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The relationship between the efficiency of treatment and the nature of morphological changes in the lung was studied in 125 patients with pulmonary tuberculosis without X-ray signs of pneumoconiosis who worked at coniosis-risk enterprises (CRR). Despite adequate specific and pathogenetic therapy, tuberculomas formed and decay cavities preserved in the patients, in this connection they had surgical treatment. Three types of morphological changes were identified. Quartz-containing industrial dust was found to exert an adverse potentiating effect on the course of tuberculosis in most CRE patients: increases in the delimiting a specific process of respiratory disorders and postoperative complications. These specific features should be borne in mind in drawing up a treatment protocol for patients working exposed to industrial dust.

Silicosis is the most common and most frequently tuberculosis-complicated pneumoconiosis with poor prognosis. So a procedure for following up patients with silicotuberculosis requires revision and elaboration. Long-term follow-ups have made it possible to define early signs of this disease and to propose a number of techniques for its early diagnosis, such as chest computed tomography and polarization serum crystal microscopy. Specific recommendations on follow-ups of patients with silicosis and silicotuberculosis by a phthisiologist are laid down.

Two hundred and fifteen case histories were studied to clarify causes of death in patients with active tuberculosis who had died from it. Males accounted for the largest proportion (86%) (n = 185). Patients above 50 years were 63.3% (n = 136). Two thirds were patients with restrictive tuberculosis without destruction and bacterial isolation. A hundred and fifty (70%) and 30% patients died from somatic diseases and other causes (sequels to alcohol abuse, violent death, suicide, etc.), respectively. Of the somatic diseases, cardiovascular diseases head the list, cancer ranks next to it, nonspecific respiratory diseases occupy the third place.

The routine methods X-ray study and computed tomography (CT) were compared in a group of patients engaged in fireproof industry. CT yields valuable additional data in early silicotuberculosis, which makes it possible to follow the extent of a silicotuberculous process more completely, to make a better diagnosis of nodal and focal shadows, to identify small decay cavities in the foci and infiltrates. CT is the method of choice in following up patients with silicotuberculosis.

Examination of 315 lung cancer patients with silicosis or silicotuberculosis gave grounds for recognition of 3 variants of bronchial stenosis. The efficacy of bronchoscopic techniques was related both to anatomic variant of the tumor and primary tumor position against the involved bronchus lumen. Central peribronchial cancer in silicosis and silicotuberculosis has specific features: combination of true tumor stenosis with false rigidity of the trachea and large bronchi, advanced scar anthracotic deformity of the bronchi and diffuse atrophy of bronchial mucosa, distinctive pattern of metastatic spreading.

A direct relationship exists between coniotuberculosis of occupational origin, thoracic lymph node coniotuberculosis in the elderly and frequency and intensity of the body response to intracutaneous administration of denatured gamma-globulin (DNGG). Positive DNGG test is a nonspecific test for dust content, anthracosilicotic induration and coniotuberculosis of thoracic lymph nodes. As additional to clinicoroentgenological examination of thoracic lymph node coniotuberculosis of occupational and non-occupational origin.

263 patients with coniotuberculosis of the intrathoracic lymph nodes were compared clinically according to whether they were or not at 0ccupational risk of silicosis. Patients exposed to quartz dust had some special morphological picture of affected lymph nodes: periadenitis, dust caseosis and tubercula in the presence anthracosilicosis sclerosis. Silicotuberculous broncho-adenitis in silicosis patients is characterized by solitary lesions of the lymph nodes, bronchi, rare dissemination to the lungs. Coniotuberculous broncho-adenitis in elderly subjects arises in the result of occupation-unrelated accumulation in the lymph nodes of coal and quartz dust and runs chronically. Unless the disease is controlled early and actively, it may generalize and aggravate with perforation in the bronchi, vessels and esophagus. Profuse hemorrhage, caverns, atelectasis are also possible.

Possibilities of roentgenologic method of examination with the use of roentgenography and tomography in the diagnosis of current forms of silicotuberculosis and tuberculosis in workers of the industries highly exposed to silicosis are analysed. ++Clinico-roentgenological+ pictures of 305 patients were studied in their dynamics for the period of 3 to 10 years. Being characterized by a benign course, silicotuberculosis is most often diagnosed in persons who left their work. A follow-up at least at 6-month intervals is of great importance in assessing its activity.

The time course of interstitial silicosis in 150 patients was investigated retrospectively by the roentgenograms for a follow-up varying from 2 to 20 years. It was shown that silicosis progress followed the affection of the intrathoracic lymph nodes. The latter was mainly predetermined by tuberculous infection in person working under silicosis-hazardous and unfavourable sanitary and hygienic conditions. The picture of pulmonary lesions developing after adenopathy in patients with silicosis was roentgenologically completely identical to that of polymorphous tuberculosis. In this connection it was recommended that thorough clinical and bronchological examinations for silicotuberculosis of adenogenic genesis be performed in all the cases with progressing silicosis.

Possible determination of silicotuberculosis activity with various clinico-laboratory, roentgenological, biochemical and immunological procedures was analyzed by the materials on observation of patients with silicotuberculosis. The authors considered 117 observations relating to 88 male and 29 female patients aged 43 to 67 years. High informative capacity of the complex investigation including determination of gamma-globulin levels in blood serum, the albumin-globulin coefficient, the absolute count of lymphocytes and T-lymphocytes and lymphocyte migration inhibition in the test with tuberculin before and after the provocative tuberculin test was shown.