Bacs Kiskun County Hospital

Kecskemét, Hungary

Bacs Kiskun County Hospital

Kecskemét, Hungary

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Szabo C.,University of Szeged | Szabo C.,Nyiro Gyula Hospital National Institute of Psychiatry and Addictions | Kelemen O.,Bacs Kiskun County Hospital | Keri S.,University of Szeged | And 2 more authors.
Neuroscience | Year: 2014

Increased low-grade inflammation is thought to be associated with several neuropsychiatric disorders characterized by decreased neuronal plasticity. The purpose of the present study was to investigate the relationship between structural changes in the human brain during cognitive training and the intensity of low-grade peripheral inflammation in healthy individuals (n= 56). A two-month training (30. min/day) with a platformer video game resulted in a significantly increased volume of the right hippocampal formation. The number of stressful life events experienced during the past year was associated with less pronounced enlargement of the hippocampus. However, the main predictor of hippocampal volume expansion was the relative peripheral expression of Nuclear Factor-κB (NF-κB), a transcription factor playing a central role in the effect of pro-inflammatory cytokines. Interleukin-6 (IL-6) and C-reactive protein levels were not related to hippocampal plasticity when NF-κB was taken into consideration. These results suggest that more intensive peripheral inflammation is associated with weaker neuronal plasticity during cognitive training. © 2014 IBRO.

Keri S.,Budapest University of Technology and Economics | Keri S.,Nyiro Gyula Hospital National Institute of Psychiatry and Addictions | Keri S.,University of Szeged | Szabo C.,Nyiro Gyula Hospital National Institute of Psychiatry and Addictions | Kelemen O.,Bacs Kiskun County Hospital
Brain, Behavior, and Immunity | Year: 2014

In recent years, increased attention has been paid to the inflammatory mechanisms of major depressive disorder (MDD). The aim of the present study was to investigate pro-inflammatory pathways related to the "leaky gut" hypothesis of MDD, which is based on the putative intestinal translocation of Gram-negative bacteria and a subsequent abnormal immune response mediated by the Toll-Like Receptor-4 (TLR-4) pathway. 50 patients with first-episode MDD and 30 healthy control subjects participated in the study. Real-time quantitative PCR was used to measure TLR-4 and TLR-2 RNA from peripheral mononuclear blood cells, as well as the expression of NF-κβ, a key transcription factor of the pro-inflammatory response. TLR-4 protein expression was determined by using flow cytometry. TLR-2 served as a control molecule. Low-grade inflammation was characterized by the measurement of interleukin-6 (IL-6) and C-reactive protein (CRP). Bacterial translocation was investigated by the measurement of the 16S rRNA subunit (16S rDNA) of intestinal microbiota in the blood plasma of the participants. We performed these analyses before (t1) and after (t2) cognitive-behavioral therapy (CBT) in MDD. The healthy control subjects were also assessed two times. We found significantly elevated expressions of all three markers (TLR-4 RNA and protein, NF-κβ RNA) and 16S rDNA in MDD at t1 relative to healthy control subjects. These markers showed a significant decrease during CBT (t1 > t2 in MDD). We observed no between-group differences and changes in the case of TLR-2. Greater reduction of pro-inflammatory markers during CBT was associated with more pronounced clinical improvement. IL-6 and CRP displayed a moderately elevated level in MDD and did not change during CBT. In conclusion, TLR-4 signaling is up-regulated in newly diagnosed patients with MDD, which may be related to bacterial translocation or to the presence of various damage-associated molecular patterns. Clinical improvement during psychotherapy is associated with decreased expression of pro-inflammatory markers. © 2014 Elsevier Inc.

Szabo C.,University of Szeged | Szabo C.,Nyiro Gyula Hospital National Institute of Psychiatry and Addictions | Kelemen O.,Bacs Kiskun County Hospital | Keri S.,University of Szeged | And 2 more authors.
Neuroscience Letters | Year: 2014

Posttraumatic stress disorder (PTSD) is characterized by hyperarousal, flashbacks, avoidance, and memory dysfunctions. Although psychotherapy improves the clinical symptoms, its effect on memory has not been explored. In addition, there is no information about gene expression changes related to hippocampal functions. We assessed PTSD patients ( n= 20) using the Wechsler Memory Scale-Revised (WAIS-R) and a paired associates learning (PAL) test, as well as changes in blood FK506 binding protein (FKBP5) mRNA expression before and after cognitive behavioral therapy (CBT). Results revealed that before CBT PTSD patients were impaired on WAIS-R delayed recall, attention/concentration, and PAL compared with trauma-exposed control subjects ( n= 20). These memory dysfunctions showed a significant improvement after CBT. Better performance on the PAL test correlated with enhanced blood FKBP5 mRNA expression. These results suggest that elevated FKBP5 expression during CBT is related to improved associative memory linked to the hippocampal formation. © 2014 Elsevier Ireland Ltd.

Szamosi A.,National Psychiatry Center | Levy-Gigi E.,National Psychiatry Center | Levy-Gigi E.,Rutgers University | Levy-Gigi E.,Haifa University | And 3 more authors.
Cortex | Year: 2013

When people perform an attentionally demanding target task at fixation, they also encode the surrounding visual environment, which serves as a context of the task. Here, we examined the role of the hippocampus in memory for target and context. Thirty-five patients with amnestic mild cognitive impairment (aMCI) and 35 healthy controls matched for age, gender, and education participated in the study. Participants completed visual letter detection and auditory tone discrimination target tasks, while also viewing a series of briefly presented urban and natural scenes. For the measurement of hippocampal and cerebral cortical volume, we utilized the FreeSurfer protocol using a Siemens Trio 3T scanner. Before the quantification of brain volumes, hippocampal atrophy was confirmed by visual inspection in each patient. Results revealed intact letter recall and tone discrimination performances in aMCI patients, whereas they showed severe impairments in the recognition of scenes presented together with the targets. Patients with aMCI showed bilaterally reduced hippocampal volumes, but intact cortical volume, as compared with the controls. In controls and in the whole sample, hippocampal volume was positively associated with scene recognition when a target task was present. This relationship was observed in both visual and auditory conditions. Scene recognition and target tasks were not associated with executive functions. These results suggest that the hippocampus plays an essential role in the formation of memory traces of the visual environment when people concurrently perform a target task at behaviorally relevant points in time. © 2012 Elsevier Ltd.

Keri S.,University of Szeged | Keri S.,Nyiro Gyula Hospital | Keri S.,Budapest University of Technology and Economics | Szabo C.,Nyiro Gyula Hospital | Kelemen O.,Bacs Kiskun County Hospital
Journal of Affective Disorders | Year: 2014

Background Results from convergent genomics indicated new peripheral biomarkers for mood states. We sought to investigate the clinical utility of the BioM-10 Mood Panel, a peripheral biomarker set of low vs. high mood states, in the diagnosis of major depressive episode and to monitor the effectiveness of cognitive-behavioral therapy (CBT). Method 44 patients with a first episode of major depression and 30 healthy control subjects participated in the study. The BioM-10 panel's gene expression profile was measured from whole peripheral blood with the Affymetrix Human Genome U133 Plus 2.0 Gene Chips, focusing on 10 top genes related to high mood states (MBP, EDG2, FZD3, ATXN1, and EDNRB) and low mood states (FGFR1, MAG, PMP22, UGT8, and ERBB3). We studied gene expression before and after CBT. Results The BioM-10 prediction score discriminated patients and controls with high sensitivity (84%) and specificity (90%). There was an increase in the BioM-10 prediction score after CBT relative to the pretreatment value. Clinical improvement was associated with higher prediction scores reflecting a greater ratio of high mood markers relative to low mood markers. Limitations Sample size was small for a genome-wide microarray study. Convergent genomic studies have not been conducted in major depressive disorder. More evidence is needed from patients with severe, recurrent, and chronic forms of depression. Conclusions The BioM-10 panel is a promising tool as a biomarker setup for the evaluation of low and high mood states across diagnostic categories. The panel includes genes related to growth factor pathways and myelination, which may provide new insights into the pathophysiology of mood dysregulation. © 2014 Elsevier B.V.

Bihari I.,Pestszentlorinc Pestszentimre Health Service KFT | Panczel G.,Bacs Kiskun County Hospital | Kovacs J.,Novartis | Beygo J.,Novartis | Fragapanec E.,Novartis
Clinical and Vaccine Immunology | Year: 2012

Preparedness against an A/H5N1 influenza pandemic requires well-tolerated, effective vaccines which provide both vaccine strain-specific and heterologous, cross-clade protection. This study was conducted to assess the immunogenicity and safety profile of an MF59-adjuvanted, prepandemic influenza vaccine containing A/turkey/Turkey/01/2005 (H5N1) strain viral antigen. A total of 343 participants, 194 adults (18 to 60 years) and 149 elderly individuals (≥61 years), received two doses of the investigational vaccine given 3 weeks apart. Homologous and heterologous antibody responses were analyzed by hemagglutination inhibition (HI), single radial hemolysis (SRH), and microneutralization (MN) assays 3 weeks after administration of the first vaccine dose and 3 weeks and 6 months after the second dose. Immunogenicity was assessed according to European licensure criteria for pandemic influenza vaccines. After two vaccine doses, all three European licensure criteria were met for adult and elderly subjects against the homologous vaccine strain, A/turkey/Turkey/1/2005, when analyzed by HI and SRH assays. Cross-reactive antibody responses were observed by HI and SRH analyses against the heterologous H5N1 strains, A/Indonesia/5/2005 and A/Vietnam/1194/2004, in adult and elderly subjects. Solicited local and systemic reactions were mostly mild to moderate in severity and occurred less frequently in the elderly than in adult vaccinees. In both adult and elderly subjects, MF59-adjuvanted vaccine containing 7.5 μg of A/Turkey strain influenza virus antigen was highly immunogenic, well tolerated, and able to elicit cross-clade, heterologous antibody responses against A/Indonesia and A/Vietnam strains 6 weeks after the first vaccination. Copyright © 2012, American Society for Microbiology. All Rights Reserved.

Kovacs T.,National Psychiatry Center | Kelemen O.,Bacs Kiskun County Hospital | Keri S.,National Psychiatry Center | Keri S.,University of Szeged
Psychiatry Research | Year: 2013

The purpose of this study was to investigate Fragile X Syndrome (FXS)-related mechanisms in schizophrenia, including CGG triplet expansion, FMR1 mRNA, and fragile X mental retardation protein (FMRP) levels in lymphocytes. We investigated 36 patients with schizophrenia and 30 healthy controls using Southern blot analysis, mRNA assay, and enzyme-linked immunosorbent assay (ELISA). General intellectual functions were assessed with the Wechsler Adult Intelligence Scale-III, and the clinical symptoms were evaluated with the Positive and Negative Syndrome Scale. Results revealed that, relative to healthy controls, CGG triplet size and FMR1 mRNA were unaltered in patients with schizophrenia. However, the FMRP level was significantly reduced in patients compared with controls. We found an association between lower FMRP levels, reduced IQ, and earlier illness onset in schizophrenia. Chlorpromazine-equivalent antipsychotic dose did not correlate with FMRP levels. These results raise the possibility of impaired translation of FMR1 mRNA, altered epigenetic regulation, or increased degradation of FMRP in schizophrenia, which may play a role in dysfunctional neurodevelopmental processes and impaired neuroplasticity. © 2012 Elsevier Ireland Ltd.

Keri S.,Semmelweis University | Seres I.,Semmelweis University | Kelemen O.,Bacs Kiskun County Hospital | Benedek G.,University of Szeged
Schizophrenia Bulletin | Year: 2011

Background: Previous studies reported an association between weak habituation of skin conductance orienting response and psychosis proneness. The aim of this study was to investigate the relationship among neuregulin 1 (NRG1)-stimulated AKT phosphorylation (a putative marker of psychosis), orienting response habituation, delusional ideas, anxiety, and depression in nonclinical individuals. Methods: One hundred twenty individuals participated in the skin conductance measurements. Weak and strong habituators were compared on measures of NRG1-stimulated AKT phosphorylation in B lymphoblasts, delusional ideas, anxiety, and depression. The predictors of delusional ideas were determined by multiple regression analysis. Results: Weak habituators displayed higher levels of delusional ideas/anxiety and a lower ratio of phosphorylated AKT as compared with strong habituators. There were 3 significant predictors of delusional ideas: decreased habituation, NRG1-induced AKT phosphorylation, and anxiety. Age, gender, education, IQ, and depression did not predict delusional ideas. Conclusions: These results suggest that decreased habituation of arousal, NRG1-induced AKT phosphorylation, and anxiety are related to delusional ideation in the general population. © 2010 The Author.

Ruzsa Z.,Bacs Kiskun County Hospital | Pinter L.,Augusta Hospital | Kolvenbach R.,Augusta Hospital
Catheterization and Cardiovascular Interventions | Year: 2012

Management of critical limb ischemia (CLI) requires a combined treatment approach: optimal medical therapy and revascularization procedures are both essential for favorable outcome. With the development of endovascular interventions these new modalities took the primary role in limb revascularization, especially in CLI patients, where the culprit lesion is often located below the knee (BTK) level, making the surgical procedure unfeasible. In our present case report, we demonstrate a successful percutaneous recanalization of a surgically non-treatable tibioperoneal trunk occlusion. The procedure was performed with dual access from anterograde and retrograde transpedal approach, and modified "V stenting" technique was used. We describe feasibility of bail out stenting using retrograde posterior tibial artery access after failed retrograde guidewire externalization. Our report discusses the feasibility, safety, and efficacy of the retrograde approach applying 4F compatible devices. Copyright © 2012 Wiley Periodicals, Inc.

Szamosi A.,National Psychiatry Center | Kelemen O.,Bacs Kiskun County Hospital | Keri S.,National Psychiatry Center | Keri S.,University of Szeged
Journal of Psychiatric Research | Year: 2012

Objective: The phosphoinositide 3'-kinase (PI3K) - protein kinase B (AKT1) - glycogen synthase kinase (GSK)-3β system is modulated by several factors implicated in the pathophysiology of schizophrenia. Evidence suggests that neuregulin 1 (NRG1) induces decreased AKT phosphorylation in schizophrenia relative to healthy controls, which may be related to dysfunctional neurodevelopment and neuroplasticity. The aim of this study was to investigate the relationship between NRG1 - induced AKT phosphorylation and hippocampal volume in schizophrenia. Methods: Participants were 20 first-episode patients with schizophrenia who did not receive psychotropic medications and 20 matched healthy controls. We measured the phosphorylated AKT - total AKT and phosphorylated ERK (extracellular signal-regulated kinase) - total ERK ratios in peripheral lymphoblasts before and after NRG1 administration. Whole-brain, left, and right hippocampal volumes were quantified using FreeSurfer software. Results: Patients with schizophrenia displayed decreased AKT but normal ERK ratio compared with controls. Patients also had a reduction in left hippocampal volume. There was no significant difference between patients and controls in whole-brain and right hippocampal volume. Decreased AKT ratio was associated with reduced hippocampal volume. There was no significant relationship between ERK ratio and brain structure. Conclusion: Activation of the AKT system is specifically associated with hippocampal volume in first-episode schizophrenia, which provides further evidence for the pivotal role of this messenger system in the pathophysiology of psychotic disorders. © 2011 Elsevier Ltd.

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