Diagnostic accuracy of contrast-enhanced computed tomography and positron emission tomography with 18-FDG in identifying malignant solitary pulmonary nodules.

Contrast-enhanced computed tomography (CECT) and positron emission tomography with 18-FDG (FDG-PET/CT) are used to identify malignant solitary pulmonary nodules. The aim of the study was to evaluate the accuracy of CECT and FDG-PET/CT in diagnosing the etiology of solitary pulmonary nodule (SPN). Eighty patients with newly diagnosed SPN >8 mm were enrolled. The patients were scheduled for either or both, CECT and FDG-PET/CT. The nature of SPN (malignant or benign) was determined either by its pathological examination or radiological criteria. In 71 patients, the etiology of SPN was established and these patients were included in the final analysis. The median SPN diameter in these patients was 13 mm (range 8-30 mm). Twenty-two nodules (31%) were malignant, whereas 49 nodules were benign. FDG-PET/CT was performed in 40 patients, and CECT in 39 subjects. Diagnostic accuracy of CECT was 0.58 (95% confidence interval [CI] 0.41-0.74). The optimal cutoff level discriminating between malignant and benign SPN was an enhancement value of 19 Hounsfield units, for which the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CECT were 100%, 37%, 32%, and 100%, respectively. Diagnostic accuracy of FDG-PET/CT reached 0.9 (95% CI 0.76-0.9). The optimal cutoff level for FDG-PET/CT was maximal standardized uptake value (SUV max) 2.1. At this point, the sensitivity, specificity, PPV, and NPV were 77%, 92%, 83%, and 89%, respectively. The diagnostic accuracy of FDG-PET/CT is higher than that of CECT. The advantage of CECT is its high sensitivity and negative predictive value.

Relationship between airway wall thickness assessed by high-resolution computed tomography and lung function in patients with asthma and chronic obstructive pulmonary disease.

Airway remodeling in asthma and chronic obstructive pulmonary disease (COPD) results in thickening of bronchial walls and may affect lung function. In the present study we set out to evaluate the relationship between small airway wall thickness and the lung function parameters in patients with asthma and COPD. The study was performed in 10 patients with asthma (4M/6F, the mean age 37+/-13 yr) and 12 patients with COPD (7M/5F, the mean age 57+/-9 yr) with stable, mild to moderate disease. The study group characteristics were based on clinical assessment and lung function testing (spirometry, body plethysmography, methacholine challenge test). All patients underwent chest high resolution computerized tomography with small bronchi (external diameter 1-5 mm) cross section measurements at five selected lung levels. The following parameters were measured in end-inspiratory scans: external (D) and internal (L) diameters, wall area (WA), percentage of the wall area (WA%), wall thickness (WT), and WT/D ratio (BWT). We found no significant correlations between airway wall thickness and spirometric parameters in either group. In the asthma group, the relationships between WA% and BWT, on the one side, and postbronchodilator residual volume, on the other, were noted (r=0.72; P<0.05 and r=0.72; P<0.05, respectively). In the COPD group, WA% related with airway resistance (r=0.72; P<0.05). The correlations between WA% and PC(20) (r=-0.61; P<0.05) and BWT and PC(20) (r=-0.72; P<0.05) were found in the COPD group. There was also a relationship between WA% and airway resistance (Raw) (r=0.72; P<0.05) and BWT and Raw (r=0.45; P=0.1). The number of pack-years correlated with WA and WT in COPD patients. In conclusion, the study shows that the thickening of airway wall in asthma is reflected by an increase in the indices of air trapping and in COPD this thickening results in a higher airway resistance and responsiveness. In COPD, the thickening of airway wall also is related to exposure to tobacco smoke.

Relationship between airway inflammation and remodeling in patients with asthma and chronic obstructive pulmonary disease.

UNLABELLED: Despite a number of important differences in the pathogenesis, course and prognosis of asthma and chronic obstructive pulmonary disease (COPD), these two entities also have common features with airway inflammation being one of them. Airway remodeling is a characteristic feature of asthma, but data on the bronchial wall thickening in COPD patients are still scarce. AIM: To assess the relation between the inflammatory cell count in the bronchoalveolar lavage fluid (BALF) and thickness of bronchial walls assessed by high resolution computed tomography (HRCT) in asthma and COPD patients. MATERIAL AND METHODS: The study was conducted in 9 patients with mild-to-moderate asthma (M/F 4/5, mean age 35 +/- 10 years) and 11 patients with mild-to-moderate COPD (M/F 7/4, mean age 57 +/- 9 years). In all subjects lung function tests and HRCT scanning of the chest were performed. External (D) and internal (L) diameters of the airways were assessed at five selected lung levels. The lumen area (A(L)), wall area (WA), wall thickness (WT) and bronchial wall thickness (WT/D ratio) were calculated. Eight patients with asthma and 8 patients with COPD underwent fiberoptic bronchoscopy and bronchoalveolar lavage (BAL). Total and differential cell counts were assessed in the BAL fluid. RESULTS: Mean FEV(1)% pred was 80 +/- 19%, and 73 +/- 20% in asthma and COPD patients, respectively (NS). No significant differences in the total and differential cell counts in BALF were found in patients with asthma and COPD. There were no significant differences in the airway diameter or airway wall thickness. The mean inner airway diameter was 1.4 +/- 0.3 and 1.2 +/- 0.3 mm and the mean lumen area was 1.8 +/- 0.7 and 1.6 +/- 0.7 mm(2) in asthma and COPD, respectively (NS). Negative correlations between the eosinophil count in BALF and inner airway diameter (r=-0.7, P<0.05) and lumen area (r=-0.7, P<0.05) were found in asthmatics. There was no significant relationship between the BALF cell count and airway wall thickness in COPD patients. - CONCLUSIONS: In mild-to-moderate asthma and COPD the airway diameter and thickness are similar. In asthmatics, the airway diameter might be associated with eosinophil count in BAL fluid.

Relationship between insulin-like growth factors (IGF-I and IGF-II), IGF-binding proteins (IGFBP-3, IGFBP-2), leptin and anthropometric parameters (height, body mass index) during antileukaemic treatment in children.

PURPOSE: The aim of the study was to estimate the anthropometric parameters and their relationship to serum levels of IGF-I, IGF-II, IGFBP-3, IGFBP-2 and leptin before and during intensive antineoplastic treatment for acute lymphoblastic leukaemia in children. MATERIAL AND METHODS: In 46 children in median age 6.6 years (range from 1.6 to 16) we evaluated at the time of diagnosis, after protocol I and after intensive treatment, height, body mass index (BMI) and IGF-I, IGF-II, IGFBP-3, IGFBP-2 and leptin. RESULTS: Height SDS lowered in successive points of analysis whereas BMI SDS rose after protocol II. IGF-I SDS was low and similar at each point, IGF-II SDS and IGFBP-3 SDS values augmented progressively and IGFBP-2 SDS was significantly elevated before treatment and lowered (but not normalized) during the therapy. Leptin SDS was elevated, especially after protocol I. CONCLUSION: Leukaemia and its treatment affect directly growth factors, its binding proteins and leptin production leading to growth retardation and overweight.

The effect of TPP, theophylline and theobromine on the angiogenic activity of mononuclear leucocytes obtained from diabetic patients with proliferative retinopathy.

Tolpa Peat Preparation (TPP) administered in various doses does not influence the ability of mononuclear cells (MNC) obtained from diabetic patients with proliferative retinopathy to induce neovascularization response in H-LIA test. Methylxanthines (theophylline, theobromine) significantly decrease the angiogenic activity of these cells. The therapeutic value of these drugs in proliferative retinopathy should be evaluated.

The effect of vitamin E on granulocyte function in patients with recurrent infections.

The influence of vit. E treatment on metabolic and bactericidal granulocyte activity in patients with recurrent infections was studied by chemiluminescence and phagocytosis assays. Vit. E serum level was significantly diminished before therapy. Six weeks supplementation with 200-300 mg/day of vit. E resulted in improvement of clinical status and normalisation of alpha-tocopherol serum level. Bactericidal activity of granulocytes was lower in patients than in the respective controls and it slightly rose after vit. E therapy. Before, therapy, patients granulocytes showed metabolic activity above or within the control range. Vit. E treatment increased, had no effect or decreased granulocyte metabolic activity, but never below the control range.

[Studies on impaired angiogenesis activity of the leucocytes in patients with oral candidiasis]. / Badania nad uposledzona aktywnoscia angiogenna leukocytów u pacjentów z kandidoza jamy ustnej.

The preliminary characteristics is reported of the cells causing active suppression leading to a decrease of the angiogenesis activity of leucocytes isolated from patients with oral candidiasis. The effect of three immunomodulators on this suppression was studied.

A contribution to studies on the mechanism of lymphocyte-induced angiogenesis: human peripheral blood mononuclear leucocytes with highest angiogenic activity.

Using the lymphocyte-induced angiogenesis test a comparison of angiogenic activity of some mononuclear cell fractions was performed. It is shown that the highest angiogenic activity was expressed by cells bearing both the receptor for the Fe portion of IgG and a CD4 surface antigen.

Modulatory effect of sera from scleroderma patients on lymphocyte-induced angiogenesis. II. Effector cells for the enhancing effect of acroscleroderma patients' sera.

In our previous study, using the modified lymphocyte-induced angiogenesis assay, we found that incubation of normal human peripheral blood mononuclear cells (PBMCs) with sera from patients with acroscleroderma, but not with diffuse scleroderma, markedly enhanced their angiogenic capability. The results of the present work suggest that this enhancement is mediated by lymphocytes bearing receptors for the Fc portion of IgG and belonging mainly to the CD4+ T-cell subset.

Regulatory role of lysosomal enzymes in rat lymphocyte reactivity in vitro.

The influence of three lysosomal enzymes, beta-glucuronidase, acid phosphatase and hialuronidase, the representatives of lysosomal enzymes which can be released by exocytosis, was tested o reactivity of rat lymph node lymphocytes in vitro. These three enzymes do not change the spontaneous lymphocyte stimulation. However, beta-glucuronidase enhances the lymphocyte response to PHA. On the contrary, acid phosphatase and hialuronidase suppress PHA-induced stimulation of lymphocytes. In the mixed lymphocyte cultures (MLC) beta-glucuronidase enhances or suppresses DNA synthesis depending on the degree of lymphocyte stimulation in control MLC. Acid phosphatase and hialuronidase suppress lymphocyte stimulation in MLC.