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M Pirozyński

Publications and source records attributed to M Pirozyński.

At least 19 recordsLinked to original sources
PubMed1999

[Usefulness of CD1 expression on surfaces of cells in bronchoalveolar fluid for diagnosis of histiocytosis X--our experience].

Histiocytosis X (HX), also referred as Langerhans cell granulomatosis is a disorder characterized by the presence of destructive granulomas containing Langerhans cells, lymphocytes, eosinophils and fibroblastes in the involved organs. Three presentations are commonly observed: 1) nonproductive cough or effort dyspnea, 2) spontaneous pneumothorax 3) incidental pulmonary infiltrates on chest X-ray in asymptomatic patients. HRCT may be helpful in the initial diagnosis of pulmonary HX. HRCT scans show nodules, cysts and estimate the extent of disease. But the final diagnosis of histiocytosis X requires the histologic demonstration of specific histiocytosis X cell in biopsy specimens of the lung. The aim of this study was to define the importance of the detection of Langerhans cells in bronchoalveolar lavage fluid (BALF) for the diagnosis of HX. The searched cells express a specific CD1 antigen, recognized by the monoclonal antibody OKT-6. In our study the demonstration of more than 5% of CD1 positive cells was defined to confirm HX. We have studied the BALF in 21 patients with suspected histiocytosis X. In BALF of 4 patients more than 5% of CD1 positive cells were found. In 1 of them HX was confirmed with open lung biopsy. Two patients displayed 5% of CD1 positive cells. The final diagnosis of the first patient was hypersensitivity pneumonitis and of the second one was bronchitis chronica. In 5 patients out of 15 patients in whom less than 5% of CD1 positive cells were found histiocytosis X was histologically proven. In other 10 patients the following disorders were histologically recognised: pulmonary emphysema 3 cases, pneumoconiosis-3, LMA-BOOP-1, sarcoidosis-1 and pleuritis eosinophilica-1. The estimation of Langerhans cells in BALF can be a useful method among the diagnostic procedures for histiocytosis X. It is necessary to remember that demonstration of less than 5% of CD1 positive cells do not exclude histiocytosis X.

Adult↗
PubMed1996

[Value of neuron specific enolase levels and squamous cell carcinoma antigen in bronchial lavage fluid in patients with lung cancer].

The aim of the study was to assess a value of NSE and SCC Ag level determination in bronchial lavage fluid in patients with lung cancer. It was found out that NSE levels in bronchial lavage fluid were much lower than in serum and did not differentiate patients with small cell lung cancer from patients with non small cell lung cancer and nonmalignant lung diseases. Bronchial lavage SCC Ag levels were significantly higher than serum SCC Ag levels. Although determination of SCC Ag levels in bronchial lavage was also not helpful in differential diagnosis.

Adenocarcinoma↗
PubMed1995

[Value of determining the concentration of carcinoembryonic antigen in bronchial lavage for diagnosis of lung cancer].

CEA levels were measured in bronchial lavage in 84 patients with endobronchial lung cancer, undergoing diagnostic bronchoscopy. The control group consisted of 94 patients with nonmalignant lung disease, in whom bronchoalveolar lavage was performed. In both groups of patients 100 ml of normal saline solution was used during the lavage procedure. CEA levels in lavage fluid and in serum were determined with polyclonal (CEA-RIA) and monoclonal antibodies (CEA-EIA). Significantly increased CEA levels in lavage fluid were observed in patients with lung cancer (97.4 +/- 56.4 ng/ml) in comparison to the patients with nonmalignant lung disease (4.2 +/- 6.3 ng/ml). Patients with lung cancer had CEA levels in lavage fluid about 30 times higher than in serum. Determination of CEA levels in bronchial lavage can be a useful additional diagnostic method in patients with lung cancer.

Adolescent↗
PubMed1995

[Initial experience with a new type of high energy neodymium laser in correcting stenosis of the airway].

The aim of the study was to assess the use of a new Nd:YAG laser--mediLas fibertom--in correcting malignant and benign stenoses of the airways. Eighteen patients were included in the study. In 9 these were caused by malignant tumors, in 3 by nonmalignant tumors, in 6 by post-inflammatory stenoses of the airways. Altogether 99 laser sessions were carried out. In patients with malignant diseases complete recanalization was achieved in 6 patients, in 2 partial. One patients did not benefit form the laser procedure. In patients with benign tumors complete recanalization was achieved in all of the patients. In 5 out of 6 patients the post inflammatory stenosis was corrected. Satisfactory results observed after the second, fourth and one year after the initial laser procedure encourage to use this from of therapy in cases of malignant and nonmalignant narrowing of the airways.

Adolescent↗
PubMed1994

[Use of fiberoptic bronchoscopy for removal of foreign bodies from the lower respiratory tract].

One of the initial indications for therapeutic bronchoscopy was removal of an aspirated foreign body. The aim of this study was to evaluate the role of bronchofiberoscopy in removal of aspirated foreign bodies. Thirty patients were included in the study (age range 4-81 years). Endoscopy was performed under local anesthesia in two sessions. During the first a complete evaluation of the tracheobronchial tree was carried out, while during the second the actual removal was performed. In the majority of the patients (23) the foreign body was aspirated into the right lung. In the majority of the patients (13) various fragments of bones were recovered. Only in one patient a major complication was observed (hemorrhage) which compelled to change from bronchofiberoscopy to rigid endoscopy. All complaints from patients subsided during 2-4 days after removal of the foreign body. Foreign bodies were removed using a bronchofiberoscope in 21 out of the 28 patients. In two patients a calcified lymph node could not be removed during bronchoscopy and the patients were referred to the Surgical Department for thoracotomy.

Adolescent↗
PubMed1993

[Significance of bronchoscopy in the early phase of chemotherapy in patients with small cell lung carcinoma for assessment of tumor regression and prognosis].

70 SCLC patients (pts): 25 women and 45 men aged 34 to 76 with limited disease were treated with chemotherapy in Institute of Tuberculosis in the period 1.01.1987-31.12.1992. After 3-5 courses of chemotherapy restaging was done using chest X-ray examination, bronchoscopy with cytological examination of bronchial material, abdomen ultrasound examination and other methods according to clinical indications. Complete regression (CR) of the tumor in chest X-ray examination was found in 17 cases, partial regression (PR) in 37 cases and no response (NR)-in 16 pts. The degree of tumor regression on chest X-ray had significant prognostic value. The median survival time in this group was 20 months while median was 13.5 months in PR patients group and 11.5 in NR patients. Bronchoscopy revealed macroscopic or microscopic signs of cancer in 5 of 17 pts with CR on chest X-ray examination, in 23 of 37 cases with PR on X-ray and in 12 of 16 with NR on X-ray. The persistence of tumor signs in bronchoscopic examination seemed to worsen the prognosis in pts with CR on chest X-ray. Complete regression of tumor revealed during bronchoscopy did not have any prognostic significance if CR on the chest X-ray was not obtained. It was concluded that bronchoscopic examinations in early phase of chemotherapy is useful to further treatment planning only in these pts in whom CR of tumor on chest X-ray examination was confirmed.

Adult↗
PubMed1993

[Correlation between chest examination with radiography, bronchoscopy and cytology of bronchial alveolar lavage in patients treated for small cell lung cancer].

In 129 SCLC patients (pts) 250 control fibrobronchoscopic (FOB) procedures were performed during chemotherapy. 71 pts had extensive disease and 58 limited disease. The evident correlation between radiologic and bronchoscopic assessment of tumor regression was confirmed in 60% of examinations. Tumor was visible during 16 bronchoscopic examinations in spite of complete regression on X-ray picture and on 53 chest X-ray examinations despite complete regression in the bronchi. Cancer cells found in 74 out of 250 bronchial washings samples were present significantly more often in these situations in which no regression of tumor in the bronchi was confirmed. Nevertheless tumor cells were also found in 3 out 57 cases in which complete regression on X-ray and in the bronchi was found. It was concluded that complete tumor regression on X-ray picture ought to be confirmed by bronchoscopy with cytologic examination of bronchial washing.

Adult↗
PubMed1993

[Usefulness of microscopic examination of bronchial cellular material for lung cancer diagnosis and determination of cell type].

Results of microscopical examination of airway material (sputum, bronchoscopy) were analysed in 563 patients with lung cancer. Bronchoscopic material was examined from all patients, while sputum only from 352. Sputum was always analysed prior examination of bronchoscopic material cancer cells were found in material from lower airways in 366 patients (65%), correct cell typing was achieved in 286 (78.1%). Cancer cells were present in the sputum in 28.1% of the analysed patients and in 60% of the material obtained during bronchoscopy. In 178 patients with squamous cell lung cancer, cancer cells were found in 64.9% while correct cell typing was found in 83.4%. In 183 patients with small cell lung cancer, neoplastic cells were found in 72.6% of the cases while correct cell typing was achieved in 88.7%. In 144 patients with adenocarcinoma cancer cells were found in 53.4% while correct typing was present in 64.9%. In 18 cases of large cell lung cancer, cancer cells were present in 50%, and correct cell typing was achieved in 22.2%. Differences were statistically significant between small cell lung cancer and adenocarcinoma. Correct cell typing was statistically more often significant in patients with squamous cell lung cancer or SCLC in comparison with the other types. Significant results of positive cytology was found when analysing localisation of the tumor. In cases of central tumor cytology was positive in 60% of the cases, while in peripheral tumors it was positive only in 43.9% of the cases. The size of the tumor did not affect the sensitivity of the cytological examination.

Adenocarcinoma↗
PubMed1991

Bronchoalveolar lavage: comparison of three commonly used procedures.

We have studied three different lavage procedures (100, 200 and 300 ml) in patients with pulmonary sarcoidosis (stage I). The effect of bronchoalveolar lavage (BAL) on cell yield, lavage fluid recovery, dwelling time, lavage-induced arterial oxygen desaturation and occurrence of side effects was analyzed. The patients did not differ significantly in prelavage lung function and blood gas parameters. The lowest BAL return was seen in the 300-ml lavage procedure (49.5%), while the medium yielded over 70%. The lowest cell yield was seen in the BAL 100 group (10.4 X 10(6)); the highest in the BAL 300 (19.4 X 10(6)), but the latter did not differ significantly from BAL 200 (18.4 X 10(6)). Dwelling time of the fluid differed only slightly between the small and middle volume lavage (average 3.2 vs. 3.9 min p less than 0.01), but was significantly lower from the average dwelling time in the BAL 300 group (9.8 min, p less than 0.001). Arterial oxygen desaturation was lowest in the BAL 100 and most pronounced in the large-volume lavage. Side effects were seen in all but 1 patient undergoing BAL 300. Cough was the most often reported side effect (9 patients); fever was observed in 6 patients, dyspnea in 4 (all undergoing large-volume lavage). Considering our results we do not think that it is justifiable to increase the volume of instilled fluid above 200 ml, because this may lead to serious side effects without increasing benefits. Using lower than 200 ml volumes decrease diagnostic yield although the risk of developing side effects is much lower.

Adult↗
PubMed1991

[Activity of angiotensin I converting enzyme in serum and bronchoalveolar lavage fluid of patients with sarcoidosis and lung neoplasms].

The lungs have an important role in the synthesis of angiotensin I converting enzyme (ACE). In BAL fluid and serum the ACE activity was determined in 18 patients with sarcoidosis (11 with high intensity and 7 with low intensity alveolitis), 14 patients with lung cancer and 16 with acute bronchitis. The activity of ACE was examined by a reagent set produced by Boehringer Mannheim Biochemica Test-Combination ACE cat. no. 789/011. The ACE activity in the high intensity alveolitis group of sarcoidosis patients was significantly increased in BAL fluid and serum in comparison to other observed patients. On the other hand, in patients with lung cancer the ACE activity was also increased in comparison to acute bronchitis and referred norms, especially in BAL fluid. This findings suggest a role of neoplastic process in ACE secretion in the airways. Very low correlation observed between ACE activity in serum and BAL fluid indicates a separate mechanism of secretion.

Acute Disease↗
PubMed1991

[Cellular analysis of bronchoalveolar lavage fluid. I. Detection of macrophage populations].

The aim of the study was to compare the results of routine counts of percentage of BAL macrophages, using morphological differential staining method--Pappenheim stain (M) and staining for nonspecific esterase activity (E) with those obtained by APAAP technique, using specific for monocytes (macrophages monoclonal antibodies (Ki-M1) and the complex APAAP (alkaline phosphatase--mouse anti alkaline phosphatase complex). The mean counts were comparable, although different criteria of estimation were used. Significant differences were seen in smokers when the criteria were based on morphology and expression of surface antigens. The results indicate that correct estimation of macrophage counts and their characteristics (enzymatic activity, expression of surface antigens) can only be made using many methods based on various criteria of estimation.

Adult↗
PubMed1991

["Blind" trans-bronchial biopsy of the lung in the diagnosis of interstitial lung diseases].

The aim of the study was to assess the diagnostic effectiveness and safety of "blind" transbronchial lung biopsy (B-TBLB) in interstitial lung diseases (ILD). The diagnostic yield of B-TBLB performed in 44 patients was compared with similar yield of classical TBLB carried out in 25 patients. A diagnosis was made by B-TBLB in 29 patients (65.9%) and 14 (56%) by classical TBLB. Most often sarcoidosis, allergic alveolitis, pneumoconioses were found. Side effects were seen in both groups: in the B-TBLB group in 11.4%, in patients that underwent classical TBLB in 32%. It seems that blind transbronchial lung biopsy is a safe, effective and acceptable diagnostical method of interstitial lung disorders.

Adult↗
PubMed1990

[Bronchial tuberculosis in bronchoscopic examinations].

In 195 cases of pulmonary tuberculosis in 70% changes in the bronchi were found. They were either active (45%) or inactive (25%). In 10% of the cases severe changes were found, this percentage did not decrease in the past 15 years. Most often bronchial findings were seen in elder women. In 4 cases bronchial cancer was co-existent. Difficulties in differential diagnosis in such cases were underlined.

Adolescent↗
PubMed1990

[Bronchial tuberculosis in bronchoscopic material].

A retrospective analysis of 14,461 patients examined at the Bronchological Unit in the years 1978-1988 was carried out in order to assess the incidence of bronchial tuberculosis confirmed histopathologically. 46 cases met the selection criteria (19 females, age range 21-75 years, mean 56.2 +/- 18.8. years, 27 males, age range 21-85 yrs, mean 50.0 +/- 17.4 yrs). Only in 22 patients acid fast bacilli were cultured. Analysis of endoscopical changes was carried out according to the Jaroszewicz-Krakówka classification. Most often diffuse inflammatory changes were seen.

Adult↗