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Introduction: The term leucopenia is still a challenge for clinicists in cases of unknown reasons. There are two main groups of leucopenia: 1. Severe, chronic leucopenia (cyclic, inborn, and idiopathic); 2. Acquired or secondary (reasons: some drugs, infections, viral mainly, autoimmune diseases, haematological abnormalities, neoplasms, hiperspleenism and metabolic diseases). The aim of this investigation was an analysis of asymptomatic, lasting over three months leucopenia myelograms of childhood., Material and Methods: 21 children (6 girls and 15 boys, aged 10-17 years, mean 13.6, median 12 years) were analysed. The children were referred to our clinic by family physicians to investigate the reason of asymptomatic, lasting over three months leucopenia. These children are still under our observation from one till four years. Despite the fact of lasting over three months leucopenia, the general condition of the patients is good. In all the patients the myelogram analysis was performed after May-Grumwald-Giemsa dying, three slides of one hundred cells were counted. Statistical analysis was made using STATISTICA (Stat Soft Polska) programme., Results: Mean number of leucocytes was 3.06x109/ l (median 2.75x109/l, values from 2.46x109/l to 3.53x109/l), mean number of neutrocytes was 1.15x109/l (median 1.07 x 109/l, values from 0.62x109/l to 1470x109/l). Hemoglobin concentration and platelets number were normal. Mean number of marrow cells were within references. However mean number of myelocytes, metamyelocytes, bands and eosynophils were lower than mean number of general population marrow cells (p<0.05). Mean values of myeloblasts, neutrophils, and monocytes were statistically higher than in general population (p<0.05)., Conclusions: 1. Hypothesis of obtained differencess in numer of marrow cells would need to be investigated in broad population of patients. 2. Considering that three children presented with positive familial leucopenia history (in one of them grandmother, in two anothers fathers) genetic predisposition can be expected.

Peripheral blood count belongs to the most frequently ordered laboratory tests performed in the assessment of the current patients condition. In addition to basic information, including analysis of individual cell populations, additional parameters are given that can be helpful in predicting the course of disease, including acute pancreatitis (AP). The aim of the study was to compare the parameters of blood counts in patients with mild and moderate to severe AP in the early stage of the disease. We confirmed a significant predictive value of monitoring the total white blood cell counts, direct neutrophil counts, platelet counts, and the value of RDW in the first week of AP. Also, the relationship was observed between increased hematocrit value and mortality in patients with severe acute pancreatitis.

Unlabelled: Chemokines promote leukocyte traffic into the site of inflammation. It depends on the repertoire of chemokines synthesized locally, and the temporal expression of chemokine receptors on leukocytes among them lymphocytes B and T which play crucial role in the pathogenesis of autoimmune diseases for example in systemic lupus erythematosus (SLE). RANTES (regulated upon activation in normal T cells expressed and secreted) is chemokine influencing T cells and BLC 1 (B-lymphocyte chemoattractant 1) is chemokine which affects B cells. The aim of the study was to evaluate serum concentration of the above mentioned chemokines in treated SLE patients and to analyze the relationships between their concentration in patients group and the control one. Another aim of our study was to assess the relationships between serum levels of these chemokines and the total peripheral blood leukocyte count and between serum levels of these chemokines and absolute peripheral blood counts of the individual forms of these cells in SLE patients., Material and Methods: Serum levels of RANTES and BLC 1 were determined in 48 treated women with SLE and mild-to-moderate disease severity. The results were compared between the total SLE group and the control (29 healthy women). The correlation between chemokines and between their levels and peripheral blood leukocyte count were evaluated. The relationships between the analyzed chemokines were also determined in the control group., Results: Lower level of RANTES in serum was revealed in patients with SLE compared to the control and the tendency to higher concentration of BLC 1 in serum was observed. No relationships were observed between the levels of these chemokines both in the SLE patients and in the control group. Whereas the negative correlations between BLC 1 and total leukocyte count and BLC 1 and absolute number of neutrophils were found without such correlation between BLC 1 the subgroup of patients with concomitant neutropenia., Conclusion: We suggest that in treated patients with SLE lowered level of RANTES and tendency to higher level of BLC 1 is observed which have not any connections with the peripheral blood leukocyte counts and individual forms of these cells counts.

Unlabelled: In myocardial infarction, the endothelial activation which induces leukocytes migration into the myocardial tissues, may play an important role in ischemic injury. Selectins, shedding from the surface of activated cells into bloodstream, maybe suggested as markers of endothelial activation and leukocytes stimulation. The aim of the study was evaluation. To evaluate serum soluble E- and P-selectin levels as endothelial activation marker and serum soluble L-selectin level as leukocytes stimulation marker in myocardial infarction., Material and Methods: We examined 27 patients with acute myocardial infarction (AMI) The control group (K) consisted of 23 healthy subjects without symptoms of coronary artery disease. The concentration of soluble selectins (sE-, sP-, sL-selectin) were analyzed in venous blood serum. Results of routine laboratory tests: lipid levels, leukocyte count, prothrombin time were also included into statistical analysis., Results: A significant decrease in serum sL-selectin level was observed in patients with acute myocardial infarction compared to the control group. However, no difference was found in sE- and sP-selectin levels between the patient group and the control group. The sE-selectin level correlated positively with triglicerides level and inversely with HDL cholesterol level. There were a positive correlation between sP-selectin level and leukocyte count as well as inverse correlation between sP-selectin level and prothrombin time. The sL-selectin level correlated positively with leukocyte count. There were also a positive correlation between sP-selectin level and sE-selectin as well as sL-selectin levels., Conclusions: The sE-selectin level increases with the severity of atherogenic changes in serum lipid profil, and sP-selectin level increases due to inflammatory and prothrombotic processes. The sL-selectin level is influenced by inflamamatory processes in the vascular wall. The sE- and sP-selectin levels, unchanged compared to the control group, do not reflect adequately the degree of endothelial activation. An decreased sL-selectin level may indicate functional depletion of leukocytes in patients with myocardial infarction and make it difficult to assess the degree of leukocytes stimulation.

Introduction: Data concerning the epidemiology, etiology and clinical course of childhood urticaria are still under discussion., Aim: To investigate the clinical presentation of urticaria in hospitalized children and to define its possible etiologies., Material and Methods: Ninety eight children (male/female 42/57) aged 0.2-17.6 years, (mean age 8.22±0.55) hospitalized due to urticaria were included in the study. The nature and localization of skin lesions, accompanying diseases and diagnostic test results were analyzed., Results: Sixty nine children (70.4%) were diagnosed as having acute, 22 (22.5%) acute recurrent and 7 (7.1%) chronic urticaria. Allergic diseases, family history of atopy and adenoid hypertrophy and/or chronic tonsillitis were present respectively in 10 (10.2%), 28 (28.6%), 21 (21.4%) children. In 32 children (46.3%) with acute urticaria, in 8 (36.3%) with recurrent and in 2 (28.5%) with chronic urticaria skin lesions covered the whole body. Serum C-reactive protein and leukocyte levels in children with acute urticaria were significantly higher compared to children with chronic urticaria (p<0.05). The serum IgE levels, the percentage and absolute count of eosinophils were similar in different forms of urticaria. Probable etiology in 62/69 children with acute urticaria (respiratory tract infections - 43, drugs - 8, lambliosis - 6, food allergy - 2, antiallergy shots - 2, urinary tract infection - 1 child), in 9/22 children with recurrent urticaria (respiratory tract infection - 7, lambliosis - 2 children) and in 3/7 children with chronic urticaria (physical urticaria - 2, urinary tract infection - 1 child) was determined., Conclusions: Among children with urticaria, the most frequent cause for hospitalization is acute urticaria. The outbreak of hives wheels is usually triggered by upper respiratory tract infection. IgE-related allergy is a rare reason of childhood urticaria. In more than 50% of cases of recurrent and chronic urticaria the etiology was not determined.

Eosinophilic disorders of the gastrointestinal tract are a heterogeneous group of rare and therefore rarely diagnosed chronic diseases occurring in both pediatric and adults. They represent a diverse clinical presentation, but their common feature is the presence of inflammatory infiltration of the intestinal wall with increased number of eosinophils. The study was a retrospective data analysis of patients hospitalized in the Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University Medical College in Krakow, in the last 34 months. Among 11191 hospitalized children with symptoms suggesting gastrointestinal tract disorders, 1918 patients underwent endoscopic examination in which only 23 patients had significantly higher number of eosinophils in biopsies. Two of the four patients with eosinophilia in esophageal biopsy were diagnosed retrospectively as eosinophilic esophagitis. In the remaining 21 patients eosinophilia was secondary to other diseases of the gastrointestinal tract. Based on the medical documentation we performed thorough characterization study population in terms of history, physical examination and carried out laboratory tests. The results were referred to the current review of the literature.

Unlabelled: Last years have brought important informations about the changes in white blood cell parameters in patients with depressive disorder and furthermore changes in the levels of cytokine production. The concept of bidirectional communications between the immune system and the central nervous system has been expressed as the 'macrophage theory of depression' and the 'cytokine hypothesis of depression' that described greater expression of monocyte-associated Interleukin-1beta (IL-1beta), Interleukin-1(see text for symbol) (IL-1(see text for symbol)), tumor necrosis factor-alpha (TNF-alpha), Interleukin-6 (IL-6), Interleukin-8 (IL-8) etc., in patients suffering from depression. It was supported by many findings e.g. administration of proinflammatory cytokines in the treatment of cancer and hepatitis C, that induced depressive symptomatology. Generally Depression accompanies a number of illnesses characterized by chronic inflammatory response. The aim of this study was to investigate the association between intensity of depression and blood cells counts in patients attending Rheumatology Department., Materials and Methods: Research included 56 patients hospitalized in Department of Rheumatology (Medical University of Bialystok), by the reason of rheumatic arthritis (RA), systemic lupus erythematosus (SLE), ankylosing Spondylitis (AS), systemic scleroderma, Churg-Strauss syndrome (CSS) and psoriatic arthritis (PA). Researched group was presenting by 46 women (mean age 51 years; range 18-73) and 10 men (mean age 50 years; range 27-78). Depressive symptoms were assessed using the Beck Depression Inventory (BDI) and Hamilton Depression Scale (HAM-D). Peripheral blood samples were obtained from all 56 patients for standard blood cell counts. Statistical analysis was performed using Statistica 9.0 pl (Statsoft, Cracov, Poland). Spearman's rank correlation coefficient was used to estimate associations between variables. P-values < 0.05 were considered statistically significant., Results: The mean BDI value was found to be 12 +/- 8 and the mean HAM-D 14 +/- 9. Monocytes ratio significantly correlated with the intensity of depressive symptoms., Conclusions: Stress and pain increase with illness progression are only fragments of the analyzed problem ground. Although monocytes value remained within the upper limit of normal value, their correlation with depressive symptoms suggests that the serious reason for such a depressive mood state is a high level of monocytes. It indicates on necessity of early diagnosis and treatment of depression associate with chronic proinflammatory diseases. It may be also speculated potential efficiency of an adjunctive treatment with cytokine inhibitors and oxidative stress inhibitory factors in the therapy of depressive disorders.

Unlabelled: The aim of the study was to evaluate the influence of endothelin-1 (ET-1) and endothelin receptor (ETA) blocker (BQ 123) on the content of white blood cells in the peripheral blood of rat., Material and Methods: Experiments were performed on Wistar rats divided into following groups: group I (control) received saline; group II (ET-1) received endothelin-1 (3 microg/kg b.w.); group III (BQ 123) received ETA receptor blocker (1 mg/kg b.w.); group IV (BQ 123+ET-1) received BQ 123 (1 mg/kg b.w) and 30 minutes later ET-1 (3 microg/kg b.w.). Peripheral blood was collected from animals at three time intervals to determine the content of white blood cells using a hematology analyzer MICROS OT 45., Results: Administration of ET-1 resulted in a statistically significant increase in the concentration of white blood cells after 1 hour after administration, compared with the control group. Contrast, administration of a specific blocker of ETA (BQ 123) reduced the leukocyte content after 1 and 5 hours after administration of ET-1., Conclusion: Intravenous administration of ET-1 significantly increased the content of white blood cells in peripheral blood of rat via the ETA receptor since reversed its blockage caused the change.

The flow cytometry is acquiring more and more clinical importance. Despite its wide application in diagnostics, it is not used commonly in the clinical toxicology. The goal of the current investigation was to evaluate the mechanism for cell death (apoptosis or necrosis) and its manifestation in circulating human lymphocytes exposed to toxic concentration of carbon monoxide (CO). Since the large subpopulation of leukocytes have undergone apoptosis the next step of the studies was to assess the mobilization of progenitor cells (CD 34+) occurring in the peripheral blood after CO intoxication. Data were compared with those of 25 healthy controls comparable in terms of age, gender and physical activity. The application of the method in clinical reasoning was also evaluated. Significantly increased apoptosis of the lymphocytes in research group compared to control individuals correlates with the poisoning severity but does not depend on hypoxia. Decreased number of leukocytes caused by the cytotoxic effect of CO, stimulates the release of the CD 34+ to the peripheral blood. Increased cell death seems to be the relevant mechanism in the pathophysiology of acute carbon monoxide poisoning--the delayed apoptosis as the consequence of the reoxygenation can influence the delayed neurological and cardiological sequelae in patients after acute CO poisoning. In order to improve the treatment and help choose best fitting therapy, there should be need to introduce the new diagnostic methods like flow cytometry or innovative imaging techniques to the standard diagnostics in clinical toxicology.

Introduction: Reports point to the significant role of inflammatory mechanisms in stroke. These mechanisms are activated in peripheral blood in response to acute ischemic injury of cerebral tissues. The aim of this study was to determine whether peripheral inflammatory response to acute ischemia of the nervous tissue develops during the first twenty-four hours of ischemic stroke., Material and Methods: We studied 53 persons divided into three groups: 25 patients with ischemic stroke, arterial hypertension, and/or type 2 diabetes mellitus, and/or dyslipidemia (group I); 17 patients with arterial hypertension, and/or type 2 diabetes mellitus, and/or dyslipidemia but without stroke (group II); 11 young, healthy individuals (group III). TNF-alpha concentrations in peripheral blood were measured in each group using a sandwich enzyme-linked immunosorbent assay (ELISA). Other markers of inflammation in peripheral blood--C-reactive protein, fibrinogen, and leukocyte count--were assayed as well. The results were analyzed in relation to age, gender, co-morbidities, and blood-brain barrier injury., Results: TNF-alpha concentrations in peripheral blood of stroke patients were similar as in the other two groups. No associations between TNF-alpha and other inflammatory parameters were found. Injury of the blood-brain barrier was not accompanied by a significant change in the concentration of TNF-alpha., Conclusion: No significant peripheral inflammatory response to brain ischemia develops during the first twenty-four hours of ischemic stroke. This finding suggests that early anti-inflammatory prevention protocols can be devised to limit further injury of ischemic nervous tissue caused by activation of inflammatory processes.

Unlabelled: After the GINA 2006 publication, asthma therapy is based on control of symptoms. However there are suggestions of monitoring of airway inflammation. Aim of the study was to compare clinical criteria of asthma control with cellular markers of lower airway inflammation in induced sputum in a group of young asthmatics. To assess relationship between sputum eosinophilia, asthma severity and spirometry., Material and Methods: A group of 154 young patients with chronic asthma (8-21 years) underwent sputum induction by inhalation of 4,5% saline solution. Sputum induction was effective in 121 patients (78%), and in this group control of clinical symptoms was assessed according to GINA 2006 criteria., Results: Asthma was controlled in 82 subjects (67.8%) and uncontrolled in 39 (32.2%). Patients with controlled asthma had higher FEV1/FVC (79.8 +/- 7.1% vs 74.2 +/- 9.9%; p = 0.004) and MMEF (80.7 +/- 23.0% vs 65.3 +/- 21.8%; p < 0.001) than those with uncontrolled disease, but the average FEV1 (as percent predicted) did not differ between the two groups. Patients with controlled asthma had lower sputum eosinophil count than those with uncontrolled asthma (3.5 +/- 6.3% vs 7.2 +/- 8.7%; p = 0.01), but difference in neutrophil count was borderline (27.3 +/- 15.5% vs 34.5 +/- 21.0%; p = 0.05). High sputum eosinophil count (> 3%) was observed in 24.4% of patients with controlled asthma and in 61.5% with uncontrolled asthma (p < 0.001). Increased sputum neutrophil count was more frequent in a group of uncontrolled asthma (2.4 vs 15.4%; p = 0.022). Mean sputum eosinophil count was lower in patients with mild astma than in patients with moderate-severe disease (3.1 +/- 5.7% vs 7.1% +/- 8.8; p = 0.006). Patients with high sputum eosinophil count had lower FEV1 (89.4 +/- 14.9% vs 94.9 +/- 13.9%; p = 0.047), FEV1/FVC (74.5 +/- 10.1% vs 79.2 +/- 9.3%; p = 0.01) and MMEF (68.7 +/- 23.3% vs 81.7 +/- 23.1%; p = 0.004)., Conclusions: In this study of young asthmatics, control of asthma symptoms was observed in 67.8% of patients. However, cellular markers of lower airway inflammation were present in 1/4 of patients with controlled asthma and in 3/4 with uncontrolled disease. Sputum eosinophilia was related to asthma severity. FEV1/FVC and MMEF were more important that FEV1 for estimating control of asthma. Improvement of asthma control scoring is needed as well as availability of simple methods of inflammation monitoring.

Cardiac surgery with cardiopulmonary bypass (CPB) in children with congenital heart disease induces neutrophil activation, degranulation and systemic inflammatory response. Matrix metalloproteinase-9 (MMP-9) and matrix metalloproteinase-2 (MMP-2) are enzymes involved in degranulation and leukocyte extravasation. These are secreted as a pro-enzyme in response to several inflammatory mediators and are inhibited by tissue inhibitor of metalloproteinase-1 (TIMP-1) and tissue inhibitor of metalloproteinase-2 (TIMP-2). To explore metalloproteinase activation during cardiac surgery we investigated MMP-9, MMP-2, TIMP-1 and TIPM-2 levels in young children during and after surgery. We measured the dynamics of these enzyme concentrations in peripheral blood. Additionally we measured CD11b and CD66b molecule expression on neutrophils. These investigations were carried out in 39 children, aged 5-38 months who were undergoing cardiacsurgery with cardiopulmonary bypass (CPB). Serum concentrations of MMPs and their inhibitors, CD11b and CD66b expression on neutrophils were sequentially measured before induction of anesthesia, at the initiation of CPB, after 30 minutes of CPB, at the end of CPB, 4 and 48 hours after CPB. MMP-9 concentration increased at the end of CPB and remained elevated for a period of 48 hours. The concentration of MMP-9 detected at the end of CPB positively correlated with time of CPB (r=0.68, p=0.0045). TIMP-1 concentration decreased significantly after 30 minutes of CPB, remained lowered to the end of CPB, and returned to the start of CPB level after 48 hours. CD11b and CD66b expression on neutrophils increased at the initiation of CPB. Our data confirm that MMPs play an important role in inflammatory complications after cardiac surgery in children. These findings suggest that kinetics of MMPs concentrations in serum after cardiac surgery appear to depend on many factors. We demonstrated the link between CPB duration and the MMP-9 concentration. Future studies will determine whether inhibition of MMPs activity diminishes morbidity in children after cardiac surgery.

Exposition to tobacco smoke as a source of free radicals leads to stimulation of lipids peroxidation. Oxidation of low-density lipoproteins (LDL) increases the risk of stroke. Aim of the study was to evaluate the effect of cigarette smoking on the serum concentration of conjugated dienes as markers of peroxidation of fatty acids. In the study participated 431 subsequent stroke patients (ischemic and with hemorrhagic transformation) hospitalized in Department of Neurology in Poznan in a period from February 2007 to may 2008. The control group consisted of 16 healthy, non-smoking volunteers. The concentration of conjugated dienes (CD) in patients' sera was estimated by spectrophotometric methods. Furthermore, lipid profile, glucose level, concentration of C-reactive protein and white blood cells count were analysed. We have also calculated waist- to hip ratio. Serum concentrations of conjugated dienes were increased both in smoking and non-smoking patients with ischemic stroke. We noticed negative correlation between conjugated dienes levels and tobacco smoking duration in patients with ischemic stroke (Kendall's tau = -0.154, p = 0.0474). Moreover, conjugated dienes concentration correlated positively with triacylglycerides levels in smokers with ischemic stroke (rSpearman = 0.198, p = 0.0452; Kendall's tau = 0.135, p = 0.0428). The abnormalities in concentrations of conjugated dienes in ischemic stroke patients resulted rather from disturbances of cerebral circulation, than from cigarette smoking itself. Hypertriglyceridemia in smokers with ischemic stroke causes up-regulation of lipids peroxidation. The rate of production of conjugated dienes is associated with distribution of adipose tissue reflected by waist to hip ratio.

Chronic neutropenia is a decrease in circulating neutrophils in the peripheral blood lasting over 6 months. Values need to be refered with the age and race. In children aged 2 weeks to 12 months reffered values are above 1000/03BCL. There are congenital and aquired reasons of neutropenia in infancy. The most common type of chronic neutropenia in infants is chronic, benign neutropenia (AIN). Authors present ten infants between three and six months with chronic, benign neutropenia. The reason of ordering laboratory tests at outpatient clinic were benign upper respiratory tract infections (four cases), pallor (four cases) and on parental demand (one case). In one infant neutropenia was observed during treatment of pneumonia at a district hospital.

The natural compounds which affect defensive mechanisms of organism are important in prophylaxis and therapy of diseases in human and animals. Lysozyme is an enzyme which originates from chicken egg proteins. It modulates non-specific and humoral immunological mechanisms. A higher bioactivity has a lysozyme dimmer. The aim of study was assessment of influence of the lysozyme dimmer on chosen blood parameters, morphology and functions of internal organs and healing processes of experimental wounds in rabbits. Lysozyme dimmer (KLP-602) was used obtained process polymerisations enzyme lyzosyme from chicken egg white. The experimental group were on New Zealand White rabbits. Systemic reactions were investigated in animals after two injections of lysozyme dimer in dose 0,02 mg/kg b.w. during 21 days. Blood was collected before and after administration of lysozyme dimer in 4, 6, 24 h and in 3, 7, 21 day after first and in 4, 24 h and 3, 7 day after second injection. The following parameters were evaluated of red blood cells number (RBC), hemoglobin concentration (HGB), haematocrit value (HCT), red blood cell indices (MCV, MCH, MCHC), white blood cells number (WBC) and leukogram. Total serum proteins, components C3 and C4 of complement, immunoglobulins G and M, concentration were determined in the serum. Activated partial thromboplastin time (APTT), prothrombin time (PT) and fibrinogen concentration were evaluated in the plasma. Simultaneously, the activity of alkaline phosphatate, GPT and GOT were assessed. Administration rabbits with lysozyme dimmer caused slight decrease in RBC number, Hb concentration, HCT and the neutrophils percentage and increase in the lymphocytes percentage. The concentrations of TSP, immunoglobulins, the components of complement ware increased too. APTT an PT were normal but the fibrinogen concentration was increased. The activity of GOT and GPT were unchanged. Changes are in range of value normal and step out more quickly after two injection than after firste injection. The morphology of organs (liver, lungs, heart and kidneys) was normal.

Unlabelled: Chronic neutropenia (CN) is defined by an absolute neutrophil count (ANC) below 1500/ul, lasting at least 6 months., Aim: clinical course and treatment of children afflicted with CN was analysed., Material and Methods: we present 60 children treated in our department due to CN. The diagnosis was based on: bone marrow smears, ANC, immunologic investigation., Results: we established the diagnosis of: Kostmann disease (KD), cyclic neutropenia (CyN), hyperIgM syndrome (HIGM), Shwachman-Diamond syndrome (SDS), severe chronic neutropenia (SCN) and chronic benign neutropenia (CBN) in: 4, 2, 2, 1, 21 and 20 children respectively. Due to positive results of tests: MAIGA, GIFT or GAT autoimmune neutropenia of infancy (AIN) was confirmed in 7 children. In 3 infants neutropenia was connected with HCMV- infection and Gancyclovir therapy. RHuG-CSF treatment was implemented in 14 and effective in 13 patients. A girl, suffering from KD, during rHuG-CSF therapy, developed chronic myeloblasts leucaemia and died. A boy, with the same diagnosis, underwent bone marrow transplantation from related donor but died from invasive pulmonary aspergillosis. Antibacterial prophylaxis was necessary in 29 children. We used Amoxicillin or Trimethoprim/Sulfametoxazole, obtaining decrease of frequency and severity of infections. During observation period all children suffered from upper respiratory tract infections, 19 had chronic gingivitis. Severe infections- bacterial pneumonia, sepsis, severe varicella and measles were observed in 30, 5, 2 and 1 patient respectively. A teenager, affected with SCN, died due to fulminant Clostridium perfringens infection., Conclusions: 1. RHuG-CSF therapy is essential in children with KD and SCN (when accompanied by severe infections). 2. AIN proved to be a mild condition, although ANC decreased below 500. In this entity rHuG-CSF is recommended during severe infections and before surgery. 3. Antibiotic prophylaxis is recommended for children with: KD, CyN, GSD1b, CN in 1st year of life, HIGM; in other cases it is considered individually.

The objective was to examine whether vegetarian diet influence biochemical parameters of blood and plasma urea in selective vegetarian group. The investigation covered 41 subject, 22 of them had been applying vegetarian diet and 19 were omnivorous. The study shows statistically significant lower values of white blood cells, % and amounts of neutrocytes and insignificant lower level of red blood cells, hemoglobine, hematocrit and platelet in vegetarian group. Significant lower plasma urea level was observed in that group. These changes indicate that high quality deficiency protein was due to vegetarian diet.

We present a case of 51-year old female patient with gastrointestinal perforation and septic shock leading to leukemoid reaction with WBC 155 x 109/l. Leukemoid reaction in neoplasms and infections can mimic chronic myelogenous leukaemia and is an important diagnostic problem.

The results of combined interferon alfacon-1 and ribavirin therapy of 94 patients with chronic hepatitis C were analyzed. Complete data, including sustained viral response (SVR), were obtained in 88 patients. 46.8% of them achieved SVR. The most important factor influencing SVR, was the presence of HCV RNA in serum at weeks 12 and 24 of therapy. SVR in these cases was achieved in 14.3% and 0%, respectively. Eight patients discontinued therapy due to adverse events. Most frequent were depressive reactions due to interferon (3 cases), and severe anemia due to ribavirin (2 cases). 37% of patients developed thyroiditis, significantly more frequent in women (27 versus 9).

Initial leucocytosis, presence of t(9;22) and t(4;11) translocations and poor response to therapy with steroids or induction chemotherapy are still included to poor risk factors group. From 1981 to 1986, children with acute lymphoblastic leukemia (ALL) and initial WBC above 50,000/mm3, achieved significantly worse treatment results than children with lower WBC: over 6-year disease-free survival were respectively 33% and 60%. In attempt to improve treatment results in children with hyperleucocytosis, modified American protocols called: New York (1987), New York I (1997), and New York II (1999) were introduced consecutively in the centers of Polish Pediatric Leukemia/ Lymphoma Study Group. Actually treatment results obtained with those protocols in three groups of patients: group I: 214 children (1987-1996), group II: 58 children (1997-1999), and group III: 77 children (1999-2001) are presented. The observation was completed in March 31, 2004. In evaluated groups the first complete remissions (CR) were achieved in 91%, 95%, and 96% of patients, respectively. Relapses occurred in 72 patients of group I (37%), in 12 patients of group II (21%), and in 13 patients of group III (18%). The 5-year overall survivals were: 62%, 79%, and 78% (p=0.05) respectively; 5 year event-free survivals (EFS) were: 52%, 74%, and 69% (p=0.01) respectively. A significant improvement in treatment results in second compared with first group was achieved. Treatment results obtained with New York II are comparable with results obtained with New York I. The analysis of treatment results achieved shows the improvement of the prognosis in children with ALL and initial WBC above 50 000/mm3 in comparison with patients treated before 1987. There is strong necessity of unification of risk group qualification criteria in childhood ALL in term of comparable estimation treatment results achieved in different centers all over the world.

Macrophages represent the most predominant immune effector cells in the alveolar spaces and conducting airways and are known to express activated phenotype. The study was aimed at assessing the differences in cellular profile and the expression of selected surface markers on sputum macrophages in asthma and healthy subjects. 17 healthy subjects (never smoked) and 10 mild asthma subjects treated with glucocorticosteroids were enrolled into the study. For macrophage phenotyping a immunocytochemistry method was used with commercially available antibodies anti: CD14, CD71, CD11b and CD54. The nonparametric Mann Whitney U test was applied for data comparison, p value <0.05 being regarded as significant. The total number of cells were increased in asthma patients 4.81+/-5.27x 10(6) /ml vs healthy 2.8+/-2.15 x 10(6)/ml and it was statistically significant. Statistically significant increase in the percentage of eosinophils was observed in mild asthma subjects. No differences were found between the proportion in macrophages and lymphocytes. The macrophage phenothype in induced sputum differed in both groups. The expression of CD11b was higher in asthma group and the difference was statistically significant. The proportion of macrophages with the expression of CD 14, CD 71 and CD54 was comparable in both groups. Macrophage phenotyping during glucocorticosteroid therapy is useful in the assessment of inflammatory process in asthma subject.

Lung cancer (NSCLC and SCLC) is one of most frequent carcinoma. Lung cancer is at the top of the list of cancers causing mortality in males. Many patients are qualified to chemotherapy which causes neutropenia. The aim of this work was to evaluate the number and function of (phagocytosis, test of NBT reduction and MPO activity) of leukocytes in patients with lung cancer before chemotherapy, during leukopenia and after stimulation with granulocyte colony stimulating factor (G-CSF). Patients with lung cancer have increased number of leukocytes before the treatment. After chemotherapy the number of leukocytes decreases. Treatment with G-CSF increases the number of leukocytes but it doesn't increase their ability to phagocytosis and to NBT reduction.

We report on 34 children with acute lymphadenitis of the neck at the age between 10 months to 12 years who were admitted in our Department of Otolaryngology Children Hospital in Warsaw between 2001-2003. In a retrospective study we evaluated clinical features and diagnostic impact of ultrasonography, white blood cell count, C-reactive protein as well as bacterial etiology of children treated surgically for bacterial cervical lymphadenitis. Leukocytosis and elevated concentrations of C-reactive protein occurred in the majority of patients in 32 children (94.12%). 24 children (70.59%) we treated conservatively. Clinical appearance and the result of ultrasound examination were relevant for diagnosis of suppurative inflammation. Treatment included antibiotic therapy in all cases and incision and drainage in 10 cases (29.4%). A positive culture grew in 20% of children treated surgically and of these isolates we found Streptococcus pyogenes and Streptococcus species. In these cases surgical drainage is a key to appropriate resolution. USG diagnoses were retrospectively correlated with clinical and surgical findings or with the outcome of treatment in 87.5% of children.

The aim of the study was to evaluate the relationship between the number of polymorphonuclear leukocytes (PMNL) and the number of selected bacteria in human oral cavity. Sixty one healthy people (periodontal index of Russel's did not exceed 0.2), aged 22-26 were investigated. PMNL were isolated by rinsing oral cavity with isotonic, buffered NaCl solution. Nonstimulated whole saliva was bacteriologically examined. The number of PMNL, which was obtained from mouth of examined people was between 100,000 and 4,200,000 in 100 mL of rinsings. Usually, i.e. in 34% of cases, the number was between 500,000-1,000,000. Streptococci were isolated from all tested people and their number was the biggest. Almost in all cases there were isolated cariogenic bacteria--Streptococcus mutans (95%) and lactobacilli (93%). Haemophili, staphylococci, including Staphylococcus aureus, were found relatively often (in 86%, 86% and 52% respectively). Gram-negative enteric rods were rarely isolated (33%) and were the least numerous group of all. It has been stated, that there is a comparatively strong negative correlation between the number of PMNL in oral cavity and the number of streptococci (r=-0.55; p<0.0001), haemophili (r=-0.564; p<0.0001), staphylococci (r=-0.538; p<0.0001), lactobacilli (r=-0.407; p=0.0017) and Streptococcus mutans (r=-0.483; p=0.0002). The results suggest that PMNL are one of the factors controlling the number of some bacteria in human oral cavity.

A leukaemic reaction is an increase of leukocytes count in peripheral blood between 20-50 G/l with significant percentage of immature white blood cells: metamyeloblasts, myelocytes and even myeloblasts in blood smear. The leukaemic reactions during cancers and many infections diseases, especially in the pregnancy, by their clinical symptoms and laboratory changes can imitate acute and chronic leukaemias. In this article we introduce a pregnant woman with the leukaemic reaction with leucocyte count 51 G/l and a presence of immature white blood cells with myeloblasts in peripheral blood smear. This leukaemic reaction was caused by inflammatory process in the myoma uteri and the urinary tract.

We present two patients with chronic myeloid leukemia and hyperleukocytosis above 350 x 10(9)/l causing the symptoms of pulmonary leukostasis. Therapeutic leukapheresis procedures with concomitant chemotherapy were initiated within 12 hours from the diagnosis. After the therapy commencement the general condition of the patients systematically improved and leukocytosis gradually decreased from the second day of treatment with disappearance of pulmonary leukostasis symptoms. Thanks to application of such treatment procedures during the cytoreductive period, severe complications related to leukostasis could be prevented.

Asthma is one of the most common chronic diseases among children. The prevalence of asthma among adult and children has systematically increased for the last thirty years. It was hypothesized that atopy was a strong background predisposing to asthma. The aim of the study was to assess the occurrence of atopy in children suffering from asthma. Two groups of children were examined. The study group consisted of 24 children aged 3-7 suffering from asthma and 26 children with bronchitis. Data about each patient's personal and family allergic history were collected. Each child had skin prick tests with common allergens made, total and specific IgE level was measured and blood eosinophil count and spirometry were performed. The result showed that asthma in 88% of the children had an atopic background. Above 70% of the children had allergic diseases other than asthma--the most common was allergic rhinitis (54%) and atopic dermatitis (37.5%). Skin tests revealed that the examined children were mostly sensitized to the allergens of house dust (85.7%), house dust mite (66.6%), and grass pollen (33.3%). Atopic features were also found in children suffering from recurrent bronchitis.

Flow cytometry analysis of leukocytes response in rats immunized and infected with Fasciola hepatica. In the present experiment the differences in blood leucocytes between rats immunised intranasally with cDNA encoding F. hepatica GST, challenged with the parasite (group 1) and non-immunised infected rats (group 2) were compared. The number of leukocytes were estimated by flow cytometry on the 1, 5, 9 week after infection. Changes in the level of blood lymphocytes and monocytes were similar, with an increasing tendency in both groups. The level of eosinophils decreased to the 9th week after infection in both groups, however the number of these cells was seven times higher in control rats than in immunised rats.

Unlabelled: Allergic inflammation is a chronic disorder underlying asthma and allergic rhinitis. There is a theory "one system--one disease" connecting these two atopic diseases. Eosinophil is a major effector cell in both processes. The possible correlations between spirometric parameters and concentrations of selected mediators in peripheral blood and nasal lavage (NLF) fluid were estimated. 14 asthmatic patients entered the study, all of them symptoms free. In NLF supernatants and in blood ECP and sVCAM-1 concentrations were measured and cells in NLF were counted., Results: Number of eosinophils in NLF correlated with sVCAM-1 concentration in NLF (R2 = 0.68; p < 0.05). In serum ECP and sVCAM-1 concentrations correlated with each other (R2 = 0.73; p < 0.05). Correlation between ECP concentration in serum or NLF and FEV1 was: R2ser = 0.49, R2NLF = 0.50 (p < 0.05), respectively. ECP concentration concentration correlated in serum and NLF correlated with MEF25: R2ser = 0.77, R2NLF = 0.45 (p < 0.05), and sVCAM-1 spirometric parameters: R2FEV1 = 0.26, R2MEF25 = 0.67, p < 0.05., Conclusion: VCAM-1 is active in selective eosinophil migration to peripheral tissue. It can also activate these cells. Concentration of ECP and sVCAM-1 in blood serum and NLF correlate with the course of bronchial asthma described by spirometric parameters, and therefore can be used in disease treatment monitoring.

Unlabelled: The main markers of intrauterine infection: C-reactive protein and white blood cell count are dependent on medical management as steroids or antibiotics therapy. Granulocyte elastase is independent variable from influence of tocolysis, steroids, antibiotics, chemiotherapeutics, hours since PROM. The aim of the study was to evaluate and compare the usefulness of determination granulocyte elastase, (EG) C-reactive protein (CRP) and white blood cell count (WBC) in prediction of chorioamninitis in pregnant women after premature rupture of fetal membranes., Materials and Methods: 67 women with single pregnancy between 24-36 week of gestation after PPROM were included into the study group. All women were managed expectantly (tocolysis, antibiotics, steroids, intravaginal chemiotherapeutics, bed rest), maternal and fetal (KTG, USG) vital signs were monitored every day. EG, CRP and WBC blood test were performed every day. Histopathologic examinations of all placentas were performed for chorioamnionitis confirmation or exclusion. Normal range for EG--88 micrograms/l, CRP--15 micrograms/l, WBC--15 x 10(9)., Results: The usefulness of granulocyte elastase plasma serial determination as biochemical marker of chorioamnionitis in cases of PPROM was confirmed: sensitivity--100%, specificity--33%, PPV--64.9%, NPV--100% in comparison with CRP: sensitivity--27%, specificity--80%, PPV--62.5%, NPV--47% and white blood cell count: sensitivity--27%, specificity--66.7%, PPV--50%, NPV-42.5%., Conclusions: We confirmed statistical correlation (p < 0.001) between granulocyte elastase plasma level > 88 micrograms/l and histological signs of intrauterine infection in pregnant women after PPROM. Granulocyte elastase determination in plasma is most sensitive indicator of histologic confirmed chorioamnionitis.

Unlabelled: The objective of the study was to determine changeableness of blood cells count, hemoglobin (HGB) and hematocrit (HCT) within the peripheral blood of patients who received betamethasone during treatment of threatened preterm delivery. 65 patients at increased risk of preterm delivery received intramuscular injections of betamethasone 3 x 4 mg/day for fetal lung maturity and to decrease the risk of CNS trauma in newborns. RBC, HGB, HCT, WBC, neutrophils count and CRP level were measured before treatment and on the 1th, 2nd and 7th days after first dose of betamethasone. The steroid administration caused a significant decrease in RBC, HGB and HCT: The lowest levels were noticed on 2nd day. Statistically significant changes were observed between before and 1st day (p < 0.0001), before and 2nd day (p < 0.0001), before and Ist week (p < 0.05), 1st day and 1st week (p < 0.006), 2nd day and Ist week (p < 0.005). The level of WBC and neutrophils were increased. Their peak levels were noticed on 1st day. Statistically significant changes were observed between before and 1st day (p < 0.0001), before and 1st week (p < 0.0003), 1st day and 1st week (p < 0.0001), 2nd day and 1st week (p< 0.001). After 3 days there was a significant decrease of WBC and neutrophils count., Conclusions: Intramuscular administration of 12 mg betamethasone per day caused decrease of the RBC, HGB and HCT account and elevation of the WBC and neutrophil count. All these parameters normalized after about 7 days.

Eosinophils are multifunctional cells which contain and produce many biologically active substances. Their presence is mainly associated with parasitic infections or allergic manifestations. Eosinophilia is a common feature of helminth infections occurring both in the blood and at local sites of infection. The highly toxic basic proteins in eosinophil granules exert a range of biological effects not only against helminth parasites but also in host tissue being responsible for their damage. Eosinophils have been shown to be strong effectors killing helminth parasites in vitro, especially the larval stages. However, this function in vivo was established only for the very small number of parasites. In the last years an opportunity has appeared to perform experiments with parasites on genetically modified mice: over expressing the gene encoding Il-5 as well as lacking some receptors on eosinophils. These new studies in mice demonstrated that Il-5 and eosinophils had a different impact on different helminth infections. Eosinophilia in human patients has only a limited predictive value for the presence of helminth infections. However, the likelihood of the presence of helminth infections increases considerably with the extent of eosinophilia.

The study included 22 patients (15 males and 7 females) with tuberculosis (infected with Mycobacterium tuberculosis), aged from 14 to 70 years. Taking into account clinical status and inflammatory state indices (ESR, leucocytosis, neutrophil count) the following groups were identified: group I--all patients with tuberculosis (n = 22), with subgroup 1--patients with tuberculosis in serious condition (n = 13), subgroup 2--patients with tuberculosis in moderately serious condition (n = 9). The control group (group II) consisted of 16 healthy volunteers aged from 22 to 52 years (12 women and 4 men). In all patients the following parameters were measured: chemiluminescence (CLmax and CLarea) and phagocytosis of neutrophils (total phagocytic capacity (TPC), phagocytic index (PI), percent of phagocyting neutrophils %phag.), ESR, leukocyte count, neutrophil differential count in blood smear. No difference in CL was shown between patients with tuberculosis and healthy people. Significantly higher TPC values were observed in patients with tuberculosis (group I, subgroups 1 and 2) than in the control group. TPC was highest in subgroup 1. PI was slightly higher in patients with tuberculosis than in the control group. On the contrary, decreased %phag was observed in group I (both subgroups). ESR, total leukocyte count and differential neutrophil count were statistically significantly higher in group I than in group II. In patients from group I, together with a slight increase of CLmax, an elevation of TPC was observed. This dependence was not observed between CLarea and TPC. There was no dependence between CLmax and PI. Together with ESR increase, an increase of phagocytic properties of neutrophils was observed.

In the research we showed some inborn syndromes with disturbances of the neutrophils' number. The diseases were divided in the following categories: disturbed proliferation of myeloid stem cells, phenotypic anomalies, panmyelophtisis, neutropenia caused of marrow infiltration, neutropenia caused of agammaglobulinemia or dysgammaglobulinemia, metabolic disorders. The nowadays diagnostic possibilities and treatment in these cases were showed.

Eosinophil-mediated damage to the respiratory epithelium is a major pathogenetic mechanism in asthma. Glucocorticoids have confirmed antiinflammatory properties and effect of formoterol, montelukast and nedocromil on markers of inflammation has been studied. Eosinophil blood counts and eosinophil cation protein (ECP) serum level are often use as markers of clinical monitoring of the disease activity. To evaluate the effect of treatment on allergic inflammation, we measured eosinophil blood counts and ECP serum level, and clinical parameters before and after 4 weeks treatment with triamcinolon, montelukast, nedocromil, formoterol. It was 8 week, placebo-controlled and randomized, double blind trial of 154 children with moderate atopic asthma. Patients were randomly allocated to receive 400 mg triamcinolon (n = 28), 5 or 10 mg (according to age) montelukast (n = 27), 16 mg nedocromil (n = 26), 24 micrograms formoterol (n = 28) or placebo (n = 45). 140 children completed the study. After treatment with triamcinolon and montelukast eosinophil blood counts significantly decreased, after treatment with triamcinolon, montelukast and nedocromil ECP serum level significantly decreased; all clinical parameters improved after treatment with each drug; treatment with triamcinolon had the strongest effect on most parameters (except of FEV1). Mean eosinophil blood counts before and after treatment with triamcinolon were 277.4 and 187.2 cells/mm3 respectively (p < 0.001); with montelukast were 279.6 and 250.7 cells/mm3 respectively (p = 0.002); with nedocromil were 181.7 and 170.1 cells/mm3 respectively (p < 0.183); with formoterol were 276.4 and 264.1 cells/mm3 respectively (p = 0.2). Mean ECP serum levels before and after treatment with triamcinolon were 94.3 and 63.5 micrograms/l respectively (p < 0.001); with montelukast were 85.1 micrograms/l and 71.2 micrograms/l respectively (p < 0.001); with nedocromil were 92.6 and 80.1 micrograms/l respectively (p < 0.001); with formoterol were 95.9 micrograms/l and 87.8 micrograms/l (p = 0.05). We found significant correlation between ECP and hyperresponsiveness after treatment with triamcinolon, montelukast. This study shows that triamcinolon, montelukast contribute to inhibition of allergic inflammation by decreasing eosinophil blood counts and ECP. The serum level of ECP seems to be a good clinical marker of monitoring the disease.

Unlabelled: This study compares the cellular profiles of induced sputum (IS), bronchial washing (BW), and BAL fluid (BAL) in newly diagnosed sarcoidosis (BBS) and hypersensitivity pneumonitis (HP) patients to COPD group, and examines whether inflammatory cell counts from IS correlated with inflammatory cell counts from BW and BAL in sarcoidosis and HP patients., Methods: We recruited 23 untreated patients with stage II pulmonary sarcoidosis, 15 untreated patients with HP and 17 COPD patients. Sputum was induced with hypertonic saline solution in all individuals. Bronchoscopy was performed on a different occasions in all patients., Results: Mean lymphocyte counts in IS, BW, and BAL fluid from sarcoidosis and HP patients were significantly higher than in COPD subjects (8.9% and 13.8 vs 2.9%, p < 0.05; 11.9% and 30.5 vs 3.2%, p < 0.05; 21.5% and 56 vs 3.4%, p < 0.05, respectively). Moreover we found higher percentage of CD4+, CD3+ CD28+, CD3+ HLADRV+, and gamma delta T cells in IS, BW, and BAL fluid from both BBS and HP groups than in from COPD. Elevated CD4/CD8 ratio characterized IS, BW and BAL fluid in BBS group. Strong correlation IS/BAL and IS/BW of CD3+ CD28+, CD3+ HLADRV+, and CD4/CD8 ratio was found., Conclusions: We demonstrated that, although the relative proportion of inflammatory cells differed in the three samples, lymphocyte counts in IS were high. This finding suggests that IS could be used as a valuable alternative method to more conventional invasive techniques in clinical assessment of interstitial lung diseases patients.

The paper presents the studies of the influence polyester knitings with a different degree of surface wettability have on the coagulation system, fibrinolytic system and blood haematological parameters in in vitro studies. The studies of Human whole blood were performed for 5, 15, 30, 60, 90, 180 and 240 min. In view of the obtained results in has been reported that a hydrophobic surface knitting does not cause important quantitative changes in any of the selected parametes of the coagulation system and fibrinolysis system. A hydrophilic surface polyester knit causes important lengthening of aPTT value and reduced factor XII, IX and VIII activity. A hydrophilic surface polyester knitting causes a bigger decrease in leukocytes and blood platelets and a bigger increase in beta thromboglobulin in relation to the hydrophobic surface knitting. Neither hydrophobic surface knit nor hydrophilic surface knitting cause changes in the erythrocyte system.

Unlabelled: Free radicals, produced in large amounts during myocardial ischemia and reperfusion, take part in the degradation of cellular and subcellular membrane structures. The source of oxygen radicals in the ischemic myocardium are neutrophils recruited into the necrotic region, as well as metabolic transformation of hypoxantine and xantine to uric acid. Subsequent reactions generate lipid peroxides and cytotoxic and-products of oxidation, among which is malondialdehyde (MDA). The aim of this study was to measure of MDA, uric acid and white cell count as markers of oxidative stress in patients with acute coronary insufficiency and acute myocardial infarction. We studied 75 participants (20 females and 55 males) aged 38-75, including 13 patients with acute myocardial insufficiency (group I: 6 females and 7 males, aged 40-66 years, mean 59.4 +/- 6.52), 40 patients with acute myocardial infarction (group II: 8 females and 32 males aged 38-72 years, mean 57.3 +/- 9.57) and 22 healthy volunteers (control group: 6 females and 16 males aged 39-75 years, mean 53.1 +/- 9.62)., Conclusions: 1. Elevated levels of MDA in patients with acute myocardial infarction may reflect secondary disorders of cellular metabolism and late appearance of degradation products of lipid peroxides; 2. Uric acid may serve as an additional marker of free radical reactions in patients with acute myocardial infarction and acute coronary insufficiency.

Thalidomide, a derivative of alpha-N-phthalimidoglutarimide acid, was withdrawn from the market in the 1960s because of severe birth defects. Recent reports have suggested antiangiogenic and antitumor activity of this drug. We have treated 52 patients with refractory multiple myeloma at age from 32 to 79 years (mean 63) with thalidomide at a dose of 200-400 mg daily. Out of the group of 52 patients, 27 patients (52%) responded to the therapy, in 25 patients (48%) a response was not achieved (decline in monoclonal protein was smaller than 25%). There was a systematic improvement in haemoglobin concentration, erythrocyte count and thrombocyte count during thalidomide therapy. Leukocyte count showed an inclination to decrease, however observed changes were not statistically significant. The improvement in morphotic parameters of blood was observed both in responder and nonresponder patients.

It has been reported that white blood cells (WBC) may contribute to the initiation and further development of stroke. WBC count could have influence on hemorheology, thrombosis and induction of vasoconstriction in cerebral arteries. The aim of this work was to determine whether WBC count assessed in patients with acute stroke in the first day of the disease have a predictive value for the late clinical outcomes. Peripheral WBC count was measured at the admission to the hospital in 100 consecutive patients with acute stroke. Ischemic stroke was confirmed in all patients by head CT. Neurological status was evaluated with the use of modified Rankin's Scale. We assessed the following clinical outcomes: in-hospital mortality, the lack of neurological improvement on the 21st day of disease, and the need for hospital stay longer than 21 days. Odds ratio (OR) with 95% confidence interval (95% CI) adjusted for patient's age, gender, cardiovascular diseases, diabetes mellitus and previous stroke was calculated with the use of logistic regression. OR was evaluated both for the presence of WBC count > 10.000 cells/microliter and for each 1000 leukocytes/microliter increase. WBC count greater than 10.000 cells/microliter was associated with a more than seventy-fold greater risk for death (OR--75.18; 95% CI: 8.89-635.84; p = 0.0001), nearly eight times increased risk for the no-improvement status (OR--7.78; 95% CI: 2.51-24.17; p = 0.0004) and approximately four times increased risk for the prolonged hospital stay (OR--4.20; 95% CI: 1.50-11.72; p = 0.0062). Each 1000 cell/microliter increase in WBC count at the admission was associated with increased risk for in-hospital mortality (OR--2.24; 95% CI: 1.39-3.57; p = 0.0008), no neurological improvement (OR--1.43; 95% CI: 1.15-1.76; p = 0.0009) and the need for prolonged hospitalization (OR--1.26; 95% CI: 1.07-1.49; p = 0.0066). Increased WBC count within the first 12 hours of stroke is an independent and strong risk factor for mortality, no neurological improvement, and the need for prolonged hospitalization in the course of acute ischemic stroke.

Chronic mucosal inflammation is referred to as the primary cause of asthma. Treatment in the first place aims to prevent and reverse the above disease. It is possible to measure the inflammation relatively noninvasively and reliably by making use of induced sputum cell counts. The differential cell count points to the existence and sort of the inflammation (eosinophilic or neutrophilic) and the total cell count--to the intensity. Sputum eosinophilia responds to treatment with corticosteroid, while there is increasing evidence that an isolated neutrophilia does not. Clinical judgement of airway inflammation is further complicated due to the various types of inflammation and their inconsistent correlation with the clinical features. Hence, reliable measurement of induced sputum cell counts may be useful to guide treatment in clinical practice. Therefore, it should be considered how to make it more available.

The aim of this study was to assess changes in serum cortisol concentration, enzymatic markers of myocardial ischemia and necrosis, leucocytosis and glucose in patients with unstable coronary disease and acute myocardial infarction. The study was performed in 75 patients (20 females and 55 males aged 38-75 years; mean age 59.4 +/- 6.52), including 13 patients with unstable coronary disease (6 females and 7 males aged 40-66 years; mean age 59.4 +/- 6.52; group I), 40 patients with acute myocardial infarction (8 females and 32 males aged 38-72 years; mean age 57.3 +/- 9.57; group II) and 22 healthy volunteers (6 females and 16 males aged 39-75 years; mean age 53.1 +/- 9.62; control group). Acute ischemia as well as myocardial infarction are potent stress factors that destabilisate the functional equilibrium of the body. Considering the mechanism of action of cortisol and its physiological role, it seems that current views on elevated plasma cortisol levels as a response to stress and pain in infarction and acute ischemia should be supplemented. Anti-inflammatory properties of cortisol deserve more attention, while elevated levels might be of prognostic value in the above-mentioned diseases.

The early response to therapy in childhood acute lymphoblastic leukemia (ALL) is typically assessed by bone marrow status. The clearance of blast cells in peripheral blood and bone marrow during induction therapy was analysed in 38 children (27 precursor-B-ALL and 11 precursor T-ALL) treated according to BFM90 or New York 93 protocols. Leukocyte count and peripheral blood smear taken at diagnosis, day 8, day 14 and day 33 as well as bone marrow cellularity and percentage of blasts on days: 0, 14, 33 were analysed. The number of blasts in bone marrow was correlated to bone marrow cellularity (Spearman's rho = 0.72, p = 0.001). Patients with T-ALL were more frequently resistant to steroids in vivo and reached remission later in comparison to precursor-B-ALL children (p = 0.019), however blasts reduction ratio was comparable in both lineages. Bone marrow cellularity on days 14 and 33 of induction therapy was similar.

We observed a lot of immune system disorders significantly influencing the development and clinical course of stroke. Depression of cell-mediated immune reactivity was observed in the early stage of stroke. It was manifested by the decrease of the number of T lymphocytes, depression in lymphocyte blastogenesis, diminished production of the migration inhibition factor and reduced delayed-type skin reactivity. Observed depression was probably caused by severe metabolic and endocrinological disorders often seen in the acute phase of the disease and related with increased patients' susceptibility to infections. Simultaneously we observed that the elevated total WBC was an independent stroke risk factor and predictor of 30-days stroke fatality. The activation of the adhesion molecules expression on granulocytes (CD18) and the increased cytokine production by leukocytes could favour leukocytes influence to the ischemic area and potentiate brain injury. The chronic inflammation could be also responsible for the development of vascular injuries leading to the ischemia. In our studies we demonstrated the high levels of antibodies to cardiolipins and heat shock proteins and the increased blood levels of immune complexes (i.c.). We observed the presence of Chlamydia pneumoniae and CMV antigens in isolated i.c. It suggests that different markers of chronic inflammation observed at very early stage of the disease are probably related with the chronic infection potentially leading to the development of atherosclerotic lesions and destabilization of atherosclerotic plaque.

The plasmapheresis is procedure removal of plasma and simultaneously, together with plasma, toxins, incorrect metabolites, antigens and immunological complexes. In patients with HIV infection often appearance periphery polyneuropathy. This is connected with autoantibody action on the damage of neurone. The aim of this study was evaluation effectiveness of plasmapheresis in treatment patients with AIDS and polyneuropathy. Seven patients with AIDS--C3 and polyneuropathy coexistence were treatment by plasmapheresis. The symptoms of polyneuropathy decrease in all patients. Were don't influence on immunological system and side effect performance plasmapheresis.

Unlabelled: Interleukin-6 (IL-6) is a multifunctional cytokine that regulates the immune response, differentiation of B cells, activation of T lymphocytes and acute phase reactions., Aim of the Study: Quantitation of interleukin-6 in cerebrospinal fluid from patients with purulent bacterial meningitis (PBM) and viral meningitis (VM) on the first day of hospitalization., Patients and Methods: IL-6 activity was measured in cerebrospinal fluid (CSF) of 15 children with VM (predominantly 13/15 caused by mumps virus) in age ranging from 2.5 to 15 years and 13 patients with PBM (age ranging from 18 to 52 years). The control group consisted of 10 patients with meningeal syndrome and normal laboratory estimation of CSF (white cells count, concentration of glucose and protein). The IL-6 assays were performed using immunoenzymatic method, ELISA (Amersham) technique., Results: Increased levels of IL-6 were detected in the CSF of patients with bacterial meningitis and with viral meningitis. CSF IL-6 levels were 6 times greater in patients with purulent bacterial versus viral meningitis. The highest level of IL-6 was observed in a 18 years old patient with pneumococcal meningitis who died., Conclusion: We suggest that cytokine levels may be valuable in distinguishing patients with purulent bacterial meningitis from viral meningitis and may help in prognosis of patients with purulent meningitis.

An increase in blood level of Cortisol and overproduction of free radicals is present during first days following acute ischemia and myocardial infarction. This increase exceeds the activity of protective compounds and systems of myocardial cells undergoing ischemia. The aim of this work was to study the relationship between the Cortisol blood level and the intensity of free radical reactions in patients with acute myocardial ischemia and acute myocardial infarction with respect to metabolic (glucose, uric acid) and enzymatic agents of ischemia and necrosis. The study was performed in 75 patients (20 females and 55 males) aged 38-75 years, including 13 patients with acute myocardial ischemia (6 females and 7 males) aged 40-66 years (group I), 40 patients with acute myocardial infarction (8 females and 32 males) aged 38-72 years (group II) and 22 healthy volunteers (6 females and 16 males) aged 39-75 years (control group). The concentration of Cortisol in blood and other biochemical determinants were measured on the second, fifth and seventh day following admission to the coronary care unit. The intensity of free radicals reactions was measured by using the concentration of Vitamin C, malondialdehyde (MDA), uric acid and white blood cells (WBC) count as markers. The results obtained have led to the following conclusions: 1. The increase in blood level of Cortisol in acute myocardial infarction is higher in comparison to the level of Cortisol in acute myocardial ischemia. 2. The intensity of free radical reactions during acute myocardial ischemia and acute myocardial infarction can be assessed by the decreased level of Vitamin C, increased level of malondialdehyde, uric acid concentration and leukocyte (WBC) count. 3. There is no correlation between the intensity of free radical reactions and elevation of blood cortisol during both acute myocardial ischemia and acute myocardial infarction. 4. Elevated levels of Cortisol in blood correlate with elevated levels of glucose and uric acid in blood during both acute myocardial ischemia and acute myocardial infarction. 5. Increase in enzymatic markers of ischemia and necrosis during acute myocardial ischemia and necrosis shows no correlation with the intensity of free radicals reactions.

The leukostasis syndrome is rare complication of leukemias with extremely high white cell counts. It occurs most frequently in chronic myelosis or acute leukemias and is exceptional in chronic lymphocytic leukemia (CLL). A severe leukostasis syndrome was observed in a case of CLL with peripheral lymphocyte count of 1,120 G/L. Typical symptoms of respiratory and central nervous system were developed (tachypnoe, hypoxia, headache, slurred speech, somnolence and confusion). Leukapheresis decreased the lymphocyte count to 305 G/l rapidly and reversed the leukostasis syndrome.

The aims of our research were: estimation of asymptomatic bacteriuria (a.b.) incidence in population of women with systemic lupus erythematodes (SLE), evaluation its clinical significance and examination of bacterial colonisation of nostrils and pharynx in SLE patients with a.b. 85 women aged 24-77 (mean 49.3) with mean SLE duration 7.8 (range 1-32) years were examined. All of them fulfilled ARA criteria for the classification of SLE. Among group of patients with a.b. were counted women who had significant bacteriuria > or = 10(4) in ml urine in two cultures. Asymptomatic bacteriuria was found in 14 cases of 85 women with SLE (16.5%). In two following urine cultures bacteria from family Enterobacteriaceae were dominated: the same types of bacteria were in 85.7%--bacteriuria persistens, in others 14.3% were observed change of bacteria--bacteriuria transistens. In 9 from 14 patients with (64.3%) a.b. very massive growth of Staphylococcus aureus in culture from vestibulae of the nose swab was, in other cultures very massive growth of physiological flora was seen. All patients with a.b. were in clinical remission of SLE and they had no clinical symptoms of infection in urinary tract in 5 months of observation. However clinical significance of asymptomatic bacteriuria and pathogenic bacteria colonisation of nostrils as a precedence to symptomatic infections needs further investigations.