Beside the laboratorial and radiological procedures the histological examination of liver is indispensable in the diagnosis of alcoholic liver disease. The biopsy can confirm the alcoholism concealed by the patient but presumed by the clinical evidences, opening the possibility of recovering. However this is the only suitable method to determine the stadium of the alcoholic liver disease.

Among the methods worked out to obtain liver tissue in case of diffuse liver damages, significant information can be given by percutaneous needle biopsy. The degree of the hepatic injury, the developing of cirrhosis can be determined from a suitable size of liver sample – which is decisive in estimating of the condition of the patient, and that of the therapy. The fine-needle aspiration compared with ultrasonic guidance can be effective in case of focal lesions. The most common use has been for the differentiation of primary liver tumours from tumour metastases to the liver.

Beside the direct hepatotoxical effect of alcohol, genetical, immunologic and environmental factors play important role in the pathogenesis of the alcoholic liver diseases.

The histological stages of alcoholic liver damages are – steatosis;, the acute alcoholic hepatitis; and cirrhosis. The author presents the histological features of certain stages, their structural background; and outlines the complications which result the death of the patient with cirrhosis.

In the past hundred years the drug treatment became the most important component of the curative activity. We give medicines, examine with a speculum, carry out lithotripsy and give medicines again; but are we aware what happens to the drug taken by patients?

Numerous drug-molecules are still inactive (prodrug) at the time of taking, and usually as a result of the first step of their metabolism in liver they become active. Regarding other agents, the first, or even the second decomposing compound has the same efficiency as their predecessor. The active metabolites are bound to the transport proteins synthesized by the liver. Only the free (non-bound) rate has a biological activity. Facing the theoretical and often practical implications of the drug-treatment of a patient suffering from liver disease, we have to review all these issues and also the problems of drug interactions.

On the effect of chronic alcohol abuse three different forms of liver diseases can develop in the consequence of pathologic biochemical and pathophysiological alterations in the liver. These are: 1. fatty liver, 2. alcoholic hepatitis, 3. clinical picture of alcohol induced liver cirrhosis. There are data for indirect evidences of the alcohol abuse in the development of hepatocellular carcinoma. The authors demonstrate the diagnostic and clinical picture of alcohol induced liver diseases, as well as they shortly summarize the therapeutic opportunities in these diseases.

There are numerous epidemiological studies showing that moderate alcohol consumption is associated with a reduced coronary heart disease mortality. However, the cardioprotective effect of alcohol consumption is absent at the population level. Ethanol damage to heart is evident if alcohol consumption exceeds 90 to100 g/d. Alcoholic cardiomyopathy has a worse outcome compared with idiopathic dilalative cardiomyopathy if drinking was not stopped. Alcohol consumption is positively correlated with a greater prevalence of hypertension. Heavy drinking leads to increased risk for hemorrhagic stroke, cardiac arrhythmias and sudden cardiac death. In patiens with coronary heart disease, alcohol use is associated with increased mortality. Any medical advice should be caution in framing guidelines for alcohol.

Dopamine receptor system can mediate euphoria. The dopaminerg pathways of the mesolimbic cortex plays a crucial role in the mechanism of reinforcing and rewarding induced by addiktive drugs. The anticraving drugs(mirtazepine venlafaxin bupropion, SSRI,s) modulate the dopamine release in the mesolimbic region.

Most of alcohol induced disorders are mediated via aceticaldehyde, which markedly alters the metabolism of neurotransmitters and plays significant role in the development of addiction and tolerance. The new drugs make the succesful result in the treatment of the delirium tremens and other alcohol-related somatic demages or Wernicke- Korsakov syndrome

The „alcoholism" used to be a bad-prognosis-sickness.

It is better now. If we would like to treat an alcohol-drinker patient, we should consider all the conditions of the drinking habit: is it a dependent, or an abusive type ? We have to decide about the question of abstinency as well.

Maybe we’d better to take the patient’s choose!

Dr. Riesz Péter, Dr. Szendrői Attila:

Authors address the management of inflammatory processes of male genitalia, epididymis, testis, and penis. Incidence rate of inflammation in certain organs can be observed in the sequence as mentioned above. Predisposing factors, pathogenesis, symptoms, diagnosis and therapy are discussed.

The author gives an overview about the most frequent manifestation, typical characteristics and treatment possibilities of akute sinusitis. He emphasizes that in most cases of akute virus rhinitis the paranasale sinuses are also affected, therefore, rather the term rhinosinusitis should be used. The treatment of virus end bacteriological sinusitis is primary conservative and the key of their treatment lies in the restoration of ventilation of paranasale sinuses. Rarely the wash of maxillary sinus and even more rarely the surgery of the affected sinuses is needed. The author calls attention to the characteristics of akute invasive fungal rhinosinusitis and to the complications of inflamed sinuses. In case of those sinusitis that occur frequently and require long lasting treatment one should consider the chance of endonasale deformation, which blocks the ventilation of sinuses and the osteomeatal unit. The correction by FESS or other types of operation of such problems contributes to the spontaneous healing of later occurring rhinosinusitis.

The author has defined the functional food, the probiotics and prebiotics and reviewed their physiological effects. The importance of the Bifidobacterium and Lactobacillus strains in the colon and their probiotic influence on the healthy and pathological conditions in infants and adults has been discussed. The structure, the function and prevention effect of oligosacharides called prebiotics has been presented. Special attention has been given to the effects of the galacto-oligosacharides and fructo-oligosacharides influencing the infants’ health. Results of clinical studies using premature and infant formulas supplemented with oligosacharides have been also discussed.

Point of Care Testing (POCT) is a clinical laboratory testing occurs next to the patient with a handheld device and unprocessed specimen collected immediately before testing. POCT is a rapidly growing component of laboratory testing which offers the advantage of reduced turaround time of test results and improved patient management.

The easy of use with these systems has improved dramatically due to the automation and incorporation of computers, miniature devices.

In USA the POCT testing became very popular due to its regulation by CLIA, easy of use and high intrest of laboratory specialists.

The POCT devices are using technics of dry chemistry,imuunochromatograhy and non invasive procedures.

In Hungary the POCT testinng has not got a wide popularity which might be due to its

low regulation.