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Magyar Onkológia
Authors: József Tímár, Miklós Kásler, Alexandra Heringh, Miklós Soós, Dóra Mathiász, Anna Romány, Adrienn Józsa, László Szilák, Tamás Forrai, László Patthy, and Gábor Kovács

A fejlesztés 3. évében 8 új molekuláris diagnosztikai szolgáltatást fejlesztett ki a Konzorcium az emlőrák, vastagbélrák, tüdőrák, GIST és melanoma prognosztikája és predikciója számára. A kutatási periódusban 2 szabadalmat jelentett be új típusú mitogén/motogén jelpálya-módosításra. Emberi daganatok preklinikai modelljein az eritropoetin erekre gyakorolt hatásainak funkcionális képalkotó vizsgálatokkal történő mérését dolgozta ki. Humán melanoma modelleken a szisztémás progresszió genomikai jellemzőit határozta meg.

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Orvosi Hetilap
Authors: Róbert Jaskó, Endre Horváth, Anna Szilágyi, and Áron Altorjay

Zinzani, P. L., Quaglino, P., Pimpinelli, N. és mtsai: Prognostic Factors in Primery Cutaneous B-Cell Lymphoma: The Italian Study Group for Cutaneous Lymphomas. J. Clin. Oncol., 2006, 24

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Orvosi Hetilap
Authors: Béla Kajtár and Hajna Losonczy

Hallek, M.: New concepts in the pathogenesis, diagnosis, prognostic factors and clinical presentation of chronic lymphocytic leukemia. Rev. Clin. Exp. Hematol., 2000, 4 , 101

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After a short explanatory Introduction, an immunotherapy protocol is presented for glioblastoma multiforme (GBM). GBM is considered to be an incurable tumor; tumor-free survival over 2 to 3 years is so rare that when it happens the original diagnosis is questioned. It is known that the type of the genetic mutation that a given GBM tumor harbors strongly influences the length of survival. However, most patients with GBM are receiving treatment without the preparation of a microarray gene map of their tumors. It is possible that the reason for a rare and exceptional long survival was not the treatment that the patient received, but the type of gene mutations that the tumor was exposed to. It is recognized that any therapeutic approach should ideally be evaluated against the background of all prognostic factors of each individual case, prominent among them the microarray gene map of the tumor. In practice, this is not easily achieved, while the patient is in need of, and is expecting, prompt therapy. Insurance companies do not reimburse the patient, or the clinical investigators, or their institutions for investigational diagnostic tests, or such treatment modalities. A temporary compromise is possible. The emergence of empirically administered treatment modalities with extraordinary efficacy has occasionally been recorded in the history of medical oncology. In some of these rare clinical trials, the control groups were discontinued (to the dismay of the statisticians), and the control patients were enrolled in the treatment groups so to escape doom and share the benefit of the unfolding high remission inductions experienced in the treatment group. Chemo-radiotherapy of Hodgkin's disease and cisplatin therapy of certain testicular carcinomas provided the first éclat examples. More recently, the rapidly approved and marketed imitanib mesylate for Ph-chromosome-positive chronic myelogenous leukemia and the anti-HER2/neu monoclonal antibody trastuzumab, and the not yet marketed double tyrosine kinase (ErbB1/2) inhibitor lapatinib (Tykerb, GlaxoSmithKline) for a subgroup of breast carcinoma patients excelled. Thus, a clinical trial for GBM, but without precise pre-identification of all its prognostic factors, however with a great deal of evidence-based empirical expectations of benefits, for patients with rapid advancement toward a fatal outcome, implying an element of urgency, appears to be justified.

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Bevezetés: Napjaink klinikai kutatásainak egyik fő iránya a megbetegedések hátterében álló kockázati tényezők azonosítása. Közlemények százai számolnak be „szignifikáns” és „független” prognosztikai faktorokról különböző humán megbetegedésekben, azonban ezek egy részében nem vagy nem megfelelően vizsgálták, hogy az új prognosztikai faktor javította-e, és ha igen, milyen mértékben az addig ismert prognosztikai modellt. A legújabb statisztikai módszertani ajánlások szerint az úgynevezett reklasszifikációs analízissel a fenti kérdést érdemben vizsgálni lehet. Célkitűzés: A reklasszifikációs analízis kivitelezésére több módszer is van, a közleményben a szerzők ezek alkalmazását saját, korábban publikált vizsgálataik újraelemzésével mutatják be. Módszer: Két marker, a vörösvértestátmérő-eloszlás szélessége és a szérum-hősokkfehérje-70 prognosztikai szerepét vizsgálták krónikus szívelégtelenségben szenvedő betegek körében. Korábban publikált eredményeik szerint mind a vörösvértestátmérő-eloszlás szélessége, mind a hősokkfehérje-70 szignifikáns, független prognosztikai markernek bizonyult többváltozós Cox-regressziós vizsgálatok alapján. Mindkét esetben újraértékelték a markerek szerepét reklasszifikációs tesztekkel. Eredmények: A szívelégtelen betegek prognosztikai modelljének diszkriminatív képessége lényegesen javult a korábbi modellhez képest, ha a vörösvértestátmérő-eloszlás szélességével egészítették ki a modellt, míg a hősokkfehérje-70 esetén ez nem volt egyértelmű. Következtetések: Az új prognosztikai faktorokat kritikusan kell kezelni mindaddig, míg alkalmas vizsgálatokkal elemzésre és bizonyításra nem kerül, mekkora a valós klinikai haszon, amely a marker már ismert prognosztikai modellhez való hozzáadásából származik. A hasznosságot a prognosztikai modell javulása során tesztelhetjük a reklasszifikáció módszereivel. Orv. Hetil., 2013, 154, 1374–1380.

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Tissue level myocardial perfusion is one of the most important prognostic factors after successful recanalisation of the occluded coronary artery in patients suffering acute ST elevation myocardial infarction (STEMI). The primary objective of the present study was to examine the relationship between videodensitometric myocardial perfusion parameters as assessed on coronary angiograms directly following successful recanalization therapy and magnetic resonance imaging (MRI)-derived myocardial tissue loss late after STEMI. The study comprised 29 STEMI patients. Videodensitometric parameter Gmax/Tmax was calculated to characterize myocardial perfusion, derived from the plateau of grey-level intensity (Gmax), divided by the time-to-peak intensity (Tmax). Myocardial loss index (MLI) was assessed by cardiac MRI following 376 ± 254 days after PCI. Results: Signifcant correlations could be demonstrated between MLI and Gmax (r = 0.36, p = 0.05) and Gmax/Tmax (r = 0.40, p = 0.03) using vessel masking. Using receiver operating characteristic curve analysis, Gmax/Tmax < 2.17 predicted best MLI = 0.3, 0.4, 0.5 and 0.6 with good sensitivity and specifcity data, while Gmax/Tmax < 3.25 proved to have a prognostic role in the prediction of MLI = 0.7. Conclusions: Selective myocardial tissue level perfusion quantitative measurement method is feasible and can serve as a good predictor of myocardial tissue loss following STEMI and revascularization therapy.

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Sudden cardiac death (SCD) remains the leading cause of death in industrialized world. The majority of SCD is caused by ventricular fibrillation associated with structural and/or ischemic heart disease. Ventricular fibrillation represents the final common pathway for SCD and, thus, is an attractive target for ablation. According to class I recommendation level of evidence A, an implantable cardioverter defibrillator (ICD) should be implanted for such patients [1]. Other than programmed electrical extrastimulus technique, isoproterenol infusion is commonly used in invasive cardiac electrophysiology labs for arrhythmia induction. We hereby report a rare case of transient coronary spasm during isoproterenol infusion for ventricular tachycardia induction testing.disorder is very rare and usually appears in middle aged patients. It is a clinical diagnosis. It could cause a variety of symptoms, especially, acute appendicitis and unidentified lesion in the right iliac fossa. According to the reasons, it could be just a curiosity without any relevancy or the sign of a malignant lesion with bad prognostic factors. The histopathological findings prove the origin.

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The Crimean-Congo hemorrhagic fever (CCHF) virus (CCHFV) is a tick-borne virus, whose viral RNA consists of S, L, and M segments. The virus is migrating through the ticks with animals and migratory birds and the geographical distribution can be investigated based on genetic analysis. To better understand the connection between the seropositivity and the mortality rate, the key factor could be the temporal and spatial analysis of the different strains. In this study, serum samples (n = 26) were selected from CCHFV RNA-positive patients and subjected to sequence analysis of the gene regions encoding the S segments. According to the neighbor-joining analysis, the obtained partial sequences were linked to the European strain. The strains were closely related to Turkey-Kelkit06, Turkey 200310849 viruses, and viruses from Russia and Kosovo. The comparison with previously analyzed isolates from the GenBank showed 95%–99% sequence similarity. The isolates in phylogenetic branches were divided into two groups. AST, platelet, and APTT levels were found significantly higher in Group 2 compared to Group 1. Nucleotide differences can be prognostic factor in CCHF disease. Increasing CCHF cases not originating from local isolates were circulating strains imported from different neighboring countries of Turkey. The results show new evidence to the emerging threat of the CCHF disease.

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Acta Veterinaria Hungarica
Authors: L. Kóbori, T. Németh, B. Nemes, G. Dallos, P. Sótonyi Jr., I. Fehérvári, A. Patonai, M. J. H. Slooff, J. Járay, and K. P. De Jong

Hepatic artery thrombosis is a major cause of graft failure in liver transplantation. Use of donor interponates are common, but results are controversial because of necrosis or thrombosis after rejection. Reperfusion injury, hypoxia and free radical production determinate the survival. The aim of the study was to create an 'ideal' arterial interponate. Autologous, tubular graft lined with mesothelial cells, prepared from the posterior rectus fascia sheath, was used for iliac artery replacement in eight mongrel dogs for six months under immunosuppression. Patency rate was followed by Doppler ultrasound. Eight grafts remained patent and another two are patent after one year. The patency rate was good (median Doppler flow: 370 cm/sec) and there was no necrosis, thrombosis or aneurysmatic formation. The grafts showed viable morphology with neoangiogenesis, appearance of elastin, smooth muscle and endothelial cells. Electron microscopy showed intact mitochondrial structures without signs of hypoxia. Tissue oxygenation was good in all cases with normal (< 30 ng/ml) myeloperoxidase production. In conclusion, this autologous graft presents good long-term patency rate. Viability, arterialisation and low thrombogenicity are prognostic factors indicating usability of the graft in the clinical practice without the risk of rejection. Further investigations such as cell cultures and standardisation are necessary.

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Acta Veterinaria Hungarica
Authors: Izabela Janus, Marcin Nowak, Agnieszka Noszczyk-Nowak, Rafał Ciaputa, Małgorzata Kandefer-Gola, Urszula Pasławska, Rafał Sapierzyński, Wojciech Łopuszyński, and Iwona Otrocka-Domagała

Primary heart tumours affect less than 1% of dogs. Due to their rare incidence, every research showing the frequency of cardiac tumours is valuable. Routine diagnostics is often complemented with immunohistochemical analysis. This study was conducted on 110 patient records from all veterinary faculties in Poland from dogs diagnosed with heart tumours between 1970 and 2014. The dogs’ age, breed and sex with tumour localisation and histopathological diagnosis were analysed. Because of its most common incidence, samples of haemangiosarcoma underwent further examination with assessment of the expression of cell markers that have not been evaluated earlier (i.e. minichromosome maintenance proteins and beta-catenin). We noted 111 tumours including 88.3% malignant and 10.8% benign ones. Haemangiosarcoma and aortic body tumour were the most frequent cardiac neoplasms in the dogs examined (45.9% and 27.9% of all tumours, respectively). Immunohistochemical analysis of haemangiosarcoma showed a positive expression of all markers examined. CD31, vimentin, and beta-catenin showed a positive reaction in all 11 samples examined. At least one proliferative marker (Ki-67, MCM-3 or MCM-7) showed a positive reaction in each sample. MCM-3 showed a higher expression than the two other proliferative markers (P = 0.006), but only Ki-67 showed a positive correlation with the mitotic index (P > 0.05, r = 0.89). Although beta-catenin, MCM-3 and MCM-7 showed a positive reaction in the haemangiosarcomas examined, their usefulness as diagnostic and prognostic factors should be a topic of further research.

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