Serum thrombopoietin levels in patients with reactive thrombocytosis due to lung cancer and in patients with essential thrombocythemia.

In patients with thrombocytosis normal to increased serum thrombopoietin (TPO) levels have been reported. The aim of this study was to investigate the relationship between serum TPO concentration, platelet number and plasma levels of fibrinogen in patients with reactive thrombocytosis (RT) due to lung cancer and in patients with essential (primary) thrombocythemia (ET). A total of 70 newly diagnosed patients with RT or ET (platelet counts >600 G/l) were studied: 45 with RT due to lung cancer (25 with non-small cell lung cancer, NSCLC and 20 with small cell lung cancer, SCLC), and 25 with ET. Twenty normal volunteers were used as controls. TPO was measured by immunoassay technique (ELISA). Mean serum TPO values in patients with RT due to lung cancer were statistically significantly higher than those in patients with ET or in controls. The highest platelet count was seen in patients with ET, and mean plasma fibrinogen levels were the highest in RT patients. In NSCLC patients mean serum TPO concentrations were higher (not statistically significant) than in SCLC, and a statistically significant relationship between TPO serum concentration and fibrinogen level was observed. No correlations between platelet counts and TPO serum concentrations were found. Our results indicate increased serum TPO levels in patients with thrombocytosis in lung cancer which may be related to the activity of neoplasms. In addition, it is postulated that the relatively low TPO values in patients with ET may result from a dysregulation of the feedback loop involved in platelet production.

[Sarcoidosis with central nervous system involvement]. / Sarkoidoza z zajeciem osrodkowego ukladu nerwowego.

A case of pulmonary sarcoidosis with central nervous system involvement was described. Diagnosis was based on hilar lymph nodes biopsy and OUN MRI scan. Patient was treated with glicocorticosteroids with improvement.

The contribution of endotoxins present in the respiratory tract to overproduction of nitric oxide associated with impaired interleukin 6 release in bronchoalveolar leukocytes from lung cancer patients.

The purpose of the study was to assess the relation between the levels of endotoxins circulating in airways of patients with lung cancer and the ability of bronchoalveolar lavage (BAL) leukocytes for ex vivo release of nitric oxide (NO) and interleukin 6 (IL-6) and for in vitro lipopolysaccharide (LPS)-induced production of the mediators. Leukocytes isolated from the BAL of 11 patients and from 5 healthy individuals were cultured in the absence or presence of LPS(E. coli). The levels of endotoxins in the BAL fluids (BALF) and the amounts of NO released ex vivo from unstimulated cells from the patients were highly (p = 0.0025) elevated in comparison with those from healthy individuals. The release of NO was significantly correlated (R(S) = 0.638, p = 0.047) with the levels of endotoxins in BALF. In contrast, production of IL-6 remained very low and a negative correlation (R(S) = -0.623, p = 0.0542) was observed between the amounts of NO and IL-6. It was also found that, in response to LPS, bronchoalveolar leukocytes from patients with lung cancer express a reduced capacity for in vitro production of NO and IL-6. Our data suggest that, in patients with lung cancer, the activation of BAL cells by endotoxins circulating in the airways may contribute, at least in part, to overproduction of spontaneous NO and, subsequently, the NO may reduce IL-6 production. Moreover, the exposure in vivo of the BAL cells to LPS renders them unable to respond to the second signals.

[Chronic alveolar hypoventilation in obstructive sleep apnea syndrome]. / Przewlekla hipowentylacja pecherzykowa w zespole zaburzen obturacyjnych podczas snu.

UNLABELLED: Among 30 patients with obstructive sleep (OSA) syndrome in 15% (50%) chronic alveolar hypoventilation developed; chronic hypercapnia was found in patients with mildly (7), moderately (2) and severely (6 patients) impaired lung ventilatory function. All patients with chronic hypercapnia were morbidly obese (BMI 44 +/- 12). Nocturnal polysomnography showed similar mean apnea duration in the groups of hypercapnic and eucapnic patients, longer duration of the longest apneas in hypercapnia (88 +/- 42 s) than in eucapnia (38 +/- 19 s), p < 0.01 and more severe desaturation during sleep (the mean of the lowest SaO2 during apneas 0.46 +/- 0.17 mol/mol) in hypercapnic and 0.71 +/- 0.11 mol/mol in eucapnic patients, p < 0.001). Polycythemia was found in 14 patients, exclusively in hypercapnia. CONCLUSIONS: Chronic alveolar hypoventilation develops in some obese patients with impaired-even mildly or moderately-lung ventilatory function and with the most severe OSA syndrome, in which apneas may occasionally be extremely long and lead to very low saturation during sleep. Polycythemia occurs in most patients with chronic alveolar hypoventilation and OSA syndrome.

[Circulating immune complexes in chronic thrombocytopenic purpura in adults before and after splenectomy]. / Krazace kompleksy immunologiczne w przewleklej maloplytkowosci samoistnej doroslych przed i po splenektomii.

Circulating immune complexes (cic) were determined by means of the immunoenzymatic method in a group of 16 adults with immune thrombocytopenic purpura (ITP) before and after splenectomy. The recurrence of immune thrombocytopenic purpura after splenectomy was observed in 9 patients, in 6 out of them there co-existed non-specific inflammatory process and cic were present in the serum. In 7 patients in whom the number of thrombocytes after splenectomy was normal, no circulating immune complexes were found. A significant decrease in the medium level of IgM after splenectomy should be attributed rather to splenectomy than to the consuming of IgM in the formation of circulating complexes. The role of circulating complexes in the pathogenesis of ITP in adults still remains not fully solved, but the authors' experience suggests that non-specific inflammatory processes may lead to their appearance.

Sister chromatid exchange in lymphocytes in myelodysplastic syndrome.

Sister chromatid exchange (SCE), percentage of first, second, third mitoses, blastic transformation index and mitotic index in patients with myelodysplastic syndrome (MDS) (3 with refractory anaemia, 2 with refractory anaemia with sideroblasts, 1 with refractory anaemia with excess of blasts, 4 with refractory anaemia with excess of blasts in transformation) and in 15 healthy volunteers were estimated. Three types of lymphocytes cultures were set up: first with phytohemaglutinin (PHA), second with PHA and bromodeoxyuridine (BRdU), third with BRdU. In healthy persons the SCE frequency was negatively correlated to proliferating rate index, but in MDS such correlation was not found. The lymphocytes cell cycle duration based on percentage of mitoses was longer in MDS patients than in controls. The results of our studies show the disturbances of lymphocytes during cell cycle division resulting in higher SCE frequency and lower proliferating rate compared to controls.