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Introduction: Infectious mononucleosis is an acute, mild infection occurring mainly in childrenand adolescents. A characteristic feature is the presence of a symptomatic which includedfever, cervical or generalized lymphadenopathy, tonsillitis, coryzam and characteristic whitecoating on the surface. Laboratory tests show changes in the amount of leukocytes and theappearance of virocytes in peripheral blood as well as an increase in liver enzymes. The virusmainly infects epithelial cells and B lymphocytes. In B lymphocytes it intensively multiplies,leading to their transformation into plasma cells and, as a result, the production of specificIgM class antibodies. The produced antibodies activate T lymphocytes (CD8+). During theinfection, the humoral response is also activated. It works by producing antibodies directedagainst early antigen (EA), nuclear antigen (EBNA) and capsid antigen (VCA).Aim: The objective of the current study was to assess the occurrence of IgM and IgG antibodiesagainst the Epstein-Barr virus in children hospitalized in the Podlaskie Voivodeship.Material and methods: The levels of antibody were determined in serum patients serum usingthe ELFA method (Enyzme Liked Fluorescent Assay) using the VIDAS analyzer.Results: Based on preliminary studies, it shown that children aged 4-10 and 15-18 are the mostvulnerable group. The analysis of the conducted studies also showed that the acute phase ofinfectious mononucleosis is more often observed in female children.Conclusions: In order to better illustrate the seroepidemiological status of EBV infection,similar analysis should be performed in children all over Poland. In order to precisely identifythe target age group of children for possible vaccination, these studies should be extended.

Recent years have confirmed the importance of oxidative stress and biomarkers of inflammation in estimating the risk of cardiovascular disease (CVD) and explaining not fully understood pathogenesis of diabetic macroangiopathy. We aimed to analyze the relation between the intima-media thickness (IMT) of common carotid arteries and the occurrence of classical cardiovascular risk factors, together with the newly proposed biomarkers of CVD risk (high-sensitivity C-reactive protein (hsCRP), myeloperoxidase (MPO), adiponectin, N-terminal-pro B-type natriuretic peptide (NT-proBNP) and vitamin D) in youth with type 1 diabetes (T1D) recognized in screening tests to present early stages of microvascular complications (VC). The study group consisted of 50 adolescents and young adults with T1D, mean age 17.1 years (10–26 age range), including 20 patients with VC (+) and 30 VC (−). The control group (Control) consisted of 22 healthy volunteers, mean age 16.5 years (11–26 age range). In the VC (+) patients, we found a significantly higher concentration of HbA1c, lipid levels, hsCRP and NT-proBNP. BMI and blood pressure values were highest in the VC (+) group. Higher levels of MPO and lower levels of vitamin D were found in both diabetic groups vs. Control. IMT in VC (+) patients was significantly higher and correlated positively with HbA1c, hsCRP, NT-pro-BNP and negatively with vitamin D levels. In conclusion, youth with T1D and VC (+) present many abnormalities in the classical and new CVD biomarkers. hsCRP and MPO seem to be the most important markers for estimating the risk of macroangiopathy. NT-proBNP may present a possible marker of early myocardial injury in this population.

Katarzyna Powierza,1 Jolanta Sawicka-Powierza,2 Beata Urban,3 Beata Żelazowska-Rutkowska,4 Bogdan Cylwik,4 Bożena Mikołuć,5 Olga Kowalewska,6 Alina Bakunowicz-Łazarczyk3 1University Clinical Hospital in Bialystok, Medical University of Bialystok, Bialystok 15-276, Poland; 2Department of Family Medicine, Medical University of Bialystok, Bialystok 15-054, Poland; 3Department of Pediatric Ophthalmology and Strabismus, Medical University of Bialystok, Bialystok 15-274, Poland; 4Department of Pediatric Laboratory Diagnostics, Medical University of Bialystok, Bialystok 15-274, Poland; 5Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, Bialystok 15-274, Poland; 6Psychiatric Clinic, Lund, Division of Psychiatry, Lund 222 40, SwedenCorrespondence: Jolanta Sawicka-PowierzaDepartment of Family Medicine, Medical University of Bialystok, Mieszka I 4B Street, Bialystok 15-054, PolandTel +48 857326820Fax +48 857327848Email jolasawicka@gmail.comPurpose: The aim of our study was to determine endothelin-1 (ET-1) concentration in chronic idiopathic uveitis in children and adolescents depending on anatomical location and grade of inflammation.Methods: The cross-sectional study was conducted among 17 patients with chronic idiopathic uveitis and 22 healthy controls. Concentration of ET-1 in serum was determined using a commercially available ELISA kit. The concentration of C reactive protein (CRP) in serum was determined by immunoturbidimetric method using CRP4 reagent kit (Roche Diagnostics GmbH, Mannheim, Germany).Results: Statistically significant difference between ET-1 concentration in patients with chronic idiopathic uveitis and controls was found 1.33 (1.22; 1.48) vs 1.93 (1.1; 3.11), p = 0.008). No correlations were found between ET-1 concentration and age, either in chronic idiopathic uveitis patients or controls. Nine out of 17 patients presented with anterior uveitis, 5 with posterior and 3 with panuveitis. There were no differences in ET-1 concentration between anterior, posterior and panuveitis (p = 0.634), and in terms of grade of inflammation.Conclusion: ET-1 expression is disturbed in pediatric chronic idiopathic uveitis irrespective of the anatomical location and grade of inflammation. Lower expression of ET-1 plays a crucial role in disturbed vascular tone control and can result in permanent visual impairment in chronic non-infectious uveitis.Keywords: adolescents, children, chronic idiopathic uveitis, endothelin-1

Bisphenol A (BPA), the most common endocrine-disrupting chemical, has been associated with male reproductive dysfunctions. Recently, it has been shown that BPA may also affect miRNAs expression. Herein, we aimed to evaluate the association of BPA levels with steroid hormone concentration and circulating miRNAs levels to investigate the potential direct effect of BPA on homeostasis in the testis environment. The level of BPA in the seminal plasma of azoospermic men was significantly higher compared to the healthy control. The concentrations of estradiol (E2) and androstenedione (A) were significantly decreased in the seminal plasma of azoospermic men compared to the normospermic men. The levels of miR-let-7a, miR-let-7b, and miR-let-7c were significantly up-regulated, and the level of miR-518f was significantly down-regulated in the seminal plasma of the azoospermic men compared to the healthy control. The level of BPA correlated negatively with sperm concentration and normal semen morphology. A significant positive correlation was found between BPA levels and miR-let-7a and miR-let-7c levels, whereas BPA negatively correlated with miR-518f levels. Our results suggest that BPA may negatively affect sperm quality. Moreover, BPA correlated with the miR-let-7a, miR-let-7c, and miR-518f levels in seminal plasma, which suggests that BPA may act directly in seminal plasma, affecting the testicular environment.

Background: Immunological and hormonal disorders have undoubted influence on the development of atherosclerotic process. Autoimmune diseases accompanying type 1 diabetes (T1D) may additionally accelerate atherosclerosis progression and increase the risk of cardiovascular events in the future. The influence of subclinical hypothyroidism on the cardiovascular system, in particular, has recently aroused great interest. The aim of our study was to assess intima-media thickness (cIMT) of common carotid arteries and the occurrence of classical atherosclerosis risk factors together with selected new biomarkers of cardiovascular diseases in young patients with type 1 diabetes mellitus coexisting with Hashimoto's disease (HD).Patients and Methods: The study included 50 adolescents and young adults with T1D with mean age 17.1 ± 3 years, with mean diabetes duration of 10.5 ± 3.3 years, including 20 patients with diagnosed HD: T1D and HD(+), and 30 patients with no additional diseases: T1D and HD(–). Twenty-two healthy, age-matched volunteers formed control group (C). We analyzed mean HbA1c value from all years of disease, BMI, blood pressure, lipids, new biomarkers of atherosclerosis (hsCRP, adiponectin, myeloperoxidase, NT-proBNP peptide, vitamin D), and cIMT of common carotid arteries.Results: In the group of patients with T1D and HD(+), significantly higher BMI was found: 23.3 ± 4.4 vs. 21.28 ± 2.9 in group HD(–) and 19.65 ± 2.4 kg/m2 in group C (p = 0.003), and higher waist circumference: 79 ± 10.9 vs. 75.10 ± 7.6 in group HD(–) vs. 69.0 ± 7.4 cm in group C (p < 0.001). The mean value of HbA1c was higher in group T1D and HD(+): 8.8% than in group HD(–): 8.1% (p = 0.04). Significantly higher concentration of hsCRP and lower vitamin D were observed in T1D and HD(+) in comparison to T1D and HD(–) and the control group. The IMT index in the HD(+) group was 0.46 ± 0.05 mm and was comparable to the HD(–) group but significantly higher than in healthy controls: 0.41 ± 0.03 mm (P < 0.05).Conclusions: Young patients with type 1 diabetes mellitus and with coexisting Hashimoto's thyroiditis have a higher BMI, a higher waist circumference, and a higher HbA1c value, which altogether may cause faster development of macroangiopathy in the near future. Additional risk for cardiovascular disease may result from low vitamin D and increased hsCRP concentration in this group of patients. Coexistence of Hashimoto's thyroiditis did not significantly affect the cIMT value in the studied population.

Aim: The aim of the current study was to assess the serum levels of insulin-like growth factor-1 (IGF-1) and ghrelin in hypertrophied adenoids in children suffering with or without otitis media with effusion before and after adenoidectomy. Material and methods: Serum IGF-1 and ghrelin concentrations were measured with specific enzyme-linked immunoassay (ELISA) methods. The study was carried out in 20 children with otitis media with effusion. The reference group comprised 24 children with hypertrophied adenoid, while control group included 19 children. Results: This mean values of IGF-1 in children with otitis media with effusion and children with hypertrophied adenoid before adenoidectomy were significantly lower than those found in healthy children. Serum levels of IGF-1 were higher after adenoidectomy. There was a significant difference of serum ghrelin levels between both examined groups and the control group. Conclusion: Our results suggest that adenoidectomy in children with hypertrophied adenoids and in children with otitis media with effusion significantly increases the level of IGF-1 in serum compared to before surgery through the effect of the GH-IGF-1 axis, which could contribute to children’s growth.

In the recent years, alterations in the carbohydrate metabolism, including insulin resistance, are considered as risk factors in the development of hypertension and its complications in young age. Hypertension is associated with significant cardiovascular morbidity and mortality. The onset of pathology responsible for the development of hypertension, as well as levels of biomarkers specific for early stages of atherosclerosis are poorly understood.To compare a group of children whose parents have a history of hypertension (study group) with a group of children with normotensive parents (reference group), with consideration of typical risk factors for atherosclerosis, parameters of lipid and carbohydrate metabolism, anthropometric data and new biomarkers of early cardiovascular disease (hsCRP, adiponectin, sICAM-1).The study population consists of 84 children. Of these, 40 children (mean age 13.6±2.7 years) had a parental history of hypertension, and 44 aged 13.1±3.7 yrs were children of normotensive parents. Anthropometric measurements were taken, and measurements of blood pressure, lipid profile, glucose and insulin levels were carried out. The insulin resistance index (HOMA IR) was calculated. Levels of hsCRP, soluble cell adhesion molecules (sICAM) and adiponectin were measured.There were no statistically significant differences in anthropometric parameters (body mass, SDS BMI, skin folds) between groups. Values of systolic blood pressure were statistically significantly higher in the study group (Me 108 vs. 100 mmHg, p= 0.031), as were glycaemia (Me 80 vs. 67 mg/dl p0.001) and insulinaemia levels (Me 8.89 vs. 5.34 µIU/ml, p=0.024). Higher, statistically significant values of HOMA IR were found in the study group (children of hypertensive parents) (Me 1.68 vs. 0.80 mmol/l × mU/l, p=0.007). Lower adiponectin levels (Me 13959.45 vs. 16822 ng/ml, p=0.020) were found in children with a family history of hypertension. No significant differences were found in the levels of sICAM, hsCRP, and parameters of lipid metabolism.Family history of hypertension is correlated with higher values of systolic blood pressure and higher values of parameters for carbohydrate metabolism in children. Hypertension in parents is a risk factor for cardiovascular disease in their children.Wstęp. W ostatnich latach zwraca się uwagę na udział zaburzeń przemiany węglowodanów, w tym insulinooporności, w rozwoju nadciśnienia i jego powikłań już w młodym wieku. Znaczny odsetek chorobowości i śmiertelności z przyczyn sercowo-naczyniowych ma związek z nadciśnieniem tętniczym. Kwestią dyskusyjną pozostaje moment rozpoczęcia procesu chorobowego odpowiedzialnego za rozwój nadciśnienia tętniczego, a także jego związek ze specyficznymi dla wczesnych stadiów rozwoju miażdżycy biomarkerami. Cel. Porównanie grupy dzieci obciążonych obecnością nadciśnienia tętniczego u rodziców (grupa badana) do grupy dzieci, których rodzice nie chorują na nadciśnienie tętnicze (grupa referencyjna) w zakresie występowania klasycznych czynników ryzyka miażdżycy: parametrów przemiany lipidowej, węglowodanowej, pomiarów antropometrycznych, jak również nowych biomarkerów wczesnego ryzyka chorób układu sercowo-naczyniowego (hsCRP, adiponektyna, sICAM-1). Materiał i metody. Badaniami objęto 84 dzieci pacjentów lekarza rodzinnego: 40 dzieci (śr. wieku 13,6 lat ± 2,7lat) z obciążonym wywiadem w kierunku nadciśnienia tętniczego i 44 dzieci w wieku średnim 13,1±3,7 lat bez obciążonego wywiadu rodzinnego w kierunku nadciśnienia. U wszystkich dzieci wykonano badanie antropometryczne, badanie ciśnienia tętniczego krwi, oznaczono lipidogram, glikemię oraz insulinemię. Obliczono wskaźnik insulinooporności HOMA-IR. Wykonano oznaczenie hsCRP, stężenie cząsteczek adhezyjnych sICAM i adiponektyny. Wyniki. Masa ciała, wskaźnik SDS BMI i pomiary fałdów skórno-tłuszczowych nie różniły się istotnie statystycznie pomiędzy grupami. Wartości ciśnienia skurczowego były istotnie statystycznie wyższe w grupie badanej (Me 108 vs 100mmHg; p= 0,031). Zaobserwowano istotnie statystycznie wyższe stężenie glikemii (Me 80 vs. 67 mg/dl p0,001) oraz insuliny (Me 8,89 vs. 5,34µUI/ml; p=0,024) w grupie dzieci rodziców z nadciśnieniem. Wskaźnik insulinooporności HOMA wykazywał wartości istotnie statystycznie wyższe w przypadku grupy badanej (dzieci rodziców z nadciśnieniem) (Me 1,68 vs 0,80 p=0,007). Dzieci z dodatnim wywiadem rodzinnym nadciśnienia charakteryzowało niższe stężenie adiponektyny (Me 13959,45 vs. 16822 ng/ml; p=0,020). Nie wykazano istotnych różnic w stężeniu sICAM i hsCRP oraz w zakresie parametrów przemiany lipidowej. Wnioski. Dodatni wywiad rodzinny w kierunku nadciśnienia tętniczego koreluje z wyższymi wartościami ciśnienia skurczowego oraz zaburzeniami przemiany węglowodanowej u dzieci. Obciążenie nadciśnieniem tętniczym u rodziców jest czynnikiem ryzyka rozwoju chorób sercowo-naczyniowych u ich potomków.

Anti-cancer treatment in children can deteriorate gonadal function and affect future fertility. We analyzed the hormonal markers of gonadal function in adolescent leukemia survivors, treated in childhood with different levels of aggressiveness. We analyzed hormone levels in 69 adolescents and young adults, leukemia survivors stratified into standard (SR), intermediate (IR), and high (HR) risk groups, and in 80 healthy controls (38 men) at a similar age. We assessed follicular stimulating hormone (FSH), luteinizing hormone (LH), and inhibin B in the whole group, testosterone in males, and E2 and anti-Mullerian hormone (AMH) in females. Males classified into HR group presented, in comparison to control, higher levels of FSH, LH, lower inhibin B, and normal testosterone, whereas in SR and IR group, the hormonal values were comparable to the control. In females, in all risk groups, the levels of FSH, LH, E2, and inhibin B were comparable with the control, but the mean AMH levels were slightly lowered. We did not observe the effect of prophylactic cranial irradiation (12 or 18 Gy) or the time of treatment (before vs. during puberty) on hormone levels. In females, a positive correlation was found between the time interval after the end of treatment and AMH levels. Male leukemia survivors having undergone more intensive chemotherapy show the symptoms of disturbed spermatogenesis and need to be followed-up in the future. Women, irrespective of the risk group, can develop the signs of preterm ovarian insufficiency. They should be informed about the impact of the treatment on gonadal function.

Childhood cancer survivors are highly exposed to the development of side effects after many years of cessation of anticancer treatment, including altered lipid metabolism that may result in an increased risk of overweight and metabolic syndrome. Adipocyte (A-FABP) and epidermal (E-FABP) fatty acid-binding proteins are expressed in adipocytes and are assumed to play an important role in the development of lipid disturbances leading to the onset of metabolic syndrome. The aim of this study was to investigate the association between serum A-FABP and E-FABP levels, overweight, and components of the metabolic syndrome in acute lymphoblastic leukemia survivors. Sixty-two acute lymphoblastic leukemia (ALL) survivors (34 females) were included in the study. The mean age at the time of the study was 12.41 ± 4.98 years (range 4.71–23.43). Serum levels of A-FABP and E-FABP were analyzed using a commercially available ELISA kit. The ALL survivors presented statistically higher A-FABP levels in comparison with the healthy controls (25.57 ± 14.46 vs. 15.13 ± 7.61 ng/mL, p &lt, 0.001). The subjects with body mass index (BMI) above the normal range (18 overweight, 10 obese) had a greater level of A-FABP compared to the ALL group with normal BMI (32.02 ± 17.10 vs. 20.33 ± 9.24 ng/mL, p = 0.006). Of all participants, 53.23% had at least one risk factor of metabolic syndrome, in this group, only the A-FABP level showed a statistically significant difference compared to the healthy control group (30.63 ± 15.91 vs. 15.13 ± 7.61 ng/mL, p &lt, 0.001). The subjects with two or more metabolic risk factors (16.13%) presented higher levels of both A-FABP (33.62 ± 17.16 vs. 15.13 ± 7.61 ng/mL, p = 0.001) and E-FABP (13.37 ± 3.62 vs. 10.12 ± 3.21 ng/mL, p = 0.021) compared to the controls. Univariable regression models showed significant associations between BMI and systolic blood pressure with the A-FABP level (coeff. 1.02 and 13.74, respectively, p &lt, 0.05). In contrast, the E-FABP level was only affected by BMI (coeff. 0.48, 0.01). The findings reported herein suggest that the increased levels of A-FABP and E-FABP may be involved in the pathogenesis of overweight and the onset of metabolic syndrome in acute lymphoblastic leukemia. However, further longitudinal, prospective studies of fatty acid-binding proteins and their potential role in the pathogenesis of obesity and metabolic syndrome in ALL survivors remain to be performed.

Cathepsin S is an emerging marker for ovarian cancer. Two ‘analytically specific’ SPRi biosensors for the determination of Cath S have been developed. The reception part of one of the biosensors consists of the rat monoclonal antibody specific for cathepsin S attached to the gold surface via covalent bonds with cysteamine linker, while the second biosensor consists of the inhibitor LY3000328 attached via hydrophobic interaction with the 1-octadecanothiol linker. Under optimized conditions, in terms of pH and receptor concentration, both biosensors have linear response ranges between LOQ (0.14 ng mL−1) and 2.5 ng mL−1, which is suitable for the determination of Cath S in blood plasma samples of ovarian cancer patients and healthy individuals, after corresponding dilution with 0.15 M PBS buffer. Precision and recoveries are quite acceptable: below 7% and 98–101% respectively for the biosensor with antibody, and below 12% and 101–103% for the biosensor with inhibitor. The biosensors were validated by the determination of Cath S in series of plasma from ovarian cancer patients and healthy volunteers using both biosensors and ELISA, giving Pearson coefficients close to 1. Plasma Cath S concentration can be used as an ovarian cancer marker, in view of the highly elevated concentrations detected.

The aim of this study is to evaluate the levels of enothelin-1 (ET-1) in children and adolescents with high myopia and its association with the axial length of the eye and the presence of myopic retinal degeneration. The cross-sectional study was carried out in 57 patients with high myopia and 29 control subjects. Serum concentrations of ET-1 were measured using enzyme-linked immunosorbent assay (ELISA) kit. A significantly lower concentration of ET-1 in highly myopic patients compared to controls was found (1.47 (0.91, 1.87) vs. 1.94 (1.1, 2.69) pg/mL, p = 0.005). In patients with high myopia, a weak negative correlation between ET-1 concentration and the longest axial length out of the two eyes was found (r = &minus, 0.255, p = 0.0558). Further analysis revealed statistically significant differences in ET-1 concentration between patients with the axial length of the eye &gt, 26 and &le, 26 mm (p &lt, 0.041) and patients with the axial length of the eye &gt, 26 mm and controls (p &lt, 0.001). ET-1 expression is disturbed in highly myopic children and adolescents. Lower ET-1 concentration in patients with the axial length of the eye &gt, 26 mm may co-occur with high myopia and should be considered a risk factor in the pathophysiology of high myopia progression.

Recent studies point out the important role of vitamin D in the pathogenesis of many autoimmune diseases, in between psoriasis. Vitamin D regulates function of the dendritic cells, proliferation and maturation of the keratynocytes and lymphocytes T. The aim of the study was to evaluate serum vitamin D (25OHD) concentrations in psoriatic patients in the north-east of Poland and their comparison in the summer and winter period of the year. We also evaluated relationship between 25OHD concentration and disease severity, prevalence of psoriatic comorbidities and laboratory results.25OHD serum concentration was evaluated by electrochemiluminescent method in 115 patients with exacerbated plaque type psoriasis. 39 patients were evaluated in the summer and 79 in the winter time. 28 patients from winter group were treated with narrow band ultraviolet B radiation (NB-UVB). The results were compared with 38 healthy persons.25OHD serum concentrations of psoriatic patients were significantly lower than in the control group (p=0,0003). Vitamin D deficiency was diagnosed in 66% of patients in the summer time and in 63% in winter time; in the control group: 24% during the summer and 71% during the winter. After UVB phototherapy we observed reduction of skin lesions, measured as a significant decline in the Psoriasis Area and Severity Index (PASI) (p0.001). The serum 25OHD concentration increased (p0.001). After the treatment 65% of the psoriatic patients reached normal range of 25OHD concentration, 35% of patients were still vitamin D insufficient. We demonstrate positive correlation between increase in 25OHD and number of NB-UVB phototherapy sessions (r=0.38).We have observed vitamin D deficiency both in psoriatic patients and in the control group. Among psoriatic patients the praevalence of deficiency were higher than in the control group, especially during the summer months. Frequent vitamin D defficiency in the groups studied indicates the need of for its supplementation. The 25OHD serum concentrations increased after phototherapy with UVB.

The aim of this study was to analyze the relationship between the qualitative abnormalities on nailfold videocapillaroscopy (NVC), and the concentrations of selected biomarkers (sE-selectin, endothelin-1, high-sensitivity c-reactive protein (hsCRP)) and lipid metabolism parameters in children and adolescents with Raynaud&rsquo, s phenomenon (RP). Raynaud&rsquo, s phenomenon, to assess whether nailfold capillary changes may reflect the degree of systemic blood vessel abnormalities. The study group included 66 patients (34 undifferentiated&mdash, uRP and 32 secondary&mdash, sRP) aged 6&ndash, 19 years and the control group. In both groups, NVC was performed and the selected biomarkers were measured (sE-selectin, endothelin-1, hsCRP) and lipid profile. Endothelin-1, sE-selectin and hsCRP concentrations in patients from both RP groups were significantly higher, concentration of HDL fraction was significantly lower compared with the control group. The analysis of multiple linear regression demonstrated that megacapillaries most strongly determine the sE-selectin value (p = 0.04) and hsCRP (p = 0.03). Both the total cholesterol and low-density lipoprotein (LDL) fraction concentrations were determined by the presence of avascular areas (p = 0.02). In conclusion, specific pathologic NVC changes were associated with higher endothelial damage biomarkers concentration and adverse changes in the lipid profile.

Aim: The study objective was to assess plasma N-terminal–pro-brain natriuretic peptide (BNP) levels and to evaluate left ventricular mass as well as left ventricular systolic and diastolic functions in 44 children who had undergone treatment for acute lymphoblastic leukaemia and Hodgkin's lymphoma, with regard to gender, age at disease onset, time that had passed since therapy completion, cumulative dose of antracyclines and mediastinal radiotherapy applied. Methods: The median levels of pro-BNP were found to be higher in the whole study group as compared with the control (55.9 ± 53.1 ng/mL vs. 38.5 ± 47.7 ng/mL, P= 0.059). The pro-BNP values >80.0 ng/mL (standard deviation score (SDS)) were noted in 11/44 patients, including those exceeding 115.0 ng/mL (2 SDS) – in 6/44 patients. Results: No correlation was observed of pro-BNP levels with the accumulated dose of antracyclines (r=−0.42, P= 0.79) or mediastinal radiotherapy (r= 0.197, P= 0.2). However, negative correlation was found between pro-BNP and the time that had passed since therapy completion (r=−0.378, P= 0.009). In echocardiography, shortening and ejection fractions remained normal, whereas the indexed stroke volume was below 40 mL/m2 in 16/44 patients. The E/A index below 1.5 was found in 6/44 cases. The left ventricular systolic mass remained within the normal range. Negative correlation was noted between isovolumetric diastolic time and pro-BNP level. Conclusions: Increased levels of pro-BNP after anti-cancer treatment with the involvement of cardiotoxic substances may indicate the first symptoms of myocardial dysfunction, despite the lack of major echocardiographic disorders.

Summary Aim The aim of this study was evaluation of the percentage and mean fluorescence intensity of lymphocytes B with expression CD80 and CD86 in hypertrophied adenoids in children with otitis media with effusion. Material and methods Expression coreceptors CD80 and CD86 on lymphocytes B in adenoid tissue were estimated by flow cytometry method. 15 children with otitis media with effusion and 15 children with hypertrophied adenoid were tested. Results This study showed significantly higher percentage of lymphocytes CD19+CD80+ in children with otitis media with effusion (OME 1,42% ± 0,91) than in comparative group with hypertrophied adenoids (AH 0,63% ± 0,21). The receptor CD86 didn’t show differences in expression on lymphocytes B between both examinated groups. Conclusion Low expression of CD80 and CD86 indicates that local immunity response in hypertrophied adenods in children with otitis media with effusion is weakened. It can contribute to the otitis media with effusion.

Summary Introduction In hypertrophied adenoid lymphocytes B make up about 60% all lymphocytes. When the lymphocytes B come in interaction with antigens this membranes signal be passed through their receptor (BCR) to interior of cell. This signal affect modulation on gene expression, activation from which depends activation, anergy or apoptosis of lymphocyte B. Accompany BCR co-receptors regulate his functions influence stimulate or inhibitive. To the most important co-receptors stepping out on lymphocyte B belong: CD40, CD22, CD72. Aim of study The aim of study was evaluation of lymphocytes B (CD19) with co-expression with CD72 and CD40 receptors in hypertrophied adenoid with at children with otitis media with effusion. Material An investigation was executed in hypertrophied adenoids with or without otitis media with effusion. Methods By flow cytometry percentage of lymphocytes B with co-receptors CD 40, CD22 and CD72 in was analyzed. Results The percentages of CD19+CD72+ lymphocytes in the group of children with adenoid hypertrophy and exudative otitis media were lower as compared to the reference group. However, the percentages of CD19+CD22+, CD19+CD40+ in the study group was approximate to the reference group. Conclusions The lower percentage of lymphocytes B CD72 + near approximate percentages of lymphocytes B CD40+ and BCD22+ at children with otitis media with effusion can be the cause of incorrect humoral response in hypertrophied adenoid at children. Maybe it is cause reduced spontaneous production IgA and IgG through lymphocyte at children with otitis media with effusion.

Summary Introduction The adenoids are organized as lymphoepithelial structures that play an important role in protecting both the upper respiratory and alimentary tract regions. This functions requires dendritic cells (DC) which are one of the major populations of immune cells. Due to the presence of specific receptors (DC) are able to respond to both inrta- and extracellular antigens. Dendritic cells activating immunological response in tonsil contribute formation immunologic competent cells on necessity of rolling inflammatory process in middle ear. Aim of study An investigation was executed in hypertrophied adenoids with or without otitis media with effusion. Methods By flow cytometry percentage of CD11c + myeloid DC and 123 + plasmacytoid DC in hypertrophied adenoid and hypertrophied adenoid and otitis media with effusion was analyzed. Results The percentage of CD11c + myeloid DC and 123 + plasmacytoid DC was similar in hypertrophied adenoid and otitis media with effusion compared to the control group. Conclusions Our data show that part of dendritic cells has not on course of inflammatory process influence rolling in middle ear.

Summary Introduction Adenoid has particular meaning to develop of immunological response to inflammations in upper respiratory inclusive middle ear. The mining of antigen CD27 on lymphocytes T and B in creation of memory cells is still unclear. Aim CD27 on lymphocytes T and B has a crucial role in development of immune response against inflammatory state. Aim of this study was evaluation functions of lymhocytes with expression CD27 in hypertrophied adenoid in children with otitis media with effusion. Matherial and methods We tested 24 children in examine group with hypertrophied adenoid and otitis media with effusion (OME), and 29 children in comparative group only with hypertrophied adenoid (HA). We also divided both groups into two groups, above 5 and over 5 years old. We made the research by flow cytometry method. We used anty-CD19, anty-CD3, anty-CD5 and anty-CD27 monoclonal antibodies to examinations. Results We showed the lowest percentage lymphocytes B CD5+ with expression of CD27 in subgroup older children with otitis media with effusion (O.M.E. 22,43 ± 2,66%) in compartative to younger children in the same group (15,96 ± 5,31%; p Conclusions Iteraction of CD27-CD70 regulates many functions of T and B lymphocytes. It seems that disorders humoral immunologucal answer in hypertrophied adenoids are supported to develop of otitis media with effusion.

Summary Introduction Chemokine receptors play a crucial role in the recruitment of leucocytes into inflamed tissue from secondary lymphoid organs. Aim of this study was evaluation of the percentage Th (CD4+) lymphocytes with expression of chemokine receptors: CCR3, CCR4, and CCR5 in hypertrophied adenois tissue in children with otitis media with effusion. Material and methods 36 children with otitis media with effusion and 25 children with hypertrophied adenoids were tested. Expression of chemokine receptors CCR3, CCR4 and CCR5 on T CD4 lymphocytes of hypertrophied adenoid's tissue was estimated by flow cytometry method. Results Average percentage of T CD4+ lymphocytes with expression CCR4 in hypertrophied adenoid in children group with otitis media with effusion (OME = 64,11%) was significantly higher than in comparative group with hypertrophied adenoid (HA = 75,05%, p Conclusion Results suggests that intensify of humoral immunological answer in hypertrophied adenoid depends on Th2 lymphocytes with expression CCR3 and CCR4 chemokine receptors in course of inflammatory state in middle ear.

Summary Introduction Apoptosis of lymphocytes can be induced by different factors mainly however the activation of antigen Fas (CD95) and his ligand FasL (CD95L) route. Apoptosis induced by Fas-FasL has large significance in elimination of lymphocytes T in final phase immune response designate AICD (activation induced cell death). Lymphocytes B undergo apoptosis induced by Fas-FasL in germinal center, which has special meaning in elimination of cells of low specificity and weak affinity of receptor BCR (B-cell antigen receptor). Aim of study The aim of this study was evaluation of percentage of apoptotic lymphocytes and expression of Fas and FasL in CD4+, CD8+, CD19+ lymphocytes in hypertrophied adenoid and hypertrophied adenoid and otitis media with effusion. Methods CD4+ Fas+, CD8+Fas+, CD19+Fas+ CD4+ FasL+, CD8+FasL+, CD19+FasL+ cells subpopulation were identified using monoclonal antibodies and flow cytometry method. Results The percentage of lymphocytes CD4+ Fas+, CD8+Fas+, CD19+Fas+ was higher in hypertrophied adenoid and otitis media with effusion compared to the control group. There was no significant difference the percentage CD4+ Fas+, CD8+Fas+, CD19+Fas+ CD4+ FasL+, CD8+FasL+, CD19+FasL+ in hypertrophied adenoid and otitis media with effusion than the control group. The percentage of apoptotic lymphocytes was higher in hypertrophied adenoid and otitis media with effusion compared to the control group. Conclusions The susceptibility the individual subpopulation of lymphocytes in hypertrophied adenoid seems to influence on change of relations of quantitative lymphocytes and upset the immunological function of tonsils which can influence on course otitis media with effusion at children.

Summary Introduction The CD44 on lymphocytes binding to its ligand hyaluronan can mediate primary adhesion (rolling interactions) of lymphocytes on high endothelial venules (HEV). This adhesion molecule plays an important role to maturation and proliferation of lymphocytes in the secondary lymphoid organs. CD44 has a crucial role in migrate of lymphocytes to inflammatory sites. The aim of this study was evaluation of the percentage and MFI (mean fluorescence intensity) of lymphocytes CD4+, CD8+, CD19+ with expression of surface adhesive molecule CD44 in hypertrophied adenoids in children with otitis media with effusion. Material and methods 42 children with otitis media with effusion and 30 children with hypertrophied adenoids were tested. Children were also divided into two subgroups: young (below 5 years) and older children (above 5 years old). Expression of adhesion molecule CD28 on lymphocytes of adenoids tissue was estimated by flow cytometry method. Results This study showed significantly higher percentage of lymphocytes CD19+CD44+ in children with otitis media with effusion (OME 87,83%) than in comparative group with hypertrophied adenoids (AH 85,61%). We did not find difference between OME and AH in mean fluorescence intensity of subpopulations lymphocytes T and B with expression CD44. Conclusions Adhesion molecule CD44 is important for developing of effectors lymphocytes in hypertrophy adenoid. Increase percentage of lymphocytes CD19 with expression CD28, especially in older children confirms their participation in developing and forming of immunological response in otitis media with effusion.

Summary Introduction Otitis media with effusion and hypertrophied adenoid are still common diseases in childhood. Adenoid has particular meaning to develop of immunological response to inflammations in upper respiratory inclusive middle ear. The origin CD19+CD5+ B cells remains controversial. The differentiation response to ligation of CD5 resulting in apoptosis or proliferation lymphocytes. The aim of this study was compare the percentage of CD19+CD5+ lymphocytes in hypertrophied adenoid tissue at children with otitis media with effusion to comparative group without inflammatory state in middle ear. Material and methods We tested 37 children in examine group with hypertrophied adenoid and otitis media with effusion (OME), and 32 children in comparative group only with hypertrophied adenoid (HA). We also divided both groups into two groups, above 5 and over 5 years old. We made the research by flow cytometry method. We used anty-CD19 and anty-CD5 monoclonal antibodies to examinations. Results In this study we showed significantly higher percentage of the CD19+CD5+ lymphocytes at children with examined group (OME 22.12 ± 4.31%) than in comparative group (HA 19.16 ± 4.32%), p Conclusions The significant higher percentage of B lymphocytes with expressions of CD5+ receptor in hypertrophied adenoid tissue at children with otitis media with effusion are important to develop of early immunological response to inflammatory state in middle ear.

Evaluation of lymphocyte homeostasis within the chronically inflamed adenoid, closely related to the functioning of the immune system, may have a role in qualifying children for adenoidectomy. Apoptosis is a major process maintaining balance between tonsillar lymphocytes. The Fas receptor and Bcl-2 protein family which show pro-apoptotic and anti-apoptotic actions are of particular significance in apoptosis induction. Adenoid excised due to hypertrophy with or without chronic otitis media with effusion was used as study material. Flow cytometry was used to assess the percentages of apoptotic lymphocytes and CD4(+), CD8(+), CD19(+) cells with CD95(+) antigen and Bcl-2 protein in the group of children who underwent adenoidectomy due to adenoid hypertrophy and accompanying otitis media with effusion. The percentages of CD4(+)Bcl-2(+), CD8(+)Bcl-2(+) and CD19(+)Bcl-2(+) lymphocytes in the group of children with adenoid hypertrophy and acute otitis media were lower as compared to the reference group. However, the percentages of CD4(+), CD8(+) and CD19(+) cells with CD95(+) antigen were higher in the study group comparing to the reference group. The tendency of reduced percentages of T and B lymphocytes with Bcl-2 expression and elevated percentages of these cells with CD95(+) expression within the adenoid may reflect local immunity disorders.