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The authors report on 5 patients, 4 of them observed over a period of only two months in one community hospital, who developed profound sinus node suppression in the early phase following acute strokes. This complication resulted in the death of 2; in the remaining 3, it was controlled by electrical cardiac pacing or intravenous atropine. In 3 patients, the strokes were due to subarachnoid hemorrhage, and in 2, they were secondary to vascular occlusion. In at least 4 patients, the prognosis seemed favorable from a neurologic standpoint. Vagally mediated sinus node arrest may, therefore, represent a potentially fatal complication of strokes and may be more frequent than currently appreciated. Continuous monitoring in the early phase of acute strokes and pacemaker therapy may be lifesaving in some patients. This and the general phenomenon of functional failure of the sinus node due to a variety of causes are discussed.

A technique for fabrication of a model to aid in teaching surgical management and suturing is presented. The model, which simulates dentition, supporting periodontium, and gingival soft tissue, can be made inexpensively in a dental laboratory.

Reference values for urinary D-glucaric acid and the influence of sex, age and smoking habits were evaluated with a low-pH enzymatic method. D-Glucaric acid measured on spot urine samples from 573 healthy subjects gave mean concentrations (mumol/1) and D-glucaric acid/creatinine ratios (mmol/mol creatinine) of 56.1 (+/- 22.9) and 3.05 (+/- 0.99) for males and 53.3 (+/- 20.9) and 3.35 (+/- 0.95) for females. No difference between morning and evening was observed for urinary D-glucaric acid/1 values, but D-glucaric acid/creatinine was higher in the evening samples for both sexes. There was a negative correlation between D-glucaric acid/1 values and age in males but not in females: the decrease of D-glucaric acid concentration was, however, quantitatively very small. Smoking produced a significant increase in D-glucaric acid concentration and in the D-glucaric acid/creatinine ratio for males and also partially for females.

Scanning electron microscopy was used to examine factory-sharpened, dulled, and resharpened scalers. The following observations were made: 1. The factory sharpened scalers exhibited metallic extensions from the lateral surface (wire edges). 2. The machine-resharpened instruments resulted in nonfunctional wire edges from the facial surface. Honing produced an exact meeting of facial and lateral surfaces. 3. Hand sharpening, using an Arkansas stone (grit 500) against the lateral surface away from the cutting edge, effected an exact meeting of the facial and lateral surfaces and no evidence of wire edges. 4. From this study an optimum cutting edge for a scaler is characterized as having a smooth, contiguous meeting of the facial and lateral surfaces free of wire edges. If a wire edge is present, it should be functional.