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Biomedical subjects

L Csernay

Publications and source records attributed to L Csernay.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Prion dementias: nosology and diagnostic difficulties in the spectrum of Creutzfeld-Jakob encephalopathy].

Creutzfeldt-Jakob disease (CJD) is one form of subacute prion diseases with spongiform encephalopathy. Hereditary, infectious and sporadic types of the disorder can be distinguished. The abnormal transformation of the prion protein, relevant in the normal synaptic transmission is considered as an important factor in the development of this disease. Gerstmann-Sträussler-Scheinker syndrome (GSS) and familial fatal insomnia (FFI) are the other diseases belonging to the same disease spectrum. The common feature of these disorders is that the different mutation of the same prion protein could result in different phenotypes and symptoms. CJD is considered as a neurologic disorder but the clinical symptoms and differential diagnosis of the disease are also relevant problems in psychiatry. Because of the early onset of dementia and the psychotic and delusive symptoms, the patients with CJD are frequently admitted to psychiatric wards. Recently worldwide public interest has been focused on prion dementias because of the possible human transmission of bovine spongiform encephalopathy in the UK. The diagnostic problems of our seven CJD patients diagnosed since 1991 in the catchment area of Szeged city are discussed in the view of recent findings of molecular biology, nosology, diagnostic and therapeutic problems of this devastating disease.

Adult↗
PubMed1997

[First Hungarian experiences with positron emission tomography (PET) studies. Members of the PET working group].

Diagnostic investigations commenced on the 28th of June 1994 in Hungary's and Central Europe's first PET Centre at the University Medical School of Debrecen. The Centre is equipped with a GE 4096 Plus whole body PET scanner. A metabolic tracer, 18F-deoxy-D-glucose (FDG), was used in the investigations. During the first 15 months 249 PET investigations were made in the Centre of which 242 were diagnostic and 7 normal subjects served as control for the patient studies with brain scans. The number of oncological indications (intra- and extracranial tumours, Hodgkin's lymphomas) was n = 105 (43.4% of the 242 diagnostic examinations), neurological investigations (without intracranial tumours) formed the dominant group (n = 117; 48.3%), whereas the number of cardiological indications was 20 (8.3%). The oncological studies included those of intracranial tumours (n = 76; 31.4%); thyroid tumours (n = 9; 3.7%); Hodgkin's lymphomas (n = 7; 2.9%) and other extracranial tumours (n = 13; 5.4%). The distribution of different neurological and psychiatric investigations was as follows: localization of focal epileptogen zone (n = 60; 24.8%); differential diagnosis of dementias (n = 30; 12.4%); exploration of cerebrovascular diseases (n = 10; 4.1%); and other neurological diseases (n = 17; 7.0%). The main objective of the cardiological PET investigations was the exploration of viable myocardium. The present paper overviews both the procedures (including administrative issues, as well) and the results of the first 249 FDG-PET investigations.

Aged↗
PubMed1997

Prognostic role of 99mTc-HM-PAO-leukocyte scintigraphy in acute pancreatitis and in patients with pancreatic pseudocysts.

Fifty-five leukocyte scintigraphies were performed. Thirty-five patients (group 1) with acute pancreatitis in the early phase and 20 patients (group 2) with pancreatic chronic pseudocysts following acute pancreatitis were tested. The clinical features, laboratory parameters, and Ranson classifications were registered during hospitalization. In group 1, most of the cases with a severe clinical outcome gave positive leukocyte scintigraphic results (10/12). Leukocyte accumulation was also detected in patients with mild acute pancreatitis (4/23), but at a lower frequency. In the acute phase, significant differences in laboratory parameters (sedimentation rate and leukocyte count) were found in the leukocyte scintigraphy-positive versus-negative cases. The scintigraphic activity correlated with the sedimentation rate, leukocyte count, fever, and duration of hospitalization. In group 2 there were five cases with a positive leukocyte scan. A pancreatic abscess was found in four of them during surgery. In seven patients with a normal scintigram, surgery revealed a noninfected pancreatic pseudocyst. Leukocyte infiltration of the pancreas can be demonstrated by leukocyte scintigraphy. A positive leukocyte scan indicated a severe course of acute pancreatitis. The method also seems useful for differentiation between infected and noninfected chronic pancreatic pseudocysts.

Acute Disease↗
PubMed1997

Effect of glyceryl trinitrate on the sphincter of Oddi spasm evoked by prostigmine-morphine administration.

OBJECTIVE: In this study the effect of glyceryl trinitrate on the prostigmine-morphine-induced sphincter of Oddi spasm was evaluated in nine female patients with sphincter of Oddi dyskinesia. METHOD: Sphincter of Oddi spasm was induced by prostigmine-morphine administration (0.5 mg prostigmine intramuscularly and 10 mg morphine subcutaneously) and visualized by quantitative hepatobiliary scintigraphy. The entire procedure was repeated during glyceryl trinitrate infusion (Nitrolingual 1 microg/kg/min for 120 min). RESULTS: Prostigmine-morphine provocation caused significant increases in the time to peak activity (Tmax) over the hepatic hilum (HH: 34.33 +/- 5.05 vs. 22.77 +/- 3.26) and the common bile duct (CBD: 60.44 +/- 5.99 vs. 40.0 +/- 2.88) and in the half-time of excretion (T1/2) over the liver parenchyma (LP: 120.04 +/- 16.01 vs. 27.37 +/- 2.19), HH (117.61 +/- 14.71 vs. 31.85 +/- 3.99) and CBD (158.11 +/- 9.18 vs. 40.1 +/- 6.24), indicating a complete spasm at the level of the sphincter of Oddi. Glyceryl trinitrate infusion completely normalized the prostigmine-morphine-induced alterations in these quantitative parameters (TmaX over the LP: 11.33 +/- 1.13; over the HH: 18.88 +/- 1.48; and over the CBD: 36.22 +/- 1.92; and T1/2 over the LP: 28.21 +/- 1.83; over the HH: 33.42 +/- 3.10; and over the CBD: 41.66 +/- 6.33), suggesting an effective sphincter-relaxing effect of glyceryl trinitrate. CONCLUSION: These results provide the first evidence of the effectiveness of glyceryl trinitrate on the morphine-induced sphincter of Oddi spasm in humans. Since glyceryl trinitrate is able to overcome even the drastic effect of morphine, it might be of relevance in the treatment of sphincter of Oddi dyskinesia.

Adult↗
PubMed1996

[Cerebral blood flow studied by SPECT and transcranial Doppler sonography in subarachnoid hemorrhage].

The detection of vasospasm plays an important role for the definition of the strategy of treatment in patients with subarachnoid hemorrhage (SAH). Besides the invasive contrast angiography, the non-invasive 99m-Tc-HMPAO brain perfusion SPECT and transcranial Doppler sonography (TCD) are recently used for this purpose. For the investigation of the possibilities of the last two methods, comparative studies were performed in 29 SAH patients in the subacute phase of the disease. In the detection of regional brain ischaemia the sensitivity of the SPECT study was 90%, the specificity was 28% and the accuracy was 50%, the corresponding values of TCD were 82%, 71% and 75%. In patients, in whom chronic neurological symptoms, or morphological abnormalities could be excluded, the specificity of the SPECT study was 67% at unchanged sensitivity. Based on the results it is concluded, that the brain perfusion SPECT and the TCD investigation are useful methods for the detection of vasospasm after SAH. The combination of the two methods is recommended for the correct diagnosis of vasospasm in SAH. Further investigations are necessary to clarify the prognostic impact of the result of these investigations.

Adult↗
PubMed1996

[Bone mineral content in osteogenesis imperfecta].

Bone mineral content (BMC) in the radius of 23 osteogenesis imperfecta (OI) patients (1-26 yr) was measured with SPA technique. Comparing the values of OI type I. patients with that of type III. patients, the decrease of BMC was more prominent in the latter group, however, the two group hadn't been distinct from each other at p < 0.05 level. Based on the measurements of 39 relatives (mother, father, brother) the method seems not to be helpful in screening of gene-carrying relatives because of the high variability of the phenotype of the disease. Follow-up SPA studies-avoiding the repositioning errors-inform about the therapeutic effect.

Absorptiometry, Photon↗
PubMed1996

Anti-granulocyte immunoscintigraphy and [99mTc]hexamethylpropyleneamine-oxime-labeled leukocyte scintigraphy in inflammatory bowel disease.

A prospective study was carried out on 13 patients with ulcerative colitis and 11 with Crohn's disease to compare the value of radioimmunoscintigraphy involving 99mTc-labeled antigranulocyte monoclonal antibody (BW 250/183) with that of hexamethylpropyleneamine-oxime-labeled leukocyte scintigraphy. The extent of the process (various segments of the small bowel; ascending, transverse, and descending colon; and rectosigmoideum) was determined in 115 segments by means of radioimmunoscintigraphy and leukocyte scintigraphy and compared with the results of enteroclysis and colonoscopy in 64 segments. The scintigraphic activity, calculated by summing the segment scores, was compared with clinical and laboratory parameters. During radioimmunoscintigraphy, the 24-hr fecal excretion of the antibody was measured. The two methods revealed a different extent of the process (P<0.01). The segmental sensitivity and specificity were 63% and 96% in radioimmunoscintigraphy, and 87% and 94% in leukocyte scintigraphy. Leukocyte scintigraphy proved to be superior in cases with small intestine involvement, but the methods are of similar value in cases with large bowel involvement. The scintigraphic activity determined by radioimmunoscintigraphy and the fecal excretion of monoclonal antibody correlated with seven parameters, while that determined by leukocyte scintigraphy did so with 12 variables. Both methods are of similar value for the detection of large bowel involvement, but leukocyte scintigraphy was the better method for determination of the involved segments in the small intestine. The scintigraphic activity proved a useful parameter, correlating well with the clinical and laboratory variables.

Adult↗
PubMed1996

HM-PAO-labeled leukocyte scintigraphy in pediatric patients with inflammatory bowel disease.

Leukocyte scintigraphy (LS) was performed in 20 pediatric patients with inflammatory bowel disease (IBD: 10 with ulcerative colitis, 2 with indeterminate colitis, and 8 with Crohn disease) in different stages of clinical activity. Leukocytes were separated from 15 to 60 ml venous blood and were labeled in vitro with [99mTc]HM-PAO. The segmental extent (small intestine; ascending, transverse, and descending colon; and recto-sigmoideum) of the process was determined by LS. The uptake of each bowel segment was scored in relation to the bone marrow uptake. The scintigraphic activity, calculated by summing the segment scores, was compared with laboratory parameters. The mean labeling efficacy was 76% (60-86%). The segmental extent of the process determined by LS was compared with the results of barium enema or colonoscopy with regard to 32 bowel segments. The sensitivity, specificity, and accuracy of LS were 93, 88, and 91%, respectively. Two extraintestinal manifestations (abdominal abscess and joint involvement) were also detected by LS. These lesions were verified by computed tomography (CT) (abscess) and on the basis of the clinical outcome (arthritis). The scintigraphic activity correlated with the C-reactive protein (CRP) level (r = 0.82, p < 0.001), the alpha 2-globulin level (r = 0.63, p < 0.02), the sedimentation rate (r = 0.51, p < 0.05), and the fS iron level (r = -0.66, p < 0.005). LS is applicable in pediatric patients. The method is an excellent technique for assessment of the extent of IBD in children. Extraintestinal manifestations of IBD can also be investigated by LS. The scintigraphic activity is a useful parameter for determination of the activity of IBD in children.

Adolescent↗
PubMed1995

Our policy in diagnosis and treatment of hydrocephalus.

The authors present the policy they have worked out for hydrocephalus patients with special reference to the pressure measurement and test methods and to rCBF, SPECT and transcranial Doppler sonography (TDC) studies. For diagnosis, the protocol proposed by Gjerris and Borgesen was followed in 75 cases: besides other methods (CT, radionuclide cisternography, MRI) the intracranial pressure waves routinely recorded and analyzed by means of ventricular catheters for 24 h. The patients were roughly divided into groups in terms of diagnosis, baseline pressure, compliance, results of infusion tests and of surgery. In 13 patients the investigations were supplemented by rCBF SPECT and in 42 patients by TCD studies before and after CSF shunting or withdrawal to analyze the acute effects on cerebral circulation. Clinical follow-up shows that need for shunting was indicated fairly well by the common results of baseline ICP, compliance and infusion loading. The rCBF SPECT studies revealed a significant increase of the cerebral perfusion at the basal ganglia after shunting while, on the basis of CBF velocity changes three types of vasoregulatory response could be defined with TCD. In our hands, monitoring of the pressure and craniospinal capacity has proved to be a valuable aid in decisions on surgery; however, for a more precise (and beneficial) appreciation of whether surgery is indicated the vasoregulatory responses should also be taken into account in future.

Blood Flow Velocity↗
PubMed1995

Evaluation of results of the prostigmine-morphine test with quantitative hepatobiliary scintigraphy: a new method for the diagnosis of sphincter of Oddi dyskinesia.

Attempts have long been made to use the prostigmine-morphine provocation test for the selection of postcholecystectomy patients suffering from sphincter of Oddi (SO) dyskinesia. Since the whole procedure is based upon the evaluation of subjective complaints, this test has frequently been criticized. To improve the diagnostic value of this method, we have visualized SO spasms during prostigmine-morphine provocation by means of quantitative hepatobiliary scintigraphy (QHBS). Twenty-two cholecystectomized patients with typical postprandial biliary pain were included in this study. In the first series of studies, QHBS with technetium-99m 2,6-diethylphenylcarbamoylmethyl-diacetic acid was performed in each patient 2 days before prostigmine-morphine provocation. The time to peak activity (Tmax) and the half-time of excretion (T1/2) over the liver parenchyma (LP), hepatic hilum (HH) and common bile duct (CBD), and the duodenum appearance time (DAT), were determined and served as control values. In the second series of experiments, sphincter spasms were evoked by prostigmine-morphine administration and visualized by means of QHBS. The same parameters were evaluated and serum levels of aspartate aminotransferase (AST) were determined simultaneously at regular intervals. In 12 patients who responded to prostigmine-morphine provocation with typical biliary pain and a significant AST elevation (Nardi positive group) the hepatobiliary scintigram demonstrated a marked biliary obstruction. Tmax and T1/2 over the LP, HH and CBD were significantly increased, while DAT was significantly longer relative to the corresponding data obtained without provocation. Four of the remaining ten patients indicated atypical abdominal pain during prostigmine-morphine provocation, but the AST level remained unchanged in all ten (Nardi negative group).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Left ventricular dysfunction induced by occlusion of coronary arteries in conscious dogs.

The aim of the present study was to investigate stable left ventricular dysfunction resulting from severe myocardial ischemia in conscious dogs, in order to evaluate the action of cardiotonic agents under pathological conditions mimicking moderate cardiac failure. Mongrel dogs with a catheter implanted in the left ventricle were trained on a treadmill and subjected to a standardized exercise before and after a Harris-type ligation of the anterior descending branch of the left coronary artery in two stages. Two weeks later the lower third of the left circumflex coronary branch was also occluded, and the exercise test repeated for at least two additional weeks to evaluate the changes in the left ventricular function indicated by left ventricular systolic pressure, end-diastolic pressure, heart rate, positive and negative dP/dtmax and dP/dt/P. Noninvasive radionuclide investigations of the left ventricular function and myocardial perfusion were done before and after the development of cardiac failure. Following occlusion of the anterior descending and circumflex coronary arteries, the baseline end-diastolic pressure increased from 7.6 +/- 2.3 mmHg to 23.3 +/- 3.0 mmHg (p < 0.05) and increased even further during exercise (to 49.2 +/- 3.5 mmHg, p < 0.05). After the development of cardiac failure, no substantial change occurred in the end-diastolic pressure, either during rest or repeated exercise tests.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

[Radioisotope study of esophageal transit].

Diagnostics relating to esophageal motility disorders has come into the focus of attention in recent years. A review is made of the possibilities of application of radioisotope esophageal transit measurement. The methods employed and the models of data recording and processing in this field are listed. The value of this procedure in different esophageal disorders is discussed in detail. Two characteristic cases are reported to illustrate the method. It is concluded that measurement of the radionuclide esophageal transit is a noninvasive, simple and safe technique for the screening of esophageal motility dysfunction.

Esophageal Motility Disorders↗
PubMed1994

Differentiation between organic stenosis and functional dyskinesia of the sphincter of Oddi with amyl nitrite-augmented quantitative hepatobiliary scintigraphy.

Recurrent biliary pain after cholecystectomy is presumably due to sphincter of Oddi dysfunction (SOD). There is no ideal non-invasive test for SOD, and the diagnosis often relies on invasive procedures such as sphincter of Oddi (SO) manometry. Amyl nitrite-augmented quantitative hepatobiliary scintigraphy (QHBS) was performed on nine asymptomatic volunteers and 22 patients with SOD of biliary types I and II. Normal QHBS parameters were established in the asymptomatic volunteers. QHBS revealed a partial obstructive pattern in nine patients in whom SO stenosis was suspected and in 13 patients in whom SO dyskinesia was suspected. This obstructive pattern remained unchanged in the former group, but was completely relieved in the latter group of patients on amyl nitrite administration. In conclusion, amyl nitrite-augmented QHBS proved to be a useful non-invasive method in the diagnosis of SOD of biliary types I and II and permitted differentiation between organic stenosis and functional motor abnormalities of the SO.

Adult↗
PubMed1994

Evaluation of cerebral vasoreactivity by SPECT and transcranial Doppler sonography using the acetazolamide test.

rCBF SPECT with 99mTc-HMPAO was performed prospectively in 29 patients (3 controls and 26 stroke patients) as well as TCD studies in 20 patients (3 controls and 17 stroke patients) before and after 1 g i.v. acetazolamide. The sensitivity of rCBF SPECT increased from 62% to 77% after acetazolamide provocation in stroke patients. In patients with a reversible neurological deficit, the sensitivity under resting conditions was 50% which increased to 71%, while in cases with a permanent deficit it increased from 75% to 83%. In the evaluation of the cerebrovascular reserve capacity the results of rCBF SPECT and TCD coincided in 91% of the hemispheres. The correlation was statistically significant.

Acetazolamide↗
PubMed1993

[Value of the ejection fraction in patients with right ventricular necrosis during the rehabilitation period].

The right ventricular ejection fraction was determined in 58 patients with simultaneous right and left ventricular myocardial infarction and in 77 patients with only left ventricular myocardial infarction. The results were analysed in four groups of patients (patients with anterior, anterior and right ventricular, posterior, posterior and right ventricular myocardial infarction). Furthermore, the relation between left and right ventricular ejection fraction, stress capacity and heart volume was investigated. There was no influence of the age and gender of patients on the observed values of right and left ventricular ejection fraction. In younger patients, after myocardial infarction, the heart volume was found to be less and the stress capacity to be higher then in elderly patients. The right ventricular ejection fraction was normal in patients with "poor" left ventricular infarction, and it was decreased in patients with right ventricular myocardial infarction. The right ventricular ejection fraction did not influence the stress capacity and the heart volume of the patients. The left ventricular ejection fraction found to be less in anterior, compared to posterior myocardial infarction. This difference was independent on the presence of right ventricular infarction. The authors consider the decreased right ventricular ejection fraction as a valuable indicator of the abnormal contractility of the right ventricle even at the time of the rehabilitation after myocardial infarction.

Age Factors↗
PubMed1993

[Measurement of bone mineral content by single-photon absorptiometry in children].

Bone mineral content (BMC) was measured in 64 children (33 boys [aged 4-17] and 31 girls [aged 2-12]) having no signs of metabolic bone disease, at the distal third of their radius using single photon absorptiometry (SPA), to establish normative data. Relationships were studied between the obtained bone mineral content and the age, weight, as well as height of children. The obtained BMC values were compared with that of healthy Swedish and American children. Authors suggest the routine use of SPA in home children suffering from metabolic bone diseases.

Absorptiometry, Photon↗