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Bujko K, Pietrzak L, Partycki M, Szczepkowski M, Wyrwicz L, Rupiński M, Rutkowski A, Mróz A. The feasibility of short-course radiotherapy in a watch-and-wait policy for rectal cancer. Acta Oncol 2017; 56:1152-1154. [PMID: 28537787 DOI: 10.1080/0284186x.2017.1327721] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- K. Bujko
- Department of Radiotherapy, M. Skłodowska-Curie Memorial Cancer Centre, Warsaw, Poland
| | - L. Pietrzak
- Department of Radiotherapy, M. Skłodowska-Curie Memorial Cancer Centre, Warsaw, Poland
| | - M. Partycki
- Department of Radiotherapy, M. Skłodowska-Curie Memorial Cancer Centre, Warsaw, Poland
| | - M. Szczepkowski
- Department of Colorectal, General and Oncological Surgery, Centre of Postgraduate Medical Education in Warsaw, Warsaw, Poland
- Clinical Department of General and Colorectal Surgery, Bielański Hospital Warsaw, Warsaw, Poland
| | - L. Wyrwicz
- Department of Gastroenterological Oncology, Maria Skłodowska-Curie Memorial Cancer Centre, Warsaw, Warsaw, Poland
| | - M. Rupiński
- Department of Gastroenterological Oncology, Maria Skłodowska-Curie Memorial Cancer Centre, Warsaw, Warsaw, Poland
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - A. Mróz
- Department of Gastroenterological Oncology, Maria Skłodowska-Curie Memorial Cancer Centre, Warsaw, Warsaw, Poland
- Department of Pathology and Laboratory Medicine, M. Skłodowska-Curie Memorial Cancer Centre, Warsaw, Poland
- Department of Patomorphology, Centre of Postgraduate Medical Education, Warsaw, Poland
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Ostrowska J, Pazik J, Lewandowski Z, Mróz A, Perkowska-Ptasińska A, Durlik M. Posttransplantation glomerulonephritis: risk factors associated with kidney allograft loss. Transplant Proc 2008; 39:2751-3. [PMID: 18021977 DOI: 10.1016/j.transproceed.2007.08.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AIM OF THE STUDY Chronic glomerulonephritis (GN) is reported as a common cause of late kidney allograft loss. The aim of this study was to identify risk factors associated with kidney allograft loss in the course of posttransplantation GN. PATIENTS AND METHODS The study analyzed 75 kidney allograft recipients with biopsy-confirmed posttransplantation GN, including 27 cases of immunoglobulin (Ig)A nephropathy (IgAN), 30 of membranous GN (MGN), 6 of mesangiocapillary GN (MCGN); and 12 of focal segmental GN (FSGS). The risk factors for kidney allograft loss, defined as dialysis reintroduction after GN onset, were identified through are historical cohort study. CLINICAL FINDINGS After the onset of posttransplantation GN, the median time to dialysis introduction was 46 months. The risk factors for kidney allograft loss were as follows: male gender (hazard ratio [HR] = 1.92; 95% confidence intervall [CI] 1.0-3.70; P = .052), initial unsatisfactory kidney function (HR = 1.86 per 1 mg/dL serum creatinine increment; 95% CI 1.0-3.46; P < .05), graft dysfunction at diagnosis (HR = 1.65 per 1 mg/dL serum creatinine increment; 95% CI 1.32-2.07; P < .001), nephrotic syndrome (HR = 2.3; 95% CI 1.13-4.99; P < .05) late-onset GN (HR = 1.1 per each additional year of observation, 95% CI 1.0-1.21; P < .05), and MPGN as a type of GN. Enhanced immunosuppression increased and ACEI and/or statin treatment decreased the risk of return to dialysis, respectively: HR = 1.56, 95% CI 0.76-3.18, P = .22; HR = 0.39, 95% CI 0.16-0.98, P = .0037; and HR = 0.367, 95% CI 0.15-0.88, P = .025. CONCLUSIONS Identification of risk factors can help discover patients who will have a faster progression to kidney allograft loss due to GN. In posttransplantation GN, statins and/or ACEI should be prescribed, if there are no contraindications.
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Affiliation(s)
- J Ostrowska
- Department of Transplantation Medicine and Nephrology, Transplantation Institute, Medical University of Warsaw, Warsaw, Poland.
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Abstract
Wingate test is short anaerobic exercise, performed with maximal power, whereas aerobic exercise at 85% maximal heart rate (HR(max)) may be performed for long period. Sustained HR elevations and changes in autonomic activity indices have been observed after latter kind of exercise. Several studies reported reduction in mean interval between consecutive R peaks in ECG (RRI) 1 h after Wingate test; however, underlying changes in autonomic activity remain elusive. In eight young males, RRI and heart rate variability (HRV) were measured daily over two 5-day trials. Subjects exercised on third day of each trial, measurements were taken 1 h after (i) two consecutive 30-s bouts of Wingate tests or (ii) after a 30-min exercise at 85% HR(max), with subjects in supine rest and breathing either spontaneously or at controlled rates of 6 and 15 breaths / min. RRI was significantly shorter after Wingate and submaximal exercise, reduction of high- and low-frequency components of HRV attained reliability only after Wingate tests. This pattern remained preserved for three modes of breathing: spontaneous, 6 and 15 breaths /min. After 24 and 48 h, no exercise effects were traceable. We hypothesize that (i) anaerobic exertion is followed by sustained inhibition of vagal activity, (ii) parasympathetic system plays dominant role in mediating suppression of high- and low-HRV frequency components during postexercise recovery, (iii) degree of alteration of autonomic activity caused by anaerobic and strenuous aerobic exercise may be similar and (iv) normalization of vagal activity precedes normalization of sympathetic cardiac nerves activity during final stage of postexercise recovery.
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Affiliation(s)
- W Niewiadomski
- Department of Applied Physiology, Medical Research Center, Polish Academy of Sciences, 5 Pawinski Street, 02-106 Warsaw, Poland.
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Górski A, Kniotek M, Perkowska-Ptasińska A, Mróz A, Przerwa A, Gorczyca W, Dabrowska K, Weber-Dabrowska B, Nowaczyk M. Bacteriophages and transplantation tolerance. Transplant Proc 2006; 38:331-3. [PMID: 16504739 DOI: 10.1016/j.transproceed.2005.12.073] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Our recent findings suggest that bacteriophages (phages) may not only eliminate bacteria, but also modulate immune functions. In this communication, we demonstrate that phages may strongly inhibit human T-cell activation and proliferation as well as activation of the nuclear transcription factor NF-kappaB in response to a viral pathogen. Phage administration in vivo can diminish cellular infiltration of allogeneic skin allografts. Thus, phage treatment should be considered in antibiotic-resistant posttransplantation infections. Furthermore, phages could find a broader application in clinical transplantation.
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Affiliation(s)
- A Górski
- Transplantation Institute, Warsaw Medical University, 02-006 Warsaw, Poland
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Pazik J, Baczkowska T, Lewandowski Z, Lewandowska D, Ostrowska J, Perkowska Ptasińska A, Mróz A, Miszewska-Szyszkowska D, Rowinski W, Durlik M. IgA Nephropathy in Kidney Allograft Recipients—Therapeutic Perspective. Transplant Proc 2006; 38:112-4. [PMID: 16504678 DOI: 10.1016/j.transproceed.2005.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION A growing number of patients are losing their kidney allografts due to glomerulonephritis. Although posttransplant IgA nephropathy (IgAN) is regarded as benign, it may lead to late allograft loss in a substantial number of patients. The aim of this study was to evaluate the influence of posttransplant IgAN on long-term transplantation outcomes, risk factors for progression of graft dysfunction, and effectiveness of therapeutic interventions. PATIENTS AND METHODS We evaluated, potential risk factors for accelerated graft loss among 27 kidney allograft recipients with posttransplant IgAN, comparing graft survival in a control group matched for population and transplantation-related parameters. We evaluated the effectiveness of therapeutic interventions regarding immunosuppressive regimen, and hypertension control including angiotensin converting enzyme inhibitor (ACEI) usage with Kaplan-Meier, Cox proportional hazard plots, and log-rank tests in statistical analyses. RESULTS Compared with the control group, patients with IgAN experienced a 6.57 higher risk for dialysis dependence (P < .01, 95% CI 1.4 to 30.83). The risk for accelerated graft loss in the course of IgAN was associated with graft dysfunction (RR = 2.16 for additional 1 mg/dL of serum creatinine at glomerulonephritis presentation; P < .03, 95% CI 1.2 to 4.36) and intense proteinuria as evidenced by a RR = 4.67 for the presence of the nephrotic syndrome (P < .05, 95% CI 0.95 to 22.8). Immunosuppression enhancement resulted in a significantly decreased risk of dialysis dependence, namely, RR = 4.76 (95% CI 1.12 to 20, P < .04). With ACEI treatment there was a tendency for a 2.8-fold decreased risk of dialysis dependence, without reaching statistical significance (P = .14). CONCLUSIONS Patients with posttransplant IgAN may benefit from intensifying maintenance immunosuppression, which slows progression to end-stage graft dysfunction.
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Affiliation(s)
- J Pazik
- Transplantation Institute, Department of Transplant Medicine and Nephrology, Warsaw Medical University, Nowogrodzka 59, 02-006 Warsaw, Poland.
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Abstract
BK virus infection has become important factor affecting graft function in renal transplant recipients. One of the most important complication of BK infection is nephropathy in patients after renal transplantation. The aim of this study was to evaluate incidence of BK reactivation and nephropathy in our population of renal allograft recipients. One hundred twelve renal or pancreas-kidney allograft recipients were included for the 24 months follow-up. The incidence of BK nephropathy was 7.85% and viremia 27.96%. In the second study group there were 28 patients with graft function deterioration evaluated at the time of biopsy. In this group incidence of BK nephropathy was 7.1% and viral reactivation was diagnosed in 10.7% of patients. In our center, the incidence of BK nephropathy is the same as worldwide. The risk of BK virus replication is highest during first 15 months after the surgical procedure.
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Affiliation(s)
- B Matłosz
- Department of Transplantation Medicine and Nephrology, Warsaw Medical School, Warsaw, Poland
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Matłosz B, Mróz A, Durlik M, Wesołowska A, Sadowska A, Cieciura T, Perkowska A, Deborska-Materkowska D, Szmidt J, Michalak G, Paczek L, Lao M. Polyomavirus BK infection. Transplant Proc 2004; 35:2196-8. [PMID: 14529886 DOI: 10.1016/s0041-1345(03)00818-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Because it is an important factor affecting renal transplant function, BK infections are significant problem in posttransplant. BK nephropathy develops in 5% of renal allograft recipients, in most cases within the first year after the procedure. The gold standard for BK nephropathy diagnosis is still immunohistochemical staining for large T antigen in graft biopsy specimens. The aim of the present study was to evaluate the incidence of and factors influencing BK nephropathy in our renal allograft population. Among 89 renal or pancreas/kidney allograft recipients, BKV DNA was detected in 1 or more serum samples in 17 patients but BK nephropathy was diagnosed in only 1 case. Plasmacytic tubulitis was an exclusive feature in PCR-positive patients with 2 (20%) cases but no such findings in the PCR-negative group. In 40% of patients in the PCR-positive group at least 1 rejection episode was diagnosed versus 22% in the PCR-negative group. There were no significant differences in both groups according to total ischemia time, immunosuppressive treatments, or mean serum creatinine at 1 year after transplantation.
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Affiliation(s)
- B Matłosz
- Department of Transplantation Medicine and Nephrology, Transplantation Institute, Warsaw, Poland
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Mróz A, Durlik M, Cieciura T, Pazik J, Baczkowska T, Chmura A, Nazarewski S, Lao M. C4d complement split product expression in chronic rejection of renal allograft. Transplant Proc 2003; 35:2190-2. [PMID: 14529884 DOI: 10.1016/s0041-1345(03)00799-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Chronic allograft rejection remains the major cause of late renal graft loss. Its pathogenesis is complex, depending on both immunological and nonimmunological factors. An important role in development of chronic rejection is ascribed to an ongoing immunological reaction mainly of the humoral type. C4d complement split product, as a stable fragment of complement degradation activated by antigen-antibody complexes, is considered to be an indicator of humoral activity in allografts. The aim of the present study was to establish a correlation between C4d expression and morphological findings specific for chronic rejection among biopsy specimens from patients with deteriorating graft function versus protocol biopsy specimens versus biopsy specimens of native kidneys with glomerular diseases. C4d deposits in peritubular capillaries and glomeruli were observed in 83% of patients with morphological changes of chronic rejection. No C4d expression was found in the protocol biopsy group. C4d deposits in glomeruli localizations were found in kidneys from patients with glomerulopathies; the pattern of distribution was similar to that for antibodies characteristic for glomerulonephritis. There was a positive correlation between C4d expression and morphological features of chronic rejection. In our opinion, only peritubular capillary localization is specific for a rejection process; glomerular localization is nonspecific and probably secondary to antigen-antibody complex deposition in course of some types of glomerulopathies.
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Affiliation(s)
- A Mróz
- Department of Transplantation Medicine and Nephrology, Transplantation Institute Warsaw, Warsaw, Poland
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Gałasińska-Pomykoł I, Mróz A, Szynaka B, Kulikowska E, Moniuszko-Jakoniuk J, Andrzejewska A. Ultrastructure of the hypothalamo-neurohypophysial system in rats exposed to lead. II. Neurohypophysis. Rocz Akad Med Bialymst 1994; 39:111-116. [PMID: 7497077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Ultrastructure of neurohypophysis was examined in rats allowed to drink for 6 weeks only solution of lead acetate. It was found the increased number of neurosecretory granules in axonal terminals, the signs of granulolysis in Herring bodies and the presence of axonal terminals with atypical, heterogeneous contents. The possible mechanisms of alterations observed in the whole hypothalamoneurohypophysial system affected by lead were discussed.
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Mróz A, Mróz S, Zagórski M. Simple angle-resolved auger electron spectroscopy system—effective rule for measurement and tests of possibilities. SURF INTERFACE ANAL 1988. [DOI: 10.1002/sia.740120111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Wodzińska-Balon J, Mróz A. [Physical development of children and adolescents following surgery for chest deformities]. Pediatr Pol 1974; 49:713-20. [PMID: 4839779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Polaczek-Kornecki T, Mróz A, Sokolowska T. [Use of trichloroethylene analgesia in postoperative breathing exercises following upper abdominal surgery]. Anaesthesist 1969; 18:410-2. [PMID: 5374290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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