Biomedical subjects
J Wojnar
Publications and source records attributed to J Wojnar.
[Kay's test and gastric mucosa biopsy in Addison's disease].
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Impact of activating killer immunoglobulin-like receptor genotype on outcome of unrelated donor-hematopoietic cell transplantation.
BACKGROUND: In a previous study we demonstrated that incompatibility regarding ligands for inhibitory killer immunoglobulin-like receptors (KIRs) is associated with a survival advantage following unrelated donor-hematopoietic cell transplantation (URD-HCT). The goal of the present analysis was to evaluate whether genotype of activating KIRs of the donor may have an impact on the outcome of URD-HCT. PATIENTS AND METHODS: Twenty-five URD-HCT recipients with hematological malignancies, mean age 27 years (range, 14-43 years), were included in the analysis. The conditioning regimen was myeloablative and based on chemotherapy alone (n = 20) or total body irradiation (n = 5). Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine, methotrexate, and pretransplant antithymocyte globulin. Patients were grouped according to their donors' activating KIR genotype including two loci: KIR2DS1 and KIR2DS2. RESULTS: The presence of KIR2DS1 in the donor (n = 16/25) was not demonstrated to influence outcome. In contrast, the presence of KIR2DS2 (n = 13/25 donors) was associated with decreased probability of overall survival (0% vs 92%, P = .04) and disease-free survival (0% vs 92%, P = .046). The reason for failures in the KIR2DS2-positive group was chronic GVHD (n = 4), acute GVHD (n = 2), and relapse (n = 1). The cumulative incidence of nonrelapse mortality equaled 90% for the KIR2DS2-positive group and 8% for the KIR2DS2-negative group (P = .09). CONCLUSION: The presence of KIR2DS2 gene in the donor is associated with a high risk of mortality following URD-HCT, resulting mainly from the incidence of severe GVHD. Whether this effect is associated with the activity of natural killer cells or KIR-bearing T lymphocytes requires further investigation.
[Blood gas analysis of forearm veins--at rest and after exercise of forearm muscles and laser Doppler flowmetry of skin on the back of the palm--use in evaluation of microcirculation in diabetes type 2].
The aim of the study was to compare of nondominant forearm microcirculation in adult-type diabetes and healthy subjects with use of venous blood gasometry (vbg) sampled from basilic vein before and after exercise of antebrachial muscles and with use of laser doppler fluxometry (LDF) with optode localized in dorsal palm surface. Examinations were performed in groups of 16 diabetic patients (aged 43.5 +/- 5.7) and 16 healthy subjects (aged 39.3 +/- 7.8). After exercise of antebrachial muscles in diabetic patients in vbg were: pH higher, pO2 and satO2 lower than in healthy subjects, pCO2 and -HCO3 were not different in both group. In LDF in diabetic patients impaired hypraemic reaction, impaired heating to 40 degrees C reaction and hyperaemic reaction in this temperature were found.
[Sucrose test in leukemias].
In 29 patients with blood diseases, in 40 with other diseases and 22 healthy blood donors sucrose test for presence of plasma haemolytic factor was performed by the method of Hartmann et al. in the modification of Hansen. The percent index of haemolysis of erythrocytes after incubation with serum in 10% sucrose solution was calculated. The results were evaluated in 4 variants: 1) positive sucrose test for presence of SHF against own erythrocytes, 2) positive sucrose test for presence of SHF against foreign erythrocytes, 3) authohaemolysis in 10% sucrose and 0.9% NaCl solution, 4) haemolysis of foreign erythrocytes in 10% sucrose and 0.9% NaCl. The test was usually negative in healthy controls and patients with non-haematological diseases and in patients with leukemia it was positive in 17%.
[Value of ultrasonographic examination in monitoring the treatment of advanced cancer of the stomach].
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[Ultrasonographic studies in evaluating the degree of advancement of stomach cancer].
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[Prevention in residential and nursing homes].
"Health" in the elderly describes an instable balance that exists between physical, psychological, and social factors as they pertain to the individual. The disruption of this balance can render the patient incapable of taking care of himself, thus requiring comprehensive care either at home or in an institution. Even the circumstance under which a transfer to an institution is made can have a negative effect on the subjects health; a careful analysis should be made of these factors before a decision to transfer is made. The following factors are critical in preventing or limiting the negative impact of either home or institutional care: architectural structuring of the environment organization of patient care type of medical care required type of physical therapy required It is a primary importance that the parties involved (patient and immediate family) be allowed to make and/or influence the decision on care and that they retain a feeling of personal responsibility for what happens. When a patient is institutionalized, he should be given the chance to continue his individual lifestyle whenever possible; his private sphere should be maintained. Disturbances that are caused by inappropriate changes in these structural factors should not be considered symptoms requiring psychopharmacological therapy.
[Pain and psychological disorders in the elderly].
This paper points to different physiological diseases which are associated with extreme pain. Extreme and chronic pain can be related to a higher risk of suicide. Special patterns of pain are characterized psychologically. Furthermore, the relationship between pain and depression is discussed. The necessity for psychosomatic concepts in diagnosis and treatment of pain is shown. Special forms of experiencing pain in patients who suffer from dementia are described. These patients appear to have difficulties in perceiving and describing (clinical) pain.