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Volume 62, Issue 4
Displaying 1-4 of 4 articles from this issue
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Yoshinobu OHSAKI, Fumiko MITO, Yuji IKEDA, Eiichi SAKAI, Sokichi ONODE ...1987 Volume 62 Issue 4 Pages 205-210
Published: April 15, 1987
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA tuberculosis epidemic in a business office in a rural area of “A” city was reported.
Five patients of lung tuberculosis and/or pleurisy were found out of eighteen personsconcerned. Case 1 was 35 year-old man who was detected an, abnormal shadow on hischest roentgenogram by a doctor who treated his vocal code polyp, and referred to ourhospital. His chest abnormal it was detected five years ago, and has been followed up underthe diagnosis of inactive lung tuberculosis. Though he had both familial and personalhistory of lung tuberculosis, no sputum examination was done. On admission his sputumsmear was Gaffky 9 and his chest roentgenogram showed an infiltrative shadow with acavity in the right upper lobe. Case 2 was 48 year-old female with cough and hemoptysis.
She was treated by a neighboring general practioner under the diagnosis of lung tuberculosis.
Because of increase of cough and hemoptysis she was referred to us, then her sputum smearwas Gaffky 2. Her chest roentgenogram showed an infiltlative shadow with a cavity inthe right upper lobe. Case 3 was 17 year-old female with fever and right chest pain.
Although M. tuberculosis was not detected, her chest roentgenogram showed an infiltrativeshadow in the right upper lobe and right pleural effusion. Case 4 was 17 year-old female.
She had no complaints, but she wanted to be examined because she was a friend of case 3. M. tuberculosis was not detected, but her chest roentgenogram showed an infiltrativeshadow in the left upper lobe. Case 5 was 29 year-old man, whose abnormal shadow wasdetected by the routine chest X-ray examination. M. tuberculosis was not detected, butchest roentgenogram showed left pleural effusion.
Case 1 had not undergone a medical check up in the year when the epidemic occured.
As he had been said that his abnormal shadow on the chest roentgenogram was curedtuberculosis, he believed that his lung tuberculosis had cured already. The causes of presenttuberculosis epidemic might be patient's ignorance of the recurrence of lung tuberculosisand insufficient instruction of doctors to the patient. The role of the doctor who are incharge of the routine health check-up was stressed.View full abstractDownload PDF (6024K) -
Nobuchika KUSANO1987 Volume 62 Issue 4 Pages 211-227
Published: April 15, 1987
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDetection of IgG antibodies against purified protein derivative (PPD) prepared fromMycobacterium tuberculosis strain Aoyama B and alpha antigen, a homogeneous proteinprepared from M. tuberculosis strain H37Rv by immunosorbent affinity chromatography, was done by a method of enzyme-linked immunosorbent assay (ELISA) and its diagnosticusefulness was also evaluated in this study. Sera from 80 patients with active pulmonarytuberculosis, 25 patients with inactive tuberculosis, 200 healthy adults, 117 healthy children, 84 patients with diseases other than tuberculosis and seven patients due to atypicalmycobacteria were examined. The titer of each test serum was calculated by a computersystem using the standard curve obtained by serial dilution of a standard serum. Use ofphosphate buffer saline (PBS) with gelatin as blocking buffer in ELISA showed considerablyuseful results than the use of PBS with bovine serum albumin.
Patients with active pulmonary tuberculosis showed statistically higher amount of IgGantibodies against PPD or alpha antigen than other groups (p<0.001). The sensitivitywas 73.8% and the specificity was 97.0% at a cut-off titer of 1: 330 in and-PPD antibodyassay. On the other hand, the sensitivity was 77.5% and the specificity was 93.3% at acut-off titer of 1: 540 in and-alpha antibody assay. However, the sensitivity of 91.3% and the specificity of 91.7% could be obtained with parallel application of both assays.
Slight elevation of antibody titers was observed in the first or second month afteradministration of some anti-tuberculosis drugs and then these titers decreased gradually.
Seven false-negative cases in active tuberculosis were observed in two patients with hypogamma-globulinemia, two casts with diabetes mellitus and three cases of fresh pulmonarytuberculosis without chemotherapy, and five of these false negative cases were positive onsmear stained by Ziehl-Neelsen's method.
From these results, it is concluded that judgment by combination of several antibodyassays using different antigens of M. tuberculosis is helpful in the diagnosis of activepulmonary tuberculosis when compared with any assay using single antigen. In addition toabove, the measurement of antibody to M. tuberculosis will be also a useful marker for thejudgment of the chemotherapeutic efficacy or clinical improvement.View full abstractDownload PDF (2037K) -
Fumio YAMAGISHI, Kiminori SUZUKI, Noriko MURAKI, Hiroshi KIMURA, Yoshi ...1987 Volume 62 Issue 4 Pages 229-233
Published: April 15, 1987
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe reported a case who suffered from multiple tuberculoma of the brain.A 40-year-old woman admitted with slight fever, productive cough, and weight loss.
She had miliary tuberculosis of the lung and treated with isoniazid 0.4g, ethambutol 0.75g, and rifampicin 0.45g daily.
About three months later. she was discharged recoveringin almost all good condition, but she readmitted within one month because of weakness of both legs and gait disturbance.
Computed tomography of the brain revealed multiple small nodular lesions with ringenhancement in cerebral cortex, basal ganglia and cerebellum.
Diagnosis was made as multiple tuberculoma of the brain.
Although the treatment is continued, neurological symptoms are slowly progressing.
We consider her prognosis is poor.View full abstractDownload PDF (6463K) -
Michio TSUKAMURA1987 Volume 62 Issue 4 Pages 235-238
Published: April 15, 1987
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS1. An ofloxacin-highly resistant strain isolated from the Ravenel strain of Mycobacteriumbovis showed no marked increase in the number of viable bacteria in the mouse liver and was considered to have an attenuated virulence to mice.
2. An ofloxacin-lowly resistant strain isolated from the Ravenel strain had an increase inthe number of viable bacteria in the mouse liver as had the parent strain. However, theincrease did not occur in the mice treated by ofloxacin (daily administration of 1 mg perday by intraperitoneal injection). Ofloxacin was to some extent effective in the treatmentof mice challenged by ofloxacin-lowly resistant strain.View full abstractDownload PDF (379K)
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