Determination of normal ß values via radio frequency echo-tracking technique in a healthy Central European population.

The aim of our article is to report normal values of ß stiffness parameter and pulse wave velocity (PWV) determined via radio frequency echo-tracking technique first in different age groups of a healthy Central European population in both gender. Values of PWV and ß stiffness parameters increase normally during aging and in certain vascular diseases including atherosclerosis. Detection of significant deviation from the normal values provides opportunity to diagnose the early stage atherosclerosis before morphological changes become visible and while therapy is more efficient. Atherosclerosis is responsible great percentage of morbidity and mortality in western world population therefore the detection of these parameters could be important and useful in primary and secondary prevention.

Cardioprotection by resveratrol: A human clinical trial in patients with stable coronary artery disease.

Several beneficial effects of resveratrol (RES), a natural antioxidant present in red wine have already been described. The aim of our study was to investigate if RES had a clinically measurable cardioprotective effect in patients after myocardial infarction. In this double-blind, placebo controlled trial 40 post-infarction Caucasian patients were randomized into two groups. One group received 10 mg RES capsule daily for 3 months. Systolic and diastolic left ventricular function, flow-mediated vasodilation (FMD), several laboratory and hemorheological parameters were measured before and after the treatment. Left ventricular ejection fraction showed an increasing tendency (ns) by RES treatment. However, left ventricular diastolic function was improved significantly (p < 0.01) by RES. A significant improvement in endothelial function measured by FMD was also observed (p < 0.05). Low-density lipoprotein (LDL) level significantly decreased (p < 0.05) in the RES treated group. Red blood cell deformability decreased and platelet aggregation increased significantly in the placebo group (p < 0.05), while resveratrol treatment has prevented these unfavourable changes. Concerning other measured parameters no significant changes were observed neither in placebo nor in RES group. Our results show that resveratrol improved left ventricle diastolic function, endothelial function, lowered LDL-cholesterol level and protected against unfavourable hemorheological changes measured in patients with coronary artery disease (CAD).

Estimation of vessel age and early diagnose of atherosclerosis in progeria syndrome by using echo-tracking.

The stiffness of the arteries normally increases with age. Radiofrequency echo-tracking is a non-invasive ultrasound method which is able to detect the stiffness of the arteries, represented by the beta stiffness index. The estimation of biological age of vessels is possible on the basis of the normal age-group specific beta stiffness values. The beta stiffness index becomes higher in early stages of atherosclerosis as well, before any visible morphological changes. Hutchinson-Gilford progeria syndrome (HGPS) is rare genetic disorder resulting in accelerated aging including appearance of progressive atherosclerosis at an early age which determines the quality and term of life of these patients. Determination of vascular age and early diagnosis of atherosclerosis seems crucial. According to our knowledge, the estimation of vascular age detected with radiofrequency echo-tracking in HGPS patients, in contrast to the normal age-specific beta stiffness values, has not been published yet.

Scavenger effect of experimental and clinically used cardiovascular drugs.

Oxygen free radicals play an important role in several physiologic and pathophysiologic processes. In pathophysiologic circumstances they can modify and damage biologic systems. Their functional properties (exposed to high oxygen tension) place red blood cells among the most susceptible cells to the harmful effect of free radicals. Because oxygen free radicals are involved in a wide range of diseases, scavenging these radicals should be an important therapeutic approach. In this study the antioxidant capacities of experimental and clinically used cardiovascular drugs were investigated. Phenazine methosulfate was used to generate free radicals and thus harden red blood cells. Filtration technique and potassium leaking were used to detect the scavenging effect of the examined drugs. The experimental drug H-2545 provided 43% protection against phenazine methosulfate-induced changes in red blood cell filterability (p < 0.001). Although some of the examined, clinically used cardiovascular drugs (carvedilol, metoprolol, verapamil, trimetazidine) also showed significant (p < 0.05) antioxidant effect, they were less efficient than H-2545. The scavenger effect of this novel drug exceeded the antioxidant properties of vitamin E. Modification of mexiletine with a pyrroline ring significantly improved its antioxidant capacity, suggesting that this molecular segment is responsible for the antioxidant effect.

Multimodality treatment resulting in long-term survival in hepatocellular carcinoma.

The early detection and complex therapy of the hepatocellular carcinoma (HCC) is one of the most seasonable questions of the gastroenterology-oncology, because of the increasing prevalence of the primary liver cancer. The course of the hepatocellular carcinoma is rapid, untreated patients rarely live over 5-6 months. Combination of different treatment modalities in HCC can offer the best chances for survival. If possible, a surgical resection should be the primary procedure, followed by adjuvant cytostatic treatment and chemoembolisation. The authors report three cases with HCC with extremely long survival. The long-term survival achieved by multimodality therapy, as presented in these cases, seems to justify aggressive therapeutical approaches in HCC. It has been concluded, that early detection and complex, aggressive multimodality treatment--even repeated liver resections and surgical elimination of duplex distant metastases--can result in long-term survival with a good quality of life.

Solid and papillary epithelial neoplasm arising in heterotopic pancreatic tissue of the mesocolon.

AIM: Solid and papillary epithelial neoplasm (SPEN) is an uncommon pancreatic tumour. Very rarely it has also been described outside the pancreas, usually arising from heterotopic pancreatic tissue. This report summarises all the published extrapancreatic SPENs and documents the sixth such case arising from heterotopic pancreatic tissue of the transverse mesocolon in a 15 year old girl. METHODS/RESULTS: Histological and immunohistochemical examination revealed typical papillary and solid areas composed of columnar, cuboidal, and round cells, which were focally positive for vimentin, cytokeratin, neurone specific enolase, carcinoembryonic antigen, alpha1-antitrypsin, alpha1-antichymotrypsin, and negative for neuroendocrine markers (neurofilament, PGP 9.5, chromogranin A, synaptophysin, and S100), p53, and oestrogen and progesterone receptors. Electron microscopy showed scant zymogen but no neurosecretory granules. In agreement with the flow cytometric result s of diploidy, comparative genomic hybridisation (CGH) did not reveal loss or gain of genetic material, and the in situ hybridisation analysis of the RB1 and p53 genes revealed no abnormality in the 13q and 17p arms. CONCLUSIONS: Immunohistochemical and electron microscopic data support exocrine differentiation. The CGH and the flow cytometric results suggest a subtle, yet unknown genetic change, rather than a large genetic alteration. RB1 and p53 in situ hybridisation ruled out the role of deletion at these sites in the pathogenesis of SPEN. Interestingly, review of the published and the present heterotopic pancreatic SPENs identified the mesocolon as the most common anatomical site (four of six), despite the very rare occurrence of ectopic pancreatic tissue at this site.

[Percutaneous drainage in the treatment of accidentally discovered hydatid cyst in patients with polycystic liver]. / Polycystás májbetegekben véletlenszerüen felismert máj Echinococcus-cysták percutan drainage kezelése.

This article report on a not very well-known therapeutical procedure used among only fairly diagnosed cases based on international and Hungarian experiences. In Hungary echinococcus cyst of the liver is mostly treated surgically (the average mortality rate of liver resection is 0-6.3%). In many places the percutan puncture and drainage are contraindicated in case of echinococcus cysts. The authors assert that the percutaneous treatment of echinococcus cysts in proper technical and methodic circumstances in safe regarding the previous studies and their own data obtained of a few cases, and describe the technique and raise some question in them. Drainage treatment is very well tolerated by the patients it reduces the duration (of time) and the cost of the hospitalization.

[Local fibrinolytic treatment in subtotal pulmonary embolism]. / Lokális fibrinolyticus kezelés subtotalis tüdóembóliában.

Authors present an interventional radiological technique used for a successful treatment of 12 patients with massive pulmonary embolism. The method for rapid statement of diagnosis and the range of indications are discussed. In massive pulmonary embolism, after a diagnostic angiography, in 12 patient's mechanical thrombus drilling, in 3 cases thrombus aspiration, in 8 cases thrombus explosion and in other 1 balloon recanalisation was performed combined with a low dose (20,000-60,000 IU/h Streptokinase or the double dose of Urokinase) local fibrinolytic infusion. No major complication was observed and all the patients were successfully treated.

[Adenomyomatosis of the gallbladder]. / Epehólyag adenomyomatosis.

A 64-year-old male patient was reported, surveying radiology and pathology of the adenomyomatosis. The authors emphasize the role of high resolution ultrasound and computer tomography in the diagnosis of gallbladder adenomyomatosis. Intramural cystic formation (anechoic diverticula) with echogenic foci and/or reverberation artifacts together with a full or a partial thickening of the gallbladder's wall was considered as the diagnostic criteria of the ultrasound examinations. They assist in finding the proper way among the difficulties of the different diagnosis, in the same time call the attention for the frequently misdiagnosed cases.

[Repeated resection of hepatocellular carcinoma and its recurrences and removal of pulmonary metastases]. / Hepatocellularis carcinoma és recidíváinak ismételt resectiója tüdömetastasisok eltávolításával.

A case of a 67 year old male successfully treated local recurrence of previously radically resected hepatocellular carcinoma with distant metastases of the lung is reported. Two years after a complete removal of the primary liver malignoma a local recurrence was resected which was followed by selective intraarterial cytostatic treatment and chemoembolisation. A three-year disease-free interval was achieved, then recurrence in the liver and lung metastases were detected at the regular check-up. All of the malignant focuses were eliminated by parenchyma sparing surgical resections, then a postoperative adjuvant chemotherapy (FAM scheme) has been followed. After eight months the patient remained symptom-free. The long-term survival seems to justify the aggressive approach of this kind of malignancies.

[Management of polycystic liver by cyst puncture and alcoholic sclerosing]. / Polycytás máj kezelése cystapunctióval és alkoholos sclerotisatióval.

A case of a 51-year-old female suffering in polycystic liver disease is presented. The patient had bulging upper abdomen, pain in the right subcostal region originating perhaps from the stretching liver capsule and a considerably shortened prothrombin time. Only minor portions of liver tissue could be detected by imaging methods, therefore surgical solution was not suggested. In order to maintain the hepatic function by reducing the compression of the functioning tissue, US-guided multiple cyst punctures were performed with sclerotisation of the cysts. Following the multi-stage procedures the size of liver decreased, the hepatic function gradually improved. In accordance with the literature the authors recommend the multi-stage cyst puncture and sclerotisation as beneficial therapy of polycystic liver disease with minor risk, without burden general anesthesia and minimal on the patients.