In a total of 860 cases, measurements of human serum tetanus antitoxin values and diphtheria antitoxin values were made with highly purified antigen to hold down nonspecific reaction to the minimum by the sheep hemagglutination method excellent in reproducibility and the values thus obtained were studied in comparison with those of in vivo measurement made by the toxin neutralization reaction hinter to in practice. The passive hemagglutination value (HA value) not being in agreement with the neutralizing value (NT value) was considered inappropriate. In the present experiment, however, the cases were divided into groups by concentration; when the HA value was compared with the NT value, the higher the amount of antitoxin was, the smaller was the HA/NT ratio irrespective of the history of preventive vaccination, and the HA/NT ratio became greater in the group with a low amount of antitoxin. That is, the HA/NT ratio stood at 1.30±0.14 in the group with the tetanus NT value of less than 1.0 Au/ml, at 0.65±0.07 in a group with the tetanus NT value of more than 1.0 Au/ml, at 1.39±0.30 in a group with the diphtheria NT value of less than 0.1 Au/ml and at 0.57±0.16 in a group with the diphtheria NT value of more than 10 Au/ml. When the correlation between HA and NT by the group of concentration was examined, it was statistically significant at less than 1% level in all groups. HA value and NT value need not be in agreement with each other judging from their respective mode of reaction. So, a method whereby the correlation between the two for each concentration is found and NT values are calculated from HA values can be put to practical use widely as an economical and easy to operate method, about which we are confident in the light of the result obtained with the present study.
What is considered the most difficult problem among the side reactions following inoculation of DPT triple vaccine is fever which is observed in about 30 percent of the cases. Particulary in infants, fever may cause convulsion, to which attention should be paid. In the present experiment, the author studied how post-inoculation fever can be suppressed using more than 1000 cases inoculated with DPT triple vaccine as the subject. Acetylsalicylic acid (ASA) 10mg/kg was administered at various time intervals. As a result, administration of 10mg/kg each at the 3rd and 9th hour after inoculation appeared to produce effective antipyretic action. Meanwhile, ASA preparations are effective for rheumatoid arthritis, and nowadays they are considered to act as an immunosuppressive agent. In fact, R. S. Punish & his co-worker reported that function of lymphocytes is lowered after administration of ASA. Thus, the amount of serum diphtheria and tetanus antitoxin was examined by hemagglutination method in a part of the cases, to which ASA was administered by the above mentioned method. As a result, there was no difference in the production of antitoxin between the ASA administered cases and the non administerd ones. When the function of lymphocyte 24 hours after administration of ASA 10mg/kg was examined by the uptake of 3H-thymidine by PHA stimulation, there was no difference either between the two groups. The blood ASA level 24 hours after administration of ASA was not more than 2.3mg/ml by the above mentioned method. From the above, it was judged that administration of ASA 10mg/kg each at the 3rd hour and 9th hour after inoculation of DPT triple vaccine would suppress fever significantly and that this dose would exert little influence on the immunogenic system.
A case of endocarditis due to Neisseria mucosa, the third case in the world, was reported. Members of genus Neisseria, other than N. meningitidis and N. gonorrhoeae, are usually considerd to be nonpathogenic. However “nonpathogenic Neisseria” are known to cause serious diseases-endocarditis, meningitis and septicemia. Endocarditis due to Neisseria was first published by Kämmerer et al. in 1914, and thereafter 23 cases are reported in the literature; four due to N. flava, three to N. perflava, one to N. subflava, two to N. pharyngis, five to N. sicca, two to N. mucosa, three to N. catarrhalis and three to unclassified Neisseria. Case: a 32 year old male with rheumatic heart disease (mitral stenoinsufficiency+aortic stenoinsufficiency) was admitted because of remittent fever and palpitation developed a few days after dental extraction. One of four blood cultures obtained on the first hospital day was positive. The organism was identified as Neisseria mucosa which is a normal inhabitant of human nasopharynx. It was suspected whether the organism was pathogene or not. On the high doses of Penicillin-G therapy, the fever was cleared after two days. In order to determine the pathogenicity of the isolate, Penicillin-G was stopped temporarily. On the next day after regimen stopped, high fever with shivering was reappeared. From all of four blood cultures taken at this time, N. mucosa was isolated again. Thus the pathogenicity of the isolate was confirmed. The organism was sensitive to Ampicillin, Carbenicillin, Penicillin-G, Cephaloridine, Chloramphenicol, Tetracycline, Streptomycin, Kanamycin, Gentamicin and Nalidixic acid, but resistent to Erythromycin, Oleandomycin, Josamycin and Lincomycin After 6 weeks of combined therapy with Ampicillin, Kanamycin and Nalidixic acid, the patient was discharged, and observed no recurrence thereafter.