Increased ion permeability of planar lipid bilayer membranes after treatment with the C5b-9 cytolytic attack mechanism of complement. The ion permeability of planar lipid bilayers, as measured electrically, was found to increase modestly upon treatment with purified complement complex C5b,6 and complement components C7 and C8. The subsequent addition C9 greatly amplified this change. No permeability changes occurred when components were added individually to the membrane, or when they were used in paired combinations, or when C5b, C7, C8, and C9 were admixed prior to addition. Thus, there is a significant parallel between the permeability changes induced in the model membrane and damage produced in biological membranes by the C5b-9 complement attack sequence. The efficiency of membrane action by C5b-9 was critically dependent on the order in whcih components were added to the membrane. There were also differences in the electrical properties of membranes treated with C5b-8 and C5b-9, though in both cases the enhanced bilayer permeability is best attributed to the formation of trans-membrane channels. Collectively, the data are consistent with the hypothesis that the mechanism of membrane action by complement involves the production of a stable channel across the lipid bilayer, resulting in cell death by colloid-osmotic lysis.


Purine metabolism in adenosine deaminase deficiency. Purine and pyrimidine metabolites were measured in erythrocytes, plasma, and urine of a 5-month-old infant with adenosine deaminase (adenosine aminohydrolase, EC 3.5.4.4) deficiency. Adenosine and adenine were measured using newly devised ion exchange separation techniques and a sensitive fluorescence assay. Plasma adenosine levels were increased, whereas adenosine was normal in erythrocytes and not detectable in urine. Increased amounts of adenine were found in erythrocytes and urine as well as in the plasma. Erythrocyte adenosine 5'-monophosphate and adenosine diphosphate concentrations were normal, but adenosine triphosphate content was greatly elevated. Because of the possibility of pyrimidine starvation, pyrimidine nucleotides (pyrimidine coenzymes) in erythrocytes and orotic acid in urine were measured. Pyrimidine nucleotide concentrations were normal, while orotic acid was not detected. These studies suggest that the immune deficiency associated with adenosine deaminase deficiency may be related to increased amounts of adenine, adenosine, or adenine nucleotides.


Experimental myasthenia in Balb/c mice immunized with rat acetylcholine receptor from rat denervated muscle. A new model of an autoimmune disease of the neuromuscular junction was obtained by injection of acetylcholine receptor purified from rat denervated muscles into Balb/c mice. Anti-rat, then anti-mouse acetylcholine receptor antibodies, appear in mouse serum during the immunization procedure. Electrophysiological investigations performed on immunized mice reveal a neuromuscular block similar to that found in myasthenia gravis. Not a single mouse with objective signs of muscular weakness was lacking anti-mouse acetylcholine receptor antibodies but no correlation was found between their level and the severity of the disease.


Nonsuppressible insulin-like activity and thyroid hormones: major pituitary-dependent sulfation factors for chick embryo cartilage. Serum from hypothyroid hypophysectomized rats did not stimulate sulfation or incorporation of amino acids into chick embryo sterna. When such rats were treated for a short time with growth hormone (somatotropin), their serum stimulated incorporation both of sulfate and of amino acids. The different actions of the two types of sera were not due to changes in thyroid state. The results support the existence in serum of a sulfation factor for chick embryo cartilage that is dependent upon growth hormone. Highly purified preparations of nonsuppressible insulin-like activity from human serum stimulated incorporation of amino acids, and of uridine into RNA, in chick embryo sterna in vitro; chondrocytes prepared from this tissue had specific high-affinity binding sites for this insulin-like activity. However, sulfate incorporation was stimulated very little, unless serum from hypothyroid hypophysectomized rats was also present. When L-3,5,3'-triiodothyronine was added as well, the stimulation was enhanced further. From these and other experiments, we conclude that (i) nonsuppressible insulin-like activity or a closely related peptide is the growth-hormone-dependent growth and sulfation factor for chick embryo cartilage: (ii) a second, unidentified factor must be present for the insulin-like activity to stimulate sulfation; and (iii) stimulation of sulfation by thyroid hormones in vitro is additive to that of nonsuppressible insulin-like activity.


Diphenylhydantoin (dilantin) gingival hyperplasia: drug-induced abnormality of connective tissue. Various degrees of gingival overgrowth may occur in individuals taking diphenylhydantoin, a drug used widely in the treatment of epilepsy. The tissue overgrowth is made up predominantly of collagen, and may therefore be a useful model for analysis of fibrosis and some other connective tissue abnormalities. Fibroblasts derived from the overgrown tissue exhibit a level of protein synthetic activity approximately twice that of comparable cells obtained from nonepileptic control individuals and from the gingiva of age-matched epileptics taking the drug but not exhibiting gingival enlargement. In addition, 20% of the protein synthesized by cells from the affected tissue is collagen, whereas collagen accounts for only about 11% of the total protein produced by control cells of both types. The drug appears to induce or select for fibroblasts characterized by enhanced levels of protein synthesis and collagen production. This alteration persists through several cell replications in vitro in the absence of drug.


Circadian organization of the estrous cycle of the golden hamster. In constant dim illumination the hamster estrous cycle free-runs with a period that is a quadruple multiple of the concurrently recorded rhythm of wheel-running activity; both activity and estrous cycles are generated by biological clocks. Maintenance of stable phase angle differences between heat onset and running onset before and after treatment with deuterium oxide suggests that a common circadian system generates periodicities in estrus and activity. An organization of the estrous cycle is proposed in which the stimulus for the ovulatory surge of luteinizing hormone is generated by a circadian system that includes the suprachiasmatic nuclei of the hypothalamus. Various possible interactions of estradiol and photoperiod with the neurogenic stimulus for the luteinizing hormone surge are described and implications of different types of circadian organization of the estrous cycle for theories of sexual differentiation are considered.


Effects of persistent selective suppression of ganglionic butyrylcholinesterase on steady state and regenerating levels of acetylcholinesterase: implications regarding function of butyrylcholinesterase and regulation of protein synthesis. Persistent selective suppression of the butyrylcholinesterase (cholinesterase; acylcholine acyl-hydrolase, EC 3.1.1.8) activity of the superior cervical, stellate, and ciliary ganglia of cats by the daily administration of tetramonoisopropyl pyrophosphortetramide, 3.0 mumol/kg, intravenously, for 6 days produced a significant elevation in the levels of ganglionic acetylcholinesterase (acetylcholine hydrolase, EC 3.1.1.7). When the same procedure was preceded by the inactivation of over 95% of the ganglionic acetylcholinesterase by sarin, 2.0 mumol/kg, intravenously, the rate of regeneration of acetylcholinesterase was decreased. Results are interpreted as evidence that ganglionic butyrylcholinesterase may serve as a precursor to acetylcholinesterase, and that the level of butyrylcholinesterase may regulate the rate of acetylcholinesterase synthesis.


Cyanoacrylate as an adhesive for other medicaments: a study with triamcinalone on the healing of experimental oral ulcers. This study was undertaken to determine whether cyanoacrylate can be used to adhere other medicaments to oral ulcers in the hope of promoting healing. Triamcinalone was chosen since it is used presently in pastes in the oral cavity. Sixty rats were dived into three equal groups. In each animal under anesthesia with ether, bilateral equivalent ulcers, 2 mm in depth and diameter, were made with the tip of a rongeur on the midlateral aspect of the tongue. The right side served as a control. The left side was experimental and received the following: group I--isobutyl-2-cyanoacrylate only; group II--powdered triamcinalone acetonide; group III--triamcinalone covered with cyanoacrylate. All materials were reapplied every 24 hours for 4 days. Two animals from each group (6) were sacrificed at 1, 4, and 8 hours and 1, 2, 3, 5, 14, and 21 days. The results indicate that a powdered medicament can be held in place on oral ulcers for at least 24 hours. The ulcers with cyanoacrylate revealed less edema and cellular response for up to 24 hours. Healing of the ulcers was neither promoted nor delayed in any group.


Saliva stimulation in dogs with permanent duct fistulae. Saliva fluids were collected from catheters inserted in the duct openings of permanent paratid and sublingual duct fistulae prepared in dogs. In anesthetized dogs stimulants applied to the tongue had no effect on saliva output. In awake dogs topically applied sucrose (1.25%-20%) had no significant stimulating effect on salivary secertion when compared to water control responses. Citric acid (1.25%-20%), applied topically, resulted in dose-related fluid increases, with parotid volumes consistently higher than sublingual volumes. Pilocarpine (0.125 mg/kg, IV), elicited similar saliva volumes in awake and anesthetized animals; sublingual secretions were higher than parotid volumes. For comparing drug secretion or saliva composition in awake and anesthetized animals, use of the same, preferable an IV, stimulant administered on a milligram perper-kilogram basis is suggested.


11beta-hydroxysteroid dehydrogenase in subcellular particulates of rat submandibular salivary gland. 11beta-hydroxysteroid dehydrogenase (11beta-HSD) was studied in intracellular components of the rat submandibular salivary gland. The difficulty in retaining 11beta-HSD activity during fractionation was overcome by using soybean trypsin inhibitor. Relatively pure subcellular particles were obtained by altering the initial centrifugal speeds used for the various fractions. 11beta-HSD was found to have its main activity in the crude nuclear fraction of the gland. Pure nuclei were isolated by centrifuging the crude nuclear fraction through 1.8-M sucrose at high speed, and these were found to retain the major enzyme activity. It was hypothesized that 11beta-HSD may influence genetic expression processes in salivary gland, but further work will have to be undertaken to investigate this possibility.


Lead health hazard in root calan filling material. It has been stated in the recent literature that the lead content of N2 endodontic filling material poses a hazard of lead otxicity to the patient. No clinical evidence in humans was offered in support of the statements. In the studies here reported, it was determined that endodontic fillings of RC2B, A U.S. variant of the N2 material, contain, per root-canal, a quantity of lead equivalent to permissible uptake of 10-15 days. It is believed lead is generally unavailable to the blood stream, due primarily to its being chemically bound, and secondarily to the known affinity of dentin for lead. It was found that the levels of lead in the blood of nine young male patients, sampled at intervals up to 90 days following placement of RC2B endodontic fillings, were mostly nondetectable, did not exceed 9 mug/100 ml in any instance, and were all far below the accepted hazard-indicating level of 40 mug/100 ml whole blood.


Biological active peptides in human urine: III. Inhibitors of the growth of human leukemia, osteosarcoma, and HeLa cells. Medium-sized peptides isolated from normal humans urine were tested for their effect on DNA, RNA, and protein synthesis, and mitosis, in tissue culture of human myeloblastic leukemia, osteosarcoma, and HeLa cells. Two types of antineoplastic peptides were found. One type consists of strongly acidic peptides (probably sulfated glycopeptides) which act specifically on different kinds of neoplasma. The other type comprises slightly acidic and neutral peptides, and has broad specificity. The active peptides produce up to 97% inhibition of DNA synthesis and mitosis in the neoplastic cells in tissue culture. The peptide fraction which has broad specificity was tested in different concentrations and gave good dose-response relationship.


Ventilator-related extra-alveolar air in adults. Extra-alveolar air (EAA) developed in 38 patients during mechanical ventilation. High ventilatory pressures and destructive lung disease predispose to EAA. Pneumoretroperitoneum and pneumoperitoneum are more common forms of ventilator-induced EAA in adults than generally realized; an associated pneumomediastinum was always identified when one of the two disorders above resulted from ventilation. Retroperitoneal air was located laterally along the liver and in the flanks, and changed little with change in patient position. Early detection of EAA may allow life-saving changes in therapy to be implemented.


Occlusal adjustment by grinding of teeth; indications and techniques. Occlusal adjustment by grinding of teeth is a therapy that all dentist can master, provided they base it on a knowledge of what constitutes an acceptable occlusion. There is hardly use for intricate or difficult rules and prescriptions for occlusal adjustment. After having diagnosed the occlusal condition in the patient, the dentist has to decide how to attain the goal : an acceptable occlusion without interferences, that is tooth substance that is in the way of harmonious function. Very often simple grinding of teeth can improve the occlusion of our patients. And in combination with other corrective measures, e.g. prosthetic rehabilitation and orthodontic treatment, occlusal adjustment by grinding deserves to be used much more frequently in clinical dentistry than it is today. It is a cheap and simple procedure that can improve our patient's occlusal hygiene. And occlusal hygiene is a concept that now should be incorporated in odontology as oral hygiene seems to have been universally accepted. And we dentists are even more responsible for increasing the quality of occlusion in our patients than we are for the standard of their oral hygiene.


[Transplantation of the lower wisdom teeth. 6 years' experience]. The authors report their experience with reference to wisdom tooth transplantation involving fifteen patients over a period of 6 years. They exclude from this paper those transplantations which they have done using buds without roots and those with teeth with completely formed roots, which would not appear to be the best time for transplantation from a physiological standpoint. They feel that the main indication occurs when (multi-ring orthodontic treatment being impossible) the first molar is impossible to preserve and the wisdom tooth cannot apparently become functional. They describe their techniques. Despite the successess obtained (11 cases out of 15) with a follow-up of 6 years to one and a half years, the authors express a degree of reserve as far as the distant future is concerned with regard to possible rhizoclasia.


[Tooth transplantation].

[Tooth transplantation]. In the light of the thesis of J. Thibault, the authors suggest, in association with transplantation of wisdom tooth buds into the alveolus of the first molar, a technique consisting of placing the graft in its pre-eruptive position, removing in a block the bud, the gubernaculum and the sub-jacent gingival mucosa. Under these conditions, eruption occurs at the same time as development of the roots, which represents the most physiological solution. At the same time as formation of the root, the authors noted a paradoxal rhizalysis, hypercementosis resulting in ankylosis and conservation of vitality. In addition, almost all the teeth transplanted proved to be highly vulnerable to caries.


[Contraindications to the use of extraoral forces in dentofacial orthopedics]. Following a brief and non-exhaustive review of the various types of extra-oral traction, the author stresses certain contra-indications which, in his opinion, should be borne in mind by the operator. These contraindications, are, essentially, a pathological mesiodistal orientation of the adult molars, reflecting dento-maxillary disharmony in the anterior segments, and an abnormality of inclination of the alveolar processes for which aetiological treatment is more rational.


[Mandibular osteosynthesis according to the Michelet technic. I. Biomechanical bases]. Experiments performed in collaboration with a group of engineers lead to following affirmations: - mandible's external cortex is strong enough to endure strains resulting from screws, - osteosynthesis plate must be screwed in high position, - the material elaborated according to biomechanical data appears constantly reliable despite more marked miniaturization and improved malleability.


Chromosome banding studies in Philadelphia chromosome positive myeloid leukaemia. A cytogenetic study of Ph1 positive myeloid leukaemia in both chronic and acute phases had been made by a chromosome banding technique. The translocation (t(9;22)(q34;q11), designated t(Ph1) was present in the myeloid cells of 43 of 44 patients; the exceptional case had normal number 9 chromosomes and a different translocation (t(19;22)(q13;q11)). A translocation additional to that involving the Ph1 was found as a stable abnormality present in all myeloid cells in 4 patients, chromosome 17 being involved in 2. The association of isochromosome number 17 with blast crisis was confirmed. New data were obtained concerning the significance of duplicated or dicentric Ph1 chromosomes and their relationship with the 9q+ anomaly. Monoclonal origin of Ph1 was confirmed in cases with polymorphic number 22 or 9 chromosomes.


[Mandibular osteosynthesis according to the Michelet technic. II. Presentation of new material. Results]. The purpose of this communication is: - To report the conclusions of a critical study realized in collaboration with a group of engineers and concerning some presently obtainable osteosynthesis materials. - To ascertain mechanical characteristics required by screws and plates used for this type of surgery. - To relate a 4 years experience concerning 130 osteosynthesis (32 performed with a new material worked out according to biomechanical data).


[100 malar fractures].

[100 malar fractures]. Fractures of the malar are treated by therapeutic methods which are simple to put into operation and very effective based on osteosynthesis, screw-in plates, grafts and, in particular, the well-tolerated silicone implants (54 cases without any signs of rejection). The 100 case histories show our successes and failures.


[Fluorescence angiographic diagnosis of the elasticity of the labial frenum]. The fluorescein angiographs of the attached gingiva of 10 out of 12 subjects showed distinct areas of ischaemia which were clinically not discernible when standardized tensions of 100 g or 200 g tensions were exerted on the mandibular frenum. The fluorescein angiographs were reproducible in 3 out of 4 cases and the ischaemic areas reached the adjacent gingival margins in 5 cases. Possible hypoxic damage of the periodontium by tension of frenum is discussed.


[Biophsical study of dental tissues under the effect of a local strontium application]. Microradiographic and electronmicroscopic observations show that topical application of concentrated strontium chloride solution on an abraded dentinal surface caused the formation in the dentine of very compact superficial layer composed of fine granules and with a high degree of radiodensity. This layer not only forms a continuous deposit on the superficial zone, but also penetrates and fills the canclicules to a certain distance. A barrier is thus created, diminishing the permeability of the dentine, which would explain the desensitization of the tooth. Electron probe microanalysis and X-ray diffraction studies show that the fundamental mechanism of the formation of strontium deposits is an exchange with the calcium fo the dentinal tissue, and recrystallization in the form of strontium apatite.


[Peripheral giant cell granuloma of the jaw. Study of 173 cases]. The authors studied G.C.P.G. in a series of 173 patients amongst 894 with epulis type tumours. The highest occurrence rate of G.C.P.G. was found during the period of mixed dentition. Whilst in childhood G.C.P.G. was commoner in boys than girls, after the age of 16 the number of women affected was twice that of men. G.C.P.G. occurs more frequently in the mandible than the maxilla and more often in the premolar-molar region than the incisor-canine region. Osteolysis of the alveolar edge was more marked than in other forms of epulis and in a smaller number of cases osteogenic forms of G.C.P.G. were found with the formation of a substantial amount of reactive bone. From a histopathological standpoint, a connective-tissue/vascular stroma with giant cells and developing in relation with the capillary endothelium, and of similar appearance to G.C.C.G., is noted.


[Problems of the treatment of prognathism by sagittal splitting of the ascending mandibular branch]. The author reports 20 years of experience at the Zurich clinic with the treatment of mandibular prognathism by sagittal cutting of the ascending mandibular rami. The original method of Obwegeser and its modifications (1955, 1957) are discussed. After mentioning the indications, the technique of surgery is described, such as it is practised today at the clinic of maxillofacial surgery in Zurich. The classical method applies to tooth bearing arches, while modifications are necessary in edentulous mandibles. Further on, modifications as mentioned in the literature, particularly applying to the soft tissue cuts, the bone cuts, the position of the buccal cut of the cortical bone, the direction of partition, the technique of partition and the fixation of the segments, finally the intermaxillary splinting and drainage are mentioned. It is explained, why in the Zurich clinic the technique of Obwegeser is still prevalently used. The most prominent modifications are the blunt partition of the ramus and the control of the position of the condyle under the radiographic viewer. The use of the modification in the cut of the buccal cortical bone after Dal Pont (1959) was abandoned again.


[The value of a cytologic examination in the diagnosis of various diseases of the oral mucosa]. The use of cytological examination in the diagnosis of different conditions of the buccal mucosa is of increasing interest in all branches of medicine. Collection of a specimen is very simple, painless and may always be repeated. Although not having an absolute value, cytological examination may contribute to the diagnosis of a group of inflammatory disorders of the buccal mucosa.


[The effectiveness of a chlorhexidine (Plak-out) gel and solution: clinical study]. A gel containing 0.2% chlorhexidine gluconate has been utilized during 6 weeks as a toothpast 3 times a day by a group of 8 students, while 8 other volonteers have brushed their teeth with a gel placebo. The gingival and plaque indices, as well as the amount of gingival fluid have been measured at the beginning and at the end of the experimental time. Colour photographs were also taken. The study, performed in double blind, did not show any significant change in the gingival conditions of the 16 students. In a second trial, the antiplaque properties of a chlorhexidine containing solution (Plak-out liquid) were tested. After thorough prophylaxis, 13 students in an experimental group and 8 students in a placebo group were asked to stop their oral hygiene procedures during 7 days and to rinse their mouth 2 times a day during 1 minute with the chlorhexidine solution or with the placebo. In each of the 2 groups, 4 subgroups were formed, each rinsing the mouth with a chlorhexidine or a placebo concentration of 0.05, 0.1, 0.15 and 0.2 per cent. In the experimental group the results show a practically complete inhibition of plaque deposits. The average plaque index, which amounted to 0.3 at the beginning of the experiment in the 2 groups, showed an increase to 1.2 in the placebo group and dropped to 0.2 in the chlorhexidine group. The plaque inhibition seems to take place as a function of the chlorhexidine concentration. The gingival index of inflammation and the amount of gingival fluid showed an increase in the placebo group but did not change in the volonteers using the active compound.


[Reproduction of cephalometric films with a soft-tissue outline]. The authors present a description of a radio-photographic technique aimed at providing on the same film a detailed picture of the skeleton together with sufficiently clear reproduction of the contours of soft tissue. This technique, the result of which resembles Xerography, provides a simple means of obtaining reproduction of bony structures and their relations with soft tissues.


[Contribution of orthophony to the treatment of periodontal diseases. Preliminary communication]. Reeducation of swallowing troubles and muscular problems represents an essential complementary factor in the treatment of paradontal pathology. Study is made of swallowing, muscle tone and power of the tongue and the oro-buccal muscles (extensometry, electromyogram) and of phonation. Reeducation is possible after 30 years. It creates new habits and reflexes. The results obtained are very encouraging.


[Treatment of gingivitis with the cavitron under water and chlorhexidine cooling]. This article deals with the question whether the success of gingivitis treatment is enhanced by Cavitron therapy employing a 0.2% Chlorhexidine solution as a cooling agent with the Cavitron instead of water. It was shown that the symptoms of gingivitis disappear after removal of plaque and calculus deposits. Addition of a 0.2% Chlorhexidine solution in the cooling system of the Cavitron however does not significantly influence the success of the treatment.


[Inhibition of polymerization by oxygen in composite filling materials and enamel sealers]. The oxygen inhibition upon the polymerization of composite materials was investigated. The method permitted the avoidance of oxygen inhibition even in cases where the special matrix could not be used. The results can be summarized as follows: 1. The depth of inhibition, when atmospheric air is admitted, varies, according to different brands of composites, between 25 and 105 mum. 2. By conducting a protective gas over the surface of the polymerizing material, the contact of oxygen is avoided just as if a matrix were used. 3. Avoidance of oxygen is particularly important during the setting period of the material, i.e. the time between the end of mixing and the end of setting. 4. Polymerization under a protective gas makes it possible to polymerize even very thin layers of material and therefore widens the scope of use for sealants in caries prophylaxis.


[Treatment results after zygomatico-orbital fractures]. Between 1973 and 1974, 96 zygomatic fractures were diagnosed of which 89 were surgically treated. 75 fractures were set openly and of these 65 were joined by osteosynthesis. 75 patient were examined later. Results show that posttraumatic complications occurred more frequently in fractures set without opening than in fractures set by osteosynthesis. Open reposition is therefore recommended, along with stabilization by osteosynthesis.


Improved oral health of schoolchildren of 16 communities after 8 years of prevention. III. Gingival conditions and calculus. In 1963, a "Caries-Preventive Program" was started in the canton of Zurich. Within this program supervised toothbrushing exercises (with fluoride preparations) were carried out at school. They were performed 3 times per year by specially trained former dental chairside assistants who also discussed the usefulness of toothbrushing (10 min at each class visit). The teachers were expected to perform 3 additional supervised toothbrushing exercises during the year. The total number of brushing exercises per year was between 4 and 6. A total of 7548 examinations of children were made in 16 communities in 1963/64 1967/68 and 1971/72. The occurrence of gingivitis was studied by considering the symptoms of edematous swelling and discoloration. The frequency of both symptoms decreased over the study period 1963/64 to 1971/72. The frequency of supragingival calculus lingually on lower incisors was also reduced, but this result was not consistently found in the communities. In a subsample, subgingival calculus was studied on bite-wing radiographs. The percentage of children 13 to 15 years of age with such deposits decreased from 9.27 to 3.22.


Fluoride content of dental hard tissues with special respect to fluoridation of domestic salt. Teeth from children with various histories of fluoride supplementation were collected and analysed for fluoride. Fluoride concentrations in dentine from the canton of Vaud with fluoridated salt at 250 ppm since 1969 were at a level comparable to that reported from regions with 1.0 ppm F- in the drinking water and in children having received fluoride tablets during their tooth formative age.


[Results of experimental studies on new materials for dental models]. Newly developed cast materials (special stone plaster and plastic materials for single-stump casts) were tested for their setting behaviour and strength, their ability to reproduce fine-profiled surfaces and, in combination with standarized silicone impressions, for their dimensional behavior. With reference to the authors' experience, the suitability of these materials for making casts is critically evaluated.


[The effect of daily controlled oral hygiene on the oral health of children in a town with drinking water fluoridation (Karl Marx Stadt)]. Under the conditions of an optimized (with regard to caries prevention) fluoride content of the drinking uater, the authors studied (in the framework of an oral hygiene measure covering 32 months) in 149 children 6.5-8 years of age the effects of supervised daily dental and oral care on dental health. The improvement in oral hygiene (OHI) by 33% is in harmony with an additional caries reduction by 33.3% (DMF/S index) and a decrease of the PM index by 47%. A wider use of oral hygiene actions as secondary preventive measures is, therefore, recommended also for towns with fluoridated drinking water.


[Epidemiologucal studies on the health condition of the masticatora organ as related to sugar consumption]. In the Republic of Cuba, the authors compared, using the method of dietary interviewing, the oral findings (DMF/T, OHI-S, PDI and plaque pH) of children with primarily caries-free dentitions (25 children), with a DMF/T index up to 2.0 (50 children) and with a DMF/T index of more than 6.0 (50 children) with their eating habits. The nutrition index determined for the sugar consumption in the last-mentioned group was by 38% (meals) and by 48% (between-meal snacks) higher than that found in the group of primarily caries-free children. The other indices were also significantly higher. The group with a DMF/T index up to 2.0 holds an intermediate place. Since all the children originated from the same region and since there were no differences in dental and oral care between the groups, the individual differences in oral hygiene and in diseases of the dental hard structures and of the periodontium must be attributed to the individual sugar consumption, the between-meal snacks seeming to play a dominating role.


[The treatment of condylar fractures by means of intramedullary nailing]. Fundamental statements regarding the osteosynthesis of condylar process fractures are made in which the author's guidelines for indication (which have been published elsewhere) have proved useful. A marrow-nailing technique is described for osteosynthesis. This technique secures sufficient fragment stabilization also in unfavourable cases. The surgical intervention is an open one. The technique permits functional loading  of the reduced fragments already within almost 14 days. Finally, a documentation of the cases treated at our Clinic is presented.


[Fluoridation at Karl Marx Stadt. XIII. Caries reduction and oral rehabilitation]. 12 years after water fluoridation (1971), the repercussions of the quantitative and qualitative changes in caries prevalence on the paedodontic care were studied on the basis of statistical findings from more than 36 000 subjects aged from 6 to 18 years. It was shown that the result of oral rehabilitation is substantially influenced by the increase in the number of subjects with primarily healthy dentitions and by the reduction in the number of carious teeth. Furthermore, the reduced number of cavities and fillings involving two or more surfaces and the less frequent occurrence of secondary caries have repercussion on the time spent by the paedodontist. Not least the caries reduction also influences the paedodontist/children ratio which has changed from 1:1659 in 1959 to 1:3208 in 1971.


[Possibilities of dental health education in the socialist school]. The possibilities of dental health education in the socialist school are dealt with. They consist in the direct influence of the stomatologist and his auxiliaries on the pupils and in the indirect influence via the teachers, educationalists and public organizations. The dental health education in the school must be brought into line with the extra-curricular dental health education. In the school, dental health education may be mentioned in many subjects of instruction. As to the extra-curricular dental health education, it seems that the co-operation with the "Young First-Aiders" is especially important. A planned, concerted action is advisable in dental health education.


[The effect of oral hygiene on the periodontal status in diabetes mellitus]. Using the Oral Hygiene Index (OHI) of Greene and Vermillion (1960), the author determined in 209 diabetics the degree of oral dirtiness and studied its effect on the periodontal conditions. He found that the OHI was significantly lower (1.17) in diabetics with healthy gingivae than in diabetics with periodontal diseases (1.60). In diabetics with parodontopathia mixta or parodontopathia inflammata profunda the OHI (1.67 and 1.86, respecitvely) was significantly worse than that in diabetics with clinically healthy gingivae or parodontopathia inflammata superficialis. Oral hygiene also correlated significantly (correlation coefficient r=0.206) with age at P less than 1%. The mean OHI for diabetics (1.55) was almost identical witoes not support the view that diabetes itself favours plaque formation.


[Results from a study of the normal values in the vertical, sagittal and transversal plane of early mixed dentitions]. 168 (21.7%) of 776 pupils from primary classes in Jena had normal tooth position and occlusion. 94 of them were selected for a longitudinal study. Up to now, they have been examined at the ages of 7 and 8 years. The evaluation of the results obtained showed differences with regard to age and sex. The data reported and the deviations observed may be considered reference values. They concrete the assessment of the growth and development in the orofacial system, facilitate the recognition of dysgnathias which must be treated and optimize the planning and performance of orthodontic treatment.


[Cross-sectional comparison of the median eruption time for permanent teeth in children from fluoride poor and optimally fluoridated areas]. Nearly 57000 children (aged from 4 years, 4 months to 15 years, 9 months) of Karl-Marx-Stadt (1.0 ppm F) and Plauen (0.2 ppm F) were examined to compare the mean eruption times of permanent teeth before and after 12 years of water fluoridation. Whereas a direct influence of internally administered fluorides is to be excluded, an indirect action on the premolars may be assumed with certainty. The delayed eruption of all premolars in children of the area with optimally fluoridated water was the only systematic effect which could be detected. This normalization is explained by a prolonged stay of the deciduous teeth in the dental arch which is due to a lesser caries prevalence.


[The dialectic unity of norm and individuality in assessing the development of the mixed dentition]. Each norm conception is self-limiting and, consequently, may be incorrect in individual cases. This contradiction is eluced by considering norm and individuality as a dialectic oneness when judging a situation. The individual characteristics of the growth and development of the dentition are determined by a great number of specific features. The importance of the individual tooth sizes and of the specific rhythm of dentition is used to emphasize that the assessment must aim at determining the patient's individual developmental optimum. It is oriented to the general norm but must not coincide with it. The achievement of this specific development optimum may be furthered by preventive regulating measures.


[Reactions of the pulp-dentin system to drugs]. The healthy or previously damaged pulp responds to most of the drugs currently applied to the dentin with an inflammatory reaction. By means of a standardized biological screening test, the modes of action of hydrogen peroxide and of Falikain preparations are demonstrated on the pulp of the rat incisor. Hydrogen peroxide produces an emphysema of the pulp tissue associated with a slowing of the circulation and partly irreversible capillary stases, whereas Falicain compound preparations (Falicid, Myrex) cause, by way of haemolysis, injuries involving entire areas of the pulp. For this reason, hydrogen peroxide should not be used for cleaning cavities. Myrex is well suited for symptomatic treatment to relieve pain, if removal of the inflamed pulp ensues.


[Technic and possible uses of mucosal transplantation in reconstructive surgery of the mouth]. In preprosthetic interventions, optimal denture support may be obtained by means of full-thickness buccal mucosa grafts. In mucogingival surgery, buccal mucosa grafts may be used to form mucosal areas which rest firmly on the alveolar process and show no measurable tendency to shrink. Plastic repair by means of mucosa grafts is also possible after excision of verrucous carcinomas and precancerous lesions of the tongue and cheek.


[Indications for and evaluation of filling therapy]. An explanation of the goal of filling therapy is followed by guidelines relevant to the indications for plastic fillings (silver-tin amalgam, silicate cement, composites) and inlays (metal and porcelain inlays) with special regard to the properties of the filling materials (colour, chemical and physical properties), the extension of the cavity and the condition of the pulp. Practice-oriented conclusions mark the end of the paper.


Inflammation and its effect on the vitreous. The role of the vitreous in inflammatory diseases of the eye is now more clearly defined because of improved methods of examination and surgery. Inflammatory diseases of various aetiology produce opacification, liquefaction, and shrinkage. Additional changes include cellular proliferation and transformation leading to fibrosis in cases of prolonged inflammation. In some eyes the fibrosis is primarily cortical while in others it is extensive. Those inflammations with outpouring of a fluid exudate lead to detachment of the vitreous from the posterior eye and extensive shrinkage. In such eyes the vitreous becomes heavily organized and opaque in the central eye behind the lens, obscuring the view of the posterior fundus. In young eyes vitreo-retinal adhesions often form at the sites of inflammation, leading to traction on the retina and ciliary body; retinal tears may result from the traction. Exudate in many inflammatory vitreal inflammations tends to collect at the vitreous base where it organizes into scar tissue. The scar is formed by the retina and ciliary body, but there are also fibrosis-produced monocytes that become transformed into fibroblasts. Shrinkage of the new-formed scar can lead to disinsertion or peripheral tears of the retina. Specific inflammations such as chronic cyclitis and toxoplasmosis produce characteristic changes in the vitreous that can be recognized on clinical examination. Melanomas and reticulum cell sarcomas also produce a characteristic vitreous opacification.


Fibroglial proliferation in pars planitis. In a 51-year-old patient with long-standing pars planitis, light and electron microscopical examination of the intravitreal 'snowbank' revealed a fibrovascular layer adjacent to the hyperplastic nonpigmented epithelium of the pars plana and an extensive fibroglial proliferation within the vitreous base. The fibrovascular layer consisted of well-differentiated capillaries, probably emanating from the peripheral retina, interspersed with aggregated vitreous fibrils. The fibroglial portion of the 'snowbank' was composed of fibrous astrocyte-like cells which had secreted basement membranes and larger diameter collagen fibrils. This fibroglial tissue was in direct continuity with an ultrastructurally similar preretinal membrane. No significant choroiditis or cyclitis could be demonstrated. It is hypothesized that, in pars planitis, a primary inflammatory process of the peripheral retina and vitreous base may stimulate the observed preretinal and intravitreal fibroglial proliferation.


Role of the vitreous in the haemoglobinopathies. The vitreous is felt to play a significant role in the development of advanced proliferative sickle retinopathy. This is particularly true in Stages 3 to 5 of the Goldberg classification. A comparison with the classification of proliferative diabetic retinopathy by Davis is presented. The role of vitrectomy in this disorder has been considered.


Treatment of massive vitreous retraction. 1 Massive vitreous retraction must be diagnosed according to a well-defined set of criteria. 2 Massive vitreous retraction is treatable, despite Machemer's assertion this morning, in its contracting as well as immobile stages, but surgery must be carried out as soon as possible after the diagnosis is made. 3 Liquid silicone is the correct treatment and is not toxic to the human eye.


Vitreous replacement.

Vitreous replacement. The long list of substances used by ophthalmologists for vitreous replacement can be reduced to only three for four. Their use depends upon the surgical procedure. After trauma or cataract extraction and in vitreous surgery, saline is the best substitute; it is rapidly replaced by aqueous humour and no inflammatory reaction occurs. Retinal detachment surgery requires a highly viscous material, harmless to ocular tissues, and these criteria are met by Healon H. Whenever highly viscous hyaluronic acid is available, it should be used instead of saline or air (Regnault and Brégeat, 1973). Sulphahexafluoride gas has also been used to treat these difficult cases of retinal detachment but further experience is needed before a definite conclusion can be reached.


Indications for vitrectomy via the pars plana. Vitrectomy via the pars plana is a surgical technique with a wide range of applications, which should be understood by all ophthalmologists, for they allow the successful treatment of conditions for which there was previously no good therapy. On the other hand, the breadth of indications for this new surgical approach and the hopelessness of the prognosis with other treatments is a temptation for its misuse. Clear guidelines must be established as to when vitrectomy is indicated. Some such guidelines are proposed.


[Salivary electrolytes and serum digoxin in the Assessment of digitalis intoxication (author's transl)]. Salivary electrolytes (potassium and calcium), as well as serum digoxin levels were measured in 114 patients receiving digoxin or one of its derivatives. The mean value of the product of salivary potassium (mVal/I) and calcium (mVal/i in digoxin-treated patients without signs of digitalis intoxication (group 1) was 235 +/- 137 (SD) and with digitalis intoxication (group 2) 404 +/- 161 (SD). The difference in these values was not of statistical significance. The mean serum digoxin levels were 1.38 +/- 0.6 ng/ml (SD) in group 1 and 2.97 +/- 0.7 ng/ml (SD) in group 2; this difference is highly significant (p less than 0.001). Both salivary electrolytes and serum digoxin levels were falsely elevated in 11% of group 1 patients. 50% of the cases in group 2 showed salivary electrolyte values within the range of group 1, but there was  only 1 patient with a serum digoxin level of below 2 ng/ml. It can, thus, be concluded that measurement of the salivary electrolytes is a test of only limited value in the assessment of digitalis intoxication, whereas determination of the serum digoxin level is a valuable diagnostic tool.


[Diagnostic and therapeutic aspects of leukoses in childhood]. 30 TO 40% of all malignant neoformations in childhood are leukaemias. Within this group 80 to 85% of acute lymphatic leukaemias are found. The indicating signs (conditioned by the suppression of the normal myelopoiesis) are briefly described, differential diagnosies are only mentioned. Primary diagnostics  and diagnostics of the course, the principles of remission induction and continuous therapy in leucaemia are sketchily described. Treatment of acute lymphatic leukaemia is performed adequate to the therapeutic scheme after Pinkel Prophylaxis of the central nervous system must be demanded. Modern therapeutic methods with the help of synchronisation and oncobiogramme are demonstrated. The possibilities of the symptomatic therapy in disease-conditioned and therapy-conditioned complications and side-effects occupy a somewhat broader space. Finally the principles of the organisation of the treatment of leukaemia in childhood are described.


[Catamnestic findings in patients following gastric resection]. A radomized study was done in 2 groups of male patients operated upon 3-17 years ago either by partial gastrectomy (Billroth II type) or hermiotomy. The inquiries covered eating, drinking and smoking habits, occupation, body weight, subjective complaints, and use of drugs. Body weight and professional activity after operation were not different in both groups. Gastrectomized patients avoided milk or foods with milk, sweets and legumes more often. Feeling of fullness, vomiting and diarrhea occurred more frequently in gastrectomized subjects, as well as statements about good or even ravenous appetite and thirst. Gastrectomized men, besides, had a higher consumption of alcoholic drinks, preferably of beer.


[Polypeptides of the virus-like particles isolated from the plasma of rats with Shvec erythromyelosis]. The structural proteins of virus-like particles isolated from ascitic fluid of rats with experimental Shvec erythroleukosis were studied by polyacrylamide gel electrophoresis. The bulk of protein (60-70%) is divided into five major bands corresponding to a molecular weight of 15,000, 20,000, 34,000, 48,000 and 61,000 daltons. Besides these bands, some distinct minor ones corresponding to a molecular weight ranging from 41,000 to 82,000 daltons were always present. There were also some slight bands that are not developed in scanning on the densitometer. These bands occurred in the region corresponding to a molecular weight above 50,000 daltons. The gels stained to detect polysaccharides revealed a distinct red colour band of a molecular weight 80,000 daltons and 3 slight of a lower molecular weight which are probably the degradating products of the main glycoprotein component. The electrophoretic pattern of the 1.16 g/cm3 fraction obtained from the healthy rat liver and Ehrlich ascitic fluid differs from the electrophoregram of the virus-like particles isolated from the rats with Shvec erythroleukosis.


A modification of the Amsterdam infant ventilator. An audible leak-alarm. An inexpensive audible leak-alarm based on photoelectric recording of the manometer setting for the Amsterdam Infant Ventilator is described. On account of its small dimensions it can also be built-in into other types of ventilators.


Nonocular cancer in retinoblastoma survivors. From a review of the records of 2,302 patients with retinoblastoma collated from CPMC and AFIP, it was found that retinoblastoma patients who survived their original eye cancer have a high incidence of second nonocular malignancies. The second neoplasms occur almost exclusively (97.5%) in patients who have had bilateral retinoblastoma, although retinoblastoma is much more commonly unilateral. The second neoplasms have appeared between 1 and 42 years after the successful treatment of retinoblastoma and have been fatal in approximately 85% of cases. Seventy-one percent of patients develop tumors in the field of the radiation beam; many of these were following treatment with low doses of radiation and after short latent periods. Nineteen percent of patients develop tumors clearly out of the field of radiation (eg, osteogenic sarcoma of the femur). Retinoblastoma patients appear to be unusually radio-sensitive to low doses of radiation and develop tumors in the field of radiation following treatment of 3,500 rads. They have a high incidence of nonocular tumors clearly distant from the radiation beam develop nonocular malignancies even if no radiation has been given. The incidence of multiple malignancies in patients successfully treated for retinoblastoma appears to be higher than for any other primary malignancy whether they receive radiation or not.


Paralytic shellfish poisoning in Papua New Guinea. Paralytic shellfish poisoning is differentiated from other forms of poisioning from marine animals. An outbreak in a village near Port Moresby is described, and the clinical picture seen in that and subsequent cases (25 plus 3 fatalities) is discussed. The clinical manifestations of almost pure cerebellar incoordination, without other constant neurological signs, is emphasized and the name Ataxic Shellfish Poisoning is suggested. The aetiology whereby toxic marine plakton organisms are siphoned and filtered from the water and accumulate in shellfish is described.


Kuru.

Kuru. Theis report discusses problems involved in the diagnosis of kuru. The gentic and epidemiological pattern is also reviewed. This reveals a continuing overall reduction in kuru incidence with the disappearance of juvenile cases and increasing age of male kuru patients a reduction  in the age of female cases. The significance of these trends in relation to the transmission of kuru is discussed.


Auyana head nodders: essential heredo-familial tremor in the Eastern Highlands. The syndrome of essential tremor occurs commonly in parts of the Eastern Highlands District. This description of the clinical features is bases on experience of over 200 patients and the influence of some pharmacological agents on the severity of the tremor are recounted. The age and sex incidence in several related linguistic groups is shown to be much greater than in neighbouring areas; so that the disorder can be epidemiologically defined within geographic and ethnic boundaries.


Neurological admissions to Goroka Base Hospital - an eight month survey. Over eight consecutive months in 1972-1973 each patient admitted to Goroka Hospital because of neurological symptoms was investigated. The nature of the symptoms, the clinical features and the final diagnosis are reviewed; whilst the circumstances leading to hospital admission and eventual outcome of the illness are described.


Subacute combined degeneration of the spinal cord. This paper describes the clinical history of an adult male who was found to be suffering from subacute combined degeneration of the spinal cord. It is believed that this is the first report of this condition in Papua New Guinea.


Normal serum biochemistry in Papua New Guinean adults. Aean concentrations of some serum biochemical variables for healthy male and female adults are provided for six Papua New Guinean communities of varying diet and location. These average values, with normal regional, sex and age variations, are presented as a reference for those using serum biochemical indices in clinical diagnosis in Papua New Guinea.


[Tumour frequency in autopsy cases. V. The leucoses (author's transl)]. The analysis is based on the catalogue of neoplasms notifiable in the German Democratic Republic (ICD-Code Nrs. 140-209, 210.2, 211.3, 211.9, 225, 226.2, 226.3, 253.2, 702, 757.2). At the Medical Academy of Erfurt 22155 autopsies (12212 males, 9943 females) of adults (15 years and upwards) were registered in the period from 1950 to 1966. Among them 322 leucoses (1,5% of autopsies and 4,3% of malignant tumours) were observed. The cases are distributed among 175 males (1,4% of males) and 147 females (1,5% of females). There is no sex difference in frequency. Age and sex distribution are presented for all leucoses and for chronic lymphatic leucosis, chronic myeloic leucosis and acute leucoses.


The adreno-medullary effect on gastrointestinal propulsion after laparotomy. An experimental study in the rat. Gastrointestinal propulsion after abdominal surgery is impaired during the postoperative phase. Adrenalectomy as well as only adrenal demedullation prevented the impairment of gastric emptying and small bowel propulsion after laparotomy. In non-laparotomized rats gastric evacuation was significantly increased after adrenalectomy and adrenal demedullation. The results indicate that adrenomedullary activity retards gastrointestinal propulsion not only postoperatively but even in intact rats.


Effect of chemical sympathectomy (6-hydroxydopamine) on gastrointestinal propulsion after laparotomy. An experimental study in the rat. The effect of chemical sympathectomy on gastric evacuation and small bowel propulsion 15 hours after a standardized laparotomy was evaluated. The animals were pre-treated with 50 mg/kg i. v. of 6-hydroxydopamine 15 or 48 hours or 150 mg/kg 48 hours before the evaluation of gastrontestinal propulsion. The treatment did not prevent the postoperative retardation. On the contrary 6-hydroxydopamine in itself seemed to retard gastrointestinal propulsion. In simultaneously adrenal demedullated rats no further retardation was produced by the laparotomy.


Catecholamine infusion and gastrointestinal propulsion in the rat. The influence of continuous i. v. infusions of adrenaline, noradrenaline, noradrenaline and saline on gastric evacuation and small bowel propulsion was recorded. The infusions were given to fully conscious rats. Two differently labelled radioactive liquid test meals were administered directly into the stomach and the duodenum, respectively, via permanent tubes during the infusions. Both gastric evacuation and small bowel propulsion were significantly inhibited under the influence of the infused catecholamines.


Influence of ether anaesthesia and oro-gastric intubation on gastric evacuation and small bowel propulsion after laparotomy. A methodological study in the rat. A model for the simultaneous study of gastric evacuation and small bowel propulsion in the rat is presented. By means of a modification, with both indwelling duodenal and gastric tubes, studies on fully conscious animals were possible. Gastric evacuation and small bowel propulsion were analysed with respect to the effects of ether anesthesia and gastric intubation. The gastric intubation in ether anaesthesia greatly retarded gastric evacuation but left small bowel propulsion unaffected one day after laparotomy. The main factor retarding gastric evacuation appeared to be the oro-gastric intubation procedure. Ether  anaesthesia neither affected gastric evacuation nor small bowel propulsion after laparotomy when the test meal was deposited into the stomach and into the duodenum, respectively, via the permanent tubes.


Effect of adrenergic blockade on gastrointestinal propulsion after laparotomy. An experimental study in the rat. The effects of alpha-adrenergic and beta-adrenergic blockade on gastric evacuation and small bowel propulsion 15 hours after standardized laparotomy were evaluated. No retardation of gastric evacuation after the laparotomy appeared when alpha-receptor blocking treatment with phenoxybenzamine was instituted. Beta-receptor blocking treatment with propranolol did not prevent the retardation of gastric evacuation after the laparotomy. The time of analysis, 15 hours after the laparotomy, seemed to coincide with the period of resumption of normal small bowel propulsion.


Effects of sympatho-adrenal activity and pharmacological treatment on gastrointestinal propulsion in the early postoperative period. An experimental study in the laparotomized rat. Gastric evacuation and small bowel propulsion were greatly retarded two hours after laparotomy in the rat. Adrenal demedullation, chemical sympathectomy with 6-hydroxydopamine or treatment with a cholinesterase inhibitor (Neostigmin), an alpha-receptor blocker (Dibenyline) or metoclopramide (Primperan) did not improve the gastric evacuation. Chemical sympathectomy or treatment with metoclopramide, however, significantly improved small bowel propulsion. A significant reflux of duodenal contents to the stomach was found in several animals treated with the cholinesterase inhibitor or subjected to adrenal demedullation.


Vaginal and cervical cytologic changes following laser treatment. Carbon dioxide laser treatment is a very effective mode of removal of small fragments of tissue from the cervix which causes minimal bleeding and trauma and is followed by rapid healing. Biopsy sections and particularly cytologic preparations obtained from the areas of laser action indicate that squamous and columnar epithelial cells and possibly fibrocytes in the underlying connective tissue are altered, appearing coagulated and elongated similar to cells which have been removed from an area of electrocautery.


Actinomycetes in cervico-vaginal smears: an association with IUD usage. A hitherto undescribed occurrence of actinomycetes in cervico-vaginal smears of IUD users is reported. The morphology of actinomycetes in Papanicolaou stained smears is described. The differential diagnosis and the significance of these observations is discussed.


Comparative cytologic and histologic studies in oral leukoplakia. Comparative analysis of cytologic and histologic results and clinical types of 201 oral leukoplakias has shown: 1) an agreement between cytologic and histologic results in 76.6% of all cases; 2) an occurrence of carcinoma in 32.9% of the erosive leukoplakias in 3.2% of the verrucous leukoplakias, and none in the leukoplakia simplex group; 3) a higher efficacy of cytology in detecting malignancy in the erosive leukoplakia group.


Aspiration biopsy cytology, mammography and clinical exploration: a modern set up in diagnosis of tumors of the breast. Six hundred and two mammary tumors were examined clinically, by mammography and cytology, with a histologic checkup following surgical biopsy. There were 247 cases of malignoma and 355 benign cases. The limited reliability of the individual methods is demonstrated, and it is shown that their combined use can improve the diagnosis. More malignomas are detected, and preoperative diagnosis is made more safely. If all three methods yield identical results, as was the case in 50.2% of the malignant and 32.7% of the benign lesions, the probability of diagnostic error is less than one per cent. With a malignoma thus established, surgical treatment may follow immediately, or irradiation can be started. In benign cases a surgical biopsy may be foregone and further developments may be awaited with due provision for regular control. If the three methods yield conflicting or doubtful results, elucidation by surgical biopsy and histology is indicated.


Needle aspiration of the breast--why bother? Needle aspiration biopsy for the examination of breast nodules is an accurate uncomplicated and rapid procedure. Of 1168 cases so examined, 127 were malignant with abnormal cells in 114. Case studies suggest that this procedure should be utilized in all palpable breast masses.


Identification of abnormal cells in short term monolayer cultures of human tumor specimens. This work was undertaken to verify that when short term monolayer cultures are prepared from human malignant biopsy specimens, the cells which grow are tumor cells and not normal cells from the stroma. A wide range of human tissues, both normal and malignant, was used to obtain monolayer cultures and chromosome spreads were prepared by a modification of standard procedures. The cells were Feulgen stained and DNA values were obtained for cells arrested in mitosis. Metaphase DNA values for normal cells and for cells from a benign tumor were constant, close to the expected value relative to bull sperm, and showed little spread about the mean. Metaphases from malignant cells had abnormal mean DNA values, and generally showed much greater spread about the mean. Results confirm that for cells grown in vitro from tumor biopsies, those which are in the cell cycle and reach mitosis are abnormal and presumably malignant. This is evidence in favor of this type of short term culture as a method for studying the properties of human tumor cells.


Cyanophilic bodies in cervico-vaginal smears. Thirty-six out of 171 (21%) cervico-vaginal smears that manifested pronounced squamous epithelial atrophy contained cyanophilic bodies about the size and shape of parabasal cells. These cyanophilic bodies have been misinterpreted as cancer cells. Patients whose smears contained cyanophilic bodies were likely to be elderly, at least ten years postmenopausal, and free of any gynecologic symptoms or abnormalities except those associated with previous surgery. Smears which contained cyanophilic bodies also contained numerous parabasal cells in various stages of degeneration, objects which closely resembled trichomonads, and a heavy background of granular material. A morphologic continuum existed between all of these elements. The conclusion, therefore, is that cyanophilic bodies, spurious trichomonads and the granular material are all derived from degenerating parabasal cells. It is suggested that cyanophilic bodies develop because of the diminished efflux of exfoliated epithelial cells and mucus associated with squamous epithelial atrophy. The ensuing stagnation of parabasal cells allows them to degenerate to an advanced degree. It appears that as some of the parabasal cells degenerative, their nuclear chromatin becomes widely dispersed throughout the cytoplasm, thereby forming cyanophilic bodies.


Meningeal mycosis fungoides: cytologic and ultrastructural aspects. Mycosis cells were identified in the pre-morbid cerebrospinal fluid of a patient with neurological symptoms and mycosis fungoides (MF). Light and electron microscopic examination at autopsy confirmed leptomeningeal involvement by mycosis fungoides. The cellular morphology of the non-cutaneous infiltrates supports the concept that mycosis fungoides retains a unique histopathology in its dissemination to the viscera. The importance of cerebrospinal fluid cytology in patients with mycosis fungoides is emphasized.


Multispecies schistosomal infections of the female genital tract detected in cytology smears. Egg morphology of Schistosomes affecting man in Africa is described and illustrated with particular reference to the appearance of the ova of S. haematobium, S. mansoni and S. mattheei in Papanicolaou stained smears.


Analysis of tooth marks in a homicide case. Observations by means of visual description, stereo-photography, scanning electron microscopy and stereometric graphic plotting. In 1957 a woman was murdered in Oslo. Her left breast exhibited tooth marks. A man was arrested and sentenced to life imprisonment partly because of the dental evidence. He never admitted guilt and filed a petition for retrial. The present author was appointed as new dental expert. The material consisted of the fixed breast, models of the bite mark and models of the teeth of the convict, and several photographs. By means of visual examination, a magnifying glass, a lens stereoscope and a stereomicroscope characteristic details were noted. Stereoscopic picture pairs were taken, the material was studied by means of scanning electron microscopy and a stereometricgraphic plotting method permitting the outline of the tooth mark or the biting edge of a tooth to be registered in great detail in all three dimensions in the form of a contour map. This method has not previously been applied in the analysis of tooth marks in human skin. These examinations revealed no discrepancies but showed many corresponding characteristic features between the tooth marks and the teeth of the convict, resulting in the conclusion that it is highly probable that the tooth marks in the breast were made by the teeth of the convict.


Cytophotometric studies in suspicious cervical smears. Papanicolaou stained smears of various cervical lesions diagnosed as "suspicious" by routine cytology were reviewed with regard to different cell types leading to this diagnosis. The smears were then submitted to Feulgen hydrolysis and redyed by Acriflavin-SO2 for fluorescence-cytophotometry. In nine of 14 cases measured, the DNA content of all types of "suspicious" cells was increased with DNA modes at euploid levels of 2 n, 4 n and 8 n indicating that the "suspicious" cells in those cases are polyploid. However, in five cases aneuploid DNA-distribution patterns were found similar to those observed in carcinoma in situ or severe dysplasia. Since polyploidization may be considered as a cellular response to higher functional requirement (i.e. inflammation or regeneration) a "suspicious" cervical smear with a polyploid DNA-distribution pattern may reverse to normal cervical epithelium after normal conditions are restored. However, a "suspicious" smear with an aneuploid DNA-distribution pattern should be considered more seriously as being related to a precancerous lesion requiring immediate surgical treatment.


Degenerative disease in the temporomandibular, metatarsophalangeal and sternoclavicular joints. An autopsy study. The right temporomandibular, sternoclavicular and first metatarsophalangeal joints were removed post mortem from 39 subjects. The surfaces of the various parts of the joints were examined and evaluated according to a grading system. Repeated evaluation of the joints showed a good reproducibility of the grading system. Of the 33 temporomandibular joints, 12 showed deviations in shape. Degenerative disease was uncommon and seen in only 3 joints. The total "score for degeneration" showed only a weak correlation with age (r = 0.28, rs = 0.08). Degenerative disease was common in the 35 sternoclavicular joints. All joints except 7 showed degenerative changes. A moderate correlation was found between age and the score for degeneration (r = 0.58). Of the 39 metatarsophalangeal joints only 5 were allotted no points of degeneration. A moderate correlation was found between age and score for degeneration (r = 0.61). No significant differences of degeneration were found between sexes. The coefficient of correlation between the score for degenerative disease of the temporomandibular joint and the degeneration score for the sternoclavicular joint and the toe-joint were r = 0.22 (rs = 0.16) and r = 0.46 (rs = 0.44), respectively. The significant association of degenerative disease found between the toe-joint and the sternoclavicular joint (r = 0.54, rs = 0.54) was reduced (to r = 0.29) when age-dependence was excluded. The degenerative changes described in this material are probably mostly due to local factors.


The cervical epithelial surface. III. Scanning electron microscopic study in atypias and invasive carcinoma in mice. The anatomy of the epithelial surface of the uterine cervix was investigated in 31 mice with scanning electron microscope (SEM). The cervox of 20 mice was painted twice a week during five months with 3,4-benzpyrene (BP) in acetone and in 11 mice with acetone alone. Only two of the 15 acetone or BP treated animals with histologic normal epithelium showed similar structures as those described earlier for the normal cervical epithelium of untreated mice. The remaining 13 animals had regular mosaics, intermediate or cobblestone structures covered with irregular microvilli with or without long, finger-like protrusions. Irregular mosaics, intermediate or cobblestone structures were seen in atypical epithelium. In atypias Grade III and in invasive carcinoma irregular cobblestone structures with cellular overlapping were present. Atypical and invasive carcinoma were usually furnished with irregular microvilli, irregular fragmented microrugae and finger-like protrusions. The proportion of mice having anisovillosis with finger-like protrusions increased with increasing degree of epithelial severity. Since pathologic SEM changes were observed in some treated mice having normal histology the possibility was entertained that alterations at the cellular membrane level may preceed the nucleocytoplasmic changes required for the recognition of atypical epithelium in conventional histologic preparations.


An in vitro method for toxicity evaluation of water-soluble substances. The purpose of the present investigation was to develop a simple method for the evaluation of reversible and irreversible toxic influences in a cell culture system. A cell monolayer established on the bottom of glass scintillation vials was exposed to a toxic substance (phenol). Changes in the DNA synthesis of the cells were utilized as a criterion of toxic influence, and were measured by recording the incorporation of tritium labelled thymidine using a liquid scintillation technique. The exposure of the cells to phenol caused a marked decrease in the rate of DNA synthesis when the phenol concentration was increased from 0.01 to 0.1%. The decrease in the DNA synthesis could be reversed by maintaining the cells in growth medium for 4 hours after the cell-phenol contact. The degree of reversibility was dependent on the cell-phenol contact time, the phenol concentration, and the cell line used. The simple test procedures and the quick and convenient obtainment of results simplify the assay of large test series and make the method particularly useful for screening tests.


The silent period in the masseter muscle of patients with TMJ dysfunction. The silent period (SP) following a jaw jerk elicited during sustained contraction in the masseter muscles has been studied in two groups of subjects, one with and one without, acute and distinct symptoms of TMJ dysfunction. The subjects with acute TMJ dysfunction symptoms showed significantly shorter latency and longer duration of the silent period and the period of their depressed activity (DA) was also significantly longer than in the group without TMJ dysfunction. The duration of the SP of both muscles was symmetrical in about 60% of subjects in each group. This study validates that the duration of the silent period may be a useful diagnostic tool of clinical interest.


Comparison of two surgical methods in combined surgical-orthodontic correction of impacted maxillary canines. The post-treatment periodontal condition of impacted maxillary canines was examined in two groups of patients. In one group (n =34) the teeth were exposed in the mouth after removal of the bone and soft tissue covering of the crown. In the other group (n =22) the bone covering the crown was removed, whereafter the mucoperiosteal flap was sutured back. In both groups the orthodontic treatment procedures were basically the same. The mean treatment duration was 18 months after radical surgical exposure and 22 months after moderate surgical exposure. The teeth were examined 1-2 years after removal of the fixed appliances. Oral hygiene and gingival inflammation were approximately the same in both groups. The palatal pocket was deeper on teeth subjected to moderate surgical exposure, and the depth also varied more. The loss of fiber attachment was not significantly different except on the palatal surface, where it was greater after radical exposure and also varied more. The interdental bone height, which was measured on radiographs, varied more after radical than after moderate surgical exposure.


Tooth mortality and endodontic status of a selected population group. Observations before and after treatment. Tooth mortality and the frequency and distribution of endodontically treated teeth was studied in a Norwegian population group. The pre- and posttreatment situation was thus surveyed in 481 individuals with endodontic treatment. The middle aged and the female patients were overrepresented in the sample. At admittance the mean number of teeth per patient was 22.8, 2.6 of which had been endodontically treated. After comprehensive dental treatment, the corresponding figures were 21.5 and 3.7. During treatment extractions were performed in 48% of the patients, twice as often in the maxilla as in the mandible, 47% of the extracted teeth being molars. At admittance, root fillings comprised 83.5% of the total number of endodontically treated teeth, while pulpotomies were observed in about 15%. Retreatments were performed in 35% of the treated roots and in every other patients.


Postnatal development of the human temporomandibular joint. I. A histological study. Temporomandibular joints from 61 humans, aged 2 days to 27 years, were examined histologically. Four layers of the condyle were studied in detail. The outermost layer was richly vascularised in new-borns but by 3 years of age it had become avascular and contained few cells. In neonates the cartilage layer constituted a large part of the condyle but soon decreased in thickness and by 5-6 years of age it constituted only a thin zone of the top of the condyle. In the proliferative zone, mitoses occurred up to 13-15 years of age. This zone then decreased in thickness; the number of cells decreased, while the amount of intercellular substance increased. At birth, the temporal component was flat and was lined by vascularised connective tissue which became richer in collagen with increasing age. The cartilage layer was lacking in the fossa but was present on the tuberculum. A proliferative zone in this cartilage could be seen up to the age of 17-18 years and cartilage having only few cells was found in adults. Remodelling processes were seen in all components of the joints. The significance of the remodelling seen in the fossa and on the mandibular neck is discussed with relation to condylar and periosteal growth of the mandible.


The effect of calcium hydroxide and fluorides on human dentine. With the aid of scanning electron microscopy and microradiography, 45 teeth including 20 contralateral tooth pairs were studied to assess the effect on human dentine of (1) a 1 minute treatment with 3% NaF, (2) a dressing of Ca(OH)2 and (3) a dressing of Ca(OH)2 and CaPO3F after follow-up periods of 2-8 weeks. After NaF treatment the SEM revealed no sign of obliteration of the dentinal tubules, and on microradiograms no indication of increased density could be registered compared to an untreated control area. Under the calcium dressing the SEM revealed in 13 cases out of 20 (5 cases of 11 intrapair comparisons) a varying degree of constriction of the dentinal tubules. Constrictions varied from one tubule to another and ceased approximately 0.1 mm in the dentine. On the microradiograms no significant difference could be registered between untreated dentine and dentine treated with the calcium dressings. Dressings of Ca(OH)2 a combination of Ca(OH)2 and CaPO3F for 2 months, or a 1 minute treatment with a cavity cleaner containing 3% NaF can thus not be considered to result in a reliable obliteration of the dentinal tubules.


The construction and use of diagnostic standards for primary radiographic caries. The aim was to establish diagnostic standards for primary approximal radiographic caries diagnosis. These were described with reference to ranking of subjects, mean "intermediate" score per subject, which was based on the majority diagnosis recorded by three examiners, and by category of a certainty scale for individual tooth surface scores. The results recorded by two fourth year dental students and two hygienists, when reading 40 pairs of posterior bitewing radiographs of children between 13 and 15 years of age, showed an acceptable level of agreement for ranking of subjects. Agreement was less satisfactory, when comparing the mean scores of these four examiners with the "intermediate" score per subject and with a standard for individual surfaces. The proposed standards do not represent true scores, but serve as guidelines, as they depend on the diagnostic level of the examiners on whose scores the standards are based, and on the diagnostic criteria employed.


The apical level of root fillings.

The apical level of root fillings. The apical level of root fillings made by general practitioners, undergraduate students and an endodontist was compared. In total, 3003 root fillings were grouped morphometrically in three classes. Class A fillings were ending at a distance from the radiographic apex. Class B fillings were ending flush with the radiographic apex or with an overfilling of not more than 1 mm, while class C consisted of fillings with a moderate (1-2 mm) or marked (greater than 2 mm) excess. For 2187 class A fillings the distance from the apical end of the root filling to the radiographic apex was measured to the nearest 0.5 mm. The 531 class B and 285 class C root fillings were given the distance 0.0 mm. A detailed classification of root fillings with regard to their length was then developed by calculating the average distances and standard deviations. A longer apex-distance was observed for root fillings made by the general practitioners than for those made by the undergraduates and the endodontist. Class B and C fillings were infrequently observed among fillings made by general practitioners. Roots from three-rooted teeth had been filled closer to the radiographic apex by the endodontist than by undergraduates. A higher relative number of class C fillings was observed for undergraduates than for the endodontist, while the opposite observation was made for class B cases.


Childhood leukemia in Norway from 1963-1974 with special emphasis on own material. Childhood leukemia in Norway in the period 1963-1974 with special emphasis on own material. Acta Paediatr Scand, 65:529, 1976. -A nation wide up-to-date survey of childhood leukemia in Norway including 499 cases in the period 1963-1974 is presented. The median survival for all cases was about one year. Around 20% of the 499 cases were still alive in Novemeber 1974. Twenty-five of the children were off therapy without any signs of relapse. In our own material thirteen of 42 cases of acute lymphatic leukemia (ALL) were still in primary remission after 3-9 1/2 years. Twelve of them were still off therapy and none had relapsed. Best results were achieved in the 31 cases of ALL followed closely by us all the time. The number of cases in continuous complete remission and the median survival rate in this series compares favourably with the last two studies published by the St. Jude group.


Myocarditis associated with Echo type 7 infection in a leukemic child. A 3 1/2-year-old boy, during the course of acute lymphocytic leukemia presented clinical, roentgenological and ECG signs of myocarditis, which disappeared completely within 1 1/2 month. ECHO type 7 virus was isolated from the faeces during the acute stage of the disease and rise in ECHO 7 neutralizing antibodies was demonstrated in paired sera of the patient. This unusual pathogenicity of ECHO 7 virus could be explained with the impairment of the host resistance induced by leukemia and immunosuppressive therapy.


VI. Somatic pubertal development.

VI. Somatic pubertal development. The pubertal development of 212 randomly selected Swedish urban children has been investigated as part of a prospective longitudinal study of growth and development. The timing and pattern of pubertal changes were in agreement with the findings in other contemporary studies. The good agreement with data on pubertal development reported in other investigations of Swedish children indicates that the present sample was representative of contemporary Swedish children. Two procedures of assessment of secondary sex characters - clinical examination and whole-body photography - have been compared and contrasted. A clinical examination is less laborious and resource-consuming and also has psychological advantages but should be supplemented in boys by the estimation of testicular volume (orchidometry). In girls the two methods have similar precision and reliability. The first pubertal changes may be observed before 9 years in girls (breast development) and before 10 years in boys (genital development). On average the first change takes place about one year earlier in girls than in boys. Peak height velocity (PHV) is an early event during puberty in girls and a relatively late event during puberty in girls and a relatively late one in boys, the sex difference in mean age being about two years. In girls, menarche is a late event, always occurring after PHV. At the age of 13-14 years some boys and girls have not yet begun theri pubertal development, while others have reached the adult stage.


VII. graphic analysis of biological maturation by means of maturograms. The attainment of various maturity criteria has been analyzed by probit analysis using a logarithmic time concept (logarithmic conceptional age). The resulting probit lines have been plotted in charts-maturograms -using the x-axis as an age-scale and the y-axis as a marker of standard deviations scores. The slope of the probit lines is in such a direction that early occurrences are assigned positive SD-scores and late ones negative scores. The maturity criteria can be divided into two catergories- sequential (e.g. number of erupted teeth) or non-sequential (e.g. the menarche). When examined a child is observed to be within a certain stage of maturity. The observation can be evaluated with a cross-sectional or a longitudinal approach. The latter requires repeated examinations. The evaluation will result in a relative scoring (SD-scores) of the observations, i.e. a relative maturity level is calculated. The practical procedure has been exemplified for pubertal and dental development. Two sets of charts-pubertograms-have been constructed for the assessment of pubertal development in each sex. For dental development there are also two sets of sex-specific charts -dentograms- one for the deciduousdentition and one for the permanent dentition. Individual patterns of maturation can be analyzed by plotting the estimated SD-scores of the various maturograms. Individual variations in the trends of the estimated SD-scores may be an indication of different velocities of maturation.


I. physical growth from birth to 16 years and longitudinal outcome of the study during the same age period. Physical growth of 212 randomly selected Swedish urban children has been investigated from birth to sixteen years as part of a prospective longitudinal study of growth and development. Twenty body measurements have been taken at specified ages. In all, about 66,000 values of measurement have been recorded. At sixteen years 179 (84.4%) ofthe original children were still regularly being followed. Thirty-three (15.6%) of the 212 children left the study at various ages. A comparison between the children who left the study and those remaining did not show any significant differences in physical growth. All recorded data have been scrutinized in order to detect errors of measurement or administrative errors. Such values have been corrected or excluded. The editorial procedures also included the adjustment of each measurement to exact target age, interpolation of missing examinations and exclusion of children with an aberrant growth pattern. When comparing the present study with older Swedish investigations a secular trend was established, while there was good agreement with other contemporary Swedish investigations. Growth charts of distance values of various body measurements are presented. In the charts standard deviation lines (+/- 1, 2, 3 SD) and mean values are plotted. A logarithmic time scale (logarithmic conceptional age) has been used for both practical and theoretical reasons. When evaluating individual values in comparison with reference values standard deviations should be used rather than centiles. With this approach even grossly deviating values can be evaluated. Longitudinal follow-up of individual children and comparison of children of different ages will also be facilitated by this approach.


II. evaluation of biological maturation by means of maturity criteria. Maturation may be conceived of as a series of gradual transformations through time going on in the human body from conception to death as part of the life cycle of the organism. Maturity should be used as the general concept of any specified stage - or level -during the process of maturation. The maturity level can be assessed by examining the attainment of various maturity criteria relating to dental development, skeletal development and pubertal development. In a group of children the attainment can be analyzed by probit analysis using a logarithmic time concept (logarithmic conceptional age). This is exemplified by the attainment of breast stages according to Tanner (10) in the girls of the present study. When examined a child will be rated as being within a certain stage of maturity. The least advanced and the most advanced maturity level consistent with the rating can be established using the probit lines. The relative maturity level is then expressed in SD-scores of the Gaussian fitted distributions of age at attainment of various maturity criteria in a reference group of children. This is a laborious approach when there are many series of maturity criteria, e.g. in the assessment of skeletal maturity. In such cases each stage is instead given a certain maturity score. The individual maturity level is calculated by averaging the maturity scores of the stages, which are then evaluated in SD-scores by comparing with the Gaussian fitted distribution of averaged maturity scores at that age. In both approaches discussed in this paper the evaluation of individual maturity is made with a relative scale of measurement. Accordingly, the rate of maturation can only be assessed indirectly.


III. dental development from birth to 16 years. Tooth eruption in 212 randomly selected Swedish urban children has been investigated from birth to 16 years as part of a prospective longitudinal study of growth and development. The ages and the order of eruption of the deciduous and permanent teeth were in agreement with those reported in other contemporary studies. The good agreement with another longitudinal study of the tooth eruption of Swedish children born during the same period is an indication that the present sample was representative of contemporary Swedish children. In the deciduous dentition a probable male advancement was found, while girls were consistently the advanced sex as regards the eruption of permanent teeth. Sex differences have also been found in the relation between dental development and other criteria of somatic growth and development. The correlations were low or moderate with, in general, higher values for girls than boys. A positive association with somatic growth was observed both for the deciduous and the permanent dentition but with intriguing sex differences for various body measurements.


Hypokalemia in children with leukemia in relapse. Eight children with acute leukemia in relapse were hypokalemic during their hospital course. All had accompanying hypophosphatemia, and three had mild metabolic alkalosis. Potassium chloride supplementation in each case resulted in resolution of the electrolyte and acid-base disturbances. These findings were not present in patients with conditions newly diagnosed or those in remission. The pathogenesis of the electrolyte and acidbase disturbances was not evident and was not related to antibiotic or cytotoxic drug therapy, but may have been related to the patients' poor nutritional status. Seven of the eight patients died within six months of the hypokalemic episode. Hypokalemia may be a common accompaniment of terminal leukemia.


Ultrastructural changes in tension zones of rat molar periodontium incident to orthodontic tooth movement. The purpose of this study was, by introducing transmission electron microscopy, to clarify fine details of tissue reactions in the periodontal ligament on the tension side. A preliminary investigation was undertaken on nine rats in which experimental tooth movement lasted 2 days, 14 days, and 28 days. It was hoped that these new observations might help in the planning and directing of further studies. A marked increase of interstitial spaces between the formed ligament structures of the periodontal ligament was characteristic of the initial phases of tension. The cells and the endoplasmic reticulum within the cells were spindle shaped and oriented in the direction of strain. Occasionally, collagen fibrils were observed within the cytoplasm of fibroblasts. During experimental tension a higher prevalence of elastic fibers was observed and new details of the reaction of collagen fibrils were obtained. The new cementum and bone deposited during the experiment were studied. The preliminary study indicated that electron microscopy may become a valuable tool for the study of the tension side.


Measurement of tooth movement.

Measurement of tooth movement. 1. Tooth movement relative to the alveolar bone can be precisely described only by superimposing on fixed points in the bone. Implants are the best known way today. Over short-term studies laminagraphy and the use of bony trabeculations are also useful. Remodeling occurs extensively on bony surfaces, making them too labile for use as stable landmarks. To project small amounts of tooth movement based on the use of such methods is so questionable as to represent little better than a guess or a clinical impression. 2. Growth can be separated into vertical and anteroposterior vectors with respect to the dentition. Since the occlusion is the concern, orientation of vertical and anteroposterior vectors to the occlusal plane is a reasonable baseline. The vertical and anteroposterior dental changes may not show a linear relationship in the anterior and posterior parts of the mouth when jaw rotations are occurring. 3. Growth can be disproportionate in either the vertical and/or the anteroposteroir plane of space. If the vertical increments of the anterior face differ from the vertical increments at the posterior face, mandibular rotations occur. This growth is accompanied by dental compensations that tend to mask the rotation. Therefore, open bite and deep bite are frequently skeletal growth problems. 4. Disproportional forward growth of the maxilla or mandible in an anteroposterior direction can lead to Class II or III relations. The growth that leads to Class II or Class III is accompanied by dental migrations that tend to mask this disproportionate growth. Orthodontic treatment of growth disproportionalities usually represents attempts to make the teeth further compensate. If surgical options are elected, the dental compensations should be removed prior to surgery in order to achieve a full surgical correction. 5. The teeth tend to move and grow in the opposite direction of the growth disproportionality. The teeth tend to mask the disproportionality. Thus, in an open bite, the incisors tend to move vertically further than in deep bites. Vertical imbalances may be more difficult to mask. Backward rotation of the mandible requires more vertical movement at the incisor than at the molar just to maintain vertical incisor relationships.


Effect of experimental microglossia on craniofacial growth. The present experiment provides data on the morphogenetic effects of experimentally produced microglossia (by glossectomy) on the maxillofacial skeleton of the rat. Nineteen males and nineteen females subjected to this surgical procedure were compared, using an analysis of variance, with an equal number (thirty-eight) of nonoperated littermates of both sexes, which served as a control group. The surgical procedures were performed on the animals when they were 21 days old. They were killed 64 days later, at the age of 12 weeks, or at the end of the growing period. It was demonstrated that the activity of different proliferating maxillofacial sites was significantly reduced (p less than 0.01 and 0.001) in all three dimensions. This affected both the basal and alveolar bones at the same time.


Infections or neoplasm as causes of prolonged fever in cancer patients. Thirty-six consecutive patients with cancer who met the classical criteria for fever of unexplained origin (FUO) were identified. A total of 18 patients had infections including all 12 with leukemia, four of 12 with Hodgkin's disease, and two with solid tumors. Fungal infections were found in nine: histoplasmosis, three; candidiasis, three; and aspergillosis, systemic sporotrichosis, or cryptococcal meningitis, one each. Six patients had unresolved pyogenic infections and one had tuberculous pericarditis. Two others had viral etiologies. Granulocytopenia was significantly more common in the FUO patients with documented infections. Clinical or laboratory abnormalities suggesting involvement of a specific organ or organ system provided important clues indicating infections. Morphological examination of biopsy specimens, with cultures, was the best method for diagnosis. In 18 patients, 12 with lymphomas and 6 with solid tumors, only the neoplasm appeared responsible for the fever. In these patients there was a paucity of abnormalities indicating organ system involvement with infection. Regardless, physicians' diagnostic efforts should not be deterred in such patients. Repeated thorough evaluations for infection are warranted.


Premolar enucleation.

Premolar enucleation. A study was made on 27 cases where enucleation of four first premolars was performed simultaneously without introduction of mechanical devices to influence space closure. The results suggested that: 1. Enucleation of premolars can be used to minimize the severity of crowding in arch-length deficiency cases. 2. There is no damage to the remaining teeth and alveolar process when enucleation is accomplished with good surgical technique. 3. The average amount of lingual tipping of the mandibular incisors in approximately four years subsequent to the enucleation procedure was 4.1 degrees. 4. This amount of lingual tipping compares quite favorably with the amount of lower incisor uprighting experienced during growth and could not be considered excessive. 5. The mandible does tend to rotate in a counterclockwise manner following enucleation of four first premolars without appliance therapy. This rotation was considered significant in comparison with the amount of rotation that could be expected from an untreated sample. 6. If orthodontic treatment is planned, the enucleation of the manddibular second premolars in borderline extraction cases to avoid excessive lingual tipping of the mandibular incisors would seem to be questionable. 7. Various combinations of enucleation and tooth extraction may be helpful in treatment planning. 8. With judicious timing the enucleation of four first premolars can minimize the severity of the malocclusion  simplifying appliance therapy if proper diagnosis and good surgical technique are employed. 9. Although conventional serial extraction may accomplish similar ends, it would appear that enucleation would offer some advantages in terms of autonomous adjustment of the mandibular incisors and root positioning of mandibular cuspids. 10. Enucleation cases usually require fewer traumatic surgical procedures and less supervision by the orthodontist. 11. The parents should be informed that serial extraction procedures including enucleation may simplify but will not eliminate the need for appliance therapy.


Anterior open bite and oral port constriction. Intraoral air pressure and rate of oral airflow were measured simultaneously during fricative sound production in ten subjects with anterior open bite and ten subjects with normal occlusion and speech. From these measurements the area of oral port constriction was calculated and the values compared within and between the two groups. Findings revealed that: (1) The area of oral port constriction was very consistent and reproducible in subjects with normal speech production and normal occlusion. (2) The area of oral port constriction was significantly larger in open-bite subjects compared with control subjects for all sounds. (3) Severe anterior open-bite subjects with a vertical defect over five millimeters were found to produce significantly larger oral port openings than those with only moderate open bite (3-5 mm) for most sounds. (4) A direct correlation between the degree of open bite and the area of oral port constriction was found. As the amount of open bite increased, the area of the oral port increased, especially in the severe open-bite group (5 mm and over).