ABSTRACT
20 years before the detection of the tubercle bacillus by Robert Koch Brehmer and Dettweiler have created the fundamentals of tuberculosis therapy. The rest-cure in the open air initiated by them and the system of sanatorium treatment resulting from it have formed the management of tuberculosis all over the world for nearly 100 years. Even collapse therapy in the heroic phase of tuberculosis treatment has remained only a supplement to conservative therapy. In the centre of the scientific discussions, substantially influenced also by the "Wiener Schule", there were the problems of the first manifestations of tuberculous disease its early detection, giving the best chances of cure at those times; there was the knowledge that the cavity was of crucial significance for the fate of the tuberculous patient; in consequence thoracic collapse surgery was developed.
Subject(s)
Tuberculosis, Pulmonary/therapy , Collapse Therapy , Europe , Germany , History, 19th Century , History, 20th Century , Hospitals, Special , Humans , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/historySubject(s)
Dapsone/therapeutic use , Isoniazid/therapeutic use , Isonicotinic Acids/therapeutic use , Prothionamide/therapeutic use , Pyrazinamide/therapeutic use , Rifampin/therapeutic use , Tuberculosis, Pulmonary/drug therapy , Adult , Aged , Antitubercular Agents/therapeutic use , Drug Combinations/therapeutic use , Drug Therapy, Combination , Humans , Male , Middle Aged , Radiography , Sputum/microbiology , Time Factors , Tuberculosis, Pulmonary/diagnostic imagingABSTRACT
The clinical picture of acute tuberculosis infection is undergoing a change. The classic symptoms of pain in the chest and night sweats are giving way to general symptoms. In 50% of the cases the infection manifests itself as an acute disease. The observation that some cases of tuberculosis are not admitted to hospital until they are in a critical condition is ascribed to lack of "tuberculosis awareness".
Subject(s)
Tuberculosis, Pulmonary/pathology , Acute Disease , Adolescent , Adult , Age Factors , Aged , Diagnostic Errors , Humans , Middle Aged , Pain/etiology , Sweating , Tuberculosis, Pulmonary/diagnosisSubject(s)
Antitubercular Agents/therapeutic use , Dapsone/therapeutic use , Isoniazid/therapeutic use , Isonicotinic Acids/therapeutic use , Prothionamide/therapeutic use , Tuberculosis, Pulmonary/drug therapy , Antitubercular Agents/administration & dosage , Antitubercular Agents/adverse effects , Clinical Trials as Topic , Dapsone/adverse effects , Drug Combinations , Drug Evaluation , Drug Therapy, Combination , Humans , Isoniazid/adverse effects , Prothionamide/adverse effectsSubject(s)
Bronchial Neoplasms/surgery , Postoperative Complications/drug therapy , Bronchial Neoplasms/drug therapy , Busulfan/therapeutic use , Cyclophosphamide/therapeutic use , Drug Therapy, Combination , Drug Tolerance , Fluorouracil/therapeutic use , Humans , Methotrexate/therapeutic use , Prognosis , Vinblastine/therapeutic useABSTRACT
In the therapy of carinomas the best results had been achieved by radical operation. The operable carcinomas, especially the bronchial carcinomas, couldn't be found among clinical patients in such amount as we would like. X-ray therapy in the manner of high voltage radiation shows remarkable results, which is now common knowledge. For the most inoperable carcinomas only a general therapy may give certain positive therapeutical aspects. The own results with polychemotherapy in 847 patients with bronchogenic carcinomas or lung-metastases in advanced stages are shown. In spite of all limitations the polychemotherapy shows possibilities and some certain changes for symptomatic help in desperate cases.
Subject(s)
Bronchial Neoplasms/drug therapy , Austria , Bronchial Neoplasms/radiotherapy , Bronchial Neoplasms/surgery , Humans , Lung Neoplasms , Neoplasm Metastasis , Prognosis , Retrospective StudiesABSTRACT
After a historic review of the ever changing views concerning the pathogenesis of tuberculosis, a special possibility of extension is closely examined, that is the lymph node perforation into the bronchial system. In the past decades, the importance of this has been commensurately over -- as well as under -- evaluated. Our own examinations are based upon the experience gained by over 20.000 bronchoscopies in the past 25 years. According to the formulations of these examinations, carried out in 3 different groups, the following correlations were determined: The first series, registered during the years 1949-1952, included tuberculosis patients alone. In these series, 5.5% of the bronchoscopically proven changes were of tubercular lymph node perforation. The second series, published in 1961, included the compiling of 350 bronchoscopies performed on 350 cases of tuberculosis in the old age. In these series 11.4% of apparent lymph node perforations were observed. The third series contained 6021 bronchoscopies which were performed during 1970-1975. In this series, the tuberculosis presents only a small percentage of pulmonary diseases. In these cases, 2,9% were revealed as florid or healed lymph node invasions. This percentage would indicate that in cases of tuberculosis, lymph node invasion into the bronchial system means a minimal incidence. However, these figures, which are only based upon bronchoscopically determined findings must be considered, from an anatomical point of view, as the lowest occurrence border. Upon the basis of individual cases, different clinical pictures have been described, whereby these lymph node perforations can be clinically manifested. Consequently, it is this obturation with symptomatic foreign bodies, the atelectasis, which can falsely be diagnosed as a malignant bronchial closure, and also spread and aspiration even as is observed in the pneumonias. Additionally, because of interlobular lymphogenic propagation a similar symptom may be produced. Finally, as a last significant clinical manifestation, bleeding must be mentioned. Such bleeding is caused primarily when a caseous lymph node simultaneously perforates into the bronchial system and into a neighboring blood vessel. Over the past 25 years the clear up of the findings, due to constant improvements in bronchoscopy, have culminated in a method, the importance of which must be necessarily emphasized. This method should be universally utilized as routine examination in pulmonary departments and its neglecting should only be justified in specifically indicated cases.