Stanislawa Bazan-Socha

Clinical and genetic features underlying the response of patients with bronchial asthma to treatment with a leukotriene receptor antagonist.

Background Treatment with antileukotriene drugs results in clinical improvement in many, though not all, patients with asthma. It can be hypothesized that the subpopulation of asthmatic patients, characterized by aspirin intolerance and cysteinyl‐leukotriene overproduction, might profit most from antileukotriene treatment.

Automatic planning of treatment of infants with respiratory failure through rough set modeling

We discuss an application of rough set tools for modeling networks of classifiers induced from data and ontology of concepts delivered by experts. Such networks allow us to develop strategies for automated planning of a treatment of infants with respiratory illness. We report results of experiments with the networks of classifiers used in automated planning of the treatment of newborn infants with respiratory failure. The reported experiments were performed on medical data obtained from the Neonatal Intensive Care Unit in the Department of Pediatrics, Collegium Medicum, Jagiellonian University.

Increased expression of collagen receptors: α1β1 and α2β1 integrins on blood eosinophils in bronchial asthma

Background Eosinophils are one of the major effector cells in bronchial asthma. Their infiltration of airways correlates with the asthma severity. Recruitment and activation of eosinophils are partially mediated by integrins α4β1 and α4β7. Collagens type I and IV constitute important components of extracellular matrix and vascular basement membrane, respectively. Therefore, collagen‐binding integrins (α1β1 and α2β1) may also play a role in eosinophil lung infiltration.

Asthma is associated with enhanced thrombin formation and impaired fibrinolysis

There is evidence that altered blood coagulation and fibrinolysis are involved in the pathogenesis of asthma. Increased thromboembolic risk has been reported in asthmatics.

Prediction of Coronary Arteriosclerosis in Stable Coronary Heart Disease

The aim of the study was to assess the usefulness of classification methods in recognizing cardiovascular pathology. From the medical point of view the study involves prediction of coronary arteriosclerosis presence in patient with stable angina using clinical data and electrocardiogram (ECG) Holter monitoring records. On the grounds of these findings the need for coronary interventions is determined. An approach to solving this problem has been found in the context of rough set theory and methods. Rough set theory introduced by Zdzislaw Pawlak during the early 1980s provides the foundation for the construction of classifiers. From the rough set perspective, classifiers presented in the paper are based on a decision tree calculated on the basis of the local discretization method. The paper includes results of experiments that have been performed on medical data obtained from II Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland.

Predicting the presence of serious coronary artery disease based on 24 hour Holter ECG monitoring

The purpose of this study was to evaluate the usefulness of classification methods in recognizing a cardiovascular pathology. Based on clinical and electrocardiographic (ECG) Holter data we propose a method for predicting a coronary stenosis demanding revascularization in patients with a diagnosis of a stable coronary heart disease. A possible solution of this problem has been set in a context of rough set theory and methods. The rough set theory introduced by Zdzisław Pawlak during the early 1980s provides a foundation for the construction of classifiers. From the rough set perspective, classifiers presented in the paper are based on a decision tree calculated on a basis of a local discretization method, related to the problem of reducts computation. We present a new modification of a tree building method which emphasizes the discernibility of objects belonging to decision classes indicated by human experts. The presented method may be used to assess the need for the coronary revascularization. The paper includes results of experiments that have been performed on medical data obtained from Second Department of Internal Medicine, Collegium Medicum, Jagiellonian University, Kraków, Poland.

Geldanamycin and Its Derivatives Inhibit the Growth of Myeloma Cells and Reduce the Expression of the MET Receptor.

Introduction. Geldanamycin (GA) is an ansamycin antibiotic that exhibits potent anti-neoplastic properties. The aim of this study was to assess the impact of GA and its derivatives on the growth and invasiveness of myeloma cell lines and CD138+ cells derived from the bone marrow of patients with multiple myeloma. Materials and methods. We evaluated cell proliferation, survival, apoptosis, cell cycle of myeloma cells, and the expression of cell surface proteins after incubation with geldanamycin or its derivatives. Results. GA and its analogs have an effect on myeloma cells by inhibiting their growth in a time and dose-dependent manner. Myeloma cell lines demonstrated decreased proliferation after incubation with 10 nM of GA or 100 nM GA analogs. The first significant effects of GA on U266 cells was observed after 24 hours. After 24 hours, U266 cells incubated with 100 nM GA were in both early and late stages of apoptosis; 17AEP and 17DMAG caused apoptosis of similar intensity to GA. It has been observed that GA and its derivatives cause caspase-3 activation. Analysis of the activity of AKT and MAP 42/44 kinases was performed by incubating U266 cells for 24 and 48 hours in100 nM of GA and its derivatives. After 24 hours incubation, no significant changes in protein expression were observed, while after 48 hours, the strongest changes were seen in AKT protein expression after incubation with GA and 17AEP-GA. In studies of the cell cycle, it was found that 100 nM 17AEP-GA and 17-DMAP-GA cause cell cycle abnormalities. We observed a nearly two-fold increase in U266 cells in the G1 phase and a simultaneous decrease in the percentage of cells in the G2/M phase, indicating that cells were halted in the G1 phase. In the case of the INA6 cells, proliferation was halted in both the G1 and G2/M phases. Conclusions. GA and the analogues that we tested can inhibit myeloma cell growth by induction of apoptosis and blockage of cell cycle progression, and have an effect on the down-regulation of the MET receptor. The GA derivatives tested, despite their modifications still retain strong anticancer properties. Specifically, two analogues of GA, 17AEP-GA and 17DMAG due to their properties can be more effective and safer chemotherapeutic agents than 17AAG, which is currently used and described in literature.

Evaluation of the quality of life in subjects with a history of severe anaphylactic reaction to the Hymenoptera venom.

INTRODUCTION Sensitization to the Hymenoptera venom is one of the main causes of anaphylaxis in Poland. Venom immunotherapy is the only effective treatment in such cases. Comprehensive patient care includes also education. The aim of our study was to assess the state of knowledge and to evaluate the quality of life and the anxiety level in patients allergic to the Hymenoptera venom after anaphylactic reaction. MATERIAL AND METHODS The survey was carried out in the period of the insects flight in 61 adult subjects (35 wasp and 26 bee allergic), using a validated Vespid Allergy Quality of Life Questionnaire (VQLQ), Hospital Anxiety and Depression Scale, and subjective assessment of anxiety level. The majority of respondents received venom immunotherapy. RESULTS Sensitized to the wasp venom had significantly impaired quality of life (VQLQ score) as compared to the bee venom allergic (p = 0.014). The intensity of anxiety decreased with the duration of immunotherapy (p = 0.01). The majority of subjects knew how to recognize and treat anaphylaxis, but only 8% employed an identification card and about 50% implemented rules of the pre-exposition prophylaxis. CONCLUSIONS History of a severe anaphylaxis to the Hymenoptera venom affected the quality of life. Venom immunotherapy reduced anxiety. We hope that presented surveys and their results might be useful in qualifying for immunotherapy in clinically uncertain cases.

Classifiers Based on Data Sets and Domain Knowledge: A Rough Set Approach

The problem considered is how to construct classifiers for approximation of complex concepts on the basis of experimental data sets and domain knowledge that are mainly represented by concept ontology. The approach presented in this chapter to solving this problem is based on the rough set theory methods. Rough set theory introduced by Zdzislaw Pawlak during the early 1980s provides the foundation for the construction of classifiers. This approach is applied to approximate spatial complex concepts and spatio-temporal complex concepts defined for complex objects, to identify the behavioral patterns of complex objects, and to the automated behavior planning for such objects when the states of objects are represented by spatio-temporal concepts requiring approximation. The chapter includes results of experiments that have been performed on data from a vehicular traffic simulator and the recent results of experiments that have been performed on medical data sets obtained from Second Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland. Moreover, we also describe the results of experiments that have been performed on medical data obtained from Neonatal Intensive Care Unit in the Department of Pediatrics, Jagiellonian University Medical College, Cracow, Poland.

A fatal case of acquired hemophagocytic lymphohistiocytosis (macrophage activation syndrome) in the initial course of dermatomyositis with anti-Jo-1 antibody.

Dear Editor, We would like to present a fatal case of macrophage activation syndrome (MAS) that developed in the early phase of an initially mild dermatomyositis with antiJo-1 antibody in a 53-year-old female patient. Our goal is to increase the awareness of this life-threatening condition associated occasionally also with autoimmune diseases, sometimes even at the initial phase of their clinical presentation. Correct diagnosis and rapid treatment of this condition is of critical importance for the outcome. MAS, or an acquired or secondary hemophagocytic lymphohistiocytosis (HLH), is a rare life-threatening disorder resulting from an uncontrolled immune inflammatory response secondary to many other conditions, including viral, bacterial, fungal or parasitic infections, malignancy (mainly hematologic) or autoimmune diseases. Its pathogenesis is linked to the exaggerated and uncontrolled activation of macrophages with prominent bone marrow and other reticuloendothelial system hemophagocytosis. In our patient the first symptoms of an autoimmune disease appeared 6 months earlier as a Raynaud’s phenomenon, progressive proximal skeletal muscle weakness, morning stiffness, arthralgias and arthritis (wrists, hands and knees), fatigue, anorexia and weight loss; skin changes were not observed. Rheumatoid factor, anti-cyclic citrullinated peptide antibodies and the indirect immunofluorescence screening test for antinuclear antibodies were interpreted as negative; creatine kinase and myoglobin levels were not checked. Initial diagnosis of reactive arthritis was made and the patient was treated with low dose methylprednisolone (8 mg/day) with a rapid clinical improvement. Five months later, while still on the same dose of steroids, symptoms reappeared again and were accompanied by high fever and large erythematous elevated skin rash localized on thighs, forearms and trunk. The patient was empirically treated with antibiotics with no improvement, and finally transferred to our University Hospital. On admission, apart from the skin lesions, high fever (39°C) and sinus tachycardia were observed. Results of some relevant laboratory tests are given in Table 1. Peripheral lymphadenopathy was not observed, but lung computed tomography (CT) scans revealed enlarged mediastinal lymph nodes with no other abnormalities. Abdominal CT was normal. Spirometry showed a mild, irreversible obstructive pattern (the patient was an ex-smoker) with normal total lung capacity in body pletysmography. Blood, sputum, throat swab and urine microbiological cultures were negative, as well as serological tests for hepatitis B virus, hepatitis C virus, human immunodeficiency virus, cytomegalovirus and Epstein–Barr virus. Toxoplasmosis, toxocarosis, brucellosis, syphilis, and Lyme borreliosis were also excluded based on serology, microbiological cultures and molecular diagnostic. Bronchoalveolar lavage fluid (BAL) showed 96% of macrophages; many of them hemosiderin-laden. Microbiological and molecular tests of BAL excluded active lung infection of Mycobacteria, cytomegalovirus, Chlamydia pneumonia, aspergillus, candida and Pneumocystis jiroveci. Skin changes on ultrasonography presented subcutaneous edema. Skin biopsy on histopathology showed orthokeratotic epidermis and dermal edema, with mild lymphoid infiltrates in the perivascular compartment. Muscle biopsy (biceps brachii) revealed mild endomysial lymphocyte infiltration, degeneration and atrophy of muscle fibers with single necrotizing muscle fibers. Screening indirect immunofluorescence test for antinuclear antibodies (HEp-2 line; Euroimmun Medizinische Labordiagnosika AG, L€ ubeck, Germany) was slightly positive (titer of 1 : 160) but Euroline Myositis Profil 3 (Euroimmun Medizinische Labordiagnosika AG, L€ ubeck, Germany) revealed presence of anti-histidyl-tRNA synthetase (anti-Jo-1) antibodies. The diagnosis of dermatomyositis with atypical skin changes was made and 10 days after admission high doses of steroids (four 500 mg methylprednisolone