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BACKGROUND: On the basis of available reports it can be stated that physical stress causes changes in distribution and activity of many components of the immune system. It is believed that psychophysical stress in soldiers can influence their immune system depressively and in consequence increase the risk of upper respiratory tract infections. Therefore, it was decided to conduct studies aimed at the estimation of the influence of military training on the some parameters of cellular immune response. MATERIAL AND METHODS: The study group consisted of 40 draft aged from 18 to 23 years. The research was conducted in the first 8 weeks of service, in the period of the most intense draft stress adaptation. The participants were divide into 2 groups, A and B respectively, 20 soldiers each. Group A derived from an assault unit. Their training induced strenuous physical stress. Group B derived from a support unit. Their training required less physical effort then one of group A. Performed examinations involved: lymphocyte percentage count, lymphocyte proliferative response to mitogen, CD69 antigen expression on T lymphocyte surface, delayed hypersensitivity reaction with CMI Multitest. All assessments were done twice at 8 weeks interval. RESULTS: After 8 weeks of training in the A group a statistically significant increase in the percentage of lymphocytes revealing antigens of the II Class Main Histocompatibility Complex (MHC) was found. In addition, in this group a statistically significant decrease in the value of lymphocyte stimulation index, a statistically significant increase in the percentage of cells revealing CD69 antigen expression after PHA stimulation were observed. During investigated period in the B group following statistically significant changes were found: an increase in the percentage of CD3+ and CD4+ cells, a decrease in the percentage of CD16+CD56+ and an increase in the CD4+ to CD8+ ratio. CONCLUSION: The obtained results show that military service conditions influence some parameters of the cellular immune response but do not result in the clinically significant suppression of the immune system.

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It is known, that psychophysical stress causes some changes in distribution and activity of many components of the immune system. The research was aimed at examination the influence of different military service conditions on some neutrophil functions. In this study granulocyte chemiluminescence both without stimulation and after stimulation with fMLP, PMA and zymosan was evaluated. In addition, the expression of surface adhesion molecules--CD11b on circulating granulocytes was examined. The studied group consisted of 20 soldiers from an assault unit (group A) and 20 soldiers from a support unit (group B), the age ranged from 18 to 23 years. The examinations were conducted at the beginning of the basic training and after the 8 weeks period. In group A the following results were obtained: a significant increase (p < 0.001) in granulocyte chemiluminescence without stimulation and after stimulation with fMLP, PMA and zymosan, as well as, a significant decrease (p < 0.05) in CD11b expression on granulocytes. And in group B: a significant increase (p < 0.05) in granulocyte chemiluminescence without stimulation but a significant decrease (p < 0.05) after cells stimulation with fMLP and PMA were observed. In this group CD11b expression on granulocytes was significantly (p < 0.001) decreased. The results of the present examination indicate, that military service conditions influence some parameters of the innate immunity.

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The aim of the present study was evaluation of correlation between big-endothelin concentration of the precursor substance of endothelin and mean values of blood pressure in 13 patients with compensates chronic renal failure. Their age ranged from 29 years to 55 years the mean age was 42.9 +/- 8.2 years. The patients were from the Consultational Nephrologic Outpatient Clinic. These patients were sent to the clinic after a hospital observation with recognised chronic renal failure (CRF), caused by chronic glomerulonephritis (without pathomorphological differentiation). The control group consistent of 10 healthy volunteers, an age ranged from 22 years to 49 years, a mean was 32.6 +/- 10.8 years. The following mean blood pressure values were found: in patient group a systolic pressure was 139.1 +/- 17.3 mm Hg and a diastolic pressure was 88.4 +/- 12.5 mm Hg and similar values in healthy control group were respectively: 118.6 +/- 4.0 and 72.4 +/- 5.9 mm Hg. Analogously the proendothelin concentration was 18.48 +/- 22.04 fmol/ml in patients with CRF and it was 4.67 +/- 0.27 fmol/ml in the control group. A positive correlation between mean blood systolic pressure values and the proendothelin concentration (r = 0.666, Y = 0.52X + 129.5; p < 0.05) in the was found patients group.

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On in-patient basis 24-hr electrocardiographic Holter monitoring was performed in 20 patients with chronic renal failure (c.r.f.) on conservative treatment (10 women and 10 men, aged 43.6 +/- 9.8 years), in 10 patients with chronic primary glomerulonephritis without arterial hypertension and renal failure (2 women and 8 men, aged 34.2 +/- 10.5 years), and in 10 patients with primary arterial hypertension without clinical symptoms of renal disease (1 woman and 9 men, aged 36.6 +/- 9.5 years). No atrio-ventricular conduction disturbances were found in patients with c.r.f. Supraventricular and ventricular arrhythmias occurred in 90% of the patients. Ventricular arrhythmias were observed in 8% of c.r.f. patients. Among them simple ventricular extrasystoles (Lown 0-3) predominated and they were found in 65% of the patient. Numbers of ventricular extrasystoles were small and amounted to 44.7 per 24 hrs. Cardiac arrhythmias registered in both comparative groups were not different from those found in c.r.f. patients. The results suggest that chronic renal failure in patients on conservative treatment does not peculiarly predispose to the occurrence of cardiac arrhythmias.

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Cardiac arrhythmias detected during 24-hr electrocardiographic Holter monitoring were correlated with some echocardiographic indices in 20 patients chronic renal failure (c.r.f.) on conservative treatment (10 women and 10 men, aged 43.6 +/- 9.8 years). Comparative groups consisted of 10 patients with chronic primary glomerulonephritis without arterial hypertension and renal failure (2 women and 8 men, aged 34.2 +/- 10.5 years), and 10 patients with primary arterial hypertension without clinical symptoms of renal disease (1 woman and 9 men, aged 36.6 +/- 9.5 years). In c.r.f. patients echocardiographic investigations disclosed that the left atrial diastolic dimension was within a normal range. The right ventricular diastolic dimension (RVDD) was, left ventricular systolic (LVDS) and diastolic (LVDD) dimensions and left ventricular end-diastolic volume (LVEDV) were slightly increased. The left ventricular ejection fraction (EF) was significantly lowered. In c.r.f. patients the left ventricular mass (LVM) was increased to approximately 300 g. In c.r.f. patients a significant positive correlation was found between number of ventricular extrasystoles registered within 24 hrs and RVDD. The investigation disclosed that: 1) in c.r.f. patients with arterial hypertension showed ultrasonographic signs of hypertrophic-dilated cardiomyopathy with impaired left ventricular ejection fraction; 2) in c.r.f. patients incidence and nature of cardiac arrhythmias were independent of LVM, LVDD and LVDS; 3) numbers of ventricular extrasystoles registered within 24 hrs can increase with the increase in RVDD and the decrease in EF.

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The study was carried out on rats. Electron micrographs of the kidney obtained under +Gz accelerations were analysed. Using stereological methods the estimation of ultrastructural markers of active transport (mitochondria energy state), and passive transport (intercellular spaces and basal infolded channels) was performed in the proximal and distal tubules. The results obtained indicated that during the actions of accelerations active tubular transport was impaired as reflected by a lowering of mitochondrial energy states (similar to condensed) in the proximal and distal tubules. Widening of intercellular spaces and basal infolded channels was also observed, which suggests fluid stasis and thus impairment of passive transport.

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The authors present a 5-year experience in formation of the arterio-venous fistulas for hemodialysis. Analysed material includes 58 fistulas in 40 patients. Fistulas were formed twice or more times in 22% of the patients. Thrombus in the fistula was the most frequent complication (10.3%). The authors form arterio-venous fistula "of choice" in the peripheral portion of the forearm anastomosing radial artery with cephalic vein "side-to-end". Such a procedure in other portions of the arm is related to a higher risk of failure. Intra-arterial subtraction angiography is of significant help in the selection of the tactics of secondary operations forming fistula.

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An effect of haemoperfusion on plasma oxidizing capacity and erythrocyte sensitivity to oxidation was investigated in patients with the chronic uremia. It was found that plasma oxidizing capacity measured with NTB reduction is more pronounced in patients with the chronic uremia than in normal subjects. Oxidizing capacity of plasma is increased at the beginning of haemoperfusion. This effect is clearly seen during single pass of blood through the column with activated carbon. Erythrocyte sensitivity to oxidation following their suspension in the normal saline with phosphate buffer and measured with ascorbic-cyanate test does not differ significantly in patients with the chronic uremia and healthy subjects and does not change markedly during haemoperfusion.

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Mitochondria of the proximal and distal tubules which are in different configurational states of epithelial cells and their surface--volume relationship of intercellular spaces and basal infolded channels were evaluated in rats. The evaluation was performed with stereological methods. The studies were carried out on 5 rats under physiological conditions using electron microscopy. Mitochondria within the proximal and distal tubules were found to occur in transitional states close to the orthodox state. However, mitochondria within the proximal tubules were in a higher energy state, closer to the orthodox state when compared with those within the distal tubules. Surface--volume parameters of intercellular spaces and basal infolded channels were unexpectedly higher than the relation to active ion transport as well as indiscernible permeability of the distal tubular basement membrane.

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Using stereological methods mitochondrial energy states and intercellular spaces with basal infolded channels were evaluated in proximal and distal tubules in rats. The studies were performed on animals with experimental diabetes insipidus and on control rats by means of electron microscopy. No significant differences were found in mitochondrial energy states and sizes of intercellular spaces with basal infolded channels in the proximal tubules, which indicates undisturbed transport in this nephron segment. However, significant differences of these parameters were found in the distal tubules. In diabetes insipidus mitochondrial energy states approximated the condensed state, while in the control animals they were similar to the orthodox state. Intercellular spaces became significantly narrowed in diabetes insipidus in comparison with these in the controls. These observations suggest that mitochondrial energy states may be considered as ultrastructural markers of active tubular transport, while intercellular spaces with basal infolded channels may reflect ultrastructural counterparts of water transport.

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In 10 chronic uraemics activities of some lysosomal enzymes were determined in peripheral blood neutrophils and plasma during haemoperfusion with charcoal cartridge Adsorba 300 C (Gambro). Blood plasma activities of arylsulfatases, beta-N-acetylglucosaminidase and beta-glucuronidase did not significantly change during haemoperfusion, while lysozyme activity was significantly increasing. Neutrophil contents of these enzymes decreased. The determinations of these enzyme activities revealed a positive outlet-inlet difference in blood plasma and a negative outlet-inlet difference in neutrophils during the first 20 minutes of the procedure. The results suggest that during haemoperfusion degranulation of the peripheral blood neutrophils occurs.

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Stereological analysis of changes in tubular transport markers in diabetes insipidus has been undertaken. Intracellular spaces and basal infolded channels were considered as the markers of water transport, while mitochondrial metabolic steady states were considered as the active transport markers. Transmission electron microscopic observations revealed morphometric differences in the surface area and volume of intercellular space and basal infolded channels in the distal tubules. Stereological markers of mitochondrial metabolic states demonstrated significant differences in the distal tubules between diabetes insipidus and control groups. In diabetes insipidus the volume and surface area of intercellular spaces and basal infolded channels in the distal tubules were decreased and the mitochondrial energy state was lowered.

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Renal biopsy material from five patients with acute ethylene glycol poisoning was taken five, 10, 16 and 22 days following poisoning and examined by electron microscopy. We found extensive crystal deposits in glomerular interloop spaces. In some of the tubules crystal accumulation seemed independent of time following poisoning. No morphological markers of reabsorption were found in the tubules tightly filled with crystals, while tubules with empty lumen had signs of enhanced reabsorption. In the early period of poisoning there were signs of epithelial damage while in the late periods, signs of epithelial regeneration prevailed. The results provide new information on the pathogenesis of anuria in acute poisoning with ethylene glycol.

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This study, performed on patients with terminal renal failure, compares the changes in plasma concentrations of middle molecules, myoinositol, low molecular weight metabolites, and blood components during 4 hour periods of hemodialysis and hemoperfusion over a charcoal cartridge. After hemoperfusion there is a more marked decrease of adsorbable substances such as middle molecules, creatinine, and uric acid, whereas after hemodialysis there is a greater change in serum concentrations of myoinositol, urea, and electrolytes. The findings show that although hemoperfusion over a charcoal cartridge cannot replace hemodialysis in the treatment of chronic renal failure, it is effective as a complementary method, because of the better removal of some uremic toxins.

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