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Most kidney transplant patients who undergo biopsies are classified as having no rejection based on consensus thresholds. However, we hypothesized that because these patients have normal adaptive immune systems, T cell–mediated rejection (TCMR) and antibody-mediated rejection (ABMR) may exist as subthreshold activity in some transplants currently classified as no rejection. To examine this question, we studied genome-wide microarray results from 5086 kidney transplant biopsies (from 4170 patients). An updated molecular archetypal analysis designated 56% of biopsies as no rejection. Subthreshold molecular TCMR and/or ABMR activity molecular activity was detectable as elevated classifier scores in many biopsies classified as no rejection, with ABMR activity in many TCMR biopsies and TCMR activity in many ABMR biopsies. In biopsies classified as no rejection histologically and molecularly, molecular TCMR classifier scores correlated with increases in histologic TCMR features and molecular injury, lower estimated glomerular filtration rate, and higher risk of graft loss, and molecular ABMR activity correlated with increased glomerulitis and donor-specific antibody. No rejection biopsies with high subthreshold TCMR or ABMR activity had a higher probability of having TCMR or ABMR, respectively, diagnosed in a future biopsy. We conclude that many kidney transplant recipients have unrecognized subthreshold TCMR or ABMR activity, with significant implications for future problems.

Background: Cardiac resynchronization therapy (CRT) is a valuable intracardiac device-based treatment option for a subgroup of patients with advanced heart failure (HF) and QRS prolongation. However, still a significant proportion of patients do not benefit from CRT implantation, labeled as non-responders. Objectives: The aim of the present study was to evaluate the N-terminal prohormone of brain natriuretic peptide (NT-pro BNP) and high sensitivity troponin T (cTnThs) value as predictors of CRT response in a 12-month observation. Materials and Methods: The study included 46 patients with HF and implanted CRT-D. Levels of NT-pro BNP and cTnThs were assessed during a 12 month follow up. Results: 46 consecutive patients (76% men) with a mean age of 64±8 were observed for 12 months. The CRT response criteria was met by 26 patients (56,5%). A significant decline in the NT-pro BNP concentrations was documented in responders (p=0.001). Moreover, ΔNT-pro BNP by at least 579 pg/ml had high sensitivity and specificity for identifying the CRT responders. There were no statistically significant differences in the results of cTnThs between the two study groups. Conclusion: The relative change in the level of NT-pro BNP by at least 43,5% allows to identify the responders to CRT after 12 months of follow-up. Serial measurements of NT-pro BNP can be a valuable tool for monitoring the effectiveness of CRT.

Endothelial dysfunction could be related to the limited availability of nitric oxide (NO). NO is synthesized with the participation of an NO synthase whose activity is inhibited by asymmetric dimethylarginine (ADMA). The synthesis of ADMA is exacerbated by oxidative stress, and several studies have shown the efficacy of drugs acting on the renin-angiotensin-aldosterone system (RAAS) (converting enzyme inhibitors and angiotensin II receptor antagonists) in reducing the level of ADMA. The probable mechanism of drug action is a reduction of oxidative stress through a decrease of angiotensin II formation. The aim of this study was to assess the influence of RAAS blockers on the plasma concentration of ADMA in patients with chronic glomerulonephritis (ChGN). The study included 37 patients, placed into group A and group B, depending on the treatment. Both groups were treated with RAAS blockers. In group B, immunosuppressive drugs were additionally administered. The control visits were at the 0, 6 and 12 months of observation. In both the studied groups (A+B), a significant reduction of ADMA (0.77 vs 0.4 μmol/l; p<0.05) was noticed. In patients suffering from ChGN, the use of RAAS blockers resulted in a significant decrease of plasma ADMA concentration, independently of immunosupressive treatment.

The area of environmental protection concern minimises the impact that technical objects have on the environment. Usually the most effective way of protecting the environment is to influence the source of the problem. For this reason studies are conducted to modify the construction of machines, power machines in particular, so as to minimise their impact on the environment.

Ultrasonography has been extensively used in obstetrics and gynecology since 1980’s. It found application in pediatric gynecology, procreation period, post-menopause, pregnancy monitoring and after delivery. Although the first reports on the use of ultrasonography in assessing delivery mechanism were published in 1990’s, yet to date labor progress is evaluated by means of physical examination in most delivery units. Intrapartumsonography is not routinely performed despite the fact that numerous studies documented high error rates of conventional obstetrical examination. Even an experienced physician makes a mistake in every third case of the fetal head descent and fontanelleposition assessment. Nowadays, obstetrician’s role is not to strain for vaginal delivery at all costs, but to provide the patient in labor and her newborn with maximal safety. To achieve this objective, an obstetrician should distinguish between women who will deliver spontaneously and whose who require Cesarean section. Proper decision should be made on the basis of objective and valid evaluation of obstetric setting, which cannot be achieved solely with physical examination. Intrapartumsonography was shown to be far more accurate than digital examination. Moreover, it is not technically demanding, provides high reproducibility and neither increases the rate of ascending infection or causes discomfort to the patient. Current research suggests that if used routinely, intrapartumsonography can increase the safety of labor and reduce cesarean section rate.

The aim of this study was to investigate the serum concentration of adipokines, such as leptin, adiponectin, and resistin, and assess its relation to nutritional and inflammatory parameters in both overweight and normal weight patients on maintenance hemodialysis.

The aim of this study was to evaluate the correlation between the serum concentration of amino acids (AAs) and nutritional status in hemodialysis (HD) patients.

Chronic hemodialysis may lead to losses of carnitine from plasma and muscles. The aim of the present study was a comparison of carnitine contents in different human muscles (brachioradialis muscle and rectus muscle of abdomen) and evaluation of the correlation between plasma and tissue carnitine concentrations in patients receiving hemodialysis and healthy control patients.

The purpose of this study was to investigate the effect of hemodialysis (HD) on myocardial cyclic variation of integrated backscatter (CVIBS), left atrium (LA) volume and tissue Doppler imaging (TDI) in end-stage renal disease (ESRD) patients. We examined 25 patients with ESRD undergoing routine HD and 19 age-matched healthy volunteers. CVIBS, LA volume and left ventricular echocardiographic parameters were measured before and after HD in ESRD patients. CVIBS of both the intervetricular septum and posterior wall were significantly diminished after HD (8.2 +/- 2.5dB vs. 6.5@?+/- 1.8dB, P < 0.001; 9.2 +/- 2.6dB vs. 7.6 +/- 2.2dB, p < 0.05 respectively). LA volume decreased significantly after HD (P < 0.05). There was no change in the mitral annulus early diastolic velocity (Em) estimated by TDI. The results of our study demonstrate that HD leads to decrease of CVIBS in ESRD patients and that early mitral annulus velocity (Em) could be preload independent marker of left ventricular diastolic function in ESRD patients.

Apoptosis is a key mechanism underlying fulminant hepatic failure. The role of gelsolin in such apoptotic pathways is not well understood because both pro-apoptotic and anti-apoptotic effects have been reported in vitro, depending on the cell type and in vitroexpression model used. Therefore, we studied an in vivomodel of hepatic failure by analyzing expression of gelsolin; intrahepatic activation of caspase-3, −8, and −9; and the extent of apoptosis in gelsolin knockout (gsn−/−) versus wild-type mice (gsn+/+) after exposure to stimulatory Fas antibody Jo-2. Gelsolin was expressed exclusively in sinusoidal lining cells, including sinusoidal endothelial cells and Kupffer cells, of gsn+/+mice. Compared with wild-type mice, Jo2-exposed gsn−/−mice showed significantly higher numbers of apoptotic cells in the liver (22 ± 9 versus 5 ± 4% terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling-positive cells, P= 0.002); shorter survival (P= 0.037); and enhanced activation of caspase-3 (P= 0.009), −8 (P= 0.004), and −9 (P= 0.004). Furthermore, inhibition of caspase-3 with z-DEVD-fmk blocked Jo2-induced liver failure in all mice. Thus, our data on Jo2-induced hepatic failure suggest that gelsolin exerts an overall anti-apoptotic effect in vivo. Moreover, selective expression of gelsolin in sinusoidal endothelial cells indicates a pivotal role for interactions between sinusoidal endothelial cells and liver parenchymal cells in Fas ligand-mediated liver failure.

An analytical method for the determination of trace levels of six different nonsteroidal antiinflammatory drugs (NSAIDs) in water samples has been developed and validated. Environmentally relevant pharmaceuticals were chosen according to human consumption in Poland. Final analysis of the target compounds was performed by RP LC–diode‐array detection–MS, whereas sample preparation included an SPE step. For this SPE step, a number of packing materials, such as LiChrolut RP‐18, calixarene, Strata‐X, BAKERBOND Narc‐2, BAKERBOND Polar Plus, BAKERBOND styrene divinylbenzene‐1, and Discovery DSC‐18, were used, and their respective advantages and disadvantages in this study were discussed. The RP‐18 phase was found to be the most retentive for all analytes. The detection limits for compounds in surface waters were varied from 0.005 for diflunisal to 0.095 μg/L for ibuprofen. The average recoveries of NSAIDs from the surface water samples ranged from 80 up to 103%. RSD value is relatively low (from 4% for fenoprofen up to 8% for ibuprofen). The performance of the method was tested with several environmental water samples.

We intended to assess the intensity of apoptosis in the CD4+ and CD8+ T-lymphocytes of haemodialysis (HD) patients on recombinant human erythropoietin (rHuEpo).

Ozonotherapy is a complementary medical approach in the treatment of resistant infections, immune deficiency syndromes, orthopedic pathologies and vascular diseases. The criticism of this method is associated with potentially harmful effects of ozone on cells. The aim of this study was to investigate the influence of ozonated autohemotherapy (O3-AHT) on the cellular response of the immunologic system represented by cytotoxic activity of natural killer cells. 12 hemodialyzed patients (8 M, 4 F) aged 64.8±7.6 years with peripheral arterial disease as the main reason for the treatment with O3-AHT were examined in a prospective, placebo controlled, single blind study. They received 9 sessions of autohemotherapy without ozone exposure as a placebo-control and subsequent 9 sessions of O3-AHT. The procedures were performed 3 times a week, just before hemodialysis session. Ozone-oxygen gas mixture with ozone concentration of 50 µg/ml produced by ozone generator (ATO3, KrioMetrum, Poland) was used during O3-AHT. Natural killer cell activity was measured using lactate dehydrogenase release assay. There was no statistical difference between natural killer cell activity (%) at the baseline (16.78±8.07), after nine sessions of control autohemotherapy (15.98±6.67), and after nine sessions of O3-AHT (18.26±8.82). In conclusion, our findings showed that O3-AHT in a dose of 50 mg/mL does not have any significant influence on natural killer cell function in hemodialyzed patients.

Ozonated autohemotherapy is used as a complementary medical approach in the treatment of vascular disorders. One of the greatest problems concerning an application of ozone in medicine is its induction of oxidative stress. The standards of ozonotherapy were elaborated recently making this treatment useful and probably non toxic. The aim of the present study was to investigate the influence of ozonated autohemotherapy on the oxidative stress extent in hemodialyzed patients, known to be particularly exposed to generation and deleterious effects of free radicals. Twelve continuously hemodialyzed subjects with atherosclerotic ischemia of the lower limbs were examined in a prospective, controlled, single blind study. Autohemotherapy with blood exposure to oxygen served as a control. The protein and lipid peroxidation products, the reduced glutathione level in red blood cells and free hemoglobin plasma concentration were measured. The study showed that ozonated autohemotherapy with ozone concentration 50 µg/ml per gram of blood induced a significant decrease in glutathione level after 9 sessions of this procedure. Therapy did not cause either the enhancement of protein and lipid peroxidation, or erythrocytes damage. It seems likely that the antioxidant defense system, part of which is glutathione, neutralizes oxidative properties of ozone in this concentration and protects against oxidative cell damage.

Recombinant human erythropoietin (epoetin) is widely used for correction of anaemia in patients with chronic renal disease and its efficacy has been confirmed in numerous studies. Disturbances in carnitine metabolism may also contribute to the development of renal anaemia. Although increases in erythrocyte count (RBC) and changes in RBC metabolism during L-carnitine administration have been observed, supplementation with L-carnitine in anaemic hemodialysis patients is not routine.The aim of our study was to determine the influence of epoetin on hematological parameters and plasma carnitine profile in anaemic hemodialysis patients. 36 hemodialysis patients (22 men, 14 female, aged from 17 to 64 years, mean 43) and 30 healthy volunteers (12 men, 18 female, aged from 25 to 65 years, mean 40) were studied. Epoetin (Eprex, Janssen-Cilag) was administered subcutaneously for twelve months with the starting dose 2000 IU three times per week (range from 75 to 133, mean 102±21 IU/kg/week). The target hemoglobin (Hb) range at the time of the study was between 10–11 g/dL. Laboratory markers of hematological response, carnitine and iron status, were measured before epoetin administration and then controlled every three months. During epoetin treatment a significant increase in Hb concentration was observed (100% of patients responded to epoetin). In the third and six month of epoetin treatment, along with a significant increase in mean reticulocyte count and the highest increment of RBC count and Hb levels, probably due to increased erythropoiesis, a significant, transient decrease of mean total and free plasma carnitine levels was observed.This may suggest the utilisation of carnitine by a new RBC population. It also indicates that there is a need for L-carnitine in carnitine deficient maintenance hemodialysis patients particularily during erythropoiesis induced by epoetin treatment.

Recombinant human erythropoietin (rHuEpo) may affect the human immune system. The aim of the study was to examine changes in CD4(+) and CD8(+) T-cell subpopulations, the expression of the inhibitory molecule, CD152 on T lymphocytes and the levels of interleukins (IL) 2, 6, 10, 12 and tumour necrosis factor alpha (TNF alpha) in primary glomerulonephritis chronic haemodialysis (HD) patients before and under rHuEpo treatment.

Background The aim of the paper was to assess reliability and validity of the QLQ-C30 questionnaire in studying the quality of life in dialysed patients, and then to compare the life quality in patients on hemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD) and healthy controls. The present study included 65 HD patients, 22 CAPD patients and a group of 76 healthy volunteers.Methods Quality of Life Questionnaire (QLQ-C30), Hospital Anxiety and Depression Scale (HADS), Cantrill ladder.Results The EORTC QLQ-C30 questionnaire appeared to be a reliable and valid tool for assessing the quality of life in dialysis patients. HD patients had significantly poorer quality of life in the areas of physical, social, cognitive and emotional functioning in comparisons to the controls. CAPD patients were not significantly different life quality-wise from controls, except for their social and professional life.

This paper presents a new methodology of chemical substructure recognition by interpretation of an infrared spectrum. The approach in spectrum interpretation is based on the determination of functional groups, which may be present or absent in compounds whose structure is unknown. The process of searching for spectrum−substructure correlation is realized by application of a statistical algorithm. In this method, correlations are generalized and condensed into a set of interpretation rules which are applied to the interpretation of an unknown compound's spectrum in order to predict whether the respective substructures are present or absent in the unknown molecule.

This paper presents a methodology for seeking the relationships between chemical substructures (molecular fragments) and spectral parameters using a computer collection data of molecular spectra. To establish the spectrum−structure correlations, the program has to search the chemical structure base in order to find compounds containing a given molecular fragment in the molecule. There exists no sole definition of a substructure, as it always depends on the type of problem dealt with. In the problem of structural identification, fuzzy definitions of substructures are applied, and their forms are imposed by the spectral methods used.

Type 2 diabetic patients with end-stage renal disease are often overweight (BMI > 24) at the start of dialysis therapy. However, there are very few reports in the literature concerning the nutritional status of these patients after prolonged haemodialysis treatment. Therefore, we compared nutritional parameters in type 2 diabetic patients and age-matched non-diabetic patients after at least 18 months of renal replacement therapy with haemodialysis.

. The induction probe method is used to study the surface potential of TGS and LATGS crystals. The influence of L-alanine doping on the magnitude and decay of surface potential for LATGS crystal is found. The samples without internal bias field show nearly the same initial value and decay rate of surface potential for opposite electrode potentials. The opposite electrode potentials applied to the sample with internal bias field give different rate of surface potential decay. These changes of decay rate are related to domain structure rearrangement.

Measurements of the surface potential were carried out by electrostatic induction probe method. The influence of doping with Fe3+ cations on the surface potential of TGS crystal was tested. The behaviour of surface potential was studied for TGS with Fe3+ cations under influence of ultraviolet irradiation. The dependence of surface potential on irradiation time was found. After the ultraviolet irradiation of Fe3+ admixtured TGS slower changes of surface potential than for pure TGS crystal were observed.

Abstract: Investigations on the separation of trace amounts of Ba, Mn, Fe, Sr+Y, Co, Ca, Zn, Ag and Na from macro-amounts of Mg are described.

Discusses the origins, processing and composition of white mineral oils as used in cosmetics. Historical background; Procedures involved in the modern white oils production; Quality standards for white mineral oil; Typical properties of different classes of white oils; Environmental and economic issues involved in the production of white oils.

Focuses on environmental protection legislation for cosmetics industry in the United States. Removal, replacement or reduction of volatile solvents in products with petroleum distillates; Provisions for petroleum distillate regulation under the California Air Resources Board (CARB) rules; Control of atmospheric pollution through regulations concerning volatile organic compounds.

The memory effect of shape-memory alloys (SMAs) has opened interesting perspectives to create prestress states in concrete elements. However, the procedure has not been yet fully resolved due to the complex thermomechanical behavior of these alloys, in addition to the practical difficulties of mechanical coupling between SMA and concrete elements. The present study deals with tests on the development of prestressing forces in concrete beams during the thermal cycle required in the procedure. Pre-stretched nickel–titanium wires were externally placed on concrete prismatic beams equipped with strain gauges. As concrete rupture may occur during the heating by the Joule effect, a compromise must be found between the SMA pre-stretch level and the maximum temperature to be applied before returning to ambient temperature. A macroscopic model was developed to analyze this compromise. The complex thermomechanical response of SMAs implies a particular attention in the definition of the ambient temperature and heating conditions for the creation of prestress states in concrete components.