Tomasz Drewa

Publications of Tomasz Drewa

• Does the Mesenchymal Stem Cells aging limit their potential application in clinical practice?

  Authors: Anna Bajek, Mateusz Czerwinski, Joanna Olkowska, Natalia Gurtowska, Tomasz Kloskowski, Tomasz Drewa

  Aging clinical and experimental research. 05/2012;

  Mesenchymal stem cells (MSCs) are in the center of attention of many investigators due to easy isolation from many tissues. MSCs capability to differentiate into many cell types makes them a startingMesenchymal stem cells (MSCs) are in the center of attention of many investigators due to easy isolation from many tissues. MSCs capability to differentiate into many cell types makes them a starting point of many new therapies, especially in tissue engineering. However, understanding the process of MSCs aging is crucial for selecting donors for cellular therapies, which is necessary for successful treatment. Cell changes can be divided into three major groups. Changes which affect their proliferate rate, differentiation capability and genome stability are leading decrease their usefulness in new therapies. There are many tools that can be used to describe and measure some feature of aging in MSCs but essence of this process still eludes. The aim of this review is to take a deep look into influence of donor age and in vitro aging on MSCs properties.

• Extraperitoneal laparoscopic Millin prostatectomy using finger enucleation.

  Authors: Piotr L Chlosta, Ioannis M Varkarakis, Tomasz Drewa, Jakub Dobruch, Jarosław Jaskulski, Artur A Antoniewicz, Andrzej Borówka

  The Journal of urology. 09/2011; 186(3):873-6.

  We evaluated the feasibilty, safety and results of extraperitoneal laparoscopic Millin prostatectomy using finger enucleation through an additional 1 cm suprapubic incision. A total of 66 consecutiveWe evaluated the feasibilty, safety and results of extraperitoneal laparoscopic Millin prostatectomy using finger enucleation through an additional 1 cm suprapubic incision. A total of 66 consecutive laparoscopic simple prostatectomies were performed with this technique in men with symptomatic bladder outflow obstruction and a prostate gland larger than 70 cc on transrectal ultrasound. Data such as operating time, intraoperative blood loss, transfusion rate, complications, catheterization period, hospitalization time and surgical specimen weight were prospectively collected and evaluated. Preoperative and 3-month postoperative International Prostate Symptom Score and urinary flow rates were used to assess the surgical outcome. Average operating time was 55 minutes with a mean estimated blood loss of 200 ml. No blood transfusion was necessary, and no conversion, complications or mortality was present. The mean postoperative catheterization period was 7.3 days with a mean hospital stay of 5.2 days. Mean enucleated tissue weight was 85.5 gm. At 3 months postoperatively the International Prostate Symptom Score improved to a mean of 5.8 (from a mean preoperative score of 29.5) while maximum urine flow improved to a mean of 18.5 ml per second (from a mean preoperative rate of 5.8 ml per second). This procedure is safe and fast with excellent functional outcomes. However, prolonged catheterization and hospitalization are still required.

• [Mesenchymal stem cells as a therapeutic tool in tissue and organ regeneration].

  Authors: Anna Bajek, Joanna Olkowska, Tomasz Drewa

  Postȩpy higieny i medycyny doświadczalnej (Online). 01/2011; 65:124-32.

  Tissue engineering is an interdisciplinary field that offers new opportunities for regeneration of diseased and damaged tissue with the use of many different cell types,including adult stem cells. InTissue engineering is an interdisciplinary field that offers new opportunities for regeneration of diseased and damaged tissue with the use of many different cell types,including adult stem cells. In tissue engineering and regenerative medicine the most popular are mesenchymal stem cells (MSCs) isolated from bone marrow. Bone marrow mesenchymal stem cells are a potential source of progenitor cells for osteoblasts, chondroblasts, adipocytes, skeletal muscles and cardiomyocytes. It has also been shown that these cells can differentiate into ecto- and endodermal cells, e.g. neuronal cells, glial cells, keratinocytes and hepatocytes. The availability of autologous MSCs, their proliferative potential and multilineage differentiation capacity make them an excellent tool for tissue engineering and regenerative medicine. The aim of this publication is to present characteristic and biological properties of mesenchymal stem cells isolated from bone marrow.

• Will tissue-engineered urinary bladders change indications for a laparoscopic cystectomy?

  Authors: Tomasz Drewa, Piotr Chlosta, Rafal Czajkowski

  Surgical innovation. 12/2010; 17(4):295-9.

  Radical open cystectomy is a treatment of choice for muscle invasive urinary bladder cancer. Laparoscopic radical cystectomy (LapRC) is surgically advanced and is an extremely difficult technique butRadical open cystectomy is a treatment of choice for muscle invasive urinary bladder cancer. Laparoscopic radical cystectomy (LapRC) is surgically advanced and is an extremely difficult technique but presents many advantages. Urinary diversion (conduit, pouch or neobladder) when performed during laparoscopy necessitates a conversion to open procedure. Urinary diversion using an autologous bowel is associated with longer operative times and complications. The authors have analyzed the LapRC procedure and its 2 main parts--that is, bladder resection and urinary diversion. The emphasis was on the operative time and complications related to the urinary diversion procedure. A urinary diversion created in vitro could make the LapRC totally intracorporeal, and it could be completed within an acceptable time. Tissue engineering techniques used for urinary diversion after cystectomy shorten the operative time and help avoid serious complications related to bowel surgery. LapRC with tissue-engineered urinary diversion could become a management of choice for muscle invasive bladder cancer.

• Ciprofloxacin criteria in antimicrobial prophylaxis and bladder cancer recurrence.

  Authors: Natalia Gurtowska, Tomasz Kloskowski, Tomasz Drewa

  Medical science monitor : international medical journal of experimental and clinical research. 10/2010; 16(10):RA218-23.

  Oral ciprofloxacin might achieve higher concentration in urine than in serum; theoretically, this drug might act as an anticancer drug against bladder cancer cells. Among fluoroquinolones,Oral ciprofloxacin might achieve higher concentration in urine than in serum; theoretically, this drug might act as an anticancer drug against bladder cancer cells. Among fluoroquinolones, ciprofloxacin is distinguished by strong inhibition of topoisomerase II. A good correlation between cytotoxic activity of ciprofloxacin toward eukaryotic cells and its ability to induce the cleavable complexes topoisomerase II-DNA has been demonstrated. These data provide a basis for supposing that ciprofloxacin may act as anticancer drug. The efforts of evaluating ciprofloxacin's influence on human bladder cell lines have been shown by many authors. The cells were exposed to ciprofloxacin at various concentrations that are attainable in the urine after oral drug administration. Antiproliferative potential of the ciprofloxacin against human bladder cells varies according to drug concentration and time of incubation. It seems that ciprofloxacin can act as an anticancer drug in eukaryotic cells. Low urine pH can enhance the antitumor effect of ciprofloxacin. Ciprofloxacin enhances the effect of action of doxorubicin and epirubicin, which are used to prevent bladder cancer recurrence after transurethral resection of superficial bladder cancer. We think that ciprofloxacin might be used for antibacterial prophylaxis and as an anticancer agent in patients with superficial bladder cancer. This idea must be checked in future placebo controlled trials.

• Is pure laparoscopic radical cystectomy still an attractive solution for the treatment of muscle-invasive bladder cancer?

  Authors: Piotr Chlosta, Tomasz Drewa, Jakub Dobruch, Artur Antoniewicz, Pawel Olejniczak, Mateusz Obarzanowski, Andrzej Borowka

  Urologia internationalis. 04/2010; 85(3):291-5.

  The aim of this study is to report our experience with laparoscopic radical cystectomy (LRC), evaluating the technique and perioperative and pathological outcomes. 47 LRCs were performed due toThe aim of this study is to report our experience with laparoscopic radical cystectomy (LRC), evaluating the technique and perioperative and pathological outcomes. 47 LRCs were performed due to muscle-invasive bladder cancer. Conduits were performed in 23 patients and neobladders in 23 (one bi-intestinal). One ureterocutaneostomy was created. In 43 patients LRC was performed with minilaparotomy for urinary diversion. The mean operation time was 290 min. Four operations were converted. Complications included sigmoid colon injury, urinary leak, lymphatic leak, short-term paralytic ileus, and heart attack. Mean blood loss was 220 ml. Hospitalization time was 6 days. Tumor stage was pT2b, pT3a, pT3b, and pT4a in 28, 13, 5, and 1 patient, respectively. No positive margins were found. The mean number of lymph nodules was 17, while in the last 25 procedures it was 21. 17% of patients had tumor in the lymph nodes. The mean follow-up was 10 months. Local recurrence and dissemination was observed in 2%. Continence in patients receiving neobladder was fully satisfactory. More complications are related to neobladder than to ileac conduit. LRC with minilaparotomy seems to be an attractive treatment option for patients with muscle-invasive bladder cancer. Radical cystectomy performed intracorporeally could be reserved for 'robot-assisted' operations.

• Re: Per-Anders Abrahamsson. Potential benefits of intermittent androgen suppression therapy in the treatment of prostate cancer: a systematic review of the literature. Eur Urol 2010;57:49-59.

  Authors: Tomasz Drewa

  European urology. 03/2010; 58(1):e4; author reply e5-6.

• Does ciprofloxacin have an obverse and a reverse?

  Authors: Tomasz Kloskowski, Natalia Gurtowska, Tomasz Drewa

  Pulmonary pharmacology & therapeutics. 03/2010; 23(5):373-5.

  Ciprofloxacin is an antibiotic that belongs to fluoroquinoles, characterized by broad spectrum of action against pathogens, especially Gram(-) aerobic bacilli. For a long time, it has been thoughtCiprofloxacin is an antibiotic that belongs to fluoroquinoles, characterized by broad spectrum of action against pathogens, especially Gram(-) aerobic bacilli. For a long time, it has been thought that ciprofloxacin has an effect only on bacterial cells. Now it is known, that this drug can significantly affect eukaryotic cells including human cancer cells. Its bactericidal action relay on inhibition of topoisomerase II, enzyme responsible for alterations in 3D structure of DNA during replication, transcription and chromatin condensation. Thanks to that, ciprofloxacin can induce cell cycle arrest and apoptosis of cancer cells. The effectiveness of ciprofloxacin was confirmed in several in vitro studies on tumor cell lines such as: human bladder cells, leukaemic cell lines, human osteosarcoma cells, human prostate cancer cells, human colorectal carcinoma cells and human non-small cell lung cancer cell line. Ciprofloxacin is particularly effective against non-small cell lung cancer mainly due to accumulation of ciprofloxacin in lung tissue after intravenous administration and its toxicity against lung cancer lines in vitro in a concentration and time-dependent manner.

• Transplantation of cultured autologous melanocytes: hope or danger?

  Authors: Rafal Czajkowski, Marta Pokrywczynska, Waldemar Placek, Barbara Zegarska, Tadeusz Tadrowski, Tomasz Drewa

  Cell transplantation. 03/2010; 19(5):639-43.

  Cultured human melanocytes are increasingly being used in the treatment of vitiligo. The growth media contain various types of mitogenic factors, both recombinant human (e.g., rhbFGF and rhSCF) andCultured human melanocytes are increasingly being used in the treatment of vitiligo. The growth media contain various types of mitogenic factors, both recombinant human (e.g., rhbFGF and rhSCF) and synthetic (e.g., TPA). High concentrations of mitogenic factors accelerate the cell cycle, and consequently may increase the risk of carcinogenesis of transplanted cells. Mutations of genes of the RAS/RAF/MEK/ERK signaling pathway are very often found in the early stages of the development of melanoma. TPA is considered to be an oncogenic factor, but so far there is no evidence to show that it is responsible for damage to the genetic material of cultured melanocytes. The aim of our study was to assess the risk of the development of mutations in selected genes of the RAS/RAF/MEK/ERK signaling pathway during the culturing of melanocytes in various growth media. Based on the results obtained, it can be concluded that TPA and high concentrations of other growth factors intensify the proliferation of melanocytes, without the risk of damage to the HRAS (exon 1 and 2), KRAS (exon 1 and 2), NRAS (exon 1 and 2), and BRAF (exon 11 and 15) genes. In order to assess the total safety of the transplantation of cultured melanocytes, it is necessary to carry out further studies on other signaling pathways as well as carry out biological tests on an animal model.

• Re: Minja J. Pfeiffer, Jack A. Schalken. Stem Cell Characteristics in Prostate Cancer Cell Lines. Eur Urol. In press. doi:10.1016/j.eururo.2009.01.015.

  Authors: Tomasz Drewa

  European urology. 11/2009;

• Re: Michael J. Morris, Daisy Huang, William K. Kelly, et al. Phase 1 Trial of High-Dose Exogenous Testosterone in Patients with Castration-Resistant Metastatic Prostate. Eur Urol 2009;56:237-244.

  Authors: Tomasz Drewa, Piotr Chlosta

  European urology. 10/2009;

• Re: João Silva, Rui Pinto, Tiago Carvallho, et al. Mechanisms of Prostate Atrophy after Glandular Botulinum Neurotoxin Type A Injection: An Experimental Study in the Rat. Eur Urol 2009;56:134-41.

  Authors: Tomasz Drewa, Zbigniew Wolski, Janusz Tyloch

  European urology. 08/2009;

• Using hair-follicle stem cells for urinary bladder-wall regeneration.

  Authors: Tomasz Drewa

  Regenerative medicine. 12/2008; 3(6):939-44.

  There are many diseases in which autologous urothelial and muscle cells cannot be used for in vitro construction of the urinary bladder wall for augmentation (cystoplasty). These diseases are theThere are many diseases in which autologous urothelial and muscle cells cannot be used for in vitro construction of the urinary bladder wall for augmentation (cystoplasty). These diseases are the most frequent indications for bladder augmentation. The present paper focuses on the idea of harvesting potentially multipotent stem cells out of hair follicles in order to use them for regeneration of the urinary bladder wall. Current clinical practice suggests the use of cultures enriched with progenitors. The hair follicle stem cell niche gives an opportunity to reduce the invasiveness of harvesting these cells. Both epithelial and dermal multipotent stem cells populations within hair follicles raise new possibilities for tissue engineering of the urinary bladder. The hypothesis is that hair-follicle stem cells can be used, with the guarantee of the sufficient cell number, for a construction in vitro of the urinary bladder wall replacement.

• Re: Udo Nagele, Sabine Maurer, Gerard Feil, et al. In Vitro Investigations of Tissue-Engineered Multilayered Urothelium Established from Bladder Washings, Eur Urol 2008;54:1414-22.

  Authors: Tomasz Drewa

  European urology. 11/2008;

• Re: Fritz H. Schröder, Karl-Heinz Kurth, Sophie D. Fossa et al. Early versus delayed endocrine treatment of T2-T3 pN1-3 M0 prostate cancer without local treatment of the primary tumour: final results of European Organisation for the Research and Treatment of Cancer protocol 30846 after 13 years of follow-up (a randomised controlled trial). Eur Urol. In press. DOI:10.1016/j.eururo.2008.09.008.

  Authors: Tomasz Drewa

  European urology. 11/2008;

• Re: Hervé Baumert, Mehrak Hekmati, Irene Dunia, et al. Laparoscopy in Ureteral Engineering: a Feasibility Study. Eur Urol 2008;54:1154-63.

  Authors: Tomasz Drewa, Piotr Chlosta

  European urology. 10/2008;

• [Islet isolation outcome is influenced by pancreas preparation method]

  Authors: Marta Pokrywczyńska, Tomasz Drewa, Zaneta Cieślak

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 10/2008; 25(147):240-3.

  Pancreatic islet transplantation is a treatment method for type I diabetes. Its outcome is influenced by numerous factors, islet quantity and function being important ones of them. THE AIM OF THISPancreatic islet transplantation is a treatment method for type I diabetes. Its outcome is influenced by numerous factors, islet quantity and function being important ones of them. THE AIM OF THIS STUDY: was to estimate the influence of pancreas preparation method on the outcome of islet isolation in rat. MATERIAL AND METHODS: 6 pancreata harvested from Lewis rats were used in this research. Pancreatic duct was cannulated and pancreas was injected with 1 mg/ml collagenase P solution (Sigma) and then excised. After cutting into smaller fragments, it was digested in collagenase P solution for 15-20 min. Enzyme activity was then stopped by adding dilution medium. Heterogenous cell suspension was centrifuged in density gradient (Gradisol) to isolate islets. Pancreatic islets were collected and islet equivalent was calculated. Islet purity degree was estimated as islet cells to all cells, including exocrine, ratio. Islet viability was estimated using propidium iodide and fluorescein diacetate staining. Photographic documentation was made. RESULTS: Proper islet morphology, highest number and viability was obtained when pancreas was excised properly (isolation 3 and 4). CONCLUSION: Pancreas preparation method is one of which influences on islet isolation outcome.

• Re: Frans Debruyne, Arkadij A. Gres, Dmitrii L. Arustamov. Placebo-Controlled Dose-Ranging Phase 2 Study of Subcutaneously Administered LHRH Antagonist Cetrorelix in Patients with Symptomatic Benign Prostatic Hyperplasia. Eur Urol 2008;54:170-80.

  Authors: Tomasz Drewa, Piotr Chlosta

  European urology. 09/2008;

• Can conception of prostate cancer stem cells influence treatment dedicated to patients with disseminated disease?

  Authors: Tomasz Drewa, Jan Styczynski

  Medical hypotheses. 09/2008;

  No survival profit has been achieved for patients with disseminated prostate cancer since hormonal therapy was introduced. It is proposed that dissemination of rare prostatic cancer stem cells mayNo survival profit has been achieved for patients with disseminated prostate cancer since hormonal therapy was introduced. It is proposed that dissemination of rare prostatic cancer stem cells may lead to metastatic disease and that resistance of these cells to androgen ablation makes them responsible for failure of current treatments. In this paper, we will discuss the significance of the stem cell model for understanding prostate cancer pathogenesis. The concept of prostate cancer as a stem cell disease has the potential to change our view of its treatment in the particular case of disseminated disease. The major cellular target of prostate cancer therapy has to be directed against neoplastic stem cells. The combination of molecular-targeted therapy with the concept of the cancer stem cells should be introduced for the treatment of disseminated prostate cancer. Disseminated prostate cancer must be treated with agents directed toward stem cells, while hormone-therapy must be only an additional treatment leading to the decrease of tumor burden.

• Re: Fritz H. Schröder. Progress in Understanding Androgen-Independent Prostate Cancer (AIPC): A Review of Potential Endocrine-Mediated Mechanisms. Eur Urol 2008;53:1129-37.

  Authors: Tomasz Drewa

  European urology. 07/2008;