Kekkaku(Tuberculosis)
Online ISSN : 1884-2410
Print ISSN : 0022-9776
ISSN-L : 0022-9776
Volume 71, Issue 10
Displaying 1-6 of 6 articles from this issue
  • TUBERCULOSIS ASSOCIATION
    Hiroe SATO, Eriko SHIGETO, Yasuyuki YOKOZAKI, Norikazu SHIGETO, Touru ...
    1996 Volume 71 Issue 10 Pages 555-559
    Published: October 15, 1996
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    In this study, we investigated 31 foreign patients who had been diagnosed as having pulmonary tuberculosis at the National Hiroshima Hospital or Hiroshima Anti Tuberculosis Association between 1982 to 1995. Their age ranged from 17 to 63 years, and all of them had been in Japan for less than five years. Twelve of the patients came from South America, 18 from Asia, and one from Egypt. Seven Peruvians had been infected in a tuberculosis outbreak. The reasons of their immigration were job-seeking (14 out of 31), education (8 out of 31), and marriage to Japanese men (6 out of 31). None of them were illegal immigrants. In four women who had married Japanese men, various symp toms such as cough, sputum, and slight fever came on during pregnancy, however, none of them had been diagnosed as having tuberculosis, and consequently they had received no medication during pregnancy. In 6 out of the 8 patients who were college students, their sputa were negative for tubercle bacilli, and they could be treated by chemotherapy as outpatients.
    In provincial cities, every effort should be made to detect tuberculosis among members of the foreign community who are living under different environments and conditions.
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  • Win Winmaw, Haruaki TOMIOKA, Katsumasa SATO, Hajime SAITO
    1996 Volume 71 Issue 10 Pages 561-567
    Published: October 15, 1996
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    The interaction of LFA-1 on T lymphocytes with ICAM-1 on antigen presenting cells (APCs) is critical in determining conjugate formation between the APCs and T cells as well as activation of T cells. Recently, it was found that stimulation of THP-1 cells, a human monocyte/Mφ cell line, with Mycobacterium tuberculosis or its lipoarabinomannan, elicited the increase in the ICAM-1 expression. In addition, in cases of lepromatous leprosy patients with a serious defect in the M. leprae antigen-specific cellular immunity, keratinocytes in the leprosy lesions were lacking in the ICAM-1 expression. Therefore, ICAM-1 seems to participate in the host response to mycobacterial infections. Here, we studied the mode of the expression of ICAM-1 molecules on murine peritoneal MφS in response to stimulation with M. avium complex (MAC). In addition, the regulatory effect of some cytokines including TNF-α, IL-10, and transforming growth factor-β (TGF-β) on the ICAM-1 expression was studied.
    Monolayer cultures of peptone-starch induced murine peritoneal Ms were cultured in RPMI-1640 medium in the presence of MAC with or without test agents. At intervals, the MO s were stained with anti-ICAM-1 antibody (Ab) and then treated with alkaline phosphatase (Ap)-conjugated anti-Ig Ab. After color development with NBT-BCIP substrate, percentage of the blue-stained (ICAM-1 positive) Mφs was determined microscopically.
    The concentrations of TNF-α, IL-10, and TGF-β in the Mφ culture fluid was measured by ELISA using capture Ab, biotin-labelled capping Ab, and Ap-conjugated streptavidin.
    When Mφs infected with MAC organisms were cultured in RPMI medium containing 10% fetal bovine serum or in serum-free GPI medium, a significant increase in their ICAM-1 expression was observed, reaching the peak at days 1 to 3, thereafter rapidly de creased and returned to the normal level by day 14. Further addition of TNF-α caused no significant change in the mode of the MAC-induced expression of ICAM-1. A transient increase in the IL-10 production of MAC-infected Mφs was observed during the first 3 days cultivation, as in the case of TNF-α. On the other hand, TGF-β production of the Mφ population was initiated from day 3, and thereafter increased gradually until day 14. ICAM-1 expression of the MAC-infected Mφs was not influenced by the addition of IL-10, while anti-IL-10 Ab retarded the decline of ICAM-1 expression at day 7. On the other hand, the addition of TGF-β attenuated the MAC infection-induced increase in the ICAM-1 expression significantly. In addition, anti-TGF-β Ab significantly delayed the reduction of the ICAM-1 expression of MAC-infected Mφs during days 3 to 7. These results indicate that, in the MAC-infected Mφs, TGF-β rather than IL-10 play important roles as a mediators for the late-phase downregulation of ICAM-1 expression which had been transiently elevated by the action of TNF-α in the early phase of the Mφ cultivation.
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  • Fumio YAMAGISHI, Kiminori SUZUKI, Yuka SASAKI, Masayoshi SAITOH, Masah ...
    1996 Volume 71 Issue 10 Pages 569-572
    Published: October 15, 1996
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    We investigated the prevalence of coexisting diabetes mellitus among patients with active pulmonary tuberculosis by the time of admission, sex and age among 2659 active pulmonary tuberculosis patients admitted to National Chiba Higashi Hospital during the 8 years period from 1987 to 1994. Out of total patients, 352 patients were diagnosed as having coexisting diabetes mellitus and the rate was 13.2%.
    Prevalence of coexisting diabetes mellitus among active pulmonary tuberculosis during the period from 1991 to 1994 was significantly higher than that from 1987 to 1990.
    The prevalence in male was higher than that in female significantly.
    The prevalence was particularly higher in male of 40s (22.0%), and 50s (21.3%), than that in the other age groups.
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  • Mitsuhiko OSUMI, Takeo TOYODA, Takeo KAWASHIRO, Teruo AOYAGI
    1996 Volume 71 Issue 10 Pages 573-585
    Published: October 15, 1996
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    A new rapid M. tuberculosis detection method, the Gen-Probe Amplified Mycobacterium Tuberculosis Direct Test (MTD), which allows direct detection of M. tuberculosis in clinical specimens by amplification of M. tuberculosis ribosomal RNA (rRNA), was evaluated.
    In the present study, MTD and conventional smear and culture examinations were performed on 225 sputum, 36 pleural fluid (PF), nine cerebrospinal fluid (CSF) and 41 bronchoalveolar lavage fluid (BALF) specimens.
    Among 225 sputum specimens from 132 patients, 20 culture-negative specimens from 14 patients and one specimen which was culture-positive for M. fortuitum on Ogawa's egg medium were MTD-positive.
    On the other hand, there were 6 M. tuberculosis culture-positive but MTD-negative specimens from 6 patients. The amount of bacilli in all six cases, however, was very few. The sensitivity of M. tuberculosis detection by MTD, as compared with Ogawa's egg me dium and MB-Check, was 93 and 92%, respectively, in sputum specimens, and the speci ficity of MTD was 80 and 85%, respectively. Taking into account not only culture positive specimens but also MTD-positive specimens from patients clinically diagnosed as active tuberculosis, the sensitivity and specificity of MTD were 93% and 99%, respectively.
    Among 36 PF specimens from 31 patients, of which 20 specimens from 16 patients were clinically diagnosed as tuberculous, only 4 from 4 patients were culture-positive for M. tuberculosis while 7 from 5 patients were MTD-positive.
    The results of MTD in 9 CSF specimens coincided well with those of MB-Check, but one MTD-positive specimen yielded a false-negative result with Ogawa's egg medium.
    Among 41 BALF specimens from 39 patients, only one was culture-positive while one culture-positive and 7 culture-negative specimens were positive on MTD. All these MTD-positive patients were later verified as having pulmonary tuberculosis either by transbronchial lung biopsy and other examinations, or by the clinical course of the disease, particularly the response to andti-tuberculosis drugs.
    Inconsistent results were seen in 21 sputum specimens from 15 patients, 4 PF specimens from 3 patients and 7 BALF specimens from 7 patients, all of which were culture-nega tive for M.tuberculosis but MTD-positive. None of these patients had any clinical findings inconsistent with diagnosis as tuberculosis.
    It was noted that MTD was very useful for rapid detection of M. tuberculosis in sputum as well as other clinical specimens.
    We observed the clinical course of 20 pulmonary tuberculosis patients by monthly examinations of sputum, using smears, Ogawa's egg medium, MB-Check and MTD. MTD-positivity rates fell down in parallel with decreased pulmonary tuberculous activity. During the clinical course, out of 61 MTD-negative specimens only 4 (6.6%) were culture-positive for M. tuberculosis, while out of 63 smear-and-culture-negative specimens 6 (9.5%) were MTD-positive.
    These data suggest that MTD is useful to assess the clinical activity and course of tuberculosis.
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  • Tadayoshi IMAIZUMI
    1996 Volume 71 Issue 10 Pages 587-589
    Published: October 15, 1996
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    Hepatocyte growth factor (HGF) was observed in sera from cases with lung tuberculosis.
    1. Serum HGF was elevated in cases with active lung tuberculosis.
    2. Stabilization of the disease by treatment lowered the level of serum HGF.
    3. General activation of mesenchymal system cells might be reflected in the elevation of serum HGF in active lung tuberculosis.
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  • Kaoru SHIMOKATA
    1996 Volume 71 Issue 10 Pages 591-596
    Published: October 15, 1996
    Released on J-STAGE: May 24, 2011
    JOURNAL FREE ACCESS
    Because of containing of numerous immunocompetent cells, tuberculous pleurisy is a good model for analysis of local cellular immunity.
    When lymphocytes in pleural effusion were cocultured with purified protein derivative (PPD), they reacted to PPD and produced far more interleukin 2 (IL-2) and interferon -γ (IFN-γ) than did peripheral blood lymphocytes. Analysis using monoclonal anti body and complement revealed that at least the OKT 4+/OKT8- T-cell subset is respon sible for the antigen-specific IFN-γ production in pleural fluid T lymphocytes.
    Tuberculous pleural fluid itself had far higher levels of IL-2 and IFN-γ than malig nant pleural fluid. Therefore, it is indicated that activated T lymphocytes in tuberculous pleural fluid concern the production of lymphokines at the morbid site.
    Treatment with IFN-γ resulted in an increased percentage of human alveolar macrohpages ingesting BCG and an increased number of ingested BCG in individual alveolar macrophage in patient with pulmonary tuberculosis. The IFN-γ treatment also showed increased killing activity of alveolar macrophages. Through these studies, IFN-γ is an essential cytokine which activates human alveolar macrophages and induces antimycobacterial activity.
    In conclusion, we could elucidate from the study of tuberculous pleurisy that exudative sensitized pleural fluid T-lymphocytes play a major role in the defence of tuberculosis at the morbid site.
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