Lymphocyte subsets in peripheral blood and bronchoalveolar lavage in patients with primary biliary cirrhosis.

BACKGROUND: The objective of this study was to examine the hypothesis that total blood and bronchoalveolar lavage (BAL) lymphocytes and their subsets in patients with primary biliary cirrhosis (PBC) with coexistent alveolitis are different from those in patients with PBC alone. Total blood and BAL lymphocytes and their subsets were evaluated in both types of patients and compared with a control group of normal healthy subjects. MATERIAL AND METHODS: 17 patients with well-documented PBC were divided into two groups: Group A--patients with coexisting alveolitis and Group B--patients with no alveolitis. Diagnosis was based on bronchoalveolar lavage. The control group consisted of healthy subjects. The lymphocyte subsets, including CD3, CD4, CD8, CD20 and CD56 were identified in blood and BAL cytospin smears using specific monoclonal antibodies. RESULTS: The percentage of CD3 and CD8 lymphocytes in BAL was significantly lower in a Group A, whereas the percentage of NK was significantly increased in group B as compared with the reference group. The percentage of blood CD4 lymphocytes in both subgroups of the PBC patients was significantly decreased as compared with the controls. The percentage of NK in both groups was significantly increased as compared with the controls. CONCLUSIONS: The relationship between the blood and BAL lymphocyte subsets in both studies groups were similar. Therefore, we suggest that PBC is a systemic disease in which lymphocytic infiltrations are not limited to the liver but may also involve lungs and probably other organs.

[Proangiogenic cytokines (bFGF and VEGF) in BALF from two different lung segments examined by high resolution computed tomography (HRCT) in patients with sarcoidosis]. / Cytokiny proangiogenne (bFGF i VEGF) w BAL z dwóch róznych segmentów pluc wskazanych badaniem tomografii komputerowej o wysokiej rozdzielczosci (HRCT) u chorych na sarkoidoze.

The aim of the study was to evaluate the concentrations of bFGF and VEGF in double BAL (2 x 120 ml) from two different lung segments: (s.A) from upper lobe with the most and (s.B) from lower lobe with the least extensive involvement estimated by high resolution computed tomography (HRCT). Examined group consisted of 28 sarcoid patients with homogeneous, regular distribution of nodular opacities in conventional chest X-ray (14 F, 14 M aged 19-54). Eleven healthy volunteers served as controls. In patients with sarcoidosis we observed the significantly higher levels (p < 0.01) of bFGF (1.79 pg/ml, 1.48 pg/ml) and VEGF (107.5 pg/ml, 109.7 pg/ml) in BAL from s.A and s.B respectively in comparison with BAL from lung segments Abis and Bbis in control group (bFGF: 0.75 pg/ml, 0.47 pg/ml and VEGF: 33.7 pg/ml, 43.9 pg/ml respectively). bFGF in BAL from s.A in active sarcoidosis was higher than in s.A and s.B in non-active sarcoidosis. Concentrations of bFGF in BAL from both s.A and s.B correlated positively with CD4/CD8 ratio and absolute number of lymphocytes, CD4 cells and lymphocytes HLA-DR estimated in BAL from these lung segments. We conclude that bFGF and VEGF may be involved in sarcoidosis pathogenesis and bFGF may be useful in estimation of sarcoidosis activity.

[Selection of bronchoscope type for removal of foreign bodies from the lower respiratory tract based on personal experience]. / Wybór rodzaju bronchoskopu w usuwaniu cial obcych z dolnych dróg oddechowych na podstawie wlasnych doswiadczen.

32 patients, in whom bronchoscopy was performed due to the removal of foreign body from the lower respiratory tract were described. Age of the patients clinical symptoms and a time lapse between aspiration and removal of foreign body from the lover respiratory tract and localization of foreign body in the particular bronchus were analysed. We conclude, that rigid bronchoscopy is still more useful and safe method of foreign body removing from the lower respiratory tract.

[Pulmonary adverse effect after amiodarone treatment--case report]. / Objawy uboczne ze strony pluc po leczeniu amiodaronem--opis przypadku.

A case of amiodarone induced pulmonary toxicity is presented in a 64 years old male. The patient had been treated with amiodarone for four years in daily dose 200 mg/day without any adverse effects until the daily dose was doubled. After withdrawing the drug, without any additional treatment, clinical, functional and partly radiological improvement was observed. Further radiological remission followed the introduction of corticosteroids. This case confirms the importance of dose boosting in the induction of amiodarone's toxicity. It also suggests a significant clinical and functional response to the discontinuation of amiodarone's administration.

[BAL from two different lung segments indicated by high resolution computed tomography (HRCT) in patients with sarcoidosis. I. Evaluation of alveolitis homogeneity and estimation of HRCT usefulness in selection of lung region for BAL]. / BAL z dwóch róznych segmentów pluc wskazanych badaniem tomografii komputerowej o wysokiej rozdzielczosci (HRCT) u chorych na sarkoidoze. Czesc. I. Ocena homogennosci procesu alveolitis i przydatnosci hrct w wyborze miejsca do BAL.

The aim of the study was: 1) to evaluate the homogeneity of alveolitis by estimation of lymphocytes subsets in double BAL (2 x 120 ml) from two different lung segments: with the most (s.A) and with the least (s.B.) extensive involvement estimated by high resolution computed tomography (HRCT) 2) to examine the usefulness of HRCT as a guide method in selection the most reliable lung region for BAL. Examined group consisted of 28 sarcoid patients with homogeneous, regular distribution of nodular opacities in conventional chest X-ray (14 F, 14 M aged 19-54). Twelve patients showed homogeneous distribution of HRCT changes (RD) in lung parenchyma and 16 showed nonhomogeneous distribution of HRCT changes (ND) with domination of pathological changes in upper lobes. Eleven healthy volunteers served as controls. BAL lymphocytes subpopulations (CD3, CD19, NK, CD4, CD8, HLA-DR, CD25,) were estimated by flow-cytometry. Among patients from ND group in BAL from s.A we found the significantly higher (p < 0.01) mean total cell yield, the significantly higher (p < 0.05) mean values of % of lymphocytes (45.2 vs 36.8%) and CD4/CD8 ratio (5.3 vs 4.4) than in BAL from s.B. Also the mean values of absolute number of lymphocytes and lymphocytes CD4, HLA-DR, CD25 in ND group were significantly higher in BAL from s.A than in BAL from s.B. In RD group and in controls no significant differences between BAL findings from s.A and s.B were noticed. Our results suggest that: 1) alveolitis process is not fully homogeneous, it's intensity is greater in upper lobes with most extensive involvement of HRCT changes 2) HRCT can serve as a useful method for selection the most reliable lung region for BAL.

[BAL from two different lung segments indicated by high resolution computed tomography (HRCT) in patients with sarcoidosis. II. The role of T gamma delta lymphocytes (T gamma delta)]. / BAL z dwóch róznych segmentów pluc wskazanych badaniem tomografii komputerowej o wysokiej rozdzielczosci (HRCT) u chorych na sarkoidoze. Czesc II. Rola limfocytów t gamma delta (T gamma delta).

The aim of the study was to evaluate the role of lymphocytes T gd in sarcoidosis by estimation of T gd cells in double BAL (2 x 120 ml) from two different lung segments: with the most (s.A) and with the least (s.B.) extensive involvement evaluated by high resolution computed tomography (HRCT) and in peripheral blood. Examined group consisted of 28 sarcoid patients with homogeneous, regular distribution of nodular opacities in conventional chest X-ray (14 F, 14 M aged 19-54). Twelve patients showed homogeneous distribution of HRCT changes (RD) in lung parenchyma and 16 showed nonhomogeneous distribution of HRCT changes (ND) with domination of pathological changes in upper lobes. Eleven healthy volunteers served as controls. Lymphocytes T gd were estimated by flow-cytometry. In peripheral blood of patients with sarcoidosis the mean value of T gd lymphocytes (4.75%) did not differ from control group (5.3%). In all patients the mean values of T gd percentage in BAL from s.A (1.7 + 1.0%) and in BAL from s.B (2.1 + 1.5%) were significantly lower (p < 0.01) than the mean value in peripheral blood (4.75 + 2.4%) and were significantly lower than mean value of T gd cells in BAL from s.B bis (4.2 + 2.7%). Among subgroups ND and RD we did find any significant differences between values of T gd in BAL form s.A and s.B. Our results suggest minimal role of T gd lymphocytes in sarcoid pathogenesis.

[BALF from two different lung segments indicated by high resolution computer tomography (HRCT) in patients with sarcoidosis. III. Correlation between pulmonary function tests and HRCT changes and BAL cell count]. / BAL z dwóch róznych segmentów pluc wskazanych badaniem tomografii komputerowej o wysokiej rozdzielczosci (HRCT) u chorych na sarkoidoze. Czesc III. Korelacje pomiedzy badaniami czynnosciowymi a rozlegloscia zmian w HRCT oraz parametrami komorkowymi BAL.

In 28 patients with sarcoidosis patients (14 F, 14 M aged 19-54) lymphocytes subpopulations were estimated in double BAL from two lung segments: with the most (s.A) and with the least (s.B.) extensive involvement estimated by high resolution computed tomography (HRCT). HRCT score for whole lung correlated negatively with DCO (r = 0.46, p < 0.05), D/VA (r = -0.46 p < 0.05), Cstat (r = -0.57, p < 0.05) and Cdyn (r = 0.-057, p < 0.01). HRCT-score for lung segments A and B did not correlate with BAL-cell count and lymphocytes subsets from these segments. The relationship between percentage of lymphocytes HLA-DR in BAL from s.A and d(A-a)O2 (r = 0.38, p < 0.05) and the relationship between absolute number of CD25 in BAL from s.A and DCO (r = -0.38, p < 0.05) were observed. The percentage of lymphocytes in BAL from s.B correlated negatively with D/VA (r = -0.40, p < 0.05) and the percentage of HLA-DR lymphocytes in BAL from s.B. correlated negatively with Cdyn (r = -0.45, p < 0.05). Our results suggests usefulness of HRCT in estimation of sarcoidosis advancement but not in it's activity and indicate the careful interpretation the relationships between BAL results from only one lung segment and pulmonary function parameters.

[Chemokine RANTES in bronchoalveolar lavage fluid(BAL)from two different lung segments indicated by high resolution tomography (HRCT) in patients with sarcoidosis]. / Chemokina RANTES w popluczynach oskrzelowo-pecherzykowych (BAL) z dwóch róznych segmentów pluc wskazanych badaniem tomografii komputerowej o wysokiej rozdzielczosci (HRCT) u chorych na sarkoidoze.

In 28 non-smoking patients with sarcoidosis (14 males, 14 females aged 19-51) the concentrations of cytokine RANTES were estimated in BAL fluid from two different lung segments: with the most (s.A) and with the least (s.B.) extensive involvement estimated by high resolution computed tomography (HRCT). In examined subjects 12 patients showed homogeneous distribution of HRCT changes (HD) in lung parenchyma and 16 showed nonhomogeneous distribution of HRCT changes (ND) with domination of pathological changes in upper lobes. Eleven healthy volunteers served as controls. In BALF from s.A and sB the significantly higher concentrations of RANTES were observed in comparison with control group (14.4 and 10.9 pg/ml vs 3.6 and 3.4 pg/ml respectively). In group (ND) in BALF from s.A (from upper lobes--the most occupied by HRCT changes) the concentrations of RANTES were significantly higher than in BALF from s.B (from lower lobes with the least involvement estimated by HRCT). RANTES concentrations in BALF from s.A and s.B positively correlated with lymphocytes count, lymphocytes CD3, CD4 and HLA-DR+ and correlated negatively with diffusing capacity in sarcoid patients. Our results suggest the significant role in pathogenesis of sarcoidosis and in alveolitis process enhancement.

[Procollagen III in bronchoalveolar lavage fluid of patients with allergic alveolitis and sarcoidosis]. / Prokolagen III w popluczynach oskrzelowo-pecherzykowych u chorych na alergiczne zapalenie pecherzyków plucnych i sarkoidoze.

In 12 patients with sarcoidosis and 11 patients with allergic alveolitis concentration of procollagen III peptide in bronchoalveolar lavage fluid (in bronchial and alveolar fraction) was estimated using RIA method. In studied populations procollagen III levels were higher in comparison to control. In patients with allergic alveolitis and with DLCO < 60% pred. procollagen III peptide concentrations in BAL fluid were significantly higher than in patients with sarcoidosis. In patients with allergic alveolitis a positive correlation between BAL lymphocytes number and procollagen III peptide concentration was observed.

[Symptomatic eye changes during the course of sarcoidosis]. / Symptomatologia zmian ocznych w przebiegu sarkoidozy.

The authors present ocular changes observed in sarcoidosis. The most frequent features are: symptoms of dry eye and uveitis. Frequency of ocular manifestations leads to the conclusion that ophthalmic examinations ought to be routine procedure at sarcoid patients.

[Diagnostic-therapeutic procedures in ocular sarcoidosis]. / Postepowanie diagnostyczno-terapeutyczne w sarkoidozie narzadu wzroku.

The authors present diagnostic and therapeutic procedure in patients with ocular sarcoidosis.

Correlation between virulence of various strains of mycobacteria and their susceptibility to ethanolic extract of propolis (EEP).

Ethanol extract of propolis (EEP) has antibacterial, antiviral, antiprotozoal and antifungal properties, in addition to many biological effects. Our laboratory has demonstrated a synergistic effect of EEP and antibiotics on the growth of Staphylococcus aureus, and suggested that the bactericidal effect of EEP was expressed mainly on virulent mycobacteria rather than on non-virulent (attenuated) ones. The present study was designed to reconfirm the latter finding, by subjecting 17 different mycobacteria strains to EEP, and evaluating whether there is a correlation between the virulence of the mycobacteria strains studied and their susceptibility to EEP. Our findings demonstrate that while the four non-virulent strains studied are not susceptible to EEP, out of the 13 virulent strains studied seven are susceptible and six are resistant to it. These results suggest that while there is no full correlation between virulence of the mycobacteria tested and their susceptibility to EEP, the few strains that were resistant to EEP were non-virulent.

[Usefulness of cryoapplication for bleeding after needle biopsy during fiberoptic bronchoscopy]. / Przydatnosc krioaplikacji w zapobieganiu nadmiernym krwawieniom po biopsji szczypczykowej podczas bronchofiberoskopii.

The protective role of superficial freezing (using a "spray" N2O cryoprobe) of tracheobronchial tumours before fiberoptic biopsy was evaluated in 21 patients with suspected lung cancer and high risk of bleeding. An excellent haemostatic effect was observed in all but two patients despite 3-9 specimens taken into histopathological examination. No serious complications besides a transient cough in 5 patients were observed. So a new "spray" type cryoprobe was found useful in protection against bleeding during bronchoscopy without negative influence on the histopathological confirmation of malignancy.

[Changes in lung parenchyma in high resolution computer tomography of patients with type type I sarcoidosis]. / Zmiany w miazszu plucnym w tomografii komputerowej o wysokiej rozdzielczosci u chorych z wezlowa postacia sarkoidozy.

The aim of this study was to describe the high-resolution computed tomography (HRCT) appearances of pulmonary abnormalities in 34 cases of type I sarcoidosis according to radiographic classification--lymphadenopathy only). Abnormalities were seen in 56% cases in which the pulmonary parenchyma appeared on radiographs. Nodules (1-4 mm) were seen in 41%. Other lesions as linear network were--present in 11.8% and ground-glass opacities--in 8.8%. The opacities are clustered in the peribronchovascular spaces, with relative sparing of the lung periphery and predominate in upper and middle lung zones. This study demonstrated the usefulness of HRCT in the correct diagnosis of type I sarcoidosis.

[Levels of procollagen III in bronchial alveolar lavage fluid in patients with sarcoidosis]. / Stezenie prokolagenu III w popluczynach oskrzelowo-pecherzykowych u chorych na sarkoidoze.

In 24 patients with sarcoidosis without pulmonary function disturbances significantly higher concentrations of procollagen III (PIIIP) in bronchoalveolar lavage fluid (BALF) were observed in comparison with control group. Patients in II radiological stage shower higher PIIIP concentrations in BALF than patients in I stage of sarcoidosis.

[Two year observation of patients with chronic extrinsic allergic alveolitis during steroid treatment]. / Dwuletnie obserwacje chorych na przewlekle alergiczne zapalenie pecherzyków plucnych leczonych Prednizonem.

In 53 patients (37 females, 16 males, aged 17-64) with chronic extrinsic allergic alveolitis after two years of prednisone treatment (40 mg as initial dose reduced to 20 mg after 6 weeks and to 15 mg after 6 months) the significant increase (p < 0.05) of mean values of FVC, FEV1 and DCO and of clinical improvement were observed. No radiological improvement was seen. Complete allergen cessation (16 patients) had very limited influence on pulmonary function parameters and chest X-ray picture, but clinical symptoms were diminished in comparison with patients who stayed on their farms and were potentially exposed to allergens.

[Bradykinin level in bronchoalveolar lavage fluid in patients with extrinsic allergic alveolitis]. / Stezenie bradykininy w popluczynach oskrzelowo-pecherzykowych u chorych na alergiczne zapalenie pecherzyków plucnych.

The presence of kinins in the tracheobronchial tree and their pharmacological properties would suggest that these peptides are involved in inflammatory responses of the airway and lungs. The aim of the study was the estimation the bradykinin level in bronchoalveolar lavage fluid (BAL) in patients with extrinsic allergic alveolitis. The investigated group consisted of 12 patients with farmers lung and a control group, of 9 healthy individuals. The statistically significant higher bradykinin concentration was found in patients BAL fluid than in the controls (675 +/- 472 pg/ml v.s., 220 +/- 57 pg/ml). No relationship was found between bradykinin level and BAL fluid cellularity and pulmonary function parameters. High levels of bradykinin in BAL fluid may suggest the increase of alveolo-capillary membrane permeability.

[Pulmonary function tests and bronchoalveolar lavage in sarcoidosis patients with 1changes and without changes in high resolution computed tomography]. / Badania czynnosciowe pluc i sklad komórkowy popluczyn oskrzelowo-pecherzykowych u chorych na sarkoidoze 1 ze zmianami i bez zmian w tomografii komputerowej wysokiej rozdzielczosci.

In 20 sarcoidosis patients with I0 of radiological changes the high resolution computed tomography (HRCT), pulmonary function tests (spirometry, diffusion capacity, static compliance) and broncho-alveolar lavage (BAL) were performed. In 8 patients with pathological changes detected in HRCT and in 12 patients without HRCT changes the similar pulmonary function disturbances and BAL-cell count were observed.

[Half-time of erythropoietin in patients with chronic obstructive pulmonary diseases]. / Czas polowiczego znikania erytropoetyny u chorych z przewlekla zaporowa choroba pluc.

Presence of elevated plasma levels of erythropoietin (EPO) has been reported both in polycythaemic and normocythaemic patients with chronic obstructive pulmonary disease (COPD). The present study aimed to elucidate in what extent prolonged erythropoietin half-life time (T1/2EPO) is involved in the pathogenesis of elevated plasma EPO levels in patients with COPD. Seven normocythaemic patients (5 men and 2 women) with CODP and 6 healthy controls (4 males and 2 females) were examined. In all examined subjects half-life time of erythropoietin was determined after i.v. administration of EPO in a dose of 50 U/kg b.m. In COPD patients the T1/2EPO value was 5.98 +/- 0.67 hours and did not differ from that found in healthy controls (5.87 +/- 0.35 h). Results obtained in this study suggest participation of factors other than prolonged half-time of erythropoietin in the pathogenesis of polycythaemia in patients with COPD.

[Evaluation of the usefulness of palpation and Daniel's biopsy for detection of metastasis to supraclavicular and scalene lymph nodes in patients with lung neoplasms]. / Ocena przydatnosci badania palpacyjnego i biopsji Danielsa w wykrywaniu przerzutów nowotworowych do wezlów znad miesni pochylych i wezlów nadobojczykowych u chorych na raka pluc.

In 169 patients with lung cancer the usefulness of physical examination and Daniel's biopsy in detection of metastases to supraclavicular and scalene lymph nodes were evaluated. In 35 patients with palpable lymph nodes and in 25 patients with nonpalpable lymph nodes metastases were confirmed by histological examination. The sensitivity, the specificity and the likelihood ratio of physical examination in detection lymph nodes metastases were respectively: 58%, 86% and 4.1. In 6 patients (5%) among 119 with nonpalpable lymph nodes the positive Daniel's biopsy was the diagnostic procedure. In 5 patients with non-small carcinoma and in 3 patients with malignant mesothelioma positive results of Daniel's biopsy enabled a change of cancer staging and giving up the eventual surgical operation.