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Biomedical subjects

I Besznyák

Publications and source records attributed to I Besznyák.

At least 19 recordsLinked to original sources
PubMed2002

Clinical validity of new ultrasound methods in the differential diagnosis of breast diseases.

The clinical application of the extended-field-of-view (EFOV) technique, 3D ultrasonography (3D US) and a newly developed US method using a homogeneous tissue equivalent phantom, the so-called attenuation in phantom (AIPH) method, was evaluated in 200 patients with breast disease. These methods improved differentiation both in the preoperative diagnostic and in the postoperative follow-up. EFOV made possible to see large or multiple lesions and also their vasculature in a single image, allowing exact measurement, comparison and better assessment of traditional criteria. In addition, costs and examination time were also reduced. The possibility of viewing the spatial arrangement and the internal and external surfaces of the lesions improved preoperative decision making. Finally, the newly developed AIPH method allowed excellent evaluation of the posterior acoustic pattern of the lesions even when the mass was near the chest wall. For this reason, it was easier to distinguish malignant lesions from benign lesions of the breast.

Journal Article↗
PubMed2000

Surgery in Hungary.

After providing data on the geography and demographics of Hungary, the 1100 years of Hungarian history are briefly surveyed. The introduction, development, and present state of medical education and, in particular, surgical education, including specialty training, are discussed. Attention is devoted to the organization of the surgical community and of surgical manpower in the country. Various disease patterns and their influence on surgical practice are discussed. Attention is also devoted to health care provision and research activity. Finally, the future of surgery, especially general surgery, is outlined.

Curriculum↗
PubMed1999

[Morphological parameters of breast cancers detected by mammography with and without organized screening; a comparative study].

Some pathological findings and prognostic indices recorded in breast cancer cases, detected, on one hand, by a provider-initiated mammography screening program (Group 1), and, opportunistically, in self-referred symptomatic women (Group 2) on the other, are compared. In 8877 symptom-free women, aged 50-65 years, individually invited to attend the screening offered for the residents of the III., XII. and XIII. districts of Budapest, 67 cancer cases were detected (7.5 in 1000 screenees), in accordance with the cancer detection rate of the first, "prevalence" round of organised screening programmes. In the other group of 1593 symptomatic, self-referred women of the same age, 113 cancer cases were diagnosed by mammography. As far as the pathological parameters are concerned, the number of cases with invasive cancer less than 15 mm in diameter, and those with axillary nodes present was found to be significantly higher in the screened group as compared to the self-referred one (p < 0.01). In "small" cancers (i.e. less than 15 mm in diameter), no significant difference was found in the proportion of histologic grade III tumours among the two groups. In screen-detected cancers both the morphometric prognostic index (as calculated by Baak et al.) and the Nottingham Prognostic Index (NPI) proved to be more favourable, as compared to those in the self-referred group. The p-value as determined by Mann-Whithey test was 0.000003 in the screened group, and 0.000015 in the other one. These findings provide convincing evidence in support of the public health importance of provider-initiated, organised mammography screening for breast cancer, therefore, the introduction on service basis of organised breast screening into the health care system in Hungary is strongly recommended by the authors.

Breast Neoplasms↗
PubMed1999

[Amyloid goiter].

Amyloid goitre is at an extremely rare occurrence. Authors review the origin of disease and its symptoms, diagnostic and therapeutic tools. The disease may be due to either primary or secondary systemic or local amyloidosis. Diagnosis may be made even before surgery on anamnestic data, on very rapid growth of thyroid glands, on diffuse appearance, on other symptoms of systemic amyloidosis, on findings of iconographic procedures and on detection of amyloid in aspirates. Final diagnosis is based on histology. Surgical therapy is aiming at avoidance of the existing and the threatening consequences of expanding mass. The outcome is independent from thyroid surgery, it is related to other manifestations of amyloidosis. Concerning with the present case the chronic superior vena cava syndrome and chylous pleural effusion as first described symptoms and asymptomatic hyperthyroxinaemia is emphasised. Neither other organ involvement, nor primary amyloidogenous molecula was found during the 18 months follow up, so patient has secondary and localised amyloidosis.

Amyloidosis↗
PubMed1998

[Malignant schwannoma of the breast].

Authors describe a malignant solitary schwannoma observed in the left breast of a 67-year old woman. Eight months after tumour removal the patient is symptom and complaint-free. The present case of breast schwannoma is the first clinical observation in the national and the 14th one in the world literature.

Aged↗
PubMed1998

Changing diagnostic and therapeutic approaches to the 'Ogilvie syndrome'.

The only thing that has remained unchanged about the genuinely described 'Ogilvie syndrome' is its name. Recently it was considered to be an acute colonic pseudoobstruction, a clinical entity mimicking the mechanic ileus of the distal large intestine, without organic obstruction. It is almost always secondary to other diseases. Not all details of the pathogenesis are known, but it has become clear that the direct factor leading to the disturbance of the motility is a vegetative imbalance. X-ray findings are highly characteristic and critical in the planning of treatment. The danger for the patients is the progression of the state or the long duration of the process. Conservative treatment is suitable only for early cases, without complications. In case of failure non-invasive endoscopic or endoscopically assisted minimally invasive procedures may be mandatory. These methods have seen rapid advance in recent years. Uncertain diagnoses or complications call for open surgery. Cecostomy is the solution of choice anyway. The mortality is high in this group of elderly polymorbid patients. Authors compare six of their cases with data collected from the literature.

Adult↗
PubMed1997

Surgical chemotherapy in the management of melanoblastoma of the lower extremities.

The therapy of advanced melanoblastomas of the lower extremities is limited. Surgery alone is insufficient due to the extent of the tumor, the radicality of mutilating surgery is questionable because of the existing or suspected subclinical metastasis. To avoid amputation, regional chemoperfusion and simultaneous hemofiltration may be the choice of treatment. Between 1993 and 1995 the authors performed surgical chemotherapy on 21 occasions in 14 patients with advanced melanoblastoma of the lower limb. Partial remission of 4 to 11 months developed in 10 patients, 3 patients achieved subjective improvement for 3 to 6 months, 1 patient had disease progression. Simultaneous application of surgical regional chemotherapy and hemofiltration offers an alternative approach in the management of patients suffering from advanced melanoblastoma.

Antibiotics, Antineoplastic↗
PubMed1996

[Pseudomyxoma peritonei].

With reference to the clinical courses of three patients treated at the Department of Surgery, National Institute of Oncology, Budapest, the literature on the diagnosis and treatment of peritoneal pseudomyxoma has been reviewed. The disease is considered to be a rare low grade malignancy. Abdominal ultrasonography, computer tomography and laparoscopy are of significance in the diagnosis of this disease which is yet confirmed usually during surgery. The treatment is principally surgical, the results of chemotherapy are modest. The disease has a slow course and is susceptible to recurrence. Despite of early diagnosis and radical surgery cure can be reached rarely.

Aged↗
PubMed1996

[Pregnancy and colorectal cancer].

Among 1761 patients operated on for colorectal malignancies by the authors in a period of 20 years, four cases were diagnosed during pregnancy. Beside analyzing the case-histories they present the relevant literature data: the incidence of colorectal tumors during pregnancy is 4-5 cases/100,000 pregnancies, and most frequently they are situated in the rectum. The prognosis of primary colorectal malignancies diagnosed during pregnancy is unfavourable, and their biological behavior is more aggressive. Authors review the advised diagnostic and therapeutic approaches in different periods of pregnancy.

Adenocarcinoma↗
PubMed1996

[Gigantomastia in pregnancy].

A 26 year old women presented with huge enlargement of breasts from 10th week of her first pregnancy. Both breast became very swollen and painful, more than tripled in size. The skin became oedematous, red, and subsequently ulceration and bleeding occurred. Interruption performed at the 12th week, it didn't stop the process. 3 months later bilateral mastectomy with free transplantation of the nipples and the areoles to the abdominal wall was performed. The pathologic diagnosis was hyperplasia of the connective tissue elements with fibroadenomas. 6 and 8 years later she delivered healthy babies. The authors review the literature of gigantomastia during pregnancy with discussion of the treatment.

Abortion, Therapeutic↗
PubMed1996

[Multiple fibrous pseudotumor of the great omentum].

The authors describe a case of multiplex fibrous pseudotumor of the great omentum that developed in a 15 year-old man and was treated by surgical resection. They discuss the clinical and pathological differential diagnostic problems and give a review of the omental tumors and pseudotumors. The occurrence of pseudotumors in the abdomen is rare and these are mostly inflammatory variants. On our knowledge this case is one of the first of multiplex fibrous pseudotumor simulating fibroma that was localized in the great omentum.

Adolescent↗
PubMed1996

An analysis of breast cancer in Hungary: experience of the National Institute of Oncology, Budapest.

Breast cancer is the most common type of cancer in women throughout the world (18%), with a yearly morbidity that is already over half a million. Its incidence in Hungary is increasing in each age group, and the mortality is strikingly high. This study was conducted to assess the effectiveness of breast-conserving surgery in comparison to more radical surgery on a large group of patients. During the 15 years between 1980 and 1994, a total of 6,358 patients with primary breast cancer underwent surgery at the National Institute of Oncology in Budapest, Hungary, as breast-conserving surgery in 2,026 patients (31.8%). Breast-conserving surgery is being performed in an ever-increasing number of patients, followed by adjuvant radiochemotherapy in premenopausal patients, or radiohormone therapy in menopausal patients. During follow-up, recurrence was found in only 5.9% of the patients who underwent breast-conserving treatment. Thus, according to our experience, breast conservation therapy for the management of breast cancer offers favourable results, provided that the preconditions to this treatment are adequately met.

Adult↗
PubMed1994

[Hormonal and biochemical characterization of breast cyst fluid in gross cystic mastopathy].

A total of 93 breast cyst fluids (BCF) obtained by needle aspiration of women suffering from gross cystic mastopathy was hormonally investigated. The mean age of the patients was 45 years (range 27-65). Estradiol (E2), progesterone (PROG), testosterone (TE), prolactin (PROL), estriol (E3), dehydroisoandrosterone and its sulfate (DHA, DHA-S) levels were investigated in the BCF and in the respective sera. Tumour marker beta-HCG and CA 15-3 as well as cations (K+, Na+) were determined, too. E2, E3, PROG, TE, PROL, DHA, DHA-S and K+ showed significant accumulation in the BCF compared to the serum values. The K+/Na+ ratio proved to be a useful tool to divide cysts into type I (> or = 1), type II (< 1 but > or = 0.1) and type III (< 0.1) subgroups. In case of type I BCF, higher E2, DHA, DHA-S and PROL levels could be detected, while PROG and TE contents proved to be the highest in type II cysts. These findings indicate that the type I BCF is a marker for "active" GCD of the breast and suggest that it may be associated with increased breast cancer risk. It is suggested therefore when macrocysts are aspirated, sex steroids, steroid hormone precursors and cations in the BCF should be examined routinely, and women with type I cysts should be controlled carefully.

Adult↗
PubMed1994

[Clinical significance of steroid receptors in breast cancer].

The steroid receptor determination (first of all estrogen receptor--ER--) of the breast cancer tissue has become an important factor for prognostication and treatment. Authors from the Surgical Department of the National Institute of Oncology provide a biostatistical survey of their 727 breast cancer patients. Following factors proved to have significant impact on the prognosis: positivity of ER, the quantitative value of ER, ER vs. lymph node status, ER vs. DFI, ER and the site of metastases and the hormone therapy. The progesterone receptor (PR) provides indication in case only for DFI for metastases. However, in this very respect it has a more significant value than that of ER. Multidimensional analysis has shown that the most important prognostic factors are the lymph node status, patient's age, size of the tumour and the ER value.

Breast Neoplasms↗
PubMed1994

Malignant colorectal tumours in young adults.

The therapeutic and diagnostic problems of colorectal cancers in young adults (under the age of 40 years) are discussed, with special considerations to the unfavourable prognosis and its underlying causes. At the Department of Surgery, National Institute of Oncology, Altogether 638 patients were treated for colorectal cancer in the course of 10 years (1975-1985). From them 34 (5.2%) were younger than 40 years old. The 5-year survival of patients younger than 40 years was 38%, while that of those older than 40 years accounted for 48%. The importance of the prudence of the general practitioners is emphasized.

Adolescent↗
PubMed1994

Dixon's anastomosis with "double-stapling" technique: experience with 235 cases.

The perioperative results of 235 Dixon's anastomoses performed between 1985 and 1994 are compared to those of 125 Dixon's anastomoses performed between 1956 and 1979, on the basis of recurrences and survival data. It is concluded that the operations carried out with double stapling are considerably superior interventions with respect to speed, sterility and anastomotic safety and involve less complications. There is no difference between the stapling and handsewn techniques concerning the development of local recurrences. A further advantage of stapling is that it makes possible the saving of the sphincter more often, namely in almost 50% of the cases.

Anastomosis, Surgical↗