Hungarian Radiology

[As much as we bring out of it]

ENGLONER László

DECEMBER 21, 2009

Hungarian Radiology - 2009;83(04)

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Hungarian Radiology

[18th Congress and Postgradual Training of the Hungarian Society of Neuroradiologists - Siófok, November 5-7th, 2009.]

OSZTIE Éva

Hungarian Radiology

[Diagnosis of ovarian torsion through the ultrasound and in the operating theatre - An audit and review of the current diagnostic modalities]

SHOAIB Shaikh, NYÁRI Edit, KONCZ Júlia, LAKATOS Andrea, LOMBAY Béla

[INTRODUCTION - This audit was carried out to assess the usefulness of ultrasound in the diagnosis of adnexal torsion in pediatric and adolescent patients, and to demonstrate any ultrasound characteristics which are predictive of ovarian torsion in this population. PATIENTS AND METHODS - Retrospective review of ultrasound reports, operative reports, and medical records for 17 pediatric patients treated at BAZ-County University Hospital, Miskolc, was performed. The patients had presented to the pediatric surgery with complaints of abdominal pain between August 2000 and August 2008, and underwent an abdominal/pelvic ultrasound prior to going to the operating room for surgical management. All ultrasounds were categorized regarding the presence or absence of adnexal torsion. Other sonographic parameters included were: the mass size, description, and the presence of signs associated with adnexal torsion (presence and arrangement of ovarian follicles, presence of free fluid in the pelvis, and the presence or absence of arterial or venous flow by color Doppler to the ovaries). Surgical and pathological findings were also studied. RESULTS - All 17 patients in this review were surgically confirmed cases of torsion. 14 (82%) of the torsions occurred on the right side, 3 (18%) on the left side. Ultrasound described 8 adnexal masses with torsion as cystic (n=8, 47%). Pelvic fluid was present in nine patients (53%). Of 10 patients in which follicles were noted, follicles were observed to be peripherally displaced in seven (41%). Only two patients (12%) underwent laparoscopic surgery, remaining received open surgery. On evidence of torsion in the operating room, detorsion was performed in all cases. Finally, tubal cystectomy was performed in 2 (12%), ovarian cystectomy in four (24%), oophorectomy in two (29%), salpingooophorectomy in 6 cases (35%), and oophoropexy was performed in three cases (2%). The majority of pathology in those with confirmed torsion were hemorrhagic cysts in 10 cases (59%), paratubal cysts in three cases (18%), and teratomas in one cases (6%). No histologies were sent for three patients who received oopheropexy. 13 patients (76%) with torsion had adnexal masses greater 5 cm. The duration of complaints prior to treatment was also an important factor: Generally patients with more than one day long complaints underwent oophorectomy, exception to this was a case with intrauterine torsion. CONCLUSIONS - In our audit, patients with adnexal masses greater than 5 cms were more likely to have torsion than those patients with masses less than 5 cms.]

Hungarian Radiology

[Once again about the membership fees]

MORVAY Zita

Hungarian Radiology

[Residents here and over the rainbow]

LOMBAY Béla

Hungarian Radiology

[The ‘Oulu’ model - Leonardo da Vinci mobility programme Oulu, April 1st-August 31st, 2009.]

BORA László

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Clinical Neuroscience

Cyanocobalamin and cholecalciferol synergistically improve functional and histopathological nerve healing in experimental rat model

ALBAY Cem, ADANIR Oktay, AKKALP Kahraman Asli, DOGAN Burcu Vasfiye, GULAEC Akif Mehmet, BEYTEMUR Ozan

Introduction - Peripheral nerve injury (PNI) is a frequent problem among young adults. Hopefully, regeneration can occur in PNI unlike central nervous system. If nerve cut is complete, gold standard treatment is surgery, but incomplete cuts have been tried to be treated by medicines. The aim of the study was to evaluate and compare clinical and histopathological outcomes of independent treatment of each of Vitamin B12 (B12) and Vitamin D3 (D3) and their combination on sciatic nerve injury in an experimental rat model. Materials and methods - Experimental animal study was performed after the approval of BEH Ethics Committee No. 2015/10. 32 rats were grouped into four (n=8) according to treatment procedures, such as Group 1 (controls with no treatment), Group 2 (intraperitoneal 1 mg/kg/day B12), Group 3 (oral 3500 IU/kg/week D3), Group 4 (intraperitoneal 1 mg/kg/day B12+ oral 3500 IU/kg/week D3). Sciatic Functional Index (SFI) and histopathological analysis were performed. Results - SFIs of Group 2, 3, 4 were statistically significantly higher than controls. Group 2 and 3 were statistically not different, however Group 4 was statistically significantly higher than others according to SFI. Axonal degeneration (AD) in all treatment groups were statistically significantly lower than in Group 1. AD in Group 4 was significantly lower than in Group 2 and 3; there was no significant difference between Group 2 and 3. There was no significant difference between Group 1,2 and 3 in Axonolysis (A). But A of Group 4 was significantly very much lower than all others. Oedema- inflammation (OE-I) in all treatment groups were significantly lower than in Group 1; there was no significant difference between Group 2 and group 4. OE-I in Group 2 and 4 were significantly lower than in Group 3. There were no significant differences between Group 1, 2 and 3 in damage level scores; score of Group 4 was significantly lower than of Group 1. Conclusions - B12 and D3 were found effective with no statistically significant difference. But combined use of B12 and D3 improve nerve healing synergistically. We recommend combined use of B12 and D3 after PNI as soon as possible.

Clinical Neuroscience

Mid-term oral isotretinoin therapy causes a predominantly sensory demyelinating neuropathy

ALTUN Yasar, INAN Esra

Aim - The purpose of this prospective study was to investigate whether mid-term treatment with oral isotretinoin may impact peripheral nerve function. Methods - In this study, we included 28 patients with no apparent neurological or neurophysiological findings. The patients received treatment with oral isotretinoin for papulopustular or nodulocystic acne. The patients with normal findings in the first examination were given 1 mg/kg/day oral isotretinoin. Neurological examinations and electroneurographic studies were performed before and 6 months after the onset of isotretinoin treatment. Results - Clinical examinations and electroneurographic evaluations prior to treatment revealed no abnormalities in any of the patients. However, 20 patients (72%) displayed one or more abnormal values in the tested parameters after treatment. Although the mean amplitudes of compound muscle action potential of the ulnar and median nerves did not vary, significant decreases were observed in the mean sensory conduction velocities of median, ulnar, sural, medial plantar, medial dorsal cutaneous, and dorsal sural nerves 6 months after the onset of treatment. Conclusion - Systemic use of isotretinoin may cause electroneurographic changes. Probable electroneurographic alterations may be detected at a much earlier period via dorsal sural nerve tracing when electrophysiological methods used in routine clinical practice cannot detect these changes.

Hungarian Radiology

[The value of multislice computed tomography in the diagnosis of pulmonary embolism and in differential diagnostics]

BODROGI Nándor, BARANYAI Tibor

[INTRODUCTION - The multislice CT (MSCT) pulmonary angiography has been used increasingly in the diagnosis of pulmonary embolism with worldwide application and nowadays it can be considered as a gold standard technique. At the author's department a single slice CT has been used from 1993 and a 10 slice CT system with 24 detector-lines was installed in 2004. The authors summarize the advantages of MSCT in the diagnosis and differential diagnosis of pulmonary embolism and its role in the follow-up of cases and the significant increase of the diagnostic safety. PATIENTS AND METHODS - 2576 chest MSCT examinations were performed between 16 February 2004 and 20 June 2005. In 261 cases pulmonary MSCT angiography was made due to suspected pulmonary embolism. In 7 cases the indication of the CT was different, but due to the findings (pulmonary embolism) this group of patients is discussed in this paper. 268 cases were evaluated retrospectively. In 12 patients, CT could not be performed due to contrast agent allergy or because of seriously impaired renal function. In 2 cases it was not possible to establish a venous access. The therapeutical result was monitored upon the request of the clinicians. The pulmonary MSCT angiography was performed in accordance with a detailed acquisition and reconstruction protocol. In the reprocessing stage the 2D (MPR) reconstruction in different directions was an important step. In addition, three-dimensional MIP was used and VRT reconstruction was also made, if needed. Bolus tracking was applied in order to achieve a good contrast phase. RESULTS - In 116 out of 268 cases pulmonary embolism was detected by pulmonary MSCT angiography. In 7 patients pulmonary embolism was not the primary diagnosis. Pathological changes could not be detected in 55 cases (20.5%) and embolism was not proven later in these patients. No false negative study was recognized. In one case, after the death of the patient the autopsy failed to prove the presence of pulmonary embolism, this represents one false positive diagnosis. In 97 patients pulmonary embolism was not detected, however other findings were found relating to the complains of the patients and thus proper therapy could be introduced. CONCLUSION - Pulmonary MSCT angiography proved to be a highly accurate method for the diagnosis and for exclusion of pulmonary embolism and also in the evaluation of its extent. MSCT can be used in monitoring the result of the therapy. In addition, MSCT gives an opportunity to detect other acute pathological conditions of the chest, thus value of the study is significant in the differential diagnosis.]

Hungarian Immunology

[In vitro methods for measuring phagocytosis and killing of bacteria by neutrophil granulocytes]

RADA Balázs

[Accounting for about two-thirds of our white blood cells, neutrophilic granulocytes are key members of the innate immune system of the human body. They are terminally differentiated cells equipped with numerous antimicrobial weapons. Neutrophils are the first to arrive at sites of infections; their main mission is to phagocytose and destroy bacteria and funghi entering the human body. They fullfill a central role in both the inflammatory response of the body and the coordination of the innate and acquired immune systems’ function. Their deficient performance leads to impaired resistance of the host against microbes and to higher frequency of infections; their uncontrolled function, in turn, may damage our own tissues. Because of all of this, it is highly important from both basic and clinical perspective that we know as much as possible about the function of our neutrophilic granulocytes. In this paper methods available for measuring phagocytic and killing capacities of human neutrophils are reviewed. Each method has its advantages and disadvantages. The method chosen mainly depends on experimental tools available and informations needed.]

Journal of Nursing Theory and Practice

[Epidemic among health care providers: burnout]

IRINYI Tamás, NÉMETH Anikó

[Aims of the study: To track the changes since 2008 in the degree of burnout among health care workers in Csongrád County, and to examine its connections with the evaluation of own health, frequency of psychosomatic symptoms, the intent to leave the profession, and the measure of fear from becoming unemployed. Methodology and sample: This is a cross-sectional study carried out through a self-designed self-report questionnaire sent to registered members of MESZK living in Csongrád County. Results: The number of burned-out health care workers increased since 2008. Burnout correlates with physical health (p<0.000), the intention to leave the profession (p<0.000), and the fear of losing the job (p<0.000). A significant increase could be observed by nurses starting their career. Conclusions: Burnout prevention trainings would be important also by career starters, which could also prevent profession leaving. ]