Ultrastructural studies of the equine uterus and placenta following parturition. Post-partum placentae and uterine biopsy samples from mares after normal and abnormal foalings are described. After normal delivery there is little damage to fetal or maternal tissues. The villous epitheliochorial palcenta separates cleanly at the maternal-fetal interface and the afterbirth consists almost exclusively of fetal tissue. Uterine involution is well advanced by the 3rd and 4th days post partum and the changes are usually complete by the oestrus 7--10 days after parturition. Placental separation and involution of the uterus appear to proceed normally in malpresented foals and in otherwise viable foals with musculoskeletal defects. In aborted, stillborn or dysmature foals there are obvious signs of damage to both fetal and maternal tissues. It is generally accepted that the growth and development of the fetus is dependent upon a placenta of adequate functional capabilities. The observations suggest that the placenta is similarly dependent upon its association with a normal healthy fetus.


Plasma biochemistry changes in thoroughbred foals during the first 4 weeks of life. Changes in plasma sodium, potassium, chloride, total carbon dioxide, urea, creatinine, glucose, total bilirubin, iron, total protein, albumin, alkaline phosphatase (AP), aspartate amino transferase (AST), calcium, inorganic phosphorus, cholesterol and triglycerides were studied in 45 Thoroughbred foals 15 min to 28 days after birth. The results were analysed in 3 groups; Group 1 (0--12 h), Group 2 (12--36 h), Group 3 (1--4 weeks). When Group 2 was compared to Group 1, there were significant reductions of sodium, creatinine, iron and calcium and elevations of total protein and bilirubin. When Group 3 was compared to Group 1 there were significant reductions of sodium, chloride, urea, creatinine, bilirubin, iron and AP. Significant elevations occurred in glucose, total protein, AST, inorganic phosphorus and triglycerides.


The effect of vesiculectomy on seminal characteristics in the stallion. Successful unilateral extirpation of an inflamed seminal vesicle in a stallion led to systematic trials of the influence of a reduction and absence of the secretion of this gland upon semen characteristics. Operations were performed by the method described for the bull. The volume of ejaculates dropped and sperm concentration per ml increased in each of 2 stallions from which the seminal vesicles had been uni- or bi-laterally removed. Total sperm number and motility remained uninfluenced, but the percentage of eosin-stained spermatozoa increased in the unilaterally operated stallion and the percentage of abnormal spermatozoa increased significantly in both. Concentration of citric acid per ml and per ejaculate was significantly reduced after bilateral vesiculectomy. Ergothioneine concentration per ml increased in the unilaterally and in the bilaterally operated stallion.


Effect of successive ejaculation on stallion seminal characteristics. Five ejaculates were collected at hourly intervals from 32 sexually rested stallions. Gel volume, total seminal volume, sperm concentration and spermatozoa per ejaculate declined (P less than 0.01) from the first to the second or third ejaculate. Gel-free seminal volume or percentage of motile spermatozoa did not vary (P less than 0.05) among ejaculates. Ejaculates from 2- to 3-year-old stallions contained less volume and fewer spermatozoa than those from 9- to 16-year-old stallions. Regardless of the stallion's age the first, first 2, first 3 and first 4 ejaculates represented 50, 74, 86 and 93% of the total numbers of spermatozoa contained in the 5 ejaculates. In addition, the number of spermatozoa that might be obtained in 5 ejaculates can be predicted by multiplying the total number of spermatozoa in two successive ejaculates by 1.35 +/- 0.03. Although some fifth ejaculates contained as few as 0.02 X 10(9) motile spermatozoa, the mean number of motile spermatozoa in fifth ejaculates from sexually rested stallions was 0.52 X 10(9) spermatozoa; presumably enough to impregnate a mare during natural service.


Influence of ovaries and photoperiod on reproductive function in the mare. A 16 h daily photoperiod hastened the onset of the ovulatory season (first ovulation); gonadotrophin and follicular changes prior to the onset were similar in intact light-treated and control mares. A preovulatory decline in FSH concentrations before the onset of the ovulatory season preceded the decrease in number of follicles (15--25 mm) and the rise in LH concentrations which was temporally associated with the growth of an ovulatory follicle. Seasonal changes of FSH and LH concentrations were found in ovariectomized mares and were influenced by photoperiod. During the anovulatory season, there was no ovarian influence on gonadotrophin concentrations. However, during the ovulatory season the ovaries exerted a positive influence on seasonally elevated LH concentrations during oestrus and a negative influence during dioestrus. The ovaries exerted a negative influence on seasonally elevated FSH concentrations throughout the oestrous cycle. The onset of the ovulatory season occurred at the time of the first sustained increase in LH concentrations resulting from positive seasonal (increasing photoperiod) and ovarian influences.


Alteration of seasonal reproductive patterns in mares following superior cervical ganglionectomy. Oestrous behaviour, ovarian follicular development, ovulation and changes in hair coat were observed in Pony mares which were unoperated, sham-ganglionectomized control or bilaterally superior cervical ganglionectomized. Surgery was performed during the winter anoestrus (1975--1976). Reproductive patterns in all groups were similar during the first breeding season (1976) after operation but in ganglionectomized mares the onset of the next breeding season (date of first ovulation in 1977), the pattern of follicular development, date of first oestrus and pattern of hair coat changes were all significantly delayed relative to those of the non-operated and sham-operated mares in 1976 and 1977 and relative to their own patterns in 1976. These results indicate that the pineal-hypothalamo-pituitary axis may regulate or moderate annual reproductive rhythms in mares.


Follicular and gonadotrophic changes during transition from ovulatory to anovulatory seasons. Observations of follicular and gonadotrophic changes were conducted on 14 Pony mares for 31-day periods beginning at the penultimate (second last) ovulation and at the last ovulation of the season. There were no main effects or interaction of day or period on the numbers of small follicles (less than 20 mm). Concentrations of FSH, numbers of large follicles (greater than 20 mm), and oestrous behaviour each showed an effect of day (P less than 0.01), but no effect of period. Concentrations of LH and diameter of the largest follicle each showed an interaction (P less than 0.01) between day and period attributable primarily to smaller values on Days 18--24 after the last ovulation than after the penultimate ovulation. It was concluded that, of the factors considered, failure of ovulation at the onset of the anovulatory season was due to lack of an adequate ovulatory LH surge and final growth of a preovulatory follicle.


Drug interactions with saralasin.

Drug interactions with saralasin. Diuretic and vasodilator drugs alter the BP response to saralasin causing drug interactions. Saralasin-induced BP reduction is related directly to PRA and intravascular volume. Diuretic agents deplete intravascular volume and elevate PRA, enhancing saralasin hypotension. Vasodilating agents increase PRA and may induce angiotensin dependence of BP. Thus, with potent vasodilators, saralasin can induce hypotension. Rebound hypertension has been reported after saralasin infusion in several patients with accelerated or malignant hypertension. Theoretically, this BP elevation could be related to sustained release of renin resulting from disinhibition of an intrarenal angiotensin receptor inhibitory to renin release. Since propranolol can block saralasin-induced renin release, angiotensin and beta-blockers could constitute a beneficial drug interaction.


Structural features of angiotensin II which are important for biologic activity. In summary, the aromatic ring of phenylalanine (COOH-terminus) is the key to the intrinsic activity with Tyr4, also involved in activation of a response. The NH2-terminal residue is a determinant of duration of action. The side chains of Tyr4 and His6 are key determinants for affinity, and the amino acids in the No. 1 and No. 2 position also contribute to receptor binding. Val3, Ile5, and Pro7 contain neutral side chains which probably establish and/or help maintain the appropriate distances among the key sidechains of Tyr4, His6, and Phe8. In other words, Val3, Ile5 (or Val), and Pro7 are key determinants of structural conformation.


Extraosseous osteogenic sarcoma: case report. Extraosseous osteogenic sarcoma is a highly malignant tumor, and in order to improve the chances of survival of those who have it, aggressive surgical treatment, including major amputations, should be performed. Based on the results obtained in the treatment of its osseous counterpart, the use of adjuvant chemotherapy is strongly recommended. Evaluation should not be done because it is usually followed by local recurrence.


Otolaryngologic presentation of tic-like disorders. Common otolaryngologic symptoms such as coughing and sneezing may not be manifestations of disease of the upper respiratory tract. Two cases are reported in which these symptoms were the first evidence of tic-like disorders. A short discussion of one such disorder, Gilles de la Tourette's syndrome, is presented. The entity of paroxysmal sneezing is also mentioned. It is pointed out that, in the absence of otolaryngologic disease, these disorders may first present to an otolaryngologist for diagnosis.


2 micrometer covalently closed non-mitochondrial circular DNA in the petite-negative yeast Schizosaccharomyces pombe. A population of small covalently closed non-mitochondrial circular DNA molecules was isolated from the petite-negative yeast Schizosaccharomyces pombe. The mean length of these molecules, possessing the same density as nuclear DNA (1.695 g/cm3) is 1.95 +/- 0.18 micrometer. The presence of these minicircles in crude mitochondrial preparations indicates their tight association with mitochondrial particles. Their disappearance after DNase treatment of mitochondria demonstrates their extramitochondrial location.


The isolation and characterisation of a plaque-forming derivative of bacteriophage Mu carrying a fragment of Tn3 conferring ampicillin resistance. We have isolated a plaque-forming derivative of phage Mu which carries a determinant for ApR. The biological properties of this MuAp phage are similar to those of normal Mu. Its genome contains a 1.1 kb substitution where Mu DNA from the right end of the G region has been replaced by a similar length of DNA from the transposon Tn3. This fragment of Tn3 DNA carries the ApR gene, but is no longer capable of independent transposition.


Evidence for mutations in the structural gene for homocitrate synthase in Saccharomycopsis lipolytica. Eight strains devoid of homocitrate synthase activity were found among lysine requiring mutants of the yeast Saccharomycopsis lipolytica. Genetic analysis of these strains showed that they were all affected at the same locus LYS 1. Three lines of evidence suggest that this locus defines a structural gene for homocitrate synthase. First, the mutations show various degrees of intragenic complementation; it could be shown in some cases that the hybrid enzyme formed in vivo displayed modified properties in vitro. Second, reversion of some of these mutations can result in a modified enzyme (desensitized). Third, a feedback mutant of homocitrate synthase was directly isolated from the wild type strain, and shown to carry a single mutation at of near LYS 1. We also present here the first attempts at genetic fine mapping in Saccharomycopsis lipolytica.


Identification and nucleotide sequence of the sup8-e UGA-suppressor leucine tRNA from Schizosaccharomyces pombe. Using the translation of rabbit globin mRNA in wheat germ extracts as an assay for ochre and opal suppression, a UGA suppressor tRNA from Schizosaccharomyces pombre strain sup8-e was purified by column chromatography and two-dimensional gel electrophoresis. The purified tRNA can be aminoacylated with leucine by a crude aminoacyl-tRNA synthetase preparation from a wild type S. pombe strain, and has high activity in the suppressor assay. By a combination of post-labeling fingerprinting and rapid gel sequencing methods the nucleotide sequence of this suppressor tRNA was determined to be: pG-C-G-G-C-U-A-U-G-C-C-ac4C-G-A-G-D-G-G-D-G-D-A-A-G-G-G-m22G-G-C-A-G-A-psi-U-U*-C-A-m1G-C-C-C-U-G-C-U-G-U-U-G-U-A-A-A-A-C-G-m5C-G-A-G-A-G-T-psi-C-G-m1A-A-C-C-U-C-U-C-U-G-G-C-C-G-C-A-C-C-AOH. The anticodon sequence U*CA is complementary to the UGA codon. An interesting feature of the suppressor tRNA is an expanded anticodon loop of nine nucleotides owing to an A-C nonpair at the first anticodon stem position.


Multiple physical differences in the genome structure of functionally related bacteriophages P1 and P7. Comparative restriction cleavage analysis of the genomes of bacteriophage P7, of several recombinant phages between P7 and P1, and of bacteriophage P1 allowed to draw PstI, Bg/II, BamHI and HindIII cleavage maps of all genomes studied. The data obtained complement Yun and Vapnek's (1977) conclusions with regard to areas of major nonhomology based on electron microscopical heteroduplex analysis and they identify several additional minor differences between P1 and P7. The use of hybrid phage strains allowed to locate the genes for particular functions on the physical genome map.


Dominant enhancer effect of the meiotic mei4 mutant on recombination frequencies restricted to linkage group VI in Podospora anserina. A mutant which increases second division segregation (SDS) frequency of locus 110 (linkage group VI) was isolated. It was called mei4 because of its meiotic deficiency. The present paper deals with its effect on meiotic recombination when heterozygous. mei4 then only acts on linkage group VI. The SDS frequencies were increased for all markers used, except locus 5 located very close to the centromere. This quasi general enhancement results exclusively in an enlargement of map distance on linkage group VI's proximal part. Crosses involving three mutant genes allowed to check that the distances on the distal part were constant. This is due to a real lack of crossover frequency modification in this region and not to a change ofchiasma interference. Among the seven linkage groups of Podospora anserina, group VI exhibits several other particularities concerning meiotic recombination, especially a lower positive chiasma interference and a more regular crossover distribution, suggesting a particular recombination regulation.


Genetic transformation of Pseudomonas phaseolicola by R-factor DNA. The bacterium Pseudomonas phaseolicola was successfully transformed, for the first time, with R-factors RSF1010 and pBR322 DNA by a calcium-shock and heat-pulse technique. Frequency of transformation for RSF1010 ranged from 0.8 x 10(-7) to 3.1 x 10(-6) and was ca. 0.4 x 10(-8) for pBR322.


Regulation of s-amino acids biosynthesis in Saccharomycopsis lipolytica. ATP-sulfurylase, cysteine synthase, homocysteine synthase, arylsulfatase and beta-cystathionase in Saccharomycopsis lipolytica are repressed on the addition of methionine, homocysteine or cysteine to the growth medium. The use of appropriate mutants enabled us to demonstrate that the synthesis of these enzymes is regulated by the system involving at least two low-molecular weight effectors--most likely cysteine and methionine (or their close derivatives).


Leukemic phase of malignant histiocytosis (arguments in favour of the histiomonocytic origin of the abnormal cells). A 15-year-old female was treated for malignant histiocytosis. The occurrence of a leukemic phase (178,000 blasts/cu mm) during the follow up provided the opportunity of studying a large number of malignant cells by cytochemical electron microscopic, and cell membrane markers techniques. Acid phosphatase reaction was strongly positive and totally inhibited by tartaric acid. Nonspecific esterase reaction was moderately positive with inhibition by sodium fluorid. Electron microscopy revealed the presence of surface membrane pseudopods and the phagocytic activity of the cells. The leukemic cells had a receptor for the Fc fragment of IgG. These findings support the histiomonocytic origin of the abnormal cells in malignant histiocytosis.


Childhood multifocal osteosarcoma--diagnosis by 99mtechnetium bone scan: a case report. A 14-year-old boy with osteosarcoma presented with evidence of a solitary bone lesion by clinical and radiographic examination. A preoperative 99mtechnetium bone scan revealed multiple skeletal osteoblastic abnormalities and upon biopsy of one of these lesions, the diagnosis of multifocal osteosarcoma was established. This unusual case dramatically illustrates the value of 99mtechnetium bone scan in preoperative staging of patients with osteosarcoma.


Combination chemotherapy for bone marrow relapse in childhood lymphoblastic leukaemia (ALL). Thirty-four children with acute lymphoblastic leukaemia (ALL) in relapse or resistant to initial induction received combination chemotherapy with prednisolone, vincristine, l-asparaginase, and daunorubicin. L-asparaginase was given subcutaneously on alternate days for four weeks and was well tolerated. A complete remission was achieved in 96% of children in relapse and in five out of six children resistant to induction. Remission was achieved without hospitalisation in over 60% of patients. The median duration of subsequent remission was only 13 weeks, but six out of eight children receiving a second course of the drug combination achieved a further remission. We conclude that prolonged l-asparaginase therapy in combination with an anthracycline might well be used in initial or consolidation therapy for childhood ALL.


The use of hypnosis in treating the temporomandibular joint pain dysfunction syndrome. Report of two cases. This article, jointly authored by an oral and maxillofacial surgeon and a psychiatrist, presents two case studies of conjoint treatment of the temporomandibular joint pain dysfunction syndrome. The authors present a short review from the literature that supports the multifactorial etiology of temporomandibular joint dysfunction and provide, in two case studies, a combination of conservative dental treatment and hypnotherapy. The two case studies show a successful resolution of temporomandibular joint dysfunction with hypnosis in one case and failure of hypnotherapy to relieve the pain in a second case. Reasons for the success and failure are discussed. The article closes with some thoughts and ideas that dental practitioners can use in treating temporomandibular joint pain via hypnosis.


Condylysis in a patient with a mixed collagen vascular disease. Condylysis has not previously been described as a complication of a mixed collagen vascular disease. A case is presented in which apertognathia and mandibular retrognathism occurred secondary to condylysis in a 26-year-old woman with features of rheumatoid arthritis, systemic lupus erythematosus, scleroderma, and Sjögren's syndrome. The disease was manifested by polyarthritis, morning stiffnes, subcutaneous nodules, and acrosclerosis. Important laboratory findings included RA slide latex negative, increased DNA binding, ANA positive, ENA negative, and an abnormal parotid scan. The malocclusion secondary to condylysis was corrected by surgical procedures usually employed for the treatment of mandibular retrognathism and apertognathia on a developmental basis.


Extent of bacterial contamination in a nonrebreathing inhalation sedation machine. In this study the extent of bacterial contamination in a nonrebreathing inhalation sedation unit was determined. Bacteriologic cultures of different areas of the Quantiflex MDM machine were obtained during successive week-long courses in conscious sedation at this institute. Results of the bacteriologic cultures revealed the microbial contamination of nasal hoods before and after attempted disinfection with alcohol. The other areas of the unit were shown to be free of bacteria. Since attempted alcohol disinfection of nasal hoods was found to be ineffective, autoclave sterilization is recommended.


Lipoma of the tongue.

Lipoma of the tongue. A case of an enormous lipoma of the tongue is presented. The absence of dentoalveolar changes and the complete adaption of the functions of the tongue are discussed briefly.


Epithelial islands associated with mandibular nerves. Report of two cases in the walls of mandibular cysts. Epithelial islands in association with nerve fibers in the jaw bones have been reported previously. We describe two such cases and present evidence that the epithelial structures as observed in this study are odontogenic rests and not neuroepithelial organs. Regardless of origin, it should be recognized that these epithelial islands do not represent neural invasion by carcinoma.


Chievitz's organ: a potential pitfall in oral cancer diagnosis. It has been reported that epithelial nests associated with sensory nerve fibers may simulate perineural invasion and pose a potential diagnostic problem for surgical pathologists working on frozen tissue specimens from patients with oral cancer. The epithelial structures are not neoplastic, and no known pathologic condition has been associated with them. They are believed to be those structures described scantily in the English literature as Chievitz's organ. The fact that the epithelial nests lie near the plane of injection for the inferior alveolar nerve should be of special interest to dentists, especially oral surgeons and pathologists. Controversy exists as to the exact nature of Chievitz's organ, but the potential hazard of misdiagnosis exists nonetheless. This study of cadaver and autopsy material reaffirms the existence of the epithelial rests and outlines a simple technique for locating them.


Lateral periodontal cyst. An analysis of forty-six cases. The clinical and histopathologic features of forty-six cases recorded as lateral periodontal cyst are reviewed. Three distinct types of epithelial lining were noted as well as varying degrees of inflammation. The data, although inconclusive, suggest that cysts arising in the lateral periodontal area may be of either an inflammatory or developmental odontogenic origin.


Melanotic macule of the oral mucosa. A clinicopathologic study of 105 cases. A series of 105 cases of melanotic macule of the oral mucosa is analyzed, both clinically and histologically. In most patients the melanotic macule was a solitary lesion, and the most common location was the vermilion border, followed by the gingiva. Histologically, the melanotic macule is characterized by increased pigmentation in either the basal-cell layer, the lamina propria (mainly within melanophages), or in both locations. It is suggested that the term melanotic macule be reserved for lesions in which there is a definite clinicopathologic correlation between a clinically pigmented macule and the aforementioned histologic features and that the term focal melanosis be used only as a histologic designation when these features appear in clinically nonpigmented pathologic conditions.


Dentinal dysplasia, Type I. Report of a case with endodontic therapy. The first reported case of endodontic therapy in dentinal dysplasia, Type I, is described. The first histologic diagnosis of periapical granuloma instead of periapical cyst in dentinal dysplasia, Type I, is also reported.


Accidental swallowing of an endodontic instrument. A report of two cases. Two cases of the accidental swallowing of endodontic instruments have been reported. The instrument passed naturally through the alimentary canal within 4 days in the first case and within 2 weeks in the second case. Routine use of the rubber dam will prevent this type of accident.


Radionuclide bone imaging in the differential diagnosis of head and neck lesions. A preliminary report. The use of technetium 99m pyrophosphate (99mTcPP) imaging in the evaluation of benign and malignant tumors of the head and neck has been limited. In a clinical prospective study, twenty-one patients with suspected benign or malignant lesions of the temporomandibular joint, temporal bone, maxilla, or mandible were evaluated with regard to clinical presentation, radiographic findings, preoperative 99mTcPP bone scan, and final pathologic diagnosis. Eleven of twenty-one patients had positive scans at the site of biopsy-proven disease. In three cases, a bone scan was the single positive diagnostic test prior to surgical intervention. 99mTcPP imaging offers an additional noninvasive technique in the preoperative evaluation of patients with lesions of the osseous structures of the head and neck.


Xeroradiography of dental structures. III. Pilot clinical studies. A new experimental intraoral dental xeroradiographic system was evaluated for future application in dentistry. Similar projections on conventional film radiographs and experimental dental xeroradiographs were compared visually and radiation exposure for both techniques was measured by thermoluminescent dosimetry. The xeroradiographic system was judged superior for imaging most structures, especially oral soft tissues, subtle bony abnormalities, and fine calculus deposits. Furthermore, xeroradiography requires only one third the radiation exposure of corresponding conventional film techniques. Dental xeroradiography appears to have great promise in radiographic interpretation of oral disease.


Eimeria maxima: the use of enzyme markers to detect the genetic transfer of drug resistance between lines. Eimeria maxima (Weybridge) and E. maxima (indentata) were distinguished by the electrophoretic mobility of phosphoglucomutase. This enzyme was used as a marker to detect the transfer of methyl benzoquate resistance between resistant and sensitive lines of these parasites.


Changes in brain levels of NE and 5-HT are not responsible for attenuation of audiogenic seizures by spinal cordotomy. Spinal cord transection affords protection from audiogenic seizures (anterior to paralysis) in 21 day-old DBA/2J mice. To test the possibility that altered brain levels of NE or 5-HT are involved in mediating this effect, whole brain levels of these amines were assayed in cordotomized and control DBA/2J mice, aged 21 days. The assay revealed no significant differences between cordotomized and control mice. Therefore, cordotomy protects mice from seizures by mechanisms other than altering brain levels of NE or 5-HT.


[The lacrimal ducts and maxillofacial traumatology (author's transl)]. Microscopic study of the human lacrimal ducts places the emphasis on the delicacy and complexity of the relations between the lacrimal muscle and the mobile lacrimal tubular system. The fixed part of the lacrimal ducts (nasolacrimal duct) contracts with the anterior pillar of the face, a fixed relation which inevitably exposes this part to lesions by shearing in the case of anterior maxillofacial trauma. The proximity of the nasolacrimal duct to the piriform cover is such that the duct may be approached surgically by trepanation of the anterior bony surface of the anterior pillar of the face.


[Dacryocytography in traumatology (author's transl)]. Radiological technique in the investigation of the lacrimal system has greatly benefited from various advances in radiology; techniques of catheterisation, contrast media, seriography, subtractions, associated complex tomography (dacryocystotomography), tomodensitometry. To these may be added the dynamic nature of isotope studies (cinegammadacrycystography). These different techniques may be used in the precise analysis of the morphology of the lacrimal system, from the canaliculi to the meatuses. After reviewing normal radiological anatomy, the authors describe morphological abnormalities, according to different forms of obstruction, according to their site. This morphological discovery requires possible changes in technique (additional tomography, for example). The quality of the preoperative morphological exploration influences the quality of the therapeutic results obtained.


[Value of dacryography in the exploration of injuries to the lacrimal ducts (author's transl)]. Dacryography is the only objective non-clinical method for studying the permeability of the lacrimal excretory ducts. Pre-operatively, it is an essential element for the choice of surgical intervention; post-operatively, it is always indicated if weeping persists. New surgical techniques such as arterial grafting have stimulated renewed interest in this method.


[Reconstruction of the lacrimal ducts: results in a series of 102 cases (author's transl)]. Surgery of the lacrimal appartus falls into the realm of a paradox: paradoxical because of the means employed to repair an excretory apparatus which is not absolutely indispensable; paradoxical because of the great difficulty encountered in assessing results in operated patients with: obstruction without weeping or; weeping without obstruction. The indication for operation is related to two factors: that of the act itself--valid in new lesions, debatable in old lesions, doubtful in relapses; that of the technique used, which in the authors' view is mainly a function of the state of the lacrimal sac. An objective analysis of a series of 102 cases strengthened the authors' opinions but with a feeling of circumspection tainted with deception.


[Critical study of dacryorrhinostomy (author's transl)]. Dacryorrhinostomy is a last-chance operation for severe palpebral and canalicular damage which can lead to loss of tissue. The reconstruction of a delicate tube remains a gamble because of the absence of normal structures. The multiplicity of the procedures proposed clearly demonstrates the difficulty in obtaining a functional result. The excellent results obtained with this procedure incited the authors to prolong their study and increase the number of cases in order to confirm the validity of their findings in a large series.


[The value of ductostomy (author's transl)]. This procedure seems to be a valid one, as after using it in 21 cases over a period of one and a half years, there was only 1 failure due to a too hasty removal of the gauze wick. Furthermore, in 12 cases, a catheter was applied to the lacrimal puncta to irrigate the anastomosis with rifocin and hydrocortisone for several days. The advantages of this method appear to be simplification, and less risk of stenosis by using a full flap, when compared to dacryocystorrhinostomy.


[Long-term results of secondary surgical repair of the lacrimal duct with arterial grafts (author's transl)]. After 5 years of experience of surgical repair of the lacrimal duct, the authors consider that secondary repair using arterial grafts has now become a reliable and valid procedure in all cases where part of the duct, at least, still remains.


[Treatment of obstruction of the lacrimal ducts (author's transl)]. The present attitude towards the treatment of obstruction of the lacrimal ducts should be based on traditional methods, but modified to take into account recent advances which allow "modern surgery" to be applied. These new procedures are based on two relatively recent new acquisitions: 1) A precise knowledge of the physiology of the lacrimal pump, mainly due to the work of Lester T. Jones. It is important to know hen this pump has been destroyed as any attempt at repair is doomed to fail. We do not yet know how to reconstruct this pump. If minor damage has occurred however, attempts at repair operations may be successful. 2) Simplification of the operative procedure, both for dacryocystorhinostomies and lacodacryocystorhinostomies. Complex reconstructive procedures which often failed have been replaced by the application of a tube made of an inert material, and this is much simpler and gives much more constant results.


[Secondary functional cheilo-rhino-plastie (author's transl)]. Secondary functional cheilo-rhino-plastie consists of restoring the normal insertions and orientations of the labio-narinary muscles (which they do not usually have after an initial cheilo-plastie), and this during the period of growth. The resultant functional transformations avoid the worsening of dento-maxillary sequelae and greatly improve orthodontic possibilities.


[Results of a retrospective study of the primary treatment of labiopalatine clefts (author's transl)]. This study concerned a homogeneous series of 233 children operated upon between 1960 and 1972 by the same surgeon, with an unchanging therapeutic attitude and followed up by a permanent team including surgeon, paediatrician, orthodontist, speech therapist. It represents a first critical analysis of the results obtained, here in an age group representing a minimum of 7 years follow up. Computer cards were prepared for each patient involving analysis of more than 400 parameters, in association with ensuring that patients who had not been followed up regularly were sent for and subjected to a complete assussment. The following main areas are covered: anatomoclinical aspects of clefts, associated lesions, initial surgical techniques and the postoperative course, ENT and paediatric problems arising during early childhood, orthodontic needs, investigations and results of speech therapy, complete assessments at 4 and 7 years.


[Harmonisation of the middle level of the face by Lefort type I osteotomy (author's transl)]. Elongation of the middle level of the face which is characterised by a short upper lip and exposure of the superior alveolar process is an indication for resection of a boney segment of the maxilla. Planning of this operation and the surgical technique are described and it is shown that osteosynthesis using a miniplate makes it possible to avoid intermaxillary block but requires a strict surgical technique and a very careful therapeutic plan.


[A classification of parodontal surgical procedures (author's transl)]. Parodontal surgery is a dynamic entity, which has evolved in a continuous manner since the beginning of the century, because of the increasing interest in parodontology itself, the growing importance of surgical treatment for parodontal diseases, and improved knowledge of biological processes involved in cicatrization. A new classification is suggested which should allow a more specific selection of indications for surgical treatment and thus to obtain a stable and long-lasting result.


Angiography in the diagnosis of carcinoid syndrome. The diagnosis of carcinoid syndrome has been confirmed by selective abdominal angiography in a consecutive series of 18 patients. In eight patients the primary carcinoid tumour was removed before angiography. The primary lesion was demonstrated in eight of ten cases. Metastases from the carcinoid tumours was present in all 18 patients. All cases of mesenteric metastases and 12 of 14 cases with liver metastases were visualized by angiography. All but one of the liver metastases were highly vascularized and therefore easy to recognize, making angiography a good monitor in the control of medical therapy or in planning of surgical intervention.


Localization of hormone-producing gastrointestinal tumours by ultrasonic scanning. The value of ultrasonic scanning in the localization of hormone producing gastrointestinal tumours was assessed in 16 patients. Fifteen patients had Zollinger-Ellison syndrome and one patient had a VIP tumour. In four patients with Zollinger-Ellison syndrome ultrasonic scanning demonstrated a solid mass lesion of the head of the pancreas of 2.2.4 and 8 cm respectively. One of these diagnoses was verified by autopsy, one was also found by subsequent CT-scanning and angiography. In one patient ultrasonic scanning demonstrated a 3 cm tumour of the tail of the pancreas. At ultrasonically guided percutaneous fine needle biopsy tumour cells were aspirated. Biochemistry confirmed a VIP tumour. In 11 patients ultrasonic scanning was normal. By laparotomy in nine of these tumours of 1--3 cm were found in three patients 5.9 and 15 months after scanning and in two patients multiple 0.5 cm tumours within the duodenal wall were demonstrated one half and 9 months after ultrasound. In four patients tumours were not demonstrated by surgery. Two of the 11 patients were not operated upon, and the tumours have not been localized. The advantages of the complete atraumatic, rapid and relatively cheap ultrasound technique and the ability of an ultrasonically guided biopsy for the demonstration of malignancy justify ultrasonic scanning to be an initial method of investigation in the localization of hormone producing gastrointestinal tumours.


CT scanning in patients with Zollinger-Ellison syndrome and carcinoid syndrome. Computed tomography of the upper abdomen was performed in 11 patients with Z--E syndrome and 6 patients with carcinoid syndrome. The liver, pancreas, spleen and upper part of the retroperitoneal space were examined to localize a primary tumour and/or metastases. The CT findings were correlated to the final diagnoses obtained by operation or by other diagnostic procedures. The correlation between CT and the clinical findings was acceptable, and we are of the opinion that with further experience this new noninvasive radiological technique might be a helpful tool in the preoperative evaluation in these diseases. Furthermore, CT is an easy method in the control of a tumour or metastases during treatment.


Direct selective catheterization of the portal venous system. A short description is given of the techniques for percutaneous transhepatic (PTP) and transumbilical (TUP) portal Venous catheterization and their use for direct selective catheterization of the portal vein and its tributaries. PTP was successful in 181 of 184 attempts (98 per cent) and TUP in 283 of 301 attempts (96 per cent). The complications are discussed in details. Among the clinical implications of the methods is the diagnosis of hormone producing tumours.


Biochemical localization of pancreatico-enteric endocrine tumours. Biochemical localization of pancreatico-enteric tumours has been proven useful, but the technique applied must be executed with great care. In this paper we present problems and some methodological demands for highly selective catheterizations within the portal system. Phlebography confirming the venous anatomy and exact position of the tip of the catheter during the bloodsampling is mandatory. Reasons for false positive and false negative investigations are discussed in order to facilitate the correct interpretation of catheterization results.


Percutaneous transhepatic catheterization technique of the portal venous system. The most widespread technique for catheterization of the portal venous system is the percutaneous transhepatic with selective catheterization of the portal tributaries. The procedure is most often used for portography in patients with liver cirrhosis, but can also be used for pharmacoligic, metabolic and hemodynamic studies. By selective catheterization of the gastrooesophageal veins varices can be obliterated. Selective catheterization of the pancreatic veins with blood sampling for hormone assay may diagnose and localize endocrine pancreatic tumours.


Clinical diagnosis of metastatic carcinoid tumours. Eighteen patients with metastatic carcinoid tumours were admitted to surgical gastroenterological department of Rigshospitalet during the period 1974--1978. Thirteen had primary carcinoid tumours in the terminal ileum, two in the lungs, one in the pancreas, one in the testis, and one possibly in the retroperitoneum. All patients had distant metastases, 13 in the liver. Carcinoid syndrome with flusing and diarrhoea was present in 15 patients (83%). The time elapsing from onset of symptoms  until diagnosis was on an average 2 1/2 years. The most valuable screening test for carcinoid syndrome was determination of the excretion of 5-hydroxy-indol- acetic-acid. The most sensitive investigation for determination of primary tumour and/or metastases was abdominal angiography, which was positive in all cases. Other radiological investigations were less sensitive.


Prostaglandins and chronic diarrhoea: methodological problems. In order to determine the arterio-venous difference in circulating prostaglandin levels the isotope derivative technique was applied to rat plasma for measurements of prostaglandin E2 (PGE2). No arterio-venous difference was observed if the blood was collected without precautions to avoid in vitro prostaglandin production in the sampling tube. In contrast, inhibition of the in vitro prostaglandin release by the infusion of indomethacin into the catheter from which the blood was drawn, showed PGE2 levels in the right atrium of 60 +/- 20 pg/ml (mean +/-SD; N = 8), and peripheral levels insignificantly different from zero. A significant difference in PGE2 levels of right atrial plasma from fed and fasted rats was observed without the use of in vitro indomethacin in blockade (210 +/- 70 pg/ml; N=4, and 330 +/- 35 pg/ml; N = 4, respectively). This difference could not be reproduced if indomethacin was infused into the catheter (60 +/- 20 pg/ml; N = 8 and 90 +/- 35 pg/ml; N = 5, for fed and fasted rats, respectively). Measurements by radio-gas-liquid-chromatography of the arachidonic acid plasma level showed values of 6.8 +/- 1.6 micrometers (N = 7) and 12.0 +/- 3.4 micrometers (N = 7) for fed and fasted rats, respectively. It is suggested that the higher level of PGE2 (without indomethacin) in fasted rats reflects that of arachidonic acid. The present available methods for the determination of primary prostaglandins and prostaglandin metabolites are discussed with respect to their value not only in physiological studies on fluid and electrolyte transport in the gut, but also for clinical use.


The clinical diagnosis of the Zollinger-Ellison syndrome. Recent clinical experiences with 34 Z-E patients indicates that the clinical features and course of the syndrome is less dramatic than described originally. Eighty-five per cent of the patients presented stories of abdominal complaints lasting more than five years and resembling the complaints presented by duodenal ulcer patients (DU). Ulcers were present in 91 per cent of the patients. Fifty-one per cent had either ectopic or multiple ulcers. One third had a single duodenal ulcer resembling an ordinary ulcer. No patients died from complications to the ulcer diathesis. Marked hypersecretion of acid and gastrin was present in the ZE group (BAO:33.7 +/- 7.4; PAO:62.8 +/- 6.1 meq H+/h; gastrin: 5094 pmol/l), but because of great individual variation in the ZE, some overlapping with the acid and gastrin measurements of the DU was seen. The diagnostic value of provocative tests using secretin, calcium, glucagon and food stimulations demonstrated a considerable overlapping between the two groups, indicating that these tests are of little clinical value. Tumours were found in half the patients, revealing malignancy in ten. The ZE can be diagnosed in most cases by combining symptomatology, with measurements of acid and gastrin.


[A possible new prognostic criterium for acute myelocytic leukemia: speed of the titer increase of antiviral antibodies after virus oncolysate injections]. In a study conducted by the Swiss Group for Clinical Cancer Research, 28 patients with acute myelogenous leukemia in complete remission were treated by chemotherapy and viral oncolysate (i.e. formalin treated fowl plague virus infected allogenous leukemia cells). Patients with a slow rise and low maximal titers of antiviral antibodies in the sera proved to have longer remissions than those with a prompt and high rise. Several patients showed association of antiviral antibody changes in the serum with the percentage of myeloblasts in the bone marrow. Determination of the antiviral antibody titer slope after repeated immunization by viral oncolysate can therefore be used for prognosis in patients with acute myelogenous leukemia in remission, and may be helpful in detecting inadequately treated patients.


Simultaneous disseminated aspergillosis and zygomycosis in a leukemic patient. Although the incidence of fungal infections is increasing, infections caused by more than one fungus are rare. We have described the clinical, pathologic, and mycologic findings in a leukemic patient with simultaneous pulmonary infection and systemic dissemination caused by Aspergillus fumigatus and Rhizopus sp.


[Dental caries, periodontal diseases and salivary immunoglobulins]. The authors determined in 80 adolescents (subdivided into 4 groups) the mean content of IgA, IgG and IgM in mixed saliva and brought it in relation to the average caries experience (DMF index), the inflammatory condition of the gingivae, and other parameters. The immunoglobulin content in the saliva was significantly increased in case of high caries experience as well as of severe inflammation. There was no correlation with the OHI which is only increased in case of marked gingivitis.


[Clinical experience with Knappwost's galvanic pin element]. Having dealt with the manufacture, application and mode of action of the pin element, the authors report of clinical and radiological findings (after six and twelve months) which they compare with corresponding results from the literature and experience gained with the treatment of apical periodontitis with iodoform paste. The paper ends with recommendations for practice.


[Efficiency criteria and priorities in school age pedodontic care]. On the basis of findings in 1200 individuals aged between 7 to 16 years, the authors indicate priorities of dental care in the different age-groups. Apart from other criteria, the readiness for treatment and the disciplined behaviour of the children and adolescents during treatment may be used for assessing the dentist's achievements.


[Problems in the diagnosis of oral surgical diseases by means of histological studies]. On the basis of findings in 1,185 out-patients who had been to undergo biopsy, the author indicates the limitations of the treatment of tissue changes in stomatological practice. The comparison of the clinical diagnosis with the histological diagnosis demonstrated that there are various difficulties in evaluating oral surgical diseases associated with tissue changes. For this purpose, a specific scheme of differentiation was elaborated. Wrong diagnoses were most frequent in tumours (65.9%) and in affections of the oral mucosa (57.4%).


[Malignant degeneration of a residual radicular cyst]. The degeneration risk is extremely low for odontogenic cysts. The present communication deals with a squamous cell carcinoma of the left maxilla. Clinically, it showed all the symptoms of an infected cyst; but histologically, it presented carcinomatous degeneration on certain parts of the cystic epithelium. It was a true cystocarcinoma.


[Experimental studies of various model materials. 1. Comparative study on linear dimension behavior]. The linear dimensional behaviour of the model materials Begolith, Dentaloc, Tewestone, Impredur and Keramik-Cement was investigated at various mixing temperature, the thickness of layer ranging from 3 to 5 mm. It seems that the model materials Begolith, Dentaloc and Tewestone will yield good results in practice. Impredur may be recommended on certain conditions. On the contrary, Keramik-Cement is not suited as a model material.


[Addition cross-linked silicone impression materials]. The principle of the polyreactions "polymerization", "polycondensation" and "polyaddition" is explained and described in detail for silicone impression materials. In the light of laboratory findings (quasi-viscosity, plasto-elasticity, dimensional and weight behaviour), three alginate materials, one condensation cross-linked silicone material, two addition cross-linked silicone materials and one polyether material are compared and evaluated with regard to their clinic-relevant properties.


[Further results from the Berlin morbidity study of 1972. 1. Educational level, knowledge of dental health and oral hygiene]. There are relationships between the general educational level and the extent of dental health knowledge on the one hand, and between the dental health knowledge and the oral hygiene condition on the other hand. A higher educational level is associated with a better dental health knowledge and, in most cases, the latter is connected with a lower oral hygiene index. School education exerts a greater effect on the level of dental health knowledge than higher or technical education. The state of dental health education and information of the population is not sufficient. Merely 25% of the interviewed graduates and 10% of the individuals having gained a school-leaving certificate reached maximum scores though only some few and easy questions (with a choice of incorrect and correct answers) had been put to evaluate dental health knowledge.


Influences of axial load and blood pressure on the position of the rabbit's incisor tooth. Changes in the axial position of the left upper incisor in response to loading by 5-20 g were measured with ultrasonic technique in anesthetized rabbits. The time-response of the load-induced intrusion described a biphasic curve, with a steep initial part followed by a slower part. Maximum amplitudes after 20 s increased with increasing loads. A rise in arterial blood pressure (aortic balloon inflation) resulted in extrusion, while i.v. injection of noradrenaline or papaverine caused intrusion and extrusion, respectively. The responses to loading and changes in blood pressure were largely unaffected by transection of the root, but the effects of pressure changes were severely diminished by local infiltration of the periodontium with noradrenaline. Participation of periodontal blood vessels in the damping of load-induced intrusion was excluded by the finding of roughly equal intrusion curves at low, normal and high blood pressure and up to 38 h after death. We conclude that the resting position of the rabbit's incisor is greatly influenced by arterial blood pressure, via the periodontal vessels. The intrusion in response to loading by up to 20 g is resisted by periodontal fibers only, the blood vessels or the pulpal and periapical tissues and pressure taking no part.


Microvascular pressure in the dental pulp and gingiva in cats. Pressure in selected microvessels was measured directly on the exposed coronal or apical pulp in one of the upper canine teeth or on the gingiva in a total of 36 cats. The vessels were punctured with glass micropipettes, diameter 1-4 micrometer, and the pressure measured with a modified Wiederhielm servocontrolled counter-pressure technique. Pressures in corresponding vessels in coronal and apical pulp were similar. The pressure in pulpal arterioles, diameter 10-70 micrometer averaged 43 mm Hg, or 36% of mean systemic arterial pressure (PA), while pressure in the pulpal venules, diameter 10-80 micrometer, was on an average 19 mm Hg or 16% of PA. Capillary pressure measured in the coronal pulp averaged 35 mm Hg. Mean arterial systemic pressure was 124 mm Hg. The total vascular pressure drop within the pulp was only 20% of the total systemic arteriovenous pressure difference. Accordingly, only one fifth of the vascular resistance governing pulpal blood flow is situated within the pulp itself. This means that blood flow in the dental pulp in cats may be influenced by mechanisms located extrapulpally. In gingiva only venular pressure was measured, which averaged 19 mm Hg.


Relationship between radiographic signs in the temporomandibular joint and hand joints. The temporomandibular joints of 64 patients and the hand joints of 62 patients with mandibular pain and/or dysfunction were exposed in oblique lateral transcranial, transmaxillary, and dorso-volar projections. The relationship between radiographic signs generally ascribed to osteoarthrosis was investigated. Indices were constructed to quantify the radiographic findings in the two joints. In the temporomandibular joint statistically significant age-independent correlations were found between flattening of the lateral part of the condyle, subcortical sclerosis of the condyle and reduced joint space. In the hand joints statistically significant age-independent correlations were found between osteophytes, subcortical sclerosis, eroded/absent cortical outlining, reduced/obliterated joint space and dislocations. No statistically significant correlation could be found between radiographic findings in the temporomandibular and hand joints. It is concluded that the radiographic signs in the temporomandibular joint of reduced joint space, subcortical sclerosis of the condyle and flattening of the lateral part of the condyle are interrelated and probably characteristic of osteoarthrosis, and that these relationships are similar to those that occur in the hand joints.


Electrolytes and whole body potassium in acute leukemia. In a consecutive series of 22 patients with acute leukemia, the total body potassium was studied in 18 patients on 39 occasions during relapse and remission. Total body water was also determined. A control group consisting of 88 age-matched healthy volunteers was also studied. The patients had a significantly lower mean potassium concentration, per kg body weight, per kg lean body mass and per kg water, than the controls (p less than 0.001). Individually, 11 out of the 18 patients had at least one value below the lower 95% confidence limit. Hypokalemia was frequent both in the patients with low (7/11) and normal (3/6) potassium per kg lean body mass. Five of 13 investigated patients showed laboratory indications of secondary hyperaldosteronism, which might be partly responsible for the hypokalemia. Increased serum or urine levels of lysozyme were found in 62% of the patients.


Expression of oncornavirus antigens in peripheral leucocytes of patients with chronic myeloid leukaemia. Peripheral leucocytes from 16 patients with chronic myeloid leukaemia (CML) were examined for the presence of oncornavirus p30 antigens by indirect cytoplasmic immunofluorescence. The leucocytes of 12 patients who could be kept in balance by chemotherapy proved to be negative or contained the p30 antigen of mammalian endogenous oncornaviruses as the only viral antigen. In the leucocytes of four patients being in blastoid crisis, an antigen related to the p30 antigen of mammalian leukaemia-sarcoma viruses was detected. In five of six patients decrease in sensitivity to chemotherapy, or blastoid crisis, was preceded by expression of leukaemia-sarcoma virus p30 antigen(s). Leucocytes from 15 CML patients kept in balance by chemotherapy and those from seven being in blastoid crisis, were examined by indirect membrane immunofluorescence for the presence of antigen(s) related to the gp70 antigen of the simian and murine leukaemia-sarcoma virus. All tests proved to be negative.


CKBB-isoenzymes as a sign of cerebral injury. CKBB-isoenzymes in serum and CSF have been shown to be raised in patients after head injury with objective signs of damaged brain tissues (contusio cerebri), but not in the absence of these signs (commotio cerebri).


Factors influencing the outcome of coma in severely injured patients. From this analysis we may conclude that the most important factors influencing the outcome of coma due to injury are age, vegetative state, level of coma, decerebration, and hypocapnia. In all cases where a combination of four or more of any of the above-mentioned factors was present the patient died. EEG seems less predictive in the early period, but may give some information for late prognosis.


Pentothal protection for delay cerebral revascularization. Thiopentone (20 mg/kg/bolus and 20 mg/kg/three hours) was effective in preventing infarction in five dogs with six hours of middle cerebral occlusion. Nine control animals sustained massive to large infarctions. Utilizing this regime therapeutic blood levels were rapidly attained for over 12 hours without side effects. From the experimental and human experience with focal cerebral ischaemia, there appears to be a finite grace period in which cerebral revascularization can be undertaken. In canine and primate models this time has been about five hours, following which the infarction process may not be reversible (Sundt et al. 1977, Laha et al. 1978). Seeking to prolong this grace period, thiopentone was selected as an ideal drug for this purpose, and its effect on the revascularized canine middle cerebral distribution was evaluated at six hours following embolectomy.


Surgical possibilities in the third portion of the vertebral artery (above C2). Anatomical study and report of a case of anastomosis between subclavian artery and vertebral artery at C1-C2 level. A reappraisal of surgical possibilities in the third portion of the vertebral artery (VA) above C2, has been done from an anatomical study on twenty autopsy specimens. A route passing between the internal jugular vein and the Sterno-cleido-mastoid muscle allows a simple approach to the transverse process of C1. After division of two muscles attached to this process, 1.5 cm of the VA can be exposed. For larger exposure of the artery, the foramen transversarium of C1 must be unroofed and the artery dissected in the guttering of the posterior arch of the atlas. This surgical route was used in a case of aneurysmal dysplasia at the C3 level. An anastomosis between the subclavian artery and VA at the C1-C2 level was performed with an autologous saphenous vein graft. The key points are the highest possible freeing of the XI nerve and the head position. Rotation and extension move the transverse process and the posterior arch of the atlas superficially and anteriorly.


The role of anastomoses in brain circulation. Anastomoses in the arterial system of brain investigated on the computer model can be divided into three basic groups. Parasitical anastomoses diverting blood into affected regions and stealing it from the unaffected parts, compensating anastomoses delivering blood from extracranial sources, and redundant anastomoses protected the vital parts of the brain.


Microsurgical approach to bilateral carotid artery occlusion. Bilateral thromboses of the carotid artery present in the form of complete bilateral occlusion or in the form of unilateral occlusion associated with stenosis of the contralateral carotid artery. From our experience in a series of 20 patients extra-intracranial microanastomosis appears to be effective in both described groups.


Using the spectral analysis of the EEG for prognosis of severe brain injuries in the first post-traumatic week. Fifty adult patients with severe brain injuries were examined with the EEG on the 1st, 2nd, 3rd, 5th, and 7th postoperative days. In 40 of these 50 cases a prognosis was given after 7 days as a result of the Fourier analysis of the EEG: 23 patients survived, 17 died. There are significant differences in the EEG's for these two groups: an increase of the absolute and relative amplitudes in the alpha and theta bands for the survivors, and a decrease or no change in the alpha and theta bands for the others, all during the first week. In 10 cases the correct prognosis could not be given: 5 patients showed spindle or alpha activity (alpha pattern coma) in the EEG; 4 cases had to be treated with barbiturates for focal seizures, and one suffered from secondary bleeding. In these cases computer tomography did not yield additional prognostic information.


Prognostic information from EEG and ICP monitoring after severe closed head injuries in the early post-traumatic phase. A clinical and experimental study. Neither the EEG investigations on the first post-traumatic day after severe enclosed brain injury nor evaluation of the clinical finding on the first day permit a pronosis. Measurement of intracranial pressure is necessary for monitoring of intracranial complications, but can only make a contribution to prognosis when a critical intracranial pressure is reached. There is a slight correlation between the severity of the EEG alteration and the later outcome on the second day. If an alpha EEG is found on the first day, the prognosis in all cases is not so poor as assumed by other authors.


The prognostic value of intracranial pressure monitoring after severe head injuries. ICP monitoring appears not to be essential for the prognosis of head injury patients, but it may be of some clinical value in association with the neurological status and other clinical data. The results of ICP measurement show that a high level in brain pressure and the poor outcome have a better correlation with one another than a lower level of brain pressure and a good recovery.


Prognostic signs during continuous monitoring of the ventricular fluid pressure in patients with severe brain injury. The presence of CSF in cases with intracranial hypertension is a favourable prognostic sign; its absence is indicative of a progressive and potentially lethal intracranial hypertension. 2. A series of characteristic changes in the absolute value of the VFP as well as in the amplitude and rate of the cerebral pulse can provide reliable evidence of the integrity of the cerebral circulation. 3. Short-lasting disappearance of the diastolic pressure towards the end of the ultimate plateau wave and subsequent significant lowering of both the systolic and diastolic pressures is an additional bad prognostic sign.


Surgical treatment of craniopharyngiomas in children. This paper sets out the surgical difficulties and the results of treatment in 50 cases of craniopharyngiomas in children up to the age of 13. During surgery, 10 patients were in a sub-comatose state, while 4 had respiratory arrest. Two-thirds of the children under 10 were given an A-V shunt implant. Radical excisions were attempted in 20 cases but were executed in only 13. Three of these died. Separation of the upper and posterior part of the capsule from the hypothalamus had to be interrupted in seven cases. The object of the operation was the radical removal of the capsule. We failed in one-third of our cases. Tumour excision is always attempted unilaterally. When this proves impossible, a second operation is undertaken on the opposite side when the hypothalamic disturbance subsides. If repeated surgery is indicated, it is always performed on the opposite side of the primary operation.


Surgical treatment of craniopharyngiomas in adults. Thirty-eight patients over the age of 21 were found to be suffering from craniopharyngiomas. According to the clinical symptoms, 8 tumours were of the juvenile type and 24 of the adult type. Thirty-four patients underwent direct surgery of the tumour. Ten were operated on unilaterally and then contra-laterally, as we were unable to remove the tumour in one go. Fifteen of the 24 adult type tumours were operated on radically, and five subtotally. Four patients were given an A-V shunt implant. The best results were obtained with subtotal excisions of adult suprasellar craniopharyngiomas.


CT follow-up studies in postoperative craniopharyngiomas. Thirty patients with histologically proved craniopharyngiomas were controlled by CT after surgical excisions. Recurrence occurred in 70%. Of these tumours 33% were cystic, 30% were solid, and 12% were calcified. The ventricles were dilated in 67%, and postoperative cavities were found in 33%. The effectiveness of various forms of therapy has been monitored by CT. The purpose of our study is to investigate the value of early and long term CT scanning in craniopharyngiomas after surgical excision.


Microsurgical removal of large sphenoidal bone meningiomas. At the Neurosurgical Department, University Medical Centre of Ljubljana, 10 extirpations of large meningiomas of the sphenoidal wing or tuberculum sellae were done during the period 1975-1978. Microsurgical technique, especially bipolar coagulation, made it possible to remove the tumourous mass from the cerebral tissue, cranial nerves, and arteries of the parasellar region. Out of 10 patients operated on, 2 died. The remainder, i.e. eight patients recovered. Only two showed any neurological signs.


Microsurgical approach to the parasellar region. The anatomical structures of the parasellar region are described from the microsurgical point of view. The study was performed on 20 autopsied specimens.


Benign intracranial hypertension. A clinical evaluation of the CSF absorption mechanisms. Fifteen patients suffering from Benign Intracranial Hypertension due to various causes were investigated by measuring the CSF resistance to flow, and the pressure difference between the CSF and the sagittal sinus. Isotope cisternography was also performed, and the patency of the dural sinuses was checked by both sinography and phlebography. In twelve the results confirm a defect in the resorption mechanism, the nature of which proved to be venous in six, and linked to impairment of subarachnoid villi in six others. Three patients could not be classified. The significance of normal isotope cisternography is discussed.


Newest ultrastructural findings after the use of a CO2-laser on CNS tissue. The first use of a "bloodless" knife in neurosurgery was a real revolution in surgical technique. This innovation enables us to reach non-accessable regions of the brain with less damage to the surrounding tissue.


Third ventriculostomy by microtechnique. The microtechnical approach to third ventriculostomy is presented. Opening of the lamina terminalis and basal membrane of the floor of the third ventricle is combined with opening of the membrane of Liliequist. The technique was used in five cases of aqueductal stenosis. We stress the importance of the microscope, and opening of the membrane of Liliequist to gain additional access.


Functional and morphological motor regeneration after different periods of denervation and following microsurgical suture of the peroneal nerve. Experimental study in the rabbit. The morphological and functional recovery of the peripheral nerve, motor endplate, and muscle has been studied in rabbits after different periods of denervation of the muscles and secondary suture of the supplying nerve, by electrophysiological (electromyography and electroneurography) and histological methods (electron microscopy, including freeze fracture techniques and histochemistry). In rabbit peroneal nerve, 10 months of denervation appears as the critical interval. Longer periods of denervation are not followed by a sufficient functional recovery.


Neurophysiological evaluation of microsurgically implanted grafts bridging peripheral nerve defects. Measurement of motor and sensory conduction velocities, amplitude of M-wave and sensory nerve action potentials, and coaxial needle EMG were used to evaluate function of grafts bridging defects in median, ulnar, and radial nerves in 73 patients. The results show values only moderately lower than the normal limits.


Value of computed tomography for the diagnosis of arachnoid cysts and assessment of surgical treatment. The clinical and radiological findings in 18 patients suffering from arachnoid cysts of the middle fossa (ACMF) are reported. The importance of computed tomography in diagnosis and in the assessment of surgical therapy in 15 cases is emphasized. The indication to operate upon ACMF and criteria of adequate surgical treatment are discussed. We want to point out the superiority of simple shunting procedures over craniotomies and removal of membranes.


Transhepatic hormone levels in the portacaval shunted pig--the effects of arginine upon gastrin and glucagon release. Hypergastrinemia and hyperglucagonemia follow portacaval shunt (PCS) or cirrhosis in man and experimental animals. The cause is unknown although portal diversion and hepatic dysfunction are suggested. In these studies transhepatic techniques were used to define the hepatic handling of basal and arginine-stimulated gastrin and glucagon levels in sham-operated and portacaval-shunted pigs and in a group of pair-fed sham-operated pigs. After PCS, basal gastrin levels were lower than those in sham-operated animals but were also lower in the pair-fed group, suggesting that the change resulted from partial starvation. Arginine-stimulation caused a rise in hepatic venous levels in PCS and in pair-fed pigs and in portal venous levels in sham-operated pigs. These data also suggested a response to diminished intake in PCS pigs. There was an immediate transitory rise in portal immunoreactive glucagon (Unger 30K) after PCS and a subsequent rise from the 4th postoperative day in all circulations. Arginine stimulation caused in sham-operated and PCS pigs a biphasic rise in the portal circulation and a later rise in the arterial circulation in PCS pigs. These data suggest that the effect of PCS upon gastrin levels is associated with the impaired appetite while the effect upon glucagon is the result of diversion past the liver.


Occlusion, arch dimensions, and craniofacial morphology after palatal surgery in a group of children with clefts in the secondary palate. A mixed longitudinal study of the occlusion and arch dimensions from 4 to 11 years of age was made on fifty-five children with solitary palatal clefts. A cephalometric study was also made on thirty of these patients when they were approximately 10 years of age. The palatal closure was made by means of a modified von Langenbeck procedure at a mean age of 1 year 9 months. The frequency of cross-bite in the deciduous dentition was comparable with that in children without clefts. As in other studies, an impairment of the occlusion was seen with increasing age. The children showed retrognathic faces and the difference between the cleft children and the noncleft children was of the same magnitude as in other studies. It was found that the arch dimensions and the craniofacial morphology were influenced by the size of the cleft, while the occlusion was not. The craniofacial morphology in the present investigation was comparable to that in other studies where a push-back technique had been used, but the frequency of cross-bite was lower. Thus, it would appear that the type of surgery influences the occlusion more than it affects the craniofacial morphology.


A cephalometric study of sexual dimorphism. In general, female cranial dimensions are smaller than the corresponding dimensions in the male. The pattern of craniofacial morphology in males and females appears to be identical except in posterior facial height. In general, male skulls are 8.5 percent larger than female skulls.


May Johnny or Janie play the clarinet? The Eastman Study: a report on the orthodontic evaluations of college-level and professional musicians who play brass and woodwind instruments. It is apparent from the findings in this study that although there are some significant differences in the incidence of certain pertinent oral and facial entities between some wind-instrument musicians and their counterpart controls, among mature persons, there is no reason to categorically prohibit all persons with potential malocclusions from studying music. On the other hand, it could be folly to permit any or all instrument pursuits without an extensive, complete, thorough orthodontic analysis. Each case must be counseled on its own merits. In addition, each orthodontically treated patient must be observed closely in the posttreatment retention phase, which should probably be much longer than usual, with particular attention devoted to prevention of lingual collapse or retroclination of the mandibular anterior teeth.


Traction--a surgical/orthodontic procedure. Maxillary crowding may cause failure of eruption of the canine. The teeth so displaced are directed buccally or palatally. In both cases, surgical intervention is indicated after space has been made in the arch. Palatally displaced canines are treated by surgical excision of palatal mucosa to promote eruption. Wide excision is indicated to prevent the healing process from covering the exposed tooth crown. Because of the anatomy of the buccal mucosa, however, surgical excision of the crowns of buccally displaced canine frequently results in periodontal problems. An alternative technique is therefore presented; this involves the surgical exposure of the crowns of buccally displaced teeth to allow the attachment of a wire traction hook. The crown is then recovered. The traction hook provides a point of attachment, so that orthodontic forces may be applied to the unerupted tooth to guide its eruption. The preservation of the mucosal flap ensures a normal epithelial attachment develops on the buccal surface of the tooth, and the normal gingival anatomy of the buccal mucosa is maintained. The procedure may also be used in cases where upper incisors have been prevented from erupting because of the presence of supernumerary teeth. Even after surgical removal of the supernumerary teeth, the permanent incisors often fail to erupt. In such cases, the placement of traction hooks will enable the orthodontist to bring the unerupted teeth into their correct positions in the arch.


Prediction of lower canine and premolar widths in the mixed dentition. The purpose of this investigation was to determine whether, with multiple regression analysis, a more accurate method than is now available for predicting the widths of unerupted mandibular canines and premolars of mixed-dentition patients could be developed. Regression analyses were performed on data derived from 83 Caucasian subjects (42 males and 41 females) who participated in the Iowa Growth Study. Measurements were taken on plaster casts of the mandibular incisors, canines, premolars, and first molars. Measurements of the mandibular canines, premolars, and first molars were obtained from periapical radiographs taken with a long-cone technique. Newly developed regression equations for each sex had the highest correlation coefficients and smallest absolute errors of estimate when compared to previously published methods. The new equations and previous prediction methods were tested on a sample of 55 orthodontic patients (23 males and 32 females). The newly developed equations were also the most accurate method of prediction in the orthodontic patient sample.


Circadian periodicity of the cell kinetics of rat molar periodontal ligament. Circadian periodicity of DNA synthesis (S) phase and mitosis over a complete 12-hour light/12-hour dark cycle was studied in rat molar periodontal ligament (PDL) with 3H-thymidine autoradiography. Maximum percent labeled cells was at 10 A.M. in all regions, and mean labeling (24-hour average) was 1.44, 0.93, and 1.46 percent for the crest, midroot, and apical areas of the PDL, respectively. Maximum percent mitotic figures were also at 10 A.M. in all areas studied, and the mean number of mitoses averaged over 24 hours was 0.19, 0.12, and 0.14, respectively for crest, midroot, and apical areas. Ratios of mean labeling and mitotic indices were 7.58, 7.75, and 10.43 from crest to apex. Duration of mitosis and S phase were estimated at 1.2 and 9 hours, respectively. Analysis of data suggested that stress/strain within the PDL, associated with masticatory function, has a regional influence on duration of S phase, mitotic rate, and percentage of cells in the S phase. These results help define an in vivo experimental model for assessing the PDL cellular response to biomechanically defined force systems. Clinical implications are discussed.


Use of an incisor diagnostic triangle for evaluating incisor positions relative to the APo line. Angular values of the upper and lower incisors to the APo line were measured in a sample of fifty subjects with clinically acceptable occlusions, ranging from 10 to 14 years of age. Correlations were high between both upper and lower incisor angulations to the APo line and the interincisal angle. The correlation was low between the upper incisor angulations to the APo line and the lower incisor angulations to the APo line. An incisor diagnostic triangle was introduced. This is made up of the interincisal angle and the intersection of the long axes of the upper and lower incisors to the APo line. Incisor diagnostic templates were introduced and their uses as diagnostic and visual aids were enumerated. These templates were constructed by using an idealized linear position of the tip of the lower incisors on the APo line, the upper incisor angulation to the APo line, and the interincisal angle. By relating both incisors to the APo line and to each other through the interincisal angle, the orthodontist is provided with a simple, specific diagnostic aid. The incisors are positioned in relation to a skeletal reference line (APo) which is more intimately associated with the patient's facial profile than more distant skeletal reference lines or planes, such as sella-nasion, Frankfort horizontal, or the mandibular plane.


The human chin and its relationship to mandibular morphology. This study evaluated the proportion of the external chin (protuberantia mentalia) in relation to the total symphyseal area in normal jaws and those with a diverse morphology. A sample of 60 cases was randomly selected and divided into three groups of 20 each on the basis of normal growth, horizontal growth and vertical growth with an open bite. Tracings of lateral dn frontal radiographs were used to describe general mandibular form and to determine the percentage of external/total symphyseal area. Dental casts were also examined to determine a basal arch form ratio. The results of this study indicate that the amount of bony chin present is related to certain morphologic features of the mandible. The most significant findings illustrate: 1. The chin increases in size as the mandibular type varies from a vertical type, to a normal type, to a horizontal type of growth pattern. 2. With dental "hypofunction" in combination with an exaggerated vertical development of the mandible, a smaller proportion of the protruding chin is present. 3. The chin increases in size as the mandibular basal arch form varies from a tapered shape for the vertical cases to a more square form in the horizontal cases. 4. The degree of lateral ramal flair does not appear to influence the proportion of protruding chin present. Several models have been presented which attempt to explain protuberantia mentalia variation. The evidence in this study supports the concept that mandibular morphology is the result of the action of compensative adaption in a developing structure. There appears to be an implied polygenic influence on symphyseal morphology operating from the cartilaginous cranial base and mandibular basilar bone. This may be manifested in the relative proportion of mandibular basal bone to cranial base width, and to the vector of cranial base growth. The ultimate proportion of the bony chin is viewed to be the result of mandibular adaption to a functional musculoskeletal balance in the craniofacial complex. The extreme variability of chin form in man may be considered to be the result of compensative growth developing in response to the most structurally efficient jaw form, the contiguous soft and hard tissue environment, and the intrinsic genotype of the mandible.


Tooth migration subsequent to surgical treatment of mandibular protrusion. Changes of the dental arch dimensions after surgical correction of mandibular prognathism are very limited. Except for a decrease of the mandibular intercanine width, an increase of the mandibular intermolar width, and a decrease of the maxillary dental arch length, the dentition remains remarkably stable. It thus seems that the changed function postoperatively does not result in great changes in the position of the teeth within the jaws.


Remodelling of collagen fibers in the periodontal ligament and the supra-alveolar region. Although the rate of turnover of collagen in the periodontal ligament may be somewhat higher than in the gingiva, it is doubtful whether this is the only factor that may explain why rearrangement of collagen fibers in the ligament occurs much more rapidly than in the supra-alveolar region under certain experimental conditions. It may well be that there are other factors that determine the ability of the periodontal tissues to rearrange themselves. On the basis of the distribution pattern of collagen phagocytosis by fibroblasts and the pattern of incorporation of 3H-proline it seems that turnover of collagen, at least in the periodontal ligament is evenly distributed across the width of the tissue. However, local variations in the presence of cells containing intracellular collagen fibrils may occur, as indicated by the observation that a relatively high concentration of ingested collagen fibrils is seen in fibroblasts in the direct vicinity of osteoclasts. It is suggested that coordinated action of fibroblasts and osteoclasts near the alveolar bone surface may represent part of a local mechanism through which rapid remodelling of certain areas in the periodontal ligament may be accomplished.


[Leukemia and hypercalcemia (author's transl)]. Two cases of childhood leukemia with hypercalcemia are reported. In the first case who died by acute granulocytic leukemia, autopsy showed a generalized calcinosis. The other case was an acute lymphocitic leukemia with hypercalcemia and destructive lessions of bones with pathologic fractures. Response to chemotherapy was good. Literature about mechanismes which can induce hypercalcemia in malignancy is reviewed.


Manpower for health services with special regard to primary health care. The World Health Organization recently reoriented its HMD program. Its aim is to collaborate with the 150 member states in their efforts to make the HMD process (planning, "production," management of health personnal) relevant to the needs of well planned health services. On the basis of this principle, properly planned PHC services should be manned by health teams in which each member is responsible for, and prepared to carry out, certain well-defined tasks to cover primary preventive, promotive, curative and rehabilitative health needs of the entire population. After an overview of the present situation and solutions which are often largely medically biased, a logical approach is proposed. On the basis of a functional analysis, job patterns should be defined for each worker in the PHC team on the principle that all health activities should be undertaken at the most peripheral level of the health activities as is practicable, by the workers most suitably, and not most highly, trained to carry out those activities. Health manpower plans should then be translated into training programs to help the learners to prepare themselves, and motivate them, to meet the challenges of PHC. Proper management of PHC teams is equally important to ensure both job satisfaction of team members and "consumer" satisfaction and improvement of health status for the people.


Primary care: contributions of nursing personnel. The planning of primary care services should not represent singular attention on one provider group to the exclusion of others. Rather the principal focus should be on the development of a national system of interdependent health care roles with viable mechanisms for communication and collaboration among providers. However, when recommendations and plans for such systems are considered it is important to remember that though all the data are not in, those available, some of which have been cited, offer compelling support for the view that more appropriate and less costly primary care services can be provided by thoughtfully constructed inter-disciplinary systems in which nurse practitioners have key roles in the provision of primary care and in planning and evaluating services. It is further suggested that not only will nurses so prepared be able to offer a broader range of services themselves, but they will be in a stronger position to work effectively with nonprofessional personnel.


Medical education for primary care.

Medical education for primary care. Teaching primary care is an important, but as yet, incompletely fulfilled responsibility of medical schools. The current surge of interest will not provide the needed personnel if primary care is defined too broadly, and if it is made everybody's business, but nobody's in particular. Primary care must not neglect first-contact care; it must be taught by an independent department which itself practices the full range of primary care services in settings which exemplify such care and which exhibit a team approach. It may be useful to consider a special track leading to primary care which differs from preparation for specialist care.


[Pyoderma gangrenosum, ovarian carcinoma treated with Melphalan and acute myelomonocytic leukaemia: report of one case and literature review (author's transl)]. A 67-year-old woman suffered from an ovarian carcinoma with lymph nodes metastasis. During 3 years, she was treated with alkylating agents (Melphalan). At the end of therapy, no recurrence was observed. Two years later, she developed concomitantly pyoderma gangrenosum and acute myelomonocytic leukaemia. Death occurred rapidly. The association between pyoderma gangrenosum and acute leukaemia is discussed in the light of 16 cases previously reported in the literature. In this case, an induction of leukaemia by cytostatic drugs seems likely. The authors conclude that pyoderma gangrenosum may be considered as a cutaneous signs of acute leukaemia.


Development of resistance to amphotericin B in Candida lusitaniae infecting a human. Candida lusitaniae associated with infection in a patient with acute myelogenous leukemia developed resistance to amphotericin B during systemic treatment of the patient. The organism, when isolated initially, was inhibited by 0.31 mug of amphotericin B per ml in yeast nitrogen base agar, but when isolated (20 days later) just antemortem and postmortem, required 100 and 50 mug/ml, respectively, for complete inhibition at 48 h.


Effective treatment for rhinopulmonary mucormycosis in a boy with leukaemia. Lymphoblastic leukaemia in a 3-year-old child was complicated by rhinopulmonary mucormycosis. This was successfully treated by surgical resection of the nasal mass, pulmonary lobectomy, combined with amphotericin.


Effect of oral D-penicillamine treatment on experimental arthritis and associated immune responses in rabbits. III: Reduction of the monoarticular arthritis. Treatment of rabbits with D-penicillamine at doses up to 30 mg/kg, beginning either before or after the onset of antigen-induced experimental arthritis, diminished the severity of the inflammatory synovitis in a considerable proportion of animals as judged by both external joint measurements and terminal histopathological assessment. D-penicillamine treatment had no effect on serum haptoglobin concentration, haemoglobin concentration, or platelet count. The venous blood white cell count was raised when D-penicillamine treatment was started before immunisation but not when treatment began after the onset of arthritis. A transient loss of appetite was observed in animals starting D-penicillamine treatment.


Transmission and scanning electron microscopy study on Burkitt-like leukemia. A young patient had Burkitt-like leukemia. The diagnosis was based on the presence of numerous vacuoles observed with the light microscope and confirmed by the finding of large lipid droplets and abundant ribosomes in the cytoplasm of the leukemic cells, seen with the transmission electron microscope. Scanning electron microscope examination of the leukemic cells showed the presence of a smaller number of microvilli and ruffles on the cell surface, which distinguished these cells from the blasts of other types of leukemia.


Cutaneous acute myeloblastic leukaemia and squamous cell carcinoma. A patient developed a cutaneous deposit of leukaemic cells within a squamous cell carcinoma as the first presentation of acute myeloblastic leukaemia.


Ocular complications in craniofacial fibrous dysplasia. Three cases of craniofacial fibrous dysplasia are reported, all presenting to the ophthalmologist first. They all had ocular complications due either to direct involvement of the orbital bones or to secondary complications. Sphenoidal mucocele is added to the other complications previously reported, and accordingly a classification of the various ways that fibrous dysplasia can affect the ocular structures is proposed.


Differentiation-associated changes in membrane proteins of mouse myeloid leukemia cells. The mouse myeloid leukemia cell line (M1) is known to differentiate in vitro into macrophages and granulocytes upon treatment with various inducers including mouse ascitic fluid. Changes of cell surface proteins during differentiation of M1 cells were analyzed by the lactoperoxidase-catalyzed radioiodination method and SDS-polyacrylamide slab gel electrophoresis. Treatment of the cells with ascitic fluid changed the electrophoretic pattern of the iodinated proteins, the prominent change being the appearance of a new protein with a molecular weight of 180 000 (P180). Iodinated P180 was also detected in normal macrophages in granulocytes, which are similar to differentiated M1 cells. This protein was metabolically labeled with L-[14C]fucose, increasing with the period of the treatment. P180 was not expressed on ascitic fluid-treatment of a resistant clone of M1 cells that could not be induced to differentiate. These results indicate that P180 is a glycoprotein that is exposed on the outer surface of differentiated M1 cells, and that its expression is associated with differentiation of the cells. P180 was solubilized from 125I-labeled macrophages with detergents bound to concanavalin A-Sepharose. This suggests that P180 is one of the receptors for concanavalin A. Therefore, P180 may contribute partly to the increases in agglutinability by concanavalin A and in the number of concanavalin A binding sites on the surface of M1 cells, which are known to be associated with differentiation of M1 cells.


On the occurrence of 5-methoxytryptamine in brain. A quantitative gas chromatography-mass spectrometry method has been used to determine 5-methoxytryptamine (5-MT) in the CNS and pineal gland of various species. The mean +/- S.D. levels of 5-MT in sheep, pig and cow pineal glands was 545 +/- 180, 228 +/- 119 and 117 +/- 48 pmol/g, respectively. The postmortem levels of 5-MT in the pig pineal gland was stable for 2 h after death but decreased by more than 90% 24 h after death. In the CNS, 5-MT was found only in the sheep hypothalamus (28 +/- 4 pmol/g). Analysis of the rat pineal gland and CNS failed to detect any 5-MT at the limit of sensitivity of the method which is at variance with previously reported results.


The "D circle": closed-circuit operation of the Bain circuit. A method of converting a Mapleson D (Bain) circuit to closed-circuit operation is presented, utilizing a laboratory air pump and a Waters carbon dioxide absorber canister to recirculate exhaled gas. The elimination of carbon dioxide from the circuit was studied and found to be adequate. The circuit would allow the use of low fresh gas flows for the maintenance of anaesthesia without the danger of carbon dioxide rebreathing. We suggest that such a circuit could provide appropriate conditions of gas humidity and temperature for endotracheal anaesthesia, while realizing the advantage of a circulator in mask anaesthesia is possible. Further design considerations for a "D circle" breathing system for clinical use are discussed.


The transcript from a DNA puff of Rhynchosciara and its migration to the cytoplasm. Electrophoretic analysis of 3H-RNA obtained from the proximal sections of Rhynchosciara salivary glands at two distinct developmental periods, one characterized by the presence and the other by the absence of the giant B-2 DNA puff, revealed that the appearance of a 14S poly(A)+ RNA is correlated with the opening of this puff. That this RNA species is transcribed from this puff is indicated by the fact that it is found in RNA extracted from B-2 puffs obtained by microdissection. This confirmed by the specific hybridization of the 14S poly(A)+ RNA to the B-2 locus. Our data indicate that the polyadenylation process takes place at the chromosome level, and that the nuclear sap is not an important compartment in the transport of polyadenylated RNA from the chromosome to the cytoplasm. The kinetics of migration of the 14S species to the cytoplasm were studied; the data indicate that this process is very rapid and, in addition, that the 14S RNA is unstable.


Characterization of active transcription units in Balbiani rings of Chironomus tentans. Specific active transcription units on chromosome IV in the salivary glands of Chironomus tentans have been visualized by the Miller spreading technique and in situ by conventional electron microscopy. These units are likely to be located in the two most conspicuous puffs on chromosome IV, Balbiani ring 1 (BR 1) and Balbiani ring 2 (BR 2). The transcription units in these Balbiani rings generate 75S RNA molecules constituting putative messenger RNA species for the predominant cellular product, the salivary polypeptides. Solitary active transcription units with a mean length of 7.7 micron were observed most frequently. The lateral ribonucleoprotein (RNP) fibers of each unit formed a single length gradient. The number of fibers per unit was 123 (+/- 24), or about 16 growing RNP fibers per micron of chromosome fiber. The considerable variation in the number of RNP fibers per unit suggests that transcription can be modulated at the level of the individual gene. The modulation is probably achieved via the initiation event and/or via an early pretermination step, but a change in the elongation rate could not be excluded. The number of polymerases starting to traverse the whole gene was estimated to be six per min and transcription unit, and the rate of RNA chain elongation was calculated to be 31 nucleotides per second at 18 degrees C. The properties of the chromosome fiber within the active 75S RNA units and also within their vicinity were studied in the Miller spreads. The inactive chromosome fiber exhibited a uniform beaded conformation, while the active fiber was sparsely and irregularly beaded. Furthermore, the chromosome fiber was more extended in the active 75S RNA unit than in inactive regions (DNA packing ratios of 1.6 and 1.9, respectively). By comparing the properties of the active 75S RNA gene with those of active genes in other systems, it was inferred that the loss of beads and the extension of the fiber in the active unit is probably directly related to the level of transcriptive activity. Finally, a smooth nonbeaded segment of 0.18 micron in length was found to precede the RNP fiber gradient. This segment may have a role in the process of transcriptional regulation. On the basis of comparison with the active transcription units in spread preparations. It was possible to identify active units in the Balbiani rings in sectioned material using conventional electron microscopy. In both BR 1 and BR 2 an active unit appeared as a loop, consisting of a fiber axis and having RNP granules attached to the loop axis by stalks. The growing RNP fibers therefore seem to be organized into granular structures during the transcription process, and the final products in BR 1 and BR2 are granules, 500 A in diameter, each containing a 75S RNA molecule.


Evaluation of standard decompression schedule by agarose gel method. The Standard Decompression Schedule was evaluated by the method of bubble formation in agarose gel, the result of which can be summarized as follows: 1) The number of bubbles formed in agarose gel corresponded well with the exposed pressure. 2) The technique of this method was simple and the number of bubbles was accurately counted. 3) Eventually, this method was useful for examining the decompression schedules. 4) It is not always safe to follow the Standard Decompression Schedule in some pressure conditions. 5) As to the period of time that a person is able to tolerate a high pressure condition, the prescription of the Standard Decompression Schedule is not necessarily correct. 6) The number of bubbles was small by the proper decompression schedule, for example, in the cases of exposure above the 60-meter depth of water. 7) This method can be applied for the prevention of decompression sickness when the agarose gel samples are attached to the workers during the compressed air work. 8) The number of bubbles was inconsistent with the coefficient of body pressure (1. N2 in the body), therefore it is not necessarily safe to rely only on the coefficient of body pressure. 9) To prevent osteonecrosis, the Standard Decompression Schedule is not proper, a deeper first stop and slower ascent being recommended.


Abrasive properties of commonly used dentifrices. This study was conducted to examine the effect of various dentifrices on the abrasion of acrylic resin and extracted human tooth. The influence of the difference in the hardness of the filament of the toothbrush on the abrasion was also studied, using three kinds of toothbrushes. The specimens (acrylic resin and extracted human tooth) were brushed 3,000 times by the back- and -forth stroke movement using a toothbrushing machine for two hours. The surface irregularities of the specimen were analyzed by the surface analyzer and observed by the scanning electron microscopy before and after the brushing procedure. Moreover, the weight loss of the test specimens of the acrylic resin materials was determined, weighing them by a microbalance before and after brushing. The abrasiveness of the dentifrices showed a wide range, but the abrasiveness of the toothbrush itself was not observed. All dentifrices except one which did not contain the abrasive materials had abrasive effects on both the acrylic resin and human tooth. There was a high correlation (r = 0.96) between the weight loss and the surface irregularities in the case of acrylic resin.