Lege Artis Medicinae

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AUGUST 31, 1994

Lege Artis Medicinae - 1994;4(08)

[Book review Frenkl Róbert "So I saw... sport health care system change"]

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Lege Artis Medicinae

[The role of baseline duplex sonographic examination in monitoring the transplanted kidney in the early postoperative period]

MORVAY Zita, MAROFKA Ferenc, CSAJBÓK Ernő, SZENOHRADSZKY Pál

[Routine baseline duplex sonography and sonographic monitoring have been performed afer kidney transplantation at our University since November, 1992. Data on 24 patients are analysed. Baseline sonograms were assessed as normal in 18 patients. Abnormalities involved collecting system dilatation, and swelling of the parenchyma. In every case in which the transplanted kidney had to be removed because of serious complications, we observed morphological changes in the follow-up examination. The resistance index (ARI) measured during duplex Doppler examinations was higher than 75% in 8 of the 24 cases. Four of these grafts had to be removed. From among the 16 cases having normal baseline RI, only 2 kidneys were lost during the postoperative period. Baseline and follow-up duplex sonographic examinations were found to have an important role in the management of kidney transplanted patients. Early complications can be detected, therapy can be initiated in time, and the changes occurring during follow-up can be evaluated more sensitively. ]

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[Catheter ablation of supraventricular tachycardias]

KEMPLER Pál, LITTMANN László, TÓTH K. Zoltán

[Medical therapy for supraventricular arrhythmias is often ineffective. Arrhythmia surgery is limited by its considerable morbidity and cost. A better understanding of the exact anatomic-electrophysiologic correlations that govern supraventricular arrhythmogenesis and the advances in catheter ablative techniques have led to a new, effectual and costeffective therapy. Catheter ablation techniques result in a high rate of success rates and a low rate of complications. Radiofrequency ablation has become an accepted form of treatment for a variety of supraventricular arrhythmias. This review summarizes current data on catheter ablation of supraventricular arrhythmias.]

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[The role of langerhans' cells in the development of cervical cancer]

PETE Imre, SÁPI Sándor, GONDA Gábor

[While the number of deaths from cervical cancer of women over the age of 45, has fallen in the recent years the mortality in women under the age of 35 has increased. The reason for this change is not clear. A large number of analytical studies tried to identify the risk factors for cervical cancer (age, marital status, time of first intercourse, number of sexual partners, coital frequencies, circumcision of partners, menstrual patterns, gravidity, type of contraception, smoking, viral infection, socioeconomic circumstances) but the real con nection between the disease and the varions risk factors remained unclear. The results of these studies suggest that, the 'one hit one tumor' hypothesis can't be proven, and it seems more appropriate to cousider a complex effect of these etiologic factors acting on the altered immunologic status of the cervix uteri. We tried to concentrate on one out of these factors from the literature which may play a cardinal role in the development of CIN or invasive cervix cancer. It is evident from the literature that the macrophages present in the cervix tissue in CIN, or infiltrating the tumor tissue in invasive cancer, could influence either the development of cervical cancer or the prognosis of the disease. It has long been known that in the cervical tissue there are a specific type of dentric cells taking part in the antigen presentation process. The examination of behavior, distribution and activity of these so – called Langerhans cells due to the exogen effect in the cervical tissue may be a which contributes to the understanding of the process leading to the development of CIN. ]

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[Morbidity of ischemic heart disease in early breast cancer patients 15-20 years after adjuvant radiotherapy]

GYENES Gábor

[Our aim was to assess the frequency of cardiac side effects, primarily ischemic heart disease, in symptom-free patients with early breast cancer previously treated with radio therapy. Thirty-seven survivors of a previous randomized study of early breast cancer were examined. Twenty patients irradiated pre- or postoperatively for left-sided disease (study group patients) were compared with 17 controls who were either treated for right-sided disease, or were non-irradiated patients. Radiotherapy was randomized in the original study; either tangential field Co-, or electron-therapy was delivered. A bicycle ergometry stress test with 99m Tc Sesta MIBI myocardial perfusion scintigraphy was carried out and the patients' major risk factors for ischemic heart disease were also listed. Our results showed a significant difference between the scintigraphic findings of the two groups. Five of the 20 study group patients (25%), and none of the 17 controls exhibited some kind of significant defect on scintigraphy, indicating ischemic heart disease (p <0,05). Radiotherapy for left-sided breast cancer with the above-mentioned treatment technique may be an independent risk factor in the long-term development of ischemic heart disease. The need to optimize adjuvant radiotherapy for early breast cancer by considering the dose both to the heart as well as the cancer, is emphasized. ]

Lege Artis Medicinae

[Recovery from persistent vegetative state of four months or more]

KEITH Andrews

[A retrospective study was carried out on 43 patients admitted to a ward specifically designed for the rehabilitation of patients with persistent vegetative states after another. Of these, 11 regained consciousness four months or more after brain injury. It was reported that the patients' first reaction to being able to follow with their eyes was between the 4th month and the 3rd year of the condition, while the first reaction to being instructed was between the 4th and the 12th month. Only one patient was unable to communicate, six used non-verbal means to express at least yes and no, four could speak. Six patients required full care, while two became independent in their daily activities. Four patients were able to eat independently, three needed assistance, and four patients required maintenance of gastric tube feeding.]

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[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

[CONTROVERSIAL EFFECTS OF NITRIC OXIDE: INTEGRITY AND TOXICITY]

KISS Róbert Gábor, BÉRES Bernát János

[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

[About Books]

FEJÉREGYHÁZI István

[A review of the book written by: László Tringer: "The Healing Conversation"]

Lege Artis Medicinae

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GRYNAEUS Tamás

[Herbalism - the basics of phytotherapy - Gábor Rácz, Erzsébet Rácz-Kotilla, László Gy.]

Lege Artis Medicinae

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NAGY Imre

[A review of the book written by Dr. Gaál Csaba : "Surgery"]