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Volume 75, Issue 9
Displaying 1-5 of 5 articles from this issue
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Yoshihiro KOBASHI, Niro OKIMOTO, Toshiharu MATSUSHIMA, Takahiro ABE, K ...2000 Volume 75 Issue 9 Pages 521-526
Published: September 15, 2000
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe retrospectively evaluated the effectiveness of desensitization therapy for antituberculous drugs (Rifampicin and Isoniazid) in 28 cases (29 episodes) with adverse reactions to these drugs. Desensitization therapy for RFP was performed in 23 cases (24 episodes) with administration of a first dose of 1-150mg and a final dose of 300-450mg for 1-29 days. The success rate of this therapy was 79% (19 of 24 episodes). Desensitization therapy for INH was performed in 12 cases with administration of a first dose of 2.5-100mg and a final dose of 200-400mg for 3-25 days. The success rate of this thprapy was 83% (10 of 12 cases).
Based on a comparative study of cases between successful and unsuccessful desensitization to RFP and INH it was concluded that there were no significant differences with regard to allergic history, adverse effects and their periods of appearance, the first dose and final dose of administration and the interval of administration, starting periods of the desensitization therapy and the periods of appearance of adverse effects due to this therapy. We evaluated desensitization therapy for two antituberculous drugs (RFP and INH) for tuberculous patients for whom the use of such drugs was restricted because of adverse effects, and we found it is a useful treatment, showing a high rate of success (80%).View full abstractDownload PDF (753K) -
Yuka SASAKI, Fumio YAMAGISHI, Takenori YAGI, Hideaki YAMATANI, Fuminob ...2000 Volume 75 Issue 9 Pages 527-532
Published: September 15, 2000
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSEpidemiological trend of tuberculosis in Japan has reversed recently. The incidence of pulmonary tuberculosis (PTB) patients has increased again in Japan, and many outbreaks of PTB including nosocomial outbreaks in health-care facilities have been reported.
The purpose of this study is to investigate patient's delay (interval between onset of the disease and first visit to a doctor) and doctor's delay (interval between first visit to a doctor and diagnosis as TB) in patients with PTB discovered by visiting doctors with symptoms, and especially, to investigate causes of doctor's delay in details.
Of 236 PTB patients who were admitted to our hospital for treatment in 1997, 118 patients (85 males, 33 females) who were detected by their symptomatic visits were enrolled in to this study. 97 were initial treatment cases and the others were re-treatment cases. Among 34 initial treatment cases who were first seen at a general hospital and diagnosed as PTB by a close medical checkup after admission to our hospital, the 50 percentile of patient's delay was 17.0 days, and the 80 percentile was 36.4 days. The 50 percentile doctor's delay was 19.6 days, and the 80 percentile was 64.2 days. The average hospital stay was 16.2 days, the 50 percentile hospital stay was 7.8 days, and 80 percentile hospital stay was 23.5 days. On the sputum test for acid fast basilli (AFB) performed on admission to our hospital, 26 (76%) out of 34 cases were positive for tubercle bacilli, with 18 cases were positive for smear and 8 cases positive for culture. Therefore, risk of nosocomial infection was suspected.
Doctor's delay had been attributed mainly to insufficient medical checkup. Among 25 initial treatment cases in whom doctor's delay as more than 4 weeks, 11 cases (44%) showed delay in chest X-ray examination and 8 cases (32%) ordered no sputum examination in spite of recognition of abnormal shadows on chest X-ray. On the sputum test for AFB on admission to our hospital, 22 (88%) out of 25 cases were positive for tubercle bacilli. Therefore, it is assumed that the delay in the adequate medical checkup was accountable for the doctor's delay.
Shortening of the doctor's delay could be possible if hospitals perform the sputum examination for AFB and chest X-ray examinations properly for patients with respiratory symptoms.View full abstractDownload PDF (782K) -
Structure of the High Incidence Rate of Tuberculosis in Osaka City Analyzed by Administrative-Ward Group, Five-Year Period and Age GroupToshio TAKATORIGE, Yoshinori AOKI, Chisato TANIGAKE, Amin RUFUL, Kozo ...2000 Volume 75 Issue 9 Pages 533-544
Published: September 15, 2000
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe tuberculosis incidence rate in Osaka City is the highest in Japan. We analyzed the incidence rate in Osaka City in five-year period from 1978 to 1997, namely, 1978-1982 (period I), 1983-1987 (period II), 1988-1992 (period III), and 1993-1997 (period N) Until the first half of 1980, the tuberculosis incidence rate in Osaka City had been dropping every year, but the rate of decline has been slowed substantially or even stopped since 1983. The incidence rate ratio of Osaka City compared with the national rate was 2.0 to 2.3 from 1970 to 1975, but it has been increasing from 1983 and is now higher than 3. We divided 24 wards of Osaka City into five groups based on selected employment indicators of population 15 years of age and over of 1995 National Census. Group A consists of two wards characterized by extremely high unemployment rate, Group B of four wards by high unemployment rate and high rate of manufacturing workers, Group C of six wards by high rate of non-manufacturing workers (tertiary industry workers), Group D of five wards by high rate of manufacturing workers, and Group E of seven wards by residential areas. The incidence rate of Group A had been declining during periods I and II but started to rise after period III. The rates of Group B and C had been declining from period I to II but the decline slowed down substantially even for every age class in periods III and N. The incidence rates of Groups D and E have been falling. The incidence rate of the 50-69 year-old age group has been increasing substantially. The proportion of newly registered patients in Group A to all patients of Osaka City increased from 25.2% in period I to 32.7% in period N. The number of newly registered patients of the 40-69 age class in Group A accounted for 45.1% of that in Osaka City in period IV. The slowdown in the reduction of the tuberculosis incidence rate has occurred not in all, but in only a few wards and it is a typical phenomenon of the middle-aged in those wards. It would be worth investigating whether a substantial decline in the tuberculosis incidence rate in Osaka City cannot be achieved by means of uniform control measures for all wards. Intensified tuberculosis control measures should focus on patients in specific wards and age groups.View full abstractDownload PDF (1430K) -
2000 Volume 75 Issue 9 Pages 545
Published: 2000
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (50K) -
The 75th Annual Meeting Lunch-Time SeminarKoh NAKATA, Yoshihiro HONDA, Naohiko TANAKA, Michael WEIDEN, Naoto KEI ...2000 Volume 75 Issue 9 Pages 547-562
Published: September 15, 2000
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSHIV-1 infection is a major cause of worldwide epidemic of tuberculosis. In Japan, the cumulative number of the patients reported is 131 by the end of 1999 with 10 to 20 annual new cases. Most of Japanese cases are advanced AIDS patients with low CD 4 number less than 100/μl. The peak age of Japanese patient is 40 to 60 years old, whereas that of foreigners is 20-30 years old, suggesting that most Japanese cases are recurrent tuberculosis. There is increasing clinical evidence that coinfection with M. tuberculosis accelerates progression of AIDS. We found that, in vivo, HIV-1 load and mutation increase in involved lung segments in patients with pulmonary tuberculosis. We also reported that Mycobacterium tuberculosis stimulates HIV-1 replication by enhancing transcription on the 5' LTR in a macrophage cell line, THP-1, in vitro. In contrast, HIV-1 replication is suppressed by M. tuberculosis infection of monocytes derived macrophages (MDM) or differentiated monocytic THP-1 cells. We observed that HIV-1 5' LTR function was repressed in PMA differentiated THP-1 cells after co-infection with M. tuberculosis. Point mutations in C/EBP-β binding domains of the HIV-1 LTR negative regulatory element (NRE) abolished promoter repression. Monocyte-derived macrophages and differentiated THP-1 cells increased expression of the 16 kDa inhibitory form of C/EBP-β after M. tuberculosis coinfection. Bronchoalveolar lavage cells obtained from normal controls and alveolar macrophages from uninflamed lung of tuberculosis patients also expressed the 16 kDa inhibitory form of C/EBP-β. However, alveolar macrophages from lung segments involved with pulmonary tuberculosis had markedly reduced C/EBP-β expression. These data suggest that 16 kDa isoform of C/EBP-β plays an important role for the control of HIV-1 replication in macrophages. We propose derepression of HIV-1 LTR mediated transcription as one mechanism for enhanced HIV-1 replication observed in pulmonary tuberculosis.View full abstractDownload PDF (4295K)
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