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Volume 67, Issue 1
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Haruaki TOMIOKA, Katsumasa SATO, Hajime SAITO1992 Volume 67 Issue 1 Pages 1-8
Published: January 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSMacrophage chemiluminescence (MφCL)-triggering activities of Mycobacterium avium complex (MAC) strains belonging to various serovars were examined. When SmT colonial variant (smooth, transparent, irregularly shaped) of M. intracellulare N-260 strain was compared with its SmD variant (smooth, opaque, dome-shaped) for Mφ CL-triggering function and resistance to antimicrobial activity of murine resident peritoneal Mcbs, the SmT variant showed much lower Mφ CL-triggering activity accompanied by its high resistance to Mφ microbicidal functions. Thus, difference in the virulence of the two MAC clolonial variants seems to be originated from their different activities in Mφ-triggering to be stimulated state in terms of O2-dependent antimicrobial functions.
When disease-associated MAC strains belonging to serovars 1, 14, 16 (major serovars seen in Japan), 8 (intermediate serovar) and 9 (minor serovar) were challenged to mice, their virulence, in terms of mortality of host animals and growth of the organisms in the lungs, was nearly in the order of serovar 16, 14, 8, 1 and 9. However, there was found no obvious serovar-dependent difference in Mφ CL-triggering activity of these MAC strains. Thus, no significant correlation was found between virulence of the MAC strains of various serovars and their triggering activities for Mφ active oxygen production, which is important for the O2-dependent microbicidal mechanisms of host Mφs.
When M. avium and M. intracellulare from human or environmental sources were examined for virulence to mice in terms of incidence and degree of gross pulmonary lesions or behavior of the organisms in the lungs, human-derived M. intracellulare caused most progressed state of gross lung lesions in all test mice, with average 2.6 Log-increase in bacterial CFU in the lungs. This was followed by environmental M. intracellulare, which caused less degree of lesions in 15 of 19 mice and 1.3Log-increase in pulmonary CFU. On the other hand, human-derived M. avium caused much weaker lesions in a small part of test animals and environmental M. avium caused no lesions. In the case of the M. aviuminfection, there was substantially no bacterial growth in the host lungs. These results indicate that the virulence of the MAC was in the order of human-derived M. intracellulare, enviromental M. intracellulare, human-derived M. avium and environmental M. avium. On the contrary, there was found no obvious difference in Mφ CL-triggering activity among these MAC species from the two types of sources.
Thus, at least among SmT variants of the MAC, there seems to be no relationship between their activity to induced MO respiratory burst and virulence to mice. Therefore, it is thought that O2-dependent antimicrobial mechanism in host Mφs plays only minor roles in the host resistance to the SmT colonial variants of the MAC.View full abstractDownload PDF (1001K) -
Shigenobu UMEKI, Rinzo SOEJIMA, Yoshito HARA1992 Volume 67 Issue 1 Pages 9-18
Published: January 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSAge-related changes in clinical features of 182 patients diagnosed as having pulmonary tuberculosis from positive culture results of tubercle bacilli were extensively investigated. The percentage of cases detected using mass miniature radiophotography (MMR) was highest in the patients aged 30-39 years, and then decreased with increasing age. It was only 16-19% in those aged 60 years or older.
Certain conditions, such as cardiovascular diseases, hypertension, diabetes mellitus, malignancy and other lung diseases, were common in the patients aged 60 years or older. Systemic symptoms, including weight loss and anorexia, and physical abnormalities, including fever and crackles, were common in these patients.
Anemia tended to be predominant in the patients aged 60 years or older. The middle/lower lobes were involved more frequently in these patients, in whom the disease distribution was more than one lobe, or disseminated.
Positive smear results and negative anergy were more frequently noted in the patients aged 60 years or older. The mortality from tuberculosis in these patients was 4% (7 cases).
Although gastrointestinal disorder due to antitubercular drugs was more common in the patients aged 80 years or older, eosinophilia was less frequently observed. Today, improved conditions, better sanitation and the development of new chemotherapeutic agents have contributed to the decline of tuberculosis among the general population. But more efficient procedures that allow the early detection or diagnosis of pulmonary tuberculosis in the elderly should be achieved as soon as possible.View full abstractDownload PDF (1223K) -
From the Cases of Nepal, Yemen and the PhilippinesAkiko FUJIKI1992 Volume 67 Issue 1 Pages 19-26
Published: January 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSEvaluation of sputum smear examination was carried out with smear slides stained by the Ziehl-Neelsen method, which were collected from Nepal, Yemen and the Philippines. The smear slides were checked macroscopically and microscopically according to the following points: 1) smear area size, 2) thickness of smear, 3) evenness of smear, 4) decolourizing condition by Ziehl-Neelsen stain, 5) smear cleanness, 6) presence of cells in sputum and 7) smear reading accuracy by cross-checking.
As the result of smear slide evaluation, it was concluded that proper sputum specimens have been smeared but smears were generally too thin and contaminated with too many dirts.
Agreement rate of the slide reading in Nepal, Yemen and the Philippines were 73%, 90% and 88% respectively. Disagreement cases were concentrated in the subtle number of acid fast bacilli or (±) and (+) results. The cause of disagreement might be attributed to contamination with debris, deposit etc., which hinderd reading or were misread as acid-fast bacilli.
Some improvement should be considered to eliminate the dirts, such as filtration of carbol fuchsin solution, preparation of proper quantity of carbol fuchsin solution to be consumed within three months, mixing the fuchsin stock solution and 5% carbol solution just before use, rinsing the mouth before sputum collection, usage of clean sputum container and slides, and smearing and drying of the slides within clean environment.
However, in many developing countries there are many difficulties for facilities, equipments, system and management. Some of these difficulties may be solved by the efforts of laboratory side but some are beyond the limits of their efforts. Under such circumstance, there should be limitation in keeping and maintaining the quality of the examination.
When evaluation or quality check of smear examination is attempted, the quality must be defined taking such background conditions into consideration.View full abstractDownload PDF (889K) -
Takashi NIIMI, Yumi HASEGAWA, Yoshiki SUGIURA, Naoto IIJIMA, Kosho YOS ...1992 Volume 67 Issue 1 Pages 27-32
Published: January 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe report a case of cerebral tuberculosis following miliary tuberculosis. A 54-year-old man was admitted to our hospital in October 1990 because of fever and general fatigue. Chest x-ray film on admission showed diffuse granular shadows in both lungs. Tubercle bacilli were seen in the sputum (Gaffky 5) by the Ziehl Neelsen's stainning, and antituberculous therapy was quickly started. But a few days after admission, the disturbance of consciousness, neck stiffness, and headache appeared. The examination of cerebrospinal fluid disclosed that leucocytes was increased in number, and that ADA was elevated to 14.6 IU/l. Tubercle bacilli were detected from cerebrospinal fluid by culture. Although CT scan of the brain was normal at first week of admission, brain CT at eighth week of admission showed several nodulus enhanced with contrast medium. The findings were confirmed by T2 weighted magnetic resonance images (MRI) as high intense areas. Although Ti weighted MRI showed isointensity of the gray matter, Ti weighted MRI enhanced by Gd-DTPA revealed abnormal enhancement. At twenty-nineth week of admission CT showed no abnormality even by contrast enhancement, but enhanced Ti weighted MRI revealed a small lesion with enhancement which was not shown by CT. MRI enhanced by Gd-DTPA was more useful for evaluating cerebral tuberculosis than brain CT.View full abstractDownload PDF (2004K) -
Noriko MORI, Kiminori SUZUKI, Fumio YAMAGISHI, Yuka SASAKI, Takenori Y ...1992 Volume 67 Issue 1 Pages 33-35
Published: January 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDuring the four-year period from 1987 to 1990, six cases of pulmonary tuberculosis, accompanied by the development of pneumothorax, were observed at our hospital. Distribution by sex was five males and one female. The mean age was 49.8 years-old. None of the patients suffered severe respiratory failure, and there were no deaths in this series. While many of the patients had bilateral exudative disease, five out of the six patients experienced pneumothorax on their right side. The realization of tuberculosis by both patients and doctor tended to be shorter than those cases without pneumothorax.View full abstractDownload PDF (372K) -
1992 Volume 67 Issue 1 Pages 37-87
Published: January 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (5426K)
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