All issues
Volume 79, Issue 6
Displaying 1-6 of 6 articles from this issue
- |<
- <
- 1
- >
- >|
-
Atsuhisa TAMURA, Akira HEBISAWA, Yuzo SAGARA, Junko SUZUKI, Kimihiko M ...2004 Volume 79 Issue 6 Pages 367-373
Published: June 15, 2004
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSAbstract [Objectives] To clarify the clinical features of the coexisting lung cancer and nontuberculous mycobacteriosis of the lung.
[Materials and methods] We analyzed clinical data on 11 admitted cases of coexisting lung cancer and pulmonary nontuberculous mycobacteriosis at National Organization Tokyo Hospital during the period from 1997 to 2002.
[Results] There were 10 men and 1 woman, with a mean age of 66 years. Five of 11 patients had underlying pulmonary disorders, such as healed tuberculosis and lung cyst. Histological types of lung cancer were squamous cell carcinoma in 4, adenocarcinoma and small cell carcinoma in 3 each, and 8 out of 11 cases were in stages III to IV. We classified the 11 cases into 2 groups: (1) lung cancer concurrently detected with mycobacteriosis (8 cases) and (2) lung cancer sequentially detected during the follow-up of mycobacteriosis (3 cases). Lung cancers in the latter group were in relatively early stages and all patients of this group received resection of the cancer, while most of lung cancers in the concurrent group were in far-advanced, and palliative and/or supportive treatment for lung cancer were frequently selected. The strains of mycobacteria were as follows: M. avium complex (6 cases) and M. kansasii (5 cases). The incidence of lung cancer among patients with nontuberculous mycobacteriosis was 2.5 percent (2 percent of M. avium complex diseases patients and 8.2 percent of M. kansasii disease patients), while the incidence of nontuberculous mycobacteriosis in untreated lung cancer patients was 1.4 percent. Analysis of anatomical relationship between lung cancer and non-tuberculous mycobacteriosis revealed that the two diseases located in the same lung in 8 cases, and also in the same lobe in 4 out of the 8 cases. Outcome of treatment for nontuberculous mycobacteriosis was good especially in patients with M. kansasii disease, and it seemed that coexisting nontuberculous mycobacteriosis did not influence on the prognosis of lung cancer patients.
[Conclusion] In the management of lung cancer, physicians should consider the possibility of coexisting pulmonary non-tuberculous mycobacteriosis, as well as coexisting pulmonary tuberculosis.View full abstractDownload PDF (5536K) -
Results of Questionnaire Survey on the Criteria for Discharging Patients from Tuberculosis Wards of the Hospitals in Kanto AreaNaoshi YANAGISAWA, Hisato SHIMADA, Motofumi RINN, Kazumi NISHIO, Hirot ...2004 Volume 79 Issue 6 Pages 375-380
Published: June 15, 2004
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSAbstract [Introduction] Emphasis in treating patients with infectious pulmonary tuberculosis has come to be laid on the execution of reliable standard chemotherapy. As a result, hospitalization for a prolonged period has become unnecessary any more. However, few attempts have been made so far on the determination of discharging criteria.
[Methods] We performed a questionnaire survey to hospitals with wards for tuberculosis in Kanto area and asked questions on the current status of discharging criteria.
[Results] The effective response rate to the survey was 63.0%. Sputum smear examination carried out mainly by Ziehl-Neelsen method and fluorescence method in 17.2% and 72.4% of the hospitals, respectively. Sputum culture examination was carried out using mainly Ogawa medium and a liquid medium in 62.1% and 27.6% of the hospitals, respectively. Discharging criteria were standardized in 79.3% of hospitals. Negative sputum smear was used as the criterion for determining discharge in 11 sets of criteria. Negative sputum culture was used as the criterion for determining discharge in 17 sets of criteria. In the remaining one hospital, patients were to be discharged after 2-month treatment. There was no consistency in the procedure and the frequency of sputum examinations, how many negative results are needed to confirm negative status and the criteria for judgment.
[Conclusion] These results suggest that further evaluation must be made on the treatment outcome at each hospital, and the standard discharging criteria should be worked out taking into account the capacity of each hospital and the care situation of local community.View full abstractDownload PDF (1041K) -
Eri TSUKISHIMA, Yuu MITSUHASHI, Aiko TAKASE2004 Volume 79 Issue 6 Pages 381-386
Published: June 15, 2004
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Objective] The objective of this study was to describe tuberculin skin test (TST) of health-care workers who had had contacts with a tuberculosis patient and to investigate whether the distributions of the size of TST were different by sputum-smear status of index cases and medical procedures done to the patient.
[Subjects] Health-care workers who were exposed to tuberculosis infection through contact with patients before diagnosis of tuberculosis were included in this study. Index cases had pulmonary tuberculosis with positive sputum smear and were registered at Sapporo Public Health Office from April 2001 to March 2002. Subjects without past history of BCG (bacilli Calmette-Guerin) vaccinacion were excluded, and final study subjects were 415 (52 male and 363 female, mean age 29.1 years).
[Method] Characteristics of index cases and contact status were obtained from the registration cards of tuberculosis cases at Sapporo Public Health Office. Subjects were divided into two or more categories by the characteristics of index cases and the contact status. Distributions of TST of the subjects in different categories were compared.
[Results] Contacts with patients received tracheal aspiration showed significantly larger TST reaction than contacts with patients not receiving tracheal aspiration. Among contacts with patients showing minimum to moderately positive sputum-smear, TST reaction was significantly larger in contacts with patients received tracheal aspiration (mean diameter of erythema 35.8mm) than those not receiving tracheal aspiration (24.8mm). In contrast, among contacts with patients of severely positive sputum-smear, TST reaction was not significantly different between contacts of patients received tracheal aspiration (35.3mm) and not receiving tracheal aspiration (33.1mm).
[Conclusion] TST was significantly stronger in contacts with a tuberculosis patient received tracheal aspiration, which indicates medical procedures such as tracheal aspiration increases the risk of tuberculosis infection in health-care workers.View full abstractDownload PDF (984K) -
Kunihiko ITO, Mitsuyoshi TAKAHASHI, Takashi YOSHIYAMA, Masako WADA, Hi ...2004 Volume 79 Issue 6 Pages 387-390
Published: June 15, 2004
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe case is 47-year-old, homeless man. He was diagnosed as cavitary, sputum smear positive pan-sensitive lung tuberculosis, and admitted to TB ward of our hospital. At the age of 4-year-old he had tuberculous hilar lymphadenopathy and took medicine. He had no other associated disease, and HIV test was negative. He started standard chemotherapy and 2 months later his sputum culture was converted to negative. His adherence to medicine was thought to be good. But about 2 weeks after the sputum conversion, his sputum culture was re-converted to positive for Mycobacterium tuberculosis. Thereafter, during and after the completion of standard chemotherapy, his sputum culture had been intermittently positive. The drug sensitivity tests of the strain after re-conversion showed multi-drug resistance. RFLP analysis revealed that the strain before conversion was totally different strain from the strain after re-conversion to positive. The case was considered to be caused by the double infection of MDR strain of Mycobacterium tuberculosis during the course of treatment for tuberculosis due to a sensitive strain of Mycobacterium tuberculosis.View full abstractDownload PDF (2161K) -
Shinya KONDO, Masaki ITO, Gen NISHIMURA2004 Volume 79 Issue 6 Pages 391-395
Published: June 15, 2004
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe treated three newborns and early infants with congenital tuberculosis between 1996 and 2001. We reported imaging presentations of the three cases born in and after 1996 when new CT equipment (CT-HAS-SGS, GE-Yokokawa, Tokyo) was introduced in our institute. These three cases of congenital tuberculosis showed periportal hypodensity, in addition to pulmonary infiltrate, mediastinal and abdominal lymphadenopathy on CT images. Early diagnosis of congenital tuberculosis is urgently needed, however, it is very difficult. Our findings suggested that clinical suspicion supplemented by careful imaging examinations may facilitate the early diagnosis of congenital tuberculosis, and the detection of periportal hypodensity may offer a new additive diagnostic option to congenital tuberculosis.View full abstractDownload PDF (6377K) -
Hiroyuki KAMIYA, Emiko TOYOTA, Nobuyuki KOBAYASHI, Kouichirou KUDO2004 Volume 79 Issue 6 Pages 397-400
Published: June 15, 2004
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 60-year-old man was admitted to our hospital complaining of general malaise for a few months, discomfort of the right shoulder and fever in May 2003. Chest X-ray film showed an infiltrative shadow in the right lung field and chest CT scan revealed right pleural effusion. Pulmonary tuberculosis complicated with pleurisy was first suspected from the findings of high ADA level of the effusion and positive result of PPD skin test. But, microscopic examination of the specimens obtained by transbronchial lung biopsy disclosed granulomatous lesions and Mycobacterium kansasii was identified from all specimens; sputum, fluids of brushing and bronchial washing. The patient was diagnosed as pulmonary Mycobacterium kansasii infection and treated with anti-tuberculous drugs including RFP. His clinical course was good and no recurrence of pleural effusion was seen. This case was a rare case of pulmonary Mycobacterium kansasii infection complicated with pleural effusion.View full abstractDownload PDF (5577K)
- |<
- <
- 1
- >
- >|