[Evaluation of the characteristics of tuberculosis patients in Ashikaga Red Cross Hospital, Tochigi Prefecture, Japan (2007-2011)].

OBJECTIVE: To retrospectively evaluate the trends in tuberculosis characteristics among patients attending the Ashikaga Red Cross Hospital, Tochigi Prefecture, Japan, between January 2007 and December 2011, and to compare this trend with that observed globally. METHODS: In total, 273 newly reported tuberculosis patients attending the Ashikaga Red Cross Hospital were examined from January 2007 to December 2011 in terms of age, sex, mortality during tuberculosis treatment, race (Japanese or non-Japanese), nationality of non-Japanese patients, pulmonary (including sputum positivity and/or cavity formation in the lungs) or extrapulmonary tuberculosis, latent tuberculosis infection, residential areas of patients, and diseases coexisting with tuberculosis. RESULTS: Among the 255 Japanese tuberculosis patients, 202 patients were aged over 60 years, while the 18 non-Japanese patients were aged less than 50 years. Latent tuberculosis infections in 10 patients, including nurses and members of the patients' family, were treated. Among the 239 patients with pulmonary tuberculosis, 160 (67%) had Mycobacterium tuberculosis-positive sputum cultures and 99 patients (41%) had cavity formation in their lungs. Moreover, 1 multidrug-resistant, 2 isoniazid-resistant, and 3 ethambutol-resistant strains of bacteria were isolated in the patients. Mortality during tuberculosis treatment, which increased with age, was observed in 41 patients. There were 66 cases of diabetes mellitus and/or chronic kidney dysfunction (or failure), which were the most common diseases that coexisted with tuberculosis. Disability, dementia, and/or residing in nursing home was also commonly observed (31 cases). Furthermore, 240 (88%) tuberculosis patients were transferred from other clinics or hospitals to our hospital, implying that people visiting nearby clinics or hospitals are cautious about interacting with tuberculosis patients. CONCLUSION: To a certain extent, tuberculosis is still prevalent among the elderly (more frequently in men than women) in Japan; however, in the younger generation, more than 30% of the patients are non-Japanese. The trends in tuberculosis observed in the Ashikaga Red Cross Hospital, Tochigi, Japan over a 5-year period were concordant with the global epidemiology of tuberculosis.

[Surgical treatment for small bowel metastasis of pleomorphic carcinoma 6 months after pulmonary resection].

The prognosis of patients with distant metastases of pulmonary pleomorphic carcinoma is poor. We report a case of pulmonary pleomorphic carcinoma patient who underwent surgical resection of small bowel metastasis. A 69-year-old man developed anemia secondary to melena 6 months after right upper lobectomy for pulmonary pleomorphic carcinoma and small bowel metastasis was detected endoscopically. He underwent laparoscopic ileocecal resection and has survived for 2 years after lung cancer resection without any other recurrence or metastasis.