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PubMed2004

[The long-term effect and associated factors of double embolization of bronchial artery in patients with lung tuberculosis and hemoptysis].

OBJECTIVE: To investigate the long-term effect and the key factors associated with relapse of double embolization of bronchial artery in patients with lung tuberculosis and hemoptysis. METHODS: Fifty patients with lung tuberculosis and hemoptysis receiving the radiography and double embolization of bronchial artery (BAG + BAE) had been followed up for two years. The causes for hemoptysis relapse was determined, followed by specific treatment, and the effect was evaluated. Among them, 37 were males, 13 females, with the age of 8-75 years (mean age 47.6 years). RESULTS: The 2 year follow-up showed that the cure rate and the effective rate were 62% (31/50) and 94% (47/50) respectively. In a short term after embolization, hemoptysis relapsed in 9 cases, the major causes being active tuberculosis and secondary bronchiectasis complicated with infection. Other responsible factors included missed-embolization of bronchial artery and remaining blood supply from systemic circulation. In mid and long term follow-up, hemoptysis relapsed in 10 cases, the major causes being secondary pulmonary mycotic infection and recurrence of tuberculosis. CONCLUSIONS: The long term result of double embolization of bronchial artery in patients with lung tuberculosis and hemoptysis was significant. It could prevent the danger from massive hemoptysis, and therefore allows the medical therapy for tuberculosis. Embolization of bronchial artery is effective for hemostasis, while etiologic therapy aimed at removing the infection leading to chronic inflammation is the cure for tuberculosis and hemoptysis.

Adolescent↗
PubMed2003

The relation between serum leptin levels and body fat mass in patients with active lung tuberculosis.

The relationship of leptin to diminished appetite and weight loss has been investigated in many diseases. Diminished appetite and weight loss are the most apparent characteristics of patients with active lung tuberculosis and in this study the relation of leptin to such diminished appetite and weight loss has been investigated in patients with active lung tuberculosis before and after treatment. Twenty-five patients (7 female, 18 male) with active tuberculosis having an age range of 18-70 years (mean 47.48 +/- 15.36 y) and 25 normal individuals (9 female, 16 male) having an age range of 25-71 years (mean 44.60 +/- 13.80 y) were included in this study. Leptin levels, body mass index (BMI), body fat ratio (BFR), and waist hip ratio (WHR) were measured before and after 6 months of antituberculosis treatment. The same measurements were also made in the control group and the results were compared. While the pretreatment BMI (22.02 +/- 4.31 kg/m2) and BFR (16.60% +/- 9.30%) values in the patient group were significantly lower than in the control group, we found no difference in their pretreatment WHR values. Pretreatment leptin levels (3.49 +/- 3.34 microg/L) were significantly higher in patients with tuberculosis than in the control group (2.33 +/- 1.10 microg/L). Leptin levels were found to be significantly increased at the 6th month of antituberculosis treatment (5.65 +/- 5.41 microg/L) than the pretreatment values (p < 0.05). We observed an evident increase in BMI (24.10 +/- 4.87 kg/m2) and BFR (17.51% +/- 9.25%) due to antituberculosis treatment (p < 0.05). This study suggests that leptin has a role in the diminished appetite and weight loss symptoms in patients with active lung tuberculosis.

Adipose Tissue↗
PubMed1988

Unusual ventilation-perfusion patterns in primary lung tuberculosis.

We report two cases of primary lung tuberculosis in children with unusual perfusion ventilation scintigraphic patterns. In the first case, a mismatch in the right upper lobe suggests an elective compression of the bronchi by the mediastinal lymph nodes; in the second case, the total absence of ventilation and perfusion of the left lobe at scintigraphy illustrates the discrepancy sometimes encountered between chest x-ray and lung scintigraphy.

Airway Obstruction↗
PubMed2004

[Pseudo-recurrence of lung tuberculosis based on the detection of smear AFB positive sputum due to excretion of necrotic material].

A 21-year-old man was admitted to our hospital for cough and hemoptysis. The patient showed smear positive pan-sensitive lung tuberculosis, and completed standard course of chemotherapy successfully. Six months after the completion of chemotherapy he had hemoptysis again. The chest radiograph showed that pre-existing tuberculoma-like shadow in the right upper lobe was changed to a cavity. Although sputum smear examinations revealed positive results several times, sputum culture was always negative. This clinical exacerbation was thought to be "pseudo-recurrence" due to excretion of necrotic material from the pre-existed abscess nodule. His disease improved without any anti-tuberculosis chemotherapy. Diagnosis of lung tuberculosis recurrence should be made on sputum culture positive results.

Adult↗
PubMed2005

Multiple metastatic tuberculosis abscesses in a patient with Pott disease and lung tuberculosis: a case report.

The incidence of tuberculosis in Western countries is rising, and continued vigilance together with an awareness of its protean manifestations is essential. Cutaneous tuberculosis is a relatively rare manifestation of the disease, accounting for only 1% of extrapulmonary cases of tuberculosis and 0.14% of all reported cases of tuberculosis. A 19-year-old male patient was admitted to our clinic with skin lesions both at the front and at the back of his body. With clinical findings, histopathology, polymerase chain reaction, PA lung graph, and computerised tomography, the patient was diagnosed with metastatic tuberculosis abscess associated with lung tuberculosis and Pott's disease. Antituberculosis drugs were administered. An increased awareness of the re-emergence of cutaneous tuberculosis will allow for the proper diagnosis and management of this increasing common skin disorder.

Abscess↗
PubMedDate not supplied

Surgery for lung tuberculosis and related lesions: change in clinical presentation as a consequence of migration of population.

In spite of better health care organization and improvement in medical treatment, the incidence of newly diagnosed cases of tuberculosis has not declined in our region as anticipated and a number of patients still require surgery for lung tuberculosis and related lesions. Thus 92 patients were operated in our institution during the 1972-1991 period. Indications for surgery were: medical treatment failures (13%), mass lesions of the lung (31%) and mediastinum (12%), complications of the disease (38%) or from previous operations (6%). The proportion of immigrants (47%) was significantly higher than expected from their relative number. They also had a tendency to have more advanced or complicated forms of disease (61% vs 49% in local natives). As a probable consequence of this, surgical resections were more aggressive in immigrants. The operative mortality was similar in both groups. This change of presentation of lung tuberculosis is a new challenge to our local strategy in treating this disease.

Adult↗
PubMed1986

Changing pattern of lung tuberculosis.

In 46 (20%) of 233 consecutive patients with active lung tuberculosis, the localization of the tuberculous process was unusual. The majority of patients (81%) were greater than 40 years of age. Men predominated in the usual localized tuberculosis group, whereas women predominated in the group with unusual localized tuberculosis (UNLT). The most common site of tuberculosis in the UNLT group was the anterior segment of the upper lobe or the middle lobe. In 17.5% of the patients in the UNLT group, the diagnosis was established by thoracotomy only. In patients with "protracted pneumonia," or chest X-ray suggestive of neoplastic disease, tuberculosis should be included in the differential diagnosis, irrespective of the site of the lesion.

Adolescent↗
PubMedDate not supplied

[The role of antioxidant defense system in the development of glycemic disorders in patients with lung tuberculosis].

The development of different carbohydrate metabolism disorders in patients with lung tuberculosis occurs against a background of significant derangements in oxidation-reduction system, caused by hypoxia and intoxication. The classical antituberculosis treatment within 2 months doesn't succeed in normalization of functional activity of enzymes of the antioxidant defense system and doesn't eliminate carbohydrate metabolism disorders.

Antioxidants↗
PubMed1993

[Tuberculosis of the tongue in chronic hematogenous lung tuberculosis].

According to epidemiological data pulmonary and extrapulmonary tuberculosis even today represents a significant socio-medical problem. Tongue tuberculosis is rare and has been described in single cases only. In our clinic a patient suffering from tongue tuberculosis and hematogenously spreading chronic pulmonary tuberculosis was treated for the first time. The diagnosis was made by means of biopsy and pathohistological examination. The tongue lesions on account of rich vascularisation reacted very quickly to the antituberculous therapy, and the pulmonary alterations regressed considerably so that the patient could be dismissed to policlinical treatment.

Antitubercular Agents↗
PubMedDate not supplied

[Place of digital X-ray fluorography in improving the diagnosis of pulmonary tuberculosis, lung cancer and mediastinal pathology].

The prime objective of this paper is an effort to make a comprehensive assessment of a place of current digital X-ray fluorography in the diagnosis of various diseases of the lung, primarily its tuberculosis and cancer, and abnormalities of the mediastinum. The investigation used a principle of obligatory examination of the diagnostic potentialities of film X-ray study and digital X-ray fluorographic findings. Assessment of digital X-ray fluorography showed its potentialities of identifying an abnormality just on the monitor screen and through printer (paper) image reproduction. A total of 2,500 cases from different patient groups (those registered at a dispensary or identified at screening, those with a previously verified pathology). In addition to a particularly diagnostic section, the authors state their ideas on a multiplicity of organizational and methodological problems in the introduction of digital X-ray fluorography into practical public health of Russia. By defining "a diagnostic field" of application of the method, the authors restrict it only to the diagnosis of lung and mediastinal diseases.

Adult↗
PubMed2000

[A case of MPO ANCA associated glomerulonephritis with interstitial pneumonitis complicated with lung tuberculosis and pericarditis].

The main target organs of myeloperoxidase (MPO) antineutrophil cytoplasmic antibodies (ANCA)-related disease are the kidney and lung. This report describes a 71-year-old man with rapidly progressive glomerulonephritis (RPGN) and interstitial pneumonitis associated with MPO ANCA. The patient was admitted to our hospital because of bloody sputum, low grade fever and appetite loss on October, 1998. He was diagnosed as having interstitial pneumonitis from the findings of chest X-ray and CT examinations. Moderate proteinuria and hematuria, renal dysfunction(serum creatinine: 5.6 mg/dl, BUN: 58.0 mg/dl) and positivity for MPO ANCA were noted. He was negative for anti-glomerular antibody and PR3-ANCA. Renal biopsy was performed and revealed crescentic glomerulonephritis without deposition of immunoglobulins. Therefore, the diagnosis of pauci immune type RPGN was made. Pulse therapy with methylprednisolone(1.0 g/day x 3 days) following oral administration of prednisolone (60 mg/day) found marked improvement of renal function maintenance and interstitial pneumonitis, respectively. However, he died because of lung tuberculosis and acute tuberculous pericarditis during treatment with prednisolone. In this case, MPO ANCA might have been directly associated with both RPGN and interstitial pneumonitis. Furthermore, chronic lung disease, such as interstitial pneumonitis, is important as a preceding disease of RPGN. MPO ANCA-related disease is more frequent in aged persons, therefore particular attention should be paid during their treatment with an immunosuppressant.

Aged↗
PubMed2004

Susceptibility to lung tuberculosis--a population-genetic study.

The aim of this study was to compare the genetic structure of lung tuberculosis (LTB) patients (Pts) to healthy controls i.e. to evaluate dependency of LTB occurrence and course of the disease in regard to subject's genetic constitution. The study group consisted of 100 LTB Pts, while the same number of healthy non-sibling individuals served as controls. The groups were analyzed with respect to homozygous recessive characteristics (HRC) that served as genetic markers, which were studied in each subject. Twenty-three HRCs were chosen according to HRC-test rules. The results show significant difference in average HRC number between two samples, a decreased number in Pts group, total cumulative chi2 difference (p<0.001) and frequency distribution (p = 0.0027). We conclude that the analyzed groups make two different samples in regard to their population-genetic structure. It means that they may give a different response to similar environmental agents. A significantly decreased HRC number in the Pts group may be a manifestation of their decreased degree of homozygosity and indicate a dominant factor inluence in predisposition to LTB. It is possible that individuals with such genetic and physiological constitution are more liable to infection/disease caused by M. tuberculosis. Deviation from optimal degree of homozygosity appoints to possibility of altered genetic-physiological organism homeostasis and its altered reaction norm that leads to illness. Particular phenotype distribution analysis of significantly decreased frequency of HRC and characteristic expression (eye and hair colour) suggest that there is a possibility of related gene alleles association with genetic basis for susceptibility to TB in humans.

Gene Frequency↗
PubMed1980

[Studies on hypercapnia in patients with lung tuberculosis (author's transl)].

Pathophysiologic ecologic and therapeutic study was made on respiratory disturbances, especially on hypercapnia in patients with lung tuberculosis. 1) Of all in-patients (497 cases), 192 (38.6%) had respiratory disturbances, among which 70 cases (14.1%) exhibited hypercapnia. 2) Of these hypercapnic patients, about one-third (31.4%) were after thoracoplastic surgery, the main disturbances being restrictive in nature. In the half of non-operative cases, obstruction and inadequate gas mixing were the main cause for hypercapnia. 3) Critical values for inducing hypercapnia were % VC 45 for patients with restrictive disturbances and FEV1-0%/expected VC 40 for hypercapnic patients. 4) Significant band in the PaCO2 similar to (HCO-3) regression chart in patients (20 cases) with chronic stable hypercapnia showed a linear relationship with an increasing PaCO2, given by an equation, (HCO-3)p = 7.7 + 0.43 PaCO2 (PaCO2 45 -- 113 mmHg, SD = +/- 1.2, r = 0.99). Twelve percent of the unstable patients (100 cases) showed an alkalosis (pH greater than 7.45) over the range above 45 mmHg of PaCO2. 5) Even in patients with normal pH values, administered HCO-3 was estimated to move into the intracellular or interstitial fluid. 6) Increase in oxygen consumption was greater with increasing ventilation volume in hypercapneic patients. Even in these patients, voluntary or drug-induced hyperventilation caused a decrease in PaCO2, resulting in an amelioration of suppressed respiration under oxygen or even pethidine HCl administration. Discussion was made on the usefulness of these therapies on patients with hypercapnia.

Blood Gas Analysis↗