1. In the year 1985, a total of 2, 507 patients with lung tuberculosis and/ or nontuberculous lung mycobacteriosis were admitted to the 11 participitating hospitals, and, of these, 150 (6.0%) had nontuberculous lung mycobacteriosis. The species which caused lung disease were as follows: Mycobacterium avium complex 99 (66.0%), M. kansasii 39 (26.0%),
M. fortuitum 6 (4.0%), M. chelome subsp. chelonae 3 (2.0%), M. scrofulaceum 1 (0.7%), M. szulgai 1 (0.7%), and M. nonchromogmicum 1 (0.7%).
2. The incidence rate of active lung tuberculosis in Japan in the year 1985 was 44.0 per 100, 000 population. The incidence rate of nontuberculous lung mycobacteriosis in the year 1985 was calculated as 2.64 per 100, 000, and that of the M. avium complex lung disease as 1.74 per 100, 000 and that of the M. kansasii lung disease as 0.69 per 100, 000.
3. Incidence of nontuberculous lung mycobacteriosis was high, as was until now, in the South coast of the Honshu Island, Kanagawa, Aichi, Osaka and Okayama prefectures.
4. The ratio of the patients with nontuberculous lung mycobacteriosis agaisnt the patients with all lung mycobacteriosis including lung tuberculosis is increasing and has reached 6.0% in the year 1985. Bed occupation rate of the nontuberculous mycobacteriosis patients also increased to 14.6% in the year 1985.
5. The average age of male patients with lung disease caused by M. kansasii was 50.9±13.8 (n=158) and was significantly lower than the age of patients with lung disease caused by M. avium complex. However, the average age of female patients with disease caused by M.kamasii was 58.8±19.7 (n=17) and was statistically significantly higher than the age of male patients (t-test, Pless than5%).
6. The incidence rate of nontuberculous lung mycobacteriosis seems to be increasing since 1984. This increase is probably due to increase of the incidence of lung disease caused by M. kansasii since 1978.

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During 39 months period from October, 1975 to December, 1978, 520 patients withpulmonary tuberculosis were randomly allocated to four drugregimens-3RHS/3RHS2, 2RHES/4RHE, 2RHZS/4RHZ, 2RHZE/4RHZ-with each group consisting of 130 cases.
Patients eligible for the trial had to satisfy the following criteria:
i) Admission to our hospital,
ii) No previous treatment, or treatment for less than 15 days.
iii) Smear test was positive for tubercie bacilli.
iv) Aged 15 years or more,
v) Size of cavity less than 5 cm.
Seventy six cases were subsequently excluded and 444 remained for the follow up studies.
We have previously reported that the bacteriological relapse rated uring 3 years after the end of chemotherapy for the pyrazinamide groups was 2% and that for the other groups was 10%. On that occasion, we included cases which were resistant to the drugs and or who had complications such as empyema, diabetes mellitus. In this study, we divided the 444 cases into two main groups, A and B (Table 2), with the focus of interest being placed on Group A without drug resistance and complications.
The conversion ratesat 8 weeks and relapses during the first 2 years and 6 years after the chemotherapy was terminated are shown in Tables 3 and 8 respectively. All cases converted to negative after 5 months, and 98% after 3 months. As to relapse, 69% occurred within one year and 85% with in 2 years. After 2 years, two relapses occurred, one at 51 months from the RHS group and the other at 65 months from the RHZS group.
If we consider only the relapses which occurred during the first two vears. then 4 out of 176 (2.3%) patients from the pyrazinamide groups with 95% confidence limits being 0.6-5.8%, and 7 out of 165 (4.2%) patients from the groups without pyrazinamide relapsed. Although the PZA groups showed lower relapse rate than the other groups, the difference was not significant. However, the superiority of the PZA groups was strikingly shown in Group B (Table 9).
The contribution of SM in the prevention of relapse appears to be doubtful as all the relapses occurred in the SM sensitive patients and not in the SM-resistant patients. Moreover, the interruption or termination of SM therapy in the early stages of treatment had no effect on the occurrence of relapse.
The resistance pattern of tubercle bacilli at the time of relapse was exactly the same as pretreatment status, except for one case which was on the borderline between resistant and sensitive.
The factors which significantly affected the occurrence of relapse were:
i) Severity of the illness,
ii) Negative culture at 8 weeks,
iii) A remaining cavity at the end of chemotherapy.
As to other factors such as sex, age, cavity size at the beginning of chemotherapy, no relation with relapse could be found.
Finally, confining to slight cases (moderatels advanced or minimum by NTA classification) inclnding A and B groups, the bacteriological relapse rate during 6 years after the end of chemotherapy was 0.6% (1 out of 161 patients) for the PZA groups with 95% confidence limits being 0.02-3.5%, and 5.9% (9 out of 152) for the groups without PZA with, the confidence limits being 2.7-11.2%.

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We studied the auscultatory findings in 117 patients with pulmonary tuberculosis and described findings using the new classification and terminology of lung sounds. The main auscultatory findings were bronchial breath sounds which were heard in 42 / 117 (35.9 %), and coarse crackles in 46 / 117 (39.1 %), respectively.
Auscultatory findings were also evaluated against chest X-ray. The infiltrative type (Type I) had fewer abnormal findings than the other 2 types. The sclerotic type (Type II), was characterized by bronchial breath sounds which were found in 29/57 (50.9%) and was often accompanied by coarse crackle which were found in 26/ 57 (45.6%). Severe or mixed type (Type III) presented auscultatory abnormalities and variegated sounds, i. e. bronchial breath sounds in 10/15 (66.7%) and coarse crackles in 12/15 (80.0 %).
Coarse crackles were auscultated in 50.0-55.6 % of patients expectorated sputa, but were not auscultated in patients with little sputa.

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Clinical isolates of Mycobacterium tuberculosis were considered as a group of homogeneous strains showing similar or, if any, only slightly different susceptibilities to antituberculosis agents, whereas those of Mycobacterium avium complex as a group of heterogeneous strains showing greatly different susceptibilities to the agents.The M. avium complex strains had been considered as resistant to most antituberculosis agents and their levels of the resistance were never studied in detail. The results of the present study revealed that they were not uniformly resistant but greatly different in their susceptibilities to antituberculosis agents.

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A resected case with massive hemoptysis due to M. scrofulaceum lung infection was reported.
The patient was 39 years old housewife with massive hemoptysis and had no underlying disease. We observed a bulge of bronchial arterial lesion that may have caused hemorrhage, bronchoscopically. Bronchial arteriography demonstrated hypervascularity, dilatation and bronchopulmonary anastomosis. The bulging lesion in bronchoscopy corresponded to the hypervascular areas. This patient was treated with bronchial arterial embolization for management of hemorrhage, which resulted in complete disappearance of hemorrhage.
M. scrofulaceum was isolated from sputum repeatedly and from bronchial lavage fluid. Two months later, she had recurrent hemoptysis and then recieved lobectomy of the right middle and lower lobes.
The resected specimens revealed the intrabronchial bulging lesion corresponded to an angiomatoid vascular convolution in a scarred, deformed bronchial wall or peribronchial tissue due to M. scrofulaceum infection.

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A 74-year old man suspected of lung cancer was admitted for the precise examination to our hospital because of an abnormal shadow on his chest X-ray film. The bronchofiberscopic examination showed submucosal tumor of the middle lobe bronchus suspecting malignancy. However, the open lung biopsy revealed mucosal extension of submucosally confined tuberculous lesions in the middle lobe bronchus, which does not extend to respiratory epithelium.

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