Mandibular anterior crowding in relation to tooth size and craniofacial morphology. In the present study the problem of mandibular anterior crowding was investigated by comparing a group of adults having approximately ideal occlusion (n = 27) with a group with  corresponding occlusion except for a slight crowding in the mandibular anterior segment (n = 39). Both sexes were represented. A statistical evaluation revealed that in the latter group the mesiodistal diameter of the four mandibular incisor teeth was significantly greater, whereas the intercanine width and the frequency of third molars were the same in both groups. A comparison of the craniofacial morphology of the two groups displayed limited differences, and only the basal sagittal jaw relationship and the mandibular inclination differed significantly. No significant correlations were observed between the space conditions and any of the variables studied.


[2 special technics improving the results of Trauner mylohyoid plasty]. The author reports twelve Trauner mylo-hyoid plasties, recommending:--a medial incision forming a covering flap on the medial aspect of the body of the mandible after lowering of the floor of the mouth,--disinsertion not only of the mylo-hyoid but of all the retro-symphyseal muscles,--keeping in place the temporary prosthesis, in part fashioned inside the mouth, for five weeks.


Application of chlorhexidine by oral irrigation systems. Low concentrations of chlorhexidine (0.006%) were found to inhibit plaque formation when 750 ml was applied twice daily by oral irrigation systems. The procedure took 1-2 min and may be a convenient method of maintaining oral hygiene in patients in whom normal mechanical cleansing is difficult.


[Importance of silicone bases in complete dentures]. The use of a silicone base under a total prosthesis makes possible the solution of certain problems of tolerance or maintenance of such denture. I.--Full denture in patients who have received radiotherapy. II.--Full denture with intolerant mucosa. III.--Following failure of classical prosthesis. IV--Prosthesis fitted following pre-prosthetic surgery. The technical problems associated with the fabrication of such prosthesis and possible adjustements are discussed.


Sealing properties of intermediary bases and effect on rat molar pulp. Five "cream-like" intermediary bases (Hypocal¿, Dycal¿, Reocap¿, Cavitec¿ and Dropsin¿) were studied using ZnO-eugenol (ZOE) and phosphate cement for comparison. The in vitro experiments, which were designed to reveal the penetration of a dye and an etching liquid, showed that Dropsin and Hyypocal were permeable to dye and that Dropsin was permeable to acid as well. The in vivo experiments revealed no definite differences between the different cream-like base materials, nor were there differences between those and the conventional cements. The overall mildness of the dentin-pulp reactions and the suitability of the rat molar for this kind of research are discussed.


Ultrastructural study of erythrophagocytosis in the rat bone marrow. I. Red cell engulfment by reticulum cells. Previous light microscopic studies have revealed the erythroclastic potential of the rat bone marrow reticulum cells, and call for ultrastructural study of the finer details of this process. Electron microscopy of rat bone marrow which had been stimulated to increase its erythrophagic activity, either by splenectomy or by transfusion of heat denatured erythrocytes, confirmed the central reticulum cell of erythroblastic islands as the main phagocytic cell in bone marrow erythroclasia. The early digestive vacuoles, which are formed by the fusion of erythrophagic vacuoles with lysosomes, correspond to the acidophilic, globular structures which characterize erythrophagocytosis as observed by light microscopy. By forming intrasinusoidal protrusions, the bone marrow reticulum cells engulf circulating effete red cells. The engulfed red cells are then transported intracellularly across the sinusoidal wall for final disintegration in the intraparenchymal part of the reticulum cell. This transmural mode of erythrophagocytosis by reticulum cells most probably demonstrates the fundamental phagocytic mechanism of the bone marrow part of the reticulo-endothelial system. Transmural transport of reticulocytes adherent to reticulum cells during the formation of protrusions illustrates a possible mechanism for liberation of red cells from the bone marrow.


Ultrastructural study of erythrophagocytosis in the rat bone marrow II. Iron metabolism in reticulum cells following red cell digestion. Intracellular transport and storage of iron in bone marrow reticulum cells can be studied in the electron microscope by the recognition of iron macromolecules. Following artificially increased bone marrow erythrophagocytosis ferritin molecules accumulate both in the cell sap and in the lysosomes of erythroclastic reticulum cells. Persistent iron loading transforms lysossomes into siderosomes, after which haemosiderin may be formed by grandual transformation of ferritin. The bone marrow reticulum cell shows evidence suggestive of autophagy, a process which may allow for the transfer of cell sap ferritin into lysosomes, as documented for other types of iron storing cells.


Erythrocyte pyruvate kinase activity in patients with haematological malignancies. Erythrocyte pyruvate kinase (PK) activity was decreased with acute myelomonoblastic leukaemia (AML) and lymphosarcoma cell leukaemia (LSAL) but increased in patients with chronic myelocytic leukaemia (CML). There was no difference in the enzyme activity between controls and relatives of patients with AML. PK activity in patients with ALL during complete remission was higher than during untreated and relapsed stages. These data provided evidence that the altered enzyme activity is acquired rather than genetic. There was a positive correlation between PK activity and red cell creatine levels. The red cell creatine was low in patients with AML but high in patients with CML. This suggests that the altered enzyme activity in these patients is at least part due to red cell age.


The ultrastructure of spontaneous radial segmentation of the nuclei in bone marrow cells from 3 patients with acute myeloid leukaemia. Bone marrow cells with spontaneous radial segmentation of the nuclei from three patients with acute myeloid leukaemia were analysed by means of electron microscopy. The centriole was found in the centre of the cluster of nuclear segments. Cytoplasmic microtubules were found in the intersegmental clefts and in the pericentriolar area. The present observations support the hypothesis that spontaneous radial segmentation of the nuclei in tumour cells is due to a microtubule-associated contractile process, by which the nucleus is folded into segments.


L-asparaginase and prednisolone pretreatment followed by rubidomycin and cytosine arabinoside for induction of remission in adult patients with acute myeloblastic leukaemia. 77 unselected adult patients with acute myeloblastic leukaemia (AML), including practically all AML patients from an area with 1.9 million inhabitants, were randomized for either (1) 5 days pretreatment with 1-asparaginase and prednisolone followed by  a combination of rubidomycin and cytosine arabinoside (ARAP), or (2) treatment with a combination of rubidomycin, cytosine arabinoside and prednisolone without 1-asparaginase pretreatment (RAP). Complete remission was induced with ARAP in 12 patients (31%) and with RAP in 13 patients (34%). Thus pretreatment with 1-asparaginase did not improve the therapeutic response. The overall remission frequency was significantly higher below the age of 60; 50% compared to 13% above this age. Side-effects such as liver dysfunction, nausea and vomiting were more common in patients pretreated with 1-asparaginase. Sterilization of the gut did not improve the remission frequency with either regime.


[Childhood leukemias].

[Childhood leukemias]. Acute leukemias of childhood differ considerably from the adult type with regard to clinical and laboratory findings as well as prognosis (Tables 1-3). Therapeutic progress (Table 4) within the last two decades has resulted not only in remarkable palliation, but increasingly also in true cure. However, this development appears to be far from complete, and to think in terms of a definitive scheme of treatment is therefore misleading and dangerous. On the contrary, work in cooperative study groups aiming at further therapeutic improvement must continue. All children with leukemia in Switzerland may benefit from the advances offered by such studies if they are initially admitted to one of our centers of pediatric oncology. Further control and follow-up, however, can continue to be carried out on a decentralized basis by practicing pediatricians and hematologists.


[Hematological problems in geriatrics].

[Hematological problems in geriatrics]. By way of introduction, the physiologic alterations of blood cells in old age are described. Besides the well known anemias in younger persons, protein deficiency may be an additional cause of anemia in the elderly. Acquired sideroblastic anemia of varying etiology is more often seen in the elderly than in younger people. In pernicious anemia the daner of gastric cancer has been overestimated. Aggressive treatment of acute leukemias is not indicated in patients over 60. The special form of smouldering leukemia is mentioned. The syndrome of anemia, thrombocytopenia and enzymatic dysfunction of granulocytes may, it is suggested, be a symptom of preleukemia. Anemia with accelerated sedimentation rate responsive to steriods is helpful in diagnosing polymyalgia rheumatica in the oligosymptomatic form.


[Anorexia in rats following protracted whole-body irradiation with low doses]. In our experiments, carried out hitherto, concerning the effect of incorporated and radioactive substances, weight behaviour and food uptake have proved to be a sensitive test. With regard to these experiments and the half-life of the radionuclides used, it is reported about trial series in Wistar rats. These rats were applied, with Co-60 gamma irradiation, different whole-body doses protracted over 48 hours. A total of 32 groups of experimental animals (20 animals each) was exposed to irradiation doses of lethal, medium lethal, and sublethal ranges, control and pseudo-irradiation series included. The experiments were carried out under observance of constant irradiation and attitude conditions, night and day changes, as conditioned by the season, included. Even in the inferior sublethal range (12 to 24 R), a significant trend of decreased food uptake is registered. This trend remains for a short period after the end of irradiation, but then it returns to normal conditions. Furthermore, a new decrease with subsequent increase seems to become evident-about ten days after termination of the radiotherapy (especially after several hundred R); report about these items will be made later on.


[Interpretation of orthodontically treated by means of punched cards. 2. Data at the completion of treatment]. The authors analysed the key-word cards of 3245 terminated orthodontic cases. Statistical data were obtained about treatment results, therapeutical aids, duration of treatment and co-operation of the patients. These data give a survey on the achievements of the orthodontic practitioner, the choice of his methods and the utilization of his therapeutical aids. The authors could draw certain conclusions as to their own work in practice. Furthermore, they realized that the use of key-word cards permits to evaluate critically their achievements and to perform collective scientific studies.


[Diagnosis of frequent periodontal diseases by the specialist for general dentistry]. It is reasonable to refer a patient to a specialist or a special clinic if the own diagnostic possibilities are not sufficient to elucidate the case. But the own diagnostic possibilities should be fully used to spare the patient unnecessary travelling and loss of time. The most reliable and important symptoms and the local causes of frequent periodontal diseases are described and tabulated. All the symptoms indicated may be verified in any institution by inspection, palpation, measuring of socket depth and radiological examination. In this way the specialist is general stomatology will be aided in establishing a periodontal differential diagnosis.


[Late results in surgical treatment of periodontal diseases]. The authors re-examined 102 patients who had undergone periodontal surgical intervention 1--15 years ago. In 50% the results were good, in 25% they were mediocre, and in 25% they were poor. The results from gingivectomies were better than those from flap operations. The operation results were better in younger patients. The proportion of lost teeth was 14%. Oral hygiene was unsatisfactory in 65,7% of the cases. The relatively unfavourable results may be explained by the tardiness of intervention and the neglect of oral hygienic measures.


[Psychological preparation of pre-school children for pedodontic diagnosis and treatment]. The psychological preparation of preschool children is of great importance to their behaviour during dental treatment. A trial show that repeated occupation with the object of play may produce positive reminiscences for years.


[The specialist-dentist regulations and the program for the traing for the "dental specialist for general dentistry"]. The Central Professional Committee for General Stomatology provides the instructors and the dentists training for a speciality with an interpretation of the regulations for the diploma of specialist physician/specialist dentist of May 23, 1974, and of the educational program. Advice and recommendations are given for the fulfilment of the training program and also for the course and methods of the training for a dental speciality.


[Studies of longitudinal section on jaw development and resulting conclusions for orthodontic treatment planning in the deciduous dentition]. From a 11 years' longitudinal study of the tooth development in 93 children conclusions are drawn as to the planning of orthodontic treatment in the deciduous dentition. In accepting the task of orthodontic treatment, the dentist assumes a very responsible function which he will only master if he knows the various patterns of dental development. The difficulties of a prognosis as to dental development in an individual child are exemplified by the evaluation of dental findings obtained at the different years of life.


[The effect of repeated spray treatment on the bacterial flora of the mouth cavity in patients with periodontal disease]. The effect of a four times repeated spray application on the clinical picture and the number of oral aerobic micro-organisms has been studied on 21 patients with periodontal disease during a stay at hospital. Comparative studies corroborated the effect of antiseptics added to the spray. The reduction of the number of micro-organisms did not continue during the four days of application so that there was a discrepancy between the clinical picture and the microbiological findings. Possible causes of this fact are indicated in the discussion.


[A method for the instruction of patients in adequate oral hygiene]. Starting from the necessity of instructing the patients in adequate oral hygiene, the authors prepared a show-case containing graphic representations, colour photographs, posters and models. It is considered to be a successful aid in health education.


[A contribution to health education].

[A contribution to health education]. Adequate health education is of importance to prophylaxis and the long-term success of periodontal (and other stomatological) measures. This possibility is illustrated by some instructional pamphlets for patients.


[An interesting case].

[An interesting case]. A rare observation on a 57-year-old female patient serves to emphasize that striking findings may also occur in the orofacial region. In the present case, the patient was afflicted with a tubular cystadenoma of the oral mucosa, extending from 22 to 24. In this connection, the authors briefly deal with the epidemiology, clinic and morphology of these tumours.


[Diagnostic contribution: the misinterpretation of radiographs]. A case report shows the difficulties of the exact interpretation of skull radiographs which result from superposition effects. The possibilities of extracting reliable diagnostic information are outlined.


[Measurement of forces in highly elastic regulating rings]. The forces developed on stretching bands of various sizes are tabulated to obtain approximate reference values for practice.


[Clinical and therapeutic aspects of acute unspecific cervical lymphadenitis of unknown etiology]. The authors give a survey of the clinic and therapy of the unspecific cervical lymphadenitis of unknown origin with special reference to its differentiation from the odontogenic abscess. The cooperation with other specialities is pointed to.


[Etiology and possibilities of treatment of the displaced and impacted front tooth]. The paper gives a survey of the causes and forms of anterior tooth impaction. Some clinical pictures serve to explain and illustrate such cases. The importance of an accurate diagnosis and the possibilities of treatment are pointed to do.


[The maxillonasal syndrome (Binder)].

[The maxillonasal syndrome (Binder)]. In the light of three case reports, the authors explain the symptoms of the maxillonasal syndrome and draw conclusions as to orthodontic therapy.


[Rational cleaning of instruments by means of ultrasonics]. The author presents an ultrasonic cleaning program which is the result of more than 3 years of experience with the 2-litre ultrasonic cleaning apparatus of the VEB Elektromat Dresden. It is based on a classification of the kinds of contaminations occurring most frequently in general stomatological practice to which cleaning solutions were assigned which have been chosen empirically and which have been found to be effective. With a view to more rational utilization, the author points to the employment of inserted receptacles in a double-bath method and gives suggestions for a more general use of this cleaning apparatus in medicine.


[Ultrasonic cleaning of dental instruments]. The author describes an inserted basket system which conformes to the size of the dental instrumentarium and of the tank of the ultrasonic cleaning apparatus.


[Dental assistants].

[Dental assistants]. On the basis of studies on the work efficiency of stomatological auxiliaries, the author suggests a standard educational program for stomatological nurses in the U.S.S.R.


[The medical-dental specialty regulation and the training program for "Orthodontic specialist"]. The Central Professional Committee for Orthodontics provides the instructors and the dentists specializing in orthodontics with an interpretation of the regulations for the diploma of specialist physician/specialist dentist of May 23, 1974, and of the educational program. Advice and recommendations are given for the fulfillment of the training program and also for the course and methods of the training for a dental speciality.


Chronic myeloid leukaemia in Zambians.

Chronic myeloid leukaemia in Zambians. Sixteen Zambian Africans with chronic myeloid leukaemia are described. Clinical and haematological features were unremarkable except for the relative extreme youth of three patients (aged 18 years or less) and one patient with the aleukaemic form in whom the diagnosis was proved by marrow examination. Thirteen patients were treated with busulphan (Myleran), of whom 12 showed varying degrees of responsiveness, and one was completely resistant both to busulphan and cyclophosphamide. One patient became pregnant while receiving busulphan and another showed depression of spermatogenesis when investigated four years after start of treatment. The poor responsiveness of some Africans to busulphan is briefly speculated upon.


[Malignant change in fibrous dysplasia (author's transl)]. Report on 2 cases of poly-ostotic fibrous dysplasia combined with pigmented areas of the skin with secondary fibrosarcoma of the ulna or femur. They are analysed together with 49 cases published so far. The average age at the time of malignancy being diagnosed was 34.4 years. The average time from recognition of fibrous dysplasia to malignant changes was 17.7 years. In 14 cases local radiotherapy preceded the development of sarcoma. Femur and jaws were the most common sites. There were 30 osteosarcomas, 11 fibrosarcomas and 7 chondrosarcomas. The prognosis is bad: only 14 patients survived for 5 years. But malignant change is rare in fibrous dysplasia. It occurs in less than 1% of cases. Severe forms of poly-ostotic fibrous dysplasia which still progress in adults with a raised alkali phosphatase appear to show an increased tendency towards malignant degeneration.


The clinical significance of serum alkaline phosphatase isoenzymes in locomotor diseases. AP isoenzymes were estimated in 292 patients with locomotor diseases and in 124 healthy controls. The diagnostic usefulness of AP determination is increased by estimation of isoenzymes. Investigations were made to study the biological profile of organ specific AP activities: 1. Rheumatoid arthritis and Reiter's syndrome - the total AP and L-AP activities were increased. 2. Ankylosing spondylitis treated by physiotherapy - the total AP, B-AP and I-AP activities were increased. After drug therapy an increase occurred also in L-AP activity while I-AP activity showed no significant change. 3. Progressive OA of hip and knee showed increased levels of total AP and B-AP activities. 4. Degenerative diseases of the spine, chiefly cases of discopathy, showed significantly reduced levels of AP and B-AP activities. 5. In osteoporosis there was an increase in total AP, L-AP, B-AP and I-AP activities. 6. In the active generalised form of Paget's disease, increased levels were found of total AP, B-AP, I-AP and L-AP activities. 7. In neoplastic diseases the isoenzymes can help to reveal metastatic dissemination and thus aid preoperative evaluation. 8. In gout and hyperuricemic syndromes there was a relative increase of B-AP activity and non-significant fall of L-AP activity. Increased levels of L-AP occured in patients with gallbladder disease, after immunosuppressive therapy or after infectious hepatitis. A fall of L-AP levels was found after Corticotrophin and after intraarticular administration of Kenalog. Increased B-AP activities occurred after total hip replacement, in acute or chronic pyelonephritis and in active osteonecrosis and osteoporosis. Anabolic therapy caused a significant fale of B-AP activity to fall significantly. Reduced B-AP levels were also found after antibiotic therapy. Increased I-AP activity was found in cases of osteoporosis, and in secondary amyloidosis; reduced I-AP activity was seen in mucous colitis. The activity of I-AP is assumed to increase as a result of the changed intestinal calcium and phosphorus regulation occurring in association with the enhanced bone tissue metabolism. From this point of view an order of significance is given for the activity of bone pathology in the separate diagnostic groups of locomotor diseases.


Ciliated bodies in gynecologic cytopathology: parasite or cellular debris? Ciliated bodies, similar to the ones described originally by Gaudefroy and Coliche, were discovered in fluid from an ovarian cyst and fluid in the Douglas pouch. These were reproduced experimentally by mucosal scraping of Fallopian tubes. In fact, they were of cellular origin from desquamation of the ciliated apical portion of columnar cells.


The cytology of transitional cell carcinoma of the urinary bladder. Urine specimens from 77 patients with transitional cell tumors of the urinary bladder, 15 patients with inflammatory lesions and five normal individuals were analyzed. The two nuclepore slides of all patients with neoplastic disease contained over 100 neoplastic cells and in one-half of the cases over 1,000 tumor cells were present. The percentage of neoplastic cells to atypical and normal cells ranged from 25 per cent for papillary carcinomas, Grade I, to 36 per cent for poorly differenciated carcinomas. There were no significant differences of the cytoplasmic features but the nuclei of malignant cells were slightly more hyperchromatic, contained significantly more nuclei and were characterized by a coarsely rather than finely granular nucleoplasm. The cell size of 5,970 cells and the nuclear size of 8,455 cells was determined by planimetry. Normal transitional cells averaged 341 square microns and were larger than those exfoliated from tumors. The mean nuclear area was 36 square microns for normal cells, 52 square microns for benign atypical cells, 54 square microns for cells from papillary carcinoma, Grade I, 78 square microns for papillary carcinomas, Grade II, and 90 square microns for transitional cell carcinoma, Grades III and IV. The study indicated that significant quantitative differences exist between normal transitional cells and those exfoliated from moderately and poorly differentiated transitional cell carcinomas. The cells exfoliated from papillomas or papillary transitional cell carcinomas, Grade I, closely resemble hyperplastic or atypical transitional cells which in turn can be differentiated from normal urothelial cells.


Hormonal patterns in vaginal smears from puerperal women. Maturation indices were determined for 1,000 vaginal smears from women three weeks to nine months postpartum. Atrophic smears predominated three to six weeks after delivery in women who were lactating, but only one-third of the non-lactators had an atrophic pattern during those weeks. There was a progressive increase in the incidence of estrogenic patterns observed beyond the sixth postpartum week, irrespective of the persistence of lactation. The incidence of mixed patterns (equal numbers of parabasal, intermediate and superficial cells) was remarkedly constant (about 5 per cent) regardless of lactation or time beyond delivery. This study confirms the traditional view of hormonally related puerperal vaginal cytologic patterns, and is at variance with recent claims that vaginal atrophy is unusual in the puerperium.


Splanchnic oxygen uptake in relation to systemic oxygen uptake during postoperative splanchnic blockade and postoperative fentanyl analgesia. In 34 patients with gallbladder disease, but otherwise healthy, the systemic and splanchnic oxygen uptake were studied in connection with cholecystectomy. Postoperatively, 22 patients were given a posterior splanchnic blockade with 0.5% plain lidocaine, and 12 were given fentanyl intramuscularly in a dose of 3.5 mug/kg b.w. Postoperatively, before the analgesic agent was administered, both the systemic and splanchnic oxygen uptake were increased by 40--50%, the splanchnic fraction of the systemic oxygen uptake being the same as preoperatively. Following administration of fentanyl, as well as after splanchnic blockade, the systemic oxygen uptake decreased almost to the preoperative level. The splanchnic oxygen uptake, however, did not change after fentanyl administration but increased further significantly following splanchnic blockade. The splanchnic fraction of the systemic oxygen uptake increased rapidly after the blockade, while it increased slowly after fentanyl administration.


Anitschkow nuclear changes observed in oral smears. Squamous epithelial cells with nuclear characteristics similar to those of the "Anitschkow myocyte" have been found in smears from the oral cavity. The cells are found in scrapings from the area around the labial fold of the lower lip and are most commonly found in abundance in people with active aphthous ulcers. Electron microscopic study of material from the oral cavity is being undertaken by the ultrastructural section of our department.


Effects of abdominal surgery under general anaesthesia and of postoperative analgesic therapy on splanchnic exchange of some blood borne energy metabolites. Sixteen patients with gallbladder disease, but otherwise healthy, were studied in connection with cholecystectomy. For postoperative analgesia, seven patients were given a posterior splanchnic blockade, 30 ml of 0.5% plain lidocaine, and nine patients were given fentanyl intramuscularly in a dose of 3.5 mug/kg b.w. Immediately after the operation and before analgesia, the arterial blood concentrations of glucose, lactate, glycerol, 3-hydroxybutyrate, and free fatty acids increased significantly. The splanchnic exchange of these metabolites was also significantly increased, except for glucose, the splanchnic release of which was significantly reduced. Induction of analgesia, both methods, was followed by a rapid significant decrease of the arterial blood concentration of glycerol, which tended to rise later when the analgesia disappeared. The arterial blood concentration of glucose and lactate showed a tendency to decrease slowly following both kinds of analgesia, while the arterial blood concentration of 3-hydroxybutyrate remained stable. The splanchnic release of glucose was significantly reduced after administration of fentanyl, while it increased significantly following splanchnic blockade, the splanchnic glucose release being correlated to arterial blood pH. The splanchnic release of 3-hydroxybutyrate was significantly reduced during maximal analgesia in both groups. The splanchnic uptakes of glycerol and free fatty acids were correlated to their splanchnic inflows.


Non-visual prescreening of cervical smears with a flow-through cytophotometer. An experiment was carried out with the fluorescence impulse cytophotometer I.C.P. 11 (Phywe, Göttingen, Germany) in a routine cytology laboratory. A total of 600 cervical smears were examined with 15 test samples of body fluids and tissue cultures. The results were compared with those obtained by classical Papanicolaou cytology and clinical "follow-up". The main purpose was to find criteria for malignancy to be used as parameters in automated non-visual cytology. The main problems in the technique of preparing and measuring specimens have been discussed. Preparation of cell suspensions was time consuming; moreover, techniques were not completely controllable. A method for judging histograms was discussed. It appears that unless a better method is found for preparing suspensions of single, naked and undamaged nuclei, free from leukocytes, impulse cytophotometric measurement of DNA will remain an unreliable method for prescreening of cervical smears.


Mixed-image planimetry. Assessment of a new method for stereometric analysis in microscopy. A new method for stereometric measurement of surface area in microscopy is described, based on the mixed-image principle. The measurement was accomplished by observing the area on which was superimposed the image of a miniature electric lamp attached to an ordinary planimeter. Mixed-image planimetric measurements were more easily made and required much less time than area calculation by an integrating eyepiece, by weight or by ordinary planimetric measurements of photomicrographs or tracings of the area. Mixed-image planimetric measurements of a finite area varied less than 1 per cent. Such precision was not obtained with the other methods. The new method was devised in vivo stereometric measurements of bone tissue remodelling in rabbit ear chambers, but should find a much wider application in quantitative microscopy of both finite and extensive objects.


Postoperative hepatic blood flow and its relation to systemic circulation and blood gases during splanchnic blockade and fentanyl analgesia. Thirty-four patients with gallbladder disease, but otherwise healthy, were studied in connection with cholecystectomy. For postoperative analgesia, 22 patients were given a posterior splanchnic blockade with 0.5% plain lidocaine, and 12 were injected intramuscularly with fentanyl in a dose of 3.5 mug/kg b.w. Postoperatively, before administration of the analgesic agent, the cardiac output, mean arterial blood pressure, heart work and estimated hepatic blood flow were increased and the total peripheral resistance, splanchnic vascular resistance, arterial oxygen tension and base excess values were decreased. Fentanyl, in addition to its analgesic effect, also decreased the arterial oxygen tension and pH and increased the arterial carbon dioxide tension. There was little change in cardiac output, mean arterial blood pressure and estimated hepatic blood flow. Following splanchnic blockade, on the other hand, pain relief was accompanied by a decrease in cardiac output, mean arterial blood pressure and heart work to about the preoperative level, while the estimated hepatic blood flow remained unchanged and the splanchnic vascular resistance decreased rapidly. Neither total peripheral resistance nor blood gases altered as a result of splanchnic blockade.


I. Validity of dichnomatic earpiece densitometry for quantitative studies in children with shunt-free cardiovascular malformations. Cardiac output was assessed in 16 children without evidence of cardiovascular shunts from simultaneously recorded earpiece and cuvette densitometric tracings. The earpiece set-up was calibrated by the end-tail method. Both instruments gave linear response to dye concentrations used. There was a close correlation between cardiac output figures recorded by the two methods (r equal to 0.95) and no systematic difference occurred. It is concluded that in infants and children earpiece densitometry constitutes a rapid and accurate method for quantitative circulatory studies.


V. Exercise studies in children with congenital heart disease. An earpiece densitometric investigation. Twenty-three patients have been studied by exercise testing during right heart catheterization. Cardiac output was measured by the earpiece densitometric technique before, during and after the exercise period. It is concluded that the earpiece densitometric technique in conjunction with exercise testing offers an attractive alternative for the study of pressure and flow characteristics in children with congenital heart disease.


II. Cardiac output studies in infants and children undergoing right heart catheterization. Cardiac output figures from 97 patients were computed by earpiece densitometry and correlated to various dimensional parameters. Stroke volume was better correlated to body dimensions than cardiac output indicating that patients undergoing right heart catheterization were not in basal state.


Pectus excavatum; a clinical study with long term postoperavtive follow-up. There are divergent views about the harm that pectus excavatum and related chest deformities does to the respiratory and heart function. The indications for surgery and the optimal age for surgical intervention are debatable. In this study 37 operated and 38 nonoperated cases of about the same severity have been followed for more than ten years and examined after the age of 18 years. The examination included socio-economic, cosmetic and cardio-pulmonary function aspects. It could be shown that from the psychological aspect there were no significant differences between the operated and the non-operated cases. The tendency to contract bronchopneumonia is not influenced by operation. The physical working capacity was the same in the two groups. The operated cases have slightly lower pulmonary function values that the non-operated in spite of the fact that the non-operated group at the time of follow-up included the more seveee cases. Age at operation did not seem to be of any importance for the long-term results. The lower pulmonary function capacity in the operated cases is thought to be attributed to a restriction secondary to the operation. There are also indications that pectus excavatum tends to become less pronounced with increasing age. The study supports a restrictive attitude towards surgery.


Myeloproliferative disorders with selective differentiation toward megakaryocytic cells. A clinicopathological study of three autopsy cases. Three autopsy cases of myeloproliferative disorders with selective differentiation toward megakaryocytic cells were reported with a clinicopathological analysis. All of these cases had some common distinctive features; (1) patients, adult of more than 40 years of age, (2) relatively acute fatal course (about 20 to 100 days), (3) continued pancytopenia in the peripheral blood, (4) so-called blast cells, occasionally showing accumulation, according to the length of total duration, in addition to overwhelming predominance of atypical megakaryocytic cells in the bone marrow, and (5) an increased tendency of fibrillosis in the interstitium of the bone marrow corresponding to the more or less prolonged duration of the course. From these facts, they should be compatible with so-called megakaryocytic myelosis. Some relationship between this disorder and myelogenous leukemia, and infiltrative tendency of megakaryocytic cells in the extramedullary organs had also been discussed shortly.


The Di Guglielmo syndrome: a study of 17 cases. I. Clinical and haematological manifestations. Based on a series of 17 patients with Di Guglielmo's syndrome, i.e., erythraemic myelosis and erythroleukaemia, a description is given of the clinical and haematological manifestations of this disease. Three cases were anerythraemic, i.e. no erythroblasts were seen in the blood smears, and three were aleukaemic, i.e. no myeloblasts and/or promyelocytes were found in the blood. The percentage of erythroblasts in the bone marrow smears varied from 34 to 96. In all cases, abnormalities (often megaloblastoid changes) of varying severity were observed in the erythroblasts. Proerythroblasts showing erythrophagocytosis, multinuclearity and vacuolation of the cytoplasm are features of great diagnostic importance. Five patients had myeloblasts or promyelocytes containing Auer rods, six had neutrophilic granulocytes showing pseudo-Pelger-Hüet anomaly, and in most cases agranular polymorphonuclears were present. Brief comments are given on the PAS, nuclear arylsulphatase and naphtol-AS-D-chloroacetate-esterase staining methods. Four of five patients studied cytogenetically revealed abnormal stem lines. The survival times after the onset of the disease ranged from 17 days to 20 months. The disease is closely related to myeloblastic leukaemia. In the course of Di Guglielmo's syndrome, the leukaemic component often becomes more conspicuous, so that, in the terminal phase, the disease cannot be distinguished from typical myeloblastic leukaemia. As, in Di Guglielmo's "leukaemia", the diagnostic problems are greater than and different from those in typical myeloblastic leukaemia, it is still reasonable to place this disease in a separate group under acute granulocytic leukaemia.


Attempted orthodontic movement in the presence of suspected ankylosis. A 37-year-old man with suspected ankylosis ("submerged" teeth, radiographically obliterated periodontal membranes, and sharp or ringing percussion tests) was subjected to attempted orthodontic movement. The maxillary canine and posterior segments were chosen as treatment areas. While the terms "light" and "heavy" are relative, forces ranging from 6 to 24 ounces were variants great enough in the areas treated to have elicited movement if movement were possible. After continuous forces had been applied for 110 days, measurements showed no movement in either maxillary quadrant.


Muscles of mastication in small children: an electromyographic analysis. The temporalis, masseter, and depressor muscles of fifteen normal children were studied electromyographically to determine their activities during the position of resting tonus, during various movements of the mandible, and during the act of swallowing. Analysis of our results led to the following conclusions: 1. Resting tonus of the mandible does not depend on neuromuscular activity in the three portions of the temporalis, masseter, and depressor muscle group; they were inactive bilaterally. 2. Opening of the jaw either slowly or maximally, and against resistance, is brought about by the contraction of the depressor muscle group. 3. Closing of the jaw quickly is brought about mainly by greater contraction of the masseter muscle, and slightly by contraction of the temporalis. 4. Closing the jaw quickly with occlusal contact of the teeth is effected by the temporalis and masseter muscles. 5. Protraction of the jaw is performed by contraction of the masseter muscles. The depressor muscle group contracts to maintain the slight depression followed by the protraction. 6. Swallowing saliva and water is accompanied by contractions of the depressor muscle group. 7. Incisor chewing of gum and peanuts mainly recruits marked contraction of the masseter muscle. Some slight-to-moderate activity is achieved by the temporalis. The depressor muscle group acts in antagonism with the elevator muscles. 8. Chewing gum on the right and left molar sides and normal mastication are effected by the contraction of the temporal and masseter muscles. The suprahyoid muscle group acts in antagonism with the elevator muscles. 9. Normal children with deciduous teeth have patterns that are similar to those of normal adults.


A test of the transmethylation hypothesis in acute schizophrenic patients. Keeping biochemical determinations and clinical judgements independent, the authors investigated three aspects of the transmethylation hypothesis. They found that 26 acutely schizophrenic patients were no more likely to have bufotenine or N,N-dimethyltryptamine present in urine or elevated serum indolethylamine N-methyltransferase activity than 10 normal control subjects. The authors conclude that these are naturally occurring substances which are equally likely to be present in normal and schizophrenic subjects.


Localization of secretory IgA, secretory component, and alpha chain in the mammary gland of lactating rabbits by immunoelectron microscopy. The different steps in the processing of secretory IgA (sIgA) of the mammary gland of lactating rabbits have been investigated with immunoelectron microscopy. The method employed consists of an indirect localization sequence, in which the immunologic reagents are allowed to diffuse into the fixed tissue prior to embedding and thin sectioning. In the first step, goat F(ab')2 fragments directed against sIgA, secretory component (SC), or alpha chain were used. To visualize the location of these first-step antibody fragments, a second Fab fragment directed against goat F(ab')2 antibody was prepared and coupled to a small heme octapeptide that possessed peroxidatic activity, the reaction product of which is visible by electron microscopy. Both the epithelial cell and the local plasmacytes of the mammary gland contain alpha chain, whereas SC is exclusively located in the epithelial cells. In the plasmacytes, both the cisternae of the rough endoplasmic reticulum and the saccules and vesicles of the Golgi complex contain alpha chain. In the epithelial cells, the elements of the Golgi complex and large apical vacuoles situated in the apical region of the cell. Based on these results, a model for processing of sIgA is proposed and discussed.


Myeloproliferative disorders.

Myeloproliferative disorders. Forty-three operative procedures were performed on a population of 250 patients with myeloproliferative disorders, including polycythemia vera, myeloid metaplasia (MM) and chronic myelogenous leukemia (CML). The overall operative mortality was approximately 7% and the incidence of excessive bleeding which could be related to coagulopathy was 5%. Twenty-one patients with MM or CML underwent splenectomy for palliation of symptoms related to the enlarged spleen or hematologic problems. Eighty-four percent of the latter group were improved. Adverse hematologic effects which could be attributed to splenectomy in these patients were confined to two patients who developed marked thrombocytosis. Among the 23 patients with MM, 9 had portal hypertension. Three underwent portacaval shunt and one a splenorenal shunt for bleeding varices. One of the patients died of hepatic necrosis. Estimated hepatic blood flow determinations (EHBF) in 4 patients with portal hypertension demonstrated a marked absolute increase and an increase in the ratio of EHBF/Cardiac Index. Absence of any evidence of intrahepatic or extrahepatic obstruction in these patients and the demonstration that splenectomy relieved portal hypertension defined at surgery in 4 patients, suggests that augmented adhepatic flow contributes to portal hypertension in some cases. The review leads to the conclusions that: 1) Operative procedures in prepared patients with myeloproliferative disorders are not associated with prohibitive mortality and morbidity rates. 2) Splenectomy is indicated for patients with increasing transfusion requirements and symptomatic splenomegaly or hypersplenism and should be performed early in the course of disease. 3) When associated portal hypertension and bleeding varices are present, hemodynamic studies should be carried out to define if splenectomy alone, or a portal systemic decompressive procedure is indicated.


[Atypical amputations of bone tumors of the lower extremity (author's transl)]. The most predominant problem concerning malignant tumors in the lower extremities is the radical removal of the tumor, for this almost always involves amputation. Referring to the eventual outfitting of a prosthesis one must keep functionality in mind from the start. This includes all the planing for the preservation of a stump that can be fitted with a prosthesis. Experience has confirmed the advantages of foot-root stumps and knee disarticulation. Good functional results can be attained with tumors of the femur in individual cases through atypical operations. This involved elongation of the stump by means of a fibula transplant; replacing the femur with a bioceramic endoprosthesis; and rotation-plasty, whereby the knee joint is replaced by the ankle joint.


Oral surgery in general dental practice. Apicoectomy. Apicoectomy is a frequently performed operation. In order to produce consistently good results the operation and its varieties are described, with stress being placed on correct assessment of each case prior to surgery.


Reorganization for intravenous procedures in dentistry. The importance of reorganization for intravenous dental procedures, involving not only premises and equipment but also the dentist and his staff, is emphasised. These matters are discussed in detail with special emphasis on certain essential factors and psychologic aspects.


Analysis of jaw opening reflexes.

Analysis of jaw opening reflexes. Electromyograms were compared with kinematograms recorded for 35 male dental students, average age 25 years, with full occlusions and without temporomandibular joint dysfunction. The records were obtained during the open-close-clench cycle rhythmically performed as the patient occluded on the molar teeth. The mechanical tracings disclosed seven subjects with centric slide and the duration of the cycle was significantly longer than normal. The kinematographic latency of the jaw opening reflex was found to be about equal to the sum of the electromyographic latency and inhibition.


Composite resin restorations. A three-year clinical assessment of four materials. The clinical characteristics of four composite resins were assessed over a period or up to three years. Two hundred and sixty nine restorations of composite resins placed in anterior teeth were subjected to 380 examinations during a three year study. The restorations had been placed in the mouth of patients aged 11 to more than 51 years by a variety of operators and the clinical characteristics observed. An increase in defects and deficiencies occurred at the progressive examinations.


Practical recording of dental caries increment. Records obtained from regular dental patients at initial examination are transferred to punch cards. Subsequent data entered on punch cards. Provision is made for transferring basic and amended information to new cards when required. Analysis of incremental data can be used to evaluate changes in practice and assess work load.


Back from the cuspid.

Back from the cuspid. Denture reduction in formal orthodontic treatment does not appear to prevent the impaction of lower third molars. The extraction of premolar teeth is best carried out as close as possible to the eruption time of the cuspids. The posterior part of the mandibular arch should be evaluated by the study of lateral oblique roentgenograms and one of several options regarding treatment should then be adopted.


Some epidemiological aspects of clefts of the primary and secondary palate in South Australia, 1949-1968. The hospital records of 559 children born in South Australia with clefting of the lip and/or palate were analysed and compared with similar reports in epidemiological characteristics.


Cytogenetic studies of the spleen in chronic granulocytic leukaemia. Using a technique of short-term in vitro culture, cytogenetic studies were performed on splenic tissue from 12 patients with chronic granulocytic leukaemia. In eight patients the disease was in its chronic phase and had been treated with busulphan (seven cases) or splenic irradiation (one case). In five of these patients, small numbers of dividing cells possessing the Philadelphia (Ph1) chromosome were observed; in one, only Ph1 -negative metaphases, presumably those of lymphocytes, occurred, and in two patients no dividing cells were obtained. In four patients chronic granulocytic leukaemia had undergone metamorphosis to an acute phase: in two of these patients no dividing cells were observed in splenic cultures with or without added phytohaemagglutinin: this result may have been attributable to prior cytotoxic therapy. In cultures from the other two patients in metamorphosis, almost all dividing cells were Ph1 -positve and many cells possessed two Ph1 chromosomes. Full cytogenetic analysis in one of these cases showed that the spleen contained several closely related cell lines, apparently reflecting progressive tumour cell evolution.


Treatment of chronic muco-cutaneous candidiasis by lymphocyte transfer factor. A beneficial clinical effect from the administration of lymphocyte transfer factor is described in six patients with idiopathic early onset chronic muco-cutaneous candidiasis. Five patients in two families showed a familial disease pattern. Dermal anergy and failure to produce migratory inhibition factor with intact general immune function were found in patients tested. Antifungal chemotherapy was effective in clearing or markedly reducing the candidiasis and remission was maintained by repeated injections of transfer factor. Therapy was monitored using Candida skin test.


A clinical and lung function study of chronic lung disease and asthma in coastal Papua New Guinea. A prevalence survey on the island of Karkar had previously shown that chronic lung disease was common in both sexes after the age of 35 years and that, in part, this was related to the smoking of home-grown air-cured tobacco. To investigate the nature of this chronic lung disease, 37 nontuberculous subjects with reduced ventilatory capacity (forced expiratory volume in one second less than 75% predicted) underwent clinical and lung function investigations. Ninety-two per cent had adventitiae, 62% had chronic productive cough and 54% had dyspnoea on exertion. Lung function tests showed an irreversible obstructive defect with a variable, but on average, only moderately reduced transfer factor. The chest radiography showed evidence of hyperinflation in 38% of cases but non had narrowing or loss of pulmonary vessels suggestive of emphysema. "Inflammatory changes" occurred in 35% and were associated with a mild but significant element of restriction. The results suggest that chronic bronchitis and chronic bronchiolitis were the main underlying abnormalities and that emphysema was comparatively unimportant. Asthma appeared to be relatively uncommon, especially in children. The clinical and lung function findings in 16 asthmatics were essentially similar to those observed in asthmatics elsewhere and the atopic status of asthmatics and controls was similar to that observed in developed societies. In common with Highland asthmatics however, the age at onset was in early adult life rather than in childhood.


Extensive drug surveillance--a pilot study. The aim of this Extensive Drug Surveillance programme was to develop a system of drug monitoring suitable for detecting adverse drug reactions in hospitalised patients. The monitored field was a general medical ward in the Royal Adelaide Hospital and monitoring was carried out for a period of one month (September 1974). A total of 85 patients (45 males and 40 females) were monitored and in 14 of them adverse reactions were noted. The overall incidence of such reactions was 16.5%. A greater intake of drugs was a significant finding in patients who experienced adverse reactions. Coupled with this was the observation that patients who stayed longer in hospital had a greater number of drugs administered to them. A third finding was the higher incidence of reactions in female patients.


Diarrhoea and colitis associated with antibiotic treatment. Sixteen cases of colitis developing within twenty-one days of antibiotic therapy are reported. There was a wide range of disease severity. Lincomycin and Clindamycin were implicated in twelve. The colitis was of two pathological patterns pseudomembranous colitis and "non-specific" colitis. There is a relative sparing of the rectum in some cases making the diagnosis more difficult on sigmoidoscopy.


Histiocytic medullary reticulosis.

Histiocytic medullary reticulosis. The clinical and pathological features of histiocytic medullary reticulosis (HMR) are described in five patients. Treatment by splenectomy and the MOPP routine resulted in a transient improvement in platelet and neutrophil counts and resolution of anaemia and apparent prolongation of survival in two of the five patients. The relationship of HMR to other histiocytic disorders is discussed. HMR is defined as a unique malignant histiocytosis in which malignant histiocytes engage in phagocytosis of eryrhrocytes, leucocytes and platelets.


Symptomatic hypergastrinaemia with achlorhydria: reflief by antrectomy. A women had hypergastrinaemia associated with the variety of gastritis (Type A) that is associated usually with pernicious anaemia, together with recurring bouts of severe abdominal pain. Fasting serum gastrin levels ranged between 600 and 2750 pg/ml. There was a rise in serum gastrin levels after a standard protein meal, indicative of a large G cell mass, and a fall after intragastric HCI, which led to a trial of treatment with HCI; this gave some symptomatic relief. After surgical antrectomy there was a profound fall of serum gastrin from a pre-operative level of 2500 pg/ml to constant values of 16--25 pg/ml, and complete and lasting relief from the bouts of abdominal pain.


Familial hypertrophic cariomyopathy and lentiginosis. Members of three generations of a family studied, manifest profuse lentiginosis and hypertrophic cardiomyopathy. The autosomal dominant inheritance of this syndrome is established. Lentiginosis should alert the physician to possible underlying heart disease.


Salmonella meningitis treatment with intravenous trimethoprim. Intravenous trimethoprim and sulphadiazine were used in the successful treatment of Salmonella meningitis in a four months old child. Pharmacological data are presented which show good penetration of the bloodbrain barrier by trimethoprim. This combination appears to be a useful alternative therapy for gram-negative meningitis.


Guillain Barré syndrome during the pre-icteric phase of acute type B viral hepatitis. A 54-year-old man presented with the Guillain Barré syndrome (GBS) during the pre-icteric phase of acute type B viral hepatitis. This neurological syndrome has been infrequently described in the clinical course of viral hepatitis but only once previously during the prodromal period. Deposition of circulating immune complexes of the HBsAg have been implicated in the pathogenesis of arthritis, nephritis and polyarteritis associated with type B viral hepatitis. Although the relationship of GBS to type B viral hepatitis is uncertain, a similar immunopathological mechanism may be involved.


Regression of acromegaly following pituitary apoplexy. A case of acromegaly complicated by pituitary apoplexy is described. The pituitary apoplexy occurred while the patient was under investigation in a metabolic ward permitting full assessment of pituitary function both before and immediately after the event. This demonstrated a remarkably selective reduction in the plasma growth hormone concentration with preservation of other pituitary function excluding mild diabetes insipidus. The plasma growth hormone fell from values greater than 120 ng/ml to less than 4 ng/ml. The brisk inappropriate release of growth hormone observed on stimulation with thyrotrophic hormone releasing hormone, associated with a severe headache and the onset of pituitary apoplexy two days later raised the possibility of provocative tests of pituitary function precipitating pituitary apoplexy.


Factor XIII deficiency in two Melanesian families from Papua New Guinea. Three patients from two families in Papua New Guinea with a deficiency of Factor XIII activity are described. Lowered levels of Factor XIII activity were found in the parents of both families. Simple screening tests for Factor XIII deficiency should be included in all coagulation screening tests, even in a developing country.


The sequelae inferior vena caval interruption. Recurrent pulmonary emboli occurred in 26 of 85 patients (31%) after inferior vena caval interruption to prevent pulmonary emboli. Sequelae following this procedure included early problems associated with bleeding, venous thrombosis, the sequestration syndrome, and death. Late sequelae were recurrent episodes of venous thrombosis, the post-phlebitic syndrome and recurrent emboli. Inferior vena caval interruption is associated with significant continuing disability, and it fails to solve the problem it was designed to prevent.


The accuracy of methods of diagnosis in patients with suspected recurrent ulcer after vagotomy. This paper reports a critical analysis of the results of the investigations used to establish a diagnosis in 37 patients submitted to a second operation for presumed recurrent or unhealed ulcer. The results of investigations have been correlated with the operative and histopathological findings.


Eosinophilic gastroenteritis.

Eosinophilic gastroenteritis. Two cases of eosinophilic gastroenteritis are reported, with a discussion of eosinophilia in general and the incidence of various disorders which may be associated with it.


Emphysematous gastritis: report of a case. Emphysematous gastritis is a rare and frequently lethal disorder, characterized by phlegmonous gastritis caused by gas-forming organisms. A patient with this condition is described, in whom the ante-mortem diagnosis was made on clinical and radiological grounds.


Large abdominal wall herniae: an easy method of repair without prosthetic material, with the induction of pneumoperitoneum. Large abdominal wall herniae may pose problems of management, particularly in the presence of obstructive airway and cardiovascular disease. Preoperative induction of pneumoperitoneum usually permits the anatomical repair of large herniae without complications and without the use of prosthetic materials to close the defect.


Dormia basket removal of a residual common duct stone: report of a case. A case is presented of successful removal of a residual common bile duct calculus by the use of a Dormia basket introduced through a T tube.


Acute diverticulitis of the caecum.

Acute diverticulitis of the caecum. Two cases of inflammation of a solitary diverticulum of the caecum are reported. These probably represent the first cases to be reported in Chinese. The pathogenesis of solitary diverticulum of the caecum is different from that of multiple diverticulosis of the colon. A study of these cases was made to understand better this uncommon entity. Before operation, the symptoms, signs and physical findings of caecal diverticulitis are those found in appendicitis. The diagnosis at operation in some cases is difficult because the inflammatory reaction may simulate a malignant process. Local excision is the operation of choice. Our two patients were treated by right hemicolectomy. Discussion is presented of the clinical presentation, pathology and treatment of this condition, so that its prompt recognition may avoid the incorrect diagnosis of caecal malignancy, which in turn would lead to unnecessary radical surgery resulting in a high mortality rate.


Enteric perforation in typhoid fever: a study of 15 cases. Fifteen patients suffering from typhoid perforation are reported and discussed. Controversy still persists regarding the best form of treatment. One can still only state that each patient should be treated on his or her merits.


Portal pyaemia secondary to carcinoma of the rectum. A case of multiple liver abscesses occurring in association with a carcinoma of the rectum is presented. This complication has not been previously recorded. It gave rise to an unexplained pyrexia and a confusing liver scan.


The management of solitary thyroid nodules under local anaesthesia. A group of patients with solitary nodules of the thyroid were treated at the University of Malaya by surgery under local anaesthesia. This was done in order to expedite exploration of a potentially malignant condition. This group comprised 43 patients, and four cancers were found. The standard technique used was satisfactory from the viewpoint of both the patient and the surgeon. The pattern of this condition in a Malaysian population is documented, the technique used is described, and thyroidectomy under local aneaesthesia is discussed.


Drill biopsy of the thyroid gland.

Drill biopsy of the thyroid gland. Needle drill biopsies were performed on 360 patients presenting with thyroid swellings. The indications and technique are discussed. Surgical treatment was carried out for 154 of the 225 solitary nodules and 82 of the 129 nodular goitres. The overall success rate in obtaining thyroid tissue was 74%. The accuracy rate was 100% in lymphocytic thyroiditis, anaplastic carcinoma and medullary carcinoma. With adenoma, 66% of those presenting as solitary nodules and 44-4% as nodular goitres were correctly diagnosed. Two-thirds of papillary carcinomas were correctly diagnosed by drill biopsy. Only 28-6% of follicular carcinomas were diagnosed before operation. The drill biopsy proved to be a simple procedure, with few complications, and served the purpose of selecting patients for operative treatment.


Slipped femoral capital epiphysis: a review of 49 cases treated at the University of New South Wales teaching Hospitals over the last ten years. The purpose of this paper is to assess critically the results of treatment of slipped femoral capital epiphyses in patients seen over the past ten years at the Prince of Wales Hospital. The problems examined in this study include: (a) the indications for prophylactic pinning; (b) the number of Knowles pins necessary for fixation; and (c) the questions whether and when these should be removed.


Below-knee amputation in peripheral arterial disease. A below-knee amputation will heal in most patients with atherosclerotic peripheral arterial disease, using no anterior flap and a long posterior myoplastic flap. The technique used by the authors is presented in detail, with their experience in 32 cases.


The effect of intrauterine phrenic nerve division on the development of the lungs and diaphragm in fetal rabbits. Intrauterine division of the left phrenic nerve has been successfully performed in rabbit fetuses as early as the 21st day of gestation, prior to alveolar differentiation. This procedure results in intrauterine atrophy of the ipsilateral hemidiaphragm and hypertrophy of the contralateral side. Light and electron microscopic studies have shown no interference with the subsequent maturation of the lung.


Non-Hodgkin's lymphoma in children: results of treatment with LSA2-L2 protocol. The results obtained with very intensive treatment in previously untreated patients early in the disease are encouraging, and we hope will change the philosophy of most investigators that even in far advanced disease such as those with marrow metastases or multiple primary sites, one can still obtain complete regression at all tumour sites within 1 to 1 1/2 months from onset of therapy by combined treatment with multiple chemotherapeutic agents and radiation therapy to one or more sites.


The relationship between personality and the symptoms of depressive illness. The Maudsley Personality Inventory and the Beck Depression Inventory, with additional items to assess depressive functional shift features and outlook on life values, were administered to 100 patients diagnosed as suffering from depressive illness. Patients' scores for questions eliciting information about symptoms assumed to be dependent on personality correlated at substantial and significant levels with N scale scores of the Maudsley Personality Inventory. Similar levels of correlation were found for the added items for assessing life values. Items believed to assess changes in functions independent of personality, such as the features of the Depressive Functional Shift, showed no correlation with either N or E scales of the Maudsley Personality Inventory, while demonstrating a substantial level of correlation with the depression scale. It is concluded that whereas changes in innate biological functions independent of environment are direct indications of the depressive illness process, psychological symptoms of the illness may reflect changes in personality dependent on upbringing, education and cultural background, thereby producing greater variation in this group of psychological symptoms.


Two cases of Gilles de la Tourette's syndrome treated with haloperidol. Two cases of Gilles de la Tourette's syndrome occurring in Sri Lanka are reported. Both patients had the characteristics of the syndrome as described by Fernando (1967): (1) Childhood onset (below 16 years of age); (2) Multiple motor tics; (3) Unprovoked vocal utterances which may progress to coprolalia. Both responded to haloperidol, withdrawal of medication being followed by relapse, and reintroduction by remission. The literature on the aetiology of the condition has been reviewed. The weight of evidence favours an organic cause, although psychological precipitation cannot be ruled out.


Treatment of acute leukemia during pregnancy. Cytarabine and thioguanine therapy for acute myelocytic leukemia, initiated during the 26th week of pregnancy, led to complete remission of the leukemia in a 22-year-old woman, and allowed for delivery of a normal infant at term. No chromosomal abnormalities were detected in the infant. Cytarabine and thioguanine in combination are effective agents in the treatment of acute leukemia in adults. Their use appears warranted in pregnant patients after the first trimester.


The relationship between the time of fractionated and single doses of radiation and hyperthermia on the sensitization of an in vivo mouse tumor. The present study was undertaken to explore the relationship of the time interval between application of heat and irradiation on enhanced tumor cell sensitivity. Using the Ridgway osteogenic sarcoma grown in AKD2F1/J mice, local tumor hyperthermia (42.5 +/- .5 degrees C for 15 minutes) was applied at various time intervals before or after single or fractionated doses of x irradiation. Enhancement of tumor cell sensitivity by combined treatment with radiation and heat, as measured by delay in tumor growth, cure rates, and mean survival times was inversely proportional to the time interval between application of both modalities. The interactions associated with this increased sensitivity appear to be transitory, diminishing with time between treatments. Possible mechanisms of action for thermal sensitization may involve the reduction of oxygen dependence as well as a reduced recovery capacity of tumor cells.


Nuclear incorporation of radioactive DNA precursors and progression of cells through S. Combined radioautographic and cytophotometric studies on normal and leukaemic bone marrow and thoracic duct lymph cells of man. Bone marrow blast cells of nine children with untreated acute leukaemia (five lymphoid, three myeloid, one monocytic), myeloid precursor cells of a haematologically normal child and thoracic duct lymph cells of a patient with sclerodermia were pulse-labelled in vitro with tritiated thymidine and/or tritiated cytidine. Combined radioautographic and cytophotometric techniques were used for the determination of the median nuclear size and the median grain count of labelled cells in different segments of S. It was found that the median grain count reached maximum values in the second or third quarter of S in all cell populations studied, and that the variation, during S, of the median grain count appeared to be independent of the median DNA synthesis times of the cell types investigated. In six cell populations a clear-cut inverse relation existed between the number and the median grain count of labelled cells in different segments of S. In three populations this relation was less apparent and in two it was not found at all.


A question of the role of the vomer in the growth of the premaxillary segment. Antero-posterior retardation of upper jaw growth became evident in all five dogs with surgically placed clefts and extirpation of the vomer within 8 weeks following surgery. Five control dogs with congenital cleft palate maintained a normal jaw relationship. The evidence indicated that the difference in growth between the two groups may be explained in terms of the role played by the vomer in the growth and support of the upper jaw in the dog. This observation suggests that the dog may be used as a model for the study of retardation of growth in the antero-posterior dimension and indicates a need for research concerned with the role of the vomer in the human bilateral cleft condition.


The occult submucous cleft palate.

The occult submucous cleft palate. We have studied 41 patients with classic submucous cleft and 32 cases with occult submucous cleft. Both groups have the same anatomic abnormality that leads to velar dysfunction-the insertion of the palate muscles onto the hard palate rather than onto the midline soft palate raphe. However, the occult submucous cleft palate does not have the classic triad of bifid uvula, hard palate bony notch, and furrow in the midline of the soft palate. Characteristic facial features, cephalmetric x-rays, and cine voice studies can help make a presumptive diagnosis of occult submucous cleft palate. Surgical management includes a diagnostic palate exploration to identify muscle configuration followed by levator muscle sling reconstruction, palate pushback, and pharyngeal flap. Excellent speech results are obtained except with patients having palate paresis.


Patterns of velopharyngeal closure in subjects with repaired cleft palate and normal speech: a multi-view videofluoroscopic analysis. Thirty subjects with repaired palatal clefts and normal speech ranging in age from 2 to 12 years were examined in multiple videofluoroscopic projections in order to assess velopharyngeal closure in three dimensions. The following points became evident from the results of this study: 1. All 30 subjects exhibited contact between the superior border of the velum and the adenoid mass in the nasopharynx. Often, a sharp levator eminance was not formed due to the small space between the velum at rest and the adenoids. Thus, there was little room for the velum to elevate. 2. All 30 subjects showed good localized medial movement of the LAPW at the approximate plane of the hard palate. 3. 10 out of 30 subjects, 33%, had a Passavant's Ridge during speech. All 10 of these subjects utilized the ridge as a point of closure, as well as the adenoids. 4. The observed patterns of closure were consistent across varied consonant utterances. 5. The mechanism of velopharyngel closure in this group of subjects is essentially the same as for normal adult speakers and differs only anatomically due to a lack of verticle head growth in children. Thus, in spite of the presence of adenoids and the lack of verticle head development, the basic sphincteric mechanism of velopharyngeal colsure is utilized in these subjects.


A roentgencephalometric investigation of the effect of adenoid removal upon selected measures of velopharyngeal function. Pre-and postoperative lateral x-rays were taken of 15 candidates for adenoid removal, ranging in age from four to seven years. Cephalometric measurements were taken during rest and during function (/s/). The postoperative group acquired pharyngeal dimensions of C.P.I. proportions as a result of adenoid removal. However, all subjects achieved velopharyngeal closure and displayd no hypernasality following this surgical procedure, indicating success in terms of speech. The success in their adaptation can be attributed to the following: 1) increased velar mobility; 2) increased height of velopharyngeal closure; 3) increased percent of velar stretch; and 4) anterior movement of the posterior pharyngeal wall when amount of velopharyngeal contact became tenuous. The normal velopharyngeal mechanism has the capacity to successfully overcome the imbalance between pharyngeal dimensions and velar length caused by adenoid removal. The normal mechanism overcomes this imbalance by means of compensations, some of which are typical of the inadequate mechanism.


Height-weight growth of cleft children, birth to six years. A study was conducted on 279 patients from the longitudinal patient series at the Institue to determine the general physical growth of cleft children using height and weight measurements. The objectives were to determine if severity of cleft type and sex in relation to severity of cleft type significantly affected height and weight and to determine if the height and weight of cleft children vary significantly from the non-cleft norm. The results showed that severity of cleft type is not significant while sex in relation to cleft type may be significant in several instances. It was also found that cleft children are neither consistently shorter nor consistenely lighter than the norm. An early lag period occurred, but by three years cleft children catch-up to the norm and rebound to growth equality, thus appearing to conform to the concept of catch-up growth.


Electromyographic verification of viable muscle tissue following a double-pendulum flap procedure for surgical repair of bilateral cleft lip. Five patients were seen in an electromyographic study of the double pendulum flap method of bilateral cleft lip repair. All five patients displayed active orbicularis oris muscle tissue. By bringing lateral lip segments to the center of the cleft, the double pendulum flap method restores muscular function and improves cosmetic appearance. This surgical procedure may be modified to be performed on other anomalies resulting from a discontinuity of muscular tissue.


A cephalometric study of velar stretch in 8 and 10-year old children. Radiographic cephalometry was used to examine the prevalence, magnitude, and relationship between velar stretch and other commonly employed cephalometric measurements in forty (40) normal-speaking 8 and 10-year-old children. Velar stretch was not universally observed although the average soft palate length characteristics of these children measured during speech were significantly longer than the resting or intrinsic palate length measurements. Significant differences in average stretch magnitude were measured as a function of speech task (/u/ vs /s/) and subject age (8 vs 10-year-olds). Although velar stretch was significantly correlated with several commonly used cephalometric measurements, stretch was not well predicted by any single cephalometric measurement used in this research. These findings are interpreted in terms of their implications for determining velopharyneal adequacy for speech and their implications with respect to developmental features of velar function.


Differential cell proliferation of embryonic rat palatal processes as determined by incorporation of tritiated thymidine. The differential cellular proliferation of the palatal processes in the Wistar albino rat was studied utilizing tritiated thymidine labeling. 3HTdr was given to pregnant rats at 14, 15, 16, and 17 days of gestation. The animals were killed one hour after injection. The fetuses were removed and the heads were embedded, sectioned, and an autoradiographic technique utilized. The autoradiograms were examined microscopically and labeling indices for various areas and regions of the palatal processes were calculated. The findings revealed that the pattern of cellular activity of mesenchymal and epithelial cells changes in different areas and regions of the palatal processes with different stages of secondary palate development.


Development of the palatal arch in relation to unilateral cleft lip and palate surgery: a comparison of the effects of different surgical approaches. Our cases are too small in number to conclude which kind of surgical method retards the maxilla development. But we can say that a maldevelopment of the maxilla may be expected to occur in the case of any surgery performed. In the cleft lip only patients, Millard's method and our method show a better effect than the other methods from the point of view of the retardation of the mid-third of the face. In the group of unilateral cleft lip and palate patients our method may be the best on this point. At the end, we would like to present our typical cases with figures (Figures 4 and 5).


Factors associated with missed appointments of patients in a cleft lip and palate clinic. This is a report of the utilization rate of patients in a cleft lip and palate clinic and to ascertain what factors are associated with missed appointments. We had a missed appointment rate of 13.4 percent which compares favorably with those rates reported in the literature. We found that the group of patients who missed all appointments were more highly educated and private payment patients. We also found that our longitudinal patients had a better record of keeping appointments than did other patients.


[Effect of mexamine on the resistance of dogs to acute hypoxic hypoxia]. As demonstrated in experiments staged on dogs mexamine hydrochloride, used in a dose of 20 mg/kg by the intraperiotoneal route 1.5 hours before the onset of acute hypoxic hypoxia increases the resistance of the organism to oxigen deficiency. Mexamine is capable of significantly intensity hypothermy in dogs during acute hypoxic hypoxia.


Two complex translocations in chronic granulocytic leukemia involving chromosomes 22, 9, and a third chromosome. Among 13 Ph-positive cases of chronic granulocytic leukemia (CGL), banding studies revealed two with complex rearrangements involving translocation of the long arm of number 22 to another autosome and a segment of that chromosome translocated to the long arm of number 9. In a patient with both CGL and sickle cell anemia, the 3-way rearrangement involved chromosomes 5, 9, and 22; and he also had a second Philadelphia chromosome and two constitutional variants: pericentric inversion of the other number 9 chromosome and satellite polymorphism in the G group. The karyotype of the leukemic cells was interpreted as: 47,XY,inv(9) (p11q13),t(5;9;22)(q13;q34;q11)+del(22)(q11). In the second patient, the complex translocation in the Ph-positive cells involved chromosomes 3, 9, and 22, resulting in a karyotype interpreted as: 46,XX,t(3;9;22)(p21;q34;q11). Several reports indicate that an abnormality of chromosome 9 is not essential for the development of Ph-positive CGL, but the very high frequency of its involvement (including these unusual translocations) suggests that some type of non-random somatic association may exist between 9q and 22q which makes simultaneous breakage likely. Attempts to correlate specific types of pH chromosome rearrangements with the clinical course of CGL must await the identification of more cases and longer follow-up.


Problems and proposals for recording gingivitis and plaque. The origin of indices for recording gingivitis and plaque is reviewed. Each index seems to have been constructed for a special purpose. The development so far has been towards more and more delicately graded indices which are well suited for evaluation of short term clinical trials. The increased sensitively, though advantageous for scientific purpose, is not always practical from a public dental health point of view. It seems that at present there is a need for several different types of index systems. In order to be able to conduct his preventive programs the practicing dentist needs a simple and well defined recording system for oral hygiene and gingival inflammation. Such an index system should be as easy and natural to use as is the scoring of decayed and filled surfaces today. Instead of using individual mean scores of multi-graded plaque and gingival indices, the use of the site prevalence of a single finding is suggested. For recording of gingivitis in daily dental practice the number of gingival margins bleeding on pressure is recommended to be determined as a percentage of the sites examined (Fig. 1,2 and 3). For oral hygiene, correspondingly, the frequency of occurrence of tooth surfaces covered with clearly visible plaque could be used as a clinically relevant parameter (Fig. 4). Keeping visible plaque and gingival bleeding away is also suggested to be a clearly understandable and practical aim in the dental health education of the individual patient.


Should I be using amalgam or composite restorative materials? Composite materials were first introduced for use in Class III and Class V cavities. They have now been accepted as the most popular material for the restoration of Class IV cavities and of fractured incisors and their use in Class I and Class II cavities has been advocated. Laboratory investigation of the physical properties of the composite materials suggests that with the exception of hardness, the values recorded are comparable with those for amalgam. In their favour are a lower coefficient of thermal conductivity and superior aesthetics. It has been claimed that a Class II composite restoration can be placed more easily and more rapidly than an amalgam but if comparable contour and adaptation is to be achieved, this claim cannot be substantiated. In contrast to laboratory studies, clinical research has shown that composite materials have some shortcomings. Their colour tends to become more yellow with time and their ability to resist marginal percolation is inferior to that of amalgam. Under clinical conditions their resistance to abrasion is unsatisfactory because of the failure of the bond between the filler particles and the resin. On balance, at the present time amalgam is preferable to composites for Class I and Class II restorations except in cases where aesthetics is the overriding consideration.


The effect of new technologies in training and utilization of dental auxiliaries in the United States Air Force. Training of Dental Auxiliaries in the United States Air Force is a highly structured process combining training in short formal courses at the School of Health Care Sciences with extended periods of formal on-the-job training and self-study correspondence courses conducted at bases throughout the Air Force. The rigid control imposed by Air Force training directives is a major factor in the success of this dual channel concept. Dental auxiliaries are trained for what they need to know, as outlined in a 'task list' for their specific career field and behavioral objectives devised from the task list. Dental auxiliaries are utilized in the field performing in four basic areas: Dental Laboratory Technology, Chairside Dental Assisting, Preventive Dentistry (dental hygiene), and Expanded Function Dental Assisting. The scope of their duties range all the way from receiving the patient at the reception desk, assisting with dental treatment and dismissing the patient, to long-range planning for resource requirements necessary for the operation of a complete dental service. To paraphrase an old saying: 'The dental auxiliary is the backbone of the Dental Corps of the United States Air Force'.


The organization of the Department of Defense in relation to the administration of the armed forces dental services in the United States. In 1947 the organization that became the Department of Defense was established. During the ensuing years the Office of the Assistant Secretary of Defense for Health and Environment (ASD (H & E)) evolved. On the staff of the Assistant Secretary (H & E) is a Special Assistant for Dental Affairs. In concert with the military departments and their Surgeons General, policies and programs are developed to provide the highest possible quality of health care by a totally voluntary, professionally satisfied, efficient and effective medical service to all for whom the military services are responsible.


Inter-examiner and intra-examiner reproducibility in clinical and radiographic diagnosis. The first technical report to be published by the FDI considered the principal requirements for controlled clinical trials of caries preventive agents and procedures. This document advocated the use of a simple reproducibility ratio as a measure of variability in caries diagnosis. In accordance with the FDI recommendations available figures from published work on duplicated examinations are presented in terms of this reproducibility ratio. The data refers to intra- and inter-examiner variability with respect to both clinical and radiographic examinations. Reproducibility studies carried out as a pre-calibration investigation and during the baseline examinations of a current clinical trial are also included. Considerable diversity is apparent, the intra- and inter-examiner variation for clinical examinations ranging from 0-13 to 0-61, and for radio-graphic assessments from 0-06 to 0-60. If an acceptable range of reproducibility ratios is to be formulated then this wide variation will have to be taken into account. Ultimately, if examiner variability cannot be maintained within reasonable limits, then the choice of an examiner could be just as important as the choice of the test substance.


Temporomandibular articular reflex control of the mandibular musculature. The results of an experimental electromyographic investigation of temporomandibular arthrokinetic reflex control of the mandibular musculature are reported. Co-ordinated, rapidly-adapting and slowly-adapting facilitatory and inhibitory reflex changes in motor unit activity in the mandibular musculature were evoked by graduated passive movements of the isolated (but innervated) temporomandibular joint. Induced dysfunction of regionally discrete groups of articular mechanoreceptors was shown to result in specific changes in static and synamic reflex motor unit activity. The possible clinical significance of these changes is discussed.


Lymphocyte stimulation by autologous tumor cells in the presence of serum from the same patient or from healthy donors. Lymphocyte blastogenesis induced by autologous tumor biopsy cells, by allogeneic lymphocytes and by PHA, was performed in the presence of autologous or allogeneic serum collected from normal blood donors. In 13 of the 15 cases lymphocyte stimulation by autologous tumor cells was inhibited in the presence of autologous serum. In contrast, autologous serum somewhat enhanced the blastogenic effect of PHA and allogeneic lymphocytes.


Monokaryon frequency among survivors from dikaryotic mycelial fragments. If unicellular fragments of dikaryotic fungal mycelia are treated with environmental agents which inactivate their nuclei, a sharp rise of monokaryotic fragments among the survivors is expected. Mathematical evidence is presented that the same is also true for homogeneous multicellular fragment populations. It is shown that almost the same increase in monokaryon frequency is to be expected if the fragment population is heterogeneous and composed of different size fragments, regardless of whether these sizes are randomly or non-randomly distributed in the population. The curves for monokaryon frequencies among survivors are almost identical for all four situations considered. We may conclude that dikaryotic mycelia of higher fungi, such as Schizophyllum commune, are very suitable systems for investigating the effect of environmental agents on the nuclei.


Genotype X environment interactions. II. Some genetical considerations. An algebraic formulation, alternative to that of Mather and Jones (1958) and hierarchial rather than factorial in nauture, is presented for describing the differences among the phenotypes produced by a number of genotypes each grown in each of a number of environments. This formuationdoes not include terms representing statistical interactions between genotypes and environments: it depends instead on comparisons between the different genotypes in their variation over the relevant ranges of environemnts. The two-line case is considered ant eht condition established for linearity of the regress ion of genotype X enviroment interaction (g in Mather and Jones' formulation) on overall effect of the envirronment (e in Mather and Jones' formulation)...


Polymorphisms in cyclically-varying environments. We analysed both continuous and discrete two-allele models of cyclically-varying environments with an arbitrary degree of dominance. In continuous models, the gene frequency fluctuates with the period of the environmental oscillation. For the discrete case, the calculations were carried out to second order in selection. In contrast to the continuous models, and depending on the amount of dominance and the intitial gene frequency, fixation is possible as well as polymorphism.


Effect of metabolic inhibitors on bone lipid synthesis from radioactive bases. Iodoacetate at 10(-3) M and 10(-4) M concentrations was found to strongly inhibit incorporation of both 14C-choline and 3H-inositol into phospholipids of calvaria from newborn rats; it had somewhat less effect on ethanolamine incorporation and almost no effect on serine incorporation. Similar though less dramatic results were observed with cyanide or dinitrophenol at similar concentrations.


Effects of single exposure to sugar on calcium and phosphorus concentrations of dental plaque. The results from three studies on the plaque of children and adults indicated that the response of the plaque to a single five-minute exposure to sugar cubes or boiled sweets (candies) depended on the initial condition of the plaque. Thus, significant decreases in the levels of calcium and phosphorus in plaque were observed in previously starved plaques but not in plaque from participants without previous dietary sugar restriction.


Electron microscopic structure of the two layers of carious dentin. Two layers of carious dentin from extracted human teeth were observed with an electron microscope. The first layer, which is superficial and fuchsin-stainable, showed degenerated collagen fibers and granular or leaflike inorganic crystals irregularly scattered. The second layer, which is profound and fuchsinunstainable, showed expanded odontoblastic processes, sound collagen fibers, and apatite crystals bound to the fibers like fringes.


Localization of amylase in major salivary glands of the guinea pig. The localization of amylase activity in the major salivary glands of adult male and female guinea pigs was determined by a substrate film technique. Parotid and submandibular glands showed intense activity localized to the acini. Only a weak reaction in the lumen of intralobular ducts was observed in sublingual glands. The sex differences in amylase activity reported in other commonly studied laboratory rodents were not detected in this species.


In vivo and in vitro corrosion products of dental amalgam. Corrosion products of amalgam produced in Ringer's solution were compared with products formed in vivo using scanning electron microscopy, X-ray microanalysis, and potentiostatic anodic polarization. The corrosion products in an old amalgam were probably a mixture of tin-oxide and tin oxychloride. In vitro corrosion of fresh amalgam resulted in the buildup of similar products.


Polyurethane elastomer as a possible resilient material for denture protheses: a microbiological evaluation. A polyurethane elastomer was microbiologically evaluated in vitro for its potential use in resilient denture liners. Specimens were immersed in suspensions of ten selected oral microorganisms; this was followed by viable cell counts at intervals during a 16-week period. Results indicated that the polyurethane neither supported the growth of the organisms nor was it degraded.


Truncated Poisson distribution with optimization techniques in the epidemiology of caries. A truncated Poisson distribution provides a closer fit to observed caries in a sample of 10- to 11-year-old children than a previously reported chain binomial distribution. Operations research techniques are used in estimating a parameter.


Glycoprotein biosynthesis at the time of palate fusion by rabbit palate and maxilla cultured in vitro. The dynamics of glycoprotein biosynthesis in rabbit maxillary and palatal explants at the time of palatal fusion was studied using 3H-fucose and 14C-leucine as precursors. The results show that there is an increase in glycoprotein biosynthesis in the rabbit palate in vitro at a time commensurate with the onset of contact and adherence of the palatal shelves.


Behaviorally based measures for evaluating the nonclinical performance of dentists in team settings. Retranslations of expectations technique was used to develop behaviorally anchored scales for evaluating dentists' utilization of expanded duty dental auxiliaries. To enhance the reliability and validity of such instruments the project focused on specific acts and decisions of the dentist which are either effective or ineffective in accomplishing the health team's tasks.


Bacterial conditions of water in dental units. Stagnant water in the boiler of a dental unit can cause a high bacterial density. A spiral unit is somewhat superior to a boiler in this respect. Normal unchlorinated tapwater is the main problem in achieving hygienic conditions in dental practice. The technical performance of the unit is only partly responsible for the water quality.


Cleft palate induction: quantitative studies of 3H corticoids in A/Jax mouse tissues after maternal injections of 3H cortisol. A/Jax mice were injected with 50 muCi of 3H cortisol and 10 mg of cortisone acetate on day 12 of gestation. At various intervals after injection, the maternal liver, placenta, yolk sac, and the fetal jaws were removed and analyzed by thin-layer chromatography in conjunction with oxidative combustion and liquid scintillation counting to identify and measure the amount of labeled corticoid metabolites. The results support the thesis that these corticoids may induce clefts by an individual or combined direct action on the fetal jaws and palatal shelf tissue.


Reduction in dentin wear resistance by irradiation and effects of storage in aqueous media. Electromechanical dentin abrasion measurements showed that the irradiation treatment applied before radiotracer dentin abrasion measurements reduced the wear resistance of dentin. This caused changes in the measured relative abrasitivities of dentifrices. Effects of storage in aqueous media were also investigated.


Composition and mechanical properties of gutta-percha endodontic points. Gutta-percha endodontic filling points were found to contain approximately 20% gutta-percha (matrix), 66% zinc oxide (filler), 11% heavy metal sulfates (radiopacifier), and 3% waxes and/or resins (plasticizer). The mechanical properties were indicative of a partially crystalline viscoelastic polymeric material. They were found to obey Hooke's law and displayed a prominent upper and lower yield point when stressed beyond the proportional limit. The essential differences in mechanical properties of individual brands were found to be a function of the gutta-percha and zinc oxide concentration.


Method for the clinical evaluation of enamel polish. Enamel polish of 600 children was scored. The method used is simple and comprises a visual comparison of the facial surfaces of incisors with a polish standard prepared by selectively polishing extracted teeth. Examiners with little experience can distinguish degrees of enamel polish. A high-polish dentifrice produced significantly greater enamel polish during the 27-month study. A "polish" with flour of pumice at the beginning of the study did not influence this enamel polish.


Biochemical and morphological studies of rat submandibular gland: I. Centrifugal fractionation of granule-rich fraction. Submandibular glands from male rats were homogenized in 0.34 M sucrose and 0.5 mM ethylenediaminetetraacetic acid in 10 mM HEPES buffer at a pH of 7.4. The extract was centrifuged and filtered through nuclepore filters to prepare a granule-rich fraction. Electron dense zymogen granules constituted approximately 85% of the particles in this fraction which also contained about a third of the total alkaline esterase activity in the gland.


Histology of fissures in human unerupted teeth. An investigation into the contents of the fissures of unerupted teeth was made using light and scanning electron microscopy techniques. For this study, 193 unerupted teeth were used. The presence of ameloblasts in the fissures was substantiated, and their role in forming the fissure is discussed.


Effects of short-term and long-term administration of procaine hydrochloride and mepivacaine hydrochloride on hexobarbital-induced sleeping times in mice. Investigations were performed to determine the effects of short-and long-term pretreatment with procaine and mepivacaine on hexobarbital-induced sleeping times in mice. It was found that short-term preadministration with procaine (40 mg/kg) and mepivacine (40 and 60 mg/kg) significantly increased hexobarbital-induced sleeping time, but long-term pretreatment had no effect.