Kansenshogaku Zasshi
Online ISSN : 1884-569X
Print ISSN : 0387-5911
ISSN-L : 0387-5911
Volume 69 , Issue 6
Showing 1-18 articles out of 18 articles from the selected issue
  • Hideaki TSUTSUMI, Yashima HODATE, Michiya OHTAKA, Toshio SHIMADA
    1995 Volume 69 Issue 6 Pages 637-641
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    Between the period January 1991 to June 1993, there were 23, 976, 238 travellers who arrived from overseas to Narita Airport, of which 20, 501 stool specimens were collected from diarrheal patients for bacteriological examination, and infectious agents were detected from 2, 751 cases (13.4%) including 250 cases (1.2%) of Vibrio cholerae non-O1.
    Countries suspected of infection of these patients were Thailand, the most in number, and followed by Indonesia, India and so on theas mostly distributed in South-east or South Asia.
    About fifty percent of the patients were associated with abdominal pain and some with vomiting or fever. Diarrher was mostly mild except in 16 patients who had severe diarrhea of more than ten times a day.
    237 of the 250 isolated V. cholerae non-O1 strains were classified into 48 serogroups. There were 2 rough strains and 11 other strains which were out of the confirmed serogroups.
    Positive rate of these strains to haemolysin, cholera toxin (CT) and NAG-ST tests were 87.2, 0.4 and 0.8% respectively.
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  • Yoshihiro YAMAMOTO, Shigeru KOHNO, Tetsuhiro NODA, Hiroshi KAKEYA, Kat ...
    1995 Volume 69 Issue 6 Pages 642-645
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    Cryptococcosis is one of the serious deep-seated mycoses in immunocompromised patients, especially those with AIDS.Cryptococcus neoformans ordinarily lives in natural environments such as soil and reproduces in pigeon excreta.It spreads in the air and infects human by inhalation.
    We isolated C.neoformans from pigeon excreta in hospitals, private houses, parks in Nagasaki from October to December in 1994.
    C.neoformans was isolated from 4 of 8 samples (50%) of pigeon excerta and the isolation rate increased to 80%(4/5) if they were weathered excreta.
    Two patients with pulmonary cryptococcosis occurred in the last two years in the area where C.neoformans was isolated during that period.
    Epidemiological studies of clinical isolates and environmental isolates are important to determine its origin of infection and the route of transmission.
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  • Masamichi MORI, Keiichi HOSHINO, Hisako SONODA, Hiromi YOSHIDA, Eiko Y ...
    1995 Volume 69 Issue 6 Pages 646-653
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    In August 1994, an epidemic of acute febrile illness occurred at the Education Center Building of a company in Shibuya-ku, Tokyo. All 43 trainees attended in two groups and 2 staff members of the Center fell ill. The 45 patients came to one of our hospitals in two groups, and 35 patients were treated.
    The patients were 4 males and 31 females, and the average age was 29.0 years.
    The duration until falling ill was 36 to 90 hours after entering the Center.
    Symptoms were fever, lumbago arthralgia, headache, dyspnea, general fatigue, etc. Physical examination revealed slightly injected mucosa of the pharynx in a patient who complained of a sore throat. On laboratory examination, leukocytosis with a left shift of the nucleus and elevation of serum CRP levels were found. Erythromycin (600mg, daily) and nonsteroidal antiinflammatory drugs (NSAIDs) were given by mouth to almost every patients. Two patients were hospitalized. The illness was self-limited, generally lasting from two to five days.
    Strains of legionellae isolated from the water of the cooling tower located at the top of the Center, were identified as L. pneumophila serogroup 7. Since seroconversion in a patient against the cooling tower strain from 1: 16 to 1: 256 was determined and the clinical courses agreed with the definition of Pontiac fever by Glick et al, we concluded that the epidemic was an outbreak of Pontiac fever due to L. pneumophila serogroup 7.
    Pontiac fever is considered to be one of the community-acquired diseases. Thus, we have to note that Pontiac fever may be misdiagnosed as we examine patients who complain of the symptoms noted above.
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  • Eiko YABUUCHI, Masamichi MORI, Atsushi SAITO, Toshio KISHIMOTO, Susumu ...
    1995 Volume 69 Issue 6 Pages 654-665
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    From August 20 to 22, 1994, an outbreak of acute febrile illness occurred in a Training Center building of a company in Shibuya-ku., Tokyo. All 43 trainees attended in two groups and 2 Center staffs were attacked. Illness was self-limiting, generally lasting three days. Though strains of legionellae, isolated from the water of the cooling tower located at the top of the building, were identified as Legionella pneumophila by microplate DNA-DNA hybridization, they failed to agglutinate with antisera against L. pneumophila serogroups 1 through 6. Two strains were sent to the Centers for Disease Control, Atlanta, Georgia, USA, and determined as serogroup 7 of the species. Since the clinical courses agreed with the definition of Pontiac fever by Glick et al. and seroconversion in a patient against the cooling tower strain (EY3698) from 1: 16 to 1: 256 was determined by indirect fluorescent antibody technique, the epidemic of acute febrile illness was concluded as an outbreak of Pontiac fever due to L. pneumophila serogroup 7.
    The cooling tower was a cylindrical open style, with volumetric flow rate of 130 liter/min, and was used for air-conditioning exclusively to the third floor of the building. The building equipped no air-inlet, and indoor-air of the training room exchanged at every break time through windows of 168 cm in height and 72 cm in width. The cooling tower was not operated for five days before the Group A trainees checked in the Center on 18 August followed by Group B trainees on 19 August. It was speculated that high atomospheric temperature and stagnation of cooling water during this period would lead L. pneumophila to overly multiply, which could be a source of infection by flowing in through opened windows to the training rooms.
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  • Masao SHINGAKI, Takeshi ITOH
    1995 Volume 69 Issue 6 Pages 666-672
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    A total of 65 Campylobacter and Helicobacter strains comprising 15 species were tested for fumarate hydration by using a rapid high-performance liquid chromatographic (HPLC) method.
    All strains of C. jejuni, C. coli, C. jejuni subsp. doylei, C. fetus, C. hyointestinalis, C. lari, “C. lari variant”, C. upsaliensis, H. fennelliae and H. pylori hydrated fumarate, whereas no strains of C. sputorum (all three biovars), H. cinaedi or H. mustelae did.
    L-malic acid was detected in the supernatant of the cultures of all strains that hydrated fumarate, but not in the culture supernatant of any of the strains that failed to hydrate fumarate.
    These findings show that all Campylobacter and Helicobacter strains that hydrated fumarate were able to form L-malic acid from fumarate.
    HPLC determination of organic acid is a rapid method that requires no chemical treatment before analysis. Because it is reproducible, the HPLC fumarate hydration test should be useful as a conventional method for identification of Campylobacter and Helicobacter spp.
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  • Tatsuya MOROOKA, Masahiko SHIBATA, Kazuhiko MURAMATSU, Hiromi MATANO, ...
    1995 Volume 69 Issue 6 Pages 673-677
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    We tried to isolate verotoxin-producing Escherichia coli (VTEC) on sorbitol-MacConkey (SMAC) agar and in part by the polymerase chain reaction (PCR) method from sporadic enteritis patients with bloody stools and intusussception patients who came to three pediatric clinics in the Fukuoka area from October 1990 to September 1994. VTEC O157: H7 strains were isolated from 6 (10.5%) of 57 patients with bloody stools, Campylobacter spp. 15 (26.3%), Salmonella spp. 14 (24.6%), and Yersinia enterocolitica 2. We were not able to detect VT genes by PCR from 11 of 20 patients from whose stools no causative bacteria were isolated. Massive fresh bloody stools following frequent watery diarrhea were typical of the VTEC enteritis patients. Only 1 patient had fever and 2 had leukocytosis, but the C-reactive protein level in all of them was below 1+. The VTEC strains were isolated during the summer season, 1 in June, 2 in July, and 3 in September. Since in the area O157: H7 appeared to be the most prevalent VTEC serotype, SMAC is very useful for screening VTEC in bloody stools. VTEC seems to be a rare pathogen of intusussception because the organisms were detected from none of the 30 patients.
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  • Hiroshi UCHIDA, Hirokazu KANEGANE, Kunihiko YOSHIYA, Kenji KITAMURA, T ...
    1995 Volume 69 Issue 6 Pages 678-683
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    Enzyme-linked immunosorbent assay using LPS derived from newly recognized serotype O 165 verotoxin producing Escherichia coli (VTEC) could identify 4 cases of hemolytic uremic syndrome (HUS) associated with 0165 VTEC. All 4 cases showed a typical clinical course seen in VTEC-associated HUS. We screened 33 cases of HUS whose pathogen was not identified by culture or serodiagnosis. The O165 serotype was not thought to be important not only as a VTEC but also as an enteropathogenic E. coli. However, the prevalence, 4 cases, was as high as of O111 serotype, which is the seond major serotype of VTEC in Japan. We have to be careful for this serotype when we look for the pathogen of the patients with hemorrhagic colitis or with HUS.
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  • Kiyoshi KITAMURA, Hideaki MIZOGUCHI, Kunitake HIRASHIMA, Shigetaka ASA ...
    1995 Volume 69 Issue 6 Pages 684-695
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    A human native immunoglobulin liquid preparation for intravenous injection, was used in combination with antibiotics and G-CSF to study its efficacy and safety in 49 patients with severe infections (Granulocyte counts were≤1000/μEl, Body temperature was≥38°C) which had not responded to antibiotic and G-CSF therapy of a 3-day or more duration. As a result of the Committee judgment, 49 patients were include in this study; 30 (61.7%) were included in efficacy and safety analysis. The analysis of 30 patients consisted of 9 patients (30.0%) with suspected septicemia, 5 (16.7%) with pneumonia, and 4 (13.3%) with septicemia.
    All patients had severe underlying diseases such as leukemia and malignant lymphoma. Clinical efficacy of Immunoglobulin preparation was judged by the doctors incharge to be “excellent” and “good” in 70.0% of the total cases. The rate of effectiveness was calculated from the results of the Committee judgment was 83.3% when “excellent” and “good” cases were included. No side effects were observed in all cases. Our results suggest that the immunoglobulin in combination with G-CSF is very effective on patients with severe in fections.
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  • Keiichi OKUDA, Seizaburo KASHIWAGI
    1995 Volume 69 Issue 6 Pages 696-700
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    To evaluate the antibacterial activities of antibacterical clothes and wall material, we measured the reduction rates of MRSA and P. aeurginosa using four products of antibacterial clothes and one wall material. Antibacterial activities are judged by the reduction rates of bacterials after 18 hours incubation at 35.0°C.
    In the 50 strains of MRSA tested, two of four brands of clothes showed over 99% reductionrates, while only one brand showed a reduction rates over 99% in the 13 strains of P. aeruginosa.The wall material tested showed a reduction rates over 99% for the 50 strains of MRSA and over90% for the 50 strains of P. aeruginosa.
    These data indicate that usage of some products of antibacterial clothes and wall material in the hospital may be useful the prevention of noscocomial infection.
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  • Akio URABE, Hideaki MIZOGUCHI, Shigetaka ASANO, Nobuyoshi TSURUOKA, Ma ...
    1995 Volume 69 Issue 6 Pages 701-710
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    In order to examine the efficacy of the combination chemotherapy with miconazole and G-CSF, patients with deep mycosis and suspected deep mycosis were divided into 3 groups. Group, I: miconazole and G-CSF were administered simultaneously. Group II: micronazole was administered later during G-CSF administration. Group III: only miconazole was administered. Of a total of 117 cases 105 cases were analyzed including group I 37 cases, group II 39 cases and group III 29 cases, excluding 12 dropout and inadequate cases. Of the 105 cases, deep mycosis were 31 and suspected deep mycosis were 74, and underlying diseases were hematological malignancies such as leukemias. Efficacy judged mainly by the change of fever was 62.2%(23/37) in group I, 43.6%(17/39) in group II, and 41.4%(12/29) in group III, respectively. Efficacy was better in the patients whose neutrophil counts increased from less than 500/μl to more than 500/μl (group I 75.0%, group II 72.7%) than in the patients whose neutrophil counts were less than 500/μl throughout the time of miconazole administration (group I 33.3%, group II 33.3%). Adverse effects were minimal in 3 gruops (group I 15.4%, group II 17.4%, group III 15.6%).
    It is concluded that the combination with miconazole and G-CSF is effective in the treatment of deep fungal infections.
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  • Hiroyuki KOBAYASHI, Hiroaki TAKEDA, Susumu SAKAYORI, Yoshikazu KAWAKAM ...
    1995 Volume 69 Issue 6 Pages 711-722
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    In the treatment of diffuse panbronchiolitis, azithromycin (AZM), a new macrolide antibiotic with 15-membred lactone ring, was studied for its efficacy and safety.
    AZM, 250 mg, was intermittently administered to a total of 60 patients twice a weeks, for 3 months as a rule, and its efficacy was clinically evaluated in 52 patients and the safety in 55.
    The rate of efficacy was 84.6%(44/52). Clinical findings 12 weeks after the start of administration showed a decrease in sputum volume in 30 of 46 patients and amelioration of dyspnea on exertion in 23 of 46 patients, and no worsening of symptoms was observed in the patients. Vital capacity (4/22), FEVi.o (6/21), cold agglutination reaction (22/28), and CRP (16/36) were also improved. The rate of eradication of organisms isolated from the sputum except for indigenous organisms was 39.5%(15/38); 4 of the 22 strains of Pseudomonas aeruginosa were eradicated.
    Adverse reactions were observed in 4 of the 55 patients (7.3%), 1 patient each with rash, itching, diarrhea, and a gastric symptom (heavy feeling in the stomach). 4 of the 54 patients (7.4%) exhibited abnormal changes in clinical laboratory test values. These were an increase in eosinophil count in 2, elevation of GOT in 1, and elevation of Al-P in 1. These adverse reactions and abnormal changes in laboratory test values were mild or moderate.
    Therefore, long-term intermittent administration of AZM, twice a week, is expected to have the same effect in the treatment of diffuse panbronchiolitis as long-term small-dose administration of 14-membered macrolides such as erythromcin and clarithromycin, whose effects have already been established.
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  • Norio OKAZAKI, Shirou YAMAI, Tsugio SASAKI, Yuko SASAKI, Kouji KOJIMA, ...
    1995 Volume 69 Issue 6 Pages 723-728
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    Polymerase chain reaction (PCR) with primers directed against the 16S-rRNA gene of Mycoplasma pneumoniae was used to diagnose M. pnuemoniae infections, and the results were compared with those of culture and serology methods. Eighty (22%) of 363 throat swab samples from patients with acute respiratory complains gave positive results by using the PCR method. Sixty-seven (18.5%) of those samples were positive in culture method. Of 35 samples which were unreliable culture results due to contamination with other bacteria, 13 gave positive results in the PCR method. Of the 97 cases obtained throat swabs and paired sera, 28 (28.9%) showed positive results by the PCR assay, and 29 (29.9%) by serology method (particle agglutination test). The positive rate was increased to 36% by using both the PCR and the serology methods. From these results it was concluded that the PCR method is useful for laboratory diagnosis of M. pneumoniae infections.
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  • Teiichi MATSUNAGA, Minako HASEGAWA, Kunihiro RYUNO, Sachiko KAWAMITSU, ...
    1995 Volume 69 Issue 6 Pages 729-737
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    Near-infrared (NIR) spectroscopy has recently come to be applied extensively in agricultural, food and chemical indusutries, and pharmaceutical science. We have been attempting to expand this method in the field of medical science. For example, we tried to use NIR spectroscopy for determination of bacteria. As the first step of this attempt, we differentiated between Escherichia coli and Staphylococcus aureus using NIR spectroscopy. This method could still further differentiate Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-sensitive Staphylococcus aureus (MSSA). Using those results as reference, the true name of bacteria from unknown bacteria was given. Not only untreated bacteria, but also we differentiated untreated MSSA, MSSA cultured in sub MIC concentration of ABPC and heat-killed MSSA. This identification method is sensitive to the bactreial concentration. In the future, the some new idea of a new direction of research from the result of plots of weights from two different bacteria will appear.
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  • Toshihide HAYASHI
    1995 Volume 69 Issue 6 Pages 738-746
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    Culture of stones and electrical microscopic observation were performed with stones collected from forty-eight patients who underwent surgery for urolithiasis. Thirty-six strains of bacteria in the stones obtained from stone culture were classified as nineteen strains of bacteria deriving from primary infection stones (Group A-I) and seventeen strains of bacteria deriving from metabolic stones (Group A-M). As for their ability to produce urease and glycocalyx, they were studied in comparison with forty-nine strains of stone surface-adhering bacteria (Group B). Glycocalyx producing ability was examined by the provisional quantitative toluidine blue assay and safranine straining method. As for the electrical microscopic observation, formation of biofilm bacterium was observed in all twenty cases of primary infection stones and in thirteen cases (46.4%) of twenty-eight cases of metabolic stones. Urease producing ability per stone was 6/14 (43.9%) in Group A-I, 4/13 (30.8%) in Group A-M and, 4/32 (12.5%) in Group B. There was a significant difference (p<0.05) between Group A-I and Group B. Similarly for the glycocalyx producing ratio (toluidine blue assay), the values were 9/14 (64.3%) in Group A-I, 11/3 (84.6%) in Group A-M and 10/32 (31.3%) in Group B. As for the glycocalyx producing ratio (safranine method), the values were 10/14 (71.4%) in Group A-I, 9/13 (69.2%) in Group A-M and 9/32 (28.1%) in Group B. As for the glycocalyx producing ability, Group A-I and Group A-M both showed significantly higher production ratios compared to Group B for both toluidine blue method and safranine method. From the above reuslts, it was suggested that both in the primary and secondary infection stones, the formation or growing of stones was strongly related to the glycocalyx producing ability of the bacteria.
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  • Yutaka MINOHARA, Tatsuo KATO, Kouzou KANKI, Toshirou GOSHIMA, Natsuki ...
    1995 Volume 69 Issue 6 Pages 747-751
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    We report a familial clustering case of hepatitis delta. All of the members of this family had evidence of past infection of hepatitis B. We investigated the hepatitis delta, three of the members had positive serological hepatitis delta markers. We assayed by polymerase chain reaction the primers corresponding to hepatitis delta antigen. The results of polymerase chain reaction was three positive. The 2nd polymerase chain reaction was used, two geno-type specific primers one was for Japanese S type the other was for Japanese M type7. Three were positive the 2nd polymerase chain reaction for Japanese M, one was negative for all of hepatitis delta polymerase chain reaction.
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  • Masahiro YAMAKOSHI, Toshinobu YAMAMOTO, Kanzou SUZUKI, Toshiyuki YAMAM ...
    1995 Volume 69 Issue 6 Pages 752-756
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
    In nursing home belonging to our hospital, influenza like syndromes were recongnized in 40 of 250 cases (16%) in 1994, and 5 cases were admitted to our hospital. On admission, three patients were unable to walk, and creatine phosphokinase levels were elevated in all patients, ranging from 337 IU/1 to 20, 672 IU/l. There were normal test findings for electrocardiography, ultrasonic cardiography. Three patients showed a significant antibody titer fall (Hemagglutinin Inhibition) in six months. The other patient did not show it, but his symptom was compatible with influenza. All patients recovered rapidly without sequelae. We reported four cases in the elderly of acute myositis associated with influenza A (H3N2) infection.
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  • Norihiko SUZUKI, Yasufumi UEDA, Hideto MORI, Yukako TAKEGAKI, Kazufumi ...
    1995 Volume 69 Issue 6 Pages 757-758
    Published: June 20, 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
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  • 1995 Volume 69 Issue 6 Pages 761
    Published: 1995
    Released: September 07, 2011
    JOURNALS FREE ACCESS
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