巻号一覧
59 巻, 2 号
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河野 俊一, 中川 秀昭, 河野 光子1984 年 59 巻 2 号 p. 67-80
発行日: 1984/02/15
公開日: 2011/05/24
ジャーナル フリーAn outbreak of tuberculosis epidemic occurred in a private high school in Kanazawa City during the period of April to November, 1982. There were thirty patients and suspects, which were 2.6% of the whole students.
An index case was a male student who had been primarily infected in his childhood through household contact and had been registered and kept under control as inactive tuber culosis when he entered the high school. His tuberculosis relapsed when he was in the second year of high school. After epidemiological analysis, this case was decided to be the source of the infection in this epidemic. As most of the secondary cases had been in contact with the index case, the main route of infection was considered to be a direct transmission from this case and the infection was supposed to have been taken place from November to December, 1981.
In most of patients and suspects, the tuberculin skin test had already been positive, but it was impossible to determine whether the positive reaction was due to tubercle bacilli or to B. C. G. vaccination.
The B.C.G. vaccination properly done was estimated to be useful to protect the onset of tuberculosis to a certain degree in the first ten years period after the vaccination. Most of the students showing strongly positive reaction to tuberculin tests which was carried out after the epidemic were considered to have been infected by this epidemic.
The main causes of this outbreak of epidemic were both patient's and doctor's delay in detecting the relapse. Unsatisfactory health control activity in a school and insufficient knowledge of school staff on tuberculosis might also attribute to the delay in detection thus increased the chance of infection.
As the result of this investigation, it is necessary to re-examine the time of tuberculin skin test and B.C.G. vaccination. Similary, it is essential to improve thoroughly the health control activity including tuberculosis in a school.抄録全体を表示PDF形式でダウンロード (4838K) -
国療化研第21次研究国立療養所化学療法研究会1984 年 59 巻 2 号 p. 81-89
発行日: 1984/02/15
公開日: 2011/05/24
ジャーナル フリーThe clinical results of two lengths of chemotherapy are compared up to three years after the cessation of chemotherapy.
The regimens studied are as follow:
Streptomycin 0.75g, Isoniazid 0.3g, and Rifarnpicin 0.45g given daily for 3 months followed by the regimen same to the original one except Streptomycin 1.0g given twice a week.
The chemotherapy was administered for 6-months (group I 128 cases) and 12-months (group II 124 cases) after negative conversion of sputum. Actual and average length of chemotherapy are 6-9 months (average 7 months) and 12-17 months (average 13 months) in group I and group II respectively.
Three bacteriological relapses (23%) were observed in group I, two relapses were observed within 12 months after end of chemotherapy (early relapse), one relapse was seen at three years after stopping chemotherapy, and no relapse was observed in group II.
Tubercle bacilli in relapsed cases were all sensitive to all the drugs used.
This result suggests that the reasonable and sufficient length of follow-up for cases treated with intensive regimen of chemotherapy is twelve months.抄録全体を表示PDF形式でダウンロード (1086K) -
結核療法研究協議会1984 年 59 巻 2 号 p. 91-104
発行日: 1984/02/15
公開日: 2011/05/24
ジャーナル フリーTreatment failures with RFP is defined as cases who has been admitted to hospitals because of positive sputum for acid fast bacilli even after more than three months RFP administration.
Of 223 cases, 26 were excluded due to various reasons, and finally 197 cases were subjected to this study. The backgrounds of these cases are mainly far advanced and cavitary on chest X-ray, show resistance to SM (52.7%), INH (61.8%), RFP (58.1%), and had been treated for a long term previously (41.6% of them had been treated altogether for more than five years).
Of 197 cases, 166 were treated further by chemotherapy. The highest sputum negative conversion rate (about 70%) was observed in RFP sensitive cases treated by regimens containing RFP, and slightly higher sputum conversion rate was observed in RFP resistant cases treated by RFP, especially after its use for seven months, compared with RFP resistant cases without the use of RFP. No difference in the negative conversion rate was observed between cases resistant to RFP 50γ and 10γ.
Significantly higher rate of improvement of chest X-ray findings (about 40%) was observed in RFP sensitive cases treated by RFP only at three months after admission, while there were no difference in chest X-ray improvement between cases treated with and without RFP in RFP resistant cases at three, six, and nine months after admission. Of 197 cases, 16 had surgical treatments (pneumonectomy 8 and lobectomy 8) and complete sputum conversion and no post-operative complications were observed in these cases.
Main reasons of failure in cases treated with RFP are irregular uncontrolled chemotherapy, complication of diabetes, multiple sclerotic-walled cavities on chest X-ray, etc.抄録全体を表示PDF形式でダウンロード (1650K) -
肺非定型抗酸薗症発生率の地域差について束村 道雄, 下出 久雄, 喜多 舒彦, 川上 景司, 久世 彰彦1984 年 59 巻 2 号 p. 105-113
発行日: 1984/02/15
公開日: 2011/05/24
ジャーナル フリーRelationship between the prevalence rate of non-tuberculous pulmonary mycobacteriosis and the prevalence rate of active lung tuberculosis in the period of 1971 to 1982 (12 years) was observed in five prefectures, Hokkaido, Tokyo, Aichi, Osaka, and Fukuoka. The prevalence rate of non-tuberculous lung mycobacteriosis was estimated as a product of the prevalence rate of active lung tuberculosis and the ratio of the number of patients with non-tuberculous mycobacteriosis against the number of patients newly hospitalized in lung tuberculosis depart ments. The ratio was determined in the National Sapporo Minami Hospital, Hokkaido, the National Tokyo Hospital, Tokyo, the National Chubu Hospital, Aichi, the National Kinki Chuo Hospital, Osaka, and the National Fukuoka Higashi Hospital, Fukuoka, respectively.
The prevalence rates of active lung tuberculosis were reduced markedly during the recent 12 years observed, while the prevalence rates of non-tuberculous lung mycobacteriosis remained at almost the same level. The prevalence rate of the non-tuberculous mycobacteriosis was highest in Osaka, 2 to 5 per 105 population, moderate in Tokyo, Aichi and Fukuoka, 1 to 3 per 105 population, and the lowest in Hokkaido, less than 0.75 per 105 population.
The difference in the prevalence rates of non-tuberculous mycobacteriosis might be explained by the following factors: (a) difference of ecological state of mycobacteria in the environment due to different climate; (b) difference of dusty environment due to different industries.抄録全体を表示PDF形式でダウンロード (1058K) -
8. マウスを対象としたMycobacterium intracellulare吸入感染の試み (続報)久世 文幸, 桜井 信男1984 年 59 巻 2 号 p. 115-122
発行日: 1984/02/15
公開日: 2011/05/24
ジャーナル フリーThe ddY conventional mice were infected aerogenically with a mouse virulent strain 31 F093T of M. avium-intracellulare (M. intracellulare), using TRI-R Airborn Infection Apparatus Model A42. The strain produced a 1, 000-fold increase in the number of viable mycobacteria recovered from lung, and a two-fold increase of lung weight after fifteen weeks of infection. The number of the viable bacilli was retained thereafter essentially on the same level with an ever increasing lung weight, which reached a 3-fold value at 28 weeks of infection. No deaths due to the infection ensued during the period of observation.
Macroscopic lung lesions consisted of densely scattered small nodular lesions combined with dispersed grossly big nodules, which became visible at six weeks of infection. These lesions demonstrated histopathologically multiple granuloma formation at six weeks of in fection, and diffuse proliferative changes thereafter.
The aerogenical pretreatment with an amorphous silica (Aerosil, Degussa, Frankfurt a.M. (FRG)) accelerated the disease, which was demonstrated macroscopically as well as micro scopically beyond nine weeks of infection. The pretreatment, however, could not change the disease process to an acute form.
These chronic persistent lung infections in mice, which were aerogenically provoked by M. intracellulare 31F093T, have a few advantages as the models for experimental chemotherapy besides its being akin to the human infection in view of the route of infection. First, the infection procedure is much easier than intravenous and intraperitoneal infections in a large scale of experiment; second, a larger number of mice can be dealt with due to easier observations aimed only at the lung disease; third, various aerogenical pretreatments can be evaluated.抄録全体を表示PDF形式でダウンロード (3104K)
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