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Papers by Barnabas Horvath

Research paper thumbnail of Risk stratification in endoscopic type I. tympanoplasty

European Archives of Oto-Rhino-Laryngology, 2021

Several risk factors were studied in endoscopic type I. tympanoplasty, however, an easy-to-use ri... more Several risk factors were studied in endoscopic type I. tympanoplasty, however, an easy-to-use risk stratification model is still missing. Retrospective chart review, focusing on individual risk factors and middle ear risk index (MERI). Patients who underwent endoscopic type I. tympanoplasty were included. Closed tympanic cavity was succesfully created in 88.1% of the 42 cases, the overall 21,5 dB air–bone gap (ABG) was reduced by 9,8 dB. The average MERI score of the patients was 2.1 ± 1.5. 78.6% of the patients were categorised into the mild, while 21.4% into the moderate risk group. The perforation was considered small in 81.0% of the cases, while large in 19.0%. The size of the perforation and the preoperative ABG, but not the MERI status were the only single predictors of success. Using a risk stratification model that is based on the size of the perforation, the preoperative ABG and MERI status, patients could be referred into two distinct groups of risk: the majority expecting excellent outcomes with maximum one risk factor present, and patients with deteriorated rate of success when having two or three risk factors. Endoscopic type I. tympanoplasty with underlay perichondrium graft can be performed with good chance of success. However, if more than one risk factors are present, the chance of residual perforation becomes great. In addition to the established risk factors, our results point out that despite its strong correlation with perforation size, ABG may have a predictive role.

Research paper thumbnail of Expression of ets-1 transcription factor in human head and neck squamous cell carcinoma and effect of histamine on metastatic potential of invasive tumor through the regulation of expression of ets-1 and matrix metalloproteinase-3

Head & Neck, 2005

Background. Ets-1 controls the expression of critical genes involved in matrix remodeling. The ma... more Background. Ets-1 controls the expression of critical genes involved in matrix remodeling. The matrix metalloproteinase-3 (MMP-3) and urokinase type plasminogen activator (uPA) are typical Ets-1 responsive genes. Recent studies have shown an increase in histamine synthesis and content in various human neoplasias. We hypothesized that the increased local histamine overproduction contributed to activation of matrix remodeling through the activation of MMP-3 expression of peritumoral fibroblasts by means of ets-1 regulation in head and neck squamous cell carcinomas (HNSCCs). Methods. Paraffin-embedded sections of 30 HNSCCs were immunostained for ets-1. The presence of ets-1 and MMP-3 mRNA in tumor samples was confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR). To simulate stromal reaction in vitro, cultured human mucosal fibroblast was used. The level of ets-1 and MMP-3 mRNA was compared by use of RT-PCR, as was their protein with flow-cytometry, in the presence or absence of basic fibroblast growth factor (bFGF) (10 ng/mL) and histamine (1 AM). Results. Correlation between ets-1 expression and clinicopathologic background was not significant. In all cases, expression of ets-1 was seen in the stroma. In in vitro study, histamine upregulates production of ets-1 and MMP-3 in cultured fibroblast, and bFGF can stimulate histamine expression in fibroblast. Immunofluorescence staining supported the results of RT-PCR and flow cytometry. Conclusions. Ets-1 expression in HNSCCs has no prognostic value; however, ets-1 plays an important role in tumor-host interaction. Histamine may accelerate the spread of HNSCC through an ets-1-related mechanism.

Research paper thumbnail of Histamine elevates the expression of Ets-1, a protooncogen in human melanoma cell lines through H2 receptor

FEBS Letters, 2005

Histamine is known to act, at least in part, as a growth factor for several cell types, and as pr... more Histamine is known to act, at least in part, as a growth factor for several cell types, and as production of this biogen amine has been found to accelerate the rate of tissue proliferation in wound repair, embryogenesis and malignant growth. Abundant experimental and clinical data suggest that histamine augments in vivo tumour cell proliferation via histamine H2 receptors (H2R). Here, we report that exogenously added histamine stimulates Ets-1(v-ets erythroblastosis virus E26 oncogene homolog 1) synthesis in human melanoma cells. Involvement of histamine receptors in the histamine induced ets-1 expression has been also studied. Our data show that these newly recognized actions of histamine are mediated by the H2R. Modification of local protooncogen Ets-1 level is likely being involved in the regulation of melanoma growth.

Research paper thumbnail of Primary tuberculosis of the middle ear cleft: diagnostic and therapeutic considerations

European Archives of Oto-Rhino-Laryngology, 2014

test, Mycobacterium-specific pCR and interferon-gamma release assay cannot distinguish between ac... more test, Mycobacterium-specific pCR and interferon-gamma release assay cannot distinguish between active, inactive or post-infective conditions. According to these considerations, these methods may serve as supplementary assays for the final diagnosis. Having the appropriate diagnosis after surgical intervention and laboratory analysis, medical management should be continued by anti-tuberculosis chemotherapy. Hereby, we demonstrate two cases with primary tOM and provide an overview of the literature in the light of diagnostic and therapeutic guidelines in the management of tOM.

Research paper thumbnail of Severe neck infections that require wide external drainage: clinical analysis of 17 consecutive cases

European Archives of Oto-Rhino-Laryngology, 2014

Infections in the neck layers and spaces are potentially life-threatening diseases causing furthe... more Infections in the neck layers and spaces are potentially life-threatening diseases causing further complications, like mediastinitis, airway obstruction, or sepsis. Despite of the need for a conservative approach, they still regularly require surgical intervention. Records of 17 patients with severe neck infections that were treated by wide external incision and open wound management were retrospectively analyzed. The aim of the study was to clinically characterize these most serious neck infections. The most common presenting symptoms were neck pain and tense neck mass (94-94 %) regularly with fever (65 %), always accompanied by a marked elevation of C reactive protein level (average 192 uG/l). These findings were constant and very similar among both the deep neck infection and necrotizing fasciitis cases. More than half of the patients (53 %) had at least one systemic co-morbidity. The parapharyngeal space was most commonly affected (83 %), but extended disease involving more than two major neck regions was found in 13 cases (76 %). Dental (29 %) was the most common primary infection, followed by peritonsillar abscess (23 %), Microbiological results showed a wide variety of corresponding bacteria. Mediastinitis was developed in three cases (18 %), and airway obstruction requiring tracheostomy in two cases (12 %). All the patients survived. Severe neck infections are a heterogenous group of diseases regarding to the primary site of infection, microbiology, localisation and host reaction. However, rapidly developed, painful, tense neck mass with a highly elevated CRP level should always alert for an extended or phlegmonous process in the layers or spaces of the neck.

Research paper thumbnail of Does The Type of Ossicular Chain Lesion Affect Outcomes in Chronic Suppurative Otitis Media Without Cholesteatoma?

The Journal of International Advanced Otology, Apr 11, 2019

We evaluated the pattern of ossicular chain (OC) lesion in chronic suppurative otitis media (CSOM... more We evaluated the pattern of ossicular chain (OC) lesion in chronic suppurative otitis media (CSOM) without cholesteatoma and its impact on outcomes in primary and revision surgeries. This was a retrospective chart review. Patients who underwent tympanoplasty due to CSOM with OC defect between 2010 and 2015 were included in the study. OC lesions were found during 40 of 147 tympanoplasties performed due to CSOM. The preoperative air-bone gap (ABG) was greater in both discontinuity and fixation cases than in cases with CSOM with an intact OC (p<0.001). Twenty-nine patients were followed up postoperatively, after excluding four patients with stapes footplate fixation, in whom stapedotomy was not performed simultaneously. Among the 29 patients, the audiological results were similar in cases of discontinuity and fixation regarding gap change, residual ABG, and the rate of successful ossiculoplasty. Primary tympanoplasties provided better results according to postoperative ABG and the r...

Research paper thumbnail of Risk stratification in endoscopic type I. tympanoplasty

European Archives of Oto-Rhino-Laryngology, 2021

Several risk factors were studied in endoscopic type I. tympanoplasty, however, an easy-to-use ri... more Several risk factors were studied in endoscopic type I. tympanoplasty, however, an easy-to-use risk stratification model is still missing. Retrospective chart review, focusing on individual risk factors and middle ear risk index (MERI). Patients who underwent endoscopic type I. tympanoplasty were included. Closed tympanic cavity was succesfully created in 88.1% of the 42 cases, the overall 21,5 dB air–bone gap (ABG) was reduced by 9,8 dB. The average MERI score of the patients was 2.1 ± 1.5. 78.6% of the patients were categorised into the mild, while 21.4% into the moderate risk group. The perforation was considered small in 81.0% of the cases, while large in 19.0%. The size of the perforation and the preoperative ABG, but not the MERI status were the only single predictors of success. Using a risk stratification model that is based on the size of the perforation, the preoperative ABG and MERI status, patients could be referred into two distinct groups of risk: the majority expecting excellent outcomes with maximum one risk factor present, and patients with deteriorated rate of success when having two or three risk factors. Endoscopic type I. tympanoplasty with underlay perichondrium graft can be performed with good chance of success. However, if more than one risk factors are present, the chance of residual perforation becomes great. In addition to the established risk factors, our results point out that despite its strong correlation with perforation size, ABG may have a predictive role.

Research paper thumbnail of Expression of ets-1 transcription factor in human head and neck squamous cell carcinoma and effect of histamine on metastatic potential of invasive tumor through the regulation of expression of ets-1 and matrix metalloproteinase-3

Head & Neck, 2005

Background. Ets-1 controls the expression of critical genes involved in matrix remodeling. The ma... more Background. Ets-1 controls the expression of critical genes involved in matrix remodeling. The matrix metalloproteinase-3 (MMP-3) and urokinase type plasminogen activator (uPA) are typical Ets-1 responsive genes. Recent studies have shown an increase in histamine synthesis and content in various human neoplasias. We hypothesized that the increased local histamine overproduction contributed to activation of matrix remodeling through the activation of MMP-3 expression of peritumoral fibroblasts by means of ets-1 regulation in head and neck squamous cell carcinomas (HNSCCs). Methods. Paraffin-embedded sections of 30 HNSCCs were immunostained for ets-1. The presence of ets-1 and MMP-3 mRNA in tumor samples was confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR). To simulate stromal reaction in vitro, cultured human mucosal fibroblast was used. The level of ets-1 and MMP-3 mRNA was compared by use of RT-PCR, as was their protein with flow-cytometry, in the presence or absence of basic fibroblast growth factor (bFGF) (10 ng/mL) and histamine (1 AM). Results. Correlation between ets-1 expression and clinicopathologic background was not significant. In all cases, expression of ets-1 was seen in the stroma. In in vitro study, histamine upregulates production of ets-1 and MMP-3 in cultured fibroblast, and bFGF can stimulate histamine expression in fibroblast. Immunofluorescence staining supported the results of RT-PCR and flow cytometry. Conclusions. Ets-1 expression in HNSCCs has no prognostic value; however, ets-1 plays an important role in tumor-host interaction. Histamine may accelerate the spread of HNSCC through an ets-1-related mechanism.

Research paper thumbnail of Histamine elevates the expression of Ets-1, a protooncogen in human melanoma cell lines through H2 receptor

FEBS Letters, 2005

Histamine is known to act, at least in part, as a growth factor for several cell types, and as pr... more Histamine is known to act, at least in part, as a growth factor for several cell types, and as production of this biogen amine has been found to accelerate the rate of tissue proliferation in wound repair, embryogenesis and malignant growth. Abundant experimental and clinical data suggest that histamine augments in vivo tumour cell proliferation via histamine H2 receptors (H2R). Here, we report that exogenously added histamine stimulates Ets-1(v-ets erythroblastosis virus E26 oncogene homolog 1) synthesis in human melanoma cells. Involvement of histamine receptors in the histamine induced ets-1 expression has been also studied. Our data show that these newly recognized actions of histamine are mediated by the H2R. Modification of local protooncogen Ets-1 level is likely being involved in the regulation of melanoma growth.

Research paper thumbnail of Primary tuberculosis of the middle ear cleft: diagnostic and therapeutic considerations

European Archives of Oto-Rhino-Laryngology, 2014

test, Mycobacterium-specific pCR and interferon-gamma release assay cannot distinguish between ac... more test, Mycobacterium-specific pCR and interferon-gamma release assay cannot distinguish between active, inactive or post-infective conditions. According to these considerations, these methods may serve as supplementary assays for the final diagnosis. Having the appropriate diagnosis after surgical intervention and laboratory analysis, medical management should be continued by anti-tuberculosis chemotherapy. Hereby, we demonstrate two cases with primary tOM and provide an overview of the literature in the light of diagnostic and therapeutic guidelines in the management of tOM.

Research paper thumbnail of Severe neck infections that require wide external drainage: clinical analysis of 17 consecutive cases

European Archives of Oto-Rhino-Laryngology, 2014

Infections in the neck layers and spaces are potentially life-threatening diseases causing furthe... more Infections in the neck layers and spaces are potentially life-threatening diseases causing further complications, like mediastinitis, airway obstruction, or sepsis. Despite of the need for a conservative approach, they still regularly require surgical intervention. Records of 17 patients with severe neck infections that were treated by wide external incision and open wound management were retrospectively analyzed. The aim of the study was to clinically characterize these most serious neck infections. The most common presenting symptoms were neck pain and tense neck mass (94-94 %) regularly with fever (65 %), always accompanied by a marked elevation of C reactive protein level (average 192 uG/l). These findings were constant and very similar among both the deep neck infection and necrotizing fasciitis cases. More than half of the patients (53 %) had at least one systemic co-morbidity. The parapharyngeal space was most commonly affected (83 %), but extended disease involving more than two major neck regions was found in 13 cases (76 %). Dental (29 %) was the most common primary infection, followed by peritonsillar abscess (23 %), Microbiological results showed a wide variety of corresponding bacteria. Mediastinitis was developed in three cases (18 %), and airway obstruction requiring tracheostomy in two cases (12 %). All the patients survived. Severe neck infections are a heterogenous group of diseases regarding to the primary site of infection, microbiology, localisation and host reaction. However, rapidly developed, painful, tense neck mass with a highly elevated CRP level should always alert for an extended or phlegmonous process in the layers or spaces of the neck.

Research paper thumbnail of Does The Type of Ossicular Chain Lesion Affect Outcomes in Chronic Suppurative Otitis Media Without Cholesteatoma?

The Journal of International Advanced Otology, Apr 11, 2019

We evaluated the pattern of ossicular chain (OC) lesion in chronic suppurative otitis media (CSOM... more We evaluated the pattern of ossicular chain (OC) lesion in chronic suppurative otitis media (CSOM) without cholesteatoma and its impact on outcomes in primary and revision surgeries. This was a retrospective chart review. Patients who underwent tympanoplasty due to CSOM with OC defect between 2010 and 2015 were included in the study. OC lesions were found during 40 of 147 tympanoplasties performed due to CSOM. The preoperative air-bone gap (ABG) was greater in both discontinuity and fixation cases than in cases with CSOM with an intact OC (p<0.001). Twenty-nine patients were followed up postoperatively, after excluding four patients with stapes footplate fixation, in whom stapedotomy was not performed simultaneously. Among the 29 patients, the audiological results were similar in cases of discontinuity and fixation regarding gap change, residual ABG, and the rate of successful ossiculoplasty. Primary tympanoplasties provided better results according to postoperative ABG and the r...