The number of rRNA genes in Mycobacterium phlei was determined by means of Southern hybridization analysis.The results indicated that M.phlei possesses at leas and probably 2 sets of rRNA genes.Based on the results together with our previous reports on Mycobacterium bovis BCG and Mycobacterium lepraemurium, the relationship between slow growth and rRNA genes was discussed.

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Since 1979, a five year mass screening for lung cancer was performed on 1, 906, 660 general habitants of Chiba Prefecture by using rolled radiophotogrammes (RP) taken as a traditional mass screening for tuberculosis.Out of the examined, 270 lung cancer cases were found.As yearly number of RP is so numerous, amounting to around 400, 000, it requires many physicians to interprete these films, and a few of them are specialists on lung cancer.In order to evaluate the quality of RP interpretation retrospectively, these physicians were divided into the following five groups;specialists on mass screening for tuberculosis, specialists on lung cancer, physicians of public health centers, physicians of sanatoria and general practitioners.Regarding the 270 lung cancer cases, the specialists on mass screening for tuberculosis did not overlook abnormal shadows on RP, however, the of correct reading as lung cancer was the highest in the group of specialists on lung cancer.
In conclusion it is desirable that the physicians who read the RP as a screening for lung cancer shoud have sufficient knowledge of lung cancer itself, along with a good skill in reading rolled radiophotogrammes.

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Chronic acneiform eruptions during administration of anti-tuberculosis drugs are found clinically with considerable frequency.In our study, the overall incidence of acneiform eruptions were19%out of88subjects, and observing by sex, 15out of 70 men (21%) and2out of18women (11%).
We have investigated, in the present study, the endocrinological changes in relation to chronic acneiform eruptions.Inpatients of our hospital who were given INH were recruited and hormone levels in the blood were determined before and at a certain interval after commencement of treatment with INH. A total study subjects were88consisted of70men and18women.The hormones tested were progesterone, testosterone and3fractions of estrogen taken from the route of sex hormones.At the same time, 2fractions of17KS in the urine were analyzed to evaluate the effects on the adrenal.
Testosterone was found to be increased in almost all men at2months of INH treatment.As for3fractions of estrogen, a distinct increase was observed in estrone and estradiol levels in men compared with those before INH administration.Concerning 2 fractions of 17 KS, a significant increase with time in 11-DOXY-17 KS was obvious in male patients.
In general, the relation between acneiform eruptions associated with INH treatment and VB₆ has been noticed.From our observations in the present study, as a causative drug of acneiform eruptions accompanied with the treatment of tuberculosis, INH is most suspected.Moreover, it cannot be completely denied that sex hormones such as testosterone, as well as deficiency of VB₆, nicotinic acid, might be involved in the occurrence of acneiform eruptions.

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In vitro and in vivo antimycobacterial activities of a cephem antibiotic, cefpimizole (CPIZ), and its effect on the oxygen metabolism of host macrophages were studied and the following results were obtained.CPIZ was weakly active against tested mycobacteria.
Phorbol myristate acetate (PMA)-triggered chemiluminescence (CL) of peritoneal cells harvested from mice injected intraperitoneally (ip) with 5 mg CPIZ was higher than that of cells from control (untreated and saline-treated) mice and cefoxitin (CFX)-or cefotetan (CTT)-injected mice.PMA-triggered O2-producing ability (NBT-reducing ability) of macrophages from mice injected ip with 5 mg CPIZ was also higher than that of control mice.However, macrophages from CFX-or CTT-injected mice showed the same level of O₂-producing ability to that of control mice.
CPIZ showed a therapeutic effect against experimental murine infection due to Mycobacterium fortuitum but not against M.avium complex infection.

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A case of bilateral cervical tuberculous lymphadenitis of85-year-old male showing multiple abscesses with cutaneous fistula associated with caseous hilar lymph node ruptured into the right bronchus revealed by bronchofiberscopy and lymph nodes swelling in the hilum and mediastinum by chest radiography was reported.
As large matted painless swelling and induration measured75×60mm suggesting malignancy were seen in the left upper neck, and it was unable to identify tuberculosis by biopsy of the suppurating abscess at the beginning, the diagnois of tuberculosis was delayed for6months since the onset of the disease until the case of consulted to our clinic.The author stressed that in the differential diagnosis of cervical lymph nodes swelling, tuberculosis still remains one of the most probable diseases.

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As BCG vaccination is compulsory for all the tuberculin negative reactors at three points during their life, namely, bef or 4 years, at 6 years and/or 12 years of age, and the coverage is as high as nearly 95%of the age six, it is found that tuberculin test is very often not reliable as a means to reveal tuberculosis infection and its result is often wrongly interpreted in Japan.As a result, the present status of tuberculosis infection is so obscure that the author was lead to make a review of recent problems regarding tuberculosis infection in Japan at this Annual Meeting.
The confusions in interpreting the results of the tuberculin test originate from the following: 1) high coverage of BCG vaccination, 2) rather rapid wanning of post vaccination allergy, 3) so-called booster effect of interim tuberculin testing, 4) late appearance of tuberculin reaction among children whose post-vaccination had already waned, 5) possibility of atypical mycobacterial infection in Japan, and 6) rare occurrence of tuberculosis infection among children.All these problems were discussed briefly.
All the newly registered cases of infants and children tuberculosis in Tokyo (excluding 23 wards) in this five year period were analysed.It was confirmed that as high as 28.5% of the cases were mis-diagnosed because of the difficulties of diagnosing tuberculosis in children, and the source of infection was detected in 100%of the cases under 4 years of age and in 60%of the cases of those 0-14 years of age.The severity of the disease wa almost the same between cases whose source of infection was detected and those it was not detected.
Recently group infection of tuberculosis is quite often reported from primary, middle and high schools and so on, in spite of high coverage of BCG vaccination.The risk factors of the occurrence of group infection were investigated.The results show that the risk of group infection is high in patients whose sputa contain more than one tubercle bacilli in each microscopic field on smear examination, and who complained of severe coughing more than 3 months before the detection of the disease.The author discussed the possibility of the tuberculosis infection among the aged because about 20-30%of the aged showed negative tuberculin reaction in repeated tuberculin testing.
The annual reduction rate of tuberculosis incidence was 11%up to 1977, but it decreased to a rate of 5.5% there after.This slowing down in the rate of decrease of the incidence is observed in all over Japan, and is marked among younger generations less than 39 years of age.Although the reason of this slow-down is not clear yet, one can say that this is not caused by the artificial factors such as the change of diagnostic criteria, reporting rate, BCG vaccination policy and so on. The possible reasons for the decrease in the rate of decrease in the risk of tuberculosis infection was discussed.

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Among many problems of the tuberculous infection today the speaker focussed on its recent trend in Japan with special reference to the estimation of the risk of infection based on the tuberculin tests and its relationship with the trend of the tuberculosis incidence.
Theoretical considerations were made of the validity of the tuberculin test for the purpose of diagnosing the infected in an extremely low prevalence situation of infection such as among young infants of present day Japan.Because the conventional 10mm cut-off can hardly be accepted, an alternative method was applied to the results of test of the unvaccinated children in which proportion of those with erythema of 30 mm or more was doubled to arrive at an estimate of the prevalence of infection.The estimates of the risk of infection thus derived for some recent years were not very much different from the theoretically predicted ones using the formula based on the TSRU's method applied to the prevalence survey tuberculin data in Okinawa 1968 and 1973.However, it is still possible that the downward trend in the risk of infection has slowed in accordance with the slower decreasing trend of the disease incidence during last several years.
The above confirmed trend in the risk of infection was used to predict the various features of the infection such as cohort prevalence, age-specific infection prevalence and proportion of recent (within 5 years of infection) infection by age-group.Comparison of the prevalence of infection with that of the incidence of tuberculosis gives an estimate of the risk of clinical breakdown.In this way it was supposed that the clinical breakdown rate for all ages had been decreasing from the early 1960s untill the early 1980s when the downward course of the clinical breakdown rate has leveled off.This may be related to the change of the proportion of the recent infection among the infected such that its downward course has become reversed or leveled off, first for age 15 years about 1980, followed by the older ages, as calculated with the formula of the risk of infection.Concerning the recent trend of the relationship between infection and clinical disease, the speaker also suggested that the relevance of the recent change in the clinical picture of the disease, eg.increasing predominance of male cases over females and the rise in the proportion of bacillary cases among total new cases.There is much to be done in clinical epidemiology in these areas.
The value of the BCG vaccination in a very low infection risk situation such as above was discussed, especially the effectiveness of the revaccination scheme as being practised in Japan.A model analysis suggested that a BCG revaccination given after the primary vaccination at the age of one has rather small additional impact.Revaccination given at the age of 12 would be of still smaller benefit than that at 6 years of age, although some conditions for the analysis should be further carefully discussed.

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