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Volume 67, Issue 6
Displaying 1-6 of 6 articles from this issue
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Fumio YAMAGISHI, Kiminori SUZUKI, Yuka SASAKI, Noriko MORI, Takenori Y ...1992 Volume 67 Issue 6 Pages 427-431
Published: June 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe study of the group younger than 29 years of age with pulmonary tuberculosis was carried out. Thirty seven out of 287 tuberculosis patients who were discharged from National Chiba-Higashi Hospital in 1989 were enrolled.
Only 5 patients (13.5%) were associated with complication. The smear and culture of sputum for acid-fast bacilli were positive in 30 cases (81.1%) and chest X-ray films revealed cavitary lesion in 31 cases (83.3%). Many of them were moderately advanced cases. Twenty four of them were found symptomatically, 10 by mass survey and 3 under treat ment of other diseases.
The total delay of symptomatical patients was 8.5 weeks until 80% of them were definitely diagnosed. The days of hospital stay were 122 until half patients were discharged. Five of them (13.5%) were non-Japanese and all stayed in Japan illegally. Their condition was rather severe.View full abstractDownload PDF (540K) -
Izumi HAMAJIMA1992 Volume 67 Issue 6 Pages 433-439
Published: June 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe studied familial attacks of pulmonary tuberculosis in Sapporo City from 1987 to 1990.
There were 146 sources of infection. Two hundred twenty three were infected secondly. Chemotherapy was given to the 75 out of 223 patients. Chemoprophylaxis was given to the total of 148 children. The average ages of the sources, those who were infected secondly and those who had given chemoprophylaxis were 44.8, 32.2 and 7.7 years of age respectively.
The ratio of male vs female was 1: 0.4 among the sources.
The main routes of transmission of this disease were from husbands to wives, from fathers to children, and from grandfathers to grandchildren.
The patients who did not have health examination in the preceding one year of their present diagnoses had more severe state of disease as well as higher Gaffky degrees and were treated for more than one year.
The infectious patients accounted for more than 50% of the active pulmonary tuberculosis in Sapporo City in 1990.
Tuberculin skin test has been performed in almost cases of family examination and the period of chemoprophylaxis has been standarized along the guideline for the chemopro phylaxis by Japan Tuberculosis Association and the Ministry of Health and Welfare.
Family and relatives of the patient who expectorates tuberculouss bacilli should take at least one examination annually. Younger people should take it more frequently and chemoprophylaxis should be given to the child whose reaction of Tuberculin skin test is strongly positive.View full abstractDownload PDF (757K) -
Toshio YAMAZAKI, Reiko M. NAKAMURA1992 Volume 67 Issue 6 Pages 441-447
Published: June 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe polymerase chain reaction (PCR) was used to detect mycobacterial DNA sequences in the cultured or the clinical specimens. Four oligonucleotide primers derived from the sequence of a gene coding 65-kilodalton antigen of Mycobacterium tuberculosis amplified DNA samples of all the 11 species of mycobacteria tested.
Serial dilution of M. bovis BCG showed that DNA extracted from only 12 bacilli was enough for the detection by PCR method. However, mycobacteria in sputum were detected by PCR when more than-103bacill were present. The PCR method may become a useful tool for the rapid diagnosis of mycobacterial infections.View full abstractDownload PDF (2705K) -
Tomoaki NAKAZONO1992 Volume 67 Issue 6 Pages 449-456
Published: June 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSTransient radiographic progressions during or after antituberculous chemotherapy were observed in 60 (4.5%) out of 1, 321 cases with active pulmonary tuberculosis who received an initial combination chemotherapy including INH and RFP. The radiographic patterns of these progressions were classified into a singular and a gregarious pattern. A correlation between the two radiographic patterns and a positive or negative culture in sputum at the time of the radiographic progressions was studied, revealing significantly more frequent singular patterns in culture nagative cases while more frequent gregarious patterns in culture positive cases. In a majority of the cases, radiographic progressions developed within 3 months after an initiation of chemotherapy. Either of the increased shadows during chemotherapy or after completion of chemotherapy showed an improvement in a moderate degree or over and a good prognosis thereafter by continuous administration of the same drugs or under observation without retreatment respectively. It is concluded that radiographic progressions appeared during an intensive chemotherapy or after its completion do not always require changing the antituberculous drugs or resumption of chemo therapy.View full abstractDownload PDF (1106K) -
Misato OKA, Masao KUSANO, Takashi MIYASAKA, Yasuaki SUGANUMA, Jun SHIM ...1992 Volume 67 Issue 6 Pages 457-462
Published: June 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThis report is concerning a case of adenosquamous carcinoma having unknown origin and showing SVC syndrome as the first symptom. A 44 year-old man was admitted to our hospital because of facial edema at the beginning of April 1990. He was diagnosed as having a mediastinal tumor of the SVC syndrome type. Resection of the SVC tumor and part of the pericardium was performed on June 20, 1990. The operation had extraordinary findings. Lymph nodes adhering to tumor invaded the adjacent right side of the trachea and were situated in a rossetlike form. Furthermore, a part of the tumor stemmed into the lumen of the superior vena cava causing complete obstruction. The pathological diagnosis of the SVC tumor was adenosquamous carcinoma, however, no clinical examinations could identify its original matrix.
Mediastinal tumors of unknown origin are reported as about 1% of all mediastinal tumors, and are responsible for 0.68% of all carcinomas in the mediastinum. This was one experience of a rare case of mediastinal tumor having unknown origin and showing SVC syndrome as the first symptom.View full abstractDownload PDF (4592K) -
Takateru IZUMI1992 Volume 67 Issue 6 Pages 463-470
Published: June 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS1. As viewed from health care office Yuko NAITO (Kobe Municipal Health Insurance Union, Health Care Center)
2. As viewed form the Medical Institutions
(1) Treatment in hospital Miyako NAGASAKI (National Sanatorium Sanyoso Hospital)
(2) Treatment in outpatient clinic Kikuo SUGIMOTO (Nagahama Red Cross Hospital)
(3) Misdiagnosis of tuberculosis Yusaku MATUI (Chest Disease Research Institute, Kyoto University)
3. As viewed from the Public Health Center Sutemi NISHIKAWA (Kyoto Municipal Shimogyo Health Center)
4. As viewed from Japan Anti-tuberculosis Association Toru MORI (Japan Anti-tuberculosis Association)
Leading into the decade of the 1950s, tuberculosis was the most widespread disease in Japan. However, Japan's economic strengths have greatly improved the social living standards, and therapeutic drugs to combat tuberculosis became widely available. The mortality rate for tuberculosis is now one-fiftieth of what it was immediately after World War II. Today, tuberculosis has almost been forgotten by physicians.
A very important consideration at hand is the fact that the current administration overseeing the care of tuberculosis in Japan is operating upon the basis of an anti-tuberculosis memorandum presented to the Japanese Government by the Allied Forces on March 17, 1947. The only revision to the memorandum was a completely revised law for the prevention of tuberculosis appended on March 31, 1951. Since the state of tuberculosis is now in an entirely different context than at that time, the administrative operations are well out of date. Professionals in the medical field who are actively engaged in the diagnosis and treatment of tuberculosis in Japan organized a panel discussion with the Ministry of Health and Welfare and the Japan Anti-Tuberculosis Association (the current administration) to confer concerning the future perspectives of operations. The opinions and suggestions of each speaker are summarized in the following.
1. Reconsider the effectiveness of health examination for the detection of tuberculosis.
2. Establish techniques to improve accuracy of tests to detect tubercle bacilli.
3. Reconsider the regulation of hospital ward for patients with tuberculosis.
4. Make efforts to minimize misdiagnosis of tuberculosis.
5. Establish a policy for managing patients in best state.
6. Problems of tuberculosis in the aged populations and foreign workers.
7. Reconsider a strategy of preventing tuberculosis (BCG, drugs) These problems cannot be solved all at once. Careful consideration of each problem, and practing each problem positively are awaited.View full abstractDownload PDF (1131K)
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