As it is well known, Campylobacter jejuni is a common cause of human enteritis. This paper describes the basal examination on Campylobacter and the isolation of Campylobacter jejuni from chickens and C. jejuni, Salmonella and Rota virus from children's diarrheal stool. The optimum temperature of C. jejuni and C. fetus ss fetus was respectively 36.5°C and 32.5°C in a clinical thioglycolate medium. Both of them attained the growth plateau when they were cultured for 70 hr at 37°C. The Cary-Blair transport medium was suitable for the stool transportation, because C. jejuni exhibited a high survival rate. The isolation rate of C. jejuni, Salmonella and Rota virus from children's diarrheal stool was respectively 24.8%, 8.1% and 7.6%. C. jejuni was found through out the year, but Salmonella was found frequently in summer, while Rota virus was found in winter. C. jejuni and Salmonella were isolated irrespective of age, however Rota virus was found most (91.3% of the isolated) among infants under two years of age. Five cases were found the mixed infection of C. jejuni and Salmonella, and 2 cases were found of C.jejuni and Rota virus. C. jejuni isolated from chickens was 18 of 45 droppings (the isolation rate 40.0%), one of 9 wings (11.1%), and none of 3 minced meats. C. jejuni survived very well in milk, the number of organisms decreased gradually when stored at 25°C or 37°C, but retained the initial level at 4° C even after one week. This can not be avoidable in the thinking of infective mechanism of the oganisms.The importance of Campylobacter as a new enteropathogen was discussed.
The epidemiological re-investigation of tsutsugamushi disease has been designed in Hokuriku district, Japan. First, the prevalence of antibody to R. tsutsugamushi (Gilliam strain) among the inhabitants in a northern half of Fukui prefecture was examined. The sera of 1, 103 adults from 8 localities (14 spots) were tested by an indirect immunofluorescence technique. An average rate of antibody positive sera in the whole spots was 10.0%(ranging from 2.2 to 27.7%), and the percentage frequencies of IgG antibody titers were 52.7% in 1: 10, 33.6% in 1: 20, 9.1% in 1:40 and 4.5% in 1:80, additionally IgM antibody in 1:10 was detected in 12.7% of IgG positive sera. The higher prevalence was indicated in farmers than in the other occupations, while the deviations were not apparent by sexes or ages. It led us to a consideration of the endemic areas in this district, as the positive rates were higher in some hilly areas than in plains. Any obvious cases of tsutsugamushi disease were not proved in the present survey, though a research with questionnaires was attempted to the inhabitants in the most highly prevalent area.
A bacterial strain isolated from feces of a diarrhea patient in Toyama Prefecture, Japan, after a trip to southeast Asia in October, 1983, was identified as Shigella boydii serovar 18, both biochemically and serologically. Although the same serovar has been known to distribute in Indian subcontinent and west Asia, this may be the first report indicating that the same organism originating from southeast Asia was isolated in Japan.
The efficacy and safety of non-steroidal analgesic/anti-inflammatory agent, Flurbiprofen were compared those of Ibuprofen in patients with acute upper respiratory tract inflammation by a double blind method. The result were as follows: 1. Final glocal improvement rate in the Flurbiprofen group (120 mg/day) was 59.2% and 59.3% in the Ibuprofen group (600 mg/day), showing no significant difference between two groups. However, the cases of excellent improvement were more in Flurbiprofen group (18.4%) than Ibuprofen group (14.8%). 2. The development of the effect was early after administration of the drug in flurbiprofen group than Ibuprofen group, especially in the symptoms of muscle pain, joint pain and hoaseness (p<0.05). 3. The incidence of side effects in Flurbiprofen was 5.1% and 2.4% in the Ibuprofen group, and there was no signicant difference between two groups. 4. In global utility rate, usefulness was 60.0% in the Flurbiprofen group and 61.2% in the Ibuprofen group, showing no significant difference between two groups. However, the case of excellent usefulness were more in Flurbiprofen group than Ibuprofen group. From these result, it is concluded that Flurbiprofen is a useful drug for the treatment on acute upper respiratory tract inflammation and that the clinical efficacy and safety of Flurbiprofen were slightly better than Ibuprofen.
The usefulness of FITC-labeled monoclonal antibodies (Micro TrakTM Culture Confirmation Testand Direct Specimen Test) for the detection of Chlamydia trachomatis from clinical specimens wasstudied. For examination of the specificity of Micro TrakTM method 15 reference strains (serovar A-Kand L1-L3) of C. trachomatis and one of Chlamydia psittaci were used. The reagents of Micro TrakTMmethod reacted strongly to all 15 strains of C. trachomatis but not to a strain of C. psittaci at all. A total of1034 clinical cases were tested for Micro TrakTM method. Culture Confirmation Test brought on thesame results for detection of chlamydial inclusions as Giemsa or iodine staining after cell culture ofspecimens. Number of inclusions detected from specimens by Culture Confirmation Test tended to morethan those by Giemsa or iodine staining method, and the inclusions stained with Micro TrakTM methodwere easier to be found out. Therefore, it would be concluded that Micro TrakTM Culture Confirmation Test is superior in detection of chlamydial inclusions to Giemsa or iodine staining which are now ususallyutilized. In Direct Specimen Test negative-coincidence ratio (number of negative-Direct Specimen Testcases in negative-culture cases/number of negative-culture cases) was 89.0%. This would show thatreactions of Micro TrakTM method in direct smears were almost specific to C. trachomatis organisms. Onthe other hand, positive-coincidence ratio (number of positive-Direct Specimen Test cases in positiveculturecases/number of positive-culture cases) was 69.7%. It is suggested that positive ratio isunequivocally influenced by the method for collection of specimens and for making direct smears, andthe experience of observation with fluorescence microscopy. Therefore, the carefulachievement andskillfulness of suitable method for detection of chlamydial organisms must bring better results. It mightbe suggested that Micro TrakTM Direct Specimen Test is a really rapid and easy-to-perform method fordetection of C. trachomatis and to be performed as a substitute method for cell culture method in clinicallaboratories.
A newly developed human immunoglobulin, SM-4300, purified by ion-exchange adsorption, hasbeen studied in the surgical field. SM-4300 has been evaluated clinically in patients with severe infections in the combined use withthe antibiotics. 1. 153 patients were treated with SM-4300 and evaluated by doctors in charge. Clinical effectswere excellent in 12 cases, good in 44, fair in 39, poor in 34 and unknown in 24. 2. Out of 153 cases 82 were accepted as the evaluable cases by the committee. These cases consistedof septicemia in 13 cases, peritonitis in 29, hepato-biliary tract infections in 14, pneumonia in 7, pulmonary suppuration and pyothorax in 4 and others. The majority of patients (90.3%) had one or moreunderlying diseases. 3. Clinical effects of SM-4300 were excellent in 8 cases (9.8%), good in 37 (45.1%), fair in 21 (25.6%) and poor in 16 (19.5%). The efficacy rate was summarised as 54.9%. 4. 57 strains from 52 cases of clinical isorates were evaluable for bacteriological effects which wereeradicated in 22 strains, decreased in 8 and persisted in 27. 5. No clinical side effects were obserbed.
Of the 71 patients with community acquired bacterial pneumonia in our clinic between April, 1982and July, 1983, 67 were followed up radiographically. In 7 of them (10.4%), clearing of radiographic densities was protracted for more than 8 weeks afterimprovement of pyrexia and leucocytosis. The background of these patients and their roentgenogramswere studied. They comprised 6 males and 1 female and their ages averaged 68. 1 years. Five of themhad an underlying disease, which was mostly chronic obstructive pulmonary disease (4 cases). Furtherstudies were made on causative organisms, level of body temperature, leucocyte counts, CRP, erythrocyte sedimentation rate (ESR), and early-stage response to the treatment. Causative organismswere undetectable in most cases, and the roentgenograms obtained during manifestation of symptomsshowed nothing peculiar. The findings on pyrexia, leucocyte count, CRP, or ESR were not notably different from those in theentire cases or old-age group (32 cases). The mean duration of pyrexic, leucocytotic, and CRP-positivestates since the start of chemotherapy, which are considered to represent the earlystage response of thepatients to the treatment, were 5.8, 7.8, and 11.7 days in the entire cases. Thus, pyrexia and positive-CRP persisted approximately twice as long as the respective conditions in the entire cases. However, thedifferences involved were within 10 days and, in addition, the duration of leucocytosis did not appreciablydiffer between this group and the entire group. From the above, it was inferred that the protraction of shadow resolution was due to an abnormalprocess in a healing stage, which might possibly be associated with the fact that the remission ofleucocytosis in peripheral blood occurred earlier than the aleviation of fever and reversal of CRP.
Clinical efficacy and safety of SM-4300, a newly developed human immunoglobulin preparation torintravenous use, were prospectively compared by the cross-over method with those of Venoglobulin®-I (PEG.γ·γ G) in patients with severe infections complicated in hematological disorders. Both drugs wereadministered to the patients in whom the antibiotics alone had not been effective, at a dosage of 5.0g/day with the same antibiotics being continued. The results obtained were as follows: 1. The difference of effectiveness in cross-over trials was observed in 12 of the 26 cases. In 7 casesof the 12 SM-4300 was favorable and in 5 cases PEG-γ G was favorable. The difference, however, wasnot statistically significant. Thus the efficacy of SM-4300 and PEG.γG was almost the same. 2. Of 77 cases studied, the clinical effectiveness was evaluable in 70 cases: 34 received SM-4300and 36 PEG.γG. Clinical effectiveness was excellent in 5 cases, good in 7, fair in 5 and poor in 17 in the SM-4300 group, and excellent in 3 cases, good in 9, fair in 7 and poor in 17 in the PEG.γG group. Theefficacy rate was 35.3% in the former and 33.3% in the lateer. There was no significant differencebetween two groups. 3. No subjective and objective clinical side effect was observed in all but 1 case in the SM-4300group, in which mild dizziness and cold sweat was observed probably due to high administration speed. 4. In conclusion, clinical efficacy and safety of SM-4300 was evaluated as being equal to those of PEG.γG. Thus, combination therapy with SM-4300 and antibiotics was considered to be useful in thesevere infections complicated in hematological disorders.