Kekkaku(Tuberculosis)
Online ISSN : 1884-2410
Print ISSN : 0022-9776
ISSN-L : 0022-9776
Volume 66, Issue 10
Displaying 1-7 of 7 articles from this issue
  • Haruaki TOMIOKA, Katsumasa SATO, Hajime SAITO
    1991 Volume 66 Issue 10 Pages 643-649
    Published: October 15, 1991
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    Sparfloxacin (SPFX), a new quinolone, was studied its in vitro and in vivo activities against various mycobacteria, especially Mycobacterium intracellulare. SPFX exhibited a potent in vitro activity against M. tuberculosis, M. kansasii and M. fortuitum with MICH values of 0.2, 6.25 and 1.6 μg/ml, respectively, and the potency of SPFX was higher than that of ofloxacin (OFLX). M. marinum, M. scrofulaceum, M. avium, M. intracellulare, M. chelonae (subsp. abscessus and chelonae) were resistant to SPFX. SPFX inhibited the growth of M. intracellulare in 7H9 broth when added at the concentration of 0.2 μg/ml and rapidly killed the organisms at the dose of 1 μg/ml. The activity of SPFX was higher than that of OFLX. SPFX exhibited a greater antimicrobial activity against M.intracellulare phagocytosed by murine peritoneal macrophages than did OFLX.
    SPFX exhibited a weak therapeutic activity against M. intracellulare infection induced in mice, on the basis of the rate of bacterial elimination in the host lungs and spleen, but such an efficacy was not noted for OFLX. SPFX combined with rifampicin (RFP), or in combination with RFP and kanamycin yielded a slightly increased therapeutic efficacy, based on the degree of pulmonary gross lesions in host animals or CFU of organisms in the lungs and spleen.
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  • Pulmonary Infection Caused by Mycobacterium hansasii has Begun to Appear in All Over Japan Including North Japan Hokkaido
    Nobuhiko KITA, Michio TSUKAMURA, Akihiko KUZE, Atsushi SHINODA, Atsuyu ...
    1991 Volume 66 Issue 10 Pages 651-659
    Published: October 15, 1991
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    In this study, the Mycobacteriosis Research Group of the Japanese National Chest Hospitals (MRG) presents the reports of study years 1987 and 1988. As reported previously, pulmonary infection caused by Mycobacterium kansasii occurred principally in South-West Japan (prefectures South-West of Tokyo) and did not appear in North Japan. However, this disease appeared in 1987 and 1988 in Hokkaido (Sapporo Hospital). Accordingly, we may say the disease occurs all over Japan. This is a noteworthy finding newly recognized in the study years. The prevalence rate of nontuberculous lung mycobacteriosis was determined as 2.92 or 2.78 in 1987 and as 2.02 or 1.91 in 1988 per 100, 000 population per year. The estimated rates based on the ratio of nontuberculous lung mycobacteriosis against active lung tuberculosis and based on the ratio of nontuberculous lung mycobacteriosis against culture-positive lung tuberculosis well agreed with each other (refer to Tables 1, 2, 4 and 5).
    Comment: In this country, chest physicians customarily report their cases of nontuberculous mycobacteriosis including lung tuberculosis, bacause the payment of treatment for patients with tuberculosis is free. Because of this custom, tuberculosis statistics surely contain cases of nontuberculous mycobacteriosis. Caution about this has been paid in calculating the prevalence rate.
    From the study year 1987, the MRG chairman moved from Michio Tsukamura, The National Chubu Hospital, to Nobuhiko Kita, The National Kinki Chuo Hospital.
    Tsukamura, M., Kita, N., Shimoide, H. et al.: Am Rev Respir Dis, 137: 1280-1284, 1988 Tsukamura, M., Kita, N., Shimoide, H. et al.: Kekkaku 63: 493-499, 1988.
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  • 379 Cases at 4 Health Centers in 1985
    Kazuhiko KAMEDA, Akiko OKAZAWA, Masatoshi ISHIDA, Eizo KANOH, Masaaki ...
    1991 Volume 66 Issue 10 Pages 661-669
    Published: October 15, 1991
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    Using the registration card of tuberculosis patient, a retrospective analysis was made on newly registered 379 patients with pulmonary tuberculosis in 1985 to examine the treatment duration, the outcome, the duration of registration, and bacteriological relapse. These patients were divided into three groups according to the results of bacteriological examination at the time of registration: (1) patients with positive-bacilli (Group A) (2) patients with negative-bacilli (Group B) and (3) patients without results of bacteriological examination (Group C).
    1) Number of cases were 164 (43.3%) in the group A, 130 (34.3%) in the group B, and 85 (22.4%) in the group C. Sputum specimens from 68 patients (80.0%) of the group C were negative on smear, however, the results of culture were not obtained, and remaining 17 cases (20.0%) were not examined bacteriologically.
    2) 54 patients (32.9%) in the group A, 25 (19.2%) in the group B, and 17 (20.0%) had a previous history of tuberculosis, respectively.
    3) Number of patients with cavitary lesions at the time of registration were 105 (64.0%) in the group A, 46 (35.4%) in the group B, and 14 (16.5%) in the group C. Patients in the group A showed the highest rate of cavitary lesions.
    4) Number of patients receiving treatment less than 12 months were 73 (53.3%) in the group A, 92 (85.2%) in the group B, and 47 (73.5%) in the group C, respectively.
    5) 317 patients (83.6%) were omitted during 5 years of period from registration although 62 (16.4%) were still under registration even after 5 years. Out of 317 patients omitted from the registration, 197 (52.0%) were omitted because of cure, 24 (6.3%) change in diagnosis, 34 (9.0%) transfer out, and 62 (16.4%) death. There were noticeably high rates of death within a year and alteration of diagnosis in the groups B and C compared than in the group A. Comparing with patients in groups B and C, however, patients in the group A most frequently died of tuberculosis (6.3%).
    6) Proportion of patients with no-tuberculous diseases was estimated at about 10% of the patients registered, and these patients were frequently seen in the groups B and C.
    7) Of the 18 patients who were retreated after the completion of original chemotherapy, positive cultures were obtained only in four patients. These four patients corresponded to 1.5% of the 259 patients who completed follow-up after the completion of chemotherapy. When the analysis was confined to patients treated for 6- to 13-month, the relapse rate was 1.3% of the 170 patients.
    The data obtained here indicates the importance of the supervision of tuberculosis patients to accurately collect the results of the bacteriological examinations not only at the time of registration but also at the time of beginning of retreatment. As considerable number of patients with negative-culture or no bacterial examination who were listed as tuberculosis assumed to be non-tuberculous diseases, we should make every efforts to eliminate the false diagnosis to save our work in the control of tuberculosis. At the same time, sputum smear positive cases should be given top priority in case-holding.
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  • On the Regional Difference of the Incidence of Pulmonary Diseases Due to M. kansasii and M. avium Complex in Tokyo Area
    Hisao SHIMOIDE, Toru FUKUI, Eiko ANZAI, Seiji MIZUTANI
    1991 Volume 66 Issue 10 Pages 671-677
    Published: October 15, 1991
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    On 397 patients with pulmonary disease due to nontuberculous mycobacteria (NTM) [102 due to M. kansasii (MK) and 295 due to M. avium complex (MAC)] observed at National Tokyo Chest Hospital, 191 patients with pulmonary disease (59 due to MK and 132 due to MAC) observed at Fukujiiji Hospital of Antituberculosis Association and 257 patients from whose sputum MK (36) or MAC (221) were isolated in Byotai-Seiri Clinical Laboratory, the distribution of these patients by domicile in Tokyo area was analysed. The percentage of patients with MK disease among the whole patients with MK disease and MAC disease (MK ratio) in each community area was investigated.
    MK ratio was 30.9% in the 23 wards and 16.4% in Tama section of Tokyo in the patients observed at National Tokyo Chest Hospital. It was 37.0% in the 23 wards and 32.1% in Tama section in the patients observed at Fukujiiji Hospital and was 17.7% in the 23 wards and 8.1% in Tama section in the patients observed at Byotai-Seiri Clinical Laboratory MK ratio in Tokyo was considerably higher in the 23 wards that were densely populated industrial and commercial areas than in Tama section, a comparatively sparsely populated suburb. MK ratio in patients of O ta Hospital located in the 23 wards was higher (36.4%) than that of Tachikawa-Sogo Hospital located in Tama area (10.0%).
    Regional differences in MK ratio were remarkable in Tokyo area. A high MK ratio appeared to correlate with a high incidence rate of tuberculosis.
    From the results mentioned above, it was suggested that M. K. disease may be transmitted from person to person.
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  • ANTIMYCOBACTERIAL ACTIVITIES OF RIFAMYCIN DERIVATIVES
    Fumiyuki KUZE
    1991 Volume 66 Issue 10 Pages 679-685
    Published: October 15, 1991
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    The Standard Initial Chemotherapy, chemotherapeutic activity of which depends mostly on the two potent bactericidal drugs, INH and RFP, has made a remarkable progress in the treatment of tuberculosis.
    However, certain difficult situations still remain in the treatment of resistant diseases, mostly in retreatment cases especially resistant to INH and/or RFP, and of the patients who are not able to continue the Standard Regimens because of side effects and/or severe complications with various organ dysfunctions.
    It is evident that presently available antituberculosis drugs are not potent enough to deal satisfactorily with the above situations, and besides, there has been unsatisfactory chemotherapeutic efficacy against infections caused by Mycobacterium avium complex.
    The above matters strongly urge our effort to develop new antimycobacterial agents. In the present review, in vitro and in vivo activities of newly synthesized rifamycin derivatives (3'-hydroxy-5'-akylpiperazinyl-benzoxazinorifamycins, KRMs) were discussed.
    Of a total of 158 newly synthesized compounds, five (KRM-1648, KRM-1657, KRM-1668, KRM-1674, KRM-2312) were selected due to significantly lower MICs than those of RFP against M. tuberculosis H37Rv and M. intracellulare 31F093T. The MIC90s of these compounds were 16 to 32 times lower than MIC90 of RFP against RFP-susceptible clinical isolates (20 strains) of M. tuberculosis, and 100 times or more lower than MIC90s of RFP against 20 disease-associated M. avium complex strains. Daily oral single administration (10mg/kg) of all these compounds demonstrated 100% survival of 20 ddY male mice infected with an intravenous lethal dose of M. tuberculosis H37Rv for 40 days, while only 40% or less of the mice treated with 10mg/kg/day of RFP survived at 40 days of infection. All of the untreated mice died within 22 days of infection. Consecutive viable counts of bacilli in lung and spleen of the female beige mice infected intravenously with ca. 108 cfu of M. intracellulare 31F093T were significantly lower in the KRM-1648-treated (20mg/kg/day) group than the untreated, although KRM-1648 could not eradicate the disease in single usage. There was no significant difference between RFP-treated and untreated groups.
    Preliminary data also suggest superior bactericidal activity of KRM-1648 against H37Rv to that of RFP in vitro, and in vivo chemotherapeutic superiority of KRM-1648 to RFP in murine tuberculosis is being confirmed by the administration of smaller doses. In experimental murine M. intracellulare model, an encouraging result was obtained for the usefulness of KRM-1648 in combination chemotherapy of M. intracellulare infections.
    The above results all suggest that KRM-1648 could be a promising drug of both M. tuberculosis and M. intracellulare infections in humans, and future plans for further evaluations were discussed.
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  • I. MANAGEMENT OF INH AND RFP-RESISTANT REFRACTORY TUBERCULOSIS
    Kazuhiko KAMEDA, [in Japanese], [in Japanese], [in Japanese], [in Japa ...
    1991 Volume 66 Issue 10 Pages 687-706
    Published: October 15, 1991
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
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  • [in Japanese]
    1991 Volume 66 Issue 10 Pages 719-721
    Published: October 15, 1991
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
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