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The aim of the present investigation was to evaluate whether the subjective symptoms of dry mouth in long-term-surviving pediatric bone marrow transplant (BMT) patients are associated with low unstimulated salivary secretion rates (USSR) and with stimulated whole salivary secretion rates (SSSR).

A Portfolio of Qualifications for academic appointments at the Karolinska Institutet has been developed to define more clearly the competence and qualifications which are given high priority for academic appointments at the Karolinska Institutet. The major fields of application are for new appointments and promotions, providing guidelines for the individual for improving his/her proficiency, and as a basis for determining individual salary rates. Four portfolios have been developed, a pedagogical, a clinical, a scientific, and a leadership, development and workplace relations portfolio. Attached to the portfolios are assessment forms. We consider the Qualifications Portfolio to be a reflection of changes in attitudes and values at the Karolinska Institutet. The system offers a method for the recognition of faculty productivity in different dimensions. This may be beneficial for the university in view of the increasing diversity and complexity of academic institutions. The Qualifications portfolio can be obtained from the world wide web, (in Swedish), (in English).

Periodontal conditions and salivary levelsof Immunoglobulins slgA, IgM, and IgG subclass distribution and albumin, quantified by enzyme‐linked immunosorbent assay, were determined in 20 patients with Down syndrome and 19 healthy controls. Gingival inflammation was more extensive (P< 0.05) among Down syndrome subjects compared to controls as well as the occurrence of periodontal pockets (< 4 mm) (P< 0.05). The immunoglobuhn levels of slgA, IgM, the sum of IgG subclasses, and the concentration of albumin did not differ significantly between the 2 groups. However, the proportion of IgGl expressed as percentage of the sum of total IgG was significantly higher (P< 0.01) in the Down syndrome group compared to controls. On the contrary, the proportion of IgG2, IgG3, and IgG4 subclasses in saliva did not differ between the 2 groups. The results indicate an altered distribution of IgG subclasses in saliva, with a higher proportion of IgGl in Down syndrome individuals compared to controls. J Periodontol 1998;69:1119–1123.

Dahllöf G, Krekmanova L, Kopp S, Borgstrom B, Forsberg C-M, Ringdén 0. Craniomandibular dysfunction in children treated with total-body irradiation and bone marrow transplantation. Acta Odontol Scand 1994;52:99-105. Oslo. ISSN 0001-6357The prevalence of pain and dysfunction in the stomatognathic system was studied in a group of 19 long-term survivors after pediatric bone marrow transplantation (BMT), conditioned with total-body irradiation (TBI). Compared with the control group, the children and adolescents in the BMT group had a significantly reduced mouth opening capacity. A reduced translation movement of the condyles was diagnosed in 53% of children treated with TBI, compared with 5% in the control group. Signs of craniomandibular dysfunction were found in 84% of children in the BMT group, compared with 58% in the control group. Both irradiation and chemotherapy induce long-term alterations in connective and muscle tissues resulting in inflammation and eventually fibrosis. These changes in tissue homeostasis and concomitant growth retardation may lead to the observed malocclusion and reduced mobility of the temporomandibular joint, with subsequent muscle pain and headaches, which were found in this study.

Mononuclear cell populations were studied in gingival biopsy specimens from adolescents (n = 10) with at least one periodontal pocket with an increased probing depth (> 5 mm). The marginal bone loss was measured on radiographs, subgingival plaque samples were collected from the lesions, and the microbial flora was identified. Specimens from gingivitis lesions (n = 5) were used as controls. The mononuclear cell populations in the specimens were detected by using monoclonal antibodies defining functional T-lymphocyte subpopulations, B lymphocytes, and monocytes. All gingival specimens from patients with increased probing depth showed large lymphocyte infiltrates, most of which were CD 3-antigen-positive cells (T lymphocytes). Few (2%) infiltrating T cells expressed receptors for interleukin-2. B cells were detected in most specimens from the periodontitis group and varied from less than 1% to 21%. This study indicates that lesions in adolescents with early signs of periodontitis are characterized predominantly by T-cell lesions with relatively few cell aggregates of B cells present.

With the improving cure rate in childhood malignancies, increasing interest has been focused on the long-term survivors of childhood cancer and the quality of their life. The severity of long-term disturbances in dental and craniofacial development is dependent on the age of the child at diagnosis, if chemotherapy is combined with radiation or not. With regard to craniofacial development combination chemotherapy has no effects compared with healthy controls, whereas children treated cranial irradiation before 5 years of age exhibit a reduced growth of the mandible. Conditioning before bone marrow transplantation with total body irradiation results in a significantly reduced growth of the craniofacial skeleton. The mandible was four times more radiosensitive compared with the maxilla. With attention to the dental and craniofacial development, occlusion and craniomandibular function, children in risk groups should be followed, and given prophylactic treatment and intervention at appropriate times to reduce the consequences of the disease itself and the therapy given.

Cell attachment and spreading appear when a cell, on contact with an appropriate substratum, adheres and changes its shape and accommodates to the substratum. The transition from a non-spreading to a spreading state is a prerequisite for growth. Cell-free extracellular matrix (ECM) was produced by fibroblast-like cells from normal gingiva (N-ECM) and phenytoin-induced gingival overgrowth (PHT-ECM). The effect of the ECM on cell attachment and spreading of human gingival fibroblasts was studied in the presence of 2% serum. Within 30 min after seeding 40% of the normal fibroblast cells showed an advanced flattening on PHT-ECM-prepared dishes, compared with 10% on normal ECM-prepared dishes and 5% on uncoated plastic dishes. The results indicate that cells derived from PHT-induced gingival overgrowth produce an ECM with special properties, which could regulate cell functions such as cell attachment and spreading.

The effect of the major phenytoin metabolite 5-(parahydroxyphenyl)-5-phenyl-hydantoin (p-HPPH) was studied on cultures on human fibroblast-like cells grown out from explanted gingival biopsies. The explants were taken from children undergoing phenytoin medication. The results showed that the number of cells per culture decreased whereas the protein and DNA- contents remained relatively unaffected. This effect was most pronounced at the concentrations of 0.20 /μg/ml p-HPPH. The results indicate that the metabolite interfere with cell division without affecting protein or DNA synthesis.