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Volume 71, Issue 4
Displaying 1-5 of 5 articles from this issue
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Mutsuo KUBA, Keisyun NAKASONE, Shigeru MIYAGI, Kunio KYAN, Takashi SHI ...1996 Volume 71 Issue 4 Pages 293-301
Published: April 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSSeventy one patients with active pulmonary tuberculosis who died during the past 5 years (1989 to 1993) were evaluated on their causes of death. Twenty two patients (31%) died directly of tuberculosis, and among them, 18 patients (81%) of 22 patients who died of tuberculosis) had very advanced tuberculosis. The majority of them (64%) were old age over 70 years and were bedridden due mostly to cerebrovascular injuries. The serum level of albumin was low in all 17 patients in whom it was measured. Establishment of diagnosis of tuberculosis was delayed over one month after the onset of symptoms in 59% of patients who died of severe disease. Sixty one percent (11/18) of patients died within the first month after the initiation of chemotherapy and about 90% (16/18) died within 3 months. Two patients died from massive hemoptysis and other patients died of either respiratory failure or tuberculous meningitis. From these observations it was found that very advanced tuberculosis was the major cause of death in patients who died of tuberculosis and that the advanced disease was chiefly caused by the delay on the establishment of diagnosis, and it was most important to detect tuberculosis as early as possible, with regular check up of chest X-ray and frequent examination for AFB (acid-fast bacilli) for tuberculosis suspected patients.
On the other hand, the majority of patients (49/71) died of complicating medical ploblem unrelated to tuberculosis. Seventeen patients died from malignancy (seven lung cancer, four lymphoma, two laryngeal cancer, etc). Ten deaths were the result of bacterial superinfection. Other patients died from respiratory failure due to COPD, arteiosclerotic heart disease, or cerebrovascular injuries, etc. Two patients of old age died of hepatic failure possibly caused by adverse reaction of TB chemotherapy.
It was found that diseases unrelated to tuberculosis were the cause of death in approxi mately 70% of patients with active tuberculosis, and it should be emphasized to detect early and to treat these diseases, in particular malignancy. And it is also imperative that the chemotherapy for TB must be instituted very carefully with frequent monitoring of liver function in patients with old age.View full abstractDownload PDF (4935K) -
The Experience of the National Chiba Higashi HospitalYuka SASAKI, Fumio YAMAGISHI, Kiminori SUZUKI, Takayuki KURIYAMA1996 Volume 71 Issue 4 Pages 303-309
Published: April 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSOut of 1628 tuberculosis patient discharged from the to National Chiba Higashi Hospital, 537 previously untreated pulmonary tuberculosis patients were selected for the study to examine the delay in case-defection. Patient's delay were longer but doctor's delay were shorter in male than in female. The main reasons for doctor's delay were the delay in taking chest X-ray, and the error in the interpretation of initial chest X-ray findings. In 88 patients who were detected in the advanced stage, the total delay were longer than the others common cases and the doctor's delay was found in 13 cases. To avoid such an unneccessary delay, the importance of sputum examinations must be re-emphasized in all patients who show respiratory symptoms and/or abnormal chest X-ray findings.View full abstractDownload PDF (977K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese]1996 Volume 71 Issue 4 Pages 311-316
Published: April 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSFour cases of pulmonary tuberculosis resembling pulmonary abscess radiographically were reviewed from their clinical features, chest X-ray and chest CT, and the mechanism of formation of so-called niveau-like shadows was discussed. Only one case showed a newly formed tuberculous cavity with air fluid level on chest X-ray, however, even in this case, the possibility of the infection with tubercle bacilli of an emphysematous bulla of the lung could not be completely excluded as several bulla were found on chest CT. The remaining three cases showed a slightly different mechanism of the formation of niveau-like shadows. Namely, mycobacterium tuberculosis spread into an existed bulla and a tubercle bacilli infected bulla was formed. Regarding the clinical features, no remarkable findings were detected and we could find no differences with common tuberculosis. Based on these experiences, the presence of pulmonary tuberculosis resembling the shadow of pulmonary abscess should be emphasized.View full abstractDownload PDF (7284K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...1996 Volume 71 Issue 4 Pages 317-318
Published: April 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe reported changes in the working status of pulmonary tuberculosis patients after the admission to our hospital. The age of patients ranged from 20 to 69 years old, and they were admitted to the 18th ward of our hospital from April 1991 to March 1993. We sent out the questionnaire to 198 patients, and the reply was sent back from 116 patients (Male 74, Female 42).
Out of the 116 patients, we excluded the unemployed, the government employees, and self-employed workers. The remaining 76 patients were examined about their working status after admission, and the results were as follows; 2 patients lost their work, 11 patients retired from the work, 2 patients faced the drop of their position, and 3 patients had their salary reduced.View full abstractDownload PDF (265K) -
Arata KOCHI1996 Volume 71 Issue 4 Pages 319-327
Published: April 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (1554K)
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