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The basic structural units of the renal filtration are the glomeruli, which, in addition to their passive hemodynamic function, also participate in complex immune-mediated mechanisms. The immune system as a double-edged sword maintains the physiological homeostasis of the glomeruli, but also plays a crucial role in the induction of glomerular damage. The immune-mediated chronic glomerular injures are the most common cause of end-stage renal diseases. The unregulated and overactive immune response can damage both the structural and the cellular components of the glomeruli, including the glomerular basal membrane, mesangial and capillary endothelial cells, podocytes, and parietal epithelium. The manuscript summarizes the role of the glomerular components and the natural and adaptive immune response in the pathomechanism of glomerular diseases. Orv Hetil. 2020; 161(24): 993-1001.

International audience; Tissue diagnosis is critical in the clinical management of cancer patients. Mass Spectrometry (MS) has long been of interest for discriminating cells using tissue sections of patient biopsies. However, the main challenge arises in the context of intraoperative tissue analyses, where the MS instrument must operate within a surgical environment. To date, only the Intelligent Knife (iKnife) system allowed real-time monitoring during surgery by collecting aerosol released during tissue excision with an electric scalpel or bipolar forceps [1]. Recently we have demonstrated that in vivo real-time analyses can be less invasive using laser ablation. In our prototype, a fibered IR Optical Parametric Oscillator (OPO) is tuned at 2.94 µm to excite the most intense vibrational band (O-H stretching mode) of water molecules found abundantly in all biological tissues. Water acts as a natural endogenous Matrix-Assisted Laser Desorption-Ionization (MALDI) matrix leading to the production of ions that can be transported over a few meters to a MS instrument for analysis without requiring further post-ionization handling. The molecular patterns (metabolites, lipids and proteins) thus retrieved are specific to cell phenotypes and benign versus cancer regions can easily be differentiated [2]. We present the first assessment of our prototype in a veterinary surgery room [3]. For this purpose, a series of benchmark studies have been initiated with the aim of building up an extensive databank able to relate distinct molecular profiles to a specific type of pathology, namely the dog sarcoma. These studies are accompanied by the development of a real-time query interface. Classification models based on tumor grade (cancer/normal/necrotic) and cancer subtype developed in this work showed a minimum of ~98% correct classification when put to use. The system demonstrated clear-cut margin detection capabilities that have been validated in correlation with histology. Finally, this instrument enables real-time diagnostics by the immediate interrogation of classification models established ahead of time.

Anomalies of the corpus callosum are the most frequent malformations of the central nervous system. The triad of spontaneous periodic hypothermia and hyperhydrosis with the agenesis of corpus callosum is described as Shapiro syndrome. Shapiro syndrome is a very rare condition and it can occur in every age group. The presence of agenesis of corpus callosum is not a strict criteria of the syndrome; the most important presenting symptom is paroxysmal hypothermia. Although the definite cause of recurrent hypothermia is unknown, dysfunction of the hypothalamus is suspected. From therapeutic aspects, only supportive therapy is available. In this report the authors present the first Shapiro syndrome case diagnosed in Hungary. The main symptoms of the 21-year-old male patient were recurrent hyperhydrosis with hypothermia resulting in severe general malaise. The skull magnetic resonance imaging demonstrated agenesis of corpus callosum. The patient was treated with clonidine resulting in significant improvement of symptoms. Orv. Hetil., 2016, 157(7), 275–278.

Establishment of a proper hemodynamic monitoring system in order to achieve optimal care among critically ill patients is fundamental. In contrast to invasive patient-checking systems, which were introduced decades ago and used in both adult and pediatric intensive care, the non-invasive methods have become more popular in recent years due to technical advancements in intensive care and patient monitoring. This increase in popularity can be attributed to the higher degree of safety and reduced complication rates as well as to its being more economical. Our summary focuses on the ICONAbsztrakt: A kritikus állapotú betegek kezelésében elengedhetetlen fontosságú a hemodinamikai monitorozás. Az utóbbi években az intenzív osztályos ellátás a technika fejlődésének köszönhetően ezen a területen is egyre inkább a nem invazív irányt követi. A néhány évtizeddel ezelőtt rutinszerűen bevezetett invazív hemodinamikai monitorozás használata a gyermek intenzív, valamint egyre több helyen a felnőtt intenzív ellátásban is csökkenő tendenciát mutat. A nem invazív monitorozás elterjedésének oka a biztonságossága, szövődménymentessége mellett a költséghatékonysága is. Összefoglalónk témája az elektromos kardiometrián (electric cardiometry) alapuló ICON