Methylmethacrylate screw implants—radiographic, histological and fluorescence microscopic investigations in dogs

Twenty-one methylmethacrylale screw implants were inserted in the jaws of three Labrador dogs. Clinical, radiographic, microscopic and fluorescence microscopic examinations were performed. Direct bone-implant contact was found in all firm implants, and the density of the alveolar bone increased towards the screw surface. In these areas no fibrous tissue was found between bone and implant. Horizontal fibres at the junction between the head and the neck of the implant seem to have impeded downgrowth of subepithelial granulation tissue.     

Paroxysmal Dysarthria and Raynaud's Phenomenon in the Tongue

ABSTRACT Three patients suffering from systemic scleroderma and Raynaud's phenomenon in the digits as well as the tongue are reported. Following exposure to cold, a vasospasm was observed in the digits and the tongue accompanied by severe dysarthria. These striking oral symptoms had been overlooked for years in the medical ward. It is recommended to question all patients with Raynaud's phenomenon about visceral manifestations during the digital attacks.     

PREMEDICATION BEFORE DAY SURGERY: A Double-Blind Comparison of Diazepam and Placebo

Premedication with diazepam 0.25 mg kg^–1 by mouth wascompared with placebo in a doubleblind trial in patients undergoingday-case surgery under general anaesthesia. Diazepam decreasedsignificantly preoperative discomfort and apprehension. Thepatients were discharged on time regardless of the type of premedication,and complaints at the time of discharge and on the followingday could be related only to the length of anaesthesia and notto the type of premedication. Premedication given early in themorning remained effective for up to 6 h.     

Pregnancy and Cesarean Section in a Patient with a Rate-Responsive Pacemaker

The function of a rate-responsive pacemaker was monitored during pregnancy and cesarean section in a woman with complete atrioventricular block. The observations during pregnancy were compared to similar observations obtained in a pregnant normal woman of comparable age, height and weight, and in 12 normal women during elective cesarean section. During pregnancy, the heart rate increased in the normal woman, whereas the pacing rate in the woman with the implanted pacemaker was unchanged. Fetal movement caused an increase in pacing rate in the 37th week of gestation, whereas the heart rate in the normal woman did not respond. During cesarean section the pacing rate was generally within the mean +/- 1 SD for normal women.     

Pacing in a Patient with Ebstein''s Anomaly

We report a case of Ebstein's anomaly in which ventricular pacing was achieved by positioning a pacing lead in the enlarged right atrium. By placing the electrode in the atrialization of the right ventricle, an aggravation of tricuspid regurgitation that may result from catheter displacement of the valve leaflets is avoided.     

Danish Patients' Attitudes to Scientific-Ethical Questions: An Interview Study Focusing Therapeutic Trials

ABSTRACT One hundred and fourteen in- and out-patients from a department of internal medicine were interviewed, on the basis of a questionnaire with the following key questions: 1) Their attitudes to medical trials with man as the subject. 2) Their emphasis on informed consent. 3) Their attitudes to inclusion of patients not being able to give informed consent. 4) Their attitudes to tentative participation in 4 concrete projects. In all, 98% considered doctors' and patients' collaboration on new therapeutical methods both necessary and desirable. Eighty-eight per cent considered information of patients participating in trials a prerequisite. Eighty-six per cent accepted participation in scientific trials based on the guarantee of the doctors responsible. Of these 86%, 58% felt that a scientific-ethical committee's accept of the project implied an extra element of security. Seventy-five per cent replied that patients not being able to give informed consent themselves could be included in scientific trials. The majority, 77%, added that patients' relatives would then have to accept, 20% that such trials could be based on the participating doctors' responsibility, and only 2% that such a responsibility was to place on scientific-ethical committees. In the 4 concrete projects, answers followed a uniform trend: full information of patients was demanded by approximately 80%, and acceptance of participation resting with responsible doctors in more than 80%. Less than half of these 80% felt that evaluation by a scientific-ethical committee would add to patients' security.     

Vasospastic Angina: Control of Disease Activity and Efficacy of Drug Treatment Using the Prolonged Hyperventilation Test

ABSTRACT Sixteen consecutive patients with vasospastic angina underwent a control provocation test in the coronary care unit or the cardiac catheterization laboratory in order to evaluate the disease activity and the efficacy of long-term calcium antagonist treatment. In patients without angina at rest, the prolonged hyperventilation test was negative in 10/10 patients on calcium antagonist treatment (group A+B) and in 4/5 patients without medication (group C). The test was positive in 1/1 patient with angina at rest without medication (group D). However, the test provoked vasospastic angina in 1/5 patients who were asymptomatic without medication. In both the latter patients the prolonged hyperventilation test became negative after the restart of calcium antagonist treatment. During a mean follow-up period of 18 months (range 16–19) after the control hyperventilation test, no relapse of angina at rest, arrhythmias, syncopes, deaths or myocardial infarctions were registered. Thus, a negative test is compatible with low disease activity and/or efficacy of calcium antagonist treatment. Further, the test may reveal a subclinical tendency to coronary artery spasm.     

Hyperplasia,keratosis, dysplasia and carcinoma in situ of the vocal cords—a follow-up study

Comparison of reported series of laryngeal lesions is complicated by the inconsistency in the terminology. The classification of these lesions should logically be based on the degree of dysplasia, as this has a bearing on the prognosis. The material for this study consisted of 193 patients with hyperplasia and/or keratosis, with or without mild dysplasia (Group I), moderate dysplasia (Group II), and severe dysplasia and carcinoma in situ (Group III). They were treated over a 14-year period (1966–1979) at Linköping University Hospital. Of the 98 patients in Group I available for follow-up, 23 had repeat excisions. Moderate dysplasia developed in 3 patients, severe dysplasia in 2, and invasive carcinoma in another 2 within 3 and 3.5 years; they both underwent laryngectomy. Among the 24 patients in Group II available for follow-up, severe dysplasia developed in 3 and invasive carcinoma in 3 up to 13 years after the initial diagnosis, all but one (with severe dysplasia) received a full course of radiotherapy, in one case total laryngectomy was subsequently performed for recurrent carcinoma. Of the 39 patients with severe dysplasia and carcinoma in situ 16 were given primary radiotherapy; 4 of these developed invasive carcinoma; 3 of them underwent total laryngectomy and one partial laryngectomy. Excision or stripping of the vocal cords was the primary treatment in 23 cases; 5 of these developed invasive carcinoma; 2 of them underwent total laryngectomy. Diffuse lesions and well differentiated forms of severe dysplasia caused most problems and had the highest incidence of invasive carcinoma irrespective of the form of treatment. Patients with hyperplasia, keratosis, dysplasia and carcinoma in situ should be carefully followed up, as invasive carcinoma may develop many years after the initial diagnosis.     

VASOACTIVE INTESTINAL POLYPEPTIDE (VIP) IN CHILDREN WITH NEURAL CREST TUMOURS

ABSTRACT. The concentration of vasoactive intestinal polypeptide (VIP) in plasma was measured in 22 children with neural crest tumours (NCT) during a 5-year period; the mean concentration of VIP in plasma was 22.5 pmol/l (interval 2.0-95.0 pmol/l). To establish a reference interval the plasma concentration of VIP was measured in 41 children without tumours; the mean concentration of VIP in plasma was 6.2 pmol/l (interval 0.5-19.0 pmol/l). Of the 22 children with NCT 16 had a plasma concentration of VIP within the normal range while 6 children (27%) had elevated plasma concentration of VIP between 28 and 95 pmol/l. Only one child, whose plasma concentration of VIP was 95 pmol/l had diarrhoea. Elevated plasma concentration of VIP in children with NCT but no diarrhoea has not previously been described. The urinary excretion of vanillylmandelic acid (VMA) was increased in 18 of the children with NCT (82%). In 2 of the children with normal excretion of VMA the concentration of VIP in plasma was elevated. Thus, the plasma concentration of VIP may be a supplement to VMA as a tumour marker in some cases of NCT.     

Initiation of Spermatogenesis during Chemotherapy for Leukemia

ABSTRACT. Although the information is sparse, cytotoxic drugs have been suspected to cause serious damage to the immature testis, especially when the treatment is given during puberty. In a prospective, longitudinal study, we have investigated the effect of combination chemotherapy on the maturation of the germinative epithelium in 22 testicular biopsy specimens from 10 pubertal boys with acute lymphoblastic leukemia. Five of the boys developed complete spermatogenesis including spermatozoa during the treatment, the biopsy specimens of two patients showed partial maturation of the seminiferous epithelium, while the germ cells of two boys remained immature. In one patient, who received large doses of cyclophosphamide and cytosine arabinoside, all germ cells disappeared during the therapy. We conclude that a significant proportion of boys with acute lymphoblastic leukemia may develop potential fertility even while on treatment with cytotoxic drugs during puberty.