Katarzyna Gorska

Publications (3)6.28 Total impact

• Article: Airway dimensions in asthma and COPD in high resolution computed tomography: can we see the difference?

  Justyna Kosciuch, Rafal Krenke, Katarzyna Gorska, Malgorzata Zukowska, Marta Maskey-Warzechowska, Ryszarda Chazan
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  ABSTRACT: Background:Airway remodeling in asthma and COPD results in bronchial wall thickening. The thickness of the bronchial wall can be measured in high resolution computed tomography (HRCT). The objectives of the study were: 1) to assess the bronchial luminal and wall dimensions in asthma and COPD patients in relation to the disease severity, and 2) to compare the airway dimensions in patients with asthma and COPD.Material and Methods:10 asthma patients and 12 COPD patients with stable, mild to moderate disease were investigated. All patients underwent chest HRCT (window level - 450 HU, window width 1500 HU). Cross-sections of bronchi (external diameter 1.0-5.0 mm) were identified on enlarged images; the following variables were measured: external (D) and internal diameter (L), wall area (WA), lumen area (A(L)), total airway area (AO), WA% - the percentage of airway wall area, wall thickness (WT) and WT/D ratio. Separate sub-analyses were performed for airways with D ≤ 2.0 mm and D > 2.0 mm.Results:261 and 348 cross-sections of small airways were measured in patients with asthma and COPD, respectively. There was a significant difference in WT and WA which were both greater in asthmatics than in COPD patients. In bronchi with D > 2.0 mm all measured parameters were significantly higher in asthma than COPD. In individual asthmatics the airway wall thickness was similar in all the assessed bronchi, while in COPD it was related to the external airway diameter.Conclusions:Our results indicate that bronchial walls are thicker in asthmatics than in patients with COPD. It seems that airway wall thickness and the luminal diameter in patients with asthma are related to disease severity. There is no such a relationship in COPD patients.HRCT may be a useful tool in the assessment of airway structure in obstructive lung disease.
  Respiratory care 01/2013; · 2.01 Impact Factor
• Article: Comparison of airway wall remodeling in asthma and COPD: biopsy findings.

  Justyna Kosciuch, Rafal Krenke, Katarzyna Gorska, Wojciech Baran, Marek Kujawa, Katarzyna Hildebrand, Ryszarda Chazan
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  ABSTRACT: Bronchial remodeling is currently known to affect not only patients with asthma, but also COPD patients. Some studies have demonstrated that basement membrane thickening and destruction of the bronchial epithelium are also found in COPD. The aim of the study was to compare the basement membrane thickness (BMT) and epithelial damage in biopsy specimens from patients with asthma and COPD. The study was performed in 20 subjects with asthma and 12 subjects with COPD, who had not been treated with corticosteroids for at least 3 months before study enrollment. Subjects' characteristics were based on the results of clinical assessment, allergic skin-prick tests, lung function testing, and methacholine bronchial challenge. All subjects underwent bronchoscopy with forceps biopsies of bronchial mucosa. Light-microscope and semi-automatic software were used to measure BMT in hematoxylin-eosin stained sections. Total (denudation) and partial epithelial damage were assessed independently by 2 pathologists. The mean BMT in subjects with asthma was 12.54 ± 2.8 μm, and only 7.81 ± 2.0 μm in COPD patients (P < .001). Overall percentage of the basement membrane length lined with damaged epithelium was 45 ± 20% in the asthma group and 47 ± 22% in the COPD group (difference not significant). Complete and partial epithelial damage did not differ between the groups. BMT might be a histopathological parameter helpful in distinguishing asthma and COPD patients, whereas the extent and pattern of epithelial damage is not.
  Respiratory care 10/2011; 57(4):557-64. · 2.01 Impact Factor
• Article: Continuous Positive Airway Pressure Treatment Increases Bronchial Reactivity in Obstructive Sleep Apnea Patients.

  Piotr Korczynski, Katarzyna Gorska, Tadeusz Przybylowski, Piotr Bielicki, Jan Zielinski, Ryszarda Chazan
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  ABSTRACT: Background: The effects of continuous positive airway pressure (CPAP) treatment on the function of the lower airways are poorly understood. One of the methods used to determine the influence of positive pressure breathing on lower airways is the bronchial hyperreactivity test. Some authors report that CPAP increases bronchial hyperreactivity, while others report decreases. Objectives: To assess the influence of CPAP treatment on bronchial reactivity and the effects of bronchial hyperreactivity on compliance to CPAP treatment. Methods: The study group consisted of 101 obstructive sleep apnea syndrome patients (88 men and 13 women) with a mean age of 51 ± 11 years, mean apnea-hypopnea index of 53 ± 20 and mean body mass index of 32.6 ± 5.4. Patients were randomly assigned to a treatment group that received 3 weeks of CPAP therapy (group 1) or to a nontreatment control group (group 2). Pulmonary function tests and the methacholine bronchial provocation test were performed at baseline and 3 weeks later. Results: There were no statistically significant differences between treated and control groups in anthropometry and polysomnography variables. At baseline, bronchial hyperreactivity was found in 6 patients from group 1 and 5 patients from group 2. A significant increase in bronchial reactivity was observed after CPAP treatment. Log PC(20)M decreased from 1.38 ± 0.30 at baseline to 1.26 ± 0.50 (p < 0.05). In group 2, changes were statistically insignificant. Patients with bronchial hyperreactivity during CPAP treatment were characterized by significantly lower FEV(1), FVC and MEF(50) values. Conclusions: CPAP produces statistically significant bronchial hyperreactivity. However, there were no clinical symptoms and it is not necessary to withdraw previous therapies.
  Respiration 04/2009; 78(4):404-410. · 2.26 Impact Factor