Hungarian Radiology

[20th Ultrasound Days in Sopron]

LOMBAY Béla

DECEMBER 10, 2005

Hungarian Radiology - 2005;79(06)

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Hungarian Radiology

[XIVth Congress and Postgraduate Course of the Hungarian Society of Neuroradiology]

WENINGER Csaba

Hungarian Radiology

[Autumn thoughts in winter]

LOMBAY Béla

Hungarian Radiology

[A farewell to professor Ernő Makó A farewell to Ernő]

AZ MRT vezetősége Mester Ádám

Hungarian Radiology

[Male breast cancer]

GÖBLYÖS Péter

[Male breast cancer does not get a sufficient attention which would be appropriate due to its special features. Diagnostical and therapeutical protocols are not existing, a national center and international collaboration would be necessary. Incidence of male breast cancer is one percent of the female breast cancers, and 5 percent of all male cancers. The absolute number of the cases increased in the past years. The mutation of gene BRCA2 plays the main role in the male breast cancer. The breast cancer of the men is a "late disease", because often neither the doctor nor the patient considers this opportunity. The diagnosis is often established at an advanced stage. Cancer can occur on both sides, but the right breast is more often affected. Staging is the same as in female patients. Prognosis is poorer than in females, the tumor-receptor rate is better, HER2 in men does not plays any role. Basic principles of diagnostics and therapy are same as in females, mainly because there is no consensus about the treatment of the male breast cancer. The same proved protocols are used in men which are applied in women. The ground-method is surgery, reduced radicality and mastectomy is usually applied. Males react on hormone therapy better, than women, mainly chemotherapy is suggested. Follow up of the patients and the psychological support is extremely important. A multidisciplinary collaboration is necessary in the treatment of the male patient, and education is of great importance.]

Hungarian Radiology

[X-ray examination of paintings]

SZABÓ Éva, SZENTKIRÁLYI Miklós

[INTRODUCTION - After the discovery of X-ray it was not only used for medical purposes, but also to study the internal structure of various objects. The X-ray examination can be applied not only to examine paintings, but other works of art. METHODS AND RESULTS - The rontgenograms are made by industrial film without any screen in the museum. In case of paintings soft-beam examination technique was used. The basic principle of the X-ray examination of different paintings is based on the presence of different atomic number in different paints. Authors after the examination of four paintings achieved a significant finding. In these paintings the stylistic and structural features of the pictures, injuries, originality, changes in the composition during the work of the artist can be studied. CONCLUSIONS - Recordings made by an industrial radiological equipment in the Museum of Fine Arts (Budapest) are helpful in the restorer work.]

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Clinical Neuroscience

[What happens to vertiginous population after emission from the Emergency Department?]

MAIHOUB Stefani, MOLNÁR András, CSIKÓS András, KANIZSAI Péter, TAMÁS László, SZIRMAI Ágnes

[Background – Dizziness is one of the most frequent complaints when a patient is searching for medical care and resolution. This can be a problematic presentation in the emergency department, both from a diagnostic and a management standpoint. Purpose – The aim of our study is to clarify what happens to patients after leaving the emergency department. Methods – 879 patients were examined at the Semmel­weis University Emergency Department with vertigo and dizziness. We sent a questionnaire to these patients and we had 308 completed papers back (110 male, 198 female patients, mean age 61.8 ± 12.31 SD), which we further analyzed. Results – Based on the emergency department diagnosis we had the following results: central vestibular lesion (n = 71), dizziness or giddiness (n = 64) and BPPV (n = 51) were among the most frequent diagnosis. Clarification of the final post-examination diagnosis took several days (28.8%), and weeks (24.2%). It was also noticed that 24.02% of this population never received a proper diagnosis. Among the population only 80 patients (25.8%) got proper diagnosis of their complaints, which was supported by qualitative statistical analysis (Cohen Kappa test) result (κ = 0.560). Discussion – The correlation between our emergency department diagnosis and final diagnosis given to patients is low, a phenomenon that is also observable in other countries. Therefore, patient follow-up is an important issue, including the importance of neurotology and possibly neurological examination. Conclusion – Emergency diagnosis of vertigo is a great challenge, but despite of difficulties the targeted and quick case history and exact examination can evaluate the central or peripheral cause of the balance disorder. Therefore, to prevent declination of the quality of life the importance of further investigation is high.]

Clinical Neuroscience

A case with reversible neurotoxicity induced by metronidazole

EREN Fulya, ALDAN Ali Mehmet, DOGAN Burcu Vasfiye, GUL Gunay, SELCUK Hatem Hakan, SOYSAL Aysun

Background - Metronidazole is a synthetic antibiotic, which has been commonly used for protozoal and anaerobic infections. It rarely causes dose - and duration - unrelated reversible neurotoxicity. It can induce hyperintense T2/FLAIR MRI lesions in several areas of the brain. Although the clinical status is catastrophic, it is completely reversible after discontinuation of the medicine. Case report - 36-year-old female patient who had recent brain abscess history was under treatment of metronidazole for 40 days. She admitted to Emergency Department with newly onset myalgia, nausea, vomiting, blurred vision and cerebellar signs. She had nystagmus in all directions of gaze, ataxia and incompetence in tandem walk. Bilateral hyperintense lesions in splenium of corpus callosum, mesencephalon and dentate nuclei were detected in T2/FLAIR MRI. Although lumbar puncture analysis was normal, her lesions were thought to be related to activation of the brain abscess and metronidazole was started to be given by intravenous way instead of oral. As lesions got bigger and clinical status got worse, metronidazole was stopped. After discontinuation of metronidazole, we detected a dramatic improvement in patient’s clinical status and MRI lesions reduced. Conclusion - Although metronidazole induced neurotoxicity is a very rare complication of the treatment, clinicians should be aware of this entity because its adverse effects are completely reversible after discontinuation of the treatment.

Lege Artis Medicinae

[ICD based data collection of sick-pay data in county Vas]

BONCZ Imre, FLAMIS László, GYŐRVÁRI Sándor

[INTRODUCTION - The analysis and evaluation of sick-pay data presents great challenge for a health insurance fund. It is very important to collect sick-pay data related to the medical diagnosis of the patients. DATA AND METHODS - The aim of the study is the analysis of sick-pay data in County Vas, Hungary. The new approach focuses on the ICD (International Classification of Diseases) based sick-pay reports which contains the cause of sicknesses according to ICD terms. The data was derived from 1998. RESULTS - During the period involved there were no significant change in the number of ICD codes used by the doctors. The cases shorter than 30 days account for 84,43 % of total cases, while they account for the 41,05 % of total disability to workdays. The most common ICD group measured by the number of cases is group Nr. X. (Diseases of the respiratory system), while most common as measured by the days spent on sick-pay is group Nr. XIII. (Diseases of the musculoskeletal system and connective tissue). Significant differences were found between men and women. Analysing the diagnosis within the main groups - ranked by the number of cases - the diseases of respiratory system and of the musculo-skeletal system are found in leading positions. Based on the number of sick-pay days the diseases of musculo-skeletal system are on the first place. CONCLUSIONS - Results of this analysis can provide valuable information for both the National Health Insurance Fund and the physicians and have contributed to the implementation of the national „Disability to work Monitoring System”.]

Clinical Neuroscience

[Subarachnoid hemorrhage in Hungary. Analysis based on the reports of the hospitals to the National Health Insurance Fund in 2009]

KOZÁK Norbert, SZABÓ Sándor, AJTAY András, BERECZKI Dániel

[Background and purpose - We analyzed the statistical characteristics of subarachnoid hemorrhage (SAH) in Hungary in 2009. Methods - Using data supplied by the hospitals about their inpatient services to the National Health Insurance Fund with ICD-10 code I60. Results - 1403 SAH hospital cases were recorded in 1028 patients. That is much more than we expected from previous data. 63.6% were women, hospital case fatality was 12.2%. The average hospital stay was 6.47 days. 763 CT examinations were done (74.2% of the patients). Hypertension was recorded in 61.3% of the patients. The incidence was increasing with age till the age group of 51- 60 years, and decreased beyond that. In 531 patients the source of bleeding could be verified. Aneurysm of the anterior communicating artery was more frequent in men, aneurysm of the middle cerebral artery (MCA) and internal carotid artery in women. In total MCA aneurysm was the most frequent. Arteriovenous malformation was present in 7.6% of the patients. SAH was most frequent in January and February, rarest in April and August. Conclusion - SAH is more frequent in Hungary than previously thought.]

Hypertension and nephrology

[The 1st Szekszárd Hypertension Days ]

BENCZÚR Béla