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Diagnostic role of secretin-enhanced MRCP in patients with unsuccessful ERCP

World Journal of Gastroenterology 2004年第20期10卷 3034-3038页

作者： lászló czakó Tamás Takács Zita Morvay lászló Csernay János lonovics First Department of Medicine University of SzegedSzegedHungary International Medical Center SzegedHungary

AIM:To evaluate the value of MR cholangiopancreatography (MRCP)in patients in whom endoscopic retrograde cholangiopancreatography(ERCP)was unsuccessfully performed by experts in a tertiary center. METHODS:From January 2000 to June 2003,22 patients fulfilled the inclusion *** indications for ERCP were obstructive jaundice(n=9),abnormal liver enzymes(n=8), suspected chronic pancreatitis(n=2),recurrent acute pancreatitis(n=2),or suspected pancreatic cancer(n=1). The reasons for the ERCP failure were the postsurgical anatomy(n=7),duodenal stenosis(n=3),duodenal diverticulum(n=2),and technical failure(n=10).MRCP images were evaluated before and 5 and 10 rain after i.v. administration of 0.5 IU/kg secretin. RESUlTS:The MRCP images were diagnosed in all 21 *** patients gave normal MR findings and required no further *** revealed abnormalities(primary sclerosing cholangitis,chronic pancreatitis,cholangitis,cholecystolithiasis or common bile duct dilation)in 20 patients,who were followed up *** patients subsequently underwent laparotomy(hepaticojejunostomy in consequence of common bile duct stenosis caused by unresectable pancreatic cancer;hepaticotomy+Kehr drainage because of insufficient biliary-enteric anastomosis;choledochoj- ejunostomy,gastrojejunostomy and cysto-Wirsungo gastrostomy because of chronic pancreatitis,or choledochojejunostomy because of common bile duct stenosis caused by chronic pancreatitis).Three patients participated in therapeutic percutaneous transhepatic *** indications were choledocholithiasis with choledochojejunostomy,insufficient biliary-enteric anastomosis,or cholangiocarcinoma. CONClUSION:MRCP can assist the diagnosis and management of patients in whom ERCP is not possible.

关键词： Adult Aged Aged, 80 and over Biliary Tract Diseases Cholangiography Cholangiopancreatography, Endoscopic Retrograde Diagnosis, Differential Female Humans Jaundice, Obstructive Magnetic Resonance Imaging Male Middle Aged Pancreatitis Prospective Studies Research Support, Non-U.S. Gov't Secretin Sensitivity and Specificity

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Association between autoimmune pancreatitis and systemic autoimmune diseases

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World Journal of Gastroenterology 2012年第21期18卷 2649-2653页

作者： Viktória Terzin Imre Fldesi lászló Kovács Gyula Pokorny Tibor Wittmann lászló czakó First Department of Medicine University of SzegedH-6701 Szeged Hungary Department of Rheumatology University of SzegedH-6701 Szeged Hungary

AIM: To investigate the association between autoimmune pancreatitis (AIP) and systemic autoimmune diseases (SAIDs) by measurement of serum immunoglobulin G4 (IgG4). METHODS: The serum level of IgG4 was measured in 61 patients with SAIDs of different types who had not yet participated in glucocorticosteroid treatment. Patients with an elevated IgG4 level were examined by abdominal ultrasonography (US) and, in some cases, by computer tomography (CT). RESUlTS: Elevated serum IgG4 levels (919 ± 996 mg/l) were detected in 17 (28%) of the 61 SAID patients. 10 patients had Sj gren's syndrome (SS) (IgG4: 590 ± 232 mg/l), 2 of them in association with Hashimoto's thyroiditis, and 7 patients (IgG4: 1388 ± 985.5 mg/l) had systemic lupus erythematosus (SlE). The IgG4 level in the SlE patients and that in patients with SS were not significantly different from that in AIP patients (783 ± 522 mg/l). Abdominal US and CT did not reveal any characteristic features of AIP among the SAID patients with an elevated IgG4 level. CONClUSION: The serum IgG4 level may be elevated in SAIDs without the presence of AIP. The determination of serum IgG4 does not seem to be suitable for the differentiation between IgG4-related diseases and SAIDs.

关键词： Autoimmune pancreatitis Serum immunoglobulin G4 level Systemic lupus erythematosus Sj gren’s syndrome Mikulicz’s disease

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Autoimmune pancreatitis: Functional and morphological recovery after steroid therapy

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World Journal of Gastroenterology 2006年第11期12卷 1810-1812页

作者： lászló czakó (E|')va Hegyk(o|¨)zi Attila Pálinkás János lonovics First Department of Medicine University of Szeged SzegedHungary Elizabeth Hospital Hódmez(o|″)vásárhely Hungary

Autoimmune pancreatitis, a recently recognized type of chronic pancreatitis, is not rare in Japan, but reports of it elsewhere are relatively uncommon. We report the first preoperatively diagnosed case of autoimmune pancreatitis in Hungary, which responded well to steroid treatment and provided radiographic and functional evidence of this improvement. A 62-year-old female presented with a 4-month history of recurrent epigastric pain and a 5-kg weight loss. The oral glucose tolerance test （OGTT） indicated diabetes mellitus and the result of the fecal elastase test was abnormal. Ultrasonography （US） and the CT scan demonstrated a diffusely enlarged pancreas, and endoscopic retrograde cholangiopancreatography （ERCP） an irregular main pancreatic duct with long strictures in the head and tail. Autoimmune pancreatitis was diagnosed. The patient was started on 32 mg prednisolone daily, After 4 wk, the OGTT and faecal elastase test results had normalized. The repeated US and CT scan revealed a marked improvement of the diffuse pancreatic swelling, while on repeated ERCP, the main pancreatic duct narrowing was seen to be ameliorated. It is important to be aware of this disease and its diagnosis, because AIP can clinically resemble pancreatobiliary malignancies, or chronic or acute pancreatitis, However, in contrast with chronic pancreatitis, its symptoms and morphologic and laboratory alterations are completely reversed by oral steroid therapy.

关键词： Autoimmune pancreatitis Steroid therapy Chronic pancreatitis Pancreatic endocrine function Pancreatic exocrine function

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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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l-arginine-induced experimental pancreatitis

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World Journal of Gastroenterology 2004年第14期10卷 2003-2009页

作者： PéterHegyi ZoltánRakonczayJr RékaSári CsabaGóg Jánoslonovics TamásTakács lászlóczakó First Department of Medicine Faculty of MedicineUniversity of SzegedSzegedH6722Hungary School of Cell and Molecular BiosciencesMedical SchoolUniversity of NewcastleNewcastle upon TyneNE2 4HHUnited Kingdom First Department of Medicine Faculty of MedicineUniversity of SzegedSzegedH6722Hungary First Department of Medicine Faculty of MedicineUniversity of SzegedSzegedH6722HungarySchool of Cell and Molecular BiosciencesMedical SchoolUniversity of NewcastleNewcastle upon TyneNE2 4HHUnited Kingdom

Despite medical treatment,the lethality of severe acute pancreatitis is still high (20-30%).Therefore,it is very important to find good animal models to characterise the events of this severe *** 1984,Mizunuma et al. developed a new type of experimental necrotizing pancreatitis by intraperitoneal administration of a high dose of l-arginine in *** non-invasive model is highly reproducible and produces selective,dose-dependent acinar cell necrosis. Not only is this a good model to study the pathomechanisms of acute necrotizing pancreatitis,but it is also excellent to observe and influence the time course changes of the *** writing this review we iluminate some new aspects of cell physiology and pathology of acute necrotizing ***,the reviews about acute experimental pancreatitis usually did not discuss this model. Therefore,the aim of this manuscript was to summarise the observations and address some challenges for the future in l-arginine-induced pancreatitis.

关键词： Arginine dosage Disease Models, Animal Animals Injections, Intraperitoneal Pancreatitis, Acute Necrotizing Regeneration Research Support, Non-U.S. Gov't

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Is rectal indomethacin effective in preventing of post-endoscopic retrograde cholangiopancreatography pancreatitis?

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World Journal of Gastroenterology 2014年第29期20卷 10151-10157页

作者： Zoltán Dbrnte Zoltán Szepes Ferenc Izbéki Judit Gervain lászló lakatos Gyula Pécsi Miklós Ihász lilla lakner Erzsébet Toldy lászló czakó Department of Gastroenterology and Internal Medicine Markusovszky Teaching Hospital 1st Department of Medicine University of Szeged 1st Department of Internal Medicine Szent Gyrgy Regional Hospital Department of Internal Medicine Csolnoky Ferenc Regional Hospital Department of Gastroenterology Karolina Hospital Central laboratory Markusovszky Teaching Hospital Institute of Diagnostics Faculty of Health SciencesUniversity of Pécs

AIM: To investigate the effectiveness of rectally administered indomethacin in the prophylaxis of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis and hyperamylasaemia in a multicentre study.

关键词： Endoscopic retrograde cholangiopancreatography Post-endoscopic retrograde cholangiopancreatography pancreatitis Hyperamylasaemia Nonsteroidal anti-inflammatory drugs Indomethacin

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Ethanol inhibits the motility of rabbit sphincter of Oddi in vitro

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World Journal of Gastroenterology 2004年第23期10卷 3470-3474页

作者： Réka Sári Attila Pálv lgyi Zoltán Rakonczay Jr Tamás Takács János lonovics lászló czakó Péter Hegyi Zoltán Szilvássy First Department of Medicine Faculty of MedicineUniversity of Szeged H-6720Koranyi fasor 10Hungary Department of Pharmacology Medical University of Debrecen H-4032Nagyerdei krt98Hungary

AIM:The rote of the sphincter of Oddi(SO)in ethanol (ETOH)-induced pancreatitis is *** aim was to characterise the effect of E-I-OH on basal and stimulated SO motility. METHODS:SOs removed from white rabbits were placed in an organ bath(Krebs solution,pH7.4,37℃).The effects of 2 ml/l,4 ml/l,6 ml/l and 8 ml/l of ETOH on the contractile responses of the sphincter were determined. SOs were stimulated with either 0.1 μmol/l carbachol,1 μmol/l erythromycin or 0.1 μmol/l cholecystokinin(CCK). RESUlTS:ETOH at a dose of 4 ml/l significantly decreased the baseline contractile amplitude from 11.98±0.05 mN to 11.19±0.07 ***,no significant changes in the contractile frequency were ***(0.6%) significantly decreased both the baseline amplitude and the frequency compared to the control group(10.50±0.01 mN, 12.13±0.10 mN and 3.53±0.13 c/min,5.5±0.13 cycles(c)/min, respectively).Moreover,0.8% of ETOH resulted in complete relaxation of the ***(0.1 μmol/l)or erythromycin (1 μmol/l)stimulated the baseline amplitudes(by 82% and 75%,respectively)and the contractile frequencies (by 150% and 106%,respectively).In the carbachol or erythromydn-stimulated groups 2-6 ml/l of E-IOH significantly inhibited both the amplitude and the ***, a 4-5 min administration of 6 ml/l ETOH suddenly and completely relaxed the ***(0.1 μmol/l)stimulated the baseline amplitude from 12.37±0.05 mN to 27.40±1.82 mN within 1.60±0.24 *** this peak,the amplitude decreased to 17.17±0.22 mN and remained constant during the *** frequency peaked at 12.8±0.2 c/min, after which the constant frequency was 9.43±0.24 c/min throughout the rest of the *** at a dose of 4 ml/l significantly decreased the amplitude from 16.13±0.23 mN to 14.93±0.19 ***,no significant changes in the contractile frequency were *** at a dose of 6 ml/l inhibited both the amplitudes and the frequencies in the CCK-stimulated group,while 8 ml/l of E

关键词： Animals Carbachol Central Nervous System Depressants Cholecystokinin Cholinergic Agonists Erythromycin Ethanol Gastrointestinal Agents Gastrointestinal Motility In Vitro Male Rabbits Research Support, Non-U.S. Gov't Sphincter of Oddi

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Insulin is necessary for the hypertrophic effect of cholecystokinin-octapeptide following acute necrotizing experimental pancreatitis

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World Journal of Gastroenterology 2004年第15期10卷 2275-2277页

作者： Péter Hegyi Zoltán RakonczayJr Réka Sári lászló czakó Norbert Farkas Csaba Góg József Németh János lonovics Tamás Takács First Department of Medicine Faculty of MedicineUniversity of Szeged Szeged H6722Hungary School of Cell and Molecular BiosciencesMedical SchoolUniversity of NewcastleNewcastle upon TyneNE2 4HHUnited Kingdom First Department of Medicine Faculty of MedicineUniversity of Szeged Szeged H6722Hungary Jr.School of Cell and Molecular BiosciencesMedical SchoolUniversity of NewcastleNewcastle upon TyneNE2 4HHUnited Kingdom First Department of Medicine Faculty of MedicineUniversity of Szeged Szeged H6722Hungary

AIM:In previous experiments we have demonstrated that by administering low doses of cholecystokinin-octapeptide (CCK-8),the process of regeneration following l-arginine (Arg)-induced pancreatitis is *** rats that were also diabetic(induced by streptozotocin,STZ),pancreatic regeneration was not *** aim of this study was to deduce whether the administration of exogenous insulin could in fact restore the hypertrophic effect of CCK-8 in diabetic-pancreatitic rats. METHODS:Male Wistar rats were used for the experiments. Diabetes mellitus was induced by administering 60mg/kg body mass of STZ intraperitoneally(i.p.),then,on d 8, pancreatitis was induced by 200mg/100 g body mass Arg *** at an interval of 1 *** animals were injected subcutaneously twice daily(at 7 *** 7 p.m.)with 1 μg/kg of CCK-8 and/or 2 IU mixed insulin(300g/l short- action and 700g/l intermediate-action insulin) for 14 d after pancreatitis *** this the animals were killed and the serum amylase,glucose and insulin levels as well as the plasma glucagon levels,the pancreatic mass/body mass ratio(pm/bm),the pancreatic contents of DNA,protein,amylase,lipase and trypsinogen were *** tissue samples were examined by light microscopy on paraffin-embedded sections. RESUlTS:In the diabetic-pancreatitic rats treatment with insulin and CCK-8 significantly elevated pw/bm and the pancreatic contents of protein,amylase and lipase vs the rats receiving only CCK-8 ***-8 administered in combination with insulin also elevated the number of acinar cells with mitotic activities,whereas CCK-8 alone had no effect on laboratory parameters or the mitotic activities in diabetic-pancreatitic rats. CONClUSION:Despite the hypertrophic effect of CCK-8 being absent following acute pancreatitis in diabetic-rats, the simultaneous administration of exogenous insulin restored this *** results clearly demonstrate that insulin is necessary for the hypertrophic ef

关键词： Animals Diabetes Mellitus, Experimental Hypoglycemic Agents Insulin Male Pancreatitis, Acute Necrotizing Rats Rats, Wistar Regeneration Research Support, Non-U.S. Gov't Sincalide

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Recent Advances in Catalytic Carbonylation Reactions in Alternative Reaction Media

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Chinese Journal of Chemistry 2024年第4期42卷 406-429页

作者： Csaba Árvai lászló T.Mika Department of Chemical and Environmental Process Engineering Faculty of Chemical Technology and BiotechnologyBudapest University of Technology and EconomicsMűegyetem rkp.3H-1111 BudapestHungary

Since the discovery of the hydroformylation(oxo-synthesis or Roelen reaction)and the Reppe-reaction,the transition metal-catalyzed carbonylation reactions,providing versatile,facile,and even atom-economic methods for the selective incorporation of C=O functionality to various skeletons,have gained tremendous importance in synthetic organic chemistry from laboratories to industrial *** carbonylation of carbon-carbon multiple bonds,aromatic halides,triflates,etc.,in the presence of various nucleophiles has led the way to produce aldehydes,carboxylic acids,esters,amides,etc.,in the fine chemical ***,these protocols usually proceed in conventional,fossil-based,and usually toxic reaction ***,several attempts have been directed to developing efficient carbonylation methods in alternative,less harmful,non-fossil-based and even in renewable reaction *** this review,we overview the recent applications of alternative solvents such as water,biomass-based alcohols,γ-valerolactone(GVl),2-methyltetrahydrofuran(2-MeTHF),ionic liquids(Ils),deep eutectic solvents(DES),alkyl levulinates,limonene,α-pinene,and dimethyl carbonate as well as fluorous media to improve efficiency,safety and environmentally benign nature of carbonylation protocols.

关键词： Carbonylation Catalysis Solvents Green chemistry Carbon monoxide Transition metals Homogeneous catalysis Palladium

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Silk-based nerve guidance conduits with macroscopic holes modulate the vascularization of regenerating rat sciatic nerve

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Neural Regeneration Research 2025年第6期20卷 1789-1800页

作者： Carina Hromada Patrick Heimel Markus Kerbl lászlóGál Sylvia Nürnberger Barbara Schaedl James Ferguson Nicole Swiadek Xavier Monforte Johannes C.Heinzel Antal Nógrádi Andreas H.Teuschl-Woller David Hercher Department life Science Engineering University of Applied Sciences Technikum WienViennaAustria Austrian Cluster for Tissue Regeneration ViennaAustria ludwig Boltzmann Institute for Traumatology The Research Center in Cooperation with AUVAViennaAustria University Clinic of Dentistry Medical University of ViennaViennaAustria Department of Plastic Reconstructive and Aesthetic SurgeryLandesklinikum Wiener Neustadt2700 Wiener NeustadtAustria Department of Anatomy Histology and EmbryologyAlbert Szent-Györgyi Medical SchoolUniversity of SzegedSzegedHungary Medical University of Vienna Department of Orthopedics and Trauma SurgeryDevision of Trauma SurgeryViennaAustria Department of Hand- PlasticReconstructive and Burn SurgeryBG Unfallklinik TuebingenUniversity of TuebingenTuebingenGermany

Peripheral nerve injuries induce a severe motor and sensory deficit. Since the availability of autologous nerve transplants for nerve repair is very limited, alternative treatment strategies are sought, including the use of tubular nerve guidance conduits(tNGCs). However, the use of tNGCs results in poor functional recovery and central necrosis of the regenerating tissue, which limits their application to short nerve lesion defects(typically shorter than 3 cm). Given the importance of vascularization in nerve regeneration, we hypothesized that enabling the growth of blood vessels from the surrounding tissue into the regenerating nerve within the tNGC would help eliminate necrotic processes and lead to improved regeneration. In this study, we reported the application of macroscopic holes into the tubular walls of silk-based tNGCs and compared the various features of these improved silk^(+) tNGCs with the tubes without holes(silk^(–) tNGCs) and autologous nerve transplants in an 8-mm sciatic nerve defect in rats. Using a combination of micro-computed tomography and histological analyses, we were able to prove that the use of silk^(+) tNGCs induced the growth of blood vessels from the adjacent tissue to the intraluminal neovascular formation. A significantly higher number of blood vessels in the silk^(+) group was found compared with autologous nerve transplants and silk^(–), accompanied by improved axon regeneration at the distal coaptation point compared with the silk^(–) tNGCs at 7 weeks postoperatively. In the 15-mm(critical size) sciatic nerve defect model, we again observed a distinct ingrowth of blood vessels through the tubular walls of silk^(+) tNGCs, but without improved functional recovery at 12 weeks postoperatively. Our data proves that macroporous tNGCs increase the vascular supply of regenerating nerves and facilitate improved axonal regeneration in a short-defect model but not in a critical-size defect model. This study suggests that further optimizatio

关键词： axon regeneration blood vessel functional recovery macroporous nerve lesion peripheral nerve repair sciatic nerve silk-based nerve guidance conduit vascularization

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