[Problems of tuberculosis patients under dialysis in Tama area, Tokyo].

OBJECTIVES: Patients undergoing renal dialysis (dialysis patients) are generally known to have a higher risk of tuberculosis (TB). In order to address this problem effectively, analyses were made of the characteristics of active TB patients under dialysis in the Tama Area of Tokyo. SUBJECTS AND METHODS: Dialysis patients were selected from the list of TB patients who were newly registered at seven public health centers in the Tama Area between 2007 and 2009. The incidence rate of TB in dialysis patients was calculated. Their personal profiles such as age, affected organs, results of sputum smear, modes of case detection, and delay in case detection, were reviewed in comparison with those in TB patients not undergoing dialysis. RESULTS: Dialysis patients had 8.34 times higher TB incidence rate than non-dialysis subjects. They were more likely to have extra-pulmonary TB. The dialysis patients visited doctors sooner after the appearance of symptoms, which resulted in a higher proportion of smear-negative TB among them. Periodic chest X-ray examination at dialysis clinics played an important role in early TB diagnosis. CONCLUSION: It is important for dialysis clinics to maintain a high index of TB, since dialysis patients are at a higher risk of TB. In addition, careful attention should be paid to a patient's past history of TB infection, as well as to the findings of periodic chest X-ray examinations.

Real-time monitoring of functional interactions between upstream and core promoter sequences in living cells of sea urchin embryos.

There are some functional compatibilities between upstream and core promoter sequences for transcriptional activation in yeast, Drosophila and mammalian cells. Here we examined whether similar compatibilities exist in sea urchin embryos, and if so, whether they are dynamically regulated during early development. Two reporter plasmids, each containing a test promoter conjugated to either CFP or YFP, were concurrently introduced into embryos, and their expression patterns were studied by fluorescence microscopy. The upstream sequence of the Hemicentrotus pulcherrimus (Hp) OtxE promoter drives the expression of its own core promoter and that of Strongylocentrotus purpuratus (Sp) Spec2a in different embryonic regions, especially at the late gastrula stage. Interestingly, when the four putative transcription factor binding sites of this upstream sequence were individually mutated, the resulting sequences directed different spatiotemporal expression from the same set of two core promoters, indicating that combinations of upstream factors may determine core promoter usage in sea urchin embryos. In addition, the insertion or deletion of consensus or nonconsensus TATA sequences changed the expression profile significantly, irrespective of whether the upstream sequence was intact or mutated. Thus, the TATA sequence may serve as a primary determinant for core promoter selection in these cells.

[Contribution of hospital pharmacists for home parenteral nutrition--the case we were concerned with pharmaceutical management and support in mixing of injections].

Home parenteral nutrition (HPN) is a useful measure when cancer patients are hoping to have a transition from the hospital to a home medical care arrangement. A contribution of pharmacist performing HPN to a patient is to manage pharmaceuticals so that an appropriate medicine is used for not only the prescription design of the infusion solution but also to give a relaxation care. Based on the patient information record gathered by a home-visit nursing care program, we tried to study what pharmacists could do to help the patient after he was discharged.