It is now well established that nitrogen dioxide (NO2) impairs pulmonary resistance to airbone Jacterial infection by inhibiting the function of the alveolar macrophage. In this study I investigated the effect of pulmonary resistance to bacterial infection in mice immediately or 24 hours after exposure to 20 ppm of NO2 for 18 hours.
As a link in the chain of the studies to clarify the epidemiological background of the human salmonellosis, an examination was conducted on pigeons living gregariously in Hiroshima City as to their Salmonella excretion in the period from 1978 to 1979. About 1, 000 fresh droppings of pigeons were collected from three parks every month, and over a oneyear period 12, 840 droppings in total were examined, out of which 213 strains of Salmonella were isolated and classified into 12 serotypes. The rate of detection from pigeon droppings reached the maximum in summer keeping pace with incidence of human sporadic cases, and marked decrease was observed in winter. The most probable number of salmonellae in pigeon droppings was enumerated to be 101/g-104/ g, and it was considered that salmonellae are not passing through the body of pigeon temporarily but can multiply therein, thus pigeons play a role of reservoir. Among salmonellae detected, S. typhimurium was counted to be 193 strains (90.6%) as an overwhelming majority, all of which were S. typhimurium var. copenhagen except one strain. As to other 11 serotypes, there were 20 strains including S. thompson, S. montevideo S, .livingstone, S. infantis, S. london, S. cerro, etc., which are just generally isolated from human patients with acute diarrhea. Nearly a half of the isolates from the human sporadic cases in the same period was S. typhimurium. Thus, to study a relationship between those strains of S. typhimurium originated from human and pigeon, a series of comparative studies was made on this serotype concerning the presence of O5-antigen and biotype as rereferred to by Cordano et al., Brandis (modified) and Duguid et al. (primary). The 96.9% of pigeonoriginated strains corresponded to a biotype b: 10: 25/O5-, which was notobserved in the human-originated strains at all. However, three biotypes, namely, a: 1: 1/O5-, a: 2: 17/O5- and b: 10: 26/O5+ were common in both human and pigeon originated strains, among which the former two types were observed popularly in the human-originated strains, and antibiograms of pigeon isolates well agreed with human isolates tested. In serotypes other than S. typhimurium, the biochemical properties and antibiograms of both human-and pigeon-originated strains also well corresponded. From the above results, it can be considered that the possibility of association of pigeons with human salmonellosis is far higher in other biotypes and serotypes, although the rate of detection is relatively low (about 10% of the total isolates), than S. typhirnuriumv ar. copenhagenb: 10: 25/O5- which is detected at the highest rate from pigeon droppings
Although intramuscularly injectable tetanus-immune human gamma globulin TIG (m) is an ideal antitoxin, the volume of dissolved TIG (m) in the treatment of tetanus, usually 3000 to 5000 iu, is 30-50 ml. This is a fairly large burden on the patients. An intravenously injectable TIG (i) was prepared by removing IgG aggregates from the cold ethanol-treated TIG. Serum antitoxin levels following iv or im injections of TIG (i), TIG (m) and TAT were investigated in the patients of tetanus and other injuries. The rate of decline of serum antitoxin levels after injection was compared and following conclusions were obtained. TAT, iv>>TIG (i), iv÷TIG (m), iv>TIG (m), im+TIG (i), iv>TIG (m), im. The peak antitoxin levels were obtained immediately following iv injection while it was reached 2-4 days after im injection. 0.01 iu/ml of antitoxin was maintained following iv injection of TIG (i) for 7±2 weeks with 1500 iu, 9±2 weeks with 3000 iu, and 2-3 weeks with 250 iu. TIG (i) is a clinically useful antitoxin for the treatment and prevention of tetanus.
Seventeen patients of tetanus were given 1500 or 3000 iu of TIG (i) iv, and 9 patients were given various amounts of TIG (m) im plus 1500 iu of TIG (i) iv. The onset time was less than 2 days in 12 cases and 7 patients required artificial respiration to control spasms. Only 2 patients died. This is a significantly less number of fatalities than 9.3 which was calculated on the basis of old records in which the patients were treated conventionally with TATeq. One hundred and two wounded patients of various severity were given either 250 or 1500 iu of TIG (i) iv for the prevention of tetanus and none developed it. A total of 128 patients were given TIG (i) iv, but no patients developed signs of shock or exanthems. 1500 or 3000 iu. or sometimes 4500 iu of TIG (i) may be given in a single dose totetanus patients according to the severity of the illness. Two hundred and fifty or 500 iu of TIG (i) may suffice for the prevention of tetanus.
This study was done to assess the incidence of group B streptococci (GBS) in the vagina of pregnant and non-pregnant women in further detailed classification into the stage of pregnancy, the phase of menstrual cycle and age groups. On cases of GBS-positive, their serotype studies were also done. The subjects of the study were the 301 outpatients (177 pregnant and 124 non-pregnant women) who visited the Department of Obstetrics and Gynecology at the Central Hospital of Japanese National Railways between April 1980 and July 1980. Vaginal specimen was obtained from each woman with sterile cotten-tipped swab that was inserted into the vagina and rubbed against the vaginal wall. The specimen was inserted into a small sterile test tube containing the sterile silicagel for transportation to the laboratory. It was placed and enriched in Pike medium and then the culture was inoculated onto a Heart Infusion medium containing 5% debrinated sheep blood. GBS was identified by the form of the colony, hemolysis, bacitracin sensitivfiity test and Phadebact Streptococcus Test for grouping, and then was examined for serotyping using the anti-sera prepared by Kanagawa Prefectural Institute. The GBS positive rate of pregnant women was 13.6%, with no variation of the rate by the stage of pregnancy. That of nonpregnant women was 21.8% with no variation of the rate by the phase of menstrual cycle. A tendency of increase of GBS positive rate by age was observed, and GBS positive rates of postmenopausal women (35.3%) is higher than that of premenopausal women (19.6%). The most frequent serotypes from pregnant women were type III (37.5%), Ia (25.0%), Ic (16.7%), but type Ib, R, IIIR were isolated less frequently. The most frequent serotypes from non-pregnant women were type Ia (40.7 %), Ic (22.2 %), R (11.1%), but type Ib, III, IIIR were isolated less frequently. Except this difference that many type III cases were seen among pregnant women and less among nonpregnant women (P<0.05), no particularly characteristic finding were not made. No statistically significant differences have been shown in the serotypes of GBS during the stage of pregnancy.
Cefopepazone (CPZ) is a newly developed antibiotic of the cephalosporin group. It has a greater antibacterial activity than any already known antibiotic of the cephalosporin group against Pseudomonas aeruginosa, Enterobacter and indole (+) Proteus. Its concentration in blood shows a half-life period which is as long as about 120 minutes. In view of these advantages, we have made clinical studies on the low dosage therapy of the medicine. We have administered 1 g of this medicine per day for 44 clinical cases. Although they includes several mild cases of infection, the medication turned out to be effective for as much as 88.6% of the cases. More specifically, the medicine was found excellent for 17 cases, good for 22 cases and fair for two cases, while it was poor for only three cases. The medicine was also effective to four of the five cases for which another known antibiotic had turned out to be ineffective. As regards the bacteriological effect of the medicine, it caused 15 of the 20 inflaming strains initially detected, or 75.0% of them to disappear. No single case was encountered with any side effect, or any abnormal result of laboratory findings, but the medicine was considered to ensure a high degree of safety in use. In view of the foregoing results, 1 g of CPZ per day would be sufficient for effective treatment of mild and moderate cases of infection.
A fatal pneumonia case is described here as the first case of Legionnaires' disease in Japan. A 64 year-old male with diabetes mellitus admitted to Nagasaki University hospital for high fever. The patient was treated with oral diabetic drugs by his general practtioner and was well until 27 October, 1980 when he felt weak to walk. The following day, he subsequently developed fever and confusion, and was admitted to our clinic as an emergency case with a temperature of 39.5° and drowsy state of consciousness.A chest X-ray showed no abnormality but the following day it showed right lower lobe infiltrates.Despite treatment with carbenicillin and then ceftezol (CTZ) and ticarcillin (TIPC), he continued to be febrile up to 41.5° and had increasing respiratory distress. The PO2 in his arterial blood fell to 46.2 torr, while receiving 100% 0 2 inhalation with 2 L/min. On the fourth hospital day his pneumonia had become panlobar .Blood culture by using commercial blood culture media was performed 5 times during the fourth hospital day, but no causative organism was obtained. At the fifth hospital day, he became hypotensive and his temperature was 40° and he was in severe respiratory failure with only scanty sputum and died. At postmortem examination both lower lobes of the lung were consolidated. Alveolar spaces were filled with neutrophils and macrophages. Lung aspirates, small amounts of lung tissue in right lower lobe, heart blood and pleural effusion were taken out during the autopsy. These materialswere inoculated directly to buffered CYE Agar and biphasic media for detection of Legionella pneu mophila, and at the same time they were also injected to guinea pigs intraperitoneally. L. pneumophila (Serotype 1) was isolated directly from lung aspirates and lung tissue homogenates, and isolated through guinea pigs from lung homogenates and pleural effusion. Direct fluorescent antibody stain oflung tissue homogenates and lung tissues samples taken at autopsy were both positive in Serotype 1. The strain isolated was identified in both our laboratory and VA Wadsworth Medical Cente r (Dr. P. H. Edelstein), Los Angeles. This organism was identified as Legionella pneumophila, serogroup I. Indirect FA titer of his serum taken at autopsy was 1: 512 in L. pneumophila serogroup. I.