Hungarian Radiology

[Development of Coronary Disease After Irradiation of Gastric Ulcer]

GYENES György

AUGUST 10, 2005

Hungarian Radiology - 2005;79(04)

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Hungarian Radiology

[Breast core needle biopsies yielding uncertain results - Experience at the complex mammographic screening unit in Kecskemét]

AMBRÓZAY Éva, BORI Rita, LŐRINCZ Margit, LÓRÁND Katalin, CSERNI Gábor

[INTRODUCTION - On occasion core biopsies yield an inconclusive (B3 or B4) result in the triple diagnostics of breast lesions. These cases may turn to be malignant in the operation specimen. This study evaluates the value of B3 and B4 diagnoses and the consequences of these diagnoses. MATERIALS AND METHODS - Core needle biopsies were generally taken under imaging guidance with an automatic gun using G14 gauge needles. They were evaluated using internationally and nationally accepted categories from B1 to B5. The analysis was based on data collected between 2000 and March 2005. RESULTS - Of the 663 core needle biopsy specimens 31 (4.7%) were classified as B3 and 22 (3.3%) as B4. Specimens were more often fragmented in the latter category (a rate of 0.64 as compared with a rate of 0.26). Patients with a B3 diagnosis were operated on in 23 cases, eight of which turned to be malignant (0.35). B4 diagnoses were followed by operations in 21 cases and were found to be malignant on 19 occasions (0.9). Whenever a B4 diagnosis was associated with radiological findings of malignancy (category 5 on mammography and/or ultrasound) the cases unanimously proved to be malignant. The same association with B3 diagnoses yielded malignancy in a rate of only 0.67. CONCLUSION - Both B3 and B4 diagnoses represent an indication for operation. Our experience suggests that B4 diagnoses when coupled with a radiological opinion of malignancy can be candidates for definitive (therapeutic breast conserving) surgery whereas B3 diagnoses require diagnostic excisions.]

Hungarian Radiology

[Installation, functioning and financing of the PET-CT and radiotherapy simulatory CT machines - Recommendations of the Hungarian College of Radiologists]

PALKÓ András

Hungarian Radiology

[Results of the radiological PhD program in Szeged, 1996-2005]

CSERNAY László

Hungarian Radiology

[Errare humanum est]

LOMBAY Béla

Hungarian Radiology

[Dogbite due to breast cancer! - A joke, or maybe not?]

GÖBLYÖS Péter

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Cognitive dysfunction (CD) is a common non-motor symptom of Parkinson’s disease (PD). Alexithy­mia is a still poorly understood neuropsychiatric feature of PD. Cognitive impairment (especially visuospatial dysfunction and executive dysfunction) and alexithymia share com­mon pathology of neuroanatomical structures. We hypo­thesized that there must be a correlation between CD and alexithymia levels considering this relationship of neuroanatomy. Objective – The aim of this study was to evaluate the association between alexithymia and neurocognitive function in patients with PD. Thirty-five patients with PD were included in this study. The Toronto Alexithymia Scale–20 (TAS-20), Geriatric Depression Inventory (GDI) and a detailed neuropsychological evaluation were performed. Higher TAS-20 scores were negatively correlated with Wechsler Adult Intelligence Scale (WAIS) similarities test score (r =-0.71, p value 0.02), clock drawing test (CDT) scores (r=-0.72, p=0.02) and verbal fluency (VF) (r=-0.77, p<0.01). Difficulty identifying feelings subscale score was negatively correlated with CDT scores (r=-0.74, p=0.02), VF scores (r=-0.66, p=0.04), visual memory immediate recall (r=-0.74, p=0.01). VF scores were also correlated with difficulty describing feelings (DDF) scores (r=-0.66, p=0.04). There was a reverse relationship bet­ween WAIS similarities and DDF scores (r=-0.70, p=0.02), and externally oriented-thinking (r=-0.77,p<0.01). Executive function Z score was correlated with the mean TAS-20 score (r=-62, p=0.03) and DDF subscale score (r=-0.70, p=0.01) Alexithymia was found to be associated with poorer performance on visuospatial and executive function test results. We also found that alexithymia was significantly correlated with depressive symptoms. Presence of alexithymia should therefore warn the clinicians for co-existing CD.

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Although vertigo is one of the most common complaints, intracranial malignant tumors rarely cause sudden asymmetry between the tone of the vestibular peripheries masquerading as a peripheral-like disorder. Here we report a case of simultaneous temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting as acute unilateral vestibular syndrome, due to the reawakening of a primary gastric signet ring cell carcinoma. Purpose – Our objective was to identify those pathophysiological steps that may explain the complex process of tumor reawakening, dissemination. The possible causes of vestibular asymmetry were also traced. A 56-year-old male patient’s interdisciplinary medical data had been retrospectively analyzed. Original clinical and pathological results have been collected and thoroughly reevaluated, then new histological staining and immunohistochemistry methods have been added to the diagnostic pool. During the autopsy the cerebrum and cerebellum was edematous. The apex of the left petrous bone was infiltrated and destructed by a tumor mass of 2x2 cm in size. Histological reexamination of the original gastric resection specimen slides revealed focal submucosal tumorous infiltration with a vascular invasion. By immunohistochemistry mainly single infiltrating tumor cells were observed with Cytokeratin 7 and Vimentin positivity and partial loss of E-cadherin staining. The subsequent histological examination of necropsy tissue specimens confirmed the disseminated, multi-organ microscopic tumorous invasion. Discussion – It has been recently reported that the expression of Vimentin and the loss of E-cadherin is significantly associated with advanced stage, lymph node metastasis, vascular and neural invasion and undifferentiated type with p<0.05 significance. As our patient was middle aged and had no immune-deficiency, the promoting factor of the reawakening of the primary GC malignant disease after a 9-year-long period of dormancy remained undiscovered. The organ-specific tropism explained by the “seed and soil” theory was unexpected, due to rare occurrence of gastric cancer to metastasize in the meninges given that only a minority of these cells would be capable of crossing the blood brain barrier. Patients with past malignancies and new onset of neurological symptoms should alert the physician to central nervous system involvement, and the appropriate, targeted diagnostic and therapeutic work-up should be established immediately. Targeted staining with specific antibodies is recommended. Recent studies on cell lines indicate that metformin strongly inhibits epithelial-mesenchymal transition of gastric cancer cells. Therefore, further studies need to be performed on cases positive for epithelial-mesenchymal transition.

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[What happens to vertiginous population after emission from the Emergency Department?]

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