The sequential events occurred in the intracellular growth cycle of Chlamydia trachomatis (from genital origin) in McCoy cells were studied under electron microscope, with special reference to their ultrastructures.
Elementary bodies (EBs) were short oval, 0.41-0.50μm in diameter, enclosed by the outer cell wall (CW) which consisted of trilaminar membrane (9-10 nm in thickness), and the inner obscure cytoplasmic membrane (CM). Between them (CW and CM), a peptidoglycan like susbstance was recognized 9-10 nm in width. The electron dense nucleoid was usually located eccentrically. Most EBs are adsorbed in the host cell surface at the opposite side of the nucleoid. The invasion process of the infectious EBs took place in the way of the phagocytosis of the host cells, starting as early as 30 minutes after inoculation, and finished in 1 hour.
The EBs converted to the intermediate forms (IFs, 0.6μm in diameter) in 1 to 3 hours, the cytoplasmic membrane became prominent, and some IFs were digested by the phagolysosomes.
The reticulate bodies (RBs) or the vegetative form (0.6-1.5μm in diameter) appeared in 6 hours. The cytoplasmic membrane turned out to be a trilaminar membrane (7-9 nm in thickness) as the cell wall was 8-9 nm in thickness. Between them was a peptidoglycan like substance (7-10 nm in width). The nucleoid from DNA fibers was untied, each center of the RBs becoming a low dense area. They began to multiply by a binary fission mechanism in 12 hours. Most RBs were adhering to the limiting membranes of the inclusions after 24 hours.
The maturing conversion from RBs to EBs through late IFs took place in 36 hours. The growth cycle was completed in 48 to 72 hours.
In some RBs, the following specific structures or ladder structures were often observed. Regularly arranged (at intervals of 15-20 nm) radial bridges (10-15 nm in width) crossed the two separated membranes (CW and CM) perpendicularly. The structures may have a role to enable the growing RBs to keep adhering to the limiting membranes of the inclusions, taking the essential substances from the host cells for their growth.

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A rapid annual increase of respiratory infections with Branhamella catarrhalis and β-lactamase producing strains have been noted in our clinic. During the last decade, we have experienced 186 cases (239 episodes) of respiratory infections: 13 pneumonia (14 episodes), 24 acute bronchitis, 87 chronic bronchitis (115), 12 chronic bronchobronchiolitis (18), 28 bronchiectases (39), 15 choronic pulmonary emphysema with infection (19) and 7 bronchial asthma with infection (10).
All of the patients with pneumonia caused by this organism had a underlying disease and in 11 (78.6%) of the 14 episodes B. catarrhalis was isolated as one of the polymicrobial agents coexistent with other organisms. One patient with pneumonia died and a few patients failed to be treat successfully with β-lactams. Acute bronchitis developed in 6 previously healthy young, and 87.5% of the patients yielded a pure culture of B. catarrhalis in the sputum.
B. catarrhalis was isolated as the only bacterial pathogen in the sputum from 116 (57.7%) of the 201 patients with chronic lower respiratory tract infection and in combination with H. influenzae, S. pneumoniae or others in 85 (42.3%) of the 201. Twenty-four patients of B. catarrhalis infection isolated from the sputum as a single pathogen were assessed clinically and bacteriologically during January through December of 1985. Haematological and biochemical studies were performed with respect to axillary temperature, total circulatory WBC counts and serum C-reactive protein.
Mean WBC counts and serum C-reactive protein of 5 patients with acute purulent exercebation of chronic bronchitis with fever (≥38°C) were obtained 9560.0/mm³ and 5.2+. Patients without fever were less likely to have WBC counts and serum C-reactive protein than were patients with fever.
Disappearance or decrease in number of the inflammatory cells (polymorphonuclear leukocytes) and the cocci of B. catarrhalis from purulent sputum coincided with clinical and laboratory improvement.
These results have clearly showed the importance of B. catarrhalis as the common pathogen for respiratory diseases.

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During 1980-1983, 5, 694, 435 overseas travellers were quarantined at Osaka Airportand 15, 232 travellers reported that they were (or had been) suffering from diarrhoea. Bacteriological examination of stools from 4, 843 persons revealed the following results.
1) Various enteropathogenic bacteria were isolated from 47.7% of the cases examined. The species of bacteria isolated, the number of cases and the rate of isolation (in parentheses) were as follows: enterotoxigenic Escherichia coli, 1, 079 cases (22.3%); Salmonella, 712 cases (14.7%); Vibrio parahaemolyticus, 572 cases (11.8%); Shigella, 221 cases (4.6%); Vibrio cholerae non-O1, 120 cases (2.5%); Vibrio fluvialis, 41 cases; Campylobacter jejuni, 18 cases; Vibrio mimicus, 7 cases; enteroinvasive E. coli, 6 cases; Vibrio cholerae O1, 5 cases; enteropathogenic E. coli, 2 cases and Salmonella typhi, 1 case.
2) There were no apparent seasonal variations in the rate of isolation of these pathogens.
3) The suspected regions for infection with these pathogens were as follows:
a) Enterotoxigenic E. coli, overall Asia, especially South-East Asia (51.7%).
b) V. parahaemolyticus, mainly South-East Asia (76.7%).
c) Shigella, South-West Asia (52.9%), especially India (37.6%).
d) V. cholerae non-O1 and V. fluvialis, South-East Asia (62.5% and 73.2%, respectively).
4) Several pathogens were isolated simultaneously from the same patient in 423 cases.
5) Several serovars of Salmonella and Shigella strains were simultaneously detected from 124 and 11 cases, respectively.
6) The serovars and antibiotic-sensitivities of the isolated strains were examined.
7) The classification of patients with enterotoxigenic E. coli strains by enterotoxin type were also examined.

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Fifteen strains of lactose-fermenting Salmonella were isolated from sporadic cases of acute enteritis and from those who were involved in an outbreak of Salmonella food-poisoning during the period of two years and four months, from June 1982 to September 1984.
One of these isolates was identified as S. litchfield and the others were as Salmonella paratyphi-B (d-tartrate+). From one of the sporadic cases, chloramphenicol (cp)-resistant and lactose-fermenting S-paratyphi-B was isolated after cp treatment, though a cp-sensitive and lactose-non-fermenting strain had been isolsolated in an acute phase. The former was phage-typed as 3b and the latter was 1.
The lactose-fermenting strains were ONPG-positive and H25 non producting no SS agar and TSI agar. Form four strains of lactose-fermenting S-paratyphi-B, lactose-non-fermenting clones were segregated in subcultures. They were ONPG-negative and H2S-producting on SS agar and TSI agar. A possible role of a prasmid in acquisition of these unusual biochemical characteristics by Salmonella was discussed.

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Adherence of gram negative bacilli to normal and injured rat tracheas was examined. Rat tracheas were injured by exposure to 0.1 N HCl for 10 min, and incubated with P. aeruginosa, K pneumoniae and E. coli. Adherence was quantitated by direct count of the number of bacteria attached to a fixed surface area as viewed by scanning electron microscopy. All the three strains adhered to injured tracheas more than to normal tracheas and the adherence of P. aeruginosa was especially high. All of them had many fimbriaes. These data suggest that the adherence of each strains is depend on the number of the receptor for them on cell surfaces.

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According to the previous records and the latest surveys, the chigger vectors, rickettsial pathogens (Rt) and the clinical cases of tsutsugamushi disease were found to distribute extensively in Hokuriku District.
The seasonal observations at a fixed point in Katsuyama, Fukui Pref. informed us that the probable vector L. pallidum was the most predominant species fed on wild rodents especially in October to December and its small occurrence reappeared there in March to May, and also Karp and Gilliam types of Rt were isolated from these rodents. The positive levels of Rt increased rather in autumn, but the pathogenicity to ddY mice (LD₅₀=10^-4.7) of a Karp type Rt isolated was lower than the standard Karp strain. The similar surveys at a point in Kanazawa, Ishikawa Pref. showed the relative peak of L. pallidum occurrence in April to May.
So this results support a hypothesis that the overwintering individuals of L. pallidum not fed on any rodents in every autumn become active and get many chances to approach man in the following spring. It may be a fundamental reason why the disease is inclined to occurr in spring in this area.

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Fifty-six clinical isolates of herpes simplex virus (HSV) from female genital tracts were examined in vitro for acyclovir (ACV) sensitivity using a plaque reduction assay. The ID50 values of ACV for HSV-1 ranged from 0.59 to 8.46μM, with a mean ID50 of 2.92 (±1.85)μM, and for HSV-2, ID50 values ranged from 3.80 to 12.05μM, with a mean of 6.24 (±1.90)μM. While mutants of HSV with altered specificity of thymidine kinase (TK^a) were found in HSV-2 (33.3%) more frequently than in HSV-1 (4.8%), no virus with markedly diminished sensitivity to ACV was found in either types. ID50 values of Japanese isolates tended to be lower than those of U.S.A. These results suggest that most HSV strains isolated in Japan are sensitive to ACV.

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We examined the prevalence of chlamydial infection in a population of pregnant women. Influence of C. trachomatis on pregnancy outcome, delivery, and their infants were observed. Eleven of the 237 women (4.6%) were C. trachomatis antigen detected from endocervical specimen. Of the 237 pregnant women, 85 (35.9%) women were IgG antibody positive, and 38 (16.1%) women were IgG and IgA antibody positive in the serum samples. Eight (72.7%) of 11 women who were antigen positive were IgA antibody positive.
The prevalence of past abortion in the seropositive group was significantly higher than in those of the seronegative group (p<0.001).
In a prospective study, prevalence of threatened abortion and preterm labor in the seropositive group was significantly higher than of those in the seronegative group. The mean duration of gestation weeks and the mean birth weight of infants in the seropositive group was significantly lower than of those in the seronegative group. Moreover the prevalence of placenta previa was 5%(3/60) in the IgG antibody positive group, 7.1%(2/28) in the IgG and IgA antibody positive group, and 0%(0/85) in the seronegative group.
Nasopharyngeal specimen were obtained from 25 infants of one month old whose cord bloods were seropositive. Of the 25 mothers, 17 mothers were IgG and IgA antibody positive, and Eight mothers were IgG positive but IgA negative. C. tracnomatis antigen were detected from six mothers who were all IgG and IgA antibody positive.
Four of the six infants born of both antigen and IgA antibody positive mothers were antigen positive in the nasopharyngeal swabs. Four of the eleven infants born of IgA antibody positive but antigen negative mothers were also antigen positive. On the other hand, none of the eigth infants born of IgA negative mothers were antigen positive. From those results, the detection of IgG and IgA antibody may be reasonable to accept as the criterion of C. trachomatis infection in a study of this kind.

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Twelve cases of chronic schistosomiasis japonica associated with other diseases were studied. All the patients have lived for a long time in an old endemic area of schistosomiasis in Ibaraki Prefecture, Honshu, and have never been overseas nor in other schistosomiasis areas in Japan. In the 8 cases shistosome eggs were found in the ectomized organs (stomach, duodenum, liver and gall bladder) surgically operated under another diagnosis. The remaining 4 cases were diagnosed radiologically at the time of their medical checkups. Specific findings in these cases, fish scale pattern of liver ultrasonography and furnicular calcification and high density streak in liver C.T. may be of great value as an early diagnostic procedure of chronic schistosomiasis. No schistosome eggs were found in the 12 stool specimens. The 6 of the 12 sera were tested for S. Japonicum egg antibodies and all were found to be negative. Symptoms and signs were much different in each patient depending on the basal diseases. There were 4 cases complicated with malignant tumors like gastric cancer or hepatoma. It is very difficult to judge the time they became infected and the hatchability of the eggs can be noted only by the pathological findings. The hatching tests of eggs in the rectal biopsy specimens may be done to observe their viability.

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The purpose of this study was to evaluate whether plasmid profile analysis could be used as an epidemiologic tool for Salmonella enteritis and to compare it with other methods such as biotyping and phagetyping in characterizing 292 Salmonella isolates from 39 outbreaks. We found no plasmid in any of the isolates from 25 out of the 39 outbreaks. In the remaining 14 outbreaks, epidemiologically associated isolates were characterized as being the same by each of the three methods and plasmid profile analysis was found to be as useful and accurate as biotyping and phage-typing. In 10 of the 14 outbreaks, however, plasmid was not demonstrated in some of the isolates associated, although they were indistinguishable from related isolates carrying plasmids by biotyping and phage-typing. It posed a question whether those 10 outbreaks were caused by a mixed infection with two distinct organisms belonging to the same biovar and phagovar or not and then suggested the necessity of a further study to resolve the question. Necessity of improving biotyping and phage-typing methods employed in the present study was also discussed.

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An association of plasmids of large molecular weights with pathogenicity has recently been reported in Salmonella serovars which cause systemic infection in certain domestic animals and poultry. A total of 479 strains of Salmonella in cluding 33 serovars isolated mainly from patients with acute gastroenteritis and from ill-animals with systemic infection were studied for the presence of those specific plasmids. Of the 479 strains, of which 206 of Typhimurium and 35 of Enteritidis were included, the large plasmid corresponded to that reported previously was found only in 8 isolates of Typhimurium from a patient with gastroenteritis and 7 ill-animals. When 104 and 108 organisms of 4 Typhimurium strains of which two contained a 60Md plasmid, one carried a small plasmid and the remaining one was plasmid-free, were administered into the stomach of 15-day old C57BL mice, systemic infection was invariably observed within 20 days after challenge, regardless of the presence of the large plasmid. However, the presence of the large plasmid was correlated with a reduction of survival period of day of the mice challenged. In another experiment, a correlation of harboring the large plasmid with the ability to colonize parenchymal organs in earlier stage of the infection that the plasmidless strains was also recognized, although the ability of strains to colonize intestine did not differ depending on the presence of this plasmid. Invasiveness of tissue cells were examined after incubation of HeLa and HEp-2 cells and organisms for 6 hr at 37°C using 20 strains of Typhimurium. The proportion of infected cells was usually as low as 7% of 300 cells counted and each infected cells contained only a few bacteria. In addition, there was no significant difference in the extent of association recognized with the plasmid-harboring and the plasmid-free strains. These results suggest that the large plasmids reported for some Salmonella serovars play an important role in the pathogenesis of systemic infection of certain animals and poultry, but may not be associated with the ability to produce gastroenteritis in humans.

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Hypersensitivity reactions to trimethoprim-sulfamethoxazole occurred in a 26 y. o. hemophiliac with Pneumocystis carini pneumonia. He had been treated with imported blood products. Human immunodeficiency virus (HIV) was isolated from peripheral blood lymphocytes, therefore this case fulfills diagnostic criteria for acquired immunodeficiency syndrome (AIDS).
On 9th day after administration of trimethoprim-sulfamethoxazole, hypersensitivity reactions appeared with fever and systemic eruptions on skin and mucus membrane. Pathological findings of these tissues suggest toxic epidermal necrolysis (TEN).

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