Abstract
The Joint Study Unit of Subacute-Myelo-Optico-Neuropathy in national hospitals was organized in 1966, since which time the report of the study for 3 years were already published.
In 1969 the Joint Study Unit for the same project has been reorganized. As the aim of the study at this time, the epidemiological and pathogenetic aspects are most stressed on. In the clinical section, the treatment and the follow-up study are encouraged among 22 institutions with use of a due form.
The total cases presented from the all study units in 1969 was 163, and they were classified into group A (definite cases), group B (suspecious cases) and group C (ruled out cases).
The results of the study are as follows The report from the epidemiological section
1. In the both A and B groups, it occurs in the female two to three times as frequent as in the male sex and preponderant over the fourth decades.
2. Often there is a history of herpes zoster or herpes labialis in past.
3. Often they have predilection of the upper respiratory infection.
4. There is no special relationship with residence or food. The report from the clinical section
1. 64.3% of cases were improved with sequelae, 15.6% of cases were neither recovered nor worse and 13.8% of cases were suffered from remissions and exacerbations.
2. Over 60% of cases were improved by either administration of adreno-cortico steroid hormons, vitamin B groups or A. T. P. -nicotinic acid I. V. drip.
3. On follow-up study, most cases improved within one and a half years although some cases were improved over two years after the onset of illness.
The report from the bacteriological and serological sections
1. The microecological studies on the fecal specimens of 11 SMON patients were carried out. E. coli, Enterococcus, Lactobacillus, Staphylococcus epidermidis and Candida were isolated from the fecal specimens of every SMON patients. The bacterial numbers of E. coli and Lactobacillus isolated from fecal specimens represented variability between 107-109 viable cells The bacterial numbers of Staphylococcus epidermidis varied considerably between 101-106 viable cells per fecal pellet and Candida did between 102-104 viable cells. Salmonella meleagridis was isolated from one SMON patient which died because of complicating encephalopathy.
2. The agglutinating antibody titers against Salmonelle meleagridis appearing in the sera derived from SMON patients were much higher than those appearing in sera obtained from normal healthy individuals and non-SMON patients.
Furthermore, the increase of IgG was observed in one patient's serum and the decrease of IgG was observed in two patient's sera as the results of the quantitative estimation of immunoglobulins on SMON patients' sera employed here.
The report from the virological section
1. Total clinical specimens were 40 examples composing of A group 34, B group 3 and C group 3.
2. Complement fixation reaction was carried out in most of sera derived from SMON patients and neutralization test was done in some of the sera.
3. There were no elevation of antibody titers in 18 paired sera tested.
4. None of viruses were isolated from feces, spinal fluid and pharyngeal slime.
The report from the pathological section In the past one year there is two postmortem examinations, which correspond with the patho-histological findings of the already reported cases of SMON, i. e.: the lesions are predominant in the long tract of the spinal cord and prominent in the distal portion. They reveal continuous symmetrical degeneration of axones and some invade even nerve roots, peripheral nerves or optic nerves. As regards the degenerative changes of the nerve fibers, some shows marked disintegration of the myelin sheath and preservation of the axis cylinder, the others show swelling, tortuousity or disappearance of axons with preservation of myelin sheath, thus the p
