23 research outputs found
ę„ę¬ć«ćććåŗč³Ŗē¹ē°ę§ę”å¼µåĪ²-ć©ćÆćæćć¼ć¼ē£ēčŗēę”æčć®ååéŗä¼å¦ēē¹å¾“ļ¼CTX-M-15ć®åŖä½ę§ćØé«ē åę§ćÆćć¼ć³ć®åŗē¾
Objective: To provide data on the molecular characteristics of extended-spectrum Ī²-lactamase (ESBL)-producing Klebsiella pneumoniae clinical isolates in Japan. Methods: A total of 100 clinical isolates of ESBL-producing K. pneumoniae collected throughout Japan between June and July 2018 were studied. ESBL genes were analyzed using PCR and DNA sequencing. Transferability of ESBL genes was investigated by conjugation experiments. Plasmid replicon types, virulence genes (rmpA, rmpA2, iucA, iroB, and peg-344) associated with hypervirulent K. pneumoniae (hvKp), and capsule types were detected using PCR. Genotyping was performed using multilocus sequence typing. Results: All ESBL-producing isolates carried blaCTX-M genes. The most predominant CTX-M-type identified was CTX-M-15 (n=55). We identified 24 sequence types (STs) among the CTX-M-15 producers, with ST25 (n=8) being the most common. Most of the transconjugants carrying blaCTX-M-15 contained the FIIk replicon. Of the 100 ESBL-producing isolates, 31 were hvKp defined by the presence of the virulence genes. These ESBL-producing hvKp isolates belonged to eight STs (STs 23, 25, 36, 65, 86, 268, 412, and 4492), with five capsule types (K1, K2, K20, K57, and undefined). Conclusions: CTX-M-15 was the predominant ESBL among K. pneumoniae isolates from Japan. This study shows that ESBL-producing hvKp strains comprising various clones are emerging in Japan.å士ļ¼å»å¦ļ¼ć»ē²ē¬¬769å·ć»ä»¤å3幓3ę15ę„Ā© 2020 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
å„čÆēć®å°åä½ę°ćØēę“»ē°å¢ć«ććććććŖčć®č延å®ę
Background: Chronic infection with Helicobacter pylori, specifically cagA-positive strains, is associated with gastric cancer. Thus, measures to prevent H. pylori infection are required. This study was conducted to clarify the prevalence of H. pylori in the community to identify the infection source and comprehensively assess the risk of H. pylori infection. Methods: We collected 90 human faecal samples and 73 environmental samples (water, vegetable, and animal faecal samples) from the residents in an area with a high incidence of gastric cancer in Japan. Polymerase chain reaction assay was performed to detect the glmM housekeeping gene and the cagA virulence gene of H. pylori. A questionnaire survey was conducted, and the responses were analyzed statistically. Results: The glmM gene was detected in 18 of 90 (20%) faecal samples obtained from residents; among them, the cagA gene was detected in 33.3% (6/18), and in all who had undergone eradication therapy. H. pylori was not detected in environmental samples. However, contact with dogs (OR 3.89, 95% CI 1.15-13.15, P < 0.05) was associated with higher odds for glmM gene positivity in the questionnaire survey. Conclusions: The prevalence of H. pylori and cagA-positive strains among the residents was low. However, the study results suggest a correlation between recurrent infection and cagA-positive H. pylori strains. Although H. pylori genes were not detected in living environments, an association between contact with dogs and a glmM positive status was revealed. Further investigations targeting community-dwelling healthy people and their living environments would be required for H. pylori infection control.å士ļ¼å»å¦ļ¼ć»ē²ē¬¬774å·ć»ä»¤å3幓3ę15ę„Ā© 2020 The Authors. Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC
BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Nodal Merkel Cell Carcinoma in Head and Neck Lesions with an Unknown Primary: A Case Report in Light of the Literature
Merkel cell carcinoma (MCC) is a rare but aggressive neuroendocrine skin cancer. To diagnose nodal MCC with an unknown primary disease is challenging, and it has to be separated from other nodal metastatic neoplasms. We report a unique case of nodal MCC in head and neck lesions with an unknown primary. A 70-year-old woman was admitted to our department with a right submandibular mass. Fine needle aspiration biopsy was performed and indicated malignancy. F-18-fluorodeoxyglucose positron emission tomography (PET) demonstrated abnormal accumulation in the right submandibular lymph node, right palatine tonsil, and right thyroid gland. For diagnostics and treatment, bilateral selective neck lymph node dissection, right tonsillectomy, and right thyroidectomy were performed. Histopathological examination revealed that most parts of the submandibular lymph node were occupied by diffuse sheets of tumor cells. Contrary to our expectation, malignant cells were not detected in the right palatine tonsil and right thyroid. Immunohistochemistry demonstrated a marked positive reaction for AE1/AE3, chromogranin A, synaptophysin, cytokeratin 20 (CK20) and CD56 and a negative reaction for vimentin, leucocyte common antigen (LCA), thyroid transcription factor-1 (TTF1) and cytokeratin 7 (CK7) in the tumor cells. Immunostaining of Merkel cell polyomavirus-large T antigen (MCPyV-LT) showed a positive reaction and MCPyV-positive MCCs were assessed by PCR analysis, demonstrating that viral copy number was 12.8 copies per cell. These histological findings confirmed the diagnosis of Merkel cell carcinoma of the lymph node. In cases of tumors in the lymph node with a neuroendocrine appearance in head and neck lesions, it is necessary to eliminate the possibility of metastasis from MCC
Endoscopic Treatment of Sinonasal Glomangiopericytoma: A Case Report in Light of the Literature
A 71-year-old Japanese male patient presented with a rare case of Glomangiopericytoma (GPC) of the left nasal with obstruction. Complete resection with endoscopic surgery was performed. Immunohistochemical staining for smooth muscle actin, Ī² catenin, cyclin D1, vimentin, and factor 13 were helpful in establishing a definitive diagnosis. Extranasal treatment has been traditionally performed for successful management. However, recent advances in endoscopic treatment have enabled complete endoscopic resection of GPC, minimizing morbidity and facilitating subsequent surveillance for recurrence. Endoscopic management should be considered in suitable cases
Specific imaging findings in the course of sinus fungus ball progression to chronic invasive fungal rhinosinusitis
AbstractScattered reports have found that sinus fungus ball (SFB) may progress to chronic invasive fungal rhinosinusitis (CIFRS), but the mechanism is not yet understood. Distinguishing between SFB and CIFRS is sometimes tricky. The invasive features of CIFRS make the symptoms and imaging findings indistinguishable from those of malignant tumors. We herein report a case in which a patient was examined and treated very early in the transition from SFB to CIRFS. An 81-year-old woman with CIFRS was treated with surgery and Voriconazole. Computed tomography (CT) showed a typical high-intensity mass in the maxillary sinus and bony hypertrophy with unusual bony erosion. Magnetic resonance imaging (MRI) showed clear contrast between edematous mucosa and mucosa with CIFRS. The diffusion coefficient (ADC) value in particular was limited to a portion of the CIFRS lesion. The ADC value is helpful as a reference for evaluating the transition of SFB to CIFRS
Clinical and Epidemiological Characteristics of Bloodstream Infections in Head and Neck Cancer Patients: A Decadal Observational Study
This retrospective study aims to describe the clinico-epidemiological characteristics of bloodstream infections (BSIs) and the risk factors in patients with head and neck cancer (n = 227) treated at the Department of Otolaryngology, Head and Neck Surgery, Tohoku University Hospital between April 2011 and March 2021. Overall, 23.3% of blood cultures were positive. In the culture-positive group, catheter-related bloodstream infections (CRBSIs) were the most common (38.8%), followed by respiratory tract infections (19.4%), and catheter-associated urinary tract infections (6.0%). Methicillin-resistant Staphylococcus aureus (26.9%), Staphylococcus epidermidis (17.9%), and Pseudomonas aeruginosa (10.4%) infections were common. The most frequent treatment for head and neck cancer was surgery (23.9%), followed by treatment interval or palliative care (19.4%), and single radiotherapy (13.4%). The 30-day mortality rate was significantly higher in the BSI than in the non-BSI group (10.4% vs. 1.8%, respectively). CRBSIs are the most frequent source of BSIs in patients with head and neck cancer. In conclusion, central venous catheters or port insertion should be used for a short period to prevent CRBSIs. The risk of developing BSI should be considered in patients with pneumonia. Understanding the epidemiology of BSIs is crucial for diagnosing, preventing, and controlling infections in patients with head and neck cancer
Chirurgia endoskopowa w leczeniu brodawczaka odwrĆ³conego jam nosa i zatok przynosowych rozprzestrzeniajÄ cego siÄ do zatok czoÅowych
Cel: Klasyczne metody leczenia brodawczaka odwrĆ³conego jam nosa iĀ zatok przynosowych to zabiegi zĀ dostÄpu zewnÄ
trznosowego. PostÄpy wĀ technikach nawigowania obrazowaniem, rozwĆ³j narzÄdzi chirurgicznych oraz metod obrazowania ÅrĆ³doperacyjnego doprowadziÅy do stopniowego odejÅcia od dostÄpĆ³w zewnÄ
trznosowych na rzecz chirurgii endoskopowej. Ze wzglÄdĆ³w anatomicznych iĀ technicznych, chirurgia endoskopowa wĀ leczeniu brodawczaka odwrĆ³conego jam nosa iĀ zatok przynosowych rozprzestrzeniajÄ
cego siÄ do zatok czoÅowych wciÄ
ż pozostaje wyzwaniem. Poniżej przedstawiono doÅwiadczenia wÅasne autorĆ³w dotyczÄ
ce chirurgii endoskopowej wĀ leczeniu brodawczaka odwrĆ³conego jam nosa iĀ zatok przynosowych rozprzestrzeniajÄ
cego siÄ do jednej lub obu zatok czoÅowych. Metody: Zaprezentowano 10 przypadkĆ³w brodawczaka odwrĆ³conego jam nosa iĀ zatok przynosowych rozprzestrzeniajÄ
cego siÄ do zatok czoÅowych, usuniÄtego skutecznie za pomocÄ
wewnÄ
trznosowego otwarcia obu zatok czoÅowych (Draf III) pod kontrolÄ
endoskopu, bez dodatkowego dojÅcia zewnÄ
trznosowego. Wyniki: Po zakoÅczonym zabiegu chirurgicznym caÅa jama obu zatok czoÅowych mogÅa byÄ wĀ Åatwy sposĆ³b kontrolowana. Nie obserwowano ani wczesnych, ani pĆ³Åŗnych powikÅaÅ. Po Årednim okresie obserwacji (39,5 miesiÄ
ca), nie odnotowano nawrotĆ³w. Wnioski: Zastosowanie dojÅcia endoskopowego zĀ obustronnym otwarciem zatok czoÅowych wĀ leczeniu brodawczaka odwrĆ³conego jam nosa iĀ zatok przynosowych rozprzestrzeniajÄ
cego siÄ do jednej lub obu zatok czoÅowych jest możliwe iĀ wydaje siÄ byÄ skuteczne
Endoscopic surgical management of sinonasal inverted papilloma extending to frontal sinuses
Objective: Sinonasal inverted papilloma has been traditionally managed with external surgical approaches. Advances in imaging guidance systems, surgical instrumentation, and intraoperative multi-visualization have led to a gradual shift from external approaches to endoscopic surgery. However, for anatomical and technical reasons, endoscopic surgery of sinonasal inverted papilloma extending to the frontal sinuses is still challenging. Here, we present our experience in endoscopic surgical management of sinonasal inverted papilloma extending to one or both frontal sinuses. Methods: We present 10 cases of sinonasal inverted papilloma extending to the frontal sinuses and successfully removed by endoscopic median drainage (Draf III procedure) under endoscopic guidance without any additional external approach. Results: The whole cavity of the frontal sinuses was easily inspected at the end of the surgical procedure. No early or late complications were observed. No recurrence was identified after an average follow-up period of 39.5 months. Conclusion: Use of an endoscopic median drainage approach to manage sinonasal inverted papilloma extending to one or both frontal sinuses is feasible and seems effective
Endoscopic surgical management of sinonasal inverted papilloma extending to the frontal sinuses
Objective: Sinonasal inverted papilloma has been traditionally managed with external surgical approaches. Advances in imaging guidance systems, surgical instrumentation, and intraoperative multi-visualization have led to a gradual shift from external approaches to endoscopic surgery. However, for anatomical and technical reasons, endoscopic surgery of sinonasal inverted papilloma extending to the frontal sinuses is still challenging. Here, we present our experience in endoscopic surgical management of sinonasal inverted papilloma extending to one or both frontal sinuses. Methods: We present 10 cases of sinonasal inverted papilloma extending to the frontal sinuses and successfully removed by endoscopic median drainage (Draf III procedure) under endoscopic guidance without any additional external approach. Results: The whole cavity of the frontal sinuses was easily inspected at the end of the surgical procedure. No early or late complications were observed. No recurrence was identified after an average follow-up period of 39.5 months. Conclusion: Use of an endoscopic median drainage approach to manage sinonasal inverted papilloma extending to one or both frontal sinuses is feasible and seems effective