Kekkaku : [Tuberculosis]
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Kekkaku : [Tuberculosis] · Jan 1991
Comparative Study[A comparative study of pulmonary disease due to Mycobacterium avium and M. intracellulare identified by a newly developed DNA probe (Gen-Probe].
By using DNA Probe, cases due to M. avium complex in Japan were grouped into those M. avium and M. intracellulare and their clinical patients were compared by multifactorial analysis. A total of 179 cases was studied (103 due to M. avium and 76 due to M. intracellulare). M. avium cases were found more commonly around Tokyo and north, whereas M. intracellulare cases were seen more frequently in the western part of Japan. ⋯ The usefulness of INH was lower. In areas western to Osaka and vicinity, MAC was reported to exert favorable effect. In case this is true, higher prevalence of M. intracellulare and the use of KM, EB, RFP in these areas may explain such phenomena.
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Kekkaku : [Tuberculosis] · Jan 1991
Case Reports[Post pneumonectomy empyema with bronchopleural fistula--a successful management using pedicled intercostal muscle flap on an atypical mycobacteriosis following the irradiation].
A 48-year-old woman underwent a right pneumonectomy for advanced mycobacterial disease (M. avium Complex), which followed the postoperative radiotherapy against a malignant schwannoma of the right lower chest wall treated seven years ago. On the 13th postoperative day, re-suture of the bronchial stump was performed urgently because of early bronchopleural fistula development. On the heels of that, reclosure of the bronchial fistula with coverage of the stump by parietal pleural flap was performed on the forty-first post operative day. ⋯ After succeeding to control the mycotic infection, reclosure of the bronchofistula, covered with pedicled intercostal muscle flap were performed on the 280th postoperative day and extraperiostal air-plombage for reducing empyema cavity. Postoperative course was uneventful and the patient was discharged one year later. With respect to pathogenetic relationship between radiation pneumonitis and feasibility of infection to atypical mycobacteria, preoperative radiotherapy and concurrence of postoperative bronchofistula, and some problems on management of empyema bronchofistula were briefly discussed.