Biomedical subjects

Michał Nowicki

Publications and source records attributed to Michał Nowicki.

At least 19 recordsLinked to original sources

PubMed2006

Serum chromogranin A concentration and intradialytic hypotension in chronic haemodialysis patients.

AIM: The aim of this study was to investigate the influence of haemodialysis on plasma chromogranin A (CgA) concentration and to assess the relationship between CgA, blood pressure, occurrence of intradialytic hypotension episodes and residual renal function, respectively. METHODS: The study included 38 chronic haemodialysis patients (24 M, 14 F; mean age 56.2+/-13.6 years). Plasma CgA and blood pressure were measured before and after a mid-week dialysis. Control group included 10 age- and sex-matched healthy subjects. RESULTS: Plasma CgA levels were on average 50-fold higher in HD patients than in the controls (699+/-138 vs. 14+/-6 U/L). In HD patients plasma CgA corrected for ultrafiltration rates significantly increased (to 836+/-214 U/L, P<0.001) at the end of dialysis procedure. In patients with (n=8) and without frequent symptomatic intradialytic hypotension episodes predialysis values of CgA were similar (701+/-169 vs. 698+/-132 U/L) but post-dialysis were significantly lower in the former group (746+/-312 vs. 860+/-177 U/L; P=0.03) despite a similar rate of ultrafiltration (2675+/-1009 and 2583+/-1311 ml, respectively). Accordingly, in patients with intradialytic hypotension an increase of plasma CgA during dialysis was also much lower than in patients without hypotension (45+/-81 vs. 163+/-144 U/L; P=0.001). CONCLUSIONS: CgA undergoes marked accumulation in renal failure. The increase of plasma CgA during dialysis is impaired in subjects with intradialytic hypotension episodes, which confirms the role of autonomic dysfunction in the pathogenesis of this complication.

Chromogranin A↗

PubMed2006

Correlates of habitual physical activity in chronic haemodialysis patients.

BACKGROUND: Results of physical performance tests may not reflect the level of habitual physical activity and health status of the dialysis patients. The aim of our study was to assess interdialytic spontaneous physical activity in chronic haemodialysis (HD) patients in relation to their nutritional status, severity of anaemia, inflammation and dialysis adequacy. METHODS: Sixty HD patients [27 female, 33 male; mean age 60+/-13 years, time on dialysis 46.2+/-62.1 months and body mass index (BMI) 25.1+/-4.7 kg/m2] without physical and neurological disabilities and 16 healthy individuals (10 female, six male, mean age 56+/-6 years, BMI 26.6+/-4.9 kg/m2) were enrolled into the study. In all patients, spontaneous daily physical activity was measured during 48 h between mid-week dialysis sessions by pedometers. Nutritional status was estimated by anthropometric methods (BMI and mid-arm muscle circumference) and serum albumin concentration. Additionally, body composition was estimated using a multifrequency phase-sensitive bioimpedance analysis (BIA). Severity of anaemia was determined by blood haemoglobin level and haematocrit value, and the presence of inflammatory state was determined by high sensitivity plasma C-reactive (CRP) protein measurements. RESULTS: The total number of steps during daily activities in dialysis patients and in healthy individuals was 6896+/-2357 vs 14 181+/-5383 per 48 h, respectively (P<0.001). Dialysis patients showed typical signs of malnutrition in the BIA, i.e. high extracellular mass/body cell mass index (1.17+/-0.28 in dialysis patients vs 0.97+/-0.1 in controls; P<0.001), low percentage cell mass (46.7+/-5.6 and 51.0+/-3.6, respectively; P = 0.002) and low phase angle (5.1+/-0.9 and 5.8+/-0.7, respectively; P = 0.006). Dialysis patients also showed lower serum albumin and blood haemoglobin and higher serum CRP levels than healthy controls. In dialysis patients, the number of steps taken positively correlated with body water (R = 0.28, P = 0.03), fat mass (r = 0.29, P = 0.04), BMI (R = 0.25, P = 0.04), lean body mass (R = 0.26, P = 0.04), intracellular water (r = 0.30, P<0.01), phase angle (R = 0.40, P = 0.002), serum albumin (R = 0.32, P = 0.01), haematocrit (R = 0.46, P = 0.001) and haemoglobin (R = 0.44, P = 0.001). Furthermore, the number of steps taken correlated significantly with mid-arm muscle circumference (r = 0.35, P = 0.006). A negative correlation was found between the number of steps and extracellular mass/body cell mass index (R = -0.37; P = 0.004). No significant relationships were found between the measures of physical activity and high sensitivity CRP or adequacy of dialysis. Multiple regression analysis revealed the independent associations between the number of steps taken by the patients and haemoglobin concentration, age, total body water, extracellular mass/body cell mass index and phase angle. CONCLUSIONS: Low habitual physical activity assessed in HD patients with simple portable pedometers is strongly related to several factors of major clinical importance in this population.

Aged↗

PubMed2006

Prognostic significance of Ki67-negative blast cell clone in the high risk group of children treated for acute myeloid leukaemia.

The aim of this study was to demonstrate the value of immunocytochemical staining of Ki67 antigen expression in blast cells of children with acute myeloid leukemia (AML) and to evaluate its correlation with treatment failure. The material included bone marrow specimens obtained during induction treatment from 46 children treated for AML between 1998-2003. Immunocytochemical staining for Ki67 was based on the ABC technique. Expression of Ki67 antigen on day 0 of induction treatment was confirmed in all patients. The percentage of immunopositive blasts ranged from 88.4% to 99.8% (mean 91.8%). On day 15, according to chemotherapy response, patients were divided into two groups: G1-36 children who responded to induction treatment and reached remission (blast level 5%, low risk group) and G2-10 patients who did not meet remission criterion (blast level > 5%) and were assigned to the high risk (HR) group. Out of 10 children assigned to this group, Ki67 expression in blast cells was confirmed in 4 cases. The fraction of immunopositive blasts ranged from 78.4% to 88.6%. In the other 6 cases, blasts were Ki67-negative. In 12-month period after beginning the treatment, 18 cases of treatment failure (including 7 deceases) were observed in both groups. Five deaths, observed in the HR group, concerned the patients characterized by Ki67-negative blasts. The results indicate a possible correlation between the Ki67-immunonegative blast pattern on day 15 of treatment induction and early decease of AML children assigned to HR group.

Antineoplastic Agents↗

PubMed2006

[Hormonal activity of the hypophysial-gonadal axis versus the mineral bone density and specific markers of bone turnover in haemodialysis population].

UNLABELLED: Among the numerous complications associated with chronic renal disease both bone and hormonal disturbances have long been recognized. The aim of this study was to assess the relations between bone mineral density, gonadal status and specific markers of bone turnover in haemodialysis (HD) population. MATERIAL AND METHODS: We performed a cross-sectional study involving 40 HD patients: 27 men (mean age 54 +/- 14, 2 years) and 13 women (mean age 58.9 +/- 9.8 years), mean HD time 68 +/- 43 months. Serum levels of testosterone, estradiol, LH, FSH, osteocalcin (OC), beta-CrossLaps, iPTH and alkaline phosphatase (ALP) were measured. Bone mineral density (BMD) was estimated in the lumbar spine and in the femoral neck using dual energy absorptiometry (DXA). RESULTS: 67.5% of HD patients showed a low BMD. Diagnostic criteria of osteoporosis were fulfilled by 32.5% of subjects, they were found more frequently in women (38.5%) than in men (29.6%). Osteopenia was observed in 35% of patients, more frequent in women (46.2%) than in men (29.6%). Mean serum levels of FSH and LH were above the normal range and they were higher in women that in men. The serum levels of estradiol in women were below normal range in 11 from 13 subjects (84.6%). The mean serum testosterone concentrations in HD men were in normal range. We also observed a positive correlation between serum beta-CrossLaps concentrations and PTH (in men p < 0.001, r = 0.66; in women p < 0.006, r = 0.71) and between serum OC levels and PTH (in men p < 0.02, r = 0.44; in women p < 0.01, r = 0.65), respectively. CONCLUSIONS; The frequency of low bone mineral density in haemodialysis patients is high, more common in women. Hypergonadotropic hypogonadism that occurs in dialysis patients may be one of the main risk factors of bone disturbances in these patients. The levels of bone turnover markers are mainly determined by the severity of hyperparathyroidism.

Adult↗

PubMed2006

[Chronic peritoneal dialysis in infants--preliminary results of the multicenter survey].

We retrospectively analysed peritoneal dialysis treatment in 29 infants dialysed in 9 paediatric centres in Poland in the years 1993-2004. The mean age at the start of dialysis was 4.9 +/- 3.5 months (range 2 days to 11 months), mean body mass 5.6 +/- 2.5 kg (range 2.5 to 11 kg). The mean duration of PD was 6.8 +/- 3.9 in the first year of life and total duration of the therapy 34 +/- 27 months. Of the 29 infants 4 died (2 in infancy), 11 underwent renal transplantation, in 2 children PD was stopped (they received a conventional treatment) and 12 were still dialysed at the date of data collection. The peritonitis rate was 1/9.5 patient-month and exit site infection rate 1/16 patient-month up to 1 year of life. 9 children (31%) required hernia repairs and in 9 catheters were replaced. Chronic peritoneal dialysis in infants is associated with high risk of infections and surgical complications and remains a challenge for paediatric nephrologists.

Causality↗

PubMed2006

[Wilms tumor as a novel model of angiogenesis in childood nephropathies].

Wilms tumor has a unique possibility of recapitulation within its substance different stages of renal development. Vascular endothelial growth factor (VEGF) and its receptors (VEGFR-1 and VEGFR-2) are regarded to play the crucial role in the process of simultaneous development of tubules and glomeruli in animal kidney. Neoangiogenesis, secondary to rearrangement of epithelial elements in Wilms tumor, may therefore follow the lack of glomeruli in this neoplasm. The aim of the present research was an immunohistochemical analysis of VEGF-C and VEGFR-2 expressions in Wilms tumor and an attempt of explanation of neovascularisation process in this malignancy. The study group was composed of 16 children diagnosed with Wilms tumor (stage III of clinical classification) hospitalised in Department of Paediatric Oncology, Hematology and Transplantology, University of Medical Sciences in Poznan. The indirect immunohistochemical assay with the use of monoclonal antibodies directed against VEGF-C and VEGFR-2 was employed. VEGF-C expression was detected within blastemal and hypocellular stromal components of Wilms tumor. On the other hand, immuno-reactivity of VEGFR-2 was established in dysplastic tubules in the closest proximity of VEGF-C positive parts of stromal origin. VEGF-C dependent neovascularisation in Wilms tumor may follow an adequate differentiation of already existing epithelial elements. It may also explain the process of glomeruli-dependent physiological development of kidney and, what is also probable, the phenomenon of neoangiogenesis described in individual childhood nephropathies.

Child↗

PubMed2006

[Immunohistochemical analysis of podocytopathy with immature glomeruli and glomerulosclerosis in children with nephrotic syndrome].

Idiopathic nephrotic syndrome in children may be complicated by resistance to steroids with constant proteinuria in diffuse mesangial proliferation (DMP) and focal segmental glomerulosclerosis (FSGS). In our observation, sometimes in children with steroid-resistant nephrotic syndrome, the presence of immature renal glomeruli can be detected (hypercellularity and presence of a constant layer of cubical epithelial cells on the surface of glomerular tufts, without sclerosis, resembling M-stage of glomerulo-genesis). The aim of this study was immunohistochemical analysis of the podo-cyte-associated proteins, particularly ezrin, podocalyxin, synaptopodin and nephrin in glomeruli with and without signs of immaturity in children. In DMP with signs of immaturity podo-cytes situated in the central region of the glomerulus were immunohistochemically negative. The positive reaction was observed exclusively in the most superficial continuous 'layer' of podo-cytes. The unfavourable clinical course of nephrotic syndrome with signs of glomerular immaturity may be a consequence of decreased immunohistochemical expression of cytoskeleton-specific proteins.

Biopsy, Needle↗

PubMed2006

[Assessment of the peripheral circulation in children with nephrotic syndrome treated with cyclosporin A].

Cyclosporin A (CsA) is an immunosuppressive agent used in children for the treatment of steroid-dependent idiopathic nephrotic syndrome (INS). Despite its benefitial effect on a course of the disease CsA may exert nephrotoxic effects because of its vasoconstrictive properties. CsA-dependent disorders of the peripheral flow (Raynaud phenomenon--RP) have been recently described. The aim of the study was to assess the effect of CsA on the peripheral circulation. The study group comprised 16 children (12 male, 4 female; mean age 9.8 +/- 4.5 years) treated with CsA for at least 6 months due to INS (mean treatment time 39 +/- 27 months). Thirteen age- and sex-matched individuals served as controls. Peripheral circulation disorders were evaluated by means of a cold stress test (both hands were held in lukewarm water (20 degrees C) for 1 minute and thereafter the changes in the hand temperature were recorded with thermographic camera (Inframetrics SC1000). RP assessment was performed according to the method described by Ammer and Ring. The temperature gradient of 4 degrees C or greater maintained between metacarpal and peripheral areas of a hand after 10 minutes was considered diagnostic for RP. According to these criteria RP was confirmed in only 3 patients from the study group and in 2 controls. However, the time of the temperature increase in the first 5 minutes after cooling was considerably shorter in the children with INS (0.26 +/- 0.26 degrees C/min vs 0.51 +/- 0.29 degrees C/min, p=0.02). No correlation between CsA serum concentration, CsA dose and impairment of the hand temperature increase was found. The study confirmed that in children suffering from INS treated with CsA peripheral blood flow disorders can be seen. It seems that impaired vessel reactivity may result from the vasoconstrictive effect of CsA.

Adolescent↗

PubMed2006

[Insulinsensitivity and beta-cell function in children with idiopathic nephrotic syndrome].

Glucose intolerance which is frequently found in patients with the idiopathic nephrotic syndrome (INS) may be linked to an increased cardiovascular risk in these patients. Recently it has been suggested that proteinuria and steroid treatment may independently affect insulin sensitivity. The aim of the study was to assess insulin resistance (IR) and beta-cell function in children with INS at various stages of the disease. The study group comprised 66 children (32 male, 34 female; age 8.1 +/- 5.0 years). 20 healthy, sex- and age-matched subjects served as controls. The study group was divided into 3 subgroups: A (n=24) children in relapse of INS (steroids 60 mg/m2/48h; proteinuria 1.02 +/- 1.04 g/dl); B (n=20) in remission treated with steroids (30 mg/ m2/48h); C (n=22) in remission but without steroids. Fasting glucose and insulin levels were measured to calculate insulin resistance (HOMA-IR) and beta-cell function (HOMA-beta) using Homeostatic Model Assessment. Fasting glucose was within normal range in all subjects. HOMA-IR was significantly higher in group A (3.2 +/- 3.3) and group B (2.4 +/- 1.7) than in group C (1.45 +/- 1.6 and controls (1.12 +/- 0.6) (p<0.05). HOMA-beta was significantly higher in group A and B than in C and controls (p<0.05). In multivariate analysis HOMA-IR correlated with proteinuria (beta=0.45, p<0.001), steroid dose (beta=0.32) and BMI (beta=0.42). In conclusion, an increase in insulin resistance with compensatory enhanced beta-cell secretion is a typical finding in children with INS treated with steroids. Proteinuria seems to be an independent risk factor for decreased insulin sensitivity.

Adolescent↗

PubMed2005

Hypertension in dialysed children: the prevalence and therapeutic approach in Poland--a nationwide survey.

BACKGROUND: The aim of this nationwide analysis was to assess the incidence and current treatment profile of arterial hypertension in children undergoing chronic haemodialysis or peritoneal dialysis and attitudes of paediatric nephrologists towards the choice of antihypertensive drugs in their patients. METHODS: The study group consisted of 134 children (89 males, 45 females, mean age 10.7+/-5 years) from all 13 paediatric dialysis centres in Poland. The data were gathered through a questionnaire for each patient dialysed in November 2004. RESULTS: The overall incidence of hypertension in the study group was 55% (74 of 134 patients; 47 males, 27 females). The incidence rate was similar in boys and girls (53 vs 60%) and in those on haemodialysis and peritoneal dialysis (56 vs 54%). Chronic glomerulonephritis as an underlying renal disease was significantly more frequent in the hypertensive than in the normotensive subjects (37 vs 10%, P = 0.004). Residual urine output was higher in normotensives (41 vs 10 ml/kg body weight; P < 0.001). Among those treated with antihypertensives: 32% were treated by monotherapy, 36% received two drugs, 22% received three drugs, while 7% received > or = 4 drugs. The therapy was effective in only 57% of subjects. We observed no differences in biochemical and clinical parameters between those who responded to the therapy and those who failed to do so. Calcium channel blockers constituted the most frequently administered class of drugs [73% of children; in 43 out of 48 (90%) combined with other drugs, but in 11 out of 24 (46%) as a monotherapy]. In monotherapy, angiotensin-converting enzyme inhibitors and calcium channel blockers were administered most frequently. CONCLUSION: We conclude that the incidence of hypertension in dialysis children in Poland is high (55%). The effectiveness of antihypertensive treatment is rather low (58%) and the choice of drugs is limited.

Adolescent↗

PubMed2005

[Prognostic values of serum concentration and urinary excretion of interleukin-1 receptor antagonist and tumor necrosis factor receptors type I and II in patients with IGA nephropathy].

Interleukin-1 receptor antagonist (IL-1ra) and tumor necrosis factor soluble receptors (sTNFR) type I and II reducing the activity of IL-1 and TNFalpha may inhibit inflammatory reactions. The aim of the study was to assess whether serum and urine IL-1ra and sTNFR measurements may be useful as the early predicting factors in patients with IgA nephropathy. Twenty seven patients (16 males, 11 females), mean age 41.6 +/- 22.3 years with biopsy-proven IgA nephropathy and nephrotic-range proteinuria were included in this study. Serum concentrations (sIL-1ra, ssTNFR I and II) and urinary excretions (uIL-1ra, usTNFR I and II) of IL-1ra, sTNFR I and II had been measured before the treatment was instituted. After 12 months of therapy with steroids and cyclophosphamide, the patients were divided into two subgroups i.e. R - responders, and NR - nonresponders according to the treatment results. The control groups comprised 8 healthy people. IL-1ra serum concentration and urinary excretion were lower in the patients than in the controls (202 vs 330 ng/ml and 970 vs 1607 ng/mg creatinine respectively; p < 0.05 both). Serum concentrations and urinary excretion rates of sTNFR 1 (5.1 vs 1.7 ng/ml and 4.1 vs 1.1 ng/mg creatinine respectively) and sTNFR II (14.4 vs. 5.0 ng/ml and 8.3 vs. 4.4 ng/mg creatinine respectively) were higher (p < 0.05 each) in the patients than in the controls. The subdivision of patients and their classification according to achieved treatment results showed no statistically significant differences between initial interstitium volume neither concentration of serum total protein, serum creatinine or proteinuria and glomerular filtration rate in R and NR subgroups. Initial IL-1ra serum concentration, its urinary excretion and sTNFR type I and II urinary excretion rates were significantly higher in R than NR (sIL-1ra - 297 vs 167 ng/ml, p < 0.05; uIL-1ra 1360 vs 87 ng/mg Cr, p < 0.01; and ssTNFR I 5.2 vs 2.2 ng/mg Cr, p < 0.05; ssTNF RII14 vs 6 ng/mg Cr, p < 0.05). However, serum concentration and urinary excretion of sTNF R type I and II were significantly higher in R and NR subgroups than in controls (p < 0.05 both), sIL-1ra and uIL-1ra were significantly lower in R and NR than in healthy subjects. The results of evaluations of serum concentration and urinary excretion of IL-1ra showed similar values to control group results only in responders. No statistically significant differences between sIL-1ra or/and uIL-1ra in both R and control groups were found. Increased serum concentration and urinary excretion of IL-1ra correlates with better prognosis for remission of proteinuria and lower risk of deterioration of kidney function. Those assessments may be helpful as a part of initial screening in patients with IgA nephritis and heavy proteinuria. In contrast the evaluation of both serum and urinary TNF RI and II seems to have no predictive value.

Adult↗

PubMed2005

Chronic renal failure in non-renal organ transplant recipients.

Recovery of the patients after transplantation of non-renal organs may be complicated by multi-faceted chronic renal failure (CKD) which is regarded as an independent risk factor of graft dysfunction and mortality. The occurrence of CKD in non-renal transplant recipients depends mainly on a type of transplanted organ, immunosuppressive protocol and pre-transplant kidney dysfunction. Several concomitant diseases including arterial hypertension, dyslipidemia, diabetes mellitus, hepatitis or perioperative renal injury may contribute to chronic kidney disease. Current data suggest that a problem of kidney insufficiency in non-renal organ transplant recipients may still be underscored. Clinicians ought be aware that renal dysfunction should be added to a list of major post-transplant complications.

Calcineurin Inhibitors↗

PubMed2005

[Microalbuminuria--underestimated cardiovascular risk factor].

The term microalbuminuria stands for an increased urinary excretion of albumin undetectable by routine methods for determination of proteinuria. Microalbuminuria is found in a substantial proportion of patients with diabetes, arterial hypertension and in the elderly. New data has provided strong evidence that albuminuria not only indicates early glomerular damage but also widespread endothelial dysfunction, early atherogenesis and increased cardiovascular and cerebrovascular risk. It has been shown that angiotensin converting enzyme inhibitors have a potential to decrease urinary albumin excretion, which confirms their well-established nephro- and vasoprotective action.

Albuminuria↗

PubMed2004

Cyclosporin A does not affect platelets in children with idiopathic nephrotic syndrome.

The immunosuppressive agents administered to maintain the remission of idiopathic nephrotic syndrome (INS) may have a deleterious effect on several cell types. The aim of this study was to analyze platelet activation and reactivity in children with INS treated with cyclosporin A (CyA). The study groups comprised 16 children with remission of INS induced by CyA and 16 children with glucocorticosteroid-induced remission 8 weeks from the onset of INS relapse. Fifteen healthy children served as controls. Surface expression of CD61, CD62P, and CD42b on resting and thrombin-stimulated platelets was analyzed with flow cytometry. No differences between groups were found in CD61, CD62P, and CD42b surface expression, but markers of the coagulation cascade and fibrinolysis or endothelial injury (F1+2 prothrombin fragments, tissue plasminogen activator inhibitor 1) were elevated in patients treated with CyA compared with children on steroids and healthy controls. No correlations between markers of platelet function and CyA concentration were found. We postulate that CyA administration in nephrotic patients causes an activation of thrombinogenesis but does not influence platelet activation and reactivity in INS.

Adolescent↗

PubMed2004

Raynaud's phenomenon and endothelial dysfunction in end-stage renal disease patients treated with hemodialysis.

BACKGROUND/AIMS: Steal syndrome is a well-known complication of arteriovenous shunt placement. Increased frequency of Raynaud's phenomenon (RP) especially concerning shunt limb is reported among hemodialysis (HD) patients. The aim of the study was to assess the relation of impairment of peripheral circulation diagnosed with cold stress test (CST) and thermography to the AV shunt location and markers of endothelial dysfunction in HD patients. METHODS: The study group comprised 21 patients (6 male, 15 female, mean age 32.6 +/- 15.0 years) treated with HD for a mean of 69 +/- 54 months. 10 healthy individuals (4 male, 6 female, mean age 38.6 +/- 14.7 years) served as controls. The diagnosis of RP was made upon the results of thermographic measurements during CST. Von Willebrand factor activity and antigen, endothelin-1 and plasma total homocysteine (tHcy) were measured in all subjects. RESULTS: RP was found significantly more often in HD patients than in controls: 11/21 vs. 1/10 (p = 0.04). RP occurred in both hands in 7/11 (64%) patients. tHcy was higher in HD patients than in the controls (31.7 +/- 13.9 vs. 10.9 +/- 3.2 microg/l, p < 0.0001). tHcy and von Willebrand factor antigen were significantly higher in the RP-positive than RP-negative patients or controls. CONCLUSION: Small vessel dysfunction diagnosed as positive RP is a frequent finding in HD patients. It seems that endothelial injury rather than AV shunt steal syndrome is responsible for development of RP in HD patients.

Adolescent↗

PubMed2004

Expression of intermediate filaments of podocytes within nephrotic syndrome glomerulopathies in children.

The study attempted to define characteristics of renal podocytes in nephrotic syndrome glomerulopathies in children with and without glomerular immaturity based on the histochemical expression of cytokeratin 18 (CK 18) and vimentin. Material consisted of 29 renal biopsies performed in the Department of Pediatric Nephrology, Poznan University of Medical Sciences, between 1991 and 2000. The study group included 16 children with mesangial glomerulonephritis (MesGN) and signs of glomerular immaturity and 13 children with MesGN without signs of glomerular immaturity. The control tissue was derived from macroscopically normal renal cortex taken from kidneys resected for localised neoplasms ( n=3). In the control samples, the immunocytochemical expression of CK 18 was found only in epithelial cells of proximal and distal tubules. Vimentin was present in all podocytes, some mesangial cells and endothelium. In all cases of children with MesGN with signs of immaturity, both CK 18-positive and vimentin-positive podocytes were found. In all cases of MesGN without immaturity we revealed CK 18-negative podocytes but with distinct vimentin-positive expression. Reorganisation of cytoskeletal proteins within immature podocytes may be associated with the unfavourable clinical course of nephrotic syndrome in children. The application of antibodies against intermediate filaments may help to differentiate between mature and immature forms of MesGN.

Child, Preschool↗

PubMed2004

Increased cystatin C concentration in urine of nephrotic children.

The aim of this study was to evaluate changes in urine and plasma concentrations of cystatin C in children with a relapse of the idiopathic nephrotic syndrome(INS). The study group comprised 12 children with INS with proteinuria and 12 children in an 8-week remission,both treated with steroids. Twelve healthy children served as controls. Cystatin C was detectable in the urine of children with proteinuria. The study suggests that massive proteinuria may influence renal cystatin C handling.

Adolescent↗

PubMed2004

[Respiratory tract diseases in the elderly].

According to recent definitions the person enters a senile age after 65. Each person starts ageing after the completion of maturation. The phenomenon of ageing is highly individual and differs among people with respect to its rate and affected systems and organs. This may be responsible for a frequent inequality of metrical and biological age. Ageing is a multisystem process which also leads to alterations in symptomatology of many diseases. The process of ageing has been very well described, especially in the cardiovascular system. In contrast, ageing of the respiratory tract is far less recognised and still remains a subject of debates. The elderly are affected by the same diseases as younger individuals. The most common diseases at this age are respiratory tract infections, tuberculosis, chronic obstructive pulmonary diseases and bronchial asthma. Their course may be, however, different in the elderly not only due to the physiologic process of ageing but also frequent comorbidities. This fact should be taken into account when establishing a diagnosis and treatment regimens. A therapy of the older person usually requires a highly individualized approach.

Age Factors↗