Adsorption inhibition as a mechanism of freezing resistance in polar fishes.

Polar fishes are known to have serum proteins and glycoproteins that protect them from freezing, by a noncolligative process. Measurements of antifreeze concentrations in ice and scanning electron micrographs of freeze-dried antifreeze solutions indicate that the antifreezes are incorporated in ice during freezing. The antifreezes also have a pronounced effect on the crystal habit of ice grown in their presence. Each of four antifreezes investigated caused ice to grow in long needles whose axes were parallel to the ice c axis. Together these results indicate the antifreezes adsorb to ice surfaces and inhibit their growth. A model in which adsorbed antifreezes raise the curvature of growth steps on the ice surface is proposed to account for the observed depression of the temperature at which freezing occurs and agrees well with experimental observations. The model is similar to one previously proposed for other cases of crystal growth inhibition.


Radionuclide bone scanning in diseases of the spine.

Radionuclide bone scans provide a sensitive, no-risk diagnostic technique for the detection and evaluation of a wide variety of diseases of the spine. Scans and radiographs provide complementary diagnostic information, and should both be considered in the medical imaging portion of the diagnostic plan.


[Recurrence factors in the surgical treatment of prognathism of the mandible].

With regard to recurrences following surgery for prognathia of the mandible, the authors draw the distinction between immediate and secondary recurrences caused by errors in surgical indication or technique. They then review late recurrences, which they classify as being alveolar, basal or by forward sliding. They then study the role played in recurrences by growth of the condyle, neuromuscular balance and the hyoid suspensor system. Finally they stress the action of the tongue and the age factor (over 17 years being, in their view, desirable).


[Resection of the mandibular angles in the treatment of prognathism].

The technique involves transposition at the site of the angle of resection via an intrabuccal approach of the horizontal ramus at its various stages. The technique is dependable and is indicated whenever correction of the malformation requires mass displacement of the dental arcade. It is preferable to sagittal split of the ascending ramus since it is more precise and less dangerous as far as the neurovascular bundle is concerned.


[Secondary sliding of the mandible after sagittal osteotomy of the ascending ramus].

Thus in the area of prognathism, modifications would seem to develop during the first three months after deblocking:-true recurrences are rare and would appear to be avoidable by careful technique;-secondary sliding shoud not be the source of too much anxiety, being the result of spontaneous attempts at equilibrium and are of little aesthetic consequence. Our statistics indicate that sagittal osteotomy of the ascending rami gives 82% good results. This would agree with statistics generally found in the literature.


[Recurrence of mandibular prognathism caused by disorders of cervical stasis].

Cranio-facial morphogenesis and (in particular) maxillo-mandibular relations are linked with cervico-cephalic stasic. In cases of mandibular prognathia in the presence of cervical lordosis, treatment should thus take this special feature into account and seek for preference anterior maxillo-mandibular adaptation (associated when necessary with partial glossectomy), rather than the correction of skeletal abnormalities linked to a problem of position which cannot be influenced. At a time when the most highly qualified American orthodontists accept the possibility of altering basic bone features and recommend the replacement of the term orthodontics by more suitable expression dento-facial orthopaedics (10), attention must also be paid to the possibilities of true cervico-cephalic orthopaedics (in the context of general orthopaedics (17, 18, 19, 20)).


[Prevention of recurrence after sagittal cleaving of the ascending ramus].

The authors describe the preparatory conditions for osteotomy, the peroperative ancillary techniques which, in their opinion, make it possible to reduce considerably the number of recurrences. The latter are to be feared if corrective technique consists only of osteotomy procedure.


[Salivary calcinosis and the immunologic context].

On the strength of three new cases, it is suggested that the term "calcifying parotiditis" must be replaced by "salivary calcinosis". This suggestion is based on clinical and pathological grounds. An analysis of 11 cases of salivary calcinosis encountered in the last eight years points to clinical analogies between this condition and Gougerot-Sjögren's disease as well as to the fairly frequent involvement of the immune system in the calcinoses.


[Experimental study of Gougerot-Sjögren disease in mice. Initial results].

The mouse was selected to provide an experimental model for Sjögren's disease. A comparative study was made between the normal mouse (C 57 Bl 6) and the spontaneously auto-immune mouse (NZB) from an immunological and scintigraphic standpoint. The first immunological results involve study of the effects of sub-mandibulectomy on the thymus of the C 57 Bl 6 mouse. The are of little significance. First scintigraphic results show marked differences from the point of view of the uptake and excretion of Technetium 99 between normal old mice (17 months) (C 57 Bl 6) and those with spontaneous auto-immune behavior. Dynamic graphs of the uptake and excretion of Technetium 99 in the latter are closely similar to those found in mice after sub-mandibulectomy.


Cytochemical demonstration of dihydrofolate reductase in leukaemia and other haematological diseases.

The dihydrofolate reductase activity has been studied cytochemically in various haematological diseases. The variation between normal controls, Hodgkin's disease, myeloma, polycythaemia vera, chronic lymphocytic leukaemia and chronic myeloid leukamia was not significant, comparing the same type of cells. In acute myeloid leukaemia and acute lymphoblastic leukaemia the blast cells were weakly positive or negative. This finding is very interesting as the blast cells are capable of division. Probably the dihydrofolate reductase appears in the blast cells in some stage of mitosis. Lymphocytes stimulated by phytohaemagglutinin showed increased enzyme activity compared with normal non-stimulated lymphocytes. The "blast like" cells were more strongly positive than the blast cells of leukaemic patients. The patients with acute lymphoblastic leukaemia or acute myeloid leukaemia treated with methotrexate showed increased dihydrofolate reductase activity cytochemically.


[Bone destructive foci as precursors of the blastic crisis in chronic myelocytic leukemia].

Shortly after diagnosis of chronic myelogenous leukemia in a 38-year-old woman, an osteolytic lesion was found in the right femur. Cytology showed this to be a destructive process caused by polymorphic myeloblast. The diagnostic and therapeutic problems of this case are discussed in the light of the very rare literature references.


[Value and limitations of radiography in dental implantology].

Numerous studies have been done on the subject of the biological, histological and clinical reactions concerned with the insertion of dental implants. The method and techniques used by various authors, based on various parameters, are hardly comparable. Also the estimated criterious of the results obtained are often influenced by a tendency to a personal interpretation varying considerably from one author to another. It is thus difficult to compare the results of studies, where the observation protocols have nothing in common with them, especially where X-ray examination is concerned. The papers which place the emphasis on the X-ray exams of the dental implantology, being few and unalike, it seemed interesting to put into evidence the X-ray indications, to state exactly the techniques and particularly to show the limits that concern the diagnosis, the pre- and postoperative control and the assessment of the clinical success. This work tries to lay down some guide lines may be of use to the practitioner.


[Preprosthetic straightening of tilted lower molars with reference to the condition of the periodontium].

30 mesially tipped lower molars in 18 patients have been uprighted previous to prosthetic treatment. The uprighting was performed using arch wires, box loops and uprighting springs. The plaque and gingival conditions as well as the pocket depths and levels of periodontal attachment were assessed at the start of the treatment, after a successfully completed hygienic phase and after the uprighting of the tipped molars. Following the successful completion of the hygienic phase a significant pocket reduction was seen on all surfaces of the teeth besides a highly significant reduction of plaque and gingival index scores. As a result of the orthodontic uprighting, a further significant reduction in pocket depth, associated with a gain of periodontal attachment, was found on the mesial and lingual aspects of the molars. The results indicate that the uprighting of lower tipped molars prior to prosthetic treatment is a simple and predictable procedure to positively influence the prognosis of the teeth involved.


[Mercury vapors in dental practice].

Mercury as a hazard to health for dental office personnel and patients has been discussed for a long time. With the efforts of ecology in this country it was necessary to examine the situation again. 32 dental offices of a Swiss town of 90000 inhabitants were examined regarding their air contamination with mercury. A relationship was determined between dosage, working method, cleaning methods and texture of office floors. The results were not alarming. If specific rules are observed, mercury is no hazard for either dental personnel or patient.


[Long-term results in regularly treated and untreated periodontitis patients].

37 patients who were treated 6-21 years ago at the institute, were recalled. The examination revealed that these patients must continue regular dental check-ups and home-care to maintain oral health and retention of the dental apparatus. It is the responsibility of the dentist to put his patients on a regular "recall" system after treatment. Depending on the severity of the case, the control intervals should be from 4-12 months apart. Oral hygiene, pocket depth, function and the hard tissues must be inspected and corrective treatment done where necessary. One time periodontal treatment is of questionable value over a long-time span. Only with regular supervision the dental structures can be retained.


Phi bodies: peroxidatic particles that produce crystalloidal cellular inclusions.

Unique, spindle-shaped particles (phi bodies) and rods with peroxidatic activity are found in certain epithelial cells of normal mice, clofibrate-fed rats, and in leukemic leukocytes. The ellipsoidal shape of phi bodies apparently results from the deformation of spherical granules by extrusion of axial crystalloid that subsequently fragments into rods.


[Bacteriological control of surgical hand disinfection by means of selected agents].

Three techniques of surgical hand disinfection (use of Fesia-cito, utilization of a Wofasteril-alcohol-water mixture and a modified Fürbringer-Ahlfeld method) were verified with regard to the reduction in the bacterial count of the non-infected day-hand. The Wofasteril-alcohol-water mixture caused a 99.8% reduction in the bacterial count on the right hand, and a 99.9% reduction on the left hand. The data obtained with Fesia-cito were 80.2% and 66.6% respectively. With the modified Fürbringer-Ahlfeld method the reduction in the bacterial count was 96.9% and 98.6% respectively. The authors emphasize the claim for the principle of non-infection in the field of maxillofacial surgery and recommended to exercise reserve in regard to the routine use of Fesia-cito for surgical hand disinfection.


[Classification of periodontologically indicated vestibuloplasties].

The present paper deals with periodontologically indicated vestibule deepenings. For the first time, a grouping of the vestibule deepenings has been elaborated that comprises all fundamental possibilities of plastic-surgical intervention. This grouping gives a survey and a classification of the different methods of operation (in part designated by the names of the respective authors) and permits to trace back many methods to a fundamental principle whereby the number of seemingly different techniques of operation is reduced.


[Surgical closure of cleft palate and its immediate effect on the maxillary development].

During the service life of the primary dentition, the direct effects of surgical closure of the palate on the size of the maxilla are unimportant for all types of clefts. Narrowings of more than 1 mm occurred only in the posterior region of the dental arch. Narrowings in the anterior region of the dental arch were observed to a small extent in patients with unilateral and bilateral clefts. There was no difference in the changes of the upper dental arch between one-stage and two-stage closures of the palate.


[Secondary retention of a permanent tooth].

The authors report of a case of secondary retention of a lower first molar. It turned out to be a true "re-inclusion" of the tooth without involvement of the antrum. The radiograph of a central metal filling performed 10 years ago also suggests a retrograde movement of this teeth and its re-inclusion in the mandible.


[Experiences with aluminum matrices of anterior teeth with a clamping device--a contribution to the planning of front tooth fillings].

Starting from the description of an innovator's suggestion (registration number: 172097), the author deals with the use of suitable anterior matrixes made of aluminium foil. Practical experience and clinical results with the filling material Frontasil recommend the technique described for wide use.


[Individual instruction for proper dental and oral hygiene and patients' reaction].

The authors examined the oral hygiene conditions in patients who had been instructed in adequate dental and oral hygiene 3 years ago. It was stated that a single individual instruction without subsequent control is not sufficient to realize plaque-free dentitions. The mean OHI of the patients under consideration was 4.7.


Loa-loa microfilaremia in the Nigerian population.

In about half of 1026 Nigerians infected with Loa loa, the microfilaria levels were low, less than 8% had more than 1000 microfilariae in 50 cumm blood. The length range of 445 microfilariae obtained from 39 infected people was 156.8 to 308.7 micron with a mean of 236.4 micron, or microgram; smaller than in the Kumba strain of Cameroon. The persistence of a rather high number of microfilariae in the peripheral blood of four patients till 22 hours was discussed in relation to the importance of Mansonia africana mosquitoes as a vector of Loa loa.


[Immunologic reactivity of patients with acute leukemia].

In sera of patients with acute leucosis the authors have determined antibodies to alpha-toxin, streptolysin-O, the complement, lysosyme. B-lysins and C-reactive protein. It was found that the indices of immune reactivity in patients with acute leucosis are dependent on a morphological variant of the disease, the duration of the conducted therapy and presence of complications. The most high immunity indices in patients with acute leucosis were observed in a primary active stage of the disease and during the period of remission. Considerable reduction of the immunity was noted in the terminal stage of the disease.


[Distinct hypokalemia in leukotic infiltrates of the kidney].

Report on a 74-year-old female patient falling ill from a chronic myelosis. Due to leukotic infiltrates of the kidneys renal loss of potassium and extreme hypopotassaemia appeared. On the basis of the present literature clinical symptomatology and morphological finding are discussed.


[Eosinophilic infiltration in chronic myeloid leukemia].

Specific infiltrations in myelogenous leukemia are rare and occur mostly in the course of an acute blast crisis often representing the terminal phase of the disease. A 50 year-old female patient is described who developed specific cutaneous lesions during such a blast crisis. The infiltrates consisted to a major part of eosinophilic myelocytes although the peripheral blood smear showed only relatively few mature eosinophils.


Epithelial repair and regeneration in the uterine cervix. I. An analysis of the cells.

Cell studies from 1,376 patients with abnormal cells derived from so-called tissue repair or regeneration comprised the basis for this study. Planimetric measurements were performed on camera lucida tractings of 1,573 atypical reparative cells (ARC). A total of 3,377 ARC were anlyzed with respect to cytoplasmic and nuclear features. On the basis of these analyses, ARC were subclassified into three types. In most instances, the morphologic type corresponded with the cervical epithelium of origin. The differential morphologic features of ARC were compared with the morphologic features of endocervidal adenocarcinoma and large cell nonkeratininzing squamous cell carcinoma. The biologic potential and clinical significance of ARC is to be the subject of a subsequent report.


Direct-vision endoscopic cytology and biopsy in the diagnosis of esophageal and gastric tumors: current experience.

In a series of 183 patients with proven cancers of the esophagus and stomach, endoscopic cytology was positive in 155 or 84.7 per cent. Endoscopic biopsy in 173 of these patients was positive in 137 or 79 per cent. At least one of the techiques was positive in 164 patients or 94.8 per cent. These results emphasize the overall accuracy of endoscopic cytology and biopsy and their complementary value in detection of malignancy. Meticulous care in technique is stressed for achievement of such accuracy rates.


On the interpretation of atypical cells in pleural and peritoneal effusion.

A histochemical method demonstrating the cellular amount of non-specific esterase is applied in the cytologic examination of pleural and peritoneal effusions concerning the recognition of malignant cells. Because of the presence of both false positive and false negative results it is concluded that the method is not conclusive of the benign or the malignant nature of the atypical cells found, but the method may be of value in certain cases.


Sputum cytology in pulmonary sarcoidosis.

Sputum cytology in patients with pulmonary sarcoidosis has been investigated. All cases of pulmonary sarcoidosis with roentgenographic evidence of pulmonary interstitial fibrosis and scarring have revealed diagnostically significant cytologic features in their pulmonary material. These include multinucleated epitheloid giant cells, epithelioid cells and lymphoid mononuclear cells in an otherwise noninflammatory, clean specimen. The characteristic cells occur in streaks, either singly or as syncytium. They are dark, cyanophilic with little phagocytic activity. Schaumann and asteroid bodies may be present. Cytologic examination of induced sputum specimens in asymptomatic patients of suspected pulmonary sarcoidosis with interstitial involvement can help in diagnosis and management of these cases.


Prostatic duct carcinoma: exfoliative cytology.

The cytologic findings in voided urine specimens from prostatic duct carcinoma are presented. Neoplastic cells from these unusual tumors were identified as well as the occasional red blood cell and histiocyte. The adenocarcinoma cells features irregular nuclei and their cytoplasm was occupied almost entirely by large secretory vacuoles. The differential diagnosis of this tumor from some other neoplasms and its association with transitional cell carcinoma as well as its histogenesis are discussed.


Cerebrospinal fluid cytomorphology identification of benign cells originating in the central nervous system.

The chief cellular consituents of CSF are the "free cells" of the pia-arachnoid, ependyma, and choroid. These cells are of diverse types, but have their mesenchymal origin in common. Usually they offer no difficulty in identification since they are predominantly histiocytic. However, these "free cells" may be morphologically changed in reaction to an appropriate stimulus, and may therefore be a source of error in diagnostic material. Cells having mesothelial characteristics are not found in the CSF compartment and therefore the term pia-arachnoid mesothelial cells appears inappropriate. The only neuroectodermal derivative that was easily identifiable was the choroidal cell. It is distinctive and unequivocal. We were unable to recognize ependymal cells in our present study. Glial cells (protoplasmic and fibrous astrocytes) and neurons can be recognized when neural tissue is penetrated in the process of collecting CSF.


Cytology at the end of pregnancy: significance of determinations of the eosinophilic and karyopyknotic indices.

The clinical usefulness of the cytologic findings "pre-term," "at term" and "post-term" are discussed briefly. For this investigation, the eosinophilic and pyknotic indices were obtained by counting one hundred cells in each of four microscopic fields. A separation function was calculated using the eosinophilic and pyknotic indices. The results of our study permitted a highly significant separation of the collectives "pre-term" and "at term."


Cytologic screening for cervical cancer in southern Iran.

In an 11 year study of cytologic examinations from the southern part of Iran with a 99 percent Moslem population, the prevalence rate of invasive cervical carcinomas in 35,222 women screened for the first time was 2.3 per 1,000 examinations. With the initiation of a mass screening program begun in 1974, the rates of CIS and moderate and severe dysplasia rose threefold. These findings indicate that carcinoma of the cervix is an important problem in Iran, despite previous reports of the contrary. There is, thus, a clear need for encouraging and expanding the mass screening program which has been initiated in this country.


Microhematuria found by mass screening of apparently healthy males.

Preparation of urinary sediments was adapted for mass screening purposes. The procedure, characterized by most careful collection and transfer of the sediment and by a rigidly controlled work scheme, was tested in a limited population screening program with 446 healthy male participants. A capacity of 100 samples per 12 manhours was achieved. The procedure was found effective in collecting the cellular content, but there was serious cytolysis due to a 11 hours delay between micturition and processing. An unexpected finding was the presence of erythrocytes in all the samples. In 8.8 per cent of the smears more than ten RBC/hpf were present. The significance of this feature is still in study, but it might prove to be a useful prescreening criterion in the cytologic assessment of bladder cancer in large populations.


The effect of intrauterine progesterone on the DNA-content in isolated human endometrial cells.

The effect of an intrauterine progesterone-releasing device on the DNA-content in human endometrial cells has been studied by means of a microfluorometric method. Following six of seven months' use of the progesterone-releasing device a significant decrease in the mean DNA-content per cell nucleus was found in the epithelial cells indicating a suppression of the proliferative activity of the endometrium. The mean DNA-values of the endometrial cells remained at a low level throughout the cycles in spite of circulating levels of steroids indicating a normal ovarian function. It is suggested that the progesterone released in utero interferes with the DNA-synthesis of the epithelial cells, which may result in a disturbed metabolic function of the endometrium at the time of implantation.


The surface coat of the human effusion cells.

Cancer cells of human effusions have a prominent surface coat clearly demonstrated by ruthenium red staining. The cancer cells forming clumps are usually interconnected with each other by gap junctions which is expressed by a free penetration of the ruthenium red through the majority of the junctions. The benign cells encountered in human effusions are also covered with the surface coat, which, however, is usually thinner in comparison to the coat observed on the cancer cells.


An analysis technique for biological shape-II.

A discrete function representing the curvature of closed contours has been derived. The function is easily computable and has properties desirable for use in shape analysis. Two curvature measures (as well as the traditional P2A) have then been applied to a set of shapes extracted from leukocyte nuclei in order to evaluate their effectiveness as numeric descriptors of shape complexity. Bending energy, (BEN), was shown to be, on the average, the most sensitive indicator of complex shape, normalized mean absolute curvature (NMAC) was next, and P2A was last. Bending energy could also have important biolgical significance due to its possible relation to developmental processes. Further studies on bending energy will be necessary in order to substantiate this possibility. Many of the discrepancies between P2A, NMAC, BEN, and the study subjects are explainable by the lack of "syntactic", or form, information used by the computer features. If an observer really classifies an object by decomposing it into simpler pieces, then a more sophisticated shape analysis procedure must be used. Such a procedure will be described in a sequel to this paper.


Primary gastric lymphoplasmacytoid malignant lymphoma (gastric plasmacytoma): an endoscopic cytologic diagnosis.

A case of primary gastric plasmacytoma in which diagnosis was made preoperatively by an endoscopic technique is presented. Exfoliative cytology using a brush under direct visual control enabled the case to be classified as lymphoplasmacytoid malignant lymphoma. Data which favor the diagnosis of plasmacytoma are: 1) plasma cells in various stages of maturation, 2) abnormal plasma cells often in mitotic division, 3) the presence of atypical immunoblasts.


Observations on the morphology at the transition between the peripheral and the central nervous system in the cat. II. General organization of the transitional region in S1 dorsal rootlets.

The aproximal segment of feline S1 dorsal rootlets were investigated light and electronmicroscopically. A one shaped protrusion of CNS tissue was found to extend distally into each rootlet for a distance of 100-1000 micrometer. That free segment of a rootlet which when cross sectioned revealed both CNS and PNS constituents was denoted the transitional region (TR). The TR was subdivided into an axial CNS compartment and a surrounding PNS compartment. The CNS compartment consisted of a core zone that showed the organisation of a CNS fiber tract, and of an outer astrocytic mantle zone which corresponded to the external glial limiting membrane of the brain and the spinal cord. The outer aspect of the mantle zone constituted the PNS-CNS borderline. The mantle zone was rich in astrocytes and projected a large number of thin processes--the glial fringe--distally into the endoneural space of the PNS compartment. There were large fenestration defects in the basement membrane that demarcated the endoneural space from the glial space. The mantle zone contained many large myelinoid bodies and some encapsulated small dark unclassified cells. Similar cells, some covered by a basement membrane, were at hand in the adjacent endoneural space. The myelinated nerve fibres were equipped with a node of Ranvier at their borderline passage.


Observations on the morphology at the transition between the peripheral and the central nervous system in the cat. III. Myelinated fibres in S1 dorsal rootlets.

Myelinated nerve fibres were analysed at their passage of the PNS-CNS borderline in the transitional region (TR) of feline S1 dorsal rootlets by means of light and electron microscopy. At the borderline, PNS internodal length was 30% shorter than noted further distally in the root. Analysis of variance based on the numerical estimation of various fibre parameters did not support the current idea that a myelinated nerve fibre decreases in diameter as it passes from the PNS into the CNS. There was a rough rectilinear correlation between axon size and number of myelin lamellae in small and medium sized fibres. In large fibres the number of myelin lamellae was highly variable and could not be predicated from axon size. The nodes of Ranvier found at the borderline showed an organization that could be described as a compound node where the PNS-CNS demarcation line runs across the nodal axon segment in the midst of the node gap. Branching at the borderline nodes was a very rare phenomenon. The length of the nodal axon segment, the nodal axon membrane area and the amount of paranodal mitochondria were similar to earlier presented data of feline ventral root fibres. The hypothesis that the elements of the paranodal apparatus of PNS fibres compensates for the lack in the PNS of nodally connected astrocytes is presented and discussed. A small number of the fibres lacked a borderline node. In these cases the CNS myelin sheath projected uninterrupted for hundreds of micrometer into the PNS compartment where it was enclosed by a Schwann cell and PNS myelin. This rare arrangement was referred to as a transitional internode.


[Impulse-cytophotometric determination of DNA content in blood cells in patients with leukemia].

The method of impulse cytophotometry was applied for determination of DNA content of blood cells in patients with various types of leukaemia. It was found that at the time of improvement in acute leukaemia the proportion of cells in the non-proliferative stage increases. In chronic leukaemias the improvement was associated with shifts in reverse direction.


Observations on the morphology at the transition between the peripheral and the central nervous system in the cat. IV. Unmyelinated fibres in S1 dorsal rootlets.

Unmyelinated (d.r.C) fibres have been investigated electronmicroscopically at their passage from the peripheral to the central nervous system in feline S1 dorsal rootlets. The earlier demonstrated rearrangement of C-fibres during their passage along the transitional region (TR) was confirmed by the observation of extensive fibre divergence. The transitional region Schwann cells was calculated to be 10-20 times as high in the TR as in the more distal parts of the rootlets. Analysis of consecutive ultra-thin sections showed that PNS unmyelinated axons 0.8 micrometer or more acquired a myelin sheath as they entered the CNS. Fibres 0.6-0.8 micrometer in diameter appeared to be segmentally myelinated in the CNS. Fibres less than 0.6 micrometer remained unmyelinated at their CNS entrance. A few fibres showed degenerative signs and terminated in the transitional region.


Tweed triangle and soft-tissue consideration of Japanese with normal occlusion and good facial profile.

A total of thirty-six Japanese adult subjects (consisting of eighteen men and eighteen women) with normal occlusion and harmonious facial features were subjected to cephalographic examination for the purpose of studying their soft tissues. Out of this group, twenty were selected and compared with twenty Class II, Division 1 and twenty Class III patients for the purpose of establishing an appropriate diagnostic guide for the Tweed triangle. These are our conclusions: 1. The Z angle of the Japanese subjects with normal occlusion was 69.70 degrees for the men and 71.75 degrees for the women. There is no significant difference between the sexes. 2. Although there are no significant differences between the sexes for the integumental and total chins, there is slight sexual difference for the upper lip measurement. 3. As compared to the subjects with normal occlusion, there is a significant difference for the Z angle of Class II, Division 1 and Class III patients. 4. In this study, the measurements of the Tweed triangle were FMA 27.28 degrees, IMPA 95.50 degrees, and FMIA 57.22 degrees. On the basis of this study and the reports of other Japanese investigators, we would like to suggest an FMIA of 57 degrees as being the most suitable basis for the diagnosis of Japanese patients, but this should be modified according to the FMA value.


Vertical proportions: a guide for prognosis and treatment in anterior open-bite.

1. Most open-bites are deficient in growth of the upper face and in growth of the posterior face. However, some varieties  have adequate posterior face height. A compensatory increase in lower anterior face height occurs in both types. 2. The ratio of upper anterior face height to lower anterior face height (UAFH/LAFH) is suggested as an aid in determining the prognosis for the orthodontic correction of anterior open-bite. 3. The treatments of eight patients were presented to illustrate this concept. The results were critically analyzed. 4. The validity of this index can be determined only after prolonged use by many orthodontists.


Treatment of anterior skeletal open-bite deformity.

Two patients with severe skeletal anterior open-bite have been presented. Treatment of these patients was accomplished mainly by mandibular repositioning (Case 1 by orthodontic means and Case 2 by a combination of surgery and orthodontics) and by an orthodontic change in the mandibular occlusal plane. A review and a discussion of the cause of this deformity were presented.


Severe mandibular retrognathism: orthodontic versus surgical orthodontic treatment.

1. Treatment of Class II, Division 1 malocclusions should be accomplished by normalization of the abnormal structures that are identified diagnostically. 2. In the presence of mandibular retrognathism and unfavorable growth potential (limited amount, undesirable direction), surgical mandibular lengthening should be incorporated into the treatment plan. 3. Compensation for mandibular retrognathism by conventional orthodontic and facial orthopedic treatment incurs the risk of (a) increase in nasolabial angle, (b) reduction in upper lip support, (c) increase in lower facial concavity, (d) excessive proclination of lower incisors with compromise of labial periodontal support, and (e) protracted duration of appliance therapy and accompanying detrimental periodontal and root resorption effects.


Tooth-size discrepancy in mandibular prognathism.

A Bolton analysis of seventy-eight cases of Angle Class III malocclusion, twenty-six cases of Angle Class I malocclusion, and twenty-six cases of Angle Class II malocclusion was recorded. Frequency of excess mandibular tooth structure, magnitude of the excess, over-all ratios, and anterior segment ratios were computed and analyzed. Two clinical cases were presented to show the advantage of tooth-size harmony in mandibular prognathism.  Analysis of the data as presented above suggests the following conclusions: 1. The frequency of mandibular tooth-size excess (over-all ratio) in this sample was greater in cases of mandibular prognathism than in Angle Class I and Angle Class II cases. 2. In those cases with mandibular tooth-size excess, there was a suggestion that the magnitude of the excess was greater in cases of mandibular prognathism than in Angle Class I and Angle Class II cases. 3. A tooth-size discrepancy analysis should be included as one part of the diagnostic records for mandibular prognathism.


Psychological timing of orthodontic treatment.

A questionnaire type of study was undertaken to test the hypothesis that prepubescent patients are more cooperative than adolescents. Older children were held to be psychologically resistant to the demands of orthodontic treatment because of their involvement in Oedipal conflicts, a normal but distracting aspect of "growing up". Our observers found that patients under 12 were more cooperative than other age groups in the wearing of headgear and other removable devices. They were less cooperative in keeping appointments or in protecting appliances from breakage. The differences were significant at the 5 per cent level of confidence. If responders' observations are an accurate index of true performance, the study suggests that, from a psychological standpoint, activator and headgear treatment should be begun sometime after age 6 and soon enough to be completed before the onset of puberty.


Hemoglobin E and glucose-6-phosphate deficiency in the Khmer Air Force (Cambodia).

This study was designed to investigate the use of primaquine in malaria control in the Khmer Republic (Cambodia). Blood was drawn from 106 male Khmer Air Force troops for analysis of hemoglobin E and glucose-6-phosphate (G-6-PD) deficiency. A test group of 15 men with G-6-PD deficiency and a group of 31 normal controls were given 15 mg of primaquine each morning for 14 days. The patients were followed for hemoglobinuria and changes in hematocrit. Primaquine induced a significant, but not a dangerous, hemolysis in G-6pD-deficient Khmer troops. The G-6-PD deficiency seen in Khmer Air Force subjects was G-6-PD Mahidol. Statistically, G-6-PD Mahidol was linked to hemoglobin E.


[The "Emona" anaesthetic baby system (author's transl)].

A paediatric breathing system, called the Emona system has been devised because commercially available anaesthetic baby systems used in head and neck surgery did not give satisfactory results. The system provides for fresh gas inflow while the expiratory path is positioned close to the patient. A precise description and schematic presentation of its action is given. The efficiency of the Emona system was tested in 65 infants and children using blood gas analyses. Furthermore, CO2 analyses of mixed expired and inspired gases, as well as some measurements applying the respiratory nomogram, were carried out. The efficiency of the Emona system is compared with results of some other baby systems (Jackson-Rees and Ruben's systems). The problems of paediatric anaesthetic systems are discussed and the dilemma of normal values for some respiratory parameters in children exposed. The results show that the Emona system is particularly advantageous in manually controlled ventilation in comparison to the results of other authors applying mechanical respiratory support.


Cutaneous infarction. Manifestation of disseminated mucormycosis.

We describe the second reported case of cutaneous infarction as a manifestation of disseminated mucormycosis. The lesion, which closely resembled ecthyma gangrenosum, occurred in a leukemic patient who was on a regimen of broad-spectrum antibiotics. In this case as in the only other reported case, Mucor pusillus was the cause.


[Erythroleukemia revealed by diabetes insipidus].

A 4 year-old girl presented simultaneously with an erythroleukemia and a diabetes insipidus. The cytologic signs of dyserythropoiesis, the increase of some red blood cell glycolytic enzymes and of fetal hemoglobin, led to discuss the existence of a double population in the red blood cell series. The revealing character of diabetes insipidus, not yet reported, is emphasized.


Surgical diseases of the mandible. The principles of diagnosis and treatment.

Several unusual abnormalities are presented in this abstract of a lecture on surgical diseases of the mandible. The importance of physical signs in clinical dental surgery is emphasized. A protocol of treatment of mandibular condylar hyperplasia and masseteric hypertrophy is suggested.


A review of the structure and function of the gingival seal.

The results of previous studies on the gingival seal at the level of the light microscope have now been correlated with studies conducted on the electron microscope. This paper attempts to correlate the findings at the two different levels and to clarify the functional role of the gingival seal.


A prevention orientated patient management programme for a dental hospital.

A patient management programme with a marked emphasis on prevention of dental disease through plaque control has been commenced in the Royal Adelaide Hospital Dental Department, and its benefits will be closely examined over two years.


The effect of verapamil on experimental myocardial ischaemia with a particular reference to regional myocardial blood flow and metabolism.

The effects of verapamil on epicardial ST segment elevation, regional myocardial metabolism and collateral blood flow were studied in open-chest anesthetized dogs following left anterior descending coronary artery occlusion. Collateral blood flow was measured by radioactive microspheres (15 +/- 5 micron diameter) and regional metabolism was studied by measuring lactate concentration in venous blood draining the infarcting myocardium. Verapamil (0-2 mg/kg intravenously) produced a significant reduction (50-60%) in the epicardial ST elevation when it was given before coronary occlusion; when administered 15 minutes after coronary occlusion and infusion continued for two hours, it minimized (30-40%) ST segment elevation, and prevented the fall in cardiac index and rise in systemic resistance found in the untreated animals in which the ST segment remained persistently elevated. Changes in epicardial ST segment occurred without alterations in the QRS duration. Verapamil had no effect on either the total collateral blood flow or the relative distribution of flow to the endocardial and epicardial halves of the ischemic ventricular myocardium. No significant differences were found between the levels of lactate in blood sampled from small epicardial veins at the center of the infarct when the control animals were compared with those treated with verapamil.


Recent insights into paroxysmal supraventricular tachycardia--an integrated approach to diagnosis and therapy.

Paroxysmal supraventricular tachycardia may result from re-entrance in the AV node, the normal A-V pathway with an accessory AV connection, in the sino-atrial node, in the atria, or else reflect ectopic impulse formation in a spontaneously automatic supraventricular focus. Electrocardiographic criteria which are helpful in differentiating these mechanisms involve an analysis of cycle length, changes in cycle length with intermittent bundle branch block, P wave morphology and the relationship of P wave to QRS complex, P-R interval, the presence of A-V block during tachycardia and the influence of autonomic tone on the tachycardia. Electrophysiologic studies further elucidate mechanism by demonstrating the mode of induction and termination of the tachycardia, the characteristics of antegrade and retrograde A-V conduction curves and refractory periods, atrial activation sequence of echo beats and the influence of premature beats introduced during tachycardia. These features are summarised in Table 1. Therapy can be accurately planned according to the results of experimental administration of antiarrhythmic agents and of pacing sequences upon induction and termination of tachycardia in the catheterisation laboratory.


The use of clonidine by intramuscular injection in the treatment of hypertension.

Clonidine (Catapres) administered intramuscularly in a dose of 150 microng produced a satisfactory reduction in blood pressure in 13 of 16 hypertensive patients. Its effect occurred within five minutes, was maximal at 75 minutes and persisted for five hours. In six patients who received two doses (150 microng and 300 microng), the response was shown to be dose-related. No serious side effects were noted. Intramuscular administration of clonidine thus appears to be safe and effective. It has a place in the management of uncontrolled hypertension when a rapid reduction in blood pressure is undesirable and in the maintenance of blood pressure control when oral therapy cannot be tolerated.


Blood lipids and lipoproteins in a rural New Zealand population.

Plasma cholesterol and triglycerides have been measured in 1202 residents of Milton, a rural town in New Zealand. Cholesterol and triglyceride concentrations in the serum lipoprotein classes of a random subgroup of the population are also reported. Mean plasma triglycerides and very low density lipoprotein (VLDL) cholesterol and triglyceride concentrations were higher for men, but mean high density lipoprotein (HDL) cholesterol concentration was higher in women. Urban-rural differences in plasma cholesterol are suggested since mean plasma cholesterol concentration in men reached a maximum in the 50-59 decade in the rural town (Milton) but the maximum for a nearby urban community was in the 40-49 decade. An evaluation of hyperlipidaemia by using arbitrary cut-off values for plasma cholesterol and triglyceride concentrations showed a prevalence of hypertriglyceridaemia in men, resulting in approximately three times as many men as women in some of the categories of hyperlipidaemia. Further, 26% of the 35-59 age group in the population had lipid risk factors for coronary heart disease.


Lack of relationship between viruses and human diabetes mellitus.

Antibodies titres against Coxsackie-B (CB) and mumps virus (MV) were determined in 180 normal subjects and two groups of diabetics, 236 with diabetes of recent onset (DRO) and 108 with diabetes of long duration (DLD). Positive antibody titres to these viruses were found more frequently in controls than in diabetics. In fact, the percentage of positive titres was significantly less than in controls in several instances particularly in juvenile onset diabetes of long duration. These data suggest that CB and MV are not causally related to human diabetes mellitus.


An Auckland high school health survey.

To assess the importance of racial and socio-economic factors on the health of teenagers attending an Auckland High School a full clinical examination was conducted. The socio-economic status of the four major racial groups, European, Maori, Pacific Island Polynesian and Asian was relatively constant and predominantly from Social Classes 4 and 5. The pattern of health in each group was not significantly different between races with the exception of a high incidence of scabies and impetigo among the Maori and Pacific Island Polynesians. These skin infections were possibly related to a significant degree of overcrowding that was found in this group where 21 to 29% of the families had five or more children under 15 years of age in the one house. Dental caries was commoner among Maori teenagers. These findings are in accord with the hypothesis that health differences between races are a reflection of socio-economic factors rather than due to any intrinsic differences in susceptibility to disease.


Plasma disappearance of intravenously injected radiolabelled glycocholic acid in patients with liver disease.

The plasma disappearance of an intravenously injected tracer dose of glycocholic acid (glycine-1-14C) was compared in patients with and without diffuse hepatocellular disease. No difference was found between the two groups of patients. We conclude that this test is not a sensitive index of the presence of significant liver disease.


Cholesterol and phospholipid: influence of body weight on the output of lipids in mesenteric lymph.

In ageing humans there is accumulation of cholesterol in adipose tissue, muscle and other organs. In human obesity increased synthesis of cholesterol has been demonstrated. In order to ascertain possible endogenous sources of lipids, the output of cholesterol, phospholipid and triglyceride from the bile and small intestine was studied in rats in relationship to body weight. The output of lipid in mesenteric lymph showed an almost two-fold increase in the heaviest rats. Small intestinal concentrations of phospholipid and unesterified cholesterol rose significantly with increase of body weight. Output of cholesterol and phospholipid in bile was found to be related to body weight and total bile salt output. The increased lipid content of mesenteric lymph may reflect lipid synthesis in the small intestine, as well as increased absorption from biliary sources, and contribute to cholesterol accumulation in obese rats. Although these are major differences between human and rat cholesterol metabolism, the intestine is a major source of endogenous cholesterol in both species, and could be part of the source of the additional cholesterol load in obese humans.


Insulin aggravated postural hypotension.

In a 76-year-old diabetic with symptomatic postural hypotension during the mornings, this was greatly improved by changing his time of insulin administration from 7.30 a.m. to 11.30 a.m.


A case of myxoedema coma successfully treated by low dose oral triiodothyronine.

Myxoedema coma is fortunately rare and is probably rarer in a warm climate such as Australia. It carries a high mortality rate. Its correct management is still a controversial issue. A case of severe myxoedema coma who was successfully treated is described. Thyroid hormone was replaced in the form of triiodothyronine given orally in doses of 20-40 microng/day. There was an improvement in body temperature within six hours of the first dose; this was accompanied by a brisk fall in serum CPK and cholesterol with a rapid rise of plasma T3 into the euthyroid range. There was a defect in water excretion which was rapidly reversed as renal function returned to normal. Review of the literature suggests that low dose oral therapy with T3 is a satisfactory form of initial management.


The treatment of malignant pericardial effusion in carcinoma of the breast.

In three patients with metastatic carcinoma of the breast, control of a malignant pericardial effusion was achieved with a single pericardiocentesis followed by intensive systemic combination chemotherapy. No patient required reaspiration or any other form of local treatment. A trial of this conservative initial approach is therefore recommended in patients with pericardial effusions due to breast carcinoma. Its use in those with other tumours likely to be sensitive to systemic chemotherapy warrants further evaluation.


Small animal ventilation using a co-axial circuit.

A method is presented for the ventilation of small animals using standard adult anaesthetic equipment.


The Philadelphia chromosome (Ph1) in adults presenting with acute leukaemia: a comparison of Ph1+ and Ph1-patients.

To evaluate the frequency and clinical significance of the Philadelphia chromosome (Ph1) in adult acute leukaemia, bone marrow chromosomes were studied in 15 adults with acute lymphocytic leukaemia (ALL) and 55 with acute nonlymphocytic leukaemia (ANLL). Morphology, clinical findings, therapeutic response and survival were compared in patients with and without the Ph1. The Ph1 was found in six newly diagnosed adults presenting with ALL. Adults with Ph1+ ALL differed from those with Ph1-ALL in being older, in having more frequent lymphadenopathy and splenomegaly and in demonstrating higher initial leucocyte counts and more peripheral blasts. Complete remissions were obtained in all nine adults with Ph1-All but in only three of six with Ph1+ ALL. Adults with Ph1-ALL survived significantly longer. Four adults with ANALL were Ph1+. They did not respond to treatment and survived significantly shorter periods than adults with Ph1-ANLL. No clinical or morphologic features indicated which patients with acute leukaemia would have the Ph1. Since the presence of the Ph1 in acute leukaemia has therapeutic and prognostic significance, marrow chromosome studies should be performed in adults presenting with acute leukaemia, especially ALL.


Basophilic chronic granulocytic leukaemia with hyperhistaminaemia.

Two patients with typical Philadelphia chromosome positive chronic granulocytic leukaemia (CGL) developed an accelerated phase of the disease characterized by an increase white blood cell count and marked basophilia in the bone marrow and peripheral blood. Histamine levels were extremely high in both patients. Hyperhistaminaemia was manifested as wheezing, urticaria, diarrhoea, and pruritus in one patient and as peptic ulcer disease and peripheral oedema in both patients. In one case, gastric acid studies revealed a very high basal to stimulated ratio (BAO/MAO). Treatment with the investigational agent metiamide, an H2 receptor histamine antagonist, resulted in marked improvement in symptoms and reduction in gastric acid output. Extreme basophilia in CGL may be associated with hyperhistaminaemia, and manifestations of both the H1 and H2 type may occur.


Occurrence of acute leukaemia in myeloproliferative disorders.

In a series of 306 cases of myeloproliferative disorders followed over a period of 21 years, 18 cases of well-documented acute leukaemia were encountered. Leukaemias were either acute myeloblastic or myelomonocytic and occurred from 6 months to 20 years after the initial diagnosis. Onset was relatively abrupt and the course rapidly fatal with with a median survival of 4 weeks. Due to the prolonged preleukaemic phase, it was possible to carry out a variety of clinical and laboratory observations. While no consistent features were noted, dysplastic haemopoiesis, a fall in leucocyte alkaline phosphatase activity, presence of Pelger-Hüet anomaly and other abnormalities suggest a disturbance in granulocytic maturation. These findings suggest that, following an initial injury to a pleuripotential haemopoietic stem cell, a prolonged 'latent' period occurs and, due to exposure to additional injurious agents or to a lack of cell regulating factors, acute leukaemia develops.


Ocular ultrastructural study in a fetus with type II glycogenosis.

The general pathological and ocular studies in an aborted fetus with type II glycogenosis revealed the widespread lysosomal storage of glycogen. Obvious lesions are observed in the viscera, in the skeletal and ocular muscles, and in all ocular tissues except the pigment epithelium of the retina. Brain and heart are relatively spared. Conjunctival and skin biopsies have a diagnostic importance, since specific alterations are evident early in the course of the disease.


A new approach to the mandibular nerve block.

A new method for the block anaesthesia of the oral branches of the mandibular nerve is described. Only one penetration of the oral mucosa is made in this injection at a site which is relatively painless and which results in a more rapid onset of anaesthesia. This method is also of value when trismus or ankylsis is present and is free of common complications.


Variations in the normal anatomy of the inferior dental (mandibular) canal: a retrospective study of panoramic radiographs from 3612 routine dental patients.

A review of 3612 panoramic radiographys from routine dental patients indicates that the mandibular canals are usually, but not invariably, single and bilaterally symmetrical. The position of the canal varies with respect to the lower border of the mandible and the apices of the roots of the teeth and this excludes its use as a set reference point for prosthetic or orthodontic assessment. Three distinct varieties of supplemental mandibular canals, large enough to be seen on panoramic radiographs, are described.


Pathological conditions of the mandible: their effect on the radiographic appearance of the inferior dental (mandibular) canal.

Whilst the special anatomical features of the mandible may make radiographic comparison of jaw lesions with similar conditions in other bones more difficult, the changes that occur in respect to the mandibular canal and the teeth may in themselves aid diagnosis. Benign cysts and neoplasms generally cause a displacement of the mandibular canal, but its cortical plate remains intact, Severe infections and malignant tumours result in an irregular erosion of bone and loss of the sclerotic outlines of the canal.


Thymic hormone (THF) therapy in immunosuppressed children with lymphoproliferative neoplasia and generalized varicella.

Four children with lymphoproliferative malignant disease, two with acute lymphocytic leukemia in remission and two with Hodgkin's disease, were treated with a Thymic Hormone, THF, for disseminated varicella infecition. It is suggested that THF increased significantly the number of peripheral blood lymphocytes and T-rosette forming lymphocytes in 3 out of 4 children, who developed the varicella at the time of impaired cellular immunity. On the other hand, in the fourth child, with Hodgkin's disease, who had a normal number of T-rosettes, a decreased absolute number of lymphocytes as well as T-rosettes was observed over a course of 14 days THF treatment, although the percent of T-cells has not changed significantly. All of the four children recovered, including the child who was at high risk, with a marked lymphopenia, severe bilateral pneumonitis, hepatitis secondary infected skin lesions and psudomonas sepsis. It is indicated that THF therapy may restore the depressed cellular immunity in immunosuppressed children with malignant disease, and has its value as a supportive immunotherapy in life-threatening disseminated varicella infection.


Subacute myelocytic leukemia associated with the philadelphia chromosome and supplementary translocation : 9-12.

The authors report a case of subacute myelocytic leukemia presenting some severe aspects. The cytogenetic findings show the Philadelphia chromosome ; t (9-22) and a second translocation between the chromosome 12, and the other chromosome 9 : t (9-12). They think that this second translocation represents a supplementary cytogenetic argument for the isolation of "Subacute myeloid Leukemia with Philadelphia chromosome" within chronic myeloid Leukemia.


Polymorphonuclear function in acute myeloblastic leukemia.

A study of granulocyte functions in acute myeloblastic leukemia is reported. Functions were assessed by the ability of polymorphonuclear to migrate in Boyden's chamber, to ingest and kill staphylococcus aureus. Chemotaxis was grossly impaired. Cellular imparirment of phagocytosis and bactericidal capacity was observed in 5 and 9 patients. An inhibitor of phagocytosis and bactericidal capacity was observed in 9 and 4 patients. Results improved in complete remission.


[Myelomonocytic leukemia: clinical, cytological, and cytogenetic studies of acute, subacute, and chronic forms (author's transl)].

44 patients suffering from myelomonocytic leukemia (MML) have been observed over the last four years. They have been subclassified in acute myelomonocytic and acute monoblastic leukemias (AMML, n = 12; AMoL, n = 10), subacute myelomonocytic leukemias (SMML, n = 13), and chronic myelomonocytic leukemias (CMML, n = 9) on the basis of bone marrow cytology(blast and promonocyte counts, maturation of granulopoesis) and cytochemical findings (peroxydase and unspecific esterase reaction). This subclassification has been proved to be of prognostic relevance by its good correlation with the mean survival times (AMML : 4.5 months, AMoL : 2.4 months, SMML : 8 months, CMML : 18 months). The acute forms have been treated in general with combined cytostatic chemotherapy, whereas SMML and CMML have been treated this way only in case of progression to an acute phase. These progressions to an AMML have been observed more often and earlier in subacute forms than in chronic forms. The diagnosis of SMML and CMML is supported by the finding of sea-blue histiocytes in the bone marrow, increased lysozyme levels in serum and urine and by the absence of the Philadelphia-Chromosome.


Prolonged remission maintenance in acute myeloid leukaemia.

Twenty-five patients with acute myeloid leukaemia were treated with three quadruple drug combinations in predetermined rotation: TRAP (thioguanine, daunorubicin, cytarabine, prednisolone); COAP (cyclophosphamide, vincristine, cytarabine, prednisolone); and POMP (prednisolone, vincristine, methotrexate, mercaptopurine). Fifteen patients (60%) achieved complete remission and five (20%) partial remission. For maintenance, five-day courses of drugs were administered every 14 to 21 days and doses were increased to tolerance. The median length of complete remission was 66 weeks. In eight patients remission maintenance treatment was discontinued and some remained in complete remission for over two years. In this series the remission induction rate was comparable with that reported for other regimens and complete remission lasted longer with this intensive maintenance regimen than with others. Nevertheless, the TRAP programme must still be regarded as only palliative treatment for acute myeloid leukaemia.


Lymphoid blastic crisis at the onset of chronic granulocytic leukemia: report of two cases.

Two patients with a typical hematologic pattern of acute lymphatic leukemia were brought into complete remission by treatment. A few weeks later they developed a typical peripheral and bone marrow pattern of chronic granulocytic leukemia, with Philadelphia chromosome and very low leukocyte alkaline phosphatase. These cases, along with other findings recently reported in the literature, support the possibility of a previously unrecognized relationship between lymphoblastic cell populations and chronic granulocytic leukemia.


Clostridium septicum infection in childhood leukemia: report of a case and review of the literature.

Overwhelming Clostridium septicum infection is a rare occurrence in children. It is seen almost exclusively as a complication of acute leukemia. A high index of suspicion in the leukemic child with an acute abdomen is the key to early diagnosis and improved survival. A case in a 13-year-old girl with acute myelogenous leukemia is reported and six pediatric cases in the literature were reviewed.


Urinary lysozyme phenotypes in monocytic leukemia.

A method of two-dimensional electrophoresis has been devised to allow the study of the electrophoretic mobility of urinary lysozyme. Three different phenotypes have been defined in a study of thirteen purified lysozymes obtained from different patients with monocytic leukemia.


Pharmacologic studies of continuous infusion of arabinosylcytosine by liquid infusion system.

Arabinosylcytosine (ara-C) was administered by prolonged intravenous infusion with a portable liquid infusion system (LIS) to patients with acute myelogenous leukemia. With the use of tritiated ara-C and this portable system, pharmacologic studies were performed in 8 patients. Most of the plasma radioactivity is in the deaminated product, arabinosyluracil (ara-U). After continuous intravenous infusion, a constant ara-C level is achieved slowly in the plasma. Unless a loading (priming) dose is administered immediately before beginning the infusion, a steady-state ara-C level cannot be achieved until 8 to 24 hr after the infusion. The infusion system has two mechanisms--one for giving a loading dose (3 ml/min) and the other for regular infusion at a rate of 0.5 to 2.0 ml/hr. If a loading dose is given before continuous infusion, a steady-state are-C level is achieved within an hour. The plasma ara-C disappearance curves are biphasic with a terminal half-life of 104 min, which is the same as that of a single injection. The cumulative urinary excretion after approximately 23 hr of infusion varied from 14% to 35% in different patients; more than 90% is ara-U and the remainder is ara-C. Our results have demonstrated that LIS can be used conveniently to sustain a constant plasma level of ara-C. The LIS increases mobility of both inpatients and outpatients and is particularly convenient for ambulatory patients.


A computerized system for the evaluation of community dental programs.

This paper reports on a relatively uncomplicated and inexpensive computerized system for prospective evaluation of clinical dental programs from the point of view of effectiveness and efficiency. Availability of this system does away with some high start-up costs. Three forms of input data, new case information, examination findings and operative procedure information, are regularly collected on data sheets and specially designed Port-a-punch IBM cards. Easily interpreted output tables are generated monthly on such variables as completed cases according to treatment series and clinician, number of various procedures performed by clinicians, etc. Productivity is measured, in part, by application of monetary constants to procedure data. This paper describes the computer programs used, the cost of setting up and operating the system (which is within the budgetary constraints of most small, publicly funded programs) and the benefits that can be derived from the use of such a system. The system provides prompt feedback of relevant administrative data, thus allowing for relatively quick response to problems. Use of the system reduces clerical needs to a minimum and the program can easily be implemented on any except the very smallest digital computer.


Time utilization, productivity and costs of solo and extended duty auxiliary dental practice.

A study was conducted to compare the time utilization of the dentist, and productivity and costs for solo (one dentist, one chairside assistant and one treatment room) and extended duty settings (one dentist, two extended duty dental hygienists, one chairside assistant and two treatment rooms). Only amalgam and composite restorations done in a general group practice were included. In the extended duty setting the dentist spent more time in managerial activities and less time in treatment than in the solo setting. Nevertheless, the dentist in the extended duty setting produced 53% more restorations as compared with solo practice. The cost ratio of solo to extended duty practice was computed to 1:1.52. From the point of view of microeconomics, the extended duty setting was found no worse than the solo setting.


The distribution of dentists and the uptake of dental treatment by schoolchildren in England.

The uptake of treatment by 508 14-year-old children in different social classes in two towns in England with different dentist:population ratios was investigated. In the town with the unfavorable dentist:population ratio (Town U) the uptake of treatment was considerably higher in the higher social classes. In the town with the favorable dentist:population ratio (Town F) the uptake was similar throughout the social scale. The results suggest that the availability of dentists rather than sociologic attitudes to dental health is largely responsible for the differential uptake of treatment by children in the different social classes.


Role of health education among services rendered by dental personnel in Finland.

The quantity and origins of dental health education information were surveyed in June 1973 by interviews with a sample comprising 505 persons drawn to cover the total Finnish population aged 15 years and over. The interview revealed that tooth extraction was the most frequent (43%) of the measures performed during the last visit to dentist and tooth filling was the measure second in frequency (41%). Rare measures were periodontal treatment (13%) and teaching of home care (2%). Radio and television were the most frequently mentioned sources of information (47%); however, the evaluations of the reliability of information on dental health education in the mass media were skeptical. Dental service personnel was a not minor source of information (33%) and its effectiveness was recognized. Although dental health education performed on the personal level is a great challenge, which should be accepted by the whole dental personnel, a total of 58% of the interviewees were of the opinion that they had not received sufficient information on dental home care.


A marked difference in caries prevalence between 5-year-old children in two areas of Staffordshire, England.

The purpose of this study was to compare the dental caries experience of 5-year-old children in an urban and rural area of Staffordshire, England. The populations comprised 365 children and 206 children, respectively. 161 children in the urban area and 124 children from the rural area were examined. Those in the rural area had 44% less dental caries experience (P less than 0.01). The mean dmf of children with good dental cleanliness was similar in each area but there was a 39% and 33% interarea difference between those with fair and poor standards of dental cleanliness. A larger proportion in the rural area belonged to social classes 1 + 2 and fewer to social classes 4 + 5. A significant difference in dmf (P less than 0.01) between the areas in social classes 3N and 3M was found. Water supplies had less than 0.20 parts/10(6) fluoride. The interarea difference in caries prevalence cannot be fully explained by consideration of the variables of dental cleanliness, social class and waterborne fluoride. It is hypothesized that tooth resistance may differ between the areas. The study will be repeated to confirm the findings.


Prevalence of hypodontia and malformations of permanent teeth in Iceland.

This study was performed to elucidate the prevalence of hypodontia and congenital malformations of permanent teeth in Iceland. Computer analysis was done on the basis of results from examining 1,116 children (521 boys and 595 girls), or about 9.5% of all schoolchildren in Reykjavík in stages DS 3 (canines and premolars erupting) and DS 4 (canines and premolars fully erupted) of dental development at the time of the study. The age range was mainly from 8-16 years. The prevalence of congenitally missing teeth (second and third molars excluded) was 6.7% in boys and somewhat higher, 8.9%, in girls, 7.9% for both sexes combined. On the average, each child was missing 1.9 teeth. In the girls, the most commonly absent teeth were the mandibular second premolar (55%), the maxillary second premolar (19%), and the maxillary lateral incisors (18%). In the boys the figures were 51%, 18%, and 10%, respectively. Malformation of permanent teeth, mainly in the form of pegshaped maxillary laterals, was also less common in the boys, 1.3% against 3.0% in the girls, and 2.2% for both sexes combined. Among Icelandic children hypodontia and/or congenital malformation of permanent teeth were found in 9.1%.


Tooth survival in institutionalized elderly Cape Coloreds from the Cape Peninsula of South Africa.

An investigation has been conducted in order to assess the oral health status and need for dental treatment among Cape Coloreds resident in homes for the aged in the Cape Peninsula of South Africa. Tooth loss was greater in females than in males (P less than 0.002) but a statistically significantly greater proportion of surviving teeth were grossly carious in men than in women (P less than 0.002). More teeth had survived in the mandible than in the maxilla (P less than 0.002) and proportionately more teeth were grossly carious in the maxilla than in the mandible (P less than 0.002). The distribution pattern of the remaining dentition according to tooth type was similar for both jaws, the canines being the most persistent teeth.


[Acute myeloid leukaemia in the course of Hodgkin's disease (author's transl)].

Acute myeloid leukaemia occurred in six patients who had been treated for Hodgkin's disease for a number of years. Usually the leukaemia diagnosis was preceded by a striking pancytopenic phase, bone-marrow aspiration being more useful diagnostically than biopsy. Five of these six patients have come under observation in the last eighteen months. This extraordinary frequency of secondary acute myeloid leukaemia once again raises the question of the leukaemogenic effect of intensive radiotherapy and chemotherapy, and also new aspects in the therapeutic management of Hodgkin's disease, especially combined radiotherapy and chemotherapy, as well as long-term maintenance chemotherapy.


[Combination chemotherapy in acute blast crisis of chronic myeloid leukaemia (author's transl)].

Sixteen patients in an acute blast crisis of chronic myeloid leukaemia (CML) were treated with a combination of vincristine, 6-mercaptopurine, hydroxyurea and prednisone. Only two of these patients had complete remission on this treatment, while four had partial remission. This experience, comparable to that reported by others, suggests that aggressive treatment in the terminal phase of CML is justified only as part of a prospective and well-controlled study.


[Epidemiological study on hepatitis morbidity in dental personnel on the model of the Erlangen university dental clinic].

1. The dentist and staff are exposed to nearly double the risk of hepatitis than the population in general. The risk of infection rises with proved contact with hepatitis patients. 2. About 60% of dental personnel suffers subclinical infections. A subclinically infected person is a source of infection for his patients. 3. The chief source of infection is blood contact. In comparisons with the practitioner with mixed dental practice, the surgically active dentist is exposed to three or four times the infection risk. 4. Serological determination of hepatitis antibodies makes it possible to demonstrate subclinical infections. 5. Consistent prophylaxis against infection is required. After proved contact with a hepatitis patient, infection can be prevented by timely treatment with hyperimmune serum.


[Clinical aspects of osteomyelitis sicca (pseudo-Paget)].

Osteomyelitis sicca of the mandible in its dry, tumour-producing form was described clinically and radiologically as pseudo-Paget's disease by Axhausen in 1934. In 1969, Hoppe et al. were able to corroborate in animal experiments different stages of this disease, previously outlined by Hoppe in a pathological histological study in 1964. Empirically, an anti-rheumatic treatment offers itself with which an exacerbation can be cut short and complete remission obtained later.


[Contribution to the microbial catabolism of xylitol].

Five xylitol metabolizing streptococci strains from the oral cavity of the rat were examined with regard to their metabolic capacities for xylitol, sorbitol, mannitol, fructose, glucose and saccharose by means of the Warburg technique. The amounts metabolized were smallest with xylitol and sorbitol and considerably bigger with mannitol and fructose. By far the highest CO2 values were obtained with glucose, while saccharose was not metabolized at all. The experimental results confirm the weak metabolic capability of these organisms with regard to the sugar substitute xylitol.


[Cephalometric analysis of the mid-facial region in Central Europeans].

In the evaluation of 101 cephalometric x-rays, the measuring point infraorbitale Io is established for the cephalometric analysis of the middle third of the face. Being the most ventral point in the infraorbital region Io can easily be identified on radiograms. As cephalometric parameters of the middle third of the face, the angles SNaIo, IoNaA as well as the distance Io-NaA are chosen. The most favorable measurement seems to be the angle SNaIo. There are correlations between the newly introduced angle SNaIo and SNaA/SNaB. When combining the two angles in pairs, hypoplasia of the middle third of the face can be cephalometrically differentiated into infraorbital, maxillary and total hypoplasia. The practical significance of this method for surgical corrections of deformations of the middle third of the face is pointed out.


[Geometric-mathematical analysis of transition errors in the articulator and their practical effects].

In a computerized program based on the conditions in the Dentatus articulator, those errors were calculated and graphically represented which resulted from the inaccurate registration of the following parameters: Sagittal and caudal distance of incisal point to condyle axis, condyle dise put into relation to 2 mm laterotrusion of a molar point. In both the frontal and the horizontal plane, the individual parameters led to differently great errors which influenced the working and the balancing sides differently. The greatest errors occur when changing the angle of the inclination of the mandibular condyle path and the sagittal and caudal distance of incisal point to condyle axis. Errors of several tenths of a millimeter in the frontal plane are potential disturbing factors.


[Lipid analysis in jaw cysts].

In patients with jaw cysts, cyst content and blood serum are examined by means of thin section chromatography with regard to their contents of cholesterol, free fatty acids, triglycerides and cholesterol esters. The increase in lipid content found in the cyst is primarily due to the increase in free cholesterol. Since the serum values are within normal ranges, it is unlikely that cysts are the result of endogenous causes. Our examinations showed that they are primarily due to local processes.


[Dentomaxillary destructions in oxalosis].

Oxalosis, a rare metabolic disorder, leads to excessive formation of oxalate and deposition of calcium oxalate crystals in the tissue. This leads to renal insufficiency with resulting secondary hyperparathyroidism and myelofibrosis. In a 27 year old female patient, extensive destruction of the maxilla, mandible and teeth was observed which has not yet been described and which led to the loss of all teeth.


Amino acid control of stable RNA synthesis in Friend leukemia cells in relation to intracellular purine nucleoside triphosphate levels.

Histidinol is known to cause deacylation of histidyl-tRNA in cultured mammalian cells, thereby producing a functional deprivation of histidine. Such deprivation of an essential amino acid is known to produce various effects, including inhibition of tRNA synthesis and of nucleolar RNA synthesis and processing. It has been proposed [Grummt, F. & Grummt, I. (1976) Eur. J. Biochem. 64, 307-312] that this response to amino acid deprivation is mediated by decreases in GTP and ATP pool sizes caused by a deacylated-tRNA-dependent hydrolysis of GTP. In contrast, we find that Friend leukemia cells treated with histidinol show no significant changes in GTP or ATP pool sizes, although this treatment does produce the expected inhibition of rRNA and tRNA synthesis.


Sex selection with biased technologies and its effect on the population sex ratio.

Current biomedical research on sex selection techniques may soon offer couples the opportunity to choose the sex of their children with greater certainty. A technique planned for marketing by mid-1978 can increase the probability of bearing a son to as much as 0.90. However, couples who wish to improve their chances of bearing a daughter have no such opportunity. The purpose of this paper is two-fold. First, a decision-making model is provided which describes how couples should choose among alternative sex-selection methods so as to maximize the probability of bearing their desired number of sons and daughters. Second, the effect of the widespread use of sex-selection techniques on the population sex ratio is explored. It is shown that even if populations have unbiased sex preferences, or sex preferences biased towards daughters, the use of biased sex-selection technologies may result in very high population sex ratios.


Differentiation of a resistant clone of mouse myeloid leukemia cells with dimethyl sulfoxide and ascitic fluid.

Mouse myeloid leukemia line cells, M1, could be induced to differentiate in vitro into macrophages and granulocytes with ascitic fluid of animals bearing various tumors. M1 cells could not be induced to differentiate with dimethyl sulfoxide alone. During the culture of M1 cells, spontaneously appearing cells resistant to factors stimulating differentiation (D-factor) in ascitic fluid were isolated. These resistant cells were more refractile to the toxic action of dimethyl sulfoxide than sensitive cells and grew in culture medium with 1% dimethyl sulfoxide. Although the resistant cells were not induced to differentiate with dimethyl sulfoxide alone, they were sensitized with the aid of dimethyl sulfoxide to undergo differentiation with the D-factor in ascitic fluid.


Glucorticoid-induced differentiation of cultured mouse myeloid leukemia cells.

Mouse myeloid leukemia cells were induced by some corticoid hormones to migrate in agar, phagocytize, and change into forms which were morphologically similar to macrophages and granulocytes. Inducing ability of corticoids was correlated with glucocorticoid activity, not mineralocorticoid activity. Other steroids were ineffective to induce differentiation of myeloid leukemia cells. Glucocorticoid-resistant cells, which could not differentiate even in a high concentrations of dexamethasone, were selected from steroid-sensitive cells by stepwise increase in concentrations of dexamethasone in culture medium.


Fluorescence banding techniques in the identification of sibling species of the anopheles gambiae complex.

The mitotic chromosomes of the sibling species A and B of the Anopheles gambiae complex were stained with Hoechst 33258 and examined by fluorescence microscopy. The autosomes fluoresce homogenously and similarly in both species while the sex chromosomes differ in the location and brightness of some heterochromatic blocks. These cytochemical differences allow the cytotaxonomic identification of these cryptic species.


The evolution of dominance: Haldane v Fisher revisited.

Fisher's model for the evolution of dominance indicates that the accumulation of dominance modifiers will be accelerated by (1) an increased frequency of the mutant heterozygote, (2) increased selection for the phenotype of the normal homozygote. The model has been criticised by Haldane on the grounds that point (1) is not fulfilled, that is dominance appears to be more common in populations with a low frequency of mutant heterozygotes (populations of inbreeders). In support of Fisher's model it is argued that intense selection for the wild type phenotype is more common in inbreeders than outbreeders. This situation should promote the accumulation of dominance modifiers (point (2) above).


The effective size of a natural drosophila subobscura population.

The effective size of a natural Drosophila subobscura population has been computed by drawing together various pieces of ecological information. The value, for both variance and inbreeding effective numbers, is approximately 400. This is largely due to reductions caused by a winter bottleneck and non-random distributions of family sizes. Areas where such estimates might be refined further are pointed out, and the implications of the results are discussed.


Linkage mapping from pair-wise recombination data.

The problem of obtaining a genetic map of a linkage group from pair-wise recombination data is considered. A non-parametric approach is proposed, that does not require the definition of a mapping function, computation of coefficients of coincidence, nor knowledge of map length or sex differences in recombination. An application to Bridges and Morgan's (1923) data on chromosome 3 of Drosophila melanogaster is presented.


The genetical analysis of covariance structure.

The analysis of covariance structures (Jöreskog, 1973) is adapted to the simultaneous maximum likelihood estimation of genetical and environmental factor loadings and specific variances. The goodness of fit is tested by chi square and standard errors of parameter estimates can be obtained. Any linear model used in univariate genetical analyses can be extended to the multivariate case. Most biological hypotheses about the relationships between variables can be specified by a variety of factor models. Individual parameters can be given fixed values or set to zero and hypotheses concerning the congruence of genetical and environmental correlations can be tested. The method is illustrated with published twin data on cognitive abilities.


The consequences of using inadequate testers in the simplified triple test-cross.

The genetical consequences of common alleles in the L1 and L2 testers of a simplified version of the triple test-cross which is applicable to populations of inbred lines are examined. The test for epistasis under these circumstances becomes ambiguous and can spuriously detect non-allelic interactions when they may not exist although it still provides a test for epistasis and the adequacy of the testers simultaneously. The tests of significance and the estimates of additive variation are biased to an extent related to the dominance and dominance x additive effects of the common loci while the significance and estimates of dominance variation are deflated because they reflect the dominance effects at the non-common loci only. The covariance of sums and differences is also underestimated for the same reasons. These expectations are illustrated by analysing the 190 simplified triple test-crosses that could be extracted from a 20 x 20 diallel set of crosses between pure-breeding lines of Nicotiana rustica.


The use of regression methods to study genotype-environment interactions: extending Griffing's model for diallel cross experiments and testing an empirical grouping method.

A model combining features of Griffing's diallel cross analysis with regression analysis for genotype-environment interactions is introduced using carp data of Moav et al. (1975) as an example. An analysis of variance based on this model provides information on the combining abilities of genetic effects and the interactions of these effects with environments from which inferences can readily be made on heterosis and heterosis-environment interactions. Applying the empirical grouping method of Lin and Thompson (1975) to these data (ignoring their diallel cross structure) established groups which were remarkably consistent with their members' crossing backgrounds.


A new index for the intensity of natural selection.

A new index for the intensity of natural selection is proposed, based upon the double exponential model for fitness functions. This index is defined as a variance and is such that a value of zero indicates no selection while a value of one indicates quite strong selection. The use of the index is demonstrated using published data on the survival of human infants with different birth weights and gestation times.


Genetics of obesity of Zucker rats and Koletsky rats.

The breeding data on Zucker rats and on Koletsky rats confirm that the obesity in these two strains of rats is inherited recessively and results from single gene mutations. Mating a Zucker heterozygote to a Koletsky heterozygote produced obese F1 progeny. Inter-stock breeding results indicate that the obesity in the Zucker-Koletsky hybrid stock is also inherited in a recessive manner. The gene that controls obesity in the Zucker rats, fatty (fa), and the gene that controls obesity in the Koletsky rats, f, are thus alleles at the same locus. We propose that f be renamed fak until it can be proven that fa and fak are identical.


A model for the specific pairing of homologous double-stranded nucleic acid molecules during genetic recombination.

A model involving a specific pairing of homologous double-stranded nucleic acid molecules is applied to some parts of genetic recombination. The most original features of this application of the model relate to the initiation process, a part of which can be described by a highly compact and symmetrical structure. The model also provides a simple view of the formation of hybrid nucleic acid. The possibilities of detecting four-strand structures are briefly discussed.


A model of assortative mating with partial dominance.

A model of assortative mating incorporating partial dominance is proposed for a single locus with two alleles. It is derived by starting from an arbitrary genotypic distribution and finding symmetric and non-selective mating frequencies which duplicate this distribution. Numerical values are imputed to genotypes, the homozygotes having numerically equal values, opposite in sign, and the heterozygote having a value determined by the gene and heterozygote frequencies. The model is specified in a canonical form which reveals the correlation between mates based on genotypic values, and relates the correlation to the fixation index. It permits negative as well as positive values of the fixation index. It is shown that this general model includes several particular cases, in equilibrium phase, occurring in the literature.


Treatment of feline myelogenous leukemia: four case reports.

Of 4 cats with myelogenous leukemia, 3 had the neutrophilic type and 1 had the basophilic type. Partial remission was achieved with chemotherapy in 2 of the cats. Their survival times, however, were 77 and 31 days from time of diagnosis. The other 2 cats did not respond to treatment and died 16 days from time of diagnosis.


Induction of globin gene expression in cultured erythroleukemia cells by butyric acid.

Butyric acid induces erythroid differentiation of cultured Friend leukemia cells when added to the culture medium. A high level of globin messenger RNA (mRNA) was detected in Friend leukemia cells treated with butyric acid by a liquid hybridization method using radioactive DNA complementary to reticulocyte globin mRNA. The content of globin mRNA molecules induced in the cytoplasm of the butyric acid-treated Friend leukemia cells paralleled the hemoglobin content determined by the benzidine staining method. Therefore, this hemoglobin synthesis may be most reasonably explained in terms of transcriptional activation of globin genes, as previously proposed in the case of dimethylsulfoxide, another inducer of erythroid differentiation. Induced accumulation of globin mRNA in the nuclei also supports this interpretation.


Renal aspergillosis: a report of two cases.

Two cases of opportunistic aspergillosis of the kidney are presented. One patient, a child with unsuspected chronic granulomatous disease of childhood, presented with a renal mass which proved to be an abscess secondary to aspergillosis. The other patient, a terminal leukemic, had a renal vein thrombosis secondary to invasion of the renal vein by aspergillosis. Aspergillosis and other fungal diseases of the kidney should be considered in debilitated patients with an abnormal urogram.


Growth of plaque while chewing sucrose and sorbitol flavoured gum.

The aim of the study was to assess the claimed toothcleansing effect of sorbitol and sucrose flavoured chewing gums. A total of 24 dental students participated in a double-blind, four times crossed over clinical trial during which each student chewed both types of gum for 4 days each. No other means to clean the teeth were allowed during the test periods. Two 4-day periods of no oral hygiene and no chewing were used as controls indicating the normal growth rate of plaque. The results confirmed earlier observations that sorbitol flavoured gum does neither increase or decrease plaque formation. Chewing of sucrose gum, however, was found to promote the growth rate of plaque. The cleansing effect of the gums was also tested on the plaque formed during the 4-day no-oral-hygiene periods. In this part of the study the chewing of 10 pieces of sorbitol flavoured gum during a time period of 3 h did not significantly reduce the plaque scores, while the sucrose flavoured gum, correspondingly used, again resulted in a statistically significant increase in the amount of bacterial deposits. Because of the rapid reaction of the plaque to sucrose flavoured gum, so-called sugarless substitutes were recommended for those who insist on chewing.


Clinical relevance of circulating immune complexes in human leukemia. Association in acute leukemia of the presence of immune complexes with unfavorable prognosis.

The occurrence of circulating immune complexes was investigated in 467 serum samples from 230 leukemia patients using the [(125)I]Clq-binding test. There was an increased serum [(125)I]Clq-binding activity in 40% of patients with acute myeloid leukemia, 23% with acute lymphatic leukemia, 46% in blastic crisis of chronic myeloid leukemia, 12% with chronic lymphatic leukemia, and 13% with chronic myeloid leukemia. In 48 patients, serum was also tested for soluble immune complexes by the Raji cell radioassay; the correlation between results of the two tests was significant. The Clq-binding material had properties identical with those of immune complexes. It sedimented as 14-28s material on sucrose density gradient. It contained IgG which could be dissociated at acid pH. Its Clq-binding properties could be removed after passage through anti-IgG immuno-absorbant or after a mild reduction-alkylation treatment, but were not sensitive to deoxyribonuclease treatment. Circulating immune complexes were found most commonly during the blastic stage of leukemia.Remission took place in 75.4% of patients with no detectable circulating immune complexes at the onset of acute leukemia, but in only 32.7% of those with detected complexes during this period. Median survival times of the former group of patients were more than 18 mo in acute myeloid leukemia and acute lymphatic leukemia and more than 8(1/2) mo in blastic crisis of chronic myeloid leukemia. The corresponding median survival times in the latter patient group were 64, 135, and 90 days. These findings were unrelated to prognostic features already known.


The reversal of localized experimental gingivitis. A comparison between mechanical toothbrushing procedures and a 0.2% chlorhexidine mouthrinse.

Twenty dental students randomly divided into four groups of five participated in this trial. Three weeks of supervised oral hygiene preceded the study in order to ensure a optimum state of gingival health. The gingival condition was assessed by means of the Gingival Index and measurements of gingival exudate. Plaque accumulation was assessed by means of the Plaque Index. Using plaque-guards, two 21-day periods were alllowed for the induction of localized experimental gingivitis around a lateral incisor and adjacent canine in each jaw. The contralateral areas served as controls. Habitual oral hygiene procedures were maintained in all other areas of the mouth throughout the experimental periods. Following 21 days of localized plaque accumulation in the mandibular experimental areas, mechanical toothcleaning procedures were introduced at intervals of once a day (Group A), once every second day (Group B), once every third day (Group C) and once every fourth day (Group D). Groups A and B regained gingival health in 10 days. The experiment was then repeated in the maxillary experimental areas. Group A, rinsing once daily with chlorhexidine solution regained gingival health in 4 days. The results obtained in the localized experimental gingivitis model were similar to those reported when totally withdrawing oral hygiene.


Microscopic evaluation of clinical measurements of connective tissue attachment levels.

The purpose of this study was to determine how accurately periodontal probes measure connective tissue attachment levels in beagle dogs with (1) clinically healthy gingivae, (2) experimental gingivitis, and (3) periodontitis. In the healthy and experimental gingivitis specimens the probes were inserted with a standardized force of 25 ponds. In periodontitis specimens the probes were inserted with a gentle, but nonstandardized force. After insertion, 120 plastic periodontal probes (40 in each group) were held in place by fusing them to the teeth. Blocks of periodontal tissue with the probes in situ were subsequently processed and serially sectioned. Histometric measurements were made from the sections in order to compare the level of connective tissue attachment to the level of probe penetration. In healthy specimens the probes consistently failed to reach the apical termination of the junctional epithelium (x = -0.39 mm). In the experimental gingivitis group most probes came closer to the apical termination of the junctional epithelium, but on the average still fell short by x = -0.10 mm. In periodontitis specimens the probes consistently went past the most apical cells of the junctional epithelium (x = +0.24 mm). A significant relationship between the degree of inflammation and level of probe penetration was found. No relationship was observed between histological and clinical sulcus depths. It is concluded that in beagle dogs (1) periodontal probes do not precisely measure connective tissue attachment levels, (2) inflammation has a significant influence on the degree of probe penetration, and (3) histological and clinical sulcus depths differ significantly.


A clinical study of the relationship between crowding of teeth, plaque and gingival condition.

A clinical trial was undertaken to assess whether crowded teeth were more likely to accumulate plaque and develop gingivitis than non-crowded teeth. A tooth was considered crowded if it was displaced by 2 mm and/or rotated 15 degrees or more from the normal position in the arch. The material consisted of 50 dental students aged 21 to 32 years. An initial examination comprised assessment of Plaque Index, Gingival Index and pocket depths. After this examination the subjects refrained from using interdental cleaning aids but continued with their normal toothbrushing for 40 days. After re-examination they were instructed in the effective use of dental floss. A final examination was carried out after 140 days. At the start of the trial no difference was found in regard to the Plaque Index between crowded and non-crowded teeth. The Gingival Index for growded front teeth, but not for crowded premolars, was somewhat higher than for the corresponding controls. The cessation of interdental cleaning resulted in a similar increase in plaque accumulation and gingival inflammation in both non-crowded and crowded teeth. The use of dental floss for approximal tooth cleaning resulted in a similar decrease in the Plaque- and Gingival Indices for both types of teeth. The results demonstrate that in a group of young adults, crowding of teeth (1) did not favour plaque accumulation on approximal tooth surfaces and (2) influenced the degree of gingival inflammation only to a minor extent.


Microbial characterization of an experimental cariogenic plaque in man.

Experimentally induced plaque seemed to originate by direct contact inoculation from the vestibular mucosa and saliva. During the next seven days, this plaque developed its own characteristics. Populations of Streptococcus mutans usually less than 2% of total streptococci population in plaques that were less than three days old, increased between days 3 and 7. Proportions of S sanguis, high in early samples, decreased after day 3. Populations of S salivarius, which usually outnumbered other streptococci, fluctuated widely through day 3, and then increased in proportion in subjects who were more productive of experimental caries, but decreased in subjects who were less productive. Proportions of plaque flora comprising lactobacilli paralleled those of S salivarius.