Advances in Respiratory Medicine

149 KiB

Open AccessEditorial

Pierwsza Polsko-Francuska Konferencja Pneumonologiczna, Poznań, 2 Grudnia 2006 r.

by Jan Zieliński

Adv. Respir. Med. 2007, 75(1), 111; https://doi.org/10.5603/ARM.28014 - 13 Apr 2007

Viewed by 213

W sobotę, 2 grudnia 2006 r. odbyła się w Poznaniu pierwsza polsko-francuska konferencja szkoleniowa w dziedzinie pneumonologii [...] Full article

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Open AccessEditorial

Wspomnienie o Profesorze Antonim Koziorowskim, Kierowniku Zakładu Fizjopatologii Oddychania Instytutu Gruźlicy i Chorób Płuc

by Janusz Kowalski and Leszek Radwan

Adv. Respir. Med. 2007, 75(1), 108-110; https://doi.org/10.5603/ARM.28013 - 13 Apr 2007

Viewed by 259

Abstract

Antoni Koziorowski urodził się 13 czerwca 1924 roku w Warszawie [...] Full article

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Open AccessCase Report

Cardiac Sarcoidosis—Own Experiences

by Magdalena Martusewicz-Boros, Elżbieta Wiatr, Dorota Piotrowska-Kownacka, Witold Tomkowski and Kazimierz Roszkowski-Śliż

Adv. Respir. Med. 2007, 75(1), 100-107; https://doi.org/10.5603/ARM.28010 - 13 Apr 2007

Viewed by 235

Abstract

Cardiac involvement in sarcoidosis may be incidentally discovered without any symptoms of the disease. When undiagnosed and untreated it is potentially fatal. Although there is no recommended strategy for the diagnosis, the introduction of newer technology is promising and may be useful for [...] Read more.

Cardiac involvement in sarcoidosis may be incidentally discovered without any symptoms of the disease. When undiagnosed and untreated it is potentially fatal. Although there is no recommended strategy for the diagnosis, the introduction of newer technology is promising and may be useful for early diagnosis of sarcoid heart disease and for the evaluation of response to therapy. We present a case of 53-years old woman, with asymptomatic cardiac arrhythmias and x-ray chest picture changes without any respiratory symptoms. Further assessment and the use of cardiac magnetic resonance imaging allowed a diagnosis of cardiac sarcoidosis to be made. Full article

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Open AccessCase Report

Unusual Cause of Right Heart Failure Decompensation in 21-Years Old Patient with Idiopathic Pulmonary Arterial Hypertension—A Case Report

by Michał Florczyk, Anna Stawecka-Pawełczyk, Marcin Kurzyna, Anna Fijałkowska, Janusz Burakowska, Joanna Żyłkowska, Monika Szturmowicz, Liliana Wawrzyńska, Witold Tomkowski and Adam Torbicki

Adv. Respir. Med. 2007, 75(1), 95-99; https://doi.org/10.5603/ARM.28009 - 13 Apr 2007

Viewed by 278

Abstract

The authors describe a case of 21-years old woman with idiopathic pulmonary arterial hypertension with atypical clinical consequences of massive internal bleeding. Despite significant hypovolemia clinical and laboratory presentation was one of RV failure with dilatation of right heart ventricle and increased plasma [...] Read more.

The authors describe a case of 21-years old woman with idiopathic pulmonary arterial hypertension with atypical clinical consequences of massive internal bleeding. Despite significant hypovolemia clinical and laboratory presentation was one of RV failure with dilatation of right heart ventricle and increased plasma level of markers of myocardial stretch and injury (NT-proBNP and troponin, respectively). This is attributed to impaired right ventricular coronary perfusion and hypoxia. Intensive treatment restored baseline RV conditions and at 15 months follow-up no persistent right heart impairment was observed. This case demonstrates that bleeding should be also considered in differential diagnosis of exacerbation of right ventricular failure in patients with pulmonary arterial hypertension. Full article

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Open AccessGuidelines

Small-Cell Lung Cancer Diagnostic and Therapeutic Recommendations of Polish Lung Cancer Group

by Maciej Krzakowski, Tadeusz Orłowski, Kazimierz Roszkowski, Marian Reinfuss, Włodzimierz Olszewski, Rodryg Ramlau, Dariusz Kowalski, Krzysztof Konopa, Jacek Jassem, Renata Jankowska, Jerzy Kozielski, Marek Wojtukiewicz, Kazimierz Drosik and Piotr Koralewski

Adv. Respir. Med. 2007, 75(1), 88-94; https://doi.org/10.5603/ARM.28015 - 13 Apr 2007

Viewed by 359

Abstract

Small-cell lung cancer is characterized by an aggressive clinical course with high tendency for early dissemination. At presentation, patients are usually symptomatic and with hilar or mediastinal mass at radiography. Staging should be focused on identifying any evidence of distant spread. Chemotherapy including [...] Read more.

Small-cell lung cancer is characterized by an aggressive clinical course with high tendency for early dissemination. At presentation, patients are usually symptomatic and with hilar or mediastinal mass at radiography. Staging should be focused on identifying any evidence of distant spread. Chemotherapy including cisplatin and etoposide is a cornerstone of treatment for all patients. Limited-stage disease should be managed by chemotherapy combined with concurrent chest irradiation. All patients who achieve complete response should be considered for elective cranial irradiation. Surgical treatment may be used in highly selected patients with TNM stage I disease, and surgery should always be combined with chemotherapy. Extensive-stage disease should be managed by multi-agent chemotherapy alone. Long-term survivorus should undergo careful monitoring for development of a second primary tumour. Full article

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Open AccessReview

Optoelectronic Plethysmography—A New Technic to Measure Changes of Chest Wall Volume

by Agnieszka Skoczylas and Paweł Śliwiński

Adv. Respir. Med. 2007, 75(1), 81-87; https://doi.org/10.5603/ARM.28012 - 13 Apr 2007

Viewed by 307

Abstract

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 [...] Read more.

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. Full article

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Open AccessReview

The Epidemiology of Lung Cancer

by Monika Kosacka and Renata Jankowska

Adv. Respir. Med. 2007, 75(1), 76-80; https://doi.org/10.5603/ARM.28011 - 13 Apr 2007

Cited by 1 | Viewed by 270

Abstract

Lung cancer is currently most frequently diagnosed neoplasm in males and the fifth most frequent cancer in females. In developed countries only breast cancer is diagnosed more often in women. Worldwide, lung cancer is the most common cause of cancer mortality in males [...] Read more.

Lung cancer is currently most frequently diagnosed neoplasm in males and the fifth most frequent cancer in females. In developed countries only breast cancer is diagnosed more often in women. Worldwide, lung cancer is the most common cause of cancer mortality in males and females. In the Europe lung cancer accounts for 21% of all cancer cases in males and 29% of all cancer deaths. The rapid increase in lung cancer incidence was observed the since beginning of the XX century till 1990–1994. The incidence in males decreased recently, but still increases in females, especially in young women. The changes in frequency of various histological subtypes of lung cancer are observed too. Despite many clinical trials, modern diagnostic techniques and improved supportive care, the prognosis remains unfavourable and long-term survival almost did not change. In Poland the incidence of lung cancer in 2002 was 81.9/100,000 in males and 22.2/100,000 in females. In both genders 1-year and 5-year survivals time are one of the shortest in Europe. Full article

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Open AccessArticle

Quality of Life of Patients with Asthma Which Has Been Well and Poorly Controlled

by Marta Chełmińska, Lidia Werachowska, Marek Niedoszytko, Marceli Bolałek, Amelia Szymanowska, Iwona Damps-Konstańska, Jan Marek Słomiński and Ewa Jassem

Adv. Respir. Med. 2007, 75(1), 70-75; https://doi.org/10.5603/ARM.28008 - 13 Apr 2007

Viewed by 325

Abstract

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 [...] Read more.

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. Full article

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Open AccessArticle

A Comparative Evaluation of Immunohistochemical Markers for the Differential Diagnosis between Malignant Mesothelioma, Non-Small Cell Carcinoma Involving the Pleura, and Benign Reactive Mesothelial Cell Proliferation

by Ewa Szczepulska-Wójcik, Renata Langfort and Kazimierz Roszkowski-Śliż

Adv. Respir. Med. 2007, 75(1), 57-69; https://doi.org/10.5603/ARM.28007 - 13 Apr 2007

Cited by 3 | Viewed by 404

Abstract

Introduction: Histopathological diagnosis of malignant mesothelioma (MM) and differentiating it from tumors infiltrating the pleura is very difficult. Distinguishing benign reactive mesothelial cell proliferation from MM also presents problems. The objective of this study was to evaluate the significance of selected immunohistochemical stains [...] Read more.

Introduction: Histopathological diagnosis of malignant mesothelioma (MM) and differentiating it from tumors infiltrating the pleura is very difficult. Distinguishing benign reactive mesothelial cell proliferation from MM also presents problems. The objective of this study was to evaluate the significance of selected immunohistochemical stains in differentiating MM from non-small cell lung cancers infiltrating the pleura and from benign reactive mesothelial cell proliferation. Material and methods: The material encompassed 86 cases of MM, 54 cases of NSCLC infiltrating the pleura, and 43 cases of benign reactive mesothelial cell proliferation. The MM cases were reclassified according to the WHO criteria (2004): epithelioid, 61 cases (71%), including well-differentiated papillomatous, 3 cases; sarcomatous, 6 cases (6.8%); fibrous, 4 cases (4.7%); biphasic, 15 cases (17.5%). A panel of immunohistochemical stains was used in this study. It included broad-spectrum antibodies to cytokeratins (CKAE1/AE3, CKMNF116), vimentin, epithelial membrane antigen (EMA), mesothelial cells (HBME1, CK5/6, calretinin), adenocarcinoma cells (BerEp4, B72.3, CEA, TTF1), antibodies enabling the assessment of proliferation (Mib1) and cell-cycle regulating proteins (p53). Results: Coexpression of cytokeratins and vimentin was found in 63.9% of MM cases and cell-membrane reactions with EMA were seen in 58.9%. Positive staining for HBME1, CK5/6, calretinin, BerEp4, B72.3, CEA and p53 was obtained in 76.7%, 51.2%, 66.7%, 1.2%, 6.2%, 1.2% and 51% of the cases, respectively. None of the MM cases stained for TTF1. MM by WHO subgroups: Coexpression of cytokeratins and vimentin occurred in 55.7% cases of epithelioid MM, 93.3% of biphasic MM, 66.6% of sarcomatous MM, and in 100% of fibrous MM cases. Positive staining for HBME1, CK5/6, and calretinin was seen only in the epithelioid and mixed subtypes of MM; the respective percentages of positive reactions were: HBME1, 90.2% and 73.3%; CK5/6 58.2% and 53.3%; calretinin, 72% and 75%. Non-small cell lung cancers infiltrating the pleura: Coexpression of cytokeratin and vimentin was found in 17.6% of the cases, positive staining of membranes for EMA, in 13% cases. Positive staining for HBME1 was observed in 22.6% of the cases, for CK5/6, in 9.3%, for calretinin, in 2%, for BerEp4, in 72.2%, for B72.3, in 64.1%, for CEA, in 58.5%, and for TTF1, in 43.8%. Benign reactive mesothelial cell proliferation: Protein p53 was present in 9.3% of cases, whereas no positive staining for EMA was found. Differentiation of MM from non-small cell carcinomas: Among the antibodies used in the study, anti-HBME1 had the highest sensitivity (76.7%) but lowest specificity (77.4%). Staining for calretinin showed high specificity (99.8%), as did CEA and TTF1 (98.8% and 100%), with moderate sensitivity (66.7%, 58.5% and 43.8%, respectively). BerEp4 showed the highest sensitivity (72.2%) and specificity (98.8%). Conclusions: In diagnosing mesothelioma it is necessary to use a panel of immunohistochemical stains, which should contain antibodies to markers for adenocarcinoma and mesothelioma. Due to the high costs of such a study, a two-stage method is advantageous. The best combination of sensitivity and specificity was found for BerEp4, CEA, and TTF1 and for calretinin and HBME1. In the diagnosis of spindle-cell pleural tumors and the fibrous form of MM and benign reactive mesothelial cell proliferation , markers of mesothelial cells are noncontributory. Immunohistochemical staining fails to identify a reactive process, but a diffuse, positive stain for EMA and the presence of protein p53 support the diagnosis of MM. Full article

333 KiB

Open AccessArticle

Influence of Treatment with Continuous Positive Airway Pressure on Respiratory Muscle Function and Physical Fitness in Patients with Obstructive Sleep Apnoea and Overlap Syndrome

by Adam Nowiński, Przemysław Bieleń, Luiza Jonczak and Paweł Śliwiński

Adv. Respir. Med. 2007, 75(1), 46-56; https://doi.org/10.5603/ARM.28006 - 13 Apr 2007

Cited by 2 | Viewed by 318

Abstract

Introduction: The aim of this study was to evaluate the effect of CPAP treatment on respiratory muscle strength and exercise tolerance in patients with obstructive sleep apnoea (OSA) and overlap syndrome (OS). Material and methods: 9 patients with OSA and 9 patients with [...] Read more.

Introduction: The aim of this study was to evaluate the effect of CPAP treatment on respiratory muscle strength and exercise tolerance in patients with obstructive sleep apnoea (OSA) and overlap syndrome (OS). Material and methods: 9 patients with OSA and 9 patients with OS were studied. Respiratory muscle assessment, 6 minute walking distance (6MWD) and cycloergometry exercise test were performed before and after six month period of CPAP treatment. Results: In OSA group exercise tolerance did not change after the treatment. Mean 6MWD was 571.8 ± 76.6 m before and 554.0 ± 125.5 m after treatment, mean W_max was 142 ± 41 W before and 139 ± 38 W after treatment. PI_max in OSA group did not change significantly, 140.4 ± 32.0 cm H₂O before and 155.9 ± 31.5 after treatment (p = 0.14). PE_max improved from 170.5 ± 49.2 cm H₂O, to 199.9 ± 27.6 cm H₂O (p = 0.067). Handgrip force in OSA group improved from 50.5 ± 16.5 kg to 61.0 ± 17.0 kg (left hand) (p = 0.05) and from 53.3 ± 14.2 to 58.9 ± 15.9 (right hand) (p < 0.05). In OS group exercise tolerance improved by 17% after CPAP treatment from W_max = 81 ± 33 W before to 95 ± 38 W after. Mean 6MWD was at the same level before (504 ± 144 m) and after treatment (492 ± 108 m). PI_max in OS group improved from 89.2 ± 35.7 cm H₂O to 106.3 ± 31.4 cm H₂O (p < 0.05). PE_max in OS group did not change significantly, 159.9 ± 45.8 cm H₂O before and 184.2 ± 45.0 cm H₂O after treatment (NS). Handgrip force in OS group improved from 38.1 ± 15.9 kg to 46.9 ± 11.1 kg (left hand) (p < 0.05) and did not change in right hand (44.5 ± 17.7 kg vs. 47.9 ± 10.4 kg) (NS). Data analysis of the whole group (18 pts) showed clear tendency to improve strength of respiratory muscles in patients treated with CPAP. Mean PI_max improved from 123 to 133 cm H₂O (p = 0.006) and PE_max improved from 168.1 to 192 cm H₂O (p = 0.02). Conclusions: CPAP treatment improved strentgh of respiratory and skeletal muscles in patients with OSA and OS and improved exercise tolerance in patients with OS. Full article

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Open AccessArticle

Analysis of Deaths Caused by Obstructive Pulmonary Diseases in Pomerania Province in 2001–2004

by Marek Niedoszytko, Maria Porzezińska, Marta Chełmińska, Marta Gruchała-Niedoszytko, Jakub Łata and Ewa Jassem

Adv. Respir. Med. 2007, 75(1), 40-45; https://doi.org/10.5603/ARM.28005 - 13 Apr 2007

Viewed by 274

Abstract

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 [...] Read more.

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. Full article

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Open AccessArticle

Tuberculosis Caused by XDR Resistant Mycobacterium tuberculosis in Poland. Microbiological and Molecular Analysis

by Ewa Augustynowicz-Kopeć and Zofia Zwolska

Adv. Respir. Med. 2007, 75(1), 32-39; https://doi.org/10.5603/ARM.28004 - 13 Apr 2007

Cited by 1 | Viewed by 276

Abstract

Introduction: The retrospective analysis of frequency of drug resistant tuberculosis XDR (XDR = MDR + resistance to: fluoroquinolones + amikacin and/or capreomycin) in Poland have been tested. Material and methods: Pattern of resistance to first, second and third line drugs has been tested [...] Read more.

Introduction: The retrospective analysis of frequency of drug resistant tuberculosis XDR (XDR = MDR + resistance to: fluoroquinolones + amikacin and/or capreomycin) in Poland have been tested. Material and methods: Pattern of resistance to first, second and third line drugs has been tested among new and treated patients. The total number of 10,913 Mycobacterium tuberculosis strains isolated from the same number of the patients surveyed in 1997–2004 in WHO programme Drug resistance surveillance countrywide study. Results: One HIV-negative patient (43 years old men) was infected by XDR (0.4% among new and treated MDR cases). Molecular analysis of the XDR strain by spoligotyping has been shown the T11558 cluster. Three others tuberculosis patients living in the same region of Poland excreted the Mycobacterium tuberculosis strains belonged to the same T11558 cluster, but they had not pattern of XDR resistance. In the same T11558 molecular cluster 13/15—87% strains have been isolated from polish patients. Conclusions: In Poland Mycobacterium tuberculosis resistance to fluoroquinolones, capreomycin and amikacine among MDR strains has been observed very rarely. Full article

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Open AccessArticle

The Significance of Spoligotyping Method in Epidemiological Investigations of Tuberculosis

by Ewa Augustynowicz-Kopeć, Tomasz Jagielski, Monika Kozińska, Anna Zabost and Zofia Zwolska

Adv. Respir. Med. 2007, 75(1), 22-31; https://doi.org/10.5603/ARM.28003 - 13 Apr 2007

Cited by 4 | Viewed by 316

Abstract

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 [...] Read more.

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. Full article

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Open AccessArticle

Analysis of Occurrence of DRB and DQ Alleles in Sarcoidosis and Tuberculosis from Northern Poland

by Anna Dubaniewicz and Grażyna Moszkowska

Adv. Respir. Med. 2007, 75(1), 13-21; https://doi.org/10.5603/ARM.28002 - 13 Apr 2007

Cited by 1 | Viewed by 322

Abstract

Introduction: Sarcoidosis is a multisystem disorder of unknown etiolgy. Pathologic similarities between SA and tuberculosis (TB) suggest M. tuberculosis antigen(s) as causative agents. It seems likely that in the genetically different predisposed hosts, the same antigen(s) may cause the development of sarcoid or [...] Read more.

Introduction: Sarcoidosis is a multisystem disorder of unknown etiolgy. Pathologic similarities between SA and tuberculosis (TB) suggest M. tuberculosis antigen(s) as causative agents. It seems likely that in the genetically different predisposed hosts, the same antigen(s) may cause the development of sarcoid or tuberculous immune response. Aim: The aim of this study was to compare the frequency of occurrence of HLA class II alleles in SA, TB and in the healthy individuals. Material and methods: To test a difference in haplotypes associated with both diseases, we compared the distribution of DQA1 and DQB1 alleles in 45 SA patients, 62 TB patients and in 143 healthy volunteers, using a PCR-SSP “low (DRB1, DQB1) and high (DQA1) resolution” method. Results: Our results revealed that DRB1*03, DRB1*11, DQB1*02 i DQA1*0501 in Stage I of SA with Löfgren’s syndrom (Ls) and DRB1*15, DQA1*0102, DQA1*0103 in Stage II of SA were more common, whereas DRB1*16, DRB1*04, DRB1*08, DQB1*02, DQB1*03, DQB1*05, DQA1*0102, DQA1*0301 in Ls and DQB1*02, DQB1*03, DQB1*05, DQA1*0102, DQA1*0301 in Stage II were less common than in the controls but after Bonferroni correction occurrence of DRB1*04, DQB1*02, DQB1*03, DQB1*05 and DQA1*0102, DQA1*0301, DQA1*0501 was significantly differ. In TB group, DRB1*16, DRB1*14, DQB1*05 i DQA1*0303 were more frequent and DRB1*11, DQB1*02, DQA1*0201, DQA1*0505 less frequently present as compared to the controls, but after correction DRB1*16, DQB1*02, DQB1*05, DQA1*0303, DQA1*0505 were significantly different. In SA, DRB1*11, DQB1*02 i DQA1*0201, DQA1*0501, DQA1*0505 in Ls and DRB1*15, DRB1*11, DQA1*0102 in Stage II were more common and DRB1*16, DRB1*04, DRB1*14, DQB1*03, DQB1*05, DQB1*06, DQA1*0301, DQA1*0302, DQA1*0303 in Ls and Stage II were less frequent than in the TB group. DQB1*02, DQA1*0501 (Ls) and DRB1*15 (Stage II) were more frequently present in SA than in TB, even after Bonferroni correction. Conclusions: In summary, we identified associations of HLA class II alleles in SA and TB with expression pattern specific and different for each group. In most cases, in SA patients frequency of HLA class II alleles occurrence is opposite to the frequency in TB patients. Full article

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Open AccessArticle

Transbronchial Needle Aspiration as a Diagnostic Method in Lung Cancer and Non-Malignant Mediastinal Adenopathy

by Artur Szlubowski, Jarosław Kużdżał, Jerzy Soja, Ewa Łączyńska, Jolanta Hauer, Piotr Kopiński, Romana Tomaszewska and Marcin Zieliński

Adv. Respir. Med. 2007, 75(1), 5-12; https://doi.org/10.5603/ARM.28001 - 13 Apr 2007

Cited by 1 | Viewed by 358

Abstract

Introduction: The aim of the study was to assess the diagnostic yield of transbronchial needle aspiration (TBNA) in mediastinal or hilar adenopathy in: lung cancer, staging of NSCLC, sarcoidosis and other non-malignant diseases. Material and methods: Transbronchial needle aspiration was performed in 347 [...] Read more.

Introduction: The aim of the study was to assess the diagnostic yield of transbronchial needle aspiration (TBNA) in mediastinal or hilar adenopathy in: lung cancer, staging of NSCLC, sarcoidosis and other non-malignant diseases. Material and methods: Transbronchial needle aspiration was performed in 347 consecutive patients—402 biopsies in groups of lymph nodes: subcarinal (7)—179, all paratracheal (2R, 2L, 4R, 4L)—168 and hilar (10R, 10L)—55, with no real-time imaging guidance, preceded by computed tomography (CT), using 22-gauge needles. All negative results in NSCLC patients were verified by transcervical extended bilateral mediastinal lymphadenectomy (TEMLA) and the remaining patients underwent mediastinoscopy or thoracotomy. Results: TBNA technique was diagnostic in 67.1% of lung cancer patients and in 59.0% of patients with sarcoidosis. In the group of all lung cancer patients specificity was 100%, sensitivity 88.5%, accuracy 91.8% and negative predictive value 77.9% and in diagnosing of lymph nodes involvement in NSCLC was respectively 100%, 86.6%, 90.7% and 76.6%. The high diagnostic yield was comparable for all mediastinal groups. In 80% of NSCLC patients with false negative results of TBNA there was observed partial involvement of metastatic lymph nodes, confirmed by TEMLA. Conclusions: The diagnostic value of TBNA is very high in diagnostics of lung cancer, NSCLC staging and sarcoidosis but much lower in lymphomas, tuberculosis and other non-malignant diseases. Full article

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Open AccessEditorial

POChP—Choroba Zbyt Rzadko Rozpoznawana Nie Tylko we Wczesnym Okresie

by Jan Zieliński

Adv. Respir. Med. 2007, 75(1), 2-4; https://doi.org/10.5603/ARM.28000 - 13 Apr 2007

Viewed by 269

Abstract

Przewlekła obturacyjna choroba płuc (POChP) jest chorobą bardzo rozpowszechnioną [...] Full article

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Open AccessEditorial

Komentarz do Zaleceń Diagnostyczno-Terapeutycznych Polskiej Grupy Raka Płuca

by Kazimierz Roszkowski-Śliż

Adv. Respir. Med. 2007, 75(1), 1; https://doi.org/10.5603/ARM.27999 - 13 Apr 2007

Viewed by 236

Abstract

Wyniki leczenia drobnokomórkowego raka płuca są nadal wysoce niezadowalające, jednak mimo to stanowią przykład postępu dokonującego się w onkologii na przestrzeni ostatnich 3 dekad [...] Full article

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Adv. Respir. Med., Volume 75, Issue 1 (April 2007) – 17 articles , Pages 1-111

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