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Volume 80, Issue 9
Displaying 1-5 of 5 articles from this issue
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Shuichi YANO, Kanako KOBAYASHI, Kazuhiro KATO, Toshikazu IKEDA2005 Volume 80 Issue 9 Pages 591-594
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Purpose] To detect factors that affected the improvement on chest X-ray findings after two months of antituberculous treatment.
[Methods] W e assessed the chest X-ray findings of 72patients with sputum culture positive to determine whether findings showed improvement after two months treatment with antituberculous drugs, and we compared the differences in disease status between the improved group (I group) and the non-improved group (N group).
[Results] The I group con sisted of 43 pts. and the N group consisted of 29 pts. The mean age in the N group was higher than that in the I group. There were no differences in sex or body weight. Though the mortality rate in the N group was 20.7% and that in the I group was 9.3%, it was not stati stically significant. The erythema size of tuberculin skin test in the I group was larger than that in the N group. There were no differences in the type or extent of lesion on Gakkai classification between the two groups, and there were no remarkable blood biochemistry findings in either group. Though there were no differences in the rates of side effects or discontinuation of treatment, the incidence rate of complications in the N group was higher than that ih the I group.
[Conclusion] Older patients with complications and smaller erythema size of tuberculin skin test reaction showed a delay in chest X-ray findings improvement after two months of antituberculous drug treatment.View full abstractDownload PDF (723K) -
Toshiaki FUKKANE, Yasuhiro YAMAZAKI, Satoru FUJIUCHI, Yasushi YAMAMOTO ...2005 Volume 80 Issue 9 Pages 595-600
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Objective] The purpose of this study was to improve the enforcement rate of the standard regimen (A) of tuberculosis chemotherapy.
[Subjective and Methods] We introduced the common database system for tuberculosis in three national hospitals in Hokkaido. From January 2002 to December 2003, we collected the anonymous informations of the patients with tuberculosis at the start of treatment, at the discharge and at the end of treatment. Then, we reported the enforcement rate of the standard regimen (A) as a clinical indicator periodically to three hospitals.
[Results] Four hundred and twenty-nine patients were registered. In patients below 80 years old, the enforcement rate of the standard regimen (A) was 48.5 % in 2002. The enforcement rate rose significantly to 62.7% (p = 0.0126) in 2003. In elder smear-positive patients (≥75) and in elder smear-negative patients (≥70), the enforcement rate was low (29.1 % and 25.0%, respectively). Furthermore in young smear-negative patients (≤29), the enforcement rate was low (28.0%). As the extent of their disease was minimal, t hey were treated with other regimens. In patients treated with the standard regimen (A), there were no significant differences in the frequency of adverse effects between elder patients (≥70) and other patients (≤69). There were also no significant differences in the frequency of changing the regimen between them. Median admission period of 2002 was 114 days. In 2003, it was shortened significantly to 110 days (p = 0.0487).
[Conclusion] By the introduction of the common database system for tuberculosis, the enforcement rate of the standard regimen (A) was improved. Low enforcement rate in young smear-negative patients in an important problem to be improved in the future. The clinical indicator based on the common database system between hospitals, is useful to clarify the problems, and then to improve the quality of medical performance.View full abstractDownload PDF (1041K) -
Including Discussions on the Diagnostic Criteri a of the DiseaseKiyohiro FUJIWARA2005 Volume 80 Issue 9 Pages 601-605
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA case was 56 years old woman, and she did not have any subjective symptom. She received multiphasic health screening, and abnormal shadow was detected on her chest radiograph. Chest radiography revealed infiltrations in the middle lobe. Computed tomography (CT) of the thorax showed clusters of small nodules in the middle lobe. The bronchial washing specimen showed acid-fast bacilli identified as Mycobacterium intracellulare by DNA-DNA hybridization (DDH)method. This case was diagnosed as Mycobacterium intracellulare lung disease. The patient received combination therapy with rifampicin, ethambutol, and clarithromycin for one year with radiological improvement. CT findings were characteristic and useful for the early diagnosis of MAC infection, which led to cure of the disease by chemotherapy.View full abstractDownload PDF (6484K) -
Masako WADA2005 Volume 80 Issue 9 Pages 607-611
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSIn 1996 a six-month short-course chemotherapy was adopted as a standard chemotherapy for pulmonary tuberculosis in Japan. The frequency of implementation of short course chemotherapy for smear positive new case was only sixty percent in 2003, although a short course chemotherapy was recommended all over the world for avoidance of acquiring a new resistance among new drug resistant tuberculosis. The reasons for the low adaptation of short course chemotherapy were speculated that high rate of elderly patients, and high frequency of drug-induced hepatitis. From our 14-year experience, the frequency of drug-induced hepatitis was 7.8%for all patients with standard 6-month or 9-month regimen, 7.2% in the patients with normal liver function tests at the start of chemotherapy, and 11.8% in the patients with any kinds of abnormality. The death rate was 0.04% among treated patients, and fatality was 0.49% among the patients with drug-induced hepatitis. Positive HCV antibody and less than 1, 000 cells/μL, of peripheral lymphocyte count at the beginning of treatment were independent risk factors for druginduced hepatitis. The management of hepatitis during antituberculosis treatment was also referred.View full abstractDownload PDF (1082K) -
2005 Volume 80 Issue 9 Pages 613-629
Published: 2005
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (13547K)
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