[Clinical and bacteriological studies on hospital outbreak of Salmonella enteritidis food poisoning].

We experienced a hospital outbreak of salmonella food poisoning after ingestion of omelet which was the hospital evening meal on August 8, 1999. Total number of patients was sixty-two (Male 25: female 37) and the mean age was 52.1 years old. Salmonella Enteritidis was isolated from the stool in 59 cases. Twenty-one of them were associated with the immunosuppression (12 with malignancy, 6 with DM, one with nephrotic syndrome, one with chronic nephritis and one with allergic purpura). Clinical symptoms of the patients were composed of watery diarrhea (100%), fever (88.7%), abdominal pain (82.3%), nausea (45.2%) and vomiting (25.8%). The laboratory data revealed leukocytosis (15/47 = 31.9%), increased CRP (44/46 = 95.7%), elevated creatinin (1/37 = 2.7%) and hypokalemia (5/42 = 11.9%). MICs of 20 strains isolated in our laboratory almost coincided with each other indicating that the source of bacteria was probably the same. In vitro, S. Enteritidis were sensitive to OFLX, TFLX, FOM, most of PCs, CEPs, AGs but resistant to MPIPC, CAM, CLDM, VCM. Therefore we administered LVFX to 59 cases (alone in 45cases, combination with FOM in 6 cases), NFLX to two children and FMOX to one pregnant woman. Lactobacillus was administered to 28 cases (45.2%) and antidiarrhetics were given to 6 cases (9.7%). Finally all patients improved within two weeks. We suspect that the salmonella food poisoning was due to infected egg. The partially cooked omelet would permit the growth of a sufficient inoculum to cause disease. To prevent food poisoning, we have to be consistent in cooking the food well (at 75 degrees C, for more than 1 minute) and should not have omelets during the hot summer season.

[Simultaneous production of parathyroid hormone-related protein (PTHrP) and granulocyte colony-stimulating factor (G-CSF) in lung cancer patients with hypercalcemia and leukocytosis].

Hypercalcemia and leukocytosis are often associated with primary lung cancer as a paraneoplastic syndrome. Recently, parathyroid hormone-related protein (PTHrP) and granulocyte colony stimulating factor (G-CSF) have been identified as major causative peptides for hypercalcemia and leukocytosis, respectively. We studied four men with advanced primary lung cancer (stages from IIIA to IV) who presented with hypercalcemia (corrected serum calcium levels: 10.5 mg/dl) and leukocytosis (WBC > 10,000 per mm3). The age of the patients ranged from 59 to 79 years old. The pathological subtypes were squamous cell carcinoma in three and adenocarcinoma in one. The mean serum calcium levels and leukocyte counts were 15.8 +/- 1.4 mg/dl (mean +/- SE) and 24,800 +/- 3,253 cells/mm3 (mean +/- SE), respectively. Abnormally high serum levels of PTHrP and G-CSF were found in three patients (mean +/- SE: 137 +/- 68 pg/ml; normal range in human serum, < 16 pg/ml), and in all four (mean +/- SE: 72 +/- 7.7 pg/ml; normal range in human serum, < 20 pg/ml), respectively. Immuno-histochemical examination of cancerous tissue obtained from these patients showed positive staining for both PTHrP and G-CSF within the cytoplasm of all the cancerous tissue. These results suggest that the association of hypercalcemia and leukocytosis in patients with advanced primary lung cancer is caused by production of both PTHrP and G-CSF by cancerous tissue.

[Comparison of D-arabinitol, candida antigen, and beta-glucan, measured by the chromogenic limulus assay, in the rabbit model of systemic candidiasis].

In this study, we measured D-arabinitol, candida antigen and beta-glucan in the rabbit model of systemic candidiasis. It was recently reported that the factor G, one of the coagulation enzymes from the horseshoe crad amebocyte lysate, reacts with beta-glucan or polysaccharide from fungus, and not with endotoxin. The newly developed endotoxin specific chromogenic Limulus assay (endospecy test), which is devoid of factor G, did not react with any rabbit serum. But the beta-glucan measured by the conventional Limulus assay (toxicolor test), which contains the factor G, was elevated (from 10 pg/ml to 100 pg/ml) in all cases of rabbit model of system candidiasis. Serum D-arabinitol, measured by Sone's enzymatic fluorometric method, increased in all cases, but Cand-Tec (candida detection system by latex agglutination) showed only one positive case in five innoculated rabbits.

[An autopsied case of disseminated cryptococcosis with marked lymphadenopathy].

A 75 year old woman who was admitted to Higashisaga National Hospital due to chronic bronchitis showed a high fever (39.2 degrees C) and marked lymphadenopathy of the bilateral inguinal lymph-nodes. Chest X-ray showed diffuse infiltration. Cryptococcus was detected in biopsied lymph-nodes. Although 5-fluorocytosine, miconazole, amphotericin-B were administered for six weeks, she died and an autopsy was performed. Disseminated cryptococcosis was observed in the lung, liver, spleen, kidney, bone marrow, and lymph-nodes of the lung hilum, paratrachea, retroperitoneum, gall bladder and groin. She was a human T cell leukemia type I (HTLV-I) carrier, and this could be related to disseminated cryptococcosis.

Efficacy of NY-198 against experimental Legionnaires disease.

The in vitro and in vivo effects of NY-198 against Legionella pneumophila were compared with those of ciprofloxacin. The MIC of NY-198 against 15 standard reference strains of Legionella of various species, between 0.03 and 0.125 micrograms/ml, was the same as that of ciprofloxacin. The peak concentration of NY-198 in the lungs and sera of guinea pigs with experimentally induced Legionella pneumonia was higher than that of ciprofloxacin after oral administration. The overall survival rate was higher in animals treated with NY-198 than in those treated with ciprofloxacin. Thus, NY-198 appears valuable in the treatment of Legionnaires disease.