Biomedical subjects
Publications and source records attributed to Tadeusz M Zielonka.
In the past 2 decades tuberculosis has again become a public health priority in the world. Despite the availability of effective and inexpensive tuberculosis treatment the global tuberculosis caseload has not declined. TB is an important cause of childhood morbidity and mortality worldwide. This paper presented epidemiological situation in Poland, Europe and the world.
For better control of tuberculosis World Heath Organization has prepared directly observed treatment short-course strategy (DOTS). The number of countries implementing the DOTS has increased bringing the total to 180. TB mortality decreased in western countries but it is very important problem in Africa and Asia. Multidrug-resistant tuberculosis, defined as resistance of M. tuberculosis to at least INH and RMP is especially worrisome because of its potential impact on the control of TB. MDRTB has been reported in most parts of the world but especially in Eastern Europe and in the countries where TB and HIV coinfection is endemic. TB is one of the most frequent opportunistic infections among HIV-infected individuals, and often the first manifestation of HIV disease.
47-year-old women was admitted to the clinic for diagnosis of an incidentally X-ray detected enlargement of the medistinum shadow. In the past, the patient had been operated for lymphangioma of the right forearm. Chest computer tomography (CT) showed an abnormal mass in the front mediastinum with spherical structures, which density could indicate high-protein contents. In the right mammarian gland an oval cyst (23-15 mm), similar in character to the lesion in the mediastinum was found. The lymphangiomatic character of the lesion with the extension up to the superior aperture of the thorax was confirmed with magnetic resonans imaging (MRI). Due to the extensive changes and lack of symptoms, the patient was disqualified for surgical treatment and remains under further observation.
We describe a case of two simultaneous malignancies--anaplastic gastric carcinoma with pleural metastases and left breast carcinoma. These malignancies were recognized in 78-year old woman after right mastectomy performed 30 years ago. Additionaly, during diagnostic procedures rectal polypus found during colonoscopy occurred to be adenoma tubulovillosum. Her parents died from malignancies--mother from gastric cancer and father from pulmonary carcinoma. One should remember that there is always possibility of simultaneous development of more than one primary malignancies in one patient and neoplastic disease is an important cancer risk factor. This observation confirms the important role of genetic factors in the pathogenesis of malignant diseases.
A case of a 56-years old male with rheumatoid arthritis and unclear tumoral radiological changes in the lungs was described. Since noninvasive diagnostic procedures failed to explain nature of the pulmonary changes, an open pulmonary biopsy was performed. Pathological examination revealed presence of rheumatoid nodules and pneumoconiosis, typical for Caplan's syndrome. In the past, the patient had been working in foundry industry for 16 years and he had been exposed to silica and iron dust. Articular symptoms were revealed prior to finding the lung changes even dust exposure had occurred many years earlier. In spite of the fact that rheumatoid arthritis is a relatively common disease and pneumoconiosis is also not rare entity, the coexistence of both conditions i.e. Caplan's syndrome has been rarely diagnosed and described.
The authors describe a case of 80-years old male hospitalized because of radiological and clinical signs suggestive of right-sided pneumonia. The main complaints of the patient were of productive cough with increasing amounts of watery sputum irregular fever up to 39 degrees C, progressive dyspnea, generalized weakness and loss of weight. Despite extensive use of antimicrobial and antituberculosis agents significant deterioration of patients general condition and the progression of X-ray picture were observed, inflammatory infiltration started to encompass the contralateral lung. Bronchial washing revealed the presence of atypical and neoplasmatic cells of adenous origin type. Since this finding contrasted with the pattern of radiological abnormality that did not show any tumor-like changes, another diagnostic approach was undertaken. Transthoracic fine needle aspiration biopsy revealed cells of non-small cell lung carcinoma. The diagnosis of bronchioalveolar carcinoma established on the basis of clinicoradiologic pattern was confirmed at autopsy. Increasing bronchorrhea was the most prominent symptom.
The authors describe the case of survival for the period of 10 years after brain metastasis surgery and removal of the left lung upper lobe due to adeno-squamous cells carcinoma. Surgery did not generate any complications. Within 8 years after the surgery the radiological examination showed infiltrations resembling changes typical for tuberculosis. Microbiological analysis showed a culture of Mycobacterium kansasi leading to diagnosis of mycobacteriosis. Hence the antituberculous treatment was extended to 12 months to be interrupted due to liver damage. Two years later the patient experienced incident of haemoptysis. Detailed examination and assessment of the respiratory tract condition revealed COPD without features of renewal of the neoplastic process or infection by Mycobacterium tuberculosis or mycobacterium other than tuberculosis. This case demonstrates that aggressive surgical approaches to lung cancer with solitary cerebral metastasis significantly improve patient survival and justifies its widespread use.
Explore the source record for details and available documents.
This first polish paper presents respiratory actinomycosis as a complication caused by aspiration of a foreign body. Aspiration of a citrus fruit stone occurred as a result of esophagus stenosis and dysphagia caused by a mistake made by a blind person of drinking a caustic substance. Clinical and bronchoscopic features suggested bronchogenic carcinoma but it's not confirmed by two histopathologic examinations of section from pathological bronchial changes. Diagnosis was based on the morphological picture of sections taken during third fibreoptic bronchoscopy and on cytological sputum examination. Removing the aspired foreign body from bronchus and prolonged penicillin treatment resulted in clinical and radiological amelioration.
Diagnosis of tuberculosis is based on clinico-radiological symptoms and on identification of mycobacteria. Accuracy of both methods is limited. Therefore reliable serologic test would have considerable advantage. The goal of our study was to evaluate serologic response against A60 mycobacterial antigen in group of 270 patients (pts) (137 pts with active tuberculosis (TB), 15 pts with mycobacterial infections other than TB (MOTT), 58 pts with sarcoidosis, 26 pts with lung cancer and 34 healthy controls. We used commercially available ELISA based kits against antigen A60 (ANDA-TB). Specificity of 87% for IgG, of 94% for IgA and for IgM, of 85% for IgG + IgA, of 89% for IgA + IgM, of 80% for IgG + IgM, and of 79% for IgG + IgA + IgM was achieved. Sensitivity of 40% for IgG, of 30% for IgA, of 18% for IgM, of 56% for IgG + IgA, of 35% for IgM + IgA, of 50% for IgG + IgM, and of 59% for IgG + IgA + IgM was obtained. The results demonstrated that humoral response differs depends on the immunoglobulin class. Measurements of IgG or IgG and IgA as most sensitive against A60 are potentially more useful serological tests in clinical practice. It is not recommended to use tests based on antigen A60 for differentiation tuberculosis and MOTT.