Effectiveness of a comprehensive oral management protocol for the prevention of severe oral mucositis in patients receiving radiotherapy with or without chemotherapy for oral cancer: a multicentre, phase II, randomized controlled trial.

The aim of this phase II, multicentre, randomized controlled trial was to evaluate the effectiveness of a comprehensive oral management protocol for the prevention of severe oral mucositis in patients with oral cancer receiving radiotherapy alone or chemoradiotherapy. In total, 124 patients with oral cancer were enrolled from five institutions. Of these, 37 patients undergoing radiotherapy were randomly divided into an intervention group (n=18) and a control group (n=19). The remaining 87 patients, who were undergoing chemoradiotherapy, were also randomized into an intervention group (n=42) and a control group (n=45). During radiotherapy, patients in the control group received only oral care, while those in the intervention group additionally received spacers to cover the entire dentition, pilocarpine hydrochloride, and topical dexamethasone ointment for oral mucositis. The primary endpoint was the incidence of severe oral mucositis. The intervention was significantly associated with a decreased incidence of severe oral mucositis in patients receiving radiotherapy alone (P=0.046), but not in those receiving chemoradiotherapy (P=0.815). These findings suggest that an oral management protocol can prevent severe oral mucositis in patients with oral cancer undergoing radiotherapy without concurrent chemotherapy.

Characterization of Orientia tsutsugamushi isolated in Taiwan by immunofluorescence and restriction fragment length polymorphism analyses.

A total of 10 strains of Orientia tsutsugamushi were isolated from field rodents and chiggers in Taiwan, and characterized by immunofluorescence analysis with monoclonal antibodies and by restriction fragment length polymorphism analysis of the 56-kilodalton (kDa) protein gene. The isolates were divided into two groups consisting of 1 and 9 strains which showed some relation to Gilliam and Karp type strains, respectively. However, all these isolates possessed characteristics distinct not only from those of known prototype strains including Gilliam and Karp but also from all isolates from Japan. These findings suggest the existence of a large number of immunotypic and genotypic variants among the strains of O. tsutsugamushi, and the distribution of distinguishable strains in each area to which this species is endemic.

Polyclonal B cell activation during the course of Angiostrongylus cantonensis infection.

The numbers of IgM antibody forming cells against various heterologous antigens: SRBC, HRBC, TNP and FITC, were found to be elevated in the spleens of rats after infection with Angiostrongylus cantonensis. In these rats, the number of splenic B cells and total IgG and IgM levels in serum also increased spontaneously about 2- to 3-fold of uninfected rats during the course of the infection. These results suggested that A. cantonensis infection may activate B cells polyclonally in the spleens of the infected rats. While, it was clearly observed that the antibody response to SRBC injection was significantly depressed in these rats, compared to those of uninfected rats. The relation between the polyclonal B cell activation and the immunodepression was discussed.

Detection of antibodies in strongyloidiasis by enzyme-linked immunosorbent assay (ELISA).

Detection of IgG antibodies to Strongyloides stercoralis in sera of 29 patients with strongyloidiasis was attempted by the enzyme-linked immunosorbent assay (ELISA) using an extract of filariform larvae of S. stercoralis. The antibodies were found with a high degree of sensitivity in almost all patients. The ELISA values, however, did not correlate with the intensity of the infection or with differences in clinical and laboratory parameters. When the ELISA values of persons with Strongyloides were compared with those showing no S. stercoralis by faecal examinations, a significant difference was obtained between these two groups. The cross reactions with other helminth infections were significantly weaker than the reaction with Strongyloides infection. It was concluded that the antibodies are strongly elicited in human strongyloidiasis and that the assay provides a sensitive and specific method for diagnosis of strongyloidiasis.

Studies on eosinophilic meningitis and meningoencephalitis caused by Angiostrongylus cantonensis in Japan.

Twenty cases of eosinophilic meningitis or meningoencephalitis suspected of being angiostrongyliasis were recognized in Japan, including 16 cases in Okinawa Prefecture. Among the cases, there was only one proven case in Okinawa. The disease evenly occurred throughout all seasons. Both sexes were equally affected, but 17 cases (more than 80%) occurred among adults. Intentional ingestion of various mollusks and fresh livers of toads for therapeutic reasons were interestingly responsible for 7 cases. The immunological diagnosis was successfully carried out on 9 cases. It was discussed that the cultural and ethnic backgrounds with different ways of life and eating habits determine the prevalence of the disease, and clinical and epidemiological features of the disease among different ethnic groups and geographic areas.

[Treatment of Diphyllobothrium latum infection with paromomycin sulfate (author's transl)].

Recently, it has been known that the treatment with paromomycin sulfate is effective against many kinds of tapeworm. Paromomycin sulfate was used for treating 56 patients with Diphyllobothrium latum aged 2 approximately 65 years old. Paromomycin was administered orally in the dose of 25 approximately 50 mg/kg. All cases with Diphyllobothriasis latum were successfully treated with paromomycin. The drug was well tolerated and no side effects were observed in any patients.

Surveys of simian malaria in Japan.

The survey of simian malaria in Japan which had been conducted since 1965 showed that no Japanese monkeys (Macaca fuscata fuscata and Macaca fuscata yakui) were infected with malaria parasites. Most interestingly, however, Babesia sp. was found in 4 (4.3%) of 93 Macaca fuscata yakui which had been reared in a monkey park. As for the monkeys imported from abroad, Plasmodium was only found in Macaca irus from Southeast Asia, namely, P. inui (14.1-25.0%), P. cynomologi (0.6, 3.2%) and P. coatneyi (4.3%) from various countries. On the other hand, Hepatocystis kochi was found in high proportion in Cercopithecus aethiops from Uganda. Two other blood sporozoa identified as H. semnopitheci and Entopolypoides macai were also seen in Macaca irus imported from Southeast Asia.