Identification of trehalose dimycolate (cord factor) in Mycobacterium leprae

AbstractGlycolipids of Mycobacterium leprae obtained from armadillo tissue nodules infected with the bacteria were analyzed. Mass spectrometric analysis of the glycolipids indicated the presence of trehalose 6,6′-dimycolate (TDM) together with trehalose 6-monomycolate (TMM) and phenolic glycolipid-I (PGL-I). The analysis showed that M. leprae-derived TDM and TMM possessed both α- and keto-mycolates centering at C78 in the former and at C81 or 83 in the latter subclasses, respectively. For the first time, MALDI-TOF mass analyses showed the presence of TDM in M. leprae

A CASE OF DIABETES INSIPIDUS ACCOMPANYING THIRST DISORDER ASSOCIATED WITH HYPEROSMOLAR DIABETIC COMA

The case of a 14-year-old female who suffered from hyperosmolar diabetic coma (HODC) after resection of craniopharyngioma and during treatment for hypopituitarism and diabetes insipidus is presented. In Aug. 1989, craniopharyngioma was diagnosed and she underwent resection surgery and radiotherapy. Since then, she had been on supplemental therapy with hydrocortisone and thyroxin and desmopressin (DDAVP). On Jan. 17, 1992, she fell into HODC upon ingesting a large amount of soft drink to supplement water due to persistent polyuria. She improved quickly when supplementary fluids and insulin were administered. She had demonstrated no abnormality in glucose tolerance prior to this manifestation. Insulin therapy was deemed unnecessary after her recovery from HODC. Because of a disorder in the central nervous thirst mechaninm, she lacked the sense of thirst and concomitantly the thirst-mediated water intake in spite of elevated plasma osmolarity due to dehydration and hyperglycemia. This seemed to be the cause of her accelerating dehydration. The resulting insulin resistance then brought about her HODC. Thus, it is difficult to consider such a case of HODC as symptomatic of diabetes when no abnormality in glucose tolerance either before manifestation or after restoration can be found. It should rather be considered as a case of “dehydration hyperglycemia" and be treated as such

Usefulness of the waterless method for surgical hand washing：A comparison with the conventional scrub method

To evaluate the usefulness of the waterless hand washing method for surgical anti-sepsis, we conducted a microbial sampling study, comparing it to a conventional surgical scrub method. A total of 18 operating-room nurses were undertaking the following three-hand washing protocols : scrubbing with blushes using 4w/v% chlorhexidine gluconate (CHG) and also rubbing with CHG, followed by application of a 0.2w/v% CHG with ethanol (HS) preparation. (conventional method); rubbing with CHG and application of HS (two-stage surgical scrub method; TSS); rubbing with anti-septic soap and application of HS (waterless method; WL). Microbial sampling was conducted after hand washing using the glove juice method. No statistically significant differences in bacterial numbers were found among these three methods. The number of bacterially positive subjects was significantly higher in the conventional method than the TSS method. These results indicate that there are adverse effects of blush-scrubbing, as the detected bacteria were related to normal skin flora. As such, the WL method for hand anti-sepsis appears to be equivalent to the conventional surgical scrubbing method in terms of microbial detection. The WL method should therefore be introduced as a standard hand anti-sepsis method at the time of surgery because it is cost-effective as well as time-efficient

ピルビンサン ダッスイソ コウソ フクゴウタイ イジョウショウ ジョジ カンジャ ノ イデンシ シンダン システム ノ カクリツ

Pyruvate dehydrogenase (PDH) complex deficiency is one of the important causes of congenital lactic acidemia and mostly due to defect in the α subunit of PDH (E1α), of which gene is located on the X chromosome. The diagnosis of the PDH E1α deficiency is usually established by the measurement of the PDH complex activity in cultured cells. However, some female patients, who are heterozygous for the mutant allele, cannot be diagnosed only by the assay of PDH complex activity, because of the skewed X-chromosome inactivation in cultured cells. Then, we established DNA diagnostic system for PDH E1α deficiency using X inactivation assay, no RI PCR-SSCP, and direct sequencing. With this DNA diagnostic system we could diagnose 4 female patients as PDH E1α deficiency from 14 female patients who were suspected PDH complex deficiency from the clinical features and concentrations of lactate and pyruvate in the blood but showed normal PDH complex activity in their cultured cells. These results indicate that this DNA diagnostic system for PDH E1 αdeficiency is very useful

BdWRKY38 is required for the incompatible interaction of Brachypodium distachyon with the necrotrophic fungus Rhizoctonia solani

Rhizoctonia solani is a soil‐borne necrotrophic fungus that causes sheath blight in grasses. The basal resistance of compatible interactions between R. solani and rice is known to be modulated by some WRKY transcription factors (TFs). However, genes and defense responses involved in incompatible interaction with R. solani remain unexplored, because no such interactions are known in any host plants. Recently, we demonstrated that Bd3‐1, an accession of the model grass Brachypodium distachyon, is resistant to R. solani and, upon inoculation with the fungus, undergoes rapid induction of genes responsive to the phytohormone salicylic acid (SA) that encode the WRKY TFs BdWRKY38 and BdWRKY44. Here, we show that endogenous SA and these WRKY TFs positively regulate this accession‐specific R. solani resistance. In contrast to a susceptible accession (Bd21), the infection process in the resistant accessions Bd3‐1 and Tek‐3 was suppressed at early stages before the development of fungal biomass and infection machinery. A comparative transcriptome analysis during pathogen infection revealed that putative WRKY‐dependent defense genes were induced faster in the resistant accessions than in Bd21. A gene regulatory network (GRN) analysis based on the transcriptome dataset demonstrated that BdWRKY38 was a GRN hub connected to many target genes specifically in resistant accessions, whereas BdWRKY44 was shared in the GRNs of all three accessions. Moreover, overexpression of BdWRKY38 increased R. solani resistance in Bd21. Our findings demonstrate that these resistant accessions can activate an incompatible host response to R. solani, and BdWRKY38 regulates this response by mediating SA signaling

Comprehensive Prospective Analysis of the Factors Contributing to Aspiration Pneumonia Following Endoscopic Submucosal Dissection in Patients with Early Gastric Neoplasms

Endoscopic submucosal dissection (ESD) has become the first-line treatment for early gastric neoplasms; however, a subset of patients treated by this method develop aspiration pneumonia. We conducted a comprehensive prospective analysis of the factors contributing to post-ESD aspiration pneumonia in early gastric neoplasms in this study, with special focus on whether pre-treatment oral care can prevent aspiration pneumonia. Sixty-one patients who underwent ESD for gastric neoplasms were randomly assigned to the oral care or control groups. ESD was performed under deep sedation. Of 60 patients whose data were available for analysis, 5 (8.3%) experienced pneumonia confirmed either by chest radiography or computed tomography. Although no difference in the rate of pneumonia was found between the control and oral care groups, the post-oral care bacteria count was significantly higher in the saliva of patients who developed pneumonia compared to those without pneumonia. In addition, the presence of vascular brain diseases and the dose of meperidine were also significantly associated with the occurrence of pneumonia. These results suggest that the number of oral bacteria as well as pre-existing vascular brain diseases and high-dose narcotics can affect the incidence of post-ESD pneumonia

The role of IL-18 in the modulation of matrix metalloproteinases and migration of human natural killer (NK) cells

AbstractIn this study, we examined whether interleukin-18 (IL-18) affects natural killer (NK) cells' migration and matrix metalloproteinases (MMPs) production. We demonstrated that chemotaxis of human NK cells through basement membrane-like Matrigel was augmented by IL-18. As well, IL-18 stimulation induces the production of activated forms of matrix metalloproteinase-2 (MMP-2) as well as the production of pro-MMP-2 from NK cells. We also demonstrated that MT1-MMP expression on human NK cells, which is a major activator of MMP-2, was induced by IL-18 stimulation coordinated with MMP-2 activation. These data suggest that the MT1-MMP/MMP-2 system participates in the degradation of basement membrane components and thus contributes to NK cell migration

高齢者の認知機能向上とITヘルスケアシステム

IT（Information Technology）ヘルスケアシステムが高齢者の認知機能の向上に影響をもたらすか，その効果を測定するため，デイサービス事業所５か所において調査を行った．効果測定は，認知機能評価スケールMini Mental State Examination（MMSE）を用い，介入前後に測定できた４９人（介入群４０人，対照群９人）のデータを分析し比較検討した．結果，ITヘルスケアシステム（ITHCS）介入前後のMMSE得点，および認知機能の変化（前後差）において，介入群の方が有意に高い得点を示す項目はなかった．しかし，介護度別にみると介入後の方が有意に高い認知機能の変化を示した項目（即時想起，物品呼称，自発書字）もあった．そのためITヘルスケアシステムの効率性を高めるには，利用者への個別的対応を組み合わせるなどのアプローチが必要であると結論付けられた．This article examines how effective IT（Information Technology）health care system is in improving cognitive functioning for the elderly people. We have organized a small project for health promotion among elderly people at five day-care centers and evaluated its effectiveness in the cognitive abilities of the service users. Mini Mental State Examination （MMSE） is used to assess the project’s efficacy, including the impact of the IT health care system. Eleven types of cognitive abilities are tested on ４９ people （４０ within intervention group and ９ within contrast group） prior the intervention and after. The result doesn’t show significant improvement on the score, however, some improvement on cognitive abilities such as short-term memory, calculation, identifying objects, and following simple directions, was seen in some group according to their care requirement level. Therefore, we concluded that the program with IT health care system combined with some individualized approach is necessary in order to improve its effectiveness

4 か月児をもつ35 歳以上の母親における育児不安とその関連要因―35 歳未満の母親との比較―

A questionnaire survey was conducted of 977 mothers who were invited to bring their infant to a 4-month health checkup in City A to compare anxiety about childrearing and related factors between older mothers (aged 35 years or older) and younger mothers (under 35 years old). Univariate analysis was performed to examine the associations of anxiety about childrearing with the following in both age groups: participant characteristics,health status, support received, experience during pregnancy and childrearing, items of a childrearing support checklist, items of the Mother-to-Infant Bonding Scale, Edinburgh Postnatal Depression Scale (EPDS) score,and generalized self-efficacy. Significant factors identified in the univariate analysis were used as independent variables in logistic regression analysis, with anxiety about childrearing as a dependent variable. The following were associated with anxiety about childrearing in older mothers: primipara or multipara; restful sleep; history of professional consultation regarding emotional and psychological issues; and 2 items of the Mother-to-Infant Bonding Scale. Sleep status and mental health status were more strongly associated with anxiety about childrearing in older mothers than in younger mother, and this needs to be considered when supporting those mothers.　4 か月児をもつ35 歳以上の母親の育児不安とその関連要因を、35 歳未満の母親と比較し明らかにするため、A 市の4 か月児健康診査対象児の母親977 名に質問紙調査を行った。年齢2 区分別に、育児不安を従属変数とし、基本属性、健康状態、サポート、妊娠期・育児期の体験、育児支援チェックリスト、赤ちゃんへの気持ち質問票の各項目、エジンバラ産後うつ病質問票（EPDS）得点、特性的自己効力感について、育児不安との単変量解析で有意であった項目を独立変数とした、ロジスティック回帰分析を行った。結果、35 歳以上の母親の育児不安には、初産経産の別や睡眠による休養、心理的・精神的な問題での専門職への相談経験、赤ちゃんへの気持ち質問票の2 項目が関連していた。35 歳未満と比較すると、35 歳以上の母親では特に母親自身の睡眠状況や精神的な健康状態が育児不安と関係しており、これを考慮した上で支援を行う必要がある