The yearly trend of tetanus mortality from 1950 through 1975 in different age groups was analysed by means of ordinary and two-phase regression lines. The purpose was to see if the trend of declining mortality was accelerated by vaccination. 1) The trend of mortality was expressed very well by the two-phase regression lines in the neonates and the 0-9 year old group. The breakpoint was in 1962 for the neonates. It was in 1969 for the 0-9 year old group when the mortality rate in 1975 was excluded because of the resaon mentioned in the text. The amount of tetanus toxoid-containing vaccines sold on the market was quite small in 1962 and was large in 1969. The DP vaccine was officially replaced by DTP vaccine after 1969. 2) The other age groups (10-19, 20-29, 30-39, 60-69, 70-79 and 80 years & more) showed an intermediate fitness of the two-phase regression lines. The breakpoint in these age groups was generally in the years when the tetanus toxoid-containing vaccines were not sold in large quantities. 3) The trend of mortality was expressed almost equally by two-phase and ordinary regression lines in the age groups of 40-49 and 50-59 years. 4) Immunization of children under 9 years old with vaccines containing tetanus toxoid (Tet, DTP, DT) was considered responsible for the greater tendency of decreasing mortality than in previous years and also for maintaining mortality at low levels.
From the metacercariae of Stellantchasums falcatus encytsed in fish, Rickettsia sennetsu-like organisms (SF strain) were occasionally isolated. These organisms were difficult to detect in stamped specimens of lymph nodes or spleens of infected mice by the Macchiavello staining or the indirect immunofluorescence. Therefore, cultivation of SF strain in RK-13 cell and its antigenic relation to Rickettsia sennetsu were studied. The results were as follows. 1. Cultivation of SF strain in RK-13 cell 0.5 ml of supernatant fluid from 10% homogenate of spleens of mice infected with SF strain was added to the monolayer culture of RK-13 cell in 50 ml bottle and incubated at 37°C. At the interval of about 12 days, the cells collected by trypsinization and centrifugation were subcultured in two bottles. The organisms were observed in a few cells of the 3rd transfered cells, and in 90% cells of the 5th. After 90% cells were infected, normal RK-13 cells must be added at the time of subculture.2. Common antigen between SF strain and Rickettsia sennetsuCommon antigen between SF strain in RK-13 cell and Rickettsia sennetsu in FL cell was studied by indirect immunofluorescence. The anti-SF strain mouse serum, homologous titer of 1: 2560, stained Rickettsia sennetsu at the dillution of 1: 160, and the three Hyuga-fever patients' sera, homologous titers of 1: 1280, 1: 1280 and 1: 160, had titers of 1: 160, 1: 160 and 1: 40 respectively against SF strain. From these results, speculatively, there is not a close relationship between SF strain and Rickettsia sennetsu.
Severe salmonella enteritis complicated with acute renal failure is often lethal. Recently we have experienced two cases with acute renal failure due to salmonella enteritis which have been successfully treated with effective transufsion. Case 1: A 57 y.o. man entered the hospital because of fever and diarrhea of 4 days duration and extensive dehydration, slight drowsiness and oliguria were observed. Acute renal failure was inindicated by 6.7 mg/dl of serum Cr and 112 mg/dl of BUN. Salmonella typhimurium was detected by the culture of the stool. Transfusion and the administration of KM (2.0 g, p.o.) improved the renal function since the 9th day of the course and the patient was discharged from hospital on the 24the day. Case 2: A 48 y.o. man noticed frequent diarrhea with nausea. He was admited to the hospital because of subsequent cramp and paresthesia of the extremities on the next day, when drowsiness, prominent dehydration and positive Trousseau phenomenon were observed. Acute renal failure was also suggested by 8.9 mg/dl and 102 mg/dl of serum Cr and BUN, respectively. Group E1 of salmonella was found in the stool by its culture. The renal function was improved by means of the transfusion therapy and antibiotics and the patient was discharged from hospital on the 25th day of the course. In salmonella enteritis with acute renal failure like the present cases, depletion of body fluid and salt is nearly inevitable. Therefore an effective transfusion of water and electrolytes (Na, K) should be emphasized as the important treatment. In a more severe case, the administration of corticoste.oids and blood dialysis will be essential.