Hungarian Radiology

[Autumn thoughts in winter]

LOMBAY Béla

DECEMBER 10, 2005

Hungarian Radiology - 2005;79(06)

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Hungarian Radiology

[Isolated gallbladder rupture following blunt abdominal trauma]

PÉTER Lívia

[INTRODUCTION - Gallbladder injuries following blunt abdominal trauma occur rarely and are usually associated with damage to other abdominal organs. Isolated rupture of the gallbladder is extremely rare. CASE REPORT - A 42-year old intoxicated male patient suffered a blunt abdominal trauma 4 days before the admission. The physical examination was of normal and no specific laboratory values were found. Ultrasound examination demonstrated the gallbladder with hyperechoic thickened wall and inhomogenous content. Beside of the gallbladder fluid collection was detected with irregular margins. To prove the diagnosis of gallbladder injury computed tomography was carried out. Break of the gallbladder wall and hight density lumen content, corresponding to blood was detected. Around the gallbladder an irregular fluid collection was seen, which reached the level of the transverse section of the mesocolon. Computed tomography excluded traumatic lesion of other parenchimal abdominal organs. Surgery confirmed the radiological diagnosis. CONCLUSION - The patient with isolated gallbladder injury had a multiphasic clinical course. Sometimes the diagnosis has to be established at a relatively asymptomatic stage. The basic methods of the diagnostics are the ultrasound examination and computed tomography.]

Hungarian Radiology

[Márton Lányi's memorial tablet]

GÖBLYÖS Péter

Hungarian Radiology

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

WENINGER Csaba

Hungarian Radiology

[Where are the Hungarian men with breast cancer?]

GÖBLYÖS Péter

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.]

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Lege Artis Medicinae

[NEUROVASCULAR COMPRESSION IN THE MEDULLA OBLONGATA AS A CAUSE OF RESISTANT HYPERTENSION - THOUGHTS APROPOS OF A PATIENT]

KOVÁTS László, BRETUS Angelika, CSUTAK Kinga, NAGY Gyöngyi, GASZTONYI Beáta

[INTRODUCTION - The vasomotor centre, the central regulator of the cardiovascular system, is localised in the rostral ventrolateral medulla oblongata. Irritation of this area and/or of the ninth and tenth cranial nerves (that are involved both in the afferent and efferent pathways of the baroreceptor reflex) causes sympathetic hyperactivity, which in some cases leads to severe resistant hypertension. A common underlying cause of this is pulsatile neurovascular compression, a vascular malformation rarely sought for. CASE REPORT - The authors present the case of a middle-aged woman with what had been considered “essential” hypertension. Magnetic resonance angiography showed vascular compression of the medulla oblongata and the departing left ninth and tenth cranial nerves as the cause of her hypertension. CONCLUSIONS - After a literature review the authors draw the attention to this rarely identified cause of resistant hypertension and to the difficulties of its diagnosis.]

Clinical Neuroscience

[Mentalizing deficit in neurological disorders: a review article]

HEROLD Róbert, VARGA Eszter, MIKE Andrea, TÉNYI Tamás, SIMON Mária, HAJNAL András, FEKETE Sándor, ILLÉS Zsolt

[Introduction – Mentalization is the ability to attribute mental states (intentions, desires, thoughts, emotions) to others, and hence to predict their behaviour. This ability fundamentally determines our participation in social relationships and adaptation to society. A significant proportion of the disorders of the central nervous system (CNS) affects those brain structures and neurotransmitter systems that play a role in the mentalizing processes. Accordingly, a number of CNS disorders may be associated with mentalizing deficits, which may affect the outcome of these diseases. Here, we review recent research on mentalizing abilities in neurological diseases. Methods – An internet database search was performed to identify publications on the subject. Results – Sixty-two publications in English corresponded to the search criteria. These publications reported impaired mentalization in several neurological disorders (e.g. epilepsy, Parkinson’s disease, multiple sclerosis, dementias, traumatic brain injury). Discussion – The results indicate that a number of neurological disorders associate with mentalizing deficit. This deficit is often present in the early stages of the diseases and has a prognostic value, which in turn emphasizes the importance of the early detection and adequate rehabilitation.]

Lege Artis Medicinae

[Some thoughts in the hospital]

GAJDOS Ágoston

LAM KID

[Comparison of different schemes of vitamin D3 therapy]

SZILI Balázs, BAKOS Bence, KATÓ Karina, KIRSCHNER Gyöngyi, TOBIÁS Bálint, BALLA Bernadett, HORVÁTH Péter

[Vitamin D plays an important role in several pathways in humans. Its relation with several diseases has been previously de­scribed. Vitamin D deficiency affects al­most the full population on temperate zone at the end of the winter. Recommendations on vitamin D supplementation are inconsistent and there are only a few data about the efficacy of cholecalcipherol given not in daily manner. In the present paper, we examine the different administration mo­dalities, and their efficacy in increasing serum vitamin D levels. High doses administered rarely appear to be equally efficient and safe compared to low doses provided frequently.]

Lege Artis Medicinae

[“Boys as victims”, or the potential public health consequences of childhood physical abuse]

GYŐRFFY Zsuzsa, IMOLA Sándor, CSOBOTH Csilla, KOPP Mária

[BACKGROUND - Whereas the scientific literature regarding physical abuse primarily focuses on female victims, few studies have been performed on the childhood abuse of men. The aim of our study was to examine the potential effects of childhood physical abuse of men on adult mental health status. METHODS - Data of 4675 male participants of the Hungarostudy nation-wide representative survey were analyzed. RESULTS - Altogether almost 13% of our study group reported physical abuse by a parent or other significant person. Compared with men who did not report abuse, depression, suicidal thoughts and attempts were significantly more common among abused men. Smoking, alcohol- and drugabuse, anxiety disorders and sleeping disorders also had a higher occurence. Moreover, we established that abused men had a significantly greater risk of marital distress and were more likely to have fewer children. Interpretation of the results in a multivariate model indicated that physical abuse is a determinate and independent risk factor of depression, suicidal thoughts and attempts, smoking habits and alcohol abuse. CONCLUSIONS - Our results underline that childhood physical abuse can have a significant effect on numerous mental disorders and maladaptive behaviours in adulthood. However, the deeper understanding of the relationship between physical abuse and mental disorders necessitates further studies.]