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Volume 71, Issue 1
Displaying 1-6 of 6 articles from this issue
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Masayoshi MINAKUCHI, Yoshirou MOCHIZUKI, Yasuharu NAKAHARA, Rieko KAWA ...1996 Volume 71 Issue 1 Pages 1-5
Published: January 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe analyzed retrospectively the clinical data of 12 patients diagnosed as pulmonary tuberculosis after admission to the National Himeji Hospital during the past 5 years. Ten out of 12 patients were male and were of elder age-groups (mean age: 65.5 years, range: 32-76 years). Seven patients at first visited the department of respiratory medicine, and the remaining three patients were admitted without consulting the department of respiratory medicine before admission.
Only patient had a history of pulmonary tuberculosis. Two patients were suspected of pulmonary tuberculosis on admission. Tubercle bacilli were positive sputum smear in 6 patients, sputum culture in 1, smear of bronchial washing in 4, and smear of BALF in 1. It took 12.7 days on the average from the admission to make a final diagnosis as pulmonary tuberculosis patients into a general hospital lacking TB ward were as follows:
(1) As pulmonary TB was not suspected, Chest X-ray and sputum examination were not performed.
(2) The admission was done due to another disease and respiratory symptoms were scarce.
(3) Tuberculous lesions on chest X-ray were harbored by pleural effusions and diffuse shadows.
(4) Though pulmonary tuberculosis was suspected, a patient was admitted because of general prostration as sputum smear was negative. After admission, however, repeated sputum culture revealed positive results.
(5) Pulmonary tuberculosis developed after the admission.View full abstractDownload PDF (3614K) -
Miwa YAMASAKI, Kotaro OZASA, Akira SHIMOUCHI1996 Volume 71 Issue 1 Pages 7-12
Published: January 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSTo review how to strengthen tuberculosis program in Hunai-Gun, Kyoto Prefecture, the recent trend of incidence of tuberculosis and 148 index cases with pulmonary tuberculosis newly registered from 1987 to 1992 were analyzed regarding the mode of detection, conditions when consulting medical facilities, risk factors, bacteriological findings, and secondary infections among contacts.
1. The high crude incidence of tuberculosis in Hunai-Gun is explained by the high proportion (19.3%) of the elderly population of 65 years old and over in Hunai-Gun compared with the average (12.6%) in the Prefecture and the high tuberculosis incidence among age group of 70 years old and over in Hunai-Gun compared with the prefectural average. However, the reason of higher incidence of tuberculosis among the elderly in the district was not clear.
2. The proportion of bacillary as well as culture positive cases were higher among patients who were diagnosed by consulting medical facilities than those detected by regular health check. The proportion of bacillary cases without risk factors for tuberculosis among patients who were diagnosed at medical facilities was the highest among those newly attending medical facilities due to complaints related to tuberculosis (group A), followed by those patients regularly attending medical facilities for other diseases but consulting because of additional complaints related to tuberculosis (group B), and lowest among patients regularly attending medical facilities but detected by chance while being examined for other diseases (group C). The severer the diseases stage, the higher the proportion of bacillary cases, however, there were no difference in the proportion of bacillary cases among the above three groups including those with risk factors. It is explained by the fact that the ratio of patients with risk factors was high in group C, which masked the higher proportion of bacillary cases among patients with risk factors.
3. As future activities of public health center on tuberculosis control, it is important to give health education to those with risk factors on the fact that the progression of the disease is faster among them in addition to the increased risk of the disease onset, and advise them to attend regular health check and visit medical facilities when they have any symptom related to tuberculosis.
4. Considering the fact that the risk of secondary infection to contacts is higher among smear positive patients than bacilli negative patients, it is needed to examine all contacts of sputum smear positive patients thoroughly. In addition, it is advisable to follow-up contacts of smear negative but culture positive patients with the similar intensity with those for smear positive patients because their risk of secondary infection to contacts was also higher than bacilli negative patients although it was not statistically significant.View full abstractDownload PDF (835K) -
Emiko TOYOTA, Atuto YOSIZAWA, Makoto TAKAHARA, Keiko TAGAWA, Nobuyuki ...1996 Volume 71 Issue 1 Pages 13-17
Published: January 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe studied on the prevalence of drug-resistance among 65 homeless cases who were admitted and treated for active tuberculosis at the Nakano National Chest Hospital during the period from 1990 to 1992 and at the International Medical Center of Japan during the period from 1993 to 1994. Resistance to one or more first line antituberculous drug were revealed in 14 cases out of 65 (21.5%) in initially treated cases 6 out of 43, and in retreated cases 8 out of 22. The prevalence of drug resistance in this study was significantly higher compared with 2 out of 39 cases (5.1%) in our previous report during the period from 1986 to 1988.
In these drug-resistant cases, multidrug-resistant cases, namely, resistant to at least 2 drugs including both INH and RFP were founded in 6 cases (9.2%).
Compared with drug-sensitive cases, the negative convertion rate of bacilli was lower and the number of defalters was significantly larger. It was suggested that higher prevalence of drug-resistance and defalting from the adequate treatment in homeless cases of tuberculosis possibly makes the prognosis of drug-resistant tuberculosis worse and treatment of such cases more difficult.View full abstractDownload PDF (509K) -
BASIC STUDIES ON TUBERCULOSIS AND TUBERCLE BACILLI IN U. S.-JAPAN MEDICAL COOPERATIVE PROGRAM TUBERCULOSIS PANELIchiro AZUMA1996 Volume 71 Issue 1 Pages 19-23
Published: January 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe U.S.-Japan Medical Cooperative Program has been started in 1965 and Tuberculosis Panel is one of the most important field of the programs. In this lecture, the recent advances in the basic studies on tuberculosis researches which were reported in Tuberculosis panel of the program were summarized.
The host defence mechanisms against M. tuberculosis infection were the most important subject. The role of Th1-mediated cytokins such as IL-2, IFNγ and TNF/3 in the host-defence mechanism against mycobacterial infection was extensively discussed. Bcg gene of the mice is the example case for the genetic background of host against mycobacterial infection. The virulence factor, however of M. tuberculosis is still unknown. The technique of molecular biology was applied to the diagnosis of tuberculosis. The PCR and RFLP methods are the useful strategies for the rapid diagnosis and analysis of the mode of infection with M. tuberculosis. The development of detection techniques of drug-resistant tubercle bacilli is also urgently required. Another approach by molecular biology to tuberculosis research is the cloning of gene of tuberculin protein and the production recombinant protein of M. tuberculosis. The amino acid sequences of several proteins have been determined and their immunological properties of recombinant proteins were investigated.
The immunological functions of lipid fractions of tubercle bacilli such as cord factor (TDM) and lipoarabinomannan (LAM) have been described. Especially the immunomodulating activities and the role of TDM as diagnostic antigen in the tuberculosis patients were described. The adjuvant activity of mycobacterial cell wall was well established and the minimum structural requirement was reported to be N-acetylmuramyl-L-alanyl-Disoglutamine (MDP). The several MDP derivatives were selected as the cytokine inducers. Especially MDP-Lys (L18) was widely used as drug for the increasing the number of white blood cells and platelets in cancer patients. The effectiveness of MDP derivatives on the stimulating of mucosal immunity was also recently reported. The preventing activities of virus infection and cancer metastasis of MDP derivatives were shown in mice models.View full abstractDownload PDF (824K) -
II. MULTIDISCIPLINARY ANALYSIS OF CHRONIC EXCRETORS OF MYCOBACTERIUM TUBERCULOSIS BACILLIAriyoshi KONDO, Mitsunori SAKATANI, Toshiaki TSUCHIYA, Hideo OGATA, Hi ...1996 Volume 71 Issue 1 Pages 25-69
Published: January 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (5784K) -
[in Japanese]1996 Volume 71 Issue 1 Pages 71-73
Published: January 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (356K)
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