H.influenzae is considered to be the most important pathogenic organism in patients with chronic lower airway infections (CLAI).But its existence and distribution of tracheobronchial trees is not clearly recognized.I made antibodies to H.influenzae (non capsulated strain) and examined the existence and distribution of H.influenzae in bronchial tissues of patients with CLAI, by using the fluorescent technique.Subjects were 8 patients with CLAI who were demonstrated H.influenzae in their aspirates obtained by transtracheal aspiration (TTA).As negative control, 2 patients with CLAI demonstrated B. catarrhalis or K. pneumaonia instead of H.influenzae by TTA were examined.Bronchial tissues were obtained from the main bronchus and segmental bronchus (By) of the patients with CLAI by transbronchial bronchial biopsy (TBB).
1.H.influenzae was not detected at main bronchus in all of 8 patient, but was detected at segmental bronchus in eight of all patients.
2.Histologically, H.influenzae was detected in the bronchial secretion and bronchial mucosa in eight of all patients, and in one of them, H.Influenzae was detected in submucosal tissue.
3.H.influenzae was not detected in the case of negative control.
From these results, it is suspected that in the lower airway of patients with CLAI, there is the place where H.influenzae tends to exist.

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Yersinia enterocolitica has become recognized as a common pathogen of gastroenteritis in childhood. The present study was carried out to assess the microbial causes of gastroenteritis and reveal the relative freaquency, clinical and laboratory features of Yersinia enterocolitica gastroenteritis.
Stool specimens, which were obtained from 3127 infants and children between January 1, 1979 and July 31, 1984, were evaluated.Pathogen included Campylobacter (14.8%), Salmonella (7.3%), Yersinia enterocolitica (1.9%), Pathogenic E.coli (31.8%), Vibrio parahaemolyticus, Yersinia pseudotuberculosis.
The isolation rates of Yersinia enterocolitica were markedly increased since 1982.In one-third of patients after the induction of cold enrichment method, Yersinia enterocolitica was isolated only by this method.
In clinical manifestations, there were no differences between Yersinia enterocolitica gastroenteritis and other types of bacterial gastroenteritis.It was noteworthy that Yersinia enterocolitica was detected from stool samples of one patient with acute appendicitis and another with intussusception.
Sensitivity testing to antimicrobial agents indicated that Yersinia enterocolitica was sensitive to gentamicin, chloramphenicol, nalidixic acid, minocycline and fosfomycin.In 12 cases treated with fosfomycin, the duration of excretion of Yersinia enterocolitica in stools ranged from 6 to 17 days.The duration of excretion was similar to those of the previous reports, in which other antimicrobial agents were used.

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For the purpose of studying the infection caused by Chlamydia trachomatis (C.trachomatis) in compromised patients with diseases of internal medicine, serum antibodies to C.trachomatis were measured by the method of micro-immunofluorescence test in Japan.
Sera from 76 patients with diabetes mellitus, 80 patients with systemic lupus erythematosus, 18 patients with malignant lymphoma, 10 patients with leukemia, 9 patients with aplastic anemia and 51 healthy individuals were obtained to detect antibodies to C.trachomatis.
The results were as follows:
1) Significant increase in the % postitivity of IgG class antibody was present in patients with diabetes mellitus (32.9%), compared with those of normal controls (11.8%).Especially, poor-controlled diabetic patients had the strong association with the % positivity of IgG class antibody (42.9%), compared with those of normal controls.
2) Slight increase in the % positivity of IgG class antibody was present in patients with malignant lymphoma (27.8%).3) IgM class antibody was also detected in 1 patient with diabetes mellitus, 1 patient with systemic lupus erythematosus and 1 patient with malignant lymphoma.The patient with malignant lymphoma showed pneumonia.C.trachomatis was suspected as the causative organism of such infection.

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In an attempt to suppress fecal flora in patient with hematological disease increasing incidence of infection, prophylactic nonabsorbable antibiotic regimen was carried out in ten patients.Ten patients were eight with acute leukemia admitted for remission induction and two with allogeneous bone marrow transplantation for severe aplastic anemia.The oral antibiotic regimen consisted of Tobramycin 720 mg/day, Vancomycin 1500 mg/day and Nystatin 300×10⁴units/day (TVN regimen).The results were obtained as follow:
1) Fecal flora was completely suppressed (undering 1×10² bacteria per 1 g feces) 2 weeks after initiation of TVN regimen.Suppression of fecal flora remained for the following 4 weeks at least.
2) Suppression of anaerobic fecal flora showed a tendency to be delayed in comparison with suppression of aerobic fecal flora.
3) Administration of TVN three times a day could suppress fecal flora.
4) During administration of TVN, Candida speicies were detected in 7 patients.
5) Concentration of Tobramycin and Vancomycin in serum, urine and feces after administration of TVN regimen were investigated.As a result, absorption of antibiotics from the intestines was a very small amount.
As mentioned above, fecal flora was completely suppressed after administration of TVN, but suppression of fungous fecal flora was unsatisfactory.Therefore, TVN regimen was thought to matter suppression of fungous fecal flora for the future.

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It has been well known that C-polysaccharide antigen of group A streptococci is extracted by nitrous acid and the agglutinating reaction is observed between this antigen and anti-C-polysaccharide antibody coated latex particles.Recently, a latex agglutination kit (Culturette Brand Ten-Minute Group A Strep ID) for the identification of group A streptococci directly from throat swabs was developed as a useful and highly rapid technique for the application of clinical use.
The purpose of this investigation was to evaluate this kit in regard to its specificity and sensitivity.
The results obtained were as follows:
1) The agglutinating reactions appeared by using 10^-1 to 10^-6 diluted fluids of the original group A streptococcal cell suspension (1.4×10⁸ cells/ml) and latex particles coating anti-group A Cpolysaccharide antibody, but the positive reaction was not observed by employing 10-7 diluted fluid of the cells.
2) Group A streptococcal cell suspension only reacted with latex particles coating anti-group A St. C-polysaccharide antibody, but group B St., group C St., group D St., group G St., St.pneumoniae, St. sanguis, St.mitior, St.mutans, S.aureus and S.epidermidis did not react with the latex particles.
3) Identification of group A St.by Strep ID test was not affected by the existence of various bacterial strains.
4) The latex particles coating anti-group A St.C-polysaccharide antibody reacted with group A St. C-polysaccharide (50ng/ml), but it did not react with C-polysaccharide of St.pneumoniae and Protein-A.
5) The reaction of strep ID test was inhibited by the addition of N-acetyl-glucosamine.
Therefore, the Strep ID test is considered to be a sensitive and specific tool to identify group A St.

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Twenty five strains (25.8%) of Clostridium difficile were recovered from the faeces of 97 cases with antibiotic-associated colitis.Seventy-five percent (9 strains from 12 cases) of pseudomembranous colitis, 17.9%(5 strains from 28 cases) of nonspecific colitis and 8.7%(2 strains from 23 cases) of the cases which did not show abnormal findings endoscopically had positive culture rate of C.difficile.
None of C.difficile strains was isolated from acute haemorrhagic colitis.Cytotoxin activity of the faeces to HeLa cells was detected in 19 faeces (83.3%) of 12 cases with pseudomembranous colitis and in 6 faeces (21.4%) of 28 cases with nonspecific colitis.
Whereas among the 16 cases with positive culture of C.difficile, pseudomembanous colitis cases accounted for 56.3%(9 cases), nonspecific colitis cases for 31.3%(5 cases) and the cases which did not show abnormal findings endoscopically for 12.5%(2 cases).
The toxin titer of the faeces in the cases of pseudomembranous colitis was significantly higher than in the cases of non-pseudomembranous colitis.It would be suggested that the toxin titer would reflect the pathogenesis or pathophysiological elements, and changing of the toxin titer in medical course would also reflect the response to the treatment.
A hamster model of haemorrhagic caecitis was produced by oral administration of antibiotics.C. difficile and its toxin were detected from the caecal contents of all the hamsters.
A haemorrhagic caecitis in hamsters was also induced by any method of oral administration of these caecal contents, faecal filtrates of pseudomembranous colitis patients or culture filtrate of C.difficile. But on the other hand, it was unable to make the caecitis in hamsters by both oral administrations of faecal filtrate of acute haemorrhagic colitis patients and culture filtrates of Klebsiella oxytoca which was isolated from the patients with haemorrhagic colitis.
It has been proved on the results of this study that the toxin of C.difficile has a significant role in pseudomembranous colitis, but the etiology on acute haemorrhagic colitis was not clear, because toxin was not detected from the faeces in this study.

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The medical records of 28 patients with Staphylococcus aureus bacteremia at the Juntendo University Hospital during a 7 year study period, 1976 to 1982, were reviewed. Bacteremias with community acquired in 12 patients and hospital acquired in 16 patients were seen.Most of the patients were 40 years of age or older.Ten of 12 patients with community acquired bacteremia had primary foci of staphylococcal infection occurring secondary to bacteremia. Patients with hospital acquired bacteremia had more serious underlying conditions than those with community acquired bacteremia.Seven of 16 patients with hospital acquired bacteremia had a malignancy and five were associated with an infected intravenous catheter for IVH.There was no patient with endocarditis secondary to Staphylococcal aureus bacteremia. Penicillin-G and ampicillin were not effective for most isolates of S. aureus from blood cultures, whereas cloxacillin, sulbenicillin, cefazolin, cefmetazole and cefotiam had an antimicrobial activity for the isolates.

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Useflueness of Fluorescent-antibody (FA) test using monoclonal antibodies to herpes simplex virus (HSV) type 1 and 2 was tested for rapid detection and serotyping of HSV.
1) Serotyping of HSV: For evaluation of specificity of FA test, 52 isolates were used. FA test showed that 31 of 41 isolates from genital tracts were HSV-1 and 10 were HSV-2, and all of 11 isolates from vesicle fluid were HSV-1.These results completely coincided with the results obtained by other methods; neutralization test, biological marker test using RL-33 cells and electrophorogram of type specific DNA.
2) Rapid detection of HSV: To examine sensitivity of FA test, MRC-5 cells were infected with serial dilution of HSV, and then harvested at 24 hr intervals after infection.FA test could detected HSV antigen as early as 24 hr after infection when 10³-10⁴ PFU/ml of HSV were inoculated to MRC-5 cells. When the cells were infected with 10¹-10³ PFU/ml of HSV, HSV antigen were detectable 48-96 hr after infection.
3) Clinical specimens from genital tracts were inoculated to MRC-5 cells which were then centrifuged for enhancement of virus isolation rate.In all of 10 specimens tested, HSV antigen was detected and serotyped by FA test at 24 hr after infection.

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An enzyme immunoassay (EIA) (Gonozyme, Abbott Laboratolies) was evaluated by a correlation of optic density (OD) reading by EIA with number of organisms of a clinical strain. According to our experiments, 10³ CFU/ml of N. gonorrhoeae was shown positive at OD reading of 0.489, and 10⁵ CFU/ml was detected at OD reading of≥2.0.
Results of EIA were compared with culture techniques and direct Gram stain (GS).Samples studied were prepared from exudate of urethral tract of 261 males and cervix of 58 females who attended a VD clinics.Compared with culture techniques, EIA had 100% and 95.5% agreements of positive results in males and females, respectively.In spite of high agreements of positive results, agreements of negative results were low: 16.7% in males and 69.4% in females .This is probably due to long duration between collection of specimens and inoculation for culture, because the length of duration was associated with low agreements.Results of EIA and cultures on the day when specimens were collected were agreed completely.Positive agreements of EIA with GS were high, 98.8%, in males and relatively low, 76.9%, in females.A low agreement was considered to be due to error of GS.Agreements of negative results were 100% in males and 94.7% in females.
Our experiments suggested that EIA be an attractive alternative as the rapid, accurate diagnosis to GS of woman patients and culture when specimens were needed to transport.

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Swine begin to produce antibody sensitive to 2-mercaptoethanol (2-ME) soon after becoming infected with Japanese encephalitis (JE) virus.This study was designed to compare the actual seropositivity rates of swine for 2-ME sensitive antibody with the rates of newly infected swine in consecutive units of time theoretically estimated by a formula derived for analysis of the spread of JE virus infection.Results showed that the theoretical units of time at which the rate of infected swine was estimated to reach a peak coincided satisfactorily with the period of an actual peak rate of swine positive for 2-ME sensitive antibody.To explore the possibility of estimating the 2-ME sensitive antibody seropositivity rate from the theoretically derived infection rate, we compared measured values for 2-ME sensitive antibody positivity rates with estimated infection rates in consecutive units of time during a course of spread of JE virus infection, by analysis using the moving sum procedure. There was a high degree of direct correlation between these two parameters;measured seropositivity rates vs.moving sum of infection rates at 2 to 5 units of time after onset of epidemic.
The results seem to suggest that it may be accomplished by use of this estimation formula to predict a general pattern of progress of a possible JE epidemic among swine of a given district in that year, before onset of epidemic.

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