This study was done to assess the variations of vaginal microbial flora according to the menstrual cycle. In order to be prepared for the study of correlativities of vaginal bacterial flora to the menstrual cycle, relations between vaginal bacterial flora vs. ovarian functions and between microbial flora vs. vaginal pH were studied.
The subjects of the study were normal and healthy women who visited the Department of Gynecology at the Central Hospital of Japanese National Railways between October 1977 and September 1979.
At first, by discharge samples obtained from the vaginal lateral wall, fornix and endocervix, pH and microbial isolation rates were studied in relation with the sites of sampling. PH was, in the higher to lower order, endocervix, fornix, vaginal lateral wall while the microbial isolation rates were, adversely, vaginal lateral wall, fornix, endocervix. As the types of bacteria were equal in three sites, the vaginal lateral wall was decided as the site of vaginal discharge sampling for the study, as follows.
The study consisted of search for relations between the ovarian function and vaginal microbial flora variations at women of regular menstruation in sexually active phase of life, at climacteric women of irregular menstruation and also at postmenopausal women by determining their bacterial isolation rates and vaginal PH, as well as the predominant organism of vaginal microbial flora. The results shoved that the number of bacteria and the number of types of bacteria were both greatly reduced in climacteric and postmenopausal women. The vaginal PH of women in sexually active phase was low, and the predominant microorganism in them was lactobacillus, while in climacteric and postmenopausal women, the vaginal PH became higher and lactobacillus became less predominant. In many cases, no predominant organism could be determined in them.
The variations of vaginal PH vs. menstrual cycle and PH vs. microbial flora were not found significantly correlative.
The variation of vaginal microbial flora according to the menstrual cycle was studied in view of the following three facters.
1) In view of the bacterial isolation rates: The 42 women of normal menstrual cycle were asked to visit the hospital in their first haif of follicular phase, second half of follicular phase, first half of luteal phase and second half of luteal phase for vaginal microbial study, and 168 samples obtained from them were studied. For anaerobic bacteria, the samples obtained were 120 from 30 of the women.
The resulted isolation rates almost did not show any significant differences from phase to phase. But only Bacteroides increased in the luteal phase.
2) In view of the bacterial amounts: The microbial amounts were studied by giving a score to each bacteria, and its found that Bacteroides increased in the luteal phase, but others did not show any significant differences from phase to phase.
3) In view of the positive rates of Doderlein bacilli (Lactobacilli) by vaginal smear: The Doderlein bacilli on the smear were studied by vaginal cytological examination, but no significant variation of them in accordance with the menstrual cycles was recognized.
The conclusion from the above study was that the increase or decrease of vaginal microbial flora is under influences of the ovarian function (estrogen) and vaginal PH variations. But there was no variation of them almost to follow the menstrual cycles, but only Bacteroides increase in the luteal phase.

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This study was done to assess the incidence and significance of P. cepacia in meningitis and to investigate the clinical backgrounds and pictures of the patients infected.
In the one year period, 1978, there had been an increase in the incidence of P. cepacia isolated from the cerebro-spinal fluid of the hospitalized patients.
From 43 patients microorganisms were isolated in this period. Ten of 43 patients encountered P. cepacia. The 8 patients were investigated in detail. All patients suffered from the disorders of C.N.S. and were performed an extra-ventricular drainage before isolation of P. cepacia. In addition, they had recieved some anti-microbial drugs for a long time prior to isolation of this organism.
This study showed that P. cepacia is an important micro-organism in hospital infection.

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Reported cases of gonococcal urethritis have been consistently decreasing in Japan.
In America, however gonococcal diseases have been abruptly increasing and its control is an important problem at present.
Clinical observations were made on male patients with gonococcal urethritis for six months between December 1978 and May 1979 at Osaka Social Welfare Center Hospital.
The results were summerized as follows:
1) 53 cases were diagnosed as having gonococcal urethritis and 15 cases as having non -gonococcal urethritis.
2) 52.8% of patients with gonococcal urethritis were in thirties.
3) The incidence of gonococcal urethritis was estimated to be 667-500 cases per year per 100, 000 men.
4) 53 strains identified as Neisseria gonorrhoeae showed low sensitivity to PC G, AB PC and MPI PC in disk sensitivity test. On the other hand, they showed relatively high sensitivity to TC, EM, LM and. CP. In aminoglycoside group, GM was most sensitive and followed by TOB, KM and DKB.

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A double blind study was performed using kanamycin (KM) as the control drug in order to make a strict objective evaluation of the efficacy and usefulness of fosfomycin (FOM) in the treatment of bacillary dysentery patients or carriers. The following results were obtained.
1.The MICs of FOM for 116 strains isolated from patients of this series distributed in a range between 0.2 and 25 μg/ml. None of the strains showed resistance to FOM, while there were 2 strains which were found resistant to KM.
2.With respect to the efficacy for symptoms, little or no significant difference was seen between the two groups, although the number of days required for disappearance of blood in stool was shorter for FOM group than for KM group with significant difference.
3.In both groups, good results were obtained for eradication of organisms. In particular, the efficacy rate of 100% recorded for patients of FOM group was higher significantly than that of 85.7% recorded for those of KM group.
4.All of the side effects observed were mild in nature, and no significant difference was seen in their incidences between the two groups. The examination of blood picture, liver and renal functions revealed little or no influences from treatment with either drug, although in one case of FOM group a slight elevation in S-GPT was seen.
From these results, FOM is considered to be a drug very useful in the treatment of patients with bacillary dysentery or carriers.

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Polyagglutination of red blood cells was observed in a 1 year and 8 month old boy, who was admitted for complaints of fever, impaired conciousness and paralysis of right sided-extremities, associated with meningitis due to Streptococcus pneumoniae. In immunological and hematological findings, patient's red cells showed potent agglutination with most of normal human sera except those of newborn infants. T-polyagglutination of red cells was identified by agglutination using several plant lectins, the agglutination with Arachis hypogaea showing the most potent titer of 1: 2056. Anti-T antibody had not been detected on admission but reappeared 10 days later, at which red cells returned to normal. This phenomenon is known to occur in patients with severe infectious diseases. In Japan, three cases of T-polyagglutination have been reported until now and all of these cases were found by discrepancy between forward and reverse ABO blood groupings. The T-polyagglutination of red cells in our case was detected only by minor crossmatching incompatibility. This case accompanied marked thrombocytopenia in absence of hemolytic anemia but it remained uncertain whether thrombocytopenia was related to T-polyagglutination.

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A 64 years oid, female, taking prednisolone to treat auto-immune hemolytic anemia for about 2 years, developed purulent arthritis of the left ankle. Thereafter, subcutaneous abscess were found at the right hypochondrium, and abnormal shadow appeared on the lower area of both lung on chest Xray examination.
Atypical mycobacteria were detected in the pus from the left ankle joint cavity and subcutaneous abscess, but were not detected from the sputum and blood.
The bacteria were characterized as Gram positive bacilli and were stainned positively by acidfast stainning. They formed slightly yellowish matured colonies on Ogawa's medium 22-42°C in a few days but no colonies on agar medium.
According to findings, mentioned above they were identified just atypical mycobacteria, group IV. Various antibiotics, including antituberculosis drugs, were not effective. Only Cefamandole, 6g per day, were able to improve in clinical symptomes.

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