Objective Clinical strains of Shigella dysenteriae isolated from eastern parts of India in 1988, 1995 and 2002 were examined for the presence of class 1, 2 and 3 integrons which closely related with drug resistance and the distribution of resistance gene cassette in order to clarify the influence of integron system on drug resistance of Shigella dysenteriae. Methods Susceptibility to antimicrobial agents was tested by the disk agar diffusion method. Class 1, 2 and 3 integron genes (intI) were screened by polymerase chain reaction (PCR) in 16 clinical strains with drug resistance.The variable regions of gene cassette of positive strains were sequenced. Results All 16 isolates were resistant to at least 4 agents including β-lactams, aminoglycosides, tetracyclines, sulfonamides,chloramphenicols and quinolones. Class 1 integron gene was detected in 13 strains and all isolates carried class 2 integron which indicated that strains with two integron structures were detected simultaneously and class 3 integron was not detected. Class 1 integron inserted gene cassette was mainly blaara30 -aadA 1 family, conferring resistance to β-lactamase, spectinomycin and streptomycins isolates carried class 2 integron were mainly dfrAl-satl genes cassettes conferring resistance to methoxybenzyl aminopyrimidine and streptothricin, while dfrA\-sat\-aadA\ genes were present only in 4 isolates. Conclusions These data indicate that class 2 integrons are widespread in Shigella dysenteriae strains, and closely associated with multidrug resistance of Shigella.

Objective San-PCR was used to analyze an outbreak of nosocomial infection caused by Brukholderia cepacia.Meanwhile a new DNA amplification technique for genetic fingerprinting-San-PCR was introduced,which owns high sensitivity and facility for homology analysis.Methods The proposed technique was based on the digestion of genomic DNA with the restriction endonuclease Sau3AI and subsequent amplification with primers which carried San3AI recognition site.Finally the homology among the DNA samples was analyzed on the basis of the profiles of agarose gel electrophoresis.Results All of the 11 strains isolated from the patients shclwed the homology except one.The results were confirmed by using PFGE and the results showed consistence with PFGE results.Condusion Sau-PCR is simple,robust,rapid method for DNA fingerprinting with broad perspective.

We report a 10-year-old boy with supratentorial cortical ependymoma that rapidly grew in the course of 3 years. He suffered generalized seizures when he was 5 years old; MRI showed a small cortical lesion in the right postcentral gyrus. MRI performed 2 years later revealed no changes. For the next 3 years he was free of seizures. However, at the age of 10 he again suffered generalized seizures and MRI disclosed a large parietal tumor. It was resected totally and he remains free of neurological deficits. The histopathological diagnosis was ependymoma. Pediatric supratentorial cortical ependymomas are extremely rare. We recommend including cortical ependymoma as a differential diagnosis in pediatric patients with cortical mass lesions presenting with seizures and careful follow-up even in the absence of symptoms because these tumors may progress.
Child ; Diagnosis ; Diagnosis, Differential ; Ependymoma* ; Humans ; Magnetic Resonance Imaging ; Male ; Rabeprazole ; Seizures

AIMTo identify proteins induced by androgen in Sertoli cells during spermatogenesis.

METHODSWe analyzed protein profiles in TM4 Sertoli cells treated with dihydrotestosterone (DHT) using surface enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS).

RESULTSWe found increases in the expression of a 5.0-kDa protein at 15 min, an 11.3-kDa protein at 24 h and 4.3 kDa, 5.7 kDa, 5.8 kDa, 9.95 kDa and 9.98 kDa proteins at 48 h after the treatment. In contrast, the expression of 6.3 kDa and 8.6 kDa proteins decreased at 30 min, and 4.9 kDa, 5.0 kDa, 12.4 kDa and 19.8 kDa proteins at 48 h after the treatment. The 11.3-kDa protein was identified as macrophage migration inhibitory factor (MIF) known to having various functions. The 9.98-kDa protein was identified as calgizzarin related to calcium channels. The timing of their expression suggests that MIF and calgizzarin are involved in late regulation of spermatogenesis in Sertoli cells by androgen.

CONCLUSIONMIF and calgizzarin are two important androgen-responsive proteins produced by Sertoli cells and they might play a role in regulating spermatogenesis.

Androgens ; pharmacology ; Animals ; Cell Line ; Dihydrotestosterone ; pharmacology ; Gene Expression Regulation ; drug effects ; Kinetics ; Macrophage Migration-Inhibitory Factors ; genetics ; Male ; Mice ; Protein Array Analysis ; S100 Proteins ; genetics ; Sertoli Cells ; drug effects ; physiology ; Spermatogenesis

Hip dysplasia is the most common cause of secondary osteoarthritis (OA). To prevent the early onset of secondary OA, Nishio's transposition osteotomy, Steel's triple osteotomy, Eppright's dial osteotomy, Wagner's spherical acetabular osteotomy, Tagawa's rotational acetabular osteotomy (RAO), and Ganz' periacetabular osteotomy (PAO) have been proposed. PAO and RAO are now commonly used in surgical treatment of symptomatic acetabular dysplasia in Europe, North America, and Asia. The aim of this paper is to present the followings: the patient selection criteria for RAO; the surgical technique of RAO; the long-term outcome of RAO; and the future perspectives.
Acetabulum* ; Asia ; Europe ; Hip Dislocation ; North America ; Osteoarthritis ; Osteotomy* ; Patient Selection

OBJECTIVEThe aim of this study is to determine whether a questionnaire-based method using the Veterans Specific Activity Questionnaire (VSAQ) is a practical tool for the development of a safe exercise program to prevent a reduction in physical performance.

METHODSOne hundred and twenty-one senior residents of Yakage, Okayama, agreed to voluntarily participate in this study. They were asked to complete a questionnaire for information on age, sex, subjective health status, exercise habits and VSAQ. We investigated the relationship between age and exercise capacity predicted by VSAQ (predicted metabolic equivalents (METs)). In addition, for 36 out of the 121 participants, we performed a 6-min walk distance test (6MD) and investigated whether its results correlate with the predicted METs. Furthermore, we prepared a modified VSAQ and examined its practicality in the evaluation of the exercise capacity of Japanese elderly (n=50).

RESULTSWe found that the predicted METs correlate well with age. Habitual exercise and subjective health status did not affect the predicted METs. A significant correlation was observed between the predicted METs and the results of 6MD (r=0.56, p<0.001). We also found that certain activities included in the original VSAQ are unfamiliar to Japanese elderly; thus, we made a few modifications to the original VSAQ in order to evaluate the physical fitness of Japanese elderly. The number of inadequate answers was reduced by employing the modified VSAQ.

CONCLUSIONThese findings imply that the modified VSAQ is useful in evaluating the exercise capacity of Japanese elderly adequately and is a practical scale for safe exercise.

The dawn of Japan’s super-aged society is accompanied by various problems, including increased social security expenditures and greater nursing care burden as well as reduced labor force. Targeting 2025, when Japan’s baby-boomer generation will be aged ≥75 years, the government’s Ministry of Health, Labour and Welfare is promoting the establishment of local comprehensive support and service provision systems (Comprehensive Community Care Systems). Although such comprehensive community care systems will require medical professionals to provide treatment through collaborative interprofessional cooperation with colleagues in other fields, effective cooperation has currently not been established because of a lack of understanding regarding the roles and functions of other occupations. Considering that the promotion of interprofessional-based collaborative learning prior to university graduation will be important for resolving this problem, we organized a workshop for medical students based in Ehime Prefecture and evaluated its usefulness based on questionnaire surveys administered before and after the workshop. Consequently, it was ascertained that pharmacy, medical, and nursing students had a heightened awareness of “the importance of interprofessional collaboration” after the workshop as against before the workshop. Students’ degree of comprehension of the nature of the work in each category increased significantly. These results demonstrate the importance and effectiveness of students familiarizing themselves with the learning and work content of other fields by working with colleagues in different medical fields as observed in this workshop. They also expect that student-led study groups will contribute to promote the comprehensive community care systems.

A 79-year-old woman presented to our hospital with high energy trauma. Enhanced CT revealed injury to the aortic arch. The left carotid artery was pulled out due to extension force and a drawing out lesion formed. Cardiopulmonary bypass was established with cannulation of the right femoral artery and the right atrium, and systemic cooling was started. We opened the aortic arch with deep hypothermic circulatory arrest, and detected a 10 mm drawing out lesion at the bottom of the left carotid artery. Aortic arch was transected at the distal of the left carotid artery to exclude the drawing out lesion, and partial arch replacement was performed. The patient's postoperative course was uneventful, and she was discharged from our hospital without any complication.