[The prevention of mental discomfort in gnathoprosthetic treatment]

The investigation of a series of patients following a treatment at the Clinic of Gnathoprosthetics of Iaşi made possible an evaluation of their general emotional state in relation with their dental problems. According to the obtained results, the emotional discomfort induced by the numerous specific and unspecific gnathoprosthetic factors was avoided by means proper to each category of patients.

Cigarette smoking among San Francisco Hispanics: the role of acculturation and gender

We conducted a phone survey of 1,669 San Francisco Hispanics ages 15 to 64 years. The age-adjusted overall smoking prevalence was 25.4 per cent (95% CI = 23.3, 27.5) with more men (32.4 per cent) smoking than women (16.8 per cent). Age-adjusted smoking rates were higher among the less acculturated males (37.5 vs 26.7 per cent) and among the more acculturated females (22.6 vs 13.6 per cent). The more acculturated, however, smoked a greater number of cigarettes per day independent of gender. Community-based smoking cessation interventions, adapted to local conditions, may have a greater potential for success among Hispanics.

Antigenic relationship between Pythium insidiosum de Cock et al. 1987 and its synonym Pythium destruens Shipton 1987

Antigens and rabbit-antisera from holotypes of Pythium insidiosum and P. destruens were prepared to elucidate their antigenic relationship. The antigens and rabbit-antisera of P. insidiosum as well as P. destruens used as a reference system showed that both shared three precipitin bands in common. The antigen and rabbit-antisera of P. destruens and P. insidiosum used as a reference system against other strains isolated from humans and animals with pythiosis, also showed three precipitin bands in common. When we used sera taken from horses with proven pythiosis against antigens of P. insidiosum and P. destruens, six common bands were observed. We concluded that the etiologic agent of pythiosis is a single species P. insidiosum, and could be identified by serologic methods.

AIDS prevention among Hispanics: needs, risk behaviors, and cultural values

Data from different sources show that Hispanics are over-represented in reported cases of acquired immunodeficiency syndrome (AIDS) (twice their proportion of the population) and that their rate of infection by human immunodeficiency virus (HIV) is three times higher than among non-Hispanic whites. The behavior risk factors most frequently associated with infection in AIDS cases are IV drug use in the Northeast and high-risk sexual behavior in the West. HIV infection prevention strategies for Hispanics need to address high risk behaviors, taking into consideration associated culture-specific characteristics. Strategies need to address as well conditions such as racism and ethnic prejudices that keep many Hispanic homosexuals and bisexuals away from white or non-Hispanic gay organizations and publications, the lack of culturally appropriate drug treatment centers, the level of mis-information among Hispanics, and the possible high incidence among men of sexual intercourse with prostitutes. Prevention campaigns need to include such Hispanic cultural values as simpatia, familialism, personalismo, and power distance, if prevention campaigns are going to be perceived as relevant by Hispanics. Appropriate wording and communication channels need to be identified in order to transmit messages that will be perceived as credible and that will reach the largest possible audience.

[The health education of the young employees of an industrial unit]

This paper underlines the role of health education as a prophylactic means and presents an original methodology of the Clinic of Dental Prosthetics of Iaşi. This methodology was applied to a group of young employees of a heavy industry unit and consisted in comments upon some specific booklets and folders and physician-patient talks, as part of the examination. The follow-up record facilitated the assessment of subjects receptivity and at the same time the initiation of an early treatment of the bucco-dental lesions.

Small hepatocellular carcinoma: percutaneous alcohol injection--results in 23 patients

Twenty-three patients with hepatocellular carcinoma less than 4.5 cm in diameter (32 lesions) were treated with a percutaneous injection of ethyl alcohol performed with ultrasound (US) guidance. No complications or sequelae occurred after 271 treatments. All lesions were smaller after 6-27 months follow-up. No evidence of hepatocellular carcinoma was present at fine-needle biopsy or contrast material-enhanced computed tomography (CT). No viable tumor cells were detected in four patients who subsequently underwent surgery. The 1-year survival rate of 12 patients was 91.7%. From these data, it can be concluded that percutaneous alcohol injection (PAI) is an appropriate first-line treatment for patients with small hepatocellular carcinoma lesions who are poor surgical risks. Given the risk of new nodular lesions occurring on resected livers and the risk of perioperative mortality, PAI might even be considered an alternative to surgery.

Absence of dawn phenomenon in normal children and adolescents

The dawn phenomenon consists of a rise in plasma glucose levels or insulin requirements in the early morning. This phenomenon has been observed in normal adults and in patients with diabetes mellitus. To determine whether this phenomenon also occurs in normal children and adolescents, we evaluated plasma glucose, insulin, C-peptide, and growth hormone levels during the early morning in 31 normal children between the ages of 8 and 18 yr. Blood samples were obtained through an indwelling catheter every 20 min for growth hormone and hourly for glucose, insulin, and C-peptide from 2100 to 0900 h. Glucose levels decreased slowly overnight from 2100 to 0900 h, despite increases in growth hormone levels. No significant rise in insulin or C-peptide levels was detected in the early morning in these normal subjects. There were no significant differences between prepubertal and pubertal children. We conclude that glucose, insulin, and C-peptide levels remain stable overnight, suggesting that the dawn phenomenon is not observed in normal children.

Perceived advantages and disadvantages of nonsmoking sections in restaurants: topics to communicate to restaurateurs

Results from interviews with 315 restaurateurs in San Francisco are reported on their perceptions of the advantages and disadvantages of having a nonsmoking section in their restaurants. The major advantage of having a nonsmoking section independent of whether one is present is to please customers. The most commonly mentioned disadvantage for those restaurants with nonsmoking sections is the fact that it is inconvenient to clients' seating preferences primarily because it breaks up dining parties. Efforts at convincing restaurateurs to set up nonsmoking sections may be directed at pointing out savings in cleaning, labor, insurance, and the improvement of the health of their employees together with meeting clients' desires.

Delayed muscular rigidity and respiratory depression following fentanyl anesthesia

A delayed effect of fentanyl used for anesthesia may be respiratory distress several hours after surgery. The findings are muscular rigidity, fall in chest wall compliance, hypoventilation, respiratory acidosis, and hypotension. In the past, to our knowledge, this complication was exclusively reported in patients undergoing cardiac surgery, when large fentanyl dosages are employed. This article describes three general surgical patients in whom respiratory distress developed three to five hours following colon surgery when a moderate dose of fentanyl citrate, 55 to 75 micrograms/kg, was used. Initially, all patients had a normal recovery from anesthesia. Later, respiratory distress was successfully treated with a fentanyl antagonist and ventilatory assistance. This delayed toxic phenomenon is thought to be due to the reentry of fentanyl into plasma from deposits in adipose tissue, muscle, and the gastrointestinal tract, leading to a secondary rise in the plasma concentration. It is more likely to be encountered when hypothermia, rewarming, and acidosis are present in the postoperative period. This life-threatening complication is treacherous, since it may occur when the patient has been transferred to the surgical ward and is less closely monitored.

HBV-DNA sequences are rarely detected in the liver of patients with HBsAg-negative chronic active liver disease and with hepatocellular carcinoma in Italy

Hepatitis B virus sequences were studied by molecular hybridization in liver biopsies from patients with HBsAg-negative chronic liver disease or hepatocellular carcinoma, collected in Italy. Among the 42 patients with chronic liver disease who had no history of drug addiction, alcohol abuse nor evidence of metabolic and autoimmune disorders, only two (5%) had HBV-DNA sequences in the liver, although 23 of them (57%) were positive for antibodies to HBV in serum. HBV-DNA was also demonstrated in integrated form in the tumorous tissue of one out of eight cases with HBsAg-negative hepatocellular carcinoma. These incidences of HBV-DNA positivity in the liver are lower than those reported from other Mediterranean areas and similar to those of North Europe, United States and Japan, suggesting that etiologic factors other than HBV are responsible for the majority of HBsAg-negative chronic liver diseases in our region.

Prelaparoscopic echography used to detect abdominal adhesions

Through the use of echography after establishing the pneumoperitoneum, it is possible to recognize the presence of intra-abdominal adhesions and the distribution of gas. Using this method, the laparoscopist is able to form a picture of the intra-abdominal situation with regard to the site of the adhesions and the pneumoperitoneal chambers. This enables him to choose the best site for the insertion of the trocar both for the avoidance of possible incidents, and for optimal inspection. This method has been successfully employed in 39 patients with large abdominal surgical scars. Laparoscopy confirmed the echographic findings in almost all the cases. Thus, in 38% of cases the laparoscopic "inspection site" chosen was atypical with respect to the usual sites for the insertion of the laparoscope, but always proved to be the most suitable.

Pineal germinoma: diagnosis, treatment and tumor response

We report the case of pineal germinoma in a 25 year old man. The neurological signs and symptoms were insidious in onset; Parinaud syndrome allowed a topical diagnosis, confirmed by CT scan. Computerized Tomography and CSF cytological examination were of the utmost importance to diagnosis and treatment and it confirmed the success of radiotherapy.

Laparoscopy in staging, follow-up, and restaging of ovarian carcinoma

Laparoscopy was systematically employed for the study of 143 cases of primary ovarian tumor in the various phases of staging, treatment, follow-up, and restaging. We found that laparoscopy allowed a more precise staging if used before laparotomy. Verification of response at any time in the course of therapy was readily achieved by laparoscopy.

[Moya-moya syndrome. Progression of the angiographic picture and therapeutic prospectives]

Moya moya is an obstructive cerebrovascular disease characterised by peculiar cerebral angiographic features consisting of intracranial stenosis or occlusion of the internal carotid artery or its terminal branches associated with telangiectatic vessels at the base of the brain. Opinion is still divided between a congenital versus an acquired aetiology. Recurrent episodes of sudden hemiplegia, headache and convulsive manifestations occur more frequently in paediatric patients, while subarachnoid bleeding is usually the presenting finding in adults. After a progressive course for many years, the disease frequently stabilizes sometimes with residual disability. Surgical approach to improve cerebral blood flow has been developed but there is a high incidence of complications in pediatric patients. To minimize the defects during ischemic phase, a pharmacological therapy might be useful. We report a new case of childhood moya moya disease which developed a typical angiographic progressive pattern during three years between the first and the latest bilateral study. Clinical course of patient suggest that antiaggregating drugs and calcium antagonists might be useful in this disease although controlled studies are of course needed.

Laparoscopy in abdominal staging of esophageal carcinoma. Report of 369 cases

Three hundred sixty-nine patients with cancer of the esophagus (280) and of the cardia (89) underwent laparoscopy, which revealed single or multiple metastases to the liver, peritoneum, omentum, stomach, and lymph nodes in 52 patients (14%) and a metastasis to the gastric wall or to the regional lymph nodes in 36 patients (9.7%). Laparoscopic false negative findings in our series of 250 cases submitted to laparotomy was only 4.4% (2.8% for the liver, 1.2% for the peritoneum, and 0.4% for the omentum). Cirrhosis was diagnosed in 14.3% and severe portal hypertension in 6.7% of our series. Laparoscopy is a very effective procedure in pretherapy staging of esophageal cancer.

Some specific features of exercise stress in athletes

Stress factors which can elicit several psychoemotional, neuromotor and cardiovascular reactions in athletes before or during training and competition are discussed. The authors' data concern firstly the significance of ACTH depletion. Exploration of the neuromotor system, the flicker test, evaluation of the urinary excretion of amine metabolites and several types of questionnaires (related to stress, anxiety and coronary risk factors) in a group of 35 athletes have outlined their psychophysiological reactions and behaviour. The necessity to prevent and manage distress phenomena found in 20 subjects is considered.

The role of p53 in growth of mouse fibroblast lines

To examine the hypothesis that p53 protein may play a central role in regulating reproduction of mammalian cells, we compared the absolute amounts and relative rates of synthesis of p53 protein in two pseudonormal cell lines, 3T3 and C3H 10T1/2, during quiescence, during log proliferation, and in quiescent cells stimulated with serum. The absolute amount of p53 protein per cell was found to be severalfold lower in quiescent cells than in log-phase cells. The ratio of the rate of synthesis of p53 protein to the rate of synthesis of total protein was slightly higher in quiescent cells than the same ratio in log-phase cells. Thus, entry into quiescence is not accompanied by a differential switch-off of synthesis of p53 protein. In quiescent cells stimulated with serum the amount of p53 protein per cell and its rate of synthesis increase, but only in proportion to the increase in total protein per cell and the increase in rate of total protein synthesis. Similarly, 12-14 h after serum stimulation, the time of the G1 to S transition, the accumulated increase in p53 protein per cell is about what would be expected for a short-lived protein whose rate of synthesis has increased in proportion to the increase in rate of synthesis of total protein. The results are not those expected for a protein that functions specifically in release from quiescence or in transition from G1 to S.