Kekkaku(Tuberculosis)
Online ISSN : 1884-2410
Print ISSN : 0022-9776
ISSN-L : 0022-9776
Volume 68, Issue 7
Displaying 1-5 of 5 articles from this issue
  • Duration of Chemotherapy
    Masako WADA, Akihiro SEITA, Toru MORI, Hideo OGATA, Takumi SUGIE, Hiro ...
    1993 Volume 68 Issue 7 Pages 469-478
    Published: July 15, 1993
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    Although standard chemotherapy for initial treatment of pulmonary tuberculosis has been established, regimens for retreatment of tuberculosis have not yet been established. One hundred fifty nine retreatment pulmonary tuberculosis cases admitted to Fukujuji Hospital were retrospectively analyzed. Regardless of the age at the start of retreatment, majority of cases were treated previously between 1955 and 1960. Bacillary negative conversion rate, duration of chemotherapy, follow-up period and bacteriological relapse rate were compared according to resistance against isoniazid and/or rifampicin. Sixty four cases were sensitive to both INH and RFP. For this group the average duration of chemotherapy was 14.6 months, mean follow up period was 47.3 months and relapse rate was 3.1 %. This rate was similar to that of initial treatment cases. Sixty one (94 %), were treated with more than two sensitive drugs containing INH and RFP. The 22 INH-resistantand RFP-susceptible cases were treated for 18.6 months and followed up for 55.2 months. The relapse rate of this group was 13.6 %. Thirteen cases were treated with more than 2 sensitive drugs containing RFP. Eleven cases were resistant to both INH and RFP. Five of them were surgically operated of which 3 cases were converted to negative and among the nonsurgical cases in this group only one remained sputum positive. All of these retreatment regimens did not contain pyrazinamide and ofloxacin. Although bacillary positive rate of INH and RFP susceptible cases was 13.0 % at 6 months after treatment and 5.3 % at 12 months after treatment, that of INH resistant and RFP susceptible cases were 25.0 % and 12.5 %, respectively. A certain rule of retreatment could be obtained from the result of this study.
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  • Espesially in Relation to Drug Susceptibility
    Masamichi MINESHITA, Teruomi MIYAZAWA, Masao DOI, Sunao SUEI, Motoki M ...
    1993 Volume 68 Issue 7 Pages 479-486
    Published: July 15, 1993
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    From 1987 to 1991, 27 patients were diagnosed as atypical mycobacteriosis in ourhospital. Some strains of M. avium complex were found to be M. avium and M. intracel lulare by means of a DNA probe test.
    1. Total cases consisted of 14 males (the average age was 66.7 years) and 13 females (65.7 years).
    2. M. avium complex was observed in 24 patients (9 cases of M. avium and 5 cases of M. intracellulare): M. kansasii and M. chelonae were found in 2 patients and 1 patient, respectively.
    3. The findings of sputum cultures became negative three months after the chemotherapy treatment in 3 out of 25 patients. Two male patients were operated on and cured. Three patients died, and all of them had respiratory infections.
    4. To determine the susceptibility of mycobacteria strains isolated from patients to various antimicrobial agents, an investigation was carried out. There were 88 strains of M. tuberculosis, 52 strains of M. avium complex (23 strains of M. avium and 17 strains of M. intracellulare), 3 strains of M. kansasii, 2 strains of M. gordonae and 2 strains of M. chelonae.
    5. Strains of M. tuberculosis, M. kansasii and M. gordonae were susceptible to various antituberculous agents and ciprofloxacin. Strains of M. chelonae were susceptible to ciprofloxacin, and one strain was susceptible to streptomycin and ethionamide.
    6. The M. avium strains were more susceptible to cycloserine and ciprofloxacin than were the M. intracellulare strains. Conversely, the M. intracellulare strains were more susceptible to ethambutol than were the M. avium strains.
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  • Report of the 32nd C Series of Controlled Trials of Chemotherapy
    Koji SATO, Masashi MORI, Toru KATAYAMA, Toshihiko HAGA
    1993 Volume 68 Issue 7 Pages 487-493
    Published: July 15, 1993
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    We studied 2247 patients with pulmonary tuberculosis who were hospitalized for the initial course of chemotherapy under the provision of the revised Tuberculosis Prevention Law issued by Japanese Ministry of Welfare. The results were as follows.
    1) There were more males than females with a ratio of 2.6: 1.
    2) There were two peaks in their ages, 20s and 60s.
    3) The average admission periods were 5.2 ±2.7 months for men and 5.1± 2.8 months 4) The average compulsory admission periods were 6.8±2.5 months for men and 6.4±2.3 months for women, so that the actual admission periods were shorter in the majority of the patients.
    5) The sputum cultures were converted negative in three months in about 80 percent of the patients who were smear and/or culture positive on admission.
    6) The appearance rate of INH-resistant and RFP-resistant strains were 2% and 1.4%
    7) Most of the death from tuberculosis was observed in the early stages of admission.
    8) With regards to the cost, there seemed to be no difference whether treated under the new or the old provisions.
    9) The newly approved extension of the admission periods for those who had complications such as diabetes mellitus or pneumoconiosis and those who had INH and/or RFP positive bacilli seemed to be appropriate respectively.for women.
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  • Hideo KASHIWAGI, Toshio IBE, Yoshio TAKAHASHI, Shinobu TERAMURA, Yoshi ...
    1993 Volume 68 Issue 7 Pages 495-499
    Published: July 15, 1993
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    Oral tuberculosis with pulmonary tuberculosis is very rare in Japan.
    A 45-year old man admitted to our hospital because of spontaneous teeth extraction and pain in oral cavity for the past 3 months. The painful granulation in palate and fistel of 7 th tooth root defect in right upper gum were observed. The diagnosis of oral tuberculosis was made by the histological examination of biopsy material and positive smear test for M. tuberculosis in surface of granulation.
    Chest X-ray showed multicavitary lesions in bilateral upper lobs and spread shadows in bilateral lower lung fidlds.
    He was treated with chemotherapy (INH, RFP, SM and EB) and with tube feeding. Five month's chemotherapy was needed to achieve cured granulation and negative smear test for M. tuberculosis in sputum.
    He was discharged 10 months after admission.
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  • [in Japanese]
    1993 Volume 68 Issue 7 Pages 501-509
    Published: July 15, 1993
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
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