Lege Artis Medicinae

[Fine Art Column]

KOVÁCS Zoltán

FEBRUARY 26, 1992

Lege Artis Medicinae - 1992;2(02)

[The importance of the Dioscorides Codex in medicine and art history.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[New methods of plastic surgery for breast reconstruction]

GULYÁS László

[The treatment and plastic surgical reconstruction of breast tumour patients raise contradictions and unsolved problems. The approach of breast tumour surgery has been changed recently. New evidence shows that in terms of survival, free from distant disease there is no significant difference between lumpectomy and radical mastectomy. Thus breast-conserving operations as a replacement for radical mastectomy have been spreading. The most characteristic features of these operation are: the horizontal incision, the conservation of the pectoral muscles and the whole or partial preservation of glandular tissues. The quality and quantity of available tissues for the breast reconstruction have changed as, the methods of plastic surgical operations has been adopted. New methods for breast reconstruction such as muscle and musculocutaneous flaps, free flaps, different breast implants, and skin expanders have become more and more preferred. For nipple and areola reconstruction local flaps, skin grafts, external prostheses and tattoo are widely used. Nowadays the most important point of view in there the construction of the breast are accurate symmetry, aesthetic breast form and harmony of the whole body. ]

Lege Artis Medicinae

[Results in the sclerotherapy of varicocele]

POKORNYI Lajos, BALI Ilona, NAGY Endre, VADON Gábor, SZÖLLŐSI János

[Testicular varicocele which is curable by surgical or transcatheteric methods is one of the most common causes of male infertility. In this study the success of the interventional radiological method was evaluated. Internal spermatic vein phlebographies were performed in the case of left sided varicocele. Before intervention the anamnesis, inspection, palpation, sonography, colour Doppler sonography and phlebography was evaluated and in a part of the cases spermiogramm too. Follow up examinations were performed at 3, 6 and 12 months after the sclerotherapy and the 1.5-4.5 years then later. The internal spermatic vein was succesfully occluded in 2/3 of the patients in the distal third, in 1/3 in the middle or in the upper third. Complications occurred in 10 cases as intima lesions without any consequencies and in 4 patients as scrotal thromboph lebitis. At the follow up examinations very good regression was demonstrated. Persistence or recurrence occured in 5.7% of cases. The spermiogramm usually got back to normal or showed an improvement and we registered 8 pregnancies from 23 formerly infertile marriages. The interventional radiological method is simpler, cheaper, requires shorter time and inpatient period, decreases sick-allowance, and the success rate reaches the level of the surgical method. The joint evaluation of the real time and the colour Doppler ultrasound is a very sensitive method in the interpretation of the results of the treatment. In our opinion sclerotherapy with Varicocid is the method of choice in the treatment of the varicocele. ]

Lege Artis Medicinae

[Mapping of EEG in neurological disorders]

SZIRMAI Imre, JUHÁSZ Csaba, SUREK György, DOLOGH Ervin

[Mapping is a new way to convey the information of the mathematical analysis of the EEG in an immediately understandable form. In this article, the history of EEG mapping is surveyed. Sixteen channel EEG mapping system was programmed on an IBM-AT personal computer which constructs absolute and relative power spectra topograms on the scalp. Hemispheric asymmetry and long term changes of absolute and relative power estimates were calculated by statistical methods (Wilcoxon and Student t-test). In comparison traditional reading of the EEG the mapping has the following advantages: 1. it uses exact procedures instead of qualitative estimation; 2. in can detect minimal cortical damages; 3. it has the ability to store data for later comparison: the power ratios in selected frequency ranges proved to be a reliable indicator of post-ischemic restitution of EEG; 4. it can evaluate of event related reactions of bioelectric signals in higher resolution. EEG topography provides early information regarding the severity of ischemic lesions in the acute stage of stroke before to the CT scan can visualize the tissue hypodensity. In cases of permanent epileptic waves, the mapping visualizes the local power maxima of dominant frequency ranges and detects the post-ic talimpairment of cortical fields of epileptic foci. Probability significance mapping has reinstated the diagnostic value of EEG by the applica tion of the neuroimaging techniques.]

Lege Artis Medicinae

[Bidirectional Doppler investigation of the internal carotid artery]

FARKAS Katalin, HORVÁTH Péter, KUSZTOS Dénes

[The blood-flow velocity in carodit arteries was measured with a bidirectional CW Kranz bühler 761 Doppler instrument. These investigations were supplemented with special compression tests. 60 investigations were performed to study the blood-flow in the supraorbital and supra trochlear arteries, while compressing the superficial temporal, the facial and the common carotid arteries. The results were compared with 30 regularly performed angiographies. Conclusions: the sensivity of this method is 80%, the specificity is 85%, its positive and negative predictive values are 76% and 87% respectively. Therefore this method is suggested for screening the internal carotid artery. ]

Lege Artis Medicinae

[Ultrasound examination of the knee]

CSÓKÁSI Zsolt, MORVAY Zita, VADON Gábor

[The knee is frequently injured. In addition to the phisical examination imaging methods are very important in determining the diagnosis of the disorders. Ultrasound method is useful in revealing the injuries of the soft tissues of the knee. The authors examined 350 patients with an Acuson 128 ultrasound machine, using 5 and 7 MHz linear transducer in standard positions. They analized the pathological disorders of the knee joint. They consider the examination of network of the band important. Sonography has a significant role in the diagnosis of knee disorders. That can replace more expensive or invasive examination methods.]

All articles in the issue

Related contents

Lege Artis Medicinae

[Focus on Lege Artis Medicinae (LAM)]

VASAS Lívia, GEGES József

[Three decades ago, LAM was launched with the goal of providing scientific information about medicine and its frontiers. From the very beginning, LAM has also concerned a special subject area while connecting medicine with the world of art. In the palette of medical articles, it remained a special feature to this day. The analysis of the history of LAM to date was performed using internationally accepted publication guidelines and scientific databases as a pledge of objectivity. We examined the practice of LAM if it meets the main criteria, the professional expectations of our days, when publishing contents of the traditional printed edition and its electronic version. We explored the visibility of articles in the largest bibliographic and scientific metric databases, and reviewed the LAM's place among the Hun­ga­rian professional journals. Our results show that in recent years LAM has gained international reputation des­pite publishing in Hungarian spoken by a few people. This is due to articles with foreign co-authors as well as references to LAM in articles written exclusively by foreign researchers. The journal is of course full readable in the Hungarian bibliographic databases, and its popularity is among the leading ones. The great virtue of the journal is the wide spectrum of the authors' affiliation, with which they cover almost completely the Hungarian health care institutional sys­tem. The special feature of its columns is enhanced by the publication of writings on art, which may increase Hungarian and foreign interest like that of medical articles.]

Lege Artis Medicinae

[Artworks in the autopsy room, or recollections of an art historian]

NÉMETH István

Clinical Neuroscience

Surveillance and management of patients with tuberous sclerosis complex

FOGARASI András, GYORSOK Zsuzsanna, BODÓ Tímea

Tuberous sclerosis complex (TSC) is an autosomal dominant disease due to the uncontrolled differentiation, proliferation, and migration of cells in several organs. Clinical expression is highly variable, from mild skin findings and asymptomatic brain lesions to seizures, mental retardation, autism, and potentially fatal kidney, cardiac, or pulmonary disease. Aim of this paper is to summarize the diagnostic criteria, surveillance and therapeutic issues of this multisystemic disorder emphasizing the most important neurological consequences. Presenting the state-of-the-art management recommendations and comparing them with the local protocols, we hope that our review might help in the proper assessment of one of the most important single gene disorder.

Clinical Neuroscience

[Minimally invasive and O-arm assisted en bloc spinal tumor resections ]

SZABÓ Viktor, LAKOSI Ferenc, NAGY Máté, DÓCZI Tamás, BÜKI András, SCHWARCZ Attila

[The en bloc resection of spinal tumors is required in primary spine tumors and in selected cases of secondary spine tumors, where the primary disease is under control and long survival time is expected. Three cases are presented, applying O-arm assisted navigation or minimally invasive anterior approaches for en bloc tumor removal. O-arm navigation assisted osteotomies were carried out to remove a Th.V. breast tumor metastasis en bloc, intact bony part of the Th.V. vertebra was spared. Vertebral corpectomies of a patient with L.IV. chordoma and of a patient with L.V. carcinoid were also performed using minimally invasive, microscope assisted, anterior approaches to the lumbar spine. No morbidity or local recurrence were detected in the patient with breast cancer 1 year after the operation. Nevertheless, new spinal metastasis were revealed 1 year after surgery despite the appropriate oncological treatment. The patient with L.IV. chordoma is still tumor free (last follow-up: 18 month after surgery), but post operatively detected lower limb paresis and gait disturbances are persisted. The posterior healthy bony parts of the spinal column remained intact, since only anterior approaches were used for en bloc L.IV. corpectomy. No morbidity or recurrence was detected in patient with L.V. carcinoid tumor on 1 year follow-up. Both the O-arm navigation assisted surgery and the minimally invasive anterior approaches to the spine can help to reduce surgical morbidity and to spare healthy bony structures of the spine. The later could play important role to provide long term spine stability. The presented new surgical technologies can be accepted only, if they produce at least the same oncological results on longer follow-ups as conventional surgical approaches.]

Clinical Neuroscience

[Diabetes, dementia, depression, distress]

SZATMÁRI Szabolcs, ORBÁN-KIS Károly, MIHÁLY István, LÁZÁR Alpár Sándor

[The number of people living with diabetes continues to rise. Therefore neurologists or other health care practitioners may be increasingly faced with comorbid neuropsychiatric disorders commonly presented by diabetic patients. More recently there has been an increasing research interest not only in the interactions between diabetes and the nervous system, the fine structure and functional changes of the brain, but also in the cognitive aspects of antidiabetic treatments. Patients with both types of diabetes mellitus may show signs of cognitive decline, and depression. Comorbid insomnia, anxiety, and distress may also occur. The bi-directional relationships between all these phenomena as well as their connection with diabetes can lead to further health and quality of life deterioration. Therefore it is important that all practitioners involved in the care of diabetic patients recognize the presence of comorbid neuropsychiatric disturbances early on during the healthcare process. Identifying higher risk patients and early screening could improve the prognosis of diabetes and may prevent complications.]