydrogenase and murine L5178Y cells. In vitro studies were made on four synthetic polymeric derivatives of the antitumor agent methotrexate (MTX): 1) divinylether-maleic anhydride-MTX (DIVEMA-MTX), 2) poly-L-lysine-MTX (PL-MTX), 3) polyethyleneimine-MTX (PEI-MTX), and 4) carboxymethyl cellulose-MTX (CMC-MTX). They were tested for their ability to inhibit tetrahydrofolate dehydrogenase (dihydrofolate reductase). Their growth inhibition of murine L5178Y leukemia cells was also studied. 1wo of these polymers, DIVEMA-MTX and PEI-MTX, had similar or only slightly reduced activity compared to equivalent concentrations of MTX, whereas PL-MTX and CMC-MTX had significantly higher (1--3 logs) minimal inhibitory concentrations.


Response of two rodents, Mastomys natalensis and Mystromys albicaudatus, to the pancreatic carcinogen azaserine. The response of two rodents to azaserine carcinogenicity for the pancreas was evaluated. Mystromys albicaudatus was not responsive; however, Mastomys natalensis developed large numbers of atypical acinar cell nodules and several adenomas in a 6-month study. Mastomys is the most responsive of several animals in which azaserine has been studied as a pancreatic carcinogen.


Classification of mouse mammary tumors in Dunn's miscellaneous group including recently reported types. A classification of mouse mammary tumors in Dunn's miscellaneous group including recently reported types is presented. Adenocarcinoma type Y, first reported in (C3H X Y)F1 mice, is characterized by tubules that branch at acute angles and are lined by cuboidal epithelium. Adenocarcinoma type L is characterized by alcelike appearance and has projections of tumor cells with cytoplasmic vacuoles into lumina. Undifferentiated carcinomas in strains SWR/J and BABL/c contain sheetlike masses of epithelial cells with very little tendency to form glands but which may contain foci of cells with keratohyaline granules. Pale cell carcinomas, which occur in strain GR mice, are hormonally responsive and are characterized by the presence of pale cells and cystic spaces lined by basophilic cells. Foci of cells with acidophilic hyaline bodies and keratohyaline granules and with intercellular bridges distinguish this neoplasm from adenocarcinoma type B. A second hormonally responsive mammary tumor in strain GR mice is adenocarcinoma type P, which consists mainly of acini lined by a single layer of polyhedral cells. Carcinosarcomas of BALB/c mice have a myxoid stoma and, also containing glands, resemble mixed mammary tumors of the bitch. Criteria for differentiating trichoepitheliomas from mammary tumors are discussed.


Malignant breast tumors among atomic bomb survivors, Hiroshima and Nagasaki, 1950-74. For 1950-74, 360 cases of malignant breast tumors were identified among the 63,000 females of the Radiation Effects Research Foundation's (Hiroshima and Nagasaki) Extended Life-Span Study sample of survivors of the 1945 atomic bombings of Hiroshima and Nagasaki; 288 of these females were residing in one of these two cities at the time of bombing (ATB). Two-thirds of all cases were classified as breast cancers on the basis of microscopic review of slides, and 108 cases received an estimated breast tissue dose of at least 10 rads. The number of cases of radiogenic breast cancer could be well estimated by a linear function of radiation dose for tissue doses below 200 rads. Excess risk estimates, based on this function, for women 10-19, 20-29, 30-39, and 50 years old or older ATB were 7.3, 4.2, 2.6, and 4.7 cases per million women per year per rad, respectively. Women irradiated in their forties showed no dose effect. Among all women who received at least 10 rads, those irradiated before age 20 years will have experienced the highest rates of breast cancer throughout their lifetimes. Separate excess risk estimates for Hiroshima and Nagasaki did not differ significantly, which indicates that for radiogenic breast cancer the effects of neutrons (emitted only in the Hiroshima explosion) and gamma radiation were about equal. Radiation did not reduce the latency period for the development of breast cancer, which was at least 10 years. The distribution of histologic types of cancers did not vary significantly with radiation dose. The data suggested that irradiation prior to menarche conferred a greater risk than irradiation after menarche.


Role of antibodies in the specificity of natural cell-mediated cytotoxicity. Freshly isolated effector cells expressing natural cell-mediated cytotoxicity (NCMC) against cultured target cells possessed antibodies attached to Fc receptors on their cell surfaces. A wide variety of natural antibodies in the circulation combined with the receptors on effector cells to allow recognition of the many specificities on cultured target cells and resulted in reactions with an overall appearance of nonselectiveness. The role of antibodies in the specificity of NCMC was demonstrated by recovery of NCMC by trypsinized effector cells when incubated in serum. With absorbed serum, activity was selectively weaker against the absorbing target cell. When effector cells were reconstituted with antibodies eluted from the absorbing cells, selective cytotoxicity for that cell was detected. The specificity of effector cells reconstituted with eluted antibodies confirmed the results from previous studies on specificity by direct cytotoxicity and by competitive inhibition of cytotoxicity and supported the role of antibodies in NCMC.


Carcinoembryonic antigen-binding immunoglobulin isolated from normal human serum by affinity chromatography. A human immunoglobulin that binds carcinoembryonic antigen (CEA) was isolated from four individual normal human sera by affinity chromatography with the use of a CEA-Sepharose solid adsorbent. The yield of isolated protein, termed human CEA-binding protein (HCBP), ranged from 1.8 to 10 microgram/ml serum. HCBP is a gamma-globulin of restricted electrophoretic heterogeneity as shown by immunoelectrophoresis. HCBP was shown to bind radioiodine-labeled CEA both by a radioimmune precipitation assay and by a radioimmunoelectrophoresis assay. This protein was of practical interest because of its potential usefulness as a carrier of radioactivity or therapeutic agents to a CEA-producing tumor for therapeutic or diagnostic purposes.


Population screening for breast cancer by single-view mammography in a geographic region in Sweden. Single-view mammography was used for the screening of a total population of women living in a defined geographic region in Sweden; 37,640 women were invited and 31,074 participated. The average participation rate was 82.6%, and in the age group 40-69 years it was 91.7%. The rate of referrals from screening to clinical examination was 1.2%. Of 209 surgical biopsies performed, 130 primary mammary carcinomas were detected, 91% of which had no clinically detectable metastatic nodes. Because of the few false-positive cases, the low rate of benign biopsy specimens, the high rate of early detected carcinomas, and the low costs, screening by single-view mammography is considered a satisfactory method, provided the positioning of the oblique view is correct and the image quality is high.


Preparation of concanavalin A-ricin A-chain conjugate and its biologic activity against various cultured cells. For the development of therapeutic agents that possess tissue-specific carriers, a method was devised to synthesize an artificial protein hybrid conjugate containing a moiety which binds to a cell membrane receptor and an active fragment of a toxic protein. By the introduction of an activated sulfhydryl group into concanavalin A (Con A), a conjugate of Con A and the ricin A-chain cross-linked with a disulfide linkage was synthesized. The purified conjugate was studied with regard to its inhibitory activity against protein synthesis in cell-free and cultured cell systems. The Con A-rich A-chain conjugate retained about one-third the inhibitory activity of ricin in a cell-free protein synthesis system. It also was highly toxic to cultured normal cells. These results indicate that the conjugate is a structural and functional analog of ricin and that the original membrane-binding chain (B-chain of ricin) could be replaced by Con A. Transformed cells were insensitive to this conjugate and required a longer preincubation time. The sensitivity of the normal cells was reduced in the presence of local anesthetics.


Use of artificial sweeteners by cancer patients. Current daily use of artificial sweeteners (AS) and diet drinks was evaluated for 1,862 patients hospitalized for cancer and for 10,874 "control" patients hospitalized for other conditions believed not to be associated with use of these substances. The data were derived from an ongoing survey in seven countries. For cancer of most sites, the age-standardized proportion of users of AS was somewhat less than that for controls. A greater proportion of users among cancer patients than among controls was noted only for cancer of the stomach among women. Little information on urinary tract cancer was available; there were no users of AS among 13 patients with cancer of the bladder, 5 with cancer of the renal pelvis, and 2 with cancer of the ureter. There were 455 cancer patients known to have been interviewed during their initial hospitalization for the disease. Based on these cases, an age-sex-country-standardized estimate of cancer incidence for users of AS, relative to nonusers, was 1.0. Only a very small proportion of patients reported daily use of diet drinks, and the proportion of users did not differ substantially between cancer patients and controls. The present data provide virtually no support for an overall positive association of AS with cancer.


Cancer in families with xeroderma pigmentosum. In 31 families of xeroderma pigmentosum (XP) patients, significantly more blood relatives than spouse controls had had nonmelanoma skin cancer. These family data support the hypothesis that heterozygosity for XP genes may predispose persons to skin cancer, particularly in association with substantial exposure to sunlight.


Linoleic acid inhibition of naturally occurring lymphocytotoxicity to breast cancer-derived cells measured by a chromium-51 release assay. Long-chain unsaturated free fatty acids have been shown to inhibit the immune responses of lymphocytes in vivo and in transformation and macrophage inhibition factor assays in vitro. The purpose of this study was to test the effect of linoleic acid on naturally occurring lymphocytotoxicity in a 51Cr release microcytotoxicity assay with the use of a human breast carcinoma cell line (AlAb) as source of the target cells. In the presence of increasing concentrations of linoleic acid, a linear decrease in lymphocytotoxicity was observed with complete inhibition at concentrations of 0.05-0.07 mg/ml. Concentrations of linoleic acid greater than 0.07 mg/ml resulted in nonspecific toxicity to target cells but not to lymphocytes as determined by trypan blue exclusion tests. When lymphocytes were pretreated with linoleic acid, washed, and then tested for cytotoxicity in the absence of linoleic acid, suppression of lymphocytotoxicity was still demonstrated. When leukocytes were depleted of macrophages, cytotoxicity in the absence of linoleic acid was enhanced 50-100%; complete inhibition of cytotoxicity was still observed at 0.05 mg linoleic acid/ml. When B- and T-cell populations were separated, each population showed typical decreases in lymphocytotoxicity in the presence of linoleic acid; however, the B-cell fraction (containing "null" cells) was two to three times more efficient at cell killing than was the T-cell fraction.


Vitamin A and lung cancer.

Vitamin A and lung cancer. Retrospective dietary and smoking data were gathered by interview of 292 white male patients with lung cancer and 801 control patients with nonrespiratory, nonneoplastic diseases at Roswell Park Memorial Institute, Buffalo, New York. A computed index of vitamin A intake was used to differentiate lung cancer patients from controls. Lung cancer patients had lower values than did controls. The reduced relative risk (RR) of lung cancer associated with vitamin A was most evident among men who smoked heavily. For them, a dose-response relationship increasing to an RR of 2.4 for low values of the index was observed. Frequency of daily milk drinking was lower among patients with lung cancer. Lower RR was found among the men who smoked heavily and frequently consumed carrots. These findings are consistent with evidence from animal studies on inhibition of tumor incidence by retinoids and with previous findings in prospective and retrospective epidemiologic studies.


Increased "pregnancy-specific" beta1-glycoprotein in certain nonseminomatous germ cell tumors. Schwangerschafts (pregnancy) protein No. 1 (SP1), a recently identified beta1-glycoprotein that occurs during pregnancy, was assayed in the sera of 97 men with germ cell tumors of the testis. SP1 was elevated at 11-440 ng/ml in 3 of 6 men with choriocarcinomas, in 5 of 17 men with teratomas or "teratocarcinomas" (embryonal carcinomas and teratomas), and in 5 of 50 men with embryonal carcinomas; the highest value in 143 patients with nonmalignant diseases was 9.1 ng/ml. None of 24 sera from men with seminomas and none of 5 sera from men with orchitis had elevated SP1. In the 1 patient examined, testicular choriocarcinoma SP1 had immunochemical and gel chromatographic properties similar to those of highly purified SP1 of placental origin.


Fibrin gel investment associated with line 1 and line 10 solid tumor growth, angiogenesis, and fibroplasia in guinea pigs. Role of cellular immunity, myofibroblasts, microvascular damage, and infarction in line 1 tumor regression. Line 1 and line 10 tumors became invested in a fibrin-gel cocoon within hours after transplantation to the subcutaneous spaces of unsensitized syngeneic inbred Sewall Wright strain 2 guinea pigs. The fibrin gel comprised more than 80% of the line 1 tumor mass and, after day 3, became organized and was subsequently replaced by fibrous connective tissue, which gave the tumor the appearance of a scirrhous carcinoma. A cellular infiltrate of lymphocytes and basophils developed at the periphery of line 1 tumors after day 8, and tumors regressed by day 13. The fibrin gel investing the highly malignant line 10 tumors accounted for less than 10% of the tumor mass and persisted without fibrous organization as a tumor grew progressively and invaded adjacent tissues. These data provide new and potentially important insights into the biology of solid tumor growth and the mechanisms of immunologic tumor rejection. Envelopment of tumors in a fibrin gel created an anatomic barrier separating the tumors from the host. Neovascularization mimicking that about line 1 and line 10 tumors was induced by sc fibrin implants; these data suggest that activation of the clotting and/or fibrinolytic systems by tumor cells may itself provide sufficient stimulus for induction of tumor angiogenesis without requiring a separate tumor angiogenesis factor. The scirrhous pattern of growth characteristic of line 1 tumors apparently was achieved by organization of an abundant fibrin gel. Line 1 tumor regression did not for the most part involve direct contacts between tumor cells and any type of inflammatory cell, including macrophages; rather, tumor destruction was effected by ischemic necrosis secondary to widespread microvascular injury. The mechanisms of such injury are uncertain, but tumor rejection was correlated with evidence of developing cellular immunity and anatomic associations between lymphocytes and myofibroblasts. Further experiments will be necessary before these findings can be generalized to other tumor systems.


Failure of cryosurgical treatment of experimental intradermal tumors to eradicate microscopic lymph node metastases in guinea pigs. Inbred Sewall Wright strain 2 male guinea pigs with established intradermal tumors and microscopic lymph node metastases were treated either by local excision, cryosurgery, or intralesional injection of BCG. Cryosurgery and local excision were effective in eliminating growth of the primary tumor but failed to prevent growth of lymph node metastases. In contrast, intralesional injection of BCG caused regression of primary tumors and prevented growth of lymph node metastases.