肺結核新病巣発見についての疫学的観察
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概要
- 論文の詳細を見る
Among 14,500 employees of Japan National Railways working at Yokohama and Atami district, 792 tuberculous cases were found during 4 years from 1952 to 1955 (about 200 cases a year). An epidemiological observation was made on them and the following results were obtaind. 1) The new discovery rate of those requiring treatment was 1.2% (1952), 1.0% (1953), 0.8% (1954) and 0.7 % (1955). The rates were onthe decrease with the elapse of time, especially in the age bracket of 25 to 29. 2) The new discovery rate of those requiring treatment was 0.7 % to 1.2 % among the previously tuberculin positive reactors with negative chest findings. This rate must be thought much of in controlling a group that consists of many previously tuberculin positive reactors. 3) Those belonging to the first category of the WHO classification were on the increase and those belonging to the third category on the decrease. In total, those requiring treatment and rest cure were found to be decreasing. 4) When the previous miniature films were retrogradely read, the foci were detected in 50〜60% in the preceding year films and 10% in films of 1948. The detective rate of foci in the miniature films was highest among the nodular types, followed by the circumscribed chirrhotic types and the infiltrative types in that order. 5) In observing by the WHO status, those with suspected cavity showed a lower detective rate of foci in the previous miniature films than those without cavity. This result may sound' paradoxical. However, the small foci under the threshold of visibility of miniature films were probably not detected until rapid advancement ("Schub") occurred. This mode of advancement is considered to be characteristic to tuberculosis. 6) The site of foci discovery among the previously tuberculin positive reactors was found to be highest in the apical field, and followed by the upper, the middle and the lower field in that order, regardless of the presence or absence of foci in the previous miniature films. The high distribution of foci in the upper field is probably due to the small original foci that can not be detected in miniature films until the foci produce metastatic foci. 7) New foci found among the previously tuberculin positive reactors are considered as the relapse or advancement of latent foci, because the newly discovered foci were found to be located in the apical and upper field and also many latent foci existed under the threshold of visibility of miniature films.
- 千葉大学の論文
- 1959-01-28