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This paper presents a collection of lidar-derived aerosol intensive optical properties for several aerosol types, namely the particle linear depolarization ratio, the extinction-to-backscatter ratio (lidar ratio) and the Ångström exponent. The data collection, named DeLiAn, is based on globally distributed, long-term, ground-based, multiwavelength, Raman and polarization lidar measurements, conducted mainly with lidars that have been developed at the Leibniz Institute for Tropospheric Research. The intensive optical properties are presented at two wavelengths, 355 and 532 nm, for 13 aerosol categories. The categories cover the basic aerosol types (i.e., marine, pollution, continental European background, volcanic ash, smoke, mineral dust), as well as the most frequently observed mixtures they form. This extensive collection also incorporates more peculiar aerosol categories, including dried marine aerosol that, compared to marine aerosol, exhibits a significantly enhanced depolarization ratio (up to 15 %). Besides Saharan dust, additional mineral dust types related to their source region were identified due to their lower lidar ratios (Central Asian and Middle Eastern dust). In addition, extreme wildfire events (such as in north America and Australia) emitted smoke into the stratosphere showing significantly different optical properties, i.e., high depolarization values (up to 25 %), compared to tropospheric smoke. The data collection reflects and underlines the variety of aerosol mixtures in the atmosphere and can be used for the development of aerosol-typing schemes. The paper contains the most up-to-date and comprehensive overview of optical properties from aerosol lidar measurements and, therefore, provides a solid basis for future aerosol retrievals in the frame of both spaceborne and ground-based lidars. Furthermore, DeLiAn can assist the efforts for the harmonization of satellite records of aerosol properties performed at different wavelengths.

A global vertically resolved aerosol data set covering more than 10 years of observations at more than 20 measurement sites distributed from 63° N to 52° S and 72° W to 124° E has been achieved within the Raman and polarization lidar network PollyNET. This network consists of portable, remote-controlled multiwavelength-polarization-Raman lidars (Polly) for automated and continuous 24/7 observations of clouds and aerosols. PollyNET is an independent, voluntary, and scientific network. All Polly lidars feature a standardized instrument design with different capabilities ranging from single wavelength to multiwavelength systems, and now apply unified calibration, quality control, and data analysis. The observations are processed in near-real time without manual intervention, and are presented online at http://polly.tropos.de/. The paper gives an overview of the observations on four continents and two research vessels obtained with eight Polly systems. The specific aerosol types at these locations (mineral dust, smoke, dust-smoke and other dusty mixtures, urban haze, and volcanic ash) are identified by their Ångström exponent, lidar ratio, and depolarization ratio. The vertical aerosol distribution at the PollyNET locations is discussed on the basis of more than 55 000 automatically retrieved 30 min particle backscatter coefficient profiles at 532 nm as this operating wavelength is available for all Polly lidar systems. A seasonal analysis of measurements at selected sites revealed typical and extraordinary aerosol conditions as well as seasonal differences. These studies show the potential of PollyNET to support the establishment of a global aerosol climatology that covers the entire troposphere.

We report on importance of conducting comprehensive studies of atmospheric aerosol particles, which cannot be done if information from various complementary sensors is unavailable. We present an example for such application and recommend on the types of sensors that should be used in view of the ACTRIS and RI-URBANS new strategies for monitoring at supersites. Although active and passive remote sensing data was not available in continuous mode, we show that synergic use of them with in-situ observations allows for comprehensive study of temporal and height-resolved distribution of aerosol in the lower troposphere and it can be successfully combined to assess biomass burning impact on air quality and optical properties. The analysed period was divided into three episodes based on the measured black carbon (BC) concentration and the prevailing wind direction. The dominant 72-h backward trajectories were ending in western Europe, mid-Atlantic and western Russia, respectively, The in-situ measured mass concentrations of BCtotal and BC apportioned to biomass burning as well as particulate matter (PM) concentrations in accumulation mode were twice higher during the first and last episodes compared to the second episode, representing long-range transport from different source regions. The obtained complementary surface, column-integrated, and layer-derived size distributions and other parameters demonstrate the added value of multisensor analyses., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

High quality lidar measurements of PollyXT operating at the University of Warsaw in the years 2013-2022 were analyzed to present a comprehensive optical characterization of biomass burning aerosols over Warsaw. The directions of the aerosol inflows were analyzed by dividing advection cases into four types, according to the area of origin: Western Europe, Eastern Europe, the Iberian Peninsula, and North America. It was shown that optical properties of smoke vary in each of these types, and emphasized that aerosol aging processes are important. It was found that as aerosol's age increases, there is more backscattering and less extinction at 355 nm in relation to 532 nm. The analysis of the lidar ratio demonstrated that the main changes of the aging process were observed in the UV spectra.

Objectives: To evaluate the presence and extent of cardiac calcifications and aortic stiffness in patients with end-stage renal disease (ESRD)., Patients and Methods: The study group consisted of 60 patients with ESRD with a mean age of 51.7 years, treated with peritoneal dialysis. In all patients transthoracic echocardiogram was performed to assess the following parameters: left ventricular end-systolic diameter, left ventricular end-diastolic diameter (LVEDd), interventricular septum end-diastolic diameter (IVSDd), posterior wall end-diastolic diameter (PWDd), ejection fraction (EF), fractional shortening (FS), aortic maximal and minimal diameter, aortic valve area, mitral valve area (MVA), left ventricular ejection time (LVET), maximal aortic velocity. Aortic stiffness index (AS) was calculated. Aortic and mitral valve calcifications were assessed., Results: Patients with ESRD had a larger left ventricle (LVEDd 5.4 cm vs. 4.76 cm) and its wall was thicker (IVSDd 1.36 cm vs. 1.02 cm; PWDd 1.31 cm vs. 0.94 cm). Patients had poorer left ventricle contractility (EF 56.1 vs. 61.6%; FS 28.5 vs. 33.2%). Atherosclerotic plaques, calcified plaques and valvular calcifications were more frequently detected in patients with ESRD. Patients with ESRD had significantly higher values of the AS index: (5.34 vs. 3.24). Among ESRD subjects with the stiffer aorta, atherosclerotic plaques including calcificones and the aortic valve damage were more frequently detected., Conclusions: Patients with ESRD are characterized by increased aortic stiffness. Atherosclerotic plaques in the aorta as well as cardiac and large vessels calcifications are more common among patients with ESRD. In patients with ESRD there is a correlation between an increase in aortic stiffness and damage of aortic valvular leaflets as well as calcifications of atherosclerotic plaques in the aorta. The degree of aortic stiffness is not related to impairment of mitral valvular leaflets and extravalvular calcifications. A relationship between aortic stiffness and aortic or aortic valve calcifications suggest a different pathogenesis of aorta calcification as compared to that underlying calcifications of other localizations.

Cardiovascular disease (CVD) is a major cause of death in peritoneal dialysed patients (PD-pts). Coronary artery calcification (CAC) is likely to affect the development of CVD. Purpose of our study was to evaluate coronary artery calcification and risk factors of this calcification in PD-pts. We studied 62 patients (38 F, 24 M) undergoing peritoneal dialysis (PD). Coronary calcification was examined by ECG-gated multidetector CT (Light Speed Ultra) using Agatson (AG) and volumetric (V) methods. Patients were divided into 3 groups depending on mean value of estimated CAC: group A-no calcification, group B-CAC maximal value 400 mm3, group C-CAC value more than 400 mm3. As risk factors of CAC were evaluated: patients age, sex, dialysis duration, serum concentration of Ca, P, homocysteine CRP and fibrinogen, as well as, CaxP product, intact PTH; presence of diabetes or hypertension. Coronary artery calcification was detected in 68% of patients. In the whole observed population positive correlation between CAC determined by AG and V methods and CRP (r = 0.36, p < 0.05) as well as patients age (r = 0.5, p < 0.01) was observed. There was also positive correlation between CAC and fibrinogen concentration (AG CAC r = 0.58, p < 0.05; V CAC r = 0.72, p < 0.05). When compared group C with the groups A and B cardiovascular complications were in this group more frequent than in the last two: 4 patients from group C died because of cardiovascular complications.

The loss of sense of smell significantly decreases a quality of life after total laryngectomy. That is why this problem should be considered within a complex rehabilitation of laryngectomized patients. The smell exercises ought to start parallely to the speech rehabilitation. The aim of our study was to estimate the efficacy of smell rehabilitation after total laryngectomy. 59 persons after total laryngectomy attending the fourteen days long rehabilitation camp were examined. All the patients had the examination of three smells identification (lemon, mint and anise) made before the beginning of exercises. All the persons had also the efficacy of air aspiration through the nose measured. The control examination of those parameters was conducted after fourteen days of exercises of making the negative pressure in the throat and nasopharynx directing the air flow into the olfactory area of the nose. We confirmed a statistically significant differences between the smell identification and the force of aspiration before and after rehabilitation. We confirmed that patient's age and the time from laryngectomy have the influence into the efficacy of smell rehabilitation.

Background: A well-functioning mature arteriovenous fistula is essential for the maintenance of haemodialysis in patients with chronic renal failure. The Brescia-Cimino arteriovenous fistula has the best survival characteristics and low rate of complications. The most common reason of fistula failure is thrombosis caused by stenosis. Colour Doppler ultrasonography has proven to be effective in the assessment of anatomical vascular features. The majority of studies were done in patients with clinically presumed arteriovenous fistula complications. However, only limited data are available about the well-functioning mature arteriovenous fistulas. The purpose of the present study was to evaluate completely asymptomatic, mature arteriovenous fistulas with colour Doppler ultrasound., Materials and Methods: From July 2001 to April 2003, we examined 139 patients with the end-stage renal disease. They were in the range of 19-79 years of age (mean, 46.7 years). The study included only the patients who met the following criteria: (1) no difficulties with haemodialysis (as reported by nurses); (2) normal venous diastolic blood pressure (<150 mmHg) at monthly evaluation; (3) normal urea clearance x time/urea volume of distribution; (4) blood cells count, plasma electrolytes, and liver function at monthly evaluation. The mean fistula age was 26 months (S.D.=21.9). The mean time of dialysis therapy was 49 months. Thirty-eight percent patients had primary fistulas, 23%--secondary, 11%--third and 11%--fourth, 4%--fifth, 5%--sixth, and 8% patients had more than sixth., Results: There was no correlation between: (1) patient's age and fistula age; (2) patient's age and number of fistulas in one patient; (3) fistula age and number of fistulas in one patient; (4) localization of fistula and fistula age. There was a strong correlation between dialysis therapy period and number of fistulas in one patient. The mean flow volume was 1204.1 ml/min (S.D.=554). It was significantly higher in the fistulas with aneurysms, calcifications and tortuous vessels and lower in those with stenosis. There was no correlation between the flow volume or presence of stenosis and fistula age. Stenosis was detected in 64% fistulas. Fifty-seven percent of stenoses were located in the anastomotic region, 22% stenoses were in vein junction, 19% were at one or both ends of aneurysm, and 2% in the remaining region of the efferent vein. Perivascular colour artefacts were present at the 94% fistulas with stenosis. Chronic venous occlusion with collateral veins was detected in 6% of fistulas. The aneurysms were observed in 54% fistulas. The mean diameter of aneurysms was 12.4 mm. Ninety-six percent of aneurysms were located at puncture sites. Ten patients had a small thrombus in an aneurysm and at puncture sites., Conclusions: We conclude that there was a high level of abnormalities present in well-functioning mature arteriovenous fistulas. However, these abnormalities were not sufficient to affect the functioning of the dialysis fistula.

Introduction: Mycobacterium tuberculosis is a facultative intracellular pathogen that developes specific T cell response expressed by the production of IL-12, IFN-gamma, and TNF-alpha. The response has been quite well investigated in the experimental models, however, there is little information about certain cytokine levels in patients with extrapulmonary tuberculosis. The shortage of data pertains also to its most common form-kidney tuberculosis, especially when bacilli dissemination into the blood circulation has occurred., Objectives: The aim of our study was to examine simultaneously the frequency of Mycobacterium tuberculosis presence in the blood circulation and the serum cytokine concentration during kidney tuberculosis to approach their relationship in the clinical infection process. It is considered that cytokine levels do not correlate with localisation of tuberculosis (pulmonary vs. extrapulmonary), however, there is little information about the cytokine levels in patients with kidney tuberculosis., Materials and Methods: 30 patients attending the urology clinic with suspicion of kidney tuberculosis were evaluated. Serum concentrations of selected cytokines in patients with urine, urine and blood Mycobacterium tuberculosis presence were quantified by ELISA and compared to PCR negative patient and group of healthy people., Results: Our study demonstrates the increase of TNF-alpha and IL-12 level in comparison to control group. TNF-alpha concentration was about 2-fold higher in the positive patients than it was in control group; IL-12 concentration was about 4-fold higher and the differences between IL-12 levels were statistically important (p < 0.05). However, no significant differences were found in IFN-gamma level among all groups. Using Spearman correlation rank test, a significant correlation was found between TNF-alpha and IL-12 in the positive patient group. The correlation factor was more significant for the group of patients with Mycobacterium tuberculosis present in blood and urine than it was in urine positive PCR group (r = -0.66 vs. r = -0.51).

Development of vascular and systemic calcification is one of the more serious and often occurring complications in hemodialyzed patients. The cardiac valves calcifications are of the essential importance. They are result of the very complicated calcification process connected with hyperphosphataemia, hyperparathyroidism, calcium carbonate administering and active vitamin D3 metabolites as well as using dialysis fluids with high concentration of calcium. Elevated P and Ca x P product are both significant predictors of cardiovascular mortality in hemodialized patients. We describe two patients with cardiac failure because of cardiac valves calcification. Both patients underwent artificial valves implantation. The patients showed a marked improvement of the quality of life and haemodynamic status.

The aim of the study was to evaluate the serum lipid and apolipoprotein profiles among patients after renal transplantation (Tx) and to compare them with the profiles obtained for permanently hemodialysed patients (HD). The investigations were performed at 15 Tx, 40 HD patients and the control group of 40 healthy subjects. There were significantly increased TG, ApoAIII, ApoE, TC/ HDL-C, ApoCIII non B, ApoCIII:B and decreased HDL-C, ApoAI, HDL-C/ApoAI, ApoAI/ApoCIII, ApoB/ApoCIII ratios comparing HD patients to the control group. There were increased TG, ApoCIII, ApoCIII non B, ApoB/ApoCIII ratios and decreased ApoAI/ApoCIII ratios in Tx patients as compared to the control subjects. Moreover, there were significantly higher HDL, ApoAI, HDL/ApoAI, ApoCIII non B and lower ApoE, ApoE/ApoB, ApoCIII:B ratios in Tx patients as compared to these of HD patients. Significant inverse correlation of the time which passed from executed Tx and ApoCIII:B ratio (r = -0.67; p < 0.01) at renal transplant patients were observed, which means the diminished risk of development of atherosclerosis.

Dialysis fistula thrombosis is the most common and dangerous complication which prevents proper dialysis therapy. The aim of this paper was to evaluate the influence of Clopidogrel on the incidence of early secondary thrombosis complications after restoring patency of fistula with surgical thrombectomy. The study included 30 patients. In 24 patients the method of surgical thrombectomy proved to be effective and they received a preventive dose of Clopidogrel [75 mg per 24h] for 28 days. In none of the patients early secondary thrombosis was recorded. Late secondary complications occurred in 11 patients 3 to 14 months after the surgical procedure. Treating acute thrombosis with surgical thrombectomy by means of Fogarthy catheter is still the most available and least expensive therapeutic method. Clopidogrel contributed considerably to the elimination of early secondary thrombosis complications in treated fistula.

Fistula thrombosis is the most common and dangerous complication resulting in vascular access insufficiency. The most "tricky" lesion of dialysis fistula is chronic thrombosis which occurs when only a short section of efferent vein becomes clotted and collateral circulation enabling further, limited in time functioning of dialysis fistula is created. In 7 chronic thrombosis patients subjected to treatment by means of endovascular recanalization, developed collateral vessels were surgically ligated to obtain single-canal blood flow. The recanalization procedure involved making a puncture, inserting a guide wire and performing balloon angioplasty. Simultaneously, 2 or 3 collateral veins were incised and ligated. The result obtained in all the 7 cases was considered successful as all fistulas remained a 100% patent 6 months after the procedure.

Unlabelled: The aim of the study was to assess the usefulness of determining the thyroid size, TRAb level and their correlation as markers for predicting the effectiveness of conservative treatment in Graves-Basedow's disease. The study included 100 patients with Graves-Basedow's disease; group I treated with thiamazole, group II treated with 131I. The biggest thyroid size, x -42.09+/-13.94ml, was found in the group unsuccessfully treated with thiamazole and was statistically significant compared to that in the euthyreosis group, x -31.65+/-11.74ml (p<0.01) and controls x -14.45+/-2.37ml (p<0.001). It is noteworthy that the initial TRAb level in the group with persistent hyperthyroidism was higher (x -54.39+/-31.21 U/I) than that in the euthyreosis group (x -29.13+/-19.44 U/I) and controls (x -2.75+/-2.06 U/l), p<0.001 for both parameters. Elevated antibody levels were also found after 12 and 18 months of treatment. Moreover, in the 131 I patients, the biggest thyroid size before iodine administration was found in the group with persistent hyperthyroidism, x -56.56+/-24.19 ml. It was statistically significantly different compared to the thyroid size in the euthyreosis patients x -37.922+/-20.69 ml (p<0.001) and in the hypothyreosis patients, x -43.47+/-18.09 ml (p<0.05). Before 131I administration, the highest antibody levels were observed in the group with persistent hyperthyroidism, x -103.61+/-43.90 U/I (p<0.001) compared to euthyreosis, hypothyreosis and control groups. The significance of differences in TRAb levels in the examined groups was still observed 18 months after 131I administration. In the groups of patients treated with thyreostatics and radioactive iodine, the positive correlation between the thyroid size and TRAb level was found before as well as 12 and 18 months after the onset of treatment., Conclusions: 1.The TRAb levels and thyroid sizes are important parameters that should be considered in predicting the effectiveness of treatment. 2. The TRAb level correlates with the thyroid size.

Two cases of Conn Syndrome with high hypertension, who were successful operated, have been prescribed. Retrospective evaluation of both cases suggests that severe and hypocalemic hypertension should motivate the researchers towards primary hyperaldosteronism. Etiology of the disease remains to be an important diagnostic challenge, optimal treatment will vary for each case of primary hyperaldosteronism. For individuals with aldosterone producing tumours the recommended type of treatment will be surgical as in most cases; it results in stabile normalization of RR level and abatement of metabolic dysfunction.

The aim of the study was to evaluate the usefulness of TRAb determinations in predicting and monitoring the effectiveness of various forms of treatment in Graves-Basedow's disease. 144 patients with Graves-Basedow's disease aged 18-76 years, x-44 were studied. Group I--54 patients treated with methizole, group II--45 patients treated with 131 I, group III--45 patients subjected to operative procedures. The TSH receptor antibodies were determined using the radioimmunoassay (TRAK-assay, Henning). The examinations were performed before, 12 and 18 months after treatment. Irrespective of the treatment type, the highest initial TRAb values were observed in the groups of patients with ineffective treatment (thiamazole x- 54.39+/-31.23 U/l, radioiodine x- 103.61+/-43.90 U/l, operative procedures x- 104.00+/- 52.34 U/l). During the 12-month follow-up of the patients subjected to surgery and 18-month follow-up of those undergoing conservative treatment, the level of antibodies did not normalize (x- 40.17+/-33.06, x- 77.18+/-44.92, x- 58.77+/-54.67, respectively). In the groups with effective treatment, the TRAb levels normalized. 1. The level of TSH receptor antibodies is a good marker for monitoring the effectiveness of treatment in Graves-Basedow's disease. 2. The high initial antibody level, irrespective of the kind of treatment instituted, is a bad prognostic feature. 3. The TRAb determinations performed 12 months after the institution of treatment also show some prognostic value. 4. The lack of normalization of antibody levels during treatment is associated with persistent hyperthyroidism, irrespective of the form of therapy.

Development of dialysis therapy over the last decade caused considerable increase in the number of patients receiving haemodialyses as kidney substitution therapy. However, a wider use resulted in greater number of A-V fistula complications. Uraemia patients were reported to develop plasmatic and platelet haemostasis disorders which provoke dialysis fistula thrombosis. The aim of the paper was to answer how Ticlopidine affected decrease in the number of late thrombosis complications in freshly created A-V fistula. The study included 60 patients, 30 of whom were given Ticlopidine (125 mg twice every 24h). The other 30 patients constituted the control group and did not received the drug. The follow-up lasted 27 months. It was concluded that preventive administration of Ticlopidine significantly reduces the extent of late thrombosis complications.

Serum levels of lipids, lipoprotein(a) Lp(a) and other apolipoproteins were determined in 47 predialysis patients, 40 hemodialysis (HD) patients, 39 chronic ambulatory peritoneal dialysis (CAPD) patients, 11 patients after kidney transplantation and 47 healthy subjects as reference group. The predialysis, HD, and CAPD patients had disturbances in the concentration of serum triglyceride (TG), high density lipoprotein (HDL)-cholesterol, apolipoprotein AI (apoAI), total apoCIII, apoCIII present in the particles without apoB (apoCIII non B), and Lp(a) and HDL-cholesterol, low density lipoprotein (LDL)-cholesterol/HDL-cholesterol, HDL-cholesterol/apoAI, apoAI/apoB, and apoAI/apoCIII ratios. Predialysis patients had significantly lower concentrations of HDL-cholesterol and total apoE levels than CAPD patients and total apoE level than HD patients. Moreover, both HD and CAPD patients had significantly increased levels of apoB containing apoE (apoB:E) and apoB containing apoCIII (apoB:CIII). The concentrations of serum TG, total cholesterol, LDL-cholesterol, apoB, Lp(a) in CAPD patients were statistically higher than in HD patients. The patients after transplantation demonstrated normalization of lipid and lipoprotein parameters and lipoprotein ratios except serum levels of TG, total apoCIII, apoCIII non B and the apoAI/apoCIII ratio. We concluded that abnormal lipid and lipoprotein concentrations in patients with uremia may be the cause of their high risk of atherosclerosis, but posttransplant patients exhibited improved levels of serum lipids, Lp(a) and other lipoprotein parameters and lipoprotein composition, which could be an index of decreased atherogenic status.

The aim of the study was to define respiratory disorders caused by central nervous system tumors. We investigated 51 patients (31 men, 20 women, mean age 58). They were divided into the following groups: patients with supra-, infratentorial and cranio-vertebral junction lesions. We analyzed: the localization of tumors based on CT and MRI examinations and intraoperative observation, the status of consciousness by GCS scale, neurological status and histological findings. For the estimation of dynamics of the respiratory changes, rhinospirography examination was repeated several times in the course of observation. The alterations of respiration were clearly visible in many cases. We have confirmed that respiratory disorders found by rhinospirography provide a source of important clinical information on the effect of the treatment and prognosis. We have also confirmed that changes in respiration are observed earlier than changes of consciousness.

Background: Lipoprotein abnormalities characteristic of renal dyslipoproteinemia are significantly associated with different stages of chronic renal insufficiency. The renal dyslipoproteinemia may contribute not only to accelerated development of atherosclerosis but also to progression of human chronic renal insufficiency., Methods: The purpose of the studies was to estimate the lipid and lipoprotein profiles in 52 not dialysed patients with various renal insufficiency advancement. Basing on creatinine level the patients were divided into 3 groups. CR1-A--serum creatinine 2-5 mg/dL (n = 16), CR1-B--serum creatinine 5-10 mg/dL (n = 19), CR1-C--serum creatinine > 10 mg/dL (n = 17)., Results: In CR1-A and CR1-B dyslipoproteinemia was found at different stages of renal insufficiency which was manifested by the significant increase of TG, TC, LDL-C, apo B levels and TC/HDL-C, LDL-C/HDL-C ratios and significant decrease of HDL-C level and apo AI/apoB, HDL-C/apoAI ratios in comparison with controls. We also observed decreased TG, TC, LDL-C, apo AI, apo B levels and TC/HDL-C, LDL-C/HDL-C ratios and unchanged HDL-C level and apo AI/apoB, HDL-C/apoAI ratios in cm-c in comparison to CR1-A. The decrease of the lipoprotein parameters in CR1-C might result from malnutrition (statistically decreased albumin level) and metabolism disturbances connected with the renal insufficiency advancement. Negative correlation between IG, HDL-C levels (r = -0.43, p < 0.001) and TG, IIDL-C/apoAI (r = -0.56; p < 0.001) were found, which confirmed the abnormal composition of HDL molecules and indicated a high risk of atherosclerosis., Conclusion: Our results may indicate that of atherosclerosis in CR1 patients is connected with dyslipoproteinemia and disturbances in HDL molecular composition and with different stages of chronic renal insufficiency.

The serum levels of lipids, apolipoproteins and lipoprotein ratios in 19 healthy persons and 20 patients with uraemia not dialyzed were determined. Based on creatinine level the patients were divided into two groups: L (serum creatinine 2-5 mg/dl) and H (serum creatinine 5-10 mg/dl). Dyslipoproteinaemia in uraemic patients is already manifested in the early stages of the disease through its abnormal apolipoproteins rather than lipid profile and it suggests a high risk of atherosclerosis.

The subjects of the studies were 31 haemodialysed (HD) patients with chronic renal insufficiency (CRI). In this group of patients the lipoprotein profile was determined and 8 patients were selected for further studies. During the study the patients were treated with cuprophane membranes for 6 months. For the next 6 months the same patients were treated using polysulfone dialysers, and for further 6 months HD with polysulfone dialysers was continued. Patients' sera were tested after every 6 months of treatment. The delta values were calculated as 6-month HD with polysulfone minus 6-month HD with cuprophane (deltaI) and 12-month HD with polysulfone minus 6-month HD with polysulfone (deltaII). We concluded that after long-term HD with low flux polysulfone treatment the lipoprotein profiles improved, but the mechanism of the process is not clear.

We present our results on the efficacy and safety of low dose r-HuEPO given subcutaneously in the treatment of anaemia in CAPD. We have studied 10 stable patients (5 males, 5 females) on CAPD. In our study subcutaneous r-HuEPO was administered twice a week for 6 months. Mean initial dose of r-HuEPO was 67.3+/-21.7 U/kg/week, and maintenance dose was 35.8+/-12.1 U/kg/week. The target Hb concentration was 10-12 g/dl. All patients responded to r-HuEPO. During treatment significant increases of haemoglobin concentration (p<0.05), haematocrit (p<0.05), red cell count (p<0.05) and reticulocyte count (p<0.05) were observed. We found no significant changes in total white cell or platelet counts. Long-term r-HuEPO treatment did not influence significantly plasma levels of electrolytes (Na, K, Ca), urea and creatinine. We found no significant changes in ultrafiltration volumes. In the present study the mean systolic and diastolic blood pressures did not change. Liver function tests were normal at the beginning and at the end of the study. r-HuEPO treatment was associated with a decrease of ferritin (455+/-90 vs. 224+/-83 microg/l. Oral or intravenous iron substitution became necessary in 6 patients. Side effects in our study were minimal; one patient had myalgia after the first seven doses but this disappeared as treatment was continued. Two patients reported pain (mild) at the injection site. In the present study, the correction of anaemia was accompanied by a substantial improvement in the quality of life, mainly in capacity for work, household and social activities.

The bleeding tendency is a common feature of chronic uremia. Abnormalities of platelet function play a role in the pathogenesis of this disorder. A direct contact between platelets and an artificial dialysis membrane results in strong activation of thrombolysis. The aim of our study was to investigate platelets activation in vivo during haemodialysis. We used monoclonal antibodies specific against platelet activation markers--selectin P (CD62) and glycoprotein CD63. The expression of those antigens was analyzed by flow cytometry. Blood samples were obtained from 20 long-term haemodialysed patients with end-stage renal disease. After 15 minutes of haemodialysis the expression of CD62 and CD63 was significantly higher (p < 0.001) as compared CD63 glycoprotein. Our results show that haemodialysis has a significant influence on platelet activation and can favour co-existence of the bleeding tendency and the prothrombotic status in long-term hemodialyzed patients.

Objective and Design: Secretion of IL-2 and sIL-2R in the peritoneal dialysis fluid and in the peripheral blood during peritonitis with reference to the process of IL-6 and IL-8 release were investigated., Subjects: 17 patients with end-stage renal disease, treated with continuous ambulatory peritoneal dialysis., Methods: ELISA method using commercial kits, Genzyme Corp Boston and DAKO., Results: Markedly increased IL-6 (mean; 2895 +/- 1360 pg/ml) and IL-8 concentration (1459 +/- 966 pg/ml) in drain dialysate fluid at the onset of peritonitis, started to drop rapidly in the successive samples after antibiotics had been administered. Statistically significant increase of IL-2 (197 +/- 92 pg/ml) and sIL-2R (287 +/- 79 pg/ml) was observed 16 h later and kept increasing until reaching the peak after 24 h., Conclusion: Secretion of IL-6 and IL-8 pro-inflammatory cytokines which are mainly synthesized in mesothelium cells is followed by the activation of lymphocytes, their infiltration and the production of T lymphocyte derived IL-2 and sIL-2R.

In respect to the immune deficiency state of long-term haemodialysed patients, both cytokines and their receptor disturbances have been taken into consideration. The purpose of our study was to evaluate the effect of uraemic and haemodialysis factors on the interleukin-6 and interleukin-2 soluble receptor levels and the reactivity after influenza vaccination. We have found that IL-6 and IL-2 receptor levels were statistically significantly elevated (98.8 +/- 39 pg/ml and 1557 +/- 544 U/ml, respectively) in serum of haemodialysed patients. The fact that increased immune complexes statistically correlated with soluble IL-2 receptor levels (p < 0.01) was very interesting for us. In order to study the immunological response after vaccination, 10 patients have been investigated after influenza vaccination. Plasma samples were collected before, as well as 1 and 4 weeks after vaccine administration. Antibody titres measured by haemagglutinin inhibition showed decreased antibody levels in haemodialysed patients. We conclude that the interleukin disturbance and the elevated interleukin-2 receptor levels together with the presence of circulating immune complexes can influence in some way the immune response of haemodialysed patients.

Mucous membranes of the nose of 90 persons exposed to cement dust were investigated clinically and cytologically. We found atrophic changes in 37.8% persons and hypertrophic changes in 13.3%. In a halt of the investigated persons abnormality in epithelium forms in cytological examination was demonstrated. The connection of inflammatory changes and pathological forms of the epithelium has been documented. The correlation between presentation of cement deposits and inflammatory infiltrations and atrophic and hypertrophic changes was confirmed.

Peritonitis is a major complication of intermittent peritoneal dialysis (IPD); over 70% of the infections are caused by Gram-positive bacteria. Vancomycin (V) is the antibiotic of choice in the treatment of peritonitis caused by G(+). The influence of vancomycin on peritoneal transport in IPD patients has not been described before. We have investigated the effect of intraperitoneal vancomycin on dialysis efficiency in 8 IPD patients using dialysis solutions containing either lactate or acetate. The following parameters were measured: net ultrafiltration (UF), concentration ratios (D/P) of urea, creatinine, potassium, peritoneal clearances (ml/min) of urea, creatinine, potassium, mass transfer of sodium (MTNa), sodium sieving index (SCNa). It has been found that vancomycin significantly decreases D/P urea (p < 0.05) and creatinine (p < 0.05). We found also a significant decrease of mean clearance of urea (p < 0.05) and creatinine (p < 0.05). The mean clearance of potassium did not change significantly. There was no significant change in UF, MTNa, and SCNa. Our preliminary data suggest that vancomycin decreases the permeability of peritoneum for certain low molecules in IPD patients which may have a negative impact on dialysis efficiency.

The clinical picture in chronic renal failure (CRF) shows great variability depending on age, sex, aetiology of disease, grades of renal injury and type of treatment. Significant increases of triglycerides (TG), low-density lipoprotein cholesterol (LDL-chol) and and apo B concentrations, significant decreases of high-density lipoprotein cholesterol (HDL-chol) levels and apo A and apo AI concentrations, and no significant changes in total cholesterol (TC) have been shown in CRF patients. Significant increases of TC/HDL-chol, LDL-chol/HDL-chol, apo B/apo AI and apo B/LDL-chol ratios were also demonstrated. That indicates a high risk of atherosclerosis even when total cholesterol levels are in the normal range. There were highly significant and positive correlations between TC/HDL-chol and LDL-chol/HDL-chol ratios, apo B and LDL-chol concentrations as well as between the apo B/apo AI and LDL-chol/HDL-chol ratios.

Thrombotic complications constitute a significant problem connected with maintaining arteriovenous fistulas (A-V) for a long time. It has been established that platelets play an important role in the development of thrombosis in high flow systems. Aspirin and dipyridamole do not decrease the frequency of shunt thrombosis. Some of the more recently synthetised antiplatelet drugs (i.e. indobufen, 2-p-oxo-isoindolinyl-phenyl-butyric acid) could be promising in the prevention of such complications. The study group consisted of 40 patients in the terminal stage of renal failure treated with intermittent peritoneal dialysis (IPD). The A-V fistulas were formed by the same surgeon anesthetist team and this allowed for the elimination of technical errors. All patients were divided into two groups. Group I received indobufen at the dose of 2 x 100 mg/24 h orally. Group II received no antiplatelet treatment. The therapy started 24 h before A-V formation. The treatment was continued for 3 weeks. The following tests of platelet function were performed before indobufen therapy, after 9 h and 3 weeks of treatment: ADP and adrenaline induced platelet aggregation, platelet circulating aggregates, MDA level, platelet factor 3 and 4 and bleeding time. During indobufen treatment only a significant decrease in ADP induced aggregation was observed. No prolongation of the bleeding time was noted. No case of fistula thrombosis in indobufen group was observed. This complication, however, appeared in 3 patients (15%) of the control group (without antiplatelet therapy).

In 16 patients on chronic haemodialysis treatment the platelet activation and function were studied during 2 weeks antiplatelet therapy with indobufen. Followings tests were made: platelet count, platelet aggregation, platelet factor 3 and 4. Indobufen inhibited platelet function, mainly release of platelet factor 4 and improved dialyser regeneration.

We have investigated the effect of intraperitoneal gentamicin on dialysis efficiency in 10 intermittent peritoneal dialysis (IPD) patients. The following parameters were measured: net ultrafiltration (UF); concentration ratios (D/P) of urea, creatinine, potassium; peritoneal clearances (ml/min) of urea, creatinine, potassium; mass transfer of sodium (MTNa); sodium sieving index (SCNa). It has been found that gentamicin significantly decreased D/P urea (p < 0.056) and D/P creatinine (p < 0.05). We found also a significant decrease of mean clearances of urea (p < 0.05) and creatinine (p < 0.05). The mean clearance of potassium did not significantly change. There was no significant change in UF, MTNa and SCNa. Our preliminary data suggest that gentamicin decreases the permeability of the peritoneum for certain low molecules in IPD patients, which may have a negative impact on dialysis efficiency.

During the years 1980-1994 159 patients with parotid tumors were treated in ENT Clinic in Bydgoszcz. 26.4% (42 patients) of tumors were malignant. The main surgical procedures were the removal of tumor, partial parotidectomy, total conservative parotidectomy and total radical parotidectomy. In malignant tumor cases the radiotherapy followed the surgery.

The authors performed epidemiological analysis of malignant neoplasms of the nose, paranasal sinuses, throat, tongue, larynx and salivary glands in Bydgoszcz area. All the patients were treated in the Otolaryngological Clinic of Medical Academy in Bydgoszcz. Patient's sex, age, profession, living and environmental conditions as well as histopathological diagnosis were taken into analysis. The data were referred to various regions of Bydgoszcz province, which were elucidated on the basis of microclimate conditions, industry, soil conditions, density of the forest area, and cultivated agriculture plants. Correlations between occurrence of oral cavity and the upper respiratory tract malignant neoplasms and living conditions as well as kind of profession in different parts of Bydgoszcz province were estimated.

In the period 1981-1994 in the ENT Department, University School of Medical Sciences in Bydgoszcz, 102 patients with malignant neoplasms of the tongue and the tonsillo-glossal angle were treated. The most common group comprised patients diagnosed with "planoepithelial carcinoma" (94 persons). The number of patients with tongue malignancies increased every year. Similarly, increasing of the neoplastic grade was observed. The majority of patients underwent surgery and, in the next step, radiotherapy. We preferred a total tumor excision involving half of the tongue. Often we had to extend surgery to resection of the lateral part of throat and, in situation of extreme penetration of neoplasms, we removed the bottom of oral cavity. We concluded that in patients with malignant neoplasms of the tongue, planoepithelial carcinoma is present in more than 90 percent of cases. The tumors are diagnosed in the late period. On initiation of treatment half of the patients were presenting with T2 tumors. We confirmed infiltration of the tonsillo-glossal angle in half of the patients. Five years survival without tumor recurrence in our material was 26.47%.

In 55 hemodialyzed and 15 patients on CAPD the presence of hepatitis B and C markers was estimated before the beginning of the vaccination series against hepatitis B with Engerix B vaccine. The initial anti-H Bs antibody titres was also estimated in these patients. The patients without H Bs Ag who have the anti-Hbs titres below 10 IU/I were qualified for this vaccination. The vaccination was needed by 40% of hemodialyzed patients H Bs(-) and 93% patients on CAPD. After completing the half year lasting series of vaccinations, the serological answer in vaccinated patients was estimated. The protective antibody titres above 10 IU/I was produced by 62.5% of patients on hemodialysis and 64.4% of patients on CAPD. The presence of anti-HCV antibodies had insignificant influence on the ability of producing the protective antibody titres in vaccinated patients.

Several factors may contribute to the pathogenesis of uraemic anaemia but there is general agreement that inadequate secretion of erythropoietin is the main cause. Recombinant human erythropoietin (r-Hu EPO) is today widely used in the treatment of patients with renal anaemia. Initial studies were conducted on patients receiving haemodialysis (HD) using intravenous dosing, and number of reports have confirmed the efficacy and safety of the hormone. However, there is still limited information on the use of r-Hu EPO in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). The cost of this treatment was initially very high. The optimal way of administration of the drug and optimal dosage is still under discussion. More studies are needed to optimize treatment from a clinical as well as an economic point of view. We therefore present our result on the efficacy and safety of low dose r-Hu EPO given subcutaneously in th treatment of anemia in CAPD patients.

In eight patients with terminal renal insufficiency treated with repeated haemodialyses (group I) and six patients treated with intermittent peritoneal dialysis (group II), the effect was studied of treatment with r-HuEPO on the platelet count and activity. In the studied patients the following was determined: platelet count, ADP-induced aggregation, circulating aggregates, and the third (PF3) and fourth (PF4) platelet factors. The studies were performed before the introduction of r-HuEPO and during the treatment--after achieving of haematocrit increase in the patients to 30%. No significant increase was observed of platelet count or activity. In none of the studied patients the development of thrombotic complications was observed with haematocrit increase to 30%. In both studied groups during the treatment with r-HuEPO a significant increase was found of haemoglobin concentration, red blood cell count, and haematocrit value in relation to the values before starting the treatment.

A case is presented of successful pregnancy in a patient with acute renal failure superimposed on chronic controlled renal failure. The cause which led to development of acute renal failure were severe water-electrolyte equilibrium disturbances due to diarrhoea. Appropriately conducted conservative treatment in the period of oliguria, and early institution of treatment with repeated haemodialysis (taking into account the minimal fluctuations of body fluids, and adequate heparinization) were decisive for successful outcome of pregnancy in this patient.

Electric resistance of forearm skin was examined in 40 hemodialyzed (HD) patients under resting conditions and after subjecting the skin to the action of a 10% pilocarpine gel. The results were compared with a control group of a 100 healthy volunteers. An increased skin resistance was observed before dialysis and then a significant post-dialysis fall to the normal level followed. The response to the applied pharmacological stimulus in the HD group was similar to that in the control group. The results suggest that the rise in skin resistance in patients with renal failure and the so-called uremic dry skin, are not connected with the dysfunction of the glands themselves but rather with their insufficient stimulation.

A long-standing arteriovenous (A-V) fistula may develop thrombotic complications. In 20 patients on intermittent peritoneal dialysis (IPD) arteriovenous fistula was made surgically. We evaluated the efficacy of three antiplatelet drugs: Ibustrin (Group A), sulphinpyrazone (Group B) and alpha-tocopherol (Group C) in preventing thrombotic occlusion of A-V fistulas. Results of the trial indicate that the three drugs significantly reduce spontaneous platelet aggregation and ADP induced aggregation. The heparin neutralizing activity was significantly increased during treatment. Significant prolongation of bleeding time was observed only in Groups B and C. In patients receiving antiplatelet drugs no occlusion of A-V fistulas was observed. In the control group such complications occurred in 3 of the 20 patients. Our results indicate that antiplatelet drugs by inhibiting the platelet function may prevent thrombotic occlusions of A-V fistulas in IPD patients.

A case of carpal tunnel syndrome in female patient treated with hemodialyses for 10 years is presented. Surgical management was applied with positive result. Histological examination of tissue collected during surgery has shown the deposits of amyloid-like substance in carpal tunnel. The authors discuss current concepts of carpal tunnel syndrome pathogenesis in hemodialysed patients.

In six patients with terminal renal failure the effectiveness was assessed of intermittent peritoneal dialyses (IPD) using the dialysing fluid of modernised composition. On the basis of the obtained results the values were calculated of the total sodium (TMTNa) and potassium (TMTK) elimination glomerular filtration rate, and the sodium elimination index. The values were calculated of the dialysing clearance of urea, creatinine, potassium, and inorganic phosphorus. The correlations were analysed between the dialysing clearance of studied substances and the body area of patients, the duration of dialysis, and glomerular filtration rate. The results were compared with the effectiveness of peritoneal dialysis carried out with the dialysing fluids of formerly used electrolyte composition.

In 6 patients treated with repeated peritoneal dialyses 48-hour ECG monitoring was carried out. In no patient significant heart rhythm disturbances were demonstrated during the dialysis and 24 hours after its completion. On the ground of pathological results of Valsalva's manoeuvre function disturbances of the autonomic nervous system were disclosed but these showed no correlation with premature ventricular and supraventricular++ ectopic beats appearing periodically in some patients. The study showed that under conditions of sufficient control of electrolyte balance (especially potassium) the patients treated with peritoneal dialyses are not a group at risk for arrhythmia development.

In 30 patients on chronic haemodialysis treatment the platelet activity and function were studied before and during antiplatelet therapy with alpha-tocopherol and sulphinpyrazone. In both kinds of treatment a significant decrease of ADP-induced and spontaneous aggregation was observed. Sulphinpyrazone exerts an inhibitory effect not only on platelet aggregation but also on platelet factor 3 and provokes a significant prolongation of the bleeding time.

The concentrations of insulin (IRI), parathormone (PTH), calcitonin (CT), some electrolytes (Ca, Mg, P), vitamin D and glucose were determined in 6 patients with terminal renal insufficiency treated by CAPD.