結核
Online ISSN : 1884-2410
Print ISSN : 0022-9776
ISSN-L : 0022-9776
56 巻, 9 号
選択された号の論文の5件中1~5を表示しています
  • 近藤 瑩子, 金井 興美
    1981 年 56 巻 9 号 p. 423-428
    発行日: 1981年
    公開日: 2011/05/24
    ジャーナル フリー
    Mice were fed with diets deficient in essential fatty acids for 3 to 7 weeks. Polymorphonuclear leucocytes and macrophages were harvested from their casein-induced peritoneal exudate to be subjected to lipid analysis comparing with the corresponding materials obtained from the mice fed with control diets. As for the distribution pattern of constituent fatty acids of phospholipids, linoleic and arachidonic acids decreased in the mice fed with the deficient diets, and the rate of oleic acid increased. At the same time, tuberculous infection developed in a more exacerbated fashion. The correlation between these two observations was discussed referring to our previous finding that polyunsaturated fatty acids in free form are highly toxic to tubercle bacilli and that phospholipid degradation of the phagocytic cell membrane at areas of close contact with the bacterial surface may release such toxic fatty acids.
  • 第1編結核菌発育阻止効果について
    山鳥 英世
    1981 年 56 巻 9 号 p. 429-433
    発行日: 1981年
    公開日: 2011/05/24
    ジャーナル フリー
    It was found in general that the activities of antituberculous agents on the growth of tubercle bacilli was attenuated when they were cultured under unfavourable conditions for the growth of bacilli. In this experiment, the air in environment of culture media of tubercle bacilli was replaced by either of N2, CO2 or O2, and the antimicrobial activities of antituberculous agents were examined.
    The experiments were performed by using the silicone-coated slide culture method with Kirchner's medium. Mycobacterium tuberculosis strain H37RV was used as the test strain.
    The minimal inhibitory concentration (MIC) of streptomycin (SM), kanamycin (KM), para-aminosalicylic acid (PAS), isoniazid (INH) and rifampicin (RFP) was determined.
    There was no growth of tubercle bacilli in any sample, regardless of the kind of drugs used, the length of the cultivation time, and the kind of gas.
    In conclusion, it was proved by this experiment that conditions used in this study was quite inadequate for the growth of tubercle bacilli.
  • 束村 道雄
    1981 年 56 巻 9 号 p. 435-439
    発行日: 1981年
    公開日: 2011/05/24
    ジャーナル フリー
    Many investigators reported that patients with lung disease due to atypical mycobacteria engaged frequently in dusty work (Reviewed by Tsukamura (Kekkaku 52: 367-372, 1977)). However, a question is raised whether the dusty work is more important in lung disease due to atypical mycobacteria than in lung tuberculosis. In relation to this question, it is desired to compare the ratio of patients engaged in dusty occupation between these two diseases. Nevertheless, such study is at present very scanty. The Research Committee of the British Thoracic and Tuberculosis Association (Tubercle 56: 295-310, 1975) and Marks (Tubercle 56: 311-313, 1975) reported that the dusty occupation especially metal grinding work was more often observed in patients with lung disease due to M. kansasii than in those with lung tuberculosis, and Shimoide (Jap. J. Chest Dis. 38: 765-773, 1977) reported that the dusty work was more frequently observed in patients with lung disease due to atypical mycobacteria than in patients with lung tuberculosis. The purpose of the present study is to compare the ratio of patients engaged in dusty work between lung disease due to Mycobacterium-avium-M. intracellulare complex (M. avium complex) and lung tuberculosis. The patients with lung tuberculosis studied were restricted to those who showed M. tuberculosis in their sputum at the time of hospitalization. This was due to consideration that all patients with lung disease due to M. avium complex were culture-positive and, therefore, the patients with lung tuberculosis studied as the control also should be culture-positive.
    The patients with lung disease due to M. avium complex were diagnosed according to the criteria described previously (Tsukamura: Kekkaku 53: 367-376, 1978). These were 77 patients who were hospitalized in the period of 1971 to 1980. The patients with lung tuberculosis were thosse hospitalized in January 1981. Identification of M. avium complex was done by the methods previously reported (Tsukamura: Identification of mycobacteria, p.1-75, 1975, The National Chubu Hospital, Aichi 474), and that of M. tuberculosis was done by the absence of growth on Ogawa egg medium containing 0.5 mg/m/ p-nitrobenzoic acid (Tsukamura & Tsukamura: Tubercle 45: 64-65, 1964).
    The dusty works shown in Table 2 were the subjects of the study. Patients who engaged in these works for more than five yeras were recorded.
    The age of patients of both groups differed not significantly from each another, except the age of female patients with M. avium complex-disease was slightly higher than that of female patients with lung tuberculosis (Table 1). The ratio of patients with dusty work in patients with M. avium complex-disease was significantly higher than that in patients with culture-positive lung tuberculosis (Tables 2 and 3).
    The above fact suggests that the dusty work has a more important meaning for the incidence of lung disease due to M. avium complex than for that of lung tuberculosis, and that the incidence of lung disease due to M. avium complex is predisposed by the exposure to dusts and the host condition is more important for the incidence of lung disease due to M. avium complex than for the incidence of lung tuberculosis.
  • 稲本 元
    1981 年 56 巻 9 号 p. 441-444
    発行日: 1981年
    公開日: 2011/05/24
    ジャーナル フリー
    Suppressed natural defense may predispose uremic patients to the development of extrapulmonary tuberculosis. In order to clarify this problem in patients receiving dialysis, I made an epidemiological study. The subjects were 2034 dialysis patients in 1976 and 2403 dialysis patients in 1977. Among them 30 males and 32 females had extrapulmonary tubercular lesions.
    Prevalence, incidence, mean duration of the disease, mortality and fatality of extrapulmonary tuberculosis in the dialysis patients were 621/105, 543/105, 1.1 year, 155/105 and 29% in male and 1340/105, 1475/105, 0.9 year, 402/105 and 27% in female, respectively. The prevalence, incidence, mortality and fatality were 24, 54, 310 and 5.8 times higher in male, and 52, 98, 804 and 9 times higher in female than those in the general population, respectively. The mean duration of the disease was shorter in dialysis patients: 1/2 in male and 1/3 in female of those in the general population.
    Extrapulmonary tuberculosis occupied 33% in male and 56% in female of all tuberculosis among dialysis patients on Jun. 30, 1976, whereas it was 3.7% in male and 10% in female in the general population. Extrapulmonary tuberculosis occupied 37% in male and 65% in female of all tuberculosis developed during 1976 among the dialysis patients in contrast to 6.7% in male and 18% in female in the general population. Extrapulmonary tuberculosis occupied 50% in male and 100% in female of all deaths from tuberculosis in dialysis patients, which were much higher than 2.9% in male and 8.8% in female in the general population.
    Thus, for the first time, an extremely high susceptibility and low resistance to extrapulmonary tuberculosis and the shorter course of the disease were proved epidemiologically in dialysis patients who were known to have the immunodeficiency. Furthermore, the present study demonstrated a remarkably high frequency of extrapulmonary tuberculosis among all tuberculosis in dialysis patients.
  • 第56回総会特別講演
    山本 和男
    1981 年 56 巻 9 号 p. 445-456
    発行日: 1981年
    公開日: 2011/05/24
    ジャーナル フリー
    I. Studies on Short-Course Chemotherapy at the Habikino Hospital
    1. First study-Twelve month short-course chemotherapy.
    Newly diagnosed bacillary pulmonary tuberculosis cases were treated by a regimen of 2-3SHR/4-3S2HR/6HP for 12 months. In all cases the cultures converted to negative by the 4th month. Of the 112 cases in whom follow-up was possible no cases with a bacteriological relapse were observed up to 4 years, whereas in the 105 control cases treated with 2-3SHP/16-15S2HP for 18 months a bacteriological relapse was seen in 3 cases.
    2. Second study-Six to nine month short-course chemotherapy.
    Duration of the HP administration in the first study was shortened to 0 to 3 months, accordingly the total duration of treatment was shortened to 6 to 9 months. Of the 132 cases in whom follow-up observation was performed, a bacteriological relapse was seen in only 3 cases (2%) up to four years after the termination of therapy.
    3. Third study-Six months treatment in smear and culture negative cases.
    In primary treatment of smear and culture negative cases, a 6 months treatment of 3SHR/3HR was performed. In the 115 cases observed from 3 to 24 months after the cessation of therapy, no cases showing worsening was observed.
    4. Fourth study-Short term chemotherapy containing PZA.
    To the chemotherapy regimen used in the second study, PZA 1.5 g was added for the initial 2 months. Of 70 cases treated with this SHRZ regimen cultures converted to negative by the third month in all cases. The negative conversion rate at the second month was 96% in contrast to 87% seen in the first study.
    This difference in the culture negative conversion rate between SHRZ and SHR regimens was more marked in cases showing abundant growth on culture (+++ or ++++) than cases showing fewer growth (++or+)
    II. Methods of Short-course Chemotherapy
    The results of short-course chemotherapy reported by foreign and Japanese investigators were summarized, and the appropriate regimens and duration of therapy were discussed.
    Personal opinion on the regimen and duration of short-course chemotherapy is summarized as follows:
    1) In primary treatment by short-course chemotherapy, the regimens 3SHR/ S2HR, 3SHR/ HR or EHR are most suitable.
    2) To intensify the primary treatment, PZA may be added to the above regimens for the initial two months.
    3) The duration of therapy should be from 6 to 9 months for bacillary cases and 6 months for smear and culture negative cases.
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