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Volume 79, Issue 1
Displaying 1-5 of 5 articles from this issue
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Yoshihiro KOBASHI, Naoyuki MIYASHITA, Yoshihito NIKI, Niro OKIMOTO, Yo ...2004 Volume 79 Issue 1 Pages 1-6
Published: January 15, 2004
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Objective] The objects of this study were to analyze clinically the outpatients and inpatients who were diagnosed as pulmonary tuberculosis during the follow-up of other underlying diseases at our affiliated hospitals and to review the past problems and to discuss how to improve the situation.
[Methods] Sixty five outpatients or inpatients diagnosed as pulmonary tuberculosis during the follow-up of other under-lying diseases were collected from 508 patients with pulmo-nary tuberculosis at our affiliated hospitals over the past 10 years.
[Results] The proportion of elderly patients over 65 years old among 65 index cases was significantly higher as compared to the control group. Forty three of these index patients were outpatients and 22 were inpatients. The most frequent underlying diseases excluding respiratory diseases were malig-nant diseases followed by diabetes mellitus, gastrointestinal diseases and psychosomatic diseases in order. Pulmonary tuberculosis without clinical symptoms was detected by periodic chest X-ray in 21 cases (32%). There were some severe TB cases caused by the doctor's delay who were followed for malignant or psychosomatic diseases.
[Conclusion] Although many doctors except for respiratory specialists tended to pay attention to pulmonary tuberculosis as a possible complication during periodic health examination, further intensive education regarding pulmonary tuberculosis is required for doctors who treat malignant or psychosomatic diseases at special hospitals because TB patients who were smear positive when they were detected may cause outbreak of tuberculosis in the hospital.View full abstractDownload PDF (831K) -
Shuichi YANO, Kanako KOBAYASHI, Kazuhiro KATO, Toshiyuki TATSUKAWA, Sh ...2004 Volume 79 Issue 1 Pages 7-10
Published: January 15, 2004
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Purpose] The usefulness of the lymphocyte stimulation test (LST) was examined in patients who arose side effects to antituberculosis drugs.
[Methods] The usefulness of LST was examined in 36 patients from January, 1999 to July, 2002.
[Results] There were 11 LST positive patients, and the LST positive rate was 30.6%. The causing agents determined by the LST positive patients were INH in 7, RFP in 3 and EB in one. The sensitivity of LST was 46.2% and the specificity of LST was 76.6%.
[Conclusion] LST positive rate of antituberculosis drugs was low and it was difficult to determine the causing drugs by LST.View full abstractDownload PDF (2853K) -
Noritaka YAMADA, Yuko ITO, Kunihiko GOTO, Takayuki ANDO, Yukio SUDO, K ...2004 Volume 79 Issue 1 Pages 11-15
Published: January 15, 2004
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 23-year-old man was admitted to our hospital because of cough and sputum in April 2001. A chest roent-genogram revealed infiltrative shadow with cavity formation in the bilateral lung fields. He was treated with sensitive anti-tuberculous drugs. After starting the antituberculous therapy with INH, RFP, EB and PZA, bilateral cervical lymphade-nopathy developed. Three months later, pericostal abscess appeared in the left anterior chest wall. Microscopic examina-tion of the specimen obtained by needle aspiration biopsy disclosed positive for acid-fast bacilli. Smears of the pus showed acidfast bacilli identified as Mycobacterium tubercu-losis by DNA-DNA PCR method. He developed tuberculous bilateral cervical lymphadenopathy and pericostal abscess during the course of antituberculosis chemotherapy. Drug sensitivity test revealed that tubercle bacilli in this case were sensitive. One year after the administration of chemotherapy, cervical lymphadenopathy and pericostal abscess were improved. Both masses were discontinuous with pulmonary tuberculosis and the possibility of lymphogenous spread of organism was speculated as its etiology. We assumed that both masses were due to paradoxical response to the anti-tuberculosis chemotherapy.View full abstractDownload PDF (6343K) -
Promoting the DOT ProgramYuki TADA, Masako OHMORI, Kunihiko ITO, Michiko FUJIU2004 Volume 79 Issue 1 Pages 17-24
Published: January 15, 2004
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSKawasaki City initiated the DOT (Directly Ob-served Therapy) program in 2000 to improve tuberculosis (TB) control in the homeless persons and individuals living in temporary subsidized housing. The program was implemented as an additional program to the city's control policy of mass TB screenings for these groups. The DOT program was imple-mented through participation of numerous agencies sharing common goals. Through coordination and cooperation, a strat-egy suitable for the regional level was developed. Sectors involved were not only the TB control staff within the public health centers but also the entire public health centers, the welfare administrative division, the city's TB task force and homeless task force, and regional medical institutions. With the implementation of the DOT program, proper medical treatment, improved patient care, and various other measures were performed, and this led to the strengthening of TB control not only in designated DOT-implemented areas but also in the entire city. As a result, the treatment outcomes improved, and incidence rate of TB began to decrease.View full abstractDownload PDF (1431K) -
Ryuzo KAWAMORI2004 Volume 79 Issue 1 Pages 25-32
Published: January 15, 2004
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDiabetes and tuberculosis are bad companions each other. In this clinical review article on diabetes, the pathophysiology of diabetes is documented from the view-point of both insulin secretory dynamics and insulin action on various target organs. The mechanisms why atherosclerosis is accelerated in diabetes is also mentioned.
Nowadays, there are many modalities to correct the derang-ed glucose fluxes, thus it is not difficult to maintain near-normal glycemic excursions in diabetic patients. Strict glyce-mic regulation is obligatory if the patient with tuberculosis has diabetes.View full abstractDownload PDF (1182K)
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