Disseminated necrotizing leukoencephalopathy: a complication of treated central nervous system leukemia and lymphoma. This report describes a form of disseminated necrotizing leukoencephalopathy that has been observed in four children with acute lymphoblastic leukemia, and one child with Burkitt's lymphoma terminating in a leukemic phase. In addition to systemic vincristine, cytosine arabinoside, cyclophosphamide, and steroids, these patients received courses of intrathecal methotrexate, cytosine arabinoside, and hydrocortisone, because of meningeal tumor cell infiltration. Whole brain radiation was also given either before or during intrathecal therapy. Three of the children had a progressive irreversible neurologic illness, which developed either at or shortly after the completion of combined triple intrathecal therapy, death ensuing approximately 2 months later. The neuropathologic lesions consisted of discrete multifocal necroses of coagulative type, apparently extending by confluence, and disseminated in the cerebral white matter in a random manner. In one case, extensive symmetrical demyelinating and necrotizing lesions involved the centrum ovale bilaterally. There was a remarkable absence of inflammatory cellular response and a relative paucity of macrophage reaction, with usually little or no tissue breakdown. In addition to demyelination and glial cell loss, there was striking axonal damage, with conspicuous axonal swelling both within and around the necrotizing lesions. The surrounding white matter showed focal status spongiosus and a moderate astrocytic response. Vascular fibrinoid necrosis was inconstant and, except in one case, rarely observed. The possible causal relationship of these lesions to combined triple intrathecal antimetabolite therapy and brain radiation is discussed.


Intracerebral calcifications appearing during the course of acute lymphocytic leukemia treated with methotrexate and X-rays. The authors present the case of a child aged 7 years who suffered from relapsing acute lymphocytic leukemia. Treatment consisting mainly of oral and intrathecal methotrexate and x-ray therapy produced remission of the hematologic symptoms. Three years after the onset of the leukemia, mental deterioration gradually appeared. Radiography of the skull revealed diffuse bilateral calcium deposits in both cerebral and cerebellar hemispheres. Four years after the onset of the disease, a hematologic relapse occurred. Behavioral disorders became more severe and the child died after a period of seizures and unconsciousness. The main pathologic data obtained by the study of a brain biopsy and after a complete postmortem examination consisted of calcifications located bilaterally in the cerebral and cerebellar cortex. No signs of leukemia were present. Cerebral calcification is an extremely rare complication in the course of the therapy of lymphocytic leukemia. Its possible causes are discussed.


Sequential therapy for induction and maintenance of remission in acute myeloblastic leukemia. A total of 114 previously untreated patients with myeloblastic leukemia was included in a sequential therapy protocol. Daunorubicin, vincristine, and prednisone were employed for the first 3 weeks, followed by two or more 5-day courses of cytosine arabinoside and 6-mercaptopurine; there was a 5-day rest between courses. Maintenance therapy was as follows: the continuing 6-mercaptopurine and methotrexate treatment was interrupted every 30 days for sequential reinforcement courses consisting of one dose of daunorubicin and vincristine and 7 days of prednisone, or by a 5-day course of cytosine arabinoside plus 6-mercaptopurine. Of the 114 patients, 48 obtained complete remission, 14 had partial remission, 16 failed to respond, and 36 died during the course of treatment. The remission rate in children (under 16) was 57%; in adults (16-45) 54%; and in those over 45, 19%. The difference in the incidence of complete remission in patients under 45 and those over 45 was statistically significant (p less than 0.01). The median duration of complete remission was 8 months: 12 months in children and 5 months in adults. The over-all survival rate was 4 months: 13 months for patients with complete remission, 4 months for those with partial remission, and 1 month for patients who did not respond to therapy. The difference in survival of those with complete remission and all the others was significant (p less than 0.01).


Fibrinogen survival and fibrinolysis in acute leukemia. Fibrinogen survival using 125I-labelled homologous fibrinogen was studied in 17 adults with acute leukemia. Five patients in complete remission had normal fibrinogen survival and turnover rate. Five of 6 patients undergoing induction therapy and 4 of 6 in relapse had shortened fibrinogen survival; the turnover rate was increased in all 12 patients. Nine of 12 patients with active disease had elevated levels of fibrinogen degradation products in the serum. Serial coagulation studies did not support the diagnosis of overt disseminated intravascular coagulation. There was no correlation between the morphological type of leukemia, chemotherapy, the presence of fever and sepsis, or liver dysfunction and fibrinogen survival. Other possible causes of the accelerated fibrinogen turnover in patients with active disease are discussed.


Meningeal leukemia after blastic transformation of chronic myeloid leukemia. In two patients with blastic transformation of chronic myeloid leukemia complete remission was induced, but meningeal leukemia subsequently developed. The recognition of blast cell crisis as the presenting feature of chronic myeloid leukemia is discussed, together with treatment of this condition and its rare complication, meningeal leukemia. The development of meningeal leukemia in this disease is almost certainly due to the increased survival that has been produced by advances in therapy for blastic transformation.


Management of the acute abdomen in children with leukemia. With the increase in remission and survival in children with acute leukemia, the complication of acute abdomen has become increasingly important in the total care of these children. A total of 286 children with acute leukemia was treated at Memorial Hospital between 1966 and 1971. Sixteen or 5.6% of these children developed an acute abdomen during the course of their disease. During the same period, many other children developed symptoms and signs mimicking an acute abdomen. Of the 9 children treated surgically, 5 were long-term survivors. Two children treated conservatively died, and 5 patients were diagnosed at autopsy. Prognosis was better in those patients in remission at the time of surgery, and where remission was maintained by immediately restarting antileukemic chemotherapy. A more aggressive surgical approach to the acute abdomen, combined with careful supportive measures, is further adding to the numbers of long-term survivors in childhood leukemia.


Primary fibrosarcoma of bone. A clinicopathologic study of 130 patients. One hundred thirty patients with histologically verified primary fibrosarcoma of bone, unassociated with any pre-existent benign bone condition, were treated at Memorial Sloan-Kettering Cancer Center between 1918 and 1973. This series of cases represents approximately 5% of primary malignant bone tumors treated in our institution. Eighty-nine of the lesions were medullary or central in location, and 41 were periosteal or peripheral. There was a nearly equal sex distribution, and a mean age of 38 years ranging from 4 to 83 years. This lesion exhibited a strong predilection for long bones, with the most common location being the femur (43 cases), humerus (16 cases), and tibia (12 cases). In 19 instances, bones of the head and neck area were the primary sites. The roentgenographic differential diagnoses included osteolytic osteogenic sarcoma, malignant giant cell tumor, metastatic carcinoma, or solitary plasma cell myeloma. Major ablative surgery was the primary method of therapy. Amputation was performed, yielding the best curative results in high-grade tumors, while radical local excision sufficed for most low-grade periosteal fibrosarcomas. Thirty-four percent of the patients survived 5 years (27% medullary and 52% periosteal), while 28% were alive after 10 years (20% medullary and 48% periosteal). These survival rates provide further evidence that fibrosarcoma of bone is a distinct clinicopathologic entity and not a variant of osteosarcoma, which carries a much poorer 5-year survival rate of approximately 17%.


The treatment of acute childhood leukemia: predictions for the future based on extrapolations from  the past. Further progress in the treatment of acute leukemia involves a careful assessment of host and disease factors in each child and the selection of a therapeutic regimen which interacts with these factors to provide the maximum chance for survival. For some children, this therapy can be carried out in the community by expertly trained hematologist-oncologists; for others, the best treatment will involve clinical research at a center. Such a general approach has the best chance of fulfilling the optimistic survival projections made by the President's Cancer Panel in 1973 for acute lymphocytic leukemia.


Fiberscopic methods for assessment of velopharyngeal closure during various activities. Fiberscope NPF, developed to observe velopharyngeal movements easily, enables a direct visualization of the soft palate, lateral and posterior pharyngeal walls under the physiological conditions. It is most useful for the diagnosis of velopharyngeal inadequacy. It is very important that a patient himself can observe velopharyngeal movements through the eyepiece of the fiberscope in order to do self exercise.


Growth and changes in maxillary arch form in complete unilateral cleft lip and cleft palate children. This study aims at the comparison of growth changes of the maxillary arch of 62 normals and 87 complete unilateral cleft lip and cleft palate subjects. This is achieved by measuring their maxillo-facial models, which will aid in clarifying such questions as: when and where the maxillary growth inhibition will occur, and the several aspects of growth-change. Patients with complete unilateral cleft lip and cleft palate were classified into four stages: 1) six month old infants before lip and palatal closure; 2) two year old children, lip repair at six months of age; 3) three year old children, lip repair at six months and palatal closure at two years; 4) four year old children, with repairs as in stage 3. Normal subjects were also classified into four stages, to match the cleft group by age and body weight. Impressions were taken for each patient's upper jaw and upper face simultaneously under general anesthesia, and the maxillo-facial model was made. Results obtained were as follows: (1) In the normal group, the forward and downward growth of the anterior alveolar region increased considerably between stages 1 and 2 and stages 3 and 4. The growth of the anterior alveolar arch was slight during all four stages. The depth and width of the retromolar point increased gradually through all four stages, and measured the growth of the posterior alveolar region. (2) In the cleft group: at stage 1 the anterior end of the larger segment was protruded and both the larger and smaller segments, especially in the anterior region, were laterally dislocated. The height of the anterior alveolar region was found to be noticeably less than that of the normal group. At stage 2 the growth inhibition in depth and height was noted in all the alveolar points of the cleft group, especially in the anterior alveolar region, in comparison to the normal group. At stage 3 the depths in all alveolar points decreased, but no significant difference was found when compared to stage 2. However, the increase in heights was marked. At stage 4 the depths and heights of alveolar points in the cleft group were found to be smaller than those of the normal group.


Acoustic features of pharyngeal /s/ fricatives produced by speakers with cleft palate. Acoustic features of pharyngeal /s/ substitutions spoken by persons with cleft palate were measured using digital computer processing and analysis techniques. Average short-time spectral characteristics of pharyngeal /s/ sounds produced by four speakers with cleft palate were compared with spectral features of normally gestured /s/ sounds spoken by two normal speakers. The output spectral characterized by a set of distinctive acoustic properties that differed markedly from normal /s/ sounds gestured in the front of the mouth. One consistent feature of pharyngeal /s/'s was the presence of multiple spectral maxima. Pharyngealization of /s/ consonants gave rise to spectral outputs with energy maxima appropriate to high F1 values which were relatively close to F2, as well as to relatively strong, low frequency excitation of F2 speakers with cleft palate were, in general, comparable to those of /h/ fricatives spoken by speakers of Arabic.


Structural goals in craniofacial surgery. Major craniofacial abnormalities can be considered as a group for purposes of operative planning. Known normal relations define what is abnormal and indicate goals to be achieved with the craniofacial operative procedures. The principle syndromes with significant facial structural changes amenable to such surgical corrective procedures are craniofacial stenoses, hypertelorism, mandibulofacial dysostoses, median facial clefts, residua of encephaloceles, and trauma. Deformities primarily involve the middle and upper thirds of the face. In planning, abnormal relations and structures must be clearly defined utilizing patient examination, x-rays, dental study models, and photography. Standards of norm indicating goals for the corrective procedure are also based on studies using these tools, data from previous publications, and measurements directly from skulls. Precise measurements about the orbits and maxillary-mandibular relation are the keystone for planning. Soft tissue, nose, and ear alterations are based on already widely known concepts of norm and symmetry. Bony interocular distance, medial intercanthal distance, height and width at the orbital rim of the bony orbits, orbital shape, orbital axis, and orbital volume as determined by measurement with an exophthalmometer are useful in determining what is to be done about the orbits. Cribiform plate level, anterior cranial base, length and contour, and size of the zygomatic arches are important dimension considerations. Paranasal sinus size and location is important. These considerations are essential prior to any major facial structural changes.


Transverse pharyngeal flaps: a dynamic repair for velopharyngeal insufficiency. During the past three years, forty-eight patients, ranging from five to thirty years of age, have undergone bilateral transverse pharyngeal pedicles to the palate. Thirty-nine patients had not had pharyngeal flaps prior to this procedure and the remaining nine patients had failure of production of acceptable speech after undergoing inferiorly or superiorly based flap operations. One patient suffered separation of the suture line. Dramatic improvement in speech has been noted in the remaining forty-seven patients. While it is difficult to compare the speech results to other procedures, a significant finding has been achievement of satisfactory speech in all nine patients referred for correction after failure with superiorly or inferiorly based flaps. Muscle survival, as evidenced by consistent electromyograph studies, demonstrated functioning double pharyngeal sphincters to control airway shunting during rapid spontaneous speech. The use of transverse pharyngeal flaps offers an obturator effect and the added benefit of active muscle for airstream control in speech function to correct nasality in cleft palate patients. Preservation of the integrity of the neuromuscular component of these pedicles assures survival of the tissue mass for its obturator effect. A modified procedure has been adapted for patients with failure of production of acceptable speech, after using inferiorly or superiorly based flaps.


Prediction of velopharyngeal competency. The question posed in this study was, are there measures which are predictive of the need for further palatal management? Articulation scores, lateral x-rays and clinical judgments of velopharyngeal competency were examined for 75 subjects in retrospect to determine their predictive value. Each of the measures resulted in at least 90% appropriate predictions. The combination of articulation score and lateral x-ray rating appeared to be the best predictor for this particular sample in that subsequent treatment was correctly predicted for 96% of the subjects. We view this study as a preliminary attempt in the prediction of further management and in future studies will consider age at the time of prediction and other possible predictor variables.


Selective movement of the lateral aspects of the pharyngeal walls during velopharyngeal closure for speech, blowing, and whistling in normals. The frontal and lateral cinefluorographic views of five normal subjects performing speech, blowing, and whistling tasks were synchronized in order to observe where the greatest degree of medial movement in the lateral aspects of the pharyngeal walls was occurring in relation to structures observed in lateral view. The results of the synchronization procedure indicates that for all five subjects, maximum medial excursion in the lateral walls of the pharynx occurred at the level of the full length of the velum and hard palate, well below the levator eminance. It is hypothesized that this observed interaction may be due to the select contraction of those fibers of the superior constrictor muscle which enter the velum via the lateral walls and those fibers attached to the pterygoid plates as well as levator muscle activity. It is also suggested that definitive physiological data must be obtained from further study of combined EMG and fluoroscopic procedures.


A telefluoroscopic study of lingual contacts made by persons with palatal defects. Telefluoroscopic tapes were viewed to obtain evaluations of lingual contacts during the production of six consonant sounds by 69 subjects who had a history of cleft palate or velopharyngeal inadequacy. Using phonetic textbook descriptions of normal lingual contacts as standards, these observed contacts were judged to be either normal or deviant in placement, and direction of deviation was noted. Clinical records of subjects afforded medical and surgical histories as well as evaluations of the subjects' intelligibility, nasal resonance and nasal emission at the time of the taping. Evaluations of velopharyngeal adequacy made from these tapes were also available. Based on the results of this study it was concluded that some but not all speakers who have a history of palatal problems use deviant lingual contacts to produce consonant sounds. The use of deviant lingual contacts does not appear to be related to the type of palatal problem, but is significantly related to the adequacy of the velopharyngeal mechanism for speech. Those with adequate mechanisms show the least use of deviant lingual contacts, subjects with borderline adequacy show a greater use, and those with inadequate closure show the greatest use of deviant contacts. There is a significant relationship between the use of deviant lingual contacts and the presence of abnormal intelligibility and abnormal nasal resonance. The tendency toward the use of deviant lingual contacts by those with velopharyngeal insufficiency suggests that these are compensations for the inadequate valving. These compensations may increase both the intelligibility and nasal resonance problems caused by the inadequate valving. Subjects who achieved adequacy of velopharyngeal mechanism for speech before the age of mastery of consonant sounds showed significantly less tendency to use deviant contacts than those who never attained adequacy. This was reflected in intelligible speech and less tendency toward abnormal nasal resonance. It is suggested that when velopharyngeal adequacy cannot be achieved through early surgical intervention, speech therapy may be indicated to promote the development of potentially adequate articulatory patterns and to discourage the development of compensatory mechanisms.


Oral language skills of adult cleft palate speakers. This study investigated selected oral language skills and their relationship to speech intelligibility in forty cleft palate and normal adult speakers. Connected speech samples were analyzed to determine spoken language status which included response length, grammar or syntax, and vocabulary size. The subjects were judged for intelligibility by two groups of listeners: sophisticated and unsophisticated. It was concluded: (a) cleft palate speakers used shorter responses and were more consistent in their language usage; (b) there were no significant differnences in syntax and vocabulary; (c) for cleft palate speakers there was a relationship between intelligibility and language measures; (d) unsophisticated listiners were more consisitent in intelligibility judgements, and (e) sophisticated listeners rated cleft palate speakers poorer than unsophisticated listeners.


Polyglutamate forms of folate in resting and proliferating mammalian tissues. 1. Tritiated folic acid (pteroylglutamic acid) was injected into rats whose livers were undergoing regeneration after partial hepatectomy, and into normal control rats. 2. The major form of labelled liver folate was found to be pteroylpentaglutamate in both hepatectomized and normal rats and there was no difference in the proportion of pteroylpentaglutamate to other forms of folate in the regenerating or resting liver. 3. Folate concentrations were also measured in leucocytes from normal and leukaemic patients. 4. Pteroylpolyglutamates constituted the main form of folate in both sets of cells. There was again no difference in proportion of pteroylpolyglutamate to pteroylmonoglutamate forms of folate between normal mature cells and primitive blast cells. 5. It is therefore suggested that pteroylpolyglutamates, which constitute nearly all the folates in cells actively synthesizing DNA and protein as well as in resting cells, probably act as the coenzymes in vivo for the folate-dependent reactions in DNA, RNA and protein synthesis in mammalian systems.


[A simple photometric test for the routine determination of delta-aminolaevulinic acid in urine for the control of lead exposure]. A simple and accurate method for determining urinary concentration of delta-aminolaevulinic acid (delta-ALA) is described. It is based on an improved application of the principle, first introduced by Tomokuni and Ogata, that a colourless pyrrole derivative is produced by the action of acetic acid ethyl ester on delta-ALA, which develops a violet colour on addition of Ehrlich's reagent. The influence of interfering substances was found to account for 20 plus or minus 3% in all examined urines samples. It is, therefore, recommended that an aqueous delta-ALA standard be prepared which contains only 80% of the concentration used in the calculation. Exact values are obtained in this way and the need for setting up a calibration curve by adding delta-ALA is avoided.


The anterior crossbite: report of cases. Some malocclusions, seen by the general pragtitioner, should be treated early with uncomplicated procedures. Simple anterior crossbites that do not involve other complications lend themselves to this type of interceptive treatment. Criteria for successful treatment include adequate space for movement of the involved teeth and opening of the bite to facilitate this movement. More complicated cases will necessitate further orthodontic study and techniques.


Oral ulcerations associated with indomethacin therapy: report of three cases. Oral ulcers developed in three edentulous patients who were receiving indomethacin (Indocin) therapy for rheumatoid arthritis. The lesions healed after reduction or discontinuation of the medication. These ulcers are attributed to the combined effects of the indomethacin and the dentures on the oral tissues. In older patient populations, drug-induced oral lesions must be ruled out before a dental prosthesis malfunction is implicated.


A descriptive survey of signs and symptoms associated with the myofascial pain-dysfunction syndrome. The signs and symptoms of 56 patients with myofascial pain-dysfunction syndrome were tabulated. Patients were classified by age, sex, education and professional background, frequency of complaints of pain, occlusal relationships, oral habits, and specific muscles that were tender on palpation. A coincidence of stress and tension and the onset of myofascial pain was observed. It is suggested that myofascial pain may be more common in women than in men. Muscle tenderness was associated particularly with the masseter, temporal, and lateral and medial pterygoid muscles.


Determination of optimal time lapse for recall of patients in an incremental dental care program. The study was designed to determine the optimal recall interval for persons, ages 5 to 19 years, in the Indian Health Service dental care program and to determine the optimal number of persons to whom maintenance care could be provided at various recall intervals. Analyses used to determine the optimal number of persons and the optimal recall period are described. As expected, the number of services required increased as the maintenance interval increased. The maximum number of persons can be treated on a recall period of 25 to 27 months, but during this time persons 5 to 9 years old had significant increases in the number of services required. Therefore, the optimal recall interval for persons in this age group is to 10 to 12 months. The optimal recall interval for persons 10 to 14 years old is 25 to 27 months, and for persons 15 to 19 years old, 22 to 24 months.


Lingual mandibular bone concavity.

Lingual mandibular bone concavity. The lingual mandibular bone concavity is not pathognomonic but is a radiographic bone entity. The origin of the entity and the histologic picture of the contents found within the concavity are probably related to the size and growth of the structures located in the submandibular space and the contiguous area. This accounted for the presence of normal submandibular space tissue contents in this patient and in nine of the ten patients whose conditions are reviewed in the literature. The question of whether a surgical exploration is indicated should be decided in terms of each individual case by the oral surgeon. However, only by performing a surgical exploration and submitting the tissue contents for a histopathologic examination can an accurate diagnosis be made. The general practitioner of dentistry should be aware of this bone entity and be prepared to discuss the condition with the patient and to refer the patient for exploration of the area if appropriate.


Laboratory evaluation of gophacide as a rodenticide for use against Rattus norvegicus and Mus musculus. Laboratory tests were carried out to assess the efficacy of gophacide as a rodenticide against the Norway rat (Rattus norvegicus) and the house mouse (Mus musculus). Results of feeding tests with wild animals suggest that the compound would be more useful against mice than rats, and that 0.3% would be a near optimal concentration for field trials for both species. The hazards of using gophacide as a rodenticide are discussed.


Field trials of the rodenticide gophacide against wild house mice (Mus musculus L.). The acute rodenticide gophacide was tested against urban infestations of the house mouse (Mus musculus L.) and treatment success was assessed from the results of census baitings conducted before and after each treatment. Seven of eight populations of mice living in premises where alternative food supplies were limited were successfully controlled when medium oatmeal bait containing gophacide at 0.1% was laid directly for 4 days. In further treatments against mice inhabiting more complex environments and having greater access to other foods, the performance of gophacide at 0.1% and at 0.25% in a wholemeal flour/pinhead oatmeal/corn oil bait was compared with that of zinc phosphide at 3.0% in the same bait-base. The poison treatments were conducted for 1 or 4 days and always after 3 days pre-baiting. Treatment success varied considerably irrespective of the type of treatment or of the poison used. In general, however, gophacide proved to be as effective as zinc phosphide for the control of mice.


Experimental studies on environmental contamination with infected blood during haemodialysis. To assess the relative importance of different postulated modes of spread of hepatitis B in dialysis units, blood charged with various tracer organisms was used in simulated haemodialysis runs in four laboratories, and the resulting contamination of equipment and environment was measured semi-quantitatively. Some airborne spread of the tracer organism occurred when tubing containing contaminated blood was needled as the "patient" went on and came off the dialyser. Virtually no small airborne particles could be demonstrated however in simulated emergencies in which a blood line was disconnected, or even when bottles of blood were dropped on to a hard floor from a height of 2 metres. Bacillus globigii spores from contaminated blood leaked in small numbers into the dialysing fluid through apparently intact coils. T3 phage, with a particle size of the same order as hepatitis B virus, passed in small quantities through the membrane of a Kiil dialyser from blood to dialysing fluid and also in the reverse direction when added to the header tank. A number of other dialysers were also permeable to phage. Visual assessment of the appropriate moment for inserting the venous line into the "patient" at the onset of dialysis was shown to be unreliable, as the displaced fluid from the end of the venous line was already contaminated before it contained visible red blood cells. Considerable contamination of exposed surfaces and of the buttons on the proportionating unit cabinet occurred. Minor visible splashing of blood was a common-place of the laboratory experiments and was shown to be also a common event during routine haemodialysis in two of the dialysis units taking part in the studies.


Myxomatosis: passive immunity in the offspring of immune rabbits (Oryctolagus cuniculus) infested with fleas (Spilopsyllus cuniculi Dale) and exposed to myxoma virus. Kittens with maternal antibodies to myxoma virus, the offspring of rabbits which had recovered from myxomatosis, were exposed to fleas contaminated with myxoma virus and/or contact with infected rabbits from birth. All kittens died or became infected before 8 weeks of age. When compared with adult animals similarly infected the kittens showed no advantage in terms of survival time or recovery rate attributable to maternal antibodies. Flea transmission of virus was found more effective than contact transmissions.


Examination of slurry from cattle for pathogenic bacteria. One hundred and eighty-seven samples of slurry from cattle were examined forthe presence of salmonellas, pathogenic leptospires and brucellas. Small numbers of salmonellas, generally less than 1/g., were isolated from 20 samples (11%). These were S. dublin (12), S. typhimurium (4), S. indiana (1), S. bredeney (1), S. cerro (1) and S. unnamed 4, 12:d:-(1). Leptospires were isolated from 56 samples (30%) but none was pathogenic for hamsters. No brucellas were isolated. The results of this survey are discussed in relation to the epidemiology of salmonellosis.


The effect of storage in slurry on the virulence of Salmonella dublin. The mouse was used as a model to determine whether storage of Salmonella dublin in slurry and in broth reduces the virulence of the organism. No reduction in virulence of S. dublin stored in slurry for 36 days or in maintenance broth for 70 days was observed. The disease hazard involved in pasture-spreading of slurry contaminated with salmonellas is related to factors other than virulence.


The production and preliminary investigation of Burulin, a new skin test reagent for Mycobacterium ulcerans infection. The preparation of a skin test antigen from Mycobacterium ulcerans by ultrasonic disintegration and filtration is described. The reagent, called Burulin, was tested in Africa in normal school children, and in patients with leprosy, tuberculosis or M. ulcerans disease. Those with tuberculosis or M. ulcerans disease were simultaneously tested with Tuberculin PPD. Burulin was found to be highly specific for patients in the reactive stage of M. ulcerans disease, and there was no cross-reaction in patients with other mycobacterioses. On the other hand, the majority of patients with M. ulcerans disease reacting to Burulin also produce positive reactions to Tuberculin PPD.


The effect of diazepam on physiologically measured stress. Responses to stress were reduced significantly in healthy volunteer subjects when diazepam was used as a sedative.  Decreases in response to painful stimuli in a nontreated group averaged 17 percent; decreases in response to the stimuli in the group sedated with diazepam averaged 84 percent.


The syndrome of ectrodactyly, ectodermal dysplasia, and clefting (EEC). Early recognition of ectrodactyly, ectodermal dysplasia, and clefting of the lip and palate as a syndrome could result in more beneficial treatment for the patient.  Patients with the EEC syndrome often have ocular and auricular deficiencies that progressively become more severe. These patients are often seen first by cleft palate teams who make the diagnosis.  The patient's dental status requires frequent evaluation after corrective procedures for cleft lip and cleft palate.


Psoriatic arthritis involving the temporomandibular joint. A case of psoriatic arthritis involving a TMJ and several peripheral joints is reported and discussed.


Massive facial infection of odontogenic origin: report of case. A case of massive facial abscess secondary to an abscessed tooth and its subsequent successful treatment is reported.


Sclerosing hemangioma of the tongue: report of case. An instance of a large sclerosing-type hemangioma of the tongue is reported with the pathogenesis of the lesion.  A review of the literature suggests that the process is part of the natural evolution of hemangiomas and merely represents a regressive phenomenon.  In the oral cavity where there are no areas that are free of repeated trauma, chronic irritation may incite the fibrosis and other retrogressive features that have been described.


Electrical testing for injuries of the seventh nerve. Electrodiagnostic testing can be used to determine the extent of injury to peripheral nerves.  assessment of the function of the nerves after injury is essential for determination of the prognosis and for treatment.


A new technique for making a moulage.

A new technique for making a moulage. A new technique for making a moulage has been described; it offers several significant advantages over standard techniques.


Lap joint mandibular ostectomy.

Lap joint mandibular ostectomy. The mandibular body ostectomy operation is indicated for specific cases of mandibular prognathism where posterior occlusion is to remain unchanged.  It may be done in one stage intraorally.  The lap joint modification has proved advantageous to the surgeon and to the patient by assuring union and by reducing the period of immobilization.


Central hemangioma of the mandible: intraoral resection and reconstruction. A review of the literature and report of a case of central hemangioma of the mandible have been presented.  This case has merit from the standpoint of the relative rarity of the lesion within the jaws, and the means by which reconstruction was carried out.  Most significant in the presentation is a reminded to all maxillofacial surgeons that any osteolytic defect in either jaw can be a central hemangioma.  Because of the serious consequences of biopsy or of extraction of teeth, hemangioma must always be considered in the differential diagnosis; proper precautions must be taken in establishment of a final diagnosis before surgical intervention is undertaken.


Development of a simplified system for clinical evaluation of occlusal interrelationships. Part I. Acquisition of information. The development of a standardized method of collecting data from a questionnaire and a simplified, yet relatively complete, occlusal and temporomandibular examination form has been described. The questionnaire and clinical examination form have evolved from earlier forms developed by the author1 which have been used in numerous private offices and institutions for a period of five years. These earlier forms have now been augmented and modified as a result of personal consultation with users of earlier forms and numerous clinical and academic authorites.2-27 The selection of information to be obtained through the use of the questionnaire and clinical examination forms was further influenced by the work of numerous authors.28-63 Part II of this report deals with (1) the development of a companion Data Processing Form and a method of transcribing to this form the data from the Patient Questionnaire and clinical examination forms, as well as (2) key-punch instructions consistent with data processing requirements.


A histologic and electronic evaluation of electrosurgical currents: nonfiltered full-wave modulated vs. filtered current. A controlled system for examining the tissue alteration and healing of electrosurgically produced wounds was established. Standardization of width, depth, stroke, amperage, average voltage, and wave form was achieved. A histologic comparison of tissue alteration and healing produced by a conventional blade and two electrosurgical currents was carried out. The need for standarization of instrumentation and clinical procedures is discussed.


Dynamic orificial resin adjustable nasal stents. A technique is described for use of intranasal acrylic resin stents with finger springs and/or orthodontic jackscrew expanders for initiating and maintaining a desired amount of opening in the presence of scar tissue or grafts.


Friend leukemia: rapid development of erythropoietin-independent hematopoietic precursors. Infection of mice with the polycythemia-inducing strain of Friend leukemia virus caused a rapid emergence of new erythroid precursor cells. These cells which, in the absence of erythropoietin, proliferated in vitro to form colonies and even differnetiated, quickly out-numbered the usual erythropoietin-dependent hematopoietic elements in bone marrow and spleen. Ultimately, the marrow and spleen were probably totally repopulated with this erythropoietin-independent cell.


[Therapy of consumption coagulopathy and hyperfibrinolysis with urokinase in a case of acute promyelocytic leukemia]. A case report is presented of a 20 year old patient with an acute promyelocytic leukemia. The presenting symptom was a macrohematuria caused by a consumption coagulopathy. Consumption coagulopathy has only been observed in acute promyelocytic leukemia in contrast to other coagulopathies in acute leukemia. The clotting disorder was successfully treated by administration of urokinase.


Terminal deoxynucleotidyl transferase activity in human leukemic cells and in normal human thymocytes. Peripheral leukocytes from patients with and without leukemia were assayed for presence of terminal deoxynucleotidyl transferase. Activity of this enzyme was detected in circulating leukemic cells from 11 to 13 patients with acute lymphoblastic leukemia, and in one of four with chronic myelogenous leukemia in blast crisis, but not in leukocytes from patients with other kinds of leukemia or in normal leukocytes. Its presence in a patient with chronic myelogenous leukemia in blast crisis lends biochemical support to the suggestion that some patients with chronic myelogenous leukemia undergo a lymphoblastic rather than a myeloblastic crisis. The thymocyte and leukemic-cell enzyme have the same substrate and primer preference. Normal thymocytes and leukemic cells contain two forms of terminal deoxynucleotidyl transferase that can be separated by phosphocellulose chromatography. The enzyme may provide a means for classifying leukemic cells on a biochemical basis independently of classic morphologic and clinical criteria.


[Development of terminal leukemia in a patient with Hodgkin's disease]. A morphological, cytochemical, genetic and autoradiographic examination of the myeloblasts observed in the terminal phase of a patient with Hodgkin's disease is reported. Comparison is made with the literature data in an assessment of the possible aetiopathogenesis of this association, which has become increasingly frequent in recent years in coincidence with the more widespread employment of more radical radio- and polychemotherapeutical management.


[Pharmacological treatment of neurotic depressions]. Neurotic depression covers all forms triggered by exogenous factors, often in conjuction with an underlying personality disposition, and includes reactive, exhaustion and neurotic depression. A feeling of sadness and loss of affection is generally present, together with anxiety provoked by insecurity and apprehension. The complexity of the picture makes treatment of the overall situation difficult with one drug only. For this reason, a series of 25 patients aged 31 to 67 yr with syndromes classifiable as neurotic depression were treated with 2 to 6 daily administrations of an association of 25 nortryptiline and 1 mg trifluoperazine. Analysis of the behaviour of a number of target symptoms showed the effectiveness of the association. There were virtually no side-effects. Success was obtained in the management of anxiety, loss of appetite, depression, irritability, weeping, failure to adapt, and remissiveness, especially in the first week of treatment.


The use of a free connective tissue graft to increase the width of attached gingiva. Various techniques have been employed for increasing the width of keratinized gingiva. In recent years free gingival grafting has been shown to produce more predictable results than previous methods. Wound-healing studies, however, have shown that the surface epithelium of free gingival grafts degenerates and re-epithelizes by cells proliferating from adjacent tissues. In addition, the donor site is left to heal by secondary intention and requires a dressing for 10 to 14 days. Most studies on epithelial-mesenchymal interactions support the concept that epithelium differentiates under the influence of stimuli from the underlying connective tissue. If this is so, then grafting of gingival connective tissue alone should induce keratinization in the proliferating epithelium. A case is presented which illustrates this principle. The graft effectively increased the width of keratinized gingiva. The donor site healed by primary intention, and no dressing was needed.


Swallowing and speech after radical total glossectomy with tongue prosthesis. Radical total glossectomy is now accepted as a useful procedure for the management of advanced cancer of the tongue. This article records our study of speech and swallowing without the tongue. An artificial tongue prosthesis has been developed and found to greatly improve these functions after total glossectomy. The special operative factors to be considered in order to permit a smooth and rapid rehabilitation regarding speech and swallowing have been stressed.


Healing after tooth reimplantation in monkeys. A radioautographic study. The purpose of this study was to examine radioautographically the dynamics of tissue changes during healing after reimplantation of maxilliary incisors in adult rhesus monkeys. The period selected for the study was 1 day to 4 months. The study revealed that a new attachment will be restored after tooth reimplantation. Epithelial tissues start to proliferate immediately after reimplantation; this proliferation reaches its peak in 3 days. After 7 days a new junctional epithelium is re-established. Connective tissue proliferation reaches its peak in 7 days and starts mainly from the supracrestal connective tissue and the bone marrow spaces. The interface is undetectable after 7 days, being replaced by young connective tissue which re-establishes the continuity of the periodontal membrane and the supracrestal connective tissue. Orientation and maturation of the fibers are not observed until 4 months after reimplantation. Changes toward root resorption and ankylosis can be seen as early as 14 days after reimplantation.


Sarcoidosis and ranula of a sublingual gland. A case is reported in which ranula was successfully managed by excision of the sublingual gland in a 26-year-old Negro man. Histopathologic examination revealed sarcoidosis of the sublingual gland. The transsected Wharton's duct was successfully transplanted in the floor of the oral cavity.


The feasibility of a screening procedure regarding temporomandibular joint dysfunction. A screening examination for the assessment of tempormandibular joint dysfunction was evaluated in a series of 279 patients. Tenderness upon palpation of one or more of the muscles of mastication and/or pain upon retrusion of the mandible was noted in seventy-nine patients (28 per cent). These objective signs of temporomandibular joint dysfunction did not correlate statistically with maximum opening of the mouth, age, taking of analesics or tranquilizers, headache or dizzy spells, crepitus, and the patients dental condition.


Periodontosis in sibs.

Periodontosis in sibs. Periodontosis is an idiopathic degeneration of the periodontium which results in migration and loss of teeth. The disease begins in the regions of the incisors and first molars. Late in the disease, other areas of the dental arches may be involved. The gingivae are not initially inflamed, and there are no associated systemic abnormalities. Local irritants cannot account for the marked alveolar destruction which leads to the tooth loss. Several heritable syndromes and periodontitis also may be associated with alveolar bone destruction. Periodontosis can be differentiated each of these on the basis of negative laboratory tests, lack of associated anomalies, distinctive pattern of bone loss and timing of onset of gingival inflammation. A family in which periodontosis was present in three of six sibs and in which ichthyosis was segregating independently of periodontosis is reported.


Autosomal dominant hypodontia with nail dysgenesis. Report of twenty-nine cases in six families. Clinical details of twenty-three of twenty-nine cases of hypodontia and nail dysgenesis are presented. The classic features of severe hypodontia and a distinctive congenital nail defect were found in all families. The use of a simple method of sweat testing disclosed a minor deficiency of sweating in one family.


Central adenocarcinoma of the mandible.

Central adenocarcinoma of the mandible. A seemingly straightforward clinical diagnosis of ameloblastoma was made of a large radiolucent, multicystic lesion in the mandible. Biopsy and metastatic tumor work-up revealed the tumor to be primary in the mandible. A histopathologic diagnosis of papillary adenocarcinoma of salivary gland origin was made. This article reports a well-documented primary mandibular salivary gland tumor. A review of the literature and light and electron microscopic interpretation of this tumor are presented.


Keratinization in odontogenic tumors.

Keratinization in odontogenic tumors. The potential of odontogenic epithelium to keratinize in the form of ghost cells is demonstrated in the histologic variants of a number of odontongic tumors. Although the cells lack keratohyaline granules, they do contain abundant tonofilaments and probably represent an altered form of keratin. The presence of this material in odontogenic tumors does not appear to alter clinical occurence or clinical behavior.


Ringed enamel hyperplasia.

Ringed enamel hyperplasia. An apparently new disorder of enamel is briefly described.


Periapical actinomycosis.

Periapical actinomycosis. Two cases of actinomycotic lesions of the periapical tissue in relation to the molars are described. The difficulty in obtaining a positive culture for actinomycetes in spite of definite histologic evidence of actinomycosis is highlighted. Besides antibiotics, the importance of planned treatment to deal with the underlying diseased periapical tissue and the tooth is emphasized.


Burkitt's lymphoma.

Burkitt's lymphoma. The case of a 33-year-old woman with Burkitt's lymphoma is presented. This is the third case that has been reported from India. The primary involvement was in the mandible. Endoxan was administered without response. Radiotherapy was resorted to as the second choice of treatment, but metastases developed rapidly in other organs. The patient survived for only 3 months after a diagnostic biopsy.


Oral focal acantholytic dyskeratosis (warty dyskeratoma). Report of two cases. Two cases of intraoral focal acantholytic dyskeratosis are presented. These uncommon, small, nodular, keratotic lesions, with a distinct histologic pattern similar to that of Darier's disease, have been reported as warty dyskeratomas. Treatment is conservative surgical removal and follow-up. It is suggested that the histologic diagnostic term of focal acantholytic dyskeratosis be used, since there may be several clinical entities with a similar histology but different etiology.


Periapical destructions caused by experimental pulpal inoculation of Streptococcus mutans in rats. The development of pulpal and periapical changes in rat molars was studied after inoculation of Streptococcus mutans (GS-5) into the pulp chamber. Before injection into the pulp Streptococcus mutans was cultured on a special collagen substrate and "trained" to break down collagen. The destruction of the alveolar bone periapically could be demonstrated both roentgenologically and histopathologically. Large numbers of inflammatory cells in the pulp chamber and the periapical area, as well as carious dentin, were present. The pulpally inoculated bacteria could also be recovered from the systemic blood. The identity between the pulpally inoculated bacteria and the bacteria recovered from the blood was proved by gel precipitation.


Fibrinolytic activity in human dental pulp. It has been shown that the fibrinolytic activity is different in different tissues. In this investigation, performed in order to study the fibrinolytic activity in human dental pulp, the authors found a very high activity in this tissue. The importance of this finding is discussed.


Radiographic densitometric evaluation of seven processing solutions. In a comparison of seven commercially available processing solutions, it was found that the soulutions designed to reduce film-processing time produced a great amount of fog at high temperatures.


Amelogenesis imperfecta. Report of two cases. Amelogenesis imperfecta demonstrating the classic mendelian heredity factor is reported in two members of the same family.


Vertebral rarefaction in acute lymphoblastic leukaemia. A 16-year-old boy is reported in whom back pain, due to localised osteoporosis and partial collapse of a lumbar vertebra, drew attention to unsuspected acute lymphoblastic leukaemia. The patient responded promptly to induction therapy, his symptoms disappeared, and he is presently in the maintenance programme. The skeletal lesion continues to heal slowly. Attention is drawn to this unusual presentation of acute lymphoblastic leukaemia, and the importance of bone-marrow examination in the study of unexplained cases of osteoporosis is emphasised.


Teaching behavioral principles to dental students: a pilot course. In an effort to amalgamate the study of behavior into the dental curriculum at West Virginia University, four primary objectives were set forth by the authors 1) creating a positive learning experience, 2) providing general information concerning behavior as it relates to dentistry, 3) dealing with special problems related to the human developmental continuum, and 4) increasing the students perception of himself and his patients. These objectives were accomplished through a variety of teaching techniques including formal didactic lectures, open and informal discussions, and videotape exercises involving mock clinical situations. There was no formal grading, although the students were requested to evaluate the course. Generally the students were enthusiastic in their regard for the class, emphasizing their feelings that follow-up courses should be offered.


Confrontation and the professional maturation of dental students. The professional maturation process through which every dental student sould pass involves perception and identification of his professional role. The process is complicated at many points by conflicts between the student's own professional role expectations and the expectations of his teachers or of society. Confrontation is described as occurring daily in the dental-school environment; many confrontational situations occur on an impromptu basis in the course of interaction between the student and his classmates, his patients, and the faculty. Other confrontational situations can be arranged deliverately by the dental educator in order to provide clinical and social experiences for the student which ordinarily would not be included in the dental curriculum. By taking advantage of the particular student-instructor relationship existing during these confrontational situations, the dental educator can reap perhaps the greatest reward to be realized from an academic career--that of being able to take an active role in the professional maturation process of his students.


Phenolization of bladder in treatment of massive intractable hematuria. Intractable hemorrhagic cystitis secondary to radiation or cyclophosphamide (Cytoxan) therapy could lead to serious complications; however, intravesical instillation of phenol has reduced the dilemma of this life-threatening problem. We present a case of intractable hemorrhagic cystitis secondary to cyclophosphamide therapy treated with 100 per cent phenol with no untoward side effects. Since formalin instillation into the bladder has been associated with severe complications, phenol appears to be safer and more effective in the treatment of intractable hematuria, and, therefore, its clinical trial is recommended.


Monocytic leukaemia in the dog.

Monocytic leukaemia in the dog. Three cases of monocytic leukaemia in dogs are reported. Clinically, they all showed dullness, lymph node enlargement and hepato-spenomegaly and the overt illness was of short duration. Haematologically, the white blood cell count was raised to different degrees in each case. The great majority of white cells were monocytes and monoblasts; their cytological, cytochemical and electron microscopic features are described. Only a mild degree of anaemia was present in all cases. Pathological examinations, carried out in two of the dogs, showed widespread leukaemic infiltration of bone marrow, spleen, lymph nodes, liver and other organs. Differentiation of this syndrome from other forms of haemopoietic neoplasia is discussed.


Cytology of the solitary papilloma of the bronchus. The cytologic and histologic findings in a case of solitary squamous cell papilloma of the bronchus are reported. The cytologic features of this rare bronchial tumor included regular squamous cells, round basal cells with no atypsim and nuclear irregularity. Although these findings suggest a benign, rather than a malignant tumor, the definite nature of the tumor was established only on histologic examination of the entire surgically resected specimen.


Neonatal pulmonary cytology and bronchopulmonary dysplasia. Cytologic evaluation of tracheo-bronchial washings from neonates on oxygen-respirator treatment results in a fairly distinct sequence of changes. Significant cellular alterations occurred in this study at an earlier date than expected but the results correlate somewhat with the histologic changes as reported by Banersee, Girling, and Wigglesworth. However, cytomorphic changes occured with lower oxygen concentrations than anticipated and the data thus far have not allowed us to define which infant will develop the long term sequella of bronchopulmonary dysplasia. The preliminary data does suggest it may be possible to identify those infants who will develop severe metaplastic-dysplastic changes at an earlier date than usually expected.


Oral exfoliative cytology in female reverse smokers having stomatitis nicotina. 1. The Karyopyknotic index of the palatal and lingual mucosa is increased in female reverse smokers when compared to non-smoking females. 2. The Karyopyknotic index of the buccal mucosa did not show any change in female reverse smokers when compared to non-smoking females. 3. The Karyopyknotic index did not show any change with age in the non-smoking females. 4. Very few cases show epithelial atypia in palatal smears from female reverse smokers having stomatitis nicotina.


Prognosis and incidence of sex chromatin in breast cancer. A preliminary report. Results of two studies, based on a total of 126 patients (prospective--76 cases and retrospective--50 cases), on the incidence of the sex chromatin in the cancerous tissue are presented. For evaluation of prognosis in the retrospective study with a five year follow up, sex chromatin incidence was correlated with other prognositc factors such as lymph node metastasis, the disease free interval of distant metastasis and the size of the tumor. Whereas positive significant correlation between sex chromatin incidence and a five year survival time or disease free interval of distant metastasis was observed, no correlation was seen between sex chromatin counts and lymph node metastasis or the size of the tumor.


Bone scanning.

Bone scanning. Scanning is based on the uptake of a nuclide by the crystal lattice of bone and is related to bone blood flow. Cancer cells do not take up the tracer. Normally, the scan visualizes the highly vascular bones. Scans are useful and are indicated in metastatic bone disease, primary bone tumors, hematologic malignancies and some non-neoplastic diseases. The scan is more sensitive than x-ray in the detection of malignant diseases of the skeleton.


X-ray and fine-needle biopsy in diagnosis of non-palpable breast lesions. Using mammography and xeroradiography among 78 patients with non-palpable breast lesions, three cases of suspected carcinoma were detected. The diagnosis was confirmed by cytology after x-ray guidance of the fine-needle biopsy.


The "Wits" appraisal of jaw disharmony.

The "Wits" appraisal of jaw disharmony. The "Wits" appraisal of jaw disharmony is a simple method whereby the severity or degree of anteroposterior jaw dysplasia may be measured on a lateral cephalometic head film. The method entails drawing perpendiculars from points A and B on the maxilla and mandible, respectively, onto the occlusal plane. The points of contact of the perpendiculars onto the occlusal plane are labeled AO and BO, respectively. In a sample of twenty-one male and twenty-five female adults selected on the basis of excellence of occlusion, it was found, on the average, that in females points AO and BO coincided and in males point BO was located 1 mm. ahead of point AO. In skeltal Class II jaw dysplasias, point BO would be positioned well behind point AO (positive reading), whereas in Class III skeltal jaw disharmonies, the "Wits" reading would be negative, that is, with point BO ahead of point AO. The advantages of the "Wits" appraisal over that of the conventional ANB angle reading are illustrated and discussed.


A systematic modification of edgewise therapy. This article describes a highly systematic modifcation of the edgewise technique that incorporates the principle of light continuous force application. It is a re-evaluation of our earlier article in view of the experience gained in applying this treatment approach in a teaching clinic. The classification of cases according to retraction requirements, the appliance designs, and the use of four basic phases of treatment remains largely the same as previously described. Some of the variations and modifications that have been necessary because of new information and pedogogical considerations are discussed. The treatment of typical orthodontic problems with differing retraction requirements is illustrated.


The shape of the dental arch.

The shape of the dental arch. The shape of the dental arcade was measured in a cross-sectional study of 2,040 sets of maxillary and mandibular study casts of Caucasoids, Mongoloids, and Negroids between 4 and 20 years of age. Three methods of dental arcade analysis were used: dental arch area, dental arch index, and length of the arc of the dental arcade. Each of these computational techniques showed that a different growth pattern was shared by the three ethic groups, and important factor to be taken into consideration in orthodontic treatment.


Correlation of in vitro immune response with clinical course of malignant neoplasia in dogs. An attempt was made to quantify the host antitumor immune response in 16 dogs with progressively growing tumors by evaluating the in vitro reactivity of their lymph node or peripheral blood lymphocytes to their own tumor cells. Serum from dogs with the same histologic type of neoplasm inhibited allogenic lymphocyte cytotoxicity, whereas serum from normal dogs, and a dog clinically free of osteosarcoma 17 months after limb amputation, did not significantly block cell-mediated reactivity. Low ratios of sensitized lymphocytes to tumor cells often stimulated tumor cell growth in vitro. Autologous serum from dogs with progressively growing neoplasms appeared to potentiate the stimulation of tumor growth above a simple blocking of lymphocyte-mediated cytotoxicity. An attempt was made to correlate the in vitro immune reactivity of the dog to the clinical behavior of its neoplasm. There was fair to good correlation in 12 dogs and no correlation in the remaining 4 dogs.


Infection prevention in acute nonlymphocytic leukemia. Laminar air flow room reverse isolation with oral, nonabsorbable antibiotic prophylaxis. Reverse isolation and prophylactic oral nonabsorbable antibiotics were evaluated among 64 consecutive noninfected adults with acute nonlymphocytic leukemia admitted for remission induction. Patients were randomly allocated to laminar air flow room reverse isolation with oral nonabsorbable antibiotics (LAF plus A), routine hospital ward care with antibiotics (W plus A), or ward care alone (W). The LAF plus A patients had a significantly decreased incidence of total infection, bacteremias, pneumonias, rectal abscesses, urinary tract infection, and pharyngitis. Infectious deaths were reduced in the LAF plus A group and the time to the first infection or to fatal infection was delayed. The W plus A patients who regularly ingested the antibiotics had a reduction in infections similar to that of the LAF plus A patients but those who could not tolerate the antibiotics had an incidence of infection comparable to the ward patients. The LAF plus A and the W plus A patients also had higher complete remission rates and longer median survival than the unprotected ward patients.


Possible physical substrates for the interaction of electromagnetic fields with biologic membranes. A quantized electrochemical model of a greater membrane concept that comprises the neuronal phospholipid sheet of the plasma membrane and the constituents of the intercellular spaces in brain tissue is proposed as a basis to explain several recent experimental results that concern the interaction of electromagnetic fields with the central nervous system. These fields consist of gradients far below those needed for direct intervention with action potentials or chemical transmitters at synaptic sites. Problems associated with the rectification of modulated signals and transduction into brain tissue are also briefly considered.


The ocular effects of microwaves on hypothermic rabbits: a study of microwave cataractogenic mechanisms. Rabbits, irradiated by known cataractogenic levels of 2.45 GHz radiation at 5 cm, did not develop cataracts if kept under general hypothermia. Radiation-induced temperature elevation appears to be essential for the cataractogenic effect of microwaves.


Ultrastructural changes in the rabbit lens induced by microwave radiation. Rabbits were irradiated with 2450-MHz continuous microwave energy. Effects of the radiation on the ocular lens were assessed by slit-lamp biomicroscopic examination of the eye. Two lenses were selected for electron microscopy, one that was severely damaged and one that appeared unaffected by the radiation. There were prominent ultrastructural changes in both lenses.


Ascorbic acid changes in cultured rabbit lenses after microwave irradiation. Whole body exposure of rabbits to microwave radiation causes a decrease in ascorbic acid in the lens. In our study, rabbit lenses maintained in culture medium (37 degrees C) were exposed to either pulsed or continuous wave S-band radiation for 10-15 min at power densities between 0 and 200 mW/cm-2. Total ascorbic acid was measured in selected lenses 1-3 days after irradiation. The temperature of the culture medium was measured during irradiation. Matched control lenses were exposed to similar time-temperature environments, but without microwave irradiation. Ascorbic acid decreased significantly in lenses exposed to microwave radiation. No differences were found, however, between irradiated and control lenses subjected to identical time-temperature conditions. At a given average power density, the time-temperature variation was independent of modulation. A decrease in ascorbic acid is apparently a direct thermal effect of microwave radiation in rabbit lens culture.


Action of Corti's organ and the cochlea: a new theory. An "engineer's model" of the labyrinth is derived from the monoclinic crystal and the avian egg. The anatomy of the human cochlea and of the semicircular canals is then related by diffraction theory and Fresnel's explanation of optic activity. Increased cochlear electric potential, which represents stored energy, is associated with mechanical translation of the basilar membrane and angular separation of Corti's rods and is effected by "pumping" by the endolymphatic sac and the muscles that act on the auditory ossicles. The semicircular canals function as valves; the utricular and saccular macules form holograms and reflect the energy into the cochlear duct. Incoming acoustic waves excite dipole resonance and stimulate emission of a fraction of the stored energy; further amplification is effected by the hair cells, which, together with the tectorial membrane, behave like a transistor. These findings lead to a new theory of static balance and the action of Corti's organ: the labyrinth functions as a traveling wave maser of which the cochlea is the slow wave structure. Cochlear geometry itself effects resolution of incoming sound pitch. Corti's organ corresponds to the melatopes of the crystal, and the inter-rod angle is critical for any particular frequency, since it is related to dispersion of the optic axes.


Some effects of exposure of the Japanese quail embryo to 2.45-GHz microwave radiation. Exposure of quail eggs 4 hr per day during the first 5 incubation days at 2450 MHz and in an exposure field of 30 mW/cm-2 and at an absorbed power of 14 mW/g does not cause any great change in body weight, observed gross malformations, rbc, wbc, hematocrit, hemoglobin, or differential wbc percentages. If small differences exist in these parameters due to microwave exposure, they are obscured by the large variability between individual quail. This variability is believed to partially result from changing blood values in the developing young quail, and the 2-day spread in ages at the time of sacrifice could account for some of the variability. The overall hatch percentages for the exposed and control eggs were approximately equal. A slight significant decrease (11%) in hemoglobin was noted in the birds irradiated on Day 2. Additional verification, however, is needed, because the observed change is less than the normal range of values observed in young quail. These data do suggest, however, that exposure of developing Japanese quail embryo to microwave radiation of the frequency and power density level used in this study does not preclude normal systemic development, hematologic differentiation, or the general hardiness of the hatched quail.


Effects of electromagnetic fields on fecundity in the chicken. Egg production was reduced when young laying hens were kept in contact with metal cages while being continuously exposed to the following cw fields: a vhf field at a frequency of 260 MHz, with an incident power that decreased from 100 to 4mW during the experiment; a uhf field at a frequency of 915 MHz, with an incident power of 800 mW during the first 2.5 weeks, zero during the following week, and 200 mW for the remainder of the experiment; a uhf field at 2.435 GHz, with an incident power of 800 mW; an elf electric field at a frequency of 60 Hz, with a calculated value of field strength of 1600 V/m; an elf magnetic field at 60 Hz, with a value of magnetic flux density of 1.4G. With the exception of the hens exposed to the uhf field at 915 MHz, all other treated groups laid significantly less eggs than the controls (p smaller than or equal to 0.01). This reduction (similar 15% less than the controls) began with the first 4-week production period. The egg production curves for the hens exposed to the vhf field at 260 MHz and to the uhf field at 2.435 GHz were approximately the same beginning with the sixth week of production, and they maintained comparable production levels for the remainder of the experiment. An 8% total drop in production also was experienced in the group of birds exposed to the 915-MHz field, which pulsed because of equipment failure. Egg production rate curves for the birds in the elf electric and magnetic fields were substantially different from those exhibited by birds in the other electromagnetic fields. The birds in the E-field regained a production level comparable to the controls after 11 weeks production, whereas those in the B-field dropped to 31% production, which was approximately 40% poorer than the controls by the twelfth week of production. Fertility of cocks and hens was not affected by continuous low-power vhf and uhf near-zone electromagnetic exposure or elf electric or magnetic field treatment. Fertility was exceptionally good, except for the controls and the hens exposed to the elf electric field. The hatchs of fertile and of total eggs were not significantly influenced by exposure to any of the five fields. A considerably lower incidence of male chicks was noted in the elf magnetic field treatment (32.3%). The sex ratio in the other groups appeared to be relatively normal. No macroscopic abnormalities attributable to treatments were noted in the chicks hatched or in the dead embryos.


Preliminary investigations of the effects of low-level microwave radiation on spontaneous motor activity in rats. Male rats were irradiated with microwaves of 10.7 GHz (cw), 3 GHz (cw), or 3 GHz (pw) for 185 hr with power densities of approximately 1 mW/cm-2. Spontaneous activity was automatically measured and analyzed in five amplitude classes, after irradiation had ceased. No differences were found between the irradiated and the similarly treated nonirradiated control rats. A few rats were exposed for 17 days to 3 GHz (pw) at 25 mW/cm-2. Here, again, the spontaneous motor activity was not affected. Before irradiation, these rats had been trained to constant peak performance in a 2-m long runway. Their running times remained unchanged by this treatment regimen and did not differ from those of nonirradiated control rats. So far, no deleterious effects of the microwave radiation used has been detected.


Discussion paper: Strong dependence of whole animal absorption on polarization and frequency or radio-frequency energy. A two-plate stripline is used to determine wide-band radio-frequency (285-4000 MHz) absorption characteristics of 96-390-g rats and brain-phantom prolate spheroidal bodies. The results compare well to those for free space irradiation. At resonance, for E along the long dimension (â), a power deposition nine times higher than that for the H parallel â orientation is observed. For rats in the k parallel â configuration, the frequencies of peak absorption and the maximum absorption at these values demonstrate W-1/3 and W 2/3 dependencies, respectively, upon the weight W of the animal. This finding implies that whole animal absorption is a size- and shape-dependent phenomenon.


Skin changes secondary to hydroxyurea therapy. Hydroxyurea is an effective agent in the treatment of chronic myelogenous leukemia. The toxic reactions have included myelosuppression and megaloblastosis. During long-term maintenance therapy, dermatologic alterations occurred in seven of 20 patients and consisted of partial alopecia, increased pigmentation, scalings, atrophy of the skin and subcutaneous tissues, nail changes, and erythema of the face and hands. The histologic changes were similar to those seen in lichen planus. These observations were a factor leading to the use of hydroxyurea in the treatment of psoriasis.


Immobilization hypercalcemia crisis.

Immobilization hypercalcemia crisis. Profound hypercalcemia associated with immobilization is rare. Hypercalcemic crisis occurring as a result of immobilization in which there was not a coexisting, contributing medical condition has not, to our knowledge, been reported previously. Failure to consider hypercalcemia as the source of progressive anorexia, nausea, vomiting, and irritability resulted in a respiratory arrest and nearly fatal outcome in the case of a 13-year-old boy one month after a simple femoral fracture. Therapy consisting of the intravenous administration of fluids and corticosteroids was successful in lowering the serum calcium level until mobilization could be accomplished. Review of previously reported cases emphasizes the difficulty in recognition and diagnosis of this unusual condition. Surgeons treating patients with fractures should be aware of this complication and familiar with its appropriate therapy.


Syndrome of recurrent increased secretion of antidiuretic hormone following multiple doses of vincristine. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) has been recognized to occur following treatment with vincristine. None of the reports have provided information regarding its potential for recurrence on further challenge with vincristine (VCR), an agent generally required for repeated use in patients with malignancies. Symptomatic hyponatremia and SIADH that occurred 8 days following administration of VCR in a child with acute lymphatic leukemia was documented with specific radioimmunoassay of urinary ADH levels. The further occurrence of recurrent elevations in ADH excretion 8-10 days following repeated treatment with VCR was also observed. However, SIADH was prevented by prophylactic rigorous fluid restriction. The occurrence of SIADH following VCR therefore does not preclude the further safe usage of this drug.


Azurophil and specific granules of blood neutrophils in chronic myelogenous leukemia: an ultrastructural and cytochemical analysis. That most patients with chronic myelogenous leukemia (CML) have either very low levels or no leukocyte alkaline phosphatase activity (LAP) is an established fact. In view of our new findings7 that normal mature human polymorphonuclear leukocytes (PMN) contain two types of granules, azurophils (1/3) and specifics (2/3), and that alkaline phosphatase is present only in specific granules, we undertook the present studies to determine whether these neoplastic PMN lack a specific granule population or simply lack the enzyme. The cellular buffy coats of five patients with CML (Ph1 plus, LAP minus) were fixed in glutaraldehyde, incubated for peroxidase to identify the azurophil population, and examined by electron microscopy. It was found that the specific granule population was present in all mature PMN. Counts of both azurophil and specific granules per cell were slightly lower than normal but were within an 80%-90% overlap of the normal range. We therefore conclude that the low level of LAP in patients with CML reflects a deficiency of the enzyme rather than a missing granule population. Although the mature PMN appeared relatively normal (with few exceptions), circulating myeloblasts and promyelocytes revealed several abnormalities, the most notable being the presence of large bundles of cytoplasmic microfilaments. The blood of two patients in the terminal phase of disease was reexamined. Most of their cells were immature, with aberrations similar to those in myeloblasts and promyelocytes in the chronic phase of the disorder. In addition, however, we discovered three adnormal populations of mature PMN: (1) PMN containing both populations of granules but lacking peroxidase, (2) PMN lacking specific granules, and (3) PMN lacking azurophil granules. Our findings emphasize the value of electron microscopy and cytochemistry in detecting abnormalities of maturation in the cytoplasm of leukemic PMN.


Histone abnormalities in adult acute leukemias. Arginine-rich and lysine-rich histones were extracted from various cytologic types of leukemic blasts and from preparations rich in normal monocytes. On polyacrylamide disc electrophoresis, the patterns of normal monocyte histones closely resembled those found in acute histiomonocytic leukemia (Schilling type). The electrophoretic patterns of histones obtained from leukemic blasts in acute myelomonocytic leukemia (Naegeli type) were similar to those found in both acute myelobastic leukemia and chronic granulocytic leukemia. The results support the concept that acute myelomonocytic leukemia may be closely related to, or a variant of, acute myeloblastic leukemia, and that acute histiomonocytic leukemia is most probably a monocytic rather than a myeloblastic disorder. In addition to accepted morphologic and enzymatic criteria, the present studies suggest that differences in histone patterns might be useful in further distinguishing between histiomonocytic, myeloblastic, and myelomonocytic leukemias.


Interacting populations affecting proliferation of leukemic cells in culture. Peripheral blood cells from three patients with acute leukemic have been studied using a suspension culture method previously described.1 Cytogenetic studies in two of the patients permitted the identification of the proliferating cells in the cultures as being derived from a leukemic population. Cell separation studies using velocity sedimentation supported the concept that growth of the leukemic cells in culture is dependent on an interaction between two populations of leukemic cells.


Long-term second remissions in acute lymphatic leukemia. Long-term second remissions were seen in 5/66 patients with all. Relapse was extramedullary in 2/5. Persistent, progressive marrow lymphocytosis preceded relapse in 4/5 patients and persistent marrow eosinophilia in 1/5. All 5 patients had had an unmaintained remission of at least 6 months prior to relapse, and responded the second time to drugs which were essentially the same as those used initially. We conclude that long-term second remissions may occur in all. Patients who relapse after 6 months or more of unmaintained remission should be treated with the drugs used in current initial induction regimens in hope of cure.


Extramedullary involvement of the testes in childhood leukemia. Thirteen out of 163 male children with acute leukemia developed extramedullary involvement of the testes. This represented an incidence of 8.0%. These 13 children experienced 19 separate episodes of enlargement. All episodes were treated with radiotherapy. The enlargement was unilateral in 9 episodes and bilateral in 10. The bone marrow (BM) was in complete remission in 13 episodes. In 8 of 13 patients the testis was the first site of relapse since the initial BM remission. Of the males with a WBC less than 20,000/mm3 on initial diagnosis of leukemia, 4.3% developed this testicular complication, as compared to 17.0% of those with a WBC equal to or greater than 20,000/mm3. The median time interval to testicular involvement was 13 months; to death, 9 months. Relapse at other sites usually followed testicular involvement. Autopsy findings did not appear to be dose-related. Radiotherapy was clinically successful when a total dose in the range of 1200 rads was used, and is the treatment of choice for this complication.


Treatment of acute lymphoblastic leukemia in childreq with "prophylactic" intrathecal methotrexate and intensive systemic chemotherapy. Sventy-five children under the age of 15 years, with acute lymphoblastic leukemia, were treated with a multiple drug chemotherapy regimen (L-2) and intrathecal methodtrexate. Remission was achieved in all except 1. Three died from infection early in remission and 1 was lost to follow-up. Of the remaining 70, relapse occurred in 19; in 3 children this was confined to the central nervous system (CNS) and in 1 was in both the CNS and bone marrow. Fifty-one children continue in complete remission from 14 to 54 months. Fourteen of these children have completed 3 years of chemotherapy and are disease free 2 to 18 months posttreatment. The results indicate that periodic administration on intrathecal methotrexate with no CNA irradiation, plus intensive systemic chemotherapy, can effectively control CNA leukemia and prolong the duration of complete remissions.


The mechanism of action of methotrexate in cultured L5178Y leukemia cells. This study investigates the relationships between the methotrexate (MTX)-induced purineless state and thymineless state and between the thymineless state and the kill of L5178Y cells. As an index of the thymineless state, we measured the effect of MTX on conversion of deoxyuridylate to thymidylate. This was measured as the rate of incorporation of tritiated deoxyuridine into DNA, but it was corrected for changes in incorporation of tritiated thymidine. Thus we derived the "calculated tritiated deoxyuridine rate." During the MTX treatment, the calculated tritiated deoxyuridine rate decreased rapidly at first and then more slowly. The slow 2nd-phase block was not reversed by hypoxanthine. As the 2nd-phase block deepened, the lymphoblasts continued to die (loss of cloning ability) but recovered the ability to incorporate tritiated thymidine into DNA. After 7 hr of MTX treatment, the kinetics of the 2nd-phase block in calculated tritiated deoxyuridine rate correlated closely with the kinetics of cell kill. Thus, MTX may inhibit dihydrofolate reductase enzyme, rapidly deplete S-phase L5178Y of reduced folates, and thus produce a purineless and thymineless state. As treatment continues, MTX intensifies the thymineless state, possibly by direct inhibition of thymidylate synthetase enzyme, and the cells die predominantly a thymineless death. The purineless state initially contributes to cell kill but later does not, possibly because it partially reverses spontaneously.


Drug therapy against a transplantable guinea pig leukemia. The effects of six clinically active drugs were tested against a ttansplantable leukemia in inbred strain 2 guinea pigs. Cytoxan and 6-mercaptopurine were found to elicit a therqeutic response against this leukemia based on complete tumor regression of the established tumor as well as a substantial increase in survival time. Animals dying in the untreated control and drug-treated groups revealed typical generalized lymphoblastic leukemia. However, only Cytoxan-treated animals that had relapsed exhibited central nervous system involvement originating from the arachnoid membrane. A tow-drug combination of Cytoxan and 1-(2-chloroethyl)-3(trans-4-methylcyclohexyl)-1-nitrosourea was found not only to prevent meningeal leukemia development but also to result in "curing" all animals from their leukemia. This observation was based on a complete clinical, hematological, and histopathological "remission" period up to 176 days. The administration of 1-(2-chloroethyl)-3-(trans-4-methylcyclohexyl)-1-nitrosourea alone was observed not only to control the systemic leukemia but also to prevent central nervous system involvement. No relapses occurred after the first "remission" period was achieved in the groups of animals that received 1-(2-chloroethyl)-3-(trans-4-methylcyclohexyl)-1-nitrosourea.


Altered membrane sodium transport and the presence of a plasma ouabain-like inhibitory factor in acute myeloid leukaemia. 1. Sodium transport studies were performed in erythrocytes from normal subjects and from patients with acute myeloid leukaemia. Sodium influx and efflux rates were increased in erythrocytes from leukaemic patients. 2. The ouabain-sensitive component of sodium efflux was increased in leukaemic erythrocytes. 3. The high sodium efflux from leukaemic erythrocytes was decreased when the incubation media contained leukaemic plasma, suggesting the presence of an ouabain-like factor in the plasma. Paired experiments failed to show the presence of a similar factor in normal plasma. 4. Leukaemic erythrocytes showed a significantly greater ouabain uptake than the normal cells. 5. The results are discussed in relation to the wide-spread electrolyte disturbances in acute myeloid leukaemia.


Serial studies of hepatitis-associated antigen and antibody in patients receiving antitumor chemotherapy for myeloproliferative and lymphoproliferative disorders. The effects of antitumor chemotherapeutic agents on hepatitis B antigen (HBAg) and antibody (HBAb) were studied serially in 25 patients with myeloproliferative and in 60 patients with lymphoproliferative disorders. HBAg was detected at some time in 17 patients, and HBAb in 40 patients. Seventeen patients who had HBAb detected immediately pretreatment had a decrease in HBAb titer which paralleled the fall in white blood cell count. In 5 of these patients, HBAg appeared when HBAb titers fell. In 3 of the 5 patients, a reappearance of HBAb was observed with disappearance of HBAg from the serum, and in the 2 other patients HBAg persisted once it appeared. In all 3 patients who had HBAg at the time of initiation of chemotherapy, bone marrow suppression was associated with a marked increase in HBAg titer. The increase in HBAg titer was associated with hepatocellular damage, as manifested by an elevation in serum transaminase enzymes. These observations suggest that antitumor chemotherapeutic agents reduce HBAb titers. In some patients, HBAg appears after a decrease in HBAb titers. In patients with preexisting HBAg, such therapy leads to large increases in HBAg titer. Whether this appearance or increase of HBAg is related to an inhibition of antibody formation, allowing expression of preexisting antigen, or to an inhibition of cellular immunity, allowing viral proliferation, is uncertain.


General comments on continuing education. Dental education should be a continuing process from undergraduate days throughout the dentists' practising life. The development of postgraduate courses has moved earlier the point at which a licence to practise is conferred, and in so doing has increased the responsibility to pursue continuing education and training after licensure. There is a growing tendency for attendance at continuing education courses to become a condition for relicensure in the hope that this will increase the status of the profession and improve the standard of dental care. So long as the requirement is for the attendance at courses this development deserves support. However any suggestion of re-examination should be resisted since this could only lead to increased stress on the competent dentist who was a poor examinee. A questionnaire sent to dental educators produced information on the proportion of dentists currently attending continuing education courses in ten countries and also enabled the popularity of different subjects to be assessed. It is suggested that courses should be arranged so that the whole field of dentistry is covered every five years. If the profession does not organize its own programme of continuing education and motivate its members to participate voluntarily in such courses, governments may well impose upon it requirements which could be less acceptable to the status and dignity of the profession.


Current systems of delivery of oral health services. It is suggested that in implementing, extending and redirecting systems of delivery of oral health services we should be maximizing preventive care, indirect payment and targeting for need, wheras for manpower employment and type the accent should be on selecting the best blend for the specific services to be provided, with a readiness to use constructive initiative in all areas. In associated operations research, the urgent need is for sound data on the effectiveness and efficiency of different payment systems, and on the optimal blend of private and public, professional and auxiliary manpower. What has been achieved in the delivery of oral health services over the past 50 years has been no mean  feat, but what lies ahead to be done both in developed and developing countries is a task of herculean proportions.


An economic perspective on dental practice: the economics of increasing practice size. Group dental practice is a form of organization which can show substantial professional and public benefits. Part of the support for group practice is derived from an extrapolation of the theory of economies of scale. Applied to dentistry, the theory holds that as practices grow they will be able to use their resources more efficiently than do smaller practices, and lower, thereby, the average costs of producing dental services.


Types of personnel projected to meet the future dental needs of society. There is mounting pressure to re-examine the traditional methods for delivery of dental care. Good health, which includes good oral health, is becoming recognized as a basic right of all people and governments are obliged to subsidize health care in many countries. Part of the cost lies in the training of health professionals in the medical and dental schools. Though  conditions vary in different countries, there is an almost universal shortage of fully trained dentists, and with increasing demand for dental care there is no possibility of producing a sufficient number to meet the need. The profession finds itself overwhelmed by the need for treatment of dental disease and prevention is relatively neglected. It is necessary to determine whether the present methods of delivering dental care are the most efficient in terms of cost, always remembering that dentistry is a personal service and must not be dehumanized. There is ample experience to show that auxiliaries can be trained to undertake a range of tasks to a high standard and with an ethical approach to the patient. A number of such schemes are discussed in detail. Though it is clear that no single pattern will fulfil the needs of each individual country, some form of team dentistry in which the graduate dentist must always be the key member seems likely to be the best way of meeting the future dental health needs of the world.


The transplantation and surgical movement of developing teeth. There has now been one hundred years of study, research and clinical application into the possibility of transplantation of tooth germs, and a short review of the literature is given. Two clinical cases are described in which replacement of upper incisors has been successfully achieved by auto transplantation of a developing lower bicuspid and upper canines respectively. Long term follow up of such cases now extends over a decade and it is suggested that this technique has reached a stage now hen it can be recommended to the dental profession generally as a worthwhile clinical approach.


The utilization of dental skills in non-dental situations. The development of electronic control systems has enabled severely physically handicapped people to revolutionize their lives by using any minimal residual movements they may have to operate micro-switches linking them with typewriters and other environmetal controls. Technical skills of a high order are required in making the unique splint or interface which links the switches with these residual movements whether of the tongue, lips, chin, eyebrow, finger or toe. Through the initiative of the Cordent Trust and generous financial support from the Leverhulme Trust a mobile laboratory was designed and built and a dental technician appointed for a three-year development project in the use of these switches as it was felt that his experience was particularly appropriate to the work and would also demonstrate how dental skills can be used to bring about a degree of rehabilitation far beyond the oral environment.


An improved abrasive enamel microsampling device. An improved enamel abrasive microsampling technique with an electronic preset counter and comparator has been designed. In vivo enamel microsamples were obtained from 30 incisors and premolars. The results showed low coefficients of variations for both enamel fluoride concentrations and depths of microsamples in vivo.


Quantitative microprobe analysis of amalgam. A quantitative microprobe analysis was conducted on three commercial amalgams to determine the nature of the phases present. The presence of tin in the Ag-Hg phase (gamma1) was confirmed and Cu-3Sn was found in the original alloy particles. In the dispersant amalgam studied, little Sn-Hg phase (gamma-2) was found and the reaction phase Cu-6Sn-5 was identified.


Effects of cement type and thickness on retention of serrated pins. The retentive capacity of cemented pins was determined. Zinc phosphate, polycarboxylate, and cyanoacrylate were used to cement threaded pins (0.024 inch) into precise channels of 0.025, 0.026, and 0.027 inch. Highest retentive values were realized when zinc phosphate and polycarboxylate cements were used with the smallest pin-channel mismatch. Ethyl cyanoacrylate was least retentive and demonstrated no mismatch dependency.


Tooth size associations of three morphologic dental traits in a melanesian population. The tooth size associations of incisor shoveling, Carabelli's cusp, and mandibular molar groove pattern were determined for a technologically primitive Melanesian population. Their significance to previously postulated adaptive mechanisms for the morphologic traits is evaluated, as is a possible mode of inheritance for the traits.


Distribution of the dental lamina and deciduous tooth development in the mandible of the domestic pig. Specimens of known age, weight, and crown-rump length were used to characterize the distribution of the dental lamina and deciduous tooth development in the mandible of the domestic pig.


Effect of constant currents on orthodontic tooth movement in the cat. Constant 10 muA currents were applied to the mandibles of 12 cats via electrodes implanted mesial and distal to premolars undergoing orthodontic treatment. A third were moved toward the cathode, a third were moved toward the anode, and a third were moved in the absence of an applied field. No significant difference in total movement was seen at the end of five weeks.


Distribution of stresses in porcelain-fused-to-metal and porcelain jacket crowns. An idealized porcelain jacket and porcelain-fused-to-metal crown model was prepared, loaded, and analyzed to establish the trends and distributions of the internal and external stresses. Loads at 30 degrees to the vertical axis created adverse tensile stresses at the level of the gingiva and specifically at the gold-dentin-cement interface.


Penetrativity of sealants: I.

Penetrativity of sealants: I. Penetration coefficients of sealants were measured. It was found that the time required for a sealant to penetrate a specific distance is highly dependent on the penetration coefficient of the sealant.


Latency and inhibition of human masticatory muscles following stimuli. Latency-inhibition behavior was always produced in contracting anterior temporal muscles following the application of various stimuli to the teeth and jaws of 31 subjects. Statistically significant differences in duration were generally observed with different procedures. In half of the subjects, the first one or two closures in a sequence of repetitive tapping evoked a longer period of inhibition than subsequent closures. No reflex or latency-inhibition behavior could be produced in contracting digastric muscles. Comparisons of means for individual subjects did not follow the pattern suggested by comparisons of total sample means in almost half of the subjects.


Levans: I. Fractionation, solution viscosity, and chemical analysis of levan produced by Streptococcus salivarius. Levan produced by Streptococcus salivarius was fractionated into a series of 20 fractions of varying molecular weight. The range of intrinsic viscosities of the fractions was 0.07 to 0.18 dl/gm in water and 0.20 to 0.29 dl/gm in dimethyl sulfoxide. The molecular weight of the unfractionated leval determined by light scattering was 31.5 times 10-6. Small amounts of fatty acids and protein were found associated with levan.


Solubility and water absorption of orthodontic cements. Solubility and water absorption of eight orthodontic cements were determined as a function of time. Two brands of BIS-GMA and three brands of acrylic cements ranked about equally in solubility and water absorption. Three brands of polycarboxylate cements were appreciably poorer in these properties.


Effects of oral streptococci on electrophoretic properties of human salivary anionic proteins. Incubation of saliva supernatant after three hours at 37 C revealed that salivary anionic proteins were susceptible to enzymatic attack by salivary enzymes not removable by centrifugation at 10,000 g. In the presence of washed suspensions of S mutans or S sanguis additional changes in electrophoretic behavior of anionic proteins occurred. Differences between organisms suggested a selectivity of attack on the anionic proteins.


Effect of conditioning with fluoride and phosphoric acid on enamel surfaces as evaluated by scanning electron microscopy and fluoride incorporation. The etching effect of 50% H-3PO-4 applied together with 2% NaF or SnF-2 was compared with the effect of H-3PO-4 on pre- and postfluoridated enamel by scanning electron microscopy. Substantial etching of enamel resulted with use of 50% H-3PO-4 with 2% NaF. High fluoride incorporation in the surface provided additional protection of the conditioned enamel.