Closed versus open debridement of facial grade II molar furcations.

Clinical responses of facial grade II molar furcations to closed (C) versus open (O) debridement were evaluated. 25 teeth were treated at baseline (BL) with scaling/root planning (S/RP) and evaluated at 4 months. 12 of the teeth were then treated with open flap debridement and the remaining teeth were treated with further S/RP. Clinical parameters of plaque, gingival inflammation, bleeding on probing, gingival fluid flow, pocket depth and probing attachment level were taken at BL, 4, 7, 10, 13 and 16 months. Pairwise differences were determined between visits and a t-test was applied to differences for C and O. For both treatment groups, the greatest changes in clinical parameters occurred from BL - 4 months. Plaque and gingival inflammation showed a gradual reduction from BL throughout the study for both groups. A reduction in pocket depth from BL - 16 months was noted in both groups (mid-furcal, C = 1.5 mm, O = 1.2 mm; root prominence, C = 1.02 mm, O = 0.84 mm)! There was a gain in probing attachment level in the midfurcal area for the C group (0.6 mm) while the O group lost (-0.46 mm). There were no statistically significant differences found for any clinical parameter between closed and open debridement. The presence of plaque and bleeding at a furcal site had not significant effect on treatment response.

Continuous postoperative epidural analgesia for gynecologic oncology patients.

The efficacy of continuous postoperative epidural analgesia (CPEA) was assessed in 193 patients who collectively underwent 254 gynecologic oncology procedures. Seventy-five patients elected to receive CPEA; 118 did not. The CPEA patients received an epidural catheter the morning of surgery. Postoperatively, a bolus of meperidine was placed in each catheter. An IVAC pump continued to deliver meperidine at the rate of 14 to 20 mg per hour. The 193 patients also received a total of 655 postoperative intramuscular narcotic injections. CPEA patients were three times less likely to request injections, and those who did required an average of 6.58 compared with 12.42 for non-CPEA patients. The presence or absence of CPEA was the only significant variable. The use of CPEA led to no secondary complications, and it greatly enhanced mood and ability to participate in postoperative care. We conclude that CPEA provides excellent postoperative analgesia for such high-risk patients.

The use of immunocytochemical techniques for the detection of steroid hormones in breast cancer cells.

Indirect immunofluorescence and immunoperoxidase assays were developed to detect estradiol and progesterone in breast cancer cells. Appropriate controls were used to confirm immunologic specificity. Studies of estradiol binding by human breast cancer cells identified three groups: no detectable binding (25%); all tumor cells exhibiting binding although to different degrees (4%); and tumors with varying numbers of positive and negative cells (71%). Similar observations were made with respect to progesterone binding. The percentage of cells with estradiol binding was correlated with the amount of estrogen receptors (ER) present in the tumor specimens. Post-hormone binding events e.g., nuclear binding of estradiol, were also evaluated. Some tumor cells showing cytoplasmic binding of estradiol did not show nuclear binding of estradiol; such tumors lacked detectable diethylstilbestrol under routine assay conditions, and relatively high concentrations of estradiol were needed to observe estradiol-specific staining. The results suggest that the immunocytochemical assays detect hormone-specific binding, but that the binding is probably due to multiple classes of steroid-binding sites.