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L Pawlicka

Publications and source records attributed to L Pawlicka.

At least 19 recordsLinked to original sources
PubMed1997

[Intralobar pulmonary sequestration treated surgically in a patient with sarcoidosis].

Pulmonary sequestration is an uncommon but clinically significant congenital malformation characterised by the presence of nonfunctioning lung tissue that receives its blood supply from anomalous systemic arteries and has no communication with the normal bronchial tree. We describe a patient with an intralobar pulmonary sequestration of the left lower lobe associated with sarcoidosis. The patient was treated successfully by resection of the lesion. The postoperative period was uneventful. We found no report where a pulmonary sequestration was associated with sarcoidosis.

Adrenal Cortex Hormones↗
PubMed1997

[Soft tissue sarcomas as a rare cause of pleural effusion].

Malignant disease is the cause of about 24% of all pleural effusions. They are caused mainly by lung and breast cancer. Three cases of pleural effusion caused by very rare neoplasm, soft tissues sarcoma are presented. In two of them the lesion found in the leg was observed for 4-14 month and not connected with the presence of pleural effusion. Difficulties in the histologic diagnosis of pleural sarcoma and of differentiating this tumour from mesothelioma are also presented.

Adult↗
PubMed1996

[The value of determining neuron specific enolase for diagnosis of complete remission during treatment of small cell lung cancer].

The aim of this study was to assess whether the lowest serum NSE obtained during treatment of small cell lung cancer patients can be helpful in the diagnosis of complete remission (CR). The material consisted of 68 patients with small cell lung cancer, treated in the Institute o Tuberculosis and Lung Diseases from 1.III.1993 to 15.II.1995. In the course of treatment CR was obtained in 13 patients, partial remission (PR) in 37 and no remission (NR) in 18. The distribution and median of the lowest NSE serum levels were the same in CR and RP patients. NSE serum levels remained above normal, that is above 12.5 ng/ml, in two CR patients and in 4 PR patients. 3 patients (2 with CR and I with PR) are still living for 26, 27 and 41 months in spite of NSE serum levels 14.3, 15.6 and 13.6 ng/ml respectively. In those patients in whom NR was obtained the lowest NSE level above 20 ng/l was connected with bad prognosis. We conclude that the estimation of the lowest NSE serum level in the course of treatment can not help to differentiate CR from PR.

Adult↗
PubMed1996

[Comparison of conventional chest radiography and computed tomography for evaluation of the degree of regression in neoplasms of patients treated for small cell lung cancer].

The aim of the study was to assess how objective is the estimation of the chest lesions regression on RT picture and how extent chest CT can increase the precision of this assessment. The material consisted of 66 SCLC pts observed in the Institute of Tuberculosis and Lung Diseases in Warsaw between 1987 and 1994 in whom RT and CT were performed to estimate the degree of response to treatment. Chest RT were estimated by 4 specialists independently. In 28 cases (42%) opinion concerning the degree of tumor regression was the same. In 23 cases (35%) the opinions were discordant and in 15 cases (13%) (mainly after chest irradiation) all examiners agreed that degree of response is impossible to precise (it ranged between PR and CR). In the second part of this study the degree of cancer regression was assessed in the same patients by 2 specialists independently estimated CT pictures. Opinions were different only in 4 cases. The comparison between these two methods was done. CI examination allowed exact estimation of response degree in 20 out of 24 pts (83%) in whom this assessment was impossible using chest radiography. In 9 cases (21%) the assessment of chest CT changed the previous estimation made using chest radiography (in 5 cases from CR to PR and in 4 cases from PR to CR). In conclusion-estimation of tumor regression using chest RT is very subjective method and many errors are possible. Chest CT estimation is a much better method for estimation of tumor response especially in irradiated patients.

Adult↗
PubMed1996

[Evaluation of effects of antituberculous treatment on the course of sarcoidosis].

From 1960 to 1994 2150 sarcoid patients were observed in our Sarcoidosis Clinic. Before the diagnosis of sarcoidosis was confirmed, 52 of those patients were treated with tuberculostatics because of the radiological changes in the lung, diagnosed as tuberculosis. In no case any conventional method-smear examination for acid bacilli or culture identification was positive. There was no radiological improvement after treatment in any patient. Subsequently in all those patients sarcoidosis was diagnosed, by typical histology (48 cases) or on clinical grounds (4 patients). In 15 cases spontaneous remission was observed. 37 patients were treated with steroids and in 31 of them radiological improvement was found. In six cases stabilization of the disease was noted. The observation time after steroids treatment was from one year to 27 years. In only one case tuberculosis of the lung has developed.

Adult↗
PubMed1996

[LGM inferior vena cava filters--follow up 50 patients].

In the Department of Medicine at the Institute of Tuberculosis and Lung Diseases 50 LGM inferior vena cava filters have been inserted since 1993. Indications for filters placement were as follows: recurrent pulmonary embolism (PE) despite anticoagulation-16 patients (pts), severe bleeding complications of thrombolytic or anticoagulant therapy-9 pts, contraindications for thrombolytic and/or anticoagulant treatment-3 pts, massive PE-6 pts, chronic thromboembolic-major vessel pulmonary hypertension (CTEPH)-18 pts, extensive deep vein thrombosis of lower limbs or vena cava inferior in patients with urgent indications for surgery-10 pts. In every patient diagnostic procedures were performed after 1, 3, 6, 12, 24 and 36 months of follow-up period. Only one non-fatal episode of recurrent PE was documented. Other complications were rare and insignificant. The LGM inferior vena cava filters are effective and safe in such selectively chosen group of patients.

Female↗
PubMed1996

[Implantation of LGM inferior vena cava filters in patients with chronic pulmonary hypertension during a course of major vessel thromboembolism--observation of 18 patients].

CTEPH have not been widely recognised until recently. Introduction of the new, sophisticated, non-invasive diagnostic tools accounts for rapid progress in that field. Patients with high pulmonary hypertension have a very poor prognosis. Medical treatment (vasodilators, anticoagulants) does not change outcome. Pulmonary thromboendarterectomy is the only therapeutic option for the patients. It is essential to prevent further episodes of pulmonary embolism both over the long term and during the high risk perioperative period by means of inferior vena cava filters. In the Department of Medicine, Institute of Tuberculosis and Lung Diseases 18 LGM ivc filters have been inserted in patients with CTEPH since 1994. In 7 patients PTE was performed-in 5 cases good result was achieved, 2 patients died after surgery. In the latter group 5 patients died mainly because of severe heart failure. Only one non-fatal episode of pulmonary embolism was observed. It should be concluded that the LGM ivc filters are safe and effective in preventing episodes of pulmonary embolism in patients with CTEPH.

Chronic Disease↗
PubMed1996

[Low doses of rtPA administered as a bolus in treatment of clinically acute massive pulmonary embolism].

12 patients (7 male and 5 female) with confirmed pulmonary embolism (PE) with: angiography-5 cases, conventional contrast-enhanced CT-2 cases, echocardiography-2 cases, autopsy-3 cases were diagnosed as clinically acute PE. Criteria of clinically acute PE were: cardiac arrest-1 case-2 cases, shock-1 case, acute cor pulmonale-9 cases and acute cor pulmonale with shock. All patients were treated with heparin, administered with therapeutic prolongation of aPTT. Clinically acute PE (if possible confirmed with angiography, TC and/or echocardiography) was treated with rtPA administered in 10 minutes lasting bolus in doses 0.6-0.8 mg per kg of body weight (50 mg of rtPA during 10 minutes administered into peripheral veins). In 9 patients with pulmonary hypertension, significant decrease of tricuspidal gradient (measured echocardiographically during several hours after administration of rtPA) was documented. Improvement in PaO2, SaO2 and decrease of heart rate and respiratory rate were also achieved. No serious bleeding complications were observed after mentioned treatment. Control investigations (conventional contrast-enhanced CT and spiral CT) performed several days after rtPA administration revealed thrombus in pulmonary artery. We conclude: I rtPA administered in bolus simultaneously with heparin significantly decreased pulmonaryhypertension; rtPA administered simultaneously with heparin is safe method of treatment of PE; hemodynamic improvement after administration of rtPA is not univocal with full fibrynolitic effect.

Adult↗
PubMed1996

[Massive pulmonary artery embolism complicated by acute pulmonary heart disease].

43-year old woman, with considerable overweight had been admitted to Intensive Medical Care Unit with suspicion of pulmonary embolism (PE). The patient had the limb immobilized in gypsum for last several weeks. This episode was tangled with recurrent thrombosis of deep veins in the left limb, treated with heparin and oral anticoagulants irregularly without sufficient control. Taking into consideration the data of anamnesis, clinical picture and the results of ECG, chest X-ray, gasometric and echocardiographic examination we got much closer to the recognition of PE. Our suspicion of PE was confirmed by the result of pulmonary angiography. Indications for thrombolytic treatment (r-tPA) had been established. During the following hours considerable improvement of general state was observed. The therapy was continued with constant drip infusion of heparin. No prolongation of therapeutic PTT was observed. The deficit of AT III was diagnosed. In this situation the patient was given AT III to obtain normalization of its level and therapeutic extension of PTT. Therefore there were settled indications for the operation of uterus with myoma changes. As the rich thrombolytic material in the leg's vein was found the patient was implanted LGM Filter, with excellent prophylactic effect (no PE in perioperative period). The clinical course of our case enabled to present most of diagnostic, therapeutic and preventive methods applied in venous thromboembolism.

Administration, Oral↗
PubMed1995

Tuberculosis in the autopsy material: analysis of 1500 autopsies performed between 1972 and 1991 in the Institute of Tuberculosis and Chest Diseases, Warsaw, Poland.

SETTING: The present study is based on 1500 autopsies done in the Institute of Tuberculosis and Chest Diseases Warsaw, Poland during the years 1972-81 and 1982-91. OBJECTIVE: To assess the correctness of tuberculosis diagnosis before death in the above mentioned time periods. DESIGN: The autopsy reports were examined for the diagnosis of active tuberculosis proved by microscopy. The form and localisation of tuberculosis was assessed. The postmortem diagnosis was compared with clinical diagnosis. In those cases in which tuberculosis was not recognised before death the possible causes of this failure were analyzed. RESULTS: Active tuberculosis was found in 119 cases, 7.9% of all autopsies. It was localised in the lungs exclusively in 72 cases, in lungs and in extrapulmonary sites in 45 and in extrapulmonary sites only in 2. The frequency of active tuberculosis was the same for the two periods under evaluation. Tuberculosis was however not recognised before death in a much higher proportion of cases in 1982-92 (54%) than in 1972-81 (24%). The main cause of diagnostic failure was connected with atypical localisation of lesions on chest X-ray and with dissemination outside the lungs. Previous tuberculosis was a factor which facilitated the diagnosis of tuberculosis. CONCLUSIONS: In parallel with the decline of tuberculosis incidence in Poland, many doctors lack experience in diagnosing this disease, especially in cases with atypical X-ray presentation and with extrapulmonary localisation. This may lead to late or even very late diagnosis and have a significant impact on the epidemiological situation.

Adolescent↗
PubMed1995

[Indications for prophylactic vena cava filters introduced subcutaneously in patients with thromboembolic disease--preliminary report].

In 10 patients with thromboembolic disease 1 Gunther filter and 9 LGM filters were inserted. Indications for filter placement were: pulmonary hypertension caused by recurrent pulmonary embolism in 3 cases; planned surgery in 2 patients with pulmonary embolism and deep venous thrombosis; recurrent pulmonary embolism despite of anticoagulant treatment in 2 cases, previously performed thrombo-endarterectomy in 1 case; contraindications for anticoagulant treatment in 1 case and complications of anticoagulant therapy also in 1 case. No serious complications after filter placement were observed.

Adult↗
PubMed1995

[Recurrence of pulmonary sarcoidosis].

From September 1960 to December 1992, 2021 patients with pulmonary sarcoidosis were registered in our Sarcoidosis Clinic. 462 patients were treated with steroids. Treatment was initiated either because of radiological evidence of disease progression after 6 months observation, lack of radiological improvement together with abnormalities of pulmonary function, presence of extra-pulmonary lesions. In 42 cases (9% of treated group); 19 men and 23 women, mean age 35 years, relapse of disease was observed from 6 months to 6 years after completion of treatment. At the entry to the first treatment 11 patients were assessed as having stage I disease, 30 as stage II and one as stage III. In 16 subjects of this group (38%), extra-pulmonary lesions were presents; skin lesions in 8 cases and enlarged peripheral lymph nodes in 6. After initial treatment, radiological and clinical improvement was observed in 32 patients. The second treatment results in radiological improvement in 38 patients, 10 are being still treated. In 4 cases a second relapse was noted. In three patients regression of pulmonary changes was achieved, in one case stabilization of the disease was observed.

Adrenal Cortex Hormones↗
PubMed1995

[Implantation of a LGM suprarenal vena cava filter--case report].

In the case of 53 years old woman LGM filter was inserted over renal veins. Indications for those procedures were: vena cava thrombosis in distal part of vena cava what not allowed to place filter below renal veins, malignancy, planned surgery, proximal deep vein thrombosis and past history of pulmonary embolism. Indications for suprarenal placement of vena cava filters and results of such as procedure were discussed.

Colonic Neoplasms↗
PubMed1995

[Comparison of the degree of regression of small cell lung neoplasm in clinical-radiologic evaluation with levels of neuron specific enolase (NSE) in serum].

NSE was estimated using Pharmacia test and radioimmunologic method in the serum of 41 SCLC patients before treatment, at the time of maximal tumor response and in some patients also during progression. The level of 12,5 ng/l was regarded as the upper limit of normal. Elevated NSE levels before treatment were found in 12 out of 20 patients with limited disease and in 19 out of 21 patients with extensive disease. Complete remission (CR) was observed only in patients with limited disease and in those in whom NSE serum level was below 50 ng/l. Elevated NSE serum levels decreased in all those in whom partial remission (PR) or CR of tumor was obtained. Decrease of elevated NSE levels was however also observed in some patients with no significant regression of tumor. The decrease of serum NSE level seemed to be a good prognostic factor even in this last group. NSE serum level increased in 7 out 10 patients where progressive disease after PR was found. In 3 patients however NSE level persisted in normal values despite progression. The significance of this fact was discussed.

Adult↗