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Biomedical subjects

Y Kudoh

Publications and source records attributed to Y Kudoh.

At least 19 recordsLinked to original sources

A sensitive method for the detection of enterotoxigenic Escherichia coli by the polymerase chain reaction using multiple primer pairs.

In this study, a polymerase chain reaction (PCR) method has been developed for the detection of enterotoxigenic Escherichia coli (ETEC). Three different sets of oligonucleotide primers synthesized were used to amplify the enterotoxin genes of heat-labile (LTh) and heat-stable (STIa and STIb) enterotoxins of ETEC. These primers amplified a 627, 240, or 169 base pair (bp) DNA fragment from LTh, STIa and STIb gene, respectively, of the reference ETEC strains. The addition of RNase A (10 micrograms/ml) to the PCR reaction solution diminished nonspecific amplification of DNA fragments other than the enterotoxin genes. Five types of ETEC strains corresponding to the LTh, STIa, STIb, LTh-STIa, or LTh-STIb genotypes were distinguished by a single procedure of PCR using the mixture of the three sets of primers. PCR, hybridization, and conventional methods were subjected to one hundred stool specimens from diarrheal patients. It was found that PCR was the most sensitive method among them. These results suggested that PCR with triple primer pairs would be useful for the laboratory diagnosis of ETEC in the stool specimens.

Bacterial Toxins

[Shigella flexneri strains having a new type antigen 89-141].

Two Shigella strains (89-141 and 89-11) isolated from the stool of patients returning from abroad (both from India) in Tokyo in 1989 showed an atypical serologic reaction of agglutination with only polyvalent antiserum to S. flexneri prepared commercially. These strains had the typical biochemical characteristics of S. flexneri and were biochemically identical. Both strains were positive for Serény test in guinea pig eye and cell-invasion test in HeLa cells. The strains also had virulence-plasmid encoding outer membrane proteins, indicating pathogenicity. The results of antigenic analyses showed that the strains were serologically identical to each other and gave significant cross-reactions with S. flexneri variant Y that has only group 3, 4 factor antigen. However, the results of reciprocal absorption tests showed that the O antigen of these strains was not identical to S. flexneri variant Y, and they were confirmed to have an additional type-specific antigen which is not included among the known S. flexneri type antigen I-VI or provisional type 88-893 which were proposed by us in 1992. Furthermore, one stock strain (TSH508) formally identified as S. flexneri variant X has this type antigen, suggesting that the new antigen can be classified into two subtypes by combination of group factor antigen. Strain 89-141 is designated as the test strain for this new type antigen of S. flexneri.

Adult

[Serovar distribution and drug resistance of Salmonella isolated from imported and domestic cases in 1980-1989 in Tokyo].

A total of 6,816 strains of nontyphoidal Salmonella isolated from oversea travellers (imported cases) and domestic healthy individuals and sporadic cases (domestic cases) in Tokyo from 1980 to 1989 were studied for their serovar distribution and antimicrobial sensitivity. The serological typing results showed that the Salmonella strains were classified into 22 O groups and 156 serovars. Among serovars identified, S. ser. Anatum, S. ser. Derby, S. ser. Blockley, S. ser. Agona and S. ser. Typhimurium were predominant in imported cases, while S. ser. Litchfield, S. ser. Typhimurium, S. ser. Hadar, S. ser. Infantis and S. ser. Thompson were predominant in domestic cases. It was also noticed that isolation rates of S. ser. Hadar and S. ser. Blockley have tended to increase noticeably in recent years in both cases. From antimicrobial sensitivity testing, 739 (28.1%) of 2,628 strains isolated from imported cases and 1,047 (25.0%) of 4,188 strains isolated from domestic cases were found to be resistant to any one of the drugs tested (CP, TC, SM, KM, ABPC, ST, NA, FOM and NFLX). From 1980 to 1983 the resistance rate was less than 20% for both cases and then the rate was increased year by year, and it became greater than 40% in 1989. Serovars of a high resistant rate during this period were S. ser. Hadar (96.3%), S. ser. Blockley (92.0%), S. ser. Typhimurium (75.7%), S. ser. Kentuckey (64.1%), S. ser. Krefeld (59.3%), and S. ser. Panama (58.3%) for the imported cases and S. ser. Hadar (97.5%), S. ser. Blockley (57.4%), S. ser. Litchfield (44.6%), S. ser. Enteritidis (44.4%), S. ser. Muenchen (42.2%) and S. ser. Typhimurium (40.9%) for the domestic cases. Drug resistance patterns of the resistant isolates varied up to as much as 50 patterns. Prevalent patterns recognized were TC.SM, CP.TC.SM.KM, TC, CP.TC.SM.KM.ABPC and SM for imported cases and TC.SM, TC, TC.SM.KM, SM, and CP.TC for the domestic cases. 21(12.4%) of 170 drug resistant strains were isolated from imported cases from 1988 to 1989 were found to have conjugative transmissible R plasmids.

Antibodies, Bacterial

[Serological studies on Campylobacter jejuni/coli: establishment of national reference system for serological typing in Japan].

In order to establish a national reference system for Campylobacter serotyping in Japan, 7 local institutes of public health collaborated to prepare 30 serogrouping antisera including 26 antisera of Lior's serogrouping system and 4 antisera of TCK serogrouping system which was developed by the Tokyo Metropolitan Research Laboratory of Public Health. A total of 603 strains (92.2%) out of 654 isolates from 23 outbreaks of C. jejuni throughout Japan were serogrouped by the 30 antisera. Out of 1,198 strain isolated from sporadic cases of Camplyobacter gastroenteritis, 883 (73.7%) were typed and 298 strains (24.9%) were untypable. The remaining 17 strains belong to rough form were not used for serogrouping. A hundred thirteen out of 883 strains have reacted with more than one typing serum. Among C. jejuni isolated from 7 prefecture, Lior's serogroup 4 was most common followed by Lior's serogroup 4, 2, 11, 1 and TCK serogroup 1 and 12. We conclude from the experiment described above that this Lior's serogrouping system by combining with TCK serogroup for Campylobacter jejuni/coli is useful in epidemiological investigations in Japan.

Campylobacter coli

[Shigella flexneri strains having a new type antigen].

Five Shigella strains isolated from stool cultures of two domestic dysentery cases and three imported cases in Tokyo in 1986-1989 had an atypial serotype that agglutinated with only antiserum to S. flexneri group 6 factor antigen. These strains showed typical biochemical reactions of S. flexneri and were biochemically identical. Four of the strains were positive for Serény test with guinea pig eye and the cell-invasion test with HeLa cells. The strains also had the virulence-plasmid encoding outer membrane proteins, indicating that these were pathogenic. These strains were serologically identical and gave significant cross-reactions with S. flexneri 1b and 4b that had group 6 factor antigen. However, results of reciprocal absorption tests showed that the O antigen of these strains were not identical to S. flexneri 1b and 4b, and were confirmed to have a new type antigen which can not be included among the known S. flexneri type antigen I-VI. Strain 88-893 is designated as the test strain for this new type antigen of S. flexneri.

Antigens, Bacterial

[Shigella dysenteriae strains having a provisional serovar isolated from imported diarrheal cases in Tokyo].

Two bacterial strains (ME448 and ME474) isolated from stool cultures of imported cases in Tokyo in 1987 had typical biochemical characteristics of Shigella dysenteriae. The results of antigenic analyses showed that they were serologically identical to each other, but did not belong to any of the established Shigella serovars. These strains were positive for Serény test in guinea pig eye and cell-invasion test in HeLa cells. The strains also had virulence-plasmid encoding outer membrane proteins, indicating that they were pathogenic. We then contacted the Centers for Disease Control in the United States and the Central Public Health Laboratory in the United Kingdom and arranged serological examinations of the strain ME448. From the results, the strain was confirmed to have provisional S. dysenteriae serovar E23507. Although the serovar had been isolated from a Swedish patient who developed diarrhea while in India, this is thought to be the first report of its isolation in Japan.

Adult

Helicobacter pylori-associated ammonia production enhances neutrophil-dependent gastric mucosal cell injury.

The role of neutrophil and its chlorinated oxidant were investigated in Helicobacter pylori-induced gastric mucosal injury in vitro. Luminol-dependent chemiluminescence (ChL) was used to detect neutrophil-derived oxidants. ChL activity was significantly elevated when neutrophils were incubated in H. pylori, indicating that H. pylori actually elicits oxidative burst of neutrophils. To assess whether H. pylori-activated neutrophils exert the cytotoxicity for gastric mucosal cells, rabbit gastric mucosal cell was monolayered in culture wells and labeled with a fluorescence dye, 2',7'-bis(2-carboxyethyl)-5(6)carboxy-fluorescein, which is retained in the intracellular space as long as the cell membrane is intact. Labeled cells were coincubated with neutrophils and H. pylori. We inferred from the cytotoxicity index (specific %cytotoxicity), which was calculated from fluorometrical measurements of supernatant and lysate, that the mucosal cells were significantly damaged by H. pylori-activated neutrophils. This injury was largely attenuated by eliminating urea from the incubation mixture or by acetohydroxamic acid, a potent urease inhibitor. Additionally, the scavengers of neutrophil-derived oxidants, including taurine, methionine, and catalase, also attenuated this injury. Cultured mucosal cells that were exposed to the solution containing monochloramine (an oxidant yielded by reaction of hypochlorous acid and ammonia) were highly damaged compared with cells exposed to hypochlorous acid or hydrogen peroxide at physiological concentrations. These data suggest that H. pylori-activated neutrophils promote gastric mucosal cell injury and that monochloramine plays a unique and important role in this process.

Ammonia

[Chemical and serological study of lipopolysaccharide isolated from Shigella flexneri 88-893 possessing a new type-antigen].

The O-specific polysaccharide chain which represents a new type-antigen in lipopolysaccharide (LPS) of Shigella flexneri 88-893 was investigated. The O-polysaccharide chain was found to be composed of repeating units comprising rhamnose, N-acetylglucosamine and glucose (3:1:2). In the passive hemolysis test, group-6 antiserum of S. flexneri exhibited a high hemolytic titer (50% hemolysis titer: 7,900) against sheep red blood cells (SRBC) sensitized with intact 893 LPS, but virtually no hemolytic activity against SRBC sensitized with alkali-treated 893 LPS. None of the type-specific antisera (I-VI), showed any significant hemolytic titer against SRBC sensitized with either intact or alkali-treated 893 LPS. Thus, 893 LPS contained both the group-6 antigen and a new type-antigen which is distinct from any known type-antigen of S. flexneri.

Animals

[A provisional serovar of Shigella dysenteriae isolated in Japan from travellers' diarrhea].

A bacterial strain was isolated that possessed the biochemical characteristics of Shigella dysenteriae but did not belong to any of the established S. dysenteriae serovars, from the feces of a diarrheal case who had travelled to Turkey, Pakistan, India and Thailand for about a month. This strain was invasive to tissue culture cells and gave a positive Serény test. Preparing antiserum against this strain and examining the antigenic relationship with the established O antigens of Shigella and Escherichia coli O1-O170, we found that the strain had O antigen identical to that of the E. coli O serogroups 150. The results indicated that this strain could be a provisional serovar of S. dysenteriae. Although our strain could probably be the same serotype as that of the strains reported in Israel, this may be the first report of isolation in Japan.

Adult

[Enteroinvasive Escherichia coli O121: H- isolated from travellers' diarrhea].

A lactose slow-fermenting, non motile Escherichia coli strain was isolated from a diarrheal patient returning from Indonesia. Examination of virulence of the strain showed that it penetrated into tissue culture cells, and were positive in Serény test and enzyme-linked immunosorbent assay for detection of enteroinvasive E. coli. A large plasmid responsible for virulence was also detected. Thus the strain was confirmed to be a typical enteroinvasive E. coli. Analysis of O serotype using the antisera against E. coli O1-O170 revealed that the strain had O121 antigen, whose antiserum is not included in the commercial serotyping kit for the diagnosis of diarrheagenic E. coli.

Diarrhea

[Species and serovar distribution, and drug resistance of Shigella strains isolated from imported and domestic cases in 1980-1989 in Tokyo].

A total of 1,189 Shigella strains consisting 804 imported and 385 domestic strains were examined for their species and serovar distribution, and their drug-resistance. In both imported and domestic strains, S. sonnei was found to be the most prevalent species, followed by S. flexneri, S. boydii and S. dysenteriae in order. In imported strains, however, the isolation frequency of S. flexneri, S. boydii and S. dysenteriae were higher than that of domestic strains, and the serovar of each species was distributed in a wider range than that of the domestic strains. The drug resistance test using chloramphenicol (CP), tetracycline (TC), streptomycin (SM), kanamycin (KM), ampicillin (ABPC), sulfamethoxazole-trimethoprim (ST), nalidixic acid (NA), fosfomycin (FOM) and norfloxacin (NFLX) showed that 80.1% of the imported strains and 82.9% of the domestic strains were resistant to any of drugs examined, although frequency of resistance varied by their species. The frequency of resistance to each drugs were SM (74.0%), TC (68.5%), CP (38.8%), ABPC (35.3%), ST (34.1%), NA (1.5%) and KM (1.0%) in imported strains, and TC (79.2%), SM (55.3%), ABPC (40.3%), CP (38.4%), ST (32.4%), NA (30.5%) and KM (4.2%) in domestic strains. No strain resistant to FOM or NFLX was found in both groups. The resistance patterns varied to 32 types. Among those, a multiple drug-resistance type with CP.TC.SM.ABPC was found most frequently in both groups. Frequency of strains carrying transferable R plasmid was tested for 50 strains isolated in 1989 and three (6%) of them had the plasmid.

Ampicillin Resistance

Acute thrombocytopenia after intravenous infusion of radiographic contrast medium.

Acute thrombocytopenia due to intravenous infusion of radiographic contrast media is extremely rare. We report the first such case in Japan. A 52-year-old male was admitted to hospital because of right ureteral stone. Two hours after drip infusion pyelography, the patient experienced chills and fever. It was shown that his platelet count had decreased abruptly from 233,000 to 8000/mm3. Platelet associated immunoglobulin was not detected. An in vitro test for platelet aggregation by contrast media was negative. Following infusion of hydrocortisone, the platelet count recovered to a normal level within several days.

Blood Platelets

[Biochemical characteristics, growth on selective media, antimicrobial susceptibility, and diarrheagenic toxin production of enteroinvasive Escherichia coli].

A total of 70 strains of enteroinvasive Escherichia coli (EIEC) belonging to 8 different O serogroups including O28ac O29, O121, O124, O136, O143, O144, and O164, was studied for their biochemical characteristics, growth on selective isolation agar, antimicrobial susceptibility, and diarrheagenic toxin production. Among the biochemical characteristics examined, all EIEC strains gave negative lysine decarboxylation and all but one belonging to O124 serogroup, were non-motile, regardless of their O serogroups. The one motile O124 strain had a H30 antigen. Some close correlations were also observed between their O serogroups and biochemicals such as utilization of sodium acetate and mucate, ornithine decarboxylation, arginine dihydrolation, gas production from glucose, and lactose fermentation. Among the selective isolation agars, MacConkey and Deoxycholate-hydrogen sulfide-lactose (DHL), and modified Shigella-Salmonella (SS) agars supported growth of the EIEC strains well, whereas SS agar was remarkably inhibitory for strains of some O serogroups. Antimicrobial susceptibility was tested for nine drugs including chloramphenicol (CP), tetracycline (TC), streptomycin (SM), kanamycin (KM), ampicillin (ABPC), sulfamethoxazole-trimethoprim (ST), nalidixic acid (NA), fosfomycin (FOM) and norfloxacin (NFLX). Forty-one of the 70 strains (58.6%) were found to be resistant to the 6 drugs, such as CP, TC, SM, KM, ABPC or ST. None of the strains were resistant to NA, FOM or NFLX. Among the resistant strains recognized, the strains which showed the resistant patterns of CP.TC.SM.ABPC, CP.TC.SM, TC.SM.ST, TC.SM, and SM appeared to be prevalent. None of the strains gave positive reactions for the production of diarrheagenic toxins of heat-labile enterotoxin, heat-stable enterotoxin, and verocytotoxins 1 and 2.

Anti-Bacterial Agents

Widespread occurrence of specific restriction endonucleases in Salmonella infantis, Salmonella thompson, and Salmonella blockley isolated from humans in Japan.

Specific restriction endonucleases were detected in three serotypes of Salmonella spp. isolated from humans in Japan from 1970 to 1987: an isoschizomer of AvaII endonuclease at a frequency of 0.91 in Salmonella infantis, an isoschizomer of KpnI at a frequency of 0.34 in Salmonella thompson, and an isoschizomer of StyI at a frequency of 0.30 in Salmonella blockley. Of interest is that restriction endonuclease-producing S. thompson was detected at high frequencies in the 1970s but at low frequencies in the 1980s.

DNA Restriction Enzymes

[Enteroinvasive Escherichia coli O29:H--isolated from travellers' diarrheal cases].

Escherichia coli strains isolated in Tokyo from stool cultures of two sporadic diarrheal cases of travellers returning from South America and Thailand in 1985 and 1987 respectively, were found to be enteroinvasive strains with rare serotype O29:H--. These E. coli O29:H-- strains showed typical biochemical reactions of enteroinvasive E. coli in that they were negative lysine decarboxylase and non-motile. They were positive for Serèny test with guinea pig eye, cell-invasion test with HeLa cells, 140 megadalton virulence plasmid, and the virulence-plasmid encoded outermembrane protein, indicating that these strains were pathogenic and may cause a Shigella-like disease. Although the same serotype strains have been isolated in other countries, this may be the first report of isolation in Japan.

Diarrhea

Tuberculosis on regular hemodialysis--a case of pericardial tamponade.

The patient presented in this paper had been stable for 3 months after the induction of hemodialysis, when nausea, vomiting and hepatomegaly suddenly developed. A chest film revealed rush cardiomegaly, and massive pericardial effusion was demonstrated by echocardiography. One liter of hemorrhagic fluid was removed by pericardiocentesis and subsequent pericardial drainage under echocardiography. The patient received chemotherapy against pulmonary tuberculosis 30 years ago and calcification on chest film was apparent. Although sputum smear and pericardial effusion was negative for acid-fast organisms, combination therapy was initiated for suspected tuberculosis. The patient recovered completely and 2 months later it was demonstrated that cultures of sputum grew mycobacterium tuberculosis. Tuberculin skin test (PPD), which was negative 2 months previously, converted to positive. Tuberculosis must be considered as a potential cause of pericardial tamponade in patients on regular hemodialysis, and prompt therapy for both cardiac tamponade and the occult infection is warranted.

Aged

Slow continuous hemodialysis--new therapy for acute renal failure in critically ill patients--Part 1. Theoretical consideration and new technique.

In order to treat acutely uremic patients in an unstable hemodynamic state, we developed a new system for slow continuous hemodialysis. It is well known that continuous hemofiltration or peritoneal dialysis are successful in terms of removing the excess body water without adverse effects on hemodynamics. On the other hand, hemodialysis is far more effective in eliminating solutes such as uremic toxins, especially under a catabolic state. In order to combine the merits of both interventions, volume control and solute removal were dealt with separately in our system. The main system is composed of a double-pump driven closed circuit for the re-circulated hemodialysis. Volume control was achieved accurately within +/- 5% error of the set rate. The dialysance was evaluated in vitro and the efficacy of solute elimination was simulated mathematically. It was speculated that slow continuous hemodialysis could be a new method of treating critically ill patients with acute renal failure.

Acute Kidney Injury