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Volume 68, Issue 2
Displaying 1-6 of 6 articles from this issue
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Yuka SASAKI, Fumio YAMAGISHI, Kiminori SUZUKI, Takenori YAGI, Hiroshi ...1993 Volume 68 Issue 2 Pages 85-89
Published: February 15, 1993
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThis study investigates 27 cases in which the patients left hospital care without permission for personal reasons. These patients were classified as “self-discharged patients”. Each of the patients had been diagnosed as having pulmonary tuberculosis, and were receiving treatment at the National Chiba Higashi Hospital during the period from January 1988 to July 1991. Disease was in an advanced stage in each of the patients when admitted: all sputum examinations were positive and chest roentgenograms revealed cavities in 26 patients. In addition to pulmonary tuberculosis, the patients were also diagnosed has having a variety of other medical complications such as diabetes mellittus, gastric ulcers and liver disease. Many of them were unemployed or were day labors. Reasons attributed to patients self-discharge from the hospital included repetition of alcohol drinking and unauthorized outings. At the time patients chose to leave hospitalization 11 cases checked positive for sputum examinations, and 16 cases never returned to complete therapy. Many of them were rated as high risk patients for pulmonary tuberculosis because they had no immediate family, did not own a residence or have regular employment thus economic and psychological conditions were very low. There is a high possibility that these individuals will suffer pulmonary tuberculosis relapse and become infectious becteria carriers. It is important that such patients be hospitalized long enough to receive adequate treatment to prevent then from becoming infectious carriers and spreading disease.View full abstractDownload PDF (620K) -
Motohisa TAKAHASHI, Narbada Lal MASKAY1993 Volume 68 Issue 2 Pages 91-97
Published: February 15, 1993
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSIn Nepal, drug sensitivity test for M. tuberculosis has been carrying out at the clinic of German-Nepal Tuberculosis Project (GENETUP) since 1986 and at National Tuberculosis Centre (NTC) since 1991.
The studies of primary drug resistance and acquired drug resistance were performed at NTC. On the other hand, results of drug sensitivity test at GENETUP and NTC were compared and analyzed.
In total, 160 M. tuberculosis strains which were isolated from new smear positive patients were studied for the primary drug resistance. One of 160 strains, 21 (13.1%) strains were resistant to one or more drugs. Resistance rate to one drug, two drugs and three drugs were 9.4%, 3.1% and 0.6% respectively. Resistance to four drugs and five drugs were not found. Prevalence of resistance of each drug were INH 8.1%, SM 5.0%, RFP 2.5%, EB 0.6% and Tbl 1.3% respectively.
In total, 125 strains which were isolated from previously treated patients were studied for the acquired drug resistance. Out of 125 strains, 103 (82.4%) strains had resistance to one or more drugs. Resistance rate to one drug, two drugs, three drugs, four drugs and five drugs were 13.6%, 28.0%, 31.2%, 4.0% and 5.6% respectively. Resistance rate of each drug were INH 56.8 %, SM 38.4%, RFP 71.2%, EB 16.8% and Tbl 24.0% respectively.
Since media, criteria of resistance and definition of resistance for drug sensitivity test are different between GENETUP and NTC, it is difficult to compare the results. However, it is necessary to understand the differences well and get good agreement with both sides.View full abstractDownload PDF (950K) -
Haruaki TOMIOKA, Hajime SAITO, Masako EMORI, Tomoichi SETOGAWA1993 Volume 68 Issue 2 Pages 99-104
Published: February 15, 1993
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSIn order to know the possibility that γδTCR+ T cells induced by Mycobacterium avium complex (MAC) infections participate in the expression of host resistance and in the occurrence of Behget disease, we examined the behaviour of them in MAC-infected host mice. In both BALB/c (Bcgs; MAC-susceptible) and CBA/JN (Iker; MAC-resistant) strain mice, a transient but appreciable increase in the number of γδTCR+ T cells in the host peritoneal lymphocytes was noted around week 1 to 2 after M. intracellulare infection viaip. route. The degree of induction of γδTCR+ T cells was somewhat higher in CBA/JN mice than in BALB/c mice. Therefore, γδTCR+ T cells are partly responsible for the expression of host resistance against the MAC in the early phase of infection. However, the subsequent decrease in the level of γδTCR+ T cells was observed by week 5. Thus, in the case of chronic state of MAC infection, the size of γδTCR+ T cell-pool seems to be in normal level. This suggests that per cell activity of γδTCR+T cells rather than mobilizing number of them is important factor in the mechanisms for occurrence of allergic diseases including Behget disease. Although, the early increase in γδTCR+T cells of peritoneal cells was also observed during the course of M. fortuitum infection, the degree of induction of γδTCR+T cells in A/J mice (M. fortuitum-susceptible) was in similar level as that in BALB/c mice (M. fortuitum-resistant).View full abstractDownload PDF (810K) -
Hiroaki KIKUCHI, Satoru SHOJI, Akira WATANABE, Masakichi MOTOMIYA, Tsu ...1993 Volume 68 Issue 2 Pages 105-107
Published: February 15, 1993
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSAttempts were made to identify Mycobacterium avium and Mycobacterium intracellulare in the M. avium-intracellulare complex (MAC) isolated in the Tohoku district of Japan by using DNA probes (Gen-Probe Rapid Diagnostic System) which are specific for M. avium, M. intracellulare and M. tuberculosis complex, respectively. In the Tohoku district, the ratio of M. avium isolates (80%) exceeded that of M. intracellulare isolates. It was thus shown that, in the Tohoku district where no data concerning the ratio of M. avium to M. intracellulare isolates had been available, the ratio of M. avium by far exceeded that of M. intracellulare.View full abstractDownload PDF (327K) -
A. J. PATHAN, A. A. KHAN1993 Volume 68 Issue 2 Pages 109-111
Published: February 15, 1993
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSVarious cold staintechniques have been tried with varying success since early part of the century. Dr. S. Kudoh of Japan and Dr. A. J. Pathan of Pakistan discussed to evolve a simple process for cold method (see the foot note) which is a simple procedure for staining tubercle bacilli in sputum specimen. And the cold method was found as sensitive, as specific and almost as reliable as Ziehl Neelsen on direct comparison of two techniques. In this paper, the cold method was further evaluated on culture results with Ziehl Neelsen stain during 1987-90 in our institute.View full abstractDownload PDF (235K) -
Lawrence G. WAYNE1993 Volume 68 Issue 2 Pages 113-129
Published: February 15, 1993
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSFrom the time of the discovery of the tubercle bacillus in the late nineteenth century until the introduction of chemotherapy in the mid-twentieth, the role of the laboratory in the management of tuberculosis was limited because the treatment of the disease was nonspecific. The advent of specific chemotherapy and the recognition of human diseases caused by a number of mycobacterial species other than M. tuberculosis increased the scope and importance of the clinical laboratory in guiding the diagnosis and management of mycobacterial disease. This included the isolation of mycobacteria, the identification of the isolates, the determination of their susceptibilities to chemotherapeutic agents and their subtyping for epidemiologic purposes. In spite of the enhanced role it has played in the past forty years, the laboratory's contribution has been impeded by the slow growth of mycobacteria, which causes delays of weeks or months between submission of a specimen and the availability of a definitive report. In the meantime both the urgency and the complexity of diagnosis and management of mycobacterial disease have increased with the emergence of epidemics of these diseases associated with the acquired immunodeficiency syndrome (AIDS). This development has also increased the need for recognition of tubercle bacilli in such specimens as blood and stools, which were only infrequently studied in past years.
Recent developments in microchemical and immunologic technology, and especially molecular biology, are greatly reducing the time needed to get information that contributes to diagnosis and management of mycobacterial disease. These include solid phase immunologic assays, sequencing of selected nucleic acid regions and development of specific probes, and exquisitely sensitive isotopic or enzymatic amplification techniques for the detection of traces of products.View full abstractDownload PDF (2778K)
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