Advances in Respiratory Medicine

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Open AccessConference Report

VII Ogólnopolska Sesja Naukowa Studenckiego Towarzystwa Naukowego Warszawskiego Uniwersytetu Medycznego “Problemy zapobiegania chorobom płuc” Warszawa, 20 marca 2010 roku

by Marcin Leszczyk, Paulina Miłkowska and Joanna Domagała-Kulawik

Adv. Respir. Med. 2010, 78(4), 310-314; https://doi.org/10.5603/ARM.27724 - 08 Jul 2010

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Abstract

Choroby układu oddechowego są bardzo powszechne, stanowią poważny problem zdrowotny, będąc jedną z głównych przyczyn zgonów [...] Full article

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Open AccessEditorial

Doktor Marian Borsuk—Ordynator Oddziału Chirurgicznego Szpitala Wolskiego (1907–1923)

by Franciszek Grzegorczyk

Adv. Respir. Med. 2010, 78(4), 306-309; https://doi.org/10.5603/ARM.27723 - 08 Jul 2010

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Abstract

Marian Stanisław Borsuk urodził się w 1860 roku w majątku Dowcewicze [...] Full article

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Open AccessCase Report

Sarcoidal Reaction in Lung Adrenocarcinoma in 50-Year Old Man

by Julita Stępień, Joanna Domagała-Kulawik, Radosław Chądzyński, Włodzimierz Kupis and Ryszarda Chazan

Adv. Respir. Med. 2010, 78(4), 302-305; https://doi.org/10.5603/ARM.27721 - 08 Jul 2010

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Abstract

A 50-year old patient was admitted to the hospital with hoarseness persisting for two weeks. Chest computed tomography revealed enlargement of lymph nodes in the aortopulmonary window. The bronchoscopy did not show any abnormalities, in transbronchial fine needle aspiration biopsy no diagnostic material [...] Read more.

A 50-year old patient was admitted to the hospital with hoarseness persisting for two weeks. Chest computed tomography revealed enlargement of lymph nodes in the aortopulmonary window. The bronchoscopy did not show any abnormalities, in transbronchial fine needle aspiration biopsy no diagnostic material was obtained. In the biopsies collected during mediastinoscopy the sarcoid granulomas were recognized. In the follow-up the computed tomography revealed a tumor mass and diagnostic thoracotomy was performed in which pulmonary adenocarcinoma was recognized. After radiotherapy the total regression was achieved. In this case sarcoid-like reaction in the course of lung cancer and the diagnostic difficulties were described. Full article

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Open AccessCase Report

Simultaneous Detection of Tumour Cells and Positive Genetic Test Results for Mycobacterium tuberculosis in Pleural Effusion

by Monika Czystowska, Anna Stokłosa, Ewa Szczepulska-Wójcik, Krystyna Maszkowska-Kopij, Lucyna Opoka, Agnieszka Skoczylas and Dorota Górecka

Adv. Respir. Med. 2010, 78(4), 296-301; https://doi.org/10.5603/ARM.27720 - 08 Jul 2010

Cited by 1 | Viewed by 255

Abstract

Pleural effusion is a frequently observed lesion in the course of respiratory diseases such as inflammatory process and cancer metastasis. Its cause may be either tuberculosis (the most common extrapulmonary location is the pleura) and malignant disease of the pleura. Confirmation of tuberculosis [...] Read more.

Pleural effusion is a frequently observed lesion in the course of respiratory diseases such as inflammatory process and cancer metastasis. Its cause may be either tuberculosis (the most common extrapulmonary location is the pleura) and malignant disease of the pleura. Confirmation of tuberculosis is often troublesome. The primary site of cancer may be als difficult to find despite the application of difficult diagnostic methods. Below we present history of 79-year old female in whom carcinomatous cells and positive result of PCR for Mycobacterium tuberculosis in pleural fluid were discovered simultaneously suggesting the tuberculosis and cancer of unknown primary origin. Full article

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Open AccessReview

Rola zakażeń Chlamydia pneumoniae i Mycoplasma pneumoniae w przebiegu astmy

by Krzysztof Specjalski

Adv. Respir. Med. 2010, 78(4), 284-295; https://doi.org/10.5603/ARM.27722 - 08 Jul 2010

Cited by 2 | Viewed by 265

Abstract

Respiratory infections are one of the major causes of asthma exacerbations. Among numerous pathogens that may lead to exacerbations, particular attention should be paid to atypical bacteria: Chlamydia pneumoniae and Mycoplasma pneumoniae. Despite significant frequency, infections caused by these species are underestimated [...] Read more.

Respiratory infections are one of the major causes of asthma exacerbations. Among numerous pathogens that may lead to exacerbations, particular attention should be paid to atypical bacteria: Chlamydia pneumoniae and Mycoplasma pneumoniae. Despite significant frequency, infections caused by these species are underestimated due to untypical clinical course and lack of easily accessible diagnostic tests. Although acute infection can be easily linked with deterioration of asthma control, the role of respiratory colonisation by Chlamydia pneumoniae or Mycoplasma pneumoniae has not been precisely defined. It is known that serologic signs of both past infection and chronic current infection (IgA) with Chlamydia pneumoniae or Mycoplasma pneumoniae are found more often in asthmatics compared to healthy controls. Besides respiratory colonisation by Chlamydia pneumoniae or Mycoplasma pneumoniae confirmed by culture or molecular tests is also more common in asthmatics. This is particularly relevant in cases of uncontrolled asthma that followed symptoms of respiratory infection. This may lead to the conclusion that atypical infections can play a role in asthma induction in previously healthy individuals as well as deteriorations in the course of the disease. Studies mentioned above have led to the new therapeutic possibility—eradication of Chlamydia pneumoniae. In some of the studies on eradication with macrolides promising results have been gained in terms of asthma control, but in most of the cases improvement was only temporary. Full article

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Open AccessArticle

Cell Phenotype Determines PAI1 Antiproliferative Effect—Suppressed Proliferation of the Lung Cancer but Not Prostate Cancer Cells

by Joanna Chorostowska-Wynimko, Marta Kędzior, Radosław Struniawski, Paulina Jaguś, Ewa Skrzypczak-Jankun and Jerzy Jankun

Adv. Respir. Med. 2010, 78(4), 279-283; https://doi.org/10.5603/ARM.27719 - 08 Jul 2010

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Abstract

Introduction: Plasminogen inhibitor activator type 1 (PAI-1) is an important regulator of tumor growth and metastasis formation acting directly via specific urokinase complexing or indirectly due to its affinity to vitronectin. We have shown previously that PAI-1 modifies angiogenic activity of endothelial [...] Read more.

Introduction: Plasminogen inhibitor activator type 1 (PAI-1) is an important regulator of tumor growth and metastasis formation acting directly via specific urokinase complexing or indirectly due to its affinity to vitronectin. We have shown previously that PAI-1 modifies angiogenic activity of endothelial cells in a dose-dependent manner but also in close relation- ship to the cell phenotype. Present study aimed on evaluating the PAI-1 effect on the proliferative activity of lung cancer cells (A549), prostate cancer cells (DU145) as well as endothelial cells (HUVEC). Results: Mutated PAI-1 (1, 10, 100 μg/mL) characterized by the prolonged antifibrinolytic activity (T_1/2 ~ 7000 h) inhibited proliferation of lung cancer A549 cells in a dose-dependent (p < 0.001) and time-dependent (p < 0.001) manner. No significant effect on the DU145 prostate cancer cells has been observed except of the 72 h cultures with highest PAI-1 concentration (100 μg/mL) (p < 0.001). Proliferative activity of endothelial cells (HUVEC) was affected by 100 μg/mL PAI-1 only, and independent of the culture period (24, 48 and 72 h, p < 0.001). Conclusion: Plasminogen inhibitor activator type 1 modulates cell proliferation via antifibrynolitic mechanizm time- and dose-dependently, however final outcome is strongly affected by the cell phenotype. Full article

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Open AccessArticle

The Influence of Inflammatory Process on the Ventilatory Impairment in Patients with Stable Chronic Obstructive Pulmonary Disease

by Krystyna Komnata

Adv. Respir. Med. 2010, 78(4), 271-278; https://doi.org/10.5603/ARM.27718 - 08 Jul 2010

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Abstract

Introduction: At present, COPD is known to be a systemic disease resulting from generalized inflammation which affects the function of many organs. Generalized inflammation is recognized from increased serum concentration of inflammatory cytokines. The aim of the present study was to investigate [...] Read more.

Introduction: At present, COPD is known to be a systemic disease resulting from generalized inflammation which affects the function of many organs. Generalized inflammation is recognized from increased serum concentration of inflammatory cytokines. The aim of the present study was to investigate the influence of inflammatory process on the respiratory impairment in patients with stable chronic obstructive pulmonary disease. Material and methods: A group of 60 stable COPD patients (GOLD stages I–IV) participated in the study. Inclusion criteria were: confirmed diagnosis of chronic obstructive pulmonary disease, clinical stable state, established treatment which had not been changed for at least 3 months prior to the study or in the course of the study. Exclusion criteria included coexistence of other diseases and/or medication causing an increase of markers of inflammation. In all patients inflammatory markers (serum concentration of fibrinogen, hs-CRP, IL-6, TNF-α) were determined. In order to assess the stage of COPD, bodyplethysmography with bronchodilating test was conducted and lung hyperinflation parameters were assessed. Results: Analysis of relationship between markers of systemic inflammation and spirometry variables revealed a significant negative correlation between the level of hs-CRP and signs of hyperinflation; IC% of predicted value (r_s = –0.29; p = 0.023) and IC/TLC (r_s = –0.32; p = 0.014). The IC/TLC index also tended to be related to the concentration of fibrinogen. Higher fibrinogen concentrations were associated with lower IC/TLC values, albeit without statistical significance (r_s = –0.23; p = 0.074). There was a positive relationship between serum concentration of TNF-α and arterial blood carbon dioxide pressure PaCO₂ (r = 0.281; p = 0.03) as well as right ventricle systolic pressure RVSP in echocardiography (r = 0.332; p = 0.01). Conclusions: Severity of hyperinflation progression may be associated with the increase of inflammatory process in patients with stable COPD. Inflammatory process may have an adverse affect on the respiratory system increasing signifi- cantly static lung hyperinflation. Full article

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Open AccessArticle

Is Prediction of the Allergic March Possible on the Basis of Nasal Cytology?

by Zygmunt Nowacki, Jolanta Neuberg, Krystyna Strzałka, Magdalena Szczepanik, Renata Szczepanik and Henryk Mazurek

Adv. Respir. Med. 2010, 78(4), 263-270; https://doi.org/10.5603/ARM.27717 - 08 Jul 2010

Cited by 1 | Viewed by 264

Abstract

Introduction: The term allergic march has been used to describe natural evolution of the atopic disease in children, accompanied by the change in organ manifestation with time. The aim of the study was to analyze the role of the cellular components of [...] Read more.

Introduction: The term allergic march has been used to describe natural evolution of the atopic disease in children, accompanied by the change in organ manifestation with time. The aim of the study was to analyze the role of the cellular components of the nasal cytology as a tool for prediction of atopic diseases and clinical symptoms preceding allergic march. Material and methods: In a retrospective manner out of a group of 1620 children, 146 symptomatic children (60 girls and 86 boys) meeting inclusion criteria (age below 4 years at first visit, symptoms suggesting allergy, nasal cytology performed at the beginning of observation, observation of at least 4 years) were included in analysis. Results: Mean age of children at time of enrollment was 27 months (SD 10 months). After 4 years allergic rhinitis (AR) was diagnosed in 85 children (58.2%), atopic eczema/dermatitis syndrome (AEDS) in 51 (34.9%) and asthma in 48 (32.9%). Non-allergic etiology was identified in 36 patients (22.5%). All patients with asthma suffered from AR. Significant differences between groups were found in number of eosinophils (p < 0.001), neutrophils (p < 0.001), and lymphocytes (p = 0.028) in cytological examination of nasal mucosa. In children with AR (alone or combined with other comorbidities) nasal eosinophilia was higher than in children with AEDS (18% v. 3%; p = 0.004) or non-allergic disease (18% v. 4%; p < 0.001). Nasal eosinophilia of at least 8% was predictive for development of AR (sensitivity 80%, specificity 95%). Conclusions: In children below 4 years nasal eosinophilia ≥ 8% was predictive for AR development. Allergic march was observed in children with AEDS or/and gastrointestinal allergy symptoms present at the beginning of observation. Nasal eosinophilia in small children might be predictive for the risk of allergic march. Full article

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Open AccessArticle

Phenotypic Characterization of Pyrazinamide-Resistant Mycobacterium tuberculosis Isolated in Poland

by Agnieszka Napiórkowska, Ewa Augustynowicz-Kopeć and Zofia Zwolska

Adv. Respir. Med. 2010, 78(4), 256-262; https://doi.org/10.5603/ARM.27716 - 08 Jul 2010

Viewed by 242

Abstract

Introduction: Pyrazinamide (PZA) is an important first-line anti-tuberculous drug, which is applied together with INH, RMP, EMB, and SM. This drug plays a unique role in the first phase of TB therapy because it is active within macrophages and kills tubercle bacilli. [...] Read more.

Introduction: Pyrazinamide (PZA) is an important first-line anti-tuberculous drug, which is applied together with INH, RMP, EMB, and SM. This drug plays a unique role in the first phase of TB therapy because it is active within macrophages and kills tubercle bacilli. Testing the resistibility of Mycobacterium tuberculosis to PZA is technically difficult because PZA is active only at acid pHs. Therefore, routine drug resistibility testing of M. tuberculosis for PZA is not performed in many laboratories. The objective of our study was to estimate the resistibility for PZA among M. tuberculosis isolates from polish patients in the years 2000–2008. Material and methods: We analyzed M. tuberculosis strains with different resistibility to first-line anti-tuberculous drugs. The strains were isolated from 1909 patients with tuberculosis. The strains were examined for PZA resistibility by the radiometric Bactec 460-TB method. The PZA-resistant strains were examined for the following MIC PZA for drug concentrations: 100, 300, 600, 900 μg/mL. Results: PZA resistance among M. tuberculosis strains was found in 6.7% of untreated patients and in 22.2% of previously treated patients (p < 0.001). In both groups, resistance to PZA correlated with drug resistance for INH+RMP+SM+EMB—in 32.7% of untreated patients and in 34.5% previously treated patients (p < 0.8). PZA-monoresistant strains were observed in 20.8% of untreated patient groups. Among the resistant strains: in 3.4% MIC for PZA was > 100 μg/mL, in 11.6% ≥ 300 μg/mL, in 8.9% ≥ 600 μg/mL, and in 76% ≥ 900 μg /mL. Conclusions: Among M. tuberculosis strains, PZA resistance was found in 6.7% of untreated patients and in 22.2% of previously treated patients. Among the PZA-resistant strains, very high MIC values for PZA (≥900 μg/mL) were revealed for 76% M. tuberculosis strains. Full article

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Open AccessEditorial

Active Detection of COPD in Poland in the Second Decade of XXI Century

by Jan Zieliński, Michał Bednarek and Dorota Górecka

Adv. Respir. Med. 2010, 78(4), 251-255; https://doi.org/10.5603/ARM.27715 - 08 Jul 2010

Viewed by 235

Abstract

W następnym, piątym zeszycie “Pneumonolo-gii i Alergologii Polskiej” publikowane będąuwspółcześnione zalecenia rozpoznawania i leczenia przewlekłej obturacyjnej choroby płuc (POChP) [...] Full article

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Adv. Respir. Med., Volume 78, Issue 4 (July 2010) – 10 articles , Pages 251-314

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