ABSTRACT
BACKGROUND: The long-term survival of 209 consecutive patients (mean age, 46 ± 15 years) from a single center with ≥1 diagnostic myocardial biopsy after heart transplantation was analyzed. METHODS: Patients were considered as C4d positive if a capillary staining (immunohistochemistry in paraffin samples) was observed in ≥1 myocardial biopsy. Data were analyzed according to pathologic consensus of antibody mediated rejection definition of C4d+ positivity: 2004 definition in group A and the 2013 definition in group B and compared with their respective controls, composed of patients who do not meet those criteria. Age, follow-up time, and number of biopsies were comparable between patients with C4d+ and controls in both groups. Follow-up was 100% complete with mean of observation time 2143 days. RESULTS: During the follow-up period, 62 patients died (group A: C4d+ 32% vs controls 29%; group B: C4d+ 36% vs controls 29% [P = NS]). There were no differences in survival between patients with positive staining and without C4d+ staining when Kaplan-Meier survival curves were compared. CONCLUSIONS: The presence of C4d positive staining in myocardial capillaries of heart biopsies of patients after heart transplantation, as an isolated finding, was not related to worse long-term survival.
Subject(s)
Capillaries/metabolism , Complement C4b/metabolism , Heart Transplantation/mortality , Myocardium/pathology , Biopsy , Female , Graft Rejection/immunology , Graft Rejection/mortality , Humans , Immunohistochemistry , Kaplan-Meier Estimate , Kidney Transplantation/mortality , Male , Middle Aged , Myocardium/metabolism , Retrospective Studies , Staining and Labeling/methodsABSTRACT
Heart transplantation is a well-established life-saving treatment for patients presenting with end-stage cardiac failure. Despite improved efficacy of the procedure, allograft rejection continues to be a major cause of mortality and morbidity in cardiact allograft patients. Although acute cellular rejection (ACR) is quite unusual nowadays, acute antibody-mediated rejection (AMR) remains a significant problem. The role of pathologists in detection of AMR is very important, especially in sub-clinical cases. In 1990, histologic hallmarks of AMR were first stated by International Society for Heart and Lung Transplantation (ISHLT) and detailed histopathologic features and immunopathologic criteria were established in 2005. Recently (2013) ISHLT revised nomenclature and classification of AMR. Aim of this paper was to present practical changes coming from new criteria as well as to highlight difficulties concerning AMR assessment in endomyocardial biopsies (EMB).
Subject(s)
Antibodies/immunology , Graft Rejection/diagnosis , Pathology, Surgical/methods , Biopsy , Graft Rejection/immunology , Heart Transplantation , HumansABSTRACT
The aim of this study was to evaluate the possibility of using PET both in assessing the susceptibility to stress and in the diagnosis of post-traumatic stress disorders. Mentally and somatically healthy soldiers were subjected to PET-CT head scan examinations before and after virtual reality stimulation with warfare scenarios. Despite stimulation of peripheral nervous system after 10 minutes, VR exposure in any of the examined soldiers simulation did not cause changes in any brain structure that was visualized in PET. PET-CT head scan was also performed in patients with typical symptoms of acute PTSD according to the criteria of DSM IV TR. In those patients no changes in any brain structure was found. Initially it was found that VR exposure techniques like clinically typical acute symptoms of PTSD do not leave changes in CNS, which could be visualized in PET. The preliminary hypothesis was put forward that exposure to stimuli like symptoms of PTSD must remain long enough to induce permanent damage of brain structure.
Subject(s)
Algorithms , Brain/diagnostic imaging , Image Interpretation, Computer-Assisted/methods , Positron-Emission Tomography/methods , Stress Disorders, Post-Traumatic/diagnostic imaging , Adult , Female , Humans , Male , Middle Aged , Pilot Projects , Reproducibility of Results , Sensitivity and SpecificitySubject(s)
Hospitalization/trends , Pesticides/poisoning , Acute Disease , Humans , Mortality , PolandABSTRACT
Basing on literature, the authors evaluate the toxicity of butylglycol, especially its narcotic effects and action inducing parenchymatous organs lesions, symptoms of inhalant, oral and percutaneous intoxications and their treatment.
Subject(s)
Butylene Glycols/toxicity , Butylene Glycols/administration & dosage , Hemolysis/drug effects , Humans , MethodsABSTRACT
The authors have described clinical pictures of acute and chronic intoxication, especially toxic effect of ethyl gasoline upon nervous sytem, parenchymatous organs, and irritating effect on skin and mucous membranes.
