OBJECTIVETo investigate the colony variation in Actinobacillus actinomycetemcomitans (Aa) from rough to smooth and recognize its different morphology during laboratory translations.

METHODSPrimary strains isolated from subgingival plaque of two juvenile periodontitis patients were repeatedly subcultured on agar plates and broth; for broth culture, every generation was translated in broth and on solid medium separately to observe the corresponding morphologies of Aa grow in broth.

RESULTSThree smooth strains of Aa from the broth culture were obtained. The process was about 7-8 generations: colonies changed from a small and adherence phenotype to a bigger and sediment ones and finally the culture supernatant became turbid; the corresponding morphologies grow on agar exhibiting an adherent, small rough colony phenotype which had a star-shaped internal structure converted gradually to a kind of bigger, opaque, nonadherent, smooth phenotype, then the colony extended out from the margin of the colony and finally converted to a flat, almost parent morphology and the same time the star-like inner structure converted to a simpler and smaller type and finally disappeared. We could not get completely smooth variants of Aa from agar.

CONCLUSIONSThe variation in colony morphology of Aa from rough to smooth is a process, in which the colony was gradually wetter and bigger and at the same time gradually lost the inner structure. During this process three colony morphologies at least can be seen, including rough, opaque smooth and almost translucent smooth.

Aggregatibacter actinomycetemcomitans ; genetics ; growth & development ; Cell Division ; genetics ; Child ; Colony Count, Microbial ; Dental Plaque ; microbiology ; Genetic Variation ; Humans ; Periodontitis ; microbiology ; Phenotype ; RNA, Ribosomal, 16S ; genetics ; Species Specificity

Objective: It has been recognized that most medical institutions preferred the printed medium for their information sheets for patient education of inhaler usage. However, some questions have arisen. In a case where patients are not sufficiently informed of drug administration guidance due to limited information with only pictures and text, they might not be able to obtain a proper understanding. Contrarily, it is assumed that video medium, with audio and visual elements, is a format for education conveying a larger amount of information. We conducted comparative research regarding patient’s degree of understanding of inhalation guidance, comparing two groups of print- and video-medium-based instructions for inhaler usage and examined how effective two types of media explanations were on patients.Methods: Research participants were thirty persons visiting Jinjo Pharmacy, who were randomly assigned to the print medium group and the video medium group. After one group read and saw an explanation sheet of an inhaler where the maker wrote inhalation instructions and the other group watched an instruction video, the two groups practiced inhaler usage. Evaluation was performed with specified items and comprehensive assessment, and in addition, the time required for inhalation was measured.Results: Score of the evaluation score was statistically significantly higher in the video medium group than in the print medium group in score of specified items and score of comprehensive assessment, and was also significantly shorter in the operation time of the inhaler.Conclusion: This study clarified that the video medium group had fewer improper inhalation occurrences and shorter operation time and, therefore, showed the effectiveness of the video medium. It is recommended that the video medium should be actively utilized,which could improve patient medication adherence. Accessibility is required for patient education to achieve inhaler techniques by watching video-based instruction.

A 77-year-old woman underwent endovascular abdominal aortic repair (EVAR) for an abdominal aortic aneurysm (AAA)．Five years after surgery, she visited the hospital with the chief complaint of a fever. Enhanced computed tomography (CT) showed enlargement of the AAA around the stent-graft and a mass, which was suspected to be an abscess, outside the aneurysm. A blood test revealed a high level of inflammatory response. The patient was diagnosed with infectious AAA. She received antibiotics; however, the inflammatory response did not completely improve. A second CT scan revealed that the suspected abscess had a spreading tendency. The patient was referred to our hospital for a highly suspected stent-graft infection. We performed Y-graft replacement using a rifampicin-immersed graft, and as much as possible of the wall around the aortic aneurysm was removed. The inflammatory response improved rapidly after the operation, and the patient was discharged 15 days later. According to the results of a pathological examination, a diagnosis of xanthogranulomatous inflammation and fibrosis was made. Here, we report a rare case of xanthogranulomatous inflammation of the aortic aneurysm wall after EVAR.

We have previously reported on a predictive model for deficiency-excess pattern diagnosis that was unable to predict the medium pattern. In this study, we aimed to develop predictive models for deficiency, medium,and excess pattern diagnosis, and to confirm whether cutoff values for diagnosis differed between the clinics. We collected data from patients' first visit to one of six Kampo clinics in Japan from January 2012 to February 2015. Exclusion criteria included unwillingness to participate in the study, missing data, duplicate data, under 20 years old, 20 or less subjective symptoms, and irrelevant patterns. In total, 1,068 participants were included. Participants were surveyed using a 153-item questionnaire. We constructed a predictive model for deficiency, medium, and excess pattern diagnosis using a random forest algorithm from training data, and extracted the most important items. We calculated predictive values for each participant by applying their data to the predictive model, and created receiver operating characteristic (ROC) curves with excess-medium and medium-deficiency patterns. Furthermore, we calculated the cutoff value for these patterns in each clinic using ROC curves, and compared them. Body mass index and blood pressure were the most important items. In all clinics, the cutoff values for diagnosis of excess-medium and medium-deficiency patterns was > 0.5 and < 0.5, respectively. We created a predictive model for deficiency, medium, and excess pattern diagnosis from the data of six Kampo clinics in Japan. The cutoff values for these patterns fell within a narrow range in the six clinics.