Interaction between chemoattractants and bacterial lipopolysaccharide in the induction and enhancement of neutrophil adhesion

Chemotactic peptides in the circulation stimulate neutrophils to become sequestered in the pulmonary vasculature, and low concentrations of bacterial lipopolysaccharide (LPS) enhance and prolong this effect. This interaction of neutrophils with the vascular endothelium is thought to involve, in part, the increase in adhesiveness induced in neutrophils by such stimuli. In this study, the binding of albumin-coated latex beads to neutrophils was used to determine whether the enhancement seen with LPS results from an increase in the number of adhesive cells, from the enhancement of the adhesiveness of individual neutrophils, or both. Chemotactic peptides alone and LPS alone induced an increase both in the adhesive population and in the number of beads bound per individual neutrophil. The number of beads bound per cell increased over a very wide range of stimulus concentrations, showing that the degree of adhesiveness of an individual cell in the population varies over a considerable range. Trace concentrations of LPS (10 ng/ml or less), i.e., levels close to those measurable in vivo, had little effect on the proportion of neutrophils that were stimulated by chemotactic factor to become adhesive but did significantly enhance the number of beads bound to each individual neutrophil. The enhancement may require the presence of the CD11/18 glycoprotein complex, but was not further upregulated by LPS. No evidence could be obtained to suggest that the effect of LPS involved release of tumor necrosis factor (TNF) from the numbers of monocytes in the preparation, and the observations are consistent with a direct effect of LPS on the neutrophils. It is suggested that this increase in adhesive sites on the cell could explain the persistence of the sequestration of neutrophils in the microvasculature seen in the presence of both chemoattractants and LPS by enhancing the "strength" of the adhesion to endothelial cells. The increased adhesion may also set the stage for enhanced endothelial injury.

Control of bleeding in cemented arthroplasty

Bleeding from cancellous bone causes lamination within bone cement and at its prosthetic interfaces, and weakens the fixation of joint replacements. We examined the effects of anaesthesia and blood pressure on bleeding in human cancellous bone, and investigated the local response to freezing saline, 1:200,000 adrenaline and hydrogen peroxide. Spinal anaesthesia reduced cancellous bleeding by an average of 44%, local freezing saline by 24%. Saline at room temperature, adrenaline solution and hydrogen peroxide each reduced it by 14%. The effects of spinal anaesthesia and of freezing saline were additive: used together they reduced bleeding by 56%. The reduction of blood contamination of cement and its interfaces should contribute to better prosthetic fixation.

Familial gigantiform cementoma: classification and presentation of a large pedigree

Very few cases of gigantiform cementoma have been reported, and those associated with a positive family history are especially rare. Confusion exists about the relationship of gigantiform cementoma to florid osseous dysplasia, cementifying fibroma, and diffuse chronic sclerosing osteomyelitis. It has been unclear whether gigantiform cementoma should be accorded the status of a separate entity. In this article, we report our findings on a family that, over five generations, has exhibited clinical, radiographic, and/or histologic findings consistent with the designation familial gigantiform cementoma. This pedigree consists of 55 members. Significant heterogeneity in expression of this trait was noted. The pattern of occurrence of the trait is consistent with an autosomal dominant mode of inheritance with variable expressivity of the phenotype. We suggest that familial gigantiform cementoma should be recognized as a separate entity.

Competitive effects of long-chain-triglyceride emulsion on the metabolism of medium-chain-triglyceride emulsions

This study was conducted to assess the potential metabolic competitive interactions of intravenous medium-chain-triglyceride (MCT) and long-chain-triglyceride (LCT) lipid emulsions. To assess this competition increasing concentrations of LCT emulsion were added to an intravenous dose of MCT emulsion of 3.0 g/kg body wt up to a maximum dose of 3.0 g LCTs/kg body wt. Blood samples were assessed for competitive interactions by analyzing the following metabolites: glucose, insulin, lactate, pyruvate, ketones (acetoacetate, beta-hydroxybutyrate), elimination of triglycerides, and free fatty acids. Evaluation of the data showed a strong competitive interaction between the MCT and LCT emulsions. This competition was evident as soon as LCTs were added to the MCT infusions and appeared to favor LCTs for removal and metabolism over MCTs. This appears to indicate that there is a peripheral, strong affinity site for LCT removal and metabolism and a shared peripheral site and specific visceral site for MCT removal and metabolism.

Generalized eruptive keratoacanthoma

Two forms of keratoacanthoma are presently recognized: a solitary form and a multiple form. The multiple form has two variants: multiple self-healing epitheliomas of skin or Ferguson Smith type and eruptive keratoacanthoma or Grzybowski type. Though solitary cutaneous keratoacanthomas are common, the multiple variants are extremely rare. A case of eruptive keratoacanthoma with oral involvement is presented with a brief discussion contrasting the two variants of multiple keratoacanthoma.

Microwave sterilization of nitrous oxide nasal hoods contaminated with virus

Although there exists a desire to eliminate the possibility of cross-infection from microbial contaminated nitrous oxide nasal hoods, effective and practical methods of sterilization in a dental office are unsatisfactory. Microwaves have been used to sterilize certain contaminated dental instruments without damage. In this study nasal hoods contaminated with rhinovirus, parainfluenza virus, adenovirus, and herpes simplex virus were sterilized in a modified microwave oven. Ninety-five percent of the virus activity was destroyed after 1 minute of exposure of the contaminated nasal hoods to microwaves. By the end of 4 minutes, complete inactivation of all four viruses was found. Repeated exposure of the nasal hoods to microwaves resulted in no damage to their texture and flexibility. Microwave sterilization may potentially provide a simple and practical method of sterilizing nitrous oxide anesthesia equipment in a dental or medical practice.

Dissociation between emotional and endocrine responses preceding an academic examination in male medical students

A study was made in 2 consecutive years of the emotional states and morning and afternoon serum levels of prolactin, cortisol and testosterone of male medical students during a 4- to 5-week period preceding a major university examination. 'Distress', 'anxiety' and, to a lesser degree, 'depression' increased during the 2 weeks immediately preceding the examination and were positively correlated with personality anxiety or neuroticism traits. Group means for hormones showed no consistent change over the same period. Neither was there evidence for a correlation between endocrine and emotional changes within individual students during the pre-examination period. A restricted study showed that there were significant increments in cortisol in samples taken during the examination itself. Changes in emotional state before an examination occurred in the absence of equally dramatic changes in levels of the three hormones studied, though this relationship may have altered during the examination itself. This suggests that the factors controlling the two categories of response may relate differently, in some way, to the imminence of this stressful event.

Comparison of meclofenamate sodium with buffered aspirin and placebo in the treatment of postsurgical dental pain

The efficacy of meclofenamate sodium (Meclomen) at two different doses was compared with that of buffered aspirin and placebo in the control of postsurgical pain in a double-blind, randomized study of 205 patients. Meclofenamate sodium, 200 mg, was significantly better than meclofenamate sodium, 100 mg, in some efficacy parameters. Both doses of meclofenamate sodium were superior to buffered aspirin in most parameters of efficacy, and more effective than placebo in every parameter.

Plasma and submandibular saliva lysosomal enzymes in cystic fibrosis

This study determined in a blind fashion the activity levels and thermostability properties of two lysosomal hydrolytic enzymes, acid phosphatase and alpha-mannosidase, in plasma samples from 25 cystic fibrosis (CF) patients and 25 age- and sex-matched normal controls. Mean alpha-mannosidase activity (3.2 +/- 1.0 mU/ml) and acid phosphatase activities (6.5 +/- 2.9 mU/ml) in CF patients were not significantly different from those found in normal individuals (2.8 +/- 0.7 and 7.6 +/- 3.4 mU/ml, respectively). Using stringent conditions no differences in thermostability properties of these enzymes were found between plasma from CF patients as compared to that of normal controls. When activity levels of these enzymes and of four additional hydrolytic enzymes, alpha-L-fucosidase, alpha-galactosidase, alpha-glucosidase and beta-galactosidase, were determined in submandibular saliva, no significant differences in enzyme levels between CF and age- and sex-matched controls were noted nor were thermostability differences found. Our data do not support the concept that altered properties of these enzymes are useful as markers for detection of CF homozygotes and heterozygotes, nor the hypothesis that the defect underlying this disease is a deficiency of post-translational modification of glycoproteins leading to their mis-compartmentalization and qualitative alteration.

Congenital epulis (gingival granular cell tumor): ultrastructural evidence of origin from pericytes

The congenital epulis (gingival granular cell tumor) is a rare lesion of unknown origin found only in newborn infants. Remarkable similarities are noted between this lesion and the adult granular cell tumor (myoblastoma) by both light and electron microscopy. An electron microscopic study of a lesion from the anterior mandibular ridge in a newborn male infant was performed. No Schwann cells, axon fibers, odontogenic elements, or any muscle cells could be found. Cytoplasmic features were similar to those in adult granular cell tumors. Cells which appeared to be in a transitional state, not yet true granular cells, were found juxtaposed to the vessels in the position of pericytes. Fine-structure details of these cells were consistent with pericytes. Cells of this type found farther from the vessels appeared more like the typical granular cells. The cells were filled with structures of the autophagic type devoid of normal cell organelles. These findings support the theory that these are nonneoplastic, degenerative, or reactive lesions arising from a mesenchymal cell, possibly the pericyte.

Spontaneous regression of oral histoplasmosis

A case of histoplasmosis with an unusual clinical presentation and subsequent disease course was diagnosed when a tooth extraction site failed to heal. Culture, biopsy, and serologic study confirmed the presence of Histoplasma capsulatum. Radiographs and sputum culture established pulmonary involvement. Oral and pulmonary lesions regressed without treatment. This case is presented to raise the question of whether all cases of histoplasmosis with oral involvement should be assumed to be disseminated disease requiring treatment with amphotercin B.

Prevalence of herpes simplex virus disease in a professional population

By virtue of occupation, dentists are frequently exposed to the herpes simplex virus. The risk of infection by the virus was evaluated by assessing disease experience as shown by history compared with the results of complement fixing or antibody titration tests, or both.

Pseudobattering of Vietnamese children (cao gio)

The case of a Vietnamese child who was subjected to the folk medicine practice of cao gio by his father after a routine dental extraction is described. The practice and the clinical appearance are discussed to distinguish it from child abuse.

A clinical trial of topically applied 3 percent vidarabine against recurrent herpes labialis

Seventy-six participants were enrolled in a clinical trial to determine therapeutic effectiveness of 3 percent vidarabine applied topically to recurrent perioral herpetic lesions. Following a 6- to- 12-month natural history phase, a 12-month clinical trial was conducted. Seventy participants developed 463 lesions during 361 episodes. Three percent vidarabine in a water-miscible gel was applied six times daily for 7 days to each lesion in the experimental group. Identically packaged placebo was used by the control group. Group assignment was by computer-generated randomization. Lesion size was reduced when vidarabine, rather than placebo, was applied. The difference was statistically significant (Student's t test, P = 0.02). Vesiculation followed tingling more rapidly when vidarabine, rather than placebo, was applied prior to vesiculation (P = 0.05). No significant difference between the two groups was found in episode frequency or lesion duration. Adverse reactions to vidarabine were not experienced.

Intravascular angiomatosis

For 55 years much has been written about a peculiar benign intravascular process which can be misdiagnosed as angiosarcoma unless careful attention is paid by the pathologist to its benign cellular morphology and growth pattern. The cases reported in the literature demonstrate an increased incidence in the extremities and the head and neck, with a propensity for the subcutaneous tissues of the perioral region. Four cases are presented to further point out the perioral incidence and emphasize the differential diagnostic criteria for benignancy, including intravascular proliferation without atypical mitotic activity and necrosis in areas devoid of vascular differentiation.

A virus-producing cell line developed by transformation of human parapharyngeal cells with SV40

Normal cultures of epithelial appearance were initiated by trypsinization of a surgically resected, histologically normal branchial cyst. Cellular morphology was consistent with derivation from the stratified squamous epithelium of the cyst or from vascular endothelium, although electron micrographs of the cultured cells failed to show any junctional complexes. Infection with SV40 produced transformants which were also epithelioid in appearance. These grew vigorously for 22 to 50 population doublings (about 23 to 32 subcultures, depending upon regimen) and then became quiescent. During this evolution, virus was detectable at all stages by both direct isolation (cell extracts) and cocultivation with permissive cells. In two sublines in which selection for rapidly growing cell types occureed, virus was detected only by cocultivation. The work confirms that of others in the finding that normal human epithelial cells are susceptible to transformation by oncogenic viruses, but are apparently less responsive than are fibroblasts to such transforming agents. It also suggests that subcultivation techniques that maintain the populations of transformed cells at low density tend to select against cell strains that are continous producers of infectious virus.

Herpes simplex virus types 1 and 2 in clinical infections: differences observed by electron microscopy

Microtubule-like structures have been observed ultrastructurally in BHK-21/4 cells infected with herpes simplex virus type 2 (HSV-2) but not in cells infected with herpes simplex virus type 1 (HSV-1). BHK-21/4 cells were infected with two known strains of HSV-2 and one known strain of HSV-1, as well as with vesicular fluid from 50 clinical isolates (47 perioral, two penile, and one from the leg) in an examination of the accuracy of electron microscopy for differentiation between clinical isolates of HSV-1 and HSV-2. Cells infected with the known strains of HSV-2 or with material from the genital or leg lesions demonstrated microtubule-like structures. Cells infected by a known strain of HSV-1 or by material from perioral lesions did not show evidence of microtubule-like structures. Typing by indirect hemagglutination of these same 50 clinical isolates gave identical results.

A clinical study for the control of facial mucocutaneous herpes virus infections. I. Characterization of natural history in a professional school population

One thousand thirty-one dental and dental hygiene students, faculty and staff at The University of Michigan School of Dentistry were interviewed in order to identify those with a past history of perioral mucocutaneous herpetic infection. Subsequently, the population was followed for 9 (+/- 3) months in order to determine various parameters of disease expression. Analysis of the results indicate the following: 1. In this professional population, 20.5 per cent described prior experience with perioral herpes. No sex difference was noted. 2. Prevalence increased with age. In the faculty-staff group (mean age 32.9 years +/ 11.8) prevalence was 30.7 per cent, whereas in the student -roup (mean age, io.6 years+/- 3.8) prevalence was 17.7 per cent. Occupational and/or socioeconomic factors did not appear to account for the age-related difference in prevalence. 3. Only 40 per cent of those who related prior disease experience developed lesions within the observation period of 9 (+/-3) months. 4. The recurrence rate, based upon an observation period of 9 (+/-3) months, in those persons who related prior disease experience was found to be 1.3 episodes per year (0.1 per month). 5. Duration of lesions ranged between 3 and 17 days, with a mean of 9 days. 6. The lower lip was the most common site of a lesion. 7. Triggering factors associated with development of a lesion in order of decreasing frequency were found to be; emotional stress, exposure to sun, and illness.