Where is obstetric anesthesiology heading in the next decade? An Eastern European perspective

European countries of "Eastern Block" origin took different healthcare and economic development trajectories after the Berlin Wall fell. Despite decreased maternal and neonatal mortality in the last two decades, healthcare disparities exist between the various countries. Minimum standards for obstetric anesthesia are not available for every maternity patient. Lack of equity in access to healthcare for maternity patients is multifactorial and includes differences in systems of care and health economics, and shortages of medical personnel. The war in Ukraine generates additional challenges for healthcare systems in the region, resulting from a significant increase in the number of refugees, some of whom are pregnant and require maternity services, including obstetric anesthesia and analgesia and maternal critical care. The next decade's challenges comprise the implementation of evidence-based medicine advances in the field of obstetric anesthesia and analgesia, and of maternal critical care at national levels, including access to neuraxial opioids, the broad implementation of enhanced recovery after cesarean section protocols, and more frequent use of labor epidural analgesia. Further, there needs to be improvement in medical education provided in the national language, so that healthcare providers, patients, and their families can build and provide a safe environment for maternity patients. In addition, better provision of services and access to healthcare providers who have been well trained and are dedicated to dealing with obstetric patients. These measures will hopefully enhance the quality of care for maternity patients, focusing on further reduction of maternal and neonatal morbidity and mortality, which is a priority and a highly desirable long-term outcome.

AB0101 INCREASED DNA DAMAGE AND LACK OF DNA REPAIR IN FIBROBLAST-LIKE SYNOVIOCYTES OF INDIVIDUALS AT RISK OF DEVELOPING RHEUMATOID ARTHRITIS

Background

Rheumatoid arthritis (RA) is a chronic inflammatory immune-mediated disease leading to synovial tissue inflammation and bone destruction. Inflammation-induced DNA damage in fibroblast-like synoviocytes (FLS) is thought to play an important role in RA pathogenesis. However, since a recent functional genomics study revealed a causal role for FLS in the genetic susceptibility of RA and synovial inflammation is absent in autoantibody positive individuals at risk for RA, we aimed to investigate whether DNA damage in FLS is present before onset of disease.

Objectives

Determine the extent of DNA damage in FLS and their capacity to repair this damage during the earliest phases of systemic autoimmunity.

Methods

We included individuals with arthralgia who were IgM rheumatoid factor (RF) and/or anti-citrullinated protein antibody (ACPA) positive but without any evidence of arthritis (RA-risk individuals, n=6), RA patients (n=6), osteoarthritis (OA) patients (n=6) and controls without inflammatory disease (n=6). Synovial tissue biopsies were collected either during joint surgery or individuals underwent a mini-arthroscopy of a knee joint. Subsequently, FLS were in vitro expanded upon enzymatic synovial tissue digestion. DNA damage in FLS (passage 6) was assessed by immunofluorescence staining for yH2AX. DNA damage repair was assessed by first irradiating the cells with 1 gray to induce DNA damage and assess yH2AX staining directly and after 3 and 24 hours of culture to allow for DNA repair.

Results

Preliminary immunofluorescence staining for yH2AX shows that DNA damage is present in RA-risk and RA FLS to more extent compared with FLS from non-inflammatory controls. OA FLS exhibit even more DNA damage and their nuclei show signs of impaired chromosomal segregation, forming micronuclei with high yH2AX staining intensity. Overall, DNA damage repair is slower in FLS from RA-risk individuals, RA and OA patients compared with controls as shown by persistent yH2AX staining after inducing DNA damage.

Conclusion

These findings reveal increased DNA damage and concomitant impaired DNA repair in FLS of not only patients with synovial inflammation but also in FLS from RA-risk individuals, suggesting that DNA damage is already present in absence of overt synovial tissue inflammation and before clinical disease onset. More research is needed to investigate DNA damage or lack of DNA repair as potential driver in development of RA.

Disclosure of Interests

None declared

Questions around mutation T1010I in MET gene: results of next generation sequencing in Polish patient with suspected hereditary adenoid cystic carcinoma

OBJECTIVE

Adenoid cystic carcinoma (ACC) is a slowly growing cancer, which is the most common malignant tumor of the salivary glands. It is claimed that it is a non-inherited cancer. People with family history of ACC are reported extremely rarely. We present patients with suspected hereditary ACC.

MATERIALS AND METHODS

Next generation sequencing (NGS) was performed for both RNA and DNA isolated from FFPE material.

RESULTS

In DNA from tumor tissue we detected the mutation in MET gene, in exon 14 c.3029C>T (p.Thr1010Ile). It has never been proven that this mutation may play a role in the pathogenesis of ACC. The most important for our case report seems to be the patient's family history of cancer occurrence which indicates presence of familial cancer aggregation (familial cancer syndrome) and even familial lung cancer.

CONCLUSIONS

ACC is extremely rare; it is difficult to observe a specific genetic pattern and NGS can provide a lot of information about the genetic causes of this disease. Our work shows that the MET p.Thr1010Ile mutation can be associated with the hereditary occurrence of ACC.

Diagnostic value of plasma expression of microRNAs complementary to Drosha and Dicer in lung cancer patients

OBJECTIVE

Lung cancer (LC) is diagnosed mostly in advanced, non-operable stage, with poor prognosis. The analysis of microRNAs may be a useful tool for early and non-invasive detection of cancer. Dicer and Drosha are enzymes with an essential role for microRNA biogenesis. The aim of our study was to analyze the expression of miRNA-27a-3p, miRNA-31, miRNA-182, miRNA-195 with the ability to reciprocal regulation of Dicer and Drosha expression in lung cancer patients.

PATIENTS AND METHODS

The relative expression of microRNAs was detected by qPCR in plasma of 160 LC patients. The U-Mann Whitney test was used to compare the relative expression between particular groups of lung cancer patients and healthy individuals. The diagnostic value of microRNAs examination was analyzed using a receiver operating curve.

RESULTS

We demonstrated that the plasma levels of miRNA-27, miRNA-31 and miRNA-182 were significantly higher and miRNA-195 significantly lower in the whole group of LC patients and in patients with early stages of NSCLC, in comparison with healthy donors. ROC analysis showed that four studied microRNAs have a potential diagnostic value for early stages of NSCLC with AUC=0.95 for miRNA-27a (94% sensitivity and 81% specificity, p=0.0001), 0.71 for miRNA-31 (73% sensitivity and 61% specificity, p=0.001) 0.77 for miRNA-182 (70% sensitivity and 79% specificity, p=0.0001) and 0.82 for miRNA-195 (74% sensitivity and 80% specificity, p=0.0001).

CONCLUSIONS

We have proved that the expression of miRNA-27a-3p, miRNA-31, miRNA-182, and miRNA-195 in patients with LC is different from the expression of these molecules in healthy people. The examination of these microRNAs in plasma could be used in non-invasive lung cancer diagnosis.

Correction: Graphene material preparation through thermal treatment of graphite oxide electrochemically synthesized in aqueous sulfuric acid

Correction for ‘Graphene material preparation through thermal treatment of graphite oxide electrochemically synthesized in aqueous sulfuric acid’ by B. Gurzęda et al., RSC Adv., 2017, 7, 19904–19911.

Cost-utility of extracorporeal membrane oxygenation rewarming in accidentally hypothermic patients-A single-centre retrospective study

BACKGROUND

Extracorporeal membrane oxygenation (ECMO) has become the treatment of choice for severely hypothermic patients in cardiac arrest or acute cardiac failure. Highly specialized ECMO centres have been established, however, no centre has ever reported the costs of extracorporeal rewarming. The aim of this study was to assess the costs of the treatment of patients in Swiss Stage III and IV rewarmed with veno-arterial ECMO.

METHODS

A retrospective exploratory cohort study analysed twenty-nine consecutive patients treated for hypothermia in the Severe Accidental Hypothermia Centre in Cracow, Poland. The main outcome parameters were the overall and specific costs of the ICU treatment of patients rewarmed with veno-arterial ECMO. The secondary outcome parameter was cost utility, determined by the costs involved for every year of life gained. Costs were processed using the bottom-up method and classified into six categories. Survivors were followed up after 1 year.

RESULTS

The mean cost of VA-ECMO was $5133 USD, which equalled 35% of all ICU expenditures ($14 668 USD). One year after discharge, 13 of 29 patients were still alive (45%). The overall gain of life of the thirteen 1-year survivors was 28 years, while the mean cost related to treatment with VA-ECMO for each year of life gained was 1138 USD.

CONCLUSIONS

In this study, the costs of VA-ECMO rewarming and intensive care treatment per patient were substantially lower than in other studies reporting ECMO and intensive care treatment of other causes.

Evaluation of ALK gene rearrangement in central nervous system metastases of non-small-cell lung cancer using two-step RT-PCR technique

PURPOSE

RT-PCR technique has showed a promising value as pre-screening method for detection of mRNA containing abnormal ALK sequences, but its sensitivity and specificity is still discussable. Previously, we determined the incidence of ALK rearrangement in CNS metastases of NSCLC using IHC and FISH methods.

MATERIALS

We evaluated ALK gene rearrangement using two-step RT-PCR method with EML4-ALK Fusion Gene Detection Kit (Entrogen, USA). The studied group included 145 patients (45 females, 100 males) with CNS metastases of NSCLC and was heterogeneous in terms of histology and smoking status.

RESULTS

21% of CNS metastases of NSCLC (30/145) showed presence of mRNA containing abnormal ALK sequences. FISH and IHC tests confirmed the presence of ALK gene rearrangement and expression of ALK abnormal protein in seven patients with positive result of RT-PCR analysis (4.8% of all patients, 20% of RT-PCR positive patients). RT-PCR method compared to FISH analysis achieved 100% of sensitivity and only 82.7% of specificity. IHC method compared to FISH method indicated 100% of sensitivity and 97.8% of specificity. In comparison to IHC, RT-PCR showed identical sensitivity with high number of false positive results.

CONCLUSION

Utility of RT-PCR technique in screening of ALK abnormalities and in qualification patients for molecularly targeted therapies needs further validation.

Graphene material preparation through thermal treatment of graphite oxide electrochemically synthesized in aqueous sulfuric acid

The present work demonstrates a simple and low-cost method to produce bulk quantities of graphene material through the thermal treatment of graphite oxide (GO).

Sensitive methods for screening of the MEK1 gene mutations in patients with central nervous system metastases of non-small cell lung cancer

BACKGROUND

The mitogen-activated protein kinases 1 and 2 (MEK1, MEK2) are fundamental partners in the RAS-RAF-MEK-ERK pathway that is involved in regulation of cell proliferation, differentiation and survival. Downregulation of the MEK cascades has been implicated in acquiring of the malignant phenotype in various cancers. Somatic mutations in MEK1 gene (substitutions K57N, Q56P, D67N) were described in <1 % of non-small cell lung cancer (NSCLC) and they were more commonly reported in adenocarcinoma patients with current or former smoking status.

MATERIALS AND METHODS

In the following study, we assessed the MEK1 gene mutations in 145 FFPE tissue samples from central nervous system (CNS) metastases of NSCLC using HRM-PCR and ASP-qPCR techniques. The studied group was heterogeneous in terms of histopathology and smoking status. The prevalence of the MEK1 gene mutation was correlated with the occurrence of mutations in KRAS, EGFR, DDR2, PIK3CA, NRAS, HER2, AKT1 and PTEN genes.

RESULTS

Using HRM and ASP-qPCR methods we identified one (0.7 %; 1/145) MEK1 substitution (Q56P) in CNS metastases of NSCLC. The mutation was identified in a single, 50-year-old, current smoking men with adenocarcinoma (1.25 %; 1/80 of all adenocarcinomas).

CONCLUSIONS

According to the current knowledge, the incidence of MEK1 gene mutation in CNS metastatic lesion of NSCLC is the first such report worldwide. The analysis of gene profile in cancer patients may extend the scope of molecularly targeted therapies used both in patients with primary and metastatic tumors of NSCLC.

Graphene material prepared by thermal reduction of the electrochemically synthesized graphite oxide

The present work describes a simple and effective way to produce bulk quantities of graphene material.

The relationship between RRM1 gene polymorphisms and effectiveness of gemcitabine-based first-line chemotherapy in advanced NSCLC patient

Purpose

Chemotherapy with platinum compounds and gemcitabine is frequently used in first-line treatment of advanced non-small cell lung cancer (NSCLC) patients in which tyrosine kinase inhibitors (EGFR or ALK) cannot be administered. Unfortunately, less than half of the patients achieve the benefit from chemotherapy. Gemcitabine is an analog of deoxycytidine (pyrimidine antimetabolite) with antitumor activity. The excess of deoxycytidine synthesized by RRM1 enzyme activity may be a cause of competitive displacement of gemcitabine, which reduces the efficacy of this cytostatic. The aim of this study was to determine the association between single nucleotide polymorphisms (SNPs) of the RRM1 promoter (−37C>A, −524C>T) and the effectiveness of first-line chemotherapy based on platinum compounds and gemcitabine in NSCLC patients.

Patients and methods

SNPs were determined by SNaPshot PCR^® in DNA isolated from peripheral blood of 91 NSCLC patients.

Results

The median progression-free survival (PFS) was significantly longer in carriers of AA (−37C>A) as well as CC (−524C>T) genotype of RRM1 compared to patients with other genotypes (10.5 vs 3.5 months, p = 0.0437; HR = 2.17, 95 % CI 1.02–4.62 and 10.5 vs 3.5 months, p = 0.0343; HR = 2.12, 95 % CI 1.06–4.27). In addition, the CC genotype carriers (−37C>A) showed a significant increase in the risk of shortening overall survival (OS) in comparison to patients with AA or AC genotypes (9.5 vs 18 months, p = 0.0193; HR = 2.13, 95 % CI 1.13–4.03).

Conclusions

Presence of rare AA (−37C>A) and CC (−524C>T) genotypes of the RRM1 may be favorable predictive factors for chemotherapy with platinum compounds and gemcitabine in NSCLC patients.

Methylation of the DCLK1 promoter region in circulating free DNA and its prognostic value in lung cancer patients

INTRODUCTION

The possibility of detection of suppressor genes methylation in circulating free DNA (cf-DNA) of cancer patients and the lack of methylation in healthy individuals makes this epigenetic alternation an ideal diagnostic marker of neoplastic processes. Moreover, hypermethylation in several genes promoter was described as a biomarker of lung cancer. Methylation in the gene encoding doublecortin-like kinase 1 (DCLK1) is observed in patients with colorectal cancer and cholangiocarcinoma. However, there are no studies concerning DCLK1 methylation in lung cancer patients. The aims of the study was to evaluate the frequency of DCLK1 promoter methylation in cf-DNA of lung cancer patients and of healthy persons as well as the usefulness of this test for predicting the lung cancer course.

MATERIALS AND METHODS

DCLK1 methylation status was evaluated in DNA isolated from peripheral blood plasma from 65 lung cancer patients and 95 healthy individuals. After DNA bisulfitation, DCLK1 methylation was determined using the qMSP-PCR technique. Moreover, the presence of DCLK1 methylation was correlated with the overall survival (OS) probability of lung cancer patients.

RESULTS

DCLK1 promoter methylation was detected in 32 lung cancer patients (49.2 %) and 8 healthy individuals (8.4 %). The methylation of the region before transcription start site (TSS) and the region after TSS of DCLK1 gene was detected in 28 and 11 patients, respectively. In seven cases (10.8 %), the DCLK1 promoter methylation in both regions was reported simultaneously. The methylation was observed slightly frequently in patients with small cell lung cancer (75 % of SCLC patients). The median overall survival of patients with DCLK1 promoter methylation was lower than that of patients without DCLK1 gene modification (p = <0.001, HR = 4.235).

CONCLUSIONS

The evaluation of DCLK1 promoter region methylation may be useful in both early diagnosis and prediction of the course of lung cancer.

TNF-alpha and TNF-beta gene polymorphisms in Polish patients with sarcoidosis. Connection with the susceptibility and prognosis

BACKGROUND

Sarcoidosis is a systemic granulomatous disease of unknown aetiology, in which genetic factors, especially the genes of the highly polymorphic MHC region, seem to play an important role in the disease predisposition and course. The aim of this study was to evaluate the role of TNF genes polymorphism in sarcoidosis and to estimate possible association between these polymorphisms and susceptibility and prognosis of sarcoidosis. The analysis of -308G > A TNF-alpha gene (TNFA*1 and TNFA*2 alleles) and 252A > G TNF-beta gene polymorphisms (TNFB*1 and TNFB*2 alleles) were performed.

METHODS

The study comprised of 130 sarcoidosis patients (75 subjects in the radiological stage I, and 55 in the stages II/III). Löfgren syndrome (LS) was manifested in 38 patients. After at least 3-years observation, 69 patients had remission, 24 subjects manifested persistent disease and 25 patients had progression. The control group consisted of 84 healthy subjects. The genotypes were determined using PCR-RFLP assay.

RESULTS

The variant allele TNFA*2 was observed significantly more frequent in patients with Löfgren syndrome when compared to control group (OR = 2.301, C.I. = [1.23-4.32], chi2 = 6.91, p > 0.01), as well as to non-LS patients (OR = 2.167, C.I. = [1.17-4.01], chi2 = 6.22, p < 0.05). Moreover, the variant allele TNFA*2 was also observed significantly more frequent in patients with disease resolution than in patients with persistent disease and progression (OR = 3.53, C.I. = [1.66-7.50], chi2 = 11.65, p < 0.001). The variant allele TNF*2 was also overrepresented in patients with disease resolution after exclusion the patients with Löfgren syndrome (OR = 2.4, C.I. = [1-5.772], chi2 = 3.98, p < 0.05). There was no significant difference in TNF-A allele distribution between the control group and whole sarcoidosis group. The variant allele TNFB*1 was observed significantly more frequent in patients with disease resolution than in patients with persistent disease and progression. This difference was caused only by overrepresentation of TNFB*1 variant allele in Löfgren group. The significant differences in the distribution of TNFB*1 allele between the sarcoidosis an the control group was also noted (OR = 1,607, C.I. = [1,033-2,5], chi2 = 4.46, p < 0.05), but it was limited only to patients displaying Löfgren syndrome.

CONCLUSION

Two alleles TNFB*1 and TNFA*2 of TNF gene are overrepresented in polish patients with Löfgren syndrome. The TNFA*2 allele is related with mild course of sarcoidosis in patients without LS.

Theoretical study of one- and two-photon absorption spectra of azoaromatic compounds

In this study, the one- and two-photon absorption spectra of seven azoaromatic compounds (five pseudostilbenes-type and two aminoazobenzenes) were theoretically investigated using the density functional theory combined with the response functions formalism. The equilibrium molecular structure of each compound was obtained at three different levels of theory: Hartree-Fock, density functional theory (DFT), and Møller-Plesset 2. The effect of solvent on the equilibrium structure and the electronic transitions of the compounds were investigated using the polarizable continuum model. For the one-photon absorption, the allowed pi-->pi(*) transition energy showed to be dependent on the molecular structures and the effect of solvent, while the n-->pi(*) and pi-->pi(*)(n) transition energies exhibited only a slight dependence. An inversion between the bands corresponding to the pi-->pi(*) and n-->pi(*) states due to the effect of solvent was observed for the pseudostilbene-type compounds. To characterize the allowed two-photon absorption transitions for azoaromatic compounds, the response functions formalism combined with DFT using the hybrid B3LYP and PBE0 functionals and the long-range corrected CAM-B3LYP functional was employed. The theoretical results support the previous findings based on the three-state model. The model takes into account the ground and two electronic excited states and has already been used to describe and interpret the two-photon absorption spectrum of azoaromatic compounds. The highest energy two-photon allowed transition for the pseudostilbene-type compounds shows to be more effectively affected (approximately 20%) by the torsion of the molecular structure than the lowest allowed transition (approximately 10%). In order to elucidate the effect of the solvent on the two-photon absorption spectra, the lowest allowed two-photon transition (dipolar transition) for each compound was analyzed using a two-state approximation and the polarizable continuum model. The results obtained reveal that the effect of solvent increases drastically the two-photon cross-section of the dipolar transition of the pseudostilbene-type compounds. In general, the features of both one- and two-photon absorption spectra of the azoaromatic compounds are well reproduced by the theoretical calculations.

The investigation on the mechanism of electrochemical hydrogen storage in sandwich nickel foam/palladium/carbon nanofibers electrodes

The kinetics of the process of reversible hydrogen sorption occurring in/on the nickel foam/palladium/carbon nanofibers (Ni/Pd/CNFs) electrodes is examined. It was shown that the hydrogen sorption/desorption properties for palladium can be altered after Pd layer is sandwiched between nickel foam and carbon nanofibers (CNF) layers. The layered Ni/Pd/CNFs electrodes were prepared by a two-step method consisting of chemical deposition of a very thin palladium layer on the Ni foam surface to form Ni/Pd electrodes followed by coating the Pd surface with the CNF layer by the CVD method. The process of hydrogen sorption/desorption into/from Ni/Pd as well as Ni/Pd/CNF electrodes was examined in alkaline electrolyte using the cyclic voltammetry method. The presence of CNF layer on the Pd surface exerts a great influence on the mechanism of the anodic desorption of hydrogen. A new anodic peak of hydrogen desorption revealed for Ni/Pd/CNF electrodes is ascribed to hydrogen storage in CNF phase. The CV measurements showed distinct differences between the rate of hydrogen release from the palladium and carbon phase.

Myeloid and lymphoid dendritic cells and cytotoxic T lymphocytes in peripheral blood of non-small cell lung cancer patient--a pilot study

PURPOSE

Dendritic cells (DCs) and cytotoxic T lymphocytes (CTLs) are the first protecting barrier against different pathogens (viruses, bacteria and neoplasms cells). Immature myeloid- and lymphoid dendritic cells possess ability to phagocytose and present antigens to lymphocytes. They have also ability to produce IL-12, which is also known as natural killer cell stimulatory factor or cytototoxic lymphocyte maturation factor. The aim of the study was to demonstrate the relationship between percentage of immature dendritic cells and percentage of CTLs subtypes in peripheral blood of non-small cell lung cancer (NSCLC).

MATERIAL AND METHODS

The study population consisted of 10 patients suffered from NSCLC (the mean age: 61.8 +/- 10.55). The monoclonal antibodies and three-color flow cytometry technique was applied to determine the cells phenotype in peripheral blood.

RESULTS

Significant negative correlation (R = -0.693, p < 0.05) between percentage of lymphoid DCs and percentage of CTLs was shown. The myeloid to lymphoid DCs ratio significantly positively (R = +0.638, p < 0.05) correlated with the percentage of CTLs. The significant negative correlation between the percentage of myeloid DCs and the percentage of CTLs-IL-12R-positive cells, as well as expression of this receptor were also ascertained (R = -0.68, p < 0.05 and R = -0.757, p < 0.01, respectively).

CONCLUSIONS

In presented pilot study we demonstrated clearly relationship between the percentage of immature DCs and the percentage and the phenotype of CTLs in peripheral blood of lung cancer patients.

[Concentration of allergic fungi spores in the air of flats in Lódź]

The real contribution of moulds to the pathogenesis of allergic diseases remains unknown, although positive skin prick tests and/or specific serum IgE to moki allergens can be detected in 1-5% of atopic patients. A significant problem in assesment of exposure to mould allergens, resulting with difficulty in standarization of methods. The aim of this work was to assess the concentration of spores of 8 mould species in flats inhabited by peoples who Bont show any symptoms of allergy. The Open Petri Dish (OPD) method involving sedimentation of participles contained in the column of air over the dish was used to assess the number of spores in 1 m3 of indoor atmospheres. All colonies were counted, but only 8 mould species implicated in inhaled allergy were identified, ie.: Alternaria tenuis, Cladosporium herbarum, Helminthosporum halodes, Pullularia pullulans, Penicillium notatam, Rhizopus nigricans, Mucor mucedo, Aspergillus fumigatus. The tests were carried out in 10 flats located in various quarters of the cify of Lodź during three consecutive days of September 1995 between 5:00 pm and 6:04 pm. In analyzing the percentage of spores of each of the eight mould species tested we determined that, independent of fiat and test day, C. herbarum predominated. It is good agreement with the observations of other authors who report that among large quantities of fungi that are detected in late summer, usually C. herbarum spores dominate. This is the season when the incidence of the Cladosporium spores in the atmospheric air increases. Spores of H. halodes were detected least frequently. Our study demonstrated the presence of substantial amounts of mould spores in indoor air of houses in Lódź. The spores belong to species with documented allergenicity, suggesting that they may play a role in development of allergic sensitization in susceptible subjects.

[Expression of platelet activation markers--selectin P and glycoprotein CD63 during hemodialysis]

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.