Biomedical subjects
Publications and source records attributed to A M Sedlaczek.
Authors present 3 cases of pulmonary sarcoidosis coexisting with disturbances in ecg. Cardiac scintigraphy showed segmental disorders of perfusion in those patients. We believe that morphological diagnosis of sarcoidosis and coexistent disturbances in ecg are indications to perform cardiac perfusion scintigraphy. Changes in cardiac perfusion can also suggest the presence of sarcoid granulomas in the heart muscle.
The 58 years old woman with chronic cough, dyspnea and infiltrations in low area of left lung was described. Antibiotics were not effective. Cancer cells were not found during bronchoscopy. Explorative thoracotomy was made. Lipoid pneumonia was recognised. Just now the patient has completed history: she has taken lipoid nasal drops for many years.
A rare case of sarcoidosis with massive pleural and pericardial effusion in 30-year-old female patient was presented. Diagnosis was established on the basis of the specimen examination of bronchial mucosa and lymph nodes. Suspicion of heart sarcoidosis was supported by radioisotopic examination. Following steroid therapy, fast disappearance of the pathological changes was observed.
This publication is a continuation of our study for the treatment of pulmonary tuberculosis with early introduction of the intermittent methods. Early results were presented in a preliminary reports (Pneumonol. Alergol. Pol., 1995, 63, 57). From among 33 patients who were treated in this way, two-year follow-up was performed in 29 persons (we lost contact with two persons, 1 patient died from other reasons, and the next one was excluded for ambulatory prolongation of II phase of the treatment). 15 patients were supervised directly in our Department, and the others were estimated from records of Regional Antituberculosis Outpatient Clinics. Two years after the completion of therapy all 29 patients remained smear-negative and radiologically stable. On this basis, we assumed that results of the treatment of smear-positive pulmonary tuberculosis with early introduction of the intermittent methods are as good as standard therapy.
The results of the treatment 33 patients for smear-positive pulmonary tuberculosis with Isoniazid, Rifampicin, Pyrazinamide and Streptomycin administrated during first two weeks daily, from 3 to 8 week also with these four drugs but in a little higher doses twice weekly and next Isoniazid and Rifampicin during 9-26 weeks also twice weekly as in standard Polish model were described. After therapy with above described regimen all patients became smear-negative and radiological improvement was observed. Drugs in higher doses were well tolerated. Only abnormality in laboratory findings was temporary elevated level of uric acid, which recovered to normal values before the end of therapy. Costs of antituberculous drugs were used in this regimen is approximately 35% lower than standard model in Poland.
The authors analyze the time period necessary for morphological diagnosis in 100 consecutive patients with inoperable lung cancer admitted for treatment to the Department of pulmonology and tuberculosis of the Szczecin Medical Academy from 1989 through 1990. The following methods were used: cytological examination of sputum, bronchoscopy, fiber bronchoscopy, transthoracic biopsy by a thin needle, biopsy of the metastatic focus and cytological examination of the pleural cavity fluid. The causes of inoperability were: tumour histobiology variants (anaplastic small-cell cancer), cardiovascular failure and technical in operability. The diagnosis was established in all patients averagely within 16 days of hospital stay. More frequently the diagnostic material was obtained by means of bronchoscopy, then cytological examination of the sputum and transthoracic biopsy. In some patients without symptoms it is expedient to carry out diagnostic procedures in outpatient condition which is of economic importance.
A case of an endobronchial hamartoma localized in the right basal bronchus is presented. The tumor was ablated bronchoscopically. Due to uncertainty of total excision and coexistence of cirrhotic changes of the right lower lobe surgical removal of the lobe was carried out. Pathological examination of the removed specimen did not disclose any remnants of the hamartoma. During surgery another growth anomaly was discovered--a bilobar right lung.
Values of VC for "theoretical subjects" of comparable sexes, age, height were found in tables and normograms according to Baldwin, Berglund, Kory, Nikodemowicz and Morris. For each series of values, mean, standard deviation, minimal, maximal, and median values were calculated. A differential test was performed to assess significance. Statistically significant differences were found. The highest values were expressed by Morris lowest by Berglund. It seems that one should rather use real values instead of predicted and new reference values are needed due to a change of height-age relation during the past 20 years.
An analysis of the clinical course of pulmonary tuberculosis diagnosed in medical personal of the Western Pomeranian macroregion in the years 1978-1987 was carried out. Most often nurses develop this disease followed by technicians and doctors. 43% of this population did not have constant contact with active tuberculosis. Symptoms led to a diagnosis in 40% of the cases. In 27 patients radiological changes involved less than two pulmonary fields. In 17 cases a three drug regimen was instituted. The average hospitalization period was lower in these cases than in other treated in this region. Also the incidence rates of at risk medical personal were lower than overal incidence rates.
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