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Volume 67, Issue 1
Displaying 1-15 of 15 articles from this issue
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Takejiro OKAZAKI, Hiroshi TAKABATAKE, Yukari SUMI, Masakatsu UMEUCHI, ...1993 Volume 67 Issue 1 Pages 1-6
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSWe investigated the infection rate of Chlamydia trachomatis in sexual partners who had pregnani wives with C. trachomatis diagnosed by means of serum-antibody test (Ipazyme®) or antigen tes1 (Chlamydiazyme®, IDEIA-chlamydia®).
Antibody-positive rate was 60.4%(90/149 cases), and antigen-positive rate was 7.4% 11/149 cases All cases with Chlamydial antigen had anti-Chlamydial antibody.
Eleven cases with Chlamydial antigen had no symptom of urethritis. Among these cases, eigh cases had abnormal laboratory findings. However, the other three cases who had no abnormal findini were careers of C. trachomatis.
In this study, sexual partners who had Chlamydial antigen were few, however, those who had anti-chlamydial antibody were many. Therefore, C. trachomatis will disseminate among many familie as a latent infection.View full abstractDownload PDF (698K) -
Shiro KUSANO, Hiroshi MUKAE, Tohru MORIKAWA, Tsunehiko ASAI, Hideaki S ...1993 Volume 67 Issue 1 Pages 7-11
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSThe mechanisms of erythromycin (EM) in chronic lower respiratory tract diseases including diffuse panbronchiolitis (DPB) has been reported. In this study we investigated the effect of EM on peripheral neutrophil adhesion molecules such as LFA-1 and Mac-1 obtained from six healthy subjects.
Pretreatment of neutrophils with each concentration (10ng/ml-100μg/ml) of EM resulted in no significant reduction in the expression of LFA-1α, β and Mac-1. Moreover, EM had no capability of reducing these expressions even when neutrophils were pretreated with μg/ml of EM at time from 0 to 60 min.
These findings indicate that EM does not directly reduce the expression of LFA-1α, β and Mac-1 on peripheral neutrophil obtained from healthy subjects.View full abstractDownload PDF (635K) -
Yasuhito HIGASHIYAMA, Hironobu KOGA, Shigeru KOHNO, Shigefumi MAESAKI, ...1993 Volume 67 Issue 1 Pages 12-17
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSWe evaluated the polymerase chain reaction method (PCR) for the rapid detection of methicillin resistant Staphylococcus aureus (MRSA), and compared it with the conventional culture method. Primers for amplification of mecA gene were synthesized by DNA synthesizer according to the published sequences of mecA gene.
The results were as follows:
Specificity of PCR was excellent, as there was no cross-reaction with any organism other than MRSA. Fifty colony forming units of MRSA were detected, indicating good sensitivity. We examined oral swabs from 13 bed-ridden patients (age range: 65-82 yrs) by PCR and the conventional culture method.
The PCR elicited positive results in 6 out of 13 cases. MRSA or coagulase negative Staphylococci (CNS) in Mueller-Hinton agar containing 12.5μg/ml methicillin were obtained from all of these PCRpositive specimens. Two of 7 PCR-negative specimens raised MRSA or CNS colonies, but the number of colonies from these specimens was below the sensitivity threshold of the PCR.
The good specificity and sensitivity of the PCR method for the detection of mecA gene obtained in this study suggest the possibility of application of this method for detection of MRSA in clinical specimens.View full abstractDownload PDF (3105K) -
Jun OGINO, Toshihiko YAMADA, Taro KOZENI, Masahiko ITO, Kazuhito KIKUS ...1993 Volume 67 Issue 1 Pages 18-23
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSAnti staphylococcal activity by Pseudomonas aeruginosa was investigated through the use of thereversed agar plate and the filter paper stamp methods. Investigation was also conducted on the dye production of different clinical isolates of Pseudomonas aeruginosa, the relationship between drug susceptibility and anti staphylococcal activity, and the influence of erythromycin on and staphylococcal activity. Seventy four strains of Pseudomonas aeruginosa were prepared which included 20 strains from pus, 34 strains from sputum and 20 strains from urine. These were then innoculated with methicillin resistant Staphylococcus aureus (MRSA). They were then cultured for 48 hours by using the reversed agar plate and the filter paper stamp methods. Anti staphylococcal activity was observed in 16 strains from pus (80%), 19 strains from sputum (55.9%) and 8 strains from urine (40%). The Pseudomonas aeruginosa strains which have no pigment tended to show poor anti staphylococcal activity. Drug susceptibility was tested using PIPC, AMK, IPM, CFS and OFLX. The strains which showed resistance to OFLX tended to show poor anti staphylococcal activity. Erythromycin inhibited the dye production of Pseudomonas aeruginosa but exhibited no effect on and staphylococcal activity.
Consequently, these results suggest erythromicin has exhibited a previously unknown pharmacological effect, furthermore, anti staphylococcal activity was not caused by pigmentation only.View full abstractDownload PDF (2977K) -
Yuji HANATANI, Tadahiko HASUMI, Tatsuo ASAGOE, Hiroshi MIYOSHI, Hirosh ...1993 Volume 67 Issue 1 Pages 24-29
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSWe studied 308 postoperative infections (216 patients) after gastrointestinal surgery during 1987-1991, to elucidate the incidence of postoperative infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and its correlation to clinical background factors. Results were as follows:
(1) MRSAs were isolated from 25.9% out of 216 patients or 22.4% out of 308 infections. (2) The isolation rate of MRSA was significantly high in infectious enterocolitis (64.7%, p<0.001), intraabdominal infections (52.5%, p<0.001) and respiratory tract infections (35.3%, p<0.05). On the other hand, it was significantly low in bacteremias (9.28%, p<0.001), wound infections (13.6%, p<0.05) and urinary tract infections (3.33%, p<0.05). OO MRSAs were found more frequently in male (p<0.05), younger patients (p<0.05) and patients with malignant disease (p<0.10). Whereas no difference was recognized between patients with or without complication. (4) The isolation rate of MRSA by the kind of antibiotics used after surgery, was 0%(0/20, the 1st generation cephems), 17.2%(10/58, the 2nd generation cephems) and 54.5%(48/88, the 3rd generation cephems). Significant differences were found among each group (p<0.05, p<0.001). (5) During 1990-1991 when the 1st generation cephems were used frequently, MRSAs were found significantly lower in frequency than during 1987-1989 (p<0.05). Especially a marked decrease in the rate of MRSA (51.4% to 8.33%, p<0.05) was seen among patients after upper gastrointestinal surgery. (6) The mortality of postoperative infection was 16.2%(35/216), and it was significantly higher in patients who have MRSA than in patients who have other organisms (p<0.001).View full abstractDownload PDF (823K) -
Masahiko YOSHIDA, Ryozo YANAGISAWA, Yoshio ISHIDA, Hiroichi KISHI1993 Volume 67 Issue 1 Pages 30-35
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSThe influence of cytotoxic chemotherapy on the number and function of peripheral neutrophils was studied in time sequence in 9 cancer patients; 6 patients with transitional cell carcinoma of urothelium treated with CAP, the combination of cyclophosphamide, adriamycin and cisplatin, and the other 3 with testicular tumor treated with PEB, the combination of cisplatin, etoposide and bleomycin. The neutrophil function was evaluated by the superoxide production, measuring chemiluminescence of the neutrophil suspension by a photometer.
The peripheral neutrophil count (PNC) significantly (p<0.01) decreased with the nadir count of 280±100/mm2 16.4 days after cytotoxic chemotherapy and recovered to the normal level by the next course. The neutrophil function declined significantly (p<0.01) as PNC decreased, reached the minimum almost at the same time as PNC, and returned to the normal level by the next course. Of the 9 cases, the neutrophil function in 6 cases reached the minimum on the same day as that of PNC.
The study shows that cytotoxic chemotherapy appears to impair the host defense mechanism in cancer patients not only in inducing neutropenia but also in deteriorating neutrophil function at the same time.View full abstractDownload PDF (703K) -
Yasunobu TOYOKAWA, Yoshimitsu OHTOMO, Tamotsu AKIYAMA, Kazushige MASUD ...1993 Volume 67 Issue 1 Pages 36-44
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSIn June 1991, there were large scale outbreaks of Yersinia pseudotuberculosis at 4 primary schools and 1 junior highschool in Noheji-machi in Aomori Prefecture. A total of 732 patients (725 pupils and school children, 7 teachers and personnel) were affected and 134 were hospitalized. Sex ratio of incidence was 1.1: 1.0 without appreciable difference. Clinicalsymptoms (478 patients) were represented frequently by pyrexia (86.4%), eruption (73.8%), abdominal pain (66.7%), vomitingnausea (63.4%), etc., and were characterized by a strawberry tongue, pharyngeal redness, membranous desquamation of the fingers and arthralgia during convalescence.
Yersinia pseudotuberculosis was isolated from 27 (81.8%) of 33 patients stool specimens, 1 waste water specimen and 2 (11.7%) of 17 cooking employees' stool specimens.
The isolates were confirmed serotype 5a, and positive for calcium-dependency and autoagglutination, and harboring 40-50 megadalton virulent plasmid. Restrictive endonuclease digestive pattern of pasmid proved to be identical.
In many cases, patients' serum antibody titer showed a significant increase ratio to the isolated strain.
In term of drug susceptibility, all the strains were sensitive to cefem, penicillin and aminoglycoside series and resistant to macrolide and sulfa series.
The infectious source was limited to the school feeding, but the responsible food remained unknown. Mean latency and exposure day were presumed to be 6.5 days and May 30, respectively.View full abstractDownload PDF (2860K) -
a Rapid Increase in Coagulase Type-VII StrainsZenzo NAGASAWA, Kouji KUSABA, Ichiro TANABE, Yutaka TAJIMA, Jutaro TAD ...1993 Volume 67 Issue 1 Pages 45-52
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSHospital infection with MRSA has increased in Saga Medical School Hospital. The causative MRSA consisted predominantly of coagulase type-II strain before 1989, but after 1990, coagulase type-VII MRSA increased rapidly. This type-VII strain has marked multiple drug-resistance, and the pattern of drug sensitivity of MRSA in this hospital was different from that of MRSA detected in other facilities, which are clinically serious problems, therefore, we conducted an etiological study of the background of the increase in MRSA infection in our hospital.
The results of the study are summarized as follows:
1) The proportions of MRSA (on strain from one patient) to all types of S. aureus detected in the hospital were 26% for 1986, 23% for 1988, 37% for 1989, 30% for 1990 and 60% for 1991. The proportion increased greatly in 1991.
2) Coagulase type VII-MRSA was first detected only in 5 patients in 1989, then it tended to spread, and this type (probably derived from the same strain) accounted for 47% of MRSA infection in patients examined in 1991.
3) The study of the drug sensitivity pattern and etiological survey of the infection showed that coagulase type VII-MRSA prevalent in the hospital consisted of two types: CLDM, and EM-sensitive, IPM/CS, and MINO-resistant and TSST-1 non-producing and enterotoxin non-producing type, and CLDM, and EM-sensitive, IPM/CS, and MINO-resistant and TSST-1 non-producing type with enterotoxin serotype A.
4) Coagulase type VII-MRSA (Probably derived from the same strain) was detected in physicians and nurses working in affected wards and also in the patients's room.
5) These results suggested that the types of MRSA had not increased but certain types of strain are explosively increasing.View full abstractDownload PDF (929K) -
Shuichi NISHIMURA, Bosu KIM, Ke-Qin XIN, Atsushi MUKOYAMA, Hiroshi USH ...1993 Volume 67 Issue 1 Pages 53-58
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSA seroepidemiological study of rotavirus was conducted in the northern part of Tokyo from 1990 to 1992 by using reverse transcription-polymerase chain reaction (RT-PCR).
G1 and G3 types were detected in the winter between 1990 and 1991, however Gi type was appeared mainly in the winter between 1991 and 1992.
G3 type was observed as the main type during the winter in the 10 year survey in the Tokyo area for the first time.
RT-PCR was useful in the seroepidemiological studies of rotavirus infection.View full abstractDownload PDF (2412K) -
Takeshi URABE, Kouichi SANO, Fumitomo ODAWARA, Toru OTAKE, Haruyo MORI ...1993 Volume 67 Issue 1 Pages 59-65
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSNon-radioisotopic reverse transcriptase assay (Non-RTA) was successfully applied for detection and identification of the retroviruses isolated from peripheral mononuclear cells from eight HIV-1-seropositive hemophiliac patients. Of 40 samples, 36 (90%) were consistent in detection between Non-RI and RI RTA. Four samples which showed RT activities slightly above the cutoff level of RI RTA were not detected by Non-RI RTA. Non-specific RT-inhibitors in the culture supernatant decreased the sensitivity of Non-RI RTA more significantly than that of RI RTA. It was demonstrated that higher concentrations (≥20%) of fetal calf serum in RPMI-1640 culture medium inhibited the hybridization of poly rA template with immobilized primer, resulting in reducing the sensitivity of Non-RI RTA. Then we identified the isolated retroviruses using specific RT-inhibiting (RTI) antibodies against HIV-1 and HIV-2. HIV-1 RTI antibody specifically inhibited RTs of isolated retroviruses and HIV-1 strain, LAV-1, but not HIV-2 and Rous-associated virus 2 (RVA-2) RT. Conversely, HIV-2 RTI antibody specifically inhibited HIV-2 RT, but not HIV-1 and RAV-2 RT. These findings agreed with previously reported results showing the type-specificity of HIV-1 and-2 RTI antibodies, and suggest the possibility that isolated retroviruses could be identified by these antibodies.View full abstractDownload PDF (820K) -
Yuichi INOUE, Takakazu OHTSUBO, Norihiko MORI, Tohru ISHINO, Tomiko TA ...1993 Volume 67 Issue 1 Pages 66-70
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSA 40-year-old male with no history of underlying disease was admitted to Hokusho Central Hospital on May 25, 1991, complaining of high fever and headache. Physical examination on admission revealed a temperature of 38.5°C, a pulse rate of 84 beat/min (relative bradycardia) and no abnormal findings for the chest or abdomen. Slight neck stiffnes without Kernig's sign was observed at neurological examination. Laboratory data were: ESR 11mm/lh, WBC 12000/mm3, C-reactive protein positive. Lumbar puncture showed an initial pressure of 230 mmH2O; CSF revealed a cell count of 2633/3mm3 with mononuclear pleocytosis, total protein of 76mg/dl and sugar of 54mg/dl (CSF: blood glucose ratio 0.47). We initially suspected tuberculous or cryptococcal meningitis, but Campylobacter fetus subsp. fetus (C. fetus) was isolated from the CSF and venous blood on the 27th hospital day. IPM/CS 1g/day, MINO 200mg/day and FOM 4g/day were intravenously administered. This antibiotic therapy was very effective: the patient was soon afebrile, and gradually all signs and symptoms were resolved. C. fetus was sensitive to IMP/CS, MINO, KM, GM, EM, OFLX, CP. The patient was discharged with no complication. He has eaten raw beef frequently before admission, but stool culture for C. fetus was negative.View full abstractDownload PDF (626K) -
Atsuko GUJI, Hajime NISHIYA, Toshiaki HAGA, Masumi AOKI, Norio NOZUE, ...1993 Volume 67 Issue 1 Pages 71-75
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSA case of spontaneous bacterial peritonitis (SBP) developed in an old man whose ascitic fluid was related neither to portal hypertension nor nephrotic syndrome, but with severe hypoalbuminemia emerged after a massive bleeding from a gastric ulcer in a malnutrition state. Ascitic fluid, increasing day by day, yielded Enterobacter cloacae and Bacteroides fragilis. Though autopsy was not carried out because of refusal of his family, neither liver necropsy, nor abdominal CT scan nor repeated abdominal ultrasonography showed findings suggesting existence of liver cirrhosis.
In the presence of his ascites, the extent of a chemiluminescence (CL) response of polymorphonuclear cells from volunteers was significantly lower than that of his serum.
This report shows that SBP can develop in a patient with ascites unrelated to portal hypertension when ascitic fluid induces little CL response.View full abstractDownload PDF (2615K) -
Takanori HIDAKA, Tsutomu YOKOTA, Kazuo TAMURA1993 Volume 67 Issue 1 Pages 76-80
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSA 54-year-old female was admitted to our hospital because of a spiking fever, right hypochondriac pain, right oribital pain and visual disturbance. Before admission she was treated with systemic antibiotics infusion for a diagnosis of liver abscess at the other hospital and the liver abscess almost diminished for a while. With the diagnosis of liver abscess and endopthalmitis, liver drainage and evisceration were carried out. The culture of pus from the eye and liver yielded K. pneumoniae. After liver drainage, evisceration, and direct injection of antibiotics into the eye, inflammatory findings tended to improve.
Seven cases of metastatic K. pneumoniae endophthalmitis have been reported so far in Japan. The cases had liver abscess as the primary disease and 3 cases had bilateral endophthalmitis. Five cases with liver abscess survived except one who died of sepsis, but unfortunately, all cases became blind in the affected eyes.
The prognosis of bacterial endophthalmitis, especially associated with K. pneumoniae liver abscess, is poor and as the outcome could appear to depend on time when treatment is started, a more aggressive diagnotic approach is required. Moreover systemic antibiotic infusion alone is inadequate for treatment of liver abscess and endopthalmitis, and liver drainage, evisceration and intravitreal injection of antibiotics must be given in early stage.View full abstractDownload PDF (4697K) -
Yasutomo ARASHIMA, Kinya KAWANO, Shunichi BABA, Toshiji TEZUKA, Tetsuy ...1993 Volume 67 Issue 1 Pages 81-84
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSWe described a forty-four-year-old female who was scratched by her cat, and developed lymphadenopathy. Cat scratch disease skin-test was positive. Cat scratch disease is well known, but there are not many reports in Japan. Reports of cat scratch disease will increase as the pathogen was recently detected. Attention must be drawn to zoonosis containning cat scratch disease.View full abstractDownload PDF (480K) -
Eriko YAMASHITA, Hikaru KUME, Hiroshi SATO, Shigeru SHIONOYA, Chieko I ...1993 Volume 67 Issue 1 Pages 85-91
Published: January 20, 1993
Released on J-STAGE: September 07, 2011
JOURNAL FREE ACCESSThe frequency of a visceral mycosis grows definitely higher with an immunocompromised host. Invasive fungal infection can be controlled by means of development of early diagnosis and antifungal therapy. In these types of cases, it is difficult to establish an antemortem diagnosis of invasive pulmonary aspergillosis and most of them were diagnosed postmortem.
A patient was diagnosed as aspergillosis from the clinical and serological features. This patient underwent successful therapy during remission induction therapy of acute myelocytic leukemia (AML).
A 26-year-old male was admitted to our hospital because of leukocytosis with a diagnosis of AML made by reviewing peripheral blood smears and bone marrow aspirate. After remission induction therapy, he was still febrile in spite of treatment with a broad spectrum antibiotics and empiric therapy of fluconazole. Unfortunately shadowing appeared on the chest radiograph and aspergillus antigen was detected from the serum and the sputum. Consequently, the patient who suffered from invasive pulmonary aspergillosis was diagnosed and treated with intravenous amphotericin B and flucytosine. The radiological shadow improved but AML relapsed, therefore, remission induction therapy of AML was started again but he died of sepsis caused MRSA.
In the postmortem histopathological examination the lung tissues, the hyphae could not be confirmed while, in immunohistochemical examinations of the lesion at the left S8, aspergillus antigens were detected around the small necrotic lesions and in the polymorphologic giant cells.
We emphasize that invasive pulmonary aspergillosis is very difficult to diagnose whereas active examinations and clinical early diagnosis may lead to more effective therapy and the prognosis.View full abstractDownload PDF (6626K)
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