Morphological basis of sensory neuropathy and neuroimmunomodulation in minor salivary glands of patients with Sjögren's syndrome.

OBJECTIVE: A predominance of sensory neuropathy was earlier described in Sjögren's syndrome (SS), which might precede the presence of sicca symptoms. The mechanism of sensory neuropathy in SS is unknown. Therefore, the aim of this study was to determine the quantitative changes of the different neuropeptide containing nerve terminals and the immunocompetent cells in labial salivary glands of primary SS. DESIGN: Immunohisto- and immunocytochemical methods were used for the detection of immunoreactive (IR) elements and the data were compared with the healthy controls. RESULTS: All of the investigated IR nerve fibres were found in different quantity and localisation in both of control and SS glands. The density of them was changed variously in SS. The number of the substance P (SP), neuropeptide Y (NPY) (P < 0.05), galanin (GAL) IR nerve terminals was decreased, however, the number of vasoactive intestinal polypeptide (VIP) and tyrosine beta-hydroxylase (TH) IR nerve fibres (P < 0.05) was increased compared to the control. There were no IR immunocompetent cells in the control materials, however, a large number of them showed IR for SP (46.2%) and NPY (34.4%) in the SS. The IR was demonstrated mainly in the mast cells, plasma cells and some of the lymphocytes. CONCLUSIONS: These neuropeptides might have a role in the sensory neuropathy; they might activate nociceptive and sympathetic pathways. Some neuropeptides (SP, NPY) are endogenous in the immune system and produced in certain conditions, e.g. inflammation and chronic autoimmune disorders such as SS, so they might participate in the neuroimmunomodulation and contribute to the atrophy, apoptosis and necrosis.

[Evaluation of clinical data and immuno-modulating treatment of patients with oral lichen planus]. / Lichenes betegeink klinikai adatainak feldolgozása és immunmoduláns kezelésük értékelése.

The number of patients with oral lichen planus increases all over the world. The treatment of this disease is not yet definitive. Although the etiology is not clear until now increasing number of data show relations between the environment and immune-responsiveness. In this study the data (medical history and laboratory test results) of 33 lichen oris patients were processed. The prevalence of diabetes mellitus was much higher in lichen patients, than in persons without lichen oris. Likewise, higher transaminase serum levels in lichen patients were found, and there were two HCV positive cases among them. In contrast to the literary data instead of immune suppressive treatment the immune modulant treatment has been applied: 78% of beta levamisole treated and 90% of interferon alpha treated patients were cured. Only lichen patients without symptoms of general diseases could be stabilized.

[The use of Betadine antiseptic in the treatment of oral surgical, parodontological and oral mucosal diseases]. / Betadine fertótlenítószer alkalmazása szájsebészeti parodontológiai, és szájnyálkahártya betegségek kezelésében.

The Betadine is an antiseptic PVP (polyvinil prrolidon)-iodine containing, water soluble solution, which has been in circulation in Hungary for years. Until now Betadine was not applied in the oral cavity for bacterial and fungal infections, although its effectiveness is unquery. The PVP-iodine is water solubilized that's why it does not sting the healthy or ill oral mucosa and has not side effects as discoloration of the teeth and tongue and trouble in the sensation of taste as does chlorhexidine. The only contraindication is iodine allergy. In the present study: in periodontal cases (abscesses, postoperative prevention) and in oral medicine cases alone or in combination with specific treatment schedule was Betadine applied. PVP-iodine as oral rinse was applied in 25 cases. According to our experience Betadine was excellent against bacterial and fungal infections in the oral cavity, which prevent or treat bacterial infections after surgical interventions. By this way the bacterial superinfections of exulcerant oral mucosal diseases avoidable.

[A 3-year experience with guided tissue regeneration procedures]. / Az irányított szövetregenerációs technikákkal nyert három éves klinikai tapasztalatok.

The Guided Tissue Regeneration (GTR) procedures are promoting a clinically and radiologically as well as histologically verifiably periodontal attachment gain. The objective of the study was to evaluate the clinical efficacy of these GTR techniques. In the past four years different barrier membranes (Gore-tex, Resolut and Guidor) were used around 318 teeth of 196 patients. 169 periodontal defects of 140 patients were followed up at least for two years. 54 patient had chronic adult type periodontitis, 67 suffered with rapidly progressing periodontitis and 15 had different severe mucogingival lesions. 111 vertical bony defects, 43 Class II-III furcation lesions and 15 mucogingival lesions were surgically corrected. The average preoperative probing depth (PD) and the clinical attachment loss (CAL) of the vertical bony defects were 5.3 +/- 1.7 mm and 6.2 +/- 1.9 mm respectively. The PD of the deepest Class III furcation lesion was 11 mm. The average gingival recession of the mucogingival lesions was 4.5 +/- 1.1 mm. The GTR technique provided the best results in the Class II-III furcation lesions, where an average 2.4 +/- 0.9 clinical attachment gain was observed one year postoperatively. The GTR techniques provided an average 1.8 +/- 1.2 mm attachment gain in the vertical bony crater cases. In both groups of cases a marked gingival recession followed the healing and the periodontal regeneration. In this way the average reduction in the probing depth exceeded the average attachment gain by more that 1.5 mm. 1 year after the operation the average radiologic bone fill was about 0.9-1.2 mm. The resorbable barrier membranes resulted in clinically significant root coverage and an average 3.5 +/- 1.7 mm gain in the width of keratinized gingiva. The success or failure of our cases were mainly determined by the patient's compliance, the level of the postoperative professional and individual oral hygiene and the number of periodontal recalls. These findings are also underlining the importance of the high standard of oral hygiene in the postoperative periodontal regeneration.

[OraTest. A new method for differentiating between benign and malignant oral tumors]. / OraTest. Egy lehetöség, mely megkönnyíti a szájban lévOFF rosszindulatú daganatok elkülönítését.

This article introduces a new, simple and quick method with which the final treatment of the patients with oral risk factors and precancerous lesions can be decided. It is a rinsing method with an 0.1% toluidine blue O dye. After a pre- and postrinse with acetic acid and toluidin blue dye application the oral mucous membrane areas retaining the dye will indicate the possible malignant lesions even in those areas where just histologically detectable dysplasia is present. On the basis of the literature and on our practice we can advice to use OraTest to examine patients in the risk factor group, the patients with suspected disease and patients with speckled, exulcerant and erythroleukoplakia.

[The role of sensitivity of oral hygiene indices in the selection of proper methodology of plaque-control clinical studies]. / A szájhigiéniás indexek érzékenységének szerepe a plakk-kontroll klinikai vizsgáló módszereinek kiválasztásában.

UNLABELLED: A double blind split-pilot study was carried out to test the potential increase in sensitivity of the Quigley and Hein (Turesky modification) plaque index using a six site recording technique against the two site technique in assessing the antiplaque effects of dentifrices. The study also evaluated the impact of asking the subjects not to brush their teeth the morning of the evaluations versus those who where hot given these instruction. The results indicated that the triclosan containing dentifrice had a significant anti-plaque effect over the placebo at 3 weeks when using both two (p = 0.003) and six (p = 0.002) sited plaque assessment methods. However the six-sited index demonstrated the greater efficacy for the active dentifrice. At six weeks no statistically significant difference between the two dentifrices was seen. The instruction of subjects not to brush before the plaque evaluation increased the mean plaque scores as well as the treatment effect at any time. IN CONCLUSION: The six-sited plaque index increased the sensitivity of the index in determining the anti-plaque efficacy of dentifrices, as well as indicating that instructing subjects not to brush preceding their plaque evaluations also increases sensitivity for determining anti-plaque efficacy of dentifrices.

Immunoscintigraphy of experimental transplantable tumours using monoclonal antibody against myelin basic protein.

Monoclonal antibody was prepared against myelin basic protein a so-called pancarcinoma antigen. After labelling with 131I the monoclonal antibody was injected into Lewis-lung cancer mice and rats with Walker breast cancer. Two, 24, 48, 72 and 96 hours after the labelled monoclonal antibody injection, radioimmunoimaging studies were carried out. After each gamma-camera study, organ distribution of the labelled monoclonal antibody was determined with radiobioassay technique which showed significantly higher activity in the tumour tissue than in healthy ones. Significant sample radioactivity could be recovered in the tumour masses 48 hours after injection, which persisted even after 96 hours. The later finding might enable diagnosing types of malignancy with isotope-labelled monoclonal antibody against myelin basic protein.

Circulating immune complex studies on patients with oral lichen planus.

To investigate the role of systemic factors such as age, diabetes, and hypertension in the formation of subepithelial immune deposits in oral lichen planus (OLP) we performed circulating immune complex CIC determinations by polyethylene glycol precipitation in sera of patients with OLP, diabetes mellitus, and hypertension and in sera of healthy control subjects. We examined patients with leukoplakia as a control group with oral keratosis but no OLP. Forty percent of the OLP patients were suffering from diabetes, hypertension, or both. The occurrence of CIC positivity was higher in the OLP group with diabetes than in the group with OLP only. However, we could not find CIC positivity in our control patients with diabetes. The almost equal distribution of hypertension among, patients with OLP who tested positive for CIC and those who tested negative does not seem to support the hypothesis that this factor causes the CIC positivity in OLP. The same applies to other assumed factors such as age, medication, dental foci, or metal framework. In summary, we support the idea that CIC positivity may be the consequence of lichen itself, but diabetes and hypertension contribute to the development of erosive OLP lesions.

Humoral leukocyte adherence inhibition (H-LAI) with basic encephalitogenic protein (BEP) in head and neck cancer.

Fourty-five patients with head and neck cancer and 30 healthy subjects were evaluated by a modified humoral leukocyte adherence inhibition assay using basic encephalitogenic protein as antigen. Ninety-three percent of cancer patients gave a positive reaction, whereas every control person remained negative. The results suggest that humoral leukocyte adherence inhibition assay performed with basic encephalitogenic protein may be useful as an early diagnostic tool in head and neck cancer.

Beta-adrenoceptor stimulation and cyclic AMP levels in bovine tracheal muscle of old and young animals.

The relationship between cyclic AMP levels and mechanical activity after exposure to isoprenaline was studied in tracheal smooth muscle. It was found that the basal cyclic AMP content decreased with age. The relaxing effects of isoprenaline, theophylline and papaverine were tested on muscles contracted by histamine, acetylcholine or carbacholine. Isoprenaline completely relaxed histamine contracted tracheas, but not those contracted by acetylcholine or carbacholine. Theophylline and papaverine completely relaxed the tracheas irrespective of whether the contracting agent was histamine, acetylcholine or carbacholine. Isoprenaline increased the cyclic AMP content of bovine trachea; this effect was stronger in muscles with spontaneous tension than in histamine contracted muscles. In muscles contracted by carbachol, isoprenaline increased the cyclic AMP level after 5 min. The correlations between the changes in the cyclic AMP levels and the tension in tracheal smooth muscle support the hypothesis that this nucleotide plays a role in the relaxation process.

[Late results in surgical treatment of periodontal diseases]. / Spätergebnisse der operativen Behandlung der Parodontopathien

The authors re-examined 102 patients who had undergone periodontal surgical intervention 1--15 years ago. In 50% the results were good, in 25% they were mediocre, and in 25% they were poor. The results from gingivectomies were better than those from flap operations. The operation results were better in younger patients. The proportion of lost teeth was 14%. Oral hygiene was unsatisfactory in 65,7% of the cases. The relatively unfavourable results may be explained by the tardiness of intervention and the neglect of oral hygienic measures.