Affinity purification of cardiac adenylate cyclase: dependence on prior hydrophobic resolution.

The interaction of cardiac adenylate cyclase [ATP pyrophosphate-lyase (cyclizing); EC 4.6.1.1] with a variety of nucleotide affinity resins was systematically investigated. None of these resins effectively bound the native, detergent-solubilized enzyme. However, after hydrophobic resolution on an uncharged resin consisting of long-chain alkyl groups linked to agarose via ether bonds, 40% of the adenylate cyclase activity biospecifically adsorbed to an ATP affinity resin. Gel filtration without detergent after hydrophobic chromatography demonstrated that the enzyme eluted in the identical position as the native enzyme chromatographed in the presence of detergent. This preparation almost completely biospecifically adsorbed to the same ATP-resin and was not eluted with 5 mM cyclic AMP, pyrophosphate, or GTP. If the GTP-washed immobilized enzyme was subsequently desorbed with ATP, then expected Gpp(NH)p (5'-guanylyliminodiphosphonate) sensitivity persisted. A preliminary purification scheme that resulted in an approximate 5000-fold increase in specific activity is presented. These observations indicate that a membrane-bound enzyme may appear to be intrinsically hydrophobic only by virtue of aggregation with other hydrophobic constituents and that prior separation of hydrophobic chromatography may permit such proteins to be fractionated subsequently by methods conventionally applied to hydrophilic proteins.


Energy conformation study of Met-enkephalin and its D-Ala2 analogue and their resemblance to rigid opiates.

Conformational similarities of Met-enkephalin and its D-Ala2 analogue to rigid opiates were studied by both empirical and quantum mechanical methods. By both methods, conformers with maximum resemblance to rigid opiates have the highest energies. Conformers with the lowest energy had no resemblance to rigid opiates. However, several low and intermediate energy conformers were identified in which at least the NH2-terminal tyrosine residue overlaps with the phenethylamine moiety of rigid opiates and which could equally well accommodate either Gly2 or D-Ala2. The conformer among these with greatest additional resemblance to other binding sites of rigid opiates is proposed as the most likely candidate for an induced fit at the receptor site.


Abnormal cellular localization of thyroglobulin mRNA associated with hereditary congenital goiter and thyroglobulin deficiency.

The goiters in a breed of hypothyroid goats contain only minute amounts of thyroblobulin-related antigens (0.01% of normal value). We have analyzed these goiters for the presence of mRNA coding for thyroglobulin. Using DNA complementary to beef 33S thyroglobulin mRNA as a probe, we found that the mRNA sequence is present in the goat goiter but at a concentration 1/10-1/40 that of normal goat thyroid. Hybrids of cDNA with either goiter or normal thyroid RNA exhibited identical sharp melting curves which suggests that the same RNA sequence is responsible for hybridization in both tissues. Normal goat thyroid contains a population of large membrane-bound polysomes engaged in throglobulin synthesis. In contrast, such polysomes are absent in the goiter. In regard to subcellular distribution, the relative amount of the thyroglobulin mRNA sequences from the goiter in nuclear RNA was 42% of normal, in cytoplasmic RNA was 7% of normal, and in the membrane fraction was only 1-2% of normal. Our results suggest that the lack of thyroglobulin in these goiters is due to a defect in thyroglobulin mRNA which leads to aberrant processing and/or transport of it from its site of synthesis to the endoplasmic reticulum.


Ovalbumin: a secreted protein without a transient hydrophobic leader sequence.

Ovalbumin mRNA was translated in a reticulocyte lysate. The primary translation product starts with methionine derived from Met-tRNAf. When the nascent polypeptide is about 20 residues long, this methionine is removed. The new NH2-terminal glycine is acetylated from acetyl-CoA when the polypeptide is 44 residues long. The sequence of 35 residues at the NH2 terminus of ovalbumin was determined by automated Edman degradation after a method was devised to prevent acetylation during protein synthesis in the reticulocyte lysate. This sequence is the same as that of secreted ovalbumin and does not resemble the transient "signal peptides" associated with most secretory proteins, including three other egg white proteins synthesized in the same cells as ovalbumin.


Aphagia, adipsia, and sensory-motor deficits produced by amygdala lesions: a function of extra-amygdaloid damage.

Small bilateral electrolytic lesions confined to the region of the central nuclei of the amygdala failed to affect food and water consumption in male rats. More medially-placed lesions which damaged portions of the internal capsule, entopeduncular nucleus and globus pallidus adjacent to the central nucleus produced transient aphagia and adipsia accompanied by sensory-motor impairments that interfered with the act of feeding, as evidenced by a large postoperative increase in the amount of food spilled. In some cases lesions restricted to the internal capsule and entopeduncular nucleus produced these sensory-motor deficits but no aphagia or adipsia. Small lesions damaging primarily ventral portions of the posteromedial pallidi resulted in aphagia and adipsia but no apparent sensory-motor impairment. The results indicate that at least two, possibly independent, deficits in food intake may be produced by lesions in the immediate area of the dorsomedial amygdala. It is suggested that the effects on ingestive behavior which several investigators have observed in rats with dorsomedial amygdaloid damage may in fact be due to incidental destruction of adjacent tissues.


Insulin-induced hyperphagia in alloxan-diabetic rats fed a high-fat diet.

Alloxan-diabetic rats fed a standard, low-fat diet lost body weight and were hyperphagic; those fed a high-fat diet lost comparable amounts of weight, but did not overeat compared to normal animals. When given injections of protamine-zinc insulin, all diabetic rats gained weight; however, while those fed the low-fat reduced food intake from elevated levels, diabetics fed the high-fat diet became hyperphagic. Diabetic rats maintained on a high-fat diet increased food intake during long-term insulin treatment sooner and to a greater extent than normal controls. These findings are interpreted in light of the effects of insulin on storage and supply of metabolic fuels.


[Prevention of caries and osteonecrosis through daily local fluoridation in radiotherapy patients].

The healthy dentition of 432 patients treated by radiotherapy for ENT and salivary gland lesions was preserved and subjected to a programme of strict hygiene and daily local fluoride application using a gel containing 1% of sodium fluoride. Effectiveness in terms of the prevention of caries was satisfactory. Caries developed in only 7% of the patients. None of the patients in whom there was a clear indication and who followed treatment carefully to an extent greater than 70% suffered decay. Thorough initial assessment, and very careful selection of cases should make it possible in the future to avoid the majority of sources of failure observed. The prevalence of osteo-necrosis secondary to dental preservation was 1.2%, identical to the prevalence of trophic complications seen in patients who underwent total extraction before radiotherapy. The technique of fluoride application is simple, with no risk of toxicity, but must be continued indefinitely. Preservation of the dentition must be undertaken only with the close cooperation of the responsible medical and odontological teams, the latter being responsible for the initial assessment, care and surveillance. Preservation of a healthy dentition together with the possibility of early fitting of a prosthesis if necessary contribute to the rapid functional rehabilitation of patients irradiated for malignant disease in the ENT area.


[Arterial embolization in malignant neoformations of the face and neck].

On the basis of 25 cases of embolisation for cervico-facial tumours, it was possible to demonstrate the value of this technique in the treatment of local haemorrhage and in the relief of pain in patients with a lesion beyond hope of any treatment.


[Bone involvement in labial cancer].

22 patients out of 256 treated for labial carcinoma showed evidence of mandibular involvement. In 6 cases, this involvement was by direct tumour extension, in 4 blood-borne metastases inferior dental and chin veins, and in 11 cases bone involvement occurred via a metastatic lymphadenopathy. The last case was mixed.


[Lithiasis of accessory salivary glands].

With respect of three new cases which may be joined to five others previously reported, the authors emphasize that lithiasis of the minor salivary glands is more ignored than uncommon. That misreading is the consequence of the ordinary X-ray transparency of these little calculus. Diagnosis is grounded on the finding of the enlarged orifice of the gland and its suppuration. Treatment may be limited to the only extraction of the calculus. Prognosis is excellent: multiple forms and relapses are rare.


[Parotid lithiasis. Surgical tactics].

Calculi situated behind the buccinator muscle must be approached via a parotidectomy incision. In many cases, simple removal of the intra-canalar or intra-parenchymatous calculus is sufficient.


[Orthodontic and surgical approach to mandibular prognathia. Prevention of recurrences].

The authors emphasize the necessity for a combined orthodontic and surgical approach to the problems posed by the treatment of mandibular prognathia. They feel that the major source of recurrences is related to the alveolar changes which accompany the new basal maxillo-mandibular relationship and the resultant modifications in muscular equilibrium. The prevention of recurrences must therefore take into account the prediction of adaptive remodelling of the alveolar processes.


[Assymmetry of the axes of the mandibular condyles in the horizontal plane. Preliminary note].

On X-rays taken in the Hirtz position, the aurthors measure:--the axes of the condyles,--the axes of the petrous temporal bone, --The condylo-pterygoid axes. Variations in these axes are studied. The axes of the petrous temporal bones would appear to be a fixed indicator for the structures of the base of the skull.


[Costal vascularization and pediculated costal grafts in mandibular reconstruction with intercostofacial microanastomosis].

As an applied study of the human costal vascularisation, the authors describe the technique of costal graft in the reconstruction of the mandible with intercosto-facial micro-anastomosis. The accent is placed upon the value of these grafts. They describe the methods for determination of the survival of the vascularised bone (X-ray, technetium pyrophosphate and labelled red cell bone scan, hyperselective arteriography and bone biopsy).


Salivary fluoride and calcium concentrations, and their relationship to the secretion of saliva and caries experience.

Samples were collected from the stimulated saliva of 113 students enrolled in institutions of higher education. The students were divided into three "carries-diagnostic groups" on the basis of indications given by the Dentocult saliva test, which shows the frequency of lactobacilli and other aciduric microorganisms in saliva. The frequency of such microorganisms in 1 ml saliva in Group A was less than or equal to 103, in Group B greater than 10(3), less than 10(4) and in Group C greater than or equal to 10(4). The rate of secretion of saliva in Group A was significantly higher than in Group C (P less than 0.05). On the average, a rise was noted in the fluoride and calcium concentrations with increasing "caries activity". In the material as a whole, there was a negative and highly significant correlation between the secretion rate of saliva and the concentrations of fluoride and calcium. In the examination by groups, significant correlations were observed between fluoride concentration and rate of saliva secretion in Group A, and with respect to fluoride and calcium only in Group C. The results suggest that the extra salivary fluoride is likely to be derived from the enamel.


Histologic and microradiographic observations on teeth during calcium deprivation in rats.

Adult female rats were subjected to severe calcium deprivation by feeding them a calcium-deficient diet containing oxalate (Group a). Furthermore, pregnant and lactating animals were subjected to the same diet (Group b). The mandibular teeth were examined by histologic, microradiographic and fluorescence microscopic techniques. The incisor enamel was found to be nearly unaffected by the experimental regimen; the dentin formed and mineralized during the experimental period was abnormal only in Group b. Characteristic features were reduced thickness, increased width of predentin and numerous globular defects. Both ameloblasts and odontoblasts were seemingly normal. No obvious differences could be observed between the molars from the controls and the test groups (a,b). "Cementolysis" seemed to be present to the same extent in all groups. In some of the animals of Group b some carious or erosional defects were observed in the molars. These may at least partially account for a small reduction in molar ash content observed in this group.


Hardness testing of some fissure-sealing materials.

The mechanical properties of fissure-sealing materials are of significant importance for their durability, i.e. their wear resistance. One of the methods of evaluating a material's resistance to attrition is to apply a hardness test. In the present investigation, the surface hardness of some fissure-sealing materials was tested. Sealants made from diluted composite materials and with inclusion of inorganic filler particles appeared to have a considerable higher surface hardness than the other sealing materials tested.


Microstructure of inner surfaces on composite restorations related to filling procedure.

The inner surfaces of 40 Concise restorations placed in vivo on permanent molars have been studied by scanning electron microscopy. Only grinding traces could be seen on fillings from cavities which had not been etched, while the morphologic structure of the enamel and dentin was reflected on fillings from acid-etched cavities. Application of low-viscous non-composite resin in the cavities before filling with the composite resin did not influence the enamel pattern on the fillings, while the amount of processes of resin corresponding to the dentinal tubules in etched cavities was significantly increased. In the discussion the difference in surface structure of the fillings is correlated to marginal leakage along similar restorations.


Epithelial-like cells in culture derived from human gingiva: response to nickel.

To obtain gingival cell cultures, human gingival tissue was minced and/or subjected to trypsin treatment with or without prior separation into epithelial and connective tissue portions. The tissues were then incubated in Eagle/Earle's MEM with 10% fetal calf serum in a humidified atmosphere of 5% CO2 in air. Fibroblast-like cell cultures were regularly obtained, and one culture showed epithelial-like cell islets that could be transferred and kept in continuous culture. These epithelial-like cells exhibited bone resorption stimulating activity as seen in gingival tissue and retained their growth pattern after prolonged storage. They were able to grow at serum concentrations down to 2.5% and with equal doubling time (about 17h) in rich or minimum essential media. Exposure to nickel gave toxic effects on the growth at concentrations down to 2.5 microgram/ml of nickel. In spite of the affinity of nickel to certain serum components, the serum concentration did not appear to be of specific importance to protect or aggravate the toxicity. It is felt that these cells may be of value for research on cytotoxicity of dental materials.


Agreement between clinical and histologic findings in chronic coronal pulpitis in primary teeth.

Pulpotomy, a common endodontic procedure in primary teeth, is usually performed because of carious exposure of the pulp, which means that at least a part of the pulp is chronically inflamed. A favorable outcome of pulpotomy combined with the use of calcium hydroxide presupposes that the root pulp is healthy. No wound dressing is known to induce healing of chronically inflamed pulp tissue. 37 primary teeth with no clinical or radiographic symptoms of total chronic pulpitis were extracted and the pulp was studied histologically by light microscopy. The histologic diagnosis of a healthy root pulp was based on absence of any infiltration of mononuclear lymphocytes. Agreement between the clinical and histologic diagnosis was found in 30 out of 37 teeth.


Long-term prognosis of traumatized permanent anterior teeth showing calcifying processes in the pulp cavity.

122 traumatized teeth with radiographic evidence of abnormal hard tissue formation in the pulp cavity were examined 10-23 years (mean 16 years) after the time of injury. Judged radiographically, partial obliteration (pulp chamber not discernible, root canal markedly narrowed but clearly visible) had occurred in 44 teeth (36%). Normal periradicular conditions were found in all teeth with partial obliteration. Seventy-eight teeth (64%) were recorded as totally obliterated. Pathologic periradicular changes indicating pulp necrosis as a sequel to the total obliteration was observed in 16 teeth (21%). The late development of pulp necrosis was significantly related to teeth classified as severely injured, and to teeth with complete root formation at the time of injury. Furthermore, a comparatively rapid progress of the calcifying process appeared to be correlated with periradicular radiolucency.


Furfurals in chlorhexidine-discolored pellicle.

The purpose of the present study was to investigate the possible presence of furfurals in chlorhexidine-discolored pellicle. Pellicle material was scraped off teeth and hydrolyzed in sulfuric acid and the hydrolysate then extracted with ether and examined by thin layer chromatography and gas chromatography-mass spectrometry. The presence of furaldehyde in discolored pellicle was demonstrated by these methods. There were also indications of hydroxymethyl furfuraldehyde in the thin layer chromatograms.


Variations in structure within the trabecular bone of the mandible.

A study of the intramandibular variations in bone mass, coarseness of the bone trabeculae and bone activity between incisor, premolar, and molar regions has been carried out, as well as estimation of possible differences in these variations between groups of mandibles with different dentition. The material consisted of 24 autopsy specimens of half mandibles from normal subjects. Microradiograms of ground sections from incisor, premolar, and molar regions were used. Quantitation of bone mass was done by an electronic point-counting system. The analysis indicates that (1) the variations in bone mass within same region are marked, (2) trabecular bone is denser and more delicately woven in the incisor region than in either premolar or molar regions, where mass of bone is the same, although there is probably more delicately woven trabecular bone in molar region, (3) bone activity lies on the same level all over in trabecular bone within the mandibular body and (4) the variations of these factors seem to be independent of state of dentition in the single mandible.


In vitro corrosion of dental amalgams with different Cu content.

Both Cu amalgam and Sn-containing Ag amalgam alloys with Cu contents ranging from 2 to 30% were used in the investigation. The amalgams were placed in artificial saliva and the content of the dissolved Cu was determined after 1 month. The amalgam remained in the saliva for another 5 months. After the amalgams were removed from the solution, metallographic and microprobe examinations were made. The Cu amalgam released about 10 times more Cu to the artificial saliva than any of the other amalgams. The dispersion type amalgams showed a relatively large dissolution of Cu, while a smaller release was found from amalgam made of powder with one composition. The phases that appeared to be corroded first were gamma2 and Cu-Sn phases. In dispersion type amalgams the gamma phase appeared to be attacked. Most of the corrosion products remained inside the amalgam and were identified to be tin oxide chlorides.


Erythrophagocytosis by acute lymphoblastic leukaemic cells.

Phagocytosis of erthyrocytes and platelets by bone marrow blast cells has been noted in 4 patients in the late relapse of acute lymphoblastic leukaemia (ALL). The underlying mechanism is unclear but prolonged course of the disease seems to be a major factor in the emergence of cells with phagocytic properties.


[Once or 3 times daily toothbrushing: theoretical basis and practical reality].

Should teeth be cleaned once or three times a day? Although scientific data imply that teeth may be efficiently kept clean by brushing them once but throughly, and although it is true that brushing one's teeth several times a day incompletely is a nonsense, such recommendations should be given only to the fully motivated and cooperative patient. Expecting results by telling this to children, teenagers and to 20--30 year old adults would provoke an increase of caries incidence particularly in the proximal area of the teeth. To renounce to the removal of food debris several times a day is indicated only in middle aged people, where the danger of new carious lesions is diminishing. With optimal home care one cleaning a day may suffice, but a patient who is sensitized to a clean feeling in his mouth will want to remove food debris all by himself.


[Gamma scan findings in various bone processes in the jaw region].

Bone scintigraphy is a new means to early diagnosis of primary and secondary bone tumors, before significant radiological changes occur. The method is used with the osteotrope radioisotope 99mTc. Scintigraphy is most important in the determination of extent and localization of malignancies, relative to the indication for surgery, the tactics of surgery and for the diagnosis of recidives. In osteomyelitis, it facilitates early discovery and judgement of a florid or chronic process.


The enamel substrate-characteristics of the enamel surface.

The outer enamel surface is of considerable interest in dentistry as it is the substrate for the acquired pellicle; the pellicle itself is the plaque carrier. In this paper the interface between outer enamel and pellicle is discussed with special emphasis on the outer enamel from a structural and chemical point of view. The outer enamel layer (less than 1 micron from the anatomical surface) is most likely a non-stoĭchiometric apatite. The chemical composition is obviously strongly different from the composition of bulk enamel. A model for the structure and atomic composition of surface enamel is presented. The available experimental evidence indicates that at an atomic scale, enamel crystallites have mainly phosphate groups (HPO42-groups) on the solid surface; the liquid adhering Stern layer contains most likely large amounts of calcium ions.


Genetic manipulation in higher organisms. I. Goldfish ova as materials of operation, mRNA mediated alteration of the liver specific isozymes.

Both crucian and carp egg-mRNAs were found to mediate the transformation of goldfish tail from the double (veil-shaped) to the single (fork-shaped). Livers of these single tailed goldfish were tested for genetic change using lactate dehydrogenase isozymes (LDH) as marker. Electrophoresis of liver extracts on starch gel showed that the liver specific LDH-C4 isozymes of both the egg-mRNA and liver-mRNA injected goldfish resembled the control goldfish except an additional intermediate band. The migration distance of this new band matched the third band of the hybrids (carp X goldfish). These findings lead to the conclusion that carp egg-mRNA contains a fraction partly responsible for liver development. Rat liver was found possessing the cathodally migrating C4 isozymes. Injection of rat liver-mRNA into goldfish eggs resulted in the intensification of the liver specific C4 isozymes. It appears therefore that the input informational molecules (liver-mRNA) and the output molecular products (liver C4 isozymes) are causally related. This causal relationship would pave the way for genetic manipulation in higher organisms.


[An interesting case].

It is reported of a case of complex odontoma preventing the eruption of a molar. After surgical removal of the odontoma, the tooth erupted.


[Indications and execution of early treatment].

42% of the school children show malocclusion. Eugnathic dentitions are observed in only 26%, and there is a downward trend. For this reason, orthodontic prophylaxis is practised systematically in Poland. All the children in nurseries, nursery schools and the first three forms of the elementary schools are involved. They are subdivided into 4 groups. Children with eugnathic dentitions are in the first group; children with severe anomalies, in the fourth group. The first group needs only supervision. The second group benefits from prophylactic measures performed by a paedodontist. In the third group, a paedodontist institutes a causal therapy using simple means. Complex orthodontic treatment by an orthodontist is needed only in the fourth group.


[Results with multi-band appliances in the treatment of class II].

Corrections of Angle's Class II malocclusions constitute nearly 1/4 of the treatments performed by the orthodontist. The author studied the results achieved with treatment methods applicable to these malocclusions and compared them with those obtained by means of multiband appliances. On the basis of 2,110 cases, he establishes the indications for the use of multiband appliances in the framework of social dental treatment.


[The system and realization of orthodontic treatment in Sweden].

The need for treatment is subdivided into 4 degrees of severity. Nearly 12% of the 7-16-year-old children and adolescents are in urgent need of treatment. The mean duration of treatment (per patient and year) is 4.2 hours. From this it is calculated that 1 orthodontist will be required for 24,000 residents or for 3,500 children and adolescents aged between 7 and 16 years. In Sweden each province (24) has at least 1 orthodontic clinic that is responsible for treatment and advice. The free treatment of patients being in urgent need for treatment is realized by an orthodontist in cases with a high degree of severity, and otherwise by a general dental practitioner who works indepently or takes the advice of an orthodontist.


[Representative study of morbidity in the Berlin population].

Representation of the frequency of crowding in a sample of 657 Berlin residents aged between 18 and 30 years. Sex and age distribution of the examined individuals with regard to the severity and location of crowding. Relationship of the crowding with the symptoms of Class III malocclusion, perversion in the position of the canine and cross-bite.


[Indication and realization of orthodontic extraction therapy].

In establishing the indication for extraction therapy, careful consideration should be given to the unharmonious relationship of the jaw and teeth, the apical bone, the anlage of the wisdom teeth and hypodontia. Beginning with the narrow, contracted dental arch, where extractions are indicated most frequently, the different groups of anomalies are discussed. The most important rules and the optimal time are dealt with at the end of the present review article.


[The suitability of the general evaluation of pupils in their report books for the prediction of their cooperation as orthodontic patients].

The author reports studies in which the ratings in the markbooks prior to orthodontic treatment are compared with the quality of subsequent co-operation. The 145 patients were subdivided into three groups differing in co-operation and rating by the teacher, respectively. It was found that there existed a statistically significant correlation between the prognosis deduced from the general rating and the actual co-operation.


[Fluoride metabolism in the rat. 2. Distribution in a number of soft tissues].

From their studies on fluorine metabolism, the authors present some results concerning the distribution of fluorine in a series of soft tissues in relation to the fluorine concentration in the blood and to the uptake by the hard tissues after intravenous injection of fluorine-18. Unlike the hard tissues, the soft ones showed no storage of fluorine.


[Rheography in the periodontium. Preliminary report].

The authors describe rheography as a method for assessing the blood circulation in the periodontium. With regard to material expenditure, electrode design and application to the alveolar ridge and the data obtained, the experimental arrangement presented by the authors proved to be a rapidly applicable and informative method of investigation, the results from which will be reported later on.


[Changes in the dental hard tissues and supporting structures in tetanic syndrome. I. Review of the literature].

The authors give a survey of the literature on the tetanic syndrome and its effects on the dental hard tissues and the tooth supporting structures. In cases of normocalcaemic tetany, no pathological alterations have been observed in the dental hard tissues, the pulp and the periodontium. On the contrary, enamel hypoplasia, broad pulp chambers, shortened tooth rootsdelayed dentition, hypodontia, inflammatory changes and bleedings from the periodontal ligament, bone densification and chronic gingivitis have been found in patients with hypocalcaemic tetany.


[Changes in the dental hard tissues and the supporting structures in tetanic syndrome. 2. Personal studies].

The authors present the changes of the orofacial system observed in 30 patients (of both sexes) with tetanic syndrome in the framework of a pilot study. The DMF-S values varied for different age groups from 40.6 to 79.5. The hypoplasia index was 1.3-2.1; and the periodontal disease index according to Kötzschke, 18.6-48.2%. Epithelial desquamation of varying markedness and intensity was seen in half of the patients. The interpretations of the radiographs revealed generalized denticle formation in 13.3% of the 30 patients; and isolated denticles in 73.3%. The authors observed a loosening of the spongiosa structure in the majority of patients, and localized radiolucencies of the jaw bone in two thirds of them. The average intra-alveolar root-length index was 46.4%.


[Fibrous dysplasia].

Fibrous dysplasia of bone may occur also in the facial skeleton. Main locations are the lateral midface and the mandible. The foci, which are sharply circumscribed in most cases, produce tumour-simulating deformities of single of several facial bones and, in part, disorders of the articulation are bulbar displacements. In contrast to Paget's disease, fibrous dysplasia is a disorder of the younger age groups. Apart from bony changes, Albright's syndrome (which occurs in women only) comprises also irregular, circumscribed café-au-lait patches and signs of somatic and sexual precocity.


[A dentinoma with rare localization].

On the basis of a report of a dentinoma measuring 2 X 2 cm that had rounded the carious tooth and extended far into the antrum, the authors present some fundamental ideas of the pathogeny, clinical picture, therapy and morphology.


Rapid cytoreduction in acute leukemia. Management of cerebral leukostasis by cell pheresis.

A patient with acute myelogenous leukemia and symptoms of cerebral leukostasis failed to respond to initial chemotherapy. Reduction in blast count from 220,000/microliter to 40,000/microliter was accomplished over a five hour period by leukapheresis using an intermittent flow cell separator, and symptomatic improvement was dramatic. The technique is simple and rapidly effective and may prove a useful adjunct in the treatment of patients with acute leukemia and high blast counts.


Management of chronic myelocytic leukemia in pregnancy by cell pheresis.

Cell pheresis was employed in the initial management of a pregnant patient with chronic myelocytic leukemia (CML). Reduction in circulating leukocyte and platelet counts was evident after two weeks of therapy. This technique is an effective mode of management of the pregnant patient with CML and may play an important therapeutic role in the treatment of other myeloproliferative diseases characterized by dangerously high levels of circulating platelets or myeloblasts.


Radiotherapy and surgery in 50 cases of osteosarcoma treated without adjuvant chemotherapy.

A consecutive series of osteosarcoma patients from one hospital is described. In 1962 radiotherapy with delayed surgery according to Cade was replacing surgery alone as the adopted treatment programme. Statistically the results were the same before and after this time with 5 out of 29 and 6 out of 21 patients, respectively, surviving 5 years. With radiation alone none out of eight survived. Surgery alone produced 3 out of 14 and radiation with delayed surgery 6 survivors out of 15. As surgery with or without radiotherapy is equally ineffective in controlling osteosarcoma a prospective randomized trial of the relative merits of chemotherapy and interferon as adjuvant therapy seems highly desirable.


Cessation of therapy in childhood leukemia. A survey of 160 cases from the Nordic Countries.

A survey is presented of 160 children from the Nordic countries who had their antileukemic therapy discontinued prior to November 1976. Twenty-seven of the 160 cases (17%) had suffered a relapse before May, 1977. Sixty-nine cases had their therapy stopped in the first ten months of 1976. All cases have been reported as acute lymphocytic leukemia. Different types of therapy schedules have been used. Thirty-five cases in sustained remission for more than 3 years without cessation of therapy are also included in the report, seventeen of whom had relapsed while still on therapy. Central nervous system or testicular relapse occurred in 21 of the total 44 cases who relapsed after three or more years of continuous remission, and whether they were on therapy or not.


[Double skin cancer coexisting with chronic myeloid leukemia].

In a 71-year-old man chronic myeloid leukaemia was diagnosed 4--5 years after cure of pulmonary tuberculosis and removed auricular cancer and 2 years after nasal cancer cured by means of local radiotherapy.


Increase in serum alkaline phosphatase (S-ALP) in chronic myelocytic leukemia--sign of drug-induced cholestasis?

In four patients with chronic myelocytic leukemia, a solitary rise in serum alkaline phosphatase (S-ALP) was noted 2--12 months prior to death. All patients had received busulphan (Myleran) therapy for longer than 12 months (total dosage 1.0--2.4 g). It is suggested that the increase in S-alp was due to a cholestatic liver damage, possible secondary to the busulphan treatment.


Ternary copper (II) complexes containing salicylate and nitrogenous chelates such as histamine.

In the introduction the chemistry of some bivalent copper complexes of aspirin and salicylate is briefly reviewed and the biological importance of mixed-ligand complexes of bivalent copper is illustrated. The nature of hydroxy-bridged copper (II) complexes and their possible role in the physiological activity of histamine is also discussed. Several neutral, insoluble copper (II) complexes of the type (Chelate-Cu-salicylate) 0-lambda H2O where chelate = 1, 10-phenanthroline (phen), chi = 1; 2,2'-bipyridyl (bipy), chi = 2; histamine (Ha), chi = 1; and where salicylate (sal) = dianion of salicylic acid have been prepared for the first time. They have been characterised by physico-chemical methods and the role of binuclearhydroxy-bridged copper (II) complex ions in their formation is demonstrated. Such complexes may be relevant to the pharmacological action of histamine and of the salicylates, the copper complexes of which are potential anti-inflammatory drugs. Results of some in vivo experiments that have been carried out with mice are also presented.


Lysosomal enzymes of phagocytic cells as humoral mediators of inflammation: modulation of their release by cyclic nucleotides.

The origin of lysosomes in phagocytic cells is described. Studies on their characterization by both morphological and biochemical methods are summarized. Lysosomal enzymes of both polymorphonuclear leukocytes and macrophages can be released by exocytosis in response to a variety of inflammatory stimuli. This response is modulated by cyclic nucleotides. In the polymorphonuclear leukocyte cAMP inhibits enzyme release while cGMP enhances release; the effects of the cyclic nucleotides are less clear in the macrophage. The possible involvement of microtubules and microfilaments in the release process is discussed.


Clinical evaluation of novel anti-rheumatic drugs.

New methodology is required to evaluate new drugs. Trials designs and measurements developed for conventional anti-inflammatory therapy will fail to demonstrate the properties of a group of novel anti-rheumatic agents including gold, penicillamine and levamisole. These compounds act slowly, producing their maximum effect after 6 months of treatment. Trials must therefore be of at least this duration and it is useful to document the time course of the action. Measurements of rheumatoid arthritis must include not only conventional indices of disease activity (pain, morning stiffness, articular index, swelling) but also extra-articular features such as nodules, E.S.R., and rheumatoid factor titre. Reduction in technetium index is a feature of the action of drugs of this type. Changes in immunoglobulins and in some other immunological measurements may also be useful. Future trials must look increasingly at modes of action of drugs and the factors which determine the presence or absence of a response in an individual patient.


Histopathology of acute and chronic inflammation.

Inflammation, defined as local reaction to injury, is basically a homeostatic process-loop system with morphological and biochemical components. If this homeostatic loop is uncomplicated a normal situation is reached soon after injury. Morphologically different patterns of inflammation can appear, depending on the character and intensity of the injury. Furthermore, the contributions made by hyperaemia, exudation of fluid, infiltrates carrying inflammatory cells, and cell proliferation not only vary with the type of injury but also depend on the time after injury. Some of the histopathological changes can be seen as essential for the restoration of the normal situation, whereas others damage the tissue more than seems desirable. The morphological aspects of different types of inflammation are discussed in relation to the homeostatic nature of the inflammatory process.


Cell kinetics during inflammation.

This communication deals with the production and kinetics of mononuclear phagocytes and polymorphonuclear phagocytes in the normal steady state and during an acute inflammatory reaction and with the humoral regulation of the increased production of leucocytes during an inflammatory reaction. The effect of hydrocortisone and azathioprine on both kinds of phagocytic cells is also discussed.


Inflammatory responses of the rabbit eye to prostaglandins.

A modified Draize scoring procedure has been used to quantify the vascular effects of prostaglandins on the rabbit eye. Topical application of 100 microgram of PGE1 caused conjunctival redness (erythema due to vasodilatation), swelling (oedema due to increased capillary permeability), discharge, lids closure (decrease in palpebral aperture) and occasionally miosis, though no corneal or iridial damage was detected up to three hours. PGE1 and GE2 produced practically identical dose-related increases in scores for most of the inflammation parameters, though oedema responses were consistently lower after PGE2. The neutral, triethanolamine salt of PGE1 was as inflammatory as PG1 itself. PGF2alpha was  10-50 times less inflammatory than PGE1. It produced relatively greater erythema responses than oedema responses, when compared to PGE1. The novel prostaglandins, 19-OH PGE1 and 19-OH PGE2, recently identified as major prostaglandin constituents of human semen, were respectively 71 and 78 times inflammatory than PGE1. The 19-OH PGEs produced much greater erythema responses, relative to oedema, lids closure or discharge responses.


Platelets and mediators in the carrageenin rat paw oedema.

A number of similarities exist between several aspects of the imflammation process and the changes occurring in platelets during aggregation. This has initiated the search for a specific role of platelets in inflammation. The aim of our experiments was to investigate firstly whether during an acute inflammatory process platelets accumulate in the inflamed area and secondly whether the inflammation has an effect on the properties of the platelets. Rat platelets were labeled with 51Cr and injected into the tail vein of rats with a carrageenin-induced edema in one of the hind paws. The amount of radioactivity was measured in the inflamed paw and compared to the control one in the 24 hr following the injection. An accumulation of platelets was found at 3-4 hr after the injection of the carrageenin which disappeared later. Maximal swelling occurred after 5 hr. The aggregability of the platelets was determined at different times of the inflammatory process. After 2 hr, a decrease was observed which was higher after 4 and 6 hr. This effect might be due to the release of mediators during the inflammation.


Comparison of the mediator release from platelets and the development of acute inflammation in rats which lack prostaglandin precursors.

Rat platelet rich plasma (PRP) generates prostaglandin endoperoxide-like activity, thromboxane A2 (TXA2) and stable prostaglandins (PGs) after collagen addition. Of the stable PGs, PGE is the main product and its formation is related to the dose of collagen. Indomethacin and eicosatetraynoic acid (TYA), both cyclo-oxygenase inhibitors, inhibit TXA2 and PGE formation simultaneously. PRP of essential fatty acid deficient (EFAD) rats, however, generates far less PG-endoperoxide like activity, TXA2 and PGE, though the release of serotonin (5-HT) is unaltered. In normal rats a marked inhibition of the cyclo-oxygenase by TYA also has no effect on 5-HT release. For these 2 reasons the role of PG endoperoxides and TXA2 seems to be unimportant for the 5-HT release reaction. The diminished biosynthesis of PGs and TXA2 in EFAD PRP is not due to an impaired cyclo-oxygenase activity since addition of AA causes an equal formation of PGE in both types of PRP. The use of platelets as in-vitro model for testing anti-inflammatory activity of drugs is discussed. The results, obtained with platelets support the hypothesis that the main reason for the decreased acute inflammatory reaction in EFAD rats is a diminished supply of endogenous PG precursors.


Effect of glucocorticosteroids on the release of prostaglandin-like substances in anaphylaxis.

During anaphylactic reactions there are released thromboxane A2 and/or prostaglandin-like substances from perfused guinea pig lungs and from incubated fragments of guinea pig mesentery. Prostaglandin-like substances appear also in mixed venous blood of anaesthetized cats following an intravenous injection of rabbit blood. These release reactions are reduced or abolished both by indomethacin and by hydrocortisone.


Effects of anti-inflammatory drugs on the carrageenin-induced hind paw inflammation of rats deprived of endogenous precursors of prostaglandins.

The carrageenin-induced paw oedema was used to study anti-inflammatory drugs in normal rats and in those deprived of endogenous precursors of prostaglandins. The latter condition was achieved by permanently keeping the rats on essential fatty acid deficient (EFAD) food. Indomethacin inhibited the carrageenin-oedema in normal rats, but failed to further suppress the poorly developed delayed phase of the carrageenin-induced inflammation in EFAD rats. In contrast, aspirin exhibited equal inhibition of the carrageenin oedema in both normal and EFAD rats. The anti-inflammatory effect of dexamethasone was also indentical in both normal and EFAD rats. Since in EFAD rats the inflammatory role of an increased output of prostaglandins is of negligible importance, the results with aspirin and dexamethasone shed some doubt on such views, that suppression of the release of prostaglandins alone explains the acute anti-inflammatory effects of these drugs. The inflammatory response of EFAD rats is a model situation appearing to be useful in studying anti-inflammatory mechanisms which, under normal conditions, might be masked by interference with the release of prostaglandins.


Metyrapone: a possible tool in investigating the role of endogenous corticosteroids in inflammation.

Despite much early work on corticosteroid levels in the blood and urine of patients with rheumatic diseases, little strong evidence is available concerning the role of endogenous corticosteroids in inflammation. Nevertheless, the modulating role of adrenal corticosteroids in inflammation seems to be taken for granted even though the small amount of evidence in laboratory animals is, in some cases, contradictory. In the light of the immunological aetiology of some chronic inflammatory diseases and the immunosuppressive properties of corticosteroids, investigations into the role of endogenous corticosteroids in these conditions seem particularly worthwhile. Adrenalectomy has been used widely in studies on the physiological roles of adrenal corticosteroids but the operation requires care to avoid mortality. The adrenal corticosteroid synthesis inhibitor, metyrapone, could be used quite profitably in such investigations. However, it has been shown to exert differential effects on prostaglandin (PG) production in uterine tissue and may produce non-selective antagonism of the actions of PGs. Because PGs are probably involved in inflammation, care should be exercised in the doses of metyrapone used in any studies on inflammatory models to avoid interactions with the PG system.


Prostaglandins and complement changes in some conditions related to inflammation.

Exposure to ionizing radiation produces several systemic and local reactions which could be mediated by prostaglandins. Prostaglandin levels were therefore studied in blood and tissues of mice which had been exposed to x-rays. Significant increases were found in spleens after 200 to 700 R, and in lungs after 600 to 700 R. These changes were most pronounced 4-7 days after irradiation. Ionizing radiation promptly and potently reduced the activity of prostaglandin dehydrogenase in the spleen, whereas prostaglandin synthesis was less affected. Evidence was obtained for the activation and consumption of haemolytic complement in serum in the course of heart-lung operations involving extracorporeal circulation. Activation involved primarily the classical pathway, and only slightly the alternate pathway.


Nocturnal intragastric infusion of glucose in management of defective gluconeogenesis with hypoglycemia.

Three children with defective gluconeogenesis and hypoglycemia were treated with frequent daytime feeding and continuous intragastric infusion of glucose at night. By this technique, the blood glucose level was maintained at or slightly above the physiological range. Secondary lacticacidemia, hyperlipidemia, hyperuricacidemia, and coagulation defects all improved. Weight and height velocity increased dramatically. Strength and sense of well-being improved. Nocturnal intragastric infusion of glucose is now the management of choice for children with defective gluconeogenesis and hypoglycemia.


Disseminated intravascular DNA thromboemboli. A complication of chemotherapy for acute lymphocytic leukemia.

Seven and one-half hours after receiving antileukemic therapy, an 11 year-old boy developed massive intravascular lysis of leukemic cells with subsequent pooling of DNA to form disseminated intravascular thromboemboli. The DNA thromboemboli produced neurologic symptoms and an alveolar capillary block with resultant dyspnea and death.


A cephalometric evaluation of American Negro women.

A cephalometric study of forty American Negro women with an average age of 24.6 years and a Class I molar and/or canine relationship was performed. When measurements were compared to a control population of twenty Caucasian women, using several standard analyses, significant differences were demonstrated between the sample populations. 1. The maxilla and mandible were more protrusive in the Negro sample. 2. The upper and lower incisors were more proclined and the interincisal angle was more acute in the Negro sample. 3. Middle facial height was shorter and lower facial height was longer in the Negro sample. 4. The projection of the soft-tissue nasal tip was less in the Negro sample. 5. The projection of the upper and lower lips as related to the facial plane was greater in the Negro sample. 6. Lip thickness was approximately the same in the two groups.


Improving petrous bone reproduction in lateral cephalometric films.

The purpose of this method is to improve the reproduction of the petrous bone area in cephalometric lateral head roentgenograms. Metal screens are used to project a high-voltage x-ray beam only to this area. Two techniques using a lead screen or a copper filter screen are described. Reproduction of the points porion and basion and of the temporomandibular joint is considerably improved.


Prediction of the mesiodistal widths of maxillary permanent canines and premolars.

Multiple regression equations for prediction of the mesiodistal widths of the maxillary canines and premolars were developed for the right and left sides of the arches of males and females. The equations were developed from longitudinal data taken from ninety-two Caucasian children (forty-six boys and forty-six girls) who participated in the Iowa Growth Study. The multiple regression equations, when compared with three currently used methods of prediction, were the best predictors. The newly developed equations and other prediction methods currently in use were tested on longitudinal data taken from a sample of forty-three Caucasian orthodontic patients (sixteen males and twenty-seven females). Again, the multiple regression equations had the best performance.


Febrile neutrophilic dermatosis in acute myelogenous leukemia.

A 50-year-old woman with acute myelogenous leukemia on two occasions had fever and exquisitely tender, warm, erythematous, indurated to frankly bullous plaques on the face and upper extremities. Histologically, the lesions showed rather dense dermal infiltrates of mature polymorphonuclear leukocytes; special stains for bacteria and fungi were negative, as were all cultures for infectious agents. The lesions did not respond to antibiotics but cleared rapidly with systemic steroid treatment. Febrile neutrophilic dermatosis of acute myelogenous leukemia is believed to be a nonspecific reaction to the underlying malignant disease process. By prompt recognition of this entity, prolonged expensive courses of antibiotics may be avoided.


Monocytic leukemia. Clinically appearing as 'malignant reticulosis of the skin'.

Enzyme cytochemical (hydrolytic enzymes for cell differentiation), immunocytologic (B and T lymphocyte differentiation), and electron microscopic studies of skin infiltrates facilitate the proper diagnosis of myelomonocytic and lymphoreticular proliferations. With use of these methods, the original clinical diagnosis of malignant reticulosis of the skin was corrected to monocytic leukemia in a 65-year-old woman. Because primary involvement of the skin preceded monocytosis of the blood, it was concluded that the cutaneous infiltrates in our patient resulted from proliferation of tumor cells in the skin rather than from homing of the cells to, or settling of the cells in, the skin.


Acute lymphoblastic leukemia. Its occurrence with hypereosinophilic syndrome' and bilateral spontaneous pneumothorax.

A patient with acute lymphoblastic leukemia had an unusual prodrome, including clinical features of "hypereosinophilic syndrome," pulmonary infiltrates, and bilateral spontaneous pneumothorax, which preceded the onset of leukemia by four months. The mechanism for the production of eosinophilia may have been related to the production of eosinopoietic factors by the leukemic cells.


Early clinical recognition of disseminated candidiasis by muscle and skin biopsy.

Disseminated candidiasis was clinically diagnosed by muscle and skin biopsies in two patients with hematologic malignancies. One patient with acute promyelocytic leukemia presented with skin lesions as the sole manifestation of disseminated candidiasis. The other patient had leukemic reticuloendotheliosis and developed fever, severe myalgias, and maculopapular rash while receiving corticosteroid therapy; this patient is the first to have antemortem documentation of candida myositis as the initial manifestation of disseminated candidiasis. These two case reports serve to emphasize the importance of careful observation and early biopsy of skin and muscle to establish the diagnosis and permit early institution of therapy.


Sarcoidosis following adjuvant high-dose methotrexate therapy for osteosarcoma.

A patient who had undergone amputation and adjuvant chemotherapy with methotrexate doxorubicin hydrochloride for osteosarcoma of the femur later developed granulomatous hilar and paratracheal lymphadenopathy and multiple pulmonary nodules. Biopsy of the nodules showed noncaseating granulomas typical of sarcoidosis. Hilar adenopathy and granulomatous pneumonitis have been reported following methotrexate therapy, but a roentgenographic pattern of isolated, discrete pulmonary nodules has not been described. Treatment with immunosuppressive chemotherapy may have inhibited the development of sarcoidosis, which became manifest only after cessation of the chemotherapy.


Multiproblem families and their psychiatric significance.

The characteristics of multiproblem families are described, and the investigations in a research project are reported. A note is made of their epidemiological significance. Reasons are suggested as to why they have received little psychiatric attention. In particular their child upbringing practices, including child rearing and learning disorders, are described. The psychiatry of inadequacy is considered and the validity of the various diagnoses used. Finally it is suggested that the place of psychiatry in their care should be reconsidered and that a better knowledge of social handicap should be acquired.


The development of a scale for the assessment of sexual behaviour in Australian women.

The aim of this study was to develop a simple method of assessing female sexual response, suitable for use in clinical investigations. Following a review of interview, physiological and psychological methods, a Scale of Sexual Response was developed. Sexually dysfunctional women and women who stated they had no sexual problems completed the Scale. The results demonstrated that 11 of the 15 subscales had concurrent validity. The 4 subscales relating to auto eroticism did not distinguish between groups. Significant changes were demonstrated in 4 subscales following successful therapy of the sexual dysfunction. The scale was shown to be reliable.


Alcohol and medical practice - the role of the psychiatrist in instituting change.

The low rate of recognition of the causative role of alcohol in much illness, and the failure to respond to the clinical challenge of such an association by many doctors, is discussed. Documentation is provided by a study of computerised hospital records. It is suggested that psychiatrists could demonstrate that a professional stance towards alcohol is possible without compromising personal freedom, and that liaison psychiatry services could accept responsibility to improve management of these problems within general hospitals.


Social implications of the "dyscontrol syndrome" (neuropsychiatric correlates).

The recent literature contains numerous publications which have tried to stimulate a new and biologically oriented approach to the problem of violence. Experimental brain research indicates that biologically important predatory and aggression responses have multiple representations in the nervous system. However, knowledge gained so far concerning emotional brain function in violent persons with brain disease, or from experimental research, can only infrequently be applied to combat the violence-triggering mechanisms in the brains of the non-diseased. In the hope of determining the neurological basis of aggression, the present author studied the brains of forty-two patients whose clinical history indicated definite aggressive behaviour. Results are reported and discussed. It is also the aim of this paper to discuss the social implications of the surgical treatment of patients with a "dyscontrol syndrome" whose investigations do not reveal definite evidence of "hard" signs and symptoms of brain pathology.


Shotgun weddings: trends in the sociopathology of marriage.

The study was concerned with secular trends in forced marriages in N.S.W. The definition of forced marriage was first nuptial birth occurring within six months of the wedding. The typical demographic profile of such marriages portends a "risk" of marital breakdown and child abuse. Formal analysis of the time series showed upward trends in the proportions of brides "at risk" in the 16-17 age groups, and in the proportions of children "at risk" born to brides in the 16 to 22 age range. The findings were discussed critically, and some prophylactic and remedial social measures suggested.


Emotional sequelae of parents and sibs following the drowning or near-drowning of a child.

This study reports the findings from an investigation to evaluate the intra-family dynamics that occurred with 111 cases of childhood drowning and near-drowning in the City of Brisbane in 1971-1975. Personal interviews were obtained with 77 of the families. 24 per cent of parent-dyads separated following the drowning of their child, whereas none of the 54 families of surviving children separated. Accident generated stresses within the studied families tended to persist for years after the incident. Parents volunteered the information that they drank more, experienced sleep disorders and nightmares, and reported significant anxiety states. 19 per cent of parents of drowned children received specialist psychiatric treatment following the drowning. Two cases of surviving children received specialist psychiatric therapy (these were both parents who had inflicted non-accidental injury on their child, and had attempted to drown their child in the bath). In one sense, a child's death is more honourable from society's point of view if the child dies from a chronic medical illness such as leukaemia. In the case of a child's death in the family bath tub or the backyard swimming pool, the extra society sanctions of culpability and accusation further intensified the likelihood of the normal grief process being transformed into a pathological variant.


Active immunotherapy in acute myelogenous leukaemia and the induction of second and subsequent remissions.

One hundred and ninety-one adults with acute myelogenous leukaemia were treated with combination chemotherapy consisting of daunorubicin and cytosine arabinoside (Barts III). Sixty-three patients achieved remission and were admitted to one of 3 trials of active immunotherapy: immunotherapy alone, immunotherapy and maintenance chemotherapy or neither of these. All patients had weekly clinical and blood examination and monthly marrow examination. Reinduction chemotherapy was given as soon as relapse was diagnosed in the marrow. The most striking observation was that immunotherapy was associated with easy and repeated reinduction of remission and marked prolongation of survival after first relapse when compared with immunotherapy plus chemotherapy. The possible reasons for this and the value of immunotherapy are discussed in relation to the third trial still in progress which includes 2 maintenance arms, immunotherapy alone and surveillance only.


Scanning electron microscopy of oral epithelial cells. Part I. Normal and malignant tissue.

The surface features of cells removed by scraping from normal human oral mucous membrane and from squamous cell carcinomas of the oral mucosa were examined by scanning electron microscopy. It was concluded that in normal oral mucosa the cell surface morphology is dependent on the state of keratinisation of the tissue. Malignant cells were observed to display modified surface characteristics which have been tabulated. It is suggested that these characteristics may be of value in the diagnosis of malignancy.


Scanning electron microscopy of oral epithelial cells. Part II. Potentially malignant lesions (a computer-assisted study).

The technique described in Part I, has been extended to the examination of cells removed by scraping from 22 lesions of oral lichen planus and leukoplakia. It was concluded that the surface morphology of the cells from these lesions was intermediate between that of normal tissue and of malignant tissue. The observations have been quantified and subjected to computer analysis together with the data derived from the observations of normal and malignant tissue. This confirms the visual observation that a relationship exists between the modified surface characteristics of the cells from these lesions and their subjectively assessed histological appearances. A correlation has been found between the SEM appearance and an epithelial atypia index (EAI) derived according to the criteria of Smith and Pindborg (1969). In the case of lichen planus inflammatory changes appear to be associated with increased modification of surface characteristics. These changes are also reflected in an increased EAI. It is suggested that the present technique may be of value in the diagnosis and assessment of potentially malignant lesions.


The effect of cryosurgery on the strength of bone.

The effect of cryosurgery on the mechanical properties of bone has been studied by freezing rats' mandibles. The mandibles of laboratory rats were subjected to cryosurgery and tested at 2, 4, 8, 16 and 26 weeks. In comparison to the control contralateral sides, a reduction in strength was recorded at four and eight weeks, the difference being highly significant at eight weeks. This indicates the susceptibility of bone treated by cryosurgery to pathological fracture and suggests that preventive measures may need to be undertaken to minimise this possibility.


Jaw tumours in Nigerian Igbos.

Sixty-three cases of jaw tumours in Nigerian Igbos are reviewed. Burkitt's tumour, fibro-osseous lesions, ameloblastoma and carcinoma were seen in progressively older patients. The Igbos, like fellow Nigerians, suffer from ameloblastoma at relatively earlier ages than other Africans. Although the Igbos are as prone to keloid formation as other Negro peoples, it is noteworthy that this fibrous tendency was not evident in their jaw tumours. None of the tumours exhibited melanin pigment. The incidence of Burkitt's tumour appears to be lower in the easterly Igbos than in the ethnic groups living in the westerly part of Nigeria.


Condylar metastasis from mammary adenocarcinoma.

A case is reported of metastatic growth in the mandibular condyle from a primary adenocarcinoma of the breast, presenting as painless total trismus of sudden onset. The investigations, treatment and its implications are discussed.


Bone scanning as an aid to diagnosis and treatment planning in oral surgery.

A short history and introduction to radioisotopes used in bone scanning is presented. Five cases of malignancy with bone involvement of the head and neck region are described to demonstrate this technique.


A preliminary study of the dynamics of resolution of experimental haematomas: radioisotope studies in animals.

A preliminary investigation was carried out in order to establish a method for the study of experimental haematomas. For this purpose haematomas were produced in rabbits by subcutaneous injection of rabbits' own blood after labelling the various blood components with appropriate radioisotopes. In addition, radioisotope labelled human serum albumin and fibrinogen were studied. The results show that there is considerable variation in the rate and pattern of dissipation of the various components of the experimentally produced haematoma. The significance of these findings is discussed.


Modification of the muco-periosteal flap design in anterior maxillary osteotomies.

A modification of the mucoperiosteal flap planning for anterior maxillary osteotomy operations is suggested. This approach involves a total reflection of the labial mucoperiosteal flap, with the advantages of direct vision of the operative field thus providing easy and precise execution of the operative bony cuts, avoiding damage to the adjacent teeth and reduction of operating time. Sufficient blood supply to the mobilised segment is maintained through the palatal blood vessels. Corrective periodontal surgery may also be carried out at the same time.


Aneurysmal bone cyst of the zygomatic arch.

A case is described of an aneurysmal bone cyst which, because of its normal anatomical location, caused considerable difficulties in diagnosis and clinical management. The literature concerning aneurysmal bone cysts of the jaw is reviewed and the pathogenesis of this rare but interesting lesion is briefly discussed.


Fractures of the zygomatic complex in the south-east region of Scotland.

With the ever increasing of facial trauma, a study has been carried out on some aspects of zygomatic complex fractures in a part of Scotland. The results were different in some aspects from those reported in the literature, but they endorse the findings of a similar study which was carried out in the Eastern regions of Scotland (Hitchen & Shuker, 1973).


Traumatic bilateral abducent nerve palsies.

A patient sustained a severe cranio-facial injury which included a transverse fracture of the middle cranial fossa through the sella turcica producing otorrhoea, rhinorrhoea, a bilateral abducents palsy and a large aero-coele. All gradually remitted spontaneously. The management of this patient and the patterns of cranial base fractures and their associated clinical features, particularly of the middle cranial fossa, are discussed.


Treatment of chronic granulocytic leukemia with melphalan.

Thirty-three patients with newly diagnosed chronic granulocytic leukemia (CGL) were treated with melphalan between 1968 and 1976. Within 3 mo of beginning therapy subjective and objective disease parameters improved. Disease control was easily maintained with this agent until hematologic exacerbation occurred. The median duration of disease control was 25.3 mo, and the median duration of survival was 28.6 mo. Serious side effects were not produced. Thus melphalan appears to be another agent that may be used to control the manifestations of CGL prior to hematologic exacerbation.


Surface membrane characteristics and cytochemistry of the abnormal cells in adult acute leukemia.

Membrane marker and cytochemical analyses were carried out on the abnormal cells from 70 adult acute leukemia patients. Such information may (1) supplement standard morphology and serve as a basis for a new classification scheme for acute leukemia, and (2) characterize the surface membranes of granulocyte, lymphocyte, and monocyte "progenitors." Classification of acute lymphoid leukemias solely on the basis of morphology was unsatisfactory. The presence or absence of T- or B-cell markers was helful in classifying lymphoid leukemias. Monocyte progenitors were characteristically nonspecific esterase positive and Fc-receptor and membrane-IgG positive, but poorly phagocytic. Promyelocytes and myelocytes were frequently Fc-receptor positive and consequently positive for surface immunoglobulin. Myeloblasts were characteristically Fc-receptor negative. We conclude that surface membrane markers are essential in diagnosing lymphoid leukemias and helpful in nonlymphoid acute leukemias, and that cytochemistry is essential in delineating lymphoid from nonlymphoid leukemias and in subclassifying the latter.


Immunological detection of residual leukaemic disease in the bone marrow of children with acute lymphoblastic leukaemia.

Peripheral blood lymphocytes incubated with tumour cells or extracts may undergo blastogenesis. This is the basis of a technique studied in children with acute lymphoblastic leukaemia (ALL) in childhood in an attempt to predict relapse. Samples of peripheral blood and bone marrow from 82 children with varying degrees of ALL were analysed. Cultures were prepared by incubating a lymphocyte suspension with an autologous bone-marrow suspension. Final ratios of lymphocytes to bone-marrow cells (L: BM) were 1: 1 and 2: 1. Control wells received bone-marrow or lymphocyte suspension only. Cultures were incubated for 72, 96, and 120 hours. All were pulse-labelled with (3)H-TdR and radioactivity was measured by scintillation counting. Results were expressed as the stimulation index, calculated by dividing the mean counts per minute (cpm) of wells containing both lymphocytes and bone-marrow cells by the sum of the mean cpm for control wells. If the stimulation index exceeded 1 at 72, 96, or 120 hours at either L: BM ratio a positive response was recorded.Seventy-six children were in clinical remission at the time of testing (group A) and six were in clinical relapse (group B). In group A 24 patients showed stimulation and relapsed later at a mean time of 3.8 months (21 with marrow disease, two with testicular infiltration, and one with lung infiltration). Sixteen patients showed stimulation and had up to 4% blasts in their bone marrow but remained in remission. Nineteen other patients showed a positive response and several factors may have contributed to this: two underwent a "rebound" lymphocytosis after stopping treatment, nine had current or intercurrent infections, two had persistent unexplained bone-marrow lymphocytosis, but six had no causative symptoms and thus their responses were "true false-positives." Seventeen patients from group A showed no response and remained in remission for a mean of 22.9 months after testing. None of the six children in group B responded, and at testing had 17-85% blasts in their bone marrow.During the study no patient relapsed who had not shown a positive response. The technique merits further study as a guide to the presence of leukaemic cells.


Vincristine, prednisone and L-asparaginase in the induction of remission in children with acute lymphoblastic leukemia following relapse.

Two hundred and twenty-seven children with recurrent acute lymphoblastic leukemia were treated with various combinations of vincristine, prednisone, cyclophosphamide and L-asparaginase in an approach to the induction of remission. The combination of L-asparaginase 1,000 mu/kg iv q.d. x 10, vincristine 2.0 mg/m2iv q.w. x 4 and prednisone 40 mg/m2 p.o.q.d. x 28 days was found to be highly effective. The incidence of remission was 73%. No significant improvement was achieved when cyclophosphamide was added to this regimen. Various combinations of cytosine arabinoside, cyclophosphamide, vincristine, prednisone, BCNU or CCNU failed to maintain remission duration for more than two or three months. Neither BCNU nor CCNU prevented the development of CNS leukemia.


Acute leukemia after chemotherapy (melphalan).

During the years 1966-1973 474 patients with ovarian carcinoma were treated with melphalan. Of these, 48 patients received at least 300 mg melphalan and survived at least 3 years; four cases of acute leukemia were found among these 48 patients. All cases belonged to a group of 12 cases receiving 800 mg melphalan or more.


Maintenance therapy of adult acute nonlymphoblastic leukemia: an argument against the need for central nervous system prophlyaxis.

The need for prophylactic therapy of the central nervous system in adult acute nonlymphoblastic leukemia has been suggested but no proven. Over a 4-year period from January 1973, to December 1976, we have maintained 40 patients achieving complete remission on a regimen consisting of monthly courses of Cytosine Arabinoside and 6-thioguanine. Twenty patients remain in remission with a predicted median remission duration for the entire group of 14.5 months. Thirty nine of the patients did not have central nervous system leukemia at diagnosis, and only one of these patients (2.6%) has had remission tenance regimen there is little need for central nervous system prophylaxis in adult acute nonlymphoblastic leukemia.


Fundamental studies on electric stimulator used for acupuncture analgesia.

In order to perform safe and effective electric stimulation in acupuncture analgesia or therapy, basic knowledge concerning the electric stimulator is required. If direct current is used, a negative square wave with a pulse duration of 0.5 approximately 1.5 msec should be applied to the needle electrode to perform effective stimulation. Negative current is more effective at lower amperage than positive current and the possible corrosion hazard by the positive current can be avoided.


Studies on flies in Korea. III. Taxonomic studies on muscid flies (Diptera, Muscidae).

Forty species belonging to 14 genera of the family Muscidae were found so far in Korea. They are described in this paper and 5th sternites, forceps and male genitalia are illustrated. Eleven species recorded by Kobayashi (1918-1940) and 16 species by Hori (1952) were revised and redescribed in this paper. The key to the species of the muscid flies in Korea are also presented.


Histological and microradiographical studies of human mandibular condyle.

Twenty-one clinically normal human mandibular condyles were examined by histologic and microradiographic methods obtaining some measurements. The histologic structures of condyle were quite different between the child group and other aged groups. The difference in the surface articular zone composed of the fibrous tissue was not so great in all age groups, while there was quite a difference in the structure in the remaining zones. It was clearly demonstrated by microradiogram that the osteons of the subarticular bone plate were more prominent in aging. Abnormal structures of the condyle were revealed in some individuals of the adult and old age groups, which were assumed probably to be the reactive remodelling against the functional changes of the temporomandibular joint.


Pulmonary toxicity recurring after a six week course of busulfan therapy and after subsequent therapy with uracil mustard.

A growing number of drugs, including a number of alkylating agents, have been implicated as the cause of pulmonary diseases. A patient with chronic myelogenous leukemia presented with typical cytology, biopsy, and roentgenologic findings of lung toxicity after only six weeks of therapy with busulfan. There was subsequent clearing. A similar roentgenologic change also occurred after administration of uracil mustard. This has not been reported previously.


Inherited metabolic disease: prospects for the future in both basic and clinical research.

The birth of a child with an inherited disorder is often the beginning of a life-long problem for the whole family. About 8.5% of paediatric deaths and 4.7% of paediatric hospital admissions are due to autosomal and sex-linked recessive diseases. These figures are likely to be erroneously low because of incomplete ascertainment. The inherited metabolic diseases therefore merit study on economic as well as humanitarian grounds. Investigations of the disorders of purine metabolism have been conducted for more than a century and a half in the borderland between biochemistry and medicine, illuminating both disciplines and reflecting their separate developments. These studies are a general model for work in other branches of human intermediary metabolism. It is hoped that the basic study of the inborn errors or metabolism will expand our knowledge of the defective gene and of its product, the enzyme protein. Clinical studies should aim to improve the prenatal, postnatal and carrier-state diagnosis of these disorders, and to improve their treatment by methods which can be made practicable and generally available at the clinical level. There may be some hope for enzyme replacement in certain circumstances. The prospect for genetic modification at the clinical level is almost infinitely far away, where many would say that is should remain.


The identification of LSD-like hallucinogens using the chronic spinal dog.

The effects of several indoleamines and phenethylamines were studied in the chronic spinal dog and compared with two standard drugs, LSD and amphetamine. In the nontolerant chronic spinal dog, their effects on a variety of physiologic and behavioral functions were measured in untreated dogs, as well as dogs treated with certain antagonists. The effects of the antagonists phenoxybenzamine and cyproheptadine on the various physiologic effects were studied for all drugs. For some idoleamines and phenethylamines, the effects of chlorpromazine and pimozide were also studied. Indoleamines and phenethylamines in the LSD-tolerant chronic spinal dog and their anorexigenic effects in the intact dog were also studied. The results of these studies indicate that psilocin, mescaline, dimethyltryptamine and tryptamine are LSD-like drugs. DOM, DOB, DMA, and TMA are predominantly LSD-like drugs but do have some amphetamine-like action. PMA and PEA are predominantly amphetamine-like drugs with some LSD-like activity. MMDA and MDA have a more complicated pharmacology showing proerties that resemble LSD and amphetamine, but they have other actions which are not shared by either LSD or amphetamine, which suggests they have yet other modes of action.


[Cardiotoxicity in long term treatment with cytostatics (author's transl)].

During cytostatic combination treatment with five different anti-tumor agents two female patients suffered from cardiac failure which proved fatal. This was mainly due to doxorubicine (adriamycin) and daunorubicine. In an 8-year-old patient the cumulative dose was reached after 14 months of treatment (total dose of adriamycin 420 mg/m2, of daunorubicine 280 mg/m2) and in a 7-year-old patient after 16 months (total dose of adriamycin 480 mg/m2, of daunorubicine 280 mg/m2). Cardiac failure which occurred 12 months after the onset of treatment in a 12-year-old girl (total dose of adriamycin 310 mg/m2 and of daunorubicine 280 mg/m2) could be brought under control. The cumulative dose of adriamycin should be limited to 500 mg/m2 in children without risk factors.


Glucose-containing oligosaccharides in the urine of patients with glycogen storage disease type II and type III.

Patients with glycogen storage disease type II and type III were recently found to excrete increased amounts of a glucose-containing tetrasaccharide DGlcp(alpha1 leads to 6)DGlcp(alpha1 leads to 4)DGlcp(alpha1 leads to 4)DGlc [Lennartson, G., Lundblad, A., Sjöblad, S., Svensson, S. and Ockerman, P.A. (1976) Biomed. Mass Spectrom. 3, 51--54]. In addition to this tetrasaccharide, urine from these patients also contains larger oligosaccharides containing only glucose. From urine of patients with glycogen storage disease type II and type III, three and four oligosaccharides respectively have been isolated. Structural studies including sugar analyses, methylation analyses, partial acid hydrolysis and optical rotation revealed that three compounds were present in the urine of both patients. Their proposed structures or partial structures are as follows: DGlcp(alpha1--6)DGlcp(alpha1--6)DGlcp(alpha1--4)DGlcp(alpha1--4)DGlcp(alpha1--4)DGlc, DGlcp(alpha1--4)DGlcp(alpha1--6)DGlcp(alpha1--6)DGlcp(alpha1--4)DGlcp(alpha1--4)DGlc, and DGlcp(alpha1--6)DGlcp(alpha1--4)DGlcp(alpha1--4)DGlcp(alpha1--4)DGlcp(alpha1--6)DGlcp(alpha1--4)DGlcp(alpha1--4)DGlc. A fourth compound has been partially characterized as a branched heptasaccharide with four (1 leads to 4) linkages and two (1 lead to 6) linkages. Glycogen is possibly the origin of these compounds. However, the number of (1 leads to 6) linkages is higher than expected and may indicate a shorter distance between branches in glycogen than has been generally assumed.


Detection and differential diagnosis of bone lesions by scintigraphy.

Bone scintigraphy using 99mTc-labeled phosphate compounds and the scintillation camera supplements X-ray diagnosis in an excellent manner, for localizing and determing the size and metabolic activity of inflammations, degenerations, and malignancies of the skeletal system. It is of prime importance in the early detection and staging of the disease, as well as in registering the course and response to therapy of osseous metastases.


Treatment of acute leukaemia: implications of recent findings in cell biology.

Some aspects of the cell biology of normal and leukaemic haematopoietic cells are reviewed. Important points are: (a) normal and possibly also leukaemic stem cells differ from more mature cells in the kinetics as well as in cell surface antigens and other properties; (b) leukaemic cells are subject to a population size control as are normal haematopoietic cells; (c) part of the normal control seems to be chalone feedback regulation of proliferation and maturation rate of precursor cells; (d) evidence is accumulating that C-type oncornaviruses may cause leukaemia in man. Various experimental and established forms of therapy for leukaemia are discussed: No alterative exists to chemotherapy in acute lymphoid leukaemia. Granulocyte chalone may possibly become a valuable adjunct to other types of therapy in acute myeloid leukaemia. Immunotherapy may prove as efficient as maintenance chemotherapy in this disease. So far it has not been possible to synchronize leukaemic and normal cells so as to occupy different positions in the cell cycle. Nor has a forced maturation of human leukaemic cells been effected. Neither bone marrow transplantation nor prophylaxis by vaccination are considered worthwhile procedures for the time being. Anti-viral therapy has been promising in animal experiments, but animal leukaemias are often poor models for the disease in man. Assessment of treatment, using stem cell assays, is advocated.


Multiple leukemic clones in acute leukemia of childhood.

Two abnormal karyotypes representing clonal populations have been demonstrated in three patients in the early stage of acute leukemia. The karyotypes were apparently unrelated in one patient, while in the other two, a relationship was conjectured. Both clones were present before therapy in two patients. Although a clone resistant to therapy was associated with relapse in one case, in two cases a clone has persisted in the lymphocyte culture during drug treatment with the patients in remission.


Expression of oncofetal antigens by murine and human normal cells in tissue culture.

Normal mouse tissues in tissue culture express fetal antigens that are not expressed on these same tissues in vivo. The fetal antigens expressed on normal mouse cells in vitro are also expressed on at least two murine sarcomas, and account for the cross-reactive antibodies between these tumors. The fetal antigens are distinct from unique tumor-specific antigens found on these neoplasms. Normal human cells in tissue culture also express antigens found in human fetuses during the first trimester of pregnancy. Many human sera contain natural antibodies directed against the fetal antigens appearing in vitro. The expression of oncofetal antigens by normal cells in tissue culture must be taken into account in the interpretation of results of studies in tumor immunology in which tissue-cultured cells are utilized.


The Kleine-Levine syndrome--a variant?

A case of Kleine-Levin syndrome in an older man is described, with a review of the literature. An important point is emphasized in our case in which the patient reacted unfavorably to Ritalin, becoming sexually aroused, although his hypersomnia improved. A possibly different mechanism in hypersomnia and hypersexuality is speculated.


Use of sequential analysis in clinical trials of caries prophylactic agents.

Using a sequential t test, the objectives of two 3-year experimental clinical trials were achieved more efficiently by using fewer subjects over a shorter time. The assumption of identical distributions of each batch of data analyzed was not apparent and further work to establish the robustness of sequential t tests is indicated. Identification of subjects with more consistent caries increments during the period of a trial would also help to satisfy this assumption.


The implementation of field trials.

Even though a preventive agent has been shown to be powerful in reducing the incidence of, for example, dental caries when tested in a longitudinal clinical trial, it might not be as powerful when tested under more realistic environmental conditions. Field trials or field demonstration programs will provide the final evidence for determining if the agent or procedure is of such practical importance as to be included as a component in a dental care delivery system. The methodology developed for health services research provides the possibility of testing the effectiveness of a single or combined components in a dental care delivery system seen in relation to the environment and conditions under which it operates. The World Health Organization is at present involved in the implementation of a long range of field demonstration programs in various parts of the world especially in developing countries in order to establish the potential of known preventive procedures in population groups with different levels and different progression patterns of oral diseases.


Oral health status of 65- to 74-year-old Danes: a preliminary report of the replication of W.H.O.'s international collaborative study in Denmark.

The survey has demonstrated that oral health is poor in the present old-age generation in Denmark. A striking relationship between social class and tooth mortality has been demonstrated. In the present dental care system in Denmark, treatment rather than prevention has had priority. A change is however necessary. Greater emphasis on preventive measures and a change in the attitude of the public to dental health is needed, if the dental health of the population is to be improved. However, the majority of the present old population cannot benefit from new, improved programs to preserve the teeth. We are therefore still left with the obligation not to neglect the need and demand for dental treatment--of whatever nature it may be--in the old generation. The survey has clearly demonstrated that, so far, these demands have not been met.


A potential model for the interaction of enamel fluoride and plaque in the development of dental caries.

A model relating caries to surface enamel fluoride and plaque has been derived by exploratory data analyses. Since the model was obtained a posteriori, it is best viewed in qualitative terms as a hypothesis for future testing. The model prompts a re-evaluation of expectations relative to the effects of surface enamel apatitic fluoride, and a consideration that the effectiveness of a given measure of fluoride may vary as a function of inherent challenge. Thus, further studies are needed, aimed at quantifying the parameters of resistance and challenge, and characterizing the relationship between them.


A longitudinal epidemiological study on dental plaque and the development of dental caries--interim results after two years.

1. During the two-year period, caries developed at 20% of the target premolar sites. The attack rate for these surfaces was similar in the plaque panel and the other subjects in the study. 2. The microbial composition of plaque samples from caries-free sites and from carious sites before and after radiographic detection of lesions was broadly similar. 3. Numerical domination of particular sites by S mutans before detection of caries can occur, but has only been observed so far in 2 of 15 sites. 4. Pooled date from sites which have developed lesions indicate a rise in the isolation frequency and mean numbers of S. mutans after detection of caries. This trend was particularly obvious in the one subject who developed bilateral lesions by the second examination and in three of four sites where caries was detected at the fourth examination. Similar observations have been made with lactobacilli. 5. In two of 15 instances no isolations of S mutans were made from sites which developed caries. 6. To date, no single species appears to be uniquely associated with the onset of dental caries.


Dentists' self-evaluations: relationship to clinical performance.

Today's dental practice standards are set by the individual dentist. Quality is assured, in large part, by the accuracy of self-evaluations by dental practitioners. As a result, dental educators have attempted to improve the accuracy of self-reported evaluations by dental students by teaching such skills in the laboratory and clinic. This investigation examines multiple self-evaluations of the quality of restorative practice of 1,196 general practitioners, and investigates the relationship between these ratings and actual quality of treatment by 102 dentists for 2,753 patients.


Survey of curriculum and instruction: continuing education courses in pain control.

Pain and anxiety control is taught at the continuing education level in a large number of diverse courses. This paper reports the results of a survey of those courses offered in 1976. The majority of courses centered on the use of inhalation or intravenous sedation. Relatively few courses were offered on the other aspects of pain and anxiety control. Very little attempt is being made at formally evaluating the competence of participants in these courses. Few courses appear to adequately cover the prevention and management of complications. Based on these findings, changes are suggested in the teaching of pain and anxiety control at the continuing education level.


A dental library current awareness service.

A simple, manual current awareness service at the University of Southern California School of Dentistry, designed to provide the user with photocopied tables of contents from selected journals, is described. Other available current awareness and selective dissemination of information services are discussed, and a general comparison and cost analysis is made between the USC program and SDILINE. The service was evaluated by means of a questionnaire distributed to the 30 faculty participants. Results indicate that the service is of value in the teaching and research programs of the school, and has a high degree of user acceptance. Cost of the service is minimal considering the benefits to the faculty.


The sequential appearance of Ia-like antigens and two different complement receptors during the maturation of human neutrophils.

Ia antigens and two different types of complement (C) receptors appeared on membrane surfaces in a distinct sequence during the maturation of human neutrophils. Taking advantage of the finding that neutrophil celll density increased with maturation, density gradient centrifugation was used to separate neutrophils into fractions that were greatly enriched in cells representing individual stages of differentiation. Myeloblasts, the earliest cells recognized in the myeloid series of both normal and myelogenous leukemic individuals, expressed Ia determinants, whereas Ia determinants were absent or diminished on the majority of promyelocytes and completely undetectable on more mature granulocytes. Double marker studies demonstrated that Ia determinants were lost from the membrane of developing myeloid cells before the appearance of any type of C receptor. In the next phase of maturation defined by surface markers, neutrophils acquired a CR2-type C receptor (C3d receptor) that was similar in specificity to CR2 of B lymphocytes. This stage of maturation approximately corresponded to the myelocyte-metamyelocyte stage defined by standard morphologic criteria, and preceded the third stage of surface marker maturation when developing neutrophils began to express CR1-type C receptors (immune adherence, C4b-C3b receptors) in addition to CR2. In the final stage of surface marker-defined maturation, CR2 was lost from high density polymorphonuclear neutrophils and CR1 was maximally expressed. Normal blood polymorphonuclear neutrophils contained only 17% of CR2-bearing cells and these were shown to be of lower density than the majority of neutrophils that expressed only CR1. There  was some variation in the correlation of surface marker expression and maturation stage defined by morphologic criteria, but in all cases the sequence of marker appearance was the same: Ia leads to CR2 leads to CR1CR2 leads to CR1.


Movement of the proximal and distal segments after mandibular ramus osteotomies.

Data was collected from 27 patients who were treated with various ramal surgical procedures. Movements of the proximal segment during and after surgery were frequently noted. If the proximal segment was moved from its preoperative position and fixed to the distal segment, occlusal relapse was visible shortly after release of maxillomandibular fixation. Proximal segments displaced during surgery and not fixed to the distal segment frequently returned to their preoperative positions during fixation or assumed positions of biologic equilibrium. In such cases, occlusal relapse was minimal or nonexistent.


Cephalometrics for orthognathic surgery.

A cephalometric analysis especially designed for the patient who requires maxillofacial surgery was developed to use landmarks and measurements that can be altered by common surgical procedures. Because measurements are primarily linear, they may be readily applied to prediction overlays and study cast mountings and may serve as a basis for the evaluation of posttreatment stability.


An evaluation of enflurane as an amnesic agent for outpatient oral surgery.

An alternative to general anesthesia for outpatient oral surgery that creates a state of cooperative amnesia without eliminating the patient's protective reflexes has been developed. Enflurane, 1.5%, administered via a nasal mask produced a high incidence of amnesia with all patients remaining cooperative, with protective reflexes intact.


Healing of large mandibular defect after treatment of osteomyelitis resulting from vestibuloplasty.

A case of mandibular osteomyelitis, which developed after vestibuloplasty, has been described. Sequestrotomy resulted in a large defect that healed spontaneously within 12 months without a bone graft or immobilization of the fragments.


Diagnosis of pheochromocytoma during treatment of a mandibular fracture: report of case.

A case of pheochromocytoma, which was discovered during the patient's admission for treatment of mandibular fracture, is presented. Pheochromocytoma represents a potentially life-threatening disease, but alsl is a curable cause of hypertension. Therefore, in spite of its low incidence, it is important that the oral surgeon consider it in his evaluation of the hypertensive patient, especially when associated symptoms of sweating, palpitations, and headache are present.


Benign cementoblastoma--cementum analogue of benign osteoblastoma?

We believe that the current case is a good example of a "borderline lesion" that shows the histologic features of benign osteoblastoma but with some clinical features suggestive of a cementoblastoma, such as attachment to the roots. We suggest, however, that the involvement of the roots should not rule out the diagnosis of benign osteoblastoma. The fact that a benign osteoblastoma may envelop the roots in a way characteristic of a benign cementoblastoma, however, is suggestive of a close relationship between the two tumors.


Osteoblastoma of the jaws: current concepts and differential diagnosis.

A review of previously documented cases of osteoblastoma has been presented and an additional case has been reported. Although the clinical and histologic distinctions for fibrous-osseous lesions cover a wide spectrum, several means of differentiating osteoblastoma from similar lesions have been discussed. A larger series of cases will allow us to further delineate clinical, histologic, and biologic variables of osteoblastoma.


Fatal mediastinitis secondary to odontogenic infection.

A case of necrotizing mediastinitis that caused death in a 38-year-old man has been reported. The cause of his infection was proved, both radiographically and clinically, to be dental infection associated with the lower molars and their supporting structures. A diffuse cellulitis involving the submandibular, masticator, and parapharyngeal spaces ensued. Sudden onset of severe pleuritic chest pains and a 100% pneumothorax of the left lung developed, which ultimately led to his death.


Local recurrence of solitary plasmacytoma of the mandible.

A case of local recurrence of mandibular plasmacytoma has been presented. Review of the literature disclosed only one previous report of this phenomenon.


Radiographic evaluation of porosities in removable partial denture castings.

Most of the removable partial denture castings examined showed radiographic evidence of internal porosity. In general the porosity ocurred in characteristic regions associated with abrupt changes in cross-sectional thickness. These were located either within the partial denture framework or at the casting-sprue junctions. The porosity is due to metal shrinkage caused by a premature solidification at some point, which in turn interferes with a controlled unidirectional soldification of the casting.


In vitro assessment of marginal leakage of six enamel sealants.

The findings of this study support previous data on marginal leakage using enamel sealants in vitro. All sealants tested except Epoxylite 9075 were described for this study. However, all in vitro studies have limitations, and the ultimate evaluation of sealant behaviour must be based on in vivo experimentation.