Norio Kikuchi

DIAGNOSIS OF PULMONARY TUBERCULOSIS IN GENERAL HOSPITAL “A STUDY OF 114 CASES”

We conducted a study on the diagnosis of pulmonary tuberculosis at Chiba Kaihin Municipal Hospital. Examinations were performed to determine the presence of active Mycobacterium tuberculosis in sputum and gastric aspirate. For the sputum smear-negative cases, fiberoptic bronchoscopy was further used as a means for detecting the tuberculosis. The results obtained were as follows: 1. A total of 114 cases in the past six years diagnosed as active pulmonary tuberculosis (including 88 primary treatment cases) were analysed. 2. The 114 cases consisted of 74 males and 40 females, the mean age was 49.3 years old. Categorically, the main age groups were: 60s, 24 cases; 30s, 21 cases; and 40s, 20 cases. 3. Chest X-ray findings: Cavitary cases were 28.9% GAKKAI classification of the sizes of the affected areas being Type 1 (mostly limited cases), 58.9% of all total cases, and 68.4% in the cases under the age of 50 years old. The number of cases having infection in a solitary nodule was 19, and the ages of 15 out of the 19 patients were under 50 years old. 4. Sputum or gastric aspirate smear-positive cases totalled 37 (32.5%), and culture-positive cases totalled 77 (67.5%). Sputum or gastric aspirate cultures were positive in 52 out of 56 cases (92.9%) with extended shadows, GAKKAI classification Types 2 and 3, but were positive in 25 out of 58 cases (43.1%) with Type 1. 5. Fiberoptic bronchoscopy was performed on 49 out of the 77 smear-negative cases. 6. Definite diagnosis was obtained in 90 (78.8%) out of total 114 cases. The results of this study suggest that examination for active mycobacterium in sputum and gastric aspirate are very useful for the diagnosis of active pulmonary tuberculosis, especially in extended cases.

Clinical and bacteriological study on pulmonary infection in cases of advanced lung cancer.

進行肺癌130例を対象として肺感染の病態について検討した.感染合併率は46.9%で, 病型は閉塞性肺炎と日和見肺感染に大別され, 両者とも扁平上皮癌に多く見られた.誘因として, 前者では気管支鏡検査と放射線照射が, 後者では副腎ステロイド投与と白血球減少が重要であった.原因菌は前者ではインフルエンザ粁菌が優位で, 病期の進行に伴い後者と同様に日和見感染菌が主体となった.死因として肺炎は25.6%を占めた.