Biomedical subjects
Publications and source records attributed to M M Ferguson.
The patient who was followed had a persistent painful condition of the side of her face. Following a total parotidectomy, the symptoms presevered and this was ultimately diagnosed as being due to sialadenitis in the accessory parotide gland as well.
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Ten female patients with a history of recurrent aphthous lesions for at least 5 years with the lesions occurring regularly in the latter half at the menstrual cycle were treated with progestogen in the form of an intramuscular depot injection. Medroxyprogesterone acetate and gestronol hexanoate was used. All 10 patients were satisfied with the treatment; the side effects were few.
1. The value of progestogen therapy in the prevention of postmenopausal bone loss was assessed in 30 women, by a preliminary randomized controlled trial of gestronol or mestranol, in comparison with a placebo. 2. When the skeletal response was measured by photon absorptiometry, bone mineral loss was prevented by both the oestrogen and the progestogen. 3. We confirm that mestranol significantly reduced the urinary output of hydroxyproline-containing peptide, but this did not occur during gestronol therapy, suggesting that progestogen has a different action on bone, perhaps stimulating bone formation.
A series of 330 patients with recurrent aphthae was screened for deficiencies of iron, folate and vitamin B12. In 47 patients (14.2%) such deficiencies were found; 23 were deficient in iron, seven in folic acid, six in vitamin B12 and in addition 11 patients had combined deficiencies. Clinical examination of the aphthae was not helpful in identifying individual patients with a nutritional deficiency although patients with an associated glossitis or angular cheilitis were more likely to suffer from such deficiencies. Screening of the patients by examination of their peripheral blood alone (estimation of haemoglobin and absolute values, and blood film examination) detected only a proportion of those with deficiencies of iron or folic acid, although in this series such screening was able to identify the small number of cases with vitamin B12 deficiency. The 33 patients with a proven nutritional deficiency who were available for follow-up showed a favourable response to corrective therapy; 23 showed a complete remission of ulcers, 11 were improved and five were not helped. The significance of these findings is discussed. It is suggested that the results indicate the need for full haematological screening of all patients with recurrent aphthae.
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A technique for sialography has been developed which gives reproducible radiographs. By employing a constant infusion pump to deliver 0.2 ml of contrast medium per minute the patient does not experience pain and glandular detail is not obscured due to overfilling. Aqueous and oily contrast media may be used satisfactorily but there is greater latitude in times of exposure with the aqueous media.
A retrospective study of 108 patients was carried out to investigate the possible relationship between infection of the mouth with Candida albicans and blood levels of iron, folic acid and vitamin B12. The patients were separated into two groups--those with hyperplastic and those with atrophic candidal lesions--and compared with separate control groups. Twenty-one patients had chronic hyperplastic candidosis and seven were iron deficient. Comparison with an age- and sex-matched control group showed the differences to be significant only at the p less than 0.1 level. Seven of the patients with hyperplastic lesions had folic acid deficiency and the difference between patients and controls was statistically significant (less than 0.05). However, no significant differences in iron or folic acid deficiency were noted between 87 patients with atrophic candidosis and 65 conttrols, and vitamin B12 deficiency was not statistically significant for either the hyperplastic or the atrophic group. It is concluded that deficiency of iron, folic acid or vitamin B12 alone does not promote growth of Candida albicans on the oral mucous membrane but that in some susceptible individuals, iron or folic deficiency may facilitate epithelial invasion by hyphae of Candida albicans.
The use of ultrasonography in the diagnosis of soft tissue lesions is described and exemplified in a 33-year-old female with a cystic hygroma in the submandibular region.
Sialography was carried out in healthy volunteers and in patients with Sjögren's syndrome. A comparison was made between xeroradiography and conventional radiography. Superior images were obtained with xeroradiography and this technique also tended to reveal glandular structure which was obscured by overlying bone when using conventional radiography. In addition to this, there was considerably greater latitude in exposure and the skin dose of radiation using xeroradiography was slightly less.
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A series of 130 consecutive outpatients with recurrent aphthous stomatitis were screened at the oral medicine department, Glasgow Dental Hospital, for deficienciesin vitamin b12, folic acid, and iron. In 23 patients (17.7%) such deficiencies werefound; five were deficient in vitamin B12, seven in folic acid, and 15 in iron. Four had more than one deficiency. Out of 130 controls matched for age and sex 11 (8.5%) were found to have deficiencies. The 23 deficient patients with recurrent aphthaewere treated with specific replacement therapy, and all 130 patients were followed up for at least one year. Of the 23 patients on replacement therapy 15 showed complete remission of ulceration and eight definite improvement. Of the 107 patientswith no deficiency receiving local symptomatic treatment only 33 had a remission or wereimproved. This difference was significant (P less than 0.001). Most patients withproved vitamin B12 or folic acid deficiency improved rapidly on replacement therapy;those with iron deficiency showed a less dramatic response. The 23 deficient patientswere further investigated to determine the cause of their deficiencies and detect the presence of any associated conditions. Four were found to have Addisonian perniciousanaemia. Seven had a malabsorption syndrome, which in five proved to be a gluten-induced enteropathy. In addition, there were single patients with idiopathic proctocolitis, diverticular disease of the colon, regional enterocolitis, and adenocarcinoma of thecaecum. We suggest that the high incidence of deficiencies found in this series andthe good response to replacement therapy shows the need for haematological screening of such patients.
11beta-hydroxysteroid dehydrogenase (11beta-HSD) was studied in intracellular components of the rat submandibular salivary gland. The difficulty in retaining 11beta-HSD activity during fractionation was overcome by using soybean trypsin inhibitor. Relatively pure subcellular particles were obtained by altering the initial centrifugal speeds used for the various fractions. 11beta-HSD was found to have its main activity in the crude nuclear fraction of the gland. Pure nuclei were isolated by centrifuging the crude nuclear fraction through 1.8-M sucrose at high speed, and these were found to retain the major enzyme activity. It was hypothesized that 11beta-HSD may influence genetic expression processes in salivary gland, but further work will have to be undertaken to investigate this possibility.
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