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Biomedical subjects

J Székely

Publications and source records attributed to J Székely.

At least 19 recordsLinked to original sources
PubMed2002

A PET study on the characterization of partially reversible radiogenic lower motor neurone disease.

OBJECTIVE: To investigate the pathomechanism of the rare radiogenic lower motor neurone disease (LMND) on the basis of a case history involving a partial functional recovery. PATIENT: A 31-year-old seminoma patient received postoperative para-aortic and para-iliac telecobalt irradiation with a biologically effective dose of 88 Gy(2) (44 Gy in 2 Gy fractions/day, with an estimated alpha/beta of 2 Gy) delivered to the spinal cord following a single cycle of chemotherapy. LMND developed 4 months after the completion of radiotherapy. The patient exhibited flaccid paraparesis of the lower extremities (without sensory or vegetative signs), followed by a worsening after further chemotherapy, due to pulmonary metastatization. A gradual spontaneous functional improvement commenced and led several years later to a stabilized state involving moderately severe symptoms. METHODS: In the 15th year of the clinical course, magnetic resonance imaging (MRI) and positron emission tomography (PET) with [(18)F]fluorodeoxyglucose (FDG) and [(11)C] methionine were conducted. Four lines of experiments (clonogenic assay using fibroblasts isolated from a skin biopsy sample of the patient, comet assay, micronucleus assay, and the testing of chromosome aberrations after in vitro irradiation of peripheral blood samples) were performed in a search for an increased individual radiosensitivity. RESULTS: MRI investigations failed to reveal any pathological change. PET demonstrated an increased FDG accumulation, but a negligible [(11)C] methionine uptake in the irradiated spinal cord segments. The radiobiological investigations did not indicate any sign of an increased individual radiosensitivity. CONCLUSIONS: We suggest that the observed partial functional recovery and stabilization of the symptoms of radiogenic LMND may be explained by the higher than normal density of sodium channels expressed along the demyelinated axons of the restored conduction. The increased energy demands of this type of conduction are proved by a higher metabolic rate (increased FDG uptake) of the irradiated spinal cord segments without a substantial regenerative process (lack of detectable protein synthesis).

Adult↗
PubMed1999

[Percutaneous embolization of hemorrhaging renal arteriovenous fistula].

A 67 year old male patient with macroscopic hematuria was treated by percutaneous intraarterial embolization with Gianturco-coil (Cook). The patient had a percutaneous stone removal from the left kidney two weeks before the bleeding. The emergency angiography showed an arteriovenous shunt in the left kidney. A superselective embolization was performed. There was no bleeding on the control angiography. The embolization was performed without complication.

Aged↗
PubMed1999

Total body irradiation before bone marrow transplantation. Technique and acute toxicity.

PURPOSE: To evaluate the total body irradiation methods in the National Institute of Oncology between January 1984 and February 1998. PATIENTS AND METHODS: One hundred and twenty-four patients underwent total body irradiation prior to bone marrow transplantation in the last 15 years. A special cobalt unit has been used, the dose rate was 6 to 8 cGy/min in the midline of the abdomen. The source-midline distance (SMD) was 340 cm and the field size was 80 x 200 cm. The dose calculation was done on the basis of a tissue-phantom ratio curve measured in total body irradiation conditions and effective tissue thickness (ETT). Between 1984 and 1992 the beam direction was horizontal, the patients laid in lateral position. In 11 cases the total dose to the abdominal midline was 10 Gy in 1 fraction. From 1986 the fractionation changed to 4 x 3 Gy in 4 days. Within individual lung shielding the average lung dose was 8.5 Gy. In 44/124 cases the order of conditioning treatment was chemo-radiotherapy. Since 1992 vertical beams were used, and the patients (80/124) laid in prone/supine position. The fractionation remained the same but radio-chemotherapy regime has been used. RESULTS: The irradiation in prone position proved to be safer than lateral because of smaller patient motion and it resulted in a more accurate positioning of lung shielding too. In all cases, the acute side effects (headache, nausea, vomiting) were moderate. Using radio-chemotherapy the acute side effects during the total body irradiation were uncommon and well tolerable. CONCLUSION: Our technique with the large source-midline distance, vertical beam direction and the supine/prone position is stable, convenient and safe to produce homogeneous dose distribution and ensures accurate and reproducible lung shielding.

Bone Marrow Transplantation↗
PubMed1996

[Extracorporeal shockwave therapy in childhood].

In 27 children aged 4-17 years extracorporeal shock wave lithotripsy (ESWL) was performed for renal and ureteral calculi between January 1 1993 and December 31 1994 at the University Medical School of Pécs. A total of 32 calculi was treated requiring 34 ESWL sessions. All treatments were done with the standard Dornier Compact Mobile Lithotripter device. The mean size of the stones was 10.65 mm and the number of shock waves averaged 2607. No serious intraoperative or postoperative complications were encountered. No auxiliary procedures were performed. The stonefree rate was 27/32 stones (84.4%) 3 months after treatment. 5 patient has residual stone fragments. Lithotripsy using Dornier Compact Mobile device in our series of pediatric patients was found safe and effective.

Adolescent↗
PubMed1993

Pyeloform-aided percutaneous litholapaxy. I. Case study.

To remove multiple calyceal stones percutaneously is not a simple task. During the act of dilating the pierced channel the stones are apt to drift away towards other parts of the renal cavitary system. For avoidance we recommend the use of Pyeloform, a bicomponent synthetic compound in which chemical reaction between the two substances produces a gel-like matter. This permits the stones partly to be embedded, partly to be fixed against the risk of displacement. Described is the effect of Pyeloform in the removal of multiple calyceal stones.

Humans↗
PubMed1991

[Nasolith removal with ultrasound lithotripsy].

We report a rhinolith that caused total nasal obstruction and that could not be removed simply. It was reduced in size by a lithotripter, as used for stone disintegration in urology, and then removed. This method is suggested in all cases where removal of the rhinolith cannot be performed non-invasively and the rhinolith can be seen by the endoscope.

Adult↗
PubMed1989

Surgical treatment of impotence due to venous outflow.

Coital impotence was studied in 94 patients. In 14 of them the history, as well as the papaverine-induced erection, penile Doppler test and dynamic cavernosography suggested venous outflow as a basic process. In 13 who underwent surgery, the draining vein visualized by dynamic cavernosography was tied down. Seven patients now have spontaneous erection, four present it upon intravenous papaverine injection. Two operations failed: one for an existent spongiocavernous fistula, the other for the development of collateral circulation in the early phase.

Adult↗
PubMed1989

Broken piece in the lungs: a complication of haemodialysis via subclavian cannulation.

For a total of 349 haemodialysis sessions in 35 patients, 50 special subclavian cannulations were performed. The catheters were implanted infraclavicularly by the Seldinger technique. The average duration of the cannulation period was 26.6 days and the number of dialysis sessions per catheter was 7. Aspects of subclavian cannulation together with indications and complications are described. In three chronically uraemic patients, after 1, 5, and 6 weeks of single-needle haemodialysis, it was noticed that the catheter tip (3-5 cm) inserted into the subclavian vein had broken off. The broken pieces, lodged in the segmental pulmonary arteries, never caused any complication during the observation periods as long as 6, 14 and 33 months. Therefore their removal, either open or transluminal, seemed unnecessary. To prevent complications of similar type it is advisable to avoid single-needle dialysis. Recommended instead is either the double-needle method or the use of a double-lumen catheter.

Acute Kidney Injury↗
PubMed1989

Prognosis of testicular tumour since the introduction of complex therapy.

Change of approach in dealing with testicular carcinoma has made it necessary to set up a central organization covering a larger geographic area in Hungary where 242 patients had been treated since 1980. Progress in the development of therapy-oriented methods cleared the way for reliable and accurate stage determination. Data analysis seems to indicate that correct therapeutic principles combined with plenty of surgical, radiological and chemotherapeutic experience may contribute a lot to improving the pathologic prospects. The mortality rates for the pure seminoma group and for the non-seminomatous plus mixed-cell group of patients were 7.5% and 26.5%, respectively. The results promise additional chances--even with increasing morbidity--to reduce the mortality rate and the incidence of complications.

Adult↗
PubMed1989

Papaverine-induced erection.

Sixty-one patients suffering from impotentia coeundi were treated with local dosages of papaverine hydrochloride, injected into the corpus cavernosum. In patients with neurogenic, psychogenic or a mild form of vascular disorders the injection induced erections which lasted on from 20 minutes to between 4 and 5 hours. Sixteen volunteers who were taught to self-administer the solution, injected the preadjusted dosage into the corpus cavernosum each time before the intended sexual act.

Adult↗
PubMed1989

[Surgical treatment of venous-induced erectile impotence in the male].

In 14 out of 94 patients with erectile dysfunction a venous insufficiency was suspected. Localization and securing of the venous leak were done by dynamic cavernosography. An insufficient penile blood supply could excluded by Doppler ultrasonography and measurement of the penile-brachial artery-pressure index. In 7 out of 13 patients treated by ligation of penile veins the erectile function was normalized after operation, in 4 cases an additional intracavernous injection therapy was necessary and in 2 patients the operation was unsuccessful. If impotence occurs once more due to venous collaterals the implantation of a penile prosthesis should considered.

Adult↗
PubMed1985

Diagnostic accuracy of lymphangiography in the demonstration of histologically verified retroperitoneal lymph node metastases of testicular tumours.

Bipedal lymphangiography was performed in 101 cases of testicular tumour for the detection of retroperitoneal lymph node deposits. The lymphangiograms of 51 patients have been checked against the results of microscopic study of lymphadenectomy specimens. The radiogram was false-positive in 3, false-negative in 7 cases. The lymphangiographic diagnosis was accurate in 81 per cent of the cases. The other diagnostic possibilities--computerized tomography, ultrasonography, isotope lymphangiography--are also discussed. The main advantage of bipedal lymphangiography is to provide information on the structures of the lymph nodes and on the lymphatic channels as well. Combination of several diagnostic methods provides for a high accuracy of staging.

False Negative Reactions↗