Search

For the purpose of a nationwide surveillance of the antimicrobial susceptibility of bacterial respiratory pathogens in patients in Japan, the Japanese Society of Chemotherapy conducted their second year survey, during the period from January to August, 2007. A total of 1178 strains were collected from clinical specimens obtained from adult patients with well-diagnosed respiratory tract infections. Susceptibility testing was evaluable for 1108 strains (226 Staphylococcus aureus, 257 Streptococcus pneumoniae, 6 Streptococcus pyogenes, 206 Haemophilus influenzae, 120 Moraxella catarrhalis, 122 Klebsiella pneumoniae, and 171 Pseudomonas aeruginosa). A total of 44 antibacterial agents, including 26 beta-lactams (four penicillins, three penicillins in combination with beta-lactamase inhibitors, four oral cephems, eight parenteral cephems, one monobactam, five carbapenems, and one penem), three aminoglycosides, four macrolides (including ketolide), one lincosamide, one tetracycline, two glycopeptides, six fluoroquinolones, and one oxazolidinone were used for the study. Analysis was conducted at the central reference laboratory according to the method recommended by the Clinical and Laboratory Standards Institute (CLSI). The incidence of methicillinresistant Staphylococcus aureus (MRSA) was high, at 59.7%, and the incidences of penicillin-intermediateresistant and -resistant Streptococcus pneumoniae (PISP and PRSP) were 30.4% and 5.1%, respectively. Among Haemophilus influenzae strains, 19.9% of them were found to be beta-lactamase-non-producing ampicillin (ABPC)-intermediately-resistant (BLNAI), 29.1% to be beta-lactamasenon-producing ABPC-resistant (BLNAR), and 6.7% to be beta-lactamase-producing ABPC-resistant (BLPAR) strains. Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae was not isolated. Two isolates (1.2%) of Pseudomonas aeruginosa were found to be metallo-beta-lactamase-producing strains, including one (0.6%) suspected multidrug-resistant strain showing resistance to imipenem, amikacin, and ciprofloxacin. These data will be a useful reference for future periodic surveillance studies and for investigations to control resistant infections as well. Continued surveillance is required to prevent the further spread of these antimicrobial resistances.

The Japanese Society of Chemotherapy (JSC) conducted the first nationwide surveillance of bacterial respiratory pathogens during the period from January to August 2006. With the cooperation of 32 medical institutions throughout Japan, a total of 924 strains belonging to seven clinically relevant bacterial species were collected from adult patients with well-diagnosed respiratory tract infections (RTIs). Antimicrobial susceptibility testing of the 887 evaluable strains (205 Staphylococcus aureus, 200 Streptococcus pneumoniae, 9 Streptococcus pyogenes, 165 Haemophilus influenzae, 91 Moraxella catarrhalis, 74 Klebsiella pneumoniae, and 143 Pseudomonas aeruginosa) to 42 antibacterial agents was conducted at the Central Laboratory of the Research Center for Anti-infective Drugs of the Kitasato Institute, according to recommendations issued by the Clinical and Laboratory Standards Institute (CLSI). The antibacterial agents employed were 25 beta-lactams, three aminoglycosides, four macrolides (including one azalide and one ketolide), one lincosamide, one tetracycline, two glycopeptides, five fluoroquinolones, and one oxazolidinone. The incidence of methicillin-resistant S. aureus (MRSA) was 63.4%, and the incidences of penicillin-intermediately resistant S. pneumoniae (PISP) and penicillin-resistant S. pneumoniae (PRSP) were 35.0% and 4.0%, respectively. Among H. influenzae, 21.2% of the strains were found to be beta-lactamase-nonproducing ampicillin (ABPC)-intermediately resistant (BLNAI), 29.1% to be beta-lactamase-nonproducing ABPC-resistant (BLNAR), and 4.8% to be beta-lactamaseproducing ABPC-resistant (BLPAR) strains. The incidence of extended-spectrum beta-lactamase-producing K. pneumoniae was 2.7% (2 of 74 strains). Three (2.1%) of the 143 P. aeruginosa strains were found to be metallo-beta-lactamaseproducing, including 1 (0.7%) multidrug-resistant strain. Through the nationwide surveillance, we obtained fundamental antimicrobial susceptibility data of clinically relevant bacterial pathogens in adult RTI to various antibacterial agents. These data will be a useful reference for future periodic surveillance studies, as well as for investigations to control antimicrobial-resistant pathogens.

To identify the superconducting gap symmetry in CeCoIn5 (T{c}=2.3 K), we measured the angle-resolved specific heat (C{phi}) in a field rotated around the c axis down to a very low temperature, 0.05T{c}, and made detailed theoretical calculations. In a field of 1 T, a sign reversal of the fourfold angular oscillation in C{phi} was observed at T approximately 0.1T{c} upon entering a quasiclassical regime where the maximum of C{phi} corresponds to the antinodal direction, coinciding with the angle-resolved density of states (ADOS) calculation. The C{phi} behavior, which exhibits minima along the [110] directions, unambiguously allows us to conclude d{x{2}-y{2}} symmetry of this system. The ADOS-quasiclassical region is confined to a narrow T and H domain within T/T{c} approximately 0.1 and 1.5 T (0.13H{c2}).

A concrete and experimentally feasible example for testing the putative Majorana zero-energy state bound in a vortex is theoretically proposed for a parallel plate geometry of superfluid 3He-A phase. We examine the experimental setup in connection with ongoing rotating cryostat experiments. The theoretical analysis is based on the well-established Ginzburg-Landau functional, supplemented by microscopic calculations of the Bogoliubov-de Gennes equation, both of which allow the precise location of the parameter regions of the Majorana state to be found in realistic situations.

To identify the superconducting gap structure in URu2Si2, we perform field-angle-dependent specific heat measurements for the two principal orientations in addition to field rotations, and a theoretical analysis based on microscopic calculations. The Sommerfeld coefficient gamma(H)'s in the mixed state exhibit a distinctly different field dependence. This comes from point nodes and the substantial Pauli paramagnetic effect of URu2Si2. These two features combined give rise to a consistent picture of superconducting properties, including a possible first order transition of Hc2 at low temperatures.

This Letter theoretically discusses quasiparticle states and nuclear spin relaxation rates T1-1 in the quasi-one-dimensional superconductor (TMTSF)2PF6 under a magnetic field applied parallel to the conduction chains. We study the effects of Josephson-type vortices on T1(-1) by solving the Bogoliubov-de Gennes equation for p-, d- or f-wave pairing interactions. In the presence of line nodes in pairing functions, T1(-1) is proportional to T in sufficiently low temperatures because quasiparticles induced by vortices at the Fermi energy relax spins. We also try to identify the pairing symmetry of (TMTSF)2PF6.

Two types of athermal wavelength locker, which use a fiber Bragg grating and a fiber Bragg grating etalon were demonstrated. Each type operates stably without thermal control as a single wavelength locker and a multi-channel wavelength locker, respectively. Thermal wavelength drift of the laser diode was less than 25 pm for the FBG type and 40 pm for the FBG etalon type in the temperature range from -5/spl deg/C to 70/spl deg/C.

Athermalized wavelength locker using fiber Bragg grating was demonstrated. Thermal drift of laser diode was locked less than 0.025nm at a temperature range from -5/spl deg/C to 70/spl deg/C.

A 52-year-old woman complained of lower back pain and gluteal pain in April 1997, and was found to have anemia, hypercalcemia and renal disorder. In September of the same year, she was diagnosed as having IgA-lambda myeloma (stage IIIA). VMMD-IFN therapy was started in November, 1997, and this resulted in improvement of the M-protein level, and relief of the pain in the lower back and gluteal region. A second course of VMMD-IFN therapy was also effective. In April 1998, however, the back pain worsened, and in July the patient suffered a fall and fractured her left femur. Upon readmission to our hospital, the level of M-protein was lower, and high fever, hypercalcemia, renal disorder, elevation of the LDH level, anemia and thrombocytopenia were observed. Bone marrow examination revealed 30% atypical large-sized CD19-, CD38+, CD56+ myeloma cells and chromosomal abnormalities. Although the symptoms were improved temporarily after a third course of VMMD therapy, disease aggravation occurred again, and extramedullary masses appeared on the head, face and pelvis. VAD therapy was performed without effect, and the patient died about 2 months after recurrence. This was a comparatively rare case of fulminant multiple myeloma occurring in the terminal stage.

Sleep splint, which is a dental device made of regin, is now widely used for the treatment of obstructive sleep apnea in our country. This device is worn in the mouth at night and makes the upper airway opened during sleep. It enlarges the velopharyngeal space as well as the space at the tongue base and prevents the collapse of the upper airway. This device is a treatment of choice for the patients with mild or moderate types of obstructive sleep apnea who are not treated ordinarily by nasal CPAP. When the patients have nasal obstruction, adenoid hypertrophy, enlarged tonsils, or improper conditions of the teeth, sleep splint is not indicated for those patients. At first, nasal obstruction should be treated, and the adenoids and enlarged tonsils should be removed surgically. The compliance of this treatment is better than that of nasal CPAP, and the major complication of this treatment is almost none.

The relationship between apoptosis and cellular proliferative activity in human non-small cell lung cancer (25 cases) was investigated using the in situ DNA nick-end labeling method and immunohistochemistry for both proliferating cell nuclear antigen (PCNA) and Ki-67 antigen. Comparison of the distribution of Ki-67-positive cells to that of apoptotic cells shows an inverse correlation in semi-serial sections. The PCNA labeling rates were closely correlated with Ki-67 labeling rates in non-small cell lung cancer. It was concluded that the immunostainings of PCNA and Ki-67 were almost equally valuable for assessing the proliferative activity in paraffin-embedded tissue from non-small cell lung cancer and that apoptosis may be related with the cell cycle in this cancer.

We report five cases of hypersensitivity pneumonitis among workers cultivating Tricholoma conglobatum (shimeji). After having worked for 5 to 20 years, they began to notice symptoms of cough, sputum, and dyspnea. They were diagnosed as having a hypersensitivity pneumonitis based on clinical features, bronchoalveolar lavage and transbronchial lung biopsy. By the double immunodiffusion test, precipitating lines between shimeji spore antigen and sera were observed in all of the patients. By enzyme-linked immunosorbent assay, the antibody activities against shimeji and three species of fungi (Cladosporium sphaerospermum, Penicillium frequentans, and Scopulariopsis species) were significantly higher in the sera of the patients than in those of normal subjects who were cultivating shimeji. Although it is not clear what causes this disease, these findings may be helpful in determining the specific antigen.

A 51-year-old man who had been working for 10 years with polyurethane paint containing isocyanate (MDI) was admitted to our hospital with complaints of fever and exertional dyspnea. Fine crackles were heard in both bases, and the patient had clubbed fingers. A chest X-ray film and computed tomograms of the lungs revealed patchy infiltrative shadows in both lung fields and subpleural honeycombing associated with irregular linear areas. Examination of bronchoalveolar lavage fluid showed increased T lymphocytes and a decreased CD 4/8 ratio. Specimens obtained by transbronchial lung biopsy revealed lymphoplasmacytic infiltration into the thickened alveolar walls, macrophage accumulation, and micro-epithelioid cell granulomas in the alveolar sacs. Hypersensitivity pneumonitis was suspected although the causative antigen was not identified because the results of short-term environmental provocation tests were negative in the patient's home and workplace. After discharge, the patient continued working as a paint sprayer. His acute symptoms recurred 1 month after exposure to isocyanate. Similar episodes occurred on two separate occasions. In addition, the patient tested positive for antibody to MDI-HSA in bronchoalveolar fluid. From the above observations, the patient was given a diagnosis of chronic hypersensitivity pneumonitis due to isocyanate (MDI). This condition is extremely rare. Furthermore, it is interesting that acute symptoms recurred 1 month after environmental exposure to the causative antigen.

A 44-year-old woman was found to have an abnormally high concentration of CA19-9 in serum. Five years later, she underwent a right upper lobectomy for an abnormal shadow on a chest roentgenogram, because it was thought to indicate a malignant tumor. A chest CT scan revealed a cyst with fluid in the right upper lobe. During the 5 years before the lobectomy, the serum CA19-9 concentration rose when the cyst fluid volume increased, and fell when the cyst fluid volume decreased. Before the operation, the serum CA19-9 concentration was very high and the cyst was swollen. The cyst wall was found to be lined with ciliated columnar epithelial cells and to contain hyaline cartilage and smooth muscle, which led to the diagnosis of bronchial cyst. The surface epithelium and cyst fluid were positively stained by a monoclonal antibody against CA19-9. The serum CA19-9 concentration decreased and was within the normal range 3 months after the operation.

The Markov random field (MRF) model, which is a method in the image restoration, is reformulated, based on the variational principle of the difference minimum between the original and damaged image datas, under the constraints for the area of black faces, the boundary length between the different darkness and the number of corners in the edge. Moreover, a new method is proposed for the estimation of the areas of black faces, the boundary length between the different darkness and the number of corners in the edge from only the damaged image.

We studied the short-term effects and complications of the use of a dental device (prosthetic mandibular advancement: PMA) in 72 patients with obstructive sleep apnea syndrome (OSAS), and the compliance of these patients with this treatment. In 61 (84.5%) of the 72 patients, the apnea index decreased by more than 50%. The lowest SaO2 and symptom scores also improved significantly. The severity of OSAS was not related to the percent reduction in apnea index. Complications of PMA use were observed in 22 patients (30.6%), but no severe adverse effects were observed. Sixty-two of the 72 patients continued using the PMA throughout the entire study period (overall compliance rate, 86.1%). In addition, the long-term compliance rate (more than 5 years) was 61.5%. We conclude that the effects of PMA in patients with OSAS are clinically significant, that there are no severe complications, and that compliance with treatment is good.

A ramp exercise test was thought to be adequate especially for evaluation of patients with respiratory system diseases. First, we told about the significances, the methods and apparatus, the arrangements for workload and the matters that demand special attentions of this exercise test. Next, various indices which were obtained during ramp exercise and the estimations of them were explained. Furthermore, we referred to the exercise-limiting factors for patients with COPD and pulmonary fibrosis as symmetrical respiratory system diseases.

A 34-year-old housewife presented to a hospital because of dry cough. Her chest radiograph showed bilateral multiple nodular lesions. Smaller but similar lesions had been seen on the chest radiograph 2 years earlier. Because the tissue taken during a trans bronchial biopsy was non-diagnostic, open lung biopsy was done and the diagnosis was pulmonary metastasis of alveolar soft part sarcoma. The primary tumor was found in her left calf by MRI. Malignant tumors are important for differential diagnosis of slow-growing multiple pulmonary nodules, and in some cases MRI is useful for finding the primary site.

A 31-year-old man, asymptomatic but with an abnormal shadow adjacent to the right tracheobronchial angle on chest roentogenogram, presented to our hospital. CT and MRI of the chest revealed this shadow to be a dilated azygos arch. The inferior vena cava was interrupted, at the intrahepatic portion, by the azygos continuation. There was also an abnormality of tracheobronchial branching. The right middle lobe bronchus gave rise to the upper lobe bronchus. The right B7 was absent though the left BX7 was present. The pulmonary arteries passed over the main bronchi bilaterally. Interruption of the inferior vena cava is often associated with significant cardiovascular and abdominal anomalies but only rarely with anomalies of tracheobronchial branching.

To assess the clinical utility of a ramp exercise test in patients with pulmonary diseases, the gas exchange variables from normal volunteers and patients with pulmonary diseases during ramp exercise were compared to those during steady-state exercise. Measurements during ramp exercise could titrate the extent of the patients' maximal exercise as well as the adequate performance of parameters in gas exchange coupling. There were no significant differences in the four variables achieved between the two exercises. These gas exchange variables during ramp exercise made it possible to predict the exercise-limiting factors for patients with COPD and pulmonary fibrosis. Furthermore, a ramp exercise test could be performed safely even in patients with severe lung diseases and required a shorter period than a steady state exercise test. Thus, a ramp exercise test is thought to be useful in the evaluation of patients with pulmonary diseases.

To examine whether alteration of 7S collagen in the alveolar basement membrane is related to the condition and prognosis of diffuse interstitial lung diseases (idiopathic interstitial pneumonia: IIP, collagen vascular diseases, sarcoidosis, and hypersensitivity pneumonitis), we measured serum 7S collagen levels in 123 patients with diffuse interstitial lung disease and other lung diseases. Patients with diffuse lung diseases (diffuse interstitial lung disease, pulmonary emphysema, and diffuse panbronchiolitis: DPB) showed significantly higher serum levels of 7S collagen than healthy normal controls. Serum 7S collagen levels in IIP and collagen vascular diseases were significantly higher than those in pulmonary emphysema and DPB. In cases of IIP, serum 7S collagen levels in the active stage were significantly higher than those in the inactive stage. Furthermore, the prognosis of patients with higher serum 7S collagen levels was significantly poorer than those of patients with lower serum 7S collagen levels. In infectious pulmonary diseases, serum 7S collagen levels of patients with adult respiratory distress syndrome (ARDS) were significantly higher than those of patients without ARDS. Autopsy specimens obtained from patients with positive serum 7S collagen showed diffuse alveolar damage and/or diffuse pulmonary hemorrhage in the alveolar areas. Immunohistochemical staining for 7S collagen showed disruption and/or loss of the alveolar basement membrane. The authors conclude that serum level of 7S collagen is useful for estimating the activity of diffuse interstitial lung diseases as an index of the destruction of alveolar structure.

We report the first ^{75}As-NMR study on a single crystal of the hole-doped iron-pnictide superconductor Ba_{0.7}K_{0.3}Fe_2As_{2} (T_c = 31.5 K). We find that the Fe antiferromagnetic spin fluctuations are anisotropic and are weaker compared to underdoped copper-oxides or cobalt-oxide superconductors. The spin lattice relaxation rate 1/T_1 decreases below T_c with no coherence peak and shows a step-wise variation at low temperatures, which is indicative of multiple superconducting gaps, as in the electron-doped Pr(La)FeAsO$_{1-x}$F$_{x}$. Furthermore, no evidence was obtained for a microscopic coexistence of a long-range magnetic and superconductivity.

To clarify the precise of cellular immunity mechanism in pulmonary tuberculosis, we investigated the amount of IL-2 in patients with untreated active pulmonary tuberculosis. When serum adenosine deaminase (ADA) activity was examined using enzyme assay, an abnormally high level was observed in all patients (29.0 + 11.6 IU/ml, mean + SD; 4.5-17.8, normal range). Likewise, the level of serum-soluble interleukin-2 receptor (IL-2R) measured by ELISA showed abnormal high level in all patients (844.3 + 584.8 IU/ml; 80-300, normal range). When stimulated using PHA, the peripheral lymphocyte's ability to produce IL-2 revealed no difference between control subjects and patients. It was, however, noted that the lymphocytes of the patients significantly suppressed IL-2 responsiveness when compared to the control subjects (P less than 0.05). The serum IL-2 concentration measured using RIA could not be detected in any of the patients as was the same for control subject. All of the above mentioned results suggest that T-cell activation which caused increment in serum ADA activity and soluble IL-2R occurred in active pulmonary tuberculosis. The suppressed IL-2 responsiveness in the peripheral lymphocytes of patients proposes the possibility of soluble IL-2R reduction by the negative feedback mechanism in IL-2-sensitive lymphocytes.

Diffuse panbronchiolitis in two brothers is reported. The elder brother aged 46, was admitted in May 1983 due to severe dyspnea and productive cough, which had gradually worsened over several years. He had severe hypoxemia and hypercapnia. He died at age 47 of respiratory failure due to pseudomonas infection despite antibiotic therapy. The younger brother, at age 41, was admitted in March 1983 due to fever, productive cough, and abnormal shadows on chest X-ray films. He showed mild hypoxemia and his symptoms improved with antibiotic treatment. Since then he has been followed as an outpatient for over 7 years while taking 400 mg of Erythromycin per day, and he has had no exacerbation. These two cases had different clinical courses despite the facts that both had similar conditions of chronic sinusitis and appeared to be exposed to no special environmental or occupational hazards. These facts suggest that not only intrinsic factors, such as defenselessness of airways, but extrinsic factors such as viral, mycoplasmal, or bacterial infection may act together on the mechanisms of the onset and progression of diffuse panbronchiolitis.

In a recent Letter Morita, Kohmoto and Maki analyzed the structure of quasiparticle states near a single vortex in a d-wave superconductor using an approximate version of the Bogoliubov - de Gennes theory. Their principal result is the existence of a bound state within the core region at finite energy with full rotational symmetry, which they assert explains the recent scanning tunneling microscopy results on YBCO single crystals. Here we argue that the approximation used in this work is fundamentally inadequate for the description of a d-wave vortex and that the obtained circular symmetry of the local density of states is an unphysical artifact of this approximation., Comment: 1 page REVTeX, to appear in PRL

Mit Hilfe elektronischer Auswerteanlagen werden reizsynchrone corticale Antworten am wachen Menschen bei Schmerzreizung extracranial abgeleitet und damit objektive elektrophysiologische Korrelate psychophysischen Untersuchungen gegenubergestellt.

The effects of electroacupuncture (EA) on the rat jaw-opening reflex elicited by tooth pulp stimulation were studied to decide the effective stimulus conditions for electroacupuncture stimulation (EAS). The present study revealed that one of the most important factors for producing a strong EA effect was the stimulus pulse-frequency and that the stimulus pulse-duration was not an essential factor for this effect. In the rat, the following stimulus conditions were very useful for the quantitative study of the EA effect. (1) Stimulation time is 15 min. (2) Stimulus pulse-frequency is 30 to 150 Hz. (3) Stimulus pulse-duration is 0.1 to 5 ms. When the EAS was applied to the Ho-Ku point under these conditions, the degree of the suppression of the jaw-opening reflex was about 50% of the control.

To determine the effect of hypoxia on lactate threshold (LT), onset of blood lactate accumulation (OBLA), and gas exchange threshold (GET), the lactate level together with VO2, VCO2, VE, and acid-base status in arterial blood from 12 female distance runners performing a progressive incremental treadmill test under the condition of hypoxic gas inhalation (HC: FIO2 is 16.0% in N2) compared with normoxic conditions (NC: FIO2 is 20.9%; i.e., air) were examined. During exercise, HC shifted LT, GET, and OBLA to a lower VO2 by 12.5%, 12.9%, and 9.3%, respectively. The GET during hypoxic exercise was well correlated with LT (GET = 0.973LT + 0.04; expressed in VO2 l.min-1). The close reciprocal changes in arterial blood lactate and bicarbonate (HCO3-) were observed during hypoxic as well as normoxic exercise. These findings provide evidence for the cause and effect relationship between LT and GET, even in hypoxic exercise. During submaximal exercise below the LT, PaCO2 and HCO3- slightly increased both in NC and HC with pH remaining unchanged. However, during exercise above the LT, the PaCO2, HCO3-, and pH all decreased with pH decreasing more markedly during hypoxia. In conclusion, this study demonstrated a clear increase in arterial lactate during hypoxic exercise above the LT. Both the LT and GET are shifted to a lower work rate by hypoxia in the same manner with the correlation between them remaining high, supporting the cause and effect relationship of these two parameters.

Neurophysiologische Untersuchung uber die Basis der Geschmacksdifferenzierung in die vier Hauptqualitaten bei Kroten und Nachweis eines offenbar spezifischen Impulsmusters im N. glossopharyngicus.