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ABSTRACT: To clarify the endemic and epidemic status of Chlamydia pneumoniae in Japan, the incidence of anti-C pneumoniae antibody was evaluated over a period of 10 years.
Serum samples were collected from 4756 healthy individuals aged 6 months to 88 years (2488 male and 2268 female individuals) between 1991 and 2000. The antibody titre was determined by a microimmunofluorescence test.
After stratification by age and sex in each year, distinct peaks with prevalences of 73.3% and 73.0% were noted in 1993 and 1999, respectively. The lowest prevalence rate was seen in 1996 (59.0%). The epidemic cycle has been estimated to be almost six years in this geographical area.
Chlamydia pneumoniae infection is highly endemic in Japan, as it is in Western countries, and there is a year to year variability. Long term studies in Japan are needed to clarify the epidemic occurrence of C pneumoniae infection.
Journal of Clinical Pathology 03/2002; 55(2):115-7. · 2.31 Impact Factor
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ABSTRACT: The in-vitro activity of moxifloxacin, a new fluoroquinolone, against Chlamydia species was investigated. The minimal inhibitory concentration of moxifloxacin for 10 standard strains of different Chlamydia species and 15 wild-type strains of Chlamydia pneumoniae isolated in Japan, which were morphologically different from clinical isolates from the United States, ranged from 0.031
to 0.125 μg/ml. The activity of moxifloxacin was almost the same as those of sparfloxacin, and it was 16, 8, 2, and 2 times
more active than ciprofloxacin, levofloxacin, grepafloxacin, and tosufloxacin, respectively. The minimal chlamydiacidal concentration
of moxifloxacin ranged from 0.031 to 0.125 μg/ml. These results suggest that moxifloxacin has potential effects against Chlamydia species.
Journal of Infection and Chemotherapy 01/2002; 8(1):115-117. · 1.80 Impact Factor
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ABSTRACT: We studied the effect of pazufloxacin mesilate (T-3762), a new fluoroquinolone for intravenous administration, on the serum
concentration of theophylline. Evaluation consisted of comparisons of serum levels of theophylline (when it was given alone,
as a control), with serum levels of theophylline when T-3762 was given concomitantly. We measured the serum concentrations
and the urinary excretion rates of theophylline in healthy adult male volunteers who were given theophylline for 5 days, followed
by an i.v. infusion of T-3762. Blood and urine samples were investigated on the third and fifth days after the concomitant
dosing with T-3762, to compare the serum levels and urinary concentrations of theophylline with the control values. We found
that the serum concentration and the urinary excretion rates of theophylline on the fifth day after concomitant dosing with
T-3762 were significantly increased compared with the levels when the volunteers had been given theophylline alone.
Journal of Infection and Chemotherapy 01/2002; 8(1):33-36. · 1.80 Impact Factor
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ABSTRACT: The in vitro and in vivo antichlamydial activity of sitafloxacin was investigated. The MICs and minimal chlamydiacidal concentrations of sitafloxacin for various species of chlamydia ranged from 0.031 to 0.125 microg/ml. Sitafloxacin had an excellent therapeutic effect on experimental Chlamydia psittaci pneumonia and was more potent than tosufloxacin, ofloxacin, and ciproflxacin, although slightly less potent than sparfloxacin.
Antimicrobial Agents and Chemotherapy 12/2001; 45(11):3270-2. · 4.84 Impact Factor
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Y Niki
Nippon rinsho. Japanese journal of clinical medicine 12/2001; 59 Suppl 7:223-9.
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ABSTRACT: The in vitro activity of telithromycin, a new ketolide, was compared with those of roxithromycin, azithromycin, clarithromycin and erythromycin A against 20 strains of Chlamydia pneumoniae. The MICs and minimal chlamydiacidal concentrations of telithromycin for the 20 C. pneumoniae strains both ranged between 0.031 and 0.25 mg/L. Telithromycin was twice as active as roxithromycin, azithromycin and erythromycin A, but less active than clarithromycin. These results appear to indicate that telithromycin is an effective antibiotic that should play some role in the treatment of respiratory tract infections caused by C. pneumoniae.
Journal of Antimicrobial Chemotherapy 10/2001; 48(3):403-5. · 5.07 Impact Factor
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ABSTRACT: Using a new plaque cloning technique, we obtained unique Chlamydia trachomatis strains, which were confirmed to be free of the 7.5-kb common plasmid and glycogen in inclusions. The inclusions in plasmid-free and glycogen-negative strains were characterized by a target-like bull's eye morphology that appeared with the formation of a central translucent area that began to be seen clearly at 30 h postinoculation. The clear zone was composed of gel materials originating from reticulate bodies (RBs) that were abnormally large in size and irregular in shape, although one could not differentiate the aberrant RBs from normal RBs at early stages of development. The in-vitro susceptibility of these strains to various chemotherapeutic antibiotics was tested by comparison with their parent strains possessing the common plasmid. No difference was detected for any of the antibiotics tested, indicating that the 7.5-kb common plasmid is unrelated to the drug susceptibility of C. trachomatis.
Journal of Infection and Chemotherapy 07/2001; 7(2):113-6. · 1.80 Impact Factor
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ABSTRACT: In Japan, an isolated vaccine of measles is used because MMR vaccines have been suspended due to the frequent occurrence of aseptic meningitis after their use. It is administered only once with the cover rate having been approximately 70%. An outbreak of measles was experienced in eight of our health care workers (three doctors, three nurses and two clerks of our hospital) and in seven of our medical students, accompanying local outbreaks. Their condition was severe enough to require admission to our school hospital. One of medical students developed encephalitis, but he has recovered completely. The social cost including medical cost per worker was approximately yen 500,000 (about $4,500). We measured antibodies against measles, rubella, chickenpox and mumps using the ELISA assay in 1048 health care workers less than 40 years of age and 99 medical students before their clinical practice two or three months after the outbreak. The cost including the measuring of antibodies and vaccination for these workers and students was approximately yen 2,800,000 and it will be yen 700,000 for new workers each year. The negative rates for workers were 1.2% for measles, 8.8% for rubella, 10.0% for mumps and 2.0% for chickenpox and those for the medical students were 1.0%, 22.0%, 9.0% and 5.0%, respectively. Of the workers, 9.6% who had more than the defined very high tiaer were thought to have subclinical reinfection because they were non-symptomatic. The rates were 1.2% for rubella, 0.5% for chickenpox and 0.0% for mumps for more than the defined high titers among the workers, suggesting a risk of outbreaks in the future. Therefore, the antibodies of health care workers and medical students should be measured at the hospital and the antibody-negative person should be vaccinated to prevent infection not only from their patients but also prevent other patients from becoming infected by contracted health care workers or students.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 07/2001; 75(6):480-4.
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ABSTRACT: A 49-year-old man visited our hospital complaining of a continuous high-grade fever and cough which had appeared during his stay in Indonesia. He was admitted on the same day because his laboratory data showed marked inflammatory changes and his chest radiograph revealed an infiltrative shadow in the right upper lung field. Initial treatment with beta-lactams was not effective and both his symptoms and his chest radiograph worsened. However, treatment with erythromycin clearly had an effect. Then, we carried out several tests for detection of atypical pathogens including Mycoplasma and Chlamydia. Finally, the case was diagnosed as one of Coxiella burnetii pneumonia because the DNA of C. burnetii was detected from his sera and seroconversion of C. burnetii--specific antibody was observed among paired serum samples. C. burnetii is one of the most commonly recognized pathogens among community-acquired pneumonias in Western countries, but in Japan, reports of community-acquired C. burnetii pneumonia have been rare. This difference may be due to the features of Q fever, in which there are large differences in frequency and form from country to country and among areas of the same country. Surveillance of C. burnetii pneumonia in Japan and different area will be required.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 07/2001; 39(6):446-51.
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ABSTRACT: A 58-year-old woman with underlying rheumatoid arthritis was admitted to the hospital because of a dry cough and the presence of an abnormal shadow in the right lower lung field. Consolidation and volume loss in the right lower lobe with air bronchogram were recognized on a chest tomogram. Bronchofiberscopic examination disclosed neither stenosis nor tumors in the large bronchi. Organizing pneumonia was recognized pathologically in transbronchial lung biopsy (TBLB) specimens. The volume of the right lower lobe decreased rapidly, and new infiltration shadows appeared in the right upper and middle lobes. Another bronchofiberscope examination revealed organizing pneumonia, and macrophage infiltrations were seen in the alveoli on histopathological examination of the TBLB specimens. The diagnosis of RA-associated BOOP was made on the basis of agreement of the expansion of the shadows on chest radiographs, the RA symptoms and the RA factor. The patient was treated with prednisolone, and the clinical course was satisfactory, with no recurrence. This case was of interest because BOOP inducing lobar cicatricial atelectasis is very rare.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 05/2001; 39(4):260-5.
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ABSTRACT: To investigate the prevalence of asymptomatic infection with Chlamydia pneumoniae in subjectively healthy adults.
Prospective study.
Kawasaki Medical School Hospital in Kurashiki, Japan.
Total of 1,018 asymptomatic healthy adults (age range, 22 to 50 years; mean age, 32.4 years; 482 men and 536 women).
Nasopharyngeal swab specimens were obtained from all subjects and analyzed by isolation in cell cultures and polymerase chain reaction (PCR) test for C pneumoniae. Serum samples were also obtained and tested for C pneumoniae-specific antibodies by the microimmunofluorescence test. Of 1,018 specimens tested, 14 specimens (1.4%) were judged positive by culture and/or the PCR. Thirteen specimens were PCR positive, and 4 specimens were culture positive. There were three specimens positive by both tests and 11 specimens positive with discrepancies in culture and PCR results. None of the individuals met the serologic criteria for acute infection. Of 1,018 sera tested, 64.1% of men and 58.0% of women had antibody to C pneumoniae. The overall prevalence of antibody was 60.9%. Forty individuals (3.9%) had an IgG titer of > or = 1:512 or IgM titer of > or = 1:16.
Our data suggest that asymptomatic infection with C pneumoniae may occur in subjectively healthy adults.
Chest 05/2001; 119(5):1416-9. · 5.25 Impact Factor
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Chest 05/2001; 119(4):1295-6. · 5.25 Impact Factor
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ABSTRACT: The measurement of serum (1-3)-beta-D-glucan (beta-glucan) in cases with deep seated mycosis is a useful diagnostic method. Beta-glucan has usually been measured using two different methods: by an alkali treatment, chromogenic automated kinetic assay (chromogenic assay), and by detergent dilution and heating methods, kinetic turbidimetric assay (turbidimetric assay). However, there are often large discrepancies in the beta-glucan values measured by these two methods. In this study, we reexamined the values of beta-glucan obtained by the two techniques, using 343 serum samples from 146 patients who had been treated in Kawasaki Medical School between January 1999 and May 1999, and then analyzed the reasons for the differences. Serum beta-glucan results measured were evaluated by segregating them into three clinical categories: cases with proven deep mycosis, cases with probable deep mycosis and cases without deep mycosis. In addition, the beta-glucan in the samples was suppressed by carboxy-methylated curdlan (CM-curdlan), and then was remeasured to find a non-specific reaction. Although a certain correlation was found between the serum beta-glucan results measured by the two methods, the values measured by the chromogenic assay were, in general, higher than those measured by the turbidimetric assay. There were also many samples in the cases without deep mycosis that showed positive values with the chromogenic assay, but not with the turbidimetric assay. With the turbidimetric assay, the addition of CM-curdlan suppressed the values of beta-glucan in all samples; however, when measured by the chromogenic assay the values in many samples remained high. These results suggest that a non-specific reaction which did not include beta-glucan was detected by the chromogenic assay. Further studies are needed to evaluate the characteristics and comparable usefulness of the two assays.
Nippon Ishinkin Gakkai Zasshi 02/2001; 42(4):237-42.
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Internal Medicine 01/2001; 39(12):1131-2. · 0.94 Impact Factor
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ABSTRACT: Amiodarone is a useful drug for the treatment of life-threatening cardiac arrhythmias. However, amiodarone can induced pulmonary toxicity (APT) and may cause life-threatening lung damage. APT can be difficult to diagnose, but early diagnosis is important. Here, in a 51-year-old man with APT, the high serum KL-6 level was correlated with the severity of symptoms and chest X-ray findings, and it was inversely correlated with PaO2 and diffusion capacity for carbon monoxide levels. The findings suggest that the serum KL-6 level may be increased in APT and that therefore it's the determination of serum KL-6 may provide a useful indicator and/or monitoring marker of APT. KL-6 is believed to be produced and secreted by type II pneumocytes. Typical pathological findings of APT include proliferation of type II pneumocytes which may produce KL-6, and result in increased serum KL-6 levels.
Internal Medicine 01/2001; 39(12):1097-100. · 0.94 Impact Factor
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ABSTRACT: We report a case of pulmonary suppuration due to a mixed infection of anaerobic bacterium and Actimomyces. A 49-year-old man was admitted to our hospital because of hemoptysis on March 30, 1999. A chest X-ray film showed a localized shadow in the right middle lobe, and a tumor shadow was recognized on chest CT. The anaerobic bacterium were isolated from specimens collected bronchofiberscopically. A diagnosis of pulmonary suppuration due to anaerobic bacterium was made, and treatment with sulbactam/ampicillin, followed by imipenem/cilastatin, was initiated. Although his clinical symptoms and laboratory data improved rapidly following this treatment, the abnormal finding on the chest radiographs remained, with only slight improvement. Accordingly, surgical resection of part of the right middle lobe was performed on June 29 using a video-associated thoracic surgery technique. Actinomycosis was recognized by pathological examination of the resected lesion. A revised diagnosis of pulmonary suppuration due to a mixed infection of anaerobic bacterium and Actinomyces was made. Anaerobic bacterium in the oral cavity are recognized as significant pathogens in pulmonary suppuration. In the present case, we considered anaerobic bacterium and Actinomyces aspirated from the oral cavity into the lung to have caused the pulmonary suppuration.
Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 10/2000; 38(9):710-3.
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ABSTRACT: Our previous study found mistakes by some doctors in the choice of an assay for determining antibodies in Japan. To compare the positivity rates for antibodies by assays, we measured the antibodies of measles, rubella, chickenpox and mumps from the same sera using such methods as the EIA, HI and CF assays. The subjects were 175 nursing students. The positivity rates for measles, chickenpox and mumps by the EIA assay were 96.6%, 93.7%, and 83.3%, respectively. Those for rubella by the HI and CF assays were 92.0% and 10.1%. The sensitivity rates for measles, chickenpox and mumps by the HI and CF assays, based on the results of the EIA assay, were 75.1%, 102.4% and 69.2% in the HI assay, and 20.6%, 38.7% and 8.0% in the CF assay, respectively. Our previous study showed that the sensitivity of the HI assay for rubella antibody is same as that of the EIA assay in Japan. Currently an EIA assay should be chosen for these antibodies and the HI assay or IAHA assay should be possible selections for rubella and chickenpox. However, international comparison of the cutoff titers for these antibodies should be considered.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 09/2000; 74(8):670-4.
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ABSTRACT: We sent questionnaires to 80 medical schools in Japan to know what the problems in hospital infection for students in medical schools are. Seventy-one % were sent back to us. There have been hospital infection from patients to students in 12% of the medical schools, included 3 cases each of measles, chickenpox and mumps, 2 cases each of rubella, hepatitis B and tuberculosis. Fourteen % of the medical schools had reports about the past history of infection and vaccination from students, 70% of the schools determined their antibodies and the 28% did nothing. Ninety-three%, 25%, 23%, 18%, and 15%, of the schools determined antibodies for hepatitis B, rubella, measles, chickenpox and mumps, respectively. Some assays of the measurement were low in sensitivity. The cost for the determination was fully paid in 48% of the schools, but only partially supported in 35%. Tuberculin reaction was performed in 40% of the schools and then BCG was done in 57%. Vaccination was recommended in 40% of the schools. The cost of vaccination was all paid in 38% of them, which was only for hepatitis B, and partially supported in 15% of them.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 06/2000; 74(5):465-9.
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Chest 03/2000; 117(2):615-6. · 5.25 Impact Factor
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ABSTRACT: To evaluate the seropositivity of Chlamydia spp. in human immunodeficiency virus (HIV)-infected subjects in Japan, Chlamydia-specific antibodies in sera collected from 106 HIV-infected subjects were measured by the microimmunofluorescence test. The prevalence of C. pneumoniae-specific IgA, C. trachomatis-specific IgG and IgA and mean titers were significantly higher in the homosexual and heterosexual HIV-infected subjects than in the hemophilic patients and HIV-negative controls. These data indicate that the higher C. pneumoniae and C. trachomatis seroprevalence among HIV-infected subjects is probably due to an HIV risk factor, such as promiscuous sexual behavior, rather than to HIV infection itself.
Microbiology and Immunology 02/2000; 44(9):781-5. · 1.30 Impact Factor