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Biomedical subjects

K Kiss

Publications and source records attributed to K Kiss.

At least 37 records · Page 2Linked to original sources
PubMed2000

Pancreatic head mass: what can be done? Diagnosis: computed tomography scan.

The diagnosis of different pancreatic diseases has recently become a recurrent problem. In cases with pancreatic head mass the main question is the differentiation between malignant and benign lesions. When a neoplasm is suspected, the main task is to judge operability. The usefulness of computed tomography imaging in the evaluation of pancreatic carcinoma has been well established. In this article the authors discuss the possibilities of computed tomography (CT) in diagnostic work-up.

Diagnosis, Differential↗
PubMed1999

Evaluation of pneumonia diagnosis in intensive care patients.

The aims of this study were to investigate the frequency of bronchopneumonia diagnosed by histological criteria among autopsied intensive care unit (ICU) patients and to compare these with rates of pneumonia diagnosed by conventional clinical methods. The study material comprised 141 autopsied ICU patients from 7 ICUs in university hospitals in Copenhagen from a 1-y period. A total of 20 lung tissue specimens were sampled from each patient and the histopathological diagnoses were classified as no, mild, moderate or severe bronchopneumonia. Inter-observer variation was calculated using kappa statistics. Demographic data and diagnoses of pneumonia were registered from the patient files. Twenty-six percent of the patients had pneumonia diagnosed whilst in the ICU. Histological evidence of pneumonia, found for every second patient, was regarded as the gold standard. Diagnosis of pneumonia in the ICU had a sensitivity of 29% and if diagnoses of pneumonia during the month before ICU-admission were included, a sensitivity of 60% was found. Specificity for pneumonia diagnosed in the ICU was 77%. The percentage of all ICU-patients with pneumonia was calculated to be between 36% and 56%, depending on the extent of excess mortality attributable to pneumonia. Pulmonary segments with histologically diagnosed pneumonic lesions were distributed diffusely, although the upper segments tended to be affected less. Nearly all patients had other histopathological findings than bronchopneumonia. The reliability coefficient among the 6 pathologists was found to be moderately good (kappa = 0.45).

Adolescent↗
PubMed1999

Partial characterization of two lymphocyte-specific natural autoantibodies isolated from newborn mice.

The early antibody-repertoire is mainly composed of multi- and polyreactive IgM autoantibodies. Some of them (about 10%) also react with cell surface antigens. It is supposed that these latter antibodies promote--particularly under the maturation of the immune system--the expansion of different lymphocyte populations and subpopulations, namely the filling of the secondary lymphoid organs by immunocompetent cells. In order to verify this hypothesis we established hybridoma clones from newborn Balb/c mice. Almost all IgM antibodies produced by these hybridomas (94%) were found to be polyreactive, but only two--the 4/5 and the 8/8--react with cell surface structures. The 4/5 IgM recognizes a glicerin-phosphathydil-inositol (GPI)-anchored membrane component expressed on the early thymocytes. The 8/8 antibody reacts with resting splenic B lymphocytes as well as B and T cell blasts via an about 40 kD protein. They do not influence the spontaneous or the mitogen induced proliferation of the lymphocytes. Therefore we cannot confirm the hypothesis that increase of the expansion of peripheral lymphocytes would be the main function of these neonatal natural autoantibodies.

Animals↗
PubMed1998

[High-resolution computer tomography of diffuse infiltrative lung diseases].

During a period of 17 months, a total of 101 patients were examined by high resolution computed tomography (HRCT) whose minor focal changes revealed by chest X-ray raised the suspicion of diffuse infiltrative pulmonary disease. The disease of the interstitium was primarily caused by idiopathic pulmonary fibrosis (19%), autoimmune disease (18%), Boeck sarcoidosis (18%) as well as by specific (16%) and aspecific inflammation (12%). HRCT disclosed reticular (61%), nodular (55%), ground-glass opacity-like (48%), emphysematous (33%) and ring-like changes (17%). Also transbronchial excision was performed in 51 patients the results of which were compared to the changes observed during HRCT. Concerning fibrosis and inflammation, HRCT and histological analysis showed identical results in 70%. According to the authors observations, this technique is suitable for detection of fairly fine fibrotic, empysematous and inflammatory signs and for defining the activity of the individual disease as also for the selection of the optimal site of transbronchial excision. HRCT is a useful investigative method both for diagnosing diffuse infiltrative pulmonary disease as well as in following up the effectiveness of treatment.

Diagnosis, Differential↗
PubMed1998

[Toxoplasma encephalitis with atypical manifestation and normal CT].

A case of cerebral toxoplasmosis in a HIV-positive man with unusual clinical manifestations and a normal computed tomographic (CT) scanning is presented. Even though most patients with cerebral toxoplasmosis have focal neurological deficits on physical examination, the patients can also present with more diffuse symptoms. Neither the lack of antitoxoplasma antibodies nor normal findings at CT scanning exclude the diagnosis of toxoplasma encephalitis. The sensitivity is higher with magnetic resonance than with CT scanning. We present a case story that demonstrate how delusive cerebral toxoplasmosis can be in HIV positive patients. It is recommended that the possibility of cerebral toxoplasmosis be considered in every HIV-positive patient with neurological symptoms and empirical therapy be instituted on wide indications.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Congenital broncho-esophageal fistula manifesting in adult age].

Congenital bronchoesophageal fistula manifesting in adulthood is an infrequent disorder. Presenting a successfully treated case, the authors review the clinicopathological features of the disease regarding the data of literature. The long-standing, non-specific respiratory symptoms recurring in the same pulmonary location call the attention to the fistula, which should be verified by esophagography and endoscopy. The adequate treatment consisting of fistulectomy and resection of the destroyed lung parenchyma lead to prompt recovery.

Age Factors↗
PubMed1996

[Fiberoptic bronchoscopy in intensive care units].

The authors have retrospectively analysed 161 bedside fiberoptic bronchoscopies performed at intensive care units and demonstrate its' main indications, results and influences on the patients' condition. In 35.4% of cases immediate improvement was observed, in 31.6% the examination contributed to choose the proper treatment. Due to the safe method only one serious complication occurred because of bronchoscopy. The results justify-according to the literature-that fiberoptic bronchoscopy is an indispensable method to check airways and for diagnostical and therapeutic interventions of critically ill patients.

Bronchoscopes↗
PubMed1996

Acanthamoeba keratitis in the south of Sweden.

Eight patients with Acanthamoeba keratitis were diagnosed and treated at our clinic between February 1991 and February 1993. Five of these were contact lens wearers, two had suffered recent corneal trauma and one had recently undergone penetrating keratoplasty. The diagnoses were based on both culture and histological examination of biopsy material in three cases, on culture alone in two cases and on histological examination alone in three cases. In all but one primary treatment was Propamidine isethionate and Neomycin/Polymyxin B topically and Ketoconazole orally. Because of poor healing three patients additionally received Paromomycin and Miconazole or Clotrimazol topically; two of these were further treated with Polyhexamethylene biguanide topically. The interval from initial symptoms to accurate diagnoses varied from one to eleven months. In one patient the eye could not be saved; in the remaining patients visual acuity after healing ranged from hand movements to 1.0.

Acanthamoeba↗
PubMed1996

Combination chemotherapy with a five-drug regimen for invasive thymoma.

Nine patients with stage III and stage IV thymoma were treated with cisplatin, vincristine, lomustine, cyclophosphamide and prednisolone. Two patients (22%) obtained remission, and four patients (44%) showed no change for 11 to 31 months. It was found that this five-drug regimen did not improve the results obtained by other chemotherapy modalities for thymoma.

Adult↗
PubMed1994

[The role of Nd-YAG in the management of tracheobronchial stenosis].

122 patients with the main airway stenosis were treated with Nd-YAG laser phototherapy. The endobronchial laser treatment was performed either with flexible bronchoscope (64%), or with rigid instrument (36%). This method can result a final recovery of the patients with benign tumors, or inflammatory processes, at the patients with malignant tumors can be achieved an effective palliation. Taking account the generally accepted indications and contraindications of the endobronchial laser phototherapy the number of the complications can be reduced.

Aged↗
PubMed1994

[Nephropathy in patients treated with ifosfamide].

Between 1987-1992 in the Department of Pediatric Oncology of Child Health Center at Miskolc the appearance of nephropathy caused by high dose Ifosfamide was studied (using different protocols) in patients with childhood malignancy. From 7 patients in 5 children nephrotoxicity were developed. In consequence of Ifosfamide rickets 2 patients are given continuous bicarbonate and calcitriol substitution. The authors call attention to the frequency of Ifosfamide nephropathy, low serum bicarbonate and phosphate concentration with glucosuria, aminoaciduria and hypochloremic acidosis were the manifestations of the disturbances of renal tubular functions. Prospective monitoring of these serum and urinary abnormalities may lead to early detection of tubulopathy and allow early replacement therapy.

Acidosis, Renal Tubular↗
PubMed1994

Intraocular T-cell lymphoma mimicking a ring melanoma. First manifestation of systemic disease. Report of a case and survey of the literature.

A case is presented of an intraocular T-cell lymphoma mimicking a ring melanoma of the iris and being the first manifestation of systemic disease. A 51-year-old woman was referred with an anterior uveitis, initially presenting as a granulomatous iritis. Nodules had developed in the circumference and the lesion now imitated a malignant melanoma of the iris, which was also the diagnosis from a biopsy specimen with routine staining. Clinical, haematological and serological examination revealed no other symptoms or signs. Lymphocytic markers applied to the biopsy specimen and to the enucleated eye revealed a highly malignant T-cell lymphoma infiltrating the iris, ciliary body, anterior choroid, retina and the adjacent vitreous body. Further examination later showed T-cell lymphoma in the bone marrow, the only other organ involved. The patient died in a leukaemic phase about 1 year after the first admission. Previous cases of T-cell lymphoma with ocular involvement are reviewed.

Ciliary Body↗
PubMed1994

A natural IgM antibody does inhibit polyclonal and antigen-specific IgM but not IgG B-cell responses.

Since a B-cell growth-inhibitory natural IgM antibody was identified in the culture supernatants of LPS-stimulated murine splenic B lymphocytes [11], attempts have been made to define other possible functional role(s) of this antibody. Here we show that this regulatory IgM is able to inhibit not only the proliferation of splenic B cells, but also their IgM secretion during LPS-induced polyclonal, as well as antigen (FITC-KLH)-specific antibody responses. In contrast, IgG1 production of hapten (FITC)-specific B cells neither during restimulation with LPS nor in the presence of carrier-specific T lymphocytes in vitro was affected by regulatory IgM. Therefore, whereas newly emerging naive B cells are highly susceptible, IgG-secreting B cells appear to be completely resistant to inactivation by the regulatory IgM autoantibody.

Animals↗
PubMed1993

[Relation of angiographic changes to clinical data and risk factors in patients with arteriosclerosis obliterans].

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.

Adult↗
PubMed1993

New method for discriminating between calcium stone formers and healthy individuals.

A new method for discriminating between the urine of potential calcium stone formers and healthy persons has been proposed, based on determination of the calcium binding capacity of urine (CBC) by titration of early morning urine with a calcium chloride solution. For this purpose a new PVC matrix calcium ion selectrode for measuring calcium ion concentration in whole urine was used. The selectrode has a disposable membrane which can easily be prepared and replaced in the laboratory. Plots of the calcium ion concentration versus the concentration of total added calcium were linear up to a point where precipitation of calcium salts commenced. The slopes of these titration lines were used as criteria for discrimination. Statistical evaluation showed good separation between the urine of healthy and stone forming donors. A 2-sample t test with unequal variances gave mean values of 0.31 for healthy urine (13 samples) and 0.64 for stone forming urine (26 samples). Individual 99% confidence intervals were 0.21-0.40 for the controls and 0.54-0.73 for the patients respectively. Discriminant analysis showed that from a group of treated patients with low Dl (13 samples), 3 were classified as stone formers and 10 were non-formers. Thus there was good correlation with the clinical situation and with the previously proposed Dl test.

Calcium↗