J. Szymszal

Acute and Late Outcomes of Unprotected Left Main Stenting in Comparison With Surgical Revascularization

OBJECTIVES The purpose of this study was to compare the early and late results of percutaneous and surgical revascularization of left main coronary artery stenosis. BACKGROUND Unprotected left main coronary artery (ULMCA) stenting is being investigated as an alternative to bypass surgery. METHODS We randomly assigned 105 patients with ULMCA stenosis to percutaneous coronary intervention (PCI; 52 patients) or coronary artery bypass grafting (CABG; 53 patients). The primary end point was the change in left ventricular ejection fraction (LVEF) 12 months after the intervention. Secondary end points included 30-day major adverse events (MAE), major adverse cardiac and cerebrovascular events (MACCE), length of hospitalization, target vessel failure (TVF), angina severity and exercise tolerance after 1 year, and total and MACCE-free survival. RESULTS A significant increase in LVEF at the 12-month follow-up was noted only in the PCI group (3.3 +/- 6.7% after PCI vs. 0.5 +/- 0.8% after CABG; p = 0.047). Patients performed equally well on stress tests, and angina status improved similarly in the 2 groups. PCI was associated with a lower 30-day risk of MAE (p < 0.006) and MACCE (p = 0.03) and shorter hospitalizations (p = 0.0007). Total and MACCE-free 1-year survival was comparable. Left main TVF was similar in the 2 groups. During the 28.0 +/- 9.9-month follow-up, there were 3 deaths in the PCI group and 7 deaths in the CABG group (p = 0.08). CONCLUSIONS Patients with ULMCA disease treated with PCI had favorable early outcomes in comparison with the CABG group. At 1 year, LVEF had improved significantly only in the PCI group. After more than 2 years, MACCE-free survival was similar in both groups with a trend toward improved survival after PCI.

Plasma levels of leptin and orexin A in the restrictive type of anorexia nervosa

OBJECTIVE The aim of the study was to analyze the pattern of leptin and orexin A plasma levels in patients with the restrictive type of anorexia nervosa (AN-R), during the course of treatment. Thirty females with AN-R, aged 18.0 ± 1.6 years (mean ± SD), range of 15.5-21.0 years, were investigated before and after 2, 3, and 6 months of treatment, which included a normocaloric diet and cognitive-behavioral psychotherapy. The control group consisted of 20 age-matched, healthy control females. RESULTS Before the therapy, both leptin and orexin A plasma levels were significantly lower than in the control group and were negatively correlated. During treatment, leptin levels increased and, after 6 months, showed a correlation with body mass index (BMI). Orexin A levels showed a further decrease during treatment, with no correlation with BMI. CONCLUSIONS The results corroborate those of other researchers showing a decrease of leptin levels in patients with AN-R and its increase with body mass increment. They may also suggest a possible relationship between leptin and orexin A plasma level patterns in such patients.

Immunogenic disparities of 11 minor histocompatibility antigens (mHAs) in HLA-matched unrelated allogeneic hematopoietic SCT

We determined the alleles of 11 mHAs and investigated the association of immunogenic mHA mismatches between a donor and a recipient with a course of allogeneic hematopoietic SCT (allo-HSCT) from 10/10 alleles HLA-matched unrelated donors in 92 recipients after myeloablative conditioning between 2004 and 2006. The frequency analysis of mHA alleles, genotypes and phenotypes accompanied by appropriate restriction HLA Ags allowed for an estimation of the probability of immunogenic mismatches, which was the highest for HA-1, HA-8 and HY. GVH-directed disparity of mHAs with broad tissue distribution, especially of the sex-related HY Ag, influenced the results of allo-HSCT from HLA-matched unrelated donors by not only increasing the probability of chronic GVHD (cGVHD) but also by decreasing the relapse rate.

Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand-Induced Apoptosis in Prostate Cancer Cells after Treatment with Xanthohumol-A Natural Compound Present in Humulus lupulus L.

TRAIL (tumor necrosis factor-related apoptosis-inducing ligand) is an endogenous ligand, which plays role in immune surveillance and anti-tumor immunity. It has ability to selectively kill tumor cells showing no toxicity to normal cells. We tested the apoptotic and cytotoxic activities of xanthohumol, a prenylated chalcone found in Humulus lupulus on androgen-sensitive human prostate adenocarcinoma cells (LNCaP) in combination with TRAIL. Cytotoxicity was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide tetrazolium reduction assay (MTT) and lactate dehydrogenase assay (LDH). The expression of death receptors (DR4/TRAIL-R1 and DR5/TRAIL-R2) and apoptosis were detected using flow cytometry. We examined mitochondrial membrane potential (ΔΨm) by DePsipher reagent using fluorescence microscopy. The intracellular expression of proteins was evaluated by Western blotting. Our study showed that xanthohumol enhanced cytotoxic and apoptotic effects of TRAIL. The tested compounds activated caspases-3, -8, -9, Bid, and increased the expression of Bax. They also decreased expression of Bcl-xL and decreased mitochondrial membrane potential, while the expression of death receptors was not changed. The findings suggest that xanthohumol is a compound of potential use in chemoprevention of prostate cancer due to its sensitization of cancer cells to TRAIL-mediated apoptosis.

Inferior performance on selected neuropsychological tests in abstinent schizophrenia patients who have used cannabis

Summary Background A substantial proportion of patients with schizophrenia have co-morbid psychoactive substance use, which can influence their cognitive functions. The aim of this study was to assess cognitive functioning in abstinent schizophrenia patients with various previous patterns of psychoactive substance use. Material/Methods The study was performed on a group of 80 schizophrenia patients (74 men, 6 women), aged 18–40 (mean 25) years, of whom in 40 a co-morbid psychoactive substance abuse was diagnosed. The latter group was subdivided, based on their predominant type of substance (opioid, amphetamine, or cannabis). All patients were examined during clinical improvement, and patients with comorbid substance use were also examined after a 6-week period of detoxification in a therapeutic community. A battery of neuropsychiatric tests was used, which included subtests of Trail Making test, Stroop test and Verbal Fluency test. Results No significant differences in clinical factors and cognitive functioning between the 2 examined groups were found. However, when the patients were divided according to their pattern of substance use, it turned out that the group of patients who used cannabis, despite the shortest duration of disease and that of addiction, and highest percentage of using atypical antipsychotics, performed worse on all cognitive tests, significantly so on Stroop and Fluency tests, compared to the groups with predominant opioid or amphetamine use. Conclusions Abstinent schizophrenic patients who previously used cannabis have worse cognitive functioning compared to other schizophrenic patients with comorbid substance use. The possible role of previous cannabis use or cannabis withdrawal in this phenomenon is discussed.

Steel Strips Flattening in Ball Rolling Mill

An effective and efficient production method of narrow and thin strips made of steel, non-ferrous metals and their alloys is wire flattening in a ball rolling mill. In this device cylindrical rollers have been replaced with balls of diameter ca. 15 mm. Proper selection of deformation process parameters enables to obtain strips with the required geometrical characteristics. Experimental planning method was applied to evaluate the influence of flattening process technological parameters on strip geometrical features. Statistical analysis enabled to determine mathematical models of stainless steel 5XCrNi18-10 strips flattening. It was established that strip widening depends on ball roughness, draft applied, relation of wire diameter to ball diameter, back-tension stress. Strips flatness depends on draft applied. It was observed that strips feature uniform thickness over their width, parallel flat surfaces, narrow dimensional tolerance, high quality surface and naturally rounded edges.

Determination of the flow curves of austenite steel wire in the drawing process

Flow curves enable to predict the response of material during metal forming processes. To establish properly the magnitude of flow stress, precise determination of the true stress from a tensile test is necessary. Calculation of true stress corresponding to the proof strength made it possible to determine the flow curves and select the appropriate flow stress equation for the tested drawn wires.

Patients Assessment in Telegeriatrics Care

Elder patients are considered to have a high degree of frailty and active multiple pathology. When access to geriatric care is very limited, diagnostic methods without face to face contact are of prime importance, especially during initial patient assessment. The goal of the paper is to present and validate telemedicine screening procedures adopted in the John Paul II Geriatric Hospital (GH), covering the neurological part of Comprehensive Geriatric Assessment (CGA). The participants of the study have been patients aged 65 and older. Three methods have been evaluated: Telephone Interview for Cognitive Assessment (TICS), Geriatric Depression Scale (GDS) questionnaire filled out during video call, and analysis of a written text. The third procedure aims at detecting cognitive skills, providing alternative to Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE). Face-to-face methods are used as a gold standard reference. High or moderate correlations have been observed in all cases, i.e. in TICS versus reference MMSE scores (Spearman’s R \(=\) 0.7955), in face-to-face GDS versus videoconference Tele-GDS (Spearman’s R \(=\) 0.7148), and in the written text versus MoCA. (Spearman’s R \(=\) −0.6649). The results of this study presume that TICS can be applied as a reliable method of remote diagnostics. In the two latter cases, the use of telegeriatrics has not been excluded, and further research is planned. Comprehensive assessment has been considered to be crucial for delivering geriatric care. Work in the field of telemedicine-based comprehensive assessment of geriatric patient should be continued.

The Application of Adapted TICS (Telephone Interview for Cognitive Status) for Diagnostics of Cognitive Function Disturbances in Elderly Patients. A Pilot Study

The early diagnosis of Alzheimer’s disease and mild cognitive impairment (MCI) may help reduce disability and enhance quality of life through early introduce of multimodal therapy. This study evaluated the utility of the telephone interview which was compared in the evaluation of cognitive function in 55 patients of geriatric hospital, with the classical methods of neuropsychological diagnosis. Data demonstrates that TICS can be used as a simple and accessible method for the observation and estimation of cognitive status on early stage of dementia. Widespread tele-diagnostics of early phases of dementia and other functional deficits of the brain, connected with its aging, stands a chance of becoming a standard in the assessment of health condition of the elderly population, and of contributing to quicker provision of medical and community care for them.

Strategic Investments of Restructured Metallurgical Companies in Sustainability Business

The article presents the strategic investments implemented in metallurgical enterprises in Poland in time of economical changes. After 1989 Polish steelwork plants started restructuring process connected with technological investments. Polish steelwork plants became a part of foreign capital groups or domestic capital groups. Privatised metallurgical enterprises after economic transformation gradually implemented new technology to their business activities. In the publication an overview of the definitions of strategic and development investments was conducted together with the presentation of the key investments which influence the sustainability of the business in the metallurgical enterprise on Polish market. As a case study was used ArcelorMittal Poland company. In 2004 international concern LNM (ArcelorMittal Poland today) bought the biggest Polish steelwork plants. Since that time the capital group invested 3 billion zlotys in new technology and modernization of the plants. Key strategic investment projects in the company were characterized in the paper.