J.Jpn. Surg. Soc.. 54(8): 693-702, 1953
Original article
STUDIES ON THE POSTOPERATIVE MODIFICATION OF MANTOUX REACTION
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2nd Surgical Dept., Faculty of Medicine, Tokyo University Yuji KOJO |
1) 1: 2,000 diluted tuberculin was injected intradermically at the contraction side of a patient's forearm prior to opration, and the size and colour was examined immediately before surgery and then the change of the colour was observed till several hours following operation. Further, Mantoux reaction injected again on the several day following operation was compared with the former.
2) Discoloration of Mantoux reaction after operation Mantoux reaction that was performed from 5 days to 10 hours prior to surgery on the same patient became purple discoloration of various degree or showed dotted hemorrhage by 1 or 2 hours, occasionally 5 hours after operation.
About 40 per cent of 130 cases showed, more or less, discoloration of Mantoux reaction post operatively.
3) With relation to surgery: 49 cases (45,4%) of 108 thoracic surgeries showed the discoloration and 2 cases (9.1%) of extrathoracic operations showed the same change. Namely Mantoux reaction seemed to show discoloration the most frevuently in the case of pulmonary tuberculosis, that was consisted of greater part of extrathoracic operations. But generally speaking, this phenomenon was neither closely related to thea diseases, nor to the site of operation. As to the degree of operative stress, it was not seemed that this phenomenon had statistically intimate relation to the technique of thoracic operation for pulmonary tuberculosis.
4) Influence on Mantoux reaction following operation In the great number of the cases, size of Mantoux reaction performed on the several day following operation till fall in temperature were obviously smaller than that prior to operation. With regard to the fact mentioned above and the previously noted operative influence on preoperatively injected Mantoux reaction, in the group of postoperative discoloration, Mantoux reaction after operation tended to be smaller than the size of preoperatively injected reaction But in the group of no discoloration, not a few postoperative reaction were smaller, too.
5) With relation to the clinical course. There were statistically no significant correlation between the post operative discoloration of Mantoux reaction, and the general clinical course, and also postoperative blood-tinged sputum.
6) From the results obtained, the mechanism and nature of this phenomenon may be as follows :
Enhanced effect for tuberculin reaction by operative stress is due to injury to the capillary wall in the sence of Shwartzman type tissue reactivity and the previous mentioned postoperative tuberculin reaction is due to inhibitory efect (Gross-Ogata), closely related to the former. (author's abstract)
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