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L Tornóci

Publications and source records attributed to L Tornóci.

9 recordsLinked to original sources
PubMed2000

Epidemiology and clinicopathology of aortic dissection.

STUDY OBJECTIVES: To determine the incidence and mortality as well as to analyze the clinical and pathologic changes of aortic dissection. DESIGN AND SETTING: A population-based longitudinal study over 27 years on a study population of 106,500, including 66 hospitalized and 18 nonhospitalized consecutively observed patients. MEASURES: Analysis of data from the medical, surgical, and autopsy records of patients with aortic dissection. RESULTS: Altogether, 86 cases of aortic dissection were found in 84 patients, corresponding to a 2.9/100,000/yr incidence. Sixty-six of the 84 patients (79%) were admitted to the hospital, and 18 patients (21%) died before admission. Their ages ranged from 36 to 97 years, with a mean of 65. 7 years. The male/female ratio was 1.55 to 1. A total of 22.7% of the hospitalized patients died within the first 6 h, 33.3% within 12 h, 50% within 24 h, and 68.2% within the first 2 days after admission. Six patients were operated on, with a perioperative mortality of two of six patients and a 5-year survival of two of six patients. All patients who were not operated on died. Pain was the most frequent initial symptom. Every patient had some kind of cardiovascular and respiratory sign. Neurologic symptoms occurred in 28 of 66 patients (42%). Five patients presented with clinical pictures of acute abdomen and two with acute renal failure. Trunk arteries were affected in 33 of the 80 autopsied cases (41%), and rupture of aorta was seen in 69 cases (86%). In five cases, spontaneous healing of dissection was also found. The ratio of proximal/distal dissections was 5.1 to 1. All 18 prehospital cases were acute. Fifty-nine cases (89.4%) were acute at admission, and 7 cases (10.6%) were chronic dissections. Hypertension and advanced age were the major predisposing factors. CONCLUSION: Aortic dissection was the initial clinical impression in only 13 of the 84 patients (15%). Thus, 85% of the patients did not receive immediate appropriate medical treatment. For this reason, these late-recognized and/or unrecognized cases may be regarded as an untreated or symptomatically treated group, whose course may resemble the natural course of aortic dissection.

Adult↗
PubMed1999

Endothelial permeability of the afferent arteriole and its changes as the result of alteration in the activity of the renin-angiotensin system.

Recent studies have demonstrated fenestrations in the juxtaglomerular part of the afferent arteriole facing the extraglomerular mesangium and the epithelioid cells in different mammals including humans. The permeability of the endothelium in afferent arteriole may play an important role in various physiologic and pathophysiologic processes. This study therefore was conducted to examine the permeability along the length of afferent arteriole using ferritin particles as an indicator of permeability/fenestration. Assuming the presence of a relationship between the development of permeable endothelial fenestration and renin formation, the permeability of the endothelium and renin granulation and their correlation along the wall of the afferent arteriole under control conditions and during inhibition of renin-angiotensin system by converting enzyme inhibition or AT1 receptor blockade were examined. The intra-aortically administered ferritin particles appeared in the interstitium of the distal part of the afferent arterioles. About one-third to half of the length of the afferent arteriole wall was ferritin-positive. There was a correlation between ferritin-positive and renin-positive portions. The density of ferritin particles was high close to the glomerulus and decreased continuously, similar to the profile of renin distribution. There was also a correlation between ferritin density in basal membrane and the renin granulation index. On the basis of these results, the afferent arteriole, according to its endothelial permeability, can be divided into two distinct portions, i.e., the permeable and the nonpermeable, the length and ratio of which may be related to the actual renin formation. These portions not only are different in the presence or absence of fenestration of the endothelium, but they also show difference in myosin and renin contents, suggesting that each portion may serve different function(s).

Angiotensin Receptor Antagonists↗
PubMed1996

The vasoconstrictor effects of L-NAME, a nitric oxide synthase inhibitor, in pregnant rabbits.

1. We have used anaesthetized, acutely instrumented non-pregnant (NP) and late pregnant (P) New Zealand white rabbits to examine the possible role of nitric oxide (NO) in the pregnancy-induced fall of vascular tone and arterial pressure. Systemic, renal and pulmonary vascular resistance, as well as plasma concentrations of cyclic GMP (PcGMP) were compared before and after the inhibition of NO synthesis by N(G)-nitro-L-arginine methyl ester (L-NAME). 2. P rabbits had lower baseline total peripheral resistance (TPR), mean arterial pressure (MAP) and higher PcGMP than NP controls (all P < 0.05 or less). L-NAME (1, 10, 50 mg kg1, i.v.) resulted in dose-dependent elevation of TPR in both groups. However, the absolute, as well as percentage increases in TPR were greater (P < 0.05) in NP than in P rabbits. 3. Cardiac output (CO) was reduced more (P < 0.01) by NO inhibition in NP than P rabbits. Therefore, despite the smaller increase in TPR, the elevation of MAP was greater (P < 0.001) in P than NP rabbits. After L-NAME, NP rabbits developed more severe bradycardia and a greater increase of pulmonary vascular resistance which might have contributed to the more pronounced reduction of CO. 4. PcGMP increased in both groups following L-NAME, but more (P < 0.01) in NP than P rabbits. 5. Infusion of acetylcholine (ACh, 0.02 micromol l-1 kg-1) reduced MAP and TPR more (both P < 0.05) in NP than P rabbits and L-NAME reduced the ACh-induced depressor response only in NP rabbits. 6. These results suggest that the low vascular tone and arterial pressure in pregnant rabbits is not mediated by NO.

Acetylcholine↗
PubMed1990

Effect of metoprolol and pindolol monotherapy on plasma lipid- and lipoprotein-cholesterol levels (including the HDL subclasses) in mild hypertensive males and females.

Forty-five patients with mild hypertension were treated for 2 months with either metoprolol or pindolol in a randomized, blind, crossover study. The effects of metoprolol (100-300 mg/day) and pindolol (5-15 mg/day) on triglyceride (TG), cholesterol (C), high-density lipoprotein cholesterol (HDL-C), and HDL subfraction (HDL2-C and HDL3-C) levels were compared in males and females separately. Pindolol and metoprolol significantly elevated (10% above baseline level) the plasma TG level in both males and females. After metoprolol treatment, the HDL-C level remained unchanged in both sexes; however, a shift was found between HDL2-C and HDL3-C:HDL2-C decreased and a concomitant elevation in HDL3-C was observed. Pindolol significantly decreased total C, HDL-C, and HDL2-C levels in males. A similar trend (although the changes were not significant) was found in females. The results demonstrate the role of beta blockers in the inhibition of TG-rich lipoprotein elimination. These findings suggest that during long-term administration of metoprolol and pindolol, risks and benefits from beta-blocker therapy must be carefully considered. Continuous monitoring of lipid profiles is suggested during this treatment in order to avoid the potential worsening effect of beta blockers on risk factors of ischemic heart disease.

Adult↗
PubMed1989

Lipid and lipoprotein measurements in a normal, adult Cuban population.

An attempt was made to determine the normal reference values of lipid- and lipoprotein levels (cholesterol), triglycerides, cholesterol in high- and low-density lipoproteins) in a selected, apparently healthy, Cuban population. Results were expressed as mean, and various percentiles of measured values; two ratios: Risk 1 (LDL-C/HDL-C) and Risk 2 (TC/HDL-C) were also calculated. Approximately 40% of the subjects aged 20 to 30 years had cholesterol values above 200 mg/dl. Females had significantly higher cholesterol HDL-C values than males, whereas the concentrations of LDL-C and LDL were higher in males. Risk 2 ratios were elevated in males. A correlation was shown between lipid levels and age. There was a strong negative correlation between HDL-C and relative body weight. It is suggested that obesity might be an individual risk factor in the population studied.

Adult↗
PubMed1989

Lipid and lipoprotein profiles in Cuban children of three age groups.

We determined the lipid and lipoprotein levels in a selected group of apparently healthy adult Cuban subjects in a previous paper /27/. In this paper the basic lipid variables (TC, TG, HDL-C) in 271 healthy children are published. LDL-C levels were also calculated. A small, but continuous, rise was found in the TC level between 0 and 14 years in both sexes. The rise of TG was accompanied by HDL increase in girls but by LDL increase in boys. This phenomenon might explain the augmented susceptibility of men to ischaemic heart disease. Children at "high risk" should be identified (in case of positive family history of ischaemic heart disease) by cholesterol determinations, the borderline of the pathologic cholesterol levels seems to be very similar to that found in the USA, 170-190 mg/dl in the age group between 0 and 14 years.

Adolescent↗
PubMedDate not supplied

Diagnostic value of combined evaluation of neopterin and anti-DNA antibody levels for assessment of disease activity in systemic lupus erythematosus.

OBJECTIVE: The present study was designed to investigate whether the combined evaluation of laboratory tests could improve their diagnostic value. Laboratory parameters of systemic lupus erythematosus (SLE), such as anti-dsDNA, neopterin, soluble IL-2 receptor (sIL-2R), C3, C4, and complement haemolytic activity (CH50), and a logistic model that provides the probable clinical activity (PCA) of a given patient, calculated by stepwise multiple logistic regression analysis from the parameters mentioned above--were evaluated as SLE activation markers. METHODS: Serum samples from 101 patients were assayed by ELISA (neopterin, sIL-2R, anti-dsDNA), radial immunodiffusion (C3, C4) and haemolytic complement assay (CH50). RESULTS: Among the parameters investigated, PCA showed the greatest difference between the values representing active and inactive stages of the disease (p < 0.001), the highest correlation with SLEDAI (p < 0.001) and the highest sensitivity and specificity values (0.91, 0.88, respectively). Moreover, this value of PCA was the most useful in discriminating between active and inactive sample pairs. CONCLUSION: We conclude that PCA is more useful in evaluating SLE activity than the single parameters studied.

Adult↗