巻号一覧
76 巻, 6 号
選択された号の論文の7件中1～7を表示しています
- |<
- <
- 1
- >
- >|
-
山口 泰弘, 川辺 芳子, 長山 直弘, 田村 厚久, 永井 英明, 赤川 志のぶ, 町田 和子, 倉島 篤行, 四元 秀毅, 毛利 昌史2001 年 76 巻 6 号 p. 447-454
発行日: 2001/06/15
公開日: 2011/05/24
ジャーナル フリーThe clinical findings of pulmonary tuberculosis in elderly patients aged 75 years of age or older (elderly group) were compared with the middle-ged patients aged between 45 and 54 years of age (middle-aged group) and the young patients aged 34 years of age or younger (young group). The elderly patients who died in hospital were also compared with the elderly patients who survived. Study subjects were culture-positive pulmonary tuberculosis patients who were discharged from our hospital from December 1996 to November 1998. There were 79 patients in the elderly group, 95 in the middle-aged group, and 88 in the young group. The results were as follows.
1) The male/female ratio was significantly lower in the elderly group (1.9: 1) than the middle-aged-group (6.9: 1).
2) Complication was noted more frequently in the elderly group. However, diabetes mel-litus was noted less frequently in the elderly group (12.7%) than the middle-aged group (28.4%).
3) The frequency of cavitation was lower in the elderly group (59.5%) than the middleaged group (87.4%).
4) The fever over 38°C was noted less frequently in the elderly group (17.7%) than the other groups, while the frequency of the fever over 37°C showed no significant differ ence between the elderly group and the other groups.
5) The frequencies of hypoalbuminemia and appetite loss were higher in the elderly group than the other groups.
6) The elderly group showed high mortality rate of 31.6%. The complication with cerebrovascular disease was noted significantly higher in the patients who died in hospital than those who survived. The frequency of widespread infiltrates, fever over 38°C, neutrophilia, hypoalbuminemia and appetite loss were all significantly higher in the patients who died in hospital while their sputa were still positive on culture than those who survived.
Our study clearly showed the features of elderly pulmonary tuberculosis patients in comparison with middle-aged patients and young patients. These features are very impor tant to suspect the diagnosis of pulmonary tuberculosis in elderly patients with some atypical manifestation. Our study also suggests that the delay in diagnosing tuberculosis causes more frequently the patients' deterioration and death in elderly patients than in middle-aged patients and young patients.抄録全体を表示PDF形式でダウンロード (917K) -
浜島 泉2001 年 76 巻 6 号 p. 455-460
発行日: 2001/06/15
公開日: 2011/05/24
ジャーナル フリーThe guideline for contacts examination and chemoprophylaxis for tuberculosis was revised in 1993. Secondary cases and chemoprophylaxis cases found by the contacts exami nation of family members were analyzed in Sapporo City. The average age of index cases and of secondary cases has become higher. Many secondary cases were found among spouse of the index case and children of male index case. Chemoprophylaxis cases were found mostly among children of male or female index cases and grandchildren of male index cases.
The results of family contacts examination carried out during the period from 1994 to 1999 were compared with those from 1987 to 1992. The incidence of family infection of tuberculosis and the number of newly infected persons and of secondary cases have decreased in the latter period. The time interval from the registration of the index case to the detection of secondary cases has become shorter, and the ratio of sputum smear positive cases among secondary cases has also decreased.
Male to female ratio of the index cases was 2: 1, that of secondary cases was 3: 5, and that of children indicated chemoprophylaxis was 4: 5.
All secondary cases found by the contacts examination carried out within 6 months after the previous examination were sputum smear negative for tubercle bacilli, and there were a few smear positive cases among secondary cases who were found by the examination with longer interval with the previous examination. Such cases with longer interval from the last periodic examination was found oftener among younger cases below 40 years of age. Most smear negative tuberculosis cases were found by the family contacts examina-tion, while most smear positive cases were found by symptomatic visit to doctors.抄録全体を表示PDF形式でダウンロード (505K) -
1997年度の各施設と結研の成績の比較平野 和重, 和田 雅子, 阿部 千代治, 青柳 昭雄2001 年 76 巻 6 号 p. 461-471
発行日: 2001/06/15
公開日: 2011/05/24
ジャーナル フリーFive years after the last survey of drug-resistant tuberculosis in Japan, a nationwide survey was conducted by the Tuberculosis Research Committee (Ryoken). A total of 78 hospitals in various districts of Japan participated in this cooperative study. Each collaborating laboratory sent all the isolated mycobacterial cultures during June 1 to November 30, 1997 to the Research Institute of Tuberculosis (RIT), which is one of the Supranational Reference Laboratories of the WHO/IUATLD Global Project on Anti tuberculosis Drug Resistance Surveillance. At RIT identification and drug susceptibility of Mycobacterium tuberculosis isolates were reexamined. The RIT received a total of 2, 167 cultures. Among them, 523 cultures were excluded from further examinations because of various reasons, such as growth of mycobacteria other than tubercle bacilli (MOTT, 453), mixed cultures of M. tuberculosis and MOTT (16), and contamination or non-viability (54). Thus drug susceptibility test results were available for 1, 644 cultures, including 47 from foreign-born people. In the local laboratories, the absolute concentration method using 1% Ogawa egg slant (standard method, 26 hospitals), its modified methods using a 48-well plate (Microtiter method, 29 hospitals) and a 16-well plate (Well-pack method, 7 hospitals), combination of above 2 or 3 methods (13 hospitals), and other method (3 hospitals) were used for drug susceptibility testing, and the proportion method using 1% Ogawa egg slant was used in the RIT. The results in the local labora tories were compared with those in the RIT. A high concordance rate (over 90 %) was seen in the testing for 1 ug/ml of isoniazid (INH), rifampin (RFP) and streptomycin (SM), but the rate was lower (under 90%) in the testing for 0.1 ti g/ml of INH andethambutol (EMB). However, there was no significant difference in the concordance rates according to the test drugs among methods for drug susceptibility testing used in the local laboratories. Median concordance rates between the results with the standard method, Microtiter method and Well-pack method in the local laboratories, and those in the RIT were 95.9%, 93.2% and 96.4% respectively. Relatively lower concordance rates were seen in the laboratories using the Microtiter method related to high overestimation rates (median overestimation rate of 5.3%), compared with 1.2% and 2.3% in the laboratories using the standard method and Well-pack method, respectively. However, relatively lower concordance rates (less than 90%) were seen in the laboratories using any of the three methods, indicating that there are variations among facilities. Part of the results concerning the resistance patterns to four first-line anti-tuberculosis drugs were reported elsewhere.抄録全体を表示PDF形式でダウンロード (1291K) -
平田 世雄, 庄野 哲史2001 年 76 巻 6 号 p. 473-478
発行日: 2001/06/15
公開日: 2011/05/24
ジャーナル フリーA 55-year-old infertile woman was referred to our clinic for further investigation on extragenital tuberculosis, as tuberculous endometritis was strongly suspected by cyto logy of her vaginal smear carried out on the occasion of the mass examination for gynecologic cancer screening. Her vaginal smear revealed epithelioid cell clusters which are characteristic for tuberculosis, and cultures of her vaginal discharge were positive for M. tuberculosis consecutively. Moreover, she was exposed for tuberculosis infection from her father who died of active pulmonary tuberculosis when she was ten years old. Her tuberculin test was strongly positive, and her chest radiography showed no abnormality, but a small nodular shadow evaluated as primary focus of tuberculosis located beneath the pleura of the right lower lung field was confirmed by chest CT. In addition, calci - fication of her para-aortic abdominal lymphnode was detected by simple abdominal Xray. Based on these data, she was diagnosed as tuberculous endometritis via abdominal cavity, and three antituberculous drugs, namely RFP, INH and EB, were administrated. The mycobacterial cultures of vaginal discharge converted to negative, and chemotherapy was terminated after 9 months treatment.
A risk factor leading to the onset of gynecologic tuberculosis, in this case was an exposure to infection from her father. In order to evaluate risk factors relating to the development of gynecologic tuberculosis, bibliographic studies were made on 19 cases of tuberculous endometrites reported recently in Japan regarding their age, its pathogenesis and immuno-suppressive conditions, and the summarized results were as follows.
1. approximately 80% of them were elderly, namely 79% were above 50 years, 63% above 60years, and 26% above 70 years.
2. 50% of them were caused by endogenous reactivation.
3. 25% of them were immuno-compromised host.
It can be concluded that more than 70% of the patients with tuberculous endometritis had risk factors on the host side to develop tuberculosis.抄録全体を表示PDF形式でダウンロード (4117K) -
水谷 宏, 堀場 通明, 進藤 丈, 木村 智樹, 孫 政実, 若原 恵子2001 年 76 巻 6 号 p. 479-484
発行日: 2001/06/15
公開日: 2011/05/24
ジャーナル フリーWe sometimes encounter difficulties in differentiating tuberculous peritonitis from other inflammatory disorders or ascites due to carcinomatous peritonitis. Acid-fast bacilli are very rarely detected in ascites.In this study, we reported a case of tuberculous peritonitis accompanied with active pulmonary tuberculosis in which acid-fast bacilli were detected in ascites.
The patient was a 37-year-old single man who had been admitted to our hospital on February 28, 2000, because acid-fast bacilli were detected in sputum, faces and ascites by a direct smear. He had a lower abdominal distention and pain. His serum CA 125 level was high, 121 U/m/. Abdominal ultrasonography showed marked ascites in Douglas pouch. However adenosine deaminase level was not high in his ascites. During treatment by the combination chemotherapy with INH, RFP, EB, and PZA, serum CA 125 level was decreased.抄録全体を表示PDF形式でダウンロード (3854K) -
佐々木 信, 望月 吉郎, 中原 保治, 田中 明, 河村 哲治2001 年 76 巻 6 号 p. 485-489
発行日: 2001/06/15
公開日: 2011/05/24
ジャーナル フリーA 45-year-old man visited our clinic because of intermittent bloody sputum. The chest roentogenogram was normal, but the high-resolution computed tomography (HRCT) showed very small nodules and bronchiolitis adjacent to pleura in the upper right lung field. The bronchoscopic examination revealed blood-streaked bronchial secretion in the right upper lobe bronchus, and the cultures of the sputa and the bronchial washing specimen showed acid-fast bacilli identified as Mycobacterium intracellulare by DNADNA hybridization (DDH) method. This case was diagnosed as Mycobacterium intracellulare lung disease. The patient received isoniazid, levofloxacin, and clarithromycin for three years without clinical and bacteriological improvement. His hemoptysis and the number of colonies recovered from sputum cultures decreased without any medication later. The serial chest roentogenograms and HRCTs have showed no changes for 6 years after the diagnosis. This case may show some clues to elucidate the mechanism of the onset of Mycobacterium intracellulare lung disease without predisposing conditions.抄録全体を表示PDF形式でダウンロード (3334K) -
2001 年 76 巻 6 号 p. e1
発行日: 2001年
公開日: 2011/05/24
ジャーナル フリーPDF形式でダウンロード (91K)
- |<
- <
- 1
- >
- >|