Makowka leonard (3 risultati)

Softcover (Spiral Bound). Condizione: Very Good. Edition Unstated. Appears to have clean text. Has light shelf and corner wear. Binding is in very good condition. Light creasing to back cover. 460 pp. Quantity Available: 1. Shipped Weight: Under 1 kilo. Category: Medicine & Health; ISBN: 1570591881. ISBN/EAN: 9781570591884. Pictures of this item not already displayed here available upon request. Inventory No: 1561002747. …

Hardcover. Condizione: Very Good. 363p large format hardback, fresh dustjacket, collection of essays with illustrations and tables and graphs, name to endpaper "Roy Calne", also inserted Calne (the artist) related material Language: English.

Soft cover. Condizione: Near Fine. No Jacket. 1st Edition. A scarce, important monograph. Stapled wraps, 8 7/8 x 5 7/8 inches, pp. 267-472, figures, references. Near fine. Address label, rear cover. (K011) Drs. Michael A. Nalesnik, L. Makowka, and Thomas E. Starzl made foundational contributions to understanding posttransplant lymphoproliferative disorders (PTLD) by defining their clinical-pathological features, establishing diagnostic frameworks, and clarifying their relationship with potent immunosuppression. Core Contributions Defining Clinical and Pathological Spectrum: Co-authored seminal comprehensive reviews and studies (such as their landmark 1988 work on diagnosis and treatment) that categorized PTLDs ranging from benign, mononucleosis-like lymphoid hyperplasias to aggressive malignant lymphomas. Cyclosporine-Era Insights: Evaluated large cohorts of solid-organ transplant recipients at the University of Pittsburgh to outline how newer immunosuppressive protocols (specifically cyclosporine-A and intensive antilymphocyte antibody therapies) impacted the onset and behavior of lymphoid proliferations. Clonal Evolution Analysis: Investigated the cellular and clonal characteristics of posttransplant lymph proliferations, helping establish how these lesions progress from polyclonal expansions to monoclonal malignant lymphomas under persistent immune suppression. The landmark 1988 monograph by Drs. Michael A. Nalesnik, L. Makowka, and Thomas E. Starzl, titled "The Diagnosis and Treatment of Posttransplant Lymphoproliferative Disorders" published in Current Problems in Surgery, is widely regarded as a cornerstone text. It organized years of clinical and pathological findings from the University of Pittsburgh's massive organ transplantation program into a definitive roadmap. Prior to this work, post-transplant tumors were often misdiagnosed or uniformly treated as standard, high-grade malignant lymphomas. The Pittsburgh team codified a diagnostic spectrum based on tissue morphology: Hyperplastic / Mononucleosis-like Lesions: Early, benign lymphoid proliferations that closely resemble an intense viral infection. Polymorphic PTLD: A mixed , unregulated cell population infiltrating tissue architecture, showing aggressive features but remaining heterogeneous. Monomorphic / Lymphomatous PTLD: A definitive sheets-of-cells malignancy indistinguishable from non-Hodgkin lymphoma. 2. Clonal Evolution Framework. The authors bridged pathology with molecular biology by correlating these shapes with clonality. They demonstrated that PTLD often starts as a widespread, polyclonal B-cell expansion driven by the Epstein-Barr virus (EBV). Over time, under the selective pressure of heavy immunosuppression, a single mutant cell line can take over, transforming the disorder into a lethal monoclonal malignant lymphoma. 3. Redefining Treatment: "Reduction of Immunosuppression". Perhaps the most practice-changing contribution of the 1988 paper was the clinical philosophy regarding therapy. While conventional lymphomas required immediate, aggressive cytotoxic chemotherapy, the authors proved that early-stage and polymorphic PTLDs could completely regress simply by lowering or temporarily stopping the patient's immunosuppressive drugs. By backing off on cyclosporine or antilymphocyte globulin therapies, they allowed the patient's own T-cells to recover enough to clear the EBV-infected B-cell proliferation. This concept remains the foundational first-line intervention for PTLD today. 4. Distinguishing PTLD from Allograft Rejection. The paper highlighted a critical diagnostic trap for transplant physicians: PTLD often mimics graft rejection. Both present with fever, organ dysfunction, and dense cellular infiltrates in the transplanted organ. The authors outlined strict histopathological criteria to prevent doctors from mistakenly increasing immunosuppression to treat "rejection"—an error that would inadvertently fuel the underlying lymphoproliferative disease.…