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D Zadrozny

Publications and source records attributed to D Zadrozny.

18 recordsLinked to original sources
PubMed2003

Hemolytic anemia after renal transplantation: analysis of case reports.

Hemolysis after renal transplantation in some cases is clearly related to hemolytic-uremic syndrome (HUS) and usually attributed to cyclosporine (CsA) treatment. Acute hemolysis in other recipients is related to anti-erythrocyte autoantibodies. In most cases these patients have received ABO-compatible, although ABO-nonidentical, organs, mostly from O blood group donors. We report three cases of autoimmune hemolytic anemia after renal transplantation. Two patients (patients: 1 and 2; ABO-compatible, but nonidentical kidneys) suffered acute hemolysis in the third week after transplantation. One patient (patient 3: ABO-identical kidney) suffered a chronic, subclinical course of disease beginning 5 months after transplantation. The clinical picture of this disease was completely different from HUS. The existence of severe anemia (patients 1 and 2), hyperbilirubinemia (particularly high in patient 3), increased serum lactic dehydrogenase levels, and decreased serum haptoglobin in the presence of good graft function suggested an hemolytic anemia. In all patients the direct antiglobulin test was positive. The acute or chronic symptoms of hemolysis disappeared, at 2 and 5 weeks, respectively, after conversion from CsA to tacrolimus. Hemolysis in these patients probably relates to alloantibodies derived from passenger B lymphocytes transplanted with the organs. Because hemolysis has been most frequently related to CsA therapy, it is suggested that B lymphocytes proliferated and produced antibodies because CsA effects to inhibit T-cell function generally spares B-cell activity. It is proposed that a subtype of B cells, which are resistant to CsA, produces anti-A and/or anti-B antibodies. Treatment with tacrolimus appears to be successful, probably due to its alternate, and likely more effective, manner of B-cell suppression.

ABO Blood-Group System↗
PubMed2000

Small intestine perforation because of capacitive coupling as a cause of abdominal wall gas gangrene and clostridial sepsis after laparoscopic cholecystectomy.

The authors present a case report regarding abdominal wall gas gangrene and clostridial sepsis after laparoscopic cholecystectomy. Capacitive coupling was considered to be the most probable cause of small intestine perforation and further complications. Despite intensive treatment, the 69-year-old patient died.

Abdominal Abscess↗
PubMed1999

[Left-side portal hypertension as a clinical problem].

Left-sided portal hypertension (LSPH) is caused by isolated obstruction (in most cases--thrombosis) of splenic vein. In about 50% of patients it generates a haemorrhage from gastric or oesophageal varices, rarer from other sources in abdominal cavity. The most common origin of the splenic vein thrombosis is a pancreatic disease--acute or chronic pancreatitis or neoplasm. The procedure of choice in the management of the haemorrhage in these cases is splenectomy. The advantages of prophylactic splenectomy in LSPH have not been verified yet.

Acute Disease↗
PubMed1999

Two-millimeter minisite mini-laparoscopy for rescue of dysfunctional continuous ambulatory peritoneal dialysis catheters.

In addition to peritonitis, mechanical outflow obstruction is the most common complication of continuous ambulatory peritoneal dialysis. If conservative methods are unsuccessful, the insufficient catheter must be placed in the right position or freed surgically. Currently, laparoscopy appears to be the method of choice in these cases. "Standard" laparoscopy using 10- and 5-mm ports can lead to dialysate wound leakage. Two-mm mini-laparoscopy was employed in three cases with good results. In two patients, catheters are still patent (after 19 and 23 months), and in one patient, the catheter had to be replaced after 5 weeks. No postoperative complications occurred. In some cases of catheter dislodgement or wrapping, mini-laparoscopy using a 2-mm MiniSite device can replace open surgery and even "standard" laparoscopy.

Catheters, Indwelling↗
PubMed1997

[Early and late evaluation of Jurasz's operation].

In the years 1971-1996, 102 patients were treated for pancreatic pseudocysts. In 42 cases pancreatocystogastrostomy modo Jurasz was done. 12 patients operated on in the years 1971-83 were included in group I--retrospective trial, other 30 patients treated in the years 1984-96 were included to group II (prospective trial). Postoperative course was uneventful in 38 patients, remaining 4 (9%) had the following complications: bleeding from gastric mucosa 2x, or from the cysts 1 x, mechanical ileus 1x. Hospital mortality was 7% (3 patients). The cause of the death was: sepsis, pulmonary oedema, cardiac arrest. Pancreatic enzymes monitoring in the postoperative period and controlled USG and endoscopic tests (group II) indicate that emptying of the cysts takes place mainly during first 3-4 days and it's closure is completed within two weeks. The follow up period is 1 month to 13 years (mean 5 years). Recurrence of the cyst was noted only in 1 patient 2%.

Adult↗
PubMed1997

[Results of treating liver cysts].

In the years 1974-96, 27 patients aged 31-74 were treated for symptomatic pseudocysts. The duration of symptoms ranged from 3 months to 20 years. Patients were complaining for: pain in the upper abdomen (82%), feeling of fullness (59%), nausea and vomiting (41%), weight loss (23%). Diagnosis was confirmed by USG and CT except of two patients who were diagnosed during emergency surgery because of the cyst rupture. Multiple cysts were present in 4 patients others had single cysts. The treatment comprised: excision of the cyst in 13 patients, excision with partial right lobectomy in 4, fenestration in 5 (laparoscopically in two), marsupialisation of ruptured cyst in one and in remaining 4 puncturing or transcutaneous drainage. Good result of treatment was achieved in all cases. Histologic examination of the cysts revealed: serosal cyst in 18, echinococcal in 2, adenoma originating from bile ducts epithelium in the remaining. The follow up period is 3 months to 21 years. No recurrence of the cyst was noted.

Abdominal Pain↗
PubMed1997

[Repeated laparotomy for acute necrotizing pancreatitis].

In the period of 1984-1996, 569 patients were treated for acute pancreatitis and 37 of them (6.5%) developed infected pancreatic necrosis (IPN). All these patients were submitted to repeated laparotomies according to Bradley's procedure. The IPN was caused by: bile duct stones--in 11 cases, alcohol abuse-14, ERCP-6, trauma-1, in 6 cases the etiology was cryptogenic. The accuracy of imaging tests was: USG-62%, CT-100%. Sepsis was present in all cases, and multiorgan insufficiency-in 25 patients. Hospital mortality was 30% (11 patients). The most frequent reason of death was multiorgan insufficiency. The actuarial survival was 26 patients (70%).

Acute Disease↗
PubMed1997

[Prospective evaluation of treatment results while using surgical esophageal devascularization and transection for esophageal varices].

During the years 1979-1996 over 300 patients aged 2-71, with esophageal varices had been treated in our Clinic. In 104 cases extended gastroesophageal devascularization and esophageal transection combined with splenectomy was performed. According to Child-Pugh's classification 60 patients (58%) were qualified to group A and B, 44 (42%)-to group C. In 61 cases (59%) the operations were carried out electively, in 30 (29%)-as an emergency and in the remaining 13 (12%)-prophylacticly. In all cases the operation was successful in controlling preoperative variceal bleeding. Postoperative mortality amounted in 20 cases (19%): in Child's group A and B-10% and in group C-32%. The highest mortality rate was noted in group C patients operated emergently (38%). The main cause of death was developing hepatic failure (18 cases) and esophageal fistula in the remaining 2. Recurrence of esophageal varices was observed in 4 patients (4%) and the recurrence of variceal bleeding in 3 of them (3%). In other 3 cases recurrent bleeding was caused by acute mucosal lesions in the stomach. No cases of postoperative encephalopathy have been observed. Follow-up period ranged from 2 months to 15 years (mean 6.5 years) and actuarial survival-67 patients (64%). In our opinion esophageal transection with extended gastroesophageal devascularization is an effective method of controlling variceal hemorrhage, with very low recurrence rate and allows to avoid postoperative encephalopathy.

Adolescent↗
PubMed1997

[Evaluation of esophageal motility after its resection and extensive devascularization].

UNLABELLED: Almost complete lack of information concerning esophageal motility after non-shunt operations due to bleeding esophageal varices was the main stimulus of this study. Thirty seven patients from 112 treated for bleeding esophageal varices in our Clinic in the years 1993-1997, were studied. To evaluate esophageal parameters the Autronic GmbH D-7500 pH-meter, and from 1995, the Microdigitrapper 2 MB (Synectics) System were used. The latter enables 24-hour, simultaneous pH and pressure measurements. In patients before operation, and those who did not undergo surgery (24 measurements), reflux occurred in 14 (58%). In 10, the varices were qualified to gr. III and IV according to Paquet's classification. Five cases of mixed (supine/upright) reflux was observed. Among 9 patients subjected to previous sclerotherapy, 4 had reflux. Ph parameters in 14 patients examined before and after operation did not differ significantly. 24-hour pressure monitoring was performed in 24 patients. Eight were examined before and after operation. All pre and postoperative results were compared. No statistic differences were found. CONCLUSION: 1. Gastroesophageal reflux is frequent in cirrhotic patients with varices, and concerns over 50% of them. 2. No significant differences between pre and postoperative results, suggest that extensive devascularisation and esophageal transection do not affect esophageal motility significantly. 3. 24-hour combined pH and manometry is an extremely helpful method of obtaining objective motility data.

Adult↗
PubMed1997

[Changes in portal circulation after esophageal transection].

UNLABELLED: 104 patients with hepatic cirrhosis and esophageal varices were treated between 1979 and 1996 using the modified Sugiura (Hirashima) procedure. In 60 cases (18 F, 42 M) portal hemodynamics (portal blood velocity (PBV) and portal blood flow (PBF)) were investigated using Doppler-USG method. In 40 cases a prospective study before operation, 2 weeks, 3 months after operation and then in 6-month intervals was completed. In 20 patients the study was done 18 months to 7 years after operation only. The control group comprised 20 healthy volunteers. Mean PBV before operation was 17.5 +/- 1.2 cm/s, 2 weeks after surgery-14.2 +/- 1.0 and 3 months after operation 15.1 +/- 0.9 cm/s, mean PBF: 1211 +/- 124 ccm/min, 987 +/- 97 ccm/min and 1179 +/- 92 ccm/min respectively. The observed decrease of PBV and PBF was not significant. In the late postoperative period mean PBV was 14.0 +/- 1.2 cm/s and PBF 1077 +/- 99 ccm/min. We observed portal vein thrombosis in 4 cases before the operation and 7 new cases after operation. In 3 of them the recanalization of portal vein trunk was noted in further investigations. CONCLUSION: Extended gastroesophageal devascularization, splenectomy and esophageal transection (Hirashima procedure) does not result in significant decrease of portal blood velocity and portal blood flow. The hemodynamic effect of this operation is stabile in the observation period 1.5 to 7 years.

Adolescent↗
PubMed1995

The endogenous cannabinoid receptor ligand, anandamide, inhibits the motor behavior: role of nigrostriatal dopaminergic neurons.

The present study has been designed to test whether the recently described endogenous ligand for the cannabinoid receptor, arachidonylethanolamide, termed anandamide, can mimic the effects produced by exogenous cannabinoids on motor behavior and to test possible neurochemical substrates for this potential effect. To this end, adult male rats were submitted to an acute i.p. injection of anandamide, delta 9-tetrahydrocannabinol (THC) or vehicle. Animals were behaviorally tested ten minutes after injection of the drug and, then, sacrificed and their brains used for dopaminergic analyses. Ambulation was not significantly affected by the treatment with either THC or anandamide, but a very pronounced increase was observed in the time spent in inactivity in rats treated with either THC or anandamide. This was accompanied by a marked decrease in the frequency of spontaneous non-ambulatory activities, such as grooming and rearing, although only the administration of THC decreased shaking behavior. The anandamide-induced decrease in grooming was dose-dependent, but the decrease in rearing was higher with the dose of 3 mg/kg than with the dose of 10 mg/kg. The administration of anandamide also caused a dose-dependent decrease in the activity of tyrosine hydroxylase and in the ratio between the number of D1 and D2 receptors in the striatum. Moreover, the administration of 3 mg/kg of anandamide significantly decreased the contents of dopamine and L-3,4-dihydroxyphenylacetic acid in the striatum although lesser and higher doses were less effective. THC only tended to decrease these parameters. No changes were seen in dopaminergic activity in the limbic forebrain after either cannabimimetics. In summary, anandamide, as well as THC, decreases motor behavior. This effect was paralleled by reduction in the activity of nigrostriatal dopaminergic neurons. However, subtle differences in the behavioral and neurochemical effects between anandamide and THC could be observed.

Animals↗
PubMed1995

[Development of renal transplantation in the Gdansk center].

The kidney transplantation is one of the renal replacement therapy methods, which prolongs live of the patients with the end stage renal disease for many years. Moreover, this method is well known, safe and not so expensive as dialysotherapy. Our purpose was to present the 15-year activity of the transplantation center in Gdańsk. The first renal transplantation took place on the 31st of March 1980 and there have been 137 renal transplantations in Gdańsk until now. We can divide the time between the 31st of March 1980 and the end of 1994 into two periods: I from 31.03.80 to 31.12.89 and II from 1991 to 1994. During the first were 46, and during the second were 91 renal transplantations performed. It means that since the second half of 1991 the activity of the center in Gdańsk has increased. The graft function was noted in 29 patients (63%) during the first period and in 75 (82%) during the second. The acute graft failure was observed in the most of the cases mentioned above. The 5-year living of the transplanted patients and the dialysed patients is comparable and amounts to 90%. Infections were the main reason of death during the first period, and cardiovascular complications during the second. The 5-year graft's functioning is 60%. Nowadays the results of the kidney transplantation center in Gdańsk are good and comparable with the results of other centers in Poland and Europe. Our center, as similar ones in Poland is prepared to extend the kidney transplantation activity. So it is necessary to intensify an effort to gain more organs for transplantations.

Cause of Death↗
PubMed1986

The effect of antenatal dexamethasone administration on the prevention of respiratory distress syndrome in preterm gestations with premature rupture of membranes.

A prospective blinded randomized study was carried out to determine the effect of antepartum administration of dexamethasone on the incidence of respiratory distress syndrome in 250 patients with gestations between 28 and 33 weeks complicated by premature rupture of membranes. The incidence of respiratory distress syndrome was not lowered by the length of rupture of membranes in the 124 untreated patients. The overall incidence of respiratory distress syndrome was reduced from 51% to 25% by the administration of corticosteroids. Further, the dexamethasone-treated group had a statistical significant reduction in the incidence of intraventricular hemorrhage, total time of hospitalization, and average cost per patient. No statistical difference was encountered in the incidence of maternal or neonatal sepsis.

Adult↗
PubMedDate not supplied

A single center experience in preemptive kidney transplantation.

Transplantation is recognized as preemptive if it takes place before the initiation of chronic dialysis. This maneuver has the potential to avoid the morbidity and burden of chronic dialysis. From November 2003 to April 2005, 15 (7 male, 8 female) end-stage renal failure patients of mean age 40 +/- 14.8 years received preemptive grafts from 2 living-related and 13 cadaveric donors, constituting 11.5% of all kidney transplantations performed in our center at that time. The period on the waiting list for preemptive recipients, namely, 2 weeks to 6 months (mean, 2.4 months), was significantly shorter than that of other patients (mean, 13.8 months). The mean creatinine clearance calculated from the Cockroft Gault formula and the mean plasma creatinine level in preemptive recipients before transplantation were 12.7 +/- 3.1 mL/min and 6.6 +/- 0.8 mg/dL, respectively. The donors for preemptive and non-preemptive groups of recipients did not differ significantly in respect to age, gender, and renal function. The mean number of mismatches of 3.73 and 3.25 and the mean total ischemic times of 9.53 +/- 5 and 11.2 +/- 5 hours, in preemptive and non-preemptive groups of recipients, respectively. The incidence of delayed graft function (dialysis in the first week after transplantation) was significantly lower among preemptive recipients (20% versus 42%, respectively). The groups did not differ either in respect to the occurrence of acute rejection episodes or graft and patient survivals. In preemptive patients the mean plasma creatinine levels at 3 and 12 months were 1.37 +/- 0.3 and 1.09 +/- 0.3 mg/dL, and in non-preemptive patients 1.7 +/- 0.5 and 1.4 +/- 0.4 mg/dL. In conclusion, these results are promising, confirming the notion that preemptive kidney transplantation is the optimal treatment for end-stage renal disease patients.

Adult↗