Hungarian Radiology

[Lifelong learning]


OCTOBER 20, 2002

Hungarian Radiology - 2002;76(05)



Further articles in this publication

Hungarian Radiology

[Intraoperative intracranial ultrasound imaging in neurosurgery]

DOBAI József Gábor, GYARMATI János, IFJ. SZÉKELY György, CSÉCSEI György István

[Diagnostic ultrasound imaging started in the 1940s. Up to the present it underwent on radical changes. Article briefly reviews the major steps of the development of ultrasound technique in neurosurgery, and possibilities of applications of different ultrasound methods in neurosurgery are described. Authors discuss their experiences with Hawk 2102 ultrasound system used in intraoperative procedures in 113 cases. Data compared with the literature. Conclusions are that use of intraoperative ultrasound in neurosurgery is modern and simple and it has various application fields. Intracranial lesions are well localized with its use, so the risk of operations decreases. Main disadvantages that ultrasound imaging requires bony trepanation and special transducers are needed for different lesions.]

Hungarian Radiology

[Examination of pancreatic exocrine function with secretin stimulated magnetic resonance cholangiopancreatography]

ENDES János, CZAKÓ László, TAKÁCS Tamás, BODA Krisztina, LONOVICS János

[INTRODUCTION - The aim of this study was to assess the feasibility and usefulness of SS-MRPD for evaluation of the pancreatic exocrine function. PATIENTS AND METHODS - SS-MRPD was performed in 20 patients with mild (n=8) or severe (n=12) chronic pancreatitis (according to the grade of exocrine pancreatic insufficiency indicated by the Lundh test) and in 10 volunteers without pancreatic disease. MRPD images were evaluated before and 10 min after the iv. administration of 0.5 IU/kg secretin. The changes in pancreatic tissue T2 signal intensity and duodenal filling after the injection of secretin were determined by means of SS-MRPD. The SSMRPD findings were then compared with those of the Lundh test. RESULTS - The basal pancreatic T2 signal intensity was significantly higher in the patients with a mild or a severe exocrine pancreatic insufficiency as compared with the controls (826.5±36.36 and 908±80.51 vs 659.2±41.67). The pancreatic T2 signal intensity exhibited a significant elevation after secretin administration both in the volunteers and in the patients with mild or severe chronic pancreatitis. This elevation was significantly lower in both the mild and the severe chronic pancreatitis patients than in the volunteers (66.85±15.77 and 24.45±5.85, respectively, vs. 200.0± 45.07). After the administration of secretin, the diameter of the duodenum was significantly increased in all three groups. This duodenal filling was significantly reduced in patients with a mild or a severe exocrine pancreatic insufficiency as compared with the volunteers (4.12±1.33 and 1.70±0.77 vs. 15.38± 1.73). There was no significant difference in pancreatic T2 signal intensity changes or in duodenal filling in patients with a mild or a severe exocrine pancreatic insufficiency. There were significant correlations between the pancreatic T2 signal intensity changes and the duodenal filling and the results of the Lundh test (r= -0.616 and -0.78). CONCLUSION - These results demonstrate that the administration of secretin increases the T2 signal intensity of the pancreatic tissue and the diameter of the duodenum to different extents in normal subjects and in patients with chronic pancreatitis. This suggests that SS-MRPD can provide information of value in the assessment of an exocrine pancreatic insufficiency.]

Hungarian Radiology

[7th Congress of the Society of Hungarian Radiographers]


Hungarian Radiology

[Osteopetrosis in the infancy]

HAJNAL Barbara, BITVAI Katalin, ALMÁSSY Zsuzsanna

[INTRODUCTION - The authors present a relatively rare, autosomal recessive osteogenetic disorder, which appearance is typical in the first year of life. The malignant osteopetrosis of infants has characteristic radiologic and haematologic status, which is often an incidental finding. CASE REPORT - A 6-month-old Chinese boy was referred with the suspition of bronchopneumony to perform a chest Xray. On the bases of our findings, additional X-ray studies were done (skull, wrist, dorsal spine, hip, femur). A general increase in the density of the bones with characteristic settlement were demonstrated. CONCLUSION - Reporting such a rare disease may help in the differential diagnosis of the osteopathies with diffusely increased density.]

Hungarian Radiology

[Before Vienna, after Szeged]


All articles in the issue

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Clinical Neuroscience

[The role of sleep in the relational memory processes ]

CSÁBI Eszter, ZÁMBÓ Ágnes, PROKECZ Lídia

[A growing body of evidence suggests that sleep plays an essential role in the consolidation of different memory systems, but less is known about the beneficial effect of sleep on relational memory processes and the recognition of emotional facial expressions, however, it is a fundamental cognitive skill in human everyday life. Thus, the study aims to investigate the effect of timing of learning and the role of sleep in relational memory processes. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. Our results suggest that the timing of learning and sleep plays an important role in the stabilizing process of memory representation to resist against forgetting.]

Lege Artis Medicinae

[Second game, 37th move and Fourth game 78th move]

VOKÓ Zoltán

[What has Go to do with making clinical decisions? One of the greatest intellectual challenges of bedside medicine is making decisions under uncertainty. Besides the psychological traps of traditionally intuitive and heuristic medical decision making, lack of information, scarce resources and characteristics of doctor-patient relationship contribute equally to this uncertainty. Formal, mathematical model based analysis of decisions used widely in developing clinical guidelines and in health technology assessment provides a good tool in theoretical terms to avoid pitfalls of intuitive decision making. Nevertheless it can be hardly used in individual situations and most physicians dislike it as well. This method, however, has its own limitations, especially while tailoring individual decisions, under inclusion of potential lack of input data used for calculations, or its large imprecision, and the low capability of the current mathematical models to represent the full complexity and variability of processes in complex systems. Nevertheless, clinical decision support systems can be helpful in the individual decision making of physicians if they are well integrated in the health information systems, and do not break down the physicians’ autonomy of making decisions. Classical decision support systems are knowledge based and rely on system of rules and problem specific algorithms. They are utilized widely from health administration to image processing. The current information revolution created the so-called artificial intelligence by machine learning methods, i.e. machines can learn indeed. This new generation of artificial intelligence is not based on particular system of rules but on neuronal networks teaching themselves by huge databases and general learning algorithms. This type of artificial intelligence outperforms humans already in certain fields like chess, Go, or aerial combat. Its development is full of challenges and threats, while it presents a technological breakthrough, which cannot be stopped and will transform our world. Its development and application has already started also in the healthcare. Health professionals must participate in this development to steer it into the right direction. Lee Sedol, 18-times Go world champion retired three years after his historical defeat from AlphaGo artificial intelligence, be­cause “Even if I become the No. 1, there is an entity that cannot be defeated”. It is our great luck that we do not need to compete or defeat it, we must ensure instead that it would be safe and trustworthy, and in collaboration with humans this entity would make healthcare more effective and efficient. ]

Clinical Neuroscience

Neuroscience highlights: The mirror inside our brain

KRABÓTH Zoltán, KÁLMÁN Bernadette

Over the second half of the 19th century, numerous theories arose concerning mechanisms involved in understanding of action, imitative learning, language development and theory of mind. These explorations gained new momentum with the discovery of the so called “mirror neurons”. Rizzolatti’s work inspired large groups of scientists seeking explanation in a new and hitherto unexplored area of how we perceive and understand the actions and intentions of others, how we learn through imitation to help our own survival, and what mechanisms have helped us to develop a unique human trait, language. Numerous studies have addressed these questions over the years, gathering information about mirror neurons themselves, their subtypes, the different brain areas involved in the mirror neuron system, their role in the above mentioned mechanisms, and the varying consequences of their dysfunction in human life. In this short review, we summarize the most important theories and discoveries that argue for the existence of the mirror neuron system, and its essential function in normal human life or some pathological conditions.

Clinical Neuroscience

[Personalised epilepsy treatment]


[Epilepsy is one of the most common chronic neurological disease in childhood. Patients with epilepsy – even with so-called benign epilepsy – need medication for years. During this time, children go through a very big change, not only gaining weight and height, but also changing hormonal and metabolic processes. Maturation processes in different brain areas also take place at different rates depending on age. All of these should be considered when preparing a therapeutic plan. In everyday practice after the diagnosis of epilepsy, the applied drug is most often selected based on the shape and type of seizure. However, a number of other factors need to be considered when designing a therapeutic strategy: 1. efficacy (form of epilepsy, type of seizure), 2. age, gender, 3. pharmacological properties of the drug, 4. adverse drug reaction profile, 5. lifestyle (community), figure (skinny, corpulent, obese), 6. other comorbidities (nutrition, behavioral and learning problems, circulatory disorders, kidney or liver disease), 7. expected interactions with other drugs already used, 8. genetics, 9. other aspects (drug registration and prescription rules). The purpose of this article is to help to decide which antiepileptic drugs are expected to have the least side effects in a particular child with different comorbidities and which medications should be avoided if possible.]

Lege Artis Medicinae

[Epilepsy in coronavirus pandemic]


[We aim to review the impact of COVID-19 pandemic on epilepsy and epilepsy-care. While the virus has no specific link with epilepsy, it may affect the nervous system both directly and indirectly, leading to seizures in several ways. The hyper-coagulable state occurring with the infection may cause strokes leading to seizures. The infection may first manifest in the form of disturbances of consciousness and behaviour, seizures, and even status epilepticus. The interactions of antiviral/antiepileptic drugs need to be taken into account during treatment. The hypercoagulable state induced by COVID-2 infection may cause stroke, which leads to seizures. The infection can occur also as an impaired consciousness of non-epileptic origin. Interactions of antiviral/antiepileptic drugs have also to be taken into account. The pandemic itself as well as quarantines and social distancing may cause anxiety and insomnia, challenge continuous antiepileptic supply; each one carrying the risk of seizing. Young epilepsy patients with learning disabilities and mental health issues are most vulnerable, justifying their hyper-protection. The danger of infection has highlighted the role of telemedicine. Internet-based video communication may ensure full care for chro­nic patients. Those methods favour bes­­ted patients with higher education. Epilepsy does not increase directly the risk of infection, but its comorbidities may worsen the course of the disease. Brain lesions and hypoxia, stress, insomnia and fever joining the infection increase seizure susceptibility. Because the danger of infection ma­de telemedicine an essential tool of pa­tient care, education and better computer supply for those in need is crucial. ]