Acta medica Hungarica最新文献

Extended lymph node dissection is an important part of the surgical treatment for cancer of the esophagus, stomach, colon and rectum. With an appropriate lymphadenectomy a more precise tumour-staging, an increase in resectability, a rise of the rate of R0-resections, further a decrease in local tumour recurrences and an improvement of prognosis can be achieved.

Those research trends which are currently in the focus of interest of various research groups are summarized. The main tendency is to look for new molecular targets and to synthesize new antitumour drugs. Moreover, new research concepts emerge out of which differentiation induction, inhibition of MDR and study of apoptosis seem to be promising. Among clinical approaches megachemotherapy, neoadjuvant treatment and progress in supportive therapy are the main research directions. Last but not least, quality of life issues of the cancer patient are of particular importance.

Treatment modalities of head and neck tumours such as cancers of the skin, lips, oral cavity, sinuses, epi-, meso- and hypopharynx, larynx and cervical soft tissues are discussed. Cervical cysts, thyroid tumours and salivary gland alterations are also examined from the therapeutic point of view. Therapeutic advices are given for the treatment of regional metastases.

The advantages of and the information given by CT examinations in the proper and valid treatment planning of radiotherapy of malignant tumours are discussed. Without individual and thoughtful application of CT before and during radiotherapy the chances of cure are significantly reduced. Radiotherapists must be familiar with this imaging method.

The study was aimed to investigate the electrophysiological properties of long QT syndrome associated with permanent bradycardia. The investigations were performed in 26 patients suffering from long QT duration (QTC-frequency adapted QT-:484 +/- 34 ms) with permanent, marked bradycardia (heart rate: 42 +/- 7 min-1). Adams Stokes syncopal attack appeared in 12 patients, while in 14 cases ventricular tachycardia attack with syncope could be observed (study group). As control served the data of 30 patients suffering from long lasting marked bradycardia (heart rate: 44 +/- 7 min-1) with normal QT (QTC:420 +/- 28 ms). Each patient was candidate for pacemaker implantation. The following questions were studied: 1. The effect of heart rate on QT duration. The experiments were performed by electrical ventricular stimulation. 2. The effect of sympathetic and parasympathetic-pharmacologic-blockade on QT time. The study was performed under electrical ventricular stimulation by administration of propranolol and atropine. 3. The dispersion of QT time was studied by using electrical heart stimulation and 12 lead ECG recording. Electrophysiological investigations were performed in 14 patients with long QT and permanent bradycardia. On augmentation of the cycle length (bradycardia) the increase in the QT duration was more-out of all proportion-expressed in long QT. On pharmacologic sympathetic blockade in long QT syndrome the QT duration significantly diminished. The QT dispersion was more expressed in patients with prolonged QT interval and on bradycardia the QT dispersion further increased significantly. The irritability of the ventricle was markedly augmented in patients with long QT and bradycardia. Appearance of polymorphous ventricular tachycardia could frequently be observed and could be regularly induced by early ventricular extrastimuli and bradycardia.(ABSTRACT TRUNCATED AT 250 WORDS)

Cytokines are pleiotropic peptides produced by lymphoid cells that play important roles in cellular proliferation and multiplication. Diminished or enhanced production or constitutive secretion of cytokines contributes to the aetiology and pathogenesis of several diseases. They are soluble mediators eliciting specific responses of different target cells of paracrine, autocrine and cascade systems of the organism. Their secretion is regulated at the molecular genetic level. Gene rearrangements of cytokines and their receptors have been demonstrated in several diseases. As means of specific or supportive therapy, cytokine treatment has been used both in neoplastic and other proliferative diseases. Lymphokines and interferons comprise the first, whereas colony stimulating factors and growth factors yield the second group of cytokines. Most scientific experience is with interferon-alpha. Its anti-viral mechanism of action has been extensively studied and clarified, whereas its antitumour effect is more obscure and is a result of many simultaneous biologic events.

The magnitude of brachytherapy doses depends on the applied dose rates: high-dose-rate or low-dose-rate techniques. Brachytherapy is usually performed as a complementary modality with megavoltage external beam therapy, but it is also used preoperatively for cancers of the uterine cervix and corpus. The most common localization is reviewed in this paper with special regard to the indications, treatment methods and prognosis of curing for rectal and breast cancer.

The aim of this work was to study in rats the temporal course of laboratory parameters and morphologic features in acute pancreatitis induced by cholecystokinin octapeptide (CCK-8) or by a closed duodenal loop. Pancreatitis was induced either with an overdose of CCK-8 (3 x 75 micrograms/kg at 1 h intervals) or by ligation of the duodenum on both sides of the bilio-pancreatic duct. The animals were examined at 0, 2, 4, 8, 16 and 24 h after AP induction. In CCK-8-induced acute pancreatitis, the pancreatic weight/body weight ratio (8.2 +/- 1.1 mg/g) and the amylase level (44.8 +/- 7.5 x 10(3) U/ml) were significantly increased vs. the controls (4.5 +/- 0.8 mg/g and 3.3 +/- 0.2 x 10(3) U/ml, respectively) 2 h after the intervention. The plasma CCK was significantly increased at 4 h (4.55 +/- 1.7 pM) and remained elevated thereafter. The tissue malonyldialdehyde concentration was significantly elevated at 8 h (0.28 +/- 0.07 mumol/mg pancreas) vs. the controls (0.20 +/- 0.02 mumol/mg pancreas). In closed duodenal loop-induced acute pancreatitis, the ratio pancreatic weight/body weight steadily increased during the study; it reached its maximum level at 24 h (7.1 +/- 0.5 mg/g) vs. the sham-operated control (4.8 +/- 0.9 mg/g). The serum amylase level was significantly elevated at 2 h (47.1 +/- 9.3 x 10(3) U/ml), and then decreased steadily. Plasma CCK values were significantly higher than the controls throughout the study. A significant increase in the tissue malonyldialdehyde concentration (0.94 +/- 0.15 mumol/mg vs. 0.20 +/- 0.01 mumol/mg pancreas) appeared at 4 h. Our data indicate that in CCK-8-induced acute pancreatitis the laboratory signs of pancreatitis are most expressed at 4 h, whereas the morphologic changes culminate 8 h, following the last CCK injection. In closed duodenal loop-induced acute pancreatitis, the histologic findings showed a progressive deterioration. Endogenous CCK and oxygen-derived free radicals seem to play a role in the pathogenesis of both types of acute pancreatitis.

The anterior pituitary hormone serum levels of 13 patients of both sexes were examined for basal secretion and response to TRH-GnRH stimulus before and after parathyroidectomy. The patients were suffering from hyperparathyroidism of parathyroid adenoma origin. After the operation, the previously high serum calcium and low serum phosphate levels decreased (P < 0.001). The serum parathyroid hormone (PTH) concentration, too, decreased significantly. After surgery, the basal and stimulated secretion of thyrotropin (TSH) showed a significant increase (P < 0.02 and P < 0.05, respectively). Significantly higher prolactin (PRL) levels were measured after surgery in those patients whose PRL levels were normal both before and after the operation. No significant change was observed in patients with hyperprolactinaemia. After surgery an increased spontaneous growth hormone (GH) secretion was found, while the basal luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretions remained unchanged. In postmenopausal women the stimulated FSH secretion decreased (P < 0.05), while the decrease of the stimulated LH secretion was not significant. The results suggest that extracellular calcium may modify the secretion of certain adenohypophysis hormones and their stimulus-induced response.

Ten patients with idiopathic Parkinson's disease (PD) (3 men and 7 women, group A) who had received no treatment for the disease; 102 patients with PD (36 men and 66 women, group B) who had undergone treatment and 45 healthy volunteers (15 men and 30 women, control group) were subject to thyrotropin-releasing hormone (TRH) tests and levodopa tests. In group A basal plasma prolactin (PRL) levels were significantly higher than in the controls both before and during treatment. Peak plasma PRL levels during TRH tests were significantly higher before treatment, but returned to the control levels during treatment. Nadir plasma PRL levels during levodopa tests were significantly increased before and during treatment. In group B basal plasma thyroid-stimulating hormone (TSH) and PRL levels were significantly higher than in the control group. Peak plasma PRL levels during TRH tests and nadir plasma PRL levels during levodopa tests were also significantly increased. The results strongly suggest a disturbance of pituitary hormone secretion due to hypothalamic dysfunction in PD patients.