著者

小橋 吉博 松島 敏春 河原 伸 多田 敦彦 宍戸 眞司 矢野 修一 重藤 えり子 横崎 恭之 冨岡 治明 竹山 博泰 西村 一孝 塩出 昌弘 上田 暢男 倉岡 敏彦 印鍮 恭輔

出版者

THE JAPANESE SOCIETY FOR TB AND NTM

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.73, no.12, pp.705-711, 1998-12-15 (Released:2011-05-24)

参考文献数

14

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In this study, we investigated 45 foreign patients who had been diagnosed as having tuberculosis in Chugoku-Shikoku area during the past 12 years. Regarding regional characteristics, in Hiroshima prefecture an epidemic of tuberculosis was experienced among patients coming from South America, but antituberculous therapy was performed for 87% of the patients because of the high coverage of the health insurance scheme. But in Okayama prefecture, most of the patients were female and came from Asian countries, such as, the Philippines. Antituberculous therapy was not performed for nine patients because of no coverage of the health insurance scheme. In the other prefectures, only a few cases of tuberculosis were experienced, but in Yamaguchi prefecture two of three foreign patients were multidrug-resistant tuberculosis.

著者

福田 眞人

出版者

THE JAPANESE SOCIETY FOR TB AND NTM

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.79, no.11, pp.655-658, 2004-11-15 (Released:2011-05-24)

被引用文献数

1

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Tuberculosis (TB) has a long history. Regarding terminology, TB has, roughly speaking, three stages. These are, PHTHISIS, CONSUMPTION and TUBERCULOSIS. Each stage has its own meanings and characteristics. In the second stage consumption, TB was thought to be responsible for the patients' beauty and creativity. This kind of romanticization can be seen both in the West and East, not only in literature but also in paintings.

著者

佐々木 結花 山岸 文雄 鈴木 公典 宮澤 裕 杉戸 一寿 庵原 昭一

出版者

THE JAPANESE SOCIETY FOR TB AND NTM

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.68, no.11, pp.695-698, 1993-11-15 (Released:2011-05-24)

参考文献数

5

被引用文献数

1

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We reported a case of Addison's disease, caused by adrenal tuberculosis. The patient was female, seventy four years old. She complained cough and body weight loss. She complained cough from June, 1989, but her home doctor didn't take care of her symptoms. September 1989, she felt appetite loss, and easy fatigue, so her home doctor suspected her disease as pulmonary tuberculosis, so he introduced our hospital, and she admitted. When she admitted, her chest roentogenogram revealed bII12. Sputum smear examinations were negative. Laboratory datas on admission, we observed slightry eosinophilia, severe iron deficiency anemia, and accenturation of blood sedimentation rate. Immediately after admission, she complained nausea, vomiting, coldness, and powerless. On 25 days after admission, she lost her senses suddenly, and her blood pressure fell 5 days after, she fell in shock state, too. We found out her blood sugar data was 29. After blood examinations, we found out that ACTH was high, cortisole, 17KS, 17-OHCS were low. So we thought she got acute hypoadrenocorticism. We found her abdominal CT revealed calcification in her right adrenal gland. We diagnosed her disease as Addison's disease caused by adrenal tuberculosis so we began to give prednisolone, 7.5mg per day. After giving, her state made better. We thought her disease as Addison's disease caused by adrenal tuberculosis, revealed acute hypoadrenocorticism.

著者

伊東 秀夫 藤平 隆司 原田 進 城戸 優光 加治木 章 中島 康秀 黒岩 昭夫

出版者

THE JAPANESE SOCIETY FOR TB AND NTM

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.59, no.4, pp.303-308, 1984-04-15 (Released:2011-05-24)

参考文献数

5

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Accelerated inactivation of corticosteroids following rifampicin therapy has beenrecognized. We observed nonresponsiveness to prednisolone treatment during rifampicinadministration in a case of systemic lupus erythematosus with diffuse alveolitis andconcomitant apical tuberculosis.A 51 year-old woman complained in September 1980, of polyarthralgia and butterflyerythema of the face. From typical clinical manifestations and positive serological tests, systemic lupus erythematosus was diagnosed and treatment with prednisolone was startedat a local hospital. To prevent exacerbation of old apical tuberculosis, isoniazid 0.2 gdaily was also administered. Good response was obtained for an initial few months butdyspnea, diffuse pulmonary infiltrates appeared following prednisolone decrement.She was transfered to our hospital in August 1981. On admission, she had a few skinulcers in bilateral hands and pigmentations over the surface of shoulder, elbow and knee.Velcro rales were audible over the lung base. No lymphadenopathy was detected.Laboratory examination revealed positive RA test, antinuclear and anti-DNA antibody. Thyroid test and microsome test were also positive, but LE test, RNP antibody, SMantibody were negative. C4, CH50 were normal but C3 was decreased. Chest X-Prevealed diffuse reticular shadows in bilateral middle and lower lung field and nodularconsolidation in right apical region. Although tubercle bacilli was negative in sputum, exacerbation of tuberculosis were suspected radiologically. Histological specimen obtained by transbronchial lung biopsy from the left lung showed mild interstitial thickening of alveoli with mononuclear cell infiltration.Prednisolone was increased from daily dose of 5mg to 80mg and 450mg of rifampicin, 1, 000mg of ethambutol were added, but no response was obtained. In December 1981, prednisolone was altered to equivalent dose of betamethasone but minimal improvementwas observed.After quitting rifampicin on January 1982, dramatic improvement in symptoms, laboratory data and chest roentgenogram was achieved. Although pharmacokineticstudies were not performed, we feel that the circumstantial evidence suggests strongly toincreased metabolism of prednisolone by rifampicin-induced microsomal enzymes.

著者

川辺 芳子 田中 茂 永井 英明 鈴木 純子 田村 厚久 長山 直弘 赤川 志のぶ 町田 和子 倉島 篤行 四元 秀毅

出版者

THE JAPANESE SOCIETY FOR TB AND NTM

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.79, no.7, pp.443-448, 2004-07-15 (Released:2011-05-24)

参考文献数

12

被引用文献数

1

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[目的] 防じんマスクの密着性の評価に使用されているマスクフィッティングテスターを用いてN95微粒子用マスク (N95マスク) の顔面への密着性の定量的評価を行うことの妥当性を検討することと, N95マスクの装着状況およびマスクの選択と使用方法の指導の重要性を明らかにすることを目的とする。 [対象] 当院に勤務する職員133名で, 男性29名, 女性104名, 常時N95マスクを使用している者は46名, 毎日は使用していない者87名であった。 [方法] 労研式マスクフィッティングテスターMT-02型TMを用いてマスクの漏れ率を測定し, 10%以下を許容範囲とした。基準に達しない場合は装着方法を指導し, それでも達しない場合はマスクの種類を変更した。 [結果] 1回目で漏れ率が10%以下であったのは87名 (65%) であった。10%を超えた46名のうち40名は指導やマスクの変更により10%以下になったが, 最終的に6名は達しなかった。マスクの選択, 鼻の部分の密着性, ゴムひもの使用方法が問題であった。 [結論] マスクフィッティングテスターはN95マスクの顔面への密着性の定量的評価に有用であり, 顔に合ったマスクの選択と日常的な指導点検, 3種類以上のマスクを準備しておくことが重要であることが明らかになった。

著者

伊東 恒夫

出版者

THE JAPANESE SOCIETY FOR TB AND NTM

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.38, no.5, pp.176-181, 1963 (Released:2011-05-24)

参考文献数

8

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Although the knowledge of the degree of drug resistance of tut ercle bacilli is an important factor in the choice of the therapeutic regimen, an accurate determination of complete or incomplete drug resistance is actually a matter of great difficulty. Here, the present author proposes a new method of determining complete or incomplete drug resistance by using a random sampling method in colony counting.

著者

谷口 夏子 福岡 篤彦 天野 逸人 岡村 英生 竹中 英昭 森井 武志 岡本 行功 吉川 雅則 古西 満 塚口 勝彦 濱田 薫 米田 尚弘 成田 亘啓

出版者

THE JAPANESE SOCIETY FOR TB AND NTM

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.77, no.4, pp.367-371, 2002-04-15 (Released:2011-05-24)

参考文献数

7

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われわれは膿胸関連リンパ腫の症例を経験したので報告する。患者は67歳男性で左側胸部腫脹と疼痛で受診した。既往としては6歳時に肺結核, 24歳時に結核性胸膜炎に罹患していた。生検標本の組織学的検査の結果, 悪性リンパ腫びまん性大細胞B細胞型と診断した。THP-COP (THP, CY, VCR, PSL) による化学療法を施行し徐々に胸痛と腫脹は改善し, 現在維持療法継続中である。また, 分子生物学的見地から膿胸壁のEBウイルス感染を証明した。悪性リンパ腫を併発した結核性慢性膿胸症例の全例にEBウイルスの感染が証明されたとの報告があり, EBウイルス陽性の結核性膿胸の患者ではより注意深く検査を進める必要がある。

著者

吉田 亜由美 松本 博之 飯田 康人 高橋 啓 藤田 結花 辻 忠克 藤兼 俊明 清水 哲雄 小笠原 英紀 斉藤 義徳

出版者

THE JAPANESE SOCIETY FOR TB AND NTM

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.71, no.6, pp.415-421, 1996-06-15 (Released:2011-05-24)

参考文献数

10

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The patient was 69-year-old male. He had a history of treatment for tuberculosis by artificial pneumothorax about 47 years ago. He was admitted an another hospital under the diagnosis of tuberculous pyothorax. He was transferred to our hospital because of chest pain and fever. Laboratory findings on the admission were as follows: ESR was 120 mm/hr, CRP was 20.22mg/dl and other data were almost within normal limits. Chest X-ray showed a massive shadow in the right lower lung field, adjacent to the chest wall. Computed tomography (CT) showed tumor shadow with low density and invasions into the adjacent chest wall. Histological examination of surgically excised tumor biopsy revealed malignant lymphoma. The patient's condition improved and the size of tumor decreased temporarily by chemotherapy. Then, he began to complain of chest pain and high fever, and tumor in the chest wall invaded into the whole chest wall. He died of disseminated. intravascular coagulation despite continuing chemotherapy. Postmortem examination re vealed the following findings: the tumor existed mainly in the parietal pleura or the chest wall, adjacent to the lesion of pyothorax, and immunohistochemical examination showed that tumor was malignant lymphoma, diffuse, large B-cell type. Recent studies have shown a close association between EBV infection and pyothorax-associated lymphoma. We have to keep in mind the possible development of malignant lymphoma following tuberculous pyothorax, when we see patients complaining of fever or chest pain with tuberculous pyothorax.

著者

高原 誠

出版者

THE JAPANESE SOCIETY FOR TB AND NTM

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.79, no.12, pp.711-716, 2004-12-15 (Released:2011-05-24)

参考文献数

16

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[目的] 肺結核治療中に死亡退院した患者の死亡原因を検討した。 [対象と方法] 対象は平成11年~14年の4年間に当院に入院した結核患者のうち, 死亡退院の40例 (男性32例, 女性8例, 平均年齢76歳), 方法は患者背景, 合併症, 結核の重症度, 治療成績をコホート調査にて山下の定義で治療成功の162例と比較検討した。 [結果] 結核死17例, 非結核死23例で, 後者の内訳では肺炎が最も多く9例を占めた。死亡例は年齢とパフォーマンス・ステータス (PS) の値が有意に高く, 栄養状態は悪く, 炎症反応は亢進していた。治療開始までの期間も長かったが, 有意ではなかった。合併症は死亡例全例が有し, 肝疾患, 脳血管障害で対照群と差を認めた。病変の拡がりも死亡例には進行例が多かった。治療成績では副作用で薬剤変更する割合が死亡例で有意に高く, 標準治療可能例が少なかった。 [考察と結語] 患者発見の遅れより標準治療が不能だった点が死亡に影響した。そのため排菌陰性化が得られにくく, 結核によって直接的または間接的に死亡した。非結核死の肺炎死の中には, 結核死に含めてもよいと考えられる症例も存在した。

著者

豊田 誠

出版者

THE JAPANESE SOCIETY FOR TB AND NTM

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.78, no.12, pp.733-738, 2003-12-15 (Released:2011-05-24)

参考文献数

15

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[目的] 建築物の環境が結核集団感染におよぼす影響を検討する。 [対象と方法] 中学校で発生した集団感染の接触者718人を対象に, 初発患者との接触状況別に感染率を比較した。6フッ化硫黄をトレーサーガスとして用い, 教室の換気状況を測定した。 [結果] 接触者から34人の結核患者が発見され, 155人に予防内服が指示された。同クラス生徒での感染率は90.0%であり, 初発患者と直接接触のないグループからも11人の発病があった。校舎の窓はアルミサッシで閉めきられており, 教室の換気回数は1.6~1.8回/hrと少なかった。教室の引き戸を開けた状態では, 教室と廊下のガス濃度は急速に撹拝された。 [考察] 初発患者がHighly Infectious Caseであったことに, 過密して換気の少ない教室の環境が重なり, 同クラス生徒の高い感染率につながった。間接的な接触者にも感染が拡大した要因としては, 初発患者が時間割によって3年校舎の1, 2階の共用教室を使っていたことや, 感染性飛沫核が休み時間中に廊下に拡散し, 初発患者の教室が3年校舎の入り口に位置したため, 3年校舎に出入りする者の動線と交わったことが考えられ。

著者

伊藤 邦彦 吉山 崇 中園 智昭 尾形 英雄 和田 雅子 水谷 清二

出版者

THE JAPANESE SOCIETY FOR TB AND NTM

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.75, no.12, pp.691-697, 2000-12-15 (Released:2011-05-24)

参考文献数

19

被引用文献数

1

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Study objectives: To assess the usefulness of commercial kits of nucleic acid amplifica tion test (NAAT) for diagnosis of smear negative (SN) pulmonary tuberculosis.Design and patients: Retrospective study of patients who were diagnosed as, or sus pected of pulmonary tuberculosis during 3 years from January 1996 to December 1998 in Fukuiuii Hospital which has 100 beds for tuberculosis patients.Measurements and Results: 145 smear-negative culture-positive pulmonary tuberculosis patients are entered to our analysis. The DNA-based amplification test kit (Amplicor Mycobacterium tuberculosis Test (AMPL), Roche Diagnostic Systems, Basel, Switzerland) detected 39.2% (20/51, 95% confidence interval (CI): 25.8-52.6%) of smear-nega tive culture-positive (SNCP) pulmonary tuberculosis cases. The RNA-based amplification test kit (Gen-Probe Amplified Mycobacterium tuberculosis Direct Test (AMTDT), Gen-Probe Inc., San Diego, Calif., USA) detected 40.5% (15/37, 95% CI: 24.7-56.3%) of SNCP pulmonay tuberculosis cases. For both NAATs (AMPL and AMTDT), between two groups with and without the NAAT at diagnosis of SNCP pulmonary tuberculosis, there was statistical difference in culture-positive rate (proportion of positivity in sputum culture tests at diagnosis), but no statistical difference in maximum number of colony of Mycobacterium tuberculosis (MTB). When stratified for the culture-positive rate, adjusted sensitivity for SNCP patients was 44.2% (AMPL) and 40.4% (AMTDT) respec tively. On the other hand, among 245 patients with sputum AMPL positive results during the 3 years, 8 were smear-negative culture-negative (SNCN), only one out of these 8 cases was judged as true active tuberculosis without treatment. Among 89 patients with sputum AMTDT positive results, 7 were SNCN, and 3 out of them were judged as true active tuberculosis without treatment.Conclusion: Usefulness of commercial NAAT kits (AMPL and AMTDT) to diagnosis SN pulmonary tuberculosis is limited in the point of sensitivity.