Kekkaku : [Tuberculosis]
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Kekkaku : [Tuberculosis] · Jan 1993
[Clinical features of the lung diseases due to Mycobacterium avium and M. intracellulare].
In recent years, it has been made easy to identify Mycobacterium avium and M. intracellulare by DNA-probe test. To evaluate possible clinical differences between the lung diseases due to M. avium and those due to M. intracellulare, we studied a total of 248 cases (136 due to M. avium and 112 due to M. intracellulare). M. avium cases were found more frequently in the eastern part of Japan, whereas M. intracellulare cases were seen more frequently in the western part of Japan. ⋯ M. avium was more susceptible to cycloserine than M. intracellulare. On the other hand, M. intracellulare was more susceptible to streptomycin and kanamycin. The prognosis of M. intracellulare cases were better than M. avium cases, when compared only the patients who showed positive tuberculin skin test.
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Kekkaku : [Tuberculosis] · Jun 1992
Case Reports[A case of adenosquamous carcinoma with unknown origin and with superior vena cava syndrome as the first symptom].
This report is concerning a case of adenosquamous carcinoma having unknown origin and showing SVC syndrome as the first symptom. A 44 year-old man was admitted to our hospital because of facial edema at the beginning of April 1990. He was diagnosed as having a mediastinal tumor of the SVC syndrome type. ⋯ The pathological diagnosis of the SVC tumor was adenosquamous carcinoma, however, no clinical examinations could identify its original matrix. Mediastinal tumors of unknown origin are reported as about 1% of all mediastinal tumors, and are responsible for 0.68% of all carcinomas in the mediastinum. This was one experience of a rare case of mediastinal tumor having unknown origin and showing SVC syndrome as the first symptom.
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Kekkaku : [Tuberculosis] · Nov 1991
[A clinical study of pulmonary tuberculosis in lung cancer patient].
We have reviewed 442 patients with lung cancer. There were 323 male patients with a mean age of 65.8 yr and 119 female patients with a mean age of 66.0 yr. Histological types of lung cancer were squamous cell carcinoma 177 patients (40.0%), adenocarcinoma 167 (37.8%), small cell carcinoma 75 (17.0%), large cell carcinoma 17 (3.8%) and undifferentiated carcinoma 6 (1.4%). ⋯ In addition, the prevalence of active pulmonary tuberculosis was significantly higher in the patients with old tuberculous lesions (5.6%: 3 out of 54 patients) than in those without ones (0.52%: 2 out of 387 patients). Finally, all of the five patients died. The causes of death were lung cancer in three patients, both pulmonary tuberculosis and lung cancer in one and pulmonary tuberculosis in one.
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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.