Inflammation is a process, and not a state, of the succession of changes which occurs in a living tissue when it is injured. Each change is controlled by both activating and inhibiting substances in the local lesions, and there exist also a process to produce these substances in the loci. However, the mechanism underlying such a process has been the subject of considerable discussion. Particular interests in inflammation are whether the motile cells present in the blood are attracted to inflamed spots and if so what chemical substances produce the effect.
The histological picture of granulomatous inflammation is both variable and nonspecific, but macrophages and their derived cells(epithelioid cells and multinucleated giant cells)provide a major features of various examples of the inflammation. These macrophages come from the peripheral blood monocytes which are derived from bone marrow. The granulomatous inflam mation is sustained by the persistence of the macrophages which may result from their con tinuing mobilization from the bone marrow, from their local proliferation, or from longevity of the cells in the tissues.
The most attractive interpretation of the macrophage infiltration in inflammation is that a substance exists around the attracting cells in a diminishing concentration gradient and that the cells have some mechanisms which directs them to the more concentrated area (chemotaxis), but the mechanism of this phenomenon is unknown. The possible importance of macrophage chemotaxis in inflammation is highlightened by the discovery of the chemotactic factors for macrophages in the inflammatory sites. At least three factors are found in vivo sites and the relative activity of the three factors are different with each other in the type of inflamm ation. The most active factor in the delayed hypersensitivity skin sites is highly purified and it shows a single band in disc gel electrophoresis. It is a heat-labile glycoprotein with a molecular weight of 150, 000 and is different from lymphokine and C5a. One of the factors is shown to be produced by a serine-type protease of polymorphonuclear leukocytes from IgG which is permeated from the vessels in the initial stage of inflammation.
Large numbers of experiments has been performed in vitro on the chemotaxis of le ukocytes using many methods, and macrophages are found to be attracted by many substances, i. e., bacterial, serum-derived (complement-derived and not), lymphocyte-derived, tissue-derived, and so on. However, the relative importance of these factors in the in vivo reaction is still far from clear. It should be emphasized that the in vivo study is very important to elucidate the mechanism of macrophage infiltration in the inflammatory sites.
The whole question of chemotaxis is still premature but is an extremely active and rapidly moving area of investigation, and “attracts” many of the investigators. The delineation of amolecular basis for in vivo chemotaxis in inflammation is the focus of much current interest and warrants further interesting investigations.

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Tsukamura and Mizuno have reported that thin-layer chromatography of ethyl ether- ethanol-soluble fraction of mycobacteria after incubation with ³⁵S-methionine is useful for differentiation among mycobacterial species, and that distribution of radioactive spots in thin- layer chromatograms show a pattern specific for the species, although it has been observed that M. gordonae shows various patterns. In the present, study, the results on the mycobacteria previously not studied are reported. The majority of the mycobacteria studied in the present study belong to rapidly growing, scotochromogenic mycobacteria.
The strains used are shown in Table 1. The methods used were the same as reported previously.
The results obtained are shown in Figs. 1 to 10 and in Table 2.
The following rapidly growing, scotochromogenic mycobacteria were shown to present an almost species-specific pattern of the distribution of radioactive spots in thin-layer chromato grams: M. chubuense; M. aichiense; M. obuense; M. rhodesiae; M. gilvurn; M. duvalii; M. phlei; M. parafortuitum; M. aurum; M. neoaurum.
Only a few exceptions were observed. A strain of M. neoaurum lacked the spot f, although other strains of this species showed the spot (Fig. 3, F). A strain of M. aurum showed the same pattern as of M. parafortuitum (Fig. 4, F). M. parafortuitum and M. phlei showed the same pattern (Fig. 3 and 4). In contrast to the above species, M. flavescens showed different patterns within the species (Fig.5). However, the patterns could be subgrouped to approximately two groups: the first type (Fig.5, upper) contained the type strain of M. flavescens, and the second (Fig.5, lower) contained the type strain of the species originally received as M. gallinarum.
Among slowly growing mycobacteria tested in the study, M. kansasii, M. marinum and M. nonchromogenicum were shown to be a homogeneous species so far viewed from the pattern, showing the same pattern within the strains of each species.
M. triviale could be differentiated from M. nonchromogenicum, showing a different pattern, and M. terrae was differentiated from M. nonchromogenicum, as the former lacked the spot f.
The pattern of M. malmoense resembled to that of M. avium-intracellulare complex. The strains of M. szulgai showed various patterns and seemed to be heterogenous when viewed from the pattern.
M. kansasii and M. marinum could be differentiated clearly by a difference of the pattern. The former showed the spot f and the latter lacked this spot.
To test the nature of the spot f, the concentrates of the ethyl ether-ethanol-soluble frac tion of the strains of these species were added with petroleum ether and a little amount of water, and a separated petroleum ether-layer was concentrated under reduced pressure and subjected to the thin-layer chromatography in the same manner. The petroleum ether-extracts of M. kansasii showed only the spot f, and those of M. marinum showed no spot (Fig. 11). The results show that a substance showing the spot f is soluble in petroleum ether, whereas other substances showing the other spots are not soluble in petroleum ether.
The test of the distribution of radioactive spots in thin-layer chromatography of the ethyl ether-ethanol-soluble fraction of mycobacteria has been shown to be useful for the differentiation among mycobacterial species.
1) Tsukamura, M. and Mizuno, S.: Int. J. Syst. Bacteriol., 25: 271, 1975.
2) Tsukamura, M. and Mizuno, S.: Kekkaku, 53: 85, 1978.

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This is an one year follow up study of the cases after completing the 6 months chemothe rapy reported in our 1st report.
The patients were all smear positive with cavity less than 4 cm in diameter or without cavity, and previously untreated or had been treated for less than 15 days.
They were treated with 3 regimens of chemotherapy containing RFP and other companion drugs at the National Nakano Chest Hospital.
A total of 113 cases were allocated to this study but 10 cases were excluded due to the reasons mentioned below.
1) atypical mycobacteria…3 cases, 2) RFP could not be used for longer than 18 days because of side effects…3 cases, 3) death by stomach surgery on the 50th day of chemotherapy…1 case, and 4) retreated elsewhere for 1-3 months after completing the 6 months chemotherapy only due to worry on relapse, although their sputum had been culture negative and without any signs of relapse by that time.3 cases.
The remaining 103 cases were subjected to the follow-up study. One case could not be followed up and 5 cases were followed up only for 1, 4, 7, 8, 10 months after completing 6 months chemotherapy with negative culture until then.
Frequency of sputum examinations of the remaining 97 cases was shown in Table 1.
Three cases relapsed out of 97 cases (Table 2), 2 cases within 6 month and one 9 month after finishing the chemotherapy. In addition one colony of atypical mycobacterium (Runyon Group IV) was found from RHZS group 2 month after completing the chemotherapy, but this case was not retreated and remained negative so far.
Relapsed cases were analysed in relation to the factors before (Table 3) and after treatment (Table 4). But the number was too few to draw any conclusion about the causes of relapse.
The bacilli isolated from these relapsed cases were all sensitive to the used drugs just as before the treatment. Among 3 relapsed cases, 2 were retreated with drugs containing RFP as in-patient and within 2 and 4 months became negative, but the other one who was retreated with RHE as out-patient has not converted until 4 months. As this case had taken the drugs too irregulerly, he was rehospitalized and soon thereafter his sputum converted to negative.
X-ray improvement continued even after stopping 6 months chemotherapy and it suggests that tubercle bacilli in the lesion either died or stopped of the harmful effects to the surrounding tissue. The progress of X-ray improvement until 18 months from the start of chemotherapy was just the same for 6, 12, 18 months chemotherapy groups (Fig. 1).
The same result was seen as to the cavity closure rate in the remaining cavity less than 3 cm in diameter at the end of 6 months chemotherapy. These 12, 18 months groups were the cases treated with RHE from May 1974 to December 1976 in our hospital.

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Authors published already the results of the follow up studies of retreatment pulmonary tuberculosis patients who showed negative sputum for more than 3 months at 6th month after starting the treatment with regimens containing rifampicin. Cumulative rate of positive reconversion was 19.3% during 7 years' observation period. Most of them showed positive sputum within one and half years after starting rifampicin treatment, and no relation was found whether the caces continuing rifampicin treatment or not.
In this study, 73 cases, which showed positive reconversion, were compared with 73 matched-pair cases, which were taken at random from the negative sputum group, for the purpose of finding out the risk factors concerning the positive reconversion of sputum. As the results, higher risk of positive reconversion was observed in the following cases;
1) cases converted to negative by RFP treatment relatively late.
2) cases whose chest roentgenogram did not improve or worsened, and
3) cases which had already acquired resistance to main antituberculous drugs.

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Amikacin (AMK) is an aminoglycoside antibiotic possessing broad antibacterial activity against Gram-positive and Gram-negative bacteria.
Antibacterial activity of AMK against acidfast bacillus was compared with kanamycin (KM).
In uitro study, antibacterial activity of AMK against Mycobacterium tuberculosis was similar to or stronger than KM. In uitro study on experimental tuberculosis of mice, quantitative culture of Mycobacterium tuberculosis in spleen was made, and the administration of 1 mg AMK was found to be as effective as 2 mg KM.
Curative effect on pathological lesions observed in lung, liver and kidney was obtained by the administration of 1 mg of AMK, and it was almost as same as that of 2 mg KM, while the administration of 0.2 mg AMK was considerably less effective.
The results obtained suggest that AMK is considerably effective as an antituberculosis agent, though the clinically full effective dose with less toxicity must be investigated in the future.

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151 pulmonary tuberculosis patients without previous chemotherapy were treated by the regimen indicated in Table 1 and followed up for more than 6 months after stopping the treatment. The characteristic of our regimen is the individualization of the duration of chemo therapy according to the speed of sputum conversion by culture. As some patients converted to negative by culture just at 4 or 5 months of chemotherapy (Table 3), the fixed schedule of 6 months' treatment seems unreasonable for such slow converters. In this series, 34 % of the cases were treated for 6 months, 41 % for 7 months and 20 % for 8 months.
Two cases relapsed during the follow up period (Fig. 4 & 5), but if the second case is excluded as it is single isolation of three colonies, the rate of relapse of our series was only 0.7%.
Although extensive and complicated lesions remained at the end of treatment, it is note worthy that radiographic regression continued even after stopping chemotherapy (Fig.6).
The analysis of background factors before chemotherapy in rapid and slow converters revealed that only difference between two groups were amount of discharged bacilli(Fig. 7).
Out of 309 patients initially registered, 46 cases were excluded from the analysis as they were treated for longer than the fixed schedule indicated in Table 1(Table 2): 37 cases due to physician's judgement on unstable radiographic findings, continuous smear positivity, etc. and 9 cases due to patient's disagreement to stop chemotherapy
In a. ease excluded from the above analysis because of complicated diabetes, not only bacte riological but also definite radiographic worsening were observed (Fig. 11).
Short course chemotherapy seems to be contraindicated to a patient with severe complications.
Short course chemotherapy in which drugs are discontinued after sputum negativity has been confirmed for 6 consecutive months seems to be very reliable measure for treating tuber culosis patients but the follow up result for longer period seems to be necessary to get the final conclusion.

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