Fear of injections and report of negative dentist behavior among Caucasian American and Taiwanese adults from dental school clinics.

Fear of injections and reports of negative dentist behavior and associations with dental anxiety and avoidance of treatment were explored among 951 adults from dental school clinics in Iowa City, Iowa and Taipei, Taiwan. Use and fear of anesthetic injections and negative dentist behavior were assessed by written questionnaire to test associations with demographics, overall dental anxiety (Dental Anxiety Scale or "DAS") and utilization behaviors. Frequency and logistic regression analyses showed that use of dental anesthetics for routine treatment was much greater overall among caucasian Americans than Taiwanese, as was fear of injections. Taiwanese and Americans with high dental anxiety (DAS 12) had similar high fear of injections, but inspite of similar fears about dental drilling, high anxiety Taiwanese reported using much less local anesthesia for routine treatments than did high anxiety Americans. Report of condescending remarks to patients ("put downs") by dentists was mainly an American phenomenon associated with high dental anxiety. Avoidance of appointment making was high for persons afraid of injections and for Americans reporting negative dentist behavior. Avoidance was highest in subjects with high dental anxiety. That predominant characteristics or etiologies of dental anxiety can differ by cultural differences in dental health care systems, dentist beliefs and/or expectations of patients within those systems was discussed in relation to the literature.

[Continuous monitoring of end-tidal CO2-tension in non-intubated patients]. / Kontinuerlig monitorering af sluttidal CO2-tension hos ikkeintuberede patienter.

We describe and evaluate a method for continuously monitoring end-tidal CO2 (PETCO2) in non-intubated, spontaneously breathing patients. In 18 ASA I patients scheduled for minor surgery a 3.3 mm (10 CH) soft plastic catheter was preoperatively inserted through one nostril placing the tip at the level of the epiglottis. In the recovery room a capnograph was connected to the catheter for monitoring PETCO2. We found no significant differences between arterial carbon dioxide tension (PaCO2) and PETCO2 obtained by the catheter (0.2 +/- 2.2 mmHg) or obtained by a maximal expiration through a mouthpiece (-0.8 +/- 2.8 mmHg). We tested the possibility of mixing expired air with supplementary oxygen via the other nostril at a flowrate of 15 litres min-1, and found no significant difference in PETCO2 with or without flow (0.0 +/- 0.9 mmHg). Values are mean +/- SD. In conclusion we find that this method allows accurate monitoring of PETCO2 in non-intubated, spontaneously breathing patients even at supplementary oxygen flow-rates of up to 15 litres min-1.

Human T-cell heterogeneity as delineated with a specific human thymus lymphocyte antiserum. In vitro effects on mitogen response mixed leukocyte culture, cell-mediated lymphocytotoxicity, and lymphokine production.

Human peripheral blood lymphocytes (PBL) were evaluated by their responses to phytohemmagglutinin (PHA-P), concanavallin A (con-A), and pokeweed mitogen (PWM), both before and after treatment with an antiserum against human thymic lymphocyte antigens (HTLA) that had been made T-cell-specific by multiple absorptions with immunoglobulin EAC-positive lymphoblast cell lines (B cells). Cells treated with HTLA were examined for their ability to react in a mixed lymphocyte culture (MLC) and to form killer cells in a cell-mediated lymphocytotoxicity (CML) system. Sensitized cells were also examined for their ability to respond to purified protein derivative (PPD) by blastogenesis, migration inhibitory factor release (MIP), and lymphotoxin (LT) production, both before and after treatment with HTLA and complement. The HTLA was in itself highly stimulatory to PBL. However, with the addition of complement and subsequent cell destruction, a marked decrease in its stimulatory response was noted. PBL treated with HTLA and complement exhibited marked inhibition of responsiveness to con-A with little decrease in PHA-P -OR PWM stimulation except at very high concentration of HTLA. MLC reaction was inhibited only when responder cells were treated with HTLA + C'. Treatment of stimulator cells with HTLA + C' did not significantly alter the MLC response. The HTLA + C'-treated cells failed to form killer cells in the CML reaction and inhibited PPD-induced blasto-genesis from PPD-sensitized individuals; however, treatment of sensitized cells with HTLA + C' had little effects on the release of MIF and LT. It is suggested that subpopulations of T-cells carry surface antigens that bind with this specific antisera, and that the con-A-responsive cells, the responder cells in the MLC, and killer T-cells comprise a separate subset from cells responding to PHA-P or PWM, OR THE MIF-and LT-producing cells.