Pseudomonas pneumonia is one of the fatal opportunistic infections. We examined Pseudomonas aeruginosa in the autopsied lung tissues by the immunostaining (Biotin-Streptoavidin peroxidase complex method).
Out of 185 autopsied casee, fifty-three cases had bacterial pneumonia. We performed the immunostaining to these 53 cases, of which 14 cases (26.4%) were diagnosed as pseudomonas pneumonia.
All of the 14 cases had severe underlying diseases which were hematologic malignancies in six, solid malignancies in five and so on. Of ten of them pseudomonas pneumonia was considered to be the direct cause of death.
P. aeruginosa was observed in alveolar space in all cases, and in bronchial and bronchiolar lumen in many cases. P. aeruginosa was also detected in alveolar and vascular walls.
Histopathologically necrotizing vasculitis and alveolar destruction were characteristic, and intraalveolar hemorrhage, fibrinous exudate, abscess formation, coagulation necrosis and thrombosis were observed in most cases. Necrotizing vasculitis and intra-alveolar hemorrhage were more severe in the cases of leukopenic patients.

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Serum samples were collected from a total of 1, 306 and 536 cattle raised in Saitama and Kagoshima Prefectures, respectively, during a period from 1982 to 1984. Their antibody titers against Japanese encephalitis virus (JEV) were determined by the hemagglutination-inhibition test. Antibody prevalences were 65.5%(856/1306) and 68.8%(369/536) in Saitama and Kagoshima Prefectures, respectively. In both prefectures, there was a rapid increase in positive rate and mean titer in summer. Afterwards, there was a gradual decrease in both rate and titer in Saitama Prefecture in winter. In Kagoshima Prefecture, however, the rate and titer did not so markedly decrease in winter, but remained high in December. The rate of positive reactors to JEV in Kagoshima Prefecture increased gradually from 29.4%(1 year old) to 74.5%(4 years old) with advance in age. This rate in each age group remained almost at the same level ranging from 64.0% to 82.8% in Saitama Prefecture.

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Two hundred and fifty Shigella strains isolated in Japan were examined for their drug-resistances and their conjugal transferability. Drugs used and the isolation frequency of resistant strains were: sulfanilamide (SA) 96%, streptomycin (SM) 85%, tetracycline (TC) 82%, fosfomycin (FOM) 76%, chloramphenicol (CP) 51%, trimethoprim (TMP) 46%, ampicillin (ABPC) 45%, nalidixic acid (NA) 6%, kanamycin (KM) 5%, cephaloridine (CER) 4%, gentamicin (GM) 0%, amikacin (AMK) 0%, colistin (CL) 0%, norf loxacin (NFLX) 0%. All of the KM-resistances and none of the FOM-resistances were transferable. Each 20 to 30% of CP, TC, SM, SA or ABPC-resistant isolates transferred each drug-resistance.
Two thirds of the isolates were brought to Japan by travellers mostly from South-East Asia. The isolation frequency of resistant strains was not different between domestic and foreign strains except that NA-resistance was not found in foreign strains.
The frequency of isolates carrying transferable R plasmids were higher in domestic strains than foreign strains. Most of the isolated had multiple drug-resistance. Major resistance types were:(CP, TC, SM, SA, ABPC) 22%;(TC, SM, SA, TMP) 20%;(CP, TC, SM, SA, ABPC, TMP) 16%;(TC, SM, SA) 8%. Strains showing different resistance types were different among each other in their serum type, conjugal transferability, and derived country. Stepwise evolution of multiple resistance in one country was not demonstrated. The resistance types of Shigella isolates in Japan have been influenced by yearly change of imported strains.

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The immune response after HB vaccination (20 μg, 3 times) was investigated in 15 alcoholics and the immunological background was also studied before the vaccination in some of these cases. Anti-HBs was detected in only 8 (53.3%) out of 15 vaccinated alcoholics and the anti-HBs titers of these 8 responders were less than 16 cut off index at the last observation.
Immunologically, peripheral lymphocyte count and/or the OKT4/OKT8 ratio of lymphocytes in 2 alcoholics (non-responders to vaccination) were lower than those in a control case (good responder). But, there were no differences in serum anti-HAV, and-EBNA positive rates, immunoglobulin levels and blastogenesis by PHA, Con-A between responders and non-responders. These data suggest that poor response to HB vaccination is probably due to an impaired cellular immunity in alcoholics and the necessity of re-vaccination for no or low responders should be considered.

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The in vitro susceptibilities to five chemotherapeutic agents agaisnt a rickettsial strain which was isolated from a case of Japanese spotted fever were determined by cell culture system. Minocyclinewas the most effective (MIC, 0.15 μg/ml) followed by Tetracycline and Demethylchlor tetracycline (0.31 μg/ml 0.16 μg/ml).
Chloramphenicol was less effective (5 μg/ml) and Aminobenzyl-penicillin was not effective with the MIC of 10 μg/ml or less. Thus, the earlier administration of Minocycline is recommended to clinically suspicious cases of Japanese spotted fever as well as Tsutsugamushi disease.

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We previously reported that a variant of herpes simplex virus type 1, which we found by Bgl II digestion of many Japanese HSV-1 isolates' DNA's, was isolated frequently in two regions of Western Japan, i.e. Yamaguchi and Fukuoka. In this paper, we analyzed 280 more isolates from eleven regions in Japan. In four western regions of Japan, i.e. Osaka, Shimane, Yamaguchi, and Fukuoka, the isolation frequecny of the variant was very high, and its proportion among all the isolates from those regions was 30 to 50%. On the other hand, in four eastern regions of Japan, i.e. Akita, Iwate, Miyagi, and Yamanashi, the proportion was 0 to 11%. In two central regions, i.e. Aichi and Kyoto, the proportions were 16 and 22%, respectively. Thus, the variant seems to be localized in the western regions of Japan.

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The authors studied the effect of antibiotics, hydrocortisone and anti-cancer drugs on gastrointestinal infections and dissemination by C. albicnas in mice inoculated orally with C. albicans. The mice were given orally, vancomycin, amikacin and polymyxin B, and they also were injected with ampicillin and gentamicin. Hydrocortisone, cyclophosphamide (CPA) which causes leukopenia and neutropenia, and methotrexate (MTX) which injures the mucous membrane of the gastrointestinal tract were injected to the mice.
In the mice treated with antibiotics and anti-cancer drugs, and inoculated orally with C. albicans, the colony forming units of the feces conspicuously incresed. Gastrointestinal candidiasis was frequently observed, particularly at the cardia and the cardio-antrum line of the stomach of these mice. In addition to these sites, gastrointestinal canditiasis was observed at the antrum and the small intestine of the mice injected with MTX. C. albicans was frequently recovered from the livers and lungs of the mice treated with antibiotics and MTX+CPA which cause leukopenia, neutropenia and the damage of mucous membrane of the gastrointestinal tract.
It is suggested that the threshold gut population of C. albicans is a determinant for gastrointestinal candidiasis, and that leukopenia, neutropenia and the damage of mucous membrane of the gastrointestinal tract are important factors for dissemination by C. albicans from the primary gastrointestinal lesions.

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From September 1986 through July 1987, all fecal specimens obtained from infants and children who visited the pediatric clinic of the Shizuoka General Hospital with complaints of abdominal pain or diarrhea were examined for thermophilic Campylobacters. Bacteriological and epidemiological studies were performed on household contacts. The mothers of the patients were compared with the mothers of age-matched control subjects. Bacteriological examination of animals in 49 primary schools in Shizuoka city was performed.
C. jejuni was isolated from 47 (9.4%) of the 499 feces samples, occupying first place in the bacterial etiology of acute bacterial enteritis. Infants and young children below 10 years of age comprised 81% of the total cases. Fourteen (13%) strains of C. jejuni were isolated in 9 families among 105 household contacts of the index patients.
Six symptomatic contacts in two households had eaten the same suspected chicken as the respective index patients. In three families, C. jejuni was isolated from the remainder of the chicken. The serotype of these isolates was identical to that of the isolates from the index cases and the other family members. It was also noted that the same chopping boards were used for the preparation of salads after cleansing with water. In two index cases, the antibody of convalescent serum against C. jejuni isolated from the chicken, as estimated by passive hemagglutination method, ranged from 1: 320 to 1: 1280. These facts strongly supported the assumption that they had been infected by the chicken. The remaining persons were asymptomatic and the possibility was left that the index cases had been secondarily infected by these carrier persons. The serotype of 42% of the 26 human isolates was type 2, according to the schemes of Penner. The predominance of type 2 was also observed in commercially available chicken in Shizuoka city.
In a case control study, the incidence of consumption of chicken, beef and pork was essentially the same in both groups. However, a significantly small number of mothers washed the chopping board or kitchen knife with a cleanser after cutting raw meat. There was no significant association with the keeping pet animals.
862 animals (251 chickens, 498 cage birds and 113 rodents) were kept in forty-nine primary schools. Three hundred and thirty-nine animals were examined. Two chickens and 5 cage birds had Campylobacter in their feces. Some of them showed signs of illness. However, long term carriage was rare and no children suffering from diarrhea were observed among animal breeders. It is already clear that in Shizuoka city, the majority of chicken carcasses sold at markets are contaminated by C. jejuni.
We conclude that in Shizuoka city, the important factor in the transmission of Campylobacter is handling of raw poultry, and subsequent cross-contamination of hands, surfaces and other foods. Careful washing of the hands and kitchen knives with water and soap or a cleanser after handling raw poultry, and the avoidance of the common use of a chopping board for raw meat and salads will greatly reduced the risk of transmission.

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A study on the growth cycle of C. trachomatis of genital origin in McCoy cells has produced the following results:
1) Two kinds of surface projections, spikelike and hemispheric, were observed. The spikelike projections were recognized 50 hours after infection in larger C. trachomatis of 1.0, um in diameter. From the surface these C. trachomatis measured 21-52 nm in height with diameters of 25-35 nm.
Hemispheric projections were observed 72 hours after infection in smaller C. trachomatis of under 0.3, um in diameter. Their average diameter was 34.0 nm. These projections were hexagonally arranged with the distances between the center of adjacent projecions at 40-45 nm.
2) Intrainclusion networks were observed. These were recognized in inclusions72 hours after infection. Their structure was three dimensional with lineal materials extending from one C. trachomatis to another. The networks were composed of granular particles averaging 53.9 nm in diameter. These granular particles were not noticed after amylase treatment and lineal material of 33.5 nm in width was noticed instead. This lineal material may be regarded asthe axis of the network. Structurally, the network is an axis 33.5 nm wide with glycogen granules attached to the perimeter.
The network structures were classified into long, short, and inclusion types.

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TE-031 (A-56268), a new macrolide antibiotics, was administered on a long-term basis (6 months) to 12 patients with diffuse panbronchiolitis (DPB). The causative microorganism was identified as H. influenzae in 5 cases, P. aeruginosa in 4 cases and B. catarrhalis in one case. The clinical picutre of those patients was monitored, and some basic studies were also carried out.
Clinically, all of the patients showed improvement in the symptoms and the various laboratory test values. Bacteriologically, as well, both H. influenzae and B. catarrhalis were eradicated. In addition, P. aeruginosa was eradicated from 2 of the 4 cases, reduced in one case and unchanged in one case. Hhowever, even in that one case in which P. aeruginosa was unchanged, the disease symptoms were alleviated. There were no instance of microbial replacement.
In spite of the long-term administraiton of TE-031, There were no side effects.
As the basic studyk, the DPB patients were examined for the presence of antibodies directed at viruses having affinity for the respiratory organs. It was found that a high perventage of the patients showed a high titer of antibodies for influenza virus type III and type II. It was thus surmised that it is likely that viral infection is involved in the progress of this disease.
From the standpoint of the progress of DPB, the NK activity was investigated as part of the natural host defense mechanisms. It was found that, compared with healthy controls, the level of NK activity was higher in DPB patients and that it was even higher in patients on long-term TE-031 administration.
On the basis of the above results, it is surmised that TE-031 elevates the NK. activity, and thereby accelerates the nonspecific defense mechanisms of the host. Patients with DBP thus acquire added protection against viral infection, which could play a role in the progress of DPB. Therefore, without viral-caused lesions in the airways to attach to, bacteria are less likely to colonize the mucosa and establish superinfection. It is surmised that, as a result of these direct and indirect mechanisms, TE-031 brings about improvement in the prognosis of DPB.

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Legionnaires' disease is primarily a respiratory disorder, but recently several cases with extrapulmonic manifestations are reported.
We report a case of Legionnaires' disease associated with pneumonia, diarrhea, central nerve disorders and rhabdomyolysis.
The pathogenesis of rhabdomyolysis in Legionnaries' disease remains speculative. Endotoxin isolated from Legionella pneumophila may play a role in the pathogenesis of the myonecrosis. An additional factor that might contribute to rhabdomyolysis in this case is severe dehydration induced by diarrhea.
Pneumonia with elevated CPK levels and myoglobinuria may suggest Leginnaires' disease.

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A 39-year-old Japanese male engineer who stayed in Nigeria from August 17, 1987 through January 22, 1988, presented chloroquine-resistant Plasmodium falciparum malaria. He was taking oral chloroquine prophylactically. But he suffered from P. falciparum malaria in November, 1987 and early January, 1988. He was treated in Nigeria.
After his return to Japan, he was admitted to our hospital with a fever of 39°C on January 29, 1988. The peripheral blood smear on admission showed the presence of ring form P. falciparum. He was diagnosed as recrudescence of P. falciparum malaria. Laboratory examination revealed severe thrombocytopenia and biologic false-positive serological tests for syphilis. The level of 50% inhibitory concentration was 0.44 nmol/ml by in vitro chloroquine sensitivity test of the strain of P. falciparum obtained from this patient. Clinically, chloroquine was not effective. The patient was treated with intravenous quinine dihydrochloride followed by sulfadoxine/pyrimethamine tablets and recovered completely.
As far as we know through our survey this patient was the first case of chloroquine-resistant P. falciparum malaria brought to Japan from Nigeria.

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