巻号一覧
68 巻, 6 号
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松葉 剛1993 年 68 巻 6 号 p. 407-418
発行日: 1993/06/15
公開日: 2011/05/24
ジャーナル フリーKnowledge, attitude and health behavior toward tuberculosis among Non-immigrant Korean people in Japan was researched by using questionnaire because of increasing the number of the tuberculosis patients among those group.
The Korean member of protestant churches in Tokyo were subjects for the survey. Immigrant Korean people and their descendants were excluded. The questionnaire form was written in Korean language under the guidance of native Korean tuberculosis specialists. Proportion of Response was 53.1%, or 251 among 473 from 10th January to 30 th June in 1992.
The knowledge of tuberculosis among them was revealed to be higher than among ordinary native Korean people. It was different statistically by generation, namely, younger subjects aged less than 40years old tended to answer that tuberculosis was a minor illness.
The mass screening system in Japan was well known by the subjects, as shown by the fact that 72.4% of them answered that they knew about it. But only 56.6% of them replied that they actually took the mass screening.
The source of its information was different statistically by sex, occupation, and generation.
As for their health behavior, nearly two thired (63.7%) of them visited the hospitalor dispensary quickly when they fell sick. A small number of them answered that they could not visit a doctor because of their problems with the Japanese language.
More than 80% of them possessed a National Health Insurance certificate. This proportion varied according to the period of stay in Japan. That is to say, The group which stayed in Japan less than one year was significantly the lowest because they were limited in their ability to enter National Health Insurance.抄録全体を表示PDF形式でダウンロード (1606K) -
山崎 利雄, 中村 玲子1993 年 68 巻 6 号 p. 419-425
発行日: 1993/06/15
公開日: 2011/05/24
ジャーナル フリーSequences of the DNA fragments amplified in PCR using a primer pair YNP-1 and YNP-2 and template DNAs from various mycobacteria were analysed with the kit Sequenase Ver. 2.0. The size of each PCR product was as follows 164 by for M. tuberculosis and M. bovis, 137 by for M. kansasii, 109 by for M. intracellulare, 136 by for M. gordonae. Homology of the sequences to M. tuberculosis was 100% to M. bovis, 76% to M. kansasii, 64% to M. intracellulare, and 74% to M. gordonae. Only 2 of 12 strains belonging to M. avium were positive in PCR in this experiment. The sequence of these PCR products was 100% homologous to that of M. intracellulare.
RFLP using Mbo I and BstE II was examined in each PCR product. The oretically, it is expected that the product of M. tuberculosis complex is cut into 119 by and 45 by fragments by BstE II and 140 by and 24 by fragments by Mbo I M. kansasii is cut by only Mbo I into 102 by and 35 by fragments M. gordonae 92 by and 44 by fragments by BstE II and 112 by and 24 by fragments by Mbo I Neither enzyme can cut the product of M. intracellulare.
The results of the enzyme digestion were consistent with the expectation. Thus, it is suggested that the combination of PCR and RFLP would become a powerful tool for the detection and identification of mycobacteria from the clinical isolates within a short time as 48 hours.抄録全体を表示PDF形式でダウンロード (3409K) -
林 文, 志村 昭光, 内山 寛子, 長尾 啓一, 栗山 喬之1993 年 68 巻 6 号 p. 427-434
発行日: 1993/06/15
公開日: 2011/05/24
ジャーナル フリーTo prescribe or withhold isoniazid (INH) for tuberculin skin test reactors is a difficult question in our country where BCG coverage rate is high. The guideline for INH preventive therapy renewed in 1989 says that the decision should be made according to the maximum erythema diameter of tuberculin skin test considering if the patient is a contact or noncontact, BCG vaccinated or non-vaccinated. In addition, evidence of recent infection is also important.
We reported the INH preventive therapy in Chiba prefecture before and after the renewal of the guideline.
There were 347 cases before and 571 after the renewal of the guideline. The cases of which maximum erythema diameter were coincided with the recommendation of the guideline were 50.2 % and 78.6 % respectively. Close contacts of infectious tuberculosis, i. e. cases founded out in extraordinary health examination and household contacts examination, showed high coincidence rate. On the contrary, tuberculin-positive infants found in routine health examination, who are neither contacts nor BCG vaccinated, showed low coincidence rate and seemed to be administrated INH by their home or school-doctors' own standards. These trends were the same before and after the renewal of the guideline.
Cases aged 16 to 29, for whom preventive therapy is indicated newly after the renewal, were 25% of all cases and almost all of them were contacts in group infections. As for the 22 cases found out in household contact examination, indication were questionable in some of the cases.抄録全体を表示PDF形式でダウンロード (1040K) -
戸井田 一郎1993 年 68 巻 6 号 p. 435-444
発行日: 1993/06/15
公開日: 2011/05/24
ジャーナル フリーBacille Calmette-Gubrin (BCG) has been widely used as a safe and effective vaccine for the protection of tuberculosis, but recent epidemic of human immunodeficiency virus (HIV) infection evoked serious concerns about the safety of BCG when vaccinated to HIV-infected persons: that is, because BCG is a live, though avirulent, bacterial vaccine, it might grow in immunocompromized host and might cause dissemination and/or exacerbated local adverse reactions. In fact, during the decade since the first report on AIDS in 1981, several reports were published on the adverse reactions, systemic or local, induced by BCG in HIV infected persons. In this paper, the present author attempted to review such reports as comprehensively as possible.
From critical examinations of the literatures, it was concluded that:
1) None of the reports dealing with dissemination of BCG provided satisfactorily enough evidence to identify the isolated mycobacteria as Mycobacterium bovis BCG. In some cases, infection with wild strain of M. bovis, instead of BCG, should be considered as more plausible pathogen. Especially, two reports, which suggested the late reactivation and dissemination of BCG vaccinated 30 years ago, could not be accepted without more detailed description of the procedures and results of the identification tests. In some cases, application of BCG were considered to be inappropriate. According to the present author's judgement, when BCG was applied appropriately as an anti-tubercul2) As for the local adverse reactions, many reported cases of outbreak of local adverse reactions, such as local ulceration and supprative lymphadenitis, were not related to HIV infection at all, but were due to the usage of an inferior vaccine produced by a specified manufacturer (Pasteur Institute, Paris). Conclusion was that BCG could be safely vaccinated to children born from HIV-seropositive mothers, even if children themselves were also infected with HIV, so long as BCG vaccine of good quality was used.osis vaccine, generalized infections were most plausively induced by BCG only in 4 cases during this decade.
3) Positive conversion rate of post-vaccination tuberculin skin-test seemed to be lower in HIV-infected children than in children born from HIV-seronegative mothers. But, about 30% of the HIV-infected children converted to tuberculin-positive after BCG vaccination suggesting the effectiveness of the vaccination for the considerable fraction of the babies at the highest risk of tuberculosis infection. Positive conversion rate was much higher in HIVnoninfected children born from HIV-seropositive mothers.
From these considerations, recommendations from WHO, which recommended to vaccinate BCG to HIV-infected babies, babies born from HIV-seropositive mothers as well as babies born from HIV-seronegative mothers so long as babies are asymptomatic, are completely justified.抄録全体を表示PDF形式でダウンロード (1688K) -
厚生省保健医療局結核感染症対策室1993 年 68 巻 6 号 p. 447-467
発行日: 1993/06/15
公開日: 2011/05/24
ジャーナル フリーPDF形式でダウンロード (2525K)
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