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Volume 59, Issue 5
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13. Findings Which Urged the DiagnosisHajime INAMOTO1984 Volume 59 Issue 5 Pages 317-322
Published: May 15, 1984
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSImpaired host defense mechanisms are known in uremia. Signs, symptoms and labora tory findings in tuberculosis would reflect the altered host responses against the parasites. In order to clarify this point, a questionaire study was done. Study subjects were 92 male and 58 female dialysis patients with tuberculosis.
Fever, especially the one which is irresponsive to usual antibiotics was most common among the findings which urged the diagnosis of tuberculosis in dialysis patients. It was followed by chest roentgenography, cough, lymphnode swelling, general malaise, sputum, appetite loss, autopsy, accelerated ESR, weakness, pyuria, chest pain, weight loss, etc. In total, indefinite systemic symptoms were common and the local findings were rather limited with diminished pulmonary findings and relatively frequent extrapulmonary findings.
Patients with weight loss, weakness or appetite loss showed the highest fatality of 38% to 35%. Weight loss was accompanied by other signs, symptoms and laboratory findings at the highest frequency, being followed by weakness and appetite loss. Existence of these 3 symptoms and general malaise correlated well with each other. Presence of fever correlated moderately with the existence of these 4 symptoms. Acceralated ESR correlated with the development of the symptoms such as weakness, appetite loss, general malaise and night sweat. Positive chest roentgenographic findings were observed frequently in cases with weight loss and with sputum.
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Youngchol LEE, Nobuyuki KATAKAMI, Hiroko SAKAMOTO, Kyosuke ISIHARA, Hi ...1984 Volume 59 Issue 5 Pages 323-328
Published: May 15, 1984
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSClinical features of the lung disease due to atypical mycobacteria were studied in fifty-one patients hospitalized in Tamatsu Hospital, Kobe, from January 1971 to December 1982. Thirty-eight cases were due to M. intracellulare and thirteen cases were due to M. kansasii. The proportion of the atypical mycobacterioses patients to all patients newly admitted to tuberculosis ward has been increasing year by year, and it was 6.9% in 1982.The number of patients with M. kansasii disease definitely increased in 1982.
The mean age of patients with M. intracellulare disease was 57.8 years in contrast to 45.5 years of patients with M. kansasii disease. Two thirds of patients with M. intracellulare disease were male, while the majority of patients with M. kansasii disease were male. Previous or coexisting respiratory diseases, including pulmonary tuberculosis, were recognized in 86.8% of M. intracellulare patients, and in 30.8% of M.kansasii patients, suggesting that the M. intracellulare infection is more likely to develop on the basis of chronic uulmonary diseases.
Among the patients with M. intrcellulare disease, ten patients (26.3%) had undergone lung surgery due to previous pulmonary tuberculosis. They developed clinical evidences of M. intracellulare infection 17 years, in average, after surgery. Furthermore, all except one patient, who had undergone right pneumonectomy, showed cavitary lesions at least in the operated side of the lung.
The conventional regimens of antituberculous agents were effective for M. kansasii disease, however the efficacy was poor for M. intracelluare disease.View full abstractDownload PDF (748K) -
NON-TUBERCULOUS MYCOBACTERIA IN JAPAN (REPORT OF THE YEAR 1982 OF THE MYCOBACTERIOSIS RESEARCH GROUP OF THE JAPANESE NATIONAL CHEST HOSPITALS)Michio TSUKAMURA, Nobuhiko KITA, Hisao SHIMOIDE, Seiji NAGASAWA, Keiji ...1984 Volume 59 Issue 5 Pages 329-336
Published: May 15, 1984
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS1) In the period of one year from the 1st January 1982 to the 31st December 1982, 3, 257 patients with mycobacterial lung disease were admitted to tuberculosis departments of participating hospitals. Of these, 111 were those with non-tuberculous lung mycobacteriosis. The kind of species which caused infection in these patients are shown in Table 1. The ratio of patients with non-tuberculous lung mycobacteriosis against the total number of patients including tuberculosis was 3.4%. From this ratio and the prevalence rate of active lung tuberculosis in 1982, 48.5 per 105 population, the prevalence rate of non-tuberculous lung mycobacteriosis was estimated as 1.65 per 105 population.
2) The prevalence rate of active lung tuberculosis is continuously decreasing from the year 1971 to the year 1982. In contrast, the prevalence rate of non-tuberculous lung mycobacteriosis is almost constant, 1 to 2 per 105 population during the same period (Table 2 and Fig.1).
3) The ratio of non-tuberculous lung mycobacteriosis in the total numberof hospitalized patients with lung disease is contiuously increasing (Table4).
4) The kind of causative organisms and the epidemiology of non-tuberculous lung mycobacteriosis have changed in this recent decade. In the period of 1971 to 1977, the kind of species that caused lung disease were almost the same and ca. 6% belonged to M. kansasii and 90% belonged to M. avium-M. intracellulare complex. From the year 1978, the disease due to M. kansasii has increased, and the area where the disease occurs has spread from the Tokyo-Kanagawa area to all West Japan. From the year 1981, various species have appeared to cause the lung disease. In the year 1982, too, seven species have appeared as causative organisms (Table2). Now, we are probably in the days of mycobacteriosis caused by various species of organisms.View full abstractDownload PDF (923K) -
Michio TSUKAMURA1984 Volume 59 Issue 5 Pages 337-339
Published: May 15, 1984
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe resistance pattern to a new antibiotic DL8280 was studied using the strain H37Rv of Mycobacterium tuberculosis and the Ogawa egg medium. This organism showed two resist: ant phenotypes to DL8280, survival curves R1 and R2 (Fig. 1). Lowly resistant phenotype had the resistance level 5μg/ml, when measured by the actual count method, and the mutants with this phenotype appeared in the parent strain at a rate of 10-6. Highly resistant phenotype had the resistance level 100μG/ml and the mutants with this appeared in the population of the lowly resistant strains at a rate of 10-6. The upper limit of resistance was 100μg/ml, which was ca. 300-times higher than the resistance level of sensitive organisms, 0.32μg/ml. To reach the upper limit of resistance, two-step selections of mutants was needed. Hence, the pattern of resistance development is the obligatory two step pattern. It was characteristic that the mutants grew eugonic colonies on initialisolation. This characteristic was observed previously only in isoniazid-resistant mutants The resistance pattern to DL8280 was the same as that of the parent strain in a streptomycin-resistant strain, an isoniazid-resistant strain, a p-aminosalicylate-resistant strain and a rifampicin-resistant strain isolated from the H37Rv strain.View full abstractDownload PDF (424K)
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