Biomedical subjects
Publications and source records attributed to M Kudla.
The authors present a case-review of a polymorbid patient, who underwent repetitive endoscopic transgastric drainage of the pancreatic pseudocyst in chronic pancreatitis. 3 months after the stents were released, the terminal ileus perforated. Ileocaecal resection was then completed. Further postoperative course was uncomplicated and the patient's current clinical condition is good.
The aim of our study was to test the immunosuppressive effect of gemcitabine in monotherapy following heterotopic SBT in the rat. The BN and LEW rats were used as donors and recipients, respectively. Recipients were divided into 4 groups--group A without immunosuppression, group B treated with a therapeutic dose of tacrolimus, groups C and D treated with various doses of gemcitabine (100 and 150 microg/kg/day). Immunosuppression was administered once a day for 7 days after SBT, when the animals were sacrificed and a histological examination of grafts was performed. Only in group B no signs of acute rejection were seen. Significant differences (P < 0.01) were noted only between group B versus groups A, C, and D. No significant differences were demonstrated between groups A versus groups C, D and between group C versus group D. Monotherapy by gemcitabine (when administered at given doses) was not shown to be effective in preventing acute rejection in a rat model of heterotopic SBT.
Intestinal transplantation is the logical alternative to definitive total parenteral nutrition in patients with chronic intestinal failure. It has become a lifesaving procedure for patients with intestinal failure who cannot be treated using conventional therapies. In children (over 50% of the recipients) indications include short gut syndrome, primary disorders of intestinal motility and mucosal diseases. In adults, the major indication for intestinal transplantation is inadaptable short bowel syndrome after total or subtotal resection. Patients with irreversible intestinal failure and total parenteral nutrition dependency without consistent liver disease must be considered as candidates for isolated small bowel transplantation. Patients with irreversible intestinal failure and end-stage liver diseases are candidates for lifesaving procedure such as combined liver-small bowel transplantation. The appropriate timing for transplantation remains vague. Advanced disease has further consequences because a considerable number of patients may die of progressive liver failure or infection before suitable organs are available. Candidates for intestinal transplantation should be assessed early and should undergo transplantation.
Small bowel transplantation (SBT) has recently the attention of clinicians as an alternative to management of patients with irreversible bowel failure. In this paper, the authors provide an overview of basic facts regarding SBT in experimental and clinical medicine. The paper describes the evolution of bowel transplantation in experiment before it was introduced into clinical practice. In the part discussing clinical SBT, the author's report the currently available international data on SBT. In its conclusion, the paper presents the authors own experience with experimental SBT in animals and humans (Ref. 15).
The aim of this work is to describe a procedure of primary reconstruction of the lymphatic vessels on a model of heterotopic intestine transplantation in a rat. Both the donor and the recipient part of the procedure are described in a detail, as well as diagnostic methods of postoperative patency of the lympahatic anastomosis. In the end, the authors' own trial group is presented. However, no statistically significant differences were detected in histological findings of the intestinal graft rejection in rats with lymphatic anastomosis, compared with the control group.
OBJECTIVE: of this study was to assess daily rhythm of androstendione (delta4alpha) and free testosterone (FT) levels in postmenopausal asthmatic women before and after hormonal replacement therapy and the influence of inhaled glucocorticosteroids (GC). METHODS: 54 asthmatic and 20 healthy postmenopausal women (aged 48-59) before and after 6 months of estrogen plus progestin therapy (EPT) were studied. Hormone concentrations in serum (delta4alpha and FT) were assessed with the use of RIA method. Statistical analysis of the circadian rhythm was performed with the use of cosinor test according to Halberg et al RESULTS: Cosinor analysis of delta4alpha and FT secretion during the day showed existence of daily rhythm in three studied groups before as well as after postmenopausal hormone therapy (HT). A statistically significant decrease of circadian concentrations of delta4alpha and FT in groups of patients treated with GC was observed. Changes in amplitude of delta4alpha and FT rhythm between studied groups were not observed. However, displacement of rhythm acrophase of studied hormones in asthmatic women in comparison to control group before and after HT was shown. No significant differences in circadian values of delta4alpha and FT concentrations before HT use compared to values after HT were shown. CONCLUSIONS: Postmenopausal asthmatic women show diminished circadian concentrations of androstendione and free testosterone in serum caused among other things by inhalative GC. Postmenopausal hormone therapy did not influence any changes in function of studied endocrine organs.
OBJECTIVE: To assess mean 24-h serum concentrations of dehydroepianrosterone (DHEAS) in postmenopausal women with asthma before and after hormone replacement therapy (HRT). METHODS: Studies were performed in 55 asthmatic and 20 healthy postmenopausal women aged 48-60 before HRT and after 6 months of transdermal 17b-estradiol (E2) and medroxyprogesterone acetate treatment (cyclical method). Serum DHEAS concentrations were assessed with the use of RIA method. RESULTS: In the group of postmenopausal asthmatic women treated with glucocorticoids the mean 24 h DHEAS serum levels were lower than in a similar group not treated with glucocorticoids and a control group of healthy postmenopausal women. However, in both groups of asthmatic women (e.g. glucocorticoid treated and untreated) a significant increase of mean daily DHEAS levels after 6 months of HRT was observed. The hormone concentrations did not change in control group. CONCLUSIONS: Postmenopausal asthmatic women show diminished circadian dehydroepiandrosterone sulphate serum concentrations irrespective whether they were treated with glucocorticoids or not. However, after 6 months of hormonal replacement therapy in these groups increased levels of DHEA were found.
OBJECTIVES: Assessment of mean 24 h oestradiol (E2) and oestrone (E1) concentration and basic FSH secretion in postmenopausal asthmatic women, before and after HRT use, and to identify any connections between changes in hormone concentrations and patients' clinical state. SUBJECTS: Postmenopausal women (55 asthmatic and 20 healthy, aged 48-60 years). METHOD: Serum hormone concentration was assessed by radioimmunoassay before HRT and after 6 months of transdermal 17beta-E2 and medroxyprogesterone acetate treatment (cyclical method). Intensification of menopausal symptoms was assessed by Kupperman's index. RESULTS: Secretion of oestrogens was lower in postmenopausal women asthmatic women than in postmenopausal healthy women. HRT caused an increase in oestrogen concentration. The 24-h fluctuations of E1 and E2 in all studied groups before and after HRT did not differ significantly. A statistically significant decrease in the number of menopausal symptoms was found during the course of HRT. During the period of HRT, there was a reduction in the number of patients in whom it was necessary to use oral glucocorticoid therapy during exacerbation of asthma. CONCLUSION: A greater reduction in oestrogen secretion was found in postmenopausal asthmatic women than in postmenopausal healthy women. HRT resulted in normalization of serum oestrogen concentration in asthmatic women and diminishing psychosomatic symptoms of the menopause and symptoms of asthma.
Forty one patients (21 women and 20 men aged 35 to 45 years), with bronchial asthma were divided into two groups: those treated with glucocorticoids (with an equivalent daily dose of 8 mg prednisone) and those receiving no glucocorticoid preparations. The control group consisted of 27 healthy volunteers. The diurnal rhythm of serum melatonin, ACTH and cortisol was evaluated in all subjects. It was found that the dysfunction and reduced reactivity of the pituitary-adrenal axis in asthmatics receiving chronic glucocorticotherapy was accompanied by suppressed melatonin rhythm.