Identification of cellulose fibers in oral biopsies

Abstract – Oral biopsies comprising five periapical cysts, three cases of exuberant granulation tissue in extraction sockets and one case of a mandibular radiopaque structure, all displaying material consistent with cellulose fibers on routine histologic examination, were subjected to histochemical, polarization, fluorescence and scanning electron microscopical, energy dispersive X-ray and chemical investigations. Routine screening of periapical lesions with polarization microscopy and identification of possible cellulose fibers with Calcofluor White is advocated. Further, attention is drawn to endodontic paper point material as an etiologic factor in postendo-dontic periapical inflammatory processes.     

Destruction of the soft palate and nose by tertiary ''benign'' syphilis.

A case of untreated tertiary syphilis involving the soft palate and nose is described and the treatment is outlined. In view of the rising incidence of acquired syphilis the clinician should bear this disease in mind whenever atypical lesions are encountered.     

Chlorhexidine solutions in histological and histochemical techniques1

Abstract. Chlorhexidine solutions have been tested to determine their usefulness as media for the transport of biopsy specimens for diagnosis in order to facilitate the use of cold microtome sectioning and enzyme histochemical techniques in routine histopathological diagnostic practice. The drug was chosen for its antibacterial and protein “preserving” capacities. Tissue morphology, chemical components and enzyme activities were found to be retained well in specimens from human gingiva when stored in a cold solution, pH 7.2, containing 2.2 mM chlorhexidine gluconate, 0.19 M cacodylate buffer and 7.5 % polyvinylpyrrolidone. The procedure allowed reliable enzyme activity evaluations to be performed under the light microscope within 48 hours after excision of the tissues. Fresh frozen tissues served as controls. In an additional electron microscopic study, morphology of the cells was found to be reasonably well preserved after transport in the solution.     

Insulin and glucose uptake and insulin sensitivity in patients with peripheral arterial insufficiency

Abstract. There have been previous reports of evidence for increased insulin sensitivity in patients with intermittent claudication as the only symptom of arterial insufficiency. This study was designed to evaluate the role of peripheral tissue with respect to insulin sensitivity in such patients. Intravenous glucose tolerance tests (IVGTT) and intravenous insulin tolerance tests (IVITT) were performed in patients with peripheral arterial insufficiency and in controls. During IVGTT the plasma insulin values were significantly lower in patients with arterial insufficiency. During IVITT the venous concentration of glucose decreased more and the area over the glucose curve was significantly larger, suggesting a higher insulin sensitivity in this group. The low insulin values could not be referred to a larger distribution volume or an increased degradation rate, suggesting decreased pancreatic insulin release in this group. At the time of surgery for arterial insufficiency and for varicose veins in controls, the uptake of insulin and glucose and the release of lactate were measured over the leg before and after a glucose load. The uptake of insulin over the leg correlated positively with the arterial insulin concentration and the uptake of glucose in both groups. The insulin uptake had a tendency to be increased in legs with arterial insufficiency during the glucose challenge. The glucose uptake in the leg did not differ in the basal state, but was 3 times higher in the legs of patients with arterial insufficiency during glucose challenge. The increased glucose uptake in this group could be ascribed to a high insulin sensitivity in the leg, as defined by glucose uptake per unit of insulin taken up.     

Capillary supply and muscle fibre types in patients with intermittent claudication: relationships between morphology and metabolism

Abstract There have been previous reports on an increased oxidative capacity in muscle tissue from the diseased legs of patients with intermittent claudication. The present study was designed to correlate metabolic and morphological data and to investigate whether the metabolic adaptive changes in muscle tissue of claudicating legs were also reflected in morphological variables such as capillary supply, fibre type distribution, and fibre area. The activity of cytochro-me-c-oxidase in gastrocnemius muscle was determined and the insulin and glucose uptakes were measured across the leg in the basal state and 10 min following intravenous administration of 25 g glucose. The finding of a reduced relative number of Type II B fibres and a reduced ratio Type II B/II A fibre area, as well as an increased capillary supply to Type II A, indicated that the most extensive morphologic changes in muscle tissue of claudicating legs had occurred in Type II fibres. The increased number of capillaries in contact with Type IIA fibres in muscle tissue from claudicating legs, compared with muscle tissue from control legs, suggested that the most apparent metabolic changes occurred in this fibre type in the adaptation process of these patients. The more pronounced morphologic and metabolic changes in Type II fibres suggest that these fibres are more intensely activated than Type I fibres during physical activity in claudicating legs. The insulin uptake correlated positively with the number of capillaries per fibre, suggesting that the endothelial surface area is one of the determining factors for insulin uptake. The percentage of Type II B fibres reflected to a certain extent the metabolic adaptation in muscle tissue.     

Increased levels of antibodies to food proteins in Down syndrome

An increased level of immunoglobulin A (IgA) antibodies to food antigens has been found in Down syndrome. Biopsy did not show any anomaly of the gut. Increased IgA levels against specific proteins reflect increased transmucosal transport of antigens. The antigens presented may be immunogenic peptides or intact antigens. In this paper, we wished to exclude an institutional cause such as infections and also age differences.     

Dental features in congenital persistent renal tubular acidosis of proximal type

The dental features in a hitherto unknown type of renal tubular acidosis (capillary blood pH 7.07–7.15) of proximal type are reported. The patient presented agenesis of three second premolars, delayed development and eruption of permanent teeth, delayed shedding of the primary dentition and severe enamel hypoplasia of the permanent teeth, Apart from exceptionally thin enamel, histologic, fluorescent and polarization microscopic and microradiographic investigation of three primary teeth did not reveal unusual findings. The changes are most probably due to a generalized, acidosis-induced defect in several highly differentiated ectodermal tissues.     

Prevalence of female alcohol dependence and abuse in Sweden

Data on prevalence of female alcoholism are scarce, especially outside North America. It is even more rare that prevalence is estimated using clinical interviews, as well as by utilizing multiple sources of information. Our sample consisted of five cohorts of adult women (n = 3130) in a mainly suburban area. In a first phase we screened for alcohol-related problems. In a second phase a strategic sample was interviewed (n = 399). Prevalence was calculated for clinical and CIDI-SAM diagnoses, both according to DSM-III-R, also taking medical record data into consideration. It was found that life-lime prevalence of alcohol dependence and abuse was 3.27% and 12-month prevalence was 1.49%. Agreement over alcohol dependence was very high for the different diagnostic methods, but lower for alcohol abuse. Prevalence of dependency/abuse was not higher in the attrition group. The alcohol abuse concept was found to be relevant, both in epidemiological research and for clinical purposes.     

Electron microscopic demonstration of bacterial lipopolysaccharides in dental plaque matrix

abstract – Bacterial lipopolysaccharide endotoxins (LPS) obtained by phenol-water extraction from oral strains of Bacteroides melaninogenicus and Fusobacterium were studied in the electron microscope. The LPS particles had a characteristic morphology comparable to that of LPS from other Gram-negative microorganisms. The LPS appeared as circular structures or discs delimited by single or trilaminar membranes, or as short rods composed of two electron-dense membranes separated by a fine, less-dense layer. Teeth with adhering soft and calcified bacterial plaque, which were extracted because of advanced periodontal disease, were obtained and processed for electron microscopy. Close examination of thin sections revealed an abundance of particles in the dental plaque which closely resembled those found in LPS preparations of Gram-negative oral microorganisms. Circular as well as rod-like particles were, identified. These particles, which were most frequent in regions containing Gram-negative bacteria, were distinctly different from the granular, filamentous, and other structures previously reported in the intercellular matrix of the dental plaque. It was concluded that the circular and rod-like structures described represent free bacterial lipopolysaccharide. LPS particles were found superficially in the plaque as well as in deeper layers and in regions undergoing calcification. In regions containing Gram-negative bacteria, intercellular mineral deposition often occurred in close association with the LPS particles.