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Zoltán Papp

Publications and source records attributed to Zoltán Papp.

At least 91 records · Page 5Linked to original sources
PubMed2003

[Fetal examination of first trimester abortions].

INTRODUCTION: Rather few papers are about first trimesters pathology. The reason of this roots in the technical difficulties. The first trimesters pathology can not be separated from prenatal diagnostics. OBJECTIVES: The authors summarized the molecular basis of embryology, malformations, and published cases that had been diagnosed prenatally. MATERIALS AND METHODS: In the I. Department of Obstetrics and Gynecology, Semmelweis University in Budapest between 1995. and 2000. altogether sixty embryos 70 gms or smaller were examined. RESULTS: Malformations included neural tube defects, disorders of twinning, body stalk defect, chromosome aberrations, hydrops, omphalocele and gastroschisis. CONCLUSIONS: Examination of early embryos may discover many results on the fields of prenatal diagnosis and the pathomechanism of developmental abnormalities.

Abortion, Spontaneous↗
PubMed2003

Assessment of uterine circulation in ectopic pregnancy by transvaginal color Doppler.

OBJECTIVE: The aim of our study was to determine the effect of abnormal implantation on uterine circulation and to evaluate whether the assessment of uterinal blood flow can provide additional information for the diagnosis of tubal pregnancies. METHODS: Forty-nine patients with ectopic pregnancy were examined by transvaginal color Doppler immediately before surgery. Resistance and pulsatility indices of blood flow in the uterine and tubal arteries were measured. RESULTS: The blood flow parameters of the uterine and tubal arteries did not change with gestational age. There was a significant increase in blood flow on the side with the tubal gestation. Differences between sides were higher in the tubal arteries than in the main uterine arteries and showed no dependence on gestational age. CONCLUSION: The abnormal implantation and tubal trophoblast invasion in ectopic pregnancy (EP) can cause more marked blood flow changes in the adjacent supplying vessels than in the main uterine arteries.

Adolescent↗
PubMed2003

Uncommon type of placentation after previous cesarean deliveries.

BACKGROUND: A rare type of placentation leading to cesarean delivery and hysterectomy is described. CASE: A young multigravida in the 26th week of gestation was referred to our department with a history of vaginal bleeding and suspected placenta previa. Three previous children were delivered by elective cesarean. Ultrasonographic examination suggested placenta previa increta with hypervascularization and with pulsatile lacunar flow. In the 38th week of gestation, an elective cesarean delivery and hysterectomy were performed. Morphological studies showed that most of the placenta developed in the anterior portion of the cervix. The implantation took place in the scar tissue, promoting infiltration of the increted growth and thus ensuring the normal development of the amnionic sac and fetus in the uterine cavity. CONCLUSION: Variations in placental implantation may result in unique situations at birth.

Adult↗
PubMed2003

Primary non-Hodgkin's lymphoma of the uterine cervix successfully treated by neoadjuvant chemotherapy: case report.

INTRODUCTION: Primary non-Hodgkin's lymphoma of the uterine cervix is a rare malignancy. The mainstay of therapy consists of irradiation alone or irradiation with either surgery or chemotherapy. CASE REPORT: We present the case of a 56-year-old woman diagnosed with a bulky, Ann Arbor stage IE, primary, diffuse, large B-cell non Hodgkin's lymphoma of the uterine cervix. We administered neoadjuvant chemotherapy according to CHOP protocol (cyclophosphamide, adriamycin, vincristine, and prednisone) followed by radical hysterectomy, bilateral salpingo-oophorectomy, and regional lymph node dissection. Clinical and pathological responses to the chemotherapy were complete. The patient is alive 5 years after the initial diagnosis. CONCLUSION: Our case emphasizes the importance of neoadjuvant chemotherapy that can provide a control of the distant microscopic metastases.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2003

Ethical dimensions of genetic counseling.

Genetics is one of the most exciting and most dynamically developing fields of medicine. Genetic counseling has reached the limelight of public attention. Given the fact that the subject of counseling is of momentous consequences and has important effects for the short and long-term, its ethical aspect is paramount. It is crucial that the relevant regulation be designed. The center of the ethical questions is occupied by the treatment of important personal information and the method of its being made public. The way the problems are dealt with is always changing just as society is in a constant process of change. It is important, however, that we always be ready to offer proper help to those in need when they need it.

Abortion, Eugenic↗
PubMed2003

Chorionic villus sampling and amniocentesis: what are the risks in current practice?

PURPOSE OF REVIEW: Public demand for genetic counselling and prenatal diagnosis has increased during the past decade. As invasive diagnostic methods, such as chorionic villus sampling and amniocentesis, still have an important role to play in evaluating the fetus, one of the most important questions to address during genetic counselling is the procedure-related risk of these techniques. RECENT FINDINGS: The possible factors modifying the specific risk of the actual fetus are discussed, together with factors that have an impact on procedure-related fetal loss and other complications. Risk factors regarding twin pregnancies, first and second-trimester chorionic villus sampling, early and mid-trimester amniocentesis are discussed separately. New developments have recently occurred in the laboratory techniques used in prenatal diagnosis. Their impact on genetic counselling and the employment of invasive techniques are also addressed. SUMMARY: During genetic counselling, an individually tailored risk assessment needs to be established before any invasive procedure. This should take into account all the factors modifying the specific risk for aneuploidy or other disorders of the fetus, as well as the actual procedure-related risks.

Amniocentesis↗
PubMed2003

Sensorineural hearing loss in chronic otitis media.

OBJECTIVE: To determine whether chronic suppurative otitis media may cause sensorineural hearing loss. METHODS: The files of 121 patients with unilateral chronic suppurative otitis media were reviewed in a retrospective study. Air conduction and bone conduction threshold averages were calculated over the speech frequencies (500 Hz, 1,000 Hz, and 2,000 Hz). Thresholds at 4 kHz were examined separately but in a similar way. Multiple linear regression models were used to clarify the relationships between sensorineural hearing loss and chronic otitis media. RESULTS: Chronic suppurative otitis media was seen to be associated with sensorineural hearing loss. When age and normal side were corrected for, pure-tone threshold and bone conduction threshold at either the speech frequencies or at 4 kHz increased gradually according to the duration of the chronic suppurative otitis media. The threshold shift was more accentuated as age increased. The sensorineural hearing loss at 4 kHz seemed to be higher than that at the speech frequencies. CONCLUSIONS: The inner ear is vulnerable against chronic suppurative otitis media. Older age increases this vulnerability. The proximity of the sensory cells to the potential source of harm (inflamed middle ear) may mean higher exposure, as reflected by the fact that sensory cells processing higher frequencies are more seriously damaged.

Adolescent↗
PubMed2003

Massive obstetric hemorrhage.

Massive obstetric haemorrhage is a major cause of maternal death and morbidity; abruption of the placenta, placenta praevia and postpartum haemorrhage being the main causes of haemorrhages. A delay in the correction of hypovolaemia, diagnosis and treatment of defective coagulation and/or surgical control of bleeding are the avoidable factors in most maternal deaths caused by haemorrhage. The main goal is to maintain effective circulating intravascular volume by prompt and adequate replacement of blood, crystalloids or fresh-frozen plasma through more than one intravenous line (it might be necessary to pump blood under pressure) with constant monitoring of the pulse rate and the arterial blood pressure. The rapid correction of hypovolaemia with crystalloids and red cells is the first priority, followed by blood component therapy. Oxytocin and prostaglandin will correct uterine atony, and appropriate surgical intervention is required for traumatic bleeding. Ligation of the uterine arteries, ovarian arteries and hypogastric arteries will usually control uterine bleeding and arterial embolization is also effective. Hysterectomy should also be considered in severe cases. All gynecologists should be able to perform without delay the operative maneuvers which are necessary to control the bleeding, including hypogastric artery ligation, or even emergency hysterectomy. This topic may have received little attention because it is perceived as being associated with maternal morbidity rather than mortality in developed countries; it is only recently that the extent and importance of postnatal maternal morbidity has been recognized.

Abruptio Placentae↗
PubMed2003

Breech deliveries and cesarean section.

Breech presentation is the most common malpresentation, with about 3-4% of singleton fetuses presenting breech at delivery. Management of breech presentation has been a contentious issue with a lowering threshold for cesarean section in recent years. Perinatal mortality and morbidity are estimated to be three times that of comparable infants with vertex presentation. Breech presentation is commonly associated with certain adverse maternal and fetal factors which inherently give rise to increased perinatal morbidity and mortality. At present, most obstetricians favor cesarean delivery for uncomplicated pre-term breech. Controlled prospective studies have shown that the outcome of breech fetuses weighing more than 1500 g was not dependent on the mode of delivery. A more recent review from the Cochrane database by Grant does not justify a policy of elective cesarean section for pre-term breech. Vaginal delivery is preferred if the following criteria are met: frank breech only, estimated fetal weight of 2500-3500 g, adequate pelvimetry without hyperextended head, normal progression of labor, no evidence of fetal hypoxia under continuous fetal monitoring, and maternal weight under 90 kg. Vaginal delivery of frank breech at term may be just as safe as cesarean section when careful selection criteria are used. If these criteria are not fulfilled, or fetal monitoring cannot be performed, cesarean section is advisable.

Breech Presentation↗
PubMed2003

Large gastrointestinal stromal tumor presenting as an ovarian tumor. A case report.

BACKGROUND: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the gastrointestinal tract localized mostly in the upper or medial part of the digestion tract. CASE: A colonic GIST in a young woman extended to the pelvis, giving the impression of an ovarian tumor. CONCLUSION: In the case of a pelvic mass, especially if other unusual anamnestic data and signs are present, the possibility of other than a gynecologic tumor has to be considered. Every effort should be made to identify the origin of the tumor and related anatomic structures, especially the ovaries.

Adult↗
PubMed2003

Calpain-1-dependent degradation of troponin I mutants found in familial hypertrophic cardiomyopathy.

The mechanism by which mutations of the cardiac troponin I (cTnI) gene evoke familial hypertrophic cardiomyopathy (fHCM) is unknown. In this investigation the potential effects of three fHCM-related cTnI mutations on Calpain-1-induced cTnI degradation were tested, and a study was made of whether additional conformational changes due to troponin complex formation and protein kinase A-induced phosphorylation affect the intensity of cTnI proteolysis. Purified recombinant wild-type cTnI and three of its fHCM-related missense mutants (R145G, G203S and K206Q), alone or in the troponin complex (i.e. together with troponin C and troponin T), in the non-phosphorylated or protein kinase A-bisphosphorylated forms were proteolyzed in vitro in the presence of Calpain-1 (0.05-2.5 U) at 30 degrees C. Following incubation with Calpain-1 for 0.5, 30, 60 or 120 min, the extent of protein degradation was evaluated through the use of Western immunoblotting and densitometry. The results indicated that both the wild-type and the mutant cTnI molecules were susceptible to Calpain-1. However, the degradation of the cTnI molecules in the troponin complex was less intense than that of the non-complexed forms. Moreover, phosphorylation by protein kinase A conferred effective protection against cTnI proteolysis. The data suggested that mutations in the central inhibitory domain (R145G) and in the C-terminal region (G203S and K206Q) of cTnI do not affect its Calpain-1-mediated degradation, or the phosphorylation-induced protection against proteolysis.

Blotting, Western↗
PubMed2002

[First case of successful pregnancy after preimplantation genetic diagnosis].

UNLABELLED: Preimplantation genetic diagnosis is introduced for prevention of genetic disorders. The combination of in vitro fertilization technique and single cell molecular genetic diagnosis allows only unaffected embryos to be selected for embryotransfer, providing a healthy pregnancy and so also avoiding the need for its possible termination. CASE REPORT: The authors report the first successful case of the clinical application of preimplantation genetic diagnosis in Hungary, resulting the birth of an unaffected baby. Preembryonal biopsy and subsequent fluorescent-PCR analysis of the blastomeres taken from the preembryos of a woman who is a carrier for Duchenne muscular dystrophy was performed. Sexing of the preembryos by X and Y chromosome specific primers were performed and three female preembryos were found. RESULT: All three preembryos were transferred into the uterus, which resulted a singleton pregnancy, resulting the birth of a healthy female baby. The authors are offering preimplantation genetic diagnosis with sexing for couples, who are at risk of having a child with X-linked diseases, or are carriers for the delta-F508 mutation of cystic fibrosis. CONCLUSIONS: The application of this diagnostic tool is also planned for other monogenic disorders.

Biopsy↗
PubMed2002

[Apolipoprotein E and fetal trisomies].

Chromosomal abnormalities are the most frequent genetic disorders observed in live births and miscarriages. Trisomies 21, 18, and 13 are the most frequently observed aneuploidy conditions among them. The biologic mechanism of this phenomenon remains unknown. Apolipoprotein E and its alleles have become the focus of the investigations lately. In this review the authors combined the available data from the literature and compared those results with their own observations. Their results based on determination of apo E alleles by PCR-RFLP method from DNA samples combined from trisomic conceptuses and healthy blood donors in the same population. They did not find significant difference in the distribution of apo E alleles, like it was published in several other author's works. The authors discuss the available theories for the development of trisomic conditions and call the attention for the theory of mtDNA mutations as the possible factor.

Alleles↗
PubMed2002

The mechanism of the force enhancement by MgADP under simulated ischaemic conditions in rat cardiac myocytes.

In this study, the effects of MgADP and/or MgATP on the Ca2+ -dependent and Ca2+ -independent contractile force restoration were determined in order to identify the origin of the tonic force increase (i.e. ischaemic contracture) which develops during advanced stages of ischaemia. Experiments were performed at 15 degrees C during simulated ischaemic conditions in Triton-skinned right ventricular myocytes from rats. In the presence of 5 mM MgATP the maximal Ca2+ -dependent force (P(o)) of 39 +/- 2 kN m(-2) (mean +/- S.E.M.) under control conditions (pH 7.0, 15 mM phosphocreatine (CP)) decreased to 8 +/- 1 % during simulated ischaemia (pH 6.2, 30 mM inorganic phosphate (P(i)), without CP). This change was accompanied by a major reduction in Ca2+ sensitivity (pCa(50) 4.10 vs. 5.62). Substitution of MgADP for MgATP restored isometric force production and its Ca2+ sensitivity (pCa(50) 4.74 at 4 mM MgADP and 1 mM MgATP). In addition, it shifted the MgATP threshold concentration of Ca2+ -independent force development to higher levels in a concentration-dependent manner. However, Ca2+ -independent force was facilitated less by MgADP than Ca2+ -dependent force. The MgADP-induced increase in force was accompanied by marked reductions in the velocity of unloaded shortening and the rate of tension redevelopment. These data and simulations using a model of cross-bridge kinetics suggest that the ischaemic force is not a consequence of a reduction in intracellular MgATP concentration, but identify MgADP as a key modulator of the cross-bridge cycle under simulated ischaemic conditions in cardiac muscle, with a much lower inhibition constant (0.012 +/- 0.003 mM) than in skeletal muscle. Therefore, MgADP has a high potential to stabilize the force-generating cross-bridge state and to facilitate the development of ischaemic contracture, possibly involving a Ca2+ activation process in the ischaemic myocardium.

Adenosine Diphosphate↗
PubMed2002

[Pathophysiology and therapeutic possibilities in twin-to-twin transfusion syndrome].

INTRODUCTION: Twin-to-twin transfusion syndrome is a threatening consequence of monochorionicity. Without therapeutic intervention it has approximately a 100% mortality rate, but due to therapeutic efforts it improved dramatically to about 20-50% mortality. It is caused by arteriovenosus anastomoses within the placenta, that causes hormonal changes, polyhydramnios, hypertension of the recipient and weight discordance. AIMS: Detection of ultrasonographic and pathologic consequences of twin-to-twin transfusion syndrome. PATIENTS AND METHODS: Ultrasonographic and pathologic findings of six twin pairs were analysed with the common feature of twin-to-twin transfusion syndrome. RESULTS: Ultrasonographic and pathologic results were suggestive for fetal hypertension in all recipients and pulmonary stenosis in four of them. CONCLUSION: The prognosis of twin-to-twin transfusion syndrome can be improved significantly with serial amnioreduction, amniotic fenestration, laser ablation of connecting vessels or selective fetocidium. Proper therapy prevents the development of the serious clinical and pathological consequences of twin-to-twin transfusion syndrome.

Adult↗
PubMed2002

[Heterotaxy syndrome, analysis of 13 cases and review of the literature].

INTRODUCTION: Heterotaxy syndrome (Ivemark syndrome, or asplenia-polysplenia syndrome) is a heterogeneous group of disease with disturbed body symmetry and malposition of internal organs. Heterotaxy syndrome is caused by the disturbance of the left/right axis in the early embryonic period. AIM OF THE STUDY: The most frequency of heterotaxy syndrome's concomitant anomalies during a five year period in own fetopathology material. MATERIALS AND METHODS: Data of fetopathologic examination of 13 fetuses suffering from prenatally diagnosed heterotaxy syndrome. RESULTS: Situs ambiguus was detected in 9 cases out of 13. In the remaining 4 cases situs inversus totalis was diagnosed. The most frequent and important associated malformation included congenital heart disease was AV channel (10/13) and great vessel anomaly (10/13). CONCLUSION: In cases with prenatally detected complex cardiac anomalies (especially AV channel cases) heterotaxy anomaly must be taken into consideration, with main consequences in prenatal counselling.

Animals↗
PubMed2002

[Transposition of ovaries during radical hysterectomy for cervical cancer].

INTRODUCTION: 422 radical hysterectomies were performed for cervical cancer between 1st July 1990. and 31st December 2000. in the 1st Department of Obstetrics and Gynecology, Semmelweis Medical University. At least one of the ovaries was conservated and suspended in 21 cases. AIM(S): The aim of this study is to preserve ovaries guaranteeing natural oestrogen production for young patients suffering in early stage cervical cancer, and to prove appropriate efficacy of their method. PATIENTS/METHOD(S): According to present examinations transposition of ovary (21 patients) and radiotherapy made as a part of the protocol can only slightly influence the endocrine function of ovary. RESULTS: Only in one case of 21 a hormonal substitution was needed for treating menopausal syndrome. Studying histopathologically ovaries removed during 422 radical hysterectomies the authors could not find any metastasis given by early stage (I/A2 or I/B) cervical cancer. Following and controlling their patients after ovarial transpositions for a long period they could not observe any pathological ovarial disorder (cyst). CONCLUSION(S): According to the data of international literature the authors conclude, that transposition of ovaries during radical hysterectomy for well-selected, younger aged, early staged cervical cancer cases can result only a low risk, but much better quality of life for the patients.

Adult↗