Atypical diarrhoeagenic Escherichia coli in milk related to a large foodborne outbreak.

A foodborne outbreak related to milk cartons served in school lunches occurred in June 2021, which involved more than 1,800 cases from 25 schools. The major symptoms were abdominal pain, diarrhoea, vomiting, and fever. Although major foodborne toxins and pathogens were not detected, a specific Escherichia coli strain, serotype OUT (OgGp9):H18, was predominantly isolated from milk samples related to the outbreak and most patients tested. The strains from milk and patient stool samples were identified as the same clone by core genome multilocus sequence typing and single-nucleotide polymorphism analysis. The strain was detected in milk samples served for two days related to the foodborne outbreak at a rate of 69.6% and levels of less than ten most probable number/100 mL but not on days unrelated to the outbreak. The acid tolerance of the strain for survival in the stomach was similar to that of enterohaemorrhagic E. coli O157:H7, and the same inserts in the chu gene cluster in the acid fitness island were genetically revealed. The pathogenicity of the strain was not clear; however, it was indicated that the causative pathogen was atypical diarrhoeagenic E. coli OUT (OgGp9):H18.

[Investigation on cognition of zoonosis among veterinary clinical staff].

We conducted a survey to determine how much veterinary clinic staff, including veterinary surgeon and veterinary technicians, know about zoonosis. Response was 52.5%. All staff members knew of zoonosis. Staff members who knew what zoonosis meant accounted for 98%. Staff members trained in zoonosis accounted for 75% among veterinary surgeons and 66% among veterinary technicians. Staff members who thought that zoonosis would increase in future accounted for 92% among veterinary surgeons and 79% among veterinary technicians. Staff members who were asked by pet owners about zoonosis accounted for 87% among veterinary surgeons and 51% among veterinary technicians. Staff members who thought veterinary surgeons must report zoonosis to public health centers accounted for 96% among veterinary surgeons and 88% among veterinary technicians. Veterinary clinic staffs thus had correct knowledge and were aware of zoonosis. The network of medical staff and veterinary staff could therefore build on this result.

[A ruptured aneurysm in the bifurcation of the proximal anterior cerebral artery and the frontopolar artery: case report].

We report a case of ruptured aneurysm in the bifurcation of the proximal anterior cerebral artery and the frontopolar artery. A 49-year-old woman complained of sudden onset of severe headache on December 24, 2000. She was admitted to our hospital and CT scan revealed subarachnoid hemorrhage. Cerebral angiography on the next day revealed an aneurysm in the bifurcation of the frontopolar artery and the proximal anterior cerebral artery. She was operated on using the left pterional approach and complete neck clipping was performed. The post-operative course was uneventful. She was discharged with no neurological deficit two months after the operation.

[Clinical evaluation of patients with isolated, traumatic, localized subarachnoid hemorrhage].

Three hundred and fifty cases of patients with head injury were admitted to our hospital from 1998 to 2000. Among these cases, 10 cases manifested isolated, localized subarachnoid hemorrhage on the first computed tomographic image after the trauma. Traumatic subarachnoid hemorrhage was found in the ambient, suprasellar, and sylvian fissure, Bleeding was seen in the ambient cistern or suprasellar cistern at the site of the blow on the frontal or occipital area of the head. The bleeding was seen in the sylvian fissure at the site of the temporal head blow. The bleeding was washed out after one day. None of the patients had symptomatic spasms, and all of the patients had a good prognosis. The mechanism of isolated, traumatic, localized subarachnoid hemorrhage was considered as shear strain or coup and contre-coup injury.

[Intracerebral pneumocephalus following a head injury: case report].

We report a case of intracerebral pneumocephalus following a head injury. This condition is relatively rare, and only 14 cases, including the present case, have been reported to data. A 40-year-old man fell from a 3rd floor window on June 29, 1999. The patient was admitted to the hospital. Plain skull X-ray films revealed a left basal skull fracture, and CT scan revealed a small contusion at the left frontobasal lobe. The patient was treated conservatively. On July 16, he underwent an MRI, and a small contusion was revealed at the left frontobasal lobe. In addition, the brain appeared to have herniated into the ethmoidal sinus. On July 22, the patient underwent a CT scan, and a intracerebral pneumocephalus was revealed in the left frontal lobe. On August 2, an MRI was performed, and intracerebral pneumocephalus in the left frontal lobe and herniation of the brain into the ethmoidal sinus were noted. In addition, intracerebral pneumocephalus had increased. The patient was admitted to our hospital. Clinotherapy was performed, but intracerebral pneumocephalus increased. On August 9, the patient underwent surgery to repair the skull base. During surgery, it was noted that the left frontal contusion had adhered to the edge of the lacerated dura around the bone defect of the ethmoidal sinus. Following surgery, no recurrence of pneumocephalus was noted. We conclude that once intracerebral air volume increases, early surgical repair should be carried out for intracerebral pneumocephalus. Meticulous MRI investigations of the lesion causing the intracerebral pneumocephalus should be conducted to select an appropriate operative procedure.