Regarding P-fimbriae, K1 antigen, sero o-type and factors on the host (age, sex and mobirity) with are the pathogenic factors in E. coli, an assessment has been made as to what relations these factors have in urinary tract infection.
By age, cases of P-fimbriae is seen in large numbers among pregnant women and infants but less among the people aged 16-30. A similar trend was observed regarding K1 antigen. An assessment made by sex show a trend that E. coli which carries P-fimbriae tends to emerge frequently in males. By morbidity, P-fimbriated strain was seen in many severe cases among pregnant women and infants. The fact has become evident further as a result of making an investigation with K1 antigen added. However, the result of an assessment made in adult cases showed that P-fimbriae was seen frequently in simple cystits conversely.
As the reason for P-fimbriae being observed more in males, participations of immunological stage and anatomical factors on the host side in the pathogenicity was resumed, and the main cause that P-fimbriae is seen more in severe pregnant and infantile cases was presumed to be vesicoureteral reflux
Regarding group sero o-type and morbidity, the types reported so far were detected also at our hospital, but a very interesting finding we have obtained was that the stains P-fimbriae and K1 antigen were observed in types 2, 12, 18 and 75.

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In order to study the correlation between chronic prostatitis and C. trachomatis, IgA and IgG antibody titers for C. trachomatis were measured in serum and prostatic secretion of cases of chronic prostatitis. IgA antibody titers have higher tendency in prostatic secretion than in serum. The other side, IgG antibody titers have higher tendency in serum than in prostatic secretion. This result suggested IgA antigen was reacted in local immunological response in prostatic gland.
Subsequently, in order to confirm that IgA antibody in prostatic secretion is formed from secretory IgA antibody mainly, IgA antibody titers were compared with secretory IgA antibody titers. That result was considered that many cases with high IgA titers had high secretory IgA titers. The fact suggested in cases of C. trachomatis prostatitis, IgA antibody was mainly formed from secretory IgA antibody in prostatic secretion.

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Polymerase chain reaction (PCR) is useful for diagnosis of HIV infection in the silent stage, for HIV transmission from mother to child and for existence of HIV in blood and blood products. We developed a simple, rapid and safe PCR method by using digoxigenin labelled probes. Furthermore, we developed a semi-quantitative dot blot method. These methods will be helpful for diagnosis.

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We have reported novel methods for screening of HIV by using polymerase chain reaction (PCR) and degoxigenin labelled probes. Here we developed a filter paper method for samples from long distances. About 50μl of peripheral bloods were absorbed in filters (5 mm diameter), dried, heated, then stored for 1 month at room temperature before PCR. This method was proved to be sufficient for detection of HIV proviruses from clinical samples.

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The & ldquo;low dose and long term & rdquo; erythromycin (EM) therapy has been reported as effective (or useful) in chronic respiratory tract disease with pseudomonas (P.) infection including diffuse panbronchiolitis (DPB), however the mode of action is still obscure. Therefore in this study we have examined the effect of EM on the interaction between P. aeruginosa and human polymorphonuclear leukocyte (PMN) in vitro.
The efficiency of intracellular killing and the ability of superoxide production were employed to evaluate the PMN functions.
For the first step, the following results were obtained;
1) Pretreatment of PMN with 20 & mu;g/ml EM did not affect the killing ability of PMNs against opsonized P. aeruginosa of standard and clinical isolate from DPB patient.
2) Superoxide production from PMNs was observed by phagocytosis of P. aeruginosa in the presence of serum. This was not affected by exposure of PMNs to 20 & mu;g/ml EM even with increased ratios of bacteria to cells.
3) Pretreatment of P. aeruginosa with 20 & mu;g/ml EM before opsonization enhanced the killing ability of PMNs in both standard and clinical isolate.
4) Pretreatment of P. aeruginosa with 20 & mu;g/ml EM resulted in no effect on superoxide production from PMNs by phagocytosis of the bacteria.
These results indicate that EM may modify a certain step of the interaction between bacteria and intracellular host defence mechanisms. Therefore for the second step, we have investigated the susceptibility of EM-exposed bacteria to killing by the cell free (glucose oxidase-glucose) system, which will detect the enzymatic generation of hydrogen peroxide (H₂O₂).
The following results were observed;
1) EM-exposed bacteria was more susceptible to killing than control bacteria.
2) The enhanced susceptibility was not dependent on the continueous presence of EM.
This enhanced efficiency indicates that EM may affect the bacteria to become more susceptible to oxygen dependent killing mechanisms of the PMNs.
Concerning the host factors, we have also investigated the influence of supernatant of BALF on PMN's function. Specimens were from five patients with DPB.
The results were as follows;
1) The superoxide production from PMNs was only observed by the presence of BALF supernatant from DPB but not from sarcoidosis, pneumonia, idiopathic pulmonary fibrosis.2) BALF supernatants from two DPB patients after a long term EM treatment could not induce superoxide production from PMNs.
3) Chemotaxis and killing of PMNs have been enhanced in the presence of BALF supernatant from DPB.
These results suggest the presence of some kind of neutrophil activating factor in BALF from DPB patients, and EM may play a role through such kinds of cytokines in an unresolved manner. Further studies are warranted to disclose the pathogenesis of chronic pulmonary infection in DPB and the effective mechanism of EM.

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Erythromycine (EM) and chrolamphenicol (CP), the inhibitors of protein synthesis, were quantitatively examined for the growth of Pseudomonas aeruginosa EA83 and its production of extracellular proteins. The minimal inhibitory concentration (MIC) of EM for the strain was higher than 100 & amp;g/ml and that of CP was 100 & amp;g/ml. The growth curve of EA83 was not influenced by adding 5 & amp;g/ml of EM to the broth culture, but proteolytic activity and the total protein in the culture supernate went down to 60% of the control. Number of organisms in 20 hour culture was almost constant regardless of EM concentration ranging from 0 to 50 & amp;g/ml, however, the suppression of proteolytic activity and total protein in the culture supernate was seen even at 1 & amp;g/ml of EM concentration. The degree of suppression was inversely proportional to EM concentration. This phenomenon was also seen in the substitution of CP for EM. All extracellular proteins separated on SDS-PAGE decreased the amount as increasing EM in the culture media. These results suggested that EM inhibited the production of not only protease including elastase, but also any other extracellular proteins including well known pathogenic factors such as exotoxin A and phospholipase C.

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Sixteen hybridomas secreting antibodies to HSV-1 and 22 hybridomas serecting antibodies to HSV-2 were derived from fusion of SP2/0 myeloma cells with spleen cells from BALB/c mice immunized with each respective virus. Four of the former 16 hybridomas and seven of the latter 22 hybridomas were subcloned and injected into pristane-primed mice to obtain high titers of monoclonal antibodies. Antigen specificity of these monoclonal antibodies were determined by the Western blotting (WB) asaay. Two out of four monoclonal antibodies that showed selective reactivity for HSV-1 in IFA, reacted with HSV-1 specific proteins:#1 reacted with 100 KD and 70 KD proteins and #4 with a 150 KD protein, respectively, while the remaining two antibodies reacted only with a 50 KD protein that is type-common antigen. On the other hand, two out of seven antibodies which showed selective reactivity for HSV-2 in IFA, reacted with HSV-2 specific proteins:#5 with a 100 KD protein and #10 with three proteins of 30, 25, and 20 KD, and the other two antibodies reacted with a 50 KD protein that is a type-common antigen. The remaining three antibodies, two of which were found to be immunoglobulin type IgM, reacted with neither HSV-1 nor HSV-2 antigens in WB assay.
In order to determine their utility in serotyping, 11 monoclonal antibodies were examined by IFA test for reactivity to cells that were infected with 20 HSV-1 or 16 HSV-2 isolates which had been typed by neutralization test. All of the antibodies except two showed the same specificity as demonstrated in the neutralization test. The two monoclonal antibodies, #5 and #10, which specifically reacted with HSV-2 antigens in WB assay, did not react with two and four isolates of HSV-2, respectively. Possible subtyping of HSV-2 using monoclonal antibodies was discussed.

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Our retrospective study for ultrasonic nebulised pentamidine in 13 patients shows that 7 of 8 patients with Pneumocystis carinii pneumonia (PCP), proven by biopsy examination, were cured (recovery rate, 88%). Two of these 8 patients were mainly treated by nebulised pentamidine and the other 5 patients were administered parenteral pentamidine before the nebulised pentamidine therapy and the final 1 patient died on day 9 without clinical improvement with nebulised pentamidine as well as conventional therapy (trimethoprim-sulphamethoxazole, parenteral pentamidine). No relapse occurred in the 7 cured patients.
The inhalation increased the cough in 4 of 13 cases and caused vomitng in 1 patient. Two patients discontinued the nebulisation because of the side-effect. No extra-pulonary side-effects of nebulise dpentamidine were seen.
These results show that an efficacy of nebulised pentamidine is at least equal to conventionaltherapy with fewer side-effects and that only patients with mild PCP without severe hypoxaemia are eligible for the inhalation therapy.

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Okinawa prefecture is well known as an endemic area of Strongyloides stercoralis infection, and its recent infection rate was reported 6.2%, which was investigated by a new technique to detect S.stercoraris, -agar plate method. Traditional treatment with thiabendazole was temporarily effective for S.stercoralis, but the recurrence rate was extremely high. We tried the new treatment for the purpose of complete eradication of the parasite.
The patients were divided into two groups, who were given 500 mg of thiabendazole three times daily for 5 days and not medicated for the following 9 days. The medication was repeated 3 times in group 1 which consisted of 92 patients and 4 times in group 2 which consisted of 70 patients.
Obtained results were as follows: 1) Six months after treatment, the cure rate was 89.5% in the only one course treatment, and 100% in more than 2 course treatments.
2) Side effects such as nausea, vomiting, anorexia or general fatigue were noted in 67.5% of all the patients after initial treatment, and 45.1% of the patients were dropped out of this trial. The dose of the drug was reduced in 32.1% of the patients, and only 22.8% were treated with full course of the regimen.
3) The elevation of S-GPT was observed in 33.8% of all patients. After initial treatment the rate was only 8.1%, but after 3 or 4 repeated course of treatments the rate was elevated to 39.0% and 45.4%, respectively. The liver injury was closely related to the total dose of thiabendazole and the period of the medication.
From these results, the treatment should be repeated at least two times for complete eradication of the parasite. But among these treatments, as the side effects, especially liver damage, were observed in higher incidence, further analysis should be necessary for the usage of the drug.

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Clinical backgrounds of 35 patients with urogenital infection, from whom methicillin-resistant Staphylococcus aureus (MRSA) was isolated, were analyzed. Susceptibilities of these MRSA strains to various antimicrobial agents were also measured. Out of 35 MRSA strains, 29, 4 and 2 were isolated from urine, pus and sputum specimens, respectively, showing a definitely high isolation rate fromurine. As for underlying diseases, 22 patients (62.8%), 11 (31.4%) and one each had a malignant tumor of the urinary tract or genital organ, prostatic hypertrophy, urolithiasis and vesicoureteral reflux, respectively. Patients aged at over 60 years numbered 20 (57%), and 32 patients (91.4%) were treated with some antimicrobial agent at the time of MRSA isolation.
Out of 35 strains, 17 were isolated after total cystectomy with urinary diversion or transurethral surgery. As for the state of MRSA infection, 9 and 26 patients had single and polymicrobial infections, respectively, but none of patients had serious symptoms definitely thought to be caused by MRSA.
On evaluation of susceptibilities of MRSA to various antimicrobial agents, the MRSA strains were found to be sensitive to minocycline, netilmicin and ofloxacin.
From these results, MRSA strains isolated from patients treated in the field of urology were thought to rarely cause serious infectious symptoms, especially true for those isolated from the urine.

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Commercially available Amies transport medium with charcoal and three isolation media were tested to assess their efficiency in the clinical isolation of B. pertussis.First, the isolation rates of B.pertussiswere compared between direct inoculation of nasopharyngeal specimens and inoculation after stored in Amies transport medium for 8 hours or less. The comparative isolation rates were 81% both (35 of 43 specimens from 29 patients) for direct inoculation and transport medium. Second, nasopharyngeal specimens were incubated for 5 days at 35°C on the three media; Bordet-Gengou Medium (BG) with 5μg of CEX per ml, Cyclodextrin Solid Medium (CSM) with 5 μg of CEX per ml, and Charcoal Agar with 40 μg of CEX per ml. The organism was detected from 44 nasopharyngeal specimens from 20 patients on at least one of the three tested media. The comparative isolation rates were 91%(40 of 44) on BG with 5 μg of CEX per ml, 93%(41 of 44) on CSM with 5μg of CEX per ml, and 91%(40 of 44) on CA with 40μg of CEX per ml. Although no differences in the isolation rates were observed among the three media, the appearance of the colonies was earlier by one day on BG than the rest of the two media. The detection ofB. pertussiswas occasionally easier on CA than the rest of the two because of its higher suppression for nasopharyngeal flora. CSM has its advantage in that it does not need any blood and can be prepared at anytime. Also, the shelf life of these three media proved to be at least one month when stored at 10°C. We conclude that the clinical isolation of B. pertussiswas highly successful with the following simple procedure: nasopharyngeal specimens stored in Amies transport medium and inoculated on one of the three media, BG, CSM, or CA, and then incubated for 5 days at 35°C.

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To elucidate the phagocytic activity of polymorphonuclear leukocytes (PMN) in systemic lupus erythematosus (SLE), we assayed the luminol dependant chemiluminescence of PMN (PMN-CL) of 30 patients with SLE, and evaluated the effects of disease activities and corticosteroid (steroid) therapy on the PMN-CL.
The PMN-CL of active SLE patients (n=10) before steroid therapy increased significantly compared to normal controls when stimulated with phorbol myristate acetate (PMA) (p<0.05). On the contrary it decreased significantly when stumilated with opsonized zymosan (OZ) (p<0.01).
The PMN-CL of SLE patients under steroid therapy (average prednisolone dose, 40.4 mg/day) revealed a tendency to decrease according to the increase of total steroid dose. It was corelated with the total steroid dose for the preceding 12 or 16 weeks, when stimulated with formyl-methionylleucylphenylalanine and PMA. However it was not related with the current steroid dose.
Thus the increase of PMN-CL by PMA stimulation as well as the decrease by OZ stumilation seems to be a charactristic phenomenon in SLE. The PMN phagocytic activity in SLE will be suppressed after more than 12 weeks therapy of large doses of steroid.

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I developed on immunoblotting assay for the detection of antibodies to mumps virus components, using purified mumps virus propagated in Vero cell cultures, and investigated the presence of antibodies after vaccination in comparison with enzyme linked immunosorbent assay (ELISA). In the immunoblotting assay, antibodies to hemagglutinin-neuraminidase (HN) and fusion (F) protein were detected two weeks after vaccination with live mumps vaccine, in accordance with the presence of ELISA antibodies. All serum samples positive in ELISA showed positive in immunoblotting, and two out of nine samples negative in ELISA after vaccination were positive in immunoblotting. Thus, the immunobotting method is considered to be more sensitive than ELISA for the detection of antibodies to mumps virus.

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Superior vena cava (SVC) syndrome caused by benign diseases is rare.
We reported a case of mediastinal abscess due toEnterococcus faecalis (E. faecalis)accompaniedwith SVC syndrome and reviewed the literature on this particular condition.
A 38-year-old female with swelling of the neck and dilatation of cervical vein was admitted to our hospital, being diagnosed as having a SVC syndrome.
Chest roentgenogram revealed an enlargement of the right upper mediastinum and a massive infiltration in the right upper lung field. CT scan demonstrated a mass with central necrosis occupying the right upper mediastinum and stenosis of superior vena cava. Further confirmation of the stenosis of vena cava was made by means of venography.E. faecaliswas recovered from the pus aspirated from the mediastinal abscess, and a definitive diagnosis of SVC syndrome caused by mediastinal abscess due toE. faecaliswas made.
There has been no report, to our knowledge, on mediastinal abscess evolving SVC syndrome in whichE. faecaliswas identified as a causative organism.
The present case indicates that a benign disease such as lung abscess should be considered to be a possible cause of SVC syndrome in addition to other frequent malignant diseases.

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