Gábor István

Publications (13)6.58 Total impact

• Article: [Perineal soft-tissue reconstruction with vertical rectus abdominis myocutan (VRAM) flap following extended abdomino-perineal resection for cancer].

  Gábor Bognár, András Novák, Gábor István, Zoltán Lóderer, György Ledniczky, Pál Ondrejka
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  ABSTRACT: Perineal wound healing problems following extended abdomino-perineal resection of ano-rectal cancer represent a great challenge to the surgeon. Perineal soft-tissue reconstruction with a myocutan flap was thought to reduce surgical wound healing complications. A review of the relevant literature was carried out on perineal soft-tissue reconstruction with rectus abdominis myocutan (VRAM) flap following extended abdomino-perineal rectal resection for cancer. The more commonly used neoadjuvant chemo- and radiotherapy as well as extended surgical radicality resulted in increased perioperative risks, therefore combined procedures between the colorectal and plastic surgical teams are inevitable. This case report illustrates the above trend.
  Magyar Sebészet (Hungarian Journal of Surgery) 10/2012; 65(5):388-95.
• Article: [Analysis of two different operative techniques for laparoscopic splenectomy].

  Gábor Bognár, Gábor István, György Ledniczky, Loránd Barabás, Pál Ondrejka
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  ABSTRACT: Laparosocopic splenectomy gradually became the gold standard procedure in the surgical treatment of certain haematological disorders. Operative experience in laparoscopic procedures facilitates the comparison of various techniques. Two variants in laparoscopic spelenectomy are analysed and presented. Sixteen patients underwent laparoscopic spelenectomy. Anterior- and postero-anterior laparoscopic approaches are compared with respect to clinicopathologic features. Using the postero-anterior technique dissection of splenic hilum is more straightforward, recognition of accessory spleen is easier and the likelihood of intraoperative complications is less. In selected cases of splenomegaly the anterior technique is recommended though.
  Magyar Sebészet (Hungarian Journal of Surgery) 12/2010; 63(6):359-63.
• Article: [Prognostic role of vascularisation and proliferation in rectal cancer with liver metastasis].

  Gábor Bognár, Andreas Imdahl, Bíborka Bereczky, György Ledniczky, Gábor István, Eva Katalin Tóth, Christian Ihling, Pál Ondrejka
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  ABSTRACT: The present study was designed to provide an analysis of factors for angiogenesis and proliferation. We analyzed tumor tissues from 37 rectal cancer patients with concurrent or subsequent liver metastasis underwent preoperative radiotherapy, surgery and adjuvant chemotherapy. Immunohistochemistry was used for expression of proliferation (staining with anti-Ki67: MIB-1) and for detection of microvessel density (MVD, expressed by CD34). Clinicopathological findings were compared with outcome with emphasis to IHC. A vascular enumeration and pN status and the time of presence of the metastases has shown prognostic role along with the factors above. Increased proliferative activity of the tumor as expressed by MIB-1 staining has no prognostic value, similarly to the localization of tumor, gender, age or grading. Different prognostic and predictive factors in colorectal cancer have been reported. Higher pN status and tumor vascularisation has been linked to poor prognosis in overall survival and tumor recurrence.
  Magyar Sebészet (Hungarian Journal of Surgery) 03/2009; 62(1):15-21.
• Article: Serum cathepsin B and plasma urokinase-type plasminogen activator levels in gastrointestinal tract cancers.

  László Herszényi, Gábor István, Romilda Cardin, Massimo De Paoli, Mario Plebani, Zsolt Tulassay, Fabio Farinati
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  ABSTRACT: Cathepsin B (CATB) and urokinase-type plasminogen activator (UPA) play an important part in cancer invasion and metastasis. The behavior of CATB and UPA has not been evaluated in the same experimental setting in different gastrointestinal tumors and in precancerous lesions. Serum CATB and plasma UPA levels were determined by enzyme-linked immunoadsorbent assay and their sensitivity, specificity, and diagnostic accuracy have been calculated in patients with colorectal (n=72), gastric (n=30), hepatocellular (n=28), and pancreatic cancer (n=15) as well as in gastric epithelial dysplasia (n=25), colorectal adenomas (n=30), and tumor-free control patients (n=44). Serum CATB and plasma UPA antigen concentrations were significantly higher in patients with cancer than in controls. When all tumors were considered, the sensitivity, specificity, and diagnostic accuracy of CATB (89, 86, and 89%) were higher than that of UPA (76, 70, and 74%). CATB demonstrated in all types of tumors a better diagnostic accuracy than UPA. The positive predictive values of CATB (95%) and UPA (89%) may suggest their use in the evaluation of patients with a suspicion of malignancy. CATB and UPA were significantly higher in patients with gastric epithelial dysplasia and colorectal adenomas than in controls. Antigen levels of CATB and UPA were significantly correlated in both cancers and precancerous lesions. At the time of clinical presentation, serum CATB and plasma UPA antigen levels are sensitive indicators of gastrointestinal malignancies. Determination of serum CATB and plasma UPA levels may be useful to identify patients at a higher risk for progression to cancer, who could be subjected to a more strict follow-up protocol.
  European journal of cancer prevention: the official journal of the European Cancer Prevention Organisation (ECP) 11/2008; 17(5):438-45. · 2.21 Impact Factor
• Article: [Detection of human papilloma virus type 16 in squamous cell carcinoma of colon and its lymph node metastases].

  Gábor Bognár, Gábor István, György Ledniczky, Pál Ondrejka
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  ABSTRACT: The etiological role of human papilloma virus (HPV) in a number of squamous cell malignant tumours is well known. Squamous cell carcinoma of colon (SCC) is a rare disease with uncertain etiology. Our objective was to detect possible HPV infection in a colon SCC patient. The 94-year-old female patient was operated for an obstructive colon tumour. Histology confirmed SCC. Tumour tissue and the removed lymph nodes were examined with polymerase chain reaction and Southern blot hybridization techniques. From HPV types 16 and 18, which most commonly associated with malignant tumours, the presence of HPV type 16 could be confirmed in the primary tumour and in 4 out of the 9 surrounding lymph nodes (of which 2 were metastatic). HPV-16 infection was detected in a colon cancer patient with SCC histological type in the primary tumour and in surrounding lymph nodes. According to our knowledge, no similar study has been published yet.
  Magyar Sebészet (Hungarian Journal of Surgery) 09/2008; 61(4):225-9.
• Article: [Successfully treated case of postoperative mesenteric panniculitis].

  Gábor Bognár, Bence Forgács, Gábor István, Bíborka Bereczky, Lajos Berczi, György Ledniczky, Pál Ondrejka
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  ABSTRACT: Mesenteric panniculitis can develop in every patient after abdominal surgery. The clinical and pathological signs are usually vague, so different therapeutic approaches are recommended at various stages of the disease. While some authors suggest that these stages are different manifestations of the the same disease, others claim that the various stages represent the progression of a single entity. We report a case of a 65 year-old male patient with mesenteric panniculitis and fibrosis, which developed after laparoscopic sigmoid resection first, and required a Hartmann's procedure finally. The disease developed once again after the elective reconstruction of the colon. This time surgical intervention was not possible and he was treated conservatively with intravenous steroids, antibiotics, parenteral nutrition and continuous nasogastric tube. The patient gradually recovered in three weeks time. We report this successful treatment, and review the relevant literature.
  Magyar Sebészet (Hungarian Journal of Surgery) 05/2008; 61(2):84-7.
• Source

  Available from: Istvan Hritz

  Article: Tumor marker utility and prognostic relevance of cathepsin B, cathepsin L, urokinase-type plasminogen activator, plasminogen activator inhibitor type-1, CEA and CA 19-9 in colorectal cancer.

  László Herszényi, Fabio Farinati, Romilda Cardin, Gábor István, László D Molnár, István Hritz, Massimo De Paoli, Mario Plebani, Zsolt Tulassay
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  ABSTRACT: Cathepsin B and L (CATB, CATL), urokinase-type plasminogen activator (uPA) and its inhibitor PAI-1 play an important role in colorectal cancer invasion. The tumor marker utility and prognostic relevance of these proteases have not been evaluated in the same experimental setting and compared with that of CEA and CA-19-9. Protease, CEA and CA 19-9 serum or plasma levels were determined in 56 patients with colorectal cancer, 25 patients with ulcerative colitis, 26 patients with colorectal adenomas and 35 tumor-free control patients. Protease, CEA, CA 19-9 levels have been determined by ELISA and electrochemiluminescence immunoassay, respectively; their sensitivity, specificity, diagnostic accuracy have been calculated and correlated with clinicopathological staging. The protease antigen levels were significantly higher in colorectal cancer compared with other groups. Sensitivity of PAI-1 (94%), CATB (82%), uPA (69%), CATL (41%) were higher than those of CEA or CA 19-9 (30% and 18%, respectively). PAI-1, CATB and uPA demonstrated a better accuracy than CEA or CA 19-9. A combination of PAI-1 with CATB or uPA exhibited the highest sensitivity value (98%). High CATB, PAI-1, CEA and CA 19-9 levels correlated with advanced Dukes stages. CATB (P = 0.0004), CATL (P = 0.02), PAI-1 (P = 0.01) and CA 19-9 (P = 0.004) had a significant prognostic impact. PAI-1 (P = 0.001), CATB (P = 0.04) and CA 19-9 (P = 0.02) proved as independent prognostic variables. At the time of clinical detection proteases are more sensitive indicators for colorectal cancer than the commonly used tumor markers. Determinations of CATB, CATL and PAI-1 have a major prognostic impact in patients with colorectal cancer.
  BMC Cancer 02/2008; 8:194. · 3.01 Impact Factor
• Article: Detection of human papillomavirus type 16 in squamous cell carcinoma of the colon and its lymph node metastases with PCR and southern blot hybridization.

  Gábor Bognár, Gábor István, Bíborka Bereczky, Pál Ondrejka
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  ABSTRACT: The etiological role of human papillomavirus (HPV) in a number of squamous malignant tumors is well known. Squamous cell carcinoma (SCC) of colon is a rare disease with uncertain etiology. Our objective was to detect possible HPV infection in a colon SCC patient. The 94-year-old female patient was operated due to colon tumor causing passage disturbances. Histology confirmed SCC. Tumor tissue and the removed lymph nodes were examined with polymerase chain reaction and Southern blot hybridization techniques. Of HPV types most often occurring in malignant tumors (16, 18) the presence of HPV type 16 could be confirmed in the primary tumor and in four out of the nine surrounding lymph nodes, of which two were metastatic. HPV-16 infection could be detected in an SCC patient in the primary tumor and in surrounding lymph nodes. According to our knowledge, no similar study has been published yet.
  Pathology & Oncology Research 02/2008; 14(1):93-6. · 1.37 Impact Factor
• Article: Tumor marker utility and prognostic relevance of cathepsin B, cathepsin L, urokinase-type plasminogen activator, plasminogen activator inhibitor type-1, CEA and CA 19-9 in colorectal cancer

  László Herszényi, Fabio Farinati, Romilda Cardin, Gábor István, László Molnár, István Hritz, De Paoli Massimo, Mario Plebani, Zsolt Tulassay
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  ABSTRACT: Abstract Background Cathepsin B and L (CATB, CATL), urokinase-type plasminogen activator (uPA) and its inhibitor PAI-1 play an important role in colorectal cancer invasion. The tumor marker utility and prognostic relevance of these proteases have not been evaluated in the same experimental setting and compared with that of CEA and CA-19-9. Methods Protease, CEA and CA 19-9 serum or plasma levels were determined in 56 patients with colorectal cancer, 25 patients with ulcerative colitis, 26 patients with colorectal adenomas and 35 tumor-free control patients. Protease, CEA, CA 19-9 levels have been determined by ELISA and electrochemiluminescence immunoassay, respectively; their sensitivity, specificity, diagnostic accuracy have been calculated and correlated with clinicopathological staging. Results The protease antigen levels were significantly higher in colorectal cancer compared with other groups. Sensitivity of PAI-1 (94%), CATB (82%), uPA (69%), CATL (41%) were higher than those of CEA or CA 19-9 (30% and 18%, respectively). PAI-1, CATB and uPA demonstrated a better accuracy than CEA or CA 19-9. A combination of PAI-1 with CATB or uPA exhibited the highest sensitivity value (98%). High CATB, PAI-1, CEA and CA 19-9 levels correlated with advanced Dukes stages. CATB ( P = 0.0004), CATL ( P = 0.02), PAI-1 ( P = 0.01) and CA 19-9 ( P = 0.004) had a significant prognostic impact. PAI-1 ( P = 0.001), CATB ( P = 0.04) and CA 19-9 ( P = 0.02) proved as independent prognostic variables. Conclusion At the time of clinical detection proteases are more sensitive indicators for colorectal cancer than the commonly used tumor markers. Determinations of CATB, CATL and PAI-1 have a major prognostic impact in patients with colorectal cancer.
  BMC Cancer. 01/2008;
• Article: [Molecular mechanisms in development of colorectal cancer metastasis].

  Gábor Bognár, György Ledniczky, Gábor István, Pál Ondrejka
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  ABSTRACT: The colorectal cancer can be mainly treated by surgery. Metastases are responsible for the poor prognosis. Development of metastases is a difficult, multi-level regulated process with complex molecular interactions. During the past decade, these mechanisms have become better known. Some parts of it had been clarified, others are still targets of the research. Analysis of this system can lead to find substances or methods, which could inhibit the development of metastases. Our aim was an exposition of the factors taking part in the process of development of colorectal metastases.
  Magyar Sebészet (Hungarian Journal of Surgery) 11/2006; 59(5):342-9.
• Article: [Large-bowel necrosis following open-heart surgery].

  István Sugár, Gábor István, Akos Szabó, Eszter Tulassay, Pál Ondrejka, Zoltán Szabolcs
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  ABSTRACT: In the last 2 years 9 patients have been operated on in our surgical department because of colon necrosis which developed after open heart surgery. The symptoms--abdominal distension, circumscript peritonitis in the right lower part of the abdomen--developed 2-4 days after the heart operation. Laparotomies were carried out within 2 days from the onset of symptoms in all but one patient. In 7 patients the necrosis of the right colon, while in 2 other patients extreme dilatation of the colon was found. In 6 patients right hemicolectomy was carried out. One operation was finished without anastomosis with double stomas. In the 2 patients with no necrosis catheter-cecostomy was performed. All patients but one after hemicolectomy with reconstruction died after several reoperations because of suture leak. The other 3 patients were cured. We examined and analysed the pre-, intra- and postoperative circumstances of the heart operations, which lead to the severe complications. We think the cause of the problems was the liberal use of wide spectrum antibiotics with caused severe dysbacteriosis and Clostridium difficile toxicosis in the colon. This condition could lead to a pseudomembraneous colitis which resulted in the colon necrosis.
  Magyar Sebészet (Hungarian Journal of Surgery) 01/2006; 58(6):398-401.
• Article: [Uncommon case of incomplete left paraduodenal hernia].

  Bence Forgács, Gábor István, István Sugár, Pál Ondrejka
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  ABSTRACT: Internal hernias are very rare. The hernial orifice, sac and content are situated inside the abdomen. Paraduodenal hernias are relatively rare congenital malformations and account about 50 per cent of all internal hernias. The cause of this malformation is the incomplete rotation of the mid-gut. Right and left paraduodenal hernias are different, varying in anatomic structure and embryological origin. In right paraduodenal hernia the small bowel is partially or completely localised behind the mesocolon of the ascending colon, in left paraduodenal hernia behind the mesocolon of the descending colon. That is why the widely used name "mesocolic" hernia is more convenient, because it refers on the pathogenesis of the disorder. The complaints can vary from recurrent atypical abdominal pains to the complete small bowel obstruction, but often there are no complaints. Abdominal CT scan and the barium meal provide the best diagnostic approach for paraduodenal hernias, but it will be recognised very often only at an emergency operation. A case of small bowel obstruction caused by incomplete left paraduodenal hernia discovered after swallowing a foreign body is described with pathogenesis, diagnosis and possible treatments for the disease.
  Magyar Sebészet (Hungarian Journal of Surgery) 01/2004; 56(6):243-6.
• Article: [Skin closure in inguinal hernia repair with rapidly absorbing Polyglactin 910/370 (Vicryl-Rapide) suture material].

  Szilárd Szabó, Gábor István
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  ABSTRACT: Results of fast absorbing Poliglactin 910/370 suture material were assessed in skin closure following invaginal hernia repairs. Fifty consecutive patients undergoing invaginal hernia repair were prospectively and randomly assigned in two groups. In Group I, wounds were closed with conventional absorbable subcutaneous Polyglactin 910 (VICRYL, ETHICON) and non absorbable cutaneous Monofilament Nylon (ETHILON, ETHICON) stitches. In Group II, running subcutaneous and intradermic irradiated Polyglactin 910/370 (VICRYL-Rapide, ETHICON) sutures were used. The time of skin closure, the price of the suture material, short and middle term cosmetic results, complications in wound healing and the subjective comfort of patients were noted. The cost of skin closing was similar, while the need for further medical wistis was lower in the VICRYL-Rapide group. The wound healing process and it's cosmetic results were similar. Patients in Group II experienced less discomfort, due to the avoidance of suture removal. The rapidly resorbing suture material (VICRYL-Rapide) is a cost effective choice for closing the skin of invaginal hernia repairs and probably of other clean operations.
  Magyar Sebészet (Hungarian Journal of Surgery) 05/2002; 55(2):77-80.