Biomedical subjects

I Gál

Publications and source records attributed to I Gál.

At least 19 recordsLinked to original sources

PubMed2001

Heart rate variability analysis.

The expansion of heart rate variability analysis has been facilitated by the remarkable development of computer sciences and digital signal processing during the last thirty years. The beat-to-beat fluctuation of the heart rate originates from the momentary summing of sympathetic and parasympathetic influences on the sinus node. According to the extensive associations of the autonomic nervous system, several factors affect heart rate and its variability such as posture, respiration frequency, age, gender, physical or mental load, pain, numerous disease conditions, and different drugs. Heart rate variability can be quantitatively measured by time domain and frequency domain methods that are detailed in the paper. Non-linear methods have not spread in the clinical practice yet. Various cardiovascular and other pathologies as well as different forms of mental and physical load are associated with altered heart rate variability offering the possibility of predicting disease outcome and assessing stress.

Autonomic Nervous System↗

PubMed2001

[Hand-assisted laparoscopic technique (HALS) in colorectal surgery (Case reports and review of the literature)].

Hand-assisted laparoscopic surgery (HALS) is a new technique in which the surgeon's hand is introduced to the abdominal cavity through a mini-laparotomy, while pneumoperitoneum is maintained. We describe the technique of HALS used successfully in the treatment of two patients of colorectal disease. We describe current literature and our initial clinical experience. Our conclusion is that, besides colorectal surgery, HALS technique may prove useful for other abdominal procedures as well; however its real value should be estimated in prospective randomized trials.

Aged↗

PubMed2000

[Raynaud syndrome and eradication of Helicobacter pylori].

In this work, the effect of eradication of Helicobacter pylori on complaints and symptoms of infected, primary Raynaud's syndrome patients was studied. Altogether 92 Helicobacter pylori positive patients with gastric complaints and with primary Raynaud's syndrome received eradication therapy. In this prospective study, before and after the eradication the severity and frequency of the complaints and symptoms of the patients were recorded. The eradication was performable in 89 patients; in 75 cases the eradication was successful. In the eradicated patients frequency and duration of Raynaud attacks were improved related to those of the not eradicated group. These results might suggest a potential etiopathogenetical role of Helicobacter pylori infection in the pathogenesis of the primary Raynaud's syndrome.

Acute Disease↗

PubMed2000

[Sjögren's syndrome and multiple myeloma].

In our recent work we present two cases of coexisting Sjögren's syndrome and myeloma multiplex. Our results obtained studying a high number of patients suggest that the occurrence of myeloma in Sjögren's syndrome is much higher than in normal population. This can possibly be explained by the common pathogenetical factors of the two diseases. The survival of one of our two patients in 4 years, and her disease is still in complete remission. The possible explanation of the therapeutical success can be the rather aggressive chemotherapeutical approach in her case. Perhaps the prognosis of myeloma coexisting with Sjögren's syndrome is different that of pure myeloma, it is suggested that the earliest possible aggressive therapy of myeloma accompanied by Sjögren's syndrome can be useful and recommendable.

Aged↗

PubMed2000

[Clinical evaluation of local lipiodol chemoembolization therapy in primary and secondary hepatic tumors].

The authors treated with locoregional lipiodol chemoembolization 32 patients suffering from primary and secondary liver malignancies. They present the clinical results of the 22 patients who received at least 2 treatments. Distribution of patients: 17 men, 5 women, mean age 56.2 (43-80) years. Seven patients suffered from primary liver carcinoma; regarding the Child's staging of the tumors 4 patients were in Child A, 3 patients in Child B. In 15 cases the treatment indication was secondary liver cancer. The primary tumors in these secondary liver cancer cases were: one case lung cancer, 11 colon (2 cases rectum) cancer, 2 cases pancreas cancer, one case gastric carcinoma. The 22 patients received in total 97 cycles of therapy. After the selective catheterisation of the hepatic artery adriamycin, mitomycin C, 5-fluorouracil or lipiodol was administered. During the mean follow up time of 9 months (3-15 months) remission could be observed in 6/22 patients. The side effects were preventable or medically treatable. It can be concluded that in the case of well-selected cases of non-resectable liver malignancies local chemoembolization could be beneficial, as it could slow down the progression of the underlying disease with the maintainment or even improvement of the quality of life.

Adult↗

PubMed2000

Fatal mediastinitis after routine laparoscopic cholecystectomy.

Laparoscopic cholecystectomy is now considered a routine operation with a low complication rate. In this case study, the authors present a laparoscopic cholecystectomy patient who died of masked mediastinitis and concomitant septicemia caused by an unrecognized esophageal perforation after difficult intubation. The authors call attention to the need for early detection of perforating mediastinitis to prevent a lethal outcome from this infrequent but life-threatening condition.

Brain Edema↗

PubMed2000

Retrospective evaluation of 5-fluorouracil-interferon-a aTreatment of advanced colorectal cancer patients.

The authors describe the retrospective analysis of treatment by 5-fluorouracil and interferon-a aof 34 patients with advanced colorectal cancer. An average of 4.6 treatment cycles (3 12) was applied. Complete remission was not observed; partial remission was observed in 8 patients; in 13 patients no change occurred and progression was detected in 14 cases. Remission rate was 22.8%, mean response time was 5.2 (3 12) months, mean progress-free survival 5.6 (0 22) months. Mean survival from the start of treatment was 11.9 (1 42) months and from the establishment of the diagnosis 26.1 (3 60) months. Severe life-threatening side-effects did not occur; other side-effects such as fever, nausea, diarrhea, leucopenia, and anemia responded to drugs. Treatment by 5-FU and interferon, in accordance with other authors findings, improved survival and well-being of patients but no breakthrough has been achieved.

Adenocarcinoma↗

PubMed2000

Protease-elicited TUNEL positivity of non-apoptotic fixed cells.

The appearance of free DNA ends in the chromatin is usually considered an indication of advanced apoptosis. Unexpectedly, the nuclei of non-apoptotic cells derived from mouse thymuses could be specifically labeled by terminal transferase after proteinase K treatment of the fixed, cytocentrifuged samples. Artifactual mechanical or contaminating nucleolytic factors have been ruled out as players in the generation of free DNA ends. The phenomenon was detected in both formaldehyde- and ethanol-fixed specimens, in agarose-embedded fixed cells, and in chromatin spreads. By urea-agarose gel electrophoresis, the average single-strand size of the DNA molecules carrying the free ends was found between 50 and 250 kb. We suggest that ss discontinuities preexisting in the fixed normal cells are unmasked by protease treatment eliciting TUNEL (terminal transferase-mediated nick end-labeling) positivity.

Animals↗

PubMed2000

Comparison of the anti-Ro/SSA autoantibody profile between patients with primary and secondary Sjögren's syndrome.

OBJECTIVE: To measure serum levels of anti-Ro52-kD/SSA, anti-Ro60-kD/SSA and anti-La/SSB autoantibodies in patients with primary and secondary Sjögren's syndrome. To examine if there is any connection between the disease and the subtype-spectrum of these antibodies. METHODS: We measured serum levels of anti-Ro52-kD/SSA, anti-Ro60-kD/SSA and anti-La/SSB autoantibodies by ELISA, in the sera of patients with primary Sjögren's syndrome with or without extraglandular manifestations and with or without anti-La/SSB positivity and of patients with systemic lupus erythematosus/Sjögren's syndrome overlapping disease with or without anti-La/SSB positivity. RESULTS: Differences of the distribution of the anti-Ro52-kD/SSA and the anti-Ro60-kD/SSA were found between the primary and secondary Sjögren's syndrome patients' groups; when Sjögren's syndrome is accompanied by systemic lupus erythematosus, the occurrence of anti-Ro60-kD/SSA autoantibodies is significantly higher than in primary Sjögren'syndrome. CONCLUSION: Our results suggest that there is a possible connection between the distribution of the subtypes of the anti-Ro/SSA autoantibodies and the disease type in primary/secondary Sjögren's syndrome.

Antibodies, Antinuclear↗

PubMed2000

Myelofibrosis in systemic lupus erythematosus.

In this study we present a case of coexisting systemic lupus erythematosus (SLE) and myelofibrosis. Literature review supports the fact that the two diseases rarely occur together in the same patient. The young female patient studied was admitted with pancytopenia and a clinical picture which met the criteria of SLE. Histological examination of the bone marrow biopsy revealed severe myelofibrosis with hypocellularity of the myeloid cell lines. Treatment with immunosuppressive and colony stimulating factor led to slow but complete regeneration of the bone marrow and subsequently to an improved haematological status, and the patient was spared bone marrow transplantation.

Adolescent↗

PubMed2000

[Laparoscopic ileo-cecal resection: case report and review of current issues in laparoscopic colorectal surgery].

A successful case of laparoscopic ileocecal resection is presented. The laparoscopic surgical techniques are described. Advantages, disadvantages and controversial issues surrounding laparoscopic or laparoscopically assisted colorectal surgery are discussed. Reviewing the current literature and the authors' collective clinical experience, the conclusion is that laparoscopic or laparoscopically assisted procedures are clear indications for benign colorectal diseases. The authors believe that these approaches can be employed as palliative measures in malignant diseases or as curative procedures in prospective randomised trials.

Adenocarcinoma↗

PubMed2000

[Laparoscopic repair of abdominal wall hernias using an intraperitoneal onlay prosthetic patch of expanded polytetrafluoroethylene (eptfe)].

The surgical treatment of ventral abdominal wall hernias is still an unsolved problem despite considerable number of conventional methods. Mesh to replace or reinforce the defect by anterior approach has marginally reduced the recurrence rate, but not the infection rate. The authors describe the technique of laparoscopic repair of abdominal wall hernias using an intraperitoneal onlay prosthetic patch of expanded polytetrafluoroethylene (ePTFE) in two cases. Postoperative complications and the advantages of this technique and other published laparoscopic procedures are discussed and compared to the open ventral repairs. It is concluded that laparoscopic prosthetic ventral hernioplasty is a feasible and safe method. It appears to have less morbidity, especially with regard to the infection rate and recurrences, when compared to the open approach. However, authors believe that prospective randomized trials will be needed for further evaluation.

Aged↗

PubMed1999

[Adult onset Still disease: comment on two cases].

The adult onset Still disease is a systemic disease of an unknown etiology. As a separate entity, it was described firstly in 1971. The diagnosis is problematic and based upon special criteria. In this study, we present the cases of two patients with adult onset Still's disease, causing several serious differential-diagnostic problems. In the beginning of the disease a high, remittent-intermittent fever was present which reacted well to salycilates. Almost simultaneously, a characteristic, confluent, no itching rash appeared on the trunk and limbs. Pain of little joints of the hands was an early symptom of the disease in both of the cases. Before the final diagnosis, the possibility of any infectious diseases, haematologic malignancies or other autoimmune disease had to be excluded. The aim of this work was to show an overall, up-to-date picture of the disease based on two typical cases.

Adult↗

PubMed1999

[Comments on Raynaud syndrome based on laser-Doppler studies].

The authors have in their care 286 Raynoud syndrome patients. They present their experience in the study of the microcirculation and the treatment of these patients. In 81% (232 patients, 196 women and 36 men) of the cases they did not find any underlying diseases. In the group of the patients with secondary Raynaud's syndrome (35 women and 19 men) underlying diseases, possibly leading to microcirculatory disturbances, could be identified. In the primary Raynaud's syndrome group the main capillary diameter measured by capillary microscopy was 15 +/- 4 micron. In patients with progressive systemic sclerosis the mean diameter was 43 +/- 9 micron. In the group of women with primary Raynaud's syndrome the authors performed laser Doppler measurements of the nailfold microcirculation. During the reactive hyperaemia test basal values (18.2 +/- 6.2 Perfusin Units, P. U.) and reactive hyperaemia values (a mean of 180% growth compared to the basal values) were similar to that perfusion values referred in the literature. In the progressive systemic sclerosis group the basal flow (9.3 +/- 3.3 P. U.) and the reactive hyperaemia (a mean of 20% increase compared to basal values) were significantly lower. Concerning the fact that the progression of Raynaud's syndrome into systemic autoimmune disease--mainly to progressive systemic sclerosis may be predicted, it is important to follow up carefully all patients with Raynaud's syndrome.

Adolescent↗

PubMed1999

[Percutaneous ultrasound-guided ethanol sclerotherapy of autonomous thyroid nodules].

Percutaneous ethanol injection therapy for autonomously functioning thyroid nodules has been performed in 53 patients. 36 patients suffered from hyperthyroidism, and 17 patients had subclinical hyperthyroidism. Ethanol was administered under ultrasonographic guidance in 2-6 sessions depending on the size of the nodule Local neck pain was the most often adverse effect. Transient dysphonia occurred in 3 patients. A subacute granulomatous thyroiditis-like reaction within 1 week after the last session occurred in 4 patients. During a 10-day steroid administration this reaction was stopped. After ethanol sclerotherapy reduction of thyroid nodular volume can be achieved. The reduction of the nodules was between 36 and 75% (mean 55 +/- 15%) of the pre-treatment volume at 6 week after therapy. In 27 of 36 hyperthyroid patients the FT4- and T3-levels became normal. Repeated sclerotherapy was successfull in 6 of the remaining 9 hyperthyroid patients. No relapse of hyperthyroidism was observed. The scintiscan showed a complete cure in 10 of 23 patients one year after PEI-therapy, while in 11 patients partial normalization of the scintiscan was observed. In 2 of 23 patients the scintiscan remained unchanged. Indication of ethanol sclerotherapy is not clear. The method appears an effective alternative procedure in patients with large nodules at high surgical risk. Under special circumstances (pregnancy or iodine-induced hyperthyroidism) ethanol sclerotherapy may be a practical alternative for toxic autonomously functioning thyroid nodules.

Adenoma↗

PubMed1999

Laparoscopic gastric surgery. Early experiences.

In the Department of General Surgery the authors performed 12 elective laparoscopic gastric operations for gastric pathologies. The indications for the procedures were recurrent or therapy resistant and complicated peptic ulcer in 9 cases, benign gastric tumors in 2 cases and early gastric cancer in 1 case. Operative procedures were the next: posterior truncal vagotomy with anterior lesser curve seromyotomy (5 patients), total truncal vagotomy with gastrojejunostomy (2 patients), total truncal vagotomy with pyloroplasty (1 patient), total truncal vagotomy with antrectomy and Billroth-II reconstruction (1 patient), resection of benign gastric tumor by the transgastric approach (1 patient), Billroth-II resection for benign gastric tumor (1 patient), wedge resection of gastric wall for early gastric cancer (1 patient). Intraoperative gastroscopy was used for location of the lesion in 4 of 12 cases. Apart from delayed gastric emptying (2 cases), patients recovered without any problem. The mean hospital stay was 5.7 days. Early experiences with laparoscopic gastric surgery has shown that there are certain important advantages to the approaches. They hold the promise of less pain, less immobility, quicker alimentation, shorter hospitalization, less wound and respiratory complications and an earlier return to normal activities.

Anastomosis, Surgical↗

PubMed1999

The importance of intraoperative endoscopy.

Nowadays it is an essential demand of the surgeon to make a correct preoperative diagnosis, that is a precondition of optimal operation. Unfortunately it cannot be clarified in each case, what is the location and extension of the alteration, or surgeon finds an unexpected disease during the operation. In similar cases the authors make an intraoperative upper gastrointestinal endoscopy and/or colonoscopy. During these procedures, the identification of the reason of bleeding and in some cases polypoid lesions were found. Over the past few years 16 examinations have been carried out. The examination influenced the course of the operation in each case advantageously. Therefore, the diagnostic repertoire can also be extended by this method. This is, why preoperative endoscopy is of primary importance.

Colonic Polyps↗

PubMed1999

[Laparoscopic truncal vagotomy, antrectomy with Billroth-II reconstruction for complicated duodenal ulcer (Case report and literature review)].

Today surgeons are performing fewer elective ulcer surgeries, as H2 receptor blockers and the eradication of Helicobacter pylori represent a major step in treatment of this disease. Nevertheless, patients with complications and those resistant to medical therapy should be offered surgical options. The laparoscopic management of these complications is an alternative to open surgery, if applied with appropriate patient selection. The authors report a case with repeated bleeding and duodenal narrowing due to a duodenal ulcer. The patient was treated by totally intraabdominal laparoscopic truncal vagotomy, antrectomy and Billroth-II reconstruction--this probably being the first performed and publicized operation in Hungarian literature. The technique this operation and common perioperative problems based on existing literature are reviewed. The benefits of the minimally invasive approach were clearly evident. The authors believe that minimally invasive approaches will renew the interest in definitive surgery for the treatment of ulcer disease.

Adult↗