結核
Online ISSN : 1884-2410
Print ISSN : 0022-9776
ISSN-L : 0022-9776
68 巻, 8 号
選択された号の論文の6件中1~6を表示しています
  • 河野 晴一, 毛利 昌史, 片山 透
    1993 年 68 巻 8 号 p. 511-516
    発行日: 1993/08/15
    公開日: 2011/05/24
    ジャーナル フリー
    To investigate genetic polymorphism of N-acetylation in Japanese population we measured isoniazid (INH) and acetylisoniazid (AcINH) in the urine of 340 unrelated Japanese subjects. For the detection of polymorphism, we used probit analysis, logit analysis, and arcsine transformation of the logarithm of molar acetylation ratio {log (INH/AcINH)}.
    The observed antimodes were-0.85 and-0.325 for the probit, 4.899 and 7.154 for the logit, 43.85 and 71.57 for the arcsine analysis plot. Probit and arcsine analysis were sensitive for the separation of intermediate from slow acetylators, while logit analysis was sensitive for the separation of rapid from intermediate acetylators.
    Clinically it is important to know to which genetic group the patient belongs because we may have to increase the dosage for the rapid acetylators to achieve the desired therapeutic effect, while we may have to reduce the dosage for slow acetylators in whom the incidence of side effect is high.
  • 冨岡 治明, 佐藤 勝昌, 斎藤 肇
    1993 年 68 巻 8 号 p. 517-520
    発行日: 1993/08/15
    公開日: 2011/05/24
    ジャーナル フリー
    We evaluated the in vitro antimicrobial activity of NM394 and ofloxacin (OFLX) against representative pathogenic mycobacteria by the agar dilution method, using 7H11 agar medium. NM394 showed appreciable antimicrobial activity against Mycobacterium tuberculosis (MIC90=0.78μg/ml), M. kansasii (MIC90=6.25μg/ml), M. marinum (MIC90=3.13μg/ml) and M. fortuitum (MIC90=3.13μg/ml), whereas the agent was not active against M. scrofulaceum (MIC90=>100μg/ml), M. avium (MIC90=50μg/ml), M. intra-cellulare (MIC90=<100μg/ml), M. chelonae subsp. abscessus (MIC90=<100μg/ml) and M. chelonae subsp. chelonae (MIC90=25μg/ml). The in vitro antimicrobial activity of the agent against M. fortuitum was a little more active than that of OFLX, whereas the activity of NM394 against the other mycobacteria was slightly inferior to that of OFLX. The antimycobacterial activity of NM394 against M. tuberculosis H37Rv (MIC: NM394=0.78μg/ml, OFLX=0.78μg/ml) phagocytosed in murine peritoneal macrophages was lessactive than that of OFLX, when the macrophages were cultured in RPMI-1640 medium containing 1μg/ml or 10μg/ml of these agents for up to 5 days.
  • 齋藤 雄二, 佐々木 文彦, 石崎 武志, 宮保 進, 塩崎 晃平, 金森 一紀, 北川 正信
    1993 年 68 巻 8 号 p. 521-526
    発行日: 1993/08/15
    公開日: 2011/05/24
    ジャーナル フリー
    A pulmonary tumorous shadow appeared and enlarged in a 25 years-old male patient undergoing intensive chemotherapy for tuberculosis. The chest X-rays taken on admission revealed effused pleura in the right lung and nodular shadows in the upper area of the right lung. After 40 days of using isoniazid (INH), rifampicin (RFP) and streptomycin (SM), a homogeneous opacity, not previously observed, appeared in the middle area of the right lung (S5). Microscopic examination of the tissues obtained during a transbronchial lung biopsy disclosed epithelioid cell granulomas with marked eosinophilic infiltration.
    The presense of eosinophilic infiltration due to the admission of antituberculosis agents was disregarded because no change was observed in the new granulomatous shadows during the drug challenge tests and the lymphocyte stimulation test to INH, RFP and SM was negative.
    Transient aggravation during the initial phase of chemotherapy for pulmonary tuberculosis, such as in this case, is suspected cause by some eosinophilic allergic-induced mechanisms, against bacillary components.
  • 猪狩 英俊, 菊池 典雄
    1993 年 68 巻 8 号 p. 527-531
    発行日: 1993/08/15
    公開日: 2011/05/24
    ジャーナル フリー
    A 28 year-old man was admitted to our hospital because of fever, cough and chestpain. A chest X-ray film taken on admission showed infiltrate in the left upper lung field with ipsilateral pleural effusion.
    Microscopical examinations of stained specimens of sputa and pleural effusions disclosed no acid-fast bacilli. The level of adenosine deaminase (ADA) in pleural effusion was 46.4IU/l. A tuberculin skin test was moderately positive.
    The most probable diagnosis was pulmonary tuberculosis with pleural effusion. Isoniazid (INH) and rifampicin (RFP) were administered on the 5 th hospital day and continued to lower the fever and reduce the pleural effusion.
    The cultured specimens of sputa and pleural effusions yielded Mycobacterium kansasii. After six months of treatment, chest X-ray film showed improvement and the administration of INH, RFP was discontinued without reccurence.
  • 青木 正和
    1993 年 68 巻 8 号 p. 533-538
    発行日: 1993/08/15
    公開日: 2011/05/24
    ジャーナル フリー
    To clarify the characteristics of the tuberculosis situation in Japan, it was analysed in comparison with those in other developed countries. The results are summarized as follows:
    1. The tuberculosis epidemic peaked at the end of 1910s in Eastern Japan, and in the 1940s in Western Japan. It is estimated that the annual risk of inberculosis infection was 4% or more until the end of the World War II. Tuberculosis has spread much later and was much more prevalent up through the 1940s in Japan than in other developed countries.
    2. A modern tuberculosis control programme including active case-finding, isolation of infectious cases, charge free medication and BCG vaccination was launched in 1951, and in 1961 an effective case-holding system was established. Tuberculosis incidence decreased rapidly thereafter. As the rate of decrease was almost the same as that of the Inuit (Eskimo) (Fig. 1), one might say that Japan is one of the countries where tuberculosis incidence decreased most rapidly.
    3. Incidence of tuberculosis in children is 2.1 per 100, 000 in 1991 which is lower than that of the U.S.A. (3.1 per 100, 000).
    4. Incidence of tuberculosis among the aged is much higher than that of other developed countries as shown in Fig. 3. Of course, this is mainly caused by the fact that a higher percentage of Japanese aged 55 years or more was infected with tubercle bacilli in the past. However, it was also shown that the rate of break-out of the disease among remote infected Japanese aged 50 years or more was several times higher than that of Dutch people.
    5. In Japan, the decrease of tuberculosis incidence has stagnated in the past 13 years. The annual rate of incidence reduction was 11% before 1980, and is 3.5% now. Recently, stagnation of increase in tuberculosis incidence is being observed in all prefectures in Japan and in almost all Western developed countries.
    It was concluded from the results of an analysis of the recent trend of incidence in each prefecture in Japan that the causes of stagnation can be summarized as follows: 1) Veryhigh prevalence of tuberculosis before 1950, 2) Rapid increase of the percentage of aged people infected with tubercle bacilli, 3) Stagnation of the rate of decrease of risk of infection by the recent longer delay in cas-finding, and 4) Increase of population in large cities and slum formation. No connection was observed for HIV infection and immigrant tuberculosis.
    6. The total number of HIV infected people was 1, 046 at the end of 1992, excluding HIV infection by blood coagulant infusion. Less than 10 cases of TB/HIV cases have been reported previously in Japan. However, the rate of increase of HIV infections is so rapid recently that it is estimated that the number of TB/HIV cases will increase gradually and the total number of these cases will top 600 by the year 2000.
    7. Number of cases of immigrant tuberculosis are increasing rapidly at an annual increase rate of 18%. However, the total number of cases only amount to 0.3% of the total new cases in 1990.
    8. The total number of the Japan Tuberculosis Society members is more than 2, 600, so the author has expressed his desire to strengthen society activities to promote basic research, to improve the tuberculosis control programme in Japan and to contribute more actively to worldwide tuberculosis control.
  • 厚生省保健医療局結核・感染症対策室
    1993 年 68 巻 8 号 p. 541-543
    発行日: 1993/08/15
    公開日: 2011/05/24
    ジャーナル フリー
feedback
Top