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Biomedical subjects

Z Nagy

Publications and source records attributed to Z Nagy.

At least 55 records · Page 3Linked to original sources
PubMed2001

Influence of hypertension and smoking as the single vascular risk factors on the intima-media thickness.

In order to compare the extent of early carotid atherosclerosis between patients with single vascular risk factors (smoking = SMO or hypertension = HYP) and risk-free normal subjects (= HCS), we used intimal-medial wall thickness (IMT) measurements of the common carotid artery. The age- and sex-adjusted mean IMTs were significantly higher in the HYP and SMO groups than in the HCS control group (p < 0.005 and p < 0.001, respectively). The estimated yearly progression rate of IMT (average difference in IMT/year age difference) was significantly higher in the HYP and SMO groups than in the HCS group (p < 0.05). In the total group, the age, hypertension, smoking and sex accounted for 52% of the variability of IMT. Our results show that the estimated yearly progression rate of IMT is slower in healthy and risk-free volunteers than previously detected and that the smoking and hypertension have a similar effect to the progression of early atherosclerosis. This also emphasises the influence of smoking in initial vascular remodelling process.

Analysis of Variance↗
PubMed2001

Evidences of vascular origin of cochleovestibular dysfunction.

OBJECTIVES: When the vascular disorder of the cochleovestibular system is mentioned, the diagnosis is based on exclusion of other diseases. Since arteries of the cochleovestibular system cannot be directly visualized, physicians must deduce from the vascular risk factors and the vascular lesion of other territories to the vascular cochleovestibular disease. MATERIALS AND METHODS: Authors analyzed the data of 19 patients with vertigo. Detailed blood tests, complete neurootological and audiological examination including ABR, carotid and vertebral artery Doppler sonography, MRI and MRA was performed. RESULTS: Cochleovestibular examination and ABR showed abnormalities in 73.7%, either carotid and vertebral artery Doppler or MRI showed abnormalities in 57.9%. MRA was abnormal in 47.4%. In most of the patients multiple risk factors of cerebrovascular disorder could be found. CONCLUSIONS: The cochleovestibular system disorders can be considered to be of vascular origin if the examinations exclude other diseases, if the patients have vascular risk factors and if other territories of brain accessible for imaging methods show vascular disorders.

Carotid Arteries↗
PubMed2001

Anosmia in dementia is associated with Lewy bodies rather than Alzheimer's pathology.

OBJECTIVES: To assess olfactory function of patients with dementia. Odour detection ability is impaired in clinical Parkinson's disease. Evidence of impaired detection in patients with clinically diagnosed Alzheimer's disease is inconsistent. No studies of olfaction have been neuropathologically validated. METHODS: The olfactory function of 92 patients with dementia and 94 controls was assessed using a simple bedside test as part of the Oxford Project To Investigate Memory and Ageing (OPTIMA). Neuropathological assessment was made of cortical Lewy bodies and substantia nigra (SN) cell counts and of Alzheimer's disease in all 92 patients, 22 of whom had SN Lewy bodies and 43 of whom had only Alzheimer's disease. RESULTS: Patients with Lewy bodies were more likely to be anosmic than those with Alzheimer's disease or controls. Patients with Alzheimer's disease were not more likely to be anosmic than controls. Nor was anosmia associated with degree of neurofibrillary tangles, as assessed by Braak stage. Among subjects with Lewy bodies, overall cortical Lewy body scores and Lewy body density in the cingulate were higher in those who were anosmic. Consensus clinical criteria for dementia with Lewy bodies had a sensitivity of 64% and specificity of 89%. In the absence of definite Alzheimer's disease, the criteria had sensitivity of 100%. In patients with definite Alzheimer's disease, anosmia was slightly more sensitive (55%) than the consensus criteria (33%). However, the addition of anosmia to the consensus criteria did not improve their overall performance. CONCLUSION: Dementia with Lewy bodies is associated with impaired odour detection. Misdiagnosis may have accounted for some previous reports of impaired odour detection in Alzheimer's disease. Simple but more sensitive tests of anosmia are required if they are to be clinically useful in identifying patients with dementia with Lewy bodies.

Aged↗
PubMed2001

Stimulation of interleukin-6 promoter by parathyroid hormone, tumor necrosis factor alpha, and interleukin-1beta in UMR-106 osteoblastic cells is inhibited by protein kinase C antagonists.

To investigate the level at which protein kinase C (PKC) regulates expression of interleukin-6 (IL-6) in osteoblastic cells, effects of several PKC antagonists and PKC down-regulation by phorbol ester were studied in UMR-106 osteoblastic cells that had been transiently transfected with a -224/+11-base pair (bp) IL-6 promoter coupled to a luciferase reporter. Parathyroid hormone (PTH) elicited a dose-dependent stimulation of the IL-6 promoter expression, with significant increases produced by 5 h of treatment with concentrations of PTH as low as 10(-14) M. The increase in IL-6 promoter expression was inhibited by the PKC antagonists GF109203X, 30 nM to 1 microM, and calphostin C, 250 nM. Prior down-regulation of PKC with 100 nM phorbol-12,13-dibutyrate (PDBU) for 48 h inhibited the PTH effect as well as the smaller stimulatory effects elicited by tumor necrosis factor alpha (TNF-alpha), 10(-9)-10(-8) M, and by IL-1beta, 1-10 ng/ml. In contrast to these findings, the stimulatory effects of PTH, TNF-alpha, and IL-1beta on the IL-6 promoter expression were enhanced by staurosporine. Treatment with GF109203X or down-regulation of PKC with PDBU prevented the stimulatory effects of staurosporine. PKC activity was increased by staurosporine. The findings with staurosporine are consistent with our earlier observations that this agent enhances the calcium signaling and bone resorption elicited by PTH. The studies support the role of PKC in the stimulatory effects of PTH, TNF-alpha, and IL-1beta on IL-6 expression.

Animals↗
PubMed2001

[Sapheno-peritoneal shunt for the treatment of ascites].

For the surgical treatment of drug resistant ascites caused by hepatic cirrhosis usually different types of valvular plastic tubes are used, implanted as peritoneo-venous shunts. These shunts drain the ascites into the jugular vein. In the 1st Surgical Department of the Semmelweis University Budapest we have performed 267 peritoneo-venous shunt operations. We introduced a new method using an autolog venous graft with a peritoneo-venous anastomosis, that drains the ascites into the saphenous, then femoral vein. So far we performed 5 such interventions. The early results suggest that sapheno-peritoneal shunt can be successfully used for treatment of ascites. With this operation complications of plastic grafts are avoidable.

Ascites↗
PubMed2001

[True aneurysm of the deep femoral artery].

Aneurysms of the profunda femoris artery are very rare. The frequency of these aneurysms is 0.5-1% of all peripheral atherosclerotic aneurysms. This condition can be symptom free for an extended period of time. In one third of the patients, palpable, pulsating swelling appears in the groin. Complications such as rupture, peripherial embolism, deep vein thrombosis, depending on the condition of the arteries ischaemia in the leg can develop. Treatment of this condition according to the literature is resection of the aneurysm with reconstruction of the artery. Our practice is the same. If diagnosis is achieved surgery is necessary to avoid further complications. The literature review from 1960 presents 51 patients with the disease, we added 3 of our own cases to this number.

Aneurysm↗
PubMed2001

[Successfully operated infraperitoneal hemangiopericytoma infiltrating the left ureter].

Hemangiopericytoma is a very rare tumour originating from the lining cells of small vessels. Despite benign histology it is clinical presentation similar to malignancy. There are only less than hundred cases reported sporadically in the literature. Authors report a case and successful radical removal of an infraperitoneal hemangiopericytoma infiltrating the left ureter. The literature of this strange, rare pathology is also analysed in the article.

Adult↗
PubMed2001

[Rare indication for surgery: liver metastasis of planocellular laryngeal cancer].

This is a report of a successfully operated case of a solid liver metastasis developed following radical total laryngeal extirpation. The biological characteristic of the laryngeal cancer is also discussed from the surgical point of view. We underline the importance of a detailed, regular control of patients with malignancies and encourage of active surgical treatment of solid metachronous liver metastases.

Carcinoma, Squamous Cell↗
PubMed2001

[The role of the V-Y plastics in vascular reconstructions directed to the deep femoral artery].

Because of the arteriosclerotic involvement of the superficial femoral artery, considerable part of the aorto-femoral reconstructions is performed with an anastomosis on the deep femoral artery. Stenosis of the deep femoral artery is usually limited to the bifurcation or to the first part of the artery; therefore the choice of treatment is desobliteration, or bypass below the bifurcation. This article describes a form of reconstruction which is suitable for direct endarterectomy of the deep femoral artery, without vein or plastic patch. The experience and advantages of this method are analysed.

Endarterectomy↗
PubMed2000

[Are the hemochromatosis (HFE) gene mutation and hepatitis C virus (HCV) infection risk factors for porphyria cutanea tarda?].

As it is not clear whether mutations in hemochromatosis gene (HFE) and hepatitis C virus (HCV) act independently in the pathogenesis of porphyria cutanea tarda (PCT), and prevalence of both risk factors reveals a great variety in different parts of the world, PCT patients from our Central East European country were investigated for this aspect. The occurrence of the C282Y and H63D mutations in HFE gene were determined in 19 PCT patients and compared with the reported control frequencies. Furthermore, the presence of HCV infection was determined and related to the patients' HFE status. The C282Y mutation was found in 3/19 cases (one patient was homozygous and two heterozygous), with an 10.5% allele frequency (vs. 3.8% control) (p < 0.05). Five patients were heterozygous for the H63D mutation, allele frequency 13.1%, which did not differ from the reported control prevalence of 12.3%. Six patients (31.7%) were HCV-RNA positive, out of the six one was heterozygous for H63D mutation and one was compound heterozygous. HCV infection and HFE C282Y mutations may probably be independent predisposing factors for development of PCT in Hungarian patients.

Adult↗
PubMed2000

[MR-guided diagnostic and therapeutic interventions. Review and own preliminary experience].

Magnetic resonance (MR) guided diagnostic and therapeutic interventions are relatively new methods in the larger field of radiologic interventions. Good spatial resolution and soft tissue characterisation, multiplanar imaging capability, functional imaging and up-to-date computer systems enable MR imaging to guide a wide range of interventional procedures. Biopsies, punctures and drainages of fluid collections, tumor ablations and vascular interventions can be performed with the help of MRI. MR imaging provides an unique opportunity for planning, guiding and monitoring certain types of intraoperative procedures. The authors outline the basic features of MR intervention and report their own initial experience in interventional procedures in 8 cases for the first time in Hungary.

Abscess↗
PubMed2000

Peptide and peptide mimetic inhibitors of antigen presentation by HLA-DR class II MHC molecules. Design, structure-activity relationships, and X-ray crystal structures.

Molecular features of ligand binding to MHC class II HLA-DR molecules have been elucidated through a combination of peptide structure-activity studies and structure-based drug design, resulting in analogues with nanomolar affinity in binding assays. Stabilization of lead compounds against cathepsin B cleavage by N-methylation of noncritical backbone NH groups or by dipeptide mimetic substitutions has generated analogues that compete effectively against protein antigens in cellular assays, resulting in inhibition of T-cell proliferation. Crystal structures of four ternary complexes of different peptide mimetics with the rheumatoid arthritis-linked MHC DRB10401 and the bacterial superantigen SEB have been obtained. Peptide-sugar hybrids have also been identified using a structure-based design approach in which the sugar residue replaces a dipeptide. These studies illustrate the complementary roles played by phage display library methods, peptide analogue SAR, peptide mimetics substitutions, and structure-based drug design in the discovery of inhibitors of antigen presentation by MHC class II HLA-DR molecules.

Antigen Presentation↗
PubMed2000

[The cumulative risk index in stroke prevention].

The screening and special management of high risk patient, is possible strategy to reduce the high morbidity and mortality of stroke. In the II. district of Budapest we examined high vascular risk patients cooperating with general practitioners. We let the severity of risk with arithmetic of the cumulative risk index. Significant relation was found between of high cumulative risk index and 50% or higher carotis stenosis, as well as the cumulative risk index and low Se HDL level. Increased blood pressure level has been found in among the treated hypertonic patient. Reduction of high blood pressure was documented in the 6 month control examination. Finally there was very low level of smoking in the high vascular risk patient group.

Aged↗
PubMed2000

Prevention of corticosteroid-induced osteoporosis by alfacalcidol.

We studied the effect of alphacalcidol (1-alpha-hydroxycholecalciferol) on bone metabolism in patients who were placed on glucocorticoid therapy. We selected 41 women (age: 32-52 yrs) who were recently diagnosed with systemic lupus erythematodes, multiple sclerosis, rheumatoid arthritis or asthma bronchiale. Patients did not have other disease or take drugs known to influence bone metabolism. Patients were randomly enrolled into two groups and were given 5-25 mg prednisone daily. After 4 weeks, group A (n = 21) received 0.5-1.0 microgram (mean = 0.54 +/- 0.03 microgram) alphacalcidol and group B (control; n = 20) was given 500 mg calcium daily for three years. There were no significant differences in age and steroid doses between groups. Serum calcium (Ca), osteocalcin (OC), collagen I C-terminal propeptide (PICP), parathyroid hormone (PTH), and urinary calcium and deoxypyridinoline crosslink excretion (DPD) were measured before corticosteroid administration, and before alphacalcidol or calcium treatment as well as 6 weeks, 6 months, and 1, 2, and 3 years later. Bone mineral density (BMD) was examined before treatment and 6 months, 1, 2, and 3 years later by DEXA and SPA. OC and PICP decreased significantly after 4 weeks on steroid in both groups and increased in group A but not in group B after 6 weeks of treatment with alphacalcidol and remained unchanged for 3 years. Serum PTH increased in both groups after 4 weeks of glucocorticoid treatment and was reduced in group A, but not in group B, after 6 weeks on alphacalcidol. Serum Ca, urinary Ca, and DPD did not change significantly in either group during the study period. Lumbar spine and femoral neck BMD were significantly reduced in group B after 6 months and 1 year, respectively, and continued to decrease during the study, while no significant change in group A was observed. BMD of the radius did not change in either group for 2 years but there was a significant reduction by the third year in group B. Based on these results, alphacalcidol treatment appears to be effective in preventing glucocorticoid-induced bone loss in these patients by reducing secondary hyperparathyroidism and stimulating bone formation.

Adjuvants, Immunologic↗
PubMed2000

Coexisting pathologies in the brain: influence of vascular disease and Parkinson's disease on Alzheimer's pathology in the hippocampus.

The finding of more than one coexisting brain pathology in dementia sufferers is not unusual. However, it is unclear how these different diseases may interact or influence the evolution of one another. In this study we analyse the hippocampal expression patterns of hyperphosphorylated tau, paired helical filament (PHF)-related protein, beta-amyloid and synaptophysin in a group of Alzheimer's disease (AD) sufferers with and without additional pathology. Compared to cases with only AD-type pathology we found that the presence of additional vascular disease augmented the accumulation of hyperphosphorylated tau in the CA1 region of the hippocampus without affecting PHF formation in cases with mild AD changes and reduced the extent of PHF formation in the CA2/3 and CA4 regions of the hippocampus in cases with severe AD pathology. We also found that synaptophysin immunoreactivity in the CA4 and dentate gyrus in pure AD was inversely related to the extent of amyloid accumulation but not to neurofibrillary pathology in the same regions. These relationships were lost when additional pathology was present. Memory scores obtained during life correlated closely with hyperphosphorylated tau and PHF-related protein expression in CA1 in pure AD but not in AD with additional pathology. Total amyloid and synaptophysin expression in the hippocampus did not correlate with memory scores in any patient group. Our findings suggest that the interactions of two pathologies in the hippocampus are complex and may differ depending on the stage reached in the evolution of a progressive disease such as AD.

Aged↗
PubMed2000

Association of butyrylcholinesterase K variant with cholinesterase-positive neuritic plaques in the temporal cortex in late-onset Alzheimer's disease.

In confirmed late-onset (>65 years) Alzheimer's disease, we found a greater load, both of overall neuritic plaques and of cholinesterase-positive neuritic plaques, in the temporal cortex of carriers of the butyrylcholinesterase K variant (BCHE-K) aged <80 years than of all other patients. The differences were most striking in the case of cholinesterase-positive neuritic plaques. Among BCHE-K carriers, densities of such plaques were over six times higher in patients <80 years at death than in those >80 years (P=0.01). Furthermore, in subjects <80 years, BCHE-K carriers had nearly six-fold greater densities of these plaques than non-carriers (P=0.009). We consider three potential explanations for these findings: that the K variant binds more readily to plaque constituents, that it promotes fibril formation or that it induces aberrant neurite growth.

Age of Onset↗