[Initial assessment of the use of polymerase chain reaction (PCR) in diagnosis of tuberculosis among patients of the Center for Diagnosis and Treatment of AIDS]. / Wstepne badania zastosowania techniki reakcji lancuchowej polimerazy (PCR) w diagnostyce gruzlicy w populacji pacjentów Centrum Diagnostyki i Terapii AIDS.

This initial report on the use of PCR in diagnosis of TB was based on a group of 180 patients observed in the AIDS Diagnosis and Therapy Center in Warsaw. Out of 6 patients with positive results of PCR assay for MTB, five had positive AFB smears in induced sputum or BAL, two had positive MTB cultures. Five of them were treated with tuberculostatic drugs with clinical improvement and had negative sputum PCR MTB results after several weeks. Additional 11 patients with AFB positive sputum or BAL smears and negative PCR MTB were observed. None of them developed pulmonary tuberculosis, and none of them was confirmed by culture as MTB infection. The results presented in this paper confirm high specificity and sensitivity of polymerase chain reaction (PCR) as an fast diagnostic test very useful in the clinical settings of AIDS. With the increase of collected material further evaluation will be continued.

[The role of bronchoscopy and bronchoalveolar lavage in diagnosis of pulmonary tuberculosis in AIDS]. / Znaczenie bronchoskopii i plukania oskrzelowo-pecherzykowego w rozpoznawaniu gruzlicy pluc u chorych na AIDS.

Bronchoscopy was carried out in 32 HIV seropositive patients, most with AIDS during the period between January 1992 and August 1993. In 14 patients tuberculosis was diagnosed, in 13 it was bacteriologically confirmed. The mean age of the examined patients was 35.5 years (range 22-49 years). In 50% of the BAL samples bacterioscopy was positive. Bacteriological examination of the sputum and BAL fluid (bacterioscopy and culture) produced a confirmation of tuberculosis in 99.9% of the cases.

[Mycobacterial infection in patients with AIDS]. / Zakazenie mykobakteriami u chorych na AIDS.

Bacteriological diagnosis of tuberculosis was performed in 104 HIV-positive patients, in majority AIDS patients hospitalized in AIDS Clinic of Infections and Parasitic Diseases Institute of Medical Academy. 390 samples were examined, e.d. 3.75 from each patient (from 1 to 22 samples). M. Tuberculosis was diagnosed in 14 patients and all of them were clinically observed because of pulmonary tuberculosis. The highest percentage of positive results was obtained from bronchial fluid evacuated during bronchoscopy.

[AIDS and tuberculosis]. / AIDS i gruzlica.

From Jan. 1, 1989, through July, 1, 1991, 193 patients with HIV infection were treated at the Department of Acquired Immunodeficiency, Infectious diseases Hospital in Warsaw. Tuberculosis was diagnosed in 11 (5.7%) cases; in three cases diagnosis was first established post mortem. In eight cases tuberculosis was diagnosed clinically and confirm by microbiologic or histologic examinations. Antituberculous chemotherapy was successful in five cases (early results). All 11 patients had other concomitant infections or neoplasms. Six of 11 patients died, of them 3 with misdiagnosis of tuberculosis prior to death. The problem of HIV infection and tuberculosis and its impact on epidemiology of tuberculosis is discussed.

[Evaluation of bronchoscopic examinations in Poland]. / Ocena Badan Bronchoskopowych w polsce.

The aim of the study was to assess the state of bronchoscopical examinations in Poland. The analysis was based on a quantitative method using a questionnaire. It encompassed the year 1986. 22,936 examinations were performed in 76 centers (61.0 per 100,000 population, 1.19 per one hospital bed per year). 239 physicians performed bronchoscopies annually. The mean was 96 bronchoscopies ranging from 14-835. Only 20 out of 76 centers were well equipped, 17-satisfactory. In 39 the equipment was judged to be below satisfactory level. The number of examinations is well below the level needed. If one would narrow down the number of patients requiring a bronchoscopy to only two groups--those with malignancy and unconfirmed tuberculosis the number of bronchoscopies per one patient is only 0.9. The authors suggest means of improving this situation in Poland.

Derivatives of (R,S)-1-N-(theophyllinyl-7'-ethyl)-amino-2-propanol with antiarrhythmic activity.

Three (R,S)-1-N-(theophyllinyl-7'-ethyl)-amino-2-propanol derivatives were obtained as soluble hydrochlorides and tested in four models of experimental arrhythmia. Two compounds 1a and 2 have shown antiarrhythmic properties and very low toxicity.

[Usefulness of bronchoscopic examination during the treatment of small cell carcinoma of the lung]. / Przydatnosc badania bronchoskopowego w leczeniu chorych na drobnokomórkowego raka pluca.

The aim of the study was to evaluate the + bronchoscopy in monitoring of therapy in SCLC. Sixty patients were included in the study. The number of bronchoscopies ranged from 1 to 4. Evaluation was based on endoscopical analysis and pathomorphological examination of the biopsied material. In 30% of the studied patients bronchoscopy had decisive influence on therapy, irrespective of clinical and radiological criteria. The authors point out, that presence of cancer cells in bronchial aspirates, even in patients with normal endoscopical findings is a decisively poor prognostic factor.

[Preliminary evaluation of the diagnostic usefulness of bronchoalveolar lavage (BAL) in selected cases of interstitial lung diseases]. / Wstepna ocena diagnostycznego znaczenia plukania oskrzelowo-pecherzykowego (BAL) w wybranych przypadkach sródmiazszowych chorób pluc.

Diagnostic usefulness of BAL was assessed in 25 selected cases of interstitial lung diseases. There were 14 cases of allergic alveolitis, 6 cases of idiopathic pulmonary fibrosis and one case each of sarcoidosis, lymphangiomyomatosis, granulomotosis bronchocentrica, lymphogranulomatosis maligna, alveolitis of unknown etiology. BAL was assessed diagnostically usefull in 77% of the cases. More helpful was medical history which proved to be useful in all cases, and pulmonary function tests which were helpful in 84%. Lung biopsy was diagnostic in 66.6% of the cases, TBLB in 36.5%, while open lung biopsy carried out in 6 patients was diagnostic in 100%. Bronchoalveolar lavage is a useful element of diagnostic evaluation in patients with interstitial lung disorders, it is a safe method and well tolerated by the patients.

[Further studies on the occurrence of mycoses in the bronchial stump and bronchial anastomosis or trachea]. / Dalsze badania nad wystepowaniem grzybicy kikuta oskrzela oraz grzybicy zespolenia oskrzela lub tchawicy.

In the years 1980-1985 sutures were removed endoscopically from stumps and anastomoses in 52 patients operated in the years 1969-1985. The total number of bronchoscopies was 154, in 88 protruding threads into the airway lumen were removed. Interval between removal of first suture and date of surgery ranged from 0.5 to 192 months. Mycotic infection was diagnosed in 5 cases (9.6%). The causative agents being Aspergillus fumigatus and Candida albicans. In all cases removal of protruding threads lead to a complete cure. It was found that incidence of such mycotic infections decreased from 20.2% observed during the years 1962-1979 to 9.6% in the years 1980-1985.

(RS), (R)(-) and (S)(+) derivatives of 2-N-arylalkylamino-1-butanol having antiarrhythmic properties.

A series of theophyllinyl-7'-ethyl derivatives of (RS), (R)(-) and (S)(+) 2-aminobutanol were synthesized and tested in various models of experimental arrhythmia for their preventive and curative properties; (R)(-) 2-N-theophyllinyl-7'-ethyl amino-1-butanol (1a) and (R)(-) theophyllinyl-7'-ethyl-2-N-methylamino-1-butanol (3a) hydrochlorides showed interesting antiarrhythmic properties. The levorotatory compounds of R configuration showed stronger protective and also therapeutic effect in different experimental arrhythmias.

Transbronchial lung biopsy in diffuse pulmonary disease.

Transbronchial lung biopsy (TBB) was performed via the fibreoptic bronchoscope in 243 patients with bilateral diffuse pulmonary shadows. Histological diagnosis was established in 54.4%. The highest diagnostic yield was obtained in sarcoidosis (73.7%), the lowest in the group of cases denoted "fibrosis" (38.7%). Statistical analysis did not allow to establish the optimal number to be taken at a single procedure but it showed that the probability of obtaining the diagnosis in sarcoidosis was 2.6% at the first specimen taken, while in fibrosis it was nul at the first and at the second specimen. The overall diagnostic yield was related to the number of cases of sarcoidosis in the material examined. Among 138 cases examined in 1984-1986, in 80 the initial biopsy failed to establish the diagnosis; in 28 of them the procedure was repeated, and positive results were obtained in 60.7% thus increasing significantly diagnostic yield. An attempt to correlate the TBB findings with bronchoalveolar lavage (BAL) showed that BAL was a valuable diagnostic factor. No major complications occurred.

Derivatives of 2-N-arylalkylamino-2-methyl-1-propanol with antiarrhythmic activity.

Several aryl derivatives of achiral 2-amino-2-methyl-1-propanol have been obtained and tested for prophylactic and curative activity in different types of experimental arrhythmia. Interesting results were obtained for compounds 3 and 4 with activity and toxicity similar to those of quinidine.