A Study of Prognostic Factors in Young Patients With Non-HPV Oral Cancer in Central Europe.

The etiological factors of squamous cell carcinomas of the head and neck have been well known for a long time. It is also well known that the incidence of oral cancer diagnosed in younger patients is on the rise. Due to the young age of these patients, the increase in the number of these cases and the fact that many of them neither smoke nor drink alcohol it has been suggested that other factors might be at play in the carcinogenesis of oral cancer. Thus, along the classic etiological factors of smoking and alcohol abuse certain molecular marker anomalies and the human papilloma virus (HPV) have emerged as potential factors. The aim of the present study is to verify the potential prognostic factors and to map the differences in biomarker expression between the young and the old patient groups. In the present study the immunohistochemical profile of samples obtained from oral squamous cell carcinomas was studied and compared with various clinico-pathological parameters. In 88 samples the expressions of p16, p53, Ki67, EGFR were studied with a tissue microarray technique under standard reaction conditions as well as the detection and typing of HPV infection with the Full Spectrum HPV DNA method. The biomarker expression profile of young patients with oral squamous cell carcinoma was compared to that of older patients (above 50). A significant difference was found between the immunohistochemical profile of the young and old patient groups in p16, Ki67 expression. The overall survival and progression free survival were influenced by p16 expression in young age.

Protective behavior or 'true' tool use? Scrutinizing the tool use behavior of ants.

In the genus Aphaenogaster, workers use tools to transport liquid food to the colony. During this behavior, ants place or drop various kinds of debris into liquids or soft food, and then, they carry the food-soaked tools back to the nest. According to some authors, this behavior is not "true" tool use because it represents two separate processes: a defense response to cover the dangerous liquid and a transport of food. Here, we investigated the debris dropping and retrieving behavior of the ant Aphaenogaster subterranea to establish which of the two hypotheses is more probable by conducting manipulative experiments. We tested the responses of eight colonies (a) to liquid food (honey-water) and nonfood liquids (water) in different distances from the nest and (b) to nonthreatening liquids previously covered or presented as small droplets. We also tested whether the nutritional condition of colonies (i.e., starved or satiated) would affect the intensity and rate of debris dropping. Our results were consistent with the tool-using behavior hypothesis. Firstly, ants clearly differentiated between honey-water and water, and they directed more of their foraging effort toward liquids farther from the nest. Secondly, ants performed object dropping even into liquids that did not pose the danger of drowning or becoming entangled. Lastly, the nutritional condition of colonies had a significant effect on the intensity and rate of object dropping, but in the opposite direction than we expected. Our results suggest that the foraging behavior of A. subterranea is more complex than that predicted by the two-component behavior hypothesis and deserves to be considered as "true" tool use.

Diagnostic problems of the mucormycosis of the maxillary sinus Case presentation.

Mucormycosis is a fulminant opportunistic infection with significant mortality in susceptible individuals. Although mortality rates vary widely (30 to 100%) according to professional literature, recently in instances with no central nervous system (CNS) involvement the survival rate averages varies between 50 and 80% owing to complex therapy. With CNS involvement, however, the fatality rate is over 80%. Predisposing diseases include diabetes mellitus, malnutrition, hematologi- cal diseases, neutropenia, burns, surgical procedures, antibiotic treatments, long-term steroid therapy and immunosuppressive therapy. Mucormycosis may at times arise even in -immunocompetent individuals. It has diverse clinical forms with the most frequent forms being rhino-maxillary and rhino-oculocerebral (the latter of which is characterized by a high mortality rate). They mainly enter the body through inhalation, with saprophytic mucor species often demonstrable in the upper respiratory tracts, which are nevertheless non-pathogenic in most healthy individuals. The spores may also enter percutaneously through traumas, skin lesions, insect bites, or injections (e.g. through intravenous drug use); as well as via the alimentary tract with contaminated foodstuff. The prognosis can be improved by a quick establishment of the diagnosis, the quick initiation of the therapy and treatment of the underlying disease. Although first and foremost the recognition and treatment of the disease does not rest with dentists and oral surgeons, in order to localize the disease it is important to examine it from a differential diagnostic point of view and interdisciplinary cooperation may also be required in a complex treatment. Our aim is to introduce mucormycosis in our case report study.

[Change in condylar and mandibular morphology in juvenile idiopathic arthritis: cone beam volumetric imaging]. / A fejecs és a mandibula morfológiájának változása juvenilis idiopátiás arthritisben: vizsgálatok cone beam CT-vel.

The aim of this study is to show the importance of Cone Beam Computerized Tomography to volumetrically quantify TMJ damage in patients with JIA, measuring condylar and mandibular real volumes. 34 children with temporomandibular involvement by Juvenile Idiopathic Arthritis were observed by Cone Beam Computerized Tomography. 4 were excluded because of several imaging noises. The mandible was isolated from others craniofacial structures; the whole mandibular volume and its components' volumes (condyle, ramus, hemibody, hemisymphysis on right side and on left side) has been calculated by a 3D volume rendering technique. The results show a highly significant statistical difference between affected side volumetric values versus normal side volumetric values above all on condyle region (P < 0.01), while they don't show any statistical differences between right side versus left side. The Cone Beam Computerized Tomography represents a huge improvement in understanding of the condyle and mandibular morphological changes, even in the early stages of the Juvenile Idiopathic Arthritis. The JIA can lead in children to temporomandibular joint damage with facial development and growth alterations.

[Introsseous schwannoma of the mandible]. / Intraosser schwannoma a mandibulában.

Schwannoma is a benign neoplasm originating from the neural sheath and occuring most often in the soft tissues of the head and neck. Intraosseous schwannoma (IS) is extremely rare, most commonly occurring in the mandible. This paper documents a case of IS and the histopathology, karyotyping, CT, and MRI in the diagnostic work-up. Histologically it was a classic schwannoma. The karyotype was normal. CT demonstrated destruction of the mandibular canal while MRI detected encasement of the inferior alveolar nerve by the tumor, and consequently the need to resect the nerve together with the tumor. Using CT and MRI, the morbidity associated with the anticipated surgery can precisely be determined preoperatively.

[A clinical study of dental surgery in anticoagulated patients]. / Antikoaguláns kezelésben részesülo betegek szájsebészeti ellátásának klinikai vizsgálata.

It is a worldwide trend that oral surgeons do not stop patients' anticoagulant therapy, but they leave the INR in the therapeutic range (INR: 2.0-3.0). The reason is that stopping drugs carries a higher risk of embolism, and thrombosis. The purpose of the present study is to reproduce these international guidelines in a Hungarian setting. On the day of surgery a lab test is performed immediately before the operation. These tests include coagulation data. A control (INR < 1.89) and an experimental group (INR: 2.0-3.0) were formed. Clinical complications, especially bleeding and thromboembolic complications were monitored. Based on the data and types of surgery no significant differences were found between the two groups. In conclusion it can be stated that it would be advisable to implement international guidelines and recommendations because there is a higher risk for anticoagulated patients if their therapy is stopped as if their INR is left in the therapeutic range. Of course appropriate wound care and bleeding control are necessary.

[Prognostic significance of type 2 diabetes in patients treated with surgery and irradiation for gingival cancer]. / A 2. típusú diabetes mellitus prognosztikai jelentôsége a sebészileg kezelt és irradiált gingiva carcinomás betegeknél.

Type 2 diabetes may be regarded as a risk factor for cancers in different sites. The aim of this study was to compare the progression of primary gingival cancers in type 2 diabetic and non-diabetic patients. This retrospective follow-up study involved 48 diabetic and 52 non-diabetic control patients with gingival squamous cell carcinoma in stage T2-3N0M0. Their treatment comprised surgical tumor extirpation, block resection of the mandible, functional cervical dissection and 60 Gy adjuvant irradiation. Progression data was recorded after a 2-year period of clinical follow-up. Surgical samples were assessed histopathologically from the aspect of tumor spread. At the end of a 2-year follow-up period, there were significantly worse clinical results in the diabetic group concerning the cervical lymph node metastases (P <0.05) and the rate of deaths (P< 0.001). Histologically, the degree of tumor invasion was significantly different in the diabetic group compared to the controls (P < 0.01). Type 2 diabetes can be regarded as a possible prognostic factor in cases of gingival carcinoma, forecasting an unfavorable course.

[A biomechanical study of the mechanical stress transmission of dental implants using finite element analysis. Part II. Experiments]. / Fogászati implantátumok mechanikai feszültség-atadásának biomechanikai vizsgálata végeselemes analízissel. II. Rész vizsgálatok.

In the first part of this two-part study the possible uses of finite element analysis in studying the stress transmission of dental implants were reviewed. In the present second part our own experiments are presented. In the first series the effect of the geometric parameters and load types on mechanical stresses arising around cylindrical implants in bone were studied with 2D and 3D finite element analysis. In the second series the stress transmissions of various implant geometries were compared and an attempt was made to determine the optimal implant shape from the point of view of stress transmission.

[A biomechanical study of the mechanical stress transmission of dental implants using finite element analysis. Review of literature. Part I]. / Fogászati implantátumok mechanikai feszültségátadásának biomechanikai vizsgálata végeselemes analizissel. Irodalmi áttekintés I. rész.

Finite Element Analysis (FEA) is a computerised investigative method that is capable of determining the mechanical stress arising in various objects and their environment as a result of forces effecting the system by using a mathematical model. The method is most often used for purposes of technical, engineering design, but is very useful for medical purposes-the static and functional investigation of the skeletal and motor system of the human body-as well. The transmission of mechanical stress between the implant and bone depends on a number of factors, and its description is quite complicated. A model has to be created to perform a FEA, the geometric data of the implant, the mechanical properties of the bone and the parameters of the bone-implant interface have to be determined, a so-called finite element network has to be created. Valuable data can be obtained by changing the individual elements of the system. The study of dental implants makes it possible to better investigate biomechanical conditions and thus the further perfection of implant methods. In the first part of the present two-part publication authors review the possibilities of use of the finite element analysis in examining the stress transmission of dental implants. In the second part of the publication their own studies will be presented.

[CE-marking in the dental profession]. / A CE jelzés a fogorvoslásban.

In the present article the authors summarise the meaning and mechanism of CE-marking in the EU in general and its significance in the dental profession. Their goal was to increase the awareness of Hungarian dental professionals to issues of quality management in the European Union.