The article is devoted to legal and forensic medical problems of postmortem donation. The substantive provisions of postmortem donation, as well as normative legal documents regulating the processes of organs harvesting from deceased persons for subsequent transplantation and governing the work of transplantologists and forensic medical experts have been considered. The practical examples illustrating the essence and nature of the problem of postmortem forensic medical expertise of persons with absent organs has been given and the importance of the participation of a forensic medical expert involved in the decision-making process on possibility (or impossibility) of the corpse\'s organs and tissues explantation without prejudice to the further expert examination has been emphasized. The authors pay particular attention to the inadequacy of the legal framework, including the lack of a clear understanding of the legal status of the person holding the position of forensic medical expert, who provides an expert opinion on the organs\' explantation.
Статья посвящена правовым и судебно-медицинским проблемам посмертного донорства. Рассмотрены основные положения посмертного донорства, а также нормативно-правовые документы, регламентирующие процессы по изъятию органов от умерших лиц для последующей их трансплантации и регулирующие работу трансплантологов и судебно-медицинских экспертов. Приведены примеры из практики, иллюстрирующие суть и характер проблемы проведения посмертной судебно-медицинской экспертизы лиц с отсутствующими органами, и сделан акцент на важности участия судебно-медицинского эксперта, привлеченного к процессу принятия решения о возможности (или невозможности) эксплантации органов и тканей трупа без ущерба дальнейшего проведения экспертизы. Авторы обращают особое внимание на несовершенство правовой базы и в том числе на отсутствие четкого понимания о юридическом статусе лица, занимающего должность судебно-медицинского эксперта, который дает заключение об эксплантации органов.

In Poland, teleconsultations (TCs) were not legally regulated or even conducted until the COVID-19 pandemic, which necessitated their abrupt implementation and posed a challenge to patients and doctors. The aim of this study was to assess the quality of TCs and the satisfaction with this mode of consultation among nephrology and kidney transplant outpatients with a high risk of severe courses of SARS-CoV-2 infection. A self-designed questionnaire regarding patients\' demographics; digital fluency; and participation in, satisfaction with, and attitude towards TCs was distributed among patients in the nephrology and posttransplant outpatient clinics at two hospitals in central Poland. The questionnaires were completed by 294 adult patients, of whom 72.1% (n = 212) had participated in TCs at one of the abovementioned clinics. Almost all (96.7%) of the TCs were conducted via phone, and in 94.8% of cases, they fulfilled the purpose of the consultation. The most commonly reported advantages were not having to leave home and the reduced risk of infection. Only a few patients felt that TCs offer no advantages. The patients\' profiles and demographic data had no significant effect on their assessments of teleconsultations. Despite the overall positive rating given to TCs, patients unhesitatingly indicated that a face-to-face visit would be a preferable way to contact a specialist.

BACKGROUND: Mandible tumors are very rare. One of the main methods of the treatments is resection of the tumor and then reconstruction of the mandible. The donor site is often distant tissue-fibula or ilium. Following this, it is necessary to improve the patient in two ways, on one hand restoring the function of the mandible, and on the other hand, improving the donor site area. For that reason, physiotherapy after tumor resection and reconstruction of the mandible is very complicated. The aim of this bibliographic review was to find the methods of the reconstruction of the mandible in the context of patients\' functional assessment after surgeries to create effective physiotherapeutic procedures in the feature.
METHODS: PEDro, Medline (PubMed), Cochrane Clinical Trials were searched.
RESULTS: 767 articles were found. 40 articles were included to this literature review.
CONCLUSIONS: Authors showed different kinds of surgeries strategy for patients with tumors of the mandible. They also showed manners of patients\' functional assessment in the localization of transplantation and donor site. It could be useful for physiotherapists during planning of comprehensive physiotherapy.

Kidney graft failure is not a homogenous disease and the Banff classification distinguishes several types of graft rejection. The maintenance of a transplant and the treatment of its failure require specific medications and differ due to the underlying molecular mechanism. As a consequence, patients suffering from different rejection types will experience distinct side-effects upon therapy. The review is focused on comparing treatment regimens as well as presenting the latest insights into innovative therapeutic approaches in patients with an ongoing active ABMR, chronic active ABMR, chronic ABMR, acute TCMR, chronic active TCMR, borderline and mixed rejection. Furthermore, the profile of cardiovascular adverse effects in relation to the applied therapy was subjected to scrutiny. Lastly, a detailed assessment and comparison of different approaches were conducted in order to identify those that are the most and least detrimental for patients suffering from kidney graft failure.

Introduction: The problem of organs\' shortage for transplantation is widely known: different manufacturing techniques such as Solvent casting, Electrospinning and 3D Printing were considered to produce bioartificial scaffolds for tissue engineering purposes and possible transplantation substitutes. The advantages of manufacturing techniques\' combination to develop hybrid scaffolds with increased performing properties was also evaluated. Methods: Scaffolds were produced using poly-L-lactide-co-caprolactone (PLA-PCL) copolymer and characterized for their morphological, biological, and mechanical features. Results: Hybrid scaffolds showed the best properties in terms of viability (>100%) and cell adhesion. Furthermore, their mechanical properties were found to be comparable with the reference values for soft tissues (range 1-10 MPa). Discussion: The created hybrid scaffolds pave the way for the future development of more complex systems capable of supporting, from a morphological, mechanical, and biological standpoint, the physiological needs of the tissues/organs to be transplanted.

In the era of growing interest in stem cells, the availability of donors for transplantation has become a problem. The isolation of embryonic and fetal cells raises ethical controversies, and the number of adult donors is deficient. Stem cells isolated from deceased donors, known as cadaveric stem cells (CaSCs), may alleviate this problem. So far, it was possible to isolate from deceased donors mesenchymal stem cells (MSCs), adipose delivered stem cells (ADSCs), neural stem cells (NSCs), retinal progenitor cells (RPCs), induced pluripotent stem cells (iPSCs), and hematopoietic stem cells (HSCs). Recent studies have shown that it is possible to collect and use CaSCs from cadavers, even these with an extended postmortem interval (PMI) provided proper storage conditions (like cadaver heparinization or liquid nitrogen storage) are maintained. The presented review summarizes the latest research on CaSCs and their current therapeutic applications. It describes the developments in thanatotranscriptome and scaffolding for cadaver cells, summarizes their potential applications in regenerative medicine, and lists their limitations, such as donor\'s unknown medical condition in criminal cases, limited differentiation potential, higher risk of carcinogenesis, or changing DNA quality. Finally, the review underlines the need to develop procedures determining the safe CaSCs harvesting and use.

Purpose of the study was to identify dental risk factors for complications at the stage of rehabilitation adaptation in patients with diffuse liver lesions. The study included 52 patients with diffuse liver lesions aged 25-55 years, who were divided between two groups of 26 persons with different dental status, depending on the main disease stage of treatment.
METHODS: Clinical, x-ray, morphological, analytical, statistical.
RESULTS: It has been reliably established that low level of oral hygiene, high intensity and prevalence of caries and its complications (foci of odontogenic infection), inflammatory periodontal diseases joined with severe teeth hyperesthesia, dominate in patients before liver transplantation, which confirms low level of sanitation on stages of preparation for surgical treatment. Chronic odontogenic infection in periodontal tissues with phenomena of epithelial cells dystrophy, candidiasis of the oral mucosa, foci of odontogenic infection, low level of oral hygine, tendency to precancerous diseases development are the risk factors for complications arise on the stage of rehabilitation adaptation in patients with diffuse liver lesions.
CONCLUSIONS: The revealed relationship between diffuse liver lesions and dental status of patients, at the stages of preparation and after liver transplantation indicates, that a low level of oral cavity sanitation, the presence of odontogenic infection and periodontal disease worsen the course of the main disease, increase the risk of transplant rejection and require the creation of a dental rehabilitation system for this category of patients.
Цель исследования - выявление стоматологических факторов риска возникновения послеоперационных осложнений на этапе реабилитационной адаптации у пациентов с диффузными поражениями печени. В исследование были включены 52 пациента в возрасте 25-55 лет с диффузными поражениями печени, которые были стандартизованы по возрасту, полу, нозологической форме соматической патологии и разделены на две группы по 26 человек в каждой в зависимости от этапа лечения основного заболевания. Использованные методы исследования: клинический, рентгенологический, цитологический, аналитический, статистический. Результаты. Достоверно установлено, что низкий уровень гигиены полости рта, высокая интенсивность и распространенность кариеса и его осложнений (очаги одонтогенной инфекции), воспалительные заболевания пародонта на фоне выраженной гиперестезии твердых тканей зубов доминируют у пациентов до операции трансплантации, подтверждая низкий уровень санации на этапах подготовки к хирургическому лечению. Хронические процессы в тканях пародонта с явлениями дистрофии эпителиальных клеток, кандидоз слизистой оболочки рта, очаги одонтогенной инфекции, низкий уровень гигиены полости рта являются факторами риска возникновения осложнений на этапе реабилитационной адаптации у пациентов с диффузными поражениями печени. Заключение. Выявленная взаимосвязь между диффузными поражениями печени и состоянием стоматологического статуса пациентов на этапах подготовки и после трансплантации печени свидетельствует, что низкий уровень санации полости рта, наличие очагов одонтогенной инфекции и хронические процессы в тканях пародонта утяжеляют течение основного заболевания, являются фактором риска отторжения трансплантата и требуют создания системы стоматологической реабилитации данной категории пациентов.

UNASSIGNED: Trophic ulcers are a common health problem, and there are numerous treatment methods. Irreversible damage in the skin, subcutaneous tissue, and fascia with long-term ulcer existence make standard autotransplantation inneffective. Skin grafts are often complicated by partial or complete rejection of skin flaps. The aim of this study was to examine the feasibility of using transplanted cultivated allogenic fibroblasts on the backing of a cellularless xenogenic fabric for wound healing.
UNASSIGNED: Transplantation of cultured embryonic fibroblasts on a backing of xenogenic tissue was used in the complex treatment of trophic ulcers for stimulation of regenerative processes. Decellularization xenogenic film was previously held. Then allogenic fibroblasts were cultivated on the surface of collagen-elastin matrix. Since 2013, we treated 12 patients with giant ulcers caused by the following: lymphedema (2 patients), vascular disease (3 patients), diabetes (2 patients), after injury (4 patients), and radiation ulcer (1 patient). Dimensions of ulcers were from 150 to 600 cm2. Duration of the lower limb ulcers ranged from 8 months to 10 years. For a number of years, all patients were on a complex therapy, which had not resulted in healing wounds. During the operation when excision of granulation tissue was performed, plastic wounds perforated with the ratio 1:2 autoskin. Xenogenic fabric with cultured fibroblasts was applied on top. In this case, xenogenic film protected the skin from drying, created optimal microclimate, and cultured fibroblasts stimulating regeneration and improving engraftment.
UNASSIGNED: The first redress was held on the fifth day. In all cases, the results of engraftment skin grafts achieved maximum possible (100%) and optimal (90%). Complete epithelialization of the cell perforation was seen in five patients on the fifth day and three on seventh day after skin plastics. Average period of inpatient treatment was 20.7 days. All patients were discharged with healed wounds.
UNASSIGNED: Thus, the treatment of trophic ulcers can be successfully solved using advances in biotechnology. Transplantation of cultivated allogenic fibroblasts on a backing of cellularless xenogenic fabric shows good clinical results due to the stimulation of regenerative processes and creates the optimum environment for autotransplants.

There are some cells in human body which have an ability to self-renewal and differentiation into particular type of cell. They are classified according to the source of gain and ability to differentiate. Several studies carry on directed stem cells programming toward formation of particular type of cells and also reprogramming somatic stem cells for induced pluripotent stem cells. In the future it could bring hope in elaboration of new ways of disease curing that will give a chance for getting healthy (especially cancers). Stem cells display application in regenerative medicine. They facilitate in repair of damaged or dysfunctional tissues using cells derived from patients. In many cancer types the presence of cancer stem cells was observed. Their ability to self-renewal and unlimited proliferation might be the reason of metastasis and relapse of cancer. The knowledge on complexed signaling pathways and mechanisms of their regulation may be crucial and should lead to elaboration of effective anticancer therapies.
W organizmie człowieka zlokalizowano komórki, które mają zdolność do samoodnawiania oraz różnicowania w określony typ komórek. Są klasyfikowane ze względu na źródło pozyskiwania oraz zdolność do różnicowania. Prowadzone są badania laboratoryjne zmierzające do ukierunkowanego programowania komórek macierzystych w tworzeniu określonego typu komórek, a także przeprogramowanie komórek somatycznych do indukowanych pluripotencjalnych komórek macierzystych. Może to w przyszłości nieść nadzieję na opracowanie nowych sposobów leczenia chorób dając szansę na ich całkowite wyleczenie (szczególnie nowotworów). Komórki macierzyste znajdują także zastosowanie w medycynie regeneracyjnej umożliwiając naprawę uszkodzonych lub niefunkcjonalnych tkanek z wykorzystaniem komórek pochodzących od pacjenta. Obecność komórek macierzystych stwierdzono w tkankach nowotworowych. Zdolność do samoodnowy i nieograniczonej proliferacji może być powodem nabywania cech predysponujących komórki nowotworowe do przerzutowania oraz do nawrotu chorób nowotworowych. Poznanie szlaków sygnalizacyjnych oraz mechanizmów ich działania wydaje się być kluczowe i prowadzi do opracowania efektywnych terapii antynowotworowych.

Regulation of immune response was found to play an important role in the course of many diseases such as autoimmune diseases, allergy, malignancy, organ transplantation. The studies on immune regulation focus on the role of regulatory cells (Tregs, Bregs, regulatory myeloid cells) in these disorders. The number and function of Tregs may serve as a marker of disease activity. As in allergy, the depletion of Tregs is observed and the results of allergen-specific immunotherapy could be measured by an increase in the population of IL-10+ regulatory cells. On the basis of the knowledge of anti-cancer immune response regulation, new directions in therapy of tumors are introduced. As the proportion of regulatory cells is increased in the course of neoplasm, the therapeutic action is directed at their inhibition. The depletion of Tregs may be also achieved by an anti-check-point blockade, anti-CD25 agents, and inhibition of regulatory cell recruitment to the tumor site by affecting chemokine pathways. However, the possible favorable role of Tregs in cancer development is considered and the plasticity of immune regulation should be taken into account. The new promising direction of the treatment based on regulatory cells is the prevention of transplant rejection. A different way of production and implementation of classic Tregs as well as other cell types such as double-negative cells, Bregs, CD4+ Tr1 cells are tested in ongoing trials. On the basis of the results of current studies, we could show in this review the significance of therapies based on regulatory cells in different disorders.