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At least 19 recordsLinked to original sources
PubMed1998

[Tuberculosis in respiratory system--tracheo-bronchial tuberculosis, pulmonary tuberculosis, tuberculous pleurisy and thoracic empyema].

Tuberculosis in respiratory system is most common in mycobacterial infections. Eighty percent of the patients with pulmonary tuberculosis visit hospital because of the respiratory symptoms, and only 10% of them were discovered by chest X-ray mass screening. In order to confirm respiratory tuberculosis, various methods to obtain specimens for mycobacterial examination have been carried out; hypertonic saline nebulizing for sputum expectoration, trans-bronchoscopic biopsy, percutaneous needle aspiration, and so on. The recent development of imaging modalities including CT, MRI, and ultrasonogram have been much contributed to the improvement of diagnosis of pleural tuberculosis. Basically, the main treatment for respiratory tuberculosis is chemotherapy except chronic tuberculous thoracic empyema. The initial chemotherapy regimen should be chosen among the three arms; [INH + RFP + PZA + EB (or SM)] x 2-->[INH + RFP] x 6, [INH + RFP + EB (or SM)] x 6-->[INH + RFP] x 3-6, and [INH + RFP] x 6-9. The sputum positive patient is recommended to have the chemotherapy regimen including PZA. In the patients with tracheo-bronchial tuberculosis an attention should be paid for the airway narrowing or obstruction during and after the scheduled chemotherapy. For a part of patients with tuberculous pleurisy and thoracic empyema, a surgical treatment must be indicated.

Empyema, Tuberculous↗
PubMed1995

[Clinical comparison of pulmonary tuberculosis with pulmonary M. avium complex disease].

At first, we reviewed radiographic findings of primary pulmonary tuberculosis, secondary pulmonary tuberculosis, pulmonary M. avium complex (MAC) disease without predisposing conditions, and pulmonary tuberculosis in AIDS patient. Infiltrates in lower field, mediastinal lymphadenopathy, and pleural effusion were the characteristics for primary pulmonary tuberculosis, while multiple nodular shadow with/without cavitation in S1,2,6 were the characteristics for secondary pulmonary tuberculosis. In pulmonary MAC disease without predisposing conditions, lesions progressed slowly from a cluster of a small nodules to cystic bronchiectasis with collapse of the segment or the lobe, and it took usually more than 10-years for the whole process interval. The characteristics of pulmonary tuberculosis in AIDS patient were nearly the same as those of primary pulmonary tuberculosis. Secondly, we compared clinical characteristics between pulmonary tuberculosis and pulmonary MAC disease. We reviewed the medical records of hospitalized patients who were diagnosed as pulmonary tuberculosis or pulmonary MAC disease. Systemic compromised host defense, such as diabetes mellitus or malignancy, played a more important predisposing factors in the development of pulmonary MAC disease. The average age of patients with MAC disease was found to be older than those with tuberculosis. By gender women were predominant in MAC disease, while men were predominant in tuberculosis.

AIDS-Related Opportunistic Infections↗
PubMed2000

Increased serum level of vascular endothelial growth factor in pulmonary tuberculosis.

Pulmonary tuberculosis, one of the granulomatous diseases, has few serological markers for its activity. Recently, an increased serum level of vascular endothelial growth factor (VEGF) was detected in patients with Crohn's disease, also a granulomatous disease. We hypothesized that VEGF might be associated with the pathogenesis of pulmonary tuberculosis. We investigated the serum level of VEGF in 43 patients with active pulmonary tuberculosis, 29 patients with old tuberculosis, and 25 patients with acute bronchitis. We were able to examine the serum VEGF levels every 3 mo for a period of 6 mo in seven patients with active pulmonary tuberculosis. We examined the presence of VEGF in the resected lungs of three patients with active pulmonary tuberculosis by immunohistochemistry. The serum levels of VEGF were significantly higher in patients with active pulmonary tuberculosis than in patients with old tuberculosis and acute bronchitis. The decrease in titer of serum VEGF paralleled the clinical improvement of patients with pulmonary tuberculosis. Immunohistochemical staining of the resected lungs demonstrated the presence of VEGF in alveolar macrophages surrounding the lesion. Therefore, VEGF may be associated with the pathogenesis of pulmonary tuberculosis.

Acute Disease↗
PubMed2002

[Phthisa-school as a way of psychosocial correction of pulmonary tuberculosis].

Pulmonary tuberculosis leads to structural personality changes, impairs interpersonal interaction, incompliance of personal hygiene. To develop educational methods, 253 patients with pulmonary tuberculosis were examined. To conduct a special cycle including 6 classes called by the author as a Phthisa-School is optimal for patient-physician contact and cooperation. Correction of altered personality traits in patients with pulmonary tuberculosis within the framework of the educational curriculum allows this to be considered as a way of sociopsychological correction.

Adult↗
PubMed2005

[Radiologic manifestations of pulmonary tuberculosis].

Pulmonary tuberculosis is an endemic infection. Chest radiography is the mainstay in the evaluation of pulmonary tuberculosis. High resolution CT is required to detect fine lesions overlooked on chest radiographs, to define equivocal lesions, to determine disease activity in some cases and to evaluate complications or sequels. We review indications of chest radiograph and CT, the radiologic features of primary and post-primary tuberculosis, and outcome of tuberculous lesions.

Child↗
PubMed1985

The larynx in pulmonary tuberculosis.

Pulmonary tuberculosis is still a common disease in the developing countries of the world. One hundred patients with pulmonary tuberculosis showed laryngeal involvement in 37 patients. The posterior part of the larynx followed by the epiglottis are the commonest sites to be involved in the larynx. Ulcerative lesions and perichondritis, so common in pre-chemotherapeutic days, were not seen.

Adult↗
PubMed1995

CT-pathology correlation of pulmonary tuberculosis.

Pulmonary tuberculosis is a chronic granulomatous disease characterized radiologically by nodules, air-space consolidation, propensity for cavitation, and calcification, and pathologically by caseating granulomas or pneumonia, and a great propensity for fibrosis and dystrophic calcification. Primary tuberculosis typically appears as air-space consolidation with hilar or mediastinal lymphadenitis. Postprimary tuberculosis appears most commonly as nodular and linear opacities at the lung apex. CT findings of early bronchogenic spread of postprimary tuberculosis are centrilobular 2- to 4-mm nodules or branching linear structure, 5- to 8-mm poorly defined nodules, lobular consolidation, cavities, and thickening of interlobular septa. Centrilobular nodules or branching linear lesions and poorly defined nodules on CT scan correspond to caseation materials filling the bronchioles, and centrilobular air-space consolidation with caseation necrosis. Poorly defined nodule or lobular consolidation usually consists of central caseation necrosis and peripheral nonspecific inflammation. Cavitation usually occurs at the centrilobular area and may progress to a larger coalescent cavity. With antituberculous therapy, resolution typically occurs from the peripheral portion of the poorly defined nodule or lobular consolidation and results in varying degrees of fibrous bands, bronchovascular distortion, emphysema, and bronchiectasis. Miliary tuberculosis appears as well-defined randomly distributed nodules on CT scan that correspond with nodules consisting of central caseation necrosis and peripheral epitheloid and fibrous tissue. Analysis of CT images on the basis of pathologic correlation is helpful in understanding the morphology of pulmonary tuberculosis.

Adult↗
PubMed2005

Clinical investigation: increased serum stromal derived factor 1 alpha levels in pulmonary tuberculosis.

Pulmonary tuberculosis, a granulomatous disease, has few serological markers for its activity. Recently, an increased plasma level of stromal derived factor 1 alpha (SDF-1alpha), which can induce strong chemotaxis of cells through its receptor CXCR4, was detected in patients with tuberculosis. In this study we investigated serum SDF-1alpha levels and CXCR4 expression on peripheral blood mononuclear cells (PBMCs). Fifty-five active tuberculosis patients, 30 resolved tuberculosis patients, 27 acute bronchitis patients and 8 healthy volunteers were examined. Histological expression of SDF-1alpha in the tuberculosis lesion and CXCR4 expression of PBMCs were also analysed. Serum SDF-1alpha levels in active tuberculosis patients were significantly higher than other groups. The sensitivity and specificity for the diagnosis of active tuberculosis was 88.5% and 85.3% (cutoff value = 650 pg/ml), respectively. CXCR4 expression levels on PBMCs showed a significant negative correlation with serum SDF-1alpha levels. Inflammatory cells including multinuclear giant cells in the lesion expressed SDF-1alpha. Measurement of serum SDF-1alpha could be a useful screening marker for the identification of active pulmonary tuberuculosis. We propose that interaction of SDF-1alpha and CXCR4 might be involved in the pathogenesis of pulmonary tuberculosis.

Acute Disease↗
PubMed1999

Cytokine levels correlate with a radiologic score in active pulmonary tuberculosis.

Pulmonary tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. This microorganism is capable of inducing a delayed hypersensitivity reaction in the lung, with subsequent expression of the disease. This reaction depends on the presence of different cytokines that exert specific functions. The aim of this study was to evaluate the presence and the concentrations of nine different modulators in bronchoalveolar lavage fluid (BALF). For this purpose, 15 patients with active pulmonary tuberculosis were enrolled at the time of diagnosis, prior to institution of antituberculous therapy. All the patients demonstrated M. tuberculosis in the sputum, and their disease extention was defined by high-resolution computed tomography (HRCT) using a score which included the presence of six findings: miliary nodules, nodules < 10 mm, consolidation, ground glass, cavity and bronchial wall thickening. This score was more sensitive than an equivalent score calculated on the basis of chest radiology. HRCT score was calculated for each area of the two lungs in order to define the more and the less affected lung for each patient. The bronchoalveolar lavage (BAL) was performed in the more affected area for each lung. The HRCT total score for each washed area ranged between 1 and 15, and showed more significant differences between the more and less affected lungs (p = 0.0004) than those obtained with the individual radiologic findings (p ranged between 0.60 and 0. 004). The BAL concentrations of the nine cytokines evaluated for the more and less affected lungs were compared: interleukin-6 (IL-6), IL-8, IL-12, tumor necrosis factor-alpha (TNF-alpha), and interferon gamma (IFN-gamma) showed significant differences (p ranged between 0. 016 and 0.0007). In addition, each cytokine concentration was correlated with the HRCT score. Significant correlations were found with IL-12, IL-6, IL-8, IL-2, and TNF-alpha. The correlations between cytokines and HRCT total score were better than those observed with the individual radiologic findings. A correlation matrix for the different cytokines evaluated one against each other, has also been added to show common behavior of these modulators. A similar analysis was also performed for the radiologic abnormalities.

Adolescent↗
PubMed2004

Radiological manifestations of pulmonary tuberculosis.

Pulmonary tuberculosis (TB) is a common worldwide lung infection. The radiological features show considerable variation, but in most cases they are characteristic enough to suggest the diagnosis. Classically, tuberculosis is divided into primary, common in childhood, and postprimary, usually presenting in adults. The most characteristic radiological feature in primary tuberculosis is lymphadenopathy. On enhanced CT, hilar and mediastinal nodes with a central hypodense area suggest the diagnosis. Cavitation is the hallmark of postprimary tuberculosis and appears in around half of patients. Patchy, poorly defined consolidation in the apical and posterior segments of the upper lobes, and in the superior segment of the lower lobe is also commonly observed. Several complications are associated with tuberculous infection, such as hematogenous dissemination (miliary tuberculosis) or extension to the pleura, resulting in pleural effusion. Late complications of tuberculosis comprise a heterogeneous group of processes including tuberculoma, bronchial stenosis bronchiectasis, broncholithiasis, aspergilloma, bronchoesophageal fistula and fibrosing mediastinitis. Radiology provides essential information for the management and follow up of these patients and is extremely valuable for monitoring complications.

Adult↗
PubMed1999

Pulmonary tuberculosis.

Pulmonary tuberculosis is a major cause of morbidity and mortality worldwide, resulting in the greatest number of deaths due to any one single infectious agent. This trend is due, at least in part, to increasing numbers of individuals co-infected with HIV and Mycobacterium tuberculosis (MTB). Concerted efforts between the World Health Organization and other agencies, therefore, are underway to improve tuberculosis control worldwide. These include basic research in tuberculosis diagnostics and vaccine development, institution of preventive therapy in individuals dually infected with HIV and MTB, and directly observed short-course antituberculous therapy in developing countries with a high prevalence of MTB infection. Further, newer, longer-acting antituberculous therapeutic agents such as rifapentine, which allow twice-weekly dosing in the continuation phase of anti-MTB therapy, have recently been released and are undergoing clinical trials. This review provides a synopsis of recent developments in these areas and serves as a reference source for interested readers.

Antitubercular Agents↗
PubMed1983

Fifteen year follow-up of lung function in obstructive and non-obstructive pulmonary tuberculosis.

Pulmonary function (VC, FEV1, RV) was assessed in patients with pulmonary tuberculosis discharged in 1958/59 as cured or markedly improved. According to FEV1/VC% the patients were divided into 40 obstructive and 59 non-obstructive cases and the tests were repeated by the same method in 1974. The control included physical and X-ray examinations, a questionnaire and the assessment of airway resistance (Rt). In the non-obstructive group the change in VC in 15 years was only -27.7 ml/year, in the obstructive group, -54.3 ml/year. There was little difference between the two groups in the diminution of FEV1 (28.8 and 35.3 ml/year, respectively). The material was subdivided into surgically and drug treated groups and studied statistically. The only significant change of function in the surgically treated group was in RV, whereas in the other group nearly all of the functional changes were significant statistically.

Adult↗