A 43-year-old male and a 39-year-old male presented with multiple pituitary adenomas with two distinct histological types. The first patient who had multiple endocrine neoplasia type 1 had developed acromegaly due to a growth hormone-releasing hormone (GHRH)-producing pancreatic tumor. Both plasma GHRH and growth hormone (GH) levels decreased to normal after resection of the pancreatic tumor. However, the plasma GH level gradually increased again and magnetic resonance imaging revealed pituitary adenoma formation. Histological examination revealed two different histological types of pituitary adenoma: GH cell adenoma and null cell adenoma. The second patient, with no such genetic condition, had a non-functioning pituitary adenoma. Histological examination revealed two different histological types of silent GH cell adenoma and silent gonadotroph adenoma. Careful histological examination is required to exclude the possibility of multiple pituitary adenomas.
Streptococcus pneumoniae isolated in various parts of Japan from a total of 590 patients with identified or putative pneumococcal infections were typed using type-specific antisera during the three years from April, 1980 to March, 1983.The results obtained were as follows:1) The 590 identified isolates belonged to 43 Danish types and the rank order of isolates was: Type 3 (12.7%), 19 F (9.3%), 23 F (6.8%), 6 B (5.9%), 6 A (5.9%), 14 (4.9%), 11 A (4.1%), 19 A (3.7%), 9 V (3.6%), 22 F (3.1%) and others.2) A total of 430 isolates (72.9%) belonged to one of the 23 pneumococcal types to be included in the commercial 23-valent pneumococcal polysaccharide vaccine and 160 isolates (27.1%) were types not be included in the vaccine. The rates of isolation of vaccine-type pneumococci were 76.2% for blood, CSF, transtracheal aspirate (TTA) and others, 66.9% for sputum and throat swabs, 90.5% for middle ear effusions, 79.1% for meningitis and septicemia, 66.9% for respiratory tract infections, and 89.3% for otitis media.When the nonvaccine-type 6 A which is known to cross-react with type 6 B antibody in humans is included, the total number of vaccine-type pneumococcal isolates was 465 (78.8%), and the rates of isolation of vaccine-type pneumococci were 83.3% for blood, CSF, TTA and others, 73.3% for sputum and throat swabs, 91.9% for middle ear effusions, 87.0% for meningitis and septicemia, 71.9% for respiratory tract infections, and 92.0% for otitis media.It seems that there is no variation depending on the distribution by type of the pneumococcal isolates according to age and region.
A murine monoclonal antibody (MAb) specific for the Pseudomonas aeruginosa immunotype 1 (It-1) lipopolysaccharide (LPS) O-side chain was evaluated in terms of its in vitro bactericidal opsonophagocytic activity and in vivo bacterial killing in a mouse thigh infection model. An immunoglobulin (Ig) G2a MAb Ld3-2F2, specific for It-1 LPS, mediated in vitro complement-dependent opsonophagocytic killing at a concentration of 10 microg/ml. MAb-mediated, complement-dependent killing also occurred in the absence of neutrophils at serum concentrations in excess of 20%. A remarkable synergy was observed in opsonophagocytic assays between MAb Ld3-2F2 (0.5 microg/ml) and ceftazidime (1/4 MIC). The administration of MAb Ld3-2F2 at a level of 1 microg resulted in a significant decrease in the number of bacteria in the thigh muscles of normal mice, while 100 microg of the same MAb was required for one log of reduction in the number of bacteria at the same site in neutropenic mice. The combined therapy with MAb Ld3-2F2 and ceftazidime provided a significant reduction in the density of bacteria in the thigh muscle at 9 hr post-infection in normal and neutropenic mice as compared with those after treatment alone or with no treatment (P< 0.01). These favorable in vitro and in vivo interactions of an LPS-specific IgG MAb and ceftazidime strongly support their potential for use in therapy, combined with an LPS-reactive MAb and parenteral antipseudomonas beta-lactam antibiotics in the therapy of systemic Pseudomonas infections in normal and neutropenic hosts.
Propionylmaridomycin (PMDM) is a new macrolide-series antibiotic developed by the Research Laboratories of the Takeda Chemical Ind. Ltd., in 1972. Pharmacological and bacteriological studies have shown this agent to have an antibacterial activity almost equal to that of kitasamycin (LM) both in vitro and in vivo.The study was carried out in order to compare the clinical effect of PMDM, by double blind method, in respiratory infectious diseases (bacterial pneumoniae, acute bacterial bronchitis, acute tonsillitis) with that of LM as the control; 29 patients with bacterial pneumoniae were treated by 1600mg of PMDM or LM daily for 2 weeks; 38 patients with acute bacterial bronchitis and 32 patients with acute tonsillitis were treated by daily dose of 1200mg of PMDM or LM for 1 week.The following results were obtained.1) Improvement of main symptomes of bacterial pneumoniae was observed in 11 of 16 patients treated with PMDM (68.8%) and in 9 of 13 patients treated with LM (69.2%).Improvement of main symptoms of acute bacterial bronchitis was observed in 14 of 22 patients in PMDM group (63.6%) and in 11 of 16 patients in LM group (68.8%).Improvement of main symptomes of acute tonsillitis was observed in 9 of 14 patients in PMDM group (64.3%) and in 15 of 18 patients in LM group (88.9%). The clinical effect of both antibiotics showed no significant difference.2) Gastrointestinal disturbance was main side effect and no severe side effects, such as fever, skin rash, anaemia, toxic hepatits were observed in both PMDM group and LM group.
gel electrophoresis (PFGE) type Staphylococcus aureus, especially methicillin-resistant S. aureus (MRSA), is an important nosocomial pathogen.In particular, MRSAis of great concern in both hospitals and nursing homes (1-3).Previous studies showed that the types of S. aureus in the hospital environment infrequently match-ed those colonizing inpatients (1).However, little information, including molecular analysis, is available regarding the relationship between colonization and S. aureus environ-
