著者

菅原 民枝 大日 康史 多屋 馨子 及川 馨 羽根田 紀幸 菊池 清 加藤 文英 山口 清次 吉川 哲史 中野 貴司 庵原 俊昭 堤 裕幸 浅野 喜造 神谷 齊 岡部 信彦

出版者

一般社団法人 日本感染症学会

雑誌

感染症学雑誌 (ISSN:03875911)

巻号頁・発行日

vol.81, no.5, pp.555-561, 2007-09-20 (Released:2011-05-20)

参考文献数

19

被引用文献数

6 8

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目的: 現在ムンプスワクチンの予防接種は任意接種であるが, 定期接種化された場合の費用対効果分析を行った.方法: 本研究は, 外来診療における医療費と家族の看護負担に関する調査を行い, 入院や後遺症死亡例の重症化例の情報を加味した.外来診療の医療費と家族看護に関する調査は, 平成16年6月15日から平成18年1月15日までの19カ月間, 人口10万人都市で, 小児科を標榜する9診療所と県立病院大学付属病院の11医療機関で実施した.入院例調査は, 平成16年1月から平成17年12月までの2年間, ムンプス及びムンプスワクチン関連により24時間以上入院あるいは死亡した例について実施した.結果: 外来診療に関する回収は189枚家族票112枚であった. 外来診療の疾病負担は, 家族看護費用も含めて平均値471億円 (最大値2, 331億円, 最小値6億円) であった.ムンプスの入院患者数は全国で4596例と推測した. 入院は, 家族看護も含めて平均値13.5億円であった. 後遺症, 死亡例を加え総疾病負担は, 平均値525億円 (最大値2434億円, 最小値109億円) であった.費用対効果分析では, 予防接種費用を6000円とすると, 増分便益費用比は, 5.2であり, 95%信頼区間下限においても1を上回っていた.考察: 増分便益費用比は1を上回っており, 定期接種化によってもたされる追加的な便益が, 追加的な費用を上回っていた. したがって, ムンプスワクチンの定期接種化に向けて政策的根拠が確認された.

著者

福光 研介 鈴木 雄二郎

出版者

一般社団法人 日本感染症学会

雑誌

感染症学雑誌 (ISSN:03875911)

巻号頁・発行日

vol.86, no.3, pp.282-286, 2012-05-20 (Released:2013-04-12)

参考文献数

13

被引用文献数

3 4

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A 30-year-old woman was admitted to our hospital with high fever and chest pain. She had a ventricular septal defect, but was asymptomatic and had not undergone surgical repair. She also had had atopic dermatitis since childhood that had not been adequately treated. Chest computed tomography showed multiple peripheral nodules and infiltrates in both lungs. A transthoracic echocardiogram detected vegetation on the wall of the right ventricle, and Staphylococcus aureus was cultured from a peripheral blood sample. She was diagnosed as having a septic pulmonary embolism associated with right-sided infective endocarditis caused by S. aureus. She was treated with Cefazolin, resulting in gradual improvement of laboratory and chest radiographic findings. Recent studies have revealed that atopic dermatitis is one of the risk factors for infective endocarditis. In this case, uncontrolled atopic dermatitis might have caused the right-sided infective endocarditis.

著者

小山 孝

出版者

一般社団法人 日本感染症学会

雑誌

感染症学雑誌 (ISSN:03875911)

巻号頁・発行日

vol.53, no.5, pp.243-257, 1979-05-20 (Released:2011-09-07)

参考文献数

23

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Time course studies were carried out on splenic lymphoid cell subpopulations, serum antibody titer and weight of the spleens in mice infected with Rickettsia sennetsu and Rickettsia tsutsugamushi of high and low virulent strains.1. All of the mice infected with R. sennetsu Miyayama strain died in two weeks. In this case, weight of the spleens and the number of lymphoid cells, both T and B cells, increased trasiently at the time of manifestation of symptoms, and decreased later at the late stage.When the mice infected with R. sennetsu Miyayama strain were treated with tetracycline, the spleens enlarged till the convalescence and then constricted to near normal range. They enlarged with the recrudescence and constricted again when symptoms of the mice became severe, and the mice died finally in spite of the treatment. In lymphoid cell subpopulations of the spleens, T cells began to increase first at a start of the treatment. Increase of B cells, on the other hand, ocurred later at the convalescence. Lymphoid cell subpopulations of the spleens returned to normal range temporarily when the mice were recovered by the treatment. However, the number of lymphoid cells of the spleens, both T and B cells, decreased again when the mice had a relapse of the disease and became in a critical condition after discontinuance of tetracycline therapy.High titers of serum antibodies were observed at the 4th week after infection and were maintained even when the mice relapsed into the disease and were in a critical condition.2. Most of the mice infected with Gilliam strain of high virulent R. tsutsugamushi died in two weeks. In this case, weight of the spleens and lymphoid cell subpopulations of the spleens showed changes similar to those observed in mice infected with R. sennetsu. But occasionally some of the mice were long-survived. In these mice, the spleens enlarged till the convalescence and then constricted to near normal range. In lymphoid cell subpopulations, T cells increased first prior to the convalescent stage, whereas, increase of B cells ocurred when the mice recovered.High titers of serum antibodies were observed at the 4th week after infection and were maintained for a long time.3. The mice infected with Irie strain of low virulent R. tsutsugamushi progressed subclinically. In this case, the spleens began to enlarge from the 2nd week to the 3rd or the 4th week after infection and c/a then constri ted to near normal r nge. T cells in the spleens began to increase at the 2nd week. On the other hand, B cells continued to decrease till the 3rd week and then increased. Finally, the number of lymphoid cells of the spleens and their subpopulations recovered to normal range.Serum antibodies were detected at the 2nd week after infection. They reached to high titers at the 4th week and were maintained in high titer for a long time.These findings suggested that increase of T cells had a very important role on recovering from rickettsial infections and that humoral immunity could not prevent the development of the rickettsial infections but cellular immunity could prevent it.

著者

秋田 博伸

出版者

一般社団法人 日本感染症学会

雑誌

感染症学雑誌 (ISSN:03875911)

巻号頁・発行日

vol.56, no.12, pp.1203-1215, 1982-12-20 (Released:2011-09-07)

参考文献数

17

被引用文献数

12 1

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抗生剤抗与による副現象は現在まだ避け難いものとして多くの問題も残しているが, その内, 腸内細菌叢の変動は臨床上よく遭遇するものである. 著者はこの変動を検討する為にIsolator内で, 同一飼料にて飼育した無菌マウスを使用し, 腸内細菌叢の主要構成菌, Gram陽性, 陰性, 嫌気性のうち4種を選択し, 下記の如く, 単一, 2種, 4種感染マウスを作成し, 従来Gram陰性菌に対して用いられたABPC, GMと現在, 尚開発の盛んなCephem系薬剤を筋肉内へ投与した時の腸内細菌叢の変動を検討した.(1) E.coli単一感染マウス(2) Ecoli, Lacto.2種感染マウス(3) E.coli, St.faecalis, Lacto, Bac.4種感染マウスその結果, 胆汁排泄の少ないといわれるGM, CETの投与例では, 菌の減少は認めなかった.ABPC投与例では単一感染マウスでE.coliに対するABPcのMlc値の上昇を投与2日目より全例に認め菌数の変動は認めなかったが, 2種, 4種感染マウスではMIC値の上昇は認めず, E.coli, Lacto.で菌数減少を認めた.CEZ投与例ではE.coliの著明な減少を認めたが, Bacは著明に減少する例と, 軽度減少する例とを認めた.St.faecalisの減少は認めなかった.CMZ, LMOX, CMX投与では, 投与3日目よりE.coli, Bac.の著明な減少を認め, CMX投与例ではLacto.も同時に著明に減少した.St.faecalisは菌の減少を認めなかった.以上の結果, 胆汁排泄が良く, 広域スペクトルを有する抗生剤を筋肉内投与すると, 感受性菌の減少, 耐性菌の残存という菌交代を惹起させる傾向を認めた.

著者

宮本 泰 児玉 威 秋山 昭一 滝沢 金次郎 松島 章喜

出版者

一般社団法人 日本感染症学会

雑誌

感染症学雑誌 (ISSN:03875911)

巻号頁・発行日

vol.44, no.1, pp.9-11, 1970-04-20 (Released:2011-09-07)

参考文献数

3

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A type distribution survey of A Group Streptococci was conducted cooperatively with twelve institutions including hospitals and public health laboratories in Japan. Six hundred eighty strains of Streptococcus pyogenes were collected, of which 506 were mainly from scarlet fever patients and 174 were from healthy carriers. The alteration of the patterns of main predominant types for the past six years was also depicted.While type 4 strain has gradually been decreasing for the past six years, type 6 strain had once increased to such an extent that the replacement of the former with the latter was about to happen. Being suppressed, however, by the rapid uprise of type 12 strain, type 6 strain has come to decrease again since 1967, thus permitting type 1- and type 2 str ins come to the front to cover the room corresponding to the depression of type 4- and type 6 strains.In April 1968 to March 1969 type 12 representing the absolute predominance (36.9%) for the period was attended by four other principal types 4, 6, 22 and 1. These types were with a slight difference in percentage, almost evenly distributed and seemed to compete with each other, thus exhibiting a trend of multipolarity.The isolation of B3264 and 5/27/44 seemed to be a characteristic of the group of our healthy cartiers. Despite the predominance of type 12 strain we seldom encountered nephritis cases or related syndromes.

著者

池田 苗夫

出版者

一般社団法人 日本感染症学会

雑誌

感染症学雑誌 (ISSN:03875911)

巻号頁・発行日

vol.48, no.4, pp.131-138, 1974-04-20 (Released:2011-09-07)

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1) A special hemogram: red cells have tendency to increase at the earlyphase and decrease after haemorrhagic phase; in the acme appeared reticulocyte; generally hemogrobin has decreasing tendency. White blood cells show a slighly decrease in the beginning, but increase at the pyrogenetic stage (febriletime); early in the second day of the pyretolysis or late in the several days return to normal. In the leucocyte analysis, the increase of the neutrophile leucocyte was seen; a marked shift to the left is noted in the beginning; myelocyte and metamyelocyte at times appear; mean nuclei counts show a high value 1.5-2.0; distinct vacuolated leucocyte and toxic granules are present in the pyrogenetic stage and the acme. The appearing and disappearing of eosinophile leucocyte are not distinct like typhoid disease. Mononuclear leucocytes and plasmacells a little increase; basophile leucocytes are present in the beginning, but basophile leucocytes are hardly seen in the acme; the platelet number decreases from the beginning and then increases and return to normal but in the patient of grave prognosis the counts remain low. I indicate the thrombopenie as a prognostically important factor of the Epidemic Hemmorrhagic Fever.2) Urinalysis: urobilinogen and urobilin or Diazo tests showed questionable results, but Indican test at times was positive. On the convarescence, the amount of the urine increased and urinary albumin and casts and flocks disappeared.

著者

池田 苗夫

出版者

一般社団法人 日本感染症学会

雑誌

感染症学雑誌 (ISSN:03875911)

巻号頁・発行日

vol.51, no.2, pp.59-61, 1977-02-20 (Released:2011-09-07)

著者

三木 寛二 吉崎 悦郎 田村 和満 坂崎 利一

出版者

一般社団法人 日本感染症学会

雑誌

感染症学雑誌 (ISSN:03875911)

巻号頁・発行日

vol.62, no.8, pp.708-711, 1988-08-20 (Released:2011-09-07)

参考文献数

12

被引用文献数

1

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最近報告された腸内細菌科の新菌種Enterobacter asburiaeをま, Enterobacter cloacaeに近似した生化学的性状をもつために, E. cloacaeと混同されていると思われたので, いままでの臨床分離E. cloacae150菌株を再同定したところ, 7株がE. asburiaeであった. これら7株はVoges-ProskauerテストでEasburiaeの記載陽性率がやや異なったが, これは用いた培地および方法の相違によるものと考察された. 7菌株の由来から, 本菌は日和見的感染菌と思われ, 現在一般に用いられている同定システムでは同定不能かまたはE. cloacaeと誤同定される. なお, 7菌株の薬剤感受性パターンもまたE. cloacaeに類似した.

著者

久保田 武美 石 和久 鈴木 正明 宇津野 栄 猪狩 淳

出版者

一般社団法人 日本感染症学会

雑誌

感染症学雑誌 (ISSN:03875911)

巻号頁・発行日

vol.73, no.3, pp.233-238, 1999-03-20 (Released:2011-02-07)

参考文献数

10

被引用文献数

3 4

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この研究の目的は子宮頸部のneoplasiaと最も関連深い高度・中等度risk typesのHPVによる感染の蔓延状況を知ることである.対象はSTDclinic受診例236例とcontrol群 (通常の婦人科外来受診者) 95例である.両群ともに, 子宮頸部擦過物を採取し, DNA診断法であるhybrid capture法を利用して, HPVの6, 11, 42, 43, 44型 (HPVA), 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68型 (HPVB) およびC.trahomatis, N.gonorrhoeaeの検出を試みた.分析にはFisherの直接法を用いた.HPVBの陽性率はSTD clinic受診群, コントロール群いずれの群においても最も高率であった.STD clinic受診群とcontrol群でのHPVBの検出率はそれぞれ47.5%, 5.3%であり有意差を認めた (p<0.00001).STD clinic受診者においては, 子宮頸部悪性病変のリスクを知るためにHPVの検査を施行する意義のあることが示唆された.