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This article demonstrates the noninvasive means of correction of gummy smile and deep bite by using mini-implants in a relapsed patient. Intrusion of the maxillary arch was achieved by using mini-implants in the anterior and posterior region. Significant reduction in the gingival and incisal display was seen with improved smile esthetics and ideal overbite and overjet by the end of the treatment. The aim of the article is to present a case where gummy smile was effectively treated by mini-implants without undergoing invasive surgical procedures.

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AIMS: To evaluate three tests used routinely for the diagnosis of herpes simplex virus (HSV) keratitis. METHODS: Corneal scrapings from 28 patients with clinically typical dendritic corneal ulcer suggestive of HSV keratitis, and 30 patients with clinically non-viral corneal ulcers, were tested by (i) Giemsa stain for multinucleated giant cells, (ii) immunofluorescence assay (IFA) for HSV-1 antigen, and (iii) polymerase chain reaction (PCR) for HSV-1 DNA, by investigators masked to clinical diagnosis. The control subjects were also investigated by smears and cultures for bacteria, fungus, and Acanthamoeba. RESULTS: The specificity and positive predictive values of all three tests for the diagnosis of HSV keratitis were between 95-100%. The sensitivity of IFA and PCR was 78.6% and 81.2%, respectively, and the difference was not significant; however, their sensitivity and negative predictive value were significantly higher than Giemsa stain. CONCLUSIONS: While a combination of IFA and PCR constitute the choice of tests in clinically suspected cases of HSV keratitis, multinucleated giant cells in Giemsa stain can pre-empt testing by IFA and PCR in otherwise atypical cases of HSV keratitis.

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Wegener's granulomatosis is characterized by a granulomatous arteritis involving the upper and lower respiratory tracts, progressive glomerulonephritis and systemic symptoms attributable to small vessel vasculitis. Although multisystemic manifestations are frequent, involvement of the gastrointestinal tract is uncommon. Cases have been reported of intestinal perforation, ulceration and hemorrhage. A patient whose initial presentation of Wegener's granulomatosis was odynophagia secondary to esophageal vasculitis is described. Endoscopy revealed multiple punched out ulcerations in the esophagus, which resolved with standard therapy for systemic Wegener's granulomatosis. There are only two previous reports of symptomatic esophageal vasculitis in patients with Wegener's granulomatosis. These reports illustrate the need to consider odynophagia as a reflection of disease activity as opposed to complications of immunosuppressive therapy.

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Crohn's disease can be acute. If proper diagnosis is not made and appropriate therapy instituted, morbidity and mortality can be high. A team approach with cooperation between gastroenterologists and surgeons is mandatory.

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Hemolytic anemia is a relatively common complication after the replacement of cardiac valves with mechanical prostheses; the prevalence rate varies from 38% to 85%, depending on the prosthesis implanted. However, cardiac valves fabricated from biologic material are associated with a reduced incidence of hemolytic anemia, and to the authors' knowledge this report is the first to document hemolytic anemia in a patient who had the mitral valve replaced with an Ionescu-Shiley valve. The anemia was not associated with evidence of hemodynamically important mitral regurgitation and was ultimately controlled by iron and folate supplements.

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The effects of radioactive iodine in acute as well as fractionated doses on male germ cells were studied. 131I in four acute doses of 10, 15, 20 and 25 microCi was given intraperitoneally. For fractionated doses, 12.5 microCi was given twice with an interval of 24 h. A dose relationship was exhibited between the concentration of radionuclide and the survival fraction of type A spermatogonia, intermediate and type B spermatogonia and preleptotene spermatocytes. The maximum depletion was recorded after 25 microCi. The survival values for this dose group were 40.4, 51.4, and 25.0% for type A cells, intermediate and type B cells and preleptotene spermatocytes, respectively. Fractionated doses of radioiodine also reduced the survival rate of gonadal cells and are more effective than 20 microCi acute dose in decreasing the survival fraction of all types of gonadal cells.

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The proliferation parameters of the Walker carcinoma were estimated from both in vivo and in vitro measurements. tthe transplantable Walker carcinoma 256 was grown in male inbred BD1 rats. During exponential growth, 5--6 days after transplantation, a PLM curve was performed, yielding estimates of TC approximately equal to 18-0 hr, TS approximately equal to 6-4 hr, TG2+M approximately equal to 4-1 hr. With the double labelling technique in vitro under 2-2 atm oxygen we obtained: TC approximately equal to 18-2 hr, TS approximately equal to 8-2 hr, TG2+M approximately equal to 2-0 hr. From pulse cytophotometry DNA content histograms the fractions of cells in the cell cycle phases were calculated using a computer program: fG1 approximately equal to (47-6 +/- 1-1)%, fS approximately equal to (34-1 +/- 1-0)%, fG2+M approximately equal to (18-3 +/- 1-5)%. These fractions remained constant between the fifth and the twelfth day after transplantation. At that time the tumour growth had already slowed down appreciably. The growth fraction determined by repetitive labelling was 0.96 on the fifth and 0-93 on the seventh and eleventh day. The cell loss factor was phi approximately equal to 17% during exponential tumor growth and increased to about 100% between the tenth and twelfth day. The agreement of the cell kinetic data determined by autoradiography from solid tumours in vivo (PLM, continuous labelling) and autoradiography as well as pulse cytophotometry from in vitro experiments (excised material) was satisfactory.

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The influence of three chemotherapeutic agents, acronycine, bleomycin and cytosine arabinoside, alone and combined with radiation, on cell cycle progression and viability of L-cells was examined. The percentages of cells in G1, S and (G2 + M)-phases as derived from pulse cytophotometric DNA distribution patterns were recorded as a function of exposure time. After 24-h treatment with 10 microgram/ml acronycine, 46.4% of cells were accumulated in (G2 + M)-phase compared to 12.1% in the controls. This accumulation was significantly enhanced by an irradiation with 150 rads of X-rays resulting in arresting 63.1% of cells in this phase. Similar findings were obtained after a 24-h treatment with 100 microgram/ml bleomycin. 54.4% of cells were arrested in (G2 + M)-phase by the chemical treatment alone, while the combined treatment, bleomycin and radiation, yielded an accumulation of 66.3% of cells in G2 + M. A 24-h exposure to 0.2 microgram/ml cytosine arabinoside (Ara-C) produced a reversible block of 72.8% of cells in S phase compared to 27.4% in the control cultures. This S block was less pronounced after the combined treatment (51.1%). Some implications of the results for combined therapy are discussed.

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Cell doubling time, DNA distribution pattern, frequency distribution of chromosome numbers per cell and degree of synchrony obtained after mitotic selection were studied in 4 different sublines of mouse fibroblast cells, NCTC L-929, in culture. The 4 sublines did not differ with respect to their cell kinetic data but showed changes of the chromosome pattern compared to the stemline and compared to each other suggesting that chromosome analysis provides a very sensitive means to detect evolutianary changes of a permanent cell line.

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Dissecting aneurysm of the descending thoraic aorta (type iii) is a specific disease process whose pathogenesis, pathologic description, surgical treatment, and prognosis is different from dissections of the ascending arota (types l and ll). From 1964 through 1974, 91 patients underwent surgical correction of type iii dissection. The operative mortality was 21% and late mortality, up to ten years follow-up, was 13%. During the past four years, operative mortality has dropped to 6.5%. Mortality was determined by extent of the aneurysm and underlying cardiac disease. Antihypertensive and negative ionotropic drugs have not been used as definitive treatment but as adjuncts in perioperative support. Based on our present mortality of 6.5%, with no late mortality, we urge early surgical treatment of acute and chronic dissecting aneurysms of the descending thoracic aorta before extension, rupture, or massive enlargement of the aneurysm occurs.

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Thiourea in three different concentrations ranging from 10-4-M to 10-2-M was employed in pre- and post-treatments to test whether it decreases the chromosomal fragment frequency induced by 1000 R of X-rays in the growing root tips of Hordeum vulgare. In pre-treatment experiments thiourea in 10-2-M concentration yielded the maximal protection of 28.9 percent against radiation- induced chromosomal fragments. In post-treatment approximately a similar rate of protection is secured. It is discussed that the test-chemical protected the chromosomes against X-rays by two different mechanisms. The recovery process by restitution of the broken chromosomal fragments and the protection against initial radiation damage were the possible protective mechanisms displayed by thiourea in this plant material.

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