[Malignant peripheral nerve sheath tumor associated with clear cell renal cell carcinoma - case report]. / Zlosliwy nowotwór oslonek nerwów obwodowych wspólwystepujacy z rakiem jasnokomórkowym nerki­ opis przypadku.

Malignant peripheral nerve sheath tumor (MPNST) is a rare malignant counterpart to benign neurogenes tumors such as schwannomas and neurofibromas and account for approximately 5-10 % of all soft tissue sarcomas. This neoplasm is also referred to older designations as a malignant schwannoma, malignant neurilemmoma or neurogenic sarcoma. A patient was a woman of 59 years old with a diagnosed malignant neurilemmoma, treated since 1993. Operated several times and subjected to radiotherapy due to the local recurrence of the tumors located in the soft tissues of the back until 2002; Treated with chemotherapy (doxorubicin) and operated due to a lung metastases. The therapy resulted in a total remission that lasted 12 months. In 2004 a new small tumor was diagnosed in the right lung, which had been followed up until 2006. The patient did not give permission to a second surgery, treated with ifosfamide. In 2006 she was operated for renal cell carcinoma of the left kidney. In 2009, due to a following progression of neurilemmoma and a worsening overall condition, she was subsequently treated with a combination of gemcitabine and docetaxel. The treatment resulted in a slight improvement, but was stopped due to complications (pancytopenia). In 2010 another progression of the disease occurred, which resulted in pleural metastases and osteolytic lesions in the vertebrae (Th6 and L2).

[Value of conjunctival biopsy in the diagnosis of sarcoidosis]. / Przydatnosc biopsji spojówki w diagnostyce sarkoidozy.

The eye signs of sarcoidosis may be observed in patients with no evidence of any other symptoms. In this paper a patient with diagnosis of sarcoidosis was presented. The proper diagnosis and treatment were possible after results of conjunctival biopsy. Conjunctival biopsy could be a useful method in the diagnosis of many systemic diseases, including sarcoidosis.

Difficulties in the diagnosis of rare immunological diseases manifesting with cystic lung disease and spontaneous pneumothorax: Case reports.

Pulmonary lymphangioleiomyomatosis (LAM) is a rare disease of an unknown cause affecting women of reproductive age and characterised by smooth muscle proliferation along lung lymphatic channels. Pneumothorax develops in up to 80% of patients with LAM and may be the presenting manifestation of the disease. Pneumothorax also precedes or complicates the clinical course of 25% of patients with Langerhans'-cell histiocytosis (LCH, histiocytosis X) pathologically characterised by involved tissue infiltration with large numbers of unusual Langerhans' cells, often organised as granulomas. A 41-year-old female patient was treated twice by simple tube drainage due to left pneumothorax in 1996. She was then diagnosed with chronic obstructive lung disease demonstrating with dyspnea, cough and wheeze. Abnormalities found in the high-resolution computed tomography (HRCT) scanning were characteristic of LAM with thin-walled parenchymal cysts distributed homogeneously in both lungs and with thickening of interlobular septa. A 38-year-old man was hospitalised due to chronic lung failure in the course of LCH characterised by small, poorly limited nodular lesions and thin-walled cysts revealed in HRCT scans. For two years of observation, he has suffered five episodes of right pneumothorax. When diagnosing pneumothorax in the middle-age patients, the possible cause of the disease is LAM or LCH. The use of HRCT scanning may enable good determination of the nature and distribution of parenchymal abnormalities found in the diseases.

Psychosocial problems of patients with bronchial asthma.

The objective of the study was the analysis of psychosocial problems of subjects afflicted with bronchial asthma. The survey comprised a group of 121 patients treated in the Pulmonary Department of Medical University of Lublin. The type and intensity of problems was determined on the basis of Handicap Problems Inventory of Wright and Rommers. In comparison with various groups of people with disabilities, patients with asthma are affected with more psychosocial problems. They feel ashamed of their illness and try to conceal it from others. It results in rare and rather not very spontaneous contacts with other people and in the feeling of inferiority. They act best in family feeling, however, guilty towards them. They worry about the future of the relationship, loss of autonomy and independence. The patients lose confidence in their chances for professional career feeling afraid for their financial future. Basing on the results, it can be ascertained that the treatment of the bronchial asthma patients requires that their psychosocial problems should be taken into account. Then, the therapeutic effects will be more effective.

Evaluation of an anti-chlamydial antibiotic therapy influence on asthma patients.

Chlamydia pneumoniae is one of the most frequent pathogens causing airways infections. Contribution of chronic chlamydial infection to the following diseases: asthma, POChP, coronary heart disease, abdominal aortic aneurysm, is particularly interesting. The connection between such infection and bronchial asthma was described in the literature in 1991. C. pneumoniae often causes asthma exacerbation; it is suggested that it also may be an etiologic factor of the disease. In a group of 55 subjects with chronic, stable bronchial asthma treated in the Pulmonary Department, serologic characteristic of C. pneumoniae infection was found in 34 patients (61,8%). Thirteen of these subjects agreed to participate in the study. They were divided into two groups; placebo was administered to the first one and azithromycin in a dose of 1000 mg once a week--to the other one. The research was conducted using the double blind trial method. Anti-chlamydial antibody level was evaluated before and after treatment. Spirometry tests as well as subjective estimation of physical fitness and dyspnoea degree were also determined. In comparison with 'the placebo group', statistically significant improvement in respiratory parameters 'in the treated group' was not ascertained.

Differences in clinical test results of patients with bronchial asthma and living environment. Research in rural and urban areas in the eastern part of Poland.

The objective of the research was to evaluate immunological and clinical parameters in bronchial asthma patients from rural and urban areas in the east part of Poland. The study comprised 55 subjects reporting from November 2001 to January 2002 at the Pulmonary Department in order to have the disease diagnosed or to continue the treatment. The type of symptoms was determined on the basis of the standardized questionnaire. The patients were subjected to spirometry and skin prick tests. Blood eosinophil number as well as total and specific IgE levels were also evaluated. Significant (p<0.05) disturbances in respiratory parameters were found in 23% of patients living in the city and in 50% of subjects from the rural area. The level of IgE against grass pollens was significantly (p<0.01) higher in urban residents. The level of IgE against house dust was similar in both groups. Our study shows important differences between clinical manifestation of asthma in rural and inner-city patients and indicates that different aetiology may play an important role in asthma development.