Bacterial Pneumonia and Cryptogenic Pleuritis after Probable Monkeypox Virus Infection: A Case Report.

A large number of monkeypox (MPOX) cases have been reported in Europe and North America in 2022, and a new outbreak of this disease was declared. We describe a case of a patient with probable monkeypox during the height of this epidemic in Poland. The patient's symptoms resolved within two weeks, but over the next two months, he developed community-acquired pneumonia requiring hospitalization and, subsequently, non-specific pleuritis. The simultaneous occurrence of such severe infections in a previously healthy young man is not typical and suggests a potential underlying cause. We believe the potential association of these diseases with probable monkeypox virus infection is very likely. Cases of monkeypox pneumonia, both viral and secondary bacterial, have already been reported in the literature. Cases of viral pleuritis in the course of MPOX in animals have also been described; however, to our knowledge, no similar cases have been described in humans to date. Our case indicates that it is important to monitor patients after MPOX in order to respond promptly to potentially life-threatening but, as of yet, not fully understood complications.

Nocturnal Hypoventilation in the Patients Submitted to Thoracic Surgery.

Introduction: Nocturnal hypoventilation may occur due to obesity, concomitant chronic obstructive pulmonary disease (COPD), obstructive sleep apnea, and/or the use of narcotic analgesics. The aim of the study was to evaluate the risk and severity of nocturnal hypoventilation as assessed by transcutaneous continuous capnography in the patients submitted to thoracic surgery. Materials and Methods: The material of the study consisted of 45 obese (BMI 34.8 ± 3.7 kg/m2) and 23 nonobese (25.5 ± 3.6 kg/m2) patients, who underwent thoracic surgery because of malignant (57 patients) and nonmalignant tumors. All the patients received routine analgesic treatment after surgery including intravenous morphine sulfate. Overnight transcutaneous measurements of CO2 partial pressure (tcpCO2) were performed before and after surgery in search of nocturnal hypoventilation, i.e., the periods lasting at least 10 minutes with tcpCO2 above 55 mmHg. Results: Nocturnal hypoventilation during the first night after thoracic surgery was detected in 10 patients (15%), all obese, three of them with COPD, four with high suspicion of moderate-to-severe OSA syndrome, and one with chronic daytime hypercapnia. In the patients with nocturnal hypoventilation, the mean tcpCO2 was 53.4 ± 6.1 mmHg, maximal tcpCO2 was 59.9 ± 8.4 mmHg, and minimal tcpCO2 was 46.4 ± 6.7 mmHg during the first night after surgery. In these patients, there were higher values of minimal, mean, and maximal tcpCO2 in the preoperative period. Nocturnal hypoventilation in the postoperative period did not influence the duration of hospitalization. Among 12 patients with primary lung cancer who died during the first two years of observation, there were 11 patients without nocturnal hypoventilation in the early postoperative period. Conclusion: Nocturnal hypoventilation may occur in the patients after thoracic surgery, especially in obese patients with bronchial obstruction, obstructive sleep apnea, or chronic daytime hypercapnia, and does not influence the duration of hospitalization.

Cryptosporidium baileyi Pulmonary Infection in Immunocompetent Woman with Benign Neoplasm.

Cryptosporidium baileyi, a bird-specific parasite, infects gastrointestinal, pulmonary, and urinary tracts of its host. We report on a C. baileyi infection associated with pulmonary hamartoma in an immunocompetent patient in Poland. Further work is needed to investigate the association between Cryptosporidium infections and tumors.

Pulmonary rehabilitation in interstitial lung diseases: A review of the literature.

There are more than 200 different diseases classed as interstitial lung diseases (ILDs). For epidemiological and practical purposes, ILDs are classified into diseases of known and unknown etiology. The aim of this review is to evaluate our current knowledge about the efficacy and safety of pulmonary rehabilitation (PR) in patients with ILDs. Other issues, such as ILD pathogenesis, prevalence and comorbidity, are also elaborated in the review. Pulmonary rehabilitation is an important part of comprehensive care for patients with ILDs. In comparison to PR for patients with chronic pulmonary obstructive disease (COPD), the number of clinical studies concerning PR for patients with ILDs is small. The majority of trials have been performed in relatively small groups of patients. The principles of PR in this group of patients are the same as for patients with COPD. Exercise-induced desaturation is frequently observed during PR, which is the main source of complications in patients with ILDs. Major differences between ILD and COPD patients include poorer exercise tolerance and faster development of respiratory failure in patients with ILDs.

Symptomatic respiratory Encephalitozoon cuniculi infection in renal transplant recipients.

OBJECTIVES: Encephalitozoon spp. and Enterocytozoon bieneusi are intracellular parasitic fungi from the phylum Microsporidia, which initially localize to the intestine. As opportunistic pathogens, Encephalitozoon spp. in particular can disseminate to the respiratory tract, among other locations. Patients on life-long immunosuppression are at higher risk of such infections, mostly symptomatic. METHODS: Sputum samples and bronchial washings from 72 renal transplant recipients and 105 patients with various respiratory diseases were screened for Encephalitozoon spp. and E. bieneusi by microscopic examination and genus-specific nested PCR followed by genotyping. RESULTS: A total of 8.3% (6/72) of immunosuppressed renal transplant recipients and 1.9% (2/105) of patients with various respiratory diseases, both immunocompetent and immunosuppressed, were positive for respiratory microsporidial infection. All six transplant recipients were Encephalitozoon cuniculi-positive by PCR/sequencing and five of them suffered from respiratory symptoms. The presence of microsporidial spores was also confirmed microscopically in three of the transplant recipients. Of the two immunocompetent patients with various respiratory diseases, one had an E. cuniculi infection, while the second had an E. bieneusi infection. CONCLUSIONS: Life-long immunosuppression in renal transplant recipients increases the risk of respiratory infection by E. cuniculi. Microsporidia should be screened in respiratory samples of these patients, particularly when they have respiratory symptoms.

Prevalence and genotyping of Pneumocystis jirovecii in renal transplant recipients-preliminary report.

Pneumocystis jirovecii is an opportunistic fungus occurring in human lungs. The group at highest risk consists of HIV-infected and non-HIV-infected immunosuppressed individuals. In these patients, P. jirovecii infection may lead to Pneumocystis pneumonia; it may, however, persist also in an asymptomatic form. This study aimed to determine the prevalence of P. jirovecii and potential risk factors for infection in a group of renal transplant recipients and to characterize the genetic diversity of this fungus in the studied population. Sputum specimens from 72 patients were tested for presence of P. jirovecii using immunofluorescence microscopy, as well as nested PCR targeting the mtLSU rRNA gene. Genotyping involving analysis of four loci-mtLSU rRNA, CYB, DHPS, and SOD-was used to characterize the diversity of the detected organisms. Pneumocystis DNA was detected in eight (11.11%) patients. It has been shown that low eosinophil count and dual immunosuppressive treatment combining prednisone and calcineurin inhibitors are potential risk factors for colonization. Analysis of genotype distribution showed an association of the wild-type genotype of mtLSU rRNA with lower average age of patients and shorter time after kidney transplantation. Furthermore, CYB 2 genotype was detected only in patients with the ongoing prophylaxis regimen. In conclusion, renal transplant recipients are at risk of Pneumocystis colonization even a long time after transplantation. The present preliminary study identifies specific polymorphisms that appear to be correlated with certain patient characteristics and highlights the need for deeper investigation of these associations in renal transplant recipients.

Genotyping of Pneumocystis jirovecii in colonized patients with various pulmonary diseases.

Pneumocystis jirovecii is an opportunistic fungus causing Pneumocystis pneumonia primarily in immunosuppressed patients. However, immunocompetent individuals may become colonized and, as asymptomatic carriers, serve as reservoirs of the pathogen. Moreover, these asymptomatic carriers are at higher risk of developing pneumonia if favorable conditions occur. This study aimed to determine the prevalence of P. jirovecii in patients with various pulmonary diseases and to characterize the genetic diversity of organisms circulating in the studied population. Bronchial washing specimens from 105 patients were tested for presence of P. jirovecii using nested polymerase chain reaction (PCR) targeting the mtLSU rRNA gene, as well as immunofluorescence microscopy. Multilocus sequence typing involving analysis of three loci-mtLSU rRNA, CYB, and SOD-was used for genotyping analysis. P. jirovecii DNA was detected in 17 (16.2%) patients. Amplification of the SOD locus was successful only in five cases (29.4% of the positive patients), while mtLSU rRNA and CYB were genotyped in all positive samples. Therefore, combined genotypes were identified based only on mtLSU rRNA and CYB loci. Eight different genotypes were identified, with Pj 1 and Pj 2 being the most prevalent (29.4% of patients each). There was no statistical correlation between these genotypes and demographic or clinical data; however, we found that infection with mutant CYB strains occurred only in patients diagnosed with lung cancer. Of the potential predictors examined, only immunosuppressive treatment was significantly associated with colonization. In conclusion, patients with various respiratory diseases, especially when immunosuppressed, are at risk of Pneumocystis colonization.

Carotid body resection for sympathetic modulation in systolic heart failure: results from first-in-man study.

AIMS: Augmented reflex responses from peripheral chemoreceptors, which are mainly localized in the carotid bodies (CBs), characterize patients with systolic heart failure and contribute to adrenergic hyperactivation. We investigated whether surgical resection of CBs in these patients can be performed safely to decrease sympathetic tone. METHODS AND RESULTS: We studied 10 male patients with systolic heart failure (age, 59 ± 3 years; LVEF, 27 ± 7%) who underwent unilateral right-sided CB resection (four patients) or bilateral CB resection (six patients). Primary endpoints of the study were changes in muscle sympathetic nerve activity (MSNA) and peripheral chemosensitivity measured as ventilatory response to hypoxia from baseline to 1 month post-CB resection. Safety analysis included analysis of arterial blood gas and oxygenation at night through 2 months post-procedure and adverse events assessed up to 12 months. At the 1-month visit, CB resection was associated with a significant decrease both in MSNA (86.6 ± 3.1 vs. 79.7 ± 4.2 bursts/100 beats, P = 0.03) and in peripheral chemosensitivity (1.35 ± 0.19 vs. 0.41 ± 0.17 L/min/SpO2 , P = 0.005). It also resulted in improved exercise tolerance. Amongst some patients with bilateral CB resection, there was a trend towards worsening of oxygen saturation at night, which in one case required therapy with non-invasive ventilation. CONCLUSION: We present first-in-man evidence that CB resection in patients with systolic heart failure is associated with a decrease in sympathetic activity. A bilateral procedure may carry a risk of worsening oxygenation at night. CB modulation constitutes an interesting research avenue, but careful consideration of the balance between safety and efficacy is necessary before further clinical trials.

Hypoxemia during bilevel positive airway pressure treatment in patients with obstructive sleep apnea syndrome and chronic respiratory insufficiency.

In patients with obstructive sleep apnea (OSA) syndrome and chronic respiratory insufficiency one of the options of treatment is bilevel positive airway pressure (BPAP) during sleep. The aim of the study was to find out what are the factors influencing the early results of BPAP treatment in such OSA patients. The study was carried out in 55 adult obese patients (mean body mass index 45 ± 7 kg/m(2)), severe OSA syndrome (mean apnea/hypopnea index 62 ± 19), and chronic respiratory insufficiency (mean PaCO(2) 54 ± 5.7 torr) who underwent polysomnography during BPAP treatment. In 31 patients (56%) the mean SaO(2) during sleep was <88% despite the optimal BPAP and oxygen titration: 83 ± 4% during NREM and 81 ± 7% during REM sleep vs. 91 ± 2% and 90 ± 3%, respectively, in the remaining 24 patients (p < 0.001). The patients with advanced hypoxemia during sleep and BPAP treatment had lower forced vital capacity (2.2 ± 0.9 vs. 2.7 ± 0.8 l, p < 0.05), lower diurnal PaO(2) (49 ± 8 vs. 54 ± 7 torr), higher diurnal PaCO(2) (57 ± 5 vs. 52 ± 5 torr, p < 0.01), and higher PaCO(2) during sleep (75 ± 13 vs. 59.5 ± 7.5 torr). In conclusion, in obese patients with severe OSA syndrome and chronic alveolar hypoventilation there is a risk of sleep hypoxemia during BPAP treatment, despite optimal pressure titration.

Pulmonary function impairment in patients undergoing allogeneic hematopoietic cell transplantation.

Deterioration of pulmonary function can be the sole symptom of early stages of pulmonary complications following allogeneic hematopoietic cells transplantation (alloHCT). The aim of the study was to evaluate the prevalence and types of pulmonary function abnormalities in allogenic cells recipients. Twenty three (5 children and 18 adults) allogeneic hematopoietic cells recipients who underwent pulmonary function assessment before and 6-12 months after alloHCT were included in the study. Forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC), total lung capacity (TLC), and lung diffusion capacity for carbon dioxide (D(L)CO) were determined. Values <80% of predicted were considered abnormal. We found significant reductions of FVC, D(L)CO, and TLC after alloHCT. The most important reduction was noted in D(L)CO (pre-alloHCT of 85%±15% vs. post- alloHCT of 60% ± 21%, p< 0.05). Six patients (26%) presented with lung function impairment before alloHCT: obstructive lung disease (4%), restrictive lung disease (13%), and decreased D(L)CO (17%). In 19 patients (83%) pulmonary function abnormalities were demonstrated after alloHCT. The most common disturbance was a D(L)CO decrease that occurred in 16 patients (70%). In conclusion, frequency of pulmonary function abnormalities in patients after alloHCT is high. A diffusion capacity decrease and restrictive pattern of ventilation insufficiency develop in the majority of patients after alloHCT. It would be reasonable to include pulmonary function testing to standard periodic examination in patients qualified for, and after, alloHCT procedure.

Galectin-3 and cyclin D1 expression in non-small cell lung cancer.

INTRODUCTION: Lung cancer is a major cause of mortality and morbidity worldwide. Galectin-3 is multifunctional protein, which is involved in regulation of cell growth, cell adhesion, cell proliferation, angiogenesis and apoptosis. Cyclin D1 together with other cyclin plays an important role in cell cycle control. Cyclin D1 regulates the G1-to-S phase transition. The aim of this study was the evaluation of correlations between clinicopathological findings and cyclin D1 and galectin-3 expression in non-small cell lung cancer (NSCLC). We wanted also to analyze the prognostic value of cyclin D1 and galectin-3 expression. Moreover we tried to evaluate the correlations between galectin-3 and cyclin D1 expression in tumor tissue. MATERIALS AND METHODS: We used the immunochemistry method to investigate the expression of galectin-3 and cyclin D1 in the paraffin-embedded tumor tissue of 47 patients (32 men and 15 women; mean age 59.34 ± 8.90). years. We used monoclonal antibodies to cyclin D1 (NCL-L-cyclin D1-GM clone P2D11F11 NOVO CASTRA) and to galectin-3 (mouse monoclonal antibody NCL-GAL3 NOVO CASTRA). RESULTS: Galectin-3 expression was positive in 18 cases (38.29%) and cyclin D1 in 39 (82.97%). We showed only weak trend, that galectin-3 expression was lower in patients without lymph node involvement (p = 0.07) and cyclin D1 expression was higher in this group (p = 0.080). We didn't reveal differences in cyclin D1 and galectin-3 expression in SCC and adenocarcinoma patients. We didn't demonstrated also differences in galectin-3 and cyclin D1 expression depending on disease stage. Moreover we analyzed the prognostic value of cyclin D1 expression and galectin-3 in all examinated patients and separately in SCC and in adenocarcinoma and in all stages, but we didn't find any statistical differences. We demonstrated that in galectin-3 positive tumors cyclin D1 expression was higher (96.55% vs 61.11%, Chi2 Yatesa 7.53, p = 0.0061) and we revealed negative correlation between cyclin D1 and galectin-3 expression (R Spearman -0.458, p = 0.0011). In squamous cell lung cancer we didn't observed correlations between these both examinated markers (R = -0.158, p = 0.460), and in adenocarcinoma the negative correlation was very strong (R = -0.829 p = 0.000132). CONCLUSIONS: We didn't reveal any important correlations between clinicopathological findings and galectin-3 and cyclin D1 expression and in non small cell lung cancer. We didn't observed also prognostic value of cyclin D1 or galectin-3 expression. But we showed higher cyclin D1 expression in galectin-3 negative tumor tissues. We revealed also differences in correlations between galectin-3 and cyclin D1 expression in two main histopathological types of NSCLC.

[The cyclin A, B1, D1 and E expression in advanced non-small cell lung cancer--stages IIIB-IV (preliminary report)]. / Ekspresja cyklin A, B1, D1 i E w zaawansowanym niedrobnokomórkowym raku pluca--stadia IIIB-IV (doniesienie wstepne).

UNLABELLED: Lung cancer is the leading cause of cancer death in the majority of developed countries. Uncontrolled cell proliferation is the hallmark of malignant tumours. Cyclins play an important role in cell cycle regulation. The aim of this study was to evaluate the expression of cyclins A, B1, D1 and E in advanced non-small cell lung cancer (stages IIIB-IV) with its prognostic significance. MATERIAL AND METHOD: An immunohistochemical assessment of cyclins A, B1, D1 and E expression was performed in the paraffin-embedded tumor tissues of 19 patients (9 men and 10 women). The mean was age 59 +/- 6.64 years. 9 patients were in IIIB and 10 in IV. The 2-years survival rate was evaluated. RESULTS: We showed positive cyclin A expression in 13 tumor tissue specimens (68%), cyclin B1 in 3 (16%), cyclin D1 in 9 (47%) and cyclin E in 7 (37%). We analyzed the prognostic value of examinated cyclins in all NSCLC patients and separately in patients with squamous cell lung cancer and adenocarcinoma and in patients in stage IIIB and IV, but we have no found any correlations. We did not find also any differences in examinated cyclins expression depending on stages nor different histopathological types. CONCLUSION: We did not observe prognostic value of cyclins A, B1, D1 or E expression in advanced non-small cell lung cancer.

[Suppression of chronic nocturnal cough during continuous positive airway pressure (CPAP) treatment in a patient with asthma and obstructive sleep apnea syndrome]. / Ustapienie przewleklego nocnego kaszlu po zastosowaniu leczenia ciaglym dodatnim cisnieniem w drogach oddechowych (CPAP) u chorego z astma i zespolem obturacyjnego bezdechu sródsennego.

Sleep disruption is a common feature both in the patients with chronic cough and in the patients with obstructive sleep apnea syndrome (OSAS). There is increasing body of evidence that chronic nocturnal cough may be related to OSAS. We describe a 59 years old, obese man (BMI 38,6 kg/m(2)) with asthma and chronic nocturnal cough not responding to the optimal anti-asthmatic treatment. On the basis of nocturnal polysomnography moderate form of the OSAS has been diagnosed and the treatment with continuous positive airway pressure (CPAP) has been started. All the nocturnal symptoms, including cough, disappeared. The effect of CPAP in preventing nocturnal cough persisted at the follow-up visit after a year since diagnosis. This case indicates that nocturnal cough may be an important symptom of the OSAS and CPAP treatment - by abolishing sleep apneas and hypopneas - may also prevent chronic cough during sleep.

[Concentrations of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinases-1 in serum of patients with chronic obstructive pulmonary disease]. / Stezenie metaloproteinazy-9 oraz tkankowego inhibitora metaloproteinaz-1 w surowicy chorych na przewlekla obturacyjnq chorobe pluc.

UNLABELLED: Chronic obstructive pulmonary disease (COPD) is characterized by the progressive destruction of the extracellular matrix of the lung. Matrix metalloproteinases (MMPs) and their inhibitors, especially tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), play a central role in the lung remodeling in COPD. Their concentrations in the sputum and bronchoalveolar lavage are considered as a sign of the local inflammation in COPD patients. The aim of the study was to evaluate of the MMP-9 and TIMP-1 serum concentration in COPD patients with respect to the correlation with a systemic inflammatory process. MATERIAL AND METHODS: Thirty six COPD patients (29 male and 7 female) were enrolled into the study. Age-matched, healthy 15 subjects (11 male and 4 female) were selected as a control group. Serum levels of MMP-9, TIMP-1 and CRP were measured. The pre- and post-bronchodilator forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio were determined. The Spearman correlation was performed. RESULTS: The serum MMP-9 concentration was significantly higher in the COPD patients than that in the control group (COPD: 194.8 +/- 129.1 ng x ml(-1); control subjects: 11.7 +/- 2.1 ng x ml(-1); p < 0.001). The serum concentration of CRP was significantly higher in the COPD patients than that in the control group (COPD: 14.3 +/- 6.3 ng x ml(-1); control subjects: 6.2 +/- 2.8 ng x ml(-1); p < 0.001). There was statistically significant correlation between the MMP-9 concentration and the CRP level in the serum of patients with COPD (p < 0.01; r = 0.45). There were no significant differences in the serum TIMP-1 concentrations between the control group and COPD patients. There was statistically significant, negative correlation between the FEV1 % of predicted value and the MMP-9 concentration (p = 0.03; r = -0.43). CONCLUSIONS: MMP-9 may play an important role in the systemic inflammatory process in COPD. The serum concentrations of MMP-9 correlate with the stage of COPD.

[Chronic obstructive pulmonary disease and cardiovascular diseases]. / Przewlekta obturacyjna choroba pluc a choroby uktadu sercowo-naczyniowego.

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Patients with COPD are at increased risk of cardiovascular diseases, osteoporosis and lung cancer. Although some of the associations between COPD and atherosclerosis may be the result of common risk factors such as smoking, epidemiological evidence suggest that impaired lung function is a risk factor for increased cardiovascular death, independent of tobacco use. This phenomenon may be related to common genetic predisposition for atherosclerosis and emphysema. Chronic obstructive pulmonary disease, like atherosclerosis, is a disease of systemic inflammation and may hasten the progression of atherosclerosis and contribute to the higher rate of death in COPD. This article reviews close relationship between COPD and cardiovascular diseases, mainly atherosclerosis. The authors also present some preliminary data suggesting a possible influence of statin therapy on the clinical course of COPD.

[Nutritional knowlegde and lifestyle of obese patients with diagnosed obturative sleep apnea]. / Wiedza zywieniowa oraz wybrane elementy stylu zycia otylych osób z rozpoznanym obturacyjnym bezdechem w czasie snu.

The study was aimed, therefore, at evaluating the nutritional knowledge and selected elements of lifestyle of obese patients with diagnosed obstructive sleep apnea (OSA), treated at the Lower Silesia Center of Pulmonary Diseases in Wroclaw. Assessment of nutritional knowledge was conducted among 49 patients including 12 women and 37 men with diagnosed obstructive sleep apnea (OSA), treated at the Lower Silesia Center of Pulmonary Diseases in Wroclaw. The nutritional knowledge and selected elements of lifestyle were evaluated by means of own-construct, standardized questionnaire elaborated at the Chair of Human Nutrition, Wroclaw University of Life and Environmental Sciences. It included questions from different fields referring to, among others: knowledge on rational nutrition, type of physical activity, frequency of cigarette smoking, etc. Despite the demonstrated some knowledge of good nutrition, its use by patients with OSA in everyday life raises many objections. This could possibly result from the message is not binding on the correct nutrition to their own health. Found in the studied group of patients with OSA obesity and low physical activity, evidence of the need to integrate into the process of treatment of individual dietary counseling.

Cyclin A and Cyclin E expression in resected non-small cell lung cancer stage I-IIIA.

BACKGROUND: Lung cancer is the leading cause of cancer death in the majority of developed countries. Cyclin E regulates the the G(1)-S phase transition of the cell cycle. Cyclin A increases during the S- and G(2)-phases, and is a regulator of the transition to mitosis.The aim of this study was to evaluate the prognostic significance of cyclin A and cyclin E expression in primary, resected stage I-IIIA non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: The expression of cyclin A and E was investigated in the paraffin-embedded tumor tissue of 71 patients (53 men and 18 women; age 59.27+/-8.50 years), using a monoclonal antibodies to cyclin A and to cyclin E. RESULTS: Forty-seven out of 71 (66%) tumor tissue specimens were positive for cyclin A and twenty-six (37%) were positive for cyclin E. In the majority of cases, nuclear staining was apparent. Cyclin A and cyclin E expression was significantly higher in squamous cell carcinoma than in adenocarcinoma (cyclin A: Chi(2) Yates'a 4.6; p=0.032; cyclin E: Chi(2) Yates'a 5.12: p=0.023). The prognostic value of cyclin A and E expression was examinated in all patients and in patients with squamous cell lung cancer and adenocarcinoma and separately for every stage, but no correlations were found. CONCLUSION: No prognostic value of cyclin A and E expression was found in NSCLC, but significantly higher cyclin A and E expression was found in squamous cell carcinomas than in adenocarcinomas.

Bronchial hyper-responsiveness, subepithelial fibrosis, and transforming growth factor-beta(1) expression in patients with long-standing and recently diagnosed asthma.

INTRODUCTION: Chronic inflammation in asthmatic airways leads to bronchial hyper-responsiveness (BHR) and the development of structural changes. Important features of remodeling include the formation of subepithelial fibrosis due to increased collagen deposition in the reticular basement membrane. Transforming growth factor (TGF)-beta might be a central mediator of tissue fibrosis and remodeling. MATERIALS AND METHODS: Immunohistochemistry was used to measure collagen III deposition and TGF-beta(1) expression in biopsies from patients with long-standing asthma treated with inhaled corticosteroids, patients with recently diagnosed asthma, and control subjects. Computer-assisted image analysis was used to evaluate total basement membrane (TBM) thickness. RESULTS: Asthmatics, particularly those with long-standing asthma, had thicker TBMs than healthy subjects. Collagen III deposition was comparable in the studied groups. BHR was not correlated with features of mucosal inflammation and was lower in steroid-treated patients with long-standing asthma than in subjects with newly diagnosed asthma untreated with steroids. Epithelial TGF-beta(1) expression negatively correlated with collagen III deposition and TBM thickness. CONCLUSIONS: The study showed that TBM thickness, but not collagen III deposition, could be a differentiating marker of asthmatics of different disease duration and treatment. The lack of correlation between BHR and features of mucosal inflammation suggests the complexity of BHR development. Corticosteroids can reduce BHR in asthmatics, but it seems to be less effective in reducing subepithelial fibrosis. The role of epithelial TGF-beta(1) needs to be further investigated since the possibility that it plays a protective and anti-inflammatory role in asthmatic airways cannot be excluded.

[A case of kappa L-chain primary nodular lung amyloidosis]. / Przypadek samoistnej guzkowej postaci amyloidozy pluc ze zlogami amyloidu z lancuchów lekkich kappa.

Amyloidosis is a generic term for a heterogeneous group of disorders associated with deposition of protein in an abnormal fibrillar form. We report a case of kappa L-chain primary lung amyloidosis. A 44-year-old woman without symptoms. Roentgenogram and computed tomography of the chest showed several small nodular shadows. The mammography revealed tumor of the breast and the metastatic breast cancer have been suspected. After the quadrantectomy the breast tumor has been diagnosed as adenoma. The diagnosis of pulmonary amyloidosis was established by an open lung biopsy. Immunohistochemistry revealed amyloid light (AL) of kappa-light chain origin. Serum protein electrophoresis was negative for monoclonal gammapathy. Over the next 6 years, the patient remained relatively asymptomatic. The case illustrates the problems with diagnosis of multiple solitary nodules and the long and relatively benign course of primary pulmonary amyloidosis.

[Changes in the percentage of activated lymphocytes in bronchoalveolar lavage fluid in patients with clinical improvement of sarcoidosis]. / Zmiany w populacji limfocytów w popluczynach oskrzelowo-pecherzykowych u chorych z poprawa kliniczna sarkoidozy.

UNLABELLED: Sarcoidosis is characterized by an accumulation of the activated lymphocytes in affected organs. The aim of the study was the analysis of lymphocytes activation markers in a bronchoalveolar lavage fluid (BALF) in sarcoidosis and the influence of the disease outcome on the changes of cells subpopulations. MATERIAL AND METHODS: We performed the study on 12 patients with the regression of sarcoidosis after the mean period of the observation 8.1 +/- 3.8 months. RESULTS: We observed a tendency toward a BALF cellularity normalization: lowering of the percentage of CD4+ lymphocytes (mean: 67.1% vs. 57.8%, p = 0.047), lowering of the CD4+/CD8+ ratio (mean: 6.3 +/- 5.4 vs. 3.7 +/- 5.2, p < or = 0.05), lowering of the percentage of HLA-DR+ lymphocytes (mean: 65% < or = 16.4 vs. 43.9% +/- 18.0, p = 0.05), lowering of the percentage of CD25+ lymphocytes (mean: 5.7% vs. 3.1%, p < or = 0.05) and CD4+CD25+ (mean: 4.0% vs. 2.4%, p = 0.011). CONCLUSION: The clinical improvement of sarcoidosis is accompanied by the lowering of the percentage of activated lymphocytes in BALF.