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Biomedical subjects

I Szilvási

Publications and source records attributed to I Szilvási.

At least 19 recordsLinked to original sources
PubMed2004

Ileocolic anastomotic ulcer after surgery in adulthood: case report and review of the literature.

Anastomotic ulcer is a rare complication after ileocolic resection, especially in adults without evidence of inflammatory bowel disease or tumor recurrence. We report the case of a 63-year-old male patient who presented 6 years after ileocolic resection, and also review the data of six similar cases described in the literature. The markedly reduced bile acid absorption found in our case raises the possibility of an etiological role of bile acids in the development of ileocolic anastomotic ulcers.

Anastomosis, Surgical↗
PubMed2001

[Latent autoimmune diabetes in adults(LADA): part of the clinical spectrum of type-1 diabetes mellitus of autoimmune origin].

According to the most recent classification of diabetes mellitus the latent autoimmune diabetes in adults belongs to the group of type 1 autoimmune diabetes mellitus, as a slowly progressive form. It is not clear whether LADA is a distinct clinical entity or it is a part of the clinical spectrum of type 1 diabetes mellitus. The authors compare the antropologic (body mass index, waist to hip ratio), immunologic (occurrence of islet cell cytoplasmic autoantibodies and autoantibodies against glutamic acid decarboxylase and tyrosin phosphatase), genetic (HLA DR and DQ alleles known to be associated to type 1 diabetes mellitus) characteristics and occurrence of the features of the metabolic syndrome in the groups of type 1 and type 2 diabetes and LADA. 81 type 1 and 190 type 2 diabetics and 38 LADA patients were involved into the study. Freshly diagnosed type 1 diabetics served for controls of the autoantibody study: 48 patients manifested < or = 16 years of age and 89 type 1 diabetics manifested above 16 years of age. The three main diabetic groups differed in age: the average age in the type 1, type 2 and LADA groups were 37, 63 and 58 years respectively. There was no difference among the three groups in gender. The duration of the disease differed significantly between the type 2 and LADA groups (4.0 and 8.0 years respectively). In spite of the shorter duration of the disease in the LADA group, compared to the type 2 diabetics the frequency of insulin dependency was significantly higher in the LADA (81.6%) than in the type 2 group (46.7%). The BMI and WHR were comparable between the type 1 and LADA patients (average values were 23 and 0.83 in type 1 patients and 23.25 and 0.89 in LADA). The type 2 group differed significantly from type 1 and LADA (average values were 29.1 and 0.5). The concentration of glycated hemoglobin was comparable in the three groups. But there was a significant difference in HbA1c concentration between the freshly diagnosed subgroups of type 1 and LADA patients: 10.85% and 8% respectively. The fasting C-peptid levels were significantly higher in the sera of type 2 diabetics (0.75 pmol/l) compared to type 1 (0.2 pmol/l) and LADA patients (0.29 pmol/l). There was a significant difference in C-peptid concentrations between the type 1 and LADA groups, too. The insulin deficiency in LADA seemed to be not as severe as in type 1 diabetes. The serum total cholesterol and triglyceride levels were significantly higher and the HDL cholesterol concentration significantly lower in type 2 diabetics comparing to type 1 and LADA patients and there was no significant difference in this respect between the type 1 and LADA groups. The frequency of occurrence of hypertension differed no significantly between type 2 and LADA, but that of in type 1 diabetes was significantly lower than both type 2 and LADA. The occurrence of multiple autoantibodies (ICA + GADA + anti-IA2) was much more frequent in type 1 diabetes compared to LADA. In the sera of LADA patients the occurrence of ICA and GADA alone or ICA + GADA was characteristic (31.5% - 21.1% - 15.8% respectively). There was no difference between type 1 diabetes and LADA in the occurrence of the alleles of the MHC kown to be associated with type 1 diabetes. The occurrence of the haplotypes HLA DQ2/DR3 and/or DQ8/DR4 was observed in two thirds of type 1 diabetic and LADA patients. Chronic diabetic complications were observed in all of the groups and there was only a secondary connection of the complications with the type of the diabetes. Based on the results the authors suggest that LADA is a part of the clinical spectrum of type 1 diabetes of autoimmune origin.

Adolescent↗
PubMed1999

[Ganglioneuroma of the adrenal gland].

149 patients with adrenal incidentalomas were examined. Sixty-eight cases were histologically confirmed, five of them had ganglioneuromas. On the basis of these patients history current knowledge of this benign tumour was summarized. Histological and pathological characteristics of one tumour suggest that ganglioneuromas may develop by maturing of malignant neuroblastic tumours. The clinical symptoms (abdominal pain, meteorism) were local. In 2 of 5 cases mildly elevated levels of urinary vanillylmandelic acid and catecholamine could be measured. One patient had persisting hypertension after surgery. In an other patient previous diarrhoea stopped after the removal of tumour. On the basis of ultrasound and computertomographic features, the size and origin of a tumour and its relation to the surrounding organs can be well characterized. One patient was inoperable because of an infiltratively spreading tumour, but during five years of follow-up no tumour progression could be observed with computertomography. After surgery we could follow only 2 of 4 patients. Until now no recurrence of tumour were detected.

Adolescent↗
PubMed1998

[Metastasized carcinoid tumor treated with interferon and octreotide].

The carcinoid tumours are rare forms of the gastrointestinal tumours (they make up 2%), though lately they have shown an upward tendency. Among different types of treatments of the carcinoid tumours in non metastatised cases, the surgical intervention stands first on the list. But when symptoms emerge, most of the tumours have metastases, for which there are various types of treatments. The authors introduce the combined therapeutical possibilities in connection with metastatised carcinoid tumours. A combination of octreotid and interferon is used in the course of the treatment. Authors introduce the therapy's indications and experiences gained during the follow up of events.

Antineoplastic Agents, Hormonal↗
PubMed1992

[Relationship between platelet hyperactivation and dyslipoproteinemia in diabetic nephropathy].

The relationship between the secundaer hyperlipidaemia and pathological platelet activation was examined in 40 insulin-treated diabetic patients without nephropathy and 21 with nephropathy. Diabetic nephropathy was recorded with the measurements of serum creatinine, serum beta 2-microglobulin, and urine albumin excretion. Haemostasis and lipoprotein metabolism were characterized with determination of platelet aggregation, plasma beta thromboglobulin, thromboxane-B2, serum triglyceride, HDL and LDL cholesterol concentration, respectively. In the normalbuminuric group serum triglyceride and thromboxane-B2 positively correlated. In the nephropathic group serum cholesterol and beta thromboglobulin, as well as LDL and beta thromboglobulin, finally, LDL and thromboxane-B2 showed significant positive correlation. In diabetic patients without nephropathy platelet aggregate ratio was in positive correlation with the serum triglyceride, while the ED50-S elevated with the increase of serum cholesterol and LDL. The nephropathic group exhibited no such parallelisms. However, there were significant correlations of LDL with serum creatinine in both groups of diabetic patients. Our results seem to indicate that the increase of LDL could be associated with the change of LDL structure. Interactions of modified LDL and the platelet membrane might contribute to the platelet hyperactivation both in the nephropathy-free and nephropathic cases.

Diabetes Mellitus, Type 1↗
PubMed1992

Elevated levels of plasma and urine beta-thromboglobulin or thromboxane-B2 as markers of real platelet hyperactivation in diabetic nephropathy.

Serum creatinine, immunoreactive serum and urine beta 2-microglobulin, plasma and urine thromboglobulin, plasma thromboxane-B2 levels and daily protein excretion were determined in 61 insulin-treated diabetic patients, comparing the different patient groups (complication free, nephropathy without and with azotaemia) with control subjects. In the groups of diabetic patients, plasma and urine beta-thromboglobulin (BTG) and plasma thromboxane-B2 levels were higher than in the controls. There was a significant positive correlation between urine BTG and beta 2-microglobulin in the group without complication, and between the plasma BTG and beta 2-microglobulin, and plasma BTG and thromboxane levels in the diabetic group with azotaemia. In contrast to some previous assumptions, the increased level of plasma BTG reflects a real platelet hyperactivation in patients with diabetic nephropathy. At the same time, urine BTG also increases. Determination of urine BTG is more simple with less possibility of methodological error.

Adult↗
PubMed1991

[Plasma and urine beta-thromboglobulin determination in the detection of thrombocyte hyperactivation in diabetic nephropathies].

Serum creatinine, immunoreactive serum and urine beta-2-microglobulin, plasma and urine thromboglobulin, plasma thromboxane-B2 levels and daily protein excretion were determinated in 61 insulin treated diabetic patients, comparing the different patient groups (complication free, nephropathy without azotaemia and nephropathy with azotaemia) with the control subjects. In the groups of all diabetic patients plasma and urine beta-thromboglobulin and plasma thromboxane-B2 levels were higher that in the controls. There was a positive significant correlation between urine beta-thromboglobulin and beta-2-microglobulin in the group without complication, and between the plasma beta thromboglobulin and beta-2-microglobulin, and plasma beta thromboglobulin and thromboxane levels in the diabetic group with azotaemia. In contradiction to some previous assumptions, the increased level of plasma beta-thromboglobulin reflects a real platelet hyperactivation also in patients with diabetic nephropathy. At the same time urine beta-thromboglobulin also increases. Determination of urine beta-thromboglobulin is more simple with less possibility of methodological error.

Blood Platelets↗
PubMed1991

[Clinical value of body surface mapping in the diagnosis of ischemic heart disease].

A series of 137 patients suffered in clinically documented angina pectoris were analyzed by 12-lead exercise ECG, exercise body surface potential mapping and exercise thallium scintigraphic methods and the results were compared to that of selective coronary angiography and left ventriculography. If coronary artery stenosis were considered to be significant in the presence of more than 70% vessel narrowing, the sensitivity figures were 76, 93 and 88% for exercise 12-lead ECG, exercise body surface potential mapping and exercise thallium scintigraphy, respectively. In considering 50% coronary artery narrowing to be significant, the same figures were 78, 94 and 89%. Specificity figures at the same order were 59, 65 and 80% for more than 70%, and 64, 70 and 88% for more than 50% coronary obstructions. Exercise body surface potential mapping and exercise thallium scintigraphy applied parallelly gave a sensitivity of 100% and specificity of 53%. False-negative and false-positive exercise body surface potential mapping and thallium scintigraphic tests were analysed taking into consideration left ventricular function indices and respective patients. The authors suggest that the outstanding high sensitivity of the above mentioned two tests applied parallelly reveals that they highlights partially different aspects of coronary artery disease, and that is why the overlapping between the methods is relatively small. The majority of false-positive tests characterize a pathological state, and in these cases the exact diagnosis should be cleared up by other noninvasive/invasive methods.

Angina Pectoris↗
PubMed1991

Immunoscintigraphy of experimental transplantable tumours using monoclonal antibody against myelin basic protein.

Monoclonal antibody was prepared against myelin basic protein a so-called pancarcinoma antigen. After labelling with 131I the monoclonal antibody was injected into Lewis-lung cancer mice and rats with Walker breast cancer. Two, 24, 48, 72 and 96 hours after the labelled monoclonal antibody injection, radioimmunoimaging studies were carried out. After each gamma-camera study, organ distribution of the labelled monoclonal antibody was determined with radiobioassay technique which showed significantly higher activity in the tumour tissue than in healthy ones. Significant sample radioactivity could be recovered in the tumour masses 48 hours after injection, which persisted even after 96 hours. The later finding might enable diagnosing types of malignancy with isotope-labelled monoclonal antibody against myelin basic protein.

Animals↗
PubMed1990

Comparative evaluation of the effect of balloon dilatation by exercise precordial mapping and exercise 201-thallium scintigraphy.

Precordial exercise electrocardiographic mapping and exercise 201-thallium scintigraphy were simultaneously used on sixteen patients before, shortly after and three months after percutaneous transluminal coronary angioplasty (PTCA) to evaluate the immediate and late results of the intervention. In spite of the limited number of observations, positive exercise precordial mapping and or a reversible 201-thallium perfusion defect after PTCA seem to be indicative of failure of balloon dilatation or of development of restenosis in a given coronary artery. "Reverse minimum", that is the minimum in the resting precordial map which disappears on exercise, may be a sign of segmental coronary artery occlusion and well functioning collateral supply.

Adult↗
PubMed1989

[A simple isotope method for studying of gastric emptying of solid foods].

A simple isotope method is explained by the authors for noninvasive functional evaluation of the gastric emptying of solid meal. According to the results of in vitro measurements suitable solid phase labelling was provided by boiling the egg traced with injected Tc-99m-pertechnetate. The evaluation of gastric emptying by means of test meal containing the radiolabelled boiled egg is simple, inexpensive and the radiation hazard is minimal. In cases of intact stomach the gastric emptying of solids (T2 = 115.1 +/- 12.4 min) were significantly slower, than in cases of Billroth I (T2 : 66.7 +/- 6.9 min, p less than 0.01) and Billroth II (T2 = 28.8 +/- 3.3 min, p less than 0.001) resections. Similarly, there was a significant difference (p less than 0.001) between the mean half time values of the two operated groups.

Adult↗
PubMed1989

[Clinical significance of beta-2-microglobulin in diabetes mellitus].

The beta-2-microglobulin (B2M) level of the serum and urine was determined in 61 diabetics and 15 control patients by enzyme-immunoassay, to asses the value of B2M in clinical diagnosis. In patients with daily protein excretion exceeding 300 mg there was a significant positive correlation between serum creatinine, daily (24-hour) protein excretion, and B2M level of the serum and urine. In patients with less than 300 mg and in those with more than 300 mg daily protein excretion the B2M levels of the serum and urine were significantly higher than in the controls. Serum creatinine level underwent a significant rise only in patients with more than 1000 mg daily protein excretion. Determination of the B2M level is a sensitive method in the diagnosis of diabetic nephropathy. Simultaneous measurement of B2M level in the serum and urine detects nephropathy at an early stage and thus it may be of value in the prevention of the disease.

Diabetes Mellitus, Type 1↗
PubMed1988

Skeletal maturation in streak gonad syndrome.

Skeletal ages of patients with streak gonad syndrome were determined by the Schinz and TW2 methods as well as by bone scans. Seventy-three subjects were examined. They were classified according to their chromosomal complement, body height, chronological age and previous hormonal treatment. Retarded bone age was a common finding on the hand, wrist, hip, knees and spine with significant coexistence; however, the extent of delay in skeletal maturation on various bones differed considerably. There was no significant correlation between bone age and chronological age, karyotype, body height and previous hormonal replacements, respectively. This finding suggests that retarded skeletal maturity in streak gonad syndrome is neither the consequence of estrogen deficiency nor due to sex chromosome abnormalities and probably is not dependent on growth hormone secretion. Its pathogenesis appears to be multifactorial and remains to be determined.

Adolescent↗
PubMed1988

Bone scanning and radiography in the evaluation of patients with malignant lymphoma.

The diagnostic value of bone scintigraphy and radiography in the detection of lymphomatous bone involvement, and the role of bone scintigraphy in the evaluation of lymphomatous bone marrow involvement, were investigated in 41 patients with malignant lymphoma. 10 patients had lymphomatous bone involvement. Whereas scintigraphy detected all the 10 cases, radiography was false negative in 2 cases. The lytic bone lesions on radiography were in most cases not detected by scintigraphy. Scintigraphy is insensitive for the detection of early bone marrow metastases. The simultaneous use of bone scanning and x-ray, however, seems to be helpful in the detection of lymphomatous bone involvement and consequently in the clinical management of patients with malignant lymphoma.

Adolescent↗