Inhibition of methicillin-resistant Staphylococcus aureus colonization of oral cavities in newborns by viridans group streptococci.

We investigated the role of viridans group streptococci in the prevention of colonization with methicillin-resistant Staphylococcus aureus (MRSA) in neonatal intensive care units. During a 26-month period at a children's hospital, 207 (49.9%) of 415 newborns were colonized with MRSA by the time of discharge. Two groups of newborns with matching durations of hospitalization were compared with regard to the prevalence of future colonization with MRSA: group 1 (103 patients) did not acquire colonization with viridans group streptococci and group 2 (63 patients) did acquire colonization with viridans group streptococci at birth or by 1 to 2 weeks (age, < or =11 days). The rate of colonization among patients in group 2 (9.5%) was significantly lower than that among patients in group 1 (44.7%; P<.001). No significant difference in patient characteristics (e.g., birth weight, diseases) was observed. These results indicate that viridans group streptococci, as bacteria that formerly occupied the oral cavities in newborns, may inhibit later colonization with MRSA.

H(2)O(2) produced by viridans group streptococci may contribute to inhibition of methicillin-resistant Staphylococcus aureus colonization of oral cavities in newborns.

In an accompanying report, we showed that viridans group streptococci may prevent methicillin-resistant Staphylococcus aureus (MRSA) colonization of the oral cavities of newborns. In the present study, we investigated the mechanism of prevention in vitro. Most viridans group streptococci had bacteriocin-like activity and killed MRSA, Burkholderia cepacia, Enterobacter aerogenes, and Pseudomonas aeruginosa; however, Escherichia coli, Enterobacter cloacae, and Candida albicans were resistant. The activity was induced only by H(2)O(2)-secreting strains and was inhibited by horseradish peroxidase or catalase in a dose-dependent manner. The mean concentration of H(2)O(2) produced by 18 strains of viridans group streptococci (1 x 10(8) cfu in 200 microL of culture medium+/-standard deviation was 1.24+/-0.60 mmol. Viridans group streptococci inhibited MRSA growth in saliva as well as in culture media. These results indicate that H(2)O(2) produced by viridans group streptococci may inhibit MRSA colonization of oral cavities in newborns.

Bacterial interference among nasal inhabitants: eradication of Staphylococcus aureus from nasal cavities by artificial implantation of Corynebacterium sp.

To evaluate the role of normal flora in the nares in preventing Staphylococcus aureus colonization, we conducted a replacement study in vivo. Staphylococcus epidermidis (rate of colonization: 100%), various species of corynebacteria (52.5%) and S. aureus (25.%) were the major bacterial inhabitants in the nares of 156 healthy volunteers. The low incidence of S. aureus colonization in the carriers with corynebacteria (8.5%), compared to non-carriers (44. 5%) indicated the possibility of competition for survival between S. aureus and corynebacteria. To confirm this hypothesis, we artificially implanted a strain of Corynebacterium sp (API Coryne bioprofile; 5100304), denoted as Co304 into the nares of 17 S. aureus carriers. S. aureus was completely eradicated in 71% of carriers by up to 15 inoculations of Co304. However, similar doses of 0.9% NaCl or S. epidermidis into the nares of 10 volunteers did not eradicate S. aureus. No bacteriocin-like activity against S. aureus was detectable, even after mitomycin C stimulation of Co304. Thus Co304 interfered with S. aureus by a different mechanism to a bacteriocin-like activity.

Holistic approach to health education on AIDS.

OBJECTIVE: To identify a method for health education using the example of an educational seminar on AIDS prevention and control at Hebei Medical University in China, 1994. METHODS: Our goal is the theoretical formulation of a unified community approach for problem solving through the combination of the self regulative approach and the case analytical approach. "Quality improvement", "essential quality" and "human ecosystems" provide the basic ideas for better understanding the integration of culture, science and technology within the "cultural norm". RESULTS: The present seminar was successfully organized for Chinese medical students based on the theme of "living with AIDS". Through this program, we identified that self regulative and case analytical approach were major issues for holistic approach to health education. We also identified that a community approach provides the scientific basis for health education in the community. CONCLUSIONS: The present paper generates a healthcare paradigm for surveillance in health/medical education. Through a better understanding of community approach, we related "community care" (emphasizing self, mutual, professional and institutional care) to the "practical norm"; and "preventive epidemiology" (emphasizing the unification of quality and quantity, as well as systems and population) to the "research norm".

Major allergens in soybean and clinical significance of IgG4 antibodies investigated by IgE- and IgG4-immunoblotting with sera from soybean-sensitive patients.

BACKGROUND: Soybean occasionally causes food allergy but its major allergens have not been sufficiently confirmed. The relationship between food allergy and food-specific IgG4 has also not been defined. OBJECTIVE: We investigated the allergenicity of soybean proteins and the clinical significance of soybean-specific IgG4. METHODS: We detected IgE- and IgG4-binding proteins in soybean by immunoblotting with sera from 30 soybean-sensitive patients (including seven patients with positive soybean challenge tests). The extract from soybeans was fractionated into the whey fraction and the globulin fraction. RESULTS: Ten and eight proteins were detected as IgE- and IgG4-binding proteins, respectively, with a significant difference between the patient and control groups. Among the IgE-binding proteins, the proteins with molecular weights of 20,000 and 58,000 in the whey fraction, and 26,000 and 31,000 in the globulin fraction, had a particularly high IgE detection rate and high specificity. Two patients with positive challenge tests showed a quite different pattern in which only a protein with a molecular weight of 78,000 in the globulin fraction was detectable with serum IgE in both patients. The majority of IgG4-binding proteins were not consistent with the IgE-binding proteins. The strong reactivity of IgG4 was observed in all five infants among seven patients with positive challenge tests, and three of them had a very weak IgE reactivity. CONCLUSIONS: There were various antigenic proteins in soybean. Five proteins with molecular weights of 20,000 and 58,000 in the whey fraction, and 26,000, 31,000 and 78,000 in the globulin fraction, were considered major allergens in the IgE-mediated reaction. Results of IgE- and IgG4-immunoblotting suggested that soybean-specific IgG4 may act anaphylactically in patients with soybean allergy.

[Orthodontic treatment of malocclusion with periodontitis].

Adults with untreated malocclusions suffer from more periodontal disease than if their malocclusion had been corrected orthodontically. What orthodontists can offer in the management of patients with periodontal disease, how they can help the periodontists and the patients, and how the periodontists can help the orthodontist make treatment safe and purposefully are widely discussed. The purpose of this study is, therefore, to discuss how orthodontic patients with severe periodontitis could be treated and what we should do for these patients during the treatment as well as at their initial visit. One case is presented as an example of treatment for malocclusion with sever periodontitis: The patient was a 23 years 8 months female with a chief complaint of protrusion of upper incisors. Since clinical examination revealed severe periodontitis, periodontal treatment was undertaken for one year prior to orthodontic treatment. From these observations, we are conviced of the importance again of the global approach and the team treatment method in treating malocclusions with periodontitis.

[An alternative theory and practice on preventive medicine with special emphasis on total cancer studies].

In order to solve our common problems on preventive medicine as well as health promotion, we have developed "General Network (GN) Approach" based on our general hypothesis "GN Concept" which should be deeply rooted among ourselves. The present paper is the application of the above approach into cancer control measures with special emphasis on the introduction of an alternative theory and methodology on preventive medicine. The main thrust of the paper is the schematic presentation on the function (theory) and structure (methodology) of preventive medicine by means of GN Model, including the methodologic illustration on (paradigm change) on the subject. It should be mentioned that GN Approach is applied for the common problem solvings on cancer prevention, epidemiology, etiology, and control systems by means of the realization of "Two-in-One" Concept. This in turn means that GN Approach should be one of pragmatic candidates for the general problem solvings.