Molecular characteristics and genetic analysis of the genes related to carbapenemase, efflux pump, and outer membrane proteins in carbapenem-resistant Klebsiella pneumoniae.

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a life-threatening pathogen that has not been fully investigated on a molecular basis. Therefore, the molecular mechanisms of carbapenem resistance in CRKP collected from medical institutions in Hyogo Prefecture has been analyzed. Antimicrobial susceptibilities and the presence of carbapenemase along with epidemiological analyzes using multilocus sequence typing (MLST) have been investigated. The relative expression of efflux pump genes and mutations of ompK35 and ompK36, encoding the outer membrane porin, were also assessed for their relationship with carbapenem resistance. Most of the collected 22 CRKP isolates were non-susceptible to imipenem (68.2%), meropenem (90.9%), and ertapenem (81.8%), but all 22 strains were susceptible to colistin. Twelve strains (54.5%) were detected for carbapenemase genes such as blaIMP-6. Sequence type 37 was detected by MLST in 10 strains (45.5%). Non-carbapenemase-producing strains had high resistance rates for three carbapenems, and the main cause of resistance was ompK35 mutation. In conclusion, the main cause of resistance was imipenemase metallo-ß-lactamase (IMP-6) production in carbapenemase-producing strains, and ompK35 mutation in non-carbapenemase-producing strains. Susceptibility to carbapenem did not differ in CRKP regardless of carbapenemase production, except for imipenem susceptibility. This result contributes to a more insightful understanding of the mechanisms of CRKP in Japan.

Determination of the triple oxygen isotopic composition of tropospheric ozone in terminal positions using a multistep nitrite-coated filter-pack system.

RATIONALE: The triple oxygen isotopic composition (Δ17 O) of tropospheric ozone (O3 ) is a useful tracer for identifying the source and is essential for clarifying the atmospheric chemistry of oxidants. However, the single nitrite-coated filter method is inaccurate owing to the nitrate blank produced through the reaction of nitrite and oxygen compounds other than O3 . METHODS: A multistep nitrite-coated filter-pack system is newly adopted to transfer the O-atoms in terminal positions of O3 to nitrite on each filter to determine the Δ17 O of O3 in terminal positions (denoted as Δ17 O(O3 )term ). The NO3 - produced by this reaction is chemically converted into N2 O, and continuous-flow isotope ratio mass spectrometry (CF-IRMS) is used to determine the oxygen isotopic compositions. RESULTS: The reciprocal of the NO3 - quantities on the nitrite-coated filters in each sample showed a strong linear relationship with Δ17 O of NO3 - . Using the linear relation, we corrected the changes in Δ17 O of NO3 - on the filters. We verified the accuracy of the new method through the measurement of artificial O3 with known Δ17 O(O3 )term value that had been determined from the changes in Δ17 O of O2 . The Δ17 O(O3 )term of tropospheric O3 was in agreement with previous studies. CONCLUSIONS: We accurately determined the δ18 O and Δ17 O values of tropospheric O3 by blank correction using our new method. Measurements of Δ17 O(O3 )term of the ambient troposphere showed 1.1 ± 0.7‰ diurnal variations between daytime (higher) and nighttime (lower) due likely to the formation of the temperature inversion layer at night.

First X-ray Spectroscopic Observations of Atmospheric Titanium Species: Size Dependence and the Emission Source.

Titanium dioxide (TiO2) in mineral dust is considered as one of the driving forces of photocatalytic reaction at the aerosol surface in the atmosphere. As a precursor of mineral dust, soil contains ilmenite (FeTiO3) and titanite (CaSiTiO5), which have lower photochemical reactivities than TiO2. However, Ti species other than TiO2 in aerosol particles are not well recognized due to the lack of observation in ambient samples. In this study, Ti species in size-fractionated aerosol samples collected in the Noto Peninsula, Japan, were determined by macroscopic and semi-microscopic X-ray absorption fine structure spectroscopy. Regardless of aerosol particle size, Ti species were primarily composed of rutile, anatase, ilmenite, and titanite. Semi-microscopic Ti speciation showed that Ti-poor spots associated with mineral dust were composed of a mixture of rutile, anatase, ilmenite, and titanite, and Ti-rich spots were primarily composed of TiO2 (rutile or anatase) derived from authigenic minerals or anthropogenic materials. Thus, the Ti species in aerosol particles, especially mineral dust, were not composed solely of TiO2 polymorphs. Therefore, the photochemical reactivities of Ti in aerosol particles may be overestimated when laboratory experiments or model studies employ TiO2 as the representative Ti species.

Differential effects of chromosome and plasmid blaCTX-M-15 genes on antibiotic susceptibilities in extended-spectrum beta-lactamase-producing Escherichia coli isolates from patients with urinary tract infection.

OBJECTIVES: To compare antibiotic susceptibilities between chromosomal and plasmid blaCTX-M-15 locations in urinary tract infection-causing extended-spectrum ß-lactamases-producing Escherichia coli blaCTX-M-15 isolated in Indonesia. METHODS: A total of 84 strains identified as extended-spectrum ß-lactamases-producing E. coli were isolated from patients with urinary tract infection in Indonesia in 2015. Antimicrobial susceptibility tests were performed on these strains using 18 antibiotics, and extended-spectrum ß-lactamase bla genes were detected by polymerase chain reaction. Gene localization of blaCTX-M-15 -positive strains was confirmed by Southern blot hybridization, and epidemiological typing was conducted using multilocus sequence typing. RESULTS: Of 54 strains harboring the blaCTX-M-15 gene, 27 showed localization on chromosome, 20 on plasmid, and seven on chromosome and plasmid. Most multilocus sequence typing sequence types of the 27 strains with chromosomal blaCTX-M-15 were ST405 (25.9%) and ST131 (22.2%) strains, whereas the 20 strains with plasmid-blaCTX-M-15 were mostly ST410 (55.0%). CONCLUSIONS: Extended-spectrum ß-lactamases-producing E. coli blaCTX-M-15 with plasmid genes show significantly higher resistant rates against piperacillin-tazobactam but lower resistant rates against chloramphenicol compared to chromosomal strains in Indonesian patients with urinary tract infection. Mechanistic investigations will be necessary to advance our knowledge of antimicrobial resistance in urinary tract infection.

Mechanisms of Increased Particle and VOC Emissions during DPF Active Regeneration and Practical Emissions Considering Regeneration.

Mechanisms involved in increased particle and volatile organic compound (VOC) emissions during active and parked active regenerations of a diesel particulate filter (DPF) were investigated using heavy-duty trucks equipped with both a urea selective catalytic reduction system and a DPF (SCR + DPF) and a DPF-only. Particle emissions increased in the later part of the regeneration period but the mechanisms were different above and below 23 nm. Particles above 23 nm were emitted due to the lower filtering efficiency of the DPF because of the decreasing amount of soot trapped during regeneration. Small particles below 23 nm were thought to be mainly sulfuric acid particles produced from SO2 trapped by the catalyst, being released and oxidized during regeneration. Contrary to the particle emissions, VOCs increased in the earlier part of the regeneration period. The mean molecular weights of the VOCs increased gradually as the regeneration proceeded. To evaluate "practical emissions" in which increased emissions during the regeneration were considered, a Regeneration Correction Factor (RCF), which is the average emission during one cycle of regeneration/emission in normal operation, was adopted. The RCFs of PM and VOCs were 1.1-1.5, and those of PNs were as high as 3-140, although they were estimated from a limited number of observations.

The Essential Role for Laboratory Studies in Atmospheric Chemistry.

Laboratory studies of atmospheric chemistry characterize the nature of atmospherically relevant processes down to the molecular level, providing fundamental information used to assess how human activities drive environmental phenomena such as climate change, urban air pollution, ecosystem health, indoor air quality, and stratospheric ozone depletion. Laboratory studies have a central role in addressing the incomplete fundamental knowledge of atmospheric chemistry. This article highlights the evolving science needs for this community and emphasizes how our knowledge is far from complete, hindering our ability to predict the future state of our atmosphere and to respond to emerging global environmental change issues. Laboratory studies provide rich opportunities to expand our understanding of the atmosphere via collaborative research with the modeling and field measurement communities, and with neighboring disciplines.

Tropospheric winds from northeastern China carry the etiologic agent of Kawasaki disease from its source to Japan.

Evidence indicates that the densely cultivated region of northeastern China acts as a source for the wind-borne agent of Kawasaki disease (KD). KD is an acute, coronary artery vasculitis of young children, and still a medical mystery after more than 40 y. We used residence times from simulations with the flexible particle dispersion model to pinpoint the source region for KD. Simulations were generated from locations spanning Japan from days with either high or low KD incidence. The postepidemic interval (1987-2010) and the extreme epidemics (1979, 1982, and 1986) pointed to the same source region. Results suggest a very short incubation period (<24 h) from exposure, thus making an infectious agent unlikely. Sampling campaigns over Japan during the KD season detected major differences in the microbiota of the tropospheric aerosols compared with ground aerosols, with the unexpected finding of the Candida species as the dominant fungus from aloft samples (54% of all fungal strains). These results, consistent with the Candida animal model for KD, provide support for the concept and feasibility of a windborne pathogen. A fungal toxin could be pursued as a possible etiologic agent of KD, consistent with an agricultural source, a short incubation time and synchronized outbreaks. Our study suggests that the causative agent of KD is a preformed toxin or environmental agent rather than an organism requiring replication. We propose a new paradigm whereby an idiosyncratic immune response, influenced by host genetics triggered by an environmental exposure carried on winds, results in the clinical syndrome known as acute KD.

Abundance and distribution of dimethylsulfoniopropionate degradation genes and the corresponding bacterial community structure at dimethyl sulfide hot spots in the tropical and subtropical pacific ocean.

Dimethylsulfoniopropionate (DMSP) is mainly produced by marine phytoplankton but is released into the microbial food web and degraded by marine bacteria to dimethyl sulfide (DMS) and other products. To reveal the abundance and distribution of bacterial DMSP degradation genes and the corresponding bacterial communities in relation to DMS and DMSP concentrations in seawater, we collected surface seawater samples from DMS hot spot sites during a cruise across the Pacific Ocean. We analyzed the genes encoding DMSP lyase (dddP) and DMSP demethylase (dmdA), which are responsible for the transformation of DMSP to DMS and DMSP assimilation, respectively. The averaged abundance (±standard deviation) of these DMSP degradation genes relative to that of the 16S rRNA genes was 33% ± 12%. The abundances of these genes showed large spatial variations. dddP genes showed more variation in abundances than dmdA genes. Multidimensional analysis based on the abundances of DMSP degradation genes and environmental factors revealed that the distribution pattern of these genes was influenced by chlorophyll a concentrations and temperatures. dddP genes, dmdA subclade C/2 genes, and dmdA subclade D genes exhibited significant correlations with the marine Roseobacter clade, SAR11 subgroup Ib, and SAR11 subgroup Ia, respectively. SAR11 subgroups Ia and Ib, which possessed dmdA genes, were suggested to be the main potential DMSP consumers. The Roseobacter clade members possessing dddP genes in oligotrophic subtropical regions were possible DMS producers. These results suggest that DMSP degradation genes are abundant and widely distributed in the surface seawater and that the marine bacteria possessing these genes influence the degradation of DMSP and regulate the emissions of DMS in subtropical gyres of the Pacific Ocean.

Measurement of air-sea exchange of dimethyl sulfide and acetone by PTR-MS coupled with gradient flux technique.

We developed a new method for in situ measurement of air-sea fluxes of multiple volatile organic compounds (VOCs) by combining proton transfer reaction-mass spectrometry (PTR-MS) and gradient flux (GF) technique. The PTR-MS/GF system was first deployed to determine the air-sea flux of VOCs in the open ocean of the western Pacific, in addition to carbon dioxide and water vapor. Each profiling at seven heights from the ocean surface up to 14 m took 7 min. In total, 34 vertical profiles of VOCs in the marine atmosphere just above the ocean surface were obtained. The vertical gradient observed was significant for dimethyl sulfide (DMS) and acetone with the best-fit curves on quasi-logarithmic relationship. The mean fluxes of DMS and acetone were 5.5 ± 1.5 and 2.7 ± 1.3 µmol/m(2)/day, respectively. These fluxes are in general in accordance with those reported by previous expeditions.

Establishment of an artificial urine model in vitro and rat or pig model in vivo to evaluate urinary crystal adherence.

The current study aimed to establish an experimental model in vitro and in vivo of urinary crystal deposition on the surface of ureteral stents, to evaluate the ability to prevent crystal adhesion. Non-treated ureteral stents were placed in artificial urine under various conditions in vitro. In vivo, ethylene glycol and hydroxyproline were administered orally to rats and pigs, and urinary crystals and urinary Ca were investigated by Inductively Coupled Plasma-Optical Emission Spectrometer. in vitro, during the 3- and 4-week immersion periods, more crystals adhered to the ureteral stent in artificial urine model 1 than the other artificial urine models (p < 0.01). Comparing the presence or absence of urea in the composition of the artificial urine, the artificial urine without urea showed less variability in pH change and more crystal adhesion (p < 0.05). Starting the experiment at pH 6.3 resulted in the highest amount of crystal adhesion to the ureteral stent (p < 0.05). In vivo, urinary crystals and urinary Ca increased in rat and pig experimental models. This experimental model in vitro and in vivo can be used to evaluate the ability to prevent crystal adhesion and deposition in the development of new ureteral stents to reduce ureteral stent-related side effects in patients.

In-depth analysis of ambient air pollution changes due to the COVID-19 pandemic in the Asian Monsoon region.

The COVID-19 pandemic has given a chance for researchers and policymakers all over the world to study the impact of lockdowns on air quality in each country. This review aims to investigate the impact of the restriction of activities during the lockdowns in the Asian Monsoon region on the main criteria air pollutants. The various types of lockdowns implemented in each country were based on the severity of the COVID-19 pandemic. The concentrations of major air pollutants, especially particulate matter (PM) and nitrogen dioxide (NO2), reduced significantly in all countries, especially in South Asia (India and Bangladesh), during periods of full lockdown. There were also indications of a significant reduction of sulfur dioxide (SO2) and carbon monoxide (CO). At the same time, there were indications of increasing trends in surface ozone (O3), presumably due to nonlinear chemistry associated with the reduction of oxides of nitrogens (NOX). The reduction in the concentration of air pollutants can also be seen in satellite images. The results of aerosol optical depth (AOD) values followed the PM concentrations in many cities. A significant reduction of NO2 was recorded by satellite images in almost all cities in the Asian Monsoon region. The major reductions in air pollutants were associated with reductions in mobility. Pakistan, Bangladesh, Myanmar, Vietnam, and Taiwan had comparatively positive gross domestic product growth indices in comparison to other Asian Monsoon nations during the COVID-19 pandemic. A positive outcome suggests that the economy of these nations, particularly in terms of industrial activity, persisted during the COVID-19 pandemic. Overall, the lockdowns implemented during COVID-19 suggest that air quality in the Asian Monsoon region can be improved by the reduction of emissions, especially those due to mobility as an indicator of traffic in major cities.

Comparative genetic analysis of the antimicrobial susceptibilities and virulence of hypermucoviscous and non-hypermucoviscous ESBL-producing Klebsiella pneumoniae in Japan.

BACKGROUND: Hypermucoviscous (HMV) Klebsiella pneumoniae produces large amounts of capsular polysaccharides, leading to high mortality. Since extended spectrum beta-lactamase (ESBL)-producing HMV K. pneumoniae strains have increased in Japan, we investigated and compared the antimicrobial susceptibilities and genetic characteristics of HMV and non-HMV ESBL-producing K. pneumoniae. METHODS: We investigated 291 ESBL-producing K. pneumoniae collected between 2012 and 2018, and in them 54 HMV strains were identified and comparable 53 non-HMV strains were selected. Then, ESBL gene detection, plasmid replicon typing, and virulence gene detection were done by PCR amplification. RESULTS: Almost all of the HMV K. pneumoniae strains possessed uge (98.1%), wabG (96.3%), rmpA (94.4%), iucA (79.6%), fimH (70.4%), iroB (70.4%), and peg-344 (70.4%). These genes were found less frequently in non-HMV strains (uge 20.8%, wabG 83.0%, rmpA 7.5%, iucA 3.8%, fimH 9.4%, iroB 5.7%, and peg-344 1.9%). K2 capsule type (40.7%) was most common in HMV strains. HMV strains showed higher resistance to cefepime (p = 0.001) and piperacillin/tazobactam (p = 0.005) than non-HMV strains. CTX-M-15 (75.9%, 60.4%) was the dominant ESBL type in both HMV and non-HMV strains, and the most common plasmid replicon type was IncFII (52.1%) in CTX-M-15-producing strains. CONCLUSIONS: We found that HMV strains had more virulence genes and showed higher resistance to antibiotics than non-HMV strains. The most common capsule type was K2. CTX-M-15 was the most common type of ESBL gene in both HMV and non-HMV strains in Japan. The FII plasmid might be related to the spread of CTX-M-15 among K. pneumoniae strains.

Impact on quinolone resistance of plasmid-mediated quinolone resistance gene and mutations in quinolone resistance-determining regions in extended spectrum beta lactamase-producing Klebsiella pneumoniae isolated from urinary tract infection patients.

Klebsiella pneumoniae is a typical pathogen in urinary tract infections (UTI), and the emergence of extended spectrum beta-lactamase (ESBL)-producing strains has been frequently reported, accompanied by higher quinolone resistance rates. There are two major mechanisms of quinolone resistance, mutations in quinolone resistance-determining regions (QRDR) and the presence of the plasmid-mediated quinolone resistance (PMQR) genes. This study aimed to investigate quinolone resistance among 105 ESBL-producing K. pneumoniae specimens isolated from UTI patients in Indonesia. These were characterized for antimicrobial resistance to nalidixic acid, ciprofloxacin, and levofloxacin, QRDR mutations in gyrA and parC and the presence of PMQR genes. We found that 84.8% of the collected isolates were resistant to at least one of the quinolones. QRDR mutation in gyrA was observed in 49.5% of these strains and parC mutations in 61.0%. PMQR genes were identified in 84.8% of strains. The QRDR mutations clearly had a greater effect on resistance than the PMQR genes. In conclusion, we found high quinolone resistance rates in Indonesian ESBL-producing K. pneumoniae, in which QRDR mutation played a major role.

Dominance of the residential sector in Chinese black carbon emissions as identified from downwind atmospheric observations during the COVID-19 pandemic.

Emissions of black carbon (BC) particles from anthropogenic and natural sources contribute to climate change and human health impacts. Therefore, they need to be accurately quantified to develop an effective mitigation strategy. Although the spread of the emission flux estimates for China have recently narrowed under the constraints of atmospheric observations, consensus has not been reached regarding the dominant emission sector. Here, we quantified the contribution of the residential sector, as 64% (44-82%) in 2019, using the response of the observed atmospheric concentration in the outflowing air during Feb-Mar 2020, with the prevalence of the COVID-19 pandemic and restricted human activities over China. In detail, the BC emission fluxes, estimated after removing effects from meteorological variability, dropped only slightly (- 18%) during Feb-Mar 2020 from the levels in the previous year for selected air masses of Chinese origin, suggesting the contributions from the transport and industry sectors (36%) were smaller than the rest from the residential sector (64%). Carbon monoxide (CO) behaved differently, with larger emission reductions (- 35%) in the period Feb-Mar 2020, suggesting dominance of non-residential (i.e., transport and industry) sectors, which contributed 70% (48-100%) emission during 2019. The estimated BC/CO emission ratio for these sectors will help to further constrain bottom-up emission inventories. We comprehensively provide a clear scientific evidence supporting mitigation policies targeting reduction in residential BC emissions from China by demonstrating the economic feasibility using marginal abatement cost curves.

Equilibrator inlet-proton transfer reaction-mass spectrometry (EI-PTR-MS) for sensitive, high-resolution measurement of dimethyl sulfide dissolved in seawater.

We developed an equilibrator inlet-proton transfer reaction-mass spectrometry (EI-PTR-MS) method for fast detection of dimethyl sulfide (DMS) dissolved in seawater. Dissolved DMS extracted by bubbling pure nitrogen through the sample was continuously directed to the PTR-MS instrument. The equilibration of DMS between seawater and the carrier gas, and the response time of the system, were evaluated in the laboratory. DMS reached equilibrium with an overall response time of 1 min. The detection limit (50 pmol L(-1) at 5 s integration) was sufficient for detection of DMS concentrations in the open ocean. The EI-PTR-MS instrument was deployed during a research cruise in the western North Pacific Ocean. Comparison of the EI-PTR-MS results with results obtained by means of membrane tube equilibrator-gas chromatography/mass spectrometry agreed reasonably well on average (R(2) = 0.99). EI-PTR-MS captured temporal variations of dissolved DMS concentrations, including elevated peaks associated with patches of high biogenic activity. These results demonstrate that the EI-PTR-MS technique was effective for highly time-resolved measurements of DMS in the open ocean. Further measurements will improve our understanding of the biogeochemical mechanisms of the production, consumption, and distribution of DMS on the ocean surface and, hence, the air-sea flux of DMS, which is a climatically important species.

Differentiation of isomeric compounds by two-stage proton transfer reaction time-of-flight mass spectrometry.

We investigated a two-stage ion source for proton transfer reaction (PTR) ionization to achieve more selective mass spectrometric (MS) detection of selected volatile organic compounds (VOCs) than that achieved with commonly used PTR-MS instruments, which are based on single-step PTR ionization with H3O+. The two-stage PTR ion source generated reagent ions other than H3O+ by an initial PTR between H3O+ and a selected VOC, and then a second PTR ionization occurred only for VOCs with proton affinities larger than the affinity of the reagent VOC. Acetone and acetonitrile were useful as reagent VOCs because they provided dominant peaks as a protonated form. Using two-stage PTR-MS, we differentiated isomeric VOCs (for example, ethyl acetate and 1,4-dioxane) by means of differences in their proton affinities; protonated acetone formed the [M + H]+ ion from ethyl acetate but not from 1,4-dioxane. The PTR-MS-derived concentrations agreed quantitatively with those independently determined by Fourier transform infrared spectroscopy (FT-IR) at parts per million by volume (ppmv) levels. In addition, interfering fragment ions formed from alkyl benzenes at m/z 79 (C6H7+) could be distinguished from the m/z 79 ion arising from protonation of benzene, and therefore this method would prevent overestimation of benzene concentrations in air samples in which both benzene and alkyl benzenes are present. This two-stage PTR ionization may be useful for distinguishing various isomeric species, including aldehydes and ketones, if appropriate reagent ions are selected.

Estimation of refueling emissions based on theoretical model and effects of E10 fuel on refueling and evaporative emissions from gasoline cars.

The effects of Reid vapor pressure (RVP) on refueling emissions and the effects of ethanol 10% (E10) fuel on refueling and evaporative emissions were observed using six cars and seven fuels. The results indicated that refueling emissions can be reproduced by a simple theoretical model in which fuel vapor in the empty space in the tank is pushed out by the refueling process. In this model, the vapor pressures of fuels can be estimated by the Clausius-Clapeyron equation as a function of temperature. We also evaluated E10 fuel in terms of refueling and evaporative emissions, excluding the effect of contamination of ethanol in the canister. E10 fuel had no effect on the refueling emissions in cases without onboard refueling vapor recovery. E10 showed increased permeation emissions in evaporative emissions because of the high permeability of ethanol. And with E10 fuel, breakthrough emissions appeared earlier but broke through slower than normal fuel. Finally, canisters could store more fuel vapor with E10 fuel.

Diurnal variations in H2O2, O3, PAN, HNO3 and aldehyde concentrations and NO/NO2 ratios at Rishiri Island, Japan: potential influence from iodine chemistry.

The presence of iodine chemistry, hypothesized due to the overprediction of HO(2) levels by a photochemical box model at Rishiri Island in June 2000, was quantitatively tested against the observed NO/NO(2) ratios and the net production rates of ozone. The observed NO/NO(2) ratios were reproduced reasonably well by considering the conversion of NO to NO(2) by IO, whose amount was calculated so as to reproduce the observed HO(2) levels. However, the net production rates of ozone were calculated to be negative when such high mixing ratios of IO were considered, which was inconsistent with the observed buildup of ozone during daytime. These results suggest that iodine chemistry may not be the sole mechanism for the reduced mixing ratios of HO(2), or that "hot spots" for iodine chemistry were present. Diurnal variations in the mixing ratios of HCHO, CH(3)CHO, peroxy acetyl nitrate (PAN) and HNO(3) observed during the study are presented along with the simulated ones. The box model simulations suggest that the effect of iodine chemistry on these concentrations is small and that important sources of CH(3)CHO and sinks of PAN are probably missing from our current understanding of the tropospheric chemistry mechanism.

Induction chemotherapy with docetaxel, cisplatin and 5-fluorouracil for tongue cancer.

Induction chemotherapy consisting of one cycle of docetaxel, cisplatin and 5-fluorouracil (5-FU) was evaluated for its primary effects on squamous cell carcinoma of the tongue. The patients were five men and one woman, 50 to 67 (mean 57.8) years of age. Clinical staging of the tongue cancers showed two patients with stage III and four with stage IV disease. All patients underwent one cycle of intravenous chemotherapy with docetaxel (60 mg/m2, on day 1), cisplatin (10 mg/m2, from days 1 to 5) and 5-FU (500 mg/body, from days 1 to 5) before surgical operation. The overall response rate was 83.3% (five PRs and one NC), with two cases with grade II A in the Ohboshi & Shimosato classification and four with grade II B. The main side effect was severe neutropenia, which was effectively managed with granulocyte colony-stimulating factor (G-CSF). In conclusion, induction chemotherapy with docetaxel, cisplatin and 5-FU for tongue cancer was tolerated well by all the patients and showed an excellent response rate in spite of only one cycle of administration.