Biomedical subjects
Gyula Kovács
Publications and source records attributed to Gyula Kovács.
[Surgical aspects in the treatment of myasthenia gravis].
We treated 81 patients suffering from myasthenia with thymectomy in a 10-year period (1991-2000). We think, that thymectomy must be carried out in the treatment of myasthenia gravis, unless contraindications are present. The operation is not urgent and in the preoperative period patients must reach optimal condition with the help of standard medical treatment. The result of the operation is influenced by the length of time between the beginning of the complaints and the operation. The best results can be expected when the operation is performed in less than 2 years time, however an operation performed later may also be successful. We operated on 63% (n = 51) of the patients between 4-12 months, on 18% (n = 15) between 13-24 months and on 18.6% (n = 15) more than 25 months after the beginning of the complaints. Complete thymectomy was performed in all patients through median sternotomy. We had no operative mortality. Our postoperative results were evaluated with Jaretzki classification: 75% of our patients are in remission and asymptomatic (n = 61).
[Jejunal feeding in necrotizing pancreatitis or after esophagectomy].
Has early jejunal glutamine-rich diet any advantage in the treatment of patients suffering from acute pancreatitis and after oesophagectomy? Eleven patients suffering from necrotizing pancreatitis and 23 patients operated on radically for esophageal cancer were fed intra jejunally with glutamine-rich Stresson Multi Fibre diet. Eight patients with necrotising pancreatitis and 13 oesophagectomy patients were fed with glutamine-poor Nutrition Multi Fibre. Nutritional status, serum proteins, acute phase proteins, immune-globulins, complement components (C3, C4), the ratio of subsets of peripheral lymphocytes were analysed on the 1st, 2nd, 4th and 10th days. Serum protein parameters were measured by laser nephelometry. CD cell surface antigen expression was measured with flow cytofluorometry, activity of phagocytes with whole blood chemiluminescences. Laboratory parameters showed an improvement during the 10-day-treatment in both diet types, but significant improvement could be measured only in patients with necrotizing pancreatitis and fed with Stresson Multi Fibre: IgG (p < 0.05), serum protein (p < 0.02), prealbumin (p < 0.05), retinol binding protein (p < 0.03). The different diets did not cause difference in the laboratory results of the oesophagectomy patients. Early immune-enhancing diet improved serum proteins, acute phase proteins and immunoglobulins significantly in necrotizing pancreatitis. The length of hospital stay also decreased.
[Mydeton: a centrally acting muscle relaxant drug from Gedeon Richter LTD].
Since its introduction in 1959 tolperisone hydrochloride (Mydeton) is still one of the leading products of Gedeon Richter Ltd. It has been successfully applied for treating different painful muscle spasms. The compound is successfully marketed also by several foreign, mostly Japanese, pharmaceutical companies, as a central muscle relaxant agent. The present summary overviews the pharmacology of tolperisone, with special emphasize on its still partly understood way of action. Data from the scientific literature as well as our own experimental results strongly support the hypothesis that inhibition of voltage gated sodium channels is a major component of the mechanism of action of tolperisone. The paper also summarizes the clinical results with tolperisone and the perspectives of the therapeutic use of centrally acting muscle relaxants.