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Article ; Online: Acute Phase Protein Orosomucoid (Alpha-1-Acid Glycoprotein) Predicts Delayed Cerebral Ischemia and 3-Month Unfavorable Outcome after Aneurysmal Subarachnoid Hemorrhage.

Zavori, Laszlo / Varnai, Reka / Molnar, Tihamer / Szirmay, Balazs / Farkas, Nelli / Schwarcz, Attila / Csecsei, Peter

International journal of molecular sciences

2023 Volume 24, Issue 20

Abstract: The pathophysiology and consequences of early brain injury (EBI) after aneurysmal subarachnoid hemorrhage (aSAH) remain incompletely understood. This study aims to investigate the role of orosomucoid (ORM) in aSAH, its potential as a marker for assessing ...

Abstract	The pathophysiology and consequences of early brain injury (EBI) after aneurysmal subarachnoid hemorrhage (aSAH) remain incompletely understood. This study aims to investigate the role of orosomucoid (ORM) in aSAH, its potential as a marker for assessing the extent of EBI-induced damage, and its correlation with delayed cerebral ischemia (DCI) and functional recovery over a 3-month period. We collected serum specimens 72 h post-aSAH to measure ORM levels. The study included 151 aSAH patients and 105 healthy subjects. The serum ORM levels within the patient cohort significantly exceeded those in the control group (
MeSH term(s)	Humans ; Subarachnoid Hemorrhage ; Orosomucoid ; Acute-Phase Proteins ; Brain Ischemia/complications ; Cerebral Infarction/complications
Chemical Substances	Orosomucoid ; Acute-Phase Proteins
Language	English
Publishing date	2023-10-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms242015267
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Article ; Online: Percutaneous Spine Fusion Combined with Whole-Body Traction in the Acute Surgical Treatment of AO A- and C-Type Fractures: A Technical Note.

Szabó, Viktor / Nagy, Máté / Büki, András / Schwarcz, Attila

World neurosurgery

2021 Volume 159, Page(s) 13–26

Abstract: Background: A diminished level of pain following the operation and shortened hospitalization are the distinct advantages of minimally invasive spine surgery (MISS). However, manipulating the spine with additional MISS tools (e.g., distraction and ... ...

Abstract	Background: A diminished level of pain following the operation and shortened hospitalization are the distinct advantages of minimally invasive spine surgery (MISS). However, manipulating the spine with additional MISS tools (e.g., distraction and compression devices) is often cumbersome. Our paper draws attention to a cost-free, fast, indirect decompression method that can be used in the acute treatment of thoracolumbar spine fractures. The presented method involves ligamentotaxis by whole-body traction in the operating room combined with percutaneous spine fixation. Methods: Fifteen patients with thoracolumbar injuries A type and C type (without distraction) by AO classification were operated sequentially with the combination of whole-body traction and percutaneous minimally invasive spine fixation. Data were analyzed retrospectively. Results: A total of 139 screws were implanted into 70 segments in 6 female and 9 male patients. The average clinical follow-up was 16 months. Average preoperative traumatic kyphosis was 17 degrees, and an average postoperative kyphosis was 1.8 degrees. The fractured vertebrae's height gain was an average of 11.0 mm (range 3.9-21.9 mm) ventrally and an average of 5.4 mm (range 1-11.2 mm) dorsally after the surgeries. The spinal canal space narrowing showed an average 6.5 mm improvement postoperatively. Operative time averaged 2 hours and 34 minutes, and blood loss averaged 250 mL (range 150-400 mL). No neurologic complications and wound healing problems were observed. Conclusions: The combination of MISS and whole-body traction provided successful anatomical correction in thirteen of the fifteen cases of compression type thoracolumbar fractures without extensive surgical exploration.
MeSH term(s)	Female ; Fracture Fixation, Internal/methods ; Fractures, Bone/complications ; Humans ; Kyphosis/surgery ; Lumbar Vertebrae/injuries ; Lumbar Vertebrae/surgery ; Male ; Retrospective Studies ; Spinal Fractures/complications ; Spinal Fractures/diagnostic imaging ; Spinal Fractures/surgery ; Thoracic Vertebrae/injuries ; Thoracic Vertebrae/surgery ; Traction/adverse effects ; Treatment Outcome
Language	English
Publishing date	2021-12-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2021.12.032
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Article: Minimálisan invazív és O-arm asszisztált en bloc gerincdaganat-reszekciók.

Szabó, Viktor / Lakosi, Ferenc / Nagy, Máté / Dóczi, Tamás / Büki, András / Schwarcz, Attila

Ideggyogyaszati szemle

2022 Volume 75, Issue 1-02, Page(s) 65–72

Abstract: Background and purpose: The en bloc resection of spinal tumors is required in primary spine tumors and in selected cases of secondary spine tumors, where the primary disease is under control and long survival time is expected. Three cases are presented, ...

Title translation	Minimally invasive and O-arm assisted en bloc spinal tumor resections.
Abstract	Background and purpose: The en bloc resection of spinal tumors is required in primary spine tumors and in selected cases of secondary spine tumors, where the primary disease is under control and long survival time is expected. Three cases are presented, applying O-arm assisted navigation or minimally invasive anterior approaches for en bloc tumor removal. Methods: O-arm navigation assisted osteotomies were carried out to remove a Th.V. breast tumor metastasis en bloc, intact bony part of the Th.V. vertebra was spared. Vertebral corpectomies of a patient with L.IV. chordoma and of a patient with L.V. carcinoid were also performed using minimally invasive, microscope assisted, anterior approaches to the lumbar spine. Results: No morbidity or local recurrence were detected in the patient with breast cancer 1 year after the operation. Nevertheless, new spinal metastasis were revealed 1 year after surgery despite the appropriate oncological treatment. The patient with L.IV. chordoma is still tumor free (last follow-up: 18 month after surgery), but post operatively detected lower limb paresis and gait disturbances are persisted. The posterior healthy bony parts of the spinal column remained intact, since only anterior approaches were used for en bloc L.IV. corpectomy. No morbidity or recurrence was detected in patient with L.V. carcinoid tumor on 1 year follow-up. Conclusion: Both the O-arm navigation assisted surgery and the minimally invasive anterior approaches to the spine can help to reduce surgical morbidity and to spare healthy bony structures of the spine. The later could play important role to provide long term spine stability. The presented new surgical technologies can be accepted only, if they produce at least the same oncological results on longer follow-ups as conventional surgical approaches.
MeSH term(s)	Humans ; Imaging, Three-Dimensional ; Lumbar Vertebrae/surgery ; Spinal Neoplasms/surgery ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed
Language	Hungarian
Publishing date	2022-02-02
Publishing country	Hungary
Document type	Case Reports
ZDB-ID	2240317-6
ISSN	0019-1442
ISSN	0019-1442
DOI	10.18071/isz.75.0065
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Article ; Online: Biomarker Associations in Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage.

Spantler, Dora / Molnar, Tihamer / Simon, Diana / Berki, Timea / Buki, Andras / Schwarcz, Attila / Csecsei, Peter

International journal of molecular sciences

2022 Volume 23, Issue 15

Abstract: The prognosis for patients with aneurysmal subarachnoid hemorrhage (aSAH) is heavily influenced by the development of delayed cerebral ischemia (DCI), but the adequate and effective therapy of DCI to this day has not been resolved. Multiplex serum ... ...

Abstract	The prognosis for patients with aneurysmal subarachnoid hemorrhage (aSAH) is heavily influenced by the development of delayed cerebral ischemia (DCI), but the adequate and effective therapy of DCI to this day has not been resolved. Multiplex serum biomarker studies may help to understand the pathophysiological processes underlying DCI. Samples were collected from patients with aSAH at two time points: (1) 24 h (Day 1) and (2) 5−7 days after ictus. Serum concentrations of eotaxin, FGF-2, FLT-3L, CX3CL1, Il-1b, IL-4, IP-10, MCP3, and MIP-1b were determined using a customized MILLIPLEX Human Cytokine/Chemokine/Growth Factor Panel A multiplex assay. The functional outcome was defined by the modified Rankin scale (favorable: 0−2, unfavorable: 3−6) measured on the 30th day after aSAH. One-hundred and twelve patients with aSAH were included in this study. The median level of CX3CL1 and MCP-3 measured on Days 5−7 were significantly higher in patients with DCI compared with those without DCI (CX3CL1: with DCI: 110.5 pg/mL, IQR: 82−201 vs. without DCI: 82.6, 58−119, p = 0.036; and MCP-3: with DCI: 22 pg/mL (0−32) vs. without DCI: 0 (0−11), p < 0.001). IP-10, MCP-3, and MIP-1b also showed significant associations with the functional outcome after aSAH. MCP-3 and CX3CL1 may play a role in the pathophysiology of DCI.
MeSH term(s)	Biomarkers ; Brain Ischemia/complications ; Cerebral Infarction/complications ; Chemokine CXCL10 ; Humans ; Subarachnoid Hemorrhage
Chemical Substances	Biomarkers ; Chemokine CXCL10
Language	English
Publishing date	2022-08-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms23158789
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Article: Cystatin-c May Indicate Subclinical Renal Involvement, While Orosomucoid Is Associated with Fatigue in Patients with Long-COVID Syndrome.

Zavori, Laszlo / Molnar, Tihamer / Varnai, Reka / Kanizsai, Andrea / Nagy, Lajos / Vadkerti, Bence / Szirmay, Balazs / Schwarcz, Attila / Csecsei, Peter

Journal of personalized medicine

2023 Volume 13, Issue 2

Abstract: Long-COVID syndrome is associated with high healthcare costs, but its pathophysiology is not yet fully understood. Inflammation, renal impairment or disturbance of the NO system emerge as potential pathogenetic factors. We aimed to investigate the ... ...

Abstract	Long-COVID syndrome is associated with high healthcare costs, but its pathophysiology is not yet fully understood. Inflammation, renal impairment or disturbance of the NO system emerge as potential pathogenetic factors. We aimed to investigate the relationship between symptoms of long-COVID syndrome and serum levels of cystatin-c (CYSC), orosomucoid (ORM), l-arginine, symmetric dimethylarginine (SDMA) and asymmetric dimethylarginine (ADMA). A total of 114 patients suffering from long-COVID syndrome were included in this observational cohort study. We found that serum CYSC was independently associated with the anti-spike immunoglobulin (S-Ig) serum level (OR: 5.377, 95% CI: 1.822-12.361;
Language	English
Publishing date	2023-02-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm13020371
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Article: Krónikus dialízis kapcsán kialakult destruktív cervicalis spondylarthropathia esete.

Berta, Balázs / Komáromy, Hedvig / Schwarcz, Attila / Kajtár, Béla / Büki, András / Kuncz, Ádám

Ideggyogyaszati szemle

2021 Volume 74, Issue 5-6, Page(s) 211–215

Abstract: A case of a 61-year-old male patient suffered chronic renal failure and dialysed for 23 years with destructive cervical spondylarthropathy is presented. The patient presented with sudden onset of cervical pain radiating into his shoulders without ... ...

Title translation	A case of destructive cervical spondylarthropathy related to chronic dialysis.
Abstract	A case of a 61-year-old male patient suffered chronic renal failure and dialysed for 23 years with destructive cervical spondylarthropathy is presented. The patient presented with sudden onset of cervical pain radiating into his shoulders without neurological deficits. CT and MRI of the cervical and thoracic spine revealed severe destructive changes and compressive fractures of C6 and C7 vertebrae which caused the narrowing of the nerve root canals at these levels. A 360-degree fixation was performed to treat the unstable fracture and the patient's pain (C6 and C7 corpectomy, autolog bone graft replacement of the two vertebral bodies, anterior plate fixation and posterior instrumentation with screws and rods). Postoperatively the patient had no significant pain, no neurological deficit and he was able to manage independent life himself. During the immediate follow-up CT of the neck showed the satisfactory position of the bone graft and the metal implantations. The 6 months follow-up CT revealed the anterior migration of the two screws from the Th1 vertebral body and 2 mm ventral elevation of the caudal end of the plate from the anterior surface of the Th1 vertebral body. The 1-year follow-up could not be performed because the patient died due to cardio-pulmonary insufficiency. This is the second Hungarian report of a chronic dialysis related severe spondylarthropathy which may cause pathologic fractures of the vertebral bodies. The typical radiological and histological findings are discussed. This disease affect patients' quality of life and the conservative treatment alone seems to be ineffective in most cases. Based on the literature and personal experiences, the authors suggest 360-degree fixation of the spine to provide sufficient stability for the vertebrae of "bad bone quality", and early mobilisation of the patient can be achieved.
MeSH term(s)	Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/injuries ; Cervical Vertebrae/surgery ; Humans ; Male ; Middle Aged ; Quality of Life ; Renal Dialysis ; Spinal Fractures ; Spinal Fusion ; Spondylarthropathies/complications ; Spondylarthropathies/diagnostic imaging
Language	Hungarian
Publishing date	2021-06-09
Publishing country	Hungary
Document type	Case Reports
ZDB-ID	2240317-6
ISSN	0019-1442
ISSN	0019-1442
DOI	10.18071/isz.74.0211
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Zs.A 6335: Show issues

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Article: Minimálisan invazív, extrapleuralis, anterolateralis gerincfeltárás.

Szabó, Viktor / Büki, András / Dóczi, Tamás / Schwarcz, Attila

Ideggyogyaszati szemle

2018 Volume 71, Issue 9-10, Page(s) 293–301

Abstract: In spine surgery, minimally invasive approaches (MIS) are getting accepted and more popular worldwide during the last decades. It is due to the reduced intraoperative blood loss, decreased infection rate, less postoperative pain and earlier discharge ... ...

Title translation	Minimally invasive, extrapleural-anterolateral approach to the spine.
Abstract	In spine surgery, minimally invasive approaches (MIS) are getting accepted and more popular worldwide during the last decades. It is due to the reduced intraoperative blood loss, decreased infection rate, less postoperative pain and earlier discharge from hospital compared to traditional approaches. The present paper puts forward a minimally invasive extrapleural approach to the thoracic spine that is not applied in Hungary. This new approach, in contrast to the standard costotransversectomy, provides direct visual control over the ventral surface of the dural sac. Furthermore, contrary to the transthoracic way, following minimally invasive extrapleural surgery thoracic drainage and intensive care are not necessary. The approach can be applied safely in treatment of ventral or ventrolateral pathologies of the thoracic spine.
MeSH term(s)	Blood Loss, Surgical ; Humans ; Hungary ; Lumbar Vertebrae/surgery ; Minimally Invasive Surgical Procedures/methods ; Orthopedic Procedures/methods ; Pain ; Pain Measurement ; Pleura/surgery ; Thoracic Vertebrae/surgery ; Treatment Outcome
Language	Hungarian
Publishing date	2018-10-18
Publishing country	Hungary
Document type	Journal Article ; Review
ZDB-ID	2240317-6
ISSN	0019-1442
ISSN	0019-1442
DOI	10.18071/isz.71.0293
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Article: Serum Periostin May Help to Identify Patients with Poor Collaterals in the Hyperacute Phase of Ischemic Stroke.

Spantler, Dora / Csecsei, Peter / Borocz, Katalin / Berki, Timea / Zavori, Laszlo / Schwarcz, Attila / Lenzser, Gabor / Molnar, Tihamer

Diagnostics (Basel, Switzerland)

2022 Volume 12, Issue 8

Abstract: Background: Periostin is a glycoprotein that mediates cell functions in the extracellular matrix and appears to be a promising biomarker in neurological damage, such as ischemic stroke (IS). We aimed to measure serum periostin levels in the hyperacute ... ...

Abstract	Background: Periostin is a glycoprotein that mediates cell functions in the extracellular matrix and appears to be a promising biomarker in neurological damage, such as ischemic stroke (IS). We aimed to measure serum periostin levels in the hyperacute phase of ischemic stroke to explore its predictive power in identification of patients with poor collaterals (ASPECT < 6). Methods: We prospectively enrolled 122 patients with acute ischemic stroke within the first 6 h after onset. The early ischemic changes were evaluated by calculating ASPECT score on admission using a native CT scan. An unfavorable outcome was defined as the modified Rankin Scale (mRS) > 2 at 90 days follow-up. Blood samples were collected on admission immediately after CT scan and periostin serum concentrations were determined by ELISA. Results: The admission concentration of serum periostin was significantly higher in patients with unfavorable outcome than in patients with favorable outcome (615 ng/L, IQR: 443−1070 vs. 390 ng/L, 260−563, p < 0.001). In a binary logistic regression model, serum periostin level was a significant predictor for ASPECT < 6 status on admission, within 6 h after stroke onset (OR, 5.911; CI, 0.990−0.999; p = 0.015). Conclusion: Admission periostin levels can help to identify patients who are not suitable for neurointervention, especially if advanced neuroimaging is not available.
Language	English
Publishing date	2022-08-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics12081942
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Article: Adverse Reactions after Booster SARS-CoV-2 Vaccination Have Less Impact on Antibody Response than after Basic Vaccination Scheme.

Kanizsai, Andrea / Zavori, Laszlo / Molnar, Tihamer / Tőkés-Füzesi, Margit / Szalai, Zoltan / Berecz, Janos / Varnai, Reka / Peterfi, Zoltan / Schwarcz, Attila / Csecsei, Peter

Vaccines

2023 Volume 11, Issue 1

Abstract: Background: It is known that adverse reactions following SARS-CoV-2 vaccinations show a positive correlation with the subsequent antibody titer. However, it is not clear how the adverse reactions following the booster vaccination are related to the ... ...

Abstract	Background: It is known that adverse reactions following SARS-CoV-2 vaccinations show a positive correlation with the subsequent antibody titer. However, it is not clear how the adverse reactions following the booster vaccination are related to the antibody levels that can be measured after a 3rd dose. The primary goal of this study was to investigate whether the adverse reactions following the booster vaccination show a correlation with subsequent antibody levels. Methods: Adverse reactions occurring within 7 days after the 3rd vaccination were recorded and the anti-SARS-CoV-2 spike protein immunoglobulin (Ig) level in the venous blood was measured on post-vaccination 14th, 60th and 120th days. Results: A total of 218 volunteers were included in the study. Main findings: (i) The adverse reactions that appeared after the booster dose did not show a positive correlation with the subsequent antibody level, except a correlation in the case of fever; (ii) there were more symptomatic patients in the group receiving heterologous booster vaccine, (iii) fever after the 2nd dose was independently associated with a reduction in the likelihood of COVID-19 positivity after the booster dose. Conclusion: No adverse reactions, but fever showed a correlation with the antibody level after the booster SARS-CoV-2 vaccine.
Language	English
Publishing date	2023-01-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines11010182
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Article ; Online: Different Kinetics of Serum ADAMTS13, GDF-15, and Neutrophil Gelatinase-Associated Lipocalin in the Early Phase of Aneurysmal Subarachnoid Hemorrhage.

Csecsei, Peter / Olah, Csaba / Varnai, Reka / Simon, Diana / Erdo-Bonyar, Szabina / Berki, Timea / Czabajszki, Mate / Zavori, Laszlo / Schwarcz, Attila / Molnar, Tihamer

International journal of molecular sciences

2023 Volume 24, Issue 13

Abstract: Growth differentiation factor 15 (GDF-15), neutrophil gelatinase-associated lipocalin (NGAL), and ADAMTS13 have previously been implicated in the pathophysiological processes of SAH. In the present study, we aim to examine their role in the early period ... ...

Abstract	Growth differentiation factor 15 (GDF-15), neutrophil gelatinase-associated lipocalin (NGAL), and ADAMTS13 have previously been implicated in the pathophysiological processes of SAH. In the present study, we aim to examine their role in the early period of SAH and their relationship to primary and secondary outcomes. Serum samples were collected at five time periods after SAH (at 24 h (D1), at 72 h (D3), at 120 h (D5), at 168 h (D7) and at 216 h (D9), post-admission) and) were measured by using MILLIPLEX Map Human Cardiovascular Disease (CVD) Magnetic Bead Panel 2. We included 150 patients with SAH and 30 healthy controls. GDF-15 levels at D1 to D9 were significantly associated with a 3-month unfavorable outcome. Based on the ROC analysis, in patients with a good clinical grade at admission (WFNS I-III), the GDF-15 value measured at time point D3 predicted a 3-month unfavorable outcome (cut-off value: 3.97 ng/mL, AUC:0.833, 95%CI: 0.728-0.938, sensitivity:73.7%, specificity:82.6%,
MeSH term(s)	Humans ; Lipocalin-2 ; Growth Differentiation Factor 15 ; Subarachnoid Hemorrhage/complications ; Kinetics ; Hospitalization ; ADAMTS13 Protein
Chemical Substances	Lipocalin-2 ; Growth Differentiation Factor 15 ; ADAMTS13 protein, human (EC 3.4.24.87) ; ADAMTS13 Protein (EC 3.4.24.87)
Language	English
Publishing date	2023-07-02
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms241311005
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