Biomedical subjects
Publications and source records attributed to E Dinya.
In this paper the author shows the basic concepts of the different data scales, which are important from statistical investigations points of view. He summarizes the characteristics of each scale and presents their sample data.
The author gives or outline of the basic concepts of probability theory. The bases of the event algebra, definition of the probability, the classical probability model and the random variable are presented.
r shows the basic concepts of function theory, which ones are necessary in biometrical works. The concept of the function, the different mapping methods and some often used function types are presented.
In this paper the author shows the basic concepts of set theory, which ones are necessary to understand biometric methods. The sets, the most important operations, the power of sets and the types of the used variables are presented.
In this study the author shows a method for the supervision of normal distribution on the basis of the mean and the standard deviation. The given method can be used to control the data of the scientific articles and the clinical data from normal distribution point of view.
Authors make known the comprehensive results of a longitudinal epidemiological examination which commenced in the 10th District of Budapest with nearly 100,000 inhabitants in 1975. The observation period is 15-20 years. Its aim was the determination of the risk factors of lung cancer. They followed up the lot of 30,561 persons, 92% of the population over 40 years of age 14,191 patients took part in a control examination supplemented with respiratory test. They analysed the connection between the supposed external risk factors and parenchyma functional damages caused by them and the development of lung cancer by detailed mathematical statistical arithmetic. 571 patients fell ill with lung cancer. The cured lung tuberculosis also proved to be a leading risk factor besides smoking. From the not endangered group 43, the highly super highly endangered groups 458 people fell ill with lung cancer. There was no difference between men and women in the lung cancer risk of the risk free population. According to their supposition the connection between the parenchyma functional damages caused by external risk factors and the development of lung cancer is determined by the different immunological status of people. (During the 20 years observation period 4% of heavy smokers and 3% of cured lung tuberculous patients fell ill with lung cancer). They urge the organization of wide ranging international prospective examination for the testing of this supposition.
Alzheimer's dementia (AD) is a progressive neurodegenerative disease which is one of the most common forms of dementia in the above 65 years old age group. Diagnosis is based upon evaluation of cognitive skills, elimination of other dementia associated diseases and on cranial CT examination. However, definitive diagnosis is proved only by neurohistological findings. The etiology of the disease is unknown and effective treatment is not available. Intensive research into the pathomechanism of the disease revealed a connection between increased frequency of apolipoprotein E4 allele and later onset of AD. The aim of the author's research was to characterize apolipoprotein E polymorphisms in AD patients and to examine immunological factors which could play an important role in the development of the disease such as the polymorphism of complement and lipoprotein(a) [Lp(a)] alleles previously had not been investigated. 35 AD patients (26 female, 9 male) were examined (mean age 66.4 years +/- 8.7 SD). 18 of these patients showed late onset of the disease. The E4 allele was significantly more frequent in both early and late onset groups compared to controls (0.29 vs. 0.14 and 0.33 vs 0.09). The high frequency of apo E4 found in the early onset group in this study differs from other international data. Serum lipid, lipoproteins, Lp(a) concentrations and Lp(a) phenotype distribution showed no significant difference compared to controls. Furthermore, it was found that the frequency of complement C4AQ0 (null) and Bf F alleles was higher in the late onset AD group compared to controls (0.35 vs 0.139 and 0.305 vs. 0.225) suggesting an active involvement of the complement system in the pathogenesis of this disease.
The aim of this examination started in an industrial district of Budapest with 100,000 inhabitants in 1968, was the determination of risk groups of pulmonary tuberculosis and the organisation of X-ray screening. The initial decrease in the incidence of pulmonary tuberculosis stopped (between 1981 and 1993) and, a minimal increase could be even demonstrated in the last years. The cause of the increase is explained by sociological factors (the influx of refugees, growth in the number of homeless people and of chronic alcoholics). The authors propose the modernization of the preventive and exploratory medical work: the use of computers in the lung-screening center and the institutionalisation of screening aimed at risk groups of pulmonary tuberculosis. In the population over forty years of age 92% of 408 new pulmonary tuberculosis patients, emerged from risk groups between 1981 and 1993, and only 8% from people who did not belong to the risk groups. The effectiveness of screening in the risk groups was 3 to 4 times higher than that of indiscriminate screening.
Three different allelic variants of apolipoprotein E determine, in concert with other gene products, the levels of plasma lipoproteins. Recently, cleavage products of the complement C3 molecule have also been implicated in determining plasma triacylglycerol concentrations. This study presents data of an ongoing study to dissect the role of the apolipoprotein E gene locus in the response to low fat/low cholesterol diet combined with gemfibrozil treatment. In addition, for the first time, the significance of C3 allelic variants to such hypolipidaemic therapy response was analysed. To this end data from 81 obese hyperlipoproteinaemic patients (Fredrickson type II/A and B and type IV and V) confirmed the usefulness of the combined gemfibrozil/diet treatment and unveiled apolipoprotein E allele group specific therapy responses. The mean changes of lipid properties due to combined treatment was 15% for total cholesterol, 48% for triacylglycerols and 28% for atherogenic index. Division into hyperlipidaemia types according to Fredrickson and subgrouping into E2, E3 and E4 groups (apolipoprotein E2/2 and 2/3, apolipoprotein E3/3 and apolipoprotein E4/2 and 4/3 phenotype groups respectively) exposed pronounced differences from these mean changes, suggesting substantial influence of apolipoprotein E variants on this therapy. We observed triacylglycerol reductions of from 17% in type IIA-apolipoprotein E3 group patients up to 78% in the type IV and V-apolipoprotein E2 group. Thus it might be concluded the apolipoprotein E genotyping aides therapy success prediction. Although, low sample number in some subgroups obscures significance in this pilot study, significant therapy success emerges for the E3 and E4 group in type IV and V hyperlipidaemia and type IIB-apolipoprotein E3 homozygous patients can be predicted to respond better than apolipoprotein E2 carriers. Finally, we present evidence that positive changes of lipid properties are also determined by the "fast" complement C3 allel (C3-F). Patients with complement factor C3-FS pattern respond better to treatment than patients with C3-SS configuration. In summary these data endorse the genotyping of apolipoprotein E alleles to predict maximal success of "fibrate" treatment. In addition they argue strongly for further assessment of the involvement of complement C3 allelic variations in lipid homeostasis.
Our clinical trial was set out to estimate the apoE allele frequency by way of polymerase chain reaction and restriction enzyme isoform genotyping amongst 81 obese, hyperlipoproteinemic patients (treated with gemfibrozil + diet). The relative frequencies of the E2, E3, E4 alleles were 0.28, 0.61, 0.11 respectively (according to the Hardy-Weinberg equilibrium). Phenotypes with increased triglycerides levels were dominant in both sexes: IV + V > II/B > II/A (44.4%, 39.5%, 16.0%). Therapy significantly decreased the atherogen lipid values with differing efficacy among each genotype group: E3 > E4 > E2. Our findings demonstrate that in the II/A group there was no great change using the gemfibrozil + diet combination: whereas in IV + V group this combination was effective in each apoE isoform. In the case of II/B it is highly important to determine the apoE genotypes, because the therapy is only efficacious in the E33 group taking all lipid parameters into consideration.
The arteriographical changes of 66 patients with peripheral arterial obliterative disease and the relationship between the observed alterations and certain clinical and laboratory data as well as some risk factors were analysed. A score system was used to quantify the arteriosclerotic lesions. The arterial alterations of the examined 90 extremities were studied in the pelvic (common and external iliac arteries), femoral (common, superficial, deep femoral and popliteal arteries) and crural (anterior and posterior tibial arteries) regions. Pathomorphological changes in 433 of the investigated 720 arteries were shown, from among them plaque in 11.8%, stenosis in 22.3%, total occlusion in 26% were proved. Most frequently (89%) the superficial femoral artery was affected. As to the single vessels, the superficial femoral and posterior tibial arteries, while among the zones the femoral region proved to be most serious radiologically. The degree and extent of vessel lesions were related to age. The morphological severity was basically concordant with the results of clinical investigations (walking distance, ergometry, Doppler index). The separately examined risk factors (smoking, hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia) were not related consequently to the radiological changes, but in certain combinations, as heavy smoking with hypertension and heavy smoking with diabetes, the relationship proved to be statistically significant.
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The authors have started a basic screening examination in one of the industrial districts of Budapest in 1975. The district has nearly 100,000 inhabitants. The aim of the examination was to determine the risk factors of lung cancer. 30,566 persons have participated. The health of all patients has been followed up between 1975-1991. During this period 3,573 patients have moved out of the district. On 26,993 patients they have examined the death ratio, the prospective life-span, in the various age groups divided into subgroups according to their smoking habits. They have studied the formation of death rate in the four risk groups determined by them on the basis of the simultaneous examination of more lung cancer risk-factors (risk-free, moderate, high and superhigh risk groups). During these 16 years the death rate both among the heavy smokers and among patients in the high and superhigh risk groups has been two, three, even almost five times higher than that in the non-smoking and in the risk-free group of the relatively younger age groups of the population (born between 1921-1930 and 1931-1938). The knowledge of these connections makes economic calculations possible in respect of life and health insurance.
The occurrence of oral leukoplakia and lichen planus in 1600 patients with diabetes mellitus (815 type 1: insulin-dependent, 761 type 2: non-insulin-dependent)-under care at the International Medicine Department-was studied. Precancerous lesions and conditions were diagnosed and grouped according to internationally accepted criteria. The prevalence of oral leukoplakia in diabetic patients was 6.2%, as compared to 2.2% in the healthy controls, that of oral lichen was 1.0% in the test-, and 0.0% in the control group. Leukoplakia and lichen both showed the highest occurrence in the second year of established diabetes, and their prevalence was higher among insulin-treated diabetics. Smokers were more often affected, by both kind of lesions, oral lichen showed a more frequent association with candidiasis. The prevalence of oral leukoplakia and lichen in diabetes mellitus patients was higher, than average ratios in population samples from the same country.
The dental clinical examination of 1600 (815 insulin dependent of type 1 and 761 non-insulin dependent of type 2 respectively) patients cared of because of diabetes mellitus was carried out and an answer to the question was sought for whether the condition of the teeth does change according to he type of the metabolic disturbance of the diabetic, the time of its manifestation, its setting, the manner of therapy, the family occurrence of the illness and the mouth hygiene, respectively. According to examination results, greater edentulousness with diabetes over 30 years showed a positive interdependence according to the confirmance time of diabetes. On the other hand, with diabetic of better setting there were less teeth with caries or removed ones and the DMF-T average was lower than with patients with worse diabetes setting. No independence was found in the development of the DMF-T average and the caries conditions, respectively, if diabetes occurred in the family history and according to the type of diabetes.
Clinical dental examination of 1600 diabetics (815 type 1 insulin dependent and 761 type 2 non-insulin dependent patients) has been performed according to the WHD criteria. According to examination results higher DMF mean value, less uncared of teeth with caries (D) and, in the age group of 19 years and above 30 years, more edentulousness has been found than with healthy individuals. The number of filled and crowded teeth (F) below the age of 35 years in diabetics (p 0.0001), above 45 years in the control group (p 0.0001) was higher. Concerning cared of teeth there was no deviation in the number of filled teeth between diabetic and healthy individuals whereas the number of crown covered teeth was higher with diabetics. (p 0.01). As to the distribution of individuals with healthy teeth and toothless ones it was found characteristic that while among diabetic individuals but 1%, in the control 1.4% possessed retained healthy teeth. The number of completely toothless individuals was higher (11.83%) with diabetics than with healthy individuals (2.25%).
In 1975 in one of the major industrial districts of Budapest some longitudinal epidemiological examinations were carried out with the aim of, among others, determination of connection between environmental injuries and lung cancer incidence in connection with determination of lung cancer risk groups. Between 1975-1989 out of the environmental injuries the most important was the radioactive contamination observed due to the atomic power station catastrophe in Chernobil (1986). In 1987 the incidence of lung cancer increased. The increase was significant among the 50-69-year-old women, and expressly among the heavy smokers. In 1987, especially among women, but also in both sexes, the ratio among the major cell types of lung cancer shifted towards micro-cellular ones. In 1988 and 1989 lung cancer incidence has decreased. In view of the above a hypothesis was raised: patients who have previously suffered immunobiological hurt, could not prevent the increased radioactive burden and got ill with lung cancer earlier, than it should have been happened without this increased burden. For clarification this question further examinations are considered to be necessary.
Between 1975 and 1978 in 10th district of Budapest a basis examination was carried out with the aim of determination of lung cancer risk factors. Out of the 30,566 inhabitants 403 persons got ill with lung cancer during the above mentioned period. In case of 321 patients the cell type was determined in detail. As to the connection between the main risk factors and the various cell types it was found that planocellular lung cancer can be regarded as the cell type of men, but exclusively of smokers, while the microcellular type lung cancer can be considered as cancer of not only the younger age-groups, but that of expressly women, especially heavy smokers. With elimination of the two main risk factors (smoking, pulmonal lesions) not only the number of patients with lung cancer could be decreased to one third, but the ratio of adenocarcinomic diseases would also increase. These diseases are more favourable in respect of operability and survival.