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OBJECTIVE: It has previously been shown that a combination of inhaled nitric oxide (iNO) and intravenous (IV) steroid attenuates endotoxin-induced organ damage in a 6-hour porcine endotoxemia model. We aimed to further explore these effects in a 30-hour model with attention to clinically important variables. DESIGN: Randomized controlled trial. SETTING: University animal laboratory. SUBJECTS: Domestic piglets (n = 30). INTERVENTIONS: Animals were randomized into 5 groups (n = 6 each): 1) Controls, 2) LPS-only (endotoxin/lipopolysaccharide (LPS) infusion), 3) LPS + iNO, 4) LPS + IV steroid, 5) LPS + iNO + IV steroid. MEASUREMENTS AND MAIN RESULTS: Exposure to LPS temporarily increased pulmonary artery mean pressure and impeded renal function with elevated serum creatinine and acidosis compared to a control group over the 30-hour study period. Double treatment with both iNO and IV steroid tended to blunt the deterioration in renal function, although the only significant effect was on Base Excess (p = 0.045). None of the LPS + iNO + IV steroid treated animals died during the study period, whereas one animal died in each of the other LPS-infused groups. CONCLUSIONS: This study suggests that combined early therapy with iNO and IV steroid is associated with partial protection of kidney function after 30 hours of experimental LPS infusion

The usefulness of optical coherence tomography in a patient on antiplatelet therapy and requiring surgery

Establishing a balance between the risk of stent thrombosis and the risk of perioperative bleeding in patients treatedwith dual antiplatelet therapy remains a major therapeutic challenge. We report a case of 60-year-old man after stent implantation in left main coronary artery and requiring urgent operative treatment. The result of optical coherence tomography helped us to decide about further proceeding and is an example of a very helpful application of this new imaging technique in everyday practice.Establishing a balance between the risk of stent thrombosis and the risk of perioperative bleeding in patients treatedwith dual antiplatelet therapy remains a major therapeutic challenge. We report a case of 60-year-old man after stent implantation in left main coronary artery and requiring urgent operative treatment. The result of optical coherence tomography helped us to decide about further proceeding and is an example of a very helpful application of this new imaging technique in everyday practice

The use of rotational atherectomy in high-risk patients: results from a high-volume centre

Background: Rotational atherectomy (RA) is indicated for fibrocalcified lesions when traditional percutaneous coronary intervention (PCI) could not be successfully performed. In some of the high-risk patients the RA procedure is the last resort for successful revascularisation. Such patients are, among others, those in whom coronary artery bypass grafting (CABG) is not feasible.Aim: The aim of the study was to assess in-hospital and one-year outcomes of PCI with RA in high-risk patients without other revascularisation options (RA-only group), in comparison to lower-risk patients undergoing RA.Methods: We evaluated data of 207 consecutive patients who underwent PCI with RA. Primary endpoints were one-year all-cause mortality and one-year major adverse cardiac events (MACEs). Secondary endpoints were in-hospital outcomes.Results: During the study 35% of patients fulfilled the inclusion criteria to the high-risk group. Those patients had significantly lower left ventricular ejection fraction, more often prior CABG, higher admission glucose level, and higher EuroSCORE II and Syntax Score. Procedural success was similar in both groups (85% in RA-only group vs. 91% in remaining patients, p = 0.18). In-hospital outcomes were similar, except more frequent no/slow-flow phenomenon in the RA-only group. The MACE and mortality rates in one-year follow-up were not statistically different in both groups (19% vs. 18%, p = 0.82 and 11% vs. 9%, p = 0.64, respectively).Conclusions: Despite the high-risk characteristics of the study subgroup, no significant differences between in-hospital and one-year outcomes were found in comparison to lower-risk RA patients. Complex PCI with RA in patients without other revascularisation options should be taken into consideration

Wokół rekodyfikacji prawa cywilnego. Prace jubileuszowe

Praca recenzowana / Peer-reviewed paperPrezentowana książka to głos w debacie nad stanem naszej kodyfikacji cywilnej. Jubileusz 50-lecia uchwalenia Kodeksu cywilnego, Kodeksu rodzinnego i opiekuńczego oraz Kodeksu postępowania cywilnego zbiega się z jubileuszem Profesora Janusza Szwai1. Profesor, wybitny cywilista, obchodzi swoje 80. urodziny, mija także 50 lat od obrony przez Niego doktoratu. Jest to doskonała okazja by przyjrzeć się propozycjom zmian prawa cywilnego płynących z różnych środowisk akademickich. Wszak dużą część swojego życia Profesor Szwaja poświęcił pracom legislacyjnym, ich komentowaniu czy krytykowaniu. Sam aktywnie w zmianach różnych kodyfikacji uczestniczył. Jego poglądy zawsze były wyważone. Dziś właśnie taki wyważony głos w dyskusji nad kształtem polskiego prawa cywilnego stał się niezbędny

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Kompleksowa protekcja mikrokrążenia wieńcowego podczas pierwotnej angioplastyki u pacjenta z zawałem serca

We describe a case of 61 year-old man with acute myocardial infarction (AMI) and with large thrombus in right coronary artery. The patient underwent primary angioplasty with complex embolic protection: pharmacological, thromboaspiration and filter protection device. This triple embolic protection was necessary to evacuate thrombi and successfully restore normal flow in coronary artery. Despite distal protection has no evidence to be beneficial in AMI, the use of filter protection might be considered in selected patients. Kardiol Pol 2011; 69, 4: 405-40