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Biomedical subjects

J Cieślicki

Publications and source records attributed to J Cieślicki.

At least 19 recordsLinked to original sources
PubMed2001

[Ten years experience of the sleep laboratory at the Institute of Tuberculosis and Lung Disease in Warsaw].

Between 1991-2000 2052 patients (81% men and 19% women) were referred to our Sleep Laboratory because of OSA suspision. In 1194 (58%) subjects (88% men and 12% women) diagnosis of obstructive sleep apnoea (OSA, AHI > 10) was confirmed. In 430 of them (36%) mild OSA (AHI 11-25), in 243 (20%) moderate OSA (AHI 26-40), and in 521 (44%) severe OSA (AHI > 40) was diagnosed. Epworth sleepiness scale score in those groups was 10.4, 10.5 and 13.0 points respectively. 908 (76%) of patients with OSA were submitted to nCPAP treatment. Effective CPAP pressure ranged from 5 to 20 milibars, mean 8.4 mbars. In 21 patients upper airway resistance syndrome (UARS) was diagnosed. Central sleep apnoea, most frequently of Cheyne-Stokes respiration type was diagnosed in 13 patients. The most common diseases accompanying OSA were: systemic hypertension (46%), coronary heart disease (29%), diabetes (12%), and COPD (9%). Majority of OSA patients (61%) were obese (BMI > 30 kg/m2), 32% were over weight (BMI 25-30 kg/m2). Only 7% had normal body weight (BMI 20-25 kg/m2). Long-term (more than one year) compliance to treatment was found in 70% of patients prescribed CPAP.

Adolescent↗
PubMed2000

[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↗
PubMed2000

[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↗
PubMed1998

[Symptomatic eye changes during the course of sarcoidosis].

The authors present ocular changes observed in sarcoidosis. The most frequent features are: symptoms of dry eye and uveitis. Frequency of ocular manifestations leads to the conclusion that ophthalmic examinations ought to be routine procedure at sarcoid patients.

Dry Eye Syndromes↗
PubMed1997

[Reconstructive surgery of bile ducts from personal material].

In the years 1976-1996, 112 patients were treated surgically for the biliary tract injuries, 156 operations were performed upon them. The long term outcome was assessed in 85 patients along with the effectiveness of different surgical techniques. The best results (86.2%) were achieved when the repair was performed immediately on detecting the lesion, the results were less encouraging for the secondary repair. Perioperative mortality was 8.8%.

Adult↗
PubMed1996

[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↗
PubMed1996

[Effect of positive pressure respiration on diurnal catecholamine excretion by patients with obstructive sleep apnea].

The aim of the study was to investigate effects of CPAP treatment on diurnal catecholamine excretion in urine in patients with obstructive sleep apnea (OSA). 12 males with severe OSA (mean AHI = 63) were measured in 3 separate 8 hour samples by fluorimetric method. NA levels were higher in OSA patients in all urine samples than in obese, mildly hypertensive males (control group = C). In C group patients NA levels were significantly lower at night than during the day contrary to OSA patients in whom NA levels dropped insignificantly during sleep. In OSA patients NA levels during sleep correlated with severity of apneas (r = 0.42) and night hypoxaemia (r = -0.46). CPAP treatment resulted in significant fall in NA levels during sleep (p < 0.01). A levels did not change after CPAP treatment. We conclude that abnormally high NA level during sleep in OSA patients may be related to sleep fragmentation and hypoxia. CPAP treatment restores normal circadian rhythm of NA excretion.

Adult↗
PubMed1996

[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↗
PubMed1996

[Effect of CPAP and BiPAP assisted breathing on pulmonary hemodynamics in patients with obstructive sleep apnea].

CPAP breathing increases alveolar and intrathoracic pressures. We aimed to investigate the effects of CPAP and BiPAP breathing on pulmonary haemodynamics in patients with OSA. Ten male patients with OSA (AHI = 48 +/- 22) were studied. In each patient intravascular and esophageal pressures were measured and mean transmural pulmonary artery and transmural wedge (Pwtm) pressures were calculated. After baseline recordings patients were submitted to 25 min. of CPAP and BiPAP breathing in random order. The pressure of 10 cm H20 for CPAP and 10/4 cm H20 for BiPAP was used. At baseline pulmonary arterial pressures and flow were normal. CPAP breathing resulted in an increase in mean pulmonary intravascular pressure from 15.5 +/- 1.8 mmHg to 17.1 +/- 2.3 mmHg (p < 0.05). Transmural pressure did not change. There was also no change in the cardiac output (CO) and pulmonary vascular resistance (PVR). At some time points pulmonary arterial pressures were higher during CPAP breathing than during BiPAP breathing (p < 0.01). BiPAP breathing had no effect on intravascular and transmural pressures, CO and PVR. We conclude that CPAP breathing increase pulmonary intravascular but not transmural, true, pressure. BiPAP breathing does not change pulmonary haemodynamics what may be of importance as pulmonary circulation is concerned.

Adult↗
PubMed1995

[Clinical picture and outcome of conservative treatment for obstructive sleep apnea].

The aim of the study was to assess the clinical picture of patients with obstructive sleep apnea (OSA) and to investigate the long term effectiveness of treatment with continuous positive airway pressure (CPAP). 170 subjects were investigated with Mesam 4 screening device. Full polysomnography was performed in suspected patients confirming the diagnosis (AHI > 10) in 72 cases (69M, 3F), mean age 46.7 +/- 8.4 yrs, mean weight 110 +/- 19 kg. Snoring (100%) apneas (96%), excessive daytime sleepiness (98%) and nocturia (73%) were the most common symptoms. Application of CPAP therapy resulted in elimination of apneas, improvement in sleep architecture and in arterial blood oxygen saturation. Apnea index decreased from 63 +/- 22 to 4 +/- 4. First night compliance to CPAP was about 95%. OSA symptoms rapidly regressed. Follow-up examination was performed in 45 patients who used CPAP for more than 1 year. All subjects presented with improvement in quality of life, all but one were using CPAP almost every night (mean 6.6 +/- 0.9 night per week). The most common side effects of CPAP were uncomfortable nose mask (42%), throat dryness (27%) and eye irritation (24%) We concluded that CPAP treatment in OSA occurs to be effective, long term compliance is high, side effects are benign and mostly due to poorly fitting mask.

Adult↗
PubMed1995

[Mediastinal seminoma--diagnostic difficulties].

A case report of a seminoma of extragonadal localization--of the mediastinum--is presented. In specimens obtained during mediastinoscopy sarcoid lesions were detected. Parasternal mediastinotomy allowed to sample larger fragment of the tumor and the final diagnosis was made.

Adult↗
PubMed1994

[Pulmonary hemodynamics in obstructive sleep apnea or overlap syndrome].

We studied pulmonary haemodynamics at rest and on exercise in 44 consecutive patients with moderate to severe obstructive sleep apnea (OSA), mean AHI > 40. The diagnosis was confirmed by standard polysomnography (PSG). According to history and results of spirometric measurements patients were divided to two groups, pure OSA and OSA complicating chronic obstructive pulmonary disease (overlap syndrome). In 34 pts with OSA (31 M, 3 F), means: age 45 +/- 8 years, body weight 108 +/- 22 kg, BMI49, VC 107 +/- 16% of N, FEV1 101 +/- 15% of N, PaO2 71 +/- 10 mmHg, PaCO2 39 +/- 3 mmHg, PSG showed AHI 66 +/- 15. Pulmonary haemodynamics at rest were within normal limits: PPA 16 +/- 5 mmHg, PW 7 +/- 3 mmHg, CO 4.5 +/- 1.5 l/min, PVR 184 +/- 92 dyne.s.cm-5. On low grade exercise (40 W) PPA increased to 31 +/- 10 mmHg, Pw to 12 +/- 6 mmHg and CO to 8.6 +/- 4.0 l/min, PVR remained unchanged. In eight pts abnormal rise in PPA on exercise resulted from the increase in driving pressure (PPA-Pw). In 2 pts it was due to abnormal increase in wedge pressure. In ten male pts presenting with COPD means: age 53 +/- 8 y, body weight 109 +/- 11 kg, BMI49, VC 53 +/- 14% of N, FEV1 36 +/- 16% of N, PaO2 57 +/- 10 mmHg, PaCO2 47 +/- 7 mmHg, PSG showed AHI 63 +/- 20. All pts presented with pulmonary hypertension (PH) at rest, PPA ranging from 21 to 37 mmHg, mean 26 +/- 5 mmHg. We conclude that patients with OSA have normal PPA at rest, 1/2 of them have PH on exercise due to restriction of pulmonary arterial bed and/or left ventricle dysfunction. Pts with overlap syndrome have moderate resting PH resulting from alveolar hypoxia.

Adult↗
PubMed1994

[Effect of bronchoalveolar lavage (BAL) on gasometric and spirometric parameters in patients with sarcoidosis].

The effect of BAL and fiberoptic bronchoscopy on gasometric and spirometric parameters was studied in 22 patients with sarcoidosis and 15 volunteers. In 12 patients with sarcoidosis during the repeated BAL procedure the effect of oxygen supplementation (by nasal prongs 3 L/min) was analysed. Significant decrease of oxygen pressure (PaO2) and vital capacity was seen in patients undergoing BAL and fiberoptic bronchoscopy. The administration of oxygen during the BAL procedure prevented the fall in oxygen pressured.

Adult↗
PubMed1993

[Chronic bronchitis and efficiency of lung ventilation in workers of the "Zawadzkie" foundry].

The aim of this study was to determine the influence of smoking habit and occupational exposure to air pollution on the prevalence of chronic bronchitis and lung function efficiency in foundry workers. MRC survey and spirographic measurements were performed in 917 men aged 18-62 years (mean age 38.6). In 455 men (49.6%), occupational exposure to air pollution significantly exceeded the permissible values. In 122 men (13.3%) the exposure was low. Chronic bronchitis was more than twice as frequent in smokers (27.3%) as in nonsmokers (11.0). Cessation of smoking led to an improvement in the symptoms of chronic bronchitis. Chronic bronchitis was slightly more frequent in highly exposed (25.5%) as compared with low-exposed workers (15.6%). Age-related lung function decline was significantly greater in smokers than in nonsmokers. Unlike chronic bronchitis, lung function was still lower after smoking cessation. Among highly exposed workers, age-related FVC and FEV1 declines were significantly larger in smokers than in non-smokers.

Adult↗
PubMed1992

[Prospective epidemiological studies of chronic bronchitis in workers in a coke-processing plant].

In 1977 an epidemiological survey was carried out on incidence of chronic bronchitis in 652 workers (age 20-64) of a coking plant. The survey was repeated six years later in 300 of the original participants (56%). The aim of the study was to assess the effect of smoking, age and occupation on incidence of chronic bronchitis and dynamic change of FEV1 values during the six years. During the 6 years the incidence of chronic bronchitis rose from 22% to 43%. Mean annual decrease of FEV1 was higher in smokers as compared to nonsmokers (57.4 versus 52.6 ml per year). Higher mean falls of FEV1 values were noted in subjects with occupational risk factors present (68.4 ml) in comparison with those with low occupational exposure (51.2 ml). Susceptible subjects presented a thrice higher annual FEV1 decrease rate (142 ml).

Adult↗
PubMed1992

[Regulation of respiration in patients with sleep apnea syndrome].

20 obese men with OSAS were examined. Polysomnography confirmed this diagnosis. In the daytime pattern of breathing, mouth occlusion pressure (P0.2) and ventilatory responses during CO2 rebreathing test were evaluated. Lung function indices were within normal limits except decreased value of MEF 25 and slight hypoxaemia (Pa0.2 -67 +/- 6 mm Hg). In comparison to control subjects the patients with OSAS when awake had increased ventilation, Vt/Ti ratio and P0.2. This suggests increased inspiratory neuromuscular output in daytime. During CO2 rebreathing test the whole ventilatory and P0.2 response lines were shifted to the left but the slopes of these lines were within normal limits. We conclude that the control of breathing in OSAS patients is changed in comparison to healthy subjects with normal weight.

Adult↗
PubMed1991

[Bronchial obstruction in pulmonary sarcoidosis].

The authors present the incidence of bronchial obstruction in patients with pulmonary sarcoidosis basing on their own material from the years 1960-1988. Bronchial obstruction was diagnosed when the Tiffeneau index was lower than 70%. In the analyzed group 93 (5.7%) patients were found to meet the criterion for bronchial obstruction. Out of this group two forms were selected those with the pure bronchial obstruction and mixed, i.e. with coexistent restrictive changes. The author discuss the possible mechanism of developing bronchial obstruction in sarcoidosis.

Bronchiolitis Obliterans↗