Biomedical subjects
Publications and source records attributed to T H Morton.
Metastasis of a tumor to the jaws can simulate an infection, but the presence of paraesthesia and loose teeth or inadequate response to treatment should alert the clinician to a more serious cause. A malignant melanoma metastatic to the jaws illustrates these points.
A variety of olfactory capacities were evaluated in H.M., a patient with bilateral medial temporal lobe resection. He demonstrated normal performance on a battery of tests of odour detection, discrimination of intensity, and adaptation. In striking contrast, H.M. was unable to discriminate or identify odours in same-different discriminations and in matching-to-sample tasks. Although he could name common objects using visual or tactile cues, he could not identify them by smell. These results indicate that the perceptual phenomena of odour detection and discrimination are dissociable by cerebral damage, and that structures in the medial temporal lobe play a critical role in odour discrimination.
Whole saliva samples and lip biopsies were collected from 12 allogeneic bone marrow transplant recipients who developed extensive chronic graft-versus-host disease (GVHD) and from 10 healthy allogeneic and syngeneic recipients without GVHD. Six of ten biopsies from patients with chronic GVHD had lichenoid stomatitis or sialadenitis, or both, with sialodochitis. Seven of nine biopsies from patients free of chronic GVHD were entirely normal, and two had either mild glandular or mucosal changes. Salivary gland involvement in chronic GVHD was associated with decreased or absent levels of salivary IgA and inorganic phosphate, decreased salivary flow rates, and increased concentrations of salivary sodium, albumin, and IgG. The most striking abnormalities were found in patients with histologic evidence of sialadenitis. In contrast, marrow transplant recipients without chronic GVHD had normal salivary immunoglobulin and electrolyte levels. Secretory IgA deficiency may contribute to the frequent sinobronchial infections observed in patients with chronic GVHD.
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Tiger salamanders (Ambystoma tigrinum) were trained to respond to two dissimilar odorants (i.e., cyclohexanone, dimethyl disulfide) but not to a third odorant (n-butanol). When the training criterion was met, the animals were anesthetized and given nasal lavages of saline or odorants in saline. Lavage with cyclohexanone decreased responding to cyclohexanone but not dimethyl disulfide, and vice-versa, in later behavioral tests. Likewise, ethyl acetoacetate lavage produced selective response decrements to cyclohexanone. Lavage with n-butanol had no effect on responding to presentations of either cyclohexanone or dimethyl disulfide. The effects of lavage increased with increasing odorant concentration. Thus, lavage with 0.05 M cyclohexanone or ethyl acetoacetate produced more persistent response decrements than lavage with 0.01 M concentrations of either odorant. Such results are consistent with several testable interpretations, including the possibility the response decrements could reflect the nature of odorant-receptor interactions.
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When a clinician is confronted with an apical radiolucent lesion he must follow an organized thought process and diagnostic technique prior to therapy. This technique employs the collection of data, called the diagnostic data base, and radiographic data. The diagnostic data base and radiographic data combined with the results of the vitality tests will provide the clinician with an appropriate working diagnosis. If the data support a diagnosis of radiolucent lesion associated with a nonvital tooth then endodontic therapy should be provided and the patient should be seen on a routine follow-up basis. Dr. H. M. Worth has most elequently summarized the responsibilities of the clinician as follows: "The endodontist cannot content himself with sufficient knowledge to deal with apical infections only, for he encounters a great number of diseases; it is necessary for him to be reasonably well informed on the radiographic appearances of most of the abnormalities and diseases that occur in the jaws."
Women were tested for sensitivity to several odorants at ovulation and menstruation. Three involatile esters (pentadecalactone, coumarin, and cinnamyl butyrate) predicted by gas chromatographic data to be strongly retarded by the olfactory mucus showed similar significant changes in sensitivity. By contrast, a more volatile ester (amyl acetate) predicted to diffuse more readily though the mucus showed no such changes. This suggests that variations in olfactory sensitivity observed between ovulation and menstruation depend on odorant volatility and thus may result from peripheral mechanisms limiting the access of odorant molecules to the olfactory receptors.
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Characteristics of a mandibular infected cyst are unique, including: the young age of the patient; involvement of a caries-free, vital mandibular molar; buccal periostitis; and radiographic preservation of the continuity of the apical lamina dura. Histologic findings in this case confirmed the diagnosis.