Epidemic respiratory tract infections occurred among elementary school children in Hiroshima prefecture during June, July and August, 1987. Forty (59%) of 68 children who were enrolled in an elementary school were confirmed to have respiratory diseases during this period, ten of whom were hospitalized with diagnoses of pneumonias. Diagnoses of M. pneumoniae infection were made from secretions obtained by throat swabs, and by serological studies of blood specimens. Twenty-four (77%) of the 31 patients examined were confirmed to have M. pneumoniae infections. Twenty-three of them had upper respiratory tract infections with cough and fever; two had pneumonia, one with myringitis. PPLO-broth, SP-4 broth and diphasic medium were used for M. pneumoniae isolation. Among these, SP-4 broth proved to have the highest isolation rate.
We tried to isolate rotaviruses from travelers with diarrhea arriving at Nagoya International Airport. 1. Ten cases revealed positive for rotavirus out of 334 diarrheal patients tested during a period from 1985 to 1988. 2. Most of the rotavirus positive cases were in their forties or in their fifties. 3. Geographic distribution of the infected area of the cases was not concentrated with specific countries. 4. Diarrhea was the most frequent clinical manifestations of the cases. 5. There was no cluster in seasonal distibution of the cases.
Multilamellar liposomes composed of phosphatidyl choline, phosphatidic acid and cholesterol at a molar ratio of 4: 1: 4 were prepared so as to entrap a solution of amphotericin B (AMB) and its efficacy in the treatment of murine systemic candidiasis were studied. There were marked differences in susceptibility to systemic candidiasis among several strains of mice. The number of cultivable Candida albicans increased remarkably in the kidney up to 6. 4×105 c. f. u./g, but not so marked in the lung, when challenged i. v. with 3. 7×105 fungal cells into a relatively resistant strain BALB/C mice. Liposome-encapsulated amphotericin B (L-AMB) permitted larger doses of AMB to be administered without the occurrence of the acute anaphylaxis-like and subacute toxicity as expressed by a decreased renal function. The mice treated with a single injection of 4 mg/kg of L-AMB showed the prolonged survival after challenge. The results obtained showed that the use of liposomes as a drug delivery system for AMB would improve significantly the therapeutic efficacy of the antibiotic against candidiasis.
A study was made on oral immunization using a tetanus toxoid. Liposome entrapped tetanus toxoid (LTT) was p.o. administered to cats and serum antibody responses were examined. As a result it was known that the LTT antigen induced antibody production in the serum and that an antitoxin antibody titer higher than 0.1 IU/ml, a prophylactic level against tetanus, was produced. On the contrary to this, no antibody was detected in the group administered a tetanus toxoid alone throughout the test period. Also, when an absorbed tetanus toxoid (ATT) was booster-injected to cats p.o. primed with LTT, high responses of the secondary immunization were obtained. Moreover, in case LTT was p.o. administered as a booster antigen, the antitoxin titer in the serum showed a rapid, steep elevation. From these results it has been clarified that LTT on p.o. administration produces an antibody equivalent to the subcutaneous inoculation of ATT.
According to reports hitherto on the isolation of Vibrio cholerae non-01 from the environment, environmental conditions at the time of detection differ depending on whether isolation is from the sea or rivers. We based this study on two rivers of differing water quality and studied the trend of a bacteria indicator to observe the conditions of existence of V. cholerae non-01. 1) It was thought that V. cholerae non-01 did not flow from the land or other areas of pollution but existed at those points in the river from which they were isolated. 2) The proportion of V. cholerae non-01 isolated was higher for the river with a higher degree of water pollution and higher in areas of high pollution in both rivers. 3) In rivers with a low degree of pollution or having a small range in water quality, an increase in Cland PO43- ions, or an increase in the number of bacteria grown on nutrient agar medium at 37°C for 24 hours appears to increase the frequency of isolation of V. cholerae non-01. 4) Approximately 13% of the samples of isolated V. cholerae non-01 exhibited the cholera enterotoxin strain.
Ninety-four cases with HIV seropositive children who were found in the Hospital Necker Enfants Malades in France from April 1983 till September 1988 due to materno-fetal transmission were surveyed for immunological studies as well as the relationship between clinical symptoms and the prognosis. Lymphoadenopathy and/or hepatosplenomegaly were found in 98% of the total cases. Opportunistic infections, severe neurological problems and LIP were found in 28%, 16% and 15%, respectively. At the first laboratory examination, cases showing under 500/mm3 of OKT4 lymphocytes and with negative antigen-induced proliferative responses were observed in 24% and 44% of the cases, respectively. Negative serological profiles of antibodies to P18 and P25 HIV antigens appeared to show low values of OKT4 lymphocytes and abnormal responses to antigens. The survival cases with these findings were minimum. These data indicate that it is very much whorth, while to estimate the degree of immunological deficiency and infectious complications.
Nine children, 1 to 13 years of age, with HBeAg positive chronic hepatitis B received transfer factor (T. F.) monotherapy for 3 to 17 months, and were monitored by check-ups every six months from serum HBeAg, anti-HBe and GPT. In 12 months, 4 subjects became HBeAg negative and had normal serum GPT. In 22 to 48 months, 6 of the nine subjects had negative HBeAg and normal GPT, 2 had positive HBeAg and high GPT values. The remaining 1 subject who was observed for six months after T. F. therapy remained HBeAg positive with a high GPT values. No side effects were observed. These preliminary obsevations may indicate beneficial effects of T. F. on the natural course of chronic hepatitis B in childhood, though the ultimate effects awaits longer and well controlled clinical trials.
A 13 year-old girl with Down's syndome was admitted to our hospital with a very positive reaction to PPD 5TU, abnormal shadow on the chest X-ray films and diarrhea. She suffered from acute enterocolitis one year ago, and then has been complaining of abdominal pain, appetite loss, and weight loss for a year. After admission, she was diagnosed as tuberculous pleuritis and suspected intestinal tuberculosis by laboratory examination. She recovered without sequelae by the combination therapy of SM, INH, and RFP, and was discharged after 5 months. The diagnosis of intestinal tuberculosis was confirmed by Colon Fiberscopy showing ulceration at the ileocecal region and simultaneous biopsy showing granuloma. Surgical treatment was not reserved, because she had no complications namely perforation and fistulizaion. We estimated that the onset of intestinal tuberculosis coincided with the acute enterocolitis which she had about one year ago. We realized the importance of paying attention to intestinal tuberculosis in the differential diagnosis of enterocolitis, especially regional enteritis. Furthermore, in the therapy of the immunocompromised host including Down's syndrome, we must pay attention to extra-pulmonary tuberculosis. Effeciency of SM for intestinal tuberculosis with complications was confirmed.
An unusual case of Campylobacter fetus subspecies fetus bacteremia was presented. A twenty four year old male was admitted to our hospital due to abdominal pain, general malaise, diarrhea, high fever, and hemoptysis. He was alcoholic and fond of eating raw liver. He had a history of partial gastrectomy and disturbance of pancreatic function. He showed pulmonary empyema, pleuritis, thrombophlebitis of lower legs, jaundice, hepatomegaly, diarrhea, pneumothorax, and low T3 low T4 syndrome. C. fetus subsp. fetus was detected from the venus blood and pleural effusion on admission. He was successfully treated by gentamicin, chloramphenicol, and minocycline. This is the fourth case of C. fetus subsp. fetus bacteremia in the Japanese literature. This microanerophilic gram negative curved bacillus has been increasingly associated with human disease and relapsing in nature, so protracted antimicrobial therapy was recommended.
A 80 year-old male was transferred to our department on 18th Aug. 1988, for high fever and clouding of the consciousness., He had been treated with steroid hormone (betamethazone 3.0 mg/day for 15 days) for his uveitis. Enterococcus faecium was isolatd from both blood and spinal fluid, and then Strongyloides stercoralis was revealed both in the sputum and stool. Anti-Human T-cell leukemia virus 1 (HTLV-1) antibody was also positive serologically. At first, β-lactam antibiotics were used for the treatment of purulent meningitis and sepsis, but after performing sensitivity tests for E. faecium, the antibiotics were changed to rifampicin (RFP), fosfomycin (FOM) and ofloxacin (OFLX) for their excellent activity against the organism. After the clinical symptoms, subsided, thiabendazole was used for disseminated stronglyoidiasis in daily dosas of 2, 500 mg for six days initially. The drug ws used three times with two week intervals. Both bacterial and parasite infections subsided and no recurrence has been noticed until now. This is the first case of meningitis caused by E. facium complicated with strongyloidiasis.