Impulse oscillometry in the diagnosis of airway resistance in chronic obstructive pulmonary disease.

Spirometry is a standard lung function test for diagnosis and staging of chronic obstructive pulmonary disease (COPD). Impulse oscillometry (IOS) can be complementary to spirometry, especially in patients at advanced age and with physical or mental disorders who cannot be diagnosed through spirometry. The aim of this study was to compare IOS and spirometry in the assessment of airway obstruction in COPD. The study was conducted in 112 stable COPD patients, including 29 females and 83 males of the mean age of 69±11 years. The oscillometric evaluation included total (R5), peripheral (R5-R20), and negative reactance (X5), which were compared with the predicted forced expiratory volume in 1 s (FEV1%pred). The findings show a significantly negative correlation between FEV1%pred and the R5, R5-R20, and X5. COPD patients had increased R5, R5-R20, and X5. The severity of bronchial obstruction found by impulse oscillometry correlated well the spirometric assessment. IOS is a simple to perform test that may be helpful for functional examination of COPD patients.

Carotid artery intima-media thickness in hypertensive patients with obstructive sleep apnea.

In this study we determined the relationship between the severity of obstructive sleep apnea (OSA) and body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), and carotid intima-media thickness (cIMT) in 30 hypertensive male patients, aged 30-70, with newly diagnosed OSA (15 with moderate OSA - Group A, and 15 with severe OSA - Group B) and 20 non-OSA hypertensive individuals (Group C). We revealed significant differences in cIMT between Groups B and C (0.9 ± 0.3 vs. 0.6 ± 0.1 mm and 1.0 ± 0.4 vs. 0.6 ± 0.2 mm in the right and left common carotid arteries, respectively; p <0.05). Increased carotid intima-media thickness in severe OSA was accompanied by higher systolic and diastolic blood pressures compared with both moderate OSA and control subjects. We conclude that in severe OSA increased blood pressure goes in tandem with the thickness of carotid intima-media, which helps explain increased cardiovascular risk in these patients.

Complications of endoscopic retrograde cholangiopancreatography (ERCP) and their risk factors.

PURPOSE: Determination of the type and frequency of complications developing after diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) as well as the risk factors predisposing to them. MATERIAL/METHODS: The retrospective study, including 734 ERCP performed in 550 patients, with 404 (55%) ES (endoscopic sphincterotomy) during a 4-year period. RESULTS: Among 734 ERCP procedures, 76.4% (561) had both diagnostic and therapeutic purpose, 15.2% (112) were only diagnostic. Complications developed after 26 procedures (3.5%): acute pancreatitis (AP) in 8 patients (1.09%), cholangitis in 7 (0.95%) and delayed bleeding in 11 (1.5%) patients. After 49 (6.7%) ES immediate bleeding was observed. The risk factors for AP were: unintentional pancreatic duct contrasting, mechanical lithotripsy, the use of the "pre-cut" technique and bile duct dilatation. Cholangitis was more common in cases with difficult cannulation at older age and with lower baseline bilirubin level. The risk factors for delayed bleeding were: location of the ampulla of Vater in the diverticulum and the use of the "precut" technique. Immediate bleeding was more frequent after revision of bile ducts with Dormia's basket or with balloon, after introduction of contrast medium to the pancreatic duct or in ductal cholelithiasis. CONCLUSIONS: ERCP performed in the endoscopy unit of a specialist hospital department is a relatively safe procedure, with a low burden of complications as compared to the benefits it provides to appropriately qualified patients.

Anti-ox-LDL and anticardiolipin autoantibodies in patients after cardiac transplantation.

INTRODUCTION: Among cardiac transplantation (OHT) of coronary arterial disease, the pathogenesis can be associated with autoimmunologic effects due to oxidative lipoprotein modification and their change in antigenicity. These factors may lead to lipoprotein vascular changes observed in antiphospholipid syndrome or systemic lupus erythematosus. The aim of the presented study was to evaluate anticardiolipin autoantibodies (ACA) and anti-ox-LDL (antibodies against oxidized LDL) levels in the plasma immunoglobulin IgG class. MATERIALS AND METHODS: The study group consisted of 90 OHT patients (79 men/11 women, age 44 +/- 13); 35 individuals were chosen as a control group. Blood samples were taken twice, in years 2002 and 2004. The investigated group was divided into 2 smaller groups: OHT patients in 2002 and OHT patients before 2002. RESULTS: OHT patients showed significantly higher ACA concentrations compared with the control group (3.53 vs 1.10 GPL U/mL), whereas anti-ox-LDL levels did not differ considerably (494 vs 385 mU/mL). During long-term observation the significant increase in ACA concentration was observed in both patients groups. Significant differences between the 2 OHT patient groups regarding anti-ox-LDL concentration were demonstrated among samples taken in 2002. CONCLUSIONS: The results may indicate the possible role of autoimmunological processes in OHT development. It is necessary to focus further research on the possibilities of developing secondary antiphospholipid syndrome.

[Familial occurrence of subacute sclerosing panencephalitis (SSPE) in children]. / W sprawie rodzinnego wystepowania podostrego stwardniajacego zapalenia mozgu (SSPE) u dzieci.

The authors discuss the etiology and pathogenesis of SSPE in the light of own observations of two boys aged 8 and 9 years whose one grandfather and one grandmother were siblings. The boys lived in different parts of Poland and never been in contact with each other. In the light of this observation the authors discuss the possibility of a genetic background in SSPE.

Cerebral blood flow and ultrastructural studies of the brain capillaries in the early state of hypertension in SHR+.

The 133Xe single bolus injection technique was used for measuring the cerebral blood flow (CBF) in spontaneously hypertensive (SHR) and normotensive rats. Their age was from 5 to 25 weeks and corresponded to the time before the initiation of the arterial blood pressure (BP) increase to the constant phase of hypertension. CBF in SHR 5 and 10 weeks of age was significantly higher than in all other groups being 155 +/- 7.2 and 151 +/- 9.3 ml/min/100 g, respectively. At 15 weeks of age the localization of the reactive products of ATP and CTP became scanty and spread over the endothelial cytoplasm. Further, at 25 weeks an enlarged number of empty pinocytic vesicles and astrocytic foot processes filled with flocculent electron dense material was found. These data suggest that the initial high CBF preceding the increase of BP can initiate the irreversible disorder of endothelial cells in brain capillaries.

Application of the 133Xe bolus technique for measuring the cerebral blood flow in young and adults rats.

For measuring the cerebral blood flow (CBF) in young (5 weeks old) and adult (25 weeks old) rats the 133Xe bolus technique was used. The effect of the preparation technique on the shape of the washout curve is discussed. The values of CGFfast estimated by the two compartmental analysis were comparable to that obtained by other methods.

Method for comparative studies of the revascularisation processes in the bone tissue, using 85Sr.

85SR was used for the local blood flow measurements in bones. A method for dynamic analysis of the magnitude of local blood flow based on 7-min analysis of the area under the logarithmic curve was presented. The radioactivity of the tibial diaphysis was followed by a gamma-scintillation dectector focused on the area of approximately 10 mm 0. The revascularisation process during bone repair after the osteotomy of the tibial diaphysis fixed intramarrowally was observed on 14 rabbits, two and four weeks after the osteotomy. In the first two weeks following the osteotomy the process of revascularisation was significantly enhanced in a comparison to the second two weeks.