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  • Author or Editor: J. Kasza x
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Abstract  

The migration of HTO from a point source was studied in the soil of the storage of radioactive waste at horizontal distances of 10 to 40 cm from the source between 2 and 4 m depths at 5 different rainfalls, up to 7641/m2. The water movement changed from 0.17 cm/l (at 10 cm) to 0.28 cm/l (at 40 cm distance) when 186 1 was irrigated, while at 764 1 rainfall it was found to be 0.11 cm/l at every distance. The estimated parameters of a three-dimensional migration model constructed to characterize HTO movement revealed that the HTO distribution migrates downwards in a small, about 1 m thick layer with an initial rate of 0.17 cm/l to slow down to about 0.05 cm/l after 50 years. The distribution is spreading horizontally with a constant rate of about 0.08 cm/l.

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Abstract  

Massive bleeding from esophagus varices presents a life threatening complication of portal hypertension. No effective method of treatment is available until now, that would guarantee high grade of patient wellness during the conditioning and investigation phase until the definitive treatment could be introduced. The aim of this study was to evaluate the tissue response to esophagus stents - designed for manage acute variceal bleeding - in animal experiment. Self-expandable nitinol stents were introduced into the esophagus of six porcines. Another twelve porcines were undergone the same procedure, using the new biodegradable stents made of PDO (polydioxanon). Histological investigations of the stented esophagus segments were observed after 2 and 4 weeks at the first 12 animals. To monitor the time of stent degradation, histology were performed 7 and 12 weeks after the implantation in the biodegradable group (3–3 animals). Differential scanning calorimetric examination was performed in all esophagus samples. Focal erosion of the esophagus segments was more explicit in the nitinol group at the histology. On the 7th week all of the biodegradable stent were in the stomach and on the 12th week these were completely solved. DSC examination showed significant alterations in the structure of the esophagus in both stented group compared to the healthy control. This experiment showed that the new self-expandable stents are safety and suitable procedure without deterioration of the esophageal wall. According to our DSC results the thermal denaturation of intact esophagus, its mucosa and muscle fragments revealed significant differences compared to healthy sample in favour the new biodegradable stent. Safety and efficiency in the experimental model had encouraged us to apply this method successfully patients with bleeding esophagus varices. The long term goal is to show that stent placement could be an effective way of decreasing or stabilising the acute bleeding from ruptured esophagus varices in cirrhotic patients.

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Abstract

Background

Immunosuppressive therapy has improved the outcome of ANCA-associated vasculitis (AAV), but infectious morbidity and mortality remained high. Recognizing its risk factors seems crucial for prevention, aiming to increase survival of these patients.

Methods

We investigated the incidence and types of infections and assessed predictive factors in 132 patients with severe systemic AAV.

Results

Patients with lower than median incidence of total infections/patient-year during induction had lower baseline serum creatinine, dialysis requirement and Charlson comorbidity index (CCI), compared to those with higher than median incidence (P = 0.037; P = 0.024; P = 0.001; respectively). In subgroups with below and above than median number of severe infections/patient-year during induction, differences were found in baseline creatinine (P = 0.002) and dialysis requirement (P = 0.001); comparing the same cohorts during maintenance immunosuppression, baseline dialysis requirement, diabetes, CCI, and dose of cyclophosphamide (CYC) administered as induction therapy differed significantly (P = 0.019; P = 0.015; P = 0.001; P = 0.015, respectively). Severe infections were predicted by baseline serum creatinine (OR 1.002 [CI 1.001–1.003]) and pulmonary manifestation (OR 2.153 [CI 1.017–4.560]) during induction immunosuppression. In multivariable Cox regression model all-cause mortality was independently predicted by severe infection (HR 1.998 [CI 1.214–3.287]). Among the 168 positive cultures Gram-negative bacteria were responsible for blood stream infections in 33%, and respiratory tract infections in 72%.

Conclusions

Advanced renal failure, pulmonary involvement and high degree of comorbidities increase the risk of infection in AAV. Those who suffer infection during induction immunosuppression have worse long-term survival. Our findings indicate the need for high vigilance for infections and close follow-up of comorbidities when treating AAV.

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