菌陰性空洞のX線像の経過
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Sixty nine open negative cavities (unilocular 29 and multilocular 40) in 57 pulmonary tuberculosis patients were radiologically followed up for 2-10 years after negative conversion of sputum.<BR>All cavities were tomographically classified according to the Iwasaki-Iwais classification. (Fig. 1). The distribution of type of cavities was investigated annually after negative conversion of sputum. At 6 months after negative conversion of sputum, the proportion of A, B and C was small, that of D, E and H was 42%, and that of F and G was about 50%. At 1 year, the proportion of A, B and C became higher (about 30%), and that of F and G became lower (about 29%). The tendency continued until 4 years after negative conversion of sputum, and at 4 years, the proportion of A, B and C reached to 43% and that of F and G reduced to 10%. (Fig. 2a). Generally speaking, the wall of an unilocular cavity became thinner more rapidly, in about 2 years, than that of a multilocular cavity, in about 4 years. (Fig. 2b). No definite difference was recognized between the primary treatment group and the re-treatment group in the yearly changes of the cavitary wall. (Fig. 2c).<BR>The changes of cavity after reaching to each A, B, C, D, E, F, G or H were annually investigated. (Table 4 and 5). Most of cavity A and C remained unchanged. Cavity B and D showed further slight changes. No bacteriological relapse was observed among types A, B, C and D. Most of cavities E, F, G and H showed further changes, and the changes was most marked among H type and many showed diminution of cav itary size. A few relapse were observed among types E, F, G and H. In general, only a few cavities showed complete disappearance, inspissation or consolidation. Some of cavities of each type diminished in size, and a very few showed dilatation in, size. A few cavities were contaminated, by fungus infection.<BR>From the above results, it is recommended that effective chemotherapy should be continued in open negative cavity for at least 2 years in unilocular cavity and at least 4 years in multilocular cavity, so that the cavity wall become stable and preferably, as thin as in cavities of A and C. Moreover, caution should be paid for the contamination of fungus infection.
- 日本結核病学会の論文
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