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Biomedical subjects

Petr Bachleda

Publications and source records attributed to Petr Bachleda.

24 records · Page 2Linked to original sources

Primary cultures of human hepatocytes as a tool in cytotoxicity studies: cell protection against model toxins by flavonolignans obtained from Silybum marianum.

The aim of this study was to evaluate the cytoprotective effects upon primary human hepatocytes of silymarin extract and its main flavonolignans following exposure to the cytotoxic actions of model toxins. The conditions for the hepatocyte intoxication were optimised for allyl alcohol, carbon tetrachloride, D-galactosamine and paracetamol. Silymarin extract, silychristin and silydianin did not exert cytotoxicity (10-100 microM), whereas silybin and isosilybin at higher concentrations and after longer incubation periods were cytotoxic. All main flavonolignans of silymarin tested displayed concentration-dependent cytoprotection against the toxic effects of both allyl alcohol and carbon tetrachloride but neither paracetamol nor galactosamine. The best protection was achieved by silydianin and silychristin and to a lesser degree by silymarin, while silybin and isosilybin were less effective. It is concluded that these differing outcomes result from the varying abilities of the Silybum marianum substances tested to stabilize the cell membrane, exert antioxidant properties and exhibit intrinsic toxicity.

Acetaminophen↗

Selected indicators of bone metabolism in patients after kidney transplant.

Bone metabolism defects and skeleton diseases, so called renal osteopathy (RO), represent very serious clinical problems in the care of patients with kidney dysfunction. Renal osteopathy is a complicated skeletal disorder with a very complicated pathogenesis and we can encounter its individual forms in kidney transplant patients.

Bone Density↗

Protocol biopsy and subclinical rejection in patients after kidney transplantation treated by tacrolimus (Prograf).

The article deals with the contribution of tacrolimus (Prograf) to improvement in kidney transplant results. Tacrolimus, in comparison with cyclosporine significantly reduces the incidence of acute rejection and improves survival of grafts as well as patients. Based on the literature, the primary immunological differences between tacrolimus and cyclosporine effects are pointed out. These differences explain the better immunosuppressive effectiveness of tacrolimus. Based on analysis of the results, subclinical rejection problems and significance of protocol biopsy for present-day transplantology are discussed. There is also a critical analysis of the questions, which priority, in relationship to the expanding availability of immunosuppressive substances currently has high interest for nephrologists researching subclinical rejection.

Biopsy, Needle↗

Endovascular treatment of central venous stenoses in patients with dialysis shunts.

OBJECTIVE: Evaluation of long-term results of percutaneous treatment of central vein stenoses or occlusions in patients with haemodialysis shunt. MATERIALS AND METHODS: In 26 patients with haemodialysis shunts and confirmed central vein stenosis or occlusion, 28 primary percutaneous transluminal angioplasties (PTA) and 5 repeated PTAs (re-PTA) were performed; in three patients a stent was implanted - primary in one patient and due to early restenosis after PTA in two patients. To maintain stent patency, 10 re-PTA were performed. RESULTS: The technical success rate of primary interventions was 96 % (100 % in stenoses and 50 % in occlusions). Primary post-PTA patency rate was 70 % at 3 months, 60 % at 6 months and 30 % at 12 months. CONCLUSION: PTA with possible stent implantation is a first-choice method in the treatment of stenoses and occlusions of the central venous system. Despite the relatively frequent re-interventions, endovascular treatment is capable to preserve long-term function of the dialysis shunt.

Adult↗

Effect of various protective solutions on function after kidney transplantation.

UNLABELLED: From 1995 to 2002 we monitored a group of 127 patients who had undergone kidney transplantations in the Olomouc transplantation centre. The aim of our study was to assess the function of the kidneys after the transplantation, which were rinsed during the removal from cadaverous donors and afterwards were treated by different preservative dilutions. We divided the patients into three groups of approximate similar size, according to the used dilution - EC (Eurocollins), HTK (Custodiol) and UW (Viaspan). In the first three weeks we assessed in each group, the immediate function of the kidneys as primary, belated and afunction. The EC group showed the primary function in 51.2 % of cases, belated in 46.8 % of cases and afunction in 2.1 % of cases. In the HTK group, primary function was found in 73.7 %, belated 23.6 % and afunction 2.7 %. The results of the UW group came to primary function 71.5 %, belated 26.2 % and afunction 2.3 %. The criteria of the immediate but also the long-term function (five year investigation) was a serum creatinine figure. The lowest decline of creatinine in three weeks after the transplantation was noticed in the EC group (the average figure = 429 micro mol/l). In contrast the HTK group (the average figure 279 micro mol/l) and the UW group (the average figure 288 micro mol/l) had comparable figures and there was no significant difference between them from the statistical point of view. It means later in the first, the third and the fifth year after the transplantation the figures levelled out: EC 154 micro m/l, HTK 182 micro m/l, and UW 133 micro m/l. There was statistically a minimum significant difference between the HTK group and the UW group. Another criteria was to determine the amount of functional grafts in alive donees. The Assessment was carried out always in each year after the transplantation, altogether five years. The amount of the functional renal grafts in EC and HTK group was 100 %, in the UW group 76.9 %. CONCLUSION: HTK and UW gave better immediate functionality results, but there were no differences found among EC, HTK and the UW group from the long-term point of view.

Adult↗

Safety and efficacy of an alternative basiliximab (Simulect) regimen after renal transplantation: administration of a single 40-mg dose on the first postoperative day in patients receiving triple therapy with azathioprine.

This was a multi-center, open-label, randomized, dose-comparative study on 202 renal transplantation patients. We evaluated for the first time an alternative dosing regimen for basiliximab, consisting of a single 40-mg intravenous dose on day 1 post-transplantation plus triple therapy, in comparison with the conventional two-dose regimen (2 h before transplantation and on day 4) plus triple therapy. At 6 months, the incidence of acute rejection was low: 22.5% of patients in the basiliximab 2 x 20-mg group and 20.0% of patients in the basiliximab 1 x 40-mg group experienced an acute rejection episode ( P = 0.628) (biopsy-proven rejection: 19.6% and 17.0%, P = 0.585). There was no statistically significant difference in any of the secondary efficacy parameters. The incidence of graft loss by 12 months was 4.9% and 6.0% in the 2 x 20-mg and 1 x 40-mg group, respectively ( P = 0.73). No differences were observed between the dosage groups with regards to safety assessments (adverse events (AEs), infections, vital signs, laboratory safety evaluations, and physical examinations). The data reveal that basiliximab can be safely and effectively administered as a single 40-mg dose on day 1 after renal transplantation as a therapeutic option to the established 2 x 20-mg dosing regimen. This alternative dosing regimen may be of significant convenience under circumstances when a first dose of basiliximab was not given prior to transplantation. Both regimens can conveniently be used during the initial hospitalization of the patient.

Acute Disease↗