[Deformities, caused by premature ossification of the cranial sutures, and their treatment]. / A koponyavarratok korai csontosodása miatti deformitások és azok kezelése.

The establishment of the Hungarian cranio-facial surgical team is reported on and the activity sphere of this special field is described. The consequences of early ossification of the cranial sutures as well as the therapeutical possibilities are dealt with. Brief review is given on the development of cranio-facial surgery. The age, diagnosis and interventions performed with the patients in 1987 are summarized in a table.

Ventral spondylodesis: basic method in the treatment of cervical spine injuries.

Ventral spondylodesis or ventrofixation is the most important surgical method for the treatment of severe cervical spine injuries accompanied by instability. Its wide indications include fracture-dislocations, compression fractures of the vertebral body, injuries to the disc, luxations, 'tear drop fractures' as well as "hangman's fractures". The essential parts of its technique: previous reduction by traction, anterior cervical approach, removal of the injured parts of vertebral body and disc(s), replacement by corticocancellous bone graft with subsequent plate-screw fixation. The authors performed in their Institute nearly 100 operations of this type, in a 10-year period of which; detailed account is given. Good results of surgery can be expected only by ensuring adequate technical conditions and professional knowledge, performing the operations in centres having sufficient experience.

Modified humoral leukocyte adherence inhibition test for detection of lung cancer.

The freshly separated indicator cells (suspension of leukocytes) used in humoral leukocyte adherence inhibition test were labeled either with 14C-amino acid mixture or 3H-concanavalin A (3H-ConA). Instead of counting the adherent cells, the amount of 'adherent' radioactivity was measured by a liquid scintillation spectrometer. By the modified method, sera from 25 lung-carcinoma-bearing patients as well as serum samples from 21 healthy persons were examined in the presence of crude antigens prepared from 'normal' lung tissue or lung tumors of various histologic types. Although the results demonstrated high specificity and reproducibility of both methods, the binding of 3H-ConA to the surface of adherent cells is more expressed and assures higher levels of radioactivity.

Screw fixation of odontoid fractures: preliminary report.

In the period from 1981 to 1985, 32 odontoid fractures were treated in the National Institute of Traumatology. In four cases anterior stabilization was provided with compression screws inserted from the front. Two cases of odontoid fracture are shown, one accompanied by ventral, the other by dorsal dislocation. A brief review is provided of the results obtained with different methods of treatment drawing on the international literature.

Up-to-date method of treatment of most frequent axis-injuries: screw-fixation of the odontoid fractures.

In the period from 1981 to 1985, 32 odontoid fractures were treated in the National Institute of Traumatology. In 4 cases anterior stabilization was made with compression-screws from the ventral approach. Two cases of odontoid fractures are shown, one accompanied by ventral, the other by dorsal dislocation. A brief review of the results with different methods of treatment is given on the basis of the international literature.

Sleeve lobectomy: an alternative to pneumonectomy in the treatment of bronchial carcinoma.

In a 20-year period between 1960 and 1979, 3,438 resections were done for primary cancer of the lung, the standard operation being either lobectomy or pneumonectomy in more than 90% of the cases. In 261 cases (7.4%) sleeve lobectomy was performed as an alternative to pneumonectomy in order to conserve pulmonary function as far as possible, provided the operation assured as equally radical a removal of the tumor as pneumonectomy. Long-term results could be evaluated for 113 cases operated before 1974. Fifty-seven (50%) were alive at least 5 years after operation, the follow-up being 100%. The postoperative mortality was 7.3% (19 cases). Indications for sleeve resection as well as some aspects of anesthesia and surgical technique are discussed.

[New type of combined surgical treatment of frontobasal injuries (author's transl)]. / Frontobazális sérülések új típusú, kombinált mütéti kezelése.

The surgical treatment of frontobasal injuries by a new, combined method has been reported. The frontobasal injury was exposed by bifrontal craniotomy. After the intradural examination and the dressing of the brain injuries the dural defect was also extradurally searched and dressed. Thereafter--taking the advantage of the bifrontal exploration--the paranasal sinus (frontal sinus, ethmoideal system) was cleaned, then the base of the anterior scala was covered with pedicled galea flap or periosteum plate. In case of the treatment of the open injuries, following the removal of the bone fragments, the dural brain injuries and the paranasal sinus injuries were similarly treated, according to the above mentioned principles. This method makes possible to prevent the liquorrhoeic complications as well as the delayed septic complications of the paranasal sinus. The method is recommended to the operative treating of the frontobasal injuries after many years of favourable experiences and supported by good follow-up results.

Herniation of the upper lumbar discs.

On the basis of investigations involving 134 patients operated on at the National Institute of Neurosurgery, Budapest, the authors point out that herniations of the intervertebral discs at L 1/2, L 2/3, L 3/4 levels are characterized by more severe neurological changes. Paresis and autonomic disorders occur much more frequently than in lower lumbar disc herniations: paresis was found in 67 cases (50%) and bilaterally in 44 cases (32.8%), with inability to walk in 21 cases (15.7%); autonomic disturbances were noted in 36 patients (26.9%). With clear symptoms of a lumbar disc herniation a raised protein content in the CSF, more than 100 mg%, makes one suspicious of an upper lumbar lesion. In most of the cases the level of the lesion could not be exactly determined on the basis of sensory symptoms alone. The importance of myelography is stressed in determining the level. The more severe neurological changes are attributed to a medial situation of many disc hernias as found at operation, and also to unduly prolonged conservative treatment. The early postoperative results are analysed, most of which show permanent further improvement. According to our classification, the immediate postoperative results were "excellent" or "good" in 124 of the 134 patients. Except for two cases with complications, all of the patients unable to walk because of pain or paresis started to walk again after the operation. In the long-term follow-up period extending from 2 to 20 years the pain continued to improve in most of the cases, with similar, though less marked improvement in motor and autonomic disturbances. In 15 patients the condition deteriorated in the late postoperative period, but among them were 8 patients, in whom the results could be considered satisfactory as compared to the preoperative complaints. In the late postoperative period only 7 patients were unchanged or even in a worse condition than before operation.