Background. Obstructive sleep apnoea syndrome (OSAS) brings risk of serious complications. The study objective was to assess elements of the cellular immune response in the course of OSAS. Methods. Peripheral blood (PB) lymphocytes: T, B, NK, NKT-like, Th, Tc, and HLA DR+ T cells were evaluated by flow cytometry of 48 OSA patients; the concentration of adiponectin, interleukin 1β, and TNFα was measured by ELISA method. The OSA complication score was developed and used for statistical analysis. Results. The proportion of B cells and Th/Tc ratio were significantly lower in the BP of OSA patients when compared with control subjects (median 7.9 versus 10.9%, 0.9 versus 1.5, p < 0.05). The proportion of Tc, NK, NKT-like, and HLADR positive T cells were elevated in OSA patients when compared with healthy subjects (36.4 versus 26.8, 15.5 versus 8.5, 5.7 versus 3.0, and 8.4 versus 4.5%, p < 0.05, resp.) and were more pronounced in patients with metabolic syndrome. The grade of OSA complication score correlated with systemic inflammation markers and the proportion of B cells. The value of adiponectin/BMI ratio correlated significantly with SpO2 (r = 0.31, p < 0.05), CRP (r = −0.35, p < 0.05), TNFα concentration (r = −0.36, p < 0.05), and proportion of B cells (r = 0.32, p < 0.05). Conclusion. Lymphocytes B, Tc, NK, NKT-like, and adiponectin are involved in systemic immune response in OSA patients possibly predisposing them to cardiovascular and metabolic complications.

Primary pulmonary angiosarcoma (PPA) is a rare tumour arising from arterial or venous pulmonary vessels of various size. It is characterized by aggressive course and poor prognosis. The early diagnosis is difficult due to diverse clinical and radiological manifestations. We present a case report of 70 year-old man, active cigarette-smoker, with a 2-month history of non-massive hemoptysis. The thorax CT revealed several solid pulmonary nodules surrounded by areas of ground glass opacity. As bronchoscopy failed to deliver adequate tissue samples, video assisted thoracic surgery (VATS) with pleura and lung biopsy was necessary. Histopathological findings were consistent with pulmonary angiosarcoma. Since no extrapulmonary lesions were demonstrated, the final diagnosis of primary pulmonary angiosarcoma was made. The patient died three months after the onset of symptoms. Our case report highlights that differential diagnosis in patients with hemoptysis and pulmonary nodules should include primary pulmonary sarcoma. Case presentationA 70-year-old man was referred to our department from one of municipal hospitals in January 2016 with a 2-month history of non-massive hemoptysis (daily volume of expectorated blood was approximately 15 ml). The patient also reported weight loss of 3 kg during the last month, general weakness and mild recurrent epistaxis. His past medical history included arterial hypertension and chronic sinusitis, both diagnosed approximately 10 years ago. He had also undergone endovascular stent grafting of abdominal aorta aneurysm as well as transurethral resection of the prostate due to benign prostatic hyperplasia. He was an active cigarette-smoker with a history of 52 pack-years of tobacco smoking. During the hospitalisation in the municipal hospital two pulmonary nodules in the left lower lobe were found in chest radiograph. These findings were confirmed in thorax CT scan which also showed ground glass areas surrounding the nodules (halo sign).On admission the patient's general condition was satisfactory. His vital signs were within normal range: arterial blood pressure was 120/80 mm Hg, heart rate 80 beats per minute, transcutaneous arterial oxygen saturation 93% while breathing room air. Dullness to percussion and diminished breath sounds over the left lower lung field was noted on physical examination. Except these findings the physical examination did not reveal any relevant abnormalities.The results of laboratory studies showed normocytic anaemia (hemoglobin level 90.5 g/L), an elevated peripheral white blood cell count (WBC)

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Introduction: Exercise-induced laryngeal obstruction (EILO) is a transient and reversible narrowing of the larynx in response to intense physical effort. The clinical picture of EILO often resembles those of asthma or exercise induced bronchospasm. The gold standard in EILO diagnostics is nasofiberoscopic examination during intense exercise (CLE).Case Description: We present two clinical cases of athletes initially treated for asthma who were diagnosed with EILO after CLE. This allowed the initiation of phoniatric rehabilitation and initial improvement of exercise tolerance.

INTRODUCTION Although the coexistence of type 2 diabetes mellitus (T2DM) and obstructive sleep apnea (OSA) may be attributed to environmental risk factors common for both diseases, a genetic background should also be considered. Data on the role of genetic factors in the development of T2DM in patients with OSA are lacking. OBJECTIVES The study was aimed to evaluate the prevalence of polymorphisms of selected genes that are known to be associated with diabetes or obesity in patients with OSA and concomitant T2DM and to assess these polymorphisms in the context of OSA severity. PATIENTS AND METHODS Consecutive patients with newly diagnosed OSA confirmed by polysomnography underwent genotyping for the following single nucleotide polymorphisms (SNPs): SREBF1 rs11868035, HIF1A rs11549465, APOA5 rs3135506, TCF7L2 rs7903146, and FTO rs16945088. The frequency of genotypes was compared between patients with and without concomitant T2DM and was analyzed with regard to OSA severity. RESULTS A total of 600 patients with newly diagnosed OSA were enrolled to the study. Of these, 121 patients (20.2%) were diagnosed with T2DM (97 men and 24 women; median age, 58 years; range, 52-64 years). The prevalence of T2DM was significantly lower in APOA5 rs3135506 GG homozygotes than in CG heterozygotes (18.8% vs 33.3%, P = 0.02). APOA5 rs3135506 CG heterozygotes were at higher risk for developing T2DM (adjusted odds ratio, 2.64; 95% confidence interval,1.38-5.04; P = 0.003). No significant differences were found for the genotype distribution of the other investigated SNPs. CONCLUSIONS Our study shows a possible link between the polymorphism of the gene encoding APOA5 and T2DM in patients with OSA.