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Volume 76, Issue 5
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Comparison of Clinical Data with Those in Children Aged One to Two YearsShinya KONDO, Masaki ITO, Sachiko KAGEYAMA2001 Volume 76 Issue 5 Pages 407-411
Published: May 15, 2001
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA number of tuberculosis (TB) infants 12 month-old or less is larger than the ones of any other age groups with childhood TB in our hospital. This study was undertaken to elucidate clinically why infants 12 month-old or less suffered from TB most among infants and early children. We studied tuberculin skin reaction, isolation frequency of Mycobacterium tuberculosis (MTB) in gastric aspirates, and frequency of systemic dissemination of TB among 45 TB infants 12 month-old or less, and compared the results with those of 31 control TB infants and children aged 13 to 35 month-old. The frequency distribution of tuberculin skin reaction size among the studied infants was significantly smaller than that among the controls (p<0.05). MTB was positive among 33 out of the 45 studied infants (73%) while 12 out of the 31 controls (39%), and the difference was significant (p<0.005). Miliary TB and/or TB meningitis were seen among 8 out of the 45 studied infants (18%) while 1 out of the 31 controls (3%), and there was marginally significant difference between them (p=0.054). These results suggest that delayed-type hypersensitivity and cell-mediated immunity to MTB among infants 12 month-old or less may be lower than those among infants and children aged 13 to 35 month-old, and the studied infants may be inferior in their capacity to kill mycobacteria and to encapsulate mycobacteria by granuloma formation.View full abstractDownload PDF (566K) -
Toshiaki SHIMIZU, Keiko OGASAWARA, Katsumasa SATO, Chiaki SANO, Haruak ...2001 Volume 76 Issue 5 Pages 413-418
Published: May 15, 2001
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSStudied were made on the profiles of the therapeutic efficacy of KRM-1648 (KRM) against Mycobacterium avium complex (MAC) infection, which was induced in mice at different challenge doses, in reducing bacterial growth in the visceral organs and altering the profiles of cytokine m RNA expression at the sites of infection. First, bacterial growth in the lungs of mice infected with either high or low challenge doses of MAC, was reduced due to KRM treatment. This effect was noted even in the early phase of infection (week 4) in mice, that were given a high-dose infection. Second, marked thera peutic efficacy of KRM was observed in mice, that were given low-dose MAC infection, in terms of the reduction in bacterial loads in the spleen. However, in mice given a high-dose bacterial challenge, KRM did not exhibit such an efficacy. Third, the expression of both proinflammatory cytokines (TNF-α, IFN-γ) and anti-inflammatory cytokines (IL-10, TGF-β) in m RNA levels were increased at 4 weeks after infection. Notably, all of the cytokines tested for the m RNA expression levels were higher in mice given a low-dose MAC infection as compared to those in mice given a high-dose infection. KRM treatment increased the m RNA levels of these cytokines at week 4, while TGF-β m RNA expression at week 8 was conversely decreased by KRM treatment. These findings suggest that the profiles of the therapeutic efficacy of KRM vary in mice given low-or high-dose MAC infection.View full abstractDownload PDF (815K) -
Setsuko TAZAWA, Kenji MARUMO, Yoshiko NAKAMURA, Michiaki NARUSHIMA, Do ...2001 Volume 76 Issue 5 Pages 419-426
Published: May 15, 2001
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSForty isolates of rapidly growing Mycobacteria, Mycobacterium fortuitum group including M. fortuitum and M. peregrinum and M. chelonae group including M. chelonae subsp. chelonae and M. chelonae subsp. abscessus at Showa University Fujigaoka Hospital collected between February 1981 and December 1997 were investigated in this study. These isolates were from the patients who were not infected with HIV. The average age of fourteen patients, from whom M. fortuitum group was isolated, was 58 years, ranging from 17 to 80 years old. One patient (71-year-old) with chronic myelogenous leukemia and another (64-year-old) with chronic diabetes mellitus were diagnosed with skin abscesses of M. fortuitum group, which were located on the right site of the neck and in the scar after injecting insulin (injection abscess), respectively. The average age of twenty-six patients, from whom M. chelonae group was isolated, was 57 years, ranging from 32 to 84 years old. One patient (75-year-old) with articular rheumatism was diag nosed with a lung infection of mixed M. chelonae group and Pseudomonas aeruginosa, - and another (74-year-old) with diabetes mellitus and kidney failure was strongly suspected of a lung infection. The isolates of the two mycobacteria from the remaining patients were due to colonization, while these patients had the following underlying diseases contributing to infections: pulmonary emphysema; diabetes mellitus; leukemia; collagen diseases; lung cancer; chronic kidney diseases; systemic lupus erythematosus; carcino matous pleurisy; bronchiectasis; post-tuberculosis. Most isolates of the two mycob-acteriawere separated from the specimens of patients' respiratory tracts, but since M. chelonae group was a contaminant in the tap-water for diluting concentrated chlorhexidine, the organism happened to be isolated with the mucous membranes of the 6 patients' colons that were picked up while using the washed fiber-scope. These findings suggest that M. fortuitum and M. chelonae groups, in spite of the fact that they rarely cause infection, have a significant risk of infecting aged patients in general hospitals with various under lying diseases attributable to infections. As only a few colonies were isolated - from patients' specimens in the majority of cases, it took time to carry out these clinical examinations, and to improve this “laboratory's delay” it is needed to make faster report to clinicians.View full abstractDownload PDF (1066K) -
Cooperative Study Unit of Chemotherapy of Tuberculosis ofSusumu HARADA, Masahiro TAKAMOTO, Tsuneo ISHIBASHI, Masashi MOHRI, Koj ...2001 Volume 76 Issue 5 Pages 427-436
Published: May 15, 2001
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSShort course regimens; 2HRZ (E) (S) /4HR (E), 6HRS (E) /3-6HR and 6-9HR have been accepted as a standard chemotherapy (SC) for initial treatment of pulmonary tuber culosis in Japan. We studied the frequency of the treatment completion, the causes of the treatment failure and the outcome of the patients in whom INH or RFP was discontinued within 6 months after starting SC. The subjects included 597 newly diagnosed culture positive pulmonary tuberculosis patients admitted to 16 national hospitals in 1996. Results were as follows.
1. In 47 (7.9%) of the 597 patients, either INH (19; 3.2%) or RFP (33; 5.5%) was discontin ued. These 47 cases were defined as a SC incompleted group and the other 550 as a SC completed group.
2. The patients in the SC incompleted group were seen more frequently in the ages of 20s (11.9%), 50s (10.9%), 60s (11.7%) or 70s (11.4%). 21 (13.6%) of 154 female patients and 26 (5.9%) of 443 male patients were in the SC incompleted group.
3. The causes of cessation of INH or RFP were drug side effects (33; 5.5%), drug resis tance (10; 1.7%) and complications or underlying diseases (8; 1.3%).
4. Fever or eruption (19; 3.2%) and drug induced hepatitis (12; 2.0%) were frequently seen as drug related side effects causing the cessation of INH or RFP.
5. The rate of culture negative conversion of TB bacilli at 6 months after the start of the treatment was 98.9% in the SC completed and 88.9% in the SC incompleted group respectively. In the SC incompleted group, there were three cases continuously positive and two other patients who relapsed and became culture positive again. In these five patients, INH or RFP was discontinued because of drug resistance.View full abstractDownload PDF (1219K)
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