[Investigation on "patient's delay" in TB detection].

OBJECTIVE: The causes of delay in receiving medical examinations (for a period of more than 2 months between the appearance of tuberculosis symptoms and the first examination at a medical institution) were investigated. METHOD: Interviews of 127 smear positive pulmonary tuberculosis patients (study period: June-December, 2008). Subjects were divided into 2 groups: those who showed delay in receiving medical examination (hereinafter referred to as "case") and those who did not show delay in receiving medical examination (hereinafter referred to as "control"), and the factors causing differences between the two groups were investigated. RESULTS: There were 44 case examples and 83 control examples. There were higher rates of "aged under 60", "employed" and "have no family doctor" among cases, however, none of them were statistically significant. The rate of smokers was significantly higher in cases. At the time of diagnosis, chest X-ray findings were significantly aggravated in cases and cases were also significantly higher in the degree of smear positivity. It was mostly cases that replied "they were not the symptoms of a serious illness" concerning the initial symptoms and, concerning the timing of medical examinations, the reply "I was busy at work and couldn't take time off" was significantly higher. CONCLUSION: It is considered that cases do not take symptoms seriously and that many of them do not receive medical examinations. Further, it is also considered necessary to carefully educate smokers in particular. There were many cases diagnosed as serious on chest X-ray findings and showed higher degree of smear positivity, so it is considered important to reduce delays in receiving medical examinations in order to treat patients early and prevent the spread of infection.

Neuronal expression of Fos protein in the brain after intravenous injection of gastrin in rats.

The present study examined whether the central neurons are involved in the stimulatory action of gastrin on the secretion of gastric acid. Gastrin (20 microg), which was examined and ascertained to induce a marked increase in gastric acid secretion in gastric-lumen perfused rats, was intravenously injected in Wistar rats under anesthesia with pentobarbital sodium. In the experiments, 1 h after injecting gastrin, rats were perfused and fixed, the brain was removed and sectioned at 40 microm thickness. Every fourth section was treated with anti-c-Fos antiserum, and c-Fos protein was immunohistochemically stained using the avidin-biotin complex method. It was found that c-Fos protein was expressed in neurons of the lateral habenular nucleus, the central nucleus amygdala, the lateral parabrachial nucleus in the pons, and the complex area of the nucleus of the solitary tract and the dorsal motor nucleus of the vagus nerve in the medulla oblongata. The control rats were injected with saline solution, and the brain sections were processed similarly as described above. c-Fos protein was expressed in few neurons in the nuclei above in the control rats. These results suggest that gastrin released into the circulation might stimulate central neurons which, in turn, may relate to the control mechanism for the secretion of gastric acid.