結核
Online ISSN : 1884-2410
Print ISSN : 0022-9776
ISSN-L : 0022-9776
72 巻, 3 号
選択された号の論文の5件中1~5を表示しています
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    野崎 博之, 厚東 篤生, 天野 隆弘, 棚橋 紀夫, 田中 耕太郎, 小張 昌宏, 福内 靖男
    1997 年 72 巻 3 号 p. 139-146
    発行日: 1997/03/15
    公開日: 2011/05/24
    ジャーナル フリー
    We evaluated the clinical features of 5 cases of tuberculous meningitis who had been admitted to our department from 1987 to 1994. Three patients were male and two were female. Their age ranged from 17 to 74 years old. All cases were examined by both CT and MRI before and during antituberculous treatment. Before the treatment, CT scan revealed abnormal findings such as nodular lesion suggesting tuberculoma, subarachnoid contrast enhancement or cerebral infarction in 2 cases, while MRI revealed abnormal findings such as inflammatory lesions with Gd-enhancement in 4 out of 5 patients. During the treatment, all abnormal findings except cerebral infarction disappeared. No abnormal findings were detected by CT, MRI and SPECT in one case who showed right hemiparesis and motor aphasia.
    In summary, CT scan could demonstrate abnormal findings in only a small portion of patients with tuberculous meningitis. One the other hand, MRI revealed various abnormal findings in most patients, and could reveal some lesions which could be responsible for the symptoms of patients. In a few patients, however, MRI could not show any lesion in spite of obvious focal neurological signs. MRI is considered to be useful for detecting the lesions in most patients with tuberculous meningitis, although its findings are not always specific for the disease.
  • 今泉 忠芳
    1997 年 72 巻 3 号 p. 147-151
    発行日: 1997/03/15
    公開日: 2011/05/24
    ジャーナル フリー
    It has been observed that lung tuberculosis shows a similar pathological feature with that of sarcoidosis. Serum angiotensin converting enzyme (ACE) was elevated in sarcoidosis. In the present study, serum ACE was measured in pulmonary tuberculosis patients.
    1. ACE showed lower level in active tuberculosis. Elevation of serum ACE, however, was observed during the treatment.
    2. Serum ACE was low in cases with chronic fibrotic pulmonary tuberculosis with extensive shadows on chest X-P.
    3. Improvement of infiltrative shadows on chest X-P paralleled with the elevation of serum ACE.
    It was suggested that the new development of lung capillary endothelium might cause the elevation of ACE during the improving process of active pulmonary tuberculosis.
  • 石井 愼一, 長澤 博, 田井 久量, 野田 容子, 秋山 一夫, 竹田 宏, 岡島 直樹, 岡野 弘
    1997 年 72 巻 3 号 p. 153-159
    発行日: 1997/03/15
    公開日: 2011/05/24
    ジャーナル フリー
    Adenosine deaminase (ADA) is one of the enzymes in the purine metabolism and divided into two isozymes, ADA-1 and ADA-2. It is known that the activity of this enzyme is elevated in the sera of patients with pulmonary tuberculosis, sarcoidosis and other diseases, however there are few reports about the change of the activity of this enzyme under treatment. It is often said that this enzyme may have its origin in T lymphocyte, but it remains to be proved. That goes for each of two isozymes, too. In this study, we investigated the activity of serum total ADA, ADA-1 and ADA-2 in patients with pulmonary tuberculosis on admission and after three months' treatment. We also studied the correlation of lymphocyte subpopulation with these enzymes. The activity of total ADA, ADA-1 and ADA-2 was significantly higher in the sera of patients with pulmonary tuberculosis than in those of healthy persons. ADA-2 activity correlated significantly and negatively with the number of CD 3 + lymphocytes and CD 4 + lymphocytes. The change rate of ADA-2 activity during three months' treatment correlated significantly and negatively with the change rate of CD 4/8. These results may suggest that there is a close correlation between the activity of ADA-2 and lymphocyte subpopulation in the sera of patients with pulmonary tuberculosis. ADA-1 activity did not correlate with lymphocyte subpopulation significantly, but it decreased significantly after three months' treatment. The activity of ADA-1 also may have certain relations with the disease process of pulmonary tuberculosis.
  • 安藤 隆之, 田中 稔彦, 佐伯 篤, 小川 賢二, 本多 康希, 笹本 基秀, 原 通廣
    1997 年 72 巻 3 号 p. 161-165
    発行日: 1997/03/15
    公開日: 2011/05/24
    ジャーナル フリー
    An 82-year-old man with the chief complaint of anorexia was referred on suspicion pulmonary tuberculosis. He had undergone thyroidectomy because of thyroid cancer years ago, had taken levothyroxine sodium, and had kept plasma level of thyroidal mone within normal range. He had never pointed out hyponatremia. On laboratory findings on admission, serum natrium level was 125 mEq/l. A chest X-ray film showed infiltration in both lower lung fields, and a chest CT scan revealed a miliary pattern both lungs. Tubercle bacilli were detected from the sputum by the Ziehl-Neelsen staining ntituberculous drugs were started. On 5th hospital day, he developed conciousness disturbance, and the serum level of natrium and osmolarity was 103 mEq/l and 250 AgH20, respectively, while plasma ADH level was increased to 5.9 pg/ml/, and urine of natrium and osmolarity was 123 mEq/l and 394 mOsm/kgH20, respectively. His mental disturbance and hyponatremia gradually improved by supplementing NaCl. We diagnosed this case as SIADH associated with miliary tuberculosis. SIADH should considered when hyponatremia was occured in the case of miliary tuberculosis.
  • 1997 年 72 巻 3 号 p. 169-171
    発行日: 1997/03/15
    公開日: 2011/05/24
    ジャーナル フリー
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