Hungarian Radiology

[New perspectives in ultrasound diagnostics Interview with professor William Lees]

HARKÁNYI Zoltán

AUGUST 20, 2003

Hungarian Radiology - 2003;77(04)

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Hungarian Radiology

[Radiotherapy]

GYENES György

Hungarian Radiology

[Cheirospondyloenchondromatosis]

IGNYS Anna, MALGORZATA Krajewska-Walasek, MARIKOVA Olga, IVO Marik, KAZIMIERZ Kozlowski

[The term of cheirospondyloenchondromatosis (CHE) was coined by Spranger et al. This generalised, distinctive form of enchondromatosis is characterised by mild to moderate dwarfism, short hands and feet with beaded fingers, prominent large joints and frequently mental deficiency. Major radiographic features include generalised mild platyspondyly, generalised enchondromatosis with marked involvement of hands and feet and small ilia with eroded crests and acetabular roofs. We report three patients with this rare, severe form of enchondromatosis and stress some differences between our patients and the classical description of Spranger et al.]

Hungarian Radiology

[Jenő Forrai's intellectual heritage]

GÖBLYÖS Péter

Hungarian Radiology

[Follow-up of infants undergoing pyeloplasty: renal ultrasound and diuresis renography changes]

KIS Éva, NYITRAI Anna, VÁRKONYI Ildikó, BÁRTFAI Katalin, GYÖRKE Tamás, MÁTTYUS István, VEREBÉLY Tibor

[INTRODUCTION - The authors reviewed their experience after pyeloplasty in infants, according to the follow-up results of ultrasound and nuclear renography. PATIENTS AND METHODS - During the period 1988-2001 184 infants underwent pyeloplasty for ureteropelvic junction (UPJ) obstruction. Patients (n=91) with unilateral UPJ obstruction and normal contralateral kidney were included in this study. Patients ages at surgery were between 1 day-36 months. Preoperative evaluation included ultrasound examinations and diuretic renograms. Follow-up ultrasound examinations were done after 3, 6, 12 months, later yearly. Depending on the result of the ultrasound examination isotope scan were done. RESULTS - The pelviureteric obstruction were detected prenatally at 65 cases (71%). Preoperative ultrasound revealed grade 3-4 pyelocaliectasis in all patients. All patients had obstruction on preoperative renography, nine kidneys had no function, in 37 cases (41%) hydronephrotic kidneys had diminished function. Nine patients underwent nephrectomy because of non-functioning kidney. Eighty two infants underwent pyeloplasty. Grade of hydronephrosis improved in 56% of kidneys and dilatation was the same one year after pyeloplasty in 44% of kidneys. Five years after pyeloplasty 91% of kidneys, after eight years 97% of hydronephrosis improved or cured. Postoperative renography showed improvement in drainage in all preoperatively obstructed kidneys. The renal function improved only in 22% of cases at the end of the first postoperative year, and no further improvement were detected later on. CONCLUSION - Pyeloplasty in infant ages significantly cured the drainage early after surgery. The resolution of hydronephrosis is relatively slow, but after eight years dilatation cured or improved in most of the affected kidneys. Improvement of the renal function was detected only in small part of the cases.]

Hungarian Radiology

[40th Congress of the European Association of Pediatric Radiology Genova, 2-6th June 2003.]

KIS Éva

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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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