Mangalica kanok fertilizációs képességének elemzése a here endokrin és exokrin működésének tükrében = Studies on the fertilizing ability of Mangalica boars with special emphasis on the testicular endocrine and exocrine function

GnRH-teszttel vizsgáltuk a mangalica kanok tesztikuláris endokrin funkciót. Az életkor, élősúly, heretérfogat és a tesztoszteron alapérték ? mint független változók ? együttes hatását vizsgálva megállapítottuk, hogy a négy vizsgált jellemző a tesztoszteron emelkedés mértékét jelentősen befolyásolja. Komplex spermatológiai vizsgálataink szerint a mangalica sertés esetében az ejakulátum volumen kisebb (177,8?18,92 ml), az átlagos spermiumkoncentráció (490x106?160x106/ml) és az ejakulátumonkénti összes spermium (894x108?308,1x108) viszont jóval magasabb az intenzív sertésfajták azonos paramétereihez képest. Sperma eltarthatósági vizsgálatokban a legjobb eredményeket a Standard (110h) és a BTS (95,5h) hígítókkal értük el. A kanok ivartalanítás előtt elvégzett GnRH-teszt, és a szövettani vizsgálat eredményeit összevetve az ép heréjű kanoknál 27 %-kal nagyobb volt a hormon koncentráció növekedés, mint a degenerált heréjű állatoknál. Az ivari funkciók szezonális változásának tanulmányozása során a testoszteron alapértékekben szignifikáns különbséget csak a nyári és az őszi adatok között tapasztaltunk (p=0,028). A GnRh-val provokált tesztoszteron hormonszintek között (p=0,007) az őszi és tavaszi medián értékek között mutatkozott szignifikáns eltérés. A here térfogatokban az őszi-téli (p=0,012) és az őszi-tavaszi (p=0,015) eredmények között szignifikáns különbséget tapasztaltunk. A spermajellemzők közül az ejakulátum mennyisége és motilitási%-a kiegyenlített képet mutatott. | The testicular endocrine function was investigated with GnRH treatment in Mangalica boars. The effect of age, live weight, testis volume and basic testosterone level as independent factors was investigated on testosterone increase (Tincr%). The combination of these factors had a high effect on the level of Tincr%. A lower semen volume (177.8?18.92 ml), but higher mean concentration (490?160 x 106 spermatozoa/ml) and mean number of sperm cells per ejaculate (894?308.1 x108) was observed in Mangalica boars compared to modern swine breeds.During the liquid preservation period the best result was obtained with Standard (110h) and BTS (95.5h) extenders. A weak correlation could be detected between testosterone increase (GnRH response) and histological findigs of the testes. The testosterone increase was 27% higher in boars with healthy testes than that had pathological alteration, however further investigation needed to confirm these findings. Basic testosterone concentrations were distinct in seasons, however significant difference was observed only between summer and autumn samples (p=0.028). Effect of seasonal changes was recorded on the volume of the testes too. Among semen parameters only small monthly variation was noticed in mean ejaculate volume and motility %

The Role of Tumor Specific DNA/gene Dose in the Development of Papillary Rencel Cell Tumors

The classification of renal cell carcinoma (RCC) is traditionally based of the microscopis evalutation of HE stained slides. After classification systems based on cytological and architectural alterations, a change in the paradigm happened in the late 80’ and early 90’s: the new classification was based on specific chromosomal changes in tumors (Kovacs, 1993 a,b). The Heidelberg classification notices tumor-specific genetical alterations that identify the type of the tumor, even in cases, when histological analysis is controversial (Kovacs et al., 1997). Papaillary renal cell carcinoma can show high histological variability, but it shows well defined choromosomal and genetical changes. During tumor development, first the trisomy of tetrasomy of choromosomes 7 and 17 develop. This is may be followed by the loss of chromosome Y. The later chromosomal trisomies of 3q, 8, 12, 16, 20 might also develop, which merks the progression into a more aggressive tumor (Kovacs 1993a, Szponar et al., 2009). These data have high significance knowing the currently used WHO classification, where the difference between the papillary adenoma and carcinoma is made only by the size of the tumor. Thus a tumor under 15mm-s is benign, and above 15mms is malignant (Moch et al., 2016). This might lead to a false prediction of the prognosis. There are two theories about the development of papillary renal cell carcinoma. According to the opinion of the WHO and ISUP (International Society of Urological Pathologists) the papillary renal cell tumors originate from the differentiated mature cells of the renal tubules, similarly to conventional renal cell carcinoma. A different theory states, that the development of papillary renal cell carcinoma follows a sequence of developmental disorder – precursor lesion – adenoma – carcinoma (Kovacs, 1993 a,b). The most important tool in the differentiation between adenoma and carcinoma is genetic analysis

Preoperative Serum Carbohydrate Antigen 19-9 Levels Cannot Predict the Surgical Resectability of Pancreatic Cancer : A Meta-Analysis

Background and Aims: Pancreatic ductal adenocarcinoma has one of the worst prognosis of all malignancies. This investigated the relationship between the preoperative serum carbohydrate antigen 19-9 and surgical resectability. Methods: A systematic search was performed in three databases (MEDLINE, EMBASE, and Web of Science) to compare the surgical resectability of pancreatic ductal adenocarcinoma in patients with high and low preoperative serum carbohydrate antigen 19-9 values. The receiving operating characteristic curves were constructed and the weighted mean differences for preoperative serum carbohydrate antigen 19-9 levels of resectable and unresectable groups of patients were calculated. The PROSPERO registration number is CRD42019132522. Results: Results showed that there was a significant difference in resectability between the low and high carbohydrate antigen 19-9 groups. Six out of the eight studies utilised receiver operating characteristic curves in order to find the cut-off preoperative carbohydrate antigen 19-9 levels marking unresectability. The overall result from the pooled area under curve values from the receiver operating characteristic curves was 0.794 (CI: 0.694-0.893), showing that the preoperative carbohydrate antigen 19-9 level is a "fair" marker of resectability. The result of the pooled weighted mean differences was 964 U/ml (p < 0.001) showing that there is a significant carbohydrate antigen 19-9 difference between the resectable and unresectable groups. Based on the results of the I-squared test, the result was 87.4%, accounting for "considerable" heterogeneity within the population. Conclusion: Carbohydrate antigen 19-9 is not a reliable marker of unresectability, it should not be used on its own in surgical decision-making

Aging and Comorbidities in Acute Pancreatitis I: A Meta-Analysis and Systematic Review Based on 194,702 Patients

Background: Acute pancreatitis (AP) is one of the most common cause of hospitalization among gastrointestinal diseases worldwide. Although most of the cases are mild, approximately 10–20% of patients develop a severe course of disease with higher mortality rate. Scoring systems consider age as a risk factor of mortality and severity (BISAP; &gt;60 years, JPN&gt;70 years, RANSON; &gt;55 years, APACHE II &gt;45 years). If there is a correlation between aging and the clinical features of AP, how does age influence mortality and severity?Aim: This study aimed to systematically review the effects of aging on AP.Methods: A comprehensive systematic literature search was conducted in the Embase, Cochrane, and Pubmed databases. A meta-analysis was performed using the preferred reporting items for systematic review and meta-analysis statement (PRISMA). A total of 1,100 articles were found. After removing duplicates and articles containing insufficient or irrelevant data, 33 publications involving 194,702 AP patients were analyzed. Seven age categories were determined and several mathematical models, including conventional mathematical methods (linear regression), meta-analyses (random effect model and heterogeneity tests), meta-regression, funnel plot and Egger's test for publication bias were performed. Quality assessment was conducted using the modified Newcastle–Ottawa scale. The meta-analysis was registered in the PROSPERO database (CRD42017079253).Results: Aging greatly influences the outcome of AP. There was a low severe AP incidence in patients under 30 (1.6%); however, the incidence of severe AP showed a continuous, linear increase between 20 and 70 (0.193%/year) of up to 9.6%. The mortality rate was 0.9% in patients under 20 and demonstrated a continuous linear elevation until 59, however from this age the mortality rate started elevating with 9 times higher rate until the age of 70. The mortality rate between 20 and 59 grew 0.086%/year and 0.765%/year between 59 and 70. Overall, patients above 70 had a 19 times higher mortality rate than patients under 20. The mortality rate rising with age was confirmed by meta-regression (coefficient: 0.037 CI: 0.006–0.068, p = 0.022; adjusted r2: 13.8%), and severity also (coefficient: 0.035 CI: 0.019–0.052, p &lt; 0.001; adjusted r2: 31.6%).Conclusion: Our analysis shows a likelihood of severe pancreatitis, as well as, pancreatitis-associated mortality is more common with advanced age. Importantly, the rapid elevation of mortality above the age of 59 suggests the involvement of additional deteriorating factors such as co-morbidity in elderly

Eosinophil Counts in the Small Intestine and Colon of Children Without Apparent Gastrointestinal Disease: a Meta-analysis

OBJECTIVES: The aim of the current study was to review the available data regarding eosinophil density in healthy tissue specimen originating from lower gastrointestinal segments to support suggested diagnostic cut-offs widely used in clinical practice. METHODS: A systematic search was performed in three different databases. Calculations were made with Comprehensive MetaAnalysis software using random effects model. Cell number measurements were pooled using the random effects model and displayed on forest plots. Summary point estimations, 95% Confidence Intervals (CIs), and 95% Prediction Intervals (PIs) were calculated. RESULTS: The cumulative mean cell numbers were 8.26 (95% CI: 3.49, 13.03) with PI of 0-25.32 for the duodenum, 11.51 (95% CI: 7.21, 15.82) with PI of 0-60.59 for the terminal ileum, and 11.10/HPF (95% CI: 9.11, 13.09) with PI of 0.96-21.23 in the large intestine and the rectum (HPF area = 0.2 mm). Previous studies included control patients with irritable bowel syndrome (IBS) and functional GI disorders. As mucosal eosinophils have a role in their pathomechanism, those patients should have been excluded. A critical point of interpreting reported data is that HPF is relative to the technical parameters of the microscopes, therefore it is important to report findings in cell/mm. CONCLUSIONS: The present meta-analysis does not support the higher (>20) or lower (<10) cut-off values for healthy tissue eosinophil number. In contrast to the esophagus, there is no normal cut-off eosinophil density in the small intestine and the colon. A prospective, multi-center study to establish normal mucosal eosinophil density is clearly needed

Meta-Analysis of the Long Term Success Rate of Different Interventions in Benign Biliary Strictures.

BACKGROUND: Benign biliary stricture is a rare condition and the majority of the cases are caused by operative trauma or chronic inflammation based on various etiology. Although the initial results of endoscopic, percutaneous and surgical treatment are impressive, no comparison about long term stricture resolution is available. AIMS: The goal of this study was to compare the long term disease free survival in benign biliary strictures with various etiology after surgery, percutaneous transhepatic-and endoscopic treatment. METHODS: PubMed, Embase, and Cochrane Library were searched by computer and manually for published studies. The investigators selected the publications according to the inclusion and exclusion criteria, processed the data and assessed the quality of the selected studies. Meta-analysis of data of 24 publications was performed to compare long term disease free survival of different treatment groups. RESULTS: Compared the subgroups surgery resulted in the highest long term stricture resolution rate, followed by the percutaneous transhepatic treatment, the multiple plastic stent insertion and covered self-expanding metal stents (SEMS), however the difference was not significant. All compared methods are significantly superior to the single plastic stent placement. Long term stricture resolution rate irrespectively of any therapy is still not more than 84%. CONCLUSIONS: In summary, the use of single plastic stent is not recommended. Further randomized studies and innovative technical development are required for improving the treatment of benign biliary strictures