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Detection of specific lytic and latent transcripts can help to predict the status of Epstein-Barr virus infection in transplant recipients with high virus load

100%
Zawilinska B., Kosinska A., Lenart M., Kopec J., Piatkowska-Jakubas B., Skotnicki A., Kosz-Vnenchak M.
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2008
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vol. 55
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issue 4
693-699
EN
Epstein-Barr virus (EBV), a member of the family Herpesviridae, is widely spread in the human population and has the ability to establish lifelong latent infection. In immunocompetent individuals the virus reactivation is usually harmless and unnoticeable. In immunocompromised patients productive infection or type III latency may lead to EBV-associated post-transplant lymphoproliferative disorder (PTLD). The aim of our research was to investigate the utility of PCR-based methods in the diagnosis and monitoring of EBV infections in bone marrow transplant recipients. Thirty-eight peripheral blood leukocyte samples obtained from 16 patients were analysed, in which EBV DNA was confirmed by PCR. We used semi-quantitative PCR to estimate the viral load and reverse-transcription PCR (RT-PCR) to differentiate between latent and productive EBV infection. In 14 patients we confirmed productive viral infection. We observed a correlation between higher number of EBV genome copies and the presence of transcripts specific for type III latency as well as clinical symptoms.
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Ultrasonografia w diagnostyce krwotocznego zapalenia pęcherza moczowego po przeszczepach szpiku kostnego u dzieci

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Zaleska-Dorobisz U., Biel A., Sokołowska-Dąbek D., Olchowy C., Łasecki M.
Journal of Ultrasonography
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2014
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vol. 14
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issue 58
258-272
EN
Objective: The aim of this study was to evaluate the usefulness of ultrasonography in the diagnosis of hemorrhagic cystitis following bone marrow transplantation in children. Material and methods: The study involved an analysis of clinical material and the results of imaging tests performed in 334 patients who underwent hematopoietic cell transplantation. Ultrasonographic findings in 42 patients with hemorrhagic cystitis were analyzed in detail. The ultrasound images served to assess the severity of hemorrhagic cystitis and the results were compared with the clinical assessment of the disease on the Droller scale, as well as the laboratory and endoscopic tests. Results: In the studied group of patients hemorrhagic cystitis following allogeneic transplantation was diagnosed in 12.5% cases. 73.8% patients received transplants from unrelated donors, 26.2% – from compatible siblings. The study revealed a higher incidence of hemorrhagic cystitis in children above 10 years of age. Grade 3 according to the Droller was diagnosed in 42.9%, grade 2 – in 30.9%, grade 4 – in 14.3%, and grade 1 – in 11.9% patients. The number of ultrasound examinations depended on the clinical symptoms, severity, duration and co-occurrence of other complications following the transplantation and was within the 1–15 range (average: 4.6). Grades 3 and 4 were related to the poor clinical condition of the patients and to their longer hospitalization. During this period there was an increased risk of renal malfunction and acute renal failure, post-inflammatory narrowing of the ureters, hydronephrosis, and in grade 4 the fibrosis of the bladder with reduced bladder capacity. Analyses demonstrated a significant correlation between the ultrasound image of the bladder wall and the clinical severity. Conclusions: Ultrasound with Doppler options remains the primary diagnostic tool in the evaluation of hemorrhagic cystitis, and is useful in terms of its diagnosis, determination of the severity, and monitoring of the treatment.
PL
Cel: Celem pracy była ocena przydatności ultrasonografii w diagnostyce krwotocznego zapalenia pęcherza moczowego, dość częstego powikłania po przeszczepach szpiku kostnego u dzieci. Materiał i metoda: W pracy przeanalizowano materiał kliniczny i wyniki badań obrazowych 334 pacjentów po transplantacji komórek hematopoetycznych. Analizie poddano wyniki badań ultrasonograficznych wykonanych u 42 dzieci z krwotocznym zapaleniem pęcherza moczowego. Na podstawie USG oceniano stopień zaawansowania krwotocznego zapalenia pęcherza moczowego, a wyniki porównywano z oceną kliniczną procesu w skali Drollera, badaniami laboratoryjnymi i endoskopowymi. Wyniki: W analizowanej grupie dzieci krwotoczne zapalenie pęcherza moczowego rozpoznano po transplantacjach allogenicznych u 12,5% badanych, u 73,8% był to przeszczep od dawcy niespokrewnionego, u 26,2% – od zgodnego rodzeństwa. Wykazano częstsze występowanie krwotocznego zapalenia pęcherza moczowego u dzieci starszych, powyżej 10. roku życia. Stopień 3. w skali Drollera stwierdzono u 42,9% dzieci, stopień 2. – u 30,9%, stopień 4. – u 14,3%, a stopień 1. – u 11,9% dzieci. Liczba badań ultrasonograficznych i rozpoznanie zależały od objawów klinicznych, stopnia zaawansowania, czasu trwania oraz współwystępowania innych powikłań po transplantacji i wynosiła 1–15 (średnio 4,6). Trzeci i czwarty stopień wiązały się ze złym stanem klinicznym chorych, a także wydłużeniem czasu hospitalizacji. W okresie tym wzrastało ryzyko uszkodzenia czynności nerek i ostrej niewydolności nerek, pozapalnego zwężenia moczowodów, wodonercza, a w końcowym stadium zwłóknienia pęcherza moczowego. Stwierdzono istotną zależność obrazu ultrasonograficznego zmienionej w przebiegu zapalenia ściany pęcherza moczowego, ze stopniem klinicznego zaawansowania. Wnioski: Badanie ultrasonograficzne z opcjami dopplerowskimi pozostaje podstawowym badaniem diagnostycznym w ocenie krwotocznego zapalenia pęcherza moczowego, jest przydatne w rozpoznawaniu, określaniu stopnia zaawansowania choroby i monitorowaniu leczenia.
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Technical and Immunological Aspects of Face Transplantation

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Siemionow M., Sonmez E., Klimczak A.
Polish Journal of Surgery
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2009
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vol. 81
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issue 1
68-74
EN
The interest in facial transplantation led to development of many experimental models and novel immunosuppressive protocols. These studies allowed testing the immunological response to immunosuppressive protocols, and tolerance induction studies with supportive cell based therapies in composite tissues allograft transplants.In this article we present our experience with face transplantation models developed in our laboratory. We also summarize immunological responses and different immunosuppressive protocols used for tolerance induction through donor chimerism.
4
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Face Transplantation: Clinical Application of the Concept

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Siemionow M., Hivelin M.
Polish Journal of Surgery
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2008
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vol. 80
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issue 10
571-578
EN
The face allotransplantation is a unique procedure, requiring a lifetime immunosuppressive therapy, and as such brings an ethical debate among medical societies and general public. The indications for this procedure have to be considered when the classic reconstructive procedures failed, and the patients are left with debilitating defects precluding them from normal social life.The transplantation protocol must be approved and registered by the institutional review board and health agencies. It is crucial that a thorough assessment of the patient for each indication will be performed by a multidisciplinary team and panel of experts in the field of plastic and reconstructive surgery, maxillo facial surgery, immunology of transplantations and psychiatry. The thorough psychiatric and psychological evaluation of potential candidates is mandatory, as well as evaluation by ethic experts.Numerous experimental models and extensive anatomical studies in cadaver model lead to the clinical success of face transplantation, raising a complex ethical question despite the fact that it is an important progress in plastic and reconstructive surgery.Three face transplantations have been performed since 2005. The transplants differed and were tailored, to match the extend of each patient facial defect.In this article we present the clinical cases of face transplantation based on our experience and dissections studies and a literature review.
5
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Advances in hematology – research that revolutionized patient care

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Wach M., Podhorecka M., Cioch M., Hus I., Wąsik-Szczepanek E., Sokołowska B., Hus M.
Polish Journal of Public Health
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2015
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vol. 125
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issue 1
32-35
EN
In the last decades, substantial strides have been made in the diagnosis, treatment, and prevention of blood diseases. The new drugs to be used in combination with cytostatic therapy have been developed, based on increased understanding of the biology of neoplasia. The diagnosis of several diseases is based exclusively on cytogenetic and molecular analysis which has become a part of routine diagnostic management. Moreover, molecular definition has allowed the introduction of therapy targeted at molecular change characteristic for a given disease. The introduction of novel agents for the treatment of hematological disorders has resulted in a great improvement in response rate and median survival. The aim of this study is to show advances and possible future directions in the treatment of chosen hematological malignancies during the recent decades.
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