An analysis of canal centering using mechanical instrumentation techniques.

The purpose of this study was to compare canal transportation in moderately curved canals using mechanical instrumentation systems. Mesial roots of mandibular first or second molars were mounted in resin using a modified Bramante muffle system and divided into four groups. The roots were cross-sectioned 2 mm from the working length and at the height of root curvature. Tracings of the canal were made from preinstrumentation slides of the cross-sections. The canals were prepared using ProFile Series 29 rotary instruments, Quantec 2000 rotary instruments, Flex-R files in the Endo Gripper contra-angle handpiece, and Shaping Hedstrom files in the M4 contra-angle handpiece. Tracings of the prepared canals were made onto the originals from postinstrumentation slides. A canal centering ratio was calculated along the line of maximum transportation. Quantec 2000 rotary instruments yielded significantly greater transportation at the apical level when compared with the Profile Series 29 system. There were no other significant differences in transportation at either level. There were no differences in the direction of canal transportation between instrument systems, and the direction of canal transportation was not related to the direction of canal curvature. Canal preparation time was shortest with Profile Series 29 system followed by Flex-R files in the Endo Gripper, Quantec 2000, and Shaping Hedstrom files in the M4.

[Successful treatment of hyperthyroidism simulating acute abdomen and psychosis]. / Akut hasi katasztrófa képében jelentkezö és psychosist utánzó hyperthyreosis gyógyított esete.

A 49 years old female patient entered the surgical department because of epigastric and ileocoecal pains with the symptoms of acute abdomen. A surgical intervention was performed because of supposed appendicitis, but it was not verified. During the surgical observation the patient was confused and negativistic so she was transferred to the psychiatric department. Because of loss of 20 kg weight, high blood sedimentation and anaemia she was sent to our department with the suspicion of an organic disease. A moderate exophthalmos, glittering eyes and Graefe's sign was noted, therefore hyperthyroidism was diagnosed, which was proved by Kocher's blood picture, low serum cholesterol, extremely high T3 and T4 level, and iodine storage diagram. The antithyreotic treatment resulted a dramatic improvement in the extremely serious moreover hopeless case and after a long-term treatment the patient became symptom-free without complaints. Later because of regression of hyperthyreoidism and the growing nodular goitre the patient was treated on two occasions with radioactive iodine. At present the patient is in remission.

[Hyperparathyroidism simulating severe hypercalcemia syndrome]. / Súlyos hypercalcaemia syndroma képében jelentkezö hyperparathyreosis.

The case history of a 65 year old female patient has been reported here by the authors. The patient was admitted to the Intensive Therapy Unit owing to her repeated heart pain. Later she was transferred to the Department of Medicine to establish the exact diagnosis. Prepyloric ulcer and hypertension were occurred in her history. The symptoms of her preceding as well as her recent illness were: pain in epigastric field, nausea, adynamia, weakness, polyuria, significant loss of weight, somnolence and the shortened Q--T time in electrocardiogram related to hypercalcemia syndrome. The calcium value in blood proved to be at critically high level from time to time. The possibility of the secondary hypercalcemic state was excluded by sonographic examination and the elevated level of parathormone in blood established the diagnosis of the hyperparathyroidism. The surgical resection of parathyroidic adenoma yielded a complete recovery of the patient. The authors call the attention to the significance of the clinical signs in the diagnosis of the disease.

Biparietal diameter as a predictor of fetal lung maturity.

A correlation has been established between fetal biparietal diameter (BPD), amniotic fluid lecithin/sphingomyelin (L/S) ratio and optical density at 650 nm (O.D. 650). We have noted that if the BPD is greater than 9.2 cm, the L/S ratio and O.D. 650 will be greater than 2.0 and 0.15, respectively, in 90% of cases. We reviewed the literature on the complication rate of third-trimester amniocentesis under ultrasonic guidance and concluded that in the absence of good dating, a reliably obtained BPD greater than 9.2 cm indicates fetal lung maturity in cases where amniotic fluid studies cannot be performed.

[The local treatment of ozaena with streptomycin and novocaine (author's transl)]. / Unsere Erfahrungen bei der lokalen Streptomycin-Novocain Behandlung der Ozaena

The essence of this treatment is the injection of a mixture of 250 mgm of streptomycin (5 ml) and novocaine 1% (5 ml) on alternate days. The 10 ml mixture was injected into the conchae and submucosally into the septum on either side. Cure generally required a total of 2--3 gm of streptomycin over 15--20 days. Review of 25 cases treated over the past 15 years showed that 44% became symptom free and "good" results occurred in another 40%. In 16% treatment proved ineffective. Rehabilation was manifest by relief of subjective symptoms and disappearance of crusting and foetor. Atrophy remained irreversible.