Microbiological and pathological examinations of the respiratory tract of young hamsters infected with Mycoplasma pneumoniae by inhalation of aerosol were carried out for up to a maximum of 98 days ...after infection. Mycoplasma pneumoniae organisms were found mainly in the pharynx and larynx for the first two weeks, then they continued to proliferate in the main bronchi or intrapulmonary bronchi for up to 98 days. On the third day after infection, inflammatory changes consisting mostly of infiltration with lymphocytes and monocytes appeared in the bronchial epithelium. These inflammatory changes proceeded to the peribronchial or interstitial tissues and reached a maximum on the 21st day after infection. After that, they showed a tendency to decrease and were replaced partially by atelectatic and emphysematous changes. These pathological processes seemed to be associated with the presence of Mycoplasma pneumoniae. On electron microscopic examination by the double staining and the ferritinantibody method, Mycoplasma pneumoniae organisms were found among cilia and microvilli of the bronchial epithelium during the first two weeks. Structures resembling mycoplasmas, which bound ferritin were also located among the debris of exfoliated cells from epithelium. As the inflammatory process spread, exfoliation and desquamation of bronchial epithelium and increase of mucus-secreting cells, became more marked and eventually vacuolation in the remaining epithelial cells, with an increased number of basal cells was seen throughout the epithelium. In the terminal stage the ciliary epithelium was replaced partially by squamous epithelium. These studies, especially the identification of intact mycoplasma organisms at the surface of the epithelial cells, suggested that this may be the site of growth of this organism in the respiratory tract.
A case of tracheopathia osteoplastica in a 62 year old woman is reported. She was admitted to our hospital because of an abnormal shadow in the chest x-ray which was point out the regular physical ...examination. The chest x-ray shows marked narrowing of the trachea, bilateral main bronchus and the truncus intermedius. The bronchofiberscope revealed characteristic findings, which showed multiple papillomas springing from the mucosa of the thrachea and bronchus and the diagnosis was confirmed by histological examination of biopsy material obtained with flexible bronchofiberscope. We studied the review of the 16th cases reported in Japan.
Endoscopic findings and TBLB histological findings were examined in 22 cases with hematological disorders, in the course of which subjective and objective respiratory symptoms occurred and ...bronchoscopy was performed. Intrathoracic lesions of these 22 cases comprised cellular infiltration of the tumor (5 cases), swelling of hilar and mediastinal lymph nodes (5 cases), pneumonia and pulmonary mycosis (4 cases), pulmonary carcinoma (2 cases), organized pneumonia (2 cases), acute bronchitis (1 case), in addition to chronic obstructive lung disease (2 cases) old pulmonary tuberculosis (1 case) and pneumoconiosis (1 case) as underlying diseases. Five cases in which bronchoscpic findings were obtained and which were all malignant lymphoma included the primarily submucosal type (4 cases) and primarily mucosal type (1 case). Of 5 cases with tumor cellular infiltration due to underlying diseases observed in the pulmonary area, 4 and 1 were ATL and Hodgkin's disease, respectively and TBLB obtained a definite diagnosis in 4. TBLB in addition to histological and clinical findings enabled us to obtain a diagnostic rate of 9/12 (75%) in 12 cases with various lesions in various areas of the lung, associated with hematological disorders. The only complication observed was slight pneumothorax in one case. For respiratory complications of hematological disorders, TBLB was considered to be useful as a comparatively safely test in certain cases.
Hayflick et al. (1965) reported that mycoplasma (M.) orale was isolated directly on PPLO agar from the bone marrow samples of patients with acute leukemia, but it has been still unknown whether M. ...orale has been identified as a pathogen in some kinds of human diseases. However, it has been generally accepted that M. orale does not have a pathogenicity in the human. In order to determine the significance of the existence of M. orale in the respiratory tract, experiments in the hamster infected with M. orale were performed. Materials and Methods; Young hamsters, 3 weeks old, were utilized. A suspension of M. orale strain containing 1.6-107 colony forming unit (CFU) per ml was introduced into the hamster by the inhalation of an aerosol spray. Throat swabs were cultured onto each of two PPLO agar plates at intervals of 2-3 days for up to 42 days after exposure. The hamsters were also sacrificed at intervals of 2 to 3 days. During this time, blood samples were taken for serological studies. Both lungs were removed aseptically for bacteriological and histological studies. For controls, a group of hamsters was infected with M. pneumoniae and a 2nd group was given PPLO broth alone. Then these animals were killed and evaluated by the same methods. Results; In the groups infected with M. orale and in those exposed to PPLO broth alone, only one hamster organisms isolated from the nasopharynx or from the lungs for up to 42 days after inoculation. In the M. orale group minimal histopathologic inflammatory changes including edema in the bronchus observed from 2 to 21 days after infection. In contrast, in the group infected with M. pneumoniae, organisms were present in cultures of the lungs of all of the hamsters in the maximum concentration of 108 CFU per ml during the period of observation. Further findings such as peribronchitis and interstitial pneumonitis were present in this group for up to 28 days. No significant differences were recognized in the serological and the hematological studies in these three groups.
As shown in the results reported in the previous part 1, M. orale had no pathogenicity for the hamster. In this report it was investigated whether the existence of M. orale and M. salivarium in the ...respiratory tract is common in normal asymptomatic individuals and in patients with respiratory diseases and if these organisms play any pathogenic role in the acute exacerbations of respiratory diseases. (a) Role of M. orale and M. salivarium in normal individuals. In 564 university students and 162 middle school students, mycoplasma isolations were made using TSB solution under aerobic and anaerobic (95% N2 + 5% CO2) conditions. Of the 726 isolations made, 541 (74.5%) were M. salvarium, 26 (3.6%), M. orale, 2 (0.3%), M. pneumoniae, and 77 (10.6%) were others and 80 (11.0%) showed no growth. There was no relationship between the mycoplasma isolations and the complement-fixation titers. M. orale and M. salivarium were not isolated more frequently from the patients with oropharyngeal pathology than from normal individuals. (b) Role of M. orate and M. salivarium of the patients with respiratory diseases. Six hundred forty-four specimens from the patients with respiratory diseases have been studied for mycoplasma. Mycoplasma species were isolated in 47.2% of total patients which included 37.6% of M. salivarium, 7.9% of M. orale, and 1.7% of M. pneumoniae. As shown in table 3, mycoplasma species have been isolated most frequently (61.5%) in the patients with bronchial asthma, followed by bacterialpneumonia (50.0%), and chronic obstructive lung diseases (49.0%). The isolation rate was lower in the patients with pulmonary tuberculosis and bronchiectasis. M. salivarium could be cultivated from only one of 18 specimens obtained by aspiration through a vinyl tube inserted transorally. No pathogenic correlation was noted between mycoplasma and bacterial organisms present in the oropharynx of the patients with respiratory diseases. However, from the group of patients treated with some antibiotics prior to specimen collection especially macrolide derivatives, tetracycline and kanamycin, lower mycoplasma isolation rates were found. The results reported in this study did not indicate that M. orale and M. salivarium had a significant pathogenic role in the respiratory tract diseases.
Tetracycline is expected to be as effective as erythromycin in the treatment of pneumonia due toMycoplasma pneumoniae. In this clinical trial 12 cases with pneumonia due to Mycoplasma pneumoniaewere ...given doxycycline (Vibramycin ‘Pfizer’), a long-acting derivative of tetracycline. Judging from time periods required for defervescence, improvement in symptoms such as cough and disappearance of shadows on chest X-ray, the therapeutic effect of doxycycline was excelletit in 8 cases and good in 4 cases.
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