Interferon-gamma release assays in patients with Mycobacterium kansasii pulmonary infection: A retrospective survey.

Objectives: Interferon-gamma release assays (IGRAs) can be positive in patients infected with Mycobacterium kansasii (M. kansasii), which carries some of Mycobacterium tuberculosis specific antigens adopted for IGRAs. Our aim is to evaluate positive rate and factors associated with positive IGRAs in patients with M.

[Evaluation of tuberculosis treatment including levofloxacin (LVFX) in cases who could not continue standard regimen].

Objective: The purpose of this study was to evaluate tuberculosis treatment including levofloxacin (LVFX) and to investigate the effectiveness of changing drug regimens at our hospital.

Subjects And Methods: A retrospective study was conducted on 331 patients with tuberculosis admitted to Tokyo National Hospital in 2005. Out of these 331 patients, LVFX was used in 48 (14.

Mycobacterium shinjukuense sp. nov., a slowly growing, non-chromogenic species isolated from human clinical specimens.

Seven isolates of a slowly growing, non-chromogenic Mycobacterium species were obtained from sputum and bronchial lavage fluid samples from elderly patients in different regions of Japan. These isolates were distinguished from related non-tuberculous species by colony morphology, positive results for Tween hydrolysis, catalase at 68 °C, nitrate reductase and pyrazinamidase and negative results for semi-quantitative catalase, urease and arylsulfatase. The mycolic acid pattern obtained by HPLC revealed a single cluster of late-eluting mycolic acids similar to but different from those of Mycobacterium malmoense ATCC 29571(T).

[Clinical research on multi-drug resistant and extensive drug-resistant tuberculosis in Japan].

Purpose: To know the number of patients with MDR-TB and XDR-TB newly diagnosed annually and the number of those with continuously culture-positive in spite of continued treatment.

Methods: To fill the questionnaire sent to all the TB hospitals in Japan and to investigate the number of beds for TB, MDR-TB cases newly admitted to each hospital in 2006 and chronic bacillary cases in spite of continued treatment.

Result: We sent the questionnaires to all the TB hospitals in Japan and 81% of 270 hospitals replied.

Comparison of performance in two diagnostic methods for tuberculosis infection.

Performance of two diagnoses, T-SPOT.TB (T-SPOT) and QuantiFERON-TB Gold (QFT-G), was compared in Japanese subjects. Forty-seven confirmed tuberculosis patients and eighty-four healthy subjects were recruited.

Biological and molecular characteristics of Mycobacterium tuberculosis clinical isolates with low-level resistance to isoniazid in Japan.

We reevaluated the BACTEC MGIT 960 antimicrobial susceptibility testing system (MGIT 960 AST) by using 1,112 isolates of Mycobacterium tuberculosis. When the results of MGIT 960 AST were compared with that of the proportion method using Ogawa medium (Ogawa PM), discrepant results were obtained for 30 strains with isoniazid, all resistant by MGIT 960 AST but susceptible by Ogawa PM. For 93% of the strains that produced discrepant results, the MIC was 0.

Comparison of the sensitivity and specificity of two whole blood interferon-gamma assays for M. tuberculosis infection.

Objectives: To compare the sensitivity and the specificity of the QuantiFERON-TB Gold (QFT-G) and QuantiFERON-TB Gold In Tube (QFT-GIT) diagnostic tests for Mycobacterium tuberculosis infection.

Methods: One-hundred patients with culture and/or PCR confirmed M. tuberculosis infection and 168 volunteers with no risk factors for M.

[Drug-induced hepatotoxicity caused by anti-tuberculosis drugs in tuberculosis patients complicated with chronic hepatitis].

Objectives: To investigate retrospectively the incidence of drug-induced hepatitis (DIH) caused by antituberculosis drugs including isoniazid (INH), rifampicin (RFP), with and without pyrazinamide (PZA), and to evaluate risk factors for DIH in tuberculosis patients complicated with chronic hepatitis (CH).

Materials: One hundred and seven tuberculosis patients with CH (M/F= 96/11, mean age +/- SE, 60.8 +/- 1.

Diagnosis of active tuberculous serositis by antigen-specific interferon-gamma response of cavity fluid cells.

Background: To develop a more accurate methodology for diagnosing active tuberculous pleurisy, as well as peritonitis and pericardits of tuberculous origin, we established an antigen-specific interferon gamma (IFN-gamma)-based assay that uses cavity fluid specimens.

Methods: Over a 19-month period, 155 consecutive, nonselected patients with any cavity effusion were evaluated. Study subjects were 28 patients with bacteriologically confirmed active tuberculous serositis and 47 patients with definitive nontuberculous etiology.

[Features of bronchial tuberculosis--an analysis of 103 cases].

Objectives: The aim of this study is to clarify the features of bronchial tuberculosis.

Materials And Methods: We analyzed the clinicopathological data from 103 out of 4467 (2.3%) cases of culture positive tuberculosis admitted to the National Hospital Organization Tokyo National Hospital in the period from 1993 to 2004 in which bronchial tuberculosis was confirmed by bronchofiberscopy.

[Usefulness of a whole blood interferon gamma assay (QuantiFERON-TB-2G) for detecting tuberculosis infection in HIV-infected persons].

Background: New blood test (QuantiFERON-TB-2G: QFT-2G), based on detection of IFN-gamma released by T cells in response to M. tuberculosis specific antigens, has the high sensitivity and specificity for diagnosis of tuberculosis. However, it is essential to evaluate this T cell-based approach in individuals with HIV-associated impairment in T cell immunity.

[Bone and joint tuberculosis concurrent with tuberculosis of other organs].

Objectives: To study the characteristics of bone or joint tuberculosis (TB) accompanied by TB in other organs (especially the lung), and to study patients' and doctors' delay in detecting bone or joint TB.

Subjects And Methods: A retrospective study was conducted on 33 patients with bone or joint TB concurrent with TB of other organs, especially the lung, who were admitted to our hospital between 1981 and 2005. The patients were divided into the following three groups according to the organ of concurrent TB : (1) miliary TB group (N = 10), (2) pulmonary TB group (N = 19), and (3) other TB site group (N = 4).

[Comparative study of bactec MGIT 960 AST and conventional proportion method using Ogawa medium for the drug susceptibility testing of Mycobacterium tuberculosis to isoniazid].

Objective: To evaluate the accuracy of drug susceptibility testing to isoniazid with BACTEC MGIT 960 (MGIT AST) comparing with the standard proportion method using Ogawa medium.

Method: A total of 1109 M. tuberculosis strains, which were selected from the collection of RYOKEN drug resistance survey in 2002, were selected and subjected to the susceptibility testing to isoniazid using MGIT AST and 1% Ogawa standard methods.

[Coexisting lung cancer and active pulmonary mycobacteriosis].

We reviewed 72 patients with coexisting lung cancer and pulmonary mycobacteriosis, and discuss the features and transition of these coexistent cases. There were 56 pulmonary tuberculosis (PTB) cases and 16 non-tuberculous mycobacteriosis (PNTM) cases, 62 men and 10 women, with a mean age of 69 years. In 43 cases, both diseases were concurrently detected, lung cancer was first detected in 19 cases, and mycobacteriosis was first detected in 10 cases.

[Application and problems of quantiFERON TB-2G for tuberculosis control programs--(2) clinical use of quantiFERON TB-2G].

Background: QuantiFERON TB-2nd Generation (QFT) is an accurate tool for detecting tuberculosis infection regardless of past history of BCG vaccination. In Japan, QFT test was recognized for diagnostic tool on April 2005, and adopted officially on January 2006. Tuberculosis Society issued Guideline for using QFT-2G on May 2006.

[Tuberculosis complicated with liver cirrhosis].

Objectives: The aim of this study is to examine the clinical characteristics of tuberculous patients complicated with liver cirrhosis.

Materials And Methods: 44 patients (39 males and 5 females) admitted to Tokyo National Hospital since 1991 till 2005 were analysed.

Results: Eighteen patients died and liver failure was the leading cause of death (N = 10).

Social course patterns of urban dwellers with tuberculosis under fragile living conditions in Tokyo, Japan.

Background: People under fragile-living conditions show a high rate of interruption of tuberculosis treatment. We examined the social courses of fragile-living urban dwellers with tuberculosis without customary and regular access to a conventional residence and investigated the factors associated with interruption of treatment.

Methods: One hundred and nineteen tuberculosis patients without customary and regular access to a conventional residence who were discharged from a hospital with the largest number of tuberculosis beds in Tokyo between January 1998 and October 2000 were followed up.

[Case of pulmonary mycobacterium avium complex disease, showing hypersensitivity pneumonitis-like diffuse shadow].

A 59-year-old man who had just completed therapy for tuberculosis, fell down in sauna and was admitted to a hospital. As acid-fast bacilli were positive (Gaffky 2) in sputum and residual cavity was shown in the right upper lobe on chest X-ray, he was transferred to our hospital. In spite of starting antituberculous chemotherapy, small nodular shadows appeared diffusely and were changed into ground-glass appearance on chest X-ray.

[Coexistence of lung cancer and active pulmonary mycobacteriosis].

Objectives: The aim of this study is to clarify the clinical and pathological anatomical picture of cases in which lung cancer and active pulmonary mycobacteriosis are intermingled in the same lobe of the lung.

Materials And Methods: We analyzed clinicopathological data on 11 cases in which lung cancer and active pulmonary mycobacteriosis are intermingled in the same lung lobe out of 61 admitted cases of coexisting lung cancer and active pulmonary mycobacteriosis, encountered at National Hospital Organization Tokyo National Hospital during the period from 1991 to 2003.

Results: The subjects were 10 men and 1 woman, with a mean age of 68 years.

[A case of malignant mesothelioma showing rapid progression during one month].

A 57-year-old man with massive right pleural effusion was admitted to our hospital. Thoracoscopy revealed, fine granulations and small nodules scattered on the parietal pleura. Biopsy specimens suggested malignant mesothelioma.

[Usefulness of support during treatment by alignment with health centers and DOT during hospitalization].

Objectives: To evaluate the effectiveness of patient support by alignment with public health centers and DOT during hospitalization, on treatment completion of tuberculosis patients.

Subjects: Four hundred seventy-seven patients (male 344, female 133) newly admitted from July 1, 2002 to June 30, 2003 to our hospital were enrolled in the study.

Method: The patients were divided into two groups: one comprised of the patients who were discussed in the conference held by the hospital staffs and the regional public health center staffs about the necessity of support for continuing treatment regularly after discharge from our hospital (Conference (+) group; N=306), and the other who were not discussed in the conference (Conference (-) group; N=171).

[Capsular polysaccharide antibodies after pneumococcal polysaccharide vaccination in patients with chronic respiratory disease].

We investigated the antibody response to a 23-valent pneumococcal polysaccharide vaccine (23PSV), in 151 patients (average age: 70 years old) with chronic respiratory disease. Serotype-specific IgG antibodies to 4 pneumococcal capsular polysaccharides (6B, 14, 19F, and 23F) were analyzed by ELISA before, and one month after, 23PSV vaccination in all patients. Patients showed a significant increase in specific IgG levels to Streptococcus pneumoniae after 23PSV vaccination (5.

[Tuberculosis and human rights].

Tuberculosis (TB) patients must be hospitalized while the smear of sputum is positive because TB spreads through air. Cooperation of a patient is important in order to complete the treatment of TB. However, a small number of patients are noncooperative for the treatment and may sometimes refuse it.