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Biomedical subjects

J Maciejewski

Publications and source records attributed to J Maciejewski.

At least 19 recordsLinked to original sources
PubMed1997

Intravenous aminophylline increases the degree of saturation of urine with calcium phosphate and struvite.

This study was designed to assess the effect of i.v. treatment with aminophylline (AMPH) on the risk of calcium phosphate and struvite stone formation. We administered AMPH in doses of 4 mg/kg body weight in 15-min i.v. infusions to 60 infants with clinical symptoms of obstructive bronchitis with dyspnoea. During 3 hours after infusion we observed a significant increase in urine saturation with brushite, octocalcium phosphate and struvite. This rise in urine saturation may increase the risk of kidney stone formation.

Aminophylline↗
PubMed1996

[Thrombo-embolic disease as a complication of nephrotic syndrome in children].

Eight children with thrombo-embolic disease in the course of nephrotic syndrome were treated at II Clinic of Children's Diseases (Institute of Pediatrics, Poznań) between 1991 and 1993. The diagnosis was established on the basis of clinical examination and noninvasive imaging techniques. Two patients had an atypical localisation of the thrombus in the left ventricle and right atrium. In laboratory tests of the coagulation system, all of the children had decreased levels of antithrombin III (AT III). All children were treated with heparin and 4 with fibrinolytic agents. AT III concentrate was administered to 3 children. Total resolution of thrombo-embolic disease was obtained in 5 patients, 3 died during treatment. Thrombo-embolic disease should be taken into account in the differential diagnosis of complications of nephrotic syndrome.

Anticoagulants↗
PubMed1996

[One center's experience with fibrinolytic treatment in children].

Fifteen children treated with fibrinolytic agents are presented. The most frequent indication was thromboembolic disease (TED). Eleven patients received streptokinase, 5-urokinase and 3-tissue plasminogen activator. Concomitant heparin was administered to 9 patients with TED. Total resolution was achieved in 9 children, partial improvement in 5; 1 child died during treatment without any improvement. Bleeding complications were observed in 6 patients, 1 of them died due to haemorrhagic stroke. According to the literature and our own experience, we recommend fibrinolytic agents as the treatment of choice for severe TED also in children.

Adolescent↗
PubMed1996

[Dysrhythmias documented by 48-hour electrocardiographic monitoring in children with mitral valve prolapse].

The association of dysrhythmias with mitral valve prolapse (MVP) in pediatric patients was examined by 48-hour ECG monitoring. Fifty unselected children with clinical diagnosis of MVP confirmed by echocardiography were studied. Eight (16%) patients manifested atrial dysrhythmias. Long runs of junctional rhythm with activity were recorded in one patient. Episodes of supraventricular tachycardia were recorded in 4 (8%) children. Seventeen (34%) patients had ventricular dysrhythmias. In 10 (20%) children, ventricular premature complexes (VPCs) were recorded. Four (8%) patients had frequent multifocal VPCs. Ventricular couplets were recorded several times in one patient (2%) and nonsustained ventricular tachycardia was recorded in two (4%) children. Clinical symptoms did not correlate with documented arrythmias. Although the prognostic implications of these findings are uncertain, this study demonstrated that potentially serious dysrhythmias are common in pediatric patients with MVP. It would appear that ambulatory ECG monitoring should be part of the complete evaluation of children with MVP.

Adolescent↗
PubMed1996

[Severe hemolytic-uremic syndrome complicated by cholelithiasis treated with laparoscopic cholecystectomy in a 12-year old boy].

A case of a 12-year old boy with hemolytic-uremic syndrome complicated with cholelithiasis is presented. Due to severe course of the hemolytic-uremic syndrome (enhanced catabolism, coagulation disorders) a laparoscopic cholecystectomy as a new, modern surgical technique has been considered. Postoperative period has been uncomplicated. Therefore, laparoscopic cholecystectomy proved useful and is recommended in patients with high postoperative risk.

Child↗
PubMed1996

Morphological and clinical aspects of membrano-proliferative glomerulonephritis in children.

Clinical and morphological studies were carried out in 34 children with the diagnosis of primary membrano-proliferative glomerulonephritis. The studies were prompted by an increasing incidence of this type of glomerulonephritis in Poland in the light of its regular decrease in the world. We found: (a) a number of discrepancies in the clinical manifestations and course of the disease in our children as compared with those in the literature; (b) difficulties in morphological diagnosis; (c) a frequent lack of correlation between the severity of morphological changes and the clinical course. It is of note that our series includes a large group of children below 6 years of age, which is a rare phenomenon.

Adolescent↗
PubMed1995

Fas antigen expression on CD34+ human marrow cells is induced by interferon gamma and tumor necrosis factor alpha and potentiates cytokine-mediated hematopoietic suppression in vitro.

Activation of Fas antigen, a cell surface receptor molecule, by its ligand results in transduction of a signal for cell death. The Fas system has been implicated in target cell recognition, clonal development of immune effector cells, and termination of the cellular immune response. Fas antigen expression on lymphocytes is regulated by interferon gamma (IFN gamma) and tumor necrosis factor alpha (TNF alpha), cytokines that also have inhibitory effects on hematopoiesis. We investigated Fas antigen expression on human marrow cells and the effects of Fas activation on hematopoiesis in vitro. Freshly isolated immature hematopoietic cells, as defined by the CD34 marker, did not express Fas antigen at levels detectable by fluorescent staining. CD34+ cells, which include progenitors and stem cells, showed low levels of Fas expression in culture, even in the presence of growth factors. Stimulation by TNF alpha and IFN gamma markedly increased Fas antigen expression on CD34+ cells. Anti-Fas antibody, which mimics the action of the putative ligand, enhanced IFN gamma- and TNF alpha-mediated suppression of colony formation by bone marrow (BM) in a dose-dependent manner. This effect did not require the presence of accessory cells. Colony formation from mature (CD34+ CD38+) and immature (CD34+ CD38-) progenitor cells and long-term culture initiating cells were susceptible to the inhibitory action of anti-Fas antibody in the presence of IFN gamma and TNF alpha. Apoptosis assays performed on total BM cells and CD34+ cells showed that anti-Fas antibody induced programmed cell death of CD34+ BM cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, CD↗
PubMed1995

Relationship between the reactivity to hepatitis B virus vaccination and the frequency of MHC class I, II and III alleles in haemodialysis patients.

To study the immunoreactivity genes in a heterogeneous human population needs a large number of individuals. Associations between HLA antigens and immunoresponse to viral or bacterial antigens have been studied with controversial results. As a homogeneous population, the MHC class I, II and III allele distribution was studied in 153 end-stage renal disease patients (ESRD, average duration of renal replacement: 8.2 + 5.1 years) immunized with a recombinant hepatitis B vaccine in accordance to the standard vaccination schedule. Thirty-four patients with an antibody titre of less than 10 U/l following the last booster injection were considered as non-responders while 119 patients with antibody titre equal to or more than 10 U/l were considered as responders. The responder group was divided into two subgroups: low responders (antibody titre: < or = 1000 U/l) and high responders (antibody titre: > 1000 U/1). Marked differences were observed between responders and non-responders in the occurrence of carriers of different MHC class I, II and III alleles. Homozygotes for HLA-A1, HLA-B8, HLA-DR3 and HLA-DQ2 were found almost exclusively in the non-responder group and significantly more heterozygotes for these alleles were found in the non-responder group compared to the responders. Similar albeit less marked differences were found in the frequency of some MHC class III alleles (C4A*6, C4A*QO, Bf*F, Bf*S0.7). Within the responder group, carriers of HLA-A2, HLA-B7 and HLA-DR4 were found to be clustered in the low responder sub-group whereas carriers of HLA-A1, HLA-B27, HLA-Cw2, C4A*6 and Bf*F were observed more frequently in the group of high responders. Similar differences were found with extended haplotypes as well. For example, the extended haplotypes HLA-A1, B8, BfS, C4AQO, C4B1, DR3, DQ2 and HLA-A1, B8, BfF, C4A6, C4B2, DR3, DQ2 were present in nine of 34 cases of non-responders but only in one of 119 case of responders (P < 0.000001). These observations indicate that the presence or absence of certain MHC alleles even in heterozygous form determine the responsiveness to hepatitis B vaccination in end-stage renal disease patients, and among responders, the intensity of antibody response is also markedly influence by immunogenetic factors.

Adult↗
PubMed1995

[Reactivity to hepatitis B vaccination (HBV) in patients with uremia: association with defined HLA antigen configuration and complement protein allotypes C4A, C4B and B factor (Bf)].

Genes, which are responsible for the effectivity of immune response are located on the chromosome 6 similarly as the genes of the class I and II of the major histocompatibility complex (MHC) together with the genes of some complement proteins (C4A, C4B, B factor/Bf/). The study investigates the interdependence between HLA configuration as well as complement protein allotypes (C4A, C4B, Bf) with the reactivity to HBV vaccination of ESRD [end stage renal disease]-patients. 153 ESRD-patients (68 females, 85 males; mean duration of hemodialysis therapy 8.2 +/- 5.1 years) were studied. Subjects were vaccinated (Gen-H-B-Vax-D; Merck, Sharp and Dohme, 40 micrograms/dosis i.m.) in the schedule at 0, 1, 2, and 6 month. Non-responders (NR) were defined when the anti-HBs antibody titer was below 10 U/liter. HLA typing was performed by means of microlymphocytotoxicity assay, whereas complement allotypes were estimated by using high voltage gel electrophoresis with subsequent specific immunofixation with antibodies against C4A, C4B and Bf. In the non-responders group [NR = 34] a) the significantly higher occurrence of single HLA-A1 and/or HLA-B8 and/or Cw4 or DR3 or DR7 or DQ2 have been found. In about 40% of NR HLA-A1, -B8, -DR3, or -DQ2 antigens occurred as homozygotes.

Adult↗
PubMed1994

Mesangial glomerulonephritis (GNMes) in children. Diagnostic problems, usefulness of repeated biopsy.

We analysed the results of clinical and morphological examinations in 256 children with mesangial glomerulonephritis. In the majority of children the onset of the disease was associated with the nephrotic syndrome, less frequently with erythrocyturia, proteinuria plus erythrocyturia or proteinuria. The course of the disease was markedly worse in those with proteinuria. The patients in this group were most frequently submitted for repeated biopsy. Renal specimens were studied in light, electron and immunofluorescence microscopy. Certain relationships between the initial symptoms and composition of deposits were found. There was, however no relation between the presence or absence of the deposits or their composition and the course of the disease. In 30 children the results of first biopsy (mainly electron microscopy examinations) suggested a possibility of focal segmental glomerulosclerosis (FSG). In 11 out of these children biopsy was repeated confirming the results of the first one. Repeated biopsy was performed in a total of 22 children. Progression of changes (signs of FSG) was found in 19 children, in 2 children changes in repeated biopsy did not differ from those in first biopsy, and in one child regression was observed.

Adolescent↗
PubMed1994

Non-responsiveness to hepatitis B vaccination in haemodialysis patients: association with impaired TCR/CD3 antigen receptor expression regulating co-stimulatory processes in antigen presentation and recognition.

The study was undertaken to evaluate the relationship between non-responsiveness to hepatitis B (HBV) vaccination in haemodialysed patients and HBs antigen (Ag) presentation and recognition depending on TCR/CD3 receptors expression. We have found that the cause of the blunted response to HBV vaccination is multifactorial and seems to be associated with the following: (1) A reduced number of TCR/CD3 antigen receptor complexes on freshly isolated uraemic CD4 T cells, especially in non-responders. (2) The blunted proliferative response of uraemic CD4 T cells isolated from non-responders and stimulated for 6 days by autologous monocytes presenting HBsAg was associated with the decreased density of the TCR/CD3 receptors. (3) Moreover, in uraemic non-responders the expression of adhesion and accessory molecules on monocytes (intercellular adhesion molecule-1/ICAM-1, HLA-DR/Ia/) was significantly decreased following the culture with autologous monocytes serving as HBsAg-presenting cells. CD4 molecules and lymphocyte function antigen-1 beta/LFA-1 beta/ on helper-inducer T cells were increased before and after the culture. (4) These findings were also associated with a diminished binding capacity of IL-1 beta and IL-6 to their receptors on helper-inducer T cells. (5) IL-2, IFN-gamma and IL-4 production was decreased in uraemic non-responders, especially after 72 h of the culture. (6) Inhibited proliferation of helper-inducer T cells in uraemic non-responders was only partially reversible in the presence of exogenous IL-1 beta, IL-6, IL-2 and IFN-gamma. (7) HLA typing of uraemic non-responders was associated with extended haplotype: HLA A1,B8,DR3,DR7,DQ2.

Adult↗
PubMed1994

Morphometric analysis in the diagnosis and differentiation of certain glomerulopathies (MCD, GNMes, FSG)

Morphometric analysis was used to evaluate mesangial components in MCD (minimal changes disease), GNMes (mesangial glomerulonephritis), FSG (focal segmental glomerulosclerosis). In GNMes the increase of matrix was found to be generally proportional to the amount of mesangial cells. There are clear statistically significant differences in the ratio of matrix volume to cell component volume and of matrix volume to the whole mesangial area in MCD and GNMes as compared with FSG. In the case of GNMes where morphometric results resemble those in FSG cautious prognosis is recommended as there is a possibility of FSG. This has been confirmed both by the course of the disease and the results of repeated biopsy.

Adult↗
PubMed1993

The effect of splenopentin (DA SP-5) on in vitro myelopoiesis and on AZT-induced bone marrow toxicity.

Splenopentin (DA SP-5) is a pentapeptide corresponding to the amino acid sequence 32-36 (Arg-Lys-Glu-Val-Tyr) of the splenic hormone splenin. We examined the influence of DA SP-5 on bone marrow progenitor cell (BMC) proliferation. DA SP-5 acts as a co-stimulant for recombinant human granulocyte-macrophage colony-stimulating factor (rHuGM-CSF) in the induction of human BMC derived colony formation in vitro (colony-forming units). When exposed to DA SP-5 and thereafter to AZT and rHuGM-CSF, BMCs show a colony-forming response similar to that after cultivation with the rHuGM-CSF alone. In contrast, when exposed to AZT and rHuGM-CSF (and not preincubated with DA SP-5) the colony formation was reduced. A similar pentapeptide thymopentin (Arg-Lys-Asp-Val-Tyr) did not influence colony formation by human BMCs. We assume that DA SP-5 could support therapeutic effects of rHuGM-CSF.

Amino Acid Sequence↗
PubMed1993

Combined mother and baby care: does it meet the needs of families?

Combined mother/baby care is thought to be an effective way to prepare a family for the changing roles and added responsibilities that the arrival of a new baby entails, but few studies have evaluated this care delivery system. Therefore, the postpartum staff at Sudbury General Hospital conducted a post-test control group study design with a self-selected sample of postpartum mothers when the unit was changing from traditional to combined mother/baby care. One hundred and three mothers who received traditional care and 102 who had combined mother/baby care completed a questionnaire to assess perceptions of their own competence and satisfaction with the type of care administered. There were no significant differences between the two study groups. Factors that may have confounded the results include: insufficient time between institution of the program and its evaluation, and the quality of prenatal education received. Multiparous mothers scored higher on self care, infant care, and maternal competence than did primiparous mothers regardless of the care delivery system. Maternal concerns related to immediate needs. Future research should take the differences between primiparas and multiparas into account, and focus on the less immediate needs of mothers.

Adolescent↗