Zur Behandlung des Prostatakarzinoms

Zusammenfassung Es wird an Hand von 173 F?llen von Prostatakarzinom zur Diagnostik, Behandlung und Prognose dieses Leidens Stellung genommen. Die Ergebnisse sprechen dafür, da? eine begonnene Hormonbehandlung auf Lebzeiten fortgesetzt werden soll. Die gro?e Bedeutung der hormonellen Nachbehandlung des an Prostatakarzinom erkrankten Patienten durch den Hausarzt wird aufgezeigt.

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Summary On the basis of 173 cases of cancer of the prostate, diagnoses, treatment and prognosis of this disease are discussed. The results irrevocably prooved that a treatment with hormones once started has to be continued for the whole life. The importance of hormone-after-treatment of a patient suffering from cancer of the prostate by the family doctor is emphasized.

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Herrn Prof. Dr.F. Spath zum 70. Geburtstag gewidmet.     

Die kieferorthopädische Apparaturein Schritt zur Sensibilisierung gegen Metalle?

Zusammenfassung Chrom ist bis zu 20, Nickel zu mehr als 10 Gewichtsprozenten Bestandteil von Dentaledelstahl, wie er in der Kieferorthopädie für Bracket-und Bandmaterial verwendet wird. Chrom ist als essentielles Spurenelement toxikologische wie allergologisch weniger suspekt als Nickel, dem in Zahnheilkunde, Dermatologie und Arbeitsmedizin viel Aufmerksamkeit zukommt wegen der Auslösung von Kontaktstomatitiden und-dermatitiden. Da in einer ersten Untersuchung von der Tragezeit abhängige Korrosionserscheinungen mikroskopisch sichtbar gemacht werden konnten, wurden zur Klärung des Ausmaßes einer zusätzlichen oralen Metallexposition durch festsitzende kieferorthopädischen Behandlungsgeräte Speichelproben von Patienten vor Beginn und während kieferorthopädischer Behandlung auf Chrom und Nickel mit der elektrothermalen Atomabsorptionsspektrometrie spurenanalytisch untersucht. Die Resultate werden hinsichtlich der klinischen Bedeutung einer auf kieferorthopädische Behandlungsgeräte zurückzuführenden zusätzlichen oralen Exposition vor dem Hintergrund der Ergebnisse einer gleichzeitig von uns durchgeführten Allergieanamneseerhebung bei 472 unserer kieferorthopädischen Patienten und der einschlägigen Literatur diskutiert.

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Summary High-grade dental steel, such as is commonly used for banding and bracketing in orthodontics, consists of up to 20% chromium and more than 10% nickel by weight. As an essential trace element chromium is less likely to produce toxic or allergic side-effects than nickel, a metal which has attracted attention in dermatology, industrial medicine and dentistry on account of its allergic potential. Preliminary microscope examination revealed corrosion phenomena related to the period of appliance wear. Saliva specimens before and during orthodontic treatment were examined for nickel and chromium utilising electrothermal atomic absorption spectrometry in order to clarify the extent of additional oral metallic exposure from fixed appliances. These results are examined against the background of case histories simultaneously conducted on 472 of our orthodontic patients, as well as the relevant literature.

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Résumé L'acier spécial dentaire utilisé communément pour faire des bagues et des brackets en orthodonie, contient du chrome jusqu'à 20% et du nickel à plus de 10%. Comme oligo-élément essentiel, le chrome est moins soupçonné de produire des réactions secondaires que le nickel, métal qui retient l'attention particulière de la dermatologie, de la médecine du travail et de l'odontologie à cause de son potentiel allergique. Comme un premier examen microscopique a pu révéler des effects corrosifs en fonction de la durée de l'application des appareillages, des prélèvements de salive avant et pendant le traitement orthodontique ont été analysés pour déceler des oligo-éléments par la spectrométrie d'absorption atomatique électrothermale, afin de clarifier la mesure d'une exposition orale supplémentaire au métal due à l'emploi d'appareillages fixes. En vue de connaître l'importance clinique de l'exposition orale supplémentaire due aux apparaillages, on a analysé les résultats d'une enquète sur les allergies, basée simultanément sur les anamnèses de 472 de nos patients orthodontiques et de la littérature relative à ce sujet.

     

Influence of Orofacial Dysfunctions on Spatial and Temporal Dimensions of Swallowing Movements

BACKGROUND AND AIM: Tongue dysfunctions are of etiologic significance for the development of malocclusions and speech disorders. Electromagnetic articulography is a means of recording orofacial movements. The aim of this study was therefore to analyze differences in the spatial and temporal sequence of swallowing movements under the influence of lip and tongue dysfunctions in order to develop new means of objectifying the diagnosis of such a dysfunction. PATIENTS AND METHOD: Thirty-one subjects were monitored during reflex swallowing and while swallowing 20 ml of water. All probands also underwent evaluation by a speech pathologist as well as palatography. The entire cohort was then divided into a viscerally and a somatically swallowing group, and the movement sequences were analyzed with reference to spatial and temporal parameters. RESULTS: The temporal parameters revealed fewer significant differences than the spatial parameters. Most differences were recorded for the section between palate separation point and end of swallowing. Specific spatial or temporal variables revealing a maximum number of differences between the two groups were found for each tongue region. Swallowing water revealed notably more significant intergroup differences. The most suitable variables during the swallowing of water were the maximum distance of tongue-palate contact and the distance or time interval between palate separation point and end of swallowing. CONCLUSION: The analysis of swallowing movements by electromagnetic articulography offers opportunities to evaluate tongue dysfunctions. The most suitable combination of variables was found for each of the regions investigated. Spatial analysis of the movement pattern seems to be the most reliable method.     

Über chirurgisch-orthodontische Zusammenarbeit

Ohne ZusammenfassungMit 32 Abbildungen     

Anwendungsmöglichkeiten der Zonographie in der Kieferorthopädie

Zusammenfassung Der Röntgenapparat Zonarc ist ein speziell für den Kopfbereich entwickeltes Schichtgerät mit verschiedenen Schichtwahlmöglichkeiten. In der vorliegenden Arbeit wurden menschliche Knochenschädel unterschiedlicher Entwicklungsstufen mit diesem Gerät untersucht, es kamen folgende Projektionen zur Anwendung: das DENT-Programm, das JLA-spezial-Programm (bei geöffnetem und geschlossenem Mund) und das JSA-Programm (bei geöffnetem und geschlossenem Mund).Die Positionierung der Schädel sowie die korrekte Einstellung des Gerätes werden beschrieben und die Qualität der Wiedergabe der abgebildeten Strukturen diskutiert.Aus den Ergebnissen läß sich folgern, daß die Projektionen JLA (Kiefergelenk seitlich) und JSA (Kiefergelenk sagittal) in der kieferorthopädischen Diagnostik Bedeutung erlangen können; der apparative Aufwand ist jedoch sehr hoch.

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Summary The Zonarc is a panoramic device in maxillofacial radiology that is programmed to cover different image layers. In this study human skulls of various sizes and various stages of development were examined with the aid of this equipment. The following projections were used: DENT program, JLA (special) program (TMJ side view, mouth open and closed), JSA program (TMJ sagittal, mouth open and closed).The positioning of the skulls as well as the correct adjustment of the equipment have been described on the basis of this investigation. The quality of reproduction of the skeletal tissue is discussed.The results indicate that the projections JLA and JSA can be used to advantage in orthodontic diagnosis. However one has to take the cost factor into consideration.

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Résumé L'appareil de radiographie «Zonarc» a été spécialement développé pour la tomographie du crâne, permettant au médecin de choisir la profondeur (couche) voulue. Dans la présente étude, on s'est servi de cet apparaeil pour examiner des crânes humains à différents stades de développement en choisissant les projections suivantes: le programme DENT, le programme (spécial) JLA (jaw lateral articulation= articulation temporo mandibulaire, plan frontal) bouche overte et bouche fermée, le programme JSa (jaw sagittal articulation=articulation temporo-mandibulaire, plan sagittal)-bouche ouverte et bouche fermée.La présente étude décrit le positionnement de divers crânes ainsi que le réglage correct de l'appareil, et traite, d'un point de vue critique, de la qualité des reproductions des structures en question.Les résultats de cette étude permettent de conclure que les projections JLA (articulation temporo mandibulaire, plan frontal) et JSA (articulation temporo-mandibulaire, plan sagittal) trouveront sans doute leur place dans le diagnostic en orthopédie dento-faciale; les frais occasionnés par ces appareils sont cependant très importants.

     

Hepatitis B and C in doctors and dentists in Nigeria

We surveyed a random sample (n = 75) of doctors and dentists at University College Hospital, Ibadan, Nigeria. They were offered anonymous testing for hepatitis B surface antigen (HBsAg), hepatitis Be antigen (HBeAG), antibodies to hepatitis B core antigen (anti-HBc) and to hepatitis C virus (anti-HCV), by enzyme immunoassay. The results suggest a high prevalence of hepatitis B virus (HBV) with a high potential of transmissibility, as well as a high prevalence of HCV infection. The majority of the doctors and dentists use universal precaution for protection against viral hepatitis on < 50% of the occasions when they carry out procedures on their patients. Infection with HBV was associated with type of specialty (surgeons, dentists) and lack of HBV vaccination (p < 0.05). After logistic regression, these factors were independently associated with HBV infection (p < 0.05). Sixty (80%) had not received prior HBV vaccination. Unvaccinated personnel were more likely to be surgeons, dentists, < 37 years of age, and have fewer years of professional activity (p < 0.05). After logistic regression, only fewer years of professional activity remained independently associated with lack of vaccination (p < 0.05). To reduce the occupational exposure of HBV, universal precautions must be rigorously adhered to when the doctors and dentists carry out procedures on their patients, and all health-care workers should be vaccinated with HBV vaccine and the HCV vaccine, when it becomes available.      

Effect of streptozotocin-induced hyperglycaemia on intravenous pharmacokinetics and acute cardiotoxicity of doxorubicin in rats.

The present study was designed to investigate the pharmacokinetics and acute cardiotoxicity of doxorubicin (DOX) after intravenous (i.v.) administration (15 mg kg(-1)) to streptozotocin (STZ)-induced hyperglycaemic and normoglycaemic male Wistar albino rats. In STZ diabetic rats the area under the serum DOX time-concentration curve (AUC(0-24 h)) increased (13.35+/-1.33 compared with 7.13+/-0.71 microg h(-1) ml(-1); P<0.0001) and plasma and renal DOX clearance decreased. The DOX accumulation in STZ-induced diabetic rat heart (12.7+/-1.2 microg g(-1)) was increased (P<0.05) compared with non-diabetic hearts (11.0+/-0.9 microg/g), 24 h after DOX administration. Serum creatine phosphokinase (CPK) activity showed 25% increase in peak level in STZ diabetic rats compared to non-diabetic rats. DOX produced a reduction in heart rate of anaesthetized non-diabetic (20%) and diabetic (14%) rats 1 and 2 h after its administration, respectively. Isolated atria of diabetic rats were more sensitive to the negative chronotropic effect of DOX (150 microm). These preliminary results indicate that hyperglycaemia may alter the pharmacokinetics and acute cardiotoxicity of DOX and suggest that i.v. doses of DOX in diabetic patients may need to be modified if the present data could be extrapolated to humans.