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Background: Surgical antimicrobial prophylaxis (SAP) is one of the major purposes of antimicrobial use.Aim: To determine the adherence to the Japanese SAP guidelines in Japanese university hospitals.Methods: This was a retrospective cohort study including 15 general hospitals and one dental university hospital. Up to three cases of 18 designated surgeries were evaluated regarding adherence to Japanese SAP guidelines: selection of antibiotics, timing of administration, re-dosing intervals, and duration of SAP. When all items were appropriate, surgery was defined as 'appropriate'.Findings: In total, 688 cases (22-45 cases per surgery) were included. The overall appropriateness was 46.8% (322/688), and the appropriateness of each surgery ranged from 8.0% (2/25, cardiac implantable electronic device implantation) to 92.1% (35/38, distal gastrectomy). The appropriateness of each item was as follows: pre/intraoperative selections, 78.5% (540/688); timing of administrations, 96.0% (630/656); re-dosing intervals, 91.6% (601/656); postoperative selection, 78.9% (543/688); and duration of SAP, 61.4% (423/688). The overall appropriateness of hospitals ranged from 17.6% (9/51) to 73.3% (33/45). The common reasons for inappropriateness were the longer duration (38.5%, 265/688) and choice of antibiotics with a non-optimal antimicrobial spectrum before/during, and after surgery (19.0%, 131/688 and 16.9%, 116/688, respectively), compared to the guideline.Conclusions: Adherence to the guidelines differed greatly between the surgeries and hospitals. Large-scale multi-centre surveillance of SAP in Japanese hospitals is necessary to identify inappropriate surgeries, factors related to the appropriateness, and incidences of surgical site infections. [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare the postoperative analgesic effects of ultrasound-guided posterior quadratus lumborum block with spinal morphine, after cesarean section, using the visual analogue scale pain score.Methods: One-hundred-and-seventy-six pregnant women scheduled for elective cesarean section with spinal anesthesia were randomly allocated into four groups to receive spinal morphine 0.1 mg (group M+); spinal saline (M-); posterior quadratus lumborum block using either 0.3% ropivacaine (0.45 mL/kg each side, maximum 150 mg) group pQ+); or saline (pQ-). All patients received 11-13 mg hyperbaric bupivacaine 0.5% and 10 μg fentanyl. Intravenous droperidol, fentanyl and acetaminophen were administered during surgery. Bilateral posterior quadratus lumborum block was performed immediately after surgery. Postoperative pain was assessed at 0.5, 1, 2, 4, 6, 18 and 24 h after surgery, and the pain score 6 h after surgery was the primary endpoint.Results: One-hundred-and-forty-six patients were included in the final analysis. Pain scores 6 h after surgery, both at rest and when moving, were significantly different when comparing the M+pQ+ group with the M-pQ+ or M-pQ- groups, and when comparing the M+pQ- group with the M- pQ+ or M- pQ- groups (all P <0.05). There was no significant difference between the M+pQ+ and M+pQ- groups, or between the M-pQ+ and M-pQ- groups.Conclusion: Spinal morphine improved postoperative analgesia but the combination of posterior quadratus lumborum block with spinal morphine did not lead to further improvement. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the expression of tumour endothelial marker 8 (TEM8) in canine mammary gland tumours (MGTs) by immunohistochemistry and to evaluate the association between tumour cell TEM8 expression and tumour histological features, histological grades and expression of luminal and basal/myoepithelial cell markers. TEM8 expression was detected in >60 % of neoplastic epithelial cells in all simple adenomas (n = 25), simple carcinomas (n = 43) and invasive micropapillary carcinomas (n = 5) studied. Six of the 18 solid carcinomas studied showed TEM8 expression in >60% of carcinoma cells present in solid structures and in 12 of the 18 solid carcinomas, <30% of the luminal structure-forming carcinoma cells showed TEM8 expression. TEM8 expression in the neoplastic cells was not associated with histological malignancy in canine MGTs. TEM8+ tumour cells frequently showed the luminal-like phenotype cytokeratin (CK)19+/p63−/α-smooth muscle actin (SMA)−, while most TEM8− tumour cells exhibited the basal-like phenotype CK19−/p63+/αSMA−. These findings indicate that TEM8 may be involved in maintaining the characteristics of luminal cells in canine MGTs and that TEM8 would be useful in identifying the type of neoplastic epithelial cell in MGTs. [ABSTRACT FROM AUTHOR]

Histidine-rich glycoprotein (HRG) is a multifunctional plasma glycoprotein involved in the regulation of coagulation, fibrinolysis, and inflammation. Recently, decreased plasma levels of HRG at 72 hours after lung transplantation (LT) has been shown to be associated with severe primary graft dysfunction and decreased overall survival after LT. In this study, we investigated the effect of supplementary HRG treatment on lung ischemia-reperfusion injury (IRI) using a mouse hilar clamp model. Mice were divided into the four groups, including the sham-operated group, the IRI group with supplementation of PBS, human serum albumin, or HRG (the HRG group) (n=5 for each group). We assessed lung function, lung injury, pulmonary neutrophil infiltrations, lung cell apoptosis, and inflammatory mediator expression between the groups. Compared to the other groups, the HRG group had significantly better PaO 2 and significant attenuation of lung injury (Figure). In the HRG group, neutrophil infiltration and prevalence of apoptotis in the reperfused lung was significantly less than the other groups. Moreover, the expression of neutrophil-associated inflammatory mediators in the reperfused lung, including CXCL1, MIP-1α, MIP-1β, G-CSF, GM-CSF, IL-1β, IL-6, and IL-10, were significantly decreased in the HRG group. In this study, supplementary HRG treatment suppressed neutrophil-associated inflammatory responses and improved lung IRI in a mouse. HRG may be a potential therapeutic agent for lung IRI. [ABSTRACT FROM AUTHOR]

We developed a new type of electron trajectories simulation inside a complete model of a modern transmission electron microscope (TEM). Our model incorporates the precise and real design of each element constituting a TEM, i.e. the field emission (FE) cathode, the extraction optic and acceleration stages of a 300 kV cold field emission gun, the illumination lenses, the objective lens, the intermediate and projection lenses. Full trajectories can be computed using magnetically saturated or non-saturated round lenses, magnetic deflectors and even non-cylindrical symmetry elements like electrostatic biprism. This multi-scale model gathers nanometer size components (FE tip) with parts of meter length (illumination and projection systems). We demonstrate that non-trivial TEM experiments requiring specific and complex optical configurations can be simulated and optimized prior to any experiment using such model. We show that all the currents set in all optical elements of the simulated column can be implemented in the real column (I2TEM in CEMES) and used as starting alignment for the requested experiment. We argue that the combination of such complete electron trajectory simulations in the whole TEM column with automatic optimization of the microscope parameters for optimal experimental data (images, diffraction, spectra) allows drastically simplifying the implementation of complex experiments in TEM and will facilitate the development of advanced use of the electron microscope in the near future. [ABSTRACT FROM AUTHOR]

Lung emphysematous changes may develop in patients with chronic lung allograft dysfunction (CLAD) after lung transplantation (LT). To evaluate the severity of lung emphysema, the percentage of low attenuation area (LAA%) of the bilateral lungs calculated on computed tomography has been shown to be a useful index. This study aimed to investigate whether the LAA% was associated with the development of CLAD after bilateral LT. We conducted a single-center retrospective study of 75 recipients who underwent bilateral LT from May 2008 to August 2015. The LAA% on computed tomography were calculated and compared between the CLAD group (N = 30) and the non-CLAD group (N = 45) from 2 years before to 4 years after the diagnosis of CLAD. The LAA% at 5 years after bilateral LT was designated as the control value in the non-CLAD group. The Pearson product-moment correlation coefficient was calculated between the LAA% and the percent baseline values of the forced expiratory volume in 1 s (FEV1), the forced vital capacity (FVC), and the total lung capacity (TLC) at the diagnosis of CLAD after bilateral LT. The median observation period after LT was 3277 (380-7691) days. The LAA% in the CLAD group was significantly higher than that in the non-CLAD group from even 2 years before the diagnosis of CLAD to 2 years after the diagnosis of CLAD (P < 0.05) (Figure 1). The difference in the LAA% between the CLAD group and the non-CLAD group tended to increase after the onset of CLAD. Furthermore, the LAA% was significantly correlated with the percent baseline values of the FEV1, the FVC, and the TLC (FEV1, r = -0.36, P = 0.0031; FVC, r = -0.27, P = 0.027; TLC, r = -0.40, P < 0.001) (Figure 2). The LAA% was associated with the development of CLAD and increased after the diagnosis of CLAD. Moreover, the LAA% was associated with declines in the FEV1, FVC and TLC at the time of CLAD diagnosis. The LAA% appears to have the potential to predict CLAD after bilateral LT. [ABSTRACT FROM AUTHOR]

Abstract: The switching dynamics of the current biased intrinsic Josephson junctions of (Hg,Re)Ba2Ca2Cu3O y [Hg(Re)1223] with typical dimensions of 1.0×1.55×0.11μm3 was investigated. The junction was fabricated using a focused Ga+ion beam from a single crystal grown by the flux method. The critical current density of IJJs was as high as 380–530kA/cm2 at 5K owing to its high T c and relatively low anisotropy of Re doped Hg system. At a given temperature, the switching current distributions, P(I), from the zero-voltage state to a nonzero-voltage state showed several maxima, which indicated the presence of several differing fluxon configurations in the junction. The temperature dependence of P(I) could be fitted well by a simple thermal activation model between 4K and 20K. [Copyright &y& Elsevier]

BACKGROUND: Secondary hyperparathyroidism is observed in patients with early chronic kidney disease (CKD). This study investigated the safety and efficacy of cinacalcet for secondary hyperparathyroidism in participants with CKD not receiving dialysis. STUDY DESIGN: Double-blind, randomized, 32-week, phase 3 study. SETTING & PARTICIPANTS: 404 participants with stage 3 or 4 CKD from 73 centers in 9 countries. INTERVENTIONS: Cinacalcet:placebo (3:1 ratio). OUTCOMES & MEASUREMENTS: Proportion of participants with a mean decrease of 30% or greater in intact parathyroid hormone (iPTH) level, proportion with iPTH level of 70 or less or 110 or less pg/mL (stage 3 and 4 CKD, respectively), and mean percentage of iPTH change from baseline, all during the efficacy-assessment phase. RESULTS: A greater proportion of cinacalcet than placebo participants achieved a 30% or greater decrease in iPTH level (74% versus 28%; P < 0.001), corresponding to a 43.1% decrease in iPTH level from baseline (cinacalcet) compared with a 1.1% increase (placebo). At week 32, serum calcium levels were 8.9 +/- 0.8 mg/dL (-8.9%; cinacalcet) and 9.9 +/- 0.6 mg/dL (+0.8%; placebo), phosphorus levels were 4.5 +/- 1.0 mg/dL (+21.4%) and 4.0 +/- 0.7 mg/dL (+6.8%), and calcium-phosphorus product values were 40.1 +/- 8.3 mg(2)/dL(2) (+18.9%) and 38.9 +/- 6.9 mg(2)/dL(2) (+17.1%), respectively. During the study course, 62% (cinacalcet) and 1% (placebo) of participants experienced 2 consecutive serum calcium concentrations less than 8.4 mg/dL. They generally were asymptomatic and without significant clinical consequences. Treatment generally was well tolerated, and most adverse events were mild to moderate in severity. LIMITATIONS: The study was not designed to assess the effects of cinacalcet on vascular calcification, bone histomorphometric parameters, or other clinical outcomes. It is not known whether the observed differences in changes in iPTH levels are clinically more important than observed differences in changes in serum calcium or phosphorus levels or dosages of vitamin D sterols and phosphate binders. CONCLUSIONS: These data show that cinacalcet treatment in patients with CKD not receiving dialysis can decrease plasma iPTH levels, but with frequent (albeit generally asymptomatic) serum calcium levels less than 8.4 mg/dL and increases in serum phosphorus levels. Copyright © 2009 National Kidney Foundation, Inc. [ABSTRACT FROM AUTHOR]

Abstract: Aims: The aim of this study was to clarify whether the metastasis of gastric cancer can be detected by identifying the sentinel lymph nodes (SNs) using only lymphatic dye. Method: The study was based on 101 patients clinically diagnosed with T1 and T2 gastric cancer. Isosulfan blue was intraoperatively injected within the submucosal layer around the lesion through an endoscope and blue stained nodes (BNs) were identified as SNs and harvested. Standard radical gastrectomy with D2 lymphadenectomy was performed on all patients and SNs and other nodes were evaluated. Results: Out of 101 patients, 21 had lymph-node metastases. The accuracy of SN identification was 97.0% (98/101) and the metastasis detection rate was 85.7% (18/21). With improvement of the manoeuvre in the latter 84 cases, the detection rate was elevated up to 100.0% (18/18), as was the accuracy (84/84). Conclusion: The sentinel concept using lymphatic dye is applicable to gastric cancer, but the identification of SNs with lymphatic dye requires some practice. Furthermore, the issue of intraoperative metastasis detection remains to be resolved. [Copyright &y& Elsevier]

Abstract: The Compton profiles (CPs) of copper are calculated by the GW approximation with FLAPW basis sets on the LDA. In the quasiparticle band structure in the GW approximation, the width of fully occupied 3d valence band which is overestimated in the LDA, is in good agreement with experimental observation. The dynamical screening effects are important for band width narrowing. The occupation number densities are evaluated from the spectral function calculation within the GW calculations. The CPs obtained using these GW calculations successfully reproduce experimental results. [Copyright &y& Elsevier]

Abstract: Photoinduced effects in a single crystal of bilayered manganites, La2-2xSr1+2xMn2O7 (x=0.38), were investigated in a wide range of temperatures by pump-probe measurement at a photon energy of 1.6eV. In a ferromagnetic metallic state, significant enhancement of positive rise in differential reflectivity with a slow relaxing time of 100ps was observed just below TC=127K, indicating that the reflectivity change with the slow relaxation time constant is induced by laser heating. We have also observed an unconventional fast relaxing component that has a time constant of the order of 10ps. This fast relaxing component, whose absolute value has an asymmetric peak at TC, is presumably due to short-range correlation of Jahn–Teller distortion. [Copyright &y& Elsevier]

Abstract: The magnetic Compton profiles (MCPs) of 3d transition metal nickel are calculated by the GW approximation with FLAPW basis sets on the LSDA. The 3d valence band width narrowing, which is ascribed to the dynamical screening effects, contributes to eliminate an anomalous peak at 0.7a.u. in the 〈110〉 direction, and also to diminish the excessive estimation of the Umklapp effects, in the LSDA MCPs. These are in good agreement with experimental observation. [Copyright &y& Elsevier]

Abstract: The c-axis resistivity measurements were performed in the vicinity of the ab-plane in order to investigate the interaction between Josephson vortices and pancake vortices in Bi2Sr2CaCu2O8+ δ mesoscopic single crystals. It was found that the angular dependence of the c-axis resistivity drastically changes in high magnetic field regime. The vortex lock-in transition becomes considerably broad in high magnetic fields, while the angular dependence of resistance exhibits the sharp lock-in features in low magnetic field region. [Copyright &y& Elsevier]

13C NMR measurements have been carried out on the quasi-two-dimensional organic conductor α-(BEDT-TTF)2I3 under hydrostatic pressure. The temperature dependencies of lineshape and relaxation rate, T1−1, at 7kbar indicate the appearance of two differently charged BEDT-TTF molecules below 120K. Magnetic susceptibility is strongly dependent on temperature in the high temperature region. [Copyright &y& Elsevier]

The authors regret that the name of the last author (p. 191) was published incorrectly. The correct name is R. Nishimura. [Copyright &y& Elsevier]