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Biomedical subjects

A Vass

Publications and source records attributed to A Vass.

At least 19 recordsLinked to original sources
PubMed2001

Ultrasonography in the diagnosis and monitoring of ascites in acute abdominal attacks of hereditary angioneurotic oedema.

BACKGROUND: Hereditary angioneurotic oedema (HAE) is a rare cause of ascites. As acute abdominal attacks of the disease can mimic surgical emergencies, prompt and accurate diagnosis is essential. This study was undertaken to evaluate the usefulness of serial abdominal ultrasound (US) examinations. PATIENTS AND METHODS: Seventy patients with HAE were followed up for almost a decade. All patients presenting with an acute oedematous attack underwent abdominal US, which was then repeated 24 and 48 h after appropriate therapy. RESULTS: Twenty-two acute oedematous attacks with abdominal complaints severe enough to justify hospital admission occurred in the study population. Abdominal US performed during the attack showed oedematous thickening of the intestinal wall in 80% of cases and invariably demonstrated the presence of free peritoneal fluid in all patients. Rapid symptomatic relief achieved by treatment was accompanied by the significant regression of US abnormalities. CONCLUSIONS: Transitory ascites demonstrated by abdominal US is a clue to the diagnosis of an acute abdominal attack of HAE. The possibility of HAE should always be considered whenever unexplained abdominal pain recurs with or without ascites.

Abdomen, Acute↗
PubMed2000

[The clinical value of coronary flow reserve in ischemic heart disease as measured by dipyridamole stress transesophageal echocardiography].

The relationship between coronary flow reserve and the result of coronarography was examined. 152 patients were investigated by stress transoesophageal echocardiography and coronary angiography. The value of coronary flow reserve was significantly lower in cases of significant coronary stenosis than in those patients who had a normal coronarography (in patients with left anterior descending coronary artery stenosis: 1.77 +/- 0.47 vs in cases with normal coronary angiogram: 3.19 +/- 1.15). There was no difference in the value of CFR in those cases where not only LAD stenosis but CX or RC stenosis was also found. The value of coronary flow reserve was significantly higher in RC or CX patients than that of LAD patients. In patients with positive stress and negative coronarography (X syndrome) the coronary flow reserve was 1.23 +/- 0.2, which value was significantly lower as compared to patients with significant coronary stenosis.

Adult↗
PubMed2000

[Skin malignancies of the head and neck: numbers and surgical concepts].

OBJECTIVE: A surgical concept for the excision of skin malignancies as applied in our department for years is presented and reevaluated. METHODS: A retrospective study analysed 82 patients treated surgically for basalioma and spinalioma of the head and neck between January 1997 and September 1999. The data are compared with three former studies. RESULTS: A high percentage of malignant skin tumours was primarily non-in-sano resected. Compared with the three former studies the number of skin malignancies is increasing. The statistics of Canton St. Gallen/Appenzell show the same trend. CONCLUSION: Comparing the one-stage procedure with the two-stage procedure, no significant difference was found regarding the incidence of residual tumor. This surgical concept allows reliable histological control of the tumour margins and precise resection of any residual tumour, and does not comprise the result of any plastic surgery to close the wound.

Adult↗
PubMed1999

Marked elevation of serum creatine kinase associated with olanzapine therapy.

OBJECTIVE: To report a case of marked elevation of serum creatine kinase (CK) associated with olanzapine therapy. CASE SUMMARY: A 39-year-old white Jewish schizophrenic man treated with olanzapine developed an elevated serum CK concentration with a peak concentration of 4000 IU/L (normal < 230). No other diagnostic criteria for neuroleptic malignant syndrome (NMS) were present. On discontinuation of the drug, serum CK concentrations returned to normal within eight days. DISCUSSION: Olanzapine, like other atypical antipsychotic drugs, may cause muscle injury with concomitant elevations of serum CK of muscle origin. We suggest that in patients treated with olanzapine, CK concentrations should be checked on initiation of therapy, within the first 48 hours, and weekly thereafter for at least one month. In addition, patients with clinical signs suggestive of NMS should be monitored more carefully. For those patients with a history of NMS, or even of isolated serum CK elevation during antipsychotic therapy, follow-up should be stricter. CONCLUSIONS: Marked elevation of serum CK may be a possible complication of olanzapine therapy.

Adult↗
PubMed1997

[Is transposition of the ulnar nerve in ulnar nerve sulcus syndrome really indicated?].

Anterior transposition of the ulnar nerve in cubital tunnel syndrome requires ligation of the segmental epineural vessels over 8 to 10 cm in order to free up and mobilize the nerve along its new course. As a result, the blood supply of ulnar nerves already compromised by entrapment is likely to be harmed even more. For the past three years we chose to perform simple decompression of the nerve with or without external/internal neurolysis on 33 patients (34 arms). After a follow-up time of six months to three years (mean 12 months), the outcome was evaluated by complete examination of hand function and by electrophysiologic studies. Four patients were excluded from the analysis due to short follow-up times. Four underwent decompression for mild entrapment symptoms, six for moderate symptoms, and 19 for severe symptoms. The functional outcome was rated as excellent in 26.7% (eight patients) and as good in 33.3% (ten patients). In group 3 (severe entrapment symptoms), seven patients (23.3%) showed moderate results and in four patients (13.3%) the outcome was poor. Considering that most of our patients had severe entrapment with advanced muscle atrophy, the overall outcome of decompression was satisfactory.

Adolescent↗
PubMed1997

[Significance of double crush in carpal tunnel syndrome].

From June 1992 to October 1995, 224 patients were operated on carpal tunnel syndrome. We treated 71 male and 153 female patients. During our investigations, we found that one third of the patients suffered from a double crush syndrome. 84% of the patients suffered from one or more predisposing accompanying diseases. In most of them (42%) we found rheumatic diseases, 19% diabetes mellitus, 8% hyperuricaemia, and 6% hypothyreosis. In 33%, we observed a very short history and a bilateral carpal tunnel syndrome. According to the preoperative tests, four different groups of patients regarding electrophysiological parameters and the graduation of thenar atrophy were differentiated. The fourth group was composed of patients with double crush syndrome, who continued to complain of considerable pain despite surgery, the operated hand remaining both weak and awkward in its movements. Inspired by the prospective study by Dellon (1992) and our results, we will perform a retrospective analysis of the longterm effect of carpal tunnel release in diabetic neuropathy.

Adult↗
PubMed1995

[Intravascular hemolysis caused by intravenous glycerin infusion in a patient with artificial mitral valve].

The case history of a sixty two years old patient is presented by the authors. The patient with an artificial mitral valve was admitted to the hospital because of sudden onset of left sided hemiparesis. The cerebrovascular accident which occurred because of a cerebral embolus as well as the heart murmurs and intravascular haemolysis were thought to be present because dysfunction of the artificial valve. Transthoracal and transesophageal echocardiography revealed a thrombus in the right atrium and a patent foramen ovale, however did not prove artificial valve dysfunction. A paradox embolus from the right atrium caused the hemiparesis. The intravascular haemolysis was caused by the 10% glycerol infusion used for the treatment of the cerebrovascular accident. The authors discuss the observations on the glycerol induced intravascular haemolysis and it has been pointed out, that all kinds of parenteral glycerol use can cause intravascular haemolysis. No Hungarian publication was found on glycerol induced haemolysis.

Blood Coagulation Disorders↗
PubMed1994

[Ephedrine psychosis].

Ephedrine has both alpha- and beta-adrenergic activity, and both direct and indirect effects on receptors. Its stimulatory effects on the central nervous system are more prolonged, though less potent, than those of adrenalin. It raises blood pressure both by increasing cardiac output and inducing peripheral vasoconstriction. It is still commonly used as a bronchodilator. However, since prolonged use leads to decreased effectiveness, patients tend to increase the dose themselves. The clinical picture of ephedrine psychosis resembles that induced by amphetamines: primarily a paranoid psychosis with delusions of persecution and auditory and visual hallucinations in a setting of unclouded consciousness. We present a 57-year-old woman who had been taking a usual dose of ephedrine for bronchial asthma (50 mg 3 times a day) for more than 30 years. When her husband died she developed depression, for which she tried to use ephedrine as an antidepressive, increasing the dose to 500 to 1000 mg a day over the course of half a year. She developed paranoid psychosis with delusions of persecution and auditory hallucinations, despite a clear sensorium. Recovery was rapid after ephedrine was gradually reduced to 200 mg a day and a small dose (200 mg) of the neuroleptic thioridazine was added.

Asthma↗