Rapid diagnosis of early Mycoplasma pneumoniae infection by indirect immunofluorescence with monoclonal antibody

Although serological methods or culture methods of Mycoplasma pneumoniae (Mp) from throat washings are used for diagnosis of Mp infection, the patient is often discharged from the hospital before definitive results can be obtained. Therefore we have developed a rapid detection from patients' throat smears by immunofluorescence with anti-rabbit IgG. Antibody specificity to Mp and the difference of titers between each lot have been a problem, because of polyclonal antibody which is prepared by immunizing a rabbit. Two hybridoma cell lines producing monoclonal antibodies to Mp were obtained by fusion of spleen cells from BALB/c mice immunized by Mp antigen with myeloma cells (X63-Ag8-6. 5. 3.). The high specificity to Mp of these monoclonal antibodies produced by the hybridomas was affirmed ELISA, immunofluorescence, and Western blot. A few cross-reactions were recognized by ELISA between Mp antigen and other Mycoplasma antigens. No cross-reactivity was found by indirect immunofluorescence. Throat smears from 4 patients suffered from Mp infection were examined by immunofluorescence with monoclonal antibody. Specific immunofluorescence was seen in all smears. Both granular and diffuse types of fluorescence were seen in smears from case 1 and 2. Only diffuse type was found in smears from case 3 and 4. Monoclonal antibodies can be obtained at any time and amount. The method may be useful and convenient for the rapid diagnosis of Mycoplasmal pneumonia

Application of KOH method for determination of Gram reaction of clinical isolates.

臨床分離細菌の検査同定作業の能率化をはかる目的で,グラム染色法によらないグラム染色性判定法の導入を試みた. KOH液を用いた簡易染色法を試験するため,教室保存株におけるグラム染色性の判定に必要なKOH液濃度およびその他の判定条件に検討を加えた.その結果, 3% KOH液を使用し,充分量の新鮮培養菌を使用するならば供試した全ての菌株でグラム染色結果と一致した.この結果に基づき,尿路感染症患者由来株253株の染色性を判定した. 3株のグラム陰性株で若干反応性が弱かったものの全ての菌でグラム染色結果と一致した.KOH液は,グラム染色性の判定が迅速,安価,かつその判定には熟練を必要としない点から今後大いに使用されるべき方法と考えられる.A rapid nonstaining method for the determination of the Gram reaction was applied to clinical isolates. In this study, 253 clinical isolates were tested by both the KOH method and Gram staining method. Both methods discriminated 110 of Gram-positive bacteria and Yeast-form fungus, and 143 of Gram-negative bacteria. These results confirmed the application of KOH method to clinical isolates

Ruptured vertebral artery dissecting aneurysm associated with parent artery occlusion

A 63-year-old hypertensive man presented with vertebral artery (VA) dissection manifesting as subarachnoid hemorrhage located mainly in the posterior fossa. Left vertebral angiography on the day of hemorrhage showed complete occlusion of the left VA. Right vertebral angiography showed retrograde filling of the distal portion of the left VA and the left posterior inferior cerebellar artery, and a “double lumen”-like finding in the left VA. He was managed conservatively. Follow-up angiography on Day 29 showed spontaneous recanalization of the occlusive lesion and an almost normal arterial configuration. T2-weighted magnetic resonance (MR) imaging on Day 45 revealed multiple infarctions in the brainstem. T1-weighted MR imaging showed a high intensity area, suggestive of intramural hematoma, in the left VA. He was transferred to another hospital in a persistent vegetative state

Comparative Study of Enterococci and Fecal Coli form Group as an Indicator of Seawater Pollution

A sampling of seawater was carried out on the coast east of Okayama Prefecture in 1984. Thirty samples of seawater were collected at 10 sampling points near beaches and were examined for both enterococci and fecal coli form group bacteria. The MPN technique was used for the detection of enterococci, and the MF technique for fecal coli form group bacteria. Enterococci were detected about 7.7 times as often as fecal coli form group bacteria. The correlation coefficient was high(r=0.8) when the bacterial numbers of both groups were plotted as logarithms. This result indicates that both bacteria can serve as a reliable indicator of the fecal pollution of seawater. However, the detection of enterococci using the MPN technique is more suitable for routine testing than that of the fecal coliform group with the MF technique in terms of the test performance and the cost involved

Persistent primitive trigeminal artery—cavernous sinus fistula with intracerebral hemorrhage: Endovascular treatment using detachable coils in a transarterial double-catheter technique: Case report and review of the literature

Intracerebral hemorrhage occurred in this 61-year-old woman with preexisting diplopia and proptosis. Results of angiography demonstrated a persistent primitive trigeminal artery (PPTA)—cavernous sinus fistula with cortical venous reflux. Two microcatheters were introduced transarterially through the PPTA into the two draining pathways in the cavernous sinus. Coils were delivered in both pathways simultaneously to prevent further venous overload on either path. The fistula was successfully occluded without complication while the PPTA was preserved. The authors describe this double-catheter technique for coil embolization of a fistula and review the literature concerning PPTA—cavernous sinus fistulas

Fundamental studies on enterococci as a pollution indicator of water

In order to develop an enterococci assay method as a pollution indicator of water or waste water, the most probable number (MPN) method using BTB azide dextrose and the membrane filter (MF) method using m-enterococcus agar were compared as to usefulness and simplicity. The appropriate concentration of NaN(3) in the media to permit selective growth of enterococci was determined to be 0.025% NaN(3) in the case of the MPN method, and 0.04% in the case of the MF method. Three hundred specimens from river water were tested by the MPN and MF methods. The correlation coefficient between the results was high enough to draw the conclusion that both methods were useful. The MPN method can be recommended as a simple procedure, and the MF method as an accurate assay, especially when specimens contain small numbers of bacteria

Mobile endovascular therapy for acute treatment of ruptured vertebral artery dissecting aneurysm in multiple hospitals

Background The patients with ruptured vertebral artery dissecting aneurysm (rVADA) should be treated as early as possible because VADA carries extremely high risk of rebleeding in the acute phase. We have established a mobile endovascular strategy for the patients with rVADA between our flagship center and its affiliated local hospitals. We introduced and reviewed our mobile endovascular therapy in this study. Methods We retrospectively evaluated 98 consecutive patients who underwent endovascular surgery for rVADA from 2000 to 2018 at our institution or five affiliated hospitals. When each patient was initially transported to the local affiliated hospitals, neuroendovascular surgeons traveled directly to the affiliated hospital from the flagship center in order to treat the patient there. Clinical outcomes using modified Rankin Scale at 6 months after treatment, radiological results, and procedure-related complications were reviewed to justify our mobile endovascular strategy. Results All aneurysms were cured successfully by internal trapping. Favorable outcome was achieved in 61 patients (62.2%) even though 53 patients (54.1%) had presented with severe subarachnoid hemorrhage. Overall mortality rate, treatment-related mortality rate, and treatment related complication rate were 18.4% (18/98), 0%, and 16% (16/98), respectively. There were no differences in clinical and radiological outcomes between the patients treated in the flagship center and those who treated in the affiliated hospitals. Treatment in the affiliated hospital was not a predictive factor of unfavorable outcome in our multivariate analysis, and elderly age (>= 60) was negatively associated with favorable outcome. Conclusions Our results prove the efficacy and safety of mobile endovascular therapy for the treatment of rVADA in the ultra-acute stage. Mobile endovascular therapy may work well in the acute treatment of rVADAs in the certain circumstance