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58 巻, 6 号
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芳賀 敏彦1983 年 58 巻 6 号 p. 329-338
発行日: 1983/06/15
公開日: 2011/05/24
ジャーナル フリーPDF形式でダウンロード (1525K) -
Mycobacterium kansasii症の増加および感染菌種の多様化 (Mycobacterium nonchromogenicum感染症の出現)国立療養所非定型抗酸菌症共同研究班1983 年 58 巻 6 号 p. 339-346
発行日: 1983/06/15
公開日: 2011/05/24
ジャーナル フリー1. Since 1978, the prevalence rate of lung disease due to Mycobacterium kansasii in this country has been increasing and reached 0.32 per 105 population in the year 1981, although rate was as low as 0.11 or less before 1977. In contrast, the prevalence rate of lung disease due to Mycobacterium avium-Mycobacterium intracellulare did not increase and remained at same level (1.19 per 105 population in the year 1981). The prevalence rate of lung disease due to all atypical mycobacteria in 1981 was 1.64 per 105 population. This was the same level as observed until now.
2. The fraction of the M. kansasii disease in all mycobacterial diseases other than tuber culosis was less than 7% before 1977, while it increased to 19.4% in the year 1981. In Europe and in the United States of America, the fraction of the M. kansasii disease is about one half of all mycobacterial diseases. It is suggested that the incidence of the M. kansasii disease in Japan will increase until the level of Europe and the United States concurrently with decrease of the incidence of tuberculosis. It is sure that some people who have general or locally attenuated resistance show clinical manifestation when they are infected with atypical mycobacteria found in the environment. When the morbidity of tuberculosis is high, such people are most likely infected with tubercle bacilli, but when it becomes lower, they might be infected more easily by mycobacteria other than tubercle bacilli.
3. Appearance of lung disease due to Mycobacterium nonchromogenicum was observed in 1981. In addition, diseases due to M. szulgai, M. scrofulaceum and M. fortuitum were also observed in 1981. This phenomenon also may be explained by the decrease of the morbidity of tuberculosis.
4. Geographic difference of the incidence of lung mycobacteriosis due to atypical mycobacteria was observed. As observed previously, the incidence was higher in the South Pacificcoast.
5. The bed occupation rate of mycobacteriosis increased to 7.9% in 1981. The rate was 0.9% in 1971, 1.7% in 1974, 2.8% in 1975, 4.1% in 1977, 6.1% in 1979, and 6.9% in 1980.
6. Sex and age of patients with atypical mycobacteriosis are shown.抄録全体を表示PDF形式でダウンロード (853K) -
国療化研第19次・20次A研究国立療養所化学療法研究会1983 年 58 巻 6 号 p. 347-353
発行日: 1983/06/15
公開日: 2011/05/24
ジャーナル フリーIntensive antituberculosis regimen (3S7H7R7→S2H7R7) were given to 151 primarily treated cases for 6 months after sputum conversion and these patients were followed up for 36 months, after the cessation of chemotherapy.
Of the 151 cases, bacteriological relapses were observed in one case within 6 months, and 3 cases with 2 radiological deterioration at about 36 months after stopping chemotherapy.
Five deaths were observed during this period, but all were not related directly to tuberculosis.
Bacteriological relapse ratio was 2.6% among all cases and 3.4% among cases who were followed up for 36 months after stopping chemotherapy.
The results strongly suggest that the follow-up period after the short-course chemotherapy should be more than 3 years after stopping chemotherapy.抄録全体を表示PDF形式でダウンロード (770K) -
桜井 信男1983 年 58 巻 6 号 p. 355-362
発行日: 1983/06/15
公開日: 2011/05/24
ジャーナル フリーThe susceptibility of atypical mycobacteria (mainly Mycobacterium-avium-M. intracellulare Complex) to Cephem and other antibiotics was studied using Dubos Tween albumin liquid medium.
The atypical mycobacterial strains tested were chosen from 46 strains including 6M. kansasii, 4M. scrofulaceum, 25M. avium-M. intracellulare Complex, and 11M. fortuitum Complex.
Thirteen Cephem antibiotics [Cephalothin (CET), Cephaloridine (CER), Cefazolin (CEZ), Cefoxitin (CFX), Cefotiam (CTM), Cefsulodin (CFS), Cefmetazole (CMZ), Cefotaxime (CTX), Ceftizoxime (CZX), Cefoperazone (CPZ), Cefmenoxime (CMX), Latamoxef (LMOX), Cefpir amide (CPM)] and five other antibiotics [Minocycline (MINO), Ampicillin (ABPC), Piperacillin (PIPC), Lincomycin (LCM), Sulbenicillin (SBPC), Fosfomycin (FOM)] were studied.
Among the Cephem antibiotics studied, CER and CMX, which showed about the same MICs as RFP, inhibited well over 90% of the strains of M. avium-M. intracellulare tested at the concentration of 3.13μg/ml. These two antibiotics were followed by CEZ, which inhibited around 70% of the strains at the same concentration. Among the other antibiotics, MINO demonstrated a moderate in vitro activity against M. avium-M intracellulare.
The MICs of these drugs seem to be not satisfactory enough to expect unequivocal effects in future clinical trials, however, it is worthwhile to continue to investigate further for the candidates in the multiple-drug chemotherapies.抄録全体を表示PDF形式でダウンロード (851K) -
佐藤 研, 大谷 明夫, 木村 光男, 志田 國治, 大泉 耕太郎, 本宮 雅吉, 今野 淳1983 年 58 巻 6 号 p. 363-367
発行日: 1983/06/15
公開日: 2011/05/24
ジャーナル フリーA 52-year-old woman was admitted to our hospital, because of high fever and swelling of superficial lymph nodes. Nine months before admission, she became aware of painful swelling of a right supraclavicular lymph node, which gradually increased in size. Widening of mediastinal shadow was found on chest X-ray film. The left paratracheal and right hilar lymphnode were swollen on tomograms. Otherwise, no abnormal shadow was found in the lung field. No tubercle bacilli were detected in spite of repeated examinations of sputum smears. Fever and leukocytosis persisted, and the findings of lymph nodes remained unimproved despite treatment with antibiotics which are effective on microorganisms other than tubercle bacilli. Her clinical status became aggravated. Neither exploratory bone marrow puncture nor biopsy of lymph node could established the diagnosis. Gynecological and ophthalmological examina tions were negative.
Two months after admission, a subcutaneous abscess appeared on the index finger of the left hand and tubercle bacilli were found in the abscess. Almost at the same time, the result of culture of sputum submitted to the laboratory at admission proved positive. Anti-tuberculous therapy with INH, EB, RFP and SM was initiated immediately. However subcutaneous abscesses appeared at several sites and tubercle bacilli were detected in all the abscesses. Miliary shadows which were found on chest film three months after admission increased rapidly in number and size.
Suddenly the patient died of severe hematemesis nine months after admission.
At post-mortem examination, marked tuberculous changes were found in several intrapelvic lymph nodes and genital organs (especially Fallopian tube and uterus). Thus one of them was suspected as the primary lesion. Numerous tubercles produced by hematogenous dissemination were found in the lung, liver, spleen and in the myocardium.
The fatal hematemesis resulted from the perforation into the aorta of the esophageal ulcer. This lesion, however, showed no tuberculous changes.抄録全体を表示PDF形式でダウンロード (1723K)
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