Provider expectations and consumer perceptions of the importance and value of dental care

Seventy-eight inner city mothers of third and fourth grade children in three racial groups--white, black, and American Indian--known to need dental treatment for disease on permanent teeth, were interviewed at home by a trained community resident interviewer. Sixty-two per cent of the mothers were on public assistance. Information relating to the mothers' perceptions of the importance and value of dental care both for herself and for her children were collected. Utilization data were obtained via two dental examinations conducted one year apart. Data were also collected from a sample of provider dentists via mail questionnaire. A yield of 315 usable questionnaires was obtained, a return rate of 53 per cent. Provider-dentists felt that low socioeconomic consumers do not value dental services, as compared to other types of consumer goods and services, and that they do not believe dental care is important. Low income mothers in the same city reported that they did value dental care and believed it important. Expectations of and orientations toward the importance of dental care were found discongruent between the two groups of respondents. These discongruities on the dentist-patient relationship are discussed as a barrier to utilization. Although financial resources were available to many of the study families, only 49 per cent of these children received the needed care. It is suggested that the psychological cost to a patient of seeking care in inhospitable settings may act as a barrier to utilization.

The survival of inoperable breast cancer treated with radiotherapy and radiotherapy followed by mastectomy

Forty-five patients with locally advanced breast carcinoma were treated by radiotherapy. Twelve of them became operable and were operated. After 3 and 4 years in comparable clinical stage the rate of metastases in the nonoperated group was 78.6% and in the operated 75%. The survival after 3 and 4 years in comparable clinical stages was similar. In more advanced stages the survival was worse. Considering the trauma of mastectomy and the similar survival obtained in our material, an international trial should be performed to decide whether inoperable breast cancer becoming operable after radiotherapy should be operated.

Lymphocyte reactivity in healthy subjects and cancer patients

Lymphocytes of 40 cancer patients with solid tumors as well as of 40 normal subjects were stimulated by phytohemagglutinin (PHA), purified protein derivative (PPD), streptokinase-streptodornase (SK-SD) and candidin (Cand) and the extent of their stimulation was expressed by the index of reactivity. The cumulative frequency distribution of reactivity indices was significantly higher in normal individuals than in cancer patients. The highest extent of information relevant to the discrimination between patients and normal subjects is obtained following stimulation of lymphocytes with Cand and in decreasing order with PPD, SK-SD and PHA. The percentage of normal subjects and patients having reactive lymphocytes was found to be the highest following stimulation with PHA, lower with PPD and the lowest to Cand and SK-SD. The importance of using increasing numbers of stimulants to achieve maximal detection of lymphocyte reactivity is documented and discussed.

A case of twin chimerism

A case of twin chimerism is presented and shown by cytogenetic studies, red cell grouping, and white cell HL-A typing. The sex of each twin is confirmed by examination of buccal smears and their chimeric state is confirmed by non-reactivity in the mixed lymphocyte culture system. The results of these investigations are discussed.

A comparative evaluation of the Scrub and Bass Methods of toothbrushing with flossing as an adjunct (in fifth and sixth graders)

The Scrub and Bass Methods of toothbrushing with flossing as an adjunct were evaluated to determine which is most effective in eliminating or reducing plaque and gingivitis in 5th and 6th grade school children. Three hundred and eleven children were randomly selected and placed in five groups (Scrub, Scrub-Floss, Bass, Bass-Floss, Comparison). Four Method groups went through four weeks of daily supervised toothbrushing with four dental hygienists, while the Comparison group received no supervised instructions. There was a marked effect on oral hygiene and gingival conditions at the end of the experimental period in all four groups with no one method superior to another. Peer group intercommunication probably accounts for the improvement in the comparison group.

Aspects of lymphocyte function in Behçet's disease

Aspects of lymphocyte function were investigated, in vitro, in nine patients with active Behçet's disease. The rosette formation technique revealed a slight decrease in number of T lymphocytes and more so of B lymphocytes. In spite of their low number, the transformation of the T lymphocytes in response to mitogens did not show a significant difference from that of normal controls. This may indicate a hyperreactivity, and in two instances a spontaneous blastogenesis prior to addition of mitogens, was also noted. The immunoglobulins and complement levels in serum were within normal limits.

Effect of crowding and litter size on several behaviors of white rats

Rats from litters of 4, 7, or 11 were placed 1, 2, 3, or 4/cage till 60 days old. Litters of four were less active in an activity wheel than litters of 7 and 11 ( p < .05) and females were more active than males ( p < .01). Neither cage density nor litter size affected time to begin eating. Although main effects were not demonstrated in a brightness discrimination, there was a cage × sex interaction. Males housed 1/cage were slower to learn than multiply caged Ss. Possible interpretations are facilitative effects of crowding, increased incentive value of food due to home-cage competition for food, or increased activity need generated by crowded living conditions.

Effect of treatment with the MER tubercle bacilli fraction on the survival of mice carrying mammary tumour isografts: injections of MER at the tumour site or at a distal location

Strain BALB/c female mice bearing syngeneic implants of 2 mammary adenocarcinomata were treated with MER, x-irradiation or both. MER was administered either subcutaneously at a site contralateral to the neoplastic growth or both into such a site and directly at the tumour location. None of the treatments effected cures but many of the treated animals survived significantly longer than did the saline injected controls. There was no evidence that introduction of MER into, or directly adjacent to, a tumour is a generally more efficacious route of administration than application at only a distal site and there was, indeed, the strong contrary impression that distal treatment alone bestowed survival protection more often and to a greater extent. In no instance was there a shortening of survival time following administration of MER at a location away from the tumour implant.

Correlation between bone scanning and the radiographic image in the diagnosis of osteosarcoma

A case of osteosarcoma of the right mandible is described. The patient had a long-standing fibrous dysplasia (Jaffe & Lichtenstein disease) in that area. The osteosarcoma did not respond to surgical treatment or radiation and continued to grow, causing the death of the patient. This case is of interest because of the correlation between the radiographic image and the 85Sr-uptake on a scintiscan which corresponded exactly to the tumor mass.

A preliminary report on the effects of methanol extraction residue of BCG (MER) on cancer patients

Twenty-seven patients with malignant neoplasia were injected intradermally with the methanol extraction residue (MER) fraction of tubercle bacilli. Two schedules of treatment were used: every other week and once a month; 1-10 courses of MER were administered to the patients. The skin reactivity to 3 recall antigens, as well as to the injected MER itself, was used to monitor the immune response. Improvement of skin reactivity occurred in 9 of 18 patients tested with recall antigens. Five of 6 patients treated every other week improved in their immune capacity whereas only 4 of 12 patients improved on the monthly schedule. Thus, repeated injections given every other week were more effective in increasing the cutaneous reactivity than monthly injections of MER. The side-effects of MER treatment were tolerable.

Effects of methanol extraction residue and therapeutic irradiation against established isografts and simulated local recurrence of mammary carcinomas

Female BALB/c mice carrying established isografts or simulated local recurrence implants of 2 rapidly growing mammary adenocarcinomas were treated either by injection of the methanol extraction residue (MER) fraction of killed Bacillus Calmette-Guérin organisms (given s.c. or into the tumor) or by focal X-irradiation or by both. None of the modalities of therapy effected cures, but in many instances there was a significant retardation of tumor cevelopment and prolongation of the lives of the mice. Administration of MER alone offered protection in a number of cases but less often than the other forms of treatment. Combined therapy with MER and irradiation was, on the whole, the most successful therapeutic intervention. MER or irradiation administered alone enhanced the neoplastic process only on rare occasions; this appeared to be the case even more infrequently with combined treatment. MER was most likely to be effective alone or in combination when small quantities were used and when only 1 treatment or 1 cycle of combined therapy was given. The therapeutic action of MER was not dependent on direct introduction of the agent into a neoplastic focus; s.c. administration distal to the tumor site was almost always at least as satisfactory as injection directly into the tumor mass and indeed was often more efficacious.