Radiotherapy of malignant lymphomas.

Radiotherapy of non-Hodgkin's lymphomas situated in the central nervous system is basically similar to the treatment applied to any other part of the body. There are two requirements: the first is the prophylactic irradiation of the CNS in a systemic disease of the reticuloendothelial system mainly in acute lymphatic leukemia; the second is the treatment of solitary tumors in the CNS. Radiotherapy can improve dramatically the results obtained with intrathecal chemotherapy, particularly in leukemic involvement of the CNS in childhood. The fractionated single radiation dose should be increased slowly and total doses of 2 500 rd should not be exceeded. Prophylactic radiotherapy of the CNS in acute leukemia has to include the entire subarachnoid space. It is therefore necessary to irradiate the entire skull and spinal cord. This treatment schedule and its results will be discussed. There is a tendency to sue prophylactic radiotherapy in other systemic diseases of the RES as well. The indications and contraindications for this will be discussed. The methods and results of treatment of focal lesions with regard to the morphologic tumor pattern are discussed. Rare primary tumors of the CNS which have the histological features of lymphoma-sarcoma or reticulosarcoma have the best prognosis as far as radiotherapy is concerned.


Chemotherapy of malignant lymphomas.

In malignant lymphomas generally, radiotherapy is the treatment of choice. Chemotherapy cannot be very effective in lymphomas of the CNS because most of the cytostatic drugs in question are not able to pass the blood-brain barrier. But in cases in which malignant lymphomas are disseminated throughout the body including the CNS, cytostatic chemotherapy is the only means of prolonging the life of the patient. In such cases one has to distinguish between Hodgkin's disease and non-Hodgkin lymphomas. Alkylating agents, metaphase inhibitors and antibiotics are used in the treatment of malignant lymphomas. The best results are achieved with combination schedules. In Hodgkin lymphomas the so-called MOPP-schedule is the most effective. In non-Hodgkin lymphomas the same drugs are ususally given without procarbacine. After having achieved a remission, maintenance therapy is very important. Vinblastine and Chlorambuzil are able to prolonge the remission. When resistance to these drugs occurs Bleomycin, Adriamycin, CCNU and Peptichemio are effective agents. The results as well as the side effects of such regimens are described.


Immunotherapy of malignant disease in man.

At present active specific immunotherapy should only be attempted where a tumour is shown to be antigenic and immunogenic, patients are immunocompetent, large numbers of tumour cells can be stored and minimal residual disease can be achieved without heavy immunosuppression. Acute myeloblastic leukaema (AML) satisfies such criteria reasonable well and evidence is presented that treatment with BCG and irradiated allogeneic AML cells is of value in this disease. It is suggested that there is insufficient evidence at present to justify embarking on similar regimes in most of the malignant lymphomas.


Meningeal localisation of acute leukaemias.

A preventive chemoradiotherapeutic treatment of the central  nervous system has to be started as soon as a complete remission is obtained in acute lymphoid leukemia. Any meningeal localisation is barely sensitive to treatment and reduces the long term chances of survival. The best treatment, according to our study, consists in the intrathecal administration of methotrexate and cytosine arabinoside followed by an irradiation of the central nervous system at a dose of 1,500 rads. The present trials have attempted to reduce the number of intrathecal injections, to increase the irradiation dose to 2,400 rads, and to restrict it to the skull.


Leukoencephalopathy following combined therapy of central nervous system leukemia and lymphoma.

We report a from of disseminated necrotizing leukoencephalopathy observed in five children with acute lymphoblastic leukemia or lymphoma, who received systemic chemotherapy, brain radiation, and intrathecal (IT) methotrexate, cytosine arabinoside and hydrocortisone because of meningeal tumor involvement. Three children developed a progressive neurologic disease at the end of IT therapy or shortly thereafter. The lesions consisted in discrete, apparently coalescent foci of coagulative necrosis in the white matter, with a remarkable absence of inflammatory cells, little or no tissue break-down, and striking axonal swellings. The adjacent tissue showed status spongiosus and moderate astrocytic hypertrophy. Vascular lesions were few and inconstant.


The ultrastructure of normal and reactive microglia.

Normal microglia have a distinct morphology. In rapidly, but now in slowly evolving pathological states the features used to identify the resting cell are often lost. When there is invasion by haematogenous monocytes, phagocytes develop whose origin - cerebral or haematogenous- cannot be ascertained on morphological features alone. These observations stress that microglia are part of the reticulo-endothelial system.


EM findings on the source of reactive microglia on the mammalian brain.

In traumatic brain lesions microglia cells are often plastered on the outer surface of capillaries. Basement membranes delimit these juxtacepillary cells from pericytes and endothelial cells. In altered nervous tissue many stages in the activation of pericytes may be seen at the same time. It is clearly demonstrable that these pericytes attack the basement membrane vigorously from inside. After penetration of the basement membrane these cells propel themselves between the perivascular feet processes of astrocytes and squeeze between the intracellular gaps, becoming surrounded by the cell processes of the neruopil. The observations suggest that in reactive stages in microglia cells may, at least in part, originate from the perivascular mesenchymal tissue.


Experimental studies on kinetics and functions of monuclear phagozytes of the central nervous system.

The described experimental studies on rabbits gave evidence of the hematogenous - obviously monocytic - origin, the lymphatic drainage, and the IgG- and complement-receptor sites of monocytoid CSF-cells, epiplexus cells, perivascular cells of the intracerebral vessels, and of some cells within damaged brain tissue - so-called progressive microglia. - Becuase of their identical kinetics and functions these types of mononuclear cells of the CNS were placed in a system known as 'Mononuclear Phagocyte System".


The relationship between microglia and brain macrophages. Experimental investigations.

A series of experiments are reported which indicate that the microglia are endogenous cells which may constitute the only source of phagocytes in certain mild degenerative conditions, such as Wallerian degeneration and retrograde nerve cell disintegration. In more extensive lesions with increased vascular permeability a substantial number of the phagocytes are derived from the blood monocytes.


Studies of the mechanism of growth promotion of lymphoma cells by 2-mercaptoethanol in vitro.

Rates of incorporation of thymidine and uridine, but not leucine, decrease markedly in L1210 (V) cells within 1 hour of incubation in DULBECCO'S medium containing 10% serum. 2-Mercaptoethanol (2-ME) after a latent period of more than 5 hours causes an increase in nucleotide incorporation. Bovine serum albumin can substitute for serum in the medium, but a higher concentration of 2-ME is required for growth. After charcoal treatment of the albumin less 2-ME is required. These experiments suggest that inhibition of the tumor cells is caused by a serum factor whose effect is antagonized by the thiol.


Myxovirus-like particles in cells of American Burkitt's-type lymphoma.

Distinct tubular arrays associated with cisternae of endoplasmic reticulum were observed in neoplastic lymphoid cells in a primary American Burkitt's-type lymphoma. A late relapse of the disease was complicated by severe CNS involvement. The pathogenesis of CNS involvement and the significance of the tubular arrays are discussed.


Acid phosphatase of azurophilic granules of C3HST4 lymphoma.

A transplantable mouse lymphoblastic tumor with unusual azurophilic granules has been recently reported. The present tumor has been studied with Gomori and Novikoff methods for lysosomal marker, acid phosphatase. By electron microscopy enzyme was found in granules surrounded by single or double membrane, which displayed a wide morphologic range appearing as 1. vesicular, 2. multivesicular, 3. compound, 4. granular and 5. tubular bodies. The occurrence and the amount of enzyme activity in the granules appeared dependent on their morphology. It was least in vesicular bodies and most in granular organelles, characteristically at their periphery. Since the present tumor, labelled C3HST4, is an unusual rich source of azurophilic granules, it might be useful for further studies of lysosomal bodies. Their functions are poorly understood. Similar structures have been observed in normal human lymphocytes and those from chronic lymphocytic leukemia.


Postirradiation syndrome and eeg findings in children with acute lymphoblastic leukaemia.

Out of 12 children with acute lymphoblastic leukaemia treated with craniospinal irradiation during primary haematologic remission, 8 developed a postirradiation syndrome characterized by fever and tiredness. The symptoms lasted 1-2 weeks and subsided spontaneously. Longitudinal EEG studies revealed no acute disturbances during the irradiation therapy but in all cases studied, moderate to severe diffuse general slowing developed during the postirradiation syndrome. Complete normalization of the EEG occurred in all children at follow-up. It is concluded that the described EEG abnormalities constitute an integral part of the postirradiation syndrome.


On thorotrast leucaemia. Evolution of clone of bone marrow cells with radiation-induced chromosome aberrations.

Results are presented of chromosome studies of bone marrow cells from a 62-year-old woman. The patient had been given 40 ml of Thorotrast in connection with a neuro-radiological examination 34 years earlier. Clinically, the patient was now considered to be in an incipient myeloid leucaemic phase. Ninety-seven per cent of the bone marrow cells belonged to a clone with characteristic marker chromosomes induced by radiation. Few data are available on chromosome analysis of bone marrow cells from Thorotrast patients. Therefore, the results of the present study are compared with data from chromosome analyses of 32P-treated patients with polycythaemia vera, in whom large clones were found in the bone marrow. The results of chromosome analysis of bone marrow cells from the Thorotrast patient support previous hypotheses concerning the carcinogenesis in radiation-induced leucaemia in patients with polycythaemia vera, treated with 32P. In the latter patients, the clone cells are pressumed to represent cell populations with selective qualities, originating from radiation-damaged cells, which possibly possess an increased tendency to malignant transformation because of a more pronounced sensitivity to carcinogenic agents. The cells might also be potentially malignant and manifest themselves as leucaemic cells, if the patient's immunological defence mechanism is broken.


The hypothalamus and vagally mediated gastric relaxation.

Experiments, with recording of gastric volume, were performed in chloralosed cats. Topical hypothalamic stimulations produced vagally mediated increases in volume by two mechanisms. One type of response, due to central inhibition of vagal excitatory tone was induced from the defence area and eliminated by atropine or vagotomy. The other type of response, far less commonly encountered, remained after atropine and spinal cord section, but was abolished by vagotomy. The latter type was not induced from any well defined hypothalamic region, and had a high stimulation threshold. While sham feeding in conscious cats with esophagostomy and gastrostomy induced prompt, marked and longlasting gastric volume increases in connection with swallowing, such responses were not evoked as "anticipatory" reaction to food intake;The relaxations could be prevented by vagotomy but not by guanethidine nor atropine. It is concluded that the vagally mediated relaxation in connection with sham feeding occurs mainly from activation of mechanoreceptors and that the hypothalamic control over the vagal relaxatory fibres is probably minor.


The autoregulation of the microcirculation.

The paper reviews August Krogh's contribution to capillary physiology stressing his formulation of useful new concepts such as "tissue cylinder model", capillary intermittency and the intimate matching of capillary perfusion and cellular metabolism. Looked upon from a control theory viewpoint. Krogh was very early in considering the microcirculation as an autoregulated system with tissue oxygen tension as the controlled parameter. Recent work on Krogh's theories is briefly summarized.


The ophthalmoscopic and fluorescein angiographic picture of diabetic retinopathy.

The ophthalmoscopic and fluorescein angiographic findings in diabetic retinopathy are reviewed. It is pointed out that the fundus lesions seen in diabetic retinopathy are characteristic, but not specific for diabetes. It is still not settled which role alterations in the microcirculation, alterations in the tissue metabolism, hypoxia or defects in the oxygen delivery system may play as provoking factors in the development of the diabetic retinopathy. Future investigations should concentrate on early diabetes and must include studies on the retinal blood-flow, electroretinographic and histopathologic changes.


Dynamic changes in the microcirculation of diabetics as related to diabetic microangiopathy.

Reversible abnormalities of many vascular beds have been observed in early diabetes, before irreversible structural changes of diabetic microangiopathy became apparent. In the bulbar conjenctiva and in the kidney the changes are associated with vascular dysfunction and may be due to autonomic neuropathy. The role of autoregulation in these vascular beds is not clear. In the limb muscles and in the retina the functional abnormality in early diabetes and in those with only mild retinopathy is increased blood flow. This increase in blood flow is probably the result of autoregulatory adaptation to hypoxia induced by 2,3 diphosphoglycerate deficiency. Lactic acid accumulation may also contribute. Breakdown of the autoregulation in the retina results in the development of diabetic retinopathy. The late stages of retinopathy, new vessel formation, are an attempt at revascularisation of areas of capillary non-perfusion.


The problems of tissue oxygenation in diabetes mellitus. III. The "three-in-one concept" for the development of diabetic microangiopathy and a rational approach to its prophylaxis.

Evidence for a causative relationship between prolonged tissue hypoxia and diabetic retinopathy and glomerulosclerosis are presented. Based on the assumption that one of the most fundamental requirements for optimal cellular metabolism is a constant cellular oxygen tension, the "three-in-one concept" for the development of diabetic microangiopathy is formulated. The term "three-in-one" is employed because this concept partly or completely includes "the glycoprotein-", "the hypoxia-", and "the growth hormone hypothesis". Diabetics show evidence of variability in the tissue oxygen availability/demand ratio which is compensated by three self-regulating factors: 1) an increase in local flow, 2) an increase in red cell 2,3-DPG leading to a shift to the right of the oxyhaemoglobin dissociation curve, and 3) an increase in the oxygen-binding capacity or the haemoglobin concentration. The level of plasma inorganic phosphate (Pi) is of importance in maintaining high 2,3-DPG levels. However, since Pi fluctuates depending upon changes in the control of diabetes, the regulatory mechanism of the 2,3-DPG modulated unloading of oxygen from the erythrocytes often becomes insufficient, and therefore in poorly regulated diabetics with less than optimal 2,3-DPG levels, the main load of compensation against tissue hypoxia is placed on an adjustment in the microcirculation of the organ involved. However, in order for the microvascular dilatation to occur, the cells must experience a hypoxic stimulus. The summation of the infinite number of discrete and occasionally pronounced hypoxic injuries to the tissue cells in association with the adverse effect of local vasodilatation with increased plasma permeation through the vessel walls might over the years lead to diabetic microangiopathy. Based on this theory the high level of Pi in diabetes becomes of particular significance. Our experience with a high phosphate diabetes diet in the treatment of diabetics is presented. This dietary regimen leads to a significant increase in the oxygen release capacity of the erythrocytes, suggesting an improvement in tissue oxygenation, and may therefore become of value in the prophylaxis of diabetic microangiopathy.


Lipid composition of the mouse spleen in Rauscher leukaemia.

Lipid constituents were examined in the spleen of mice 10, 14 and 18 days after infection with Rauscher leukaemia virus. (i) The total lipid content, as related to the amount of protein, decreased with the development of the tumour. (ii) Spleen cells of control and infected mice synthesized the same lipids. (iii) In the infected spleen, free fatty acids increased by 80% and triglycerides decreased by 44% as compared to the control. The percentage distribution of phospholipid components showed a change in tumour cells: lecithin and phosphatidylethanolamine increased, lysolecithin and sphingomyelin decreased. (iv) After intraperitoneal injection of [32P] orthophosphate, in infected mice the incorporation of 32P into phosphatidylcholine and phosphatidylethanolamine increased, while 32P incorporation into lysophosphatidylcholine + sphingomyelin and phosphatidylinositol + phosphatidylserine fractions decreased.


Glucocorticoid binding proteins in myeloblasts of acute myelogenous leukemia.

The myeloblasts of 16 patients with untreated acute myelogenous leukemia were examined for specific glucocorticoid binding proteins. In only 3 of the 16 patients were such high affinity receptors found. The presence of glucocorticoid binding protein activity was positively correlated with inhibition of macromolecular synthesis of myeloblasts in vitro whereas absence of binding protein activity was associated with lack of glucocorticoid inhibition of the cells. Since glucocorticoids appear efficacious in only a small fraction of cases of acute myelogenous leukemia, determination of glucocorticoid binding protein activity may provide assistance in planning chemotherapeutic regimens.


Peripheral retinal microaneurysms in chronic leukemia.

Of 25 patients with chronic leukemia, there was clinical evidence of peripheral retinal microaneurysm formation in two of eight patients with chronic lymphocytic leukemia and six of 17 patients with chronic myelogenous leukemia. There was no proliferative retinopathy in any of the 25 patients. An elevated leukocyte count seemed necessary for microaneurysm formation in leukemia, although some patients with elevated counts had no microaneurysms. The prolonged leukocytosis of chronic leukemia can produce peripheral capillary dropout, vascular stagnation, microaneurysm formation, and, rarely, peripheral proliferative retinopathy similar to sickle cell disease.


Basis for late expiratory spinal inhibition of phrenic nerve discharge.

The relationship between spinal inhibition of phrenic nerve activity and thoratic expiratory motoneuronal discharge was studied in chloralose-anesthetized and unanesthetized decerebrate cats.  The amplitude of the phrenic nerve response elicited by singleshocks applied to descending tracts in the second cervical spinal segment progressively fell during the late expiratory phase of the central respiratory cycle.  The depression resulted, at least in part, from active spinal inhibition since the spina-to-phrenic evoked response was smaller in late expiration than after C'1 spinal transection.  Inhibition of the spinal-to-phrenic evoked was time-locked to the spontaneousburst of activity recorded from the eigth internal intercostal nerve.  The degree of inhibition of the spinal-to-phenic evoked discharge was directly related to theamplitude of spontaneously occurring internal intercostal nerve activity.  A similiarrelationship was observed when internal intercostal nerve activity and spinal inhibitionof phrenic discharge were evoked by stimulation of the superior laryngeal nerve.  It is concluded htat late expiratory spinal inhibition of phrenic discharge was dependent on those neural events responsible for the activation of thoracic expiratory motoneurons.


Loa loa: development to the infective stage in an American deerfly, Chrysops atlanticus.

Chrysops atlanticus, an American species of deerfly collected along the Mississippi Gulf Coast, will support the development of the microfilaria of human Loa loa to the infective stage. Development takes place in the fat body of the fly and requires 9 to 10 days of development and pattern of morphogenesis of the parasite in C. atlanticus is virtually identical to that described in natural African vectors. Chrysops atlanticus will support the development of large numbers of L. loa to the infective stage without apparent ill effects. Two uninfected patas nonkeys each were given 75 third-stage larvae obtained from experimentally infected C. atlanticus. Both animals developed patent infections in approximately 5 months, clearly demonstrating that the entire life cycle of Loa loa can be maintained in the laboratory outside endemic areas.


Influence of serum blocking factors on cancer patients undergoing immunotherapy.

Blocking factors are small polypeptide molecules that may appear in the serum of patients with cancer. These factors block the transformation of lymphocytes in culture to nonspecific mitogens such as phytohemagglutinin or concanavalin A and, therefore, may reflect changes in the immunocompetence of the patient. Blocking factors were monitored during the clinical course of thirty-five patients with cancer. These factors did not develop in patients with response to therapy whereas they did develop in patients without response. A third group of patients without response to therapy after a previous remission showed an absence of lymphocyte responsiveness in culture that was not due to blocking factors, suggesting that immune clone consumption had occurred. Dermal responsiveness to tumor antigen correlated with a favorable clinical course and was usually absent when serum blocking factors were present.


Effects of iproniazid, chlorpromazine and methiothepin on DMT-induced changes in body temperature, pupillary dilatation, blood pressure and EEG in the rabbit.

The effects of i.v. N,N-dimethyltryptamine (DMT) were studied on arterial blood pressure, rectal temperature, pupil size and the electroencephalogram of the rabbit. DMT altered these parameters in a dose-related manner causing increased blood pressure, hyperthermia, pupilary mydriasis and activation of the electroencephalogram. Pretreatment with the monoamine oxidase inhibitor, iproniazid, prolonged the effects of DMT, while pretreatment with chlorpromazine or methiothepin attenuated these actions of DMT.


Torsion of the testis in the newborn.

A series of 12 patients with torsion of the testis in the newborn is reported. In all patients the torsion occurred above the investment of the tunica vaginalis. Torsion occurred on the right side in six patients, on the left side in five, and was bilateral in one. The clinical features, operative findings and treatment are described


Mean flow measurements in aortofemoral arterial reconstructions.

Eighty-seven limbs in 48 patients have been studied with an electromagnetic flow meter at the time of arterial reconstruction designed to restore blood flow from the aorta to the femoral artery system. The mean overall flow was 339 ml per minute. Blood flow in aneurysmal disease was significantly higher than that recorded in obstructive disease. Blood flow in arteries running into a fully patent femoral system was significantly higher than in those that ran only into the profunda. Age, sex, type of surgery and size of graft had no influence on the flow achieved. Reconstructions for rest pain or advanced trophic change produced flows of the same magnitude as reconstructions for intermittent claudication. The patient's weight correlated significantly with the intraoperative flow. The mean flow in the limbs of 28 patients in whom an accurate preoperative weight was known was 2-56 ml/100 gm/minute, taking the hind limb and hemi-pelvis as 25% of the body weight. This is an acceptably "normal" value. A flow of less than 100 ml per minute in an aortoiliac reconstruction was found to be not likely to result in long-term patency.


Postoperative complications of thyroidectomy: a comparison of two series at an interval of ten years.

A comparison is presented of the complications found in two series each consisting of 331 consecutive patients undergoing thyroidectomy in the same Unit ten years apart. The overall incidence of postoperative complications has been reduced, particularly in the group of patients having thyroidectomy for thyrotoxicosis following which it is now no greater than after thyroidectomy for benign non-toxic goitre. The techniques used to try to reduce the postoperative complication rate are discussed. The incidence of permenent recurrent laryngeal nerve palsy has been reduced to 0-3% and of permanent hypoparathyroidism to 1-2%. The overall incidence of complications causing permanent disability is now 3-9%.


Chondromatous hamartoma of the thyroid gland: report of a case.

A case of congenital chondromatous hamartoma of the thyroid gland in a male infant is reported. It presented as a congenital goitre. The thyroid swelling started to increase in size and became hard. It was excised. Histopathological examination revealed the tumour to be a chondromatous hamartoma of the thyroid gland. Reports of this condition in the literature are few.


Preoperative irradiation for carcinoma of the bronchus.

This paper reports a series of 43 patients with lung cancer treated by means of planned preoperative radiotherapy between 1961 and 1966. A five-year survival figure of 23% is reported for the series. The rationale of the treatment is discussed, together with some clinical situations in which it was felt that this regime had a definite advantage over other methods.


Primary malignant tumours of the mediastinum and their management.

Primary malignant tumours of the mediastinum are difficult clinical problems in thoracic surgery from both diagnostic and therapeutic points of view. Three cases of malignant seminoma of the mediastinum have been documented, thus bringing the total number of cases reported in the literature to 78. A case of metastasis to the subcutaneous tissue in malignant thymoma has been documented. Because of the multiple-cell types of these tumours and their ill-defined extent due to involvement of adjacent structures, surgery is often difficult. Radiotherapy along with chemotherapy has a definit place in their management, either as a primary treatment in inoperable cases or as a supplement to surgery if the condition is operable.


The fractured patella: a long-term follow-up study.

One hundred and three patients with 104 patellar fractures were examined over a follow-up period ranging from three to 11 years. Patients were assessed subjectively and objectively. The fractures were classified into three groups, transverse, comminuted and polar. Four methods of treatment were used, conservative, internal fixation, partial excision and total excision. In general, the results in the majority of patients were satisfactory, those patients who underwent total patellectomy faring at least as well as any others requiring surgical intervention.


Experience with the below-knee total-contact cast in the management of tibial fractures.

The method of application of the below-knee total-contact cast is illustrated, stressing the importance of firm moulding over the medial flare of the tibia, the popliteal space and the patellar tendon. Forty patients with tibial shaft fractures treated in this manner in Middlemore Hospital during the past four years are reviewed, and a comparison of some features is made with those of forty similar fractures treated in conventional above-knee plasters. The results indicate that a well-applied total contact case controls these fractures adequately and that convalescence is relatively straighforward. In addition, there are obvious advantages to the patient in respect of comfort and mobility.


Tropical pyomyositis.

Six cases of tropical pyomyositis occurring in Australian, New Zealand and British soldiers in Malaysia and Singapore are described.


Actinomycosis of bone.

Actinomycosis is a rare disease, which is most commonly seen in the cervicofacial region and provides problems in diagnosis and treatment. Cervicofacial actinomycotic osteomyelitis is a curable disease. Its natural history and guides to its management are described.


Ureterostomy-in-situ.

A simple operation is described, which in the presence of upper urinary tract obstruction is under certain conditions an alternative to nephrostomy, and which may be modified for use in conjunction with conservative upper urinary tract surgery.


Giant ureteric calculus.

A case of giant ureteric calculus 12 cm in length is reported. Only 11 cases of such calculi measuring 12 cm or more have been previously reported in the literature. The relevant features of giant ureteric calculus are discussed.


Focal nodular hyperplasia of the liver: a further contribution.

A new dimension has been added to the concept of focal nodular hyperplasia of the liver, in the observation of recent upsurge in incidence pari passu with the use of anovulatory pills. A newly recognized significant surgical feature of the disease is its propensity to serious haemorrhage.


Gliomas: a review of an 11-year series.

A series of gliomas is reviewed in an endeavour to establish the efficacy or otherwise of the various forms of treatment available. In general, it would seem that prognosis depends upon the activity of tumour cells and the anatomical relationships of the lesion. From the experience of this series it appears that wide resection, if this is possible, offers a longer survival time than any other form of treatment.


Traumatic pancreatitis and pleural effusion.

Two cases of pleural effusion are described, both of which were associated with pancreatitis of traumatic origin. It is suggested that in some cases of unexplained pleural effusion, concomitant pancreatitis should be sought as a possible cause.


Temporo-mandibular joint ankylosis and oro-nasal fistula as complications of facial trauma.

Condylar fractures with or without disruption of the temporo-mandibular joint occur commonly with other facial injuries. The subsequent development of ankylosis presents surgical and anaesthetic problems in management and results in severe physical disability to the patient. Oro-nasal fistula is a rare complication of fractures involving the middle third of the facial skeleton, and two cases are reported.


Malignant parotid cyst.

A case of primary malignant cyst of the parotid gland is described, and the possible origins of such cysts are discussed.


A comparative study of four depression rating scales.

Comparisons were made between the overall scores on the Beck, Hamilton, Zung and a visual analogue rating scale in a group of depressed patients. The comparisons were made initially and at one, two and three weeks. Significant correlations between the global scores were found on these depression scales. The value of these scales in clinical research studies in depression is discussed wirh special mention of the value of the visual analogue scale.


Some preliminary observations on a questionnaire technique for classifying depressive illness: its relationship with clinical diagnosis and a biological technique for depressive classification.

A questionnaire designed to assist in the classification of depressive illness, was administered to 20 acute depressive patients and 10 normal controls. Patient classification according to the decision rules employed by the questionnaire, were compared with patient classification arrived at by symptomatic (diagnostic) and physiological (G.S.R. inhibition threshold) means. It was found that a preponderance of patients classified as "endogenous depressives" by the questionnaire technique, also had clinical diagnoses of endogenous depression, and had low G.S.R. inhibition thresholds relative to normals. Furthermore a preponderance of patients classified as "non-endogenous depressives" by the questionnaire technique, had clinical diagnoses of neurotic depressive illness, and had high G.S.R. inhibition thresholds relative to normals. This supports the assertion that the questionnaire technique has some validity in the classification of depressive illness.


Psychotherapy and the iatrogenic "love affair".

After giving an introductory outline of the phenomenology and theoretical aspects of the concept "love affair", the author proceeds to review a number of symptomatic love affairs arising in the lives of a series of female patients during the course of analytically oriented psychotherapy.. The material is presented in its general aspects and in the form of one detailed case history. In subsequent discussion the author attempts to explain the genesis of these love affairs in terms of phase-speciifc conflicts in the patient and certain iatrogenic aspects of the therapy.


Ritual prevention in the treatment of obsessive-compulsive neurosis.

Behaviouristic theories of obsessive-compulsive neurosis are reviewed and their relationship indicated to the introduction of ritual prevention as a form of treatment for this condition. Studies investigating aspects of ritual prevention are summarised. The treatment of six obsessive-compulsive patients in a psychiatric ward of a general hospital is described and the difficulties encountered outlined. The authors' impression was that the response of patients shown was more marked and immediate than with any other treatment apart from leucotomy.


The effects of discharge on long-stay psychiatric hospital patients.

One hundred and forty long-stay patients discharged from Callan Park Hospital were followed up. All except nine were accounted for and 90 who were living outside hospital at the time of the study were interviewed. Thirty percent of the total sample were readmitted during the mean follow up period of 20.4 months. Most of those living outside hospital said that they were happier than when living in hospital. They formed a relatively homogeneous socio-economic group with the majority living in boarding houses and convalescent homes and being unemployed.


Mental health organizations in transition.

Many mental health institutions are changing their traditional treatment policies and practices and their organizational structures. Literature is reviewed which provides a model for changing mental health organizations based in general systems theory. The systems organizational model has empirical support in the growing community mental health movement. The strong interaction of technological and ideological factors determining the nature of the new mental health organizations is stressed. Also considered are some of the problems facing those planning and managing changing mental health organizations.


Out-patient follow-up of those who have attempted suicide: fact or fantasy?

46% of patients who had attempted suicide and were referred to the out-patient clinic of the Royal Adelaide Hospital failed to attend. Similar findings have been reported from other centres. Though it is not known why this is so, tentative speculation is possible. Since it has been shown that persons who attempt suicide are more at risk for suiciding in the future, it seems surprising that their non-attendance has not been more fully investigated.


Puerperal psychosis: a follow-up study of a joint mother and baby treatment programme.

A cohort of 54 mothers with puerperal psychoses admitted between 1965 and 1969 to a joint mother and baby short stay treatment programme is reported with a follow-up at the end of 1973. The outcomes indicate that this treatment routine is as satisfactory as other programmes. Those who, for various reasons, did not complete the joint programme of treatment did not do so well.


The two town study: a comparison of psychiatric illness in two contrasting Western Australian mining towns.

The results are presented of a survey of patients identified by their general practitioner as having conspicuous psychiatric morbidity, according to Kessel's (1960) Classification, during a three months general practice survey in two Western Australian towns, one Gynalla, a new expanding town in the Pilbara area and the other, Jaburoo, an established economically stagnant town in the South West. The findings show a higher general practice consultation attendance rate for both sexes, and a higher rate of psychiatric illness among females, in Jaburoo than in Gynalla. In Gynalla psychiatric cases among women formed a disproportionately high percentage of all general practice attendances. The implications of these findings are discussed.


Psychotherapy in a large open family group.

A technique of psychotherapy is reported, using a large open group of theoretically unlimited lifetime. Family and friends are encouraged to attend and new members are added independently of those leaving the group. Various features of such a group are comparable to small group analysis. The group may be used for the exploration and treatment of family psychopathology. Meetings containing 20 or more members, with several families being represented, are not uncommon. Observers likewise are not limited in number and the group serves a useful teaching and training function as a consequence. A wide range of patients, including those regarded as unsuitable or too difficult for conventional psychotherapeutic management, may be treated by this technique. Illustrative cases are described. The purpose of this paper is to describe a technique of group psychotherapy which has been practised over a period of several years and which differs in some important respects from established methods. This technique, the large open family group, has proven itself to be useful in treating a wide range of patients.


Influence of hypothalamic hyperphagia on tolerance of lung to explosive decompression.

A study was made of the effect of hypothalamic hyperphagia on the tolerance of lung to explosive decompression in male Long-Evans rats. The control and hypothalamic hyperphagic rats were explosively decompressed together from 1 atm to an ambient pressure of 30 min Hg in 0.04s. The hypothalamic-lesiones rats gained from 252 g average weight to 460 g, a 82% gain. The respective figures for the controls. were from 248 g to 336 g and 36%. It was also observed that a considerable amount of fat was accumulated between pleura and lungs in experimental animals. The average accumulation of fat between pleura and lungs in experimental rats was 3.23 g, while the value of the control group was only 0.42 g. The difference was statistically significant. Such an increase of fat accumulation in the thoracic cage could decrease the tidal volume. The severity of decompression-induced pulmonary hemorrages might thus be decreased. On the other hand, it also seems possible that the soft fat cushion between pleura and lungs might damp the bruising of the pulmonary tissue against the resistant thoracic wall to a certain extent, thus resulting in a decreased susceptibility to decompression-induced lung damage. Besides  , the mortality in obese rats undergoing explosive decompression was also significantly lower than that of the controls


Adenosine deaminase activity in leukaemia.

Adenosine deaminase (EC 3.5.4.4., ADA) has been measured in the blast cells of 36 patients with acute lymphoblastic, acute myeloid, chronic myeloid and chronic myeloid blast crisis leukaemia. Particularly high levels were found in acute lymphoblastic and chronic myeloid blast crisis patients. The measurement of ADA may be useful diagnostically in the undifferentiated acute leukaemias and in detecting the early onset of blast crisis in chronic myeloid leukaemia. Possible reasons for the elevation of ADA in malignant cells are discussed.


Growth rate of pulmonary metastases in human sarcomas.

The growth rate of spherical pulmonary metastases was studied in 15 patients with osseous and soft tissue sarcoma. The median volume doubling time (Dt) was 25 days. The time from diagnosis of the primary tumor to occurrence of pulmonary metastases correlated directly with the length of Dt. No correlation between Dt and tumor histology was observed. The effect of therapy on the tumor growth curve was studied in 1 patient. The therapeutic implications derived from the quantitative evaluation of tumor growth rate are discussed.


Treatment of acute leukemia in adults.

Improvement in the management of acute leukemia in adults has not progressed nearly so rapidly as has the treatment of childhood leukemia. One important difference is that most adults have myeloblastic or related forms of the disease (AML), whereas the majority of children have lymphoblastic leukemia (ALL). However, even adults with ALL fail to respond as well to a similar regimen as do children with the same type of leukemia. In a recent series of patients with ALL who were treated with the complex multiple drug "L-2" protocol, the incidence of complete remission in adults was 78% vs. 99% in children, and the median duration of remission was only 24 months in the adults, whereas it has not yet been reached in the children and is projected to be over 4 years. In AML and the related nonlymphoblastic forms of acute leukemia, therapy is still unsatisfactory in both adults and children. With the best current drug treatment schedules, the incidence of complete remission is now better than 50%, but it is often difficult to compare the exact remission rates in different series because of differences in reporting results. In adults treated with the multiple drug "L-6" protocol, the incidence of remission in previously untreated patients was 56% and the median duration of remission was 10 months. The median survival of all patients (responders and non-responders) was 1 year whereas that of responders only was 2 years. It is encouraging that a significant proportion of those patients with AML who have complete remissions now remain in remission for extended periods; about 45% of patients responding to the "L-6" protocol remained in remission over 1 year, and 18% have been in continuous remission for 2 to over 4 years. Even after discontinuing treatment, some patients with AML stay in remission for long periods, and it is possible that some of them may have been cured. If this proves to be true, it becomes of great importance to determine what is different about the patients who do exceptionally well as compared to the majority who continue to die within a year. However, no consistent nor distinctive favorable prognostic features have yet been identified.


Antigens shared by leukemic blast cell and lymphoblastoid cell lines detected by lymphocyte-dependent antibody.

Lymphocyte-dependent antibodies (LDA's) directed against antigenic determinants present on lymphoblastoid cell lines as well as human leukemia blast cells were demonstrated in heterologous antisera obtained by immunizing rabbits with a membrane fraction from RPMI-4265 (a lymphoblastoid cell line derived from a patient with chronic myelogenous leukemia). LDA was present at high titers against B-lymphoblastoid, myelomonocytic, and stem cell lines. The T-lymphoblastoid cell line MOLT-4, however, did not react. LDA was demonstrated against acute myelogenous as well as lymphoblastic leukemia cells. The reactivity was not directed against phytohemagglutinin-induced blastoid antigens, fetal antigens, or fetal calf serum. Absorptions with lymphoblastoid cell lines removed all LDA reactivity. Similar results were obtained by absorbing the rabbit antiserum with acute lymphoblastic and/or acute myelogeneous leukemia cells. These findings indicate the presence of cross-reactive antigens between lymphoblastoid cell lines and leukemia cells. Furthermore, cross-reactivity between acute lymphoblastic and acute myelogenous leukemia cells was demonstrated.


Speech results after Millard island flap repair in cleft palate and other velopharyngeal insufficiencies.

Twenty-four patients were evaluated for voice quality after primary palatal repair by the Millard island flap procedure. In patients with overt cleft palate, acceptable speech was obtained in 71 percent. In patients with velopharyngeal insufficiency without an overt cleft, the success rate was 60 percent. Although we consider this method reliable and useful, we have no reason to believe that it offers substantial advantages over other established procedures. We suggest that the main reason for our failures to achieve velopharyngeal competence and acceptable voice quality after a repair is the inherent hypoplasia of palatal musculature.


Location of the levator veli palatini insertion following levator retropositioning, palatal pushback, and pharyngeal flap procedures.

A long-term cineradiographic follow-up study of twenty patients with velo-pharyngeal incompetence fails to demonstrate predictable retrodisplacement of the levator insertion following combined levator retropositioning, pushback, and pharyngeal flap procedures. Simple levator retropositioning gave posterior displacement in the two patients evaluated. Patients with normal or posterior levator insertions pre-operatively all demonstrated post-operative anterior displacement following pharyngeal flap procedures, either alone or in combination with pushback. Anterior levator displacement may be the result of scar contraction or division of the levator sling (during insetting of a pharyngeal flap). Pre-operative and post-operative speech evaluation demonstrated substantial improvement in all except 3 patients; 2 of the poor speech results were patients with demonstrated levator retrodisplacement on post-operative cineradiography.


A review of the results of two different surgical procedures for the repair of clefts of the soft palate only.

This study evaluated results of the two surgical procedures for repair of cleft palate. Simple closure using the Von Langenbeck technique was compared with the V-Y retroposition technique as modified by Wardill and Kilner. The population consisted of two groups of children who were similar in chronological age and intelligence and for whom surgery was performed at an average age of 1 year, 11 months, in the simple closure group and 1 year, 8 months, in the V-Y repair group. In the early pre-school years, the children were evaluated in the areas of intelligence, language, hypernasality hearing, articulation, and voice quality. The two groups were found to be roughly similar in intelligence, language, and articulation at that time. The simple closure group was at first found to be slightly more hoarse than the V-Y repair group while the latter was found to have slightly more hypernasality. Hearing acuity was somewhat poorer in the simple closure group. The final evaluation was carried out when the mean chronological ages were 10 years, 1 month, for the simple closure group and 10 years, 2 months, for the V-Y repair group. Included in the second assessment were measurements of intelligence, language, articulation, nasal resonance, hoarseness, nasal emission, hearing, and velopharyngeal closure, The groups were judged to roughly comparable in intelligence, language, articulation, hypernasality, nasal emission, and velopharyngeal closure. A difference between groups occurred in regard to hearing acuity where the simple closure group showed slightly more hearing loss. This group was also judged to have more hoarseness. In regard to velopharyngeal closure, it was noted that all subjects in both groups had mechanisms of adequate or borderline efficiency. However, the children in the simple closure group compared as well as they did with the V-Y retroposition group only after 27 per cent had had secondary procedures as compared to 11 per cent in the V-Y repair group...


Radioautographic study of chondrocytic proliferation in nasal septal cartilage of the 5-day-old rat.

Relative rates of chondrocytic proliferation in the 5-day-old rat nasal septum are determined radioautographically, using tritiated thymidine as the labeling agent. The results are tabulated and charted graphically; they show that the zone of greatest activity is the portion just anterior to the septoethmoidal junction. The area of second highest activity is the antero-superior tip of the septum. All other regions are either relatively inactive or show only sporadic areas of proliferative activity.


Two dimensional ultrasonic demonstration of lateral pharyngeal wall movement in real time--a preliminary report.

Preliminary observations are reported in three normal subjects using a multi-element, ultrasonic transducer unit for demonstrating in real time and two dimensions the movements of the lateral nasal and oropharyngeal walls during phonation. Ultrasonic images produced are similar to those seen on frontal roentgen motion recordings. Present limitations, potential applications and advantages of this technique are discussed.


Sociological aspects of cleft palate adults: IV. Social integration.

The patterns of social integration of adults with primary and secondary groups were evaluated for 196 adult cleft subjects, their 190 siblings and 209 random controls. Results indicated that cleft adults tended to rely on the extended family for mutual aid and social activities. They also participated less frequently in voluntary associations and relied on a few one-to-one friendships. Social activities tended to be that of informal visiting patterns. While it would be inaccurate to characterize the cleft adult family as grossly different from other American families, they are a definable population experiencing some degree of limitation associated with having a cleft.


Incidence and type of otologic disease in the older cleft-palate patient.

Cleft lip and palate patients, 16 years and older, selected at random, were studied to determine the type and frequency of middle ear disease. Various morphologic and physiologic factors interrelating to cleft form and otopathology are discussed.


Current concepts of treatment of ear disease in cleft palate children and adults.

This author had demonstrated that the incidence of conductive hearing loss in adults who have had cleft palates approximates 50%. That their ear disease arises during infancy has been well documented by Stool and Paradise. The serous otitis media which develops in infancy and persists through adolescence is presently best treated by tympanic aeration tubes. Whether or not a limited adenoidectomy is a useful adjunct in treatment remains to be conclusively demonstrated. That cleft palate repair and/or pharyngeal flap surgery is helpful in the eventual outcome of ear disease would seem to be so. The end product of recurrent serous effusions and/or ear infections can be a chronic draining ear and/or cholesteatoma which following the attainment of adolescence is best treated by mastoid tympanoplasty with ossicular reconstruction. The effect of hearing on the speech of palate patients is discussed and a new method for using visual cues in helping palate patients speak less hypernasally offered.


A family with oculodentodigital dysplasia.

Three members of a family present definite features of the oculodentodigital (ODD) dysplasia and one presents only a few features. The mother shows no clinical evidence of the syndrome but does have an isolated cleft of the palate. The syndrome is compatible with Mendelian autosomal dominant inheritance with father-to-son transmission. The variable expression of the gene in the three affected members is clearly demonstrable.


Chemotherapy of osteosarcoma.

Recent advances in the use of chemotherapy for treatment of osteosarcoma have altered out pessimism in this disease. Results are presented from 3 groups of investigators using different agents as adjuvant chemotherapy following immediately upon amputation of the primary. The Roswell Park Memorial Institute began a regime, immediately after amputation, of adriamycin 30 mg/M2 for 3 doses and given every 4-6 weeks. This study was subsequently expanded in a cooperative group (ALGB) and the results on 20 patients analyzed. At 19 months approximately 75 per cent are free of any pulmonary metastases compared with 10-25 per cent expected from amputation alone. Similar results have been obtained by other Centers using different chemotherapeutic agents. In Boston Children's Hospital high dose Methotrexate with citrovorum factor is used. In 12 of these patients local control of the primary by surgery was obtained and of these only 1 developed pulmonary metastases during an observation time of 23 months. At the M. D. Anderson Hospital multi-drug combinations were used including Cyclophosphamide, Vincristine, L-Phenylalamine Mustard and Adriamycin. They reported a survival rate of 55 per cent (10 out of 18). All of these neoplastic agents have toxic side effects but when carefully used these effects are minimized and the quality of life is quite good. Many questions must be answered by future controlled long term follow-up studies.


The implications of "skip" metastases in osteosarcoma.

A prospective study of 40 consecutive classic primary osteosarcomas employing tomography, angiography, radio-scanning, tetracycline labelling, macroscopic and microscopic study revealed that in 10 (25%) "skip" metastases were found. In 8 the "skips" were completely unsuspected prior to computation. It is evident that patients with "skips" are more prone to local recurrence and have a worse prognosis following amputation than those without such satellite lesions. Through-bone amputation entails a considered risk of leaving micro-foci of tumor; proximal disarticulation does not obviate the risk of cross joint "skips" when the lesion is in a sub-articular site. What affect such residual foci has upon the effectiveness of adjunct therapy and conversely whether such therapy will permit more conservative surgery by suppressing residual "skips" is an important but unanswered question.


The surgical management of primary osteosarcoma.

Regrettably amputation remains to the present day an essential part of treatment in osteosarcoma of the limb bones. Only by its inclusion in the therapeutic regime can the present best level of about 20 per cent survival be achieved in any large group of patients. Preliminary biopsy is essential and there is no evidence that it is harmful even if followed by a delay of many days before definitive treatment. In patients treated initially by radiotherapy, selective amputation some 6 months later only in patients free of metastases, carries just as good a prognosis for the group as a whole as initial primary amputation in all patients. This method, first described by Cade, is widely practiced in the United Kingdom and spares many patients who develop early metastases following initial radiotherapy from unnecessary mutilating surgery shortly before inevitable death. Local recurrence may follow retention of a femoral stump following amputation for osteosarcoma at the most common site in the lower femoral metaphysis. There are cogent arguments in favor of hip disarticulation in such patients although they do not include evidence of greater survival. The balance between the two procedures is finely drawn but is weighted in favor of disarticulation.


The host immune response in human osteosarcoma.

A patient's immunologic response to a malignant tumor may be a major factor in determining his ultimate prognosis. An in vitro microcytotoxicity test using cultured tritiated thymidine (3HT) labeled osteosarcoma cells and autologous fibroblasts has been developed to determine the nature of this response. The role of cell mediated and serum factors has been quantitatively evaluated and the following results obtained. Osteosarcoma patients have been demonstrated to possess a normal cellular immune response which exhibits non-specific cytotoxicity in vitro. These patients can not differentiate their tumor cells from autologous fibroblasts, even though they may significantly suppress the growth of homologous tumors or fibroblasts. Serum blocking factors capable of inhibiting lymphocyte mediated cytotoxicity are occasionally noted. A reliable quantitative microcytotoxicity technique is presented which demonstrates that: (1) osteosarcoma is not due to host immuno-incompetence, (2) a common sarcoma antigen does not exist and (3) serum blocking factors may occasionally be present.


Osteosarcoma. Results of treatment employing adjuvant immunotherapy.

The treatment of patients with osteosarcoma continues to result in few survivors despite advances in surgery and radiotherapy. Since the primary site of failure is pulmonary, it is apparent that a systemically active adjuvant must be employed if a cure is to be achieved. Because of the experimental evidence for an immune response against osteosarcoma and because of the potential systemic activity of the immune system, a trial of postoperative adjuvant immunotherapy was begun. Seventeen patients received immunotherapy consisting of BCG and an allogeneic tumor cell vaccine following surgical removal of all gross tumors. Eighteen per cent (3/17) of the patients who received immunotherapy remained alive and free of disease compared to 0/12 who did not. An analysis of the 14 patients with recurrence, revealed that the median time to recurrence was 3.0 months in both groups. It is, therefore, apparent that at the time of initiation of immunotherapy subclinical metastasis must already have been present. Therefore, on the basis of this study we conclude that adjuvant chemotherapy should be employed to further reduce the tumor cell burden in order for immunotherapy to be effective for osteosarcoma.


Mechanism of induction of RNA tumor viruses by halogenated pyrimidines.

Frome these studies on JLS V-9 cells, a number of conclusions can be drawn about the mechanism of MuLV induction by halogenated pyrimidines. The compounds can induce virus from otherwise healthy cells as long as deoxycytidine is present along with the inducing agent. The compounds must be present during the S phase of the cell cycle and must be incorporated into DNA in order to induce virus (Teich et al. 1973). Only one strand of DNA need be substituted by BrdU or IdU in order to induce virus, because a one-hour period of incorporation leads to induction. From these results it is possible to construct a model for how halogenated pyrimidines are able to induce viruses from otherwise uninfected cells. Because the critical period for the incorporation of the compound is a restricted segment of the S phase of the cell, there would appear to be a critical segment of the genetic information of the cell which, when substituted with BrdU or IdU, leads to a transcriptional derepression. Presumably the critical segment of DNA is either a controlling element of the integrated provirus or it is a separate gene which controls the expression of the integrated provirus. Whichever is true, these results strongly imply that the search for specific repressors of the segments of mammalian DNA is likely to be successful and that RNA tumor viruses may offer a system in which such repression systems can be identified and investigated.


Mapping of adenovirus 2 RNA sequences in lytically infected cells and transformed cell lines.

The strands of the six EcoRI fragments and the HpaI fragments E and C of Ad2 DNA were separated by electrophoresis in agarose gels. Using 32P-labeled fragment strands in solution hybridization experiments, the fraction of each strand complementary to RNA extracted from infected or transformed cells was assayed by chromatography on hydroxylapatite. In this manner, a tentative map of the cytoplasmic RNA sequences has been constructed for viral RNA extracted from cells both early and late during infection (see Fig. 16; in the map shown, the two strands of Ad2 are named the r and l strands following the bacteriophage convention). Since early cytoplasmic RNA anneals to four distinct regions of the genome, Ad2 probably codes for at least four early gene functions. Summation experiments have shown that all RNA sequences found in the cytoplasm of cells early during infection are also present in the cells' cytoplasm at late times. Viral RNA sequences in five independently isolated and cloned transformed rat cell lines were also mapped on the Ad2 genome. One class of Ad2-transformed rat cells contains RNA sequences complementary to only the segment of Ad2 DNA from 0.03-0.10 on the physical map, and this corresponds to one of the four regions of the genome expressed early during infection. If a viral gene product is necessary to maintain the transformed phenotype of the cell or codes for the virus-specific tumor (T) antigen, this genetic information must be at the left end of the genome (see Fig. 16). The two other classes of Ad2-transformed rat cells contain viral RNA sequences complementary to two or three of the regions of the genome transcribed into early cytoplasmic RNA. At both early and late times during the lytic cycle, the nucleus of the infected cell contains viral RNA sequences that are not transported to the cell's cytoplasm, suggesting that RNA processing and selection may play a role in the regulation of viral mRNA production.


The transcriptional role of host DNA-dependent RNA polymerases in adenovirus-infected KB cells.

From the present experiments, we can conclude that late in infection two classes of DNA-dependent RNA polymerase transcribe the viral genome. Although we cannot definitively exclude the possibility that one or both of these enzymes are coded for by the virus, it appears more probable that these are hos enzymes, because of the coincidence of the alpha-amanitin sensitivities for synthesis of specific viral RNAs with the toxin sensitivities of the respective host RNA polymerases. Furthermore, the chromatographic properties of the enzymes, the alpha-amanitin sensitivities of the purified RNA polymerases and the levels of solubilized activities are the same for uninfected and late infected cells. It seems probable that some virus-coded or virus-induced factor(s) modifies either the selectivity or the activity of these host RNA polymerases. As an example, the "inactivation" of RNA polymerase I activity in vivo or the increased endogenous activity of isolated infected cell nuclei, without changes in the solubilized level of the respective RNA polymerases, could be mediated by such factor(s). The effect of such factors may not be detected by activity measurements on exogenous DNA, because it acts as a nonspecific template. Analysis of such factors will require reconstitution of appropriate in vitro systems, which retain some transcriptional specificity. Since several viral mRNAs synthesized at late times (Tal et al. 1974) and the 5.5S RNA (J. Pan, pers, comm.) are transcribed from the same region (R-R1 restriction enzyme fragment A), initiation and termination signals for both RNA polymerase II and III are contained in this portion of the genome. Further studies of the interaction of these two enzymes with the adenovirus 2 genome should contribute to understanding the control of transcription in eukaryotic cells, in particular in the case of virus-infected or -transformed cells.


The viral DNA replication machinery of adenovirus 12.

The viral DNA replication complex was found in the M band after fractionation. However, it did not associate with the nuclear membrane, but was found in association with types II and IV inclusions. It is suggested, therefore, that the viral DNA replication complex is the inclusions types II and IV. The analysis with Ad12 ts mutants showed the involvement of three viral genes in initiation of viral DNA replication, in formation of the viral DNA replication complex and the inclusions types II and IV. Temperature sensitivity of the gene products involved in viral DNA replication was also examined. From the data presented, the following sequence of viral DNA replication in Ad12-infected cells is suggested: (1) Synthesis of a protein (gene A product), which may be an acceptor or may modify the nuclear constituent to be an acceptor for parental viral DNA, to form the viral DNA replication complex; (2) synthesis of a protein (gene B product), which may be required for the parental viral DNA to associate with the acceptor and to form a type II inclusion-like structure (precursor of type II inclusion?); (3) synthesis of a protein (gene C product), which may be required for activation of the complex or type II inclusion and to alter type II inclusion to type IV inclusion. Further studies are necessary to substantiate the suggestion.


The mechanism of replication of adenovirus type 5 DNA.

The analysis of replicating Ad5 DNA has led to a model for replication involving linear intermediates. The origin of replication has been localized at the molecular right end, suggesting the presence of a unique sequence of nucleotides which can be recognized by an initiation factor. On the other hand, the study of the molecular ends has shown, so far, a high degree of symmetry in the terminal nucleotide sequences of Ad5 DNA. A more detailed study of the nucleotide sequences at the ends is necessary to solve this problem.


Analysis of multiple viral genome fragments in adenovirus 7-transformed hamster cells.

The presence of multiple copies of a portion of the viral genome was demonstrated in Ad7-transformed cells by a new method based on the kinetic analysis of labeled viral DNA reassociation in the presence of unlabeled transformed cell DNA. DNA-DNA homology measurement utilizing defined DNA fragments (restriction endonuclease digests) as labeled probes supported the above conclusion.


[Combined radiotherapy and chemotherapy of the central nervous system in malignant neoplasms of children (author's transl)].

A combination of radiotherapy and cytostatic drugs was used in the treatment of 39 children with primary brain tumour between 1961 and 1974, and 40 children with acute lymphoid leukaemia between 1971 and 1974. Best results were obtained with medulloblastoma using cerebrospinal radiotherapy and cytostatic drugs: 10 of 17 children are still alive. Of 40 children with acute lymphoid leukaemia 18 are still alive after cerebrospinal or cranial radiotherapy. The side effects of the combined therapy were within justifiable limits.


[Plasmocytoma, alkylating agents, and acute myeloid leukemia (author's transl)].

Two cases of the development of acute myeloid leukemia (AML) after treatment with alkylating agents are reported. In Case 1, melphalan and then cyclophosphamide had been given for multiple myeloma. 46 months after onset of cytostatic treatment AML occurred, as confirmed cytochemically and by qualitative determination of urinary lysozyme. In Case 2, cyclophosphamide had been given for rheumatoid arthritis. After a latency of 34 months 'smouldering leukaemia' developed with an atypical monocytic leukaemic cell population. In a third case, multiple myeloma and monocytic leukaemia developed synchronously. The causative role of melphalan and cyclophosphamide in the development of AML seems securely established. Despite the risk of alkylating agents in the treatment of multiple myeloma or Hodgkin's disease causing AML, they should not be replaced, as other drugs have been shown to be less beneficial. On the other hand, alkylating agents should be used with great caution in the treatment of non-malignant diseases.


[Studies on grinding according to Lauritzen in the articulator and in the patient's mouth].

After functional analysis and diagnostic grinding-in in the Dentatus articulator, the teeth of 10 patients were ground in directly in the mouth using a list of corrections. The results achieved in the patients were re-evaluated in the Dentatus articulator. It was compared to what extent correctional grinding-in in the articulator and the results achieved hereby can be transferred to the natural dentition. The tests showed that the diagnostic grinding-in can be largely reproduced, so that treatment at the patient himself becomes more effective.


[The heredity of odontogenic cysts].

It is reported on a family in which diseases of the jaws in considerable conformity were observed over four generations. The diagnosis of the latest case (keratocyst) has been verified. In the paper some peculiar characteristics are pointed out and the question of heredity is discussed.


[The treatment of collum fractures in children, clinical and radiographic results].

18 children -- with unilateral or bilateral fractures of the condyle -- were treated with conservative measures only. The clinical and radiological results showed a restitution mainly with children of less than 10 years whereby the true repositioning of the dislocated condyloid process is of no importance. Ankylosis, pseudoarthrosis, nearthrosis, or microgenia were not found in any of the tested children. The wire-and-acrylic splint according to Schuchardt is especially appropriate for the conservative treatment.


[The daily consumption of table salt in relation to body weight].

The fluoride concentration of table salt and kitchen salt used for the prevention of caries can only be determined when the consumption of salt is related to the bodyweight (Kg). Therefore the amount of salt consumed was determined in 242 subjects aged between 4 months and 85 years. The subjects lived in different parts of Hungary. The daily average intake of salt (ingestion) per kg was 0.0668 g. The consumption of salt is greater in youth than later. Men up to the age of 30 appear to consume more salt than women, but in relation to the whole group investigated, there is no important difference between the two sexes. The average commercial sales data over a number of years were compared with the average salt consumption in a kitchen service for 2929 persons.


[Documentation and physician's letter by means of modern data processing].

When starting our surgical out-patient department at the Hannover Medical School we were forced to computerize our medical correspondence as far as possible. In cooperation with the department of biometrics of the Hannover Medical School, a set of three computerized forms was established which in addition to facilitating medical correspondence enabled systematic documentation. The FTSS system generally used in the computer language PL/1 was used for computerization of our forms.


Hormology with inorganic compounds.

Three components of the dose-response reaction, usually seen as three separate curves, are reviewed as a single continuum of the effect of the dose of any agent upon an organism. The usual considerations of any agent in toxicology are the harmful actions. The individual considerations of an essential nutrient or of a hormone usually suggests a positive action. The third component is the stimulatory action as understood in hormone research and as seen in many studies with minute doses of toxic materials. The coelescence of these concepts into one continuum gives a broad viewpoint which is helpful to understand the biologic implications of any toxic, nutritious or stimulating material under a variety of conditions. Such a view is useful in predicting results and in understanding the reaction of living organisms to their environments; when small amounts of a chemical are added to a biologic system, one parameter may be affected in one way and another parameter in the opposite manner. Consideration of the complete dose-response curve led to the concept of hormology, the sutdy of excitation. The thesis of hormology is that any harmful agent may be stimulatory for any parameter when it is administered in subharmful quantities to an organism existing in a suboptimum environment. Concepts fro hormology allow the suggestion that the zero equivalent point (zep) could be used to replace zero tolerance as a practical, legislative concept for dangerous chemicals in our environment. A reivew of three pharmacology texts revealed four types of dose-response curves. The alpha curve demonstrated a simple toxicity, the beta curve exhibited a single stimulation peak followed by a toxicity as more material was added; the gamma curve showed an initial harmful reaction followed by a stimulatory reaction which, in turn, was followed by a toxic reaction as the quantity of material administered was increased; and the delta curve was essentially a sign wave in which two peaks of stimulation were separated by a "harmful valley", then, as greater concentrations of material were administered, toxicity was noted. A brief review of agents which are stimulatory in minute doses showed that a considerable amount of work had been done with radiation and late work has established emf as a stimulatory vehicle. Little work is done with other physical agents. Organic chemical compounds are known to be stimulatory in small quantities; e.g. dietary antibiotics. The fact that antibiotics stimulate growth in germfree animals and the fact that nongermicides stimulate classic animals proves their direct effect on the animal tissues.


Administrative structure of an accredited hospital.

The administrative structure of an accredited hospital is defined by the Joint Commission on Accreditation of Hospitals. It includes a governing board that represents the community, an executive committee that is responsible for patient care activities and is supported by standing committees, and a hospital administrative unit consisting of a chief administrator and numerous assistants. Policy recommendations are received by the governing board from the executive committee and must be approved by the board. Problems are resolved through a joint conference committee made up of representation from the executive committee and the board, as well as participation by hospital administrators. Finally, the medical staff is divided into departments that assume responsibility for patient care within their disciplines, as well as determine the awarding of credentials to applicants for hospital privileges.


Ambulatory hospital dentistry.

The scope of outpatient hospital dentistry is broad and embraces a full range of patient care as well as education and investigative activities. The ambulatory dental service provides an ideal setting for the care of medically compromised patients and treatment requiring a multidisciplinary approach. The hospital dental staff and administration are especially well qualified to bring dignified, high quality, total health care to patients and educational programs to the profession. These factors are paramount in formulating a strategy for meeting the future health care needs of our population.


Inpatient hospital dentistry.

Inpatient hospital dentistry has been reviewed. The expanding role of the hospital as a focal point for dental treatment of the healthy as well as medically compromised patient has been emphasized. A portion of this article has been devoted to admission and discharge procedures for the dental inpatient. The hospital chart is seen as the only instrument and record of the patient management and thus the various parts of the chart have been outlined. A review of the common laboratory tests useful to dentist and physician alike is included in this section. It is hoped that the material contained herein will serve as a guide to the general dentist or specialist who may utilize the hospital to admit patients.


Pain control--the team approach.

The most important factors involved in administering sedation and anesthesia to patients undergoing dental treatment are good preoperative evaluation, a well equipped facility with all necessary equipment not only for the safe administration of drugs but also for resolving complications that may ensue, and a team of experts capable of working together smoothly and able to deal with any emergency. This care is possible in the office situation; however, we believe it is only achieved at great expense and with the underutilization of equipment as well as personnel. It may be, therefore, that the best way to achieve this goal is for dentists and anesthesiologists to work together in the hospital environment. Hopefully, an ever increasing number of dentists will be joining the staffs of hospitals so that these objections may be achieved simply and with maximal utilization of equipment and personnel.


Some laboratory studies on the accuracy of bite mark comparison.

Bite marks in wax and in pig skin were compared with study models of the subject making the bite. Photographs, impressions and measurements of the bites were used. Bites in wax could be readily identified especially if measurements were made on photographs but identification from bites in non-vital pig skin was more unreliable. It is suggested that similar difficulties may be encountered in the assessment of bites in human skin. Expert witnesses involved in presenting evidence on bite marks in a court of law should be aware of the difficulties of making valid comparisons even under standardized laboratory conditions. Further studies to improve and substantiate the reliability of the technique are clearly required.


A hotel fire.

A hotel fire in Copenhagen claimed 35 victims of eight different nationalities. An account is given of some major aspects of the dental identification work, including a few case reports. This disaster became professionally important because the dental expert team was allowed a completely free hand. Eight dental experts cooperated closely in recording, photographing and radiographing dental conditions in the victims and thereby became able to establish that, with adequate facilities at hand, complete dental registration of a single victim required an average of three man-hours. Three of the experts subsequently cooperated in establishing comparable antemortem data on the known missing persons, in comparing the ante- and postmortem data sets, and in completing the necessary paper work. Here, it could be shown that a further two man-hours were required per victim. In a final report to the police it was proposed that---in any future case---such number of dentists should be assigned which, allowing three man-hours per victim, would enable the dental team to finish the oral autopsy of the given number of victims within five full working days, i.e. a minimum of two dentists per 30 victims. Two dentists will accomplish complete recording in less than half the time it will take any dentist working single-handed to finish it, so that the question of cost can hardly become an obstacle. It remains for the profession to make sure that an adequate number of knowledgeable dental experts are always available.


A new approach to the basic principles of endodontics.

The basic principles on which successful endodontic therapy depends have been commonly accepted as (1) debridement, (2) sterilization and (3) obturation. Each of these principles is subjected to critical evaluation. Because of the morphological complexity of most root canals complete debridement is not possible. No sampling technique is yet available to ensure total sterility of the prepared root canal nor is it possible to ensure that the root canal system is hermetically sealed by the filling material. Although it has been shown that 43 per cent of biopsies from the periapical area of endodontically involved teeth show evidence of cyst formation, the fact that up to 90 per cent of cases show evidence of healing following endodontic treatment without surgery indicates that radicular cysts can resolve without surgical intervention. In the light of these findings it is suggested that the basic principles should be accepted as (1) adequate debridement, (2) adequate obturation and (3) trephination where indicated.


There are no two cases alike.

A number of routine cases are reviewed: 1. A skull with a canine porcelain crown nicely glued in line was considered a study object, not a case of actual forensic interest (Fig. 1). 2. A murder victim was identified as a certain young girl; records including radiographs and plaster models showed no inconsistencies, but at least 28 concordant traits, among them characteristics in a root-filled central incisor (Fig. 2). 3. The body of a young suicide could be identified by means of one intraoral radiograph taken prior to one extraction, the only treatment listed in his dental record (Fig. 3). 4. After a fire, an unmarked rubber denture was found among debris; it showed burning along the distal palatal edge, so could not have been in the mouth of the owner during the fire. Being so completely deformed, it had to be discarded as evidence. 5. Another denture, removed from the mouth of a victim of the same fire, showed typical burning of the frontal parts, but also a stripe of burning along the midline (Fig. 4); accordingly, this victim must have inhaled flames before he died. 6. An old woman disappeared; in her home, police found an unmarked full lower denture left behind on her bed. When recovered dead several months later, this woman carried a full upper denture but no lower. Dental experts were not involved in this case but later saw both dentures; they had been made at different times and occluded badly. Did this woman have two sets? Or did the lower denture maybe originate from her murderer? The author urges that the FDI design an international system of denture marking. 7. A man was found murdered with an axe; police experts had reason to believe that he might have been executed somewhere else, but tooth 12 (Fig. 6)---found lying loose under the head---showed marks which proved that it had been exarticulated by one of the axe blows (Fig. 5). Consequently, the recovery site was also the execution site.


Dental care of the special patient in the hospital environment.

In this new era, where the emphasis in dental care is gradually moving in the direction of the patient, as differentiated from the former emphasis on the teeth and the mouth, the 'special patient' can and should receive the type of total dental care he or she deserves. The environment of the hospital, and all that the hospital brings with it to the patient care environment, makes the facilities for special patient care better and allows patients who were formerly seriously neglected to receive much the same attention as so-called normal patients. The group of special patients considered includes the physically handicapped, institutionalized or home-bound chronically ill, those with psychiatric disturbances and the mentally retarded as well as the hospitalized patient. One example of a hospital dental service conducted as a group practice is described in some detail. Advantages of this pattern of practice to the participants include the availability of conferences and clinics, access to a broad range of patient experience and the possibility of further study in specialized hospital activities. For the patient, total dental care is available throughout the 24 hours. Each patient is normally assigned to his or her own dentist, but is referred to another member of the group when special skills are needed.


Ewing's tumour. A study of behaviour and treatment in forty-seven cases.

Forty-seven histologically confirmed cases of Ewing's tumour are reported, with typical age, sex and skeletal distributions. The disease-free survival curves are like those for osteosarcoma of corresponding types of bone, but with higher mortality. The two-year disease-free survival rates were 24 percent for tumours of long bones and 5 per cent for those of other bones. Osseous metastases were most frequent, although the lung was the commonest single site involved. There were secondary deposits in lymph nodes in nine patients, possibly also in four more with mediastinal enlargement. Although initially radiosensitive, one-third of tumours recurred locally, almost always with the appearance of metastases. Neither whole bone irradiation nor high dosage alone ensures complete control of the primary tumour, and it is suggested that recently reported improved results of treatment should be attributed to adjuvant multi-drug chemotherapy. Inadequate control of the primary tumour diminishes the chance of survival and for some sites radical operation merits reconsideration.


Osteosarcoma in children. A study of 125 cases.

A study is presented of the aetiology and results of treatment in a group of 125 proven osteosarcomas present in children under fifteen years of age. These cases have been collected from the records of one English and six European treatment centres. There is a slight male preponderance, but the striking aetiological feature is the very high proportion of tumours of the long bones of the limbs (96 per cent). The two and a half and five year disease-free survival rates were respectively 15 and 12 per cent, with a further 9 per cent still living, but under observation for less than two and a half years. Evidence of metastasis after two and a half years is very unusual, but no child with a tumour of an axial or girdle bone lived this length of time. Although the differences in the results of the different methods of treatment employed are not statistically valid, the largest number of long survivors had been treated by early amputation, which method also provided the lowest rate of local tumour recurrences. Reasons are discussed which indicate that prompt ablation is the treatment of choice, perhaps with certain advantages in the light of recent advances in adjuvant treatment. The past situation in connection with childhood osteosarcoma certainly provides strong support for immediate carefully designed clinical trials of the new adjuvant methods cited.


Cytofluorometric studies on the action of podophyllotoxin and epipodophyllotoxins (VM-26, VP-16-213) on the cell cycle traverse of human lymphoblasts.

Flow microfluorometric analysis of human lymphoid cells exposed in vitro to cytostatic concentrations of podophyllotoxin (0.01-5 mug/ml for 24 h) shows that a major part of this population (40-60%) has the DNA content of cells in the G2-M part of the cell cycle, and that approximately 60% of these cells are arrested in mitosis. Although a similar pattern of DNA distribution is seen in cultures exposed to cytostatic concentrations of VM-26(0.01 mug/ml) and VP--16-213(0.1 mug/ml), no mitotic cells are seen in these cultures. Exposure to higher concentrations: of VM-26 (0.1 mug/ml) and VP-16-213 (1.0 mug/ml) inhibits cell cycle traverse, and after 24 hr of exposure a major part of the population is arrested with the DNA content of cell in the S part of the cell cycle. Exposure to higher drug concentrations leads to a reduction in the number of cells with the late S-G2DNA content. Whereas the cell cycle block induced by cytostatic concentrations of podophyllotoxin (0.01 mug/ml) is readily reversible by reincubation of cells in drug-free medium, cells blocked by VM-26 and VP-16-213 are unable to resume cell-cycle traverse under similar conditions.


Variations in microbial and biochemical components of four-day plaque during a four-week controlled diet period.

Variation in microbial and biochemical components of human four-day plaque was studied in seven subjects who were maintained on a high-sucrose diet during a four-week period. Significant changes in populations of lactobacilli dextranase-producing organisms, Streptococcus mutans, and S sanguis occurred during this period.


An epidemiologic study of deciduous molar relations in preschool children.

This study indicated that distoclusion decreased significantly with age and was more prevalent in siblings of children with Class II molar relation as compared with the prevalence for the total population. Children of middle socioeconomic status (SES) and girls with Class I molar relation had prevalences of posterior crossbite significantly greater than lower SES children and boys, respectively. Finger habits were highly associated with posterior crossbite (P less than 0.001).


Occurrence of haemophili in dental plaque and their association with neuraminidase activity.

The mean concentration of haemophili in 31 specimens of plaque was 1.23 times 10(6) per milligram or approximately 4.4% of the viable bacteria present. Occurrence of different species was similar to saliva with Haemophilus parainfluenzae constituting 87.8%. Most haemophili produced neuraminidase and appeared to be primarily responsible for the small amounts of this enzyme in plaque.


SNA and SNB angles in a population of Nubian schoolchildren.

The descriptive statistics for the sella-nasion-A point (SNA) and sella-nasion-B point (SNB) angles computed from a sample of Nubian schoolchildren are presented, by age and sex, and compared with the analogous statistics for American Caucasian schoolchildren.


Impedance of amalgam-dentin interface in cat tooth.

The impedance between two amalgam electrodes implanted in the maxillary canine of a cat was measured at various frequencies between 0.02 kilohertz (kHz) and 100 kHz. When plotted on the X-R plane as a function of frequency, two types of impedance loci were obtained. One resembled a circular are at low frequencies, whereas the other was parabolic or exponential in formmthe circular-arc loci are similar to those calculated from membrane models. The parabolic or exponential loci are predicted by a polyelectrolyte model.


Polymerizable amines as promoters of cold-curing resins and composites.

The accelerating activity of N,N-substituted aminoethyl methacrylates on the curing of methyl methacrylate and composite resins with benzoyl peroxide is somewhat smaller than that of dimethyl-p-toluidine. Tesins cured with aminoethyl methacrylates containing a p-tolyl and 3,5-xylyl substituent on the nitrogen atom turned approximately the same color in ultraviolet light as resins cured with dimethyl-p-toluidinemthe incorporation of the predominant part of an unsaturated tertiary amine into polymer chains reduces to a minimum the possibility of its diffusion from the resin into the surrounding tissue.


Localization of bacteria on the rat tongue with scanning and transmission electron microscopy.

Scanning microscopy of rat tongue showed that bacterial habitation of the tongue was almost completely localized to the middle third of the anterior surface of the filiform papillae. Transmission microscopy showed coccal forms attached to the surface of the epithelium by means of fibrillar strands and present up to four cell layers deep within the epithelium.


Use of filmed modeling to reduce uncooperative behavior of children during dental treatment.

Sixteen inner city children attending a pedodontic clinic were shown either a filmed demonstration of a child model cooperatively undergoing dental treatment or a film unrelated to dental activity. The group viewing the modeling film showed significantly fewer disruptive behaviors during restorative care and were rated as less fearful than the control group.


Frequency of dental trait anomalies in cleft, sibling, and noncleft groups.

The incidence and types of dental trait anomalies found in individuals with cleft lip or cleft palate or both (cleft group), in siblings of the cleft group, and in a group of individuals without cleft lip or cleft palate (noncleft group) were compared. The cleft group had 1.02 anomalies per individual, the sibling group, 0.38; and the noncleft group, 0.17. The frequency of occurrence of thick-curved maxillary central incisors, incisal fissures, and missing teeth were significantly different among the three groups.


Analysis of stress patterns in the human mandible.

Replicas of a dentate human mandible were prepared in photoelastic resin material. They were positioned in a supporting frame by means of struts, representing the principal muscles of mastication. Occlusal loading was simulated, and the stresses generated within the models were examined by three-dimensional photoelastic stress analysis.


Dose-dependent ultrastructural changes induced by tetracycline in developing dental tissues of the rat.

Tetracycline was administered to rats in varying doses in order to study the likelihood of ultrastructural alterations to ameloblasts and to study odontoblasts and dentin as well. The changes caused by tetracycline to the mineralization of dentin and the ultrastructural changes to the odontoblasts and ameloblasts increased with larger doses.


Failure of rabbit anti-Streptococcus mutans serum to penetrate in vitro plaque.

An indirect fluorescent antibody technique indicated that specific antiserums did not penetrate in vitro plaque formed by Streptococcus mutans. Specific reactions did occur between the antiserums and antigens in the surface layers of plaque globules. Measurements of plaque diameters indicated that the serums exerted a nonspecific effect of enhancing plaque growth.


Dentist's ratings and adolescents' perceptions of oral health.

The extent to which adolescents' self-appraisals of dental status agree with the dentist's evaluation is analyzed. The dentist's evaluation was expressed in standard dental status indicators (DMF, OHI-S, Russell Index) and in a rating of overall status as "excellent," "good," "fair," "poor." The relationship between the adolescents' self-reported dental care practices and the dentist's evaluation is also examined.


Electromyographic investigations of the tongue and circumoral muscular sling with fine-wire electrodes.

The electromyographic (EMG) examination of 11 normal individuals in whom bipolar fine-wire indwelling electrodes were placed showed no EMG activity during rest periods and only very slight to slight activity during normal oral functionsmduring aberrant oral activity, such as thumb-sucking, the orbicularis oris and genioglossus muscles gave a marked EMG response and the buccinator muscles were slightly active. These findings may help explain the classical malocclusions seen in tongue-thrusters and thumb-suckers.


Electrophoretic patterns of parotid fluid proteins from caries-resistant and caries-susceptible individuals.

Parotid saliva samples from caries-resistant and caries-rampant individuals were electrophoresed on polyacrylamide gel slabs. The parotid saliva of the caries-rampant group showed a significantly higher level of anodemigrating proteins, predominantly isoamylases, and a significantly lower level of cathode-migrating proteins than that of the caries-resistant group in both paraffin-stimulated and sour lemon-stimulated salivary flows.


Investigation of possible solvents for extracellular polysaccharides from Streptococcus mutans and Streptococcus sanguis.

The solubilities of extracellular polysaccharide fractions produced by 14 oral streptococcal strains were compared in water, aqueous lithium and guanidine salt solutions, dimethyl sulfoxide (DMSO), and a 9:1 DMSO-water mixture. The best results for solubilizing the fractions were obtained with the DMSO-water mixture procedure, which used the water and DMSO in sequence. By this method all fo the fractions were solubilized.


Reproducibility of the electromyogram.

Electromyographic recordings of masseter muscles were taken during mastication without the introduction of an experimental variable. The amplitude, duration, and sequence of the onset of muscle bursts were used to evaluated the recordings. Amplitude showed the most variation during the same session, at different sessions, and between three different areas of the masseter muscle. Onset showed the least variation during the same session and at different sessions; duration showed the  least variation between areas.


Effects of dietary sucrose levels on the quantity and microbial composition of human dental plaque.

The effects of dietary sucrose levels on the microbial composition of 4- and 12-day plaque were investigated in eight dental students. Sucrose-rich diets had no demonstrable effects on total plaque accumulation, whereas total viable microbial density, Streptococcus mutans, and the lactobacilli populations increased. The S sanguis population was unaffected. However, in individual subjects, an inverse relationship between the S sanguis and S mutans population was observed.


Effects of dietary sucrose levels on extracellular polysaccharide metabolism of human dental plaque.

The effects of increased and low dietary sucrose levels on the biochemical activities and composition of 4- and 12-day plaque were investigated in eight young men. The subjects were fed supervised, nutritionally adequate diets. Dextran hydrolase, levan hydrolase, and total carbohydrate content were increased during a sucrose-rich diet while invertase activity was decreased. Base-extractable carbohydrate was decreased in four-day plaque during the sucrose-rich diet. Glucosyltransferase and fructosyltransferase activity, buffer-soluble carbohydrate, and buffer-soluble protein were also determined.


Role of attrition and occlusal contact in the physiology of the rat incisor: IX. Impeded and unimpeded eruption in lathyritic rats.

In the rat, the administration of a lathyrogenic agent reduced both impeded and unimpeded eruption rates of incisors. Unimpeded eruption rates were greater than impeded eruption rates. The general eruption pattern in the experimental rats was, however, similar to that in the control rats. Thus, eruption was possible even in rats with a lathyrogenically impaired periodontal ligament.


Residual fluoride concentrations and scanning electron microscopic examination of root surfaces of human teeth after topical application of fluoride in vivo.

Fluoride concentrations in root surfaces of human teeth after a single topical application with a 2% acidulated sodium fluoride solution in vivo were investigated. Increased residual fluoride concentrations in the root surfaces and precipitations on the peritubular dentin, as revealed by SEM micrographs, may be factors in reducing hypersensitivity.