Sophisticated radiology in otolaryngology. I. Diagnostic imaging: roentgenographic (x-ray) modalities. Conventional radiography is now complemented by a large range of newer radiologic diagnostic techniques, involving both roentgenographic and non-roentgenographic modalities. It is the purpose of this presentation to present these new roentgenographic modalities in graphic form, and demonstrate their application to otolaryngic diagnosis. The major roentgenographic modalities which will be stressed are: xeroradiography, angiography, and computerized tomographic scanning.


Indications for operative management of renovascular hypertension.


The clinical significance of plasma renin activity determination.


Emergency rooms and cost containment.

Emergency rooms and cost containment.


Disinfectants: their selection and use.

Disinfectants: their selection and use.


Health care and hospital costs.

Health care and hospital costs.


Public health consequences of Outer Continental Shelf Development. On-shore impacts of outer continental shelf (OCS) development.


Consequences of OCS development. Health-air quality interactions.


Consequences of OCS development. Impact on social and administrative aspects of resource management.


Physicians and the environment.

Physicians and the environment.


"Effort" pneumomediastinum.

"Effort" pneumomediastinum.


Simultaneous radiation and drug therapy: tumor response and toxicity. Three patients who received simultaneous radiation and chemotherapy are described. Increased tumor response and enhanced radiation reaction were observed. Simultaneous drug and radiation therapy may prove to be the treatment of choice for particular malignant tumors. More data concerning the magnitude of the toxic effects when 2 modalities are used in conjunction is needed. Dose adjustments will be required for each modality to allow for optimal damage to the tumor with minimal and acceptable adverse reaction in the normal tissue.


Cells on stems.

Cells on stems.


Hyperphosphatemia and lactic acidosis.

Hyperphosphatemia and lactic acidosis.


Cellular distribution of hemoglobin F in a clonal hemopoietic stem-cell disorder. Because all erythroid cells in chronic myelogenous leukemia are believed to arise from a common pluripotent stem cell, we studied the cellular distribution of fetal hemoglobin in patients with the disease to test whether cells with and without hemoglobin F have a common or separate pluripotent stem-cell origin. In a patient with chronic myelogenous leukemia and sickle/beta thalassemia, 17 per cent of the red cells during remission and 18 to 22 per cent during the blastic phase contained fetal hemoglobin. In 24 non-hemoglobinopathic leukemic patients 0.3 to 28 per cent of red cells contained hemoglobin F. Since the erythrocytes in chronic myelogenous leukemia are almost exclusively derived from the malignant clone, these data suggest that cells containing fetal hemoglobin originate from the same pluripotent stem-cell progenitor as those without hemoglobin F. The findings argue against a separate line of "partially switched" pluripotent stem cells as being responsible for maintenance of hemoglobin F production in the adult.


Continuous growth and differentiation of human myeloid leukaemic cells in suspension culture.


The geriatric population and dental care in nursing homes.


A case report: periodontal surgery in Parkinsonism utilizing intravenous sedation.


Mandible-like structure with teeth in an ovarian cystic teratoma. The findings of a tooth-bearing mandible-like structure within a large ovarian dermoid cyst is reported. Although the presence of assorted teeth and bone is not uncommon in teratomatous lesions, the formation of an apparent alveolar structure possessing multiple teeth is found less often.


An unusual triad: microdontia, taurodontia, and dens invaginatus. A 12 1/2-year-old white boy was examined and found to have permanent teeth that were smaller than those of the average adult. The microdontia was accompanied by taurodontia of the mandibular molars and several teeth with dens invaginatus. The patient was normal in appearance and had no other illness. The pedigree was compatible with X-linked recessive inheritance.


Paresthesia from N2 or N2 substitute. Report of a case.


Antimicrobial effects of N2 in vitro.

Antimicrobial effects of N2 in vitro. The antimicrobial effect of the root canal filling material N2 has been studied in vitro. Pulverized as well as intact set N2 inhibited the growth of the mixed bacterial flora of saliva or pure cultures of S. mutants and A. viscosus on blood agar for at least 100 days. Intact set N2 transferred daily to blood agar inoculated with saliva lost its antimicrobial activity after nine transfers. The antimicrobial effect of N2 against S. mutants was found to be bactericidal. N2 also appeared to possess an antimicrobial "vapor effect".


Cell-mediated immune response to dog pulp tissue altered by N2 paste within the root canal. After pulpal extirpation of twenty teeth in each of four dogs, these animals were primarily immunized intramuscularly with the dogs' own pulp (three dogs) altered by N2 paste and saline solution with pulp (one dog). A fifth dog was used as a control for skin tests. Secondary immunizations were accomplished via the root canal every 7 days over a 28-day period. Cell-mediated skin tests reactions demonstrated less of a response to the N2 paste alone than when the dogs' pulp was altered with this material. In vitro analysis of cell-mediated immune response (lymphocyte proliferation) showed a marked response to the pulp altered by N2 paste as compared to the saline-treated pulp (P less than 0.002). Therefore, dogs' pulp tissue became antigenically altered by the N2 material, recognized by the host, and a specific cell-mediated lymphocyte proliferation resulted.


An evaluation of the XR-10 intensifier in dental radiography.


Congenital facial fistula with formation of accessory bone and teeth. Report of a case.


Iatrogenic foreign body.

Iatrogenic foreign body.


Monostotic (craniofacial) fibrous dysplasia.


A microangiographic study of vascular changes in replanted and autotransplanted teeth of young dogs. The purpose of the present investigation was to study the revascularization process of the pulp of replanted and autotransplanted teeth with incomplete root development in dogs. A barium-sulfate injection method combined with contact microradiography was used. Ingrowth of apparently new vessels was seen during the first postoperative days. After 10 days, visible vessels were seen in the apical half of the pulp, and after 30 days, in the whole pulp. Branches and apparently also anastomoses between pulpal vessels were seen after 10 days but were especially numerous after 30 days. One hundred eighty days postoperatively, only one of fifteen teeth was devoid of visible vessels, indicating pulpal necrosis. Thirteen of the remaining fourteen teeth exhibited visible vessels throughout the entire length of the pulp. It seems, therefore, that replanted and autotransplanted teeth with open apices have a high potential for repair. The revascularization of the pulp appeared to occur mainly by ingrowth of new vessels. In some instances, however, anastomoses seemed to form to pre-existing vessels in the pulp.


Subacute pericoronitis from an unerupted supernumerary third molar. Report of a case. Any tooth may be affected by pericoronitis. A case of acute pericoronitis from an unerupted supernumerary third molar tooth is described. The importance of the patient's history and the clinical examination in reaching a diagnosis is stressed.


Thyroglossal-tract cyst.

Thyroglossal-tract cyst. Thyroglossal-tract cyst should be included in the differential diagnosis of any mass found in the anterior midline of the neck. A discussion and review of forty-two cases diagnosed between 1970 and 1976 at Wilford Hall USAF Medical Center are presented.


Frustration and temporomandibular joint pain. The significance of frustration as a cause of temporomandibular joint pain is investigated through the use of bilateral electromyographic recording. Interpretation of both parametric and nonparametric data indicates the lack of relationship. The need for careful controls and the problems of psychologizing are discussed.


Correlative study of pain perception and masticatory muscle reflexes in man. An attempt was made  to explore the possibility of using the masticatory muscle reflexes as pain indices in human subjects. It was found that the digastric reflex, so readily evoked by electrodental stimulation in experimental animals, could not be consistently elicited in man. The reflex silent period of the masseteric muscles, on the other hand, may be used as a pain index for evaluating dental analgesia, provided that analgesic interference is anticipated at points along the reflex arc.


Sialochemistry of patients with rheumatoid arthritis. Electrolytes, protein, and salivary IgA. Sialochemistry was undertaken to detect subclinical involvement of salivary glands in patients with rheumatoid arthritis (RA). The concentrations of salivary sodium and IgA were significantly elevated in 24 percent of the RA patients. Eighty per cent of the patients with elevated sodium and IgA concentrations had keratoconjunctivitis sicca as well. No correlation between serum and salivary IgA levels was found. The results indicate that salivary sodium and IgA levels can be used for detection of subclinical salivary gland involvement and for follow-up of RA patients.


Sialadenoma papilliferum of the oral cavity. Sialadenoma papilliferum is a rare tumor of salivary gland origin. A review of the English-language literature indicates that only four cases have been reported. This article describes the clinical and histologic characteristics of an additional case occurring on the left retromolar pad.


Intradermal nevus associated with epidermoid cyst in the mucous membrane of the cheek. A case of epidermoid cyst associated with an unusual amelanotic intradermal nevus, with structures identical to Meissner's tactile corpuscles, is reported. The possible relationship and the origin of both lesions are discussed.


Clinical and roentgenographic evaluation of thirty-seven autotransplanted impacted maxillary canines. Thirty-seven autotransplanted canines in thirty-one patients were observed for a period of 2 to 7 years. Transplants with less than 2 years follow-up were not included in this study. Although the surgical root canal, and fixation techniques were identical, the delayed pathophysiologic changes were different.


Intravascular papillary endothelial hyperplasia in the oral mucosa. An intraluminal reactive hyperplastic lesion from the lower labial mucosa of an adult male patient is described. It has been termed intravascular papillary endothelial hyperplasia and may have arisen in an organizing thrombosed vein. The importance of distinguishing it from a malignant vascular neoplasm is stressed, and the differential diagnosis is discussed.


Sialadenoma papilliferum.

Sialadenoma papilliferum. Two previously unreported cases of sialadenoma papilliferum are presented. This brings the total number of reported cases of this entity to five. A review of the literature and a discussion of the histopathologic characteristics and possible histogenesis of the sialadenoma papilliferum are included.


Angiolipoma of the cheek in a child.

Angiolipoma of the cheek in a child.


Osteoma cutis: cutaneous ossification with oral manifestations. Subcutaneous and mucosal calcifications are rare lesions which present problems in diagnosis. A large bony mass is presented, with dermal and mucosal findings. The literature is reviewed on this non-neoplastic bony lesion and differential diagnosis is discussed.


State board examinations: are they needed.


Cavosurface design and marginal leakage of composite resin restorations.


A jaw movement not reproduced by an articulator.


Deformation of human teeth under the action of an amalgam matrix band.


Gold foil: education, evaluation, or elimination.


Mechanical amalgam condensers compared.

Mechanical amalgam condensers compared.


Pulsed nuclear magnetic resonance studies of human bone marrow. Pulsed nuclear magnetic resonance (NMR) studies of human bone marrow reveal that the proton spin-lattice relaxation times (T1) of acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) are much greater than the T1 of normal bone marrow.


Birth order, motor performance, and maternal influence.


Compatibility in the coach-athlete dyad.


A comparison of the motor performance of Black and Caucasian girls age 6--8.


Influence of group success-failure and relative ability on intrapersonal variables.


Comparison of peak performance measures in children ages 6 to 8, 9 to 10, and 11 to 13 years.


Analysis of the static strength and relative endurance of women athletes.


Stabilometer performance of educable mentally retarded children under differential feedback conditions.


Effects of self-enhancement and consistency on causal and trait attributions following success and failure in motor performance.


Social acceptance of female athletes by college women.


Rhythmic isometric fatigue patterns of the elbow flexors and knee extensors.


Body composition and somatotype of male and female Nordic skiers.


Relationship of body composition to somatotype in boys ages 7 to 12 years.


Relationship of Heath and Carter's second component to lean body mass and height in college women.


Empirical study of training and performance in the marathon.


Exercise stress testing programs in the United States: a 1975 status study.


Adolescent body size and flexibility.

Adolescent body size and flexibility.


Exercise recovery, lactate removal, and subsequent high intensity exercise performance.


Measuring the adaptation of movement to outside forces.


Toppling techniques in diving.

Toppling techniques in diving.


A note on the practicality of sprinter's starts for base stealing.


The management of extramedullary disease in acute leukemia with therapeutic radiations. The authors reviewed 181 patients who received local radiation therapy for the prevention or control of extramedullary disease resulting from acute leukemia. 126 had acute lymphocytic leukemia and 55 had acute granulocytic leukemia. They were treated over a 18-year period of time with different forms of chemotherapy. Most had not received prophylactic CNS radiation therapy. Patients were evaluated for local control until death or hematologic relapse intervened. More than 80% of patients with clinical ALL meningeal leukemia had a successful response to doses over 1000 rads. This same response was not apparent in AML. More than 80% of clinical non-CNS extra medullary leukemia was controlled with doses of 600 rads or greater. Only one patient with extra-medullary relapse is still alive. The authors feel that lower preventative doses of radiation to the CNS are compatible with similar control rates, based on their own data and other suggestive data.


Fluoride content of dental plaque before, during and after ingestion of sucrose modified with fluoride or bicarbonate-phosphate. Students ingested tablets daily during a period of 3 d growth of dental plaque and in connection with the collection of plaque specimens. The tablets varied in composition: sucrose (C), sucrose containing sodium bicarbonate-monopotassium orthophosphate and fluoride (BPF), and sucrose modified with fluoride (F). The daily fluoride dose in conjunction with the growth of plaque and the collection of specimens was 0.5 mg of total fluoride and 0.2 mg in the determination of ionized fluoride. The fluoride taken during the growth period did not significantly affect the total and ionized fluoride contents of the plaque. During the consumption of all the tablets, the total fluoride content of the plaque increased temporarily, after which a drop took place to close to the original value. In the case of the C- and the BPF-tablets, the increase was statistically significant (P-values less than 0.02 and less than 0.001, respectively). During the consumption of the BPF- and F-tablets, the ionized fluoride content dropped significantly (P-values less than 0.001 and less than 0.01, respectively). The investigation showed that a binding of the free fluoride ions in dental plaque takes place in connection with fermentation.


Adsorption of Streptococcus mutans lipoteichoic acid to hydroxyapatite. Lipoteichoic acid extracted from cells of S. mutans strain BHT exhibited a high affinity for hydroxyapatite. Phosphate ions, fluoride ions and to a lesser extent human saliva inhibited or reversed this adsorption. Extracellular lipoteichoic acid preparations obtained from the supernatant of cultures of the same bacteria exhibited similar properties. It is suggested that lipoteichoic acids could play a significant role in the colonization of teeth by Gram-positive bacteria and thereby contribute to the formation and pathogenicity of dental plaque.


Evaluation of histologic criteria applied for description of pulp reactions in replanted human premolars. To test the reproducibility of a scoring system prepared for the study of the tissue changes in replanted teeth, 30 teeth were allocated at random from a material comprising 70 replanted and control teeth. The scoring system elaborated was applied for description of the odontoblast layer, predentin, secondary dentin, circulatory alterations, resorption, Weil's zone, cellular infiltration and calcification. The registrations were performed twice with a time interval of approximately 2 months. The scores were subsequently compared. Generally speaking, the double determinations were in good agreement as only 4.7% of the pairs of registrations failed to correspond. The agreement was particularly good for secondary dentin, cellular infiltration, resorption, Weil's zone and calcification scores. These criteria are accessible for group comparisons when differences in pulp tissue characteristics are small. The remaining three criteria may prove not to be useful unless the tissue response is substantial.


Exact method for clinical measurement of loss of periodontal attachment. The aim of the present investigation was to develop a clinical method for measuring loss of periodontal attachment, with a measuring unit of less than 1 mm, which did not require surgical intervention. The method was based upon impressions of the pocket area. Sixteen teeth on which the cementoenamel junction was situated below the gingival margin and which were scheduled for extraction for prosthetic reasons were used. Two impressions of the facial gingival pockets of each tooth were taken using steel strips dipped in Coe-flex and inserted at the bottom of the pocket. The loss of attachment in relation to the cementoenamel junction was measured in a stereomicroscope with a  measuring unit of 0.04 mm. After extraction, the teeth were stained for connective tissue attachment and the loss of attachment was measured. Duplicate measurements and pre- and post-extraction measurements of the same situation were compared. The results show that the accuracy and reproducibility of the method is high.


Microorganisms in recurrent aphthous ulcerations. Qualitative and quantitative examinations of the cultivable bacterial flora in biopsies from recurrent aphthous ulcerations (RAU), experimental oral ulcerations (EOU), and normal oral mucosa (NOM) were carried out under aerobic and continuous anaerobic conditions. An attempt was made to culture yeasts, mycoplasma, and virus from the biopsies of RAU, which were also tested for the presence of herpes virus antigen by the fluorescent antibody method. The predominant bacteria recovered in RAU were alpha-hemolytic streptococci, coagulase-negative staphylococci, and Neisseria. In EOU the main recoveries were alpha-hemolytic streptococci, Corynebacterium, Veillonella, Neisseria, and Haemophilus. In NOM alpha-hemolytic streptococci dominated the cultures. Yeasts were only cultured from one patient with RAU. No mycoplasmas or viruses were isolated, nor was herpes virus antigen demonstrated in any of the RAU specimens. The role of the microorganisms in the pathogenesis of RAU is discussed.


Clinical findings in temporomandibular joint osteoarthrosis. The clinical findings in 20 patients with TMJ-crepitation (E1-group) and 19 patients with TMJ palpatory tenderness (E2-group) have been compared with the findings in 29 other patients with mandibular dysfunction (R-group). The patients underwent a clinical examination of the masticatory system and of the second distal interphalangeal joints (DIP II joints). No statistically significant differences could be found between groups with respect to clinical signs, occlusal interferences, or dental attrition. Loss of molar support was found to be significantly more frequent in the E1-group than in the R-group. The frequency of tenderness to palpation or pain on movement of DIP II joints was significantly higher in the E2-group than in the R-group. Periarticular bony swelling of DIP II joints was significantly correlated with TMJ-crepitation. The patients with TMJ-crepitation were considered to have TMJ-osteoarthrosis. The results of the present study indicate that patients with TMJ-OZ have a similar clinical picture to other patients with mandibular dysfunction and that molar loss plays a role in the etiology of TMJ-OA.


Variations in bone mass within the cortices of the mandible. A study of intermandibular variations in bone mass in cortices between regions of the alveolar process and mandibular body and between buccal and lingual cortices in the same region has been carried out. The material consisted of 24 autopsy specimens of half mandibles from normal subjects. Microradiograms of ground sections from incisor, premolar, and molar regions were used. Quantitation of bone mass in percent within the cortices was done by an electronic point-counting system. The analysis indicates that bone mass may lie on nearly the same level all over in the entire lingual cortex. In buccal cortex, bone mass may vary from region to region, as a fall in bone mass from incisor to premolar to molar region in the buccal alveolar cortex, and a rise in bone mass from premolar to molar region in the mandibular body may occur. Bone mass in buccal incisor cortex of mandibular bodies shows great individual variations. Generally, bone mass may lie on a lower level in the buccal than in the lingual incisor and premolar cortec of the mandibular body while bone mass elsewhere lies on nearly the same level in the same part of the two cortices. Bone biopsies should be taken in either the premolar or the molar region of mandibular bodies.


Effect of acupuncture on myogenic headache. The purpose of the investigation was to study the effect of acupuncture on myogenic headache and to examine whether electromyographic recordings of jaw muscle activity would provide objective evidence of the effect of such treatment. In 21 dental students, 14 males and seven females, with a history of 2--10 years of headache, acupuncture was performed unilaterally in the foot between the 4th and 5th metatarsal bones (G 41). The needle was inserted to a depth of 10--15 mm and moved continuously by hand for 15--20 min. Electromyographic recordings of postural activity in the right and left anterior temporal and masseter muscles were obtained in the same sitting before, during and after acupuncture treatment. In clinical controls 24 h, 1 month and 4 months after the treatment, 12 subjects reported considerable improvement, two variable results, and seven no change. The electromyographic recordings showed an average decrease in postural activity during acupuncture, particularly of the temporalis muscles, and a further decrease after completed treatment. However, marked individual variations in muscular response were noted. The results indicate that acupuncture treatment can relieve headache, and that electromyographic recordings may provide objective evidence of the effect of acupuncture.


Galvanic series of some dental alloys.

Galvanic series of some dental alloys. Galvanic series for different metals in different electrolytes have been published, but never for dental alloys in artificial saline solution. The material classes studied are amalgam, gold alloy, nickel alloy, chromium cobalt casting alloy and temporary crown form. The electrogalvanic potentials were measured and determined in reference to a hydrogen electrode (H2/H+) arbitrarily defined as zero. A galvanic series of the tested materials was arranged in order of their potentials.


Creep of dental amalgam and its phases.

Creep of dental amalgam and its phases. The intention of the study was to evaluate creep as a function of temperature and stress, and to determine creep rate of compounds with a composition equivalent to the gamma, gamma1, and gamma2 phases in dental amalgam. The results were consistent with a creep model in which the deformation takes place in the gamma1 phase, and is dominated by glide pileups of dislocations in grain boundaries.


Correlation between strength and hardness of dental casting gold alloys. The yield strength, tensile strength, and hardness of Type IV dental casting gold alloys were measured. Regression lines and prediction intervals for the estimation of yield strength and tensile strength from hardness measurements were then determined. The 95% prediction intervals for the yield strength and tensile strength were found to be +/- 45 MN/m2 and +/- 105 MN/m2, respectively.


Measurements of currents between dissimilar alloys in the oral cavity.


Fluoride release from a glass ionomer cement. The release of fluoride from a glass ionomer cement (ASPA) was compared with that from a silicate cement. Test specimens were shaken in a solution with hydroxyapatite for 7 weeks. The solution was changed every week and the fluoride taken up by the hydroxyapatite measured. The specimens released considerably more fluoride during each of the first 2 weeks than during each of the subsequent 5 weeks. The continued release did not decrease very much with time. Slightly more fluoride was released from the glass ionomer cement than from the silicate.


Soft-tissue stretching: a possible control factor in craniofacial morphogenesis.


Acute myeloid leukaemia with the Philadelphia chromosome. A case report of serial chromosome studies on a 26-year-old male with acute myeloid leukaemia (AML) is presented. The classic Philadelphia chromosome (Ph1) translocation, t (9;22) was found in 77% of the metaphases at diagnosis and in 100% in relapse; during a 3-month remission period the cytogenetic picture was normal or the Ph1 was present in a minor cell population only. The clinical and morphologic features of this case indicated that it was really a case of AML and less likely chronic myeloid leukaemia (CML) presenting in blast crisis. It is suggested that the oncogen producing the 9;22-translocation and CML may also induce AML in rare instances.


The transcobalamins in polycythaemia vera. The unsaturated B12 binding capacity (UBBC) of the serum and the binding capacity of each of the 3 vitamin B12 binders--the transcobalamins (TC) I, II and III were determined in 21 patients with polycythaemia vera (PV) during the course of the disease and following treatment, using the recently described charged cellulose filter technique. High serum UBBC due to elevated serum TCIII was found in all patients. TCI was moderately elevated in patients who had leucocytosis with a shift to the left. The changes in serum TCIII and UBBC correlated with the activity of the disease. Chemotherapy resulted in a decrease in TCIII and UBBC. The decrease in TCIII and UBBC folowing chemotherapy may be observed before a decrease in the haematocrit and the leucocyte count occurs. Activation of the disease may be assessed by the elevation of TCIII and UBBC. The onset of acute myeloblastic crisis in 1 patient was associated with a decrease in TCIII and TCI levels and a rise in serum TCII. The determination of TCIII and UBBC may be helpful in differentiating true from secondary polycythaemia.


Experience on the treatment of chronic myelocytic leukaemia (CML) in blastic crisis. A group of 50 patients with chronic myelocytic leukaemia in blastic crisis were treated with different chemotherapeutic regimens. A total of 19 remissions (6 CR + 13 PR) were achieved with an overall and complete response rate of 38% and 12% respectively. Of the 4 patients presenting with a lymphoblast-like appearance of the blasts, the 3 treated with the combination of vincristine and prednisone all achieved remission (2 CR + 1 PR). Duration of survival was significantly longer in responding patients (median 11.5 versus 4.5 months). Either more effective therapeutic regimens or prevention by aggressively approaching the chronic phase are to be sought in order to improve the prognosis of blastic crisis of CML.


A comparison of the phenomenology of hallucinogens and schizophrenia from some autobiographical accounts.


A brief overview of the Minnesota Multiphasic Personality Inventory and its application to medicine and psychology.


Some diagnostic problems in lesions of bone and joint.


Treatment of organic psychosis.

Treatment of organic psychosis.


Multiple myeloma terminating in acute myelogenous leukemia with the presence of a Philadelphia (Ph1) chromosome.


Leukaemic involvement of the pleura. A case report. In chronic myelocytic leukaemia (CML), the pleura is a most uncommon site of extramedullary involvement. A 34-year-old man with CML presented with a massive pleural effusion. His peripheral blood contained few blast cells and the leucocyte alkaline phosphatase level was low. Cytological examination of the pleural fluid revealed cells with the morphological features of myeloblasts and monoblasts. The patient was treated with systemic chemotherapy, with no effect on the leukaemic pleural effusion.


Mucus in the healthy and diseased eye.

Mucus in the healthy and diseased eye. Mucous glycoproteins play an important role in maintaining the normal surface of the eye. Changes in the physical properties and chemical composition occur in disease with increased viscosity and a shift in the type of acid glycoprotein towards a predominance of sulphomucin causing some of the distinctive clinical features seen in dry eyes, superior limbic keratitis (SLK), vernal catarrh, and neuroparalytic keratitis.


Changes in the permeability of the lens capsule in senile cataract. When the water permeability of the lens capsule of a group containing all types of cataractous lenses is compared with a group of transparent lenses matched for age, there is no significant difference in permeability between the groups. If however, only those cataracts are selected which show changes in the cortex, namely, cuneiform opacities or 'water clefts', then the correlation between the water content of the cortex of these lenses and the permeability of their capsules is significant.


Effect of lid specula and superior rectus traction on intraocular pressure. The Pneumatonometer of Langham was used to record the effect upon intraocular pressure of a range of eyelid specula, lid sutures, and eyelid clamps. It was concluded that all methods tested produced a rise in intraocular pressure in most patients, and that the degree of rise was related to the degree to which the eyelids were separated. It was therefore recommended that a method of eyelid retraction which allows adjustment is to be preferred, and that specula which do not allow this, such as the Barraquer speculum, are not to be recommended. Traction upon the superior rectus suture was shown to lead to a considerable rise in intraocular pressure and this should therefore be avoided unless strictly necessary. The traction produced by two limbal sutures pulling tangentially downwards, rotates the eye downwards for intraocular surgery without inducing a rise in intraocular pressure. Measurement of intraocular pressure in the operating theatre is recommended in order to ascertain whether the method used to retract the eyelids or to rotate the eye to the field of surgery is having an adverse effect.


Anaesthesia for cataract surgery. A preliminary communication. It is well recognized that patients presenting for cataract surgery are usually old, with a high incidence of medical disease. This combination is said greatly to increase the risk of general anaesthesia. In an unselected series of patients undergoing cataract surgery, 53.5% had a significant medical problem and 50% were receiving some form of medical treatment. All but three of the patients were given a general anaesthetic. The series is discussed against the background of anaesthetic morbidity. The authors recommend that routine electrocardiograms should be carried out on all patients over 60 years of age.


Haemostasis in cataract surgery. The Down bipolar coagulator. The Downs bipolar coagulator is a precision microsurgical instrument for use in cataract surgery and other ophthalmic operations. Its chief advantages are robustness, ease of sterilization, mechanical reliability, and small size. The coagulation is delivered by a fine pair of forceps (designed for ophthalmic use). Precision can be achieved together with the advantage of being able to coagulate fine vessels under a wet film (as in the iris). The coagulation current can be varied and tissue shrinkage is lessened.


Corneal thickness after cataract surgery. An increase in corneal thickness occurs so regularly after cataract surgery as to be considered to be the rule. It reflects the state of endothelial activity and is therefore affected both by the preoperative condition of the endothelium and the degree of surgical manipulation. The question how quickly the endothelium can be expected to recover with consequent disappearance of corneal swelling is still open to discussion. The central corneal thickness of 55 eyes with normal slit-lamp endothelial appearance undergoing cataract surgery was measured preoperatively and on the 3rd, 7th, 14th, 21st, 28th, and 42nd postoperative days. The initial corneal thickness was 0.56 mm. The greatest corneal swelling, found on the third postoperative day, was 16%. Corneal thickness returned to preoperative values in four eyes within 7 days, in 19 eyes within 14 days, in 39 eyes within 21 days, in 50 eyes within 28 days, and in all 55 eyes within 42 days. Corneal swelling, as measured on the third postoperative day, was greatest (19%) when chromic catgut was used, less (13-16%) when black silk 7/0 was used, and least (9%) when virgin silk 8/0 was used.


Assessment of major intraocular and extraocular surgery performed as day cases. A review of 473 patients operated upon as day cases indicates that such surgery is safe, effective, and practicable. The surgical procedures included strabismus and ptosis correction in 265 children; major oculoplastic surgery for subtotal full-thickness eyelid reconstruction; and intraocular surgery in adults for trabeculectomy, cataract extractions with or without simultaneous intraocular implant introduction, and cataract extractions combined with trabeculectomy. No modification in surgical technique was required for strabismus and ptosis surgery. Slight modification was necessary for cataract surgery, and certain innovations were made in oculoplastic surgery.


Review of progress in the medical use of contact lenses.


Hard contact lenses. Medical aspects.

Hard contact lenses. Medical aspects. Hard lenses, corneal and scleral, are still useful in correcting ametropia. They offer better visual acuity and increased field of vision in high myopia, irregular astigmatism, and aphakia. Since their chemical and physical properties are reliable they are likely to be used for some time to come.


Management of keratoconus with hard corneal lenses. The lens lid attachment technique. Four modalities of corneal contact lens fitting in keratoconus have been considered: 1. The large alignment lens. 2. The large flat lens. 3. The small lens fitting flat on the apex of the cone. 4. The lens lid attachment technique. The lens lid attachment technique is considered in some detail and its particular merits discussed.


Soft contact lenses in keratoconus.

Soft contact lenses in keratoconus. In forming a special contact lens for use in cases of keratoconus, the centre the curves vary from 7.2 mm (47 dioptres) to 5.6 mm (60 dioptres), and at the periphery the curve is a constant 7.65 mm (44 dioptres) in all lenses. This special lens has the following advantages: (1) It protects the cornea: (2) It exerts a strong analgesic effect; (3) Vision is improved in 26% of cases from 0.03 to 0.6 and in 43% from 0.03 to 0.8. (4) Ophthalmometry gives equal values of about 69% and keratometry equal values of about 19%. The lenses may be made from PMMA, HEMA, CAB, and Polycon. The HEMA lenses did not correct the visual acuity, but those made with CAB and later with Polycon gave highly satisfactory results.


Soft contact lenses. What choice is there?


Protective corneal membranes in the treatment of eye disease. A protective corneal membrane (PCM) is a specific hydrophilic bandage lens made from Sauflon 85% hydrophilic material, chosen for its high oxygen transmission. The back curve or radius is 8.40 mm, the overall diameter 15.50 mm, and the centre thickness 0.15 mm. The PCM is made afocal, so that it will not alter whatever vision is present in the eye. This is particularly important when it is used for long-term treatment.


Contact lens in aphakia.

Contact lens in aphakia. Aphakia may be said to be the best reason for contact lenses. All types are used--(hard) corneal lenses, soft lenses both for daily and extended wear, and even (hard) scleral lenses in exce,tional cases. At present all have their problems so that, although on theoretical grounds an extended wear lens would be ideal, the corneal lens is probably still the lens of choice.


Continuous wear soft lenses in the treatment of alphakia. Continuous wear soft lenses made of Sauflon 85% were used in the treatment of 38 cases of uniocular aphakia. The patients were of all ages, but most of them were aged between 70 and 90 years. The success rate was greater than that achieved by hard contact lenses, especially after senile cataract extraction.


Management of cataracts in infancy and childhood. In recent years there has been a considerable improvement in our understanding of the mechanism of stimulus deprivation amblyopia and a continuous development of better surgical techniques for the removal of cataracts in very young patients. In spite of these advances and the fact that modern constant wear soft contact lenses are now a reliable proposition, there has not been a parallel improvement in the visual results achieved after cataract extraction and aphakia continues to present considerable problems of management in children. This study analyses over 100 cases treated at Moorfields Eye Hospital in recent years. As a result of our findings a Paediatric Aphakia Service has been established in order to integrate the surgical, contact lens, and orthoptic care of these patients.


Laboratory studies in the management of soft contact lens use. Laboratory procedures may be of great value in dealing with lens spoilation and in monitoring the state of the cornea during lens wear. Deposition of calcium-rich material remains the only defined non-mechanical process involved in spoilation although other forms of deposit and discolouration occur. Excess calcium levels in tear fluid are not a feature of contact lens wear, but changes in the sodium-potassium concentration ratio of tears are found. The basis for this effect is obscure but ratio changes may be useful empirical indices of corneal function.


Microscopical changes in soft contact lenses.


"Minor" application of soft contact lenses. Some of the minor applications of soft contact lenses are believed to be more important than was hitherto thought. Soft contact lenses may be used to potentiate the therapeutic action of drugs, for the pleoptic treatment of ambylopic patients, for determining the visual field in aphakia and high myopia, and for the treatment of corneal wounds and descemetocoele.


Pilocarpine administration by contact lens. A previous investigation had indicated that pilocarpine delivered to the eye by means of a hydrophilic contact lens provided better control of the intraocular pressure over a longer period and with a smaller concentration of pilocarpine. To clarify the situation further, an animal experiment was undertaken with radioactive labelled pilocarpine. Three situations were compared: pilocarpine administered by a contact lens, by drops, and by subconjunctival injection. The results indicated that the contact lens gave a greater concentration of the pilocarpine in the iris and ciliary body than either the drops or the subconjunctival pilocarpine. A high concentration of pilocarpine was achieved in the conjunctiva with drop administration and was comparable to that of subconjunctival administration.


Autoregulation of the blood supply to the anterior optic nerve and lamina cribrosa. In the optic nerve an axial arterial system of peripheral origin is present; several intraneural collaterals of the central retinal artery are absent in the majority of cases while a rich pial network always exists. The question whether the central retinal artery should be considered as an important axial nutritional artery for the anterior optic nerve has to be answered in the negative. One or two large centrifugal collaterals running to the pial sheath-network probably play an autoregulatory role, protecting the laminar region from a temporary lack of blood supply during moderate rises in intraocular pressure.


Combined reflectometric and photographic study of the retinal and choroidal circulation at raised intraocular pressure. Preliminary report.


Ocular manifestations of Wilson's disease in Iran. Within the last 5 years, 25 proved cases of hepato-lenticular degeneration (Wilson's disease) have been seen at the Children's Hospital Medical Center affiliated to Tehran University. The disease manifested abnormal copper metabolism in the following respects: (1) Hypoceruloplasminaemia was present: (2) 24-hr urinary copper excretion was low; (3) Tissue concentration of copper was high; (4) Treatment with penicillamine led to increased copper excretion in the urine and usually to relief of symptoms. The ophthalmologist cannot always assist the paediatrician in diagnosis, but fourteen of the 25 patients showed a Kayser-Fleischer ring and these were all in the older age groups. The following conclusions were drawn: (1) The incidence of Wilson's disease in Iran is high; (2) Penicillamine treatment may be successful; (3) Any young person with kidney, liver, or neurological disease of uncertain aetiology should have a detailed ophthalmological examination.


Meteorological triggering of acute glaucoma attacks. The files of all patients admitted to the Geneva and Lausanne University Eye Hospitals during 1972, 1973, and 1974 with the diagnosis of acute glaucoma were examined. Only those cases in which the exact date of onset and recorded, and in which the diagnosis of acute closed-angle glaucoma left no doubt, were retained. The dates corresponding to the first symptoms in the 34 remaining cases were submitted to meteorlogical and statistical study. Twenty of these cases (60%) occurred during the same meteorological condition: an advection of cold maritime air from the north-west at the rear side of a low-pressure system together with, or following, the passage of an active atmospheric disturbance. These conditions occurred only 57 times during the period of 1,096 days under study.


Value of prophylactic peripheral iridectomy on the second eye in angle-closure glaucoma. In a group of 250 patients with gonioscopically proved angle-closure glaucoma, 72 who did not have prophylactic peripheral iridectomy were reviewed and the adverse effects suffered by these patients were analysed. Comparison was made with 63 patients from the same group who did have peripheral iridectomy. All these patients were drawn from the Glaucoma Clinic, University Department of Ophthalmology, Manchester Royal Eye Hospital.


Near vision tests--an apotheosis?

Near vision tests--an apotheosis?


Role of the vertical muscles in horizontal deviations. This study was prompted by the observation that after horizontal muscle surgery a large number of cases of non-paralytic squint ended up with no binocular vision and an appreciable residual vertical deviation with a "V" or "A" pattern. It has become clear to us that the associated vertical deviation is usually present from the onset, and may play a major part in the mechanism of the squint. In less marked cases the vertical deviation is noticed only when the eye movements are fully examined, and is missed unless the extremes of elevation and depression are evoked. We have been largely influenced by the work and experience of Dr. M.H. Gobin (1964, 1968a, b, c), who feels that cyclotropia is an important factor in the aetiology of convergent squint. Gobin regards torsion as a third dimension in ocular motility, and thinks that for images to fall on corresponding retinal points it is reasonable to try to make the visual axes parallel horizontally and vertically, and that the retinal meridians should coincide.


Conservative management of central serous retinopathy. A study of 26 patients (thirty attacks) with central serous retinopathy was made in order to assess the results of conservative management, and the factors which might affect the incidence of residual symptoms. There were two groups, one given systemic steroids and one given no treatment. Comparison is made with two groups treated by laser coagulation and another given no treatment.


Day case surgery for strabismus in children. A consecutive series of 140 children was observed after strabismus surgery. All the postoperative problems are attributable to general anaesthesia, vomiting and drowsiness being the principal ones. Respiratory difficulties were unusual. There is no reason to keep a healthy child in hospital for longer than one night, and day case strabismus surgery appears to be safe if (1) an experienced doctor gives the anaesthetic, (2) there is adequate supervision for 3 to 4 hours after surgery, (3) the appropriate district nurse is forewarned that a child is returning home after general anaesthesia, and (4) facilities are available to retain a child in hospital if a problem arises before discharge. Signs of emotional trauma may be less in children treated as day cases than in those hospitalized for one or more nights.


Retinal detachment surgery without cryotherapy. The traditional role of the cryotherapy adhesion in retinal detachment surgery is challenged by the successful treatment of 26 out of a series of 29 cases. The omission of cryotherapy has not interfered with the absorption of subretinal fluid and re-detachment has not occurred.


Aetiological survey of visually handicapped children in Northern Ireland. A survey of visually h,ndicapped children in Northern Ireland identified 486 subjects aged 0 to 20 years on January 1, 1976, with a corrected visual acuity of 6/18 or less in the better eye. The prevalence of visual handicap was 81/100,000 of the population with an estimated ascertainment rate of 80%. Genetically determined diseases accounted for 51% of the cases. Birth hypoxia secondary to prenatal and perinatal complications was the second most important aetiological factor contributing towards visual handicap.


Retinal dialysis.

Retinal dialysis. The aetiology of retinal dialysis has traditionally been closely linked to blunt trauma to the eye, and experimental work in the past has tended to confirm this view. However, a close look at eyes that have suffered known concussional injury indicates that trauma is rarely associated with retinal dialysis. The aetiology of dialysis is discussed and a technique for treatment is proposed.


Encirclement versus 360 degrees buckling and prognostic factors in retinal separation surgery. In 554 consecutive primary cases, adverse prognostic factors for successful retinal detachment surgery were aphakic retinal detachment, severe vitreous traction creating retinal breaks, especially with lattice degeneration, long-standing retinal separations, choroidal or combined detachments, giant tears, Marfan's syndrome, and preoperative massive vitreous retraction (MVR). Vitreous haemorrhage was of secondary importance, and not a primary cause of MVR. The use of therapeutic encirclement is unnecessary and does not prevent the proliferative process of MVR. The few indications for cerclage, such as total retinal separation with no detectable breaks, total retinal separation with breaks in all quadrants, and MVR, are more effectively treated by 360 degrees scleral buckling. Encirclement should not be used as a constriction to obtain a buckle or to compensate for lost intraocular volume after drainage of subretinal fluid.


Lens aspiration. A decade in retrospect.


Lensectomy.

Lensectomy. Lensectomy is a new technique of lens extraction by which lens material is cut and aspirated through a fine-bore needle. The technique is simple and atraumatic. The small limbal incision, which does not require suturing, has the advantage of reducing the risk of vitreous loss and the amount of surgically-induced astigmatism to a minimum. Instruments designed primarily for vitreous surgery were used in the removal of cataracts from seventy eyes. This preliminary report shows that this new approach offers several advantages over conventional methods in selected cases. It appears to be of particular value in the management of cataracts secondary to chronic anterior uveitis. It is also a good alternative in the treatment of traumatic, presenile, and congenital or juvenile cataracts. Lensectomy is not a suitable technique for the removal of calcified lenses or those with hard nuclei. Possible complications include endothelial damage, loss of lens matter into the vitreous, and retinal detachment.


Traumatic cataract.

Traumatic cataract. In many cases of trauma it is presence of cataract which denies the patient a good final visual result. Cataract may be caused by blunt or perforating injury. Intraocular foreign bodies may be held within the lens or pass through it. Lens opacities may also be caused by chemical burns and remote forces such as electrical current and radiational injury. Frequently the cataract is unilateral, causing considerable impairment of vision of one eye while the function of the other eye is normal and expected to remain so. The aim of surgery must be to remove all lens protein from the pupillary area and as far as possible from behind the iris.


Kelman phaco-emulsification. Results and complications. The visual results and complications in an unselected group of 100 patients are reviewed. The implantation of a posterior chamber acrylic lens is described.


Intraocular lens implants. An introduction.


Iris-supported lens implantation v. simple cataract extraction. An analysis of data. In a study of a selected age (greater than 60) and ocularly matched population requiring cataract extraction, a perfectly executed intracapsular cataract extraction followed by the introduction of a Fyodorov Type II ("Sputnik") lens did not lead to irreversible anterior or posterior segment changes different from those seen in a group followed for from 5 to 9 years. It did lead to an incidence of implant support dislocation and to membrane formation in about 10% of cases, reducible to about 2% with correctly made lenses and the appropriate use of postoperative drugs. The incidence of corneal degeneration (0), retinal detachment (2%), and intraretinal cystic maculopathy (3%) was equal in each group. Visual acuity levels were also equal. In appropriate cases, if the surgery is carried out with sufficient skill, the reward to risk ratio of implantation not only justifies but indicates the use of such lenses.


Management of patients with intraocular lenses. Guidelines for those who do not perform this operation. Patients with intraocular lenses can be managed quite well by any experienced ophthalmologist. Every exmination must include the measurement of intraocular pressure and a slit-lamp examination, specifically noting: Corneal oedema, local or diffuse, Increasing corneal guttata, Touch of lens or iris suture to the cornea, AENS DISPLACEMENT, Iris suture problems, Pupil margin erosion, Secondary cataract, Vitreous face loss or thickening, Retrolenticular membrane formation, Vitreous cells. Lens implants should be removed only after very carefully consideration and consultation with an implant surgeon.


Manifestations of immunodeficiency diseases in ophthalmology. The clinical features in various types of immunodeficiency are presented in patients selected from a total of fifteen seen at the Bristol Eye Hospital. Immunodeficiency, either primary or secondary, can produce severe infective disease of the eye which is often bizarre in nature and slow to respond to therapy. It is important for the ophthalmologist to be aware of the various immunodeficiency syndromes in order that a realistic policy towards prognosis and treatment can be adopted.


The safer operation for iris-clip lens implants. This short paper is not designed to show any new techniques and will not present any large scale statistical evidence. Rather it will, I hope, show a trend in the way intraocular implant surgery is progressing. I believe the problems are rarely due to the intraocular lens itself, but are more often due to a poor selection of cases and, all too often, an inadequately trained surgeon.


Corneal oedema and endothelial cell loss after iris-clip lens implantation. Lens implantation as a form of replacement surgery has some clear advantages over other forms of aphakic correction. The most feared complication of this type of operation is bullous keratopathy. A short-term study was carried out in two comparable groups of patients to assess corneal oedema and endothelial cell loss after simple cataract extraction and after iris-clip lens implantation following intracapsular extraction as a primary procedure. All patients were randomly chosen to have one or other procedure. The results indicate that lens implantation causes greater postoperative corneal oedema and greater endothelial cell loss. It is therefore important for implant surgeons to bear in mind the possible harm they may be inflicting and the need both for stringent criteria of selection and for the adoption of techniques which will minimize endothelial trauma.


The theoretical ideal for an artificial lens implant to correct aphakia. In considering the theoretical ideal for an artificial intraocular lens implant to be used in the correction of aphakia it has always been taken for granted that Nature's bioconvex lens is best. But there is some evidence that other configurations may be an improvement. We also have to decide how large it should be and whether it should be placed in front of the iris or behind it. Moreover we have to consider the management of eyes which are already aphakic when first seen and cataractous eyes requiring lens extraction before the pseudophakos can be inserted.


Binocular effects of intraocular lens insertion. Observation of fifty patients submitted to primary Binkhorst intraocular lens insertion for uniocular cataract has shown that 88% regained 6/12 or better visual acuity in the operated eye. All but three patients with healthy fellow eyes and a good visual result from surgery regained orthotropia and some binocular functions promptly without squint surgery, but formal tests of stereoacuity were poorly performed. The best clinical guide to binocular performance for near vision was found to be Lang's pen test.


Physician, look in your mirror!

Physician, look in your mirror!


Undetectable ABO isoagglutinin in a patient with chronic myelocytic leukemia. An instance of undetectable anti(A+B) was described in a patient, group O, in acute crisis of chronic myelocytic leukemia. The finding was not parallel to the level of gamma globulin in the patient and a possibility of functional abnormality of the related antibody was discussed.


Renal calcium and its implications.

Renal calcium and its implications.


Evaluation of the hypertensive patient.

Evaluation of the hypertensive patient.


Thyroid carcinoma.

Thyroid carcinoma.


Proper interpretation of chloride determinations in the early diagnosis of bromism--a reminder.


Munchausen's syndrome: a case report.

Munchausen's syndrome: a case report.


Report: 40 cases of closed intramedullary nailing of the femur.


Autopsies in Papua New Guinea.

Autopsies in Papua New Guinea.


Spinal adhesive Arachnoiditis.

Spinal adhesive Arachnoiditis.


Childhood pertussis and pneumonia admissions in the highlands of Papua New Guinea. During a pertussis epidemic, the majority of children admitted with respiratory disease were under one year old and had pneumonia, with or without pertussis syndrome; heart failure was common. A greater proportion of those with 'pneumonia alone' were slightly older, were malnourished, were admitted earlier and recovered slightly faster than those who had 'pertussis with pneumonia'. Differential white cell count was of little help in diagnosis and chest X-ray findings seldom altered management. Eight percent of the pertussis and 3 percent of the pneumonia groups died: all had pneumonia and additional complications, and 71 percent of those who died were under one year of age. Results suggest that two or more infections of triple antigen may protect some children from an attack of pertussis so severe that hospital care would be needed.


Recent advances in gastro-enteritis.

Recent advances in gastro-enteritis. This paper briefly reviews new knowledge about the causes, consequences and control of gastro-enteritis. Various recently discovered viral and bacterial causes of gastro-enteritis are discussed and the possible role of prolonged gut infection in causing malabsorption and thus malnutrition, considered. The revival of interest in prevention by improved water supplies is discussed and the need to critically evaluate the relative importance of the quality and quantity of a water supply stressed. Some newer regimes for treating acute and chronic infections are also discussed.


Patterns of tumoral calcinosis in Nigeria and Papua New Guinea. An analysis was made of 7 cases of tumoral calcinosis diagnosed during a period of 6 years at a central laboratory serving the Igbos of Nigeria, West Africa. As in Papua New Guinea, the hip is the region of predilection and adults are usually affected, especially females. In both populations , most cases show discrete, solitary, hard, subcutaneous lesions which measure from 1 cm to 8 cm across.


Crisis in Medical Manpower.

Crisis in Medical Manpower.


Medical education and Chinese society.

Medical education and Chinese society.


Turtles and botulism.

Turtles and botulism.


Some observations on the behaviour of small calibre projectiles in soap targets.


Local effects of assault rifle bullets in live tissues. Part II. Further studies in live tissues and relations to some simulant media.


Diagnostic accuracy and clinical applicability of cytological and histological methods for investigating endometrial carcinoma.


Effect of a Ca(OH)2 solution and a chlorhexidine based detergent on the microbial activity of human carious teeth. Occlusar carious lesions from human molars, preserved in continuous humidity after extraction, were removed using conventional clinical techniques. Bacteriological samples were taken after rinsing the cavity with water only, after experimentally infecting the cavity and after treating uninfected cavities either with a saturated Ca(OH)2 solution or with a chlorhexidine based detergent. The samples were cultivated on blood agar plates aerobically and anaerobically. Cavities rinsed with water only showed very sparce bacterial growth. After experimental infection the growth was significant, but decreased radically after treatment with the test materials. In order to describe the effect of the two test materials on the microbial enzyme activity in infected dentin, cryostat sections of 10 micrometer were prepared from undermineralized carious dentin fragments excavated from freshly extracted human teeth. Conventional histochemical techniques were applied to demonstrate the aminopeptidase activity in the sections using N-L-leucyl-2-naphthylamide as a substrate. The aminopeptidase activity of carious dentin was inhibited totally with the Ca(OH)2 solution, whereas the chlorhexidine based detergent had no effect on the enzyme activity.


Vulvar malignancies treated at Sabbatsberg Hospital over 20 years.


Thickness of the soft tissue layers and articular disk in temporomandibular joints with deviations in form.


Bite force and state of dentition.

Bite force and state of dentition. The maximal bite force and the strength of the finger-thumb grip of 125 Skolt Lapps, aged 15 to 65, was measured with a specially devised apparatus. The bite force was measured with the biting fork placed between the first molars and between the incisors, respectively. The finger-thumb grip was measured by letting the subject press the prongs of the fork between the thumb and forefinger of each hand as hard as possible. The range of inter-individual variation of the maximal bite force and finger-thumb grip was great. The mean values were higher for the males than for the females. In the males the maximal bite force thus measured in the molar region was 39 kg (382 N) and 18 kg (176 N) in the incisor region. The corresponding values for the females were 22 kg (216 N) and 11 kg (108 N). The finger-thumb grip strength for males was, on the average, 10 kg (98 N); that of the females, 7 KG (69 N). The average difference in bite force between the men and the women was larger in the group with natural teeth than in the one with complete dentures. The values found for the bite force decreased with increasing age, especially for the females. Most of this reduction with increasing age was probably due to the age-dependent deterioration of the dentition. In both sexes the bite force was notably smaller among the denture wearers than among the dentate persons. The number of natural teeth varied closely with the bite force, i.e. the greater number of natural teeth the greater the bite force.


Discoloration of dental pellicle by tannic acid. The ability of tannic acid to discolor pellicle was studied in vitro and in vivo. Freshly extracted teeth were submerget in solutions of tannic acid, and in the clinical study individuals rinsed three times daily with 0.1% or 0.2% tannic acid. It was fount that 0.2% tannic acid caused brownish discolorations within 10-12 days both in vitro and in vivo. Discolored pellicle material collected from the in vivo test group was shown to contain furaldehyde after hydrolysis. The origin of the furaldehyde is not ascertained, but could be due to the presence of dietary deposits, transformation of pellicle pentoses, or from reactions between reducing sugars and amino compounds.


14C vitamin A in developing rat teeth and bone. A whole body-autoradiographic study. The distribution of vitamin A in developing young rats has been studied. Low doses of 14C-retinol were administered intraperiotoneally and the uptake analyzed autoradiographically. The vitamin was found to accumulate mainly in the intestines, liver, kidney, adrenal and brown fat. No uptake could be detected in hard tissue forming cells nor in any hard tissue, except in the secretory ameloblasts of the incisors.


Legg Calvé Perthes disease. The late occurence of coxarthrosis.


Statistical studies in the aetiology of malignant neoplasms. V. Trends and risks. Denmark 1943--72.


Seventy-year-old people in Gothenburg a population study in an industrialized Swedish city. II. General presentation of social and medical conditions.


Intake of energy and nutrients and meal habits in 70-year-old males and females in Gothenburg, Sweden. A population study.


Body composition in 70-year-old males and females in Gothenburg, Sweden. A population study.


Uterine prolapse in dairy cows. A clinical study with special reference to incidence, recovery and subsequent fertility.


Clinical and epizootiological studies on keratitis in reindeer.


Development of chronic myelocytic leukemia during the course of acute lymphocytic leukemia in an adult. A 59-year-old patient is described who presented with acute lymphocytic leukemia. Complete remission was induced rapidly with vincristine and prednisone. Nine months later he acquired the clinical and hematological picture of a myeloproliferative disease, and bone marrow cytogenetic studies demonstrated the presence of the Philadelphia chromosome. Within 4 months he again developed overt acute lymphocytic leukemia and died. Several lines of evidence have recently indicated a relationship between myeloproliferative and lymphoproliferative disorders, particularly chronic myelocytic and acute lymphocytic leukemia. This patient's course is another example of that association.


Second molar extraction in orthodontic treatment.


The adult orthodontic patient.

The adult orthodontic patient. Adults now make up an increasing portion of the orthodontist's patient load. Though most seek esthetic correction, requests for multidiscipline treatment are expanding. The etiology of adult malocclusion, unlike that of malocclusion in the young, presents us with psychological and physiologic factors that specifically affect treatment and dictate special diagnostic, planning, and mechanical procedures. The adult patient offers the orthodontist a new challenge and the stimulus to develop successful treatment approaches peculiar to the nongrowing patient. Careful diagnosis and treatment planning on a multidiscipline basis will result in satisfactory resolution of most adult malocclusions, and there is no requirement for esoteric appliances or mechanics. An evaluation of treated cases indicates that all corrective dental movements are possible and that the health, function, and esthetics of the dental apparatus can be markedly improved. The cases presented demonstrate that adults are amenable to treatment over the full orthodontic spectrum. Treating the adult patient can be very satisfying. The patient is invariably pleased with his effort (and your help), once the "braces" are off. Since the original need was great in the patient's mind, success in its satisfaction is especially rewarding and it overflows on everyone involved.


Maxillary control in class II, Division 1 Begg treatment.


Early class II mixed-dentition treatment with the universal appliance. I have attempted to describe Dr. Nagamoto's rationale and a method of treating early-mixed-dentition cases. This particular adaption of a two-phase approach to this type of case was formulated by him in the early 1950's and has since been used in his office and mine. The steps, mechanics, and arch wires necessary for treatment have been outlined. It is thought that, by approaching these cases at an early age, the potential is increased for development so as to avoid the extraction of premolars and to prevent possible irreparable damage to the procumbent maxillary anterior teeth in the event of an accident. It has been shown that these young patients can be treated successfully with an efficient, gentle appliance that, in my own clinical experience, has proved to be most valuable.


A modified technique for ligating impacted canines. This article describes a combined surgical-orthodontic method to manage impacted teeth, primarily maxillary canines. The method uses a modified type of ligation chain that enables the oral surgeon to lasso the tooth with ease and affords the orthodontist large, successively placed eyelets to which he can easily tie elastic thread in order to keep continuous heavy force pulling the tooth toward the oral cavity.


Tensile properties of orthodontic wire.

Tensile properties of orthodontic wire. 1. Wires with a range of tensile properties are available for construction of a Stage 1 arch wire in the Begg orthodontic appliance. 2. Over a period of 3 days, a detectable amount of stress relaxation occurs in some orthodontic wires loaded initially to 20 kg.


The journal: a major benefit for AAO members.


The growth in situ of isolated mandibular segments.


Computerized interactive orthodontic treatment planning.


Facial and dental arch morphology in children with and without early loss of deciduous molars.


Oral myofunctional therapy.

Oral myofunctional therapy.


The use of regression constants in estimating tooth size in a Negro population. A study of a sample of 105 Negro children and adolescents, residents of Connecticut, was undertaken to determine the degree of correlation between mandibular tooth size and the size of the canines and premolars. The correlation between the total mesiodistal width of the mandibular permanent incisors and that of the maxillary or mandibular canine and first and second premolars was found to be 0.63 and 0.71, respectively. Further, regression constants were determined in an attempt to estimate the buccal segments from the mandibular incisors.


Interception of malocclusion in the deciduous dentition: long-term results.


ABO presents typical case report examples for future candidates.


A new device for synchronized intermittent mandatory ventilation.


Effect of a pneumatic breathing aid on the minute ventilation of patients with chronic obstructive lung disease and bronchial asthma. A pneumatic breathing aid is described in which air pressure is used to compress the thorax and abdomen of patients with bronchial asthma and chronic obstructive lung disease. Pressures of 40 to 44 mm Hg were applied during the latter half of expiration. A mean decrease in minute ventilation of 14% was recorded 10 minutes after thoracic-abdominal compression in 18 tests. The mean decrease in expiratory volume was 218 in 10 cases. The use of this new pneumatic breathing aid is a preliminary report with the suggestion that similar studies be utilized to increase the ventilatory function of patients who present suggestive evidence of air trapping and alveolar over-distention.


Prospects for plant genome modification by nonconventional methods.


Anterior cervical arachnoid cyst simulating syringomyelia: a case with preceding posterior arachnoid cysts. An arachnoid cyst lying anterior to the cervical cord at level C6-7 was found in a 28-year-old woman believed to have syringomyelia. This diagnosis was based both on previous findings at laminectomy and on computerized tomography. The diagnosis of arachnoid cyst was suspected because of clinical features atypical for classical syringomyelia and a history of arachnoid cysts found during childhood. Air myelography demonstrated an extramedullary intradural mass anteriorly that proved to be an arachnoid cyst. Drainage and subtotal resection resulted in marked clinical improvement. This case illustrates the need for reevaluation when a patient with "known" syringomyelia presents an atypical clinical picture. Anterior cervical arachnoid cyst, which may accompany or succeed posterior arachnoid cysts, should be considered.


The relationship between dietary sugar experience and the quantity and biochemical composition of dental plaque in man.


The uptake and release of 18F by rat liver.


Differences in fluoride levels in the blood between sheep, rabbit and rat.


Fluoride content of buccal surface enamel and its relation to dental caries in children.


The fine structure of nerve endings in human baccal mucosa.


Experiments on local and systemic action of fluoride in caries inhibition in the rat.


The salivary concentration of Streptococci mutans and Streptococci sanguis and their colonization of artificial tooth fissures in man.


Autoradiography of 65zinc in developing rat teeth and bones.


Getting ready for tomorrow.

Getting ready for tomorrow.


Urology in Australasia.

Urology in Australasia.


Recent advances in colorectal surgery.

Recent advances in colorectal surgery.


Renal angiography and the management of severe closed renal trauma. The purpose of this study was to determine the place of selective renal angiography in the assessment of major renal trauma. Thirty-one cases of renal injury assessed by urography and angiography were reviewed, and the radiological features correlated with the subsequent clinical course. Based on the angiographic findings, a classification of these more severe injuries is proposed, and the prognostic significance of renal ischaemia demonstrated. Because conservative treatment in those cases with significant ischaemia is likely to fail, early elective surgery is recommended. In this selected group, viable renal tissue can be preserved, and the necessity for subsequent nephrectomy due to secondary haemorrhage, or continuing urine leakage, is avoided.


Surgical and external ureteric trauma.

Surgical and external ureteric trauma. This paper details the aetiology, presentation, diagnosis, prophylaxis, treatment, and results, of 84 surgical and external ureteric injuries. Although the incidence of surgical ureteric trauma was found to be low it was related to both the particular operation performed and certain faults in surgical technique. The series emphasizes the importance of prophylaxis, early diagnosis, and specific therapy. There were 94 operations carried out on the 84 ureters, resulting in 22 nephrectomies and 63 open repair procedures, of which 55 were regarded as successful and 8 as failures.


Experiences with cryosurgery in the management of benign prostatic obstruction. Cryosurgery of the prostate gland has been used on mainly unfit patients for ten years as an alternative to open and endoscopic surgery in over 250 patients. With the use of a simple "rule of thumb" technique, blind cryosurgery can be recommended as causing few complications. Furthermore, the patient's early discharge from hospital can be achieved. Long-term functional results are satisfactory. More complicated techniques have been described and are mentioned, but as a result of experience simplicity of technique is recommended.


The surgical treatment of retrocaval ureter. Ureteric obstruction resulting from retrocaval ureter may be due to either compression of the ureter by the vena cava or stenosis of the postcaval segment. If obstruction is due to stenosis, the commonly described operation of division and anastomosis through the proximal dilated ureter or pelvis, after repositioning of the ureter, is likely to fail, as is division of the vena cava itself. Excision of the postcaval segment with anastomosis of the spatulated ureter over a Silastic splint is therefore recommended. Three case histories of patients with retrocaval ureter treated surgically are presented and support this view.


Testicular tumours: treatment by surgery and radiotherapy.


Carotid body tumours.

Carotid body tumours. Carotid body tumours are rare, but important. Their reputation for slow growth and virtual non-malignancy has had, in the light of experience, to be revised. Sudden spurts of growth are well known, and the tumour may become irremovable in a relatively short time. Aggressive local invasion and widespread metastasis are now well recognized. Histological features are no guide to malignancy. These tumors can nearly all be removed with an acceptable mortality and morbidity, without damage to the internal carotid artery. Ideally the diagnosis should be made by clinical acumen and confirmatory X-ray examination. Biopsy makes subsequent removal of the tumour much more difficult, and should be avoided if at all possible. Eleven personal cases of carotid body tumours are reported, and the technique of surgical excision is discussed in detail.


Radionuclide pancreatic scanning: a retrospective analysis. Records of 346 patients were studied to determine the reliability and diagnostic value of pancreatic scanning. In 157 the pancreatic diagnosis was established subsequent to scanning. The scan was abnormal in 28 of 34 patients (82%) with pancreatic neoplasm, and in 21 of 26 patients (81%) with chronic pancreatitis. Of 71 with normal scans, 56 (79%) had a normal pancreas, and 15 had pancreatic disease (a false negative rate of 21%). Of the 86 with abnormal scans, the pancreas was diseased in 56 (65%), and of the others, 14 had extrapancreatic conditions known to be associated with a high incidence of scan abnormalities. In obstructive jaundice all 21 patients with pancreatic carcinoma had abnormal scans (and the scan accurately diagnosed all four cases of bile duct carcinoma). A normal scan reliably indicated that the cause of jaundice was outside the pancreas. In chronic abdominal pain an abnormal scan was unreliable, but a normal scan excluded pancreatic disease with reasonable accuracy.


Arterial problems seen in a teaching hospital in Hong Kong. Over a 12-month period, 58 patients presented with arterial disease or other arterial problems to the University Surgical Unit, Queen Mary Hospital, Hong Kong. These patients accounted for only 0.6% of this Unit's annual admissions. In spite of the reported rarity of atherosclerotic arterial disease in this part of the world, this was the cause of the disease in nearly half of our patients. Abdominal aortic aneurysm was the single most common condition encountered. In at least one-third of patients with atheromatous disease of the aortoiliac segment, chronic peptic ulcers were demonstrated. It is concluded that peripheral arterial disease is rare, but atherosclerosis is the most common cause.


Migration of a ureteric calculus to the bladder via a ureterocolic and a vesicocolic fistula. Following a difficult nephrectomy for pyonephrosis, two large calculi in the left pelvic ureter were not removed. The upper of these two calculi finally found its way into the bladder after ulcerating into the sigmoid colon and thence into the bladder. The calculi and the residual ureter were removed and the fistulae closed, with a successful outcome.


A case of transitional cell carcinoma of the renal pelvis, clear cell renal carcinoma, and analgesic nephropathy.


Ileal replacement for gunshot injury of the ureter. A case of gunshot injury of the upper third of the ureter is reported. The injury was managed by ileal replacement with complete conservation of the kidney, after an attempt at primary repair had failed. A survey of the literature has not disclosed any previous report of a gunshot injury of ureter being treated by this method. However, we recommend it only in cases where the conventional procedure of end-to-end repair fails.


Isolated perforations of the ileum and jejunum in blunt abdominal trauma. A report of ten cases of perforations of the ileum and jejunum from blunt abdominal trauma is presented. The perforation was the only injury in eight patients, while in two there were other visceral injuries. The perforations were single in seven patients and double in three. Simple closure was used in seven cases and resection in three. Of the three patients who were operated upon late, one died.


Abdominal pain and gonorrhoea.

Abdominal pain and gonorrhoea. Two patients are described who presented with features of the Fitz-Hugh-Curtis syndrome. Recognition of this entity may prevent unnecessary investigation before diagnosis and treatment. As the incidence of gonorrhoea is increasing, complications such as this may be seen more frequently among patients presenting to surgical or gynaecological wards.


The simplification of a clinical data base: application to gallstone patients. In patients with gallstones, recommendations for cholecystectomy depend on evidence of abnormality in the cholecystogram. Symptoms and signs, usually related as a syndrome, are employed to identify patients who should have a cholecystogram. Triplet combinations of clinical data from gallstone patients and controls were examined to find which combination was the best discriminator between diseased and non-diseased, and between those who should be investigated radiologically and those who need not. The cholecystogram was confirmed as the best overall discriminator, but right costal margin pain by itself was as efficient as any triplet. The performance of a cholecystogram on all patients with right costal margin pain is as efficient a system for identifying patients with gallstones as the consideration of any quantity of clinical data.


The pathophysiology of renal hypertension. The increased understanding of the mechanisms leading to production of renal hypertension, and in particular the recognition of the renin-angiotensin-aldosterone axis as an integrated capacity-volume system for the control of arterial blood pressure, now allows a rational approach to the diagnosis and management of patients suffering from this disease. In this brief review some of the experimental evidence behind this rational approach is presented.


The management of blunt injuries of the urinary tract.


A gas chromatographic procedure for determining N, N-dimethyltryptamine and N-monomethyltryptamine in urine using a nitrogen detector.


Treatment of acute myeloid leukaemia with a triple cytotoxic regime: DAT. Twenty patients with acute myeloid leukaemia (AML) were treated with a combination of chemotherapy which included daunorubicin, cytosine arabino-side and 6-thioguanine (DAT). The complete remission rate was 85% and was achieved, in responsive cases, after an average of 2 courses of therapy. Patients remained in hospital for an average of 37.5 days during remission-induction therapy and 3.7 days per month thereafter. The median remission period was 48 weeks and median survival was 70 weeks. A disappointing feature was the high relapse rate. This feature of the results re-affirms the need for a more effective form of remission therapy.


Meningeal leukaemia in lymphoid blast crisis of chronic myeloid leukaemia.


Spectral analysis of mouse EEG after the administration of N,N-dimethyltryptamine. Mice were implanted with permanent cortical electrodes. The EEG was recorded during the sleep-wake cycle and after the administration of N,N-dimethyltryptamine (DMT). Based upon spectral analysis the EEG was classified into three categories: awake, slow-wave sleep (SWS), and rapid eye movement sleep (REM). The dominant frequencies were located below 2 Hz in the case of SWS and between 6 and 9 Hz for REM. When DMT was administered intraperitoneally at 20 or 40 mg/kg, a dose-dependent hypersynchrony at 2.5-4.5 Hz was always observed lasting for up to 60 min. Hypersynchronous activity in the same range was occasionally observed during awake. In this range DMT induced a different but unique frequency for each animal. This individual frequency was closely reproduced by repeated administrations of DMT to the same animal.


Philadelphia-chromosome-positive childhood chronic myeloid leukaemia.


Combination chemotherapy for acute lymphoblastic leukaemia in adults. Fifty-one adults with acute lymphoblastic leukaemia were entered into a trial of intense initial chemotherapy and early "prophylaxis" of the central nervous system (CNS). Initial treatment with OPAL (Oncovin (vincristine), prednisolone, adriamycin (doxorubicin), and L-asparaginase (colaspase)) followed by craniospinal or cranial irradiation and intrathecal methotrexate produced remission in 36 patients (71%). Seventeen of these patients relapsed three to 18 months after the start of remission; the remainder had been in remission for 12 to 52 months by the end of the study. The predicted median duration of complete remission was 18.5 months. None of the four patients who initially had clinical evidence of CNS disease, three of whom also had leukaemic cells identical to those found in Burkitt's lymphoma, achieved remission. Those patients who initially had hepatomegaly or splenomegaly had a shorter remission than those without. The predicted median survival was 27 months in those who achieved complete remission, one month in those who did not, and 21 months overall. The addition of colaspase and doxorubicin to vincristine and prednisolone and the use of early CNS treatment clearly improved the remission rate among adults with acute lymphoblastic leukaemia, though the presence and length of remission was affected by the extent of disease at presentation. Burkitt-like leukaemia, which had a poor prognosis, is probably a separate disease and may benefit from a different therapeutic approach.


Seven cases of Gilles de la tourette's syndrome: partial relief with clonazepam: a pilot study. The histories of seven consecutive cases of Gilles de la Tourette's syndrome are presented to exemplify the range of clinical manifestations in this disease and to collate preliminary results with the new benzodiazepine, clonazepam, as possible adjuvant therapy of this disorder. Controlled trials with clonazepam alone and in association with haloperidol are now justified. Five of our 7 patients had a positive family history of tics, and 2 a confirmed family history of gout. Because clonazepam improves myoclonia and tics and because its mechanism of action possibly involves serotonin, we thought it worthwhile to study simultaneously the relative roles of serotonin and dopamine metabolism in the production of tics, and their relationship to possible defects in purine metabolism in Gilles de la Tourette's syndrome.


Suppression of human myelosarcoma growth in athymic mice by a primate antiserum. A primate (Macaca speciosa) antiserum prepared against the human chronic myelogenous leukemia cell line K-562 suppressed the growth of the human myelosarcomas in nude mice. The ip administration of 0.5 ml of immune serum plus 0.5 ml of guinea pig complement, starting 7 days after sc tumor transplantation, resulted in a fourfold to fivefold decrease in tumor weight at 15 days when compared to nude mice given pre-immune serum plus complement or complement alone. Whereas the other two groups experienced an exponential increase in tumor volume at 7-9 days after tumor transplantation, the immune serum-treated mice remained in a "lag" phase of tumor growth during which the tumor volume neither increased nor decreased substantially. Histopathologic studies revealed various degrees of tumor alterations ranging form focal hydropic cellular degeneration to massive coagulation necrosis. The incorporation of tritiated thymidine into the tumors was also markedly diminished in the mice given immune serum.


Four chemically distinct stages in developing enamel from bovine incisor teeth.


Calcium fluoride and fluoridated hydroxyapatite formation in relation to the acid dissolution rate of enamel mineral.


Interaction of microbial challenge and age at inoculation in the production of dental caries in rats.


Lipid composition of Streptococcus mutans.


The production of secondary caries-like lesions in vitro.


The effect of differing concentrations of SnF2 on demineralized enamel.


The effect of demineralization on SnF2-treated white spot enamel lesions.


Acid production from a nonsugar licorice and different sugar substitutes in Streptococcus mutans monoculture and pooled plaque-saliva mixtures.


An osteosarcoma cell and matrix retained morphogen for normal bone formation. Histophysiology, ultrastructure, chemical analyses of transplants and implants of Dunn and Ridgway mouse osteosarcomas demonstrate that tumorigenesis is a manifestation of deranged morphogenesis in developing mesenchymal cell populations. The end product of development is defective, incompletely calcified, disorganized bone without any inclusions of bone marrow tissue. When Dunn osteosarcoma is freeze-dried and then implanted, the tumor is resorbed and replaced by deposits of normal cartilage, bone, and bone marrow. Freeze-dried Ridgway osteosarcoma is replaced only by a fibrous connective tissue scar. Disaggregated Dunn tumor osteoblasts synthesize a trypsin-labile collagenase-resistant cell surface localized bone morphogen. Tumor matrix stroma, prepared by sequential chemical extraction of soluble non-collagenous proteins also contains significant quantities of the same bone morphogen. Tumor tissue pulverized to particle size as small as 44 micrometer3 transmitted bone morphogen more rapidly than intact tumor tissue. The total tumor cell and stroma mediated bone morphogen produces three times more normal bone than normal cortical bone matrix. Our working hypothesis is that a normal bone morphogenetic polypeptide (BMP) is synthesized by Dunn osteosarcoma cells and retained by the tumor matrix stroma. Neither the mechanism of transmission nor the mesenchymal cell receptor sites of BMP are known.


Cross-correlation digital registration techniques for multispectral cell images.


Total femur and total knee replacement. A preliminary report. Osteogenic sarcoma, a highly malignant tumor of bone, is generally treated by amputation. This is a report of 19 cases of excision of the entire femur because of skip areas which are occasionally seen. The femur usually has the lowest cure rate according to site of involvement. In total femur replacement, the whole bone is removed while the limb is saved. The operation consists of isolating the neurovascular bundle and removing the knee joint and femur including some surrounding normal tissue for margin of safety. The femur and knee replacements are made entirely of metal. The resultant extremity is weak, but functional. The patients can walk without support, but their gait is better using a cane and/or an ischial weight bearing brace.


Focal epithelial hyperplasia (Heck's disease).


Bacteriologic study of the systemic disturbances accompanying primary teething.


Systemic disturbances accompanying primary teething. A haematologic study.


Rural awakening.

Rural awakening.


Genuine trigeminal neuralgia:- An analysis of forty-nine cases.


An indigenously designed electric pulp tester.


They cried to make us laugh (a history of the birth of anesthesia).


Long-term storage of frozen mouse embryos under increased background irradiation.


Configuration and variations in the macroscopic endodontic anatomy of mandibular first molar.


The role of bacterial endotoxins in the etiology of gingival and periodontal diseases.


An indigenously designed endodontic electro-sterilizer.


Effect of denture immediate settling on the occlusal vertical dimension.


Re-inforcement of amalgam. 1: Effect of pin orientation, type, and number on the tensile strength of amalgam.


Dentist's concern with blood chemistry in bone diseases.


Dental hygiene and nursing: perspectives on program planning.


A competency-based educational model for dental hygiene instructors.


Changing patterns of health care delivery: impact on dental auxiliaries.


The use of student evaluations to improve a course in dental assisting.


Fire and ashes.

Fire and ashes.


Values of dental hygiene faculty and students.


Nuclear labelling of leukaemic blast cells with tritiated thymidine triphosphate after daunomycin.


Reagents specific for cell surface components. Mercury, diazonium ions and dyes which bind nucleic acids were covalently linked to dextrans using methods that resulted in non-hydrolyzable reagent-dextran bonds without impairing the binding abilities of the reagents, i.e. these dextran derivatives reacted with thiols, phenols/imidazoles and nucleic acids respectively. Since these dextran derivatives cannot penetrate into cells and since dextran itself does not bind to cells, these compounds represent reagents specific for the cell surface. They may be used both to evaluate cell surface constituents of intact cells and to affect viable cells via an interaction with those constituents. Mercury-dextran was found to bind to cells; the amount of mercury thus attached to the cells was about ten times smaller than when an equivalent concentration of free mercury ions was used. Mercury-dextran, bound to cells after a 30-min exposure at room temperature, was localized on the surface of these cells, as sodium borohydride reduced this complex giving rise to the intact cells, elementary mercury and free dextran which was released into medium. When cells were constantly exposed to the mercury-dextran, its toxic effects were comparable to that of free mercury ions. Diazonium-dextran, which also binds tightly to the cell surface, was also considerably toxic. Dextrans substituted with dyes which bind to nucleic acids were less toxic than the parent dyes themselves; it was shown that the attachment of such a dye to dextran decreased the binding of dye to cells under detection limits.


Cross-reaction between antigens of human myelogenous leukemia and Mason-Pfizer monkey virus.


The verruciform xanthoma.

The verruciform xanthoma.


A comparison of clinical and photographic assessment of plaque and gingivitis.


Effects of the spinal cord section and of subsequent denervation on the mechanical properties of fast and slow muscles. The Soleus muscle of the rat, 3--6 months old, becomes significantly faster than in the controls, if the spinal cord is cut at birth. Mechanical properties of Extensor Digitorum Longus (EDL) muscle are not altered by spinal cord section. In cordotomized animals Soleus muscle always remains slower than EDL muscle. Denervation, performed 3--6 months after birth, has the same slowing effects in the Soleus and EDL muscles, both in cordotomized and in the control animals.


Psychological components of pain perception.


Pharmacotherapy I: non-narcotic analgesics.


Sensory receptor morphology in the teeth and their supporting tissues.


Inflammation and the role of endogenous pain-producing substances.


Neuromuscular mechanisms in mandibular function.


Differential diagnosis of orofacial pain. No attempt has been made to deal with all of the various diseases that the dentist has to consider when diagnosing orofacial pain. One of the most important causes of facial pain--so-called temporomandibular joint or myofascial pain dysfunction (MPD) syndrome--has not been mentioned, yet it accounts for many of the patients attending facial pain clinics. There are several textbooks devoted to the MPD and the reader is referred to these for a full description of the condition. Whenever a patient presents for evaluation of orofacial pain the dentist must remember: (1) to take a detailed history of the characteristics of the pain; (2) to complete a full examination of not only the teeth and the oral cavity but also the face, head, and neck; (3) not to assume that the patient in his chair necessarily has a dental condition producing his pain; (4) that if he is unaware of the existence of certain diseases he will never diagnose them!; and (5) to have no hesitation in referring a patient for evaluation rather than perform irreversible dental procedures.


Selected pain states and the use of anesthesia in dentistry. Certain pain disorders may be difficult to diagnose because their presenting symptoms are confusing and difficult to classify, or because they occur so infrequently that they are not commonly considered. This article has presented a classification and discussion of selected pain states which the practitioner may find difficult to diagnose. When faced with a perplexing pain problem, the dentist is encouraged to perform a careful evaluation to determine whether the patient's pain is or is not of dental origin. Certain pain states require that the patient be referred for evaluation to other dental or medical specialists. The value of local anesthesia as a diagnostic aid in evaluating face and head pain has been presented.


A factor inducing differentiation of mouse myeloid leukemia cells in human amniotic fluid. The M1 line cells of mouse myeloid leukemia can be induced to differentiate in vitro into macrophages by a factor in human amniotic fluid. The macrophages showed phagocytosis and locomotic activity, and also gained Fc receptors on the cell surface. This factor in amniotic fluid capable of inducing differentiation of M1 cells was heat-labile, trypsin-sensitive, and non-dialysable. A growth-stimulating factor for the M1 cells was also found in the human amniotic fluid, and it was heat-stable and trypsin-resistant. The conditioned medium obtained from the amnion had the activity of differentiating the M1 cells.


Induction of lysosomal enzyme activities with glucocorticoids during differentiation of cultured mouse myeloid leukemia cells.


A case of chronic myeloid leukemia with a translocation (12;22)(p13;q11). Chromosomal studies of the bone marrow and cultured peripheral blood cells in a 42-year-old female with the clinical and laboratory features typical for CML revealed a previously undescribed variant translocation involving chromosomes 12 and 22.


Scientific method and the Philadelphia chromosome.


Nonrandom chromosome rearrangements in 27 cases of human myeloid leukemia. The R-banding pattern of the chromosomes of 31 patients hospitalized in the Hematologic Clinic for myeloid leukemia were studied before chemotherapy. This analysis permitted identification of one unusual 3-chromosome rearrangement t(3;9;22) in addition to 25 classic forms of (22q-;9q+) translocation accompanied by the specific Ph' chromosome in chronic granulocytic leukemia patients, independent of the blastic course of the disease. During blastic crisis observed in 6 patients, extra 8 and 10 chromosomes, monosomy for chromosome 17, isochromosomes 17q, translocation (12q;13q), and additional Ph' were noted. The nonrandomness of these findings is determined from results published by other authors. Their significance for the cellular phenotype is presently unknown.


Adolescence in Israel.

Adolescence in Israel.


On becoming a parent.

On becoming a parent.


Suicide and object-representations.

Suicide and object-representations.


"... If thy right eye offend thee...". A case of bilateral self-enucleation.


The body mind problem from the viewpoint of psychoanalysis and of biosemiotic.


A case report.

A case report.


Integrating psychiatry into community health care epidemiologic foundations.


Target groups in community psychiatry: an epidemiological approach.


Child psychiatry in a community health centre.


The measurement of neurosis as a basis for preventive psychiatry.


General characteristics of referrals to traditional healers in Israel.


Training professionals for community mental health services in a reluctant society: issues in training social workers for community mental health services in Israel.


Training mental health care manpower: the medical student.


Community mental health services in times of an emergency.


Towards a systemization of a social competency approach to rehabilitation: theory and definitions.


Myofunctional therapy in specialty as well as general practice.


Periodontal considerations for functional utilization of a retained root after furcation management.