巻号一覧
53 巻, 10 号
選択された号の論文の5件中1～5を表示しています
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青木正 和, 森 亨, 松崎 正子, 伊波 茂雄, 小渡 有明, 大嶺 経勝, 平田 久夫, 原 実, 砂川 恵徹, 伊波 恒雄, 下地 恵 ...1978 年 53 巻 10 号 p. 489-494
発行日: 1978/10/15
公開日: 2011/05/24
ジャーナル フリーMethod of central registration of tuberculosis cases (including suspects) at prefectural level was introduced in this report.
In Japan, tuberculous patients are registered at the local health centres, which are distributed all over Japan. As the total number of health centres is over 850, it is rather difficult to get doctors who are concerned with tuberculosis problems in all the health centres especially in peripheral part of the country. On the other hand, as the incidence and prevalence of tuberculosis have been declining so markedly and as the system of analysis of informations has been developed so extensively it is possible to establish the central registration system for tuberculosis cases at the prefectural level even by using mini-computer. It will give more correct, precise and useful results of analysis and will elucidate more clearly and correctly the problems of tuberculosis in each health centre, even though there is no tuberculosis specialist in health centre.
In 1975, the Committee for Tuberculosis Surveillance in Okinawa Prefecture was established and the studies for central registration of tuberculous patients was launched. The total population in Okinawa Prefecture is about 1 million and the total registered patients including suspects and inactive after treatment are about 7, 000 at present. The data imput to mini computer are shown in Table 1. Priority was given on the cohort analysis of patients because of the lack of such kind of informations and the importance of improvement of longterm treatment in Japan.
To minimize the work at health centre, copies of registration cards, and application forms for treatment expenses by the Tuberculosis Control Law are used as information sources. Several informations such as the list of cases completed treatment, etc., are collected, too, as shown in Figure 1. All these data were imput to mini-computer and all the individual data are up dated. The total number of informations to up-date the data in these three years are shown in Table 3.
One full-time clerk to accept the information and to give code number for each information is required. Two epidemiologists and one computer operator are working for the central registration, although they spend less than one-fifth of their time for this work.
The results of analysis are reported to the Committee for Tuberculosis Surveillance in Okinawa Prefecture, and realistic ways of improving tuberculosis control measures are discussed. The central registration system at Prefecture level is being considered as possible and useful for the surveillance of tuberculosis in the future.抄録全体を表示PDF形式でダウンロード (839K) -
東村 道雄1978 年 53 巻 10 号 p. 495-498
発行日: 1978/10/15
公開日: 2011/05/24
ジャーナル フリーPatients with chronic cavitary pulmonary tuberculosis who were treated previously with antituberculous agents for more than two years were treated with a regimen composed of an agent previously unused and two agents to which tubercle bacilli were already resistant, and the time of resistance development was observed. The time that required for resistance develop ment to a single agent was as follows: rifampicin resistance (25μg/ml) (0.45g per day, daily, per os) 2.27 months; rifampicin resistance (25μg/ml) (0.45g per day, twice weekly, per os) 2.50 months; kanamycin low level resistance (100μg/ml) (1g per day, three times weekly, intramuscularly) 3.07 months; ethionamide resistance (30μg/ml) (0.5g per day, daily, per os) 3.33 months; kanamycin high level resistance (500μg/ml) (1g per day, three times weekly, intramuscularly) 5.07 months; lividomycin resistance (200μg/ml) (1g per day, three times weekly, intramuscularly) 4.68 months; enviomycin resistance (100μg/ml) (1g per day, daily, intramuscularly) 4.80 months.
From the results obtained, the generation time of tubercle bacilli growing in cavities was estimated theoretically as 54 hours. This value is much longer than the generation time of 12 hours estimated in in vitro experiments (Ogawa egg medium).
From theoretical considerations based on the above results, the ranking of in vivo effec tiveness of antituberculous drugs was summarized as follows: rifampicin (daily or intermittent) >kanamycin=lividomycin>enviomycin.抄録全体を表示PDF形式でダウンロード (559K) -
M M ABDEL KADER, K. M. SULEIMAN, S. A. ELIAN, S. SHOUAB, B. A. EL MOUR ...1978 年 53 巻 10 号 p. 499-502
発行日: 1978/10/15
公開日: 2011/05/24
ジャーナル フリーAbdel Kader and co-workers showed that tryptophan and some of its metabolites had tuberculostatic effect in vivo, in vivo and in human patients as well. Abdel Kader et al. also showed that histidine possessed bacteriostatic effect on Mycobacterium tuberculosis both in vivo and in vivo. This investigation was, therefore, conducted to study the effect of some imidazole derivatives on Mycobacterium tuberculosis both in vivo and in vivo in guinea pig.抄録全体を表示PDF形式でダウンロード (576K) -
Wallace FOX1978 年 53 巻 10 号 p. 503-509
発行日: 1978/10/15
公開日: 2011/05/24
ジャーナル フリーPDF形式でダウンロード (900K) -
砂原 茂一1978 年 53 巻 10 号 p. 511-516
発行日: 1978/10/15
公開日: 2011/05/24
ジャーナル フリーThe following topics were discussed in the lecture.
1. Structure of clinical medicine.
2. Physician scientist.
3. Science and ethics.
A scientist must be responsible at least ethically for “uncertain consequence”of his research. Even medical science of today is a system of insufficient information and medical progress might result sometimes in unexpected outcome. In order to enhance welfare of human being and at the same time guard the society from “disease of medical progress”, a balance between unrestricted creative activity of investigators and severely critical evaluation by the fellow scientists and physicians is indespensable. In addition to it, scientists can not reject the assess ment of the society, for science is not the only value but one of values and medicine is science not only on but for human being.
4. Ethics for medical research.
“Primum non nocere” is one of the most important instructions for clinical scientists but it is also true that medical progress depends largely on a brave doctor who dares to make entirely new trial on man. Easy extrapolation of animal data to bed side is unscientific and unethical because of insurmountable species difference. It is the greatest ethical dilemma in medical research that an investigator is obliged to run a risk to utilize a healthy or sick person as an experimental subject, if he wants to be ethical. Declaration of Helsinki and other ethical codes are for the purpose of dealing with the difficulties.
5. Ethics for medical care.
Medical care is based on relationship between patients and physicians, not between myco bacteria and rifampicin. The operational way of thinking is essential especially for control of tuberculosis, but as a man is always extraordinary and “einmalig”, medical care must finally aim at individualization. In other words, individual morality should predominate statistical morality.
It is not physician's exclusive duty to transmit information from laboratory to bed side. Feedback action from bed side is also essential for sound progress in clinical medicine. For instance, monitoring system covering practioners is the most important safeguard against adverse drug reactions.
The purpose of medical care is not only to add hours to life but also to add life to hours and it is beyond question that recent advance in medical science has largely contributed to alleviate even untractable disease. But medicine of today is successful sometimes only in pro longing patient's life without restoring independence in daily living and dignity of man. From technological point of view, medical care might have nothing to do with vegitable state, senile idioty, etc., but from ethical point of view, a physician can not disregard a hopeless case. Medical progress raised a very difficult problem of basic importance: what is life? what is a man? and what is medical care抄録全体を表示PDF形式でダウンロード (1085K)
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