PROTECTION OF CONFIDENTIAL MEDICAL INFORMATION IN UKRAINE: PROBLEMS OF LEGAL REGULATION.

The aim of the article is to analyze the legal aspects and mechanisms of confidential medical information protection about an individual in the health care sphere in Ukraine. During the scientific research, various methods of cognition of legal phenomena were used. Among the general scientific approaches, the dialectical method was primarily used, which allowed to identify trends in the development of patient information rights and formulate proposals for improving legislation in the field of medical data protection. The formal-legal method was used to provide a comprehensive characterization of the EU (European Union) and Ukrainian legislation in the sphere of confidential medical information protection. Additionally, general scientific logical methods (analysis and synthesis, comparison and analogy, abstraction, and modeling) were used in order to study the problems of information relations in the medical field and establish legal liability for violation of the confidentiality of such information. The definitions of medical data, medical information, confidential medical data, and medical confidentiality have been researched and compared. The article identified the legitimate grounds for disclosing confidential medical information about an individual in the healthcare sector. Authors revealed the gaps in Ukrainian legislation regarding the confidential medical data protection by healthcare professionals and electronic medical systems regulators. The necessity of expanding the list of subjects responsible for preserving confidential medical information has been substantiated. The study explored the case law of the European Court of Human Rights in the field of the medical data confidentiality violation. It has been outlined the potential judicial remedies and liability for violating the right to personal medical information confidentiality of an individual in the healthcare sector. The legal grounds and cases of possible lawful disclosure of confidential medical information have been analyzed. Attention has been drawn to the insufficient regulation of access to medical confidentiality during martial law. It has been emphasized that the mechanism for protecting the violated right to confidentiality of medical information involves appealing to the Ukrainian Parliament Commissioner for Human Rights or to the court. The increasing role of international legal acts in ensuring the protection of medical data in the European Union and Ukraine has been highlighted.

[Passporting of parents of disabled children as an analytical resource of social policy].

The article presents the results of a study of the main social and household characteristics of families with disabled children, conducted in the territory of the Belgorod region (targeted survey; n = 990). The research made it possible to answer questions about children's health problems, their living conditions, the economic status of the family, the work of parents, the social environment and other characteristics of families. The article examines the passporting method of target problem (socially vulnerable) groups as an effective way of obtaining system information, a social picture of the situation, conditions, and problems of such families. The results of the research made it possible to determine the risks associated with the condition of children who require constant help and support, the category of families with unsatisfactory living conditions, the need for advanced training and retraining among parents. An important result of the study was the income map of families with disabled children, which identified the problematic characteristics of the socially vulnerable group and helped determine the directions of primary assistance and support. The scientific result of the article is the conclusion about the need for systematic control of all problematic components of the life of families raising disabled children, about the need for monitoring such information for the organization of targeted assistance and changes in social policy to meet the actual needs of such families.

[The studying of motivation of student youth to healthy life-style].

The article considers motivation of students to maintain healthy life-style. The empirical study was carried out on the basis of the Institute of Social Sciences and Mass Communications of the The Belgorod State National Research University (n=440; proportional sampling was based on characteristics of gender, age and course of education). The study results concerning most preferred sources of information about healthy lifestyle, factors of formation of attitudes and habits of healthy life-style, subjective ideas about one's own health and components of healthy life-style are analyzed. The study established that unstable motivational attitudes to healthy life-style are associated with lacking of awareness of value of health as most important factor of life well-being, conniving attitude to one's own health, lacking of competence in matters of health dependence and various aspects of life, lack of formed behavioral standards of healthy lifestyle. The conclusion is made about necessity of forming sustainable motivation for healthy life-style in students.

Broadband and fine-structured luminescence in diamond facilitated by femtosecond laser driven electron impact and injection of "vacancy-interstitial" pairs.

Ultrafast heating of photoionized free electrons by high-numerical-aperture (0.25-0.65) focused visible-range ultrashort laser pulses provides their resonant impact trapping into intra-gap electronic states of point defect centers in a natural IaA/B diamond with a high concentration of poorly aggregated nitrogen impurity atoms. This excites fine-structured, broadband (UV-near-infrared) polychromatic luminescence of the centers over the entire bandgap. The observed luminescence spectra revealed substitutional nitrogen interaction with non-equilibrium intrinsic carbon vacancies, produced simultaneously as Frenkel "vacancy-interstitial" pairs during the laser exposure.

[The prevention of tobacco smoking and development of skills of healthy life-style in students of professional educational institutions].

The purpose of the study is to analyze issues of prevention of smoking among college students and to reveal influence of social environment including influence of healthy lifestyle to development addiction. The study was based on value social model of health. The study covered student survey (n = 495, proportional selection by gender, age, year of study) and standardized interview with youth professionals (n = 21) to analyze in the youth the main motives for smoking, attitudes to healthy lifestyle and preventive social work methods that are implemented in colleges. The comparative analysis of data was carried out in subgroups of smoking and non-smoking students and experts. The results of study demonstrated the unformed negative attitudes to smoking. Among 25% of smoking students and 39% of non-smoking students smoking itself is considered as mean of communication and integration in youth community. Among 45.6% of respondents the exposure to and conformal behavior as reasons for starting smoking were declared. The analysis of results of the study concerning assessing attitude to smoking from the perspective of fashion and social recognition occurred to be unexpected: the number of non-smoking students who assume smoking is fashionable is 17 times higher than the number of smokers who share these beliefs. The comparison of the data permitted to establish possible causes of such a distribution of answers: in everyday life, smokers are faced with various legislative restrictions and social censure, while their non-smoking peers focus on social communicative and recreational effects of this habit. There are particular contradictions in the interpretation by students and youth professionals of causes of smoking. This testifies certain unawareness of professionals about age-related psychological characteristics and emotional conditions of students.

[The analysis of expert survey on factors of self-preserving behavior of population of the central regions of Russia].

For the reproduction of healthy society, it is necessary to pay special attention to self-preserving behavior of population, since health is not only medical, but also and social category. The health acts both as result of interaction of individual and the social environment, and as key condition for successful implementation of social statuses and roles, viability of social system as a whole. The spontaneous "health-saving" socialization, and, as a result, lacking of formation of behavioral patterns related to maintaining and strengthening health, imitation practices of self-care, which are demonstrated by different social demographic groups, especially young population, form danger of development of chronic diseases, further deterioration of national health indices, including decreasing reproductive potential of the state and increasing risks of for demographic policy in the future. This dictate needs for systematic analysis of factors and causes that lead to weak behavioral activity of Russian population in matters of "health-saving", determining their significance and relationship with health indices. The expert survey was carried out that allowed to identify configuration of main factors and risks in the system "environment - health", significantly affecting development of patterns of behavior in relation to it. The participation of experts representing various areas of professional activity (health care, physical education, ecology, state and municipal administration, education and science) proves high reliability of results and makes it possible to consider localization of main external dangers with highest rates of negative impact on development of self-preservation attitudes. The overall pattern of significance of various factors determining possible variations and main line of behavior of population of the central regions of Russia in context of health conservation allows to bring to foreground personal factors associated with willingness to ensure reproduction of one's own health, infrastructural and socio-economic factors that determine individual and group opportunities for Russia population to use potential of "health-saving" attitudes as well as factors of trust acting as an impulse, activating relationship of population and health care system.

Global transcriptome profiling of mild relapsing-remitting versus primary progressive multiple sclerosis.

BACKGROUND AND PURPOSE: Genetic research in multiple sclerosis (MS) mostly compares patients with MS with healthy controls, but does not differentiate between MS disease courses. We compared peripheral blood gene expression patterns between extremes of MS phenotypes, i.e. patients with mild relapsing-remitting MS (mRRMS) and primary progressive MS (PPMS). METHODS: We analyzed global gene expression profiles of peripheral blood samples of age- and gender-matched patients with mRRMS and PPMS. Detailed bioinformatic and gene set enrichment analysis, pathway and principle component analyses were used to identify differentially expressed genes and pathways. RESULTS: A total of 84 genes were significantly deregulated between the groups. Of those, 19 had been previously reported to be deregulated in patients with MS as compared with healthy controls, including major histocompatibility complex, interferon receptor 2 and interleukin 6 receptor. Detailed molecular pathway analysis revealed significant up-regulation of antigen processing and presentation, leukocyte transendothelial migration, nucleotide-binding oligomerization domain-like receptor signaling, chemokine signaling and down-regulation of RNA transport, spliceosome and aminoacyl-tRNA biosynthesis pathways in PPMS compared with mRRMS. CONCLUSION: Our analyses show significant differences between mRRMS and PPMS gene expression. Surprisingly, the differentially expressed genes were mostly involved in immunological and inflammatory pathways, suggesting that the difference in MS phenotypes is caused primarily by a difference in immune responses. It should be kept in mind that our analyses were in peripheral blood only, and that the observed differences in inflammatory pathways may be a substrate of the analysed tissue. Further research into gene expression differences between disease courses including analyses in central nervous system tissue is warranted.

DYNAMICS OF MORPHOLOGICAL CHANGES OF RATS' ADENOHYPOPHYSIS IN BURN DISEASE.

The article presents data relating to structural changes in rat adenohypophysis in experimental burn disease and its treatment. Experimental studies were conducted for defining peculiarities of structural changes in rats' adenohypophisis without and after skin burn injuries (in 7-14 and 21-30 days) alongside its correction with 0.9% NaCl solution. Application of DNA-cytometry allowed defining subtle mechanisms of pathogenic influence of burn injuries on the organism in general and the cells in particular.

Intensity matters: brain, behaviour and the epigenome of prenatally stressed rats.

There is a general consensus that prenatal stress alters offspring brain development, however, the details are often inconsistent. Hypothesizing that variation to the level of stress would produce different maternal experiences; this study was designed to examine offspring outcomes following a single prenatal stress paradigm at two different intensities. Pregnant Long Evans rats received mild, high, or no-stress from gestational days 12-16. Offspring underwent early behavioural testing and global methylation patterns were analysed from brain tissue of the frontal cortex and hippocampus. The two different prenatal stress intensities produced significantly different and often, opposite effects in the developing brain. Mild prenatal stress decreased brain weight in both males and females, whereas extreme stress increased female brain weight. Mild prenatal stress slowed development of sensorimotor abilities and decreased locomotion, whereas high prenatal stress also slowed development of sensorimotor learning but increased locomotion. Finally, mild prenatal stress increased global DNA methylation levels in the frontal cortex and hippocampus whereas high prenatal stress was associated with a dramatic decrease. The data from this study provide evidence to support a dose-dependent effect of prenatal stress on multiple aspects of brain development, potentially contributing to long-term outcomes.

Comparison of serology assays and polymerase chain reaction for the monitoring of active cytomegalovirus infection in renal transplant recipients.

BACKGROUND: Cytomegalovirus (CMV) infection is a common complication of renal transplantation. It can be diagnosed serologically, mainly based on seroconversion or by the detection of viral antigen via CMV-DNA amplification (polymerase chain reaction [PCR]). AIM: We sought diagnosis of an active CMV infection in renal transplant patients comparing serologic assays of CMV-IgM antibodies with CMV-DNA amplification. METHODS: We retrospectively studied renal transplant recipients 26 (including 15 women) hospitalized with clinical suspicion of CMV disease. The diagnosis of CMV infection was suspected on the basis of nonspecific symptoms, including fever, leukopenia, hyperbilirubinemia, and alanine aminotransferase elevation, alone or in combination. At the time of admission, all patients were screened for CMV-IgM antibody (immunoassays AxSYM/IMx) and CMV-DNA (qualitative PCR). RESULTS: The confirmation of CMV infection by the two methods (immunoassay and PCR) was obtained in only three patients (11.5%), its unambiguous exclusion--in four cases (15.4%). Nineteen patients (73.1%) were positive for CMV-IgM and negative for CMV-DNA. CONCLUSION: Detection of CMV-IgM antibodies by various immunoassays is not sensitive enough for diagnosis and cannot be used for monitoring during the active period in renal transplant recipients. This observation supported the prolonged presence of IgM antibodies after recent CMV infection in this patient group.

Concentrations of ssDNA in liver tissue and its correlation with sFas and sFasL in serum of patients infected with HBV, HCV, HCV and HIV.

PURPOSE: The concentration of nucleic acids that undergo apoptosis (ssDNA) determines the actual activity of programmed cell death. ssDNA concentrations in liver tissue of patients with chronic HBV, HCV and HCV and HIV infections were assessed. The concentration of this nucleic acid was analyzed in relation to the concentrations of serous apoptosis indicators, sFas and sFasL receptor proteins, the activity of inflammatory processes and fibrosis in liver tissue as well as HBV, HCV and HIV viraemia. PATIENTS: The study included 153 patients: 48 chronic HBV infected, 86 chronic HCV infected and 19 HCV and HIV infected. PATIENTS AND METHODS: The concentrations of HBV-DNA, HCV-RNA and HIV-RNA were determined by use of RT-PCR method. CD3+, CD4+ and CD8+ lymphocytes count were detected in HIV infected patients' blood by use of a flow cytometer. The concentration of ssDNA was determined by use of monoclonal antibodies and ELISA tests. The concentrations of sFas and sFasL in serum were determined by use of an immunoenzymatic method (ELISA). RESULTS: The concentration of ssDNA in liver tissue of both HCV and HBV infected patients was higher in comparison to those co-infected with HCV and HIV (1332 x 10(-6) g/mg, +/-664 x 10(-6); vs 1508 x 10(-6) microg/mg, +/-810 x 10(-6); vs 886 x 10(-6) microg/mg, +/- 388 x 10(-6); p < 0.004). No correlation between ssDNA concentration and HBV and HCV viraemia was observed. In patients infected with HCV genotype 3, the concentration of ssDNA was 1343 x 10(-6) microg/mg, +/-700 x 10(-6), comparable from patients infected with genotype 1, 296 x 10(-6) microg/mg, +/- 615 x 10(-6). The highest concentration of ssDNA in liver tissue was detected in HBV infected patients with low inflammatory activity (1645 x 10(-6) microg/mg, +/-987) and low fibrosis (1606 x 10(-6) microg/mg, +/- 876 x 10(-6). Mild inflammatory changes and low fibrosis were observed in all HCV and HIV infected patients. No correlation between ssDNA concentration in liver tissue and HIV viraemia (r = 0.03; p = 0.90), HCV, CD8+ and CD4+ count (r = -11; p = 0.66) was observed. The concentration of ssDNA among HCV and HIV infected patients correlated with the concentration of sFas in serum (r = 0.52; p < 0.02). CONCLUSIONS: HCV, HBV and HIV viraemias do not correlate with ssDNA concentration in liver tissue. In patients with HCV and HIV infections, CD4+ and CD3+ counts do not correlate with the concentration of ssDNA in liver tissue. HIV infection seems to inhibit apoptosis processes in liver tissue of HCV and HIV co-infected patients. In the case of HCV and HIV infections, the concentration of sFas in serum correlates with the concentration of ssDNA in liver tissue.

Acute lymphoblastic leukaemia cells express CCR7 but not higher amounts of IL-10 after CD40 ligation.

OBJECTIVE: Production of cytokines that support T-cell activation and proliferation and migration to lymph nodes is one of the most important terms of cancer vaccine development. In previous studies we and others used CD40 ligation to obtain higher expression of co-stimulatory and adhesion molecules on leukaemic cells from children with acute lymphoblastic leukaemia (ALL). This time we assess the cytokine and chemokine gene expression profile in CD40-stimulated ALL cells. MATERIAL AND METHODS: Malignant cells from 25 children with BCP-ALL were stimulated (or not) with huCD40LT and rIL-4 for 96 h. Eleven different molecule, cytokine and chemokine mRNAs levels (CCR7, IL-23, TGF-beta-IP, IFN-gamma, IL-10, CD1a, CD40, CD54, CD80, CD83, CD86) were determined using the real-time PCR technique with TaqMan chemistry using ready-to-use low-density arrays for gene expression by Applied Biosystems. RESULTS: 1) Increases in mRNA levels for CD40, CD54 and CD80 after CD40L and IL-4 stimulation were observed, 2) CCR7 mRNA expression was higher after CD40 ligation than before the culture (p = 0.002), 3) IL-10 mRNA expression was higher after the culture with medium than before the culture (p = 0.01). CONCLUSIONS: The results show that leukaemia-derived dendritic cells obtained with CD40 ligation express CCR7 - chemokine is involved in migration to lymph nodes and does not produce higher amounts of IL-10, a potent immunosuppressive cytokine. Our preclinical findings could be used in the design of immunotherapy trials for the treatment of children with ALL.

The root-vole Microtus oeconomus (Pallas, 1776): a new potential reservoir of Anaplasma phagocytophilum.

Anaplasma phagocytophilum infection is a recently emerged tick-borne zoonosis. The bacterium's reservoirs likely comprise cervids, some ruminants, rodents, and perhaps other small and intermediate-size mammals; the main vector in Europe is the Ixodes ricinus tick. The Bialowieza Primeval Forest is an ecosystem with a known prevalence of tick-borne pathogens. We studied the root-vole Microtus oeconomus to evaluate the natural infection of A. phagocytophilum. Intragranulocytic bacterial clusters (morulae) were not seen, but the A. phagocytophilum-specific nested polymerase chain reaction (PCR) product, targeting the rrs gene, was detected in two out of 30 rodent samples (GenBank accession nos. DQ361024 and DQ361025). Twenty-six root vole (86.6%) hosted ticks, mainly Dermacentor reticulatus larvae and nymphs. Only two rodents were parasitazed by I. ricinus single larvae. These data show the presence of natural infection of A. phagocytophilum among the root-vole M. oeconomus in the Bialowieza Primeval Forest ecosystem.

Low expression of costimulatory molecules and mRNA for cytokines are important mechanisms of immunosuppression in acute lymphoblastic leukemia in children?

UNLABELLED: Mechanisms leading blasts of acute lymphoblastic leukemia to escape from immune surveillance are still unknown. Only few reports showed that ALL cells are inefficient antigen presenting cells. The aim of the study was to assess expression of critical costimulatory/adhesion molecules and mRNA for main pro- and anti-inflammatory cytokines in ALL cells. Children with B-cell precursor ALL (n=20) were prospectively enrolled into the study. Expression of costimulatory/adhesion molecules (CD1a, CD11c, CD40, CD54, CD80, CD83, CD86, CD123, HLA class I and II) was assessed by flow cytometry and mRNA for cytokines (IFN-gamma, IL-10, IL-4, TGF-beta) - with real-time PCR. RESULTS: 1) high expression was observed for HLA I and II class, moderate for CD40, CD83, CD86 and low or no expression for CD80, CD54, CD1a, CD11c and CD123; 2) we found expression of mRNA for IFN-gamma, IL-10, IL-4 and TGF-beta in blasts cells (but not in all specimens). We noted relatively lower expression of all assessed cytokines comparing to T-cells obtained from healthy donors but interestingly expression for IL-10 was higher in normal B-cells than in blast cells, and IFN-gamma and IL-4 were not found in normal B-cells. In summary we suggest that ALL-blasts present low expression of costimulatory/adhesion molecules and mRNA for cytokines and this probably contribute to the absence of host T- cells stimulation to immune response.

Irradiation induces DNA damage and modulates epigenetic effectors in distant bystander tissue in vivo.

Irradiated cells induce chromosomal instability in unirradiated bystander cells in vitro. Although bystander effects are thought to be linked to radiation-induced secondary cancers, almost no studies have evaluated bystander effects in vivo. Furthermore, it has been proposed that epigenetic changes mediate bystander effects, but few studies have evaluated epigenetic factors in bystander tissues in vivo. Here, we describe studies in which mice were unilaterally exposed to X-irradiation and the levels of DNA damage, DNA methylation and protein expression were evaluated in irradiated and bystander cutaneous tissue. The data show that X-ray exposure to one side of the animal body induces DNA strand breaks and causes an increase in the levels of Rad51 in unexposed bystander tissue. In terms of epigenetic changes, unilateral radiation suppresses global methylation in directly irradiated tissue, but not in bystander tissue at given time-points studied. Intriguingly, however, we observed a significant reduction in the levels of the de novo DNA methyltransferases DNMT3a and 3b and a concurrent increase in the levels of the maintenance DNA methyltransferase DNMT1 in bystander tissues. Furthermore, the levels of two methyl-binding proteins known to be involved in transcriptional silencing, MeCP2 and MBD2, were also increased in bystander tissue. Together, these results show that irradiation induces DNA damage in bystander tissue more than a centimeter away from directly irradiated tissues, and suggests that epigenetic transcriptional regulation may be involved in the etiology of radiation-induced bystander effects.

Comparison of long-term results of laparoscopic and endoscopic exploration of common bile duct.

BACKGROUND: To compare long term results of laparoscopic and endoscopic exploration of common bile duct, to assess post-procedure quality of life. MATERIALS AND METHODS: From September 1992 to August 2003, we performed 4058 cholecystectomies, out of which 479 (11.80%) patients had choledocholithiasis. There were 163 males and 316 females. Mean age was 63.65 ± 5.5 years. These patients were put in two groups. In the first group of 240 patients, a majority of patients underwent two-stage procedures. ERCP/ES was performed in 210 (87.50%) cases. In the second group of 239 patients, a majority of patients underwent single-stage procedures. ERCP/ES was done in 32 (13.38%) cases. RESULTS: Mortality was zero in both groups. Morbidity was 15.1% in first group and 7.5% in second group. Mean hospital stay was 11.7 ± 3.2 days in first group and 6.2 ± 2.1 days in second group. Average operative time was 95.6 ± 20 minutes in first group and 128.4 ± 32 minutes in second group. Completed questionnaires received from 400 (83.50%) patients revealed better long-term results in the second group. Clinical features of low-grade cholangitis were seen in 20% of patients who underwent ES. Hence the post-procedure quality of life in patients who underwent single-stage procedures was definitely much better, because of minimal damage of sphincter of Oddi. CONCLUSIONS: Single-stage laparoscopic operations provide better results and shorter hospital stay. Damage to sphincter of Oddi should be minimal, to avoid long-term low-grade cholangitis. In young patients, the operation of choice should be single-stage laparoscopic procedure with absolutely no damage to sphincter of Oddi.

Clinical usefulness of K-RAS mutation detection in colorectal cancer and in surgical margins of the colon.

The incidence of K-RAS gene mutations in tumour and surgical margins was investigated in 63 patients with adenocarcinomas of varied clinical stage and histological grade. Point mutations of codon 12 K-RAS gene were detected, using the PCR-RFPL technique in cancer tissue in 23 patients (36.5%) and in colon margin mucosa in 1 patient (3.7%), out of 27 examined subjects. No significant correlations were found between the mutations and clinical features. Tumours, located in the left colon, and mucinous neoplasms displayed a higher incidence of mutations. No correlation was observed with either Dukes or TMN clinical advancement.

mRNA for chosen pro- and anti-inflammatory cytokines in T-lymphocytes in paediatric leukemias and lymphomas--a preliminary report.

We assessed mRNA for chosen pro- and anti-inflammatory cytokines in T-lymphocytes of peripheral blood in paediatric patients with leukemias and lymphomas. Levels of four different cytokine mRNAs (IFN-gamma, IL-10, IL-4, TGF-beta) were determined by the real-time PCR technique. In the whole examined group, at the time of diagnosis, we noted lower amounts of mRNA for TGF-beta1, comparing to respective values in the control patients. In the ALL group, we observed the following: 1) at the time of diagnosis: lower amounts of mRNA for IL-4 and for TGF-beta1, comparing to respective values in the control group; 2) lower amounts of mRNA for IL-10 after remission induction, comparing to the time of diagnosis. In our opinion, "immunedysregulation" in lymphoproliferative diseases in children is not caused by IFN-gamma deficiency. The deficit of anti-inflammatory cytokines, i.e., IL-4, TGF-beta, with higher amounts of IL-10, suggests their role in cancer development.

Attempts to detect Helicobacter pylori in atherosclerotic plaques.

Cardiovascular and cerebrovascular diseases are regarded to be the main causes of mortality in developed countries, atherosclerosis being at their pathological base. During the recent years, attention was paid to the role of bacterial infections, including Helicobacter pylori, in the process of atherogenesis and coronary heart disease development. The aim of the study was an evaluation of H. pylori presence--by means of PCR technique--in atherosclerotic changes, obtained by endarterectomy, performed during coronary artery bypass grafting (CABG). In the analysed group of patients, the following risk factors were found: hyperlipidaemia, smoking, hypertension, obesity, diabetes mellitus, cardiac infarction. No DNA of the bacteria was traced in any of the patients.

Serum levels of interleukin-18 (IL-18) and soluble interleukin-2 receptor (sIL-2R) in lung cancer.

PURPOSE: We evaluated the clinical usefulness of interleukin-18 (IL-18) and soluble interleukin-2 receptor (sIL-2R) during chemotherapy of lung cancer in relation to the histological type of the tumor, clinical stage, response to therapy and time survival. MATERIAL AND METHODS: Serum levels of IL-18 and sIL-2R were determined in 73 patients (62 males; mean age 64 years; 41 with non-small cell lung cancer-NSCLC, 32 with small cell lung cancer-SCLC); 12 healthy subjects served as controls. To determine IL-18 serum concentrations (Elisa), venous blood samples were collected from each patient before and after chemotherapy. RESULTS: The mean serum IL-18 level in all patients with lung cancer was significantly higher compared with healthy volunteers (p = 0.0001; NSCLC vs control p = 0.0001; SCLC vs control p = 0.004). In NSCLC group with stage IV the mean IL-18 level was significantly higher than those with stage IIIB (p = 0.04). Regarding tumor stage and response to therapy, no significant differences in IL-18 were observed. Using cut-off serum IL-18 concentration of 319.6 pg/ml, the prognoses of the two groups were different, but it was not statistically significant. The serum levels of sIL-2R in NSCLC patients were significantly higher than in controls (p = 0.018). There were no significant differences in serum sIL-2R levels in relation to clinical stage of lung cancer and response to therapy. The cut-off value between high and low serum sIL-2R concentration was defined as 582.27 U/ml. The difference in survival rate between the high and low sIL-2R groups was not significant. CONCLUSIONS: Serum IL-18 and sIL-2R levels can be useful in clinical practice, but their practical significance needs further studies.