Hungarian Radiology

[Imre Kaszás, Magor Babos: CT-MR Investigational Technique]

PALKÓ András

DECEMBER 15, 2008

Hungarian Radiology - 2008;82(07-08)

COMMENTS

0 comments

Further articles in this publication

Hungarian Radiology

[Professor Tibor Szenes, Founder of the Szeged X-Ray Clinic, was Born 100 Years Ago]

FRÁTER Loránd

Hungarian Radiology

[European Congress of Pediatric Radiology Edinburgh, 4-7 June 2008]

VÁRKONYI Ildikó

Hungarian Radiology

[A Deliberate Violation of Symmetry My Entry for the Ig Nobel Prize]

LOMBAY Béla

Hungarian Radiology

[Anniversary Meeting of the Mihály Erdélyi Memorial Medal Foundation The 100th Anniversary of the Birth of Mihály Erdélyi MD Budapest, 7 February 2008]

BOHÁR László

Hungarian Radiology

[Role of contrast enhanced ultrasound in clinical practice]

HARKÁNYI Zoltán

[Ultrasound contrast agents consist of micro bubbles which can be visualized during their short intravascular and parenchymal transit time. An US system with special software, a small amount of intravenous contrast agent and a skilled operator is necessary to produce a successful study. This method can also be introduced into the clinical practice in our country. Careful indications and well performed studies can reduce the number of unnecessary CT and MR studies and biopsies. Contrast enhanced US has special clinical significance in the detection and characterization of focal liver masses, monitoring drug and local treatment effects of different abdominal tumors and in the case of injury of abdominal parenchymal organs.]

All articles in the issue

Related contents

Clinical Neuroscience

The effects of the level of spinal cord injury on life satisfaction and disability

GULSAH Karatas, NESLIHAN Metli, ELIF Yalcin, RAMAZAN Gündüz, FATIH Karatas, MÜFIT Akyuz

Introduction - Spinal Cord Injury (SCI) may often lead to significant disability in affected individuals and reduce life satisfaction. Herein we aimed to investigate the effects of the level of injury on disability and life satisfaction as well as the relation between life satisfaction and disability. Methods - Patients with at least one-year history of SCI were included. Demographic-clinical data of patients were recorded. The Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) was used for quantifying the degree of patients’ disability. Life satisfaction was assessed by the Satisfaction with Life Scale (SWLS). Results - Of the 76 patients, 21 (27.6%) were tetraplegic and 55 (72.4%) were paraplegic. SWLS was found to be similar in tetraplegic vs. paraplegic patients (P=0.59), whereas CHART parameters such as physical independence, mobility, occupation, and total CHART value were significantly higher in paraplegic patients (P=0.04, P=0.04, P=0.001 and P=0.01, respectively). Social integration was found similarly high in both groups. There was a positive correlation between elapsed time after the injury and CHART physical independence, occupation and the level of economic sufficiency (P<0.01, P<0.01, P=0.01). Excluding the economic sufficiency (P=0.02), there was not any other association between the rest of CHART parameters and SWLS. Conclusions - According to our findings, although the level of injury seems to be influential on disability, it seems to have no significant effect on life satisfaction. Since the only thing that positively affects life satisfaction is economic sufficiency, more emphasis should be placed on regulations that increase the return to work in patients.

Clinical Neuroscience

The yield of electroencephalography in syncope

NALBANTOGLU Mecbure, TAN Ozturk Ozlem

Introduction - Syncope is defined as a brief transient loss of consciousness due to cerebral hypoperfusion. Although the diagnosis of syncope is based on a thorough history and examination, electroencaphalography (EEG) is also an important investigational tool in the differential diagnosis in this group of patients. In this study we aimed to identify the diagnostic value of EEG in patients with syncope. Methods - We retrospectively examined EEG recordings of 288 patients with the diagnosis of syncope referred to the Cankiri State Hospital EEG laboratory, from January 2014 to January 2016. The EEG findings were classified into 6 groups as normal, epileptiform discharges (spike and sharp waves), generalized background slowing, focal slowing, hemispherical asymmetries, and low amplitude EEG tracing. The EEGs were separated according to gender and age. Results - Total of 288 patients were included in this study, 148 were females (51.4%) and 140 (48.6%) were males. Among all the EEG reports, 203 (70.5%) were normal, 8 of them (2.8%) showed generalized background slowing and 7 (2.4%) demonstrated focal slow waves. Epileptiform discharges occured among 13 patients (4.5%). Hemispherical asymmetries were detected in 10 patients (3.5%) and low amplitude EEG tracing in 47 patients (16.3%). There was no significant difference between age groups in EEG findings (p=0.3). Also no significant difference was detected in EEG results by gender (p=0.2). Discussion - Although the diagnosis of syncope, epilepsy and non-epileptic seizures is clinical diagnosis, EEG still remains additional method

Clinical Neuroscience

[Serum IgG and IgM ganglioside GM1 antibodies in patients with multiple sclerosis]

ZAPRIANOVA Emilia, MAJTÉNYI Katalin, DENISLAVA Deleva, OLIA Mikova, ANDON Filchev, BORISLAV Sultanov, VERA Kolyovska, SULTANOV Emil, LILIA Christova, XENIA Kmetska, DIMITAR Georgiev

[INTRODUCTION - In order to obtain more information concerning the pathogenic significance of ganglioside GM1 in multiple sclerosis serum polyclonal IgG and IgM antibodies to GM1 were evaluated in multiple sclerosis patients with relapsing-remitting and secondary progressive forms of the disease. PATIENTS AND METHODS - The evaluated sera were from 55 patients with clinically definite multiple sclerosis and from 20 healthy subjects. Forty-two of patients were with relap-sing-remitting and 13 with secondary progressive multiple sclerosis. Antibodies to GM1 were measured using a modification of the enzyme-linked immunosorbent assay technique of Mizutamari et al (1994). RESULTS - A statistically significant difference of serum IgG antibody titres to GM1 was found between the healthy subjects and the multiple sclerosis patients with relapsing-remitting form of the disease (p=0.04), as well as of serum IgG antibody titres to GM1 between the patients with relapsing-remitting multiple sclerosis in relapse and in remission (p=0.01). CONCLUSION - Bearing in mind the heterogeneity of multiple sclerosis, the pathogenic significance of serum antibo-dies to GM1 should be interpreted concerning the precise clinical form of the disease and not the whole group of MS patients. The findings in this study argue for the possible involvement of ganglioside GM1 in the pathogenesis of demyelination in relapsingremitting multiple sclerosis.]

Lege Artis Medicinae

[Incisional hernia and diabetes. Could we improve the results?]

MARTIS Gábor, DAMJANOVICH László

[GOALS - Diabetes mellitus is considered as a risk factor concerning surgical interventions as well. Connection between incisional abdominal hernias and diabetes mellitus were investigated in this prospective four years study. The primary aim was to evaluate the proportion of recurrencies, the secondary aim was determining the ratio of surgical complications in the investigated two groups (Group I: non diabetic, group II: diabetic patients). PATIENTS AND METHOD - The results of the incisional and abdominal hernia operations performed between 01. 01. 2011. and 31. 12. 2014. were investigated. Data for study was gained from the consecutively and obligatorily registered database of the authors’ institution. The type of reconstruction, elective or acute character of surgery, primary or recidive operation, the patients’ body mass index (BMI), as well as among complications the seroma and fistula formations, the reoperations and postoperative infections were registered. Patients with type I and type II diabetes mellitus were not differentiated. The HgbA1c was investigated separately in elective and acute operations. RESULTS - There were 56 (8.94%) diabetic patients (39 male, 17 women, avr. age 54.3 years) out of all 626 patients operated on incisional and/or abdominals wall hernias. Total recurrency rate was 19.6% during the average 32 months (6-66 months) follow-up period. The recurrency rate in diabetic patients was 50.0% (48.7% in women, 52.9% in men). Non-diabetic patients’ recurrency ratio were only 8.3% (11.2% and 5.4% in men and women, respectively). Median BMI is significantly higher in patients with diabetes than in those of non diabetics (35.4kg/m2 vs 27.75kg/2). Ratio of the elective and acute operations were 69.6% and 28.6%, respectively. The most frequently used operations technique was the direct transversal abdominal wall suture (14.3%) and the direct suture plus synthetic mesh implantation (64.3%). Eleven (19.7%) diabetic patients with incisional hernia were reconstructed with a so-called autologous tension free dermal flap. In 2 (18.2%) out of 11 patients were registered recurrency. Seroma and haematoma formation was occured in four patient (36.4%) and in one (9.1%), respectively after dermal flap reconstructions. Mean recurrency time after surgery in non-diabetic and in diabetic patients was 12.3 months and 9.2 months, respectively. The average HgbA1c level was significantly higher (8.1% in electively operated patients than in those acutly operated ones (9.8%). There were two lethal (0.36%) postoperative complications in this study. CONCLUSION - Considering the recurrency ratio of the incisional hernias and the postoperative complications, diabetes mellitus is a significant risk factor compared the data to non-diabetic patients. Seroma and haematoma formations, postoperative complications ratio are significantly higher in patients with diabetes than in those of non-diabetic. Appearance of recurrencies require significantly shorter time in patients with diabetes mellitus The rate of recidive and postoperative complication after the autolog, dermal, traction free abdominal wall reconstructions made by authors was lower, than in abdominal hernias reconstructed in other ways (direct suture, direct suture plus xenograft).]

LAM Extra for General Practicioners

[RESISTANT HYPERTENSION - DIFFERENTIAL DIAGNOSIS AND THERAPY]

TISLÉR András

[Hypertension is considered resistant to therapy if the target blood pressure is not achieved despite treatment with three different types of antihypertensive drugs, including a diuretic. Causes of therapy resistance may be grouped into three broad categories: Pseudoresistance can be the result of inadequate blood pressure measurement technique, the “white-coat” effect or the patients’ noncompliance with pharmacological and nonpharmacological medical advices. Evaluation of the measurement technique - including the size of the cuff used - and blood pressure monitoring at home can help identify the causes of pseudoresistance. Secondary resistance comprises drug interactions and concomitant medical conditions that elevate blood pressure or antagonize antihypertensive therapy. In addition, secondary resistance can result from disorders associated with secondary hypertension, among which appropriate screening for hyperaldosteronism as well as for renoparenchymal and renovascular hypertension need special emphasis. Suboptimal therapy is frequently related to subclinical volume overload and the use of inappropriate type or dosing of diuretics. Furthermore, when choosing the optimal drug combination, care should be taken to inhibit the various systems that regulate blood pressure as much as possible. In addition to combining the most frequently used antihypertensive drugs, the use of aldosterone antagonists, vasodilators, nitrates or drugs affecting the central nervous system might help to optimise treatment.]