Tazobactam/piperacillin for moderate-to-severe pneumonia in patients with risk for aspiration: comparison with imipenem/cilastatin.

BACKGROUND: Treatment of aspiration pneumonia is becoming an important issue due to aging of populations worldwide. Effectiveness of tazobactam/piperacillin (TAZ/PIPC) in aspiration pneumonia is not clear. PURPOSE: To compare clinical efficacy between TAZ/PIPC (1:4 compound) and imipenem/cilastatin (IPM/CS) in patients with moderate-to-severe aspiration pneumonia. PATIENTS AND METHODS: In this open-label, randomized study either TAZ/PIPC 5 g or IPM/CS 1 g was intravenously administered every 12 h to patients with moderate-to-severe community-acquired aspiration pneumonia or nursing home-acquired pneumonia with risk for aspiration pneumonia for average 11 days. The primary outcome was clinical response rate at the end of treatment (EOT) in validated per-protocol (VPP) population. Secondary outcomes were clinical response during treatment (days 4 and 7) and at the end of study (EOS) in VPP population, and survival at day 30 in modified intention-to-treat (MITT) population. RESULTS: There was no difference between the groups in primary or secondary outcome. However, significantly faster improvement as measured by axillary temperature (p < 0.05) and WBC count (p = 0.01) was observed under TAZ/PIPC treatment. In patients with gram-positive bacterial infection, TAZ/PIPC was more effective at EOT in VPP population (p = 0.03). CONCLUSION: TAZ/PIPC is as effective and safe as IPM/CS in the treatment of moderate- to-severe aspiration pneumonia

Purification and Characterisation of Malate Dehydrogenase From Synechocystis sp. PCC 6803: Biochemical Barrier of the Oxidative Tricarboxylic Acid Cycle

Cyanobacteria possess an atypical tricarboxylic acid (TCA) cycle with various bypasses. Previous studies have suggested that a cyclic flow through the TCA cycle is not essential for cyanobacteria under normal growth conditions. The cyanobacterial TCA cycle is, thus, different from that in other bacteria, and the biochemical properties of enzymes in this TCA cycle are less understood. In this study, we reveal the biochemical characteristics of malate dehydrogenase (MDH) from Synechocystis sp. PCC 6803 MDH (SyMDH). The optimal temperature of SyMDH activity was 45–50°C and SyMDH was more thermostable than MDHs from other mesophilic microorganisms. The optimal pH of SyMDH varied with the direction of the reaction: pH 8.0 for the oxidative reaction and pH 6.5 for the reductive reaction. The reductive reaction catalysed by SyMDH was activated by magnesium ions and fumarate, indicating that SyMDH is regulated by a positive feedback mechanism. The Km-value of SyMDH for malate was approximately 210-fold higher than that for oxaloacetate and the Km-value for NAD+ was approximately 19-fold higher than that for NADH. The catalytic efficiency of SyMDH for the reductive reaction, deduced from kcat-values, was also higher than that for the oxidative reaction. These results indicate that SyMDH is more efficient in the reductive reaction in the TCA cycle, and it plays key roles in determining the direction of the TCA cycle in this cyanobacterium

Eddy Correlation Measurements of Carbon Dioxide Flux over Coastal Sea Surface

The carbon dioxide flux over coastal seawater was measured by the eddy correlation technique at the Shirahama Oceanographic Tower Station of Kyoto University on August 23 and 24, 1994. The mean value of carbon dioxide fluxes measured is 0.10 mgm^-2 s^-1 with a standard deviation of 0.09 mgm^-2 s^-1. These upward fluxes are within ranges obtained over the Sea of Japan in 1986 and 1987. It is also noted that the present values of upward fluxes are about one tenth of the downward flux of carbon dioxide measured over actively growing paddy fields. Within a particular set of environmental conditions, the feasibility of applying the aerodynamic technique and the bulk technique to measuring the cabon dioxide flux over the ocean is demonstrated

Resection and anterior transposition of the inferior oblique muscle for treatment of inferior rectus muscle hypoplasia with esotropia

Purpose: To report a case of inferior rectus muscle hypoplasia with esotropia, which was treated successfully by resection and anterior transposition of the inferior oblique muscle. Observations: A 1-year-old boy presented with esotropia. He had esotropia of 15–30° and intermittent left hypertropia. At the age of 3 years, the alternate prism cover test showed esotropia of 35Δ and left hypertropia of 25Δ. Magnetic resonance imaging of the orbit revealed left inferior rectus muscle dysgenesis. Strabismus surgery was performed and a hypoplastic left inferior rectus muscle was identified. We performed bilateral medial rectus muscle recession, and resection and anterior transposition of the left inferior oblique muscle. Nine months after the surgery, the patient had esotropia of 8Δ and left hypertropia of 6Δ. Conclusions and importance: Resection and anterior transposition of the inferior oblique muscle is useful for hypoplasia of the inferior rectus muscle accompanied by horizontal strabismus

Non-contact force measurement for current collection in a 25kV overhead line electrified railway

Network Rail's Western Route is undergoing a wide-ranging modernisation programme, with £7.5bn investment in 175 miles of electrification and infrastructure upgrades allowing the introduction of four new fleets of train by 2019. This paper reviews the potential utilisation of camera imagery to inform maintenance processes that need to absorb a step change in pantograph movements and OLE management