Effectiveness of dental health educational programs in schools

The largest and most important group that may be reached by health education is found in the school system. Children not only are fast learners and anxious to acquire new skills but also are at risk for the development of dental health problems. Therefore, regardless of the equivocal nature of the evidence regarding the effectiveness of school dental health educational programs, it is important that they continue to be developed. The programs created should have objectives, pretesting, participatory and cognitive experiences, periodic review of dental health program by an advisory committee, a liaison between school personnel and health professionals, and realistic models to assess the effects of the program on health. Because dental disease preventive programs and regimens such as water fluoridation, topical fluorides, dental sealants, and oral hygiene regimens are available that have the potential to eliminate dental disease, effort should be made to increase the awareness of the children who can benefit from them.     

Superior oblique palsy: diagnosis and treatment

To pinpoint the diagnostic dilemmas and to look for differentiating preoperative features in cases of masked bilateral superior oblique palsy, the authors reviewed the charts of 50 patients (26 males and 24 females with an average age at presentation of 25.6 years) with an established diagnosis of superior oblique palsy seen between 1980 and 1987. Most patients had a history of symptoms from childhood or following trauma. Typically, patients complained of torticollis and diplopia and manifested inferior oblique overaction and superior oblique underaction of the paretic eye. Twenty-two of the patients underwent a total of 28 operations; surgery resulted in elimination of symptoms and neutralization of the hyperdeviation in 77%. On the basis of this experience the authors discuss the presenting features and the differential diagnosis of superior oblique palsy and present a rational approach to surgical intervention.     

In situ saphenous vein bypass grafts: angiographic evaluation and interventional repair of complications

In situ saphenous vein grafts are being used with increasing frequency for bypass procedures involving the femoral and popliteal arteries. Complications of these procedures include anastomotic stenoses and persistent arteriovenous fistulae that may result in failure of the graft. Balloon angioplasty and embolotherapy with detachable balloons were employed successfully in three or four recent cases of patients with complications from in situ grafts. Tailored angiography is essential for evaluating in situ grafts, and interventional techniques are extremely useful for managing complications.     

Unusual dissection of the proximal vertebral artery: description of three cases.

We report three cases that reveal an array of etiologic and radiologic findings associated with dissection of the proximal segment of the vertebral arteries. Regardless of etiology, the proximal segment may be the principal site of dissection in these vessels.     

Presence of transforming growth factor-beta and their selective cellular localization in human ovarian tissue of various reproductive stages.

Immunohistochemical studies were performed using specific polyclonal antibodies to transforming growth factor (TGF)-beta 1 and TGF-beta 2 to determine their presence and cellular localization in human ovarian tissues of various reproductive states. In the small ovarian follicles, the immunostaining for TGF-beta 1 was present in oocytes, follicle cells, and granulosa and theca cell layers. The level of immunostaining associated with granulosa and theca cell layers intensified as the size of the follicles increased. In the luteal tissue, both the small and large luteal cells immunostained for TGF-beta 1 and their intensities were similar to theca and granulosa cell layers, respectively. The patterns of immunostaining were similar in early (days 14-19), mid (days 22-25), and late (days 26-29) luteal phases; however, the intensity was highest at mid and decreased at late luteal phase. Corpus albicans showed a very weak immunostaining for TGF-beta 1, whereas ectopic pregnancy small luteal cells immunostained relatively intensely. The ovarian stromal, luteal tissue fibroblasts, and arterioles endothelial and smooth muscle cells were also immunostained for TGF-beta 1. The immunostaining of the ovarian tissues for TGF-beta 2 indicated that the theca cell layers were the exclusive cells in the follicles with intense immunostaining, which increased in the larger follicles. A low immunostaining was also observed in granulosa cell of the large follicles. In the luteal tissues, only small luteal cells showed intense immunostaining for TGF-beta 2, which was similar in intensity to that in the theca cells; however, the large luteal cells showed a low level of immunostaining at midluteal phase. The small luteal cells in corpus albicans and ectopic pregnancy luteal tissues retained their immunostaining for TGF-beta 2, but with lower intensity. Endothelial and smooth muscle cells of arterioles also immunostained for TGF-beta 2, but not ovarian stromal cells. Atretic follicles showed very low or no detectable immunostaining for TGF-beta 1 or TGF-beta 2. The results of present studies show that human ovarian tissue at all the reproductive states locally produces TGF-beta 1 and TGF-beta 2, and although TGF-beta 1 is present in most major ovarian cell types, TGF-beta 2 is only produced by theca cells in the follicles and small luteal cells in luteal tissues.