39 women attending a clinic for sexually transmitted diseases with vulval condylomata acuminata were investigated to examine cervical abnormalities by cytology, colposcopy, biopsy and peroxidase-antiperoxidase method.
1) Most genital warts were seen between 20 and 30 years old.
2) Cervical condylomatous cells (koilocytosis etc.) of the women with vulval condylomata acuminata infection was present in 12 (31%).
3) Colposcopical abnormalities was presented in 22 (59%). Cervical abnormality detected by biopsy was presented in 16 (41%). In these 16 case had evidence of cervical abnormalities, 6 (37%) was showed positive reaction for papillomavirus antigen.
4) After 6 months follow up study in the women with HPV infection of the cervix was without any changes in 6 cases, disappearance of abnormality in 2 and extension in 1.
5) 5 of 10 cases in pregnant women with genital warts had complicated with HPV infection of the cervix. These abnormalities were slight extension noted in 3 cases and without any change in 2 during the prgnancy.
The results of this study provided that the patient with genital warts should be examined the cervical abnormalities throughly be cytology, colposcopy and histology. Furthermore, should be have long term follow up with the three method mentioned above.

View full abstract

Twenty university students regarded as seronegative by haemagglutination inhibition (HI) test were given a rubella vaccine. The persistence of HI and IgM antibodies were measured in serum samples taken up to a year after vaccination. The results obtained were as follows;
1) HI antibodies were detected in all of 20 vaccinees (100%) 6 weeks after vaccination and responded with increases in geometric mean (GM) titers of 1: 34.3. These titers were maintained one year later.
2) The results of IgM obtained by solid-phase attachment red cell (SPARC) method were better than those obtained by the sucrose density gradient centrifugation (SDGC)-HI and enzyme immunoassay (EIA) techniques.
3) Rubella-specific IgM measured by SPARC method showed the highest positive rate, 13 of 20 vaccinees (65%), 6 weeks after vaccination and responded with increases in GM titers of 1: 3300. Although at low levels, rubella-specific IgM were present in 3 of the 19 (15.8%) at 52 weeks.
4) From 3 weeks to 52 weeks after vaccination, a correlation of r=0.75 was revealed between the IgM values obtained by both SPARC and EIA methods.
5) The present studies showed no correlation between side effects and higher HI antibody response or prolonged IgM response.

View full abstract

In order to survey the populations carrying antibodies to Japanese encephalitis virus in each age-group in Kagawa Prefecture, ELISA IgG titers were measured. Correlation of ELISA IgG to HI titers gave a coefficient of 0.89. Cut off value of ELISA titers was determined to be 3, 500. Specimens of 680 persons in all age-groups in Kagawa Prefecture were subjected to assay IgG antibodies by the ELISA technique. No antibody positive case in infants and young children under 3 years of age was found, possibly because of no vaccination. Percentage of antibody positive cases in age-groups 4-9 and 10-19 years were 73.5 and 75.0%, respectively; the higher values might have resulted from vaccination in these age-groups. The lowest value of 33.3% was observed in the age-gruop of 30-39 years, but the percentage of positives increased over the age-group of 40-49 years, reaching 56.5% in a group over 70 years of age. Average of positives was 49.5% throughout all age-groups.

View full abstract

Thirty one cases with first-episode genital herpes simplex virus infection were treated for five days with acyclovir tablets, 200 mg orally five times daily.
Twenty seven of these were of primary infections and the remaining four were non-primary. Eighteen cases were caused by herpes simplex virus type 1 and the remaining 13 by type 2.
This treatment was markedly effective in 17 and effective in 12 out of 30 evaluable cases. Within 5 days of treatment, virus culture from the genital tract became negative in 89%.
Two patients discontinued medication because of diarrhea or nausea, but adverse effects were rarely experienced and in general, they were mild and tolerable.
Oral acyclovir treatment of first-episode genital herpes shortens the duration of viral shedding and accelerates healing.

View full abstract

The clinical efficacy, safety and usefulness of ciprofloxacin (CPFX), a new oral antimicrobial agent, were compared with those of pipemidic acid (PPA) in the treatment of the patients with infectious enteritis (shigellosis, campylobacter enteritis and acute enteritis by enteropathogenic E. coli, etc.) by a double-blind method.
CPFX was administered orally in a dose of 300 mg/day, and PPA was administered orally 2000 mg/day. The duration of the treatment was five days.
Of 266 cases studied, 113 cases were excluded from the analysis of effectiveness. The effectiveness was evaluated in 153 cases; 74 received CPFX and 79 received PPA.
There were no significant differences between the two groups in terms of the background characteristics and distribution of MIC's for each drug.
The results obtained were as follows:
1. The bacteriological effect of CPFX was superior to that of PPA in all cases and the patients with Shigella sp. (p<0.001). The eradication rates of Shigella sp. were 96.9% in CPFX group and 91.4% in PPA group, respectively.
Duration required for eradication of organisms for CPFX group was significantly shorter than those for PPA group in all cases and the patients with Shigella sp. (p<0.001).
2. The clinical effect of CPFX group, according to the doctors in charge was similar to that of the PPA group. There were no significant differences between the two groups in defervescence, decrease in number of defecation and improvement of stool character. However, in disappearence of bloody stool within three days, the CPFX group was superior to the PPA group (p<0.05).
3. Side effects were observed in two cases of the CPFX group (1.6%) and one case of the PPA group (0.8%). No significant difference was seen in their incidences between the two groups.
4. Slightly abnormal laboratory findings were seen in 14 cases in each group. No significant difference was seen in their incidences between the two groups.
5. In clinical usefulness judged by doctors in charge, the CPFX group was superior to the PPA group (p<0.001).
From these results, CPFX is considered to be a very useful medicine in treatment of the patients with infectious enteritis and carriers.

View full abstract

Five to six-weeks old ICR mice were inoculated intranasally, intraperitoneally and intravenously with C. trachomatis B, C, D and E strains.
ICR mice that were 2 weeks and 6 weeks convalescent after primary intravenous infection, were intranasally reinoculated with C. trachomatis E strain.
By means of haematoxylin-eosin (H-E) staining, the most evident histopathological changes of the lung, inoculated intranasally, were observed at 3 or 4 days after inoculation, there appeared interstitial pneumonitis with polymorphonuclear leukocyte (PMNs) infiltration in the alveolar space, and PMNs were gradually replaced by mononuclear leukocyte at 3 days after inocultion.
The histopathologic appearance of the lung became normal 10 to 14 days after inoculation.
By the infectivity assays by means of cell culture technique, the highest yield of C. trachomatis was obtained from the lung at 2 days after intranasal inoculation. Following that, C. trachomatis in the lung were gradually decreased and eliminated in the lung after 7 days.
Histopathological changes of the lung in mice intravenously inoculated were few when compared with those nasally inoculated. By the infectivity assays of the spleen, the highest yield of C. trachomatis was obtained at 2 days after intravenous inoculation. After 7 days, C. trachomatis was not proven in the spleen.
The serum antibody titers against C. trachomatis, which were measured by microplate immunofluorescence antibody (MFA) technique, were detected 7 days after intranasal inoculation. IgG level rose to a maximum of 1: 256, continuing at the same level for 25 days or more and then gradually decreased.
Intranasal reinoculation group at 2 weeks or 6 weeks after primary intravenous inoculation, showed no significant difference in the survival rate compared with the control group.
In this study, respiratory tract infection of C. trachomatis in mice was self-limited and the immune-responce to infection of C. trachomatis was obscure.

View full abstract

The efficacy of plasma-derived and recombinant hepatitis B vaccines (HB vaccine) was assessed among children in nursery schools where there was at least one hepatitis B surface antigen (HBsAg) positive child with hepatitis B e antigen. Of the 496 children who completed the protocol, 243 (mean age 2.7 years) in six of the nursery schools received three injections of the plasma-derived HB vaccine (10 μ g) subcutaneously. In five other nursery schools, 253 children (mena age 2.3 years) did not receive the vaccine. The antibody to HBsAg (anti-HBs) seroconversion rate after three vaccinations increased to 82.3% in nine months (after the first vaccination) and then decreased to 66.0% in 36 months. The proportion of those who produced high antibody titer (2⁷) increased to 44.4% in nine months and then decreased to 7.4% in 36 months. However, both anti-HBs seroconversion rate and the group of high antibody titers increased to 84% and 29.3% after a supplementary vaccination (2 μ g) of recombinant HB vaccine intradermaly. Although nine of the non-vaccinated group (whom the others were able to follow for 24 months) were infected with hepatitis B virus, none of the vaccine recipients were infected.
The vaccine appears to be efficacious in preventing infection with hepatitis B virus in nursery schools. The immunity by vaccine decreased in 36 months. Small dose of the recombinant HB vaccine was useful as a booster injection. Furthermore, these data suggested that there was cross immunity between plasma-derived vaccine and recombinant vaccine.

View full abstract

We evaluated the clinical usefulness of serological procedures in the diagnosis of chlamydial infection by measuring serum specific IgA and IgG antibodies to C. trachomatis with indirect immunoperoxidase assay and ELISA, respectively.
1. The positive rates of serum IgA and IgG antibodies were found to be 40.0% and 72.2% in the non-gonococcal urethritis patients (NGU) having C. trachomatis antigen, respectively. Of those without C. trachomatis antigen, the positive rates of IgA and IgG antibodies were 10.0% and 68.0%, respectively. The positive rate of IgA antibody was significantly higher (p < 0.01) in NGU with C. trachomatis antigen than in those without it. This result suggested that IgA antibody might be a good marker of active chlamydial infection in NGU.
2. In pregnant women of the third trimester, the positive rates of IgA and IgG antibodies were 44.4% and 72.7% in those having C. trachomatis antigen, respectively, while 8.9% and 24.1%, were found in those without it. The positive rates of IgA and IgG antibodies were significantly higher (p < 0.01) in the former than the latter, which suggested that the detection of both IgA and IgG antibodies would be useful for the screening of chlamydial infection in pregnant women.
3. The positive rate of IgA antibody was 30% in non-gonococcal cervicitis patients and prostitutes, weather there was the presence or absence of C. trachomatis antigen. In these cases, the usefulness of serological diagnosis seemed to be lessened, and therefore, the detection of C. trachomatis antigen must be repeated.
4. In four pregnant women having C. trachomatis antigen at the first trimester of pregnancy and not receiving treatment during follow-up for the entire pregnant period, three showed the persistence of the antigen and positive antibodies. This result demonstrated that IgA antibody persisted with the antigen for a long period.

View full abstract

Attachment is an important step in the initiation of infection. Measurement of attachment activities of Mycoplasma pneumoniae (M. pneumoniae) was performed by the micro-attachment assay using in vitro WiDr cell culture systems and enzyme-linked immunosorbent assay (ELISA). This method incorporating ELISA was reproducible, simple and useful for investigation of host-parasite adherence.
Attachment activities of 20 clinically isolated strains of M. pneumoniae were measured by this assay. No differences were shown among the strains, however, mean value of clinically isolated strains was higher than that of standard strain, FH. No correlation was found between clinical manifestations and attachment activities.
Secretory IgA and lactoferrin are known to have important roles in host defense mechanisms at mucosal surfaces, but, their roles in an attachment of M. pneumoniae are not known yet. This study revealed that secretory IgA inhibited the attachment of M. pneumoniae to WiDr cell monolayers depending on its dose, while lactoferrin had no effect on attachment activity of M. pneumoniae.

View full abstract

The increased of susceptibility of diabetic patients to infection has been well-known. Serious infection in the diabetic foot often may be accompanied by marked production of gas in the infected tissue. Such gas gangrene may be frequently caused by Gram-negative rods, Gram-positive cocci, or by a combination of these microorganisms rather than the clostridium family.
In this paper, we describe a case of diabetic patient associated with non-clostridial gas gangrene of the right foot with multiple organ failure. He was suffering from long standing peripheral neuropathy and repetitious ulcers of the foot. After admission, he was treated with antibiotics which were subsequently proved to be sensitive. An above knee amputation was carried out. Satisfactory improvement of his general condition was obtained.
It was suggested that identification of the causative organisms of gas gangrene was essential, especially in the diabetic patient as appropriate chemotherapy and surgical treatment could result in a low mortality.

View full abstract

Three cases of gonococcal pharyngitis were presented. The patients were all female and the partners of male patients with gonococcal urethritis. Neisseria gonorrhoeae was isolated using selective media both from the cervix and pharynx of all three cases. Pharyngeal sympotms were obscure and all patients were brought to our clinic passively for epidemiological treatment. Spectinomycin MIC of three isolates were 12.5g/ml that suggest the isolates were sensitive to Spectinomycin clinically. Though after one shot treatment with Spectinimycin 2gim, N. gono. were eradicated from the cevix, but were not eradicated from the pharynx of the same patients in three cases. Epidemiological studies in our clinic revealed that 5-10% of male gonococcal urethritis were not infected by genital intercourse but by fellatio. Pharyngeal gonorrhea is at present an important source of gonococcal transmission because of both its latency and its unresponsiveness to the treatment effective for genital gonorrhea.
The report of pharyngeal gonorrhea has been sparce in Japan. The presence of pharyngeal gonorrhea is masked by both blind use of broad spectrum antibiotis and difficulty of gonococcal isolation from the pharynx due to lack of opportunity to culture throat swabs on selective media for N. gono. Special characteristics and epidemiological importance of pharyngeal gonorrhea were stressed. EIA detection of gonococcal antigen (Gonozyme) is not applicable to throat swab due to the cross reactivity of Gonozyme to normal habitant of pharynx.

View full abstract

Fulminant hepatitis in a 27 yr. old Japanese woman was effectively treated with plasmapheresis. Serological examination at each transfusion revealed a seronegativity for hepatitis B virus (HBV) and none of her relatives were HBV carriers. She stated that she had had sexual intercourse with HBe antigen positive fiancé who had chronic active hepatitis, 2 months before the onset of the fulminant hepatitis. Her survival is attributed to young age, good health, acute type of fulminant hepatitis, and an uncomplicated clinical course. The 4902ng/ml level of a-fetoprotein indicated regeneration of the liver. While it is known that HBV can be transmitted sexually, related occurrences of fulminant hepatitis are rare. In light of these events, carriers of HBV have to be carefully educated.

View full abstract