Lege Artis Medicinae

[About books]

SVASTICS Egon

JANUARY 29, 1992

Lege Artis Medicinae - 1992;2(01)

[Summary of the book "The Big Health Book"]

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Lege Artis Medicinae

[Biological and Pathological Significance of Apoptosis (Programmed Cell Death)]

SZENDE Béla

[Programmed cell death (apoptosis) basically differs from necrosis regarding its biological significance, the morphological signs and biochemical events. Apoptosis is the result of an active cell function, so-called cell-suicide and it is observable in several biological as well as pathological processes. Enhancement of apoptosis can be achieved in malignant tumors by hormonal treatment. This explains the mode of action of hormones in tumor therapy and also contributes to the alterations in gene regulation leading to apoptosis.]

Lege Artis Medicinae

[The use of BCG immunotherapeutic for the treatment of superficial bladder cancer (carcinoma in situ and papillary tumor)]

CSIZÉR Zoltán

[BCG Immunotherapeutic (BCG IT) is the first immunomodulator to be licenced in Canada, Germany and the United States for the use in the treatment of carcinoma of the urinary bladder. The product licence was granted following the conduct of a well designed efficacy study. The study was multicente red, independent and controlled with well defined end points and a long follow up period. The results clearly shows that BCG immunotherapy is significantly more effective than Adriamycin chemotherapy. There is no evidence to suggest a difference in severity of toxicities between BCG and Adriamycin treatment groups.]

Lege Artis Medicinae

[Transesophageal and transthoracic echocardiography in aortic dissection]

LENGYEL Mária

[ The severe prognosis of aortic dissection can only be improved by early diagnosis. The role of echocardiography was assessed. Echocardiographic findings were analysed in 32 patients in whom aortic dissection was confirmed by other methods between September 1984 and July 1991. In 19 of them only transthoracic echo (TTE), in 13 patients both TTE and transesophageal echo (TEE) was performed. Control group consisted of 21 patients in whom the clinical suspicion of dissection was ruled out. The DeBakey classification was used. Among 14 acute and 18 chronic cases type I was confirmed in 9, type II in 15 and type III in 8. The sensitivity of clinical suspicion, TTE, TEE and angiography was 34, 72, 92, 94% resp. TEE correctly identified the types, entry and reentry sites, false lumen and left coronary ostium. TTE was valuable in the detection of complications and of etiologic factors of dissection. Hypertension (12) and Marfan's syndrome (7) were the leading etiologic factors. As previously has been reported in the diagnosis of aortic dissection TEE was a safe and reliable technique. It was superior to TTE and was as correct as angiography. The combined use of TTE and TEE is recommended in each case of clinically suspected dissection. The importance of the echocardiographic detection of cardiac complications and etiologic factors is emphasized in the management and prevention.]

Lege Artis Medicinae

[Oral symptoms in the early diagnosis of leukaemias]

GYURKOVICS Csilla, BÁNÓCZY Jolán

[Diseases of the haemopoetic system are often preceeded and/or accompanied by clinical changes in the oral cavity, which, as first signs of the disease, might be of important diagnostic value. Primary oral findings are characteristic mainly of acute leukaemias, such as haemorrhagies, petechias, ecchymoses, ulcera, gingival hy pertrophy, painful gingiva, tooth mobility, candidiasis, herpes simplex infection, lymph node enlargements. Oral manifestations of chronic leukaemia may also arouse the suspicion of a haemopoetic disease. Applied cytostatic therapy might aggravate the condition of oral manifestations. ]

Lege Artis Medicinae

[Peritoneal dyalisis in hungary]

KARÁTSON András, MAKÓ János

[Traditional intermittent peritoneal dialysis in patients with chronic uremia lasts for 8 to 10 hours three times a week. In 1976 Popovich et al. outlined the principle of CAPD (Continu ous Ambulatory Peritoneal Dialysis), a technique giving good results in the removal of water and toxic substances. The procedure is used in 19 000 patients in US and in 9600 patients in Europe. In early 1991 the technical conditions and the number of patients receiving peritoneal dialysis were surveyed in the Hungarian nephrological and dialysing units. Not only the number of patients with chronic uraemia (those undergoing dialysis + transplantation) is lower in this country as compared to the European average (106 versus, 236 per million people, respectively) but the distribution of patients according to the type of treatment they receive is also different. In Hungary intermittent peritoneal dialysis has been used in more than 10% of the cases for several years whereas the number of those receiving continuous peritoneal dialysis has been under 2%. (In Europe < 2% and 4–43%, respectively). The survey also included the types of solution, desinfection and connecting devices used in peritoneal dialysis, as well as the incidence of peritonitis and the administration of antibiotics . The principles of biocompatibility, the function of interleukin as well as the effectiveness and the conditions of home treatment are summarized. ]

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[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. ]

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[CONTROVERSIAL EFFECTS OF NITRIC OXIDE: INTEGRITY AND TOXICITY]

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[Nitric oxide is a key molecule of the human body. Since its discovery, a library of books and papers have been published on its physiological and pathophysiological role. It is involved in almost all pathological processes. In healthy individuals nitric oxide plays a crucial role in the vascular regulation by protecting against atherosclerosis, myocardial infarction and stroke. In the central nervous system, nitric oxide in its function as a neurotransmitter is responsible for synaptic plasticity, long-term potentiation, memory and a number of neuroendocrine control mechanisms. Furthermore, during inflammation and host defense, macrophages and neutrophils produce nitric oxide that has antibacterial, antiviral, and tumour cell killing activity. In pathologic conditions, however, nitric oxide reacts with superoxide anion to form peroxynitrite that damages the enzymes of the mitochondrial respiratory chain, superoxide-dismutase, reduced glutathion and activates or inactivates signalling molecules. During ischaemia- reperfusion, nitric oxide and peroxynitrite contribute to nitrative/nitrosative stress, DNAfragmentation and consequent polyADP-ribosepolymerase- 1 enzyme activation both in coronary thrombosis and ischaemic stroke.]

Lege Artis Medicinae

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