Anatomical description of the perforating cutaneous nerve.

BACKGROUND: The perforating cutaneous nerve/perforating nerve of the sacrotuberous ligament is rarely observed. It usually arises from the posterior division of the sacral plexus or the pudendal nerve and perforates the sacrotuberous ligament. The anatomy of this nerve and its variants is poorly described in the literature, but there are data indicating its role in pudendal neuralgia. MATERIALS AND METHODS: Herein, we present an anatomical study of six formalin-fixed cadavers with descriptions of the topography of spinal nerves S2-S4, the pudendal bundle, the perforating cutaneous nerve and the sacrotuberous ligament. RESULTS: We found three perforating cutaneous nerves and described each of them in detail, with measurements of length and width, and point of perforation of the sacrotuberous ligament. CONCLUSIONS: We distinguished three types of perforating cutaneous nerve on the basis of our findings and previous publications; two of the three types were observed in our study.

Computed tomography with positron emission tomography is more useful in local than systemic infectious process related to cardiac implanted electrotherapy device: a prospective controlled multicenter diagnostic intervention PET-Guidance Trial.

Assess the diagnostic value of 18-F FDG PET/CT in cardiac implantable electronic devices (CIED) infections in facilitating diagnostic process and optimizing decision-making process.Study group (n = 21) patients with initial suspected diagnosis of CIED-related infection or fever of unknown origin and patients referred for device removal due to infection. Control group (n = 13) patients with implanted CIED, who underwent PET/CT due to other non-infectious indications and had no data for infectious process in follow-up.PET/CT scan showed pocket infection in 12 patients (including 1 in whom infection was not finally diagnosed-the examination was performed early after the implantation procedure-1.5 months), increased tracer uptake in intravascular lead part in 3 patients, and increased uptake in intracardiac part in 5 patients.We found that sensitivity, specificity, positive predictive value, and negative predictive value of the diagnosis made by PET/CT in generator pocket infection was 91.7%, 70%, 78.6%, 87.5% and in lead-dependent intracardiac infection 100%, 47.1%, 35.7%, 100% respectively. PET/CT scan enabled reclassification of diagnosis from possible to definite CIED-related infection in 6 out of 9 patients, and to excluded in 3 out of 9.Establishing diagnosis of device related infections may be challenging due to non-specific symptoms. Incorporation of PET/CT scan in the diagnostic schema can improve accuracy and timing of the diagnosis and help to assess the extent of infection. PET/CT is more useful in local than systemic infectious process related to cardiac implanted electrotherapy device.Trial registration Consent of the bioethics committee nr IK-NP.-0021-85/1465/14. Registration in the www.clinicaltrials.gov database: NCT02196753.

Coeliac trunk and its anatomic variations: a cadaveric study.

BACKGROUND: Coeliac trunk (CT) is the first major visceral branch of the abdominal aorta. The aim of this work was to present the CT division pattern and its anatomical variants in a sample of Polish population. MATERIALS AND METHODS: Coeliac trunk dissection was performed in 50 adult cadavers in the Department of Anatomy, Jagiellonian University Medical College. Cadavers of Polish subjects were included. Cadavers with previous upper abdominal surgery, abdominal trauma, disease process that distorted arterial anatomy or signs of putrefaction were excluded. CT variations, accessory vessels, and vertebral level of origin were described. CT patterns were reported according to the Adachi classification. This study was reviewed and approved by the local Ethics Committee. RESULTS: Coeliac trunk consisting of the left gastric, common hepatic and splenic artery (type 1 according to the Adachi classification) was found in 82% of cadavers. The true tripod was found in 20% and the false one in 80%. Additional vessels were also found: greater pancreatic from the splenic artery and left inferior phrenic from the left gastric artery, which accounted for 2% sections. Type 2 according to the Adachi classification (i.e. the hepatosplenic trunk) was found in 16% of the sections. Other types of CT were not observed. The level of origin was found to be at the inter-vertebral disc between T12 and L1 in all of the cases. CONCLUSIONS: Based on the analysis of the sectional material of the Department of Anatomy, it was found that the typical visceral segmental division is approximate to that observed by Adachi in its classification, whereas the second type of CT was twice as frequent and no other, less frequent types were found.

Unusual variations in the branching pattern of the coeliac trunk and their clinical significance.

BACKGROUND: The anatomical variations of the coeliac trunk are due to developmental changes in the ventral segmental arteries. Multidetector computed tomography (MDCT) has been used to investigate vascular anatomy for scientific and diagnostic purposes. These studies allow for much larger sample sizes than traditional cadaveric studies. The aim of this research was to isolate rare anatomical variants of the coeliac trunk and emphasize their clinical significance. MATERIALS AND METHODS: A descriptive, retrospective study was carried out on MDCT angiographies performed from January 2020 till March 2020 in Polish patients. Coeliac trunk was studied and normal and anatomical variations were identified. RESULTS: Out of total 350 patients, hepatogastrosplenic trunk was predominant. However, we observed: coeliaco-mesenteric and hepatogastric trunk type, hepatic artery variations and coeliac axis stenosis with collateral mesenteric circulation. CONCLUSIONS: Rare variations of the coeliac trunk should always be anticipated before radiological and surgical interventions. Knowledge of unusual coeliac trunk anatomy is important in hepatopancreatobiliary surgery, transplantology, and interventional radiology.

Anatomical variants of coeliac trunk in Polish population using multidetector computed tomography angiography.

BACKGROUND: Multidetector computed tomography angiography (MDCTA) has become a major part in evaluation of normal anatomy and its variants in patients undergoing operative or interventional procedures. The purpose of this study was to assess the frequency of anatomical variation of coeliac trunk in patients undergoing MDCTA of the abdominal aorta. MATERIALS AND METHODS: A descriptive, retrospective study was carried out on MDCTAs performed from January 2014 till January 2020 in Polish patients. Coeliac trunk was studied and normal and anatomical variations were noted according to Adachi's classification. All patients with abnormalities affecting the vessels or a history of any vascular abnormality were excluded from the study. RESULTS: Out of total 1000 patients, hepatogastrosplenic trunk was found in 93.0%. True and false types of trifurcation were observed. Hepatosplenic trunk was found in 2.8%, coeliacomesenteric trunk in 1.1%, hepatomesenteric trunk in 1.7% gastrosplenic trunk was found in 1.4%. We have not observed hepatosplenomesenteric trunk. CONCLUSIONS: The type and knowledge of anatomy is of prime importance for an optimum preoperative planning in surgical or radiological procedure. MDCTA allows minimally invasive assessment of arterial anatomy with high quality three-dimensional reconstruction images.

Rare combined variations of the coeliac trunk, accessory hepatic and gastric arteries with co-occurrence of double cystic arteries.

Many variations of the coeliac trunk and hepatic or gallbladder arterial supply have been reported before in many cadaveric and radiologic studies. In this case we present combined anomalies observed in dissected cadaver of a 73-year-old female. The left gastric artery arises directly from the abdominal aorta and gives two branches: the right inferior phrenic artery in the proximal part and the accessory left hepatic artery in the distal part. The coeliac trunk is bifurcated into the common hepatic artery and the splenic artery. The right gastric artery emerges from the left hepatic artery. The right hepatic artery gives two cystic arteries and the accessory right hepatic artery is noticed arising from the posterior superior pancreaticoduodenal artery. The deep cystic artery and the right inferior phrenic artery give hepatic branches. Also, we noticed small accessory biliary duct going to the cystic duct. This complexity of the arterial supply with anomaly of the biliary ducts has many surgical implications which will be herein discussed.

Concentration levels of cadmium and lead in the raw and processed meat of Helix pomatia snails.

This work reports on cadmium and lead contaminations in the edible snail Helix pomatia harvested in Poland. One hundred and 24 samples of Helix pomatia meat collected from seven provinces (voivodeships) of Poland were analyzed for their trace metal levels by graphite furnace atomic absorption spectrometry (GFAAS). The research was conducted in 2 stages. The 1st stage analyzed snail meat prior to any further technological treatment (raw meat). In the 2nd stage, the trace element levels were measured in meat subjected to technological treatment (processed meat). The trace element contents in raw meat samples ranged from 0.06 mg kg-1 to 0.22 mg kg-1 for Cd and from 0.06 mg kg-1 to 0.18 mg kg-1 for Pb. The analyses revealed an increase in the cad- mium content from 0.12 mg kg-1 to 0.18 mg kg-1 in thermally treated snail meat and no changes in lead concentration during the two-stage heat treatment. Regulation (EC) 1881/2006 does not specify the Cd and Pb residue limits in meat of terrestrial edible snails. The limits are set for in- vertebrate aquatic organisms meat (i.e. shellfish, mollusc, cephalopod) and range from 0.5 mg/kg to 1.5 mg/kg of tissue fresh weight for Pb and from 0.5 mg kg -1 to 1 mg kg-1 for Cd (EU Commis- sion 2006). The results demonstrate that the land snail Helix pomatia has a tendency to bioaccu- mulate trace elements, and the cooking process is likely to affect (increase) the Cd content in the snail meat.

Evaluation of Pretransplant Donor-Specific Alloantibodies With Different Crossmatch Techniques.

Donor-recipient crossmatching for kidney transplantation is an obligatory step for the transplant work-up process. Attention is currently put on single bead assay (SBA) that enables virtual crossmatching. In contrast, methods developed for complement binding capacity are still not routinely established. We compared modified, cytolytic flow cytometry crossmatch (cFC-XM) with complement-dependent serological crossmatch (CDC-XM), SBA, and flow cytometry crossmatch (FC-XM) to verify whether newly developed techniques may be beneficial for transplant immunological matching. Also, the cutoff value for donor-specific alloantibodies levels currently used for virtual crossmatch was verified. Serum from 22 sensitized patients was crossmatched with surrogate donors by CDC-XM, FC-XM, and cFC-XM, while anti-HLA antibodies were measured by SBA. In all cases, virtual crossmatch was positive at 5000 mean fluorescence intensity cutoff. Among 22 tested sera with donor-specific alloantibodies above 5000 mean fluorescence intensity, the positive CDC-XM result was noted only in 41% of patients (n = 9), but positive FC-XM was noted in 86% (n = 19), and further lytic antibodies (cFC-XM) were confirmed in 27% of cases (n = 6). Our results suggest that donor-recipient immunological matching for kidney transplantation requires different methods to verify the importance of alloantibodies, and improvement in laboratory investigation is needed. This is especially important for immunized patients that have many types of alloantibodies and virtual crossmatching used as a tool for deceased donor allocation should balance between the likelihood of transplantation and risk of positive crossmatch result.

Sperm quality and selected biochemical parameters of seminal fluid in dogs with benign prostatic hyperplasia.

Benign prostatic hyperplasia (BPH) in dogs is most commonly associated with age and increasing concentrations of dihydrotesterone, a hormone that stimulates growth and secretion of the prostatic epithelial cells. During this process, the biochemical composition of prostatic secretion changes, which can affect the quality of semen and limit the ability of the sperm to contribute to fertilization. Therefore, the present study was conducted to examine possible correlation between BPH and biological quality of semen. The study was performed in 11 sexually mature dogs of various breeds. Animals were divided into two groups: healthy dogs (Group I; n = 5; mean age 4.32; SEM = 1.28) and dogs with BPH (Group II n = 6; mean age 6.16; SEM = 0.65). Semen and prostate secretions were collected and evaluated in this study. Standard semen examinations were conducted in the ejaculates collected; moreover, the extent of apoptosis and DNA defragmentation was determined. The selected biochemical parameters were determined in the prostate secretion. According to the examination results, there were no significant differences in standard semen parameters between the two groups of dogs. Nevertheless, morphological tests of semen in dogs with BPH demonstrated elevated percentages of primary defects in spermatozoa. A significant increase (P = 0.01) in DNA defragmentation of sperm was found in dogs with BPH. Moreover, changes in the biochemical composition of prostate secretion were demonstrated. In dogs with BPH, pH of prostate secretions was greater (P = 0.03), concentrations of cholesterol increased while concentrations of Zn and Cu decreased. The study findings reveal that BPH does not change semen quality in dogs.

On the Basicity of 8-Phenylsulfanyl Quipazine Derivatives: New Potential Serotonergic Agents.

A protonation state of serotonergic ligands plays a crucial role in their pharmacological activity. In this research, the basicity of 8-phenylsulfanyl quipazine derivatives as new potential serotonergic agents was studied. The most favorable protonation sites were determined in the gas and aqueous phases. In water, a solvation effect promoting the protonation of the N3 atom overcomes a positive charge delocalization phenomenon favoring a N1 atom protonation. The most stable conformations of neutral and protonated molecules in gas and water were found. It was demonstrated that a diprotonation reaction may occur. The most favorable among the diprotonated structures is the molecule with the N1 and N3 atoms protonated. A calculation of the pKa and pKa2 in water of a set of monosubstituted 8-phenylsulfanyl quipazine derivatives was performed using B3LYP/6-31G(d) and the SMD continuum solvation model. Enthalpic and entropic contributions to the pKa and pKa2 in gas and water were separated for a rationalization of a substituent effect on values of the pKa and pKa2. The relationship of the proton affinity and the solvation enthalpy in water with some reactivity descriptors, such as the Fukui function, the molecular electrostatic potential (MEP), and the global softness, was investigated. The order of the pKa values is the most controlled by the entropy. The diprotonation reaction, despite having an unfavorable enthalpy in water, is driven entropically. Final state effects in the diprotonated species were analyzed with the triadic formula. Results of a calculation of the theoretical basicity of the 8-phenylsulfanyl quipazines indicate that they should be monoprotonated on the N3 atom in the CNS environment. Diprotonation of the studied compounds may occur in very acidic body fluids such as the gastric juice.

Experimental and theoretical studies on the molecular properties of ciprofloxacin, norfloxacin, pefloxacin, sparfloxacin, and gatifloxacin in determining bioavailability.

The aim of this investigation is to identify, by in silico and in vitro methods, the molecular determinants, e.g., solubility in an aqueous medium and lipophilic properties, which have an effect on the bioavailability of five selected fluoroquinolones. These properties were estimated by analysis of the electrostatic potential pattern and values of free energy of solvation as well as the partition coefficients of the studied compounds. The study is based on theoretical quantum-chemical methods and a simple experimental shake-flask technique with two immiscible phases, n-octanol and phosphate buffer. The solvation free energy values of compounds in both environments appeared to be negative. The wide range of electrostatic potential from negative to positive demonstrates the presence of dipole-dipole intermolecular interactions, while the high electron density at various sites indicates the possibility of hydrogen bond formation with solvent molecules. High partition coefficient values, obtained by summing the atomic contributions, did not take various correction factors into account and therefore were not accurate. Theoretical partition coefficient values based on more accurate algorithms, which included these correction factors (fragmental methods), yielded more accurate values. Theoretical methods are useful tools for predicting the bioavailability of fluoroquinolones.

Novel renin inhibitors containing a non-peptide aminoalkanoyl moiety at P1-P1' position.

Six novel potential renin inhibitors have been designed and synthesized. All these inhibitors contained an unnatural aminoalkanoyl moiety at the central position P1- P1' of the molecule, which is attacked by renin. The moiety consists of pseudodipeptidic units, transition state analogues of a natural dipeptide of the parent substance: 4-amino-3-hydroxybutanoic acid (AHBA), 4-amino-5-(4-ethoxyphenyl)-3-hydroxypentanoic acid (AEPHPA), 4-amino-5-cyclohexyl-3-hydroxypentanoic acid (ACHPA) or 4-amino-3-hydroxynonanoic acid (AHNA). An unnatural moiety, 4-methoxyphenylalanylhistydyl (Phe(4-OMe)-His) has been introduced at the P3-P2 position of the obtained compounds. Five compounds contain isoamylamide of 6-aminohexanoic acid (epsilon-Ahx-laa) at the P2'-P3' position. One of designed inhibitors has been obtained in the form of an ethyl ester. The in vitro renin inhibitory activity of all synthesized compounds is contained within the range 10(-6) - 10(-8) M. The compound in the form of an ethyl ester has proven to be the most active (IC50 = 1.3 x 10(-8) M) but also susceptible to enzymatic degradation. The other five inhibitors were stable to chymotrypsin.

The influence of neuropilin-1 silencing on semaphorin 3A and 3C activity in B16(F10) murine melanoma cells.

Neuropilin-1 (Nrp1), originally characterized as an adhesion molecule in the nervous system, is a co-receptor for class-3 semaphorins. Neuropilins and semaphorins are highly expressed in a wide spectrum of tumors and have been shown to influence their growth and vascularization. Despite the growing body of data on neuropilin/semaphorin regulation of tumor growth, still the exact mechanism of their activity remains to be elucidated. Previously published data suggests that Nrp1 has both anti- and promigratory characteristics in different tumor types, although no data is available on its role in melanoma cells. In this paper, we studied the effect of Nrp1 downregulation on B16(F10) melanoma cells migration. Our results show that the silencing of Nrp1 significantly increases the overall mobility of B16(F10) cells and changes their morphology. Moreover, Nrp1-silenced B16(F10) cells show a decreased response to Sema3A. We also observed reduced binding of Sema3A to these cells. Contrarily, no changes were observed in the binding of Sema3C to Nrp1-silenced B16(F10) cells, nor in its chemorepellent activity. Our results suggest that modulation of B16(F10) cells migratory ability by semaphorin 3A can be preferentially mediated by Nrp1, while the contribution of semaphorin 3C in this process is less evident. In addition, silencing of Nrp1 did not change the migratory ability of B16(F10) cells towards VEGF.

Contents of zinc, copper, chromium and manganese in silver foxes according to their age and mineral supplementation.

Serum, livers and kidneys of 30 silver foxes from one breeding farm were subjected to analysis of the four microelements contents. The samples derived from 3 groups of animals (n = 10) selected according to age and developed reproduction disorders. Cu, Cr and Mn were determined by a graphite furnace AAS whereas Zn by the flame AAS methods. Serum levels of Zn were the least variable (x (n = 30) = 4.72 +/- 2.313 microg x mL(-1)) and the mean of Cu content was 0.26 +/- 0.244, of Cr was 0.029 +/- 0.032 and of Mn was 0.074 +/- 0.085 microg x mL(-1). The livers and kidneys contained respectively: 159.9 +/- 23.66 and 74.25 +/- 14.44 microg g(-1) of Zn; 34.03 +/- 12.43 and 13.66 +/- 1.67 microg g(-1) of Cu as well as 6.28 +/- 0.97 and 2.60 +/- 0.33 microg g(-1) of Mn. The most variable was Cr level achieving 1.00 +/- 1.06 and 1.43 +/- 2.64 microg g(-1) (all results per gram of wet weights). The differences between means and medians within the age groups did not exceed 41%, however chromium was an exception, its values differed more than 2 times. High zinc level found both in the serum and the organs resulted from its concentration in feedstuff being 1040,5 microg g(-1), exceeding the recommended level for farming foxes. Over-supplementation of dietary Zn might suggest connection between subtoxic action of Zn or its interaction with Cu or Cr followed by subsequent effect on reproduction events. Whether nature of Zn effects derived from direct target action or from Zn - Cu or Zn - Cr interactions have to be solved experimentally. Some foxes contained copper and chromium in livers and kidneys at levels exceeded significantly those concidered as physiological ranges for mammals, whereas manganese was within these limits. Thus, manganese was considered to keep homeostasis status of this element in the examined foxes.

Heavy metal concentration in coat hair and hoof horn in stabled and reserve Polish Konik horses.

The objective of the study was to determine if there were differences in Cr, Mn, Cu, Cd, Pb and Ni levels in coat hair and hoof horn between Polish Konik horses maintained in stabled and reserve systems in Roztocze National Park in Poland. Summer and winter feeding seasons (seasons of the year in case of hooves) and age of horses were taken into account. 107 samples of hair and hooves, as well as all kinds of feed and sources of water available for the horses were examined. The results of the study indicate that the concentration of the elements in the coat hair, hoof horn, feeds and water is usually too low to show possible influence of the system of maintenance in feeding seasons and age effect. The reserve horses are not more exposed to heavy metal contamination than the stabled horses. In the hair, solely Mn level is affected by the systems of maintenance in summer and winter feeding seasons: during winter it is higher, particularly in the stabled system, than during summer. In hooves, Cr concentration is higher in stabled horses than in reserve horses and conversely, Cu content is higher in the reserve horses. Mn content is age-affected both in hair and hooves, likewise is Cu content in the hooves. The results indicate a necessity of Cu compound supplementation in feeding the horses in both systems of maintenance.

Cytomegalovirus infection does not accelerate microvasculopathy development in heart transplant recipients.

BACKGROUND: Clinical studies with intravascular ultrasound have suggested that even subclinical cytomegalovirus (CMV) infections increase intimal hyperplasia in transplanted heart coronary arteries after 1 year. The potential influence of CMV on microvasculopathy development is not known. The Aim of our study was to compare the occurrence of microvasulopathy in endomyocardial biopsies (EMBs) of heart transplant recipients with versus without CMV infection. MATERIALS AND METHODS: We performed a case-controlled, retrospective study of 58 subjects diagnosed with CMV infection by the presence of pp65 antigen. The 49 men and 91 women of overall age 49 +/- 8 years showed ischemic cardiomyopathy in 52%. We matched a control cohort of 58 subjects without CMV disease. Microvasculopathy was assessed using 4-degree grading system developed by Hiemann et al for elective EMBs performed at 1 and 12 months after transplantation. RESULTS: Significant acute rejection episodes were observed among 22% versus 21% of 1-month EMBs, and 3% versus 5% of 12-month EMBs for CMV(+) versus control group subjects respectively. The commonest microvasculopathy was nonstenotic thickening (grade B) 60% versus 59% (35 versus 34 patients) among 1-month EMBs; and 50% versus 60% (29 vs 35 patients) among 12-month EMBs, respectively. Progression of microvasculopathy score between 1- and 12-month EMB was observed in 40% versus 41% of subjects, and regression occurred in 22% versus 21%, respectively. None of differences was significant. CONCLUSION: Our data do not support the thesis that CMV infection promotes microvasculopathy development among heart transplant recipients.

A role of thymidine phosphorylase and P53 tissue protein expression in biology of endometrial cancer.

Tumor suppressor gene p53, the most commonly mutated gene in human cancers has been shown to play an important role in the biology of gynaecological carcinomas. Thymidine phosphorylase is one of the most important angiogenic factors, which is connected with tumor expansion and invasiveness. The aim of the study was an evaluation of thymidine phosphorylase and p-53 tissue protein expression in human endometrial cancer cells by immunohistochemistry and comparison obtained data with clinicopathological factors as FIGO stage of disease and histopathologic grade. Endometrial cancer specimens were obtained from 55 postmenopausal patients (aged 52 to 74 years) operated by total abdominal hysterectomy with bilateral salpingo-oophorectomy. None of patients received preoperative pelvic irradiation. Histopathological typing and grading of the endometrial tumors (G-1, G-2, G-3) as well as myometrial invasion (<1/2, >1/2) were assessed using standard criteria, on hematoxylin-eosin sections. FIGO clinical stage of disease was determined. at the surgery. Thymidine phosphorylase overexpression was observed in 23 (41,8 %) cases. Although we found no statistically significant differences in TP expression between histopathologic grades, particular FIGO stages showed a significant trend of increase TP tumor overexpression. P53 protein overexpression was observed in tumor tissue in 21 cases (35,2%). It tended to be more frequent in cases of advanced disease as well as in low differentiated tumors. Although we found no statistically significant differences in p53 gene expression between groups of FIGO stage and histopathologic grade, we obtained a significant trend of increasing the P53 positive rate with both FIGO and tumour differentiation grading Joint assessment of thymidine phosphorylase and tumor suppressor genes expression may be of additional value in determining the biology of endometrial carcinoma. Key words: endometrial cancer, thymidine phosphorylase, p-53.

The effects of methylprednisolone and mitoxantrone on CCL5-induced migration of lymphocytes in multiple sclerosis.

OBJECTIVES: Chemokines are involved in migration of inflammatory cells to the central nervous system (CNS) in multiple sclerosis (MS). The aim of this study was the analysis of the impact of MS treatment on CCL5-induced migration of leukocyte subpopulations. MATERIAL AND METHODS: Migration of lymphocytes and monocytes from blood of MS patients treated with methylprednisolone (MP) or mitoxantrone (MTX) was analysed in a chemotaxis chamber. RESULTS: CCL5-induced migration of lymphocytes from untreated MS patients was significantly increased over controls. The treatment of MS with MP and MTX reduced this chemotaxis. The plasma level of CCL5 was increased in MS patients before treatment and was also significantly decreased in the treatment of MS with MP and MTX. CONCLUSIONS: This observation supports the hypothesis that in MS, chemokine CCL5 may induce migration of leukocytes to the CNS and suggests that treatment of the disease with MP and MTX may reduce this migration.

The effect of Epstein-Barr virus infection on medium-term survival after orthotopic heart transplantation.

UNLABELLED: Our aim was to assess the medium-time results after orthotopic heart transplantation (OHT) depending on the serostatus of heart transplant recipients at the time of transplantation. MATERIALS AND METHODS: We enrolled 120 patients in this retrospective study including 107 males and an overall mean age of 49.1 +/- 8.6 years ischemic heart disease (IHD) was the diagnosis before OHT in 46%. The mean follow-up was 48 months. The first diagnostic coronary angiography was routinely preformed at 1 year after OHT, and then every second year. We evaluated every incidence of a change in the coronary arteries, the presence of significant stenosis (requiring percutaneous coronary intervention), acute myocardial infarction, death, or retransplantation. Using indirect immunofluorescence assays we detected Epstein-Barr virus (EBV) antigenemia by identification of antibodies against early antigens of EBV (EA) of IgM and IgG classes as well as IgG antibodies against nuclear antigen of EBV (EBNA). Since April 2001 all three types of antibodies were routinely investigated on admission to the hospital for OHT. RESULTS: At the time of transplantation, IgM-EA antibodies were detected in 17 (14%) patients, IgG-EA in 35 (29%), and IgG-EBNA in 113 (94%). Survival rate, incidence of cardiac allograft vasculopathy and death, as a function of the serostatus of the heart recipient at the time of transplantation were estimated by Kaplan-Meier curves; the results were compared by log-rank tests. The findings among IgM EA, IgG EA, and IgG EBNA-positive and -negative groups were statistically comparable. CONCLUSION: Infection with EBV before OHT did not worsen the prognosis over the first 4 years after transplantation.

The influence of cytomegalovirus infection, confirmed by pp65 antigen presence, on the development of cardiac allograft vasculopathy.

AIM: We sought to determine the impact of cytomegalovirus (CMV) infection on cardiac allograft vasculopathy (CAV) development in the long term after orthotopic heart transplantation (OHT). MATERIALS AND METHODS: We enrolled 144 patients in this retrospective study including 128 men with an overall age at transplantation of 48.4 +/- 9.3 years. Before OHT, 45% exhibited ischemic heart disease (IHD). The mean follow-up was 62 months. Detection of CMV antigenemia was performed by identification of pp65-antigen on peripheral blood leukocytes. The first diagnostic coronary angiography was routinely performed at 1 year after heart transplantation and thence every second year. We evaluated every incidence of change in the coronary arteries, of significant stenosis (requiring percutaneous coronary intervention), acute myocardial infarction, of death or of transplantation. All patients were followed to the incidence of a cardiovascular event, death, or the end of observation. RESULTS: Of 144 patients, 33 were pp65 positive, namely 29 men with overall mean age at transplantation of 48 +/- 10.3 years. Before OHT, 52% had IHD. The incidence of CAV during follow-up was 24% (n = 8) in the pp65(+) and 22% (n = 24) in the pp65(-) group. It was significant in 3 (9%) versus 8 (24%) patients. There were 4 (12%) deaths in pp65(+) and 9 (8%) deaths in the pp65(-) groups. Kaplan-Meier survival curves to estimate the time for CAV development and death showed no significant differences by log-rank tests. CONCLUSION: No impact of CMV infection on CAV development was observed in first 5 years after OHT.