Using a mouse model, we previously demonstrated that subcutaneous infection with the JaTH160 strain of Japanese encephalitis virus (JEV) causes significantly higher virulence and stronger virus propagation in the brain compared with that of the JaOArS982 strain. We also showed that the JaTH160 strain, but not JaOArS982, expresses the NS1’ protein and that NS1’ enhances JEV production in avian cells and embryonated chicken eggs. In this study, we examined whether NS1’ expression affects virulence in mice infected with the JaOArS982 and JaTH160 strains using the corresponding recombinant viruses S982-IC and JaTH-IC. Expression of the NS1’ protein in S982-IC diminished the mortality in mice, whereas S982-IC viruses without NS1’ caused 40–60% mortality. However, the viral loads in the brains of these mice were not significantly different despite the dvariation in NS1’ expression. JaTH-IC viruses depleted of the NS1’ protein exhibited high mortality levels, similar to those of the virus expressing NS1’. Previous studies showed that the NS1’ protein plays a role in the enhanced virulence of the JEV SA14 strain in mice. However, our current data suggest that NS1’ protein expression in S982-IC reduces, rather than enhances, the mortality in mice. Thus, the effect of NS1’ on pathogenicity in vivo may vary among virus strains. Our data also suggest that the reduced mortality resulting from NS1’ expression in S982-IC is not simply due to viral replication in the brains. Further investigation is needed to uncover the mechanism by which NS1’ affects pathogenicity in JEV-infected animals.

Using a mouse model,we previously demonstrated that subcutaneous infection with the JaTH160 strainof Japaneseencephalitis virus (JEV) causes significantly higher virulence and strongervirus propagation in the brain compared with that of the JaOArS982strain. We also showed that the JaTH160 strain,but not JaOArS982, expresses the NS1’ protein and that NS1’ enhances JEVproduction in avian cells and embryonated chicken eggs. In this study, weexamined whether NS1’ expression affects virulence in mice infected with theJaOArS982 and JaTH160 strains using the corresponding recombinant viruses S982-ICand JaTH-IC.Expression of the NS1’ protein in S982-IC diminishedthe mortality in mice, whereas S982-IC viruses without NS1’ caused 40% mortality.However, the viral loads in the brains of these mice were not significantlydifferent despite the difference in NS1’ expression. JaTH-IC viruses depletedof the NS1’ protein exhibited high mortality levels, similar to those of thevirus expressing NS1’.Previousstudies showed that the NS1’ protein plays a role in the enhanced virulenceof the JEV SA14 strain in mice. However, ourcurrent data suggest that NS1’ protein expression in S982-IC reduces,rather than enhances, the mortality in mice. Thus, the effect of NS1’ on pathogenicity invivo may vary among virus strains. Our data also suggest that the reducedmortality resulting from NS1’ expression in S982-IC is not simply due to viralreplication in the brains. Furtherinvestigation is needed to uncover the mechanism by which NS1’ affectspathogenicity in JEV-infected animals.

Good Death Scale (GDS) is a provider assessment scale of quality of dying of terminally ill cancer patients, and its reliability and validity has been confirmed. The aim of this study is translating the GDS into Japanese (GDS-J) according to the standard methods of conducting linguistic validation. In the forward translation, there was a disagreement in the translation of “will” into Japanese translation of “will” of GDS question 3 “Has the patient arranged everything according to his/her own will?” We confirmed linguistic validity in the research team and eventually got approval from the original author in writing and decided on GDS-J. Using the GDS-J, a quality assessment scale for palliative care by provider, it will be possible to evaluate the quality of palliative care to be done by themselves and to be expected to be useful for providing higher-quality palliative care.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging disease endemic in East Asia. Transmitted to other organisms by infected ticks, the SFTS virus (SFTSV) and is endemic to Nagasaki in western Japan. However, epidemiological information regarding SFTSV in Nagasaki ticks has not been available to date. In this study, we began by examining the sensitivities of SFTSV gene detection by real-time RT-PCR and virus isolation in cultured cells and mice. These methods could detect SFTSV in the samples containing more than 4 × 10⁰ ffu. Next, we attempted to isolate SFTSV and to detect viral gene in 2,222 nymph and adult ticks collected from May to August 2013 among seven regions of Nagasaki. However, neither virus isolation nor viral gene detection were confirmed in the tick pools. SFTSV positivity rates are considered to be very low in ticks, and viral loads are also very limited. Further investigations increasing the number of ticks and including larval samples as well as improved detection methods, may be required to find SFTSV-positive ticks in this region.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging disease that is endemic in East Asia. The SFTS virus (SFTSV) is transmitted to other organisms by infected ticks and is endemic to Nagasaki in western Japan. However, epidemiological information regarding SFTSV in Nagasaki ticks has not been elucidated. In this study, we first examined the sensitivities of SFTSV gene detection by real-time RT-PCR and virus isolation in cultured cells and mice. These methods could detect SFTSV in the samples containing more than 4 × 10⁰ ffu. Next, we attempted to isolate SFTSV and to detect viral gene in 2,222 nymph and adult ticks collected from May to August 2013 among seven regions of Nagasaki. However, neither virus isolation nor viral gene detection were confirmed in those tick pools. SFTSV positivity rates are considered very low in ticks and viral loads in ticks are also very limited. Further investigation by increasing the number of ticks and including larval samples in the investigation, as well as improved detection methods, may be required to find SFTSV-positive ticks in this region.

Twenty-two patients who underwent vascular reconstruction for carotid occlusive disease by April 1998 were examined in terms of long-term results. The cause of disease was atherosclerosis in 16, and aortitis in 6. The operation method included CEA in 11 and bypass in 5 cases in the atherosclerosis cases, and CEA in 2 and bypass in 6 cases in aortitis. Cases of occlusive disease included 1 early occlusion (atherosclerosis) and 4 late occlusion (atherosclerosis 2, aortitis 2). The cause of early occlusion was considered to be due to technical factors, but late occlusion was thought to be related to progression of disease, anastomotic intimal thickening, and recurrence of inflammation. It is important to enforce strict operative indications, accurate intraoperative monitoring, and perioperative drug control.

Dengue is an emerging disease in Nepal and was first observed as an outbreak in nine lowland districts in 2006. In 2010, however, a large epidemic of dengue occurred with 4,529 suspected and 917 serologically-confirmed cases and five deaths reported in government hospitals in Nepal. The collection of demographic information was performed along with an entomological survey and clinical evaluation of the patients. A total of 280 serum samples were collected from suspected dengue patients. These samples were subjected to routine laboratory investigations and IgM-capture ELISA for dengue serological identification, and 160 acute serum samples were used for virus isolation, RT-PCR, sequencing and phylogenetic analysis. The results showed that affected patients were predominately adults, and that 10% of the cases were classified as dengue haemorrhagic fever/ dengue shock syndrome. The genetic characterization of dengue viruses isolated from patients in four major outbreak areas of Nepal suggests that the DENV-1 strain was responsible for the 2010 epidemic. Entomological studies identified Aedes aegypti in all epidemic areas. All viruses belonged to a monophyletic single clade which is phylogenetically close to Indian viruses. The dengue epidemic started in the lowlands and expanded to the highland areas. To our knowledge, this is the first dengue isolation and genetic characterization reported from Nepal.

We investigated the number of drugs and pharmaceutical cost among 159 patients prescribed Western medicine and hospitalized from August 2006 to August 2015 in the Department of Oriental (Kampo) Medicine at Chiba University Hospital. The number of drugs used in Western medicine among improved patients significantly decreased from 5.6 ± 3.6 at hospitalization to 5.3 ± 3.5 at discharge, but the number of Kampo medicine drugs was not changed. The total number of drugs including both Western medicine and Kampo medicine significantly decreased from 7.0 ± 3.8 to 6.7 ± 3.6. The number of drugs used in Western medicine among nochanged patients decreased from 5.1 ± 3.4 at hospitalization to 5.0 ± 3.7 at discharge, but the number of Kampo medicine drugs significantly increased from 1.0 ± 0.0 at hospitalization to 1.3 ± 0.5. The total number of drugs including both Western medicine and Kampo medicine increased from 6.1 ± 3.4 to 6.3 ± 3.9. We thus conclude that a combination of Kampo medicine with Western medicine can be useful for reducing the number of drugs related to polypharmacy. To achieve these results, it is essential to use the concept of sho (a way of pattern recognition of a patient's symptoms in Kampo medicine).

The purpose of this study is to clarify the current state of nursing for the sexuality of patients with cancer at the end-of-life. In December 2018, we asked 313 nurses from 18 palliative care units in Kanagawa Prefecture about their awareness, feelings, and behavioral intentions and hands-on experience for the environment in which patients with cancer nurture love with their partners at the end-of-life. The collection rate of the questionnaire was 52.7% (165 cases). Eighty-two nurses (49.7%) had experience supporting the environment in which patients with cancer nurture love with their partners at the end-of-life. The contents of the support were “Recommend physical contact”, “Listening”, “Recommend hug”, and “Take sufficient time when entering the room, such as waiting for a reply after knocking or calling out”. Meanwhile, at ward conferences, only 11 (6.7%) had talked about the environment in which patients with cancer nurture love with their partners at the end-of-life. It has been suggested that, at present, support for the environment in which patients with cancer nurture love with their partners at the end-of-life is left to individuals and not systematically.