In the quest for potent anti-Helicobacter pylori agents, we found 70% EtOH extract of Mallotus philippinensis (LAM.) MUELL. (MPM) with strong bactericidal activity at the concentration of 15.6-31.2 mg/l against eight H. pylori strains. Further fractionation and purification of 70% EtOH extract of MPM led to the isolation of 5 compounds, namely 5,7-dihydroxy-8-methyl-6-prenylflavanone (1), 3 -prenylrubranine (2), red compound (3), isorottlerin (4), and rottlerin (5) which were elucidated on the basis of nuclear magnetic resonance and mass spectroscopy. Among the isolated compounds, rottlerin exhibited most potent bactericidal activity with minimum bactericidal concentration (MBC) value of 3.12-6.25 mg/l against several clinical H. pylori isolates including Japanese and Pakistani strains, nine clarithromycin resistant (CR), and seven metronidazole resistant (MR) strains. Minimum inhibitory concentration (MIC) values of CR (8-Ͼ Ͼ256 mg/l) and MR (Ͼ Ͼ256 mg/l) strains were analyzed by E test. Moreover, the clarithromycin resistant strains were evaluated for A2143G and A2144G point mutations of 23s rRNA gene to correlate the MBC values with mutation type. Our results revealed the potent in vitro anti-H. pylori activity of MPM and rottlerin, specially against CR and MR strains, which could be gainfully utilized for the development of novel antimicrobials to prevent H. pylori related disorders.

a Japanese university hospital were reviewed to follow changes in the clinical features offungemia. The percentage offungi among microorganisms isolated from blood cultures was almost constant (6-10%) throughout the study period. Fungemia was highly associated with use of intravascular catheters, and some changes in clinical features were observed: 1) Candida albicanSy C. parapsilosis and C. glabrata were the main isolates, and the number of fungal species showed a tendency to increase. 2) The percentage of patients over 65 years old increased from 36 to 50%. 3) The percentage of patients who were treated with anti-fungal agents and/or removal of catheter increased from 50 to 89 and to 86%. 4) The percentage of patients who died within 28 days after isolation offungus decreased from 64 to 27%. The improved prognosis was thought to be due to the development of newanti-fungal agents and faster removal of intravascular catheter when infection was suspected. (Internal Medicine 35: 707-711, 1996)

: Malnutrition of patients is an important factor of poor prognosis and outcome and long stay in hospital. Nutrition screening is of course necessary for detecting underand malnutrition. However, appropriate rapid and easy screening tools for only acute and emergent hospitalized patients are not known. In this study, 14 questions composed with reported and new items were prepared and the utility of those questions for detecting malnutrition in novel hospitalized patients was evaluated. Combined questions on disturbance of swallowing, diarrhea and fever, and also on ageing, food intake and history of fall are very important for detecting malnutrition in newly hospitalized patients, although further study will be absolutely required. J. Med. Invest. 60 : 138-145, February, 2013

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Clinical features of nosocomial bacteremias due to methicillin-resistant Staphylococcus aureus (MRSA) (M group, n = 71) and Pseudomonas aeruginosa (P group, n = 25) in a university hospital during 1982-1993 were retrospectively analyzed. The majority of these patients had an underlying disease, and bacteremia occurred in hospital. There were no differences in the male to female ratio and the mean age of the patients between the two groups. The ratio of medical wards to surgical wards was higher in the P group (18/7 = 2.6) than for the M group (38/33 = 1.2). P. aeruginosa was more frequently isolated from patients with hematological malignancies and MRSA with solid tumors. The percentage of MRSA among gram-positive bacteremia and of P. aeruginosa among gram-negative bacteria has shown a tendency to increase in recent years, and antibiotic sensitivity of these two organisms showed, on a whole, a tendency to decrease. Attention should be called to the increase of these two pathogens.

During the period from January of 1995 to June of 1998, 27 beta-hemolytic streptococci were isolated from 25 cases of infectious skin diseases including secondary infections, impetigo, phlegmone, and paronychia. The rate of beta-hemolytic streptococci among all kinds of the isolates was found to be similar during those 4 years, ranging from 3.5% to 5.6%. Staphylococcus aureus were found to coexist with beta-hemolytic streptococci in 20 (80%) out of 25 cases. beta-hemolytic streptococci were also often associated with coagulase-negative staphylococci, gram-positive rods, or other species. Twelve cases (48%) carried beta-hemolytic streptococci predominantly. Most beta-hemolytic streptococci showed high susceptibilities to all antimicrobials tested; however S. agalactiae showed no susceptibility to gentamicin. The evaluation of characteristics of Streptococcus species is very important for selecting the right antimicrobial agents and the proper term of chemotherapy.