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ABSTRACT: Aim of the study was to determine the role of perfusion chest computed tomography (pCT) in evaluation of pulmonary diabetic angiopathy.
18 never-smoking patients (10 diabetic patients and 8 healthy controls) underwent chest high resolution CT (HRCT) and then pCT scanning. In both groups, blood tests, biochemical analysis, fibrinogen, HbA(1c), spirometry, diffusion capacity for carbon monoxide (DLCO) and body pletysmography were performed.Following parameters of pulmonary perfusion have been analysed: blood volume (BV), blood flow (BF), mean transit time (MTT), time to peak (TTP) and permeability surface (PS).
there were no statistically significant differences between groups in terms of age, sex, BMI, forced expiratory volume in one second (FEV(1)), DLCO. Chest HRCT revealed no pathologies. Significantly higher values of chest pCT for BF (p=0.05), BV (p=0.05) and PS (p=0.01) have been found in diabetics in comparison to controls. No differences were found in MTT.
significant increase of perfusion parameters in diabetes seems to confirm pulmonary microangiopathy. The results indicate that further studies on application of pCT in diabetic patients may be beneficial for better understanding of lung microangiopathy, its diagnosing and monitoring.
Diabetes research and clinical practice 01/2011; 91(1):80-6. · 2.16 Impact Factor
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ABSTRACT: In some cases it is difficult to define an etiology of lung tumour in the other way than thoracotomy. In these diagnostic difficulties patients with tuberculous tumour are also involved. The aim of the present study was to define if A60-ELISA test, a new valuable tool in the diagnosis of tuberculosis, might be useful in the differential diagnosing of lung tumours. The levels of IgG antibodies against A60 antigen of mycobacteria was measured with the use of the ELISA test. 228 persons were enrolled into the study: 58 healthy controls (Group I), 26 nonmalignant and nontuberculous patients (Group II), 56 patients with the diagnosis of pulmonary tuberculosis bacteriologically confirmed (Group III), 54 pulmonary tuberculosis patients culture negative (Group IV), 16 patients with lung tumour, without histologic diagnosis before thoracotomy (Group V) and 18 patients with defined diagnosis of lung cancer (Group VI). By using 200 U/ml as a cut-off point the test was positive in: 2/58 subjects from Group I, 2/26 from Group II, 44/56 from Group III, 31/54 from Group IV, 3/16 from Group V and 0/18 from Group VI. In three patients from group V having positive result of A60-ELISA test pulmonary tuberculosis was diagnosed when the thoracotomy was performed. We conclude that the new, simple, noninvasive and inexpensive A60-ELISA test migt be the useful tool in the differential diagnosing of lung tumours because of its good sensitivity and specificity in pulmonary tuberculosis. We also consider that in lung tumour patients with the positive result of this test the prophylactic antituberculosis treatment have to be ordered before planned thoracotomy.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 02/2000; 7(43):31-3.
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ABSTRACT: Recent studies indicate clinical value of intra-venous to oral switch therapy. The aim of this study was to analyze our results i.v. Cefotaxime to oral Cefetamet Piroxil switch therapy in lower respiratory tract infections. Group consists 35 patients in whom 27 has bacterial pathogen definitely established. Cefotaxim (Tarcefoksym-Polfa) i.v. has been used for 3-4 days followed with oral Cefetamet Pivoxil (Tarcevis-Polfa). Patients has been treated for 7 days in hospital and then as an out-patients afterwards. Excelent result has been observed in 27 cases (77% of the study group). Mild symptoms of medication intolerance has been observed in 8 patients (23% of all patients). Results of our experience with third generation cefalosporin i.v. to oral switch therapy are satisfactory. This method reduced total cost of treatment, reduced in-hospital days and was very well accepted by patients.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 10/1999; 7(39):99-101.
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ABSTRACT: The majority of community acquired pneumonia patients are treated by family doctors, most frequently in empiric way, what delays the treatment when a choice of antibiotic is not proper. In this case the resistance to the antibiotics of the bacteria can occurred and there is more often the necessity of patient admission to the hospital. The aim of the study was to analyse retrospectively the treatment of mycoplasmal pneumonia patients. The material consisted of consecutive 27 patients (17 females and 10 males; average age 31.9 yrs.) treated in the Pneumonology Department of Medical University of Gdańsk in the period from 1995 to 1997 year because of mycoplasmal pneumonia. The etiologic diagnosis was defined first of all on the base of serologic test, measuring the complement-fixing antibodies, beside clinical data. The retrospective analysis revealed that all patients had been admitted to the hospital after previous not effective anti-bacterial or anti-viral treatment as out-patient. At the admission no patients had the temperature exceeding 38 degrees C, myalgia and headache occurred in 44% and 40.7% of patients respectively, splenomegaly was reported in 4 patients. In chest roentgenograms pulmonary infiltrations were observed in all patients, most frequently unilaterally (68% of pts.), in 29% of patients complicated by pleural effusion. The titers of complement-fixing antibodies against Mycoplasma pneumoniae antigen ranged from 1:245 to 1:2000. In the treatment most frequently (70.3% of cases) doxycycline in monotherapy was used. Eight patients were treated with doxycycline together with erythromycine. In 33.3% patients the antimycoplasmal treatment was ordered only on the base of clinical data. The period of hospitalisation ranged from 18 to 34 days, on an average 24 days. CONCLUSION: In case of mild community acquired pneumonias with not defined ethiology, if the initial antibacterial or antiviral treatment is not effective, tetracyclines or/and erythromycine should be ordered without the necessity to confirm the diagnosis of mycoplasamal pneumoniae with the serological test.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 10/1999; 7(39):102-4.
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ABSTRACT: Serological tests available for diagnosis of tuberculosis can provide the valuable informations about host immune response to the mycobacterial infection. The aim of our study was to assess the correlation between clinical, radiological and bacteriological state of pulmonary tuberculosis patients and the serum concentration of IgG antibodies against A60 antigen of Mycobacterium bovis BCG. 110 active pulmonary tuberculosis patients--56 culture positive and 54 culture negative--were involved into the study. In all patients serum level of IgG ati-A60 antibodies was measured with the use of A60-ELISA test. We found that bacteriologically confirmed pulmonary tuberculosis is associated with higher serum level of anti-A60 antibodies. Our study also showed the significantly higher levels of anti-A60 IgG in patients with cavitary and more progressive forms of this disease. We conclude that the greater antigenic challenge in progressive forms of pulmonary tuberculosis stimulates more expressed antibody response.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/1999; 67(1-2):28-37.
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ABSTRACT: 32 year-old patient was hospitalized because of disseminated lung lesions. 2 years earlier he manifested chorioditis. Exact disease history suggested suspicion of toxocare infection. The diagnosis was confirmed by serological tests with anti-Toxocara canis antibodies, bronchial lavage and chest CT scan. Administration of 450 mg of dietylokarbamasin (Hetrazan) resulted in complete resolution of pulmonary lesions.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/1999; 67(11-12):554-7.
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ABSTRACT: Cigarette smoking by teenagers is conditioned by many factors with psychosocial ones among them. The aim of our study was to define the reasons for cigarette smoking by juveniles in Poland nowadays. The analysis was performed on the basis of questionnaire given to 598 school pupils resting in the summer camps in the Tricity of three neighbouring towns of Gdańsk, Sopot and Gdynia. The study group included 357 females and 241 males, with an age of 8-19 years, on average 14.4. Out of the hole group 111 (18.6%) were smokers. This subgroup, 58 boys and 53 girls (age: 12-19 yrs.; on average 15.4), answered to several questions concerning cigarette smoking. Among remaining 487 non-smokers the prevalence of cigarette smoking among their parents was only assessed. As the main reason for smoking the majority (69.4%) of smokers reported the stress reduction. Pleasure was another frequently reported (29.7%) reason for cigarette smoking. Peers smoking was an important reason for cigarette smoking for 28.8% of school pupils. We found that the example of smoking parents significantly influenced the prevalence of smoking cigarettes among teenagers. The majority (73.9%) of smoking pupils knew the cigarette were harmful. Obtained results show the multiplicity of reasons for cigarette smoking by juveniles resulting mainly from psychosocial factors. There is a great necessity of antismoking programs for school pupils adjusted to specificity of psychology of adolescence as well as the exemplary role of adults creating a life style without cigarette.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/1999; 67(11-12):511-7.
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ABSTRACT: Asthma is a chronic inflammatory disorder of airways. It is characterised by bronchoconstriction, oedema and airways mucus hypersecretion. The main clinical features of asthma are dyspnea, cough, wheezing and heaviness in the chest. The pathology of asthma is characterised by presence of many inflammatory mediators, where the most important are cysteinyl leukotriens. Leukotriens C4, D4 and E4 are 1000 times more potent than histamine in contracting airways smooth muscles. Inhibitors of arachidonic acid metabolism have been used in asthma treatment. They can block the 5-lipoxygenase enzyme and/or 5-lipoxygenase-activating-proteine (FLAP), or can block the cysteinyl leukotriene receptors on the cell surface. Many inhibitors of arachidonic acid metabolism have been found during experimental trials. But only two are used as a drugs: zafirlukast and montelukast (leukotriene receptor inhibitors) montelukast and zileuton (5-lipoxygenase inhibitors) having the best efficacy in asthma treatment. Chronic treatment with these drugs results in a decrease of asthmatic symptoms, improvement of lung function (FEV1, PEF) and decreased usage of other medications--beta-adrenergic agonists and inhaled steroids. It has been proved that zafirlukast and zileuton show the high efficacy in mild-to-moderate asthma, exercise-induced asthma, allergen-induced asthma and aspirin-induced asthma. These oral drugs have been shown to course only mild adverse effects (such as temporary elevation in liver function tests, gastrointestinel disturbances, headache). Clinical usage of zafirlukast, montelukast and zileuton is limited in our country, they are hardly approachable on the market and the cost of treatment is high.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 01/1999; 5(30):317-20.
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ABSTRACT: A measurement of antimycobacterial antibodies levels provides important informations about infection with tubercle bacilli and the development of tuberculosis. A tuberculin test as a manifestation of cellular immunity, has lost in diagnostic value. The aim of the present study was to assess the correlation between the level of IgG antibodies against A60 antigen of Mycobacterium bovis BCG and tuberculin reactivity. 213 persons were involved into the study: 104 subjects without history of tuberculosis in the past (Group I) and 109 active pulmonary tuberculosis patients (Group II)--56 culture positive patients and 53 culture negative patients. In all subjects the A60-ELISA test with the use of Immune kit was performed. All subjects were also tuberculin tested by the Mantoux technique using 2 units of tuberculin Rt23. We found that the levels of anti-60 antibodies in patients with active pulmonary tuberculosis were significantly higher than in controls (median value 43 U/ml and 237.5 U/ml respectively; p = 0.0001). We observed 47.1% and 74.3% tuberculin positive subjects in Group I and Group II respectively. We did not find relationship between the level of IgG anti-A60 antibodies and tuberculin reactivity in tuberculin-positive and tuberculin-negative subjects both in controls and active pulmonary tuberculosis patients. We conclude: 1. There is no correlation between A60-ELISA results and tuberculin reaction status. 2. The serological test can better than tuberculin test differentiate subjects with non-active tuberculous infection from active disease.
Polskie archiwum medycyny wewnȩtrznej 12/1998; 100(5):426-30. · 1.37 Impact Factor
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ABSTRACT: The purpose of the study was to evaluate prevalence of COPD in sea-port workers who has been employed with handling phosphoric compounds, sulphur compounds and grain. Smoking habits has been also analysed. Study group consists of 238 persons working in Gdańsk sea-port. Protocol of the study has included: medical history, detailed description of work place, smoking habit analysis and spirometric study. As a spirometric parameters FEV1, FVC, FEV1%VC, PEF, MEF25%VC, MEF50%VC and MEF75%VC has been assessed. In study group 106 persons worked with phosphoric compounds handling, 42 persons with sulphuric compounds handling and 90 persons with grain handling. COPD had been diagnosed in 55 persons--43 smokers and 12 non-smokers. Mean values of FEV1% in groups with equal 10-20 years time-work has been compared. Typical COPD features has been present in 37 persons--25 smokers and 12 non-smokers. COPD has been defined based on medical history, physical examination and no response o FEV1 after bronchodilatator application (Berodual). CONCLUSION: Smoking habits in Gdańsk sea-port workers has been more important factor in COPD development than work place toxicities.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 06/1998; 4(23):238-40.
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Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/1998; 66(11-12):568-73.
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ABSTRACT: A case of eosinophilic granuloma of the lung in a 24 years old male is presented. The initial manifestations were hemoptysis and cough. During hospitalization the bronchoscopy was performed, which revealed granuloma in the right bronchus. Computer tomography showed tumour in the right bronchus, without pulmonary changes characteristic for histiocytosis X. The granuloma was removed by bronchoscopy, but control examination performed after three months showed the residue. Once again residual tumor was removed by bronchoscopy and oral steroids were ordered. Unfortunately the next local residue was observed and the residual tumour was finally removed by thoracotomy. Now patient is free of symptoms.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/1998; 66(7-8):422-5.
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ABSTRACT: The polymerase chain reaction (PCR) and direct culture were applied for detection of Mycobacterium tuberculosis complex in samples obtained from patients with suspicion of pulmonary and extra-pulmonary tuberculosis. In the reaction of amplification IS6110 was applied as a target region, and PCR reaction products were of the size of 123 bp and 317 bp. A total of 278 samples (158 sputum, 36 urine, 25 pleural effusion, 23 bronchial washings, 8 blood, 4 stomach washings, 3 cerebrospinal fluid, 2 fragments of skin, 2 pleural effusion, and 17 others samples) from 181 patients were tested. Mycobacterium tuberculosis complex was detected by PCR in 144 out of 278 samples and by culture in 68 of 278 samples. The PCR test enabled a rapid and sensitive diagnosis particularly in a number of samples which were negative on culture.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/1998; 66(1-2):31-7.
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ABSTRACT: A was reported case of binocular blindness associated with small cell lung cancer. Most probably this complication was a clinical manifestation of the paraneoplastic syndrome. No tumor response was induced with chemotherapy and patient died due to tumor progression.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/1998; 66(1-2):94-7.
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ABSTRACT: At the beginning of 80-ties new system BACTEC for mycobacteria culture has been introduced. So time of this culture has been shortened to 1-3 weeks. At the end 80-ties Polymerase Chain Reaction (PCR) technique was started and at present it is used in many laboratories in order to get information about genetic material of mycobacteria in different biological samples. Most often insertive factor IS 6110, located in chromosome Myc. tub. complex, is used. DNA amplification occurs in three stages: 1) DNA denaturation. 2) addition of starters (primers): 3) elongation of starter with d NTP synthesis. PCR technique identifies genetic material (DNA) of mycobacterium which is presented in a given biological sample. Positive PCR result not necessarily means that active disease takes place.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 11/1997; 3(16):206-7.
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ABSTRACT: The aim of this study was to assess the occurrence of non-sporeforming anaerobes in bronchoalveolar lavage in patients with pneumonia coexisting with lung cancer. Material consisted of 40 patients with lung cancer. Bronchoalveolar lavage was performed before administration of antimicrobial treatment and obtained material was cultivated in anaerobic and aerobic conditions. Quantitative assessment of anaerobic bacteria and their susceptibility to common antimicrobial agents were also performed. Peptostreptococcus, Prevotella, Fusobacterium and Bacteroides were the most common anaerobes. Among aerobic bacteria, the most frequent were G-negative bacilli. G-negative anaerobes were susceptible to most tested agents, whereas G-positive rods were resistant to metronidazole and tinidazole. This study demonstrates presence of non-sporeforming anaerobic bacteria in lower respiratory tract infections accompanying lung cancer.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/1997; 65(9-10):643-8.
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ABSTRACT: The serum levels of cytokeratin-19 were measured in 116 patients--96 with NSCLC and 20 with non-malignant lung diseases. The reference group consisted of 60 healthy volunteers--30 smokers and 30 non-smokers. Significantly elevated Cyfra 21-1 values were observed in NSCLC. There was not a correlation between of cytokeratin-19 serum levels and histologic types of lung carcinoma. Cyfra 21-1 concentrations generally increased with stage of diseases and the highest were in patients with evidence of distant metastases. In NSCLC, the distribution of Cyfra 21-1 varied significantly according to the performance status of NSCLC patients.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc 02/1995; 63(11-12):615-20.
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ABSTRACT: In a group of 20 patients with active pulmonary sarcoidosis and in 20 healthy subjects, serum levels were determined of angiotensin I converting enzyme, immunoglobulins, and of the third and fourth complement components. An increased level of IgG and IgM was found in patients with sarcoidosis, as compared with the control group. High ACE levels were observed in the second and third phase of the disease. A tendency was also observed for simultaneous increase of IgG and ACE levels in patients with sarcoidosis.
Wiadomości lekarskie (Warsaw, Poland: 1960) 01/1993; 45(23-24):887-9.
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Polski tygodnik lekarski (Warsaw, Poland: 1960) 02/1988; 43(2):50-1.
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ABSTRACT: A group of 153 patients with scintigraphically detected autonomic "hot" nodules of the thyroid has been subjected to clinical and histopathological analysis. Substantial part of these patients (30.1%) had hyperthyroidism, partly (in 19.9% of cases) in the form of the thyrocardiac syndrome. A most frequent histopathological lesion found within "hot" nodules was follicular adenoma. The occurrence of malignancy in the form of highly differentiated thyroid carcinoma was observed in 2.6% of cases. The incidence of thyroid carcinoma within "hot" nodules was in our material only two and half times smaller than in a previously analyzed group of patients with "cold" nodules of the thyroid.
Endokrynologia Polska 02/1988; 39(6):301-7. · 1.24 Impact Factor
