Giant hydronephrosis (GH) is a rare entity that should beconsidered in the differential diagnosis of huge intraabdominalcystic masses. A hydronephrotic kidney usually contains1–2 litres of fluid in the collecting system. We report a caseof a 24 year old man with a hydronephrotic left kidney, fromwhich 14 litres of fluid was surgically drained. In this reportthe importance of computed tomography in the diagnosis anddifferential diagnosis of giant hydronephrosis to other cysticmasses is emphasised. Conclusion. GH should be includedin the differential diagnosis of huge intraabdominal cysticmasses. CT alongside MR should be the method of choice.

Introduction: Reed-Sternberg cells are typical for Hodgkin’s lymphoma. They are transformed post-germinative B cells that not achieve successful immunoglobulin gene rearrangement, and therefore predetermined to apoptosis. Several mechanisms, including latent Epstein Barr virus infection (EBV), enable survival of Hodgkin’s lymphoma neoplastic cells. Goal of this study is correlation of Hodgkin’s lymphoma EBV status with expression of apoptosis associated proteins in neoplastic cells. Association of Hodgkin’s lymphoma with EBV was determined by chromogenic hybridization in situ detection of EBER1 and EBER2. Material and Methods: Presence of apoptosis associated proteins: bcl-2, bcl-X, bax and p53, were determined immunohistochemicaly in neoplastic cells of 39 EBV positive, and 42 EBV negative Hodgkin’s lymphomas. Results: Bcl-2 protein was detected in neoplastic cells in 22.2%, Bcl-X in 87.7%, Bax in 80.2% and p53 in 67.8% of cases. In 44.4% cases simultaneous presence of Bcl-X, Bax and p53 protein was detected. Bcl-X is significantly more produced in mixed cellularity, and Bcl-X and Bax in nodular sclerosis. No significant difference was found in production of all four proteins between EBV positive and negative Hodgkin’s lymphoma. Median intensity of p53, Bcl-2, Bcl-X and Bax staining of complete examined group, EBV positive and EBV negative group show significant difference, except between Bcl-X and Bax. Discussion: Survival capacity of Hodgkin’s lymphoma neoplastic cells depends on activity of numerous regulators of programmed cell death. Expression of bcl-2, bcl-X, bax and p53 proteins is not different in neoplastic cells of EBV positive and EBV negative Hodgkin’s lymphoma.

INTRODUCTION Transplantation of kidneys (TK) is the best way of curing patients with terminal kidney disease. Unfortunately, right after the operation, different kinds of complications are possible and might happen to transplant. The worst and the most often complication is acute rejection (AR). PURPOSE The aim of work is to find the most often clinical signs and symptoms of AR. The aim of research is to value the influence of AO on function of graft and to find the influence of AR on surviving patients and graft. METHODS This study has been done on 91 patients, 62 male and 29 female patients in the age of 38.58 +/- 11.4. Patient are divide in two groups: experimental group which includes 29 patients that have had one or more episodes of acute rejection. We used serum concentration of creatinine defined by Cocroft-Gault curve to measure function of transplant. Time of patients and graft survival is estimated by Caplan-Meier curve. RESULTS In a group of patients with acute rejection we registered 42 episodes of dysfunction of graft which are treated as AR. The average creatinine in a group of patients with acute rejection was 183.42 +/- 65.39 micromol/L. Clearance of creatinine of group patient without AR is much bigger (p < 0.0001) than average clearance of creatinine of patients with acute rejection. Average serum creatinine in this group of patients is 147.59 +/- 62.57 and it is quite smaller (p < 0.002) than average creatinine at patients with acute rejection. Survival of all patients after five years is 91%, survival of patients without acute rejection is 96%, and with acute rejection is 80% (p < 0.014). Five year survival of graft is 78%, at the patients without acute rejection is 96% and at the patients with acute rejection is 64% (p < 0.0001), which is quite shorter. DISCUSSION Clinical image of acute rejection is unspecific. There is not arranged values of serum creatinine although in some research those values are 130-170 micromol/L. This values includes patients which did not have an acute rejection. Five year survival patients and graft in our patients that did not have an acute rejection is same as in the results of relevant centers. But survival of patients and grafts in patients that had an acute rejection is little bit lower than it is in the results in relevant centers. CONCLUSION There is no clinical picture than can help you to recognize an acute rejection because many other dysfuncion look the same. Acute rejection reduces function of transplant. Survival of patients and graft is mutch longer in the patients without acute rejection.

The needle biopsies from 60 transplanted and native kidneys have been processed and a prospective analysis of pattern, intensity and distribution of immunoglobulin deposits (IgA, IgG and IgM) and complement components (C3c and C1q) identified in these lesions has been carried out by immunohistochemistry with three step immunoperoxidase, in the period from 2000 to 2004. Those deposits were previously detected and analyzed by immunofluorescence. The samples consisted of 30 renal biopsies, previously diagnosed with glomerulonephritis and positive immunofluorescence and 30 renal biopsies without morphologic changes and deposits on immunofluorescence. 78,7% of the analyzed samples showed the identical results of the deposits of immunoglobulin and components of the complement with both, immunohistochemistry and immunofluorescence method. Sensitivity of the immunohistochemistry method with three step immunoperoxidase for all analyzed immunoglobulin and complement components is high (0,93), while specificity for the same method is 0,79. Standardized method of the three step immunoperoxidase on the paraffin embedded, formalin fixed needle renal biopsies could successfully replace the immunofluorescence method in diagnostic of GN, with the emphasis on a follow up and control of each single step in the procedure of the method.

The role of Epstein Barr virus (EBV) in the onset of Hodgkin's lymphoma has been a subject of ongoing research. However, confirmation of EBV oncogenic involvement was not possible due to the small number of neoplastic cells characteristic for this type of tumor. Presence of EBV infection in neoplastic and non-neoplastic cells was analyzed in 81 cases of Hodgkin's lymphoma. In neoplastic cells, using an immunohistochemical method, latent membrane protein 1 (LMP1) was found in 33,3% of cases, while in situ hybridization results demonstrated the presence of EBER RNA in 48,1% of the cases. EBER RNA was found in non-neoplastic lymphocytes in 38,3% of cases. EBV is most frequently associated with Hodgkin's lymphoma in the first and seventh decade of life, specifically the nodular sclerosis subtype. No apparent difference was observed in the association of Hodgkin's lymphoma with EBV between genders, or in relation to clinical stage of the disease and average age of the patient. However, association with childhood age is significantly greater in comparison to adults. EBV associated disease shows a significantly greater prevalence in T lymphocytes. Slightly more abundant are cytotoxic T lymphocytes, which are also more frequently in contact with Reed-Sternberg cells, although there is no difference in number and positioning of histiocytes. Variations between the data on the association of EBV with Hodgkin's lymphoma among studies from different parts of the world suggest that factors of age, gender, ethnic background and social status might present biological modifiers of EBV influence on the pathogenesis of this neoplasm. The differences in non-neoplastic infiltrate EBV+ and EBV- lymphoma indicate the effect of the virus on the immune interaction of tumor and host in this disease.

UNLABELLED Low grade squamous intraepithelial lesion (LGSIL) and atypical squamous cells undetermined significance (ASCUS) are the most frequent verified cellular abnormalities. Their management are still highly controversial mostly caused by uncertainty about their histology and nature of originate. Detection of HPV DNA in the absence of cytological abnormalities can also indicate presence of high-grade cervical intraepithelial neoplasia (CIN). The aim of this study was to show the association of the benign cellular changes, ASCUS and LGSIL with oncogenic types of HPV and to prove the necessity of more intensive screening of this group of patients. Cytology and pathomorphology analyses were performed first. Identification of the presence of human papiloma virus was carried out by the Digene Hybride Capture II test for all patients. Identification of different HPV types for the particular number of patients was carried out by RFLP (Rsetriction Fragments Length of Polymorphism). Out of the 101 patients in the first group 92 (91,08%) were HPV positive, and 41, 58% had no cellular abnormalities, ASCUS or LGSIL. Out of 509 patients of the second group 26.92% were positive for HRHPV, and 78,97% of them had no cellular abnormalities, ASCUS or LGSIL. HPV 16 was detected in 27.36% (ASCUS/LGSIL) of low risk cervical lesion of the first examined period. CONCLUSION The combination of smears with the detection of high risk HPV types increases the triage sensitivity especially at patients with mild.

Background The prognostic importance of renal involvement in Systemic Lupus Erythematosus (SLE) is well known. Predominant interstitial nephritis is a rare manifestation of SLE. The prognostic importance of histopathological tubulointerstitial (TIC) changes in renal tissue in patients with lupus nephritis (LN) is very little known. Objectives Our objectives were to more precisely determine TIC in the renal tissue and correlate these data with clinical features, daily proteinuria and 24-hour creatinine clearance in pts with LN. Our long-term goal is to identify pts during clinical quiescence who may be at high risk of developing progression to renal failure from LN. Methods Renal biopsies from 26 pts were analysed with emphasis on TIC. At the time of biopsy all pts had defined clinical evidence of active LN. Presence and intensity of oedema, inflammatory mononuclear infiltrate, fibrosis, hyaline casts and tubular atrophy were determined. TIC were graded from 0 to 3 (absent, mild, moderate and severe). We correlated these results with clinical data of 24-hour creatinine clearance (CC) and 24-hour urine total protein excretion (TP) at pre-treatment and post-treatment period. Results Patients were divided into 4 group: first group with absent TIC (0 score) 6 pts with TP mean 2.17 gr/24 h, CC mean 1.32 ml/s; second group with mild TIC (1–5 score), 12 pts with TP mean 2.61 gr/24 h, CC mean 0.76 ml/s; third group with moderate TIC (6 do 10 score) 5 pts with TP mean 2.67 gr/24 h, CC 0.95 ml/s; forth group with severe TIC (11 to 15 score) 3 pts with TP mean 1.52, CC mean 0.37 ml/s. These analyses we repeated after treatment with corticosteroids and citotoxyc drugs at period of 3 to 6 months and correlated with previous data. Significant results occurred for TP in first group (p < 0.05) and in second group (p < 0.01), as well as in second group for CC (p < 0.05). Significant improvement for both parameters occurred in group of 12 pts with mild TIC. (TP p < 0.01; CC p < 0.05). In group of pts with severe TIC, TP has decreased as well as CC. Conclusion TP decrease as well as increase of CC correlated well with mild degree of TIC. TIC could be prognostic predictors in LN. This has to be proved with a greater number of pts.