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Volume 47, Issue 6
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A Report of the 12th Series Controlled Trial of ChemotherapyThe Cooperative Study Unit.1972 Volume 47 Issue 6 Pages 151-158
Published: June 15, 1972
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSCases of pulmonary tuberculosis who were previously untreated and most of them with far advanced lesions were treated by the alternative chemotherapeutic regimen consisting of the following two kinds of triple combinations SM·INH·PAS for 3 months, KM·TH·CS for 3 months
The total number of cases accepted to the trial was 163, but 55 cases were excluded due to various reasons shown in Table 1.
Background factors of the remaining 108 cases and those of far advanced cases were presented in Table 2 and Fig. 1, respectively. Up to the end of 6 th month, 12% of the cases dropped out and up to 12th month 28.7%, and the causes of dropout were shown in Tables 3 and 5.
The negative conversion of sputum at 12th month was 98.6% by smear and 97.8% by culture, and for far advanced cases, the rates were 98.4% and 97.4%, respectively.
The drug sensitivity tests were performed for culture positive cases, and 16 cases showed resistance to at least one of the above six drugs during the former half year, and another 1 case became resistant during the latter half year.
At 12th month, significant improvement in chest X-ray findings was seen in 53.8%, and that of cavity was 38.0%. (Tables 9 and 10)
Various side-effects were seen in 80 cases or 56.3%, and in 19 cases, the regimen had to be changed because of severe adverse reactions.
Matched pairs were made from our previous trial groups treated originally with SM·INH·PAS, and as shown in Table 12 and Fig. 5, the pairs were comparable. No significant difference was found between the pairs as to the sputum conversion rate and the cavity closure rate.
It is concluded that the alternative regimen consisting of the major drugs and three of the minor drugs does not give more favourable clinical results as compared with the standard triple drug regimen.View full abstractDownload PDF (1051K) -
A Report of the 12th Series B Study of the Controlled Trials[in Japanese]1972 Volume 47 Issue 6 Pages 159-166
Published: June 15, 1972
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSSM 1g twice weekly, INH 10mg/kg twice weekly and PAS 10g daily regimen was administered to previously untreated pulmonary tuberculosis patients, and the results were compared withthose treated by the standard regimen including ordinary dose of INH daily for cases with similar background factors.
Though 272 cases were accepted to the trial, 122 were excluded due to various reasons shown in Table 1, and the remaining 150 cases were subjected to the final analysis. Background of these 150 cases were indicated in Tables 3, 4 and 5.
The bacilli negative conversion rate at 12 month was 100% by smear and 98.4% byculture (Tables 6 and 7, and Fig. 2). The results of drug sensitivity tests for culture positive strains were shown in Table 8. The radiographic changes were shown in Tables 9 and 10. The marked or moderate improvement in chest X-ray findings at 12 month was 76.7% and that for cavity was 71.9%. Various kinds of adverse reactions were observed in 91 cases or 46.9%, and 36 cases were dropped out from the trial due to side effects.
Matched pairs were made from the previous trial cases treated with the standard regimen of triple drugs including INH 300mg daily. The compatibility of the pairs was shown in Table 12 and Fig. 5. No significant difference was obtained in the bacilli negative conversion rate and the rate of significant improvement in chest X-ray findings between the INH high dose twice weekly regimen and the INH ordinary dose daily regimen.
In conclusion, high dose intermittent INH regimen showed almost the same clinical effects as that of the ordinary dose daily INH regimen.View full abstractDownload PDF (1066K) -
Consideration of Short-term HospitalizationKazuhiko KAMEDA, Seiroku TOKUCHI1972 Volume 47 Issue 6 Pages 167-175
Published: June 15, 1972
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA study was made on 585 originally treated cases of pulmonary tuberculosis to clarify whether the duration of hospitalization influences the effect of chemotherapy and regularity of drug administration after the discharge from the hospital.
The duration of the stay in hospital was divided into the following 5 groups; i. e., less than 3 months, 4 to 6 months, 7 to 9 months, 10 to 12 months and more than 12 months.
There was no significant difference in the rate of radiological improvement according to these 5 groups, and the bacteriological findings were also quite the same at the end of the first as well as the second year, showing only 1 and 2 positive cases, respectively.
As to the regularity of drug administration, cases were divided into the following 4 categories; those received drugs for more than 150 days or 90% during the period of six months (7th to 12th month or 19th to 24th month after starting treatment) were designated as regular drug taking, those received drugs 118 to 149 days or 70 to 89% as slightly irregular, 84 to 117 days or 50 to 69% as irregular, and less than 84 days or 50% as defaulter.
The rate of defaulters after the discharge was higher in cases with shorter hospitalization period, even if it was compared at the period in which the interval from the discharge was equal. The rate of defaulters was higher in the age groups younger than 29 and over 60 than in the age groups 30 to 59. The rate was also higher in minimal cases. It is an urgent and essential problem to improve the status of drug administration in domiciliary treatment, and if this condition is fulfilled, the shortening of the hospitalization period is considered to be quite reasonable.View full abstractDownload PDF (1290K) -
Toshio OHSATO, Mareichi TOYOHARA1972 Volume 47 Issue 6 Pages 177-180
Published: June 15, 1972
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSAuthors reported the results of Tuberactinomycin (TUM) used for pulmonary tuberculosis patients who failed to respond to the treatment by the usual primary and secondary anti-tu-berculosis drugs (Kekkaku, Vol.46, No.3, 1971). Tuberactinomycin was isolated from the culture filtrate of Streptomyces griseoverticillatus var. tuberacticus. Tuberactinomycin-N (TUM-N) was isolated from mutant strain (N 6-130) of original strain and showed the less auditory impairment for guinea pig than kanamycin, capreomycin, viomycin and tuberactinomycin.
This paper presents the results of Tuberactinomycin-N used for pulmonary tuberculosis patients who failed to respond to the previous treatment.
Usually 1g of TUM-N was injected intramuscularily once a day. For the initial 3 months, TUM-N was injected daily followed by the TUM-N twice a week. The patients were treated by TUM-N combined with one or more drugs previously not used. In many cases rifampicin and ethambutol were combined with TUM-N. 27 patients were treated by TUM-N for more than one month. Bacteriological examinations by both smear and culture were performed twice a month. The X-ray photography, the urine and blood examination and liver function test were performed every month. The audiometry was also performed once a month.
The results were summarized asfollows:
(1) The bacteriological findings by smear of 17 smear positive casesduring TUM-N treatment were shown in Table 1. The smear negative rate was 53.3% at third month and 80% at sixth month.
(2) The bacteriological findings by culture of 15 culture positive cases were shown in Table 2. As seen in this table, the culture negative rate was 64.3% at third and 100% at sixth month.View full abstractDownload PDF (603K) -
Mareichi TOYOHARA1972 Volume 47 Issue 6 Pages 181-187
Published: June 15, 1972
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSTuberactinomycin-N (TUM-N) was isolated and purified from Streptomyces griseoverticillatus var. tuberacticus N 6-130, one variant of streptomyces producing TUM, as a new antibiotic, and it is different from Tuberactinomycin (TUM) reported previously. As it was proved that the acute and chronic toxicity as well as the ototoxicity to the experimental animals of TUM-N was less than those of TUM, the antituberculous activity of TUM-N was studied experimentally.
TUM-N is the basic peptide, and the chemical formula is shown in Fig. 1. LD50 of TUM-N to mice is 485mg/kg intravenously, 2, 000mg/kg intramuscularly and more than 3, 000mg/kg subcutaneously.View full abstractDownload PDF (806K)
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