Acid phosphatase and β-glucuronidase activities of T and B cells were studied cytochemically in 30 patients with pulmonary tuberculosis and 28 healthy controls.
The results were as follows:
1. The absolute number of T cells significantly decreased in the cases of F, C and B types according to Gakken classification, and in the F.A. and M.A. cases according to NTA classification as compared to the control subjects. However, it significantly increased in the type D and the Min. cases as compared to the control subjects.
2. The absolute number of B cells tended to increase in the cases of D and B types, whereas it tended to decrease in the type F cases as compared to the control subjects. Although the absolute number of B cells significantly increased in the Min. cases, it tended to decrease in the F.A. cases as compared to the control subjects.
3. Acid phosphatase and β-glucuronidase activities of both T and B cells were significantly higher in the cases of F, B and C types, and in the F.A. and M.A. cases than in the control subjects. In the type D and the Min. cases, only β-glucuronidase activity of B cells was significantly higher than in the control subjects.
4. The two enzyme activities of both T and B cells in the cavitary cases were slightly higher than in the non-cavitary cases, but the difference was not statistically significant.
5. The two enzyme activities of both T and B cells tended to be higher in the bacillary cases than those with negative bacilli, but the difference was not significant.
6. Acid phosphatase activity significantly correlated with β-glucuronidase activity in both T and B cells.
7. Negative correlations were observed between the two enzyme activities and the absolute number of T and B cells.

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Histological features of tuberculous cavities of resected lungs treated with regimens of chemotherapy containing rifampicin were compared with that of patients treated with primary drugs by using the matched pair method.
The following findings were noted as peculiar to lung specimens treated with rifampicin:
1. Gaseous material showed trend to be more concentrated and dehydrated.
2. Migration of many macrophages into caseous lesion which was followed by the digestion of necrotic debris by these macrophages.
3. Invasion of capillaries into caseous lesion.
These findings suggest that caseous material becomes a foreign body already in the early stage of treatment due to very strong bactericidal activity of rifampicin and a foreign body is then degradated, ingested and organized.

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The present author (Tsukamura, M.: Kekkaku, 50: 17-30, 1975; 56: 23-33, 1981) divided the X-ray picture of lung disease due to Mycobacterium avium-M. intracellulare complex (M. avium complex) into two types: Primary infection type and secondary infection type. Although the X-ray feature of the secondary infection type, which is due to secondary infection of the M. avium complex into tuberculous cavities, could not be differentiated from that of lung tuberculosis, the X-ray feature of the primary infection type was characterized by ‘strong tendency to caseation’ and ‘deficiency of fibrotic process’. In an aid to observe whether the characteristics of the disease due to M. avium complex is based on either host condition (decreased immune response of the host) or parasite condition (different composition of bacterial substances), a comparative study of the X-ray picture was carried out between lung tuberculosis and disease due to M. avium complex in the present study.
Patients who were previously untreated or, if any, treated within three months by chemotherapy and showed rapid conversion of tubercle bacilli in sputum (disappearance of causative organisms by culture within three months) after hospitalization were subjected to the study. The patients showed fresh, non-sclerotic cavitary lesion in their X-ray picture at the hospitalization. Out of 115 patients who had lung tuberculosis, 107 showed rapid conversion of sputum cultures within three months (Table 1). Out of these 107, 99 (92.5%) showed disappearance of cavities within six months after the sputum conversion (Table 3). In contrast, out of 15 patients who had lung disease due to M. avium complex and showed rapid conversion of sputum, 9 (60.0%) showed disappearance of cavities within six months. Furthermore, such comparison was carried out between patients with lung tuberculosis, who were more than 50 years-old, and patients with lung disease due to M. avium complex. The rate of disappearance of cavities in tuberculous patients (40/45 or 88.9%) was much higher than that of patients with lung disease due to M. avium complex (60.0%) (Table 4). It was shown thus that the disappearance of cavities in patients with lung disease due to M. avium complex was rather difficult to occur even when parasite factor was diminished by the sputum conversion.
Previously, the present author (Tsukamura, M.: Kekkaku, 51: 369-372, 1976) reported two cases who showed no acid-fast organism in their sputum for a long time and showed M. avium complex from cavities of resectcd lungs, and one case who showed a thin.walled cavity without showing acid-fastorganism fbr 4 years and then showed.M. avium complex in its sputum persistently. Thin-walled cavi-ties without cxcreting acid-fast organism in sputum were shown in six patients of the present study, and suchfindings may be characteristic fbr lung disease due to M. avium complex.
Furthermore, as an evidence suggesting that the characteristic feature of X-ray picture of lung disease due to M. avium complex is produced by host condition, a peculier case of lung tuberculosis plus diabetes mellitus, who showed a X-ray picture similar to that of lung disease due to Ivl. avium complex, was shown in the present study (Photo. 2).
In conclusion, two factors are considered as the factors which produce the persistence of culturenegative cavities in the lung disease due to M. avium complex: 1) persistence of small amount of M. avium complex organisms in cavity wall, which may appear as culture-negative; 2) host condition with attenuated immune response.

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There are many experimental and clinical investigations on Enviomycin (EVM). In these papers, EVM is reported to have an almost equal clinical effectiveness to Viomycin (VM) and have less side effects than conventional antituberculosis drugs in the treatment of pulmonary tuberculosis (PTB).
EVM was administered to a total of 81 patients with PTB, consisted of 73 re-treatment cases and 8 initial treatment cases, to whom Streptomycin (SM) could not be given either because of resistance to SM or development of tinnitus after SM injection. Sputum and serum levels of EVM were also assayed in 10 cases with PTB after intramuscular administration of 1.0g EVM.
The results obtained were as follows;
1. Negative conversion rate of tubercle bacilli in sputum was 100% in initial treatment cases and 27.3% in re-treatment cases. However, in re-treatment cases who were treated with EVM in combination with two other potential drugs, such as Rifampicin and Ethambutol, the rate was 66.7%. EVM was not effective in re-treatment cases when combined with non-potential drugs and the negative conversion rate was only 14.7%.
2. None showed worsening of hearing disturbance in spite of the fact that EVM was used for cases who showed initially slight hearing impairment.
3. Eight cases showed side effects; i.e. tinnitus in 2, skin eruption in 1, a slight elevation of serum transaminase in 2 and eosinophilia in 3.
4. EVM was penetrated into the sputum of patients with PTB at high level.
5. Two out of 81 cases studied were dropped out because of skin eruption and tinnitus after EVM injection.

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Recently, rifampicin (RFP) has been regarded as one of the most effective anti-tuberculous agent and has been widely used. Although many papers have been published recently concerning the adverse effects of RFP, one of the most serious one, among them, is the acute renal failure. We experienced one case who was administered 450 mg RFP daily and suffered from acute renal failure.
Recently, liver dysfunction induced by RFP and isoniazid (INH) has been paid much attention. Twelve cases (25.6%) out of 47 cases who were admitted to our department and administered both RFP and INH showed the slight liver dysfunction. It seems to us that such a liver dysfunction is not so severe and occurs at an early stage from the beginning of drug administration, and usually almost all of patients show the quick recovery from the liver dysfunction while continuing the administration of these drugs.

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