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Volume 71, Issue 5
Displaying 1-6 of 6 articles from this issue
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Tsukasa YAMAMOTO, Keiichi NAGAO, Osamu OKADA, Jun-ichi YASUDA, Nobuhir ...1996 Volume 71 Issue 5 Pages 331-337
Published: May 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe examined a relationship between tissue hypoxia and pulmonary hemodynamics or ventilatory capacity during rest and exercise in patients with tuberculosis sequelae. Nine patients performed exercise test until their symptom limit. Mean pulmonary arterial pressure (PPA) during exercise was plotted against cardiac index (C.I.) from rest to maximum exercise in each patient. In most of the patients, the changes of PPA showed linear relation with the C.I., and a slope (P-F slope) was obtained from the regression equation in each patient, and it was used as an index of circulatory disability during exercise. At the same time a coefficient of oxygen delivery (COD) was calculated and mixed venous oxygen tension (PvO2) was measured to evaluate a tissue hypoxia at rest and during exercise. The changes of COD were similar to those of PvO2 during exercise. COD positively correlated with PvO2 (R=0.873, P<0.01) from rest to maximal exercise, indicating that the values of PvO2 depended on those of COD. P-F slope negatively correlated with S.I. (R=-0.887, P<0.01), oxygen transport (R=-0.780, P<0.01), COD (R=-0.827, P<0.01) and PvO2 (R=-0.760, P<0.01) at maximal exercise. Whereas no significant relationship between ventilatory variables and COD or PvO2 was noted at maximal exercise. In conclusion, the patients with pulmonary tuberculosis sequelae who had a steep P-F slope showed low mixed venous oxygen tension during exercise as a result of limited oxygen transport in consequence of low stroke volume.View full abstractDownload PDF (881K) -
Hiroshi YAMAMOTO, Tokuro OHTSUKA, Yoshio IMURA, Akira FUJITA, Akira SU ...1996 Volume 71 Issue 5 Pages 339-344
Published: May 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe authors experienced two cases of multiple pulmonary tuberculomas, which were suspected of metastatic lung tumors. First patient was a 63-years-old male, who was found to have multiple pulmonary nodular shadows on his check up chest X-ray film, suspected of pulmonary metastases of rectal cancer. VATS biopsy, performed for one of nodules revealed that it was caseating granuloma, suggestive of pulmonary tuberculosis. Second patient was a 55-years-old female with rheumatoid arthritis and a chest X-ray film showed multiple pulmonary nodules, which were thought to be metastatic lung tumor from unknown origin. VATS biopsy for a subpleural nodule showed epitheloid granuloma with caseous necrosis of lung, indicating pulmonary tuberculosis. VATS biopsy is, therefore, an useful technique for differential diagnosis of small pulmonary nodules of unknown origin.View full abstractDownload PDF (2969K) -
Makoto NAGANUMA, Takeo TOYODA, Mitsuhiko OSUMI, Ikuko KANNO, Tomoaki T ...1996 Volume 71 Issue 5 Pages 345-349
Published: May 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA case is 48 years-old Japanese man who had a history of frequent sexual contact with prostitutes in Thailand and the Philippines. He presented with chief complaint of chest discomfort in April 1995. His chest X-ray film showed right mediastinal lymph node swelling in other hospital and the sputum smear was strongly positive for acid fast bacilli. In May 1995, he was admitted to our hospital and serological tests for HIV were positive both by EIA and Western blot methods. The CD4 lymphocyte count was 167/μg.
He was diagnosed as a case of AIDS according to the criteria proposed by the AIDS surveillance committee of the Japanese Ministry of Health and Welfare. Although numerous tubercule bacilli were detected in sputum, the chest X-ray did not show abnormal shadow in lung fields. So the diagnosis of bronchial tuberculosis was suspected by these apparently contradictory findings and the bronchoscopy was performed. Biopsy specimen of the bronchial mucous membrane obtained by bronchoscopy confirmed the presence of acid fast bacilli by Ziehl-Neelsen's staining method, however, histological findings were atypical of tuberculosis.
A month after the initiation of treatment with isoniazid, rifampicin and ethambutol and AZT, his clinical symptoms improved and the sputum smear and the culture tests for tubercule bacilli converted to negative.
Complications of AIDS, (Pneumocystis carinii infection, Cytomegalo virus infection, Kaposi's sarcoma, etc) other than tuberculosis have not developed to date.
In the past reports, we could not find reports of bronchial tuberculosis with AIDS. Tuberculous granuloma formation was scarce in this case, and it was suspected that bronchial tuberculosis with AIDS would show characteristic sign as same as pulmonary tuberculosis with AIDS.View full abstractDownload PDF (3991K) -
Takenori YAGI, Kiminori SUZUKI, Fumio YAMAGISHI, Yuka SASAKI, Hiroshi ...1996 Volume 71 Issue 5 Pages 351-355
Published: May 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA case of abdominal tuberculous lymphadenitis diagnosed by percutaneous needle biopsy under ultrasound control and followed up by ultrasound imaging was reported. A 63 years-old male was admitted to a certain hospital complaining of dizziness and diplopia. Chest roentgenogram showed bilateral infiltrative shadows in the upper lung fields and Mycobacterium tuberculosis was detected in cultures from specimens of gastric aspiration. Abdominal ultrasound examination and computed tomography showed abdominal lymph nodes swelling. Needle biopsy under ultrasound control was performed, and the specimens showed necrosis and Mycobacterium tuberculosis was positive by culture. He was diagnosed as lung tuberculosis with abdominal tuberculous lymphadenitis and admitted to our hospital for anti-tuberculous chemotherapy. Ultrasound examination done every two weeks showed diminution in size of the lymph nodes after a month of anti-tuberculous therapy. For the diagnosis of abdominal lymph node swelling, a needle biopsy under ultrasound control is safe and useful technique, and a ultrasound examination is also valuable to follow up the course of abdominal tuberculous lymphadenitis.View full abstractDownload PDF (1564K) -
Yuka SASAKI, Fumio YAMAGISHI, Kiminori SUZUKI, Masayoshi SAITOH, Masah ...1996 Volume 71 Issue 5 Pages 357-361
Published: May 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 77-year-old male consulted an orthopedist with complaints of lumbago and a lumbar swelling, and was treated with acupancture. As the symptoms deteriorated, and smear of a specimen aspirated from the lumbar swelling was positive for acid fast bacilli which were later identified as Mycobacterium tuberculosis, he was hospitalized in the National Chiba Higashi Hospital. On admission to our hospital, CT-scan of lumbar vertebrae showed the destructive change of spinous process of the third lumbar vertebra accompanied by the abscess formation, and an occipital swelling with the destructive change of skull was also detected. Whole body examinations with CT-scan and bronchoscopy did not reveal any other abnormal findings suspective of tuberculous lesions. The above lesions were both gradually improved by antituberculous chemotherapy with INH, RFP, and EB.
He was finally diagnosed as posterior tuberculous spondylitis of the lumbar vertebra with cold abscess, and also clinically diagnosed as skull tuberculosis caused presumably by the inoculation of tubercle bacilli from the lumbar lesion by acupuncture.View full abstractDownload PDF (1943K) -
1996 Volume 71 Issue 5 Pages 387-389
Published: May 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (360K)
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