Susceptibility of medical students to vaccine-preventable viral diseases: a serological study.

As a measure for the prevention and control of nosocomial infections in medical school students, we examined the students' titers of antibodies to measles, rubella, varicella, and mumps viruses to determine whether vaccination was required. We also analyzed and discussed correlations among antibody titers to the viruses. Subjects were 363 Juntendo University students, ranging from freshmen to seniors. EIA was used to measure IgG antibody titers. Eight subjects (2.2%) had negative titers for measles, 36 (9.9%) for rubella, 8 (2.2%) for varicella, and 10 (2.7%) for mumps. Seronegative subjects were vaccinated against each virus and high seroconversion rates were obtained: 100% for measles and rubella, 67% for varicella, and 89% for mumps. In addition, we used Pearson's test to search for correlations among the antibody titers for each virus. A weak correlation was observed among antibody titers for measles, rubella, and mumps but not for varicella. These results suggest that MMR vaccine might be effective in people with low levels of antibody to measles, rubella, and mumps.

[Laboratory medicine in the field of emergency medicine and disaster medicine--Old-And-New tools of emergency medical service].

We reviewed the characteristics of the field of laboratory medicine concerning emergency medicine and disaster medicine. Gram's stain was apt to be made light of by clinicians, but it has been reviewed again. A modern sophisticated analysis system is expected for the consequence management of NBC terrorism and mass poisoning, but we would like to emphasize the importance of the basic physical strength of laboratory medicine, such as Gram's stain, to the meaning of old-and-new technology.

[Campylobacter fetus subsp. fetus sepsis: a case report and review of the literatures in Japan].

We report a 32-year-old female with eating disorder whose body weight was only 20 kg. She was admitted to the hospital with severe low nutrition, low proteinemia, liver dysfunction, hypokalemia and hypoglycemia. On the third hospital day, she had a high fever and Campylobacter fetus subsp. fetus (C. fetus) was isolated from the blood. After treatment with meropenem (1 g/day) intravenous drip injection, her condition improved. C. fetus sepsis is not common disease in Japan. A review of 37 cases of this disease in Japan revealed that the age range of adult patients was 20 to 60 years old. The male-to-female ratio was 4.6 to 1.0. Seventy-eight percent of the patients had underlying diseases which were composed of 11 patients with liver disease, 6 patients with blood dyscrasia and some with diabetes mellitus, heart disease, other malignant tumor and collagen disease. There was no case with eating disorder. All apparent sources of infection in Japan originate from eating raw food. Gastrointestinal symptoms were observed in only 16% of the patients. Recent recommendations for the treatment of C. fetus sepsis are to use gentamicin, imipenem and meropenem. Some strains of C. fetus have resistance to erythromycin, ciprofloxacin. The mortality of this infection is 14% in Japan.

[Two cases of infectious mononucleosis-like syndrome associated with human herpes-virus 6].

We experienced two cases of infectious mononucleosis-like syndrome associated with human herpesvirus 6 (HHV-6). One of the patients had been under medication for depression and the other one for schizophrenia. Both of them were taking carbamazepine for more than a week along with the other drugs. The manifestation of the symptoms of those two were almost same, such as high fever, generalized eruption, liver dysfunction, lymph-adenopathy, and existence of atypical lymphocytes. Serological tests for EB virus, cytomegalovirus and herpes simplex virus showed no significant change while the tests for HHV-6 showed increased titers of IgG antibody during the courses. We also examined HHV-6 DNA by real time quantitative PCR tests for HHV-6, and they appeared significantly high in the peripheral blood samples.