An investigation into the effect of axillary surgery on ipsilateral axillary sweating--a pleasing 'complication' or a potential treatment for hyperhidrosis?

Although there had not been complaints of excessive sweating pre-operatively, it was noticed incidentally that a large proportion of patients who had undergone axillary lymph node sampling or clearance for breast carcinoma seemed to report ipsilateral sweat loss as a pleasing 'complication'. We interviewed 65 consecutive patients who had all had axillary dissections performed by the same surgeon's technique; the interviews were held 2-102 months after their operations. In 36 cases, patients reported no change in axillary sweating (mean 35 months), whereas 29 patients reported a decrease (mean 50 months). This result was statistically significant at the 95% confidence interval (p=0.022).

Effects of 4-wk training using Vmax/Tmax on VO2max and performance in athletes.

PURPOSE: The aim of this study was to determine the effects of a 4-wk individualized training program using Vmax as the exercise intensity and utilizing between 60 and 75% of a subject's Tmax as the exercise duration. METHODS: Five male, middle-distance, trained subjects with the following characteristics (mean +/- SD): age, 22.8 +/- 4.5 yr; height, 181 +/- 4.7 cm; weight, 74.1 +/- 3.2 kg; skinfolds based on five areas, 35.9 +/- 3.9; and VO2max, 61.5 +/- 6.1 mL O2 x kg min(-1) volunteered to participate in this study. Before the training program, the subjects completed a 3000-m time trial, and three each of VO2max/Vmax and Tmax tests. Subjects then completed a 4-wk training program on the treadmill and were then retested on the VO2max/Vmax and Tmax tests. RESULTS: Pretraining versus posttraining results showed significant (P < 0.05) increases in average Vmax (20.5 km x h(-1) vs 21.3 km x h(-1) posttraining), Tmax (225.5 s vs 300.9 s posttraining), and VO2max (61.5 mL O2 x kg x min(-1) vs 64.5 mL O2 x kg x min(-1)). The 3000-m time trial decreased significantly from a pretraining value of 616.6 s to a posttraining value of 599.6 s (P < 0.05). CONCLUSIONS: The results of this study indicate that by utilizing between 60 and 75% of Tmax as an exercise duration and using Vmax as an exercise intensity that these two parameters can be extremely valuable in the prescription of exercise programs for athletes.

Testing of Streptococcus pneumoniae for resistance to penicillin.

The increasing prevalence of penicillin-resistant Streptococcus pneumoniae requires antibiotic susceptibility tests that can be done with greater ease and reliability. We measured the MIC of penicillin for pneumococci by the tube macrodilution method with Mueller-Hinton broth (MHB), Haemophilus Test Medium (HTM), Todd-Hewitt broth with 0.5% yeast extract (THY), and MHB with 3% lysed horse blood (LHB). Eight (19%) and 6 (14%) of 42 pneumococcal isolates failed to generate turbid growth in MHB and HTM, respectively, whereas all pneumococcal isolates did so in THY and LHB. For those strains that replicated to turbidity, the mean MICs of penicillin were lower in MHB and HTM than in THY and LHB, with differences being significant (P < 0.05) for comparisons with LHB. Four isolates appeared to be penicillin susceptible in HTM but were actually moderately resistant in THY and LHB, and two isolates appeared to be moderately resistant but were resistant. A similar failure to detect resistance was seen with MHB. S. pneumoniae ATCC 49619, a moderately penicillin-resistant strain that has been proposed for quality control testing, gave variable results in MHB or THM and appeared to be susceptible to penicillin in some assays, whereas the MICs for S. pneumoniae ATCC 49619 in THY or LHB fell within a twofold dilution range, with geometric means of 0.16 and 0.18 micrograms/ml, respectively. Pneumococcal isolates thus may appear falsely susceptible to penicillin when tested in MHB or HTM. LHB remains the standard medium; however, because THY is an easily prepared clear medium that can be used in automated systems and appears to yield results similar to those obtained with LHB, THY deserves consideration for routine use.

Rigid endosseous implant utilized as anchorage to protract molars and close an atrophic extraction site.

A two-stage endosseous implant, placed in the retromolar area of the mandible was utilized as rigid anchorage to translate two molars 10-12 millimeters mesially into an atrophic endentulous ridge. Despite substantial anchorage demand over a three year period, the endosseous implant remained rigid ("osseointegrated"). At the end of treatment the implant and adjacent, intravitally labeled bone were recovered. Microradiographic and polarized light analyses revealed that about 80 percent of the endosseous portion of the implant was in direct contact with mature lamellar bone. Bone labels demonstrated a remarkably high remodeling rate (about 30 percent/year) for cortical bone within 0.5 millimeter of the interface. Continuous remodeling may be the long-term mechanism whereby loaded implants resist bone fatigue and maintain "osseointegration." Clinical use of orthodontic implants, placed outside the dental arches, requires careful attention to soft tissue management.

Restructuring of mainstream sociometry with learning disabled and nonhandicapped students.

Sociometric ratings assigned by and to 50 elementary school students with learning disabilities and 50 nonhandicapped elementary school students (in matched pairs) were compared in this study. In addition, traditional sociometric status applied to social impact and social preference was also examined. Results showed that the matched pairs did not differ significantly in assigned status to their peers, but differed significantly in acceptance and rejection received from their shared classmates. Students with learning disabilities and nonhandicapped students differed significantly in social preference, but not in social impact.

Changing perceptions of the requirements of cavity preparations.

Perceptions of the requirements of cavity preparations have changed over the years. These have had a significant effect on undergraduate teaching at the University of Bristol Dental School, an explanation of which may help general dental practitioners in their quest for information on this important aspect of dental practice. A method is described for teaching undergraduate dental students cavity preparation in caries-free teeth, based upon the position, shape and extent of imaginary carious lesions. Scale diagrams of teeth are used, on which imaginary caries at the amelodentinal junction has been marked. The students are instructed to apply the principles of cavity preparation to equivalent, but caries-free, teeth in the laboratory. 'Outline forms' and other predetermined cavity shapes are not taught. Dental practitioners may find it appropriate to apply similar thinking to cavities they prepare in everyday practice, in an endeavour to avoid the unnecessary removal of tooth tissue that would be better retained.

Rigid endosseous implants for orthodontic and orthopedic anchorage.

Clinical rigidity ("osseointegration") was achieved by 94 percent of the titanium implants placed in dog mandibles. All loaded implants remained rigid. Inadvertent impingement on the periodontal ligament and roots of adjacent teeth was uneventful. Microradiographic imaging was more reliable than polarized light microscopy for assessing bone contact at the endosseous interface. Implants with less than 10 percent of the endosseous interface in direct contact with bone successfully resisted a continuous load of 3 N (greater than 300 grams) for 13 weeks.

Acute necrotizing ulcerative gingivitis in a case of systemic lupus erythematosus.

Presented is an unusually severe case of acute necrotizing ulcerative gingivitis (ANUG) in association with systemic lupus erythematosus (SLE), in which the patient was observed to slough a considerable amount of attached gingival tissues and eventually to lose a number of teeth and supporting bone. The usual limited and treatable nature of ANUG is reviewed, and attention is directed to the mechanisms by which SLE and therapeutic amounts of steroids can contribute to the increased severity of the oral disease.

Noma. Report of two cases.

Noma is an infectious process involving the oral cavity and occasionally other structures. It is characteristically a childhood affliction, and it never occurs in healthy persons. Conservative treatment in debriding facial lesions greatly enhances reconstructive efforts.