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Négyesi J, Petró B, Salman DN, Khandoker A, Katona P, Wang Z, Almaazmi AISQ, Hortobágyi T, Váczi M, Rácz K, Pálya Z, Grand L, Kiss RM, Nagatomi R. Biosignal processing methods to explore the effects of side-dominance on patterns of bi- and unilateral standing stability in healthy young adults. Front Physiol 2022; 13:965702. [PMID: 36187771 PMCID: PMC9523607 DOI: 10.3389/fphys.2022.965702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
We examined the effects of side-dominance on the laterality of standing stability using ground reaction force, motion capture (MoCap), and EMG data in healthy young adults. We recruited participants with strong right (n = 15) and left (n = 9) hand and leg dominance (side-dominance). They stood on one or two legs on a pair of synchronized force platforms for 50 s with 60 s rest between three randomized stance trials. In addition to 23 CoP-related variables, we also computed six MoCap variables representing each lower-limb joint motion time series. Moreover, 39 time- and frequency-domain features of EMG data from five muscles in three muscle groups were analyzed. Data from the multitude of biosignals converged and revealed concordant patterns: no differences occurred between left- and right-side dominant participants in kinetic, kinematic, or EMG outcomes during bipedal stance. Regarding single leg stance, larger knee but lower ankle joint kinematic values appeared in left vs right-sided participants during non-dominant stance. Left-vs right-sided participants also had lower medial gastrocnemius EMG activation during non-dominant stance. While right-side dominant participants always produced larger values for kinematic data of ankle joint and medial gastrocnemius EMG activation during non-dominant vs dominant unilateral stance, this pattern was the opposite for left-sided participants, showing larger values when standing on their dominant vs non-dominant leg, i.e., participants had a more stable balance when standing on their right leg. Our results suggest that side-dominance affects biomechanical and neuromuscular control strategies during unilateral standing.
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Affiliation(s)
- János Négyesi
- Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
- *Correspondence: János Négyesi,
| | - Bálint Petró
- Faculty of Mechanical Engineering, Department of Mechatronics, Optics and Mechanical Engineering Informatics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Diane Nabil Salman
- Biomedical Engineering Department, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Ahsan Khandoker
- Biomedical Engineering Department, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Péter Katona
- Department of Kinesiology, Hungarian University of Sports Science, Budapest, Hungary
| | - Ziheng Wang
- Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | | | - Tibor Hortobágyi
- Department of Kinesiology, Hungarian University of Sports Science, Budapest, Hungary
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
- Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary
| | - Márk Váczi
- Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary
| | - Kristóf Rácz
- Faculty of Mechanical Engineering, Department of Mechatronics, Optics and Mechanical Engineering Informatics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Zsófia Pálya
- Faculty of Mechanical Engineering, Department of Mechatronics, Optics and Mechanical Engineering Informatics, Budapest University of Technology and Economics, Budapest, Hungary
| | - László Grand
- Faculty of Information Technology, Pázmány Péter Catholic University, Budapest, Hungary
| | - Rita M. Kiss
- Faculty of Mechanical Engineering, Department of Mechatronics, Optics and Mechanical Engineering Informatics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Ryoichi Nagatomi
- Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan
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Pálya Z, Rácz K, Nagymáté G, Kiss RM. Development of a detailed canine gait analysis method for evaluating harnesses: A pilot study. PLoS One 2022; 17:e0264299. [PMID: 35263359 PMCID: PMC8906618 DOI: 10.1371/journal.pone.0264299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 02/09/2022] [Indexed: 11/19/2022] Open
Abstract
Dog harnesses are becoming more popular, with their large variety stemming from the idea that different dogs and scenarios require different types of harnesses. While their benefits over collars are self-explanatory, there is a lack of research on their effect on gait, and even the existing studies examine only a limited set of parameters. The goal of present study was to establish a method capable of quantifying canine gait in detail. Based on 3D motion capture, the developed method allows for the examination of 18 joint angles and 35 spatio-temporal parameters throughout multiple gait cycles, and can be used to analyze canine movement in detail in any kind of scenario (e.g. comparing healthy and lame dogs, or measuring the effect of training). The method is presented through the measurement of how different harnesses affect walking kinematics compared to free (unleashed) movements. Four dogs with varying body sizes and breeds and multiple types of harnesses were included. Marker data was filtered using a zero-lag 6th order Butterworth-filter with a cutoff frequency of 20 Hz. The normality of the spatio-temporal and joint range of motion parameters was tested using the Anderson-Darling test (p = 0.05), with most parameters passing in 60+% of test cases. Swing time and range of motion of the sagittal aspect of spinal angle at T1 vertebrae failed more regularly, both resulting from the measurement setup rather than the actual parameters being not normally distributed. Two-sample Kolmogorov-Smirnov tests (p = 0.05) were used to compare each parameter’s distribution between cases, showing that most parameters are significantly altered by the harnesses in about 2/3rd of the cases. Based on the results, there’s no absolute superior harness, however, it is possible to select the best fit for a specific dog and application, justifying their large variety.
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Affiliation(s)
- Zsófia Pálya
- Department of Mechatronics, Optics and Mechanical Engineering Informatics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Kristóf Rácz
- Department of Mechatronics, Optics and Mechanical Engineering Informatics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Gergely Nagymáté
- Department of Mechatronics, Optics and Mechanical Engineering Informatics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Rita M. Kiss
- Department of Mechatronics, Optics and Mechanical Engineering Informatics, Budapest University of Technology and Economics, Budapest, Hungary
- * E-mail:
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Tokodi M, Németh E, Lakatos BK, Kispál E, Tősér Z, Staub L, Rácz K, Soltész Á, Szigeti S, Varga T, Gál J, Merkely B, Kovács A. Right ventricular mechanical pattern in patients undergoing mitral valve surgery: a predictor of post-operative dysfunction? ESC Heart Fail 2020; 7:1246-1256. [PMID: 32220010 PMCID: PMC7261576 DOI: 10.1002/ehf2.12682] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/14/2020] [Accepted: 03/01/2020] [Indexed: 11/20/2022] Open
Abstract
Aims The PREPARE‐MVR study (PRediction of Early PostoperAtive Right vEntricular failure in Mitral Valve Replacement/Repair patients) sought to investigate the alterations of right ventricular (RV) contraction pattern in patients undergoing mitral valve replacement/repair (MVR) and to explore the associations between pre‐operative RV mechanics and early post‐operative RV dysfunction (RVD). Methods and results We prospectively enrolled 42 patients (63 ± 11 years, 69% men) undergoing open‐heart MVR. Transthoracic three‐dimensional (3D) echocardiography was performed pre‐operatively, at intensive care unit discharge, and 6 months after surgery. The 3D model of the RV was reconstructed, and RV ejection fraction (RVEF) was calculated. We decomposed the motion of the ventricle to compute longitudinal ejection fraction (LEF) and radial ejection fraction (REF). Pulmonary artery catheterization was performed to monitor RV stroke work index (RVSWi). RVEF was slightly decreased after MVR [52 (50–55) vs. 51 (46–54)%; P = 0.001], whereas RV contraction pattern changed notably. Before MVR, the longitudinal shortening was the main contributor to global systolic RV function [LEF/RVEF vs. REF/RVEF; 0.53 (0.47–0.58) vs. 0.33 (0.22–0.42); P < 0.001]. Post‐operatively, the radial motion became dominant [0.33 (0.28–0.43) vs. 0.46 (0.37–0.51); P = 0.004]. However, this shift was temporary as 6 months later the two components contributed equally to global RV function [0.44 (0.38–0.50) vs. 0.41 (0.36–0.49); P = 0.775]. Pre‐operative LEF was an independent predictor of post‐operative RVD defined as RVSWi < 300 mmHg⋅mL/m2 [OR = 1.33 (95% CI: 1.08–1.77), P < 0.05]. Conclusions MVR induces a significant shift in the RV mechanical pattern. Advanced indices of RV mechanics are associated with invasively measured parameters of RV contractility and may predict post‐operative RVD.
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Affiliation(s)
- Márton Tokodi
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Endre Németh
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | - Bálint K Lakatos
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Erika Kispál
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | | | | | - Kristóf Rácz
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | - Ádám Soltész
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | - Szabolcs Szigeti
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | - Tamás Varga
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | - János Gál
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Attila Kovács
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
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Mészáros K, Karvaly G, Márta Z, Magda B, Tőke J, Szücs N, Tóth M, Rácz K, Patócs A. Diagnostic performance of a newly developed salivary cortisol and cortisone measurement using an LC-MS/MS method with simple and rapid sample preparation. J Endocrinol Invest 2018; 41:315-323. [PMID: 28815484 DOI: 10.1007/s40618-017-0743-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 08/07/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Late-night salivary cortisol level is one of the first-line tests recommended by the Endocrine Society for the diagnosis of endogenous hypercortisolism. Most routine laboratories measure cortisol levels using immunoassay tests which fail to determine low cortisol levels accurately due to the numerous interfering substances. A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method with simple and rapid sample preparation was developed for the simultaneous measurement of cortisol and cortisone and its performance in the diagnosis of endogenous hypercortisolism was evaluated. METHODS 324 late-night saliva samples were analyzed from which 272 samples were derived from patients with a suspected diagnosis of endogenous hypercortisolism. Salivary cortisol levels were assayed using an electrochemiluminescent immunoassay (ECLIA, Cortisol II, Roche), and simultaneous measurement of cortisol and cortisone was performed using an LC-MS/MS method. RESULTS A strong correlation between cortisol results measured using ECLIA and LC-MS/MS (r 2 = 0.892) was demonstrated. Receiver operating characteristics (ROC) analysis showed good diagnostic performance of cortisol and cortisone levels assayed using LC-MS/MS method and for cortisol measured using ECLIA. CONCLUSIONS Late-night salivary cortisol and cortisone are useful parameters for the diagnosis of hypercortisolism. Using samples obtained from patients where the diagnosis of hypercortisolism is extremely challenging cut-off values for midnight salivary cortisol and cortisone measured by LC-MS/MS method were established.
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Affiliation(s)
- K Mészáros
- Department of Laboratory Medicine, MTA-SE Lendulet Research Group, Hungarian Academy of Sciences, Semmelweis University, 46. Szentkiralyi str, Budapest, 1088, Hungary
- "Lendület" Hereditary Endocrine Tumours Research Group, HAS-SE, Budapest, Hungary
- Bionics Innovation Center, Budapest, Hungary
| | - G Karvaly
- Department of Laboratory Medicine, MTA-SE Lendulet Research Group, Hungarian Academy of Sciences, Semmelweis University, 46. Szentkiralyi str, Budapest, 1088, Hungary
- Bionics Innovation Center, Budapest, Hungary
| | - Z Márta
- MS Metabolomics Research Group, HAS, Budapest, Hungary
| | - B Magda
- MS Metabolomics Research Group, HAS, Budapest, Hungary
| | - J Tőke
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
| | - N Szücs
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
| | - M Tóth
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
| | - K Rácz
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
- Molecular Medicine Research Group, HAS-SE, Budapest, Hungary
| | - A Patócs
- Department of Laboratory Medicine, MTA-SE Lendulet Research Group, Hungarian Academy of Sciences, Semmelweis University, 46. Szentkiralyi str, Budapest, 1088, Hungary.
- "Lendület" Hereditary Endocrine Tumours Research Group, HAS-SE, Budapest, Hungary.
- Bionics Innovation Center, Budapest, Hungary.
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Rácz K, Pálya Z, Takács M, Nagymáté G, Kiss R. Investigation of calibration accuracy of anatomical landmarks in an optical motion analysis method. Biomech Hung 2018. [DOI: 10.17489/2018/1/04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Lakatos BK, Tokodi M, Assabiny A, Tősér Z, Kosztin A, Doronina A, Rácz K, Koritsánszky KB, Berzsenyi V, Németh E, Sax B, Kovács A, Merkely B. Dominance of free wall radial motion in global right ventricular function of heart transplant recipients. Clin Transplant 2018; 32:e13192. [PMID: 29315873 DOI: 10.1111/ctr.13192] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2018] [Indexed: 12/28/2022]
Abstract
Assessment of right ventricular (RV) function using conventional echocardiography might be inadequate as the radial motion of the RV free wall is often neglected. Our aim was to quantify the longitudinal and the radial components of RV function using three-dimensional (3D) echocardiography in heart transplant (HTX) recipients. Fifty-one HTX patients in stable cardiovascular condition without history of relevant rejection episode or chronic allograft vasculopathy and 30 healthy volunteers were enrolled. RV end-diastolic (EDV) volume and total ejection fraction (TEF) were measured by 3D echocardiography. Furthermore, we quantified longitudinal (LEF) and radial ejection fraction (REF) by decomposing the motion of the RV using the ReVISION method. RV EDV did not differ between groups (HTX vs control; 96 ± 27 vs 97 ± 2 mL). In HTX patients, TEF was lower, however, tricuspid annular plane systolic excursion (TAPSE) decreased to a greater extent (TEF: 47 ± 7 vs 54 ± 4% [-13%], TAPSE: 11 ± 5 vs 21 ± 4 mm [-48%], P < .0001). In HTX patients, REF/TEF ratio was significantly higher compared to LEF/TEF (REF/TEF vs LEF/TEF: 0.58 ± 0.10 vs 0.27 ± 0.08, P < .0001), while in controls the REF/TEF and LEF/TEF ratio was similar (0.45 ± 0.07 vs 0.47 ± 0.07). Current results confirm the superiority of radial motion in determining RV function in HTX patients. Parameters incorporating the radial motion are recommended to assess RV function in HTX recipients.
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Affiliation(s)
| | - Márton Tokodi
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | | | | | | | | | - Kristóf Rácz
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | | | - Viktor Berzsenyi
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | - Endre Németh
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | - Balázs Sax
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Attila Kovács
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
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Farkas P, Csuka D, Mikes B, Sinkovits G, Réti M, Németh E, Rácz K, Madách K, Gergely M, Demeter J, Prohászka Z. Complement activation, inflammation and relative ADAMTS13 deficiency in secondary thrombotic microangiopathies. Immunobiology 2017; 222:119-127. [DOI: 10.1016/j.imbio.2016.10.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 10/17/2016] [Accepted: 10/17/2016] [Indexed: 01/17/2023]
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Sztanó B, Kiss G, Márai K, Rácz G, Szegesdi I, Rácz K, Katona G, Rovó L. Biodegradable airway stents in infants - Potential life-threatening pitfalls. Int J Pediatr Otorhinolaryngol 2016; 91:86-89. [PMID: 27863648 DOI: 10.1016/j.ijporl.2016.10.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 10/10/2016] [Accepted: 10/12/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The solution of severe tracheobronchial obstructions in early childhood means a great challenge. Biodegradable stents were intended to be a minimally invasive temporary solution which may decrease the number of interventions and limit the possible complications of stenting procedures. However, our first experiences have brought out a new, - especially in childhood - potentially life-threatening complication of this concept. METHODS Five SX-ELLA biodegradable polydioxanone stents was applied in three patients because of severe tracheobronchial obstruction: congenital tracheomalacia (7 day-old), acquired tracheomalacia (10 month-old), and congenital trachea-bronchomalacia (10 month-old). RESULTS The breathing of all children improved right after the procedure. We observed degradation of the stent from the 5th postoperative week which resulted in large intraluminar fragments causing significant airway obstruction: one patient died of severe pneumonia, the other baby required urgent bronchoscopy to remove the obstructing 'foreign body' from the trachea. In the third case repeated stent placements successfully maintained the tracheal lumen. CONCLUSIONS Polydioxanone stents may offer an alternative to metallic or silastic stents for collapse or external compression of the trachea in children; however, large decaying fragments mean a potential risk especially in the small size pediatric airway. The fragmentation of the stent, which generally starts in the 4-6 postoperative weeks, may create large sharp pieces. These may be anchored to the mucosa and covered by crust leading to obstruction. As repeated interventions are required, we do not consider the application of biodegradable stents unambiguously advantageous.
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Affiliation(s)
- B Sztanó
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Hungary.
| | - G Kiss
- Heim Pál Children's Hospital Anesthesiology and Intensive Care Department, Budapest, Hungary
| | - K Márai
- Heim Pál Children's Hospital Anesthesiology and Intensive Care Department, Budapest, Hungary
| | - G Rácz
- Department of Pediatrics and Pediatric Health Care Center, University of Szeged, Hungary
| | - I Szegesdi
- Department of Anaesthesiology and Intensive Therapy, University of Szeged, Hungary
| | - K Rácz
- Department of Pediatrics and Pediatric Health Care Center, University of Szeged, Hungary
| | - G Katona
- Heim Pál Children's Hospital ENT Department, Budapest, Hungary
| | - L Rovó
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Hungary
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Fazekas L, Sax B, Hartyánszky I, Pólos M, Horkay F, Varga T, Rácz K, Németh E, Székely A, Paulovich E, Heltai K, Zima E, Szabolcs Z, Merkely B. [Mechanical circulatory support saves lives -- three years' experience of the newly established assist device program at Semmelweis University, Budapest, Hungary]. Orv Hetil 2015; 156:521-7. [PMID: 25796280 DOI: 10.1556/oh.2015.30115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Since the celebration of the 20th anniversary of the first heart transplantation in Hungary in 2012 the emerging need for modern heart failure management via mechanical circulatory support has evolved. In May 2012 the opening of a new heart failure and transplant unit with 9 beds together with the procurement of necessary devices at Semmelweis University accomplished this need. AIM The aim of the authors was to report their initial experience obtained in this new cardiac assist device program. METHOD Since May, 2012, mechanical circulatory support system was applied in 89 cases in 72 patients. Indication for support were end stage heart failure refractory to medical treatment and acute left or right heart failure. RESULTS Treatment was initiated for acute graft failure after heart transplantation in 27 cases, for end stage heart failure in 24 cases, for acute myocardial infarction in 21 cases, for acute postcardiotomy heart failure in 14 cases, for severe respiratory insufficiency in 2 cases and for drug intoxication in one case. Among the 30 survivor of the whole program 13 patients were successfully transplanted. CONCLUSIONS The available devices can cover all modalities of current bridge therapy from short term support through medium support to heart transplantation or long term support and destination therapy. These conditions made possible the successful start of a new cardiac assist device program.
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Affiliation(s)
- Levente Fazekas
- Semmelweis Egyetem, Általános Orvostudományi Kar Városmajori Szív- és Érgyógyászati Klinika Budapest Városmajor u. 68. 1122
| | - Balázs Sax
- Semmelweis Egyetem, Általános Orvostudományi Kar Városmajori Szív- és Érgyógyászati Klinika Budapest Városmajor u. 68. 1122
| | - István Hartyánszky
- Semmelweis Egyetem, Általános Orvostudományi Kar Városmajori Szív- és Érgyógyászati Klinika Budapest Városmajor u. 68. 1122
| | - Miklós Pólos
- Semmelweis Egyetem, Általános Orvostudományi Kar Városmajori Szív- és Érgyógyászati Klinika Budapest Városmajor u. 68. 1122
| | - Ferenc Horkay
- Semmelweis Egyetem, Általános Orvostudományi Kar Városmajori Szív- és Érgyógyászati Klinika Budapest Városmajor u. 68. 1122
| | - Tamás Varga
- Semmelweis Egyetem, Általános Orvostudományi Kar Aneszteziológiai és Intenzív Terápiás Klinika Budapest
| | - Kristóf Rácz
- Semmelweis Egyetem, Általános Orvostudományi Kar Aneszteziológiai és Intenzív Terápiás Klinika Budapest
| | - Endre Németh
- Semmelweis Egyetem, Általános Orvostudományi Kar Aneszteziológiai és Intenzív Terápiás Klinika Budapest
| | - Andrea Székely
- Semmelweis Egyetem, Általános Orvostudományi Kar Aneszteziológiai és Intenzív Terápiás Klinika Budapest
| | - Erzsébet Paulovich
- Semmelweis Egyetem, Általános Orvostudományi Kar Aneszteziológiai és Intenzív Terápiás Klinika Budapest
| | - Krisztina Heltai
- Semmelweis Egyetem, Általános Orvostudományi Kar Városmajori Szív- és Érgyógyászati Klinika Budapest Városmajor u. 68. 1122
| | - Endre Zima
- Semmelweis Egyetem, Általános Orvostudományi Kar Városmajori Szív- és Érgyógyászati Klinika Budapest Városmajor u. 68. 1122
| | - Zoltán Szabolcs
- Semmelweis Egyetem, Általános Orvostudományi Kar Városmajori Szív- és Érgyógyászati Klinika Budapest Városmajor u. 68. 1122
| | - Béla Merkely
- Semmelweis Egyetem, Általános Orvostudományi Kar Városmajori Szív- és Érgyógyászati Klinika Budapest Városmajor u. 68. 1122
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Kender Z, Fleming T, Kopf S, Torzsa P, Grolmusz V, Herzig S, Schleicher E, Rácz K, Reismann P, Nawroth P. Effect of Metformin on Methylglyoxal Metabolism in Patients with Type 2 Diabetes. Exp Clin Endocrinol Diabetes 2014; 122:316-9. [DOI: 10.1055/s-0034-1371818] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Z. Kender
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
| | - T. Fleming
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
| | - S. Kopf
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
| | - P. Torzsa
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - V. Grolmusz
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
| | - S. Herzig
- Joint Research Division, Molecular Metabolic Control, German Cancer Research Center DKFZ, Network Aging Research, ZMBH, Heidelberg, Germany
| | - E. Schleicher
- Division of Clinical Chemistry/Central Laboratory, Department of Internal Medicine, University of Tubingen, Tubingen, Germany
| | - K. Rácz
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
| | - P. Reismann
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
| | - P. Nawroth
- Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
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Zsippai A, Szabó PM, Szabó DR, Nagy Z, Patócs A, Rácz K, Igaz P. In silico analysis of pathways affected by differentially expressed microRNA in adrenocortical tumors. J Endocrinol Invest 2013; 36:1011-9. [PMID: 23812403 DOI: 10.3275/9024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND MicroRNA are involved in the pathogenesis of several tumors, and several studies have been performed on the microRNA profile of adrenocortical tumors to date. The pathways affected by these microRNA, however, have not been analyzed yet by a systematic approach. AIM To perform an in silico bioinformatics analysis of microRNA commonly altered in at least two studies and to decipher the pathways affected by microRNA in adrenocortical tumors. METHODS Datasets on microRNA and mRNA expression have been retrieved from 5 and 3 studies, respectively. MicroRNA mRNA targets have been identified by our tissue specific target prediction pipeline, and mRNA have been subjected to Ingenuity Pathway Analysis. RESULTS Thirty- nine microRNA were identified as commonly altered in two studies. Altogether 49,817 mRNA targets have been found for these microRNA. One-hundred and seventy-eight significant pathways associating with these have been identified and were found in all studies. We have selected 12 pathways involving retinoic acid signaling (lipopolysaccharide/ interleukin-1 mediated inhibition of retinoic X receptor (RXR) function, peroxisome proliferator-activated receptor (PPAR)α/RXRα activation, retinoic A receptor activation and PPAR signaling pathways) and cell cycle alterations (aryl hydrocarbon receptor signaling, growth arrest and DNA damage-inducible 45 signaling, integrin signaling, G2/M DNA damage checkpoint regulation, cyclins and cell cycle regulation and cell cycle control of chromosomal replication pathways) as these have been also established in our previous study on the functional genomics meta-analysis of adrenocortical tumors. Several microRNA have been identified that could affect these pathways. CONCLUSIONS MicroRNA might affect several pathogenic pathways in adrenocortical tumors. Validation studies are required to confirm the biological relevance of these findings.
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Affiliation(s)
- A Zsippai
- 2nd Department of Medicine, Faculty of Medicine, Semmelweis University, H-1088 Budapest, Szentkirályi str. 46, Hungary
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13
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Szabolcs Z, Hartyánszky I, Hüttl T, Fazekas L, Balogh O, Becker D, Soós P, Varga T, Paulovich E, Németh E, Rácz K, Horkay F, Merkely B. [2012 -- the year of success in the 20 year-old adult heart transplant program of Hungary]. Orv Hetil 2013; 154:863-7. [PMID: 23708987 DOI: 10.1556/oh.2013.29622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The Hungarian adult heart transplant program, which started in 1992, has changed gradually in the past 20 years. After the early enthusiasm of the first cases it changed significantly and it became an organized programme. However, low donation activity and moderate referral numbers to the national transplant waiting list slowed down the process therefore, heart transplant numbers did not fulfill expectations in the early years. After a moderate increase in 2007 transplant numbers have dropped again until recently when Hungary partially joined Eurotransplant network. Excess fundamental resources allocated to cardiac transplantation by health care professionals and reorganizing transplant coordination as well as logistics forced dramatic changes in clinical management. In 2011 and 2012 major structural changes had been made at Semmelweis University. The newly established transplant intensive care unit and the initiation of mechanical circulatory support and assist device programme increased transplant numbers by 131% compared to previous years, as well as it resulted an 86.63% 30-day survival rate, hence last year was the most successful year of cardiac transplantation ever.
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Affiliation(s)
- Zoltán Szabolcs
- Semmelweis Egyetem, Általános Orvostudományi Kar, Ér- és Szívgyógyászati Klinika, Budapest, Városmajor utca 68. 1122.
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Grolmusz VK, Stenczer B, Fekete T, Szendei G, Patócs A, Rácz K, Reismann P. Lack of association between C385A functional polymorphism of the fatty acid amide hydrolase gene and polycystic ovary syndrome. Exp Clin Endocrinol Diabetes 2013; 121:338-42. [PMID: 23616186 DOI: 10.1055/s-0033-1337941] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The endocannabinoid system contributes to the regulation of appetite, food intake and energy balance. Fatty acid amide hydrolase is responsible for degradating anandamide, a key messenger of the endocannabinoid system. C385A is a common, functionally active genetic polymorphism of the gene encoding fatty acid amide hydrolase and has been associated with overweight and obesity. Our aim was to establish whether single nucleotide polymorphism C385A has an association with polycystic ovary syndrome or its clinical features.A monocentric pilot study was performed on 63 patients with polycystic ovary syndrome and 67 healthy control subjects. Anthropometric parameters and laboratory data were acquired from subjects. The alleles of the polymorphism were detected using polymerase chain reaction and subsequent cleavage by Eco130I (StyI) restriction endonuclease verified by direct DNA sequencing.No difference was found in minor allele frequency between patient and control groups. Those patients, carrying the C385A polymorphism were associated with higher free thyroxine hormone levels. In the control group, carriers of the polymorphism had significantly lower insulin levels.Our data indicate that the C385A polymorphism of the fatty acid amide hydrolase gene is not a genetic susceptibility factor for the development of polycystic ovary syndrome. However, the polymorphism might have a role in influencing the synthesis or metabolism of different hormones including thyroxin and insulin.
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Affiliation(s)
- V K Grolmusz
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
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15
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Stark J, Tulassay Z, Lengyel G, Szombath D, Székács B, Adler I, Marczell I, Nagy-Répas P, Dinya E, Rácz K, Békési G. Increased total scavenger capacity in rats fed corticosterone and cortisol on lipid-rich diet. Acta Physiol Hung 2013; 100:84-88. [PMID: 23232702 DOI: 10.1556/aphysiol.99.2012.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND In our earlier studies both corticosterone and cortisol had antioxidant effect in vitro. OBJECTIVES Our aim was to clarify whether corticosterone and cortisol oral administration results in beneficial antioxidant changes in Sprague-Dawley adult male rats in vivo. METHODS Experimental animals were fed a lipid rich diet and treated with corticosterone or cortisol in the drinking fluid. Control group was fed only lipid rich diet with untreated drinking water. The untreated group was feda normal diet with untreated water. Total scavenger capacity (TSC) was measured before and after 4 weeks of treatment in blood samples using a chemiluminometric assay. RESULTS Both corticosterone and cortisol treatment caused increased TSC. The control group and the untreated group showed no significant changes in TSC. CONCLUSION Our results support the hypothesis that corticosterone and cortisol administration can improve the antioxidant status not only in vitro but also in vivo.
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Affiliation(s)
- J Stark
- Semmelweis University 2nd Department of Medicine, Faculty of Medicine Budapest Hungary
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16
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Abstract
The protooncogene c-myc is a major factor in tumourigenesis. Whereas c-myc overexpression is considered to be a general feature of many tumours, we have recently demonstrated c-myc underexpression in adrenocortical cancer by a meta-analysis. We hypothesise that c-myc underexpression might be a central event in adrenortical tumourigenesis based on network topology modelling and previous experimental observations. In this brief hypothesis, we present our arguments and their possible relevance.
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Affiliation(s)
- P M Szabó
- 2nd Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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17
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Szappanos A, Toke J, Lippai D, Patócs A, Igaz P, Szücs N, Füto L, Gláz E, Rácz K, Tóth M. Bone turnover in patients with endogenous Cushing's syndrome before and after successful treatment. Osteoporos Int 2010; 21:637-45. [PMID: 19513576 DOI: 10.1007/s00198-009-0978-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Accepted: 05/07/2009] [Indexed: 10/20/2022]
Abstract
UNLABELLED We investigated bone turnover and its restoration in a large number of patients in the active phase and after cure of endogenous Cushing's syndrome. Furthermore, the usefulness of serum osteocalcin and collagen breakdown products as potential markers of active Cushing's syndrome was also evaluated. INTRODUCTION Suppressed bone formation is one of the most characteristic features of Cushing's syndrome (CS). Despite numerous previous reports, many aspects of the disturbed bone metabolism of these patients are unexplored. In this study, we investigated the time course of bone marker changes after the cure of CS as well as correlations between bone markers and serum cortisol concentrations. METHODS Eighty-seven patients with CS were studied. Patients were followed up to 48 months after surgical cure. Serum osteocalcin (OC) and collagen breakdown products (CTX) were measured with immunochemiluminescence method and compared to the results of 161 healthy controls. RESULTS OC showed a negative, while CTX displayed a positive correlation with serum cortisol. Patients with diabetes mellitus and myopathy had significantly lower serum OC levels compared to those without these complications. The area under the curve of OC obtained by receiver-operating characteristics analysis for the discrimination of patients with CS from healthy controls was 0.9227. Postoperative OC increased rapidly from the first few days or weeks reaching its maximum at the sixth month and remained stable after the 24th postoperative month. CONCLUSIONS Our study demonstrated significant correlations between serum cortisol and both bone formation and resorption markers in the active phase of CS. We propose that OC may serve as a sensitive biologic marker of glucocorticoid activity in endogenous CS during its active phase and it may reflect the clinical cure of the disease.
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Affiliation(s)
- A Szappanos
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
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18
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Rácz K, Tiszai-Szűcs T, Gál J, Kertai MD. Preoperative revascularization in high-risk patients undergoing vascular surgery. Orv Hetil 2009. [DOI: 10.1556/oh.2009.28620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Helyreigazítás a
DOI: 10.1556/OH.2009.28545
közleményhez. (OH 150. évfolyam, 8. szám – 2009. február 22. 341–352. o.)
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Affiliation(s)
| | - Tamás Tiszai-Szűcs
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar Aneszteziológiai és Intenzív Terápiás Tanszék Budapest Hungary
| | - János Gál
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar Aneszteziológiai és Intenzív Terápiás Tanszék Budapest Hungary
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Abstract
Cushing's syndrome is a rare disease with significant morbidity and mortality. Surgical intervention represents the most effective treatment option in both adrenocorticotropin-dependent and -independent forms of hypercortisolism. It is not uncommon, however, that surgery fails to cure or control the disease. Pharmacotherapy with drugs inhibiting steroid biosynthesis can be effectively used in these cases in order to alleviate symptoms or even to induce chemical adrenalectomy. A few drugs inhibiting single or multiple steps in adrenal steroid biosynthesis can be used in clinical practice. Drugs predominantly inhibiting single enzymatic steps include the 11beta-hydroxylase inhibitor metyrapone and the 3beta-hydroxysteroid dehydrogenase inhibitor trilostane, whereas mitotane, aminoglutethimide, ketoconazole and etomidate block multiple enzymatic reactions. Etomidate is the only agent available for parenteral administration that renders it as a treatment of choice in critically ill patients requiring a rapid control of hypercortisolemia. Ketoconazole, metyrapone and aminoglutethimide can be used alone or in combination for the treatment of hypercortisolism caused by benign adrenocorticotropin- or cortisol-secreting tumors. The clinical utility of trilostane is variable. Besides blocking multiple steps in adrenal steroid biosynthesis, the DDT (insecticide) analogue mitotane also has adrenolytic properties by inducing mitochondrial degeneration that renders it superior to other drugs in the treatment of adrenocortical cancer. Severe side effects may develop during therapy with each aforementioned drug that include hepatic, endocrine and neurological toxicity. After summarizing the chemical and biological properties of steroid biosynthetic inhibitors, the authors describe their possible clinical applications and limitations.
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Affiliation(s)
- P Igaz
- 2nd Department of Medicine, Faculty of Medicine, Semmelweis University, 1088 Budapest, Szentkirályi str. 46., Hungary
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20
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Rácz K, Tiszai-Szucs T, Gál J, Kertai D M. [Preoperative revascularization in high-risk patients undergoing vascular surgery]. Orv Hetil 2009; 150:341-52. [PMID: 19218144 DOI: 10.1556/oh.2009.28545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Patients undergoing vascular surgery are at increased risk for cardiac complications related to the presence of underlying coronary artery disease. Preoperative cardiac evaluation may help to identify high-risk patients in whom coronary angiography may be planned with subsequent coronary revascularization for the purpose of improving perioperative and long-term cardiac outcomes. However, the indications and efficacy for type of revascularization for the reduction of cardiac complications compared to medical therapy have been controversial. The aim of the review was to summarize the role of preoperative revascularization compared to conservative medical therapy before elective vascular surgery using current evidence from published studies.
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Affiliation(s)
- Kristóf Rácz
- Semmelweis Egyetem, Altalános Orvostudományi Kar Aneszteziológiai és Intenzív Terápiás Tanszék Budapest, Hungary
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21
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Füto L, Toke J, Patócs A, Szappanos A, Varga I, Gláz E, Tulassay Z, Rácz K, Tóth M. Skeletal differences in bone mineral area and content before and after cure of endogenous Cushing's syndrome. Osteoporos Int 2008; 19:941-9. [PMID: 18043854 DOI: 10.1007/s00198-007-0514-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Accepted: 10/26/2007] [Indexed: 11/24/2022]
Abstract
UNLABELLED We examined bone densitometric data in a four-year follow-up period before and after the cure of CS. Plasma cortisol concentrations were similar, but the duration of estimated glucocorticoid excess was longer in patients with prevalent bone fractures compared to those without fractures. After therapy of CS, bone area, BMC and BMD increased significantly at the LS and femur during follow-up, but they decreased at the forearm, suggesting redistribution of bone minerals from the peripheral to the axial skeleton. INTRODUCTION Only a few studies report the changes in bone mineral density (BMD) after the cure of Cushing's syndrome (CS). METHODS Forty-one patients with Cushing's disease, 21 patients with adrenal CS and 6 patients with ectopic CS were prospectively enrolled. BMD, bone mineral content (BMC) and bone area were measured by DXA. RESULTS No significant correlations were found between serum cortisol concentrations and baseline bone densitometric data. After successful therapy of CS, bone area and BMD increased significantly at the lumbar spine (LS) and femur during follow-up, but they decreased at the forearm. The progressive increase in BMC at the LS had a significant negative correlation with the change of the BMC of radius in the first and second follow-up years. The change in the body mass index was an independent predictor for changes in BMC both at the LS and at the forearm at the second year of remission. CONCLUSIONS The regional differences and the time-dependent changes of BMC suggest that the source of marked increase in axial BMC after the cure of CS is, at least partly, due to the redistribution of bone minerals from the peripheral to the axial skeleton.
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Affiliation(s)
- L Füto
- Department of Internal Medicine, Ferenc Markhot Hospital, Eger, Hungary
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22
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Benko T, Fehérvári I, Rácz K, Friedrich O, Gálfy I, Török S, Remport A, Járay J, Bodor E, Szabolcs Z. [The first successful combined heart-kidney transplantation in Hungary]. Orv Hetil 2008; 149:147-52. [PMID: 18201956 DOI: 10.1556/oh.2008.28243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Combined heart-kidney transplantation has become a new therapeutic solution for patients with coexisting, irreversible heart and kidney failure. Though this combined approach has several theoretical advantages over sequential transplantation, it remains to be established whether it has a jeopardizing impact on patient and graft outcome. The authors report their experience of the first successful combined heart-kidney transplantation in Hungary from a single donor and review the literature in order to clarify this issue. Young male patient candidate for heart transplantation was suffering from concurrent end stage kidney disease. Donor was selected on the basis of weight and size matching, AB0 compatibility and negative T-cell cross-match. The heart was grafted first, and after the hemodynamic stabilization kidney from the same donor was transplanted. The surgical procedure was uneventful. Heart and kidney function recovered quickly, and the patient is doing very well with good cardiac and renal function even a year following the double organ transplantation. The first Hungarian experience showed that combined heart-kidney transplantation is a therapeutic solution for patients with end stage heart and kidney failure. The lower rate of rejection compared to single heart or kidney transplantation, known from the literature as well, supports their current approach to immunosuppression.
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Affiliation(s)
- Tamás Benko
- Semmelweis Egyetem, Altalános Orvostudományi Kar Transzplantációs és Sebészeti Klinika, Budapest, Hungary.
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23
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Halász Z, Bertalan R, Toke J, Patócs A, Tóth M, Fekete G, Gláz E, Rácz K. Laterality disturbance and hypopituitarism. A case report of co-existing situs inversus totalis and combined pituitary hormone deficiency. J Endocrinol Invest 2008; 31:74-8. [PMID: 18296909 DOI: 10.1007/bf03345570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The authors present the case history of a 52-yr-old male patient with a unique association of combined pituitary hormone deficiency (CPHD) and situs inversus totalis. Except for signs and symptoms of pituitary hormone deficiency, the patient had no dysmorphic features, and hearing impairment, primary mental or neurological defects were also absent. Pituitary magnetic resonance imaging (MRI) scan showed hypoplasia of the anterior lobe of the pituitary gland and an ectopic posterior pituitary lobe. Despite the presence of situs inversus totalis, the patient was right-handed and functional MRI demonstrated left-hemisphere activation during language tests. Kartagener syndrome was considered, but immunofluorescence analysis showed normal localization of the outer dynein arm protein in respiratory epithelial cells obtained from the nasal mucosa. Direct DNA sequencing of all coding exons of the pituitary transcription factor 1 (PIT1) and prophet of PIT1 (PROP1) genes failed to detect disease-causing mutations, suggesting that these genes were not involved in the development of CPHD in our patient. More interestingly, the potential role of the paired like homeodomain transcription factor 2 (PITX2) gene, which has been implicated not only in CPHD, but also in left-right patterning in animal models, was also excluded, as sequencing showed the absence of mutations in coding exons of this gene. To our knowledge, PITX2 gene mutations have not been investigated in CPHD patients who had situs inversus totalis. We conclude that in contrast to animal models, the PITX2 gene is not involved in the development of situs inversus totalis, at least not in our CPHD patient.
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Affiliation(s)
- Z Halász
- 2nd Department of Pediatrics, Semmelweis University, Budapest H-1094, Hungary.
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24
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Rácz K, Nagy Á, Szomor Á, Kosztolányi S, Losonczy H. P149 Case report: lymphomatoid granulomatosis transformed from CLL. Blood Rev 2007. [DOI: 10.1016/s0268-960x(07)70228-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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25
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Pusztai P, Sármán B, Illyés G, Székely E, Péter I, Boer K, Tihanyi T, Rácz K. Hypercalcitoninemia in a Patient with a Recurrent Goitre and Insulinoma: a Case Report. Exp Clin Endocrinol Diabetes 2006; 114:217-21. [PMID: 16804794 DOI: 10.1055/s-2006-924257] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Serum calcitonin has become a very sensitive and specific marker for medullary thyroid carcinoma that should be determined in patients with nodular thyroid disease. However, a few earlier reports indicated that tumors other than medullary thyroid carcinoma including insulinomas arising from pancreatic islet cells may also produce calcitonin. Of the few cases of calcitonin-producing insulinomas previously reported, most had incomplete data or lack of documentation of the association between raised serum calcitonin concentration and immunohistochemical detection of calcitonin in pancreatic islet cell tumors. In this paper we are reporting a 54-year-old woman with a history of partial thyroidectomy for multinodular goitre at the age of 50 yrs, she was evaluated for a 2-months history of fasting hypoglycemia (plasma glucose 1.9 mmol/L during a supervised fast), raised serum insulin (at the time of hypoglycemia 88.8 microU/ml; normal, 5 - 35 microU/ml) and C-peptide levels (at the time of hypoglycemia 6.1 ng/ml; normal, 1.37 - 3.51 ng/ml), markedly increased serum calcitonin concentration (481 pg/ml; normal, < 9.9 pg/ml), and an enlarged residual thyroid gland. Aspiration biopsy of the thyroid was negative for parafollicular C-cell hyperplasia or medullary thyroid carcinoma. Abdominal ultrasound and CT scan revealed a tumor in the head of the pancreas, which was surgically removed. Histopathological evaluation of the pancreatic tumor showed typical features of a neuroendocrine neoplasm with strong immunostaining for both insulin and calcitonin. After removal of the pancreatic tumor, clinical symptoms resolved and biochemical markers normalized (serum insulin, 14.9 microU/ml; C-peptide, 3.0 ng/ml; calcitonin, 2.9 pg/ml) confirming the causal relationship between insulinoma and markedly increased serum calcitonin levels.
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Affiliation(s)
- P Pusztai
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary.
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26
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Patócs A, Karádi E, Tóth M, Varga I, Szücs N, Balogh K, Majnik J, Gláz E, Rácz K. Clinical and biochemical features of sporadic and hereditary phaeochromocytomas: an analysis of 41 cases investigated in a single endocrine centre. Eur J Cancer Prev 2004; 13:403-9. [PMID: 15452453 DOI: 10.1097/00008469-200410000-00008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aims of this study were to estimate the prevalence of phaeochromocytomas among adrenal tumours and to analyse the clinical and biochemical features of sporadic and hereditary tumours. Our series of 609 adrenal tumours evaluated between January 1995 and July 2003 was reviewed. Catecholamine content in phaeochromocytoma tissues was also determined and correlated with clinical behaviour and biochemical parameters of patients. Forty-one (6.7%) of the 609 patients had phaeochromocytomas, of which 28 were sporadic (25 benign and three malignant) and 13 (all benign) were associated with hereditary diseases (multiple endocrine neoplasia type 2A in seven cases from four unrelated families carrying mutations of the RET gene, von Hippel-Lindau disease in two unrelated cases with mutations of the VHL gene, and type 1 neurofibromatosis in four unrelated cases). Bilateral tumours were found in three patients with hereditary syndromes and in one sporadic case. Tumour diameter was slightly but not significantly greater in patients with hereditary than in those with sporadic tumours. Systolic but not diastolic blood pressure was significantly higher in patients with sporadic compared with those with hereditary tumours, but comparison of other clinical data and biochemical parameters indicated an absence of significant differences in the mean age, presenting symptoms, heart rate, or fasting serum glucose levels. Tissue catecholamine content measured in 8 sporadic and 5 hereditary phaeochromocytomas was highly variable and it failed to show significant differences between hereditary and sporadic tumours. These results indicate a high proportion of hereditary diseases among patients with phaeochromocytomas. Genetic and clinical testing for hereditary diseases may be of great help to offer an appropriate treatment, follow-up and family screening for these patients.
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Affiliation(s)
- A Patócs
- 2nd Department of Medicine, Faculty of Medicine, Semmelweis University, Szentkirályi 46, H-1088 Budapest, Hungary
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Majnik J, Szücs N, Patócs A, Tóth M, Balogh K, Varga I, Gláz E, Rácz K. Effect of single doses of dexamethasone and adrenocorticotrop hormone on serum bone markers in healthy subjects and in patients with adrenal incidentalomas and Cushing's syndrome. J Endocrinol Invest 2004; 27:747-53. [PMID: 15636428 DOI: 10.1007/bf03347517] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The aim of the present study was to explore whether short-term changes in glucocorticoid activity which occur during dynamic testing of the pituitary adrenal axis with dexamethasone, ACTH, or metyrapone could have an effect on serum osteocalcin (OC) and beta-crosslaps (beta-CTx) concentrations in healthy subjects, in patients with adrenal incidentalomas and in those with Cushing's syndrome. The study included 40 healthy subjects (35 women and 5 men, age range 18-69 yr), 49 patients with adrenal incidentalomas (34 women and 15 men, age range 19-77 yr) and 8 patients with Cushing's syndrome (5 cortisol-producing adenomas and 3 pituitary-dependent Cushing's syndrome, 3 women and 5 men, age range 19-70 yr). Serum OC and beta-CTx concentrations were determined with electrochemoluminescent immunoassays at midnight, after an overnight fast between 08:00 and 09:00 h, after an overnight dexamethasone test (1 mg, orally) and after a single dose of metyrapone (30 mg/kg, orally). In healthy subjects and in patients with adrenal incidentalomas, serum bone marker concentrations were also measured after a single dose of ACTH injection (Cortrosyn depot, 1 mg im). Patients with Cushing's syndrome, but not those with adrenal incidentalomas, showed significantly lower serum OC at midnight (18.5+/-12 ng/ml, mean+/-SD) and between 08:00 and 09:00 h (17.7+/-9.6 ng/ml) compared to corresponding values obtained in healthy subjects (24.5+/-7.0 and 28.3+/-12.2 ng/ml, respectively). Serum OC concentrations were significantly decreased after a single dose of 1-mg dexamethasone in healthy subjects (from 28.3+/-12.2 to 21.8+/-9.5 ng/ml) and in patients with adrenal incidentalomas (from 29.8+/-15.9 to 24.1+/-14.1 ng/ml), whereas serum OC concentrations remained unchanged in patients with Cushing's syndrome. In addition, serum OC concentrations were even more markedly decreased after a single dose of ACTH injection in both healthy subjects (12.5+/-4.6 ng/ml) and in patients with adrenal incidentalomas (12.2+/-6.5 ng/ml). By contrast, metyrapone administration failed to induce significant changes in OC levels. There were no significant differences in beta-CTx concentrations between the three groups or after drug treatments. Thus, serum OC levels should be interpreted with caution when obtained during testing of the pituitary-adrenal axis with dexamethasone or ACTH.
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Affiliation(s)
- J Majnik
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
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Hubina E, Kovács L, Szabolcs I, Szücs N, Tóth M, Rácz K, Czirják S, Görömbey Z, Góth MI. The effect of gender and age on growth hormone replacement in growth hormone-deficient patients. Horm Metab Res 2004; 36:247-53. [PMID: 15114525 DOI: 10.1055/s-2004-814458] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We analyzed the effect of growth hormone replacement therapy (36 months) analyzed at a dose adjusted to maintain serum insulin-like growth factor-I level between the median and the upper end of the age-related reference range on bone mineral density, body composition, and carbohydrate metabolism with respect to gender and age in 20 adult patients (9 women, 11 men, mean age: 43 years, range: 21-61 years). The lumbar and femoral T-score was increased after 12 and after 18 months of therapy respectively in men (p < 0.001 and p = 0.002), but did not changed significantly in women. The increase of femoral T-score was greater in young men (< or = 45 years, n = 6) than old men (> 45 years, n = 5, p < 0.001). Body fat was lower in men than in women after 6 months (p = 0.002). The waist/hip ratio only decreased in women (p = 0.044). The waist circumference decreased in both genders after 6 months of therapy (p < 0.001), but more markedly in females than in males (p < 0.05). The sum of skinfold thicknesses was reduced in males after 6 months of therapy (p < 0.001). Changes in body composition parameters measured were independent of age. The glycosylated hemoglobin increased without sex or age difference after 12 months of initiation of therapy (p < 0.001), but fasting glucose and insulin levels did not change during the therapy. Our results indicate that the effect of growth hormone replacement on bone mineral content in adults is age- and gender-dependent, gender dependent on body composition, but independent of age and gender on carbohydrate metabolism.
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Affiliation(s)
- E Hubina
- Department of Medicine, National Medical Centre, Budapest, Hungary
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Békési G, Rácz K, Hrabák A, Kakucs R, Várbíró S, Magyar Z, Fehér J, Dinya E, Pázmány T, Paku S, Székács B. Systematic investigation of different steroid precursors with respect to their effect on superoxide anion production by human neutrophil granulocytes. Horm Metab Res 2004; 36:155-63. [PMID: 15057668 DOI: 10.1055/s-2004-814339] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Free radicals are involved in several pathological processes in living organisms, for example in athero- and oncogenesis. Some steroids are known to be effective antioxidants, while others do not play any such role. The aim of our study was to examine the antioxidant capability of different metabolites in the synthesis of steroid hormones. As a model, we chose human neutrophils producing superoxide anion, which is the source of many other radicals. Neutrophils were separated from healthy volunteers. Isolated cells were incubated with varying concentrations of steroid compounds and stimulated with N-formyl-Met-Leu-Phe. Superoxide anion production was determined by photometry. Neutrophils incubated with corticosterone and 18-hydroxy-deoxycorticosterone showed a significant reduction in superoxide production, whereas we found a significant enhancement in the presence of 11beta-hydroxyprogesterone. Furthermore, we observed a non-significant decreasing trend after incubation with cholesterol 3-sulphate and an increasing tendency using 11-hydroxyandrostenedione. We were also able to produce newer morphological and functional evidence of the role of myeloperoxidase enzyme in the steroidal antioxidant effect by electronic microscopy and use of sodium hypochlorite in our incubation model. Based on these results, we conclude that not only steroid end products but also their intermediate metabolites, most of which are also present in human plasma, partly influence free radical metabolism. Thus, this study provides further argument for the search for the molecular basis responsible for the antioxidant effect of steroid structures. This may lead to new opportunities for finding really efficient antioxidants, which might perhaps be used in a combined manner with other agents in the fight against certain life-threatening diseases.
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Affiliation(s)
- G Békési
- 2nd Department of Medicine, Semmelweis University, Budapest, Hungary
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31
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Hubina E, Lakatos P, Kovács L, Szabolcs I, Rácz K, Tóth M, Szucs N, Góth MI. Effects of 24 months of growth hormone (GH) treatment on serum carboxylated and undercarboxylated osteocalcin levels in GH-deficient adults. Calcif Tissue Int 2004; 74:55-9. [PMID: 14508626 DOI: 10.1007/s00223-002-2149-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2002] [Accepted: 04/14/2003] [Indexed: 11/25/2022]
Abstract
We studied the effect of growth hormone (GH) replacement on bone mineral density (BMD) and some parameters of bone metabolism, including undercarboxylated osteocalcin (ucOC), an independent predictive marker of fracture risk, which has not been previously determined or compared during GH treatment. Measurements were performed at baseline and after 6, 12, 18 and 24 months of the initiation of the GH therapy in 21 adult patients with GH deficiency. Significant increases were observed in BMD after 1 year at the lumbar spine and after 1.5 years at the femoral neck. Serum total OC and carboxylated (c) OC increased and reached the maximum at 6 months, but the values remained over the baseline at both 12 and 18 months. The ucOC:total OC ratio changed contrarily: it decreased at 6 months, then increased again and reached the baseline level during the next 18 months. Serum calcium (Ca), phosphate (P) and total alkaline phosphatase (ALP) levels increased after 6 months, thereafter the Ca and P values decreased, while the total ALP remained elevated until 12 months. Serum parathormone decreased at 12 months and increased again thereafter. GH replacement therapy is associated with improvement of ucOC, a marker of fracture risk, which in addition to the increase of BMD, might contribute to the beneficial effect of GH replacement therapy on bone metabolism.
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Affiliation(s)
- E Hubina
- Department of Medicine, National Medical Center, Budapest, Hungary
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32
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Szücs N, Varga I, Patócs A, Tóth M, Jakab C, Gláz E, Rácz K. Plasma 6beta-hydroxycortisol measurements for assessing altered hepatic drug metabolizing enzyme activity. Acta Physiol Hung 2003; 90:217-23. [PMID: 14594192 DOI: 10.1556/aphysiol.90.2003.3.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
To study the usefulness of 6beta-hydroxycortisol (6betaOHF) measurements for assessing hepatic drug metabolizing enzyme activity, plasma 6betaOHF and cortisol were measured in 22 patients with alcoholic liver disease after at least 2 weeks of alcohol abstinence, in 5 patients with severe Cushing's syndrome and in 12 healthy non-drinker subjects. Blood samples were drawn under resting conditions during midnight, in the morning at 0800 h, after a 1-mg overnight dexamethasone test and after ACTH administration. Plasma cortisol and 6betaOHF were determined with radioimmunoassay. In patients with alcoholic liver disease, the plasma cortisol levels at midnight and 0800 h, as well as after the administration of dexamethasone and ACTH were not different from corresponding values measured in non-drinker controls. In addition, these patients with alcoholic liver disease had similar plasma 6betaOHF levels at midnight, 0800 h and after dexamethasone administration as compared to corresponding values in controls. By contrast, ACTH administration in patients with alcoholic liver disease resulted in a significantly (p<0.05) larger increase of plasma 6betaOHF (from 106 +/- 22 to 1102 +/- 106 ng/dl, mean +/- SE) as compared to that found in controls (from 74 +/- 3 to 337 +/- 76 ng/dl). The markedly increased 6betaOHF response to ACTH administration in patients with alcoholic liver disease was similar to that measured in patients with severe Cushing's syndrome, in whom increased and non-suppressible plasma cortisol levels were accompanied by markedly elevated plasma 6betaOHF levels. These results indicate that alcohol abstinence in patients with alcoholic liver disease is associated with an exaggerated 6betaOHF response to ACTH and that this abnormality may prove to be a clinically useful parameter for a sensitive detection of altered drug metabolism present in these patients.
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Affiliation(s)
- Nikolette Szücs
- 2nd Department of Medicine, Gastroenterological and Endocrinological Research Group, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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33
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Horányi J, Duffek L, Szlávik R, Darvas K, Lakatos P, Tóth M, Rácz K. Parathyroid surgical failures with misleading falls of intraoperative parathyroid hormone levels. J Endocrinol Invest 2003; 26:1095-9. [PMID: 15008247 DOI: 10.1007/bf03345256] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
According to earlier reports, a decrease below 50% of baseline of intraoperative PTH levels measured 5 min after resection of the parathyroid adenoma predicts a cure of hyperparathyroidism. To reveal previously unrecognized pitfalls of intraoperative PTH measurements, we reviewed surgical failures in our series of parathyroidectomies combined with intraoperative PTH sampling. PTH measurements were performed in 251 patients with primary hyperparathyroidism (PHPT) between November 1999 and December 2002. PHPT due to parathyroid hyperplasia were found in 8 cases, double parathyroid adenomas in 6 cases, parathyroid carcinoma in 1 case and single parathyroid adenomas in 236 cases, all confirmed by histological examination. Of the 236 cases of single adenomas, initial surgery failed to cure PHPT in 4 patients. In 3 patients a false-positive decrease of intraoperative PTH (from 269 to 40 pg/ml, from 211 to 27 pg/ml, and from 140 to 59 pg/ml) was observed, whereas in the fourth patient a true-negative decrease of intraoperative PTH (from 758 to 401 pg/ml) was mistakenly interpreted as indication for a cure of PHPT. In each of the 4 patients in whom initial surgery failed the intervention included thyroid surgery and reoperative parathyroid surgery resulted in a permanent cure of PHPT. These observations support the possibility that thyroid surgery may compromise the blood supply of parathyroid adenomas resulting in a misleading drop of intraoperative PTH levels. Therefore, a careful evaluation of intraoperative PTH levels and, perhaps, other intraoperative aids such as histological evaluation of frozen sections are recommended when parathyroid surgery is combined with simultaneous thyroid intervention.
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Affiliation(s)
- J Horányi
- First Department of Surgery, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
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Varga I, Jakab C, Szücs N, Patócs A, Tóth M, Kiss R, Gláz E, Rácz K. Plasma and salivary 6beta-hydroxycortisol measurements for assessing adrenocortical activity in patients with adrenocortical adenomas. Horm Metab Res 2003; 35:421-6. [PMID: 12931273 DOI: 10.1055/s-2003-41623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this study was to examine and compare the potential usefulness of plasma and salivary 6beta-hydroxycortisol measurements for assessing adrenocortical activity in patients with adrenocortical adenomas. Plasma and salivary cortisol as well as 6beta-hydroxycortisol determinations were performed by radioimmunoassay after extraction with ethyl acetate followed by chromatographic separation using a modified paper chromatographic system. Samples were obtained from 36 control subjects and 37 patients with non-hyperfunctioning adrenocortical adenomas in the morning at 8 a.m. after a low-dose of dexamethasone and after stimulation with synthetic depot ACTH. Basal and post-dexamethasone hormone levels were also measured in plasma and salivary samples of 4 patients with Cushing's syndrome from adrenal adenomas. In the baseline state, patients with non-hyperfunctioning adrenocortical adenomas had significantly higher plasma and salivary 6beta-hydroxycortisol levels (mean+/-SE, 79.0+/-7 and 17.1+/-2.2 ng/dl, respectively) compared to those measured in controls (62.0+/-4 and 7.7+/-0.6 ng/dl, respectively), whereas baseline plasma and salivary cortisol levels (9.6+/-0.5 microg/dl and 342+/-39 ng/dl, respectively) were similar to those measured in the control group (9.9+/-0.4 microg/dl and 366+/-24 ng/dl, respectively). In all groups, the changes in plasma and salivary 6beta-hydroxycortisol concentrations after dexamethasone suppression and ACTH stimulation were similar to the changes in plasma and salivary cortisol levels, although the differing ratios of 6betaOHF to cortisol indicated potentially important variations in the induction of 6beta-hydroxylase activity between the three groups. In patients with Cushing's syndrome, baseline plasma and salivary 6beta-hydroxycortisol concentrations (754+/-444 and 104+/-88 ng/dl, respectively) were more markedly increased than plasma and salivary cortisol levels (24.8+/-6.7 microg/dl and 1100+/-184 ng/dl, respectively), and all remained non-suppressible after dexamethasone administration. These results suggests that plasma and salivary 6beta-hydroxycortisol determinations may precisely detect not only overt increases of cortisol secretion in patients with Cushing's syndrome but also mild glucocorticoid overproduction presumably present in patients with non-hyperfunctioning adrenocortical tumors.
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Affiliation(s)
- I Varga
- Gastroenterological and Endocrinological Research Group, 2nd Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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Patócs A, Valkusz Z, Igaz P, Balogh K, Tóth M, Varga I, Rácz K. Segregation of the V804L mutation and S836S polymorphism of exon 14 of the RET gene in an extended kindred with familial medullary thyroid cancer. Clin Genet 2003; 63:219-23. [PMID: 12694233 DOI: 10.1034/j.1399-0004.2003.00044.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In multiple endocrine neoplasia type 2A (MEN 2A) and familial medullary thyroid cancer (FMTC), the majority of germline mutations are restricted to specific positions in exons 10 and 11 of the RET gene. However, germline mutations may very occasionally occur in other exons, including exon 14 of the RET gene. Interestingly, an increased frequency of a rare germline sequence variant of the RET exon 14, S836S, has been detected in patients with sporadic medullary thyroid cancer (MTC), and this variant has been proposed to play a role in the genesis of MTC and, perhaps, FMTC. In this study we report the segregation of a germline V804L mutation and a germline sequence variant S836S in exon 14 of the RET gene in an extended Hungarian FMTC kindred comprising 80 individuals of four generations. Molecular analysis of the RET gene was performed by direct DNA sequencing in 23 family members, of whom 12 had the V804L mutation, three had the V804L mutation and S836S polymorphism in separate alleles, and six had the S836S polymorphism, all in heterozygous forms. Two of the family members had neither mutation nor polymorphism of the RET gene. Three of the family members who had the V804L mutation and one member who could not be tested for mutation were operated for non-metastatic MTC, while one member with MTC who had the V804L mutation refused surgery. In all patients affected with MTC, the disease developed relatively late in life and never caused death. None of the other family members carrying the V804L mutation and/or the S836S polymorphism had clinical or biochemical evidence of MTC. These observations suggest that the co-existence of the V804L mutation and S836S polymorphism in separate alleles does not seem to aggravate the relatively low-risk disease phenotype characteristic in most patients with codon 804 mutations of the RET exon 14.
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Affiliation(s)
- A Patócs
- 2nd Department of Medicine, Faculty of Medicine, Semmelweis University, Szentkirályi 46, H-1088 Budapest, Hungary
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36
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Czirják S, Bezzegh A, Gál A, Rácz K. Intra- and postoperative plasma ACTH concentrations in patients with Cushing's disease cured by transsphenoidal pituitary surgery. Acta Neurochir (Wien) 2002; 144:971-7; discussion 977. [PMID: 12382124 DOI: 10.1007/s00701-002-0984-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The optimal treatment of choice for ACTH-producing pituitary adenomas is their complete removal by the transsphenoidal surgical approach. ACTH-producing pituitary adrenomas are, however, often small in size not detectable with neuro-imaging techniques, which may result in difficulties during their surgical removal. With the advent of rapid methods for plasma ACTH measurement, a few neurosurgical centers introduced intra-operative plasma ACTH determinations in peripheral and central blood samples to help improve the outcome of pituitary surgery in patients with Cushing's disease. METHOD To evaluate the usefulness of this new method, we performed, under standardized conditions, intra-operative plasma ACTH measurements with a rapid immunochemiluminometric method at different stages of transsphenoidal pituitary surgery in 7 patients with Cushing's disease. FINDINGS We found that from the beginning of anesthesia until the end of operation, ACTH concentrations in venous plasma were highly variable by both the rapid and the standard methods. In most cases the changes in venous plasma ACTH concentrations that occurred until the end of surgery failed to indicate the removal of the ACTH-producing pituitary adenoma. However, a more than 50% decrease of venous plasma ACTH concentrations by the rapid assay was observed 2 h after completion of the operation in all but one of the patients. As evidenced by a long-term hormonal and clinical remission, these changes in plasma ACTH levels in all patients were accompanied by a complete removal of the ACTH-producing pituitary adenoma. INTERPRETATION These findings indicate a slow disappearance of ACTH from the circulation after a successful pituitary surgery in patients with Cushing's disease.
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Affiliation(s)
- S Czirják
- National Institute of Neurosurgery, Budapest, Hungary
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37
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Pap E, Rácz K, Kovács JK, Varga I, Buzás E, Madarász B, Földes C, Szalai C, Watanabe T, Ohtsu H, Ichikawa A, Nagy A, Falus A. Histidine decarboxylase deficiency in gene knockout mice elevates male sex steroid production. J Endocrinol 2002; 175:193-9. [PMID: 12379503 DOI: 10.1677/joe.0.1750193] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Histamine is synthesized in cells by histidine decarboxylase (HDC). HDC-deficient knockout (KO) mice lack functional HDC and histamine in the tissues. In the present study we used this in vivo model for studying the role of HDC deficiency in the regulation of male steroid hormone metabolism. In agreement with earlier studies showing the lack of effects of central histamine on the basal secretion of gonadotrope hormones, we found no difference with in situ hybridization in the expression of GnRH in the hypothalamus of wild type and KO mice. The tissue concentrations of testosterone and several androgenic steroids were significantly elevated in the testes but not in the adrenal glands of HDC-KO mice. In contrast, serum estradiol levels failed to show a significant difference between the two groups. The weight of the testes was significantly smaller in both 7-day-old and adult KO mice. The ultrastructure of the adult testis indicated elevated steroid synthesis with more tightly coiled membranous whorls in Leydig cells. The present results suggest that changes in reproductive functions and sex steroid secretion in male HDC-KO mice are not due to altered hypothalamic GnRH expression but are probably related to definite modifications during fetal development of KO mice reinforced later by the lack of the effect of peripheral histamine. This may provide in vivo evidence that peripheral histamine is an important regulatory factor of male gonadal development during embryogenesis and of sex steroid metabolism later in adulthood.
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Affiliation(s)
- E Pap
- Department of Genetics, Cell- and Immunobiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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38
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Czirják S, Bezzegh A, Gál A, Rácz K. Intra- and Postoperative Plasma ACTH Concentrations in Patients with Cushing's Disease Cured by Transsphenoidal Pituitary Surgery. Acta Neurochir (Wien) 2002. [DOI: 10.1007/s701-002-8284-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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39
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Igaz P, Patócs A, Rácz K. Novel sequence variants of the genes associated with the multiple endocrine neoplasia syndromes 1 and 2. analysis by an "in silico approach.". J Endocrinol Invest 2002; 25:609-13. [PMID: 12150335 DOI: 10.1007/bf03345084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
MEN syndromes (1 and 2) are hereditary tumor syndromes inherited as autosomal dominant traits. The genes that harbor the mutations responsible for the development of these syndromes have been cloned in recent years. In the present study we applied an "in silico" approach to find previously undescribed sequence variants of the RET protooncogene and the MEN1 gene. Sequence comparisons were performed at the National Center for Biotechnology Information Database by the search tool blastn. We found several sequence alterations in both coding and non-coding sequences. The majority of polymorphisms described to date were found by our approach, in addition we observed novel sequence variants of both genes as well. These sequence variants may have both diagnostic and theoretical relevance. In silico strategies may represent new, and potentially effective ways for finding novel sequence variants.
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Affiliation(s)
- P Igaz
- 2nd Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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40
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Cserepes E, Szücs N, Patkós P, Csapó Z, Molnár F, Tóth M, Dabasi G, Esik O, Rácz K. Ovarian steroid cell tumor and a contralateral ovarian thecoma in a postmenopausal woman with severe hyperandrogenism. Gynecol Endocrinol 2002; 16:213-6. [PMID: 12192893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
A 49-year-old woman presented with rapidly progressing hirsutism, receding hairline, male-pattern baldness and deepening of voice, which had developed over the past 2 years. Hormonal evaluation showed a markedly elevated serum testosterone level (418 ng/dl) and no evidence of increased production of cortisol, dehydroepiandrosterone, dehydroepiadrosterone-sulfate, androstenedione, or 17-hydroxyprogesterone. Transvaginal ultrasound examination suggested the presence of a small mass within the left ovary, but all other radiological studies, including adrenal and ovarian computed tomography, magnetic resonance imaging, radio-labelled cholesterol scintigraphy and positron emission tomography, were negative. Subsequently, bilateral selective venous sampling showed a marked testosterone gradient in the right ovarian vein. Bilateral salpingo-oophorectomy was performed (the patient had had a previous vaginal hysterectomy), and histopathological examination revealed a 10-mm steroid cell tumor within the right ovary and a 15-mm thecal cell tumor within the left ovary. The postoperative serum testosterone level returned to normal and the patient showed a slow regression of clinical symptoms. The simultaneous occurrence of a virilizing ovarian steroid cell tumor and an apparently non-functioning thecoma within the contralateral ovary emphasizes the potential pitfalls that may exist in the preoperative evaluation of patients with markedly increased testosterone production.
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Affiliation(s)
- E Cserepes
- Department of Radiology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
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41
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Szabó P, Tóth M, Horányi J, Rácz K, Gláz E, Tulassay Z. [Dual-energy x-ray absorptiometry and quantitative ultrasound bone density examinations in primary hyperparathyroidism]. Orv Hetil 2001; 142:2251-4. [PMID: 11760468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The aim of this study was the analysis and comparison of bone density data obtained by dual-energy X-ray absorptiometry (DEXA) and quantitative ultrasound (QUS) and the follow up of bone density after parathyroidectomy of our patients with primary hyperparathyroidism. The authors performed bone mineral density (BMD) measurements using DEXA (Hologic QDR 4500 C) and QUS (Lunar Achilles Plus) devices in 22 patients with primary hyperparathyroidism between 1997 and 1999 (19 sporadic, 1 MEN 1., 2 MEN II.). Fifteen patients underwent parathyroidectomy (13 adenoma, 2 carcinoma). According to DEXA measurements all patients had osteoporosis. The lowest bone mineral density was detected at the wrist: the mean t-score was -4.00 +/- 1.79. After parathyroidectomy nine patients were followed for a mean of 12.8 months. After one year following surgery the most significant increase in BMD was 14.6%. The QUS values did not correlate with the DEXA data before the operation and no significant changes in stiffness were detected after surgery. The QUS values do not reflect the severity of the BMD decrease by DEXA in patients with primary hyperparathyroidism.
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Affiliation(s)
- P Szabó
- Altalános Orvostudományi Kar II. Belgyógyászati Klinika, Semmelweis Egyetem, Budapest
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42
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Miheller P, Tóth M, Molnár E, Zágoni T, Rácz K, Tulassay Z. [Serum bone marker measurements in bone metabolism disorders associated with inflammatory bowel diseases]. Orv Hetil 2001; 142:1557-60. [PMID: 11494747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Patients with inflammatory bowel disease (IBD) have decreased bone mineral density (BMD), which is usually much more remarkable in patients with Crohn's disease (CD) than those with ulcerative colitis (UC). The aim of the present study was to investigate the usefulness of serum beta-Crosslaps (bCL) and osteocalcin (OC) determinations to assess bone metabolism in patients with IBD. Forty-nine patients with IBD (23 UC, 26 CD) and 46 healthy controls were studied. Serum bCL and OC were measured by Elecsys immunoassay. Compared to controls (0.275 +/- 0.14 ng/ml) the mean bCL concentration was significantly higher in the CD (mean = 0.489 +/- 0.25 ng/ml; p < 0.001) and UC groups (mean = 0.439 +/- 0.3 ng/ml; p < 0.01). The mean OC concentration was significantly higher in the CD group (28.52 +/- 14.75 ng/ml) than in controls (21.42 +/- 7.43 ng/ml) but OC level was not significantly increased in the UC group (24.89 +/- 15.08 ng/ml). There was no significant difference in bCL or OC concentrations between the CD and UC groups. These results indicate that the accelerated bone resorption is not associated with increased bone formation in patients with IBD. These two marker of the bone metabolism could be a good laboratory parameter of bone pathology in patients with IBD, especially in CD.
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Affiliation(s)
- P Miheller
- Altalános Orvostudományi Kar, II. Belgyógyászati Klinika, Semmelweis Egyetem, Budapest
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Abstract
Cytokines, the polypeptide mediators of the immune system, were shown to exert numerous actions on endocrine functions. Bidirectional links based on the sharing of mediators and receptors between the immune and neuroendocrine systems lead to the concept of the immune-neuroendocrine system that seems to constitute an important and sophisticated regulatory system in the homeostasis. Several cytokines were found to be involved in the pathogenesis of diseases of the endocrine system. In this brief review, we attempt to present a general outline of the local actions of cytokines on cells of endocrine organs with an emphasis on disease etiology (pituitary tumours and autoimmune endocrine diseases in particular).
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Affiliation(s)
- P Igaz
- 2nd Department of Medicine, Semmelweis University, Medical School, Szentkirályi u. 46, Budapest, H-1088, Hungary
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44
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Abstract
Regulation of adrenal corticosteroid secretion by leptin may involve interactions at multiple levels of the hypothalamic-pituitary-adrenal axis. To investigate the possible direct effects of leptin on corticosteroid secretion of human adrenocortical adenomas, cells from adrenocortical adenomas causing primary aldosteronism (n = 1) and Cushing's syndrome (n = 1), as well as cells from nonhyperfunctioning adrenocortical adenomas (n = 5) were isolated and incubated for 2 h with human recombinant leptin (1-1000 ng/ml) in the presence and absence of adrenocorticotrop hormone (ACTH), then cortisol, corticosterone and aldosterone concentrations in incubating media were determined using radioimmunoassays. It was found that leptin effectively and dose-dependently inhibited basal and ACTH-stimulated cortisol and corticosterone secretion in the three types of human adrenocortical adenoma cells. The inhibiting effect of basal corticosterone secretion was detectable in the presence of leptin concentration as low as 1 ng/ml, with decreases of corticosterone secretion to 34+/-4%, 57+/-11% and 79+/-9% in Cushing's syndrome, primary aldosteronism, and nonhyperfunctioning adrenocortical adenoma cells, respectively. The inhibition of basal cortisol secretion in the presence of low concentration of leptin was less prominent, but 10 ng/ml leptin significantly diminished basal cortisol secretion to 81+/-9% in adrenocortical adenoma cells from Cushing's syndrome, to 68+/-6% in adenoma cells from primary aldosteronism, and to 83+/-8% in cells from nonhyperfunctioning adenomas. The inhibition of ACTH-stimulated cortisol and corticosterone secretion by leptin was similar to those found in cells without ACTH stimulation. By contrast, leptin even at 1000 ng/ml concentration exerted no clear effect on basal and ACTH-stimulated aldosterone secretion in cells from primary aldosteronism and in those nonhyperfunctioning adenoma cells in which aldosterone secretion was detectable. These results indicate that leptin is a potent inhibitor of cortisol and corticosterone secretion in human adenomatous adrenocortical cells. The inhibition of these corticosteroids by leptin may represent a potentially important interaction that exists between leptin and the hypothalamic-pituitary-adrenal axis.
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Affiliation(s)
- N Szücs
- 2nd Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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45
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Békési G, Kakucs R, Várbíró S, Rácz K, Sprintz D, Fehér J, Székács B. In vitro effects of different steroid hormones on superoxide anion production of human neutrophil granulocytes. Steroids 2000; 65:889-94. [PMID: 11077087 DOI: 10.1016/s0039-128x(00)00183-5] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Neutrophil granulocytes play an important role in atherogenesis also through their free radical generation. According to recent studies, a point of action by which estrogens can provide protection against atherosclerosis is their inhibiting effect on superoxide anion production. The aim of our study was to test whether this means a common effect of steroids on superoxide production, or whether various steroid hormones have different action on superoxide generation of human granulocytes. Neutrophils were separated from the blood samples of twelve healthy volunteers. Isolated cells were incubated with different concentrations (10(-9), 10(-8), 10(-7) M) of hydrocortisone, aldosterone, cortexolone, 17-beta-estradiol, progesterone, and testosterone. Superoxide anion production was determined by photometry using the reduction of ferricytochrome-C. Compared to that of control cells neutrophils incubated with 17-beta-estradiol, progesterone, testosterone and hydrocortisone showed significantly reduced superoxide production. No significant alteration of superoxide anion production was found after the incubation of cells with aldosterone and cortexolone. It is concluded that similarly to estradiol other sex steroids and cortisol can inhibit the free radical production of human granulocytes, but mineralocorticoid aldosterone and Reichstein's substance S do not show such activity. Our results provide new evidence supporting the theory that certain types of steroid hormones have antioxidant capacity. This may give further reasons for investigating the molecular background of the existence or absence of this property and thus might lead to the development of new free radical scavengers.
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Affiliation(s)
- G Békési
- Second Department of Medicine, Semmelweis University, Szentkirályi utca 46, H-1088, Budapest, Hungary.
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Góth M, Laczi F, Rácz K. [Growth hormone replacement therapy in adulthood]. Orv Hetil 2000; 141:2381-2. [PMID: 11105554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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47
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Hubina E, Kovács L, Szabolcs I, Rimanóczy E, Ferencz A, Czirják S, Tóth M, Szücs N, Rácz K, Góth M. [Effects of growth hormone replacement therapy in adults with severe growth hormone deficiency]. Orv Hetil 2000; 141:2375-9. [PMID: 11105553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
UNLABELLED The aim of the study was to analyse the effects of GH replacement therapy (1 year duration) on body composition, carbohydrate metabolism, thyroid hormone metabolism and bone mineral density in 8 adults with growth hormone deficiency (5 women, 3 men; mean age 40 years). Mean maintenance dose of GH was 1.5 IU/day-1.76 IU/day for women and 1.07 IU/day for men, respectively--determined according to individual patient requirements. Serum insulin-like growth factor-I standard deviation score increased from -5.4 to 0.0 (p < 0.001). There was a significant negative relationship between serum insulin-like growth factor-I standard deviation score at the start of therapy and the increase in this score (r = -0.85; p < 0.05). The waist:hip ratio decreased after 12 months by 0.039 (p < 0.05). The glycosylated hemoglobin increased (4.43 +/- 0.56% vs. 5.86 +/- 0.27; p < 0.05), and a negative correlation of the baseline glycosylated hemoglobin to the glycosylated hemoglobin increase was found (r = -0.88; p < 0.01). Both the free triiodothyronine and free triiodothyronine:free thyroxine ratio increased (3.09 +/- 0.22 vs. 4.17 +/- 0.40; p < 0.05, and 0.234 +/- 0.02 vs. 0.324 +/- 0.04; p < 0.01), and a positive relationship was observed between this ratio at the start of therapy and the increase in the ratio (r = 0.76, p < 0.05). The bone mineral density of lumbar spine and femoral neck expressed as z-score increased (-1.18 +/- 0.56 vs. -0.75 +/- 0.48; p < 0.01 and -0.06 +/- 0.60 vs. 0.43 +/- 0.43; p < 0.05), while the bone mineral density of forearm was unchanged. CONCLUSIONS Growth hormone replacement leads to a decrease in visceral fat, modulates the thyroid hormone levels by increasing peripheral conversion of thyroxine to triiodothyronine and probably is a physiological regulator of peripheral thyroxine metabolism, slightly deteriorates the carbohydrate metabolism, and results in an increase of bone mineral density of lumbar spine and femoral neck.
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48
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Tóth M, Rácz K, Adleff V, Varga I, Fütö L, Jakab C, Karlinger K, Kiss R, Gláz E. Comparative analysis of plasma 17-hydroxyprogesterone and cortisol responses to ACTH in patients with various adrenal tumors before and after unilateral adrenalectomy. J Endocrinol Invest 2000; 23:287-94. [PMID: 10882146 DOI: 10.1007/bf03343725] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Patients with non-hyperfunctioning adrenal adenomas often have an increased plasma 17-hydroxyprogesterone response to ACTH stimulation. The effects of adrenal surgery on this abnormality have rarely been investigated. One hundred and sixty-one patients with unilateral adrenal tumors (non-hyperfunctioning adenomas, 78; cortisol-producing adenomas, 8; aldosterone-producing adenomas, 37; adrenal cysts, 12; pheochromocytomas, 26) were studied. Patients before and after adrenal surgery as well as 60 healthy subjects underwent an ACTH stimulation test using 2 mg synthetic ACTH(1-24) (Cortrosyn Depot, Organon). Basal and ACTH-stimulated plasma 17-hydroxyprogesterone and cortisol concentrations are reported. Before adrenal surgery, the basal plasma 17-hydroxyprogesterone concentrations were normal in patients with all types of tumors. However, the ACTH-stimulated plasma 17-hydroxyprogesterone levels were abnormally increased in 53% and 31% of patients with non-hyperfunctioning adenomas and aldosterone-producing adenomas, respectively. In addition, a few patients with adrenal cysts and pheochromocytomas also showed an increased ACTH-stimulated 17-hydroxyprogesterone response. After unilateral adrenalectomy, this hormonal abnormality disappeared in most, although not all patients with adrenal tumors. In patients with non-hyperfunctioning adrenal tumors, ACTH-stimulated plasma 17-hydroxyprogesterone and cortisol concentrations significantly correlated with the size of the tumors. These results firmly indicate that the tumoral mass itself may be responsible for the increased plasma 17-hydroxyprogesterone and cortisol responses after ACTH stimulation in patients with non-hyperfunctioning and hyperfunctioning adrenal adenomas.
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Affiliation(s)
- M Tóth
- 2nd Department of Medicine, Semmelweis University Medical School, Budapest, Hungary
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49
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Igaz P, Tóth M, Mezödy M, Gláz E, Pénzes I, Rácz K, Tulassay Z. [Effective demeclocycline therapy in a patient with over-secretion of antidiuretic hormone following head trauma]. Orv Hetil 1999; 140:2873-5. [PMID: 10647278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a common cause of hyponatremia. In this study a case of SIADH caused by head trauma is reported, in which severe hyponatraemia, escorted by life-threatening neurological symptoms was observed that could only be managed by parenteral sodium chloride infusions. Severe hyponatraemia was accompanied by elevated urinary sodium excretion, a characteristic sign of SIADH. After introducing the therapy with demeclocycline, a tetracycline type antibiotic that inhibits the renal action of antidiuretic hormone, serum sodium levels began to rise gradually, and the urinary sodium excretion slowly decreased. These observations show the effectiveness of demeclocycline in the treatment of SIADH.
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Affiliation(s)
- P Igaz
- Semmelweis Orvostudományi Egyetem, Budapest
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50
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Esik O, Bødrogi I, Dóczi T, Fekete S, Galuska L, Kálvin B, Kásler M, Kubinyi K, Lengyel Z, Losonczy H, Nyáry I, Rácz K, Rosta A, Szakáll S, Szentirmay Z, Sziklai I, Vitéz A, Trón L. [Positron emission tomography ia an effective tool in modern oncology]. Orv Hetil 1999; 140:2555-62. [PMID: 10628196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
A total of 399 positron emission tomography (PET) examinations were carried out with a GE 4096 Plus PET scanner during the past 5 years on patients referred to the National Institute of Oncology in Budapest. The majority (n = 316) of these investigations were performed with the use of [18F]-fluorodezoxyglucose (FDG) to map the glucose metabolism; [11C]-methionine PET was indicated in 79 cases to detect protein transport and metabolism. The perfusion tracer [15O]-butanol was applied in only 4 cases to answer certain oncology-related, differential diagnostic questions. The oncological examinations were related to primary diagnostics, staging/restaging and therapy monitoring. In the staging/restaging and therapy monitoring of known tumours, conclusive results were achieved in 81-82% of the cases by using either FDG or [11C]-methionine as tracer. The concordant numerical data indicated that the PET investigation provides a definite answer to the question of the presence or absence of viable tumour tissue, with similar effectivity in any of the above indications, no matter whether FDG or [11C]-methionine is used. The search for occult primary tumours was the most frequent indication within the primary diagnostics: 10 (37%) primaries were localized by using FDG PET in the 27 investigated cases. This is a remarkably high value, especially in view of the failure of all the conventional diagnostic procedures carried out prior to the PET investigations. Application of PET may be indicated in all cases when the ultimate question is a non-invasive estimation of viable tumorous tissue.
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Affiliation(s)
- O Esik
- Országos Onkológiai Intézet, Budapest.
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