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PubMed1999

[Clinical analysis of 96 cases with pulmonary disease caused by nontuberculous mycobacteria].

OBJECTIVE: To study the clinical characteristics of nontuberculous mycobacteria (NTM) pulmonary disease. METHODS: Ninety-six out of 173 cases with NTM pulmonary disease diagnosed through identification of mycobacterium strains isolated from 5,592 sputum acid-fast staining positive cases from 1981-1996 were selected, and a retrospective analysis was made. RESULTS: According to Runyon classification, there were 14 cases with M. kansasii and 1 with M. marinum in type I, 4 with M. scrofulsceum in type II, 23 with M. intracellulare or M. avium in type III, 24 with M. chelonae and 30 with M. fortuitumin in type IV. Cases whose courses of disease were more than 10 years accounted for 31%. Main clinical symptoms included cough (78%), expectoration (71%), haemoptysis (58%) and fever (26%). Fifty-seven percent cases in X-ray chest film were seen lesions bilaterally, 42% in one side, 27% in the right and 15% in the left. One percent showed no obvious lesion in X-ray chest film. Excluding one case with incomplete data, the total resistance rate of NTM was 96% in other 95 cases, 93% in type I, 50%, 100% and 100% in type II, III, IV respectively. After antituberculous chemotherapy, sputum negative conversion was seen in 14 of 15 cases with type I NTM, 6 of 23 with type III and 14 of 54 with type IV, while definite data in 4 cases with type II were not available. CONCLUSIONS: NTM pulmonary disease is characterized by long course of disease, nonspecific symptoms, high resistance rate and unsatisfactory therapeutic efficacy.

Adult↗
PubMed1999

[The clinical analysis and review of literature of pulmonary carcinosarcoma and blastoma].

OBJECTIVE: To explore the clinical characteristics, diagnosis, treatment of pulmonary carcinosarcoma and blastoma. METHODS: Summarizing retrospectively 15 cases of pulmonary carcinosarcoma and 2 cases of pulmonary blastoma from January 1979 to November 1998, and reviewing literature to analyse their histologic, clinical feature, diagnosis and treatment. RESULTS: Pulmonary carcinosarcoma and blastoma both were found to be rare malignant tumors, and both epithelial and mesenchymal elements can be seen under the microscopy with different characteristic features. It was hard to be diagnosed before operation. The main symptoms of pulmonary carcinosarcoma were cough, expectoration, sometimes bloody phlegm. X-ray showed that peripheral type were most common, and 2-5 cm in size, well-distributed in density, some showed central or eccentric cavities whose wall was irregular. The margin of the focuses were clear, leafy, the distensive lymph nodes of hilum or mediastium could also be seen. Bronchoscopic examination revealed the bronchial cavity was obstructed by mass or became stricted. Local biopsy can found squamous, adenocarcinoma or large cell carcinoma, respectively. Malignant cell can also be found in sputum. So it was easy to be confused with lung cancer. 14 cases of the carcinosarcoma were treated surgically and diagnosed, 1 case was diagnosed by lymph node biopsy. The symptoms of pulmonary blastoma were fever and hemoptysis. X-ray or CT scan showed an isolated mass in the lung, with uneven density. Malignant cells in pleural effusion were found in one case and can not be diagnosed definetely but by pulmonary puncture. The another case was diagnosed by surgical operation. 15 cases of this group were followed up, in which 4 cases are still alive (including 1 case of pulmonary blastoma), the 1-year survival of carcinosarcoma is 30% (3/10), 2-year survival 20% (2/10), in which 1 case survived more than 6 years. Another pulmonary blastoma case only survived 3 months. CONCLUSIONS: These 2 kinds of malignant tumor are often easy to be misdiagnosed, and prognosis is very poor. Surgical resection is the main method of diagnosis and treatment.

Adult↗
PubMed1999

[Clinical observation on treatment of postcardiotomic complications with Chinese herbal medicine based on syndrome differentiation with angiocardiopathy].

OBJECTIVE: To study the effect of Chinese herbal medicine (CHM) based on Syndrome Differentiation on postcardiotomic complications in patients with angiocardiopathy. METHODS: Aimed at the frequently encountered postcardiotomic complications including fever, cough and expectoration, belching, abdominal distension, palpitation, short breath, etc. CHM treatment was applied in combination with routine western drugs treatment (cardiac tonic, diuretics, vascular dilatator and anticoagulant). RESULTS: Twenty out of 22 patients with protracted fever and irresponsive to multi-antibiotics therapy were cured, the other one with hydrothorax received other therapy and the another one with drug fever was natural cured after stopping medication. Among 23 patients complicated mainly with respiratory symptoms, 17 were cured and 6 improved, among 15 with digestive symptoms, 12 cured and 3 improved, and among 7 with cardiovascular symptoms, 3 cured, 2 improved and 2 ineffective. CONCLUSION: CHM has good effect on postcardiotomic complications, it could improve the functional recovery of heart and lung.

Adolescent↗
PubMed1999

[A clinical trial of 14 and 15 membered macrolides in treating six cases of diffuse panbronchiolitis].

OBJECTIVE: To observe the therapeutic effect of macrolides in treating diffuse panbronchiolitis (DPB). METHODS: 14- and 15-ring macrolides were used in the treatment of six confirmed cases of DPB for 3 approximately 24 months. The improvement in symptoms, X-ray findings, lung function and results of blood gas analysis was recorded. RESULTS: Symptoms such as cough, sputum expectoration and exertional dyspnea alleviated significantly during the first 2 weeks. PaO(2) level, FEV(1)%, and vital capacity (VC) increased remarkably. Diffuse small nodular lesions on chest X-ray or CT decreased in size within a few months. CONCLUSION: Macrolides have significant therapeutic effect on DPB and the patients have good tolerance to them. However, the mechanism of its action, the selection of the best macrolide, the most suitable dosage and the appropriate period of treatment still need further investigation.

Adult↗
PubMed2001

[Pulmonary damage caused by right side infective endocarditis in intravenous drug users].

OBJECTIVE: To highlight the understanding of pulmonary damage caused by right side infective endocarditis (RIE). METHODS: 28 intravenous drug users with pulmonary damage caused by RIE from 1994 to 2000 were reviewed with chest roentgenogram, chest B-ultrasound, blood gas analysis and sputum cultures. RESULTS: 100% (28/28) cases with RIE showed pulmonary damage, in which cough 100% (28/28), expectoration 71% (20/28), breathlessness 64% (18/28), pleuritic chest pain 57% (16/28), hemoptysis 36% (10/28) rales were present in 20 cases (71%) (20/28). By chest X-rays 82% (23/28) patients showed pulmonary infiltrative lesion, 21% (6/28) showed multiple thin wall cystic lesion. manifestations for pulmonary embolism were shown in 6 cases (21%). Pleural effusion was confirmed by chest B-ultrasound in 6 cases (21%). Respiratory failure present in 4 cases (4/28). Positive rate of sputum cultures was 54% (15/28). The prognosis for twenty-three patients (82%) when treated with the regimen of 4 to 6 weeks of parenteral antibiotics was good, Five patients (18%) underwent surgery, and two of them died. CONCLUSION: The pulmonary damage by RIE should be paid more attention to for avoiding misdiagnosis.

Adolescent↗
PubMed2001

Hydrogen peroxide decomposition in the oral cavity.

PURPOSE: To determine the clearance of hydrogen peroxide from the oral cavity of infants (3-4 yrs of age), juveniles (7-12 yrs of age), adults (35-66 yrs of age), and adults with impaired salivary flow (34-71 yrs of age). MATERIALS AND METHODS: In all subjects, the amount of H2O2 present in the oral cavity was assessed following a 1-min brushing period with an experimental dentifrice formulated with 3% hydrogen peroxide for up to 9 mins postbrushing. In addition, the oral clearance of 3% hydrogen peroxide delivered in an experimental dentifrice formulated with 5% baking soda was determined in a control population of adults and adult subjects with impaired salivary flow. RESULTS: Most of the hydrogen peroxide decomposed during brushing, with less than 30% of the prebrushing dose of hydrogen peroxide remaining in the oral cavity after 1 min of brushing. No differences between infants, juveniles, and adults were seen in levels of hydrogen peroxide recovered from the oral cavity after tooth brushing. When a mixture of hydrogen peroxide and baking soda was used for brushing, less than 5% of the hydrogen peroxide was recovered from the oral cavity after 1 min of brushing. In conclusion, clearance of hydrogen peroxide from the oral cavity was very rapid in children, adults, and adults with impaired salivary flow. Decomposition of hydrogen peroxide was enhanced approximately six-fold in adults by the presence of baking soda in the dentifrice. No substantial amount of hydrogen peroxide survived beyond the brushing period, and very little material would be present to interact with soft tissues in the oral cavity after expectorating any remaining dentifrice containing hydrogen peroxide.

Adolescent↗
PubMed2001

[Clinical evaluation of 8 patients with pulmonary tuberculosis in a community hospital without restricted tuberculosis wards].

The clinical features of 8 patients with pulmonary tuberculosis under treatment in the Koebaru Central Hospital, a community hospital without restricted tuberculosis wards, between 1992 and 2000 were evaluated. The major findings in the present study were: i) recently, the number of elderly patients with reactivated pulmonary tuberculosis has increased, ii) none of the patients showed respiratory symptoms, and 3 patients had negative Mantoux skin tests, iii) only one patient showed cavities on chest radiography, and iv) none of the expectorated sputum samples was smear-positive for Mycobacterium tuberculosis. Smears of intrabronchial sputum sampled using a fiberoptic bronchoscope from pulmonary lesions in patients without any symptoms were useful for establishing the diagnoses. Considering all aspects, it is important to perform aggressive evaluations, even for elderly patients, utilizing a fiberoptic bronchoscope for early diagnosis of pulmonary tuberculosis and to prevent nosocomial infections.

Aged↗
PubMed1996

Bacteriologic diagnosis of respiratory tract infections.

The use of the Gram stain for determination of the presence of bacteria in respiratory secretions is described. Success of the procedure depends on the use of fresh samples of high cellular quality. The Gram stain can be used to distinguish the presence (among other organisms) of Streptococcus pneumoniae, Haemophilus influenzae, Branhamella catarrhalis enterobacteria and Pseudomonas. This paper also discusses the use of sputum samples for bacteriologic culture and the value of bacterial counts in expectorated sputum, and describes the use of transtracheal aspiration and transthoracic aspiration puncture. Finally, it considers the optimum procedures for the testing of antibiotic susceptibility of presumptive pathogens isolated from the lower respiratory tract.

Journal Article↗
PubMed2000

[Pathological study of the pleomorphic carcinoma of the lung].

OBJECTIVE: A clinicopathological study of 10 patients with pleomorphic carcinoma of the lung. METHODS: Histopathological and immunohistochemical staining for keratin, vimentin, Mac387, desmin, actin and S-100 protein were used for this study. RESULTS: Pleomorphic carcinoma of the lung was found to often occur in males above 50 years of age and with clinical symptoms including cough, expectoration, haemoptysis and chest pain. The most frequent microscopic diagnosis was squamous cell carcinoma, and adenocarcinoma, accompanied by spindle and giant cells. The epithelial component of pleomorphic carcinoma of the lung displayed positivity for keratin and the spindle cells displayed positivity for vimentin. In some cases the neoplastic epithelial component and spindle cells showed positive expression of both keratin and vimentin. CONCLUSION: Pleomorphic carcinoma of the lung may display various histopathological changes making it easy to be misdiagnosed as carcinosarcoma. Understanding its pathogenesis and histopathology is important for the diagnosis and differential diagnosis.

Adenocarcinoma↗
PubMed1975

Clinical infectious bovine rhinotracheitis in cattle fed organic iodine and urea.

The feeding of ethylenediamine dihydriodide (EDDI) at the dose levels of 50 and 500 mg/animal/day and urea at the dose level of 45 g/animal/day did not affect duration of clinical signs, body weight gain, magnitude or duration of fever, serum concentration of glutamic oxalacetic transaminase, packed cell volume, and differential white blood cell counts in feeder cattle experimentally infected with infectious bovine rhinotracheitis (IBR) virus. However, coughing and abundance of nasal discharge were significantly greater in calves fed EDDI before and during primary IBR virus infection. Those calves fed 500 mg of EDDI/day coughed more, had greater nasal discharge, and exhibited greater lacrimation than did those given the smaller dose. These 3 clinical signs were considered to reflect both the expectorant action of EDDI and the pathogenic effects of IBR virus. In all calves, including controls, the coughing, nasal discharge, and lacrimation were most prominent during the period of peak infection (7 to 14 days after the calves were given intranasal inoculation) of the IBR virus. Total serum iodine concentration became maximal (mean of 1,400 ng/ml) in 8 calves after they had been fed the larger dose of EDDI for 2 weeks. This value was maximal (about 300 ng/ml) in another 8 calves after 3 weeks' feeding of the smaller dose (50 mg/day). When EDDI exposure was maintained at the dose level of 50 mg/day for 5 weeks longer, mean serum iodine values remained at about 275 ng/ml, and those of control calves averaged 140 ng/ml.

Ammonia↗
PubMed2002

[Respiratory symptoms and ventilatory disorders among a group of cement workers in Morocco].

There are 8 cement works in Morocco employing 3 600 people and producing 8 million tons annually. The aim of our study is to determine the prevalence of respiratory symptoms and to propose some preventive measures. The study involved a group of workers of whom 280 were exposed to cement dust (who were further subdivided into three categories according to the intensity of exposure) and 73 who were not. It included a medical history with a standardised questionnaire, a clinical examination and spirometry. 65% of those exposed had clinical symptoms as opposed to 34.2% of the non-exposed. Cough, expectoration rhinitis, chronic bronchitis and asthma were significantly more common with incidences of 56.1%, 52.5%, 49.3%, 29.3% and 14.3% respectively in the exposed against 19.2%, 24.6%, 26%, 9.6% and 6.8% in the non-exposed. Among the exposed the prevalence of chronic bronchitis increased significantly with the degree of exposure, from 11.4% in category 1 to 41.6% in category 3. Age did not seem to influence the development of chronic bronchitis but on the other hand a smoking history of more than 10 years did. Exposure is responsible for the development of respiratory problems because among non smokers the exposed (55.6% are more symptomatic than the non-exposed (13.3%). Tobacco smoking potentiates the effects of occupational airborne contamination because exposed smokers (73.6%) and ex-smokers (67.8%) have more respiratory problems than exposed non-smokers (55.6%). The incidence of abnormalities of respiratory function is significantly higher in the exposed than in the non-exposed (32.5% against 13.7%). Among the exposed workers presenting disorders of ventilatory function 72.5% have no more than a disorder of the small airways or a slight deficit. Among the exposed the prevalence of impaired respiratory function is greater in smokers and ex-smokers (47.9% than in non-smokers (10.4%). Tobacco smoking augments the impairment of respiratory function. Prevention depends therefore on a programme of technical (collective and individual) and medical protection of the workforce.

Adult↗
PubMed2002

Physiology of airway mucus clearance.

Respiratory tract secretions consist of mucus, surfactant, and periciliary fluid. The airway surface fluid is present as a bilayer, with a superficial gel or mucous layer and a layer of periciliary fluid interposed between the mucous layer and the epithelium. A thin layer of surfactant separates the mucous and periciliary fluid layers. The mucous layer extends from the intermediate airway to the upper airway and is approximately 2-10 microm thick in the trachea. Airway mucus is the secretory product of the goblet cells and the submucosal glands. It is a nonhomogeneous, adhesive, viscoelastic gel composed of water, carbohydrates, proteins, and lipids. In health, the mucous gel is primarily composed of a 3-dimensional tangled polymer network of mucous glycoproteins or mucin. Mucin macromolecules are 70-80% carbohydrate, 20% protein, and 1-2% sulfate bound to oligosaccharide side chains. The protein backbones of mucins are encoded by mucin genes (MUC genes), at least 8 of which are expressed in the respiratory tract, although MUC5AC and MUC5B are the 2 principal gel-forming mucins secreted in the airway. Mucus is transported from the lower respiratory tract into the pharynx by air flow and mucociliary clearance. Expectorated sputum is composed of lower respiratory tract secretions along with nasopharyngeal and oropharyngeal secretions, cellular debris, and microorganisms. Disruption of normal secretion or mucociliary clearance impairs pulmonary function and lung defense and increases risk of infection. When there is extensive ciliary damage and mucus hypersecretion, airflow-dependent mucus clearance such as cough becomes critically important for airway hygiene.

Cough↗
PubMedDate not supplied

Clinical profile of tuberculosis in patients with HIV Infection/AIDS.

Tuberculosis is said to be one of the commonest opportunistic infection in patients with HIV/ AIDS. A study was carried out to study the clinical, bacteriological and radiological features of HIV/TB patients. Over a period of two years, a total of 301 tuberculosis patients were suspected to have HIV/AIDS co-infection, and upon testing, 42 patients were found to be HIV seropositive. Most of the study patients were manual labourers followed by truck drivers. Sexual (heterosexual) route was found to be the major risk factor for HIV/AIDS. The most common symptom in these patients was cough and expectoration, followed by fever and weight loss. Acid-fast bacilli (AFB) smear positivity was found in 21.4% patients. On chest skiagram, infiltrative lesions were commonly seen in 61.9% patients. Extra-pulmonary tubercular manifestations were seen in 45.6% of HIV/TB cases.

AIDS-Related Opportunistic Infections↗
PubMed2001

[The introduction of tobacco and the diffusion of smoking culture in Korea].

Since its introduction to Korea from Japan at the beginning of the seventeenth century, tobacco became very popular with an amazing rapidity among Koreans. Along with widespread cultivation of tobacco, smoking also became very popular among Koreans, regardless of their classes, ages, and sexes. On the other hand, other imported crops from America via Europe in the sam period, like sweet potato, potato, corn and tomato, did not enjoy such popularity in Korea. A long time after their introduction, Koreans began to cultivate these crops. Why did Koreans respond enthusiastically to the newly-imported tobacco? What kind of factors contributed to the rapid transmission of tobacco in Korea? This study examined the causes of rapid diffusion of the smoking population in three aspects. First was economic aspect. The farming of tobacco yielded a profit by selling it to Chinese. The climate and the soil of Korea fit for farming of tobacco. So the farm land of tobacco expanded gradually since the 18th century. Second was medical aspect. At first, many Koreans believed that smoking was helpful to digestion, expectoration, protecting coldness, and exterminating parasites. Afterwards, they believed smoking could encourage vitality and protect diseases. There was no reason of smoking cessation for the people's health in that the hazards of smoking were not well known to the commonage in those days, though a few intellectuals acknowledge its harm. Third was sociocultural aspect. We could trace the smoking culture of Chosun dynasty through arts, poems, and essays. The making of smoking culture made stable reproduction of smokers generation by generation. Especially, the smoking culture secured juvenile's smoking. Considering the three aspects above, we know that what reason the Decree of Ban of Smoking in Korea was not strict in comparison to that of China (Qing Dynasty), in which the violators were executed. The regulation of smoking by the government failed except controlling in sociocultural aspect. The government reinforced controlling of smoking culture in counteraction to the threat of collapse of the hierarchy of Chosun dynasty in 18th century.

History, 17th Century↗
PubMed2002

[Laryngeal carcinoma associated with congenital tracheobronchomegaly (Mounier-Kuhn syndrome): a case report].

Congenital tracheobronchomegaly or Mounier-Kuhn Syndrome is a rare disorder of controversial etiology. It is characterized by an abnormal enlargement of the trachea and primary bronchi, because of atrophy or absence of their elastic fibers and smooth muscles. Such alterations lead to the collapse of the respiratory tract during forced exhalation, making expectoration by coughing of little use. Subjects with this disorder are, therefore, predisposed to the development of phlogistic bronchopulmonary pathologies such as bronchitis, emphysema, bronchiectasis and pulmonary fibrosis. The present work reports the case of a 65-year-old man suffering from asymptomatic congenital tracheobronchomegaly which was unknown until preoperative testing was performed (standard chest x-ray, tracheobronchoscopy) following a diagnosis of squamous cell carcinoma of the larynx. The patient underwent total laryngectomy and bilateral neck dissection without any intra- and postoperative complication. This is the first case reported in the literature of an association between laryngeal carcinoma and Mounier-Kuhn Syndrome, although a cause-effect relationship between the two pathologies cannot be advanced at this time. This paper also reports how the patient was managed in terms of anesthesiology and surgical technique, both conditioned by the marked tendency for anteroposterior tracheal wall collapse and its high reactivity to mechanical insults.

Aged↗
PubMed1975

Fluoride retention after rinsing with sodium fluoride and amine fluoride.

Fluoride retention from fluoride rinses (250 ppm F), calculated from F-concentrations and volumes of expectorates, and fluoride clearance, determined in whole saliva samples collected 1, 5 and 10 minutes after rinsing, were studied in 70 adults. F-retention from a 1:1 oleylamine-cetylaminefluoride rinsing solution (15 ml. 15 sec) was 410 mjg F, from a sodium fluoride rinse 343 mug F. 563 mug F were retained from a 30-sec amine fluoride rinse. Fluoride clearance was significantly slower after cetylaminefluoride rinses than after NaF rinses. Prerinsing with sodium lauryl sulfate or cetylaminechloride annihilated the F clearance superiority of cetylaminefluoride over NaF.

Adult↗
PubMed2002

[AIDS complicated by Pneumocystis carinii pneumonia: report of 20 cases].

OBJECTIVE: To report our experience in diagnosis and treatment of AIDS complicated by Pneumocystis Carinii Pneumonia (PCP), and explore the relations between preventive medication and occurrence as well as recurrence of PCP. METHODS: The clinical characteristics of 20 patients with AIDS complicated by PCP (identified from a cohort of 109 patients with AIDS) treated in our hospital during July 2000 to May 2002 were analyzed. RESULTS: All the 20 cases had fever, 90 % of whom also had cough or expectoration, and chest radiography revealed bilateral interstitial changes in 80 % of the cases. CONCLUSION: It is possible to diagnose PCP by typical clinical findings and chest X-ray, and compound sulfamethoxazole may prove effective for preventing the occurrence of PCP.

AIDS-Related Opportunistic Infections↗