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Biomedical subjects

A Balogh

Publications and source records attributed to A Balogh.

At least 73 records · Page 4Linked to original sources
PubMed1999

Endothelin-A receptor antagonism improves small bowel graft perfusion and structure after ischemia and reperfusion.

BACKGROUND: We hypothesized that endothelin-A (ET-A) receptor activation plays a central role in intestinal ischemia-reperfusion-induced hemodynamic changes and may trigger the process of mucosal barrier destruction. Our aims were to investigate and compare the effects of systemic and intragraft ET-A receptor antagonist therapy during the early revascularization phase of small bowel transplants. METHODS: In Groups 1, 2, and 3 orthotopic small bowel autotransplants were performed in anesthetized dogs. Group 4 served as sham-operated control. Group 2 was treated i.v. with the ET-A receptor antagonist ETR-p1/fl peptide at the onset of reperfusion. In Group 3, intragraft infusion of the ETR-p1/fl peptide was applied during cold ischemia. The mucosal myeloperoxidase activity and the free radical-producing capacity of the granulocytes passing the intestinal graft were determined, and the systemic hemodynamic features were recorded. The extent of the mucosal injury was determined from tissue biopsies taken after 4 hr of reperfusion. RESULTS: Reperfusion progressively decreased the mesenteric blood flow, increased the mesenteric vascular resistance, and enhanced the accumulation and free radical production capacity of the leukocytes. These changes were significantly inhibited in Group 2 with systemic (i.v.) administration of the ET-A receptor antagonist. The local, intragraft treatment improved the mesenteric hemodynamic changes and decreased the accumulation but not the activation of the circulating leukocytes. The structural injury of the graft was prevented in both treated groups. CONCLUSIONS: Endothelins are involved in the hemodynamic events leading to structural injury of the intestinal graft after ischemia-reperfusion. The antagonism of intestinal ET-A receptors by a combination of local and systemic drug delivery offers a rational treatment modality in these conditions.

Animals↗
PubMed1999

[Changes in the approach to epilepsy].

The last decades resulted unlikely development in the investigation and therapy of epilepsy. This process made the classification and separation of the epileptic seizures and epileptic syndromes possible. The new classification established the functional assessment of the convulsive disorder and revealed the fact that epilepsy is not only a symptom but an illness. The new computer assisted neuroimaging methods disclose more and more details in the etiology and extremely reduce the number of cryptogen epilepsies. Understanding the role of different ionchanels and certain excitatory and inhibitory transmitters in the generation and propagation of epileptic excitement gives new possibilities in therapeutic approach. The pharmacokinetic features of the antiepileptic drugs basically determined therapeutic concepts. Most of the antiepileptic drugs exert their therapeutical effect through their blood level. This recognition led to the development of the mono and rational polytherapy. In the last five year developed large cohort of the newest antiepileptic drugs and the renaissance of the epilepsy surgery make a revolution in the treatment of the epileptic disorder.

Anticonvulsants↗
PubMed1999

Suppressive effect of pentoxifylline on natural killer cell activity; experimental and clinical studies.

The methylxanthine derivative pentoxifylline, widely used in the treatment of vascular diseases, also has numerous immunological effects. In in vitro experiments, the human natural killer cell cytotoxicity was investigated in the presence of pentoxifylline. A clinical trial involved an investigation of the natural killer cell activity in patients to whom pentoxifylline had been administered for different periods. The natural cytotoxicity in macroangiopathic patients treated with pentoxifylline was compared with that in healthy controls and that in patients with vascular diseases who did not receive pentoxifylline therapy. A total of 62 macroangiopathic patients and 20 healthy controls were investigated. The natural killer cell activity in patients receiving pentoxifylline therapy for more than a year proved to be significantly lower (P<0.005). The presence of vascular disease did not influence the natural killer activity. In the in vitro cytotoxicity reaction, pentoxifylline at a concentration of 100 microg/ml was found to suppress the natural killer cell cytotoxicity at any stage of the reaction. The influence of pentoxifylline on the natural killer cell activity was not due to inhibition of the expression of intercellular adhesion molecule-1. However, this drug significantly decreases (P<0.05) the apoptosis of target cells. It is presumed that the suppressor effect of pentoxifylline on natural killer cell activity should be taken into consideration in the treatment of clinical diseases where this drug is administered chronically.

Adult↗
PubMed1999

[Progressive systemic sclerosis - treatment results of extracorporeal photopheresis].

The treatment of progressive systemic sclerosis (PSS) is still unsatisfactory. We report on clinical, laboratory and immunological findings in 26 patients with PSS (6 males, 20 women) treated with extracorporeal photopheresis (ECP) for 8 cycles in a nonrandomized, uncontrolled study. ECP was performed on two consecutive days once a month. 8-methoxypsoralen concentrations in plasma and buffy coat were monitored by HPLC. We performed a standardized examination programme and determined parameters of inflammation and immune function. Global assessment revealed a partial remission in 18 patients, a stable disease in 8 patients and a slight progression in one patient. In the peripheral blood count a significant increase of CD3-positive NK cells was noted (p=0.03) although the leukocyte count decreased from 2,255 to 1,156 cells/microl. There was a non-significant decrease of elastase (102. 9 vs. 90.4 ng/ml), sulfidoleukotriens (2,255.4 vs. 1,688.9 pg/ml), ICAM-1 (301.9 vs. 276.6 ng/ml), soluble IL-2 receptor (609.0 vs. 422. 3 U/ml), and IL-10 (164.7 vs. 138.7 pg/ml). IL-6 and IL-8 did not show significant changes. The ECP treatment of patients with PSS shows immunomodulatory effects changing levels of pro-inflammatory and cytokine substances. Even after 8 cycles partial remission or stable disease is seen in patients as shown by global assessment and certain clinical symptoms. On the other hand, sufficient data on the long-term outcome are still missing.

Adult↗
PubMed1999

Operative treatment of tentorial herniation in herpes encephalitis.

Herpes simplex virus is the most common cause of acute viral encephalitis in children. Due to the variety of possible clinical manifestations the diagnosis is often overlooked in the early stages of the disease. Anti-viral therapy with acyclovir should be started whenever HSE is suspected. When there is further deterioration under virostatic therapy, a brain biopsy should be performed to verify the diagnosis. But even when the adequate medical therapy is established, massive brain edema and brain shift resulting in tentorial herniation can develop. Up to now the reported mortality of these patients is still around 30%. Here we report on a child with severe necrotizing herpes simplex encephalitis who developed severe tentorial herniation due to a right-sided mass lesion. The patient's status markedly improved after decompressive anterior temporal lobe resection. To our knowledge a similar case has not yet been reported in the literature. We suggest that anterior temporal lobe resection and decompressive craniotomy is of benefit in selected cases with tentorial herniation because both decompression and reduction of infectious material can be achieved.

Acyclovir↗
PubMed1999

Ethanol's effect on rat pituitary adrenal axis is prevented by purine metabolic pathway inhibitors.

This study investigated the in vitro dose effects of ethanol (EtOH), adenosine (ADO), and urate (URA) on the basal and CRF stimulated ACTH production of pituitary tissue culture (PTC). Furthermore, the effects of low (LE = 0.5 g/kg bodyweight) and high (HE = 2.5 g/kg bodyweight) concentrations of EtOH were tested in rats on plasma ACTH and corticosterone concentration (PCC), with or without the following ADO metabolic pathway inhibitors: 6-mercaptopurine (6MP) (salvage pathway) and purpurogallin (PPG) (xanthine dehydrogenase). EtOH at 0-50 mM does not increase the in vitro basal or CRF (10-7 M) stimulated ACTH secretion in PTC; in fact doses up to 20 mM tended to be inhibitory. ADO significantly increased only basal ACTH secretion whereas URA increased both basal and CRF-stimulated ACTH secretion. Pretreatment with PPG or 6MP + PPG significantly increased both in vivo ACTH and PCC over control values in rats. HE versus LE significantly increased ACTH and PCC in the control (H2O) and 6MP pretreated groups whereas in the PPG pretreated animals, only ACTH was increased significantly by HE. However, combined pretreatment with 6MP + PPG prevented the effect of HE on ACTH and PCC. The current experiment suggests that purine metabolism is involved in ethanol's effect on the hypothalamic-pituitary-adrenal axis.

Adenosine↗
PubMed1999

Comparison of a new automatically controlled electrocoagulator (Valleylab NS 2000-INSTANT RESPONSE technology) with a high-frequency coagulator.

Bipolar electrocoagulation is one of the most important procedures in modern neurosurgery. However, there are still many practical problems, especially tissue adherence to the tips of the coagulating forceps and the difficulty removing carbonized clots from the tips. Both make the process less accurate and more time-consuming. To prevent formation of coagulum, recently, irrigation with a saline solution and coating of the forceps tips with a special metal have been tried. In this work, we compare a new bipolar electrocoagulator with automatic output control in relation to tissue impedance (Auto Suture - Valleylab NS 2000 with INSTANT RESPONSE technology) with a high-frequency coagulator (Erbotom ICC 350, Erbe). The femoral arteries and nerves of Wistar rats, weighing on average 360 g, were prepared and coagulation was carried out with variable power settings during a constant time (3 seconds). Sections were stained with haematoxylin-eosin, van Gieson and Luxol-Fast-Blue for histological examination. Coagulation with Erbotom ICC 350 resulted in tissue sticking to the tips of the forceps in all cases, regardless of the power chosen. With the new electrocoagulator, tissue adherence to the forceps tips was not seen. With the new system, effective coagulation was also achieved at comparably lower power settings.

Animals↗
PubMed1999

Successful thoracoscopic surgical treatment of oesophageal cyst.

The authors report a video-thoracoscopically successfully treated case of oesophageal cyst. The symptomatic lesion was diagnosed by swallowing, X-ray, oesophagoscopy, chest CT scan and endoscopic ultrasonography. The benign tumour was removed by a videothoracoscopic method using selective intubation. There were no intraoperative and postoperative complications. The patient was discharged on the fifth postoperative day. The videothoracoscopic technique is safe, involves little pain and permits a rapid return to normal activity. It is a preferred method for removing benign lesions of the oesophagus.

Adult↗
PubMed1999

Ureter diverticulum of transplanted kidney. Case report.

OBJECTIVES: Authors present a case of successful surgical treatment of a ureter diverticulum observed 3 months after kidney transplantation. METHODS: The fluid collection was detected by ultrasound. Percutaneous drainage was performed, after that the excretion of 4 litres of fluid was observed during 12 hours. This finding clearly indicated the connection with the urinary system. This fact was proved and precisely localised by contrast filling of the lesion under fluoroscopic control. RESULTS: Resection of the ureter diverticulum was performed, and the patient recovered fully, there was no change observed in the graft function during the whole procedure. CONCLUSION: The ureter diverticulum is a rare complication after kidney transplantation: the present case is the only one observed among more then 600 kidney transplantations performed during 20 years in our centre.

Adult↗
PubMed1999

[Esophago-pericardial fistula caused by recurrent esophageal tumor].

The esophago-pericardial fistula is a rare disease that causes a rather high mortality. Up to now less than 70 cases were published in the literature. The authors report an esophago-pericardial fistula caused by recurrent esophageal tumor one year after resection in the lower third esophagus for esophageal cancer. With conservative treatment the patient was kept alive for a month. No case report can be found in the literature of an esophago-pericardial fistula of the same etiology.

Esophageal Fistula↗
PubMed1999

[Subtotal duodenal necrosis as a surgical complication (A case successfully treated with multiple-stage surgery)].

A 53 year-old woman was admitted to our Department with serious sepsis, biliary-, fecal peritonitis, and subtotal duodenal necrosis following 5 previous operations. The first surgical intervention ceased the insufficiency of the small intestine anastomosis, and the marsupialization of Vater's papilla was achieved. After the sepsis and peritonitis ceased the authors performed a successful reconstruction. For two and a half years the patient has been free from complaints.

Bacteremia↗
PubMed1998

[In vitro and clinical effect of pentoxifylline on natural killer cell activity].

Pentoxifylline used in the treatment of vascular diseases has also some immunological effects. Among of these effects the influence of pentoxifylline on the natural killer cell activity was studied. In in vitro experiments the human natural killer cell cytotoxicity was examined in the presence of pentoxifylline. In our clinical trial we investigated the topic whether this drug has an immunomodulatory effect while administering it for different periods. The natural cytotoxicity of macroangiopathic patients treated with pentoxifylline was compared with the values of healthy controls and patients suffering from vascular disease and obtaining no pentoxifylline therapy. Sixty two macroangiopathic patients and twenty healthy controls were investigated altogether. In the in vitro natural killer cell reaction we found that the pentoxifylline was able to suppress the cytotoxicity at any time of the reaction. The influence of pentoxifylline on natural killer cell activity was neither due to the expression of intercellular adhesion molecule-1, nor to the alteration of membrane fluidity. However, this drug significantly (p < 0.05) decreases the apoptosis of target cells. The natural killer cell activity of patients with chronic pentoxifylline therapy lasting for more than a year was proved to be significantly (p < 0.005) lower. The presence of vascular disease does not influence the natural killer activity by itself. Concluding our results we can state that the suppressing effect of pentoxifylline on natural killer cell activity needs to be taken into consideration in case of clinical diseases where this drug is administered chronically.

Adult↗
PubMed1998

Transtracheal electrical stimulation of the spinal cord for intraoperative monitoring of the motor pathway.

Because of the suppressant effects of anesthetic drugs and muscle relaxants on motor responses elicited by either magnetic or electrical transcranial stimulation, intraoperative monitoring of the motor system, and especially monitoring of lower limb function, presents many difficulties. The upper part of the spinal cord was stimulated in 14 anesthetized and relaxed dogs with a cathode attached to the intratracheal tube and an anode fixed above the upper cervical spinous processes. Action potentials evoked by single and serial stimuli were recorded from the exposed right femoral nerve and quadriceps muscle Averaging was necessary for serial stimulations. Reproducible early and late responses to both single and serial stimulations were recorded during regular anesthesia. The origin of the different responses is discussed. Transtracheal stimulation of the spinal cord is easy to perform and the responses recorded from the peripheral nerve or limb muscle are well reproducible in regular anesthesia. The method seems to be appropriate for intraoperative monitoring of the thoracolumbar spine.

Action Potentials↗
PubMed1998

Beneficial effect of octreotide treatment in acute pancreatitis in rats.

CONCLUSIONS: Octreotide treatment contributes to the regulation of tumor necrosis factor (TNF) production in sodium taurocholate-induced acute necrotizing pancreatitis in rats. Owing to its complex effect, octreotide can partially ameliorate the deleterious consequences of acute necrotizing pancreatitis. Elevated TNF and interleukin-6 (IL-6) levels in the peritoneal fluid may be considered a consequence of the activation of peritoneal macrophages. BACKGROUND: The effects of octreotide on exocrine pancreatic function have been investigated in numerous studies, but little attention has been paid to its influence on cytokine production in acute pancreatitis. METHODS: Acute pancreatitis was induced by the retrograde injection of taurocholic acid into the pancreatic duct in male Wistar rats. Serum amylase activity, wet pancreatic weight/body weight (pw/bw) ratio, and TNF and IL-6 levels were measured. Four micrograms/kg of octreotide was administered subcutaneously at the time of induction of pancreatitis and 24 or 48 h later. Rats were sacrificed 6, 24, 48, or 72 h after the operation. RESULTS: The serum amylase level and pancreatic weight to body weight ratio were decreased significantly in the octreotide-treated group. The serum TNF level was decreased significantly in the octreotide-treated group as compared with the control group at 6, 24, and 48 h (0.6 +/- 1.5, 2.0 +/- 3.3, and 0 vs 50 +/- 15.5, 37.5 +/- 18.4, and 13.1 +/- 12.5 U/mL, respectively). The ascites TNF level was decreased to 0 in the octreotide-treated group and was elevated in the control group at 72 h (28.0 +/- 49.0 U/mL). IL-6 production in ascites was extremely high in both groups at 6 h (80,000 +/- 43,817 pg/mL and 58,500 +/- 33,335 pg/mL), but the difference was not significant.

Amylases↗
PubMed1998

Beneficial effects of pentoxifylline treatment of experimental acute pancreatitis in rats.

UNLABELLED: The purposes of this study were to determine the tumor necrosis factor (TNF) and interleukin-6 (IL-6) levels after the induction of acute necrotizing pancreatitis, and to establish the effects of pentoxifylline on cytokine production. METHODS: acute pancreatitis was induced by the retrograde injection of 200 microliters taurocholic acid into the pancreatic duct in male Wistar rats. The serum amylase activity, the wet pancreatic weight/body weight ratio, and the TNF and IL-6 levels were measured. Seven mg/kg pentoxifylline were administered intraperitoneally at the time of operation 6, 12 or 24 h later. Rats were killed 6, 24, 48 or 72 h after the operation. RESULTS: the TNF bioassay revealed high levels of TNF (30.2 +/- 5.4 U/ml, 35.0 +/- 5.0 U/ml and 36.6 +/- 6.0 U/ml) in the control group at 6, 24 and 48 h and (54.1 +/- 20 U/ml and 10.9 +/- 4.2 U/ml) in the pentoxifylline-treated group at 6 and 24 h, respectively, whereas the level had decreased to zero in the pentoxifylline-treated group at 48 h. The IL-6 bioassay likewise demonstrated high levels of IL-6 in the control group at 48 h and in the pentoxifylline-treated group at 6 and 24 h, and markedly decreased levels in the pentoxifylline-treated group at 48 h (7083 +/- 2844 pg/ml, 6463 +/- 1307 pg/ml, 10,329 +/- 5571 pg/ml vs 137.5 +/- 85.5 pg/ml, respectively, P < 0.05). The high mortality observed in the pancreatitis group (43%) was decreased by pentoxifylline administration to 11%. CONCLUSION: these results demonstrate that pentoxifylline very effectively inhibits cytokine production in acute pancreatitis.

Acute Disease↗