Management of chronic myelocytic leukemia in pregnancy by cell pheresis. Cell pheresis was employed in the initial management of a pregnant patient with chronic myelocytic leukemia (CML). Reduction in circulating leukocyte and platelet counts was evident after two weeks of therapy. This technique is an effective mode of management of the pregnant patient with CML and may play an important therapeutic role in the treatment of other myeloproliferative diseases characterized by dangerously high levels of circulating platelets or myeloblasts.


Radiotherapy and surgery in 50 cases of osteosarcoma treated without adjuvant chemotherapy. A consecutive series of osteosarcoma patients from one hospital is described. In 1962 radiotherapy with delayed surgery according to Cade was replacing surgery alone as the adopted treatment programme. Statistically the results were the same before and after this time with 5 out of 29 and 6 out of 21 patients, respectively, surviving 5 years. With radiation alone none out of eight survived. Surgery alone produced 3 out of 14 and radiation with delayed surgery 6 survivors out of 15. As surgery with or without radiotherapy is equally ineffective in controlling osteosarcoma a prospective randomized trial of the relative merits of chemotherapy and interferon as adjuvant therapy seems highly desirable.


Fracture of the tibial shaft treated by primary operation and early weight-bearing.


Morphology of experimentally induced respiratory tumors in syrian golden hamster. A histological, histochemical and ultrastructural study.


New methods for the recording of the eustachian tube function.


Cessation of therapy in childhood leukemia. A survey of 160 cases from the Nordic Countries. A survey is presented of 160 children from the Nordic countries who had their antileukemic therapy discontinued prior to November 1976. Twenty-seven of the 160 cases (17%) had suffered a relapse before May, 1977. Sixty-nine cases had their therapy stopped in the first ten months of 1976. All cases have been reported as acute lymphocytic leukemia. Different types of therapy schedules have been used. Thirty-five cases in sustained remission for more than 3 years without cessation of therapy are also included in the report, seventeen of whom had relapsed while still on therapy. Central nervous system or testicular relapse occurred in 21 of the total 44 cases who relapsed after three or more years of continuous remission, and whether they were on therapy or not.


Social and medical prognosis of child with acute nontuberculous purulent meningitis.


Long-term, continuous monitoring of multiple physiological parameters in newborn and young infants. Procedural manual.


Exploring child health and its ecology. The Kirkos study in Addis Ababa an evaluation of procedures in the measurement of acute morbidity and a search for causal structure.


Adenocarcinoma of the uterine cervix. An evaluation of the available diagnostic methods.


Increase in serum alkaline phosphatase (S-ALP) in chronic myelocytic leukemia--sign of drug-induced cholestasis? In four patients with chronic myelocytic leukemia, a solitary rise in serum alkaline phosphatase (S-ALP) was noted 2--12 months prior to death. All patients had received busulphan (Myleran) therapy for longer than 12 months (total dosage 1.0--2.4 g). It is suggested that the increase in S-alp was due to a cholestatic liver damage, possible secondary to the busulphan treatment.


Medical, occupational and smoking characteristics related to ischemic heart disease in men and women. Field survey of age group 40 - 59 in a rural population at Haapavesi, Northern Finland.


Ternary copper (II) complexes containing salicylate and nitrogenous chelates such as histamine. In the introduction the chemistry of some bivalent copper complexes of aspirin and salicylate is briefly reviewed and the biological importance of mixed-ligand complexes of bivalent copper is illustrated. The nature of hydroxy-bridged copper (II) complexes and their possible role in the physiological activity of histamine is also discussed. Several neutral, insoluble copper (II) complexes of the type (Chelate-Cu-salicylate) 0-lambda H2O where chelate = 1, 10-phenanthroline (phen), chi = 1; 2,2'-bipyridyl (bipy), chi = 2; histamine (Ha), chi = 1; and where salicylate (sal) = dianion of salicylic acid have been prepared for the first time. They have been characterised by physico-chemical methods and the role of binuclearhydroxy-bridged copper (II) complex ions in their formation is demonstrated. Such complexes may be relevant to the pharmacological action of histamine and of the salicylates, the copper complexes of which are potential anti-inflammatory drugs. Results of some in vivo experiments that have been carried out with mice are also presented.


Are there antirheumatic drugs which could increase the synthesis of prostaglandins?


Actions of anti-inflammatory drugs on smooth muscle.


Interactions of anti-rheumatic drugs.

Interactions of anti-rheumatic drugs.


Salicylate toxicology.

Salicylate toxicology.


A pharmacokinetic approach to the understanding of therapeutic effects and side effects of salicylates.


Lysosomal enzymes of phagocytic cells as humoral mediators of inflammation: modulation of their release by cyclic nucleotides. The origin of lysosomes in phagocytic cells is described. Studies on their characterization by both morphological and biochemical methods are summarized. Lysosomal enzymes of both polymorphonuclear leukocytes and macrophages can be released by exocytosis in response to a variety of inflammatory stimuli. This response is modulated by cyclic nucleotides. In the polymorphonuclear leukocyte cAMP inhibits enzyme release while cGMP enhances release; the effects of the cyclic nucleotides are less clear in the macrophage. The possible involvement of microtubules and microfilaments in the release process is discussed.


Endogenous substances as modulators of inflammation.


Arthritis: a clinical model of inflammation.


Clinical evaluation of novel anti-rheumatic drugs. New methodology is required to evaluate new drugs. Trials designs and measurements developed for conventional anti-inflammatory therapy will fail to demonstrate the properties of a group of novel anti-rheumatic agents including gold, penicillamine and levamisole. These compounds act slowly, producing their maximum effect after 6 months of treatment. Trials must therefore be of at least this duration and it is useful to document the time course of the action. Measurements of rheumatoid arthritis must include not only conventional indices of disease activity (pain, morning stiffness, articular index, swelling) but also extra-articular features such as nodules, E.S.R., and rheumatoid factor titre. Reduction in technetium index is a feature of the action of drugs of this type. Changes in immunoglobulins and in some other immunological measurements may also be useful. Future trials must look increasingly at modes of action of drugs and the factors which determine the presence or absence of a response in an individual patient.


Some experimental models for the study of inflammation and anti-inflammatory drugs.


Histopathology of acute and chronic inflammation. Inflammation, defined as local reaction to injury, is basically a homeostatic process-loop system with morphological and biochemical components. If this homeostatic loop is uncomplicated a normal situation is reached soon after injury. Morphologically different patterns of inflammation can appear, depending on the character and intensity of the injury. Furthermore, the contributions made by hyperaemia, exudation of fluid, infiltrates carrying inflammatory cells, and cell proliferation not only vary with the type of injury but also depend on the time after injury. Some of the histopathological changes can be seen as essential for the restoration of the normal situation, whereas others damage the tissue more than seems desirable. The morphological aspects of different types of inflammation are discussed in relation to the homeostatic nature of the inflammatory process.


Cell kinetics during inflammation.

Cell kinetics during inflammation. This communication deals with the production and kinetics of mononuclear phagocytes and polymorphonuclear phagocytes in the normal steady state and during an acute inflammatory reaction and with the humoral regulation of the increased production of leucocytes during an inflammatory reaction. The effect of hydrocortisone and azathioprine on both kinds of phagocytic cells is also discussed.


Leucocytes and chemotaxis.

Leucocytes and chemotaxis.


Interaction between lymphocytes and macrophages.


Involvement of complement and kinins in some non-immunogenic paw inflammations in rats.


Inflammatory responses of the rabbit eye to prostaglandins. A modified Draize scoring procedure has been used to quantify the vascular effects of prostaglandins on the rabbit eye. Topical application of 100 microgram of PGE1 caused conjunctival redness (erythema due to vasodilatation), swelling (oedema due to increased capillary permeability), discharge, lids closure (decrease in palpebral aperture) and occasionally miosis, though no corneal or iridial damage was detected up to three hours. PGE1 and GE2 produced practically identical dose-related increases in scores for most of the inflammation parameters, though oedema responses were consistently lower after PGE2. The neutral, triethanolamine salt of PGE1 was as inflammatory as PG1 itself. PGF2alpha was  10-50 times less inflammatory than PGE1. It produced relatively greater erythema responses than oedema responses, when compared to PGE1. The novel prostaglandins, 19-OH PGE1 and 19-OH PGE2, recently identified as major prostaglandin constituents of human semen, were respectively 71 and 78 times inflammatory than PGE1. The 19-OH PGEs produced much greater erythema responses, relative to oedema, lids closure or discharge responses.


Some biochemical complexities of inflammatory disease affecting drug action.


Platelets and mediators in the carrageenin rat paw oedema. A number of similarities exist between several aspects of the imflammation process and the changes occurring in platelets during aggregation. This has initiated the search for a specific role of platelets in inflammation. The aim of our experiments was to investigate firstly whether during an acute inflammatory process platelets accumulate in the inflamed area and secondly whether the inflammation has an effect on the properties of the platelets. Rat platelets were labeled with 51Cr and injected into the tail vein of rats with a carrageenin-induced edema in one of the hind paws. The amount of radioactivity was measured in the inflamed paw and compared to the control one in the 24 hr following the injection. An accumulation of platelets was found at 3-4 hr after the injection of the carrageenin which disappeared later. Maximal swelling occurred after 5 hr. The aggregability of the platelets was determined at different times of the inflammatory process. After 2 hr, a decrease was observed which was higher after 4 and 6 hr. This effect might be due to the release of mediators during the inflammation.


Effect of glucocorticosteroids on the release of prostaglandin-like substances in anaphylaxis. During anaphylactic reactions there are released thromboxane A2 and/or prostaglandin-like substances from perfused guinea pig lungs and from incubated fragments of guinea pig mesentery. Prostaglandin-like substances appear also in mixed venous blood of anaesthetized cats following an intravenous injection of rabbit blood. These release reactions are reduced or abolished both by indomethacin and by hydrocortisone.


Comparison of the mediator release from platelets and the development of acute inflammation in rats which lack prostaglandin precursors. Rat platelet rich plasma (PRP) generates prostaglandin endoperoxide-like activity, thromboxane A2 (TXA2) and stable prostaglandins (PGs) after collagen addition. Of the stable PGs, PGE is the main product and its formation is related to the dose of collagen. Indomethacin and eicosatetraynoic acid (TYA), both cyclo-oxygenase inhibitors, inhibit TXA2 and PGE formation simultaneously. PRP of essential fatty acid deficient (EFAD) rats, however, generates far less PG-endoperoxide like activity, TXA2 and PGE, though the release of serotonin (5-HT) is unaltered. In normal rats a marked inhibition of the cyclo-oxygenase by TYA also has no effect on 5-HT release. For these 2 reasons the role of PG endoperoxides and TXA2 seems to be unimportant for the 5-HT release reaction. The diminished biosynthesis of PGs and TXA2 in EFAD PRP is not due to an impaired cyclo-oxygenase activity since addition of AA causes an equal formation of PGE in both types of PRP. The use of platelets as in-vitro model for testing anti-inflammatory activity of drugs is discussed. The results, obtained with platelets support the hypothesis that the main reason for the decreased acute inflammatory reaction in EFAD rats is a diminished supply of endogenous PG precursors.


Effects of anti-inflammatory drugs on the carrageenin-induced hind paw inflammation of rats deprived of endogenous precursors of prostaglandins. The carrageenin-induced paw oedema was used to study anti-inflammatory drugs in normal rats and in those deprived of endogenous precursors of prostaglandins. The latter condition was achieved by permanently keeping the rats on essential fatty acid deficient (EFAD) food. Indomethacin inhibited the carrageenin-oedema in normal rats, but failed to further suppress the poorly developed delayed phase of the carrageenin-induced inflammation in EFAD rats. In contrast, aspirin exhibited equal inhibition of the carrageenin oedema in both normal and EFAD rats. The anti-inflammatory effect of dexamethasone was also indentical in both normal and EFAD rats. Since in EFAD rats the inflammatory role of an increased output of prostaglandins is of negligible importance, the results with aspirin and dexamethasone shed some doubt on such views, that suppression of the release of prostaglandins alone explains the acute anti-inflammatory effects of these drugs. The inflammatory response of EFAD rats is a model situation appearing to be useful in studying anti-inflammatory mechanisms which, under normal conditions, might be masked by interference with the release of prostaglandins.


Metyrapone: a possible tool in investigating the role of endogenous corticosteroids in inflammation. Despite much early work on corticosteroid levels in the blood and urine of patients with rheumatic diseases, little strong evidence is available concerning the role of endogenous corticosteroids in inflammation. Nevertheless, the modulating role of adrenal corticosteroids in inflammation seems to be taken for granted even though the small amount of evidence in laboratory animals is, in some cases, contradictory. In the light of the immunological aetiology of some chronic inflammatory diseases and the immunosuppressive properties of corticosteroids, investigations into the role of endogenous corticosteroids in these conditions seem particularly worthwhile. Adrenalectomy has been used widely in studies on the physiological roles of adrenal corticosteroids but the operation requires care to avoid mortality. The adrenal corticosteroid synthesis inhibitor, metyrapone, could be used quite profitably in such investigations. However, it has been shown to exert differential effects on prostaglandin (PG) production in uterine tissue and may produce non-selective antagonism of the actions of PGs. Because PGs are probably involved in inflammation, care should be exercised in the doses of metyrapone used in any studies on inflammatory models to avoid interactions with the PG system.


Prostaglandins and complement changes in some conditions related to inflammation. Exposure to ionizing radiation produces several systemic and local reactions which could be mediated by prostaglandins. Prostaglandin levels were therefore studied in blood and tissues of mice which had been exposed to x-rays. Significant increases were found in spleens after 200 to 700 R, and in lungs after 600 to 700 R. These changes were most pronounced 4-7 days after irradiation. Ionizing radiation promptly and potently reduced the activity of prostaglandin dehydrogenase in the spleen, whereas prostaglandin synthesis was less affected. Evidence was obtained for the activation and consumption of haemolytic complement in serum in the course of heart-lung operations involving extracorporeal circulation. Activation involved primarily the classical pathway, and only slightly the alternate pathway.


Nocturnal intragastric infusion of glucose in management of defective gluconeogenesis with hypoglycemia. Three children with defective gluconeogenesis and hypoglycemia were treated with frequent daytime feeding and continuous intragastric infusion of glucose at night. By this technique, the blood glucose level was maintained at or slightly above the physiological range. Secondary lacticacidemia, hyperlipidemia, hyperuricacidemia, and coagulation defects all improved. Weight and height velocity increased dramatically. Strength and sense of well-being improved. Nocturnal intragastric infusion of glucose is now the management of choice for children with defective gluconeogenesis and hypoglycemia.


Disseminated intravascular DNA thromboemboli. A complication of chemotherapy for acute lymphocytic leukemia. Seven and one-half hours after receiving antileukemic therapy, an 11 year-old boy developed massive intravascular lysis of leukemic cells with subsequent pooling of DNA to form disseminated intravascular thromboemboli. The DNA thromboemboli produced neurologic symptoms and an alveolar capillary block with resultant dyspnea and death.


Laboratory and clinical analyses of nitinol wire.


A cephalometric evaluation of American Negro women. A cephalometric study of forty American Negro women with an average age of 24.6 years and a Class I molar and/or canine relationship was performed. When measurements were compared to a control population of twenty Caucasian women, using several standard analyses, significant differences were demonstrated between the sample populations. 1. The maxilla and mandible were more protrusive in the Negro sample. 2. The upper and lower incisors were more proclined and the interincisal angle was more acute in the Negro sample. 3. Middle facial height was shorter and lower facial height was longer in the Negro sample. 4. The projection of the soft-tissue nasal tip was less in the Negro sample. 5. The projection of the upper and lower lips as related to the facial plane was greater in the Negro sample. 6. Lip thickness was approximately the same in the two groups.


Improving petrous bone reproduction in lateral cephalometric films. The purpose of this method is to improve the reproduction of the petrous bone area in cephalometric lateral head roentgenograms. Metal screens are used to project a high-voltage x-ray beam only to this area. Two techniques using a lead screen or a copper filter screen are described. Reproduction of the points porion and basion and of the temporomandibular joint is considerably improved.


Prediction of the mesiodistal widths of maxillary permanent canines and premolars. Multiple regression equations for prediction of the mesiodistal widths of the maxillary canines and premolars were developed for the right and left sides of the arches of males and females. The equations were developed from longitudinal data taken from ninety-two Caucasian children (forty-six boys and forty-six girls) who participated in the Iowa Growth Study. The multiple regression equations, when compared with three currently used methods of prediction, were the best predictors. The newly developed equations and other prediction methods currently in use were tested on longitudinal data taken from a sample of forty-three Caucasian orthodontic patients (sixteen males and twenty-seven females). Again, the multiple regression equations had the best performance.


Constituent society presidents discuss current orthodontic issues. Part I.


Dental materials and orthodontic fees.

Dental materials and orthodontic fees.


Preparation of a stable folate-sepharose complex for affinity chromatography.


Pre- and postoperative studies of in vitro cell-mediated reactivity in canine osteosarcoma.


Blood pressure screening: patient service in dentistry.


The calcifying odontogenic cyst (gorlin cyst). Review of the literature and report of a case.


Febrile neutrophilic dermatosis in acute myelogenous leukemia. A 50-year-old woman with acute myelogenous leukemia on two occasions had fever and exquisitely tender, warm, erythematous, indurated to frankly bullous plaques on the face and upper extremities. Histologically, the lesions showed rather dense dermal infiltrates of mature polymorphonuclear leukocytes; special stains for bacteria and fungi were negative, as were all cultures for infectious agents. The lesions did not respond to antibiotics but cleared rapidly with systemic steroid treatment. Febrile neutrophilic dermatosis of acute myelogenous leukemia is believed to be a nonspecific reaction to the underlying malignant disease process. By prompt recognition of this entity, prolonged expensive courses of antibiotics may be avoided.


Monocytic leukemia. Clinically appearing as 'malignant reticulosis of the skin'. Enzyme cytochemical (hydrolytic enzymes for cell differentiation), immunocytologic (B and T lymphocyte differentiation), and electron microscopic studies of skin infiltrates facilitate the proper diagnosis of myelomonocytic and lymphoreticular proliferations. With use of these methods, the original clinical diagnosis of malignant reticulosis of the skin was corrected to monocytic leukemia in a 65-year-old woman. Because primary involvement of the skin preceded monocytosis of the blood, it was concluded that the cutaneous infiltrates in our patient resulted from proliferation of tumor cells in the skin rather than from homing of the cells to, or settling of the cells in, the skin.


Acute lymphoblastic leukemia. Its occurrence with hypereosinophilic syndrome' and bilateral spontaneous pneumothorax. A patient with acute lymphoblastic leukemia had an unusual prodrome, including clinical features of "hypereosinophilic syndrome," pulmonary infiltrates, and bilateral spontaneous pneumothorax, which preceded the onset of leukemia by four months. The mechanism for the production of eosinophilia may have been related to the production of eosinopoietic factors by the leukemic cells.


Vaporizers for ether.

Vaporizers for ether.


Early clinical recognition of disseminated candidiasis by muscle and skin biopsy. Disseminated candidiasis was clinically diagnosed by muscle and skin biopsies in two patients with hematologic malignancies. One patient with acute promyelocytic leukemia presented with skin lesions as the sole manifestation of disseminated candidiasis. The other patient had leukemic reticuloendotheliosis and developed fever, severe myalgias, and maculopapular rash while receiving corticosteroid therapy; this patient is the first to have antemortem documentation of candida myositis as the initial manifestation of disseminated candidiasis. These two case reports serve to emphasize the importance of careful observation and early biopsy of skin and muscle to establish the diagnosis and permit early institution of therapy.


Sarcoidosis following adjuvant high-dose methotrexate therapy for osteosarcoma. A patient who had undergone amputation and adjuvant chemotherapy with methotrexate doxorubicin hydrochloride for osteosarcoma of the femur later developed granulomatous hilar and paratracheal lymphadenopathy and multiple pulmonary nodules. Biopsy of the nodules showed noncaseating granulomas typical of sarcoidosis. Hilar adenopathy and granulomatous pneumonitis have been reported following methotrexate therapy, but a roentgenographic pattern of isolated, discrete pulmonary nodules has not been described. Treatment with immunosuppressive chemotherapy may have inhibited the development of sarcoidosis, which became manifest only after cessation of the chemotherapy.


A histochemical study of the effects of 19-nortestosterone on the RNA in the secretory tubules of the submandibular glands of castrated--adrenalectomized mice.


Experimental caries in young human permanent teeth implanted in removable dentures.


Regulation of genioglossus and masseter muscle activity in man.


Progressive stages of subsurface demineralization of human tooth enamel.


Separation of human tooth enamel microstructures by density fractionation.


Oxytalan meshwork associations observed histologically in the periodontium of the mouse mandible.


In-vivo estimation of the permeability of surface human enamel.


The role of amniotic fluid on the in-vitro palatal fusion of normal and vitamin A-treated rat foetuses.


Effects of triiodothyronine upon the 131I and 99mTc uptake by the submandibular salivary glands in A2G mice.


An ultrastructural study of Langerhans cells crossing the basal complex in oral lichen planus.


The influence of mechanical input parameters on the duration of the mandibular joint electromyographic silent period in man.


The sickness of Heracles: some forensic aspects of the omnipotent narcissistic personality.


Adaptation problems of asian migrants.

Adaptation problems of asian migrants.


Further categorization of patients with anorexia nervosa.


Multiproblem families and their psychiatric significance. The characteristics of multiproblem families are described, and the investigations in a research project are reported. A note is made of their epidemiological significance. Reasons are suggested as to why they have received little psychiatric attention. In particular their child upbringing practices, including child rearing and learning disorders, are described. The psychiatry of inadequacy is considered and the validity of the various diagnoses used. Finally it is suggested that the place of psychiatry in their care should be reconsidered and that a better knowledge of social handicap should be acquired.


The development of a scale for the assessment of sexual behaviour in Australian women. The aim of this study was to develop a simple method of assessing female sexual response, suitable for use in clinical investigations. Following a review of interview, physiological and psychological methods, a Scale of Sexual Response was developed. Sexually dysfunctional women and women who stated they had no sexual problems completed the Scale. The results demonstrated that 11 of the 15 subscales had concurrent validity. The 4 subscales relating to auto eroticism did not distinguish between groups. Significant changes were demonstrated in 4 subscales following successful therapy of the sexual dysfunction. The scale was shown to be reliable.


Alcohol and medical practice - the role of the psychiatrist in instituting change. The low rate of recognition of the causative role of alcohol in much illness, and the failure to respond to the clinical challenge of such an association by many doctors, is discussed. Documentation is provided by a study of computerised hospital records. It is suggested that psychiatrists could demonstrate that a professional stance towards alcohol is possible without compromising personal freedom, and that liaison psychiatry services could accept responsibility to improve management of these problems within general hospitals.


Social implications of the "dyscontrol syndrome" (neuropsychiatric correlates). The recent literature contains numerous publications which have tried to stimulate a new and biologically oriented approach to the problem of violence. Experimental brain research indicates that biologically important predatory and aggression responses have multiple representations in the nervous system. However, knowledge gained so far concerning emotional brain function in violent persons with brain disease, or from experimental research, can only infrequently be applied to combat the violence-triggering mechanisms in the brains of the non-diseased. In the hope of determining the neurological basis of aggression, the present author studied the brains of forty-two patients whose clinical history indicated definite aggressive behaviour. Results are reported and discussed. It is also the aim of this paper to discuss the social implications of the surgical treatment of patients with a "dyscontrol syndrome" whose investigations do not reveal definite evidence of "hard" signs and symptoms of brain pathology.


Prevalence and prognosis in anorexia nervosa.


Shotgun weddings: trends in the sociopathology of marriage. The study was concerned with secular trends in forced marriages in N.S.W. The definition of forced marriage was first nuptial birth occurring within six months of the wedding. The typical demographic profile of such marriages portends a "risk" of marital breakdown and child abuse. Formal analysis of the time series showed upward trends in the proportions of brides "at risk" in the 16-17 age groups, and in the proportions of children "at risk" born to brides in the 16 to 22 age range. The findings were discussed critically, and some prophylactic and remedial social measures suggested.


A factor analytic study on the twelve item general health questionnaire.


Emotional sequelae of parents and sibs following the drowning or near-drowning of a child. This study reports the findings from an investigation to evaluate the intra-family dynamics that occurred with 111 cases of childhood drowning and near-drowning in the City of Brisbane in 1971-1975. Personal interviews were obtained with 77 of the families. 24 per cent of parent-dyads separated following the drowning of their child, whereas none of the 54 families of surviving children separated. Accident generated stresses within the studied families tended to persist for years after the incident. Parents volunteered the information that they drank more, experienced sleep disorders and nightmares, and reported significant anxiety states. 19 per cent of parents of drowned children received specialist psychiatric treatment following the drowning. Two cases of surviving children received specialist psychiatric therapy (these were both parents who had inflicted non-accidental injury on their child, and had attempted to drown their child in the bath). In one sense, a child's death is more honourable from society's point of view if the child dies from a chronic medical illness such as leukaemia. In the case of a child's death in the family bath tub or the backyard swimming pool, the extra society sanctions of culpability and accusation further intensified the likelihood of the normal grief process being transformed into a pathological variant.


Adelaide congress - presidential and Squibb academic lectures.


Psychiatric case registers.

Psychiatric case registers.


Coronary arterial spasm--A proposal.

Coronary arterial spasm--A proposal.


Coronary arterial spasm--a reappraisal.

Coronary arterial spasm--a reappraisal.


Looking at dental education.

Looking at dental education.


Cadmium in denture base materials.

Cadmium in denture base materials.


The clinical features and risk of malignant transformation in sublingual keratosis.


Deterioration of disperse-phase amalgam alloy.


Joint committee for higher training in dentistry. Criteria for recognition of training programmes for senior registrars (or equivalent) in community dentistry.


The 'rap' house and volunteers: helpful or harmful?


Some effects of type of group and sex on attitudes toward alcohol and alcoholism.


Serum folate and B12 and haematological status of in-patient alcoholics.


'Mixed' (drug abusing) and 'pure' alcoholics: a socio-medical comparison.


Minimal, moderate and long-term treatment of alcoholism.


Locus of control and treatment dropout in an alcoholic population.


Community attitudes to drug abuse in three countries.


Addictions: some reasons for investigating their hematology.


Some aspects of chronic cannabis use in the United Kingdom.


Measures of heart rate and skin conductance to orienting stimuli during repetitive administration of marijuana.


Some aspects of nutritional state in 'hard' drug addicts.


Differences in interpersonal orientation of heroin, amphetamine, and barbiturate users.


A retrospective study of a selected population of drug dependence subjects in Kuwait.


A study of authorized opium addiction in Shiraz city and Fars Province, Iran.


Continuous culture of malignant haemic cells from human acute myelomonocytic leukaemia: cytological, cytochemical, cytogenetic and immunological studies.


Active immunotherapy in acute myelogenous leukaemia and the induction of second and subsequent remissions. One hundred and ninety-one adults with acute myelogenous leukaemia were treated with combination chemotherapy consisting of daunorubicin and cytosine arabinoside (Barts III). Sixty-three patients achieved remission and were admitted to one of 3 trials of active immunotherapy: immunotherapy alone, immunotherapy and maintenance chemotherapy or neither of these. All patients had weekly clinical and blood examination and monthly marrow examination. Reinduction chemotherapy was given as soon as relapse was diagnosed in the marrow. The most striking observation was that immunotherapy was associated with easy and repeated reinduction of remission and marked prolongation of survival after first relapse when compared with immunotherapy plus chemotherapy. The possible reasons for this and the value of immunotherapy are discussed in relation to the third trial still in progress which includes 2 maintenance arms, immunotherapy alone and surveillance only.


Scanning electron microscopy of oral epithelial cells. Part I. Normal and malignant tissue. The surface features of cells removed by scraping from normal human oral mucous membrane and from squamous cell carcinomas of the oral mucosa were examined by scanning electron microscopy. It was concluded that in normal oral mucosa the cell surface morphology is dependent on the state of keratinisation of the tissue. Malignant cells were observed to display modified surface characteristics which have been tabulated. It is suggested that these characteristics may be of value in the diagnosis of malignancy.


Scanning electron microscopy of oral epithelial cells. Part II. Potentially malignant lesions (a computer-assisted study). The technique described in Part I, has been extended to the examination of cells removed by scraping from 22 lesions of oral lichen planus and leukoplakia. It was concluded that the surface morphology of the cells from these lesions was intermediate between that of normal tissue and of malignant tissue. The observations have been quantified and subjected to computer analysis together with the data derived from the observations of normal and malignant tissue. This confirms the visual observation that a relationship exists between the modified surface characteristics of the cells from these lesions and their subjectively assessed histological appearances. A correlation has been found between the SEM appearance and an epithelial atypia index (EAI) derived according to the criteria of Smith and Pindborg (1969). In the case of lichen planus inflammatory changes appear to be associated with increased modification of surface characteristics. These changes are also reflected in an increased EAI. It is suggested that the present technique may be of value in the diagnosis and assessment of potentially malignant lesions.


The effect of cryosurgery on the strength of bone. The effect of cryosurgery on the mechanical properties of bone has been studied by freezing rats' mandibles. The mandibles of laboratory rats were subjected to cryosurgery and tested at 2, 4, 8, 16 and 26 weeks. In comparison to the control contralateral sides, a reduction in strength was recorded at four and eight weeks, the difference being highly significant at eight weeks. This indicates the susceptibility of bone treated by cryosurgery to pathological fracture and suggests that preventive measures may need to be undertaken to minimise this possibility.


Jaw tumours in Nigerian Igbos.

Jaw tumours in Nigerian Igbos. Sixty-three cases of jaw tumours in Nigerian Igbos are reviewed. Burkitt's tumour, fibro-osseous lesions, ameloblastoma and carcinoma were seen in progressively older patients. The Igbos, like fellow Nigerians, suffer from ameloblastoma at relatively earlier ages than other Africans. Although the Igbos are as prone to keloid formation as other Negro peoples, it is noteworthy that this fibrous tendency was not evident in their jaw tumours. None of the tumours exhibited melanin pigment. The incidence of Burkitt's tumour appears to be lower in the easterly Igbos than in the ethnic groups living in the westerly part of Nigeria.


Condylar metastasis from mammary adenocarcinoma. A case is reported of metastatic growth in the mandibular condyle from a primary adenocarcinoma of the breast, presenting as painless total trismus of sudden onset. The investigations, treatment and its implications are discussed.


Bone scanning as an aid to diagnosis and treatment planning in oral surgery. A short history and introduction to radioisotopes used in bone scanning is presented. Five cases of malignancy with bone involvement of the head and neck region are described to demonstrate this technique.


A preliminary study of the dynamics of resolution of experimental haematomas: radioisotope studies in animals. A preliminary investigation was carried out in order to establish a method for the study of experimental haematomas. For this purpose haematomas were produced in rabbits by subcutaneous injection of rabbits' own blood after labelling the various blood components with appropriate radioisotopes. In addition, radioisotope labelled human serum albumin and fibrinogen were studied. The results show that there is considerable variation in the rate and pattern of dissipation of the various components of the experimentally produced haematoma. The significance of these findings is discussed.


The applied anatomy of closed condylotomy.


Modification of the muco-periosteal flap design in anterior maxillary osteotomies. A modification of the mucoperiosteal flap planning for anterior maxillary osteotomy operations is suggested. This approach involves a total reflection of the labial mucoperiosteal flap, with the advantages of direct vision of the operative field thus providing easy and precise execution of the operative bony cuts, avoiding damage to the adjacent teeth and reduction of operating time. Sufficient blood supply to the mobilised segment is maintained through the palatal blood vessels. Corrective periodontal surgery may also be carried out at the same time.


Aneurysmal bone cyst of the zygomatic arch. A case is described of an aneurysmal bone cyst which, because of its normal anatomical location, caused considerable difficulties in diagnosis and clinical management. The literature concerning aneurysmal bone cysts of the jaw is reviewed and the pathogenesis of this rare but interesting lesion is briefly discussed.


Fractures of the zygomatic complex in the south-east region of Scotland. With the ever increasing of facial trauma, a study has been carried out on some aspects of zygomatic complex fractures in a part of Scotland. The results were different in some aspects from those reported in the literature, but they endorse the findings of a similar study which was carried out in the Eastern regions of Scotland (Hitchen & Shuker, 1973).


Traumatic bilateral abducent nerve palsies. A patient sustained a severe cranio-facial injury which included a transverse fracture of the middle cranial fossa through the sella turcica producing otorrhoea, rhinorrhoea, a bilateral abducents palsy and a large aero-coele. All gradually remitted spontaneously. The management of this patient and the patterns of cranial base fractures and their associated clinical features, particularly of the middle cranial fossa, are discussed.


An adverse reaction to metoclopramide therapy.


Treatment of chronic granulocytic leukemia with melphalan. Thirty-three patients with newly diagnosed chronic granulocytic leukemia (CGL) were treated with melphalan between 1968 and 1976. Within 3 mo of beginning therapy subjective and objective disease parameters improved. Disease control was easily maintained with this agent until hematologic exacerbation occurred. The median duration of disease control was 25.3 mo, and the median duration of survival was 28.6 mo. Serious side effects were not produced. Thus melphalan appears to be another agent that may be used to control the manifestations of CGL prior to hematologic exacerbation.


Surface membrane characteristics and cytochemistry of the abnormal cells in adult acute leukemia. Membrane marker and cytochemical analyses were carried out on the abnormal cells from 70 adult acute leukemia patients. Such information may (1) supplement standard morphology and serve as a basis for a new classification scheme for acute leukemia, and (2) characterize the surface membranes of granulocyte, lymphocyte, and monocyte "progenitors." Classification of acute lymphoid leukemias solely on the basis of morphology was unsatisfactory. The presence or absence of T- or B-cell markers was helful in classifying lymphoid leukemias. Monocyte progenitors were characteristically nonspecific esterase positive and Fc-receptor and membrane-IgG positive, but poorly phagocytic. Promyelocytes and myelocytes were frequently Fc-receptor positive and consequently positive for surface immunoglobulin. Myeloblasts were characteristically Fc-receptor negative. We conclude that surface membrane markers are essential in diagnosing lymphoid leukemias and helpful in nonlymphoid acute leukemias, and that cytochemistry is essential in delineating lymphoid from nonlymphoid leukemias and in subclassifying the latter.


Rehabilitation of people with acquired deafness in adulthood.


Epidemiological priorities as a basis for health policy.


Assessing medical technologies.

Assessing medical technologies.


Overutilization of health care.

Overutilization of health care.


Priorities in the organizations of medical practice.


Priorities in educating the public about health.


Experience with the implementation of national health-planning legislation.


The formulation of Federal health care policy.


Health policy: realistic expectations and reasonable priorities. The theme of the conference.


The linkage between health policy making and planning.


Technical assistance and implementation.


Modeling the gastrointestinal system.

Modeling the gastrointestinal system.


The effect of New York City's fiscal crisis on the Department of Health.


Immunological detection of residual leukaemic disease in the bone marrow of children with acute lymphoblastic leukaemia. Peripheral blood lymphocytes incubated with tumour cells or extracts may undergo blastogenesis. This is the basis of a technique studied in children with acute lymphoblastic leukaemia (ALL) in childhood in an attempt to predict relapse. Samples of peripheral blood and bone marrow from 82 children with varying degrees of ALL were analysed. Cultures were prepared by incubating a lymphocyte suspension with an autologous bone-marrow suspension. Final ratios of lymphocytes to bone-marrow cells (L: BM) were 1: 1 and 2: 1. Control wells received bone-marrow or lymphocyte suspension only. Cultures were incubated for 72, 96, and 120 hours. All were pulse-labelled with (3)H-TdR and radioactivity was measured by scintillation counting. Results were expressed as the stimulation index, calculated by dividing the mean counts per minute (cpm) of wells containing both lymphocytes and bone-marrow cells by the sum of the mean cpm for control wells. If the stimulation index exceeded 1 at 72, 96, or 120 hours at either L: BM ratio a positive response was recorded.Seventy-six children were in clinical remission at the time of testing (group A) and six were in clinical relapse (group B). In group A 24 patients showed stimulation and relapsed later at a mean time of 3.8 months (21 with marrow disease, two with testicular infiltration, and one with lung infiltration). Sixteen patients showed stimulation and had up to 4% blasts in their bone marrow but remained in remission. Nineteen other patients showed a positive response and several factors may have contributed to this: two underwent a "rebound" lymphocytosis after stopping treatment, nine had current or intercurrent infections, two had persistent unexplained bone-marrow lymphocytosis, but six had no causative symptoms and thus their responses were "true false-positives." Seventeen patients from group A showed no response and remained in remission for a mean of 22.9 months after testing. None of the six children in group B responded, and at testing had 17-85% blasts in their bone marrow.During the study no patient relapsed who had not shown a positive response. The technique merits further study as a guide to the presence of leukaemic cells.


Outlook following "somnolence syndrome" after prophylactic cranial irradiation.


Vincristine, prednisone and L-asparaginase in the induction of remission in children with acute lymphoblastic leukemia following relapse. Two hundred and twenty-seven children with recurrent acute lymphoblastic leukemia were treated with various combinations of vincristine, prednisone, cyclophosphamide and L-asparaginase in an approach to the induction of remission. The combination of L-asparaginase 1,000 mu/kg iv q.d. x 10, vincristine 2.0 mg/m2iv q.w. x 4 and prednisone 40 mg/m2 p.o.q.d. x 28 days was found to be highly effective. The incidence of remission was 73%. No significant improvement was achieved when cyclophosphamide was added to this regimen. Various combinations of cytosine arabinoside, cyclophosphamide, vincristine, prednisone, BCNU or CCNU failed to maintain remission duration for more than two or three months. Neither BCNU nor CCNU prevented the development of CNS leukemia.


Acute leukemia after chemotherapy (melphalan). During the years 1966-1973 474 patients with ovarian carcinoma were treated with melphalan. Of these, 48 patients received at least 300 mg melphalan and survived at least 3 years; four cases of acute leukemia were found among these 48 patients. All cases belonged to a group of 12 cases receiving 800 mg melphalan or more.


Maintenance therapy of adult acute nonlymphoblastic leukemia: an argument against the need for central nervous system prophlyaxis. The need for prophylactic therapy of the central nervous system in adult acute nonlymphoblastic leukemia has been suggested but no proven. Over a 4-year period from January 1973, to December 1976, we have maintained 40 patients achieving complete remission on a regimen consisting of monthly courses of Cytosine Arabinoside and 6-thioguanine. Twenty patients remain in remission with a predicted median remission duration for the entire group of 14.5 months. Thirty nine of the patients did not have central nervous system leukemia at diagnosis, and only one of these patients (2.6%) has had remission tenance regimen there is little need for central nervous system prophylaxis in adult acute nonlymphoblastic leukemia.


Effect of a cariogenic challenge on fluoride uptake by enamel of rats receiving fluoridated drinking water.


Relationship between fluoride in the drinking water and the plasma fluoride concentration in man.


Symbiotic relationship of Veillonella alcalescens and Streptococcus mutans in dental plaque in gnotobiotic rats.


Quantitative study of the interaction of salivary acidic proline-rich proteins with hydroxyapatite.


Further evidence for the non-immunoglobulin nature of the bacterial aggregating factor in saliva.


Comparability of the biochemical composition of dental plaque samples collected from 12- to 13-year-old males on a 'split-mouth' basis.


LD50 of SnF2, NaF, and Na2PO3F in the mouse compared to the rat.


Effect of dietary supplements of fluoride on development of dental caries in the rat.


Fundamental studies on electric stimulator used for acupuncture analgesia. In order to perform safe and effective electric stimulation in acupuncture analgesia or therapy, basic knowledge concerning the electric stimulator is required. If direct current is used, a negative square wave with a pulse duration of 0.5 approximately 1.5 msec should be applied to the needle electrode to perform effective stimulation. Negative current is more effective at lower amperage than positive current and the possible corrosion hazard by the positive current can be avoided.


Studies on flies in Korea. III. Taxonomic studies on muscid flies (Diptera, Muscidae). Forty species belonging to 14 genera of the family Muscidae were found so far in Korea. They are described in this paper and 5th sternites, forceps and male genitalia are illustrated. Eleven species recorded by Kobayashi (1918-1940) and 16 species by Hori (1952) were revised and redescribed in this paper. The key to the species of the muscid flies in Korea are also presented.


Histological and microradiographical studies of human mandibular condyle. Twenty-one clinically normal human mandibular condyles were examined by histologic and microradiographic methods obtaining some measurements. The histologic structures of condyle were quite different between the child group and other aged groups. The difference in the surface articular zone composed of the fibrous tissue was not so great in all age groups, while there was quite a difference in the structure in the remaining zones. It was clearly demonstrated by microradiogram that the osteons of the subarticular bone plate were more prominent in aging. Abnormal structures of the condyle were revealed in some individuals of the adult and old age groups, which were assumed probably to be the reactive remodelling against the functional changes of the temporomandibular joint.


Effect of antibody binding on the mobility of serum lysozyme.


Pulmonary toxicity recurring after a six week course of busulfan therapy and after subsequent therapy with uracil mustard. A growing number of drugs, including a number of alkylating agents, have been implicated as the cause of pulmonary diseases. A patient with chronic myelogenous leukemia presented with typical cytology, biopsy, and roentgenologic findings of lung toxicity after only six weeks of therapy with busulfan. There was subsequent clearing. A similar roentgenologic change also occurred after administration of uracil mustard. This has not been reported previously.


Inherited metabolic disease: prospects for the future in both basic and clinical research. The birth of a child with an inherited disorder is often the beginning of a life-long problem for the whole family. About 8.5% of paediatric deaths and 4.7% of paediatric hospital admissions are due to autosomal and sex-linked recessive diseases. These figures are likely to be erroneously low because of incomplete ascertainment. The inherited metabolic diseases therefore merit study on economic as well as humanitarian grounds. Investigations of the disorders of purine metabolism have been conducted for more than a century and a half in the borderland between biochemistry and medicine, illuminating both disciplines and reflecting their separate developments. These studies are a general model for work in other branches of human intermediary metabolism. It is hoped that the basic study of the inborn errors or metabolism will expand our knowledge of the defective gene and of its product, the enzyme protein. Clinical studies should aim to improve the prenatal, postnatal and carrier-state diagnosis of these disorders, and to improve their treatment by methods which can be made practicable and generally available at the clinical level. There may be some hope for enzyme replacement in certain circumstances. The prospect for genetic modification at the clinical level is almost infinitely far away, where many would say that is should remain.


The identification of LSD-like hallucinogens using the chronic spinal dog. The effects of several indoleamines and phenethylamines were studied in the chronic spinal dog and compared with two standard drugs, LSD and amphetamine. In the nontolerant chronic spinal dog, their effects on a variety of physiologic and behavioral functions were measured in untreated dogs, as well as dogs treated with certain antagonists. The effects of the antagonists phenoxybenzamine and cyproheptadine on the various physiologic effects were studied for all drugs. For some idoleamines and phenethylamines, the effects of chlorpromazine and pimozide were also studied. Indoleamines and phenethylamines in the LSD-tolerant chronic spinal dog and their anorexigenic effects in the intact dog were also studied. The results of these studies indicate that psilocin, mescaline, dimethyltryptamine and tryptamine are LSD-like drugs. DOM, DOB, DMA, and TMA are predominantly LSD-like drugs but do have some amphetamine-like action. PMA and PEA are predominantly amphetamine-like drugs with some LSD-like activity. MMDA and MDA have a more complicated pharmacology showing proerties that resemble LSD and amphetamine, but they have other actions which are not shared by either LSD or amphetamine, which suggests they have yet other modes of action.


Glucose-containing oligosaccharides in the urine of patients with glycogen storage disease type II and type III. Patients with glycogen storage disease type II and type III were recently found to excrete increased amounts of a glucose-containing tetrasaccharide DGlcp(alpha1 leads to 6)DGlcp(alpha1 leads to 4)DGlcp(alpha1 leads to 4)DGlc [Lennartson, G., Lundblad, A., Sjöblad, S., Svensson, S. and Ockerman, P.A. (1976) Biomed. Mass Spectrom. 3, 51--54]. In addition to this tetrasaccharide, urine from these patients also contains larger oligosaccharides containing only glucose. From urine of patients with glycogen storage disease type II and type III, three and four oligosaccharides respectively have been isolated. Structural studies including sugar analyses, methylation analyses, partial acid hydrolysis and optical rotation revealed that three compounds were present in the urine of both patients. Their proposed structures or partial structures are as follows: DGlcp(alpha1--6)DGlcp(alpha1--6)DGlcp(alpha1--4)DGlcp(alpha1--4)DGlcp(alpha1--4)DGlc, DGlcp(alpha1--4)DGlcp(alpha1--6)DGlcp(alpha1--6)DGlcp(alpha1--4)DGlcp(alpha1--4)DGlc, and DGlcp(alpha1--6)DGlcp(alpha1--4)DGlcp(alpha1--4)DGlcp(alpha1--4)DGlcp(alpha1--6)DGlcp(alpha1--4)DGlcp(alpha1--4)DGlc. A fourth compound has been partially characterized as a branched heptasaccharide with four (1 leads to 4) linkages and two (1 lead to 6) linkages. Glycogen is possibly the origin of these compounds. However, the number of (1 leads to 6) linkages is higher than expected and may indicate a shorter distance between branches in glycogen than has been generally assumed.


Kinetic features of a lymphoid population in the blastic crisis of chronic granulocytic leukaemia.


Detection and differential diagnosis of bone lesions by scintigraphy. Bone scintigraphy using 99mTc-labeled phosphate compounds and the scintillation camera supplements X-ray diagnosis in an excellent manner, for localizing and determing the size and metabolic activity of inflammations, degenerations, and malignancies of the skeletal system. It is of prime importance in the early detection and staging of the disease, as well as in registering the course and response to therapy of osseous metastases.


Amputation and doxorubicin for treatment of canine and feline osteogenic sarcoma.


The influence of gland size on the flow rate and composition of human parotid saliva.


Stomatitis areata migrans.

Stomatitis areata migrans.


Occlusal examination.

Occlusal examination.


Prevention--the need for attitude change.


Federal income tax returns by dentists.

Federal income tax returns by dentists.


Discrimination of messenger RNA.

Discrimination of messenger RNA.


Treatment of acute leukaemia: implications of recent findings in cell biology. Some aspects of the cell biology of normal and leukaemic haematopoietic cells are reviewed. Important points are: (a) normal and possibly also leukaemic stem cells differ from more mature cells in the kinetics as well as in cell surface antigens and other properties; (b) leukaemic cells are subject to a population size control as are normal haematopoietic cells; (c) part of the normal control seems to be chalone feedback regulation of proliferation and maturation rate of precursor cells; (d) evidence is accumulating that C-type oncornaviruses may cause leukaemia in man. Various experimental and established forms of therapy for leukaemia are discussed: No alterative exists to chemotherapy in acute lymphoid leukaemia. Granulocyte chalone may possibly become a valuable adjunct to other types of therapy in acute myeloid leukaemia. Immunotherapy may prove as efficient as maintenance chemotherapy in this disease. So far it has not been possible to synchronize leukaemic and normal cells so as to occupy different positions in the cell cycle. Nor has a forced maturation of human leukaemic cells been effected. Neither bone marrow transplantation nor prophylaxis by vaccination are considered worthwhile procedures for the time being. Anti-viral therapy has been promising in animal experiments, but animal leukaemias are often poor models for the disease in man. Assessment of treatment, using stem cell assays, is advocated.


Myeloid antigens and antigen densities in mice and men.


Immunofluorometric analyses of membrane bound IgM in individual human lymphoid cells in cases of leukemia and malignant lymphoma.


Studies on the immune status of children with acute lymphocytic leukemia (ALL).


Alterations of blood group receptors of erythrocytes in leukemia--immunofluorescence studies.


Cationic proteins of leukocyte lysosomes: marker antigens for the immunological diagnosis of acute leukemias.


Multiple leukemic clones in acute leukemia of childhood. Two abnormal karyotypes representing clonal populations have been demonstrated in three patients in the early stage of acute leukemia. The karyotypes were apparently unrelated in one patient, while in the other two, a relationship was conjectured. Both clones were present before therapy in two patients. Although a clone resistant to therapy was associated with relapse in one case, in two cases a clone has persisted in the lymphocyte culture during drug treatment with the patients in remission.


Blocking of oncofoetal cross-reactivity in human osteogenic sarcoma with solubilized tumour antigen.


A study of leukaemia in Goa.

A study of leukaemia in Goa.


The psychologic determinants of Jewish identity.


Karyotype evolution in chronic myelogenous leukaemia.


Dream translation.

Dream translation.


Humour as a "courage mechanism".

Humour as a "courage mechanism".


The messianic psychotic patient.

The messianic psychotic patient.


Amphetamine dependence. Psychodynamic aspects.


Personality types of suicidal patients as reflected in Rorschach's test.


The Ulpan as a model for effective integration of new immigrants: a psychological overview of an Israeli absorption center.


Expression of oncofetal antigens by murine and human normal cells in tissue culture. Normal mouse tissues in tissue culture express fetal antigens that are not expressed on these same tissues in vivo. The fetal antigens expressed on normal mouse cells in vitro are also expressed on at least two murine sarcomas, and account for the cross-reactive antibodies between these tumors. The fetal antigens are distinct from unique tumor-specific antigens found on these neoplasms. Normal human cells in tissue culture also express antigens found in human fetuses during the first trimester of pregnancy. Many human sera contain natural antibodies directed against the fetal antigens appearing in vitro. The expression of oncofetal antigens by normal cells in tissue culture must be taken into account in the interpretation of results of studies in tumor immunology in which tissue-cultured cells are utilized.


The Kleine-Levine syndrome--a variant?

The Kleine-Levine syndrome--a variant? A case of Kleine-Levin syndrome in an older man is described, with a review of the literature. An important point is emphasized in our case in which the patient reacted unfavorably to Ritalin, becoming sexually aroused, although his hypersomnia improved. A possibly different mechanism in hypersomnia and hypersexuality is speculated.


Use of sequential analysis in clinical trials of caries prophylactic agents. Using a sequential t test, the objectives of two 3-year experimental clinical trials were achieved more efficiently by using fewer subjects over a shorter time. The assumption of identical distributions of each batch of data analyzed was not apparent and further work to establish the robustness of sequential t tests is indicated. Identification of subjects with more consistent caries increments during the period of a trial would also help to satisfy this assumption.


Methodological developments for clinical trials.


The implementation of field trials.

The implementation of field trials. Even though a preventive agent has been shown to be powerful in reducing the incidence of, for example, dental caries when tested in a longitudinal clinical trial, it might not be as powerful when tested under more realistic environmental conditions. Field trials or field demonstration programs will provide the final evidence for determining if the agent or procedure is of such practical importance as to be included as a component in a dental care delivery system. The methodology developed for health services research provides the possibility of testing the effectiveness of a single or combined components in a dental care delivery system seen in relation to the environment and conditions under which it operates. The World Health Organization is at present involved in the implementation of a long range of field demonstration programs in various parts of the world especially in developing countries in order to establish the potential of known preventive procedures in population groups with different levels and different progression patterns of oral diseases.


Experimental studies on the combination of radiation and chemotherapy.


Epidemiology and public health aspects of diseases of the oral mucosa.


Differences in effectiveness of combined treatments with ionizing radiation and vinblastine, evaluated for experimental sarcomas and squamous cell carcinomas in rats.


The effect of a plaque control program on gingivitis and dental caries in schoolchildren.


Oral health status of 65- to 74-year-old Danes: a preliminary report of the replication of W.H.O.'s international collaborative study in Denmark. The survey has demonstrated that oral health is poor in the present old-age generation in Denmark. A striking relationship between social class and tooth mortality has been demonstrated. In the present dental care system in Denmark, treatment rather than prevention has had priority. A change is however necessary. Greater emphasis on preventive measures and a change in the attitude of the public to dental health is needed, if the dental health of the population is to be improved. However, the majority of the present old population cannot benefit from new, improved programs to preserve the teeth. We are therefore still left with the obligation not to neglect the need and demand for dental treatment--of whatever nature it may be--in the old generation. The survey has clearly demonstrated that, so far, these demands have not been met.


Ethical considerations in human experimentation.


Epidemiology and public health aspects of malocclusion.


A potential model for the interaction of enamel fluoride and plaque in the development of dental caries. A model relating caries to surface enamel fluoride and plaque has been derived by exploratory data analyses. Since the model was obtained a posteriori, it is best viewed in qualitative terms as a hypothesis for future testing. The model prompts a re-evaluation of expectations relative to the effects of surface enamel apatitic fluoride, and a consideration that the effectiveness of a given measure of fluoride may vary as a function of inherent challenge. Thus, further studies are needed, aimed at quantifying the parameters of resistance and challenge, and characterizing the relationship between them.


Changing periodontal status in a changing environment.


A longitudinal evaluation of the Burlington growth centre data.


Caries experience and the mineral content of plaque in a primitive population in New Guinea.


Genetic and environmental factors in the etiology of dental disease in the Aleut.


Global problems of oral diseases.

Global problems of oral diseases.


A longitudinal epidemiological study on dental plaque and the development of dental caries--interim results after two years. 1. During the two-year period, caries developed at 20% of the target premolar sites. The attack rate for these surfaces was similar in the plaque panel and the other subjects in the study. 2. The microbial composition of plaque samples from caries-free sites and from carious sites before and after radiographic detection of lesions was broadly similar. 3. Numerical domination of particular sites by S mutans before detection of caries can occur, but has only been observed so far in 2 of 15 sites. 4. Pooled date from sites which have developed lesions indicate a rise in the isolation frequency and mean numbers of S. mutans after detection of caries. This trend was particularly obvious in the one subject who developed bilateral lesions by the second examination and in three of four sites where caries was detected at the fourth examination. Similar observations have been made with lactobacilli. 5. In two of 15 instances no isolations of S mutans were made from sites which developed caries. 6. To date, no single species appears to be uniquely associated with the onset of dental caries.


Comments on "general practice residency programs".


A comprehensive caries control program--design and evaluation of the clinical trial.


Dentists' self-evaluations: relationship to clinical performance. Today's dental practice standards are set by the individual dentist. Quality is assured, in large part, by the accuracy of self-evaluations by dental practitioners. As a result, dental educators have attempted to improve the accuracy of self-reported evaluations by dental students by teaching such skills in the laboratory and clinic. This investigation examines multiple self-evaluations of the quality of restorative practice of 1,196 general practitioners, and investigates the relationship between these ratings and actual quality of treatment by 102 dentists for 2,753 patients.


Survey of curriculum and instruction: continuing education courses in pain control. Pain and anxiety control is taught at the continuing education level in a large number of diverse courses. This paper reports the results of a survey of those courses offered in 1976. The majority of courses centered on the use of inhalation or intravenous sedation. Relatively few courses were offered on the other aspects of pain and anxiety control. Very little attempt is being made at formally evaluating the competence of participants in these courses. Few courses appear to adequately cover the prevention and management of complications. Based on these findings, changes are suggested in the teaching of pain and anxiety control at the continuing education level.


Introduction and summary of workshop proceedings on current and future dental roles in primary care.


Evaluation of clinical dental procedures by senior dental students.


The MEd degree in dental education--a survey.


Examination termination time as a predictor of students' performance on objective tests.


A dental library current awareness service. A simple, manual current awareness service at the University of Southern California School of Dentistry, designed to provide the user with photocopied tables of contents from selected journals, is described. Other available current awareness and selective dissemination of information services are discussed, and a general comparison and cost analysis is made between the USC program and SDILINE. The service was evaluated by means of a questionnaire distributed to the 30 faculty participants. Results indicate that the service is of value in the teaching and research programs of the school, and has a high degree of user acceptance. Cost of the service is minimal considering the benefits to the faculty.


Glycogen storage disease of the heart--hemodynamic and angiocardiographic features--report of a case.


The sequential appearance of Ia-like antigens and two different complement receptors during the maturation of human neutrophils. Ia antigens and two different types of complement (C) receptors appeared on membrane surfaces in a distinct sequence during the maturation of human neutrophils. Taking advantage of the finding that neutrophil celll density increased with maturation, density gradient centrifugation was used to separate neutrophils into fractions that were greatly enriched in cells representing individual stages of differentiation. Myeloblasts, the earliest cells recognized in the myeloid series of both normal and myelogenous leukemic individuals, expressed Ia determinants, whereas Ia determinants were absent or diminished on the majority of promyelocytes and completely undetectable on more mature granulocytes. Double marker studies demonstrated that Ia determinants were lost from the membrane of developing myeloid cells before the appearance of any type of C receptor. In the next phase of maturation defined by surface markers, neutrophils acquired a CR2-type C receptor (C3d receptor) that was similar in specificity to CR2 of B lymphocytes. This stage of maturation approximately corresponded to the myelocyte-metamyelocyte stage defined by standard morphologic criteria, and preceded the third stage of surface marker maturation when developing neutrophils began to express CR1-type C receptors (immune adherence, C4b-C3b receptors) in addition to CR2. In the final stage of surface marker-defined maturation, CR2 was lost from high density polymorphonuclear neutrophils and CR1 was maximally expressed. Normal blood polymorphonuclear neutrophils contained only 17% of CR2-bearing cells and these were shown to be of lower density than the majority of neutrophils that expressed only CR1. There  was some variation in the correlation of surface marker expression and maturation stage defined by morphologic criteria, but in all cases the sequence of marker appearance was the same: Ia leads to CR2 leads to CR1CR2 leads to CR1.


Renin and aldosterone measurements in the diagnosis and management of hypertension. I. Renin and aldosterone measurements in the etiological diagnosis of hypertension.


Renal tubular acidosis in Wilson's disease: characteristics, mechanisms and implications.


Serum thyrotropin in normal subjects and patients with thyroid diseases.


Cellular immunity in nasopharyngeal carcinoma. II. Leukocyte migration inhibition test and clinical stages.


Influence of age on altitude convulsion threshold in mice.


Roentgenocephalometric studies on normal occlusion and malocclusion among Chinese. I. Cranio-dento-facial structural variations associated with mandibular inclination in normal-bites.


Autoplagiarism.

Autoplagiarism.


Business or profession: the choice is yours.


Movement of the proximal and distal segments after mandibular ramus osteotomies. Data was collected from 27 patients who were treated with various ramal surgical procedures. Movements of the proximal segment during and after surgery were frequently noted. If the proximal segment was moved from its preoperative position and fixed to the distal segment, occlusal relapse was visible shortly after release of maxillomandibular fixation. Proximal segments displaced during surgery and not fixed to the distal segment frequently returned to their preoperative positions during fixation or assumed positions of biologic equilibrium. In such cases, occlusal relapse was minimal or nonexistent.


Cephalometrics for orthognathic surgery. A cephalometric analysis especially designed for the patient who requires maxillofacial surgery was developed to use landmarks and measurements that can be altered by common surgical procedures. Because measurements are primarily linear, they may be readily applied to prediction overlays and study cast mountings and may serve as a basis for the evaluation of posttreatment stability.


An evaluation of enflurane as an amnesic agent for outpatient oral surgery. An alternative to general anesthesia for outpatient oral surgery that creates a state of cooperative amnesia without eliminating the patient's protective reflexes has been developed. Enflurane, 1.5%, administered via a nasal mask produced a high incidence of amnesia with all patients remaining cooperative, with protective reflexes intact.


Traumatic cyst of the mandible.

Traumatic cyst of the mandible.


Healing of large mandibular defect after treatment of osteomyelitis resulting from vestibuloplasty. A case of mandibular osteomyelitis, which developed after vestibuloplasty, has been described. Sequestrotomy resulted in a large defect that healed spontaneously within 12 months without a bone graft or immobilization of the fragments.


Diagnosis of pheochromocytoma during treatment of a mandibular fracture: report of case. A case of pheochromocytoma, which was discovered during the patient's admission for treatment of mandibular fracture, is presented. Pheochromocytoma represents a potentially life-threatening disease, but alsl is a curable cause of hypertension. Therefore, in spite of its low incidence, it is important that the oral surgeon consider it in his evaluation of the hypertensive patient, especially when associated symptoms of sweating, palpitations, and headache are present.


Benign cementoblastoma--cementum analogue of benign osteoblastoma? We believe that the current case is a good example of a "borderline lesion" that shows the histologic features of benign osteoblastoma but with some clinical features suggestive of a cementoblastoma, such as attachment to the roots. We suggest, however, that the involvement of the roots should not rule out the diagnosis of benign osteoblastoma. The fact that a benign osteoblastoma may envelop the roots in a way characteristic of a benign cementoblastoma, however, is suggestive of a close relationship between the two tumors.


Osteoblastoma of the jaws: current concepts and differential diagnosis. A review of previously documented cases of osteoblastoma has been presented and an additional case has been reported. Although the clinical and histologic distinctions for fibrous-osseous lesions cover a wide spectrum, several means of differentiating osteoblastoma from similar lesions have been discussed. A larger series of cases will allow us to further delineate clinical, histologic, and biologic variables of osteoblastoma.


Local recurrence of solitary plasmacytoma of the mandible. A case of local recurrence of mandibular plasmacytoma has been presented. Review of the literature disclosed only one previous report of this phenomenon.


Cutting of nasoendotracheal tube: an unusual complication of maxillary osteotomies.


Fatal mediastinitis secondary to odontogenic infection. A case of necrotizing mediastinitis that caused death in a 38-year-old man has been reported. The cause of his infection was proved, both radiographically and clinically, to be dental infection associated with the lower molars and their supporting structures. A diffuse cellulitis involving the submandibular, masticator, and parapharyngeal spaces ensued. Sudden onset of severe pleuritic chest pains and a 100% pneumothorax of the left lung developed, which ultimately led to his death.


A simple, inexpensive support for endotracheal tubes and anesthetic hoses.


Massive osteolysis: phantom bone disease.


Late-onset pulmonary fibrosis and chest deformity in two children treated with cyclophosphamide.


Etiology of pneumonitis in children with leukemia.


Clinical experience in prevention of candidiasis by nystatin in children with acute lymphocytic leukemia.


A reevaluation of Hanau's Laws of Articulation and the Hanau Quint.


Counseling and related factors influencing satisfaction with dentures.


Radiographic evaluation of porosities in removable partial denture castings. Most of the removable partial denture castings examined showed radiographic evidence of internal porosity. In general the porosity ocurred in characteristic regions associated with abrupt changes in cross-sectional thickness. These were located either within the partial denture framework or at the casting-sprue junctions. The porosity is due to metal shrinkage caused by a premature solidification at some point, which in turn interferes with a controlled unidirectional soldification of the casting.


Metal-ceramic restorations.

Metal-ceramic restorations.


In vitro assessment of marginal leakage of six enamel sealants. The findings of this study support previous data on marginal leakage using enamel sealants in vitro. All sealants tested except Epoxylite 9075 were described for this study. However, all in vitro studies have limitations, and the ultimate evaluation of sealant behaviour must be based on in vivo experimentation.


Physical and mechanical behavior of polyurethane elastomer formulations used for facial prostheses. The initial results of this study of the physical and mechanical behavior of polyurethanes used for facial prostheses are presented. The parameters studied were surface hardness, modulus of elasticity (M), strength (S), percentage of elongation, and S/M ratio. Results showed that the physical and mechanical behavior of the polyurethanes can be altered by variations in the basic composition of the material accomplished through changes in the ratio of Part A to Part B and by the addition of catalysts. Properties of compositions with low quantities of Part B (isocyanate) and no catalyst reached or approximated those parameters proposed as ideal goals to simulate living tissue. When preparing polyurethane material, proper mixing is essential to avoid entrapment of air and phase separation of the catalyst. These conditions, which may render the prostheses less durable, are masked by the addition of colorants in the prearation of a sample for clinical application.


Characteristics of the condylar path in internal derangements of the TMJ.


The prevalence and magnitude of mandibular displacement in a survey population. The prevalence and magnitude of mandibular displacement from RCP to IP in a principally adult sample was evaluated. The findings and their possible clinical significance were discussed.


The measurement of distortion: mathematical considerations. The proposed method for accurately determining the coordinates of given points in a three-dimensional space, along with the mathematical rigid body displacements to move these points into some predefined reference position, builds a complete model of the positional relationships of these points. On this basis additional information can easily be extracted, e.g., the distance between any two given points or the angle in degrees between any two given points or the angle in degrees between any three given points. An important advantage of the procedure is that the normally tedious calculations involved with distortions have been computerized, thus eliminating the tedium of repeated calculations. The possibility of calculation error is also reduced. Perhaps the greatest advantage to the investigator arises from the fact that once the procedural routine has been established and the computer programs written, the entire procedure can be done by technical personnel and does not necessarily require a large time committment from the principal researcher. Also, because of the normally small amount of time needed to read the coordinates and compute the inherent distortions, a set of computed distortions which appear unreasonable may be checked by repeating the entire set of coordinate readings and distortion calculations in a relatively short time.


Biologic laws governing functions of muscles that move the mandible.


Leukaemia in children of Jehovah's Witnesses: issues and priorities in a conflict of care. Throughout this paper PJ Kearney attempts to balance the risks and benefits of different approaches in paediatric oncology. Decisions have to be considered both in the short and the long term. Where religious beliefs, such as those held by Jehovah's Witnesses in relation to blood transfusions, conflict with normal medical practice the decision is often removed from the doctor, parents or patient to the courts. This sort of solution can be counter-productive, especially as good health care and subsequent recovery rely, to a large extent, on good relationships between and among the parties concerned. Destruction of these relationships, for whatever reason, often has a detrimental effect on the patient, in whose best interest everyone believes they are acting.


Waardenburg-like features with cataracts, small head size, joint abnormalities, hypogonadism, and osteosarcoma. A 32-year-old black man was observed with osteosarcoma and multiple anomalies including deafness, hypopigmentation, cataracts, small head size, hypogonadism, and restricted joint mobility. The birth defects may comprise a new syndrome or combination of syndromes, of which the malignancy may be a part.


A new and successful technique of suspending a completely prolapsed vaginal stump.


Satellite genetic clinic in a community hospital.


Feasibility of data processing for group medical practices.


Pathophysiology of focal cerebral ischemia and the rationale of surgical management.


Legionnaires' disease in New Jersey.

Legionnaires' disease in New Jersey.


Chronic ethmoid sinus foreign body.

Chronic ethmoid sinus foreign body.


Fatal poppet embolization from a Braunwald-Cutter aortic valve prosthesis.


Primary and delayed primary repairs of flexor tendons in "no-man's land": 18 consecutive cases.


Perforating ocular injuries--a second look.


Case report. Azathioprine-induced megaloblastic erythropoiesis.


Pneumatosis coli: report of a successful therapeutic approach.


Non-invasive cardiology. Case presentation.


Pain in malignancy: cordotomy.

Pain in malignancy: cordotomy.


Prolonged meningeal leukemia. Occurrence during hematologic remission of acute myeloblastic leukemia.


Lymphosarcoma with lymphoblastic leukemia in a New Zealand white rabbit. An 8 to 10-week-old female New Zealand white rabbit, Oryctolagus cuniculus, which exhibited clinical signs of anorexia, depression, and torticollis was found to have lymphosarcoma with lymphoblastic leukemia. The multiple visceral involvement with neoplastic lymphoid cells observed in this animal was similar to previously reprted cases of lymphosarcoma in the rabbit. An unusual finding was the occurrence of lymphoblastic leukemia since lymphosarcoma in the rabbit has previously been reported as aleukemic.


Open heart surgery in the community hospital: 100 consecutive cases without mortality.


Percutaneous rhizotomy in the treatment of facial pain.


Computer communications in rural practice.


Intestinal parasites in South Carolina--a three year study.


Laboratories in the offices of private physicians in South Carolina: results of a survey.


The changing status of rabies in South Carolina.


Coronary heart disease and stroke death in South Carolina: geographical differences.


Post lumbar puncture headache: a review of the literature.


Changing trends in medical ethics: codes and oaths.


Medical insurance peer review--progress and problems in South Carolina.


New trends in medical ethics.

New trends in medical ethics.


Pulmonary resection in children with metastatic osteogenic sarcoma: improved survival with surgery, chemotherapy, and irradiation. Twelve consecutive unselected patients (aged 6 to 18 years) with osteogenic sarcoma underwent 19 thoracotomies for resection of pulmonary metastases. Wedge excisions of 41 metastatic nodules, one bilobectomy, and one pneumonectomy were performed. Six patients each required one thoracotomy, five patients underwent two thoracotomies, and one patient required three. Serious surgical complications were limited to one patient who required reoperation for closure of a bronchopleural fistula following bilobectomy. Initial pulmonary metastasis occurred 9 months (mean) after amputation (range 1 to 21 months). Complete excision of all identifiable metastatic tumor was possible in 17 of 19 thoracotomies. All patients received intensive cyclical chemotherapy after initial definitive amputation, after thoracotomy, or both. Tumor doubling time (TDT) during chemotherapy (mean 74 days) was significantly prolonged (p = 0.017) compared to TDT during intervals of no therapy (mean 22 days). Five patients received pulmonary radiotherapy prior to thoracotomy and five after thoracotomy. Four patients died during the observation period, having survived 10 to 30 months after amputation. Two patients are alive with known extrapulmonary metastases. Six patients are free of disease. The survival rate is 91.7 percent 1 year after amputation, 82.5 percent at 2 years, and 57.8 percent at 3 years. These results suggest improved survival when aggressive surgical resections of pulmonary metastases are combined with chemotherapy and radiotherapy. Thoracic surgical procedures in this group of patients are safe and associated with a low incidence of complications despite the potentially increased risks owing to antecedent chemotherapy and pulmonary irradiation.


Extreme leukemic leukocytosis (blast crisis) in childhood. Children with leukemia who have extremely high leukocyte counts (more than 100,000/mm3) when seen initially are at high risk of early sudden death, usually from massive intracerebral hemorrhage. Nine such patients were seen during a 39-month period. Eight had pronounced adenopathy and hepatosplenomegaly without severe anemia or thrombocytopenia. The first six patients died suddenly. Cerebral perivascular infiltration and increased blood viscosity are the probable pathophysiologic mechanisms. A treatment program was developed, the goal being the early elimination of blast cells. Three consecutive patients patients presenting with leukocyte counts greater than 100,000/mm3 were treated with emergency cranial irradiation, and all three survived to receive systemic chemotherapy.


Testicular relapse in childhood leukemia. Five patients in bone marrow remission from childhood leukemia who subsequently had relapse in the testicle are reviewed. Clinically, recurrence of disease is often limited to this site. In spite of satisfactory local control with radiotherapy, further systemic progression generally occurs within 1 year. Previous studies suggest that patients who are in clinical remission harbor tumor in multiple occult "sanctuaries." Testicular leukemia reflects this uncontrolled extramedullary disease, and studies in optimal management of the generalized process are needed.


Hypothalamic syndrome in children with acute lymphocytic leukemia. Five children had six episodes of central nervous system leukemia which were characterized by features suggestive of hypothalamic infiltration. All five patients had been in prolonged bone marrow remission and had no other evidence of active leukemia when the hypothalamic syndrome was diagnosed. Five of the six episodes responded promptly to intrathecally administered methotrexate and cranial irradiation, but bone marrow relapse, which was resistant to further therapy, developed within 4 months in three patients and after 18 months in the fourth. Only one patient remains in bone marrow remission without recurrence of hypothalamic symptoms 10 months later.


Treatment of the leukemias.

Treatment of the leukemias.


Was it 'pseudoleukaemia' or the real thing?


Terminal transferase as a predictor of initial responsiveness to vincristine and prednisone in blastic chronic myelogenous leukemia: a co-operative study. We undertook a prospective trial to evaluate terminal deoxynucleotidyl transferase activity as a predictor of responsiveness to vincristine and prednisone in 22 Philadelphia-chromosome-positive patients with blastic chronic myelogenous leukemia. Thirteen patients were transferase positive, and nine negative. None of the nine negative patients responded, whereas eight of the 13 positive (P = 0.004) responded with complete clearing of peripheral blood blast cells and a return of normal marrow cellularity with less than 5 per cent blast cells. Among transferase-positive patients under 50 years of age the response rate was 78 per cent. Blast-cell morphology (i.e., lymphoblastic versus myeloblastic) had no significant correlation with either responsiveness or terminal transferase activity. The results of this study suggest that responsiveness to vincristine and prednisone in blastic chronic myelogenous leukemia is confined to patients whose leukemic cells are transferase positive.


Abnormal CT scans of the brain in asymptomatic children with acute lymphocytic leukemia after prophylactic treatment of the central nervous system with radiation and intrathecal chemotherapy. Thirty-two asymptomatic patients with acute lymphocytic leukemia, who had received prophylactic cranial radiation (2400 rads) and either intrathecal methotrexate or cytosine arabinoside were studied by computed tomography of the brain 19 to 67 months after initiation of prophylaxis. Seventeen of 32 (53 per cent) had one or more abnormal findings. Dilatation of the ventricles (eight patients) and widening of the subarachnoid spaces (nine patients) were equally distributed among patients in both intrathecal-chemotherapy groups. Areas of decreased attenuation coefficient (hypodense, abnormally radiolucent regions) (four patients) and intracerebral calcification (one patient)--lesions previously described in methotrexate leukoencephalopathy--were found only in those who had received intrathecal methotrexate. Mild central-nervous-system dysfunction was detected in seven patients but did not correlate with the presence of tomographic abnormalities. Nevertheless, these tomographic findings may represent preclinical lesions. The unexpectedly high prevalence of such abnormalities contrasts with the essentially normal tomographic findings in a control group with acute lymphocytic leukemia who received no central-nervous-system prophylaxis. These results suggest that alternative approaches to such prophylaxis be considered.


Terminal transferase: its evolving role.


Leukemia in patients treated for Hodgkin's disease.


Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 15-1978.


Myeloid leukaemia in x-ray irradiated CBA mice.


A Canadian view of bilingualism in Carolina.


Hemophilus parainfluenzae bacteremia with meningitis.


The post-traumatic "swan-neck" finger--two common causes.


The improvement of health education in Nassau County.


L-asparaginase in treatment of acute leukemia in children. L-asparaginase from Escherichia coli--Crasnitin was used in 14 children with acute leukemia unresponsive to conventional treatment: 11 acute lymphoblastic leukemias, 1 acute myeloblastic leukemia, 2 other forms of leukemia. The remission induction was obtained in 70% of applications. Median of remission duration was 90 days. Serious side effects were observed. The validity of L-asparaginase in therapy of advanced childhood ALL is stressed.


The betrayal of youth. Part II.

The betrayal of youth. Part II.


Effects of PGE2 and colchicine on the intestinal fluid volume. a) Colchicine, prostaglandin E2 (PGE2) and carbachol increase the intestinal fluid volume in the rat. b) The effect of carbachol and prostaglandin E2 is augmented whereas that of colchicine is diminished in the pithed rat. c) The effect of colchicine is diminished in anaesthesia whereas that of PGE2 remains unchanged. d) The effect of PGE2 and of colchicine are both inhibited by atropine. e) The effects of PGE2 and of colchicine are both enhanced by phentolamine. f) Pretreatment with indomethacin decreased the effect of colchicine whereas that of PGE2 remained unchanged. g) The PGE2-induced increase in intestinal fluid volume may partly be mediated by a peripheral mechanism involving acetylcholine receptors. h) The increase in intestinal fluid volume by colchicine can mainly be explained by a central action of the drug which is mediated by cholinergic neurones.


Filling a gap in home health care services. A model for the training of certified home health aides.


The negotiations process.

The negotiations process.


The most prevalent childhood disease.

The most prevalent childhood disease.


Chronic vague abdominal pain in children.


A public health nurse liaison for schools.


New York, Washington, D.C., and now school nursing in New Jersey. A professional journey.


International study for health professionals.


Dunedin sports injuries, 1974-1976.

Dunedin sports injuries, 1974-1976. An analysis of 3894 sports injuries presented to the Dunedin accident and emergency centre between 1 April 1974 and 30 March 1976 is reported. An outline of the general age, sex, sport, site and type of injury trends follows, and comparisons with published New Zealand and overseas studies are made. The paper concludes with comments on problem areas and suggests some safety measures.


Drug reaction simulating malignant lymphoma: a case due to pyrimethamine. A 9 1/2-year-old boy who had been treated with pyrimethamine and sulphadimidine presented with generalised lymphadenopathy, fever, and an unusual sun-tanning. He was found to have mild anaemia, severe leucopenia and thrombocytopenia. The bone marrow was megaloblastic. Lymph node biopsy was initially interpreted as showing malignant lymphoma. No treatment for neoplasia was given and he was well 4 1/2 years later. We consider that the seemingly malignant changes were due to pyrimethamine.


Fibreoptic bronchoscopy.

Fibreoptic bronchoscopy.


The aetiology of an unpleasant itch.

The aetiology of an unpleasant itch.


Sharing responsibility: a hospital/community rehabilitation programme for chronic psychiatric patients.


Treatment of Vaginismus.

Treatment of Vaginismus.


Nurse teachers are role models whether they like it or not!


Spinal injury units and rehabilitation.

Spinal injury units and rehabilitation.


Community health nursing in England and Scotland.


Surveys reveal women's attitudes to breast self-examination.


Dying in hospital.

Dying in hospital.


Code of ethics. Revised October, 1977. The First District Dental Society of New York.


Treatment planning for the periodontal patient.


A visualization of calcification in teeth.


Sickle-cell anemia: dental implications.


Mandatory continuing education: a new twist for New York State.


Government relations: an update on advertising.


Observations in the teaching of oral diagnosis and treatment planning.


Dental care--a primary health service.

Dental care--a primary health service.


Calcified stylohyoid attachments with amphiarthroses.


Desensitizing hypersensitive dentin by iontophoresis with fluoride.


Dental school reports.

Dental school reports.


Ultrastructural observations on the retina in type II glycogenosis (Pompe's disease). The retina of a 9-month-old boy afflicted with biochemically proven type II glycogenosis contained abundant lysosomal glycogen. This was present in almost every cell type and occasionally associated with lipofuscin in choroidal macrophages. Lysosomal glycogen was absent from melanocytes and pigment epithelial cells. No degeneration of any cell layer was noted. The ubiquitous accretion of lysosomal glycogen resembles the widespread distribution of lipopigments in canine neural ceroid lipofuscinosis, another lysosomal disorder.


Mandibular deficiency syndrome. I. Clinical delineation and therapeutic significance. The mandibular deficiency syndrome is a constellation of abnormalities, including a spectrum of skeletal, neuromuscular, occlusal, and esthetic conditions. The extremes of this syndrome exhibit different skeletal and esthetic morphology and growth patterns. Different orthodontic and surgical approaches must be considered for optimal functional and esthetic correction in the three different facial types. Differentiation between cases with low, medium, and high mandibular plane angles and knowledge of the growth tendencies will permit different surgical and orthodontic considerations for each of the three basic morphologic types. Predictable functional and esthetic results can then be expected.


Mandibular deficiency syndrome. II. Surgical considerations for mandibular advancement. Eight factors which contribute to the successful surgical correction of the deficient mandible have been briefly discussed. Consideration of the recommendations made will permit surgeons to avoid pitfalls, regardless of the specific surgical technique used to advance the mandible, and will result in improved treatment results. The type of mandibular deficiency syndrome and its severity will dictate which factors need to be considered in a given case. A modified sagittal osteotomy is described as our preferred surgical technique to achieve these objectives and minimize untoward sequelae.


Mandibular deficiency syndrome. III. Surgical advancement of the deficient mandible in growing children: treatment results in twelve patients. The surgical-orthodontic correction of mandibular deficiency in growing children (8 to 16 years of age) can be employed to achieve excellent results. Mandibular advancement by a modified sagittal osteotomy proves to be an acceptable procedure with good skeletal stability. Dentofacial growth following surgery will be harmonious and not adversely affected. Direction of growth varies, with the mandibular plane angle becoming more vertical with an increasing mandibular plane angle.


D-penicillamine-induced mucocutaneous lesions with features of pemphigus. Penicillamine (beta1 beta2 dimethylcysteine) is the drug of choice in the therapeutic management of Wilson's disease and cystinuria and has been used in the treatment of some heavy-metal intoxications. Recent studies have shown that it is efficacious in patients with rheumatoid arthritis. Side effects include sensitivity reactions, nephrotoxicity, bone-marrow suppression, hypogeusia, skin lesions, and the formation of autoantibodies. Two cases are described with the features of pemphigus which were attributed to penicillamine therapy.