Biomedical subjects

János Strausz

Publications and source records attributed to János Strausz.

16 recordsLinked to original sources

PubMed2006

[Imaging technics in bronchology].

Bronchoscopic imaging and diagnostics are tightly connected with radiological and pathological techniques. While computer tomography (virtual bronchoscopy) makes possible to mimic a realistic endobronchial situation, autofluorescent bronchoscopy holds significant potential to discover precancerous lesions not identifiable by standard bronchoscopy. Endoscopic ultrasound and fluoroscopy can be applied in order to obtain images and tissue samples from the extrabronchial areas. Electromagnetic navigation during flexible bronchoscopy, a novel technology that facilitates approaching peripheral lung lesions, involves creating an electromagnetic field around the thorax and localizing an endoscopic tool using a microsensor overlaid upon previously acquired CT images. In conclusion, parallel use of invasive and non-invasive imaging has the potential for considerable improvements in the diagnostic possibilities of routine bronchoscopic procedures.

Bronchial Neoplasms↗

PubMed2006

Pathology of chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease is one of the leading causes of death and morbidity worldwide. Despite intensive investigation, its pathology and pathophysiology are not well understood. The hallmarks of the disease are irreversible airflow limitation and chronic inflammation. Small airway obstruction due to progressive inflammation and fibrosis, and the loss of elastic recoil mediated by elastolysis and apoptosis equally contribute to pathologic changes. However, it is debated to what extent the obstruction of large airways leads to altered lung function. Three morphologic entities are described in the literature under one disease; chronic bronchitis, obstructive bronchiolitis and emphysema may appear in the same patient at the same time. The authors review pathologic changes observed in chronic obstructive pulmonary disease, including acute exacerbations and secondary pulmonary hypertension as severe but common complications of the disease. Furthermore, we detail recent scientific evidences for major cellular and molecular inflammatory pathway activation. These mechanisms result in accelerated apoptosis, remodeling and increased proinflammatory cytokine release. Targeting intracellular pathological changes may lead to the discovery of a new generation of drugs that could reduce chronic obstruction before airway irreversibility is established.

Humans↗

PubMed2006

[Bronchoscopic lung volume reduction surgery in emphysema].

Despite of the clinical studies proving the benefits of lung volume reduction surgery and determining the indications and candidates, the surgical intervention has not penetrated into the standard treatment of emphysema. Perioperative mortality is relatively high at patients with end-stage emphysema, therefore a less invasive procedure might be most useful in medical practice. Bronchoscopic lung volume reduction is a technically simple procedure including insertion of a bronchial blocker (plug) or an endobronchial valve, either totally blocking the air flow, or blocking it only during the inspiration. However, there are only few clinical data available concerning of surgical and bronchial interventions. A multinational clinical study is in progress in three Hungarian pulmonological centers implanting endobronchial plugs into the subsegmental bronchi of patients with severe emphysema.

Bronchoscopy↗

PubMed2004

[The role of bronchoscopy in examination and treatment of esophageal tumours].

The role of bronchoscopy in examination and treatment of esophageal tumours. The esophageal tumours are diagnosed in many cases in inoperable stage, and if a surgical resolution is possible, it's a heroic, great operation with high mortality rates and poor results. The involvement of great airways should be explored preoperatively by imaging methods, but bronchoscopy is also mandatory. The authors report their one year's experience of 121 bronchoscopic examinations in esophageal cancer patients. The finding was negative in 40.5% of all examinations, and 29.7% was concerned the cancer propagation to bronchial system. 29.8% of all examinations resulted a suspicion of propagation. The opinion of bronchologist can be decisive postoperatively if a fistula is suspected, or after an esophageal stent implantation airway symptoms occur. Bronchoscopy is a standard method for removal of airway excretion. The author's overview is comparing their fifteen years experience with international literature.

Adult↗

PubMed2004

[Endobronchial ultrasonography in postintubation tracheal stenosis].

INTRODUCTION: The correct evaluation of the tracheal wall's structure is necessary for the management of postintubation tracheal stenosis (PTS). Endobronchial ultrasonography (EBUS) is suitable for visualisation of layers of the tracheal wall and the assessment of cartilages' damage. AIM: The authors assessed the usefulness of EBUS in the anatomical characterization of PTS and in the decision making in its therapy. PATIENTS, METHODS: Between March 2002, and September 2003, 22 patients with PTS were examined by bronchoscopy together with EBUS. RESULTS: 13 patients had complex stenosis and from them destruction of tracheal cartilage was demonstrated in 5 patients. Of them bronchoscopic intervention resulted in only short term symptom free period in 3 patients. CONCLUSION: The destruction of tracheal cartilage detected by EBUS might be an indication for an early surgical intervention. According to author's results EBUS can be a useful method in evaluation of PTS.

Bronchi↗

PubMed2004

[Our experience using autofluorescence bronchoscopy].

INTRODUCTION: Lung cancer is responsible for most cancer deaths in the world. The main reason for the poor prognosis is late diagnosis. Many patients could be successfully treated in early stage. AIMS: The authors performed 369 bronchological examination on 336 patients using autofluorescence bronchoscopy between 1998 and 2003 to detect preinvasive lesions and early forms of lung cancer. METHODS: Storz D-Light autofluorescence system has been used to perform the examinations. RESULTS: In one third of these patients invasive lung cancer developed during follow-up. Combining traditional white light and autofluorescence technique 50% more intraepithelial lesions have been observed and sensitivity has been increased by 69% compared to the lone use of white light bronchoscopy. CONCLUSIONS: Supported by most international studies these results emphasise that autofluorescence bronchoscopy has a major role in the early diagnosis of preinvasive bronchial lesions and may help in the prevention and early therapy of lung cancer.

Bronchial Neoplasms↗

PubMed2004

[Bronchoscopic specimen collection, role of the protected specimen brush in lower respiratory tract infections].

INTRODUCTION: The ineffectiveness of microbiological methods in the lower respiratory tract infections are caused by anachronistic sampling methods. Authors checked the protected specimen brush effectiveness and those of the influencing factors. MATERIALS AND METHODS: 103 patients were involved in the study. The causative agents were identified in 44 cases. These results were compared to last year's classic sampling techniques and they experienced 20.4% improvement of the sensitivity. Further increasing in effectiveness can be reached if we perform bacteriological sampling after the first unsuccessful antibiotic treatment was performed. Out of 103 examined patients only 69 underwent antibiotic treatment. In the case of 13 patients after the course of one type antibiotic treatment 10 positive bacteriological cultures were positive. In the case of 31 patients 2 types of antibiotics were administered sequentially and examined afterwards and the authors found 15 positive bacteriological cultures. In the case of 25 patients the administered sequentially 3 times of antibiotics and examined afterwards, 6 cultures were positive. CONCLUSION: The examinations prove that the protected specimen brush, used in time, raises the sensitivity of microbiological processes.

Adult↗

PubMed2004

NT-brain natriuretic peptide levels in pleural fluid distinguish between pleural transudates and exudates.

BACKGROUND: Pleural effusion is not pathognomic and distinguishing between transudates and exudates often presents a diagnostic dilemma. The purpose of our study was to examine whether the inclusion of pleural fluid brain natriuretic peptide (BNP) measurement into the analysis improves the diagnostic accuracy of pleural effusion. METHODS: The pleural effusion of 14 patients with CHF (group A) and 14 subjects with different pleural pathology (group B) were analyzed. Samples of pleural fluid and serum were obtained from all patients on admission and biochemical analysis, bacterial and fungal culture, acid-fast bacilli smear and culture and cytology were performed on the pleural fluid. In vitro quantitative determination of N-terminal pro-Brain natriuretic peptide (NT-proBNP) in serum and pleural fluid were performed by electrochemiluminescence immunoassay proBNP method on an Elecsys 2010 (Roche) analyzer. RESULTS: The median NT-proBNP levels in groups A and B were 6295 pg/ml and 276 pg/ml, respectively: (P=0.0001). There was no overlap between the two groups. While the Light's criteria had a sensitivity of 93% and specificity of 43% for transudates, the pleural fluid NT-proBNP level accurately differentiated between the two groups. CONCLUSIONS: The pleural NT-proBNP levels were elevated in all patients who had transudate. Therefore if the NT-proBNP levels of pleural effusion are within the normal range, transudate resulting from congestive heart failure can be ruled out. Our results suggest that the inclusion of pleural fluid NT-proBNP measurement in the routine diagnostic panel would enhance discrimination among the different causes of pleural effusions.

Aged↗

PubMed2003

[Effectiveness of Gemzar-Cisplatin therapy in stage IIIA-N2, IIIB and IV non-small cell lung cancer].

UNLABELLED: 120 chemotherapy naive patients were treated with gemcitabine 1250 mg/m2 iv. days 1 and 8 and cisplatin 70 mg/m2 iv. on day 1 between May 1999 and June 2001. The treatments were administered in 21 cycles. The median age of the patients was 53.1 years, the male/female ratio 65%-35%. Performance status was: WHO 0: 26%, WHO 1: 74%. The staging of patients were: IIIA-N2 23%, IIIB 37%, IV 40%. By histology the tumors were: 53.3% adenocarcinoma, 40% squamous cell carcinoma, 2.5% adenosquamous carcinoma, 0.8% macrocellular carcinoma and 3% non-small cell carcinoma (not categorised). We evaluated 413 cycles of chemotherapy. The median number of cycles was 3.44. The primary endpoint of the study was the median survival and time to progression, and the response rate. The results are the following: RR 40% (PR 37.5%, CR 2.5%), MR 13.3%, SD 25%, PD 22%. The time to progression (TTP) in the SD+MR group: 29.8 weeks, in the RR group: 34.1 weeks, mean of all patients: 28.1 weeks. The survival time was estimated by Kaplan-Meier curves. The median survival (MS) of all treated patients was: 54.9 weeks, in the PD group: 34.4 weeks, in the SD+MR group: 59.1 weeks, in the PR+CR group: 62.1 weeks. CONCLUSION: gemcitabine and cisplatin combination is a very well tolerated therapeutic regimen in the 1st line treatment of NSCLC. Furthermore, this treatment improves the RR and the survival of the patients as well.

Adenocarcinoma↗

PubMed2002

[Endobronchial ultrasonography].

Endobronchial ultrasonography is an imaging method which has been developed during the last decade. It can be performed by applying tools that are used today during conventional bronchofiberscopy. This method is recommended for identifying processes that affect the bronchial wall and the mediastinal lesions next to central airways as well as for localizing peripheral lung lesions. The authors present a compilation of publications and summarize their own experiences based on 44 cases of application of this method.

Bronchi↗

PubMed2002

[Tumor-like tracheal and lung diseases in biopsy samples].

Tumor like miscellaneous lung diseases are rare conditions. They can be confused with benign and malignant tumors. We describe the clinicopathological features some of this conditions i.e.: two cases of osteoplastic tracheopathy, one inflammatory tracheal polyp, two cases of tumor mimicking foreign body aspiration, and one case of tracheobronchial amyloidosis.

Amyloidosis↗

PubMed2002

[Benign pulmonary and tracheal tumors in our biopsies].

INTRODUCTION: Benign lung and trachea tumors account for only a small percentage of a bronchologist's and a histopathologist's everyday practice. AIMS: The authors describe the clinicopathological features some of these tumors because they may be confused with malignant conditions. To avoid misdiagnosis of malignancy the knowledge of bronchologic and histologic appearance of these tumors is important. RESULTS: In the past three years 1453 cases were examined and 14 cases of benign tumors were diagnosed, which is 1% of the total number of biopsies and 2.68% of the tumor cases. The diagnoses were: granular cell tumor (Abrokosoff's tumor), neurilemmoma, hemangioma, endobronchial hamartoma, and papillary adenoma. Two of the reported tumors: granular cell tumor and papillary adenoma appeared in the trachea. Tracheal granular cell tumor and bronchial hemangioma were incidental findings beside bronchial carcinoma. CONCLUSION: To our best knowledge this is the fifth reported case of the coexistence of Abrikossoff's tumor with bronchial carcinoma.

Adult↗

PubMed2000

[Diagnosis of lung cancer]

Lung cancer is the most common malignant tumor among male and second among female. The most effective diagnostic tool would be the early detection of the lung cancer. The diagnosis of tumors has to be based on patho-morphological findings. The invasive diagnostic tools can be used if the proved lung process has any therapeutic consequence. Only an experienced team has the chance to examine quickly and effectively the patients.In Hungary there are pulmonological centers where these teams consisting of pneumonologist, radiologists and pathologists are working effectively.

Journal Article↗

PubMed1996

Lung Cancer: A Bronchoscopic Approach.

The unfavourable epidemiological data of lung cancer has not been changed during the past ten years. The only possibility to cure this malignancy is surgical resection. The five year survival rate after surgery is highly dependent on early discovery of the tumor. Today, bronchoscopy plays a central role in the diagnosis staging and therapy of lung cancer. The main indications of diagnostic bronchoscopy are the identification of the tumor and the determination of its extent. The aim of therapeutic bronchoscopy - laser photocoagulation, high dose rate afterloading irradiation and stent implantation - is to provide an acceptable quality of life and to manage symptoms such as bleeding, cough and dyspnea.

Journal Article↗

PubMed1996

Differential Expression of Markers in Extensive and Restricted Langerhans Cell Histiocytosis (LCH).

Langerhans cell histiocytosis (LCH) represents a poorly defined pathologic entity characterized by diverse clinical appearence and falling into two major categories namely a restricted and an extensive disease. Since the outcome and the course of the disease is variable, we postulated that this might be reflected by the phenotype of the Langerhans cells. We have selected 11 adult restricted cases and 10 extensive childhood cases and compared the phenotype of LCH cells by immunohistochemistry on paraffin sections. Morphometric analysis indicated a significantly higher expression of histiocytic (CD68, S-100, lysozyme) markers in the adult restricted cases compared to the extensive form of the disease. Both groups were equally positive for LCH marker CD1a and negative for T cell marker CD4. On the other hand, HLA-DR expression was significantly higher in LCH cells of the extensive childhood cases suggesting higher activation. These data suggest that LCH cells have a different phenotype in the extensive childhood and restricted adult LCH where the latter is characterized by a more differentiated histiocytic phenotype.

Journal Article↗

PubMedDate not supplied

Efficacy of gemcitabine--cisplatin treatment in stage IIIA ("bulky"N2), IIIB and IV non-small cell lung cancer.

UNLABELLED: The objective of the study was to assess the efficacy of a gemcitabine and cisplatin combination for patients with stage IIIA"bulky"N2, IIIB or IV non-small cell lung cancer(NSCLC). PATIENTS AND METHODS: Patients with histological and/or cytological diagnosis of NSCLC were administered gemcitabine 1250 mg/m2 on days 1 and 8, and cisplatin 70 mg/m2 on day 1, every 3 weeks. RESULTS: One hundred and twenty patients with NSCLC, with median age of 53 years, and a WHO performance status of 0 (26%) or 1 (74%), were evaluated. The overall response rate was 40.0% with 37.5% partial response (PR) and 2.5% complete response (CR). Also, 38% of the patients had either minimal response (MR) or stable disease (SD). The median survival was 54.9 weeks. The time to progression was 28.1 weeks. There was no treatment-related death in this series. CTC grade 3/4 neutropenia occurred in 4.4% of the patients, while febrile neutropenia developed in 0,9% of the patients. CTC grade 4 thrombocytopenia occurred in 2.2%, and CTC grade 3/4 anemia developed in 3.3%. CONCLUSION: Our results support that gemcitabine and cisplatin administered as a 3-week cycle is an effective and safe regimen for the treatment of locally advanced or metastatic NSCLC.

Adult↗