[Spirometric evaluation of lung function in patients with myasthenia]. / Spirometryczna ocena funkcji pluc u chorych na miastenie.

UNLABELLED: Effort dyspnoea or dyspnoea at rest are predominating among subjective complaints in patients with myasthenia (myasthenia gravis--MG). THE AIM of the study was to evaluate the airway function in patients with MG by means of the chosen spirometric parameters analysis. MATERIAL AND METHODS: We observed 68 patients with MG in which type I (the ocular myasthenia), type IIA (the mild generalized form), type IIB (the subacute generalized form) and type IIC (the acute generalized form) was diagnosed based on Osserman classification and on 20 healthy volunteers (control group--CG). The function of the airways was assessed by means of "flow-volume" spirometry. RESULTS: The mean values of FEV1, MEF25-75 i FVC in the type II MG were lower than in CG. The mean value of PEF in the type II was lower than in CG and lower than in type I. In the type I of MG the mean values of evaluated parameters were not different than in CG. Decrease of PEF value was the most often found. The frequency of decreased PEF and FEV1 values was higher in type II than in CG. In all types of generalized MG the reduced FVC was found more frequently than in healthy people. In each types of MG (the type IIA, IIB, IIC) the mean values of the estimated parameters and the frequency of the deviation from predicted values were not different. CONCLUSION: The results show that in type II of MG the decrease of spirometric parameters is observed more often than in healthy people and these abnormalities are most marked in PEF. In the ocular MG the distinct tendency to FVC decrease is observed.

[Pulmonary masks of achalasia cardiae]. / Maski plucne achalazji przelyku.

In this article, the literature regarding the effects of achalasia cardiae on pulmonary disorders is reviewed. We specifically focused on the issue how achalasia may be associated with: airway obstruction, stridor, cough and recurrent pneumonia. Authors suggested it is necessary to carry out full differential diagnosis considering achalasia cardiae in patients with unsatisfactory treatment of recurrent respiratory tract diseases.

[Pseudoasthmatic syndrome due to achalasia cardiae]. / Zespól pseudoastmatyczny maskujacy achalazje przelyku.

The authors present a case of an 18-year-old woman, were referred to an allergologist because of a suspicion of bronchial asthma. She had complained of respiratory symptoms: chronic bronchitis for three years, cough and dyspnoea. Auscultation revealed wheezies and rales. Spirometry showed severe airway obstruction. Because of negative result of a reversibility test, ex iuvantibus treatment with prednisone was used but no results were obtained. The next step of diagnostic procedure was computed tomography which revealed the trachea compression by the dilated oesophagus. Finally she was found by us to have esophageal achalasia. Pharmacological treatment with nifedipine did not give an improvement. After operation the asthmatic symptoms disappeared and marked improvement was found in the flow-volume curve and in the chest radiogram. The demonstrated case proves that esophageal achalasia should be considered as one of the differential diagnoses of pathological respiratory symptoms suggesting asthma difficult to treat.

[Nasal provocation tests with house dust mite in patients with perennial rhinitis]. / Prowokacje donosowe alergenami roztoczy kurzu domowego u chorych z calorocznym alergicznym niezytem nosa.

UNLABELLED: The aim of this study was to evaluate a response of the upper airways mucosae to allergens house dust mite: Dermatophagoides farinae and Dermatophagoides pteronyssinus. Compared were results of nasal challenge with results of skin prick tests. 87 patients with perennial rhinitis allergic to Dermatophagoides farinae and/or Dermatophagoides pteronyssinus were included. There were 58 men, 29 women, age 18-54 years, mean age 26 years. Nasal provocation tests were performed first with solvent, and next if flow rate did not change more than 20%, with Dermatophagoides farinae and Dermatophagoides pteronyssinus extracts. The nasal response was evaluated with active anterior rhinomanometry. Nasal flow was measured at 15, 30 and 45 minutes after allergen challenge. There were 99% positive skin prick tests Dermatophagoides farinae and 94% positive skin prick tests Dermatopagoides pteronyssinus. Nasal provocation tests with Dermatophagoides farinae extract were positive in 63% patients and Dermatophagoides pteronyssinus extract--in 62% patients. Majority of nasal challenges were positive at 15th minute. There is association between skin prick tests Dermatophagoides farinae and Dermatophagoide pteronyssinus 4+ and positive nasal provocation tests with the same allergen (p < 0.05). We have found correlation between skin tests Dermatophagoides farinae and Dermatophagoides pteronyssinus (correlation index = 0.58) and no correlation between nasal provocation Dermatophgoides farinae and Dermatophagoides pteronyssinus extracts. CONCLUSION: Nasal provocation tests are more specific than skin prick tests in patients with perennial rhinitis.