Role of radiation therapy in management of adult leukemia.

There are both defined and evolving roles for radiation therapy in the management of adult leukemias. For the acute leukemias, emphasis presently is on adjuvant irradiation of local manifestations including CNS "prophylaxis" for subclinical meningeal involvement. In chronic myelocytic leukemia, local palliative radiotherapy is complemented by the use of splenic irradiation for its systemic effect. Recently, total body irradiation has been shown to influence the natural history of chronic lymphocytic leukemia. For the first time, it has been possible to achieve remissions that prolong survival as well as improve the quality of life. Future exploitation or radiotherapy in adults with leukemia will be dependent upon improved communication and cooperation between the various medical specialists concerned with patient care in these diseases.


Deanol in Gilles de la Tourette Syndrome: a preliminary investigation.

On the basis of its pharmacologic action Deanol (dimethyl aminoethanol) was hypothesized to be of benefit in the Gilles de la Tourette Syndrome. In one case report the addition of Deanol to perphenazine did not result in an improvement of uncontrollable movements or involuntary speech utterances. Gilles de la Tourette Syndrome is a condition combining organic and psychogenic features existing in the interface between two etiologies. Classically the disease begins in childhood and is characterized by the appearance of sudden involuntary movements, involuntary speech utterances frequently consisting of curse words (coprolalia), and imitative phenomena such as echolalia and echopraxia. Neurotic symptomatology such as anxiety and obsessive thinking have also been reported. This condition is regarded neuropharmacologically as a dopaminergic state that responds to drugs with antidopaminergic activity e.g. the phenothiazines and butyrophenones. Deanol (dimethyl aminoethanol) is a putative cholinergic agonist and has reported effectiveness in conditions where there is a predominance of dopaminergic versus cholinergic activity, e.g. levodopa-induced dyskinesias, neuroleptic induced tardive dyskinesia, and Huntington's chorea. Because of its effectiveness in dopaminergic states it was hypothesized that Deanol could also be of benefit in the Gilles de la Tourette Syndrome.


Characteristics of osteosarcoma cells in culture.

Osteosarcoma cells (BFO cell line) were successfully maintained in tissue culture for 3 years. BFO cells showed 100 per cent tumorigenicity by the isologous implantation, and almost the same histological features as the original BF osteosarcoma. BFO cells synthesize and secrete large quantities of alkaline phosphatase both in vitro (cell culture) and in vivo (tumor bearing mice). BFO cells showed a suppression in synthesizing the osteoinductive factor in vitro, but regained the capacity to synthesize it when implanted back into an isologous host. The cells showed rapid growth, a serum requirement, and no contact inhibition. Doubling time was 8.6 hours in a logarithmic growth phase. Cell cycle analyses by pulse labeling of 3H-thymidine was performed after synchronization of the cells by double treatment with an excess thymidine.


[Altered platelet surface glycoproteins in chronic myeloid leukemia (author's transl)].

The present status of knowledge about the platelet membrane components suggests that glycoproteins (GP) are involved in the intercellular platelet specific reactions, such as adhesion and aggregation. Normal human platelets and platelet membranes solubilized under dissociating conditions produce characteristic polypeptide and GP electrophoretic patterns (PAGE). Platelets and isolated platelet membranes from patients with chronic myeloid leukemia (CML) presented dissimilarities of their glycoconjugates as compared to the normal platelets. The modification of the electrophoretic banding visualized by the periodic acid-Schiff's reagent (PAS) consisted in the decrease of the 155,000 GP L, the presence of two PAS positive bands in the area of the 135,000 normal PAS positive GP LL and a variable decrease of the 100,000 GP LLL (Apparent mol. wt. are indicated). In addition, preliminary data showed an increased catalytic transfer of the labelled galactosyl and N acetygalactosaminyl residues from exogenous nucleotide 14C-sugar precursors onto the CML-platelet endogenous sugar acceptors. These firstly reported data on molecular abnormalities of the platelet membrane GP in CML, suggested their possible relationship with the impaired platelet adhesion and aggregation occurring in this disease or the ability of leukemic platelets to express modified surface membrane components.


Cytochemical detection of histamine in the human granulopoietic series of healthy subjects and of patients affected by chronic myeloid leukaemia. A spectrophotofluorimetric test for checking OPT-induced fluorescence in isolated cells.

Cellular histamine in blood and bone marrow has been identified histochemically using an o-phthaldialdehyde fluorescence reaction. The specificity of the reaction was tested by a spectrofluorometric analysis of cell extracts. In normal blood, the basophils emit a bright yellow fluorescence, whereas neutrophils, eosinophils and platelets react less consistently and when they do, they give off a less intense yellow or blue emission. In normal marrow, basophils react strongly whereas the metamyelocytes and later granular cells show only a weak yellow or blue fluorescence. In chronic myeloid leukaemia, cells of the granular series emit a strong yellow fluorescence at all stages of development, although still less intense than the basophils. During remission, the fluorescence pattern of cells from leukaemic subjects reverts to that of normal cells.


Regional intrapulmonary gas distribution in awake and anesthetized-paralyzed man.

Intrapulmonary distribution of ventilation/unit lung volume was studied in 28 volunteers in the sitting, supine, or right lateral decubitus position, either awake or anesthetized-paralyzed and mechanically ventilated. We found significant differences between the awake state and anesthesia-paralysis with mechanical ventilation in 1) intrapulmonary gas distribution, and 2) the vertical gradient of regional functional residual capacities for the subjects in the lateral decubitus position, but not for those in the sitting and supine positions. The effect of increasing the tidal volume on distribution of ventilation was significantly different 1) between the three body positions for a given state, and 2) between the two states for a given body position. The data suggest thoracoabdominal mechanics are different in the three body positions and that anesthesia-paralysis and mechanical ventilation may cause a different pattern of expansion of the respiratory system than spontaneous breathing in the awake state.


Dental plaque and dietary intakes in schoolchildren in Hawaii.

Plaque formation on the teeth as measured by the number of teeth with a heavy plaque accumulation was found to be influenced by diet. Accumulation of plaque was enhanced by the frequent consumption of food items such as sweet rolls, sweet breads, manapua, and poi. All of these are characterized by their sucrose content and stickiness. However, fruit drinks were shown to have a retarding effect on plaque growth. The information on the amount of plaque had little relationship with the dental caries status of the subjects, whereas it was significantly associated with periodontal health.


Effect of multiple dental floss-SnF2 treatment on Streptococcus mutans in interproximal plaque.

Samples of dental plaque obtained from the interproximal tooth surfaces of seven young men showed considerable variation in the prevalence and anatomic site distribution of the potentially cariogenic microorganism S mutans. Multiple application of 10% SnF2 topical solution and saline solution delivered to interproximal test sites with dental floss were evaluated as short-term measures for eliminating S mutans from these surfaces. A greater overall reduction in the number of positive S mutans sites was observed for the SNF2-treated sites than the saline solution-treated sites. Long term studies are required to evaluate the effect of the treatments on the incidence of dental caries.


Diffusion of strontium from desensitizing agents into human dentin as determined by energy-dispersive analysis.

Strontium-containing desensitizing agents were applied to one set of tooth surfaces and were burnished onto another set of diametric surfaces. Concentration of strontium at dentin depth was determined by X-radiation dispersive analysis. Burnishing produced deeper strontium penetration. Fick's Second Law provided an estimate of relative effective time for equal strontium distributions by the two methods.


Creep and phase transformation in dental amalgam.

Creep measurements were performed on different types of amalgams as a function of heat treatment after specimen preparation before testing. The types of amalgams included lathecut, spherical, nonpreamalgamated amalgams, and an amalgam containing Ag-Cu particles. Heat treatment significantly reduced the creep of all alloy types studied. Creep reduction was associated with the phase and transformation gamma1 leads to beta1 (Ag-Hg), which was detected by metallographic and microprobe analysis.


Structure and effects of non-gamma-2 amalgam.

The metallurgical structure of a non-gamma-2 amalgam was investigated by using metallurgical microscopy, surface, point, and line analyses by an electron probe microanalyzer, and a microhardness test. Referring to these findings, their effects on clinical results were then discussed. Findings were as follows: The residual dispersant particle was less hard than the gamma 1 matrix, but the ring around it was much harder than the gamma 1 matrix or the residual gamma particle. The improved mechanical properties seem to be the result of the presence of this ring. The gamma 2 phase was absent in this amalgam. The absence of gamma 2 phase seems to improve chemical resistance, to prevent the deformation by mercuroscopic expansion of amalgam margins, and thus to decrease their fracture potential. The minute gamma 1 crystals found adjacent to the ring around the residual dispersant particle seem to indicate that they were late in crystallization, resulting in low early strength.


Effects of parathyroid extract on the rupture strength of intact skin of the rat.

Rats were injected with parathyroid extract (PTE) to search for possible effects on connective tissue of the skin. Rupture strength analysis of skin samples showed a significant increase in strength of skin from PTE-treated rats. The explanation for this effect is not understood at present.


In vitro strength of the human periodontal ligament.

The tensile properties of the human periodontal ligament were studied by direct loading and compression experiments. It was found that the ligament behaved in an elastic manner up to an elastic limit after which rupture occurred. The values obtained for the tensile strength of the ligament are in general agreement with those of other workers for similar tissues.


Distribution of Streptococcus mutans biotypes in five human populations.

The distribution of S mutans biotypes in five geographically separated human populations was investigated. Samples of dental plaque were obtained from recruits at the US Naval Training Center in Orlando, Fl (N=49) in San Diego, Calif (N=25), and in Great Lakes, Ill (N=194), and from a sample of Hawaiian school children (N=55) and Saudi Arabian Navy personnel (N-217). Cultural and biochemical methods were used for the isolation and identification of the five different biotypes of S mutans which correlate with Bratthall's serotypes a through e. Geographic differences in S mutans biotype distribution were most apparent when the Saudi Arabian sample was compared to the other four groups. Single and multiple biotypes were observed in each group. Multiple biotypes occurred most frequently in the Saudi Arabians. Biotypes a and b were rarely observed; c was the most common in each of the populations; and d and e were more prevalent in the Saudi Arabians than in the other groups. Because of the multifactorial nature of dental caries, caution should be exercised in the interpretation of population differences in caries experience that seem to be associated with differences in S mutans-type distribution.


Effect of topical application of fluoride on the healing rate of experimental calvarial defects in rats.

The effect of the local application of fluoride on the healing process of experimental calvarial defects in rats was studied. A total of 172 male rats, 6 weeks old, weighing 100 to to 160 gm, were used in the experiments. Two standard defects, each approximately 2.8 mm in diameter, were drilled through the parietal bones on either side of the sagittal suture. In one half of the rats that were operated on, a 20-minute topical application of 2% acidulated (0.1 M H3PO4) NaF solution was used. The control rats underwent the same local treatment with saline solution. Groups of 9 to 13 rats were killed at 4, 5, 7, 9, and 12 weeks after the operation. Radiographs of each calvarium demonstrated the healing area in the bone. Linear bone apposition was measured from histological sections. Fluoride content was determined in ashed calvaria with an Orion electrode. The results indicate that all fluoride-treated groups had increased bone gain compared with the control group. The histological examination revealed no major differences in the structure, number, and size of the cells of the newly formed bone in either group. The mean fluoride concecreased until completion of the experiment.


Lymphatic vessels of the human dental pulp.

Noncarious teeth obtained from individuals 15 to 50 years of age were used to study the lymphatic drainage of the human pulp. Thick sections (50 to 150 microns) were stained with iron hematoxylin for the demonstration of lymph and blood vessels. Lymph capillaries originated as blind sacs in the odontoblastic layer and in the pulp proper near the pulpo-odontoblastic border. They drained into small thin-walled collecting vessels that were irregular in shape and showed great variability in their drainage patterns. Communications between these vessels were very common. The larger conducting lymphatic vessels accompanied the blood vessels and nerves in their course through the pulp. They could be identified by their thin walls and small size. The large caliber lymphatic vessels contained valves, a structure not present in the veins of the same size. The conducting lymphatic vessels passed through the roots as individual units without draining into a large single vessel. The lymphatic vessels of the human pulp must be considered as a pathway for the removal of excessive tissue fluid in normal and diseased pulps.


Relation of body mass to oxygen consumption rate in dental pulp.

Oxygen consumption rates of dentinogenically active dental pulp at 38 C have been determined for 13 different species of mammals ranging from 18.6 gm to 800 kg in mean body mass. The QO2 is inversely related to body mass. The influence of body mass on the oxygen consumption rate seems to be about ten times greater in animals weighing less than 18 kg than it is in larger animals.


Rate of permeation of isotopes through human dentin, in vitro.

A simple in vitro method has been described for quantitatively measuring the rate at which isotopically labeled substances permeate through dentin in occlusal cavity preparations. The presence or absence of pulp tissue had only a minor effect on the kinetics of permeation. As the dentin was made thinner there was a resulting increase in the rate of iodide permeation. The relative rates of permeation were 3H2O greater than 131I greater than 99mTc greater than 14C-urea, a sequence that follows the molecular dimensions of these substances.


HL-A histocompatibility antigens in recurrent aphthous ulceration.

The frequency of HL-A phenotypes has been investigated in 64 patients who had recurrent aphthous ulcers and 100 subjects who did not. The HL-A phenotypes were determined by a two-step microcytotoxicity test on peripheral blood lymphocytes, incubating these cells with a range of defined antiserums and complement and subsequently assessing lymphocyte viability by dye exclusion. There were no significant differences between the frequency of individual HL-A antigens in the patients with aphthous ulceration and those of subjects without aphthous ulceration. Similarly, no differences in numbers of shared antigens could be demonstrated. The distribution of HL-A antigens was essentially similar in subdivisions of patients with aphthous ulceration, grouped on the basis of sex, family history, age at onset, and maximum number of concurrent ulcers and their duration before healing.


Color of gingival tissues of blacks and whites.

Value, chroma, and hue of gingiva of 100 black and 100 white patients were measured clinically with Munsell color tabs under fluorescent light and under simulated daylight. The color of uniformly pigmented attached gingiva of both blacks and whites was described most often by a value between 5/ and 7/, a chroma of /4, and a range of hues from 2.5R to 7.5R when determined under fluorescent light. The color of gingiva pigmented by melanin in 61 black patients was lower in value (3/ to 4/) and chroma (/1 to /2) but had a similar range of hues compared with uniformly pigmented gingiva. The use of a simulated daylight source instead of a fluorescent light present in the clinic resulted in a modest change in color described by an I of no more than 3.6.


Dental condition of two tribes of Taiwan aborigines--Ami and Atayal.

This is a study of dental and oral conditions of Taiwan aborigines from the epidemiological and anthropological points of view. A total of 166 Ami and 128 Atayal adolescents were included from their original living area, the Hwa-Lien Hsin and Wa-Lai District, Taiwan, Republic of China. Oral examination was done carefully and caries incidence, periodontal index, and Angle's Classification combined with OFI were included. After that, hydrocolloid impressions were taken, and dental casts were immediately made. The mesiodistal and buccloingual crown diameters and also the arch depth and width were measured using a sliding caliper. Dental morphological traits, such as shovel-shaped incisors, Carabelli's cusp, protostylid, and upper and lower molar groove patterns were observed and classified, and the results are given with statistical analysis. The aborigines have a quite low incidence of dental caries and periodontal disease which may be related to their dietary habits, good oral hygiene, and good dental occlusion. With regard to the differences between the Ami and Atayal, most of the date show no statistical significance except in the dental occlusion. The Atayal's occlusion is better than that of the differences of genetics or other factors. There are no sex differences in all the date in the dental survey, but there are sex differences in both the misiodistal and buccolingual crown diameters of both the Ami and Atayal tribes (the tooth crown of the male subjects is invariably broader and larger than that of females). In the dental arch dimensions, most of the data show no sex diffreence, except in the breadth of the upper and lower dental arch of the Atayal. Anthropologically, there are no statistical differences,  in  mesiodistal and buccolingual crown diameters and most of the data of dental arch dimesions, but there is a difference in arch depth in Ami and Atayal adolescents. The Atayal have a deeper dental arch than do the Ami. As for dental morphologi, the Taiwan aborigines have a high frequency of shovel-shaped incisors and Carabelli's trait but a relatively low frequency of protostylid.  There are no definite differences between races in the occlusal pattern of maxillary first molars, but there are differences in the maxillary second molars. The usual pattern is 4-- for the upper first and second molars of the Taiwan aborigines as well as for thedibular occlusal pattern, the first molar tends to follow the primitive "dryopithecus" pattern of 5 cusps and Y configuration, but in the second molar there are varying degrees of departure from Y5 to the more advanced +4 pattern with +5 and Y4 as intermediates.


Role of attrition and occlusal contact in the physiology of the rat incisor: XL Kinetics of inner enamel epithelium during severely impeded eruption.

Under conditions of high impediment, the rate of eruption of the rat incisor decreases considerably as does the rate of cell production of the inner enamel epithelium (IEE). The latter is acomplished by a decrease in the size of the proliferative compartment and an increase in the generation time. A linear relation exists between IEE cell production and tooth eruption, and cell production can be estimated from eruption measurements.


Proteolipid and calculus matrix calcification in vitro.

The initiator of calculus matrix calcification, in vitro, was isolated. Crude phospholipid, known to contain the factor, was separated into five fractions by column chromatography. A single protein-containing fraction induced apatite formation during incubation. The nucleating fraction was indentified as a proteolipid.


Pore size measurements and some age-related changes in human alveolar bone and rat femur.

Bone pore volume of pores ranging from 0.1 to 77 mum in diameter was unchanged in alveolar bone from patients with periodontal disease compared with control subjects, a finding that is inconsistent with the involvement of systemic factors in alveolar bone loss in this disease. Bone density was decreased in alveolar bone from patients with periodontal disease. Bone density of normal alveolar bone increased with age. A similar finding was obtained in rat diaphyseal bone, suggesting that this is a general phenomenon in aging bone. This could be significant inasmuch as high density bone would be expected to be more brittle. In contrast to these findings in normal alveolar bone, bone density decreased rather than increased in the 50- to 59-year-old age group in patients with periodontal disease. The cause of  decreased bone density remains to be established.


Ceramic hydroxylapatite as a plaque growth and drug screening substrate.

A new polycrystalline form of hydroxylapatite, CHA, has been shown to closely mimic dental enamel, in vitro, in regard to rate and degree of plaque formation and effectiveness of antiplaque drugs. The material has successfully been exploited as a standardized hydroxylapatite plaque growth substrate in conjuntion with a mass antidental plaque drug screening program.


Competitive binding among oral strptococci to hydroxyapatite.

The relative affinity of various oral streptococci for hydroxyapatite (HA) differed widely. Streptococcus mutans affinity for dextran-coated HA was the highest of all the streptococci to any HA coating. S salivarius had the lowest affinity, and S sanguis affnity was higher then S miteor for saliva-coated HA. Competition for binding sites on saliva-dextran-coated, dextran-coated HA. Hhwever, competition between this pair was not for the same binding site but for closely associated sites.


Isoproterenol and G2 acinar cells in the developing rat parotid gland.

In the present study, premitotic period (G2)-delayed or blocked acinar cells were identified in the parotid gland of the neonatal rat. The noncycling G2 cells retain the potential to divide and respond to administration of the sympathomimetic amine, isoproterenol (IPR). The effects of IPR on suckling and weaned rats were compared. Both groups showed the presence of G2-acinar cells with a possible age-related change occurring after weaning.


Prevention of xerostomia-related dental caries in irradiated cancer patients.

Three caries preventative regimens: oral hygiene; oral hygiene and topical fluoride; and oral hygiene, typical fluoride, and sucrose restriction were evaluated in patients with cancer given xerostomia-producing radiotherapy. The oral hygiene-fluoride gel combination was remarkably effective in protecting these high risk patients from caries, regardless of the cariogenicity of the diet.


An expanded model for extramural dental clinics.

The extramural program at the University of the Pacific School of Dentistry is described. The program is designed to facilitate the students' transition from a school clinic to dental practice after graduation. Management skills are taught by providing supervised experience in a model practice setting. Five major facilities are described along with the curriculum modifications made to permit all students to spend eight four-day weeks in these remote sites. The quality control mechanism is discussed as well as four key concepts developed in the six-year experience of operating this program.


An outreach cancer education program: a model for continuing education in the dental office.

During the period 1970-1973, only 2.5 percent of the dentists practicing in Kentucky attended cancer continuing education courses offered by the University of Kentucky College of Dentistry. In the fall of 1973 a different approach to cancer education was launched: Learn about Oral Cancer in Your Office. Self-instructional materials, developed in the College of Dentistry, were taken to the dentist's office on an appointment basis. This method had great appeal and significantly increased the number of dentists involved in cancer continuing education. Other positive results of this approach were a greater awareness on the part of the dentist of his role in cancer detection, a desire amont the participants to alter the pattern of practice to include cancer detection techniques, and exposure of dental auxiliary personnel to cancer education material.


Characterization of airborne particles from irreversible hydrocolloids.

Airborne particles of irreversible hydrocolloid powders were monitored and characterized. Ten to fifteen percent of the particles were siliceous fibers with dimensions of less than 3mum in diameter and more than 20mum in length. These dimensions conform closely to the dimensions of  the fibrogenic and carcinogenic fibres of asbestos, glass, and aluminum oxide. With almost daily utilization of irreversible hydrocolloid materials in the dental office, the improper handling of the materials could be hazardous to the health of dental personnel. It is recommended that inhalation of aerosols arising from irreversible hydrocolloid powders be avoided.


Repair and restoration of a fractured, pulpally involved anterior tooth: report of case.

An 8-year-old boy was hit on the maxillary central incisor with a rock, resulting in a diagonal fracture and exposure of the pulp. After endodontic treatment, the fragment was joined to the tooth and the tooth restored using pins, a cold-curing composite, and an ultraviolet-light-activated material. This is a useful technique in cases were preparation of a fractured tooth is impossible or undesirable.


Hepatitis B prevalence within a dental student population.

In this descriptive epidemiologic study, prevalence rates of hepatitis B surface antigen (HBsAg) and its antibody (anti-HBs) among fourth-year dental students and second-year dental hygiene students were found to be comparable to those of a control population and a local age-adjusted blood donor group. This observation contrasts with the rates reported for practicing dentists, especially oral surgeons, and indicates that the increased risk experienced by dentists after dental school may be attributable to potentially greater exposure to the hepatitis B virus resulting from an expanded patient load. No significant correlation was found between a positive serologic response and several potential risk factors: previous liver disease, prior contact with hepatitis patients, parenteral injections, facial hair, and punctures sustained during dental procedures. In contrast, prevalence of HBsAg and anti-HBs was increased significantly among black students.


Effects of an alexidine mouthwash on dental plaque and gingivitis in humans over a six-month period.

The primary purpose of this study was to determine the safety and effectiveness of alexidine in the control of plaque and gingivitis in humans. For six months, 207 persons who continued their usual oral hygiene procedures rinsed twice daily with 15 ml of either alexidine (0.035% or a placebo solution. At the 30-day examination and for the remainder of the study, a statistically significant reduction in plaque between the two groups was recorded. Gingivitis was reduced in persons in both the test and placebo groups (the former always had the greater reduction), and a statistically significant difference was found at the 30-day and 90- day examinations. The preponderance of data indicates that, under the described experimental conditions, the alexidine rinse was effective in reducing both indicators of oral health and it may have important therapeutic potentials.


Effect of acidulated phosphate-fluoride chewable tablets in schoolchildren: results after 55 months.

Two groups of children initially in the first and second grades chewed, rinsed with, and swallowed an acidulated phosphate-fluoride tablet containing 1 mg of fluoride either once or twice a day in school. A control group of children followed the procedure once a day using a placebo tablet. An interim evaluation after 55 months showed that the children receiving two fluoride tablets daily had a significant reduction in incremental caries on early erupting teeth, which received primarily topical exposure to the fluoride, as well as on late erupting teeth, which received mainly preeruptive, systemic exposure. The findings also suggested that the use of a single fluoride table daily may reduce dental caries, although the presence of a benefit was less definitive than it was for the two-tablet procedure.


Transposition: orthodontic treatment.

Case reports of three brothers, a father, and cousin portray a genetic influence relative to transposed teeth, congenitally missing teeth, and pershaped incisors. Orthodontic treatment, the associated problems, and the appliance used in treatment were discussed.


Eagle's syndrome: diagnostic considerations and report of case.

Orofacial pain, as well as other neurologic symptoms, can result from the presence of an elongated styloid process. These symptoms are familiar to dentists and can indicate a broad range of dental conditions. Eagle's syndrome of the type, symptomatic elongated styloid process, has been described and a case presented. We believe that the simple diagnostic procedure of palpation of the tonsillar fossa should be routine during oral examination. Eagel's syndrome must be considered as a differential diagnosis of hemifacial pain of obscure causation.


High condylectomy for treatment of arthritis of the temporomandibular joint.

A review of 55 high condylectomies is presented with a discussion of diagnosis, rationale, technique, some simultaneous problems, and complications. An average two-year follow-up shows good results, and the procedure is thought to be useful when indicated. Many of our respondents, who classified themselves as improved, were actually cured of their arthritis, but had a previously diagnosed synergistic disorder. Muscle spasms and anxiety syndromes frequently required continued treatment after a 6- to 12-month interval. Despite the difficulty in diagnosis and the frequent occurrence of simultaneous disorders there is a definite place for the high condylectomy. Its use, however, is still restricted at this institution to that group of patients with persistent pain in the TMJ or severe functional disorders caused by actual pathologic conditions of the condyle. After surgery, all patients should be followed for at least two years for recurrence of any TMJ-related disorder.


Cryotherapy in the treatment of ameloblastoma of the mandible: report of cases.

Two cases of ameloblastoma treated in part by cryotherapy have been presented. The first case was of particular interest because of the extensive intraoral involvement and history of recurrences. The second case evolved as an example of the rare peripheral ameloblastoma. In both cases, cryotherapy was used as an adjunctive modality to conserve mandibular bone without compromising the primary objective of adequately treating the tumor. We contend that the judicious use of cryotherapy offers the advantage of treating a broad area of bone without destruction of the basic structural matrix of this tissue.


Parotid sialocele and fistula after mandibular osteotomy.

Two cases are presented that show the progression to sialocele or salivary fistula, or both, after a modified Risdon approach is used for mandibular subcondylar osteotomy. Use of antisialogogues and conservative management is recommended.


Gustatory sweating caused by blunt trauma.

A case of gustatory sweating after blunt trauma to the left side of the face has been discussed. In addition to a fibular fracture, the patient sustained multiple mandibular fractures as well as paralysis of the left facial nerve, which disappeared within five weeks. Three months after the trauma, the patient had gustatory sweating, which was controlled with topical applications of scopolamine hydrobromide.


Intraoral extranodal Hodgkin's disease.

A case of extranodal Hodgkin's disease that was limited to the maxillary alveolus has been presented. A team approach was used to diagnose and treat the lesion. After appropriate staging procedures, treatment consisted of local excision and cobalt teletherapy. Follow-up examinations for the past three years have failed to disclose recurrent or new disease.


Congenital fibromyxoma: report of case.

We have reported the clinical behavior and histochemical patterns of a congenital fibromyxoma in the soft tissues. The tumor was excised without difficulty; one year postoperatively, no recurrence was seen by clinical and radiographic examinations. There were no findings to suggest that the myxoma is a true neoplasm derived from the so-called myxoblast.


Leiomyoma of the tongue: report of case.

An instance of leiomyoma of the tongue has been reported. The theories of origin of smooth muscle tumors within the oral cavity have been reviewed. The necessity for differentiation of leiomyomas from other spindle-cell tumors and the need for thorough examination of the specimen have been discussed. Complete surgical excision of these tumors is the preferred treatment.


Photocephalography for evaluation of tissue relations in mandibular surgery.

A technique permitting evaluation of the relation of the facial soft tissues to the mandible is presented. This procedure can be used both preoperatively and postoperatively in patients having orthognathic surgery.


Lateral coronoid approach for intraoral reduction of fractures of the zygomatic arch.

A technique for reduction of fractures of the zygomatic arch with use of a more direct anatomical approach is presented. This method obviates the potential difficulty of coronoid interposition and elevation of an isolated fragment encountered with use of the old Keen approach.


Subgingival plaque and loss of attachment in periodontosis as evaluated on extracted teeth.

The correlation between downgrowth of subgingival plaque and loss of attachment was evaluated on 27 teeth which had to be extracted because of advanced bone loss in 16 patients between ages 12 and 22. The diagnostic criteria were those used for periodontosis. The teeth were stained and examined under the stereomicroscope. There was a very high degree of congruence between the subgingival plaque front and the line of lost attachment on all the teeth, thus showing that plaque is strongly involved in the destruction of the attachment apparatus. On some of the vestibular and lingual surfaces where efficient supragingival plaque control had been maintained, there was no subgingival plaque and no loss of attachment, showing that subgingival plaque develops from supragingival plaque. The highest speed of apical growth of the subgingival plaque front in any one case was estimated to be about 5 mu per day, or about 1,8 mm per year. Such an unusually rapid advancement must be the combined effect of an extremely high invasiveness of some inhabitants of the plaque and some deficiency in the host's defense mechanism against the same organisms. The subgingival plaque was found to be very thin and only occasionally calcified to form calculus. Symptoms of inflammation, if any, were only seen at the gingival margin, giving the clinical impression of a noninflamatory, degenerative condition. This explains why the concept of diffuse atrophy has developed. The observations made in this material indicate that what has been diagnosed as periodontosis, in fact is a highly destructive juvenile periodontitis which should be so named. The high destructiveness depends on a host parasite imbalance rather than on a degenerative condition.


Short term results of three modalities of periodontal treatment.

Short term data were obtained from 74 patients who recieved comprehensive periodontal treatment using a split mouth approach to test three variables; subgingival curettage, pocket elimination surgery, and modified Widman flap procedure. The patients initially had an average interproximal loss of attachment of 3.2 mm and an average interproximal pocket depth of 3.9 mm. Evaluation of the data indicate that after 4 to 6 weeks: 1. All three surgical procedures reduce pocket depths. In order of effectiveness they are: pocket elimination surgery, modified Widman flap, and subgingival curettage. 2. Pocket elimination surgery reduces pockets more than subgingival curettage on the buccal, lingual and interproximal, and more than the modified Widman flap on the lingual. The modified Widman flap procedure reduces pockets more interproximally than subgingival curettage. 3. Subgingival curettage results in a gain of attachment interproximally, and on the lingual side, while the modified Widman flap resulted in a gain of attachment interproximally only. 4 Pocket elimination surgery resulted in a loss of attachment buccally. 5 Subgingival curettage results in a more favorable postoperative attachment level on all surfaces than did pocket elimination surgery.


The remodeling of human gingival tissues following gingivectomy.

A total of 30 facial gingivectomies were carried out for reduction of suprabony pockets (mean +/- S.D. preoperative pocket depth 2.8 mm +/- 0.3 mm). Remodeling of the gingival margin was monitored by clinical measurements. The following techniques were utilized: A polyvinyl stent was constructed for each surgical quadrant. This stent covered the occlusal margins of the involved teeth and contained the fixed point of reference. Preoperatively, the following measurements were taken: the distance from the fixed point to (a) the height of the free gingival margin, and (b) the base of the clinical pocket. For control purposes similar measurements were taken at the facial surface of an adjacent tooth. A standard gingivectomy to the base of the clinical pocket was then performed and a periodontal dressing was applied for 1 week. Utilizing the stent (fixed point of reference), measurements were taken of the healing margin and control sites inn the same manner as preoperatively; 1,4,8 and 12 weeks after surgery. Our findings indicate that 12 weeks after gingivectomy, the newly formed free gingival margin was located coronally to the line of incision in all cases. The mean pocket depth at 12 weeks after surgery was 0.7 mm +/- 0.2 mm. However, the mean gain in coronal marginal height was 1.2 mm +/- 0.3 mm. Thus, a clinical coronal pocket closure of about 0.5 mm seemed to have taken place at the soft tissue-tooth interface. Measurements at the nonoperated control site showed no significant variations in crevicular depth during the experimental period. We therefore conclude that the excisional reduction of a crevice to 0 mm depth was altered by gingival remodeling during the healing phase. In our experience, this remodeling took place within 3 months after surgery and clinically appeared as a limited coronal pocket closure and gain of marginal height.


Coronal positioning of a previously placed autogenous gingival graft.

A procedure has been presented, with indications and necessary precautions, for predictably covering the denuded root surfaces of canines and premolars. The results of treating other areas with this technique have been less predictable. An alternate technique for covering denude root surfaces of the same teeth has been described. The alternate technique is more difficult to carry out and the results achieved are not as favorable.


In vitro antiplaque effects of antiseptic phenols.

Several phenols known to be antiseptics were tested in vitro for their ability to adsorb to saliva-coated enamel and subsequently inhibit plaque formation. 3,5,4'-tribromosalicylanilide was found to be effective against growth and plaque formation of A viscosus, A naeslundii, S mutans and S sanguis. Dibromsalicil was effective against A viscosus. The other phenols (hexylresorcinol, thymol, phenylphenol and zinc phenolsulfonate) did not inhibit in vitro growth or plaque formation.


A new semiadjustable articulator. Part III. An investigation of the capability of the Hanau XP-51 articulator.

A new semiadjustable articulator, the Hanau XP-51, was investigated by comparing its movements at the cusp level to those of a Stuart articulator when guided by straight condylar elements. No clinical trial was undertaken in this investigation, and no mandibular movements were registered on the Stuart articulator for transfer to the Hanau XP-51 articulator. A method of comparison and mathematical formulae were described whereby specific angles were calculated for both articulators. All tabulated angles were correlated by determining the least-squares slope of the observed angular variation as a function of the three independent variables in a computerized program. The standard deviation from these was calculated for each articulator, and the differences were found to be very small. It was concluded that the experimental Hanau XP-51 articulator could reproduce specific movements made by the Stuart articulator. Further, the adjustable posterior wall within the condylar housing was found to compensate for the lack of an adjustable intercondylar distance on this articulator.


Effect of xenogeneic immune RNA on normal human lymphocytes against human osteosarcoma cells in vitro.

New Zealand White rabbits were immunized with whole-cell suspensions of TE-85 cells (from a human osteosarcoma) maintained in tissue culture. RNA was extracted from the lymphoid tissues of the immunized animals. Normal human peripheral blood lymphocytes were pretreated with both the whole-cell immune RNA (IRNA) and the Sephadex column-eluted fractions of the whole-cell IRNA. Significant stimulation of the cytotoxic effect of the lymphocytes was observed following whole-cell IRNA pretreatment and pretreatment with peak III fractions eluted from the column. This increase in inhibition was observed whether the target cells were TE-85 (the immunizing cells), L.M. and M.Mc. (two unrelated osteosarcoma primary cell cultures), or TE-85-M-MSV cells (a cell line capable of producing a human osteosarcoma in immunosuppressed hamsters). No inhibition was observed when cells from other types of human tumors were used as target cells. The results suggested that the transferred immunity was directed against tumor-specific osteosarcoma antigens.


Therapeutic embolization of symptomatic secondary renal tumors.

A patient with colic and hematuria from renal involvement with osteogenic sarcoma who was palliated by percutaneous arterial embolization is described. While there has been much experience with embolization of primary renal tumors, this represents the first reported case of therapeutic embolization of a secondary renal tumor. Embolization is recommended as an adjunct to chemotherapy in the poor-risk patient with a symptomatic secondary renal tumor.


[The fundamental and clinical studies on clindamycin-2-phosphate in the otorhinolaryngologic field (author's transl)].

Fundamental and clinical investigation with a new antibiotic, clindamycin-2-phosphate, were performed with the results which may lead to following conclusions. 1) Concentration in blood: The blood level of clindamycin-2-phosphate in healthy adults who were given 300 mg by intramuscular injection reached a peak level of 4.3 mug/ml one hour after injection. Even after 6 hours, clinically effective serum concentration of 0.5 mug/ml was still demonstrable. 2) Concentration in tissues: Clindamycin-2-phosphate activity was demonstrable at the concentrations of 1.6 approximately 2.3 mug/g in human palatine and mucous membrane of maxillary specimen one hour after the intramuscular injection of 300 mg. Further the concentration was 2.9 approximately 5.4 mug/ml. 3) Results of clinical treatment: When clindamycin-2-phosphate was injected intramuscularly in 30 cases of representative infections in the otorhinolaryngolgic field, it was excellent in 12 cases, good in 12 cases, fair in 4 cases and poor in 2 cases. Excellent and good results were obtained in 24 cases, being the effectiveness 80 per cent. 4) Side effect: No side effect was shown with the intramuscular injection of clindamycin-2-phosphate. The comparative examination of hepatic function, electrolyte and auditory acuity before and after injection showed no significant disturbance.


[Fundamental and clinical investigation of clindamycin-2-phosphate in otorhinolaryngological field (author's transl)].

Some laboratory examinations were made with clindamycin-2-phosphate (CLDM-2-phos.). The drug was applied clinically to several otorhinolaryngological infections and the good results were obtained as follows. 1) Observing by biophotometer, the growth of Staphbylococcus aureus FDA 209P was inhibited well by the serum (diluted 10-fold) 30 minutes, 1, 2, 4 hours after 300 mg of CLDM-2-PHOS. were injected intramuscularly. 2) Serum concentration was determined by thin-layer method with Sarcina lutea ATCC 9341 as the test organism. The peak of serum level was obtained at 1 hour after a single intramuscular injection of 5 mg/kg or 10 mg/kg dosis of CLDM-2-phosphate. The peak of blood concentration was 5.4 mug/ml, 5.6 mug/ml respectively. 3) CLDM-2-phosphate concentration in tissues was estimated one hour after intramuscular injection of CLDM-2-Phosphate. The concentrations in blood and palatine tonsilla were 5.0 mug/ml and 2.9 mug/ml respectively after the intramuscular injection of 10 mg/kg. The concentrations in blood and mucous membrane of maxillar sinusitis were 4.1 mug/ml and 2.5 mug/ml respectively after the intramuscular injection of 10 mg/kg. 4) CLDM-2-phosphate was administered by intramuscular injection into 30 cases with various infections in otorhinolaryngological field. The clinical results were excellent in 22 cases (73.3%), effective in 3 cases (10.0%) and ineffective in 5 cases (16.7%). The effectiveness was 83.3%. 5) No side effects were observed in 30 cases.


[Cytological classification and nomenclature of leukaemias in childhood. Present situation of the cytomorphological and cytochemical differentiation (author's transl)].

The classification and nomenclature of leukaemias in childhood under cytomorphological and cytochemical criteria is presented base on our own longstanding studies as well as on literature. Particular consideration is given to clinically relevant subtypes of acute lymphoblastic leukaemias (ALL), acute myeloid leukaemias (AML) and chronic myeloid leukaemias (CML). The more subtle differentiation leads to a more reliable diagnosis, a better estimation of the individual prognosis and is of immediate importance for the therapeutical decisions. We show the necessity of diagnosis centralisation in cooperative prospective therapy studies and in a risk dependant therapeutical approach.


[Clinical significance of cytochemical findings of childhood acute lymphoblastic leukaemia (author's transl)].

The initial bone marrow smeasrs of 821 children with ALL have been cytochemically analysed. (PAS-, acid phosphatase-(SPH), peroxydase-(POX), alpha-N-esterase-(EST)reaction) with regard to presenting clinical data and course of disease. Granular reactions of PAS and SPH were not meaningful in this respect. The paranuclear SPH-reaction was associated with high incidence of mediastinal mass, high peripheral blas count and male preponderance. All 5 patients with histories of more than 12 weeks duration belongs to the PAS-type of ALL (cloddy reaction). The PAS-type showed a higher incidence of CNS-leukaemia and generally a less favorable prognosis as compared to the UND-type. Thereby a high proportion of PAS positive cells, independently of other risk factors, indicates a better prognosis. The highterto neglected weak EST-reaction (Grad I and II according to Löffler) seems to signalise a clincally distinct subtype of ALL with a younger age distribution maximum as compared to the UND-type, low incidence of risk factors, high rate of remissions lasting more than 2 years but unfavorable endprognosis.


[Necrosis of the caput femoris in complete remission of lymphoblastic leukaemia (author's transl)].

Two cases of necrosis of caput femoris in children are reported. In both of them the lesion developed three years after diagnosis of acute lymphoblastic leukaemia, but during complete remission. Possible relations of the necrosis to ALL, Prednisone-therapy or constitutional factors are discussed.


[Concepts in therapy of the first relapse in acute lymphoblastic leukaemia: experience with 28 children (author's transl)].

In 10 out of 15 children with first relapse of ALL complete remission could be achieved by a combination of Adriamycin + Methylprednisolon followed by Asparaginase + Methylprednisolon. Median remission duration was 24 weeks. The results of this regimen proved superior to other regimens tested.


[Conservative induction treamtment at bone marrow relapse (author's transl)(proceedings)].

5 patients with ALL under protocol Freiburg 71 suffered bone marrow relapse. They received a conservative reinduction treatment with vincristine-prednisone +/- daunorubicin, followed in one case by L-asparaginase. Complete remission was achieved in 4, partial remission in 1. The duration of complete remissions was 1 to 11+ months.


[Treatment and results of the first relapse of acute lymphatic leukemia in childhood (author's transl)].

In our experience the prognosis of hematological relapse in patients with acute lymphatic leukemia treated according to the Pinkel programme is very bad. It may be a little better for patients in whom relapse occurred after the end of therapy and who were submitted to intensified cytostatic treatment. The chances for achieving a second long-term remission, if the relapse is confined to the CNS, are also better. This is true particularly for those patients who in addition were given radiotherapy. In recurrence in the testes radiotherapy alone will not suffice and additional intensified cytosatic treatment should be considered.


[Therapy of childhood acute lymphoblastic leukemia. Treatment results 1971-75 in 78 patients (author's transl)].

From December 1971 until July 1973 44 children with ALL have been treated according to branch A of the randomised DAL study series of June 3rd 1972 (1/71), which is a slight modification of study VII of Memphis. Afterwards until July 1975 34 patients received a somewhat intensified initial therapy (11/73). The results of 1/71 with a 3-year-remission rate of 39% and an expected 5-year-remission rate of 32% are comparable to those of study VII. The results of 11/73 with an expected 3-year-remission rate of 54% seems clearly superior and unterline the importance of an intensive initial therapy, like it is introduced now in a still more aggressive manner in our running protocol III/75. Therapy mortality was found to be about 5% and seemed to be dependant on the staff's experience. Cytosin-arabinoside orally proved effective as a prophylactic measure during incubation as well as a therapeutic agent in manifest varicalla/zoster infections.


Recent progress in chemotherapy and immunotherapy of sarcomas of bony origin, both as primary and adjunctive therapy.

Treatment for primary malignant tumors of bone, in the past several decades, has yielded uniformly poor results. Recent progress in chemotherapy and immunotherapy are detailed. An important advance in treating osteogenic sarcoma has been the application of adjuvant chemotherapy after initial amputation. CONPADRI-I and COMPADRI-II chemotherapy (a multiple drug approach) is discussed. Adriamycin in combination or alone has proved effective in treating osteogenic sarcoma. Ewing's tumor is showing increased survival rates from radiation therapy alone, as well as by use of systemic adjuvant chemotherapy combined with local radiation. Adjuvant triple chemotherapy with radiotherapy has resulted in pronounced improvement in survival. Chondrosarcomas are largely chemotherapy-resistant. Immunotherapy in bone tumors still is in the experimental stage and investigations with immunotherapy are preliminary. It appears, however, that the immunological status of a patient definitely relates to prognosis. Through increased sophistication in specific chemotherapy and magnitude of treatment, further advances in treatment of primary malignant bone tumors may be expected.


Remission maintenance of adult acute lymphoblastic leukemia.

This report describes the results of a study of central nervous system (CNS) prophylaxis and combination chemotherapy for the maintenance of remission in adult acute lymphoblastic leukemia. Adults with acute lymphoblastic leukemia who achieved complete remission were treated with 2,400 rads cranial irradiation and intrathecal methotrexate for CNS prophylaxis followed by continuation systemic chemotherapy with oral methotrexate, 6-mercaptopurine and cyclophosphamide. There were no CNS relapses following treatment. One-half of the patients relapsed within 11 months, with 5 patients remaining in remission for 27+ to 31+ months. The toxicity was acceptable with no treatment-related deaths. This regimen is capable of producing long remissions in a significant proportion of adults with acute lymphoblastic leukemia and appears to be effective in reducing the incidence of CNS relapse. It has the additional advantage of ease of administration and can be largely administered in the community.


Variable duration of vincristine-induced metaphase block in leukemic and nornal bone marrow cells of children.

In four children with previously untreated acute leukemia the stathmokinetic effect of a single IV dose of vincristine (in two children with AML), or of a single IV dose of vincristine combined with daily prednisone (in one child with AMMoL and one with ALL), were investigated. The kinetics of bone marrow blast cells from all patients, and of red cell precursors from the patient with ALL, were studied by conventional methods (determinations of mitotic index and pro-+metaphase/ana-+telophase ratios). In two of the four patients (one AML and one AMMoL) the progression of cells through S, the incorporation pattern of tritiated thymidine, and the nuclear projection area changes during S were analyzed by a combination of autoradiographic and cytophotometric techniques. The results suggest that the doses of vincristine used (0.05 and 0.075mg/kg body weight) did not influence the progression of cells from G0/G1 into S nor from S into G2, and had no effect on the incorporation pattern of tritiated thymidine or on the nuclear projection area changes during S. The results suggests, however, that the duration of the metaphase block induced by vincristine varied from one cell system to another. Differences in the time course of regeneration processes in neoplastic and normal cell systems might be one of the mechanisms responsible for the anti-neoplastic effect of vincristine in man.


Intermittent chemotherapy and BCG in continuation therapy of children with acute lymphocytic leukemia.

Continuation therapy using intermittent chemotherapy and BCG inoculation was commenced in 28 children with acute lymphocytic leukemia (ALL) immediately after remission induction and "CNS prophylaxis." At a median followup time of 17 months, 71% remain in total remission and 86% in bone marrow remission. Complications of the therapy were minimal. Major infections occurred on two occasions and there were no deaths in remission. Neutropenia, "minor" infections and postponement of chemotherapy occurred most often during the first three courses of treatment. There were no local or systemic BCG infections. Tuberculin sensitivity was tested in 25 patients. It was positive in 17 of 18 patients in total remission and all four patients with only CNS relapse, and was negative prior to relapse in three patients who developed bone marrow disease.


Correction of maxillary excess by anterior maxillary osteotomy. A review of three basic procedures.

With proper planning, execution, and follow-up care, the anterior maxilla can be surgically repositioned in selected cases to correct the anteroposterior, vertical, and horizontal manifestations of maxillary excess. The technical problems in planning and design for the necessary bony and soft-tissue incisions for three basic anterior maxillary osteotomy techniques are discussed and illustrated. Selection of the most appropriate procedure is based upon the type of positional change that is planned.


How critical is the interval between extractions and irradiation in patients with head and neck malignancy?

A total of sixty-two patients with head and neck malignancy who had teeth extracted prior to irradiation therapy were studied. Only one in this group of sixty-two patients developed posttherapy necrosis, and this instance was in no way related to the pre-irradiation extractions. Our experience with patients who have undergone extractions prior to radiotherapy indicates that exodontia may not be, within itself, associated with increased serious postirradiation sequelae. The incidence of osteoradionecrosis in these patients is extremely low. Further, our data do not indicate a critical time period for healing of extraction sockets prior to initiation of radiotherapy. When the state of the underlying disease allows, a healing time of 10 to 14 days should be granted when teeth are extracted prior to irradiation. This recommended interval is only a guideline, since a shorter healing time does not entail a significantly greater risk and should therefore not be arbitrarily classified as inappropriate.


Atypical facial pain.

"Atypical facial pain" is the current label for a possibly heterogeneous group of discomforts localized in the lower half of the head and often confused with dental disease. As illustrated in seventeen cases reviewed here, the condition occurs mostly in women, and there are often neurotic problems in addition to the pain. The pain is dull or burning, incessant, and, in contrast to trigeminal neuralgia, relatively poorly relieved by carbamazepine or diphenylhydantoin sodium; antidepressants and psychotropic agents are worth considering. Although local pathology can occasionally be detected, in this condition the entire state of the patient and the emotional concomitants of the illness require particular attention.


Aspergillosis of the maxillary sinus. Review of the literature and report of a case.

Aspergillosis of the paranasal sinuses is an infrequently reported disease which can occur in two forms: (1) a noninvasive form that can clinically mimic nonspecific chronic sinusitis and (2) an invasive form that can simulate malignant disease of the sinuses. The disease occurs without known predisposing systemic disease. Primary treatment consists of surgical eradication of infected tissue. The question of whether concomitant antifungal chemotherapy should be used in the noninvasive form of aspergillosis has not been definitely resolved. Presented is a review of the literature, the report of a case, and a discussion of possible pathogenic mechanisms.


Chronic sclerosing osteomyelitis of the mandible. Histologic and histochemical findings.

The histologic features of chronic sclerosing osteomyelitis of the mandible were studied. Four different types of tissue reaction were found to be characteristic of the disease. Histochemical recordings were used in an attempt to facilitate differential diagnosis. Similar types of fibro-osseous lesions and biopsy technique are discussed.


Oral manifestations of pachyonychia congenita. Report of a case.

Few cases of pachyonychia congenita are reported in the dental and medical literature because of the rarity of the disease. This article presents a review of the literature and adds a new case history. Examination of a 4-year-old boy revealed the presence of the disease, which was also present in the mother and a newborn sibling.


Chronic staphylococcal stomatitis resistant to penicillin and tetracycline, with evidence of local immune response. Report of a case apparently precipitated by toothbrushing trauma.

Described is a case of chronic staphylococcal stomatitis, apparently precipitated by toothbrushing, which persisted for almost 6 months. The implicated organism, Staphylococcus aureus, was resistant to penicillin and tetracycline but sensitive to erythromycin. Recovery finally occurred after antibiotic therapy combined with surgical excision of some small persistent ulcers. Ther sera from a paired set of blood specimens failed to show a significant agglutinating titer, but the samples of saliva collected at the same times gave evidence of specific secretory Iga and showed relatively high agglutinating titer.


A follow-up study of sixty-one oral dysplastic precancerous lesions in Indian villagers.

In a 7-year follow-up study of 107 cases of oral epithelial dysplastic precancerous lesions in Indian villagers, 6.6 per cent were found to develop into carcinomas. A clinical spontaneous regression occurred in 14.8 per cent. Follow-up biopsies showed histologic regression of dysplasia in six cases.


Malignant transformation of ameloblastic fibro-odontoma to ameloblastic fibrosarcoma.

Two cases of malignant transformation of ameloblastic fibro-odontomas are presented, along with a review of the literature on ameloblastic fibrosarcomas. The occurrence of this malignant transformation of ameloblastic fibromas, ameloblastic odontomas, and ameloblastic fibro-odontomas appears to be more frequent than previously thought. This potential transformation alone does not justify radical treatment of all these benign lesions. If there is recurrence accompanied by a histologic pattern change toward a more unorganized fibrous stroma with displacement of the epithelial component, however, then more extensive treatment procedures appear to be indicated.


Oral leiomyosarcoma. Report of a case and review of the literature pertaining to smooth-muscle tumors of the oral cavity.

Primary malignant smooth-muscle tumors of the mouth have rarely been reported. A review of the literature has yielded only eleven cases; to these, a new case is added. The age, sex, and site distribution of oral leiomyosarcomas are compared with those of oral leiomyomas.


Smoking habits of 611 patients with oral lichen planus.

The smoking habits of 611 patients (68 per cent females and 32 per cent males) with oral lichen planus were studied. Forty-six per cent were daily smokers, 4 per cent smoked only at social events, and 50 per cent were nonsmokers. In comparison with the nonsmokers, the daily smokers showed significantly lower prevalences of reticular and atrophic types of oral lichen planus lesions and a significantly higher prevelance of the plaque type (P less than 0.001). It is suggested that these findings depend on a mechanism whereby original atrophic and reticular types of lesions are altered into the plaque type of lesions under the influence of smoking. The question arises whether such plaque type of lesion can be regarded as leukoplakias which have been superimposed on the oral mucosa affected by lichen planus.


Root amputation as a predictable procedure. Report of a case.

The diagnostic procedures required to arrive at an accurate treatment plan when one is confronted with severe periodontal and endodontic involvement in the same tooth are reviewed. A case report is presented, relating these techniques to the clinical situation. The clinical management of the "combined lesion," once the diagnosis and treatment plan have been determined, is described, with emphasis on methods which will improve the predictability of these difficult cases.


Endodontic procedures must never be performed without the rubber dam.

The rubber dam is an absolute essential in all endodontic procedures. In documentation of that fact, we have presented the case of a 50-year-old man who swallowed an endodontic broach during endodontic treatment; the instrument passed through the gastrointestinal tract without difficulty.


Densitometric evaluation of quick x-ray developing solutions.

1. A 1:2 dilution is the most effective concentration when Kodak developer-replenisher is used as a quick processing solution. 2. Clayton solution used at the manufacturer's recommended concentration with rapid processing times produces radiographs with greater densities than Kodak developer-replenisher or Dry-X-Sol. 3. Clayton, Dry-X-Sol, and concentrated Kodak developer-replenisher used as rapid developers produce radiographs with less image densities than standard Kodak developing solution used at conventional processing times. 4. Radiographic contrast is slightly less when rapid processing is utilized.


Radiographic changes of the mandible related to oral contraceptives.

This study tested a hypothesis that some radiopacities on radiographic surveys, specifically in the alveolar bone of the mandible from first molar to first molar, not related to the teeth by position or by pathosis, were related to the taking of oral contraceptives. The random sample included 218 adults entering consecutively for full-mouth radiographic surveys at the Radiology Department. All female patients were asked pertinent questions regarding their use of oral contraceptives. Those not responding (fourteen) were not included in the final tabulations. Radiographs were viewed without regard to sex by two persons at the same time, and an interpretation was made concerning the presence (positive) or absence (negative) of the radiopacities in question. Results were based on 204 patients (112 women and 92 men). Positive radiographic findings were significantly more frequent in women (45/112 versus 14/92; chi-square = 14.12; df = 1; p less than 0.001). Positive radiographs were significantly more likely in women using oral contraceptives (28/45 versus 5/67; chi-square = 36.25; df = 1; p less than 0.001).


[Permanent identification team of the central criminal police bureau and its requirements for dentists].

The Norwegian Department of Justice has by Order in Council in 1975 established an identification team under the jurisdiction of the Central Criminal Police Bureau. The team has four members: two police officers, one expert in forensic medicin and one in forensic dentistry. Deputy members of the team are also appointed and those for forensic medicine and forensic dentistry are residents of the three largest cities of Norway, viz. Oslo, Bergen and Trondheim. The responsibility of the team is to identify victims of mass disasters, and to assist in other difficult identifications both in Norway and in foreign countries when Norwegian interests are involved. Each member of the team shall sign the identification report and will thus have a veto in uncertain cases. Consquently the dentist in the team must also evaluate the entire material in each case. For identification purposes, the dentists are urged to comply with some requirements as to dental charts, radiographs and treatment. Each patient must have a clear and readable dental chart containing his name, address and date of birth. Dental characteristics should be noted. Radiographic status should be made of the teeth of regular patients and of special teeth when extensive treatment is required. The radiograms must be kept in file and identified by the name of the patient and the date of exposure. Patients wearing dental prosthesis should be offered denture marking, and the dentures should be recorded in detail on the chart. For flying personell radiographic status is regarded mandatory, and recording of all resotrations are recommended. The aviation company should be informed of the name of the dentists of their crew. Wehn a dentist is asked for assistance in an identification case, the original dental chart, all radiograms models etc. are requested to be delivered. Additions or explantations may also be valuable.


[Study of living conditions, 1973. Some odontological results].

The central Bureau of Statistics has conducted an interview survey of the level of living in Norway in 1973. The level of living is made up of many welfare components such as: Employment, working conditions, income and consumption, housing conditions, health, education, etc. The purpose of this publication is to inform about results concerning dental health. A sample of 3874 persons born 1957 or earlier was drawn among persons in 4707 households which made up the sample in the survey of consumption expenditure 1973. The sample was a stratified, self-weighting two stage sample drawn among all private households in the country. The material and methods are described in English in the preface of the publication (Levekårsundersøkelsen 1973 1975). Because of the way of coding answers for time since last visit to dentist, the group: "During the last year" covers a period of 10-14 months. Very few had never been to a dentist and included only men in age group 67 years and more.Fifty-five percent of the total sample had been to a dentist within the last year in the south-eastern part of Norway. This was longer travelling time to the dentist in the sparsely populated middle and northern part of Norway. Almost equally many people had visited a dentist regardless of whether their self-assessed condition of their teeth was: Few fillings and restorations or many fillings and resotrations. The role of age is uncertain in these findings. The role of age is uncertain in these findings. One half of the persons with natural teeth said that they had few cavities and fillings.


[Changes in the level of various amino acids in leukemia].

The determination of blood amino-acids by column chromatography has been carried out on 53 patients, 17 with acute myeloid leukemia, 22 with chronic myeloid leukemia. A comparison was made with 25 normal subjects. These determination has shown a significant increase in glycin, cystin and a non significant increase of tryptophan. A positive relationship may exist between uricemia and content of glycin and glutamin, both amino-acids which are messengers of uric acid. A positive correlation has been found between glycin tryptophan and the number of myeloblasts.


Aspects of the dosimetry of alpha-emitting radionuclides in bone with particular emphasis on 226Ra and 239Pu.

The dosimetry of alpha-emitting radionuclides in bone is discussed. Results are presented for average dose rates to tissues close to endosteal surfaces and to haematopoietic bone marrow from thin plane sources of radionuclides buried to different depths in bone and emitting alpha-particles with energies in the range 3-8 MeV. These results are used to demonstrate that on an activity basis 239Pu is unlikely to be more than fifteen times as toxic as 226Ra with respect to osteosarcoma and leukaemia induction in man.


WHO's accent on prevention.

It is widely recognized that oral health has its major obstacles in the form of dental caries and periodontal diseases and that in many populations each of these disease areas attacks nearly 100% of the population during the normal life span. Furthermore, there are clear signs of sharp increases in the dental caries problem in populations which previously benefited by a near absence or low prevalence of the disease. For highly developed countries dental caries and periodontal disease are responsible for an ever increasing economic burden which could easily become intolerable for even the richest of economies. In developing countries where dental caries prevalence is increasing the extreme lack of manpower resources is the first barrier, any response to which will encounter the second and associated economic constraint. It is essential for both situations that greater emphasis be given to prevention of oral diseases both by methods already proven, such as fluoridation of water supplies and other uses of fluorides, by oral hygiene programs, and by coordinated research to develop complementary or other methods. The WHO program in oral health has now developed a priority activity to promote and guide such endeavors.


Fluoride concentrations in saliva after single oral doses and their relation to plasma fluoride.

The saliva and plasma fluoride (F) concentrations following intake of different doses of fluoride tablets were studied in six subjects. There was a close relationship between saliva F and plasma F and the ratio was 0.64 +/- 0.01 (s.e.). The plasma half life of F was 4-16 h. This results indicate that saliva F may be a useful substitute for blood sampling in studies concerning the pharmacokinetics of fluoride.


SIMS study of element concentration profiles in enamel and dentin.

The ion probe technique has been employed for the determination of the concentrations of P, F, Cl, C, Na, K, Mg, Sr, Al, and Si at different depths in human tooth. The applicability of the method depends selectively on the element's position in the periodic table, but may be regarded as good for a wide range of microelements of dental interest.


Early supply of fluoride and enamel fluorosis.

A study of enamel fluorosis in 1,094 children was carried out in areas with a water fluoride content of from less than 0.2 mg/l with and without supplementary fluoride, to 2.75 mg/l. The fluorosis was correlated with different infants diets and also with the calculated supply per kilo body weight. As in cattle, 0.1 mg F/kg body weight daily appears to cause fluorosis. This dose may for example be reached with water-diluted gruel powder in low-weight infants with high consumption in low F areas, in normal weight infants in 0.8 areas, and also in high-weight infants in 1.2-1.5 areas. The resultant fluorosis is very mild or mild and not disfiguring. Enamel fluorosis can be avoided or minimized in areas with up to at least 1.2 mgF/l water if F-supply, e.g. water-diluted gruel and/or supplementary fluoride, is not commenced until 6 months of age when body weight is higher. With a water fluoride content of 2.75 mg F/l a very mild fluorosis is difficult to avoid also with normal water consumption during the 1st year of life.


Ph1-positive polycythemia vera.

The rare presence of the ph1 chromosome in chronic myeloproliferative disorders other than chronic granulocytic leukemia (CGL), i.e. polycythemia vera (PV), myeloid metaplasia with myelofibrosis (MMM) and hemorrhagic thrombocytopenia (HT) raised the question whether or not the Ph1 chromosome is peculiar to CGL. In an attempt to answer this question, the authors reports six cases of positive-Ph1 of which two are from their personal experience and four from the literature. Three of these six cases converted to CGL. The authors conclude that the cases of Ph1-positive PV and HT are transition forms to CGL, and the cases of Ph1-positive MMM are in fact secondary forms derived from CGL.


Fortnightly fluoride rinsing combined with topical painting of fluoride solutions containing Al-, Fe-, and Mn-ions.

The possibility of achieving a caries-reducing effect by a combination of fortnightly mouthrinsings with 0.2% NaF-solutions and topical painting with solutions containing Al-, Fe-, and Mn-ions was examined in a 4-year clinical study. In addition to the fluoride rinses one of two randomized groups was given three paintings per year with a 0.2% NaF-solution. The other group was painted three times per year with a potassium fluoride solution containing Al-, Fe-, and Mn-ions. This group developed significantly less caries during the study than the NaF-group. The results indicate that certain metal ions can enhance the caries-prophylactic action of the fluoride ions.


Quantification of dental plaque through planimetric analysis.

The aim of this study was to develop a planimetric, automatic method for evaluation of the extension and volume of plaque. Series of color macrophotographs of stained plaque were analyzed with a digitizer entering Cartesian coordinate data from the graphic records in a calculator. Estimations were carried out on the reproducibility, discriminatory power, and time required for the planimetric analysis. In addition, the ratios between values obtained before and after reproducible cleansing were interpreted as measurement of the adhesion of plaque in vivo.


The relation between betel chewing and dental caries.

In the eastern part of Java and on the island of Bali betel chewing is a very common habit confined principally to females. The purpose of the present study was to examine the influence of betel chewing on the prevalence of dental caries. The study, which is based upon 982 villagers, indicates a strong inverse relationship between the prevalence of dental caries and the intensity of betel chewing. The possible mechanisms whereby betel chewing may have a caries-inhibiting effect are discussed.


Sucrolytic enzymes from human dental plaque in saliva.

The total effect of sucrose-splitting activity from three sucrose metabolizing enzymes has been investigated in "resting" saliva in contact with dental plaque material in 356 military recruits. Invertase effect is defined as the splitting of sucrose into equimolar quantities of glucose and fructose, dextransucrase as a glucosyl-transferase producing glucan and free fructose, and levansucrase as a fructosyl-transferase producing fructan and free glucose. Total monohexose and glucose production as well were determined quantitatively in each subject. Monohexose production was related to specific oral conditions, and a difference in tooth decay significant at a 5% level was found between samples with high and low enzyme content. The production of free glucose was lower than that of free fructose, significant at less than a 1% level. This may indicate that more glucose is bound to form with a high level enzyme content a slight increase in relative effect of dextranscrase was found. This was not statistically significant.


Identification and quantitation of carbohydrates in fluid from non-keratinizing jaw cysts.

Glucose, mannose, galactose, glucosamine, and fucose were detected by paper or thin-layer chromatography, and N-acetylneuraminic acid (sialic acid) was identified by absorption spectroscopy in acid hydrolysates of pooled cyst fluid. Quantitation of these monosaccharides in 37 frozen-stored cyst fluids and autologous sera showed that the average content of hexoses, hexosamine, and sialic acid in cyst fluid approximated that in serum, whereas cyst fluid contained significantly more fucose than did serum. Fifteen of the cyst fluids and samples of autologous serum were also analyzed for free glucose. A mean cyst fluid to serum concentration ratio of 0.48 was found. The results show that the sugar components bound to proteins are the same in cyst fluid and serum. High levels of fucose in cyst fluid indicate the presence of fucomucins.


Leukaemia-associated antigen (LAA) in proliferative blood disorders.

Serum leukaemia associated antigen (LAA) was found in 41-75% of patients with acute leukaemia or chronic myelogenous leukaemia, but in only 12% of persons suffering from chronic lymphocytic leukaemia. LAA was present in detectable amounts in 1% of healthy blood donors. Thus LAA is truly leukaemia associated rather than leukaemia specific. Occurrence of LAA in the serum of a leukaemia patient may signal a serious turn of the disease.


Concentration of fluoride in plaque - a possible mechanism.

A mechanism of concentration of fluoride (and phosphate) ions in plaque is suggested: calcium ions from saliva are bound to fixed acidic groups in the plaque, and fluoride (or phosphate) ions are attracted to the bound calcium as counterions. The principle was demonstrated by equilibrium dialysis of calcium-treated acidic ionic exchange material (Sephadex SP and CM) against 1 part/10(6) of fluoride. A part of the fluoride was found to be bound under these conditions.


Electromyographic activity in digastric muscles and opening force of mandible during static and dynamic conditions.

A method is presented for simultaneous recording of the integrated electrical activity in the anterior belly of the digastric muscle and the force developed at the chin during static and dynamic conditions of opening. A linear relationship was demonstrated between force and integrated electrical activity during isometric contraction.


Mineral composition of enamel and dentin of primary and permanent teeth in Finland.

The concentrations of 12 different elements were measured in dentin and enamel of primary and permanent teeth collected in six different localities in Finland. Na, Cl, Al, Mn, Ca, and P were determined by neutron activation analysis, K, Mg, Zn, Cu, and Fe by the atomic absorption method, and F with the fluoride-specific electrode. Most elements were present in higher concentrations in the enamel than in the dentin: Mg, however, was higher in the dentin. Compared with the permanent teeth, the primary teeth contained more K and Mn in enamel and K and Mg in dentin, but less Na and Zn in enamel. Differences between the six localities were significant for F, Cl, K, Zn, Na, and Mn. Fe, Cu, and Mn contents of teeth were much lower in Finland than elsewhere; in the typical Finnish diet the contents of Fe and Cu are relatively low and iron deficiency anemia is usually common in Finland.


Syndrome of Shwachman and leukaemia.

The syndrome of Shwachman is characterized by pancreatic insufficiency and bone marrow dysfunction, usually manifesting itself as neutropenia. The pancreas shows replacement of the exocrine glands by adipose tissue; sweat electrolytes are normal. A 23-year-old male who was known to suffer from neutropenia and pancreatic dysfunction from early childhood, presented with fever, acquired Pelger-Huet anomaly (of the polymorphonuclear granulocytes) and sideroblastic anaemia, a combination of symptoms suggestive of preleukaemia. A few months later he died of acute myeloblastic leukaemia and autopsy showed a dystrophic pancreas. Considering this case history it seems possible that the haematological anomalies of Shwachman's syndrome are signs of preleukaemia. Careful follow-up of patients suffering from Shwachman's syndrome seems warranted.


The peripheral blood in chronic granulocytic leukaemia. Study of 50 untreated Philadelphia-positive cases.

The haematological findings in the peripheral blood of 50 patients in whom the diagnosis of chronic granulocytic leukaemia (CGL) had been made in the haematology laboratory, and who were subsequently shown to be Philadelphia-chromosome-positive, have been reviewed. The differential leucocyte counts were performed by 3 observers, examining a total of 1,500 cells in each patient. The degree of anaemia at diagnosis was unrelated to sex and correlated poorly with leucocyte count; thrombocytopenia seemed unrelated to leucocytosis. A differential luecocyte count which included a complete spectrum of granulocytic cells, with prominent peaks in the percentages of myelocytes and neutrophils, was an invariable finding. Absolute basophilia occurred  in all patients and absolute eosinophilia in 92%. In 54% of the patients there was an absolute lymphocytosis. Unlike the finding in normal subjects, there was no linear relationship between the numbers of circulating neutrophils and monocytes. Application of these findings should improve the accuracy of the haematological diagnosis of CGL, while study of the rare cases which possess the above features but are Ph1-negative may throw further light on the role of the Philadelphia chromosome in the natural history of CGL.


Assessment of dental restorative status.

Class I and Class II restorations on selected teeth of children aged 7-13 years were recorded in order to find which types of restorations were suitable for clinical evaluation of amalgam restorations with regard to frequency and anticipated observation period. Restorations suited for amalgam evaluation were found to be MO type restoration on all first molars and occlusal, palatal, and occlusal/palatal restorations on maxillary first molars and buccal pit restorations on mandibllar first molars. For the age group 7-11 years, the MO type restoration in the first molars will reflect the caries situation; the DO type restoration on maxillary first molars will serve this purpose for an age group approximately 2-4 years older. Thus selected recording of restorations must be considered age dependent in order to give a representative reflection of the caries experience. The most striking difference between the groups with high and low restoration frequency was a 2-year delay in the group with low frequency as compared with the group with high restoration frequency.


Trisomy 8 in acute myeloid leukaemia: A non-random event. Lack of correlation with prognosis and cytokinetic parameters.

6 cases of AML with a supernumerary chromosome 8 as the only aberration in practically all bone marrow mitoses and 10 cases with a normal chromosome composition of the marrow cells were investigated in order to evaluate the possible influence of trisomy 8 on some clinical and cytokinetic parameters. No significant differences between the groups were found. In our laboratory a supernumerary chromosome 8 is present in 36% of AML cases with chromosomal aberrations.


Acute leukaemia.

Current concepts underlying the treatment of the acute leukaemias are presented. Improved drug regimens and ancillary services have been developed and their role in the management of acute leukaemia is reviewed.


[Neuroblastoma: diagnosis, therapy and prognosis on the basis of 56 cases (author 's transl)].

Within the last 20 years 56 children with neuroblastoma were seen at the Paediatric Departments of the University Hospitals of Graz, Innsbruck and Vienna. Case histories, clinical details and diagnostic procedures are discussed. The poor prognosis (only 18 out of the 56 children i.e. 32% are still alive) is due to the high incidence of metastasis (55% of the patients were admitted in stage IV of the disease). Diagnosis within the first year of life, mediastinal localization and histological differentialtion to ganglioneuroblastoma are good prognostic features, whereas therapeutic measures are of less importance. Radical surgery still provides the patient with the best chance of survival, but is rarely feasible (complete primary removal was possible in only 7 out of the 56 patients; in futher 2 patients the tumour proved to be resectable at a 2nd look operation). Cytostatic therapy has not really increased the survival rate. At present improvement in prognosis can only be expected in case of early diagnosis of the tumour.


[Radiotherapy of neuroblastoma (author's transl)].

The indication for radiotherapy in neuroblastoma depends on the stage of the disease; the irradiation dosage depends on the age of the child. The tumour is radiosensitive, but tends to recur if the irradiation dosage is inadequate. Irradiation of the tumour may induce coversion to a more differentiated tumor pattern. Radiotherapy can reduce the tumour volume, thereby rendering previously inoperable tumours resectable. Since 1959 11 out of 16 children with neuroblastoma undergoing treatment at the Paediatric Department of the University of Vienna were subjected to radiotherapy. Out of 9 children with suprarenal origin of the tumour only one child is still alive (survival time to date-26 months since diagnosis). Out of 7 children with extraadrenal tumour localization 70% have survived for more than 2 years. The side effects of radiotherapy survived for more than 2 years. The side effects of radiotherapy were: 1 case of quadripelgia, 1 case of symmetric growth delay of the pelvis and 1 case of scoliosis.


Insulin and growth hormone secretion in a leukaemic girl with hypothalamic syndrome.

The authors report a girl with acute lymphoblastic leukaemia presenting hypothalamic syndrome characterized by meningeal leukaemia, hyperphagia and obesity. Insulin and growth hormone secretion, studied with arginine and insulin stimulation tests, showed a high peak of serum insulin and no response of growth hormone. Insulin and growth hormone responses to these tests reverted to normal after intrathecal methotrexate.


Hemoglobin A2 levels in health and various hematologic disorders.

Using a method involving elution of hemoglobin bands from cellulose acetate strips following electrophoresis of hemolysates, hemoglobin A2 (Ab A2) was quantitated in bloods from 300 healthy individuals and 904 patients. The percentage of Hb A2 was elevated in beta-thalassemia heterozygotes and some patients who had megaloblastic anemia. In the latter, the highest Hb A2 levels were observed in patients with the most severe anemia. Low Hb A2 percentages were found in iron-deficiency anemia, hereditary persistance of fetal hemoglobin, and Hb H disease. In iron-deficiency anemia, the lowest levels of Hb A2 were observed in association with the most severe anemia. Iron and folate deficiency each suppressed Hb A2 levels in beta-thalassemia heterozygotes; however, vitamin B12 deficiency did not alter the percentage of Hb A2 in thalassemia. Malignant tumors, renal and hepatic insufficiency, chronic infections and inflammation, hemolytic disease, lead poisoning, aplastic anemia, leukemia, myelofibrosis, and hypothyroidism did not change Hb A2 levels. The pathogenesis of altered Hb A2 levels and their clinical significance in various diseases are discussed.


Surgical-orthodontic correction of open-bite deformity.

The combined simultaneous anterior and posterior maxillary ostectomy has proved to be a useful method of treating skeletal open-bite. It is indicated primarily in patients with lip incompetence, excessive exposure of maxillary anterior teeth, long lower-face height, contour-deficient chin, and Class II malocclusion. Primary contraindications are the Class III skeletal open-bite and lip competence. We have used the procedure as routine treatment for many open-bites over the past 5 years since we first described it. Clinically, the results have been most gratifying, with marked improvement in facial appearance and stability of the open-bite correction. A preliminary study of stability following this procedure indicated good stability with regard to the vertical repositioning of the maxillary segments. A recently completed study by us on thirty-two patients treated with this procedure and followed for an average of 1.5 years showed excellent stability. This is by no means the only method by which open-bite may be successfully treated, but it is one more method to add to our armamentarium. The surgical procedure must be carefully planned and executed to attain the best possible results. Furthermore, the orthodontic procedures, particularly those involving vertical forces, must be provided at the proper time so that the surgical results are not compromised. Nevertheless, with proper planning, attention to detail, and meticulous execution, the results are rewarding.


Catecholamine metabolism in Gilles de la Tourette's syndrome.

Abnormal central catecholamine neurotransmission has been suggested in Gilles de la Tourette's syndrome. The authors evaluated the sympathetic nervous system in both the basal state and in its responsivity to postural and exercise stress. Plasma norepinephrine and the activities of its synthetic and degradative enzymes were not different in 33 Tourette patients, a control group of unaffected relatives, and another control group of unrelated healthy volunteers. This finding suggests that these patients have neither a generalized dysfunction of norepinephrine metabolism nor a defect in the central control of sympathetic function.


[Blood gas studies on the efficiency of narkosepiromat 650 (dräger) (author's transl)].

Efficiency of ventilation of Spiromat 650 (Dräger) has been examined in 54 patients under general anaesthesia and relaxation during normoventilation and hyperventilation of 15 and 30% degree. Changes in the acid-base status of arterial blood were used as criteria. There was a tendency to metabolic acidosis in all kinds of ventilation-probably as a consequence of surgical trauma-which was covered by an respiratory alkalosis. In all groups arterial PCO2 was reduced about 25%, without any significant difference between results of normo- 15%-and 20% hyperventilation. Using the Spiromat 650 (Drger) as  respirator to normovolemic ventialtion is recommanded for clinical use.


Carotid-cavernous sinus fistula accompanying facial trauma.

The development of a carotid-cavernous sinus fistula is an uncommon complication of a maxillo-facial injury. A case report in which this developed within three days of injury is described, and the aetiology and incidence of the condition discussed.


Plastic bullet injury: a case report.

Plastic bullets have been introduced into Northern Ireland for use by the Security Forces in riot control. They are alleged to be more accurate in flight than the rubber bullet and are cheaper to produce. The injuries to a patient caused by a plastic bullet are described.


A method of internal splinting for unstable nasal fractures.

A method of intra-nasal splinting has been outlined which revives principles and improves on methods established particularly well by two French Stomatologists at the beginning of this century. It uses a simple splint, carefully chosen from a range of sizes, that requires precise insertion, and has proved to have several advantages over more commonly employed techniques.


The button wire as an aid to fixation.

A new aid to intermaxillary fixation in the treatment of fractures of the jaws is described. It has all the advantages of eyelet wiring while simplifying some of the difficulties connected with that technique.


A semi-precision cast splint for fixation following segmental osteotomies.

A method of fixation following intra-oral segmental osteotomies is presented. Immobilisation is obtained by a three-part cast splint connected by a semi-precision horizontal pin attachment. The advantages of this method are discussed.


Fractures of the genial tubercles: two cases and a review of the literature.

Two cases of fractures of the genial tubercles are reported. The differential diagnosis and possible aetiology is discussed and it is shown that no treatment is required for this condition.


Delayed facial paralysis after a condylar fracture.

Facial paralysis following facial injuries during childhood is rare. The literature is reviewed and the mechanisms of facial nerve injuries are discussed. The case of a five-year-old boy with facial paralysis 48 hours after a condylar fracture is presented. The surgical and conservative treatment of traumatic facial paralysis is discussed.


Recurrent dislocation of the mandible: treatment of seven cases by a simple surgical method.

Hypermobility of the tempero-mandibular joint is a fairly common condition. It can arise from acute or chronic trauma or be present naturally as a result of a lax capsular structure. It can lead on to chronic subluxation and in rare instances to recurrent dislocation. Recurrent dislocation becomes a problem to the patient as he has to seek medical help. A variety of treatment methods have been described in the literature to deal with this problem. These methods are briefly discussed and perhaps the simplest and most effective of these methods is that described as capsular plication. Seven cases have been treated by this method over the last five years and the results of this experience are presented.


Mucosal petechiometry: a reliable method for the measurement of capillary resistance.

The method of mucosal petechiometry, as described by Kozam (1968), was investigated and found to be a valid technique for investigating capillary resistance. Recommendations are made on the use of this technique as a research method.


Lipodystrophy: a case report of partial lipodystrophy of the face.

Lipodystrophy is a disorder of the subcutaneous adipose tissue. It can occur in two forms--partial and total. Gorlin and Goldman (1970) suggested that facial lipodystrophy can only occur bilaterally, and should it occur unilaterally, then it is hemifacial atrophy. A case is reported to illustrate that partial lipodystrophy can occur unilaterally.


Suppurative cervical adenitis caused by opportunist mycobacterium.

Of 45 consecutive submandibular abscesses treated by external drainage in a district oral surgery unit, four cases, representing nearly 9% of the sample, were caused by opportunist Mycobacterium avian-intracellulare, an organism known to give a poor response to all known antimycobacterial chemotherapeutic agents. Treatment by excision of the diseased tissue is indicated in these cases. The diagnosis and management of these conditions is discussed.


Ph1-positive childhood leukemias: spectrum of lymphoid-myeloid expressions.

Two children presented with Ph1-positive leukemia, confirmed by Giemsa banding as 22q-. One child showed an initial presentation characteristic of acute lymphoblastic leukemia, followed by development of chronic myelocytic leukemia 2 yr later. A second child presented in blast crisis. Both patients showed blast cells possessing both lymphoid and myeloid characteristics, as demonstrated by histochemical, biochemical, or surface receptor properties of each cell series. The evidence provided supports the assumption of mixed lymphoid-myeloid properties of blast cells in chronic myelocytic leukemia in children. Detailed study of the leukemic cells may aid in the understanding of complex stem cell relationships and suggest more effective therapeutic approaches.