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Krolopp Á, Fésűs L, Szipőcs G, Wikonkál N, Szipőcs R. A 20 MHz Repetition Rate, Sub-Picosecond Ti-Sapphire Laser for Fiber Delivery in Nonlinear Microscopy of the Skin. Life (Basel) 2024; 14:231. [PMID: 38398740 PMCID: PMC10889949 DOI: 10.3390/life14020231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/10/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
Nonlinear microscopy (NM) enables us to investigate the morphology or monitor the physiological processes of the skin through the use of ultrafast lasers. Fiber (or fiber-coupled) lasers are of great interest because they can easily be combined with a handheld, scanning nonlinear microscope. This latter feature greatly increases the utility of NM for pre-clinical applications and in vivo tissue imaging. Here, we present a fiber-coupled, sub-ps Ti-sapphire laser system being optimized for in vivo, stain-free, 3D imaging of skin alterations with a low thermal load of the skin. The laser is pumped by a low-cost, 2.1 W, 532 nm pump laser and delivers 0.5-1 ps, high-peak-power pulses at a ~20 MHz repetition rate. The spectral bandwidth of the laser is below 2 nm, which results in a low sensitivity for dispersion during fiber delivery. The reduction in the peak intensity due to the increased pulse duration is compensated by the lower repetition rate of our laser. In our proof-of-concept imaging experiments, a ~1.8 m long, commercial hollow-core photonic bandgap fiber was used for fiber delivery. Fresh and frozen skin biopsies of different skin alterations (e.g., adult hemangioma, basal cell cancer) and an unaffected control were used for high-quality, two-photon excitation fluorescence microscopy (2PEF) and second-harmonic generation (SHG) z-stack (3D) imaging.
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Affiliation(s)
- Ádám Krolopp
- HUN-REN Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, H-1525 Budapest, Hungary
- R&D Ultrafast Lasers Ltd., Konkoly-Thege Street 29-33, H-1121 Budapest, Hungary
| | - Luca Fésűs
- HUN-REN Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, H-1525 Budapest, Hungary
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária Street 41, H-1085 Budapest, Hungary
| | - Gergely Szipőcs
- HUN-REN Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, H-1525 Budapest, Hungary
- R&D Ultrafast Lasers Ltd., Konkoly-Thege Street 29-33, H-1121 Budapest, Hungary
| | - Norbert Wikonkál
- HUN-REN Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, H-1525 Budapest, Hungary
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária Street 41, H-1085 Budapest, Hungary
| | - Róbert Szipőcs
- HUN-REN Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, H-1525 Budapest, Hungary
- R&D Ultrafast Lasers Ltd., Konkoly-Thege Street 29-33, H-1121 Budapest, Hungary
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2
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Bozsányi S, Czurkó N, Becske M, Kasek R, Lázár BK, Boostani M, Meznerics FA, Farkas K, Varga NN, Gulyás L, Bánvölgyi A, Fehér BÁ, Fejes E, Lőrincz K, Kovács A, Gergely H, Takács S, Holló P, Kiss N, Wikonkál N, Lázár I. Assessment of Frontal Hemispherical Lateralization in Plaque Psoriasis and Atopic Dermatitis. J Clin Med 2023; 12:4194. [PMID: 37445231 DOI: 10.3390/jcm12134194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/09/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Each brain hemisphere plays a specialized role in cognitive and behavioral processes, known as hemispheric lateralization. In chronic skin diseases, such as plaque psoriasis (Pso) and atopic dermatitis (AD), the degree of lateralization between the frontal hemispheres may provide insight into specific connections between skin diseases and the psyche. This study aims to analyze the hemispherical lateralization, neurovegetative responses, and psychometric characteristics of patients with Pso and AD. METHODS The study included 46 patients with Pso, 56 patients with AD, and 29 healthy control (Ctrl) subjects. The participants underwent frontal electroencephalogram (EEG) measurement, heart rate variability (HRV) assessment, and psychological tests. Statistical analyses were performed using ANOVA, with Bonferroni correction applied for multiple comparisons. RESULTS This study shows a significant right-lateralized prefrontal activity in both AD patients (p < 0.001) and Pso patients (p = 0.045) compared with Ctrl, with no significant difference between the AD and Pso groups (p = 0.633). AD patients with right-hemispheric dominant prefrontal activation exhibited increased inhibition and avoidance markers, while Pso patients showed elevated sympathetic nervous system activity. CONCLUSION Psychophysiological and psychometric data suggest a shared prevalence of right-hemispheric dominance in both AD and Pso patient groups. However, the findings indicate distinct psychodermatological mechanisms in AD and Pso.
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Affiliation(s)
- Szabolcs Bozsányi
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Natália Czurkó
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Melinda Becske
- Institute of Behavioral Sciences, Semmelweis University, 1089 Budapest, Hungary
- Selye János Doctoral College for Advanced Studies, 1085 Budapest, Hungary
| | - Roland Kasek
- Institute of Behavioral Sciences, Semmelweis University, 1089 Budapest, Hungary
- Selye János Doctoral College for Advanced Studies, 1085 Budapest, Hungary
| | - Botond Keve Lázár
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Mehdi Boostani
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Fanni Adél Meznerics
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Klára Farkas
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Noémi Nóra Varga
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Lili Gulyás
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Bence Ágoston Fehér
- Institute of Behavioral Sciences, Semmelweis University, 1089 Budapest, Hungary
| | - Emese Fejes
- Selye János Doctoral College for Advanced Studies, 1085 Budapest, Hungary
| | - Kende Lőrincz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Anikó Kovács
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Hunor Gergely
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Szabolcs Takács
- Institute of Psychology, Faculty of Humanities, Károli Gáspár University of the Reformed Church in Hungary, 1042 Budapest, Hungary
| | - Péter Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Norbert Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
- Central Hospital of Northern Pest-Military Hospital, 1139 Budapest, Hungary
| | - Imre Lázár
- Institute of Behavioral Sciences, Semmelweis University, 1089 Budapest, Hungary
- Institute of Social and Communication Sciences, Faculty of Humanities and Social Sciences, Károli Gáspár University of the Reformed Church in Hungary, 1091 Budapest, Hungary
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Farkas K, Kiss N, Szabó V, Resch M, Vámos R, Borbándy Á, Nagy A, Apor A, Arányi T, Szeri F, Wikonkál N, Nagy Z, Merkely B, Medvecz M. Pseudoxanthoma elasticumban szenvedő betegek multidiszciplináris ellátása. Orv Hetil 2022; 163:702-711. [DOI: 10.1556/650.2022.32438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/23/2021] [Indexed: 11/21/2022]
Abstract
Összefoglaló. A pseudoxanthoma elasticum (PXE, OMIM # 264800) egy
autoszomális recesszív módon öröklődő multiszisztémás érintettséggel járó
kórkép, melynek háttérében az ABCC6 gén mutációi állnak. A
tünetek kialakulásának oka az ektópiás mineralizáció. Kalcium-só kristályok
rakódnak le elsősorban a bőrben, a szem Bruch-membránjában és az erek
endotheliumában, így a bőrelváltozások mellett a látás csökkenése és
cardiovascularis eltérések is jelentkezhetnek. A klinikai tünetek változó
súlyosságúak lehetnek, heterogén megjelenésűek. A betegek fenotípusának
azonosítása, valamint gondozása multidiszciplináris feladat, bőrgyógyász,
szemész, kardiológus és klinikai genetikus együttműködésén alapul. Célunk, hogy
bemutassuk a betegségben előforduló tüneteket, melyek ismerete megkönnyíti a
kórkép felismerését, illetve hogy felhívjuk a figyelmet a korai diagnózis
fontosságára és ismertessük a korszerű diagnosztikai módszereket. A súlyos
szisztémás tünetek kialakulása miatt rendkívüli jelentőséggel bír a társszakmák
együttműködése, hogy a korai diagnózis által időben megfelelő gondozásban és
terápiában részesülhessenek a betegek. Orv Hetil. 2022; 163(18): 702–711.
Summary. Pseudoxanthoma elasticum (PXE, OMIM # 264800) is an
autosomal recessive, multisystemic disorder, associated with mutations of the
ABCC6 gene. Ectopic mineralization is in the background of
the clinical manifestations of the disease. Calcium-salt crystals are deposited
primarily in the skin, in the Bruch membrane of the eyes, and in the vascular
endothelium. Thus, in addition to the skin lesions, visual impairment and
cardiovascular involvement also occur. Clinical symptoms show varying severity
and display heterogeneous appearance. The identification of the phenotype and
care of the patients require a multidisciplinary perspective based on the
collaboration of a dermatologist, ophthalmologist, cardiologist, and clinical
geneticist. The aim of our work is to describe the development of symptoms of
the disease, in order to facilitate the diagnosis. In addition, we aim to draw
attention to the importance of early diagnosis of pseudoxanthoma elasticum, and
to present modern diagnostic methods. Considering the development of severe
systemic complications, the early diagnosis with the collaboration between
related specialists is crucial to provide optimal clinical care and management
of the patients. Orv Hetil. 2022; 163(18): 702–711.
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Affiliation(s)
- Klára Farkas
- Semmelweis Egyetem, Általános Orvostudományi Kar, Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest, Mária u. 41., 1085 Magyarország
| | - Norbert Kiss
- Semmelweis Egyetem, Általános Orvostudományi Kar, Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest, Mária u. 41., 1085 Magyarország
| | - Viktória Szabó
- Semmelweis Egyetem, Általános Orvostudományi Kar, Szemészeti Klinika Budapest Magyarország
| | - Miklós Resch
- Semmelweis Egyetem, Általános Orvostudományi Kar, Szemészeti Klinika Budapest Magyarország
| | - Rita Vámos
- Semmelweis Egyetem, Általános Orvostudományi Kar, Szemészeti Klinika Budapest Magyarország
| | - Ágnes Borbándy
- Semmelweis Egyetem, Általános Orvostudományi Kar, Szemészeti Klinika Budapest Magyarország
| | - Anikó Nagy
- Semmelweis Egyetem, Általános Orvostudományi Kar, Városmajori Szív- és Érgyógyászati Klinika Budapest Magyarország
| | - Astrid Apor
- Semmelweis Egyetem, Általános Orvostudományi Kar, Városmajori Szív- és Érgyógyászati Klinika Budapest Magyarország
| | - Tamás Arányi
- Semmelweis Egyetem, Általános Orvostudományi Kar, Molekuláris Biológiai Tanszék Budapest Magyarország
| | - Flóra Szeri
- Semmelweis Egyetem, Általános Orvostudományi Kar, Molekuláris Biológiai Tanszék Budapest Magyarország
| | - Norbert Wikonkál
- Semmelweis Egyetem, Általános Orvostudományi Kar, Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest, Mária u. 41., 1085 Magyarország
| | - Zoltán Nagy
- Semmelweis Egyetem, Általános Orvostudományi Kar, Szemészeti Klinika Budapest Magyarország
| | - Béla Merkely
- Semmelweis Egyetem, Általános Orvostudományi Kar, Városmajori Szív- és Érgyógyászati Klinika Budapest Magyarország
| | - Márta Medvecz
- Semmelweis Egyetem, Általános Orvostudományi Kar, Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest, Mária u. 41., 1085 Magyarország
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Takács I, Dank M, Majnik J, Nagy G, Szabó A, Szabó B, Szekanecz Z, Sziller I, Toldy E, Tislér A, Valkusz Z, Várbíró S, Wikonkál N, Lakatos P. Magyarországi konszenzusajánlás a D-vitamin szerepéről a betegségek megelőzésében és kezelésében. Orv Hetil 2022; 163:575-584. [DOI: 10.1556/650.2022.32463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/28/2022] [Indexed: 11/19/2022]
Abstract
Összefoglaló. Kilenc magyarországi orvostársaság közös ajánlást
alakított ki a D-vitamin javasolt normáltartományával, a D-vitamin-pótlás
adagjával és az adagolás módjával kapcsolatban. Összefoglalták azokat a klinikai
állapotokat, betegségeket, amelyek kialakulása összefüggésben lehet a
D-vitamin-hiánnyal. Magyarországon a D-vitamin-hiány – főleg a tél végére –
rendkívül gyakori. A javasolt normáltartomány alsó határa 75 nmol/l, annak
ellenére, hogy a hiány klinikai jelentősége főleg 50 nmol/l alatti értékeknél
nyilvánvaló, ám mivel a D-vitamin pótlása a javasolt dózisban biztonságos,
mindenkinél érdemes csökkenteni a D-vitamin-hiánnyal kapcsolatos egészségügyi
kockázatot. A D-vitamin-pótlás célja a hiány megszüntetése. A javasolt
normáltartomány 75–125 nmol/l, az ezt meghaladó tartományban a D-vitamin
adásának nincs további egyértelmű előnye. A normáltartomány fenntartásához
felnőttekben napi 2000 NE bevitele javasolt az UV-B sugárzástól mentes
időszakban. Gyermekeknek is javasolt a D-vitamin pótlása azokban az időszakokban
és állapotokban, mint a felnőtteknek, de az adag korfüggő módon változik.
D-vitamin-pótlásra D3-vitamin adása javasolt. Felnőttekben a
D3-vitamin-pótlás napi, heti és havi gyakoriságú adagolással is
egyformán hatásos és biztonságos. Súlyos hiányban javasolt telítő adagot
alkalmazni, majd ezt követően fenntartó adagolással kell folytatni a pótlást. A
D-vitamin-hiány jól ismert csontrendszeri, immunológiai és onkológiai hatásai
mellett egyre több adat támasztja alá előnytelen nőgyógyászati és szülészeti
hatásait is. A legerősebb érv a D-vitamin-hiány megszüntetése és a szükséges
pótlás alkalmazása mellett a halálozási kockázat D-vitamin-hiányban észlelt
növekedése. A konszenzus elkészítésének folyamata megfelelt a
Delfi-irányelveknek. Orv Hetil. 2022; 163(15): 575–584.
Summary. Nine Hungarian medical societies have developed a consensus
recommendation on the preferred normal range of vitamin D, the dose of vitamin D
supplementation and the method of administration. They summarized the clinical
conditions and diseases the development of which may be associated with vitamin
D deficiency (VDD). VDD is extremely common in Hungary, especially in late
winter. The lower limit of the recommended normal range is 75 nmol/l, although
the clinical significance of deficiency is evident mainly at values below 50
nmol/l, but since vitamin D supplementation at the recommended dose is safe, it
is worthwhile for everyone to reduce the health risk associated with VDD. The
aim of vitamin D supplementation is to prevent deficiency. The recommended
normal range is 75–125 nmol/l, above which there is no clear benefit of vitamin
D supplementation. To maintain the normal range, a daily intake of 2000 IU in
adults is recommended during the UV-B radiation-free period. Vitamin D
supplementation is also recommended for children during the same periods and
conditions as for adults, but the dose varies with age. In adults, vitamin
D3 supplementation at daily, weekly and monthly intervals is
equally effective and safe. In severe deficiency, a loading dose is recommended,
followed by maintenance supplementation. In addition to the well-known skeletal,
immunological and oncological effects of VDD, more and more data support
unfavorable gynecological and obstetric effects. The process of building the
consensus has met the requirements of the latest Delphi criteria. Orv Hetil.
2022; 163(15): 575–584.
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Affiliation(s)
- István Takács
- Semmelweis Egyetem, Általános Orvostudományi Kar, Belgyógyászati és Onkológiai Klinika Budapest, Korányi Sándor utca 2/a, 1083 Magyarország
| | - Magdolna Dank
- Semmelweis Egyetem, Általános Orvostudományi Kar, Belgyógyászati és Onkológiai Klinika Budapest, Korányi Sándor utca 2/a, 1083 Magyarország
| | - Judit Majnik
- Semmelweis Egyetem, Általános Orvostudományi Kar, Reumatológiai és Klinikai Immunológiai Tanszék Budapest Magyarország
| | - György Nagy
- Semmelweis Egyetem, Általános Orvostudományi Kar, Belgyógyászati és Onkológiai Klinika Budapest, Korányi Sándor utca 2/a, 1083 Magyarország
- Semmelweis Egyetem, Általános Orvostudományi Kar, Reumatológiai és Klinikai Immunológiai Tanszék Budapest Magyarország
| | - András Szabó
- Semmelweis Egyetem, Általános Orvostudományi Kar, II. Gyermekgyógyászati Klinika Budapest Magyarország
| | - Boglárka Szabó
- Semmelweis Egyetem, Általános Orvostudományi Kar, Belgyógyászati és Onkológiai Klinika Budapest, Korányi Sándor utca 2/a, 1083 Magyarország
| | - Zoltán Szekanecz
- Debreceni Tudományegyetem, Általános Orvostudományi Kar, Reumatológiai Tanszék és Klinika Debrecen Magyarország
| | - István Sziller
- Dél-budai Centrumkórház, Szent Imre Egyetemi Oktatókórház, Szülészet és Nőgyógyászati Osztály Budapest Magyarország
| | - Erzsébet Toldy
- Synlab Hungary Kft., Diagnosztikai Központ, Klinikai Kémiai és Immunológiai Laboratórium Budapest Magyarország
| | - András Tislér
- Semmelweis Egyetem, Általános Orvostudományi Kar, Belgyógyászati és Onkológiai Klinika Budapest, Korányi Sándor utca 2/a, 1083 Magyarország
| | - Zsuzsanna Valkusz
- Szegedi Tudományegyetem, Általános Orvostudományi Kar, Szent-Györgyi Albert Klinikai Központ, Belgyógyászati Klinika, Nyugati Telephely Szeged Magyarország
| | - Szabolcs Várbíró
- Semmelweis Egyetem, Általános Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika Budapest Magyarország
| | | | - Péter Lakatos
- Semmelweis Egyetem, Általános Orvostudományi Kar, Belgyógyászati és Onkológiai Klinika Budapest, Korányi Sándor utca 2/a, 1083 Magyarország
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5
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Fésűs L, Plázár D, Kolonics A, Martin L, Wikonkál N, Medvecz M, Szipőcs R. Low concentration Phloxine B staining for high chemical contrast, nonlinear microscope mosaic imaging of skin alterations in pseudoxanthoma elasticum. Biomed Opt Express 2022; 13:252-261. [PMID: 35154868 PMCID: PMC8803028 DOI: 10.1364/boe.443507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/17/2021] [Accepted: 11/26/2021] [Indexed: 06/14/2023]
Abstract
Pseudoxanthoma elasticum (PXE) is an autosomal recessive metabolic disorder characterized by ectopic mineralization of soft connective tissue. Histopathology findings include fragmented, mineralized elastic fibers and calcium deposits in the mid-dermis. Nonlinear microscopy (NLM) can be used for visualization of these histopathological alterations of the mid-dermis in PXE-affected skin sections. Upon introducing a normalized 3D color vector representation of emission spectra of three of the main tissue components (collagen, elastin and calcification) we found that due to their broad, overlapping emission spectra, spectral separation of emission from elastin and calcification is practically impossible in fresh-frozen or unstained, deparaffinized PXE sections. However, we found that the application of a low concentration Phloxine B staining after the deparaffinization process creates an imaging contrast for these two tissue components, which enables spectral decomposition of their fluorescence images. The obtained concentration maps for calcium deposits can be well suited for the determination of illness severity by quantitative analysis.
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Affiliation(s)
- L. Fésűs
- Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, H-1525 Budapest, Hungary
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - D. Plázár
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - A. Kolonics
- Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, H-1525 Budapest, Hungary
| | - L. Martin
- PXE Reference Center (MAGEC Nord), Angers University Hospital, Angers, France
| | - N. Wikonkál
- Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, H-1525 Budapest, Hungary
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - M. Medvecz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - R. Szipőcs
- Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, H-1525 Budapest, Hungary
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6
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Singh K, Maity P, Koroma AK, Basu A, Pandey RK, Beken SV, Haas P, Krug L, Hainzl A, Sindrilaru A, Pfeiffer C, Wlaschek M, Frank NY, Frank MH, Ganss C, Bánvölgyi A, Wikonkál N, Eming S, Pastar I, Tomic-Canic M, Kluth MA, Scharffetter-Kochanek K. Angiogenin Released from ABCB5 + Stromal Precursors Improves Healing of Diabetic Wounds by Promoting Angiogenesis. J Invest Dermatol 2021; 142:1725-1736.e10. [PMID: 34808236 DOI: 10.1016/j.jid.2021.10.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 10/05/2021] [Accepted: 10/14/2021] [Indexed: 01/07/2023]
Abstract
Severe angiopathy is a major driver for diabetes associated secondary complications. Knowledge on underlying mechanisms essential for advanced therapies to attenuate these pathologies is limited. Injection of ABCB5+ stromal precursors (SPs) at the edge of non-healing diabetic wounds in a murine db/db model, closely mirroring human type II diabetes, profoundly accelerates wound closure. Strikingly, enhanced angiogenesis was substantially enforced by the release of the ribonuclease angiogenin from ABCB5+ SPs. This compensates for the profoundly reduced angiogenin expression in non-treated murine chronic diabetic wounds. Silencing of angiogenin in ABCB5+ SPs prior to injection significantly reduced angiogenesis and delayed wound closure in diabetic db/db mice implying an unprecedented key role for angiogenin in tissue regeneration in diabetes. These data hold significant promise for further refining SPs-based therapies of non-healing diabetic foot ulcers and other pathologies with impaired angiogenesis.
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Affiliation(s)
- Karmveer Singh
- Department of Dermatology and Allergic Diseases, Ulm University, Ulm, Germany
| | - Pallab Maity
- Department of Dermatology and Allergic Diseases, Ulm University, Ulm, Germany
| | | | - Abhijit Basu
- Department of Dermatology and Allergic Diseases, Ulm University, Ulm, Germany
| | - Rajeev Kumar Pandey
- Department of Dermatology and Allergic Diseases, Ulm University, Ulm, Germany
| | - Seppe Vander Beken
- Department of Dermatology and Allergic Diseases, Ulm University, Ulm, Germany
| | - Philipp Haas
- Department of Dermatology and Allergic Diseases, Ulm University, Ulm, Germany
| | - Linda Krug
- Department of Dermatology and Allergic Diseases, Ulm University, Ulm, Germany
| | - Adelheid Hainzl
- Department of Dermatology and Allergic Diseases, Ulm University, Ulm, Germany
| | - Anca Sindrilaru
- Department of Dermatology and Allergic Diseases, Ulm University, Ulm, Germany
| | - Christiane Pfeiffer
- Department of Dermatology and Allergic Diseases, Ulm University, Ulm, Germany
| | - Meinhard Wlaschek
- Department of Dermatology and Allergic Diseases, Ulm University, Ulm, Germany
| | - Natasha Y Frank
- Transplantation Research Center, Boston Children's Hospital and Brigham and Women's Hospital, Boston, MA, USA; Department of Medicine, Boston VA Healthcare System, West Roxbury, MA, USA; Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Markus H Frank
- Transplantation Research Center, Boston Children's Hospital and Brigham and Women's Hospital, Boston, MA, USA; Harvard Skin Disease Research Center, Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Transplantation Research Center, Boston Children's Hospital and Brigham and Women's Hospital, Boston, MA, USA; Harvard Stem Cell Institute, Harvard University, Cambridge, Massachusetts, USA; School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Christoph Ganss
- TICEBA GmbH, Heidelberg, Germany; RHEACELL GmbH & Co. KG, Heidelberg, Germany
| | - András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Norbert Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Sabine Eming
- Department of Dermatology and Venereology, University of Cologne, Cologne, Germany
| | - Irena Pastar
- Wound Healing and Regenerative Medicine Research Program, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Marjana Tomic-Canic
- Wound Healing and Regenerative Medicine Research Program, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Mark A Kluth
- TICEBA GmbH, Heidelberg, Germany; RHEACELL GmbH & Co. KG, Heidelberg, Germany
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7
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Virág D, Kremmer T, Lőrincz K, Kiss N, Jobbágy A, Bozsányi S, Gulyás L, Wikonkál N, Schlosser G, Borbély A, Huba Z, Dalmadi Kiss B, Antal I, Ludányi K. Altered Glycosylation of Human Alpha-1-Acid Glycoprotein as a Biomarker for Malignant Melanoma. Molecules 2021; 26:molecules26196003. [PMID: 34641547 PMCID: PMC8513036 DOI: 10.3390/molecules26196003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/01/2021] [Indexed: 11/16/2022] Open
Abstract
A high-resolution HILIC-MS/MS method was developed to analyze anthranilic acid derivatives of N-glycans released from human serum alpha-1-acid glycoprotein (AGP). The method was applied to samples obtained from 18 patients suffering from high-risk malignant melanoma as well as 19 healthy individuals. It enabled the identification of 102 glycan isomers separating isomers that differ only in sialic acid linkage (α-2,3, α-2,6) or in fucose positions (core, antenna). Comparative assessment of the samples revealed that upregulation of certain fucosylated glycans and downregulation of their nonfucosylated counterparts occurred in cancer patients. An increased ratio of isomers with more α-2,6-linked sialic acids was also observed. Linear discriminant analysis (LDA) combining 10 variables with the highest discriminatory power was employed to categorize the samples based on their glycosylation pattern. The performance of the method was tested by cross-validation, resulting in an overall classification success rate of 96.7%. The approach presented here is significantly superior to serological marker S100B protein in terms of sensitivity and negative predictive power in the population studied. Therefore, it may effectively support the diagnosis of malignant melanoma as a biomarker.
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Affiliation(s)
- Dávid Virág
- Department of Pharmaceutics, Semmelweis University, Hőgyes Endre utca 7., H-1092 Budapest, Hungary; (D.V.); (T.K.); (Z.H.); (B.D.K.); (I.A.)
| | - Tibor Kremmer
- Department of Pharmaceutics, Semmelweis University, Hőgyes Endre utca 7., H-1092 Budapest, Hungary; (D.V.); (T.K.); (Z.H.); (B.D.K.); (I.A.)
| | - Kende Lőrincz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária utca. 41., H-1085 Budapest, Hungary; (K.L.); (N.K.); (A.J.); (S.B.); (L.G.); (N.W.)
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária utca. 41., H-1085 Budapest, Hungary; (K.L.); (N.K.); (A.J.); (S.B.); (L.G.); (N.W.)
| | - Antal Jobbágy
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária utca. 41., H-1085 Budapest, Hungary; (K.L.); (N.K.); (A.J.); (S.B.); (L.G.); (N.W.)
| | - Szabolcs Bozsányi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária utca. 41., H-1085 Budapest, Hungary; (K.L.); (N.K.); (A.J.); (S.B.); (L.G.); (N.W.)
| | - Lili Gulyás
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária utca. 41., H-1085 Budapest, Hungary; (K.L.); (N.K.); (A.J.); (S.B.); (L.G.); (N.W.)
| | - Norbert Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária utca. 41., H-1085 Budapest, Hungary; (K.L.); (N.K.); (A.J.); (S.B.); (L.G.); (N.W.)
| | - Gitta Schlosser
- MTA-ELTE Lendület Ion Mobility Mass Spectrometry Research Group, Institute of Chemistry, Faculty of Science, ELTE Eötvös Loránd University, Pázmány Péter sétány 1/A, H-1117 Budapest, Hungary; (G.S.); (A.B.)
| | - Adina Borbély
- MTA-ELTE Lendület Ion Mobility Mass Spectrometry Research Group, Institute of Chemistry, Faculty of Science, ELTE Eötvös Loránd University, Pázmány Péter sétány 1/A, H-1117 Budapest, Hungary; (G.S.); (A.B.)
| | - Zsófia Huba
- Department of Pharmaceutics, Semmelweis University, Hőgyes Endre utca 7., H-1092 Budapest, Hungary; (D.V.); (T.K.); (Z.H.); (B.D.K.); (I.A.)
| | - Borbála Dalmadi Kiss
- Department of Pharmaceutics, Semmelweis University, Hőgyes Endre utca 7., H-1092 Budapest, Hungary; (D.V.); (T.K.); (Z.H.); (B.D.K.); (I.A.)
| | - István Antal
- Department of Pharmaceutics, Semmelweis University, Hőgyes Endre utca 7., H-1092 Budapest, Hungary; (D.V.); (T.K.); (Z.H.); (B.D.K.); (I.A.)
| | - Krisztina Ludányi
- Department of Pharmaceutics, Semmelweis University, Hőgyes Endre utca 7., H-1092 Budapest, Hungary; (D.V.); (T.K.); (Z.H.); (B.D.K.); (I.A.)
- Correspondence:
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8
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Piros ÉA, Szabó Á, Rencz F, Brodszky V, Wikonkál N, Miheller P, Horváth M, Holló P. Anti-Interleukin-17 Therapy of Severe Psoriatic Patients Results in an Improvement of Serum Lipid and Inflammatory Parameters' Levels, but Has No Effect on Body Composition Parameters. Life (Basel) 2021; 11:life11060535. [PMID: 34207504 PMCID: PMC8228146 DOI: 10.3390/life11060535] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/27/2021] [Accepted: 06/07/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND: Psoriasis is frequently accompanied by metabolic syndrome. Effect of anti-tumor necrosis factor therapies on increases in body weight is well-known. Data on the effects of interleukin-17 inhibitors are limited. Authors determined the effect of anti-interleukin-17 therapies on the body composition and serum lipid and inflammatory parameters among severe psoriatic patients. METHODS: Thirty-five severe psoriatic patients were enrolled. Twenty-two received secukinumab and 13 received ixekizumab as their 2nd-or 3rd-line biological treatment. Before treatment initiation and 6 months later, laboratory examinations measuring metabolic and inflammatory panels and body composition analyses were performed. RESULTS: After 6 months, a significant reduction was observed in psoriasis area severity index (p < 0.001) from 18 to 0, in c-reactive protein (p < 0.001) from 6.6 to 4.00 mg/L, in low-density lipoprotein-cholesterol (p = 0.004) from 3.69 to 3.19 mmol/L, and an improvement in high-density lipoprotein-cholesterol (p = 0.022) from 1.31 to 1.40 mmol/L. Median baseline body mass index was 32.80 kg/m2. The body composition parameters did not show any significant changes. CONCLUSIONS: Anti-interleukin-17 therapy of severe psoriatic patients does not cause significant changes in body composition parameters. Improvements in the lipid and inflammatory parameters might have a beneficial effect on patients’ cardiometabolic status. This effect might be detectable in high-risk obese psoriatic patients.
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Affiliation(s)
- Éva Anna Piros
- Department of Dermatology, Venereology and Dermato-Oncology, Semmelweis University, 1085 Budapest, Hungary; (N.W.); (P.H.)
- Rácz Károly Doctoral School of Clinical Medicine, Semmelweis University, 1085 Budapest, Hungary;
- Correspondence:
| | - Ákos Szabó
- Rácz Károly Doctoral School of Clinical Medicine, Semmelweis University, 1085 Budapest, Hungary;
- Department of Health Economics, Corvinus University, 1093 Budapest, Hungary; (F.R.); (V.B.)
| | - Fanni Rencz
- Department of Health Economics, Corvinus University, 1093 Budapest, Hungary; (F.R.); (V.B.)
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University, 1093 Budapest, Hungary; (F.R.); (V.B.)
| | - Norbert Wikonkál
- Department of Dermatology, Venereology and Dermato-Oncology, Semmelweis University, 1085 Budapest, Hungary; (N.W.); (P.H.)
- Military Hospital-State Health Centre, 1134 Budapest, Hungary
| | - Pál Miheller
- 1st Department of Surgery and Interventional Gastroenterology, Semmelweis University, 1082 Budapest, Hungary; (P.M.); (M.H.)
| | - Miklós Horváth
- 1st Department of Surgery and Interventional Gastroenterology, Semmelweis University, 1082 Budapest, Hungary; (P.M.); (M.H.)
| | - Péter Holló
- Department of Dermatology, Venereology and Dermato-Oncology, Semmelweis University, 1085 Budapest, Hungary; (N.W.); (P.H.)
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9
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Bató A, Brodszky V, Gergely LH, Gáspár K, Wikonkál N, Kinyó Á, Szabó Á, Beretzky Z, Szegedi A, Remenyik É, Kiss N, Sárdy M, Rencz F. The measurement performance of the EQ-5D-5L versus EQ-5D-3L in patients with hidradenitis suppurativa. Qual Life Res 2021; 30:1477-1490. [PMID: 33534032 PMCID: PMC8068690 DOI: 10.1007/s11136-020-02732-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects up to 1% of the population in Europe. The EQ-5D is the most commonly used generic instrument for measuring health-related quality of life among HS patients. This study aims to compare the measurement properties of the two adult versions of EQ-5D (EQ-5D-3L and EQ-5D-5L) in patients with HS. METHODS We recruited 200 consecutive patients with HS (mean age 37 years, 38% severe or very severe HS) to participate in a multicentre cross-sectional survey. Patients completed the EQ-5D-3L, EQ-5D-5L, Dermatology Life Quality Index (DLQI) and Skindex-16 questionnaires. RESULTS More than twice as many different health state profiles occurred in the EQ-5D-5L compared to the EQ-5D-3L (101 vs. 43). A significant reduction in ceiling effect was found for the mobility, self-care and usual activities dimensions. A good agreement was established between the EQ-5D-3L and EQ-5D-5L with an intraclass correlation coefficient of 0.872 (95% CI 0.830-0.903; p < 0.001) that was confirmed by a Bland-Altman plot. EQ-5D-5L improved both the absolute and relative informativity in all dimensions except for anxiety/depression. EQ-5D-3L and EQ-5D-5L demonstrated similar convergent validity with DLQI and Skindex-16. EQ-5D-5L was able to better discriminate between known groups of patients based on the number of comorbidities and disease severity (HS-Physician's Global Assessment). CONCLUSION In patients with HS, the EQ-5D-5L outperformed the EQ-5D-3L in feasibility, ceiling effects, informativity and known-groups validity for many important clinical characteristics. We recommend using the EQ-5D-5L in HS patients across various settings, including clinical care, research and economic evaluations.
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Affiliation(s)
- Alex Bató
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
- Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, Üllői út 26, H-1085, Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.
| | - L Hunor Gergely
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - Krisztián Gáspár
- Faculty of Medicine, Departments of Dermatology, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
- Faculty of Medicine, Department of Dermatological Allergology, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - Norbert Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - Ágnes Kinyó
- University of Pécs Medical School Department of Dermatology, Venereology and Oncodermatology, Akác utca 1, H-7632, Pécs, Hungary
| | - Ákos Szabó
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
- Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, Üllői út 26, H-1085, Budapest, Hungary
| | - Zsuzsanna Beretzky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - Andrea Szegedi
- Faculty of Medicine, Departments of Dermatology, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
- Faculty of Medicine, Department of Dermatological Allergology, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - Éva Remenyik
- Faculty of Medicine, Departments of Dermatology, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - Miklós Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
- Premium Postdoctoral Research Programme, Hungarian Academy of Sciences, Nádor u. 7, H-1051, Budapest, Hungary
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10
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Gáspár K, Hunor Gergely L, Jenei B, Wikonkál N, Kinyó Á, Szegedi A, Remenyik É, Kiss N, Jin X, Sárdy M, Beretzky Z, Péntek M, Gulácsi L, Bánvölgyi A, Brodszky V, Rencz F. Resource utilization, work productivity and costs in patients with hidradenitis suppurativa: a cost-of-illness study. Expert Rev Pharmacoecon Outcomes Res 2021; 22:399-408. [DOI: 10.1080/14737167.2021.1895753] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Krisztián Gáspár
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, . Debrecen, Hungary
| | - L. Hunor Gergely
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Balázs Jenei
- Quality of Life Statistics Department, Earnings Statistics Section, Hungarian Central Statistical Office, Budapest, Hungary
| | - Norbert Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Ágnes Kinyó
- Medical School Department of Dermatology, Venereology and Oncodermatology, University of Pécs, Pécs, Hungary
| | - Andrea Szegedi
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, . Debrecen, Hungary
| | - Éva Remenyik
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Xiang Jin
- Corvinus University of Budapest, Budapest, Hungary
- School of Slavonic and East European Studies, University College London, London, The United Kingdom
| | - Miklós Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Zsuzsanna Beretzky
- Doctoral School of Business and Management, Corvinus University of Budapest, Budapest, Hungary
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary
| | - András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
- Hungarian Academy of Sciences, Premium Postdoctoral Research Programme, Budapest, Hungary
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11
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Rencz F, Mitev AZ, Szabó Á, Beretzky Z, Poór AK, Holló P, Wikonkál N, Sárdy M, Kárpáti S, Szegedi A, Remenyik É, Brodszky V. A Rasch model analysis of two interpretations of 'not relevant' responses on the Dermatology Life Quality Index (DLQI). Qual Life Res 2021; 30:2375-2386. [PMID: 33683650 PMCID: PMC8298357 DOI: 10.1007/s11136-021-02803-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 01/28/2023]
Abstract
PURPOSE Eight of the ten items of the Dermatology Life Quality Index (DLQI) have a 'not relevant' response (NRR) option. There are two possible ways to interpret NRRs: they may be considered 'not at all' or missing responses. We aim to compare the measurement performance of the DLQI in psoriasis patients when NRRs are scored as '0' (hereafter zero-scoring) and 'missing' (hereafter missing-scoring) using Rasch model analysis. METHODS Data of 425 patients with psoriasis from two earlier cross-sectional surveys were re-analysed. All patients completed the paper-based Hungarian version of the DLQI. A partial credit model was applied. The following model assumptions and measurement properties were tested: dimensionality, item fit, person reliability, order of response options and differential item functioning (DIF). RESULTS Principal component analysis of the residuals of the Rasch model confirmed the unidimensional structure of the DLQI. Person separation reliability indices were similar with zero-scoring (0.910) and missing-scoring (0.914) NRRs. With zero-scoring, items 6 (sport), 7 (working/studying) and 9 (sexual difficulties) suffered from item misfit and item-level disordering. With missing-scoring, no misfit was observed and only item 7 was illogically ordered. Six and three items showed DIF for gender and age, respectively, that were reduced to four and three by missing-scoring. CONCLUSIONS Missing-scoring NRRs resulted in an improved measurement performance of the scale. DLQI scores of patients with at least one vs. no NRRs cannot be directly compared. Our findings provide further empirical support to the DLQI-R scoring modification that treats NRRs as missing and replaces them with the average score of the relevant items.
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Affiliation(s)
- Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, 8 Fővám tér, 1093, Budapest, Hungary.,Hungarian Academy of Sciences, Premium Postdoctoral Research Programme, 7 Nádor u, 1051, Budapest, Hungary
| | - Ariel Z Mitev
- Institute of Marketing, Corvinus University of Budapest, 8 Fővám tér, 1093, Budapest, Hungary
| | - Ákos Szabó
- Department of Health Economics, Corvinus University of Budapest, 8 Fővám tér, 1093, Budapest, Hungary.,Doctoral School of Clinical Medicine, Semmelweis University, 26 Üllői út, 1085, Budapest, Hungary
| | - Zsuzsanna Beretzky
- Department of Health Economics, Corvinus University of Budapest, 8 Fővám tér, 1093, Budapest, Hungary.,Doctoral School of Business and Management, Corvinus University of Budapest, 8 Fővám tér, 1093, Budapest, Hungary
| | - Adrienn K Poór
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, 41 Mária u, 1085, Budapest, Hungary
| | - Péter Holló
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, 41 Mária u, 1085, Budapest, Hungary
| | - Norbert Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, 41 Mária u, 1085, Budapest, Hungary
| | - Miklós Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, 41 Mária u, 1085, Budapest, Hungary
| | - Sarolta Kárpáti
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, 41 Mária u, 1085, Budapest, Hungary
| | - Andrea Szegedi
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, 98 Nagyerdei krt, 4032, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, 98 Nagyerdei krt, 4032, Debrecen, Hungary
| | - Éva Remenyik
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, 98 Nagyerdei krt, 4032, Debrecen, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, 8 Fővám tér, 1093, Budapest, Hungary.
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12
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Gergely LH, Gáspár K, Brodszky V, Kinyó Á, Szegedi A, Remenyik É, Kiss NF, Bató A, Péntek M, Gulácsi L, Sárdy M, Bánvölgyi A, Wikonkál N, Rencz F. Validity of EQ-5D-5L, Skindex-16, DLQI and DLQI-R in patients with hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2020; 34:2584-2592. [PMID: 32618022 DOI: 10.1111/jdv.16642] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/30/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Numerous generic, skin- and disease-specific health-related quality of life (HRQoL) measures are available for patients with hidradenitis suppurativa (HS). Yet, robust psychometric evidence is lacking in many aspects of these outcome measures. OBJECTIVES We sought to determine convergent and known-groups validity of multiple generic and skin-specific HRQoL measures and to identify predictors of impaired HRQoL in patients with HS. METHODS Between 2017 and 2019, a multicentre cross-sectional study was carried out involving 200 consecutive HS patients. HRQoL outcomes included the EQ-5D-5L, EQ visual analogue scale (EQ VAS), Skindex-16, Dermatology Life Quality Index (DLQI) and DLQI-Relevant (DLQI-R). Disease severity was graded by HS-Physician's Global Assessment (HS-PGA) scale and the Modified Sartorius scale (MSS). RESULTS Overall, 77%, 56%, 51%, 46% and 28% reported problems in the pain/discomfort, usual activities, anxiety/depression, mobility and self-care dimensions of EQ-5D-5L. Mean ± SD EQ VAS, DLQI and DLQI-R scores were 64.29 ± 22.68, 11.75 ± 8.11 and 12.19 ± 8.33, respectively. Skindex-16 responses indicated that the emotional burden of HS (64.55 ± 29.28) far exceeded those of functioning (49.40 ± 34.70) and physical symptoms (46.74 ± 29.36). EQ-5D-5L, EQ VAS, DLQI, DLQI-R and Skindex-16 total scores had moderate or strong correlations with each other (range: |0.487| to |0.993|), weak or moderate correlations with HS-PGA (|0.350| to |0.433|) and weak correlations with MSS (|0.324| to |0.389|). DLQI-R slightly outperformed DLQI both in terms of convergent and known-groups validity. Being female, lower education level, more severe disease and genital involvement were associated with worse HRQoL (P < 0.05). CONCLUSION This study provides high-quality evidence that among skin-specific outcomes, the DLQI, DLQI-R and Skindex-16, and among generic instruments, the EQ-5D-5L are suitable to be used in HS patients. In future research, we recommend the use of existing well-validated HRQoL tools instead of developing new measures for each study. The development of composite measures that combine physician- and patient-reported outcomes is not supported by evidence in HS. [Correction added on 25 July 2020, after first online publication: in the Abstract section, the ± signs were missing and have been added to this version.].
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Affiliation(s)
- L H Gergely
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - K Gáspár
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Á Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs Medical School, Pécs, Hungary
| | - A Szegedi
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - É Remenyik
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - N F Kiss
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - A Bató
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - A Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - N Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - F Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.,Premium Postdoctoral Research Programme, Hungarian Academy of Sciences, Budapest, Hungary
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13
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Rencz F, Gergely L, Wikonkál N, Gáspár K, Péntek M, Gulácsi L, Tamási B, Poór A, Kinyó Á, Bali G, Hidvégi B, Sárdy M, Hajdu K, Szegedi A, Remenyik É, Bata‐Csörgő Z, Holló P, Baji P, Brodszky V. Dermatology Life Quality Index (DLQI) score bands are applicable to DLQI‐Relevant (DLQI‐R) scoring. J Eur Acad Dermatol Venereol 2020; 34:e484-e486. [DOI: 10.1111/jdv.16398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F. Rencz
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
- Hungarian Academy of Sciences Premium Postdoctoral Research Programme Budapest Hungary
| | - L.H. Gergely
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - N. Wikonkál
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - K. Gáspár
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - M. Péntek
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - B. Tamási
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - A.K. Poór
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - Á. Kinyó
- Department of Dermatology, Venereology and Oncodermatology University of Pécs Medical School Pécs Hungary
| | - G. Bali
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - B. Hidvégi
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - M. Sárdy
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - K. Hajdu
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - A. Szegedi
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - É. Remenyik
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - Z. Bata‐Csörgő
- Department of Dermatology and Allergology Albert Szent‐Györgyi Medical Centre University of Szeged Szeged Hungary
| | - P. Holló
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - P. Baji
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - V. Brodszky
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
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Abstract
Hidradenitis suppurativa is a chronic inflammatory disease of the hair follicles, usually presenting after puberty on the apocrine gland-bearing areas of the body. It usually flares up periodically and can lead to a severe condition affecting the 20-40-year-old childbearing age group. HS occurs more commonly in women. The main clinical features consist of painful, cicatrizing nodules and abscesses which develop mostly in the axillary, inguinal, genital and perianal regions and also on the breasts. HS is often accompanied by severe pain and malodorous discharge, both of which cause significant psychological stress and social stigma. Our main aim with this review paper is to highlight the gynecological aspects of this disease, as many times - due to the typical localization of the disease - patients seek gynecological care first when they experience the first symptoms of this disease. The most important classification of HS is the Hurley scale, which is based on the severity of the clinical symptoms. In recent years, numerous clinical trials have been conducted to seek optimized care of HS patients. Several drugs are used for the treatment of HS, but in most cases, the treatment has to be switched many times. It is of great importance to carefully follow comorbidities and possible pregnancies as in these cases, careful selection of treatment is required. Thus, HS is not only a dermatological, but also a gynecological disease. With an appropriate treatment and follow-up, the disease can be effectively handled. Orv Hetil. 2019; 160(8): 291-299.
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Affiliation(s)
- Norbert Kiss
- Bőr-, Nemikórtani és Bőronkológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Mária u. 41., 1085
| | - Dóra Plázár
- Bőr-, Nemikórtani és Bőronkológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Mária u. 41., 1085
| | - Kende Lőrincz
- Bőr-, Nemikórtani és Bőronkológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Mária u. 41., 1085
| | - András Bánvölgyi
- Bőr-, Nemikórtani és Bőronkológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Mária u. 41., 1085
| | - Sándor Valent
- II. Szülészeti és Nőgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Norbert Wikonkál
- Bőr-, Nemikórtani és Bőronkológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Mária u. 41., 1085
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15
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Szabó B, Szűcs M, Horváth A, Székely E, Pánczél G, Liszkay G, Holló P, Wikonkál N, Nyirády P. [Mucosal melanoma primary and metastatic cases with urogenital localization in our department]. Orv Hetil 2019; 160:378-385. [PMID: 30829059 DOI: 10.1556/650.2019.31303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Both primary and metastatic cases of mucosal melanoma in urogenital localization are rare tumors. Only 4-5% of all primary melanomas do not arise from the skin. Extracutaneous melanomas have a complex clinical presentation, but these aggressive tumors have a poor prognosis. MATERIALS AND METHOD In our department, we found 7 patients with malignant melanoma of the genitourinary tract in the past few years. The 7 cases were: primary amelanotic melanoma of the female urethra, a primary melanoma of the bladder, two primary melanomas of the penis, a metastatic melanoma of the urethra and another to the testis and a metastatic melanoma of the bladder with melanuria. We retrospectively analyzed the available data to describe the presentation, management, and clinical outcome of the patients. RESULTS In the three inoperative cases, palliative, urologic surgical procedures and systemic antitumor therapy were performed. Two of the four primary urogenital tumors were localized to the penis. In one case, local recurrence developed after surgical treatment, but with a radical, repeated surgery, the patient has been asymptomatic for a year and a half. In the other, neglected case, the penis melanoma spread through the urethra and the inguinal lymph nodes two years after radical surgery and inguinal block dissection. In the female primary urethral melanoma case, the first histological study reported a primary mesenchymal tumor, and the recurrent tumor that occurred one and a half years later showed melanoma diagnosis. Radical surgery performed because of urethral involvement resulted in a 5-year asymptomatic state, followed by local recurrence and distant metastasis. In the fourth case of a primary bladder melanoma, the rapid progression of the disease and the BRAF positivity of the tumor suggested that not the firstly diagnosed bladder melanoma was the primary tumor. CONCLUSION The occurrence of urinary tract melanoma is very rare and its discovery happens often in a disseminated state, so the expected prognosis of the cases is also poor. The most important factors for increasing therapeutic efficacy are early diagnosis and radical surgical intervention. Tumors appearing in different localizations require different urological surgical approaches. The literature recommendations for treatment are not uniform. Their prognosis is worse compared to the cutaneous melanoma, which may be due to clinical and pathological diagnostic difficulties. The latest targeted and immunotherapeutic agents can significantly improve the survival of metastatic patients. Orv Hetil. 2019; 160(10): 378-385.
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Affiliation(s)
- Balázs Szabó
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
| | - Miklós Szűcs
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
| | - András Horváth
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
| | - Eszter Székely
- II. Patológiai Intézet, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | | | | | - Péter Holló
- Bőr-, Nemikórtani és Bőronkológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Norbert Wikonkál
- Bőr-, Nemikórtani és Bőronkológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Péter Nyirády
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
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16
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Bánvölgyi A, Anker P, Lőrincz K, Kiss N, Márton D, Fésűs L, Gyöngyösi N, Wikonkál N. Smoothened receptor inhibitor vismodegib for the treatment of basal cell carcinoma: a retrospective analysis of efficacy and side effects. J DERMATOL TREAT 2019; 31:387-398. [PMID: 31039644 DOI: 10.1080/09546634.2019.1601155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Smoothened receptor inhibitor vismodegib is indicated to treat locally advanced basal cell carcinoma (laBCC) and lesions in nevoid basal cell carcinoma syndrome (NBCCS).Methods: We treated 11 patients - including four NBCCS and seven laBCC patients - with vismodegib at our department.Results: Complete remission was achieved in three cases, without relapse after discontinuation. Two of the aforementioned patients had NBCCS, in their cases further treatment might be needed. Two patients showed improvement, but later passed away due to unrelated conditions. Two patients with laBCC initially showed remission, then the treatment was suspended due to side effects. After re-administration of the drug, loss of efficacy was observed. We did not observe therapy resistance in our NBCCS group. The rest of the patients showed good response to therapy, but have not reached full remission yet. The main side effects of vismodegib were muscle cramps, dysgeusia, nausea and alopecia. The frequency of adverse events did not show significant differences between the patient groups.Conclusions: Our results show that vismodegib therapy is effective in the treatment of BCC; however, side effects are often severe. Since the suspension of treatment can lead to therapy resistance, the management of side effects is of great importance.
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Affiliation(s)
- András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Pálma Anker
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Kende Lőrincz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Dalma Márton
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Luca Fésűs
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Nóra Gyöngyösi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Norbert Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
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17
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Kiss N, Avci P, Bánvölgyi A, Lőrincz K, Szakonyi J, Gyöngyösi N, Fésűs L, Lee G, Wikonkál N. Intralesional therapy for the treatment of keratoacanthoma. Dermatol Ther 2019; 32:e12872. [DOI: 10.1111/dth.12872] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/24/2019] [Accepted: 03/11/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Norbert Kiss
- Department of Dermatology, Venereology and DermatooncologySemmelweis University Budapest Hungary
| | - Pinar Avci
- Department of Dermatology, Venereology and DermatooncologySemmelweis University Budapest Hungary
| | - András Bánvölgyi
- Department of Dermatology, Venereology and DermatooncologySemmelweis University Budapest Hungary
| | - Kende Lőrincz
- Department of Dermatology, Venereology and DermatooncologySemmelweis University Budapest Hungary
| | - József Szakonyi
- Department of Dermatology, Venereology and DermatooncologySemmelweis University Budapest Hungary
| | - Nóra Gyöngyösi
- Department of Dermatology, Venereology and DermatooncologySemmelweis University Budapest Hungary
| | - Luca Fésűs
- Department of Dermatology, Venereology and DermatooncologySemmelweis University Budapest Hungary
| | - Goeun Lee
- Department of Dermatology, Venereology and DermatooncologySemmelweis University Budapest Hungary
| | - Norbert Wikonkál
- Department of Dermatology, Venereology and DermatooncologySemmelweis University Budapest Hungary
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18
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Szakonyi J, Medvecz M, Wikonkál N, Holló P, Hídvégi B, Demeter J, Csomor J, Szepesi Á, Marschalkó M. Lymphoproliferative diseases among patients treated with biologicals: a case study and single center survey. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30633-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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19
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Kiss N, Haluszka D, Lőrincz K, Gyöngyösi N, Bozsányi S, Bánvölgyi A, Szipőcs R, Wikonkál N. Quantitative Analysis on Ex Vivo Nonlinear Microscopy Images of Basal Cell Carcinoma Samples in Comparison to Healthy Skin. Pathol Oncol Res 2018; 25:1015-1021. [PMID: 29981012 DOI: 10.1007/s12253-018-0445-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 06/19/2018] [Indexed: 12/21/2022]
Abstract
Basal cell carcinoma (BCC) is the most frequent malignant neoplasm in the Caucasian population. There are several therapeutic options for BCC, but surgical excision is considered gold standard treatment. As BCCs often have poorly defined borders, the clinical assessment of the tumor margins can be challenging. Therefore, there is an increasing demand for efficient in vivo imaging techniques for the evaluation of tumor borders prior to and during surgeries. In the near future, nonlinear microscopy techniques might meet this demand. We measured the two-photon excitation fluorescence (TPEF) signal of nicotinamide adenine dinucleotide hydride (NADH) and elastin and second harmonic generation (SHG) signal of collagen on 10 ex vivo healthy control and BCC skin samples and compared the images by different quantitative image analysis methods. These included integrated optical density (IOD) measurements on TPEF and SHG images and application of fast Fourier transform (FFT), CT-FIRE and CurveAlign algorithms on SHG images to evaluate the collagen structure. In the BCC samples, we found significantly lower IOD of both the TPEF and SHG signals and higher collagen orientation index utilizing FFT. CT-FIRE algorithm revealed increased collagen fiber length and decreased fiber angle while CurveAlign detected higher fiber alignment of collagen fibers in BCC. These results are in line with previous findings which describe pronounced changes in the collagen structure of BCC. In the future, these novel image analysis methods could be integrated in handheld nonlinear microscope systems, for sensitive and specific identification of BCC.
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Affiliation(s)
- Norbert Kiss
- Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, Budapest, H-1525, Hungary.,Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Dóra Haluszka
- Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, Budapest, H-1525, Hungary.,Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Kende Lőrincz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Nóra Gyöngyösi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Szabolcs Bozsányi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Róbert Szipőcs
- Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, Budapest, H-1525, Hungary. .,R&D Ultrafast Lasers Ltd, P.O. Box 622, Budapest, H-1539, Hungary.
| | - Norbert Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
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20
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Lőrincz K, Medvecz M, Kiss N, Glász-Bóna A, Hársing J, Lepesi-Benkő R, Hatvani Z, Mazán M, Kárpáti S, Wikonkál N. Confirmation of the role of a KRT5 mutation and successful management of skin lesions in a patient with Galli-Galli disease. Clin Exp Dermatol 2018; 43:972-974. [PMID: 29882260 DOI: 10.1111/ced.13683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2018] [Indexed: 11/30/2022]
Affiliation(s)
- K Lőrincz
- Department of Dermatology, Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | - M Medvecz
- Department of Dermatology, Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary.,Molecular Medicine Research Group, Hungarian Academy of Sciences, Budapest, Hungary
| | - N Kiss
- Department of Dermatology, Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | - A Glász-Bóna
- Department of Dermatology, Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | - J Hársing
- Department of Dermatology, Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | - R Lepesi-Benkő
- Molecular Medicine Research Group, Hungarian Academy of Sciences, Budapest, Hungary
| | - Z Hatvani
- Department of Dermatology, Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | - M Mazán
- Department of Dermatology, Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | - S Kárpáti
- Department of Dermatology, Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary.,Molecular Medicine Research Group, Hungarian Academy of Sciences, Budapest, Hungary
| | - N Wikonkál
- Department of Dermatology, Venerology and Dermato-oncology, Semmelweis University, Budapest, Hungary
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21
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Kiss N, Haluszka D, Lőrincz K, Kuroli E, Hársing J, Mayer B, Kárpáti S, Fekete G, Szipőcs R, Wikonkál N, Medvecz M. Ex vivo nonlinear microscopy imaging of Ehlers-Danlos syndrome-affected skin. Arch Dermatol Res 2018; 310:463-473. [PMID: 29725758 DOI: 10.1007/s00403-018-1835-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 04/19/2018] [Accepted: 04/25/2018] [Indexed: 10/17/2022]
Abstract
Ehlers-Danlos syndrome (EDS) is the name for a heterogenous group of rare genetic connective tissue disorders with an overall incidence of 1 in 5000. The histological characteristics of EDS have been previously described in detail in the late 1970s and early 1980s. Since that time, the classification of EDS has undergone significant changes, yet the description of the histological features of collagen morphology in different EDS subtypes has endured the test of time. Nonlinear microscopy techniques can be utilized for non-invasive in vivo label-free imaging of the skin. Among these techniques, two-photon absorption fluorescence (TPF) microscopy can visualize endogenous fluorophores, such as elastin, while the morphology of collagen fibers can be assessed by second-harmonic generation (SHG) microscopy. In our present work, we performed TPF and SHG microscopy imaging on ex vivo skin samples of one patient with classical EDS and two patients with vascular EDS and two healthy controls. We detected irregular, loosely dispersed collagen fibers in a non-parallel arrangement in the dermis of the EDS patients, while as expected, there was no noticeable impairment in the elastin content. Based on further studies on a larger number of patients, in vivo nonlinear microscopic imaging could be utilized for the assessment of the skin status of EDS patients in the future.
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Affiliation(s)
- Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary.,Institute for Solid State Physics and Optics, Wigner RCP, Budapest, Hungary
| | - Dóra Haluszka
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary.,Institute for Solid State Physics and Optics, Wigner RCP, Budapest, Hungary
| | - Kende Lőrincz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary
| | - Enikő Kuroli
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary
| | - Judit Hársing
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary
| | - Balázs Mayer
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary
| | - Sarolta Kárpáti
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary
| | - György Fekete
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Róbert Szipőcs
- Institute for Solid State Physics and Optics, Wigner RCP, Budapest, Hungary.,R&D Ultrafast Lasers Ltd, P.O. Box 622, Budapest, 1539, Hungary
| | - Norbert Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary
| | - Márta Medvecz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary.
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Kiss N, Haluszka D, Lrincz K, Bozsányi S, Szipcs R, Wikonkál N. 1126 Quantitative analysis on ex vivo nonlinear microscopy images of basal cell carcinoma. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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23
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Pogácsás L, Borsi A, Takács P, Remenyik É, Kemény L, Kárpáti S, Holló P, Wikonkál N, Gyulai R, Károlyi Z, Rakonczai P, Balázs T, Szegedi A. Long-term drug survival and predictor analysis of the whole psoriatic patient population on biological therapy in Hungary. J DERMATOL TREAT 2017; 28:635-641. [DOI: 10.1080/09546634.2017.1329504] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Lilla Pogácsás
- Division of Dermatological Allergology, University of Debrecen, Debrecen, Hungary
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - András Borsi
- Department of Health Economics, Market Access and Reimbursement, Janssen-Cilag Hungary Ltd., Budapest, Hungary
| | - Péter Takács
- Real World Evidence Centre of Excellence, Janssen-Cilag Hungary Ltd., Budapest, Hungary
| | - Éva Remenyik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Lajos Kemény
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Sarolta Kárpáti
- Department of Dermatovenerology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Péter Holló
- Department of Dermatovenerology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Norbert Wikonkál
- Department of Dermatovenerology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Rolland Gyulai
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs, Pécs, Hungary
| | | | - Pál Rakonczai
- Department of Research and Analysis, Healthware Consulting Ltd., Budapest, Hungary
| | - Tamás Balázs
- Department of Research and Analysis, Healthware Consulting Ltd., Budapest, Hungary
| | - Andrea Szegedi
- Division of Dermatological Allergology, University of Debrecen, Debrecen, Hungary
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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24
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Krolopp Á, Csákányi A, Haluszka D, Csáti D, Vass L, Kolonics A, Wikonkál N, Szipőcs R. Handheld nonlinear microscope system comprising a 2 MHz repetition rate, mode-locked Yb-fiber laser for in vivo biomedical imaging. Biomed Opt Express 2016; 7:3531-3542. [PMID: 27699118 PMCID: PMC5030030 DOI: 10.1364/boe.7.003531] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/11/2016] [Accepted: 08/16/2016] [Indexed: 05/29/2023]
Abstract
A novel, Yb-fiber laser based, handheld 2PEF/SHG microscope imaging system is introduced. It is suitable for in vivo imaging of murine skin at an average power level as low as 5 mW at 200 kHz sampling rate. Amplified and compressed laser pulses having a spectral bandwidth of 8 to 12 nm at around 1030 nm excite the biological samples at a ~1.89 MHz repetition rate, which explains how the high quality two-photon excitation fluorescence (2PEF) and second harmonic generation (SHG) images are obtained at the average power level of a laser pointer. The scanning, imaging and detection head, which comprises a conventional microscope objective for beam focusing, has a physical length of ~180 mm owing to the custom designed imaging telescope system between the laser scanner mirrors and the entrance aperture of the microscope objective. Operation of the all-fiber, all-normal dispersion Yb-fiber ring laser oscillator is electronically controlled by a two-channel polarization controller for Q-switching free mode-locked operation. The whole nonlinear microscope imaging system has the main advantages of the low price of the fs laser applied, fiber optics flexibility, a relatively small, light-weight scanning and detection head, and a very low risk of thermal or photochemical damage of the skin samples.
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Affiliation(s)
- Ádám Krolopp
- Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, H-1525 Budapest, Hungary
- R & D Ultrafast Lasers Ltd, P.O. Box 622, H-1539 Budapest, Hungary
| | - Attila Csákányi
- Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, H-1525 Budapest, Hungary
| | - Dóra Haluszka
- Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, H-1525 Budapest, Hungary
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, H-1085 Budapest, Hungary
| | - Dániel Csáti
- R & D Ultrafast Lasers Ltd, P.O. Box 622, H-1539 Budapest, Hungary
| | - Lajos Vass
- R & D Ultrafast Lasers Ltd, P.O. Box 622, H-1539 Budapest, Hungary
| | - Attila Kolonics
- Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, H-1525 Budapest, Hungary
- R & D Ultrafast Lasers Ltd, P.O. Box 622, H-1539 Budapest, Hungary
| | - Norbert Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, H-1085 Budapest, Hungary
| | - Róbert Szipőcs
- Wigner RCP, Institute for Solid State Physics and Optics, P.O. Box 49, H-1525 Budapest, Hungary
- R & D Ultrafast Lasers Ltd, P.O. Box 622, H-1539 Budapest, Hungary
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Herszényi K, Jókai H, Wikonkál N, Rencz F, Brodszky V, Kárpáti S, Nagy E, Holló P. 317 Anti-drug antibody formation against biological agents in psoriasis. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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26
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Marschalkó M, Gyöngyösi N, Noll J, Károlyi Z, Wikonkál N, Hársing J, Kuroli E, Csomor J, Matolcsy A, Sarolta K, Szepesi Á. Histopathological aspects and differential diagnosis of CD8 positive lymphomatoid papulosis. J Cutan Pathol 2016; 43:963-973. [DOI: 10.1111/cup.12779] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 07/07/2016] [Accepted: 07/22/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Márta Marschalkó
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Nóra Gyöngyösi
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Judit Noll
- Department of Dermatology; Heim Pál Childrens Hospital; Budapest Hungary
| | | | - Norbert Wikonkál
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Judit Hársing
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Enikő Kuroli
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Judit Csomor
- 1st Department of Pathology and Experimental Cancer Research Institute; Semmelweis University; Budapest Hungary
| | - András Matolcsy
- 1st Department of Pathology and Experimental Cancer Research Institute; Semmelweis University; Budapest Hungary
| | - Kárpáti Sarolta
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Ágota Szepesi
- 1st Department of Pathology and Experimental Cancer Research Institute; Semmelweis University; Budapest Hungary
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27
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Rencz F, Gulácsi L, Péntek M, Wikonkál N, Baji P, Brodszky V. Alopecia areata and health-related quality of life: a systematic review and meta-analysis. Br J Dermatol 2016; 175:561-71. [PMID: 26914830 DOI: 10.1111/bjd.14497] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND No systematic review has yet evaluated the available evidence on health-related quality of life (HRQOL) in alopecia areata (AA). OBJECTIVES To conduct a systematic review and meta-analysis of HRQOL studies among patients diagnosed with AA. METHODS A systematic search was performed for papers published between 1946 and 15 December 2014 in Medline, Embase, Web of Science, CINAHL, PsycINFO and the Cochrane Library. Random-effects meta-analyses were conducted to pool data. RESULTS Twenty-one studies were included, representing a total of 2530 adult patients with AA. Of the 14 different HRQOL measures used in the studies, Dermatology Life Quality Index (DLQI; n = 8) and SF-36 (n = 7) were the most common. Three AA-specific HRQOL instruments were identified: Alopecia Areata Quality of Life Index, Alopecia Areata Quality of Life and Alopecia Areata Symptom Impact Scale. The mean pooled DLQI score of patients with AA was 6·3 (95% confidence interval 5·6-7·1). Comparing age- and sex-matched controls, the meta-analysis of SF-36 studies revealed significantly reduced HRQOL across the role-emotional, mental health and vitality domains (P < 0·001). Wearing a wig had a positive impact, while scalp involvement, anxiety and depression had a negative impact on HRQOL. Conflicting results were found regarding the association between HRQOL and age, sex, marital status and disease duration. CONCLUSIONS Patients with AA experience significant impairment in HRQOL, especially in the area of mental health. Several generic and dermatology-specific HRQOL instruments have been used, but no validation studies have confirmed their applicability in AA. The newly developed AA-specific measures seem very promising; however, a more extensive assessment of validity and reliability is needed.
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Affiliation(s)
- F Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.,Doctoral School of Clinical Medicine, Semmelweis University, Pf. 2, H-1428, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - N Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - P Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.
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Wikonkál N, Nagy P, Tóth B, Marschalkó M, Tislér A, Kárpáti S. [Syphilitic glomerulonephritis: case report and review of the literature]. Orv Hetil 2015; 156:32-5. [PMID: 25544053 DOI: 10.1556/oh.2015.30082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The authors report the history of a patient with syphilitic glomerulonephritis, a rare complication of syphilis. The patient was admitted to the hospital with clinical symptoms of neurosyphilis. During his hospital stay urine analysis revealed an extremely high proteinuria, that had not been known before. Intravenous penicillin treatment improved the renal protein loss, but it took a total of six months until complete resolution was achieved. The serology that confirmed the syphilis, the concomitant nephrotic syndrome and the improvement after penicillin therapy met the criteria of syphilitic glomerulonephritis. This case prompted the authors to review the literature about this rare complication of syphilis that has a great clinical significance.
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Affiliation(s)
- Norbert Wikonkál
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest Mária u. 41. 1085
| | - Patrícia Nagy
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest Mária u. 41. 1085
| | - Béla Tóth
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest Mária u. 41. 1085
| | - Márta Marschalkó
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest Mária u. 41. 1085
| | - András Tislér
- Semmelweis Egyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Budapest
| | - Sarolta Kárpáti
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest Mária u. 41. 1085
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Mihály E, Székely H, Herszényi L, Wikonkál N, Tulassay Z. Letter: dermatological complications with therapy for inflammatory bowel disease. Aliment Pharmacol Ther 2014; 39:232-3. [PMID: 24330244 DOI: 10.1111/apt.12566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Accepted: 08/11/2013] [Indexed: 12/16/2022]
Affiliation(s)
- E Mihály
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
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Tóth B, Marschalkó M, Kovács T, Wikonkál N, Holló P, Pónyai K, Mihalik N, Ostorházi E, Kárpáti S. P2.190 Neurosyphilis Cases in the Hungarian National STD Centre in the Last 5 Years. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Infliximab is a TNFα inhibiting recombinant monoclonal antibody, which provides an efficient therapeutic opportunity in the treatment of psoriasis and other immune-mediated inflammatory diseases. It is well tolerated and improves quality of life significantly. The authors present a case of drug-induced lupus erythematosus as a possible side effect of this medication. The patient developed psoriasis 9 years ago when she was on beta-receptor blocker therapy. The symptoms deteriorated despite topical and systemic treatments and, therefore, biological therapy was introduced. In the third year of treatment drug-induced lupus erythematosus was diagnosed on the background of general symptoms. After cessation of the biologic treatment a low dose corticosteroid therapy was introduced which proved to be effective. Symptoms as well as pathological laboratory parameters showed an improvement. The authors conclude that biologicals are effective and safe in the treatment of psoriasis, nevertheless, they have risks too. To reduce side effects a meticulous follow-up of patients is essential. Any general symptom requires careful examination since they might be linked to serious side effects of the biological therapy. Orv. Hetil., 2013, 154, 590–598.
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Affiliation(s)
- Nóra Gyöngyösi
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest Mária u. 41. 1085
| | - Kende Lőrincz
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest Mária u. 41. 1085
| | - Sarolta Kárpáti
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest Mária u. 41. 1085
| | - Norbert Wikonkál
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest Mária u. 41. 1085
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Markó L, Paragh G, Ugocsai P, Boettcher A, Vogt T, Schling P, Balogh A, Tarabin V, Orsó E, Wikonkál N, Mandl J, Remenyik É, Schmitz G. Keratinocyte ATP binding cassette transporter expression is regulated by ultraviolet light. Journal of Photochemistry and Photobiology B: Biology 2012; 116:79-88. [DOI: 10.1016/j.jphotobiol.2012.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Revised: 06/02/2012] [Accepted: 06/17/2012] [Indexed: 01/06/2023]
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33
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Takács I, Benkő I, Toldy E, Wikonkál N, Szekeres L, Bodolay E, Kiss E, Jambrik Z, Szabó B, Merkely B, Valkusz Z, Kovács T, Szabó A, Grigoreff O, Nagy Z, Demeter J, Horváth HC, Bittner N, Várbíró S, Lakatos P. [Hungarian consensus regarding the role of vitamin D in the prevention and treatment of diseases]. Orv Hetil 2012; 153 Suppl:5-26. [PMID: 22934332 DOI: 10.1556/oh.2012.29410] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The metabolism of vitamin D is unique in the human body and its diverse effects are present in almost every organ. Vitamin D deficiency is one of the most prominent health issues in the civilized world. For the solution of this concern an extensive collaboration is imperative. Recognizing this necessity the most prominent Hungarian medical associations fighting with the effects of vitamin D deficiency worked out a collective consensus on the importance, diagnosis, prevention and suggested therapy of vitamin D deficiency. Along with the clinical guidelines of the different associations, the result of this consensus could serve as guidance for the practicing doctors in the prevention and therapy of vitamin D deficiency. In addition the consensus aims to direct the attention of decision-makers and the general public on the significance of this issue.
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Affiliation(s)
- István Takács
- Altalános Orvostudományi Kar, I. Belgyógyászati Klinika, Budapest
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34
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Holubar K, Wikonkál N. David Gruby 1810-1898: unveiling of a portrait bust in his birthplace. Skinmed 2010; 8:294-295. [PMID: 21137641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
David Gruby (1810-1898) was an early mycologist, the most prominent between Agostino Bassi (1773-1856) who discovered the fungus on silk worms and Raymond Sabouraud (1864-1938) who wrote the first textbook in the field.
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Affiliation(s)
- Karl Holubar
- Department of Dermatology and the History of Medicine, Medical University of Vienna, Vienna, Austria.
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35
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Máté S, Silló P, Wikonkál N, Csapó Z, Sziller I, Ujházy A, Kárpáti S, Papp Z. [Radical vulvectomy to treat severe vulvar acne inversa]. Orv Hetil 2007; 148:609-12. [PMID: 17383955 DOI: 10.1556/oh.2007.27847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
UNLABELLED A rare case, when radical vulvectomy had to be done to treat a benign skin disorder is presented. PATIENT AND METHOD A 56-year-old white woman suffered from severe vulvar acne inversa. The systemic treatments, the incisions and drainages were not successful. The only solution was the radical excision of the seriously damaged vulva, with a satisfactory cosmetic and functional result. The pathology, the diagnosis and the treatment of the disease are also discussed. CONCLUSION The authors put emphasis on the importance of the interdisciplinary collaboration.
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Affiliation(s)
- Szabolcs Máté
- Semmelweis Egyetem, Altalános Orvostudományi Kar, I sz Szülészeti és Nogyógyászati Klinika, Budapest, Hungary.
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Abstract
A 51-year-old female developed urticarial lesions of her right forearm which progressed into transient edema and subcutaneous swelling. Later a small infiltrated subcutaneous nodule also appeared and was removed in toto. Histopathological examination revealed the presence of Dirofilaria repens. This worm is the cause of an endemic zoonosis in the Mediterranean area. In the past decade many cases have been reported worldwide, but the condition appears rare in Hungary and skin findings have not been described.
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Affiliation(s)
- Katinka Pónyai
- Semmelweis University, Faculty for Medicine Clinic for Dermatology, Venerology and Dermato-oncology, Budapest, Hungary.
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Wikonkál N. [Life-threatening dermatoses]. Orv Hetil 2006; 147:2407-12. [PMID: 17274186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
In the present review an overview from a special angle of dermatologic practice is provided: dermatologic diseases that represent immediate danger for the patients' life. Diseases were included in this circle on the basis of their importance in general medical practice. This selection includes diseases from dermatologic oncology, pustular and erythrodermic forms of psoriasis, bacterial, allergic conditions, and STDs. Severe burns, autoimmune bullous skin diseases and classic immunologic conditions are also covered. Beside the general approach, novel therapeutic possibilities are discussed in significant details.
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38
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Pónyai K, Wikonkál N, Bottlik G, Hársing J, Kucsera I, Horváth A, Kárpáti S. Ein Dirofilaria repens Fallbericht aus Ungarn. J Dtsch Dermatol Ges 2006. [DOI: 10.1111/j.1610-0387.2006.06056_supp.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Remenyik E, Lanyon GW, Horkay I, Paragh G, Wikonkál N, Kósa A, Moore MR. Erythropoietic protoporphyria: a new mutation responsible for exon skipping in the human ferrochelatase gene. J Invest Dermatol 1998; 111:540-1. [PMID: 9740256 DOI: 10.1046/j.1523-1747.1998.00300.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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40
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Horkay I, Wikonkál N, Patkó J, Bazsa G, Beck M, Ferenczi A, Nagy Z, Rácz M, Szalay T. SUNTEST: a chemical UVB radiation dosimeter. Journal of Photochemistry and Photobiology B: Biology 1995. [DOI: 10.1016/1011-1344(95)07194-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
Nuclei isolated from higher eukaryotic cell lines were directly analyzed by field inversion gel electrophoresis. Brief incubation of nuclei with ionic detergents yielded a single band between 50-100 kb. The apparent fragment size decreased to approximately equal to 50 kb after proteinase digestion. The latter treatment alone induced less regular, less than or equal to 50 kb fragmentation. DNA extracted from detergent and proteinase-treated nuclei also appeared in a band of about 40 kb. Embedding into agarose plugs did not protect nuclei, as opposed to cells, from detergent-induced fragmentation. The phenomenon is strikingly analogous to the double-strand DNA cleavage reactions mediated by topoisomerase II. Our data are compatible with any of the following interpretations: 1.) regularly spaced protein bridges, probably involving topoisomerase II, maintain or control continuity of chromosomal DNA in certain states of higher eukaryotic cells. 2.) The DNA might become accessible to a putative endonuclease at regularly spaced sites upon detergent treatment of isolated nuclei.
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Affiliation(s)
- G Szabó
- Department of Biophysics, University Medical School of Debrecen, Hungary
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