巻号一覧
73 巻, 10 号
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岩永 知秋, 岸川 禮子, 池田 東吾, 広瀬 隆士, 鶴谷 秀人, 吉田 章子1998 年 73 巻 10 号 p. 579-584
発行日: 1998/10/15
公開日: 2011/05/24
ジャーナル フリーPulmonary mycobacteriosis is usually caused by Mycobacterium tuberculosis, Mycobacterium avium complex, or Mycobacterium kansasii. There are, however, other slow-growing mycobacteria which can cause pulmonary infection. Mycobacterium szulgai, first reported in 1972, is a scotochromogenic species which can affect human lungs, although human-to-human spread of infection is thought to be unlikely. We have recently treated three cases of middle-aged to elderly persons (45-87 year-old), two of them had underlying diseases (one with intrapulmonary and the other with extrapulmonary). All patients had constitutional symptoms (cough, sputum, dyspnea), and chest roent - genograms demonstrated either cavitation with scattered nodules or peripheral infiltrates predominantly in upper lobes, resembling pulmonary tuberculosis. In two cases, M. szulgai was identified by using DNA-DNA hybridization method. The in vitro susceptibility of M. szulgai to antimycobacterial drugs was better than that of M. avium complex, and it was resistant only to paraaminosalicylate, cycloserine, and partially to isoniazid. Pulmonary disease of three patients were successfully treated with a combination of multiple antimycobacterial agents including rifampin, ethambutol, isoniazid, or streptomycin.抄録全体を表示PDF形式でダウンロード (5089K) -
近藤 有好, 桶谷 典弘, 丸山 倫夫, 田口 洋子, 山口 義文, 宮尾 浩美, 真島 一郎, 大野 みち子, 和田 光一, 土屋 俊晶, ...1998 年 73 巻 10 号 p. 585-590
発行日: 1998/10/15
公開日: 2011/05/24
ジャーナル フリーElevated levels of serum surfactant protein-D (SP-D) have been previously reported in patients with idiopathic pulmonary fibrosis (IPF) and pulmonary alveolar proteinosis. To determine whether the same change is seen in other pulmonary diseases, especially pulmonary tuberculosis (TB), we measured the serum SP-D levels in active pulmonary TB (smear and/or culture: positive), acute interstitial pneumonia (AIP), IPF, acute exacerbation of IPF, hypersensitivity pneumonitis (HP), pneumoconiosis, bronchiectasis, and bacterial pneumonia by an enzyme linked immunosorbent assay using monoclonal antibodies to human lung SP D, and compared them with those of healthy elderly subjects over 50 years of age.
The SP-D level in the healthy elderly subjects was 57.6 ±38.4 ng/ml (mean ±SD, n=287). The levels in patients with active pulmonary TB(140.6±18.2 ng/ml, n=49), AIP(1, 021ng/m/, n=1), IPF(307.0±180.7ng/m/, n=42), acute exacerbation of IPF(817.7±283.6ng/ml, n=3), and HP (716.6±548.8ng/m/, n=4) were significantly higher than those in the healthy elderly controls (p>0.05), whereas those of pneumoconiosis, bronchiectasis, and bacterial pneumonia, 121.9+92.8ng/m/ (n=8), 93.9±72.9 ng/ml (n=11), and 72.7±3.4 ng/ml (n=4), respectively, showed no significant difference with the controls.
In active pulmonary TB, the percentage of patients whose serum SP-D levels were over 134.6ng/ml (mean×2SD of healthy elderly controls) was 34.7%, and therefore we considered the serum SP -D level was not useful for the diagnosis of pulmonary TB. However, it was significantly higher in the patients with cavity formation than in those without (p>0.05), and there was a significant positive correlation between the serum SP -D level and the number of tubercle bacilli in the sputum (r=0.416, p=0.00165), erythrocyte sedimentation rate at lhr (r=0.489, p>0.01), and CRP level (r=0.383, p=0.003). These findings suggest that the serum SP -D level is a useful indicator of the disease activity in pulmonary TB.抄録全体を表示PDF形式でダウンロード (656K) -
高倉 俊二, 田中 栄作, 木本 てるみ, 渡辺 勇夫, 松本 久子, 露ロ 一成, 新実 彰男, 鈴木 克洋, 網谷 良一, 久世 文幸1998 年 73 巻 10 号 p. 591-597
発行日: 1998/10/15
公開日: 2011/05/24
ジャーナル フリーA 52-year-old woman with visual loss of her left eye consulted a ophthalmology clinic. She was conducted left vitrectomy and administered corticosteroid under the diagnosis of uveitis of unknown cause. But her visual acuity was not improved. Although re-surgery was planned, pus retention was found in her left eye. After her left eye was resected, fever and general malaise appeared suddenly. Her chest X-ray film revealed diffuse micronodular opacities. Acid-fast bacilli were detected from her sputum and identified to be Mycobacterium tuberculosis. She was diagnosed miliary tuberculosis, and then antituberculous chemotherapy consisting of 4 drugs was started. Granulomatous inflammation destructing retina and numerous acid-fact bacilli were found in histologic examination of the resected eye. This case was thought to be miliary tuberculosis disseminated from intraocular tuberculosis. After 2 months of therapy, neurologic symptoms which might be caused by brain tuberucloma appeared and deteriorated rapidly. But by adding corticosteroid to antituberculous therapy, symptoms were diminished gradually.抄録全体を表示PDF形式でダウンロード (4053K) -
山本 正彦, 荒井 秀夫, 河原 伸, 岸 不蓋弥, 倉島 篤行, 近藤 有好, 坂谷 光則, 佐藤 滋樹, 原 耕平, 水谷 清二, 一山 ...1998 年 73 巻 10 号 p. 599-605
発行日: 1998/10/15
公開日: 2011/05/24
ジャーナル フリー日本結核病学会治療委員会は1987年に「非定型抗酸菌症の治療に関する見解」を発表したが, 本委員会は, 最近の10年間の非定型抗酸菌症に関する研究の進歩を踏まえて, 「非定型抗酸菌症の治療に関する見解-1998年」を公表することとした.抄録全体を表示PDF形式でダウンロード (988K)
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