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Volume 74, Issue 8
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Jun-ichi YASUDA, Osamu OKADA, Takayuki KURIYAMA, Keiichi NAGAO, Fumio ...1999 Volume 74 Issue 8 Pages 585-598
Published: August 15, 1999
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe investigated pulmonary hemodynamics and chest X-ray findings to explore pathophysiological significance of chronic hypercapnia in patients with pulmonary tuber culosis sequelae.
One hundred and seven patients underwent examinations of blood gases and right car diac catheterization. The patients were divided into two groups, according to arterial car bon dioxide tension under room air breathing (Paco2). Group I (n=35) was defined as 45 Torr or lower of Paco2, and Group II (n=72) was the hypercapnic group whose Paco2 was over 45 Torr. In addition, spirometry was done in 34 patients of Group I and 68 of Group II.
First, the values of blood gases, spirometry and pulmonary hemodynamics were compared between the two groups.
Secondly, between 22 of Group I and 50 of Group II, the values of pulmonary arteriolar resistance (PAR) before andafter 100% oxygen breathing for 10 minutes were com pared.
These comparisons were made by exploratory data analysis.
Lastly, we described in all cases with five items of chest X-ray findings and the extent of each finding we had defined. The items were emphysematous change; fibrosis, bronchiectasis, and/or cavity (hereafter abbreviated as“ fibrosis”); lung resection and/or atelectasis; pleural thickening; and thoracoplasty. We explored the items of X-ray find ings which may relate to hypercapnia by ridit (abbreviation for“ relative to an identified distribution”) analysis.
The results were as follows.
(1) Hypercapnic patients tended to have severer restrictive ventilatory impairment and hypoxemia. Under an even level of arterial oxygen tension (Pa02), tissue oxygenation was not poorer in Group II than in Group I.
(2) Hypercapnic patients tended to have more unfavorable pulmonary hemodynamics. More than half of them had pulmonary hypertension defined as 20 mmHg or higher of pulmonary artery mean pressure (PAm). Under an even level of PaO2, PAm was higher in Group II. Although 34 patients of Group II showed PaO2 over 60 Torr, 23 of them had pulmonary hypertension.
(3) PAR after oxygen breathing was more likely to decrease in Group II than in Group I.
(4) As any mean ridit was standardized and adjusted to 0.5 in Group I, the maximum was the mean ridit of“ pleural thickening” (=0.67), next“fibrosis” (=0.65) in Group II. The above two items of X-ray findings, in which each mean ridit was higher than in any other item, were more influential on hypercapnia.
We conclude as follows.
(1) Pulmonary hypertension is severer in hypercapnic patients with pulmonary tuberculosis seauelae; it may be mainly attributable to hypoxic pulmonary vasoconstriction.
(2) An important cause of chronic hypercapnia may be pathological changes such as “ pleural thickening” and“ fibrosis” seen on the radiogram.View full abstractDownload PDF (1838K) -
A Trial for Solving the Biohazard Problem in TB LaboratoriesMasamichi KINOMOTO1999 Volume 74 Issue 8 Pages 599-609
Published: August 15, 1999
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSAn acid-fast staining can detect mycobacteria in clinical specimens rapidly and specifically. It equally stains living and dead bacteria.
It would be of more clinical use if the viability of mycobacteria in a sample was determined by the staining. In the present paper, the problems of FDA/EB staining, which detects live or dead bacteria, were solved by establishing a new technique, a slide-method.
An air-dried smear of
Mycobacterium bovis BCG (Tokyo 172) on a glass slide was covered by a filter paper fully soaked in the staining solution (500 μg FDA and 40 μg EB per ml PBS). This was kept in an incubator at 37°C for 20 min. The filter paper was removed after incubation and the slide was examined using a fluorescent microscope with a blue filter. Live bacteria were stained greenish yellow taking the FDA stain in while dead bacteria were stained red with EB. This new slide technique eliminated the problems associated with FDA/EB staining. Moreover, stained smears appeared to be more stable compared with the conventional tube method.
To overcome the biohazard problems in smear examination of tubercle bacilli, heating of the slides on a heat block at 100°C for 20 min or passing air dried smears in a flame 5 to 30 times was tried to kill the bacteria. The heat-treated slides were stained with FDA/EB and the number of green and red bacteria were counted. Samples of the smeared bacteria were taken after heating and cultured on a solid medium to determine the presence of any colony-forming unit.
It was found that no CFU was observed after heating and the morphology of the stained sample was the same to that before heating.
These facts suggest that the above mentioned method is a simple, safe yet inexpensive diagnostic tool for mycobacterial clinical specimens.View full abstractDownload PDF (3909K) -
Junko MIYAMOTO, Atsuro HASHIMOTO, Ryusuke MIZUKANE, Toyohiro SASAKI, T ...1999 Volume 74 Issue 8 Pages 611-616
Published: August 15, 1999
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe usefulness of MTD (Amplified Mycobacterium Tuberculosis Direct Test) for a rapid diagnosis of tuberculosis was evaluated. A total of 400 clinical samples obtained from July, 1995 to June, 1997 were tested by MTD, direct microscopy and culture. The results of MTD and smear/culture were coincident in 387 out of 400 samples. Eight samples (2 %) were MTD false-positive (i. e. they were MTD positive but smear and culture negative), and 5 (1.25%) were MTD false-negative (i. e. MTD negative but smear and/or culture positive). Despite a careful review of the clinical data of those patients whose samples showed discrepant results, the reasons of discrepancy were not clear in 2 (0.5%) of the 8 false positives and 3 (0.75%) of the 5 false negatives. In the other cases, the MTD false positives may be accounted for the presence of previous M. tuberculosis infection, the influence of anti-tuberculous medication and so on, and the MTD false negatives are most likely due to the presence of inhibitors (blood, for example) or to the small number of organisms in the specimens. It can be concluded that adequate samples should be obtained, and that MTD should be repeated in case of discrepant resultsView full abstractDownload PDF (759K) -
Toshiaki SHIMIZU, Haruaki TOMIOKA, Katsumasa SATO, Tatsuya AKAKI, Kiko ...1999 Volume 74 Issue 8 Pages 617-621
Published: August 15, 1999
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe previously examined the effects of a Chinese medicine“Mao -Bushi-Saishin To” (MBST) which has anti-inflammatory activity on the therapeutic efficacies of a benzoxazinorifamycin, KRM- 1648 (KRM), against Mycobacterium avium complex (MAC) infection induced in mic. MBST potentiated the therapeutic activity of KRM aginst MAC infection. In the present study, we xamined the effects of another anti-in-flammatorydrug Glycyrrhizin, which is effective for chronic hepatitis, on the therapeutic efficacy of KRM against MAC infection induced in mice. First, KRM significantly inhibitd the bacterial growth in the lungs and spleen of MAC-infected mice. Glycyrrhizin exhibited no therapeutic activity against MAC infection and did not affect the expression of th therapeutic efficacy of KRM. Secondly, treatment of murine periton al macrophages (Mφ s) with Glycyrrhizin caused no significant changes in the Mφ anti-MAC activity.View full abstractDownload PDF (707K) -
[in Japanese]1999 Volume 74 Issue 8 Pages 623-652
Published: August 15, 1999
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (5213K)
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