Sheep recombinant IGF-1 promotes organ-specific growth in fetal sheep.

IGF-1 is a critical fetal growth-promoting hormone. Experimental infusion of an IGF-1 analog, human recombinant LR3 IGF-1, into late gestation fetal sheep increased fetal organ growth and skeletal muscle myoblast proliferation. However, LR3 IGF-1 has a low affinity for IGF binding proteins (IGFBP), thus reducing physiologic regulation of IGF-1 bioavailability. The peptide sequences for LR3 IGF-1 and sheep IGF-1 also differ. To overcome these limitations with LR3 IGF-1, we developed an ovine (sheep) specific recombinant IGF-1 (oIGF-1) and tested its effect on growth in fetal sheep. First, we measured in vitro myoblast proliferation in response to oIGF-1. Second, we examined anabolic signaling pathways from serial skeletal muscle biopsies in fetal sheep that received oIGF-1 or saline infusion for 2 hours. Finally, we measured the effect of fetal oIGF-1 infusion versus saline infusion (SAL) for 1 week on fetal body and organ growth, in vivo myoblast proliferation, skeletal muscle fractional protein synthetic rate, IGFBP expression in skeletal muscle and liver, and IGF-1 signaling pathways in skeletal muscle. Using this approach, we showed that oIGF-1 stimulated myoblast proliferation in vitro. When infused for 1 week, oIGF-1 increased organ growth of the heart, kidney, spleen, and adrenal glands and stimulated skeletal myoblast proliferation compared to SAL without increasing muscle fractional synthetic rate or hindlimb muscle mass. Hepatic and muscular gene expression of IGFBPs one to three was similar between oIGF-1 and SAL. We conclude that oIGF-1 promotes tissue and organ-specific growth in the normal sheep fetus.

Pulsatile hyperglycemia increases insulin secretion but not pancreatic ß-cell mass in intrauterine growth-restricted fetal sheep.

Impaired ß-cell development and insulin secretion are characteristic of intrauterine growth-restricted (IUGR) fetuses. In normally grown late gestation fetal sheep pancreatic ß-cell numbers and insulin secretion are increased by 7-10 days of pulsatile hyperglycemia (PHG). Our objective was to determine if IUGR fetal sheep ß-cell numbers and insulin secretion could also be increased by PHG or if IUGR fetal ß-cells do not have the capacity to respond to PHG. Following chronic placental insufficiency producing IUGR in twin gestation pregnancies (n=7), fetuses were administered a PHG infusion, consisting of 60 min, high rate, pulsed infusions of dextrose three times a day with an additional continuous, low-rate infusion of dextrose to prevent a decrease in glucose concentrations between the pulses or a control saline infusion. PHG fetuses were compared with their twin IUGR fetus, which received a saline infusion for 7 days. The pulsed glucose infusion increased fetal arterial glucose concentrations an average of 83% during the infusion. Following the 7-day infusion, a square-wave fetal hyperglycemic clamp was performed in both groups to measure insulin secretion. The rate of increase in fetal insulin concentrations during the first 20 min of a square-wave hyperglycemic clamp was 44% faster in the PHG fetuses compared with saline fetuses (P0.23). Chronic PHG increases early phase insulin secretion in response to acute hyperglycemia, indicating that IUGR fetal ß-cells are functionally responsive to chronic PHG.

Bronchial hyperreactivity in sarcoidosis patients: correlation with airflow limitation indices.

UNLABELLED: Bronchial hyperreactivity (BHR) in sarcoidosis has been reported in 5 to 83% of patients, but the relationship between BHR and airway functional status being unclear. The aim of the study was to assess the prevalence and degree of BHR in a group of pulmonary sarcoidosis patients and how BHR does relate to the functional status of airways. MATERIAL AND METHODS: 56 consecutive sarcoidosis outpatients (26 f, 30 m) were included. There were 14 (25%) patients in stage I, 32 (57.1%) patients in stage II and 10 (17.9%) patients in stage III. In all patients the standard evaluation included a history, physical examination, chest radiogram, serum ACE activity and lung function assessment were done. The provocation challenge test with doubling concentrations of histamine was performed in all patients using the standardized protocol recommended by the ERS. RESULTS: 4 patients (7%) were restrictive, airway obstruction was detected in 7 (12.5%) cases. Up to 32% of patients had maximal expiratory flows at low lung volumes below the lower limit of normal (LLN). The histamine challenge test results: in 9 cases (16%) the fall in FEV1 was < 20% of the baseline; mean PC20H (n = 47) was 5.7 +/- 5.9 mg/mL, range: 0.56-26.7 mg/mL. The challenge test was regarded as positive (PC20H < or = 8 mg/mL) in 71.4% of the group. BHR expressed as ln(PC20H) correlated weakly but significantly with FEV1, FEV1%VC, MMEF and PEF. CONCLUSION: BHR occurs frequently in sarcoidosis patients and should be considered especially in patients with airflow limitation.

Impaired lung compliance and DL,CO but no restrictive ventilatory defect in sarcoidosis.

Sarcoidosis is a systemic granulomatous disease with predominant manifestation in the lungs, often presenting as interstitial lung disease. Pulmonary function abnormalities in sarcoidosis include restriction of lung volumes, reduction in diffusing capacity of the lung for carbon monoxide (D(L,CO)), reduced static lung compliance (C(L,s)) and airway obstruction. The aim of the present study was to assess various lung function indices, including C(L,s) and D(L,CO), as markers of functional abnormality in sarcoidosis patients. Results from 830 consecutive patients referred for lung function tests with a diagnosis of sarcoidosis (223 in stage I, 486 in stage II and 121 in stage III) were retreospectively analysed. The mean ± sd age of the patients was 40 ± 11 yrs; 18% were active smokers and 24% were former smokers. Normal total lung capacity was found in 772 (93%) patients. Of these cases, 24.5% had a low C(L,s) and 21.5% had a low D(L,CO). At least one abnormality was observed in 39.3% of these patients, whereas, in restrictive patients, this figure was 88%. Airway obstruction was present in 11.7% of cases. Lung volumes usually remain within the normal range and measurement of either C(L,s) or D(L,CO) often reveal impaired lung function in sarcoidosis patients, even when their lung volumes are still in the normal range; these two measurements provide complementary information.

The inspiratory muscle training in elite rowers.

AIM: The aim of the investigation was to assess the effects of the resistive inspiratory muscle training (IMT) in elite male rowers. METHODS: Fifteen senior rowers were assayed for the maximal inspiratory mouth pressure (PImax) and maximal oxygen uptake (VO2max), and then randomized into two groups: the control and the experimental group. The latter athletes, in addition to basic training, were subjected to the 11-week IMT consisting of a series of 30 inspiratory efforts performed twice a day. Athletes from the control group did only the basic training. RESULTS: No significant relations were detected between the initial values of PImax and the VO2max value. After 6 weeks of IMT the PImax values increased by 20+/-10% (P < 0.05), whereas the final improvement (after 11 weeks of IMT) equaled to 34+/-19% (P < 0.05). In the control group, the final increase equaled to 4+/-9% and was statistically insignificant. Compared to the values obtained at the end of IMT, 14 weeks after cessation of the training PImax insignificantly decreased in the experimental group by 10+/-9%, but the measured values were still significantly higher than before the commencement of IMT. CONCLUSION: The data obtained corroborate the observations that in well-trained athletes the introduction of the principle of incremental inspiratory resistance allows to improve methodically the inspiratory muscles' strength. Once the essential period of IMT has been completed, the training volume should be reduced in order to secure the attained level of the inspiratory muscles' strength.

Cellular components of the bronchoalveolar lavage correlate with lung function impairment and extrapulmonary involvement markers in active sarcoidosis.

Sarcoidosis is a chronic inflammatory multiorgan disease of unknown origin. Our previous study demonstrated a significant correlation between the relative count of non CD4(+), non CD8(+) lymphocytes in bronchoalveolar lavage of active sarcoidosis patients and proangiogenic activity of BAL homogenates. The aim of the present study was to evaluate in a group of 40 patients with active sarcoidosis the possible relationship between the intensity of alveolitis, particularly the non CD4(+), non CD8(+) lymphocyte subset, and other parameters characterizing the level of pulmonary (lung function tests) and extrapulmonary (spleen longitudinal dimension) disease activity. We found that the relative count of non CD4(+), non CD8(+) lymphocytes in BAL correlated positively with spleen size (r=0.50, P<0.01) and negatively with static compliance (r=0.43, P<0.05). We concluded that the lymphocytes belonging to the non CD4(+)non CD8(+) subset participate in the inflammatory process in sarcoidosis. However, more detailed phenotypic and functional characteristics of this cellular population are needed.

Quantitative genomics: exploring the genetic architecture of complex trait predisposition.

Most phenotypes with agricultural or biomedical relevance are multifactorial traits controlled by complex contributions of genetics and environment. Genetic predisposition results from combinations of relatively small effects due to variations within a large number of genes, known as QTL. Well over 200 QTL have been reported for growth and body composition traits in the mouse, which likely represent at least 50 to 100 distinct genes. Molecular biology has yielded significant advances in understanding these traits at the metabolic and physiological levels; however, little has been learned regarding the identity and nature of the underlying polygenes. In addition to the significantly poor precision inherent to QTL localization, it is very difficult to differentiate between co-localization and coincidence when comparing QTL with other QTL and with potential candidate genes. The wide gap between our knowledge of physiological mechanisms underlying complex traits and the nature of genetic predisposition significantly impairs discovery of genes underlying QTL. Identification and genetic mapping of key transcriptional, proteomic, metabolomic, and endocrine events will uncover large lists of significant positional candidate genes for growth and body composition. However, integration of experimental approaches to jointly evaluate predisposition and physiology will increase success of QTL identification by merging the power of recombination with functional analysis. Measuring physiologically relevant subphenotypes within a structured QTL mapping population will not only facilitate pathway-specific prioritization among candidate genes, but may also directly identify genes underlying QTL. This would advance our understanding of the genetic architecture of complex traits by testing the central hypothesis that genes controlling predisposition to a quantitative trait are primarily involved in trans-regulation of the primary physiological pathways that regulate the trait.

[Own experience in diagnosis and therapy in pulmonary Langerhans cell granulomatosis]. / Wlasne doswiadczenia w rozpoznaniu i leczeniu plucnej postaci ziarniniakowatosci komórek Langerhansa.

UNLABELLED: We have assessed 12 patients (2 females, 10 males) aged between 19 and 53 years (mean 38.3 +/- 10.3) diagnosed with LCG during 14-year period (1985-1998). All patients were smokers. Follow-up was from 6 to 132 months (mean 47.5 +/- 44.4). LCG diagnosis was confirmed by histology in 10 cases (9 lung, and 1 bone biopsy). In 2 patients the diagnosis was made on clinical grounds, including characteristic appearance on HRCT scans. Mean FVC was 78.9 +/- 15.9% of predicted, DLCO 64.1 +/- 22% of predicted. In 8 patients (67%) FVC or DLCO were below 80% of predicted. In 2 patients with histologically proven diagnosis, HRCT was not characteristic for LCG. The treatment was introduced in 8 patients (67%). Only 3 out of 8 patients initially treated with steroids responded to this treatment. In the rest treated patients, therapy was changed to cytotoxic agents. 3 patients died (1 after 2 years, and 2 after 11 years) 2 due to LCG and 1 due to pneumonia. CONCLUSION: HRCT appearance is not always characteristic in patients with histological diagnosis of LCG. Pulmonary involvement in LCG is frequently connected with lung function derangements. Response to steroids is poor, and switching to cytotoxic agents is often necessary.

Electron affinities of the DNA and RNA bases.

Adiabatic electron affinities (AEAs) for the DNA and RNA bases are predicted by using a range of density functionals with a double-zeta plus polarization plus diffuse (DZP++) basis set in an effort to bracket the true EAs. Although the AEAs exhibit moderate fluctuations with respect to the choice of functional, systematic trends show that the covalent uracil (U) and thymine (T) anions are bound by 0.05-0.25 eV while the adenine (A) anion is clearly unbound. The computed AEAs for cytosine (C) and guanine (G) oscillate between small positive and negative values for the three most reliable functional combinations (BP86, B3LYP, and BLYP), and it remains unclear if either covalent anion is bound. AEAs with B3LYP/TZ2P++ single points are 0.19 (U), 0.16 (T), 0.07 (G), -0.02 (C), and -0.17 eV (A). Favorable comparisons are made to experimental estimates extrapolated from photoelectron spectra data for the complexes of the nucleobases with water. However, experimental values scaled from liquid-phase reduction potentials are shown to overestimate the AEAs by as much as 1.5 eV. Because the uracil and thymine covalent EAs are in energy ranges near those of their dipole-bound counterparts, preparation and precise experimental measurement of the thermodynamically stable covalent anions may prove challenging.

[Pulmonary lymphangioleiomyomatosis: presentation and results of treatment]. / Limfangioleiomiomatoza pluc: obraz kliniczny i wyniki leczenia.

Lymphangioleiomyomatosis is a rare lung disease of unknown aetiology that affects only women. Eight premenopausal women with LAM confirmed by lung biopsy specimens were observed in 1984-2001. The most common presenting feature was exertional dyspnea (6) followed by chylous pleural effusions and pneumothoraces. In two women severe airflow obstruction was observed at presentation. HRCT revealed characteristic cysts in all cases. All women were given hormonal therapy (tamoxifen, medroxyprogesterone). The best results of treatment were achieved in cases with chylothoraces.

[Clinical presentation of own idiopathic pulmonary fibrosis patients according to international consensus statement]. / Próba zastosowania kryteriów diagnostycznych miedzynarodowej grupy ekspertów do oceny obrazu klinicznego samoistnego wlóknienia pluc w materiale wlasnym.

Clinical presentation of idiopathic pulmonary fibrosis (IPF) restricted, according to current definition to usual interstitial pneumonia (UIP) was presented. 62 patients (39 males and 23 females) were assessed. The diagnosis of IPF/UIP has been based upon a combination of clinical, radiographic and physiologic features in majority of patients. Histologic confirmation from lung biopsy has been obtained in 16% of cases. Mean age of the patients was 64.4 +/- 8.0 years. Mean duration of symptoms was 20.1 +/- 14.1 months. The main symptom was exertional dyspnea. Crepitations were found in 98% of patients. Lung volumes were in normal range in substantial number of patients; TLC in 15 (24%) and FVC in 33 (53%) out of 62 patients. Disturbances of lung function concerned mainly gas exchange (DLCO diminished in 92% of cases) and lung compliance (diminished in all patients). Presentation of clinical, radiographic and physiologic features of IPF/UIP in a homogenous group of patients may be helpful in diagnosis of this common interstitial lung disease.

[Clinical significance of pattern types in high resolution computed tomography images of patients with idiopathic pulmonary fibrosis]. / Znaczenie kliniczne typu zmian w obrazie tomografii komputerowej wysokiej rozdzielczosci u chorych na samoistne wlóknienie pluc.

UNLABELLED: The aim of the study was to assess significance of two types of HRCT pattern in patients with idiopathic pulmonary fibrosis (IPF), corresponding to usual interstitial pneumonia. The study population consisted of 34 patients, 11 women and 23 men, mean age 64.5 +/- 10.5 years. The patients were divided into two groups according to HRCT appearance: Group A--reticular pattern with some ground-glass attenuation (30 patients); group B--reticular pattern only (4 patients). Age, level of dyspnea, pulmonary function tests were similar in both groups. Longer history of dyspnea and more frequent finger clubbing (all patients) were found in Group B. 30 patients were followed-up for at least 12 months. In this period 4 out of 27 patients died in Group A, and 2 out of 3 patients died in Group B (p < 0.05). CONCLUSION: HRCT showing reticular pattern only corresponds to late phase of IPF and is connected with very short survival.

[Clinical presentation and medical management in patients with idiopathic pulmonary fibrosis before diagnosis]. / Obraz kliniczny i postepowanie lekarskie u chorych na samoistne wlóknienie pluc w okresie poprzedzajacym ustalenie rozpoznania.

UNLABELLED: The aim of the study was to find factors that may influence diagnostic process of idiopathic pulmonary fibrosis (IPF). Clinical presentation and medical management in the period before the diagnosis of IPF were assessed in 57 patients. There were 25 females and 32 males in the study group; mean age was 61.4 +/- 10.9 years. Mean duration of symptoms in the whole group was 18.4 +/- 16.0 months. The most common symptoms were dyspnea on exertion (96.5% of cases) and cough (84.2% of cases). 56 out of 57 patients (98.2% of cases) had crackles on auscultation of the lungs. In one third of the patients clubbing of the fingers was found. Mean FVC% of predicted was 77.2 +/- 19.8%, and mean DLCO% of predicted was 61.6 +/- 16.8%. The most common associated disease was ischemic heart disease, found in 43.9% of patients. Duration of symptoms in patients with ischemic heart disease was 25.7 +/- 18.8 months and was as twice long as in the rest of the patients, 12.8 +/- 10.5 months (p < 0.005). Prior the diagnosis of IPF 22 patients (38.6% of cases) did not any receive treatment for symptoms of interstitial lung disease. 31 patients (54.4% of cases) received antibacterial treatment (29 antibiotics and 2 anti-Tb drugs), although there were no clear signs of infection. CONCLUSIONS: 1. Associated ischemic heart disease may cause delay in establishing the diagnosis of IPF; 2. In the period before diagnosis of IPF over half of the patients were given antibacterial treatment without appropriate indications.

[Ischemic heart disease as a factor for hindering diagnosis of idiopathic pulmonary fibrosis]. / Choroba niedokrwienna serca jako czynnik utrudniajacy rozpoznanie samoistnego wlóknienia pluc.

UNLABELLED: The aim of the study was to find factors that may influence diagnostic process of idiopathic pulmonary fibrosis (IPF). Clinical presentation, lung function data and radiological changes were assessed in 57 patients with diagnosis of IPF. There were 25 females and 32 males in the study group; mean age was 61.4 +/- 10.9 years. Mean duration of symptoms in the whole group was 18.4 +/- 16.0 months. The most common symptoms were dyspnea on exertion (96.5% of cases) and cough (84.2% of cases). 56 out of 57 patients (98.2% of cases) had crackles on ausculation of the lungs. In one third of the patients clubbing of the fingers was found. Mean FVC% of predicted was 77.2 +/- 19.8%, and mean DLCO% of predicted was 61.6 +/- 16.8%. The most common associated disease was ischemic heart disease, found in 43.9% of patients. Duration of symptoms in patients with ischemic heart disease was 25.7 +/- 18.8 months and was as twice long as in the rest of the patients, 12.8 +/- 10.5 months (p < 0.005). CONCLUSIONS: 1: Associated ischemic heart disease may cause delay in establishing the diagnosis of IPF; 2. Crackles on ausculation are characteristic for IPF and together with disseminated changes on chest radiograms indicate correct diagnosis in patients with associated ischemic heart disease.

[Prevalence of diagnosing extrinsic allergic alveolitis in Poland in the years 1990-1994]. / Czestosc rozpoznawania alergicznego zapalenia pecherzyków plucnych W Polsce, w latach 1990-1994.

Poland is the country, where almost 40% of population inhabit rural areas. So EAA may be an important health problem. The aim of the study was to assess incidence of EAA in different districts in Poland. We asked hospitals to send us lists of patients with diagnosis of EAA established in the period of 1990-1994. In some hospitals we collected information by ourselves. This way, we have got data concerning patients with EAA. The highest prevalence of EAA 1.5-7.0/100,000 population was observed in eastern and south-western regions of Poland. Eastern Poland is rural area with small not specialised farms and possible high exposure to EAA antigens. In south-western Poland (Silesia) keeping pigeons is a very popular hobby, which may explain high incidence of EAA.

[Dyspnea, respiratory mechanics and gas exchange in patients with idiopathic pulmonary fibrosis]. / Dusznosc, mechanika oddychania i wymiana gazowa u chorych na samoistne wlóknienie pluc.

The sensation of dyspnea on exertion is usually the first clinical symptom in patients with IPF. The aim of the study was to assess breathlessness in patients with IPF at the time of diagnosis. The study group included 9 patients (5 women and 4 men), aged 61.4 +/- 10.5 (mean +/- SD) yrs, (range 38-71 yrs). FVC was 65.8 +/- 8.3% pred., FEVI 70.0 +/- 9.0% pred., TLC 65.1 +/- 10.5% pred. 6 min walking test was performed, during which pts reported their breathlessness according to Borg scale. All patients but one reported breathlessness during exercise. Patients were divided into two groups according to the level of dyspnea at the end of the walking test. Patients with dyspnea equal or less than moderate (= < level 3 Borg scale) had significantly higher lung volumes FVC (2.57 +/- 0.44 vs 1.79 +/- 0.5 l, p < 0.05), FEVI (2.23 +/- 0.29 vs 1.56 +/- 0.36 l, p < 0.02), TLC (4.26 +/- 0.26 vs 3.13 +/- 0.69 l, p < 0.02), DLCO (4.49 +/- 0.52 vs 3.43 +/- 0.23 mmol/min/kPa, p < 0.02), and smaller alveolar-arterial oxygen tension difference at rest (31.8 +/- 5.6 vs 43.8 +/- 2.8 mmHg, p < 0.01) as compared to the patients with more severe dyspnea (> level 3 Borg scale). All patients desaturated during the test, but there was no correlation between the degree of desaturation and dyspnea level at the end of the test. 4 patients from the first group (dyspnea level = < 3 Borg scale) desaturated from 6.3% to 19.4% from baseline value. So patients with IPF may experience severe desaturation during normal daily activity not being aware of it. Dyspnea on exertion in these patients seems to depend on both disturbed lung mechanics and gas exchange. Simple 6-minutes walking test proved to be useful in assessing severity of the disease in patients with IPF.

[Bronchiolitis obliterans organizing pneumonia]. / Zarostowe zapalenie oskrzelików z organizujacym sie sródmiazszowym zapaleniem pluc.

Idiopathic BOOP is a clinicopathological entity defined histopathologically by the presence of granulation tissue in bronchioles, alveolar ducts and alveoli. 2 men and 6 women (mean age 47.2 years, range 22-66) with idiopathic BOOP have been observed, the mean period of observation being 31.1 months. In 7 cases the disease started with fever, cough and in 6 with progressive dyspnea. The interval between the onset of symptoms and the beginning of treatment ranged from 2 to 10 months. One woman was asymptomatic. The initial findings were: tachypnoea (6), crackles (7), decreased VC (6), reduced diffusing capacity (6), raised erythrocyte sedimentation rate (7). In 6 cases chest radiographs showed multiple alveolar patchy opacities of various size predominantly in the middle and lower lung zones. HRCT demonstrates peripheral distribution of changes. In one case diffuse reticulonodular infiltrates and in one case solitary tumor-like opacity with cavitation were observed. Seven subjects were given prednisone. Three subjects recovered completely, in 1 clinical and radiological improvement was observed. In 3 cases relapse occurred. The woman with the solitary tumor-like opacity was cured by surgical excision of the lesion.

[Lung and pleural changes caused by exposure to asbestos]. / Zmiany plucne i oplucnowe wywolane ekspozycja na azbest.

Asbestos exposure results in an increased risk of nonmalignant as well as of malignant pulmonary and pleural disease. The asbestos-related disease are inexorably progressive (cancer) or insidious (fibrosis), untreatable and widespread in the industrialized and urban world. The identification of these diseases is important because therapy and prognosis differ from the other pulmonary fibrosis. The case reports indicate that careful clinical and histologic examination allows proper diagnosis. Two patients with asbestos-related disease after asbestos exposure are described.

[Deaths from asthma, bronchitis and pulmonary heart disease in Warsaw in the years 1993-1994]. / Zgony na astme przewlekle zapalenie oskrzeli i serce plucne w Warszawie w latach 1993-1994.

By the regular checking the death certificates in the municipal offices in 7 districts of Warsaw, the morality rate from asthma has been established as 2.98/100.000, from chronic bronchitis as 8.71/100.000 and from pulmonary heart disease as 6.27/100.000. During one year of this survey only 15 deaths (4.7%) from these diseases were below age of 50.67% of patients died in hospitals and 22 (7%) died suddenly (at home). In general, deaths reported as the results of COLD were only 1.59% of the total number of deaths in Warsaw (21.530). 6.9% of all death certificates were without clinical diagnosis (Number 798 of ICD)-described as "natural death", "death before doctor's arrival" or "noncriminal death". Authors discuss the problem of over- and under-diagnosis of asthma as the cause of death, the historical background of asthma mortality and also put the question of the righteousness of regard the pulmonary heart disease as the primary cause of death.

[Treatment of patients with pulmonary aspergilloma with itraconazole]. / Leczenie itrakonazolem chorych z grzybniakami kropidlakowymi pluc.

The study aimed to assess effectiveness of itraconazole in treating pulmonary aspergilloma. Treatment with this triazole derivative was employed in 11 patients with pulmonary aspergilloma. Nine patients underwent a complete 6 month treatment at 200-400 mg dose. The treatment was discontinued in lesions 2 patients who demonstrated progression of lesions. Haemoptysis withdrew in 5 patients, the same number of patients displayed negative fungus culture. Only in 1 patient radiological appearances improved and negative sputum culture as well as cessation of haemoptysis were observed. No significant adverse reactions were reported for any patients. Six months after completion of the treatment haemoptysis recurred in 2 patients, renewed growth of A. Fumigatus was quoted for 3 patients and intensified precipitating test results for 2 patients. Only 1 patient improved within all the required parameters. The results of the conducted study indicate that itraconazole by infiltrating lung cavity inhibits fungus growth on the surface of aspergilloma, which, in isolated cases can lead to aspergilloma necrosis. The results of itraconazole treatment are not sufficiently satisfactory to justify application of itraconazole in routine treatment of pulmonary aspergilloma.