[Validation of the Russian version of the ureteral stent symptoms questionnaire (USSQ) for the evaluation of quality of life and stent-related symptoms].

INTRODUCTION: Ureteral stents are frequently used in urology practice and have a significant impact on health-related quality of life (QoL). In 2003 . Joshi et al. developed the specific questionnaire for evaluation of QoL and stent-related symptoms, namely Ureteral Stent Symptoms Questionnaire (USSQ). USSQ consists of 40 questions and 2 visual analog scales (VAS), divided into 6 domains. Over the past decade, this questionnaire has been translated into 9 languages. A Russian version of the questionnaire has not been developed yet. AIM: To perform linguistic validation of the Russian version of the USSQ. MATERIAL AND METHODS: Linguistic validation of the original USSQ was performed through a standard process including translation, back translation and pilot study. A total of 103 patients undergone ureteral stent placement and successfully filled in the Russian USSQ at weeks 1 and 4 after stenting, and at week 4 after stent removal. In addition, 30 healthy people filled in the same questionnaires twice at 3-week intervals, as a control group. To evaluate reliability, validity and sensitivity to change of the Russian USSQ, statistical analysis was performed. External criteria included validated questionnaires (EQ-5D, IPSS and pain VAS). RESULTS: Content validity was approved by experts and proved during patients interviewing. Reliability test-retest was satisfactory for urinary symptoms, body pain, general health, and work performance domains (p<0,001 between test and retest evaluation). USSQ domains showed good correlations between each other (correlation coefficient was 0,80-0,94). Cronbach's alpha coefficient of internal reliability was 0.73-0.95. Correlation between other instruments and corresponding USSQ domains was good (p<0,001), proving criterial validity. Sensitivity to changes after stenting and stent removal was also good for most domains (p less or equal 0,001). CONCLUSION: Russian version of USSQ is a valid, reliable and sensitive instrument for the assessment of QoL and stent-related symptoms and is ready for application in the routine clinical practice.

The effect of Prometheus device on laboratory markers of inflammation and tissue regeneration in acute liver failure management.

Prometheus, based on modified fractionated plasma separation and adsorption (FPSA) method, is used in the therapy of acute liver failure as a bridge to liver transplantation. As the therapeutic effect of Prometheus is caused not only by the elimination of terminal metabolites, the aim of the study was to identify the effect of FPSA on the levels of cytokines and markers of inflammation and liver regeneration. Previous studies assessing cytokine levels involved mostly acute-on-chronic liver failure patients. Data concerning markers of inflammation and liver regeneration are not published yet. Eleven patients (three males, eight females) with acute liver failure were investigated. These patients underwent 37 therapeutic sessions on Prometheus device. Before and after each treatment, the plasma levels of selected cytokines, tumor necrosis factor alpha (TNFα), C-reactive protein (CRP), procalcitonin (PCT), hepatocyte growth factor (HGF), and α(1) fetoprotein, were measured, and the kinetics of their plasma concentrations was evaluated. Before the therapy, elevated levels of interleukin (IL)-6, IL-8, IL-10, TNFα, CRP, and PCT were detected. The level of TNFα, CRP, PCT, and α(1) fetoprotein decreased significantly during the therapy. In contrast, an increase of HGF was detected. The decline of IL-6, IL-8, and IL-10 concentrations was not significant. Our results show that Prometheus is highly effective in clearing inflammatory mediators responsible for systemic inflammatory response syndrome and affects the serum levels of inflammatory and regeneration markers important for management of acute liver failure.

Hepatocyte growth factor and antibodies to HLA and MICA antigens in heart transplant recipients.

Recent unconfirmed literature data suggest that elevated concentrations of the multifunctional cytokine hepatocyte growth factor (HGF) might be a marker of increased incidence of acute rejection after organ transplantation. The aim of this study was to test the hypothesis that HGF levels may correlate with the rejection and/or with the production of HLA and MHC Class I chain-related antigens A (MICA) specific antibodies. Sixty-three heart transplant recipients were included into the study. Hundred and eighty-five endomyocardial biopsies (EMB) obtained up to 6 months after transplantation were retrospectively analyzed for signs of cellular (CR) and antibody-mediated rejection (AMR). Pre- and post-transplant sera were tested for HGF concentrations and antibodies to HLA class I, class II and MICA antigens by xMap technology (Luminex). Pre-transplant HGF did not correlate with the incidence of CR or AMR. However, higher HGF concentrations correlated significantly with HLA antibody production before and after transplantation (P = 0.006 and P < 0.0001 respectively). Patients with both HLA class I and class II antibodies before transplantation had significantly lower AMR-free survival. Furthermore, recipients with pre-transplant donor-specific antibodies (DSA) had significantly lower AMR-free survival (50%) than recipients without pre-transplant HLA antibodies (90%) and patients with antibodies not specific to donor antigens (92%) (P = 0.005). Post-transplant MICA antibodies tended to be more frequent in patients with AMR (P = 0.063). In conclusion, elevated HGF concentrations in our study were not associated with the incidence of CR and/or AMR but with the presence of HLA-specific antibodies. Testing for DSA before heart transplantation by Luminex may be helpful for the identification of patients with increased risk of AMR.

Distribution of KIR genes in the Czech population.

Killer cells immunoglobulin-like receptors (KIRs) are a family of inhibitory and activating receptors expressed mainly by natural killer (NK) cells and few subsets of T lymphocytes. KIRs regulate NK cells' activity through interactions with specific HLA class I molecules and other yet unknown ligands presented on target cells. At present, 17 KIR genes and pseudogenes have been identified. As the number of KIR genes in different haplotypes varies, a wide range of genotypes in different ethnic populations may be observed. In our study, 125 healthy non-related Czech individuals were KIR typed both by sequence-specific primers and by sequence-specific oligonucleotide KIR genotyping methods. Thirty-eight different genotypes were observed in the Czech population and all 16 KIR genes known to date were found. Framework genes KIR 3DL3, KIR 2DL4, KIR 3DL2 and the pseudogene KIR 3DP1 were present in all individuals. The most frequent non-framework KIR genes detected in the Czech population were: KIR 2DL1 (95%), KIR 3DL1 (94%), KIR 2DS4 (92%) and the pseudogene 2DP1 (94%). Human leucocyte antigen (HLA)-C typing demonstrated prevalence of the C1/C2 heterozygosity (43%) and C1 homozygosity (41%) over the C2 heterozygosity. One hundred and twenty individuals from our panel carried at least one inhibitory KIR for the corresponding HLA-C group found in the genotype. Gene frequencies and found genotypes demonstrated similarity of the Czech population's KIR repertoire with the KIR repertoires of other Caucasian populations studied before.

Developmental expression and distinctive tyrosine phosphorylation of the Eph-related receptor tyrosine kinase Cek9.

Cek9 is a receptor tyrosine kinase of the Eph subfamily for which only a partial cDNA sequence was known (Sajjadi, F.G., and E.B. Pasquale. 1993. Oncogene. 8:1807-1813). We have obtained the entire cDNA sequence and identified a variant form of Cek9 that lacks a signal peptide. We subsequently examined the spatio-temporal expression and tyrosine phosphorylation of Cek9 in the chicken embryo by using specific antibodies. At embryonic day 2, Cek9 immunoreactivity is concentrated in the eye, the brain, the posterior region of the neural tube, and the most recently formed somites. Later in development, Cek9 expression is widespread but particularly prominent in neural tissues. In the developing visual system, Cek9 is highly concentrated in areas containing retinal ganglion cell axons, suggesting a role in regulating their outgrowth to the optic tectum. Unlike other Eph-related receptors, Cek9 is substantially phosphorylated on tyrosine in many tissues at various developmental stages. Since autophosphorylation of receptor protein-tyrosine kinases typically correlates with increased enzymatic activity, this suggests that Cek9 plays an active role in embryonic signal transduction pathways.