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Despite of a fast development in the techniques of rapid identification of mycobacteria by molecular genetic techniques, serodiagnosis may be of special values as non-expensive, easy to perform method. Several serodiagnostic tests, principally those using immunoenzymatic (ELISA) methodology are available. The goal of our study was to evaluate one step coloured immunochromatographic assay detecting IgG antibodies against antigen 38 kDa (Rapid Test TB). Our material consisted of 278 serum samples--tuberculosis (n = 155), healthy (n = 36), sarcoidosis (n = 50), lung cancer (n = 25) mycobacterial infections other than tuberculosis (n = 12). Tuberculosis group consisted of new culture positive cases (n = 66), new culture negative cases (n = 23), chronic cases (n = 43) and extrapulmonary TB (n = 23). Specificity of 96% and sensitivity of 54% was obtained. In pulmonary TB sensitivity of 50% and in extrapulmonary TB of 74% was obtained. In chronic cases sensitivity of 70% and in new cases of 40% was received. Sensitivity of 44% in new culture positive cases and 30% in new culture negative cases was obtained. We conclude that immunochromatographic test may be a very useful tool improving tuberculosis diagnosis, especially in extrapulmonary tuberculosis. Strip test may be an interesting alternative as it is an extremely simple, rapid, and cheap technique.

Restriction is a typical functional abnormality in interstitial lung diseases (ILD) patients but not all of them represent this pattern. The aim of this study was to evaluate 164 patients with ILD in whom normal lung volumes (FVC and TLC > 80% predicted) were found. There were 111 patients with sarcoidosis (phase I--9, II--77, III--25 patients), 25 patients with pulmonary fibrosis, 12 patients with allergic alveolitis and 16 patients with disseminated radiological changes in the lungs of different etiology. Some patients (40%), mostly with fibrosis and allergic alveolitis, were treated with corticosteroids. Measured parameters included static compliance (Cst), transfer factor for CO (TLco and Kco) and maxima expiratory flow-volume curves (MEF50). 33% of patients had all examined functional parameters in normal range, 50% had decreased maximal expiratory flows (particularly in the sarcoidosis group), 46% decreased Cst and 24% decreased transfer factor. Decreased Cst was found in 31% of patients with sarcoidosis, in 67% of patients with allergic alveolitis and in 96% of patients with lung fibrosis. Decreased TLco or Kco was found only in 11% of patients with sarcoidosis, in 42% of patients with allergic alveolitis and in 60% of patients with pulmonary fibrosis. It seems that, these discussed tests are very helpful in detecting functional abnormalities in patients with ILD without signs of restriction. Increased lung elasticity and decreased transfer factor for CO indicate the existence of early or presisting functional disturbances (despite treatment) in patients with ILD and normal lung volumes.

Tuberculosis diagnosis bases on clinical and radiological symptoms and identification of mycobacteria. Accuracy of both methods is limited. Therefore reliable serological test would have considerable advantage. The present study was aimed at evaluating IgG-mediated immune response against specific mycobacterial antigens 38 kDa in group of 200 patients and control subjects. Our material consisted of 104 tuberculosis patients, 25 with sarcoidosis, 24 with lung cancer, 13 with bacterial or fungal pulmonary infection, 8 with mycobacterial infections other than tuberculosis and 26 healthy persons. We used commercially available ELISA based kits (Pathozyme TB-complex). Specificity of 100% and sensitivity of 49% was achieved. Sensitivity increased to 59% in chronic cases and to 52% in culture positive cases. Sensitivity decreased to only 14% in group of new culture negative cases. Measurement of IgG serum level against 38 kDa can be helpful in tuberculosis diagnosis. As the test lacks falsely positive results it indicates its high positive predictive value.

Angiogenesis is a process of new blood vessels' formation occurring in many physiological and pathological conditions. Neovascularisation is the principal vascular response in chronic inflammation and concomitant fibrotic process. Microvascular changes in various organ sites in sarcoidosis (BBS) and some of the symptoms of the disease may be related to microangiopathy. Moreover, vascular alterations were also observed in lung specimens from idiopathic pulmonary fibrosis (IPF) and avian fanciers lung (AFL) patients. The present study was aimed at testing the effects of serum from 43 patients with ILD (24 BBS, 8 AFL, 8 IPF, 3 DIPF--drug induced pulmonary fibrosis) and 11 healthy controls on angiogenic capability of normal blood peripheral mononuclear cells (PBMC) in the murine intradermal angiogenesis assay (according to Sidky and Auerbach). The data demonstrated that sera from ILD patients significantly enhanced angiogenic capacity of normal PBMC as compared to control sera (p < 0.001). The effect was more pronounced for AFL patients than for BBS and IPF ones (p < 0.05). Sera from DIPF did not stimulate angiogenesis compared to control sera. The data showed that sera from ILD patients constitute sources of mediators participating in angiogenesis. This phenomenon may play role in pathogenesis of chronic immunological processes in lung.

For many years a genetic predisposition to sarcoidosis has been considered likely, however no convincing evidence have ever been found. We report histologically proven cases of sarcoidosis in two brothers. Initially, the case of sarcoidosis was diagnosed in a 36-year-old male patient (II stage of radiological lesions) and 4 years later the case of sarcoidosis was diagnosed in 28-year-old younger brother of the first patient (III stage). The brothers did not live together but, in the same neighbourhood. We evaluated the active evolution of a disease by clinical, radiological, including high resolution computed tomography and functional methods as well as by evaluating cellular and soluble components of bronchoalveolar lavage fluid (angiotensin converting enzyme, protein, phospholipids). The above constitutes the first report on familial sarcoidosis recorded in Poland.

Sialic acid is a component of cell membranes and it can take part in immunological processes with lymphocytes and neutrophiles. In the present work the concentration of sialic acid in BALF in selected interstitial pulmonary disease was studied (in sarcoidosis, pulmonary fibrosis, avian fanciers lung) and compared with the control group of healthy persons. The investigations were repeated during the observations. The patients were divided into active and inactive groups. The analysis included the results in 187 patients divided into 9 groups. Sialic acid was measured with colorimetric method with the use of Ehrlich's reagent. The growth of sialic acid concentration in supernatant of BALF was observed in the studied diseases. The increase of sialic acid occurs in inflammatory processes especially those with neutrophiles. The correlation of acid concentration with the percentage or the total number of lymphocytes in BALF was observed. It is specific that the concentration of sialic acid in BALF in patients with avian fanciers lung keeps growing even after the contact with the antigen was discontinued.

Two cases of Wegener's granulomatosis are presented. The first case due to improper diagnosis died five months following initial clinical symptoms. The second case was diagnosed basing on clinical findings. Cyclophosphamide produced a quick and full remission. Both cases illustrate the need of proper diagnosis and introduction of treatment.

A case of the rare Churg-Strauss disease is presented, the first such in Poland. The disease is characterized by granulomatous vasculitis, bronchial asthma and eosinophilia. Diagnostical difficulties are presented and an earlier case report of Wegener's granulomatosis is discussed which also fulfilled diagnostical criteria of the Churg-Strauss disease.

A case is presented of primary, pulmonary B-cell lymphoma imitating bronchocentric granulomatosis. The initial manifestations were of multiple, pulmonary nodules, without intra- and extrathoracic lymph node, bone marrow and spleen involvement. Despite the initial removal of the affected pulmonary tissue the progression of the disease led to additional immunohistochemical evaluation of the resected tissue and final diagnosis. The authors also carry out a differential diagnosis of the reported changes.