結核
Online ISSN : 1884-2410
Print ISSN : 0022-9776
ISSN-L : 0022-9776
62 巻, 1 号
選択された号の論文の5件中1~5を表示しています
  • 感染防御としての表現様式
    野本 亀久雄
    1987 年 62 巻 1 号 p. 1-10
    発行日: 1987/01/15
    公開日: 2011/05/24
    ジャーナル フリー
    We have attempted to propose the bio-defense as a new entity of biological science onthe basis of following senses for understanding the complicated action of various factors.
    1) Sequence and tempo of bio-defense after invasion of microorganisms.
    2) Differing contribution of each factor to the protection against individual microorga nisms.
    3) Mechanisms of selective expression of non-specific functions at desired sites.
    4) Traffic of factors from the central organ to periphery in the response to emergencyat the periphery.
    I will discuss about expression of bio-defense in the protection to microbial infectionsfollowing these four ways for understanding.
  • 小江 俊行, 犬山 正仁, 笹山 一夫, 宮崎 正信, 福嶋 弘道, 近藤 鴻一郎, 谷川 博美, 平野 長熈
    1987 年 62 巻 1 号 p. 11-15
    発行日: 1987/01/15
    公開日: 2011/05/24
    ジャーナル フリー
    We surveyed a tuberculosis epidemic during past seven years from 1979 to 1985 bycollecting informations from 122 health centers in Kyusyu.
    There were 5 outbreak cases (2 cases in a kindergarden, one case in a hospital, and 2cases in a high school).
    In one of 2 cases in a kindergarden, 5 children were infected from a 23-year-old nurse.
    In another case in a kindergarden, 60 children were infected most likely from a 49-year-old nurse. The chest X-ray examinations showed abnormality in 7 children and 3nurses.
    In a case in a hospital, the chest X-ray examination showed abnormality in 4 patientsafter a 54 old-man developed tuberculosis.
    In a case in a highschool with about 1, 000 students, 10 students who are friends eachother developed tuberculosis during the period from 1983 to 1985.In another highschool with 784 students, 11 students suffered from tuberculosis fiveof them used the same schoolbus. As seven patients of them developed tuberculosis aftergraduating from the school, the epidemic was not detected soon.
  • 吉田 文香, 劉 朝漢
    1987 年 62 巻 1 号 p. 17-24
    発行日: 1987/01/15
    公開日: 2011/05/24
    ジャーナル フリー
    At present, the most important regimen of tuberculosis chemotherapy is a combinationof isoniazid and rifampicin combination, to which either of streptomycin, ethambutol or/and pyrazinamide is added in the earlier stage. If isoniazid is resistant, the efficacy of thisregimen is diminished. In order to confirm this fact, we investigated the prognosis of isoniazid-resistant patients of pulmonary tuberculosis, comparing with that of sensitivepatients or resistant patients to the other anti-tuberculous drugs.
    Out 456 patients of pulmonary tuberculosis, who were admitted to our sanatoriumduring 3 years from 1982 to 1984, 196 were culture positive for tubercle bacilli on admission.
    They were composed of 128 original treatment cases and 68 re-treatment cases. All of these culture strains were assessed for the grade of resistance to various anti-tuberculousdrugs, according to the sensitivity tests advocated by the Japanese Society for Tuberculosis (1% Ogawa solid media). The criterion of resistance to isoniazid was determined as follows: completely resistant to than 1 μg/ ml or higher, and incompletely resistant to 1 and 5 μg/ml of isoniazid.
    In 128 original treatment cases, 7 patients (5.4%) were completely resistant and 7patients (5.4%) were incompletely resistant to isoniazid. Among these 14 patients (10.9%), only 2 cases failed to convert to negative sputum. The other 126 patients, including notonly sensitive but also resistant cases, converted to negative. It is suggested that no cleardecrease in the efficacy of original treatment is seen, even if drug resistance exists in a fewcases, but we must be careful only for isoniazid-resistant cases, as treatment failure maybe found in a few isoniazid-resistant cases.
    In 68 patients of re-treatment group, 23 patients (33.8%) were completely resistant, and 7 patients (10.3%) were incompletely resistant to isoniazid. Among these 30 patients (44.1%), 15 patients failed to convert to negative sputum with various kinds of drugcombination treatment. As a whole, in re-treatment cases, isoniazid resistant patientswere frequently detected, and the more the number of resistant drugs, the less theeffectiveness of treatment. Moreover, much worse results were obtained in patientsshowing double resistance to isoniazid and rifampicin. Therefore, we should choose morecarefully the combination of anti-tuberculous drugs, not to make the other drugs resistant, especially not to make double resistance to isoniazid and rifampicin. But such a choice wasoften very difficult.
    Conclusively, isoniazid-resistance, and isoniazid-rifampicin double resistance arethought to give unfavorable influence on the efficacy of isoniazid-rifampicin combinationtreatment, especially in re-treatment. The attenuation of virulence of isoniazid resistanttubercle bacilli was not observed in our patients as the grade of isoniazid resistance was notso high.
  • 橋本 雅能, 横山 繁樹, 谷口 博之, 日開 誠子
    1987 年 62 巻 1 号 p. 25-29
    発行日: 1987/01/15
    公開日: 2011/05/24
    ジャーナル フリー
    A 33-year-old female suffering from pulmonary tuberculosis was treated with Rifampicin and INH.
    After a few days she felt bad, so she stopped by herself to take RFP and INH.
    Seven days later she again took INH, and had no side effects. However, the next morningbefore breakfast she took 450 mg RFP and in half an hour, she had nausea, vomiting, dyspnea and fever. Therefore, she was admitted to our hospital.
    On admission, her bloodpressure was 60/30 mmHg. pale edematous face, tachypnea, andpulse rate was 120/min.
    Chest X-ray showed small patchy shadow at left subclavicral area and a chest physicalexamination showed nothing particularly wrong. A bloodtest showed a little pancytopenia BRC 332-104, Hb. 9.8 g/dl, Ht. 29.5%, platelet 12.6-10 4, liver function; GOT 46, GPT 19, increaced serum bilirubin to 1.38 mg/dl; and bloodgasanalysis: Pa O2 48.7 Torr, Pa CO229. 4 Torr, pH 7.12; hypoxemia and acidosis.
    The patient was treated with a vasopressor by continuous drop infusion with diuretic and oxygen inhalation.
    Twelve days after the biginning of the disease the anaphylaxic shock was ceased andthe recovery of the patient was swift and remarkable, and she was then discharged.
  • 小松 彦太郎
    1987 年 62 巻 1 号 p. 31-36
    発行日: 1987/01/15
    公開日: 2011/05/24
    ジャーナル フリー
    Serum tumor markers (CEA, TPA, IAP and FRN) were measured in 36 patients withpulmonary tuberculosis before and during chemotherapy and the significance of serumtumor markers in pulmonary tuberculosis were compared to that in patients with lungcancer.
    By the chest X-ray on admission, serum tumor marker levels in the patients withcavity were higher compared with the patients without cavity.
    Serial measurement of serum markers were performed during chemotherapy. Serumlevel was increased untill three months after chemotherapy and thereafter decreased.
    At the active phase in pulmonary tuberculosis, serum tumor markers showed higherlevel. Thus, the measurements of serum markers are not always useful as a screening testfor patients with lung cancer.
    It is nessesary, however, to consider the coexistence of carcinoma in the case ofpatients with higher level of serum tumor markers or more than cut off level at two monthsafter negative conversion of tubercle bacilli.
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