Survey on pneumonia caused by Mycoplasma pneumoniae was performed in Kanagawa prefecture from 1983 to 1985. The disease was diagnosed by isolation of M. pneumoniae from throat swabs of patients with primary atypical pneumonia (PAP). In addition, several kinds of media were examined on the utility for M. pneumoniae isolation.
A total of 173 strains of M. pneunomiae (35%) were isolated from 493 PAP patients for 3 years. The number of isolates and isolation rate in each year were as follows; 23 (24%) in 1983, 115 (51%) in 1984 and 35 (20%) in 1985. Thus, the highest isolation rate was recognized in 1984. The pattern of monthly isolation in 1984 showed that epidemic of M. pneumoniae pneumonia occurred in the period from June to November, with an peak in July.
M. pneumoniae pneumonia began to appear among school children chiefly aged 7 to 9 years in the latter half of pre-epidemic year. Although the occurrence of the disease in those children increased in June of epidemic year, a total occurrence in children aged 4 to 12 year increased in the period of summer vacation from July to August. These results suggested that M. pneumoniae infection was introduced into families by the school children above and that infection in families occurred frequently during summer season with the epidemic peak.
Pneumonia caused by M. pneumoniae were found frequently in children aged 4 to 12 years, whereas the occurrence of the disease was a little observed in children less than 3 years old. The incidence of the disease in PAP increased with age of the children.
As for isolation medium of M. pneumoniae, diphasic medium containing 15% of heated (56°C, 30min) horse serum was slightly more effective than ordinary one containing 20% of unheated serum. Diphasic medium containing 10% of gammaglobulin free calf serum and egg yolk medium were useful for M. pneumoniae isolation. As compared with the unheated horse serum medium above, these two media shortened incubation days for the isolation, whereas the isolation rates by them were lower. Therefore, it was considered that combination use of these three media was more effective for M. pneumoniae isolation.

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β-hemolytic streptococci, particularly members of Strebtococcus bvogenes, are important pathogens which cause various acute infections and post-streptococcal diseases. It is not uncommon that organisms of S. pyogenes are isolated from the throat of apparently healthy children. Therefore, the etiologic significance of a small number of S. pyogenes detected from children with symptoms of upper respiratory infections has not been determined yet. Thus there have been few laboratories which use a selective enrichment broth for detection of S. pyogenes.
We made a clinical evaluation on the employment of a selective enrichment broth (SEB, Nissui Seiyaku) in detecting S. pyogenes from throat specimens of children, who visited the outpatient clinic at our hospital. It was observed that even a small number of S. pyogenes only detectable by employment of the SEB showed an etiologic relationship with the disease. The results indicated the usefulness of the SEB for culturing throat specimens from the children.

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For the prevention on neonatal infection due to group B streptococcus (GBS), we determined the serum concentration of human IgG antibody to the GBS type III and cultured the lower vagina of pregnant women.
Antibody was measured by an ELISA using the TCA extracted antigen and the goat antibody to human IgG coupled to horse-raddish peroxidase as the secondary antibody.
The ELISA indicated that the coefficient variations of inter-assay and intra-assay were 7.8%, 5.6% respectively. Sera were collected from 994 pregnant women. The mean+/-SD of antibody in sera was 0.311+/-0.196 by absorbance.
The holders of antibody were 125 cases (12.6%) when the antibody holder assumed more than 0.507 corresponding to+1SD.
297 vaginal cultures were tested. 35 samples (11.8%) wre postivie for GBS. In the GBS positive cases, 4 cases were type III (11.4%).
Concerning antibody levels of carriers of GBS type III, some GBS type III carriers had lower antibody levels than non-carrier pregnant women. These cases should be followed up through the course of time with perinatal care. We are presently following up these cases.

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Anti-HTLV-I antibody and anti-HIV antibody were measured by ELISA in hemophiliacs, patients of hemodialysis or nephrosis syndrome and blood donors in order to investigate the infection of acquired immunodeficieny syndrome (AIDS) and adult T cell leukemia (ATL).
With regard to anti-HTLV-I antibody, 4 out of 13 cases (30.8%) in hemophila, 21 out of 75 cases (28.0%) in renal desease and 12 out of 500 cases (2.4%) in blood donor were positive, respectively. With regard to and-HIV antibody, both Abbott and Litton assays were evaluated in those patients. Antibody titers correlated well statistically in two assays, but false positive cases were found in 16 cases (2.7%) by Abbott and 5 cases (0.9%) by Litton out of 558 cases, respectively. Ten out of 13 hemophiliacs (76.9%) were positive of and-HIV antibody, but no case was positive in patients of renal desease and blood donors. Immunological investigation reveals that OKT4/8 ratio was remarkably lower (0.86) in anti-HIV antibody positive cases than in negative cases.

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Geographically extension of epidemics on Influenza (area-to-area spread) was surveyed during the epidemic period from 1985 to 1986 in Kyushu island. Among 36 intensive B zones of Person Trip Survey organized by several administrative areas in Fukuoka prefecture, when the correlation coefficients were caluculated between person trip and spread of epidemics regarding each intensive B zone as the starting point of influenza epidemic, these of Kokurakita and Tobata zones of Kitakyushu city, which were r=-0.355 (n=33) and r=-0.409 (n=24) each, were statistically significant at 5% level. Furthermore, the area-to-area spread of influenza epidemics was visualized on the isopleth map of Kyushu island on the basis of the closure in class or school. With respect to the isopleth patterns, there are the differences between north and south area of Kyushu island, and between virus types.

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The Gonochek-II test kit (E-Y Laboratories, INC.) is a rapid identification system for pathogenic Neisseria species. This kit consists of oxidase swabs, Gonochek-II tubes, and 13-lactamase tubes. We evaluated the kit especially for routine use in diagnostic laboratories. One hundred fourteen strains of N. gonorrhoeae, 55 strains of N. meningitidis, 10 strains of N. lactamica, and 9 strains of M. (B.) catarrhalis were tested with this kit. Gonochek-II identified 100% of N. gonorrhoeae, N. lactamica, and M. (B.) catarrhalis, and 98% of N. meningitidis. The kit also detected all strains of β-lactamase producing N. gonorrhoeae and M. (B.) catarrhalis. The minimum concentrations required for confirmation with Gonochek-II tubes were 3.2 × 10⁸ CFU/ml for N. gonorrhoeae, 3.2 × 10⁹ CFU/ml for N. meningitidis, and 1.0 to 3.2 × 10⁸ CFU/ml for N. lactamica. The β-lactamase tubes require at least 0.5 to 1.0 × 10⁸ CFU/ml for both N. gonorrhoeae and M. (B.) catarrhalis. Because of the simple procedure, the small inoculum requirement, and the quick, reliable results, Gonochek-II test kit can be an extremely usuful and economical alternative to conventional testing methods.

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The captured-ELA [CMV-IgG-ELA (Enzyme Linked Immunosorbent Assay with direct peroxidaselabelled Antigen) kit: medac] method, measuring the specific IgM antibody without the involvenent of nonspecific reactions such as reumatoid factor (RF), has been used for a rapid diagnosis of cytomegalovirus (CMV) infection. The results obtained with this method were summarized as follows. 1) The ELA assay kit system did not react with RF. 2) The sensitivity in the ELA assay was simiar to that in ELISA when the IgM fraction was used. 3) In the primary CMV infection of new born babies, the virus was isolated from every cases (6/6) when their IgM antibodies were positive. 4) The IgM antibody to CMV was substantially demonstrated with the paired sera from the patients with CMV infection. 5) In new born babies having CF antibody to CMV, the proportion of IgM antibody positives was 11.7% and 31% within 13 days and 30 days after the delivery. 6) In an acute lymphatic leukemia (ALL) case, accompaning with the consistent liver injury, the IgM and hightitered CF antibodies to CMV were noted for longer period (2 years). From the foregoing results it is concluded that the captured ELA method can be used for a rapid serologic diagnosis for the CMV infection.

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T cell line specific for R. tsutsugamushi antigen was established by the long term culture of splenocytes from mice immunized with live Gilliam strain of R. tsutsugamushi and was propagated in the presence of homologous rickettsial antigen and syngeneic filler cells. The characteristics and the capacity to induce anti-rickettsial protection in vivo of the T cell line were studied. Flow cytometrical analysis demonstrated the T cell line had a phenotype of Thy 1.2⁺, L3T4⁺, and Lyt2^-. The T cell line produced gamma interferon, one of macrophage activating factors, in cultures with specific antigen and could adoptively mediate anti-rickettsial protection in vivo. It is concluded that antigen-specific helper T cells play an, important, g role in the protection anainst rickettsial infection.

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We report two cases of pulmonary nocardiosis during treatment of long term prednisolone administration for systemic lupus erythematodes. Nocardia asteroides was detected from sputum in both cases. They improved with minocycline and ST compounds, but case 1 was recurrent after 6 months of onset.
Visceral nocardiosis reported in Japan has a tendency to increase, and most of them appear in immunocompromised hosts. The prognosis is dependent upon not only the severity of underlying disease but involvement of the central nervous system. As we have effective medications against this disease, healing can be expected even if in immunocompromised host, and it is necessary to try for early diagnosis and early treatment.

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An 84-year-old man born in Matsuyama city, Ehime prefecture, was admitted to Ehime University Hospital on June 5, 1985, because of cutaneous abscesses. Neck and inguinal abscesses with fistula and generalized lymphadenopathy were recognized. Cryptococcus was detected from both abscesses and lymphnodes. Chest X-p showed no abnormal shadow. Abnormal lymphocytes with lobulated or convoluted nuclei were found in 1.0% of peripheral leukocytes. The ATLA antibody was positive. Bone marrow smear showed normal myelogram. Cerebrospinal fluid was normal. Responses of peripheral lymphocytes to PHA and PWM were extremely decreased.
According to these data, the patient was diagnosed as smoldering adult T-cell leukemia with generalized cryptococcosis. In this case, it was suggested that generalized cryptococcosis was caused by decreased cellular immunity in ATL.

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A 16-year-old woman who used a tampon during her menstrual period presented with a high fever, sore throat and serious shock associated with typical TSS symptoms. With intensive care she gradually improved and all the acute symptoms resolved by the 12th day from onset. Fine desquamation of affected skin, and peeling of palms and soles were observed during convalescence. Staphylococcus aureus was isolated from a tampon used and a vaginal fulid. The isolate produced toxic shock syndrome toxin-one (TSST-1) but did not produce enterotoxins A-E, and coagulase type VII. This is the first report of toxic shock syndrome from which TSST-1 producing Staphylococcus aureus was isolated from a tampon and a vaginal fluid.

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