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Background: \ud Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial.\ud \ud Methods: \ud NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy.\ud \ud Findings: \ud Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk of recurrent ischaemic stroke between rivaroxaban and aspirin (hazard ratio [HR] 0·54; 95% CI 0·22–1·36), and the risk was similar for those without known PFO (1·06; 0·84–1·33; pinteraction=0·18). The risks of major bleeding with rivaroxaban versus aspirin were similar in patients with PFO detected (HR 2·05; 95% CI 0·51–8·18) and in those without PFO detected (HR 2·82; 95% CI 1·69–4·70; pinteraction=0·68). The random-effects meta-analysis combined data from NAVIGATE ESUS with data from two previous trials (PICSS and CLOSE) and yielded a summary odds ratio of 0·48 (95% CI 0·24–0·96; p=0·04) for ischaemic stroke in favour of anticoagulation, without evidence of heterogeneity.\ud \ud Interpretation: \ud Among patients with ESUS who have PFO, anticoagulation might reduce the risk of recurrent stroke by about half, although substantial imprecision remains. Dedicated trials of anticoagulation versus antiplatelet therapy or PFO closure, or both, are warranted.\ud \ud Funding: \ud Bayer and Janssen.

A 64-year-old man presented with symptoms of systemic immune disease dominated by rapidly progressive glomerular injury with highly positive ANCA of cytoplasmic distribution. The clinical course was characterized by dependence upon the intensity of immunosuppression, which has finally led to development of fungal septicaemia and death. The post mortem examination revealed occult gastric cancer with regional lymphatic involvement and crescentic glomerulonephritis, while failing to substantiate clinical findings of systemic vasculitis. This is, to our knowledge, the first case of ANCA-positive glomerulonephritis accompanying visceral malignancy and as such raises the question of whether it results from a simple coincidence or a causal relationship.

Deoxyribonucleases activity in T and B lymphocytes isolated from 45 patients with chronic renal failure and 30 control subjects was measured. The results obtained clearly show a dramatic increase in enzyme activity in both T and B lymphocyte cells isolated from uraemic patients whencompared with the control cell. The increase in enzyme activity was limited to the group of relatively small nucleases ranging from 14 kDa to 18 kDa. Since it was shown previously that these nucleases are among the cleavage products of the largest subunit of DNA-dependent RNA polymerase class I, it is suggested that a characteristic feature of the lymphocyte cell isolated from uraemic patients is increase of RNA polymerase lability, thus resulting in RNA synthesis decrease. Amongst toxins increasing catabolism of the active polymerase enzyme, a significant correlation with the vise of lymphocyte Mg2+ and Mn2+ ions was disclosed.

The DNA-dependent RNA polymerase activity and endonucleases in uraemic lymphocyte cells were investigated. It was found that the activity and quantity in three classes of polymerases are remarkably reduced. The reduction in enzyme activity is accompanied by increasing endonuclease activity. The relationship of polymerase enzymes with endonucleases is discussed.

The activity of nucleases and concentrations of highly important metal ions in T and B lymphocytes were examined. The source of lymphocyte was the blood of patients with chronic renal failure and activity of enzyme as well as ion concentrations were compared to the control group. Concomitant with the increase in enzyme activity was an increase of metal ion concentrations assayed in both T and B lymphocytes isolated from patients with renal disease. The data suggest that the enhancement of nuclease activity is a result of increased enzyme polypeptide synthesis and its stimulation by metal ions. Utilization of the nuclease test for monitoring uraemic toxicity is considered.

The effect of uremia on the activity of the erythrocyte complement receptors type 1 (CR1), and the changes occurring after renal transplantation, were studied. The complement receptor activity was measured by immune adherence utilizing a rosette technique. Patients with terminal kidney failure on the hemodialysis program exhibited significantly lower values of the erythrocyte CR1 activity in comparison with healthy controls. The circulating immune complexes did not affect erythrocyte CR1 activity. After successful renal transplantation, irrespective of the immunosuppressive program used, a significant increase in erythrocyte CR1 activity appeared, similar to control group values. However, the activity of erythrocyte CR1, in the graft recipients under cyclosporin A treatment, was significantly higher than in the patients receiving azathioprine with prednisone. Therefore, it is possible that cyclosporin A, transported in the erythrocytes, modifies the complement receptor function.

In order to assess the effect of erythropoietin (Epo) treatment on amino acids profile in hemodialysis patients (HD pts) 2 groups of pts were analyzed: I-12 pts HD for 146 +/- 71 months, Epo treated for 64 +/- 10 months, II-17 pts HD for 120 +/- 39 months, non Epo treated, mean Hb 11.5 +/- 1.2 g/dl. Controls consisted of 11 healthy individuals. Amino acids were estimated by HPLC OPA method. In group I blood levels of leucine (p0.03), valine (p0.002) were decreased and alanine (p0.05) was increased when compared to controls. In this group, blood levels of methionine, tyrosine and asparagine were elevated (p0.04) when compared to group II but they were lower (about 30%) then in controls. In group II pts showed reduced levels of valine (p0.008), leucine (p0.001), methionine (p0.0001), tyrosine (p0.003), asparagine (p0.04), whereas serine, glutamate and alanine (p0.04) were increased when compared to controls. Essential to nonessential amino acids ratios in group I, II and controls were as follows: 0.17; 0.12; 0.49 respectively. There were not substantial differences in amino acids in pts with elevated or normal PTH level in both HD groups. Long term EPO treatment only partially corrected changes in amino acids levels in pts with chronic renal failure.

Acute graft rejection and delayed function are considered to be the major risk factors of short-term as well as long-term graft survival. We studied the impact of these factors on graft outcome among 109 renal transplant recipients. All recipients were treated with triple drug protocol. The recipients were divided into two groups: I group included 57 patients with delayed graft function (DGF), II group included 52 patients with immediate graft function (IGF). We studied graft survival, incidence of acute rejection, serum creatinine levels and the cause of graft loss for patients in both groups. Acute rejection episodes occurred in 49% of patients from DGF group and 45% of patients from IGF group. Graft survival in IGF group was better than in DGF group. Actuarial graft survival at 1, 2, 3 and 4 years in examined groups was 84%, 82%, 72%, 65% vs. 92%, 86%, 84%, 84%, respectively. One-year graft survival in patients with acute rejection from DGF group and IGF group was significantly lower than in patients who remained rejection free (69%, 74% vs. 94%, 96%). We concluded that delayed graft function decreases long-term graft survival, while immediate graft function has an excellent impact on graft outcome. Acute graft rejection is the strongest risk factor of graft loss.

In order to assess the effect of long term erythropoietin (EPO) therapy on the nutritional status of hemodialysed (HD) patients 2 groups of HD patients were studied: I-EPO treated for 72 +/- 8 mo, 12 patients, HD for 138 +/- 66 mo, II-control group, 14 patients with Ht 30%, HD for 121 +/- 35 mo. At the onset and after 6 years of follow up patients underwent the following examination: length, body weight, body mass index, body fat stores, arm muscle circumference and total serum protein, serum albumin, lymphocyte count, creatinine, urea, cholesterol and PTH. In EPO group mean BMI, body fat, arm muscle circumference, visceral protein and total lymphocyte count were not change. In control group the decrease in height, body weight, BMI, body fat stores, arm muscle circumference and albumin were observed. Elevation of PTH estimated in half of patients in EPO group and 75% of patients in control group could influence the nutritional status of hemodialysed patients.1. Nutritional status of majority of hemodialysed patients was not change during six years EPO therapy. 2. Non EPO treated patients showed the decrease of anthropometric measurements and serum albumin.

Iterative transfusions are one of the most important mechanism of the induction as well as maintenance anti-HLA antibodies. We evaluated the evolution of PRA (panel reactive antibodies) in 46 sensitized patients during and after withdrawal of blood transfusion. Twenty nine of them (22 women and 7 men in age 38 +/- 7 years) were treated with EPO for 13 to 60 months. With EPO therapy anemia improved, allowing transfusions withdrawal in 19 patients. PRA level decreased from 62 +/- 23% to 42.5 +/- 25% after 1 year of therapy. At 2 year PRA reduced to 37.7 +/- 30% and remained on this level at 3 year. PRA levels became negative in 4 patients, decreased in 11 (by 35%) and remained high in 7 patients. The results of the patients were compared with 17 sensitized patients (9 women, 8 men in age of 40 +/- 10) who did not receive EPO and only part of them required sporadicly transfusions (mean 3 unit of blood) during last 2-3 years. PRA levels decreased from 59 +/- 20% to 45 +/- 22% at 3 year. PRA became negative in 6 patients. The reduction in PRA levels in this group of patients was lower than in EPO treated patients (24.3% vs 14%) as well as in fewer number of patients PRA droped (53% vs 63%). Analysis of risk factors for persistent high levels of alloantibodies showed, that female sex and DR2 phenotype were significant factors.

DNA metabolism in lymphocytes was evaluated in patients suffering from the nephrotic syndrome decompensation, basing on measurement of endonucleases (DNases) activity in these cells. The examination involved 17 patients, aged 27.7 +/- 7.11 with clinical and biochemical active disease, all with the nephrotic syndrome decompensation and erythrocytes in urine. A significant rise in the enzyme activity was observed in T and B lymphocytes (p0.001) in all the patients, with a distinct 3-fold increase in enzyme activity in B lymphocytes, when compared with the other cell populations. To elucidate the nature of the observed changes in DNases activity in systemic lupus erythematosus, nucleus proteins of the cells were separated electrophoretically in acrylamide gradient with immobilized DNA. Degradation processes in nucleic acids were considerably more efficient than the DNA synthesis in B lymphocytes of these cells. A smaller increase in the enzyme activity in T cells than in B lymphocytes results exclusively from more intense catabolism of nucleic acids not parallel to the intensified DNA synthesis in these cells.

Deoxyribonucleases and DNA-dependent RNA polymerase activities in T and B lymphocytes isolated from patients with chronic renal failure and control subjects were studied. The data clearly shows that the nuclease activity in T and B cells isolated from uraemic patients is remarkably enhanced when compared to the control cells. Concomitant with the enhancement in enzyme activity, the reduction in RNA polymerase I activity and quantity was observed. It was found that the increase in nuclease activity and quantity was limited to the group of relatively small nucleases with molecular weights ranging from 14 kDa to 18 kDa. It has been reported previously that these nucleases are among the cleavage products of the largest subunit of DNA-dependent RNA polymerase I. Thus we suggest that the depressed metabolic activity is a characteristic feature of the uraemic lymphocyte cells and the observed increased in DNase activity in those cells is a result of polymerase I degradation.

The nuclease activity in T and B lymphocytes isolated from patients with chronic renal failure and control subjects was studied. The data obtained show a slight increase in nuclease activity in T and B cells isolated from uraemic patients as compared to the control cells. The increase in enzyme activity was limited to the group of relatively small nucleases with molecular weights ranging from 14 kDa to 18 kDa. It was documented previously that these nucleases are among the cleavage products of the largest subunit of DNA-dependent RNA polymerase I, which is responsible for ribosomal RNA synthesis. Thus, we suggest that the characteristic feature of lymphocytes isolated from uraemic patients is lowering of their metabolic activity. Amongst toxins increasing catabolism of the active enzyme, a significant correlation with the rise of lymphocyte Mg2+ and Mn2+ ions was disclosed.

Deoxyribonuclease (DNase) activity and metal ion concentrations in lymphocytes of patients with chronic renal failure and in healthy controls were studied. The data suggest that T and B lymphocyte nuclei of patients with renal failure show increased DNase activity when compared to their healthy counterparts. It is suggested that the enhancement of enzyme activity is a result of increased metal ion concentration rather than increased enzyme copy count. The data strongly suggest that haemodialysis of uraemic patients is more effective for improvement of lymphocyte metabolism than the conservative chemical treatment.

The increased number of the genitourinary system infection caused by Chlamydia trachomatis (Ch. Tr.), increased number of patients with dysuria or sterile leukocyturia gave stimulus to studies of 615 patients from Department of Nephrology and District Outpatient Nephrological Care Unit with regard to infections with that microbes. Material for investigations derived from urethra. Diagnostic examinations were performed using the Mc Coy cell culture and the immunofluorescence method. The infection was noted in 176 patients (119 women and 57 men) that is in 28.6% of cases studied. The mean age of patients was 42.7 +/- 12 years. Clinical symptoms such as dysuria or frequency were typical for that kind of infection. The most frequent abnormality was leukocyturia or leukocyturia accompanied by erythrocyturia noted in 66% of patients. Isolated erythrocyturia was observed in 24.4% of cases. It has been stated that anamnesis or routine laboratory examinations were not able to the identification of infection. In face of poorly characteristics of clinical picture of infection the infection with Ch.Tr. could be the cause of unsuccessful therapy in patients with signs of genitourinary tract infections.

In attempt to avoid a detrimental synergism between CsA and renal ischemia in the immediate postoperative period, ALG (425 lymphocytotoxic units/kg) with small doses of CsA (6-8 mg/kg) and P were applied as the initial immunosuppressive therapy in 14 recipients of cadaveric kidneys. ALG was administered for 5 to 14 days and 2 days before withdrawing ALG, Aza (2 mg/kg) was introduced. Results of this protocol were compared with those of 19 pts treated with CsA (12 mg/kg) and P. All the pts were followed for at least 12 months. The duration of posttransplant anuria was significantly reduced in the ALG/CsA/P group (p0.02). The sCr concentration after 12 months of observation was significantly lower (p0.05), no alterations in urinalysis were detected, the number of hypertensive pts was decreased. The acute rejection rates were equivalent in both groups, however 3 of 4 rejections in ALG/CsA/P group were resistant to steroids and occurred in pts with shortened period of ALG administration. The one year patient and graft survival in the ALG/CsA/P and control groups were respectively: 78.5%, 71.4% and 89.4%, 78.9%. Severe infectious complications in the group treated with ALG/CsA/P occurred in pts who were subsequently treated with OKT3.

A case of not expected turn in the course of mesangiocapillary glomerulonephritis in a 30-year old patient is presented. The patient has been treated with EACA. It confirms possible efficiency of EACA inhibitory effect on various immunological reactions. This new, unknown property of EACA justify some new concepts in pathogenetic mechanisms of glomerulopathy.

The activity of three classes DNA-dependent RNA polymerases in T and B lymphocyte cells nuclei isolated from peripheral blood of patients with transplanted kidney were investigated. Twenty three patients with transplanted organ in age 35 +/- 9.7 treated simultaneously with cyclosporin A and small doses of prednisone and thirteen persons after renal transplantation in age 34.8 +/- 6.3 treated conservatively (azathioprine plus prednisone) were studied. The enzymes activity was assayed by the measurement of [3H] UTP incorporated into acid insoluble product in the presence of alpha-amanitin when specified. Both, "bound" and "free" enzymes activity was analysed. "Bound" polymerase is defined by the ability to transcribe endogenous template in the absence of exogenous DNA. "Free" enzyme was determined by the additional transcription on exogenous, calf thymus DNA as template. The quantity of polymerase I subunits by Western blotting was also analysed. It was shown that the polymerizing enzymes activity strongly depend upon haemodialysis period of time prior to organ transplantation as well as upon the treatment after transplantation. Characteristically in case of T lymphocyte isolated from patients treated with cyclosporin A, the transplant rejection process was accompanied by large increasing in polymerase activity especially in polymerase I. The correlation in polymerase activity and transplant rejection time was clearly observed. In case of lymphocyte cells isolated from patients with renal transplant treated conservatively, the polymerase activity in both T and B cell was slightly reduced. The useful of polymerase assay for monitoring of patients with renal transplant is considered.

We investigated the activity of some enzymes of the transcriptive DNA system to assess lymphocyte metabolic potential in patients with proliferative glomerulopathies. This study included analysis of the activity of three classes DNA-dependent RNA polymerases, before and 6 months after immunosuppressive therapy (Azathioprine + Prednisone). The enzyme activity was measured in nuclear extracts of T and B lymphocytes by estimation of the uptake of 3/H/UTP in the presence of alpha-amanitine. The immunoblotting technique using anti-polymerase I antibodies and nuclear proteins separation with immobilized exogenous DNA were employed to assess a type of the increase of the DNA-dependent RNA polymerase activity in lymphocytes populations (enhancement of the synthesis or limited depolymerization and degradation of the active enzyme). We found that the RNA polymerizing activity was increased in both lymphocyte populations. In T lymphocytes the increase was caused by an enhanced activity of transcript DNA enzymes, secondary to increased gene expression. In B lymphocytes an increase in enzyme activity was rather due to large stability RNA-polymerases in these cells. DNA-dependent RNA polymerase I in T and B cells was not modified by immunosuppression, while reduction in enzymatic activity of the remaining RNA-polymerase classes in T lymphocytes depends on partial limitation of their gene expression. Our study indicates that profound and various lymphocyte metabolic changes occur in patients with proliferative glomerulonephritis resulting from modifications in a gene expression and initiation of DNA synthesis in these cells.

Cefoperazone was used in the treatment of infections in 13 cases of chronic renal failure. In 8 cases recurrent urinary tract infections were diagnosed, septicaemia in 3 cases, pneumonia in 2. Cefoperazone 2-4 g daily was a very effective and well tolerated drug. Only one therapeutic failure was noted in a patient with mixed urinary tract infection (strains of Enterobacter cloacae and Klebsiella pneumoniae). No side effects developed, and in patients in the phase of moderate renal failure some decrease of serum creatinine was noted after the completion of treatment.

Recombinant human erythropoietin (EPO) was administered i.v. to anaemic patients (pts) on hemodialysis in doses from 40 to 120/IU/kg 3 times a week. 20 out of 21 pts showed an increase in hemoglobin (Hb) level above 11 g/dl after 8-12 weeks. Maintenance doses to keep Hb value about 10 g/dl varied from 2 X 40 IU/kg to 3 X 40 IU/kg per week (subcutaneous). EPO improved the well-being and physical condition in all of pts. Six pts developed rise in blood pressure and most an increase in predialysis serum potassium and urea levels during first 16 weeks of treatment.

Studies on the adenosine deaminase (ADA) and aldolase activities in lymphocytes were performed in 67 patients with glomerulonephritis (gn) and in 20 healthy individuals from the control group to get an insight into the lymphocyte metabolism. Statistically significant decrease of ADA activity was found in the groups of patients with chronic proliferative gn, membranoproliferative gn, membranous gn and lupus nephritis in comparison with the healthy individuals from the control group. As far as decrease of aldolase activity is concerned it has reached statistical significance in patients with mesangial gn, membranoproliferative gn, membranous gn and lupus nephritis. The lymphocyte metabolism did not show any abnormalities in the enzymatic indicators only in patients with acute proliferative gn and submicroscopic gn. The activity comparison between both enzymes in the lymphocytes, contrasted on the basis of high and low clinical dynamics of gn, revealed a tendency to lower ADA and aldolase activities in patients with high clinical dynamics. However, this difference was at the limit of statistical significance (p less than or equal to 0.10).

The aim of this work was to determine the activity of helix-destabilizing protein (HD-protein), which is indispensable in basic genetic processes such as DNA replication, genetic recombination and transcription, in lymphocytes of patients with different morphological types of glomerulonephritis and with chronic renal insufficiency, treated conservatively and by maintenance hemodialysis. The estimation was done on 44 patients with glomerulonephritis and on 20 patients with chronic renal insufficiency. The control group consisted of 20 healthy individuals. The investigations prove the fact that in human lymphocytes helix-destabilizing protein occurs, and its quantity enables us to determine its activity in the diseased and healthy state. Measurement of HD-protein activity seems to be a good marker of the altered lymphocyte function. Especially high HD-protein activity was noticed in cases of acute glomerulonephritis, lupus glomerulonephritis and in the active forms of chronic glomerulopathies. Generally, the tested parameter showed a positive correlation with the activity of the glomerulonephritic process. In lymphocytes of patients with chronic renal insufficiency treated conservatively, a greater activity of helix-destabilizing protein occurred than in the control group. Lymphocytes from patients with chronic renal insufficiency, treated with repetitive maintenance hemodialysis, did not reveal significant differences in HD-protein activity, determined directly before hemodialysis and after its completion, in comparison to the control group of healthy individuals.

A total of 234 patients with chronic glomerulonephritis, detected on the basis of clinical, immunological and pathomorphological criteria, have been examined. A group of 23 chronic glomerulonephritis patients with massive deposits of immunoglobulin A found by immunofluorescent examination, has been separated on the basis of immunohistochemical studies. In this group, occurrence of different morphological forms of glomerulonephritis has been observed: 30.4% mesangial-proliferative glomerulonephritis, 13% submicroscopic glomerulonephritis and one case of membranous glomerulonephritis. Complete haemolytic activity of complement, level of complement components C3 and C4, immunological complexes circulating in blood, properdin and immunoglobulin A levels, fibrin and fibrinogen (FDP) degradation product concentrations and their 24-hour excretions with urine have been determined. Preliminary observations of this group of patients seem to indicate a positive effect of steroid therapy in glomerulonephritis with IgA deposits, irrespective of the morphological form of the disease.

The only effective management of life-threatening hypervolemia in course of terminal renal failure is dialysis or hemofiltration. Nonetheless we succeeded in attenuating hypervolemic pulmonary edema utilizing low doses of Captopril in three patients awaiting entry into the maintenance hemodialysis program. The drug added to diuretic and, in two cases, digitalis therapy enabled pharmacologic management of patients volume overload for 12-25 days before the dialysis treatment could be started. No further decline in renal function or other side effects of Captopril were encountered. We conclude that Captopril may be life-saving in settings requiring pharmacologic relief of uremic pulmonary edema.

Blastic transformation of peripheral blood lymphocytes following stimulation with phytohemagglutinin during immunosuppressive therapy (prednisone 2 mg/kg body weight, indomethacin 2--3-5 mg/kg, azathioprine 2--4 mg/kg, cyclophosphamide 1-5--3 mg/kg per day) was studied in 59 patients with various morpholigic forms of chronic glomerulonephritis and in 7 with lupus erythematosus nephritis. No uniformly regular influence of immunosuppressive therapy in the doses employed in glomerulonephritis on blastic transformation in in vitro cultures was noted. The specific drug administered was not decisive for the character of the change in reactivity of lymphocytes (increase or decrease in blastic transformation). The interesting observation was made that efficacy of treatment was high in patients with lowest initial values of blastic transformation and its greatest increase during therapy. Apparently, disorders of cellular immunity assessed on the basis of blastic transformation of lymphocytes stimulated with phytohemagglutinin are not a decisive prognostic factor in glomerulonephritis. The results are discussed from the aspect of a possible influence of immunosuppressive therapy on restoration of the physiological proportion of T and B lymphocytes in peripheral blood.

Lymphocyte suppressive activity after stimulation with Con A and lymphocyte function as the effectors in the ADCC test had been examined in 68 patients with chronic glomerulonephritis (GN) and in 20 healthy controls. Lymphocyte suppressive activity was lower in patients with chronic GN than in the healthy individuals. In regard to chronic proliferative GN and mesangial GN the difference was statistically significant. The lymphocyte efficiency in the ADCC test was generally adequate in patients with chronic GN and none of the morphological types showed significant deviation from the control group. In the general analysis of patients with chronic proliferative, mesangial, membrano-proliferative and membranous GN a decrease of lymphocyte suppressive activity below the lower standard limit has been detected (45% of cases). A similar defect in lymphocyte function in the ADCC test has been found in 18.6%. A statistically significant relationship between the lymphocyte function disorders and the high clinical dynamism of GN has been noticed, although in some cases there was a deviation from this tendency. It is supposed that circulating immune complexes, detected in some patients with chronic GN are not the only decisive factors responsible for defects in lymphocyte function.

The hemodialysis program was carried out in four male chronic schizophrenic patients hospitalized 3--12 months in the Psychiatric Clinic, Medical University, Wroclaw. The diagnosis was made independently by three psychiatrists. The disease lasted 5 to 26 years. The clinical assessment of mental and physical state followed each dialysis. The BPRS, CGI and Wing's Ward Behavior Scale were filled. Eleven to 20 dialyses were conducted once a week (two patients) or twice weekly (two patients). Neuroleptics were withdrawn. A short period of slight, unspecific improvement was followed by a deterioration in all cases, which made it necessary to put the patients back on neuroleptics. At the end of the dialysis program none of the patients improved. Further research on the efficacy of dialysis in chronic schizophrenia should be made before the final assessment of its value.

The effect of acute experimentally induced renal failure after intramuscular injection of glycerol on serum and urine GGTP, LAP and AP activities was studied in 30 rabbits. High doses of glycerol caused shock, myolysis and hemolysis, leading to acute renal insufficiency. Serum urea and creatinine levels significantly increased, there was proteinuria, and significant decrease in 24-hr diuresis, glomerular filtration, and urinary urea excretion. The changes in LAP and AP activities were significant, and in GGTP-nonsignificant. In the urine GGTP and LAP increased significantly, and AP nonsignificantly. Urinary excretion of AP increased significantly, and GGTP and LAP nonsignificantly. The highest activity and urinary excretion of GGTP and LAP were observed on the 2nd day, and of AP--on the 5th day of renal failure.