A retrospective study was performed in order to document the sequence and time scale of radiological changes occurring during the healing of spinal tuberculosis. 28 episodes occurred in 26 patients, of whom only two were Caucasian. All demonstrated good response to conventional chemotherapy. Soft-tissue masses increased in size for up to 1.5 months and took about 12 months to resolve. Bone destruction was seen in all cases and progressed in 70% of patients, whilst on treatment. There was loss of vertebral body height in 79%, which progressed for up to 14 months; any recovery of height was a very late feature. Sclerosis was seen at presentation in 52% and developed in most of the remaining patients within 5 months of instigating treatment. It progressed for up to 14 months and took, on average, 31 months to return to normal. Reduction in disc height was commonly seen and the vertebrae fused in three-quarters of those affected, the time of onset of fusion being very variable. To manage patients with spinal tuberculosis, an appreciation of the variability of radiological changes that can occur during treatment is necessary.
We examined the sera of patients with tuberculosis for the presence of immune complexes to determine whether they were present, whether their presence was related to disease activity, and if the levels diminished with successful therapy. Methods PATIENTSNinety-six patients (41 male, 55 female), who were either currently affected by tuberculosis or were known to have had a previous infection were studied. These were the first 96 patients to be seen at the Chest Clinic during the period of this study. The mean age was 36 years (range 4-80 years). The racial distribution was Indian 80 (83 %), Caucasian 11 (12 %), Negro three (3%), and Chinese two (2 %).A diagnosis of tuberculosis was established by using standard clinical, radiological, and bacteriological criteria. Sites of disease were as follows: pulmonary (40); extrathoracic glandular (40); bone (9); abdominal (three); and hilar or mediastinal glands (22); 18 patients had more than one area
. A preliminary study ofthe effect of guaiphenesin on mucociliary cleaance from the human lung. The effect of guaiphenesin (administered as Robitussin1) on mucociliary clearance has been assessed in 15 subjects from the rate of removal from the lung of previously inhaled radioactive tracer particles. The guaiphenesin was compared with a positive control preparation consisting of the guaiphenesin vehicle only in two double-blind crossover trials. The first trial examined eight aged 'healthy' volunteer subjects and the second trial examined seven chronic bronchitic patients. Sequential gamma counts were made from the whole lung by scintillation counters for 6 hours after inhalation and the chest was also scanned rectilinearly. In the first 5 hours after inhalation the mean rate of removal of particles and therefore of secretions was faster after guaiphenesin than after the control preparation. This difference was not statistically significant in the healthy volunteers but achieved significance (P < 0-05) in the chronic bronchitic patients. Lung scans after inhaling the tracer aerosol indicated that on average the initial penetration of the particles into the lung was similar in the guaiphenesin and control runs. The faster clearance aftet guaiphenesin was unlikely to be due to bulk movements of mucus caused by coughing since the mean frequency ofcoughing during the experiment was somewhat less after the drug.Guaiphenesin is glyceryl guaiacolate (C10H1404) which is a glyceryl ether of guaiacol. It has been used for many years as an expectorant and it is found in the sputum after oral administration (Chodosh, 1972). It is said to reduce the tenaciousness of the sputum and to diminish the frequency of coughing. The rate of clearance of inhaled radioactive particles from the lungs offers an objective means of assessing the efficiency of this drug in aiding the removal of secretions from the lung. We report below two double-blind crossover trials in 15 subjects using this method to evaluate the expectorant action of this drug. METHOD GENERAL The 15 subjects were examined on two occasions by the same standardized technique; eight of these were 'healthy' aged volunteers from old Requests for reprints: Dr. M. L. Thomson,
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