巻号一覧
65 巻, 12 号
選択された号の論文の8件中1～8を表示しています
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特に胸水中CEA値, ADA活性値を中心に矢木 晋1990 年 65 巻 12 号 p. 775-783
発行日: 1990/12/15
公開日: 2011/05/24
ジャーナル フリーWe reviewed 327 patients with pleural effusion who had been examined at our department for identification of its cause during the 14 years between 1974 and 1987, and studied the percentages of definitive diagnosis by examining the pleural fluids of patients with malignant tumor and tuberculosis.We also measured the levels of carcinoembryonic antigen (CEA) and adenosine deaminase (ADA) in the pleural fluids of these patients and evaluated their diagnostic usefulness.We further carriled out a detailed clinical study of the factors affecting the CEA and ADA activities in the pleural fluids, which are considered to be particularly important in differential diagnosis of patients with pleural effusion.
Of 327 patients with pleural effusion, malignancy-related pleurisy was observed in 166 patients (50.8%), and tuberculous pleurisy in 85 (26.0%).The rate of definitive diagnosis based on the examination of the pleural effusion in these patients indicated that 20-30% of them pose difficulty in clinical diagnosis.CEA was positive in 64.7% of patients with malignancy-related pleurisy, and ADA was positive in 97.7% of those with tuberculous pleurisy. These suggested their usefulness as supportive diagnostic methods of those diseases. In addition, CEA was elevated in patients with complications such as empyema, suggesting an effect of non-specific cross-reacting antigen (NCA).ADA showed high values in patients with conditions related to cell-mediated immunological responses as well as empyema and hemolysis.It suggested the release of ADA from blood cells due to hemolysis.These factors must be carefully evaluated in the interpretation of the CEA and ADA activities in pleural effusion.抄録全体を表示PDF形式でダウンロード (963K) -
Mycobacterium tubercuLosis, M.avium ComplexおよびM.smegmatis間の耐性形式の比較束村 道雄1990 年 65 巻 12 号 p. 785-789
発行日: 1990/12/15
公開日: 2011/05/24
ジャーナル フリーThe resistance development pattern of Mycobacterium smegmatis strain 17023 (Jucho) to streptomycin and kanamycin was studied.The medium used was Ogawa egg medium, and the level of resistance was determined for each clone derived from single colony by the ‘actual count’ method. Hence, the resistance level was estimated as the highest concentration of drugs, in which small inocula consisting of 20 to 100 colony-forming units could grow after seven days incubation.Only one type of resistance mutants resistant to more than 1, 000μg/ml streptomycin was isolated and these mutants were also resistant to 8μg/ml kanamycin.On the other hand, only one type of kanamycin-resistant mutants resistant to 8μg/ml kanamycin was isolated and these mutants were also resistant to more than 1, 000μg/ml streptomycin. Accordingly, there was a complete cross-resistance relationship between streptomycin and kanamycin resistances. Therefore, there existed only one phenotype, which is simultaneously resistant to streptomycin and kanamycin. The mutants occurred at a rate of about 2×10-8 per viable bacterial population of the parent strain.Streptomycin-dependent mutants occurred at a rate of about 2×10-9.
The number of resistant phenotypes to streptomycin and kanamycin was only one in M.smegmatis, while it was five in M.tuberculosis and 2 or 3 in M.avium complex (Tsukamura, M.and Mizuno, S.: J. Gen. Microbiol. 88: 269-274, 1975 Tsukamura, M.: Kekkaku 62: 445-458, 1987).The simplicity of the resistance system of M.smegmatis suggests that this organism is evolutionally primitive in the world of mycobacteria.抄録全体を表示PDF形式でダウンロード (523K) -
亀田 和彦, 川幡 誠一, 益田 典幸1990 年 65 巻 12 号 p. 791-803
発行日: 1990/12/15
公開日: 2011/05/24
ジャーナル フリーA retrospective analysis was made for 644 patients with pulmonary tuberculosis newly diagnosed during the time of 1977 to 1985 to evaluate the influence of diabetes mellitus (DM) on the drug response rate and the long-term relapse rate in the treatment of tuber-culosis. These patients were divided into four groups: (1) 123 patients with DM on-9-to 12-month short course regimens; (2) 79 with DM on 13-to 36-month long-term regimens; (3) 379 nondiabetic patients on short-term regimens;and (4) 63 nondiabetics on long-term regimens.
Bacteriological relapse after chemotherapy was defined as positive cultures growing at least 20 or more colonies.
1) Bacteriological negative conversion rates were similar in both diabetic and nondiabetic patients who had received combination regimens including INH and RFP. The degree of control of DM did not affect the conversion rate.
2) Of 297 patients who had received short-course chemotherapy and the information for analysis were available as of August 1989, 8 (10.3%) had relapses in 78 diabetic, and patients 23 (10.5%) in 219 non-diabetic patients;the difference was not statistically significant. There were also no discernible differences in the relapse rates between patients on the short-course regimens and those on the long-term regimens.
3) Most of the relapses occurred around 6 months and 30 months after completing the short-course chemotherapy.Similar pattern of relapses was observed also in the long-term therapy group.
4) Pretreatment radiographic findings and quantity of the acid-fast bacilli in the sputam, and the presence of cavitary lesions at the completion of therapy bore no significant relation to the development of relapse.
5) In the diabetic patients the degree of control of DM contributed little to the development of recurrence.
6) Although most of the patients without DM relapsed with sensitive strains and achieved a good response to retreatment, diabetic patients frequently relapsed with resistant strains and had a grave prognosis.
7) Of 41 patients who died after having been on the short-course regimens, two were attributed to tuberculosis. Only one was attributed to tuberculosis of 25 patients who died after receiving the long-term regimens.
8) The data obtained here confirmed that the 12-month regimen for diabetic patients could achieve favorable results in the response rate and the long-term relapse rate, as that for nondiabetic patients.However the cases of tuberculosis complicated with DM frequently showed a poor prognosis once the relapse took place.These results suggest that pyrazinamide-containing 4-drug combination regimens in an initial intensive phase is the preferred treatment for the patients with DM.抄録全体を表示PDF形式でダウンロード (1440K) -
山本 誉, 網谷 良一, 久世 文幸, 鈴木 克洋1990 年 65 巻 12 号 p. 805-810
発行日: 1990/12/15
公開日: 2011/05/24
ジャーナル フリーThe in vitro anti-M.tuberculosis and anti-M.avium complex activities of five new rifamycin der vatives, KRM1648, KRM1657, KRM1668, KRM1674 and KRM2312, provided, by Kanegafuchi Chem. Ind. Co. Japan were evaluated and compared with those of rifapicin (RFP) and rifabutin (RBU).
Antimycobacterial activity was tested by broth dilution method using Kirchner's liquid medium supplemented with 10% bovine serum. The MICs 90 (μg/ml) of all five KRMs and RBU for 20 clinical isolates of M.tuberculosis were 0.035-0.07, whereas that of RFP was 1.25.The new rifamycin derivatives showed 16 to 32 times lower MICs than those of RFP against M.tuberculosis.
All five KRMs inhibited 100% of 20 clinical isolates of M.avium complex at a concentration of 1.25 μg/ml, while only 35% and 10% of the strains were inhibited by the same concentration of RBU and RFP, respectively. The MICs 90 (μg/ml) for the strains tested were 0.07-0.3 for all five KRMs, and 5 and 40-80 for RBU and RFP, respectively.The new rifamycin derivatives were 16 times more active than RBU, which was 8 times more active than RFP.
The new rifamycin derivatives were far more effective against M.tuberculosis in vitro than RFP, and their superiority to RBU which showed the effect superior to RFP was notable in in vitro anti-M.avium complex activities.抄録全体を表示PDF形式でダウンロード (678K) -
陶山 時彦, 佐藤 浩昭, 井上 亨, 野口 佳子, 大塚 盛男, 吉澤 靖之, 長谷川 鎮雄, 塚田 次郎, 石田 裕1990 年 65 巻 12 号 p. 811-819
発行日: 1990/12/15
公開日: 2011/05/24
ジャーナル フリーA 55-year-old man was admitted with complaints of remittent fever (39°C) and dyspnea on exertion which began ten days previously. His family and past histories were non-contributory for diagnosis except his occupation as a stone mason for 26 years. The chest X-ray film taken on admission showed diffuse small nodular shadows associated with small amounts of pleural effusion and bilateral hilar adenopathy.Arterihl blood gas analysis showed severe hypoxemia and hypocapnea (PaO2 32.2 Torr, PacO2 31.6 Torr). The serum level of LDH was 985 IU/L and ACE was 49.0 IU/L, lysozyme was 28.8, μg/ml. Biopsied materials of the lung obteined by TBLB, liver and bone marrow showed noncaseating epithelioid granuloma without caseating necrosis. T-lymphocyte ratio increased in BALF. The patient was diagnosed to have sarcoidosis. The administration of predniso lone was initiated, which resulted in a marked improvement of clinical data including chest X-ray films, BGA, LDH, ACE and lysozyme.抄録全体を表示PDF形式でダウンロード (8976K) -
寺尾 一郎, 田野崎 隆二, 藤野 忠彦, 斎藤 武文, 渡辺 定友, 玉井 誠一1990 年 65 巻 12 号 p. 821-825
発行日: 1990/12/15
公開日: 2011/05/24
ジャーナル フリーMiliary tuberculosis associated with cutaneous lesion has been rarely reported.We report a case of miliary tuberculosis in whom the cutaneous lesion was confirmed as tuber culosis by skin biopsy and bacrerial examination.A 46-year-old man was admitted because of cough, fever, sore throat and abnormal shadow on the chest X-ray. Physical examination revealed an emaciated man with two ulcerous lesions overlying yellowed crust on the chest wall and fine crackles on the left side of the lung.Laboratory workup revealed a white blood cell count of 10, 000 with 15% lymphocytes and positive CRP. Chest X-ray film showed the infiltration with cavity formation in left upper lung field and nodular dissemination. His tuberculin reaction was negative on admission.Sputum, urine and secrete from cutaneous lesion were positive for the acid-fast bacilli and the culture grew Mycobac terium tuberculosis. Examination of the skin biopsy specimen and bone marrow aspiration showed Langhans giant cells around necrotic lesion;therefore the diagnosis of miliary tuberculosis was made.After an initiation of antituberculosis therapy with combined regimen composed of streptomycin (SM), isoniazid (INH), ethambutol (EB) and rifampicin (RFP), this patient improved significantly. Although the case report of miliary tuberculosis tends to increase recently, the report of cutaneous lesion is relatively rare in association with miliary tuberculosis.We discussed this subject with reference to the literatures.抄録全体を表示PDF形式でダウンロード (3985K) -
米田 良蔵1990 年 65 巻 12 号 p. 827-882
発行日: 1990/12/15
公開日: 2011/05/24
ジャーナル フリーPDF形式でダウンロード (9629K) -
厚生省保健医療局結核・感染症対策室編1990 年 65 巻 12 号 p. 883-884
発行日: 1990/12/15
公開日: 2011/05/24
ジャーナル フリーPDF形式でダウンロード (248K)
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