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Volume 80, Issue 5
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Masakazu AOKI2005 Volume 80 Issue 5 Pages 401-411
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSTuberculosis outbreak is defined as group infection more than 20 persons had been infected with tubercle bacilli in Japan, provided one person developed disease is counted as 6 persons had been infected. Outbreak is to be reported compulsory to the Ministry of Health, Welfare and Labor. A total of 365 outbreaks of tuberculosis have been reported in these 10 years during 1994 and 2004. Out of them, large scale outbreak more than 10 persons have developed disease were 41 (11.2%). Results of contact surveys has reported that 0.36% of newly registered smear positive cases had caused tuberculosis outbreak, 1.1% had resulted small scale group infection (5 to 19 persons had been infected), although majority of the bacteriology positive cases didn't infected even one person. To make clear the mode of airborne infection with tubercle bacilli more clearly, the author has discussed the results of quantitative model on droplet nude infection by Riley RL and others, nosocomial infection of smallpox virus in Germany in 1970, the results of analysis of airflow at the sites of outbreaks at business office and middle school in Japan, and so on. Finally, the author has reviewed the development of research on annual risk of tuberculosis infection in Japan and discussed about the present problems of risk of tuberculosis infection in Japan.View full abstractDownload PDF (2496K) -
Atsuhisa TAMURA, Akira HEBISAWA, Yuzo SAGARA, Junko SUZUKI, Kimihiko M ...2005 Volume 80 Issue 5 Pages 413-419
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Objectives] The aim of this study is to clarify the clinical and pathological anatomical picture of cases in which lung cancer and active pulmonary mycobacteriosis are intermingled in the same lobe of the lung. [Materials and methods] We analyzed clinicopathological data on 11 cases in which lung cancer and active pulmonary mycobacteriosis are intermingled in the same lung lobe out of 61 admitted cases of coexisting lung cancer and active pulm onary mycobacteriosis, encountered at National Hospital Organization Tokyo National Hospital during the period from 1991to 2003. [Results] The subjects were 10 men and 1 woman, with a mean age of 68 years. The species of mycobacteriosis were M. tuberculosis in 6 and nontuberculous mycobacteriosis in 5(M. avium disease and M. abscessus disease in 2 each, and M. kansasii disease in 1). The frequency of the mixture was 13%(6/45) in patients with lung cancer and tuberculosis and was 31% (5/16) in patients with lung cancer and nontubercul ous mycobacteriosis. Radiographic findings revealed that both cancer shadows and mycobacteriosis shadows are identified in 8 of the 11 patients, whereas cancer shadows were recognized but mycobacteriosis shadows could not be pointed out in the remaining 3 patients. We divided 7 cases (5 resection scases and 2 autopsy cases) with the mixture of cancer and mycobacteriosis into 2 types from the macroscopic images: (1) type A (4 cases, the foci of lung cancer and tuberculosis, which were separated originally, progressed mutually, and has adjoined), and (2) type B (2 cases, the foci of mycobacteriosis existed within or in the edge of the foci of lung cancer). There were 3nontuberculous mycobacteriosis cases and 1 tuberculosis case in type A, and 2 tuberculosis cases and 1 nontuberculous mycobacteriosis in type B. In nontuberculous mycobacteriosis cases, cancer and mycobacteriosis had often adjoined under the conditions of preexisting lung disease, such as a lung cyst, whereas in tuberculosis cases, it was characteristically shown that the wall of encapsulated caseous nodules was destroyed by cancer invasion, and that the tuberculous nodules were reactivated. These findings seemed to be related to exogenous infection of nontuberculous mycobacteriosis to the injured lungs and to endogenous reactivation of tuberculosis from inactive tuberculous lesions. [Conclusion] Lung cancer and active pulmonary mycobacteriosis are often seen intermingled in the same lung lobe, and the mixture pictures of the two diseases are variable. The physicians should carefully note about the mixture of lung cancer and mycobacteriosis, though the findings are not clear on the chest plain radiographs.View full abstractDownload PDF (10266K) -
Shinya KONDO, Masaki ITO, Gen NISHIMURA2005 Volume 80 Issue 5 Pages 421-425
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Objectives] We previously reported the presence of periportal hypodensity on CT image in two newborns and an early infant with congenital tuberculosis as an adjunct diagnostic'option. The aim of this study was to determ ine the degree of treatment based on both periportal hypodensity and serum IgM presented in asymptomatic newborns born from tuberculosis mothers.
[Subjects a nd Methods] Eight newborns born from mothers with untreated tuberculosis between 1996 and 2002 were retrospectively studied. Newborns who presented periportal hypodensity and high serum IgM were treated with anti-tuberculosis medicines, combination of isoniazid and rifampicin for nine to 12 months with streptomycin in the initial two months, and the outcomes of the treatment were followed for at least two years.
[Results] All eight newborns had gastric aspirates negative for Mycobacterium tuberculosis. Three of eight newborns (38%) demonstrated periportal hypodensity, and they also demonstrate a tendency of high serum IgM. None of these three newborns treated with combination of isoniazid, rifampin, and streptomycin for 9 to 12 months developed tuberculosis during the observation period.
[Conclusions] Th ese results suggest that presence of both periportal hypodensity and high serum IgM in asymptomatic newborns born from mothers with untreated tuberculosis may be one of risk factors of developing congenital tuberculosis, and that anti-tuberculosis treatment for nine to 12 months may prevent them from the disease development despite possible criticism of overdiagnosis and overtreatment.View full abstractDownload PDF (3733K) -
Minako HAMADA, Akira KAJIKI, Nobuhiko NAGATA, Kentaro WAKAMATSU, Masas ...2005 Volume 80 Issue 5 Pages 427-432
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe rate of pulmonary nontuberculous mycobacteriosis (NTM) in the total pulmonary mycobacteriosis has been continuously increasing. While M. avium complex is the most common cause of NTM, there are a few case reports of pulmonary infection due to M. szulgai. We described two cases of pulmonary NTM caused by M. szulgai. A 75-year-old male was admitted to our hospital because of dyspnea on effort, and productive cough. A chest X-ray showed an infiltrative shadow with cavity in the right upper lobe. A sputum smear for mycobacteria was positive, and a culture grew M. szulgai which was identified by DNA?DNA hybridization. He was treated with isoniazid, rifampicin, and ethambutol. His symptoms and CT and X-ray findings improved, and his sputum smear and culture converted to negative for mycobacteria. Second case was a 73-year-old male who had previously been diagnosed as MAC and pulmonary aspergillosis, and had been treated with antituberculous and antifungal drugs. He was readmitted to our hospital, because of general fatigue and hemoptysis. A chest X-ray revealed a consolidation with bronchiectasis and cavity in the both upper lung fields. A sptum smear for mycobacteria was positive, and a grown culture was identified as M. szulgai. He was treated with rifampicin, ethambutol and kanamycin based on the results of susceptibility testing. After 3 months of this treatment his sputum smear and culture converted to negative for mycobacteria, and his symptoms, and CT and X-ray findings improved.View full abstractDownload PDF (7562K) -
[in Japanese]2005 Volume 80 Issue 5 Pages 433-434
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (409K)
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