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Biomedical subjects

D Görög

Publications and source records attributed to D Görög.

At least 19 recordsLinked to original sources
PubMed2001

[Viral screening of organ donors and human cytomegalovirus seroprevalence in the Hungarian population].

The authors investigated 998 organ-donors for Human cytomegalovirus seroprevalence. The donors were divided into three age-groups. In organ-donors the seroprevalence was found to be 84%. A study was also conducted on a fourth group consisting of 200 residents from an old-age home. The youngest donor was 2 years of age, the eldest old-age home resident was of 92 years. The examined persons represent the hungarian population. It was found that as the result of the investigation of all 1198 subjects, the Human cytomegalovirus overall seroprevalence in Hungary is 86%. The age specific prevalence increases starting from 73% in the first group (2 to 20 years old) to 99% in the fourth group (71 to 92 years old). This has indicated that most of the population acquired the primary infection in the childhood or during early adulthood. According to these results the authors resumed that in Hungary the Human cytomegalovirus seroprevalence is high. This would cause problems when a seronegative organ-recipient needs an organ transplantation. Between males and females a significant difference of Human cytomegalovirus seroprevalence was found: 89% of females were seropositive in contrast to 81% of males (p < 0.05). The organ-donors were also examined for the presence of HBsAg, anti-HCV and anti-HIV. 1.8% of donors were HbsAg positive, 0.9% were anti-HCV positive and 1 person was anti-HIV positive, but these results weren't verificated.

Adolescent↗
PubMed2001

[Qualitative and quantitative detection of hepatitis C virus RNA by PCR technique. Monitoring of viral copies after liver transplantation].

The authors demonstrate the HCV nucleic acid amplification method is not wide-spread in Hungary yet. The HCV-RNA is usually detectable 2-4 weeks after infection independently the immunostate of the patients. The authors help to select the adequate measurement(s) in logical order when HCV infection is suspected. The benefit of the PCR method is emphasized. Monitoring of the HCV-RNA titer of the liver transplanted patients promotes to establish the fluctuation of HCV-RNA copies and the effectivity of therapy following transplantation. The detection of HCV-RNA by PCR method is a proof of an acute or chronic infection and rules out past infection. The quantitative PCR measurement is useful for determination of indication and control of efficacy of antiviral therapy.

Adult↗
PubMed2001

[Pathologic evaluation of orthotopic liver transplantation in Hungary].

A total of 81 orthotopic liver transplantations were performed on 74 patients between January 1995 and December 1999 at the Department of Transplantation and Surgery of the Semmelweis University in Budapest. Indication for transplantation was liver cirrhosis in 57 cases, 10 patients were transplanted due to fulminant liver failure, while 7 patients underwent transplantation because of liver metastasis of different semimalignant tumours. During the above period, retrospective studies on 205 pre- and posttransplantation liver biopsies, 74 explanted livers, 7 explanted liver grafts and 22 autopsy cases were performed at the First Institute of Pathology and Experimental Cancer Research of the Semmelweis University in Budapest. A number of 116 protocol biopsies (dates as zero time, 7th day, 6th month and 12th month) and 73 non-protocol biopsies (taken due to liver allograft dysfunction) were analysed. Different gradings of acute rejection--characterised by trias of portal inflammation, venous endothelitis and bile duct damage--were detected in 62 cases. Chronic rejection occurred in 7 patients, with 4 cases of vanishing bile duct syndrome and one of the case of foam cell arteriopathy, add to 2 cases of chronic rejection characterized by undetermined bile duct damage. The present study includes the evaluation of 22 autopsy cases according to liver transplantation in Hungary, with the finding that liver allograft insufficiency was the main cause of mortality. Authors conclude that pathomorphological analysis has an important role in relation to liver transplantation.

Acute Disease↗
PubMed1999

[Severe relapse of hepatitis C following liver transplantation. Successful treatment with a combination of interferon-alpha and ribavirin].

A 38-year-old, male patient, with end-stage HCV cirrhosis, underwent liver transplantation (OLT). After a sufficient recovery a rapid elevation of ALT and profound jaundice developed 3 months after OLT, together with a 15-fold rise of pre-transplant HCV RNS level. Liver biopsy was carried out, histology excluded rejection and signs of acute hepatitis were observed. Interferon alpha 2b 3 MU TIW and ribavirin 800 mg/day resulted in normalization of ALT, se. bilirubin and decrease of viral load by 90 per cent at the 3rd month of treatment. Improvement of hepatitis and no rejection was shown by control histology. A 6-month combination therapy followed by continuous ribavirin monotherapy maintains a permanent good condition with normal ALT, no icterus, a continuously low HCV RNA level and a mild chronic hepatitis with fibrosis in the liver histology 18 months after OLT. Danger of HCV reactivation after OLT, difficulties of diagnosis, interactions of immunostimulant and immunosuppressive drugs, advantages of combination therapy are discussed.

Adult↗
PubMed1999

Dipeptidyl peptidase activity of CD26 in serum and urine as a marker of cholestasis: experimental and clinical evidence.

Dipeptidyl peptidase IV (CD26) is a membrane-associated enzyme that is expressed on the surface of T cells and on the hepatocyte brush border. In a soluble form it is present in serum. CD26 has been implicated in the regulation of T cell activation and in the metabolism of hormones and cytokines. Dipeptidyl peptidase (DPP) activity is elevated in the urine and serum of patients with biliary atresia (BA). To clarify the role of cholestasis in the development of increased serum and urinary DPP/CD26 activity, we studied the mechanism of activity increase in experimentally induced cholestasis of CD26-deficient and wild-type rats. The clinical utility of serum and urinary DPP/CD26 activity measurements was tested in adult and pediatric patients with hepatobiliary diseases and in liver transplant recipients. The results establish CD26-associated serum DPP activity as a novel, clinically useful marker of cholestasis and demonstrate that in contrast with alkaline phosphatase levels, DPP levels do not change in metastatic bone disease. Additionally, DPP activity is useful as a urinary test of cholestasis in infants who are not receiving nephrotoxic medication.

Alkaline Phosphatase↗
PubMed1997

Prognosis of untreated liver metastasis from rectal cancer.

UNLABELLED: Majority of studies based of treatment of liver metastases from colorectal cancer compare their results to historical controls that include patients having untreated secondary liver tumours. The aim of this study was to show the natural history of patients with liver metastasis from rectal cancer. Data of 303 patients underwent laparotomy between 1984 and 1992 were reviewed. 47 of 57 patients who had liver metastasis at the time of surgery fulfilled the criteria of the study. The mean survival time was 8.5 (1-27) months for all patients, 11 months for patients with solitary hepatic tumour (n = 13) and 7.5 months for those with multiple tumours (n = 34). Patients who had liver and other distant metastases simultaneously (n = 9) survived a shorter time than those with hepatic secondaries only (4 and 9 months respectively). The mean survival time for patients in whom the primary tumour was resected (n = 17) was 11 months contrary to 7 months for those who underwent colostomy or exploratory laparotomy, but comparison of survival curves didn't revealed significant difference between the two groups. CONCLUSIONS: The incidence of liver metastases from rectal cancer at the time of laparotomy was 19%. The prognosis was very poor in case of synchronous secondary tumours. Palliative resection of the primary tumour is recommended for selected patients only to control local symptoms.

Carcinoma↗
PubMed1997

Our preliminary results in application of Stoppa technique for recurrent groin hernia.

In 1994 we have started the Stoppa technique which was only used for the recurrent groin hernia repair, when Mersilene mesh was implanted in preperitoneal position from a lower midline incision. From March, 1994 to March, 1996 seventeen Stoppa procedures were performed in our department (14 men, 3 women, mean age of 66 years). Type of hernias: 13 unilaterale, 3 bilaterale recurrent groin hernias and 1 primary bilaterale groin hernia combined with a lower midline incisional hernia. Operations were performed by 7 surgeons. The mean time of the surgery was 85 min. (35-165). The mean postoperative stay in the hospital was 9 days (7-19). The Stoppa technique could be performed in all patients. Serious early postoperative complications didn't occur. The two late recurrences were observed amongst the first five patients. All implanted mesh were well tolerated by the patients. Author believe, this procedure has some advantages: the site of the incision is located in a new place from where the dissection is easier than in the previous incision, the stich fistulas from the previous operation can be avoided, furthermore this method could be applicated for combined hernias located in the lower part of abdomen and it is cheaper than the laparoscopic hernioplasty.

Aged↗
PubMed1997

Prospective randomized trial comparing Shouldice and Bassini-Kirschner operation technique in primary inguinal hernia repair.

The authors conducted a prospective randomized trial to compare the Shouldice and the Bassini-Kirschner technique between April, 1994 and December, 1995. During this period 129 adult patients, mean age 54 (17-87) years underwent operation on primary inguinal hernias in their department. 63 Shouldice and 66 Bassini-Kirschner operations were performed by 17 surgeons. The duration of surgery, the technique of anesthesia, the perioperative complications, the duration of postoperative care, then one year after the operation the recurrence rate and the patient's subjective complains were investigated. 85 patients of 129 were examined one year after the operation in spite of that all the patients were invited for control. Both operations gave almost the same results in the perioperative period and nearly identical recurrence rate (4.44% in Shouldice and 5.0% in Bassini-Kirschner group). The patient's subjective complains were also very similar one year after the operation. The authors could not find significant difference in the results of the two types of surgery although they were well experienced with the Bassini-Kirschner operation and just starting to practice the Shouldice procedure. These facts suggest that having more experience with the Shouldice operation makes available the extreme low recurrence rate published by several authors.

Adolescent↗
PubMed1997

Benefits of cell saver during the operation of gastric haemorrhage following repeated pancreatitis.

Authors report on a case of repeated pancreatitis causing several characteristic complications and concluded to splenic vein thrombosis, with an enlarged perisplenic vein network. The source of gastrointestinal bleeding is uncommon: originates from the submucous vein of the stomach. Cell saver was used under splenectomy because of great blood loss, and due to hyperimmunization occurred as consequence of massive transfusion. The benefit of cell saver was clearly evident from both point of view.

Adult↗
PubMed1996

[Experience gained from the organization of the first group of patients who benefited from liver transplantation].

The authors report in this ciency in the majority of the cases was alcohol abuse or article about their experiences, how could they select a small group of patients awaiting liver transplantation since September 1994. The cause of the liver insuffiHCV infection. During 37 weeks 3 liver transplantations were performed and 5 patients died on the waiting list. (15,6% of the patients on the waiting list.)

Adult↗
PubMed1996

[Availability of livers from cadaver donors in Hungary].

The availability of cadaver livers for transplantation have been studied based on data recorded prospectively by authors. Between January 1, 1995 and August 31, 1995, 98 cadaver kidney donors were accepted in Hungary. Using well established selection criteria 52 of them could have been suitable for liver donation. Steatosis or cirrhosis of the donor livers have been considered most frequent causes of unsuitability for transplantation. Based on these data 70-75 cadaver livers could be transplanted yearly in Hungary that's enough to start a transplant program. The treatment of acute hepatic failure with transplantation seems to be uncertain because of unequal time and blood group distribution of donors. There are just few available cadaver livers for children therefore transplantation of reduced sized liver is needed.

Blood Group Incompatibility↗
PubMed1996

[Small intestinal leiomyoma causing gastrointestinal hemorrhage].

Leiomyomas are uncommon benign tumors of smooth muscle which may occur wherever smooth muscle is present. The small bowel is the most frequent site. Bleeding is the most common presenting symptom. Other symptoms, nausea, vomiting, abdominal pain are rare. In this article a 44 year-old male, presented, who was admitted with intermittent gastrointestinal bleeding in requence of jejunal leiomyoma with exulceration.

Adult↗
PubMed1996

[The effect of blood transfusion on the late results of the surgical treatment of rectal cancer].

UNLABELLED: Prospectively recorded data of 149 patients undergoing curative resection for rectal cancer between 1985-1992 were evaluated. Survival rate and tumor recurrence were studied in transfused and non-transfused groups of patients. There wasn't statistically significant difference found between the two groups concerning the 5 year survival rate (53 and 59%). Whole blood had more deleterious effect on survival than packed red cells (48 versus 61%), but the difference didn't reach the statistical significance level. The 5 year survival rate of patients without transfusion was significantly higher (p < 0.05) than those received > 800 ml of blood (59 v.s. 33%). The tumor recurrence wasn't associated with transfusion. Neither the quality, nor the amount of blood seems to influence on the recurrence rate significantly. In the group of patients with > 800 ml of transfusion the lower preoperative hematocrit, the higher rate of abdominoperineal resection of the rectum and the longer duration of surgery than those of patients nontransfused reflect the unfavorable tumor stage and the difficulties in removing the tumor. Authors believe these circumstances necessitating the transfusion may be responsible for worse outcome of rectal cancer but the immunosuppressive effect of the blood can't be excluded. CONCLUSIONS: stricter indication than earlier is necessary for administration of blood transfusion to patients with rectal cancer to decrease the risk of transfusion-transmitted infections and to avoid the possible immunosuppressive effect of the blood. Packed red cells is preferable. Decreasing volume of perioperative homologous transfusion by improving surgical technique and clinical application of autologous transfusion should be considered.

Blood Transfusion, Autologous↗
PubMed1996

The results of 1009 kidney transplantations performed in Hungary.

Kidney transplantation is a widely used method throughout the world for the treatment of end-stage renal disease. Following the pioneering work of Szeged Medical University Hospital and Miskolc District General Hospital, the first successful kidney transplantation in Hungary was performed at the Department of Transplantation and Surgery at Semmelweis Medical University on November 16, 1973. This patient is still alive with a functioning kidney graft after 21 years. We report herein our review of the global results of Hungarian kidney transplantation. Hungary is a medium-developed country with a population of over 10 million where the gross national product is about 4000 U.S. dollars per person per year. In Hungary there are 49 dialysis centers, 4 immunological laboratories, and 4 transplantation centers.

Adolescent↗
PubMed1994

[The role of local excision in the surgical treatment of rectal cancer].

UNLABELLED: Between 1984 and 1992 authors performed 307 surgical interventions for patients with rectal cancer, of these 199 operations were curative (65%). Local excision of the tumour was carried out in 9 cases: 2 with palliative intent, 7 were considered a curative treatment, that constituted 3.5% of all curative procedures. Five tumours were removed by transanal local excision, 2 located in the upper part of the rectum required laparotomy and rectotomy. No operative mortality. One wound sepsis was registered after laparotomy. There was one local recurrence after removing the primary tumour. At the same time 83 patients suffering abdominoperineal resection or anterior resection had tumour limited to the rectal wall without lymph node metastasis. The mortality was 1.4%, the morbidity 28% and local recurrence rate was 19% in this group. The difference between the the results of the two groups did not achieve statistical significance included the survival too. Of the 83 tumours removed by more radical operations 38 located between 1-8 cm from the anal verge. Excluding tumours poorly differentiated and those with diameter larger than 3 cm, 17 rectal cancer would have been suitable for transanal local excision, that constitutes 8.5% of the curative operations. CONCLUSION: with more accurate preoperative staging the transanal local excision for carcinoma of the rectum can be performed more frequently than earlier. The risk of the operation is lower than those of the abdominoperineal or anterior resection and the late results are comparable if strict selection criteria are implemented.

Abdomen↗
PubMed1991

[Initial experience with ultrasonic examination of the rectum].

The authors report their initial results obtained by the use of transrectal sonography in examination of known or suspected rectal and perirectal masses. 42 patients were examined with commercially available endosonographic probes. 22 patients had known rectal cancer. 13 patients underwent surgical exploration. Malignant infiltration of perirectal fat were detected as accurately with US as with histology in 9 cases. Lymph node involvement was accurately identified in 11 cases. They recommend this new technique for the assessment of invasion of rectal tumours and lymph node involvement, for postoperative follow-up and for examination of benign diseases of the rectum.

Adult↗