Hungarian Radiology


MAY 15, 2010

Hungarian Radiology - 2010;84(01)



Further articles in this publication

Hungarian Radiology

[Breast malignancies: review of the year 2008/2009 radiological diagnostics and therapy news - Onco Update, 2010]


[Systematic review of the recent articles of the years 2008/2009 about breast tumours’ radiological diagnostics and guided therapy, the actual place of the imaging and interventional methods are presented.]

Hungarian Radiology

[Farewell to dr. Levente Lukács 1984-2010]

HÜTTL Kálmán

Hungarian Radiology

[Radiological assessment of the combined high tibial osteotomy in the frontal plane]

PAPP Miklós, KÁROLYI Zoltán, FAZEKAS Péter, SZABÓ László, PAPP Levente, RÓDE László

[INTRODUCTION - High tibial osteotomy (HTO) is a generally accepted treatment for medial unicompartmental osteoarthritis of the knee with varus alignment. The main principle of HTO is to achieve a transfer of loading from diseased, arthritic areas of the joint to areas with relatively intact, healthly cartilage. This stress reduction can be achieved with correction of the loading axis. A stress reduction occurs in the medial compartment of the knee when the loading axis is transferred from the medial compartment to just lateral to the center of the joint. PATIENTS AND METHODS - We performed radiological assessment of 52 knees preoperatively and after combined high tibial osteotomy (CO) in the 10th postoperative week, in the 12th postoperative month and in the 5th postoperative year on a standing weight-bearing anteroposterior radiograph. CO involved performing a proximal osteotomy parallel to the tibial plateau, followed by a distal osteotomy extending from the lateral part of the tibia to the line of the proximal osteotomy at the center of the tibial condyle. After closure of the lateral part of the osteotomy and consequent opening of the medial part, the removed lateral bone wedge was transferred to the gap on the medial side. Pre- and postoperatively we measured the lateral angle between the anatomic axis of the femur and the distal articular surface of the femur (FCFS), the lateral angle between the anatomic axis of the tibia and the proximal articular surface of the tibia (TP-TS) and the lateral angle between the distal articular surface of the femur and the proximal articular surface of the tibia (the articular component of the varus deformity FC-TP). We determined the FTA as a sum of FC-FS, TP-TS and FC-TP. RESULTS - The FC-TP, the TP-TS and the FTA decreased significantly after CO according to data measured in the 10th postoperative week. We achieved the planned correction (FTA 171-169°) in 77% of cases. Undercorrection (FTA ≥172°) was detected in 7, overcorrection (FTA ≤168°) was noted in 5 cases. We detected significant loss of correction between the 10th postoperative week and the 12th postoperative month (the FTA increased significantly, the loss of correction was 1° in 26 cases, 2° in 7 cases). The valgus alignment did not increase in any case. The articular component did not change in 36 cases. We did not note significant loss of correction and the valus alignment did not increase in any case between the 12th postoperative month and 5th postoperative year. We noted the recurrence of varus deformity in 1 case. We detected loss of correction due to increasing articular component in further 4 cases. The FC-FS did not change during the first 5 postoperative years. CONCLUSION - If we achieved the planned correction (FTA 171-169°) according to data measured in the 10th postoperative week on a standing weight-bearing anterposterior radiographs, we did not detect recurrence of varus deformity in any case during the first 5 postoperative years. If the articular component (FC-TP) did not change between the 12th postoperativ month and the 5th postoperative year (in 61.5% of cases), in our opinion we achieved the optimal correction.]

Hungarian Radiology

[Use of imaging in the up-to-date diagnosis and screening of breast cancer - 2nd Kecskemét Breast Cancer Consensus Conference, 2009]


Hungarian Radiology

[Régnier: Vanitas - Unusual story of a painting depicting a breast cancer woman]


All articles in the issue

Related contents

Clinical Neuroscience

[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


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]


[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. ]

Hypertension and nephrology

[Letter to the Reader A Letter to Society Members]

KISS István, TÚRI Sándor,

Hypertension and nephrology

[Professional Guideline of the Hungarian Society of Hypertension]