Hungarian Radiology

[Placebo effect]


AUGUST 20, 2003

Hungarian Radiology - 2003;77(04)



Further articles in this publication

Hungarian Radiology

[Radial scar associated with lobular neoplasia in the breast]


[INTRODUCTION - The authors are presenting the case of a 55-year-old female patient with breast abnormalities of unclear morphology. CASE REPORT - The lesion seen in the left breast was characteristic of radial scar in which, however, numerous, but not clearly benign microcalcifications were detected. During histological examination a radial scar associated with a small lobular neoplasia was diagnosed. However, these microcalcifications were not related to the malignancy. CONCLUSION - In radial scar extensive benign microcalcifications may develop. Nevertheless we should bear in mind that in 10-30% of cases this disorder can be associated with malignancy even without mammographic signs. The final diagnosis, however, should always be made on the basis of histological examination.]

Hungarian Radiology



Hungarian Radiology


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]


Hungarian Radiology

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


[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.]

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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.]

Clinical Neuroscience

The etiology and age-related properties of patients with delirium in coronary intensive care unit and its effects on inhospital and follow up prognosis

ALTAY Servet, GÜRDOGAN Muhammet, KAYA Caglar, KARDAS Fatih, ZEYBEY Utku, CAKIR Burcu, EBIK Mustafa, DEMIR Melik

Delirium is a syndrome frequently encountered in intensive care and associated with a poor prognosis. Intensive care delirium is mostly based on general and palliative intensive care data in the literature. In this study, we aimed to investigate the incidence of delirium in coronary intensive care unit (CICU), related factors, its relationship with inhospital and follow up prognosis, incidence of age-related delirium and its effect on outcomes. This study was conducted with patients hospitalized in CICU of a tertiary university hospital between 01 August 2017 and 01 August 2018. Files of all patients were examined in details, and demographic, clinic and laboratory parameters were recorded. Patients confirmed with psychiatry consultation were included in the groups of patients who developed delirium. Patients were divided into groups with and without delirium developed, and baseline features, inhospital and follow up prognoses were investigated. In addition, patients were divided into four groups as <65 years old, 65-75 yo, 75-84 yo and> 85 yo, and the incidence of delirium, related factors and prognoses were compared among these groups. A total of 1108 patients (mean age: 64.4 ± 13.9 years; 66% men) who were followed in the intensive care unit with variable indications were included in the study. Of all patients 11.1% developed delirium in the CICU. Patients who developed delirium were older, comorbidities were more frequent, and these patients showed increased inflammation findings, and significant increase in inhospital mortality compared to those who did not develop delirium (p<0.05). At median 9-month follow up period, rehospitalization, reinfarction, cognitive dysfunction, initiation of psychiatric therapy and mortality were significantly higher in the delirium group (p<0.05). When patients who developed delirium were divided into four groups by age and analyzed, incidence of delirium and mortality rate in delirium group were significantly increased by age (p<0.05). Development of delirium in coronary intensive care unit is associated with increased inhospital and follow up morbidity and mortality. Delirium is more commonly seen in geriatric patients and those with comorbidity, and is associated with a poorer prognosis. High-risk patients should be more carefully monitored for the risk of delirium.

Clinical Neuroscience

Acute effect of sphenopalatine ganglion block with lidocaine in a patient with SUNCT


Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing/short-lasting unilateral neuralgiform headache with cranial autonomic features (SUNCT/SUNA) is a rare severe headache. At the time of an attack, it can hinder a patient from eating and requires acute intervention. The sphenopalatine ganglion is an extracranial parasympathetic ganglion with both sensory and autonomic fibers. Sphenopalatine ganglion block has long been used in the treatment of headache, particularly when conventional methods have failed. Here, we present a patient who was resistant to intravenous lidocaine, but responded rapidly to sphenopalatine ganglion block during an acute episode of SUNCT/SUNA.

Clinical Neuroscience

Delirium due to the use of topical cyclopentolate hydrochloride


Introduction - Our aim is to present a rare case where a child had delirium manifestation after instillation of cyclopentolate. Case presentation - A 7-year old patient was seen in our outpatient clinic, and cyclopentolate was dropped three times at 10 minutes intervals in both eyes. The patient suddenly developed behavioral disorders along with gait disturbance, and complained of visual hallucinations 20-25 minutes after the last drop. The patient was transferred to intensive care unit and 0.02 mg/kg IV. physostigmine was administered. The patient improved after minutes of onset of physostigmine, and was discharged with total recovery after 30 minutes. Conclusion - Delirium is a rare systemic side effect of cyclopentolate. The specific antidote is physostigmine, which can be used in severely agitated patients who are not responding to other therapies.

Clinical Neuroscience

[Zonisamide: one of the first-line antiepileptic drugs in focal epilepsy ]


[Chronic administration of antiepileptic drugs without history of unprovoked epileptic seizures are not recommended for epilepsy prophylaxis. Conversely, if the patient suffered the first unprovoked seizure, then the presence of epileptiform discharges on the EEG, focal neurological signs, and the presence of epileptogenic lesion on the MRI are risk factors for a second seizure (such as for the development of epilepsy). Without these risk factors, the chance of a second seizure is about 25-30%, while the presence of these risk factors (for example signs of previous stroke, neurotrauma, or encephalitis on the MRI) can predict >70% seizure recurrence. Thus the International League Against Epilepsy (ILAE) re-defined the term ’epilepsy’ which can be diagnosed even after the first seizure, if the risk of seizure recurrence is high. According to this definition, we can start antiepileptic drug therapy after a single unprovoked seizure. There are four antiepileptic drugs which has the highest evidence (level „A”) as first-line initial monotherapy for treating newly diagnosed epilepsy. These are: carbamazepine, phenytoin, levetiracetam, and zonisamide (ZNS). The present review focuses on the ZNS. Beacuse ZNS can be administrated once a day, it is an optimal drug for maintaining patient’s compliance and for those patients who have a high risk for developing a non-compliance (for example teenagers and young adults). Due to the low interaction potential, ZNS treatment is safe and effective in treating epilepsy of elderly people. ZNS is an ideal drug in epilepsy accompanied by obesity, because ZNS has a weight loss effect, especially in obese patients.]