Dental Age Assessment: a comparison of 4- to 24-year-olds in the United Kingdom and an Australian population

Background.  The physiological age of a person is determined by the degree of maturation of the different tissue systems. Children of the same chronological age (CA) can demonstrate different degrees of maturation. Dental age (DA) is based on the maturation of teeth. Tooth formation is a continuous process, where the developmental stages of the tooth can be sequenced and defined depending on the degree of mineralization. These stages can be visualized on a dental panoramic tomograph (DPT).
Aim.  The aim of this study was to use a new method of Dental Age Assessment (DAA) to compare a United Kingdom (UK) and an Australian (AUS) population.
Design.  The DPTs used are from the archives of the Westmead Centre for Oral Health (Westmead, Australia) and the King's College London Dental Institute. From the preliminary sample of 89 DPTs from each population, 77 were suitable for use as matched pairs. The radiographic technique used was developed by Demirjian and describes eight stages of tooth development. This was used in combination with numerical data derived from a meta-analysis of a single UK subject.
Results.  A significant difference was shown between the CA and DA of the AUS patients. The AUS patients were also shown to have a significant 0.82 years delay in their DA compared to the UK patients. The findings indicate a difference in AUS compared to UK patients. These results indicate the need to develop a reference data set for the AUS population for DAA.
Conclusions.  This research is of significance in a number of clinical disciplines and can also be used to assist in age determination of subjects of unknown birth date to assist in forensic dentistry or social deliberations.     

An unusual pattern of metastases from Merkel cell carcinoma

An unusual case of Merkel cell carcinoma is presented in which the time course to development of nodal and haematogenous metastases was protracted and the predominant site of metastatic disease was small bowel.     

Salivary oestriol in normal and abnormal pregnancies

Summary. Profiles of daily salivary oestriol concentrations throughout the third trimester of pregnancy have been constructed for 14 normal and 11 abnormal pregnancies. Day-to-day variations were significantly higher than those reported for unconjugated oestriol in plasma or serum. A sustained decline in salivary oestriol concentrations was observed in one pregnancy in which intrauterine death occurred. Sustained falls were also observed in two pregnancies in which a healthy infant was born at term. In all other patients a normal salivary oestriol profile correlated with a favourable outcome. Salivary oestriol measurements provide similar information to plasma unconjugated oestriol measurements while offering the advantages of a simple, non-invasive sample collection procedure.     

Time course and mechanisms of decreased plasma volume during acute psychological stress and postural change in humans

In this study, we examined the effects of psychological stress on calculated plasma volume, the relationship of these changes to changes in hematologic factors, and the time course of plasma volume changes. Plasma volume changes were assessed using mass densitometry techniques, which measured changes in blood and plasma density. Hematologic and hemodynamic variables were assessed in 40 healthy men and women during a mental arithmetic (math) or benign reading task and during postural change (standing). Results indicated that math and posture change produced a significant decrease in plasma volume (ps < .001) and increases in blood pressure (ps < .001), blood and plasma density (ps < .001), and total plasma protein (p < .001). Correlations were observed between plasma volume changes and changes in systolic (r= .55, p < .0001), diastolic (r= .61, p < .0001), and mean (r= .65, p < .0001) arterial pressure during math; plasma volume and blood pressure returned to baseline within 12 min following the math task. These results suggest that an important mechanism for stress-induced decreases in plasma volume is increased blood pressure leading to increased fluid shifts from the vasculature into the interstitial spaces.     

Harlequin fetus successfully treated with etretinate

A harlequin fetus seen at birth was treated with etretinate and more general measures, including careful attention to fluid balance, calorie intake and temperature control. She improved, continued to develop, and had survived to 5 months at the time of this report.