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Author

Hideyo Noguchi

Bio: Hideyo Noguchi is an academic researcher from Rockefeller University. The author has contributed to research in topics: Bartonella bacilliformis & Carrion's disease. The author has an hindex of 21, co-authored 127 publications receiving 1547 citations.


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Journal ArticleDOI
TL;DR: The patient was admitted in an hallucinatory depression with nihilistic ideas and a history of a probable attempt at suicide, and the duration of the disease before admission is unknown.
Abstract: s of the case records follow. J. C. ( Io3) , age fifty years ; durat ion of disease unknown. He was committed from the workhouse. There was much confusion; he was disoriented and his memory was extremely poor. The knee-jerks were unequal and exaggerated; the pupils sluggish and unequal. His speech was distorted, and there were marked tremors. Convulsions occurred. Death occurred af ter seven months in the hospital. C. M. ( io6) , age thir ty-nine years; durat ion unknown, but probably about four months. Syphilis ten years previously. W h e n he was admitted he was depressed and apprehensive; he had hallucinations of hear ing; he was disoriented, and his memory was very poor, with spells of marked confusion. The Noguchi, H., Jour. Am. Med. Assn., I912 , lix, I236. Hideyo Noguchi and J. W. Moore. 285 knee-jerks were normal, the pupils sluggish. There were ataxia, distorted speech, coarse tremors, and convulsions. He died after eleven months in the hospital. F. B. ( I I3) , age thirty-six years; duration before admission, fourteen months. Syphilis was denied. On admission he was dull, silly, mildly restless, and had occasional hallucinations. His memory showed marked discrepancies. The knee-jerks were absent, and the pupils slow to light and unequal. His speech was distorted, and he had convulsions. Later he developed a silly elation and deteriorated progressively. Death occur red 'a f te r fourteen months in the hospital. The total duration of the disease was thirty months. S. V. ( I3I ) , colored, age thirty-seven years; the duration of the disease before admission is unknown. Syphilis eight years previously. He was euphoric, his memory was very poor, and he was disoriented. The knee-jerks were much diminished, the pupils slightly slow, his speech ataxic, and there were coarse tremors. Later he developed typical expansive ideas and became very ataxic. Death occurred after twenty-seven months in the hospital. J. D. (I38), age thirty-three years; duration before admission, five months. He was admitted in an hallucinatory depression with nihilistic ideas and a history of a probable attempt at suicide. A complete mental status was impossible. The knee-jerks were exaggerated ; pupils unequal, Argyll-Robertson sign present ; there were marked tremors. The spinal fluid showed marked lymphocytosis. Death occurred after ten months in the hospital. F. M. (I59), age fifty-five years; duration of disease unknown. He was picked up on the street in a confused condition. He had absurd hypochondriacal ideas; \" his insides were falling out,\" etc. He was disoriented and his memory was very poor. The knee-jerks were exaggerated, and the pupils sluggish. There were marked tremors, unsteadiness, and Romberg's sign. His speech was not seriously affected. Depression continued, and he insisted that he could not breathe or urinate, and that parts of him were dead. He died after four months in the hospital. The spinal fluid showed positive lymphocytosis and a positive W:assermann-Noguchi reaction. E. W. (I7o), age forty-four years; duration unknown. He had had syphilis. The psychosis was a simple deterioration with marked confusion and disorientation but no delusions. He was silly, his memory was poor, and there were occasional attacks of excitement. Thekneej e rks were diminished, and the pupils slightly slow. The speech showed extreme ataxia. Romberg's sign was present, and tremors were prominent. There were frequent convulsions. Death occurred after two months in the hospital. E. R. (23o), age forty-eight years; duration unknown. When admitted she was much demented, confused, completely disoriented, and her memory was poor. Her mood was one of silly elation. The knee-jerks were exaggerated, the pupillary reaction slow and of narrow range. There was marked distortion of speech and writing. There were coarse tremors and increasing ataxia. The spinal fluid showed marked pleocytosis. Death occurred after six months in the hospital. 286 Demonstration of Treponema pallidum in the Brain. M. M. (235), age forty-two years; duration uncertain. She had been blina from optic atrophy for two years before admission and had experienced occasional visual hallucinations, but definite mental symptoms seem to have begun only a few weeks before commitment, when she began to show a change of disposition and became forgetful. Syphilis probably occurred twenty years previously. Her husband was a paretic. On admission she was excited, resisting, and obscene. She seemed clear and gave correct answers in the orientation test but her memory showed marked discrepancies in time relations. The knee-jerks were absent, the pupils rigid, her speech drawling and distorted, no tremors, and only slight ataxia. The spinal fluid showed extreme lymphocytosis. She quieted down, and during the next two years showed a gradual deterioration without any particular mental trend. Ataxia increased steadily; she had occasional apoplectic attacks and convulsions. Death occurred after two years in the hospital. G. F. (236), age sixty years; duration before admission, one month. He became gradually childish, forgetful, and irritable. When admitted he was disoriented, and his memory was poor. The knee-jerks were absent, and the pupils unequal and slow; his speech was slurring and distorted. There were marked tremors and Romberg's sign. He deteriorated rapidly and died after four months in the hospital. M. D. (242), age thirty-seven years; duration eight months. The onset seemed to date from an injury to the head. There was a probable history of syphilis. He was depressed, confused, and had attempted suicide. His memory was poor, and he was much demented. The knee-jerks were exaggerated; and the pupils unequal and Argyll-Robertson sign present; his speech was ataxic. There were tremors and occasional convulsions. He died after four months in the hospital. The total duration of the disease was one year. F. B. (299) (figure I), age fifty-eight years; duration before admission, one month. There was a probable history of syphilis. He was depressed and whining, and had typical paretic ideas, such as that his bowels never moved, and that he had an incurable disease. He would point to a leg or an arm and say, \" See, it's all dead, all gone,--there's no hope.\" His orientation and memory showed marked defects. The knee-jerks were slightly exaggerated, the pupils slow, his speech was distorted, and tremors were excessive. The spinal fluid showed pronounced lymphocytosis and a positive Wassermann-Noguchi reaction. Death occurred after eleven months in the hospital. N a t u r a l l y the first ques t ion that ar ises is, A r e these no t cases of cerebra l syphi l is in the n a r r o w e r sense? I n reply to this we can but rev iew br ief ly the d i f fe rent ia l points . T h e y all showed, in the i r c l inical course, a diffuse, p rogress ive de t e r i o r a t i on in all the men ta l fields, and no t the demence lacu~aire so o f t e n observed in syphi l i t ic b r a i n disease. T h e r e were i10 c ran ia l s y m p t o m s or o ther focal man i f e s t a t i ons . These po in ts are admi t t ed ly no t conv inc ing , for it is possible for an old syphi l i t ic e n d a r t e r i t i c m e n i n g i t i c cond i t i on to Hideyo Noguchi and J. W. Moore. 237 simulate paresis so closely as to be indistinguishable by its clinical features from the latter disease. It is upon the post-mortern findings that the diagnosis must depend. Anatomically the brains of our cases showed the usual pial thickening, more marked over the frontal convexity. In two it was also prominent over the gyri recti, cerebellum, and cisterna, but it did not assume the degree of meningitis usually seen in syphilis of the base. In one case (235) there was an old hemorrhagic membrane beneath the dura; in another (131) there was a marked preponderance of the paretic process in the right hemisphere, but these conditions were not represented clinically and the findings were otherwise typical. In the microscopic examination the meningeal process in all cases was diffuse, being more marked in the frontal region. The vessel infiltration was also diffuse and found at all depths of the cortex and in the marrow. Plasma cells were, in each case, numerous and usually outnumbered the lymphocytes. RQd cells were always present. The nerve cell alterations and changes in the neuroglia do not present differential characteristics and will not be enumerated. With regard to the vessels, a number of our cases, as in all general paralysis material, showed endarteritic changes. In six there was definite thickening of the vessel walls of the type described as syphilitic. In no instance did the intimal proliferation embarrass the lumen to any extent. In the remaining cases the vessels appeared normal. It seems hardly possible that the presence of the spiroch~etm could be traced to the luetic endarteritis, since they were not found associated, at least with those vessels which are visible with the Levaditi stain. In none of the cases were there softenings, and no gummata were found either in gross or microscopically. The spiroch~et~e were found in all layers of the cortex with the exception of the outer, or neuroglia layer. One was located at the border of this layer, 'but not within it. A few were found subcortically. Careful search of the pia failed to reveal any of the organisms. In all instances they seemed to have wandered into the nerve tissue. They were not found in the vessel sheaths and seldom in close proximity to the larger vessels. There seems to be no ratio between the number of spirocha~t~e and the severity of the 238 Demonstration of Treponema pallidum in the Brain. paretic process, a l though the case in which they were most numerous showed excessive paretic changes. Whe the r or not, by improving the technique, Treponema pallidum can be demonstra ted in a much higher percentage of paretic cases will be determined by fur ther inves

115 citations

Journal ArticleDOI
TL;DR: Nine strains of herpetomonads have been isolated in pure culture from eight varieties of insects, and three strains from two species of plants, which represent two distinct species, which have been designated H. oncopelti and H. lygaegorum.
Abstract: Nine strains of herpetomonads have been isolated in pure culture from eight varieties of insects, and three strains from two species of plants. Four of the cultures were derived from latex-feeding insects (Oncopeltus fasciatus, Oncopeltus sp. ?, Lygaeus kalmii) and three from latex plants (Asclepias syriaca, Asclepias nivea), two from mosquitoes (Culex pipiens and Anopheles quadrimaculatus), one from the house fly (Musca domestica), and two from bluebottle flies. In addition impure cultures have been obtained from Oncopeltus cingulifer and from its plant host, Asclepias curassavica. The flagellates cultivated, all of which belong to the genus Herpetomonas, have been identified chiefly by their biological relationships, which will be described in detail in Part II of this report. The seven strains from latex-feeding insects and latex plants represent two distinct species, which have been designated H. oncopelti and H. lygaegorum. The two strains from mosquitoes proved to be the same organism and have been called Herpetomonas culicidarum. The culture obtained from Musca domestica contained larger individuals than those of any other strain, and the organism is morphologically distinct from either of the Calliphora strains. None of the fly flagellates cultivated could be identified with the. species H. muscae domesticae or H. calliphorae, and hence they have been given new names, Herpetomonas muscidarum, H. media, and H. parva. Blood agar plates were used for initial cultivation of the strains from insects and the semisolid leptospira medium for isolation of the plant flagellates. A number of the strains were purified by plating on acid blood agar, a procedure which reduces considerably the growth of bacterial contaminants. The Barber technique was utilized for isolation of the flagellates from flies, because of the very large number of bacteria found with them in these insects, and, in one or two instances, for the purification of impure cultures. Once they have been obtained in culture, all the strains grow well on leptospira medium, as well as on blood slants. Growth takes place both at 26 degrees C. and at 37 degrees . The morphology of the organisms is considerably modified by cultivation. This is especially true of the plant flagellates. In the latex they have ribbon-like bodies, often twisted, and comparatively short flagella; the protoplasm is clear, almost hyaline. The flagellates seen in the gut and feces of insects are usually large, slender organisms, with flagella as long as or even longer than the body, which contains numerous volutin granules in the cytoplasm. In cultures under parallel conditions the flagellates from both these sources become shorter and thicker, the plant forms no longer appear flat and ribbon-like, and in general the organisms approach one another in morphological features. Even in the case of the least modified insect flagellates, i.e. those from flies, there is never exact correspondence between the natural and the cultivated forms. The morphological features of the cultivated flagellates vary according to the medium on which the organisms are grown and the age of the culture. The flagellates grown on the surface of blood slants are pyriform, with truncated anterior portion, and short flagellum; in the condensation water, however, the individuals are elongated and have long active flagella. On the leptospira medium the slender active forms with long flagella predominate. In the presence of fermentable carbohydrate, or in medium containing considerable acid, peculiar bifurcated or multifurcated individuals are seen. Similar forms have been seen under natural conditions. Cultures of Leishmania behave in the same way under the conditions described. There is a striking difference in rapidity of growth between the organisms isolated by us and the leishmanias, H. ctenocephali, and T. rotatorium. While the stock cultures of the group first mentioned multiply rapidly at 37 degrees C., growth becoming visible within 24 hours, the latter group grow scarcely at all at 37 degrees and only slowly at 25 degrees , 1 to 2 weeks being required for growth to become macroscopically demonstrable. While the flagellum of the leishmanias, as also of H. ctenocephali, is long, serpentine in its movements, and heavy, having the appearance of being enveloped by a sheath throughout its entire length, that of the recently isolated strains is thin, less flexible, and without the sheathlike appearance. The only exceptions to this rule are the flagellates from Musca domestica and Calliphora No. 1, which have a long flagellum not unlike that of the leishmanias. As the foregoing observations indicate, morphological differentiation of the flagellates studied, while not impossible, is subject to error by reason of the variations due to age and cultural conditions. The flagellates of the latex-feeding insects, the plants, the flies, and the mosquitoes can readily be distinguished from Leishmania by their rapid growth at 37 degrees C., but their differentiation from one another is possible only by serological and fermentation reactions.

73 citations

Journal ArticleDOI
TL;DR: It is hoped that the creation of a new genus may facilitate a more exact morphological description than has hitherto been possible, due to the vague use of the term Spirochæta which indiscriminately covered at least six large genera of spiral organisms.
Abstract: The present study deals with the morphology and systematic position of the causative agent of infectious jaundice. There are several features which are not found in any of the hitherto known genera of Spirochaetoidea which led me to give this organism an independent generic name, Leptospira, denoting the peculiar minute elementary spirals running throughout the body. The absence of a definite terminal flagellum or any flagella, and the remarkable flexibility of the terminal or caudal portion of the organism are other distinguishing features. Unlike all other so called spirochetes the present organism resists the destructive action of 10 per cent saponin. A detailed comparative study of related genera, including Spirochaeta, Saprospira, Cristispira, Spironema, and Treponema, has been given with the view of bringing out more strongly the contrast between them and the new genus. A study has been made to discover whether any differential features exist among the strains of Leptospira icterohaemorrhagiae derived from the American, Japanese, and European sources, but none has been found. It is hoped that the creation of a new genus may facilitate a more exact morphological description than has hitherto been possible, due to the vague use of the term Spirochaeta which indiscriminately covered at least six large genera of spiral organisms.

63 citations

Journal ArticleDOI
TL;DR: The organism can be cultivated from the blood over a long period, and it has been detected within the red corpuscles of the monkeys, reproducing the precise appearances observed in human cases of Oroya fever.
Abstract: A pure culture of a microorganism resembling in morphology and pathogenic action Bartonella bacilliformis has been obtained from blood taken during life from a case of Oroya fever which ended fatally The blood taken at Lima into citrate solution and transported to New York at refrigerator temperature yielded positive cultures 28 days after its withdrawal from the patient The strain of Bartonella bacilliformis thus isolated grows well on the semisolid leptospira medium, and also on slant agar containing animal blood The initial growth is not readily recognizable to the naked eye, but the presence of the organisms can be determined by means of the dark-field microscope and by Giemsa and Gram staining methods No growth has been obtained on the more ordinary culture media The organism is an obligate aerobe, is Gram-negative, and under certain cultural conditions motile All the forms which have been described as occurring in human red corpuscles may be found in the cultures, and in addition many granular and coarsely irregular forms have been met with The inoculation of cultures of Bartonella bacilliformis into Macacus rhesus produces infection and gives rise to effects which differ with the mode of inoculation The intravenous injection of the culture into young macaques induces a prolonged irregularly remittent fever The organism can be cultivated from the blood over a long period, and it has been detected within the red corpuscles of the monkeys, reproducing the precise appearances observed in human cases of Oroya fever The intradermal injection of the culture into the eyebrow of young macaques gives rise to nodular formations rich in new blood vessels and showing the bacilliform organism within the endothelial cells From the experimentally induced nodules cultures of the organism are readily recovered

50 citations

Journal ArticleDOI
TL;DR: It is concluded that the spirochetes designated here as the Japanese, Belgian, and American strains are probably identical and a new genus, Leptospira, has been suggested as the designation of this organism.
Abstract: The principal points brought out in the present article are the following 1 Wild rats captured in this country carry in their kidneys a spirochete which possesses the morphological and pathogenic properties characteristic of Spirochata icterohamorrhagia discovered by Inada in the Japanese form of infectious jaundice 2 Cultures of the American, Belgian, and Japanese strains of the spirochete were obtained by a special technique described, the first two strains having been cultivated artificially for the first time 3 Animals actively immunized against the Japanese strain resist inoculation, not only of the same strain, but also of the Belgian and American strains The Belgian strain produces immunity equally effective against all three strains Experiments to ascertain whether the immunity afforded by the American strain also protects against the Japanese and Belgian strains are in progress 4 These findings warrant the conclusion that the spirochetes designated here as the Japanese, Belgian, and American strains are probably identical 5 On account of its distinctive features, a new genus, Leptospira, has been suggested as the designation of this organism

49 citations


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TL;DR: The roles of phlebotomines in the spreading of leishmaniases, sandfly fever, summer meningitis, vesicular stomatitis, Chandipura virus encephalitis and Carrión's disease are reviewed.
Abstract: Phlebotomine sandflies transmit pathogens that affect humans and animals worldwide. We review the roles of phlebotomines in the spreading of leishmaniases, sandfly fever, summer meningitis, vesicular stomatitis, Chandipura virus encephalitis and Carrion's disease. Among over 800 species of sandfly recorded, 98 are proven or suspected vectors of human leishmaniases; these include 42 Phlebotomus species in the Old World and 56 Lutzomyia species in the New World (all: Diptera: Psychodidae). Based on incrimination criteria, we provide an updated list of proven or suspected vector species by endemic country where data are available. Increases in sandfly diffusion and density resulting from increases in breeding sites and blood sources, and the interruption of vector control activities contribute to the spreading of leishmaniasis in the settings of human migration, deforestation, urbanization and conflict. In addition, climatic changes can be expected to affect the density and dispersion of sandflies. Phlebovirus infections and diseases are present in large areas of the Old World, especially in the Mediterranean subregion, in which virus diversity has proven to be higher than initially suspected. Vesiculovirus diseases are important to livestock and humans in the southeastern U.S.A. and Latin America, and represent emerging human threats in parts of India. Carrion's disease, formerly restricted to regions of elevated altitude in Peru, Ecuador and Colombia, has shown recent expansion to non-endemic areas of the Amazon basin.

575 citations

Patent
29 Jun 1994
TL;DR: A number of different embodiments of implantable probes have been disclosed as mentioned in this paper, including the use of an away of light emitting diodes (LEDs) (54) or solid-state laser dioders (LDs) inside the implantable probe and energized either using a storage battery power source, an inductively coupled external transformer, or with current provided in leads running through a flexible catheter that extends outside the patient's body to an external source.
Abstract: Light developed by an implantable probe (40) is used to illuminate a treatment site that has been perfused with a photoreactive agent. A number of different embodiments of implantable probes ace disclosed. Preferably, an away of light emitting diodes (LEDs) (54) or solid-state laser diodes (LDs) are mounted on a light bar (72) inside the implantable probe and ace energized either using a storage battery power source, an inductively coupled external transformer, or with current provided in leads running through a flexible catheter that extends outside the patient's body to an external source. The implantable probe (40) is normally intended to be disposed inside a patient's body during a surgical procedure, at a treatment site, and left in place for several days (or longer) after an incision is closed, while light produced by the away of LEDs (54) or solid-state LDs irradiates the treatment site.

487 citations