PPV susceptibility of commonly used peach rootstock-scion combinations.

Sharka disease is one of the most devastating plant epidemics of Prunus species, caused by plum pox virus (PPV). The viral infection affects the fruits by weight-loss and degradation of quality properties. Breeding of resistant rootstocks and cultivars is one of the most effective disease control methods. PPV determines the peach production all over the world. On the world's fruit production list peach is in the sixth, in the Mediterranean region in the fourth place. In this study new data were shown about PPV susceptibility of commonly used rootstock-scion combinations from Hungary. Reverse transcription PCR (RT-PCR) analysis was conducted on the samples from a commercial orchard; the results were evaluated by chi-square test and binary logistic regression. Four rootstock ('GF677', 'PeMa', 'Cadaman' and almond seedlings) and three scion cultivars (Prunus persicae 'Michelini', 'Babygold 6' and 'Cresthaven') were included in this experiment. The rootstocks did not show any significant differences in regard to the resistance of the virus infection (40-50%), but in case of scions, strong significant relations were observed. In case of the combinations there were results in both directions; tolerant and susceptible combinations were observed as well.

A flavonoid fraction purified from Rutaceae aurantiae (Daflon(R)) inhibiting AGE formation, reduces urinary albumin clearance and corrects hypoalbuminemia in normotensive and hypertensive diabetic rats.

AIM: Advanced glycation endproducts (AGEs) have been shown to contribute to alteration of glomerular permselectivity to proteins in diabetes. Oxidative stress is required for AGE formation. Therefore we studied the effect of an antioxidant micronized purified flavonoid fraction (MPFF, Daflon(R) 500 mg), on urinary albumin clearance in diabetic rats. METHODS: Hyperglycaemia was induced by streptozotocin 55 mg/kg IM at days 0 and 7 in normotensive Wistar rats (NWR, diabetes duration 5 months) or hypertensive Wistar Kyoto rats (SHR, diabetes duration 2 months). MPFF was administered at 300 mg/kg/day, from day -2 until sacrifice. RESULTS: After 5 months of diabetes in NWR, MPFF reduced albumin clearance from 729±92 to 392±60 nl/min/kg, p<0.01, and restored albuminemia from 20.4±0.9 to 24.0±1 g/l, p<0.05; albumin fractional clearance was significantly diminished in the flavonoid-treated diabetic rats (0.360±0.037‰ versus 1.335±0.430‰ in the diabetic controls, p<0.001); MPFF did not significantly modify blood glucose and plasma fructosamine levels. After 2 months of diabetes in SHR, MPFF reduced albumin clearance from 243±121 to 101±47 nl/min/kg, p<0.05, and restored albuminemia from 21.1±1.6 to 26.7±2.2 g/l (p<0.05); MPFF also decreased plasma fluorescence characteristic of AGEs (p<0.02). Besides hesperetin, a main metabolite of MPFF recovered in plasma, inhibited in vitro the formation of the crosslinking AGE pentosidine in collagen incubated with high glucose (p<0.001). CONCLUSION: Our results confirm the role of glycoxidative stress in diabetic nephropathy. MPFF might be useful as complementary treatment for preventing diabetic microangiopathy.

Stimulating effect of growth hormone on type IV collagen production by endothelial cells cultured in normal and high glucose.

Collagen IV accumulation is characteristic of diabetic angiopathy. To test the possible contribution of GH, we studied its effects on collagen IV production by human umbilical vein endothelial cells at 5.5 and 16.7 mmol/l glucose. GH (100 ng/ml) markedly increased collagen IV level in the culture supernatant and in the insoluble extracellular matrix and cell fraction at both glucose concentrations. This stimulating effect of GH was additional to that of high glucose. It was more pronounced on collagen IV than on total protein synthesis. GH increased free latent gelatinase activity slightly at normal and markedly at high glucose. Using GF109203X, a PKC inhibitor, we observed that high glucose, but not GH, activated PKC. These two factors stimulating collagen IV production appear to work through different pathways, favoring an additivity of their effects. This supports the contribution of high plasma GH in diabetic vascular basement membrane thickening.

Aspirin inhibits the formation of pentosidine, a cross-linking advanced glycation end product, in collagen.

Aspirin showed an inhibitory effect on the formation of pentosidine, a cross-linking advanced glycation endproduct, in collagen incubated with glucose in vitro. IC(50) was evaluated at 10mmol/l. Aspirin might act by metallic ion chelating (as did EDTA and DTPA) and by oxygen radical scavenging. Since aspirin was reported to inhibit retinopathy in diabetic dogs, it could act partly by inhibiting advanced glycation endproduct accumulation in long-lived proteins like collagens.

Predictive value of hysteroscopic examination in intrauterine abnormalities.

STUDY OBJECTIVE: This study was set up to evaluate the predictive value of hysteroscopic examination in patients referred to the Department of Obstetrics and Gynecology at the Medical and Health Science Center, Debrecen, Hungary. STUDY DESIGN: The authors performed 835 biopsies by hysteroscopy over more than 13 years. They compared their findings with histological findings held in a a computerized clinical database. RESULTS: The sensitivity of hysteroscopy was 0.52 for hyperplasia, 0.87 for polyps, 0.85 for myomas, 0.68 for carcinoma, and 0.73 for atrophy. CONCLUSION: It seems that for findings facing into the uterine cavity (such as submucosal myomas and peduncular polyps), hysteroscopy can predict the histological results. The evaluation of endometrial cycles and of the thickness of the endometrium by hysteroscopy is less accurate.

Follow-up study on the effectiveness of transcervical myoma resection (TCRM).

STUDY OBJECTIVE: To measure the efficacy of transcervical hysteroscopic fibroid resection (TCRM) among the authors' patients. STUDY DESIGN: In one department, 73 transcervical hysteroscopic fibroid resections were performed on 68 patients over a 6-year period. Using a computerized database and mailed questionnaires, 58 patients were followed up. RESULTS: Thirty-six of the 58 patients showed no symptoms after the procedure; in 15 cases subsequent fibroid was detected, while in seven cases other types of complaints occurred, not related to the myoma. During the procedures complications happened in four cases; one perforation and three bleeding episodes occurred. CONCLUSION: Our data indicate that TCRM is a safe and successful method of treating submucosal fibroids.

Effect of an oral contraceptive containing drospirenone and ethinylestradiol on general well-being and fluid-related symptoms.

Oral contraception is the most widely used reversible contraceptive method. Continuous research over the past decades has led to a range of highly reliable, effective and safe oral contraceptives. Newly developed progestogens may also provide additional non-contraceptive health-related benefits that differentiate the products from each other. Women desiring contraception may thus choose from a wide range of oral contraceptives according to their individual needs. A variety of physical and emotional changes have been linked to hormonal fluctuations during the menstrual cycle. To date, only very few studies have been performed on the impact of fluid retention-related symptoms on well-being and few data are hence available on suggested methods of measurement. This open, multicenter, uncontrolled study evaluated the effects of a combined preparation containing 3 mg drospirenone and 30 microg ethinylestradiol (Yasmin, Schering AG, Berlin, Germany) on general well-being and fluid-related symptoms in women experiencing psychological, behavioral and somatic premenstrual symptoms. The study was conducted over six 28-day cycles, with 336 subjects enrolled. A significant beneficial effect on psychological general well-being, as measured by the Psychological General Well-Being Index (PGWBI), was evident by cycle 3 and maintained at cycle 6. There was a significant reduction in both the incidence and severity of somatic symptoms associated with the menstrual cycle (abdominal bloating and breast tension) during treatment. Assessment by the investigator showed that 80% of subjects had improved on study treatment and 75% of subjects considered themselves satisfied with the study treatment. There was good agreement between the clinician and subject in their assessment of the treatment. Cycle control was very good and body weight remained stable or decreased slightly during the study. In conclusion, 3 mg drospirenone in combination with 30 microg ethinylestradiol has been shown to have a beneficial effect on psychological general well-being, as measured by the PGWBI. Reductions in the incidence and severity of somatic symptoms associated with the menstrual cycle were also observed, suggesting a beneficial effect due to the antimineralocorticoid nature of drospirenone. To our knowledge, this is the first study on oral contraceptives which has used the PGWBI in this population. As quality of life is one of the least explored segments in oral contraceptive users, more studies should investigate the impact of oral contraceptives on quality of life and general well-being in this overall healthy population.

[Open heart surgery with extracorporeal circulation during pregnancy]. / Szívmútét extracorporalis keringéssel és terhesség.

The incidence of heart disease in pregnancy has been gradually falling during the last three decades. Cardiopathy still remains a prominent cause of maternal and fetal morbidity and mortality. Most patients know about their heart disease long before conception, even though the potential risk factors of deteriorating cardiac function during pregnancy are generally not emphasized. These women when pregnant may develop heart failure due to the increased cardiorespiratory requirements. When medical therapy proves insufficient heart surgery becomes mandatory to save the patient's life. The pregnant state is not optimal for cardiac surgery as the principle interest of the mother and the fetus is different. We report on two pregnant patients who underwent unavoidable heart surgery with cardiopulmonary bypass and review the literature regarding the optimal management of open-heart operation in pregnancy aiming to decrease the feto-maternal mortality. The successful outcome of the cardiac surgery on pregnant women is determined by the severity of the preexisting disease, the surgical techniques, and the circumstances of the cardiopulmonary bypass. The best possible results can be achieved by providing preconceptional counseling for the cardiopathic patients regarding the relation between the preexisting risk factors and the adverse maternal and neonatal outcome. When heart surgery is mandatory in pregnancy the careful technical precautions and the continuous cardiotocography help to minimize fetal complications during the cardiopulmonary bypass (CPB).

[Prevalence of human papillomavirus infections in our five-year data]. / Humán papillomavírus-infekció prevalenciája közel ötéves anyagunkban.

Human papillomavirus infection proved to be the most important risk factor for the development of cervical cancer and its preblastomatosis. Human papillomavirus was detected from 1996. June to 2000. September at 1635 patients, who had been positive by colposcopy and/or cytology in an earlier examination. The place of the study were our outpatients' departments and consultations by specialists of Debrecen University, Department of Obstetrics and Gynecology. Hybrid capture system was used to demonstrate the presence of the virus and managed to prove it in the 28.9% of cases. 3.1% of the patients (51 persons) had acquired low-risk, and 23.6% (386 persons) high risk virus types, however 2.1% of the woman (35 patients) were infected with both low-risk and high-risk human papillomavirus types at the same time. Long time decrease of virus prevalence was observed after the age of 35 year, and the significant degree and timing decrease of after the age of 30 year at patients infected with combination of low-risk and high-risk virus types, respectively. This observation is indicative of the correlation between colposcopic-, cytologic abnormalities and the persisting high-risk human papillomavirus infections.

Effect of hyperventilation on cerebral blood flow velocity in preeclamptic pregnancies: is there evidence for an altered cerebral vasoreactivity?

The purpose of this study was to investigate cerebral arteriolar vasoreactivity function in preeclampsia. Preeclamptic (n = 26) and healthy pregnant (n = 22) women underwent transcranial Doppler sonography of the middle cerebral artery at rest and after 60 seconds of hyperventilation (HV). Systolic, diastolic, and mean blood flow velocities were recorded. The percentage change of the blood flow velocities after HV was calculated. Mean blood flow velocity of the middle cerebral artery was higher in preeclamptic women as compared with healthy pregnant women. No difference could be detected in percentage change of middle cerebral artery blood flow velocities after HV between the two groups. There is no evidence of a small-vessel vasoconstriction among preeclamptic patients. The role of vasoconstriction of the large cerebral arteries and vasodilation of the resistance arterioles, as well as a combination of these 2 pathomechanisms, in determining cerebral blood flow in preeclampsia and eclampsia should be investigated in further studies.

The role of preoperative brachytherapy as an adjunct to surgery and postoperative radiotherapy in the treatment of stage I endometrial carcinoma.

PURPOSE: Between 1978 and 1993, 817 cases of endometrial carcinoma were treated with simple hysterectomy with bilateral salpingo-oophorectomy. Five hundred and twenty-six cases had preoperative brachytherapy (Preo), and 291 cases underwent surgery without preoperative radiotherapy (Nopre). The aim of the study was to compare disease-free survival of the two groups. METHODS AND MATERIALS: Survival comparison of the two groups was controlled for postoperative treatment type, according to stage, histological type, degree of differentiation, depth of myometrial invasion and age. The life-table method was used for survival analysis. Cumulative disease-free survival probabilities were calculated as a function of the proportion of normal remaining life elapsed from the time of diagnosis. RESULTS: Five-year disease-free survival of patients with and without preoperative brachytherapy in stage IA, IB and IC was 93 and 93.6%, 93 and 94%, and 80 and 65%, respectively. In well differentiated tumors and poorly differentiated tumors, there was no difference in disease-free survival between patients with and without preoperative brachytherapy. Patients with moderately differentiated tumor treated with preoperative brachytherapy had significantly better disease-free survival than those without preoperative radiotherapy, however, this was confounded by uneven distribution of invasion depth. CONCLUSION: Preoperative brachytherapy plays a limited role in the treatment of early stage endometrial carcinoma.

[The healing process following gynecologic laparoscopy: data on the significance of psychological factors]. / A gyógyulás folyamata nögyógyászati laparoscopiát követóen: adatok a pszichés tényezök jelentóségéhez.

It is known that patients undergoing laparoscopic surgery can be discharged from hospital sooner and their reconvalescence is achieved faster than after laparotomy. Beside the medical judgement of the healing process it is also important to assess the length of time needed for the patients to feel themselves completely cured and be free of complaints. The data on the subjective judgement of the healing process provided by 335 patients who underwent laparoscopic surgery are analyzed retrospectively here. The aim of the study was to assess how anxiety as a personality trait might influence the healing process and also if there is any connection between anxiety, clinical diagnosis and laparoscopic findings. Anxiety was measured by Spielberger's State-Trait Anxiety Inventory (STAI). The estimated average healing time is 29.8 days (appr. 4 weeks), but patients with diagnostic and/or operative laparoscopy felt themselves free of complaints after 18.9 days (appr. 3 weeks) on the average. The duration of the healing process is independent of the laparoscopic findings and the type of procedure. There is a strong correlation between the anxiety level and the healing process. The average level of anxiety trait was 47.99 +/- 9.50. Anxiety level was the highest in the group of patients operated on for pelvic pain (mean = 51.21). There was no serious organic alteration in the small pelvis in 37% of the cases. One year after the operation 11.3% of the patients did not feel themselves cured and 17.6% had complaints. These data emphasize the role of anxiety and that of psychological factors in the etiopathogenesis and treatment of gynecologic diseases, especially in chronic pelvic pain and infertility or sterility.

Cyclic guanosylmonophosphate urinary excretion in parasympathicomimetic or parasympatholytic syndromes induced by reserpine or diphemanil-methylsulfate.

Parasympathetic hyperactivity is found in some infants presenting faint episodes and could be responsible of certain Sudden Infant Death Syndrome cases. Therefore it was interesting to look for a noninvasive biochemical indicator of parasympathetic activity. A parasympaticomimetic syndrome associated with muscarinic receptor stimulation, which has been followed during 48 h, was obtained in the awake rat by reserpine injection (6.25 mg/kg at T0 and T24h), and a model of prolonged parasympatholytic syndrome, by administration of diphemanil-methylsulfate (DPMS), a muscarinic receptor inhibitor, in drinking water (mean daily dosis: 150 mg/kg). Significant bradycardia and tachycardia were respectively observed. In the reserpine-treated rats we found significantly increased cyclic guanosylmonophosphate (cGMP) urinary excretion between T24h and T48h, when compared with vehicle-treated controls (+87% in one experiment, +135% in the other, when expressed in pmol/microg creatinine); norepinephrine urinary excretion between T24h and T48h was decreased (-44%); the increase in cGMP urinary excretion was not significantly modified by the NO-synthase inhibitor, L-nitroarginine-methyl-ester. In the DPMS-treated rats, we observed a significantly decreased cGMP (-20%) and increased norepinephrine urinary excretion (+61%). Thus cGMP excretion varied in opposite directions in the reserpine- and DPMS-treated rats. The link between these modifications in cGMP excretion and muscarinic receptor stimulation or blockade has still to be fully demonstrated. Urinary cGMP excretion could be tested as screening parameter in infants at risk of faint episodes associated with bradycardia.

[Intrauterine fetal death in the third trimester]. / Harmadik trimeszterbeli intrauterin magzati elhalások.

Retrospective analysis of third trimester intrauterine deaths has been performed at the Department of Obstetrics and Gynecology University Medical School Debrecen, Hungary. Among 32,126 deliveries between 1988 and 1997 retrospectively 163 intrauterine deaths occurred in the third trimester. Cases were analysed on the basis of the Nordic-Baltic Perinatal Death Classification. The role of intrauterine growth retardation, cord complication and fetal malformation are discussed. An interesting finding was the high rate of intrauterine growth retardation where cord complication was supposed to be the cause of intrauterine death. Concerning both to medical and legal aspects precise and exact documentation should be needed for the correct retrospective analysis.

[Empty follicle syndrome as cause of unsuccessful in vitro fertilization]. / "Ures" tüszö szindróma, mint a sikertelen in vitro fertilizáció egyik oka.

The authors report a case, where ultrasound guided transvaginal follicle aspiration was carried out for oocyte retrieval during the source of in vitro fertilization. Despite the favourable situation described by ultrasound and prognosed by serum hormone levels aspiration of oocytes proved unsuccessful even after lavage of follicules. The authors give an overview of the literature of "empty" follicle syndrome, its possible aetiology and methods of treatment.

Operative hysteroscopy: minimally invasive surgery to control of menorrhagia.

Diagnostic hysteroscopy is a valuable method for evaluation of intrauterine disorders. After diagnosing, the endoscopic treatment of these pathologies is the major question of past decade. Possibility of solving cause of infertility or abnormal uterine bleeding without laparotomy or hysterotomy/hysterectomy is the great advantage of operative hysteroscopic methods. In Department of Obstetrics and Gynaecology of University Medical School of Debrecen more than 1400 hysteroscopic interventions were performed from 1 September 1989 to 31 December 1996. In treatment of intractable uterine bleeding 347 operative hysteroscopy (targeted biopsy, polypectomy, transcervical endometrial ablation, fibroid resection etc.) were performed. The rate of complications was low, only 2% (4 perforations and 2 bleedings). The high success rate and low rate of complications offers a modern, safe, minimally invasive method for treatment of menorrhagia.

Trend from laparotomy to laparoscopy in the case of treatment of ectopic pregnancy.

Ectopic pregnancy is a very hazardous, life threatening complication of the women. Diagnosis and treatment previously were very conservative. When not typical symptoms were found, only waiting or observing was the main task of hospitalisation and only the beginning of typical signs came laparotomy. Nowadays, with the introduction of vaginal ultrasound, color doppler or power imaging techniques and sensitive blood HCG analysis greatly reduced hospitalisation period. The need for the change from laparotomy to laparoscopic treatment in surgical operations became everyday practice. We analyzed the data in our department for the operation procedures of ectopic pregnancies from 1990.

Second-look surgery (SLO) in the management of carcinoma of the ovary.

There is a permanent controversy on the clinical relevance of second-look laparotomies. In the first approach the majority of clinical experts evaluated this procedure experimental. Our results support the idea of clinical relevance of this procedure as patients with SLOs through the early detection of recurrence really profited from the procedure.

The prognostic value of CA-125 in epithelial ovarian cancer patients during and after chemotherapy.

In the past ten years the investigations on CA-125 levels of epithelial ovarian cancer patients have raised several questions both in the screening and in the follow-up. The predictive value of the test during the postoperative chemotherapy and the follow-up period was the topic in the series of examinations. Our findings are as follows. The decrease of the CA-125 level predicts a long tumour free survival. The permanent high level of CA-125 is a signal of a recurrence within few month after stopping therapy. In case of increase of the CA-125 level an early recurrence can be expected.