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Volume 75, Issue 5
Displaying 1-4 of 4 articles from this issue
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Toshiko YAMAMOTO, Susan PHALEN, Kazuyuki UCHIDA, Kiyoko UMEMORI, Yasuh ...2000 Volume 75 Issue 5 Pages 379-388
Published: May 15, 2000
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSBCG Tokyo 172 strain was examined for its protective efficacy against pulmonary tuberculosis in a guinea pig model. Guinea pigs were vaccinated with an intradermal injection of 103 CFU of BCG Tokyo 172 strain. BCG Copenhagen 1331 was employed as a control strain. Eight weeks after the vaccination, the animals were infected with about 10 CFU of M. tuberculosis H37Rv by a respiratory route in an aerosol chamber. Five weeks after infection, the animals were euthanized and their spleens, lungs and livers were obtained for enumeration of M. tuberculosis H37Rv and histopathological examinations. The mean log10 CFU of M. tuberculosis H37Rv recovered from right lower lung lobes of guinea pigs vaccinated with BCG Tokyo 172 (frozen), BCG Tokyo 172 (freeze-dried), BCG Copenhagen 1331 (freeze-dried) and placebo were 4.72, 4.23, 4.35 and 5.76, respectively. The mean log10 CFU of the bacteria recovered from spleens were 2.11, 1.51, 1.37 and 5.90, respectively. There was a significant difference in bacterial recovery from both lung and spleen between the vaccinated and the non-vaccinated groups. No significant difference was seen among the groups vaccinated with different strains of BCG in any organ. The lungs exhibited just small granulomatous nodules and the spleens showed no granulomatous nodules in the BCG-vaccinated guinea pigs. On the other hand, the lungs and spleens from non-vaccinated guinea pigs showed much larger granulomatous nodules with central necrosis. These histopathological difference between the vaccinated and the non-vaccinated guinea pigs was consistent with the difference of bacterial growth between them. The results of this study have clearly indicated that BCG Tokyo 172 strain possesses a significant protective efficacy against M. tuberculosis as well as BCG Copenhagen 1331 strain. These results have also shown that the respiratory infection model in guinea pigs is very useful to evaluate efficacy of vaccines against pulmonary tuberculosis.View full abstractDownload PDF (3890K) -
Takuya KURASAWA, Atsuo SATO, Koichi NAKATANI, Takashi IKEDA, Harukazu ...2000 Volume 75 Issue 5 Pages 389-394
Published: May 15, 2000
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe report an outbreak of pulmonary tuberculosis (TB) in a dormitory of construction labors, and this outbreak is suspected to have been caused by exogenous reinfection, based on the restriction fragment length polymorphism (RFLP) analysis and other findings.
After a patient entered our hospital with active TB, 12 new other patients were discovered by contacts examination. These patients lived together in the same dormitory. They were all male and single, and were aged from 43 to 63 years old. Except one patient (No.3) previously treated for TB for three months about 2 years ago and was suspected to be the index case of this outbreak, 12 other patients did not have a medical history of TB.
The bacilli cultured from 11 patients (No.1-11) were tested by RFLP analysis, three patterns were identified, and the fingerprints from 9 patients (No.1-9) were identical, and the patterns of incomplete resistance of some antituberculous drugs were quite similar between No.1-9 and No.12 and between No.10 and No.13, respectively.
The locations of the main lesions of TB on chest X-ray pictures were the apico-posterior segments of bilateral upper lobes. No signs suspected to indicate primary tuberculosis were detected.
Considering the rate of tuberculous infection in Japan among the middle age and above as well as the identical RFLP results, most of patients in this outbreak except the index case No.3 were suspected to have TB due to the exogenous reinfection.View full abstractDownload PDF (2126K) -
Goh TANAKA, Hideaki NAGAI, Akira HEBISAWA, Yoshiko KAWABE, Kazuko MACH ...2000 Volume 75 Issue 5 Pages 395-401
Published: May 15, 2000
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe patients with active tuberculosis in whom respiratory failure requiring mechanical ventilation developed were studied retrospectively. Nine patients (M 8, F1) were identified at the National Tokyo Hospital during 5 years from January, 1993 to December, 1997. Seven of 9 patients were single men, and the duration of symptoms before admission was over 1 month in all patients, while the time from first visit to diagnosis was less than 7 days. All patients were identified as malnourished, and 7 patients suffered from another underlying diseases. The patients were classified into two groups. Six of 9 patients had pulmonary tuberculosis and the other three had miliary disease. The proportion of cases requiring mechanical ventilation was 0.3% and 8.6%, respectively, in pulmonary tuberculosis and miliary tuberculosis. At the start of mechanical ventilation, PaO2/FIO2 was lower than 200 in all 9 patients, and 6 patients were probably ARDS. Steroids (methylprednisolone 250-1000 mg/day) were used in all 9 patients. Despite the use of mechanical ventilation and antituberculous therapy, 8 out of 9 patients died. Only one patient with miliary tuberculosis survived. The establishment of the therapy for acute respiratory failure is needed so as to improve prognosis of such cases. At the same time, the delay in consulting a doctor led to acute respiratory failure in most cases, so it is also important to encourage tuberculosis patients to visit a doctor as soon as possible, after the appearance of symptoms.View full abstractDownload PDF (4221K) -
Tetsuro INOUE, Nobuaki IKEDA, Takuya KURASAWA, Atsuo SATO, Kohichi NAK ...2000 Volume 75 Issue 5 Pages 403-407
Published: May 15, 2000
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 47-year-old asymptomatic female was referred to our outpatient department with pulmonary infiltration in the left S6. PPD skin test revealed 12×11mm redness. The infiltration disappeared without treatment. Hilar lymphadenopathy appeared 2 months after the first visit. In 6 months after the first visit, the hilar lymphadenopathy disappeared without treatment, but infiltration appeared in the left S6 (different site to that of the first visit). A repeated PPD revealed 47×40mm redness and 20×15mm induration. Bronchoscopy revealed a polipoid lesion at the orifice of left B6, MTD (Mycobacterium tuberculosis direct test) was positive from the bronchial washing of left B6. She was diagnosed as tuberculosis based on the courses and radiographic appearances. After anti-tuberculous chemotherapy, the pulmonary infiltration and the polipoid lesion at the orifice of left B6 improved.View full abstractDownload PDF (6221K)
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