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Biomedical subjects

E Toth

Publications and source records attributed to E Toth.

At least 19 recordsLinked to original sources
PubMed2005

Daily treatment with esomeprazole is superior to that taken on-demand for maintenance of healed erosive oesophagitis.

BACKGROUND: On-demand therapy with esomeprazole is effective for long-term treatment of non-erosive gastro-oesophageal reflux disease, but it has not been evaluated in erosive gastro-oesophageal reflux disease. AIMS: To compare endoscopic and symptomatic remission over a 6-month period when patients with healed erosive gastro-oesophageal reflux disease are treated with esomeprazole 20 mg, either once daily or on-demand. METHODS: Patients with verified erosive reflux oesophagitis of Los Angeles grades A-D were enrolled. Following 4-8 weeks treatment with esomeprazole 40 mg daily, those who were endoscopically healed and had symptom control during the last week were randomized to maintenance therapy for 6 months with esomeprazole 20 mg, taken either once daily or on-demand. RESULTS: Of 539 enrolled patients, 494 (91%) were healed at 8 weeks and 477 were randomized to maintenance therapy with esomeprazole 20 mg, 243 once daily and 234 on-demand. After once daily treatment, 81% of patients were still in remission at 6 months, compared with only 58% who took on-demand treatment (P < 0.0001). A difference in remission was found irrespective of baseline grade of oesophagitis, but it was more pronounced for the more severe grades. There was no difference in overall symptomatic remission between the two treatments, although heartburn was significantly more prevalent in the on-demand group. CONCLUSIONS: Once daily esomeprazole 20 mg was better than that taken on-demand for maintaining healed erosive oesophagitis, regardless of baseline Los Angeles grade.

Adult↗
PubMed2005

Is there any connection between the presence of kidney stones in primary hyperparathyroidism and the location of an underlying adenoma?

The majority of the patients with primary hyperparathyroidism (pHPT) recurrently produce kidney stones, while the rest have other clinical manifestations. The aim of this study was to examine the possibility of an association between the presence of kidney stones and the location of an underlying adenoma. This was a retrospective evaluation of the records of 91 patients (10 males, 81 females, mean age: 61.9 years [20 - 70 yrs]) operated for primary hyperparathyroidism between 1995 and 2000. One patient was excluded due to carcinoma. Kidney stones were found in 55 cases and other clinical symptoms in 35 cases. In 50 of the 55 patients (91 %) with kidney stones, the adenoma was located in the left inferior parathyroid gland (chi2 = 67.5, p < 0.00,001), while in 24 of the 35 patients (69 %) without kidney stones, the adenoma was in the right inferior parathyroid gland (chi2 = 43.9, p < 0.0001). These results suggest that the location of the adenoma may influence the presence of kidney stones in pHPT. It is proposed that the biologic effects of parathyroid hormone could differ depending on which of the four parathyroid glands it was secreted in, or the four glands may produce different biologically active fragments.

Adenoma↗
PubMed2003

One-week esomeprazole treatment: an effective confirmatory test in patients with suspected gastroesophageal reflux disease.

BACKGROUND: Symptomatic response to acid inhibition can be used as a guide in diagnosing patients with reflux symptoms. The proton-pump inhibitor (PPI) omeprazole has been used as such a diagnostic tool. Intragastric acid control with esomeprazole is more effective than other PPIs and has the potential to offer an advance in the diagnostic use of PPIs. METHODS: Patients experiencing heartburn (for > or = 6 months) were studied in this randomized, double-blind, multicenter study. Following a 3-day placebo run-in, 440 patients were randomized to 14 days' treatment with esomeprazole 40 mg once daily (o.d.), esomeprazole 20 mg twice daily (b.i.d.) or placebo. Heartburn symptoms were recorded daily. Endoscopy and 24-h esophageal pH-monitoring were performed to determine the presence of gastroesophageal reflux disease (GERD). The esomeprazole treatment test was considered positive if patients' symptoms improved during the treatment period compared with symptoms recorded on Day 0. RESULTS: 63 patients were excluded from the analysis due to lack of symptoms on Day 0 or failure to complete pH-monitoring. The sensitivity of an esomeprazole treatment test in confirming GERD increased during the first days of treatment and stabilized between 79% and 86% after 5 days (both esomeprazole arms). The corresponding figure for the placebo arm was 36%. Specificity was variable (24%-65%) for both active treatment and placebo. CONCLUSION: A treatment test with esomeprazole 40 mg has a high sensitivity in confirming GERD. Furthermore, the data indicate that 1-week treatment with a once-daily dosage is sufficient to ensure adequate diagnosis.

Adult↗
PubMed2001

First solvation shell of the Cu(II) aqua ion: evidence for fivefold coordination.

We determined the structure of the hydrated Cu(II) complex by both neutron diffraction and first-principles molecular dynamics. In contrast with the generally accepted picture, which assumes an octahedrally solvated Cu(II) ion, our experimental and theoretical results favor fivefold coordination. The simulation reveals that the solvated complex undergoes frequent transformations between square pyramidal and trigonal bipyramidal configurations. We argue that this picture is also consistent with experimental data obtained previously by visible near-infrared absorption, x-ray absorption near-edge structure, and nuclear magnetic resonance methods. The preference of the Cu(II) ion for fivefold instead of sixfold coordination, which occurs for other cations of comparable charge and size, results from a Jahn-Teller destabilization of the octahedral complex.

Journal Article↗
PubMed2000

Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen.

BACKGROUND: Registry data on patients with type 1 diabetes mellitus who undergo pancreatic islet transplantation indicate that only 8 percent are free of the need for insulin therapy at one year. METHODS: Seven consecutive patients with type 1 diabetes and a history of severe hypoglycemia and metabolic instability underwent islet transplantation in conjunction with a glucocorticoid-free immunosuppressive regimen consisting of sirolimus, tacrolimus, and daclizumab. Islets were isolated by ductal perfusion with cold, purified collagenase, digested and purified in xenoprotein-free medium, and transplanted immediately by means of a percutaneous transhepatic portal embolization. RESULTS: All seven patients quickly attained sustained insulin independence after transplantation of a mean (+/-SD) islet mass of 11,547+/-1604 islet equivalents per kilogram of body weight (median follow-up, 11.9 months; range, 4.4 to 14.9). All recipients required islets from two donor pancreases, and one required a third transplant from two donors to achieve sustained insulin independence. The mean glycosylated hemoglobin values were normal after transplantation in all recipients. The mean amplitude of glycemic excursions (a measure of fluctuations in blood glucose concentrations) was significantly decreased after the attainment of insulin independence (from 198+/-32 mg per deciliter [11.1+/-1.8 mmol per liter] before transplantation to 119+/-37 mg per deciliter [6.7+/-2.1 mmol per liter] after the first transplantation and 51+/-30 mg per deciliter [2.8+/-1.7 mmol per liter] after the attainment of insulin independence; P<0.001). There were no further episodes of hypoglycemic coma. Complications were minor, and there were no significant increases in lipid concentrations during follow-up. CONCLUSIONS: Our observations in patients with type 1 diabetes indicate that islet transplantation can result in insulin independence with excellent metabolic control when glucocorticoid-free immunosuppression is combined with the infusion of an adequate islet mass.

Adult↗
PubMed1999

1H-NMRD and 17O-NMR assessment of water exchange and rotational dynamics of two potential MRI agents: MP-1177 (an extracellular agent) and MP-2269 (a blood pool agent).

The parameters that govern water proton magnetic relaxation (e.g. water exchange rates, and rotational and electronic correlation times) of representatives of two classes of Gd(III) complexes have been estimated, using two different approaches and the results compared with those derived for known analogs. The complexes studied are: (i) the non-ionic GdDTPA-bis(-methoxyethyl-amide) [Gd(DTPA-BMEA)], a typical small-molecule extracellular MR agent, and (ii) the ionic Gd(III) complex of 4-pentylbicyclo[2.2.2]octane-1-carboxyl-di-L-aspartyl-lysine-deriv ed-DTPA [GdL]4-, a prototype MR blood pool agent, which binds to serum albumin in vivo through non-covalent hydrophobic interactions. An 17O-NMR study of [Gd(DTPA-BMEA)] gives a water exchange rate constant of k(ex)298 = (0.39 +/- 0.02) x 10(6) s(-1), identical to that for the bismethylamide analog [Gd(DTPA-BMA)]. Both approaches yield longer rotational correlation times for [Gd(DTPA-BMEA)], consistent with its higher molecular weight. An 17O-NMR study of [GdL]4- gives a water exchange rate constant of k(ex)298 = (4.2 +/- 0.1) x 10(6) s(-1), identical to that for [Gd(DTPA)]2-. The water exchange rate on [GdL]4- did not decrease considerably when bound to albumin, the lowest limit is k(ex,GdL-BSA) = k(ex,GdL)/2. Both approaches yield identical rotational correlation times for [GdL]4-, however, it was difficult to derive a consistent rotational constant for the albumin-bound [GdL]4- using the different approaches (values ranged between 1.0 and 23.0 ns).

Chelating Agents↗
PubMed1999

A comparative analysis of the six-strand double-loop flexor tendon repair and three other techniques: a human cadaveric study.

The ideal zone II flexor tendon repair would be easy to perform, cause minimal scarring, and be strong enough to allow early active motion. A 6-strand loop suture technique devised by the senior author (T.M.T.) was studied in vitro. Forty flexor tendons were harvested from fresh-frozen human hands and divided into 4 groups of 10 tendons each. Each group of tendons was repaired with a specific technique: group 1, the modified Kirchmayr (modified Kessler) technique; group 2, the single-loop 2-strand technique described by Tsuge; group 3, Tsai's double-loop 4-strand modification of Tsuge's technique; and group 4, Tsai's double-loop 6-strand modification of Tsuge's technique. Gap resistance of each repair technique was recorded on a computer using a Differential Variable Reluctance Transducer (MicroStrain, Burlington, VT) and on videotape to record first gap formation, 1-mm and 2-mm gap formation, and maximum load. Statistically significant differences between groups were as follows: at first gap formation between the 2-strand and 6-strand loop suture techniques, and at maximum load between the modified Kessler and 4-strand, modified Kessler and 6-strand, 2-strand and 4-strand, and 2-strand and 6-strand loop suture techniques. The 6-strand double-loop suture technique had a higher tensile strength than the other techniques, as measured in this model at each stage in our experiment. The 6-strand double-loop suture technique simplifies flexor tendon repair. It improves the repair's strength and its resistance to gapping without increasing tendon handling or bulk. This increased repair strength allows us to pursue a more aggressive rehabilitation program.

Biomechanical Phenomena↗
PubMed1999

Limited joint mobility in diabetes.

Cheiroarthropathy is a syndrome usually associated with diabetes mellitus that involves mainly the small joints of the hand. It is generally painless and seldom treated until hand deformity is severe enough to interfere with daily life. Because cheiroarthropathy is correlated with microvascular complications of diabetes, patients with hand symptoms should be carefully investigated for neuropathy, retinopathy, and nephropathy. Improved control of diabetes is the cornerstone of management, but surgery and corticosteroid injection may alleviate severe symptoms in some patients.

Contracture↗
PubMed1998

Hyperplasia of gastric antral beta-microseminoprotein endocrine-like cells and increased serum levels of beta-microseminoprotein in atrophic corpus gastritis.

BACKGROUND: Beta-microseminoprotein is a 94-kDa protein present on most mucosal surfaces in the body. It is produced in mucin cells but is also found in a particular type of cells (E-cells) in the gastric antral mucosa. Most of these cells also contain gastrin. In atrophic corpus gastritis the gastrin-producing cells become hyperplastic, and the patients have hypergastrinemia. We wanted to ascertain whether there is a similar effect on the E-cells and on the concentration of beta-microseminoprotein in serum. METHODS: Antral biopsy specimens from 10 patients with atrophic corpus gastritis and 10 controls were stained immunohistochemically for beta-microseminoprotein and gastrin. beta-Microseminoprotein and gastrin were measured by radioimmunoassay in serum from 15 women with atrophic corpus gastritis and 31 healthy female blood donors. RESULTS: There was a 3.5-fold increase of the number of E-cells (which also were hypertrophic) and a 2.1 times higher serum concentration of beta-microseminoprotein in the patients with atrophic corpus gastritis than in the control subjects. Gastrin was seen in 28% of the E-cells in patients with atrophic corpus gastritis, compared with 87% in normal antral mucosa. There was no correlation between the serum concentrations of beta-microseminoprotein and gastrin. CONCLUSIONS: In atrophic corpus gastritis antrum E-cells undergo hyperplasia and hypertrophy, and the proportion of E-cells containing gastrin decreases. Increased amounts of beta-microseminoprotein are secreted to the blood but uncorrelated with gastrin.

Adult↗
PubMed1998

Effect of enteral nutritional products differing in carbohydrate and fat on indices of carbohydrate and lipid metabolism in patients with NIDDM.

Non-insulin dependent diabetes mellitus (NIDDM) is associated with chronic hyperglycemia, which increases the risk of developing microvascular and macrovascular complications. Elevated triglyceride (TG) and VLDL cholesterol levels and low levels of HDL cholesterol have also been frequently reported in NIDDM patients. A diet high in complex carbohydrate and low in fat is typically recommended for management of NIDDM, however, this has recently been challenged by scientific reports of the benefits of dietary intakes high in monounsaturated fat. Thirty-two individuals with NIDDM were randomized to receive either Ensure with Fibre (30% fat) or a high monounsaturated fatty acid product, Glucerna (50% fat). These products were consumed for 28 days at > 80% of daily energy intake. Post-treatment, dietary compliance was verified by a higher plasma TG 18:1 n-9 (p < 0.001) in the Glucerna group and a higher plasma TG 18:2 n-6 (p < 0.001) in the Ensure with Fibre group. The postprandial rise in blood glucose levels, determined by fingerprick samples, was significantly lower (p < 0.01) in the Glucerna group. Trends of clinical interest were greater mean decreases in the Glucerna group compared to the Ensure with Fibre group in: fructosamine, 9.13 umol/L vs 0.14 umol/L; glucose, 1.61 mmol/L vs 0.63 mmol/L; and insulin, 46.0 pmol/L vs 12.6 pmol/L; respectively. However, overall, fasting plasma glucose, fructosamine, TG and cholesterol levels were not significantly different between groups. Thus, in these patients, the high monounsaturated fat diet and the standard diet were similar with regard to usual indicators of carbohydrate and lipid metabolism. A high monounsaturated fat diet appears to pose no risk to lipoprotein metabolism in NIDDM patients.

Adolescent↗
PubMed1997

Effects of iminodipropionitrile on cerebral amino acid levels.

Iminodipropionitrile (IDPN), a compound that causes dyskinetic symptoms in animals and has possible use as a model for human dyskinesia, was tested in mice and rats for its effect on cerebral amino acids. In mice, 2 h after IDPN administration, the level of total brain alanine was reduced; after 5 h the levels of aspartic acid and glutamic acid were also reduced, and the level of glutamine was increased. In rats, after chronic administration of IDPN, the level of glutamic acid in the total brain tissue was reduced. After acute administration of IDPN using microdialysis, extracellular GABA and extracellular glutamine levels in the striatum were elevated. This study shows that IDPN causes alterations in total and extracellular levels of neurotransmitter amino acids in the brain, which could have a role in IDPN-induced dyskinesia.

Animals↗
PubMed1996

Differential effects of learning and recall of a spatial task on phosphoinositide hydrolysis induced by the metabotropic glutamate receptor agonist 1S,3R-ACPD (1S,3R-1-amino-cyclopentane-1,3-discarboxylic acid) in the hippocampus and the prefrontal cortex of rats.

Phosphoinositide (PI) hydrolysis, stimulated by 1S,3R-1-amino-cyclopentane-1,3-dicarboxylic acid (1S,3R-ACPD), an agonist of metabotropic glutamate receptors (mGluRs), was measured in hippocampal and prefrontal cortical slices obtained from rats which had been trained for 8 days in a Morris water maze and had learned an allocentric spatial task. Brain slices were pre-labeled with myo-3H-inositol and 1S,3R-ACPD (100 microM) stimulation was assessed by measuring the accumulation of [3H]inositol phosphates ([3H]IPs) in the presence of Li+. Measurements conducted 24 h following the last training session revealed no differences in 1S,3R-ACPD-stimulated formation of [3H]IPs, either in the hippocampus or in the prefrontal cortex. However, a diminished response to mGluRs stimulation was detected in the hippocampus of animals re-trained after an 11-day interval. The decrease was not evident in the prefrontal cortex. These data indicate a differential involvement of the hippocampus and the prefrontal cortex in the processing of spatial information and correspond to the functional differences attributed to these areas.

Animals↗
PubMed1996

Effect of nicotine on the level of extracellular amino acids in the hippocampus of rat.

Using microdialysis, we compared intracerebral and subcutaneous administration of nicotine for the effect on the levels of extracellular amino acids in the hippocampus of anesthetized rats. Administration by microdialysis of 10 mM nicotine, resulting in a nicotine concentration of 0.134 mumol/g in the hippocampus, increased the extracellular levels of aspartic acid, glutamic acid, and serine by 26-60%. At 50 mM nicotine the increases in the levels of aspartic acid, glutamic acid, serine, glycine, and glutamine were between 76% and 141%. Subcutaneous administration of nicotine at a dose of 6 mumol/kg caused a 57% increase in the extracellular level of glutamic acid. After a dose of 12 mumol/kg that resulted in a nicotine level of 0.015 mumol/kg in the hippocampus, the extracellular level of glutamic acid was increased by 100%, and that of aspartic acid by 24%. Thus, higher cerebral nicotine levels were needed with intracerebral than with subcutaneous administration to obtain similar amino acid changes. Prior administration of mecamylamine or L-kynurenine prevented the subcutaneous nicotine-induced elevation of the extracellular levels of aspartic acid and glutamic acid. Our results indicate that receptor interactions modulate nicotine effects and that both nicotinic cholinergic and NMDA/glycine glutamatergic receptors participate in the action of nicotine in increasing extracellular amino acid levels.

Amino Acids↗