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Biomedical subjects

J Wojnar

Publications and source records attributed to J Wojnar.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Excretion of beta-2-microglobulin and Tamm-Horsfall protein in patients undergoing a conditioning regimen before bone marrow transplantation].

UNLABELLED: This study aimed assess function of renal tubules in patients undergoing conditioning regimen before bone marrow transplantation. The examined group comprised 19 patients. 13 of them underwent autologuous bone marrow transplantation (ABMT), or autologuous peripheral blood stem cells transplantation (APBSCT). These patients were treated with Cyclophosphamide (Cy) (120 mg/kg), Etoposide (1.6-1.8 g/m2) and Carmustine (400-450 mg/m2). The remaining 6 patients underwent allogenic bone marrow transplantation (BMT). They were treated with Cy 200 mg/kg or with Cy 120 mg/kg and Busulfan 16 mg/kg (doses given are the total amount or respective drugs were administered during the whole conditioning regimen). Urinary excretion of beta-2MB and THP was assessed a) before the conditioning regimen was started, b) one day before completion of it, and c) one day before bone marrow transplantation. In ABMT/APBSCT patients urinary excretion of beta-2-MG was significantly higher before and during conditioning regimen as compared with baseline value (3309 +/- 1123.7 vs 3919 +/- 1417.8 vs 246.7 +/- 50.3 mg/24h, respectively, p < 0.05). Urinary excretion of THP in these patients was significantly higher only during the conditioning regimen (90.6 +/- 14.3 vs. 30.4 +/- 6.24 mg/24h, p < 0.0002). In BMT patients conditioning regimen was followed by similar but less marked changes of urinary excretion of beta-2-MG and THP as compared with ABMT/APBSCT patients. CONCLUSIONS: 1. Conditioning regimen do influence significantly function of proximal and distal renal tubules. 2. The extent of disturbed function of renal tubules seems to depend on kind of medication that is given during the conditioning regimen.

Adjuvants, Immunologic↗
PubMed1994

[Results of induction treatment with idarubicin for acute nonlymphoblastic leukemia in adults].

Fifty six adult acute nonlymphoblastic leukemia patients were randomised in 1993 year according to Polish Acute Leukemia Group (PALG) into prospective, cooperative trial with the same prognostic factors distribution. The results of induction treatment using idarubicin on days 1, 3, 5 plus arabinoside cytosine 1-7/10 plus etoposide 1-5 (ICE7/10) vs. daunorubicin on days 1-3 plus Ara-C 1-7/10 with additional HD Ara-C in case of not sufficient cytoreduction in 6th day's bone marrow biopsy (3+7/+/-HD) and etoposide in M4-5 subtype are comparable (63 vs. 61% CR). Complete remission was achieved significantly more frequency (p < 0.02) after 1 cycle of induction treatment with ICE7/10 (93%) compared with 3+7+/-HD (55%), and 10 days shorter time to CR was observed. Side effects were comparable in both groups. The program with IDA needed more intensive supportive therapy.

Adolescent↗
PubMed1992

Biocompatibility of extracorporeal circulation with autooxygenation.

Platelet damage, complement activation and neutropenia during cardiopulmonary bypass are the result of blood contact with artificial surfaces, mainly in the oxygenator. To evaluate biocompatibility of this kind of bypass we compared two techniques of extracorporeal circulation in 40 patients undergoing elective coronary bypass operations. In 20, a standard technique with a bubble oxygenator was used (group 1), and in the remaining 20 patients with autooxygenation, the patients' own lungs were included in the perfusion circuit (group 2). Several blood samples were taken before, during and after perfusion to estimate the corrected platelet numbers and pulmonary leucocyte sequestration in all patients, and additionally in 6 patients from each group, complement C3a and C5a anaphylatoxins were measured (radioimmunoassay). At the end of cardiopulmonary bypass, the decline of platelet number corrected to haematocrit platelet number in group 1 was significantly higher than in group 2 (P less than 0.01). There was a significant increase in circulating white blood cells when compared to pre-bypass time in both groups (P less than 0.05). However, comparison of differences between leucocyte counts in the blood of the patients' right and left atria showed enhanced leucocyte sequestration in group 1, 1.46 +/- 0.5 x 10(3)/mm3 vs only 0.34 +/- 0.2 x 10(3)/mm3 in group 2. The C3a rose progressively during extracorporeal circulation: in group 1 from 268 +/- 46 ng/l to 521 +/- 65 ng/l, and in group 2 from 244 +/- 46 ng/l to 418 +/- 34 ng/l (P less than 0.05). No characteristic changes in C5a activation were observed in either group.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Loss, Surgical↗
PubMed1992

[The physician's role in relation to the guardianship law].

Legislation concerning guardianship and tutelage of the mentally and/or physically handicapped had so far been governed by the antiquated concept of mental diseases. The revised law (literally: "Care" law) took shape mainly on the lines of the development that followed the great "Psychiatry Inquiry Project" conducted in Germany a few years back. All decisions to be made on the grounds of the new law should always place the well-being of the mentally diseased and handicapped patients first. In this connection medical expertise is one of the most important decision aids for the judge who is called upon to decide on tutelage and guardianship. Hence, demands to be made on the quality of expertises are correspondingly high.

Expert Testimony↗
PubMed1992

Sonography in the diagnosis and therapy monitoring of lymphomas.

Multiple ultrasonographic (USG) evaluations of abdomen were performed in 97 patients: 30 with Hodgkin's disease (HD), 60 with non-Hodgkin lymphomas (NHL) and 7 with primary gastric lymphoma (PGL) before or during chemo- or X-ray therapy. In 33% of HD patients USG was normal, while in 63% splenomegaly, in 40% hepatomegaly and in 20% lymph node enlargement were observed. After therapy, in 57% USG was improved and in only 3% of patients worsening was observed. In NHL patients splenomegaly was observed in 70%, hepatomegaly in 60% and lymph node enlargement in 35%. During follow-up, in 49% of patients improvement and in 3% worsening was observed. In 5 patients with PGL no changes were observed, in further 2 patients in Stage IV stomach wall and infiltration of nearest lymph nodes was observed. USG evaluation of abdomen may be useful in staging and therapy monitoring of malignant lymphomas.

Adolescent↗
PubMed1992

[Use of cardiopulmonary bypass decreases leukocyte count and activation of the complement system].

Platelet damage, complement activation and neutropenia during extracorporeal circulation are the result of blood contact with artificial surfaces, mainly in the oxygenator. To evaluate the biocompatibility of the ++auto-oxygenation technique of cardiopulmonary bypass (CPB) 2 techniques of extracorporeal circulation were compared in 40 patients undergoing elective coronary bypass surgery. Patients were studied in 2 groups, 20 patients in each: I (++auto-oxygenation --patients lungs used in CPB) and II (conventional technique of CPB with bubble oxygenator). Several blood samples were taken before, during and after perfusion to estimate pulmonary leukocytes sequestration in all patients and additionally complement C3a and C5a anaphylatoxins + were measured (radioimmunoassays) in 6 patients of each group. During cardiopulmonary bypass the decline in leukocyte number was observed in both groups, but leukocyte count was higher in group I then II, due to the transpulmonary leukocyte sequestration which was higher in group II. The difference between leukocytes count in group II was 1.46 +/- 0.5 x 10(3)/mm3 vs only 0.34 +/- 0.2 x 10(3)/mm3 in group I, p less than 0.001. In postoperative period an increase in circulating white blood cells was observed in both groups when compared to pre-bypass time, but the difference between groups was non significant. The level of C3a increased in group I from 244 +/- 46 ng/ml to 418 +/- 34 ng/ml, in group II from 268 +/- 46 ng/ml to 521 +/- 65 ng/ml, p less than 0.001, but in group I the levels were significantly lower, p less than 0.001. The current study confirms that cardiopulmonary bypass results in significant leukocyte and complement activation and supports the theoreticaly better biocompatibility of CPB with lung over oxygenator.

Adult↗
PubMed1991

Improved biocompatibility of extracorporeal circulation by the use of auto-oxygenation instead of artificial oxygenator in perfusion circuit.

The aim of this study was to determine the biocompatibility of an auto-oxygenation technique of cardiopulmonary bypass. Forty patients undergoing coronary bypass surgery were studied in two groups: A (auto-oxygenation, patients' lungs used in cardiopulmonary bypass) and B (conventional technique of cardiopulmonary bypass with bubble oxygenator). The platelet count decreased to -73% of initial value in group B vs only -27% in group A, P less than 0.001. Platelet aggregation to ADP decreased slightly in group A and hardly at all in group B, P less than 0.001. A transpulmonary leukocyte sequestration was greater in group B: 1.46 +/- 0.5 x 10(3)/mm3 vs only 0.34 +/- 0.2 x 10(3)/mm3 in group A, P less than 0.001. The level of C3a increased in group A from 244 +/- 46 ng/ml to 418 +/- 34 ng/ml and in group B from 268 +/- 46 ng/ml to 521 +/- 65 ng/ml, P less than 0.001, but in group A the levels were significantly less, P less than 0.001. The current study clearly confirms the superior biocompatibility of cardiopulmonary bypass with lung over oxygenator.

Biocompatible Materials↗
PubMed1990

Haemocompatibility of extracorporeal circulation technique with autooxygenation: influence on platelet function and homologous blood requirement.

Forty male patients: group A-autooxygenation and group B-bubble oxygenator used in extracorporeal circulation (ECC) were studied to evaluate the haemocompatibility of 2 types of ECC. The Plt count dropped significantly in group B patients: -73% of initial value vs only -27% in group A, (p less than 0.001). In both groups a rise in BTG was shown, but higher in group B, p less than 0.001. At the end of CPB aggregation decreased only slightly in group A after epinephrine and 4-ADP, and decreased hardly in group B with the significant difference between two groups (p less than 0.02 and p less than 0.001, respectively). In group A the mean blood loss was 278 +/- 49 ml/m2 and 483 +/- 67 ml/m2 in group B, p less than 0.001. The mean blood transfusion in group A and B was 198 +/- 82 ml/m2 and 427 +/- 85 ml/m2, respectively (p less than 0.001). We are positive that the elimination of artificial oxygenator from the ECC diminished markedly the decline in Plt count and Plt activation during CPB.

Bleeding Time↗
PubMed1989

Clinical studies on aclacinomycin A cardiotoxicity in adult patients with acute non lymphoblastic leukaemia.

Nine patients with acute non lymphoblastic leukaemia (ANLL) were treated with Aclacinomycin in the doses of 20 mg/m2/day x 7 days in 30' lasting intravenous infusion and Cytosin arabinosid 100 mg/m2/day x 7 days in continuous infusion as well as control group consisted of 30 healthy people were examined by means of 24 hrs Holter ECG monitoring and ultrasonocardiography (UCG) to evaluate the influence of Aclacinomycin A (Aclaplastin - Behring) on cardiac rhythm and function. The UCG and Holter examinations were performed before Aclacinomycin and after 7-10 days from the beginning of the therapy. There were no statistical differences between the results of UCG examination in Aclacinomycin-treated group before the therapy and the control group. A slight nonsignificant decrease in left ventricular stroke volume and ejection fraction were observed after Aclacinomycin. Cardiac index decreased after the therapy (p less than 0.05) but was of normal value. The only true significant (p less than 0.001) decrease was observed in the contractility of cardiac fibres but the cardiac failure was not observed. No alterations in left ventricular posterior wall and intraventricular septum thickness were found. The effusion to pericardium was observed in 2 pts in the initial study and in 1 of them also after the therapy. The obtained results supported the clinical observations that Aclacinomycin A is promising agent for the treatment of ANLL because of its low cardiotoxicity.

Aclarubicin↗
PubMed1984

Electrophoretic mobility of blood lymphocytes stored at -196 degrees.

To determine the influence of low temperature (-196 degrees C) during preservation upon the electrophoretic mobility (EM) of lymphocytes ten healthy donors were examined. Lymphocytes were isolated from venous blood by Ficoll-Uropolinum (Polfa) density gradient centrifugation and iron powder technique was used to eliminate macrophages. EM of lymphocytes was analyzed on Parmoquant 2 computer system (Carl-Zeiss, Jena) before and ten days after cryopreservation. There was no significant difference between the mean EM before freezing (1.046 um.sec-1.v-1.cm) and after it (1.034 um.sec.-1v-1 cm). No significant changes in histograms showing slow (lymphocytes B) and fast (lymphocytes T) fractions were observed. It indicates, that cryopreservation does not change EM of lymphocytes and thus can be used in situations, when immediate examination cannot be done.

Adult↗