Dissertation of reported cases of nontuberculous mycobacteriosis in Thailand.

During the period from 1967 to 1988, there were 10 published reports of 44 patients from whom mycobacteria other than tubercle bacilli had been isolated clinic specimens. This communication presents results of a scrupulous review of each of the papers which revealed that some of the patients cited in the reports did not meet with the criteria for diagnosis, and some of the cases might have been the same patients as those documented by different investigators.

Pleural and pulmonary ultrasonography.

Eighteen patients (12 with pleural lesion and 6 with pulmonary lesion seen on chest roentgenograms) were taken for study by ultrasound. Thoracocentesis was performed under ultrasound guidance in 10 patients. Final diagnosis was infection in 10 malignancy in 8 patients. There was no characteristic ultrasonic finding that could be used to differentiate between benign and malignant lesions.

Respiratory centre sensitivity and exercise tolerance in healthy Thais and in Thai COPD patients.

This study was conducted with the aim of determining the range of normal value of respiratory centre sensitivity and exercise tolerance in healthy Thais and any divergence from the normal range in those with COPD. Findings in healthy subjects disclosed that the end-tidal PCO2 and tidal volume response to CO2 were higher and exercise tolerance was lower among the elderly compared with younger subjects; only in young males was the ventilatory response to CO2 higher than in females. In the group of Thai COPD patients, all data were comparable to those of the match healthy subjects, with the exception that one-third of the patients experienced stronger ventilatory drive while breathing room air and a lower musculo-ventilation transfer index during room-air breathing as well as CO2 rebreathing.

Tuberculosis of the cervical lymph nodes.

Analysis of 188 patients with pathological diagnosis of tuberculosis or findings consistent with tuberculosis of the cervical lymph nodes during the period 1985-1988 disclosed the following pertinent findings: (1) The histo-pathological diagnoses, based on findings of chronic granuloma with or without the presence of acid-fast bacilli (AFB) on staining, were “probable tuberculosis” in 38.8 percent of the cases, and “consistent with tuberculosis” in 61.2 percent of them. It is worthy of note that proof for AFB in the 1973 report (from the same laboratory) was available only in 1.58 percent of the cases.1 (2) The supraclavicular group was the frequently diseased of the lymph nodes as found in a previous study;1 this finding also conforms to the high incidence of palpable supraclavicular lymph nodes in pulmonary tuberculosis patients.5 This persistent prevalence of the site of tuberculous involvement may be used as evidence in support of early post-primary haematogenous dissemination of the pathogenic organism, rather than the less occurring lymphogenous spread from the site of upper digestive tract infection, as recently suggested.4

Lung cancer at Siriraj Hospital, Bangkok, 1974-1983.

This report is based on a retrospective analysis of 1,078 lung cancer patients treated at Siriraj Hospital during 1974-1983. Of the 565 histologically proven patients, 79.17 percent were men (M:F = 3.8:1). The sex ratio was conspicouous (M:F = 10.5:1) in cases with small-cell type. The highest tumor frequency for both sexes was in the age groups 51-60 years (35.93%) and 61-70 years (30.80%) respectively. The youngest patient was an 18 year-old girl with adenocarcinoma, and the oldest was an 82-year-old man with squamous-cell carcinoma. There was no statistical difference between the mean age of patients with various cell types. Adenocarcinoma was highly prevalent (32.39%) in the present series. Second and third in frequency were squamous-cell carcinoma (29.20%) and undifferentiated cell carcinoma (13.45%). The incidence of small-cell carcinoma was 8.14 percent, large-cell type was seen in one instance (0.17%); 7.08 percent remained unclassified. A history of cigarette smoking was noted in 86.73 percent. Among the 13.27 percent who were non-smokers, adenocarcinoma comprised the highest rate (30.77%) as compared to other cell types. Specific treatment was instituted in 63.81 percent of the cases, via: surgery 10.84 percent, radiotherapy 23.64 percent, chomothorapy 21.69 percent, and combined treatments 22.12 percent. Data on results of treatment were not available owing to the lack of follow-up records.