Kansenshogaku Zasshi
Online ISSN : 1884-569X
Print ISSN : 0387-5911
ISSN-L : 0387-5911
Volume 65 , Issue 6
Showing 1-16 articles out of 16 articles from the selected issue
  • Yotaku GYOBU, Hirohide KODAMA, Shigeaki SATO
    1991 Volume 65 Issue 6 Pages 665-671
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    Lethality, adhesion, colonization, hemagglutinable activity, invasiveness and cytopathogenicity of non-O1 V. cholerae were compared between enteropathogenic and non-enteropathogenic strains. The following results were obtained. 1) Minimum lethal doses (MLD) of enteropathogenic strains were significantly lower than those of non-enteropathogenic strains. 2) There were no differences in adhesive and hemagglutinative activities between enteropathogenic and non-enteropathogenic strains. 3) A greater majority of enteropathogenic strains showed cytopathogenic effect on HEp 2 cells, but non-enteropathogenic strains did not. 4) Regardless of enteropathogenicity of viable cells, none of the 13 strains examined were found to be invasive to HEp 2 cells.
    These results suggest that adhesion and colonization do not draw a clear distinction between enteropathogenic and non-enteropathogenic strains, and that both lethal and cytopathogenic activities of these organisms are correlated with enteropathogenicity.
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  • Hideaki NINOMIYA, Yoichiro ICHIKAWA, Hideyuki KOGA, Takafumi YANO, Kot ...
    1991 Volume 65 Issue 6 Pages 672-680
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    The clinical and pathological features of diffuse panbronchiolitis (DPB) have been well reported to date though its pathogenesis remains unknown.
    This study was designed to evaluate the protease antiprotease imbalance in patients with DPB. For this purpose, we performed bronchoalveolar lavage (BAL) in sixteen patients with DPB, twelve patients with chronic bronchitis (CB) and control subjects (nine smokers and eleven non-smokers), and determined elastase activity and α1 antitrypsin (α1 AT) concentration in bronchoalveolar lavage fluid (BALF). Elastase activity was measured using a synthetic substrate, succinyl-tri-L-alanine-pnitroanilide.
    BALF from eleven of sixteen patients with DPB showed elastase activity. However, only two of twelve patients with CB showed elastase activity, and control subjects did not show any elastase activity in BALF. Although α1 AT concentration is elevated in BALF from patients with DPB, it is assumed that elastase burden exceeded the elastase inhibitory capacity of α1 AT in BALF.
    The percentage of neutrophils in BALF correlated significantly with elastase activity which was inhibited by DFP, but not by EDTA. These data revealed that the elastase in BALF was a serine protease of neutrophil origin.
    In five DPB-patients treated with low-dose long-term erythromycin chemotherapy, elastase activity in BALF decreased significantly.
    The above mentioned findings suggest that the neutrophil elastase plays an important role in the pathogenesis of DPB, and the mode of action of erythromycin on DPB is to decrease the elastase burden.
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  • Koushin SHIKIYA, Nagisa KINJO, Minoru IKEMA, Akihiro YAMASHIRO, Hiroyu ...
    1991 Volume 65 Issue 6 Pages 681-686
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    We previously treated 47 patients with 100 mg of mebendazole (MBZ) twice a day by oral use for 5 days and this treatment was repeated 1, 3 and 4 weeks later. Although the cure rate was 100%, liver injury was observed in 48.9% of the patients. On this study, we reduced the periods of administration of MBZ (powder; 100 mg twice a day) to 4 days, and repeated it once after 3 days interval, and this initial treatment was performed one more time after 10 days interval (group 1).
    As Strongyloides stercoralis is mainly located in upper digestive systems, we used the drug reduced to powder for the purpose of better contact with the parasites. We considered that the powder should be absorbed well and liver injury occurred in high incidence.
    As group 2, we used the tablet itself in the same schedules of group 1.
    The results obtained were as follows;
    1) The eradication rates at 10 days after the initial treatment were 97.8%(44 of 45 patients) in group 1 (powder) and 93.0%(40/43) in group 2 (tablet).
    2) At 3 days after the whole treatment, the eradication rates were 100.0% in group 1, and 97.7%(42/43) in group 2.
    3) Slight side effects such as constipation (6.7% in the group 1), dizziness or vertigo (6.7% in the group 1) and itching (6.7% in the group 2) were observed.
    4) Liver injury was observed at 11.1%(5/45) 10 days after the initial treatment in the group 1 and 13.3%(6/45) in the group 2. After whole treatment, it was observed at 60.0%(27/45) and 68.9%(31/45) in the both groups, respectively.
    In comparison of the two groups, there were no significant differences of HTLV-1 antibody positive rate and improvement of symptoms, side effects, eradication rate of the parasite and incidence of liver injury after the treatment, but significant difference was obtained in liver function between examination after the initial treatment and the whole treatment in the both groups.
    As conclusion, tablet or powder of MBZ could be used either with safe and satisfactory eradication in the initial treatment, i.e. in dosis of 100 mg, twice a day for 4 days and this treatment repeated after 3 days interval.
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  • Tetsunori MUTO, Kazuji ARAI, Mitsuo MIYAI
    1991 Volume 65 Issue 6 Pages 687-691
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    To compare the isolating efficiency of diarrhea-causing Escherichia coli between Fluorocult agar plates, which reveal the β-glucuronidase activity of E. coli, and a combination of SS and DHL agar plates, a total of 330 fecal specimens collected from outpatients were examined. Diarrhea-causing E. coli, identified by serological and toxigenic characters, were demonstrated in 52 samples. Among these specimens, 35 samples tested were positive on the Fluorocult agar plates, and 26 samples on the combination of SS and DHL agar plates. However, only 10 samples were positive on both the Fluorocult agar plates and the combination of SS and DHL agar plates. Thus, using Fluorocult agar plates for the isolation of diarrhea-causing E. coli in addition to the conventional SS and DHL agar plates will improve isolating efficacy.
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  • Hiroshi MUKAE, Osamu SAKITO, Hiroshige ODA, Reiko SENJU, Kazuto HIRATA ...
    1991 Volume 65 Issue 6 Pages 692-697
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    Cellular analysis including lymphocyte surface markers in BALF in 17 patients with DPB (14 male; 36 female) was performed. The total number of cells increased remarkably, especially the percentage of neutrophils (72.9±14.1%). On the contrary the percentage of alveolar macrophage decreased (15.4±8.9%). The CD4/CD8 ratio in DPB was also significantly decreased to 0.73±0.38% when compared with normal healthy nonsmokers.
    Five patients with low dose and long term EM treatment were analyzed. Total cell counts as well as the neutrophil percentage (7.3±4.0%) decreased significantly. On the other hand the percentage of alveolar macrophage increased to 76.6±0.6%, which was almost similar to those obtained from normal healthy volunteers.
    Therefore it is concluded that both clinical and BALF findings improved concordantly after EM treatment.
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  • Shuji TOKUNAGA, Mitsuo OHKAWA, Yukinosuke OSHINOYA, Takao NAKASHIMA, H ...
    1991 Volume 65 Issue 6 Pages 698-702
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    We studied the incidence of the postoperative bacteremia developing in 44 patients undergoing transurethral resection of the prostate under prophylactic use of antibiotics. In 15 of the patients, postoperative endotoxinemia was also investigated. Postoperative bacteremia was found in 10 (22.7%) of the patients, in only one of whom septicemia developed. The incidence of bacteremia was not influenced by the kind of antimicrobial agent administered prophylactically, but was significantly higher in the patients with preoperative urinary tract infection or prostatitis on histological examination of resected prostatic tissue (p<0.01). Concerning species isolated from the blood, gram-positive cocci were isolated more frequently than gram-negative bacteria, and Staphylococcus epidermidis was the most common species. In 7 (70%) of the bacteremia patients an identical species was isolated from preoperative urine cultures. In the patients with bacteremia, significant increases in white blood cell count and maximal body temperature were found within 3 hours after the procedure as compared to before the procedure. To lower the postoperative bacteremic rate, appropriate and adequate antimicrobial agents must be used preoperatively in patients with infection of the genitourinary tract. As to blood endotoxin, the endotoxin levels in the patients with postoperative fever did not significantly differ from those of the patients without this complication.
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  • Yoshiko KOBAYASHI, Yuji AMANO, Masayuki ICHINOSE, Takayuki MATSUE, Tak ...
    1991 Volume 65 Issue 6 Pages 703-709
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    The infections with C. trachomatis and N. gonorrhoeae have recently been determined routinlly with the commercial kits for detecting the antigens of these organisms in both the clinical and mass examinational laboratories. In mass examination, a change during transporting the specimens must be avoided. Hence, a study on whether the antigens were changed with atomospheric temperature was carried out.
    As for C. trachomatis, no change in antigen was found on the enzyme immunoassay (EIA) absorbance of the antigen quantity corresponding to the cell of 4.8×104, 2.4×104 and 6.0×103 (IFU/ml) until 5 days at 4, 25 and 37°C respectively after sampling. The coefficient variation was found out to be ca. 10%.
    In a test on antigen stability of N. gonorrhoeae, simillar results to that of C. trachomatis were obtained on the following antigen quantity: 2.4×103, 3.3×102 and 9.0×10 (CFU/ml) under the sameconditions as in the above. The coefficient variation was found out to be 10% or less.
    To investigate whether there is any difference on the stability of C. trachomatis antigen between mailing and hand carrying, a total of 133 specimens collected from many clinics were subjected to the detection of antigen with the commercial EIA kits. The results of comparison on both transport methods were as follows: agreement rate 96.2%, positive rate 100% and negative rate 95.2%.
    The highly correlation between the both transpotation was confirmed in the detection of antigen; that is, Y=1.03X+0.03, r=0.936.
    These results indicate that the mailing of specimens is applicable to the detection of C. trachomatis and also N. gonorrhoeae in mass examination.
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  • Misako MURATA, Gohta MASUDA, Masachika TSUJI, Masayoshi NEGISHI
    1991 Volume 65 Issue 6 Pages 710-717
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    Patients with typhoid or paratyphoid fever, admitted to 14 hospitals for infectious diseases during 1984-1987, were epidemically and clinically studied. of the total number of 183 typhoid, 49 paratyphoid fever patients, those infected overseas was 44.3% and 71.4% respectively, giving an overall annual decrease, yet marking an increased ratio of overseas infection. Patients aged 20s-30s and males were dominant. One hundred and seventy six cases (96.2%) of typhoid and all the paratyphoid fever cases were bacteriologically diagnosed. The period from the onset to the diagnosis was around 14 days in most cases, but beyond 29 days in over 10% of the cases. We would like to emphasize that enteric fever, focusing on high fever, bradycardia, roseola, hepatosplenomegaly, leukopenia, elivated serum-GOT GPT and LDH, can be easily diagnosed by blood/stool culture before beginning chemotherapy. Intestinal bleeding was recognized in 24 cases (13.1%) of typhoid and 4 (8.2%) of paratyphoid fever, intestinal perforation in 2 (1.1%) and death in 1 (0.5%) of typhoid fever. CP was most commonly used in chemotherapy. Bacteriological relapse was recognized in 7/127 cases (5.5%) of typhoid, 6/48 (13.0%) of paratyphoid fever those followed beyond 3 weeks, though eradication was attaind by retreatment. One strain of S. typhi resistant to CP·ABPC·KM·SM was isolated in 1986 from a patient infected overseas. New quinolones seem reliable in our preliminary studies.
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  • Hirokazu GOTO, Hiroshi KIYOTA
    1991 Volume 65 Issue 6 Pages 718-724
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    In order to clarify the role of polymorphonuclear leukocytes (PMNs) in the defence mechanism of the urinary tract, we investigated the superoxide anion (O2-) generation of PMNs in the urine. We tested urines mixing concentrated urine with diluted ones in various ratios. Peripheral blood derived PMNs were stimulated in tested urines or phosphate buffer solution (1M, pH 7.0) with phorbolmyristate acetate and O2-generation of PMNs was measured by means of chemiluminescence (CL) method. The CL values of PMNs in tested urines were 1/30 that of phosphate buffer solution. However, PMNs generated Oi at maximum levels when the urine osmolarity was 300-400 mOsm/kg. Futhermore, PMNs did not generate Oi when the urine osmolarity was more than 600 mOsm/kg, or less than 200 mOsm/kg. We also investigated the influence of urea and creatinine on O2-generation of PMNs. The O2-generation of PMNs decreased when the urea concentration rose. However, there was no influence of creatinine on O2-generation of PMNs.
    From these results, it was elucidated that PMNs generated O2-when the urine osmolarity was 300-400 mOsm/kg. Therefore, urine osmolarity of the patients with urinary tract infection should be kept at 300-400 mOsm/kg, and diuresis might be important for the patients with urinary tract infection.
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  • Minoru NASHIDA, Etsuko SHIMOHARA, Shinroku SUGISHIMA
    1991 Volume 65 Issue 6 Pages 725-729
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    In 1986, under the Infectious Disease Surveillance system in Fukuoka Prefecture, no isolation of echovirus type 7 from aseptic meningitis patients were reported. It was unclear that epidemics of this virus occurred in Fukuoka Prefecture, including Kitakyushu City.
    We tried to isolate enteric viruses from the sewage (activated sludges) in Kitakyushu City in 1986. Outbreaks of isolations of echovirus type 7 started in September and continued until in December. This result suggested that echovirus type 7 caused epidemic during this period in Kitakyushu City.
    Sera were collected from children in 1989, and were examined neutralizing antibody titer against echovirus type 7. Antibody titers were positive in the sera of about half of children above 1 year of age in 1986.
    From results of virus isolations from the sewage and serological study, it was confirmed that echovirus type 7, reported no isolation in Fukuoka Prefectural surveillance system, caused epidemics in Kitakyushu City in 1986.
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  • Akihiro MIYANO
    1991 Volume 65 Issue 6 Pages 730-737
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    Twelve serovar type strains (C, D, E, F, G, H, I, J, K, L1, L2 and L3) and eight isolates (D, 4; E, 2; K, 2) of C. trachomatis were examined by restriction endonuclease analysis (REA) of DNA extracted from the elementary bodies. No difference was observed in DNA patterns of three serotypes (L1, L2 and L3) of the biovar LGV when they were digested with EcoRI and analysed by electrophoresis in a 0.6% agarose gel. The genital strains of the biovar trachoma (serovars D-K) showed similar EcoRI patterns with or without detectable differences. Serovar C of the biovar trachoma differed from the biovar LGV and the genital strains. Comparative analysis of DNAs digested with EcoRI, BamHI, HindIII, Sall andNcoI revealed that C. trachomatis isolates belonging to serovars D and K, but not E, could be subdivided into different genome types. These results suggest that DNA cleavage pattern analysis is useful for epidemiological, clinical, and taxonomic studies of C. trachomatis.
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  • Yuriko ETO, Hideo TERAO, Hideaki SHIGENO, Takayoshi TASHIRO, Toshio FU ...
    1991 Volume 65 Issue 6 Pages 738-743
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    Liver dysfunction in patients with measles infection is reported commonly in Europian and American literatures, but those in Japan are relatively rare. We observed the abnormal elevation of serum transaminase in 17 of 18 juvenile patients with measles from December 1989 to February 1990, however severe complications such as pneumonia or meningitis were not observed. A diagnosis of measles was made by typical clinical symptoms and the elevation of IgM antibody against measles (EIA method). Ninety four percent of the patients showed the elevation of serum transaminase, (GOT 118.6±96.2 IU/l, GPT 161.5±167.6 IU/l), and all patients recovered completely in 30.5±12.8 days after the onset. The abnormal elevation of serum LDH was seen in 94% of the patients, (mean value was 872.2-216.2 IU/l). LDH4 mainly elevated in most cases, however, LDH5 elevated only in 4 cases. The intensity of liver dysfunction did not correlate to the severity of measles in the present cases. It is considered to be characteristic to the patients with measles that the serum level of LDH is markedly high as compared with that of transaminase.
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  • Hironori MASAKI, Satoshi MITARAI, Akiko FUKAHORI, Masataka KIHARA, Ken ...
    1991 Volume 65 Issue 6 Pages 744-748
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    A 55-year-old male was admitted to our hospital for the treatment of suspected brain abscess on March 18, 1989. The brain CT scan showed low density area with ring enhancement.
    After admission, both cefminox 2 g/day and clindamycin 500 mg/day were administered intravenously.
    On March 29, 1989, the patient developed cerebral herniation suddenly. Therefore emergency burr hole operation was done. Many gram-positive cocci were observed on gram-staining of the aspirated pus. Moreover neutrophils with phagocytosed gram-positive cocci were also observed. Culture of aspirated pus revealed colonies of gram-positive cocci which were subsequently identified as E. faecalis. Same species of bacteria were also isolated from fistula of right mastoid. From both findings of brain CT scan and data of MICs of E. faecalis, it may be suggested that direct infection developed from right mastoiditis to intracranial space. We experienced a severe case who developed cerebral herniation because of brain abscess due to E. faecalis which is an infrequent pathogen of brain abscess.
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  • Kouji KAJINAMI, Hajime FUJITA, Masoyoshi HIRATA, Kosei UEDA, Shohji KA ...
    1991 Volume 65 Issue 6 Pages 749-753
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    Most of patients with tsutsugamushi disease are diagnosed by their clinical histories suggesting the opportunities of Rickettsia infection in a rural region. We reported a 76-year-old female patient, who was considered to be infected in her house in the urban area of Komatsu City. She has shown typical clinical manifestations of tsutsugamushi disease, and was remitted successfully by oral administration of minocycline. Although specific antibodies to Rickettsia tsutsugamushi could not be detected in her serum by the complement fixation (CF) method during her clinical course, their significant elevation was confirmed by the indirect immunofluorescence (IF) method.
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  • Chie NAKAI, Yoshio AMANO, Toshio NISHI, Masakazu EKAWA, Akiko NAKATANI ...
    1991 Volume 65 Issue 6 Pages 754-758
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    Case 1 was a 55 year old female whose primary complaint was pyrexia. Anamnesis consisted of a fever at a 39°C level beginning on September 15, 1987 with headache and muscle pain. The patient was examined by a nearby physician. Despite taking medication, there was no break in the fever. The patient was examined and admitted to this institution on September 18.
    Case 2 was a 32 year old female whose primary complaint was pyrexia and an abnormal sensation in the pharynx. Anamnesis consisted of a fever at a 39°C level beginning on February 13, 1989 and the manifestation of a cough beginning on February 17. Although the fever broke on February 20, as the abnormal sensation in the pharynx persisted, the patient was examined and admitted to this institution on February 21.
    Case 3 was a 42 year old male whose primary complaint was pyrexia. Anamnesis consisted of a fever of 38°C, cough and a sensation of pressure in the right precordia beginning on November 18, 1989. The patient was examined and admitted to this institution on November 21.
    Chest X-rays revealed the presence of atypical pneumonia in all three cases. As a significant rise in antibodies to the Chlamydia of parrot fever was observed in the cases at the time of admittance as well as after admittance, treatment was begun by administration of Minocycline. Although case 1 had a history of close contact with birds such as feeding birds by passing the food to them by mouth, and case 2 had a history of breeding birds, case 3 appeared to manifest the disease despite having no history of breeding birds. As indicated by this report, the occurrence of this disease is increasing accompanying the increased number of imported birds in recent years resulting from the current pet boom, and as such, is a disorder that should continue to be closely observed in the future.
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  • Akira YAMADA, Jiro IMANISHI, Etsuro NAKAJIMA
    1991 Volume 65 Issue 6 Pages 759-760
    Published: June 20, 1991
    Released: September 07, 2011
    JOURNALS FREE ACCESS
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