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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.

Unlabelled: 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., Results of the Study: 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).

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.

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.

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).

Unlabelled: 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., Material and Methods: 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., Results: 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., Conclusions: 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.

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.

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.

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.

It was a randomised, double-blind, placebo controlled comparative study of the clinical symptoms and chosen parameters of ventilation of inhaled ambroxol in patients hospitalized with exacerbation of chronic obstructive pulmonary disease (COPD). Eligible patients--30 patients (13 men and 17 women) aged of mean value 70.5 +/- 6.9 years who fulfilled the clinical traits of exacerbation of chronic bronchitis entered the study. 15 patients were treated with inhaled ambroxol and 15 were treated with placebo. Moreover all patients were treated with concomitant medications typical for exacerbation of COPD (systemic steroids, intravenous infusions with euphillin, antibiotics, Berodual nebulizations and oxygen therapy). Spirometry and data related to clinical symptoms were taken at the beginning of the study and after 1 and 3 days and after the end of the treatment. At the end of the treatment period in both groups (inhaled ambroxol therapy vs. placebo) there wasn't found statistically significant difference in the number of cough and dyspnoe attacks. There was found the difference in FEV1 and FEF 50 in both groups, but improvement in patients treated with ambroxol was statistically significantly faster, that can influence the cost of treatment. Moreover there were not found important adverse events in ambroxol group.

Chemokines and cellular adhesion molecules are crucial determinants of the migration of immune effector cells to the tissues asthma and chronic obstructive pulmonary disease (COPD) are a complex of conditions, which have airflow limitation in common. The aim of this study was to determine the numbers and percentages of lymphocytes expressing adhesion molecules: LFA-1, ICAM-1 together with assessment of chemokines concentrations: IL-8 and MCP-1 in bronchoalveolar lavage fluid (BAL) of patients with asthma or chronic obstructive pulmonary disease (COPD). 12 patients with asthma, 14 patients with COPD, and 6 subjects of control group took part in this study. The expression of LFA-1 and ICAM-1 was assessed on lymphocytes by using immunohistochemistry (streptavidyn-biotin, DAKO, Denmark). ELISA test was used to measure IL-8 and MCP-1 concentrations in BAL (kits from R&D, USA). The percentage of lymphocytes expressing LFA-1 and ICAM-1 were: 33.9 +/- 23.8% and 25.8 +/- 12.2% in COPD patients, 23.9 +/- 12.1% and 15.3 +/- 4.42% in asthma patients, and 14.2 +/- 10% and 5.2 +/- 1.6% in the control group respectively. There was observed significant difference between the percentage of lymphocytes expressing LFA-1 and ICAM-1 of COPD and the control group. The concentrations of IL-8 were: 2306 +/- 1501 pg/ml in COPD, 233 +/- 27.3 pg/ml in asthma and 64 +/- 28.7 in the control group (p < 0.05). The concentrations of MCP-1 were: 768.9 +/- 668.1 pg/ml in COPD, 126.8 +/- 30.8 pg/ml in asthma, and 83.0 +/- 16.4 pg/ml in the control group (p < 0.05). There was observed correlation between lymphocytes expressing LFA-1 and IL-8 concentration (r = +0.5, p < 0.05) and between lymphocytes expressing LFA-1 and MCP-1 concentration (r = +0.5, p < 0.05), and between lymphocytes expressing ICAM-1 and MCP-1 concentration (r = +0.4, p < 0.05) only in COPD patients. Our data suggest that LFA-1 and ICAM-1 are important molecules in the recruitment of leukocytes and together with IL-8 and MCP-1 may have a role in pathomechanism of inflammation in asthma and especially in COPD.

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.

Not fully successful therapy of carcinomas makes us search for new methods of antitumor treatment. Beside radiotherapy and chemotherapy, immunotherapy is the method we put our hopes on. Since its isolation in mid 70s TNF-alpha has been the subject of careful studies investigating its clinical usefulness. In phase I and II clinical trials dose- and manner of administration-dependent side effects were observed, which considerably limited the use of TNF-alpha in clinical practice. Topical (intratumoral) therapy eliminated most systemic side effects. Synergic antitumor efficacy of TNF-alpha, cytokines, such as interferon-gamma (IFN-gamma) and interleukin-2 (IL-2), and cytostatic drugs (etoposide, cyclophosphamide) was proved.

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.

Granulocyte-macrophage colony stimulating factor (GM-CSF) is an important hematopoietic growth factor which has been shown to induce proliferation and activation of inflammatory cells and may play a role in allergic diseases. An activity of GM-CSF was determined in serum and BAL-fluid of 12 asthma patients with bronchial hyperreactivity to histamine before and 24 hours after challenge test. It was found statistically significant increase (p < 0.05) of GM-CSF activity in patients with bronchial hyperreactivity to histamine.

In 38 patients with atopic bronchial asthma DNCG (disodium cromoglycate) and DNCG comp. (disodium cromoglycate and reproterol hydrochloride) were applied in inhalation way. After 7 days course spirometric values were monitoring in all patients. Decrease of Raw values and increases of FEF50 and FEV1 were noticed in all patients, especially in asthmatics treated with DNCG comp. Obtained results suggest a good clinical effect and improvement of spirometric values in patients with atopic bronchial asthma during DNCG and DNCG comp. therapy.

Cell morphology of BAL- fluid and index bronchitis (by Thompson) were evaluated in 52 patients with acute and chronic bronchitis. A significant increase of index bronchitis and percentage of neutrophils in BAL were observed in acute and chronic bronchitis. There was no correlation between index bronchitis and cell in BAL- fluid.

Records of 1,010 bronchofibroscopies were reviewed. Patients were examined with diagnostic and therapeutic indications, of which 6.8% were asthmatics. In most of them typical findings were seen signs of inflammation with thick, mucous secretions. In patients with status asthmaticus (0.6% of the analyzed population) bronchofibroscopy was carried out under life threatening conditions, the endoscopes being introduced through an intubation tube. Large volumes of secretions were evacuated producing more suitable conditions for further therapy and an improvement of the patients clinical condition. The authors believe that their data suggest the use of more invasive therapeutical methods in bronchial asthma.