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Volume 82, Issue 7
Displaying 1-5 of 5 articles from this issue
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Shuichi YANO, Kanako KOBAYASHI, Toshikazu IKEDA, Yoshiyuki TOKUDA, Hir ...2007 Volume 82 Issue 7 Pages 557-561
Published: July 15, 2007
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Purpose] To investigate the infection rate of tuberculosis in high-risk employees at our hospital.
[Methods] We measured interferon ga mma levels in 40employees and evaluated the infection rate in doctors working in the Tuberculosis Ward (D group), nurses in the Tuberculosis Ward (N group), and other high-risk employees (0 group).
[Results] The overall infection rate including probable infection was 6/40 (15.0%). The infection rate in the N group was 0%, while those in the D and O groups were 27.3 % and 20.0% respectively. No new infection of tuberculosis was observed after the introduction of tuberculosis infection measure manual of our hospital.
[Conclusion] Our hospital's tuberculosis infection measure manual was effective in decreasing the new tuberculosis infection despite a high infection rate in high-risk employees at our hospital.View full abstractDownload PDF (2768K) -
Yoshinori MATSUI, Shinobu AKAGAWA, Masahiro KAWASHIMA, Junko SUZUKI, K ...2007 Volume 82 Issue 7 Pages 563-567
Published: July 15, 2007
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Aims] In the treatment of tuberculosis with rifampicin in patients treated with prednisolone and cyclos porine, we have to increase the dosage of these drugs. Although prednisolone dosage is recommended to be doubled, there is no established consensus about cyclosporine dosage. Our aim is to review the current situation at our institution regarding the dosage of cyclosporine administered to tuberculous patients after the addition of rifampicin to the treatment regimen.
[Methods and Results] We reviewed patients' clinical status and how dosages of cyclosporine were altered during a course of tuberculosis treatment including rifampicin in 4 patients (2interstitial pneumonitis, 2 collagen vascular disease) who were being treated with cyclosporine between 2001 and 2003. Prednisolone had been also administrated in all patients and the dosage was doubled from the beginning of the treatment. The appropriate dosage of cyclosporine was found to be 2.53.5 (average 3) times that of initial dosage, and it required 512 weeks (average 8.3) measurements of trough levels and 6-27 (average 12) weeks until appropriate trough levels were obtained.
[Conclusions] The appropriate dosage of cyclosporine was found to be approximately 3 times that of the initial dosage in all patients, but it required a long term and frequent measurements of trough levels before reaching this goal. It seems that trebling the dosage of cyclosporine from the start of anti-tuberculosis chemotherapy will be an efficient way to achieve good clinical outcome.View full abstractDownload PDF (874K) -
Shinya KONDO, Tomoo MIYAGAWA, Masaki ITO2007 Volume 82 Issue 7 Pages 569-575
Published: July 15, 2007
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Object] We try to reevaluate the pathogenesis of epituberculosis in infants and children with tuberculosis, because most studies on epituberculosis were done more than 50 years ago.
[Subje ct and methods] Nineteen children (less than 1 y /o: 12, 1 y/o: 2, 2 y/o: 3, and 4 y/o: 2) were studied by CT imaging and bronchofiberscopy in addition to gastric Mycobacterium tuberculosis examination and regular chest XP.
[Results] In 13 of total 19 patients (68%), lobar or segmental epituberculosis occured after starting antituberculous chemotherapy, including a case in which epituberculosis of right upper lobe was recognized at the time of diagnosis of tuberculosis and after starting chemotherapy, epituberculosis of right middle lobe was observed. CT imaging revealed that all 19 patients had enlargement of mediastinal and/or hilar lymphonodes compressing neighboring bronchi, and 16 of total 19 patients (84%) demonstrated relevant parenchymal infiltration. Gastric Mycobacterium tuberculosis was positive in 15 out of 19 patients (79%). Bronchofiberscopy was done in 16 patients, and it demonstrated mass lesion of various size on the bronchial wall in 13 patients (81%).
[Conclusion] The present study d emonstrated that epituberculosis predominantly occured in tuberculosis infants less than one year old, which was different from the previous reports. The CT imaging also makes clear that epituberculosis may be the atelectasis of lobe or segment which occurs mostly due to compression of bronchi by the enlargement of mediastinal and/or hilar lymphonodes and their early exacerbation after starting chemotherapy. Bronchofiberscopy also elucidated that bronchial wall mass lesion resulted from perforation of lynphonodes may partially contribute to the formation of epituberculosis.View full abstractDownload PDF (5620K) -
Kazuhiko KOYAMA, Kenji KAWAKAMI, Yoshitaka HARADA, Takeshi YAMARYO, Yu ...2007 Volume 82 Issue 7 Pages 577-581
Published: July 15, 2007
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 31-year-old woman complained of cough and fever for 2 months. She was admitted to a hospital and was diagnosed as pulmonary tuberculosis. She received combination therapy with isoniazid, rifampicin, ethambutol, and pyrazinamide. As the drug susceptibility test revealed that the isolated strain was multi-drug resistant, the regimen was changed to pyrazinamide, ethionamide, cycloserine, enviomycin, and levofloxacin. The chemotherapy was not effective, so she received pneumonectomy for left destroyed lung. After surgical treatment, her sputa converted to negative for tubercle bacilli. Surgical treatment such as pneumonectomy is considered to be useful in a case of multi-drug resistant pulmonary tuberculosis.View full abstractDownload PDF (4550K) -
2007 Volume 82 Issue 7 Pages 583-628
Published: July 15, 2007
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (14217K)
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