Nationwide surveillance of bacterial respiratory pathogens conducted by the surveillance committee of Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for clinical microbiology in 2014: General view of the pathogens' antibacterial susceptibility.

The nationwide surveillance on antimicrobial susceptibility of bacterial respiratory pathogens from the patients in Japan was conducted by Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in 2014. The isolates were collected from clinical specimens obtained from well-diagnosed adult patients with respiratory tract infections during the period between January 2014 and April 2015 by three societies. Antimicrobial susceptibility testing was conducted at the central reference laboratory according to the method recommended by Clinical Laboratory Standards Institute. Susceptibility testing was evaluated in 1534 strains (335 Staphylococcus aureus, 264 Streptococcus pneumoniae, 29 Streptococcus pyogenes, 281 Haemophilus influenzae, 164 Moraxella catarrhalis, 207 Klebsiella pneumoniae, and 254 Pseudomonas aeruginosa). Ratio of methicillin-resistant S. aureus was 43.6%, and those of penicillin-susceptible S. pneumoniae was 100%. Among H. influenzae, 8.2% of them were found to be ß-lactamase-producing ampicillin-resistant strains, and 49.1% to be ß-lactamase-non-producing ampicillin-resistant strains. Extended spectrum ß-lactamase-producing K. pneumoniae and multi-drug resistant P. aeruginosa with metallo ß-lactamase were 9.2% and 0.4%, respectively.

Nationwide surveillance of bacterial respiratory pathogens conducted by the surveillance committee of Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in 2012: General view of the pathogens' antibacterial susceptibility.

The nationwide surveillance on antimicrobial susceptibility of bacterial respiratory pathogens from the patients in Japan was conducted by Japanese Society of Chemotherapy, Japanese association for infectious diseases and Japanese society for Clinical Microbiology in 2012. The isolates were collected from clinical specimens obtained from well-diagnosed adult patients with respiratory tract infections during the period between January and December in 2012 by three societies. Antimicrobial susceptibility testing was conducted at the central reference laboratory according to the method recommended by Clinical Laboratory Standard Institutes. Susceptibility testing was evaluated in 1236 strains (232 Staphylococcus aureus, 225 Streptococcus pneumoniae, 16 Streptococcus pyogenes, 231 Haemophilus influenzae, 147 Moraxella catarrhalis, 167 Klebsiella pneumoniae and 218 Pseudomonas aeruginosa). Ratio of methicillin-resistant S. aureus was 51.3%, and those of penicillin-intermediate S. pneumoniae was 0.4%. Among H. influenzae, 5.6% of them were found to be ß-lactamase-producing ampicillin-resistant strains, and 37.2% to be ß-lactamase-non-producing ampicillin-resistant strains. Extended spectrum ß-lactamase-producing K. pneumoniae and multi-drug resistant P. aeruginosa with metallo ß-lactamase were 4.2% and 3.2%, respectively. Continuous national surveillance is important to determine the actual situation of the resistance shown by bacterial respiratory pathogens to antimicrobial agents.

[Clinical evaluation of a newly developed high-sensitive detection of hepatitis B virus surface antigen by a semi-automated immune complex transfer chemiluminescent enzyme immunoassay].

AIM: A highly sensitive semi-automated immune complex transfer chemiluminescence enzyme immunoassay (ICT-CLEIA) for the detection of hepatitis B surface antigen (HBsAg) was recently developed. Our aim is to investigate clinical significance of ICT-CLEIA in patients with HBV. METHODS: Of 829 HB carriers in our hospital and 167 commercial panels, performance of ICT-CLEIA(detection range 0.0005-2.5 IU/mL) was compared with two quantitative HBsAg detection systems (Architect HBsAg QT assay [0.05-250 IU/mL] and HISCL HBsAg assay [0.03-2500 IU/mL]) and COBAS TaqMan HBV-DNA assay (CTM, 2.1 Log copies/ml) using serum samples from patients or panels. RESULTS: The ICT-CLEIA had good accuracy and reproducibility. The sensitivity of wild type and HBsAg escape mutants (I126S, D144A, G145R) by ICT-CLEIA was 2- -5 to 2- -6 times higher than that of Architect HBsAg QT. For clinical practice, ICT-CLEIA assay could detect HBsAg even in the presence of anti-HBs during window periods in acute hepatitis B panel. HBsAg has been detectable for around 9 years in a patient with HBsAg clearance by Architect. In a patient with HBV reactivation after bone marrow transplantation followed by systematic chemotherapy, HBsAg by ICT-CLEIA was detectable at the same time point when HBV-DNA was detected by PCR. In conclusion, the ICT-CLEIA assay permits not only an earlier detection of acute hepatitis B infection but also may be useful for monitoring hepatitis B patients.

Giant iliopectineal bursitis presenting as neuropathy and severe edema of the lower limb: case illustration and review of the literature.

We report a 61-year-old woman with rheumatoid arthritis (RA: Steinblocker stage III, class 3) who developed severe swelling and neuropathy of the right lower limb caused by an iliopectineal bursa associated with destruction of the hip joint. Physical examination revealed an inguinal mass and groin pain. X-ray examination indicated destruction of the hip joint. Contrast-enhanced computed tomography showed the bursa connected with the hip joint and a markedly compressed external iliac vein among the inguinal ligament, pubis, and bursa. The patient underwent partial synovial resection and total hip arthroplasty for recovery of hip function, and this led to successful resolution of the symptoms and bursa. We present the characteristic images from this case and review all previously reported cases of RA iliopsoas bursitis causing leg swelling or neuropathy, and summarize the background. Since this lesion may cause various symptoms, clinical awareness that iliopsoas bursitis may present with unique clinical symptoms may aid correct diagnosis.

In vivo measurement of lumbar foramen during axial loading using a compression device and computed tomography.

STUDY DESIGN: In vivo measurement of lumbar foramen using computed tomography and an axial loading device in healthy young subjects. OBJECTIVE: To investigate the effects of axial loading on the morphology of the lumbar foramen in vivo. SUMMARY OF BACKGROUND DATA: In vitro studies have shown morphologic changes in the lumbar foramen in response to axial loading. The effects of axial loading on foraminal dimensions in vivo, however, are poorly understood. MATERIALS AND METHODS: The study population consisted of 12 asymptomatic healthy young volunteers [6 men and 6 women; age range, 22-34 y (mean, 27 y)]. Lumbar computed tomography images were compared with and without axial loading using a compression device (DynaWell), and differences in disk height (DH), foraminal height (FH), foraminal width (FW), and the cross-sectional area (CSA) of the intervertebral foramen (IVF) were determined. RESULTS: During axial loading, the FHs at L1/L2, L2/L3, L3/L4, and L4/L5 each decreased significantly (P<0.01 each), by 4.0%, 6.6%, 6.6%, and 5.1%, respectively. Maximum FW decreased significantly (P<0.05 each) at L2/L3 (7.2%) and L3/L4 (5.7%), and increased significantly (P<0.05) at L5/S1 (8.9%). The CSAs of the IVF decreased significantly (P<0.01 each) at L2/L3 (10.8%) and L3/L4 (10.7%) and increased significantly (P<0.01) at L5/S1 (23.3%). Changes in FH, maximum and minimum FW, and CSA of the IVF significantly (P<0.01) correlated with change in posterior DH. CONCLUSIONS: FH, FW, and CSA of the IVF, except for L5/S1, decreased significantly during axial loading. Changes in posterior DH correlated well with the changes in foraminal dimensions.

Treatment of trochanteric fractures with the PFNA (proximal femoral nail antirotation) nail system - report of early results.

Currently, intramedullary devices are widely used for the treatment of trochanteric femoral fractures. A new device designed by AO/ASIF, the PFNA (proximal femoral nail antirotation), represents a unique intramedullary nail system for improved management, particularly in the elderly. The aim of the present study was to analyze the results of treatment with PFNA in 50 patients with trochanteric fractures. The operating time, intraoperative blood loss, and intraoperative and postoperative complications were recorded. The length of the surgical procedure averaged 20.3 min, and intraoperative blood loss averaged 22.8 mL. Reoperation was necessary in two patients (4%). We conclude that the PFNA nail is as effective as other implants in the treatment of trochanteric fractures.

[Determination of K-value and histamine of mackerel and tuna, by using the oxygen-sensor method].

Determination of K-value (fish freshness index) and histamine (Hm) of mackerel and tuna during storage at various temperatures was done by using the oxygen-sensor method. Hm in mackerel increased even at low temperature (5 degrees C), and reached the Defect Action Level (DAL) of the U.S. FDA, 5 mg/100 g, before the K-value approached the inedible level. As the storage temperature was increased, the rate of Hm formation increased remarkably and the amount of Hm in fish meat passed through the DAL, and reached the real hazard level, AL (50 mg/100 g), in a short time. The initial Hm level of raw tuna was too low to determine by our oxygen-sensor method, and the final Hm level after 8 days' storage at under 5 degrees C was only 0.6 mg/100 g. But, when the storage temperature was elevated, the rate of Hm formation increased rapidly, as in mackerel, and the Hm level reached the DAL, then the AL, in a short time. Simultaneous determination of K-value and Hm is recommended for accurate and reliable quality inspection of fish and fish products.