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Volume 67, Issue 7
Displaying 1-6 of 6 articles from this issue
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Norio KIKUCHI, Hidetoshi IGARI, Tatsuo KAWASHIMA, Ikushi ONOZAKI, Taku ...1992 Volume 67 Issue 7 Pages 495-507
Published: July 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe conducted a study on the diagnosis of pulmopnary tuberculosis at Chiba Kaihin Municipal Hospital.
Examinations were performed to determine the presence of active Mycobacteriumtuberculosis in sputum and gastric aspirate. For the sputum smear-negative cases, fiberoptic bronchoscopy was further used as a means for detecting the tuberculosis.
The results obtained were as follows:
1. A total of 114 cases in the past six years diagnosed as active pulmonary tuberculosis (including 88 primary treatment cases) were analysed.
2. The 114 cases consisted of 74 males and 40 females, the mean age was 49.3 years old.Categorically, the main age groups were: 60s, 24 cases; 30s, 21 cases; and 40s, 20 cases.
3. Chest X-ray findings: Cavitary cases were 28.9 %, GAKKAI classification of thesizes of the affected areas being Type 1 (mostly limited cases), 58.9 % of all total cases, and68.4 % in the cases under the age of 50 years old. The number of cases having infection in asolitary nodule was 19, and the ages of 15 out of the 19 patients were under 50 years old.
4. Sputum or gastric aspirate smear-positive cases totalled 37 (32.5 %), and culturepositivecases totalled 77 (67.5 %). Sputum or gastric aspirate cultures were positive in 52out of 56 cases (92.9 %) with extended shadows, GAKKAI classification Types 2 and 3, butwere positive in 25 out of 58 cases (43.1 %) with Type 1.
5. Fiberoptic bronchoscopy was performed on 49 out of the 77 smear-negative cases.
6. Definite diagnosis was obtained in 90 (78.8 %) out of total 114 cases.
The results of this study suggest that examination for active mycobacterium in sputumand gastric aspirate are very useful for the diagnosis of active pulmonary tuberculosis, especially in extended cases.View full abstractDownload PDF (4602K) -
Junko MIYAMOTO, Hironobu KOGA, Shigeru KOHNO, Haruko MATSUDA, Yuko YOS ...1992 Volume 67 Issue 7 Pages 509-513
Published: July 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSForty-eight cases of tuberculous pleurisy were examined and the following results wereobtained.
(1) Most of the patients were male, and there was no significant age and underlyingdiseases.
(2) Fever and chest pain were observed mainly in younger patients, and sputum anddyspnea in older patients.
(3) All of the cases examined had exudative pleural effusion, and increased ADA activitywas frequently observed.
(4) Mycobacterium tuberculosis was detected in the sputum of 65%, and also in thepleural effusion of 28% of the patients. The pathological diagnosis of tuberculosis wasmade by pleural biopsy in 83 % of the patients, suggesting that pleural biopsy is very usefulin the diagnosis of tuberculosis pleurisy.
(5) The prognosis of the patients with tuberculosis pleurisy was good. Steroid therapywas generally ineffective.View full abstractDownload PDF (677K) -
Haruaki TOMIOKA, Katsumasa SATO, Hajime SAITO, Yoshifumi IKEDA1992 Volume 67 Issue 7 Pages 515-520
Published: July 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSY-26611, a newly developed fluoroquinolone having a morpholine moiety at the 7 position was examined for in vitro antimycobacterial activity by the agar dilution methodusing 7H11 medium. The MIC90 values of Y-26611 were as follows: Mycobacteriumtuberculosis (25 strains), 0.4, μg/ml; M. kansasii (19 strains), 6.25, μg/ml; M. marinum (10strains), 25, μg/ml; M. scrofulaceum (19 strains), 50μg/ml; M. avium (18 strains), 50μ g/ml; M. intracellulare (31 strains), >100, μg/ml; M. fortuitum (20 strains), 0.4, μg/ml; M. chelonae subsp. abscessus (15 strains), >100, μg/ml; and M. chelonae subsp. chelonae (20 strains), 100 μg/ml. The MICs against M. tuberculosis and M. fortuitum were lowerthan those of ofloxacin (OFLX), although it had somewhat higher MICs against M. aviumcomplex than OFLX. Antimicrobial activity of Y-26611 against M. tuberculosisphagocytosed in cultured murine peritoneal macrophages were somewhat lower, as comparedto that of OFLX. When M. fortuitum-infected (iv) A/J mice were treated with Y-26611 bygavage at doses of 0.5-2 mg/mouse, once daily, six times per week, from day 1 for up to 4weeks after infection, mice were protected from death and the number of CFU recoveredfrom their visceral organs, such as the lungs, spleen and kidneys were reduced. Thetherapeutic efficacy of Y-26611 was similar as that of OFLX.View full abstractDownload PDF (610K) -
Keizo KITSUKAWA, Atsushi NAKAMOTO, Atsushi SAITO1992 Volume 67 Issue 7 Pages 521-528
Published: July 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe quantitative relationships among the in vitro lymphocyte proliferation inperipheral blood in 19 healthy doners to purified protein derivative (PPD) and the killed Mycobacterium tuberculosis, interferon-γ (IFNγ) and tumor necrosis facter-α (TNFα) production in these culture supernatants, and the in vivo skin reaction to PPD which weresimultaneously measured were studied. Statistical analysis was performed with t-test andmultiple regression analysis.
The results obtained were as follows;
1) The magnitude of the in vitro lymphocyte proliferation by PPD and the killed M. tuber culosis failed to correlate with the erythema and the induration of the in vivo skin reaction to PPD.View full abstractDownload PDF (958K) -
Kimiaki NAGANO, Hideo KASHIWAGI, Motoko YAMAGUCHI, Toshio IBE, Yoshio ...1992 Volume 67 Issue 7 Pages 529-534
Published: July 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThis report is a case study of a vagrant whose state of tuberculosis showed noteworthyimprovement due to clinical treatment. A 54-year-old male, vagrant, was admitted to thehospital in a state of preshock because of a serious stage of lung tuberculosis. The clinicalcourse was severe, but after three months of intensive care the patient recovered. It wasnoted that the echocardiogram taken after recovery revealed improvement when comparedwith the one taken upon admission, which showed remarkable right ventricular overload.Furthermore, anti-tuberculosis agents proved to be very effective in this case. The patientsrespiratory functions improved more markedly than had been expected.
The reason for reporting this case study is to bring attention to the improvements inthe patient's clinical course and echocardiographic findings. These suggest that tuberculosisin vagrants may differ from the usual stage of tuberculosis diagnosed in elderly persons interms of response to anti-tuberculosis agents and potential recovery.View full abstractDownload PDF (2046K) -
Hajime SAITO, Haruaki TOMIOKA, Katsumasa SATO, Keitaro INOUE, Eriko SH ...1992 Volume 67 Issue 7 Pages 535-538
Published: July 15, 1992
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSFourty-five sputum specimens were subjected to isolation for mycobacteria either MBCheck system (MB method; F. Hoffmann-La Roche Ltd., Basel, Switzerland) or 3% Ogawaegg medium (Ogawa method). Test suptum was treated with 4 volumes of 4% NaOH for 1- 2 min and 0.1 ml of the resulting mixture was inoculated onto 3% Ogawa egg medium. Theremaining portion of the mixture was neutralized with 1N HC1, diluted with 1/15 Mphosphate buffer (PB; pH 6.8), and subsequently centrifuged at 3, 000 rpm for 20 min. Thesediment was suspended in 1.5 m/ of PB and 0.5 m/ each was inoculated into MB Check Mbottle (20ml) supplemented with M supplement (1 ml). In MB method, bacterial growthwas measured on Middlebrook 7H11 agar medium and Middlebrook 7H11 agar mediumcontaining NAP (p-nitro-α-acetylamino-β-hydroxy-propiophenone).
Among 45 sputum specimens, the number of positive specimens for mycobacterialgrowth in the above two cultivation methods and time required for growth were as follows: 3% Ogawa egg medium; 12 specimens (26.7%) gave positive growth, including 7 of M.tuberculosis complex strains on 14-35 days (average 22 days) and 5 of M. avium complexstrains on 14-21 days (average 18 days); MB method; 15 of specimens (33.3 %) gavepositive growth, including 8 of M. tuberculosis complex strains on 7-21 days (average 15days), 6 of M. avium complex strains on 7-14 days (average 11 days) and 1 of M.scrofulaceum strain on 28 days. There was no specimen which was positive for mycobacterialgrowth on 3% Ogawa egg medium but nagative on MB medium.View full abstractDownload PDF (493K)
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