Lege Artis Medicinae

[Polydactylic Human Figures on North American Stone Paintings]

dr. NAGY Gyula

APRIL 22, 2008

Lege Artis Medicinae - 2008;18(04)

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[STEM CELL THERAPY AFTER ACUTE MYOCARDIAL INFARCTION]

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[Left ventricular remodelling and chronic heart failure as a consequence of myocardial infarction is a major problem despite of the everimproving therapeutic options. The available treatment methods have fairly limited success in preventing the development of these changes. Myocardial regeneration with stem cell treatment is a promising therapeutic alternative. Although the results should still be confirmed in large, randomised, multicentric controlled trials, data from animal studies and small clinical trials suggest that therapy with stem cells after acute myocardial infarction is safe and feasible, is able to reduce the extent of necrosis, and may improve myocardial perfusion and left ventricular function. This review presents the types of cells that can be used, the ways of application, and the available results of clinical trials of stem cell therapy after acute myocardial infarction.]

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Hungarian Radiology

[Pictures to the past Methodological possibilities in the palaeoradiology]

ALIDA Lilla Kristóf, BARTA H. Miklós, PETRIK Anikó, PAP Ildikó, PÁLFI György, FORNET Béla, FORRAI Gábor

[INTRODUCTION - The radiology as a method is useful not only in the field of the traditional medicine, but in the historic anthropology examining the ancient human remains, and in the palaeopathology examining the pathological changes of the ancient human remains. The aim of our study was the correction of the palaeopathological methods and the radiological diagnosis of the ancient pathological remains. MATERIAL AND METHODS - Approximately 25 specimens originating from the Avar-, the Hungarian Conquest Period and from the Arpadian Age with pathological changes were examined. Besides these 11 naturally mummified individuals were examined by radiological methods, too. The X-ray examinations were done at the Department of Radiology of the National Medical Centre, in Budapest. RESULTS - Vertebral changes, pulmonary tuberculosis and traumatic lesions were found on the mummified individuals. The most frequent changes of the bone alterations were traumas: fractures of the ulna, clavicule, ribs, and trephanation of the skull. Several degenerative changes of the vertebral columns and of the articulation surfaces were detected (osteophyta, spondylosis, arthrosis). The rheumatoid arthritis, Paget-disease, facies leprosa, and the traces of vertebral tuberculosis should be mentioned among the rare pathological disorders. CONCLUSIONS - Since there are no sufficient palaeoradiological methodological references, it was necessary to develop new methods for X-ray examinations.]

Lege Artis Medicinae

[The prevalence of musculoskeletal symptoms among ambulance personnel in a national subsample]

PÉK Emese, BÁNFAI Bálint, DEUTSCH Krisztina, JEGES Sára, BETLEHEM József

[BACKGROUND - The ambulance workers face a lot of mental stress and physical demands in their everyday life. The physical demands can be originated from caring heavy equipment and moving patients. The poor mental health can strengthen physical problems, too. In this study our aim was to detect and compare the musculoskeletal status of ambulance personnel in two regions of Hungary. SAMPLE AND METHODS - On a voluntary base a cross-sectional anonymous, standardized self-fill-in questionnaire (Nordic Musculoskeletal Questionnaire) was used with additional items. All ambulance personnel over 18 years old were involved in the study who worked in direct patient care either in the North-Hungarian or in the West-Hungarian Region of the country. RESULTS - In the regional representative sample N=810 workers answered our questions. Out of them 587 persons (72.5%) reported about some musculoskeletal problem during his lifespan. Most of them suffered from lower back pain (448 persons, 55%), back pain (318 persons, 39%), neck pain (250 persons, 30.9%). Parallel with the aging and with the time spent working for the ambulance service more and more overall discomfort can be detected (p=0.013; p=0.020). Having a second job affected the level and frequency of discomfort negatively (p=0.005). CONCLUSIONS - More than 70% of the ambulance workers experienced musculoskeletal problem during his emergency workers carrier which may worsen the quality of his work and his personal life. To handle the situation primary prevention, screening and possibilities for recreation should be forced among ambulance workers. ]

Hungarian Radiology

[The role of static MR-urography in diagnostics of urinary obstruction]

KIS Zsuzsanna, FAZEKAS Péter, KULCSÁR Dániel, KÖTELES Márta, KOVÁCS Annamária, MAGYAR Klára

[INTRODUCTION - The idea and methodology of MRurography has just crystallized recently due to the development of technology. The traditional MRU technology means the strongly T2 weighted sequence, suitable for depicting stationary liquid spaces. Its use is independent of the functional status of the kidneys thus it is suitable for depicting dilatated ureters in case of nonfunctioning kidneys, too. Authors's aim was to define the role of sMRU in the diagnostics of obstructive urinary diseases. PATIENTS AND METHODS - 60 sMRU examinations were performed on 59 patients using a 1.5 T Siemens Symphony MR scanner in the CT-MR Laboratory of the Markhot Ferenc County Hospital between May 1, 2003 and October 31, 2005. The sMRU was performed with 2D T2 TSE sequence with angiographic character. In each case, the examinations were completed with conventional sequences in multiple planes. The role of gadolinium enhanced T1-weighted MR urography in the same diseases was not studied. In 7 cases, low-dose thin slice CT examination was performed to reveal the precise cause of obstruction. The examinations were preceded by abdominal ultrasound or intravenous urography (IVU). RESULTS - Out of the 60 sMRU examinations uretery dilatation were observed in 50 cases. In the background of obstruction, stone could be detected in 13 patients, dilatation was observed in 4 patients and MR did not indicate stone. In 7 cases with known neoplastic disease, associated urinary obstruction could be detected. In the background of obstruction primary neoplasm was found in 10 patients unknown prior the MR examination. Other benign obstruction occurred in 13 cases. Obstruction was not proved in 10 patients. In these cases the examination was justified by uncertain ultrasound findings together with abnormal renal function parameters. Follow up sMRU was performed in one patient. False diagnosis was established in two patients, the cause of dilatation was not found in one patient. CONCLUSIONS - The sMRU examination can provide more precise detection of the causes of severe urinary obstructions. It helps to define the level of obstruction in case of known malignant tumors. The grade of urinary dilatation could be also evaluated. The sMRU examination in conjunction with conventional sequences in multiple planes made possible to set up a correct therapy plan.]

Clinical Neuroscience

[HANS SELYE 70 YEARS LATER: STEROIDS, STRESS ULCERS & H. PYLORI]

SZABÓ Sándor

[Although Hans Selye is mostly known for his discovery & development of the stress concept, he also introduced the first physiologically sound, structure-activity classification of steroids that was also based on the chemical structure of steroids in 1943. He not only introduced the names of glucocorticoids & mineralocorticoids but discovered the anti- & pro-inflammatory properties, respectively, of these steroids in animal models. Furthermore, he not only described the first stress-induced gastric ulcers in rats (1936) & characterized the first human ‘stress ulcers’ during the air-raids in London during World War II (1943). Thus, Selye was a much more productive & creative scientist than it is generally considered.]

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[Personality development in East and West, and some clinical implications ]

PUREBL György

[Exploring human personality focused mainly on trait and state markers of behaviour so far. Nevertheless, the concept of the universal, culture-independent model of personality carries more disturbing difficulties: hardly understandable inter-cultural conflicts, culture-related mental disorders and scientific experiences with unexpected outcomes. It can be hypothesized, that beside personality concept represented by the Euro-Atlantic civilisation and mainstream psychology there is an alternative concept of personality. Opposed to the independent, autonomous ego concept of individualistic cultures, collectivistic (primarily far-eastern) cultures are providing an interdependent model. According to this model, the core element of personality are determined rather by social embedding instead of the person’s own characteristics, which are secondary to the personal traits and characteristics. This study attempts to briefly outline the concept of interdependent personality, with some illustrative clinical examples. ]