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PubMedDate not supplied

[Broncho-Vaxom in the treatment of chronic pulmonary lesions].

Two hundred patients with various chronic pulmonary diseases were treated with the bacterial lysate Broncho-Vaxom (BV) in addition to conventional treatment, or alone, over a period of 2 years. The efficacy of BV was assessed ob the basis of clinical symptoms (dyspnoea, cough, expectoration, fever and bronchial rales), pulmonary function, number of relapses and immune status, in particular serum immunoglobulins A, G and M. The results demonstrated the efficacy of BV in the treatment and prevention of chronic pulmonary disease. In patients treated with BV, clinical symptoms improved significantly compared to controls, incidence of infectious episodes was reduced and impaired immune functions were restored. BV was generally well tolerated.

Adjuvants, Immunologic↗
PubMedDate not supplied

[Results of utilization of intermittent normobaric hypoxia in patients with bronchial asthma and chronic obstructive bronchitis].

The results of intermittent normobaric hypoxytherapy in 42 patients with bronchial asthma (BA) and 14 patients with chronic obstructive bronchitis (COB) are analyzed. The positive effect is obtained in 76% of patients with BA and 92.8% of patients with COB. In the group of patients with BA the best effect was achieved for atopic form of BA--in 90% of patients, the effect was less pronounced for infection-allergic form--in 73.9% and for mixed form of BA--in 66.7%. In the process of treatment the attacks of asphyxia disappeared or became more occasional in 60.7% of patients; in 32.1% the attacks were more easily arrested or stopped independently; 33.8% of patients decreased doses of constantly taken drugs; in 33% cough ceased or decreased, sputum became to expectorate better; in 41% of patients dyspnea disappeared and considerably decreased. Improvement of the state in 54% of patients was retained for one year and more, in 29%--for 6 months, in 16.6%--for 3-4 months. The course of treatment consisted of 20-25 sessions. The patients breathed in hypoxic gas mixture containing 10% of oxygen (HGM-10) under intermittent conditions alternating with respiration of free air.

Adult↗
PubMed1992

Clinical observations with Paxirasol aerosol in patients suffering from chronic bronchitis accompanying silicosis.

Paxirasol aerosol applied in daily 3 x 5 puff doses in the treatment of silicosis patients is found to be a well tolerated drug form. In the course of the 21-day therapy especially coughing and chest pain were moderated, but the product also controlled, the catarrhal coat formation on the mucosa. It influenced abundant expectoration and dispnoea beneficially. During the therapy the laboratory parameters did not change. The objective respiratory parameters improved but the change was non-significant. Paxirasol aerosol is found useful in the treatment of chronic bronchitis accompanying silicosis. Evaluable side-effects were not registered.

Administration, Inhalation↗
PubMedDate not supplied

[Aerobic flora examination of sputum (author's transl)].

The routine bacteriological test of expectorate, except for mycobacteria, is usually unsatisfactory. There is a need of standardization which results in the present paper from a comparison between the data obtained by two different laboratories on the same samples. It is possible to achieve reasonable and uniform results establishing a uniformity of some procedures, namely; collection of specimens, homogenization, number and type of media, interpretation of data and so on.

Aerobiosis↗
PubMed1992

[The diagnosis of smear negative pulmonary tuberculosis in superior segment of lower lobe].

20 cases of tuberculosis in the superior segment of the lower lobe of the lung were misdiagnosed as lung cancer, pneumonia, bronchiectasis and inflammatory pseudoneoplasm were reported. The final diagnosis were confirmed by fiberoptic bronchoscopy (FOB). The causes of the misdiagnoses were: (1) the hilar mass shadow found on the PA chest film, mistaken for central type lung cancer; (2) the mass shadow found on the lateral chest film, mistaken for peripheral lung cancer; (3) the patients with fever, cough and expectoration accompanied by exudative infiltrative shadow, mistaken for pneumonia; (4) patients with recurrent attacks of hemoptysis but the lesions overshadowed by the spinal column on the lateral chest film were misdiagnosed as bronchiectasis. The author suggested PA and lateral chest films taken simultaneously were needed. The special points, to which should be pay attention during reading the films were listed and noted. FOB examination including TBLB, brushing and BALF for pathologic and AFB determination could be of help to confirm the diagnosis.

Adolescent↗
PubMed1992

An in vitro procedure based on chewing to predict metabolic response to starch in cereal and legume products.

A new method for measuring the rate of in-vitro starch digestion in products with a structure 'as eaten' is introduced. An equivalent amount of potentially available starch from each product was chewed by subjects, expectorated into a beaker and incubated with pepsin. The incubate was thereafter transferred to a dialysis tubing and incubated with pancreatic alpha-amylase for 3 h. Samples were removed from the dialysate at time intervals and the degree of hydrolysis was calculated as the proportion of the potentially available starch degraded to maltose. A hydrolysis index (HI) was calculated as the area under the hydrolysis curve with the product as a percentage of the corresponding area with white wheat bread. The method was applied to 21 cereal and legume products, chosen to cover as wide a range as possible with respect to metabolic response, and to include several of the proposed mechanisms to differences in metabolic behaviour of starch. The accuracy of the in-vitro method was evaluated versus the metabolic responses obtained with the same products in healthy subjects. A significant correlation between HI and glycaemic index (GI) was obtained in cereal as well as in legume products. A significant correlation was also obtained between HI and insulin index (II) with pooled data from all products. However, in the case of II no correlation was obtained with the legume products only. It is concluded that the presently described in-vitro procedure offers a good potential to predict the metabolic behaviour of starchy foods.

Digestion↗
PubMed1992

[An autopsy case of Marfan syndrome with bronchiectasis and multiple bullae].

We report an autopsy case (27-year-old male) with Marfan syndrome, who died of chronic respiratory failure due to bronchiectasis and multiple bullae in both lungs. He had suffered from expectoration of massive amounts of sputum since the age of 15 years. At this time, chest roentgenogram had revealed bronchiectatic changes in the bilateral lower lung fields. Seven years later at the age of 22 years, the formation multiple bullae in both lungs were added to the bronchiectatic changes on chest roentgenogram. Administration of erythromycin (400 mg/day) was started in February, 1987, and the massive sputum volume markedly decreased according to appearance of bullous formation. He was admitted to our department because of deterioration with chronic respiratory failure and right heart failure at 26 years in December, 1989. Although various therapy was performed, he died of chronic respiratory failure in February, 1990. Autopsy findings were as follows: (1) cyclindrical bronchiectatic changes in bilateral lower lobes and (2) extensive multiple bullae in the subpleural areas with bronchiectatic changes in the middle and bilateral lower lobes, with no bronchiectatic changes in the bilateral upper lobes. Several pulmonary disorders accompanying Marfan syndrome have been reported, especially in children. However, the present case demonstrated that fetal pulmonary involvement by Marfan syndrome may not present until adulthood, and affect both airways and lung parenchyma.

Adult↗
PubMedDate not supplied

[Effectiveness of sodium cromoglycate in the reduction of bronchodilator doses in asthmatic patients].

Thirty asthmatic patients, ages ranging from 6 to 72 years, who were submitted to a 14 weeks clinical evaluation, were studied measuring the severity of dysnea, coughing, expectoration and wheezing. Sodium chromoglycate (SCG) was administered in aerosol starting the second week of the study and the doses of bronchial dilators was reduced starting the fourth week, with a 25% decrease in the total established initial dosage, every two weeks. In this study, SCG showed to be useful in decreasing symptoms caused by bronchial hyperreactivity and the use of bronchial dilators in 70% of asthmatics who react with the presence of just one risk factor (cold, the most frequent).

Adolescent↗
PubMed1992

[Generalized histoplasmosis due to Histoplasma duboisii with mediastino-pulmonary infection. Cure after 15 months of treatment with ketoconazole].

We report a case of a young burkinabian, who presented with the disseminated african form of histoplasmosis, Histoplasma duboisii. There was pulmonary mediastinal disease with superficial lymphadenopathy and also hepatic involvement. The diagnosis was achieved by a histological examination of the peripheral glands and micrological examination of the expectorate. A clinical cure (despite the radiological persistence of enlarged but stable left hilar glands) with the follow up 10 months was achieved after 15 months of treatment with ketoconazole in a dose which was increased to 10 mg/kg/day.

Biopsy↗
PubMed1992

[Sputum leukotrienes in chronic airway diseases and bronchial asthma attacks].

To determine the pathogenetic role of leukotrienes in chronic airway diseases, sputum samples from patients with bronchial asthma (BA), diffuse panbronchiolitis (DPB), sinobronchial syndrome (SBS), and bronchiectasis (BE) were examined for the presence of leukotrienes (LT) C4, D4, E4, B4, all apparently derived from airway inflammatory cells. Sputum samples from 21 patients, including 10 with BA attack (5 atopic type, 5 non-atopic type) and 11 with chronic obstructive airway diseases (3 DPB, 6 SBS, and BE), were studied. Patients expectorated sputum directly into test-tubes containing 80% ethanol. Following ethanol extraction and partial purification by a C18 SEP-PAK column, LTs were further purified by high performance liquid chromatography (HPLC). Fractions from HPLC with elution times corresponding to synthetic LTC4, D4, E4, and B4 were used to quantify LTs by radioimmunoassay. Eosinophils and neutrophils in the sputum (0.5 ml) were counted following Papanicolaou staining. Percentages of eosinophils in sputum were higher in BA, while those of neutrophils were higher in DPB. Sputum levels of LTC4 were 1.2 +/- 1.6 in BA, 0.12 +/- 0.11 in SBS, and 0.42 +/- 0.14 ng/ml in DPB. Those of LTD4 were 0.21 +/- 0.27 in BA, 0.9 +/- 0.13 in DPB, and 0.10 +/- 0.07 in SBS. LTE4 levels were 5.06 +/- 3.83 in DPB and 2.66 +/- 4.32 in BA. Levels of LTB4 were 1.36 +/- 1.19 in DPB, 0.28 +/- 0.27 in BA, 0.12 +/- 0.07 in SBS, and 0.04 +/- 0.04 in BE. In asthmatics, peptide leukotriene content in sputum was higher than that in chronic airway disease patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[A case of pulmonary alveolar proteinosis and disseminated atypical mycobacteriosis complicating chronic myelogenous leukemia].

A 47-year-old woman with chronic myelogenous leukemia was treated with daily busulfan (total dose approximately 500 mg) from December 1988 to January 1990. The disease thereafter remained stable with no evidence of blastic transformation. In February 1990 she developed productive cough and abnormal acinar lung shadows appeared transiently on her chest X-ray. In October 1990, productive cough and linear and abnormal acinar lung shadows reappeared. Expectorated sputa contained acid-fast bacilli (Gaffky 6, 10). Antituberculous therapy was started, which caused severe liver dysfunction. She was admitted to our hospital for evaluation of abnormal lung shadows. Transbronchial lung biopsy revealed pulmonary alveolar proteinosis with thickening of alveolar septa. The alveolar septal thickening was suspected to be a pathological change following pulmonary alveolar proteinosis. Cultures from sputum, cerebrospinal fluid, and bone marrow aspiration specimens revealed atypical mycobacterium (M. avium complex), and the diagnosis of disseminated atypical mycobacteriosis was established. The pathogenesis of the disseminated atypical mycobacteriosis was considered to be superinfection by mycobacteria.

Busulfan↗
PubMed2003

[Dynamic analysis of TCM syndrome in 63 patients of SARS].

OBJECTIVE: To observe the dynamic characteristics of symptoms and tongue figure in SARS patients, and the relationship between them and laboratory indexes. METHODS: The dynamic changes of 63 patients, who were hospitalized in authors' hospital from March 11 to April 30, 2003, were observed. RESULTS: The symptoms mostly often revealed in patients of early stage were fever in 56 patients, cough in 41 and weakness or heaviness of limbs in 40, which in patients of middle or crisis stage were cough in 53 and weakness or heaviness of limbs in 43. The clinical symptoms in patients of recovery stage were atypical, they occasionally manifested as limb weakness or heaviness in 17, chest stuffiness or pain in 13, low fever in 11, cough in 12 and expectoration in 11. In the early stage, patients' tongue was pink or red in tongue tip, with thin-white, white-greasy or yellow-greasy coating; in middle stage, tongue in most patients were red, with white-greasy or yellow-thick-greasy coating; in recovery stage, tongues of patients were mostly pink or red in tongue tip, few were dark purple, with thin-white or white-greasy, occasionally yellow-greasy coating. CONCLUSION: TCM syndrome of SARS patients has its characteristics and regularity of changes, which was in accordance with the laboratory findings.

Adolescent↗
PubMed2003

[Coagulation activity in the airways of asthmatic patients].

Fibrin deposition in the mucus plugs of asthmatic patients has long been known, and asthmatic sputum has been held to be important in the pathogenesis of bronchial obstruction. We examined the coagulation activity in the airways of asthmatic patients. Albumin as an index of plasma leakage into the bronchial lumen, thrombin antithrombin III complex (TAT), tissue factor, FDP, D-dimer and the TAT/D-dimer ratio as indices of coagulation and fibrinolytic markers were determined in expectorated or hypertonic saline-induced sputum from patients with acute and stable asthma, and with chronic bronchitis, and from normal control subjects. Patients with acute asthma, in comparison with patients with stable asthma or chronic bronchitis and normal control subjects, had significantly higher levels of albumin, TAT and TAT/D-dimer. The fibrin antigen was more positively stained immunohistochemically in sputum from acute asthmatics than in other sputa. In both patients with acute asthma and those with stable asthma, there was a significant positive correlation between albumin and TAT or albumin and TAT/D-dimer in the sputum. However, in normal control subjects, there was no correlation between these markers. These results suggest that the coagulation system in the airways of acute asthmatic patients is activated, that this favors fibrin deposition in the bronchial lumen and that coagulation pathways in the bronchial compartment and the degree of plasma exudation into the airways are dependently regulated in patients with asthma but not in normal control subjects.

Adult↗
PubMed1992

[Active tuberculosis in children who received INH chemoprophylaxis].

Twelve children who developed active tuberculosis even after receiving isoniazid (INH) chemoprophylaxis were seen at Tokyo Metropolitan Children's Hospital from 1982 through 1991. All cases received INH more than 9 mg/kg/day, except for one case in which the amount of INH administered at the referring hospital was unknown and Streptomycin was administered together with INH. The age of starting INH prophylaxis ranged from 2 months to 13 years, and the age at which clinical symptoms and/or laboratory evidences of active tuberculosis were first manifested ranged from 4 months to 18 years. Five patients developed active tuberculosis after the completion of chemoprophylaxis and patients during chemoprophylaxis, with the first presentation ranging from primary complex (seven), chronic pulmonary tuberculosis (two), tuberculous meningitis (two), and tuberculous pleuritis (one). None of the Mycobacterium tuberculosis resistant to INH was isolated. Reviewing these patients, eleven cases had at least one of the following factors: (1) age less than two years old (2) infectious sources expectorated more Mycobacterium tuberculosis (3) delay in starting INH. Above factors should be considered in initiating INH chemoprophylaxis and subsequent follow-up of the patients.

Adolescent↗
PubMed2003

A comparative study of clinical manifestations caused by tuberculosis in immunocompromised and non-immunocompromised patients.

OBJECTIVE: To characterize the differences between clinical manifestations in immunocompromised patients (ICPs) and non-immunocompromised patients (non-ICPs) with tuberculosis. METHODS: Underlying diseases, clinical presentations, misdiagnosis, treatment and prognosis, etc, were analyzed retrospectively in 115 tuberculosis patients, including 39 ICPs and 76 non-ICPs. RESULTS: Compared with non-ICPs, the individuals who were ICP had more expectoration (64.1% vs 35.5%), pulmonary moist rale (41.0% vs 9.2%), miliary pulmonary tuberculosis (30.8% vs 2.6%), pleural effusion (48.7% vs 25.0%) and lymphadenopathy (18.0% vs 4.0%). ICPs had less lung cavity (15.4% vs 22.4%) and pleural thickening (15.4% vs 23.7%) compared to non-ICPs. Pulmonary tuberculosis in ICPs was prone to be misdiagnosed as pneumonia (23.1% vs 6.6%). Pulmonary tuberculosis was found in the apicoposterior segment (SI + SII) in more cases in non-ICPs (21.7%, 10/46) than ICPs (10.3%, 3/29). The diagnostic value of tuberculin skin test and adenosine deaminase in pleural effusions was limited in ICPs. ICPs had significantly poorer prognoses than non-ICPs. CONCLUSION: The clinical manifestations of ICPs with tuberculosis are atypical, misdiagnosis often occurs, resulting in a worse prognosis.

Adult↗
PubMed2002

[Effects of rush-mat dust on the health of exposed workers].

OBJECTIVE: To evaluate the effect of exposure to rush-mat dust on the health of workers. METHODS: A cross sectional study of 661 workers (349 men, 312 women) from 35 rush-mat plants was carried out by using occupational health investigation, questionnare and physical examination. RESULTS: The geometric mean total dust concentration in the workshop was up to 20.00 mg/m3, and the geometric mean respirable dust concentration reached 8.22 mg/m3. The mean free SiO2 concentration of accumulated dust was 25.6%. The prevalence of radiographic small opacities profusion category > or = 1/0, according to the China Classification for pneumoconiosis (GB 5906-2000), and compared with the ILO 1980 system, was 2.57%. Even more, one man had category 2 pneumoconiosis with progressive massive fibrosis. However, the incidence of pneumoconiosis (1/0 at least) was correlated with work duration and dust concentration(r = 1.156, P < 0.001; r = 0.106, P = 0.006, respectively). Some positive correlations were found between the incidence of cough or expectoration and occupational exposure (r = 0.085, P = 0.028; r = 0.094, P = 0.016, respectively). CONCLUSION: To our knowledge, this is the first report of rush pneumoconiosis in China. The results have offered the possibility of a dose-response relationship between rush-mat dust and pneumoconiosis. More investigation in this area is need.

Aluminum Silicates↗
PubMed2003

The cost-effectiveness of a questionnaire as a screening test for chronic obstructive pulmonary disease among the Bangkok elderly.

This study aimed to explore the cost-effectiveness of using a questionnaire as a screening test for Chronic Obstructive Pulmonary Disease (COPD) among the Bangkok elderly residing around Siriraj Hospital. The gold standard used for diagnosing COPD followed the guidelines of the Thoracic Society of Thailand. The questionnaire consisted of 10 questions on smoking status, respiratory symptoms and previous history of pulmonary tuberculosis. There were 3,094 elderly who participated, completed the questionnaire, and underwent spirometry as well as chest radiography in the community. The results showed that elderly individuals who are smokers (> 0.5 pack-year) or have ever experienced sudden cough with chest oppression or dyspnea when the weather changes or who have expectorated more than two tablespoons of sputum would be suspected of having COPD with a sensitiviy of 81.4 per cent (95% CI 79.4-83.4), specificity of 62.2 per cent (95% CI 60.4-64.0) false negative rate 1.2 per cent (95% CI 0.7-1.7) and false positive rate 38 per cent (95% CI 35.3-40.7) and subsequently required spirometry and chest X-ray for definitive diagnosis. The test needed to screen 17 elderly individuals to detect one COPD case at a cost of 1,538 baht. This questionnaire is also a self-assessment tool for COPD screening among the elderly in order to encourage them to seek for early medical attention and it is recommended that this should be publicized via the mass media.

Aged↗
PubMedDate not supplied

[Wegener's granulomatosis of the colon. Case report and review of the literature].

INTRODUCTION: Wegener's granulomatosis is not very common and it is associated with colonic affection is extremely rare. It was first described by Klinger, and by Wegener in 1936. It is a systemic clinico-pathologic entity to be mediated by immune mechanisms. The most common clinical manifestations are of respiratory, renal, and vascular origins. Diagnosis is histologic. OBJECTIVE: Presentation of a clinical case and literature revision. MATERIAL AND METHODS: The patient was a 46 year old male who vegan 3 years previously with symmetrical arthralgia in ankles and knees, cough, purulent expectoration, intermittend fever, occasional moderated hematoquezia, profuse diarrhea, and abdominal pain. The patient was subjected to laboratory and cabinet studies, by means of which it was established a diagnosis secondary colitis colonic mucosa. Definitive histopathologic study confirmed diagnosis of colonic Wegener's granulomatosis.

Colitis↗