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Volume 71, Issue 6
Displaying 1-4 of 4 articles from this issue
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Yoko MATSUSHITA, Nobuaki IKEDA, Takuya KURASAWA, Atsuo SATO, Koichi NA ...1996 Volume 71 Issue 6 Pages 391-398
Published: June 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe studied the clinical features of culture-positive, previously untreated patients with pulmonary tuberculosis (77 in females and 200 in males), with special reference on the gender differences in clinical features.
The mean age was 50.8 y.o. for female and 54.4 y.o. for male, and the age distribution was almost similar to that of newly-registered patients of whole Japan in 1993, namely, small peak in 20s decade and large peaks in the age group over 50 in female, and gradual increase up to 50 years and get to plateau in male.
Thirty-nine % in female and fifty-four % in male had various past histories and/or complications which might affect to the deterioration of tuberculosis, such as diabetes mellitus, liver function distress, respiratory failure, malignancy, stomach resection and so on. The rates with each complication were, in general, higher in male than in female. The positive rate to Mantoux reaction was higher in female than in male, and stronger reactions were observed in female than in male.
According to the classificaion of pulmonary tuberculosis designed by the Japanese Society for Tuberculosis (GAKKAI classification), the site (s) of affected lung, the stage and the extent of lesions were more advanced in male than in female, and the positive rate and the amount of bacilli on smear were higher in male than in famale.
The most marked difference was the location of the main lesions, 80% in the apical and posterior segments of upper lobe (S1, 2) and 8% in the superior segments of lower lobe (S6) in male, while 60% in S1, 2 and 25% in S6 in female.
The rate of complete resistance against to anti-tuberculosis agents was higher in male than in female, but the combination chemotherapy of isoniasid and refampicin with streptomycin or ethambutol was almost equally effective both in males and females, and almost all patients converted to bacilli negative within three months after the initiation of the chemotherapy, except in a few male patients.View full abstractDownload PDF (1013K) -
Hajime SAITO, Yoshiko KASHIWABARA, Kohji SATO, Tohru KATAYAMA, Hyuk-Ha ...1996 Volume 71 Issue 6 Pages 399-405
Published: June 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe BBL® MGITTM Mycobacteria Growth Indicator Tube is a novel broth based culture system for the detection of mycobacteria from clinical specimens. The tubes consist of a fluorescent indicator embedded in silicone on the bottom of a 16×100mm round-bottom tube, filled with 4ml of an enriched BBL® Middlebrook 7H9 broth base, with 0.25% glycerol. Actively growing mycobacteria consume the oxygen dissolved in the medium and fluorescence will occur when the tubes are observed with a 365nm transilluminator.
The purpose of this study is to evaluate comparatively MGIT with 1% Ogawa egg medium by using two hundred and forty-five clinical specimens. The samples were digested, decontaminated and concentrated for culture using N-acetyl-L-cysteine-sodium hydroxide method. Fifty-nine of 245 (24%) clinical samples were culture positive for mycobacteria (43 M. tuberculosis complex, 12 M. avium complex and 4 other species) by one or both test systems. The MGIT detected 4 isolates of M. tuberculosis complex and 6 isolates of M. avium complex not recovered by the Ogawa egg medium, respectively.
The mean time of detection of M. tuberculosis complex was 13 days (range: 2-26days) and 19 days. (range: 8-31 days) for MGIT and Ogawa egg medium, respectively, and that of M. avium complex was 5days (range: 2-8days) and 16days (range: 6-22days) for the MGIT and Ogawa egg medium, respectively.
Overall, the MGIT is a sensitive culture system for the detection of mycobacteria from clinical specimens, is easy to use and may be applicable to clinical laboratories.View full abstractDownload PDF (779K) -
Atsushi SAEKI, Kenji OGAWA, Kousuke HONDA, Takayuki ANDO, Takashi OISH ...1996 Volume 71 Issue 6 Pages 407-413
Published: June 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSNon-invasive pulmonary aspergillosis is frequently seen in cases with cavity as sequela of tuberculosis. Diagnosis of non-invasive pulmonary aspergillosis is not easy except for cases whose chest X-ray findings show a typical fungus ball. How to diagnose pulmonary aspergillosis was studied in 21 patients who showed changes in the radiological findings of cavity as sequela of tuberculosis. We made sputum culture of Aspergillus, measurement of precipitin antibody titer to Aspergillus fumigatus and measurement of PASTOREX ASPERGILLUS in serum and sputum on the 21 patients (group A). PASTOREX ASPERGILLUS in sputum was evaluated in three grades: 1+-3+. We diagnosed 14 patients as pulmonary aspergillosis (PA group) among the 21 patients taking into account the chest X-ray findings and the results of the above-stated investigations. The types of chest X-ray findings of these 14 patients were fungus ball type (FB) in 2 patients, productive aspergilloma on the inner wall of a cavity (PAIC) in 8, mixed type with FB and PAIC in 2 and non-specific change in 2. However, there were 3 patients with the chest X-ray findings suggestive of PAIC in 7 patients (non-PA group) who were not diagnosed as pulmonary aspergillosis. Sputum culture were positive in 11 patients of PA group (79%) and negative in all patients of non-PA group. Precipitin antibody were positive in 8 patients of PA group (67%) and negative in all patients of non-PA group. PASTOREX ASPERGILLUS in serum were negative in all 21 patients. PASTOREX ASPERGILLUS in sputum were 3+ (+++) in all 14 patients of PA group and in 2 patients of non-PA group and 2+ (++) in 2 patients of non-PA group. 12 patients of PA group were treated by antifungal agents and 11 patients responded well to the treatment.
We also made sputum culture of Aspergillus and measurement of PASTOREX ASPERGILLUS in sputum on 14 patients (group B) who had respiratory diseases with stable cavities and 17 patients (group C) who had respiratory diseases without a cavity. In group B, sputum culture were positive in 1 patient and PASTOREX ASPERGILLUS in sputum were 3+ (+++) in 2 patients, 2+ (++) in 1 and 1+ (+) in 2. In group C, sputum culture were negative in all patients and PASTOREX ASPERGILLUS in sputum were 3+ (+++) in 1 patient, 2+ (++) in 3 and 1+ (+) in 2. Measurement of PASTOREX in sputum was a useful tool to diagnose non-invasive aspergillosis in addition to sputum culture and measurement of precipitin antibody titer. The sensitivity of PASTOREX in sputum was high but its specificity was low, however, its specificity could be raised by applying semi-quantitative analysis of PASTOREX in sputum.View full abstractDownload PDF (892K) -
Ayumi YOSHIDA, Hiroyuki MATSUMOTO, Yasuto IIDA, Toru TAKAHASHI, Yuka F ...1996 Volume 71 Issue 6 Pages 415-421
Published: June 15, 1996
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe patient was 69-year-old male. He had a history of treatment for tuberculosis by artificial pneumothorax about 47 years ago. He was admitted an another hospital under the diagnosis of tuberculous pyothorax. He was transferred to our hospital because of chest pain and fever. Laboratory findings on the admission were as follows: ESR was 120 mm/hr, CRP was 20.22mg/dl and other data were almost within normal limits. Chest X-ray showed a massive shadow in the right lower lung field, adjacent to the chest wall. Computed tomography (CT) showed tumor shadow with low density and invasions into the adjacent chest wall. Histological examination of surgically excised tumor biopsy revealed malignant lymphoma. The patient's condition improved and the size of tumor decreased temporarily by chemotherapy. Then, he began to complain of chest pain and high fever, and tumor in the chest wall invaded into the whole chest wall. He died of disseminated. intravascular coagulation despite continuing chemotherapy. Postmortem examination re vealed the following findings: the tumor existed mainly in the parietal pleura or the chest wall, adjacent to the lesion of pyothorax, and immunohistochemical examination showed that tumor was malignant lymphoma, diffuse, large B-cell type. Recent studies have shown a close association between EBV infection and pyothorax-associated lymphoma. We have to keep in mind the possible development of malignant lymphoma following tuberculous pyothorax, when we see patients complaining of fever or chest pain with tuberculous pyothorax.View full abstractDownload PDF (3030K)
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