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001-es BibID:	BIBFORM125045
Első szerző:	Halmi Sándor (belgyógyász)
Cím:	Single center experience in localization of insulinoma by selective intraarterial calcium stimulation angiography : a case series of 15 years / Halmi Sándor, Berta Eszter, Diószegi Ágnes, Sira Lívia, Fülöp Péter, Nagy Endre V., Győry Ferenc, Kanyári Zsolt, Tóth Judit, Bhattoa Harjit Pal, Bodor Miklós
Dátum:	2024
ISSN:	1664-2392
Megjegyzések:	Background: Insulinomas are rare insulin-secreting neuroendocrine neoplasms of the pancreas. First-line treatment is the surgical removal of the tumor, however, the localization with standard imaging techniques is often challenging. With the help of selective intraarterial calcium stimulation the insulinoma's localization can be narrowed down to one third of the pancreas which the selected artery supplies. Objective: We aimed to prove the usefulness of the calcium stimulation test in case of 9 patients treated between 2006 and 2021 diagnosed with endogenous hyperinsulinemic hypoglycemia confirmed by fasting test, where conventional imaging methods, like transabdominal ultrasound, CT or MRI failed to detect the source of hyperinsulinemia. Methods: We performed selective intraarterial calcium stimulation with angiography with calcium gluconate injected to the main supporting arteries of the pancreas (splenic, superior mesenteric and gastroduodenal arteries); blood samples were obtained from the right hepatic vein before, and 30, 60 and 120 seconds after calcium administration. Results: With selective angiography we found a significant elevation of insulin levels taken from the right hepatic vein in five of the nine cases. On histopathology, the lesions were between 1-2 cm, in one case malignancy was also confirmed. In four patients we found a significant rise of insulin levels obtained from all catheterized sites, which confirmed the diagnosis of nesidioblastosis. In three cases no surgery was performed, and the symptoms relieved with medical treatment. Conclusions: Selective intraarterial calcium stimulation remains an important tool in localization of the source of insulin excess, especially in cases where other diagnostic modalities fail.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk insulinoma selective intraarterial calcium stimulation ASVS nesidioblastosis hyperinsulinemic hypoglycemia pancreas functioning neuroendocrine tumor
Megjelenés:	Frontiers in Endocrinology. - 15 (2024), p. 1-7. -
További szerzők:	Berta Eszter (1980-) (belgyógyász) Diószegi Ágnes (1987-) (belgyógyász) Sira Lívia (1973-) (endokrinológus) Fülöp Péter (1974-) (belgyógyász, endokrinológus, lipidológus) Nagy Endre V. (1957-) (belgyógyász, endokrinológus) Győry Ferenc (1964-) (sebész) Kanyári Zsolt (1964-) (orvos) Tóth Judit (1978-) (laboratóriumi szakorvos) Bhattoa Harjit Pal (1973-) (laboratóriumi szakorvos) Bodor Miklós (1969-) (belgyógyász, endokrinológus)
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001-es BibID:	BIBFORM079170
035-os BibID:	(WoS)000500179300051 (Scopus)85065488320
Első szerző:	Kovács Dávid Ágoston (sebész)
Cím:	Surgical Treatment of Hyperparathyroidism After Kidney Transplant / D. Á. Kovács, R. Fedor, L. Asztalos, M. Andrási, R. P. Szabó, Zs. Kanyári, S. Barna, B. Nemes, F. Győry
Dátum:	2019
ISSN:	0041-1345
Megjegyzések:	Chronic renal impairment is often associated with complex bone disorders. Improvement of secondary hyperparathyroidism (HPT) is expected after kidney transplant (KT) if the glomerular filtration rate is normalized. Patients and Methods There were 888 KTs performed between 1996 and 2017 at our department. A total of 558 general patients have been operated on for HPT during the same period. The 2 populations had a common part: out of the 558, a total of 69 (12.4%) were in end-stage renal failure when operated on because of secondary HPT. That also means that 7.8% of all KTs were associated with HPT. Retrospective, single-center analysis was performed using the patients' medical records. The aim of our study was to analyze the results of parathyroidectomies after KT. Results Parathyroid surgery was performed on 19 patients (2.14%) because of HPT after KT. The applied surgical technique was total parathyroidectomy with autotransplant in 6 cases, subtotal parathyroidectomy in 3 cases, and selective parathyroidectomy in 10 cases. In all cases, histology revealed benign disease. Complications were observed in 10 cases (52%); there were 6 cases of postoperative hypocalcaemia (31.58%), 1 case of transient laryngeal recurrent nerve paresis (5.26%), and 6 cases of recurrent HPT (31.58%). Summary The first step of HPT management is calcimimetic drug treatment. It is essential to prevent possible complications with regular laboratory monitoring. If the proper conservative therapy is refractory or severe in complications, surgery should be chosen. If the patient is already waiting for a KT, it is worth performing the parathyroid surgery before KT. Close collaboration with endocrinologists and nephrologists is needed to achieve successful therapy.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok konferenciacikk folyóiratcikk hyperparathyroidisim kidney transplant
Megjelenés:	Transplantation Proceedings. - 51 : 4 (2019), p. 1244-1247. -
További szerzők:	Fedor Roland (1975-) (sebész) Asztalos László (1951-) (sebész) Andrási M. P. Szabó Réka (1979-) (belgyógyász, nephrológus) Kanyári Zsolt (1964-) (orvos) Barna Sándor (1982-) (kutató orvos) Nemes Balázs Áron (1969-) (sebész) Győry Ferenc (1964-) (sebész)
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