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Volume 75, Issue 11
Displaying 1-5 of 5 articles from this issue
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Takashi YOSHIYAMA2000 Volume 75 Issue 11 Pages 629-641
Published: November 15, 2000
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe target for isoniazid preventive therapy against tuberculosis in Japan has been contact persons of tuberculosis patients with the age of less than 30. This paper discusses about the cost effectiveness analysis of preventive therapy with the mathematical model. The effectiveness was measured with averted tuberculosis cases, averted death, averted loss of DALY (disability adjusted life years), averted loss of healthy years of life. With all indicators, isoniazid preventive therapy was effective if preventive chemotherapy is given to persons younger than 70 years old and with the higher probability of new infection than 20 %, and if it is given following the present criteria of tuberculin testing for preventive therapy in Japan. The total medical cost is cheaper among persons with the preventive therapy than those without the preventive therapy, if the probability of new infection among the contact persons is more than 29 % at the age of 40. The isoniazid preventive therapy for health care workers, whose prevalence of infection is higher than the average population, was also effective in both cases with and without baseline tuberculin testing. However, the positive predictive value of criteria of preventive therapy highly depends on the probability of new infection.View full abstractDownload PDF (1739K) -
Masaaki MIKAMI, Yuji KAWASAKI2000 Volume 75 Issue 11 Pages 643-648
Published: November 15, 2000
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThis study was carried out to know the prevalence and determinants of tuberculin reactors and the size of booster phenomenon in 211 Japanese residents of a provincial nursing home for eldery. The age of the study subjects ranged from 65 to 99 (mean 83.2), and no subjects were foreign born, and had any history of BCG vaccination. The prevalence of TB infection in this aged group was estimated 70% or higher. Testing was done according to the standard method used in Japan. Results showed that 35.1% of subjects were positive by the initial test, and 27.0% converted to positive by the second test, thus altogether 52.6% were positive by two step test. No association was found between the prevalence of tuberculin positive rate and the age or the performance status. Lower body mass index, lymphocytopenia, hypoalbuminemia and PNI (prognostic nutritional index) were seen to relate with the weaked tuberculin skin reaction.View full abstractDownload PDF (641K) -
Kazue HIGUCHI, Nobuyuki HARADA, Hiroyuki YAMADA, Kazuo KOBAYASHI, Mino ...2000 Volume 75 Issue 11 Pages 649-659
Published: November 15, 2000
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSTo explore the ability of tubercle bacilli to invade and survive within non-phagocytic cells, we used in this study a human fibroblast cell line, WI-38, derived from normal embryonic lung and a human epithelial cell line, SQ-5, derived from lung squamous cell carcinoma. Live M. tuberculosis Erdman and M. tuberculosis H37Rv invaded WI-38 cells more efficiently than live M. tuberculosis H37Ra, M. bovis Ravenel, M. bovis BCG Tokyo and M. bovis BCG Pasteur. The capability of tubercle bacilli to invade WI-38 cells was Erdman≥H37Rv>BCG Pasteur≈M. bovis Ravenel BCG Tokyo>H37Ra. A similar in vasive ability was observed using SQ-5 cells. In contrast with live bacilli, heat-killed bacilli failed to invade WI-38 cells, whereas they were detected within SQ-5 cells. These results and incorporation of latex beads suggest that SQ-5 cells, but not WI-38 cells, possess phagocytic activity. H37Rv multiplied most actively within WI-38 cells when compared to H37Ra and BCG Tokyo, suggesting that the ability to invade and survive within non-phagocytic cells reflects the more active invasion of virulent M. tuberculosis than avirulent M. tuberculosis. The assay system used in this study may help us to clarify the virulence of tubercle bacilli in vitro.View full abstractDownload PDF (2819K) -
Keiko INATOMI2000 Volume 75 Issue 11 Pages 661-664
Published: November 15, 2000
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 20-year-old female was checked by chest X -ray film just before starting practical nurse training in the hospital.
She was diagnosed as tuberculosis in the initial phase of treatment. In Japan, the number of newly registered tuberculosis has been increasing since 1997, and the stoptuberculosis campaign is organized by the Ministry of Health and Welfare. The incidence rate of tuberculosis announced officially by the Ministry of Public Welfare was 33.9 per 100, 000 in 1997, while that of nontuberculous mycobacteriosis has been increasing year by year, and it was 2.45 in 1997. The one out of 4 nontuberculous mycobacteriosis is caused by M. kansasii.
Six colonies of Mycobacterium kansasii were detected by gastric juice culture from this patient. Untreated strains of M. kansasii are susceptible to rifampicin, isoniazid, ethambutol, ethionamide, streptomycin and cycloserine at concentrations readily available in the serum with usual therapeutic doses. Isolates are usually resistant to available serum level of pyrazinamide. The patient was treated with rifampicin, isoniazid and ethambutol for 6 months. Pyrazinamide was stopped at 1 month and 10 days treatment due to liver dysfunction and resistance to the organism.
Pulmonary infiltration with cavity disappeared during follow-up examination. Nowa days we must take into account not only tuberculosis but also primary nontuberculous mycobacteriosis at regular medical check of young female.View full abstractDownload PDF (2003K) -
2000 Volume 75 Issue 11 Pages 665-684
Published: November 15, 2000
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (2071K)
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