Orvosi hetilap最新文献

{"title":"[Surgical steps of organ retrieval from deceased donor for uterus transplantation].","authors":"Bálint Farkas, Kálmán Kovács, Szilárd Kolumbán, Kata Szilvia Papp, Zsombor Márton, József Bódis, Gábor Fazekas","doi":"10.1556/650.2025.33247","DOIUrl":"10.1556/650.2025.33247","url":null,"abstract":"<p><p>Introduction: A new surgical treatment method for absolute uterine infertility is uterus transplantation. We performed cadaver surgeries in preparation for human deceased donor uterus transplantation. Objective: The objective of the surgeries was to identify anatomical structures, to demonstrate the steps of graft retrieval, and to practice the collaboration of the medical staff as a team. Method: With the approval of the ethical committee, respecting the mercy and personal rights of the deceased, we dissected the ureter from its entry into the minor pelvis, also dissected the parietal and visceral branches of the internal iliac artery and vein, then clamped and cut them, while keeping the vascular bundles of the parametrium intact. Finally, a hysterectomy was performed along with the long vaginal cuff. Results: The operation was successful in 3 out of 3 cases, as it was possible to remove the uterus with bilaterally intact parametrium and intact vasculature. Discussion: During uterus transplantation, the graft can originate from a living or deceased (brain-dead) donor. Both interventions have many advantages and disadvantages. Currently, it is a matter of scientific debate which is the preferred method of organ removal, but in any case, proper preparation and practice are essential. Conclusion: We consider and recommend cadaver surgeries as it is suitable for preparation for human brain-dead donor uterus transplantation. Orv Hetil. 2025; 166(10): 385–391.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 10","pages":"385-391"},"PeriodicalIF":0.8,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaál Csaba: Válogatott orvosi írások. Semmelweis Kiadó, Budapest, 2024.","authors":"Róbert Langer","doi":"10.1556/650.2025.9M","DOIUrl":"https://doi.org/10.1556/650.2025.9M","url":null,"abstract":"","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 9","pages":"359"},"PeriodicalIF":0.8,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Fetal growth restriction as the disease of the placenta].","authors":"Balázs Gérecz, Zorán Belics, Gizella Molnár, Petronella Hupuczi","doi":"10.1556/650.2025.33254","DOIUrl":"10.1556/650.2025.33254","url":null,"abstract":"<p><p>Fetal growth restriction (FGR) as a common pregnancy complication is generally defined as the failure of a fetus to achieve its genetically determined full growth potential due to placental dysfunction. Early-onset (<32. gestational week) FGR is associated strongly with abnormal trophoblastic invasion and consequent placental insufficiency. Conditions leading to FGR are the disorders inherent to the fetal-placental-maternal unit, fetal malnutrition, resulting in a significantly increased risk of stillbirth, neonatal morbidity, neonatal death, and long-term adverse outcome. Once the fetal size, typically using estimated fetal weight and/or abdominal circumference below the tenth percentile compared to gestational age reference standards, multimodality assessment (including Doppler velocimetry in umbilical, and middle cerebral arteries, CTG and biophysical profile) is recommended. At present, the most recognized criteria to define early and late FGR are those derived from an international Delphi survey consensus. Early diagnosis, close follow-up and timely delivery of pregnancies with FGR are of crucial importance for perinatal short- and long-term outcome. The main distinction between small for gestational age (SGA) and growth-restricted fetus is that the healthy SGA fetus may be small but not at increased risk of adverse perinatal outcome. Orv Hetil. 2025; 166(9): 331–340.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 9","pages":"331-340"},"PeriodicalIF":0.8,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Gastrointestinal amyloidosis - retrospective analysis based on data of a center in Budapest].","authors":"Liza Dalma Sümegi, Daniella Nagy, Ádám Vida, Gergely Varga, Emese Mihály, János Mihály Papp, Zoltán Pozsonyi, Ákos Iliás","doi":"10.1556/650.2025.33238","DOIUrl":"10.1556/650.2025.33238","url":null,"abstract":"<p><p>Introduction: In case of amyloidosis, an abnormal protein is formed which deposits and leads to dysfunction. Any organ can be affected. The most common digestive system symptoms are gastrointestinal dysmotility, dysphagia, satiety, gastroparesis, bleeding and constipation. Objective: Review of amyloidosis patients with gastrointestinal involvement treated at Semmelweis University, taking symptoms, endoscopic and histological results into account. Method: 15 amyloidosis patients with gastrointestinal involvement treated between 2009 and 2024 were collected using the hospital’s computerized registry system. Results: In 12 patients, amyloid light chain amyloidosis was confirmed, while transthyretin amyloidosis variant was described in 1 case, lysozyme amyloidosis in 1, and amyloid A amyloidosis in 1 patient. The median age at diagnosis and death was 65 years, reflecting the late-stage diagnosis, and the high Mayo-score (mean value: 2.67) predicted a poor prognosis for light chain amyloidosis. Other affected organs were heart (73.3%), kidneys (33.3%) and peripheral nerves (40%). The leading gastrointestinal symptoms were unintentional weight loss (20%), dysphagia (6.6%), hematochezia (6.6%), abdominal pain (6.6%), and diarrhea (6.6%). Common laboratory findings were anemia and chronic renal failure, while the most frequently described gastroscopic abnormalities were gastroduodenitis, gastroparesis, ulcers and polypoid formations. Discussion: A clear understanding of the mechanisms underlying gastrointestinal dysfunction is still lacking. Gastroparesis, diarrhea, polyneuropathy, and malabsorption can occur as a result of dysfunction resulting from amyloid deposition that damages blood vessels and nerves. Abnormalities seen during endoscopy may correspond to those seen in amyloidosis, and ulcers may be the source of hematochezia, occult bleeding, and anemia. Conclusion: Systemic amyloidosis is a disease with a poor prognosis that can affect many organs. The symptoms, laboratory parameters and endoscopic findings are varied, but not specific, so close cooperation of the allied professions is essential for the fastest diagnosis. Orv Hetil. 2025; 166(9): 351–358.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 9","pages":"351-358"},"PeriodicalIF":0.8,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diagnostic and therapeutic aspects of odontogenic sinusitis].","authors":"Andor Hirschberg","doi":"10.1556/650.2025.33258","DOIUrl":"10.1556/650.2025.33258","url":null,"abstract":"<p><p>Odontogenic sinusitis is classified as a localized, secondary form of the paranasal sinus inflammation, in which odontogenic focus, foreign body and/or any surgical intervention violating the Schneiderian membrane may be found in the background. Rhinosinusitis is defined by at least two from the symptoms of nasal blockage, anterior or posterior nasal discharge, facial discomfort/pain, loss of smell and typical alterations with nasal endoscopy. Acute rhinosinusitis seems to be infectious, while the chronic phenotype shows immunopathological signs of primary, diffuse bilateral disease. Acute and chronic rhinosinusitis as well as odontogenic sinusitis appear to have markedly different symptoms, pathomechanistic properties and therapeutic possibilities, thus the appropriate diagnosis is of utmost importance. The symptoms of the odontogenic sinusitis is similar compared to acute bacterial rhinosinusitis, though putrid nasal discharge and/or foetor from the nose might be pathognomic, while anosmia is usually not present. Mucosal changes and alterations in sinus-CT scans without typical clinical symptoms and nasal endoscopic findings do not define the diagnosis of odontogenic sinusitis. The goal of the therapy comprises treatment of the acute symptoms and inflammation, improvement of sinus drainage, eradication of the odontogenic focus, removal of foreign bodies if present, and finally closure of the oroantral fistules, if needed. Conservative medical therapy should be initiated first, and in the case of failure, endoscopic sinus surgical intervention is considered as the next step. In individual and more complicated cases, consultation with dental-, maxillo-facial surgeon and specialist in otorhinolaryngology is recommended, together with repeated nasal endoscopy and sinus-CT-scan. Diagnostic and therapeutic algorithms are suggested in order to promote up-to-date treatment of odontogenic sinusitis patients. Orv Hetil. 2025; 166(9): 323–330.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 9","pages":"323-330"},"PeriodicalIF":0.8,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Cornea Bank Debrecen is thirty years old].","authors":"László Módis, Miklós Ágoston Lukács, Sára Makhoul, Mariann Fodor","doi":"10.1556/650.2025.33252","DOIUrl":"10.1556/650.2025.33252","url":null,"abstract":"<p><p>Objective: To present the 30 years of operation of the Eye Bank Debrecen (1994–2023), the demographic characteristics of corneal donors, the procurement, storage, utilization, and distribution of donor tissues, moreover, to disclose the long-term results of eye bank practice. Methods: We performed a retrospective analysis of eye bank practices between 1994 and 2023 at the Department of Ophthalmology, University of Debrecen. We collected data on corneal donation (gender and age of donor, cause of death, time from death to removal, preservation, and finally transplantation of donor tissue), preserved corneas (endothelial cell density), and operations (type of intervention, indication). Our bank collects tissue from cadavers, multiorgan, and living donors. Donors are stored in hypothermic conditions for a maximum of 14 days. Our activities also include the preservation, deep freezing and use of amniotic membrane, as well as the storage and use of fascia lata. Results: The Cornea Bank Debrecen performed 3270 corneal preservations between 1994 and 2023. Based on the data of the preserved corneas, 57.8% of the corneoscleral discs derived from cadaver, 37.6% from multiorgan and 4.6% from living donor. The mean age of donors was 55.5 ± 11.8 years. The average endothelial cell density of donor corneas was 2235.6 ± 158/mm2. The mean time between death and enucleation from the pathology institute was 12.3 ± 5.2 hours and the mean time between death and preservation was 14.9 ± 6.3 hours. After preservation (+4.0 °C Eusol-C, Alchimia, Italy), donor tissue was used at an average of 6.1 ± 2.3 days. Of the preserved corneas, 20.3% were discarded, the most common reason being serological positivity (hepatitis B and C in 25.6% of non-transplanted donor corneas). Based on the eye bank data, a total of 2864 corneal transplantations were performed between 1994 and 2023. The most common surgical indication was bullous keratopathy (21.6%). The rate of lamellar surgical techniques was 6.4% from 2011 to 2023. From 2006 to 2023, 312 amniotic membrane transplantations were performed. Conclusion: The Cornea Bank Debrecen has been continuously developing since its foundation, complying with the legal requirements and European professional standards. Donor harvesting from cadaver, multiorgan and living donors is also feasible. In addition to corneas, amniotic membrane and fascia lata tissue are also available in our bank, providing a background for the surgical treatment of various ophthalmological pathologies. Orv Hetil. 2025; 166(9): 341–350.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 9","pages":"341-350"},"PeriodicalIF":0.8,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The philanthropist Albert Schweitzer (1875-1965) was born 150 years ago].","authors":"József Makovitzky","doi":"10.1556/650.2025.HO2825","DOIUrl":"https://doi.org/10.1556/650.2025.HO2825","url":null,"abstract":"","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 8","pages":"317-319"},"PeriodicalIF":0.8,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Catheter ablation of the distal arborization of the left ventricular Purkinje network in the therapy of recurrent ventricular fibrillation].","authors":"Dóra Krányák, László Sághy, Róbert Pap","doi":"10.1556/650.2025.33209","DOIUrl":"10.1556/650.2025.33209","url":null,"abstract":"<p><p>An increasing number of studies suggest the role of the Purkinje network and Purkinje-myocardial junction in the development of malignant ventricular arrhythmias. Radiofrequency catheter ablation of the distal arborization of the left ventricular Purkinje network may influence the recurrence of ventricular fibrillation. In three patients (all male, age: 52 ± 6.6 years), radiofrequency ablation of the distal left ventricular Purkinje network was performed due to recurrent ventricular fibrillation despite amiodarone treatment. One patient had hypertrophic cardiomyopathy, another had ischemic cardiomyopathy, and the third had idiopathic ventricular fibrillation. Target identification was achieved by mapping Purkinje-originated ventricular extrasystoles induced by isoproterenol infusion (in two patients) and by pace-mapping based on clinical ECG documentation and intracardiac defibrillator recordings (two patients). The radiofrequency ablation target included the area identified by Purkinje potentials along the left ventricular posterior fascicle and, in one case, also the distal arborization of the anterior fascicle. During a mean follow-up period of 17 ± 11 months following the procedure, one patient experienced malignant ventricular arrhythmia, less frequently than before. In recurrent ventricular fibrillation of various origins, catheter ablation of the distal arborization of the left ventricular Purkinje network may reduce the recurrence of malignant ventricular arrhythmias. Orv Hetil. 2025; 166(8): 307–312.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 8","pages":"307-312"},"PeriodicalIF":0.8,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Duplication of the X-chromosomal Xq28 region containing the MECP2 gene in X-linked intellectual disability syndrome Lubs-type].","authors":"Zsófia Németh, Gabriella Sinkó, Judit Kárteszi, Violetta Csákváry","doi":"10.1556/650.2025.33234","DOIUrl":"10.1556/650.2025.33234","url":null,"abstract":"<p><p>In the case of a suspected genetic disease, it is a big challenge to integrate the wide range of symptoms, to select the appropriate diagnostic steps and then to evaluate the results. In this case report, we present the medical history of a boy with congenital heart defects, neurodevelopmental and endocrine disorders. In connection with recurrent, psychomotor developmental delay, detection of minor anomalies and recurrent, severe sepsis since his birth, we started his genetic testing. Multiplex ligation-dependent probe amplification (MLPA-) analysis identified MECP2 duplication syndrome. This genetic syndrome, also called X-linked intellectual disability syndrome Lubs-type, is an X-linked recessive genetic defect. The exact frequency of this genetic disorder is unknown. We know about 200 people in the world, based on literature data. The severity of the clinical symptoms is related to the size of the duplicated chromosome segment. In our patient the affected region, in addition to MECP2, also contained SLC6A8, IDH3G, L1CAM, IRAK1, FLNA, GDI1, DKC1, F8 and VAMP7 genes. These genes may have contributed to the appearance of the diverse clinical picture. We emphasize the pathological role of the reduced cortisol response in the background of recurrent, severe septic conditions. A wide spectrum of genetic testing methods is available, but it depends on the clinician to initiate them. Our main goal with this announcement is to draw attention to these special analyses, which can shorten the diagnostic path, therefore during the next pregnancis the prenatal genetic diagnosis is possible. Orv Hetil. 2025; 166(8): 313–316.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 8","pages":"313-316"},"PeriodicalIF":0.8,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[On the toxicity of intracameral cefuroxime administration].","authors":"Ágnes Elekes, Péter Vámosi","doi":"10.1556/650.2025.33245","DOIUrl":"10.1556/650.2025.33245","url":null,"abstract":"<p><p>Nowadays, the most frequently performed surgical procedure in the world is cataract surgery. Thanks to the precise intraocular lens power calculation and the sophisticated phacoemulsification technique, the results of cataract surgery are excellent. A mandatory step in international and domestic professional guidelines is the injection of 0.1 ml of 1% cefuroxime, an antibiotic used to prevent endophthalmitis, into the anterior chamber at the end of the surgery. A drug administered in larger quantities than prescribed or improperly diluted can cause serious permanent complications in both the anterior chamber of the eye and the fundus. With the prescribed dosage, little-known lesions may rarely occur, but they respond well to local therapy. In our article, we aim to provide a literature review on intracameral cefuroxime and its potential toxicity in relation to a case. Orv Hetil. 2025; 166(8): 301–306.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 8","pages":"301-306"},"PeriodicalIF":0.8,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}