Fire eater's lung (FEL) is an acute hydrocarbon pneumonitis caused by aspiration or inhalation into airways of liquid hydrocarbons. This disorder is classified into distinct form of chemical toxic pneumonitis. An amateur fire-eater is presented in this work. He accidentally aspirated into airways about 1/3 of glass of grill lighter fluid composed of mixture of liquid hydrocarbons. A few hours after this incident he had severe symptoms like weakness, high temperature, midsternal pleuritic chest pain, myalgia of the back, shortness of breath, and dry cough. Radiologic examination revealed consolidations with well−defined cavitary lesions (pneumatoceles) in lower lobes mainly in the left lower lobe. After one week of this event clinical improvement was observed. The lesions resolved nearly completly during three months. The review of the literature connected with fire-eater's lung is also presented.

Background: Pulmonary veins (PVs) are important during segmentectomy. Many case reports prove that they may be the source of bleeding during surgery, especially when anatomical variants are present. We decided to describe venous variations and prepare a computed tomography based atlas of our observations. Methods: The study was conducted using 135 chest computed tomography studies with intra venous iodine contrast injection. The study population contained 86 females and 49 males, mean age was 60. Thirteen people had atrial fibrillation. Images were analysed using radiological workstation. Results:The variations were divided into three categories: atypical topography of the PV, atypical venous outflow to the left atrium (LA), atypical venous vascularization of the lung bronchopulmonary segment.Retrobronchial course of the vein of the posterior segment of the right upper lobe was observed in 8.15%.The most common variant of atrial venous outflow was the direct outflow of the middle lobe vein, observed in 25.19% of cases and the long common trunk of left PVs in 11.11%. The split drainage from the middle lobe into the right superior pulmonary vein (RSPV) and the right inferior pulmonary vein (RIPV) was observed in 9.63% as the full drainage into the RIPV in 2.96%.Conclusions: Long common trunk of left PVs and numerous variants of venous vascularisation of the middle lobe are the variations that may pose potential problems during thoracic surgeries. The frequency is high enough to justify the routine assessment of pulmonary vessels with computed tomography before surgery.

Mycobacterial lung disease is caused by nontuberculous mycobacteria (NTM), also known as atypical mycobacteria. NTM are widely distributed in the environment, particularly in soil and water; they may colonize the airways, gastrointestinal tract and genitourinary system, without the apparent signs of disease. Nevertheless, in some risk groups such as patients with chronic lung diseases or with immunodeficiency, mycobacterial lung disease is identified. Recently, increased recognition of mycobacterial lung disease in chronic obstructive pulmonary disease (COPD) patients has been observed, especially in those treated with high doses of inhaled corticosteroids. In the present paper, we describe the patient treated for many years due to COPD and bronchiectasis, with clinical and radiological picture suggestive of lung tumor, in whom final diagnosis of mycobacterial lung disease caused by Mycobacterium avium was made.

In patients with chronic obstructive pulmonary disease, respiratory infections are of various aetiology, predominantly viral and bacterial. However, due to structural and immunological changes within the respiratory system, such patients are also prone to mycobacterial and other relatively rare infections. We present the 70-year old male patient with chronic obstructive pulmonary disease (COPD) and coexisting bronchial asthma, diagnosed due to cough with purulent sputum expectoration lasting over three months. The first microbiological investigation of the sputum sample revealed the growth of mycobacteria. The identification test based on protein MPT64 production indicated an organism belonging to NTM (nontuberculous mycobacterium). However, further species identification by genetic testing verified the obtained culture as not belonging to the Mycobacterium genus. Based on observed morphology, the new characterisation identified an aerobic actinomycete, possibly a Nocardia spp. The isolated strain was recultured on standard microbiological media. The growth of colonies was observed on Columbia blood agar plates and solid Löewenstein-Jensen medium. The Gram and Zhiel-Nielsen stains revealed the presence of Gram-positive acid-fast bacilli. The extraction protocol and identification were performed in two repetitions; the result was G. bronchialis, with a confidence value of 99% and 95%, respectively. The gene sequencing method was applied to confirm the species affiliation of this isolate. The resulting sequence was checked against the 16S ribosomal RNA sequences database (Bacteria and Archaea). The ten best results indicated the genus Gordonia (99.04–100%) and 100% similarity of the 16S sequenced region was demonstrated for Gordonia bronchialis. The case described indicates that the correct interpretation of microbiological test results requires the use of advanced microbiology diagnosis techniques, including molecular identification of gene sequences. From a clinical point of view, Gordonia bronchialis infection or colonization may present a mild course, with no febrile episodes and no significant patient status deterioration and thus, it may remain undiagnosed more often than expected.

Background Idiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis share commonalities in pathogenesis shifting haemostasis balance towards the procoagulant and antifibrinolytic activity. Several studies have suggested an increased risk of venous thromboembolism in IPF. The association between venous thromboembolism and chronic hypersensitivity pneumonitis has not been studied yet. Methods A retrospective cohort study of IPF and chronic hypersensitivity pneumonitis patients diagnosed in single tertiary referral center between 2005 and 2018 was conducted. The incidence of symptomatic venous thromboembolism was evaluated. Risk factors for venous thromboembolism and survival among those with and without venous thromboembolism were assessed. Results A total of 411 (259 IPF and 152 chronic hypersensitivity) patients were included (mean age 66.7 ± 8.4 vs 51.0 ± 13.3 years, respectively). There were 12 (4.6%) incident cases of venous thromboembolism in IPF and 5 (3.3%) in chronic hypersensitivity pneumonitis cohort. The relative risk (RR) of venous thromboembolism in chronic hypersensitivity pneumonitis was not significantly different to that found in patients with IPF (7.1 vs 11.8/1000 person-years, RR 1.661 95% CI 0.545–6.019, respectively). The treatment with systemic steroids (OR 5.38; 95% CI 1.65–18.8, p = 0.006) and GAP stage 3 (OR 7.85; 95% CI 1.49–34.9; p = 0.037) were significant risk factors for venous thromboembolism in IPF. Arterial hypertension and pulmonary hypertension significantly increased risk of venous thromboembolism in chronic hypersensitivity pneumonitis. There were no significant differences in survival between patients with and without venous thromboembolism. Conclusions The patients with chronic hypersensitivity pneumonitis have a marked increase in the risk of venous thromboembolism, similar to the patients with IPF. Venous thromboembolism does not affect the survival of patients with IPF and chronic hypersensitivity pneumonitis.

Hypersensitivity pneumonitis (HP) is a complex syndrome caused by exaggerated immune response to inhalation of a variety of organic particles in susceptible individuals. In this study we assessed the relationship between age at the time of diagnosis and the degree of functional and radiological changes in HP. The diagnosis of HP was made on the basis of a combination of clinical symptoms, medical history, serological tests, radiologic evidence of diffuse lung disease, and absence of other identifiable causes of lung disease. We reviewed the records of 111 patients (68 women) diagnosed with HP over a period of 18 years (1995-2013). The patients were stratified into 3 age-groups: <30, 30-49, and ≥50 years old. The commonest cause of HP was avian antigens (56.8 %). Dyspnea was present in 97.3 % of patients, weight loss in 54.7 % of patients, and respiratory insufficiency in 24.3 % of patients. Lung fibrosis in chest computed tomography was found in 35.1 % of patients. Lung function was impaired more seriously in the youngest age-group, with lung diffusing capacity for carbon monoxide (DLCO) <40 % in 69.2 % of these patients. Restrictive pattern was present in 92.3 % of patients in this group, as compared with the 41.0 % in the whole cohort. In this group, desaturation in the six minute walk test also was most notable, amounting to a median of 11 %. In conclusion, diagnosis of HP at young age is predictive of a more severe clinical course of disease, with lung fibrosis and higher disturbances in pulmonary function.

Introduction: In the 19th and 20th centuries the cerebellum was mainly associated with human somato-motoric function, but later studies proved that its activity is much more complex. The cerebellum participates in the regulation of cognitive functions such as planning, verbal fluency, operational memory and abstract thinking. Case studies: We present the cases of two patients with cerebel-lar hyperplasia and a description of the functions of their working memory before and after neurosurgical treatment. Conclusions: The results indicate positive changes in working memory in the patients after surgical treatment of tumours in this area, and confirm the significant role of the cerebellum in this regard. ABSTRAKT Wstęp: Móżdżek kojarzony był w XIX i XX w. głównie z funkcjami somatyczno-motorycznymi człowieka, jednak późniejsze badania dowiodły, że czynność jego jest znacznie bardziej złożona. Bierze on udział w regulacji funkcji poznawczych takich jak: planowanie, fluencja słowna, pamięć operacyjna czy myślenie abstrakcyjne. Opis przypadków: W pracy przedstawiono przypadki dwóch pacjentek z procesami rozrostowymi w obrębie móżdżku oraz opis funkcjonowania w zakresie ich pamięci roboczej przed leczeniem neurochirurgicznym i po leczeniu. Wnioski: Otrzymane wyniki wskazują na pozytywne zmiany w funkcjonowaniu pamięci roboczej u chorych po przebytym leczeniu operacyjnym guzów tej okolicy i potwierdzają zna-czenie móżdżku. Słowa kluczowe: móżdżek; pamięć operacyjna; funkcje poznaw-cze. WSTĘP Pamięć odgrywa istotną rolę w adaptacji człowieka do zmienia-jących się warunków otoczenia, dzięki temu, że nowe informa-cje są modyfikowane przez doświadczenie zdobyte w dotych-czasowym życiu. Współczesne klasyfikacje pamięci wyróżniają m.in. model oparty na czasie trwania zapamiętywanych infor-macji. Baddeley i Hitch doszli do wniosku, że pamięć krót-kotrwała jest jednym z podsystemów pamięci roboczej [1, 2]. Pamięć robocza pozwala na krótkotrwałe utrzymywanie infor-macji oraz na manipulowanie nimi w zależności od aktual-nych potrzeb sytuacyjnych. Jej funkcjonowanie jest związane z grzbietowo-boczną częścią kory przedczołowej mózgu [3]. Werbalna pamięć operacyjna wiąże się z aktywnością lewej półkuli mózgu, zaś pamięć operacyjna wzrokowo-przestrzenna z czynnością prawej półkuli mózgu [4, 5]. Na pamięć roboczą składają się cztery elementy: 1) centralna funkcja wykonawcza-odpowiedzialna za odbieranie informacji z modalności zmy-słowych oraz przechowywanie ich przez krótki czas; 2) pętla artykulacyjna-stanowiąca system werbalnego powtarzania; 3) notes wzrokowo-przestrzenny-przechowujący informacje wzrokowo-przestrzenne; 4) bufor epizodyczny-integrujący informacje nowe z tymi, które znajdują się w pamięci długo-trwałej [1, 6]. Móżdżek kojarzony był w XIX i XX w. głównie z funkcjami somatyczno-motorycznymi człowieka, jednak później dowie-dziono, że czynność jego jest znacznie bardziej złożona. Bierze on udział w regulacji funkcji poznawczych takich jak: plano-wanie, fluencja słowna, pamięć operacyjna czy myślenie abs-trakcyjne [7]. Wys...

Diffuse alveolar haemorrhage (DAH) refers to a clinical syndrome resulting from injury of the alveolar capillaries, arterioles and venules leading to red blood cel accumulation in the distal air spaces. The conditions associated with DAH and underlying disease determine the prognosis and the treatment regimen. The coexistence of DAH with venous thromboembolism (VTE) is a seroius problem for clinicians and poses a challenge in the therapeutic management. We describe a young patient who developed massive DAH in the course of anti-glomerular basement membrane (anti-GBM) disease (formerly called Goodpasture's syndrome) complicated by pulmonary embolism (PE).