Photodynamic diagnosis (PDD) and photodynamic therapy (PDT) in dermatology: "How we do it".

In dermatology PDT has been proven to be effective in the treatment of actinic keratoses, basal cell carcinomas (BCC), Bowen's disease, superficial squamous cell carcinomas (SCC).

[Fluorescence diagnostics of premalignant and malignant changes in patients with Barrett's esophagus: doubts and hopes]. / Diagnostyka fluorescencyjna zmian przednowotworowych i nowotworowych u chorych z przelykiem Barretta--watpliwosci i nadzieje.

Increasing incidence of esophageal adenocarcinoma that mostly arises from Barrett's esophagus (BE) has been observed. Therefore sensitive methods for early detection of dysplasias and adenocarcinomas in BE are more and more necessary. Fluorescence endoscopy is an alternative or complementary to standard four-quadrant biopsies technique. The basics of diagnostics application of tissue autofluorescence and exogenous dyes fluorescence such as protoporphyrin IX, induced by 5-aminolevulinic acid are summarized. There are two methods of fluorescence diagnostics of dysplasia in BE: point fluorescence spectroscopy and real-time fluorescence imaging. Fluorescence spectroscopy is sensitive and specific but can be targeted only toward lesions visible in white-light endoscopy. Fluorescence imaging allows to examine large areas for occult foci of dysplasia but selectivity is somewhat limited by the background fluorescence of Barrett's mucosa. Laser induced fluorescent endoscopy (LIFE) images of esophageal dysplasia are presented. Up-to date results of fluorescence spectroscopy and fluorescence imaging of BE are reviewed. These results indicate fluorescence diagnostics promising and clinically useful for detection of early adenocarcinoma and dysplasia in BE.

[The analysis of heart rate variability as non-invasive method of cardiovascular system assessment]. / Analiza zmiennosci rytmu zatokowego jako nieinwazyjna metoda oceny ukladu sercowo-naczyniowego.

Heart rate variability (HRV) is estimated using time and frequency method. This analysis allows a non-invasive assessment of both the heart and autonomic nervous system. The usefulness of HRV estimation has been confirmed in patients not only with diabetic neuropathy, tetraplegia, various heart diseases (after heart transplantation, with heart failure, after myocardial infarction, with hypertrophic and dilated cardiomyopathy, with cardiological syndrome X and with arrhythmia), but also with thyroid gland diseases and in physiological states of human being. The described information indicate a wide range and increasing usefulness of HRV analysis in medical studies.

[Proangiogenic cytokines (bFGF and VEGF) in BALF from two different lung segments examined by high resolution computed tomography (HRCT) in patients with sarcoidosis]. / Cytokiny proangiogenne (bFGF i VEGF) w BAL z dwóch róznych segmentów pluc wskazanych badaniem tomografii komputerowej o wysokiej rozdzielczosci (HRCT) u chorych na sarkoidoze.

The aim of the study was to evaluate the concentrations of bFGF and VEGF in double BAL (2 x 120 ml) from two different lung segments: (s.A) from upper lobe with the most and (s.B) from lower lobe with the least extensive involvement estimated by high resolution computed tomography (HRCT). Examined group consisted of 28 sarcoid patients with homogeneous, regular distribution of nodular opacities in conventional chest X-ray (14 F, 14 M aged 19-54). Eleven healthy volunteers served as controls. In patients with sarcoidosis we observed the significantly higher levels (p < 0.01) of bFGF (1.79 pg/ml, 1.48 pg/ml) and VEGF (107.5 pg/ml, 109.7 pg/ml) in BAL from s.A and s.B respectively in comparison with BAL from lung segments Abis and Bbis in control group (bFGF: 0.75 pg/ml, 0.47 pg/ml and VEGF: 33.7 pg/ml, 43.9 pg/ml respectively). bFGF in BAL from s.A in active sarcoidosis was higher than in s.A and s.B in non-active sarcoidosis. Concentrations of bFGF in BAL from both s.A and s.B correlated positively with CD4/CD8 ratio and absolute number of lymphocytes, CD4 cells and lymphocytes HLA-DR estimated in BAL from these lung segments. We conclude that bFGF and VEGF may be involved in sarcoidosis pathogenesis and bFGF may be useful in estimation of sarcoidosis activity.

[Risk factors for airway obstruction in school children with respiratory symptoms assessed in a five year prospective study]. / Czynniki ryzyka obturacji dróg oddechowych u dzieci szkolnych z objawami ze strony ukladu oddechowego w wywiadzie w piecioletnim badaniu prospektywnym.

The aim of this prospective study was to assess age-related changes of the respiratory status and to evaluate risk factors for persistent airflow obstruction in symptomatic school children. One hundred fifty children aged 7-12 years (mean age 9.5 yr.) were followed-up. In 1994 parents--administered questionnaire, skin prick tests and three dynamic spirometries in 4-6 week intervals were performed. Airways flow limitation was defined as FEV1%, MEF50 or MEF25 below minimal value. In 1999 questionnaires and spirometry were repeated by the same methods. The response rate was 74.7%. Children's respiratory status generally improved. Frequency of respiratory symptoms and obstructive disturbances (37.5% in 1994 versus 22.3% in 1999) decreased. Significant risk factors for airways flow limitation in 1999 were nocturnal dry cough, doctor diagnosed asthma, female gender and parental smoking. Advanced or persisting airway obstruction during several month in 1994 was valuable to predict lung function impairment in 1999. No relation between skin tests results and persistent airway obstruction was observed.

[Effect of asymmetric respiratory exercise therapy on respiratory system function; evaluation using spirometric examination in children with idiopathic scoliosis]. / Wplyw leczenia metoda asymetrycznych cwiczen oddechowych na czynnosc ukladu oddechowego, oceniana za pomoca badania spirometrycznego u dzieci z idiopatycznym bocznym skrzywieniem kregoslupa.

Current work presents the results of spirometric examinations in 124 children aged 5 to 16 years (mean age 12.1 years) suffering from idiopathic scoliosis. Children were treated according to asymmetric respiratory exercises method applied in period of 24 days. Healthy children living in Upper Silesia industrial region were the control group. Examined scoliotic group was characterized by generally mild lung function impairment, although the values of spirometric indexes tended to deplete with time of duration and severity of the scoliosis. Especially the tendency of the forced expiratory volume in first second (FEV1) decrease was apparent, as well as maximal expiratory flows MEF50 and MEF25, in conjunction with Cobb angle increase. Slight but evident increase of forced vital capacity (FVC) and FEV1 was observed as a result of rehabilitation utilizing asymmetric respiratory exercises method.

[Ventilatory disturbances in school children with asthmatic symptoms in anamnesis]. / Zaburzenia wentylacji u dzieci w wieku szkolnym z objawami astmatycznymi w wywiadzie.

In 102 school children aged 7 to 12 yr with diagnosed asthma or wheezing in the past 12 months spirometry was performed three times in 4 to 6 weeks intervals. Maximal expiratory flows at low lung volumes (MEF50 and/or MEF25) were reduced in more than one third of children. The reduction of MEF50 and MEF25 was more frequent, more deep, and more persistent in following tests as compared with FEV1%. Small airways obstruction was observed in almost 90% children with FEV1% slightly above limit value.

[Chronic bronchitis and efficiency of lung ventilation in workers of the "Zawadzkie" foundry]. / Przewlekle zapalenie oskrzeli i sprawnosc wentylacyjna pluc u pracowników Huty "Zawadzkie".

The aim of this study was to determine the influence of smoking habit and occupational exposure to air pollution on the prevalence of chronic bronchitis and lung function efficiency in foundry workers. MRC survey and spirographic measurements were performed in 917 men aged 18-62 years (mean age 38.6). In 455 men (49.6%), occupational exposure to air pollution significantly exceeded the permissible values. In 122 men (13.3%) the exposure was low. Chronic bronchitis was more than twice as frequent in smokers (27.3%) as in nonsmokers (11.0). Cessation of smoking led to an improvement in the symptoms of chronic bronchitis. Chronic bronchitis was slightly more frequent in highly exposed (25.5%) as compared with low-exposed workers (15.6%). Age-related lung function decline was significantly greater in smokers than in nonsmokers. Unlike chronic bronchitis, lung function was still lower after smoking cessation. Among highly exposed workers, age-related FVC and FEV1 declines were significantly larger in smokers than in non-smokers.

[Study of the effect of salbutamol inhalation on the function of small airways in patients with chronic bronchitis without ventilatory disorders using simple spirographic tests]. / Wplyw inhalacji salbutamolu na czynnosc drobnych dróg oddechowych u chorych z przewléklym zapaleniem oskrzeli bez zaburzen wentylacji w prostych testach spirograficznych.

In 68 males with chronic bronchitis and normal standard spirometric parameters and in 30 healthy males the following were assessed: VC, FEV1, V50 and V75 before and after Salbutamol inhalations. In chronic bronchitis Salbutamol slightly decreased FEV1 values. Significant improvement of V50 and V75 was seen after Salbutamol inhalations in chronic bronchitis. This was observed more promeinently in comparison with the control group. Significant increase of V50 and V75 was seen in 14% of chronic bronchitics. The improvement in pattency of small airways following administration of bronchodilators can be an index for early identification of patients with chronic bronchitis, although this needs to be verified in prospective spirographic studies.