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A szabadföldi kisparcellás nehézfém terhelési tartamkísérlet beállítására 1994 őszén a Károly Róbert Főiskola Tass-pusztai Tangazdaságában (ma Magyar Agrár- és Élettudományi Egyetem, Károly Róbert Campus) került sor csernozjom barna erdőtajon. A növényi cink- és rézfelvétel vizsgálata 1996, 2001, 2002 években történt, ekkor a növények és a talaj Cu- és Zn-tartalma is meghatározásra került. A vizsgált években a jelzőnövény a kukorica (Zea mays L.), az őszi árpa (Hordeum vulgare L.), a fehér mustár (Sinapis alba L.) és a lucerna (Medicago sativa L.) volt. A növények Cu és Zn felvételét a talaj-növény transzfer koefficiensek meghatározásával értékeltük. A vizsgált nehézfémek talaj-növény transzfer koefficiensének ismeretében lehetőség van annak vizsgálatára is, hogy az „oldható” (NH4-acetát+EDTA) elemtartalom mennyiben felel meg a tényleges növényi elemfelvételnek. Ehhez meghatároztuk az egyes nehézfémek megoszlási arányának értékeit a talaj „oldható” és „összes” (cc.HNO3+cc.H2O2) elemtartalmának hányadosaként. A talaj-növény transzfer koefficiensek értékei alapján a cink mobilisabbnak mutatkozott a réznél. A cink megoszlási aránya a transzfer koefficiens értékének átlagosan 1/5-e volt. Ez azt mutatja, hogy cinkből a talajnak vannak olyan, a növények számára felvehető tartalékai, amelyek Lakanen-Erviö (1971) módszerérel nem mutathatók ki. A réz esetén a megoszlási arány és a talaj-növény transzfer koefficiens értéke nem mutatott jelentős eltérést.

Introduction: Patients with inflammatory bowel disease (IBD) have an increased risk to develop malignant neoplasms. Neither the exact mechanism, nor the frequency of different malignancies is completely clear. Our aim was to assess the IBD associated malignancies, to collect clinical and mortality data and to analyse possible risk factors. Methods: Data on malignancies developed between January 2015 and May 2019 in Hungarian IBD patients was recorded. Every member of the Hungarian Society of Gastroenterology was prospectively interviewed. The following data were collected: demographic data, disease characteristics, previous therapy, patient adherence, type and localisation of malignancies. Results: 140 IBD patients with newly diagnosed malignancies were reported. 61.4%, 35.7%, and 2.9% of the patients had ulcerative colitis (UC), Crohn’s disease (CD) and indeterminate colitis, respectively. The mean latency was 15.2±10.5 years. Colorectal cancer (CRC) was the most common cancer (49.6%, 70). 72.9% (51/70) of them was associated with UC, more than 80% had extensive (50.9%, 26) and left-sided (31.2%, 16) colitis. The most frequent CRC localisation was the rectosigmoid colon in UC (54.9%), and the rectum in CD (38.9%). The most common non-CRC malignancies were non-melanotic skin-cancer, haematological and pulmonary cancer. Disease duration at the time of the diagnosis of malignancy was lower (17.9±10.7 versus 12.6±9.7 years); mean age at the time of the death was higher (49.3±9.4 versus 64.3±16.4 years); and survival was longer after the diagnosis of extraintestinal malignancy than CRC (0.73±1.01 versus 1.2±0.8). Summary: CRC presented typically in the distal part of the colon by male UC patients with pancolitis or left-sided colitis with a long-standing disease course of IBD. The most common non-CRC malignancies were non-melanotic skin cancer, haematological cancer and lung cancer. Non-CRC malignancies developed typically in female patients, older than CRC patients with shorter disease-course of IBD and longer survival times.

Hungary as a state of the CEE region tries to reconcile the realities of its energy sector built up during the Communist period with EU requirements of free-market principles and the interconnected internal market. Recent changes in this sector included strong state intervention, enhanced competences for regulatory authority, some deprioritization of free market principles, and the plan to build new nuclear reactors in the Paks 2 project. The Court of Justice of the European Union (CJEU) concluded that the standing rights of interested parties regarding networks, energy and environmental sectors needs to be broadened. At the same time the Paks 2 project and sector-specific measures have also been challenged before the CJEU, which might have a substantial impact on Hungary’s energy policy in the future.

Az időjárás szerepe a termés mennyiségére és minőségére ősidőktől fogva ismert. Napjainkban a gazdálkodóknak meg kell tanulniuk ezekkel az extrém időjárási események együtt élni és ellenük a lehető legjobb technológia alkalmazásával védekezni. Jelen munkámban azt mutatom be, hogy az időjárási hatások az utóbbi évtizedekben felerősödtek, hatásaik a mai - a termés mennyiségre és minőségre érzékeny - korban felértékelődtek. A dolgozatban több éves adatsorok elemzésével azt mutatom be, hogy az extrém időjárási események gyakran ciklikusan visszatérnek és az extrémitásuk fokozódásával hatásaik többéves vegetációs ciklusokra kihatnak jelentősen befolyásolva ezzel a termőhelyen kialakult termés nagyságát és minőségét.

We present a clinical, neuro-radiological and genetic study on a family with members suffering from an autosomal dominantly inherited syndrome characterised by epilepsy, cerebral calcifications and cysts, bone abnormalities; progressive neuro-cognitive deterioration and paranasal sinusitis. This syndrome shares several features with leukoencephalopathy with calcifications and cysts also called Labrune syndrome and the condition of cerebroretinal microangiopathy with calcifications and cysts (CRMCC; Coats plus syndrome). Genetic studies in this family did not reveal mutations in the CTC1 gene defected in CRMCC. We interpret our results as those supporting recent findings that despite clinical similarities, late-onset Labrune and Coats plus syndrome might be distinct entities. This family may have Labrune syndrome or a yet unclassified entity; exploration of similar cases could help classifying this one, and related conditions.

The response of the European Union to the financial crises included the establishment of bodies dedicated to macroprudential as well as microprudential supervision called European System of Financial Supervisors. As result of the reform regulatory powers have been delegated to sector-specific European Supervisory Authorities in charge of microprudential supervision. The delegation could contravene the Lisbon primary law, especially the related case law followed by the Court of Justice of the European Union as the so-called Meroni doctrine restricts the delegation of concrete binding decision-making powers on European agencies like ESAs. However their power to issue individual decisions, addressed to financial institutions, could be considered as required tool in crisis management which makes it obvious that the primary EU law on European agencies needs to be clarified and broadened.

Palliative treatment of malignant gastroduodenal obstructions with enteral stents is an effective and safe method, and a viable alternative to gastroenterostomy.The authors present the most common malignancies behind gastroduodenal obstructions, the aspects of stent selections, insertion techniques, technical and clinical success rates, and possible procedure-related complications.Between 1 March, 2013 and 9 April, 2015 nineteen patients were treated with uncovered, self-expandable enteral stents. Out of the 19 patients, 6 were females and 13 males, with an average age of 67 years. Indications of stenting were peripyloric ventricular tumour in five cases, malignancies of the duodenum, gastroenteralis anastomosis, Vater papilla and gallbladder in one case respectively, pancreatic tumor in seven cases and bile duct malignancies in three cases.The technical success rate of stent placement was 100%. The evaluation of clinical success was analised on the basis of the Gastric Outlet Obstruction Scoring System.The use of enteral stents in malignant gastroduodenal obstructions is a reliable and safe method, which promptly decreases symptoms of the patients and improves their quality of life.

Introduction Environmental pollution is placing and ever-increasing load on various environmental resources, including soil. There are increasing interest in potentially toxic microelements and hazards related to heavy metals and environmental pollution (Szab6-Fodor 1998, Fodor 2000). The loading threshold values for soils is a function of the soil properties (pH, soil organic matter content, clay content, type of clay materials, etc.) (Kaddr-Morvai 1998, Fodor 2002). There are no universal solvents or methods that provide a satisfactory characterization of the exchangeable or plant available fractions of all harmful materials in various soil types. At the present time, the total content is used to estimate the level of microelement contamination (Fodor-Szabo 2003). As most microelements and heavy metals are strongly bonded to soil particles (minerals and oxides), the total content does not indicate the actual availability and/or mobility of elements. From physiological, ecological and hazard aspect, the more soluble fractions are more important (Fodor 1998, Fodor-Szabo 2003, Kadar et al. 2000). Our objective was to follow the changes of mobility of various microelements after heavy application rates to the soil.

Resume Tout comme les autres maladies auto-immunes systemiques, la polyarthrite rhumatoide peut impliquer plusieurs autres organes avec des manifestations immunologiques complexes. Le purpura thrombocytopenique auto-immun cause par une reaction auto-immune contre les plaquettes est une complication hematologique rare. Chez une patiente atteinte de polyarthrite rhumatoide, un purpura thrombocytopenique auto-immun est apparu rapidement a la suite de l’abandon de la corticotherapie orale. L’atteinte de la muqueuse du caecum, du colon ascendant et de l’antre du pylore etait compliquee par le saignement d’un polype gastrique au nadir de la crise de thrombopenie. L’hemorragie a ete prise en charge par une intervention endoscopique et en deux jours la numeration plaquettaire s’est amelioree avec une corticotherapie a forte dose.

Rheumatoid arthritis, in common with other systemic autoimmune diseases, can involve several other organs presenting with complex immunological manifestations. Immune thrombocytopenic purpura caused by an autoimmune reaction against platelets is an infrequent haematological complications. A female patient with rheumatoid arthritis rapidly developed extremely severe immune thrombocytopenic purpura upon suspending oral corticosteroid therapy. Besides the involvement of the mucosa of the coecum, ascending colon and the gastric antrum, the situation was further complicated by bleeding of a gastric polyp, at the nadir of the thrombocytopenic crisis. The bleeding was managed by endoscopic intervention and platelet count recovered upon high dose corticosteroid treatment within a couple of days.

OBJECTIVE. Patients with celiac disease, who often carry human leukocyte antigen-DR3;DQ2, are prone to inadequate response to hepatitis B immunization. We evaluated vaccine response in relation to disease activity and whether previous treatment with a gluten-free diet influences the achievement of protective antibody titers. PATIENTS AND METHODS. We studied 128 children and adolescents with celiac disease and 113 age-matched control subjects. Twenty-two patients with celiac disease were prospectively immunized after diagnosis during dietary treatment (group 1). A total of 106 (group 2) and the control subjects received vaccination by mass immunization in schools at 14 years of age regardless of diet status and when celiac disease was still undiagnosed in 27 of these children. Diet compliance and celiac disease activity were monitored by measurement of antibodies against transglutaminase and endomysium. Vaccine response was determined by measuring antihepatitis B antibodies from serum. RESULTS. The seroconversion after hepatitis B vaccination was 95.5% in group 1. All of these patients carried human leukocyte antigen DQ2. The response rate in group 2 was 50.9% and correlated with gluten intake (untreated patients: 25.9%, non-strict diet: 44.4%, strict diet: 61.4%). Treated and compliant patients did not significantly differ from control subjects (75.2%). Thirty-seven antihepatitis B–negative patients with celiac disease received a booster during a controlled gluten-free diet, and 36 (97.3%) seroconverted, irrespective of the presence of human leukocyte antigen DQ2. CONCLUSIONS. Nonresponse to recombinant hepatitis B surface antigen may be a sign of undiagnosed celiac disease. However, there is a good vaccine response in adequately treated patients. Human leukocyte antigen DQ alleles do not seem to have a primary role. Revaccination is recommended during a controlled gluten-free diet.

The stricture of the anastomosis is one of the most common complications of the subtotal esophageal resections. The authors present indications, technics and results of the endoscopic dilatation.In a 10 year period 26 patients (22 male, 4 female, mean age of 53.7 years) with stricture of anastomosis between the esophagus and the neo-esophagus after subtotal esophageal resection were dilated endoscopically 82 times. The indication of the resection was tumour in 23 (88.5%) cases, congenital atresia in 2 (7.7%) cases and corrosive disease in one (3.8%) case. In 7 (31.8%) cases the stricture developed after anastomosis leakage. The mean time between the operation and the dilatation was 7.8 months. The cause of the stricture was cancer recurrency in 4 (15.4%) cases.There were no complications related to the dilatation. The mean number of the dilatation was 3.2 (1-9). There was no significant difference between the number of dilatation in patients with or without previously anastomotic leakage. The success rate of the dilatation for benign strictures was 95.5%. In only one patient (4.5%) was needed operative intervention. In the 4 patients with tumour recurrency a stent was also implanted in the stenosis.The endoscopic dilatation for the treatment of the cervical anastomosis stricture after subtotal esophageal resection is a successful method with a low rate of complications. In cases of tumour recurrency a stent implantation is suggested.

Stromal tumors of the gastrointestinal tract are rare mesenchymal neoplasms. The majority of them are appearing in the stomach: their quite common first manifestation is bleeding. The authors report a case of polypoid gastric GIST causing severe bleeding which needed urgent surgical intervention and partial resection of the stomach. Although histological analysis of the tumor revealed low proliferation rate, the urgent operation did not result in a complete eradication of the neoplasm, thereby our patient needs further follow-up and treatment.

Of patients with malignant esophageal tumors, more than the half has incurable disease at the time of diagnosis. In such cases, quality of life and ability to swallow should be improved or restored by palliating the process e.g. by inserting esophageal stents. In the recent years, use of covered self-expandable metal stents (SEMS) has led to an increased success rate in the palliative treatment of--mainly malignant--strictures of the esophagus. High occurrence of complications (perforation, bleeding) associated with the use of rigid plastic esophageal stents necessitated the development of flexible stents. First generation self-expandable stents were made of special metal alloys, such as nickel-titanium. In the recent years, self-expandable plastic stents are available, too, offering new alternatives in the palliative treatment of esophageal diseases. In our present review article, we discuss the most important aspects about the use of self-expanding esophageal stents, based on recent clinical observations and data.

Since its recent introduction, capsule endoscopy has revolutionized the diagnostics of diseases of the small bowel. The number of studies on the use of this method is constantly increasing. Along with this, our knowledge about the usability and diagnostic power of capsule endoscopy is growing and the indications for this technique are getting progressively more accurate.To study the usability of capsule endoscopy in suspected Crohn's disease, in gastrointestinal bleeding of small bowel origin, and in undetermined abdominal complains.Capsule endoscopy was performed in 20, previously examined, carefully selected patients.Positive findings were recorded in all patients with gastrointestinal bleeding and in 3/4 of patients with suspected Crohn's disease. However, in patients with indeterminate abdominal complains, the capsule endoscopy proved to be inefficient.In the study below, based on their own experience, the authors try to provide an overall picture of capsule endoscopy by reviewing contemporary medical literature. The usability of the capsule endoscopy in suspected Crohn's disease and gastrointestinal bleeding of small bowel origin is suggested by the results of the study.

Az ENSZ keretein belül elfogadott Aarhusi Egyezmény (a továbbiakban: Egyezmény) a környezeti ügyekben az információhoz való hozzáférésről, a nyilvánosságnak a döntéshozatalban történő részvételéről és az igazságszolgáltatáshoz való jogbiztosításáról rendelkezik. Vegyes egyezményként olyan nemzetközi megállapodás, amelynek a tagállamok mellett az Európai Unió (akkor Európai Közösség) is részes fele, így annak követelményei az Unió jogának részét képezik. Az utóbbi években az Európai Unió Bírósága (a továbbiakban: EUB) aktivista felfogást követve több döntésében is kinyilvánította, hogy az Egyezmény eljárási követelményeinek széleskörű érvényesülését a tagállami bíróságoknak biztosítaniuk kell. Szlovákia különösen érintett az EUB megállapításai révén. A „szlovák barnamedvék” (C-240/09. sz.)ügyben hozott ítéletével az EUB nem ismerte ugyan el, hogy a civil szervezetek közvetlenül hivatkozhatnának az Egyezmény azon rendelkezésére, amely elvárja az igazságszolgáltatáshoz való hozzáférés tág értelemben vett biztosítását. Ugyanakkor a tagállami bíróságok egyezménykonform jogértelmezési kötelezettségét általános jelleggel fektette le ebben az ügyben a luxemburgi esetjog, ami több, e régióbeli tagállam jogalkalmazására is kihatott. Ezt követően pedig a „szlovák szarvasok” (C-243/15. sz.) ügyben (amely a szakirodalomban gyakran LZ II. ügyként, illetve szlovák barnamedvék II. ügyként is szerepel) hozott legújabb ítéletében az EUB ismét az eddigi (kiterjesztő) megközelítését követte. Eszerint ugyanis az igazságszolgáltatáshoz való széles körű hozzáférés aarhusi követelménye akkor teljesül, ha a fellépni kívánó civil szervezetek ügyféli minőségéről azelőtt születik jogerős döntés, hogy az alapeljárás jogerősen lezárulna. A címben említett tagállami eljárási autonómia bár elméletileg máig érvényesül, az EUB aarhusi ítéletei egyértelműen jelzik, hogy a luxemburgi esetjog azt egyre inkább visszaszorítja. E gyakorlat tükrében persze kérdéses, hogy az említett uniós bírósági gyakorlat csak a környezetvédelmi ágazatra vonatkozik-e, vagy egyre inkább általános követelményként kell-e ezekre a tagállami bírónak tekintenie. Célom az Egyezmény aláírásának 20. évfordulóján annak bemutatása, hogy ez az aktivista hozzáállás milyen típusú ügyekben merült fel egy olyan szomszédos államban, ahol az EUB több esetben is állást foglalt már az aarhusi követelmények értelmezését illetően, valamint annak vizsgálata, hogy ezek az esetjogi megállapítások mennyiben kaphattak határokon átívelő jelentőséget. Ugyanis a korábbi ítélet több régióbeli tagállam ítélkezésében is hivatkozási alapként tűnt fel, így ezen ítéletek Magyarországon is külön figyelemre tarthatnak számot.