Lege Artis Medicinae

[A Poem Cycle by Zsuzsa Tamás – Pictures by Tímea Fodor]

MARCH 19, 2007

Lege Artis Medicinae - 2007;17(03)

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Lege Artis Medicinae

[Velopharyngeal Insufficiency With and Without Cleft Palate Diagnostics and Treatment of Hypernasality]

MÉSZÁROS Krisztina

Lege Artis Medicinae

[PATHOPHYSIOLOGY, DIAGNOSIS AND THERAPY OF THE EXTRAOESOPHAGEAL MANIFESTATIONS OF GASTRO-OESOPHAGEAL REFLUX DISEASE]

ROSZTÓCZY András

[Recently, considerable interest has been focused on the extra-oesophageal manifestations of gastro- oesophageal reflux disease. Vago-vagal reflex mechanisms have been shown to play a leading role in the pathogenesis of the extra-oesophageal manifestations. In addition, proximal reflux and subsequent chemical irritation of the respiratory tract mucosa are important factors in the development of respiratory symptoms. In contrast to the uncomplicated cases of gastrooesophageal reflux disease, the recognition of these variations may pose a diagnostic challenge right because of the lack of typical symptoms. Successful diagnosis rests with the cooperation of the general practitioner, the specialist observing the extra-oesophageal symptom and the gastroenterologist. The establishment of the pathogenic role of gastro-oesophageal reflux may require verification by oesophageal functional tests. Treatment is based on long-term administration (for at least 3 months if respiratory symptoms are present) of an increased-dose proton pump inhibitor. In the long term, laparoscopic anti-reflux surgery is a realistic alternative to medical treatment in suitable patients. Dietary and life-style education of patients has an important complementary role in the successful long term management.]

Lege Artis Medicinae

[Our Forgotten Medical Historians from the 19th Century]

KAPRONCZAY Károly

Lege Artis Medicinae

[19th World Congress of Diabetology]

HIDVÉGI Tibor

Lege Artis Medicinae

[Scientific Browsing]

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Clinical Neuroscience

[EEG investigations in cognitive impairments]

SZIRMAI Imre, KAMONDI Anita

[The EEG is an indicator of all physiological and neuropsychological activity. The α rhythm was considered as a key phenomenon in research of human mentation from the discovery of EEG. Two methods are known for the estimation of cognitive deficit by the use of quantitative EEG (QEEG). The first is based on the hypothesis, that the mean values of the normal EEG from healthy volunters can be used as reference, and deviation from the normal values of EEG parameters may suggest disease. This kind of “neurometry” was elaborated by R. E. John. The second method asseses event related (ER) transients evoked by somatosensory and mental stimuli. Quantity and localization of signals may refer to the functional state of the cortex. These reactions depend strongly on the test-paradigms. Recognition of the attention-intention cycle disclosed the psysiological mechanism of ERD (event related desynchronisation) and ERS (event related synchronisation). In contrast with the classical “stimulus-reaction” model, both perception and voluntary movement are iniciated by the brain itself, and not by the environment. Human behavior and conscious actions depend on the intention. QEEG analysis proved that the attention and intention localize in segregate areas of the brain. Both “static” and “dinamic” neurometric methods are able to differenciate the EEG records of demented patients from healthy controls, furthermore some dementias from each other. We conclude that with the help of sofisticated methods of QEEG analysis minimal functional deficit of the electrogenesis can be recognized, which could be helpful in the differential diagnosis Notwithstanding the EEG can not explain the evolution neither the normal or the diseased mental processes. The only “instrument” which is able to approach the human mind is the human cogitation itself with the aids of appropriate tests. The QEEG can be conclusive in the analysis of particular processes of mental activity, such as timing, state of activation, hierarchical organisation of cortical territories and mechanism of electrogenesis.]

Clinical Neuroscience

[THE SIGNIFICANCE OF CHLAMYDIA PNEUMONIAE IN SELECTED NEUROLOGIC DISORDERS]

HORVÁTH Zoltán, VÉCSEI László

[Chlamydia pneumoniae has recently been implicated in the pathogenesis of several neurological diseases. As an intracellular parasite with its unusual life cycle it is able to circumvent the immune system and to persist in the organism. It has the ability to modify the function of the infected cell and supposedly induce autoimmune reactions. These properties can make it pathogenic in several chronic neurological diseases including multiple sclerosis, atherosclerosis, stroke, Alzheimer dementia and giant cell arteriitis. The evaluation of the available, often contradictory, data that are based on various different methods is not easy. The importance of the issue is enhanced by the potential need for antibiotic treatment.]

Lege Artis Medicinae

[The Loves of Abe Moyra – Pictures of a Posthumous Exhibition ]

NÉMETH István

Hungarian Radiology

[Digital volume tomography - The use of cone beam CT in dentistry, oral and maxillofacial surgery]

PLACHTOVICS Márk

[Oral and maxillofacial radiology is a subspecialty with its own field of indication. The goal is to achieve proper diagnostic image quality with the minimal amount of harmful radiation. The most common acquisition techniques are the intraoral radiograph and the panoramic radiograph which result in an overview picture of the whole dental status of the patient or the full mouth survey with the higher doses of radiation indicated for periodontological treatment. The next level is the supplementary radiograph such as occlusal radiograph, transversal tomography (some panoramic radiographs have this option), lateral cephalometric projection, submentovertex view or Waters projection, etc. More over cone beam CT acquisition or digital volume tomography as is called. In case of some described special indications CT, MRI or sometimes US acquisition can be made. In the field of three dimensional radio-diagnostics, the CT has a superior place with well-known advantages for everybody, and the usage has been limited only by the high radiation dose. The main point of the acquisition is the image quality. The load of radiation only makes the field of indication narrow. In every day practice - because of the higher radiation load of each high quality CT - the pictures passing to the doctor are preferred to take with lower resolution and wider slices although the diagnostic value of this never reaches the wanted level. This is why this new acquisition system also mentioned in the title would be better known. This system works with reasonable low radiation coupling with the possibilities of the high fidelity 3D imaging focusing on the bony structures of the head and neck region. The purpose of this article is to give a comprehensive introduction to this method in use for more than a decade. From 2006 in Hungary we also have the option to use the technology.]

Hungarian Radiology

[Computer tomography based planning by personal computer in surgery of forefoot]

HUSZANYIK István, HEGEDŰS Franciska, RÓDE László

[BACKGROUND - In contradiction to traditional osteographic registrations CT pictures give the possibility of precise and size proportional measurements. Three-dimensional reconstructions can help in imaging of stereoscopic structures, however later reediting is not possible. Authors elaborated a CT based system for planning surgical interventions with personal computer. MATERIALS AND METHODS - The new method is described using a forefoot surgery model. The measurements were based on three subcapital osteotomy of 1st metatarsus. The length of 1st metatarsus, the 1st-2nd metatarsus index, the 1st-2nd intermetatarsal angle, and dorsoplantar movement of 1st-2nd metatarsal head were determined. RESULTS - The postoperative result of correction and pathologic bone movement can also precisely determined by this method. CONCLUSION - This method seems to be practical for elaboration of other new operating techniques, predicting and verifying their results before clinical use.]