bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostyczne znaczenie stopnia ekspresji cytokeratyny 19 w niedrobnokomórkowym raku płuca
Authors: Kosacka Monika , Jankowska Renata
Published: June 2022

Introduction: Cytokeratins are important part of cytoskeleton. Cytokeratin 19 (CK 19) belongs to type I cytokeratins. Lung cancer is currently most frequently diagnosed neoplasm in males in many developed countries and in Poland. The prognosis in lung cancer remains unfavourable. The aim of this study was to evaluate the prognostic value of cytokeratin 19 expression in non-small cell lung cancer. Material and methods: We examined the degree of cytokeratin 19 expression in 94 patients with non-small cell lung cancer, who had undergone surgery. The group consisted of 64 men and 30 women. The mean age was 59.12 ± 8.61 years. Histological diagnosis was squamous cell carcinoma in 59 patients, adenocarcinoma in 26 patients, large cell carcinoma in 5 patients and non-small cell lung cancer without determination of the subtype in 4 patients. Cytokeratin 19 expression was examined immunohistochemically with Monoclonal Mouse Anti-Human Cytokeratin 19 Clone BA 17 DAKO M 0772. All patients were observed for 24 months. 45 patients (48%) survived, 49 died. Results: In all examined tumors we observed positive cytoplasmatic staining of cytokeratin 19. In 41 cases (44%) it was weak staining (CK 1), in 35 (37%) medium (CK 2) and in 18 (19%) strong one (CK 3). We demonstrated higher expression of cytokeratin 19 in these patients, who survived 2 years (p = 0.003). We also observed relationship between higher expression of CK 19 and survival in patients with squamous cell cancer, but there was no correlation with survival in patients with adenocarcinoma. Conclusions: Our results suggest that the degree of cytokeratin 19 expression could be a new prognostic factor in non-small cell lung cancer. Cytokeratin 19 expression has prognostic value in patients with squamous cell lung cancer but not in patients with adenocarcinoma.
Zmienność szczytowego przepływu wdechowego (PIF) na zastawkach imitujących opory inhalatorów proszkowych w zaostrzeniu astmy i POChP
Authors: Grabowski Marcin , Barg Wojciech , Chmielowicz Beata , Kopeć Agnieszka , Panaszek Bernard
Published: June 2022

Introduction: Drugs used in asthma or COPD exacerbation are delivered to the lungs by inhalation. This is facilitated, among other factors, by the use of dry powder inhalers (DPIs). Lung deposition from DPI depends predominantly on peak inspiratory flow (PIF). The aim of the study was to asses the variability of PIF generated by patients using different types of DPI inhalers during asthma or COPD exacerbation and to trace possible relationships between PIF value and some spirometric values. Material and methods: There were 28 patient fulfilling inclusion criteria, among them 17 (4 women) were suffering from COPD and 11 (8 women) from asthma. Spirometry, PEF and PIF measurements were performed in the first and the last day of hospitalisation. Peek inspiratory flow was obtained using In-Check DIAL—a device which simulated airflow resistances equivalent to Turbuhaler, Diskus and Aeroliser respectively. Results: The significant improvement in PIF was observed only in patients with COPD. There were no statistically significant correlations between PIF and both FEV1 and PEF except those in the first day of hospitalization in COPD patients (r = 0.66–0.81). Optimal PIF was achieved in all patients only with Diskus. Conclusions: Measurements of peek inspiratory flow are useful in choosing the most suitable DPI for patients with COPD and asthma exacerbations. We conclude that in those patients, PIF measurement should complement a standard spirometry
Organising Pneumonia and Lung Cancer—Case Report and Review of the Literature
Authors: Radzikowska Elżbieta , Nowicka Urszula , Wiatr Elżbieta , Jakubowska Lila , Langfort Renata , Chabowski Mariusz , Roszkowski Kazimierz
Published: June 2022

Organizujące się zapalenie płuc jest chorobą wynikającą z reakcji płuc na szereg czynników uszkadzających, zarówno pochodzenia egzo-, jak i endogennego. Notowane są również przypadki o nieustalonej etiologii. Ogniska organizującego się zapalenia płuc mogą stosunkowo często towarzyszyć naciekom nowotworowym w płucach, w tym szczególnie rakowi płuca. Organizujące się zapalenie płuc u chorych na raka płuca może być indukowane również przez chemio- lub radioterapię. Autorzy pracy przedstawiają przypadek 65-letniego chorego przyjętego do Kliniki z powodu gorączki, suchego kaszlu, duszności wysiłkowej i stwierdzanych w obrazie radiologicznym klatki piersiowej zacienień w dolnym polu płuca prawego. W badaniu tomokomputerowym uwidoczniono naciek zapalny z powietrznym bronchogramem łączący się z wnęką. Bronchoskopowo stwierdzono obturację oskrzela segmentu 9. płuca prawego przez kalafiorowaty guz. W wycinkach stwierdzono utkanie raka płaskonabłonkowego płuca. Z wydzieliny oskrzelowej nie wyhodowano flory patogennej, nie wykryto również w surowicy przeciwciał w kierunku patogenów atypowych (Mycoplasma pneumoniae, Chalamydia pneumoniae, Legionella pneumophila). Chorego leczono operacyjnie, dokonując resekcji płata dolnego płuca prawego. W badaniu histologicznym specimenu pooperacyjnego wykryto w oskrzelu niewielkie ognisko nowotworu płuca oraz rozległe nacieki organizującego się zapalenia płuc. W opinii autorów pracy leczenie operacyjne było wystarczające zarówno w stosunku do raka płuca, jak i indukowanego nowotworem organizującego się zapalenia płuc. W 6 miesięcy po zabiegu stan chorego był bardzo dobry i nie stwierdzono wznowy opisywanych procesów chorobowych. Reasumując, autorzy przedstawiają przypadek chorego na raka płaskonabłonkowego płuca (T1N0M0) z towarzyszącym rozległym naciekiem organizującego się zapalenia płuc.
Malakoplakia płuca i zakażenie Rhodococcus equi Opis dwóch przypadków i przegląd piśmiennictwa
Authors: Szołkowska Małgorzata , Langfort Renata , Szczepulska Ewa , Bestry Iwona , Religioni Jarosław
Published: June 2022

Malakoplakia is a rare, chronic, granulomatous disease seen in immunocompromised patients, caused by multiple infectious agents, most often bacteria. Microscopically, accumulations of macrophages with granular cytoplasm and intra- or extracellular structures, called Michaelis-Gutmann bodies are characteristic. Main cause of pulmonary malakoplakia is Rhodococcus equi infection. We report two cases of pulmonary malakoplakia, in one case R. equi infection was confirmed. We also present a summary of recent knowledge about the pathogenesis, morphology and clinical course of the disease.
Zespół złożonego bezdechu śródsennego
Authors: Kuźniar Tomasz , Kasibowska-Kuźniar Kamilla
Published: June 2022

Some patients with obstructive sleep apnea (OSA) develop persistent central sleep apnea activity when started on continuous positive airway pressure (CPAP). This recently recognized syndrome, complex sleep apnea syndrome (CompSAS), is thought to be due to dysfunction of the respiratory center in a setting of an obstructive sleep apnea. We present the current knowledge on epidemiology, pathophysiology, and treatment options in CompSAS. We review the current literature on CompSAS, and present our own data on this interesting condition.
Opieka paliatywna w przewlekłej chorobie obturacyjnej płuc (POChP)
Authors: Modlińska Aleksandra , Buss Tomasz , Lichodziejewska-Niemierko Monika
Published: June 2022

Traditionally focusing on terminally ill cancer patients, palliative care services have recently attempted to involve patients with other chronic, life—threatening diseases, e.g. chronic obstructive pulmonary disease (COPD). In this group of patients both quality of life and life expectancy is poor. Unfortunately, patients with COPD don’t receive adequate special medical service, although this progressive disease causes almost as many deaths as lung cancer. The suffering of patients dying from COPD is not smaller than cancer patients. The major symptoms are usually dyspnoe, cough, fatigue, depression, emotional and psychosocial problems. In fact, their needs are really palliative, so we try to pay attention to the quality of life of people suffering from COPD. It is important to underline that medical palliation of these patients falls not only to the management of the main clinical symptoms, but also to adopt a holistic, multiprofessional approach and working with their families and caregivers.
Patogeneza i klinika nieastmatycznego eozynofilowego zapalenia oskrzeli
Authors: Dor-Wojnarowska Anna , Panaszek Bernard
Published: June 2022

The introduction of induced sputum, as the diagnostic and research tool allowed to define nonasthmatic eosinophilic bronchitis characterized as a chronic cough in patients with no symptoms or objective evidence of variable airflow obstruction, with normal airway hyperresponsiveness and sputum eosinophilia. Eosinophilic bronchitis is an important cause of chronic cough. Studies in which the assessment of airway inflammation has been undertaken in chronic cough patients have shown that nonasthmatic eosinophilic bronchitis accounts for 10 to 30% of cases referred for specialist investigation. Eosinophilic bronchitis, like asthma, is characterized by eosinophilic airway inflammation, but unlike asthma, there is no airway hyperresponsiveness or bronchoconstriction. The airway immunopathology of asthma and eosinophilic bronchitis are almost identical. An obvious question is why an apparently similar pattern of airway inflammation is associated with different functional abnormalities in patients with nonasthmatic eosinophilic bronchitis and asthma. The differences in functional association may be related to differences in the localization of mast cells within the airway wall, with airway smooth muscle infiltration occurring in patients with asthma, and epithelial infiltration in patients with nonasthmatic eosinophilic bronchitis.
Komentarz do pracy L. Kępki i wsp. pt.: “Pooperacyjna radioterapia u chorych na niedrobnokomórkowego raka płuca: Wyniki badań a praktyka kliniczna”
Authors: Jodkiewicz Zbigniew
Published: June 2022

Rak płuca pozostaje nowotworem o najwyższym wskaźniku umieralności wśród mężczyzn i kobiet w Europie i na całym świecie [...]
Community-Acquired Pneumonia Complications in a Patient with Hereditary Glucose-6-Phosphate Dehydrogenase Deficiency
Authors: Nowiński Adam , Jabłońska-Skwiecińska Ewa , Wojda Emil , Bieleń Przemysław , Ptak Jakub , Śliwinski Paweł , Górecka Dorota
Published: June 2022

Severe complications of lower respiratory tract infection in a patient with hereditary glucose-6-phosphate dehydrogenase (G-6-PD) deficiency may occur. The case of a 68-year-old man with hereditary glucose-6-phosphate dehydrogenase (G6PD) deficiency who developed severe haemolysis after community-acquired pneumonia is presented. G6PD deficiency in our patient was diagnosed during childhood. We observed complications of community-acquired pneumonia: empyema, haemolytic crisis and renal failure. Videopleuroscopy and pleural drainage were successfully performed. Community-acquired streptococcal pneumonia may also lead to haemolysis in G6PD deficient patients. Acute haemolysis, severe anaemia and renal insufficiency secondary to haemoglobinuria can be observed. Severe purulent complications of pneumonia in G6PD deficient patients may suggest granulocyte function impairment.
Dylematy transplantologii płuc w Polsce
Authors: Grodzki Tomasz
Published: June 2022

Przeszczepienie płuc to sposób leczenia zarezerwowany dla krańcowych stadiów schorzeń układu oddechowego, niepoddających się innym konwencjonalnym rodzajom terapii. Najczęstszymi wskazaniami do wykonania przeszczepienia są: uogólniona rozedma, idiopatyczne włóknienie płuc i zwyrodnienie wielotorbielowate. Rocznie na świecie wykonuje się około 1600 przeszczepień pojedynczego płuca i obu płuc. W Polsce, mimo relatywnie dobrego rozwoju transplantacji innych narządów (w tym serca), liczba przeszczepień płuc jest znikoma, chociaż szacowane zapotrzebowanie wynosi minimum 50 transplantacji rocznie. W niniejszym artykule krótko omówiono historię, wskazania i przeciwwskazania do operacji oraz najczęstsze, wczesne i późne powikłania. Podjęto próbę przeanalizowania przyczyn małej liczby chorych przedstawianych torakochirurgom jako potencjalni biorcy płuc oraz zaproponowano pakiet rozwiązań interdyscyplinarnych mających na celu poprawę istniejącego stanu rzeczy.
Trudności interpretacyjne w ocenie rozmazów komórkowych BAL i plwociny indukowanej
Authors: Domagała-Kulawik Joanna
Published: June 2022

W ostatnich latach istotnie wzrosło znaczenie badań ilościowych: płynu z płukania oskrzelowo-pęcherzykowego (BAL) i plwociny indukowanej (PI) w cytodiagnostyce chorób płuc. W rozmazach komórkowych otrzymanych po odwirowaniu płynu z BAL i PI identyfikuje się komórki nabłonka oraz makrofagi, limfocyty, granulocyty obojętnochłonne i kwasochłonne. O ile badanie BAL ma największe znaczenie w diagnostyce chorób śródmiąższowych, o tyle badanie PI—w diagnostyce i różnicowaniu chorób obturacyjnych dróg oddechowych. Celem opracowania jest przedstawienie podobieństw i różnic w morfologii komórek w BAL i PI oraz interpretacja wyników tych badań na podstawie wyników badań własnych: ponad 1000 badań BAL i 200 badań PI. Podstawowe znaczenie ma przygotowanie rozmazów komórkowych według obowiązujących standardów oraz zasady uznania materiału za diagnostyczny. Domieszka krwi obwodowej lub zwiększony odsetek komórek nabłonka dyskwalifikują materiał. W analizie ilościowej konieczna jest odpowiednia znajomość morfologii komórek; szczególne trudności może sprawiać ocena makrofagów i różnicowanie ich z innymi formami komórek jednojądrzastych. O ile w płynie z BAL jest to dominująca populacja komórek, o tyle w PI stanowią mniej liczną, bardziej jednorodną populację komórek. Cechuje je bardziej skondensowana cytoplazma, u palaczy zawierająca mniej pyłów niż komórki z BAL. Podobnie w odniesieniu do granulocytów kwasochłonnych obserwuje się znaczne różnice morfologiczne. W identyfikacji komórek nabłonka należy zwrócić uwagę na własności fagocytarnekomórek nabłonka oraz występowanie tak zwanych nagich jąder. W pracy szczegółowo omówiono różnice istotne w analizie ilościowej i jakościowej BAL i PI w badaniach rutynowych i immunocytochemicznych.
Pierwotny chłoniak oskrzela o klinicznym przebiegu guza Pancoasta
Authors: Zaucha Renata , Jassem Jacek
Published: June 2022

Okolica szczytu płuca jest wyjątkowo rzadką lokalizacją pierwotnych chłoniaków oskrzela. W pracy przedstawiono przypadek zaawansowanego pierwotnego chłoniaka szczytu lewego płuca rozpoznanego podczas badań przesiewowych u 72-letniej bezobjawowej pacjentki. Przezskórna biopsja cienkoigłowa nie przyniosła rozpoznania histopatologicznego. Było to powodem wykonania otwartej biopsji płuca, w której wykazano obecność zmian charakterystycznych dla chłoniaka B-komórkowego o niskiej złośliwości, marginal zone lymphoma (BALTL); CD20+, CD3−. Zastosowano leczenie skojarzone: 9 cykli chemioterapii i napromienianie masy resztkowej, co pozwoliło na uzyskanie długotrwałej całkowitej remisji.
Wspomnienie o dr Jadwidze Truszczyńskiej, specjaliście II stopnia chorób płuc u dzieci, wieloletnim pracowniku Wojewódzkiego Szpitala Gruźlicy i Chorób Płuc dla Dzieci w Otwocku
Authors: Kowalski Janusz
Published: June 2022

Jadwiga Truszczyńska urodziła się 1 października 1933 roku w Otwocku [...]
Komentarz do Zaleceń Diagnostyczno-Terapeutycznych Polskiej Grupy Raka Płuca
Authors: Roszkowski-Śliż Kazimierz
Published: June 2022

Wyniki leczenia drobnokomórkowego raka płuca są nadal wysoce niezadowalające, jednak mimo to stanowią przykład postępu dokonującego się w onkologii na przestrzeni ostatnich 3 dekad [...]
The Significance of Spoligotyping Method in Epidemiological Investigations of Tuberculosis
Authors: Augustynowicz-Kopeć Ewa , Jagielski Tomasz , Kozińska Monika , Zabost Anna , Zwolska Zofia
Published: June 2022

Introduction: The control of tuberculosis (TB) requires methods for rapid detection and tracing sources of infection, so that further transmission can be arrested. Recent developments in molecular biology have resulted in techniques that allow prompt identification and tracking specific strains of M. tuberculosis as they spread through the population. Most of these techniques take advantage of M. tuberculosis DNA polymorphism and are based on various repetitive DNA elements as genetic markers. Each method yields strain-specific genetic profiles (fingerprints). Strains showing identical fingerprints are referred to as clustered and are usually associated with recent transmission, whereas strains whose fingerprints are unique are presumed to represent remote transmission, a reactivation of infection acquired in the distant past. Material and methods: In recent years, spoligotyping has become one of the most widely used genotyping method for epidemiological studies of TB. Spoligotyping is a PCR-based method allowing to analyze strain-dependent polymorphisms observed in spacer sequences present within the direct repeat (DR) genomic region of M. tuberculosis complex strains. Spoligotyping provides some important advantages over other genotyping techniques. These are simplicity, rapidity, high reproducibility and stability of the results, with the latter being expressed in a simple digital pattern, readily named and databased, and the ability to perform spoligotyping directly on clinical samples, without the need for prior culture. However, spoligotyping has relatively low discriminatory capacity, which makes it necessary to use secondary fingerprinting methods to prove clonality between isolates. Results: The aim of this study was to evaluate the usefulness of spoligotyping in epidemiological investigations of TB by analyzing 16 isoniazid-resistant M. tuberculosis strains isolated from patients with pulmonary TB in the central region of Poland. A total of 11 distinct spoligopatterns were obtained. 9 isolates were represented by a unique pattern, whereas 7 were clustered in 2 groups of 5 and 2 isolates, respectively. When compared with an international spoligodatabase SpolDB4, 13 isolates shared already described spoligotypes, whereas 3 did not match any existing spoligopattern in database and were defined as orphans. Spoligotyping overestimated the number of clustered isolates in one of its two clusters when compared to IS6110 Mtb1/ /Mtb2 PCR. Strains clustered using the latter method were assumed to be closely epidemiologically related. Conclusions: This report demonstrates the utility of spoligotyping as an initial screening technique, to be supplemented by another typing method of greater discriminatory power, such as the IS6110 Mtb1/Mtb2 PCR in order to better recognize the epidemiological links between TB patients.
Analysis of Deaths Caused by Obstructive Pulmonary Diseases in Pomerania Province in 2001–2004
Authors: Niedoszytko Marek , Porzezińska Maria , Chełmińska Marta , Gruchała-Niedoszytko Marta , Łata Jakub , Jassem Ewa
Published: June 2022

Introduction: Lung diseases, especially COPD, are one of the leading causes of death. The aim of the study was to assess mortality caused by COPD, asthma and cor pulmonale in the years 2001–2004 in the Pomerania province. Material and methods: Death certificates of patients who died of asthma, COPD or cor pulmonale registered in Regional Health Centre were analyzed. Results: The mortality rate for COPD was 14.02/100,000, asthma 2.04/100,000 and cor pulmonale 2.4/100,000 inhabitants. Mortality rate from COPD increased from 12.5/100,000 found in 2001 to 15.6/100,000 found in 2004 (p = 0.005). The number of deaths was higher in the winter time. The peak mortality was found in patients 65 years old. 71% of COPD and cor pulmonale patients died in the hospital, whereas 75% of asthma deaths occurred at home (p = 0.0001). Conclusions: The mortality rates from chronic respiratory diseases in the analyzed population are comparable to data found in other studies. The alarming result is the increase in the number of COPD deaths and high percentage of asthma patients who die at home.
Quality of Life of Patients with Asthma Which Has Been Well and Poorly Controlled
Authors: Chełmińska Marta , Werachowska Lidia , Niedoszytko Marek , Bolałek Marceli , Szymanowska Amelia , Damps-Konstańska Iwona , Słomiński Jan Marek , Jassem Ewa
Published: June 2022

Introduction: The aim of the study was to assess the quality of life of patients with asthma who were well and poorly controlled. Material and methods: 70 patients with diagnosed asthma, aged from 18 to 40, were included into the study between November 2005 and February 2006 at the Specialist Hospital in Chojnice and Allergy out-patient Clinic of Medical University of Gdańsk. The diagnosis and stage of asthma, as well as the assessment of the control of disease was performed by the physician. Quality of life was assessed with the use of St. George Respiratory Questionnaire (SGRQ). Statistical analysis was made with the use of computer statistical program Statistica. Results: According to GINA in 26 patients mild asthma was diagnosed, in 31—moderated and in 13—severe disease. 41 patients were assessed as well controlled and 29—as poorly controlled. Older age and longer duration of the disease were related to severe asthma, p = 0.01 and p = 0.003, respectively. In well controlled patients overall score for SGRQ was 48.86, whereas in poorly controlled was—74.4. There was a significant difference between the overall quality of life in well and poorly controlled patients with asthma, p = 0.0001. This difference was found in all three domains: for symptoms, activity and impact on life, p = 0.014, p = 0.035 and p = 0.003, respectively. Conclusions: Quality of life is strongly dependent on the control of symptoms in asthmatic patients.
Optoelectronic Plethysmography—A New Technic to Measure Changes of Chest Wall Volume
Authors: Skoczylas Agnieszka , Śliwiński Paweł
Published: June 2022

Optoelectronic plethysmography (OEP) is a new, noninvasive diagnostic tool that allows to measure changes of chest wall volume and its three compartments. Mathematical basis of the method, elements of the system and possibilities of combining OEP with other recording techniques used in pneumonology were discussed in details. OEP applications, results of the latest investigations and development perspectives were briefly presented.
Serum and Sputum Eosinophil Cationic Protein Levels and Clinical Status in Cystic Fibrosis Patients
Authors: Korzeniewska Aleksandra , Sołoniewicz Anna , Stelmach Piotr , Sobocińska Agnieszka , Stelmach Iwona
Published: June 2022

Recent studies have emphasied the role of eosinophils and it’s metabolites in the pathogenesis of lung disease in cystic fi brosis. This study was designed to assess the relationship between serum and sputum ECP levels and clinical status of cystic fi brosis patients. Material and methods: 30 patients, aged 6–30 with moderate cystic fi brosis were recruited. Spirometry, weight and high, and Shwachman-Kulczycki score were measured, and serum and sputum samples were obtained for measure-ments of the eosinophil cationic protein (ECP). Results: We observed signifi cant inverse correlation between sputum ECP levels and BMI (p < 0.001) and FEV1 (p < 0.001), and not signifi cant inverse correlation between sputum ECP levels Shwachman-Kulczycki score (p = 0.057). There was no signifi cant correlation between sputum ECP levels and FEF25/75% and between serum ECP levels and measured clinical parameters. Conclusions: Results of this study suggest infl uence of eosinophil infl ammation in respiratory tract on clinical status of CF patients.
Respiratory Responses to CO2 Stimulation in Hypercapnic Patients with Obstructive Sleep Apnea Syndrome
Authors: Franczuk Monika , Radwan Leszek , Pływaczewski Robert , Śliwiński Paweł , Boros Piotr , Wesołowski Stefan
Published: June 2022

Obstructive sleep apnea can be associated with daytime chronic hypercapnia in some patients, but the prevalence of the phenomenon is highly variable in the published literature. The most often it is found in patients with coexisting COPD. There is also an evidence of persisting hypercapnia in OSA patients without other respiratory disease. In previous studies lung function impairment, obesity, gender, severity of OSAS have been considered to contribute to daytime hypercapnia. Several studies demonstrated that the defect in control of breathing can play a role in the development of chronic hypercapnia in patients with OSAS. The aim of the study was to estimate respiratory responses to hypercapnic stimulation in patients with OSAS and chronic daytime hypercapnia. Material consisted of 38 patients with OSAS and chronic hypercapnia (COPD was present in 24–group B, “pure” OSA in 14–group A) and 40 normocapnic OSA patients (group C). Lung function testing, blood gases and chemical control of breathing tests were performed in all of them before initiating therapy with nCPAP. Diagnosis of OSAS was stated with standard polisomnography and AHI was similar in mentioned groups. Results: Respiratory responses to hypercapnic stimulation were signifi cantly lower in hypercapnic patients (A 10.6 ± 4.6; B 9.5 ± 5.6) in opposition to normocapnics (C 23.3 ± 14.0 l/min/kPa). In all studied patients PaCO2 level signifi cantly correlated with respiratory responses to hypercapnic stimulation (r= −0.61), lung function indices (VC r = −0.69 and FEV1 r = −0.71), mean SaO2 during sleep (r = −0.68), and BMI (r = 0.49), but not with the factors like age, AHI or minimal SaO2 during sleep. Analysis with multiple regression revealed that hypercapnic drive, mean SaO2 during sleep, FEV1 and BMI were the best predictors of hypercapnia in studied group, being responsible for 72% of the total variance in PaCO2 in our OSA patients (R2 = 0.72; p < 0.0001). Conclusion: predisposition to daytime hypercapnia in our OSA patients was related to dimished chemosensitivity to CO2, mean desaturation during sleep, the severity of obesity and impairment of lung function mainly due to coexisting COPD.
Exacerbation of Idiopathic Pulmonary Fibrosis
Authors: Ziora Dariusz
Published: June 2022

Samoistne włóknienie płuc (IPF, idiopathic pulmonary fibrosis) jest najczęściej obserwowaną manifestacją kliniczną spośród samoistnych śródmiąższowych zapaleń płuc (IIP, interstitial idiopathic pneumonias) [...]
The Role of Interleukin 17 Cytokine Family in Inducing Allergic Inflammation in the Pulmonary Tract
Authors: Semik-Orzech Aleksandra , Barczyk Adam , Pierzchała Władysław
Published: June 2022

IL-17 family is a group of proinfl ammatory cytokines produced by activated memory T-cells. These cytokines play an important role in the development of cellular and humoral mechanisms of immunological re-sponses lying at the basis of allergic disorders. The aim of this paper is to present the current knowledge on the role of interleukin 17 cytokine family in the pathogenesis of allergic disorders of the respiratory tract. IL-17A (as well as IL-17F) plays role in the development of airway hyperresponsiveness through activation of allergen-specific T-cells. Levels of IL-17A are elevated in sputum of asthmatic patients and correlate with airway hyperresponsiveness to methacholine. However, it remains fact, that the main effect of IL-17A in the pulmonary tract is recrutation of polymorphonuclear leukocytes, depending on CXC chemokine release from stromal cells. IL-17E evokes differ-ent immunological responses. This cytokine participates in the development of Th2-cell-dependent immunological response and the coexisting pathological tissue changes. These actions take place mainly through the induction of synthesis of the Th2 cell-derived cytokines (IL-4, IL-5, IL-13) and the development of eosinophilic infl ammation. It is thought, that the character of the immunological response evoked by different cytokines of IL-17 family depends on the differences between the spatial structure of their fragments including disulfi de bridges and that these differences determine their receptor interactions and biological functions.
Cardiac Involvement in Sarcoidosis
Authors: Dybowska Małgorzata , Gralec Renata , Kuca Paweł , Burakowski Janusz , Tomkowski Witold
Published: June 2022

Sarkoidoza jest uogólnioną chorobą o nieznanej etiologii, charakteryzującą się tworzeniem nieserowaciejących ziarniniaków, które mogą występować w każdym narządzie [...]
Miracle Survival
Authors: Trepczyński Eugeniusz
Published: June 2022

Urodziłem się 1 grudnia 1924 roku w Warszawie i mieszkałem w dzielnicy Żoliborz [...]
FIZJOPATOLOGIA ODDYCHANIA
Authors: Pneumonologia i Alergologia Polska Editorial Office
Published: June 2022

An obstructive ventilatory defect is defined as the disproportional reduction of maximal airflow from thelung in relation to the maximal volume (i.e., VC) that can be displaced from the lungs [...]
The Epidemiology of Tuberculosis of the Respiratory Tract in TH Homeless in Poznań
Authors: Karpińska-Jazdon Lidia , Gałęcki Jerzy , Ruszczcak Anna
Published: June 2022

The Department of Health and Social Care of the Municipal Council in Poznan initiated a programme of prophylaxis against tuberculosis in the homeless. The study involves those homeless people who are registered in Poznan-based homeless shelters and temporary residential sites. Chest X-ray was performed in 403 homeless and 57 persons of staff. Abnormal picture of the chest was found in 83 person, but only in 30 lesions were suspected of tuberculous etiology. 43 persons with abnormal chest X-ray and/or with clinical symptoms were exactly examinated in Chest Clinic (with microbiological examination of sputum or bronchoscopic material). AFB were found in 7 of them, in 1-granulomatosis with necrosis was found in lung specimen and in 2 clinical and radiological diagnosis of TB was estabilished.
Safety of Venom Immunotherapy in Patients Pretreated with Antihistamines—A Retrospective Study
Authors: Tworek Damian , Bocheńska-Marciniak Małgorzata , Kupczyk Maciej , Kupryś-Lipińska Izabela , Kuna Piotr
Published: June 2022

Imrnunotherapy is the only effective method of treatment of allergy to Hymenoptera venom. Pretreat­ment with antihistamines diminishes the incidence of adverse reactions (AR) such as large local and mild systemic reactions but it is suggested that it may mask a development of serious allergic reactions. The aim of the study was a retrospective evaluation of the incidence and nature of AR during venom immuno­therapy in patients receiving pretreatment with antihistamines in the Department of Pneumonology and Allergy of the Medical University of Lodz. Results: 50 patients started “ultra-rush” immunotherapy in our center, 8 were taken in our care after the initiation phase had been conducted elsewhere. During the dose increase phase IO systemic adverse reactions were observed. 50% of them were only subjective and the rest mild objective reactions. During the maintenance phase IO systemic reactions were noted, among them 2 cases of the anaphylactic shock. The incidence of systemic adverse reactions was I per 86 injections. Late as well as unusual reactions appeared twice. Conclusions: Venom immunotherapy combined with pretreatment with antihistamines is safe. A vast majority of systemic adverse reactions is of subjective and mild objective nature and appropriate treatment leads to contain­ment of severe reactions.
Invasive Aspergillosis (IA) In Patients Treated in the Institute of Tuberculosis and Chest Diseases in the Years 1993–2005—Diagnostic Problems
Authors: Ramiszewski Paweł , Gawryluk Dariusz , Podsiadło Barbara , Wiatr Elżbieta , Szopiński Janusz , Rowińska-Zakrzewska Ewa , Bestry Iwona , Langfort Renata , Roszkowski-Śliż Kazimierz
Published: June 2022

The aim of this study was to present the diagnostic problems in pts treated for invasive aspergillosis (IA) in the Illrd Clinic of the Institute of Tuberculosis in the years 1993–2005. The material consisted of clinical documentation of 18 pts. 15 out of 18 pts (83.4%) died. In all those cases autopsy examination was done. In 13 pts IA was the main and in another 2 only the accessory cause of death. AU pts were treated with corticosteroids and/or cytostatic drugs because of lung cancer (13 pts), haematologic disorders (1 pts), Wegener's granulomatosis (3 pts) and idiopathic pulmonary fibrosis (1 pts). In 13 out of 18 pts granulocytopenia was revealed (on an average from 0.008 × 109/L to 0.95 × 109/L) one month before death. In 13 pts IA was limited to the lungs, in 5 others there were also fungal lesions in brain, kidneys, liver, spleen, pleura, pericardium and heart. Pts with disseminated fonn ofIA had significantly lower granulocyte count and were treated with higher doses of corticosteroids than others. Immunosupressive drugs and granulocytopenia can be regarded as predisposing factors. IA was diagnosed before death only in 5 out of 18 pts. This was mainly caused by the lack of the symptoms of in­fection (4 pts) and negative results ofmycological (6 pts) and serological examination (8 pts). We should underline that mycological examination was only done in 11 pts and serological examination of blood for fungal antigen only in 6 pts. We conclude that mycological infection ought to be searched in all pts treated with high doses of corticosteroids and those with prolonged granulocytopenia, especially if they have the symptoms of infection which does not respond to antibiotic therapy.
Thrombocytopenia Probably Heparin-Induced in Women with Tumor of the Heart and Pulmonary Embolism
Authors: Gralec Renata , Dybowska Małgorzata , Kuca Paweł , Burakowski Janusz , Tomkowski Witold
Published: June 2022

43 years old women with tumor of the right ventricle was admitted to ICU due to pulmonary embolism and suspicion for heparin-induced thrombocytopenia. Thrombocytopenia was successfully treated with Arixtra and the patient was qualified for the cardio surgery intervention. Heparin is widely used in treatment and prophylaxis of venous thromboembolism and other diseases. One of the most important adverse effect of treatment with heparin is heparin-inducted thrombocytopenia (HIT), which is one of the most frequent drug-induced, immune-mediated type ofthrombocytopenia. Ifit is unrecognized is associated with significant morbidity and mortality. According to our knowledge this is first report of Arixtra usage in patient with suspicion of HIT in Poland.
Latent Tetany Masked by Syndroms of Bronchial Asthma and Depressive Syndrome. Case Raport
Authors: Wajda Beata , Drozdowska Adrianna , Kuziemski Krzysztof , Górska Lucyna , Lewandowska Katarzyna , Jassem Ewa
Published: June 2022

Tetany, which occurs in young women, poses common diagnostic problem. Two types of tetany are distinguished: one which is characterized by hypocalcemia and which rarely occurs (in person after strumectomy in the course of post-operational hypoparathyroidism) and latent one, which occurs more often. In the literature there is a lack of precise data concerned witch most probably results from its underestimation. Clinical symptoms which appear in latent tetany (normocalcemic) are related to the intracellular magnesium ddiciency and increased respiratory drive. A noncharacteristic clinical picture and the lack of a pathognomonic symptom, cause that despite of the fearly common occurrence, the latent tetany is rarely recognized. In this paper the case of a 53 year old women has been described. The women had the symptoms of gastroesopha­geal reflux of asthma and depressive syndrome, witch masked the symptoms of the latent tetany.
Pulmonary Complications in Patient with Ulcerative Colitis, Treated with 5-Aminosalicylic Preparations
Authors: Radwan Piotr , Łupina Tomasz , Radwan-Kwiatek Karolina , Milanowski Janusz
Published: June 2022

Pulmonary complications in patients with ulcerative colitis treated with 5-aminosalicylic acid are infrequent adverse events. The authors present a 35-year-old man, talcing sulfasalazine and mesalazine in whom pulmonary abnormalities resembling tuberculosis were observed during several months of therapy. Withdrawal of mesalazine resulted in complete resolution of lung injury. Patient is doing well on maintenance treatment with im­munosuppressants.
Bacteria of the Genus Acinetobacter: Clinical Significance And Therapy of Infections
Authors: Wróblewska Marta
Published: June 2022

Bakterie z rodzaju Acinetobacter naleza do grupy Gram-ujemnych paleczek niefermentujacych, do ktorych zalicza sie rowniez patogeny takie jak Pseu­domonas aeruginosa, Stenotrophomonas maltophi­lia i Burkholderia cepacia [...]
Influence of Bronchoscopy on Nitric Oxide in Exhaled Air
Authors: Hildebrand Katarzyna , Krenke Rafał , Przybyłowski Tadeusz , Frangrat Adam , Górska Katarzyna , Chazan Ryszarda
Published: June 2022

Nitric oxide has been extensively studied as a noninvasive marker of airway inflammation, especially in asthma. Assuming, bronchoscopy can produced not only systemic but also local inflammatory response we hypothesized that bronchofiberoscopy can be responsible for an increase in nitric oxide synthesis with resulting increase in fractional concentration of exhaled nitric oxide (FENO). Seventeen subjects (10 M, 7 F), at mean age of 53.8 ± 14.1 yrs undergoing diagnostic bronchoscopy participated in the study. The indications for bronchoscopy were as follows: lung cancer (n = 5; 29%), interstitial lung diseases (n = 3; 18%), slowly resolving pneumonia (n = 3; 18%), hemoptysis (n = 3; 18%), differential diagnosis of asthma/dyspnea (n = 3; 18%). During bronchoscopy bronchial washing (n = 7) and bronchoalveolar lavage (BAL) (n = 10) has been performed. FENO has been analyzed online with chemiluminescence analyzer (NIOX, Aerocrine, Sweden) according to American Thoracic Society guidelines, before and at 1, 2, 3 and 24 h after bronchoscopy. Mean FENO before bronchoscopy was 19.7 ± 4.5 ppb (mean ± SEM), post–bronchoscopy a decrease with a nadir at second hour (12.1 ± 1.5 ppb, p < 0.05) was observed, FENO 24 h after bronchoscopy was not different than baseline (18.4 ± 2.5 ppb). There were no differences in the FENO profile in BAL patients when compared to those inwhom only the bronchial washing has been performed. Conclusions: Bronchoscopy leads to a significant decreasein exhaled nitric oxide. The underlying mechanisms are unclear. Future studies including analysis of other inflammatory markers are needed to explain these changes.
Familial Clustering of Symptoms Typical for OSAS
Authors: Bielicki Piotr , Przybyłowski Tadeusz , Droszcz Wacław , Byskiniewicz Krzysztof , Korczyński Piotr , Chazan Ryszarda
Published: June 2022

The aim of the study was to compare the incidence of obstructive sleep apnoea syndrome (OSAS) symptoms in relatives of subjects with OSAS and in relatives without OSAS but with clinical symptoms of this disease. The study group consisted of 186 relatives of patients with OSAS and 117 relatives of patients with symptoms of OSAS in whom the disease was not confirmed by polysomnography. They were all mailed a questionnaire with questions concerning anthropometric data, the presence of symptoms typical for OSAS and the presence of concomitant diseases. Analysis of the obtained data revealed an increased frequency of snoring, sleep apnea and nycturia in the relatives of patients with OSAS when compared to relatives of patients without OSAS, but the difference was not statistically significant. The incidence of daytime OSAS symptoms was significantly higher in the group of relatives of patients with OSAS. No differences in the incidence of arterial hypertension, ischaemic heart disease and diabetes mellitus were found.
Maximal Respiratory Pressures and Exercise Tolerance in Patients with COPD
Authors: Maskey-Warzęchowska Marta , Przybyłowski Tadeusz , Hildebrand Katarzyna , Wrotek Katarzyna , Wiwała Joanna , Kościuch Justyna , Chazan Ryszarda
Published: June 2022

Many authors reported respiratory muscle function impairment in patients with chronic obstructive pulmonary disease (COPD). Impaired respiratory muscle function may contribute exercise intolerance which is frequently observed in this disease. Aim of the study: was to determine the influence of respiratory muscle function on exercise capacity in patients with COPD. Methods: 23 patients with stable COPD aged 62.7 ± 9.3 years (6F, 17M; mean post-bronchodilator FEV1 = 47.9 ± 12.4% value predicted) participated in the study. Exercise capacity was assessed by the six-minute walk test and the incremental cardiopulmonary exercise test (CPET) on a treadmill. Maximal respiratory pressures (PImax, PEmax) were evaluated before and directly after CPET. Results: The mean peak oxygen uptake (VO2max) was 27.2 ± 6.1 mlO2/min/kg and the mean distance walked during the 6 MWT was 569.4 ± 101.7 m. Both PImax and PEmax decreased significantly after maximal exercise (71.4 ± 23.0 vs. 63.6 ± 22.2 cm H2O, p = 0.001 and 124.9 ± 46.5 vs. 112.3 ± 46.6 cm H2O, p = 0.02 respectively). No correlation between VO2max and the 6-minute walk distance and the maximal respiratory pressures was found. We observed a negative correlation between the 6-minute walk distance and the difference between the pre- and post CPET maximal inspiratory pressure. Conclusions: respiratory muscle function is impaired in patients with COPD but this does not affect exercise performance. Exercise causes a decrease of the respiratory muscle strength.
Identification of Mycobacteriaceae Species Based on the Hsp-65 Gene Polymorphism Analysis by PCR–RFLP
Authors: Frangrat Adam , Walkiewicz Renata , Safianowska Aleksandra , Grubek-Jaworska Hanna , Chazan Ryszarda
Published: June 2022

The polymorphism of the short fragment of the heat shock protein 65 encoding gene was evaluated by the PCR–RFLP technique described by Telenti and further developed by Devallois for identification of mycobac-terial species in routine laboratory work. We analysed 58 strains representing 25 different mycobacterial species (24 reference strains and 34 clinical isolates). The results obtained by PCR-RFLP and HPLC identification techniques were highly concordant The results were compatible for 87.5% (21/24) reference strains and for 97.1% (33/34) clinical isolates. The PCR–RFLP method allowed for accurate identification mycobacterial species, especially pathogenic strains. Restriction patterns obtained for 25 species of Mycobacteriaceae genus could help in constructing the data base and algorithms used in routine laboratory practice.
Macrophage Phenotype in Induced Sputum in Asthma Subjects
Authors: Hermanowicz-Salamon Joanna , Domagała-Kulawik Joanna , Maskey-Warzęchowska Marta , Chazan Ryszarda
Published: June 2022

Macrophages represent the most predominant immune effector cells in the alveolar spaces and conducting airways and are known to express activated phenotype. The study was aimed at assessing the differences in cellular profile and the expression of selected surface markers on sputum macrophages in asthma and healthy subjects. 17 healthy subjects (never smoked) and 10 mild asthma subjects treated with glucocorticosteroids were enrolled into the study. For macrophage phenotyping a immunocytochemistry method was used with commercially available antibodies anti: CD14, CD71, CD11b and CD54. The nonparametric Mann Whitney U test was applied for data comparison, p value < 0.05 being regarded as significant. The total number of cells were increased in asthma patients 4.81 ± 5.27 × 106/ml vs. healthy 2.8 ± 2.15 × 106/ml and it was statistically significant. Statistically significant increase in the percentage of eosinophils was observed in mild asthma subjects. No differences were found between the proportion in macrophages and lymphocytes. The macrophage phenothype in induced sputum differed in both groups. The expression of CD 11b was higher in asthma group and the difference was statistically significant. The proportion of macrophages with the expression of CD 14, CD 71 and CD54 was comparable in both groups. Macrophage phenotyping during glucocorticosteroid therapy is useful in the assessment of inflammatory process in asthma subject.
Diagnosis of Tuberculous Lymphadenitis Based on the Fine Needle Aspiration Samples Analysis
Authors: Fangrat Adam , Domagała-Kulawik Joanna , Krenke Rafał , Safianowska Aleksandra , Walkiewicz Renata , Chazan Ryszarda
Published: June 2022

Tuberculous lymphadenitis is one of the most common extrapulmonary manifestations of tuberculosis. The most common lymph nodes involved are in the cervical region. Lymphadenitis due to M. tuberculosis generally presents with enlarging neck lymph nodes over weeks or months associated with fever, weight loss and fatigue. Fine needle aspiration (FNA) of affected lymph nodes has been shown to yield a high sensitivity and specificity in the diagnosis of tuberculous lymphadenitis. Specimens should be examined cytologically, as well as by AFB smear and cultures. The time between the onset of symptoms, clinical presentation and final diagnosis is often too long. We present a case of 60 years old man with tuberculous lymphadenitis, initially suspected of lymphoproliferative disease.
Interstitial Pneumonia Connected with Rituximab Therapy—Case Report
Authors: Wyrostkiewicz Dorota , Skorupa Wojciech , Barańska Inga , Kuś Jan
Published: June 2022

Rituximab (RTX) is a monoclonal antibody against the CD20 antigen found on the surface of B cells. RTX causes cell lysis and is therefore used to treat lymphomas, leukaemias, transplant rejection and certain autoimmune disorders. Pulmonary adverse events associated with RTX have been reported in literature. We describe a patient with follicular lymphoma treated with R-CHOP scheme (rituximab, cyclophosphamide, doxorubicin, vincri- stine, prednisone) who had pulmonary symptoms during chemotherapy which were diagnosed as rituximab-induced interstitial pneumonia. Symptoms and radiological changes resolved with prednisone therapy.
The Application of MDCT in the Diagnosis of Chest Trauma
Authors: Błasińska-Przerwa Katarzyna , Pacho Ryszard , Bestry Iwona
Published: June 2022

Wstęp: Urazy stanowią główną przyczynę zgonów pacjentów do 40. rż., trzecią pod względem częstości występowania na świecie, po chorobach układu krążenia i nowotworach. Współczesna diagnostyka obrazowa urazów klatki piersiowej wykorzystuje klasyczne zdjęcia rentgenowskie (RTG), wielorzędową tomografię komputerową (WTK), badanie USG przez ścianę klatki piersiowej, USG przezprzełykową, angiografię RTG i rezonans magnetyczny. Celem pracy była ocena wskazań do wielorzędowej tomografii komputerowej (WTK) u chorych po urazie klatki piersiowej oraz ocena przydatności tej metody w ocenie uszkodzeń urazowych. Materiał i Metody: 60 chorych z urazem klatki piersiowej diagnozowanych w Zakładzie Radiologii IGiChP w Warszawie w okresie od maja 2004 roku października 2007 roku miało wykonane WTK klatki piersiowej. Wyodrębniono dwie grupy zależne od typu urazu — tępego albo drążącego, analizowano uszkodzenia urazowe w grupach oraz zbadano zależność poszczególnych obrażeń od rodzaju urazu. U 30 pacjentów porównano wykrywalność 20 wybranych typów obrażeń w RTG i WTK. Przeanalizowano zgodność wyników WTK z rozpoznaniem śródoperacyjnym i bronchoskopią oraz wpływ wyniku WTK na leczenie. Wyniki: Uraz tępy w wywiadzie stwierdzono u 51 chorych (grupa 1), uraz drążący u 9 (grupa 2). U chorych z grupy 1 stwierdzono istotnie częściej stłuczenie płuca i złamania żeber, w grupie 2 — krwiak osierdzia. Przyjmując wynik WTK jako punkt odniesienia czułość i swoistość RTG w badanej grupie chorych wynosiła odpowiednio 66.7% i 58%. Zmianę postępowania leczniczego na podstawie wyników WTK wykazano u 83.3% pacjentów. Czułość i swoistość badania WTK w ocenie uszkodzenia dróg oddechowych, w odniesieniu do bronchoskopii wynosiła: 72.7% i 100%. Zgodność wyników WTK z oceną śródoperacyjną wyniosła 43%, a wiodącą przyczyną niezgodności był brak rozpoznania uszkodzenia przepony w badaniu WTK. Wnioski: WTK jest cenną metodą obrazową w diagnostyce urazów klatki piersiowej, o wysokiej czułości i swoistości w wykrywaniu zagrażających życiu obrażeń, także w ocenie uszkodzeń tchawicy i oskrzeli. Wartość diagnostyczna RTG była niska. Wykazano zgodność WTK z oceną śródoperacyjną, za wyjątkiem przypadków uszkodzeń przepony i rozerwania płuca. W przedstawianym materiale WTK zmieniła postępowanie lecznicze u 83% badanych pacjentów.