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The purpose of the coverage was to define and discuss sustainable development indicators of European Union facing the current science and innovations. There have been established several actions which should be fulfilled in the countries of European Union, so as the purpose of providing stable sustainable development would be achieved. Bio-economy is the basis of development of current and future world economy. In the article there have been used statistics of the Eurostat, legislations and specialist literature.

Background: Due to the widespread use of coal and wood in households for heating purposes, Poland has one of the weakest air quality in the EU. Moreover in East-Central Europe there is still relatively little evidence on the relationship between air pollution, respiratory efficiency and the occurrence of obstructive diseases. Material: 500 people living in a small city in the Warsaw area were surveyed in the ongoing investigation focused on exposure to fine PM originating from the low-stack emission sources. A questionnaire was conducted followed by selected pulmonary, allergy and cardiology examinations (e.g. spirometry, induced sputum, FeNO, SPT, IgE, hemodynamics, vascular endothelial function). Stochastic-exploratory analysis (e.g. ANOVA, GRM or PCA) was conducted. Results: PM 2.5 concentration in the city does not meet the EU standards (in 2014 exceeded 31 ug/m 3 -the highest in the region). Though only 21% of the investigated inhabitants suppose that air quality is low or very low. Significant fraction of never-smokers (56.4% of the whole examined group) demonstrate symptoms typical for people exposed to polluted air, like conjunctivitis (21.5% of the non-smokers), rhinitis (34.2%), larynx inflammation (18.1%) but also breathlessness/tightness and pain behind the breastbone (14.8%). 16.1% of the never-smokers suffer from frequent respiratory infections. Asthma was diagnosed in 8.1%, CHD in 4.7% and COPD in 2% of the group. Conclusion: The initial results may indicate a relationship between continuous exposure to PM 2.5 and the prevalence of respiratory and circulatory systems diseases in never smokers. Ongoing research will help to verify this thesis.

Płukanie oskrzelowo-pęcherzykowe (BAL, bronchoalveolar lavage) nadal zajmuje bardzo istotną po-zycję w diagnostyce pierwotnych chorób płuc o różnym podłożu: infekcyjnych, śródmiąższowych, no-wotworowych oraz patologii płucnych występujących w przebiegu innych schorzeń, w tym układowych [...]

Astma oskrzelowa i choroba refluksowa przełyku są często współwystępującymi jednostkami chorobowymi. Uważa się, że refluks stanowi potencjalny czynnik wywołujący lub zaostrzający astmę. Hipoteza ta opiera się zarówno na przesłankach patofizjologicznych, jak i badaniach klinicznych. W badaniach eksperymentalnych wykazano, że zakwaszanie dolnej części przełyku powoduje wzmożoną reaktywność oskrzeli. Powstało kilka teorii wyjaśniających to zjawisko, do najistotniejszych należą teoria nerwowa, zapalna i mikroaspiracji. Wykazano również, że nieswoiste testy nadreaktywności oskrzeli mogą indukować epizody refluksu, co przemawia za udziałem samej astmy w promowaniu GERD. Do osłabienia mechanizmów antyrefluksowych prowadzą związane z zaostrzeniami astmy wzrost ujemnego ciśnienia w klatce piersiowej oraz „pułapka powietrzna”, a także niektóre doustne leki rozszerzające oskrzela, zwłaszcza teofilina. Obie choroby mogą oddziaływać na siebie na zasadzie błędnego koła, co pociąga za sobą implikacje terapeutyczne. Nie ma jednak jednoznacznych danych z badań randomizowanych o skuteczności antyrefluksowej terapii farmakologicznej i chirurgicznej. Najnowsze dane z piśmiennictwa nie potwierdzają pozytywnych rezultatów takiej terapii w grupie astmy trudnej, w której dotąd rekomendowano wdrożenie leczenia dużymi dawkami IPP. Nadal brak jest przekonywają- cych danych dotyczących roli niekwaśnego i/lub żółciowego refluksu w astmie. Konieczne jest udoskonalenie i standaryzacja metod diagnostycznych oraz protokołów terapeutycznych pozwalających wyodrębnić grupę pacjentów, u których terapia antyrefluksowa przyniesie najlepsze efekty dla kontroli astmy.

Celem pracy jest omówienie najważniejszych doniesień, jakie miały miejsce w 2011 r. i 2012 r. i dotyczyły metod endoskopowych stosowanych w pneumonologicznej diagnostyce zawłaszcza raka płuca oraz leczenia rozedmy płuc [...]

BACKGROUND: Different forms of chronic airway inflammation may involve diverse pathogenic elements. In general, deficient defence response is a feature of chronic obstructive pulmonary disease (COPD), whereas distorted immunoregulatory mechanisms lead to development of asthmatic symptoms. In addition to diverse effector mechanisms, the cellular and humoral elements participating in the development of immune response may appear to be different in COPD and bronchial asthma (BA) patients. AIMS: To evaluate the immunoregulatory properties of T cells and monocytes in cultures of peripheral blood mononuclear cells (PBMC) and to determine the chosen cytokine profiles in COPD and BA patients. METHODS: The microcultures of PBMC from COPD and BA patients were assessed for the T-cell response to mitogens, saturation of interleukin (IL)-2 receptors, T-cell suppressive activity and monokine influence on lymphocyte proliferation. Concomitantly, the cytokine (IL-1beta, interleukin-1 receptor antagonist, tumour necrosis factor-alpha, IL-4, IL-6, IL-8) concentrations were determined in the serum, the broncho-alveolar lavage fluid and in the culture supernatants. RESULTS: The T-lymphocyte reactions (response to phytohaemagglutinin, IL-2 receptor saturation, suppressive activity) were lower in BA patients than in COPD patients. Reversely, the immunogenic activity of monocytes (IL-1beta versus IL-1ra production) was higher in BA patients than in COPD patients. The highest values of cytokine concentrations were found in the culture supernatants. The concentrations of tumour necrosis factor-alpha, IL-4, IL-6 and IL-8 were significantly higher and the concentration of IL-1ra was lower in BA patients than in COPD patients. CONCLUSION: The assessments of cellular immunoregulatory properties and cytokine profiles in the cultures of blood mononuclear cells may prove helpful for diagnostic and therapeutic discrimination between BA and COPD patients.

Lower respiratory tract infections (LRTI) account for 20-30 % of all hospital-acquired contagions. They are characterized by high mortality of hospitalized patients. The most serious form of LRTI is pneumonia, and the most common etiological factors in such cases are bacteria. The article gives the analysis of bacterial flora samples obtained from lower respiratory tract of hospitalized patients. In vitro susceptibility of pathogens to selected antibiotics has also been assessed. We carried out a retrospective analysis of 1,171 bacterial strains isolated from 1,171 patients treated in clinics of the Military Institute of Medicine in Warsaw, Poland. In most cases the samples were collected from an endotracheal or tracheostomic tube (71.5 %) and from bronchoalveolar lavage (21.7 %). The most commonly isolated pathogens included Acinetobacter baumannii (35.8 %), Staphylococcus aureus (27.6 %), Klebsiella pneumoniae (19.4 %), and Pseudomonas aeruginosa (16.2 %). Multidrug-resistant gram-negative bacteria exhibited 100 % susceptibility to colistin only. Klebsiella pneumoniae ESBL+ and Acinetobacter baumannii were most susceptible to carbapenems, while Pseudomonas aeruginosa strains to ceftazidime. Methicillin-resistant Staphylococcus aureus were 100 % susceptible to vancomycin, linezolid, and tigecycline. In conclusion, identifying the etiological factors causing infections of the lower respiratory tract and determining their drug-susceptibility is of key importance in empirical treatment.

Neisseria meningitidis, etiological factor of invasive meningococcal disease, is a human commensal that colonizes the nasopharynx. Colonization is usually asymptomatic, but it is a prerequisite for disease. Asymptomatic carriers are the major source of infection. In the present study, a survey of N. meningitidis carriage was conducted between January and March 2013 in a military unit in Poland. Single-time throat culture samples were collected from professional 559 soldiers (302 unvaccinated vs. 257 vaccinated individuals with the quadrivalent conjugate vaccine ACYW-135). Bacterial identification was performed with classic microbiological methods (culture, incubation, identification). Non-culture method (PCR) was used for confirmation of detected strains of N. meningitidis and determination of serogroups. We found 29 carriers in the group of unvaccinated soldiers (9.6 % of examined individuals) whereas among vaccinated soldiers only 3 persons were carriers of N. meningitidis (1.2 %). The most frequently identified serogroups among the carriers serving in the same military facility were serogroup B (28 %), followed by Y (25 %), and C (22 %). In conclusion, the initiation of mass vaccination with the quadrivalent conjugate vaccine ACYW-135 in the military environment seems an effective method of suppressing N. meningitidis carriage.

At present also radionuclide methods are used to diagnose pulmonary malignancies. One of them is solitary pulmonary nodule (SPN) scintigraphy using 99mTc-depreotide. 99mTc-depreotide is a somatostatin analogue with affinity to 3 out of 5 subtypes of somatostatin receptors.was to confirmed the usefulness of 99mTc-depreotide in detecting malignancy in SPN; finding lymph nodes metastases; and overlapping scintigraphic scans and CT in precise localizsation of malignancy and its lymph nodes metastases.The group studied comprised 50 patients with radiologically diagnosed SPN. Forty patients had a high resolution CT scan done with a GE Light Speed equipment-device. The acquired CT scans were sent via LAN (Local Area Network) to an ARPACS server in the Department of Nuclear Medicine, and thence to a Hermes Nuclear Diagnostics workstation. CT examinations were followed by scintigraphy with 99mTc-depreotide.In 32 patients 99mTc-depreotide was found to have accumulated excessively in SPN: in 23 cases malignancy was found, in the 9 remaining cases they were other abnormalities. In the 23 lung cancer patients, 99mTc-depreotide was found in 24 foci, including 18 in the mediastinum and axillary region. CT revealed affected lymph nodes only in 7 cases. The calculated sensitivity, specificity and accuracy in SPN were 89%, 60%, 82%, respectively. The tumour/background index in malignancies confirmed histologically was 2.58 +/- 0.89. Where lymph nodes metastases were suspected in the diagnosed malignancies, the lymph node/background index was 2.60 +/- 0.85. In 25 cases lesion localization was more accurate when scans were overlapped.99mTc-depreotide based examination is a sensitive method in the evaluation of SPN malignancy. Overlapping SPECT and CT scans in diagnosing SPN enables both pathological and physiological changes to be localized precisely. This method seems particularly valuable in imaging lymph nodes where metastases are suspected, especially when CT scans revealed no abnormalities.

THE AIM OF THIS STUDY was the evaluation of T lymphocytes and NK function in patients with non-allergic asthma.Three groups: patients with non-allergic asthma (n = 30), patients with non-allergic asthma with concomitant recurrent infections (n = 24) and group of healthy adult volunteers (n = 20) were examined. CD4+ and NK cells were isolated from peripheral blood by magnetic separation method. Cells were cultured and level of cytokine IL-10, IL-13, IFN-gamma in medium were measured.In patients with non-allergic asthma with recurrent infections mean value of IFN-gamma in medium from IL-15 + IL-12 stimulated NK cells was significantly lower compared with control group (p0.01). Mean value of IL-10 and IL-13 in medium from Con A stimulated CD4+ cells in patients with non-allergic asthma with recurrent infections were significantly higher than in control group (p0.05).Multitudes of cell and humoral factors interactions overlap dysfunction of immunological system in patients with non-allergic asthma. It causes higher susceptibility to infections factors especially viruses. Viruses give feedback for escalation of infection and worsening of clinical course of disease. Knowing mechanisms of inflammation intensification would let us specific prophylaxis use (specific antinflammatory or immunomodulatory drugs).

Pneumonia is the second most common cause of pleural effusion. The presence of pleural fluid makes the prognosis in patients with pneumonia worse and causes a higher mortality rate. This is why it is very important to undertake suitable treatment as soon as possible. Most parapneumonic pleural effusions resolve with antibiotic alone, but sometimes more invasive treatment is necessary. Therapeutic decisions are based on different criteria. For many years determining biochemical fluid characteristics has been used for this purpose. Presentlythe usefullness of new parameters is being evaluated. Their application in diagnostics was possible thanks to better knowledge of mechanisms that participate in the development of parapneumonic pleural effusion.

The primary tracheo-bronchial amyloidosis is a rare entity with long lasting and progressive course. Precise diagnosis can be established on the basis of pathological features seen in samples derived from the airways, obtained during fibreoptic bronchoscopy or during lung biopsy sometimes. Describing the case of an insidious course of primary tracheobronchial AL type amyloidoisis, that was initially recognised and treated as a chronic obstructive pulmonary disease. The authors represent its clinical course and the diagnostic difficulties. The changes in the respiratory tract, both radiological and endoscopic suggested a tuberculous or proliferative process. They were responsible for a severe increasing dyspnoea, due to bronchial obstruction, with muco-haemoptic expectoration. A forceps resection of the endobronchial lesions enabled to established the right diagnosis and further treatment limited to local procedures.

The pathogens of atypical respiratory infections form a big heterogeneous group of different microorganisms. The classical ones belong to bacterial species of Mycoplasma pneumonaie, Chlamydia pneumoniae and Legionella pneumophila. This category comprises also some viruses and rickettsia. In many cases they are responsible for the asthma course exacerbation. Their contribution in the asthma development is suspected, too. Potential protecting effect against atopy and asthma is a subject of speculations. The authors discuss all three aspects, reporting own observations. A precise determination of the role of atypical infection in asthma remains to be determined.

Amyloidosis is a group of biochemical disturbances, leading to extracellular deposition of misfolded protein fibril's. It can be of primary, secondary or hereditary (familial) origin. The disorder is known from 150 years, and as already 23 fibril precursor proteins have been identified. Its symptoms can be systemic, localized; some forms don't produce any clinical manifestation. In this article amyloidosis pathogenesis, classification, epidemiology, prognosis and clinical characteristics are described, mainly with reference to the respiratory system.

Acute respiratory infections are the most common diseases in all age groups in the world. Lower respiratory infections are the main reason of death, hospitalization and antibiotic use in immunocomprised patients and/or patients with respiratory system chronic diseases. The leading role plays viruses: rhinoviruses, influenza and parainfluenza viruses, respiratory syncytial viruses (RSV), adnenoviruses and coronaviruses. The "youngest" pathogen in this group are human metapneumowiruses (hMPV), identified in 2001. They are the reason of infections in infants, older adults and immunocomprised patients. Manifestation of the infection can have a form from a self-limiting upper respiratory tract inflammation, through bronchitis (in adults), bronchiolitis (in infants) and pneumonitis (in infants and adults), and extremely of severe acute respiratory failure with a need of mechanical ventilation. The authores describe microbiological, epidemiological and clinical features on infection with hMPVs.

Authors present a case of EH as an accidental finding in 40 year old woman appeared as the presented small, solid nodules in both lungs on a routine chest radiograph and HRCT scans. There were no signs in clinical examination, no abnormalities were presented in the spirometric and respiratory tests, neither in the endoscopic digestive tract examinations nor in CT scans of abdomen. The histological examination of open lung biopsy revealed the morphology of epithelioid haemangioendothelioma. During one year follow up no clinical nor radiological progressions have been observed.

In the medical literature there have been described some methods to determine bronchodilator response. They are different because of the required percentage increase in FEV1 and /or FVC and the way of expressing results -as the percent of predicted or initial value. This study on 38 subjects evaluated that there is better bronchodilator responses when the results are presented as the percentage of the initial value compared with the predicted value. The intensity of improvement in FEV1 depends on the baseline airway obstruction. There are more meaningful responses in subjects with 'poor' initial value when using the criteria of change in FEV1 as a percentage of initial value. About 10% of positive responses are misunderstood as 'poor' when it was considered improvement only in FEV1 (they are positive with reference only to FVC).

Recently there has been an intense research what is the role of nitric oxide (NO) in physiological and pathological processes is, especially in pneumonology. Authors discussed endogenous NO synthesis, its molecular mechanism of action, as well as the importance of its detection in exhaled air and clinical utility of such measurements in asthma (AO) and chronic obstructive pulmonary disease (COPD). There is evidence that eNO is increased in asthma, correlates with other inflammatory markers and corticosteroids, and anti-leukotrienes reduce its levels. In contrast, assessments of eNO in patients with COPD revealed conflicting results. The authors pointed out, that the eNO level analysis is easy to perform, may be used to diagnose and monitor disease activity and the effects of anti-inflammatory therapy. However this method has limitations resulting from high costs.

The aim of this study was to evaluate the influence of air pollution on pulmonary function parameters in healthy non-smoking young men. The study comprised 1,278 healthy, non-smoking young men (aged 18-23) living in Poland in regions with different levels of air pollution. The examined population was divided into three groups A, B, and C, based on low, moderate and high air pollution levels, respectively. Spirometry and bodyphletysmography at rest were performed by using of mobile lab PNEUMOBIL. Lung function parameters were analyzed and compared with respect to the level of air pollution. The mean values of the pulmonary function parameters were within the limits in all groups, but we observed statistically significant differences between the groups (lowest mean values in group C and the highest in group A). In all groups we found persons with significant airflow limitation in the central and peripheral bronchi, defined as the decrease of FEV(1) %FVC ratio70 and FEV(1)80 % of predicted value (central bronchi), and FEV(1) %FVC ratio70, FEF(50)70 % predicted (peripheral bronchi). The percentage of persons with airflow limitation in the central bronchi was in group A (0.3 %), B (0.4 %) and C (1.4 %). The incidence of flow limitation in small bronchi was as follows: in group A (1.2 %), B (0.5 %) and C (6.7 %). The majority of factors defining the capacity of lungs as well as the intensity of the airflow showed a negative correlation with the concentrations of the basic air pollution (SO(2), NO(2), PM(10)). Our study showed, for the first time, the influence of air pollution on pulmonary function parameters in healthy non-smoking young men in the Polish population.

Lung carcinoma is one of the most common neoplasms, both in men and women. Many methods are employed within diagnostics approaches in oncology, among them are radiological, endoscopic, cytological and isotopic ones. Synthetic proteins labelled with gallium (Ga67), indium (In111) or technetium (Tc99) binding with receptors localised on cells surface enable scintigraphic determination of intensive uptake sites. The aim of the study was to asses clinical usefulness of technetium99 labelled synthetic somatostatin analogue (depreotide) in the diagnosis of solitary pulmonary nodules. Thirty one patients (19 men and 12 women) with isolated peripheral pulmonary lesions in chest X-ray examination were included into the study. All patients received intravenous infusion of synthetic protein compound, trifluorodepreotide acetate labelled with technetium99, with radio activity of 555-740 MBq (mega Becquerel) [Neospect--Nycomed Amersham, UK]. Radiopharmaceutical uptake was determined by two-head gamma camera according SPECT method (single photon emission computed tomography) after 3-4 hours after an injection. Intensive radiopharmaceutical uptake by abnormal lesions was found in 22 patients (71%), however in 9 (29%) it was not found in the sites of radiological changes. Among 22 patients with intensive uptake, in 17 (77%) patients a diagnosis of carcinoma was confirmed and in 5 patients benign lesions were diagnosed. In the group of 5 patients without marker uptake single case of carcinoma was found and in 4 benign lesions. Four patients refused further invasive diagnostic procedures. The sensitivity of this method was 94% with a specificity of 44%. No serious adverse clinical reactions associated with 99Tc depreotide were observed.1. Technetium99 labelled synthetic somatostatin analogue [(depreotide) (NeoSpect)] is safe in pulmonological and oncological clinical diagnostics. 2. The use of this compound is a valuable scintigraphic, supplementary method to qualify patients for further invasive diagnosis of peripheral pulmonary solitary nodules.

At present, chronic obstructive pulmonary disease (COPD) is considered as serious clinical, social and economic problem. Widespread habit of smoking together with air-pollutions is the basic etiologic factors, whereas inflammatory process, which involves bronchial tree and pulmonary tissues, is the core of COPD pathogenesis. Quality of life has much been improved by the introduction of pharmacological treatment including: long-acting beta2-mimetics, cholinolytics, mucolytics and in severe cases inhaled glucocorticosteroids. Prophylactic immunization against influenza and pneumococci also has been proved to be helpful. Continuous patient education together with efforts promoting smoking cessation constitute the mainstay of non-pharmacological management. Chronic oxygen therapy, respiratory rehabilitation and non-invasive ventilation proved to be a practical alternative in patients with chronic respiratory failure. Lung-volume-reduction surgery may sometimes be considered as an alternative to lung transplantation in very severe cases of COPD.

Inhaled corticosteroids with long acting beta 2-mimetics have become the mainstay of therapy for patients with asthma. The clinical and biological activity of the inhaled corticosteroids expressed as anti-inflammatory effect depends on their bioavailability, receptor affinity, lipophility, half-life terminal elimination and molecule value. Ciclesonide as a novel corticosteroid itself is inactive and used as prodrug form and needs to be cleaved by pulmonary esterases to acquire anti-inflammatory activity. Due to its quick initial activity, long clinical effectiveness in dose range of 100-800 micrograms/day, rather mild side effects, Ciclesonide is efficacious as a local potency anti-inflammatory drug.

The aim of study was to evaluate possible influence of air pollution on pulmonary function in the population of 1278 healthy non-smoking young men (18-23 years old) from different parts of Poland. Poland was divided into three regions depending on different concentration of SO2, NO2 and airborne particulate matter (PM10) in the air: region 1 comprised North Poland--agricultural areas with the lowest concentrations of pollution, region 2 comprised Central Poland--big agglomerations with moderate air pollution, region 3 comprised South Poland--big agglomerations and industrial centres with the highest pollution level. Subjects were divided further according to a study place (North Group--subjects from region 1, Central Group--subjects from region 2 and South Group--subjects from region 3). Spirometry and bodypletysmography were performed at rest by using of mobile lab PNEUMOBIL (Jaeger). The results of the study were statistically analysed with the use computer packet Statistica.Significant decrease of medium values of pulmonary function test (PFT) was observed in the non-smokers from the region of increased air pollution (South Group) in comparison to the non-smokers from the region of low pollution level (North Group).

According the mass spirometry, every third person over forty years old, suffer from COPD in Poland. Prophylaxis, early detection and proper treatment are necessary for the limitation of group of patients with severe COPD in the future. We analyzed the usage of particular group of medicines and estimated conformability of COPD treatment with actual recommendations.We included 125 subjects--26% women (n = 33), and 74% men (n = 92). Mean age was 62 +/- 10. Current smokers were 46% (n = 58) with mean time of smoking was 28 +/- 14 pack-years, ex-smokers 41% (n = 51), non-smokers 13% (n = 16). We recorded the treatment way and HbCO level in expired air. Spirometry and flow-volume test were provided. We used Statistica program for results statistical analysis.Usually, patients with mild COPD are treated with theophilline (49%), long-acting beta 2-agonists (40%), short-acting beta 2-agonists (35%), inhaled steroids and anticholinergics (24%). In mild-severe and severe form of COPD are used: theophilline (50%), short-acting beta 2-agonists (40%), long-acting beta 2-agonists (27%), inhaled steroids (19%) and anticholinergics (12%). 8.1 subjects with mild, 1.7% with mild-severe and 5.5% with severe COPD are treated with recommended connection of anticholinergic and long-acting beta 2-agonist.Mostly theophilline and short-acting beta 2-agonists are used. Anticholinergics are used too seldom. COPD treatment is insufficient and inconsistent with actual recommendations. Only 1.7 to 5.5% patients are treated with recommended combination of anticholinergic and long-acting beta 2-agonist.

The set of cellular and humoral elements which participate in the pathogenetic chain of bronchial asthma is regarded as characteristic for this disease. They include, among many others: mast cells, basophils, eosinophils, macrophages, Th2 phenotype lymphocytes, IgE antibodies, histamine, leukotrienes and some pro-inflammatory cytokines. The majority of them are effectory agents active at the end of pathogenic immune response. The therapy antagonizing their influences alleviates the symptoms but does not eliminate the cause of the illness. The authors call the attention to the pathogenic significance of immunoregulatory disorders which appear during the induction phase of immune response in patients with symptoms of bronchial asthma. On the basis of current literature and own, already published studies, the authors point to the significance of recently discovered and described thymus-dependent cellular population of regulatory T lymphocytes which are active in prevention of development of allergic and autoaggressive reactions. It is suggested that deficiency of regulatory T cell population caused by undesired environmental influence on thymic lymphopoiesis and the concomitant overstimulation of immunogenic antigen-presenting dendritic cells, create the conditions under which pathogenic immune response may well develop. Therefore, the possibility of introducing of prothymic immunocorrective treatment in bronchial asthma should be taken into account in further clinical studies.

The category of atypical respiratory infection involves viruses, bacteria and rickettsia. These micro-organisms can play a marked role in the exacerbation an asthma course but also participate in its development. Authors discuses both aspects, reporting own observations. The knowledge of real importance of atypical infections in asthma remains to be established.

Inflammation is a defensive reaction of an organism in response to injuring factors and is characterised by effector cells infiltration. Adhesion molecules are involved in their ordered influx. These molecules are glycoprotein particles present on cell surface and on intracellular matrix proteins. Cytokines, chemokines and other inflammatory process mediators modulate the expression of adhesion molecules. Anti-adhesion therapy involves many techniques. Most frequently monoclonal antibodies are used. Other forms of therapy contribute to blocking the synthesis of molecules at transcription level or to inhibition of their transfer from cell interior to its surface. Soluble molecule forms or their receptors are also applied.

Lung cancer is the leading cause of cancer mortality worldwide. The therapy including combinations and novel schedules of administration with chemotherapy, X-ray therapy, endoscopic procedure--brachy and laser therapy, don't contribute to prolong a human survival rates. Among these, new endobronchial diagnosis and treatment methods, including fluorescence and photodynamic therapy are used. The authors shown diagnostic and therapeutic usefulness of fluorescence bronchofiberoscopy.

The affinity of various malignant neoplasms including small cell and non-small cell lung cancer for peptide analogue of somatostatin has been documented. Depreotide is such an analogue and can be combined with technetium--99m (99mTc depreotide) for optical imaging properties. Using this radiopharmaceutical product, solitary pulmonary nodules (SPN) were previously successful evaluated. In this article the preliminary study of the depreotide (NeoSpect--Amersham, Wielka Brytania) in clinical practice has been shown.

Chemokines and T-lymphocytes play an important role in lower respiratory tract inflammation. This study evaluated the concentration of IL-8 and count of T-lymphocytes expressing adhesion molecules LFA-1, Mac-1, Lsel and their correlation in patients with asthma and COPD in periods of exacerbation and clinical improvement (after seven days of anti-inflammatory treatment). In all subjects bronchoscopic examination with BAL procedure were done in exacerbation period and after seven days of treatment. The concentration of IL-8 was measured by ELISA, and the expression of adhesion molecules by biotin-streptavidin methods. The highest concentration of IL-8 was observed in asthma patients in clinical improvement period, and the highest count of T-lymphocytes was observed in patients with COPD in remission phase. Increased concentration of chemokines could have been influenced by type of treatment administered, especially beta 2-mimetics. The significant correlation observed in COPD patients between IL-8 concentration and counts of T-cells expressing LFA-1 (r = 0.44), Mac-1 (r = 0.49), Lsel (r = 0.42) in exacerbation period suggest a chemotactic influence of IL-8 on T-lymphocytes.

Despite of numerous studies on etiology and pathogenesis of sarcoidosis, it has been impossible to explain the reason of disease initiation. The possible beginning of sarcoid process is broken balance of cytokines secreted by T-lymphocytes (Th1 and Th2), which generates various complicated immunological phenomenons. This broken balance of cytokines may be caused by particular antigen in the shape of microorganism or other factor, which disturbs organism's homeostasa.

Lower respiratory tract infections are a heterogeneous group of disorders induced by plenty of pathogens. Atypical bacteria play an important role in the respiratory tract pathology. In our study 90 patients with acute infection of the respiratory tract were examined in serological screening test for Mycoplasma pneumonia and Chlamydia pneumoniae. It was confirmed that in 21 patients with community acquired pneumonia Mycoplasma pneumonia antibodies were detected in 38% and Chlamydia pneumoniae in 10%. In our opinion this screening serological tests are useful for early diagnosis of atypical bacterial infections of the respiratory tract.

Adhesion molecules play an important role in inflammatory processes and influence on recruitment of effector cells. The aim of our study was to assess the percentage of T-lymphocytes expressing LFA-1, Mac-1 and ICAM-1 in bronchoalveolar fluid (BALF) and blood of patients with sarcoidosis, atopic bronchial asthma and chronic bronchitis. The reference group consisted of patients with haemoptysis or suspected of having bronchial carcinoma. Expression of adhesion molecules was revealed by /APAAP/ alkaline phosphatase anti alkaline phosphatase method. The highest percentage of lymphocytes expressing all adhesions molecules in BALF and blood was observed in patients with chronic bronchitis. Reductions of T-cells in BALF of patients with bronchial asthma and sarcoidosis may reflect of their direct binding in inflammatory sites. This studies confirm the involvement of adhesion molecules in maintenance of chronic inflammatory processes in the respiratory tract.

The role of eosinophil cationic protein (ECP) in allergic inflammatory reaction has been documented in experimental and clinical studies, but a clinical usefulness is still discussed. In the study serum level of ECP has been evaluated in children with allergic diseases of the respiratory system in exacerbation and remission of symptoms for purpose of monitoring of disease course. In 111 children aged 12.0 +/- 3.3 yrs with atopic bronchial asthma and/ or allergic rhinits ECP serum concentrations have been determined in following groups: children with grass pollen hypersensitivity (group P, 17 female and 41 male), children with hypersensitivity to D. pteronyssinus and D. farinae (group D, 16 female and 37 male) and controls without allergic hypersensitivity with negative prick skin tests (19 children, 11 female and 5 male). All children have been qualified to immunotherapy with pollen or mite allergens (Allergovit or Novo-Helisen, Nexter, Allergopharma) and ECP evaluation was performed before, during and after therapy. Serum ECP and IgE levels have been determined with CAP-system (Pharmacia) and obtained results related to clinical symptoms. In all analyzed children serum total IgE has been significantly increased in relation to controls. Serum ECP levels have been increased during clinical exacerbation of symptoms in observed children and parallel with clinical score of symptoms, especially during pollen season. Authors conclude that a degree of increase of serum ECP level is parallel with clinical score of symptoms, especially during highest exposition to pollen allergens. Observed changes of serum ECP levels during immunotherapy suggest the close relationship with allergic inflammatory reaction and indicate clinical usefulness for monitoring of this process.

Zgodnie z wieloletnią tradycją, w dniach 17–20 June 2006 roku w Coimbrze w Portugalii odbyła się 10th International Conference on Bronchoalveolar Lavage [...]

The studies investigating antitumor efficacy of bacterial infections, started by Coley, resulted in isolation of tumor necrosis factor (TNF-alpha), released by activated macrophages. It was hoped that direct and indirect cytotoxic, cytostatic and immunomodulatory effects of TNF-alpha would prove helpful in obtaining an effective antitumor drug. In this paper, we describe biologic and immunologic activity of cachectin as well as pre-clinical trials of TNF application in antitumor therapy.

Tumor Necrosis Factor alfa (TNFa) is a cytokine with cytolytic and cytotoxic properties. First clinical trials in which TNF was administered parenterally date back to early 70-ties. Soon it was noticed that when administered strictly to the tumor mass TNF exhibits high anti-tumor efficacy, exemplified by total or at least substantial regression of the tumor mass while producing minor and controllable symptoms. In this paper the case of local administration of the recombinant TNFa directly into the tumor mass constricting the bronchus was presented.

The aim of this article was to describe rarely occurred non-Hodgkin's lymphomas from peripheral lymphocyte T. Epidemiology, course of the disease and difficulties of diagnostic was described with the special regards of early diagnostic.

The authors present a case of a 70-years old patients with bilateral pneumonia of pneumococcal etiology. During the treatment, after the initial improvement respiratory failure was observed and mechanical ventilations was applied. Following this procedure appeared such complications as left pneumothorax and pleural empyema. After drainage and evacuation of purulent fluid from pleural cavity the clinical improvement was observed. The case shows how pneumonia is still dangerous, especially for patients with chronic obstructive pulmonary disease.