In order to examine the effect of ozone in the aquaous phase, studies were performed on the relationship between the sterilizing effect and the injection rate of ozone, reaction temperature or dissolved organic carbon.
As a result, a linear and high coefficient relationship was seen between residual bacterial counts and the injection rate of ozone, and the relation depended on the temperature.
Injection rate of ozone decreased along with the decline of the temperature. It was realized that the effect of sterilization is more effective at a lower temperature.

View full abstract

Drug susceptibility of 30, 921 strains of clinically isolated bacteria (from 1979 to 1986) was examined. Bacteria that were subjected to the present analysis were 16 species, isolated from urine, pus, ear discharge, sputum and pharyngeal mucus. The following results were obtained.
1) Bacterial species that showed significant differences on the antibiotic susceptibility from one source of specimen to another were Staphylococcus aureus, Staphylococcus epidermidis , Enterococcus sp., Escherichia coli, Citrobacter sp., Klebsiella sp., Enterobacter sp., Serratia sp., Proteus mirabilis, Acinetobacter sp. and Pseudomonas aeruginosa.
2) When drug susceptibility of the isolates from various sources were compared with that from urine, Gram negative rods from urine appeared to be less susceptible in general than that from the other sources. Whereas Gram positive cocci from urine were generally more susceptible than that from other sources.
3) Number of drug resistant strains of S. aureus, Enterobacter sp. and P. aeruginosa tended to increase in the order of the following sources; urine, pus, ear discharge, sputum and pharyngeal mucus. Number of resistant strains of these species isolated from sputum showed the sharpest increase during the past 7 years as compared to the bacteria from other sources.
The statistics predict that the drug resistant isolates from the lower respiratory tract may be increasing and therefore the investigators in this field should keep aware of this.

View full abstract

The clinical course of two cases of spotted fever rickettsiosis was described including data of laboratory examinations and treatment. In addition, the clinical, laboratory, and epidemiological features of 23 confirmed cases experienced from 1983 to 1986 in the Muroto area of Kochi Prefecture were analyzed. Infections occurred in individuals of all ages irrespective of sex. The illness appeared from April to October. The incubation period was 4 to 7 days, although the vector has not been detected. Symptoms and signs were as follows: all cases developed a fever reaching 40°C. An erythematous rash covered the trunk and extremities in all cases, and it became hemorrhagic when patients received treatment late after the onset. In some cases the rash appeared on the palms. An eschar was found in half of the cases. Regional lymphadenopathy was noticed in 2 cases but no generalized lymphadenopathy was detected. Other clinical symptoms were anorexia, headache, vomiting, arthralgia, chill, malaise, hypotension and stupor. The CRP test showed strongly positive results, but leukocyte counts were within the normal range. In differential leukocyte counts, neutrophils increased and lymphocytes decreasd in the acute pahse, and vice versa in the convalescent phase; in many cases eosinophils disappeared. Three fourth of the cases showed an elevation of the serum transaminase activities. Specific immunofluorescence test with Rickettsia montana of spotted fever group demonstrated a significant rise in IgG and IgM antibody titers in all cases. Within 1 to 7 days after the onset, patients were treated with tetracycline antibiotics, resulting in defervescence and recovery within 2 to 5 days.

View full abstract

Hemolytic and antigenic activities of hemolysin produced by Vibrio cholerae non-01 and 01 El Tor cultured in syncase medium were examined. El Tor vibrios revealed positive hemolytic activity in 33 strains out of 56 examined and antigenic activity was detected in 55 out of 56. Whereas, NAG vibrios were positive for hemolytic activity in 52 strains out of 55, and antigenic activity was detected in 54 out of 55. There were many El Tor strains without hemolytic activity but with high antigenic activity of the hemolysin. Hemolytic and antigenic activities of each NAG vibrio, however, were fairly coincident in the extent of titers. Most El Tor vibrios produced much larger amount of hemolysin in the stationary test tube culture than in shaking flask culture. The hemolysin production by NAG vibrios was also much influenced by culture condition, however, the preferable condition was variable depending on strains. Since biological activity of hemolysin is labile, immunoassay is significant in qualitative and quantitative analysis of the hemolysin.

View full abstract

It is well established that the Epstein-Barr virus (EBV) is a causative agent for infectious mononucleosis and that the EBV is strongly associated with Burkitt lymphoma and nasopharyngeal carcinoma.
For the serological detection and titration of specific EBV/VCA antibody in human serum. Immunofluorescence Assay has been most commonly used to detect the antibodies against EBV and its related antibodies.
The following results were obtained by comparison of indirect immunoperoxidase assay (IPA) using the IPAzyme kit and indirect immunofluorescense assay (IFA) for the sensitive and specific determination of EBV and its related antibodies.
1) In the detection of anti-VCA IgG antibodies, the correlation coefficient between IFA and IPA was 0.51. When it is assumed that the error range is plus or minus 1 dilution is the serial dilutions, 41% sera did not show the same antibody titer in both IFA and IPA.
In IPA, 26.3% sera (7 patients with IM, 2 patients with enlarged liver and spleen, one patient with chronic EBV infection) showed a higher antibody titer than in IFA by more than 2 dilutions.
In IFA, 14.3% sera (2 patients with leukemia, one patient with hepatitis) showed a higher antibody titer than in IPA by more than 2 dilutions.
2) In the detection of IgM antibodies, 42.7% sera did not show the same antibody titer between IFA and IPA. However, in the case of patients with autoimmune disease, most sera were positive for IgM antibodies in IFA whereas they were negative in IPA. Thus, a great difference was observed, which was due to the non-specific reaction commonly seen in the patients with autoimmune deseases.
3) In the detection of anti-VCA IgA antibodies, 5.9% sera were positive in IFA, whereas in IPA, 22.3% sera were positive. From these results, the present results indicate that IPA is more sensitive than IFA in detecting anti-VCA IgA antibodies, since it is difficult to detect anti-VCA IgM and IgA antibodies in IFA.
More than half of the patients who were positive for anti-VCA IgA antibodies by IPA were the patients with IM, which indicated the first infection of EBV, and the patients with malignant lymphoma with a high anti-VCA antibody titer.
However, IgA antibodies were not detected in any of the patients with carcinoma in the digestive system (gastric carcinoma) with a high anti-VCA antibody titer (VCA: 1: 640, NA: greater than 1: 160) which was caused by the reactivation of EBV.

View full abstract

To investigate how long the antibody to hepatitis B surface antigen (anti-HBs) remains in the serum after a hepatitis B vaccine (HB vaccine) is given, a total of 262 hospital personnel (male 61, female 201, mean age 35.1) were followed up from four to five years after the first injection. They were negative for all of hepatitis B virus (HBV) markers and were immunized three times with 20μg_ Three kinds of plasma-derived HB vaccine were used in the study. The A aroup (120 cases) was treeze vaccine from Y company, the B group (74 cases) was given liquid vaccine from Y company, subcutaneously, and the C group (68 cases) was given liquid vaccine from Z company, intramusclarly.
The anti-HBs seroconversion rate (RIA) after three vaccination was 79.8% of the A group, 78.9% of the B and 95.4% of the C within nine months (after the first vaccination). The seroconversion rate of the A group decreased to 42.3% within five years and that of the B group decreased to 46.8% within four years. However, that of the C group remained in 89.4% within four years.
The titer of anti-HBs (PHA) was 2^6.5 in the B group within nine months and 2^7.7 in the C group within one year. In four years, the titer of anti-HBs slightly dropped to 2^4.5 in the B group and 2^5.9 in the C group. An explanation for the higher immunogenic potency of HB vaccine made by X company as compared with the vaccine made by Y company may be that chemical inactivation might preserve the immunogenicity better than heat and chemical inactivation procedures, and that the intramuscular route is superior to the subcutaneous route.
It was observed that 97.4% of the vaccinees whose anti-HBs titer was 2⁷>(PHA) after three injections were positive for anti-HBs (RIA) and 30% of the vaccinees whose anti-HBs titer was 2³<(PHA) were positive within four years. It was considered that the vaccinees who had a low titer of anti-HBs after the third injection easily became negative for anti-HBs within four years.

View full abstract

The ecological survey was carried out for distribution of both trombiculid mites and Rickettsia tsutsugamushi in wild rodents living in the Tama area. Ninety eight of the 105 rodents captured during April 1985 to November 1986 were subjected to rickettsial isolation, and R. tsutsugamushi were successfully isolated from 16 rodents (16.3%). By means of IF and CF test, serum antibodies against R. tsutsugamushi were detected in rodents.
All of the isolated R. tsutsugamushi were proved to be the Karp-related strain by IF method using antisera from mice or guinea pigs immunized with the isolates. Although the isolated R. tsutsugamushi could be maintained easily among mice inoculated intraperitoneally, its adaptation to cultured L929 cells was unsuccessful.
Eight species of the trombiculid mites were found from wild rodents captured: Leptotrombidium pallidum in Machida, Fussa and Itsukaichi districts, and Leptotrombidium scutellare in Itsukaichi district.

View full abstract

In view of a necessity to have a national reference system for Campylobacter serotyping in Japan, 8 local institutes of public health have embarked upon a joint work to obtain a typing system to be used in Japan until the completion of an international system is developed. This paper describes the serotyping results of Campylobacter jejuni isolated from human subjects throughout Japan by a slide agglutination test developed by the Tokyo Metropolitan Research Laboratory of Public Health (TCK system).
The 33 typing sera numbered TCK 1 through TCK 33 have successfully been used to type 282 strains (84.2%) out of 335 isolates from 37 outbreaks of C. jejuni gastroenteritis throughout Japan, leaving 53 strains (15.8%) untypable. Out of those strains, 242 reacted with only single serum, while 40 strains with 2 or more.
In 14 outbreaks, all isolates from one outbreak were found to have the same serogroup, while 2 serograoups were detected in each of the 10 outbreaks and 3 or more in each of the 13 outbreaks.
Out of 1, 064 strains isolated from sporadic cases of gastroenteritis, 714 (67.1%) were typed and 340 (32.0%) were nontypable. The remaining 10 strains were not typed since they deteriorated into a rough form. The most common serogroups include TCK 1 (12.8%), 20 (12.3%), 4 (8.2%), 7 (6.8%) and 24 (6.6%) and no geographical bias was noted in their distribution. The next common serogroups were TCK 26, 21, 6, 12, and 10. Ninety five out of 714 strains (13.3%) have reacted with more than one typing serum.
On the basis of these results, the authors believe that this serotyping system will serve the purpose till the establishment of the international system.

View full abstract

In order to apply serum-free meida to the HIV study, the effects of serum-free media in chronically HIV-1 infected cell growth, in HIV-1 replication and in RTA were studied for detecting the virus.
1) all the serum-free media gave good cell growth compared with the RPM-1640 supplemented with 10% FCS.
2) HIV-1 replicated more in lower protein content serum-free media than in higher protein content serum-free media and in RPM-1640 supplemented with 10% FCS.
3) HIV-1 RT activity was reduced by FBS in proportion to the concentration. Serum-free media showed no reduction of the activity compared with high concentrations of FCS.
These data indicate that serum-free media are useful for HIV study in vitro.

View full abstract

Two cases of metastatic K. pneumoniae endophthalmitis spreading from biliary treact infections are reported.
Case 1 A 69-year-old woman with acute fever (39.4°C) and right upper quadrant abdominal discomfort, was admitted. On the 5th hospital, day, she complained of a right orbital pain and acute loss of visuality. Evisceration of the right eyeball contents was performed. Abdominal discomfort continued and a slight elevation of alkaline phosphatase was noted. Cholecystolithiasis and chronic cholecystitis were diagnosed and a cholecystectomy was performed. The culture of both the eyeball contents and the bile yielded K. pneumoniae.
Case 2 A 77-year-old woman with acute fever (39.6°C) and nausea, complained of oribital pain and loss of vision when admitted to the hospital. With the diagnosis of endophthalmitis, the oribtal contents were drained. On admission, it was diagnosed as a cryptogenic liver abscess. The culture of both the eye discharge and liver abscess pus yielded K. pneumoniae.
In the literature, 20 cases of metastatic K. pneumoniae endophthalmitis including our 2 cases are reported. Of the 15 cases biliary tract infection with liver abscess were found in all but 1 case. The prognosis of visual acquity is poor. Sixteen cases became blind and the other 4 cases resulted in severe loss of visual acquity. Because of the poor prognosis, a more aggressive diagnostic and therapeutic approach is required.

View full abstract

Lactobacilli are usually considered non-pathogenic. However, only a few cases of severe infection due to lactobacilli have been reported. Among them infective endocarditis (IE) are extremely rare. We described here the first case of IE due to Lactobacilli in Japan.
A 26-year-old housewife was admitted to our hospital with a low grade fever, malaise and anorexia during the last three months after artificial abortion. She had been suffering from pulmonary stenosis and regargitation since the operation of Fallot's tetralogy at the age of 10 years old. On admission physical examinaiton revealed a low grade fever, moderate cardiomegaly, a grade 3/6 systolic and diastolic murmur and thrill over the entire anterior chest. Laboratory studies showed a WBC count of 4, 900/mm³ (N. band 26%, N. seg 36%); ESR was 67 mm/h.; and CRP was moderately positive. Four blood cultures taken over three days resulted in a pure culture of a Gram positive bacillus, which was identified as Lactobacillus acidophilus group. The same organism was also isolated from the uterine secretion. The organism seemed to be a new species, because their DNA/DNA homology did not coincide with those of any standard strains of Lactobacillus acidophilus. Disc sensitivity test revealed that the organism was sensitive to penicillin-G (PCG). The MIC of PCG against the isolate was 0.0125 μg/ml. She was treated with 12 million units of intravenous PCG per day for three weeks. And thereafter she was treated with erythromycine 1, 200 mg per day for two weeks because of mild granulocytopenia due to penicillin allergy. Neither vascular phenomena nor heart failure developed in her hospital course. She remained well for 18 months after the therapy.
Only 27 cases of IE due to Lactobacilli have previously been described in the world. The clinical features of these cases are summarized as follow: most of the patients have a subacute clinical course and have a history of oral disease and mitral or aortic valvular disease or congenital heart disease as underlying disorders. For the treatment of IE due to Lactobacilli, high doses of intravenous PCG for more than four weeks have proved successful. In conclusion, IE due to Lactobacilli is very similar to those of streptococcal origin.

View full abstract

A 83-year-old man was admitted because of complaints such as abdominal pain and distention. The plain X-ray examination of the abdomen showed a gaseous figure. Therefore, laparotomy was immediately performed. On the eighth day after surgery, a culture of the abdominal exudate obtained from the drain showed large numbers of Mycoplasma. He was medicated daily with 100 mg each of Minocycline and Dibekacin, and as a result was in cure on the 44th day after surgery. A serum analysis showed a significant rise in the titers of antibodies to M. hominis in both the ELISA and Metabolic Inhitition (MI) tests. The convalescent serum showed specific antibodies to M. hominis in the immunoblotting analysis. This suggested that peritonitis was due to M. hominis.

View full abstract