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001-es BibID:	BIBFORM031120
Első szerző:	Bajnok László (belgyógyász)
Cím:	Calculation of the radioiodine dose for the treatment of graves' hyperthyroidism : is more than seven-thousand rad target dose necessary? / Laszlo Bajnok, Emese Mezosi, Endre Nagy, Jeno Szabo, Ilona Sztojka, Jozsef Varga, Laszlo Galuska, Andras Leovey
Dátum:	1999
ISSN:	1050-7256
Megjegyzések:	Some authors recently suggested a significant increase in the target dose of radioiodine treatment in Graves' disease. The aim of the present study was to investigate the impact of thyroid gland mass on the success rate of radioiodine treatment. For this purpose, the thyroid function of 105 consecutive Graves' patients was assessed 6 and 12 months after a 131I treatment and correlated to the gland mass. The patients were categorized according to the gland mass into small (< or = 30 g; 19 patients), medium size (31-50 g; 40 patients), and large size (> 50 g; 46 patients) groups (S, M, L groups, respectively). None of the patients received more than a 10,000-rad (100-Gy) target dose. During the calculation of administered 131I activity, late uptake measurement has also been routinely used, in addition to the usual maximal uptake parameter. The established effective half-life of 131I was highly variable (5 +/- 1.2 days; range: 2-7.6 days) and could not be predicted based on other clinical data without measuring an extended radioiodine uptake curve of the given patient. However, the correlation between the administered activity calculated from the complete set of uptake values and that of only a single late one was excellent (r = 0.99). Six months after the 131I treatment, hyperthyroidism was cured in 81% of patients with small and medium size thyroid glands, with 62% euthyroid and 19% hypothyroid ratios respectively. In the early phase of study for large goiters, the same linear mass activity function was used during calculation as in smaller glands. In these 17 patients the nonhyperthyroid result was comparable to the results of treatment of the small and medium size gland groups only after 1 year (77%), but the 6-month success rate was significantly lower (53%; p < 0.05). After obtaining these results, the usual 7000-rad target dose was increased to 8000-10,000 rad (depending on the gland mass) in another group of 29 patients with large thyroid glands that result in an acceptable 6-month success rate of 72%. In conclusion, instead of the "mCi 131I/g gland mass/maximal uptake" dose calculation, we suggest a method in which (1) the late 131I uptake measurement is taken into account and (2) for large goiters there is an additional dose adjustment, ie, increase is needed over the usual linear, size driven calculation. No overall increase of target dose over 10,000 rad is necessary if no antithyroid medication is given shortly before 131I treatment.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban egyetemen (Magyarországon) készült közlemény
Megjelenés:	Thyroid 9 : 9 (1999), p. 865-869. -
További szerzők:	Mezősi Emese Nagy Endre V. (1957-) (belgyógyász, endokrinológus) Szabó Jenő (belgyógyász, endocrinologus) Sztojka Ilona Varga József (1955-) (fizikus) Galuska László (1946-) (belgyógyász, izotópdiagnoszta) Leövey András (1926-) (belgyógyász)
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001-es BibID:	BIBFORM019212
Első szerző:	Szűcs-Farkas Zsolt
Cím:	Volume Changes in Intra- and Extraorbital Compartments in Patients with Graves' Ophthalmopathy : effect of Smoking / Szucs-Farkas Zsolt, Toth Judit, Kollar Jozsef, Galuska Laszlo, Burman Kenneth D., Boda Judit, Leovey Andras, Varga Jozsef, Ujhelyi Bernadett, Szabo Jeno, Berta Andras, Nagy Endre V.
Dátum:	2005
ISSN:	1050-7256
Megjegyzések:	The objective of this study was to demonstrate the effect of smoking history on soft tissue expansion in specific orbital compartments in patients with Graves' ophthalmopathy. The volumes of the rectus muscles, intra and extraorbital connective, and soft tissues were measured in 110 orbits of 35 patients and 20 control subjects. Data sets from current smokers, ex-smokers, and non-smokers were compared. The total number of cigarettes smoked was calculated, and it was used as an estimate for the severity of smoking (cumulative smoking). The volume measurements were performed on T1-weighted contiguous transversal magnetic resonance images of the orbits. Connective tissue volumes were influenced by smoking history, while muscle volumes were not affected. Ex-smokers had larger amount of extraorbital connective tissue than current smokers (p = 0.012), and this volume showed a good correlation with the number of cigarettes smoked (r = 0.539, p < 0.05). In current smokers, the amount of intraorbital connective tissue correlated well with the cumulative smoking (r = 0.635, p < 0.001). We conclude that connective tissue volumes in certain orbital compartments correlate well with cumulative smoking. Extraocular muscle volumes are not influenced by smoking in patients with Graves' ophthalmopathy.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Thyroid. - 15 : 2 (2005), p. 146-151. -
További szerzők:	Tóth Judit (1964-) (radiológus) Kollár József (1950-) (radiológus) Galuska László (1946-) (belgyógyász, izotópdiagnoszta) Burman, Kenneth D. Boda Judit (belgyógyász, endokrinológus) Leövey András (1926-) (belgyógyász) Varga József (1955-) (fizikus) Ujhelyi Bernadett (1981-) (szemész) Szabó Jenő (belgyógyász, endocrinologus) Berta András (1955-) (szemész, gyermekszemész) Nagy Endre V. (1957-) (belgyógyász, endokrinológus)
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001-es BibID:	BIBFORM029177
Első szerző:	Ujhelyi Bernadett (szemész)
Cím:	Retrobulbar 99mTc-diethylenetriamine-pentaacetic-acid uptake may predict the effectiveness of immunosuppressive therapy in Graves' ophthalmopathy / Bernadett Ujhelyi, Annamaria Erdei, Laszlo Galuska, Jozsef Varga, Lajos Szabados, Erzsebet Balazs, Miklos Bodor, Bela Cseke, Zsolt Karanyi, Andras Leovey, Emese Mezosi, Kenneth D. Burman, Andras Berta, Endre V. Nagy
Dátum:	2009
ISSN:	1050-7256
Megjegyzések:	Background: In Graves' ophthalmopathy (GO), only patients with immunologically active disease respond toimmunosuppressive therapy. Previous studies and theoretical considerations suggest that elevated orbital 99mTcdiethylenetriamine-pentaacetic-acid (DTPA) single photon emission computed tomography (SPECT) reflectsinflammatory disease activity. We studied whether corticosteroid treatment causes a substantial decrease inDTPA uptake in GO, a result consistent with successful immunosuppressive treatment of GO and referred to asa favorable treatment outcome.Methods: One hundred fourteen orbits in 57 patients with active GO (CAS?4) were entered into the study. Allpatients received corticosteroid treatment. Orbital DTPA uptakes were numerically quantified for the entire orbitas well as the anterior and posterior segments separately. DTPA SPECT was performed before, and 2 to 9months after the initiation of immunosuppressive treatment. The normal range for DTPA uptake was establishedin 34 orbits of 17 patients who were being worked up for Raynaud's phenomenon and had no thyroiddisease.Results: The mean DTPA uptake of the 114 orbits of GO patients was higher prior to corticosteroid therapy thanafter this treatment (11.03?4.26MBq/cm3 and 9.84?3.51MBq/cm3, respectively, p<0.001) but a substantialdecline in DTPA uptake was seen in only 39.5% of GO patients. The positive predictive value of an initialDTPA >12.28MBq/cm3 for a substantial decline in DTPA uptake (favorable treatment outcome) was 76%, whilea negative predictive value of a pretreatment DTPA?12.28MBq/cm3 was 78%.Conclusions: Corticosteriod treatment is associated with a decline in DTPA uptake in a fraction of GO patients.GO patients with a DTPA uptake above 12.28MBq/cm3 are more likely to have a favorable response to corticosteroidtherapy while patients with lower values are less likely to have this potentially favorable response.An elevated DTPA uptake may identify patients who are most likely to benefit from immunosuppressivetreatment.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Graves' orbitopathy immunological activity DTPA SPECT egyetemen (Magyarországon) készült közlemény
Megjelenés:	Thyroid. - 19 : 4 (2009), p. 375-380. -
További szerzők:	Erdei Annamária (1976-) (belgyógyász) Galuska László (1946-) (belgyógyász, izotópdiagnoszta) Varga József (1955-) (fizikus) Szabados Lajos (1977-) (orvos) Balázs Erzsébet (1952-) (szemész) Bodor Miklós (1969-) (belgyógyász, endokrinológus) Cseke Béla (1974-) (belgyógyász, endokrinológus) Karányi Zsolt (1961-) (biostatisztikus, bioinformatikus) Leövey András (1926-) (belgyógyász) Mezősi Emese Burman, Kenneth D. Berta András (1955-) (szemész, gyermekszemész) Nagy Endre V. (1957-) (belgyógyász, endokrinológus)
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