Hungarian Radiology

[REVIEW OF THE LITERATURE]

WENINGER Csaba, GYENES György

JUNE 20, 2006

Hungarian Radiology - 2006;80(03-04)

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Hungarian Radiology

[Renal cystic lesions The importance of CT in diagnosis and management in correlation with Bosniak classification]

AL-ABSI Mohammed, QAIS Abdulmalik, AL-NONO Ibrahim, GHILAN Abdulilah, GAFOUR Abdul Mohammed

[OBJECTIVE - The purpose of this study was to assess the importance of CT in differentiating renal cystic masses of surgical causes from those of non-surgical masses. PATIENTS AND METHODS - The patients included in this study were collected from a private diagnostic center and university hospital prospectively, yielding a total of 55 analyzable renal cystic lesions. A careful helical CT abdomen focusing on the kidneys with intravenous contrast was obtained from all patients. The lesions were categorized into surgical and medical renal cystic masses using the Bosniak classification system supported by histology reports and follow up protocols for medical cases. RESULTS - Of 55 cases, 35 were classified as surgical (13 lesions as category IV and 22 as III) and 20 as medical cases (15 as category II and 5 as III). Out of 22 resected category III lesions 15 were found to be malignant and all categorized as type IV were malignant. No malignancies have been identified in the prospectively monitored group of patients. CONCLUSION - Our series results are comparable with other teaching institution series, and support the usefulness of the Bosniak classification system in separating renal cystic lesion into surgical and non-surgical lesions but with diagnostic categorization difficulty of complicated multilocular hydatid cysts versus neoplastic (category III) cystic masses.]

Hungarian Radiology

[Radiological diagnosis of lung cancer - 2005 Literature review Onco Update 2005]

BALÁZS György

[Our aim is to review the radiologic literature of lung cancer of 2004 and some remarkable publications from 2003. There are three main groups in the recent publications dealing with lung cancer’s radiology. The first group comprises those reviews and metaanalyses which focus on the overall utility and reliability of routinely applied modalities such as CT and MRI. In the second group we find original articles reporting on the experience with new modalities. This group is dominated by publications dealing with positron emission tomography and the first clinical results of combined PET-CT technology. In the third part we review those articles dealing with lung cancer screening. Radiological lung cancer screening is in the focus of interest again, mainly due to the introduction of low-dose CT which is undoubtadly the most sensitive radiological modality for the early detection of lesions, however, its clinical utility is debated. The papers referred are basically sceptic, but this is not the end, because controlled long term follow-up studies are still in progress. Part of the publications report on the first clinical results of new methods, while others give valuable additional data regarding the performance of “well established” radiological modalities.]

Hungarian Radiology

[Markusovszky memorial session]

GÁSPÁRDY Géza

Hungarian Radiology

[Scientific session on the 85th Anniversary of the Clinic of Radiology in Debrecen]

MÓZES Péter

Hungarian Radiology

[Advisory Meeting of the European radiographers]

VANDULEK Csaba

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Interest in the hippocampal formation and its role in navigation and memory arose in the second part of the 20th century, at least in part due to the curious case of Henry G. Molaison, who underwent brain surgery for intractable epilepsy. The temporal association observed between the removal of his entorhinal cortex along with a significant part of hippocampus and the developing severe memory deficit inspired scientists to focus on these regions. The subsequent discovery of the so-called place cells in the hippocampus launched the description of many other functional cell types and neuronal networks throughout the Papez-circuit that has a key role in memory processes and spatial information coding (speed, head direction, border, grid, object-vector etc). Each of these cell types has its own unique characteristics, and together they form the so-called “Brain GPS”. The aim of this short survey is to highlight for practicing neurologists the types of cells and neuronal networks that represent the anatomical substrates and physiological correlates of pathological entities affecting the limbic system, especially in the temporal lobe. For that purpose, we survey early discoveries along with the most relevant neuroscience observations from the recent literature. By this brief survey, we highlight main cell types in the hippocampal formation, and describe their roles in spatial navigation and memory processes. In recent decades, an array of new and functionally unique neuron types has been recognized in the hippocampal formation, but likely more remain to be discovered. For a better understanding of the heterogeneous presentations of neurological disorders affecting this anatomical region, insights into the constantly evolving neuroscience behind may be helpful. The public health consequences of diseases that affect memory and spatial navigation are high, and grow as the population ages, prompting scientist to focus on further exploring this brain region.

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Creutzfeldt-Jakob Disease: A single center experience and systemic analysis of cases in Turkey

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We aimed to analyze the clinical, laboratory and neuroimaging findings in patients with sporadic Creutzfeldt-Jakob disease (CJD) in a single center as well as to review other published cases in Turkey. Between January 1st, 2014 and June 31st, 2017, all CJD cases were evaluated based on clinical findings, differential diagnosis, the previous misdiagnosis, electroencephalography (EEG), cerebrospinal fluid and cranial magnetic resonance imaging (MRI) findings in our center. All published cases in Turkey between 2005-2018 were also reviewed. In a total of 13 patients, progressive cognitive decline was the most common presenting symptom. Two patients had a diagnosis of Heidenhain variant, 1 patient had a diagnosis of Oppenheimer-Brownell variant. Seven patients (53.3%) had been misdiagnosed with depression, vascular dementia, normal pressure hydrocephalus or encephalitis. Eleven patients (87%) had typical MRI findings but only 5 of these were present at baseline. Asymmetrical high signal abnormalities on MRI were observed in 4 patients. Five patients (45.4%) had periodic spike wave complexes on EEG, all appeared during the follow-up. There were 74 published cases in Turkey bet­ween 2005 and 2018, with various clinical presentations. CJD has a variety of clinical features in our patient series as well as in cases reported in Turkey. Although progressive cognitive decline is the most common presenting symptom, unusual manifestations in early stages of the disease might cause misdiagnosis. Variant forms should be kept in mind in patients with isolated visual or cerebellar symptoms. MRI and EEG should be repeated during follow-up period if the clinical suspicion still exists.

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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.

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