Influence of temperature and relative humidity on human rotavirus infection in Japan

A climatologic analysis of human rotavirus infection in inpatients with acute diarrhea was conducted over a seven-year period. The infection frequency appeared to be related to temperature, but not to relative humidity. Human rotavirus infection was found to appear abruptly when the mean temperature of any 10-day period became less than 5 C (November or December), reached a peak when it was less than 0 C (January and February), and waned when it became greater than 20 C (June and July) in the city of Yamagata in northern Japan.

Isolation of human rotavirus subgroups 1 and 2 in cell culture

One strain of human rotavirus subgroup 1 (KUN) and one strain of subgroup 2 (MO) were isolated with the MA104 cell line, a fetal rhesus monkey kidney cell line. Their subgroup specificities and RNA patterns were identical to those of rotaviruses present in stools before cultivation. Distinct cytopathic effects consisting of obscure cell boundaries, cell fusion, cell rounding, cell detachment, and lytic foci were recognized at passage 3 of MO and passage 6 of KUN. No differences in cytopathic changes were found between the two isolates.

[Experimental and clinical studies of cefmenoxime in the field of obstetrics and gynecology]

The study group was organized to evaluate the usefulness of cefmenoxime (CMX) injection, a new synthetic cephalosporin, for the treatment of infections in the field of obstetrics and gynecology. Fundamental and clinical studies were made by the society and the following results were obtained. 1. The peak distribution of CMX's MIC for E. coli, Klebsiella sp., Enterobacter sp., Bacteroides sp. and Peptococcus sp. isolated from obstetrical and gynecological infections with relatively high frequencies area 0.1, less than or equal to 0.05, 0.2, 3.13, 1.56 micrograms/ml, respectively, with an inoculation of 10(6) cells/ml. 2. When 1 g of CMX is administered by intravenous drip infusion for 1 hour, the maximum concentrations in various tissues of female genital organs were as follows: 14.2 and 13.2 micrograms/g in ovary and oviduct, respectively, at 1.20 hours after the start of administration, and 16.9 and 26.3 micrograms/g in corpus uteri and cervix uteri, respectively, after 1 hour. As for the transfer to the exudate in the pelvic dead cavity, the peak concentration was 15.6 micrograms/ml after 2.13 hours. 3. In the clinical studies, CMX was given to 258 cases with female genital organ infections and others. As for the clinical effects, with exclusion of 3 cases in which other antibiotics are concomitantly used, responses were excellent in 76 cases, good in 162 cases and poor in 17 cases, among 255 cases in total. The efficacy rate was 93.3%. The efficacy rates by diseases were 97.1% (68/70) for intrauterine infections, 88.8% (79/89) for intrapelvic infections, 98.4% (62/63) for adnexitis, and 100% (23/23) for infections of external genital organs. As for the clinical effects on causative bacteria, the efficacy rates were 100% (19/19) for single infections due to Gram-positive bacteria, 94.8% (55/58) for single infections due to Gram-negative bacteria, and 88.2% (15/17) for single infections due to anaerobic bacteria. And its efficacy rates were 89.6% (69/77) for mixed infection cases. Side effects were observed in 2 cases (0.8%); 1 case with eruption, and 1 case with diarrhea and vomiting. As for abnormal laboratory findings, lower white blood cell count was observed in 2 cases and elevation of the values regarding hepatic functions in 9 cases. All cases were returned to the normal after the completion of the administration. Cefmenoxime showed a satisfactory clinical efficacy and a potent bacteriological effect in treatment of the infections in the field of obstetrics and gynecology, and it has been concluded that cefmenoxime will be useful addition to the antibiotics for the therapy of these infections.

Cyclic AMP concentrations in plasma, cerebrospinal fluid and urine in patients with acute cerebral hemispheric infarction

Plasmas, cerebrospinal fluid and urine were sampled from 22 patients with cerebral hemispheric infarction and analyzed for cyclic AMP. The following observations were made: (1) In mild cases with slight dysarthria and/or hemiparesis but without disturbance of consciousness (Group I), cyclic AMP in peripheral venous plasma (PVP) remained over the normal lowest level more than 10 days after the onset. Patients with apparent neurological deficits could be divided into two groups. In one group, cyclic AMP in PVP decreased to a subnormal level within about 5 days after the onset of stroke (Group II). In another group (Group III), such a decrease was not observed. Brain isotope scintigrams were revealed negative in Group I. The size of brain infarct as judged by isotope uptake was larger in Group III than in Group II, except for a few cases in which the lesion was restricted in the basal ganglionic region. (2) No clinical significance was, however, found in the time course of cyclic AMP levels in internal jugular venous or femoral arterial plasma, or in cerebrospinal fluid, or of the daily amount of cyclic AMP excretion into urine. (3) Cerebral arterio-venous difference of cyclic AMP was negative in most of the cases.

Morphogenesis of human rotavirus type 2 Wa strain in MA 104 cells

Morphogenesis of human rotavirus type 2 Wa strain in MA 104 cells was observed. The virus antigen in the cytoplasm was detected by indirect immunofluorescence twelve hours after infection. The cytopathic effect occurred 24 hours after infection when virus particles were detected by EM in the culture fluid as well as in thin sections of the infected cells. Virus particles were observed in the dilated RER, nuclear envelope (perinuclear space), viroplasm, and a lysosome-like body. Three types of virus particles were noted: double-shelled particles 75-85 nm in diameter, single-shelled particles 64-68 nm in diameter and electron-dense nucleoids or cores 32-40 nm in diameter. The outer shell of virus particles was acquired by budding through the membrane of the dilated RER. Tubular structures, similar in diameter to the single-shelled particles, were found in the cytoplasm and nucleus of infected MA 104 cells. Bundles of filaments or the leaflet-like inclusion bodies of membrane-bounded bundles of filaments were found in the cytoplasm and seemed to be associated with virus particles.

[Changes in plasma dopamine-beta-hydroxylase activity in patients with acute subarachnoid hemorrhage (author's transl)]

In 24 patients with subarachnoid hemorrhage (SAH) who were admitted within 48 hours after the onset, the activity of dopamine-beta-hydroxylase (DBH) in peripheral venous plasma was analyzed applying the method described by Nagatsu and Udenfriend (Clin. Chem., 18: 980-983, 1972) with a minor modification. Plasma samples were serially collected every a few days for three days to four weeks after the onset. DBH activity in peripheral venous plasma increased markedly after the onset, reaching the highest level within 48 hours, and thereafter declined time-dependently for about two weeks. There was no significant difference in the plasma DBH activities on admission between patients with and without cerebrovascular spasm revealed by angiography. The decline of the activity was significantly remarkable in patients with spasm compared with those without spasm. The difference was most prominent around the 7th day after the onset when spasm was shown most frequently. Neurosurgery or administration of analgesics and/or sedatives had little effect on the changes in plasma DBH activity in acute SAH. The activity correlated with the pressure of cerebrospinal fluid (r = 0.587, P less than 0.05), when it was higher than the normal range. With these results we obtained following: 1) The activity of sympathetic nervous system increases following SAH for a week after the onset. 2) The activity declines more rapidly in patients with cerebrovascular spasm than those without spasm, when it was judged from the activity of plasma DBH activity.

The occurrence of calicivirus in infants with acute gastroenteritis

Calicivirus was detected in 8 (1.2%) of 647 hospitalized patients during a survey of acute gastroenteritis in infants and young children, conducted between December 1974 and September 1977. Morphologically calicivirus was approximately 30 nm in diameter with an easily recognizable staining "star of David" configuration. Its buoyant density in cesium chloride was 1.38-1.40 gm/ml. The serologic response to calicivirus by immune electron microscopy (IEM) was demonstrated only in paired sera from patients who shed the virus in their stools. The results suggest that calicivirus might be a cause of acute gastroenteritis in infants and young children.

A long-term survey of rotavirus infection in Japanese children with acute gastroenteritis

Human rotavirus was detected by electron microscopic examination of the stools of 320 (63%) of 506 infants and young children hospitalized with acute gastroenteritis between December 1974 and March 1977. Serologic responses to infection with the rotavirus were revealed by the complement-fixation test in 130 (70%) of 185 patients examined. During the study period three epidemics of human rotavirus infection occurred during the winter months. The peak incidences occurred in January 1975 (88% of patients positive by serologic analysis or electron microscopy of stools), January 1976 (92%), and February 1977 (96%). Rotavirus was detected in the stools of 288 (79%) of 365 patients tested during the cooler months (December to March) and 35 (25%) of 141 during the rest of the year. In the summer (June to August), rotavirus infection occurred rarely. The frequency of human rotavirus infection was highest among patients aged six to 11 months. These results indicate that human rotavirus can be regarded as a major etiologic agent of acute gastroenteritis in infants and young children, of which wintertime epidemics are common in Japan.

Human rotavirus infection in infants and young children with intussusception

Human rotavirus was detected by electron microscopy in 11 of 30 infants and young children with intussusception (37% of subjects under study). Serologic complement fixation tests revealed evidence of infection with the rotavirus in 70% of the patients examined who eliminated the rotavirus in their stools. These results indicate that human rotavirus, in addition to adenovirus, may be an infectious agent causing intussusception in infants and young children.

Cerebrovascular CO2 reactivity in normotensive and hypertensive man

Cerebrovascular reactivity to CO2 inhalation and voluntary hyperventilation was studied in seven normotensive subjects and nine hypertensive patients without clinical or angiographical signs of arteriosclerosis. Cerebral blood flow (CBF) was measured by the intracarotid 133Xe clearance method and calculated as the initial slope index. Three to five CBF measurements were made in each patient in the PaCO2 range of 20 to 55 mm Hg. No difference was observed in reactivity between hypertensive and normotensive patients, either during CO2 inhalation or during hyperventilation. The shape of the CBF:PaCO2 curve suggested a decrease in reactivity below a PaCO2 of 30 to 35 mm Hg in both groups. Above a PaCO2 of 35 mm Hg, exponential regression analysis yielded a mean reactivity of 6 +/- 2%, whereas below a PaCO2 of 30 mm Hg it was about 2%. The rise in CBF during CO2 inhalation was not influenced by the intravenous infusion of a small dose of trimethaphan which blocked the concomitant rise in blood pressure.

Regional cerebral blood flow in patients with hypertensive intracerebral hemorrhage

Regional cerebral blood flow was measured by 133 Xe clearance method in 44 patients with hypertensive intracerebral hemorrhage (HIH) within three weeks from attack. Mean CBF in cases with the more disturbed consciousness was the lower value. There was no definite relationship between mean CBF and the duration from last stroke to measurement. In 44 cases, 35 showed hematoma of so-called "lateral type" and nine showed a "mesial type." There was no difference of mean CBF between these two groups. In the group with lateral-type hematoma, 14 cases were thought to show large space-occupying signs, and their mean CBF was significantly lower than that of the other 21 cases.

In 16 cases, relative hyperemic regions were observed in both the focal and nonfocal areas. In seven cases, relative ischemic regions were frequently in nonfocus rather than focus.

Response of hyperemic region to carbon dioxide was good in seven and poor in three regions in focal area, and was good in eight and poor in one region in nonfocal area. Reactivity of ischemic region to 5% CO 2 inhalation was good in three and poor in zero regions in focus, and was good in three and poor in two regions in nonfocus.

Early venous filling (EVF) was observed in 13 cases and all of them were with lateral-type hematomas.

Only four out of 13 cases showed good correlation between angiographical findings and cerebral circulation.

Lactate in the cerebrospinal fluid and pressure-flow relationships in canine cerebral circulation

In 11 dogs, lactate and pH in the cerebrospinal fluid and in the arterial and the venous blood were measured during stepwise reductions of the arterial blood pressure by controlled bleeding. Increase in lactate and decrease in pH of the cerebrospinal fluid occurred with lowering of the mean arterial blood pressure even within the pressure ranges of 110 to 50 mm Hg, where autoregulation was fairly observed. Reductions of the blood pressure by 20 to 40 mm Hg led to a significant increase in lactate, and reductions by 60 mm Hg led to a significant decrease in pH of the cerebrospinal fluid.

The relation of decrease in pH and increase in lactate was linear, suggesting that lactacidosis occurred. In the arterial and the venous blood, a marked increase in lactate and decrease in pH also were observed. Lactate concentrations of the cerebral venous blood were significantly higher than those of the arterial blood until the arterial blood pressure had been reduced below 70 mm Hg. Therefore, it was suggested that increase in lactate of the cerebrospinal fluid might be attributed solely to increase in lactate of the brain tissue, so far as the blood pressure was not lowered below 70 mm Hg at least. The possibility of participation of the cerebrospinal fluid lactacidosis in autoregulation of the cerebral blood flow was discussed.