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Volume 71, Issue 11
Displaying 1-7 of 7 articles from this issue
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Comparison between Patients Medically Treated and Those Surgically TreatedMasashi MORI, Kazuko MACHIDA, Yoshiko KAWABE, Toru KATAYAMA, Fujiya KI ...1996 Volume 71 Issue 11 Pages 597-601
Published: November 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSIn Japan there are about 40, 000 patients under home oxygen therapy (HOT), of whom about 30 to 40% are pulmonary tuberculosis sequelae (TBS). These patients can be divided into three groups depending on the treatments they had, Group 1: those who had medical treatments only, Group 2: those who had artificial pneumothorax, and Group 3: those who had thoracoplasties or other surgical treatments. The purpose of this study was to observe the distributions and possible differences in the survival rates among these groups. The study included 1537 patients with TBS under HOT followed at National Hospitals and Sanatoriums nationwide in Japan. In 819 patients the treatments were specified and of those 354 were in Group 1, 29 in Group 2, and 436 in Group 3, so that the proportion of surgically treated patients in PTS was estimated between 28.4% (436/1537) to 53.2% (436/819). The ages at the onset of tuberculosis, at the start of HOT and the intervals in between were 36.6, 66.2 and 29.8 in Group 1, and 26.8, 65.5, and 38.1 in Group 3 respectively. Though the ages at the start of HOT were the same, those at the onset of tuberculosis were about ten years younger in Group 3 than in Group 1. Com paring Group 1 and 3, the survival rates after the initiation of HOT (Kaplan-Meiermethod) was better in Group 2 (surgically treated) than in Group 1 (medically treated). It is speculated that the reason could be a better preservation of the function of the re maining lung in the surgically treated and a higher incidence of obstructive impairments in the medically treated patients.View full abstractDownload PDF (643K) -
Hiroshi KAWADA, Naohito SUZUKI, Yuko TAKEDA, Emiko TOYODA, Makoto TAKA ...1996 Volume 71 Issue 11 Pages 603-606
Published: November 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThis study was designed to compare the results of culture for tubercle bacilli using in duced sputum by an ultrasonic nebulizer and gastric aspirates from same patients who were suspected of having active tuberculosis with little or no sputum and had received no prior chemotherapy. 22 patients included in this series were either culture positive for tu bercle bacilli or showed unequivocal radiographic improvement after three months of therapy with three anti-tuberculosis drugs. Induced sputum from 17 patients and gastric aspirates from seven patients were culture positive for M.tuberculosis. This difference is significant (p< 0.01). Paired induced sputum and gastric aspirates were both positive for tubercle bacilli in seven patients. The finding of acid-fast bacilli on microscopy or tubercle bacilli in culture in four of the seven patients were available much earlier with in duced sputum than with gastric aspirates. Positive gastric aspirates and negative induced sputum for tubercle bacilli was not seen. These results suggest that induced sputum by an ultrasonic nebulizer is superior to gastric aspirates in terms of high sensitivity and early finding for tubercle bacilli and induced sputum and gastric aspirates do not supplement each other.View full abstractDownload PDF (614K) -
MURINE PERITONEAL MACROPHAGESKatsumasa SATO, Haruaki TOMIOKA, Hajime SAITO1996 Volume 71 Issue 11 Pages 607-614
Published: November 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSGrowth inhibition of the intracellular mycobacteria such as Mycobacterium tuberculosis, M. bovis, M. kansasii, M. avium, M. intracellulare, M. fortuitum, and M. chelonae subsp. abscessus by interferon γ (IFN γ) or tumor necrosis factor a (TNF a)-treated murine peritoneal macrophages elicited by proteose peptone was studied in vitro. Macro phages were infected with slowly growing mycobacteria and the extracellular mycobacteria were washed out. Then, macrophages were treated with IFN γ or TNF a at a concentra tion of 10 to 1000 U/ml for 2 days. In another experiment, macrophages were pretreated. with these cytokines for 1 day then infected with rapidly growing mycobacteria as before. Macrophages were cultured with or without IFN γ or TNF a for additional day. Mycobacterial growth was assessed by determination of colony-forming units on 7H11 agar plates after destruction of the macrophages. Stimulation of macrophages with IFN y reduced the growth of mycobacteria. However, except for M. tuberculosis and M. bovis, growth was not inhibited by macrophages treated with TNF a. IFN γ seems to be an important cytokine for the activation of mycobactericidal mechanisms in murine macro phages. Stimulation with IFN-γ or TNF-α and subsequent phagocytosis of M. tuberculosis or M. intracellulare increased O2-production, which was assayed by the method of cytochro me C reduction by murine peritoneal macrophages. Phorbol myristate acetate-triggered O 2- production was also elevated by the cytokine pretreatment of the macrophages, sug gesting that mycobacterial growth inhibition did not parallel the production of reactive oxygen intermediates in TNF a activated murine peritoneal macrophages. These data sug gest that bactericidal mechanisms of murine macrophages against nontuberculous mycobacteria may not depend on reactive oxygen intermediates.View full abstractDownload PDF (1096K) -
Tadayoshi IMAIZUMI1996 Volume 71 Issue 11 Pages 615-618
Published: November 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSLymphocyte surface marker from periferal blood of patients with active cavitary tuberculosis was observed.
CD3×/HLA-DR×cell and CD25×/ CD4×cell were increased in cases with good clini cal course. Disease course was prolonged in cases with no increase of such cells.
CD4×/HLA-DR×cell was increased in cases with far advanced pulmonary lesions.
Thus, analysis of lymphocyte surface marker from periferal blood of patients with tuberculosis seemed to reflect immunological status of patients.View full abstractDownload PDF (364K) -
Takashi IKEDA, Nobuaki IKEDA, Takuya KURASAWA, Atsuo SATO, Koichi NAKA ...1996 Volume 71 Issue 11 Pages 619-623
Published: November 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe report a case of tuberculous infection of emphysematous bulla, who is a 71-years old male and ex-smoker. He had no past-history and had been treated for chronic obstructive pulmonary disease.
At the periodical consultation on Sept 28 '95, abnormal shadow was found in left middle lung field on plain chest X-ray without any exacerbation of symptoms. Nearly alllaboratory tests on admission were within normal limit, except of slight elevation of inflammatory markers and slight hypoxemia. The Mantoux's skin test was positive.
Roentogenologically, the air-fluid level was detected in the bulla of superior segment of left lower lobe. By percutaneous thoracentesis of the bulla under fluoloscopy and ultra sonic echo-guide, the fluid in the bulla was obtained. The fluind was exudate, the activi ties of ADA and LDH were elevated, but neutrophils were more dominant than lymphocytes in the fluid. The MTD test was positive, which amplifies rRNA of Mycobac terium tuberculosis (MTB), and MTB were cultered after four weeks from the fluid. However, MTB was not cultured from sputum and bronchial washing of left S6 via bron choscope.
After the administration of RFP, INH and EB, the fluid gradually disappeared with re duction of the size of bulla.
We discussed the usefullness of the examination of the fluid in the bulla, especially the measurement of the activity of ADA and the MTD test for the confirmation of diagnosis as tuberculosis.View full abstractDownload PDF (1374K) -
Takahiro YONEDA1996 Volume 71 Issue 11 Pages 625-631
Published: November 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSAlthough natural killer (NK) cells, which lyse certain tumors in vitro, have been shown to provide early defense mechanism against cancer growth and viral infection, possible role in the host defense against pulmonary tuberculosis remains undefined. A series of my studies have recently provided several evidence supporting the involvement of NK cells in the immunopathology of pulmonary tuberculosis.
NK cell activity in patients with active pulmonary tuberculosis was significantly aug mented compared with that in age-, sex- matched healthy controls, which suggests NK cells are activated in vivo in pulmonary tuberculosis. Lung NK cells from BCG-infected mice also are shown to be activated. Asialo GM 1 was demonstrated to be a novel sur face marker of mice NK cells, which inhibited activation of NK cells by interferon.
Chronic intractable tuberculosis was classified with a combination of NK cell activity and delayed-type hypersensitivity reaction to 2, 4-dinitrochrolbenzene. Subgroup defined with high NK cell activity and normal delayed-type hypersensitivity was characterized with moderate radiographical lesions and stable clinical course, suggesting the immunespectrum classification was associated with clinical manifestations.
Malnutrition has been suggested to be a risk factor associated with the development and reactivation of pulmonary tuberculosis. NK cell activity was significantly correlated with visceral proteins. IL-2 producing capability was significantly decreased in patients with serum albumin less than 3.5g/dl.
More recently, I established an in vitro system evaluating quantitative capability for intracellular killing by human monocytes, in which monocyte phagocytize Mycobacterium tuberculosis and subsequently inhibit intracellular replication of the organisms by adding some cytokines or cells. Purified NK cells by using discontinuous gradient centrifugation and magnetic separation technique were added to M. tuberculosis-infected monocytes monolayer. Purified NK cells inhibit intracellular replication within monocytes in dose re sponse manner.
In conclusion these findings suggest that (1) NK cells are activated in pulmonary tu berculosis and that (2) NK cells are related with nutritional status and that (3) the immune spectrum defined by NK cell and delayed-type hypersensitivity are related with clinical manifestations and that (4) NK cells may be involved with an early defense mechanism in terms of activation of intracellular killing by human monocyte/macrophage system.View full abstractDownload PDF (982K) -
[in Japanese]1996 Volume 71 Issue 11 Pages 637-654
Published: November 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (2062K)
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