Nosocomial Infection with Serratia marcescens: Comparison of Bacteriocin Types and Antibiograms between Two University Hospitals

Nosocomial distribution of Serratia marcescens at two university hospitals was studied by bacteriocin typing and antibiogram from January 1981 to July 1983, and the results were compared. The 126 strains isolated from Medical College Hospital of Oita (MCHO) consisted mainly of bacteriocin types 4 (29%), 9 (23%), 52 (19%) and 42 (6%) , and the 86 from Nagasaki University Hospital (NUH) were mainly of types 14 (20%) , 4 (17%), 9 (12%) and 26 (12%); these four types amounted to 77% and 61% respectively. Types 4 and 9 which formed a high proportion of isolates at both hospitals were apparently the most common bacteriocin types. Using 154 strains of the bacteriocin types 4 , 9, 14, 26, 42 and 52 of S. marcescens, antibiogram with 13 antimicrobial agents was tested. The strains isolated from MCHO were found to be more resistant than those from NUH. The isolates of S. marcescens at each hospital showed characteristic , different distribution in bacteriocin type and antibiogram. The close relation was not always observed between antibiograms and bacteriocin types

Clinicopathological Study of 50 Cases of Lung Cancer Associated with Silicosis

To clarify any causal relationship between lung cancer and silicosis, we studied clinicopathological findings in 50 men, mainly tunneling workers, aged from 47 to 85 years with both diseases. The histological types were : squamous cell carcinoma, 29 cases; small cell carcinoma, 10; adenocarcinoma, 6 ; large cell carcinoma, 4 ; and adenosquamous carcinoma, 1. The high frequency of cancer, particularly squamous and small cell cancer, in sites of silicotic fibrosis suggested a causal relationship, perhaps via a carcinogen. If a weak carcinogen accumulastes in fibrotic leasions, its prolonged presence may induce cancer. We believe that silica alone is rarely carcinogenic, but it may interact with polycyclin aromatic hydrocarbons from cigarette smoking or from pyrolysis, or with other substances encountered in occupational environments

Evaluation of an Experimental Animal Model for Estimating the Pathogenicity and the Efficacy of Antibiotic Treatment in Bacterial Infection

An experimental model of intracutaneous infection in the guinea pig, which was based on the study of MILES et al. (Br. J. Exp. Path. 38: 79-96, 1957) :and MASKELL (J. Med. Microbiol. 14: 131-140, 1981), was used to investigate the pathogenicity and the effect of chemotherapy with lincomycin, using 36 strains of the genus Bacteroides. The pathogenicity was estimated by intracutaneous injection of 0.1-ml quantities of bacterial suspension into guinea pigs and the value was expressed as the number of inoculated organisms required to induce a skin lesion 10 mm in diameter 24 hours after injection. Bacteroides fragilis was, on average, three times as pathogenic as non-B. fragilis strains (p<0.1). Two intramuscular injections of lincomycin were more effective than a single one against the intracutaneous infection, and the lower was the MIC value, the greater was the effect (p<0.001). This experimental animal model was simple and convenient for estimating the pathogenicity and efficacy of antimicrobial agents. However, the skin lesions were often not clear if the bacteria with low virulence were inoculated and the induced infection is not natural

Bronchiolitis Obliterans Organizing Pneumonia: Case Report and Review of Literature

A 69-year-old female complaining of fever, cough and dyspnea was admitted to our hospital. Chest X-ray examination showed bilateral infiltration shadows that increased in spite of antibiotics therapy. Broncho-alveolar lavage fluid analysis demonstrated an increased lymphocytes with an inverted CD4/CD8 ratio. Histopathology of lung biopsy specimens showed organizing granulation tissue in the lumens of bronchioles, alveolar ducts, and alveoli, along with mononuclear cell infiltration in the interstitium. A diagnosis of bronchiolitis obliterans organizing pneumonia (BOOP) was thus made. The patient completely recovered by cortico steroid therapy, and is now without any indication of disease

A Case of Pulmonary Alveolar Proteinosis associated with Pulmonary Silicosis

A 53 years old man complaining productive cough and dyspnea admitted to a hospital on 8th March, 1982. Chest X-ray showed the fine granular shadow through out lung fields. Arterial blood gas tensions were PO2 31 torr, PCO2 27 torr and AaDO2 86 torr at pH 7.45. Transbronchial lung biopsy was performed and the microscopic findings of which showed eosinophilic, PAS positive granular materials filled in the intraalveolar space and the swelling of the alveolar lining cells. The patient was diagnosed as pulmonary alveolar proteinosis and was saved by bronchoalveolar lavage with the aid of extracorporeal circulation. Histochemical and electron microscopic observation and biochemical analysis were performed, and it was suggested that the materials accumulated in the intraalveolar space were mostly originated from the lung surfactant secreted by the pulmonary alveolar cells type II

A Case of Adult Respiratory Distress Syndrome Associated with Acute Pancreatitis

A 52-year-old man was admitted to our department for acute pancreatitis. He developed adult respiratory distress syndrome (ARDS) on the 2nd hospital day, and was treated with respiratory management using positive endexpiratory pressure (PEEP) in addition to pharmacologic therapy for pancreatitis. The treatment was very effective, and he was discharged on the 72nd hospital day

The Echogenic Patterns of the Pancreatic Parenchyma in the Endoscopic Ultrasonography

Using the pancreas of the Japanese Macaque and human pancreas from autopsy cases, the echogenic patterns of the pancreatic parenchyma obtained by the ultrasonic endoscopy were compared with the histological findings. The parenchyma of the normal pancreas was observed as an echogenic pattern with homogeneous accumulation of small granular echoes. Such granular echoes are suggested to represent pancreatic acini on comparison with the tissue structure. This was confirmed by widening the pancreatic interstitium by infusing physiological saline into the main pancreatic duct. Such granular echoes became indistinct in the pancreas from autopsy cases due to autolysis. In the experimental pancreatic lesion produced by local injection of 1 % deoxycholic acid into the pancreas of Japanese Macaque, hemorrhage and fibrosis were noted 1 week later and fibrosis appears after 2 to 3 weeks. Hemorrhagic lesions were appeared as an area of high echogenicity, and fibrosis was appeared as an area of low echogenicity, with irregularity of the granular structure seen in the normal tissue

PANCREATIC HISTOLOGY IN PATIENTS UNDER LONG TERM CORTICOSTEROID TREATMENT

In 52 autopsy cases (30 cases treated with corticosteroid and 22 cases not treated), changes of the pancreas due to corticosteroid administration were histologically studied. Light microscopy revealed a significantly more frequent appearance of PAS positive materials inside of the acinar lumen, goblet cell metaplasia and hyperplasia of the pancreatic duct epithelium and spotty necrosis of the acinar cells in corticosteroid- treated cases than in non-treated cases. The mean number of dilated acini containing PAS positive materials (DAPPM) in ten 400 power fields was 1.63±2.0 in the non-treated group and 3.76±2.6 in the corticosteroid-treated group(p<0.01). Thus, these findings seems to play an important role in outflow disturbance of pancreatic juice. Electron microscopy revealed filamentous and electron dense materials filling in the dilated acinar lume, probably representing pancreatic juice with high viscosity and degradate on products of exocrine pancreatic cells

Renal Distribution of Vasohibin-1 in Patients with Chronic Kidney Disease

Experimental studies have demonstrated the involvement of angiogenesis-related factors in the progression of chronic kidney disease (CKD). There have so far been no reports investigating the distribution and clinical roles of Vasohibin-1 (VASH-1), a negative feedback regulator of angiogenesis, in CKD. We recruited 54 Japanese CKD patients and 6 patients who had normal renal tissues excised due to localized renal cell carcinoma. We evaluated the correlations between the renal expression level of VASH-1 and the clinical/histological parameters. VASH-1 was observed in renal endothelial/mesangial cells, crescentic lesions and interstitial inflammatory cells. Significant positive correlations were observed between 1) crescent formation and the number of VASH-1+ cells in the glomerulus (r＝0.48, p＝0.001) or cortex (r＝0.64, p＜0.0001), 2) interstitial cell infiltration and the number of VASH-1+ cells in the cortex (r＝0.34, p＝0.02), 3) the glomerular VEGFR-2+ area and the number of VASH-1+ cells in the glomerulus (r＝0.44, p＝0.01) or medulla (r＝0.63, p＝0.01). These results suggest that the renal levels of VASH-1 may be affected by local inflammation, crescentic lesions and VEGFR-2