The PCR-based detection ofBabesia gibsoniinfection in dogs (German shepherds) reared in South Korea

German-shepherd dogs from the South Korean provinces of Gangwon and Gyunggi were used in a study exploring both the detection of Babesia gibsoni infection, by use of a PCR-based assay, and the nucleotide sequences of part of the P18 gene of the parasite. Nine (1.8%) of the 501 dogs checked were found PCR-positive. Although the prevalence of the infection appeared slightly higher in the male dogs than in the female (2% v. 1.7%), and in the dogs aged <3 years than in the older animals (2.7% v. 1.1%), these differences were not statistically significant. In addition, the prevalences of infection among the dogs from Gangwon (in the east of the country) and those from Gyunggi (in the west) appeared similar. All nine PCR-positive dogs were confirmed to have B. gibsoni infection by the microscopical examination of thin bloodsmears, which revealed that 0.1%-3% (mean=1.5%) of the dog's erythrocytes harboured the parasite. The nucleotide sequences of the P18 gene of B. gibsoni from each of the PCR-positive dogs were identical to each other and to the corresponding sequence - recorded under accession number AB053292 in the DNA Data Bank of Japan (DDBJ) - previously determined for isolates of B. gibsoni from Japanese dogs. Although the PCR products sequenced in the present study represent only a part of the P18 gene of B. gibsoni, it seems that South Korean and Japanese dogs carry a similar strain of B. gibsoni. These results may help to clarify the phylogenetic position of the B. gibsoni found in South Korea.

Serological and molecular survey of Dirofilaria immitis infection in stray cats in Gyunggi province, South Korea

The aim of this study was to carry out a serological and molecular survey for the presence of Dirofilaria immitis infection in stray cats using an ELISA kit and PCR assay. One hundred and fifty-five stray cats (77 females and 78 males) in Gyunggi province in South Korea, were used in this study. Four (2.6%) tested with the ELISA kit showed a positive reaction, and all positive samples by the ELISA kit showed a positive reaction by PCR analysis. No significant difference was observed between the male (2.6%) and female (2.6%) cat groups by ELISA kit. The positive rates for dirofilariosis were 2.8% in the 4-6-year-old group, and 18.2% in the > 6-year-old group by ELISA kit. With regard to the age element, older cats showed a higher prevalence of D. immitis infection in this study. A statistical analysis revealed that significant difference was observed in > 6-year-old group (p < 0.01). In conclusion, D. immitis infection in stray cats was present in Gyunggi province, although its incidence was low. Therefore, heartworm treatment and/or prophylaxis for stray cats captured are required in this area.

Seroprevalence of canine dirofilariosis in South Korea

Eight-hundred and forty eight dogs (480 females and 368 males) not on chemoprophylaxis were examined for Dirofilaria immitis infection from 2001 to 2002. Three-hundred and thirty nine (40.0%) of 848 samples tested with antigen detecting ELISA kits showed positive reaction for D. immitis antigen. More male (43.5%) than female (37.3%) dogs were affected in this study, although there was no significant difference between both groups. Chi2 analysis showed that female and male dogs of shoreline areas had higher significant prevalence than other areas (P<0.001), respectively. The mean overall positive rates of heartworm infection were 10.4% in dogs <2-year-old group, 46.5% in 2-4-year-old group, 48.4% in 4-6-year-old group and 50.3% in >6-year-old group. The older the age, the higher the prevalence of D. immitis infection in this study. Chi2 analysis revealed a significant higher prevalence in 4-6-year-old group (100%) of shoreline areas and in 2-4-old-year group (51.2%) of urban areas (Chungnam province), respectively (P<0.001), and also revealed that the over 6-year-old group (50.3%) in mean overall prevalence had the significant higher prevalence than other age group (P<0.001). In climate comparison, our data showed that shoreline areas (69.5%) had the significant higher prevalence than urban areas and mountain areas (P<0.001). This survey confirms that the prevalence of canine heartworm infection increases, and also that the prevalence in shoreline areas is higher than in other areas in South Korea.

Diurnal variation in microfilaremia in a cat experimentally infected with larvae of Dirofilaria immitis

In five healthy mongrel female cats used, four cats (Cats 1-4) were experimentally inoculated with 100-123 larvae (L(3)) of Dirofilaria immitis. Cat 5 was an uninfected control. Only Cat 1 became microfilaremic on Day 201 after inoculation and the diurnal changes in the microfilaria population were monitored every 2 h for 24 h on Day 237 when a sufficient number of microfilaria were detected in the circulation. The maximum number of microfilaria in the blood (1,350/ml) occurred at 9:00 p.m. and then gradually decreased to the minimum of 300/ml at 7:00 a.m., indicating that the number of microfilaria shows a nocturnal sub-periodic pattern of diurnal rhythm even in peripheral blood of cats as an abnormal host. On postmortem examination, 10 live adult worms (three males and seven females) in Cat 1 and one live adult worm (one male) in Cat 2 were detected.

Expression of T helper 1 and T helper 2 cytokine mRNAs in freshly isolated peripheral blood mononuclear cells from dogs with atopic dermatitis

Using reverse transcription-polymerase chain reaction (RT-PCR) and semi-quantitative PCR techniques, mRNA expression for canine interferon (IFN)-gamma, interleukin (IL)-4, IL-5 and IL-10 in freshly isolated peripheral blood mononuclear cells (PBMCs) was examined in dogs with or without atopic dermatitis (AD). The expression of IFN-gamma mRNA in dogs with AD was lower than that in dogs without AD (healthy control). The expression of IL-5 mRNA was higher in dogs with AD than in control dogs, but there were no significant differences in IL-4 mRNA and IL-10 mRNA expression between the groups. The number of circulating eosinophils was higher in dogs with AD than in control dogs, although eosinophilia was found in only one dog with AD. These results suggest that there is a tendency for the PBMCs of atopic dogs to express a type 2 cytokine pattern that is similar to the pattern observed in human AD patients.

Intraspecific variation of 18S-5.8S-26S rDNA sites revealed by FISH and RFLP in wild oat, Avena agadiriana

The tetraploid species Avena agadiriana that was first described in 1985 is distributed on the Atlantic coastal strip south of Casablanca in Morocco. Five accessions of this species (M55, M59, M60, M71 and M74) were compared by using FISH and RFLP analysis of 18S-5.8S-26S rDNA. The FISH data indicated that three pairs of major hybridization sites of the rDNA were located on satellite chromosomes in accessions M55, M59, M60 and M71. Accession M74, however, had only two pairs of major sites of hybridization. A pair of the major rDNA sites in M71 was very small and closely located at the terminal region of Nor-ST (Nucleolar organizing region of subtelocentrics) chromosomes. RFLP analysis of the rDNA sequence fragments identified differences among M55, M71 and M74, whilst M59 and M60 were the same with regard to the four restriction enzyme fragments utilized. M74 always lost single rDNA fragments in four restriction enzyme digests. The RFLP data made it possible to distinguish M55 from M59 and M60 in the northern Haut-Atlas Mountains group. A unique 20 kb EcoRI fragment characterized M71. Thus, a combination of FISH and RFLP analysis of rDNA was a good tool for inferring intraspecific evolutionary relationship of A. agadiriana.

Immunological analysis of agglutination in Dirofilaria immitis microfllariae

The mechanism of agglutination phenomenon of Dirofilaria immitis microfilariae was analyzed. Circulating microfilariae were collected from a D. immitis-infected microfilaremic dog and cultured in the several kinds of sera from dogs and animals. The agglutination of D. immitis microfilariae is a specific phenomenon due to some immune complexes formed with the anti-microfilarial antibody, heat-instable factor(s) and excretory-secretory products of microfilariae. Only live microfilariae were agglutinated and the agglutinated microfilariae remained alive as long as 27 days in culture in vitro.

Intergenomic translocations of polyploid oats (genus Avena) revealed by genomic in situ hybridization

Wild and cultivated hexaploid oats share the same genomes (AACCDD) and display a considerable level of interspecific variation in both plant and chromosome morphology. The GISH was utilized to detect the interspecific genomic compositions in four hexaploid and two tetraploid oats using total genomic DNA of Avena eriantha (a C-genome diploid) as probe. Intergenomic translocations between A/D and C-genome chromosomes were frequently observed in hexaploid and tetraploid species. In the hexaploid, two pairs of A/D genome segments on C-genome chromosome (A/D-C) translocation and four to six pairs of C-genome segments on A/D genome chromosome (C-A/D) translocation were clearly identified whilst the number of A/D-C translocations was constant among species. In the tetraploid A. maroccana (AACC), a pair of A-C and four pairs of C-A translocations were observed. Moreover, the A/D translocation segments on chromosome 5C was detected only in A. byzantina and A. maroccana, whilst A/D-C translocations were observed on the 1C and 7C of A. sativa, A. fatua and A. sterilis. A. byzantina did however also carry the 1C rearrangement. This result shows that A. byzantina has retained a similar genomic constitution to the tetraploid ancestor of hexaploid oats, A. maroccana. Three pairs of A-C translocations were detected only in A. murphyi (AACC), and two pairs of those were the 1C and 7C as well as the three hexaploid species except A. byzantina.

Mycoplasma genitalium in the cervices of Japanese women

BACKGROUND

Mycoplasma genitalium is considered a cause of nongonococcal urethritis in men. This organism also is a cause of genital infections in women, and has been detected in women attending sexually transmitted disease clinics in the United Kingdom and Denmark, although its prevalence is unknown in Japanese women.

GOALS

To determine the prevalence of M. genitalium in the cervices of women with cervicitis or adnexitis as well as in asymptomatic pregnant women in Japan.

STUDY DESIGN

Two hundred women who attended obstetric and gynecologic clinics were recruited. Sixty-four women had cervicitis, 53 had adnexitis, and 3 had both. Eighty pregnant women were asymptomatic for infection. Cervical swab specimens were examined for M. genitalium using a polymerase chain reaction-based assay.

RESULTS

Five (7.8%) of 64 women with cervicitis and 3 (5.7%) of 53 women with adnexitis were positive for M. genitalium. After exclusion of Chlamydia-positive women, 5 (8.8%) of 57 women with cervicitis, and 2 (4.1%) of 49 women with adnexitis were positive for M. genitalium. In none of 80 asymptomatic pregnant women, including a Chlamydia-positive woman, was M. genitalium detected. Overall, 7 (6.6%) of 106 women with Chlamydia-negative genital infections were positive for the M. genitalium. This prevalence was significantly greater than that in asymptomatic pregnant women (P < 0.05).

CONCLUSIONS

A significantly greater prevalence of M. genitalium was demonstrated in Japanese women with Chlamydia-negative cervicitis or adnexitis, compared with that in asymptomatic pregnant women. This study suggests that M. genitalium may play a pathogenic role in a portion of cases with Chlamydia-negative genital infections.

Re-migration of fifth-stage juvenile Dirofilaria immitis into pulmonary arteries after subcutaneous transplantation in dogs, cats, and rabbits

An assessment was made of the capacity for re-migration of the 5th-stage juvenile canine heartworm, Dirofilaria immitis. Live, 5th-stage juvenile worms recovered from the pulmonary arteries of infected dogs were transplanted into the subcutaneous tissue of uninfected dogs, cats, and rabbits. A mean of 45%, 61%, and 18% of the transplanted worms were recovered from the pulmonary arteries of dogs, cats, and rabbits, respectively, 1 and 3 mo later. The 5th-stage juvenile worms thus have the ability to re-migrate through tissue into the pulmonary arteries of the host.

Comparative study and cDNA cloning of the flavoprotein subunit of mitochondrial complex II (succinate-ubiquinone oxidoreductase: fumarate reductase) from the dog heartworm, Dirofilaria immitis

Mitochondrial complex II functions as a fumarate reductase (FRD), the reverse reaction of succinate dehydrogenase (SDH), and plays an important role in the anaerobic respiratory chain of parasitic helminths. In this study, complex II from the dog heartworm, Dirofilaria immitis adult, which is thought to act as a homolactatic fermenter, was examined in terms of its enzymatic features and primary structure in order to investigate the possible role of mitochondria in this filaria. Mitochondria from D. immitis adult showed high FRD activity when the enzymatic assay was performed using methylviologen as an artificial electron donor. The ratio of SDH to FRD in D. immitis was comparable to that in Ascaris suum adult, which is known to have an anaerobic mitochondrial respiratory chain with a high FRD activity of complex II. The FRD activity of D. immitis mitochondria was inhibited by the sulfhydryl reagent N-ethylmaleimide (NEM), while that of A. suum complex II was resistant to this inhibitor. The presence of the flavoprotein (Fp) subunit, which contains the substrate binding active site, was confirmed in D. immitis mitochondria by immunoblotting using a monoclonal antibody against the A. suum Fp subunit. By homology probing with the polymerase chain reaction, the entire cDNA for the D. immitis adult Fp was cloned and sequenced. The deduced amino acid sequence showed significant homology to that of A. suum and other mitochondrial Fps, in contrast to much less similarity to bacterial FRD, even though the D. immitis complex II showed high FRD activity. These results are the first indication of the presence of a functional complex II in D. immitis mitochondria.

Immunoblotting analysis of somatic components of Dirofilaria immitis

SDS-PAGE analysis of Dirofilaria immitis extracts demonstrated the complexicity of protein components of microfilariae, similar to that of adult male and female worms. Immunoblotting analysis using sera from microfilaremic and amicrofilaremic dogs with D. immitis infection suggest that antigenic components in the low molecular weight region may be related to the anti-microfilarial mechanism of the host.

Immunological treatment of cough occurring in dogs with dirofilariosis

A persistent, spasmic and productive cough known as filarial cough often occurs in dogs with dirofilariosis, and has been considered to be the consequence of an allergic response to Dirofilaria immitis. Twenty-one dogs with filarial cough were subcutaneously injected with worm antigen (200 micrograms of protein concentration) extracted from adult D. immitis once a day for 5 days. These injections were effective for 17 (81%) of the dogs, resulting in a complete cure for 7 dogs and marked improvement for 10 dogs.

[Pharmacokinetic and clinical studies on flomoxef in perinatal period]

Pharmacokinetic and clinical studies on flomoxef (FMOX) in the perinatal period were carried out. The results are summarized as follows. 1. The concentration of FMOX in umbilical cord serum was about 10 micrograms/ml in about 30 minutes after 1 g one shot intravenous injection. Amniotic fluid concentration was 7 micrograms/ml in 41 minutes after administration. By 1 hour intravenous drip infusion, FMOX concentration in umbilical cord serum was about 5 micrograms/ml in 2-3 hours after administration. Amniotic fluid concentration of about 20 micrograms/ml was found in 1 case. 2. FMOX 1-2 g x 2-3/day was given by intravenous drip infusion to 7 cases of perinatal infection for 4-26 days. Clinical efficacies were evaluated a good for all cases. Neither side effect nor abnormal laboratory test value was observed. Consequently, FMOX was considered to be highly effective and safe for its clinical use in perinatal period infections.

Antigenic identification of excretory-secretory products of adult Dirofilaria immitis

Excretory-secretory (ES) products collected from adult Dirofilaria immitis cultured in vitro were analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting. ES products of male (M-ES) and female (F-ES) worms were separated into 16 and 21 bands by SDS-PAGE with Coomassie blue and silver staining, respectively. The antigenic bands were then analyzed by immunoblotting, using pooled sera from dogs that had naturally contracted D. immitis. Sera from dogs with microfilaremic infection showed 7 bands in M-ES and 10 bands in F-ES, while those from dogs with occult infection revealed 3 bands in M-ES and 10 bands in F-ES. Among these bands, those of 14, 18, 21, 22, 29, and 32 kilodaltons (Kd) were common to M-ES and F-ES, those of 39 and 44 Kd were specific to M-ES, and those of 20, 38, 43, 53, 63, 90, 110, 125 and 136 Kd were specific to F-ES.

Histopathological and immunopathological evaluation of filarial glomerulonephritis in Dirofilaria immitis infected dogs

Filarial glomerulonephritis was studied using Dirofilaria immitis infected dogs. Of 34 infected dogs examined, 15 dogs (44.1%) had histopathological lesions in the kidney. These lesions included an increased number of mesangial cells and increased thickness of the matrix, the infiltration of the small round and plasma cells into the interstitium and thickening of the basement membrane. Deposits of IgG were demonstrated in the infected dogs, whereas C3 deposits were found in all dogs. Combined immunoglobulin and complement deposits were not always found in the dogs with histopathological lesions. The mean concentration (expressed as absorbance) of circulating immune complexes (CIC) was 0.675 +/- 0.517 in infected dogs, and 0.132 +/- 0.092 in uninfected dogs. Although there was significant difference in the level of CIC between infected and uninfected dogs (P less than 0.001), 11 dogs (32.4%) in infected group were negative. Otherwise, the CIC levels were correlated to the adult worm burden (r = 0.848; P less than 0.001) but not to the number of circulating microfilariae (mf) (r = 0.398; P less than 0.05). Transfer of mf to 7 naive dogs was performed to clarify the role of mf in the pathogenesis of filariasis. Antibodies to crude mf antigen became detectable two weeks after the transfer. Neither pathologic findings nor deposits of IgG and C3 in the kidney were found in dogs examined 20 days or 70 days after transfer. There was no evidence that histopathological lesions were induced by live mf, suggesting that adult worm burdens may be more closely related to filarial nephropathy.

Pharmacokinetics of cephem antibiotics in exudate of pelvic retroperitoneal space after radical hysterectomy and pelvic lymphadenectomy

Many cephalosporin antibiotics have recently been invented and attempts have been made to use them clinically. The choice of which of these drugs should be used has been difficult in gynecology. The efficacies of these drugs depend on their antibacterial spectra, potencies, and concentrations in tissues. This study was designed to investigate the pharmacokinetics of various cephem antibiotics in the exudate of the retroperitoneal space that is formed after radical hysterectomy and pelvic lymphadenectomy. These cephem antibiotics were cefoxitin, cefotiam, cefotetan, cefpiramide, cefminox, cefotaxime, ceftizoxime, cefoperazone, cefmenoxime, cefbuperazone, ceftazidime, cefpimizole, flomoxef, and cefuzonam. The maximum concentrations after administration of a 1-g dose in the exudate of the pelvic retroperitoneal space were 37.9 micrograms/ml with cefminox, 30.3 micrograms/ml with cefpimizole, 21.6 micrograms/ml with flomoxef, 21.5 micrograms/ml with ceftazidime, and 17.6 micrograms/ml with cefbuperazone, which were relatively high. When selecting antibiotics for prophylactic use against infections in the retroperitoneal space after radical hysterectomy and pelvic lymphadenectomy, on the basis of drug transfer, flomoxef, cefminox, cefbuperazone, ceftazidime, and cefpimizole were considered to be the drugs of first choice at a dose of 1 g.

Influence of immunosuppressants against Dirofilaria immitis infection in dogs

Two immunosuppressive drugs, azathiopurine (AZP) and prednisolone (PDS), were examined on dogs experimentally infected with Dirofilaria immitis in order to estimate the involvement of immunological assail in rejecting the parasite by the host. AZP was orally administered to 3 dogs daily at a dosage of 1-10 mg/kg for a period from 3 days before infection until the end of the experiment. The dose was then varied and transiently ceased according to the severity of the side effects. PDS was subcutaneously administered daily to 2 dogs. They were administered 10 mg/kg of PDS from 3 days before infection to day 15 and 5.0-8.5 mg/kg from day 60 after infection to day 70. The serum D. immitis-specific antibody level assessed by an indirect hemagglutination test was steadily decreased in the AZP-medicated dogs. However, in the PDS-medicated dogs, the antibody titer was decreased until day 32 and, thereafter, was recovered. When all dogs were sacrificed between days 145-148, an average recovery rate of worms in both the AZP- and PDS-medicated dogs was 52.5% and 49.6%, respectively, while the controls showed 42.5%. The statistical analysis revealed no significant difference among the groups, indicating that the administration of AZP and PDS was not effective in protecting the larvae from the host's immune attack.

Influence of immune treatments against Dirofilaria immitis infection in dogs

Mongrel dogs were inoculated with two kinds of antigenic substances. The first was a phosphate buffered saline extract of whole Dirofilaria immitis mixed with aluminum hydroxide gel (group 1), and the second was an orally administered live Metastrongylus apri infective larvae (L3) (group 2). Both groups were then infected with D. immitis L3. Indirect hemagglutination (IHA) tests showed that the antibody was produced by these inoculations before the infection was introduced, even in dogs inoculated with M. apri. This suggests a cross-reactivity between D. immitis and M. apri. The initial passive cutaneous anaphylaxis (PCA) antibody production was markedly delayed by about 70 days in group 2 compared with the production in the infected control dogs (group 3). The appearance of microfilaremia was also delayed by about one month in group 2 compared with that in the above control group. All dogs were sacrificed after the termination of the observation and worms recovered from the right ventricle and pulmonary arteries were counted and measured. The results indicated that immunization resulting from the homologous worm-somatic antigen might accelerate the growth of the infected larvae, whereas immunization resulting from the heterologous worm antigen, but cross-reactive to D. immitis, might disadvantageously affect the growth.

[Fundamental and clinical evaluation of imipenem/cilastatin sodium in the perinatal period]

To evaluate the efficacy of imipenem/cilastatin sodium (IPM/CS) in the field of obstetrics and gynecology, fundamental (measurement of IPM/CS concentrations in mothers' milk) and clinical studies were performed. Concentrations of IPM/CS in mothers' milk were measured every 1 hour up to 6 hours after a 30-minute drip infusion of 500 mg/500 mg of IPM/CS. IPM/CS was distributed similarly to other cephalosporins. In the clinical study, a 500 mg/500 mg dose of IPM/CS was administered to 5 patients with puerperal intrauterine infections and to 3 patients with urinary tract infections by a 30-minute drip infusion b.i.d. or t.i.d. Good responses were observed in all 8 patients, though the infections were mild or moderate. From these results, IPM/CS appeared to be a useful drug for the treatment of perinatal infections.

[Pharmacokinetic and clinical studies of ceftizoxime in obstetrical and gynecological field (2)]

Pharmacokinetic and clinical evaluations of ceftizoxime (CZX) in 3 obstetrical and gynecological clinics have substantiated the therapeutic usefulness of this drug in the relevant specialty. The results are summarized below. 1. The peak serum CZX concentration after drip infusion of 2 g given over 60 minutes was 115.3 micrograms/ml. The peak CZX concentration in the pelvic dead space exudate was 34.10 micrograms/ml which was attained 2.02 hours after beginning infusion. Half-lives of CZX in the serum and in the pelvic dead space exudate were 1.64 hours and 3.65 hours, respectively. 2. The passage of infused CZX to the umbilical cord serum was satisfactorily rapid, as evidenced by figures reaching 10 micrograms/ml or higher at 1 hour and 15 minutes and still as high as 3 micrograms/ml or higher at 6 hours after administration. 3. The passage of CZX to the milk of mothers receiving this drug was low, and no untoward effect on the infant was likely. 4. CZX would effectively prevent infections due to premature ruptures of membrane.

Onchocerca volvulus. Monoclonal anti-idiotype antibody as antigen signal for the microfilaricidal cytotoxicity of diethylcarbamazine-treated platelets

Over the past 35 yr, diethylcarbamazine (DEC) has been the most widely used agent for the treatment of filarial diseases, particularly in onchocerciasis. The microfilaricidal action of DEC has been recently shown to be mediated by blood platelets with the additional triggering of a filarial excretory Ag (FEA). This FEA could be detected by using mAb in the serum of infected patients. By using one mAb (IA2(23] directed against Onchocerca volvulus and recognizing circulating Ag (Ab1), we purified by affinity chromatography the target molecule of IA2(23) (an O. volvulus glycoprotein recognized by IA2(23) mAb). This compound had a dose-dependent effect on the cytotoxic action of DEC-treated platelets. We subsequently produced an anti-idiotype mAb to Ab1 (Ab2), and considered the possibility of replacing the O. volvulus glycoprotein recognized by IA2(23) mAb by Ab2. Ab2 was selected according to its ability to inhibit the binding of radioiodinated Ab1 to the filarial target Ag. It induced the production of anti-O. volvulus antibodies (Ab3) in rats. At a constant concentration of DEC platelets, the addition of increasing amounts of Ab2 led to a dose-dependent cytotoxic effect against parasite larvae. Experiments performed with Ab2 on detergent solubilized surface proteins of platelets identified four bands of Mr 18, 26, 43.5, and 100 kDa, supporting the idea of the presence of binding sites on the platelets for a FEA required for the microfilaricidal cytotoxicity of DEC-treated platelets.

Onchocerca volvulus. Monoclonal anti-idiotype antibody as antigen signal for the microfilaricidal cytotoxicity of diethylcarbamazine-treated platelets

Over the past 35 yr, diethylcarbamazine (DEC) has been the most widely used agent for the treatment of filarial diseases, particularly in onchocerciasis. The microfilaricidal action of DEC has been recently shown to be mediated by blood platelets with the additional triggering of a filarial excretory Ag (FEA). This FEA could be detected by using mAb in the serum of infected patients. By using one mAb (IA2(23] directed against Onchocerca volvulus and recognizing circulating Ag (Ab1), we purified by affinity chromatography the target molecule of IA2(23) (an O. volvulus glycoprotein recognized by IA2(23) mAb). This compound had a dose-dependent effect on the cytotoxic action of DEC-treated platelets. We subsequently produced an anti-idiotype mAb to Ab1 (Ab2), and considered the possibility of replacing the O. volvulus glycoprotein recognized by IA2(23) mAb by Ab2. Ab2 was selected according to its ability to inhibit the binding of radioiodinated Ab1 to the filarial target Ag. It induced the production of anti-O. volvulus antibodies (Ab3) in rats. At a constant concentration of DEC platelets, the addition of increasing amounts of Ab2 led to a dose-dependent cytotoxic effect against parasite larvae. Experiments performed with Ab2 on detergent solubilized surface proteins of platelets identified four bands of Mr 18, 26, 43.5, and 100 kDa, supporting the idea of the presence of binding sites on the platelets for a FEA required for the microfilaricidal cytotoxicity of DEC-treated platelets.

[Pharmacokinetic, bacteriological and clinical studies of cefuzonam in the field of obstetrics and gynecology]

To study the transfer of cefuzonam (CZON, L-105) into female genital organs, concentrations of the compound in pelvic dead space exudate were measured in cases of radical hysterectomy due to cervical cancer and analyzed by the two-compartment model. When CZON 1 g was drip-infused intravenously, the concentration in the cubital vein blood was 46.95 micrograms/ml at 1 hour after the start of infusion. Concentrations in the pelvic dead space exudate reached the peak of 11.29 micrograms/ml at 2.44 hours after the start, were higher than 4 micrograms/ml after 8 hours and were higher than 1.7 micrograms/ml after 12 hours. The area under the concentration-time curve in the pelvic dead space exudate was 77.85 micrograms X hr/ml. From these results CZON was considered to be effective when administered at 1 g against infections of Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris, and haemophilus influenzae, but increased dose levels seemed necessary against infections of Staphylococcus epidermidis and Bacteroides fragilis. In 3 cases of obstetric and gynecological infections the efficacy of CZON was good in 2 cases and unknown in the other case.

[Pharmacokinetic and clinical studies of cefotiam in the perinatal period]

Patients, who had undergone cesarean sections, and those who had experienced premature rupture of membranes, received cefotiam (CTM) and the clinical efficacy and the safety for mothers and fetuses were investigated. At the same time, pharmacokinetic analysis was done to study the maternal fetal transfer. Following results were observed. In cases of premature rupture of membranes, the maternal-fetal transfer ratio after intravenous administrations of CTM was 50.3% at a dosage of 1 g. Maternal and fetal serum concentrations of CTM were maintained higher levels than the MIC80 (0.78 micrograms/ml) against major pathogens excluding anaerobic of gynecologic-obstetric infections and were maintained up to 5.87 hours and 6.15 hours in mothers and fetuses, respectively. The CTM was administered once every 12 hours at a dosage of 1 g to 38 cases up to the 3rd or 4th day of puerperium after the rupture of membranes. Also, the CTM was administered up to times of delivery to another 20 cases, in one of which the fetus developed pneumonia. The maternal-fetal prophylactic effect was recognized in 98.3% (57/58) of cases. Forty-three cesarean section cases received CTM at a dosage level of 1 g by one-hour intravenous drip infusion in the following manner: after surgery to the 4th day, twice a day; from the 5th to the 7th day, once a day. Postoperative prophylactic effect against infection was achieved in all the cases. In 1 case, a slight transient elevation in the maternal GOT was observed. Neonatal jaundice with total bilirubin levels higher than 15.0 mg/dl was observed in 19 neonates (32.8%) in the group in which premature rupture of the membranes had occurred. However, the cause/effect relationship between CTM and the total bilirubin levels is unclear. The maternal-fetal transition of CTM was excellent, and the safety toward the fetus and neonate was high. When an antimicrobial activity and pharmacokinetics are considered, CTM will be a useful drug in the treatment of perinatal infections.

[Fundamental and clinical evaluation of ceftazidime in the perinatal period]

Following an intravenous injection of ceftazidime (CAZ) 1 g, the ratio of transfer of the drug into a fetus was 59.9%, and umbilical serum concentrations of the drug reached the peak of 18.2 micrograms/ml at 1.5 hours, and were slightly higher than maternal serum concentrations at 2.93 hours and after, with half-life of 1.37 hours, the same as in maternal serum. Following an intravenous injection of CAZ 1 g, concentrations of CAZ in mother's milk at 2 hours after injection were 1.16 micrograms/ml on the 4th day of the treatment of CAZ, and 0.86 micrograms/ml on the 7th day. The CAZ was administered to cases of premature rupture of membrane. The prophylactic efficacy against puerperal infections in mothers was 92%, and that against fetal infections in neonates was 96.7%. The CAZ was also administered after cesarean section, and the prophylactic efficacy against postoperative infections was 93.3%. Neither subjective/objective adverse effects nor abnormal laboratory findings for which CAZ was suspected were observed in any mothers or neonates. From the above results demonstrating satisfactory maternal transfer into fetuses and the high degree of safety in fetuses and neonates, as well as its high antibacterial activity, CAZ is considered to be a useful drug for the treatment of perinatal infections.

[Fundamental and clinical studies of imipenem/cilastatin sodium in the field of obstetrics and gynecology]

To evaluate the penetration of imipenem/cilastatin sodium (MK-0787/MK-0791) into the female genital organ, concentrations of MK-0787/MK-0791 in antecubital vein blood, portio vaginalis, myometrium, endometrium, ovary and oviduct of patients who underwent simple hysterectomy and in the pelvic dead space exudate of patients who underwent radical operations for cancer of the uterine cervix were determined and analyzed using a two-compartment model. Concentrations at the end of a 30 minutes drip infusion of 500 mg/500 mg of MK-0787/MK-0791 were 48.38/52.69 micrograms/ml in plasma from the antecubital vein, 9.46/14.92 micrograms/g in the portio vaginalis, 14.10/9.79 micrograms/g in the myometrium, 6.47/11.42 micrograms/g in the endometrium, 14.72/13.30 micrograms/g in the ovary and 10.59/13.62 micrograms/g in the oviduct. Maximum concentrations of MK-0787 and MK-0791 in the pelvic dead space exudated were 10.66 micrograms/ml at 1.33 hours and 12.74 micrograms/ml at 1.15 hours after the start of the drip infusion, respectively. The concentration in plasma from the antecubital vein after an infusion of 1,000 mg/1,000 mg of MK-0787/MK-0791 reached 68.37/61.57 micrograms/ml at the end of a 60 minutes drip infusion, and the maximum concentration of MK-0787 in the pelvic dead space exudate was 20.02 micrograms/ml at 1.50 hours after the start of the drip infusion and that of MK-0791 was 14.90 micrograms/ml at 2.01 hours after the start of the drip infusion. MK-0787/MK-0791 was administered to 9 patients with obstetric and gynecological infections, and clinical efficacies were found to be excellent in 1, good in 6, and poor in 2 patients.

[Fundamental studies on aspoxicillin in the field of gynecology. Penetration of the drug into the genital organs and the dead space fluid. Antibacterial activity of the drug against various strains of clinical isolates]

A new semisynthetic penicillin aspoxicillin (ASPC, TA-058) has been evaluated in regard to distribution into the genital organs and the dead space fluid and also in regard to antibiotic activity against various strains clinically isolated in the field of gynecology. The pharmacokinetic studies were made by using two-compartment model on the data of concentration in ovary, oviduct, endometrium, myometrium, cervix uteri and portio vaginalis of the genital organs and in dead space fluid. The following results were obtained. After one shot intravenous administration of 2.0 g ASPC, no marked difference was observed in concentration pattern between peripheral vein and uterine artery. Half-lives were 1.8 hours and 3.5 hours, respectively. The concentrations in various tissues of genital organs reached to the maximum at 36.2-73.6 micrograms/g during 0.07-0.44 hour with half-life varied from 0.53 to 1.3 hours. Area under the curves (AUC) of various tissues were reached to 30-65% of that uterine artery. After 2.0 g administration of ASPC drip intravenously (d.i.v.; for 30 or 60 minutes), there are no remarkable difference on simulation curve of concentration between peripheral vein and uterine artery. The peak level of various tissues attained to 22.5-40.3 micrograms/g during 0.53-0.56 hours and AUC of their concentration achieved about 20-40% of that of uterine artery after intravenous drip infusion for 30 minutes. After intravenous drip infusion for 60 minutes, tissue level reached to the maximum during 1.01-1.82 hours with half-life of 0.65-1.4 hours and AUC of tissue concentration achieved about 20-57% of that of uterine artery. The concentration of the drug in dead space fluid was reached to the maximum at 3.1 hours after the administration and its half-life was 5.3 hours. The in vitro activities of ASPC against clinical isolates were examined. The values of MIC70 and MIC80 were ranged 0.35-5.1 micrograms/ml against S. aureus, S. epidermidis, E. faecalis and P. mirabilis, respectively. Against E. coli, the value of MIC70 was attained 2.9 micrograms/ml, however, the value of MIC80 was more than 100 micrograms/ml due to the two-peaked activity of this drug against the bacteria. AUC and duration time of various tissue concentration were scrutinized regarding to the value of MIC80 of ASPC against S. aureus, S. epidermidis, E. faecalis and P. mirabilis.(ABSTRACT TRUNCATED AT 400 WORDS)

[Basic and clinical studies on cefminox in the field of obstetrics and gynecology]

In order to determine transference of cefminox (CMNX, MT-141) into the female genital organ tissues, the drug concentration in the pelvic dead space exudate was measured in cases undergone radical hysterectomy due to uterocervical cancer. For analysis of data the three-compartment model was used. When CMNX was given at a dose of 1 g as an intravenous drip infusion taking 1 hour, the serum concentration of the cubital vein reached its peak of 89.53 microgram/ml at 1 hour after start of administration. In the pelvic dead space exudate the peak concentration of 39.84 microgram/ml was reached at 2.55 hours after administration and a concentration higher than 7 micrograms/ml was still detected even at 12 hours. The area under the curve (AUC) for CMNX concentration in the pelvic dead space exudate was 295.63 microgram X hr/ml. These results suggest that CMNX achieves high concentration in the pelvic dead space exudate and that it is an antibiotic with clinical utility. CMNX was used in the treatment of 6 cases of obstetrical and gynecological infections. The clinical results were excellent in 1 case, good in 2 cases and poor in 2 cases. In the remaining 1 case the results was unknown.

[Fundamental and clinical studies of cefpimizole in obstetrics and gynecology]

Cefpimizole (AC-1370) concentrations in the pelvic dead space exudate were determined in patients under-going curative resection of carcinoma of the uterine cervix to study the transfer of the drug into the female genital organs, and the results were statistically analyzed, using the two-compartment model. When 1 g of AC-1370 was administered by intravenous drip infusion over 1 hour, the AC-1370 concentration in the serum from the antecubital vein reached a level of 129.09 micrograms/ml at 1 hour of intravenous drip infusion, and the AC-1370 concentration in the pelvic dead space exudate reached a peak of 30.32 micrograms/ml at 2.51 hours of intravenous drip infusion, and remained at not less than 12 micrograms/ml 8 hours after the beginning of the drip infusion, with the area under the curve (AUC) for the AC-1370 concentration in the pelvic dead space exudate being 213.66 micrograms X hr/ml. Seven patients with obstetrical and gynecological infections were treated with 1 g of AC-1370 by intravenous drip infusion over 1 hour, 2 approximately 3 times daily. Although the patients all had rather mild infections, the treatment was effective in all of them. The findings in this study proved a dose of 1 g of AC-1370 at a time to be sufficiently effective in mild cases, but in view of the transfer of the drug into tissues, it seemed necessary to administer 2 g of the drug at a time in severe cases.

[Fundamental studies of cefoxitin in the field of obstetrics and gynecology]

The concentration of cefoxitin (CFX, Merxin) in dead space exudate was studied in 14 patients following total extirpation of diffuse uterine cervical cancer. A two-compartment model was used for the analysis. The results obtained were as follows: Calculated maximum concentrations of CFX in the pelvic dead space exudate were 26.55 micrograms/ml at 2.11 hours, 31.07 micrograms/mg at 2.01 hours and 51.51 micrograms/ml at 2.10 hours after 1 hour intravenous drip infusions of CFX 2, 3 and 4 g, respectively. These concentrations were higher than the MIC80 of 12.5 micrograms/ml against E. coli and B. fragilis and were maintained for a sufficient period of time. Based on the results of this study, CFX is considered to be an important and valuable drug in the field of obstetrics and gynecology.

[Fundamental study of ceftriaxone in the field of obstetrics and gynecology]

Excretion of ceftriaxone (Ro 13-9904, CTRX) into female genital organs was studied by determining its concentration in the dead space exudate of the patients who received radical hysterectomy due to uterocervical cancer. Data analysis was performed by the three-compartment model. The serum peak level of CTRX in the cubital vein was 177.74 micrograms/ml 1 hour after the initiation of intravenous drip infusion for 1 hour with 1 g. The concentration of CTRX in the exudate of pelvic dead space reached a peak of 62.75 micrograms/ml 4.61 hours after the start of administration and still showed a very high level of 25 micrograms/ml at 24 hours. The AUC of the excretion into the exudate of pelvic dead space was 1,432.43 micrograms X hr/ml. These results indicate that CTRX is a clinically useful drug, being excreted into the exudate of pelvic dead space favorably.

[Fundamental and clinical studies on sulbactam/cefoperazone in the field of obstetrics and gynecology]

Concentrations of sulbactam/cefoperazone (SBT/CPZ) in the pelvic dead space exudate were examined in 5 patients who received radical hysterectomy due to uterocervical cancer. Data analysis was performed by the simulation curves prepared from pharmacokinetics parameters using a three-compartment model. Following 1 hour intravenous drip infusion of 2 g of SBT/CPZ, the mean drug concentration in venous blood was 50.62 micrograms/ml for SBT and 120.16 micrograms/ml for CPZ at 1 hour after start of the infusion. The peak SBT level in the pelvic dead space exudate was 21.24 micrograms/ml at 1.58 hours after start of the infusion. The peak CPZ level was 19.13 micrograms/ml at 3.46 hours after start of the infusion. In the treatment of 4 cases with gynecological infections, the clinical efficacy of SBT/CPZ was assessed as effective in 3 cases and poor in 1 case.

[Pharmacokinetic studies on ceftazidime in the obstetrical and gynecological field]

Concentrations of ceftazidime ( CAZ ) were examined in the pelvic dead space exudate in 6 patients who received radical hysterectomy due to uterocervical cancer. Data analysis was performed by the simulation curves prepared from pharmacokinetics parameters using the three-compartment model. Following 1-hour intravenous drip infusion of 1 g of CAZ , the mean drug concentration in venous blood was 75.54 micrograms/ml at 1 hour after start of the infusion. The mean CAZ level in the pelvic dead space exudate was as high as 23.87 micrograms/ml at 2.09 hours after start of the infusion, and the AUC was 149.11 micrograms . hr/ml. The above results suggest that CAZ is a useful drug clinically with good penetration into the pelvic dead space.

[Experimental and clinical studies on latamoxef in the perinatal period]

Pharmacokinetics and clinical studies on the perinatal use of latamoxef (LMOX, Shiomarin), a new parenteral oxacephem antibiotic, were carried out and the results obtained were as follows: After LMOX was intravenously given to mother at a dose of 1 g, the umbilical cord serum concentration of LMOX reached to peak with 18.4 micrograms/ml in 1 hour 20 minutes and its concentration was higher than the maternal serum after 2 hours 25 minutes and decreased gradually (T 1/2 beta = 1.61 hours). The materno-fetal transfer of LMOX was 71.0%. LMOX showed the good transfer as well as other cephalosporins. After LMOX was intravenously administered to mother at a dose of 1 g, LMOX concentration in milk wasn't detectable up to 12 hours. LMOX was intravenously administered to 18 cases with premature rupture of membrane, at a daily dose of 2 g for 3--6 days. The prophylactic effects were observed in all cases, both mother and neonate. No adverse effects were observed in mother except for 1 case with low grade abnormality of S-GPT, transiently. We observed 3 neonates with jaundice (total bilirubin greater than or equal to 17.0 mg/dl) probably not related to LMOX. It is concluded that LMOX is less toxic, safe and clinically useful antibiotic for the treatment of perinatal infections.

[A fundamental study on T-1982 (cefbuperazone) in the field of obstetrics a gynecology]

T-1982 (cefbuperazone) concentrations in antecubital venous blood and pelvic dead space exudate were examined in 4 patients who had received radical hysterectomy due to uterocervical cancer. Data analysis for the transfer of T-1982 into pelvic dead space exudate was performed with the stimulation curves prepared from pharmacokinetic parameters by the three-compartment model. When T-1982 was given at a dose of 1 g, the peak level in the venous blood was 83.7 micrograms/ml at 1 hour after the start of administration. With regards to T-1982 concentration in pelvic dead space exudate, the peak level of 19.3 micrograms/ml was observed at 2.24 hours after the start of administration and relatively high concentration of about 6.1 micrograms/ml was observed even at 8 hours after the start of administration. From the above results, it is concluded that T-1982 is a useful drug for the treatment of infections in the field of obstetrics and gynecology.

[Studies on the causes and prophylaxis of urinary tract infection following radical hysterectomy for cervical cancer]

In patients undergoing radical hysterectomy for cervical cancer, suprapubic bladder drainage by INGRAM's trocar catheter, which was removed when the postvoiding residual urine was under 30 ml, was attempted to reduce urinary tract infection. The incidence of urinary tract infection was 63.6% during 4 weeks after radical hysterectomy. Most appeared on the 7-14 th postoperative days. In the 6 months after radical hysterectomy, the incidence of significant bacteriuria in the suprapubic group was 9.4% compared to 21.1% in the urethral catheterized group. The difference between the two groups is significant. In view of these results the following is suggested: 1) The antibacterial mechanisms of both the urethra and urinary bladder are greatly weakened immediately following radical surgery for cervical cancer due to organic changes occurring as a result of the surgery. Urethrovesical reflux can regurgitate bacteria from the urethra into the bladder and cause infection despite the absence of urethral catheterization. 2) Indwelling and frequent urethral catheterization for residual urine may cause a chronic urethritis which may prove to be the greatest factor predisposing to urinary tract infection following radical surgery for cervical cancer.

[Fundamental and clinical studies of ceftizoxime in obstetrical and gynecological field]

This paper, is concerned with fundamental and clinical studies of ceftizoxime, a newly developed cephalosporin derivative, in the field of obstetrics and gynecology. 1. Concentrations of ceftizoxime after administration 1 g of ceftizoxime by 1 hour drip infusion were determined in genital organs in 17 patients and the exudate of pelvic dead space in 6 patients. Simulated maximal concentrations with the ratios to the simulated peak serum levels were as follows: 27.9 micrograms/g for fundal myometrium with the ratio of 48%, 36.0 micrograms/g for portio vaginalis with 62%, 17.1 micrograms/g for ovary with 29%, 15.0 micrograms/g for oviduct with 26% and 16.2 micrograms/ml for the exudate of pelvic dead space with 30%. 2. Minimal inhibitory concentrations of ceftizoxime were determined against clinically isolated organisms from female genital infectious diseases. Ceftizoxime was found to have a potent in vitro activity against Gram negative bacilli; for example, 0.1 microgram/mg or low against E. coli and K. pneumoniae. Against P. aeruginosa, P. cepacia and b. fragilis, ceftizoxime had an activity which expected to be effective in the clinical use. 3. We gave ceftizoxime to 6 patients comprising 4 patients with puerperal fever, 1 with septic abortion and 1 with tubo-ovarian abscess in daily doses of 2 to 3 g by b.i.d or t.i.d intravenous drip infusion for 4--12 days. The results of the treatment were 'excellent' in 3 patients, 'good' in 2, and 'unevaluatable' in 1. 4. Adverse reactions occurred in 2 patients who showed eruption during the medication with ceftizoxime. These patients had allergic histories due to penicillin derivatives. From the above results it is concluded that ceftizoxime is a useful drug for infections in obstetrical and gynecological field.

[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.