Quantitation of targets for PCR by use of limiting dilution.

We describe a general method to quantitate the total number of initial targets present in a sample using limiting dilution, PCR and Poisson statistics. The DNA target for the PCR was the rearranged immunoglobulin heavy chain (IgH) gene derived from a leukemic clone that was quantitated against a background of excess rearranged IgH genes from normal lymphocytes. The PCR was optimized to provide an all-or-none end point at very low DNA target numbers.

Rapid method for detecting monoclonality in B cell lymphoma in lymph node aspirates using the polymerase chain reaction.

Aims: To use the polymerase chain reaction to detect monoclonality at the immunoglobulin heavy chain gene locus in cells derived from lymph node aspirates.

Methods: A nested two-stage polymerase chain reaction (PCR) for the VDJ region of the immunoglobulin heavy chain gene was used to detect monoclonality. The total number of cells available for diagnosis by PCR in lymph node aspirates was between 10(4) and 10(5).

Physical evaluation of the patient.

The physical evaluation of the patient before and during anesthesia and sedation is assuming an ever greater importance with the advent of sophisticated and reliable monitoring devices. This paper reviews the possible methods of evaluation and describes the types of mechanical monitors most suited to the dental office.

Management of an emergency: to be prepared for the unwanted event.

Every dental office needs an adequate emergency treatment structure. While theoretical and practical pregraduate education in emergency medicine is included (in differing degrees) in the curricula of dental schools throughout the world, postgraduate training is generally undertaken on a voluntary basis. Repeated training in emergency techniques is encouraged for the dentist and dental office staff, as the trained and coordinated action of the whole team in the dental office is necessary when an emergency occurs.

How safe is dental anesthesia?

In the United Kingdom, the number of general anesthetics given under the National Health Service in general dental practice (excluding those given in hospitals) has declined steadily during the past 10 years. The mortality rate has also declined from approximately 1 in 200,000 (1952) to 1 in 2,000,000 (1990). These figures include deaths that occurred following treatment in hospitals and are divided almost equally between anesthetics given in hospitals and those given in dental practices.

Local anesthesia: a review.

Local anesthetics are the most widely administered drugs in dentistry. Significant advances have been made in past decades that have greatly increased both the safety and the efficacy of these important drugs. This paper reviews the history of local anesthesia, pharmacokinetics and clinical implications, techniques, complications, and future directions in the quest for more effective pain control in dentistry.

Detection and quantitation of neoplastic cells in acute lymphoblastic leukaemia, by use of the polymerase chain reaction.

We report a simple and robust method for sensitive quantitation of leukaemic cells in acute lymphocytic leukaemia. Chain determining region 3 (CDR3) of the immunoglobulin heavy chain gene is a precise genetic marker for a patient's leukaemic clone. Quantitation of the leukaemic lymphocytes was achieved by use of the polymerase chain reaction to detect CDR3 at limiting dilution of DNA samples.

Risk factors and operative mortality in surgery for colorectal cancer.

The operative mortality rate after surgery for colorectal carcinoma remains significant. A series of 578 patients has been studied prospectively. The features which most significantly affect operative mortality are the age of the patient, a history of loss of weight, limited preoperative patient mobility and the presence of intestinal obstruction with perforation of the bowel.

Does training reduce the incidence of industrial hand injuries?

The incidence of industrial hand injuries remains high despite the introduction of statutory measures and other advances in health and safety awareness. A prospective study was undertaken to determine if training before employment helps to reduce these injuries. A significant number of patients did not receive any training and this may have played a part in their injury but other contributory factors, such as human error, must also be taken into consideration.

The versatility of the free fibula flap in the management of traumatic long bone defects.

The free fibula flap has been used to treat ten patients with important long bone defects (mean length 14 cm) following severe trauma. Defects in all the long bones of the limbs have been treated by this technique. Five free osseous and five osteocutaneous flaps were performed.

Pollicisation of the index finger in congenital anomalies. A retrospective analysis.

Between 1977 and 1988, 30 pollicisations were performed on 22 children with hypoplasia or aplasia of the thumb. A review was undertaken to grade the results. 73% were graded good or excellent, 17% fair and ten % poor.

A method of assessment of pollicisation.

The evaluation and comparison of results of pollicisation for different pre-operative conditions is difficult as no standard method exists. An assessment is proposed, based upon tip pinch, opposition, pulp pinch, grasp, mobility, sensitivity and cosmetic appearance which gives a numerical score.

Surgery in a district general hospital.

All operations performed in all surgical specialties in a district general hospital over a 4-week period were monitored. Although most elective operations were performed or supervised by trained staff, the service, particularly emergency care, was heavily dependent on incompletely trained doctors. Consultants, who operated on 41% of elective cases, were more likely to perform major operations.

Ingrowing toenails: studies of segmental chemical ablation.

Recent studies have suggested that segmental ablation is the treatment of choice for patients with ingrowing toenails and that the success rate is 96%. This procedure has been common practice among chiropodists for 20 years, usually using phenol in the United Kingdom, and sodium hydroxide in the United States. However, there has been little critical evaluation of the relative merits of the two chemicals, of the period of chemical application, or of the duration of post-operative pain and healing time.

Detection of autoantibodies to ribosomal P protein using recombinant autoantigen in a quantitative immunoassay.

Antibodies to ribosomal P proteins are markers for systemic lupus erythematosus (SLE) but are often missed by assays utilizing routine immunofluorescence or immunoprecipitation. Expression of autoantigenic sites encoded by complementary DNA (cDNA) clones offers an inexpensive source of antigen for use in quantitative immunoassays. Using a monospecific ribosomal P positive serum to screen a human placental lambda gt11 expression library, a cDNA clone was isolated which reacted with all anti-P human sera tested.