Search PubMed⌕ Search

Biomedical subjects

E Székely

Publications and source records attributed to E Székely.

At least 19 recordsLinked to original sources
PubMed2007

Effects of vitamin E administration on the hemorheological status and redox homeostasis of patients with porphyria cutanea tarda treated with phlebotomy.

BACKGROUND: Conflicting results were reported about the efficacy of vitamin E (E) treatment in porphyria cutanea tarda (PCT). We conducted a study in PCT patients to investigate whether E treatment has any additional beneficial effects compared with phlebotomy (P) treatment alone on rheological and oxidative stress parameters. METHODS: Twenty three patients with sporadic PCT in clinical remission and 10 healthy control patients were studied. All patients were treated with P prior to the study until clinical remission was achieved. Baseline routine laboratory [blood glucose, serum lipids, C-reactive protein (CRP), iron metabolism indices, liver function tests], oxidative stress [serum thiobarbituric acid reactive substances (TBARS), plasma H-donor activity, plasma free SH-groups, erythrocyte glutathion peroxidase activity] and rheological parameters (whole blood and plasma viscosity, cell transit time, clogging rate) were measured in both groups. Then all PCT patients received E (tocopherol acetate) 200 mg/day for 8 weeks and at the end of treatment measurements identical to those performed at baseline were repeated. RESULTS: Increased urine uroporphyrin, serum CRP, TBARS concentrations, whole blood and plasma viscosity and decreased plasma H-donor activity, free SH-group level, erythrocyte glutathione peroxidase activity were detected in PCT patients treated with P alone compared with control group consistent with residual oxidative stress in PCT patients. E treatment decreased urine uroporphyrin and serum TBARS concentrations; increased plasma H-donor activity and did not influence whole blood and plasma viscosity compared with P treatment alone. CONCLUSIONS: E treatment reduced the residual oxidative stress and did not influence increased plasma and whole blood viscosity present in PCT patients receiving P treatment prior to clinical remission.

Adult↗
PubMed2006

Hypercalcitoninemia in a patient with a recurrent goitre and insulinoma: a case report.

Serum calcitonin has become a very sensitive and specific marker for medullary thyroid carcinoma that should be determined in patients with nodular thyroid disease. However, a few earlier reports indicated that tumors other than medullary thyroid carcinoma including insulinomas arising from pancreatic islet cells may also produce calcitonin. Of the few cases of calcitonin-producing insulinomas previously reported, most had incomplete data or lack of documentation of the association between raised serum calcitonin concentration and immunohistochemical detection of calcitonin in pancreatic islet cell tumors. In this paper we are reporting a 54-year-old woman with a history of partial thyroidectomy for multinodular goitre at the age of 50 yrs, she was evaluated for a 2-months history of fasting hypoglycemia (plasma glucose 1.9 mmol/L during a supervised fast), raised serum insulin (at the time of hypoglycemia 88.8 microU/ml; normal, 5 - 35 microU/ml) and C-peptide levels (at the time of hypoglycemia 6.1 ng/ml; normal, 1.37 - 3.51 ng/ml), markedly increased serum calcitonin concentration (481 pg/ml; normal, < 9.9 pg/ml), and an enlarged residual thyroid gland. Aspiration biopsy of the thyroid was negative for parafollicular C-cell hyperplasia or medullary thyroid carcinoma. Abdominal ultrasound and CT scan revealed a tumor in the head of the pancreas, which was surgically removed. Histopathological evaluation of the pancreatic tumor showed typical features of a neuroendocrine neoplasm with strong immunostaining for both insulin and calcitonin. After removal of the pancreatic tumor, clinical symptoms resolved and biochemical markers normalized (serum insulin, 14.9 microU/ml; C-peptide, 3.0 ng/ml; calcitonin, 2.9 pg/ml) confirming the causal relationship between insulinoma and markedly increased serum calcitonin levels.

Calcitonin↗
PubMed2005

Major and trace elements in whole blood of phlebotomized patients with porphyria cutanea tarda.

Porphyria cutanea tarda (PCT) is a disorder of hem biosynthesis resulting from a decreased activity of the uroporphyrinogen decarboxylase enzyme. Hem precursors are accumulated in the blood, liver and skin. Inherited and acquired factors also contribute to the pathogenesis of PCT. Hem precursors and porphyrins are excreted with urine and faeces. Whole blood of 8 PCT patients and 6 volunteers of Caucasian origin were analysed. In addition to routine laboratory measurements, 19 elements (Al, B, Ba, Ca, Cd, Co, Cu, Fe, K, Li, Mg, Mn, Mo, Na, Ni, P, S, V, Zn) were determined by means of inductively coupled plasma optical emission spectrometry (ICP-OES). Mg, P and S concentrations in whole blood were decreased significantly (p<0.05), whereas Ba was increased in PCT patients compared to controls. Metabolic alterations are reflected in the correlation of parameters. Positive correlations were found between the element pairs of Zn-Al, Zn-Mg, Zn-Mn, B-S, Fe-Mg, K-P, Mg-Mn for PCT patients, whereas in the control group Al-Mn, Ca-Cu, Ca-Na, Cu-Mg, Fe-K, Mg-Na, Zn-P showed positive correlations.

Acetic Acid↗
PubMed2001

[Lymphoepithelial cyst of the pancreas].

Authors present a case of a retroperitoneal lymphoepithelial cyst, which occurs rarely in this localisation. The histological picture is reminiscent of a branchiogen cyst. Usually it is recognised accidentally, with US or CT examinations performed for other reasons. In case the general condition of the patient is satisfactory, the surgical removal of such a tumour is recommended, since it is almost impossible to differentiate from more harmful lesions by CT or US examination, and if there are no tumour cells on the smears obtained by fine needle aspiration, there is always the doubt of sampling error.

Aged↗
PubMed2001

[Severe necrotic processes of the penis and scrotum].

Authors summarise the two-decade experience of their department in severe tissue necrosis of penis and scrotum. Presented cases represent a shared field of urology with dermatology, infectology, nephrology and andrology. Tissue necrosis extended to different depth of the penis, from superficial skin and subcutaneous tissues, fascias to the entire organ. Underlying diseases are acute and chronic inflammations, metabolic diseases, vascular lesions. Diagnostic difficulties and therapeutic choices, both conservative and operative, are discussed.

Abscess↗
PubMed2001

Optical resolution of 6-fluoro-2-methyl-1,2,3,4-tetrahydroquinoline by supercritical fluid extraction.

6-Fluoro-2-methyl-1,2,3,4-tetrahydroquinoline (FTHQ) enantiomers were separated by supercritical fluid extraction using carbon dioxide. Diastereoisomeric salts were formed from the racemic base with less than one equivalent of O,O'-di-(4-toluoyl)-(2R,3R)-tartaric acid (DPTTA). Further purification was achieved by partial salt formation of the enantiomeric mixture with an achiral acid (HCl) followed by the supercritical fluid extraction of the free enantiomers.

Anti-Infective Agents↗
PubMed2001

Leiomyosarcoma of the female breast.

Leiomyosarcomas of the breast are rare tumors. Less than 15 such cases have been reported in the literature so far. In this paper authors describe a case of leiomyosarcoma of a female breast presenting as a firm lobulated mass, mimicking a phylloid tumor radiographically. By fine needle aspiration biopsy, on the smears discohesive malignant looking cells were conclusive to a poorly differentiated invasive ductal carcinoma of the breast. The mastectomy specimen contained a lobulated mass, microscopically showing a partly epithelioid spindle cell tumor, immunoreactive for vimentin, desmin, smooth muscle actin antibodies, and negative for epithelial markers, hormone and growth factor receptors. Axillary lymph nodes were free of tumor. A primary leiomyosarcoma of the breast was diagnosed.

Actins↗
PubMed2001

[Rare indication for surgery: liver metastasis of planocellular laryngeal cancer].

This is a report of a successfully operated case of a solid liver metastasis developed following radical total laryngeal extirpation. The biological characteristic of the laryngeal cancer is also discussed from the surgical point of view. We underline the importance of a detailed, regular control of patients with malignancies and encourage of active surgical treatment of solid metachronous liver metastases.

Carcinoma, Squamous Cell↗
PubMed2001

[New possibilities and results in pediatric thoracic surgery].

In the last 5 years 104 thoracic operations were performed on children and adolescents in the 3rd Surgical Clinic of the Semmelweis University of Budapest and in the Heim Pál Children's Hospital by the authors. The number of the lung interventions was 47 and 57 operations were performed on the mediastinum, thoracic wall, pleura, trachea and on the diaphragm. Distribution ot the lung operations: 21 developmental malformations, 14 bronchiectasia, 9 tumours and 3 others. All the 16 mediastinal operations were performed because of tumours. The others were: 27 thoracic wall interventions, 11 pleural, and 3 other operations. All the operations were performed by the same surgeon. Authors introduced new techniques in the pediatric thoracic surgery in their country as the laser technique and the Video Assisted Thoracic Surgery. One reoperation was performed because of postoperative bleeding. No patients died in the postoperative period.

Adolescent↗
PubMed2000

[Lansoprazole versus ranitidine bismuth citrate containing triple regimens for Helicobacter pylori eradication in patients with duodenal ulcer].

The aim of this study was to compare in an open, controlled and prospective trial the efficacy of one-week regimen using either lansoprazole (2 x 30 mg) + 2 x 500 mg metronidazole + 2 x 250 mg clarithromycin (group I, 60 cases) or ranitidine bismuth citrate (2 x 400 mg) + 2 x 500 mg metronidazole + 2 x 250 mg clarithromycin (group II, 61 cases) on the eradication of Hp infection in duodenal ulcer patients. The diagnosis was stated endoscopically. Hp infection was confirmed from 2 antral + 2 corporeal biopsies by the modified Giemsa stain and rapid urease test. After eradication the patients were given on-demand treatment with 30 mg lansoprazole (group I) or 2 x 150 mg ranitidine (group II). Control 13C-urea breath test was performed 4-6 weeks after eradication. On intention to treat basis, Hp was eradicated in 78.3% (confidence interval, CI: 67.6-89.1%) in group I and 78.7% (CI: 68.1-89.2%) in group II (p > 0.05). Per protocol eradication rates were 92.1% (CI: 84.5-99.7%) in group I and 90.5 (CI: 82.4-98.6%) in group II (p > 0.05). Side effects were recorded in 13.5% in group I and 18.3% of cases in group II. Short term triple therapies using either lansoprazole or ranitidine bismuth citrate + 2 antimicrobials were effective and safe in the eradication of Hp in duodenal ulcer patients.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2000

Trabecular angiomyolipoma mimicking hepatic cell carcinoma.

Hepatic angiomyolipomas are rare tumors, especially in comparison with those occurring in the kidney. Nevertheless, it is important to be aware of their existence, especially when occurring in the liver, where they might have different subtypes. Not infrequently they are composed of rather irregular cells with epithelioid appearance. In these cases hepatocellular carcinoma or the possibility of other malignant tumors has to be ruled out, with the aid of numerous immunohistochemical reactions. The authors present a case of a female patient, whose liver lesion was first diagnosed on cytological examination as a hepatocellular carcinoma. Based on the preoperative cytological diagnosis, a large liver lobe resection was performed. Histological examination found an angiomyolipoma of the above-mentioned type, and the final diagnosis was ascertained with the aid of vimentin, smooth muscle actin (SMA), and HMB-45.

Actins↗
PubMed2000

Leiomyosarcomas of great vessels.

Sarcomas of the great vessels are rare. Altogether 400 such cases have been described in the aorta, the pulmonary artery, and inferior vena cava. The clinical symptoms are generally related to embolic phenomena, aneurysm formation, and widespread metastases, especially to bones. With improved diagnostic modalities more cases are diagnosed and treated surgically. Resection of the tumor may prolong the patient s life. In this paper authors present two cases of such rare sarcomas. In our first case a tumor has developed in the thoracic aorta with symptoms of imminent aortic dissection. The tumorous nature of the lesion was revealed only histologically, since neither the operation, nor macroscopic picture gave any clue to its tumorous nature. The second case was a male patient with a huge retroperitoneal tumor arising from the inferior vena cava, which was clinically suspected to be a carcinomaarising in the adrenal gland.

Adrenal Gland Neoplasms↗
PubMed1999

[Effectiveness of ceftibuten++ in the sequential therapy of respiratory and urinary tract infections].

A prospective, comparative, multicentre trial was performed to study the efficacy and safety of ceftibuten in respiratory and complicated urinary tract infections. Patients (n = 152) requiring parenteral 2nd or 3rd generation cephalosporine therapy were randomly assigned to continue parenteral therapy (Group A) or to receive oral ceftibuten 400 mg, or 9 mg/kgbw/day (Group B) from the 3.-5. days on. The patients, whose conditions have not improved significantly at day 3-5, were omitted from the study, so the number of evaluated patients was 131. In Group A, out of 59 patients 51 were clinically cured, the bacteriological eradication rate was 47/54. In Group B, out of 72 patients 67 were cured and 62 out of 66 pathogens were eradicated. The cost of step-down therapy was 44.3% less than the parenteral one. No adverse effect was observed that could surely be attributed to ceftibuten. According to these data, ceftibuten can be used in step-down therapy in respiratory and urinary tract infections requiring parenteral therapy at first and that offers a safe and less expensive therapeutic approach.

Ceftibuten↗
PubMed1999

[Eradication of Helicobacter pylori in peptic ulcer patients].

The aim of this study was to compare in an open trial the efficacy of 2 x 500 mg clarithromycin + 2 x 1000 mg amoxicillin + 40 mg pantoprazole/day given for 7 days (I. group, 48 cases), with that of 2 x 500 mg clarithromycin + 2 x 400 mg ranitidine bismuth citrate/day given for 14 days (II. group, 51 cases). The diagnosis of peptic ulcer was established endoscopically. HP infection was confirmed the modified Giemsa stain and rapid urease test. After eradication all patients were given 2 x 150 mg ranitidine for one month. Controls were performed 4-6 weeks after eradication. Peptic ulcer healing was proven in the group I in 93.0% and in the group II in 91.6% (p > 0.05). On intention-to-treat basis, HP was eradicated in 80.3% (confidence interval, CI: 73-92.7%) in the I. and 80.3% (confidence interval: 76-95%) in the II. group (p > 0.05). Per protocol analysis revealed eradication rates of 88.3% (CI: 81-97.6%) and 85.4% (CI: 80-97%) (p > 0.05). Side effects were recorded in 9.5% and 14.5% of the cases. Both regimens were equally effective in the eradication of HP and healing of peptic ulcers.

Drug Therapy, Combination↗
PubMed1998

[Aortopexy as a surgical treatment method in infantile congenital tracheo-chondrohypoplasia and tracheomalacia].

Congenital tracheal chondrohypoplasia and tracheomalacia have come to present a significant challenge in recent paediatric surgery. Authors shortly describe their pathology, pathophysiology, symptoms, diagnostic evaluation and outline the most frequency surgical procedures for them. The first three aortopexies in the authors' departments are described in this paper, with particular attention paid to the clinical problems of congenital tracheal chondrohypoplasia and tracheomalacia and the role of this method in surgical treatment, respectively. Aortopexy is quick, easy to carry out and atraumatic for the growing trachea. Authors want to draw attention to the fact that not every form of congenital tracheal chondrohypoplasia and tracheomalacia may be treated by conservative therapy, and that surgical treatment is recommended not only for life threatening forms, but for other severe forms as well.

Abnormalities, Multiple↗
PubMed1997

[Study of the cost-effectiveness of sequential antibiotic (ciprofloxacin) therapy].

A multicenter, prospective, randomized study was performed to compare the cost-effectiveness of parenteral antibiotic versus parenteral antibiotic + oral ciprofloxacin sequential therapy in the treatment of moderate and severe infections in hospitalized patients. After deciding on inclusion (n = 298), the patients were randomly allocated in group "A" (evaluable 120 cases) receiving only parenteral antibiotics, or in group "B" receiving parenteral antibiotic + oral ciprofloxacin from the 3.-5. day of therapy on. The local physician decided on the starting parenteral therapy and the necessity of other therapeutic interventions, and in case of group "B" patients on the possibility of switching parenteral to oral therapy. The overall cure rate was 68% in group "A" and 82% in group "B" (improved 33 and 21, failure 5 and 1 cases resp.). Of the direct costs in patients, care, the costs of antibiotic treatments based on purchase prices was compared: the cost of antibiotic treatment in group "B" was 32% less than in group "A", and the sequential therapy saved 9000 Ft/patient in average. In conclusion, ciprofloxacin proved to be an effective antimicrobial agent that can also be used in sequential therapy and the oral administration resulted in a significant save of money with the same therapeutic effectiveness.

Adult↗
PubMed1994

[Clinico-pharmacologic studies on pefloxacin].

The impact of liver impairment, renal insufficiency and age-related changes on the pharmacokinetics of pefloxacin was studied in 55 patients. The elderly patients were stratified into three age groups (61-70, 71-80 and above 81 years). The patients suffering from various infections were treated with oral or intravenous pefloxacin in a dose of 400 mg bid. Blood samples were withdrawn on the first and seventh day of therapy. The pharmacokinetics of pefloxacin was characterized by marked interindividual differences that became even more pronounced during multiple dosing. The elimination rate of pefloxacin during therapy slowed down, presumably due to its decreased metabolism. In elderly patients, the rate of cumulation is greater than in the young ones, but no significant differences could be detected among the elderly age-groups. Pefloxacin elimination also decreased in renal and hepatic impairment. There was no correlation between serum concentrations of pefloxacin and the development of adverse effects. In elderly subjects and in patients with renal or hepatic impairment, dose reduction might be considered. In mild or moderate infections or in urinary tract infections smaller doses of pefloxacin also could assure good therapeutic results. However, in severe infections especially caused by less susceptible pathogens, routine dose reduction is not recommended because of the significant interindividual differences in serum concentrations of pefloxacin.

Administration, Oral↗