The Oinono basin in Akita Prefecture is known as an endemic focus of the classical type (Summer type) tsutsugamushi disease. Recently, it was becoming clear that an epidemiologically different type of the disease which is called the new type (Spring and Autumn type) tsutsugamushi disease to differentiate from the former type was also seen anywhere in Akita Prefecture, and we found 21 cases of this type disease in a period from 1978 to 1979.
The present study was conducted to determine the correlation between the place presumed of being infected, time of onset, clinical findings and the prototype of etiologic agent, Rickettsia tsutsugamushi.
1) The new type disease occurred inside the classical endemic area had generally severe clinical symptoms which were essentially identical to the classical type disease occurred in that area, whereas the new type disease occurred outside that area had relatively milder than the classical type disease.
2) Typing the rickettsiae isolated from human cases and wild rats trapped in both areas, it was defined that the Gilliam type was dominant in the former area and the Karp type was in the latter.
3) Among 10 species of trombiculid mites collected from wild rats, Leptotrombidium pallidum which is considered as a most important vector of this type disease was dominant species in both areas.
4) The above results may indicate that the differences in clinical pictures between two areas could be attributed to difference in mite vector but a difference in rickettsial virulence.

抄録全体を表示

In relation to the effect of an oral antibiotic agent on intestinal bacterial flora, we wanted to study the influnce by the region of absorption and concurrently existing bacteria using germfree mice. First we produced the following four kinds of mice:
1) Monocontaminated mice by E. coli;
2) Dicontaminated mice by E. coli and Lactobaccillus;
3) Tricontaminated mice by E. coli, Lactobacillus and Streptococcus; and
4) Multicontaminated mice by E. coli, Lactobacillus, Streptococcus and Bacteroides.
Then, Ampicillin and Gentamicin were administered to the mono-, di-, tri-. and multicontaminated mice respectively and to multicontaminated mice, Ciclacillin, Caphalexin, and Erythromycin were also administered and the fluctuation in the number of each kind of bacteria in feces and each region of the intestinal tract was measured.
1) From the above results we assumed that, in the upper region of the small intestine, Ciclacillin and Cephalexin were absorbed well, whereas the absorptions of Ampicillin and Erythromycin were not too good, and Gentamicin was hardly absorbed in the intestinal tract.
2) With respect to the effect of intestinal bacteria of an agent which was not absorbed from the intestinal tract such as Gentamicin, it seemed the time necessitated to pass through the intestinal tract was an important influencing factor.
3) With regard to the difference in the effect of an antibiotic agent where other bacteria concurrently existed, there was almost no difference observed in the effect of Ampicillin and Gentamicin administered to dicontaminated mice by E. coli and Lactobacillus. On the other hand, in the mono-, tri-, and multicontaminated mice, a tendency of decreasing number of sensitive strains was observed depending on the degree of absorption. In other words, the role of Lactobacillus in dicontaminated mice seemed very interesting.
4) Regarding the tolerance, Ampicillin resistant E. coli was found in both the mono-, and tricontaminated mice.
5) In our experiments at this time, we used gnotobiotic mice produced by establishing specific kinds of bacteria in germfree mice so that such experiments may indicate the result on the neonatal period in a sense and we think there would be disagreement in some aspects with the result obtained using conventional mice having a formation of bacterial flora. However, at the same time our result might indicate the correlation between antibiotic agents and bacteria in vivo.

抄録全体を表示

ABPC, ACPC, CEX and EM were orally administered to children suffering from infectious diseases and effects of each antibiotic on intestinal bacteria were investigated; in other words, the fluctuations of bacteria in stool and the nature of stool were examined. Also, the relation between the microbisme sélectionné et substitutée in urinary tract infections and the fluctuations of bacteria in stool by oral administration of antibiotics was investigated. The following are the results of our studies:
1) The highest frequency of diarrhoea was caused by administration of ABPC; loose stool, nausea and discomfort at the stomach were recognized in the case of EM administration and almost no symptom was discovered at the digestive organs by administration of either of ACPC and CEX.
2) The fluctuations of bacteria in stool were found as follows: by administration of ABPC, E. coli and Streptococcus decreased, Klebsiella increased and Bacteroides decreased; by ACPC, almost no fluctuations were recognized; by CEX, a decrease in E. coli and no change in Streptococcus meaning a correlative increase of Streptococcus against E. coli, and an increase in Enterobacter were recognized; by EM administration, E. coli and Streptococcus decreased while Bacteroides, Lactobacillus and Peptostreptococcus decreased remarkably.
3) When ABPC or CEX is administered orally to patients suffering from urinary tract infections, the following microbisme sélectionné et substituté must be taken into consideration: in the case of ABPC, a change-over of bacteria to Klebsiella, and in that of CEX, to Enterobacter, Streptococcus and/or Pseudomonas. The above phenomena correlate to the fluctuations of the number of organisms in stool.
4) Urinary tract infections during the baby and infant years often cause recurrences and are likely to become chronic, which may eventually result in dysfunction of the renal parenchyma. Therefore, antibiotics must be administered very carefully to the above-described patients and it seems preferable to administer such an agent intravenously rather than orally.

抄録全体を表示

Examinations of pathogenic Escherichia coli, Staphylococcus and Pseudomonas from various objects, new-born infants and workers in the neonatal intensive care unit in the college hospital were performed in 1973 and 1979. In 1978 new nursery which equipped the clean air ventilation and pre-room for incoming person was opened in the hospital ward newly constructed and had been used for 8 months until this study.
The results obtained as follows:
1. Pathogenic Excherichia coli was not isolated from any specimen.
2. Staphylococcus aureus was isolated from sink and catheters for nutrition. The isolates showed resistance to penicillin, erythromycin, and sulfoisoxasol. Staphylococcus epidermidis was isolated from fingers of all of doctors and nurses working in nursery.
3. Pseudomonas aeruginosa was isolated from sink, catheters for nutrition and thermometer and humidifier of incubators in both examinations, and also from the throats of new-born infants in 1973 and from the throats of new-born infants and nurses in 1979. The isolates showed sensitivity to gentamicin.
4. The results suggest that new-born infants and medical care takers are capable both of recieving and of mediating microbial contaminations, and also new-born infants, nurses and spots retentive of moisture are easily contaminated by Pseudomonas aeruginosa.

抄録全体を表示

Comparative test by double blind method were conducted by administering 2 g of CPZ and 4 g of CEZ as a control per day for comparing the actions of both the medicines in order to ascertain the efficacy and safety of CPZ against respiratory tract infection.
Clinical examination indicated the effectiveness of CPZ in 75.2% of the cases, while CEZ proved effective in 56.5% of the cases, and showed that CPZ was significantly advantageous over CEZ.
CPZ showed a signifficant advantage over CEZ against the individual diseases. In the cases involving bacterial pneumonia, CPZ was effective in 86.2% of the cases, while CEZ was effective in 64.4% and in the cases involving chronic respiratory tract infection, CPZ showed an efficacy of 63.6%, while CEZ was effective in 40.0% of the cases.
As regards the bacteriological effects of the medicines, CPZ showed a significantly high efficacy in Gram-negative bacteria. CPZ was effective in 70.6% of the cases, while CEZ was effective in 54.5%, even though Pseudomonas, Enterobacter and H. influenzae having no or very little sensitivity to CEZ were excluded from consideration.
No significant difference was observed between the two medicines in the manifestation of any side effect or abnormality in laboratory findings. All of such side effects and abnormalities that were observed were merely of the type usually observed with medicines composed of β-lactam.
The utility of CPZ was significantly superior to that of CEZ.
In view of the foregoing results, CPZ would be sufficient for effective treatment of respiratory tract infection.

抄録全体を表示

A case of 18-year-old girl student with pneumonia to M. pneumoniae was reported.
She was admitted to this hospital in October 1976 with a history of cough, sputum and fever for six days. The chest X-ray revealed a homogeneous infiltration on the right lower lung field.
During the next two weeks she was in a critical condition with dyspnea, cyanosis and remittent fever. On the 23th day the chest X-ray revealed a cavity (1.8×1.6 cm) on the right lower lung field.
The laminagraphy revealed the cavity to be intrapulmonary. The complement fixation titre to Mycoplasma pneumoniae was 1: 1280. Cole agglutination test was 512x. She was treated with E.M. and Betamethasone.
But after two years her X-ray revealed the same cavity yet.

抄録全体を表示