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53 巻, 5 号
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岩崎 龍郎1978 年 53 巻 5 号 p. 277-281
発行日: 1978/05/15
公開日: 2011/05/24
ジャーナル フリーPDF形式でダウンロード (844K) -
国立療養所非定型抗酸菌症共同研究班1978 年 53 巻 5 号 p. 283-286
発行日: 1978/05/15
公開日: 2011/05/24
ジャーナル フリーThe isolation rate of atypical mycobacteria (mycobacteria other than tubercle bacilli) and their kinds of species were studied in twelve participating hospitals located in various places of Japan during 5 years (1971 to 1975). The subject of the study was patients hospitalized in these hospitals during screening-months, June, September, December and March, of every year.
The isolation rate (ratio of the number of atypical mycobacterial strains per the number of all mycobacterial strains) was significantly higher in four hospitals (Tokyo, Tenryuso, Chubu and Kinki) locating in Tokyo, Shizuoka, Aichi and Osaka Prefectures, respectively (refer to Fig.1), than the average (6.2%), and the rates in these hospitals were about 8%. Three hospitals, Kanagawa, Tochigi and Nagasaki, showed the rates of about 5%, three hospitals, Miyagi, Niigata and Fukuoka, showed the rates of 2 to 3%, and two hospitals, Sapporo and Ehime only 0.7 to 0.8% (Table 1).
Distribution of the kind of species in various hospitals did not differ significantly from each other, except for a few cases. (1) The ratio of M. kansasii in Tokyo and Kanagawa Hospitals was significantly higher than the others. (2) The ratio of M. fortuitum in Fukuoka Hospital was significantly higher than the average. (3) The ratio of M. gordonae was significantly higher in Kanagawa Hospital than the average in all hospitals. The ratios of species of 950 strains of atypical mycobacteria are shown in Table 2.抄録全体を表示PDF形式でダウンロード (552K) -
馬場 治賢, 新海 明彦, 吾妻 洋1978 年 53 巻 5 号 p. 287-294
発行日: 1978/05/15
公開日: 2011/05/24
ジャーナル フリーThis investigation was designed to find out the 6 month's regimen of chemotherapy which is expected to be most effective with less adverse reactions and least relapse rate.
The patients were chosen from those admitted to the National Nakano Chest Hospital in October 1975 and thereafter. Smear positive cases of pulmonary tuberculosis with cavity less than 4cm in diameter or without cavity, who were previously untreated or had been treated for less than 15 days were subjected to the study.
They were allocated at random to the following 3 regimens; A) RHS daily 3m.→RH daily S2 3m., B) RHZS daily 2m.→RHZ daily 4m., C) RHZE daily 2m.→RHZ daily 4m. Drug sensitivity tests were done by Canetti's proportion method. Criteria for sensitivity was less than 50% to 10 mcg or 1% to 50 mcg RFP, less than 1% to SM 10mcg, INH 0.2mcg and EB 3mcg.
By the end of February 1977, 113 cases have completed the 6 month's chemotherapy, and 7 cases were excluded due to reasons cited in Tab. 1. The remaining 106 cases were divided into 2 categories, one completed the fixed regimen and the other in which the regimen was changed, but in all cases, the duration of chemotherapy was fixed to 6 months.
All 106 cases became culture negative by the end of the 4 th month of chemotherapy, and the negative conversion took place much faster in regimen B than in regimen A (Fig. 2), and it was similar even in the aged patients and cases complicated with diabetes. The negative conversion occured much faster in this study subject than any other previous cases treated with regimens without RFP.
Adverse reactions were seen most frequently in regimen B, then in C and least in A (Tab. 3) Among them, those attributable to SM and PZA were found to be most frequent. Those due to SM were allergic reactions, tinnitus and dizziness, and those due to PZA were liver dysfunction and gastrointestinal disturbances. They occured especially frequently during the first 3 months. Even though the X-ray shadow and cavity were still unstable at the end of 6 month's chemotherapy, they continued to improve after stopping the chemotherapy as if they were treated continuously (Tab.2 and 6).
No bacteriological relapse was seen up to the end of February, 1977, but as the observation period after stopping the chemotherapy was still short, we are following up these cases carefully.
It is our regret that there are some doctors who started again an additional chemotherapy for cases who completed the 6 month's chemotherapy in our hospital. The reason for restarting chemotherapy was unstable X-ray findings, and the result of bacteriological findings were disregarded by these doctors.抄録全体を表示PDF形式でダウンロード (1172K) -
近藤 螢子, 金井 興美1978 年 53 巻 5 号 p. 295-298
発行日: 1978/05/15
公開日: 2011/05/24
ジャーナル フリーWith a basic idea that elimination of persistent bacilli to the minimum level, if not eradication, is the best way to reduce the possibilities of relapse in later years, an attempt was made to work out highly efficient short-course regimens through experimental model in mouse tuber culosis.
The experiment was designed as shown in Fig. 1 and the results are demonstrated in Figs.2 and 3. The daily administration of three drugs, e. g. INH+RFP+SM or INH+RFP+EB, in an appropriate dose was found to be capable of eliminating infecting bacilli down to the undetect able level in a month or so. Even after cessation of the treatment, this “sterilized” condition was kept for some weeks, and then the bacilli began to make irregular appearance in the lung within a limited level of viable counts. In the spleen the reappearance of the bacilli was more consistent than in the lung. Nevertheless, the therapeutic effect as obtained here was so remarkable as never been experienced by us before the time when rifampicin became available.
Futher experiments are now under way to improve the regimen, particularly by adjusting the period of treatment.抄録全体を表示PDF形式でダウンロード (564K) -
中村 善紀, 宮澤 健, 井口 欽之丞, 北原 昇, 小松 康文, 若原 正男, 小岩井 長雄, 上原 章平, 中川 昭三, 清水 卓造, ...1978 年 53 巻 5 号 p. 299-306
発行日: 1978/05/15
公開日: 2011/05/24
ジャーナル フリーThe clinical effect of Enviomycin (EVM) for original treatment group (10 cases) and retreatment group (24 cases) of pulmonary tuberculosis was studied.
One gram of EVM was injected intramuscularily for the initial 3 months daily and thereafter twice a week for 3 months.
One to four antituberculous drugs were combined with EVM for both groups.
The results were summarized as follows:
1) X-ray findings:
In all original treatment cases, chest X-ray findings showed improvement; while in retreat-ment cases, 50% showed improvement on basic lesions and the remaining 50% unchanged, and 60% of cavities unchanged.
2) Bacteriological findings:
The negative conversion rate of tubercle bacilli in sputum on culture was 100% in original treatment group and 50% in retreatment group.
3) Emergence of EVM resistant strains:
Since all cases of original treatment group showed negative conversion, it was impossible to carry out sensitivity test. Tubercle bacilli isolated from patients in retreatment group during the EVM treatment for 6 months showed either complete resistance to 25μg/ml EVM or incomplete resistance to 100μg/ml EVM.
4) Sid eeffects:
During the EVM treatment for 6 months, each one case of anorexia, eruption, transient rise of transaminase and zinc sulfate test (ZTT) was observed.
However, no cases were dropped out from the EVM treatment due to these side effects.
5) Case report of lung autopsy:
One male patient in original treatment group died after the chemotherapy for 10 months due to myocardial infaraction.
One male patient in original treatment group died after the chemotherapy for 10 months due to myocardial infaraction.抄録全体を表示PDF形式でダウンロード (3720K)
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