Allozymic and chromosomal similarity in two Drosophila species.

D. setosimentum and ochrobasis are a pair of very close, partly sympatric species endemic to Hawaii island. Males of the two species differ strikingly in wing-pattern and there are altitudinal and breeding-site differences. Similarity indices have been calculated for both chromosomal (C) ald allozymic (A) variants. Within the main populations of each species both kinds of data give coefficients above 0.98. Interspecific comparison of the main populations shows 0.66 (C) and 0.79 (A). An isolated population of ochrobasis from Kohala Volcano (Ohu), when compared with setosimentum, shows 0.68 (C) and 0.98 (A). Chromosomes are thus much more sensitive than allozymes in distinguishing these species; the same is true in the case of D. silvestris and heteroneura from the same forests. These morphologically distinct species, when compared, show 0.96 (A). All four species appear to be very new in the historical sense. In one area, about 2% of wild-caught D. setosimentum/ochrobasis are interspecific hybrids although adequate samples indicate that the separate gene pools have not broken down. The specific names should be retained but the two entities are perhaps best described as quite advanced semispecies in which reproductive isolation in nature is now nearly complete.


Gene dosage: evidence for assignment of erythrocyte acid phosphatase locus to chromosome 2.

A child, trisomic for the distal short arm of chromosome 2 due to a familial 2/18 translocation, has elevated levels of activity of erythrocyte acid phosphatase [orthophosphoric-monoester phosphohydrolase (acid optimum), 3.1.3.2] Ferguson-Smith et al. [(1973) Nature New Biol. 243, 271-274] previously had found decreased levels of activity and loss of expression of an erythrocyte acid phosphatase allele in a subject who lacked one of the two homologous regions containing the distal three bands of chromosome 2. They suggested that the locus for erythrocyte acid phosphatase is located on that segment. Our findings provide further evidence for this assignment and also suggest an in vivo gene dosage effect of this autosomal locus, which depends on both the type and number of alleles present.


General kin selection models for genetic evolution of sib altruism in diploid and haplodiploid species.

A population genetic approach is presented for general analysis and comparison of kin selection models of sib and half-sib altruism. Nine models are described, each assuming a particular mode of inheritance, number of female inseminations, and Mendelian dominance of the altruist gene. In each model, the selective effects of altruism are described in terms of two general fitness functions, A(beta) and S(beta), giving respectively the expected fitness of an altruist and a nonaltruist as a function of the fraction of altruists beta in a given sibship. For each model, exact conditions are reported for stability at altruist and nonaltruist fixation. Under the Table 3 axions, the stability conditions may then be partially ordered on the basis of implications holding between pairs of conditions. The partial orderings are compared with predictions of the kin selection theory of Hamilton.


Effect of temporal fluctuation of selection coefficient on gene frequency in a population.

The diffusion equations describing the change of gene frequencies are extended to indlude the effect of temporal fluctuation of selection coefficient that may persist for some generations. The equilibrium distribution of gene frequencies and the fixation probability of a mutant gene are obtained from the extended equations. Comparison is made with the experimental data on protein polymorphism. A possible bearing of the fluctuation of selection coefficient on the problem of molecular evolution is discussed in relation to the neutral theory.


Genetic analysis in the dinoflagellate (Crypthecodinium (Gyrodinium) cohnii: evidence for unusual meiosis.

The atypical structure and behavior of dinoflagellate chromosomes suggests that the genetics of these organisms might show comparable peculiarities. We have begun genetic analysis of the neritic, marine heterotroph Crypthecodinium (Gyrodinium) cohnii by means of motility mutants that show complementation shortly after zygote formation, permitting identification of heterozygotes. Six mutations, conferring four microscopically distinguishable phenotypes, have been isolated and investigated. These "genes" were found to complement in double heterozygotes in all pairwise combinations, indicating that the lesions are recessive and non-allelic. Clones of all possible combinations of these factors have been established and each complements only those combinations expected on the assumption that there are six independent recessive mutant "genes." Tetrad analysis following isolation of over 200 complementing zygotes showed: (1) regular segregation with recovery of parental phenotypes and genotypes; (2) independent assortment, with one possible exception; (3) segregations that were always 1:1, that is, in all tetrads showing recombination, only the two reciprocal recombinant genotypes were found; there were no tetratypes. This behavior could result from centromere linkage or the absence of crossing over in an otherwise conventional meiosis, or it could result from an unusual one-division "meiosis." Some evidence is provided that favors the latter hypothesis.


Guinea pig transfer factor-like activity detected in vitro.

"Transfer factor" was prepared by Sephadex G-25 chromatography of lymph node cell lysates from guinea pigs immunized with ovalbumin or bovine gamma globulin. Treatment of nonimmune peritoneal exudate cells with the transfer factor and specific antigen leads to inhibition of migration of the cells, whereas cells treated with the transfer factor alone or specific antigen alone are not inhibited from migrating. An average of 24-28% inhibition is observed in the presence of transfer factor and specific antigen, but only 5-15% inhibition in the presence of transfer factor and nonspecific antigen. The guinea pig transfer factor we have tested in vitro has some physical characteristics in common with human transfer factor.


Genome of hepatitis B virus: restriction enzyme cleavage and structure of DNA extracted from Dane particles.

DNA extracted from Dane particles has been characterized by gel electrophoresis and restriction enzyme cleavage with endonuclease R-HaeIII (from Hemophilus aegyptius). Dane particle DNA is proposed to be a double-stranded circular DNA approximately 3600 nucleotides in length containing a single-stranded gap of 600-2100 nucleotides. The endogenous DNA polymerase (DNA nucleotidyl-transferase; deoxynucleosidetriphosphate:DNA deoxynucleotidyltransferase; EC 2.7.7.7) reaction appears to repair this single-stranded gap.


Measurement of cholesterol synthesis in man by isotope kinetics of squalene.

A method for measuring the rate of total daily cholesterol synthesis in man has been developed through isotope kinetic studies of squalene biosynthesis after intravenous administration of [14C]mevalonic acid. Plasma squalene becomes rapidly labeled, reaching maximal specific activity approximately 100 min after mevalonate administration and then decays exponentially to reach undetectable levels in 12 hr. The rate of daily squalene synthesis equals the percent dose of mevalonate converted to cholesterol divided by the area under the specific activity curve of squalene; the fraction of the dose of mevalonate converted to cholesterol is calculated by the simultaneous injection of [3H]- and [14C] cholesterol in plasma. The premise that squalene and cholesterol synthetic rates are equivalent was tested. In seven patients it was found that the mean daily cholesterol synthesis rates estimated simultaneously by sterol balance and by sqyalene kinetic methods agreed within 8%. In addition, fractional conversions of mevalonic acid to cholesterol were highly correlated with cholesterol synthesis rates. Maximum estimates of the pool sizes and half-lives of metabolically "active" squalene also were obtained. This measurement of daily cholesterol synthesis by squalene kinetics minimizes patient inconvenience, is suitable for outpatient studies, and yields results in 4 weeks or less. Because of the rapidity of the rate of squalene synthesis, the results obtained reflect cholesterol synthesis over a period of less than 10 hr and are therefore uniquely applicable to unsteady state situations.


An inherited "neoplasm" in fungus.

An abnormal growth form in the fungus Schizophyllum commune is described that interferes with the development of reproductive structures. The abnormality, which takes the form of relatively large, compact, hemispherical bodies, depends on a dominant Mendelian gene, mound, for its expression. When mound is expressed in a mycelium that has the potential to form fruiting bodies, the fruiting response is affected and the effect is variable within a replicate series: fruiting bodies may be normal or abnormal, abort at various stages, or not develop at all. Occasionally, fruit bodies are overgrown and are completely enveloped by the hemispherical bodies. When hyphae from hemispherical bodies are subcultured, a seemingly normal mycelium forms that eventually differentiates hemispherical structures, but the ability to form fruiting bodies in not expressed. Continuous mycelial subculture has shown this loss of fruiting expression to be a permanent transformation, which is demonstrated to be a characteristic of hemispherical bodies.


Dopamine receptor binding in the corpus striatum of mammalian brain.

Specific binding of [3H]dopamine to membranes from the corpus striatum of rat and calf brain appears to involve the postsynaptic dopamine receptor. Specific [3H]dopamine binding is saturable, wnd with half-maximal binding in calf membranes at 7 nM. Apomorphine is about twice as potent as dopamine in competing for binding sites, whereas (-)norepinephrine is 5% as potent as dopamine and isoproterenol is virtually inactive. The relative potencies of phenothiazines as inhibitors of specific dopamine binding correlates with their clinical potencies and actions on the dopamine-sensitive adenylate cyclase.


Studies on memory: inhibitors of protein synthesis also inhibit catecholamine synthesis.

The rates of accumulation of newly synthesized catecholamines and endogenous catecholamine levels in mice were determined after treatment with cycloheximide, acetoxycycloheximde, puromycin, and anisomycin. The rates of accumulation were found to be decreased by all antibiotics tested, weakening the assumption that their amnestic effects are due solely to inhibition of protein synthesis.


Isolation of subunits of citrate lyase and characterization of their function in the enzyme complex.

Citrate lyase [EC 4.1.3.6; citrate oxaloacetate-lyase (pro-3S-CH2-COO--leads to acetate)] from Klebsiella aerogenes has been dissociated with urea; the three different subunits, alpha-chain (molecular weight congruent to 54,000), beta-chain (molecular weight congruent to 32,000), and gamma-chain (acyl carrier protein; molecular weight congruent to 10,000), have been isolated in pure and catalytically active state. Recombination of the three subunits produced citrate lyase that was indistinguishable from the untreated enzyme. The alpha-chain in the presence of acetyl-S-acyl carrier protein catalyzed the formation of the corresponding citryl thioester with liberation of acetate, and the beta-chain catalyzed the cleavage of citryl-S-acyl carrier protein with liberation of oxaloacetate. A simple enzymic method for the preparation of citryl-S-acyl carrier protein is described.


New experimental and clinical data on leukaemia immunotherapy.

The present results of our treatment of acute lymphoid leukaemia patients are summarized: 7 out of 20 randomized patients given active immunotherapy after chemoradiotherapy are still in complete remission after periods varying from seven to ten years (compared to none in the control group). The actuarial results on 100 patients show remission and survival curves presenting a plateau between three and five years for a certain percentage, suggesting a possible cure. Several parameters studied in 200 patients indicate that the factors affecting this percentage are age, cytological type, volume of the tumour, and the localization of leukaemic cells in certain areas. Experiments with L1210 leukaemia show that immunotherapy enhances the effect of chemotherapy when administered after chemotherapy but decreases it when administered before, which is in favour of the use of the sequence chemotherapy-immunotherapy clinically.


The effect of varying tidal volume on the associated phrenic motoneurone output:studies of vagal and chemical feedback.

Two groups of dogs were anaesthetised, paralysed and artificially ventilated using a respirator driven by the phrenic motoneurone output, electrically processed to resemble transpulmonary pressure. In one group, blood gases were maintained constant with closed-chest cardiopulmonary bypass; the second group were studied without "bypass". Therefore it was possible to determine the relative contributions of vagal and chemial feedback to the effect of altering the depth of an inspiration on the associated phrenic motoneurone output. Mono-exponential regressions between change of respirator gain and changes in both inspiratory time and peak amplitude of the processed phrenic signal were found for all dogs. The rate of rise of the processed phrenic signal usually changed in the direction of the change in respirator gain, suggesting the presence of vagal positive feedback during eupnoeic breathing. After vagotomy, all responses were absent in the "bypass" group and small in the "non-bypass" group. These experiments quantitate the role of pulmonary vagal afferent discharge, in phase with inspiration, in the regulation of phrenic motoneurone output in a closed-loop situation.


[Isomorphism of primary and secondary tumors of bone in radiographs (author's transl)].

The fact that primary and secondary tumors of bone may present identical appearances (isomorphism) in radiographs is due to the unspecific reaction to different diseases of bony tissue. Radiographic differential diagnosis has narrow limits. Interpretation must take account of localization and age of the patient. Two cases of osteoplastic metastases in long bones are described which look very much like osteogenic sarcoma. Some 20 observations of this kind have been collected from the literature. The factors causing primary and reactive proliferation of bone are analyzed in detail.


Periodontal status of neighboring teeth after orthodontic closure of mandibular extraction sites.

The gingival health, pocket depth and loss of fiber attachment of the mandibular first molars and first premolars were studied by clinical and radiographic methods after the embedded second premolar had been surgically removed on one side and extracted after eruption on the other, and the spaces had been closed orthodontically. Twenty-nine children participated in the study. Their mean age at the time of tooth removal was 11 years 3 months. The mean duration of the treatment was 20 months, and the children were examined 1 1/2 to 2 years after removal of the bands. The gingival status was generally similar on both sides. Some constriction of the alveolar process was observed in more than half the cases, both after extraction and after surgical removal. The loss of attachment on the buccal and lingual surfaces was approximately the same in both groups, whereas the radiographic distance from the cementoenamel junction to the bone margin on the proximal surfaces adjacent to the removed tooth was somewhat greater after extraction than after surgical removal.


Caries frequency in children with controlled diabetes.

The frequency of caries was assessed in 33 diabetic children in whom the diabetes required insulin and dietary restriction and had been diagnosed before eruption of the permanent teeth. The frequency of caries and the number of erupted teeth were obtained from the dental records of the school dental service. Age- and sex-matched non-diabetic classmates served as controls. The mean number of DFS at the last dental examination of the diabetic children was 13.4, compared with 20.5 in the controls. The difference was largest in 12- to 14-year-old children, particularly in the premolar region, where the mean number of carious and filled surfaces in the diabetics was 2.6 compared with 5.9 in the controls. In all age groups, proximal carious lesions were less common in the diabetics than in the controls. No notable difference was found between the mean number of erupted teeth in the diabetics and that of the controls, except among the 12- to 14-year-old children. In that age group the diabetics had, on the average, 6.0 erupted premolars compared with 7.3 in the controls and 2.7 erupted permanent second molars compared with 3.5 in the controls. The results indicate that the dietary restriction observed by the diabetics had a favorable effect in promoting a lower caries frequency on all groups of teeth and on most tooth surfaces.


The stoichiometric solubility of calcium orthophosphates.

On the assumption that the calcium orthophosphates dissolve stoichiometrically, the solubility of Hap, Fap, DCPD, OCP and TCP, as well as of CaCO3 and CaF2, have been calculated in terms of grams of solid phase per liter under equilibrium conditions. As exemplified in the text, these calculated solubilities facilitate the understanding of the complex behavior of the orthophosphates when in solution.


Repair characteristics of root fractures in permanent anterior teeth.

A follow-up study was made of repaired root fractures in 51 permanent anterior teeth, with a mean observation period of 6 years. The material was subdivided into three repair types (Figs. 1-3): Type 1 - invisible or hardly discernible fracture line (15 teeth), Type 2 - fragments separated by a narrow radiolucent line and peripheral rounding of the fracture edges (33 teeth), and Type 3 - fragments separated by a distinct bony bridge (3 teeth). The majority of repaired teeth gave a normal or slightly decreased response to electric pulp tests and the mobility was physiologic or slightly increased. Reduced transparency or slight yellowish discoloration was observed in 14 teeth. The most conspicuous radiographic finding was pulp obliteration which occurred in 86%. Two different patterns were observed: (1) partial obliteration located in the apical fragments and the fracture area, and extending 0.5-4 mm into the coronal fragment, and (2) progressive obliteration of the entire pulp cavity ending with almost total obliteration. Pulp necrosis did not develop as a sequel to progressive obliteration in any case. Several different characteristics of the fracture influenced the repair pattern, the most important being the degree of fragment dislocation and mobility, stage of root development and localization of the fracture. Correlation between type of repair and various treatment procedures was observed only with regard to reduction.


Creep of dental amalgam as a function of heat treatment.

The creep of dental amalgam was measured as a function of heat treatment of the amalgam. The treatment significantly reduced the creep rate. The beta 1 (Ag-Hg) phase was detected in the heat-treated amalgam by X-ray diffraction and metallographic methods, and it appeared that the reduction in creep rate was due to the gamma 1 leads to beta 1 transformation.


Monosomy 7 in two adult patients with acute myeloblastic leukaemia.

Two patients with acute myeloblastic leujaemia were found to have a population of bone marrow cells with C-group monosomy. Using the Quinacrine Mustard fluorescence technique the lacking chromosome was in both patients identified as a number 7. Both patients entered a complete remission. Monosomy 7 may indicate a separate entity of acute myeloblastic leukaemia associated with a comparatively favourable prognosis.


Chromosome banding studies in acute leukaemia at diagnosis.

Cytogenetic study by a chromosome banding technique has been attempted in 93 cases of acute leukaemia at diagnosis. Banding patterns were difficult to visualise in the bone-marrow chromosomes of patients with acute leukaemia because of the fuzzy appearance of the fixed metaphases. The proportion of patients with abnormal chromosomes was higher in acute lymphoblastic (ALL) than in acute myeloid (AML) leukaemia. Abnormalities were present in all cases of other cytological types. Hyperdiploidy was the most commonly found numerical error in both ALL and AML but a larger proportion of patients with ALL had hyperdiploidy in more than 30% of the cells. In ALL it was generally found that the higher the frequency of hyperdiploidy the greater was the number of chromosomes per cell. Hypodiploidy not attributable to random losses was found in only 6 patients. Clones identified by rearranged or marker chromosomes were found in all types of leukaemia. Clones marked by a 7q-chromosome, in which the break point was the same, were identified in 1 adult with ALL and 2 children with AML. The high frequency of randomly disturbed chromosomal breakage found in the bone-marrow chromosomes of a high proportion of the patients may be related to the disease process.


Megakaryocyte quantifications in relation to thrombokinetics in primary thrombocythaemia and allied diseases.

Megakaryocyte morphology was studied quantitatively in primary thrombocythaemia (PT) and in chronic myelogenous leukaemia (CML). The relation of thrombokinetics to megakaryocyte quantifications was evaluated in PT and compared to previously obtained results in polycythaemia vera (PV) and idiopathic thrombocytopenic purpura (ITP). Megakaryocyte area, number and volume per mul bone marrow were significantly higher in PT as compared to controls. The nuclear lobe number was significantly increased and the megakaryocytes were shifted towards more mature forms, suggesting a prolonged megakaryocyte generation time. In CML the megakaryocyte number and volume per mul bone marrow were also significantly above normal, but the megakaryocyte area, number of lobes and degree of megakaryocytic maturation were significantly below normal. Platelet production was in PT 6.2 times normal and proportional to the increase in megakaryocyte volume which was 6.8 times normal. In PV with major splenomegaly the mean platelet production rate was higher (9.5 times normal) although their peripheral platelet count was lower than in PT. This discrepancy is explained by the greatly enlarged splenic platelet pool in the PV patients. In ITP the mean platelet production rate was 2.2 to 3 times normal and was significantly lower than in PT and PV.


Molecular vehicle properties of the broad host range plasmid RK2.

The pladmid RK2 is stably maintained in a broad range of gram-negative bacteria. The RK2 DNA has a single Eco RI restriction site. The insertion of a DNA fragment into this site does not interfere with either plasmid maintenance or self-transmissibility. Because RK2 has a broad host range, it should be useful for the construction in vitro of hybrid plasmid molecules capable of being established by conjugal transfer or transformation into many genera of gram-negative organisms.


Leukaemoid reaction and disseminated tuberculosis. A case report.

Four cases of leukaemoid reactions to tuberculosis, notwithstanding the presence of Auer's rods in the myeloblasts, have previously been reported. A fifth case of disseminated tuberculosis in which Auer's rods were similarly observed, is described. However, we believe that this association does not mean that Auer's rods occur as part of a leukaemoid response, but rather that it indicates the simultaneous presence of acute leukaemia and tuberculosis.


[In vitro studies on the caries reducing effect of glycerophosphate. 2. Studies with dentin of human teeth].

In vitro experiments on the reduction of the solubility of human dentine in decinormal lactic acid have shown that, under the experimental conditions chosen, disodium beta-glycerophosphate was less efficient than sodium fluoride alone or in combination with ammonium metavanadate and/or ammonium molybdate.


[Morpho-histology of the maxilla in cleft palate].

The author's morphohistological study on 5 maxilla specimens without clefts from neonates and on 1 specimen with a median cleft of the palate was designed to detect possible differences which might be of importance to the anatomical and functional rehabilitation of the cleft patient. The results obtained permit to draw the following conclusions: 1. The changes confirmed in the structures of the hard and soft tissues exert, in themselves, no unfavourable effects on the surgical closure of the cleft palate if the date of operation and the operating method are chosen with regard to the general primary underdevelopment of the cleft maxilla. 2. An anatomically correct "reconstruction" of the musculature of the soft palate cannot be expected from the closure of the cleft. By avoiding extended scars, it is possible to inhibit further negative effects on from and function. 3. The functionally "inferior" musculature in the region of the soft palate needs intensive postoperative activation to achieve the closure of the nasopharynx which is necessary for undisturbed speech.


[The surgical treatment of mandibular fractures].

In certain cases, open reduction of the fragments is absolutely necessary in mandibular fracture treatment. According to an evaluation of the relevant literautre and to the author's studies, plate osteosynthesis ensures functional stability. For the treatment of certain mandibular fractures the author composed a set for plate osteosynthesis. The use of this set in the management of mandibular fractures and in osteoplastic interventions is illustrated by two casuistic contributions.


[Lipomas in the head and neck region].

According to the present state of knowledge, lipomas must be classified as rare benign tumours of the fatty tissue with low quality of dignity. Apart from their pathogenesis, the present paper discusses their histology as well as their clinical picture and therapy, evaluating the patients who had passed through the Outpatients' Department of the Rostock University Clinic and Policlinic of Stomatology between 1959 and 1974. Of 267 patients with benign tumors only 15 (9 men, 6 women) had lipomas in the cephalocervical region. The mean age at treatment beginning was 44.4 years. Only 8 patients had been referred with the provisional diagnosis of lipoma; the remaining patients, with the diagnosis of "questionable tumour", "fibroma", "lymphoma", "cervical cyst" and "submental dermoid".


[The interesting case. 6-year follow-up of a patient with atypical root length of various teeth].

Six-year observations of a female patient (13 years of age at treatment beginning) in whom the roots of certain teeth were extremely short (the causes of which being unknown) revealed no changes in the degree of resorption and so further root resorptions. The growth of the roots of these teeth (which had not fully developed at treatment beginning) progressed without disturbances. The author is of opinion that these atypical root lengths are sequelae of a temporary disturbance of the process of growth, the causes of which are unknown.


[The use of modern documentation methods in dental offices, an analysis of the literature].

The aim of the present paper was to assess, on the basis of an analysis of the relevant modern, national and international literature as available in the GDR, the present state of the introduction of data processing to stomatology and to deduce recommendations for further lines of work.


[The possibility to test stereognosis in the juvenile mouth].

The stereognostic capacity of the mouth was studied in 6 groups of 10 children each, the respective age ranges being 3.5-4, 4-4.5, 4.5-5, 5-5.5, 5.5-6 and 6.5 years. This capacity is fully developed only if the 5th year of life is reached. The stereognostic performance of the mouth which is attained at this age seems (according to data from the literature) to remain unchanged until the age of 40 years.


[The radiation protection shield--a useful radiation protective device for stomatological routine radiodiagnosis].

Starting from the shortcomings of the radioprotective devices at present used in routine stomatological radiodiagnosis, the authors describe the advantages of a radioprotective shield which has been produced in the Greifswald University Stomatological Clinic. On the basis of dosimetric studies, the State Board for Nuclear Safety and Radiological Protection of the GDR (Staatliches Amt fur Atomsicherheit und Strahlenschutz der DDR) could demonstrate the suitability of this shield as a radioprotective device for routine stomatological radiodiagnosis.


[In-vitro studies on the caries-reducing effect of glycerophosphate. 1. Studies on whole human teeth].

In vitro experiments have shown that the solubility of human enamel in decinormal solutions of malic, lactic, tartaric and citric acid was in most cases reduced by treatment with a 2.5% aqueous solution of disodium beta-glycerophosphate.


[The behavior of unspecific acid phosphatase in the human gingiva before and after the effect of aminofluorides].

The authors determined the activity of the unspecific acid phosphatase in dental papillae excised from healthy subjects and individuals afflicted with periodontitis before and after the action of Elmex fluid. Clinically and histologically, the authors observed a regression of the inflammation. The possible causes are discussed. The total activity of acid phosphatase in the interdental papilla showed no significant changes, but the various tissue layers behaved differently. No permanent lesion will result from the wetting of the papillary and marginal gingiva which occurs during topical application of Elmex fluid to the surfaces of teeth.


[Experience with surgical deepening of the oral vestibulum in the mandible].

The present paper deals with the deepening of the oral vestibule in 25 patients by means of a technique indicated by Edlan. The results obtained are compared with those achieved with the method of Clark.


[The flat vestibulum. Problems, indications for surgery, modification of vestibuloplasty and evaluation of success].

Among the aetiological factors of periodontal disease, the shallow vestibule plays a rather important role. The deviations from normal architecture may be subdivided into several forms. Surgical intervention is indicated in case of functional trouble which already exists if the blood supply is reduced by loading. A discussion of various operating techniques is followed by the description of a modification of the method of Edlan and Mejachar that has been used in more than 1000 cases up to now. The objectice evaluation of the results achieved justifies the recommendation of this technique.


[The condition of the 2d milk molars and the 6 year molars in a Copenhagen suburban community].

The increase in fillings, i. e. in caries, of the second deciduous and first permanent molars was recorded for a period of 18 months, using the dmfs/DMFS index, in 117 children, aged from 7 to 9 years, of the Copenhagen suburb of Brøndby. According to the findings concerning the second deciduous molars, the children were subdivided into three groups of caries incidence. The three groups differed but little in caries progression, which may be explained by the fact that the school dental service ensures the regular treatment of the children and achieves fairly stable results.


[The narrowing of the support area by premature tooth loss and caries in various abnormal alignments].

On the basis of the findings from 1470 patients referred for orthodontic treatment, the authors analyse, for various types of anomalies, the sequelae of untreated proximal caries and premature extractions in the supporting areas of the upper and the lower jaw. The results obtained indicate that the premature loss of deciduous teeth causes, in case of malalignment associated with lack of space, secondary alterations.


[Self evaluation and objective dental findings].

In the course of a stomatological study, 354 students were asked for a self-assessment of their dental and oral hygiene and of their dental state. The results obtained were compared with those from an objective evaluation of the dental and oral hygiene and of the dental state of these individuals. Furthermore, the authors made inquiries about oral hygiene habits and knowledge of health, using anonymous questionnaires, 352 of which could be evaluated. Owing to the considerable overestimation of their dental and oral hygiene and of their dental state by the students, there was a great discrepancy from the objective findings, which existed also between the actual knowledge of health and its regular and deliberate application.


[The medical-dental specialist regulation and the educational program for "Specialist for dental surgery"].

The Central Professional Committee for Oral Surgery provides the instructors and the dentists specializing in oral surgery with an interpretation of the regulations for the diploma of specialist physician/specialist dentist of May 23, 1974, and of the educational program. Advice and recommendations are given for the fulfilment of the training program and for the course and methods of the training for a dental speciality.


Canine osteosarcoma karyotypes from an original tumor, its metastasis, and tumor cells in tissue culture.

Radiation-induced osteosarcoma, its metastasis, and cells grown in tissue culture were karyotyped. Both hypodiploid and hyperdiploid stem lines were observed. The hypodiploid line contained 45-55 chromosomes with 10-15 abnormal metacentric and submetacentric chromosomes and one subtelocentric marker. The hyperdiploid line contained 90-105 chromosomes with 20-30 abnormal metacentric and submetacentric chromosomes with two subtelocentric markers. Karyotypic analysis can be used to monitor osteosarcomas maintained in tissue culture.


Leukapheresis of a five-year-old girl with chronic granulocytic leukemia.

A therapeutic leukapheresis of a five-year-old girl with adult-type chronic granulocytic leukemia is described, with techniques for minimizing the effects of hypovolemia. The patient's unduly rapid response to chemotherapy suggested that the procedure had effected a substantial reduction in the leukocyte mass.


Morphology of the basal ganglia in Parkinson's disease.

This work consists in part of volume measurements for the caudate nucleus, putamen and pallidum; and in part of a determination of cell-distribution and cell density in the corpus striatum from 9 paralysis agitans patients and 15 control persons from the Institute of Forensic Medicine. All 24 brains were sectioned on a specially constructed apparatus. For each of the individual sections, the size of the basal ganglia was determined by measurements of the section thickness with a capillary tube and area measurements were made by microscopic projection method combined with planimetric methods. For the first six control brains, the area measurements were also taken using point-counting method. The values thus obtained were used in the basic formula for a truncated cone and the volume of the basal ganglia for the individual hemispheres was calculated. The only exception was a single hemisphere where the volume of the basal ganglia was determined after dissecting out and weighing these structures. The results showed that the volume measurements of the corpus striatum and the pallidum in these two groups of brains were quite similar, when differences due to body height, age, and brain weight were taken into account. The volume of the basal ganglia decreased with age in both groups of brains and increased with brain weight. The shrinkage of the tissue as a consequence of the histological procedures was also determined. The shrinkage from fresh to formalin-fixed condition was determined by comparing the distance between the same two marked points in the fresh and formalin-fixed tissue. The shrinkage from the formalin-fixed condition to the completed histological preparation was determined by comparing the distance between known structural characteristics, as measured on photographs showing the formalin-fixed sections, lying beside a millimeter scale, with the same distance on the histologically treated preparations. The accumulated shrinkage in volume was 47.3%.


The shape of the amniotic pressure curve before and after paracervical block during labour.

Paracervical block (PCB) given during labour reduces the uterine activity necessary for cervical dilatation. The aim of the present investigation was to find out whether this effect of PCB changes the form of the amniotic pressure curve. A preliminary investigation showed that the ascending limb of the amniotic pressure curve, A, consists of three phases. The first phase shows an increasing slope and is called the acceleration phase of the ascending limb, Aa; the second phase is rectilinear, Ar. The third phase has a decreasing slope, and is named the deceleration phase, Ad. The descending limb of the amniotic pressure curve, D, was found to have corresponding phases. The initial part has a downward increasing slope and is called the acceleration phase of the descending limb, Da. Then follows a rectilinear phase, Dr and finally a phase with a decreasing slope, the deceleration phase, Dd. The duration of each phase, except Dd, was measured during an observation and a treatment period in 27 patients receiving PCB, and 25 control cases who were given N2O/O2, pethidine, or a combination of both analgesics. The patients were strictly selected and allocated at random to either group. Local analgesia in combination with adrenaline was given at cervical dilatation 3-6 cm; 20 minutes were allowed to elapse from the administration of analgesia until registration of the contraction of the treatment period, to assure an established analgetic effect. PBC shortens Aa and Ad, but prolongs Ar. A + Da + Dr and Ad + Da are shortened while Dr is prolonged after PCB (Table IV). On the presumption that PCB inactivates a part of the lower uterine segment, the changes of Aa, Ar and Ad + Da were predictable. To determine the significance of adrenaline, another series of 21 patients were given PCB, injecting 0.25 per cent bupivacaine without adrenaline added to the solution. The duration of the phases before and after the block was compared. PCB without adrenaline brought about the same changes as it did with adrenaline, but the changes were smaller, only those of Aa, Ar, Dr and Ad + Da being statistically significant. The pressure curves of six patients receiving epidural block were examined using the same method as in the PCB and control groups. The changes typical of PCB did not occur after epidural block. The discovery of the six phases of the amniotic pressure curve, their change after PCB and the results of other investigators make possible a suggestion of the basic physiological processes that influence amniotic pressure during coordinated labour contractions. It is held that the form of the amniotic pressure curve can be explained in terms of contraction, relaxation, and propagation of a contraction and a relaxation wave.


Oral treatment of menopausal symptoms with natural oestrogens. Experiences with a new series of oestrogens and oestrogen-gestagen combinations.

A series of preparations containing 17-beta-oestradiol and oestriol in a proportion of 2 : 1 was studied with respect to their effects and side effects in 352 women in the menopause and postmenopause in a total of 2 101 woman months. In certain of the treated groups it was considered of value to produce regular bleeding, and in these patients the oestrogen therapy was complemented with noretisterone acetate during short periods. Both the subjective and the objective effects of the treatment were excellent. Side effects were rare and the treatment seems to have advantages over other oestrogenic compounds. No signs of disturbance of the liver function were observed. In contrast to the alkyl substituted steroids the natural oestrogens seem to have a normalising effect on the blood lipids.


Twin pregnancy. The role of active management during pregnancy and delivery.

In a series of 335 twin patients delivered over 1965-1973, active management was promoted during the pregnancy and delivery. The twin diagnosis was made in the 33.7th gestational week on an average. The diagnosis was made prior to delivery in 83.0 % of the cases, and during 1971-1973 the diagnosis was made before the 32nd week of pregnancy in 40.2 % of the cases. The perinatal mortality (PNM) rates were highly significantly (p less than 0.001) lower, the birthweights of A and B higher (p less than 0.001), and the number of gestational weeks at delivery greater (p less than 0.001) in the group diagnosed during pregnancy than in the group in which the twins were not diagnosed until at delivery. 56.4 % of the patients stayed in hospital for more than 2 days during the pregnancy and 34.9 % for over 10 days. The average period of hospitalization was 11.3 days. The perinatal mortality (PNM) of both the A and the B infants was lowest in the group hospitalized for over 10 days. In the group which had stayed in hospital for over 10 days the mean birthweight of the A infants was higher by 100 g and that of the B infants by 94 g than in the group not hospitalized despite the early diagnosis of twins. The average duration of delivery was 9.3 hours. Active efforts were made to shorten the interval between the births of the two infants, and it was 17.5 minutes on an average. This interval was not, however, related to the PNM rate of the B twins. On the basis of our findings, we wish to emphasize particularly the importance of the early diagnosis of twins.


Twin pregnancy. Neonatal morbidity and mortality.

The neonatal morbidity and mortality rate of 335 twin pairs born during the years 1965-1973 was investigated. 649 twins were born alive. 29 % of the twins were preterm. 31 % of the twins were small for date infants, and 41 % weighed less than 2 500 g. Mean birth weight was 2 590 g in A twins and 2 560 g in B twins. The neonatal mortality (0-28 days) was 7.1 %. The most common causes of death were the respiratory distress syndrome, intracranial haemorrhage and anoxia. Low one minute Apgar scores occurred more often in B twins than among A twins. Breech delivery gave low one minute Apgar scores more often than did spontaneous vertex delivery in both twins. Full term twins and infants weighing more than 2 500 g had fewer low one minute Apgar scores than the preterm infants and those with low birth weight. Neonatal disorders were equally common in both twins except the birth asphyxia and/or aspiration syndrome, which were more frequent in the B twins. The respiratory distress syndrome was diagnosed in 8 % of A twins and 12 % of B twins. Hypoglycaemia was recorded for 8 %, and hyperbilirubinaemia exceeding 15 mg % for 7 %. Infections occurred in 6 %. Transfusion syndrome was verified in 7 % and malformations in 6 %. Although mortality in twin pregnancies has declined, neonatal morbidity is very high. Twin pregnancies thus form a high risk group for obstetricians and pediatricians.


Twin pregnancy. A clinical study of 335 cases.

In order to study the complications and therapeutic outcome of twin pregnancies, a retrospective survey was carried out in the University Central Hospital of Oulu. Twin deliveries during 1965-1973 numbered altogether 335, and their relative frequency was 1.7 %. The deliveries took place in the 37.2th gestational week on an average. The mean weights of the infants were 2590 g (A) and 2562 g (B). Perinatal mortality in the total series was 9.3 % (A 9.0 % and B 9.6 %). Pregnancy terminated before the 37th week in 29.2% of the cases. Perinatal mortality in this group was 27.0 %, while the corresponding value in the full-term group was 1.7 %. The perinatal mortality of primigravidas (14.1 %) was about twofold compared with that of the multiparas (7.2 %). Twin pregnancies were complicated by hyperemesis gravidarum, pre-eclampsia, anaemia, pyelonephritis and hepatosis more often than were the single pregnancies. The complications which contributed towards an increase of perinatal mortality included uterine bleeding in early and late pregnancy, hydramnion and superimposed pre-eclampsia. The complications generally associated with twin pregnancies and the increased perinatal mortality involved require that mothers with twin pregnancy, particularly primigravidas, should be subjected to intensified follow-up and treatment.


Cochlear action potentials in experimentally induced hypothyroidism in guinea pigs.

Hypothyroidism was induced in guinea pigs by various methods. Using a new technique, electrodes were permanently implanted and action potentials aroused by different sound stimuli recorded and measured. The results obtained before and during the hypometabolic state were analysed and compared with those obtained after replacement therapy. A tentative attempt was made to extrapolate the changes in pattern and magnitude of the action potentials caused by the experimentally induced hypothyroidism, to the hearing disorders observed in patients with thyroid deficiency.


Type IV glycogenosis - a study of two cases.

Liver biopsy materials of two siblings with type IV glycogenosis were studied by light and electron microscopy. Biochemical analysis was added using autopsy material in one of the two cases. Two kinds of polysaccharides were noted not only in the cardiac muscle, skeletal muscles, smooth muscles and reticuloendothelial cells, but also in the neutrophils and platelets. One was glycogen and the other was similar to amylopectin. Ultrastructurally, a large amount of fibrils, 60 A in width, glycogen rosettes and glycogen granules were detected in those cells. Branching glycosyltransferase deficiency was biochemically confirmed in one case examined.


Bacitracin production by the neotype; bacillus licheniformis ATCC 14580.

A small but significant bacitracin production has been observed in the neotype Bacillus licheniformis ATCC 14580. This strain produces bacitracin only during the phase of rapid growth. The bacitracin production ceases before growth is completed, and the relationship between growth and antibiotic production was not influenced by different environmental conditions. The maximum titre produced by the neotype strain was about 1 i.u. bacitracin/ml. This maximum titre was not influenced by the environmental conditions which resulted in a great variability of the maximum titre of the known bacitracin producer Bacillus licheniformis ATCC 10716. In contrast to B. licheniformis ATCC 10716, the bacitracin production of the neotype B. licheniformis ATCC 14580 was not stimulated by Mn(II)ions. It is suggested that bacitracin may be incidentally overproduced by certain strains grown in certain environments. The controlled bacitracin production by the neotype is not consistent with the definition of secondary metabolites and the hypothesis concerning the function of secondary metabolites after growth of the producer organisms.


The serology of Bordetella bronchiseptica isolated from pigs compared with strains from other animal species.

The serology of freshly isolated strains of Bordetella bronchiseptica from pigs and some other animal species was studied by the agglutination and agglutinin absorption tests. Differentiation was made between heat stable O-antigens and heat labile K-antigens. All the strains examined contained a common O-antigen (1). In addition, three heat stable antigens were detected. The heat labile antigens of freshly isolated strains were found to be very different. The major antigens 2 and 3 were not found in combination. A common weak K-antigen (1) was found in all strains. The pig strains were found to be serologically identical (0, 1, 2; K 1, 2). The same serotype was isolated from a rabbit. Another rabbit strain was found to be similar to a strain isolated from an SPF-rat (O, 1, 3; K 1, 3, 4). The antigenic pattern found in two cat strains was O 1, 3; K 1, 3. Typing of freshly isolated strains from pigs with monospecific factor sera confirmed that all the strains so far examined were serologically identical. This uniform serology hampers epidemiological studies of porcine bordetellosis by antigenic analysis. The occurrence of serologically different serotypes of B. bronchiseptica is of significance in the diagnostic bacteriology since the final diagnosis must be confirmed by a serological test.


Recurrent Aeromonas sepsis in a patient with leukemia.

A case of recurrent sepsis due to Aeromonas hydrophila in a patient with acute myelogenous leukemia is reported. The patient's first infection leading to bacteremia followed contamination of a mosquito bite by stagnant water. After recovery from the first bacteremia, the patient again became septic with a second strain of Aeromonas hydrophila, which again responded to antimicrobial therapy. It is hypothesized that contamination of the local water supply may have led to the establishment of a gastrointestinal carrier state that produced the second bout of Aeromonas sepsis when the patient was markedly leukopenic. The importance of the oxidase test to differentiate Aeromonas species from members of the family Enterobacteriaceae is re-emphasized.


Pulmonary mucormycosis caused by Cunninghamella elegans in a patient with chronic myelogenous leukemia.

Cunninghamella elegans was cultured from autopsy materials of the infected lung of a patient with chronic myelogenous leukemia. The histologic sections revealed extensive growth of nonseptate, broad hyphae in and about the large and small arteries and veins, occluding the vessels. This case is believed to be the second in which human infection by C. elegans has been documented.


Restoration of effective hemopoiesis preceding suppression of leukemic clone in myeloblastic leukemia.

A 63 year old Caucasian woman presented with myeloblastic leukemia and a hyperdiploid C group chromosome change in 10 per cent of marrow metaphases. Treatment iwth cytotoxic agents resulted in an increased percentage (52 per cent) of these hyperdiploid marrow cells. Furthermore, the marrow continued to show leukemic fearures morphologically and in culture. Despite the indications of persistence or progression of the hyperdiploid, putatively leukemic line at cessation of chemotherapy and for a period of time thereafter, remission was achieved and blood and marrow cell numbers one year after cessation of all treatment are normal. The hyperdiploid line is no longer detectable. This case raises questions concerning the mechanism whereby remission is attained in some cases of acute leukemia and is discussed in terms of the restoration of normal hemopoiesis eliminating the leukemic process.


Ophthalmologic manifestations of granulocytic sarcoma (myeloid sarcoma or chloroma). The third Pan American Association of Ophthalmology and American Journal of Ophthalmology Lecture.

The clinicopathologic review of 33 well-documented cases of granulocytic sarcoma on file in the Registry of Ophthalmic Pathology confirmed the facts that this tumor is encountered mainly in children, that boys are affected more frequently than girls, and that white Americans appear to be less vulnerable than other ethnic groups. While granulocytic sarcoma is a variant of granulocytic leukemia, the tumor may appear before, after, or concomitantly with hematologic evidence of leukemia. In the present series only four of the 33 patients were already known to have leukemia when they were first seen by an ophthalmologist for their orbital, ocular, or adnexal lessions. The Leder stain has proved extremely helpful in arriving at a definitive histopathologic diagnosis. Accurate diagnosis is important to prevent inappropriate medical or surgical treatment and to indicate the need for vigorous antileukemic chemotherapy. Prognosis at best is poor.


Craniomaxillary orthopedic correction with en masse dental control.

Craniomaxillary (high-pull) traction is a well-established part of today's orthodontic armamentarium. It is useful in a wide range of problems involving excessive anterior and/or downward displacement of one or more components of the maxillary complex. Such growth-related problems are most amenable to correction during the active growing period; in fact, optimum improvement is often attainable only during this period. Attachment of these devices by means of cemented orthodontic appliances is limited in some developmental stages by the teeth available for banding. It is limited at all ages by the tolerance of the periodontal ligament of the attachment teeth. In  terms of over-all maxillary change, the locations of the banded teeth further restrict the orientation and application of therapeutic forces. A rigid splint precisely engaging all or part of the upper dentition expands the potential applications of this form of traction in terms of age range, force levels, and force orientation. This is basically an orthopedic applicance with concurrent orthodontic effects. In contrast to the gross destructive effects experienced in early applications of the Milwaukee brace, the application of force with this appliance can be planned to redirect maxillary growth and occlusal relationships from often progressively dysplastic patterns to a more harmonious over-all functional relationship among all facial structures. The resultant interplay of orthopedic and orthodontic effects makes close orthodontic supervision and care essential throughout the treatment and post-treatment periods. This is especially important because some of the orthodontic side effects may be unfavorable. Failure to anticipate and plan for control of these effects could be disastrous. Occasions for its use as the sole therapeutic measure are rare. The nature of treatment with this appliance is such that in most cases it must be used as a discrete stage of a comprehensive treatment plan, either before or after other orthodontic measures or both. It is poorly suited to simultaneous combination with other orthodontic appliances operating on the same teeth. Its value lies in careful coordination with the other phases, using each where and when it will be most effective. The cases reported here illustrate only the changes accomplished during such isolated treatment stages; they do not represent the total orthodontic effort required for these patients.


Diagnosis and treatment of maxillomandibular dysplasias.

Skeletal dysplasia of the maxilla and/or mandible is responsible for prognathism or retrognathism. The severity of either condition is in direct proportion to the degree of dysplasia noted within each jaw. Mandibular prognathism is real or apparent. Some of the patients described in this article demonstrate this quite clearly when the jaws are analyzed individually and related to each other. A differential diagnosis is essential to determine whether the abnormality is in the maxilla or the mandible,  or both. When recognized early in the formative years, it permits the orthodontist to employ guidance and full therapy procedures in a treatment plan that is programmed to include surgical procedures specifically for the skeletal aberration to be corrected. The treatment skills of the orthodontist and  his knowledge of growth of the skeletal and dental structures aid in diagnosis and treatment planning in the areas of both orthodontics and surgery. Close cooperation between the orthodontist and the surgeon permits a more definitive resolution of the existing and potential skeletal and dentoalveolar abnormalities.


Arcial growth with metallic implants in mandibular growth prediction.

The present investigation was undertaken to determine whether the Ricketts theory of arcial growth of the mandible can be put to practical use by the clinician to predict mandibular morphology. Eight subjects (six girls and two boys) were selected from the earliest implant samples at the Orthodontic Department of Emory University School of Dentistry. The initial cephalograms were coded and sent to Ricketts, and a 6-year manual growth forecast using the arcial method was requested. The final cephalograms were traced and compared. The three tracings (initial, prediction, and final) were superimposed over the metallic implants and presented on a case-by-case basis. The forecasts, in form, were clinically acceptable in five of the eight cases. In two of the cases (girls) (Cases 2 and 4) a hand-wrist radiograph to determine skeletal age would have improved their accuracy. The forecast in Case 2 was not acceptable. In view of our results in this small sample, the arcial method appears valid for prediction of amndibular growth; however, hand-wrist radiographs will improve the accuracy of short-range predictions of the amount of growth expected. For this reason, the orthodontist should constantly monitor his patients, watching for each individual to assert himself.


Adaptation of the mandible in children with adenoids.

In a sample of lateral x-ray cephalograms of children with obstructing adenoids, a dorsal rotation of the mandibular ramus was found to characterize the facial skeleton. The mandibular body and the condylar process were not correspondingly rotated. The findings suggest that dorsal rotation of the mandible occurring in association with various pathologic processes could always be primarily a response to an encroachment of the pharyngeal space. A possible involvement of the clivus region, to a minor degree, was also indicated. The need for "tailormade" cephalometric methods in studies of specific problems is stressed.


A new self aspirating plunger.

In another approach to the problem of aspiration before injection of local anesthetics, a new self aspirating plunger was designed. It is composed of similar materials currently in use. Its action is simply the elastic return of a temporarily stretched diaphragm in the center of the plunger. A gentle pressure and release will cause aspiration. No harpoon is used; therefore the cartridge can be more quickly loaded and changed. No special syringe is needed.Stanley C. Harris has said, "one of the most insidious dangers in therapeutics is the complacency which develops when undesirable reactions are infrequent. With local anesthesia, this complacency is intensified by the knowledge that local anesthetics are given intravenously by intention in certain medical procedures. However, when this procedure is employed, the patient is hospitalized, in an operating room with emergency equipment and drugs instantly available."(1)Dentists are aware of the possible consequences of intravascular injection of local anesthetics and know that these can range from lack of anesthesia to an unplesant experience or to a rare lethal one.(2-3) Case histories of complications of intravascular injection appear regularly in the literature. The presence of the anesthetic in the blood can easily be demonstrated.(4)


Polycythemia rubra vera progressing to Ph1-positive chronic myelogenous leukemia.

Polycythemia rubra vera and chronic myelogenous leukemia are both myeloproliferative disorders and, as such, share certain clinical features. Although some myeloproliferative disorders may transform into others, conversion of polycythemia rubra vera to chronic myelogenous leukemia has been denied. We report here an elderly man with polycythemia rubra vera and a normal leukocyte alkaline phosphatase who developed chronic myelogenous leukemia with a low leukocyte alkaline phosphatase and a marrow karyotype of 45, X, Ph1-positive. In addition, we have collected evidence of two similar cases and thus conclude that, although uncommon, polycythemia rubra vera may on occasion progress to chronic myelogenous leukemia.


Splenectomy in the chronic phase of chronic granulocytic leukemia. Effects in 32 patients.

Splenectomy in the chronic phase of chronic granulocytic leukemia was done in 32 patients, in 24 as part of a trial of elective splenectomy in early disease and in 8 because of thrombocytopenia preventing adequate therapy of the chronic phase. Patients with splenectomy had a median survival after diagnosis of 60 months. However, survival of patients operated on within 1 year of diagnosis was no different (median, 44 months) from that recorded in 120 consecutive Philadelphia chromosome-positive patients treated during the same time period (median, 42 months). After blastic transformation of disease, splenectomy patients survived slightly longer, responded more frequently to platelet transfusions, and avoided the morbidity of massive splenomegaly seen in 30% of patients treated with spleens retained. Response to blastic phase chemotherapy, however, was not improved. Prophylactic splenectomy in the chronic phase of disease did not influence survival but may ameliorate some complications of the terminal stages of illness.


Protective effects of ascorbic acid against toxicity of heavy metals.

Toxicity of cadmium in the young Japanese quail rapidly produced moderate growth depression, hypogonadism in the male, decreased bone ash, severe anemia, alterations of "indicator" tissue levels of several essential inorganic elements, and marked histological abnormalities of the duodenum, bone marrow, adrenal medulla, and esophageal mucus glands. Cadmium appeared to have direct effects on zinc and iron, particularly iron (III), by decreasing intestinal absorption of these elements. Small amounts of dietary ascorbic acid were protective against many of the adverse effects of cadmium. The young quail proved to be a useful species for these studies. The experience with cadmium may have some facets that would prove useful in further studies of the effects of ascorbic acid on the toxicity of other metals.


Reduction of gastric carcinogens with ascorbic acid.

The formation of nitrite from nitrate was studied in potatoes incubated at room temperature. After 24 hours of incubation at 25 degrees, 112 ppm and 373 ppm of nitrite formed in homogenized cooked potatoes containing 284 ppm and 584 ppm of nitrate, respectively. In homogenized fresh potatoes incubated at 21 degrees and containing 284 ppm of nitrate, 103 ppm of nitrate formed within 24 hours. During the period of nitrite formation, nitrate levels decreased sharply, indicating that reduction of nitrate to nitrite occurred. Incubation at 2 degrees completely prevented nitrite formation in all cases. The formation of methylnitrosourea from added methylurea and nitrite was observed in potato incubated under simulated gastric conditions (37 degrees, pH 1.5). An ascorbate-nitrite mole ratio of 4 gave a 93% inhibition of methylnitrosourea formation. Ascorbate reacted directly with nitrite in potato incubated under identical conditions, yielding a 43% decrease in nitrite concentration. Ascorbate did not react with methylurea or the product, methylnitrosourea.


Tissue changes induced by marginal vitamin C deficiency.

Chronic marginal vitamin C deficiency in guinea pigs results in alterations in certain tissues that are quite different from those observed following acute deficiency. In autonomic ganglia, although changes observed in the organelles of some cells are similar to those seen in acute deficiency, the specific changes are the presence of large numbers of cilia in the cytoplasm of both ganglion cells and their associated neuroglia and the marked proliferation of collagen fibers in the extracellular spaces. The evidence presented points to a link between vitamin C and arteriosclerosis. One mode of interaction may be the effect of latent vitamin C deficiency on cholesterol metabolism. The data presented indicate important changes in the liver with marked increases of agranular endoplasmic reticulum. Together with the liver cholesterol studies, the indications suggest an increased cholesterol deposition in the liver. Light-microscopic sections of the aorta reveal alterations in many of these vessels ranging from endothelial proliferation to large, well-formed musculofibrotic arteriosclerotic plaques.


Effects of ascorbic acid on health parameters in guinea pigs.

The maximal response of a selection of ascorbic-acid-dependent parameters to a range of intakes of ascorbic acid has been shown to occur at virtually one level of intake in the present experiments. Further, this response occurred with intakes that produced only 1/2 saturation or less of tissues with ascorbic acid. Excessive intakes did not enhance effects, and, as in the case of serum copper levels, may have a detrimental effect. In view of the known factors that may influence requirements and the intralaboratory variability in experimental conditions, the more reasonable approach to the interpretation of dose response data is likely to relate the response to the accompanying degree of tissue saturation, rather than to an absolute level of ascorbic acid intake.


Changes in ascorbic acid metabolism of the offspring following high maternal intake of this vitamin in the pregnant guinea pig.

Guinea pigs were fed a control (0.05%) or a high (0.5%) ascorbic acid diet during the last half of pregnancy. When the pups were tested at 5 and 10 days of life the ones from the high-ascorbic-acid group demonstrated a marked increase in 14CO2 excretion, compared with the control pups, following an intraperitoneal injection of 14C-labeled ascorbic acid. When the animals were weaned to an ascorbic-acid-deficient diet signs of scurvy appeared earlier in the pups from the high vitamin C group and their survival was shorter. When excretion of labeled CO2 in both groups was correlated with the day of onset of scurvy signs, a linear correlation was found between these two parameters, suggesting that the earlier appearance of signs of scurvy in the experimental pups is secondary to an increased rate of ascorbic acid catabolism.


Ascorbic acid in cholesterol and bile acid metabolism.

Latent chronic ascorbic acid deficiency provokes in guinea pigs a metabolic disorder in the liver, causing an impaired cholesterol transformation to its principal catabolic product, bile acids. This metabolic disorder induces hypercholesterolemia and accumulation of cholesterol in the liver and slows the release of cholesterol from the circulation. Ascorbic acid probably intervenes into the biosynthesis of bile acids at the stage of 7 alpha-hydroxylation of the cholesterol nucleus. High doses of ascorbic acid significantly stimulate cholesterol transformation to bile acids in guinea pigs and decrease plasma cholesterol concentration in humans.


Human requirements and needs. Vitamin C status: methods and findings.

Although vitamin C nutritional status in man may be determined on the basis of dietary intake findings and on clinical signs of a dietary deprivation, biochemical measurements represent the most objective approach. Without the availability of a functional biochemical procedure that relates to vitamin C status, information concerning inadequacies in this nutrient has been derived mainly from measuring ascorbate levels in serum (plasma), leukocytes, blood, and urine. The measurement of serum levels of ascorbic acid is the most commonly used and practical procedure for determining vitamin C nutritional status in individuals or population groups. Although leukocyte ascorbate levels provide information concerning the body stores of the vitamin, the measurement is technically more difficult to perform, and, hence, its use is largely confined to clinical situations as an aid in the diagnosis of scurvy. The clinical diagnosis of scurvy can be aided also by information on the urinary levels of ascorbic acid and the use of vitamin C loading or saturation tests. With recognized limitations, ascorbic acid can be measured in biological samples with the use of automated or manual colorimetric and fluorometric procedures. Nutrition surveys conducted in Canada and the United States have indicated vitamin C deficits among certain population groups.


Relationships of ascorbic acid to pregnancy, and oral contraceptive steroids.

The 1974 RDA is 60 mg per day for pregnant women and 80 mg per day for lactating women. In the present study an attempt was made to simulate this intake in the guinea pig and study reproduction performance in relation to guinea pigs fed chronically low and high levels. In animals that conceived and carried the young to term, all 3 dietary levels of ascorbic acid appeared to be adequate for maintaining viability of fetuses and of offspring, and for growth of offspring during the nursing period. The chronically low intake level was not adequate for growth after weaning. The control group was superior to the chronically low-intake group but inferior to the high-intake group in conceiving, producing litters, and carrying litters to term. The level of intake in the control group was inadequate to maintain tissue stores. Even the high intake was inadequate to maintain some tissues at saturation levels. The results suggest that the requirement for ascorbic acid during pregnancy and lactation has been markedly underestimated.


Heterogeneity of carcinoembryonic antigen. II. Monosaccharide composition of concanavalin A-reactive and -nonreactive CEA.

Monosaccharide compositions of Con A-reactive CEA (CEA-M) and Con A-nonreactive CEA (CEA-P) separated from two different samples of CEA were analysed by gas liquid chromatography. It was revealed that all CEA subfractions possessed N-acetylglucosamine, fucose, and galactose residues. One out of 4 subfractions did not contain sialic acid and another one lacked glucose in its carbohydrate moiety. N-acetylgalactosamine was not detected in measurable amount in any of the 4 subfractions. A large amount of mannose was found in CEA-M, but only a small amount in CEA-P.


Parosteal osteogenic sarcoma of the mandible, Existence masked by diffuse periodontal inflammation.

A 38-year-old man was in a state of poor oral hygiene, with multiple broken carious teeth and diffuse inflammatory hyperplasia of the gingival tissues. A mandibular, alveolar soft tissue mass in the premolar-molar region was noted on the right side, in continuity with the gingival hyperplasia. Biopsy of the lesion ruled out a diagnosis of squamous cell carcinoma. The patient underwent extraction of his teeth, and all hyperplastic tissues including the tumefaction were excised. Five months later, the patient had a recurrent mass in the same location that was removed via hemimandibulectomy. The mass was diagnosed as a parosteal osteogenic sarcoma.


Surgical management of osteogenic  sarcoma of the mandible.

Osteogenic sarcoma is the most common malignant tumor of the mandible. It is less aggressive than osteogenic sarcoma of the long bones, and mortality is often due to local persistence or intracranial extension. We report such a case to emphasize that disarticulation of the mandible is necessary, since clinical and pathologic evaluation of tumor extent may be impossible. Except for parasymphysial lesions, disarticulation with midline hemimandibulectomy and frozen section assessment of all margins is recommended.


The management of pathological grief.

Earlier descriptions of pathological grief are reviewed. From the study of recently bereaved widows major forms of pathological grief are outlined. These are suppressed or inhibited grief and distorted grief, including forms with extreme anger or extreme guilt. Other grief variants are noted. The management of pathological grief is outlined; specifically the encouragement of the expression of suppressed affects especially sadness, anger and guilt; as well as the going over of memories and feelings to do with the lost relationship. Consideration is given to: the establishment of the therapeutic contract; the specific exploration of the response to the death and the pre-existing relationship; resistances; interpretation of defences; assessment of progress of mourning; social network factors; termination; and transference and counter-transference.


A new application of closed group psychotherapy in a public psychiatric hospital.

This paper describes an intensive group psychotherapy treatment program in a public psychiatric hospital to which patients with severe personality disorder are referred. A unique structure within the patient/staff community is described concerning the inter-relationships of the closed psychotherapy groups and the relationships between the groups and staff within the broader therapeutic milieu. The regular arrival and departure of the closed groups serves to activate relevant latent instinctual conflicts which are of significance in personality disorder. The advantages of this approach to treatment of personality disorder are discussed and the results of evaluation of progress of the unit's first eleven closed groups are presented.


Nodular fasciitis causing unilateral proptosis.

A case report of an unusual case of nodular fasciitis in the orbit presenting with unilateral proptosis is described, and the radiological features are outlined. The histological features are discussed and the benign nature of the lesion stressed. Nodular fasciitis arising in the orbit and presenting as unilateral proptosis has not previously been reported in the literature.


Treatment of acute lymphoblastic leukemia in adolescents and a-dults: A retrospective study of 41 patients (1970-1973).

During the period from January 1970 until December 1973, therapy was started in 41 previously untreated adolescents and adults with acute lymphoblastic leukemia. Induction therapy was started with vincristine and prednisone in all patients, resulting in complete remission in 19 and death due to infection during the first month in one case. After 3 wk on these two drugs, the addition of daunorubicin was required in the remaining 21 patients. Fifteen of these obtained remission, one died during induction therapy, and five patients were unresponsive to this therapy, as well as to all subsequent induction schemes. The overall remission rate was 83%. Significantly higher initial leukocyte counts were found in the group treated with vincristine, prednisone, and daunorubicin. Meningeal leukemia prophylaxis, by either periodic methotrexate injections given intrathecally or a combination of cranial irradiation and intrathecally administrated methotrexate, was administered in 29 therapy responders. The median duration of complete remission obtained with various maintenance therapy schemes was 13 mo. No differences were seen in the results obtained in patients between 14 and 20 yr of age and older patients. Twenty-two patients relapsed within 2-37 mo. Relapses were confined to the central nervous system in two cases, to the bone marrow in 18, and to the bone marrow and CNS simultaneously in two. A second remission was obtained in 17 cases (77%). The median survival time of the whole group was 27 mo, as compared with 32 mo for therapy responders and 7 mo for the nonresponders. The percentage and duration of remission and the survival time in our group of adolescents and adults were comparable to those currently being achieved in other centers, but not as good as those reported for children treated with the same protocols.


Intensive leukapheresis as initial therapy for chronic granulocytic leukemia.

Intensive leukapheresis has been used as the initial treatment of chronic granulocytic leukemia (CGL) in six patients. The number of leukaphereses ranged from 3 in 7 days to 13 in 39 days (mean, 8 in 22 days). The procedures were well tolerated, and in all patients there was improvement in hematologic values, in most cases with considerable reduction in the peripheral leukocytosis and thrombocytosis and in the proportion of immature granulocytic cells in the circulation. Splenomegaly decreased considerably in the four patients who had more than four leukaphereses. Symptoms of sweating, malaise, and pain due to splenomegaly were rapidly relieved. Problems due to hyperuricemia did not occur, but four patients required blood transfusions for correction of anemia. This method of initial treatment of CGL appears to give more rapid relief of symptoms than does conventional chemotherapy; it incurs no risk of hyperuricemia and lessens that associated with thrombocytosis. In addition, large quantities of granulocyte-rich plasma are made available for the treatment of infections in neutropenic patients. Intensive leukapheresis deserves more widespread evaluation as the initial treatment of CGL.


Antibody responses to leukemia-associated antigens during immunotherapy of chronic myelocytic leukemia.

We have studied immunologic reactivity to leukemia-associated antigens in patients with chronic myelocytic leukemia (CML) treated with chemotherapy and adjunctive immunotherapy. All patients were immunologically competent as measured by skin test reactivity to dinitrochlorobenzene. Immunotherapy consisted of allogeneic irradiated leukemic myeloblasts injected intradermally, with BCG vaccine (Research Foundation, Chicago, Ill.) given by multiple puncture at the same site. 10(9) cells plus BCG were given weekly for 4 wk, and 10(8) cells plus BCG were given at monthly intervals thereafter. Eight patients judged clinically to be in the stable phase of their disease developed circulating antibody against the immunizing blast cells demonstrable by cytotoxicity and immunofluorescence assays. The antibody also showed reactivity against a panel of myeloblasts (12 paients) but not against the corresponding remission lymphocytes (five patients) or normal lymphocytes (20 donors). In two cases the antibody showed reactivity against the patient's own leukemic blasts. Seven of these eight patients have maintained a steady clinical course ranging from 20 to 40 mo, while one entered the blastic phase and died. Six patients were judged to be in the aggressive phase of CML because of progressive leukocytosis and splenomegaly or increasing myeloblastosis; five died an average of 16 mo after diagnosis. Humoral antibodies were not detected in these patients after repeated courses of BCG and allogeneic leukemic cells. We conclude that specific active immunotherapy of patients with CML can abet the production of humoral antibody against blast cell antigens and that this response may be impaired during the aggressive phase of the disease.


Ultrastructural histochemical alteration of the plasma membrane in chronic myelocytic leukemia.

Ultrastructural histochemical evaluation of the surface of normal human blood and bone marrow cells exposed to the pyroantimonate-osmium (PAO) reaction indicated the selective binding of pyroantimonate to certain cations (calcium, magnesium, and possibly sodium) associated with the plasma membrane of neutrophilic leukocytes and their developmental forms. Other leukocytes and their precursors did not exhibit plasma membrane PAO reactivity. The extent of surface binding was related to cell maturity, with maximal labeling evident in the mid and late promyelocytes; decreased binding occurred with subsequent maturation while myeloblasts were nonreactive. This study was initiated to ascertain if histochemical surface modifications of neutrophilic cells occur in certain myeloproliferative disorders. In this regard, we have been able to demonstrate a distinctive defect in the plasma membrane PAO binding characteristics of the leukemic cells in chronic myelocytic leukemia (CML). Limited binding of pyroantimonate to the plasma membrane of the leukemic cell series in four patients with CML contrasted with that of the normal granulocytic cell series and the neutrophilic cells seen in myelomonocytic leukemia (two patients), myelofibrosis (one patient), and acute myelocytic leukemia (three patients). Comparison of surface PAO reactivity of neutrophilic cells in all stages of maturation in two patients with CML in blast crisis revealed that, in the patient with 30% circulating blast cells, PAO reactivity was identical to that noted in CML, while in the patient with 80% circulating blast forms, the PAO reactivity of the maturing neutrophilic cells more nearly resembled that observed in neutrophilic cells from normal individuals. Many neutrophilic cells from patients with myelofibrosis and myelomonocytic leukemia and from one patient in severe blast crisis had large surface deposits of pyroantimonate considered to reflect increased membrane-associated reactive cation.


Osmotic behavior of normal and leukemic lymphocytes.

The response of normal human peripheral blood lymphocytes to a hypotonic environment may be divided into two phases: the cells first exhibit rapid osmotic swelling, followed by a slower shrinking phase, during which they regain their initial physiologic volume. This osmotic behavior is characteristic of most mammalian and avian nucleated cells so far examined. The normal human blood lymphocyte, however, shows the most rapid recovery phase (5 min). Lymphocytes from chronic lymphatic leukemia patients, in comparison, show a strikingly slower rate of return to their initial isotonic volumes. The mechanism underlying osmotic cell volume regulation and its significance are discussed.


Chronic myelogenous leukemia presenting in the blastic phase and its association with a 45 XO Ph1 karyotype.

A 58-yr-old male patient presented in the blastic phase of chronic myelogenous leukemia (CML). Cytogenetic studies revealed a 45 XO Ph1 chromosome pattern in bone marrow cells during a short remission and again in the blastic phase of the disease. The patient expired 8 mo following diagnosis. The blastic phase of CML can stimulate acute myelogenous leukemia (AML) clinically and hematologically; CML can be differentiated by the presence of the Ph1 chromosome and the stigmata of CML. Absence of the Y chromosome from the bone marrow in CML is a recently described finding. Previous reports indicating the prevention of the blastic phase in patients with this karyotype could not be confirmed by our or other recently reported cases.


[Cytochemical polymorphism of acid phosphatase in hairy cell leukemia].

In four cases of hairy cell leukemia a cytochemical polymorphism concerning acid phosphatase (AP) is evident. Any AP is lacking in all hairy cells of one case; only tartrate inhibitable AP is occurring in two cases, in another case tartrate resistant AP is found in high activity. Thus, the lack of tartrate resistant AP seems not to be an argument against hairy cell leukemia.


Acute lymphoblastic leukaemia: cyclical chemotherapy with three combinations of four drugs (COAP-POMP-CART regimen).

Forty-two adults and children with previously untreated acute lymphoblastic leukaemia (ALL) were entered into a programme of chemotherapy in which three combinations, each of four drugs were administered in a predetermined cyclical rotation together with cranial irradiation and intrathecal injections of methotrexate. Forty-one patients (98%) entered remission and no patient developed neuroleukaemia. Relapse of ALL occurred in 10 patients, and three patients died during remission, while eight patients stopped treatment after two and a half years and have remained in remission for two to 26 months. Comparison of remission and survival experience in this mixed group of children and adults with the experience of children treated at Memphis and in the Medical Research Council's UKALL-I trial showed no significant differences. On the other hand, analysis by prognostic factors showed that neither age nor blast cell count at presentation had any adverse effect in patients treated in this study. No relapses occurred in nine patients with blast cell counts greater than 20 x 109/1 at presentation. This regimen is effective treatment for ALL and may be of special value in patients with poor prognoses. The regiment has not as yet proved superior for the treatment of children with ALL who do not have adverse prognostic features.


Daunorubicin, cytosine arabinoside, 6-mercaptopurine riboside, and prednisolone (DCMP) combination chemotherapy for acute myelogenous leukemia in adults.

Thirty-seven adults with acute myelogenous leukemia (AML) were treated with a combination of daunorubicin, cytosine arabinoside, 6-mercaptopurine riboside, and prednisolone (DCMP) for remission induction. Twenty-three of 37 patients (62.2%) achieved complete remission, three, partial remission and 11, failure. Patients with prior therapy responded as well as patients without it. The median survival time of the patients who received DCMP for their initial remission induction therapy was 10.3 months and that of the patients who obtained complete remission was 17 months. Complete remission occurred in 21 out of 28 patients (75%) less than 40 years old but in only two out of nine patients (22.2%) more than 40 years old. The most common toxic effects were severe myelosuppression and liver function abnormalities. DCMP therapy is an effective remission induction chemotherapy for adults with AML.


Unfavorable prognosis of acute leukemia in infancy.

Pretreatment characteristics of 48 infants (under 2 years of age) with leukemia treated over a period of 18 years at a single institution were studied in relation to response to therapy, extramedullary involvement, and survival. In order to provide a basis of comparison, 45 of the infants were each paired with an older (2-9 years of age) leukemic child, who had the same race, and disease type, who was treated within the same period of time and received similar suportive care and chemotherapy, and when possible, was of the same sex. The overall median survival times of infants and their pairmates were 211 days and 445 days, respectively. Initial status of the spleen was the single significant factor in relation to the length of survival. Median survival time for infants with splenomegaly was 186 days compared to a median survival time of 414 days for infants without splenomegaly. The complete response rate was 75% for infants and 80% for the pairmates. Median duration of remission was 84 days for infants and 280 days for their pairmates. Initial peripheral leucocyte count was significantly related to the duration of remission; patients with very high leucocyte counts had the shortest remissions. The duration of remission increased throughout the period covered by this study, however, prognosis relative to pairmates remained poor. Central nervous system leukemia occurred in 44% of infants and 40% of the pairmates; incidence of CNS leukemia was much higher (70%) in infants under one year of age than in infants one year old (37%). Extramedullary leukemia occurred at other sites in 46% of the infants and 31% of the pairmates. The only pretreatment characteristic of prognostic importance for predicting extramedullary involvement was the patient's age at diagnosis.


Initial features and prognosis in 363 children with acute lymphocytic leukemia.

The relationship of a variety of initial features and the outcome of therapy was analyzed for 363 children with acute lymphocytic leukemia (ALL). All had entered "total therapy" studies between 1962 and 1971. The standard for comparing outcome of therapy was whether patients with a given feature attained or exceeded the median duration of complete remission, hematologic remission or survival for the group. The results showed that, in general, the more massive or extensive the disease at diagnosis, the poorer the outcome. Factors associated with a significantly poorer prognosis included: initial leukocyte count above 100,000/mm; spleen enlargement greater than 5 cm; mediastinal involvement and early CNS involvement. Children over 10 years old at diagnosis and Negro children also had a poor prognosis. From another viewpoint features were examined for patients who attained at least 3 years of continuous complete remission. This confirmed some earlier findings and, in addition, showed that children under 2 years of age at diagnosis or with hepatomegaly over 5 cm were less likely to attain this goal. With the exception of early CNS involvement, however, patients with excellent responses to therapy were found with each factor of poor prognosis. Two major factors were not analyzed because their relationship to prognosis is generally accepted: therapeutic differences and acute nonlymphocytic leukemia.


Prognostic factors in osteosarcoma. A review of 20 year's experience at the University of Pittsburgh Health Center Hospitals.

The histologic and clinical characteristics of 54 patients with osteosarcoma are reviewed. The association of rapid linear bone growth with the occurrence of this tumor is confirmed, and evidence for increased growth in these adolescent patients is presented. A significant increase in female survival is seen in this study, and the literature relevant to gender and survival is reviewed. A histologic characterization of six predominant tumor patterns is presented with correlation to survival. Increased survival is seen with two specific histologic patterns, but there is great variability in the histology and sampling of osteosarcomas, and the series is small.


"Skip" metastases in osteosarcoma.

Careful study of 40 cases of osteosarcoma without evidence of multifocal disease, pulmonary metastasis, or history of exposure to predisposing factors has given histologic evidence of microscopic foci of osteosarcoma separate from the primary focus of osteogenic sarcoma. These "skip" lesions are to all pathologic examination completely separate from the primary focus of osteogenic sarcoma. They are more often found proximal to the primary, both intraosseously and transarticularly. Histologically, these "skips" represent areas of osteosarcoma which in many cases are a less-differenitated form of the tumor. The natural history  of such tumors with "skips" following ablative surgery is an increased incidence of local recurrence and subsequent pulmonary metastases.


Successful control of systemic Aspergillus niger infections in two patients with acute leukemia.

The diagnosis and successful control of systemic Aspergillus niger infection in 2 adult patients with acute leukemia is reported. During induction therapy, the first patient developed pulmonary infiltrates, skin lesions and abnormal liver function tests. Aspergillus niger was found on skin and liver biopsy. This patient was successfully treated with Amphotericin B and granulocyte transfusions and he remains in remission. The second patient developed a pneumonitis and adynamic ileus with positive sputum and stool cultures for Aspergillus niger. The infection only responded to Amphotericin B and granulocyte transfusions and the leukemia to cytoreductive chemotherapy. The patient later relapsed and died after a febrile illness. Fungi morpholocially consistent with Aspergillus were found in the liver at autopsy. Infection with A. niger is rare even in this patient population; however fungal infections have become an increasing problem. The need for a high index of suspicion, especially when an infection is unresponsive to antibacterial antibiotics, the various diagnostic tools, and the need for aggressive therapy are stressed. Amphotericin B is the chemotherapy of choice but may be insufficient in a severely neutropenic host where the simultaneous use of granulocyte transfusions might be lifesaving.


Remission maintenance of acute nonlymphoblastic leukemia with BCNU (NSC-409962) and cyclophosphamide (NSC-26271).

Thirteen of 29 patients with acute nonlymphoblastic leukemia achieved complete remission with cyclophosphamide, cytosine arabinoside, and vincristine, and remissions were maintained with a combination of BCNU and cyclophosphamide. The maintenance drugs (200 and 1000 mg/m respectively) were given at 8-week intervals intravenously. Only six of the 13 patients achieving a complete remission have relapsed. The projected median duration of complete remission is 65 weeks and of survival from diagnosis is 144 weeks. These remission and survival durations compare favorably with the results achieved using other forms of remission-maintenance therapy. The advantage of our form of maintenance therapy is that only overnight hospitalization is required at 8-week intervals.


Experimental studies of the antitumor activity of amygdalin MF (NSC-15780) alone and in combination with beta-glucosidase (NSC-128056).

Amygdalin MF was evaluated alone and in combination with an activating agent, beta-glucosidase, against three transplantable rodent tumors; Ridgway osteogenic sarcoma, Lewis lung carcinoma, and P388 leukemia. In dose-response studies up to the LD20 in normal mice, amygdalin MF alone did not demonstrate significant antitumor activity against any of these three tumor systems. Similarly, at doses not exceeding the LD10 in normal mice, amygdalin MF plus beta-glucosidase did not demonstrate antitumour activity against any of these three tumor systems. Potentiation of the lethal toxicity of amygdalin MF by beta-glucosidase was observed in all studies where the two agents were given in simultaneous combination.


A comparative study of results of the von Langenbeck and the V-Y pushback palatoplasties.

The incidence of velopharyngeal competence noted in 267 cleft palate patients following palatoplsty has been reviewed. Comparisons have been drawn with regard to the cleft type and the surgical technique performed. Since there were relatively small numbers of subjects in some categories, differences in age at last examination between the von Langenbeck and V-Y palatoplasty groups, some patients were very young at time of evaluation, and a number of different surgeons at different levels of training and experience performed the surgery, the differences in velopharyngeal competence found should be viewed as trends and this report as preliminary. In general, there was a trend toward smaller percentages of patients attaining acceptable velopharyngeal competence as the severity of the cleft increased. Of those with clefts of the soft palate only 86 per cent achieved competence. Among those patients with clefts of the palate only, 67 per cent achieved competence, whereas only 57 per cent of those with clefts of the lip and palate were able to do so. When comparing all cleft types, the V-Y palatoplasty resulted in a significantly higher percentage of velopharyngeal competence (74 per cent) than did the von Langenbeck method (56 per cent), although the data for the V-Y group are probably less reliable than those for the von Langenbeck group. In the soft palate only category, the results were slightly better with the von Langenbeck technique, though not significantly so. In all other cleft types, the results with the V-Y method were better than those with the von Langenbeck.


"Nasalance" vs. listner judgements of nasality.

In this article, judgements of nasality from sound field recorded utterances of 23 children with repaired palatal clefts are compared with "nasalance" values derived from TONAR II analyses of parallel sound separated recordings. For the nasality judgements, the sound field recordings were presented in forward reproduced mode to 20 "naive" listeners and in backward reproduced mode to 10 naive listeners. A four-level task progression was followed in each mode of presentation: sorting the responses by "normal" or "abnormal" nasality, ranking them by severity of nasality, classifying them within five degrees of nasality, and, finally, assigning a discrete score to the magnitude of nasality perceived in each recording. Scores from the individual judges were highly variable, especially in the first listening task. They were consitently more variable when nasality was judged from backward reproduced recordings. As the listeners gained experience and as the listening tasks demanded more precision in nasality judgements, variability was reduced. Correlations computed between the nasality ratings and nasalance measurements increased and variability decreased. Highest agreement between physical and perceptual measurements was found when variability among the judges was reduced by pooling the scores and comparing the mean scores of nasality with the nasalance scores. Using this procedure, a correlation of .91 was obtained between listener judgemental scores of forward reproduced speech and nasalance scores. Under these conditions, the instrumental score could apparently account for over 80 per cent of the variability in the listener judgements of nasality. From the findings of this study, it was concluded that listeners without prior training are capable of judging nasality reliably and that nasalance scores provide a valid correlate of perceived nasality. The use of backward reprodeced recordings was questioned as a means of assessing nasality.


Behavior and achievement of cleft palate children.

Forty-four cleft lip and palate/palate only children were individually matched with forty-four normal school children on the basis of sex, age, grade, intelligence and socioeconomic status. All children received behavioral ratings by classroom teachers, and achievement test scores were obtained. The cleft children were rated by teachers as displaying significantly greater inhibition of impulse (internalizing behavior). Cleft children also were significantly lower on overall basic skills achievement test scores. It was suggested that cleft children may be responding to the social-behavioral environment which may include negative social responses from others.


Repeated superiorly based pharyngeal flap operation for persistent velopharyngeal incompetence.

A secondary pharyngeal flap procedure, superimposed, on the primary flap, is described after having successfully improved the speech of the three patients on whom it has been used. The raising of a secondary flap is made possible by the fact that minimal scarring occurs from previous pharyngeal flap surgery and also because of the presence of a muscle layer. The combination of factors leading to further reduction in the size of the velopharyngeal lumen is discussed. This operation offers some measure of hope for the not insignificant number of patients who have been left with poor speech after pharyngeal flap surgery and supports the recent work of Cosman and Falk (2).


Survey of publications for parents of cleft palate children: a preliminary report.

In summary, these findings indicate that the general quality of the publications for parents of cleft palate children is probably mediocre and that both parents and speech pathologists tend to agree on assessments to this effect. The publications which appear to be most widely used are not necessarily those which appear to be the best available. Attention needs to be given to the design and content of future parent publications which should probably be written with knowledge of the parents' changing concerns over time. Since parent publications are used by many professionals involved in clef palate habilitation and there is no information about their opinions of the quality of these publications, additional work on this problem is planned for the future.