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László Csernay

Publications and source records attributed to László Csernay.

11 recordsLinked to original sources
PubMed2006

Correlations between clinical symptoms, working memory functions and structural brain abnormalities in men with schizophrenia.

Thirteen male patients with schizophrenia and thirteen male normal control subjects were compared by magnetic resonance imaging (MRI) on volumes of the straight gyrus (SG), anterior cingulate gyrus, middle frontal gyrus, hippocampus, third ventricle, cavum septi pellucidi, total brain volume and intracranial volume. In addition, neuropsychological tasks were used to measure working memory and executive functions. Healthy volunteers and schizophrenic patients showed no significant differences in mean values for volumes of regions of interests. In the case of the SG, we found a significant difference in laterality: the tendency toward left dominance in healthy volunteers changed to significant right dominance in patients. The schizophrenic patients showed lower performance in working memory tasks, and strongly significant group differences were observed in measures of neurological signs assessed by the Neurological Evaluation Scale (NES). Negative symptoms correlated with the level of spatial working memory and executive functions. Negative symptoms also correlated with the volume of the right hippocampus, while the rate of anhedonia negatively correlated with the relative volume of the left SG.

Adult↗
PubMed2005

Regional cortical blood flow changes following sodium lactate infusion in Alzheimer's disease.

Bilateral temporoparietal hypoperfusion is a characteristic single photon emission computed tomography (SPECT) finding in Alzheimer's disease (AD). Lactate is a metabolic vasodilator and is known to provoke increased cerebral blood flow (CBF) in healthy adults. This work investigated whether lactate, which is present in high concentrations in AD cerebrospinal fluid, affects AD-specific perfusion abnormalities. Twenty mild-to-moderately demented AD probands participated in the self-controlled study. The regional CBF was examined utilizing (99m)Tc-HMPAO SPECT after sodium lactate infusion (0.5 M, 5 mL/kg body weight) and 0.9% NaCl infusion, one on each of two separate days. Despite the vasodilatator effects of sodium lactate, AD rCBF patterns did not show increase in temporo-parietal regions after its infusion. AD-specific bi-temporo-parietal reduction in CBF was accompanied by further hypoperfusion in the parieto-occipital areas after the sodium lactate infusion in seven patients, while no CBF changes were observed in the case of the remaining 13 probands. The pattern of the CBF abnormalities was not correlated with the apolipoprotein E genotype. The decreased vascular responsiveness to sodium lactate reflects disturbed vasoregulatory processes in AD and it is unlikely that lactate would have any relevance in the treatment of AD-related cerebral hypoperfusion, but could be used to improve the value of perfusion SPECT in the diagnosis of AD.

Aged↗
PubMed2004

Diagnostic role of secretin-enhanced MRCP in patients with unsuccessful ERCP.

AIM: To evaluate the value of MR cholangiopancreatography (MRCP) in patients in whom endoscopic retrograde cholangiopancreatography (ERCP) was unsuccessfully performed by experts in a tertiary center. METHODS: From January 2000 to June 2003, 22 patients fulfilled the inclusion criteria. The indications for ERCP were obstructive jaundice (n = 9), abnormal liver enzymes (n = 8), suspected chronic pancreatitis (n = 2), recurrent acute pancreatitis (n = 2), or suspected pancreatic cancer (n = 1). The reasons for the ERCP failure were the postsurgical anatomy (n = 7), duodenal stenosis (n = 3), duodenal diverticulum (n = 2), and technical failure (n = 10). MRCP images were evaluated before and 5 and 10 min after i.v. administration of 0.5 IU/kg secretin. RESULTS: The MRCP images were diagnosed in all 21 patients. Five patients gave normal MR findings and required no further intervention. MRCP revealed abnormalities (primary sclerosing cholangitis, chronic pancreatitis, cholangitis, cholecystolithiasis or common bile duct dilation) in 10 patients, who were followed up clinically. Four patients subsequently underwent laparotomy (hepaticojejunostomy in consequence of common bile duct stenosis caused by unresectable pancreatic cancer; hepaticotomy+Kehr drainage because of insufficient biliary-enteric anastomosis; choledochojejunostomy, gastrojejunostomy and cysto-Wirsungo gastrostomy because of chronic pancreatitis, or choledochojejunostomy because of common bile duct stenosis caused by chronic pancreatitis). Three patients participated in therapeutic percutaneous transhepatic drainage. The indications were choledocholithiasis with choledochojejunostomy, insufficient biliary-enteric anastomosis, or cholangiocarcinoma. CONCLUSION: MRCP can assist the diagnosis and management of patients in whom ERCP is not possible.

Adult↗
PubMed2004

[Diagnostic value of secretin-enhanced magnetic resonance cholangiopancreatography (S-MRCP) after unsuccessful endoscopic retrograde cholangiopancreatography (ERCP)].

BACKGROUND AND AIMS: To evaluate the value of S-MRCP in patients in whom ERCP performed by experts in a tertiary center were unsuccessful. PATIENTS AND METHODS: From January 2000 to June 2003, 22 patients fulfilled the inclusion criteria. The indications for ERCP were obstructive jaundice (n = 9), abnormal liver enzymes (n = 8), suspected chronic pancreatitis (n = 2), recurrent pancreatitis (n = 2) or suspected pancreatic cancer (n = 1). The reasons for the ERCP failure were postsurgical anatomy (n = 7), duodenum stenosis (n = 3), duodenal diverticulum (n = 2), or technical failure (n = 10). MRCP images were evaluated before and 5 and 10 min after the i.v. administration of 0.5 IU/kg secretin. RESULTS: The MRCP images were diagnostic in all but 1 patient. Five patients gave normal MR fadings and required no further intervention. S-MRCP detected abnormalities (primary sclerosing cholangitis, chronic pancreatitis, cholangitis, cholecystolithiasis or common bile duct dilatation) in 10 patients, who were followed up clinically. Four patients subsequently underwent laparotomy (hepatico-jejunostomy owing to common bile duct stenosis caused by unresectable pancreatic cancer; hepaticotomy + Kehr drainage because of narrow biliary-enteric anastomosis; choledocho-jejunostomy, gastro-jejunostomy and Wirsungo-gastrostomy in consequence of chronic pancreatitis or choledocho-jejunostomy because of common bile duct stenosis caused by chronic pancreatitis). Three patients participated in therapeutic percutaneous transhepatic drainage; the indications were choledocholithiasis in one patient choledocho-jejunostomy anastomosis, narrow biliary-enteric anastomosis, or cholangiocarcinoma. CONCLUSION: S-MRCP is the method of choice in cases where ERCP is not possible.

Adult↗
PubMed2004

The prognostic value of dopamine receptor occupancy by [123I]IBZM-SPECT in schizophrenic patients treated with quetiapine.

BACKGROUND: In the present study D2 receptor occupancy was investigated in quetiapine treated schizophrenic patients for the detection of a relationship between the scintigraphic pattern and clinical signs and symptoms. MATERIAL AND METHODS: In 10 schizophrenic patients [123I]IBZM-SPECTs were performed during the introduction of quetiapine therapy (600-800 mg/day) and during a lower maintenance dose (200-400 mg/day). The patients' clinical follow-up was continued for 1 year. For the evaluation of SPECT images, visual interpretation was performed and striatum/occipital lobe (S/O) activity ratio was calculated. RESULTS: The initial striatum/occipital ratio was significantly higher in patients with relapse compared to the others (1.86 +/- 0.17, 1.53 +/- 0.15, p < 0.01). The decreasing striatum/occipital ratio (increasing D2 receptor occupancy) on the 2nd SPECT was a predictive factor for the relapse. CONCLUSIONS: D2 receptor occupancy and its changes during quetiapine therapy were related to the prognosis of the treatment efficacy.

Adult↗
PubMed2002

[The role of FDG-PET scan in the diagnosis of pancreatic carcinoma].

In 22 patients with focal pancreatic lesions, the values of different diagnostic modalities were analysed for the evaluation of malignancy. The CA 19-9 level was elevated in 4/5 malignant cases (sensitivity: 80%) and in 4/15 of benign cases (specificity: 73%). Hypodensity/hypoechogeneity was considered to be the characteristic sign of malignancy during CT/ultrasound (sensitivity: 100%, specificity: 50%/47%). ERCP was found to be specific but not sensitive enough and the rate of unsuccessful investigations was relatively high (4/22). The diagnostic value of FDG-PET was found to be superior to other diagnostic modalities (sensitivity 100%, specificity 88%). In cases with focal pancreatic hypoechogenic/hypodense lesions detected by CT or US in suspicion of malignancy, the FDG-PET should be the next step in the diagnostic strategy.

Adult↗
PubMed2002

Effect of nitric oxide on gallbladder motility in patients with acalculous biliary pain: a cholescintigraphic study.

The aim of the present study was to evaluate the influence of the exogenous nitric oxide donor glyceryl trinitrate on cerulein-induced gallbladder contraction in patients with acalculous biliary pain. Quantitative hepatobiliary scintigraphy was performed on 33 patients. From the 60th min cerulein (1 ng/kg body wt/min for 10 min intravenous) then from the 90th min the same dose of cerulein plus glyceryl trinitrate (0.5 mg sublingually) (21 patients) or placebo (12 patients) were administered and the gallbladder ejection fraction was measured repeatedly. After the first dose of caerulein, the gallbladder ejection fraction was less than 35% in 23 of 33 patients (nonresponders), while it was more than 35% in the remaining 10 patients (responders). After the second dose of cerulein in 16 nonresponder patients glyceryl trinitrate administration significantly increased the previously impaired gallbladder ejection fraction while in 7 nonresponder patients placebo administration had no effect. In conclusion, normalization of the gallbladder ejection fraction in the majority of patients following glyceryl trinitrate administration suggests that impairment of gallbladder emptying is caused by a functional motility disorder rather than any organic disease.

Biliary Dyskinesia↗
PubMed2002

The possible role of F-18 FDG positron emission tomography in the differential diagnosis of focal pancreatic lesions.

PURPOSE: To compare the diagnostic values of different methods for the differentiation of malignant from benign pancreatic lesions. METHODS: In 22 patients with focal pancreatic lesions, the carbohydrate antigen (CA) 19-9 level was measured; abdominal ultrasound (US), computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP), and F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) were performed; and the value of these methods were analyzed for their use in cancer diagnosis. RESULTS: Malignant lesions were identified in six patients and verified by surgery or clinical follow-up. The CA 19-9 level was elevated in four of the five patients examined (sensitivity, 80%). In all six cases, US and CT revealed hypoechogenic and hypodense areas (sensitivity, 100%). In one patient, ERCP was unsuccessful but yielded true-positive results in three others (sensitivity, 60%). The sensitivity of FDG PET was 100%. Sixteen focal cases of pancreatic disease proved to be benign. The CA 19-9 level was elevated in four of them (specificity, 73%). Hypoechogenic and hypodense areas were evident on US and CT in eight patients. The specificity of CT was 50% (8 of 16 cases). The specificity of US was 47% (7 of 15 cases). The specificity of successful ERCP was 92%. Fourteen negative FDG-PET results were truly negative. In two patients, however, the PET findings proved to be falsely positive (specificity, 88%). CONCLUSIONS: FDG-PET is an effective tool to differentiate malignant from benign focal pancreatic lesions. In persons with focal pancreatic hypoechogenic or hypodense lesions detected by CT or US and an elevated CA 19-9 level, FDG PET should be the next step in the diagnostic strategy.

Adult↗