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69 巻, 7 号
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半田 真紀子1994 年 69 巻 7 号 p. 463-469
発行日: 1994/07/15
公開日: 2011/05/24
ジャーナル フリーIn recent years, the rate of decrease of the number of new patients with tuberculosis has slowed down. The aging of the Japanese population partially accounts for the increase in the number of patients with tuberculosis. The disease is often transmitted from these aged patients to those who were uninfected. Since it is well-known that a poor nutritional condition lowers the immunological resistance to tuberculosis, we used Onodera's PNI (Prognostic Nutritional Index; 10×serum albumin concentration+0.005×peripheral lymphocyte count) as a parameter to check the nutritional condition and immunological deficiency in patients suffering from tuberculosis.
We examined a total of 451 patients with tuberculosis who were admitted to our hospital from 1987 to 1991. The PNI value decreased with age and was low in patients with extensive lesions on chest X-ray as well as in those with complications, PNI was also low in patients showing negative tuberculin skin reaction, and increased with the intensification of the positive reaction. In patients showing negative conversion of bacilli during treatment, PNI value on admission increased significantly immediately before discharge. Patients with percent ideal body weight (IBW, calculated by the Broca's method modified by Katsura) on admission less than 90% accounted for 48.6% of all patients. There was a positive correla tion between PNI and an obesity index (P<0.01, r=0.24). After admission, in patients showing negative conversion of bacilli, there was a positive correlation between the increase in PNI and the gain of body weight (P<0.01, r=0.30).
Hence PNI is considered to be useful for estimating nutritional/immunological conditions and evaluating the efficacy of treatment in patients with tuberculosis.抄録全体を表示PDF形式でダウンロード (907K) -
四十坊 典晴, 平澤 路生, 犬塚 学, 浅川 三男, 阿部 庄作, 今井 浩三1994 年 69 巻 7 号 p. 471-474
発行日: 1994/07/15
公開日: 2011/05/24
ジャーナル フリーIntercellular adhesion molecule 1 (ICAM-1) plays an important role in inflammatory diseases. We investigated levels of circulating soluble ICAM-1 in patients with miliary tuberculosis (n=8) and pulmonary tuberculosis (n=49). We also attempted to compare ICAM-1 levels among pulmonary tuberculosis patients according to chest X ray classifica tion of the Japanese Society for Tuberculosis. Significantly increased levels of circulating ICAM-1 were found in patients with miliary tuberculosis and extensive (extent 3) pulmonary tuberculosis (n=9) compared to those of controls (n=48), but not in patients with extent 1 (n=24) or extent 2 pulmonary tuberculosis (n=16). Immunohistochemical examination of the tuberculous lung tissues from the patients showed intensive cellular ICAM-1 on epithelioid cells and giant cells as well as on vascular endothelial cells. These results suggest that ICAM-1 is an important adhesion molecule in tuberculosis抄録全体を表示PDF形式でダウンロード (2646K) -
高橋 基久1994 年 69 巻 7 号 p. 475-482
発行日: 1994/07/15
公開日: 2011/05/24
ジャーナル フリーTo strengthen National Tuberculosis Programme (NTP) in Nepal, where tuberculosisstill remains as one of major infectious diseases, the tuberculosis control project organized by the Japan International Cooperation Agency (JICA) has been carried out since April 1987. The programme has covered 55 districts out of 75 districts in the whole country, and the population in the project area was about 90% of the total population.
1) The numbers of sputum examination and of detected smear positive patient have decreased in 55 districts during the period from 1988 to 1991. The number of newly registered smear positive patients has decreased too, while the number of newly registered smear negative patients has increased during the same period.
2) Detection rate of smear positive pulmonary tuberculosis out of sputum examined cases was 11.0% in 1990-1991. The highest rate was observed in the central region (15.9%) and the rate was lowest in the mid-western region (6.7%). The rate was also high in plain (Terai) area (12.6%), while low in mountain area (7.3%).
3) At National Tuberculosis Centre (NTC), agreement rate between smear microscopy and culture examination has increased from 86.5% in 1990 to 88.9% in 1992.
4) Quality control of sputum-smear examination for the laboratories of the District Public Health Office (DPHO) was carried out in 1991. In smear staining, inadequate decolorization was obvious. In smear reading, agreement rate between positive and negative results was 90.3%. Disagreement rates in positive slides and negative slides were 16.3 and 2.4%, respectively. Correlation between the quality of smear-staining technique and of smear reading result was clearly observed.抄録全体を表示PDF形式でダウンロード (1118K) -
猪狩 英俊, 菊池 典雄, 川島 辰男, 小野崎 郁史, 栗山 喬之1994 年 69 巻 7 号 p. 483-490
発行日: 1994/07/15
公開日: 2011/05/24
ジャーナル フリーIn the past eight years, we experienced 94 cases of nontuberculous mycobacteria (NTM) isolation from the specimens of sputum, gastric juice, pleural fluid and fiberoptic bron choscopic procedure at Chiba Kaihin Municipal Hospital. The species of NTM were M. avium complex (MAC) in 23, M. gordonae in 15, M. kansasii in 12, M. fortuitum in 8, M. chelonae in 7, etc. The number of isolation of NTM has increased, and it is worthwhile to mention that it had exceeded the number of isolation of M. tuberculosis since 1991.
We experienced 28 cases of pulmonary infections caused by NTM during the same period. Thirteen cases were by M. avium complex, 11 cases by M. kansasii, one case by MAC and M. kansasii, one case by M. chelonae and two cases by unidentified NTM.
Pulmonary infections by NTM also gradually increased. Thirteen cases (46.4%) had underlying diseases in the respiratory system. Most of them were progressive diseases with cavities and were easily diagnosed by mycobacterial examinations of the specimens such as sputum or gastric juice.
We were unable to diagnose 12 cases (42.9%) by mvcobacterial examinations. Most of them had no underlying diseases and showed small lesions without cavitation on the chest X-ray. Eight cases were diagnosed by the histopathological examination of TBLB (transbronchial lung biopsy) specimens. In such cases, these procedures were also useful for the early diagnosis.
This study indicated the increase of the isolation of NTM and the pulmonary infections by NTM. Once the infections are established, they are progressive, and the early diagnosis of these infections are thought to be important.抄録全体を表示PDF形式でダウンロード (973K) -
大滝 光生, 市川 洋一郎, 大泉 耕太郎1994 年 69 巻 7 号 p. 491-495
発行日: 1994/07/15
公開日: 2011/05/24
ジャーナル フリーA case of endobronchial tuberculosis complicated with atelectasis of upper lobe of the right lung is reported. A 79-years old female was admitted to our hospital for rehabilita tion of her Perkinsonisms.
On admission, her chest X-ray photo showed atelectasis of right upper lobe.
A nodule of a broad-bean size was observed at the orifice of the right upper bronchus by a bronchofiberscopic examination and it was considered as the cause of the atlectasis.
Histological examination of a specimen obtained by transbronchial biopsy of this nodule showed epithelioid granuloma.
Mycobacterium tuberculosis was isolated from a bronchial washing after 4-weeks cultivation.
Anti-tuberculous treatment with INH, RFP and EB was started on January 1992. and, consequently, her chest X-ray findings showed remarkable improvment.
Bronchofiberscopic examination in January 1993 showed a marked reduction in the size of the nodule, and the atelectactic shadow had disappeared and just a residual scar was observed on her chest X-ray photo in June 1993.抄録全体を表示PDF形式でダウンロード (4412K) -
1994 年 69 巻 7 号 p. 497
発行日: 1994年
公開日: 2011/05/24
ジャーナル フリーPDF形式でダウンロード (54K) -
厚生省保健医療局エイズ結核感染症課編1994 年 69 巻 7 号 p. 499-501
発行日: 1994/07/15
公開日: 2011/05/24
ジャーナル フリーPDF形式でダウンロード (357K)
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