Cd-Fe interactions: comparison of the effects of iron deficiency and cadmium on growth and photosynthetic performance in poplar

To check the importance of Cd-induced iron deficiency in Cd stress, symptoms of Cd stress were compared with those of iron deficiency or the combination of these two stresses. Poplar plants grown in hydroponics with Fe-EDTA (e) or Fe-citrate (c) up to four-leaf stage were treated for two weeks either by the withdrawal of iron (Fedef), or supplying 10 μM Cd(NO3)2 in the presence (Cad) or absence of an iron source (Fedef + Cad). Cadmium and iron content of leaves developing under the stress was in the order of cCad > eCad > cFedef + Cad and cCad ≈ eFedef ≈ cFedef + Cad < eCad < cFedef, respectively. Growth inhibition was much stronger in Cad than Fedef plants. The inhibitory effects on CO2 fixation, maximal and actual efficiency of PSII, chlorophyll synthesis, as well as the stimulation of the accumulation of violaxanthin cycle components and increase in non-photochemical quenching were the strongest in cFedef+Cad plants, otherwise these parameters changed parallel to the iron deficiency of leaves. Tendency of changes in thylakoid composition were similar under Cad treatments and strong iron deficiency: particularly PSI and LHCII decreased. Therefore, the development of the photosynthetic apparatus under Cd stress was mainly influenced by the Cd-induced strong iron deficiency, while leaf growth was affected primarily by the presence of Cd.

Increased platelet activation and decreased fibrinolysis in the pathogenesis of aseptic necrosis of the femoral head

Thrombotic events, increased tendency toward intravascular thrombosis and decreased fibrinolysis seem to be possible pathologic causes for aseptic necrosis of the femoral head (ANFH) in adults. This project was to study whether either increased platelet activation or decreased fibrinolytic activity and/or any other thrombogenic factor may be implicated in the evolvement of ANFH. The speed of the in vitro lysis was significantly lower in patients (both in primary and in secondary cases) compared with healthy controls. The platelet activation (measuring with beta TG) proved to be significantly higher in the primary group as well as in the secondary group compared with healthy controls. Lp(a) levels were elevated in primary and secondary cases. This alteration was more characteristic in the primary cases. Fibrinogen levels were also elevated in the primary group, but the difference was not significant. The data shown here may further support that hypofibrinolysis and increased thrombogenesis are major causes of ANFH. Early diagnosis of ANFH increases the chances of modifying the course of this disabling disease.

Effects of two iron sources on iron and cadmium allocation in poplar (Populus alba) plants exposed to cadmium

Effects of 10 microM cadmium (supplied as Cd nitrate) on the utilization and allocation of iron (Fe) were investigated in poplar (Populus alba L.) plants grown in nutrient solution with Fe(III)-EDTA or Fe(III)-citrate as the Fe source. The effects of Cd were also compared with those of Fe deprivation. The accumulation of Fe in roots was 10-fold higher in plants grown with Fe-citrate than with Fe-EDTA. Cadmium decreased leaf chlorophyll concentrations and photosynthetic rates, and these decreases were more marked in plants grown with Fe-citrate than with Fe-EDTA. In both Fe treatments, addition of Cd caused large increases in root and shoot apoplasmic and non-apoplasmic Cd contents and increases in root Fe content; however, Cd decreased shoot Fe content, especially in plants grown with Fe-citrate. New leaves of plants grown with Fe-citrate had small cellular (non-apoplasmic) Fe pools, whereas these pools were large in new leaves of plants grown with Fe-EDTA. Non-apoplasmic Cd pools in new leaves were smaller in plants grown with Fe-citrate than with Fe-EDTA, indicating that inactivation of non-apoplasmic Cd pools is facilitated more by Fe-EDTA than by Fe-citrate. In the presence of Cd, Fe-EDTA was also superior to Fe-citrate in maintaining an adequate Fe supply to poplar shoots. Differences in plant responses to Fe-EDTA and Fe-citrate may reflect differences in long-distance transport of Fe rather than in acquisition of Fe by roots.

Rejuvenation of ageing bean leaves under the effect of low-dose stressors

The effect of low concentrations of some stress-inducing compounds like Cd, Pb, Ni, and Ti salts and DCMU on the senescence of chloroplasts was investigated in detached primary leaves of bean. After the petioles of ageing leaves had developed roots, these low-dose stressors stimulated chlorophyll synthesis and photosynthetic activity, as compared to the control, thus causing rejuvenation in treated leaves. The amount of photosystem I (lowest in DCMU-treated leaves) and light-harvesting complex II increased, while that of photosystem II decreased or remained unchanged. Fluorescence induction parameters indicated unchanged electron transport (except for DCMU treatment). CO2 fixation and, in some cases, starch accumulation was stimulated. In parallel, the occurrence of large plastoglobuli seemed to decrease in plastids of heavy metal-treated leaves. A cytokinin bioassay of leaf extracts confirmed the cytokinin-mediated effect of low-dose stressors, as the slopes of Chl and cytokinin curves were similar during the rejuvenation process. It is assumed that these stressors generate non-specific alarm reactions, which involve changes in the hormonal balance by increasing the synthesis of cytokinins.

The most severe forms of Perthes' disease associated with the homozygous Factor V Leiden mutation

It has recently been postulated that thrombophilia may have a role in the aetiology of Perthes' disease. The published reports, however, remain conflicting. In this study a retrospective analysis of the coagulation parameters was made in 47 patients with Perthes' disease and the results compared with the clinical data. Five patients with Factor V Leiden mutation were found (10.6%) and surprisingly four of them had a homozygous pattern. These four patients showed the most severe form of the disease, Catterall group IV, with flattening of the entire epiphysis, involvement of the metaphysis, shortening and broadening of the femoral neck, trochanteric overgrowth and developed mushroom-shaped aspherical laterally displaced femoral heads in dysplastic acetabula. We would like to suggest that the homozygous form of Factor V Leiden mutation has some role in the clinical course of Perthes' disease and particularly its most severe form.

Multilevel callus distraction: a novel idea to shorten the lengthening time

Lower extremity inequality is a common problem in everyday orthopaedic practice. The leg discrepancy can lead to variety of other problems, i.e., spinal problems. Surgical intervention is very demanding and requires patient compliance. Wagner's and Ilizarov's elongation technique are most commonly used worldwide, but it gives satisfactory results only in a long period of time and as we know there could be several inconvenient outcomes. Our idea aims at shortening this time period, and avoiding some of the inconvenient outcomes. Unfortunately we do not have the opportunity to go further in our investigations, but we hope that someone interested in this field will have an idea which would make continuation possible.

Contradictions of derotation in scoliosis surgery using the CD principle

Current literature has increasingly emphasized the problem of derotation in scoliotic deformities. The Cotrel-Dubousset (CD) principle as a means of correcting rotation has been questioned by various authors. This paper aims to draw attention, using algebraic methods, to the importance of the remaining rotational deformities, and to suggest the introduction of the notion 'rotational balance'.

Mosaicplasty for the treatment of osteochondritis dissecans of the talus: two to seven year results in 36 patients

An osteochondral defect (OCD) is known as a symptomatic lesion causing pain, recurrent synovitis, and altered joint mechanics most commonly in a weight-bearing joint. Loose bodies may develop, which may then cause joint destruction and/or locking. The damage to the articular surface is most likely a precursor of ankle osteoarthritis. With the recent advances in diagnostic imaging, such as MRI, as well as the development of ankle arthroscopy, the identification and classification of these lesions has become much more precise. This allows more accurate staging and improves treatment recommendations. The assessment of a particular treatment is also improved. A variety of treatment alternatives are now available. These include arthroscopic procedures including debridement, retrograde drilling, and bone grafting. Compared to open treatment, arthroscopic procedures may be particularly advantageous in the treatment of small defects and stable OCD lesions. Until recently, however, favorable results have been less predictable for large or unstable osteochondral defects. We treat these more difficult lesions with a mosaic autogenous osteochondral transplantation. In our hands, this appears to provide an optimal treatment result. The present report evaluates the clinical outcome of 36 patients followed for two to seven years after a mosaicplasty autogenous osteochondral transplantation from a non or less weight bearing portion of the knee to the ipsilateral talus. Ankle function was measured by the Hannover scoring system and showed good to excellent results in 34 cases (94%) with no long term donor site morbidity. The encouraging clinical results are supplemented with radiographs and histology, which support the premise of lasting relief of symptoms and prevention of ankle arthrosis.

[Hypophosphatemic oncogenic osteomalacia]

The first case of oncogen osteomalacia in Hungary is reported, to draw the attention of the medical profession to it and to present the new data about its pathomechanism. Pathological hip fracture caused by hypophosphataemic osteomalacia due to isolated renal phosphate wasting was found in a previously healthy 19 years old sportsman. In spite of daily 1.5 micrograms calcitriol treatment and phosphate supplementation, hypophosphataemia persisted for 13 years and he needed regular indometacin medication for his bone pain. During that time an 1.5 cm gingival tumour was found and radically removed. The serum phosphate level returned to normal in a few hours after the operation (preoperative 0.51, after 2, 4 and 8 hours 0.61, 0.68 and 0.79 mmol/l respectively), and remained normal without calcitriol. The histological examination showed epulis with fibroblast and vascular cell proliferation, which has never been previously reported in connection with oncogenic osteomalacia. The pain resolved after 3 months and the bone density became normal in one year. Oncogenic osteomalacia must be considered in every case presenting with atypical hypophosphataemic osteomalacia. Careful dental examination is needed also in the course of search for the underlying tumour. Every tumour-like growth, even the common epulis, has to be operated radically and serum phosphate monitored in the postoperative period in all such cases.

Functional membrane changes due to tumor induction in rat pituitary cell cultures

Membrane functions in tumorous cells are different from those in healthy cells. The aim of the present study was to investigate the changes in pituitary cell membrane functions and hormone secretion after tumor induction in vivo and in vitro. Prolactinomas were induced in vivo in female Wistar rats with estrone acetate. Normal anterior pituitaries and prolactinomas of female Wistar rats were dissociated enzymatically and mechanically, then cultured on collagen-treated plastic dishes. Some normal anterior pituitary cultures were treated with benz(c)acridines as tumorigenic agents in vitro. Intracellular 3',5'-cyclic-adenosine monophosphate (cAMP) levels were determined by a competitive binding technique, membrane fluidity was assayed by fluorescence anisotropy, and ATP-ase activities were estimated via ATP loss. The results indicated decreased membrane fluidity in tumorous cell cultures. However, in vitro benz(c)acridine treatment exerted more pronounced effects than those observed after in vivo estrone treatment. The ATP-ase activities were highly increased in benz(c)acridine-treated cells and in estrogen-induced prolactinoma cells, more strongly so in the former ones. The intracellular cAMP levels were higher than normal in both of them. The results concerning the ACTH, alpha-MSH, PRL and GH levels of normal and tumorous cell cultures were published in our previous study. Our findings show that the tumorous transformation of pituitary cells can cause significant changes in functional membrane parameters and hormone secretion. Decreased membrane fluidity was accompanied by an increased exocytosis (hormone release) and adenylate cyclase activity in tumorous cells.

[Large cysts of dental origin in the maxilla]

The authors give a common survey of clinical and pathological appearance of cysts of maxillary sinuses, especially their dental origin. They review the possibilities of diagnosis and show the treatment technic they used the past 4 years on 11 cases. They emphasise the importance of radiological controlling the root canal treated teeth and the role of the dentist in instructing the patient about this.

[Clinical experience with the use of benzylalcohol and amyl-m-cresol (Strepsils) in stomatological diseases]

The results gained with the treatment of benzylalcohol and amyl-m-cresol tablets in oral inflammatic diseases (153 cases) and in the prophylaxis of possible infections (119 cases) accompanied with surgical interventions has been summarised. It was concluded that, the average healing process shortened by 30% in time, and the quality parameters (pain, function etc.) showed 30% better results in 78.4% of the cases treated with Strepsils. 88.3/ of patients preferred to get the tablets, the tolerability was excellent. The two third of the patients suffering from inflammatory diseases reported reduction of the pain within the first 60 minutes after the very first tablet application. The experience gained with 272 patients showed very good effectivity especially in the cases aphtha, gingivostomatitis herpetica, stomatitis mycotica, gingivitis, denture stomatitis, erythema exsudativum multiforme, stomatopharyngitis, periodontitis. The drug has showed of remarkable result in the prophylaxis of periodontal, dentoalveolar, implant, soft tissue, maxillofacial surgical interventions.

Molecular forms of alpha-melanocyte-stimulating hormone in pheochromocytoma tissue

The molecular forms of alpha-melanocyte-stimulating hormone (MSH) in pheochromocytoma tissues have been characterized using reversed-phase HPLC and radioimmunoassay. Six alpha-MSH-related peptides were detected. Three of the six peaks had elution times identical to those of synthetic desacetyl-alpha-MSH, alpha-MSH and diacetyl-alpha-MSH. The remaining three forms of the alpha-MSH-like immunoreactivity suggest a different processing of pro-opiomelanocortin in this tissue than in the intermediate lobe of the pituitary gland. Current results confirm that alpha-MSH are present in human pheochromocytoma and suggest that alpha-MSH has role in the pathophysiology of this tissue.

The 'rotational preconstraint'

This model provides a novel view of the etiology of some scolioses and can answer some of the biomechanical questions regarding pathogenesis of dorsal curves. According to our findings, paravertebral muscular imbalance is likely to favour such a pathological condition which, with the interference of the postural reflexes and the body weight-related vertical loading, might lead to the formation of a true scoliotic curve. Review of earlier research studies in the light of our findings reveals controversy in some authors' reported results and their own interpretations and seems to generally support our theory.

Surface changes and hormone production in pituitary cells during tumorigenesis

Prolactinomas were induced by chronic estrone acetate treatment in female Wistar rats in vivo. After enzymatic dissociation of the tumor tissue, monolayer cell cultures were obtained. In vitro tumor induction was performed by treatment of normal monolayer anterior pituitary cell cultures with a 1:1 mixture of 7,9-dimethylbenz[c]acridine: 8-methylbenz[c]acridine. For immunohistochemistry, the cell cultures were stained by the peroxidase-antiperoxidase method for standardization; the nonspecific hormone release was induced with 30 mM K+. The prolactin, alpha-melanotropin, and adrenocorticotropin levels in the supernatant were measured by specific, sensitive radioimmunoassays. The results indicated surface differences between the in vivo induced prolactinoma cells and normal pituitary cells: the attachment of the prolactinoma cells required 15% collagen treatment, whereas normal cells required only 3-4% collagen. Tumor cells induced in vitro by methylbenz[c]acridine treatment were able to attach only after ammonia activation of the collagen surface. These findings strongly suggest that the mode of tumor induction can result in differences in membrane fluidity; this phenomenon is possibly connected with the levels of prolactin, adrenocorticotropin and alpha-melanotropin hormone production of these endocrine tumor cells.

[Experience with clindamycin in stomatologic diseases]

In 114 patients suffering from dental inflammatory diseases (periostitis, gingivitis, sinusitis, periodontitis etc.) and in 41 cases of dental surgical procedures (implantation, dentoalveolar surgery etc.) 3 x 300 mg/day clindamycin was applied during 7 days in the framework of GCP phases IV. In 150 cases (97%) the product proved to be effective and only in 2 cases a mild side effect was observed. On the base of the results clindamycin can be advised for the treatment of stomatological diseases.

Separate and combined use of Nd:YAG and carbon dioxide lasers in oral surgery

The experience obtained with 789 laser interventions used in oral surgery is summarized. In the first group, 756 patients were operated on by CO 2 laser, in the second, 17 were treated with Nd:YAG laser, and in the third, 16 were treated simultaneously with both types of lasers. Among the outpatient interventions performed under local anesthesia were 233 precancerous conditions, 491 benign tumours, and 65 other lesions. Following CO 2 laser interventions, the zone of the irreversible tissue damage did not exceed 300 mum in the instance of high energy cutting; it was almost 1 mm following Nd:YAG laser cutting, and it was 500 mum when cut by a combined laser beam. The precancerous conditions can successfully be treated by CO 2 laser, especially by evaporation. The Nd:YAG laser leaves a broad necrotic zone. The combined application, however, is highly advantageous to treat vascular lesions and markedly hemophilic structures/hemangioma, epulis, tongue resection, and so forth. In oral surgery the combined use of the CO 2 and Nd:YAG laser beams is extremely beneficial due to their excellent hemostatic effect.

[Risk patients in dentistry]

Authors study the risk diseases in dental practice. They analyze the possible complications and the methods of their prevention in each risk group. They take deal with the importance of antibiotic prophylaxis, the problems of local anaesthesia and the management of patients who suffer from coagulation disturbances. They present the management of risk patients in two cases. They emphasize the importance of anamnestic history in every case before dental treatment.

[Clinical experience with enzymes (collagenase, protease) in the treatment of skin lesions caused by CO2-laser surgery]

The authors applied collagenase and protease in lipofil solution for the treatment of skin lesions caused by CO2 laser interventions. 354 surgical interventions were performed on 91 patients (43 verruca vulgaris, 32 naevus intradermalis, 16 keratosis). The laser methods were excision or/and vaporisation of the lesion. The authors created methodological groups and all of the patients had a control laser wounds without enzymatic treatment. The patients were controlled periodically from the 1st to the 56th postoperative day. The first experience shows that, the use of enzymatic treatment is advantageous for the laser wounds healing. The colour, scar formation and other aspects proved to be better after the enzymatic treatment. The optimal method was the use of the cream for 2-4 postoperative days on very thin layer, without bandage. The result seemed to be better compared with the enzymatically untreated cases.

[The use of benzyl alcohol and amyl-m-cresol (Strepsils) in the oral cavity. (Review of the literature and first clinical experiences)]

The authors summarised the literature data of benzylalcohol and amyl-m-cresol. In the clinical practice they used Strepsils in the treatment of 22 patients suffered from oral inflammatic diseases and in the 20 prophylactic cases of oral surgical interventions. The preliminary clinical report shows that, the Strepsils seems to be very effective in the treatment of oral inflammations and in the prophylaxis too.

[The tendency of antibiotic therapy in dental and oral surgical practice]

The large number of dental inflammations can be explained by the bad general dental condition in Hungary. Antibiotics have been used more extensively here then in several other countries. The recently introduced antibiotics are preserving the beneficial effects of the older ones with less side effects. The oral flora and their resistance to antibiotics are very different in certain countries. Therefore the professional protocols of the stomatological inflammations followed by certain countries cannot be applied directly in other countries. The changing resistance and the appearance of the new antibiotics make necessary the general evaluation of different antibiotics from time to time. The patients, the doctors and the society has the same interest: to get or provide more and more fast, safe and effective treatment. But to achieve this objective the dentists have to reevaluate their treatment habits accordingly.

Identification of oxytocin and vasopressin from neurohypophyseal cell culture

Our observation that dispersed cultures of neurohypophysis obtained from adult rats are capable of synthesizing and releasing oxytocin and vasopressin is unexpected, because in whole animals these hormones are known only to be stored, not to be produced in the posterior lobe of the pituitary. The hormone content of cell culture medium was elevated from 0 to 129 +/- 14 pg/mg protein for oxytocin and from 0 to 42 +/- 4 pg/mg protein for vasopressin during two weeks as determined by specific radioimmunoassay. By molecular mass and structure determination (tandem mass spectrometry) we have proved that the supernatant of the cell cultures contains not only immunologically but mass spectrometrically identified neurohypophyseal hormones.

Experimental studies for the surgical correction and fixation of dorsal spine deformities

One of the specific features of the scoliosis operations with a posterior approach is that both the correction of the deformity and then the maintaining of the corrected situation are carried out with the help of the implants. With the currently applied systems based on the CD principle it is still difficult to control the rotational component of the scoliotic curve. To complement the systems based on the CD principle, we have developed an implant family whose application makes the correction of the dorsal deformity generally simplier and derotation more effective. Our method is based on the application of such hooks which, linked to the longitudinal rods and hooked on both transverse processes of the instrumented vertebrae, transmit the concerted forces exerting their influence in the direction of the correction. Depending on their symmetrical relations, the hooks are capable of tilting in the frontal plane and derotating in the horizontal plane simultaneously, in the direction of our choice. The stability and applicability of the hooks were tested in implants into cadavers, and then the intimate relations of the implants were examined by means of radiological tests and dissection on instrumented specimens. On the basis of our results, the implants can already be used in clinical practice.

The pathological plica in the knee

Fourteen patients were evaluated who had an arthroscopic removal of the symptomatic mediopatellar plica of the knee in this retrospective study. The main complaint of the patients was the pain at the medial side of the knee. Before the operation only in 3 cases was the diagnosis the pathological plica. The arthroscopy was performed in a routine way. The plica was consider pathological, and removed, when it was thickened. There was grade I or II chondropathy in the knee on the medial femoral condyle and the patella respectively, caused by the plica. Good to excellent result were obtained in 93% of the knee with or without chondromalacia.

Acute arthroscopy

The role and significance of acute arthroscopy have been evaluated in the treatment of knee joint injuries on the basis of findings during 59 arthroscopic operations which were conducted within two weeks after the accident. The injuries developed isolated in more than half of the cases (65%) whereas they appeared in a combination of two or more in 26% and in 9%, respectively. Injuries requiring operation were found in 91.5%, most of which were ruptures of the ACL (33 cases) and menisci (23 cases). In the case of ACL rupture, in the acute phase on sportsmen and physical workers primary arthroscopically assisted transligamental replacement was performed with patellar graft while in the case of proximal rupture of the ACL reinsertion and augmentation were carried out with semitendinosus tendon. The ruptures of dislocated eminentia were refixed in each case. In the case of the rupture of meniscus the refixation of the meniscus of resection of the ruptured part was attempted. By means of acute arthroscopy the lesion of the intraarticular structures or that of their combinations can be exactly diagnosed. Depending on the findings of arthroscopy the injuries can be treated immediately or operated on at a later time, thus preventing the joint from further deterioration.

Therapeutic value of continuous passive motion after anterior cruciate replacement

The aim of this study is the evaluation of the therapeutic value of continuous passive motion after ACL replacement. After 41 ACL reconstruction in 13 cases only active motion, in 28 cases active motion and CPM were used postoperatively. Stability, the range of motion and complications were evaluated at the time of discharge, 3 and 6 months after the operation. The flexion-extension in the CPM group was significantly greater at the time of discharge, but this difference was practically eliminated in 6 months after the operation. There were not any other significant difference between the two groups. The CPM gives only a little advantage in the rehabilitation after the ACL replacement.

[Prophylactic use of roxithromycin in dental procedures]

In this study roxithromycin was applied for prophylactic treatment of 104 patients (implantology, dentoalveolar surgery, risk patients etc.) underwent dental surgery. The efficacy and side effects of roxithromycin were studied. The efficacy of this antibiotic was 92%, gastrointestinal complains, as the most common side effects were obtained in 2.8% of the patients treated with roxithromycin.

[Use of drugs in stomatology II. Use of antibiotics in dental practice]

The authors summarized 514 questionner on dental patient medication, and established that, the dentists use an average in Hungary 29 box antibiotics per months. The most frequently prescribed medicine (Dalacin C, Rulid, Augmentin, Semicillin, Maripen, Doxycycline) take the 75% of the total number. The 52% of dentists use antibiotics for prophylactic aims, 94.6% for the treatment of inflammatory diseases. The examination gave data for creating the picture of the use of antibiotics in Hungarian dental practice in 1995.

[Use of drugs in dentistry I. Introductory study]

The authors summarized 514 questioners on the dental patient medication in the general stomatological practice. In the 10 medication group they count 135 different drugs. The number of different minor analgesics were 28 the medicines for local application 26, and the brand of antibiotics 22. The hungarian dentist use 23 different drugs, 5 antibiotics, 5 medicine for local application. An average of the dentist monthly dosage is 97.6 box of medicine (29 antibiotics, 23.2 minor analgesics, 18.4 local anesthetics, 17.5 local drugs). The 70% of the medicines hungarian origin in the dental practice.

[Management of maxillofacial injuries under extraordinary conditions]

The authors analyze the most important conditions of the management of patients with maxillofacial injuries in disaster circumstances. Under extraordinary conditions the injuries are frequently complex therefore the establishment of a precise diagnosis is difficult, and one must reckon with the lack of time caused by the occasionally large number of patients to be managed. Under extraordinary conditions the management of maxillofacial injured can only be solved with compromises.

[Current trends in antibiotic therapy in dentistry]

The place and role of surgical, dental physio- and pharmacotherapy in oral and head and neck diseases has been debated for decades. In addition the price and reimbursement system had been changed lately in our country that also underlines the relevance of this issue. The overconsumption (1.7 packages per inhabitant per year) of antibiotics is also proven in Hungary. Beside surgical and dental interventions the treatment of dental inflammations caused by pathogenics requires the administration of different kinds of antibiotics. The first choice antibiotic is determined on the base of clinical features and general resistance of oral flora in the given period. When the first choice antibiotic proves to be ineffective, treatment has to be followed by antibiotics determined on individual resistance. In stomatology antibiotics are administered for prevention or treatment of dental inflammations. The length of therapy has a great importance which is usually 4 days in prevention and 5 days in treatment of dental inflammations. The modern antibiotics have to comply with the following requirements: efficacy, safety and cost-effectiveness. The typical mistakes in the administration of antibiotics can be avoided by the application of therapeutical schedules. The macrolide and cephalosporin derivates have become more and more popular. The mixed bacterium flora has been changing in time and also influenced by geographical factors depending on the habit of prescriptions. Therefore the experiences obtained in other countries are not applicable.

[15-year echocardiographic follow-up of acromegalic patients]

An echocardiographic follow-up of 25 patients (pts) was performed, after the first examinations in 1978-1979. 15 pts have died in the last 15 years (Group 1), while 10 still living (Group 2). In Group 1 either the impaired global left ventricular at the time of the first echocardiography predicted a high mortality i.e. there were only two pts with normal echocardiographic findings. The other 6 acromegalic pts with a "normal heart" have survived. The left ventricular hypertrophy of pts in Group 2 was observed to increase during the 15-year follow-up, because of the development of systemic hypertension. In conclusion, the echocardiographic findings are of a good predictive value in estimations of the survival rate in acromegalic pts.

[Management of patients with maxillofacial injuries at the Oral Surgery Department of the Hungarian Central Military Hospital (analysis of a 10-year patient material)]

The authors have worked up the most important data of as many as 500 patients with malar and mandibular bone injuries. It is established that these injuries mostly derive from aggressive actions and traffic accidents. During this decade the ratio of injuries regarding the mandible and centre of the face has changed from 2.5:1 to 1:1. Since January 1, 1994 the number of managed injured patients has significantly increased, as a consequence of the maxillofacial service connected into the duty management in Budapest.

[The importance of professional cooperation in the management of orbital injuries]

The injuries of the maxilla and the mandible are usually composite, often requiring the close cooperation of professionals of various specialties. In the Central Military Hospital the authors have set up a team for the complex diagnostic and therapeutic management of patients with orbit injuries. The organizational aspects and basic principles of the team work are dealt with.

[Major trends in the activities of the Oral Surgery Department at the Hungarian Central Military Hospital]

The author summarizes the main trends of activities of the Department of Oral Surgery of the 45-year old Central Military Hospital. Through the restructuring of the department the basis of the up-to-date therapeutic, educational and scientific activities corresponding to the tasks of a university teaching hospital has been created. The department takes part in the undergraduate and postgraduate education. Research programs have been elaborated primarily in the field of laser medicine, traumatology and reconstructive surgery. In the therapy both the dentoalveolar and maxillofacial surgery play a key role, in addition to the highly important military and disaster medicine.

The use of high-power lasers in oral surgery

This study describes the treatment of 2989 patients with different type of lasers. The argon laser beam was used in 57 cases for procedures ranging from portwine stains, telangiectasias, and angiofibromas to other vascular lesions. Eighty-four operations including treatment of leukoplakia and hemangioma were performed using the Nd YAG laser. An additional 53 operations were performed using the combined Nd:YAG laser beam and 2795 operations were done using the carbon dioxide laser on precancerous states and other white lesions, benign tumors and tumor-like states, malignant tumors, and other lesions. The laser procedures were performed under local anesthesia. Operations were rapid and bloodless yielding both excellent cosmetic and functional results. The experience gained with this group of patients suggests that the ideal cases for laser treatment were leukoplakia, hemangiomas, and other vascular tumors and lesions of the face and the oral cavity, and clotting disturbance.

[Combined effect of CO2 and Nd:YAG laser on the rat tongue]

Authors fixed the handpieces of a CO2 and Nd:YAG lasers together so, that the two laser beams had a common focus. It is histologically proved in this paper, that the combined effect fulfills all the known advantages of either of the two lasers, while disadvantages are largely eliminated. Based on these results the device is planned to be introduced in oral surgery.

[Indication for Chiari's pelvic osteotomy]

The results of 61 Chiari's pelvic osteotomies carried out during a 10 years period are reported. Present role of the operation in the correction of acetabular dysplasia in comparison to Pemberton's acetabuloplasty, to triple pelvic osteotomies and to the prosthetic replacement of the hip joint is discussed. In conclusion the operation is still indicated in special cases. Depending on the age of the patients pain can be observed already after 3-5 years however a great part of the patients is completely free of complaints even 10 years postoperatively.

[Laser in contemporary dentistry]

In the 30 years of laser history the oral cavity application has always played an important role. In the laboratory diagnostics the analysis of the saliva, tissues and hard dental tissues is performed by laser. In the clinical diagnostics the laser is used for examining the caries, dental matter, in orthodontics, in the surgical analysis of splanchnocranium and the teeth. The photodynamic treatment involves the diagnostic and therapeutic use of the lasers in the management of oral cavity cancers. The soft laser therapy is widely applied in diseases of the oral mucosa, parodontal and pain syndromes, temporomandibular articular diseases, dental inflammations, salivary gland diseases and in osseal healing processes. The surgical lasers are applied in the treatment of teeth, in preprosthetic surgery, salivary gland diseases, precancerous conditions, tumour surgery and in the surgery of hemophilic patients, respectively. In the 90s one cannot speak about modern oral surgery or dentistry without the application of lasers. Though in various fields the research is merely in initial phase (holography, caries-treatment, photodynamic therapy, etc.), the lasers are becoming an indispensable (treatment of precancerous conditions, hemophilic patients, diseases of the oral mucosa, etc.). The oral surgical use of lasers might bring about fundamental changes in diagnosis and treatment, becoming a new professional branch, opening up new vistas, representing "future" today. The invention of lasers in 1960 and their broad dissemination in oral surgery and dentistry since 1980 have resulted in basic changes in numerous diagnostic and therapeutic approaches. The medical use of lasers is of such an extent that it can well justifiably regarded as a new branch of science namely the laser medicine. This considerably relates to stomatology, too.

[Comparative light microscopic, scanning-electron microscopic and electron microscopic studies of the effect of experimental interventions by surgical scalpel, electrocautery and CO2-laser beam in the oral cavity]

Tissue effect interventions by means of surgical scalpel, elecrtokauter and CO2-laser ray in the mouth cavity of 20 white rats has been examined. According to their light microscopical examinations both the laser and the electrokauter caused thermal injuries taking place in typical zones while by the scalpel the cut surface in rendered ragged. The band-width of the thermoinjury caused by the kauter is a multiple of that caused by the laser. It has been proved by means of scanning electronmicroscopical examinations that interventions by means of laser result in sharp wound borders, the wounds cut by means of kauter are characterised by the presence of a great number of carbonized specks while by means of the scalpel a mechanical tear of the tissues is brought about. By means of electronmicroscopical examination the characteristics of the typical thermoinjured zones are described. It has been established that in the case of laser the injury of the ultra-structure extends to 400 microns while in case of electrokauter it reaches a width of 1500 microns. The excellent haemostatic effect brought about by the thermoeffect by means of the laser, in contrast to the broad thermoinjured zone caused by the kauter, is obtained at a very mild thermoinjury.

[Measuring the looseness of the knee joint by using the Kt 1000 arthrometer]

Authors measured the stability in the sagittal plane of the intact knee joints of 50 young men with the MEDmetric KT 1000 apparatus. The greatest movement during the measurements on 100 knees was observed in 25 degrees flexion and during the application of force 89N. In 70 degrees flexion the movement was only half of that observed in 25 degrees flexion. The difference of the average movements measured bilaterally was neither in active nor in passive experiments more than 0.5 mm. The difference between the average values of the compliance indexes on the left and right side was only 0.01 mm. In all measurements the frequency distribution of the differences between the two sides was essentially the same. The difference between the movements on the two sides did not exceed 2 mm-s in 90-100 percent of the cases.

[CO2-laser surgery of rhinophyma]

Authors are the first in Hungary to report on a CO2-laser dermabration performed for the treatment of rhinophyma. They describe the mode and results of the laser intervention justifying the application of the CO2-laser.

[Comparative study on wound healing in the oral cavity following experimental surgery using a scalpel, electrocauterization and CO2 laser beam]

In the mouth cavity of white rats lesion was created by means of surgical scalpel and electrokauter the course of the wound healing was observed on basis operations of various types (coagulation, vaporization, excision) as well as scalpel and electrokauter the course of the wound healing was observed on basis of histological examination of biopsies taken on the second, fifth, tenth, twentieth and fortieth day. It was verified that the wound healing is excellent after all three types of laser surgical intervention and is significantly more favourable than in case of electrokauter. The course of healing is finished during 3 weeks after coagulation and vaporaziation, and during 4 weeks after excision. The new epithelium layer became thinner than the original while the submucosa became twice as thick. The laser treated surfaces are protected by coagulation proteins, the wound edges are sharp, the amount of the cicatrice tissue formed after the wound healing is less than after the employment of the scalpel and the electrokauter.

[Significance of the CO2-laser angle, oral cavity endoscopes]

The CO2-laser ray guided at 90 degrees to the surface creates a crater of typical "v" shape. If the guide angle of the ray deviates therefrom and the smaller the angle of incidence than 90 degrees, destruction becomes the more astymmetric, the crater takes an ever more flattened eliptical shape. The lack of tissue becomes even more superficial, thus removal of a circumscribed pathological area requires the sacrifice of more ambient healthy tissue. Consterning the possible angle of incidence of the laser ray instrumental measurements were carried out. It has been ascertained that in the pharinx third of the mouth cavity behind the plain corresponding to the premolars, as a rule, only guide angles below 50 degrees, in the middle third of the mouth cavity corresponding to the area between the front teeth and the molars guide angles between 50-70 degrees, and in the front third mostly a ray guiding below 90 degrees are possible. In the middle and rear third of the mouth cavity the ideal rey-guiding at 90 degrees can be obtained but with reflection, certain areas even cannot be treated directly, are visible but in mirrors. By transforming the hand piece of the laser apparatus endoscopes with fixed mirror and rotating mirror have been constructed. By means of the endoscope with fixed mirror already all parts of the mouth cavity have been rendered accessible while the rotating mirror model became suitable even to admit the laser ray to the surfaces at the ideal angle of incidence of 90(2).

Removal of epulis by CO 2 laser

From analysis of the epulis patient population for 40 years, it could be established that of 1019 lesions, 12.8% relapsed, in 40% of surgical interventions, with the extraction of the tooth involved. For the removal of epulis, we have developed our own method. As a first step, the tumor is excised by CO 2 laser. Thereafter, excochleation and bone decortication are performed, followed, as a third step, by evaporation. In each case, an attempt is made at preserving the teeth. When necessary, radicular treatment and fixation are performed. Postoperatively, minimal edema and pain occurred, and the majority of the patients were able to work on the first postoperative day. Following laser removal of 63 epulides, recurrence was seen in 5 cases (7.9%) without intraoperative tooth extraction. The combined method was applied successfully also in a hemophilic patient. Besides the conventional laser surgical handpiece, an endoscope of own construction was used on surfaces untreatable by direct sight.

[Significance of the angle of the CO2 laser beam, experimental studies in the oral cavity]

In the mouth cavity of white rats the surface extension and depth of the defect brought about by laser beam arriving at various angles of incidence have been examined by means of hand- and operational microscopy and micro manipulator, respectively. In case of an angle of incidence of 90 degrees at the same energy, exposition time and focusing the forming crater is the deepest and the surface diameter the smallest. The more the angle of incidence of obliquely incident race deviates from 90 degrees, the more diminishes the depth of the lesion and increases its surface. Sparing of the surrounding healthy tissues and exact removal of pathological tissues at the surface and in the depth can best be obtained by a ray incident at 90 degrees. Thus, the operation not only spares the tissue but permits to keep the surrounding structures and, thus, the functions intact. Where an incidence at 90 degrees cannot be ensured by direct ray guiding, it is preferable to let the laser ray reach the tissue surfaces in a range of angles near 90 degrees.