Biomedical subjects

Mária Szilasi

Publications and source records attributed to Mária Szilasi.

10 recordsLinked to original sources

PubMed2006

[Results in 42 non-resectable NSCLC IIA-B patients with initial concurrent Taxotere-Cisplatin chemoradiotherapy].

GOALS: A prospective multicenter study to treat non-small cell lung cancer (NSCLC) with inductive chemoradiotherapy for improving chances of operability. If used as first-line therapy, combined treatment improves survival and it is well tolerated with a low rate of side effects. PATIENTS: 42 patients with stage IIIA-B NSCLC from which 36 could be followed. METHODS: A full dose Taxotere-Cisplatin chemotherapy was given to patients with concurrent radiotherapy in 2 Gy fractions up to 60 Gy via conformal irradiation. RESULTS: Local response was very high and 40.47% of patients became operable while in inoperable cases consolidation chemotherapy showed similar results as other protocols. We also found a low rate of side effects. The high rate of brain metastasis suggests that prophylactic cranial irradiation (PCI) should be considered.

Adult↗

PubMed2006

Pathology of chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease is one of the leading causes of death and morbidity worldwide. Despite intensive investigation, its pathology and pathophysiology are not well understood. The hallmarks of the disease are irreversible airflow limitation and chronic inflammation. Small airway obstruction due to progressive inflammation and fibrosis, and the loss of elastic recoil mediated by elastolysis and apoptosis equally contribute to pathologic changes. However, it is debated to what extent the obstruction of large airways leads to altered lung function. Three morphologic entities are described in the literature under one disease; chronic bronchitis, obstructive bronchiolitis and emphysema may appear in the same patient at the same time. The authors review pathologic changes observed in chronic obstructive pulmonary disease, including acute exacerbations and secondary pulmonary hypertension as severe but common complications of the disease. Furthermore, we detail recent scientific evidences for major cellular and molecular inflammatory pathway activation. These mechanisms result in accelerated apoptosis, remodeling and increased proinflammatory cytokine release. Targeting intracellular pathological changes may lead to the discovery of a new generation of drugs that could reduce chronic obstruction before airway irreversibility is established.

Humans↗

PubMed2005

[Interstitial lung disease in mixed connective tissue disease].

INTRODUCTION: The authors analyzed the incidence of interstitial lung disease in mixed connective tissue disease. They were seeking an answer to the following problems: the nature of the pathological course of mixed connective tissue disease complicated by and the therapy to be used in interstitial lung disease. PATIENTS AND METHODS: 179 patients were followed up during a period of 15.9 +/- 6.1 years. Interstitial lung disease was diagnosed using high resolution computed tomography. The diagnosis of interstitial lung disease was not obvious in 5 patients thus open lung biopsy was performed, which confirmed common interstitial pneumonitis. The patients were followed-up, and the data of computed tomography and respiratory function tests were detected 6 months, and then 4 years after the acute lung disease complicated by mixed connective tissue disease. RESULTS: Out of the 179 mixed connective tissue disease patients 96 (53.6%) had interstitial lung disease. The onset of interstitial lung disease was the most frequent in the 2-4 years of the disease. Four years after the first appearance of interstitial lung disease severe fibrosis was diagnosed in 24 patients (25%). A honey comb formation in the lung developed only in one patient. For the treatment of interstitial lung disease, corticosteroid treatment had to be combined with cyclophosphamide in 51 cases. In 4 patients (24%), pulmonary arterial hypertension evolved 2-4 years following interstitial lung disease. The high pulmonary arterial pressure decreased using pulsed corticosteroid treatment, cyclophosphamide, prostacyclin analogue, anticoagulants therapy and the 4 patients stay alive. The pulmonary arterial hypertension was caused by obliterative vasculopathy. CONCLUSION: Pulmonary involvement is found in more than half of the patients with mixed connective tissue disease. Early diagnosis of interstitial lung disease is possible by computed tomography. Interstitial lung disease can be treated by the combination of corticosteroids and cyclophosphamide. The authors were the first to detect the coexistence of interstitial lung disease and pulmonary arterial hypertension in mixed connective tissue disease. Subsequent respiratory alterations in these patient necessitate regular patient follow up.

Adult↗

PubMed2005

[Atypical pneumonia].

International epidemiologic surveys show that apart from community acquired "typical" pneumonia the number of cases caused by atypical pathogens are increasing. A number of problems are to be faced while diagnosing and treating the lower respiratory tract infections due to atypical pathogens. The article gives a detailed overview of pneumonia caused by Chlamydia pneumoniae, Chlamydia psittaci, Mycoplasma pneumoniae, Coxiella burnetti and Legionella species, and emphasizes that these pathogens should be considered and thought about more in lower respiratory tract infections as appropriate treatment, if started in time, decreases the risk of a more severe outcome.

Chlamydophila Infections↗

PubMed2005

[Determination of urinary NAG to detect renal ischemia-reperfusion injury and the protective effect of Allopurinol].

We analysed the effect of ischemia-reperfusion injury to renal parenchyma after unilateral renal artery clamping using urinary N-acetyl-beta-D-glucosaminidase (NAG) that is a sensitive parameter of early renal tubular injury. In the study 60 mongrel dogs were divided into 3 groups: in the 1st group the left renal artery was clamped for 45 minutes, in the 2nd group Allopurinol was administered before the clamping, the 3rd was the control group, where only laparotomy and closure of the abdomen was performed. Urinary NAG activity referring to urinary creatinine (NAG index) was determined before the operation, at the beginning of the reperfusion, in the 60th and 120th minute of the reperfusion then 1, 2, 3 and 5 days after the operation. The highest NAG indices relating to injury of the proximal tubuli were found at the beginning of the reperfusion, in the 60th and 120th minutes of the reperfusion, then NAG returned to preoperative level in each group. Significantly higher NAG indices were found in the ischemia-reperfusion group compared to the group with Allopurinol pretreatment. Renal ischemia-reperfusion injury and the protective effect of Allopurinol could be detected by lysosomal NAG enzyme. The injury of the tubular function was reversible so it could be a change in tubular function.

Acetylglucosaminidase↗

PubMed2004

[The role of bronchoscopy in examination and treatment of esophageal tumours].

The role of bronchoscopy in examination and treatment of esophageal tumours. The esophageal tumours are diagnosed in many cases in inoperable stage, and if a surgical resolution is possible, it's a heroic, great operation with high mortality rates and poor results. The involvement of great airways should be explored preoperatively by imaging methods, but bronchoscopy is also mandatory. The authors report their one year's experience of 121 bronchoscopic examinations in esophageal cancer patients. The finding was negative in 40.5% of all examinations, and 29.7% was concerned the cancer propagation to bronchial system. 29.8% of all examinations resulted a suspicion of propagation. The opinion of bronchologist can be decisive postoperatively if a fistula is suspected, or after an esophageal stent implantation airway symptoms occur. Bronchoscopy is a standard method for removal of airway excretion. The author's overview is comparing their fifteen years experience with international literature.

Adult↗

PubMed2004

Inhaled carbon monoxide confers antiinflammatory effects against ventilator-induced lung injury.

Ventilator-induced lung injury (VILI) is a major cause of morbidity and mortality in intensive care units. The stress-inducible gene product, heme oxygenase-1, and carbon monoxide (CO), a major by-product of heme oxygenase catalysis of heme, have been shown to confer potent antiinflammatory effects in models of tissue and cellular injury. In this study, we observed increased expression of heme oxygenase-1 mRNA and protein in a rat model of VILI. To assess the physiologic function of heme oxygenase-1 induction in VILI, we determined whether low concentration of inhaled CO could serve to protect the lung against VILI. Low concentration of inhaled CO significantly reduced tumor necrosis factor-alpha levels and total cell count in lavage fluid, while simultaneously elevating levels of antiinflammatory interleukin-10 levels. To better characterize the mechanism of CO-mediated antiinflammatory effects, we examined key signaling pathways, which may mediate CO-induced antiinflammatory effects. We demonstrate that inhaled CO exerts antiinflammatory effects in VILI via the p38 mitogen-activated protein kinase pathway but independent of activator protein-1 and nuclear factor-kappaB pathways. Our data lead to a tempting speculation that inhaled CO might be useful in minimizing VILI.

Administration, Inhalation↗

PubMed2004

[Bronchoscopy in intensive care units].

The authors report their 1535 urgent bronchoscopic examinations performed between 1998-2002. The examinations/interventions were requested mostly by surgical and internal medicine intensive care units. The main indications were: postoperative excretion removal, stump control, suspicion of fistula, foreign body, injury of a large bronchus, tracheal stenosis, specimen taking and bronchoscopic local drug treatment. The authors mention the most important contraindications for urgent bronchofiberscopy too: missing written consent of the patient (except the cases of unconsciousness), size discrepancy between the tool and tracheal lumen, and asthmatic attack. The authors also underline the emerging importance of both diagnostic and therapeutic bronchoscopy performed on emergency wards and intensive care units. They conclude: it's necessary for the anesthetists to get a basic level ability to work with bronchofiberscope and for pulmonologist-bronchologists to be experienced to answer the questions of other specialists.

Airway Obstruction↗

PubMed2004

Distinct groups of multidrug resistance modulating agents are distinguished by competition of P-glycoprotein-specific antibodies.

P-glycoprotein (Pgp) is one of the ABC transporters responsible for the multidrug resistance of cancer cells. The conformational changes of Pgp that occur in the presence of substrates/modulators or ATP depletion are accompanied by the up-shift of UIC2 monoclonal antibody (mAb) binding. In the case of cyclosporin A, vinblastine or valinomycin, this up-shift was found to be concomitant with the near-complete suppression of labeling with other mAbs specific for Pgp epitopes overlapping with UIC2, while pre-treatment with verapamil or Tween 80 brings about a modest suppression. Here we have extended these observations to 44 Pgp interacting agents, and found that only 8 fall into the cyclosporin-like category, inducing a conformational state characterized by the complete UIC2 dominance. The rest of the drugs either did not affect antibody competition or had a modest effect. Thus, Pgp substrates/modulators can be classified into distinct modalities based on the conformational change they elicit.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed2003

[Therapy of patients with end-stage pulmonary disease. Review of lung transplantation based on four cases of our own].

The pathogenesis of infiltrative pulmonary diseases is largely unknown, and their final outcome is variable. These inflammatory processes may involve the alveoli and the pulmonary interstices, and they may lead to pulmonary fibrosis. The development of end-stage pulmonary disease is irreversible. Patients with respiratory failure have a poor prognosis. For young patients at the end-stage of their pulmonary disease, lung transplantation is a promising therapeutic modality. The therapeutic protocols for unilateral or bilateral lung transplantation and heart-lung transplantation were established only in the last 10 years. In Hungary there is no center yet performing lung transplantation. This therapy is available only for those who could be effectively rehabilitated with this method. Four patients 27-35 years of age suffering pulmonary fibrosis, despite their young age developed honey-comb lungs with therapy resistant respiratory failure. No other organic symptoms were detected by detailed examination, so their predicted survival was dependent on their pulmonary status alone. Cases of four young patients, who were effectively treated with lung transplantation, are discussed from pre-operative preparations to post-operative follow-up, with the review of the literature.

Adult↗