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Comparison of long-term outcome between patients aged 〈 65 years vs. ≥ 65 years after atrial fibrillation ablation

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Journal of Geriatric Cardiology 2017年第9期14卷 569-574页

作者： Zsuzsanna Kis Anna ME Noten Mihran Martirosyan Astrid A Hendriks Rohit Bhagwandien tamas Szili-Torok Department of Cardiology Erasmus MC University Medical Center Rotterdam the Netherlands

Background Atrial fibrillation （AF） is the most frequent arrhythmia, and its prevalence is increasing with aging. We aimed to com-pare the long-term outcome data of patients 〈 65 years vs.≥ 65 years who underwent catheter ablation （CA） for drug-refractory AF. MethodsConsecutive patients with primary pulmonary vein isolation performed between March 2001 and December 2011, and those who completeda five-year of follow-up were divided into two groups： patients aged 〈 65 years into group 1, and patients aged ≥ 65 into group 2. Long-termoutcome data concerning mortality, thromboembolic events （TE） and success rates were compared between these groups. Results A totalnumber of 390 patients were included, group 1 contained 310 patients, and 80 patients in group 2. In group 2, patients had more often impairedrenal function （P 〈 0.001） and thyroid disease （P = 0.047）. A total of fifteen patients died during the 6.63 ± 2.1 years of follow-up, with a sig-nificantly higher incidence in the older group （8/80 vs. 7/310 patients, P = 0.004）. The majority of fatal outcome was due to cancerous dis-eases in both groups. No difference was observed concerning the long-term TE rate （12/310 vs. 4/80 patients, P = 0.75）. Rhythm controlfailed in 25.9% of the patients, with no difference between the groups： 26.4% in group 1 vs. 23.7% in group 2 （P = 0,67）, ConclusionsDespite growing prevalence of AF in aging population, the elderly patients are underrepresented in CA procedures. Similar clinical successand TE complication rate are observed between the age-groups. Our data suggest more liberal criteria might be applied while selecting pa-tients for AF ablation.

关键词： Atrial fibrillation Catheter ablation Clinical outcome The elderly Thromboembolic complication

Staging of portal hypertension and portosystemic shunts using dynamic nuclear medicine investigations

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World Journal of Gastroenterology 2008年第24期14卷 3841-3848页

作者： Mircea Dragoteanu Ioan A Balea Liliana A Dina Cecilia D Piglesan Ioana Grigorescu Stefan tamas Sabin O Cotul Department of Nuclear Medicine "ProfessorDr. Octavian Fodor" Clinical Emergency Hospital Resident doctor in nuclear medicine "ProfessorDr. Octavian Fodor" Clinical Emergency Hospital Department of Internal Medicine "ProfessorDr. Octavian Fodor" Clinical Emergency Hospital

AIM： To explore portal hypertension and portosystemic shunts and to stage chronic liver disease （CLD） based on the pathophysiology of portal hemodynamics. METHODS： Per-rectal portal scintigraphy （PRPS） was performed on 312 patients with CLD and liver angioscintigraphy （LAS） on 231 of them. The control group included 25 healthy subjects. We developed a new model of PRPS interpretation by introducing two new parameters, the liver transit time （LTT） and the circu-lation time between right heart and liver （RHLT）. LTT for each lobe was used to evaluate the early portal hypertension. RHLT is useful in cirrhosis to detect liver areas missing portal inflow. We calculated the classical per-rectal portal shunt index （PRSI） at PRPS and the hepatic perfusion index （HPI） at LAS. RESULTS： The normal LTT value was 24 ± 1 s. Abnormal LTT had PPV = 100% for CLD. Twenty-seven noncirrhotic patients had LTT increased up to 35 s （median 27 s）. RHLT （42 ± 1 s） was not related to liver disease. Cirrhosis could be excluded in all patients with PRSI 〈 5% （P 〈 0.01）. PRSI 〉 30% had PPV = 100% for cirrhosis. Based on PRPS and LAS we propose the classification of CLD in 5 hemodynamic stages. Stage 0 is normal （LTT = 24 s, PRSI 〈 5%）. In stage 1, LTT is increased, while PRSI remains normal. In stage 2, LTT is decreased between 16 s and 23 s, whereas PRSI is increased between 5% and 10%. In stage 3, PRSI is increased to 10%-30%, and LTT becomes undetectable by PRPS due to the portosystemic shunts. Stage 4 includes the patients with PRSI 〉 30%. RHLT and HPI were used to subtype stage 4. In our study stage 0 had NPV = 100% for CLD, stage 1 had PPV = 100% for non-cirrhotic CLD, stages 2 and 3 represented the transition from chronic hepatitis to cirrhosis, stage 4 had PPV = 100% for cirrhosis. CONCLUSION： LTT allows the detection of early portal hypertension and of opening of transhepatic shunts. PRSI is useful in CLD with extrahepatic portosystemic shunts. Our hemodynamic model stages the evolution

关键词： Chronic liver disease Portal hypertension Portosystemic shunts Per-rectal portal scintigraphy Angioscintigraphy

Evaluation of Mixing Efficiency in Coagulation-Flocculation Process in Wastewater Treatment

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Journal of Environmental Science and Engineering(A) 2012年第7期1卷 898-903页

作者： tamas Karches Department of Sanitary and Environmental Engineering Budapest University of Technology and Economics (BME) BudapestH-1111 Hungary

Fluid flow and mixing phenomenon have a significant impact on coagulation and flocculation processes. Particles dissipating the turbulent kinetic energy increase the efficiency of collision, grow in size and incorporate phosphate from the wastewater Only certain flocks can be separated depending on their stability, size, density, etc.. According to the literature the velocity gradient of the flow （G-value） is the main design parameter of the flocculators, but there is a need to take into account at least the flocks age, too. In this paper, it presents a novel approach to determine the efficiency of flocculators using local mean age theory, residence time distribution and dimensional analysis. Calculations were performed for two constructions of cascade reactors---one with small baffles and one without these; hydraulical performance and the achievable conversion were compared. As a result, the flocculator with small baffles proved to be more efficient than the traditional construction.

关键词： Flocculation kinetics fluid dynamics G-value local mean age wastewater treatment.

Expression of anti-Mullerian hormone receptor on the appendix testis in connection with urological disorders

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Asian Journal of Andrology 2013年第3期15卷 400-403页

作者： Kornel Kistamas Olga Ruzsnavszky Andrea Telek Livia Kosztka Ilona Kovacs Beatrix Dienes Laszlo Csernoch tamas Jozsa Department of Physiology Medical and Health Science Center University of Debrecen Debrecen 4032 Hungary Department of Pathology Kenezy Gyula Hospital Debrecen 4032 Hungary Department of Pediatrics Medical and Health Science Center University of Debrecen Debrecen 4032 Hungary Department of Pediatric Surgery Division of Urology Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm SE-171 76 Sweden

The female internal sex organs develop from the paramesonephric （Mullerian） duct. In male embryos, the regression of the Mullerian duct is caused by the anti-Mullerian hormone （AMH）, which plays an important role in the process of testicular descent. The physiological remnant of the Mullerian duct in males is the appendix testis （AT）. In our previous study, we presented evidence for the decreased incidence of AT in cryptorchidism with intraoperative surgery. In this report, the expression of the anti-Mullerian hormone receptor type 2 （AMHR2）, the specific receptor of AMH, on the AT was investigated in connection with different urological disorders, such as hernia inguinalis, torsion of AT, cysta epididymis, varicocele, hydrocele testis and various forms of undescended testis. The correlation between the age of the patients and the expression of the AMHR2 was also examined. Reverse transcriptase-polymerase chain reaction （RT-PCR） and immunohistochemistry were used to detect the receptor＇s mRNA and protein levels, respectively. We demonstrate that AMHR2 is expressed in the ATs. Additionally, the presence of this receptor was proven at the mRNA and protein levels. The expression pattern of the receptor correlated with neither the examined urological disorders nor the age of the patients; therefore, the function of the AT remains obscure.

关键词： anti-Mullerian hormone receptor (AMHR) appendixtestis (AT) hernia inguinal is retention testis testicular descent testisretractile

Territorial Governance in Flux： A Case of the City-Regions in England

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Journalism and Mass Communication 2018年第2期8卷 68-87页

作者： tamas Kaiser National University of Public Service Budapest Hungary

Answers to challenges in a changing environment highlight the need to work with a more flexible sense of geography, developing institutional reforms in delivering public services. The emerging city regions in England can be regarded as a prime test of what the need for optimal territorial scope and enhanced coordination needs. The aim of this paper is to examine the emerging new forms of territorial governance in the light of the ＂piecemeal＂ approach of reforms launched by the post-2010 Conservative Liberal Government. We argue that the creation of city-regions is an organic part of the new territorial paradigm; an important element of which is an integrated and functional approach that intersects public administrative borders. Since 2010, the uniformed regional model has been replaced by primarily ad hoc, informal, and flexible approaches. The successive governments placed the bigger cities and its hinterland at the centre of English devolution, but wished to implement them in varying forms of ＂deal-making＂ as a means of decentralization, encouraging solutions tailored to local requirements and opportunities, and retaining the fundamental characteristics of the ＂asymmetrical devolution＂. However, in terms of regional governance, the relationship between the new and old regional configurations has seen the creation of a much-debated, malleable framework which, during the process of Brexit could generate new, further interpretations, narratives, and practical solutions

关键词： English devolution city-region devolution deal metro-mayor territorial governance

A case of interstitial pneumonitis in a patient with ulcerative colitis treated with azathioprine

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World Journal of Gastroenterology 2007年第2期13卷 316-319页

作者： Ferenc Nagy tamas Molnar Eva Makula Ildiko Kiss Peter Milassin Eva Zollei Laszlo Tiszlavicz Janos Lonovics First Department of Medicine University of Szeged Faculty of Medicine Szeged Hungary Department of Radiology University of Szeged Faculty of Medicine Szeged Hungary Medical Intensive Care Unit University of Szeged Faculty of Medicine Szeged Hungary Institute of Pathology University of Szeged Faculty of Medicine Szeged Hungary

The early hypersensitivity reaction and late bone marrow depression are well-known side-effects of azathioprine, whereas interstitial pneumonia is a rare complication. A 40-year old male patient had been treated with azathioprine in consequence of extensive ulcerative colitis for 10 years. He then complained of 7 d of fever, cough and catarrhal signs, without symptoms of active colitis. Opportunistic infections were ruled out. The chest X-ray, CT and lung biopsy demonstrated the presence of interstitial inflammation. Azathioprine therapy was discontinued as a potential source of the pulmonary infiltrate. In response to steroid therapy, and intensive care, the pulmonary infiltrate gradually decreased within 4 wk. Three months later, his ulcerative colitis relapsed, and ileo-anal pouch surgery was performed. In cases of atypical pneumonia, without a proven infection, azathioprine-associated interstitial pneumonitis may be present, which heals after withdrawal of the drug.

关键词： Inflammatory bowel disease Ulcerative colitis Azathioprine Interstitial pneumonitis

Diversification Dilemmas in Turkey’s Natural Gas Imports

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Asian Journal of Middle Eastern and Islamic Studies 2017年第2期11卷 90-106,I0007页

作者： tamas KOZMA University of Pecs&Antall Jozsef Knowledge Centre Hungary

Due to the fact that Turkey does not possess hydrocarbon resources,it largely depends on imports from other ***,energy security and energy diversification issues are of key importance in Turkish foreign ***,the energy nexus is an important organizing principle in Turkish foreign *** article limits itself to focus on the diversification attempts in terms of source countries from where natural gas is being imported to *** diversification in case of Turkey might be analyzed in a dual ***,Turkey is highly interested in diversifying its own energy􀃼or specifically natural *** the moment,Turkey meets nearly 58%of its total natural gas consumption from Russian gas *** are aspirations to alter this energy status quo and geopolitical dynamics,by exploring further partnership opportunities to initiate imports of natural gas potentially from Israel,Qatar and other ***,given the geostrategic location of the country,Turkey is a highly important actor in the energy diversification endeavors of the European Union,as it is considered as potential transit country of natural gas from third *** it is completed,the TANAP natural gas pipeline might become a pivotal component of European energy security and could further integrate Turkey in international energy *** the moment,the lack of adequate infrastructure is a hurdle to the diversification of Turkey’s natural gas *** construction of new pipelines needs complex multiparty agreements;moreover,examples from the past prove that pipeline projects might get easily *** another possibility into account,investments in LNG capacities require very high ***,this article argues that despite the aspirations,the inclusion of new countries and thus significant changes in Turkey’s current natural gas imports are rather likely to happen in the long run.

关键词： Energy Security Energy Diversification Natural Gas Turkey Pipeline

Special nanostructures in Al-Mg alloys subjected to high pressure torsion

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Transactions of Nonferrous Metals Society of China 2010年第11期20卷 2051-2056页

作者：刘满平 Hans J.ROVEN 刘新涛 Maxim MURASHKIN Ruslan Z.VALIEV tamas UNGáR Levente BALOGH National Engineering Research Center of Light Alloy Net Forming Shanghai Jiao Tong University Department of Materials Science and Engineering Norwegian University of Science and Technology Institute of Physics of Advanced Materials Ufa State Aviation Technical University Department of Materials Physics Etvs University

Deformation twins and stacking faults were observed in nanostructure A1-Mg alloys subjected to high pressure torsion. These observations are surprising because deformation twinnings have never been observed in their coarse-grained counterparts under normal conditions. Experimental evidences are introduced on non-equilibrium grain boundaries, deformation twinnings and partial dislocation emissions from grain boundaries. Some of these features can be explained by the results reported from molecular-dynamics simulations of pure FCC metals. Special emphasis is laid on the recent observations of high density hexagonal and rhombic shaped nanostructures with an average size of 3 nm in the A1-Mg alloys processed by high pressure torsion. A possible formation process of these nanostructures is proposed based on molecular-dynamics simulations.

关键词： aluminum alloys severe plastic deformation high pressure torsion grain boundary structure deformation twinning nanostructures

Impact of tumour histological subtype on chemotherapy outcome in advanced oesophageal cancer

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World Journal of Gastrointestinal Oncology 2017年第8期9卷 333-340页

作者： Michael Davidson Ian Chau David Cunningham Komel Khabra Timothy Iveson tamas Hickish Matthew Seymour Naureen Starling Royal Marsden Hospital NHS Foundation Trust London and Surrey Southampton University Hospital NHS Trust and Salisbury Hospital NHS Foundation Trust Department of Haematology and Oncology Bournemouth University and Poole Hospital NHS Trust St James’s Institute of Oncology St James’s Hospital

To investigate the impact of histology on outcome in advanced oesophageal cancer treated with first-line fluoropyrimidine-based chemotherapy. METHODSIndividual patient data were pooled from three randomised phase III trials of fluoropyrimidine-based chemotherapy ± platinum/anthracycline in patients with advanced, untreated gastroesophageal adenocarcinoma or squamous cell carcinoma (SCC) randomised between 1994 and 2005. The primary endpoint was overall survival of oesophageal cancer patients according to histology. Secondary endpoints were response rates and a toxicity composite endpoint. RESULTSOf the total 1836 randomised patients, 973 patients (53%) were eligible (707 patients with gastric cancer were excluded), 841 (86%) had adenocarcinoma and 132 (14%) had SCC. There was no significant difference in survival between patients with adenocarcinoma and SCC, with median overall survivals of 9.5 mo vs 7.6 mo (HR = 0.85, 95%CI: 0.70-1.03, P = 0.09) and one-year survivals of 38.8% vs 28.2% respectively. The overall response rate to chemotherapy was 44% for adenocarcinoma vs 33% for SCC (P = 0.01). There was no difference in the frequency of the toxicity composite endpoint between the two groups. CONCLUSIONThere was no significant difference in survival between adenocarcinoma and SCC in patients with advanced oesophageal cancer treated with fluoropyrimidine-based chemotherapy despite a trend for worse survival and less chemo-sensitivity in SCC. Tolerance to treatment was similar in both groups. This analysis highlights the unmet need for SCC-specific studies in advanced oesophageal cancer and will aid in the design of future trials of targeted agents.

关键词： Oesophageal cancer Adenocarcinoma Chemotherapy Squamous Pooled analysis