Hungarian Radiology

[Passed away dr. Imre Szatai]

TÓTH Erzsébet

FEBRUARY 20, 2004

Hungarian Radiology - 2004;78(01)

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Further articles in this publication

Hungarian Radiology

[Conference of the Senior and Junior Club of the Society of Hungarian Radiologists]

MAKULA Éva

Hungarian Radiology

[Cornell Seminar]

VÁRKONYI Ildikó

Hungarian Radiology

[Recovery of multiple brain abscesses caused by Serratia marcescens in newborn age]

FEJES Melinda, BORBÁS Éva, PAPP Attila, SZÉKHELYI Zsuzsanna, SZŰTS Ágnes

[INTRODUCTION - Multiple brain abscesses caused by Serratia marcescens is a rare disease in newborn infants. The paper describes the development, case history and treatment of the disease. Radiological features of Gram negative bacterial meningitis and brain abscesses are also discussed. PATIENT AND METHODS - A newborn baby boy presented polycythaemia and fever was admitted to the hospital in the first days of his life. On the 11th day after admission convulsions occured and because of suspected intracranial abnormality or meningitis cranial CT was performed. On CT scans multiple abscesses were revealed and surgical therapy including drainage and ventricle shunt was done. During the treatment he had epileptic seisures frequently, but he became symptome free after the introduction of complex antiepileptic therapy. Now the two year old boy is in a good physical condition but he has mild motoromental deficience. CONCLUSION - Radiological imaging plays an important role in the diagnosis and the follow up of brain abscesses and also in the evaluation of its complications.]

Hungarian Radiology

[Future planning of radiology before joining the EU]

BARANYAI Tibor

Hungarian Radiology

[Theoretical basis of tumor staging The significance of imaging in oncological diseases]

GŐDÉNY Mária

[The general goal for staging patients with any cancer is to determine the overal extent of disease prior to choice of therapy. It has been well documented that biological behavior of any cancer and, therefore, the prognosis of the patient is strongly linked to the extent of the tumor, the presence or absence of lymphatic dissemination as well as systemic metastases. The staging systems have undergone a number of modifications. Classifications of TNM system identifies the depth of tumor invasion (T), the status of regional lymph nodes (N) and the distant metastases. These three parameters are then incorporated into the final clinical stage. There are further modifications which influence the patient survival, e.g. biological, genetical, hystological factors, tumor grade. All cancer cells show dysregulation of cell cycle controll. As the cancer proliferates and the tumor reaches approximately 1-2 mm in diameter further growth recquires the development of new blood vessels (neo-angiogenesis). Intensity of tumor growth has a prognostic influence to the patient's life and depends on the tumor doubling time, which classifies tumors into slow, intermadiate and rapid growing types. The diagnostic impact of imaging is based on the ability of a technique to detect and evaluate the cancer accurately. The very high accuracy and reproducibility of cross-sectional imaging, paticularly computed tomography (CT) and magnetic resonance imaging (MRI) make these methods extremely important in the detection, staging and in the evaluation of the tumors. The revolutionary advances in detection and treatment of malignant disease have led to an increasing role of the radiologist as a member of the multidisciplinary cancer team.]

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Clinical Neuroscience

Long-term follow-up results of concomitant chemoradiotherapy followed by adjuvant temozolomide therapy for glioblastoma multiforme patients. The importance of MRI information in survival: Single-center experience

LUKÁCS Gábor, TÓTH Zoltán, SIPOS Dávid, CSIMA Melinda, HADJIEV Janaki, BAJZIK Gábor, CSELIK Zsolt, SEMJÉN Dávid, REPA Imre, KOVÁCS Árpád

Introduction - Glioblastoma multiforme (GBM) is the most common malignant primary anomaly of central nervous system. The GBM infiltrates the nearly sturctures from the initial tumor and its metastatic attribution is well known. The aim of our single-centered retrospective study was to introduce the importance of postoperative medical imaging confirmation of total tumor resection for patient with GBM combined concomitant and adjuvant chemoradiotherapy on a 10 year long patient follow up. Methods - From January 2006 to April 2015 we registered 59 patients with newly diagnosed GBM at the University of Kaposvár Health Center Institute of Diagnostic Imaging and Radiation Oncology. The histological diagnosis was confirmed by a proficient neuropathologist (World Health Organisation WHO; grade IV astrocytoma). According to histological status if the ECOG performance status of patients allowed it the mutidisciplinary oncoteam recommended adjuvant chemoradiotherapy all features strictly by Stupp protocol. (60 Gy dose on the gross tumor volume and 2-3 cm margin for the clinical target volume with parallel 75 mg/m2 TMZ. Four weeks after monotherapial phase patients had to recieve 6 cycles of TMZ first cycle with 150 mg/m2 up to 200 mg/m2). The irradiation was carried out by a conformal three dimensional planning system. Results - 59 patients with the median age of 63 (range 17-84) year. Our sample counted 34 male patients and 25 woman patients. 14 patients underwent gross total tumor resection while, 39 patients underwent partial resection and the rest from our sample 6 patients passed through biopsy. Statistical analysis showed a lengthier survival among males than females, with a median survival of 13 months for males and females, the OS of 26.209 for males, meanwhile 15.625 for females. However, the difference is not considerable (log-rank p=0.203). Our study found that the estimated survival of patients at least 50 years old is significantly shorter at a median survival of 12 months (log rank p=0.027) than that of patients below 50 years of age at a median survival of 23 months. The longest estimated median survival was calculated with patients of ECOG '0' condition (16 months). However, no significant difference was found in the estimated survival of patients of different ECOG conditions (log-rank p=0.146). Based on the extent of surgery, complete resection resulted in the longest average survival of 36.4 months, followed by 21.5 months among patients with biopsy, and 15.8 months among patients with partial resection. Different surgical procedures, however, did not result in significant differences in survival (log-rank p=0.059). The overal survival of patients who had complete resection confirmed by MRI compared with the overal survival of patients with residual tumor confirmed by MRI as well we can estimate that there is significant difference between these two groups (p=0,004). Conclusion - Despite complex and intense treatment, recurrence is inevitable and causes relatively rapid death. In our analysis complete resection, as defined from the neurosurgeon’s report and postoperative MRI, resulted in an independently significant improvement in OS. Our results are the evidences that the treatment of patients with glioblastoma multiforme in Hungary is at least on the same level as any other developed European countries.

Clinical Neuroscience

[In memoriam Prof. Dr. Ferenc Garzuly (1937-2021)]

ILLÉS Zsolt, HAHN Katalin, KÁLMÁN Bernadette

[Ferenc Garzuly passed away after a long and productive life at the age of 84. He worked for almost 60 years at the Markusovszky University Teaching Hospital, where primarily led the laboratory of neuropathology and the department of neurology, but transferred to the department of pathology after his retirement. By authoring several books on rare diseases, he greatly enriched the case-based tea­ching approach in medicine. He described the Hun­garian type of transthyretin mutation causing the familial me­nin­go­cerebrovascular amyloidosis phenotype. The presentation of a special phenotype of Fabry disease associated with megadolichobasilar anomaly and a novel mutation in the alpha-galactosidase-A gene is also associated with his name. ]

Lege Artis Medicinae

[Frequency and risk factors of “de novo” tumors after kidney transplantation ]

BORDA Bernadett, HÓDI Zoltán, SZEDERKÉNYI Edit, OTTLAKÁN Aurél, SEREGÉLY Edit, LÁZÁR György, KERESZTES Csilla, VIRÁG Katalin

[After kidney transplantation, the administration of immunosuppressive therapy not only renders the patient susceptible to infections, but it may also damage the function of tumor cell recognition and elimination. Our study was performed at the Department of Surgery, University of Szeged. After establishing the inclusion criteria, 570 patients were involved in the study. We examined the age, sex, immunosuppressive therapy of the patients, and searched for the rela­tionship between the different immunosuppressive agents and the type of the tumor. In 81 cases, de novo cancer was diagnosed. Among patients treated with cyclosporin and tacrolimus there was no significant difference in the mean age (p = 0.734) and body mass index (p = 0.543). There was no significant difference in graft function between the two groups of patients (Tac vs Cyc; 44 vs 20). Related to the time passed since the trans­plantation to diagnosing the tumors the earliest were prostate and cervix cancers however without significant difference. Skin cancers are the most frequent followed by post-transplant lym­pho­prolife­ra­tive diseases. The increasing risk of developing tumors is mainly due to immunosuppressive therapy. ]

Lege Artis Medicinae

[Premises and standards in medical ethics]

LŐRINCZ Jenő

[The definition of medical ethics seems simple: 'the right conduct of medical life' (in more modern terms: the rules of medical behaviour in professional situations). It follows József Imre's Medical Ethics, published in 1925; a problematic that pervades the principles and practice of medicine as a whole, an expanding repertoire, in the sense of 'humanistic medicine', as advocated by László Levendel (also), in which the focus is on patient-centredness rather than disease-centredness.]

Lege Artis Medicinae

[Regime change?]

[Finally, the first law of the comprehensive reform of the health care system, the Law on Public Health and Medical Services, has just been passed! Live long and fulfill the hopes of its creators! There must be tens of millions of us for whom this is a vital necessity.]