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Bevezetés: Az intesztinális alkalikus foszfatáz (iAP) fontos szerepet játszik a bél barrierintegr... more Bevezetés: Az intesztinális alkalikus foszfatáz (iAP) fontos szerepet játszik a bél barrierintegritásának megőrzésében. Az iAP megköti a lipopoliszacharidot (LPS), a Toll-like receptor 4 (TLR4) ligandját és semlegesíti aktivitását. Gyulladásos bélbetegségben (IBD) eddig az iAP-fehérjeszinteket nem vizsgálták. Beteganyag és módszer: Az iAP-fehérjeszinteket Western-blottal határoztuk meg 15 újonnan diagnosztizált IBD-s gyermek gyulladt és nem-gyulladt colonbiopsziás mintájában, 10 egészséges gyermek kontroll mintájával összehasonlítva. Ezen kívül az iAP-TLR4 ko-lokalizációt vizsgáltuk ezekben a betegcsoportokban. Eredmények: Az iAP-fehérjeszintek a colitis ulcerosas (UC) gyerekek gyulladt bélszakaszában 22%-kal, a Crohn-beteg (CD) gyermekekben 20%-kal csökkentek az egészséges kontrollok mintáihoz viszonyítva. A CD-s gyermekek gyulladt bélszakaszában 24%-os fehérjeszint-csökkenést tapasztaltunk a nem-gyulladt területhez viszonyítva. Az immunfluoreszcens festés mindhárom csoportban igazolta az iAP és a TLR4 epithelialis kompartmenten belüli ko-lokalizációját. Következtetés: Vizsgálataink szerint az IBD-s gyermekek gyulladt colon mucosájában az iAP-szint csökkent. Ez a változás magasabb TLR4-expresszióval és fokozott LPS-aktivitással járhat, amely a gyulladásos folyamatot erősítheti
Virchows Archiv, Sep 4, 2014
Celiac disease (CD) is a chronic autoimmune enteropathy caused by exposure to dietary gluten in g... more Celiac disease (CD) is a chronic autoimmune enteropathy caused by exposure to dietary gluten in genetically predisposed individuals. The transcription factor peroxisome proliferator-activated receptor gamma (PPARγ) was shown to exert protective effects in several immune-mediated disorders. Activation of PPARγ suppressed the expression of thymic stromal lymphopoietin (TSLP), an inducer of proinflammatory cytokines. Since the role of TSLP in gluten-sensitive enteropathy is completely unknown, we investigated the involvement of TSLP and its regulator PPARγ in childhood CD. We collected duodenal biopsy specimens from 19 children with newly diagnosed CD, 6 children with treated CD (gluten-free diet, GFD), and 10 controls. Expression of mRNA and protein levels of PPARγ, TSLP, and TSLP receptor were determined by real-time RT-PCR and Western blot, respectively. Duodenal localization of PPARγ and TSLP was studied by immunohistochemistry. In duodenal mucosa of children with CD, the amount of PPARγ was significantly lower and simultaneously that of TSLP significantly higher compared to controls (p < 0.05). In GFD-treated patients, the levels of PPARγ mRNA and protein were significantly higher while that of TSLP markedly lower compared to newly diagnosed CD (p < 0.05). Immunohistochemistry revealed PPARγ and TSLP expression in lamina propria immune cells and in enterocytes. Low expression of PPARγ and high expression of TSLP in the duodenal mucosa of children with newly diagnosed CD suggest that they are involved in the pathophysiology of CD. We hypothesize that PPARγ may be an inhibitory regulator of TSLP-stimulated inflammatory processes in CD.
Magyar onkologia, Dec 1, 2009
Gastrointestinal tumors are highly ranked regarding tumoral mortality worldwide. The development ... more Gastrointestinal tumors are highly ranked regarding tumoral mortality worldwide. The development and progression of gastrointestinal (GI) diseases go hand in hand with the changes of tight junctions (TJ). Claudins (CLDN) are the main TJ proteins, showing different expression by the different tissues, with the expressed CLDN profile being representative. I. We explored the changes of CLDN expression in Barrett's esophagus and related adenocarcinoma. CLDN2 and -3 expression in Barrett's esophagus was higher than in normal foveolar epithelium. Adenocarcinoma showed higher CLDN2 and -3 expression compared with normal and Barrett's epithelia. The similar CLDN expression profile of Barrett's esophagus and adenocarcinoma supports their sequential development. II. Gastric intestinal metaplasia showed higher expression of CLDN2, -3 and -4 as compared with normal antral foveolar mucosa. Tumors of small and large bowels exhibited higher CLDN2 expression when compared with normal epithelia. Colorectal adenoma and adenocarcinoma could not be differentiated according to their CLDN profile. Intestinal metaplasias of Barrett's esophagus and stomach show similar CLDN profile to small bowel epithelium. III. Studies on duodenal mucosa in celiac disease in childhood demonstrated CLDN2 and -3 expression to be higher than in normal mucosa. The expression was significantly higher in the distal part of the duodenum samples. This and the serious histological findings suggest that the distal duodenum is more adequate for biopsy testing. IV. Beside the epithelial cells, mesenchymal tumors express intercellular junctional proteins. Expression of claudins in gastrointestinal stromal tumors (GIST) and other mesenchymal neoplasia was also studied. The CLDN profile was found to be representative to the individual tumor. GIST, angiosarcoma, hemangioma, leiomyosarcoma and leiomyoma showed expression of various CLDNs. CLDN2 was detected in all entities. CLDN1, however, was found positive in leiomyosarcoma only. Leiomyoma, on the other hand, expressed only CLDN2. GISTs and leiomyosarcomas showed CLDN2, -3, -4, -5 and -7-expression. The angiogenic tumors revealed CLDN2 and -5 expression. The similar CLDN profile observable in GIST and leiomyosarcoma is suggestive of a histogenetic relationship. Smooth muscle and vessel tumors of different dignity could also be separated from each other based on CLDN profile.
Journal of Pediatric Gastroenterology and Nutrition, 2011
The American Journal of Surgical Pathology, May 1, 2003
Gastrointestinal stromal tumors (GISTs), the specific KITpositive mesenchymal tumors of the gastr... more Gastrointestinal stromal tumors (GISTs), the specific KITpositive mesenchymal tumors of the gastrointestinal tract, have been sporadically reported in the rectum, but there are few clinicopathologic series. In this study we analyzed the clinicopathologic features of 133 anorectal GISTs, 3 intramural leiomyomas (LMs), and 8 leiomyosarcomas (LMSs) from the files of the Armed Forces Institute of Pathology and the Haartman Institute of the University of Helsinki. Ninety-six GISTs were documented as KIT-positive and three additional ones as CD34-positive. Thirty-four tumors were included by their histologic similarity to KIT-or CD34-positive cases. GISTspecific c-kit gene mutations, mostly in exon 11, were documented in 18 of 29 cases (62%). The GISTs occurred in adults with the age range of 17-90 years (median 60 years) with a significant male predominance (71%). The tumors ranged from small asymptomatic intramural nodules to large masses that bulged into pelvis causing pain, rectal bleeding, or obstruction. They were mostly highly cellular spindle cell tumors; four tumors had an epithelioid morphology. The tumors coexpressed CD34 and KIT and were rarely positive for smooth muscle actin or desmin and never for S-100 protein. Seventy percent of patients with tumors >5 cm with more than 5 mitoses/50 high power fields (HPF) (n ס 31) died of disease, whereas only one tumor <2 cm with <5 mitoses/50 HPF (n ס 21) recurred and none caused death. Long latency was common between primary operation and recurrences and metastases; either one occurred in 60 of 111 patients with follow-up (54%). Distant metastases were in the liver, bones, and lungs. Three benign actin-and desmin-positive and KIT-negative intramural LMs, similar to those seen in the esophagus, were identified. There were eight LMSs, six of which formed a polypoid intraluminal mass and were actin-positive and KIT-negative. Despite high mitotic counts, only one LMS patient died of disease. A great majority of rectal smooth muscle and stromal tumors are GISTs, which have a spectrum from minimal indolent tumors to overt sarcomas. Intramural LMs are exceptional, and true LMSs are rare, and similar to colonic ones, often present as intraluminal polypoid masses that appear to have a better prognosis than GISTs with similar mitotic rates.
Orvosi Hetilap, Sep 1, 2012
Az intestinalis alkalikus foszfatáz enzim alapvető fontosságú a bélnyálkahártya épségének fenntar... more Az intestinalis alkalikus foszfatáz enzim alapvető fontosságú a bélnyálkahártya épségének fenntartásában, mivel detoxifi kálni képes a lipopoliszacharidot, amely a Toll-like receptor-4 ligandja. A helytelen immunválasz, valamint a mucosalis barrier sérülése hozzájárulhat a gyulladásos bélbetegség és a coeliakia kialakulásához. Gyulladásos bélbetegségben szenvedő gyermekek gyulladt vastagbél-és újonnan diagnosztizált coeliakiás gyermekek duodenumnyálkahártyájában a csökkent intestinalis alkalikus foszfatáz és a Toll-like receptor-4 fehérjeexpresszió emelkedése következményesen fokozott lipopoliszacharid-aktivitással járhat, amely a szövetkárosító folyamatokat erősítheti. Az intestinalis alkalikus foszfatáz aktivitásának elősegítése colitises állatmodellben és terápiarezisztens colitis ulcerosás felnőtt betegekben csökkentette a bélgyulladás tüneteit. Ennek megfelelően a két vizsgált kórképben az enzim célzott intestinalis bejuttatása kiegészítő terápiás konzekvenciával is járhat a jövőben.
Orvosi Hetilap, Mar 1, 2008
A duodenumra lokalizált Crohn-betegség az összes Crohn-betegség kb. 0,5–4%-át teszi ki. Leggyakor... more A duodenumra lokalizált Crohn-betegség az összes Crohn-betegség kb. 0,5–4%-át teszi ki. Leggyakoribb tünete a gyomorürülési zavar és a jelentős fogyás. Az endoszkópos biopszia eredménye gyakran bizonytalan, ami megnehezíti az egyéb benignus szűkületektől való elkülönítését. A műtétet igénylő megbetegedés kezelése tekintetében a betegséggel foglalkozó európai konszenzusos nyilatkozat sem ad pontos irányelveket. Beteganyag: Eredménytelen konzervatív kezelés miatt a Semmelweis Egyetem I. Sebészeti Klinikáján 2002–2007 között három betegnél a gyomorürülési panasz megoldására műtétre volt szükség. Mindegyik betegnek a műtét előtt jelentős súlyvesztése (13–30 kg) volt. Két esetben sikerült a gyulladt bélszakasz eltávolítása a duodenum parciális reszekciójával, és az emésztőtraktus Billroth-II. szerint végzett rekonstrukciójával, egy esetben a leszálló duodenum érintettsége miatt csak bypassműtétre (gastro-jejunostomia) nyílt lehetőség. Eredmények: A betegek a műtét óta eltelt 45/24/9 hónap óta panaszmentesek, műtét előtti súlyukat visszanyerték. Sem korai, sem késői szövődményt nem észleltünk. Következtetések: A konzervatív kezelésre tartósan nem reagáló, szűkületet okozó duodenalis Crohn-betegség műtéti javallatot képez, azonban a fennálló malnutritio a műtét előtt kezelést igényel. A műtét típusa előre nem tervezhető, a kellően előkészített patkóbél-Crohn-beteg gyógyhajlama nem rosszabb, mint egyéb lokalizációjú sorstársaié.
Clinical case reports, 2017
Small-cell neuroendocrine carcinoma is a high-grade carcinoma rarely encountered in extra-pulmona... more Small-cell neuroendocrine carcinoma is a high-grade carcinoma rarely encountered in extra-pulmonary sites. A 40-year-old lady presented with epigastric pain and was noted to have an ulcerated small-cell neuroendocrine carcinoma in her duodenum with liver metastases. She underwent palliative chemotherapy but unfortunately passed away. Duodenal SCNC is an unusual malignancy with an aggressive phenotype.
Orvosi hetilap, Jan 23, 2005
The authors review a case of a 24-year-old male patient hospitalised for repeated acute abdominal... more The authors review a case of a 24-year-old male patient hospitalised for repeated acute abdominal symptoms. His medical history included no diseases worth of mentioning. By imaging techniques (abdominal US and CT scan) a cystic lesion, measuring 40 x 35 x 30 mm in diameter was found, and was diagnosed as pseudocyst in the region of the tail of the pancreas. Jejunal feeding was introduced. The lesion did not improve and the second CT scan suggested a suspicion of pancreatic cystadenoma. Three months after first presentation the surgical resection was performed. The tumour, however, was found independent of the pancreas (90 x 80 x 50 mm). Both histologically and immunohistochemically the lesion proved to be the metastasis of a germ cell (yolk-sac) tumour. Following the morphological diagnosis, detailed urological and medical check up was performed. A previously nonpalpable small tumour was found in the left testis which was radically resected. The testicular tumour measuring 9 x 9 x 5...
Bevezetés: Az intesztinális alkalikus foszfatáz (iAP) fontos szerepet játszik a bél barrierintegr... more Bevezetés: Az intesztinális alkalikus foszfatáz (iAP) fontos szerepet játszik a bél barrierintegritásának megőrzésében. Az iAP megköti a lipopoliszacharidot (LPS), a Toll-like receptor 4 (TLR4) ligandját és semlegesíti aktivitását. Gyulladásos bélbetegségben (IBD) eddig az iAP-fehérjeszinteket nem vizsgálták. Beteganyag és módszer: Az iAP-fehérjeszinteket Western-blottal határoztuk meg 15 újonnan diagnosztizált IBD-s gyermek gyulladt és nem-gyulladt colonbiopsziás mintájában, 10 egészséges gyermek kontroll mintájával összehasonlítva. Ezen kívül az iAP-TLR4 ko-lokalizációt vizsgáltuk ezekben a betegcsoportokban. Eredmények: Az iAP-fehérjeszintek a colitis ulcerosas (UC) gyerekek gyulladt bélszakaszában 22%-kal, a Crohn-beteg (CD) gyermekekben 20%-kal csökkentek az egészséges kontrollok mintáihoz viszonyítva. A CD-s gyermekek gyulladt bélszakaszában 24%-os fehérjeszint-csökkenést tapasztaltunk a nem-gyulladt területhez viszonyítva. Az immunfluoreszcens festés mindhárom csoportban igazolta az iAP és a TLR4 epithelialis kompartmenten belüli ko-lokalizációját. Következtetés: Vizsgálataink szerint az IBD-s gyermekek gyulladt colon mucosájában az iAP-szint csökkent. Ez a változás magasabb TLR4-expresszióval és fokozott LPS-aktivitással járhat, amely a gyulladásos folyamatot erősítheti
Virchows Archiv, Sep 4, 2014
Celiac disease (CD) is a chronic autoimmune enteropathy caused by exposure to dietary gluten in g... more Celiac disease (CD) is a chronic autoimmune enteropathy caused by exposure to dietary gluten in genetically predisposed individuals. The transcription factor peroxisome proliferator-activated receptor gamma (PPARγ) was shown to exert protective effects in several immune-mediated disorders. Activation of PPARγ suppressed the expression of thymic stromal lymphopoietin (TSLP), an inducer of proinflammatory cytokines. Since the role of TSLP in gluten-sensitive enteropathy is completely unknown, we investigated the involvement of TSLP and its regulator PPARγ in childhood CD. We collected duodenal biopsy specimens from 19 children with newly diagnosed CD, 6 children with treated CD (gluten-free diet, GFD), and 10 controls. Expression of mRNA and protein levels of PPARγ, TSLP, and TSLP receptor were determined by real-time RT-PCR and Western blot, respectively. Duodenal localization of PPARγ and TSLP was studied by immunohistochemistry. In duodenal mucosa of children with CD, the amount of PPARγ was significantly lower and simultaneously that of TSLP significantly higher compared to controls (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). In GFD-treated patients, the levels of PPARγ mRNA and protein were significantly higher while that of TSLP markedly lower compared to newly diagnosed CD (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Immunohistochemistry revealed PPARγ and TSLP expression in lamina propria immune cells and in enterocytes. Low expression of PPARγ and high expression of TSLP in the duodenal mucosa of children with newly diagnosed CD suggest that they are involved in the pathophysiology of CD. We hypothesize that PPARγ may be an inhibitory regulator of TSLP-stimulated inflammatory processes in CD.
Magyar onkologia, Dec 1, 2009
Gastrointestinal tumors are highly ranked regarding tumoral mortality worldwide. The development ... more Gastrointestinal tumors are highly ranked regarding tumoral mortality worldwide. The development and progression of gastrointestinal (GI) diseases go hand in hand with the changes of tight junctions (TJ). Claudins (CLDN) are the main TJ proteins, showing different expression by the different tissues, with the expressed CLDN profile being representative. I. We explored the changes of CLDN expression in Barrett&amp;amp;amp;amp;amp;amp;amp;#39;s esophagus and related adenocarcinoma. CLDN2 and -3 expression in Barrett&amp;amp;amp;amp;amp;amp;amp;#39;s esophagus was higher than in normal foveolar epithelium. Adenocarcinoma showed higher CLDN2 and -3 expression compared with normal and Barrett&amp;amp;amp;amp;amp;amp;amp;#39;s epithelia. The similar CLDN expression profile of Barrett&amp;amp;amp;amp;amp;amp;amp;#39;s esophagus and adenocarcinoma supports their sequential development. II. Gastric intestinal metaplasia showed higher expression of CLDN2, -3 and -4 as compared with normal antral foveolar mucosa. Tumors of small and large bowels exhibited higher CLDN2 expression when compared with normal epithelia. Colorectal adenoma and adenocarcinoma could not be differentiated according to their CLDN profile. Intestinal metaplasias of Barrett&amp;amp;amp;amp;amp;amp;amp;#39;s esophagus and stomach show similar CLDN profile to small bowel epithelium. III. Studies on duodenal mucosa in celiac disease in childhood demonstrated CLDN2 and -3 expression to be higher than in normal mucosa. The expression was significantly higher in the distal part of the duodenum samples. This and the serious histological findings suggest that the distal duodenum is more adequate for biopsy testing. IV. Beside the epithelial cells, mesenchymal tumors express intercellular junctional proteins. Expression of claudins in gastrointestinal stromal tumors (GIST) and other mesenchymal neoplasia was also studied. The CLDN profile was found to be representative to the individual tumor. GIST, angiosarcoma, hemangioma, leiomyosarcoma and leiomyoma showed expression of various CLDNs. CLDN2 was detected in all entities. CLDN1, however, was found positive in leiomyosarcoma only. Leiomyoma, on the other hand, expressed only CLDN2. GISTs and leiomyosarcomas showed CLDN2, -3, -4, -5 and -7-expression. The angiogenic tumors revealed CLDN2 and -5 expression. The similar CLDN profile observable in GIST and leiomyosarcoma is suggestive of a histogenetic relationship. Smooth muscle and vessel tumors of different dignity could also be separated from each other based on CLDN profile.
Journal of Pediatric Gastroenterology and Nutrition, 2011
The American Journal of Surgical Pathology, May 1, 2003
Gastrointestinal stromal tumors (GISTs), the specific KITpositive mesenchymal tumors of the gastr... more Gastrointestinal stromal tumors (GISTs), the specific KITpositive mesenchymal tumors of the gastrointestinal tract, have been sporadically reported in the rectum, but there are few clinicopathologic series. In this study we analyzed the clinicopathologic features of 133 anorectal GISTs, 3 intramural leiomyomas (LMs), and 8 leiomyosarcomas (LMSs) from the files of the Armed Forces Institute of Pathology and the Haartman Institute of the University of Helsinki. Ninety-six GISTs were documented as KIT-positive and three additional ones as CD34-positive. Thirty-four tumors were included by their histologic similarity to KIT-or CD34-positive cases. GISTspecific c-kit gene mutations, mostly in exon 11, were documented in 18 of 29 cases (62%). The GISTs occurred in adults with the age range of 17-90 years (median 60 years) with a significant male predominance (71%). The tumors ranged from small asymptomatic intramural nodules to large masses that bulged into pelvis causing pain, rectal bleeding, or obstruction. They were mostly highly cellular spindle cell tumors; four tumors had an epithelioid morphology. The tumors coexpressed CD34 and KIT and were rarely positive for smooth muscle actin or desmin and never for S-100 protein. Seventy percent of patients with tumors >5 cm with more than 5 mitoses/50 high power fields (HPF) (n ס 31) died of disease, whereas only one tumor <2 cm with <5 mitoses/50 HPF (n ס 21) recurred and none caused death. Long latency was common between primary operation and recurrences and metastases; either one occurred in 60 of 111 patients with follow-up (54%). Distant metastases were in the liver, bones, and lungs. Three benign actin-and desmin-positive and KIT-negative intramural LMs, similar to those seen in the esophagus, were identified. There were eight LMSs, six of which formed a polypoid intraluminal mass and were actin-positive and KIT-negative. Despite high mitotic counts, only one LMS patient died of disease. A great majority of rectal smooth muscle and stromal tumors are GISTs, which have a spectrum from minimal indolent tumors to overt sarcomas. Intramural LMs are exceptional, and true LMSs are rare, and similar to colonic ones, often present as intraluminal polypoid masses that appear to have a better prognosis than GISTs with similar mitotic rates.
Orvosi Hetilap, Sep 1, 2012
Az intestinalis alkalikus foszfatáz enzim alapvető fontosságú a bélnyálkahártya épségének fenntar... more Az intestinalis alkalikus foszfatáz enzim alapvető fontosságú a bélnyálkahártya épségének fenntartásában, mivel detoxifi kálni képes a lipopoliszacharidot, amely a Toll-like receptor-4 ligandja. A helytelen immunválasz, valamint a mucosalis barrier sérülése hozzájárulhat a gyulladásos bélbetegség és a coeliakia kialakulásához. Gyulladásos bélbetegségben szenvedő gyermekek gyulladt vastagbél-és újonnan diagnosztizált coeliakiás gyermekek duodenumnyálkahártyájában a csökkent intestinalis alkalikus foszfatáz és a Toll-like receptor-4 fehérjeexpresszió emelkedése következményesen fokozott lipopoliszacharid-aktivitással járhat, amely a szövetkárosító folyamatokat erősítheti. Az intestinalis alkalikus foszfatáz aktivitásának elősegítése colitises állatmodellben és terápiarezisztens colitis ulcerosás felnőtt betegekben csökkentette a bélgyulladás tüneteit. Ennek megfelelően a két vizsgált kórképben az enzim célzott intestinalis bejuttatása kiegészítő terápiás konzekvenciával is járhat a jövőben.
Orvosi Hetilap, Mar 1, 2008
A duodenumra lokalizált Crohn-betegség az összes Crohn-betegség kb. 0,5–4%-át teszi ki. Leggyakor... more A duodenumra lokalizált Crohn-betegség az összes Crohn-betegség kb. 0,5–4%-át teszi ki. Leggyakoribb tünete a gyomorürülési zavar és a jelentős fogyás. Az endoszkópos biopszia eredménye gyakran bizonytalan, ami megnehezíti az egyéb benignus szűkületektől való elkülönítését. A műtétet igénylő megbetegedés kezelése tekintetében a betegséggel foglalkozó európai konszenzusos nyilatkozat sem ad pontos irányelveket. Beteganyag: Eredménytelen konzervatív kezelés miatt a Semmelweis Egyetem I. Sebészeti Klinikáján 2002–2007 között három betegnél a gyomorürülési panasz megoldására műtétre volt szükség. Mindegyik betegnek a műtét előtt jelentős súlyvesztése (13–30 kg) volt. Két esetben sikerült a gyulladt bélszakasz eltávolítása a duodenum parciális reszekciójával, és az emésztőtraktus Billroth-II. szerint végzett rekonstrukciójával, egy esetben a leszálló duodenum érintettsége miatt csak bypassműtétre (gastro-jejunostomia) nyílt lehetőség. Eredmények: A betegek a műtét óta eltelt 45/24/9 hónap óta panaszmentesek, műtét előtti súlyukat visszanyerték. Sem korai, sem késői szövődményt nem észleltünk. Következtetések: A konzervatív kezelésre tartósan nem reagáló, szűkületet okozó duodenalis Crohn-betegség műtéti javallatot képez, azonban a fennálló malnutritio a műtét előtt kezelést igényel. A műtét típusa előre nem tervezhető, a kellően előkészített patkóbél-Crohn-beteg gyógyhajlama nem rosszabb, mint egyéb lokalizációjú sorstársaié.
Clinical case reports, 2017
Small-cell neuroendocrine carcinoma is a high-grade carcinoma rarely encountered in extra-pulmona... more Small-cell neuroendocrine carcinoma is a high-grade carcinoma rarely encountered in extra-pulmonary sites. A 40-year-old lady presented with epigastric pain and was noted to have an ulcerated small-cell neuroendocrine carcinoma in her duodenum with liver metastases. She underwent palliative chemotherapy but unfortunately passed away. Duodenal SCNC is an unusual malignancy with an aggressive phenotype.
Orvosi hetilap, Jan 23, 2005
The authors review a case of a 24-year-old male patient hospitalised for repeated acute abdominal... more The authors review a case of a 24-year-old male patient hospitalised for repeated acute abdominal symptoms. His medical history included no diseases worth of mentioning. By imaging techniques (abdominal US and CT scan) a cystic lesion, measuring 40 x 35 x 30 mm in diameter was found, and was diagnosed as pseudocyst in the region of the tail of the pancreas. Jejunal feeding was introduced. The lesion did not improve and the second CT scan suggested a suspicion of pancreatic cystadenoma. Three months after first presentation the surgical resection was performed. The tumour, however, was found independent of the pancreas (90 x 80 x 50 mm). Both histologically and immunohistochemically the lesion proved to be the metastasis of a germ cell (yolk-sac) tumour. Following the morphological diagnosis, detailed urological and medical check up was performed. A previously nonpalpable small tumour was found in the left testis which was radically resected. The testicular tumour measuring 9 x 9 x 5...