The so-called “Sashima Hepatitis” which is considered to be infectious hepatitis and is now named such by its peculiar epidemiological outlook was most prevalent in Sashima area, Ibaragi prefecture during the period from the summer, 1963 to the autumn, 1967.
The patterns of the course of illness varied considerably according to individual cases, but we could classify the patients into three types, repetition type, persistence type and remission type, according to changing patterns of their serum transaminase values.
In this paper, serum immuno-globulin response and HIM (Hepatitis Infectious Mononucie Qsis test) reactivity were pursued mainly in relation to the above-mentioned types.
The results were epitomized as follows:
1) In repetition type and persistence type, high serum IgG and IgM levels were observed, whereas, in remission type, only IgM levels were high. In all three types, IgA levels remained normal
2) The results of follow-up studies of immunoglobulins were suggestive of the existence of a feed back mechanism between IgG and IgM in the course of disease.
3) Immunoglobulin levels fluctuated widely in the course of disease in repetition type and persistence type. The fluctuations were mild in remission type. Long-term pursuing of immunoglobulins appeared to be useful for type-differentiation of viral hepatitis.
4) In all cases except one case of remission type, HIM test was positive during the tested term. The mean HIM titer was highest in persistence type and lowest in remission type.
5) In almost all cases regardless the type, HIM followed upward curve or maintained the level once raised in the course of observation period. Cases showing downward trend of HIM values were few and cases reduced to HIM negative were none.

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Intratracheal instillation therapy with antibiotics was given to 43 cases of bronchiectasis. Of them, 21 cases were markedly and 22 cases were moderately improved. Intratracheal instillation was done by intercartilagenous puncture once every or every other day. This method is simple, easy and safe in repeating. Tracheal sputa are completely free from contamination from oral and pharyngeal cavity. The patterns of intratracheal bacterial flora were constant and stable in each individual case through the course of treatment.
In 43 cases of bronchiectasis tracheal sputa were examined aerobically. In 9 cases no aerobic bacteria were cultured and 66.7% of them were markedly improved. In 12 cases Streptococci and/or Staphylococci were cultured and 50.0% were markedly improved. In 13 cases Coli-Paracolon group with or without Streptococci and/or Staphylococci were cultured and 61.5% were markedly improve. In 9 cases Pseudomonas with or without Streptococci and/or Staphylococci and/or Coli-Paracolon group were cultured and 11.1% were markedly improved.
In 34 cases with positive aerobic culture, Streptococci were obtained in 21 cases and Coli-Paracolon group in 15 cases, Staphylococci in 11 cases and Pseudomonas in 9 cases.
In 15 cases of bronchiectasis tracheal sputa and expectorated sputa were cultured on chocolate agar plates. In tracheal sputa of 2 cases Hemophilus were cultured, whereas, in expectrated sputa of 5 cases Hemophilus were cultured.
Considering these bacteriological patterns, antibiotics were selected: Penicillin to negative culture cases and cocci infection cases; Therramycin or Kanamycin to bacilli infection cases; Penicillin, Terramycin or Kanamycin, alone or alterately, to mixed infection cases.
Thirty one cases of bronchiectasis were divided into three groups according to the extent of the lesions, 12 cases of (+) group, 9 cases of group and 10 cases of group. Gram-negative bacilli were found in 42.8% of (+) groups, whereas, 60.0% of group. Thirty one cases of bronchiectasis were grouped into three groups according to duration before the chemotherapy, 12 cases of less than 5 years duration, 9 cases of less than 10 years and 10 cases of more than 10 years. Gramnegative bacilli were found in 47.6% of less than 5 and 10 years group, whereas, in 70.0% of more than 10 years group.
The infection of Gram-negative bacilli, the longer duration of the disease before this therapy and the greater extent of the lesions are, relating each other, the main causes of lowering the cure rate of bronchiectasis.

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As the fourth report of this series, the authors investigated the possessing rate of HI antibody to Rubella virus in inhabitants of Oki Islands and the suburbs of Matsue city in 1966 and 1967.
The results were summarized as follows:
1) In Oki Islands, the possessing rate of 1966 differed little from that of 1967. In both, the possesing rate in age group of 0-10 was almost zero, increased by age rapidly, and at 20 years of age reached. almost 100%.
2) In the suburbs of Matsue city, the possesing rate in 1966 differed little from that of 1967 at young adult or older age group. They were almost 100% in both. However, in younger age group, the former was very low and the latter found very high. This finding suggested that Rubella epidemic occurred during 1967 in this area.
3) Geometric mean titers of HI antibody in positive sera of the inhabitants in 1966 and 1967 were estimated in both areas. In Oki Islands, they dropped from 1966 to 1967, but in the suburbs of Matsue, they differed little to each other except in young age group.

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Recently the rate of the isolation of non-pigment producing strains of Ps. aeruginosa tended to increase according to the observations of various workers. Therefore, investigations were made to observe the influence of addition of various antibiotics to the media on the pyocyanine production of Ps. aeruginosa.
Tetracycline, chloramphenicol, erythromycin and gentamicin inhibited apparently the pyocyanine production even at the concentration at which no growth inhibition was noted. In the case of tetracycline the mechanism of suppression of pigment production was thought to be due to the decrease of metallic ions in the media by chelating.
Although the high concentration of cephaloridine did not cause the inhibition of growth, it showed distinct inhibition of pigment production at considerably high concentration. The influence of streptomycin varied according to the sensitivity of the used strain. Streptomycin-sensitive strains showed considerable decrease of pigment production by the addition of low level of the drug.
Colistin and polymyxin B showed no influence on the pyocyanine production. The pyocyanine production was apparently enhanced by high concentration of benzylpenicillin or ampicillin, pyocyanine being produced about twice as high in the broth containing 10, 000 units of benzylpenicillin as the control culture.
The added antibiotics did not seem to induce the mutation of pyocyanine-producing activity of the used strain of Ps. aeruginosa, because the washed cells from the broth culture containing antibiotics showed quite the same pigment production as the original culture

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Eleven adults with respiratory tract infections, sixteen infants with scarlet fever and twenty-seven patients with bacillary dysentery were treated with Rifampicin (RF) in a study to evaluate clinical effectiveness of the drug, with the results which may be summarized as follows
1) The treatment was effective in 7 of the 11 cases of respiratory tract infections (pneumonia, bronchitis and angina follicularis) and failed to produce any significant symptomatic amelioration in 4 cases, indicating the medication to be not particularly superior to the conventional chemotherapeutic agents in these categories of diseases.
2) Of the 16 infants with scarlet fever admitted to the present study, 14 eventually provided adequate clinical data for clinical evaluation. Ten of the 14 responded with significant clinical improvement, and the treatment was ineffective in the remaining 4 patients. In comparison with the clinical response in previously experienced cases of the same condition treated similarly but with several other antibiotics, the response of the children to the Rifampicin therapy was found to be less clinically beneficial than intramuscular penicillin therapy, to be practically comparable in efficacy to Clindamycin administration and to be more effective than treatment with Bicillin, EM, TC, or Spiramycin.
3) Significant clinical benefit from the use of Rifampicin was evident in 7 of the adults with bacillary dysentery and in 17 of the 19 children with the same disease. The results stress chinical effectiveness of Rifampicin in this disease state for therapy with no concomitant medications. Those, however, who had failed to display complete arrest of bacillary excretion in the feces following institution of the drug continued to excrete the organism. This was the finding rather characteristic of the response to Rifampcin therapy. There was one infantile case among the 19 studied, in which laboratory and clinical data suggested emergence of drug resistance in the population of the pathogen involved. Detailed accounts are given with respect to the clinical course of this patient.
4) Growing decrease in clinical efficacy in bacillary dysentery of colimycin which has seen practically no increase in incidence of resistant strains in vitro is pointed out. Further evaluation of Rifampcin therapy, in this context, as to dosage, duration and advisable concomitant chemotherapy especially with drugs not readily absorbed from the gastrointcstinal tract rcmains to be pursued.

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[in Japanese]

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