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Volume 66, Issue 8
Displaying 1-7 of 7 articles from this issue
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Toru RIKIMARU, Yasuyuki TANAKA, Mitsuo OTAKI, Toshinobu YOKOYAMA, Emik ...1991 Volume 66 Issue 8 Pages 511-516
Published: August 15, 1991
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA total of 36 patients (16 male and 20 female) with tracheobronchial tuberculosis were admitted during the last nine years and were evaluated for their clinical features.
The chief complaint in three quarters of the patients was intractable cough, in particular, in those with tracheal tuberculosis. One of three patients who suffered from wheezing was prescribed steroid, being diagnosed as having bronchial asthma instead of tuberculosis.
Plain chest X-rays of two patients revealed no abnormality. Pleural effusion was observed in three patients, and miliary tuberculosis in two patients.
Bronchial biopsy was carried out in 23 patients, however, in only 11 patients a histopatho logical diagnosis of tracheobronchial tuberculosis could be made. In contrast, in all 36 patients smear and/or culture for tubercle bacilli were positive. Therefore, bronchial biopsy was considered not to be essential in making a definite diagnosis of bronchial tuberculosis, although it did not exacerbate the lesion to lead to endobronchial stenosis.
Only seven out of 36 patients were in the habit of smoking but three of the four had already broken the habit at least one year before being diagnosed as having the disease. The remaining four patients were still smoking but less than 10 cigaretts a day, with one exceptional patient who was smoking 30 cigarettes on average a day. It has been well known that there is a sexual difference in the incidence of bronchial tuberculosis, namely among females with relatively low population of smokers, the incidence is high. Another probable reason for the higher female incidence is assumed to be due to the structural susceptibility of the bronchus with smaller diameter lumen. Furthermore, it has been found that more than 4, 000 chemical compounds are contained in cigarette smoke. Some of them might act to inhibit the multiplication of tubercle bacilli, leading to the low incidence of the disease in smokers. Our other experiments revealed that tar in cigarette smoke inhibited the multiplication of tubercle bacilli.
Further detailed observation is needed to clarify the possible inhibitory effect of smoking on the development of bronchial tuberclosis.View full abstractDownload PDF (2550K) -
Atsuko UEMATSU, Katsumi YAMANAKA, Ryuichiro SASAKI1991 Volume 66 Issue 8 Pages 517-523
Published: August 15, 1991
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe incidence and prevalence of pulmonary tuberculosis has declined steadily in Japan, but the trends differ greatly by area according to epidemiological status.
We studied the incidence and trends of pulmonary tuberculosis in an urban area (population approx. 150, 000) during the period of 1979-1988. The area studied is a part of a large commercial city, characterized as having the most prevalent rate of tuberculosis area in that city.
Of 1245 newly registered cases, 80% were over 40 years of age. While the incidence rate decreased to 57% in the last 10 years in this area, compared to 69% decrease for all of Japan, it was still considerably higher than the national average. Especially in the 20-59 age group it continued to be 2 times higher than that of the whole of Japan. Moreover, the positive rate of tubercle bacilli at the time of registration had increased remarkably from 27% in 1979 to 62% in 1988.
These results suggest the tuberculosis continues to be a significant problem in this urban area, although the steady decline in the incidence of tuberculosis had led to a lack of awareness of this disease.View full abstractDownload PDF (752K) -
Yoichi NAKANISHI, Kenya HIURA, Osamu KATOH, Tsuneko YAMAGUCHI, Shigeta ...1991 Volume 66 Issue 8 Pages 525-530
Published: August 15, 1991
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe measured CAl25 levels of the sera and pleural effusions in both patients with tuberculous pleurisy (TB) and with benign non tuberculous pleurisy (non-TB). In all the TB patients, serum CAl25 levels were increased (78 to 370U/ml, mean±SD=167.3±96.8U/ml, n=8), and were significantly higher than those in non-TB patients (167.3±96.8U/ml v.s. 36.9±18.4U/ml, p<0.01). Neoplastic diseases or gynecological disorders were not found in these patients. On the other hand, either CAl25 or LDH levels of pleural effusions were not significantly different between these two groups. Although adenosine deaminase (ADA) levels in pleural effusions were also significantly higher in the TB patients (p<0.05), there were no correlation between serum CAl25 and ADA levels in pleural effusions. Serial measurement of serum CAl25 levels in the TB patients revealed that serum CAl25 levels were markedly decreased one to two months after anti-tuberculous therapy (172.6±103.3U/ml to 23.3±9.9U/ml, p<0.01). It is suggested that the measurement of serum CAl25 in patients with tuberculous pleurisy is useful as an indicator of disease activity.View full abstractDownload PDF (641K) -
2. Clinical ResultsFumika YOSHIDA1991 Volume 66 Issue 8 Pages 531-542
Published: August 15, 1991
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe reported earlier in the 1st report the use of treadmill walk apparatus and trans cutaneous blood gas measurement apparatus as a newly designed exercise test. In this report, test was carried out in 90 persons (4 healthy, 66 recovered from pulmonary tuber culosis, 3 recovered from silico-Pulmonary tuberculosis, 12 of COPD, and 5 of pulmonary fibrosis et bronchiectasis).
The changing curves of transcutaneously measured O2 partial pressure (tPo2) were, as previously reported, classified into 4 types: 1. unchange-6, 2. slightly decreased-38, 3. moderately decreased-24, 4. markedly decreased-21. And unexpected odd curves were seen in 4 patients, 3 of whom were retested the other day, and their changing curves of tPo2 in the second test were corrected and classified into slightly or moderately decreased type.
The decreasing slopes of 4 types of tPo2 curves were subclassified, in each type, into 3 to 4 forms.
In recovered pulmonary tuberculosis patients, in general, when the spread of pathologic changes in the lungs was wider, the more decreased types of tPo2 curves were seen. But in COPD patients, such was not the case.
In the exercise test, total tolerance time (minuites) against the definite load was significantly shorter in the more decreased type unchanged-13.5-14.3, slightly decreased-7-10, moderately decreased-6-9, and markedly decreased-3-5. The recovering time of tP02, pulse rate, blood pressure etc. from the records in the end of the exercise to the preexercise records, was longer in the more decreased type.
On the other hand, usually the lower Pao2 of the patients were, the more their changing curves of tPo2 decreased. Pao2 was previously measured in blood taken from brachial artery in supine position before the test. But exceptionally in some patients with high Pao2 value, the curves belonged to markedly decreased type. The changes of oxygen values of some patients during exercise test were individually different, showing that this exercise test reflected their comprehensive respiratory function. Prognosis was especially bad in patients with markedly decreased type, 8 of whom had died from respiratory failure within 2 years after the test.
In conclusion, it can be said that this exercise test was effective in judging the pulmonary reserve function and the prognosis in recovered pulmonary tuberculosis patients, but more detailed investigations are neccesary, especially in more COPD patients, for the understanding of the respiratory distress.
As our main purpose was to investigate the changing curves of oxygen values under exercise, we used tPo2 because of its safty and convenience on measurement. The relationship between the values of Pao2 and tPo2 is now being planned to investigate in the future.View full abstractDownload PDF (1511K) -
Yuuichi INOUE, Yorikazu KANAMORI, Naoki MIURA, Takasi WATANABE, Kouich ...1991 Volume 66 Issue 8 Pages 543-551
Published: August 15, 1991
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe reported a case of tuberculous mesenteric lymphadenitis. A twenty three year old man was admitted to our hospital with pulmonary tuberculosis on May, 1988. Chest X ray findings improved after 4 months' antituberculous chemotherapy, but he complained of right lower abdominal pain and a mass with tenderness. Barium series of gastro intestinal tract showed evidence of extrinsic compression on the intestine. Abdominal CT showed rim enhancement and a multiloculated appearance, and the ultrasonography showed a hypoechoic mass. But we did not make a definite preoperative diagnosis, therefore exploratory operation was done. An abscess with caseous granuloma was found in the mesenteric lymphnodes removed at laparotomy.View full abstractDownload PDF (7443K) -
Takayuki MASAKI, Hozo UMEHASHI1991 Volume 66 Issue 8 Pages 553-555
Published: August 15, 1991
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe characterization of extracellular enzymatic activities of Mycobacterium avium and Mycobacterium intracellulare which were identified by DNA probe (Gen-Probe, Cal., USA) was carried out using the API ZYM system (API, La Balme Les Grottes, France).
The enzymatic activities of M. avium were attributed to esterase (C4), esterase lipase (C8), leucin arylamidase, acid phosphatase and phosphoamidase.
Enzymatic characterization of M. intracellulare was very similar to that of M. avium. However, M. intracellulare differed from M. avium in the following two points:
(i) Alkaline phosphatase activity was demonstrated,
(ii) Acid phosphatase activity was much stronger.View full abstractDownload PDF (300K) -
[in Japanese]1991 Volume 66 Issue 8 Pages 561-562
Published: August 15, 1991
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (249K)
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