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Biomedical subjects

J Németh

Publications and source records attributed to J Németh.

At least 73 records · Page 4Linked to original sources
PubMed1992

Biologic markers in blood reflecting thyroid hormone effect at peripheral tissue level in patients receiving levothyroxine replacement for hypothyroidism.

Plasma fibronectin, serum procollagen-III-peptide and sex-hormone binding globulin as not specific markers of thyroid hormone effect at peripheral tissue level were determined and their values were related with serum levels of TSH, free-thyroxine and triiodothyronine during levothyroxine sodium replacement therapy for hypothyroidism. Low levels of biologic markers characteristic of hypothyroidism were normalized in consequence of hormone replacement and a negative correlation between their serum levels and TSH concentration was demonstrated in most subjects. However, in some patients a discrepancy in the response to levothyroxine between the pituitary and other target organs could be revealed. Additional evidence was disclosed that the pituitary thyrotroph sensitizes a minor decrease in serum thyroxine level, which would not be recognized by other target organs. Furthermore, it was revealed that during L-T4 replacement therapy in a large fraction of patients with subnormal serum TSH concentration blood levels of the measured markers often exceeded the upper limit of the normal range indicating the possibility of "tissue"-thyrotoxicosis beside the pituitary in other target organs, too. According to the present study which takes into consideration markers reflecting end-organ responsiveness to thyroid hormones it is recommended to adjust the dose of levothyroxine to maintain serum TSH in the normal range. For patients with subnormal TSH concentration a close follow-up is obligatory and in case od concomitantly raised free-thyroxine level the reduction of the levothyroxine dosage is proposed.

Adult↗
PubMed1992

Unusual echographic form of retinoblastoma.

A case of an 8-year-old girl with unilateral retinoblastoma is presented. The clinical picture was dominated by inflammatory signs and retinal detachment. Ultrasonographic A/B-scan showed a funnel-shaped total retinal detachment and a thick solid mass with similar shape just behind it. The main characteristics of the mass were: irregular inside echo pattern, medium high internal reflectivity, no sign of vascularity, no after movements following a sudden ocular movement, and no shadowing of the scleral or orbital tissues behind it. The vitreous cavity in front of the retina and behind the mass was ultrasonographically clear. The described funnel-shaped echographic pattern might be typical of the diffuse infiltrating retinoblastoma.

Child↗
PubMed1992

Diffuse type alteration of the ocular wall in different eye diseases.

The ocular wall dimensions (thickness and volume) were measured by means of ultrasonography in 61 eyes of 61 patients with different eye diseases and 31 eyes of 31 healthy subjects with or without refractive error. The results confirmed, that in spite of the great variance in the ocular wall thickness, depending on the axial eye length, the volume of the ocular coats is constant in healthy eyes (ca. 1.65 cm3). In patients with ocular hypotony (eyes after intraocular surgery or trauma, and eyes with uveitis or with phthisis bulbi) and in patients with exophthalmus, the ocular wall was thicker and larger in volume than in the healthy control groups. In contrast, the ocular wall dimensions (thickness and volume) were smaller in patients with glaucoma. The results of the study showed that an alteration in the volume of the ocular wall implies a pathological condition of the eye, and thus ultrasound examination of the ocular wall dimensions might play a role in the diagnosis and in the follow-up of the patient.

Adolescent↗
PubMed1992

Impact of a single insulin treatment (imprinting) applied during liver regeneration on hepatic insulin receptor development, blood glucose level and liver function parameters in adult rats.

Rats subjected to partial hepatectomy (surgical removal of two thirds of the liver) showed no appreciable change in serum cholesterol, bilirubin, albumin, total protein and A/G values at 2, 5, 12 and 21 days after the intervention. The enzyme activities characteristic of liver damage (GOT, GPT, LDH, AP) were high in the control group and low in the insulin-imprinted group at 2 days, tended to normalize in both groups at 5 days and changed slightly at 12 days. The blood glucose level was markedly decreased in the control group and to a lesser degree also in the experimental group at 2 and 5 days of sampling. Insulin treatment (loading) performed at 2 and 5 days accounted for a drop of blood glucose which was followed by normalization within 2 h. Starving value and response to insulin loading uniformly fell into the physiological range at 21 days, whereas at 12 days no normalization occurred in either group within 2 h of insulin loading, although the starving value was physiological. The binding capacity of the insulin receptor was markedly low in the control group as long as 12 days, and tended to normalize by 21 days. In the insulin-imprinted group the binding capacity increased over the control at 2 and 5 days and normalized by 12 days.

Animals↗
PubMed1991

[Prinzmetal angina and syncope].

Authors report an unusual case of variant angina associated with unconsciousness. They were able to prove by coronary angiography the vasospasm of the circumflexus artery which was responsible for the morning attacks of the 35 year old patient with unconsciousness, ST segment elevation and high degree AV block. Unconsciousness was the first and earliest sign of the coronary vasospasm.

Adult↗
PubMed1991

[Thrombolysis by tissue plasminogen activator in acute myocardial infarct].

The authors participated in the European multicenter investigation, ESPRIT, organized by the Wellcome Research Laboratories. Thrombolytic treatment by intravenous tissue plasminogen activator was performed in 25 patients with early (less than 6h) myocardial infarction. The efficacy of the treatment was controlled by repeat coronary arteriography at 60 minutes, at 90 minutes and at 24 hours of the tpA treatment. The infarct related artery was reperfused in 9/25 patients at 60 minutes, in 16/25 at 90 minutes and 17/18 at 24 hours. Four patients died after unsuccessful treatment or reocclusion. In two patients significant bleeding occurred at the puncture site but no transfusion was required. No other untoward effect was registered. The left ventricular function did not change significantly during the first day of infarction. It is concluded, that tpA is a safe thrombolytic agent in myocardial infarction. Its thrombolytic efficacy is similar to that of streptokinase.

Humans↗
PubMed1991

[Biological markers reflecting peripheral effects of thyroid hormones in autonomous thyroid adenoma].

In some patients with functioning thyroid autonomous nodules preclinical hyperthyroidism is detected. It is important to know, whether in this intermediate clinical state beside the suppression of pituitary TSH secretion other target organs are also affected by serum free-thyroxine and free-triiodothyronine levels still within the normal range. Determining some sensitive, but not specific biologic markers reflecting the impact of thyroid hormones at the peripheral tissue level, it was demonstrated that in the group of preclinical hyperthyroidism the mean level of plasma fibronectin exceeded that of the controls (mean +/- S. D.: 583.5 +/- 163.9 vs. 424.2 +/- 84.1 micrograms/ml, p less than 0.001), serum procollagen-III-peptide concentration was already significantly raised, though its value was still within the normal range (mean +/- S. D.: 0.73 +/- 0.17 vs. 0.57 +/- 0.16 U/ml, p less than 0.05), conversely, mean sex-hormone binding globulin level was the same as in euthyroid controls (mean +/- S. D. 47.4 +/- 18.2 vs. 48.3 +/- 16.3 nmol/l). The value of all three parameters was significantly elevated in patients with toxic nodular goiter. Based on the results of this study "tissue"-thyrotoxicosis is suspected in some patients with preclinical hyperthyroidism, which may have therapeutical implications.

Adult↗
PubMed1991

[Effect of somatostatin analogue on experimental pancreatic lesions and their sequelae].

The authors examined the effect of long acting somatostatin analogue (Sandostatin, Sandoz) on acute experimental pancreatitis and on the subsequent regeneration. Acute injury to the pancreas was produced by an intraductal intervention (ligature of the bile duct and intraductal injection of taurocholic acid) and by a metabolic route (supramaximal dose of caerulein by repeated subcutaneous injections). The effect of the drug on the acute injury was examined at 6 and 24 hours following the intervention and the effect on regeneration was examined on day 3 and 5 in all cases by determination of plasma enzyme levels and examination of the pancreatic tissue. Long acting somatostatin analogue did not prove to be effective in the serious acute pancreatitis produced by the intraductal intervention. However, in the acute phase of the caerulein induced pancreatitis, it had a beneficial effect as seen by it's ability to moderate the serum enzyme levels. During the examination of pancreatic regeneration was found that in caerulein induced pancreatitis the weight of the pancreas decreases due to atrophy and that this was not affected by long acting somatostatin analogue. As a matter of fact, the somatostatin counteracted the caerulein induced DNA increase, and therefore acted against the reactive hyperplasia. Therefore, the favorable effect of long acting somatostatin analogue is witnessed only in the caerulein induced acute injury but it does not accelerate the rate of pancreatic regeneration following injury. Due to this fact, protracted administration of this agent can not be rationalized.

Acute Disease↗
PubMed1991

[Decreased serum osteocalcin level in non-alcoholic and alcoholic chronic liver diseases].

Serum level of osteocalcin (OC) is believed to be a specific biochemical parameter of bone formation. Decreased serum OC has been reported in alcohol-intoxicated subjects, in patients with primary biliary cirrhosis and in patients with chronic alcoholic liver disease. The question was, whether lower OC level could be detected in patients with nonalcoholic and non-cholestatic chronic liver disease. The serum OC was measured by RIA developed in our laboratory. Results were compared to age and sex matched controls. Decreased OC level was found in 35 out of 47 (74%) patients with non-alcoholic and non-cholestatic liver disease as chronic persistent hepatitis, chronic active hepatitis, fatty liver and cirrhosis, in 21 out of 26 (80%) patients with alcoholic liver disease and in 8 out of 15 (53%) primary biliary cirrhosis. None of the patients had elevated value. There was no correlation between the decreased OC level and the duration or severity of the liver disease and the laboratory parameters as bilirubin, AST, ALT, alkaline phosphatase, albumin, prothrombin, and serum 25-OH-D3 vitamin level. Decreased OC was found also in the patients without cirrhosis. The possible causes are discussed. Relying upon these findings it is supposed that chronic liver disease by itself can influence the osteoblast activity also by some unknown mechanism.

Bone Diseases, Metabolic↗
PubMed1991

Use of ultrasound diagnostics in lacrimal sac diseases.

Ultrasonographic examinations of the lacrimal drainage system demonstrated that the Ultrascan System IV apparatus used was not able to represent the normal-size lacrimal canaliculi, the common canaliculus, the lower part of the nasolacrimal duct and the lacrimal ostium. It can be used routinely, however, in the diagnostics of diseases of the lacrimal sac and its surrounding tissue, for surgical indication and in order to examine the postoperative condition, in most cases without other expensive diagnostic methods. The advantages over dacryocystography are that it is simple, quick, and inexpensive, it can be used post-operatively immediately, the patient is not exposed to radiation, it can be used without any contrast medium, and it is useful when the common canaliculus is occluded.

Humans↗
PubMed1991

Primary Sjögren's syndrome from the viewpoint of an internal physician.

The characteristics of primary Sjögren's syndrome are described on the basis of the follow-up of 65 patients with extraglandular symptoms at the onset and during the disease. The mean age of the patients at onset was 41.8 years and at the time of definite diagnosis was 45.8 years. Articular (32 cases), lacrimal (30 cases) and salivary (30 cases) manifestations were the most frequent initial symptoms. In only 22 of the 65 patients could Sjögren's syndrome be diagnosed at the onset. In most cases, the articular symptoms observed observed in 56 patients during the course corresponded to true polyarthritis, as verified by joint scintigraphy. Most frequently the wrists and ankles were affected. Chronic atrophic gastritis was found in 35 patients. In the young patients (13 cases), both the antrum and the corpus were affected more frequently than in the controls. In middle-aged patients (21 cases), atrophy of the antrum, and in the elderly (10 cases) atrophy of the corpus was more frequent than in the controls. All three types of chronic atrophic gastritis occurred in the disease. The decreased gastric acid secretion was characteristic of types A and AB gastritis, but the hypergastrinaemia only of type A. It was verified that chronic duodenitis and jejunitis occur in the disease. The pancreatic lesions were mild. Renal involvement was detected in 15 patients, vascular symptoms in 22 and lower-airway changes in 21. The variety of the different symptoms proved that primary Sjögren's syndrome can involve many organs.

Acidosis, Renal Tubular↗
PubMed1991

Types of atrophic gastritis in patients with primary Sjögren's syndrome.

Histological examination of the gastric mucosa was performed in 44 patients with primary Sjögren's syndrome with extraglandular symptoms (mean age 51.9, range 22-76). Biopsy specimens were taken from each of three separate regions: the antrum, the corpus, and the transitional zone between the antrum and the corpus. The incidence of chronic atrophic gastritis was considerably higher in patients with Sjögren's syndrome than in the controls. In the young patients with Sjögren's syndrome atrophic lesions were more common both in the antrum and in the corpus than in the control group. In middle aged patients, however, only the antrum, and in the elderly only the corpus, was much more commonly affected than in the controls. All three types of chronic atrophic gastritis occurred in patients with Sjögren's syndrome. Decreased gastric acid secretion was associated mainly with atrophic gastritis of types A and AB, whereas hypergastrinaemia occurred almost exclusively in gastritis of type A.

Adult↗
PubMed1991

Biologic blood markers reflecting thyroid hormone effect at peripheral tissue level in patients receiving levothyroxine replacement for hypothyroidism.

Plasma fibronectin, serum procollagen-III-peptide and sex-hormone-binding globulin as non-specific markers of thyroid hormone effect at peripheral tissue level were determined and their values were related with serum levels of TSH, free-thyroxine and triiodothyronine during levothyroxine sodium replacement therapy for hypothyroidism. Low levels of biologic markers characteristic of hypothyroidism were normalized in consequence of hormone replacement and a negative correlation between their serum levels, and TSH concentration was demonstrated in most subjects. However, in some patients a discrepancy in the response to levothyroxine between the pituitary and other target organs was revealed. Additional evidence was disclosed that the pituitary thyrotroph sensitizes a minor decrease in serum thyroxine level, which would not be recognized by other target organs. Furthermore, it was revealed that during L-T4 replacement therapy in a large fraction of patients with subnormal serum TSH concentration blood levels of the measured markers often exceeded the upper limit of the normal range indicating a possibility of "tissue" thyrotoxicosis, besides the pituitary, in other target organs, too. According to the present study, which takes into consideration markers reflecting end-organ responsiveness to thyroid hormones, it is recommended to adjust the dose of levothyroxine to maintain serum TSH in the normal range. For patients with subnormal TSH concentration a close follow-up is obligatory and in case of concomitantly raised free-thyroxine level the reduction of the levothyroxine dosage is proposed.

Adult↗
PubMed1990

[The significance of hypocitruria in calcium oxalate induced nephrolithiasis].

The citrate concentration of the daily collected urine was measured by citrate lyase method in 25 untreated patients with recurrent calcium stone disease (10 hypercalciuric and 15 normocalciuric) and in 11 patients with stone disease treated with hydrochlorothiazide and in 16 healthy controls. We found a great variancy of the results what rather looks like biological than methodic type. The concentration (1.99 +/- 1.33 mmol/l in normocalciuric and 2.77 +/- 1.62 in hypercalciuric stone formers but 5.06 +/- 2.81 in controls) and the daily output of the urinary citrate (2.74 +/- 1.38 mmol/d and 4.24 +/- 1.69 vs. 4.41 +/- 1.85) but not the citrate/creatinine ratio was significantly less in about the half of stone formers. The hypocitraturia was frequent in the normocalciuric and very rare in the hypercalciuric group of the renal stone patients. Measurement of the urine citrate concentration is more sensitive tool in the diagnosis of hypocitraturic state than daily citrate output while the latter is more characteristic for the patient, so common study of the two parameters is recommended.

Adult↗
PubMed1990

[Plasma fibronectin level in thyroid disease].

Fibronectins are widespread components of connective tissues and their production is partly under hormonal control. A study was undertaken to reveal the influence of thyroid diseases on plasma fibronectin level. It is stated that compared with a euthyroid control group (n = 33; 436 +/- 82 micrograms/ml) plasma fibronectin content is significantly higher in untreated, overt hyperthyroidism (n = 27; 1036 +/- 389 micrograms/ml), while its plasma level is lower in hypothyroidism (n = 18; 230 +/- 123 micrograms/ml). Data hint to the possibility that the measurement of plasma fibronectin level may yield a help to assess the effect of thyroid hormones at target organ (connective tissue) level.

Adult↗
PubMed1990

[Early calcipenic osteopathy in the panoramic x-ray image of the maxillary and mandibular alveolar process of young adult alcoholics].

The authors have examined 220 maxillary and mandibular panoramic roentgenograms of 55-55, all 110, between 21-34 years of age alcohol addict males and females with a complete dentitions and intact parodontium. In 19 per cent of patients developed osteoporomalacia, cystic rarefications and multiple pathologic microfractures of the alveolar spongy bone tissues. The calcipenic osteopathia was verified by the routine laboratory disorders of calcium and phosphor metabolisms, besides by the diminution of roentgenmorphometrical index of right 2nd metacarpus and tibia. The osteoporomalacia of alveolar parts preceded calcipenic osteopathia of all bones in 52 per cent of patients. A quantity of 25-50 g alcohol consumed daily would be resulting the calcipenic osteopathia after 3-5 years. Its development may be due to individual praedisposition influenced by nutritional, hormonal, genetic and hepatopancreatic factors.

Adult↗
PubMed1990

The posterior coats of the eye in glaucoma. An echobiometric study.

The axial length of the eye and the thickness of the posterior coats of the eye were measured sonographically in 50 eyes of 25 patients with glaucoma. From these data, the volume of the posterior half of the ocular coats was calculated. The intraocular pressure (IOP) of the patients varied between 10 and 69 mmHg. A negative correlation was found between the IOP and the ocular coat dimensions (thickness and volume, r = 0.5, P less than 0.05 and r = 0.6, P less than 0.005, respectively). The possible connection between elevated IOP and the choroidal circulation is also discussed.

Aged↗