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001-es BibID:	BIBFORM046541
Első szerző:	Ésik Olga
Cím:	Characteristics of radiogenic lower motor neurone disease, a possible link with a preceding viral infection / Ésik, O., Vönöczky, K., Lengyel, Z., Sáfrány, G., Trón, L.
Dátum:	2004
ISSN:	1362-4393
Megjegyzések:	To investigate the pathogenesis of the rare radiogenic lower motor neurone disease (LMND) on the basis of a meta-analysis of the published case histories. MATERIALS AND METHODS: The authors reviewed 47 well-documented radiogenic LMND cases from the English literature. RESULTS: The disease typically occurs following the irradiation of radiosensitive cancers situated near the spinal cord. It arises predominantly (46 cases) in the lower extremities; only one case involved the upper extremities. There is a male predominance (male:female ratio 7.8:1), and the patients are characteristically young (13-40 years, with four exceptions). An overdose does not seem to be a particular risk factor for the development of the disease, as total dose, fraction size and biologically effective dose are typically below 50 Gy, 2 Gy and 128 Gy2, respectively, which are regarded as safe doses. Other risk factors (chemotherapy, operations, etc) have been identified only rarely. Radiogenic LMND is manifested in an apparently random manner, 4-312 (mean 48.7) months after the completion of radiotherapy. DISCUSSION: The complete lack of a dose-effect relationship argues strongly against a pure radiogenic nature of the pathological process. The latency period is typically several years and it varies extremely, which excludes a direct and complete causal relationship between radiotherapy and LMND. As the interaction of ionizing radiation with living tissues is highly unspecific, thus a selective motor injury due to irradiation alone, without comparable effects on the sensory and vegetative fibers, seems improbable.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Spinal Cord. - 42 : 2 (2004), p. 99-105. -
További szerzők:	Vönöczky Katalin Lengyel Zsolt (nukleáris medicina szakorvos) Sáfrány Géza (Pécs; Budapest) Trón Lajos (1941-) (biofizikus)
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001-es BibID:	BIBFORM038884
035-os BibID:	PMID:12185608
Első szerző:	Ésik Olga
Cím:	A PET study on the characterization of partially reversible radiogenic lower motor neurone disease / O. Esik, Zs. Lengyel, G. Sáfrány, K. Vönöczky, P. Ágoston, J. Székely, E. Lengyel, T. Márián, L. Trón, I. Bodrogi
Dátum:	2002
ISSN:	1362-4393
Megjegyzések:	OBJECTIVE: To investigate the pathomechanism of the rare radiogenic lower motor neurone disease (LMND) on the basis of a case history involving a partial functional recovery. PATIENT: A 31-year-old seminoma patient received postoperative para-aortic and para-iliac telecobalt irradiation with a biologically effective dose of 88 Gy(2) (44 Gy in 2 Gy fractions/day, with an estimated alpha/beta of 2 Gy) delivered to the spinal cord following a single cycle of chemotherapy. LMND developed 4 months after the completion of radiotherapy. The patient exhibited flaccid paraparesis of the lower extremities (without sensory or vegetative signs), followed by a worsening after further chemotherapy, due to pulmonary metastatization. A gradual spontaneous functional improvement commenced and led several years later to a stabilized state involving moderately severe symptoms. METHODS: In the 15th year of the clinical course, magnetic resonance imaging (MRI) and positron emission tomography (PET) with [(18)F]fluorodeoxyglucose (FDG) and [(11)C] methionine were conducted. Four lines of experiments (clonogenic assay using fibroblasts isolated from a skin biopsy sample of the patient, comet assay, micronucleus assay, and the testing of chromosome aberrations after in vitro irradiation of peripheral blood samples) were performed in a search for an increased individual radiosensitivity. RESULTS: MRI investigations failed to reveal any pathological change. PET demonstrated an increased FDG accumulation, but a negligible [(11)C] methionine uptake in the irradiated spinal cord segments. The radiobiological investigations did not indicate any sign of an increased individual radiosensitivity. CONCLUSIONS: We suggest that the observed partial functional recovery and stabilization of the symptoms of radiogenic LMND may be explained by the higher than normal density of sodium channels expressed along the demyelinated axons of the restored conduction. The increased energy demands of this type of conduction are proved by a higher metabolic rate (increased FDG uptake) of the irradiated spinal cord segments without a substantial regenerative process (lack of detectable protein synthesis).
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban egyetemen (Magyarországon) készült közlemény
Megjelenés:	Spinal Cord. - 40 : 9 (2002), p. 468-473. -
További szerzők:	Lengyel Zsolt (nukleáris medicina szakorvos) Sáfrány Géza (Pécs; Budapest) Vönöczky Katalin Ágoston Péter Székely Judit Lengyel Erzsébet Bodrogi István Márián Teréz (1950-) (radiobiológus) Trón Lajos (1941-) (biofizikus)
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001-es BibID:	BIBFORM047956
035-os BibID:	PMID:14504618
Első szerző:	Lengyel Zsolt (nukleáris medicina szakorvos)
Cím:	Autopsy verifies demyelination and lack of vascular damage in partially reversible radiation myelopathy / Z. Lengyel, G. Rékó, K. Majtényi, J. Pisch, M. Csornai, J. Lesznyák, L. Trón. O. Ésik
Dátum:	2003
ISSN:	1362-4393
Megjegyzések:	Case report of recovering radiation myelopathy.OBJECTIVE:To present autopsy and functional imaging findings on a unique case of slowly recovering radiation myelopathy with the aim of the clarification of the underlying mechanism.PATIENT:The cervical spinal cord and the distal part of the medulla oblongata of a 36-year-old thyroid cancer patient had been incorrectly irradiated with a total dose of 61 Gy and a fraction size of 3.4 Gy (J Neurol Sci 1999; 163:39-43), resulting in incomplete cervical transection with a 5-month latency period following the termination of radiotherapy. This was followed by a 9.5-year spontaneous improvement until her demise, during which the check-ups were supplemented by positron emission tomography (PET) investigations; these indicated increased [18F]deoxyglucose and [15O]butanol uptakes, but a diminished [11C]methionine accumulation by the irradiated spinal cord segment.RESULTS:Autopsy revealed demyelination (with axonal loss) and neuronal damage in the cervical spinal cord and the distal part of the medulla oblongata. In the same region, only minimal vascular injury (thickening of some of the capillary walls) was detected, but not cell proliferation or chronic inflammation. Bilateral, secondary pyramidal tract degeneration caudal to the irradiated segment was observed. The PET and autopsy findings, although separated by 2 years, are consistent.CONCLUSIONS:The pathological state of the spinal cord revealed by the autopsy is concordant with the incomplete cervical transection, implying that the functional recovery is supported by a process that probably differs from the restoration of the mechanism destroyed by the radiotherapy. For the restoration of the function, we suggest an altered conduction mechanism of the action potential, involving an increased number of sodium channels along the demyelinated segments of the injured axons, which is fully congruent with the PET findings.
Tárgyszavak:	Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Spinal Cord. - 41 : 10 (2003), p. 577-585. -
További szerzők:	Rékó G. Majtényi K. Pisch J. Csornai Márta Lesznyák J. Trón Lajos (1941-) (biofizikus) Ésik Olga
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001-es BibID:	BIBFORM014436
Első szerző:	Székely György (neurobiológus)
Cím:	Epidural malignant lymphomas of the spine : collected experiences with epidural malignant lymhomas of the spinal canal and their treatment / G. Székely, Z. Miltényi, G. Mezey, Z. Simon, J. Gyarmati, L. Gergely, L. Bognár, Á. Illés
Dátum:	2008
ISSN:	1362-4393
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban egyetemen (Magyarországon) készült közlemény
Megjelenés:	Spinal Cord. - 46 : 4 (2008), p. 278-281. -
További szerzők:	Miltényi Zsófia (1975-) (belgyógyász, haematológus) Mezey Géza (1978-) (idegsebész) Simon Zsófia (1977-) (belgyógyász, haematológus) Gyarmati János (1926-1983) (radiológus) Gergely Lajos (1965-) (belgyógyász, haematológus) Bognár László (1958-) (idegsebész, gyermekidegsebész) Illés Árpád (1959-) (belgyógyász, haematológus, onkológus)
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