The volume of the carotid bodies and blood pressure variability and pulse pressure in patients with essential hypertension.

AIM: To assess the relationship between the volume of the carotid bodies (VrCB+lCB) examined by means of computed tomography angiography (CTA) and blood pressure variability and pulse pressure (PP) in 24-hour ambulatory blood pressure monitoring (ABPM) in patients with essential hypertension. MATERIALS AND METHODS: A group of 52 patients with essential hypertension was examined (mean age: 68.32±12.31 years), the sizes of carotid bodies were measured by means of carotid artery CTA, and 24-hour ABPM was carried out. The 24-hour ABPM established systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), PP, SBP variability (SBPV), and DBP variability (DBPV). RESULTS: SBP, MAP, and SBPV were significantly higher in the group of hypertension patients with VrCB+lCB equal to or above the median than in the group of hypertension patients with VrCB+lCB less than the median, as well as in the group of hypertension patients with oversized carotid bodies, than in the group of hypertension patients with normal VrCB+lCB. Moreover, the PP was statistically significantly higher in the group of hypertension patients with VrCB+lCB equal to or above the median than in the group of hypertension patients with VrCB+lCB less than the median. The existence of statistically significant positive linear relationships was revealed between VrCB+lCB and SBP, PP, and SBPV. A higher body mass index, older age, smoking, and higher VrCB+lCB are independent risk factors increasing SBPV in the research group. CONCLUSION: A positive relationship between the size of the carotid bodies and variability of the SBP and PP is observed in patients with essential hypertension.

Low-dose computer tomography as a screening tool for lung cancer in a high risk population.

The aim of the study was to evaluate the usefulness of low-dose computer tomography as a screening tool for early stage lung cancer. The study was performed in 332 individuals aged 55-70 who were asymptomatic, who had not previously suffered from cancer, and who smoked at least ten packs of cigarettes a year. Baseline and repeated LD-CT scans were performed. Pulmonary nodules were classified according to the size and morphology, and the results were categorized as negative (no nodules observed), semi-positive (nodules of 4 mm or smaller in diameter) and positive (nodules 5 mm or larger). Based on the category of the patient, either a repeat low-dose CT, a bronchoscopy with or without a biopsy, or a PET-CT was performed. The baseline screening showed 59 positive results. Eighteen patients were hospitalized and underwent bronchoscopy and biopsy. One of these patients had Stage I non small cell lung carcinoma (NSCLC) and a lobectomy was performed. Three patients had Stage IV NSCLC and were referred for chemotherapy. We identified 103 semi-positive results. Only 25 of those patients had a repeat scan because of noncompliance. We observed no significant growth of diagnosed nodules in a semi-positive group. Low-dose CT can be used as a screening tool for early stage lung cancer. A high percentage of false-positive results are observed. There are difficulties in diagnosing nodules in patients with post-tuberculosis changes. A high rate of noncompliance was noticed.

Chyloperitoneum, chylothorax and lower extremity lymphedema in woman with sporadic lymphangioleiomyomatosis successfully treated with sirolimus: a case report.

Lymphangioleiomyomatosis (LAM) is a rare disease characterized by diffuse thin-walled cysts throughout the lungs on computed tomography and diffuse proliferation of abnormal smooth muscle-like cells (LAM cells) on lung biopsy. LAM affects women almost exclusively, predominantly in their reproductive age. The most typical presenting symptoms include dyspnea, spontaneous pneumothorax, cough and chylothorax. Abdominal findings represent less common initial manifestations of the disease and may pose diagnostic difficulties. The treatment of LAM has not been fully established. Recent studies report effectiveness of sirolimus in LAM patients. We report the case of a 45-year-old woman with sporadic LAM, successfully treated with sirolimus, in whom the first manifestation of the disease was chyloperitoneum and after three and nine years, respectively, lymphedema of the left lower extremity and right sided chylothorax occurred.

Favorable resolution of hepatic infarctions in transplanted liver after portal vein thrombosis treated by surgical thrombectomy: a case report.

Portal vein thrombosis (PVT) after orthotopic liver transplantation (OLT) is a life-threatening complication associated with a high rate of graft loss and patient death, with reported incidence of 1% to 2% in adults. We report a case of an early PVT after OLT complicated by hepatic infarctions in the liver graft. After surgical thrombectomy and restoration of the portal inflow, hepatic infarctions resolved spontaneously within 6 months, which was confirmed by computed tomography.

[Thoracic aortic dissecting aneurysm with bleeding into the pleural cavity]. / Tetniak rozwarstwiajacy aorty piersiowej z krwawieniem do jamy oplucnej.

A rare case of dissecting aneurysm of the aortic arch with left haemothorax was presented. The authors describe modern methods of visualising diagnostics used in case of suspected dissecting aortic aneurysm.

[Gas gangrene or inflammation of the neck--diagnostic difficulties]. / Zgorzel gazowa czy ropowica szyi--trudnosci diagnostyczne.

The authors describe a patient with an extensive inflammation of the neck soft tissues as a complication of the peritonsillar abscess. Follow-up computed tomography revealed gasi-form follicles in the inflammed neck soft tissues, suggesting gas gangrene. We report disseminate ways of the inflammation process on the financial tonsil, reasons of the gangrene also the infections of soft tissues caused by anaerobic bacteries--Clostridium. CT--examination in inflammatory tumors of the neck is valuable, permits to exclude expansion process, but it cannot give unequivocal answer to differentiate gas gangrene and phlegmon.

[Foreign body in the right frontal lobe of the brain as a result of right eyeball and right eye-socket trauma--case report]. / Cialo obce w prawym placie czolowym mózgu w nastepstwie urazu prawej galki ocznej i oczodolu prawego--opis przypadku.

We report a case of a 44 year old man, who was admitted to our hospital because of right eyeball and right eye-socket due to a piece of diamond circular saw. Right eyeball was sutured. CT--examination showed a metallic foreign body in the right frontal lobe of brain. Metallic foreign body, which damaged the right eyeball, caused upper restriction of right eye-socket ceiling and stuck in a frontal lobe of the brain was removed.

[Disorders of the bone density in the chest x-ray examination in the course of myelosclerosis]. / Zaburzenia utkania kostnego w obrazie radiologicznym klatki piersiowej w przebiegu zwlóknienia szpiku.

The authors report a rare case of myelosclerosis diagnosed during hospital stay in internal Department on account of hepatosplenomegaly and anaemia. The case of patient described by authors was diagnosed on the ground of examination and executed additional investigations: morphology, peripheral blood picture, chest radiography, scintiscan of skeleton.