Hungarian Radiology

[Board meeting of the Educational Committee of the European Society of Radiologists]

HARKÁNYI Zoltán

JUNE 20, 2007

Hungarian Radiology - 2007;81(03-04)

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Hungarian Radiology

[The quality control of radiological equipments in Hungary]

PELLET Sándor, PORUBSZKY Tamás, BALLAY László, GICZI Ferenc, MOTOC Anna Mária, VÁRADI Csaba, TURÁK Olivér, GÁSPÁRDY Géza

Hungarian Radiology

[Investigation of colon transit with radiopaque m]

WENINGER Csaba, KIRÁLY Ágnes

[The constipation is a frequent disorder, which often requires gastroenterological examination. Colon transit study and defecography are indicated in case of making difference between slow colon transit time and outlet obstruction. The method, the mode of administration of the radiopaque markers and the evaluation of the radiological study are discussed. Radiopaque markers ingested on the first day are followed by abdominal X-ray taken at regular times. The normal value of the colon transit time is less than 70 hours. The etiology of constipation has to be clarified by functional examinations, since the treatment of outlet obstruction is different from slow transit constipation. To determine the large bowel transit time is necessary also in the differential diagnosis of slow colon transit. The method is a simple, reliable and easily reproducible.]

Hungarian Radiology

[Sonographic appearance of the cytostatic therapyrelated hepatic injury]

JÓKÚTI László, VARGA Edit, KARÁDI Zoltán, KOVÁCS GÁBOR

[INTRODUCTION - The correlation between biochemical parameters and sonographic appearance of the liver in children and young adults receiving cytostatic therapy was investigated. PATIENTS AND METHODS - 104 (54 male, 50 female) patients at the hemato-oncologic unit of 2nd Department of Pediatrics, Semmelweis University Budapest were enrolled into this prospective, single-blind, uncontrolled study: patients’ ages were between 2.0 and 32.7 years (mean 12.2 yrs, ± SD 5.7). 69 patients received chemotherapy for acute lymphoblastic leukemia (ALL), 35 patiens for osteogenic osteosarcoma (OSC). The time interval between the initiation of the cytostatic therapy and the examination was between 1 month and 16 years (mean 3.9 yrs). Ultrasonography was performed after 5-8 hours of fasting, without sedation. Echogenicity, distal attenuation of liver parenchyma and Doppler waveforms of the hepatic vein branches were evaluated. Alanine-aminotransferase (ALT) and gamma-glutamyltransferase (GGT) activity were measured in peripheric blood samples. Statistical correlation was analysed between sonographic appearance and biochemical parameters of the liver. RESULTS - 35 patients had at least one sonographic abnormality: of these, 9 had elevated enzyme activity. Among the 69 patients with normal ultrasound findings, only 2 had increased enzyme activity (Chi square test, p=0.001). When tested against enzyme activity, echogenicity and attenuation showed significant (p=0.002 and p=0.01, respectively), Doppler waveform in the hepatic vein branches showed marginally significant correlation (p=0.05). All three ultrasound parameters had low sensitivity regarding the elevation of enzyme levels, however attenuation and hepatic vein waveform proved to be specific (both 94%) for enzyme level elevation and all three showed high negative predictive values (96%, 93% and 92%, respectively). When combining all three sonographic parameters in a single variable, correlation was even higher (p=0.001), sensitivity became acceptable (82%) and negative predictive value increased further to 97%. CONCLUSIONS - The authors conclude that a correlation exists between three simple sonographic indicators (echogenecity, distal attenuation, Doppler waveforms of the HVs) and liver injury detected by biochemical parameters. Due to the low sensitivity of the ultrasound parameters to confirm of the presence of diffuse liver injury is not possible. However, the combined use of the ultrasound and biochemical parameters a good negative predictive power can be achieved and therefore this is a useful tool in the follow-up for hepatic status.]

Hungarian Radiology

[First Central and Eastern European Workshop on Quality Control, Patient Dosimetry and Radiation Protection in Diagnostic and Interventional Radiology and Nuclear Medicine]

GÁSPÁRDY Géza

Hungarian Radiology

[Imaging of mesenterial panniculitis - Case report]

KOVÁCS Anita, KISS Ildikó, PALKÓ András

[INTRODUCTION - Mesenterial panniculitis is a rare benign disorder, however it is important to be familiar with, because of the difficulties in differential diagnosis. Authors describe the characteristic imaging signs of the disease based on their two cases. CASE REPORTS - Two male patients (72 and 62 years old) presented with uncertain abdominal pain and weight loss. Acute pancreatitis, chronic gastritis and duodenitis are noted in their case history. The laboratory parameters were normal and the physical examination revealed a palpable epigastrial terime in both patients. Abdominal ultrasound and CT examinations depicted different degree of mesenterial infiltration with lymph node enlargement. Histological analysis of the biopsy sample proved the process to be benign in the first patient. The mass was surgically removed in the second one and histology proved mesenterial panniculitis. CONCLUSION - Mesenterial panniculitis is a benign, chronic non-specific inflammatory disorder. Its appearance may simulate malignant diseases, thus making differential diagnosis is important. Abdominal ultrasound, CT and result of image guided biopsy play an important role in the diagnosis, in case of which conservative therapy and regular follow-up is sufficient.]

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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

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

The prevalence of sarcopenia and dynapenia according to stage among Alzheimer-type dementia patients

YAZAR Tamer, YAZAR Olgun Hülya

Aim - In this study, the aim was to identify the prevalence of sarcopenia and dynapenia according to disease stage among Alzheimer-type dementia (AD) patients and collect data to suggest precautions related to reducing the disease load. Method - The study was completed with 127 patients separated into stages according to Clinical Dementia Rating Scale (CDR) criteria and 279 healthy volunteers aged 18-39 years and 70-80 years abiding by the exclusion criteria who agreed to participate in the research. Our prospective and cross-sectional study applied the CDR and mini mental test (MMSE) to patients with disorder in more than one cognitive area and possible AD diagnosis according to NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer’s Disease and Related Disorders Association) diagnostic criteria. The patient and control groups had skeletal muscle mass index (SMMI), muscle strength and physical performance assessed with sarcopenia diagnosis according to European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic criteria. Results - In our study, in parallel with the increase in disease stage of AD patients, the prevalence of sarcopenia (led by severe sarcopenia) and dynapenia was higher compared to a control group of similar age. Conclusion - In chronic, progressive diseases, like AD, identification of changes in parameters, like muscle mass and strength and reductions in physical performance in the early period, is important for identification and to take precautions in the initial stages considering the limitations of the preventive effects of treatment applied after diagnosis of AD.

Hungarian Radiology

[European Congress of Radiology - ECR 2009 - Vienna, 6-10 March, 2009]

WENINGER Csaba és munkatársai

Lege Artis Medicinae

[Diseases of the kidneys due to non-cancer mortality characteristics of Hungary between 2005-2014]

PAKSY András, KISS István

[The authors review the time of 10 years between 2005-2014 concerning the development of the mortality rate of kidney diseases in Hungary. They’ve compared the Hungarian mortality data with the ones from three other countries, namely Austria, the Czech Republic and Germany. The analyses included kidney diseases originated from hypertension, glomerulonephritis and tubulointerstitial kidney diseases, kidney failure and polycystic kidney diseases. They weren’t concerned about kidney tumors or diabetes originated kidney diseases because of the lack of data concerning the latter. The mortality data were retrieved from the KSH Demography Yearbook and the European Detailed Mortality Data-base (DMDB). The statistically examined causes of death only add up to 1.2% of the total causes of death, but with the aging of the population this proportion will surely grow. During the last 10 years, the mortality of cardiovascular diseases decreased significantly, namely the mortality of ischaemic heart disease and stroke, but the mortality of hypertension increased. These processes can also be seen in Austria, the Czech Republic and Germany. The mortality connected to primal kidney diseases decisively concerns people aged over 70. The glomerular diseases’ standardized rate is significantly higher in Hungary than in the compared countries. The tubulointerstitial kidney diseases’ mortality rate decreased over the last 10 years and we are in the middle of the international field in this regard. During the evaluation of the mortality of kidney diseases it is important to consider that in the statistics every death can only have one cause nominated, which can be (correctly) the basic disease causing the kidney disease or in other cases the kidney disease itself. This problem makes it more difficult to compare data internationally. Only 20-30 patients die of acute kidney disease on a yearly basis which is a low mortality rate even by international standards but the above-mentioned problem still exists. Of all of them the chronic kidney disease is the most significant one and between 2005-2014 the number of deaths and their rate connected to it decreased, but with the aging of the population the morbidity of kidney diseases will surely increase. Analyzing the data of all the primer kidney diseases it can be determined that between 2005-2014 the mortality rate showed a decreasing tendency, so our international situation can be viewed positively. It is important to note though that the mortality of this disease type includes patients of lower average age in Hungary than in the more developed countries. The mortality rate of polycystic kidney disease hasn’t changed significantly during the past 10 years. Although some patients live to many years, the average age of the dead is significantly lower compared to the ones of other kidney disease types. The cases below the age of 1 year of the latter add up to 10%. The comparison between the countries concerning the po­lycystic kidney disease shows that the standardized mortality rate is higher in Hun­gary.]