Biomedical subjects

J Pawlak

Publications and source records attributed to J Pawlak.

At least 19 recordsLinked to original sources

PubMed2004

Apoptosis phenomenon in the selected neoplasms of the glial origin.

Gliomas cause a therapeutic problem because of their localization and asymptomatic growth in the initial phase. Neoplastic growth is connected with disturbance between proliferation and apoptosis. In the study, we assessed the Bcl-2 family proteins involved in apoptosis in gliomas. The study comprised 61 patients with gliomas and based on tissue material sent for the diagnosis. Apoptosis was assessed in various types of gliomas and was defined by the apoptotic index (IA) and shown immunohistochemically with using Bcl-2, Bax and Bcl-x antibodies. The data were statistically analyzed. We found an increased percentage of the Bax (+) cells in less matured gliomas. A reverse dependence was revealed for Bcl-x. It was found that, probably in gliomas, the assessment of the Bcl-2 family proteins may serve only as an additional parameter for the evaluation of the disease course and the therapeutic success.

Apoptosis↗

PubMed2004

Expression of Ki-67, PCNA and MPM2 antigens in follicular cells of the thyroid gland after iodotherapy.

Hyperfunctional nodular goitre is the most common thyroid non-neoplastic condition in endemic areas. Iodotherapy is the basic method in thyroid gland hyperfunction treatment. The aim of the study was to evaluate proliferation of thyroid follicular cells in nodular goitre after iodotherapy. The study was carried out on 32 women, 30-76 years old. Cytological and immunohistochemical evaluations were based on the material, obtained by Fine-Needle Aspiration Biopsy (FNAB). Proliferative activity was immunohistochemically assessed. The influence of radioiodine on thyroid follicular cells was evaluated as a difference between the proliferation of follicular cells before and after its application. It was concluded that the proliferative activity of thyroid follicular cells decreased considerably after radioiodine therapy.

Adult↗

PubMed2003

Results of liver transplantation according to indications for orthotopic liver transplantation.

OBJECTIVE: This study assessed the results of liver transplantation in patients with a variety of different indications. METHODS: From 1989 to April 2003, 209 orthotopic liver transplantations (OLTx) were performed on 196 patients, including 178 cases. The diagnoses were: PBC (n = 34); PSC (n = 13); elective postinflammatory cirrhosis in the course of hepatitis C (n = 29); hepatitis B (n = 16); postalcoholic cirrhosis (n = 23), autoimmune cirrhosis (n = 11); Wilson's disease (n = 6); cirrhosis of unknown etiology (n = 10); secondary biliary cirrhosis (n = 5); Budd-Chiari syndrome (n = 6); and benign liver neoplasms (n = 7). RESULTS: The 3-year survival rate in the group of patients transplanted electively was 74.1%. In other groups it was: PBC, 91.4%; PSC, 69.2%; hepatitis C, 69.6%; hepatitis B, 55.5%; postalcoholic cirrhosis, 80%; autoimmune cirrhosis, 81.8%; Wilson's disease, 57.1%; secondary biliary cirrhosis, 40%; Budd-Chiari syndrome, 66.6%; hemochromatosis, 100%; benign neoplasms of the liver, 87.5%; and liver cysts, 100%. CONCLUSIONS: Results of liver transplantation were closely related to the urgency of the procedure. Better results were achieved in patients operated upon routinely compared with in those operated upon emergently (74.1% vs 50%). The best results of liver transplantation were achieved in patients transplanted on a routine basis with a diagnosis of PBC (91.4%), autoimmunologic cirrhosis (81.1%), postalcoholic cirrhosis (80%), or hemochoromatosis (100%). Patients with liver insufficiency due to hepatitis B and Wilson's disease have an increased risk of graft destruction, and the rate of survival in these patients is significantly lower than in other patients.

Female↗

PubMed2003

Resistance of gram-positive pathogens to antibiotics is a therapeutic challenge after liver transplantation: clinical experience in one center with linezolid.

BACKGROUND: Orthotopic liver transplantation has become an established therapeutic option for a large variety of fulminant and chronic liver diseases. Postoperative infections are the major cause of morbidity and the leading cause of mortality. The microbes responsible for these severe infections are predominantly gram-positive. METHODS: This article reviews results of linezolid therapy based on the clinical characteristics, microbial features, and outcomes of severe bacterial infections due to known or suspected resistant gram-positive species in selected liver allograft recipients. RESULTS: Among the 7 patients who received linezolid, methacillin-resistant Staphylococcus aureus. was isolated from 3, no pathogen from 2 patients, and serious pulmonary infection in 2 patients, 1 of whom had to be reintubated due to of respiratory failure. Cholangitis observed in 5 of 7 patients was caused by enterococci and staphylococci with septicemia in 1 subject. All patients demonstrated clinical improvement; microbiological eradication was observed in 4 patients. The majority of reported adverse events were mild or moderate in intensity. No potential drug interactions were observed between linezolid and concomitant medication. CONCLUSIONS: In the present study, linezolid proved to be effective and well tolerated. In summary, linezolid may represent an effective and safe antimicrobial agent for the treatment of infections due to susceptible and resistant gram-postive bacteria after solid organ transplantation.

Acetamides↗

PubMed2003

Biochemical assessment of the early liver graft function in relation to selected donor parameters.

The aim of this study was to assess the usefulness of liver grafts procured from "marginal donors." Among 62 liver transplants in 2002, almost half were harvested from donors who were not deemed acceptable by other transplant units. The authors compared the data concerning the donor's status with the function of the transplanted liver. The relations between individual parameters were estimated, as well as the differences between two groups of recipients: those who received a graft from the "poorer" donors versus those who received "better" grafts. Regardless of the relations between particular parameters a statistical analysis revealed that differences of liver function that were detected during the first 5 days after transplantation disappeared thereafter.

Alanine Transaminase↗

PubMed2003

Comparison of the results of liver transplantation for elective versus urgent indications.

The authors present an analysis of early and remote liver transplantation outcomes related to the presence of emergent indications among 196 of the 209 operations performed from 1989 to April 2003; namely 178 elective and 18 emergent transplantations. Perioperative mortality was 15%. The survival rate during the first 12 months was 79.8% and within 3 years 73.5% among patients operated on an elective basis (UNOS 3 and 2B). In contrast, patients with acute liver failure (UNOS 1 and 2A) showed rates of 45%, 50%, and 47%, respectively. Liver transplant outcomes depend primarily on the urgency of an operation. Longterm results are much better among patients operated on electively. Liver transplantation in patients with acute hepatic insufficiency is burdened with a high 45% mortality.

Adult↗

PubMed2003

Biliary tract complications following liver transplantation.

INTRODUCTION: Biliary tract complications, which occur in 5.8% to 24.5% of adult liver transplant recipients, remain one of the most common problems following transplantation. The aim of this study was to evaluate these problems and analyze methods of treatment. MATERIAL AND METHODS: From 1989 to 2003, 36 (18.7%) among 193 patients who underwent orthotopic liver transplantations in our center developed biliary complications. Biliary strictures that developed in 18 cases (9.3%) were the most common complications. Clinical manifestations of strictures developed at 2 to 24 months after transplantation. Bile leaks occurred in 10 patients (5.2%), and were diagnosed in along the T-tube 4 cases and was not accompanied by any clinical manifestation. Bile leak to the peritoneum after T-tube removal occurred in 2 patients (1.1%). Solitary gallstone formation in one case (0.5%) was removed with the use of ECPW. One patient required retransplantation within 3 months after transplantation, because of the most severe complication-ischemic necrosis of biliary tract. RESULTS: Uneventful recovery was achieved in 34 patients in the analyzed group (94.4%). There was no case of recurrence during outpatient follow up. Two patients died in late follow-up of unrelated causes: namely, gastrointestinal bleeding due to a duodenal ulcer and multi-organ failure (MOF) due to a third severe episode of acute liver transplant rejection. CONCLUSIONS: Biliary complications remain an important problem in liver transplantation. Endoscopic and radiologic management are effective in the majority of cases. Surgical intervention is obligatory in selected cases.

Biliary Tract Diseases↗

PubMed2003

The impact of experience of a transplantation center on the outcomes of orthotopic liver transplantation.

The so-called learning factor has been disregarded for many years in analyzing the causes of surgical complications and post-operative mortality; it is also the case for OLT. In our center until April 2003, 209 OLT were performed in 196 patients. We evaluated the impact of experience of the transplantation team on the outcomes of liver transplantation. Thirty-four patients died (mortality rate, 16%) and 1-year survival rate, 64%. Mortality rates varied during different periods of observation due to increasing experience of the transplantation team. The causes of mortality were assessed for a series of 34 patients: it was 75% at the beginning of transplantation procedures while recent deaths have not recently exceeded 10% of cases.

Gallbladder Diseases↗

PubMed2003

Vascular complications after liver transplantation.

Vascular complications following liver transplantation is reviewed based upon literature data and our own results. Our study conclusions are mostly based on literature data, because our center does not have the liver transplantation experience of other centers worldwide. Thus, we may conclude, that the number and character of complications does not differ from those reported by other centers. The enbloc technique used in liver harvesting minimizes the risk of arterial damage in case of vascular anomalies. Recipient retransplantation is the most effective treatment method in cases of hepatic arterial occlusion. Doppler ultrasound examinations are effective to monitor vascular blood flow in the transplanted liver.

Arterial Occlusive Diseases↗

PubMed2003

Intracerebral varicella-zoster virus reactivation in congenital varicella syndrome.

Patients with congenital varicella syndrome (CVS) typically present with clinical symptoms consisting of skin lesions, neurological defects, eye diseases, and/or limb hypoplasia. In rare cases, isolated manifestations in the brain or eye have been reported. The varicella-zoster virus (VZV), as the causative agent of CVS, could only be detected in a few infants with CVS. In addition, there is little in the literature on antiviral treatment of infants born with signs of CVS. We report a case of CVS in a male infant who presented with generalized clonic cerebral seizures at age 4 months. An endogenous intracerebral viral reactivation following intrauterine VZV infection was assumed. After the diagnosis was confirmed virologically, acyclovir was administered intravenously for 10 days and afterwards orally for 3 weeks. This antiviral treatment was aimed at preventing progression of the disease. We concluded from this case that infants with intrauterine VZV infection can suffer intracerebral VZV reactivations that require antiviral treatment.

Central Nervous System Diseases↗

PubMed2003

Assessment of early graft function in relation to different preservation fluids--preliminary results.

The parameters of transplanted liver functions were exposed to a retrospective analysis during the past year. A group of 51 patients out of 223 were thoroughly examined, all of them having undergone orthotopic liver transplant in Department of General, Transplant and Liver Surgery, Medical University of Warsaw until 1.09.2003. With transplants, two types of preservation fluids: UW (Viaspan) and Celsior were used alternatively. Liver function was assessed on the basis of the clinical feature and biochemical data. The results obtained were statistically verified. The way of fluid perfusion during the operation and the rinsing effectiveness were also evaluated, additionally the level of marked K during the reperfusion was checked. There were no statistically significant differences noticeable between both groups of recipients. Among all the liver and kidneys effectiveness parameters assessed with the recipients after OLTx, the considerable difference statistically, was visible only with the levels of AspAt, AlAt, INR and APTT during the first days and nights after the operations. Later the difference was gradually disappearing. However, in accordance with the harvesting teams' opinions, the usage of Celsior, owing to lower viscosity, allowed for faster and more exact blood rinsing from a vascular bed of the organ transplanted. The organ's even penetration was also possible. The lack of necessity to use additional stabilizers also simplified radically the harvesting technique. Celsior--the preservation fluid used in the authors' clinic meets all the requirements necessary to efficacious preservation and storage of a to be transplanted liver.

Adenosine↗

PubMed2002