Fulminant candidemia diagnosed by prompt detection of pseudohyphae in a peripheral blood smear

A 77-year-old man treated with prednisolone for pemphigus developed severe sepsis by Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus. Several antibiotics were administered. A peripheral blood smear showed growth of a large number of yeast extending pseudohyphae which could be seen both inside and outside of leucocytes. Antifungal agents were added immediately, however, he did not recover. Several days later, blood culture showed Candida albicans septicemia. The autopsy revealed microabscesses in the lung, heart, liver and kidney. A large amount of neutrophil invasion and yeast with peudohypae were also detected

<REPORTS>Re-ordering a wheelchair for a spastic cerebral palsy adolescent : a case study

The purpose of this case study was specifically intended to reinforce the necessity for proper positioning in the wheelchair using a spastic cerebral palsy patient as an example. The patient sat in the wheelchair with the pelvis sliding forward, uneven weight distribution on both hips, hip adduction, neck extension, and forward trunk bending. The abnormal posture observed was first corrected by seating the patient well back in the wheelchair with the patient's weight evenly distributed between both hips and with no observable pelvic obliquity. A seat belt, firm foot rest, abduction wedge, and special "H" chest strap were inserted to help the patient maintain the corrected posture. Points to consider when ordering a wheelchair and adaptive equipment are reviewed. The optimal sitting position and positioning objectives and considerations, as well as the selection process, are also presented. Inclusion of the patient and the caregivers in the selection and decision-making processes helps lead to successful results. A thorough assessment of the patient's prognosis and environment is important to prevent harmful, expensive, and disappointing results. On-going reviews of the patient and use of the equipment is helpful in preventing deformities and other problems. As is already known, increasing the patient's function and ability to move around and explore the environment can effect the patient's attitude as well as quality of life.国立情報学研究所で電子

Minocycline Induces Autophagy and Inhibits Cell Proliferation in LPS-Stimulated THP-1 Cells

Excessive activation and proliferation of inflammatory cell and uncontrolled release of cytokines and chemokines, also known as cytokine storm, is considered to be the main cause of sepsis. Accumulating evidence has indicated that autophagy may play an important role in regulating immune response and controlling excessive inflammation. Recent studies have showed that minocycline has immunomodulatory effects on cytokine and chemokine production. It has also been reported that minocycline can induce autophagy, suggesting that autophagy may be involved in the process of minocycline regulating inflammation and immune response. However, the precise mechanism is unclear. In the present study, we used enzyme-linked immunosorbent assays (ELISA) to measure the production of cytokines following minocycline treatment of lipopolysaccharide- (LPS-) stimulated THP-1 cells. Western blotting analysis was performed to confirm autophagy and the mTOR signal pathway. Cell proliferation was measured by WST-1 cell proliferation assay. We demonstrated that LPS induced autophagy in a tumor necrosis factor- (TNF-) α-mediated manner, and simultaneously, LPS induced the release of TNF-α to trigger inflammation and activated mammalian target of rapamycin (mTOR) to potentiate cell proliferation. Minocycline, which induces autophagy by inhibiting mTOR, suppresses cytokine production and cell proliferation and protects THP-1 cells from LPS toxicity. Further study demonstrated that there might be an intimate crosstalk between the inhibitor kappa B kinase (IKK)/nuclear factor-kappa B (NF-κB) signaling pathway and autophagy flux in modification of inflammatory responses. In addition, rapamycin, the mTOR inhibitor, has cooperative effect with minocycline on suppression of TNF-α release and induction of autophagy by repressing mTOR. Our data brought a novel clue to evaluate minocycline using as a potential therapeutic medicine for sepsis