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Introduction: Left common pulmonary vein is the most common anatomical variant of pulmonary veins that may affect the outcome of pulmonary vein isolation., Objective: Our aim was to compare procedural data and outcomes in patients with common trunk versus normal left atrial anatomy for radiofrequency and cryoballoon catheter ablation., Method: Data from patients who underwent pulmonary vein isolation for atrial fibrillation and had a preprocedural cardiac CT scan at our Institution between 01. 10. 2019 and 10. 03. 2022 were retrospectively evaluated. We defined a common trunk where the left superior and inferior pulmonary vein merged at least 5 mm before the left atrial ostium., Results: From the study population (n = 210), data from 42 patients with a left common trunk (LCPV group) and 60 patients with normal left atrial anatomy (control group) were examined. No significant differences were found between the common trunk and the control group in terms of demographic data. There was no significant difference between the two groups in procedural data for radiofrequency and cryoballoon ablation (procedure time, fluoroscopy time, left atrial dwelling time, radiation dose). After radiofrequency ablation, the success rate at 1-year follow-up was 72.0% in the common trunk group and 76.2% in the control group (p = 0.659). For cryoballoon ablation, the success rate was 64.7% and 69.2% for common trunk and normal anatomy, respectively (p = 0.641)., Conclusion: There was no significant difference in the procedural parameters and clinical outcome between patients with left common pulmonary vein and those with normal left atrial anatomy. Both radiofrequency and cryoballoon ablation techniques are well suited for this population. Orv Hetil. 2023; 164(4): 140-147.

Background and Purpose: Pre-surgical functional MRI (fMRI) is an important modality of examinations before brain surgery. There are several artefacts (e.g. motion, susceptibility) which may hinder the evaluation of fMRI data. Physiological artefacts (breathing, pulsation) also affect the sensitivity and specificity of anatomical localization. The aim of this study is to demonstrate the efficiency of physiological artefact identification and removal methods for presurgical evaluation., Methods: Siemens Magnetom Verio 3T MRI scanner was used to collect data. The physiological parameters (breathing, pulse) were recorded with the MRI system's built-in devices. Data from fourteen patients - with primary brain tumour - were evaluated with SPM12 utilizing the RETROICOR/RVHR tool to detect and decrease the effect of physiological artefacts. We compared the statistical maps obtained with and without the physiological correction using the Jaccard similarity coefficient, and ROI analyses., Results: Significant differences were found in the mean ROI values (p<0.0016) and the extensions of eloquent activations (p<0.0013), when using the physiological correction (RETORICOR/RVHR) based on convolution method. On the other hand, no significant differences were found between the ROIs' standard deviations (F=0.28). The RETROICOR/ RVHR method helps to define the precise localisation of eloquent areas (p<0.009). The number of irrelevant (non-significant) voxels were increased (p<0.001). ., Conclusion: Minimising of physiological artefacts in fMRI data calculations, the (RETROICOR/RVHR) method based on convolution has been successfully adapted. This algorithm could be helpful before neurosurgical intervention. The activity pattern became more reliable.

Introduction: CO 2 laser- assisted sclerectomy surgery (CLASS) can be used for the surgical treatment of open-angle glaucoma., Aim: To introduce our results with CLASS., Method: We performed 21 CLASS operations using OT-134-IOPtiMate (IOPtima Ltd, Ramat-Gan, Israel). Patients were examined on the 1st day, and in the 1st, 3rd, 6th, 9th and 12th months postoperatively. We evaluated intraocular pressure (IOP), antiglaucomatous medication-use, visual acuity, complications., Results: Mean age was 65.6 yrs. Complete success (no hypotensive medication required to target IOP) was achieved in 61.1% (18 patients) at 6 months, whereas in 50% (10 patients) at 12 months. Qualified success (hypotensive medication required to target IOP) was achieved in 72.2% and in 70%, preoperative mean IOP was 29.2 ± 9.4 Hgmm, which falled to 17.7 ± 4.9 Hgmm and 17.3 ± 4.3 Hgmm, respectively. Antiglaucomatous medication use falled significantly from 2.90 ± 0.83 to 2.05 ± 1.46. Apart from 1 macroperforation, no serious complication occurred., Conclusions: With CLASS it is possible to effectively lower intraocular pressure in open-angle glaucoma. Orv Hetil. 2017; 158(18): 701-705.

Introduction: The prevalence of morbid obesity and its co-morbidities - first of all diabetes type 2 - increased dramatically in the last decades. As the conservative ways of treatment (diet, training, etc.) in most cases does not lead to effective and long term weight loss, there is an increasing need for the metabolic surgical interventions., Method: During the last 6 and half years 514 laparoscopic RouxY gastric bypass (LRYGB) and 54 laparoscopic gastric sleeve resection (LGSR) were performed in our department. The data of random selected 40 patients after primary LRYGB and 15 patients after sleeve resection were collected. The applied criteria of the indication for surgery, the routine examinations and treatments before and after the intervention, the results and the type and the rate of the complications will be presented., Results: According to our experience both procedures are long term effective for weight loss and for the resolution of co-morbidities, and can be performed with low risk of complications. After LRYGB more effective weight loss (extra weight loss 88% vs. 68%) and higher rate of resolution of diabetes type 2, hypertension and gastro-esophageal reflux were found compared to sleeve resection., Conclusion: Based on our results we prefer LRYGB. Gastric sleeve resection is indicated by us, when there is no way - or only with high risk - to perform gastric bypass, taking into consideration of course the individual requirements of the patients.

Introduction: the aim of this study was to examine and to understand the experience of voice hearing, the meaning and participants' relationship with their voices. And also to explore what 'recovery' means in this context, and the role of self-help group., Method: six semi-structured interviews were conducted and analyzed using interpretative phenomenological analysis (IPA). Emerging themes were identified and clustered into master themes, then interpreted., Subjects: 6 (3 females, 3 males) voice hearers, recovering from psychosis., Results: Analysis resulted in four master themes to represent the key points of life story interviews; the role of voices (first master theme), relationship with voices (second master theme); asymmetric and symmetric relational concept, position of voices (outside or inside). The third and fourth master theme refer to the role of self-help group, and the method applied by the group., Conclusion: applying self-help group in clinical context contributes to better outcomes in treatment of voice hearers.

Unlabelled: The authors report the validation process of the cardiac module of the Pediatric Quality of Life Inventory (PedsQL ) into Hungarian., Background: The PedsQL which is a modular instrument to evaluate health-related quality of life (HRQL ) in children and adolescents of ages 2-18 years, comes up to the current professional requirements at a high level. There is no report on health-related quality of life measure in Hungary which was performed among children with heart disease., Objective: To adapt and to test a pediatric quality of life questionnaire for measuring HRQL in children with heart disease., Methods: Sequential validation process which follows international guidelines. Pilot-study on 105 children with heart disease., Results: According to the results of the pilot-study the psychic domains have a negative influence on general HRQL index in both child and parent-proxy reports in all age groups. On the cardiac module parents of children of all age groups but only children of ages 5-7 years reported marked treatment anxiety. Cognitive and communication problems are mainly important for children of ages 8-18 years. Parent-child concordance is depending on the age of the child, there was expressed difference in the psychosocial domains. We have found no negative effect of heart operation on HRQL by itself but taking medicine may impair it., Conclusion: Further methodologic research should evaluate the psychometric properties of the newly validated Hungarian version of the PedsQL cardiac module. The detailed report about the validation process can help in the spreading of patient reported outcome measures in Hungary.

Because of the long waiting time for pediatric liver transplantation, new techniques of liver transplantation were invented. Split and living-donor related liver transplantation are common today and the Kaplan-Meier (3 years) overall survival is over 80%. By splitting the liver, two recipients can be transplanted. In general, the left lobe is used for the pediatric, the right lobe for the adult recipient. There are a lot of combinations depending on the donor and recipient weight. The accepted liver volume is approx. 1% of the recipient body weight. The results of the Hungarian pediatric program improve, 27 transplantations were done using 14 partial liver grafts and living donor program was started. Using strict protocols and improving surgical skills, the overall pediatric survival was over 80% in the last 5 years.

Goals: A prospective multicenter study to treat non-small cell lung cancer (NSCLC) with inductive chemoradiotherapy for improving chances of operability. If used as first-line therapy, combined treatment improves survival and it is well tolerated with a low rate of side effects., Patients: 42 patients with stage IIIA-B NSCLC from which 36 could be followed., Methods: A full dose Taxotere-Cisplatin chemotherapy was given to patients with concurrent radiotherapy in 2 Gy fractions up to 60 Gy via conformal irradiation., Results: Local response was very high and 40.47% of patients became operable while in inoperable cases consolidation chemotherapy showed similar results as other protocols. We also found a low rate of side effects. The high rate of brain metastasis suggests that prophylactic cranial irradiation (PCI) should be considered.

The discovery of a new human herpesvirus in Kaposi's sarcoma tissues of AIDS patients has opened up new facts in virology and oncology. This herpesvirus was first descriptively named Kaposi's sarcoma-associated herpesvirus, but was recently renamed human herpesvirus 8. Human herpesvirus 8 DNA has been consequently found in all forms of Kaposi's sarcoma, suggesting that it might be involved in the pathogenesis of the disease. Additionally, human herpesvirus 8 can be detected in both malignant and benign lymphoproliferative diseases, such as body-cavity-based B-cell lymphomas and multicentric Castleman disease. The virus was also recently found in rare vascular tumors in patients with angiosarcoma of the face and angiolymphoid hyperplasia with eosinophilia. Although only a limited portion of the viral DNA has been sequenced, it has become evident that the new herpesvirus is equipped with genes that could confer oncogenic potential. The virus can now be cultured, providing the possibility for studies of viral replication and the mode of transmission, and also for the development of serologic tests.

Basic food allergens (bread, milk and egg) were investigated in patients with idiopathic chronic urticaria. In 29 of 43 patients, sensitivity could be shown against one or more antigens. The results suggest not only the anaphylactic IgE-mediated reaction in same patients, but also an antibody or cell-mediated mechanisms in the development of the disease. Besides the Prick test, therefore, testing of other circulating antibodies by means of the ELISA technique and the leukocyte migration test is recommended to establish the causative agents in patients with chronic urticaria.

Results obtained with the immunoblot technique and indirect immunofluorescence on the specific circulating autoantibodies in 20 patients with bullous pemphigoid and in 15 patients with pemphigus vulgaris were compared. In 17 of the 20 patients with bullous pemphigoid, autoantibodies against the 230 kD major antigen could be demonstrated, and in 9 of these 17 patients more specific autoantibodies against "salt-split" epidermis antigen (220, 180, 130, 100 and 75 kD) were shown. Indirect immunofluorescence were positive only on the sera of 5 of the 20 patients with bullous pemphigoid. The sera of 11 of the 15 patients with pemphigus vulgaris yielded autoantibodies against specific antigen (130 and 85 kD protein). To summarize the results, the immunoblot technique is an excellent method to demonstrate circulating autoantibodies in patients with autoimmune bullous skin diseases and its sensitivity is better than that of the indirect immunofluorescence, procedure. Moreover, it gives a possibility to differentiate among different clinical types.

The detection and typing analysis of human papillomavirus (HPV) were carried out by means of BIOHIT in situ HPV DNA hybridization screening and typing kits in condyloma tissues of patients with genital condyloma acuminatum, in cytological smears of their asymptomatic female consorts, and in female patients with vulval condyloma acuminatum. "Low"-risk HPV 6 and HPV 11 were demonstrated most frequently in the condyloma tissues of the male patients. It is noteworthy that all but one female consorts carried similar HPV type(s) in their cervical smears to those of their sexual partners in condyloma tissues. "Medium" and "high"-risk HPV 18, 31 and 33 types (frequently associated with high-grade dysplastic lesions and carcinomas) were demonstrated more frequently in female condylomas than in male. These three HPV types were identified in both tissues in a female patient with condyloma acuminatum and carcinoma epidermoids cornescens.

Antibodies against ENA (Extractable Nuclear Antigens), SSA/Ro and SSB/La were investigated in parallel in the serum and the immune complex precipitates of 41 patients with autoimmune disease (10 systemic lupus erythematosus, 23 discoid lupus erythematosus, 3 subacute cutaneous lupus erythematosus, and 5 progressive systemic sclerosis). It was demonstrated that in some cases the autoantibody spectrum of the serum did not coincide with that of the immune complex precipitate. In the majority of patients the protein content of isolated immune complexes was increased and the increase was attributed to IgG solely. In some patients antibodies appeared not only in the serum but also in immune complex, even in 4 patients (2 systemic lupus erythematosus, 1 subacute cutaneous lupus erythematosus, and 1 progressive systemic sclerosis) antibodies were detected only in the immune complex precipitate.

Ouchterlony immunodiffusion and ELISA were used for the detection of antimitochondrial antibodies. The results were compared with those of immunofluorescence measurements. The occurrence of antimitochondrial antibodies was investigated in 20 patients with primary biliary cirrhosis, in 30 with autoimmune disease and in 28 with porphyria cutanea tarda. Sonicated rat liver mitochondria fractions were used as antigens. Among the patients with primary biliary cirrhosis, Ouchterlony immunodiffusion revealed antimitochondrial antibodies in 18 cases, whereas antibodies were not found in the other groups of patients, except for 1 case of systemic lupus erythematodes. ELISA demonstrated that in all 20 patients with primary biliary cirrhosis where immunofluorescence revealed antimitochondrial antibodies, there was an increase in the quantity of antibodies against mitochondrial inner membrane fractions, and in 7 cases even against the outer membrane fractions. These 7 were the most serious cases clinically. These methods allow the differentiation of antimitochondrial antibody subtypes and promote the establishment of the diagnosis.