Hypoalbuminemia and lymphocytopenia are predictive risk factors for in-hospital mortality in patients with tuberculosis.

Objective: The aim of this study was to clarify the association between nutritional state on admission and in-hospital death in tuberculosis (TB) patients, including a high proportion of elderly patients.

Methods: A retrospective cohort study of 246 TB patients was conducted. The serum albumin concentrations and peripheral blood lymphocyte counts were measured on admission, and the primary outcome of interest was in-hospital death.

Flare phenomenon following gefitinib treatment of lung adenocarcinoma with bone metastasis.

The skeleton is the most common site for distant metastasis in patients with cancer. To detect bone metastasis and evaluate the efficacy of treatment, we usually use bone scintigraphy and check serum alkaline phosphatase (ALP). However, such evaluation is sometimes difficult due to flare phenomenon.

Clinical Evaluation of COBAS TaqMan PCR for the Detection of Mycobacterium tuberculosis and M. avium Complex.

A retrospective observational study was performed to determine the sensitivity and limitation of PCR test for the detection of Mycobacterium tuberculosis and M. avium complex. We obtained clinical specimens collected from the respiratory tract, cultured M.

Clinical and microbiological differences between Mycobacterium abscessus and Mycobacterium massiliense lung diseases.

In recent years, many novel nontuberculous mycobacterial species have been discovered through genetic analysis. Mycobacterium massiliense and M. bolletii have recently been identified as species separate from M.

Congenital cystic adenomatoid malformation in adulthood complicated by Mycobacterium celatum infection.

A 25-year-old woman with no underlying disease presented with a large fluid-filled cavitary lesion in the right lung. Mycobacterium celatum was isolated from the cavitary fluid, and treatment with ethambutol, rifampicin, and clarithromycin was initiated. After 4 months of treatment, right lower pulmonary lobectomy was performed.

[Mycobacterium immunogenum isolated from a metal worker in Japan].

In the United States and European countries, Mycobacterium immunogenum has been identified in metalworking fluids and is reported to be a causative agent of metalworking fluid-associated hypersensitivity pneumonitis. However, in Japan, there has been no reports of M. immunogenum isolated from metalworking fluids.

The clinical efficacy and safety of micafungin-itraconazole combination therapy in patients with pulmonary aspergilloma.

In spite of recent advances in chemotherapy, the treatment of pulmonary aspergilloma remains unsatisfactory. To evaluate the clinical efficacy and safety of combination therapy for pulmonary aspergilloma, we conducted a multi-institutional prospective study using micafungin (MCFG) and itraconazole (ITCZ). Adult patients who fulfilled the criteria for pulmonary aspergilloma were enrolled in this study.

A retrospective analysis of 111 cases of pneumococcal pneumonia: clinical features and prognostic factors.

Objective: Streptococcus pneumoniae is an important and common pathogen of acute pneumonia. The urinary pneumococcal antigen test has been increasingly used for the diagnosis of pneumococcal pneumonia, but there have been few studies on pneumococcal pneumonia after this test became prevalent. The present study was conducted to characterize the clinical features of pneumococcal pneumonia after the introduction of the urinary antigen test.

[Reversed halo sign in organizing pneumonia secondary to Sjögren syndrome].

We report a case of a 41-year-old woman admitted to our hospital for dyspnea on exertion and nonproductive cough. High-resolution computed tomography (HRCT) revealed central ground-glass opacities surrounded by ring-shaped areas of consolidation (reversed halo sign), predominantly in the lower lobes. Bronchoalveolar lavage fluid revealed an increase of the total number of cells (35 x 10(4)/ml), including elevated lymphocyte level (69%) and decreased CD4/CD8 ratio (0.

Nutritional assessment in patients with pulmonary nontuberculous mycobacteriosis.

Objective: To determine the nutritional factors that influence disease spread in patients with pulmonary Mycobacterium avium complex (MAC) infection.

Methods: A prospective observational study.

Patients: Patients with pulmonary MAC infection were enrolled in this study.

Mantle cell lymphoma involvement of the pleura and tuberculous pleurisy with pulmonary tuberculosis: a case report and literature review.

A 78-year-old Japanese woman was admitted to our hospital for fever, dry cough, and right pleural effusion. She was diagnosed with mantle cell lymphoma (MCL) at 73 years of age and was treated with carcinostatics, but MCL was refractory. Chest computed tomography (CT) on admission revealed a localized trabecular shadow in the middle lobe of the right lung and right pleural effusion with thickened visceral pleura.

The clinical efficacy and safety of a fluoroquinolone-containing regimen for pulmonary MAC disease.

Despite recent advances in chemotherapy, the treatment of pulmonary Mycobacterium avium complex (MAC) disease remains unsatisfactory. Judging from its MIC, fluoroquinolones including gatifloxacin (GFLX) are expected to demonstrate efficacy against MAC disease. However, there have been few clinical studies using fluoroquinolones.

[A case of mild pulmonary tuberculosis complicated with the syndrome of inappropriate antidiuretic hormone secretion which caused impaired consciousness].

An 81-year-old woman was admitted to our hospital for hyponatremia and impaired consciousness after unsuccessful antibiotic treatment for pneumonia-like symptoms by a previous doctor. A chest X-ray film revealed unilateral infiltration. Mycobacterium tuberculosis was detected on a sputum smear and pulmonary tuberculosis was diagnosed.

Relationship between computed tomography findings and nutritional status in elderly patients with pulmonary tuberculosis.

Objective: This study was aimed to identify the relationship between radiographic features of elderly pulmonary TB patients and nutritional deficiency.

Methods: Ninety-two patients older than 70 years of age with pulmonary TB were retrospectively enrolled. The influence of nutritional parameters, such as serum albumin concentration and peripheral blood total lymphocyte count on CT findings was examined.

[A case of pulmonary tuberculosis with diminished lung function whose paradoxical reaction led to death].

Paradoxical reaction in tuberculosis treatment is not generally fatal. On rare occasion it can lead a patient with diminished lung function and poor general condition to death. A 60-year-old man with history of left upper lobe resection from tuberculosis was referred to our hospital due to the recurrence of tuberculosis.

[The relationship between the nutritional states of tuberculosis patients at the time of their admission to tuberculosis wards and their treatment results].

Objectives: To prospectively investigate the relationship between the nutritional states of tuberculosis patients at the time of their admission to tuberculosis wards and their treatment outcomes.

Patients And Methods: We observed body mass index (BMI), peripheral blood lymphocyte count, serum albumin concentration, and induration size in the PPD skin test of a total of 107 tuberculosis patients after they had been newly admitted to NHO Omuta National Hospital during the period from Aug. 2004 to Jul.

[Clinical review of 8 patients with tuberculous peritonitis].

Objective: With the progress of anti-tuberculous therapy, tuberculous peritonitis (TBP) has become a rare manifestation of active tuberculosis. Its early diagnosis is difficult due to lack of pathognomonic findings and specific symptoms. However, early diagnosis is important for effective treatment and for reducing fatality.

Nocardia transvalensis pulmonary infection in an immunocompetent patient with radiographic findings consistent with nontuberculous mycobacterial infections.

A chest roentgenogram of a 75-year-old immunocompetent woman showed disseminated micronodular densities in bilateral lung fields. Subsequent high-resolution computed tomography (CT) confirmed centrilobular micronodular densities associated with bronchial wall thickening and bronchiectatic changes. CT imaging also revealed volume loss with bronchiectatic changes in both the right middle lobe and the left lingular segment.

Prognostic value of immunohistochemical surfactant protein A expression in regenerative/hyperplastic alveolar epithelial cells in idiopathic interstitial pneumonias.

Background: It is difficult to predict survival in patients with idiopathic pulmonary fibrosis. Recently, several proteins, such as surfactant protein (SP) and KL-6, have been reported to be useful biologic markers for prediction of prognosis for interstitial pneumonias. It is not clear whether there is any relationship between expression of these proteins in regenerative/hyperplastic alveolar epithelial cells and prognosis of idiopathic interstitial pneumonias (IIPs).

[Non-tuberculous mycobacteriosis. What has been coming out].

Diagnosis of non-tuberculous mycobacteriosis is relatively easy, because of recent technological advances (HRCT, MGIT, PCR, DDH etc). Although many reports of this disease have been published, there are many problems to resolve. (1) Prevalence of non-tuberculous mycobacteriosis: Shigeki SATO (Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Sciences) Questionnaire surveys to determine the prevalence of nontuberculous mycobacterial (NTM) disease were carried out in 2001, 2007, and 2009.

A case of isoniazid-resistant miliary tuberculosis in which tuberculous meningitis paradoxically developed despite systemic improvement.

A 63-year-old man with chronic myelomonocytic leukemia was admitted to our hospital with miliary tuberculosis. He received anti-tuberculosis drugs: isoniazid (INH), rifampicin (RFP), ethambutol (EB), and pyrazinamide (PZA). His condition clearly and immediately improved after the therapy, but he experienced a high fever of about 38°C every day from 1 month after the initiation of the therapy.

A case of isoniazid-induced liver injury diagnosed by use of the DLST, and successful reintroduction of isoniazid for pleural tuberculosis.

A 54-year-old woman was admitted for pleural tuberculosis diagnosed by right chest pain and cough. She received combination antituberculosis therapy consisting of isoniazid, rifampicin, ethambutol, and pyrazinamide. However, liver damage was observed 15 days after initiation of therapy (aspartate aminotransferase (AST) 248 IU/l, alanine transaminase (ALT), 132 IU/l).

[Two cases of intravascular lymphomatosis diagnosed by transbronchial lung biopsy].

Patient 1 was a 54-year-old woman who was admitted with high-grade fever. Abnormal laboratory findings included hypoxemia, and elevated levels of LDH and soluble interleukin-2 receptor (sIL-2R). Chest computed tomography scans (CT) revealed diffuse ground-glass shadows in both lungs.

[The relation between nutritional state of tuberculous patients admitted in tuberculous ward and their outcome at the time of discharge].

Objectives: To investigate the relation between nutritional state of tuberculous patients admitted in tuberculous ward and their outcome at the time of discharge.

Patients And Methods: We retrospectively investigated BMI, peripheral blood lymphocyte count, serum albumin concentration, and induration size of PPD skin test at the time of admission from their clinical charts of all 174 tuberculous patients newly admitted in NHO Omuta National Hospital during the period from 2000 to 2002, and based on these indices, the nutritional state of tuberculous patients was divided into severely impaired, moderately impaired, and mildly impaired or normal. The relation between nutritional state on admission and the outcome at the time of discharge was examined.

[A case of Streptomyces pneumonia].

A 85-year-old man who had a past history of gastrectomy but no subsequent chemotherapy was suffering fever and fatigue. The infiltrative shadow with cavitation on his chest X-ray film did not improve despite treatment with several antibiotics after admission. Transcutaneous needle aspiration performed for diagnosis of the cavitated lung lesion yielded Streptomyces.