[Reconstruction of the mandible using a vascularized graft from the iliac bone]

Twelve vascularized iliac crest free-tissue transfers were used for oromandibular reconstruction, 2 as osteocutaneous and 10 as osseous flaps. Two patients had preoperative radiotherapy. Nine of the 12 reconstruction were carried out primarily, following radical surgery for oral cancer. One graft was lost by venous thrombosis. Evidence of bone union was noted in 11 patients, and no pseudoarthrosis was observed. The main advantage of this method is the availability of a large bloc of living composite tissue and both the functional and cosmetic results should be improved in patients undergoing resection of the anterior part of the mandible.

[Use of an osteo-musculo-cutaneous flap from the trapezius muscle for the immediate restoration of a mandibular defect following surgery for cancer of the oral cavity]

The authors state their experiences using trapezius osteomusculocutaneous flaps in 22 clinical patients for primary reconstruction of mandibular defects. The additional investigative study examines the anatomy of 100 osteomusculocutaneous flaps in 50 fresh cadavers. 78 percent of the major vascular pedicle arose form the thyreocervical trunk. The advantages of this method are as follows: 1. This flap provides a well-vascularized bone graft; 2. The operation comparing to other bone grafting methods is simple; 3. After radical neck dissection the trapeziu muscle protects the carotid artery; 4. The vascularized bone graft can be used after irradiation; 5 Good functional and esthetic results can be obtained.

Influence of tissue acidification and halothane anesthesia on hepatic electrical and biochemical properties during ischemia

In order to further corroborate the recent findings on liver ischemia after perfusion with solutions containing an additive of heptanol, that the intraischemic loss of cell-to-cell communication in protected livers can be detected by electrical impedance measurement (1), we tried to induce uncoupling in porcine liver by tissue acidification applying acidified protective solutions. Moreover, the effects of preischemic inhaling of high concentrations of the decoupling anesthetic halothane were examined in unprotected ischemic livers (2-5). Electrical impedance, biochemical analyses, and pH measurements were applied in parallel. In addition, typical time courses of impedance parameters of unprotected liver and skeletal muscle were compared, because the latter is devoid of gap junctions. In spite of overlapping side-effects of the respective uncoupling measure, the results suggest that the loss of cell-to-cell communication in the liver is associated with measureable effects on the electrical impedance.

Heptanol effects on protected livers

Heptanol, an agent known for inducing closure of gap junctions in a variety of organs, was used to evaluate the influence of uncoupling on the electrical impedance of livers during ischemia. Heptanol was added to a modified HTK solution or to Belzer's UW-CSS solution. Livers of swine were then perfused for 8 min with either one of the solutions containing heptanol or a solution devoid of this additive. During the following ischemia the phase angle of impedance at 5 kHz, pH and different biochemical parameters were determined. Heptanol fundamentally changed the time course of impedance and made the otherwise characteristic fast increase of the phase angle of impedance disappear. Already early during ischemia the phase angle was raised in a dose-dependent manner up to even highest values at the beginning of the whole observation period in case of a fully developed effect. Heptanol also stimulated anaerobic energy turnover. The results suggest that, besides unspecific effects, heptanol induces uncoupling which is detectable by electrical impedance measurement.

[The condition of the permanent teeth of students 15 to 17 years of age in secondary schools in Csongrád County]

The teeth of altogether 1253 students studying in 38 secondary educational establishments of the County of Csongrád have been examined. The number of the examined amounts in case of the 15 years old to 13.51% and in case of the 17 years old to 8.8% of the total number of youth of similar age living in the County. The caries frequency is 98.95% at the age of 15 years, and 98.78% at the age of 17 years. The DMF-T index is 10.35 for the 15 years old, and 10.93 for the 17 years old. With respect to the DMF-T indices found with people of the same year in Szeged in 1961 the present data are higher by 39.11% (15 years old) and by 29.66% (17 years old), respectively.

T cell responses to a Parietaria judaica pollen extract: comparison between Parietaria-sensitive patients, other atopics and healthy controls

We investigated the in vitro proliferation of peripheral blood mononuclear cells (PBMC) from Parietaria-allergic subjects, atopic patients with other sensitizations and healthy controls to Parietaria judaica pollen extracts. PBMC from almost all 44 subjects, divided into five groups (Parietaria-, grass-, Parietaria and grass-, Dermatophagoides-sensitive patients and normal individuals) were able to proliferate in response to the extract without statistically significant differences between groups. Mean values of the stimulation indexes for the five groups were respectively: 10.73, 3.18, 5.50, 10,56, 9.28. The results of separation experiments showed that the responding cells were T lymphocytes. Mitogenic effect of the Parietaria pollen extract was excluded by the absence of proliferative PBMC response from cord blood of seven newborns. These results indicate that Parietaria-sensitive, other atopics and normal individuals have Parietaria-specific T cells able to proliferate in vitro to Parietaria allergens.

[Clinical wear of posterior composites]

In our days, Posterior Composites are in the way to replace the traditional and well established materials, such as the amalgam, from the region of the posterior teeth. As time passed however, the first problems connected with these materials were soon to appear. If composites must be used in posterior teeth for occlusal bearing fillings, wear is an important consideration and stands as one of the main problems concerning these materials with serious clinical consequences for the restoration as well as for the occlusion. It is difficult to give an answer to the question concerning the resistance or the behavior of the Posterior Composites to the wear mechanisms. There is no doubt that with the continuous improvement of the Posterior Composites there is also an improvement in the degree of wear. Therefore the purpose of this bibliographical review is to examine the phenomenon of wear and the mechanisms which cause it. We will deal mainly with the clinical study of this phenomenon, while we will also try to explain the behavior from the viewpoint of the wear of the various types of Posterior Composites which are in use today.

[Danazol in the treatment of menometrorrhagia in patients with mitral prosthesis treated with warfarin]

The difficulty in the treatment of patients undergoing Warfarin therapy for mitral stenosis, is underlined and cases treated with Danazol in sideropenic anaemia caused by menometrorrhagia are reported.

Reconstructing the rate of appearance of subcutaneous insulin by deconvolution

In this paper a deconvolution scheme is presented to reconstruct the rate of appearance of subcutaneously injected insulin. Relevant aspects of experiment design are briefly described. Intravenous insulin kinetics are modeled to determine the impulse response of the system. The deconvolution problem is not ill conditioned and is solved using a least-squares method without imposing constraints on the input. An estimate of the error of the reconstructed input is provided. The reliability of the deconvolution scheme is tested by means of an independent validation study. Finally, the different sources of error that affect the method are discussed, and a figure of the global error is derived.

An epidemiologic study of mandibular dysfunction dependence on different variables

Age and sex characteristics of different signs and symptoms of mandibular dysfunction were studied in 600 randomly selected urban persons. With regard to mandibular mobility marked differences were observed between the sexes, and a steady decrease parallel with ageing. Against this, the percentages of the objective dysfunction signs of impaired mobility and TMJ-sounds, as well as those of the pooled percentages of all the objective signs (Di-I + II + III), increased parallel with ageing. The percentages of headache occurrence peaked in different age groups for men and women. Statistically significant correlations were found between headache, parafunctions, stress, age, the existence of a preferred chewing side, as well as several dental-occlusal factors, and the prevalence of mandibular dysfunction; between Ai and Di according to Helkimo, and between excessive tooth wear and parafunctions.

Non-steady state: error analysis of Steele's model and developments for glucose kinetics

The model proposed by Steele (Ann. NY Acad. Sci. 82: 420-430, 1959) to compute rates of appearance and disappearance in non-steady state is subjected to theoretical analysis. It is shown that this model introduces an error with two components, one dependent on the volume of the compartment, the other related to the complex configuration of the system. The errors depend on the time course of specific activity, change differently with time, and may take the opposite sign but they do not, in general, cancel each other. Corollaries of this analysis are the following: there is no single pool-fraction value satisfactory under all non-steady-state situations; keeping tracer specific activity as constant as possible during the experiment minimizes both errors; and non-steady-state analysis demands proper modeling of the system. Tracer experiments were carried out in five normal volunteers. Plasma [3-3H]glucose concentration was first brought to equilibrium by means of a primed constant 2-h infusion, and then the steady state was perturbed by a 2-h euglycemic insulin (1 mU X min-1 X kg-1) clamp, realizing a transition between a basal and a euglycemic hyperinsulinemic steady state. These data were analyzed with Steele's equation, the two compartment models of Radziuk et al. [Am. J. Physiol. 234 (Endocrinol. Metab. Gastrointest. Physiol. 3): E84-E93, 1978], and a new model based on a study on glucose kinetics carried out in the two steady states separately. Steele's equation yielded negative values for hepatic glucose production already 40 min into the clamp and throughout the study. The average value of glucose production during the 2nd h was -0.88 mg X min-1 X kg-1; the suppression of basal release over the 2-h period was 115%. In contrast, the new model calculated a mean glucose production of 0.37 mg X min-1 X kg-1 during the 2nd h and an overall suppression of 62%; no negative values were obtained.