In order to study on Immunoglobulin Response in pertussis were used 40 blood samples from 20 children infected with pertussis. Serological methods used for this study were Bacterial agglutination test and Sucrose density gradient centrifugation. The results obtained are summerized as followed: 1. In patients, the appearance of 19S antibody was detected in 100% of the cases at the first week, and the 19S antibody persisted for long-term. 2. The appearance of 7S antibody was detected later than 19S antibody, and was detected in 100% of the cases at the seventh to eighth weeks. Whereas, in reinfection, it was detected at the first week. 3. The appearance of the IgA polymer followed 19S antibody, it was detected in theabout 30% of the cases at the second to sixth weeks. 4. In regard to the sedimentation pattern and agglutinin titer, it was found that the agglutinin titer rose in the sequence of negative, 19S, 19S+IgA polymer, 19S>7S, 19S=7S+IgA polymer, 19S<7S.
The study group consisted of 56 patients in acute stage of typhoid fever, 35 men and 21 women, who admitted to Tokyo Metropolitan Toshima Hospital between January 1.1970 and December 31. 1979. All of the patients without hypertension or any other cardiac disease, revealed S. typhi in blood or stool culture and were examined body temperature, blood pressure, electrocardiogram, chest X-ray film, complete blood count, serum electrolytes, GOT, GPT, LDH and Al-P on admission. Twenty-five (44.6%) of 56 patients demonstrated some abnormal electrocardiographic findings (abnormal ST-T change: 9 patients, QTc prolongation over 0.45 sec.: 9 patients, first degree A-V block: 5 patients, premature ventricular contraction: one patient and complete right bundle branch block: one patient) and the remaining 31 cases (55.4%) showed normal findings. The longer bacteremia S. typhi remained, the more abnormal electrocardiographic findings found. Because the incidence of abnormal findings was indicated 20.0% during one to 10 days after onset of typhoid fever, 40.0% during eleven to 20 days and 77.8% during twenty-one to 30 days. Ten (18.9%) of 53 patients whose chest X-ray film we were able to study showed CT ratio more than 50% and eight of them were disclosed abnormal electrocardiographic findings. These results indicate that cardiac enlargement may be associated with abnormal electrocardiographic findings. Relative bradycardia, one of the trias of typhoid fever, was confirmed in this study group. However, in the patients having severe anemia less than 10 g/dl of hemoglobin we could not find out the relative bradycardia. And the relative bradycardia was not thought as the clinical manifestation of myocarditis caused by S. typhi because it was little related to QTc prolongation, A-V block, cardiac enlargement and elevation of GOT, GPT and LDH.
The indirect immunoperoxidase (IIP) technique was assessed for detection of human IgG antibodies against Toxoplasma gondii. First, 100 sera were tested for the IIP technique using peroxidase (P0)-conjugated goat IgG fraction against human IgG: Fc and human IgG: F (ab') 2. Secondary, the antibody titers determined by the IIP technique were compared with those by the indirect immunofluorescence (IIF) technique using isothiocyanate sothiocyanate (FITC)-conjugated rabbit antiserum against human IgG (gamma chain), and those by Latex agglutination (LA) test using Toxotest-MT (Eiken). Thirdly, some technical problems were clarified. The results obtained are as follows: 1) Either goat or rabbit antiserum against human IgG contained the toxoplasma antibodies. Therefore, it was prerequisite to absorb the secondary sera with the toxoplasma cells before use. 2) Nonspecific staining (polar staining) due to normal IgM bound to the surface of the toxoplasma cells was observed by the IIP technique using anti-F (ab') 2 antiserum but not by the IIP nor by the IIF technique using gamma chain-specific antibodies. 3) Out of 100 sera tested, 33 were positive for the toxoplasma antibodies by both the IIP (1: 20 or greater) and the IIF techniques (1: 10 or greater), with a correlation between antibody titers determined by each method; 67 sera was negative for the toxoplasma antibody by either method. Since some negative sera (4 out of 67) were positive at 1: 10 dilution with anti-F (ab') 2 but not with anti -Fc antiserum, a serum with antibody titer of 1: 20 or greater was decided to be positive for the toxoplasma antibody. 4) Out of 94 sera tested, 25 sera were positive for the toxoplasma antibodies by the LA test (1: 40 or greater). All but one of the LA positive sera were also positive by the IIP technique (1: 20 or greater). Sixty-three sera were negative by both the LA test and the IIP technique. Six sera were questionally positive at 1: 20 dilution by the LA test; 2 of 6 sera were negative and 4 of 6 sera were positive by the IIP techni que. In conclusion, the IIP technique is useful for quantifying anti-toxoplasma IgG antibodies, with several advantages over the IIF technique.
Extrapulmonary tubercular lesions generally result from extention or dissemination from a pulmonary infection. Immunodeficiency is assumed to predispose uremic patients to dissemination. In order to elucidate the characteristics of extrapulmonary lesions accompanied by pulmonary tuberculosis in uremic patients, I made an epidemiological study. The subjects were 4722 males and 2552 females receiving chronic dialysis in 161 institutions. Patients with pulmonary tuberculosis were 59 males and 26 females among 84 male tuberculars and 53 female tuberculars on dialysis. Fourteen males and thirteen females have pulmonary tuberculosis accompanied by extrapulmonary lesions. Dialysis patients with pulmonary tuberculosis accompanied extrapulmonary lesions more frequently than patients in non-uremic stage. Pulmonary tuberculosis with extrapulmonary lesions showed worse prognosis than that without extrapulmonary lesions. Fatality became higher along with the increment of the number of organs tuberculously involved. Pulmonary tuberculosis in dialysis patients was accompanied by tubercular lesions in almost all extrapulmonary organs except brain and muscle. Frequency of involvement differed from organ to organ. The fatality of the patients was low, when frequently involved organs suffered. On the other hand, the fatality became high, when infrequently involved organs suffered. The fatality of the patients was almost reversely correlated with the frequency of organ involvement. Extrapulmonary organs which showed high fatality were observed among dialysis patients but were not observed among non-uremic patients.
Specific etiological cause was not used as the primary factor in the preparation of the discriminant function on the food poisoning outbreak prediction chart. In preparing the discriminant function chart, data on the meteorological factor obtained from the Tokyo Meteorological chart, and the studies made on the actual cases of food poisoning outbreaks in Tokyo Metropolitan, which are quite numerous, were used. By combining the following three factors, the direct varimax method, the multiple regression analysis, and the discriminant analysis, we were able to prepare the discriminant function chart that will give 65-68% accuracy in the prediction of food poisoning outbreak. It is believed that the discriminant function chart can be used in verifying that the condition of the day of the food poisoning outbreak was such that the food poisoning would have broken out. The chart can also be used to predict any future food poisoning by applying the data obtained on the climatic factor of the day preceeding the date the prediction is desired against the discriminant function chart.
The therapeutic effectiveness of CLDM-P was investigated in a well-controlled study using LCM as control in the treatment of acute pneumonia due to gram-positive cocci, mycoplasma and anaerobic organisms. CLDM-P and LCM were given intramuscularly in a dose of 600 mg twice dailyfor a period of two weeks, as a rule. Out of 30 patients treated with CLDM-P and 27 with LCM, 46 were accepted for evaluation as cases of acute pneumonia. Eighteen (18) of them received CLDM-P and 19 LCM for bacterial pneumonia and another 5 CLDM-P and 4 LCM for mycoplasmal pneumonia. CLDM-P and LCM proved effective in 88.9% and 89.5% of patients with bacterial pneumonia respectively. They were also effective in 100% of patients with mycoplasmal pneumonia respectively. No significant difference was noted between two treatment groups in the incidence of side effects nor in the degree of utility as rated by doctors incharge. These findings indicate that CLDM-P is as useful a drug as LCM in treating acute pneumonia.
The therapeutic effectiveness and side effects of CLDM-P were investigated in a series of double blind studies using LCM as control in the treatment of acute pneumonia. These studies were conducted in 25 institutions throughout the country on 119 cases. Twenty-five (25) out of these cases were excepted from evaluation and 94 cases were evaluated. A dose of 600 mg of the compounds were dissolved in 200-300 ml of aqueous sugar solution or normal saline solution and given by drip infusion over an hour twice a day with a 12 hours interval. Evaluation was made on 50 patients treated with CLDM-P and 44 with LCM. General improvement was shown in 88.0% of the CLDM-P group and 93.2% of the LCM group; both drugs proved highly effective, with no significant difference between them. As for symptoms or clinical findings, the CLDM-P group showed significantly better improvement or improving tendency than the other in some evaluation items, probably because CLDM has higher activity than LCM. No significant difference was noted between two treatment groups in the incidences of side effects and abnormal laboratory values. It may be concluded that CLDM-P is effective in treating acute pneumonia.
The efficacy and safety of miroprofen, a new non-steroidal analgesic/anti-inflammatory agent, were compared those of ibuprofen in 179 patients with acute upper respiratory infections by a double blind method. Patients were administered either miroprofen 150 mg t.i.d. or ibuprofen 300 mg t.i.d. for 4 days. The results were as follows; 1. In final global improvement rating, clinical improvement was 89%(70/79) in miroprofen group and 83%(70/84) in ibuprofen group, showing no significant differences between two groups. 2. In overall safety rating, adverse effects were 8%(7/83) in miroprofen group and 3%(3/86) in ibuprofen group, showing no significant differences between two groups. 3. In improvement of severity rating on hoarse voice and pharynx redness on 2nd day, and headache on 4th day, miroprofen group was significantly superior to ibuprofen group (p<0.05). 4. In global utility rating, usefulness was 81%(64/79) in miroprofen group and 81%(68/84) in ibuprofen group, showing no significant differences between two groups.