[Clinical studies on the transference of cephem-type antibiotics into bile and gallbladder tissues with special reference to cefotiam and cefmenoxime]

Cefotiam (CTM) and cefmenoxime (CMX) were studied for their serum concentrations and transference into bile in patients with PTCD or T-tube. One gram of CTM or either 1 g or 2 g of CMX was administered by an intravenous drip infusion for over 30 minutes. These drugs were also studied for their serum concentrations, bile concentrations, and tissue concentrations in the walls of the gallbladder of patients operated on for cholelithiasis. Intravenous drip infusion (over 30 minutes) was used to administer 1 g of CTM or 1 g or 2 g CMX immediately before surgery. Both CTM and CMX were readily transferred into bile. Their bile concentrations, however, varied greatly among patients, and extremely low levels were detected in some patients. A crossover analysis of concentrations of CMX in bile of patients given doses of 1 g and 2 g revealed a dose-response relationship. The crossover analysis of drug concentrations in bile of patients given CTM and CMX showed that CMX is transferred more readily to bile. The relationship between liver functions and drug transfer to bile was examined by plotting the total bilirubin level against drug concentrations in bile. The plots formed an exponential curve with a correlation coefficient (r) being -0.52 in cases when each subjects received 1 g of CTM and -0.72 in cases when each subjects received 1 g of CMX. A study of 3 patients given CMX at a dose of 1 g suggested that bile levels of CMX may be correlated to ICG. Concentrations of CTM and CMX in tissues of the gallbladder wall were fairly high, with unexpectedly small variance among patients. Even in patients with low bile concentrations of these drugs, drug levels in the tissues of the gallbladder wall were high. Drug levels in the noninflammatory tissues were higher than those in inflammatory lesions. The above findings suggest that CTM should be the antibiotic of choice for patients with ordinary biliary tract infections and after the surgery of the liver and biliary tract system, while CMX should be the antibiotic of choice for patients with severe biliary tract infections, and for compromised hosts after the surgery of the liver and biliary tract system.

B cell activity and regulatory T cell function in systemic lupus erythematosus by human B cell colony formation

We have examined the ability of B cells from patients with systemic lupus erythematosus (SLE) to form colonies in vitro. Significantly more B cell colonies growing in the absence of irradiated T cells were observed in patients with active SLE. Helper T cell function of active SLE was normal. Culture supernatants of SLE T cells had significantly less activity to support the B cell colony formation. Our results suggest that the hyperactivity of B cells in SLE may reside in the lupus B cells themselves and that SLE T cells are defective in releasing the soluble factor.

The role of peripheral blood T and B lymphocytes in mitogen responses during human pregnancy

Studies on the role of T and B lymphocytes of pregnant and post-partum women were performed in a pokeweed mitogen (PWM) stimulated culture system. The responses were assessed by immunofluorescent staining for intracytoplasmic immunoglobulins and solid-phase radioimmunoassay for Ig secretion into culture supernatants. As compared with non-pregnant control subjects, a slight decrease of helper T cell function and accelerated suppressor activity of T cells in pregnant and post-partum women in B cell differentiation promoted by PWM were demonstrated. Conversely, B lymphocytes in pregnant and post-partum women were hyperreactive in the presence of T lymphocytes from non-pregnant control subjects in the mitogen stimulated culture system.

Antigenic analysis of Japanese encephalitis virus by using monoclonal antibodies

Hybridoma cells were produced by fusing P3X63Ag8.653 mouse myeloma cells with spleen cells from BALB/c mice immunized with Japanese encephalitis (JE) virus, Nakayama-RFVL strain. The resulting 26 clones produced hemagglutination inhibition antibodies against the homologous strain. The hemagglutination inhibition reactivity of each clone was tested against six flaviviruses: JE, Murray Valley encephalitis (MVE), Egypt 101 strain of West Nile (WN), St. Louis encephalitis (SLE), Russian spring summer encephalitis, and dengue type 1. The 26 monoclonal antibodies fell into four groups: 14 JE species-specific antibodies, 6 antibodies reactive to JE and MVE viruses, 3 antibodies to three or four viruses in the JE-MVE-WN-SLE subgroup, and 3 antibodies to all six flaviviruses. Furthermore, antigenic comparison of 27 strains of JE virus was carried out by using five JE species-specific monoclonal antibodies. Of these, 24 strains were isolated in various parts of Japan, and 3 strains came from Southeast Asia. In reactivity, the 27 strains were classified into at least four antigenic groups. The results showed that the Nakayama-Yakken strain is a mutant strain which lacks the Nakayama strain-specific antigen and that the recently isolated strains are immunologically different from Nakayama and JaGAr 01 strains. One clone (NARMA 13) produced a JE species-specific antibody which showed almost the same titer against 26 JE virus strains, whereas one clone (NARMA 5) produced a Nakayama strain-specific antibody which reacted only to the Nakayama-RFVL and Nakayama-Yoken strains.

Characterization of monoclonal antibodies against etiological agents of Weil's disease

Monoclonal antibodies against etiological agents of Weil's disease were produced by cell fusion technology. Twenty hybridomas were produced through the fusion of P3X63Ag8 .653 cells with spleen cells from BALB/c mice immunized against Leptospira interrogans serovar icterohaemorrhagiae RGA strain and serovar copenhageni Shiromizu and M20 strains. Reactivities of the antibodies produced by the hybridomas were determined by the microscopic agglutination test. Among the five hybridoma antibodies to the RGA strain, two reacted specifically to serovar icterohaemorrhagiae, two reacted to serovar icterohaemorrhagiae at a high titer and serovar copenhageni at a low titer, and one reacted to serovars icterohaemorrhagiae, copenhageni, pyrogens, and canicola. Of the ten hybridoma antibodies to the Shiromizu strain, one reacted specifically to serovar copenhageni, seven reacted to both serovars copenhageni and icterohaemorrhagiae at almost the same titer, and two exhibited intermediate properties. Of the five hybridoma antibodies to the M20 strain, three reacted to both serovars copenhageni and icterohaemorrhagiae at almost the same titer, one reacted to serovar copenhageni at a low titer and serovar icterohaemorrhagiae at a high titer, and one reacted to serovars copenhageni, icterohaemorrhagiae, and pyrogens. The results revealed that each serovar has its own antigen(s) and their common antigens. In addition, 20 strains of leptospires were recently isolated and tested with three monoclonal antibodies characterized by different reactivities. Twenty strains were clearly identified by their antibodies, i.e., 16 strains were identified as serovar icterohaemorrhagiae and three strains were identified as serovar copenhageni. The remaining strain, which was not agglutinated by three antibodies, was identified as serovar autumnalis by an agglutination test with immune rabbit sera.

An epidemiologic study of hepatitis B virus in Okinawa and Kyushu, Japan

In 1968-1981, a total of 3222 serum samples were collected from healthy subjects in Okinawa--in Ishigaki City, on Hateruma Island, and on Iriomote Island--and in Kyushu, in Fukuoka City and Nichinan City. These serum samples were tested for the presence of hepatitis B surface antigen (HBsAg) by reverse passive hemagglutination (RPHA), for antibody to hepatitis B surface antigen (anti-HBs) by passive hemagglutination (PHA) and radioimmunoassay (RIA), and for antibody to hepatitis B core antigen (anti-HBc) by RIA. Overall prevalence of HBsAg (7.5%), anti-HBs by PHA (41.0%) and RIA (56.4%), and anti-HBc (65.5%) in Okinawa was significantly higher than prevalence of HBsAg (2.4%), anti-HBs by PHA (24.7%) and by RIA (28.1%), and anti-HBc (30.9%) in Kyushu. In both areas, anti-HBc was more frequently detected than anti-HBs by both methods. In Okinawa, HBsAg was significantly more prevalent in males than in females. No significant differences by sex in other hepatitis B virus markers were found. On Iriomote Island and Ishigaki City, second samples were collected after intervals of 10 and 12 years, respectively. Over these periods, the prevalence of all hepatitis B virus markers decreased significantly for the 0-9 and 10-19 year age groups. These data suggest that hepatitis B infection among children has declined in recent years and that high prevalence of hepatitis B infection in adults may reflect high rates of infection in their childhood.

Determination of the second component of complement (C2) by electroimmunoassay in sera from patients with systemic lupus erythematosus

The concentration of C2 was determined by electroimmunoassay in sera from healthy controls, patients with systemic lupus erythematosus (SLE), their relatives and patients with other diseases. Monospecific anti-human C2 serum was obtained by immunizing rabbits with purified human C2 and then absorbing the rabbit serum with inactivated normal human serum that was made insoluble. In addition, it was shown that human C2 could be purified by means of affinity chromatography on anti-C2 antibody coupled Sepharose. The serum concentration of C2 was 37.8 +/- 5.0 (s.d.) micrograms/ml in healthy controls (n = 133). In patients with SLE, the values were below normal in the active phase and were within normal limits in the inactive phase, showing good correlations with other complement parameters such as CH50, C4, C3 and factor B. C2 concentration was well correlated with C2 haemolytic activity in the inactive phase of SLE, but there was no relationship between the two in the active phase. The mean value of C2 concentration in the relatives of patients with SLE showed no significant difference from that in healthy controls. C2 concentration tended to be high in patients with scleroderma, polymyositis, rheumatoid arthritis, Behçet's disease and aortitis syndrome. However, the values were often low in patients with chronic liver diseases, suggesting a decrease of C2 production in the liver.

Prevalence of antibody to hepatitis A virus in Okinawa and Kyushu, Japan

Between 1968 and 1981, a total of 1955 serum samples from healthy subjects chosen at random in seven districts of Okinawa and two districts of Kyushu were surveyed for antibody to hepatitis A virus (anti-HAV) by radioimmunoassay. Overall prevalence of anti-HAV was 55.1% in Okinawa and 35.9% in Kyushu. Prevalence of less than 10% was observed in subjects less than or equal to 14 years of age in Okinawa and less than or equal to 24 years of age in Kyushu. In three of the districts of Okinawa, second serum samples were collected after intervals of eight, 10, and 12 years, respectively. Overall prevalence of anti-HAV decreased significantly over these time periods. When the age-specific prevalence of anti-HAV on the first occasion is compared with that on the second occasion, it can be seen that there have been few new cases of hepatitis A infection. These data suggest that hepatitis A infection among children has declined dramatically in recent years, and that young people may be highly susceptible to hepatitis A virus.

Phagocytosis-connected oxygen consumption by peripheral leukocytes from patients with systemic lupus erythematosus

The phagocytic activity of peripheral blood leukocytes was assayed by means of oxygen consumption in 28 patients with systemic lupus erythematosus (SLE) and 22 normal individuals. The method in which zymosan was added to a small volume of whole blood enabled us to assay quantitatively and rapidly both the phagocytosis-connected oxygen consumption and the opsonizing time. The degree of oxygen consumption by phagocytes from SLE patients was not significantly different from that in normals. Opsonizing time of zymosan by autologous serum in SLE patients did not differ from that in normals either. It should be emphasized, however, that the opsonizing time of zymosan in SLE patients was inversely correlated with serum complement level, especially C3 level (coefficient of correlation = -0.76, p less than 0.001). This raises the possibility that the phagocytosis may be delayed in SLE patients with low titers of C3.

[Early detection of recurrent uterine cervical cancers (author's transl)]

In the treatise the authors aimed to find some early signs of aggravation on the treated uterine cervical cancers by routine clinical methods. Initially nine autopsy materials died of cancer were studied to survey the anatomical spreading and each documented. Then their ante mortem findings were summarized to review. Secondarily chief complains and clinical manifestations collected above were investigated among twenty one patients who were clearly attacked and/or died of recurrence. As a control thirteen patients free from the disease were encountered. Progressive pain associated with edema either in ipsilateral low back, limbs or lower abdomen was one of the most suspicious signs of intra-pelvic recurrence. Palpable noduli and thickening of parametrial areas and pelvic walls were as well a sign of exacerbation, if they appeared after treatments. Repeating urinary infection and aggravating hydro-nephrosis et-ureter frequently implied an insidious sign of pelvic recurrence. Continuing obstinate cough may be suggestive for pulmonary metastasis and needs chest roentgenogram. Increased serum alkaline phosphatase, LDH and ESR, and decreased peripheral lymphocyte count were frequently observed in the recurrent group. A suspicious or positive vaginal cytology was mostly indicative for pathological examination that would give us a final validity. Biopsy was done for superficial enlargements.

Purification of complement-fixing antigens of Rickettsia sennetsu by ether treatment

Soluble and particulate complement-fixing antigens of Rickettsia sennetsu were prepared from spleen suspensions of mice infected with the rickettsia and treated with cyclophosphamide. The medium used during purification of antigens, a solution consisting of equal volumes of phosphate-glutamate-sucrose buffer and veronal-buffered saline, was suitable for obtaining antigens with high titers and no anti-complementary activity. By heat treatment, it was demonstrated that the soluble antigen was heat labile and the particulate antigen was heat stable. The soluble antigen was precipitated by 80% saturation with ammonium sulfate. Cross-complement fixation tests using both soluble and particulate antigens revealed that there was no antigenic difference among strains of R. Sennetsu. On the other hand, no cross-activity was observed between R. sennetsu and R. orientalis.