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Article ; Online: A primer központi idegrendszeri tumorok konvencionális külső sugárkezelése – aktuális trendek és gyakorlat.

Kovács, Árpád

2023 Volume 68, Issue 1, Page(s) 37–50

Abstract: The family of primary central nervous system (CNS) tumors is a highly heterogeneous group of diseases. In the complex care of CNS tumors, in addition to surgical and systemic treatments, modern external beam radiation therapy (EBRT) plays a prominent ... ...

Title translation	External radiation therapy of primary central nervous system tumors - current trends and practice.
Abstract	The family of primary central nervous system (CNS) tumors is a highly heterogeneous group of diseases. In the complex care of CNS tumors, in addition to surgical and systemic treatments, modern external beam radiation therapy (EBRT) plays a prominent role. This summary article provides an overview of the current indications related to EBRT, diagnostic procedures, contouring, planning, and radiation therapy techniques and applications that can be used in daily routine for adults' most common primary CNS tumors.
MeSH term(s)	Adult ; Humans ; Central Nervous System Neoplasms/radiotherapy
Language	Hungarian
Publishing date	2023-10-22
Publishing country	Hungary
Document type	English Abstract ; Journal Article
ZDB-ID	414033-3
ISSN	2060-0399 ; 0025-0244
ISSN (online)	2060-0399
ISSN	0025-0244
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Article: Gene Therapy of Extracellular Vesicles in Cardiovascular and Metabolic Diseases.

Kovács, Árpád Ferenc

Advances in experimental medicine and biology

2023 Volume 1418, Page(s) 207–228

Abstract: The ultimate and most complex form of treating human diseases is embodied by gene therapy. For an effective gene therapeutic product we need to hack the cellular plasma membrane entry-system, then escaping degradation in the cytosol and in most cases, we ...

Abstract	The ultimate and most complex form of treating human diseases is embodied by gene therapy. For an effective gene therapeutic product we need to hack the cellular plasma membrane entry-system, then escaping degradation in the cytosol and in most cases, we need an efficient hacking of the nuclear membrane-system, achieving the delivery of genetic construct into the central stage of the target cells: nucleoplasm or chromosomal DNA found in this highly controlled space. These steps need to be performed in a targeted, ordered, and efficient way. Possessing intrinsic ability of nucleic acid and protein delivery, extracellular vesicles can bypass biological barriers and may be able to deliver a next-generation platform for gene therapy. Fine-tuned genetic constructs included in (synthetic) extracellular vesicles may provide an upgraded approach to the current gene therapeutical technologies by significantly upgrading and improving biosafety, versatility, and delivery, thus evoking the desired therapeutic response. This chapter addresses the main types, vectors, challenges, and safety issues of gene therapy. Afterwards, a brief introduction and beneficial roles of extracellular vesicles are given. The concept of engineering vesicles for gene therapy is also discussed. A snapshot of most relevant clinical trials in the field of cardiovascular and metabolic diseases is shown. Finally, a wrap-up and outlook about gene therapy are presented.
MeSH term(s)	Humans ; Cardiovascular System ; Extracellular Vesicles/genetics ; Genetic Therapy ; Metabolic Diseases ; Cell Membrane
Language	English
Publishing date	2023-08-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	410187-X
ISSN	0065-2598
ISSN	0065-2598
DOI	10.1007/978-981-99-1443-2_14
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Zs.A 3192: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: The role of chemoradiotherapy and immunotherapy in stage III NSCLC.

Orosz, Zsuzsanna / Kovács, Árpád

Pathology oncology research : POR

2024 Volume 30, Page(s) 1611716

Abstract: Locally advanced non-small lung cancer encompasses a diverse range of tumors. In the last few years, the treatment of stage III unresectable non-small lung cancer has evolved significantly. The PACIFIC trial opened a new therapeutic era in the treatment ... ...

Abstract	Locally advanced non-small lung cancer encompasses a diverse range of tumors. In the last few years, the treatment of stage III unresectable non-small lung cancer has evolved significantly. The PACIFIC trial opened a new therapeutic era in the treatment of locally advanced NSCLC, establishing durvalumab consolidation therapy as the new standard of care worldwide. A careful evaluation of this type of lung cancer and a discussion of the management of these patients within a multidisciplinary team represents a crucial step in defining the best treatment strategy for each patient. For unresectable stage III NSCLC, definitive concurrent chemoradiotherapy (CCRT) was historically recommended as a treatment with a 5-year survival rate ranging from 20% to 30%. The PACIFIC study conducted in 2017 compared the use of chemoradiotherapy and maintenance therapy with the anti-PD-L1 monoclonal antibody durvalumab to a placebo in patients with locally advanced NSCLC who had not experienced disease progression. The study was prospective, randomized, and phase III. The administration of this medication in patients with locally advanced non-small cell lung cancer (NSCLC) has demonstrated a notable improvement in overall survival. Multiple clinical trials are currently exploring various immune checkpoint inhibition regimens to enhance the treatment efficacy in patients with stage III cancer. Our goal is to offer an up-to-date summary of the planned clinical trials for treatment options, focusing on the significant obstacles and prospects in the post-PACIFIC era.
MeSH term(s)	Humans ; Carcinoma, Non-Small-Cell Lung/therapy ; Carcinoma, Non-Small-Cell Lung/pathology ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Chemoradiotherapy/methods ; Lung Neoplasms/therapy ; Lung Neoplasms/pathology ; Lung Neoplasms/drug therapy ; Immunotherapy/methods ; Neoplasm Staging ; Antibodies, Monoclonal
Chemical Substances	durvalumab (28X28X9OKV) ; Antibodies, Monoclonal
Language	English
Publishing date	2024-04-19
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	1375979-6
ISSN	1532-2807 ; 1219-4956
ISSN (online)	1532-2807
ISSN	1219-4956
DOI	10.3389/pore.2024.1611716
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Zs.A 4936: Show issues

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Article: Editorial: LINAC-based stereotactic radiosurgery in daily practice.

Kovács, Árpád / Lakosi, Ferenc

Frontiers in oncology

2023 Volume 13, Page(s) 1306329

Language	English
Publishing date	2023-11-29
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2023.1306329
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Article ; Online: Flow Cytometry-Based Assay to Detect Alpha Galactosidase Enzymatic Activity at the Cellular Level.

Fekete, Nóra / Li, Luca Kamilla / Kozma, Gergely Tibor / Fekete, György / Pállinger, Éva / Kovács, Árpád Ferenc

Cells

2024 Volume 13, Issue 8

Abstract: Background: Fabry disease is a progressive, X chromosome-linked lysosomal storage disorder with multiple organ dysfunction. Due to the absence or reduced activity of alpha-galactosidase A (AGAL), glycosphingolipids, primarily globotriaosyl-ceramide (Gb3) ...

Abstract	Background: Fabry disease is a progressive, X chromosome-linked lysosomal storage disorder with multiple organ dysfunction. Due to the absence or reduced activity of alpha-galactosidase A (AGAL), glycosphingolipids, primarily globotriaosyl-ceramide (Gb3), concentrate in cells. In heterozygous women, symptomatology is heterogenous and currently routinely used fluorometry-based assays measuring mean activity mostly fail to uncover AGAL dysfunction. The aim was the development of a flow cytometry assay to measure AGAL activity in individual cells. Methods: Conventional and multispectral imaging flow cytometry was used to detect AGAL activity. Specificity was validated using the Results: Flow cytometric detection of specific AGAL activity is feasible with fluorescently labelled Gb3. In the case of Jurkat cells, a substrate concentration of 2.83 nmol/mL and 6 h of incubation are required. Quenching of the aspecific exofacial binding of Gb3 with 20% trypan blue solution is necessary for the specific detection of lysosomal substrate accumulation. Conclusion: A flow cytometry-based assay was developed for the quantitative detection of AGAL activity at the single-cell level, which may contribute to the diagnosis of Fabry patients.
MeSH term(s)	Humans ; Flow Cytometry/methods ; Jurkat Cells ; alpha-Galactosidase/metabolism ; alpha-Galactosidase/genetics ; Fabry Disease/metabolism ; Fabry Disease/enzymology ; Fabry Disease/diagnosis ; 1-Deoxynojirimycin/pharmacology ; 1-Deoxynojirimycin/analogs & derivatives
Chemical Substances	alpha-Galactosidase (EC 3.2.1.22) ; 1-Deoxynojirimycin (19130-96-2)
Language	English
Publishing date	2024-04-19
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells13080706
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Article: CBCT Verification of SRT for Patients With Brain Metastases.

Papp, Judit / Simon, Mihály / Csiki, Emese / Kovács, Árpád

Frontiers in oncology

2022 Volume 11, Page(s) 745140

Abstract: Background: The aim of our work is to demonstrate the role of image guidance and volumetric imaging in stereotactic radiotherapy (SRT) of brain metastases.: Methods: Between 2018 and 2020, 106 patients underwent intracranial stereotactic radiotherapy. ...

Abstract	Background: The aim of our work is to demonstrate the role of image guidance and volumetric imaging in stereotactic radiotherapy (SRT) of brain metastases. Methods: Between 2018 and 2020, 106 patients underwent intracranial stereotactic radiotherapy. 10 patients with metastatic brain tumors treated with SRT were randomly selected and included in our study model. Patients were scanned pre- and post-treatment with cone beam CT. Total of 100 verifications of 50 stereotaxic treatments were performed and analyzed. Results: Population mean X, Y, Z values were -0.13 cm, -0.04 cm, -0.03 cm, respectively, rotation values 0.81°, 0.51°, 0.46°, respectively. Systematic error components for translational displacements pre corrections were as follows: 0.14 cm for X, 0.13 cm for Y and 0.1 cm for Z. Systematic error components of the post-treatment HR 3D CBCTs were as follows: 0.01 cm for X, 0.06 cm for Y and 0.04 cm for Z. Conclusions: Population mean values close to 0 confirmed that there is no systematic variation in our system and the accuracy of our equipment and tools is reliable. HR 3D CBCT scans performed pre SRTs further refine patient and target volume setting, support medical decision making and eliminate the possibility of gross error.
Language	English
Publishing date	2022-01-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2021.745140
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Article: Plan Quality Assessment of Fractionated Stereotactic Radiotherapy Treatment Plans in Patients With Brain Metastases.

Simon, Mihály / Papp, Judit / Csiki, Emese / Kovács, Árpád

Frontiers in oncology

2022 Volume 12, Page(s) 846609

Abstract: Background and purpose: The treatment options available in the management of brain metastases includes fractionated stereotactic radiotherapy (FSRT) and stereotactic radiosurgery (SRS) treatments. FSRT treatments have proved to be useful mainly in the ... ...

Abstract	Background and purpose: The treatment options available in the management of brain metastases includes fractionated stereotactic radiotherapy (FSRT) and stereotactic radiosurgery (SRS) treatments. FSRT treatments have proved to be useful mainly in the treatment of larger volumes. This study aims to evaluate the FSRT treatment technique used in our department based on various plan quality indices. Methods and materials: 24 treatment plans of 23 patients were analyzed. Volumetric modulated arc therapy (VMAT) plans were generated in line with the department protocol. The following parameters were extracted: Radiation Therapy Oncology Group conformity index (RTOG CI), Paddick conformity index (Paddick CI), gradient index (GI), quality index (Q), homogeneity index (HI), and V24.4 volume as a parallel index of V12 used at SRS plan evaluation. Results: Plan conformity was acceptable, RTOG CI mean was 0.942; Paddick CI mean was 0.824. The mean GI value was 6.146. The mean of HI and Q indices were 1.263 and 0.94, respectively. V24.4 mean was 33.434 cm Discussion: Our results based on the derived indices show that our FSRT approach can achieve clinically acceptable treatment plans. Furthermore, the clustering of PTV volumes show that these plan quality metrics remain acceptable for a wide spectrum of PTV volumes.
Language	English
Publishing date	2022-03-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2022.846609
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Article: Current Understanding of Molecular Pathophysiology of Heart Failure With Preserved Ejection Fraction.

Budde, Heidi / Hassoun, Roua / Mügge, Andreas / Kovács, Árpád / Hamdani, Nazha

Frontiers in physiology

2022 Volume 13, Page(s) 928232

Abstract: Heart Failure (HF) is the most common cause of hospitalization in the Western societies. HF is a heterogeneous and complex syndrome that may result from any dysfunction of systolic or diastolic capacity. Abnormal diastolic left ventricular function with ... ...

Abstract	Heart Failure (HF) is the most common cause of hospitalization in the Western societies. HF is a heterogeneous and complex syndrome that may result from any dysfunction of systolic or diastolic capacity. Abnormal diastolic left ventricular function with impaired relaxation and increased diastolic stiffness is characteristic of heart failure with preserved ejection fraction (HFpEF). HFpEF accounts for more than 50% of all cases of HF. The prevalence increases with age: from around 1% for those aged <55 years to >10% in those aged 70 years or over. Nearly 50% of HF patients have HFrEF and the other 50% have HFpEF/HFmrEF, mainly based on studies in hospitalized patients. The ESC Long-Term Registry, in the outpatient setting, reports that 60% have HFrEF, 24% have HFmrEF, and 16% have HFpEF. To some extent, more than 50% of HF patients are female. HFpEF is closely associated with co-morbidities, age, and gender. Epidemiological evidence suggests that HFpEF is highly represented in older obese women and proposed as 'obese female HFpEF phenotype'. While HFrEF phenotype is more a male phenotype. In addition, metabolic abnormalities and hemodynamic perturbations in obese HFpEF patients appear to have a greater impact in women then in men (Sorimachi et al., European J of Heart Fail, 2022, 22). To date, numerous clinical trials of HFpEF treatments have produced disappointing results. This outcome suggests that a "one size fits all" approach to HFpEF may be inappropriate and supports the use of tailored, personalized therapeutic strategies with specific treatments for distinct HFpEF phenotypes. The most important mediators of diastolic stiffness are the cardiomyocytes, endothelial cells, and extracellular matrix (ECM). The complex physiological signal transduction networks that respond to the dual challenges of inflammatory and oxidative stress are major factors that promote the development of HFpEF pathologies. These signalling networks contribute to the development of the diseases. Inhibition and/or attenuation of these signalling networks also delays the onset of disease. In this review, we discuss the molecular mechanisms associated with the physiological responses to inflammation and oxidative stress and emphasize the nature of the contribution of most important cells to the development of HFpEF via increased inflammation and oxidative stress.
Language	English
Publishing date	2022-07-07
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2564217-0
ISSN	1664-042X
ISSN	1664-042X
DOI	10.3389/fphys.2022.928232
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Article ; Online: A Silver-Russell-szindróma diagnosztikai lépései és terápiás lehetőségei egy családi halmozódást mutató eset kapcsán.

Kovács, Árpád Ferenc / Beniczky, Nikolett Jusztina / Bertalan, Rita Ágnes / Sallai, Ágnes

Orvosi hetilap

2022 Volume 163, Issue 45, Page(s) 1775–1781

Abstract: Characterized by both intrauterine and postnatal growth retardation, and consequent small stature, Silver-Russell syndrome is associated with typical minor anomalies (relative macrocephalia, protruding forehead, downturned corners of mouth, micrognathia, ...

Abstract	Characterized by both intrauterine and postnatal growth retardation, and consequent small stature, Silver-Russell syndrome is associated with typical minor anomalies (relative macrocephalia, protruding forehead, downturned corners of mouth, micrognathia, low set ears, facial, skeletal and limb asymmetry) and findings involving mainly the endocrine system. The molecular background of the syndrome is complex, but it is most often caused by the involvement of critical regions of chromosome 11 and/or chromosome 7. Beside the molecular diagnosis, the Netchine-Harbison clinical scoring system aims to contribute to the successful diagnosis of Silver-Russell syndrome. Although Silver-Russell syndrome is mostly sporadic, in our case report we present an extremely rare familial accumulation, where three of four siblings are affected by Silver-Russell syndrome. Early diagnosis is important to initiate adequate feeding and nutritional guidance, enhance early development and start growth hormone therapy as soon as possible. We would like to emphasize that management and long-term follow-up is crucial to prevent potential complications and treat specific issues appropriately. Orv Hetil. 2022; 163(45): 1775-1781.
MeSH term(s)	Humans ; Silver-Russell Syndrome/diagnosis ; Silver-Russell Syndrome/genetics ; Face
Language	English
Publishing date	2022-11-06
Publishing country	Hungary
Document type	Case Reports ; Journal Article
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2022.32616
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Article: Occupational Stress Levels among Radiologists and Radiographers in Hungary during the COVID-19 Era.

Sipos, David / Kövesdi, Orsolya / Raposa, Bence / Ferkai, Luca / Deutsch, Krisztina / Pandur, Attila / Kovács, Árpád / Csima, Melinda Petőné

Healthcare (Basel, Switzerland)

2024 Volume 12, Issue 2

Abstract: The COVID-19 pandemic has heightened stress levels, potentially affecting the occupational wellbeing of radiographers and radiologists. Our study aimed to assess occupational stress levels within the radiology department and identify contributing factors. ...

Abstract	The COVID-19 pandemic has heightened stress levels, potentially affecting the occupational wellbeing of radiographers and radiologists. Our study aimed to assess occupational stress levels within the radiology department and identify contributing factors. A cross-sectional survey was conducted between September and November 2022, with participants comprising radiographers and radiologists affiliated with the Hungarian Society of Radiographers and the Hungarian Society of Radiologists. The online survey collected socio-demographic and COVID-19 data, and the participants completed an effort-reward imbalance questionnaire. The analysis of 406 responses revealed significantly higher effort-reward imbalance (ERI) levels among the radiologists compared to the radiographers (
Language	English
Publishing date	2024-01-10
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2721009-1
ISSN	2227-9032
ISSN	2227-9032
DOI	10.3390/healthcare12020160
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