Adherence of gram negative bacilli to normal and mechanical injured rat tracheas was examined. Rat tracheas were injured by endotracheal intubation and balooning for 2 hours with Swan Ganz catheter, and they were incubated with P. aeruginosa, K pneumoniae and E. coli. All of the three strains were suspended at 2×10⁷ CFU/ml for the experiment. All of them adhered more to the injured tracheas than to normal tracheas, and the adherence of P. aeruginosa was especially high. These data were similar to the data of acid injured rat tracheas.
Rat tracheal mucin was preincubated with all the three strains and the adherence of mucin treated bacteria to mechanical injured tracheas was examined. Mucin inhibited the adherence of P. aeruginosa. This suggested that P. aeruginosa adhered to tracheal mucin very well.

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To investigate usefulness of absorption of immunoglobulin G (Ig-G) by Protein A in estimating epidemic of recent infection of Japanese encephalitis (JEV) and Dengue (DV) viruses, sera of 481 inhabitants in a region of Thailand were tested by hemagglutination inhibition method before and after treatment by Protein A.
Ig-G antibody in 0.3 ml of serum was almost completely absorbed by 0.05 g of Staphylococcus aureus of Cowan I strain containing Protein A.
The overall rates for presence of antibodies against JEV and DV were 77.3% and 77.5%, respectively, before absorption of Ig-G. The rate for presence of Ig-M antibodies judged from the HI titer after absorption and considered to express the rates of recent infection within about six weeks irrespective of primary or reinfection were 12.3% and 19.8% against respective viruses.
When analyzed by age and district subgroups, the rate for presence of Ig-M antibody was not necessarily in propotion to that obtained before absorption of Ig-G. Furthermore, there were 4.3% and 22.7% cases possessing Ig-M antibodies against JEV and DV even among those with titer values of as low as 160 or less before absorption. Among 336 cases whose serum showed positive reaction to both JEV and DV before absorption, 22.9% had specific Ig-M antibody to either one of the two viruses and only 10.4% had Ig-M antibodies to both.
These results suggest that detection of Ig-M antibody with the aid of Protein A is useful in estimating epidemic of recent infection as well as discriminating causative virus.

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Isolation of enteric viruses from sewage of a sewage treatment plant in Nara Prefecture was carried out during one-year from June 1984 to May 1985. Both supernatant and sediment of the sewage samples were subjected to virus isolation. Viruses were isolated almost similarly from the supernatants and the sediments.
Poliovirus, echovirus, coxsackievirus, adenovirus and reovirus were found in the sewage. Polioviruses were isolated during the periods which coincided with those of vaccine administration, and the group B coxsackieviruses were frequently isolated all year round. Among the group B coxsackieviruses isolated type B2, B4 and B5 viruses were isolated successively for a long period, suggesting that these type viruses caused epidemics. The incidences of antibodies against the group B coxsackieviruses in the sera collected in this study area supported that these types of viruses caused epidemics. Futhermore, we observed that the epidemic of type B4 which virus occurred in 1984 though this type was isolated successively for a long period in 1983.

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The organisms used in this study, were isolated from various clinical materials submitted to the Central Clinical Laboratory, Teikyo University Hospital from October 1986 to March 1987. We investigated the isolation frequency of fluoroquinolones (QNLs)-resistant strains in every species and their susceptibilities to norfloxacin (NFLX), ofloxacin (OFLX), and ciprofloxacin (CPFX).
The results were as follows:
1. Of the isolated organisms, the species highly resistant frequency to QNLs were S. aureus (13.0%), S. marcescens (45.8%), and P. aeruginosa (8.7%). QNLs-resistant strains were less than 5.0% in other species.
2. QNLs-resistant S. aureus already were isolated from various clinical materials, whereas the majority of the isolates of S. marcescens and P. aeruginosa were from urine.
3. Many of the QNLs-resistant S. aureus were acquired QNLs resistance in addition to methicillin resistance.
4. QNLs-resistant S. marcescens were also resistant to multiple antibiotics and the half of them were resistant to all β-lactams and aminoglycosides (AGs) used in this study.
5. In contrast with the above species, QNLs-resistant P. aeruginosa were sensitive to either β-lactamsorAGs.
6. Susceptibilities of QNLs-resistant strains to the above three chemically synthetic antibiotics were diferent from that of QNLs sensitive strains. furthermore, these strains could be divided into 2 groups; the one had moderate MICs near 6.25 μg/ml, the other had high MICs about 100, μg/ml. Correlations between MICs to 3 antibiotics were noted.

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The prevalence rate of the rubella antibody in pregnant women was determined and the subjected women were interviewed to investigate their history of rubella, rubella vaccination and acquisition of antibody. In addition, the interval between infection or vaccination and antibody assay, as well as antibody titer, were studied. The subjects comprised 382 pregnant women ranging from 18 years to 42 years old, among whom 301 had acquired the rubella antibody. The prevalence rate was 78.8%. History taking revealed that 149 women (39.0%) had suffered from rubella, 134 (35.1%) not suffered and 99 women (25.9%) could not tell whether they had or not. 47 women (12.3%) had been vaccinated: among them, 21 women received periodic vaccination and 26 were vaccinated occasionally. The relationship between rubella and vaccination history, and antibody acquisition, was studied. The result was that all vaccinated women had acquired the antibody, and 61.2% showed correspondence of rubella history to antibody titer. This suggested that taking history of anamnesis is not reliable in determining whether they experienced rubella or not. An investigation of interval from infection or vaccination to antibody assay showed that the interval ranged from 2 years to 31 years in the group with rubella, and their antibody titers were from 8 times to 256 times higher. In the vaccinated group, the period was 5 months-10 years and titer ranged between 16 times to 128 times higher. Both titers of 2 subjects where there was a lapse of more than 9 years after vaccination were 64 times higher.

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In Japan, the number of tetanus cases has markedly decreased, as has that of diphtheria. The mortality rate decreased more steeply in the younger generation than in the elder one. We determined tetanus antitoxin (TA) levels in various age-groups (AGs) comparing it to diphtheria antitoxin (DA) levels.
Mean antitoxin titers in AGs of 6-17 were more than 1.0 Hemagglutination Unit (HAU)/ml and those in AGs of 18-30 were 0.15-0.6 HAU/ml. In AGs of older than 31 years the mean TA titer decreased at the level of 0.02-0.06 HAU/ml, and persons without detectable TA increased in number. While the mean DA titer slightly decreased in AGs of 36-40 years, but it remained over 0.03 HAU/ml in elder AGs. The positive rate for DA gradually decreased in AGs of 26-40 years and reincreasd in AGs over 41 years. It is speculated that the differences observed among various AGs and found between tatanus and diphtheria antitoxin levels have a relation with the practice of the official vaccination against these diseases in Japan and with kinds of vaccine adopted. Furthermore, they seemed to relate to the prevalence of the disease. Namely, the younger subjects gained their TA and DA through vaccination and the elder ones, who have had no opportunity to receive vaccines in their infancy, obtained DA following inapparent diphtheria infections.

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A 44-year-old male was admitted to Kinki University Hospital on April 12 1977, because of pancytopenia. With the result of examinations, a diagnosis of aplastic anemia was made. On admission, he was febrile and antibiotics were not effective. In May, loss of consciousness was observed, following nausea and vomiting. Cryptococcus neoformans was detected from the cerebrospinal-fluid, and Amphotericin B (AMPH-B) and 5-Fluorocytosine were given. A total of 2190 mg AMPH-B was administered intravenously and intrathecally 3.2 mg. Consequently the cerebro-spinalfluid findings and clinical symptoms improved markedly and he could be discharged. Blood disorders such as leukemia have readily complicated with Cryptococcal meningitis, but there have been few cases of aplastic anemia. Moreover, this case was rare in that it was succesfully treated, in spite of the compromised host.

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A 34-year-old previously healthy man was seen at this hospital after a two-week history of high temperature and mild nonproductive cough. He had kept four parakeets, one of which had been weak recently. A roentgenogram of the chest showed consolidation in the right lower lung field. TBLB from rS8 revealed alveolar macrophages, lymphocytes and fibrin which were found within the alveoli mainly and the alveolar lining cells were swollen. There was a slight increase of mononucler leucocytes within the interstitial spaces. Bronchoalveolar lavage cellular constituents showed alveolar macrophage 71%, neutrophil 27%, lymphocyte 1%, respectively. We could isolate organisms from the bowel and faeces of his parakeet revealing C. psittaci by Giemsa stain.

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Weaning of patients supported by prolonged artificial ventilation is difficult on account of complicated incurable lower air way infections by P. aeruginosa etc. Four typical cases of lower air way infections responded positively to EM.
(Case 1) A 70 years old male patient had both upper lung lobes resected in the past due to T. B. Since the onset of respiratory failure when he underwent a surgical operation due to gastric cancer, he inevitably needed continual support by artifical ventilation and this was complicated by a lower air way infection by P. maltophilia. Application of EM brought about a successful weaning and he was able to be discharged.
(Case 2) A 74 years old female patient was inevitably supported by a continuous artificial ventilation due to sever attacks of bronchial asthma which gave rise to a complicated lower air way infection by P. aeruginosa. Application of EM resulted in anacceptable healing, and she was discharged.
(Case 3) A 56 years old male patient, with previous artificial pneumothorax due to T. B., needed the support of a contunous artificial ventilation upon the occurrence of an acute exacerbation, which gave rise to a complicated lower air way infection by P. aeruginosa. Application of EM resulted in healing and then he was able to be discharged.
(Case 4) A 50 years old male, who was prescribed predonisolone due to sarcoidosis, gave rise to a complicated lower air way infection of Aspergillus, M. tuberuculosa, and P. aeruginosa. Consequently the respiratory failure was relieved by a tracheostomy. Many antibiotics and EM were then applied. Notwithstanding an inevitable interruption of anti-P. aeruginosa agents due to a fever, his clinical course was good so he could be discharge.
These 4 cases suggestted the efficacy of EM for the treatment of lower air way infection of patients tracheomized with chronic respiratory diseases.

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