Vasoactive intestinal polypeptide (VIP), a neuropeptide with possible neurotransmitter function, was demonstrating in nerves of dental pulps of several mammals including man. The VIP containing nerves were observed around blood vessels and as single terminals in the pulpal stroma. In view of the potent vasodilatory actions of VIP it is conceivable that pulpal VIP nerves take part in the regulation of local blood flow.

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Abstract. A factor IX concentrate, prepared by modifications of the method of Tullis and with the supernatant of fraction 1‐0 as a base material, has become available in Sweden. The factor IX activity of the concentrate is about 20 times that of an equivalent volume of normal plasma. The factor IX concentrate, altogether 226 bottles, has been given to 18 patients with haemophilia B in connection with major and minor surgical procedures (7 patients) and bleeding episodes such as joint bleeding, renal bleeding and large haematomas. After injection abnormal bleeding was arrested and the surgical procedures could be performed without any haemorrhagic complications. The factor IX activity in vivo ranged from 16 to 69% (average 38%) of the in vitro activity of the concentrates administered. The half‐life of the injected factor IX was about 20 hours. A dose of 10–16 units per kg b.wt. is recommended for raising the factor IX level to 16–20% and a dose of 30–40 units per kg b.wt. for raising it to at least 40%. Four patients developed hepatitis, but otherwise no side‐reactions were seen.

In vitro tissue culture has shown that plasminogen activators are released both from normal and from pathological mucous membrane in the oral cavity. Immunological study (Ljungnér et al 1983) has shown that the plasminogen activators in the mucosa of the mouth are not urokinase in character. Increased local fibrinolytic activity, causing post‐operative bleeding, is a serious complication in patients with hemophilia or other bleeding disorders. The occurrence of pathologically increased local fibrinolytic activity can be prevented and the risk of post‐operative bleeding reduced by the administration of epsilon‐amino‐caproic acid (EACA) or tranexamic acid (AMCA). In 72 hemophilia patients, from whom 191 teeth were extracted, satisfactory results were achieved with but a simple dose of factor VIII and IX per patient in combination with the administration of tranexamic acid. In connection with oral surgery in a number of paitents with mild hemophilia A or mild von Willebrand's disease, the synthetic vasopressin derivative DDAVP has been used instead of factor concentrate. In connection with tranexamic acid, it enabled teeth to be extracted without any post‐operative bleeding complications.