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Volume 76, Issue 10
Displaying 1-6 of 6 articles from this issue
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Noboru NAKANO, Takeshi HIRAYAMA, Masahiro ABE, Kazutaka NISHIMURA, Tsu ...2001 Volume 76 Issue 10 Pages 649-656
Published: October 15, 2001
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSFrom 1990 to 1999, three patients with non-tuberculous mycobacteriosis and 14 patientsof tuberculosis underwent pulmonary resection in the National Sanatorium Ehime Hospital.
Of the patients with tuberculosis, two were multiple drug-resistant cases and twelvecases were suspected of lung cancer before diagnostic resection. All three patients withnon-tuberculous mycobacteriosis were symptomatic, had chest cavities in the lung, andwere sputum-culture positive.
There were no operative death in all patients, and one case of post-operative complication.
Two patients, one with non-tuberculous mycobacteriosis and another with tuberculosis, failed in sputum negative conversion. The former had been treated for a long timepreoperatively.
Early resection in patients of pulmonary non-tuberculous mycobacteriosis and of pulmonarymultiple drug-resistant tuberculosis is recommended to prevent further progressionof pulmonary lesions.View full abstractDownload PDF (1749K) -
Chiyoji ABE, Akio AONO, Kazue HIRANO2001 Volume 76 Issue 10 Pages 657-662
Published: October 15, 2001
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe methods most widely used for susceptibility testing against anti-tuberculosis drug (AST) are the proportion method on LOwenstein-Jensen egg (L-J), Ogawa egg or Middlebrookagar media, and BACTEC TB 460 system. Recently, drug concentrations have beenestablished for AST using the automated BACTEC MGIT 960 system (aMGIT). We haveevaluated the BACTEC MGIT 960 SIRE kit for AST of Mycobacterium tuberculosis toisoniazid, rifampin, streptomycin and ethambutol. Also we compared the results with theproportion methods on Middlebrook 7H 10 agar (7H 10), L-J and Ogawa egg, and themanual MGIT system (mMGIT). Overall concordance rates among aMGIT and theproportion method on 7H 10 or Ogawa media were 98.3 % and 96.9 % for 4 first-linedrugs, respectively. Rates were particularly high for isoniazid and rifampin betweena MGIT and 7H 10 (efficiency of 100%). On the other hand, overall concordance ratesamong two egg media, L-J and Ogawa were 99.9 %. Agreement between aMGIT and mMGIT was high for the AST to isoniazid and rifampin, but lower for the AST toethambutol (90.9 %), which relates to a lower specificity of mMGIT. The mean times toaMGIT and mMGIT results of susceptibility were 7 and 6 days, respectively, contrastedwith 3 weeks in 7H 10 and 4 weeks in L-J and Ogawa, indicating that both MGITsystems have the potential to consistently meet the turnaround time suggested by Centersfor Disease Control and Prevention (CDC) of the United States. These results demonstratethat the fully automated BACTEC MGIT 960 SIRE system for AST is useful forrapid diagnosis of drug resistant tuberculosis.View full abstractDownload PDF (840K) -
Makoto TOYOTA, Shigeharu MORIOKA2001 Volume 76 Issue 10 Pages 663-666
Published: October 15, 2001
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 15-year-old man, who was a classmate with the index case of a large outbreak oftuberculosis in a junior high school in Kochi city, showed strongly positive reaction totuberculin skin test in March 1999. After taking a chest X-ray film, which showed noabnormal finding, chemoprophylaxis with isoniazid was started in April 1999. He wascompliant with therapy, and had no symptom until July 1999, when he was checked againby chest X-ray and abnormal finding was suspected. He visited a hospital for furtherexaminations, and chest X-ray revealed cavitary lesion and sputum smears showed acid-fastbaccili. Cultures of the sputum was positive for Mycobacterium tuberculosis, and drugsusceptibility tests revealed that the organism was resistant to isoniazid (5μg/ml) andsensitive to RFP, SM, and EB. RFLP analysis of Mycobacterium tuberculosis isolatedfrom the index-case patient and the present patient demonstrated an identical pattern, although the organism obtained from the index-case patient was sensitive to isoniazid, RFP, SM, and EB. Mycobacterium tuberculosis isolated from other 7 patients in thesame outbreak showed an identical pattern in RFLP analysis and were also sensitive toisoniazid. The present patient was a close contact with the highly infectious index-casepatient. The patient was estimated to be infected around September to October, 1998, andchemoprophylaxis with isoniazid was started in April 1999, when the tubercle baccili hadgrown considerably, but not enough to show radiographic abnormality. These two factorsmight be attributable to rarely seen development of isoniazid resistance in this case.View full abstractDownload PDF (919K) -
Hiroshi MIZUTANI, Michiaki HORIBA, Joh SHINDOH, Tomoki KIMURA, Masami ...2001 Volume 76 Issue 10 Pages 667-672
Published: October 15, 2001
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSTwo cases of multi-drug-resistant pulmonary tuberculosis with para-aminosalicylicacid (PAS)-induced hypothyroidism were reported.
Case 1; a 73-year-old male, complaining of edema, was admitted to our hospital. Hehad been treated for his multirug-resistant pulmonary tuberculosis during the past 1year with an antituberculous regimen consisting of ethambutol (EB), ethionamide (ETH) and PAS. A thyroid profile performed when he was admitted to our hospital showed severalmarked abnormalities: serum thyroid stimulating hormone (TSH) was elevated (69.4 ii IU/ml: normal, 0.4-4.2 m IU/ml), free thyroxine level (T4) (0.01 ng/dl; normal, 0.70-1.60 ng/dl) and free triiodothyronine level (T3) (0.60 pg/ml; normal, 2.3-4.1 pg/ml) were low.
PAS was discontinued after he was admitted to our hospital, since PAS was believed to bethe cause of the hypothyroidism. A thyroid profile that was repeated after the exclusionof PAS from treatment showed the following results: the TSH level was decreased (13.4m IU/ml), the free T4 (0.93 ng/dl) were normal. During treatment with PAS, he hadnever received thyroid replacement therapy.
Case 2; A 22-year-old female, complaining of hemosputum. She had been treated forher multi-rug-resistant pulmonary tuberculosis during the past 11 months with anantituberculous regimen consisting of EB, ETH and PAS. A thyroid profile performed when she was admitted to our hospital showed several marked abnormalities: elevatedserum TSH (112.7 m IU/ml), and low T4 (2.0 μg/ dl) and T 3 (1.1 ng/ml). A thyroid profilethat was repeated after the exclusion of PAS from treatment showed the followingresults: the TSH level was decreased (5.1m IU/ml). Drug-induced hypothyroidism is aninfrequent side effect of therapy with PAS, and only a few cases of PAS-induced hypothyroidismhave been reported so far. In this report, we describe patients with hypothyroidismwho were receiving therapy for multi-drug-resistant tuberculosis, tuberculosisnamely, resistant to at least isoniazid (INH) and rifampicin (RFP), with a regimen thatcontained PAS.View full abstractDownload PDF (1341K) -
Naomi KUNICHIKA, Kazuo MURAKAMI, Kiyoshi MAKIHATA, Kazushi TAKAO, Keni ...2001 Volume 76 Issue 10 Pages 673-676
Published: October 15, 2001
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThis paper describes two cases with tuberculous epididymitis. The first case was a 69-year-old man who was admitted to our hospital because of ulceration of right scrotum.
Physical examination revealed a hard, rounded, a little bigger than egg-sized mass in theright scrotum. The second case was a 40-year-old man who was admitted to our hospitalbecause of cough, fever and body weight loss. He was treated for pulmonary tuberculosiswith isoniazid, rifampicin, streptomycin and pyrazinamide. Six months after admission, he complained of a painless swelling of the right scrotum. Physical examination revealeda hard, rounded, more than egg-sized mass in the right scrotum. Right orchiectomy wasperformed in these two cases, and they were cured.View full abstractDownload PDF (3970K) -
V. STRATEGY OF TUBERCULOSIS CONTROL AND ACHIEVEMENT IN OKINAWAMorio OSHIRO, Tadashi NAKASONE2001 Volume 76 Issue 10 Pages 677-678
Published: October 15, 2001
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSAfter fierce battles in World War II, Okinawa was occupied by military of U. S. A. andconsequently was administrated by USCAR (United States Civil Administration of Ryukyus).
During 27 years from April 1945 to May 1972, reversion to Japan, the public Health Activitiesincluding T. B. control were performed by Ryukyus Government indirectly controlled by USCAR. The first issue of T. B. statistics was made in 1950. It revealed remarkable reductionof T. B. death rate, a quarter of that before the war. The main reasons of the reductionwere considered due to the over-death in battles. But epidemic of T. B. had increased rapidly, especially since the Korean War occurred in 1950. Constructions of the military base werebooming, and T. B. infection was spread among laborers, employees, and also their families. Then, Ryukyus Government enacted a temporary law of T. B. prevention and control in 1954. Home-care treatment of T. B. patient was started with registration and managementin newly constructed Public Health Centers. Because of shortage of government budget, man-power including doctor and poor institutes, a system of short-termed admissiontreatment (6 months) and home cared chemotherapy were started. Public Health Nurses (PHN) took care the patient at home, and medical fee of T. B. treatment was free incharge to patients. So activities of PHN were very important.
In 1962, Dr. Shoukou Imamura, from JATA, came to study the system of home caretreatment. And 7, 000 cases under supervision of Public Health Center were investigated.
He reported that this system was fairly efficacious in Okinawa.
In 1976, after reversion to Japan, study of T. B. surveillance control system was advised andintroduced by Dr. Masakazu Aoki and Dr. Tooru Mori (JATA). By this modern systemof surveillance, T. B. control is improved progressively in Okinawa.View full abstractDownload PDF (196K)
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