[Therapeutic problems with HIV-infected tuberculous spondylitis patients in the South African Republic]. / HIV fertözött spondylitis tuberculosában szenvedö betegek ellátásának problémái a Dél-afrikai Köztársaságban.

We can only hope, that the dual epidemic of tuberculosis and HIV disease is not going to affect the population of Europe and Hungary so badly and unexpectedly as it happened in sub-Saharan Africa. The spinal tuberculosis with or without paraplegia presents with increasing frequency and their management may differ from those without HIV infection. The success of antituberculotic drug therapy alone reduced the role of surgeons to a largely diagnostic one, however complications frequently require surgery.

Segmental spinal instrumentation in the early fixation of the fracture-dislocations of the dorsal and lumbar spine (S.S.1).

A total of 24 patients were admitted to the Department of Neurosurgery and Traumatology between April 1, 1985 and March 31, 1987 for fracture-dislocation of the dorsal and lumbar spine. Review of the observation of the patients is given from their hospitalization to the surgical indication. The patients with unstable spinal fracture were operated independent of their neurological status. The operative technique which contains in fixing the spine according to the operative technique elaborated by Edwardo Luque is reviewed in detail. The advantage of their method is that bent Steinmann rods are used for fixation of the spine. A detailed review of the postoperative treatment and the complications is given.

A clinico-pathological study on the correlation of immunosuppression and multiple primary malignant neoplasmas.

At present it is obvious that the incidence of second malignancies in patients with malignant diseases increases after prolonged treatment with immunosuppressive, or antineoplastic agents. The occurrence of such additional malignant diseases was analysed in our five-years autopsy material. During this period 7670 autopsies were performed. Malignant diseases were observed in 1707 cases (22.1%) and among them in 58 cases were proved multiple primary malignant neoplasms (3.3%). The average time between the occurrence of initial and second tumors was 29 months. The frequency of second tumors in patients with leukemias (mainly chronic lymphocytic leukemia) were four times higher than in patients with tumors of epithelial origin. Hepatocarcinomas arose in cirrhotic livers and astrocytomas were often followed by new malignancies. In consequence of successfully applied surgical, radiological and combined immunosuppressive, antineoplastic therapy the survival of cancer patients lengthened, so among different side-effects of the used therapy the oncogenesis cannot be left out of account. The danger of subsequent malignant tumors makes it imperative that immunosuppression should only be applied when strictly indicated.

A case of IgD-lambda myeloma.

A case of IgD myeloma is presented. The severe damage of both kidneys resulted in uraemia, and death. Fluorescein angiography failed to reveal a typical paraproteinaemic fundus. The elevated serum IgD level decreased form 1000 mg to 400 mg per 100 ml during cytostatic therapy. The effect of the antineoplastic drugs on the plasmocytes was demonstrated by microphotograms. The caryograms revealed multiple changes.