Hungarian Radiology

[7th Congress of the Society of Hungarian Radiographers]

SOMOGYINÉ Csiki Mária

OCTOBER 20, 2002

Hungarian Radiology - 2002;76(05)

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Hungarian Radiology

[Examination of pancreatic exocrine function with secretin stimulated magnetic resonance cholangiopancreatography]

ENDES János, CZAKÓ László, TAKÁCS Tamás, BODA Krisztina, LONOVICS János

[INTRODUCTION - The aim of this study was to assess the feasibility and usefulness of SS-MRPD for evaluation of the pancreatic exocrine function. PATIENTS AND METHODS - SS-MRPD was performed in 20 patients with mild (n=8) or severe (n=12) chronic pancreatitis (according to the grade of exocrine pancreatic insufficiency indicated by the Lundh test) and in 10 volunteers without pancreatic disease. MRPD images were evaluated before and 10 min after the iv. administration of 0.5 IU/kg secretin. The changes in pancreatic tissue T2 signal intensity and duodenal filling after the injection of secretin were determined by means of SS-MRPD. The SSMRPD findings were then compared with those of the Lundh test. RESULTS - The basal pancreatic T2 signal intensity was significantly higher in the patients with a mild or a severe exocrine pancreatic insufficiency as compared with the controls (826.5±36.36 and 908±80.51 vs 659.2±41.67). The pancreatic T2 signal intensity exhibited a significant elevation after secretin administration both in the volunteers and in the patients with mild or severe chronic pancreatitis. This elevation was significantly lower in both the mild and the severe chronic pancreatitis patients than in the volunteers (66.85±15.77 and 24.45±5.85, respectively, vs. 200.0± 45.07). After the administration of secretin, the diameter of the duodenum was significantly increased in all three groups. This duodenal filling was significantly reduced in patients with a mild or a severe exocrine pancreatic insufficiency as compared with the volunteers (4.12±1.33 and 1.70±0.77 vs. 15.38± 1.73). There was no significant difference in pancreatic T2 signal intensity changes or in duodenal filling in patients with a mild or a severe exocrine pancreatic insufficiency. There were significant correlations between the pancreatic T2 signal intensity changes and the duodenal filling and the results of the Lundh test (r= -0.616 and -0.78). CONCLUSION - These results demonstrate that the administration of secretin increases the T2 signal intensity of the pancreatic tissue and the diameter of the duodenum to different extents in normal subjects and in patients with chronic pancreatitis. This suggests that SS-MRPD can provide information of value in the assessment of an exocrine pancreatic insufficiency.]

Hungarian Radiology

[Osteopetrosis in the infancy]

HAJNAL Barbara, BITVAI Katalin, ALMÁSSY Zsuzsanna

[INTRODUCTION - The authors present a relatively rare, autosomal recessive osteogenetic disorder, which appearance is typical in the first year of life. The malignant osteopetrosis of infants has characteristic radiologic and haematologic status, which is often an incidental finding. CASE REPORT - A 6-month-old Chinese boy was referred with the suspition of bronchopneumony to perform a chest Xray. On the bases of our findings, additional X-ray studies were done (skull, wrist, dorsal spine, hip, femur). A general increase in the density of the bones with characteristic settlement were demonstrated. CONCLUSION - Reporting such a rare disease may help in the differential diagnosis of the osteopathies with diffusely increased density.]

Hungarian Radiology

[Interaction between metformine and iodized contrast materials]

SZABÓ Endre

Hungarian Radiology

[CALENDAR OF RADIOLOGICAL EVENTS, 2002-2003]

Hungarian Radiology

[Intraoperative intracranial ultrasound imaging in neurosurgery]

DOBAI József Gábor, GYARMATI János, SZÉKELY György, CSÉCSEI György István

[Diagnostic ultrasound imaging started in the 1940s. Up to the present it underwent on radical changes. Article briefly reviews the major steps of the development of ultrasound technique in neurosurgery, and possibilities of applications of different ultrasound methods in neurosurgery are described. Authors discuss their experiences with Hawk 2102 ultrasound system used in intraoperative procedures in 113 cases. Data compared with the literature. Conclusions are that use of intraoperative ultrasound in neurosurgery is modern and simple and it has various application fields. Intracranial lesions are well localized with its use, so the risk of operations decreases. Main disadvantages that ultrasound imaging requires bony trepanation and special transducers are needed for different lesions.]

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[Advanced Parkinson’s disease characteristics in clinical practice: Results from the OBSERVE-PD study and sub-analysis of the Hungarian data]

TAKÁTS Annamária, ASCHERMANN Zsuzsanna, VÉCSEI László, KLIVÉNYI Péter, DÉZSI Lívia, ZÁDORI Dénes, VALIKOVICS Attila, VARANNAI Lajos, ONUK Koray, KINCZEL Beatrix, KOVÁCS Norbert

[The majority of patients with advanced Parkinson’s disease are treated at specialized movement disorder centers. Currently, there is no clear consensus on how to define the stages of Parkinson’s disease; the proportion of Parkinson’s patients with advanced Parkinson’s disease, the referral process, and the clinical features used to characterize advanced Parkinson’s disease are not well delineated. The primary objective of this observational study was to evaluate the proportion of Parkinson’s patients identified as advanced patients according to physician’s judgment in all participating movement disorder centers across the study. Here we evaluate the Hungarian subset of the participating patients. The study was conducted in a cross-sectional, non-interventional, multi-country, multi-center format in 18 countries. Data were collected during a single patient visit. Current Parkinson’s disease status was assessed with Unified Parkinson’s Disease Rating Scale (UPDRS) parts II, III, IV, and V (modified Hoehn and Yahr staging). Non-motor symptoms were assessed using the PD Non-motor Symptoms Scale (NMSS); quality of life was assessed with the PD 8-item Quality-of-Life Questionnaire (PDQ-8). Parkinson’s disease was classified as advanced versus non-advanced based on physician assessment and on questions developed by the Delphi method. Overall, 2627 patients with Parkinson’s disease from 126 sites were documented. In Hungary, 100 patients with Parkinson’s disease were documented in four movement disorder centers, and, according to the physician assessment, 50% of these patients had advanced Parkinson’s disease. Their mean scores showed significantly higher impairment in those with, versus without advanced Parkinson’s disease: UPDRS II (14.1 vs. 9.2), UPDRS IV Q32 (1.1 vs. 0.0) and Q39 (1.1 vs. 0.5), UPDRS V (2.8 vs. 2.0) and PDQ-8 (29.1 vs. 18.9). Physicians in Hungarian movement disorder centers assessed that half of the Parkinson’s patients had advanced disease, with worse motor and non-motor symptom severity and worse QoL than those without advanced Parkinson’s disease. Despite being classified as eligible for invasive/device-aided treatment, that treatment had not been initiated in 25% of these patients.]

Clinical Neuroscience

Evaluation of anxiety, depression and marital relationships in patients with migraine

DEMIR Fıgen Ulku, BOZKURT Oya

Aim - The aim of this study was to evaluate the frequency and characteristics of attacks in patients with migraine, to determine the effects of anxiety or depressive symptoms, and to evaluate the marital relationships of patients with migraine. Method - Thirty patients who were admitted to the neurology outpatient clinic of our hospital between July 2018 and October 2018 and were diagnosed with migraine according to the 2013 International Headache Society (IHS) diagnostic criteria were included in this cross-sectional study. Age, sex, headache frequency and severity, depressive traits, marital satisfaction and anxiety status were examined. We used the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Maudsley Marital Questionnaire (MMQ) and Visual Analogue Scale (VAS) for measuring relevant parameters. Results - The mean severity of migraine pain according to VAS scale was 6.93 ± 1.41 and the mean number of migraine attacks was 4.50 ± 4.24. The mean BDI score of the patients was 12.66 ± 8.98, the mean MMQ-M score was 19.80 ± 12.52, the mean MMQ-S score was 13.20 ± 9.53, the mean STAI-state score was 39.93 ± 10.87 and the mean STAI-trait score was 45.73 ± 8.96. No significant correlation was found between age, number of migraine attacks, migraine duration, migraine headache intensity, and BDI, STAI and MMQ scores (p>0.05). But there was a positive correlation between MMQ-S and scores obtained from the BDI and STAI-state scales (p<0.05). Conclusion - In this study more than half of the migraine patients had mild, moderate or severe depression. A positive correlation was found between sexual dissatisfaction and scale scores of depression and anxiety.

Clinical Neuroscience

[Decisional collisions between evidence and experience based medicine in care of people with epilepsy]

RAJNA Péter

[Background – Based on the literature and his long-term clinical practice the author stresses the main collisions of evidence and experience based medicine in the care of people with epilepsy. Purpose – To see, what are the professional decisions of high responsibility in the epilepsy-care, in whose the relevant clinical research is still lacking or does not give a satisfactory basis. Methods – Following the structure of the Hungarian Guideline the author points the critical situations and decisions. He explains also the causes of the dilemmas: the lack or uncertainty of evidences or the difficulty of scientific investigation of the situation. Results – There are some priorities of experience based medicine in the following areas: definition of epilepsy, classification of seizures, etiology – including genetic background –, role of precipitating and provoking factors. These are able to influence the complex diagnosis. In the pharmacotherapy the choice of the first drug and the optimal algorithm as well as the tasks during the care are also depends on personal experiences sometimes contradictory to the official recommendations. Same can occur in the choice of the non-pharmacological treatments and rehabilitation. Discussion and conclusion – Personal professional experiences (and interests of patients) must be obligatory accessories of evidence based attitude, but for achieving the optimal results, in some situations they replace the official recommendations. Therefore it is very important that the problematic patients do meet experts having necessary experiences and also professional responsibility to help in these decisions. ]

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Hypertension and nephrology

[Professional Guideline of the Hungarian Society of Hypertension – Guidelines of Hypertension Care 11th Amended and Completed Edition.]

FARSANG Csaba, JÁRAI Zoltán