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M Kosieradzki

Publications and source records attributed to M Kosieradzki.

16 recordsLinked to original sources
PubMed2005

Health-related quality of life after the surgical treatment of obesity.

The aim of the study is to answer the question: what is the range and character of changes within health-related quality of life (HRQL) in obese patients who have undergone surgical treatment (VBG - vertical banded gastroplasty or RYGBP - Roux-en-Y gastric bypass) in the period of three and six months after operation? Three groups of patients participated in the study: G I (n=33; BMI 49.90 +/- 6.74 kg/m(2)) - tested prior to the operation, G II (n=17; BMI 34.26 +/- 5.28 kg/m(2)) - tested six months after the operation, and G III (n=11) - examined prior to the operation (BMI 45.72 +/- 5.27 kg/m(2)) as well as three months after the operation (BMI 36.10 +/- 4.60 kg/m(2)). The Nottingham Health Profile (NHP) questionnaire was used as an indicator of HRQL. Surgical treatment of obesity resulted in significant positive changes in relation to the basic dimensions of NHP: energy, pain, physical mobility and in the influence of the current health state on selected spheres of life: paid employment, jobs around the house, social life, sex life, interests and hobbies, holidays. Significant changes in HRQL resulting from bariatric surgery occur in a relatively short period of time and are related not only to physical but also to social functioning.

Activities of Daily Living↗
PubMed2003

Extracellular matrix proteins, proteolytic enzymes, and TGF-beta1 in the renal arterial wall of chronically rejected renal allografts.

Chronic rejection (CR) is the leading cause of long-term failure of transplanted kidneys. The vascular hallmark is intimal hyperplasia, accompanied by macrophage, foam cell, and T-cell infiltration. Intimal thickening results from the migration and proliferation of smooth muscle cells and increased deposits of extracellular matrix (ECM) proteins, due to release of growth factors and cytokines as well as altered ECM protein turnover. We assessed the content of fibronectin (FN) and transforming growth factor-beta1 (TGF-beta1) as well as the activities of collagenase and cathepsin B and L in renal artery walls of chronically rejected human renal allografts. We investigated renal artery samples from 8 patients with CR undergoing graftectomy, 12 patients undergoing nephrectomy, and 7 organ donors. The results were related to the DNA content of homogenates. Cathepsin B and L activities were significantly higher among those with compared with donors (P =.022). There was a trend toward higher collagenase activity in CR compared with donors and the nephrectomy group. TGF-beta1 was significantly enhanced in CR compared with donors (P =.010), and showed a trend toward higher concentrations in CR compared with the nephrectomy group. The trend was toward lower FN concentrations in CR compared with the nephrectomy group and toward higher concentrations compared with donors. Summarizing, renal CR is accompanied by enhanced proteinase activity, alterations of ECM proteins, and increased TGF-beta1 in the renal artery wall. We conclude that ECM turnover and cytokines play an important role in neointimal formation and CR pathogenesis.

Cathepsin B↗
PubMed2003

Simultaneous pancreas-kidney transplantation: analysis of donor factors.

There are no urgent indications for simultaneous pancreas-kidney transplantation. So our policy is to harvest only a pancreas in good biologic condition. The criteria for acceptance of a pancreas donor are: age 15 to 40 years, ICU stay < 7 days, no clinical signs of infection, negative virologic status, no history of hypotension or cardiac arrest, serum amylase elevation below three times normal values, controllable hyperglycemia, no history of pancreatic disease, no history of abdominal trauma damaging the organ, no history of alcohol addiction, BMI < 25, no functional or anatomical lesions of the kidneys, and expected ischemia time less than 12 hours. The proper selection of a pancreas donor allows one to achieve good insulin secretion immediately after transplantation. In 2000 to 2002 all 20 pancreases transplanted at transplant center displayed immediate secretory function after transplantation.

Adolescent↗
PubMed1999

Activity of glutathione S-transferases in the urine of kidney transplant recipients during the first week after transplantation.

UNLABELLED: Glutathione S-Tranferases (GST) are the enzymes which are strictly specific for epithelial cells of the proximal and distal tubules in the kidney. These enzymes are detected in the urine when some tubular damage process is found. In healthy people urine GST is hardly detected. The goal of this study was to evaluate the release of two isoenzymes -- alpha and pi GST in the urine of kidney graft recipients during the first week after kidney transplantation, aiming to differentiate the cause of the delayed function (DF) of transplanted kidney. MATERIAL AND METHODS: 50 cadaveric kidneys were procured using standard technique with "in situ" cooling using UW solution. All kidneys were machine perfused. After preservation kidneys were transplanted to 50 ERSD patients. Standard triple drug immunosuppression was applied (steroids, CsA, Cell-Cept or Aza.). Graft function and the release of alpha and pi GST in the urine were measured 1, 3 and 7 days after transplantation. RESULTS: immediate function (IF) was found in 72% (36pts), DF in 28% (14pts). 5 of DF patients had ATN, 4 had acute rejection (REJ) and the remaining 5 had ATN and acute rejection (see table below). CONCLUSIONS: High alpha and pi GST concentrations were found in pts with DF graft function during the first 7 days after Tx. Elevated pi GST and low alpha GST in the urine indicates acute rejection. High alpha and pi GST in pts with DF should raise suspicion of graft rejection.

Cyclosporine↗
PubMedDate not supplied

Increased mRNA expression of transforming growth factor beta in the arterial wall of chronically rejected renal allografts in humans.

INTRODUCTION: Transforming growth factor beta (TGF-beta) has an established role in interstitial damage of renal transplants during chronic rejection (CR). However, its involvement in transplant vasculopathy is not clear. The aim of the study was to assess TGF-beta gene expression in the walls of large-caliber arteries within chronically rejecting renal allografts. We evaluated associations between gene expression of this factor and intimal thickness or clinical data. MATERIAL AND METHODS: Renal artery samples of kidney allografts were obtained from 20 hemodialysis patients with end-stage renal graft disease due to CR, who were undergoing graftectomy. The control group included 32 hemodialysis patients with end-stage renal disease, undergoing nephrectomy due to autosomal dominant polycystic kidney disease (n = 12), chronic pyelonephritis (n = 13), or kidney limited tumor (n = 7). Gene expression of TGF-beta was measured using real-time PCR. RESULTS: TGF-beta mRNA expression was 3.25-fold higher in CR than in control patients (P < .001). Expression of mRNA for this cytokine was not influenced by the following factors: intimal thickness; age; serum cholesterol, triglycerides and glucose; BMI; graft survival; time of dialysis before transplantation; total ischemic time; immunosuppressive regimen; incidence of acute rejection episode; panel reactive antibodies; and period of dialysis before graftectomy. TGF-beta is involved in neointimal formation in CR.

Adult↗
PubMedDate not supplied

Chlamydia pneumoniae infection: an additional factor for chronic allograft rejection.

INTRODUCTION: Chronic rejection (CHR) of organ allografts, one of the most significant problems in modern transplantation, is not fully understood. This study sought to evaluate the influence of selected parameters on late kidney transplant function. PATIENTS AND METHOD: The studied group consisted of eighty-six patients who received allogeneic transplants between 1988 and 1999 for leukocyte Chlamydia pneumoniae-DNA, immunoglobulin (Ig)A/IgG anti-C pneumoniae, blood lipids, ischemic damage in the donor and during organ preservation, HLA mismatch, and acute rejection episodes. RESULTS: Eighty-six patients were segregated as 26 patients (30%) with histologically proven chronic graft rejection (CHR[+]) and 59 patients (70%) without (CHR[-]). The presence of C pneumoniae-DNA in peripheral blood leukocytes was significantly more frequent in CHR(+) than CHR(-) group (46% vs 20%). Patients with leukocytes positive for C pneumoniae-DNA more frequently (50%) had CHR than patients negative for C pneumoniae-DNA (22%). CHR(+) patients showed significantly lower HDL levels (47 mg/dL vs 58 mg/dL) and higher triglyceride levels (193 mg/dL vs 148 mg/dL). To study the cumulative effect of differences between the CHR(+) and CHR(-) groups, we applied a multiple binary logistic regression analysis. An econometric model enabled us to calculate the probability of CHR for a given patient taking into account covariates chosen by means of stepwise selection: the presence of C pneumoniae-DNA in blood leukocytes, the use of continuous pulsatile perfusion in hypothermia, myocardial infarction occurrence, and triglyceride concentrations. CONCLUSION: The presence of C pneumoniae-DNA in peripheral blood leukocytes increased the risk of CHR, which may be predicted by a multifactor analysis of chosen parameters.

Adult↗
PubMedDate not supplied

Intraoperative blood flow measurements and liver allograft function: preliminary results.

INTRODUCTION: Our previous studies showed a correlation of intraoperative renal allograft blood flow and immediate functions. A similar relation is not well established for liver transplantation. The aim of this study was to assess the relation between hepatic blood flow on revascularization and immediate liver graft function (IF). METHODS: Studies evaluating arterial and portal flow in newly transplanted livers were started in May 2004. Total hepatic artery and portal vein blood flow were assessed in 15 liver transplant recipients. Parenchymal flow was also recorded. Measurements were taken at 30 and 120 minutes after simultaneous arterial/portal reperfusion. Flow results were correlated with IF. RESULTS: Mean arterial blood flow (ABF) was 16.3 mL/min/100 g in both measurements. Portal flow was reduced from 168 to 127 mL/min/100 g from the first to the second measurement. Mean parenchymal flow (PF) did not alter over time (29.1 and 30.4 mL/min/100 g, respectively). Among recorded flow results we observed a significant correlation between PF with IF measured as: bile volume (R = 0.36 to 0.62; P < .05), serum AST (R = -0.4 to -0.68; P < .05), and ALT level (R = -0.2 to -0.71; P < .05), bilirubin level as well as INR (R = -0.39 to -0.61; P < .05) assayed daily for 14 days. Similar observations were made between ABF and INR, hiatal parenchymal flow, and ALT as well as INR. CONCLUSIONS: These preliminary results suggest hepatic blood flow may be a reliable predictor of graft viability and function. Of the variables measured, portal blood flow seems to be the most valuable indicator of liver function.

Bile↗