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PubMedDate not supplied

[The evaluation of serum angiotensin-converting enzyme in silicosis and silicotuberculosis].

In order to verify the value of the determination of serum angiotensin converting enzyme (ACEs) in the assessment of silicosis and silicotuberculosis, we studied 105 subjects: 61 suffering from silicosis, 12 from silicotuberculosis, 19 from tuberculosis and 13 from chronic obstructive pulmonary disease (COPD). The patients with silicosis and silicotuberculosis were classified into two categories on the basis of the radiological pattern of pneumoconiosis according to the ILO 1980 CLASSIFICATION: mild silicosis (from 1/1 to 2/1) and severe silicosis (from 2/2 to 3+ and/or conglomerate masses). ACEs values were higher in the subjects suffering from silicotuberculosis and silicosis; in the latter, however, we did not find any significant relation between ACEs values and the radiological pattern. The lowest values of ACEs were found in the COPD group. Our data showed a statistically significant difference between silicotic or silicotuberculotic patients and the COPD group (p less than 0.05). It can be supposed that COPD, which was also found in all subjects suffering from silicosis or silicotuberculosis, might have caused an underestimation of the observed ACEs values which, however, were higher than normal. This increase might have been caused by a numerical or functional enhancement of the macrophages, which produce ACE and play an important role in the pathogenesis of such diseases.

Bronchopneumonia↗

PubMed2001

[Mycobacterium tuberculosis L forms in patients with pulmonary silicotuberculosis and silicosis].

OBJECTIVE: To evaluate significance of Mycobacterium tuberculosis L forms in pathogenesis of silicotuberculosis and silicosis. METHODS: Sputum culture for Mycobacterium tuberculosis and its L forms was conducted from both silicotuberculosis and silicosis groups, and the results were compared. RESULTS: Among 60 silicotuberculosis patients, 6 (10%) were sputum Mycobacterium tuberculosis culture positive, of which 5 (83%) were Mycobacterium tuberculosis L forms culture positive; 28 were sputum Mycobacterium tuberculosis L forms culture positive (positive rates in the patients with silicosis stage I, stage II, stage III were 33%, 67%, 100% respectively), with a positive rate of 47%, and a significant difference was found comparing with the frequency of detecting Mycobacterium tuberculosis (P < 0.01). All of the 30 cases with silicosis were Mycobacterium tuberculosis culture negative, however, 3 of them were sputum Mycobacterium tuberculosis L forms culture positive, accounting for 10 percent. CONCLUSIONS: Sputum culture for Mycobacterium tuberculosis L forms is a convenient and rapid way to improve the detection rate of Mycobacterium tuberculosis, with a positive value in early diagnosis of silicotuberculosis by reducing misdiagnosis and underdiagnosis of this disease. Detection rate of Mycobacterium tuberculosis L forms significantly increases with deterioration of silicosis.

Aged↗

PubMed1978

Cellular and humoral hypersensitivity reactions during silicosis and silicotuberculosis.

Together with the synthesis of specific antibodies and autoantibodies, effects of cellular allergy, such as damage to neutrophils, agglomeration of leukocytes and inhibition of migration of leukocytes with tuberculin and isologous pulmonary antigen were established in patients with silicosis and silicotuberculosis. Autoallergy becomes manifest already in the "pre-roentgenological" stage of development of silicosis; in silicotuberculosis it correlates with the stage of the specific process. In both silicosis and silicotuberculosis, it includes elements of immediate and delayed hypersensitivity. In clinical practice, allergic reactions of leukocytes with tuberculin can be of assistance in determining the stage of the specific process and in differential diagnosis of silicosis and silicotuberculosis.

Antibody Formation↗

PubMed2004

[Immunological parameters in the diagnosis of silicotuberculosis].

The study has defined criteria for the concomitant development of tuberculosis as secondary to silicosis. Factorial and discriminant analyses identified the most significant factors of immune homeostasis in silicotuberculosis. The major signs of possible development of tuberculosis in the presence of silicosis are the elevated levels of total IgE and IgG, fibronectin; the cells expressing CD4+ and CD20+ markers; and the decreased concentration of the mucinic antigen 3EG5. The findings were used to construct models of immunity in tuberculosis, silicosis, and silicotuberculosis. The use of a complex of immunological studies promoted the better early diagnosis of silicotuberculosis.

Adolescent↗

PubMed1984

Short-course chemotherapy for silicotuberculosis.

The use of short-course chemotherapy in silicotuberculosis in the goldmining industry in South Africa is described in a comparative trial of 94 cases of silicotuberculosis and two matched-pair control groups with pulmonary tuberculosis only. The theoretical and practical considerations of short-course chemotherapy are discussed. It is concluded that this is an effective means of treatment for pulmonary tuberculosis in patients with silicosis as well as in patients with pulmonary tuberculosis only, irrespective of previous exposure to silica dust. There are no valid reasons why the basic tenets of short-course chemotherapy for the treatment of pulmonary tuberculosis should not apply in silicotuberculosis.

Adult↗

PubMed1977

Evaluation of surgical treatments for the major lesion of bilateral silicotuberculosis.

The present communication deals with the follow-up study of 24 patients with bilateral silicotuberculosis in whom only unilateral operation was carried out for major lesions. The operative procedure consisted of pulmonary resection, thoracoplasty or combined operation such as cavernostomy, intracavitary filling of a pedunculated muscle flap and thoracoplasty. The follow-up period ranged 1 year to 12 years and 5 months. The results of surgical treatment for unilateral major lesions and their effect on the contralateral minor lesions were clinically assessed by alterations in the chest x-ray findings and tubercle bacilli in sputum. In 16 of 24 patients (67%) alleviation was obtained, whereas no change occurred in 3 (13%) and aggravation in 5 (21%). The surgical treatment for unilateral major lesion brought about 41% of improvement in the contralateral minor lesions. Contralateral minor lesions remained unchanged in 46% of patients and aggravated in 14%. This shows a value of the surgical threatment for bilateral silicotuberculosis. It should be emphasized that surgical treatments more aggressive than have been heretofore practiced can be employed.

Adult↗

PubMed1982

An attempt to eradicate silicotuberculosis in Ottawa County, Oklahoma.

In 1974 and 1975, a selective tuberculosis screening program was conducted in a small mining community in Ottawa County, Oklahoma. Former miners, 50 years of age and over, who had abnormal chest radiographs consistent with silicosis or inactive tuberculosis and positive tuberculin skin tests, were offered isoniazid preventive therapy. Since the project ended, morbidity from silicotuberculosis has declined but silicotuberculosis has continued to occur. In this report, we examine the reasons for the failure to eradicate this disease from the community.

Humans↗

PubMedDate not supplied

Silicotuberculosis in the elderly: report of two cases.

Silicotuberculosis is observed rarely in the current clinical practice. We present two patients (a 72-year-old man and a 84-year-old woman) who developed silicosis after having worked for several decades in the ceramics industry. In both, pulmonary tuberculosis complicated the clinical picture several years after retirement. The first subject presented a multicavitary lesion in the apex of the right lung, which subsequently evolved with fibrosis. The other developed bilateral tubercular bronchopneumonia and right tubercular pleurisy, that improved after prolonged antimycobacterial polychemotherapy. The two cases confirm that patients with silicosis are at an increased risk of developing tuberculosis, and show that, nowadays, silicotuberculosis may represent a geriatric problem. In the elderly, recognition of tuberculosis associated with silicosis is often difficult. Occupational history, radiology (conventional chest radiography and computed tomography) and microbiology (identification of Mycobacterium tuberculosis in sputum and pleural exudate) are helpful for the correct diagnosis, which, in turn, is important for prognosis and treatment, as well as in relation to medico-legal issues and occupational-related compensation claims.

Aged↗

PubMed2001

[Dispensary registration groups and follow-up periods of patients with silicotuberculosis].

Silicosis is the most common and most frequently tuberculosis-complicated pneumoconiosis with poor prognosis. So a procedure for following up patients with silicotuberculosis requires revision and elaboration. Long-term follow-ups have made it possible to define early signs of this disease and to propose a number of techniques for its early diagnosis, such as chest computed tomography and polarization serum crystal microscopy. Specific recommendations on follow-ups of patients with silicosis and silicotuberculosis by a phthisiologist are laid down.

Antitubercular Agents↗

PubMed1992

[The clinical significance of red cell immune adherence function in patients with pulmonary tuberculosis and silicotuberculosis].

In our study, we observed that (1) High RCIA were discovered in these two groups. (2) In the group of pulmonary tuberculosis, the C3b receptor activities remained no change after antituberculous therapy, but the amounts of immune complexes bearing on RBC decreased. In the patients with the high RCIA, CIC was discharged rapidly and the lesions of tissue produced by CIC were prevented. In the patients with silicotuberculosis, both silica and tuberculous bacilli may act as immune adjuvant and enhance the hypersensitivity. So the C3b receptor activities were higher in silicotuberculosis patients.

Adult↗

PubMed2006

[A case of silicotuberculosis with difficulty in its diagnosis].

A 68-year-old man who had worked as a stone mason for more than 50 years with a heavy smoking history consulted our clinic with symptoms of cough, low grade fever, weightloss, malaise and a single expectoration of hemo-sputum. He had been diagnosed as silicosis by the mass survey 5 years ago based on nodular shadows with egg-shell calcification in hilar lymphnodes on his chest radiography, and has received chest radiographic examination once a year. As the author was not so familiar with the radiographic features of silicotuberculosis, it was difficult to interprete ill-defined contour of silicotic nodules accompanied by patchy opacities formation in right midlung field and silicotic conglomeration accompanied by an ischemic cavity in the left basal segments. A definitive diagnosis could not be established until 10 months later when a second attack of exacerbation of silicotuberculosis occurred showing multiple thin walled fresh tuberculous cavities on the chest radiography with positive smear and culture. Among multiple tuberculous cavities, there was a cirrhotic-walled cavity caused by endogenous reactivation of a quiescent tuberculous lesion on the right apex. This lesion was considered to be the source of dissemination of this case. Finally, it took about two and a half years before establishing the diagnosis in this case because of a series of doctors delays. He was treated successfully with antituberculous drugs for one and a half years including one year rifampicin medication. The clinico-pathological findings of silicotic conglomeration in the left basal segments were discussed based on the findings of transbronchial biopsy from occluded B10 and chest radiographic findings, and it was revealed that silicotic conglomeration might consist of inflammatory granulation combined with granulomatous tubercle, but not a fibrous lesion.

Aged↗

PubMed1990

[Roentgenological diagnosis of silicotuberculosis].

Possibilities of roentgenologic method of examination with the use of roentgenography and tomography in the diagnosis of current forms of silicotuberculosis and tuberculosis in workers of the industries highly exposed to silicosis are analysed. ++Clinico-roentgenological+ pictures of 305 patients were studied in their dynamics for the period of 3 to 10 years. Being characterized by a benign course, silicotuberculosis is most often diagnosed in persons who left their work. A follow-up at least at 6-month intervals is of great importance in assessing its activity.

Adult↗

PubMedDate not supplied

The principles of predicting the individual risk of silicosis and silicotuberculosis.

A series of investigations conducted in different "silicosis-risk" industries using a methodology based on the mathematical theory of pattern recognition has shown that in the given conditions of dust exposure, the probability of contracting pneumoconiosis depends for each individual on a complex influence of many factors, both environmental and intrinsic for the individual. Genetic predisposition was one of the most important factors and while the direction in which a factor influences predisposition was the same in every industry, its relative contribution to predisposition to simple silicosis was different in the studied working populations. So a reliable prediction of the high probability of this form of pneumoconiosis on the basis of such a multifactorial analysis is possible only with respect to specific conditions of a particular industry. The complex of factors determining predisposition to silicotuberculosis is more general: this complex comprises both factors influencing susceptibility to silica dust and specially those influencing susceptibility to tuberculosis. Despite the low prevalence of genetic resistance to pneumoconiosis in working populations, the risk of contracting the disease in modern industrial conditions of relatively low dust exposure is high only for a proportion of workers for whom the genotype of predisposition to silicosis or to silicotuberculosis coincides with a most unfavourable combination of non-genetic factors enhancing this predisposition. In the opinion of the authors, the task of screening off those applicants for a "silicosis-risk" employment for whom the risk may be estimated as high on the basis of the developed methodology, is quite feasible.

Discriminant Analysis↗

PubMed1990

[Diagnostic errors in silicotuberculosis (clinical-autopsy comparisons)].

Basing on 42 post-mortem examinations of silicotuberculosis cases, the contributors display the most frequently encountered errors in diagnosing this disease. Silicotuberculous bronchadenitis, conglomerate-cirrhotic lower-lobe silicotuberculosis and their complications (e.g. concomitant pericarditis and endobronchitis) are the most difficult cases for detection. To avoid diagnostic errors, a most detailed case history study is needed, along with a complex clinico-functional and tomography examinations, a wide use of endoscopy and bacteriological techniques.

Autopsy↗

PubMed1989

[Diagnosis of silicotuberculosis activity].

Possible determination of silicotuberculosis activity with various clinico-laboratory, roentgenological, biochemical and immunological procedures was analyzed by the materials on observation of patients with silicotuberculosis. The authors considered 117 observations relating to 88 male and 29 female patients aged 43 to 67 years. High informative capacity of the complex investigation including determination of gamma-globulin levels in blood serum, the albumin-globulin coefficient, the absolute count of lymphocytes and T-lymphocytes and lymphocyte migration inhibition in the test with tuberculin before and after the provocative tuberculin test was shown.

Adult↗

PubMed1988

[An autopsy case revealing the simultaneous coexistence of adenocarcinoma, malignant lymphoma and silicotuberculosis in the same lung].

A case of 70-year old male manifesting a simultaneous adenocarcinoma, malignant lymphoma and silicotuberculosis in the same lung has been reported. The patient, who had worked as a miner for 24 years and had been treated for silicosis 11 years previously, was found to have a new, abnormal shadow during a routine chest X-ray. Later, sputum cytology revealed the adenocarcinoma. He was treated with chemotherapy, but died 24 months later, his death attributed to lung cancer, complicated with respiratory insufficiency and weakness. An autopsy confirmed the presence of an adenocarcinoma and silicotuberculosis, and a histological examination revealed the coexistence of malignant lymphoma in the same lung.

Adenocarcinoma↗

PubMed1996

[Bronchoscopic diagnosis of central peribronchial lung cancer in silicosis and silicotuberculosis].

Examination of 315 lung cancer patients with silicosis or silicotuberculosis gave grounds for recognition of 3 variants of bronchial stenosis. The efficacy of bronchoscopic techniques was related both to anatomic variant of the tumor and primary tumor position against the involved bronchus lumen. Central peribronchial cancer in silicosis and silicotuberculosis has specific features: combination of true tumor stenosis with false rigidity of the trachea and large bronchi, advanced scar anthracotic deformity of the bronchi and diffuse atrophy of bronchial mucosa, distinctive pattern of metastatic spreading.

Adult↗

PubMed1998

[Efficiency of computed tomography in diagnosis of silicotuberculosis].

The routine methods X-ray study and computed tomography (CT) were compared in a group of patients engaged in fireproof industry. CT yields valuable additional data in early silicotuberculosis, which makes it possible to follow the extent of a silicotuberculous process more completely, to make a better diagnosis of nodal and focal shadows, to identify small decay cavities in the foci and infiltrates. CT is the method of choice in following up patients with silicotuberculosis.

Humans↗