Orthodontie oder Kieferorthopädie?

Zusammenfassung Es wird die Entwicklung der Kieferorthopädie in Europa, so wie sie der Verfasser miterlebt hat, dargestellt. Die Vielfalt der Auffassungen, die vereinfacht auf den Gegensatz Kieferorthopädie-Orthodontie reduziert werden kann, wird diskutiert und gezeigt, daß ein solcher nur scheinbar besteht. Das Gesamtgebiet ist so groß, daß es von einem einzelnen kaum mehr beherscht werden kann. Prophylaxe, Früh- und Spätbehandlung, wozu noch Unfälle im Kindergebiß und das schwierige Gebiet der Mißbildungen im Kieferbereich, insbesondere die Linpen-Kiefer-Gaumenspalten kommen, setzen eine gute Ausbildungsbasis im Studium und intensive postgraduate Ausbildung voraus. Die Zukunft wird zu einer Synthese zwischen funktioneller und aktiver Therapie führen, also zu einer Annäherung zwischen europäischer und amerikanischer Auffassung.

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Summary The author has traced the development of European orthodontics from the vantage point of his own personal experience. The multiplicity of approaches to orthodontie problems, in particular the functional versus active mechanical controversy is shown to be more apparent than real.As the scope of orthodontics expands it becomes increasingly more difficult for a single individual to master. In addition to a knowledge of preventive, interceptive, and comprehensive orthodontic therapy, today's specialist must be trained in the treatment of traumatic injuries to the young dentition, and dentofacial anomalies, with special emphasis on cleft lip and palate.The future will be witness to a synthesis of the functional and active-mechanical schools, a rapprochement between European and American philosophies.

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Herrn Professor Dr. E. Hausser zum 60. Geburtstag     

Behaviour of spherical and irregular (U,Pu)O2 particles after inhalation or intratracheal instillation in rat lung and during in vitro culture with bovine alveolar macrophages

Spherical and irregularly shaped mixed (U,Pu) oxide particles were administered to rats by inhalation and by intratracheal instillation. The lung retention of the particles was independent of particle shape and of the route of administration. Only a small percentage of the administered radioactivity was found in other organs. Detailed electron microscopic studies showed particles within membrane-enclosed vacuoles as well as lying free in the cytoplasm.     

Results After Partial Left Ventriculectomy in a European Heart Failure Population

Abstract Background: Forty-nine consecutive patients undergoing partial left ventriculectomy (Batista) surgery between January 1995 and June 1998 were studied. Methods: Patient ages ranged from 12 to 85 years, and all patients were in New York Heart Association functional Class III or IV. Thirty-three patients had ischemic cardiomyopathy, and 16 had idiopathic myopathy. Inclusion criteria were left ventricular end diastolic volume index of < 150 mL/m², left ventricular ejection fraction of c 20%, or left ventricular end-diastolic diameter of > 70 mm. Sixteen patients were transplant candidates. Partial left ventriculectomy and mitral valve repair by means of a Cosgrove annuloplasty ring plus the Alfieri repair constituted only part of the complex cardiac reconstruction in 38 patients. Results: Five patients died early and five patients died late between 3 and 30 months postoperatively. The actuarial l-year survival rate was 81%. Twenty-seven patients with coronary artery disease underwent one to five bypass grafts when appropriate. In addition, three patients received aortic valve replacement, four received tricuspid valve repair, two received mitral valve replacement, and two underwent dynamic cardiomyoplasty. Left ventricular (LV) diameter could be reduced from a preoperative mean of 71 to 56 mm postoperatively. LV ejection fraction increased to 36% postoperatively. Ninety percent of patients are in New York Heart Association functional Class I or II. Conclusions: Patients with end-stage idiopathic or ischemic cardiomyopathies can be improved considerably with partial left ventriculectomy. Any cardiac comorbidity should be repaired simultaneously.     

Rapid detection of HBsAg and anti-HBs by enzyme-immunoassay

Enzyme-immunoassay (EIA) for HBsAg is a reliable method with third generation sensitivity. Using a mechanized system for washing and reading and computerized data processing, subnanogramme amounts of subtypes ad and ay could be detected in approx. 5.5 h.Using EIA-kit reagents and an HBsAg ‘standard’, anti-HBs could conveniently be detected. Sensitivity comparisons with dilution series of the WHO anti-HBs standard showed RIA to be 8–128 times more sensitive than EIA for anti-HBs. However, similar percentages of positives were found in a patient population, and discrepancies were found between RIA and EIA results which cannot be explained on the basis of sensitivity differences only. A careful examination of the specificity of EIA and RIA is indicated.     

Surfactant protein A, exposure to endotoxin, and asthma in garbage collectors and in wastewater workers

Endotoxin causes an inflammation at the bronchial and alveolar level. The inflammation-induced increase in permeability of the bronchoalveolar epithelial barrier is supposed to cause a leakage of pneumoproteins. Therefore, their concentrations are expected to increase in the bloodstream. This study aimed at examining the association between occupational exposure to endotoxin and a serum pneumoprotein, surfactant protein A, to look for nonoccupational factors capable of confounding this association, and examine the relation between surfactant protein A and spirometry. There were 369 control subjects, 325 wastewater workers, and 84 garbage collectors in the study. Exposure to endotoxin was assessed through personal sampling and the Limulus amebocytes lysate assay. Surfactant protein A was determined by an in house sandwich enzyme-linked immunosorbent assay (ELISA) in 697 subjects. Clinical and smoking history were ascertained and spirometry carried out according to American Thoracic Society criteria. Multiple linear regression was used for statistical analysis. Exposure was fairly high during some tasks in wastewater workers but did not influence surfactant protein A. Surfactant protein A was lower in asthmatics. Interindividual variability was large. No correlation with spirometry was found. Endotoxin has no effect on surfactant protein A at these endotoxin levels and serum surfactant protein A does not correlate with spirometry. The decreased surfactant protein A secretion in asthmatics requires further study.     

Interrelationship between TP53 gene deletion, protein expression and chromosome 17 aneusomy in gastric adenocarcinoma

Background  

This study evaluates the existence of numerical alterations of chromosome 17 and TP53 gene deletion in gastric adenocarcinoma. The p53 protein expression was also evaluated, as well as, possible associations with clinicopathological characteristics.     

Identification of the amino-acetonitrile derivative monepantel (AAD 1566) as a new anthelmintic drug development candidate

Anthelmintic resistance has become a global phenomenon in gastro-intestinal nematodes of farm animals, including multi-drug resistance against the three major classes of anthelmintics. There is an urgent need for an anthelmintic with a new mode of action. The recently discovered amino-acetonitrile derivatives (AADs) offer a new class of synthetic chemicals with anthelmintic activity. The evaluation of AADs was pursued applying in vitro assays and efficacy and tolerability studies in rodents, sheep, and cattle. Amongst various suitable compounds, AAD 1566 eliminated many tested pathogenic nematode species, both at larval and adult stages, at a dose of 2.5 mg/kg bodyweight in sheep and 5.0 mg/kg bodyweight in cattle. The same doses were sufficient to cure animals infected with resistant or multi-drug-resistant nematode isolates. These findings, complemented by the good tolerability and low toxicity to mammals, suggest that AAD 1566, monepantel, would be a suitable anthelmintic drug development candidate.     

Systematic mechanism-orientated approach to chronic pancreatitis pain

Pain in chronic pancreatitis(CP) shows similarities with other visceral pain syndromes(i.e.,inflammatory bowel disease and esophagitis),which should thus be managed in a similar fashion.Typical causes of CP pain include increased intrapancreatic pressure,pancreatic inflammation and pancreatic/extrapancreatic complications.Unfortunately,CP pain continues to be a major clinical challenge.It is recognized that ongoing pain may induce altered central pain processing,e.g.,central sensitization or pro-nociceptive pain modulation.When this is present conventional pain treatment targeting the nociceptive focus,e.g.,opioid analgesia or surgical/endoscopic intervention,often fails even if technically successful.If central nervous system pain processing is altered,specific treatment targeting these changes should be instituted(e.g.,gabapentinoids,ketamine or tricyclic antidepressants).Suitable tools are now available to make altered central processing visible,including quantitative sensory testing,electroencephalograpy and(functional) magnetic resonance imaging.These techniques are potentially clinically useful diagnostic tools to analyze central pain processing and thus define optimum management approaches for pain in CP and other visceral pain syndromes.The present review proposes a systematic mechanism-orientated approach to pain management in CP based on a holistic view of the mechanisms involved.Future research should address the circumstances under which central nervous system pain processing changes in CP,and how this is influenced by ongoing nociceptive input and therapies.Thus we hope to predict which patients are at risk for developing chronic pain or not responding to therapy,leading to improved treatment of chronic pain in CP and other visceral pain disorders.