Many cases of floral change by Pseudomonas aeruginosa occurring after administration of p-iactam antibiotics have recently been reported. It has not been clarified, however, whether P. aeruginosa is present endogenously and multiplies after the drug administration or it is not present endogenously but infected secondarily after the drug administration.
The present investigation aimed at clarifying this point and evaluating procedures for detection of P. aeruginosa. These results may be summarized as follows:
In cases of mixed infection with Escherichia coli and P. aeruginosa, the latter may not always be detected if its population is smaller than 10⁴ cells/ml.
Such media as NAC agar, BTB agar, BTB agar containing added cephalexin, DHL agar, and NAC broth were examined. The rate of detection on NAC agar was the highest. The medium was able to detect a small number of P. aeruginosa in samples.
Sotne clinical specimens (mostly urine) gave P. aeruginosa in NAC broth but not in any other medium.
In certain clinical specimens, detection of a small number of P. aeruginosa may not always be necessry, but it is of value in foretelling possible floral change colonization, or superinfection during administration of antibiotics.

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There has been an increase of fungal infections in the patients with blood diseasein the recent years and in whom the fungal infections have been often found at the autopsy.
One hundred and four blood disease patients; 46 leukemia, 31 malignant lymphoma, 16 multiple myeloma, 7 aplastic anemia and 4 idiopathic thrombocytopenic purpura, were performed an autopsy from 1967 to 1976 in Kasasaki Medical School Hospital and the related hospitals.
From the findings of the autopsies, infections were most frequent as the cause of death, and the pulmonary infections predominated and were observed in half of the cases studied, especially among them bacterial infection was most frequent, followed by the mycotic one.

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Three different types of rubella strains-an attenuated vaccine strain (TCRB-19), wild strains (Wt) and a strain from patient with the congenital rubella syndrome (CRS-N)-were compared for some virus characteristics. The characteristics studied were plaque forming on RK-13c cell line with agar overlay, temperature sensitivity on RK-13c cells, interferon (IF) production in RK-13c cells and immunogenic activity ind ced in rabbits.
The results are as follows:
1. Three different types of strains formed plaques on RK-13c cells. The plaques of Wt were less clear and smaller in size than the other two strains.
2. Infective dose at 39°C was reduced in all three types. PFU was decreased by four logs at 39°C as compared to 30°C in TCRB49. In Wt the decrease was only one log. The reduction of PFU in CRS-N was two logs under the same conditions.
3. The highest IF production was in Wt. TCRB49 showed no IF production activity and CRS-N induced much smaller amount of IF than Wt.
4. HI antibody was produced at high levels after injection of Wt into the rabbit. No response was shown in TCRB-19. In CRS-N the response was delayed, but in the end high amounts of HI antibody were produced.
5. These data confirmed that there were some remarkable differences between TCRB-19 and Wt. The CRS-N was shown to have characteristics falling between the other two types. It might be suggested that some special variant rubella strains affected the pathogenesis of congenital rubella syndrome.

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Anaerobic culture techniques has been recently simpler and more general in Japan. Thus, it is not always difficult to isolate Clostridium tetani from clinical materials.
We reviewed our experiences with ten patients with tetanus during the past ten years from January 1968 to July 1978. The mortality rate among these patients was 20%.
In four of ten patients Clostridium tetani was isolated from the wound concomitantly with facultative or strict anaerobic bacteria: Staphylococcus aureus, Staphlyococcus epiderrnidis, Peptococcus sp., Escherichia coli, Peptostreptococcus sp., etc. The result that Clostridium tetani was isolated from all three cases with foreign bodies such as sand in the wound should be noted. Therefore, physician must carefully treat any slight wound in order to clear away all foreign bodies completely.
The diagnosis of tetanus is usually due to clinical findings, but detection of Clostridium tetani is very useful to make the diagnosis in a suspicious mild patient. On the Gram stained film made from wound exsudate, the appearance of “drum stick” bacilli is a suggestive evidence of the presence of Clostridium tetani. On blood agar plate incubated for two days anaerobically, the characteristic colony formation which spread along the streaked line with irratative sour odor, is also a presumptive evidence of Clostridium tetani. These findings are valuable for early diagnosis of tetanus.

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In recent years, so called opportunistic infections have been increasing. Among them, Pseudomonas aeruginosa is one of the most important pathogens, because this infection is very difficult to treat, and the outcome is often a very unhappy one.
In any bacterial infection, phagocytosis and intracellular killing by phagocytes is one of the most important defence mechanisms of human beings. To study this defence mechanisms against Pseudomonas aeruginosa under more natural circumstances than in vitro, a method using diffusion chambers was developed.

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A 20 years old woman with campylobacteriosis associated with protein-losing gastroenteropathy was reported. She had had edema in legs, anorexia and watery diarrhea since July 1975.
She was admitted to the hospital of Miyazaki Medical College on March 19, 1978. The laboratory examinations showed that she had marked hypoproteinemia (2.8 g/dl), hypogammaglobulinemia (IgG, 284 mg/dl; IgA, 40 mg/dl), lymphocytopenia (6%) with normal white cell counts (5, 200/mm³) and negative delayed type skin reaction with PPD and PHA. She was diagnosed as protein-losing gastroenteropathy due to primary intestinal lymphangioectasia from the roentogenologic and angiographic findings of gastro-intestinal tract, being compatible with results of ¹³¹I-Triolein and ¹³¹I-PVP tests. The patient was maintained on diet rich in protein and medium chain triglyceride (MCT) but refractory to the other various treatments. On the 153 date of admission she had high temperature and Campylobacter (probably C. coli) on blood culture, which is known very rare in Japan, was detected according to the classification of Veron and Chatelain (1973). Further, Escherichiacoli and Aeromonas hydrophila were isolated from this patient on the date of 273 and 289, respectively.

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