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Biomedical subjects

J Kozielski

Publications and source records attributed to J Kozielski.

At least 19 recordsLinked to original sources

An increase in exhaled nitric oxide is not associated with activity in pulmonary sarcoidosis.

Exhaled nitric oxide (eNO) concentration measurement may permit the noninvasive estimation of the severity of airways inflammation in respiratory tract diseases. The aim of this study was to evaluate the correlation between eNO concentration and the activity of sarcoidosis, its radiographic staging and lung function abnormalities. eNO concentration was measured using a chemiluminescent analyser in 27 patients with sarcoidosis and 11 control subjects. The mean eNO concentration in patients with sarcoidosis was significantly higher (6.7+/-0.50 parts per billion (ppb)) than that in the control group (5.17+/-0.73 ppb). eNO concentration was similar in radiographic stage I, II and III patients (6.53, 7.32 and 6.24 ppb, respectively). No significant difference was found in eNO concentration between the patients with active and inactive disease. Nor did eNO concentration differ between the patients with and without indication for therapy. There was no significant correlation between eNO concentration and forced vital capacity or bronchoalveolar lavage fluid lymphocyte and macrophage counts. There was a weak correlation between eNO concentration and single-breath carbon monoxide diffusing capacity of the lung. Exhaled nitric oxide concentration is elevated in patients with sarcoidosis. This concentration does not depend on the radiographic staging, activity or progression of the disease.

Adult↗

Human cytomegalovirus DNA level in patients with idiopathic pulmonary fibrosis.

The objectives of the study were to estimate human cytomegalovirus (HCMV) DNA copy number in broncho-alveolar lavage cells, blood leukocytes, and serum of patients with idiopathic pulmonary fibrosis (IPF). The study groups consisted of 16 patients, newly diagnosed with IPF and never treated, (mean age 40.9 +/-11.0 yr; F/M-7/9) and in 16 adult healthy volunteers (mean age 36.8 +/-6.4 yr; F/M-4/12) used as controls. The HCMV DNA copy number was calculated by a Q-PCR method using TaqMan ABI PRISM 7700. We found that the prevalence of the HCMV DNA positive subjects in the patient group (75%) did not differ significantly from that in the control group (69%). We also found that in both patient and control groups the mean HCMV DNA copy number in BAL cells was significantly higher than that in blood leukocytes (log10=2.7 vs. 1.2 for patients and 2.8 vs. 0.9 for controls, respectively). However, a higher HCMV DNA copy number in blood serum was observed in IPF patients than in controls (log10=3.2 vs. 2.0, respectively). We conclude that the lungs play an important role in the human pathobiology of cytomegalovirus sustenance.

Adult↗

Dyspnoea exaggerated in the supine position and during exertion--diagnostic challenge.

The case of dyspnoea, exaggerated when in the supine position and during exertion, as a result of severe weakness of the diaphragm is reported. The aim of the study was to present a rare case of idiopathic bilateral diaphragmatic paresis (BDP) and to describe all the diagnostic procedures necessary to perform differential diagnostics. In order to establish the final diagnosis, chest radiography, haemodynamic evaluation of the circulatory system, ultrasonography, ultrasonocardiography, measurement of transdiaphragmatic pressures, scintiscanning of the lungs, spirometry, analysis of arterial blood gases, computed tomography of the thorax and external stimulation of the phrenic nerve were performed. The measurement of transdiaphragmatic pressure was crucial to establish and confirm the diagnosis of BDP, as only a small difference in gastric and oesophageal pressures during tidal breathing and inspiratory efforts was recorded. As no cause of diaphragmatic paresis was found, the case was classified as idiopathic. The final diagnosis of non-trauma related bilateral diaphragmatic weakness was generally delayed. In the case of the described patient, dyspnoea, the main symptom he was suffering from, was supposed to result from his congenital heart defect. We recommend that the suspicion of idiopathic diaphragmatic paresis should always be raised in patients suffering from respiratory failure of unknown origin. It is, however, necessary to perform extensive diagnostics to exclude the other causes of phrenic-diaphragmatic impairment. It's also necessary to consider all infections, injuries and surgical procedures within the thorax as possible causes of diaphragmatic paresis.

Diagnosis, Differential↗

[Endometriosis of the lungs: analysis of diagnosis and therapy].

A casuistic case has been presented with endometriosis of the lung in an 18-year-old girl. Several diagnostic difficulties including haemoptysis accompanying changes in the hings and chest, suggesting a npl process. The final diagnosis has been made after the second thoracotomy and was confirmed by the histopathological examination of the lungs and pleurae. Because of the patient's age the a-GnRH therapy was not taken and the treatment with new progestin (dienogest) was administered. The 4-months therapy have appeared to be fully positive without any side effects.

Adolescent↗

[Cytokines TNF-alpha and GM-CSF in BAL from two different segments of lungs defined by high resolution computerized tomography (HRCT) in patients with sarcoidosis].

The aim of the study was to evaluate the concentrations of TNF-alpha and GM-CSF in double BAL (2 x 120 ml) from two different lung segments: (s.A) from upper lobe with the most and (s.B) from lower lobe with the least extensive involvement estimated by high resolution computed tomography (HRCT). Examined group consisted of 28 non-smoking sarcoid patients with homogenous, regular distribution of nodular opacities in conventional chest X-ray (14 F, 14M aged 19-54). In examined patients 16 had nonhomogenous distribution (ND) and 12 had regular distribution (RD) of HRCT changes. Eleven healthy volunteers served as controls. In patients with sarcoidosis we observed the significantly higher concentrations (p < 0.01) of TNF-alpha (3.18 pg/ml, 2.64 pg/ml) and GM-CSF (1.01 pg/ml, 0.95 pg/ml) respectively in BAL fluid from s.A and s.B in comparison with BAL from s.Abis and s.Bbis in control group (TNF-alpha: 0.46 pg/ml, 0.47 pg/ml and GM-CSF: 0.28 pg/ml, 0.31 pg/ml respectively). Mean concentration of TNF-alpha in BAL from s.A (3.77 pg/ml) in ND group was significantly higher than in BAL from s.B in RD group (2.91 pg/ml). TNF-alpha in BAL from s.A in active sarcoidosis was higher than in BAL from s.A and s.B in non-active sarcoidosis. Concentrations of TNF-alpha in BAL from both s.A and s.B correlated positively with CD4/CD8 ratio, percentage of lymphocytes, lymphocytes HLA-DR+ and absolute number of CD4 cells and negatively with CD8 cells estimated in BAL from these lung segments. In patients with indications to therapy the level of GM-CSF in BAL from s.A (1.44 pg/ml) was significantly higher (p < 0.05) than in BAL from s.A (0.64 pg/ml) in patients without indications to treatment. We conclude that TNF-alpha and GM-CSF may be involved in sarcoidosis pathogenesis and TNF-alpha may be useful in estimation of sarcoidosis activity.

Adult↗

[Selection of bronchoscope type for removal of foreign bodies from the lower respiratory tract based on personal experience].

32 patients, in whom bronchoscopy was performed due to the removal of foreign body from the lower respiratory tract were described. Age of the patients clinical symptoms and a time lapse between aspiration and removal of foreign body from the lover respiratory tract and localization of foreign body in the particular bronchus were analysed. We conclude, that rigid bronchoscopy is still more useful and safe method of foreign body removing from the lower respiratory tract.

Adolescent↗

[A procedure for bronchial dilatation using a balloon-based technique as a method for removing post-inflammatory stenosis].

18-years old girl was admitted to hospital because of recurrent infections after pulmonary tuberculosis treated 4 year ago. Chest X-ray was near normal but during bronchoscopy--narrowing of lingula bronchi was revealed. In order to dilate the bronchi, a balloon, bronchoscopically directed, coming from a set designed for percutaneous transluminal coronary angioplasty, was applied.

Adolescent↗

[Unilateral hyperlucent lung syndrome--differentiation from lung vasculature pathology].

A cases of unilateral hyperlucent lung syndrome (Swyer-James', MacLeod's syndrome) in a 45-years old male patients is presented. The patient was being treated since 1982 because of recurrent upper and lower respiratory tract's infections. An increasing dyspnea was the main patient's manifestation. In 1997 the patient was admitted to the Department of Phthisiopneumonology Silesian Medical University when diagnosis of unilateral lucent lung syndrome was established. The value of conventional radiological examination of the chest in diagnosis of this syndrome and the meaning of perfusion and ventilatory lung scintigraphy in its differentiation are emphasised.

Diagnosis, Differential↗

[Pulmonary adverse effect after amiodarone treatment--case report].

A case of amiodarone induced pulmonary toxicity is presented in a 64 years old male. The patient had been treated with amiodarone for four years in daily dose 200 mg/day without any adverse effects until the daily dose was doubled. After withdrawing the drug, without any additional treatment, clinical, functional and partly radiological improvement was observed. Further radiological remission followed the introduction of corticosteroids. This case confirms the importance of dose boosting in the induction of amiodarone's toxicity. It also suggests a significant clinical and functional response to the discontinuation of amiodarone's administration.

Amiodarone↗

[Pulmonary microlithiasis--difference between radiology results and pulmonary function tests].

The case od 22-years old woman with pulmonary microlithiasis is described. The diagnosis was confirmed by histopathological examination of lung tissue. In electron microscopy lung fibrosis was seen. High resolution computed tomography (HRCT) and pulmonary function tests (lung compliance, diffusion capacity, exercise test) were done. The role of bronchoalveolar lavage (BAL) and lung scintigraphy with technetium in the diagnostic procedure of this disease is discussed.

Adult↗

[Usefulness of cryoapplication for bleeding after needle biopsy during fiberoptic bronchoscopy].

The protective role of superficial freezing (using a "spray" N2O cryoprobe) of tracheobronchial tumours before fiberoptic biopsy was evaluated in 21 patients with suspected lung cancer and high risk of bleeding. An excellent haemostatic effect was observed in all but two patients despite 3-9 specimens taken into histopathological examination. No serious complications besides a transient cough in 5 patients were observed. So a new "spray" type cryoprobe was found useful in protection against bleeding during bronchoscopy without negative influence on the histopathological confirmation of malignancy.

Adult↗

[Changes of smoking habits over 10 years among II year medical students].

In 1983 and 1993 among second year medical students surveys were conducted with regard to their cigarette smoking habits. After 10 years we found decrease in smoking habit among medical students (in 1983 48% of students smoked cigarettes, in 1993 only 28% smoked cigarettes). In 1983 only 27% but in 1993 75% of the students who smoked had started smoking prior to their university studies. In 1983 69% of the students smoked fewer than 5 cigarettes a day. Today, the figure is 36%. The corresponding figures of students smoking more than 20 cigarettes a day are 4.5% and 5.6% respectively. The reasons for smoking--chiefly among women students--are stress and sociability.

Female↗

[Bradykinin levels in BAL fluid in patients with sarcoidosis].

In 14 patients with sarcoidosis and in 9 healthy controls the bradykinin level was estimated in broncho-alveolar lavage fluid. The statistically significantly higher bradykinin concentrations was found in sarcoid patients than in controls. No relationship was found between level of bradykinin in BAL and lymphocytes % and no relationship was found between bradykinin level and pulmonary function parameters.

Adult↗

[Thoracic empyema].

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Empyema, Pleural↗

[Evaluation of the usefulness of palpation and Daniel's biopsy for detection of metastasis to supraclavicular and scalene lymph nodes in patients with lung neoplasms].

In 169 patients with lung cancer the usefulness of physical examination and Daniel's biopsy in detection of metastases to supraclavicular and scalene lymph nodes were evaluated. In 35 patients with palpable lymph nodes and in 25 patients with nonpalpable lymph nodes metastases were confirmed by histological examination. The sensitivity, the specificity and the likelihood ratio of physical examination in detection lymph nodes metastases were respectively: 58%, 86% and 4.1. In 6 patients (5%) among 119 with nonpalpable lymph nodes the positive Daniel's biopsy was the diagnostic procedure. In 5 patients with non-small carcinoma and in 3 patients with malignant mesothelioma positive results of Daniel's biopsy enabled a change of cancer staging and giving up the eventual surgical operation.

Adult↗