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The Effect of Dialysis Modality and Membrane Performance on Native Immunity in Dialysis Patients

, N.; Hirakata, H.; Nagashima, A.; Fujishima, M. Cellular immunity in hemodialysis patients: a quantitative analysis of immune cell subsets by flow cytometry. Am. J. Nephrol. 1995; 15: 57–65, doi:10.1159/000168802. 17. Peraldi, M.-N.; Berrou, J.; Metivier, F.; Toubert, A. Natural killer cell dysfunction in uremia: the role of oxidative stress and the effects of dialysis. Blood Purif. 2013, 35 Suppl 2, 14–19, doi:10.1159/000350839. 18. Renaux, J. L.; Thomas, M.; Crost, T.; Loughraieb, N.; Vantard, G. Activation of the kallikrein-kinin system in

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Identification of Periopathogenes from Dental Plaque in Periodontal Patients with PCR Technique and Their Association with Composite Interleukin-1 Genotype

. 2004 Nov-Dec; 112(11-12): 785–807. Molecular genetic methods for the diagnosis of fastidious microorganisms.[APMIS. 2004] 17. Veal DA, Deere D, Ferrari B, Piper J, Attfield PV. Fluorescence staining and flow cytometry for monitoring microbial cells. J Immunol Methods 2000; 243: 191–210. [PubMed] 18. Morikawa M, Chiba T, Tomii N, Sato S, Takahashi Y, Konishi K, Numabe Y, Iwata K, Imai K.Comparative analysis of putative periodontopathic bacteria by multiplex polymerase chain reaction. J Periodontal Res. 2008 Jun; 43(3): 268–74. doi: 10.1111/j.1600

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The Effect of Continuous Renal Replacement Therapy with the AN69ST Membrane on Inflammatory Markers and the Level of Consciousness of Hemodialysis Patients with Stroke: Comparison with Hemodialysis with Low Blood Flow Rate

Abstract

Introduction: Hemodialysis (HD) with low blood flow rate, continuous renal replacement therapy (CRRT), and peritoneal dialysis are recommended for patients with stroke complications to prevent intracranial hypertension because of the low diffusion capacity of the brain barrier. However, detailed guidelines are not currently available; thus, there is an urgent need to establish such guidelines.

Material and Methods: We developed a novel protocol for performing CRRT with the AN69ST membrane, which has excellent adsorption capacity for various cytokines. The objective of this study was to compare the effect of the novel protocol with that of the current standard protocol, i.e. hemodialysis with low blood flow rate. To compare the effect of hemodialysis with low blood flow (HD group, n=27) and CRRT with AN69ST membrane (CRRT group, n=8), we measured the following consciousness and blood inflammatory parameters in patients with stroke complications at baseline and after 1 week of treatment: Glasgow Coma Scale (GCS) score, C-reactive protein (CRP) levels, and white blood cell (WBC) and platelet count.

Results: After 1 week, the total GCS score did not improve in the HD group, but improved significantly in the CRRT group (HD group: 13.1±3.0 to 13.3±3.1, p=0.5508, CRRT group: 8.9±3.9 to 11.5±3.9, p=0.0313). Improvement in the CRRT group was significantly higher than in the HD group (p=0.0039). CRP levels did not change significantly in either the HD (3.8±5.5 to 5.3±4.3 n.s.) or CRRT groups (7.7±10.0 to 3.7±3.2 n.s.); however, they tended to increase in the HD group and decrease in the CRRT group. No significant changes were observed in WBC and platelet counts after 1 week of treatment in either group.

Conclusion: CRRT with the AN69ST membrane might have a beneficial effect on the consciousness level and inflammation of patients with stroke.

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Doppler velocimetry of the uterine arteries: an early screening test for miscarriage

, Pozzan C, Marchiori S, Zen T, Gangemi M. Assessment of uterine artery blood flow in normal first-trimester pregnancies and in those complicated by uterine bleeding. Ultrasound Obstet Gynecol. 2002; 19: 366–70. 12. Manal M, et al. Uterine artery Doppler and urinary hyperglycosylated HCG as predictors of threatened abortion outcome, Middle East Fertility Society Journal (2013) from 18.42 to 46.

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First Bioresorbable Vascular Scaffold Implantation in Patients with Acute Coronary Syndrome in the Republic of Macedonia

of anterograde flow in acute myocardial infarction: The first 15 years. J Am Coll Cardiol. 1995; 25: 1S. 9. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet. 2003; 361(9351): 13-20. 10. Steg PG, Huber K, Andreotti F, et al. Bleeding in acute coronary syndromes and percutaneous coronary interventions: position paper by the Working Group on Thrombosis of the European Society of Cardiology. Eur Heart J. 2011

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Effects of Serenoa repens Alcohol Extract on Benign Prostate Hyperplasia

Abstract

An increasing tendency has recently emerged for the use of phytotherapeutic agents as alternative to commercial pharmacological agents for the treatment of benign prostate hyperplasia (BPH). The purpose of this study is to evaluate the effects of Serenoa repens alcohol extract treatment on BPH patients’ symptoms and major parameters during one-year follow-up.

The study was performed on 70 men aged 40 - 79 years (mean 60.58) with symptomatic BPH that were divided into a group of 40 patients treated with Serenoa repens extract (SRT) and a control group of 30 patients that received no treatment and were observed only. The following parameters were determined at the time of diagnosis (baseline), and after 6 and 12 months: prostate size, serum prostate-specific antigen (PSA) and uroflowmetry parameters including maximum flow rate (MFR), average flow rate (AFR) and post-voiding residual volume (PVRV). In addition, the relevant patient symptoms were evaluated using the International Prostate Symptom Score (IPSS) system.

The patients in the SRT group showed a statistically significant increment of the average MFR and AFR values and reduction of PV relative to the control group (p<0.05). The significant differences between the proportion of patients with prostate volume >40 ml in the SRE treated group vs. control group was observed (p<0.05). The mean IPSS score was highly significantly reduced in the SRT group (p<0.01).

The mild improvements of the urine flow, prostate size and IPSS score during 12 months treatment with the Serenoa repens extract indicate possible efficiency of this phytotherapeutic agent in patients with BPH.

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Partial Caecal Necrosis – a Rare Cause of Right-Sided Inferior Abdominal Pain and Tenderness

Abstract

Introduction: Non-occlusive caecal infarction is a rare condition that has been described in association with a variety of clinical entities, generally due to a low-flow state, and has been reported to occur in association with chronic heart disease, open-heart surgery, certain drugs, and haemodialysis. The aim of this article is to describe the presentation, diagnosis and management of this unusual clinical problem.

Case presentation: We report on an 84-year-old female with known chronic heart disease presenting with right lower abdominal quadrant pain, tenderness and leukocytosis. Although initial clinical findings were highly suggestive of acute appendicitis, CT revealed marked circumferential wall thickening of the caecum. Intraoperatively, caecal necrosis was confirmed, while the appendix and the remainder of the intestine appeared normal. There was no evidence of major vascular occlusion or embolization. The right hemicolectomy was performed with ileo-transverse anastomosis. Histopatho-logic analysis demonstrated isolated transmural caecal necrosis with marked infiltration of the caecal wall by numerous bacteria and neutrophils as a consequence of nonocclusive ischaemic colitis. The patient recovered completely and was discharged from the hospital on the tenth postoperative day without any surgical complications.

Conclusion: Partial caecal necrosis should be included in the differential diagnosis of acute right lower quadrant pain, especially in elderly patients with chronic heart disease.

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Diagnostic and Surgical Approach to Prenatally Detected Urinary Tract Anomalies

Abstract

Regular ultrasound examinations carried out in the second trimester of pregnancy help in detecting many anomalies in the fetal urinary tract. Their percentage ranges from 1% to 3% of all controlled pregnancies. There is a wide spectrum of anomalies that affect the urinary tract, but the most significant are: uretero/hydronephrosis (unilateral or bilateral), kidney agenesis, dysplastic kidney, polycystic and multicystic kidneys, anomalies of ascent, anomalies of kidney rotation or fusion, bladder exstrophy, posterior urethra valve etc.

Many of these anomalies do not have impact either on urine flow or on kidney function and hence they can be qualified rather as a condition than as a disease. At the same time, most of the hydronephroses that are seen prenatally are being resolved spontaneously, and they are not detected neither presented postnatally as uretero/hydronephroses of unobstructed type and do not require surgical treatment. Only one tenth of these anomalies are subject to active surgical treatment.

Therefore, the assessment of these conditions should be done by a specialized team, who will make adequate therapeutic decisions based on clinical guidelines, as well as will advise the parents on the future clinical implications of the detected anomaly.

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MUC1 immunotherapy against a metastatic mammary adenocarcinoma model: Importance of IFN-gamma

Abstract

Immunotherapy using mucin 1 (MUC1) linked to oxidised mannan (MFP) was investigated in an aggressive MUC1+ metastatic tumour, DA3-MUC1 because, unlike many MUC1+ tumour models, DA3-MUC1 is not spontaneously rejected in mice making it an alternative model for immunotherapy studies. Further, DA3-MUC1 cells are resistant to lysis by anti-MUC1 cytotoxic T cells (CTLs). The inability of DA3-MUC1 tumours to be rejected in naïve mice as well as vaccination to MUC1 was attributed to a deficiency of expression of MHC class I molecules on the tumour cell surface. In vitro and in vivo analysis of subcutaneous tumours and lung metastases demonstrated that DA3-MUC1 tumour cells have a low expression (< 6%) of MHC class I which can be upregulated (> 90%) following culturing with IFN-γ. Results from flow cytometry analysis and immunoperoxidase staining indicated that the in vitro up-regulation of MHC class I could be maintained for up to seven days in vivo, without affecting the expression levels of MUC1 antigen. Interestingly, MUC1-specific CTL that lyse DA3-MUC1 targets in vitro were induced in MFP immunised mice but failed to protect mice from a DA3-MUC1 tumour challenge. These results highlight the importance of MHC class I molecules in the induction of anti-tumour immunity and the MFP immune response.

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Evaluation of Different in Vitro Testing Methods for Mechanical Properties of Veneer Ceramics/ Евалуација На Тестовите In Vitro За Одредување На Механичките Особини На Порцеланските Маси За Фасетирање

Abstract

Metal-ceramic and all-ceramic prosthetic restorations in the patient mouth are often damaged by esthetic and functional problems that reduce their success and longevity.

Аim: To evaluate methods for testing mechanical characteristics of dental ceramics through analysis of different testing methods.

Material and methods: Dental ceramic materials are tested with in vivo and in vitro methods for their most important mechanical characteristics: hardness, toughness, flexural strength and abrasion. In vitro testing methods are faster and more efficient, without subjective factors from the patient according to ISO standards. Testing is done with universal testing machines, like Zwick 1445, Universal Testing Machine (Zwick DmbH & Co.KG, Ulm, Germany), Instron 4302 (Instron Corporation, England), MTS Sintech ReNew 1123 or in oral chewing simulators.

Results: According to the testing results, flexure strength is one of the most important characteristic of the dental ceramic to be tested, by the uniaxial and biaxial tests. Uniaxial tests three-point and four-point flexure are not most appropriate because the main stress on the lower side of the tested specimens is tension that causes beginning fractures at the places with superficial flow. Uniaxial results for flexural strength are lower than actual force, while with biaxial test defects and flows on the edges of tested specimens are not directly loaded.

Conclusion: Biaxial flexural method has advantages over uniaxial because of real strength results, but also for simple shape and preparing of the testing specimens.

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