This paper reports the serum antibody response to neuraminidase following immunization with various influenza hemagglutinin (HA) vaccines during the years 1978-1981. About 450 volunteers (including adults, high school students, and physically handicapped children) were inoculated with HA vaccines containing type A (H1N1) virus of various CCAeq/ml (A/USSR/92/77, A/Fukushima/103/78, A/Kumamoto/37/79), type A (H3N2) virus (AIYamanashi/2/77, A/Bangkok/1/79) and type B virus (B/Kanagawa/3/76).
The results obtained were as follows:
HA vaccines used in these studies were less potent in eliciting antibody against neuraminidase than against hemagglutinin. The seroconversion rates (rate of those who showed 3-fold or greater rise in titer) of homologous anti-neuraminidase antibody (ANAb) to vaccinated strains varied from 0 to 40%(10-40% to A/USSR/92/77, 0% to A/Fukushima/103/78, 5% to A/Kumamoto/37/79, 6% to A/Yamanashi/2/77, 12% to A/Bangkok/1/79, 0-38% to B/Kanagawa/3/76). As to A/USSR/92/77 and B/Kanagawa/3/76 strains, the pre-vaccination antibody titers may have affected the seroconversion rates. Good ANAb responses were observed in groups with low titer of pre-vaccination ANAb. Their seroconversion rates were 38-40%. ANAb responses to other strains were low (0-13%). There was no significant rise in ANAb titer to A/Fukushima/103/78, though HI antibody response to the same strain was good (67%).
From these results, ANAb responses after immunization of HA vaccine were not satisfactory, and future studies for potent vaccine are required.

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Type distribution of group B streptococci recently isolated in Japan from the infants with sepsis and/or meningitis has shown and for the purpose to investigate the relationship between serological type and virulence of strains, intracerebral challenge method has been applied.
The results were as follows;
Total of 127 strains of group B streptococci from the infants with sepsis and/or menigitis were identified from 1976 to 1982 in this laboratory. And 64.5% of them were type 111 or 111 R which had polysaccharide 111 and 29.1% were type 1a or 1c which had polysaccharide 1a. Case fatality rate of these disease with the strains having polysaccharide la was about 50%, showing significantly higher rate compared with the other type of strain.
For the discussion of the virulence of group B streptococcus, mouse virulence test by intracerebral challenge method which is the reference method of a protection test for B. pertussis, has been applied. Group B streptococci grown in Todd Hewitt broth for 18 hours were centrifuged and resuspended in steriled physiological saline and 0.025 ml of serially diluted suspension were challenged to mouse intracerebrally. Death and illness were observed for seven days after the challenge. This method seems to be useful for the comparison of virulence of group B streptococci for the following reasons. 1) There were clear dose-response relationship between challenge dose and fatality of mouse. 2) There observed clear relationship between challenge dose and survival time. 3) It was observed difference in virulence among the serotypes of strains with reproducibility. 4) Passive immunization was successfully examined with hyperimmune serum by this method.
It was confirmed polysaccharide 1a was important factor for virulence in the case of type 1a or 1c strains from the results by mouse intracerebral challenge method.

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An experimental model of intracutaneous infection in the guinea pig was utilizedin investigating the chemotherapy with lincomycin (LCM), using 23 clinical isolates of Bacteroides fragilis involving high resistant ones, and the results obtained were reported with some discussions.
The pathogenicity of B. fragilis was estimated by measuring the skin lesion diameter after 24 hours revealed by intracutaneous injection of 0.1 ml of the bacterial suspension (10⁹ cells/ml). The diameter of the skin lesion showed correlation with a number of the inoculums of B. fragilis (r=0.75, Y=0.0111X+4.06).
Administration of LCM (200 mg/kg) was carried out as follows by four groups: A; control (untreated), B; given one hour before bacterial inoculation, C; given six hours after bacterial inoculartion, D; given both one hour before and six hours after bacterial inoculation.
Peak levels of LCM in the skin lesion and serum reached 23, 7, 54μg/ml respectively and were generally exceeded the MICs except for six high resistant strains (MIC of LCM:>100μg/ml). The skin lesions in LCM therapy groups (B, C, D) were generally smaller than those of theuntreated (A, p<0.01), especially diminished effectively in the lesions caused by LCM sensitive strainsin the D group (p<0.001). The skin lesions due to high resistant strains were also diminished significantly in the D group (p<0.05). There were no significance between B and C or C and D group by a statistical analysis (t-test:ρ=ns).
This experimental animal model was simple, conventional for estimating the pathogenicity and efficacy of antimicrobial agents, but the edge of the skin lesion was often not clear if the inoculum size of B. fragilis with low virulence was smaller than 10⁷ cells/ml.

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The feces and rectal swabs from dogs in 3 different veterinary clinics for pets were obtained and cultured on Skirrow's agar for 48 hours at 37°C under microaerophilic condition.
Of 196 diarrheal dogs examined, Campylobacter jejuni were isolated from 13 dogs (6.6%). Nine (13.8%) of the 13 positive cases were from 65 dogs under one old year. However, of 209 dogs without gastrointestinal disturbance, 8 (3.8%) samples were positive. Thus the frequency of C. jejuni isolated was higher in diarrheal symptom dogs than in non-diarrheal dogs.
All isolated strains were identified as C. jejuni biotype 1 by Skirrow and Benjamin system.
Fifteen strains (71.4%) showed a positive slide agglutination reaction with our serotyping system for C. jejuni. Serotypes were TCK 1, 2, 6, 7, 10, 12, 13, 15, 16, 18, 21 and TCK 23. These serotypes were found in strains of human diarrheal cases and outbreaks. This may suggestthat dogs may act as possible sources of campylobacter infection in human.
Salmonella was isolated from 4 dogs, Yersinia enterocolitica from 2 dogs and Yersinia pseudotuberculosis from 1 dog.

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The survey on infective endocarditis, myocarditis and pericarditis in infancy and childhood in recent years was made by sending questionaire to 30 main large medical centers in Japan.
1. There were 107 cases of infective endocarditis. Eighty-one % of the cases were in ages of 1 to 11 years. In the underlying heart disease congenital heart disease was the highest incidence (90%). Nine To of all the cases were postoperative patients. Of identified causative agents 30% were S. viridans, 22% S. aureus, 19% gram positive cocci, 9% gram negative bacilli, 3% peptostreptococcus, 2% Candida albicans, 2% S. epidermidis, 3% any other strains. In 11% of the cases any agents were not revealed by blood culture.
The mortality rate accounted for 17%. Almost half of the deaths were caused by S. aureus. In 3 cases of the fatal patients any agents were not revealed by blood culture. Fifty-two of infective endocarditis were completely cured, and 31% improved. Many of improved cases developed variouse sequelae. Eighteen cases, 17% of cases died. Of the causes of death 4 cases died of cerebral lesions, 4 cases congestive heart failure. In 34% of the cases more than one of the various complications were seen. There were special relationships between mortality of infective endocarditis and its causative agents. The highest mortality was encountered in cases of Candida infection, followed by S. aureus, peptostreptococcus infection and so on.
2. There were 102 cases of myocarditis. Twenty-eight cases were infectious origin, 4 cases were rheumatic, and 70 cases were idiopathic myocarditis. Coxsackie B viruses were the most common cause of viral myocarditis. In few cases adeno, ECHO, rubella, measles, varicella and influenza viruses were recognized. Fifty-nine o7o were cured or improved. After the acute stage various kinds of sequelae developed in 24%. Those were consisted of severe arrhythmias, congestive heart failure, congestive cardiomyopathy, and mitral regurgitation. The overall mortality rate was 17%. Among the fatal cases idiopathic myocarditis was most frequent (20%). Congestive heart failure was the most common cause of death.
3. There were 32 cases of pericarditis. The patients ranged in ages from 14 days to 15 years of age. Among the infectious origins only 5 cases were viral, 5 cases bacterial, 2 cases mycoplasma pneumoniae. Eleven cases, or approximately one-third of cases were occurred as a partial manifestation of collagen disease. In 9 cases etiology was unknown. Among the 32 cases of acute pericarditis 78% improved without sequelae. They consisted of myocarditis, mitral regurgitation, myelitis and constrictive pericarditis. One case died, the mortality rate of the pericarditis being 3%.

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A survey was conducted on a population of 246 high-school girls over a period of epidemic of influenza from 1982 to 1983. In it, the effect of commercial vaccine supplied in 1982 was examined with serological reactions as indicators. The following results were obtained.
1) The vaccinated group consisted of 194 girls (78.8%) and the unvaccinated group of 52 girls (21.1%).
2) It was demonstrated serologically that influenza type B was prevalent in this population. On the 246 girls, 23 (9.3%) were found infected. They were broken into 8 girls (4.1%) of the inoculated and 15 girls (28.8%) of the uninoculated group.
3) The infection rate was compared statistically between the two groups. It was significantly higher (x²=29.1, n=1, and p<0.001) in the uninoculated than in the inoculated group. This result in dicated that the commercial vaccine supplied in 1982 had a preventive effect.
4) The fact mentioned in item 2) was also noticed in the vicissitude of HI and NI antibodies examined again before and after the epidemic.
5) Type B virus was not isolated from any other part of Japan over the period of the present survey. Therefore, it was presumed that the epidemic of influenza type B in this population of high-school girls might have been restricted to a region or an area.
Attention should be paid to the facts mentioned above when an epidemiological survey is conducted on an epidemic of influenza type B in future.

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In an attempt to prevent infections complicating bone marrow transplantation, selective intestinal decontamination was carried out in 3 patients. The antibiotic regimen consisted of oral gentamicin (960 mg/day) and amphotericin B (800-1600 mg/day) (GA).
Aerobic gram-negative bacilli initially cultured from the feces were completely suppressed within one week after initiation of antibiotic prophylaxis. On the other hand, the number of anaerobic bacteria remained unchanged during GA administration. In 2 patients GA administration extended over a period of 8 weeks. In one patient aerobic gram-negative bacilli were not isolated during antibiotic prophylaxis. In the other patient, gentamicin-resistant Klebsiella pneumoniae appeared when fecal anaerobic flora was completely suppressed by intravenous cefmetazole administration. Candida persisted in 2 patients despite the prophylaxis. The suppression pattern of the throat flora after initiation of the oral antibiotics was similar to that observed in the stool. Diarrhea, weight loss and hypocholesterolemia were noted during the prophylaxis. Nausea and vomiting were often associated with the radio-chemotherapy. During antibiotic prophylaxis enterococcal septicemia developed in one patient. This organism persisted in the patient's own stool during the antibiotic prophylaxis.
Therefore, GA is thought to produce satisfactory suppression of intestinal aerobic gram-negative bacilli and deserve further study.

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A case of Salmonella pneumonia in a patient without an underlying disease is reported.
A 67-year-old man was hospitalized because of fever of unknown origin and hemosputum in April, 1983. He had no gastrointestinal symptoms. Chest X-ray films and a computed tomography of chest showed pneumonia in right posterior basal segment. Plain abdominal X-ray film revealed a silent gall stone. Salmonella enteritidis was isolated twice from sputum and three times from stool, but four blood cultures were negative. The infection was succesfully treated with chloramphenicol and fosformycin. Although pleuropulmonary infections with S. enteritidis have been reported, this appears to be a rare case report of pneumonia with S. enteritidis which was isolated from the sputum. Sputum analysis shoud be considered as a routine procedure in evaluating patients with suspected Salmonellosis.

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A case of African trypanosomiasis, the first in Japan, was reported. The patient was a 26-year-old Japanese female. During her trip to Botuana, an endemic area of Trypanosoma rhodesiense, she was bitten by a tsetse-fly on her left thigh. On the 13th day after her return to Japan, a high fever with chills and a severe headache suddenly developed. On the 4th day after the onset of the disease, Trypanosoma protozoas were demonstrated in her peripheral blood film. Physical examination on admission disclosed no neurological abnormalities, although she had stuporous consciousness, jaundice and facial edema. Morover, neither peripheral lymphadenopathy nor hepatosplenomegaly could be observed. A brownishpurple induration of 14 mm×14 mm was noted on the lateral portion of her left thigh. The parasites in the peripheral blood were calculated to be 5, 000, 000/ml utilizing a blood cell counting chamber. Laboratory data yielded the possibility of DIG and impaired liver functions. Hypergammaglobulinemia with an elevated IgM value and unusual results when serologically tested for syphilis were also observed.
The patient was treated with suramin (Germanin, Bayer), and the parasites disappeared from her peripheral blood on the 3rd day of the therapy. The clinical course seemed favorable, and the patient was discharged on the 73rd day after her admission. Since then, no recurrence of symptoms or other abnormalities have been observed for 11 months.

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A 53-year-old male with no history of underlying disease suddenly developed fever, chills, and headache on July 27, 1982. He was treated with antimicrobial agents by his personal physician, but fever and headache continued, and vomiting occurred on the 5th and 9th of August. He was admitted to the Department of Infectious Diseases of Tokyo Metropolitan Komagome Hospital on August 10. Physical examination on admission showed a temperature of 38.0°C, blood pressure of 130/84, and no abnormal findings for the chest or abdomen. Neurological examination indicated that the patient was drowsy and that his ability to calculate was impaired. Nuchal rigidity was present.
Laboratory data was: ESR 11mm/lh, WBC 8, 400/mm3, BUN 25mg/dl, S-GOT 231U/l, S-GPT 43 IU/l, and FBS 114mg/dl. No significant microbes were recovered from urine or stool. Spinal tap study showed an initial pressure of 80 mmH₂O, total protein in the CSF 490 mg/dl, cell count 1, 138/3 mm³ with mononuclear pleocytosis, and sugar 47mg/ml.
Campylobacter fetus (C. fetus subsp. fetus) was isolated from the CSF and venous blood. Therapy using 4g/day of chloramphenicol for 7 days was attempted, but no improvement resulted. We then tried 160 mg/day of gentamicin divided into four doses by drip infusion, and an additional dose of 5 mg intrathecally; this therapy was continued for 13 days, and resulted in a favourable clinical outcome.
As pleocytosis (270/3 mm³) still persisted after this treatment, 12g/day of latamoxef (LMOX; moxalactam) was given for 14 days, after which CSF improved (to 26/3 mm³).
The patient was discharged as recovered on November 17.
A follow-up study in October 1983 showed complete clinical recovery, with the CSF data nearly normal.

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