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Clinical studies of experimental human vitamin B complex deficiency
Abstracts
and Reviews
lG.5
Hereditary Edema of the Legs (Milroy’s Disease), Associated With Other Congenital Anomalies : By William A. Rosenberg, M.D., Arch. Dermat. and Xyph. 42: 113, 1940. Rosenberg reports a case of hereditary edema of the legs in which among other congenital anomalies, the lower incisor and canine deciduous teeth had falIen out and had never been replaced with permanent teeth. The two upper first deciduous incisors had remained as baby teeth until extracted.
Visit to the Nutrition
Clinic, Hillman
Hospital,
Birmingham,
Ala., June 15,
1940: By R. M. Wilder, Proc. XtafF iVeetings, Mayo Clinic, Rochester, Minn. 16: No. 4, June 22,1941. Wilder visited the clinic of Dr. T. D. Spies and found that some twenty physicians and scientists who were interested in this field were working under the direction of Doctor Spies. Approximately 400 visits are made by patients every week and pellagra can be seen in practically all its manifestations. In almost all cases of pellagra, deficiencies other than that of nicotinic acid could be demonstrated, and indeed, except for the characteristic pellagrous lesion of the exposed skin and the fiery redness of the tongue, it may be questioned whether the symptoms associated with pellagra are attributable to deficiency of nicotinic acid. The evidences of riboflavin (vitamin B?) deficiency consist of the typical cheilosis, cracking of the skin at the corners of the mouth. Wilder reports that a curious vascularity of the gums, especially at the position of the mandibular incisors is seen in many patients with pellagra. A dentist attached to the staff considered it to be a diagnostic early sign of pellagra. The same dentist commented that he had studied the teeth of forty-five pellagrous children for caries and although the children were all at the age, between six and sixteen years, when caries are prevalent, he had found only one cavity per month. Many of these children also gave evidence of deficiency of both thiamin and riboflavin. It thus appears that the principal factors of the vitamin B complex have little to do with the prevention of caries. T. J. Cook.
Clinical
Studies of Experimental
Human Vitamin
B Complex Deficiency:
K. O’Shea Elsom, hI.D., F. H. Lewy, M.D., and 0. W. Heublein, J. Med. SC. 200 : 757-764,194O.
By M.D., Am.
The authors, by a carefully controlled experiment, were able to observe and have described the clinical signs and alterations in function attributable to vitamin B complex deficiency. The volunteer, a healthy woman, voluntarily consumed a constant daily quantity of a weighed diet which was adequate in protein, fat, carbohydrate and t,otal calories and was supplemented with optimal amounts of vitamins A, C, and D and of iron and calcium. Thiamin was present in approximat,ely one-third the individual’s minimal requirement as calculated by the Cowgill formula. It was assumed that other members of the vitamin B complex were correspondingly reduced. The subject was examined daily and a record kept of symptoms and physical signs. Of dental interest is
the note that mild soreness of the tongue was an occasional complaint and mental symptoms formed a striking part, of t,he clinical picture. This same volunteer was studied in 1933, when little of the vitamin B complex was known, and at that time, glossitis and neurologic abnormalities were prominent, while in 1938 though present, they were comparatively mild. T. J. Cook. Surgical Treatment of Roentgen and Radium Dermatitis: By R. K. Ghormley, M.D., Section on Orthopedic Surgery, YYOC.Staff Xwtings, MWJO Clinic 16: No. 5, Jan. 29, 1941. Roentgen dermatitis is a potentially malignant lesion and although a malignant lesion develops in only a part of the instances of rocntgen and radium dermatitis, the incidence is so high as to make adequate treatment imperative in all cases, particularly those in which ulceration is present. They have found wide excision followed by a skin graft of some type to be the best treatment in their hands. Of fifteen amputations, eleven were fingers, seven of the fifteen were performed for squamous-cell epithelioma on a basis of complicated roent.gen derlnatitis. T. J. Cook.
Malignant
Tumors
pedic Surgery,
of Bone: Poe.
By H. W. Meyerding, M.D., Section on Ortho5’tn.f Heetings. M~!Jo Clinic 16: No. 5, Jan. 29, 1941.
Four hundred and twenty-four patients sufferin g from primary malignant tumors of bone were studied. Half were osteogenic sarcomas ; more than a fourth were Ewing’s sarcomas ; less t,han 10 per cent were fihrosarcomas ; about 10 per cent were multiple myelomas; less than 2 per cent were giant-cell sarcomas (malignant) ; and t,here were less than 2 per cent concerning which a nonsurgical diagnosis of sarcoma had been made. More than two-thirds of the patients were males and less than a t,hird were females. The majority of tumors occurred in young patients and a positive history of trauma was elicited from about four of every t,en patients. T. J. Cook.
Cancer of the Face: Plastic Surgery,
By G. 13. New, M.D., Section of Laryngology, P1-oc. Stnf Meetings, Nnyo Clinic 16: No. 5, Jan.
Oral and 29,
1941.
Complete primary removal of cancer of t,he face, regardless of the a.pparent inactivit,y of the lesion, is essential in order to prevent the marked deformities that result from the late removal of recurring disease. Surgical diathermy for removal of malignant lesions of the face gives the most uniformly good results of any treatment that has heen employed. By means of present-day plastic surgery, reconstruction of dcfect,s following removal of a. malignant, lesion makes the patient appear near enough t)o normal so that he can continue his work and his social activities. T. J. Cook.
and Reviews
lG.5
Hereditary Edema of the Legs (Milroy’s Disease), Associated With Other Congenital Anomalies : By William A. Rosenberg, M.D., Arch. Dermat. and Xyph. 42: 113, 1940. Rosenberg reports a case of hereditary edema of the legs in which among other congenital anomalies, the lower incisor and canine deciduous teeth had falIen out and had never been replaced with permanent teeth. The two upper first deciduous incisors had remained as baby teeth until extracted.
Visit to the Nutrition
Clinic, Hillman
Hospital,
Birmingham,
Ala., June 15,
1940: By R. M. Wilder, Proc. XtafF iVeetings, Mayo Clinic, Rochester, Minn. 16: No. 4, June 22,1941. Wilder visited the clinic of Dr. T. D. Spies and found that some twenty physicians and scientists who were interested in this field were working under the direction of Doctor Spies. Approximately 400 visits are made by patients every week and pellagra can be seen in practically all its manifestations. In almost all cases of pellagra, deficiencies other than that of nicotinic acid could be demonstrated, and indeed, except for the characteristic pellagrous lesion of the exposed skin and the fiery redness of the tongue, it may be questioned whether the symptoms associated with pellagra are attributable to deficiency of nicotinic acid. The evidences of riboflavin (vitamin B?) deficiency consist of the typical cheilosis, cracking of the skin at the corners of the mouth. Wilder reports that a curious vascularity of the gums, especially at the position of the mandibular incisors is seen in many patients with pellagra. A dentist attached to the staff considered it to be a diagnostic early sign of pellagra. The same dentist commented that he had studied the teeth of forty-five pellagrous children for caries and although the children were all at the age, between six and sixteen years, when caries are prevalent, he had found only one cavity per month. Many of these children also gave evidence of deficiency of both thiamin and riboflavin. It thus appears that the principal factors of the vitamin B complex have little to do with the prevention of caries. T. J. Cook.
Clinical
Studies of Experimental
Human Vitamin
B Complex Deficiency:
K. O’Shea Elsom, hI.D., F. H. Lewy, M.D., and 0. W. Heublein, J. Med. SC. 200 : 757-764,194O.
By M.D., Am.
The authors, by a carefully controlled experiment, were able to observe and have described the clinical signs and alterations in function attributable to vitamin B complex deficiency. The volunteer, a healthy woman, voluntarily consumed a constant daily quantity of a weighed diet which was adequate in protein, fat, carbohydrate and t,otal calories and was supplemented with optimal amounts of vitamins A, C, and D and of iron and calcium. Thiamin was present in approximat,ely one-third the individual’s minimal requirement as calculated by the Cowgill formula. It was assumed that other members of the vitamin B complex were correspondingly reduced. The subject was examined daily and a record kept of symptoms and physical signs. Of dental interest is
the note that mild soreness of the tongue was an occasional complaint and mental symptoms formed a striking part, of t,he clinical picture. This same volunteer was studied in 1933, when little of the vitamin B complex was known, and at that time, glossitis and neurologic abnormalities were prominent, while in 1938 though present, they were comparatively mild. T. J. Cook. Surgical Treatment of Roentgen and Radium Dermatitis: By R. K. Ghormley, M.D., Section on Orthopedic Surgery, YYOC.Staff Xwtings, MWJO Clinic 16: No. 5, Jan. 29, 1941. Roentgen dermatitis is a potentially malignant lesion and although a malignant lesion develops in only a part of the instances of rocntgen and radium dermatitis, the incidence is so high as to make adequate treatment imperative in all cases, particularly those in which ulceration is present. They have found wide excision followed by a skin graft of some type to be the best treatment in their hands. Of fifteen amputations, eleven were fingers, seven of the fifteen were performed for squamous-cell epithelioma on a basis of complicated roent.gen derlnatitis. T. J. Cook.
Malignant
Tumors
pedic Surgery,
of Bone: Poe.
By H. W. Meyerding, M.D., Section on Ortho5’tn.f Heetings. M~!Jo Clinic 16: No. 5, Jan. 29, 1941.
Four hundred and twenty-four patients sufferin g from primary malignant tumors of bone were studied. Half were osteogenic sarcomas ; more than a fourth were Ewing’s sarcomas ; less t,han 10 per cent were fihrosarcomas ; about 10 per cent were multiple myelomas; less than 2 per cent were giant-cell sarcomas (malignant) ; and t,here were less than 2 per cent concerning which a nonsurgical diagnosis of sarcoma had been made. More than two-thirds of the patients were males and less than a t,hird were females. The majority of tumors occurred in young patients and a positive history of trauma was elicited from about four of every t,en patients. T. J. Cook.
Cancer of the Face: Plastic Surgery,
By G. 13. New, M.D., Section of Laryngology, P1-oc. Stnf Meetings, Nnyo Clinic 16: No. 5, Jan.
Oral and 29,
1941.
Complete primary removal of cancer of t,he face, regardless of the a.pparent inactivit,y of the lesion, is essential in order to prevent the marked deformities that result from the late removal of recurring disease. Surgical diathermy for removal of malignant lesions of the face gives the most uniformly good results of any treatment that has heen employed. By means of present-day plastic surgery, reconstruction of dcfect,s following removal of a. malignant, lesion makes the patient appear near enough t)o normal so that he can continue his work and his social activities. T. J. Cook.