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Volume 61, Issue 4
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Report of The B Series of 26th Controlled Trials of ChemotherapyJoichi KONISHIIKE, Masazumi UNNO, Satoru YAMAMOTO1986 Volume 61 Issue 4 Pages 243-252
Published: April 15, 1986
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSOut of 741 cases, admitted to the 39 institutions of national sanatoria, in which the clinical individual cards were available, 66 cases (8.9%) were intestinal tuberculosis and tuberculous peritonitis during the past five years (1978-1982).
Among 66 cases of both diseases, 48 cases with averaged 43.7 years, 32 males and 16 females, were intestinal tuberculosis and 18 cases with averaged 46.7 years, 3 males and 15 females, were tuberculous peritonitis.
Forty-five (93.8%) of the 48 intestinal tuberculous cases were associated with pulmonary tuberculosis, but in the 18 cases with tuberculous peritonitis, only 8 (44.4%) were associated cases.
The therapeutic effects of the regimens including RFP and INH for intestinal tuberculosis and tuberculous peritonitis were observed.
Response to these treatment is evaluated as effective except some aggravating cases, for intestinal tuberculosis without association of pulmonary tuberculosis and the optimum duration of chemotherapy is considered to be about twelve months.
In cases associated with pulmonary tuberculosis, however, the duration of chemotherapy should be prolonged to some extent, both in non-operated and operated cases, compared with cases without association.
Chemotherapy of tuberculous peritonitis was continued for 8.0 months in average in cases without association of pulmonary tuberculosis, and associated cases had responded well by continuing of 12.5 months in average.
In operated cases, either with or without association of pulmonary tuberculosis, results of their chemotherapy were shown to be well about in eleven to 15 months in average.
The mortality and morbidity from both diseases are appreciably less than in the prechemotherapy era. But the hospital mortality is still more 16.7 per cent (11 of the 66 cases) in this study.
Therefore, it is emphasized that early diagnosis and intensive chemotherapy at early stage of intestinal tuberculosis and tuberculous peritonitis are necessary andimportant for further improvement of clinical results and decreasing mortality.View full abstractDownload PDF (3335K) -
Katsutoshi TAKADA, Hiroshi HASHIGAMI, Munehiko MORISHITA, Masahiko YAM ...1986 Volume 61 Issue 4 Pages 253-256
Published: April 15, 1986
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSIn order to better understand the surface markers of lymphocytes in peripheral blood (PB), pleural effusion (PE) the subsets of the lymphocytes of PB, PE from 44 cases of pulmonary tuberculosis and 11 cases of pleuritis tuberculosa were assayed by means of the immunofluorecent technique. The following findings were obtained.
1) In subpopulations of lymphocytes in PB, the ratio and the absolute number of OKT3×, OKT11×, OKT4×, and OKT8× cells were smaller than those for healthy persons, while those of B1×, OKM1×, and Leu7× cells were larger.
2) When studies were made by classifying pulmonary tuberculosis according to the classification of the committee of education of the Japanese society for tuberculosis, the OKT3×, 0KT11× and OKT4× cell ratios in inactive type were found to be smaller than those in active type, while the OKT8×, OKIal×, OKM1× and Leu7× cell ratioswere found to be higher.
3) In subpopulations of the lymphocytes in the PE, the OKT3×, OKT11×, OKT4× and OKIa1× cell ratios were found to be higher in comparison with those obtained from the PB. On the other hand, the OKT8×, OKM1× and Leu7× cell ratios in PE were found to be strikingly lower.
In pulmonary tuberculosis the subpopulations of lymphocytes in PB seemed to be related to the disease activity and the helper/inducer T cell ratio in PE were found to be strikingly higher than that of PB.View full abstractDownload PDF (568K) -
Michio TSUKAMURA, Hiroshi AMANO, Shoji MIZUNO1986 Volume 61 Issue 4 Pages 257-264
Published: April 15, 1986
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 55-year-old male, who had been considered as suffering from pulmonary tuberculosis and was treated by antituberculosis agents, including rifampicin, isoniazid, streptomycin, ethambutol and p-aminosalicylate, for 3 years (1979-1982) was admitted to the National Chubu Hospital in May 1984, showing a small cavity in fibrocaseous lesion in the right upper lobe and another infiltrative, caseous lesion in the left lower lobe in the roentgenographic feature and complaining fever (37.2-37.7°C), cough and sputum. The blood sedimentation rate was 48 mm (1 hour) and the white blood cell count was 8, 700/mm3. The sputum examination was made 3 times in May, 6 times in June, and once in July, and three isolates (2, 1 and 1 colonies, respectively) were obtained on the 16th and on the 18th June and on the 10th July. The patient was discharged by his request on the 10th July.
The isolates were resistant to all antituberculosis agent, except for kanamycin streptomycin sulfate (20 μg/ml), isoniazid (10 μg/ml), paraaminosalicylate (2 mg/ml), enviomycin sulfate (100 μg/ml), rifampicin (50 μg/ml), ethambutol (5 μg/ml), and ethionamide (40 ug/ml). They were susceptible to kanamycin sulfate (100 μg/ml) in the Ogawa egg medium. The characters of the isolates are shown in Table 1 and have been considered as belonging to a new species. They have been named Mycobacterium acetamidolyticum sp. nov. The type strain is NCH E 11620 (ATCC 35931). The source is the sputum of a patient. It is considered as lung pathogen.
The organism is unique in that it is unable to utilize glutamate as nitrogen source but is able to utilize acetamide as nitrogen source. It is differentiated from all other known species of mycobacteria (Table 2). The organism is characterized by the following: (1) produce rough, nonphotochromogenic colonies after 5 days on the Ogawaegg medium (do not grow, or if any, show scanty growth after 3 days); (2) grow at 28°Cto 42°C; (3) resistant to NH2OH·HCl (0.5 mg/ml) in the Ogawa egg medium; (4) show positive arylsulfatase activity after 3 days; (5) show acetamidase activity; (6) do not utilize glutamate but utilize acetamide as simultaneous nitrogen and carbon sourcesView full abstractDownload PDF (872K) -
2. Survival Rates of Mycobacteria in Sputum and in Saline after Pretreatment with Na OH SolutionKenji MARUMO, Yoshio AOKI1986 Volume 61 Issue 4 Pages 265-271
Published: April 15, 1986
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSIn experiments using 4% NaOH solution, it was found that with longer pretreatment time, there was a significant decrease in the survival rates of mycobacteria (M. tubercu losis H37Rv IID 591, M. kansasii P-1, M. scrofulaceum ATCC 19881, M. intracellulare ATCC 15984, M. fortuitum ATCC 6841) (p<0.05, ttest). M. tuberculosis was the most resistant strain to 4% NaOH solution, and M. fortuitum (Runyon group IV) was the most sensitive. The survival rates of them following pretreatment with 1% NaOH solution were higher than the values obtained with 4% NaOH solution. It was considered that pretreatment with 1% NaOH solution for 30 min at 37°C was not only bactericidal to contaminating bacteria but also significantly to mycobacteria, and not so good as for 5 min treatment at room temperature with 4% NaOH solution.
It was clear in this experiment that mycobacteria in sputa were also significantly damaged by pretreatment with 4 and 1% NaOH solutions. It was considered that pretreatment with NaOH solution would be one of the causes of the “smear-positive and culture-negative” phenomenon, so that consequently a misdiagnosis of mycobacteri osis might be made. Therefore, new methods to replace the pretreatment with NaOH solutions should be investigated.View full abstractDownload PDF (766K)
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