Pneumonologia polska最新文献

In 27 asthmatic patients a cell culture was made from mononuclear cell stimulated by PHA. Indomethacin was added to part of the cultures. After 2 days the culture was terminated and the supernatant was prepared for bronchoprovocation studies. Patients underwent baseline respiratory function studies, after which bronchial provocation was carried out with different concentrations of the supernatant. Bronchial provocation using supernatant from cells cultured with indomethacin produced significant respiratory function alterations in comparison with tests carried out with supernatant from cells stimulated with PHA.

An analysis of factors producing advanced small cell lung cancer in 57 patients from the Chemotherapy Department of the Oncological Center in Cracow. The main reason for delay in chemotherapy in small cell lung cancer were diagnostic mistakes. Almost 40% of the patients were treated with improper diagnoses for a mean period of 6 months. Although 28.3% seeked non-medical help this did not effect nor delay chemotherapy.

A case report is presented of a 74 year old male with chronic bronchitis in whom fever, malaise and sputum hypersecretion was observed. Inflammatory changes in the right upper lobe were found on a chest radiogram. Broad spectrum antibiotics and antituberculous agents did not produce any improvement. Due to the fact that Aspergillus fumigatus organisms were cultured from the sputum and the precipitin test was positive to aspergillin the diagnosis of Aspergillus fumigatus infection was made. 5-fluorocytosine--Ancotil did not bring any improvement. After initiating steroid therapy with 30 mg of prednisone an improvement was observed. This allowed to diagnose hyperreactivity to Aspergillus fumigatus as the cause of the disease.

The aim of the study was to assess the state of bronchoscopical examinations in Poland. The analysis was based on a quantitative method using a questionnaire. It encompassed the year 1986. 22,936 examinations were performed in 76 centers (61.0 per 100,000 population, 1.19 per one hospital bed per year). 239 physicians performed bronchoscopies annually. The mean was 96 bronchoscopies ranging from 14-835. Only 20 out of 76 centers were well equipped, 17-satisfactory. In 39 the equipment was judged to be below satisfactory level. The number of examinations is well below the level needed. If one would narrow down the number of patients requiring a bronchoscopy to only two groups--those with malignancy and unconfirmed tuberculosis the number of bronchoscopies per one patient is only 0.9. The authors suggest means of improving this situation in Poland.

A case report of a 45 year old female with a high suspicion of a lung tumor based on radiological and bronchoscopic findings is presented. Typical sarcoid changes were seen in biopsies from bronchial mucosa. Steroid therapy was instituted but due to intolerance had to be terminated. The patient was treated with chlorambucil, cyclophosphamide and azathioprine. Therapy was monitored with bronchoscopy. The best response was seen after steroid therapy, less to chlorambucil and cyclophosphamide. Azathioprine was least effective.

The course of allergic alveolitis was observed in 19 patients. The diagnosis was based on medical history, exposition to organic dust, clinical findings, respiratory function and in selected cases on results of transbronchial lung biopsy. All patients presented restrictive patterns of lung function abnormalities. Although a clinical improvement was seen, in none of the patients was a normalization of respiratory function observed. The results of treatment were more promising in patients with a shorter time between the onset of symptoms and making of diagnosis. Isolation from allergens resulted in better effect without prophylactic treatment with prednisone. Steroid therapy did not effect the relapses nor worsening of the respiratory function.

The case of a 57 year old male with Wegener's granulomatosis is reported in whom the course of cyclophosphamide and prednisone treatment a subacute mycobacterial tuberculosis pneumonia evolved. The diagnosis was based on culture of Mycobacterium tuberculosis organisms from the bronchoalveolar lavage fluid. The authors discuss the role of bronchoscopy and bronchoalveolar lavage in the diagnosis of pulmonary tuberculosis.

A routine neurological examination, electromyography studies and conductance in sensory and motoric fibres of upper and lower extremity peripheral nerves, was carried out in 65 subjects with small cell lung cancer prior instituting chemotherapy. None of the patients demonstrated metabolic changes nor toxic injury to the neurological system. The results of the neurological examination led to suspicion of neuropathy in 22 (34%) which was later confirmed by the electromyographic studies. In 12 subjects only EMG abnormalities were found allowing to diagnose a subclinical phase of neuropathy. Altogether 52% of the subjects demonstrated injury of the peripheral nervous system. Sensory neuropathy was observed in 6 patients, motor-sensory in 7, motoric neuropathy in 12. In one of the subjects from the latter group a myasthenic syndrome of the Eaton-Lambert type was found. In 7 patients the EMG results suggested injury of the anterior horn cells, in two further patients the clinical and EMG data suggested injury of the peripheral and spinal column.