Biomedical subjects
Publications and source records attributed to J Kozielski.
Three cases of histiocytosis X were described. Diagnosis was confirmed with histological examination of the lung taken during pleuroscopy in 2 cases and--with typical HRCT lung scan in 1 case.
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.
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.
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.
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.
A case of a young man with chylopericardium followed by chylothorax was described. Performed diagnostic procedures did not reveal infectious, neoplastic or traumatic cause of chylothorax. Only partially deformed lymphatic system of the thorax was found.
Presence of elevated plasma levels of erythropoietin (EPO) has been reported both in polycythaemic and normocythaemic patients with chronic obstructive pulmonary disease (COPD). The present study aimed to elucidate in what extent prolonged erythropoietin half-life time (T1/2EPO) is involved in the pathogenesis of elevated plasma EPO levels in patients with COPD. Seven normocythaemic patients (5 men and 2 women) with CODP and 6 healthy controls (4 males and 2 females) were examined. In all examined subjects half-life time of erythropoietin was determined after i.v. administration of EPO in a dose of 50 U/kg b.m. In COPD patients the T1/2EPO value was 5.98 +/- 0.67 hours and did not differ from that found in healthy controls (5.87 +/- 0.35 h). Results obtained in this study suggest participation of factors other than prolonged half-time of erythropoietin in the pathogenesis of polycythaemia in patients with COPD.
Pulmonary alveolar proteinosis is a very rare disease, first described by Rosen in 1958. It is characterized by the accumulation of lipoproteins in the pulmonary alveoli. Clinical and radiologic presentations are typical for the interstitial lung disease. Only few cases of this disease have been described in the Polish literature. A patient with disseminated lesions to the lungs is presented. A diagnosis was possible after an analysis of BAL fluid and histological examination of the lung tissue collected by the transbronchial biopsy.
In 20 sarcoidosis patients with I0 of radiological changes the high resolution computed tomography (HRCT), pulmonary function tests (spirometry, diffusion capacity, static compliance) and broncho-alveolar lavage (BAL) were performed. In 8 patients with pathological changes detected in HRCT and in 12 patients without HRCT changes the similar pulmonary function disturbances and BAL-cell count were observed.
The effect of Salbutamol (Polfa) inhalation on small airway function was studied in 20 patients with stage II sarcoidosis and 8 healthy volunteers. MEFV values and dynamic compliance were assessed. A significant statistical increase of FEV1, MEF50, Cdyn20 and Cdyn60 were seen only in healthy volunteers. In patients with sarcoidosis the assessed parameters were not effected by the Salbutamol inhalation.
A survey throughout world literary output concerning physiology of respiratory system in pregnancy was made in this work. Metabolical changes caused by the increase of progesterone and other substances concentration and changes of the mechanics of ventilation connected by diaphragm raising caused by the growing uterus was discussed.
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.
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) are characterized by compensatory polycythaemia probably induced by increased erythropoietin (EPO) secretion in the kidneys. METHODS AND RESULTS: As the regulatory mechanisms of erythropoietin secretion in chronic obstructive pulmonary disease are scarcely known we studied plasma EPO levels in 14 patients with COPD (pO2 = 61.9 +/- 1.4 mm Hg, Hct = 47.8 +/- 1.1%) under basal conditions, after two hours of isobaric oxygen breathing and two and four hours after discontinued oxygen breathing. The control group consisted of 12 healthy subjects (pO2 = 87.5 +/- 2.2 mm Hg, Hct = 43.7 +/- 1.6%). Under basal conditions patients with COPD showed significantly higher plasma erythropoietin levels as compared with healthy controls. Oxygen breathing was followed by a significant decline of plasma EPO levels both in patients with COPD as in the control group. This decline was significantly more marked and of longer duration in COPD patients than in healthy controls. CONCLUSIONS: 1. Patients with chronic obstructive pulmonary disease are characterized by significantly higher plasma EPO levels as compared with healthy subjects. 2. The renal oxygen sensor function involved in the regulation of EPO secretion seems to be altered in COPD patients.
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A case of lung fibrosis is presented in a 44 year old male in whom interstitial pulmonary changes were observed in the course of bleomycin therapy of malignant granulomatosis. Following introduction of corticosteroids a radiological, clinical and functional improvement was observed. The functional changes were analyzed during the 7 month period of treatment. This case suggests that post bleomycin induced injury can be reversed with appropriate high doses of corticosteroids.