LongoVital in the treatment of Sjögren's syndrome.

OBJECTIVE: Sjögren's syndrome (SS) is a chronic autoimmune disease complex of unknown aetiology. There is no curative treatment for SS, however, in recent years the influence of nutrients on autoimmune processes has attracted increasing attention. LongoVital (LV) (DK. Reg. No. 5178/75) is an herbal-based tablet enriched with the recommended daily doses of vitamins. The purpose of the present study was to investigate whether 4 months' daily intake of LV as compared to placebo would affect clinical and laboratory disease parameters in patients with SS. METHODS: Forty patients with SS participated in a placebo-controlled, double-blind, randomised, clinical, 8 month cross-over study. Group A (n = 22) received LV during the first 4 months and Group B (n = 18) LV during the last 4 months. RESULTS: The unstimulated salivary flow rate increased during the LV period in Group A (p < 0.001). The stimulated salivary flow rate increased in Group B during the LV period (p < 0.05), and in Group A during the subsequent 4 months on placebo (p < 0.05). The rose bengal score decreased in Group B during (p < 0.01) and in Group A after the LV intake (p < 0.05). During the last 4 months of the study both groups showed an increase in serum levels of alpha-amylase (total: Group A, p < 0.01; Group B, p < 0.05; pancreatic fraction: Group A, p < 0.0001; Group B, p < 0.01) and in serum levels of IgM (Group A and B: p < 0.001), while levels of circulating immune complexes decreased (Group A, p < 0.05; Group B, p < 0.001). CONCLUSION: It is concluded that LV has a beneficial and prolonged effect on some of the clinical and immunoinflammatory disease markers in SS.

Malignant melanoma of the conjunctiva: occurrence and survival following surgery and radiotherapy in a Danish population.

PURPOSE: To describe patient characteristics, risk of recurrence, and survival in patients with premalignant and malignant melanocytic lesions of the conjunctiva. METHODS: In a retrospective study, 55 cases with a minimum follow-up of 10 years were reviewed. RESULTS: The actuarial 5-and 10-year survival rates were 86% (95% Cl: 76-96%) and 73% (95% Cl: 60-87%) respectively. The 5-year risk of local recurrence was 35% (95% Cl: 21-49%), and the 10-year risk was 43% (95% Cl: 28-58%). Primary acquired melanosis with atypia was the first manifestation in 13 cases, malignant melanoma in 42 cases. No significant difference in survival and recurrence was found between the two groups or by gender, location of primary lesion, histological characteristics, or extent of surgical procedure. A minimum incidence of 0.052 cases a year per 100 000 in Denmark was calculated. CONCLUSION: The results are estimated to represent a nationwide sample of patients. No prognostic factors of significance were identified.

Conjunctival naevi in Denmark 1960-1980. A 21-year follow-up study.

The clinicopathological characteristics of 343 naevi of the conjunctiva were studied. A significant increase in the number of naevi excised per annum was observed. This may have been caused by an increased exposure to actinic rays. Approximately even distribution in the three main locations: caruncle, limbal area and eyeball, was found. Intrastromal naevi were excised at a higher median age than compound naevi, and the lowest observed median age at excision was for junction naevi, which is in accordance with the known histopathological nature of naevi. Recurrence occurred in nine patients (2.7%), and one transformed to a malignant melanoma. Eight of the recurring naevi were located in the limbal area. Eight of the nine patients were women, suggesting hormonal factors as a possible cause. Recommendations for the handling of conjunctival naevi are given, based on the present findings and on previous reports.

Validity of the radiographic assessment of ankylosis. Evaluation of long-term reactions in 10 monkey incisors.

The accuracy and sensitivity of radiographic assessments of reactive processes in dental tissues were evaluated by comparison of radiographs and histologic sections. Experimental lesions inflicted on the roots of 10 monkey incisors had been observed by means of serially obtained radiographs over a period of 315 to 370 days. The material was used for evaluation of radiographic assessment of ankylosis. For comparative purposes, assessment of the experimental lesion penetrating to the pulp and periapical radiolucency was added. True and falsely positive or negative recordings formed the basis for calculation of the accuracy and sensitivity of the radiographic assessment. The sensitivity, or the observers' ability to detect the actual changes, was high for pulp penetration, intermediate for inflammation, and low for ankylosis.

Experimental transplantation of teeth to simulated maxillary alveolar clefts.

A total of 14 teeth were transplanted to simulated alveolar clefts in 5 monkeys. Autogenous cancellous bone was grafted to the cleft together with the tooth in ten instances. Healing processes were observed 216 or 271 days postoperatively. Another group of four teeth were transplanted in the cleft areas 133 days after bone grafting. These teeth were observed for 138 days before sacrifice. Radiological and histological findings support previous reports on adverse effects to dental tissues when placed in direct contact with fresh transplanted bone. Root resorption and ankylosis occurred to a large extent. Establishment of a normal periodontal membrane could, however, be observed when the tooth was transplanted to an area grafted 4 months previously. An interval before tooth transplantation allowing the cancellous graft to organize and bone to remodel seems to be indicated.

HIV and hepatitis B infection in an international cohort of dental hygienists.

The risk for dental hygienists to contract HIV and hepatitis B infection at work was studied in an international cohort of 167 dental hygienists from 13 countries. A significant proportion of the hygienists had taken care of HIV-positive patients or patients known to be at risk for contracting HIV infection. None of the hygienists had antibodies to HIV. Five hygienists who came from or worked in high-endemic areas for hepatitis B infection had antibodies to hepatitis B core antigen, consistent with previous infection with hepatitis B virus. The study is in agreement with previous reports on blood-borne infections among health care workers, concluding that the risk for dental hygienists of contracting HIV and hepatitis B infection is minimal.

Results following reduction mammaplasty as evaluated by the patients.

Reduction mammaplasty was performed on 365 patients using the technique of Pers and Bretteville-Jensen. Two to 13 years after the operation, the patients were asked to complete questionnaires; the answers were analyzed and compared with answers from a smaller group of patients who had undergone surgery with McKissock's technique. Primary complications to the procedure were few, and it is remarkable that total necrosis of the nipple was absent in the series. More than 80% of the patients had their general expectations fulfilled, but one third in both groups found the resulting scars unacceptable. The character of the scars seems to be more important than the location. Primary complications were more frequent in overweight patients, and preoperative weight regulation is recommended. An improvement in the character of scars after reduction mammaplasty would be beneficial, and detailed preoperative information is essential if postoperative disappointment is to be avoided.

Acquired immune deficiency syndrome (AIDS)--complications in dental treatment. Report of a case.

Acquired immune deficiency syndrome (AIDS) is a new disease which has recently alerted the medical world. AIDS may also concern dental practitioners and oral surgeons who may be the first to suspect impairment of immunity in patients presenting opportunistic oral infections. Extraordinary resistance to treatment of dental infections, such as encountered in a 27-year-old man developing AIDS, could also be a sign of immunodepression. Epidemiological features of AIDS indicate transmissibility, and interim recommendations for prevention of spread correspond to the measures appropriate for hepatitis B.