Experimental Pseudomonas pneumonia was induced in normal mice by intratracheal inoculation of P. aerugionosa NC-5. The LD₅₀ of this bacteria was 5.1×10⁶ colony forming units per mouse.
The number of bacteria in lungs increased without initial clearance after inoculation of 1×10⁷ colony forming units per mouse and all mice died within 24-48 hours after inoculation.
Bacetria appeared in the blood of pneumonia mice 6 hours after inoculation and the number of bacteria in blood increased gradually.
Histopathological examination of pneumonia mice showed typical findings of Pseudomonas pneumonia with hemorrhage.
The effect of antibiotics such as ceftazidime and gentamicin was evaluated using this murine Pseudomonas pneumonia.

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We reported previously an clinical analysis of the three quarters of 147 patients with septicemia due to six common organisms such as E. coli, α-streptococcus, S. aureus, P. aeruginosa, K. pneumoniae and B. fragilis during 16 years (1968-1983) in the vol.60, No. 5 of the journal of Japanese association for infectious disease. Among remaining one quarter of the patients due to rare organisms, there are not a few noteworthy instances in clinical practice. We now focused on such 39 patients in order to reveal clinical features.
Causative organisms in these patients with septicemia consisted of 14 strains of non-fermentative Gram negative rods, 10 of Enterobacteriaceae, 4 of Salmonella species, 2 of Neisseria species, and one of S. pneumoniae. All these patients were suffered from septicemia due to single organism. Most of underlying diseases in these patients were non-fatal. Septicemia due to cocci, anaerobes, C. perfringens and Salmonella species were generally community acquired. On the other hand, those due to non-fermentatives and Enterobacteriaceae were hospital acquired. Non-fermentatives and Enterobacteriaceae have a tendency to cause shock. Mortality of these patients with septicemia due to rare organisms was 23% in contrast to the 33% due to common organisms. Among the former, mortality rate in patients with septicemia due to non-fermentatives and Enterobacteriaceae was high as the latter.
There were many noteworthy instances of septicemia and infective endocarditis due to rare organisms such as Peptostreptococcus species, N. mucosa, S. marcescens, F. meningosepticum, Ngonorrhoeae, A. hydrophila, A. calcoaceticus, and P. multocida. A great majority of these cases had already reported in this journal and etc.

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Thirty-eight patients with diffuse panbronchiolitis (DPB) and 9 patients suffering from other maladies were administered a multicomponent vaccine consisting of toxoids of protease (P), elastase (E) and exotoxin (Ex) and a common protective antigen (OEP). Antibody titers were estimated by ELISA.
Antibody levels rose markedly within 2 to 3 months after administration and maintained high levels thereafter.
The 38 cases of DPB were divided into two groups: Group I showing formation of P. aeruginosa colonies in sputum and Group II showing no formation. Antibody titers of the four antigens in the two groups were compared after vaccination. Group I had higher antibody titers for the four kinds of antigens before vaccination than Group II. This difference was especially pronounced in the case of OEP and Ex antigens. However, both groups demonstrated higher levels of the four antibody titers after vaccination than before vaccination.
We then determined the antibody titers for the four antigens which were found to maintain the same levels for more than six months and compared them between the two groups. The maintained levels of antibodies against OEP and E were found to be significantly higher (p<0.05) in Group I than in Group II. However, no difference was found between the maintained levels of antibodies against P and Ex in the two groups.
These results show that the multicomponent vaccine raises antibody titers against OEP, P, E, and Ex in DPB patients regardless of whether P. aeruginosa colonies are formed in sputum specimens, and that approximately the same levels of antibody titer are maintained in cases showing no bacterial colony formation in sputum specimens as in cases which show colonization.

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The clinical effectiveness, safety and usefulness of HAPA-B, a new aminoglycoside, in the treatment of respiratory tract infections were compared with those of amikacin (AMK) ina double blind study.
The following diseases were included in this study; bacterial pneumonia, pulmonary suppression, infectious exacerbation of chronic bronchitis and diffuse panbronchiolitis and chronic respiratory tract diseases with infection (bronchiectasis, pulmonary emphysema, lung fibrosis, bronchial asthma).
HAPA-B and AMK were intramusculary administered twice a day for 14 days, at a daily dose of 400 mg of both drugs (one ampoule containing 200 mg).
The following results were obtained.
1) Case distribution
Total cases administered HAPA-B or AMK were 218 patients. Out of these cases, 185 patients (HAPA-B 98, AMK 87) were evaluated on clinical effectiveness, 207 (HAPA-B 108, AMK 99) on side effects, 193 (HAPA-B 102, AMK 91) on laboratory findings, 182 (HAPA-B 96, AMK 86) on usefulness.
2) Clinical effectiveness
Out of 98 patients in HAPA-B group, one patient was judged as “Excellent”, 65 as “Good”, 9 as “Fair”, 23 as “Poor” and the efficacy rate was 67.3%. On the other hand, out of 87patients in AMK group, one patient was judged as “Excellent”, 56 as “Good”, 10 as “Fair”, 20 as “Poor” and the efficacy rate was 65.5%. There was no significant difference between two groups.
However, the improvement rates of HAPA-B group in cough, dyspnea and volume of sputum were significantly superior to those of AMK at 3rd or 7th day after administration.
3) Bacteriological effect
Bacteriologically, the eradication rate of 60.6% was observed out of 66 clinical isolates in HAPA-B group and it was 59.5% in 42 clinical isolates in AMK group. There was no significant difference between two groups.
4) Side effects and abnormal changes in laboratory findings
Side effects were observed in 3 of 108 patients (2.8%) with HAPA-B and 6 of 99 patients (6.1%) with AMK. Allergic symptoms were observed in both groups but pain at the injection site and dizziness were observed only in AMK group. Abnormal changes in laboratory findings were observed in 20 of 102 patients (19.6%) with HAPA-B and 27 of 91 patients (29.7%) with AMK after administration. Elevations of BUN and s-creatinine were observed only in AMK group, while eosinophilia and elevation of transaminases were observed in both groups. There was no significant difference between two groups.
5) Usefulness
The usefulness of HAPA-B group was 65.6% and that of AMK was 62.8% judged by committee members. The usefulness judged by doctors in charge of HAPA-B group was 65.2% and that of AMK was 54.8%.
There was no significant difference between two groups.
6) From the above results, it was concluded that clinical effectiveness of HAPA-B was at least equal to that of AMK in the treatment of respiratory tract infections and because of no adverse reaction to renal and auditory functions, HAPA-B was considered to be a useful aminoglycoside.

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The clinical efficacy and safety of HAPA-B, a new aminoglycoside, was investigated fundamentally and clinically by intravenous drip infusion for internal (81 Cases) and urological (101 Cases) field infections. The following results were obtained.
1. After 1 hour infusion of 200 mg of HAPA-B, the mean value of peak serum and plasma concentration was 14.13±4.44μg/ml at the termination of infusion. In patients with impaired renal function, the plasma concentration of HAPA-B tended to be maintained higher and urinary recovery rates after 12 hrs found decreased in parallel with the decreased value of creatinine clearance.
2. Clinical efficacy of HAPA-B on internal field infections were 70.5%(43/61) for respiratory tract infections, 100%(6/6) for urinary tract infections and 100%(7/7) for other infections, respectively, with a total effectiveness rate of 75.7%. Its bacteriological efficacy was 62.5%.
3. Clinical effectiveness rate of HAPA-B on urological field infections was 61.2%(60/98) by doctor's evaluation. According to the criteria of UTI committee, the effectiveness rate was 54.9%(50/91) and the bacteriological efficacy was 68.3%.
4. Clinical symptoms seemed to be side effects were observed in three cases (1.6%) of 182 cases and abnormal laboratory findings were observed in nine cases. But all of them were transient without severe reactions observed.
5. It was suggested from these investigations that intravenous drip infusion of HAPA-B was as effective and safe as intramuscular injection. Therefore, the intravenous drip infusion of HAPA-B will be useful for treatment of infections.

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A total of 2, 559 patients attending the gynecological outpatient clinic with various complains were attempted to detect Chlamydia trachomatis (C. trachomatis) by the direct immunofluorescent test (Micro Trak^TM) method for confirmation of occurrence rate of C. trachomatis in a female genital tract.
107 cases (4.2%) showed positive reaction. Positive rates according to thier occupations were as follows; student (14.1%), fuzokueigyo worder such as a salacious night club etc. (10.1%), self-employed worker (5.9%), office worker (5.5%) and house wife (2.4%). The students and fuzokueigyo workers exhibited a tedency to high rate than the others.
Positive rates according to the ages showed a tendency to fall with increasing age as follows; under 20 years old (9.4%), 21-30 (4.9%), 31-40 (3.1%), 41-50 (2.1%) and over 51 years (1.1%).
On the other hand, positive rates relating to thier chief complains are as follows; pregnancy 6.0%(student 12.5%, fuzokueigyo worker 12.5%, self-employed worker 10.5%, office worker 9.2% and house wife 2.7%), sterility 16.7%, examination for venereal disease 13.3%, genital discherge 7.0%, irregular genital bleeding 4.8%, discomfort of vulva 3.6% and screening of uterine cancer 1.4%. The high positive ratio was observed in pregnant single women, the patients of sterility and the patients requested the examination for venereal disease.
The author almost reported 2.3%(25 out of 1, 096 cases) C. trachomatis occurrence (Micro Trak^TM method) by cancer screening cytological materials. Combined with these paper, we may say that general occurrence rate of C. trachomatis is about 2-3% in housewives over 30 years in Japan.
Younger patients under 20 years occupy 26.2% of all positive cases, while under 30 years 69.2%, indicating marked increase in younger ages.
Sexual liberation promoted by prevalence of pills and enhanced sexual activity in the adolescent will bring about increase of STD including C. trachomatis to the level of USA and Europian countries in future, in our country. Socio-medical measures are urgently required for the prevention of these STD.

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A case of antibiotics-associated pseudomembranous colitis (PMC) due to a toxin produced by clostridium difficile was reported.
A 78-year-old woman had received intravenous injection of cefazolin 4 g/day for 16 days, cefoperazone 3 g/day for 3 days, and ticarcillin 10 g/day for 12 days because of pneumonia with heart failure. Fourteen days after the cessation of antibiotics therapy, bloody stools with mucus developed. The colonoscopy revealed an edematous mucosa with numerous small yellowish-white plaques indicating PMC. C. difficile of over 10³/g and its toxin with high titer were detected in the stool. Administration of vancomycin 1.5 g/day for 8 days led to rapid recovery.
As far as we know, this case is the first case of PMC possibly associated with ticarcillin. Clinicians should be alerted to the possibility of the occurrence of such a complication in patients being treated with ticarcillin.

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We reported two cases of chronic Shistosomiasis japonica infected in the Tone River Basin of Saitama Prefecture. There were several reports about schistosomiasis in the lower Tone River basin around Tokyo. As the intermediate host of the disease, Oncomelania snail, lives at the very edge of the river and moves easily at the time of overflow, it is suggested that there was an outbreak of schistosomiasis in the upper river beds of Saitama Prefecture. Patients in this report lived in Saitama Prefecture, very near to the Iruma River and the Naka River. They were operated surgically under another diagnosis, and many old eggs of Schistosoma japonicum without calcification were found in the ectomized organs. A case with the gastric cancer provided the interesting suggestion correlated with the possibilities of carcinogenicity of Schistosoma infection. There seemed to be little possibility of new infections because no snails could be found around these area. However, these cases indicate much more latent patients in Saitama Prefecture.

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