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Volume 66, Issue 5
Displaying 1-18 of 18 articles from this issue
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Takami SATO, Toshiro INOUE, Masato KAJIWARA, Chiaki MIYAZAKI, Koichi K ...1992 Volume 66 Issue 5 Pages 551-554
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESS -
Takashi DEGUCHI, Hiroyuki YAMAMOTO, Kohji TADA, Hisao KOMEDA, Hideki I ...1992 Volume 66 Issue 5 Pages 555-560
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSA polymerase chain reaction (PCR) procedure was developed for detection of Neisseria gonorrhoeae. Two oligonucleotides based on sequences within a 16S ribosomal RNA gene from N. gonorrhoeae were used as extension primers for the PCR. A single DNA fragment of 206 bp was amplified, when N. gonorrhoeae DNA was template for the PCR. No amplified product was detected in Chlamydia trachomatis DNA, Ureaplasma urealyticum DNA or other bacterial DNAs. The DNA fragment of 206 bp was detected on agarose gel electrophoresis, when DNA of >6.5 N. gonorrhoeae per PCR was used as template DNA for the PCR. The culture and the PCR were carried out for detection of N. gonorrhoeae in 67 urethral swabs obtained from male patients with urethritis. In 27 of 28 specimens in which N. gonorrhoeae was isolated and identified by the culture, 206 bp DNA fragment was amplified by the PCR, but in one specimen no DNA fragment was detected. In 2 of 39 culture-negative specimens, 206 pb DNA fragment was detected and in the remaining specimens, PCR was negative for N. gonorrhoeae. The overall detection coincidence rate between the culture and the PCR was 95.5%(64/67). Thus, the PCR procedure developed in this study was sensitive and specific for detection of N. gonorrhoeae and could be applied for diagnosis of gonococcal urethritis.View full abstractDownload PDF (2762K) -
Third Report: Clinical Study of Cases Administrated EM Over 3 YearsKeiichi MIKASA, Masayoshi SAWAKI, Mitsuru KONISHI, Koichi MAEDA, Shoji ...1992 Volume 66 Issue 5 Pages 561-567
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSAn investigation was made of the use of EM therapy which began in 1986 or earlier in 31 cases with chronic lower respiratory tract infections.
1) Of the 20 cases in which EM (Erythromycin stearate) administration (600-1200 mg/day) was continued for 3 years or more and its usefulness could be evaluated, treatment with this agent was judged markedly effective in three, effective in 14, somewhat effective in two, and ineffective in one. This amounted to an effectiveness rate (effective or better) of 85%. 2) Improved QOL was observed in 15 of the 20 cases. 3) In the Pseudomonas infected cases, a discrepancy was seen between the effectiveness rate of 87.5% and the disappearance rate of the organism (12.5%), while in the Haemophilus cases no such discrepancy was found (75%). 4) EM administration was stopped in 11 cases because of side effects in two (stomatis, gastrointestinal disorder) death in five, desire of the patient in three, and transfer to another hospital in one. The cause of death cases had no connection with administration of EM. 5) In the three patients who stopped EM on their own, the agent was again administered because of exacerbation of symptoms, although this readministration proved ineffective in two of the cases.
The above results suggest that long term EM therapy is useful and that its continued administration is important.View full abstractDownload PDF (881K) -
Susumu SAKAYORI1992 Volume 66 Issue 5 Pages 568-578
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSThis study was performed to demonstrate the role of TNF in septic ARDS. The interaction with neutrophil and TNF was examined in both in vitro and in rat experimental observation.
The results obtained are as follows: Serum level of natural TNF was significantly increased immediatly after the endotoxin injection into the rat vein.
In in vitro observation, TNF activated neutrophil and enhanced super oxide production and elastase was released from neutrophil. On the other hand, TNF was inactivated by contact with elastase released from activated PMNs both in dose and in time dependently.
Also, in the in vitro study, the serum level of natural TNF that was enhanced by endotoxin injection was continued for a longer period in neutropenic rats than in the normal rat.
The lung tissue injury such as cell infiltration, capillary congestion and increased intrapulmonary fluid in morphometric determination were observed only when the extremely high dose of TNF was injected. These findings were more significantly observed in the neutropenic rats than in the normal neutrophil rat. The weaker interaction of PMNs elastase to TNF is suspected in such neutropenic animals.
From the above, the role of TNF in septic ARDS may be explained as follows:
By endotoxin injection, TNF is released from stimulated macrophages. The released TNF activates neutrophil which plays the main role of septic ARDS. In the usual system, lung tissue damage induced by TNF is inhibited, because TNF is inactivated by elastase released from activated PMNs. However, in neutropenic state, PMNs elastase is not enough to inhibit the TNF action, then the tissue damage is directly induced by TNF.
As my conclusion, the role of TNF in septic ARDS is to provide two different ways by the host is condition. One is to activate neutrophils in the usual condition and the another is to introduce direct damage of lung tissue in the neutropenic state.View full abstractDownload PDF (6921K) -
Tomohiko TAKASAKI, Kouichi SANO, Etsuko TANAKA, Shinichi MORIMATSU, Ko ...1992 Volume 66 Issue 5 Pages 579-583
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSWe designed an effective virus concentration method to prevent the infection with human immunodeficiency virus type 1 (HIV-1) in laboratories. The absorbent of Minicon ® concentrators (Amicon Division, M.R. Grace & Co.-Conn.) was changed to chitin, a mucopolysaccharide extracted from the shells of Japanese pink crab. HIV-1 in the supernatant of HIV-1 infected Molt-4 cells was concentrated by Minicon ® and the new concentrators. The new concentrator showed good concentration rate and equality of concentration speed.View full abstractDownload PDF (5138K) -
Akira MATSUMOTO, Hiroko BESSHO, Toshio KISHIMOTO, Rinzou SOEJIMA, Hiro ...1992 Volume 66 Issue 5 Pages 584-591
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSTo develop EIA kit with low cross-reactivity for the quantitative detection of anti-chlamydial antibodies, we examined the preparation of trachomatis antigens and its specificity to mouse antisera and human sera.The chlamydial elementary body (EB) purified from C. trachomatis L2/434/Bu strain was treated by Sarkosyl, dithiothreitol and SDS by turns to obtain the soluble EB outer memblane (COMC).SDS-PAGE showed that the major components of the COMC were 96K, 60K and 39.5 KDa peptides.The reactivity of the COMC immobilized to 96 wells microtiterplate to mouse anti-serum to C. trachomatis was higher than the other two mouse anti-sera to C. psittaci and pneumoniae. In human sera, the cut off values were calculated from an average optical density plus itstwo-fold standard deviation obtained by the testing of 100 samples of healthy human sera. We evaluated the specificity of the kit to 17 anti-C. pneumoniae, 9 C. trachomatis and 4 C. psittaci antibodies positive patients' sera judged by the MFA method respectively. The results showed that the concordance ratio of IgG and IgA were 88%, 100% in and-C. pneumoniae, 89%, 78% in anti-C. trachomatis and 50%, 50% in anti-C. psittaci respectively.From the results obtained in this study, we concluded that the HITAZYME method which had a very low cross-reactivity to C. pneumoniae is clinically useful in the serodiagnoses of C. trachomatis infections, even if it has a little common antigenecity with C. psittaci antigen.View full abstractDownload PDF (2809K) -
Yoshihiko TANO, Toshiharu MATSUSHIMA, Junichi NAKAMURA, Tatsutoshi YAN ...1992 Volume 66 Issue 5 Pages 592-598
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSThroat secretions (TS) and bronchial secretions aspirated from tracheostomy (TSTA) were cultured at the same time in 9 subjects with long term tracheostomy every two weeks from January, 1990 to December, 1990. Total number of each examination in TS and TSTA were 200 times. Mean number of bacteria isolated by single culture were 2.9 strains in TS and 1.8 strains in TSTA. Isolated bacteria were mainly α-Streptococcus (84.8%) and Neisseria (69%) in TS, and Pseudomonas aeruginosa (53.5%) and Serratia marcescens (30%) in TSTA. Only 20% of P. aeruginosa or S. marcescens in TSTA were isolated from TS. In 8 cases of 9, P. aeruginosa in TSTA were isolated with every time or long term. There were 14 episodes of respiratory infections in 6 cases. P. aeruginosa were causative organisms in 7 episodes. It suggests that P. aeruginosa tended to colonize in lower respiratory tracts of the patients with long term tracheostomy and to become causative organisms in respiratory infections.View full abstractDownload PDF (886K) -
Yoshinobu HORIUCHI, Masako TODA, Sachie OKUBO, Yukihiko HARA, Tadakats ...1992 Volume 66 Issue 5 Pages 599-605
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSWe examined the bactericidal activity of tea and catechins against Bordetella pertussis. Green tea, black tea and coffee showed marked bactericidal activity at their concentrationsin beverages, while pu-erh tea killed the bacteria in a moderate way. (-) Epigallocatechin gallate (EGCg) and theaflavin digallate (TF3) showed also marked bactericidal activity. Green tea and black tea also effectively blocked the adhesion of B. pertussis to HeLa and CHO cells, whereas ECGg and TF3could not. EGCg and TF3 markedly inactivated leuco-lymphocytosis promoting activity of pertussistoxin. Black tea showed slight but significant inactivation of the activity, whereas green tea showed no inactivation. These results suggest that green tea, black tea, EGCg and TF3 might act as prophylactic agents against pertussis infection.View full abstractDownload PDF (883K) -
Hiroshi CHOSA, Masako TODA, Sachie OKUBO, Yukihiko HARA, Tadakatsu SHI ...1992 Volume 66 Issue 5 Pages 606-611
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSWe examined tea extracts, (-) epigallocatechin gallate (EGCg) and theaflavin digallate (TF3) fortheir antimicrobial and microbicidal activities against Mycoplasma. Green tea and black tea showedantimicrobial activities against M. pneumoniae. At a concentration of 0.2% green tea and black teashowed microbicidal activities against M. pneumoniae and M. orale but not against M. salivarium.Extracts of pu-erh tea showed a slight microbicidal activity against M. pneumoniae and M. orale.EGCg purified from green tea and TF3 from black tea markedly showed microbicidal activities againstM. pneumoniae. M. orale and M. salivarium. These results suggest that tea and catechins can be usedas prophylactic agents against Mycoplasma pneumoniae infection.View full abstractDownload PDF (611K) -
Shinhachi NAKAZAWA, Takeshi MORI, Ichirou HIBIYA, Toyoko OGURI1992 Volume 66 Issue 5 Pages 612-619
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSEighty-four patients with fungemia were analyzed. Fungi had been isolated by culture of blood samples, including blood from the catheter for intravenous hyperalimentation, between 1986-1990.
Candida albicans (39.3%), Candida parapsilosis (20.2%), Candida tropicalis (11.9%), Candida glabrata (10.7%), Candida guilliermondii (4.8%) and Trichosporon beigelii (4.8%) were the most frequently isolated fungal pathogens. Four patients' blood yielded two different fungal species. Fifty-nine cases were male, and 25 cases were female. Forty-six of the 84 patients died (54.8%), but there were no differences in the overall mortality rate as a function of the fungal species or sex.
All patients had underlying diseases: solid cancer, 37 cases; cardiovascular diseases, 9 cases; gastrointestinal diseases excluding gastrointestinal cancer, 8 cases; central nervous system diseases, 7 cases; premature infants and congenital abnormality, 7 cases; leukemia, 6 cases and miscellaneous, 10 cases.
Twenty-four of the 46 dead cases were autopsied, and eight cases showed systemic fungal lesions. However, in one case of pulmonary cryptococcosis and one case of pulmonary penicilliosis, there was no correlation between the isolation of C. glabrata by blood culture and the pathological findings.
A fungus-positive blood culture was surmised to be a result of contamination of the sample in 33 cases, and the mortality rate for those cases was 72.2%(24 cases). For 6 of the corpses, fungal lesions observed at autopsy were compatible with the types of lesions found by the fungi which had been isolated before death. Removal of the catheter reduced the mortality rate to 41.7%. Fungal endophthalmitis was diagnosed in six cases.
If fungi are isolated from a blood culture, any indwelling catheters, should be removed, and blood cultures and careful examination for fungal endophthalmitis should be repeated.View full abstractDownload PDF (949K) -
Kouichi WADA, Norio SUZUKI, Takashi KAWASHIMA, Hiroki TSUKADA, Kyoko O ...1992 Volume 66 Issue 5 Pages 620-627
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSBetween 1976 and 1990, 208 cases of bacteremia in our department were studied. Community acquired bacteremias were only 18 (8.7%) cases. Bacteremias, particularly caused by Gram positive organisms, increased significantly after 1981, compared with the first five years. It was related to the marked increase in cases of venous access devices and less sensitivity of the Gram positive organisms to the new cephem antibiotics.
In the study, 144 (69.2%) cases were eradicated. Severe underlying diseases or complication of pneumonia influenced the eradication rate of bacteremia. Bacteremia caused by methicillin resistant Staphylococcus aureus or Pseudomonas aeruginosa showed poor prognosis. The average duration from onset to death, was 5.1 days. Forty cases (62.5%) died within 3 days.
Among the 201 cases, leukocytosis (WBC>10000/mm3) was present in 38.3%, while leukopenia (WBC<1000/mm3) in 25.3%. Eradication rate between the two groups was not significant. CRP was elevated (>8.5mg/dl) in 63.5%. The prognosis of this group was significantly poor. Elevation of serum birilubin was also related with increase of mortality.
According to these results, empiric therapy before the isolation of organisms is the most important stratagem for treatment of bacteremia.View full abstractDownload PDF (1112K) -
Masafumi FUKUYAMA, Kumiko KAWAKAMI, Yatsuka IMAGAWA, Takeshi ITOH, Mot ...1992 Volume 66 Issue 5 Pages 628-631
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSPhage types were determined for 102 strains of motile Aeromonas isolated from patients with diarrhea at four metropolitan hospitals in Tokyo. The following results were obtained.
1) Of the 102 strains examined, 52 (51.0%) were divided into 28 phage types. This rate was considerably higher, compared to our previous results, namely, 21.7% for strains isolated from natural environments and 25% for those isolated from meats. By bacterial species, phage types could be determined for 33 (52.4%) of 63 strains of A. hydrophila, for 16 (45.7%) of 35 strains of A. sobria, 2 (50.0%) of 4 strains of A. caviae and 1 (100%) strain of Aeromonas spp.
2) Of the 52 strains for which the phage types could be determined, the greatest number (16 strains, 30.8%) were identified as belonging to Type I group. These are followed by 5 strains (9.6%) which were identified as Type I/III group and 2 strains (3.4%) each identified as Type I/II, I/II/V, IV, V and VI groups. The remaining 21 strains were identified as belonging to one of the other phage type groups. Thirty-five (67.3%) of the strains for which the phage types were identified, were found to belong either to Type I group or to combinations with Type I. This demonstrated that 34.0% of the isolates from patients with diarrhea were related to Type I.View full abstractDownload PDF (447K) -
Tsutomu YAMAZAKI1992 Volume 66 Issue 5 Pages 632-636
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSA strain of Chlamydia pneumoniae (C. pneumoniae) which had been isolated from a Japanese child (AC-43) was examined morphologically and serologically using micro-immunofluorescent (micro-IF) test. Inclusions of AC-43 were stained by an indirect immunofluorescent method using C. pneumoniae specific monoclonal antibody. They were dense round inclusions which had been reported as a characteristic figure for C. pneumoniae. An elementary body (EB) of AC-43 was pear-shaped by electron micrograph, which was the same as previous reports for C. pneumoniae.
We produced monoclonal antibodies using purified EB of AC-43 as antigen. Culture fluids of these clones reacted with C. pneumoniae antigens, but did not react with C. trachomatis or C. psittaci antigens by micro-IF tests.
There was no difference in morphological and serological findings among standard strains and Japanese isolate of C. pneumoniae.View full abstractDownload PDF (3877K) -
Yasuo KANAMOTO, Takashi SAKANO1992 Volume 66 Issue 5 Pages 637-642
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSChlamydia was isolated from the throat of a 15-year-old male patient with acute bronchitis. The Chlamydia isolate, YK-41, was stained with FITC-conjugated monoclonal antibodies specific to C. pneumoniae and the genus Chlamydia, whereas staining of monoclonal antibody specific to C. trachomatis was negative. These results indicated that the strain YK-41 could be identified as C. pneumoniae.
Serum IgM antibody against C. pneumoniae was detected in high titer in the patient in the acute phase using the microimmunofluorescence (MIF) test, serum IgG antibody against C. pneumoniae demonstrated a fourfold antibody titer rise between acute and convalescent serum using MIF test.
Thus, our patient almost certainly contracted acute bronchitis caused by C. pneumoniae.View full abstractDownload PDF (4791K) -
Akihiko OKANO, Masao SHIBATA, Atsuhiko SATO1992 Volume 66 Issue 5 Pages 643-647
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSA 75-year-old female was admitted to our hospital with complaints of fever, cough and left hypochondralgia. She had been operated for cholecystectomy ten years ago.
Chest roentgenogram indicated bilateral pleural effusion. Tube drainage was done to the left thorax and empyema was caused by Bacteroides fragilis and Escherichia coli (E. coli). Though antibiotic therapy was already being conducted, the left hypochondralgia persisted.
A CT scan and MRI demonstrated local subphrenic abscess around the spleen due to E. coli. Tube drainage was conducted to the subphrenic abscess under ultrasound control and the symptoms disappeared rapidly.
The present results show that examination of the abdomen is necessary for empyema with complication of compromised host. The past history of abdominal surgery and disturbance in the biliary tract should also be considered.View full abstractDownload PDF (5195K) -
Hideo MASHIMOTO, Naofumi SUYAMA, Jun ARAKI, Sadahiro ASAI, Hironobu KO ...1992 Volume 66 Issue 5 Pages 648-652
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSLife threatening mediastinitis as a complication of acute epiglottitis is very rare. A 38-year-old male in previously good health was admitted to our hospital in a state of unconsciousness. Seven days prior to admission he had complained of a sore throat, dysphagia, high fever and dyspnea. A chest X-ray on admission showed widening of the mediastinum, mediastinal emphysema, subcutaneous emphysema and left pleural effusion. Bronchoscopy showed the swelling of supraglottic structures. He was diagnosed as having acute mediastinitis and pyothorax as a complication of acute epiglottitis, but pathogens were not identified. The blood was hyperglycemic and insulin therapy was started. Though he gradually improved by massive antibiotic therapy, steroid therapy, tracheotomy and surgical drainage of both the left thoracic cavity and the mediastinum, he died suddenly of massive hemoptysis. Autopsy revealed that the acute mediastinitis had healed, but that the Aspergillus infection was present in both lungs and the pericardium. The Aspergillus infection was not lethal in the present case, and it seemed that death had resulted from arterial hemorrhage caused by erosion of the trachea. The present case suggests the need for antifungal therapy even in non-immunocompromised patients in particular when massive doses of antibiotics and steroids are administered.View full abstractDownload PDF (5494K) -
Mika SAKAGUCHI, Nobuo ITAGAKI, Masanori FUNAUCHI, Hirofumi HASEGAWA, K ...1992 Volume 66 Issue 5 Pages 653-656
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSA case of Vibrio cholerae non-O1 septicemia is described in this paper. A 45-year-old male with a three year history of liver cirrhosis, was admitted to our division with hematemesis, abdominal pain, high fever and a loss of consciousness. Three days before onset of symptoms, he traveled to Ishigaki Island and ate a raw lobster. Two days after, his temperature rose to 39.7°C and the blood pressure dropped to 36/-mmHg. By endoscopic examination, an ulcer was found in the stomach, and the bleeding was stopped by electorical coagulation. Blood culture showed growth of V. cholerae non-O1. The organism was found to be sensitive to OFLX, CZX, MINO, LMOX and CP. Although DIC, infections of fungus and MRSA occurred as complications, he recovered by adequate procedures. Subsequently, he left this division after eight weeks. There are various reports related to V. cholerae non-01 septicemia in foreign countries, but few cases have been reported in Japan. And these cases had severe underlying diseases such as leukemia and liver cirrhosis.View full abstractDownload PDF (479K) -
Junichi ASHITANI, Yasumasa DOUTSU, Haruko TANIGUCHI, Toshihiko II, Shi ...1992 Volume 66 Issue 5 Pages 657-658
Published: May 20, 1992
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSDownload PDF (2592K)
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