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World Journal of Gastroenterology 2005年第13期11卷 2039-2040页

作者： zsolt barta Zsofia Miltenyi Laszlo Toth Arpad Illes 3rd Department of Medicine Department of Pathology

The case of a 22-year-old patient with symptomatic hypokalemia caused by rhabdomyolysis is presented as a rarely reported complication of gluten-sensitive enteropathy (GSE) and dermatitis herpetiformis Duhring. The patient's myopathy ceased on potassium supplementation and her other complaints resolved while on gluten-free *** was otherwise uneventful with a rapid decline in serum CPK level. At the time of her last follow-up a few months later, she was free of symptoms and CPK remained stable. Patients with GSE may present with hypokalemia in association with diarrhea and emesis, and if potassium loss is rapid, rhabdomyolysis may occur.

关键词： Gluten-sensitive enteropathy Hypokalemia RhabdomyolysisAbstract

Pulse cyclophosphamide therapy for inflammatory bowel disease

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World Journal of Gastroenterology 2006年第8期12卷 1278-1280页

作者： zsolt barta László Tóth Margit Zeher 3~(rd) Department of Medicine Faculty of MedicineMedical and Health Science CentreUniversity of DebrecenDebrecenHungary Department of Pathology Faculty of MedicineMedical and Health Science CentreUniversity of DebrecenDebrecenHungary

AIM:To assess the efficacy of intravenous cyclophos-phamide pulse therapy for refractory inflammatory boweldisease(IBD).METHODS:We included in our cohort eight patientswith(moderate/severe)steroid refractory IBD(4 withulcerative colitis and 4 with Crohn's disease).They allreceived 6 cycles of intravenous cyclophosphamide(800mg)per ***:Patients entered into remission after the sec-ond/third cyclophosphamide *** activity *** were no side effects and *** thepatients went into long lasting *** Crohn's diseasepatients and 3 of 4 ulcerative colitis patients achievedcomplete *** patient with ulcerative colitisshowed an impressive clinical response but did not enterinto *** the maintenance,patients with Crohn'sdisease were treated with methotrexate(15 mg/wk)andpatients with ulcerative colitis were treated with azathio-prine(2.5 mg/kg body weight/d).CONCLUSION:Remission was maintained in all pa-tients for 6 mo on the *** drug was well *** findings suggest that aggressive immuno-suppressive therapy may be useful in some refractorypatients and further controlled study should be consid-ered in order to fully evaluate this type of treatment as apotential therapy for IBD.

关键词： Crohn's disease Ulcerative colitis Cyclophos-phamide

Successful use of adalimumab for treating fistulizing Crohn's disease with pyoderma gangrenosum:Two birds with one stone

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World Journal of Gastroenterology 2009年第18期15卷 2293-2295页

作者： Eva Zold Arpad Nagy Katalin Devenyi Margit Zeher zsolt barta Division of Clinical Immunology 3rd Department of MedicineMedical and Health Science CenterUniversity of DebrecenDebrecen 4004Hungary Euromedic Diagnostics Szeged Kft Debrecen 4004Hungary

Crohn＇s disease （CD） is a chronic relapsing and remitting autoinflammatory disorder of the gastrointestinal tract that has many intestinal and extraintestinal complications. The purpose of treatment is long-term remission, reduction of complications, and improvement of patients＇ quality of life. In many cases, this can be quite challenging and it is necessary to have a well thought out management strategy. We present the case of a 38-year-old woman with fistulizing CD that manifested as diffuse abdominal pain and bloody diarrhea accompanied by arthralgia. In addition, there were ulcerative lesions surrounded by cutaneous inflammation and erythema on her extremities, indicative of pyoderma gangrenosum. The patient was treated with high doses of parenteral methylprednisolone without any improvement and was started on adalimumab. A positive response to adalimumab therapy was observed： after 2 mo of therapy, the ulcerative skin lesion healed completely and the enterogastric fistula was closed affcer 5 mo adalimumab treatment. Adalimumab might be a suitable initial as well as maintenance therapy in patients with complicated CD.

关键词： Adalimumab Crohn's disease Pyoderma gangrenosum

Celiac disease and microscopic colitis:A report of 4 cases

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World Journal of Gastroenterology 2011年第16期17卷 2150-2154页

作者： zsolt barta Eva Zold Arpad Nagy Margit Zeher Istvan Csipo 3rd Department of Medicine Institute for Internal MedicineMedical and Health Science CenterUniversity of Debrecen

Celiac disease (CD) is an autoimmune disorder of the small intestine that occurs in genetically predisposed people at all ***,it can be associated also to other immunopathological disorders,and may be associated with abnormal histology in segments of the gut other than the small bowel including colonic *** guidelines for endoscopic investigation of the jejunum are well defined,no indication is defined for colonic *** describe four cases of concurrent CD and microscopic colitis (MC) diagnosed at our department over a 10-year period and analyzed the main features and outcomes of CD in this *** symptoms of these patients were improved initially by a gluten-free diet before the onset of MC *** of the patients were siblings and had an atypical form of *** other two patients with CD and MC also presented with fibrosing alveolitis and were anti-Saccharomyces cerevisiae antibody *** co-existence of immune-mediated small bowel and colonic inflammatory and pulmonary diseases are not well-known,and no systematic approach has been used to identify the lifelong patterns of these immune-based *** can develop,or present with CD at any stage in life,which can co-exist with other gastrointestinal diseases of (auto-) immune *** addition,the fa-milial co-existence and prevalence of MC in patients with a prior diagnosis of CD are *** managing celiac disease should be aware of these associations and understand when to consider colon investigation.

关键词： Collagen colitis Lymphocytic colitis Celiac disease Fibrosing alveolitis Anti-saccharomyces cerevisiae antibody

Seroreactivity against Saccharomyces cerevisiae in patients with Crohn's disease and celiac disease

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World Journal of Gastroenterology 2003年第10期9卷 2308-2312页

作者： zsolt barta István Csíp■ Gábor G.Szabó Gyula Szegedi 3~(nd) Department of Medicine University of DebrecenMóricz Zs.Krt.22.4004 DebrecenHungary

AIM:To explore whether there was anti-Saccharomyces cerevisiae antibodies (ASCA) positivity in our patients with biopsy-confirmed celiac disease. METHODS:A cohort of patients with inflammatory bowel diseases (42 patients with Crohn's disease and 10 patients with ulcerative colitis) and gluten sensitive enteropathy (16 patients) from Debrecen,Hungary were enrolled in the study. The diagnosis was made using the formally accepted criteria. Perinuclear antineutrophil cytoplasmic antibodies (pANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA), antiendomysium antibodies (EMA),antigliadin antibodies (AGA) and anti human tissue transglutaminase antibodies (tTGA) were investigated. RESULTS:The results showed that ASCA positivity occurred not only in Crohn's disease but also in Celiac disease and in these cases both the IgG and IgA type antibodies were proved. CONCLUSION:It is conceivable that ASCA positivity correlates with the (auto-) immune inflammation of small intestines and it is a specific marker of Crohn's disease.

关键词： Adult Antibodies, Antineutrophil Cytoplasmic Antibodies, Fungal Celiac Disease Cohort Studies Crohn Disease Female Gliadin Humans Immunoglobulin A Immunoglobulin G Male Middle Aged Saccharomyces cerevisiae Seroepidemiologic Studies

Pedigree and genetic analysis of a novel mutation carrier patient suffering from hereditary nonpolyposis colorectal cancer

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World Journal of Gastroenterology 2006年第8期12卷 1192-1197页

作者： Miklós Tanyi Judith Olasz Géza Lukács Orsolya Csuka László Tóth Zoltán Szentirmay Zsuzsa Ress zsolt barta János L Tanyi László Damjanovich 1~(st)Department of Surgery University of DebrecenMedical and Health Sciences CenterDebrecenHungary Department of Pathogenetics National Institute of OncologyBudapestHungary Department of Pathology University of DebrecenMedical and Health Sciences CenterDebrecenHungary Department of Human and Experimental Tumor Pathology National Institute of OncologyBudapestHungary 3~(rd)Department of Medicine University of DebrecenMedical and Health Sciences CenterDebrecenHungary Department of Obstetrics and Gynecology Baylor College of MedicineHoustonTXUnited States

AIM： To screen a suspected Hungarian HNPCC family to find specific mutations and to evaluate their effect on the presentation of the disease. METHODS： The family was identified by applying the Amsterdam and Bethesda Criteria. Immunohistochemistry was performed, and DNA samples isolated from tumor tissue were evaluated for microsatellite instability. The identification of possible mutations was carried out by sequencing the hMLH1 and hMSH2 genes. RESULTS： Two different mutations were observed in the index patient and in his family members. The first mutation was located in exon 7, codon 422 of hMSH2, and caused a change from Glu to STOP codon. No other report of such a mutation has been published, as far as we could find in the international databases. The second mutation was found in exon 3 codon 127 of the hMSH2 gene, resulting in Asp→Ser substitution. The second mutation was already published, as a non-pathogenic allelic variation. CONCLUSION： The pedigree analysis suggested that the newly detected nonsense mutation in exon 7 of the hMSH2 gene might be responsible for the development of colon cancers. In family members where the exon 7 mutation is not coupled with this missense mutation, colon cancer appears after the age of 40. The association of these two mutations seems to decrease the age of manifestation of the disease into the early thirties.

关键词： Hereditary nonpolyposis colon cancer Bethesda criteria Mutation hMLH1 hMSH2

Microscopic colitis: A retrospective study of clinical presentation in 53 patients

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World Journal of Gastroenterology 2005年第9期11卷 1351-1355页

作者： zsolt barta Gabriella Mekkel István Csíp(o|") László Tóth Szabolcs Szakáll Gábor G.Szabó Gyula Bakó Gyula Szegedi Margit Zeher Third Department of Medicine Department of Pathology

AIM: To evaluate the relationship between symptoms and microscopic colitis (MC) subtypes: to test whether collagenous colitis (CC) and/or lymphocytic colitis (LC)might be related to both constipation and ***: A cohort of patients with independently confirmed typical histopathological changes was investigated. Fifty-three patients with histologically proved MC (46 with CC, 7 with LC) were included. The existence of diarrhea or constipation and the co-existence of autoimmune diseases were also investigated and all data were retrospectively ***: Twenty-three (43.39%) of MC patients had chronic constipation (20 in CC, 3 in LC patients). Twentyfour(45.28%) of MC patients had autoimmune disease and the diagnosis of autoimmune disease was always prior to MC. Sjogren's syndrome was associated only with the constipation ***: The Janus face of MC resembles the subgroups of irritable bowel syndrome. The co-existence of autoimmune diseases and MC is confirmed in both the constipation and diarrhea subgroups.

关键词： Microscopic colitis Constipation Autoimmune

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World Journal of Diabetes 2021年第5期12卷 658-672页

作者： Nikolett Bódi Diána Mezei Payal Chakraborty Zita Szalai Bence Pál barta János Balázs zsolt Rázga Edit Hermesz Mária Bagyánszki Department of Physiology Anatomy and NeuroscienceFaculty of Science and InformaticsUniversity of SzegedSzeged 6726Hungary Department of Biochemistry and Molecular Biology Faculty of Science and InformaticsUniversity of SzegedSzeged 6726Hungary Department of Pathology Faculty of MedicineUniversity of SzegedSzeged 6720Hungary

BACKGROUND The importance of the neuronal microenvironment has been recently highlighted in gut region-specific diabetic enteric neuropathy. Regionally distinct thickening of endothelial basement membrane(BM) of intestinal capillaries supplying the myenteric ganglia coincide with neuronal damage in different intestinal segments. Accelerated synthesis of matrix molecules and reduced degradation of matrix components may also contribute to the imbalance of extracellular matrix dynamics resulting in BM thickening. Among the matrix degrading proteinases, matrix metalloproteinase 9(MMP9) and its tissue inhibitor(TIMP1) are essential in regulating extracellular matrix *** To evaluate the intestinal segment-specific effects of diabetes and insulin replacement on ganglionic BM thickness, MMP9 and TIMP1 *** Ten weeks after the onset of hyperglycaemia gut segments were taken from the duodenum and ileum of streptozotocin-induced diabetic, insulin-treated diabetic and sex-and age-matched control rats. The thickness of BM surrounding myenteric ganglia was measured by electron microscopic morphometry. Wholemount preparations of myenteric plexus were prepared from the different gut regions for MMP9/TIMP1 double-labelling fluorescent immunohistochemistry. Post-embedding immunogold electron microscopy was applied on ultrathin sections to evaluate the MMP9 and TIMP1 expression in myenteric ganglia and their microenvironment from different gut segments and conditions. The MMP9 and TIMP1 messenger ribonucleic acid(m RNA) level was measured by quantitative polymerase chain *** Ten weeks after the onset of hyperglycaemia, the ganglionic BM was significantly thickened in the diabetic ileum, while it remained intact in the duodenum. The immediate insulin treatment prevented the diabetes-related thickening of the BM surrounding the ileal myenteric ganglia. Quantification of particle density showed an increasing tendency for MMP9 and a decreasing tenden

关键词： Type 1 diabetes Diabetic enteric neuropathy Neuronal microenvironment Basement membrane Matrix metalloproteinase 9 Tissue inhibitor of metalloproteinase 1