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Intraoral radiographs are widely used in periodontal diagnosis and research. However, accurate radiographic interpretation is only possible with high quality images. Some of the technical and geometric variables to consider have been presented. Early periodontal lesions are not detected in radiographs. The amount of periodontal destruction in more advanced disease is generally underestimated. The accurate topography of periodontal pockets and the buccal and lingual aspects of the teeth cannot be visualized. Clinical probing is therefore a prerequisite for a complete periodontal diagnosis. However, radiographs are a valuable adjunct for the periodontal diagnosis and the diagnosis of trauma from occlusion. With standardized systems, radiographs may furnish additional quantitative data in clinical research.

From our retrospective review of 30 patients having hepatic resection, we have made the following conclusions: (1) Hepatic resection is an uncommon procedure. (2) The majority of liver injuries require only drainage or suture ligation and drainage. (3) Midline incision, early arterial occlusion, and resectional debridement should be used for massive liver trauma. (4) Resection for tumor requires preoperative arteriography, transverse incision, and anatomic resection. (5) Wide irrigation with drainage is used after liver resection. (6) Reperitonealization of raw liver should be done. (7) Postoperative support should include administration of blood products, glucose, and albumin.

Leiomyosarcoma is a malignant tumor which rarely occurs in the rectum. Three patients with leiomyosarcoma of the rectum are presented. Treatment should include wide surgical excision followed by adjuvant chemotherapy. Emphasis is placed upon computerized tomography as the method of choice for the diagnosis of recurrent disease. Recurrent tumor should be resected whenever possible.

Prostaglandin H synthase (PHS), an arachidonic acid-dependent peroxidase, has been implicated in the peroxidative activation of carcinogenic aromatic amines in extrahepatic carcinogen target tissues of experimental animals. We have examined the arachidonic acid-dependent activation of [3H]benzidine to DNA-bound products by microsomal preparations from 75 normal human tissues obtained during necessary surgical procedures. For several samples of urinary bladder epithelium, prostatic epithelium, colonic mucosa, and peripheral lung tissue, an arachidonic acid-dependent, microsomal-catalyzed activation of benzidine was observed; and the activity could be inhibited appreciably by indomethacin, a known inhibitor of PHS. Little or no arachidonic acid-dependent activity was detected in human placenta, breast, or liver microsomes or the majority of colon microsomes. Substrate specificity was also examined with purified ram PHS and with human bladder and with active colon preparations. Purified PHS catalyzed the activation of benzidine much greater than 2-naphthylamine, 2-amino-6-methyldipyrido[1,2-alpha:3',2'-d]imidazole greater than 4-aminobiphenyl greater than 2-amino-3-methylimidazo[4,5-f]quinoline greater than 3-amino-1-methyl-5H-pyrido[4,3-b] indole. In comparison, human bladder and colon microsomes catalyzed the activation of benzidine greater than 4-aminobiphenyl, 2-amino-6-methyldipyrido[1,2-alpha:3',2'-d]imidazole, 2-naphthylamine greater than 2-amino-3-methylimidazo[4,5-f]quinoline, 3-amino-1-methyl-5H-pyrido[4,3-b]indole. To confirm the occurrence of PHS antigen in human extrahepatic tissues, an avidin/biotin-amplified competitive enzyme-linked immunoabsorbent assay was developed with purified ram PHS and a commercially available monoclonal antibody known to cross-react with human platelet PHS. The avidin/biotin-amplified enzyme-linked immunosorbent assay, which detected ng quantities of ram PHS, clearly established the presence of the PHS protein in human bladder, prostate, and lung microsomes. In contrast, PHS antigen was not detected in the liver or placental microsomes. The interindividual and tissue-dependent variability of PHS and its role in aromatic amine carcinogenesis are discussed.

To plan a dental care program for geriatric patients, the dental treatment needs of 219 elderly patients consecutively admitted to a geriatric hospital were quantitatively assessed. Of 89 patients with residual teeth, 97.8% were assessed as needing dental treatment of a mean projected duration of about 312 min per patient. Of the 130 edentulous patients, 30.8% needed dental treatment of a mean projected duration of about 194 min per patient. Patients exhibiting high (greater than 60 min) dental treatment needs were more frequently impaired in activities of daily living than patients with low (less than or equal to 60 min) dental treatment needs (e.g. impaired transfer function 60.2% vs. 28.0%). There was no difference in the oral hygiene or in the cleanliness of removable dentures between patients needing and not needing help in activities of daily living. In conclusion, the present results show a high amount of dental treatment needed in elderly patients. For the planning of an effective dental care program, special attention has to be paid to the interdisciplinary treatment of patients with limitations in activities of daily living. Furthermore, the improvement of the oral hygiene status is of paramount importance in most elderly patients.

The introduction of digital subtraction radiography for the evaluation of standardised dental radiographs offered increased diagnostic accuracy in the detection of subtle density changes over interpretation of conventional radiographs. The digital imaging techniques for the analysis of dental radiographs were reviewed with emphasis on periodontal diagnosis. Recently, these methods, which have been extensively tested in vitro, were applied to clinical trials for the assessment of alveolar bone density changes due to progression of disease or healing following therapy.