巻号一覧
75 巻, 11 号
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吉山 崇2000 年 75 巻 11 号 p. 629-641
発行日: 2000/11/15
公開日: 2011/05/24
ジャーナル フリーThe 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.抄録全体を表示PDF形式でダウンロード (1739K) -
三上 真顯, 河崎 雄司2000 年 75 巻 11 号 p. 643-648
発行日: 2000/11/15
公開日: 2011/05/24
ジャーナル フリーThis 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.抄録全体を表示PDF形式でダウンロード (641K) -
樋口 一恵, 原田 登之, 山田 博之, 小林 和夫, 竹田 稔2000 年 75 巻 11 号 p. 649-659
発行日: 2000/11/15
公開日: 2011/05/24
ジャーナル フリーわれわれは, ヒト正常胎児肺由来の繊維芽細胞株WI-38とヒト肺扁平上皮癌由来細胞株SQ-5を用い, 非貧食細胞内へのヒト型結核菌, ウシ型結核菌およびBCGの侵入能とその内部での生存能を調べた。 ヒト型結核菌ErdmanおよびH37Rvの生菌は, ウシ型結核菌Ravenel, ヒト型結核菌H37Ra, BCG東京株およびBCGパスツール株の生菌より効率良くWI-38に侵入した。生菌のWI-38への侵入能は, Erdman≧H37Rv>BCGパスツール株≒M. bovis Ravenel≒BCG東京株>H37Raの順であった。同様の侵入能は, SQ-5細胞を用いても得られた。生菌とは対照的に, 熱処理死菌はWI-38細胞に取り込まれなかったが, SQ-5細胞には取り込まれた。これらの結果とラテックスビーズの取り込みの結果は, WI-38にはないがSQ-5細胞は貧食能を持っていることを示唆している。H37Rvは, H37RaおよびBCG東京株と比較しWI-38細胞内で最も多く増殖した。このことは, 非貧食細胞内への侵入能とその内部での生存能は, 弱毒結核菌より強毒結核菌の能動的な侵入を反映していることを示唆している。われわれが用いた系は, in vitroにおいて結核菌の毒力を解析するために有用であると思われる。抄録全体を表示PDF形式でダウンロード (2819K) -
稲冨 恵子2000 年 75 巻 11 号 p. 661-664
発行日: 2000/11/15
公開日: 2011/05/24
ジャーナル フリーA 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.抄録全体を表示PDF形式でダウンロード (2003K) -
2000 年 75 巻 11 号 p. 665-684
発行日: 2000/11/15
公開日: 2011/05/24
ジャーナル フリーPDF形式でダウンロード (2071K)
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