Serial Assessment of Immune Status by Circulating CD8+ Effector T Cell Frequencies for Posttransplant Infectious Complications

To clarify the role of CD8+ effector T cells for infectious complications, 92 recipients were classified according to the hierarchical clustering of preoperative CD8+CD45 isoforms: Group I was naive, Group II was effector memory, and Group III was effector (E) T cell-dominant. The posttransplant infection rates progressively increased from 29% in Group I to 64.3% in Group III recipients. The posttransplant immune status was compared with the pretransplant status, based on the measure (% difference) and its graphical form (scatter plot). In Groups I and II, both approaches showed a strong upward deviation from pretransplant status upon posttransplant infection, indicating an enhanced clearance of pathogens. In Group III, in contrast, both approaches showed a clear downward deviation from preoperative status, indicating deficient cytotoxicity. The % E difference and scatter plot can be used as a useful indicator of a posttransplant infectious complication

Coexistence of Multiple Genotypes, Including Newly Identified Genotypes, in Outbreaks of Gastroenteritis Due to Norovirus in Japan

Norovirus (NV) (formerly called Norwalk-like virus) is the most common cause of acute nonbacterial gastroenteritis in humans. Recently, we reported an NV genotyping scheme based on variability in the capsid N-terminal/shell (N/S) domain gene (Katayama et al., Virology 299:225-239, 2002). We found 19 genotypes, including nine of genogroup I and 10 of genogroup II. In the present study, we investigated the molecular epidemiology of NV from 66 outbreaks that occurred in Saitama Prefecture, Japan, from 1997 to 2002. We screened 416 stool specimens by a real-time reverse transcription (RT)-PCR method (Kageyama et al., J. Clin. Microbiol. 41:1548-1557, 2003) and detected 156 NV-positive specimens, from which we amplified the capsid N/S domain gene by RT-PCR and then cloned the PCR products. After sequencing these clones, we obtained 368 sequence variants (strains). By applying our classification scheme to the strains from Saitama and other published strains, we identified a total of 31 genotypes, including an additional five genotypes for genogroup I and seven for genogroup II. Of the 31 genotypes, 26 were present in the Saitama area during that time period. These results provide additional evidence for the great diversity of human NV genotypes. Specimens from all shellfish-related infections contained multiple genotypes, including several new genotypes. On the other hand, single genotypes were observed mostly in outbreaks that originated in semiclosed communities. Thus, the number of NV genotypes in each outbreak depended on the route of transmission

キャリアステージベツ ニ ミタ カンゴシ ノ ソシキ ニ タイスル ジョウドウテキ コミットメント ノ カンレン ヨウイン

看護師の組織コミットメントを高めることは、離職を防止し、組織のパフォーマンスの質を高めるとされている。そこで本研究は、組織コミットメントの3要素(情動的要素、存続的要素、規範的要素)のうち、とりわけ看護師の離職と強い関連のある情動的コミットメントを取り上げ、その関連要因を看護師のキャリアステージ別に明らかにすることを目的とした。無作為抽出法(抽出確率20%)により抽出されたA県内の病院11ヶ所に勤務する正看護師650名を対象に自記式質問紙調査を実施した。そのうち、318名(有効回答率6 1.8%)を分析対象とした。勤続年数に基づき、「3年未満」「3-5年未満」「5-10年未満」「10年以上」の4つに区分したキャリアステージごとに情動的コミットメントの関連要因を重回帰分析により検討した。その結果、上司の支援、夜勤回数、同僚の支援、研修制度への満足、福利厚生への満足、病棟における評価といった情動的コミットメントに影響を与える要因はキャリアステージによって異なっていることが明らかとなった。以上の結果より、看護師の情動的コミットメントを高めるためには、それぞれのキャリアステージに適した支援の必要性が示唆された。Enhancement of organizational commitment may lead to prevention of turnover and high quality organizational performance. A questionnaire survey was administered to clarify the relationship between nurses\u27 career stages and factors relating to affective commitment to the organization. Out of 650 nurses working in 11 hospitals (4 public hospitals and 7 private hospitals) randomly selected from all hospitals in one prefecture, 524 nurses responded (61.8% response rate), and 318 female nurses under 60 years of age who had no missing values for any of the variables were divided into four career stages (less than 3 years, 3 to less than 5 years, 5 to less than 10 years, and 10 years or more). Multiple regression analysis revealed that although personal and organizational characteristics (e.g., duration of service with the hospital; satisfaction with salary, welfare, and onthe-job training,s upervisor supp ,otr number of night shifts,a nd positive job evaluation) were significant predictors of affective commitment to the organization, each career stage was associated with different predictors. These findings suggest the importance of taking into account career stages as well as various working conditions and support systems to enhance nurses\u27 affectivecommitment to the organization and reduce staff turnover