PubMed Health⌕ Search

Biomedical subjects

S Wesołowski

Publications and source records attributed to S Wesołowski.

At least 19 recordsLinked to original sources
PubMed2004

Cellular components of the bronchoalveolar lavage correlate with lung function impairment and extrapulmonary involvement markers in active sarcoidosis.

Sarcoidosis is a chronic inflammatory multiorgan disease of unknown origin. Our previous study demonstrated a significant correlation between the relative count of non CD4(+), non CD8(+) lymphocytes in bronchoalveolar lavage of active sarcoidosis patients and proangiogenic activity of BAL homogenates. The aim of the present study was to evaluate in a group of 40 patients with active sarcoidosis the possible relationship between the intensity of alveolitis, particularly the non CD4(+), non CD8(+) lymphocyte subset, and other parameters characterizing the level of pulmonary (lung function tests) and extrapulmonary (spleen longitudinal dimension) disease activity. We found that the relative count of non CD4(+), non CD8(+) lymphocytes in BAL correlated positively with spleen size (r=0.50, P<0.01) and negatively with static compliance (r=0.43, P<0.05). We concluded that the lymphocytes belonging to the non CD4(+)non CD8(+) subset participate in the inflammatory process in sarcoidosis. However, more detailed phenotypic and functional characteristics of this cellular population are needed.

Adult↗
PubMed2001

[Own experience in diagnosis and therapy in pulmonary Langerhans cell granulomatosis].

UNLABELLED: We have assessed 12 patients (2 females, 10 males) aged between 19 and 53 years (mean 38.3 +/- 10.3) diagnosed with LCG during 14-year period (1985-1998). All patients were smokers. Follow-up was from 6 to 132 months (mean 47.5 +/- 44.4). LCG diagnosis was confirmed by histology in 10 cases (9 lung, and 1 bone biopsy). In 2 patients the diagnosis was made on clinical grounds, including characteristic appearance on HRCT scans. Mean FVC was 78.9 +/- 15.9% of predicted, DLCO 64.1 +/- 22% of predicted. In 8 patients (67%) FVC or DLCO were below 80% of predicted. In 2 patients with histologically proven diagnosis, HRCT was not characteristic for LCG. The treatment was introduced in 8 patients (67%). Only 3 out of 8 patients initially treated with steroids responded to this treatment. In the rest treated patients, therapy was changed to cytotoxic agents. 3 patients died (1 after 2 years, and 2 after 11 years) 2 due to LCG and 1 due to pneumonia. CONCLUSION: HRCT appearance is not always characteristic in patients with histological diagnosis of LCG. Pulmonary involvement in LCG is frequently connected with lung function derangements. Response to steroids is poor, and switching to cytotoxic agents is often necessary.

Adult↗
PubMed2001

[Pulmonary lymphangioleiomyomatosis: presentation and results of treatment].

Lymphangioleiomyomatosis is a rare lung disease of unknown aetiology that affects only women. Eight premenopausal women with LAM confirmed by lung biopsy specimens were observed in 1984-2001. The most common presenting feature was exertional dyspnea (6) followed by chylous pleural effusions and pneumothoraces. In two women severe airflow obstruction was observed at presentation. HRCT revealed characteristic cysts in all cases. All women were given hormonal therapy (tamoxifen, medroxyprogesterone). The best results of treatment were achieved in cases with chylothoraces.

Adult↗
PubMed2001

[Clinical presentation of own idiopathic pulmonary fibrosis patients according to international consensus statement].

Clinical presentation of idiopathic pulmonary fibrosis (IPF) restricted, according to current definition to usual interstitial pneumonia (UIP) was presented. 62 patients (39 males and 23 females) were assessed. The diagnosis of IPF/UIP has been based upon a combination of clinical, radiographic and physiologic features in majority of patients. Histologic confirmation from lung biopsy has been obtained in 16% of cases. Mean age of the patients was 64.4 +/- 8.0 years. Mean duration of symptoms was 20.1 +/- 14.1 months. The main symptom was exertional dyspnea. Crepitations were found in 98% of patients. Lung volumes were in normal range in substantial number of patients; TLC in 15 (24%) and FVC in 33 (53%) out of 62 patients. Disturbances of lung function concerned mainly gas exchange (DLCO diminished in 92% of cases) and lung compliance (diminished in all patients). Presentation of clinical, radiographic and physiologic features of IPF/UIP in a homogenous group of patients may be helpful in diagnosis of this common interstitial lung disease.

Aged↗
PubMed2000

[Clinical significance of pattern types in high resolution computed tomography images of patients with idiopathic pulmonary fibrosis].

UNLABELLED: The aim of the study was to assess significance of two types of HRCT pattern in patients with idiopathic pulmonary fibrosis (IPF), corresponding to usual interstitial pneumonia. The study population consisted of 34 patients, 11 women and 23 men, mean age 64.5 +/- 10.5 years. The patients were divided into two groups according to HRCT appearance: Group A--reticular pattern with some ground-glass attenuation (30 patients); group B--reticular pattern only (4 patients). Age, level of dyspnea, pulmonary function tests were similar in both groups. Longer history of dyspnea and more frequent finger clubbing (all patients) were found in Group B. 30 patients were followed-up for at least 12 months. In this period 4 out of 27 patients died in Group A, and 2 out of 3 patients died in Group B (p < 0.05). CONCLUSION: HRCT showing reticular pattern only corresponds to late phase of IPF and is connected with very short survival.

Aged↗
PubMed1999

[Clinical presentation and medical management in patients with idiopathic pulmonary fibrosis before diagnosis].

UNLABELLED: The aim of the study was to find factors that may influence diagnostic process of idiopathic pulmonary fibrosis (IPF). Clinical presentation and medical management in the period before the diagnosis of IPF were assessed in 57 patients. There were 25 females and 32 males in the study group; mean age was 61.4 +/- 10.9 years. Mean duration of symptoms in the whole group was 18.4 +/- 16.0 months. The most common symptoms were dyspnea on exertion (96.5% of cases) and cough (84.2% of cases). 56 out of 57 patients (98.2% of cases) had crackles on auscultation of the lungs. In one third of the patients clubbing of the fingers was found. Mean FVC% of predicted was 77.2 +/- 19.8%, and mean DLCO% of predicted was 61.6 +/- 16.8%. The most common associated disease was ischemic heart disease, found in 43.9% of patients. Duration of symptoms in patients with ischemic heart disease was 25.7 +/- 18.8 months and was as twice long as in the rest of the patients, 12.8 +/- 10.5 months (p < 0.005). Prior the diagnosis of IPF 22 patients (38.6% of cases) did not any receive treatment for symptoms of interstitial lung disease. 31 patients (54.4% of cases) received antibacterial treatment (29 antibiotics and 2 anti-Tb drugs), although there were no clear signs of infection. CONCLUSIONS: 1. Associated ischemic heart disease may cause delay in establishing the diagnosis of IPF; 2. In the period before diagnosis of IPF over half of the patients were given antibacterial treatment without appropriate indications.

Adult↗
PubMed1998

[Ischemic heart disease as a factor for hindering diagnosis of idiopathic pulmonary fibrosis].

UNLABELLED: The aim of the study was to find factors that may influence diagnostic process of idiopathic pulmonary fibrosis (IPF). Clinical presentation, lung function data and radiological changes were assessed in 57 patients with diagnosis of IPF. There were 25 females and 32 males in the study group; mean age was 61.4 +/- 10.9 years. Mean duration of symptoms in the whole group was 18.4 +/- 16.0 months. The most common symptoms were dyspnea on exertion (96.5% of cases) and cough (84.2% of cases). 56 out of 57 patients (98.2% of cases) had crackles on ausculation of the lungs. In one third of the patients clubbing of the fingers was found. Mean FVC% of predicted was 77.2 +/- 19.8%, and mean DLCO% of predicted was 61.6 +/- 16.8%. The most common associated disease was ischemic heart disease, found in 43.9% of patients. Duration of symptoms in patients with ischemic heart disease was 25.7 +/- 18.8 months and was as twice long as in the rest of the patients, 12.8 +/- 10.5 months (p < 0.005). CONCLUSIONS: 1: Associated ischemic heart disease may cause delay in establishing the diagnosis of IPF; 2. Crackles on ausculation are characteristic for IPF and together with disseminated changes on chest radiograms indicate correct diagnosis in patients with associated ischemic heart disease.

Aged↗
PubMed1997

[Prevalence of diagnosing extrinsic allergic alveolitis in Poland in the years 1990-1994].

Poland is the country, where almost 40% of population inhabit rural areas. So EAA may be an important health problem. The aim of the study was to assess incidence of EAA in different districts in Poland. We asked hospitals to send us lists of patients with diagnosis of EAA established in the period of 1990-1994. In some hospitals we collected information by ourselves. This way, we have got data concerning patients with EAA. The highest prevalence of EAA 1.5-7.0/100,000 population was observed in eastern and south-western regions of Poland. Eastern Poland is rural area with small not specialised farms and possible high exposure to EAA antigens. In south-western Poland (Silesia) keeping pigeons is a very popular hobby, which may explain high incidence of EAA.

Adult↗
PubMed1997

[Bronchiolitis obliterans organizing pneumonia].

Idiopathic BOOP is a clinicopathological entity defined histopathologically by the presence of granulation tissue in bronchioles, alveolar ducts and alveoli. 2 men and 6 women (mean age 47.2 years, range 22-66) with idiopathic BOOP have been observed, the mean period of observation being 31.1 months. In 7 cases the disease started with fever, cough and in 6 with progressive dyspnea. The interval between the onset of symptoms and the beginning of treatment ranged from 2 to 10 months. One woman was asymptomatic. The initial findings were: tachypnoea (6), crackles (7), decreased VC (6), reduced diffusing capacity (6), raised erythrocyte sedimentation rate (7). In 6 cases chest radiographs showed multiple alveolar patchy opacities of various size predominantly in the middle and lower lung zones. HRCT demonstrates peripheral distribution of changes. In one case diffuse reticulonodular infiltrates and in one case solitary tumor-like opacity with cavitation were observed. Seven subjects were given prednisone. Three subjects recovered completely, in 1 clinical and radiological improvement was observed. In 3 cases relapse occurred. The woman with the solitary tumor-like opacity was cured by surgical excision of the lesion.

Adult↗
PubMed1997

[Dyspnea, respiratory mechanics and gas exchange in patients with idiopathic pulmonary fibrosis].

The sensation of dyspnea on exertion is usually the first clinical symptom in patients with IPF. The aim of the study was to assess breathlessness in patients with IPF at the time of diagnosis. The study group included 9 patients (5 women and 4 men), aged 61.4 +/- 10.5 (mean +/- SD) yrs, (range 38-71 yrs). FVC was 65.8 +/- 8.3% pred., FEVI 70.0 +/- 9.0% pred., TLC 65.1 +/- 10.5% pred. 6 min walking test was performed, during which pts reported their breathlessness according to Borg scale. All patients but one reported breathlessness during exercise. Patients were divided into two groups according to the level of dyspnea at the end of the walking test. Patients with dyspnea equal or less than moderate (= < level 3 Borg scale) had significantly higher lung volumes FVC (2.57 +/- 0.44 vs 1.79 +/- 0.5 l, p < 0.05), FEVI (2.23 +/- 0.29 vs 1.56 +/- 0.36 l, p < 0.02), TLC (4.26 +/- 0.26 vs 3.13 +/- 0.69 l, p < 0.02), DLCO (4.49 +/- 0.52 vs 3.43 +/- 0.23 mmol/min/kPa, p < 0.02), and smaller alveolar-arterial oxygen tension difference at rest (31.8 +/- 5.6 vs 43.8 +/- 2.8 mmHg, p < 0.01) as compared to the patients with more severe dyspnea (> level 3 Borg scale). All patients desaturated during the test, but there was no correlation between the degree of desaturation and dyspnea level at the end of the test. 4 patients from the first group (dyspnea level = < 3 Borg scale) desaturated from 6.3% to 19.4% from baseline value. So patients with IPF may experience severe desaturation during normal daily activity not being aware of it. Dyspnea on exertion in these patients seems to depend on both disturbed lung mechanics and gas exchange. Simple 6-minutes walking test proved to be useful in assessing severity of the disease in patients with IPF.

Adult↗
PubMed1997

[Lung and pleural changes caused by exposure to asbestos].

Asbestos exposure results in an increased risk of nonmalignant as well as of malignant pulmonary and pleural disease. The asbestos-related disease are inexorably progressive (cancer) or insidious (fibrosis), untreatable and widespread in the industrialized and urban world. The identification of these diseases is important because therapy and prognosis differ from the other pulmonary fibrosis. The case reports indicate that careful clinical and histologic examination allows proper diagnosis. Two patients with asbestos-related disease after asbestos exposure are described.

Asbestos↗
PubMed1996

[Deaths from asthma, bronchitis and pulmonary heart disease in Warsaw in the years 1993-1994].

By the regular checking the death certificates in the municipal offices in 7 districts of Warsaw, the morality rate from asthma has been established as 2.98/100.000, from chronic bronchitis as 8.71/100.000 and from pulmonary heart disease as 6.27/100.000. During one year of this survey only 15 deaths (4.7%) from these diseases were below age of 50.67% of patients died in hospitals and 22 (7%) died suddenly (at home). In general, deaths reported as the results of COLD were only 1.59% of the total number of deaths in Warsaw (21.530). 6.9% of all death certificates were without clinical diagnosis (Number 798 of ICD)-described as "natural death", "death before doctor's arrival" or "noncriminal death". Authors discuss the problem of over- and under-diagnosis of asthma as the cause of death, the historical background of asthma mortality and also put the question of the righteousness of regard the pulmonary heart disease as the primary cause of death.

Aged↗
PubMed1993

[Analysis of fenoterol efficacy given as an aerosol using various mouth pieces].

The effect of different mouth pieces on efficacy of fenoterol was studied in 40 patients with atopic and non-atopic bronchial asthma with reversible bronchial constriction. Four devices were studied: standard MDI unit, MDI unit with Boehringer and Astra mouth pieces, MDI unit with spacer. PEF values were registered 7 hours following inhalation. Statistical differences were not significant within the whole group. In selected older patients (above 60 years of age) spacer and Astra mouth pieces produced significant changes.

Adult↗
PubMed1993

[Pulmonary lymphangiomyomatosis and tuberous sclerosis--similarities and differences].

Two cases pulmonary lymphangioleiomyomatosis and tuberous sclerosis with pulmonary involvement were presented. Clinical picture of both diseases was similar. Breathlessness was the main symptom of lymphangioleiomyomatosis and there were signs of chylothorax. Chest x-ray interstitial changes disseminated in both lungs. High resolution computer tomography showed numerous cysts in both lungs. Proliferation of smooth muscle bundles was found in lung biopsy. Main symptoms of tuberous sclerosis were breathlessness on exertion and recurrent pneumothorax. Changes in chest x-ray, CT and lung biopsy were similar to found in lymphangioleiomyomatosis. Diagnosis of tuberous sclerosis was based on typical extrapulmonary signs and symptoms.

Adult↗
PubMed1990

[Gold salts in the treatment of bronchial asthma].

Gold salts are used mainly in the therapy of rheumatoid diseases. Thanks to their immunoregulative and antiinflammatory properties they may be used in treatment of chronic bronchial asthma. In order to study the efficacy of gold salts in such therapy the authors studied the effect of Solganal B (Schering) in 8 patients with chronic steroid dependent bronchial asthma. In 6 patients a clinical improvement was observed enabling to lower the steroid dose. Basing on this pilot study we believe that gold salts have an beneficial effect on the course of chronic bronchial asthma.

Aged↗
PubMed1989

[Respiratory regulation in bronchial asthma].

The aim of this study was to determine the changes in respiratory regulation in patients with bronchial asthma in different phases of the disease and after pharmacological bronchodilation. This study was carried out on 10 healthy volunteers and 35 asthmatics. In order to assess the changes in respiratory regulation the respiratory response to increasing hypercapnia using the rebreathing method. Changes in minute ventilation (VE) and CO2 induced occlusion pressure (PO2) were analysed. The respiratory index and PO2 during quiet breathing were registered. It was found that patients with bronchial asthma have increased respiratory drive (increased VT/TI and PO2), with unchanged time control fo the respiratory cycle. The response to hypercapnic stimulation based on evaluation of occlusion pressure is two times higher bronchial asthma compared with healthy volunteers. The ventilatory response to CO2 is decreased proportionally to the degree of bronchoconstriction. Bronchodilating agents decreased respiratory drive and increased the CO2 ventilatory response. In 2 patients with a history of asthmatic states an individual low reactivity to CO2 was found, which could be the reason for respiratory insufficiency in them.

Adult↗