A 51-year-old Japanese male who had spent six months in Saudi Arabia was diagnosed by biopsy in his right thigh as having cutaneous leishmaniasis and was successfully treated with metronidazole and local heat. The dose of metronidazole used was 250 mg three times a day, and the drug was given for three ten-day periods with intervening rest periods of ten days. Leishmania promastigotes could be cultured from the lesion on the first day that metronidazole was administered but could not be cultured after two ten-day periods of treatment with the drug. After medication was given, local heat therapy was applied at 42°C, using hot water in a vinyl bag, for a total of 29 hrs, and heating under an infrared lamp at 43°C for 1 hr on one occasion only. Details of heat treatment are given in Table 1.

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Twenty-two cases of Diplogonoporus grandis infection have already been reported from Kochi Prefecture, and in this report, additional 12 cases were described.
In contrast to other regions, Kochi Prefecture aparently exhibits a marked increase in the incidence of cases in recent years.
Since the first description of this tapeworm was reported by Iijima and Kurimoto (1984) in Nagasaki Prefecture, the 162 cases of human infection with the worm were recorded in Japan in the literatures until 1989.

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Electron microscopical studies were performed on gametogenesis and fertilization of the gametes developed in the prolonged culture of P. falciparum. gametocytes which appeared during the culture of the parasites in the gametocytogenesis-induction medium. When the erythrocyte plasma membrane separated from the gametocyte during gametogenesis, a small part of the gametocyte cytoplasm which was enveloped with the multilayered sheaths of the erythrocyte plasma membrane, was released from the gametocyte into culture medium. We could observe the process of penetration of the macrogamete cytoplasm by the microgamete and then the fusion of the membrane surrounding microgamete with the nuclear envelope of macrogamete. From the findings of two microgamete nuclei were present in the cytoplasm of a macrogamete at fertilization, it is assumed that the multiple nuclear-fusion may occur.

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Three kinds of peptides termed ABJ917, ABJ918 and ABJ919 were synthesized and tested their capability of inhibition of Natural Killer (NK) cell mediated cytotoxicity. ABJ917, which is conserved among various retroviral transmembrane envelope proteins inhibited NK activities of the peripheral blood lymphocytes (PBLs) of both asymptomatic carriers and normal controls. ABJ918 or ABJ919 which correspond to this conserved region also inhibited NK activities. To know the mechanism of inhibition of NK cells by these synthetic peptides, conjugate formation assay and triggering assays were then performed. ABJ917 which inhibited overall NK cytotoxicity did inhibit neither NK and target tumor cell binding nor NK cell triggering by target K562 tumor cells. These results show that the inhibition of NK cytotoxic activity by synthetic HIV peptide is caused in the stage of post-triggering. Peripheral blood CD4⁺ cell rate of the asymptomatic carriers of HIV was almost 0% when we obtained enough NK activities and these carriers were still quite healthy. Taken together, the immunosuppression of AIDS patients is thought to be caused at least partly from some defects of post-triggering lytic activity of NK cells by HIV transmembrane peptides.

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An etiological study of bacterial diarrhea in infants under five years of age in Paraguay from May to July of 1990 was done. Enteropathogenic E. coli (EPEC) strains of known serogroups were isolated from 35.8% of the patients with diarrhea, Salmonella spp. were isolated from 15.1%, enterotoxigenic E. coli (ETEC) strains were isolated from 5.7%, and Shigella and Campylobacter spp. were isolated from 3.8% respectivery. No enteroinvasive E. coli (EIEC) or Vibrio spp. was isolated. Out of 53 diarrheal patients, 34 cases (64.1%) had bacterial diarrheal diseases. The infants under one year of age with diarrhea were predominant among inpatient and outpatient children under five years of age and the total number of male diarrheal cases was greater than that of female cases. Enteropathogenic organisms were isolated from nine out of 12 water samples taken from the Paraguay River. The major serotype (O18) of the EPEC isolated from the water samples of the Paraguay River corresponded to the major serotype isolated from patients with diarrhea.

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We have previously reported that there exists a time limit for effective treatment of falciparum malaria. In short, four days after the onset of the illness was found to be the time limit beyond which severe, life-threatening complications may develop.
In order to elucidate the level of laboratory variables beyond which the patient's prognosis is poor, we examined the correlation between time lag in days vs maximum parasite count, minimum red blood cell (r.b.c.) count, minimum hemoglobin (Hb), maximum blood urea nitrogen (BUN) and creatinine concentration of each patient during the period of admission. A linear correlation was found between time lag (x) and the maximum parasite count in log units (y), y= 4.031+0.124x, r =0.3579. All variables among patients whose treatment was started after 5 to 11 days of time lag (6th to 12th day of illness) were significantly worse than the variables of patients whose treatment was started after only 1 to 4 days of lag time. However, the most conspicuous change was observed in the abrupt increase of BUN and creatinine in the members of the late-treatment group : the mean BUN and creatine levels in the early and late treatment groups were 16.0 vs 57.1 and 1.2 vs 3.4 mg/dl (p <0.01), respectively. The mean parasite counts of the early and late treatment groups were 23, 400 vs 69, 200/μl of blood (p < 0.05), while the mean r. b. c. count and Hb concentration of the two groups were 3.81 vs 3.28 million per μl and 12.4 vs 10.0 g/dl (p<0.01), respectively., BR.In addition to the level consciousness of the patient, special attention should be paid to kidney function in the treatment of falciparum malaria patients whose treatment is delayed beyond the 5th day of illness.

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The serum bilirubin of malaria patients was investigated in an effort to show that jaundice occuring in malaria patients differs from hepatocellular (hepatitis) and obstructive jaundice.
1. The incidence of abnormally high serum total bilirubin (≥ 1.1 mg/dl) was more frequent in cases of falciparum than in vivax and ovale malaria patients put together (71% vs 49%, p <0.01). The maximum value of a falciparum malaria patient was 42.3 mg/dl.
The following data were obtained concerning falciparum malaria :
2. All 14 patients showing ≥ 5.1 mg/dl of serum total bilirubin were moribund, and 7 of them died.
3. A positive correlation was noted between the maximum parasite count and serum total bilirubin (p <0.01).
4. The mean values of total, direct and indirect bilirubin and the ratio of direct / total (d/t) bilirubin were 9.4, 5.4, 3.9 mg/dl and 0.5, respectively. There were no significant differences in the mean and variance of direct and indirect bilirubin.
5. A positive correlation was found between serum total bilirubin and d/t ratio (p < 0.02).
6. The mean values of SGOT, SGPT, γ-GTP and LDH were 70, 132, 74 and 1, 110, respectively. The maximum value of LDH was 15, 140. The above data may prove to be helpful in differentiating jaundice in malaria patients from hepatocellular and obstructive jaundice.

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