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Biomedical subjects

R Soejima

Publications and source records attributed to R Soejima.

At least 19 recordsLinked to original sources
PubMed1997

[The clinical study of clarithromycin for pulmonary Mycobacterium avium-intracellulare complex infection].

A nationwide study was conducted to investigate the efficacy of Clarithromycin (CAM) on pulmonary atypical mycobacteriosis caused by the Mycobacterium avium-Mycobacterium intracellulare complex, including intractable cases. Out of total 97 patients examined, the analysis for bacteriological efficacy was possible in 69 cases. The negative conversion of bacilli was observed in 18 cases (26.1%), and 5 out of 12 cases in which the follow-up was conducted turned out continued negative status. The efficacy of CAM was relatively high in the following cases: the duration of the disease was less than 6 months the extent of pulmonary lesions on chest roentogenograms was limited or moderate; and antituberculous agents which were previously unused were applied in combination with CAM. Also, the efficacy was high in cases where the dose of CAM was 600 mg/day or higher. Major side effect was mill to moderate digestive symptoms. In conclusion, at daily dose of 600 mg or higher, CAM was effective in the elimination or reduction of M avium M. intracellulare complex that caused atypical mycobacteriosis, without developing serious side effect. Treatment with this drug should be attempted in intractable cases.

Anti-Bacterial Agents↗
PubMed1996

Evaluation of a direct fluorescent antibody assay for detection of Chlamydia pneumoniae.

We examined the utility of the direct immunofluorescent antibody test kit, IMAGEN (DAKO Diagnostic Co., Ltd.). The stainability of inclusions and purified elementary bodies (EBs) of all the Chlamydia pneumoniae strains used in this study was highly specific. Immunoelectron microscopy and light microscopy of stained EBs revealed the target antigen of IMAGEN to be located on the surface of the EB outer membrane. In a clinical study, we tested oropharyngeal swab specimens obtained from 41 patients (45 specimens). The results were compared with those obtained by isolation in cell culture, the indirect immunofluorescent antibody (IFA) assay and serum antibody titration. C. pneumoniae was isolated from six specimens (13.3%), and the organisms were detected in 11 specimens (24.4%) with IMAGEN and nine specimens (20%) with IFA. A diagnosis of C. pneumoniae infection was made in six patients (13.3%) by the serological examination. Six specimens positive in isolation were positive in the IMAGEN but there were three cases which seemed to be false-positive by the IMAGEN. We conclude that the use of IMAGEN is an easy, rapid and sensitive method for detecting C. pneumoniae when there is a large amount of chlamydial antigen in the clinical specimen and when identification of the chlamydial species forming inclusions in cell cultures is required.

Adult↗
PubMed1996

[Assay of specific anti-Chlamydia pneumoniae antibodies by ELISA method. 1. Evaluation of ELISA kit using outer membrane complex].

Studies were conducted with the goal of developing a kit for assaying anti-Chlamydia pneumoniae antibodies in human serum which would enable judging positive cases with high specificity by means of an objective numerical index. Thus, an enzyme-linked immunosorbent assay (ELISA) method employing a C. pneumoniae outer membrane complex protein was established. Elementary bodies (EB) were purified from the YK-41 strain of C. pneumoniae, and subsequent treatment with Sarkosyl, DNase and RNase yielded chlamydial outer membrane complex (COMC). COMC was employed as the antigen and immobilized on 96-well microplates for ELISA method. This ELISA method was used to test 51 serum specimens from patients who had been demonstrated to be positive for C. pneumoniae antigen (throat swab: PCR positive), and the levels of IgG, IgA and IgM antibodies were assayed. For each specimen, comparison was made with the antibody titers determined by the micro immunofluorescence test (Micro-IF method). The results showed good correlation coefficients of 0.950 for IgG, 0.852 for IgA and 0.866 for IgM. In addition, the two assay methods showed the following high agreement rates: 90.2% for IgG, 84.3% for IgA and 82.4% for IgM. Specimens which did not yield the same results with the ELISA method and Micro-IF method were subjected to analysis by Western blot method, and the rates of agreement with the ELISA results were 80% for IgG, 87.5% for IgA and 88.9% for IgM. These data indicate the efficacy of this new ELISA method. Moreover, COMC was reacted with mouse antisera to three Chlamydia species, and the mouse IgG antibody was assayed. Anti-C. pneumoniae antiserum showed the strongest reactivity, whereas weaker reactivity was shown by anti-C. trachomatis antiserum (1/32nd of the reactivity of the anti-C. pneumoniae antiserum) and anti-C. psittaci antiserum (1/4th). In addition, sera from patients infected with C. trachomatis or C. psittaci (Psittacosis) were subjected to the ELISA method using COMC from C. pneumoniae. It was found that the correlation between the ELISA and Micro-IF methods was higher in relation to the anti-C. pneumoniae antibody titer than either the anti-C. trachomatis antibody titer or anti-C. psittaci antibody titer. These findings indicate this new assay kit based on the ELISA method has high specificity for C. pneumoniae.

Animals↗
PubMed1996

[Assay of specific anti-Chlamydia pneumoniae antibodies by ELISA method. 2. studies on clinical usefulness and serological diagnostic standards].

We measured anti-Chlamydia pneumoniae (C. pneumoniae) specific antibody titers by means of a newly-developed enzyme-linked immunosorbent assay (ELISA) method using an anti-C. pneumoniae specific antibody detection reagent. The clinical usefulness of this method was hereby evaluated. The IgG, IgA and IgM titers in 418 serum specimens obtained from patients with respiratory tract infections were measured by this new ELISA method, and the results were compared with the titers determined for the same specimens with the micro immunofluorescence (Micro-IF) method. The results showed good correlation coefficients for IgG, IgA and IgM. The two assay methods showed high agreement rates for positivity and for negativity. Specimens which did not yield the same results with the ELISA method and the Micro-IF method were subjected to analysis by the Western blot method, and the rates of agreement with the ELISA results were high. In addition, the child (0 approximately 15 yrs old; n = 122) and adult (16 approximately 90 yrs old; n = 133) cases were classified on the basis of being antigen-positive or antigen-negative at the initial examination, and their antibody-positive rates were determined. The adults showed no statistically significant differences in the antibody-positive rates for either IgG or IgA antibodies as a function of the pretreatment antigen status. However, the children showed statistically significant (p < 0.001) differences in the antibody-positive rates for both IgG and IgA antibodies as a function of the antigen status in the antigen-positive group compared with the rates in the antigen-negative group. Furthermore, the IgM-positive rates for the children were high in the antigen-positive group compared with the rates in the antigen-negative group, and the difference was statistically significant (p < 0.001). The IgM-positive rates in the adults were also significantly (p < 0.05) different between the antigen-positive group and the antigen-negative group. The Micro-IF method was applied to 34 specimens from antigen-positive patients, and 22 specimens were found to show an IgG titer of > or = 512 or an IgM titer of > or = 16. The diagnoses of these patients were acute respiratory disease in sixteen, pneumonia in four. Application of the ELISA-method to those 22 specimens showed all of them to exhibit IgG absorbance of > or = 0.6 and IgA absorbance of 0.2. The results described above indicate the clinical usefulness of our new ELISA method for the detection of antibodies specific for C. pneumoniae. The significance of this ELISA method for serological diagnosis of C. pneumoniae infections and the criteria for diagnosis of acute infections were also discussed.

Adolescent↗
PubMed1995

[A case of Plasmodium ovale malaria with thrombocytopenia and an abnormality grade in FDP concentration despite the use of chloroquine as a malaria prophylaxis].

A 45-year-old Japanese male, who had been to the Central African Republic, was admitted to our hospital because of high fever with chills on July 29, 1994. He used chloroquine as a malaria prophylaxis during his stay and for 6 weeks after his return to Japan. On admission, Plasmodium ovale was detected in his blood smears and in the DNA analysis. He was treated successfully with chloroquine (1500 mg over 3 day period) and primaquine (15 mg/day for 14 days beginning day 4). Disappearance of malarial parasites in the peripheral blood smear occurred on the third day and his temperature returned to normal on the 4th day. Interestingly, he had thrombocytopenia and an abnormal grade in fibrin degradation products (FDP) concentration. This led to the suspicion of disseminated intravascular coagulation (DIC). This report indicates the importance of thrombocytopenia which may develop into DIC even though P. ovale malaria infection rarely becomes severe. This is the second report of a P. ovale malaria case in the Central African Republic.

Animals↗
PubMed1995

[Spontaneous cure of pneumonia caused by Chlamydia pneumoniae].

A 62-year-old male was admitted to our hospital after an abnormal shadow was pointed out by Chest X-ray in June, 1994, even though he was asymptomatic otherwise (first episode). The serum IgG antibody against Chlamydia pneumoniae was elevated up to 512-fold in the acute phase and decreased to 32-fold in the convalescent phase using the micro-immunofluorescence (MIF) test, indicating a C. pneumoniae acute infection. In fact, no other micro-organisms were detected. The patient recovered from the pneumonia without any treatment. He was admitted to our hospital again after having right chest pain in December, 1994 (second episode). An X-ray examination revealed a slight infiltration of the right lower lung field and pleural effusion. In this episode, he received therapy with carbapenem anti-bacterial agent and he recovered from the pneumonia 9 days after the administration of the antibiotic. The serum IgG titer against C. pneumoniae was elevated up to 1024-fold on admission, indicating mixed infection with bacteria and C. pneumoniae. It was concluded that both of these episodes indicated a spontaneous cure of the pneumonia which had developed from C. pneumoniae.

Antibodies, Bacterial↗
PubMed1994

Characterization of a Chlamydia pneumoniae strain isolated from a 57-year-old man.

The isolation of Chlamydia pneumoniae, especially from elderly persons, is generally not easy. Recently, we succeeded in isolating a chlamydial strain, which was designated KKpn-15, from a 57-year-old man suffering from acute bronchitis. It was compared with well established strains of C. pneumoniae, C. trachomatis and C. psittaci, and its biological properties, such as the morphology of elementary bodies (EBs) and inclusions, and the immunochemistry of EB proteins, were investigated. Based on the results obtained in the present study, it was confirmed that the new chlamydial strain, KKpn-15, is a member of the C. pneumoniae strain and that the organisms of KKpn-15 are useful as an antigen for the serodiagnosis and epidemiology of C. pneumoniae infection.

Antibodies, Bacterial↗
PubMed1994

[Fungal infection in hepatobiliary and pancreatic diseases: clinical evaluation in autopsy cases].

A clinical assessment of fungal infection in hepatobiliary and pancreatic diseases during 1975 and 1991 was made and 25 cases of systemic mycosis were noted. Among 25 cases there were 20 liver diseases (hepatocellular carcinoma 12, liver cirrhosis 5, fulminant hepatitis 2, polyarteritis nodosa 1), 2 cases of gallbladder cancer and 3 cases of pancreatic cancer. The fungus was consisted of 14 cases (56%) of Candida, 9 cases of Aspergillus (36%), and 2 cases of Cryptococcus (8%). Fungal infection was most frequent in the lung (8 cases) and esophagus (6 cases), but rarely in the stomach, lymph node, liver, thyroid, kidney and gallbladder. Generalized fungus infection was noted in four cases (16%). Fatal fungal infection was complicated in liver cirrhosis (2 cases), fulminant hepatitis (one case), gallbladder cancer (one case) and cystadenocarcinoma of the pancreas (one case). In five fatal cases three cases of Aspergillus pneumonia and two cases of Candida septicemia were included. Glucocorticoid was used in 13 cases (52%) and anti-cancer drugs was administered in two cases (12%). However, in 9 cases (36%) without treatment of glucocorticoid or anti-cancer drug fungal infection was detected. In conclusion, there is a possibility of fungal infection in grave hepatic diseases and empirical administration of anti-fungal agent may be necessary.

Adult↗
PubMed1994

[A case of needlestick-induced acute type C hepatitis].

The patient was a 25-year-old male doctor, who had pricked his finger with a needle contaminated with blood from a 69-year-old male patient with liver cirrhosis (HCV-Ab positive, genotype II). He was informed from the blood bank that his blood was positive for anti-HCV and his GPT being 148 IU/l on the 65th day after exposure. He was admitted on February 16, 1993 and received a liver biopsy, which was consistent with acute viral hepatitis. His genotype was the same (type II) with the donor patient. IFN-alpha-2b of total doses of 656 Megaunits resolved the hepatitis completely and the HCV-RNA became negative as early as two weeks after starting IFN therapy. Liver biopsy after IFN therapy showed convalescence of acute hepatitis. The progression of acute hepatitis C to chronicity could be prevented by interferon therapy even in unfortunate cases of HCV transmission by needlestick. In conclusion, accidental needlestick should be followed for at least six months, and serum GPT and second-generation anti-HCV ELISA tests are recommended for all infected personnel.

Acute Disease↗
PubMed1994

[A case of Aspergillus niger pneumonia cured with an early diagnosis].

We have experienced a case with A. niger aspergilloma who developed Aspergillus pneumonia after bacterial pulmonary infection. Examinations of sputum cytology and detection of serum Aspergillus antigen were useful for an early diagnosis of his condition. Early and intensive antifungal chemotherapy mainly with intravenous amphotericin B brought about his complete remission.

Amphotericin B↗
PubMed1994

In vitro and in vivo activities of azithromycin, a new azalide antibiotic, against chlamydia.

The in vitro and in vivo activities of azithromycin against chlamydia were investigated. The MIC of azithromycin for five standard strains of different species of chlamydia and six wild-type strains of Chlamydia pneumoniae was 0.125 microgram/ml, which was superior to that of erythromycin but inferior to those of clarithromycin and minocycline. However, the therapeutic effect of a 7-day course of azithromycin at a dose of 10 mg/kg of body weight administered orally once daily to mice with experimental Chlamydia psittaci pneumonia was excellent, with a 100% survival rate at 14 days after infection, which was the same as that for treatment with minocycline administered at 10 mg/kg twice daily; all erythromycin treated animals died within 10 days. When treatment was discontinued 3 days after the infection, the survival rate for mice treated with azithromycin was 90% and that for mice administered minocycline was 30%. These results suggest that azithromycin may be useful in the treatment of respiratory infections caused by intracellular pathogens, including chlamydia because of its excellent accumulation within host cells.

Animals↗
PubMed1994

Characterization of Chlamydia pneumoniae species-specific proteins immunodominant in humans.

Proteins of Chlamydia pneumoniae immunodominant in humans were characterized with the sera of 13 patients who were not likely to have been exposed to C. trachomatis or C. psittaci. The serological responses among these patients were similar on a qualitative basis, but some differences were found quantitatively. However, the serological responses of the patients who were infected with C. pneumoniae differed markedly from those of two patients who were infected with C. trachomatis and two who were infected with C. psittaci and those of mice that were transtracheally infected with C. pneumoniae. Among proteins immunodominant in the patients who were infected with C. pneumoniae, a 40-kDa major outer membrane protein was genus specific and 53-, 46-, and 43-kDa proteins were species specific in their reactions with the majority of the human sera used. A few sera reacted strongly with a 73-kDa protein genus specifically. Some proteins with weak immunogenicity exhibited species specificity. An antigenic analysis with human sera and murine monoclonal antibodies against the 53-kDa protein showed that hte antigenicities were strictly conserved among the seven strains of C. pneumoniae tested. The genus-specific 73-kDa protein was solubilized with octylglucoside. All of the species-specific immunodominant proteins were solubilized with sodium dodecyl sulfate, but the genus-specific major outer membrane protein was not. These results suggest that a serological diagnosis of C. pneumoniae infection could be achieved species specifically by comparison of the serum responses to sodium dodecyl sulfate- and octylglucoside-soluble fractions.

Adolescent↗
PubMed1994

Inhibitory effect of clindamycin on production of beta-lactamase in beta-lactam-resistant bacteria.

The inhibitory effect of clindamycin on beta-lactamase biosynthesis was investigated in beta-lactam resistant bacteria with inducible and/or constitutive production of the enzyme(s). Clinical isolates of Enterobacter cloacae (E. cloacae) and Pseudomonas aeruginosa (P. aeruginosa) were examined. Three strains of each, against which sulbactam at 8 micrograms/ml reduced the minimum inhibitory concentration (MIC) of cefoperazone (CPZ) at least 4 fold, were studied in greater detail. Although clindamycin had no appreciable effect on bacteria growth at concentrations up to 50 micrograms/ml, it suppressed inducible beta-lactamase biosynthesis almost completely at a concentration of 20 micrograms/ml. There was also a significant reduction of constitutive enzyme biosynthesis by clindamycin at 50 micrograms/ml. Thus, it was estimated that a high concentration of clindamycin was required to suppress beta-lactamase biosynthesis in beta-lactamase producing bacteria of the constitutive type.

Anti-Bacterial Agents↗