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Clinical significance of granuloma in Crohn's disease

World Journal of Gastroenterology 2005年第20期11卷 3118-3121页

作者： Tamás Molnár lászló tiszlavicz Csaba Gyulai Ferenc Nagy János lonovics First Department of Medicine Faculty of Medicine University of Szeged H-6720 Szeged Korányi fasor 8. Hungary Department of Pathology Faculty of Medicine University of Szeged H-6720 Szeged Korányi fasor 8. Hungary Department of Radiology Faculty of Medicine University of Szeged H-6720 Szeged Korányi fasor 8. Hungary

AIM: Granuloma is considered the hallmark of microscopic diagnosis in Crohn's disease (CD), but granulomas can be detected in only 21-60% of CD patients. The aim of this study was to evaluate the frequency of granulomas by multiple endoscopic biopsies in patients with CD and to examine whether group of patients with or without granuloma exhibit a different clinical course. METHODS: Fifty-six patients with newly diagnosed CD were included in the study. Jejunoscopy, enteroclysis and ileo-colonoscopy were performed in all patients. At least two biopsy specimens from each examined gastrointestinal segment were examined microscopically searching granuloma. The clinical course was followed in all patients, and extraintestinal manifestations as well as details of any immunosuppressive therapy and surgical intervention were noted. RESUlTS: Granuloma was found in 44.6% of the cases (25 patients). Patients with granuloma had higher activity parameters at the time of the biopsies. Extraintestinal manifestations were observed and surgical interventions were performed more often in the granuloma group. The need of immunosuppressive therapy was significantly more frequent in the patients with granuloma. Granuloma formation is mote often seen in younger patients, and mainly in the severe, active penetrating disease. CONClUSION: The significantly higher frequency of surgical interventions and immunosuppressive therapy suggests that granuloma formation is associated with a more severe disease course during the first years of CD.

关键词： Crohn's disease Granuloma Activity Complication

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Effects of chronic and subtoxic chlorobenzenes on adrenocorticotrophic hormone release

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Journal of Environmental Sciences 2015年第8期27卷 165-170页

作者： Zsolt Molnár Regina Pálf?ldi Anna lászló Marianna Radács Krisztián Sepp Péter Hausinger lászló tiszlavicz Zsuzsanna Valkusz Márta Gálfi Institute of Applied Science Department of Environmental Biology and Education Gyula Juhász Faculty of Education University of Szeged Department of Pulmonology Faculty of Medicine University of Szeged Department of Medical Physics and Informatics Faculty of Medicine University of Szeged Endocrine Unit of First Department of Internal Medicine Faculty of Medicine University of Szeged Invasive Cardiology Department Second Department of Internal Medicine and Cardiology Faculty of Medicine University of Szeged Department of Pathology Faculty of Medicine University of Szeged

Many environmental chemicals and pesticides have been found to alter neuroendocrine communication in exposed biological objects. The environmental loads have primary and secondary effects that can alter the homeostatic regulation potential. Since it is difficult to avoid human exposition, a potentially important area of research to develop in vivo and in vitro experimental models. In this context, the primary aim of this study was to demonstrate the effects of chlorobenzenes on adrenocorticotrophic hormone（ACTH） release. In our experimental study, male Wistar rats were exposed to 0.1, 1.0 and 10 μg/b.w.（body weight） kg of 1,2,4-trichlorobenzene and hexachlorobenzene（Cl B） mix via gastric tube for 30, 60 or 90 days. At the endpoints of the experiment blood samples were taken and animals were decapitated. Primary,monolayer adenohypophysis cell cultures were prepared by enzymatic and mechanical digestion. The ACTH hormone content in serum and supernatant media was measured by immuno-chemiluminescence assay. The Mg2＋-dependent ATPase activity was determined by modified method of Martin and Dotty. Significant differences were detected in the hormone release between the control and treated groups. The hormone release was enhanced characteristically in exposed groups depending upon the dose and duration of exposure. The Mg2＋-ATPase activity enhanced after chronic and subtoxic Cl B exposition. light microscopy revealed that the adenohypophysis seemed to be more abundant. Results indicate that Wistar rats exposed to subtoxic Cl B have direct and indirect effects on hypothalamus–hypophysis–adrenal axis.

关键词： Chlorobenzenes Subtoxic Adrenocorticotrophic hormone release Mg2+ -dependent ATPase

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Effects of octreotide on acute necrotizing pancreatitis in rabbits

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World Journal of Gastroenterology 2004年第14期10卷 2082-2086页

作者： lászl6Czakó PéterHegyi TamásTakács CsabaGóg AndrásFarkas YvetteMándy Ilona Sz.Varga lászlótiszlavicz Jánoslonovics First Department of Internal Medicine University of SzegedSzegedHungary Second Department of Internal Medicine and Cardiological Center University of SzegedSzegedHungary Department of Microbiology University of SzegedSzegedHungary Biological Department of Pathology University of SzegedSzegedHungary

AIM:To assess the role of oxygen-derived free radicals and cytokines in the pathogenesis of taurocholic acid-induced acute pancreatitis,and to evaluate the preventive effects of octreotide towards the development of acute pancreatitis. METHODS:Acute pancreatitis was induced in male New Zealand white rabbits by retrograde injection of 0.8 ml/kg·b.m,of 50 g/l sodium taurocholate (NaTC) in the pancreatic ***- operated animals served as *** i mg/kg·b.m. was administered subcutaneously before the induction of *** was taken from the jugular vein before and at 1,3,6,12 and 24 h after pancreatitis induction. Serum activities of amylase,Il-6 and TNF-α and levels of malonyl dialdehyde (MDA),glutathione (GSH),glutathione peroxidase (GPx),catalase and superoxide dismutase (Mn-, Cu-,and Zn-SOD) in pancreatic tissue were measured. RESUlTS:Serum TNF-α and Il-6 levels increased significantly 3 h after the onset of pancreatitis,and then returned to control *** tissue concentration of MDA was significantly elevated at 24 h,while the GSH level and GP-x,catalase,Mn-SOD,Cu-,Zn-SOD activities were all significantly decreased in animals with pancreatitis as compared to the *** pretreatmnent significantly reversed the changes in cytokines and reactive oxygen *** treatment did not alter the serum amylase activity and did not have any beneficial effects on the development of histopathological changes. CONClUSION:Oxygen-derived free radicals and proinflammatory cytokines are generated at an early stage of NaTc-induced acute pancreatitis in *** octreotide treatment can prevent release of cytokines and generation of reactive oxygen metabolites,but does not have any beneficial effects on the development of necrotizing pancreatitis.

关键词： Animals Cytokines inhibitors Male Octreotide Pancreas Pancreatitis, Acute Necrotizing control Rabbits Reactive Oxygen Species Research Support, Non-U.S. Gov't Taurocholic Acid

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Therapeutic proteasome inhibition in experimental acute pancreatitis

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World Journal of Gastroenterology 2007年第33期13卷 4452-4457页

作者： Tamás letoha liliána Z Fehér lászló Pecze Csaba Somlai Ilona Varga József Kaszaki Gábor Tóth Csaba Vizler lászló tiszlavicz Tamás Takács Department of Medical Chemistry University of Szeged H-6720 Szeged Hungary Institute of Biochemistry Biological Research Center of the HungarianAcademy of Sciences H-6726 Szeged Hungary Department of Genetics and Molecular Biology University of Szeged H-6726 Szeged Hungary Institute of Surgical Research University of Szeged H-6720 Szeged Hungary Department of Pathology University of Szeged H-6720 Szeged Hungary First Department of Medicine University of Szeged H-6720 Szeged Hungary

AIM： To establish the therapeutic potential of proteasome inhibition, we examined the therapeutic effects of MG132 （Z-leu-leu-leu-aldehyde） in an experimental model of acute pancreatitis. METHODS： Pancreatitis was induced in rats by two hourly intraperitoneal （ip） injections of cholecystokinin octapeptide （CCK; 2×100μg/kg） and the proteasome inhibitor MG132 （10 mg/kg ip） was administered 30 min after the second CCK injection. Animals were sacrificed 4 h after the first injection of CCK. RESUlTS： Administering the proteasome inhibitor MG132 （at a dose of 10 mg/kg, ip） 90 min after the onset of pancreatic inflammation induced the expression of cell-protective 72 kDa heat shock protein （HSP72） and decreased DNA-binding of nuclear factor-κB （NF-κB）. Furthermore MG132 treatment resulted in milder inflammatory response and cellular damage, as revealed by improved laboratory and histological parameters of pancreatitis and associated oxidative stress. CONClUSION： Our findings suggest that proteasome inhibition might be beneficial not only for the prevention, but also for the therapy of acute pancreatitis.

关键词： Acute pancreatitis Cholecystokinin octapeptide Proteasome inhibition Nuclear factor-κB Heat shock proteins

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Analysis of risk factors-especially different types of plexitis-for postoperative relapse in Crohn's disease

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World Journal of Gastrointestinal Surgery 2017年第7期9卷 167-173页

作者： Agnes Milassin Anita Sejben lászló tiszlavicz Zita Reisz Gyorgy lázár Mónika Szucs Renáta Bor Anita Bálint Mariann Rutka Zoltán Szepes Ferenc Nagy Klaudia Farkas Tamás Molnár First Department of Internal Medicine University of Szeged Department of Pathology University of Szeged Department of Surgery University of Szeged Department of Medical Physics and Informatics University of Szeged

AIM To evaluate the presence of submucosal and myenteric plexitis and its role in predicting postoperative *** Data from all patients who underwent Crohn's disease(CD)-related resection at the University of Szeged, Hungary between 2004 and 2014 were analyzed retrospectively. Demographic data, smoking habits, previous resection, treatment before and after surgery, resection margins, neural fiber hyperplasia, submucosal and myenteric plexitis were evaluated as possible predictors of postoperative recurrence. Histological samples were analyzed blinded to the postoperative outcome and the clinical history of the patient. Plexitis was evaluated based on the appearance of the most severely inflamed ganglion or nerve bundle. Patients underwent regular follow-up with colonoscopy after surgery. Postoperativerecurrence was defined on the basis of endoscopic and clinical findings, and/or the need for additional surgical resection. RESUlTS One hundred and four patients were enrolled in the study. Ileocecal, colonic, and small bowel resection were performed in 73.1%, 22.1% and 4.8% of the cases, respectively. Mean disease duration at the time of surgery was 6.25 years. Twenty-six patients underwent previous CD-related surgery. Forty-three point two percent of the patients were on 5-aminosalicylate, 20% on corticosteroid, 68.3% on immunomodulant, and 4% on anti-tumor necrosis factor-alpha postoperative treatment. Postoperative recurrence occurred in 61.5% of the patients; of them 39.1% had surgical recurrence. 92.2% of the recurrences developed within the first five years after the index surgery. Mean disease duration for endoscopic relapse was 2.19 years. The severity of submucosal plexitis was a predictor of the need for second surgery(OR = 1.267, 95%CI: 1.000-1.606, P = 0.050). Female gender(OR = 2.21, 95%CI: 0.98-5.00, P = 0.056), stricturing disease behavior(OR = 3.584, 95%CI: 1.344-9.559, P = 0.011), and isolated ileal localization(OR = 2.671, 95%CI: 1.033-6.

关键词： Submucosal plexitis Postoperative recurrence Crohn’s disease Stricturing disease behavior Isolated ileal disease

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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

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儿童和成人肺毛细血管的血管瘤:1新病例报道以及文献回顾

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世界核心医学期刊文摘（儿科学分册） 2005年第5期1卷 43-44页

作者： Bartyik K. Bede O. tiszlavicz l. 王一飞 Department of Paediatri cs Albert Szent-Gyorgyi Med. P. University of Szeged 14-15 Koranyi fasor 6720 Szeged Hungary

Pulmonary capillary haemangiomatosis (PCH) in childhood is a rarity, character ised by the uncontrolled proliferation of pulmonary microvessels which may invad e pulmonary, bronchial and vascular structures, resulting in diffuse alveolar ha emorrhage, manifesting clinically in haemoptysis, dyspnoea and symptoms of pulmo nary hypertension (PH). A 14-year-old boy with some particular features (peric ardial effusion and thrombocytopenia) is presented and 14 paediatric/adolescent cases from the literature are surveyed. The diagnostic problems and difficulties are discussed, including the importance of imaging (high-resolution CT) and hi stopathological studies, with the aim of providing a clear-cut distinction of P CH from other conditions such as primary PH (PPH). The literature data can be re garded as ambiguous: both similarities and relatively sharp distinctions between PCH and PPH are to be found. New developments in the field of genetics are also discussed. The early coexistence of PCH and other (vascular) disorders and asso ciations, involving focal or diffuse, disseminated forms is summarised briefly. Conclusion: The diagnosis of this progressive disorder may lead to effective the rapy. Treatment possibilities include the rapidly evolving field of anti-angiogenic therapy, but at present lung transp lantation is universally accepted as the final definitive treatment for pulmonar y capillary haemangiomatosis.

关键词：文献回顾肺毛细血管血管瘤新病例弥漫性肺泡出血肺动脉高压抗血管生成治疗血管结构血管疾病异常增殖

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