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Volume 72, Issue 10
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Pulmonary Aspergilloma Study Group[in Japanese]1997 Volume 72 Issue 10 Pages 557-564
Published: October 15, 1997
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSItraconazole 100-200mg was orally administered to 49 patients with pulmonary aspergilloma once a day in principle immediately after breakfast. Drug concentrations in fungus balls and in aspergilloma cavities were determined in each measurable case and the data were evaluated in terms of efficacy and safety.
Overall evaluation was done considering the following 3 criteria: improvement of clinical symptoms, X-ray findings and mycological findings. The efficacy rate was 63.4% (26/41 cases).
Out of 49 cases, adverse reactions and abnormal laboratory test values were observed in 8 (16.3%) and 13 (26.5%) cases, respectively. The safety rate was 81.6% (40/49 cases).
16Ong/g 4, 010ng/g of itraconazole was detected in aspergilloma in 4 measurable cases. This finding showed that itraconazole had infiltrated into the fungus balls. Itraconazole was detected in aspergilloma cavities as well drug concentration was 825ng/g and 1, 020ng/g respectively.
Based on overall view of clinical effects and drug concentrations in fungus balls and in the walls of lung cavities, it is concluded that itraconazole showed efficacy in reducing the size of aspergilloma and that this drug is useful also in terms of safety.View full abstractDownload PDF (2064K) -
Takashi NAITO, Morio OHTSUKA, Hiroichi ISHIKAWA, Hiroaki SATOH, Shizuo ...1997 Volume 72 Issue 10 Pages 565-572
Published: October 15, 1997
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe measured the activity of adenosine deaminase (ADA) and the concentration of interleukin-1β (IL-1β), interleukin-2 (1L-2), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) in the pleural effusions from 28 patients with tuberculosis, 30 with neoplastic. diseases, 25 with bacterial infections and 18 with congestive heart failure or liver cirrhosis. The levels of ADA (83.0±32.1 IU/L) and IFN-γ (795.0±666.4 pg/ml) in tuberculous effusions were significantly higher than those in other groups (p<0.0001). IL-1β level in the effusions of bacterial infections (265.2±379.2 pg/ml) was higher than that in other groups (p<0.0001). TNF-α level in the effusions of tuberculosis (31.7±36.7 pg/ml) and bacterial infections (69.5±232.9 pg/ml) was higher than that in other groups. IL-8 level of exudative effusions was higher than that of transudates. IL-2 was only present in 4 effusions from tuberculosis and 1 effusion from bacterial infections.
Diagnostic utilities of cytokines and ADA for tuberculous effusion were evaluated using receiver operating characteristics (ROC) curve analysis. The cut-off points of ADA, IL-β, IL-8, TNF-α and IFN-γ determined in this analysis were 54 IU/L, 5.5pg/ml, 405 pg/ml, 4.5pg/ml and 28pg/ml, respectively and the sensitivity and the specificity of them were 88.0% and 95.9%, 19.1% and 74.1%, 57.1% and 63.2%, 81.0% and 77.2%, and 96.2% and 98.5%, respectively. In ADA, TNF-α and IFN-γ, the areas under the curve (AUC) that represent the diagnostic accuracy were 0.968, 0.719 and 0.993, respectively. AUC of IFN-γ was significantly higher than that of ADA or TNF-α. In tuberculous pleural effusion, IFN-γ was significantly correlated with TNF-α, IL-1β and ADA. The correlation was also present between TNF-α and ADA.View full abstractDownload PDF (1077K) -
Yuka SASAKI, Fumio YAMAGISHI, Kiminori SUZUKI, Masayoshi SAITOH, Masah ...1997 Volume 72 Issue 10 Pages 573-577
Published: October 15, 1997
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 43 year-old Japanese male was admitted to our hospital because of productive cough and fever. He was diagnosed as acquired immunodeficiency syndrome (AIDS) in 1994. Laboratory findings were as follows: WBC was 3200/μl, CD 4 + T lymphocyte count was 22/μl. His chest X-ray film taken on admission showed infiltration with small cavity lesion in middle left lung field. Tuberculin skin reaction was negative. He was treated with isoniazid 0.4g, rifampicin 0.45g, and ethambutol 0.75g each daily. Sputum smear was positive for acid fast bacilli. The cultured isolates were identified as Mycobacterium kansasii (M. kansasii) and Mycobacterium avium complex (MAC). Urine smear was also positive for acid fast bacilli. The cultured isolates were identified as M. kansasii. He was diagnosed as disseminated M. kansasii infection and suspected MAC infection. About one hundred days later, his chest X-ray film showed reticular shadow. His clinical symptoms improved and the sputum smear and culture converted to negative for acid fast bacilli. Based on these findings, his MAC discharge was considered not as MAC infection, but MAC colonization. He returned to the former hospital for AIDS treatment, and he died in August, 1996.View full abstractDownload PDF (1273K) -
BASIC AND CLINICAL STUDIES ON PATHOGENESIS OF PULMONARY MYCOBACTERIUM AVIUM COMPLEX DISEASKatsuhiro SUZUKI1997 Volume 72 Issue 10 Pages 579-599
Published: October 15, 1997
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSI have studied pathogenesis of pulmonary Mycobacterium avium complex disease (PMAC), using mouse and human alveolar macrophage (PAM) model of the infection as well as clinical evaluations.
The mouse model revealed no relation between natural resistance against the bacteria, and the activation of macrophages which was evaluated on the basis of releasing capacities of prostaglandin E2 and superoxide anion. The PAM model suggested that TNF-α and GM-CSF could activate PAM to restrict the intracellular growth of the bacteria, probably not through the superoxide anion release, but through the myeloperoxidasae-halide system.
It was also found that rifamycins in combination with clarithromycin could have a good bactericidal effect in the PAM-model of the infection. Clinical evaluations suggested that defect in local pulmonary defense, such as healed pulmonary tuberculous lesions, pneumoconiosis, and COPD was more important predisposing factor than defect in systemic defense in the development of PMAC.
Most patients having PMAC without predisposing factors are elderly women, the reason of which is the most important question to be answered in the future studies.View full abstractDownload PDF (2620K) -
1997 Volume 72 Issue 10 Pages 607-609
Published: October 15, 1997
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (359K)
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