We developed a new quantitative system for diagnosis of invasive pulmonary aspergillosis (IPA) using real-time automated polymerase chain reaction (PCR). Intra-assay and interassay precision rates for in vitro examination were 2.53% and 2.20%, respectively, and the linearity of this assay was obtained when there were >20 copies/well. We examined 323 samples taken from 122 patients with hematological malignancies, including 33 patients with IPA and 89 control patients. Blood samples were subjected to PCR antigen detection methods, using enzyme-linked immunosorbent assay (ELISA) and determination of plasma (1-->3)-beta-D-glucan (BDG) concentration. The sensitivities of PCR, ELISA, and BDG measurement for diagnosis of IPA were 79%, 58%, and 67%, respectively; the specificities were 92%, 97%, and 84%. Positive findings on PCR preceded those of computed tomography by -0.3+/-6.6 days, those of BDG measurement by 6.5+/-4.9 days, and those of ELISA by 2.8+/-4.1 days. Real-time PCR was sensitive for IPA diagnosis, and quantitation was accurate.
The ratio of leukocidin-producing strains to clinical isolates of Pseudomonas aeruginosa was investigated together with the production of protease, elastase, and exotoxin A. We also examined whether these strains contain the common antigen which resides in the cell wall. By using the agar gel diffusion test with specific antisera, we found that 87 of 90 (96.7%) of clinical isolates produced leukocidin. Protease, elastase, and exotoxin A were also produced at high percentages. The common antigen was found to exist in all strains. Next, to estimate antileukocidin antibody in the sera of patients, we used an enzyme-linked immunosorbent assay with horseradish peroxidase-protein A. The sera of 39 patients with diffuse panbronchiolitis (DPB) were investigated for antileukocidin antibody. The mean antileukocidin titer in the sera of 17 DPB patients who were not infected with P. aeruginosa and 5 DPB patients who were transiently infected with the bacteria was about the same as the mean antileukocidin titer in the sera of 11 healthy controls, whereas the mean antileukocidin titer in the sera of 17 DPB patients who were persistently colonized was significantly higher than that in healthy controls. These results indicate that leukocidin was produced at the local site of infection in DPB patients.
Seven non‐Hodgkin's malignant lymphomas (MLs) were found in 25 Japanese AIDS (acquired immune deficiency syndrome) patients who died at two hospitals in Tokyo. All of these MLs originated from extranodal organs including the brain (three cases), skin (two cases) liver and adrenal gland. B cell markers were demonstrated in all of them. Epstein‐Barr virus (EBV) capsid antigen (EBVCA) was demonstrated in 5/7, nuclear antigen (EBNA) in 2/2, the W fragment of EBV DNA by in situ hybridization in 5/7 and the same fragment by PCR in 6/7, indicating high association of these MLs with EBV. The adult T cell leukemia/lymphoma (ATL), endemic in south‐west Japan and known to have a high association with HTLV‐I, was not found in this series. The incidence of ML among the present AIDS cases is higher than in any other autopsy reports from western countries, although statistical analysis did not show this to be significant in comparison to some of these reports at a level of p<0.05. In spite of apparent higher incidence, the histopathologic and immunophenotypic characteristics of AIDS‐associated MLs in Japan are in accordance with those in western countries. Acta Pathol Jpn 41: 744‐750, 1991.
Tonsillitis is the most common disease in the otorhinolaryngeal location. For most patients, tonsillitis is attributed to a group A streptococcal infection if the throat culture is positive for that organism or to a viral infection if the throat culture is negative. However, recent studies have shown that Chlamydia trachomatis can produce tonsillar infection. In this study, we evaluated the efficacy of Rokitamycin, a 16-membered ring macrolide antibiotic agent, in the treatment of tonsillitis associated with C. trachomatis. In 26 of 28 (92.9%) patients from whom C. trachomatis was isolated, the organism was eradicated by antimicrobial treatment with Rokitamycin of five days to three weeks' duration. In 25 of the 26 patients, they were totally free of tonsillar symptoms.
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