巻号一覧
67 巻, 4 号
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鈴木 清, 高嶋 義光, 山田 孝, 秋山 仁一郎, 八木 一之, 川島 正裕, 佐藤 雅樹1992 年 67 巻 4 号 p. 303-311
発行日: 1992/04/15
公開日: 2011/05/24
ジャーナル フリーIn order to evaluate the clinical effectiveness of response to antituberculous chemotherapy, we measured the serum levels such of acute phase reactants as C-reactive protein (CRP), alpha-1-acid glycoprotein (α1-AG), haptoglobin, alpha-1-antitrypsin (α1-AT) and sialic acid in 24 patients with pulmonary tuberculosis. Furthermore the relationship between these parameters and other biochemical indicators, such as serum immunoglobulins (IgG, IgA and IgM) and blood erythrocyte sedimentation rate (ESR) were observed.
In the case studies of the eighteen prognostically cured patients, the serum levels of α1-AG, haptoglobin, α1AT and sialic acid were significantly higher than those of healthy controls (P<0.01), and were significantly decreased to normal levels within three to five weeks after negative results for tubercule bacilli were obtained in the sputum cultures, while CRP, immunoglobulin and ESR showed a tendency to be lower than the healthy controls.
In conclusion, α1-AG, haptoglobin, α1-AT and sialic acid are considered to be the sensitive biochemical indicators capable of being used to predict and monitor the clinical response to antituberculous chemotherapy.抄録全体を表示PDF形式でダウンロード (993K) -
角 誠二郎, 礒部 威, 石岡 伸一, 山木戸 道郎, 柴田 好彦, 倉岡 敏彦1992 年 67 巻 4 号 p. 313-318
発行日: 1992/04/15
公開日: 2011/05/24
ジャーナル フリーWe investigated the clinical feature of 22 diabetic patients diagnosed as havingreccurent pulmonary tuberculosis. More than half of the patients relapsed within five years after discharge from the hospital. The mean serum albumin concentration of those patients who experienced relapses within three years was significantly lower than that of the patients who experienced relapses a period of time greater than three years. We recognized a significant negative correlation between the reccurent period and body mass index or fasting plasma glucose values.
Among these patients, 50% of them ceased treatment fodiabetes mellitus personally or had not been diagnosed as having diabetes mellitus before the relapse. All of the patients who ceased treatment for diabetes mellitus before readmission were able to obtain good plasma glucose control only through diet therapy during their first hospital admission for pulmonary tuberculosis.
From this study, We concluded that strict plasma glucose control is important for the prevention of a relapse of the mycobacterial infection in patients with diabetes mellitus.抄録全体を表示PDF形式でダウンロード (681K) -
五十里 明1992 年 67 巻 4 号 p. 319-329
発行日: 1992/04/15
公開日: 2011/05/24
ジャーナル フリーA survey was done on the conditions of the tuberculosis surveillance system used for extraordinary examination in high tuberculosis prevalence areas in Aichi Prefecture during the period from 1981 to 1989.
The results were as follows:
1) A total of 25 health centers provided information to 456 cases in specific groups known as “danger groups” and 227 cases within a furniture company. Information was most frequently provided when the index cases had been diagnosed bacillary positive.
2) Extraordinary examinations were performed on 222 cases for nine years, one case a year per each health center. The frequency of extraordinary examination was never high. A total of five epidemic cases (2.3%) and 30 microepidemic cases (13.5%) were discovered.
3) Coordination among health centers to make examinations was required in 81 cases (36.5%).
4) In index cases in which extraordinary examinations were performed, 43 preventable cases (19.4%) were found. It is therefore important to thoroughly enforce family-contact examinations.
In order to complete extraordinary examinations, the importance of not only the systematic collection of information and the action of examination about specific groups but also the establishment of a surveillance system for extraordinary examinations is vital.抄録全体を表示PDF形式でダウンロード (1563K) -
加藤 万之輔, 柿原 秀敏1992 年 67 巻 4 号 p. 331-346
発行日: 1992/04/15
公開日: 2011/05/24
ジャーナル フリーAmong the patients diagnosed as having pulmonary tuberculosis who were newly admitted to six major tuberculosis centers in Aichi Prefecture during the period from January 1, 1982 to December 31, 1986, 73 patients were chronic excretors of Mycobacterium bacilli (chronics), whose sputum cultures tested positive at both 11 and 12 months after admission. In this study, those 73 patients were analyzed in March 1988. If the patient was still hospitalized at that time, the patient was re-evaluated six months later.
The life table method was used for analysis of clinical procedures. For the analysis of risk factors for chornics, 37 patients who were treated after 1971 when RFP was available for treatment were used.
The results in this study are as follows:
1 A total of 49.3% of the patients were determined chronics (those who had initial chemotherapy before 1970 when RFP was not available). This result suggests that the use of RFP may contribute to the reduction of chronics.
2 Patient delay in diagnosis, as well as irregular chemotherapy, was one of the factors for the development of chronics.
3 In the chronics, many patients showed severe findings in their chest X-rays, high bacillary counts in the sputum, and low drug-sensitivity bacilli when treated with the major anti-tuberculosis drugs.
4 The rate of chronics from newly admitted patients with positive sputum cultures following the initial chemotherapy treatment was 1.3%. This rate could increase following longer observation periods.
5 Chronics were more prevalent in patients with Type I (extensive cavitary type) findings in the chest X-rays, and positive sputum smears for Mycobacterium bacilli in the clinical findings when compared with all newly registered active tuberculosis patients during the same period in Aichi Prefecture.
6 Concerning the outcome, 55 patients were discharged (17 improved 13 personally released 25 deceased) while 18 remain hospitalized. Among those discharged patients, 17 patients were released as a result in improved health while 25 died. These results indicate poor prognosis. Using the life table method, the estimated mortality rate is 49.7%, and the negative sputum rate is 30.5% five years later.
7 Using a multivariate analysis on the prognosis, the risk factor was greatest for poor prognosis for those patients who had Type I findings in their chest X-rays, initial chemotherapy before 1970, complications, and that were male. 8 The patients with improved health, were more sensitive to the drugs applied when compared to the fatal patients.
9 Careful chemotherapy during the first two years may contribute to the reduction of chronics.抄録全体を表示PDF形式でダウンロード (2120K) -
その成因に関する臨床病理学的考察平田 世雄, 山本 健介1992 年 67 巻 4 号 p. 347-352
発行日: 1992/04/15
公開日: 2011/05/24
ジャーナル フリーSurgery performed on a 70 year-old male revealed a case of chronic calcified pleural empyema open healing that was induced through an effective bronchiolar drainage mechanism.
The patient had previously received anti-tuberculosis medication, including INH and RFP, 7 years prior for positive sputum cultures and symptoms of fistulation observed in an x-ray finding of right lung pleural calcification.
The four cardinal signs of chronic calcified pleural empyema open healing are as fallow:
1. Failure to isolate tubercle bacilli
2. Inability to locate necrotic coagulation or specific inflammatory granulation tissue on the cavitary wall
3. Calcified pleural plaque detached from the cavitary wall, and 4. Microscopic recognition of many drainge bronchiolar openings to the empyema and the inner surface of the empyema covered with stratified squamous epithelium, which possibly penetrated via the entering bronchioles.抄録全体を表示PDF形式でダウンロード (7637K)
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