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Genomics and informatics The story of a „love marriage” 基因组学与信息学“爱情婚姻”的故事
Pub Date : 2019-12-01 DOI: 10.2478/orvtudert-2019-0013
Falus András
Abstract The rapid development of molecular biology over the past seventy years led to the molecular understanding of the structure and function of hereditary material in the living world. Through the processing of the gigantic amount of data obtained as a result of technological advances and the exploration of different mechanisms of action, information technology has become an indispensable part of genomic research. This article addresses the background of the genomic and bioinformatics revolution, its application areas, and the perspective of personalized medicine.
摘要七十多年来,分子生物学的飞速发展使人们对生物世界中遗传物质的结构和功能有了更深入的了解。通过对技术进步所获得的海量数据的处理和对不同作用机制的探索,信息技术已经成为基因组研究不可或缺的一部分。本文阐述了基因组学和生物信息学革命的背景、应用领域以及个性化医疗的前景。
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引用次数: 0
Current aspects of polycystic ovary syndrome II: treatment of hyperandrogenism, insulin resistance and infertility 多囊卵巢综合征的现状2:治疗高雄激素,胰岛素抵抗和不孕症
Pub Date : 2019-12-01 DOI: 10.2478/orvtudert-2019-0016
K. Zoltán, Kun Ildikó, Kolcsár Melinda
Abstract This work is a continuation of an earlier article published in this journal (no. 91/1: “Current aspects of polycystic ovary syndrome I: definition, pathophysiology, clinical manifestations, diagnosis and complications”). As the pathology of polycystic ovary syndrome is not fully known, the treatments used do not constitute a causal therapy, only pathogenetical interventions to break the vicious circles of pathological events. It does not currently have a universal therapeutic procedure or an approved specific drug. Treatment may be aimed at reducing hyperandrogenism, inducing ovulation and preventing complications. The patient’s complaints and desire for becoming pregnant should also be taken into account. In mild cases, an appropriate lifestyle (prevention/treatment of obesity) is sufficient, i.e. a 5-10% reduction in body weight can already result in significant improvement and also serves to prevent late complications (diabetes, hypertension, cardiovascular disease, hyperlipidemia). Oral contraceptives and antiandrogens are mainly used to treat hyperandrogenism (hirsutism, acne, and alopecia). A contraceptive whose progestogen component has antiandrogenic properties, or at least is androgen-neutral, is preferred, such as third-generation contraceptives. However, combined contraceptives (containing gestodene, desogestrel, drospirenone and cyproterone acetate) may increase the risk of venous thromboembolism and are therefore contraindicated in case of hypercoagulability. Antiandrogens (cyproterone acetate, spironolactone, finasteride, etc.) can also be used independently, but only with effective contraception (as these can cause feminization of the male fetus). Insulin resistance plays a crucial role in the development of this disease. Metformin is used as primary therapy, as it also has many other beneficial effects (e.g. cardiovascular and anti-cancer) described in recent years. These pleiotropic effects and their subtle mechanisms are discussed in detail. We highlight the possibilities of avoiding side effects and the current interpretation of rare contraindications (acidosis, hypoxic conditions, renal damage). Insulin resistance lowering agents include thiazolidinediones, acarbose, GLP-1 agonists, vitamin D, resveratrol, octreotide, but the beneficial effects of myoinositol and D-chiro-inositol are also mentioned. In the last part of the paper, the treatment options for infertility are discussed, highlighting the efficacy of clomiphene citrate, gonadotropins (“step-up”, “step- down” methods), IVF techniques, and ovarian drilling used for ovulation induction. We detail the importance and possibilities of the prevention of ovarian hyperstimulation syndrome and multiple pregnancies.
这项工作是在该杂志上发表的一篇早期文章的延续。91/1:“多囊卵巢综合征的现状1:定义、病理生理学、临床表现、诊断和并发症”)。由于多囊卵巢综合征的病理尚不完全清楚,所采用的治疗方法不构成因果治疗,只能通过致病干预来打破病理事件的恶性循环。目前还没有一个通用的治疗程序或批准的特定药物。治疗的目的可能是减少高雄激素,诱导排卵和预防并发症。患者的抱怨和怀孕的愿望也应考虑在内。在轻微的情况下,适当的生活方式(预防/治疗肥胖)就足够了,即体重减少5-10%已经可以显著改善,也有助于预防晚期并发症(糖尿病、高血压、心血管疾病、高脂血症)。口服避孕药和抗雄激素主要用于治疗雄激素过多症(多毛症、痤疮和脱发)。首选孕激素成分具有抗雄激素特性或至少雄激素中性的避孕药,如第三代避孕药。然而,联合避孕药(含孕酮、地格孕酮、屈螺酮和醋酸环丙孕酮)可能增加静脉血栓栓塞的风险,因此在高凝性的情况下是禁忌的。抗雄激素(醋酸环丙孕酮、螺内酯、非那雄胺等)也可以单独使用,但只能在有效避孕的情况下使用(因为这些药物会导致男性胎儿女性化)。胰岛素抵抗在这种疾病的发展中起着至关重要的作用。二甲双胍被用作主要治疗方法,因为近年来它还具有许多其他有益作用(例如心血管和抗癌)。详细讨论了这些多效效应及其微妙机制。我们强调避免副作用的可能性和目前对罕见禁忌症(酸中毒,缺氧条件,肾损害)的解释。降低胰岛素抵抗的药物包括噻唑烷二酮类、阿卡波糖、GLP-1激动剂、维生素D、白藜芦醇、奥曲肽,但也提到了肌醇和D-氨基肌醇的有益作用。在论文的最后一部分,讨论了不孕不育的治疗选择,重点介绍了克罗米芬、促性腺激素(“上升”、“下降”方法)、体外受精技术和用于诱导排卵的卵巢钻孔的疗效。我们详细介绍了预防卵巢过度刺激综合征和多胎妊娠的重要性和可能性。
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引用次数: 0
Famous Hungarian Chemists and Pharmacists from Transylvania: 150 years since the birth of Pál Scheitz, collaborator of Professor Lajos Ilosvay 来自特兰西瓦尼亚的著名匈牙利化学家和药剂师:Pál Scheitz诞辰150周年,他是Lajos Ilosvay教授的合作者
Pub Date : 2019-12-01 DOI: 10.2478/orvtudert-2019-0014
G. Árpád, K. Mihály, Gyéresi Mária
Abstract Several Transylvanian chemists and pharmacists have played an important role in the development and advancement of modern Hungarian chemical sciences. Regarding these prominent personalities we paid tribute in our series to the career and role of Lajos Ilosvay, Lajos Winkler and Tibor Széki in Budapest, Hungary. Pál Scheitz who was born 150 years ago in Marosvásárhely/Târgu-Mures worked at the Chemistry Institute of Professor Lajos Ilosvay. After graduating from the University of Munich and earning a PhD degree, he worked at the University of Kolozsvár/Cluj for a short period of time after which he pursued a full-time academic career at the Budapest University of Technology for the rest of his life. During his relatively short life (1870-1912) he managed to produce some outstanding works in the field of analytical chemistry. His most significant work is a contemporary book on methods of qualitative chemical analysis, which was printed in two editions. His studies and investigations of litmus dyes are also significant, which are still considered to be the most comprehensive studies of the Hungarian scientific literature.
几个特兰西瓦尼亚化学家和药剂师在现代匈牙利化学科学的发展和进步中发挥了重要作用。关于这些杰出人物,我们在我们的系列节目中向匈牙利布达佩斯的Lajos Ilosvay, Lajos Winkler和Tibor szacimki的职业生涯和作用表示敬意。Pál Scheitz 150年前出生在Marosvásárhely/ t rgu- mures,曾在Lajos Ilosvay教授的化学研究所工作。从慕尼黑大学毕业并获得博士学位后,他在Kolozsvár/Cluj大学工作了很短的一段时间,之后他在布达佩斯工业大学从事全职学术生涯,度过了他的余生。在他相对短暂的一生中(1870-1912),他设法在分析化学领域做出了一些杰出的作品。他最重要的工作是一本关于定性化学分析方法的当代著作,该书分两版印刷。他对石蕊染料的研究和调查也很重要,这仍然被认为是匈牙利科学文献中最全面的研究。
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引用次数: 0
The morphological response of the heart and spleen following acute myocardial infarction-induced sterile inflammation: a clinicopathological study 急性心肌梗死引起无菌性炎症后心脏和脾脏的形态学反应:临床病理研究
Pub Date : 2019-12-01 DOI: 10.2478/orvtudert-2019-0015
Harsa Mihai Iuliu, B. Nándor, Horváth Emőke
Abstract Introduction as an outcome of sterile inflammation-inducing acute ischemic processes, many splenic cells enter the circulatory system and migrate into the lesion, defending tissues against the spread of ischemia or enhancing necrosis. Objective investigating the therapeutic effect of splenic morphological response to sterile inflammation-inducing myocardial infarction. Material and method We examined the weight and structure of the heart and spleen of 106 patients deceased due to acute myocardial infarction. These data were correlated with demographic (personal) and epidemiological data, and disease history. After morphological investigation of archived myocardial and splenic tissue samples, the acute ischemia-induced structural alterations of splenic samples were quantified using a digital morphometric method. Results were evaluated in comparison to the myocardial ischemia coefficient. Changes in distribution of ischemia-induced cell types were characterized by defining the immunological phenotypes of macrophages (M1 vs. M2). Spleen samples from patients without history of ischemia were used as controls. Results The modification of the spleen weight was associated with an increase in peripheral blood leucocyte levels. Our morphological analysis proved a positive correlation between the ischemia coefficient and the decrease of spleen weight. Structural analysis of splenic tissue revealed the collapse of red pulp sinusoids, a significant size decrease of the white pulp marginal zone (p<0.05), and depleted follicles with irregular margins without any distinct germinative centers. Concurrently, with the proliferation of granulocytes, the increase of M1 macrophages was observed in the myocardium, and a higher M1/M2 ratio was detected in the marginal zone of splenic follicles. Conclusion On the background of acute ischemia, time critically determines the dynamic structural changes of the spleen. Along with reducing the marginal zone, immunomodulation targeting its cellular composition will be a putative therapeutic approach in the future.
作为无菌炎症诱导的急性缺血过程的结果,许多脾细胞进入循环系统并迁移到病变处,保护组织免受缺血扩散或增强坏死。目的探讨脾形态学对无菌性炎症性心肌梗死的治疗作用。材料与方法对106例急性心肌梗死死亡患者的心脏和脾脏进行重量和结构检查。这些数据与人口统计(个人)和流行病学数据以及病史相关。在对存档的心肌和脾组织标本进行形态学调查后,采用数字形态计量学方法对急性缺血引起的脾组织结构改变进行定量分析。将结果与心肌缺血系数进行比较。通过定义巨噬细胞的免疫表型(M1 vs. M2)来表征缺血诱导细胞类型分布的变化。无缺血史患者脾脏标本作为对照。结果脾脏重量的改变与外周血白细胞水平升高有关。形态学分析证实缺血系数与脾脏重量下降呈正相关。脾组织结构分析显示红髓窦塌陷,白髓边缘区明显缩小(p<0.05),滤泡减少,边缘不规则,无明显萌发中心。同时,随着粒细胞的增殖,心肌中M1巨噬细胞增多,脾滤泡边缘区M1/M2比值升高。结论在急性缺血的背景下,时间对脾的动态结构变化起关键作用。随着减少边缘区,针对其细胞成分的免疫调节将是未来可能的治疗方法。
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引用次数: 0
Dénes Szabó (1856-1918), the Clinic-founder Professor of Gynecology, A Centennial Commemoration 达姆斯Szabó(1856-1918),妇科诊所创始人,百年纪念活动教授
Pub Date : 2019-12-01 DOI: 10.2478/orvtudert-2019-0001
G. György
Abstract Dénes Szabó (1856–1918) was the second professor of obstetrics and gynecology of the Franz Joseph University from Kolozsvár (Cluj). This is a centennial commemoration. Szabó was born in the family of a great geologist professor at Pest. He studied at the University from Budapest and Strasbourg. He took his doctor’s degree in 1879. He spent a year with medical studies in foreign countries. In 1881 he became assistant to Professor Tivadar Kézmárszky, head of the Gynecological Clinic No. I. from Budapest. He was qualified as private lecturer in gynecology in 1888. In this period he published a lot of studies and review articles in the weekly medical papers Orvosi Hetilap and Gyógyászat. The Kolozsvár professor of obstetrics János Maizner in 1892 got retired. As a result of a competition Szabó was appointed professor of both obstetrics and gynecology. Until 1899 he worked in very poor conditions in a suburb building. Then the new 2 floor hospital from Mikó Street was built, where there were separate sections for obstetrics and gynecology. There he could also train midwives during 5 month courses. He became member of the Medical section of Transylvanian Museum Society, from 1894 up to 1912 he was the editor of its review journal (Értesítő...). Most of his studies were published there. The Medical Faculty elected him three times dean, in 1905/6 he was the rector of the university. He published around 65 studies. Some of them discuss deontological problems or deal with medical history. He was one of the editors of two memorial volumes, one dedicated to Professor Purjesz (1906), the other to Professor Lechner (1915). He compiled the first history of the Medical Faculty in 1896. He was also one of the editors of the monographic album of the Kolozsvár University from 1903. Five of its chapters were written by him. He was awarded with the title of Court Counselor. During WWI he did much for the medical care of wounded soldiers, so he got military awards, too. A number of medical and civil associations elected him president. He died because of gastric cancer at a Budapest hospital. According to his final wish he was buried in the Házsongárd Cemetery
d涅斯Szabó(1856-1918)是来自Kolozsvár(克鲁日)的弗朗茨约瑟夫大学第二任妇产科教授。这是百年纪念活动。Szabó出生在佩斯一个伟大的地质学教授的家庭。他在布达佩斯和斯特拉斯堡的大学学习。他于1879年获得博士学位。他在国外学了一年医学。1881年,他成为蒂瓦达教授Kézmárszky的助手,蒂瓦达教授是妇科诊所的负责人。我是从布达佩斯来的。1888年,他获得了妇科私人讲师的资格。在此期间,他在每周医学论文Orvosi Hetilap和Gyógyászat上发表了大量研究和评论文章。Kolozsvár产科教授János迈兹纳于1892年退休。由于竞争,Szabó被任命为妇产科教授。1899年以前,他一直在郊区一栋建筑里工作,条件非常恶劣。然后在Mikó街新建了一座两层楼的医院,那里有独立的产科和妇科。在那里,他还可以在5个月的课程中培训助产士。他成为特兰西瓦尼亚博物馆协会医学分会的成员,从1894年到1912年,他是其评论杂志的编辑(Értesítő…)。他的大部分研究都发表在那里。医学院三次选举他为院长,在1905/ 06学年他是大学的校长。他发表了大约65项研究。其中一些讨论义务论问题或处理病史。他是两本纪念册的编辑之一,一本献给Purjesz教授(1906年),另一本献给Lechner教授(1915年)。1896年,他编纂了第一本医学院历史。从1903年起,他还参与编辑了Kolozsvár大学的专题画册。书中有五章是他写的。他被授予法庭顾问的称号。在第一次世界大战期间,他为受伤士兵的医疗护理做了很多工作,所以他也获得了军事奖励。一些医疗和民间协会选举他为主席。他在布达佩斯的一家医院因胃癌去世。按照他的遗愿,他被安葬在Házsongárd公墓
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引用次数: 0
Success of teamwork: diagnosis and personalized treatment of advanced rectal carcinoma - case presentation 团队合作的成功:晚期直肠癌的诊断与个体化治疗-个案报告
Pub Date : 2019-12-01 DOI: 10.2478/orvtudert-2019-0012
Fülöp Zsolt Zoltán, Bara Tivadar, S. Kalman, Simu Patricia, Drágus Emőke, Fülöp Réka Linda, J. János
Abstract Background Finding the appropriate treatment for advanced rectal cancer patients represents a challenge for surgeons. Determining the right diagnosis and the proper treatment requires multidisciplinary collaboration. Our aim is to present a case with advanced stage rectum cancer, who received successful multidisciplinary treatment. Material and method A prospective multidisciplinary research is being conducted at our Department from 2018 within which patients with malignant rectal cancer are examined. Patients’ treatment is realized by the same multidisciplinary team. The patient’s preoperative investigations included MRI and a lymph node map designated by radiologists. Results In case of a 60-year-old patient the preoperative MRI showed a stenotic formation in the middle level of the rectum that penetrated the seminal vesicle. During surgery, we found a 10x10 cm stenotic, perforated rectal cancer, which penetrated the bladder, seminal vesicle, prostate and sacrum, respectively a metastatic lesion in the livers 8th segment. During surgery R2 recto-sigmoid resection was performed with colostomy. The patient was mobilized on the first postoperative day and bowel movements were regained on the second day. The patient left the hospital on the eighth postoperative day. Conclusions Adequate treatment of patients with advanced rectal cancer can be achieved only through multidisciplinary co-operation. Preoperative radiological examinations are mandatory. A map representing the positive colorectal lymph nodes, implemented by the radiologists, can significantly help the surgeons and pathologists.
背景寻找适合晚期直肠癌患者的治疗方法对外科医生来说是一个挑战。确定正确的诊断和适当的治疗需要多学科合作。我们的目的是提出一个病例与晚期直肠癌,谁接受了成功的多学科治疗。材料与方法自2018年起,我科开展一项前瞻性多学科研究,对恶性直肠癌患者进行检查。患者的治疗由同一个多学科团队实现。患者术前检查包括MRI和由放射科医生指定的淋巴结图。结果60岁患者术前MRI显示直肠中层狭窄形成,穿透精囊。术中发现一例10x10cm狭窄穿孔的直肠癌,经膀胱、精囊、前列腺、骶骨分别侵及肝脏第8节段转移灶。手术中,R2直肠乙状结肠切除术合并结肠造口术。患者术后第一天即可活动,第二天便可恢复排便。患者于术后第8天出院。结论通过多学科合作,才能使晚期直肠癌患者得到充分的治疗。术前放射检查是强制性的。放射科医师绘制的阳性结直肠淋巴结图对外科医生和病理学家有很大的帮助。
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引用次数: 0
Where Law and Digital Health Care Meet… 法律和数字医疗相遇的地方
Pub Date : 2019-12-01 DOI: 10.2478/orvtudert-2019-0017
Feith Helga Judit
Abstract The modern information and communication tools and technologies of the 21st century open up new opportunities for patients and healthcare providers, thus contributing to human health, reducing the number of morbidities and premature deaths. The application of modern technology in healthcare has resulted in a number of positive changes, but it has also been subject to multiple challenges, including legal dilemmas in this area: e.g. data management, data security and data protection, access to eHealth, etc. After a brief introduction to the legal history of healthcare and the presentation of key statistics related to the current digital situation, the main objective of the present work is to analyze the relationship between health digitalization and law. One of the key issues for successful healing in all historical eras is the legal protection and respect of patients and healthcare workers in the face of changes in the modern world. For this reason, it is important to address this unusual dimension of health care.
21世纪的现代信息通信工具和技术为患者和医疗保健提供者提供了新的机会,从而为人类健康做出了贡献,减少了发病率和过早死亡人数。现代技术在医疗保健领域的应用带来了许多积极的变化,但也面临着多重挑战,包括这一领域的法律困境:例如数据管理、数据安全和数据保护、获取电子健康等。在简要介绍了医疗保健的法律历史和与当前数字形势相关的关键统计数据之后,本工作的主要目标是分析卫生数字化与法律之间的关系。在所有历史时期,成功治愈的关键问题之一是面对现代世界的变化,对患者和医护人员的法律保护和尊重。因此,必须处理卫生保健的这一不寻常方面。
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引用次数: 0
Famous Hungarian chemists and pharmacists: Tibor Széki 著名的匈牙利化学家和药剂师:Tibor szacimki
Pub Date : 2019-07-01 DOI: 10.2478/orvtudert-2019-0006
K. Mihály, G. Árpád
Abstract Tibor Széki pharmacist, professor of pharmacy, member of the Hungarian Academy of Science, co-worker at Kolozsvár University, rector at Szeged University, professor of Budapest. He was a talented teacher, intuitive researcher, well organizing (founder of several institutes of chemistry) and public personality. His importance is beyond dispute in development of Hungarian chemical education.
蒂博尔·斯扎伊奇药剂师,药学教授,匈牙利科学院院士,Kolozsvár大学同事,塞格德大学校长,布达佩斯大学教授。他是一位才华横溢的教师、直觉敏锐的研究者、组织能力强(他创立了几个化学研究所)和公众人物。他对匈牙利化学教育发展的重要性是不容置疑的。
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引用次数: 2
Solubility enhancement of atorvastatin by embedding in micro sized carrier 微粒径载体包埋增强阿托伐他汀溶解度的研究
Pub Date : 2019-07-01 DOI: 10.2478/orvtudert-2019-0004
Rédai Emőke, Zsombori Mónika, Székely-Szentmiklósi Blanka, Sipos Emese
Abstract The aim of this experimental work was the enhancement of water solubility of the lipid lowering atorvastatin, by embedding it in polymer based micro sized fibers obtained by electrospinning. We prepared a polyvinylpyrrolidone (Kollidon 90F®) dispersion and added the active substance. By setting the experimental parameters we obtained four different microfibers containing atorvastatin, and one without the drug. The pH, viscosity and conductivity of the dispersions have been measured. The drug content and dissolution of atorvastatin had been studied by capillary electrophoresis. The size and thermal behavior of the fibers was determined. The parameters of the microfibers are influenced by the experimental parameters of electrospinning. The micro-method for dissolution showed a twofold solubility enhancement.
摘要本实验的目的是通过将降脂剂阿托伐他汀包埋在静电纺丝制备的聚合物基微纤维中,提高其水溶性。我们制备了一种聚乙烯吡咯烷酮(Kollidon 90F®)分散体,并加入了活性物质。通过设置实验参数,我们得到了四种不同的含有阿托伐他汀的微纤维,一种不含阿托伐他汀。测定了分散体的pH值、粘度和电导率。用毛细管电泳法测定了阿托伐他汀的含量和溶出度。测定了纤维的尺寸和热性能。静电纺丝的实验参数对微纤维的性能有一定的影响。微溶法可使溶解度提高两倍。
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引用次数: 0
The endocannabinoid system: from the receptors to therapy 内源性大麻素系统:从受体到治疗
Pub Date : 2019-07-01 DOI: 10.2478/orvtudert-2019-0002
Bába László-István, Kolcsár Melinda, Hack Beatrix, Gáll Zsolt, K. Zoltán
Abstract The endocannabinoid system (ECS) received a lot of attention ever since its discovery. Advancements of the last three decades have shown that there are numerous mechanisms by which the ECS regulates the energy metabolism. These can either be central (regulating appetite and calorie expenditure) or peripheral (adipocyte-specific and other) mechanisms. The current review highlights some of the most important observations leading to the discovery of the ECS first, followed by a part detailing the synthesis and transport of these mediators, the receptor types and second messenger systems involved. The next part is dedicated to the mechanisms by which this system regulates the energy metabolism. Lastly, the drugs that reached the clinical phase and the main targets and strategies for future drug development will be reviewed.
摘要内源性大麻素系统(endocannabinoid system, ECS)自被发现以来就备受关注。近三十年来的研究进展表明,ECS调节能量代谢的机制多种多样。这些机制可以是中枢机制(调节食欲和卡路里消耗),也可以是外围机制(脂肪细胞特异性和其他)。目前的综述首先强调了导致发现ECS的一些最重要的观察结果,然后详细介绍了这些介质的合成和运输,受体类型和所涉及的第二信使系统。下一部分将专门介绍该系统调节能量代谢的机制。最后,对已进入临床阶段的药物以及未来药物开发的主要靶点和策略进行了综述。
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引用次数: 0
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Bulletin of Medical Sciences
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