Typology of the antegonial notch in the human mandible.

BACKGROUND: Surgical treatment for serious malocclusions and fractures of the organ of mastication is a golden standard in medicine. Procedures performed on the mandible require detailed knowledge of the anatomy of the organ. Antegonial notching constitutes a serious technical challenge for surgeons. Therefore, a detailed anatomical description of this structure, which is the subject of this paper, is essential. MATERIALS AND METHODS: We analysed 251 human Caucasian mandibles of identified sex and took measurements of all sections describing the mandibular antegonial notch. Depending on the proportion between sections we classified the shape of the antegonial notch into three types. The surface area of the notch was calculated. We analysed the dimorphic and bilateral differences for each of the three types of notch. We used variance analysis for the assessment of statistical difference. RESULTS: The analysis revealed that in both men and women, regardless of body side, the type 3 antegonial notch was the most frequent. Type 3 occurred with a frequency of between 38% in men on the right side and 55.9% in women on the left side of the body. Type 1 was the least frequent. Dimorphic differences in the presence of individual types of antegonial notch were statistically significant only for the left side of the body. The symmetrical type (type 2) occurred more frequently in men (by 11%) than in women. Type 3 was found more frequently in women (by 10%) than in men. Bilateral differences in men were revealed for the frequencies of types 1 and 3. On the right side type 1 was more frequent (by 8%), and on the left side type 3 was also more frequent (by 8%). The greatest surface area was found for the asymmetrical posterior type (type 1). The smallest surface area was found for the asymmetrical anterior type 3. This difference was statistically significant with respect to the surface area of types 1 and type 2 and found for both sexes for both sides of the body. However, no statistically significant differences were found between the surface areas of types 1 or 2. CONCLUSIONS: Knowledge of the preangular notch anatomy can be useful for surgeons during reconstructive and plastic procedures on the body of the mandible.

A controlled, double-blind, randomized study on the efficacy of Lactobacillus plantarum 299V in patients with irritable bowel syndrome.

BACKGROUND: Irritable bowel syndrome (IBS) is a widespread functional disorder of the digestive tract. Its aetiology is unknown and therapeutic options are limited. Recent reports suggest that probiotics may have a role in regulating the motility of the digestive tract. AIM: To assess the efficacy of Lactobacillus plantarum 299V (LP299V) in patients with IBS. PATIENTS AND METHODS: Forty patients were randomized to receive either LP299V in liquid suspension (20 patients) or placebo (20 patients) over a period of 4 weeks. Clinical examination was performed at baseline and at the end of the study. Additionally, patients assessed their symptoms by applying a scoring system. RESULTS: All patients treated with LP299V reported resolution of their abdominal pain as compared to 11 patients from a placebo group (P = 0.0012). There was also a trend towards normalization of stools frequency in constipated patients in six out of 10 patients treated with LP299V compared with two out of 11 treated with placebo (P = 0.17). With regards to all IBS symptoms an improvement was noted in 95% of patients in the LP299V group vs 15% of patients in the placebo group (P < 0.0001). CONCLUSIONS: LP299V seems to have a beneficial effect in patients with IBS. Further studies on larger cohorts of patients and with longer duration of therapy are required in order to establish the place of L. plantarum in the treatment of IBS.

Impact of functional dyspepsia on quality of life and health care consumption after cessation of antisecretory treatment. A multicentre 3-month follow-up study.

BACKGROUND: The impact of response to treatment on subsequent symptoms, quality of life, health care consumption, and absence from work in functional dyspepsia is unknown. METHODS: Patients with functional dyspepsia from Denmark, France, Germany, The Netherlands, Hungary, and Poland (n = 567 (215 men), 18-80 years old) were followed up for 3 months after a 4-week treatment trial with omeprazole (20 mg or 10 mg) or placebo. The patients were blinded to the initial treatment. Dyspeptic symptoms and quality of life were assessed, and dyspepsia-related costs were calculated in terms of number of clinic visits, days on medication, and absence from work. RESULTS: Responders had fewer clinic visits than non-responders (1.5 versus 2.0 mean visits) and fewer days on medication (mean, 9 days versus 23 days) over the 3-month period (both, P < 0.001). The quality of life in responders was better at study entry and persisted over 3 months (all, P < 0.001). When analysed country by country, health care costs due to clinic visits and medications were significantly lower in responders in all countries (P < 0.05), except Denmark and The Netherlands. CONCLUSION: Symptom resolution in patients with functional dyspepsia has a positive impact on quality of life and reduces the subsequent costs over a 3-month period after cessation of initial treatment.

Efficacy of omeprazole in functional dyspepsia: double-blind, randomized, placebo-controlled trials (the Bond and Opera studies).

BACKGROUND: The efficacy of H2-receptor antagonists in functional dyspepsia is equivocal and the therapeutic place of proton pump inhibitors in functional dyspepsia is unknown. AIM: To evaluate the efficacy of proton pump inhibitor therapy in functional dyspepsia. METHODS: Patients (n = 1262) with a clinical diagnosis of functional dyspepsia (persistent or recurrent epigastric pain or discomfort for at least 1 month and a normal upper gastrointestinal endoscopy) were randomized to receive omeprazole 20 mg, 10 mg or identical placebo, for 4 weeks. Symptoms were assessed using validated measures. Helicobacter pylori status was determined pre-entry by a 13C-urea breath test. RESULTS: On an intention-to-treat analysis (n=1248), complete symptom relief was observed in 38% on omeprazole 20 mg, compared with 36% on omeprazole 10 mg and 28% on placebo (P = 0.002 and 0.02, respectively). Among those with ulcer-like and reflux-like dyspepsia, complete symptom relief was achieved in 40% and 54% on omeprazole 20 mg, and 35% and 45% on omeprazole 10 mg, respectively, compared with 27% and 23% on placebo (all P < 0.05, except omeprazole 10 mg in ulcer-like dyspepsia, P = 0.08). There was no significant benefit of omeprazole over placebo in dysmotility-like dyspepsia. Symptom relief was similar in H. pylori-positive and negative cases. CONCLUSIONS: Omeprazole is modestly superior to placebo in functional dyspepsia at standard (20 mg) and low doses (10 mg) but not in patients with dysmotility-like dyspepsia.

Is Helicobacter pylori infection a risk or protective factor for mucosal lesions development in patients chronically treated with acetylsalicylic acid?

The interaction between ASA and H.p. as the strongest irritants to gastric mucosa has not been sufficiently documented to date. The aim of our study was to evaluate the frequency of mucosal lesions in stomach and duodenum and the frequency of H.p. infection in patients suffering from IHD and chronically taking ASA. We evaluated the number of mucosal lesions and the incidence rate in relation to the daily dose of ASA. We examined 96 with IHD treated with ASA in doses: 75, 150 or 300 mg per day. We assessed the number of mucosal lesions and H.p. status. The control groups included 80 patients treated for IHD who did not take ASA and 50 patients who did not suffer from IHD. The highest rate of mucosal lesions we found in the group of patients with IHD treated with ASA: 62% vs 41% in patients not using ASA and 8% in the control group. We did not find any essential difference in mucosal lesions occurrence between patients treated with 75 or 150 and 300 mg per day. In patients with IHD using ASA the frequency of H.p. infection was higher in comparison to patients not receiving ASA (68% vs 47%) and to control group (68% vs 26%). ASA users infected with H.p. had more mucosal lesions (75%) in comparison to those not using ASA (47%). Our results confirm the synergistic harmful influence of ASA and H.p. infection on gastric and duodenal mucosa. It seems to us that the frequency of mucosal lesions development does not depend on the daily dose of ASA.

[Alcoholic hepatitis]. / Alkoholowe zapalenie watroby.

The character is presented of the changes in the pathomorphological picture of alcoholic hepatocellular damage. The most frequently observed forms of clinical picture of alcoholic hepatitis are discussed. In the diagnosis of this nosological entity the role is stressed of liver biopsy as the method making possible obtaining of the most reliable diagnostic-prognostic information. In comparison with pathological examination of liver biopsy specimen, biochemical investigations are less useful in view of their low specificity.

[Myeloblastoma of the brain and spinal cord in a patient with acute myelomonocytic leukemia]. / Myeloblastoma mózgu i rdzenia kregowego u chorego na ostra bialaczke mielomonocytowa.

A case of the myeloblastoma involving brain and spinal cord in a patient with acute myelomonocytic leukemia is reported. Numerous mitoses within the tumor provide an evidence for local cell proliferation in the neoplasm. Surgery combined with radiotherapy is suggested as the most efficient modality of the treatment.

Application of a multistage classifier to the diagnosis of some occupational disease groups.

This paper describes the basic concept of a multistage classifier and gives the results of the application of this approach to the diagnosis of vibratory syndrome and other diseases with similar symptoms. The multistage classifier was applied to classification of the most informative symptoms at particular stages of classification.

[The mechanism of cell proliferation in acute (immature-cell) leukemia]. / Badania nad mechanizmem proliferacji komórkowej w bialaczkach ostrych (niedojrzalokomórkowych).

In 40 patients with acute leukaemias the 3H-thymidine and mitosis indices were determined in the population of blast cells in bone marrow and the cellularity of bone marrow was determined. The studies were carried out in the first episode of the disease before treatment and in some patients (13) they were repeated during relapse after remission or improvement. The results showed that proliferative activity of blast cells was reduced in relation to precursors of normal granulopoiesis in all forms of acute leukaemia. Myeloblastic leukaemias showed a greater scater of values of both proliferation parameters in relation to lymphoblastic leukaemias. It was found, moreover, that in highly cellular bone marrow the proliferative activity of blast cell population was significantly lower than in patients with low bone marrow cellularity. On the ground of this observation the authors put forward the view that in acute leukaemias the intrinsic mechanism controlling the proliferation of cells is disturbed.

The parameters of cellular proliferation in acute (immature-cell) leukemias.

In 20 patients with acute leukemia the 3H-thymidine labelling index and the mitotic index were determined in the population of leukemic blast cells and the degree of bone marrow infiltration was evaluated. Determinations were carried out in acute stage of the disease and in 4 cases additionally during improvement or remission and then during subsequent exacerbations. In the acute phase of the disease both indices were low in comparison with the indices obtained in normal granulocytopoiesis. In acute leukemia in 15 cases the bone marrow contained high or moderate number of cells, while in 5 remaining cases it was low. The 3H-thymidine labelling index and the mitotic index were lower in acute period of the disease in patients with bone marrow infiltration as compared with patients with hypoplastic bone marrow. During improvement both proliferation indices increased.