Lege Artis Medicinae

[The diagnostics of changes in the mouth cavity]


FEBRUARY 21, 2008

Lege Artis Medicinae - 2008;18(02)



Further articles in this publication

Lege Artis Medicinae



[Thyroid cancers derived from follicular epithelial cells are histologically classified as papillary, follicular and anaplastic. Cancers that originate from parafollicular, or C-cells, are termed medullary carcinomas. Their annual incidence is fairly low; 3 to 7 cases per 100 000 people. After the Chernobyl disaster, however, thyroid cancers have received much attention. They often occur at young age, and frequently and early give metastases. They typically grow slowly and have a good prognosis even in the metastatic stage. The main prognostic factors include age, tumour size and extent, the completeness of surgical removal, distant metastases and tumour grade. Based on these parameters, they are classified into high-risk and low-risk groups. There are no prospective randomized studies available on the optimal treatment of thyroid cancers. Their biological aggressiveness differs according to geographic location, which explaines why the management of thyroid carcinomas has not been standardized internationally. Contrary to America and Australia, in Europe there are several endemic goitre regions, and background radiation is higher. It is generally accepted that here the standard therapy of choice is total thyreoidectomy with adequate lymph node dissection followed by postoperative radioiodine ablation. It is a reasonable demand to minimize the higher morbidity associated with radical surgery (e.g., recurrent nerve palsy, postoperative hypoparathyroidism) below 1%. It is recommended that such operations are performed by experienced thyroid surgeons in centres with multidisciplinary endocrine teams.]

Lege Artis Medicinae

[The Nuremberg Doctors' Trial - The forever valid social message of the forced euthanasia programme]


Lege Artis Medicinae

[Accepting the Patient’s Decision]

dr. VADÁSZ Gábor

Lege Artis Medicinae


PINCZÉS István, KOVÁCS Attila, KARDOS Magdolna, GARA Ákos, GYŐRY Gabriella, SZALAY Ferenc, SPEER Gábor

[INTRODUCTION - Primary neoplasm of the great blood vessels is rarely reported. The tumour most commonly presents in the inferior vena cava. In general, the prognosis is very poor, since intimal sarcomas metastasise early, and mural sarcomas grow silently and remain hidden for a long time. Also, because this type of tumour is so uncommon, it is often not considered for diagnosis. CASE REPORT - We report on the case of a 77- year-old woman with progressive symmetric oedema of the lower limbs. The investigations revealed a tumour thrombus that obliterated the inferior vena cava in its entire length. No surgery was possible because of the advanced stage of the disease. Later, Budd-Chiari syndrome developed and the patient died of progressive hepatic failure. The tumour was initially thought to be that of extravascular origin breaking into the vein. However, autopsy revealed a primary tumour of vascular origin, which histologically proved to be a leiomyosarcoma. CONCLUSION - Today, the recognition of the insidiously growing vascular mural sarcomas is assisted by an entire diagnostic arsenal. It is important, however, that the possibility of this rare disease is considered in time to permit surgical removal, the only treatment that can prolong survival. The authors would like to contribute to this by presenting this rare clinical case.]

Lege Artis Medicinae


dr. TÓTH Csaba

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Related contents

Clinical Neuroscience

Mid-term oral isotretinoin therapy causes a predominantly sensory demyelinating neuropathy

ALTUN Yasar, INAN Esra

Aim - The purpose of this prospective study was to investigate whether mid-term treatment with oral isotretinoin may impact peripheral nerve function. Methods - In this study, we included 28 patients with no apparent neurological or neurophysiological findings. The patients received treatment with oral isotretinoin for papulopustular or nodulocystic acne. The patients with normal findings in the first examination were given 1 mg/kg/day oral isotretinoin. Neurological examinations and electroneurographic studies were performed before and 6 months after the onset of isotretinoin treatment. Results - Clinical examinations and electroneurographic evaluations prior to treatment revealed no abnormalities in any of the patients. However, 20 patients (72%) displayed one or more abnormal values in the tested parameters after treatment. Although the mean amplitudes of compound muscle action potential of the ulnar and median nerves did not vary, significant decreases were observed in the mean sensory conduction velocities of median, ulnar, sural, medial plantar, medial dorsal cutaneous, and dorsal sural nerves 6 months after the onset of treatment. Conclusion - Systemic use of isotretinoin may cause electroneurographic changes. Probable electroneurographic alterations may be detected at a much earlier period via dorsal sural nerve tracing when electrophysiological methods used in routine clinical practice cannot detect these changes.

Clinical Neuroscience

The prevalence of sarcopenia and dynapenia according to stage among Alzheimer-type dementia patients

YAZAR Tamer, YAZAR Olgun Hülya

Aim - In this study, the aim was to identify the prevalence of sarcopenia and dynapenia according to disease stage among Alzheimer-type dementia (AD) patients and collect data to suggest precautions related to reducing the disease load. Method - The study was completed with 127 patients separated into stages according to Clinical Dementia Rating Scale (CDR) criteria and 279 healthy volunteers aged 18-39 years and 70-80 years abiding by the exclusion criteria who agreed to participate in the research. Our prospective and cross-sectional study applied the CDR and mini mental test (MMSE) to patients with disorder in more than one cognitive area and possible AD diagnosis according to NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer’s Disease and Related Disorders Association) diagnostic criteria. The patient and control groups had skeletal muscle mass index (SMMI), muscle strength and physical performance assessed with sarcopenia diagnosis according to European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic criteria. Results - In our study, in parallel with the increase in disease stage of AD patients, the prevalence of sarcopenia (led by severe sarcopenia) and dynapenia was higher compared to a control group of similar age. Conclusion - In chronic, progressive diseases, like AD, identification of changes in parameters, like muscle mass and strength and reductions in physical performance in the early period, is important for identification and to take precautions in the initial stages considering the limitations of the preventive effects of treatment applied after diagnosis of AD.

Lege Artis Medicinae

[An International Survey to Assess the Opinions About Foreign Bodies Left in a Body Cavity]

dr. SÓTONYI Gergely

Lege Artis Medicinae


PALKÓ András

[Magnetic resonance imaging (MRI) plays more and more important role in the abdominal imaging diagnostics since fast measurement sequences have become available making it possible to avoid movement artifacts and resulting in better quality and more informative images of the abdominal parenchymal organs and most segments of the gastrointestinal tract. The greatest advantage of MRI is that it is able to create images of adequate geometric resolution and excellent tissue characterization capacity without the use of ionizing radiation and iodinated contrast media. Today MRI is applied mostly in those cases when previous data suggest that computed tomography will not be informative or the results of recent imaging examinations (x-ray, ultrasound, computed tomography) do not provide sufficient diagnosis. Presumably MRI will be used with increasing frequency as the first or single best method of choice in the near future. Beased on these facts in abdominal diagnostics, MRI may be considered as a problem-solving modality which plays an outstanding role in the detection, differential diagnosis, staging and follow-up of many neoplastic and inflammatory lesions.]

Journal of Nursing Theory and Practice

[The importance of serum albumin level in patients with chronic renal disease on maintenance dialysis]

TÓTH Csitkovicsné Tünde, SZAKÁCS Gyuláné, KULCSÁR Imre

[The aim of the study: Evaluation of changes in serum albumin levels and their effects on mortality in chronic haemodialyzed (HD) population. Material and Methods: We analysed the serum albumin values and survival in 253 HD patients, in a retrospective observational study. Data were analyzed using Spearman-correlation, Cox-modell, endpoint analysis and Kaplan-meier analysis. Results: We did not find any significant correlation between serum albumin levels and gender or basic diseases, but the median serum albumin level was lower in patients with ages 65 years or older than in younger ones, and had decreased until observational period (5.4±3.0 years). Lower the serum albumin level the risk of mortality was higher (if the serum albumin level was <35 g/L versus >40 g/L), the HR was 5.69. Conclusions: The serum albumin level is a main indicator of the nutrition in dialyzed patients, but the target level would be different in older and younger patients. The serious malnutrition (lower serum albumin level) increases the risk of mortality in haemodialyzed patients.]