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Volume 68, Issue 4
Displaying 1-7 of 7 articles from this issue
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Eriko SHIGETO, Hiromichi TASAKA1993 Volume 68 Issue 4 Pages 283-291
Published: April 15, 1993
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSTo reveal the epidemiology of mycobacteria other than Mycobacterium tuberculosis in Japan, we tested 379 healthy volunteers from Self Defence Force Army stationed in Hiroshima Prefecture with 0.05 mcg of PPDs, 0.1 mcg of PPD-B, PPD-Y and PPD-F. Majority of the volunteers had been immunized with BCG by thirteen years old. Rate of positive reaction (diameter of redness≥10mm) in each PPD in each ae group were; PPDs [18-19yr (n=39); 30.8%, 20-29yr (n=178); 63.5%, 30-39yr (n=78); 91.0%, 40-53yr (n=84); 92.9%], PPD-B [12.8%, 24.7%, 38.5%, 48.8%], PPD-Y [5.1%, 14.6%, 26.9%, 26.2%], PPDF [0%, 10.1%, 12.8%, 10.7%]. Frequency distribution curve of PPDs in age groups above 20 years old had a peak at about 14mm of diameter, while low-responder were dominant in age 18 to 19. In PPD-B, there were two peaks, one in less than 5mm and the other between 10 to 15mm which was considered as the group sensitized by M. avium complex and became larger in older age group. In PPD-Y and in PPD-F, the frequency distribution showed an exponential curve with a little shift to right in older group in PPD-Y. As there was a considerable degree of cross-sensitivity, we provisionally regarded the maximum reaction of four PPD (larger than 5 mm) or the reaction which is 75 per cent or more of each person's maximum reaction as specific. On this assumption, we calculated following sensitization rate: PPD-B [15.8%, 21.9%, 20.5%, 32.1%], PPD-Y [2.6%, 10.1%, 3.6%, 10.7%], PPD-F [0%, 6.2%, 1.3%, 3.6%]. These rates of sensitization of each PPD are not incompa tible with that estimated from frequency distribution curves.
In conclusion the sensitization rate by M. avium complex in the population we tested is estimated as about 16 to 32 per cent, with higher rate in older age group. The sensitization rate by M. kansasii is lower, and that by M. fortuitum is very low, several per cent at the most. Prevalence rate for disease by M. kansasii varies with the area in Japan, so the sensitization rate by M. kansasii may differ in other areas.View full abstractDownload PDF (982K) -
Haruaki TOMIOKA, Katsumasa SATO, Hajime SAITO1993 Volume 68 Issue 4 Pages 293-299
Published: April 15, 1993
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA new macrolide, clarithromycin (CAM), with increased acid-stability and thus having a markedly improved absorption efficiency from gastrointestinal tract, was evaluated for its in vitro antimicrobial activity against various mycobacterial species. CAM had nearly the same level of anti-mycobacterial activity as that of sparfloxacin (SPFX) and slightly higher activity than rifampicin (RFP), except that its anti-M. tuberculosis activity was much lower than those of SPFX and RFP. Anti-M. avium complex activity of CAM (MIC90 values against M. avium and M. intracellulare were 12.5 and 6.25ug/ml, respectively) was in similar level as SPFX and RFP. However, MIC distribution pattern revealed that anti-M. avium activity was in the order of SPFX>CAM>RFP, while anti-M. intracellulare activities of them were almost the same with each other. Moreover, CAM showed bactericidal action against M. intracellulare growing in 7H9 medium.
Furthermore, we investigated the therapeutic efficacy of CAM against M. intracellulare infection induced in mice and also determined its combined effect with other antimicrobials including KRM-1648, SPFX and ethambutol (EB). When CAM suspended in 5% gum arabic saline was given s.c. to mice infected i.v. with M. intracellulare (8×106 CFU) at 0.2 to 2 mg/mouse/day, once daily six times per week from day 1 for 8 weeks, CAM exhibited a potent therapeutic efficacy, in terms of reduction in the incidence of gross lung lesions and reduction of bacterial loads in the visceral organs (reduction of bacterial CFU by 0.9-3.4 log units in the lung and by 0.4-4.6 log units in the spleen during week 4 to 8, depending on its administration dose).
When mice infected i.v. with M. intracellulare (2×107 CFU) were given either CAM (1.0mg/mouse/day) alone, KRM-1648 (0.2 mg/mouse/day) alone, or a combination of both (1.0mg/0.2 mg), by gavage, in the same protocol as above from day 1 to the end of experiment (weeks 12), both of CAM and KRM-1648 showed a significant therapeutic efficacy, and reduced the incidence of gross lung lesions and decreased bacterial loads in the lungs and spleen. SPFX (0.5mg) and EB (0.4mg) failed to show such an action. CAM and KRM-1648 reduced the bacterial CFU in the lungs by 2.1 and 0.9-1.3 log units, respectively, at weeks 4, 8, and 12. The combined use of the two drugs caused an additive potentiation and decreased the bacterial CFU in the lungs by 2.7-3.3 log units. A similar combined effect was also noted for the bacterial loads in the spleen. However, multidrug therapy such as CAM with KRM-1648 in additional combinations with SPFX or EB or both of them failed to achieve more improved therapeutic efficacy as compared to the two drug combination of CAM with KRM-1648.View full abstractDownload PDF (902K) -
Hidenori MASUYAMA, Hiroko SHIMADA, Tsugiko KINOSHITA, Sadao TAJIRI, Sh ...1993 Volume 68 Issue 4 Pages 301-312
Published: April 15, 1993
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe studied 130 cases of pulmonary tuberculosis in foreigners residing in Japan to obtain the results as follows;
1. Of the cases of pulmonary tuberculosis in foreigners who are registered and receiving treatment in Japan, 20.3% were treated at three dispensaries of the Japan Anti-tuberculosis Association in Tokyo.
2. The nationality of the cases treated was China in more than half of them, followed by the Republic of Korea.
3. The number of days taken from entry into Japan to the start of treatment was about 11.4 months; 0.9% of the total number of cases examined by chest radiophotography required medical treatment.
4. Their living conditions in Japan according to questionnairing are: 56.2% have jobs in Japan; working hour, 4.99±1.19 hours a day; 64.4% take night work; 57.6% work in food/drink service industry; living space is 12.5 m2; 52.4% share the same house with other persons, living together with 1.6 persons.
5. As for the type of illness at the start of treatment, GAKKAI classification type III accounted for 90% and spread 1 83.8%. GAKKAI classification type II accounted for 10%, consisting of many relatively mild cases.
6. The defaulter rate was high at 40.8%. The reason for defaulting was broken down to discontinuation on his own 68%, repatriation 15 % and side-effects 19%. The time to default was average 3.2±3.1 months after the start of treatment. They defaulted 1.2±0.4 times on the average.
7. To reduce the defaulter rate to the minimum in treating the foreigners residing in Japan, the following may be needed.
a. To give guidance on the regimen including the need of treatment and iisk associated with discontinuation of treatment at the first visit.
b. Measures to reduce the amount to be born by the individual in the medical expenses.
c. Preparation of a pamphlet for therapeutic guidance in foreign languages.View full abstractDownload PDF (1457K) -
Annual Transition by Sex and AgeHiroshi MIYAGAWA, Ryuichi YAMADA, Shizuo TAMURA1993 Volume 68 Issue 4 Pages 313-318
Published: April 15, 1993
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe investigated incidence of pulmonary tuberculosis for 31 years (from 1960 to 1990) by sex and age among workers of NTT (Nippon telegraph and telephone corporation) in Tokyo area. Annual transition of recent years was mainly analyzed and following results were obtained.
(1) Incidence in male of the twenties, thirties and forties decreased smoothly from 1960 to around 1980, then came to standstill and increase tendency was suspected, that is to say,
1) incidence in male of the twenties was minimum in 1976 (21 per 100, 000 persons). Annual reduction rate (minus means decrease, plus means increase) from 1960 to 1976 was-11.7 % and that from 1977 to 1990 was -0.4%.
2) incidence in male of the thirties was minimum in 1983 (0 per 100, 000 persons). Annual reduction rate from 1960 to 1982 was-8.8% and that from 1984 to 1990 was +6.8%.
3) incidence in male of the forties was minimum in 1981 (0 per 100, 000 persons). Annual reduction rate from 1960 to 1980 was-11.5% and that from 1982 to 1990 was +1.3%.
(2) Incidence in male of the fifties decreased gradually from the 1960's and no tendency of increase was observed.
(3) Incidence in female of the twenties, thirties and forties decreased almost continuously from 1960 to 1990 and no tendency of increase was observed in each age group, but total incidence in female (from the teens to the sixties) seemed to be leveling off after 1979. From these results, stagnant or increase tendency of pulmonary tuberculosis in young and middle-aged male was noticed.View full abstractDownload PDF (656K) -
Mikio TOYOSHIMA, Masami TANIGUCHI, Shiro IMOKAWA, Koji NAKAZAWA, Atsuh ...1993 Volume 68 Issue 4 Pages 319-323
Published: April 15, 1993
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA case of streptomycin-induced lupus occuring in a 48-year-old female is presented. She was admitted to our hospital in July 1990, complaining of productive cough and general fatigue. A chest roentgenogram showed cavitary lesions and infiltrative shadows in the bilateral upper and middle lung fields and a sputum smear tested positive for acid-fast bacilli. She was diagnosed as lung tuberculosis and antituberculous therapy with isoniazid, rifampicin and streptomycin was started. Ten days after starting the treatment, she began to complain of high fever and erythema on her face and forearms. Blood cell count revealed leucopenia. The antinuclear antibody and antihistone antibody were positive. The improvement of clinical findings and the lowering of antinuclear antibody titer seen after stopping streptomycin confirmed the diagnosis as streptomycin-induced lupus. Streptomycin-induced lupus is very rare.View full abstractDownload PDF (1661K) -
Hajime SAITO1993 Volume 68 Issue 4 Pages 325-331
Published: April 15, 1993
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSNew technologies for isolation or identification of mycobacteria, such as BACTEC 460 TB System, MB Check System, polymerase chain reaction (PCR) and DNA probe test, were introduced, and their usefulness was evaluated on the basis of studies in my laboratory.View full abstractDownload PDF (886K) -
[in Japanese]1993 Volume 68 Issue 4 Pages 341-343
Published: April 15, 1993
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (335K)
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