Static cold storage compared with normothermic machine perfusion of the liver and effect on ischaemic-type biliary lesions after transplantation: a propensity score-matched study.

BACKGROUND: Given the susceptibility of organs to ischaemic injury, alternative preservation methods to static cold storage (SCS), such as normothermic machine perfusion (NMP) are emerging. The aim of this study was to perform a comparison between NMP and SCS in liver transplantation with particular attention to bile duct lesions. METHODS: The outcomes of 59 consecutive NMP-preserved donor livers were compared in a 1 : 1 propensity score-matched fashion to SCS control livers. Postoperative complications, patient survival, graft survival and bile duct lesions were analysed. RESULTS: While patients were matched for cold ischaemia time, the total preservation time was significantly longer in the NMP group (21 h versus 7 h, P < 0.001). Patient and graft survival rates at 1 year were 81 versus 82 per cent (P = 0.347) and 81 versus 79 per cent (P = 0.784) in the NMP and SCS groups, respectively. The postoperative complication rate was comparable (P = 0.086); 37 per cent NMP versus 34 per cent SCS patients had a Clavien-Dindo grade IIIb or above complication. There was no difference in early (30 days or less) (NMP 22 versus SCS 19 per cent, P = 0.647) and late (more than 30 days) (NMP 27 versus SCS 36 per cent, P = 0.321) biliary complications. However, NMP-preserved livers developed significantly fewer ischaemic-type bile duct lesions (NMP 3 versus SCS 14 per cent, P = 0.047). CONCLUSION: The use of NMP allowed for a significantly prolonged organ preservation with a lower rate of observed ischaemic-type bile duct lesions.

Molecular Motions and Interactions in Aqueous Solutions of Thymosin-ß4 , Stabilin CTD and Their 1 : 1 Complex, Studied by 1 H-NMR Spectroscopy.

Wide-line 1 H NMR measurements were extended and all results were interpreted in a thermodynamics-based new approach on aqueous solutions of thymosin-ß4 (Tß4 ), stabilin cytoplasmic domain (CTD), and their 1 : 1 complex. Energy distributions of potential barriers controlling the motion of protein-bound water molecules were determined. Heterogeneous and homogeneous regions were found in the protein-water interface. The measure of heterogeneity of this interface gives quantitative value for the portion of disordered parts in the protein. Ordered structural elements were found extending up to ∼20 % of the individual whole proteins. About 40 % of the binding sites of free Tß4 get involved in bonds holding the complex together. The complex has the most heterogeneous solvent accessible surface (SAS) in terms of protein-water interactions. The complex is more disordered than Tß4 or stabilin CTD. The greater SAS area of the complex is interpreted as a clear sign of its open structure.

Letrozole may be a valuable maintenance treatment in high-grade serous ovarian cancer patients.

OBJECTIVES: Endocrine therapy is used as maintenance in estrogen receptor (ER) positive breast cancers and has been proposed in low-grade serous ovarian cancers (LGSOC). Here we examine a rationale for its use as maintenance in high-grade serous ovarian cancers (HGSOC). METHODS: We accessed the TCGA PANCAN dataset to evaluate the expression of ESR1. ESR1 expression data on all cancers (n=8901) and HGSOC (n=527) were followed by investigation of ER expression via immunohistochemistry (IHC) (n=4071). The same was performed in an independent cohort for matched primary and recurrent HGSOC (n=80). Finally, newly diagnosed ER+ HGSOC patients were offered a maintenance therapy with Letrozole. RESULTS: ESR1 was strongly expressed in similar levels in HGSOC as in breast cancer. We found a strong ER expression via IHC in both the primary and matched recurrent HGSOC, particularly in the Platinum-resistant subgroup. The additional use of Letrozole as maintenance treatment was associated with a significantly prolonged recurrence free interval (after 24months 60% when taking Letrozole versus 38.5% in the control group; p=0.035; RFS: IC50 reached by one subject versus 13.2months). This effect was also present in patients treated additionally with Bevacizumab; 20.8% of patients had no recurrence after 12months compared to 87.5% when taking Letrozole in addition to Bevacizumab (p=0.026). CONCLUSIONS: Primary HGSOC have a slightly higher ESR1 than and a similar ER expression breast cancer where aromatase inhibitor maintenance is routine for decades. Here we demonstrate evidence for the usefulness of Letrozole in HGSOC, particularly in patients with chemotherapy resistance or residual disease.

Excessive alcohol consumption induces methane production in humans and rats.

Various studies have established the possibility of non-bacterial methane (CH4) generation in oxido-reductive stress conditions in plants and animals. Increased ethanol input is leading to oxido-reductive imbalance in eukaryotes, thus our aim was to provide evidence for the possibility of ethanol-induced methanogenesis in non-CH4 producer humans, and to corroborate the in vivo relevance of this pathway in rodents. Healthy volunteers consumed 1.15 g/kg/day alcohol for 4 days and the amount of exhaled CH4 was recorded by high sensitivity photoacoustic spectroscopy. Additionally, Sprague-Dawley rats were allocated into control, 1.15 g/kg/day and 2.7 g/kg/day ethanol-consuming groups to detect the whole-body CH4 emissions and mitochondrial functions in liver and hippocampus samples with high-resolution respirometry. Mitochondria-targeted L-alpha-glycerylphosphorylcholine (GPC) can increase tolerance to liver injury, thus the effects of GPC supplementations were tested in further ethanol-fed groups. Alcohol consumption was accompanied by significant CH4 emissions in both human and rat series of experiments. 2.7 g/kg/day ethanol feeding reduced the oxidative phosphorylation capacity of rat liver mitochondria, while GPC significantly decreased the alcohol-induced CH4 formation and hepatic mitochondrial dysfunction as well. These data demonstrate a potential for ethanol to influence human methanogenesis, and suggest a biomarker role for exhaled CH4 in association with mitochondrial dysfunction.

Biology and Management of the Mexican Rice Borer (Lepidoptera: Crambidae) in Rice in the United States.

The Mexican rice borer, Eoreuma loftini (Dyar), is an invasive pest of rice, Oryza sativa L., in the Gulf Coast region of the United States. This pest also damages sugarcane, Saccharum spp. hybrids; corn, Zea mays L.; and sorghum, Sorghum bicolor (L.) Moench, and feeds on weedy noncrop grasses. Multiple aspects of integrated pest management including use of pheromone traps, manipulation of planting dates, harvest cutting height, stubble management, noncrop host management, soil fertility management, host plant resistance, use of insecticides, and biological control have been studied for Mexican rice borer management. However, the current management strategy in rice primarily relies on the use of chlorantraniliprole insecticide seed treatments. This profile addresses Mexican rice borer biology and management in rice in the United States.

El barrenador mexicano del arroz [Eoreuma loftini (Dyar)] es una plaga invasora de arroz (Oryza sativa L.) en la región de la Costa del Golfo de Estados Unidos. Esta plaga también afecta híbridos de caña de azúcar (Saccharum spp.), maíz (Zea mays L.), sorgo [Sorghum bicolor (L.) Moench), y se alimenta de malezas gramíneas. Múltiples aspectos del manejo integrado de plagas incluyendo el uso de trampas con feromonas, la manipulación de las fechas de siembra, la altura del corte durante la cosecha, el manejo de rastrojos, el manejo de hospederos alternos, el manejo de la fertilidad del suelo, la resistencia de la plantas, el uso de insecticidas y el control biológico han sido estudiados para el manejo del barrenador mexicano del arroz. Sin embargo, la estrategia de actual de manejo en arroz se basa principalmente en el tratamiento químico de la semilla con el uso del insecticida clorantraniliprol. Esta revisión se enfoca en la biología y manejo del barrenador mexicano del arroz en arroz en los Estados Unidos.

Brucellosis of the European brown hare (Lepus europaeus).

The European brown hare (Lepus europaeus) is an important reservoir of Brucella suis biovar 2 and also of the life-threatening zoonotic agent Francisella tularensis. Since both bacteria can produce similar gross pathological lesions in this species, laboratory tests are necessary for the final diagnosis. The aim of the present study was to develop an immunohistochemical method for the detection of B. suis infection and to describe the pathological and histological lesions caused by B. suis in European brown hares. Hyperimmune serum for immunohistochemistry (IHC) was produced by subcutaneous infection of mice with 2 × 10(9) colony forming units of live B. suis biovar 2, injected four times at 1-week intervals. The antiserum did not react with F. tularensis or Yersinia pseudotuberculosis in IHC and displayed only weak cross-reaction with B. canis. Numerous, yellow-white necrotic foci (0.1-0.5 cm diameter) were found in the spleen of five B. suis-infected female European brown hares and also in the lung, uterus, kidney or liver of four of these cases. Microscopically, the foci comprised single or coalescing granulomas with a central necrotic area. Both bacterial isolation and IHC gave positive results for B. suis infection in these animals. B. suis antigens were found as granular or amorphous extracellular material in the necrotic centre of several granulomas. IHC appears to be a suitable complementary diagnostic method for the detection of B. suis infection in the European brown hare.

Seasonal infestations of two stem borers (Lepidoptera: Crambidae) in noncrop grasses of Gulf Coast rice agroecosystems.

Infestations of two stem borers, Eoreuma loftini (Dyar) and Diatraea saccharalis (F.) (Lepidoptera: Crambidae), were compared in noncrop grasses adjacent to rice (Oryza sativa L.) fields. Three farms in the Texas rice Gulf Coast production area were surveyed every 6-8 wk between 2007 and 2009 using quadrat sampling along transects. Although D. saccharalis densities were relatively low, E. loftini average densities ranged from 0.3 to 5.7 immatures per m(2) throughout the 2-yr period. Early annual grasses including ryegrass, Lolium spp., and brome, Bromus spp., were infested during the spring, whereas the perennial johnsongrass, Sorghum halepense (L.) Pers., and Vasey's grass, Paspalum urvillei Steud., were infested throughout the year. Johnsongrass was the most prevalent host (41-78% relative abundance), but Vasey's grass (13-40% relative abundance) harbored as much as 62% of the recovered E. loftini immatures (during the winter). Young rice in newly planted fields did not host stem borers before June. April sampling in fallow rice fields showed that any available live grass material, volunteer rice or weed, can serve as a host during the spring. Our study suggests that noncrop grasses are year-round sources of E. loftini in Texas rice agroecosystems and may increase pest populations.

Tularemia of European Brown Hare (Lepus europaeus): a pathological, histopathological, and immunohistochemical study.

The European brown hare (Lepus europaeus) plays an important role in the ecology of tularemia, and it may serve as a significant source of human infection. The aim of the present study was to examine the lesions induced by Francisella tularensis in 50 cases of naturally infected seropositive European brown hares. Gross pathological examination revealed scant to numerous grayish-white foci with diameters of 0.1 to 1.0 cm in single organs (24 cases) or multiple organs (20 cases) in 44 of 50 cases (88%). These lesions proved to be areas of granulomatous inflammation, frequently encompassing necrosis. F tularensis antigen was detected with immunohistochemistry in 46 of 50 cases (92%), whereas F tularensis ssp holarctica was isolated by culture and identified by polymerase chain reaction from 35 of 50 cases (70%). Infection by the respiratory route is suggested by the presence of the tissue lesions in thoracic organs of 44 of 50 cases (88%). These results emphasize the importance of the European brown hare as a reservoir of tularemia.

Attention deficit hyperactivity disorder (ADHD): gender- and age-related differences in neurocognition.

BACKGROUND: Despite the growing recognition that the clinical symptom characteristics associated with attention deficit hyperactivity disorder (ADHD) persist into adulthood in a high proportion of subjects, little is known about the persistence of neurocognitive deficits in ADHD. The objective was twofold: (1) to conduct a meta-analysis of neuropsychological studies to characterize attentional performance in subjects with adult ADHD by examining differences in ADHD versus normal control subjects; and (2) to investigate whether these differences vary as a function of age and gender. METHOD: Twenty-five neuropsychological studies comparing subjects with adult ADHD and healthy controls were evaluated. Statistical effect size was determined to characterize the difference between ADHD and control subjects. Meta-regression analysis was applied to investigate whether the difference between ADHD and control subjects varied as a function of age and gender across studies. RESULTS: Tests measuring focused and sustained attention yielded an effect size with medium to large magnitude whereas tests of simple attention resulted in a small to medium effect size in terms of poorer attention functioning of ADHD subjects versus controls. On some of the measures (e.g. Stroop interference), a lower level of attention functioning in the ADHD group versus the controls was associated with male gender. CONCLUSIONS: Adult ADHD subjects display significantly poorer functioning versus healthy controls on complex but not on simple tasks of attention, and the degree of impairment varies with gender, with males displaying a higher level of impairment.

Computer control of pH and DO in a laboratory fermenter using a neural network technique.

In this contribution, the advantages of the artificial neural network approach to the identification and control of a laboratory-scale biochemical reactor are demonstrated. It is very important to be able to maintain the levels of two process variables, pH and dissolved oxygen (DO) concentration, over the course of fermentation in biosystems control. A PC-supported, fully automated, multi-task control system has been designed and built by the authors. Forward and inverse neural process models are used to identify and control both the pH and the DO concentration in a fermenter containing a Saccharomyces cerevisiae based-culture. The models are trained off-line, using a modified back-propagation algorithm based on conjugate gradients. The inverse neural controller is augmented by a new adaptive term that results in a system with robust performance. Experimental results have confirmed that the regulatory and tracking performances of the control system proposed are good.

Evaluation of asthma knowledge and quality of life in Hungarian asthmatics.

BACKGROUND: The objective was to develop an educational instrument, to assess its impact as an intervention instrument and to examine quality of life (QoL). METHODS: 119 asthmatics were randomized (64 in the intervention and 55 in the reference group). The education instrument was developed based on the EuroPharm-Forum Guidelines and its impact assessed by a self-developed questionnaire. Patients' QoL, asthma knowledge was assessed twice, once before and after the education seminar, education was only provided for the intervention group. QoL was measured with the St George's Respiratory Questionnaire (SGRQ) and a visual analogue scale (VAS). RESULTS: We found significant differences in answers to the asthma questions, by 40% improvement, but no changes in the control group. In inhaler-use technique, we could not find significant changes neither in the intervention nor in the control group. There were no significant differences between the results of the two visits neither with the VAS nor with the SGRQ on the QoL data. CONCLUSION: The results indicate that asthmatics experience lower QoL. As the subjects were regularly controlled asthmatics they had better general knowledge and inhaler-use technique was expected. The results suggest that it is necessary to regularly refresh asthma knowledge, to assess patients' self-management plans to achieve long-term effectiveness of asthma management.

Triacontanol-supported micropropagation of woody plants.

The effectiveness of triacontanol in the micropropagation of two woody, economically important fruit plant species was investigated. Triacontanol was added to the routine multiplication and rooting media of apple (Malus domestica cv. JTE-E4) and sour cherry (Cerasus fruticosa cv. Probocskai) rootstocks at concentrations of 2, 5, 10 and 20 µg/l. It was found to increase the number of shoots and the fresh weight of apple in the multiplication phase and to enhance root number and chlorophyll content in the rooting phase. The addition of indole-3-butyric acid (IBA) to the media further improved the effect of triacontanol. A less pronounced effect could be seen in the multiplication phase of sour cherry, although there was an enhancement of shoot proliferation. In the rooting phase, however, the application of triacontanol caused a significant increase in the number of roots per plant, and this effect was further improved when triacontanol was combined with 0.5 mg indole-3-butyric acid/l.

[Quality of life in asthmatics]. / Az asthmás betegek életminóségének vizsgálata.

UNLABELLED: Despite the availability of effective treatments asthma is increasing in both prevalence and severity specially in the well developed countries. As a consequence of this a large part of population is affected and the disease has a significant burden to the society. Evaluation of therapeutic effectiveness can be determined by measuring the quality of life. OBJECTIVE: As asthma has a major impact on the patients everyday life, we examined the quality of life of adult asthmatics with a disease specific questionniare (St. George's Respiratory questionniare SGRQ) and a visual analogue scale (VAS). We wanted to find out if the quality of life scores are significant with the results of clinical tests. METHODS: We examined 321 adult asthmatic patients. Patients were randomly selected. The influence of three factors age, sex, and FEV1 on quality of life was investigated. The data was analysed with user SPSS system. RESULTS: The results of the visuala analog scale were the following in female asthmatics 61.38%, in males 63.86%, the VAS results were the following according to the disease severity: mild intermittant 76%, mild 69%, moderate 60%, sever 49%. From the St. George questionniare three component scores were calculated: symptom (304.15 +/- 11.01), activity (580.71 +/- 19.57), impact (842.18 +/- 31.53) and the total score (1727.05 +/- 57.24). When we examined the different scores according to the age we found significant differences with the activity, impact and total score, but could not find significant differences with the symptom scores. The relationship between spirometry and quality of life is not as strong (coefficient of correlation: 0.37) but the majority of patients have high SGRQ scores even those patients whose FEV1 lies within the normal range. CONCLUSIONS: For patients with asthma it is common that one might see improvement in the FEV1 and yet not see an improvement in patients feelings or functioning. It was interesting to see that in spite of their bad conditions patients do accept the chronic nature of asthma, a degree of impairment and regard that as normal, limits in their everyday life, as they adjust their activity so that they can avoid the asthma attacks.

Macrophage-induced neutrophil apoptosis.

Macrophages (Mphi) contribute to the resolution of early inflammation by recognizing and ingesting apoptotic polymorphonuclear neutrophils (PMN). In addition, experiments reported here demonstrated that Mphi can actively induce PMN apoptosis. Coculture of cells from 2- or 5-day-old wounds in rats, or of Mphi purified from such preparations, with PMN-rich wound cell populations obtained 1 day after wounding increased PMN apoptosis by >3-fold. Neither resident- nor Proprionibacterium acnes-elicited peritoneal Mphi-induced PMN apoptosis. Apoptosis was not mediated by a soluble factor and required E:T contact. Fixed wound-Mphi and membrane isolates from viable Mphi were as effective as intact cells in inducing PMN apoptosis. Mphi-induced apoptosis was inhibited by peptide Arg-Gly-Asp-Ser, anti-beta3 (CD61) Ab, CD36 peptide, or anti-TNF-alpha Ab. Soluble TNF-alpha did not induce PMN apoptosis. In additional studies, K562 cells (negative for beta3, TNF-alpha, and Fas ligand) transfected to express either alphavbeta3 integrin, an uncleavable membrane form of TNF-alpha, or both were used in cocultures with wound PMN. Only the double transfectants were able to induce PMN apoptosis, an effect inhibited by anti-beta3 (CD61) or anti-TNF-alpha Abs. These results demonstrate that wound Mphi induce PMN apoptosis through a constitutive effector mechanism requiring both intercellular binding through integrin-ligand interactions and membrane-bound TNF-alpha.

Molecular and metabolic evidence for the restricted expression of inducible nitric oxide synthase in healing wounds.

Tissue injury initiates a temporally ordered sequence of local cellular and metabolic responses presumably necessary for successful repair. Previous investigations demonstrated that metabolic evidence for nitric oxide synthase (NOS) activity is detectable in wounds only during the initial 48 to 72 hours of the repair process. Present results identify the cell types contributing inducible NOS (iNOS) to experimental wounds in rats. iNOS antigen was expressed in most macrophages present in wounds 6 to 24 hours after injury, and these cells exhibited NAPDH diaphorase and NOS activity. Polymorphonuclear leukocytes contained little iNOS antigen and no NADPH diaphorase activity and were minimally able to convert L-arginine to L-citrulline. The frequency of iNOS-positive macrophages declined on days 3 and 5 after wounding. By day 10, most macrophages in the wound were negative for iNOS. These cells, however, acquired iNOS antigen and activity in culture. Wound fluids, but not normal rat serum, suppressed the induction of iNOS during culture. Findings indicate that the expression of iNOS in healing wounds is restricted to macrophages present during the early phases of repair and that components of wound fluid suppress the induction of iNOS in macrophages in late wounds. Polymorphonuclear leukocytes contribute little iNOS activity to the healing wound.

Qualitative and quantitative study of wound healing processes in the coelenterate, Plexaurella fusifera: spatial, temporal, and environmental (light attenuation) influences.

Following injury, the Caribbean soft coral, Plexaurella fusifera, forms an epithelial front containing amoebocytes and zooxanthellae, a photosynthetic endosymbiont. Amoebocytes may be responsible for extruding the connective mesogleal fibers necessary for regeneration of tissue and zooxanthellae may provide the energy for repair. This study examined the effects of time, space, and environment (light attenuation) on wound healing in this coral species and quantitatively confirmed the increase of amoebocyte concentrations in the injured area. A wound was made on coral branchlets by removing approximately 4.5 mm of coenenchyme. At assigned times after injury, samples were collected for gross morphological and histological evaluation, in which amoebocytes and zooxanthellae concentrations were quantified within 0.009 mm3 of tissue. Overall amoebocyte numbers within uninjured and wounded tissue were similar. However, when numbers of amoebocytes per area of injured tissue were calculated and compared to those of uninjured tissue, 82.4% more amoebocytes occurred at distances 0-0.5 mm from the wound edge, while areas of tissue >2 mm from the wound edge were occupied by fewer amoebocytes. Overall increases in concentrations of zooxanthellae also occurred within wounded coral, but no apparent temporal, spatial, or light-related pattern was detected. Therefore, this study supports the conjecture that amoebocyte accumulation at a wound site is an effect of cells migrating from uninjured tissue adjacent to the wounded edge. In addition, this movement occurs regardless of light attenuation. Light, which in this study was confined to ranges between 70 and 545 microE s-1 m-2, did not significantly affect the wound healing process in regard to either closure or cellular concentrations.

Macrophage phagocytosis of wound neutrophils.

Resolution of acute inflammation is thought to require the recognition and phagocytosis of apoptotic neutrophils (PMN) through receptor-ligand interactions with macrophages (Mphi). This hypothesis was tested in rat wounds by quantifying apoptosis in freshly harvested and aged-in-culture PMN taken from wounds 1-3 days after injury and by using these wound PMN as phagocytic targets for wound, immune-activated peritoneal, and resident peritoneal Mphi. Less than 6% of freshly harvested PMN exhibited characteristics of apoptosis. On aging in culture, day 1 PMN did not undergo apoptosis, whereas 41+/-1 and 29+/-1% of day 2 and 3 PMN, respectively, developed apoptosis, which corresponded to increased ingestion by Mphi. All three Mphi populations engaged different receptor-ligand pairs for the recognition and phagocytosis of PMN. Results indicate the resistance of early wound PMN to age-induced apoptosis, demonstrate wound-Mphi phagocytosis of wound PMN, and identify distinct receptor utilization by wound and other Mphi to ingest wound PMN.

The effect of triacontanol on micropropagation of balm, Melissa officinalis L.

Triacontanol, a long-chain primary alcohol was found to be an effective growth regulator in the micropropagation of balm, Melissa officinalis. In both the multiplication and the rooting phase, concentrations of 2, 5, 10 and 20 µg triacontanol per liter were applied. After 4 weeks of culture, the fresh weight of shoots was measured in the multiplication phase and root formation, photosynthetic activity, chlorophyll content and the fresh and dry weights of shoots were analyzed in the root induction phase. In the multiplication phase, 5 µg/l triacontanol was found to be the optimal concentration, while in the rooting phase 2 µg/l was the most effective. Triacontanol increased the number and length of roots, and it enhanced shoot growth, fresh weight, and the chlorophyll content, but it had no effect on the dry weight and the photosynthetic activity of the plants. Results of our work demonstrate that triacontanol can be applied as an effective growth regulator in the tissue culture of balm.

[The gypsy population in Hungary in the 1990s]. / Romske obyvatelstvo v Madarsku v 90. letech.

PIP: "The population of Gypsies in Hungary, as arrived at by various estimates made over the past 100 years, has risen at a rate exceeding the increase of the population as a whole.... The rise in number and proportion arises from the high fertility rate--more than twice of the country in total." Aspects examined include age distribution, spatial distribution, employment and occupations, unemployment, income, and socioeconomic status. (EXCERPT)^ieng

Vascular disease risk factors and findings in patients with Alzheimer's disease.

Vascular risk factors and data of different examinations relating to extracerebral vascular conditions were analysed in demented patients. Data of demented patients subsequently admitted to the Memory Clinic of the National Institute of Psychiatry and Neurology between March 1995 and February 1996 were registered in a specially designed data sheet. Three vascular examinations (ECG, Doppler examination of main extracerebral arteries on the neck, ophthalmoneurological examination) were carried out. The risk factors and vascular alterations were condensed in two factors. Neither the descriptive data nor the two factors showed statistically significant differences in the main groups (probable Alzheimer's disease--n=24, vascular dementia--n=23, mixed forms--n=15). Based on our results: vascular risk factors and pathological changes can occur in probable form of Alzheimer's disease; they can be present in early onset form as well; the most marked changes are in the vascular dementia group; relevant findings lack any correlation with each other in the point of severity of vascular changes. The extremely high cardio-cerebrovascular morbidity in Hungary seems to be reflected in the results. The role of vascular risk factors and (subclinical) pathological findings seem worth exploring further in Alzheimer's disease.