[Routine direct detection of Mycobacterium tuberculosis with a rapid test of polymerase chain reaction applied to a Hungarian patient population]. / A Mycobacterium tuberculosis komplex direkt kimutatására szolgáló polimeráz láncreakción alapuló gyorsteszt rutinszerú alkalmazása magyarországi betegpopuláción.

The results of the present study, based on 1869 examined clinical specimens of 543 patients, represent the Hungarian parameters of a PCR test. By using the final and resolved results, the clinical sensitivity, specificity, positive and negative predictive values were 83.8%, 99.2%, 95.4% and 97%, respectively for PCR, 63.5%, 100%, 100% and 93.5%, respectively for culture, and 16.2%, 100%, 100% and 86.3%, respectively for Ziehl-Neelsen (ZN) staining. These results are essential to allow Hungarian clinicians to interpret PCR results in accordance with local conditions. The present study has demonstrated a high sensitivity (PCR vs. culture and smear, p < 0.01) and an excellent specificity of PCR. Our results indicate that the majority of M. tuberculosis-positive specimens can be identified rapidly with the test and, because of the high negative predictive value, the PCR test can help to exclude tuberculosis from the differential diagnosis in 24 hours. Moreover, the PCR can detect the presence of M. tuberculosis in 66.6% of ZN-negative and subsequently culture-positive specimens at the time of admission. The results of PCR must be interpreted with extreme caution, and the procedure is recommended only for laboratories, which simultaneously perform culture and microscopy for control of the performance of PCR tests.

Molecular characterization of rifampin-resistant isolates of Mycobacterium tuberculosis from Hungary by DNA sequencing and the line probe assay.

Two regions of rpoB associated with rifampin resistance were sequenced in 29 rifampin-resistant (determined by the proportion method) isolates of Mycobacterium tuberculosis obtained from patients from three counties in Hungary. Of the 29 resistant strains, 27 had a mutation in either the 81-bp region (26 strains) or the N-terminal region (1 strain), while the other 2 strains had no mutations in either region. The locations and frequencies of the mutations differed from those previously reported. The most common mutation in this study, D516V, was found in 38% of the Hungarian strains, a frequency 2 to 10 times higher than that found in studies from other countries. These same 29 isolates were also evaluated with the Inno-LiPA Rif. TB test (LiPA), a reverse hybridization assay for the rapid detection of rifampin resistance. Although LiPA detected the presence of an rpoB mutation in 26 of the resistant isolates, the type of mutation could not be determined in 4 isolates because the mutations present were not among those included on the LiPA strip. In addition, a silent mutation in one of the rifampin-susceptible control strains was interpreted as rifampin resistant by LiPA. These findings demonstrate the importance of validating this rapid molecular test by comparison with DNA sequence results in each geographic location before incorporating the test into routine diagnostic work.

[Quality of life in asthmatics]. / Az asthmás betegek életminóségének vizsgálata.

UNLABELLED: Despite the availability of effective treatments asthma is increasing in both prevalence and severity specially in the well developed countries. As a consequence of this a large part of population is affected and the disease has a significant burden to the society. Evaluation of therapeutic effectiveness can be determined by measuring the quality of life. OBJECTIVE: As asthma has a major impact on the patients everyday life, we examined the quality of life of adult asthmatics with a disease specific questionniare (St. George's Respiratory questionniare SGRQ) and a visual analogue scale (VAS). We wanted to find out if the quality of life scores are significant with the results of clinical tests. METHODS: We examined 321 adult asthmatic patients. Patients were randomly selected. The influence of three factors age, sex, and FEV1 on quality of life was investigated. The data was analysed with user SPSS system. RESULTS: The results of the visuala analog scale were the following in female asthmatics 61.38%, in males 63.86%, the VAS results were the following according to the disease severity: mild intermittant 76%, mild 69%, moderate 60%, sever 49%. From the St. George questionniare three component scores were calculated: symptom (304.15 +/- 11.01), activity (580.71 +/- 19.57), impact (842.18 +/- 31.53) and the total score (1727.05 +/- 57.24). When we examined the different scores according to the age we found significant differences with the activity, impact and total score, but could not find significant differences with the symptom scores. The relationship between spirometry and quality of life is not as strong (coefficient of correlation: 0.37) but the majority of patients have high SGRQ scores even those patients whose FEV1 lies within the normal range. CONCLUSIONS: For patients with asthma it is common that one might see improvement in the FEV1 and yet not see an improvement in patients feelings or functioning. It was interesting to see that in spite of their bad conditions patients do accept the chronic nature of asthma, a degree of impairment and regard that as normal, limits in their everyday life, as they adjust their activity so that they can avoid the asthma attacks.

Comparison of recoveries of mycobacterium tuberculosis using the automated BACTEC MGIT 960 system, the BACTEC 460 TB system, and Löwenstein-Jensen medium.

Using two different liquid media and one conventional solid medium, a total of 57 mycobacterial isolates (Mycobacterium tuberculosis, n = 55; nontuberculous mycobacteria, n = 2) were recovered from 377 clinical specimens. The rates of recovery of M. tuberculosis were 96. 4% with the BACTEC MGIT 960 liquid medium, 92.7% with BACTEC 12B liquid medium, and 81.8% with the Löwenstein-Jensen (LJ) medium. The mean time to detection of M. tuberculosis in smear-positive specimens was 12.6 days for BACTEC MGIT 960 medium, 13.8 days for BACTEC 12B medium, and 20.1 days for LJ medium, and in smear-negative specimens it was 15.8 days for BACTEC MGIT 960 medium, 17.7 days for BACTEC 12B medium, and 42.2 days for LJ medium. The rates of contamination were 3.7, 2.9, and 1.2% for the BACTEC MGIT 960, BACTEC 12B, and LJ media, respectively. In conclusion, the nonradiometric, fully automated 7-ml BACTEC MGIT 960 system can be considered a viable alternative to the semiautomated, radiometric BACTEC 460 TB system.

Effect of denervation on the neurogenic inflammation of the rat mandibular mucosa.

Effects of local exposure to capsaicin on the vascular permeability and blood flow were studied in the rat oral mucosa at days 2 and 14 after the unilateral transection of the inferior alveolar nerve (IAN). The distribution of nerve fibers displaying substance P (SP) and calcitonin gene-related peptide (CGRP) immunoreactivity (IR) in the mandibular mucosa was also assessed. While the capsaicin-induced augmentation in vascular permeability was about 50% (P less than 0.05) higher on the intact side (at both days 2 and 14) than on the denervated side, no difference in blood flow elevation was seen between the two sides. Transection of IAN caused only a slight reduction in the density of SP- and CGRP-IR fibers in the mucosa. It is concluded that in addition to the IAN fibers the mandibular mucosa examined also seems to be supplied by other sensory fibers. The presence of accessory trigeminal branches was also supported by immunohistochemical studies.

[The effect of the transsection of the inferior alveolar nerve on neurogenic inflammation of the mouth mucosa. II. Immunohistochemical studies]. / A nervus alveolaris inferior átmetszésének hatása a szájnyálkahártya neurogén gyulladása. II. Immunhisztokémiai vizsgálatok.

The distribution of nerve fibers displaying calcitonin gene-related peptide (CGRP) immunoreactivity in the mandibular mucosa was studied in control rats, in rats after unilateral transection of the inferior alveolar nerve (IAN), and in animals following cervical sympathetic denervation. According to the results, the transection of the peripheral branch of the IAN has no effect on the distribution of the CGRP immunoreactive nerves.

[Morphologic and morphometric analysis of atheromatous changes in the aorta in silibinin-treated cholesterin-fed rabbits]. / Atheromatózus aorta elváltozások morfológiai és morfometriai elemzése Silibininnel kezelt, koleszterinnel etetett nyulakban.

Authors studied the effect of Silibinin of antioxidative effect on cholesterin sclerosis of rabbits. Qualitative analysis of aorta sections, macroscopic and microscopic morphometric examination of aorta were the applied methods. Their results seem to show that Silibinin has a favourable influence on cholesterin sclerosis. According to their opinion only joint use of qualitative and quantitative macroscopic and microscopic methods can provide basis for really accurate judgment of any atheromatose change.