Endobronchial cryptococcosis without pulmonary parenchymal involvement caused by Cryptococcus neoformans in an immunocompetent host.

Cryptococcus is a yeast-like fungus. Pulmonary lesions caused by Cryptococcus neoformans typically present as single or multiple nodules or infiltrative lesions in the lungs; however, endobronchial lesions are rare. A 40-year-old previously healthy Japanese man was referred to our hospital due to an abnormality detected on chest computed tomography. The analysis revealed focal bronchiectasis and bronchial wall thickening in the right upper lobe, which persisted for 6 months. Bronchoscopy showed reddish and edematous mucosa, stenosed bronchi (right B1 and B3), and white moss at the bifurcation of the right upper bronchus. Transbronchial biopsy revealed numerous yeast-like fungi and an encapsulated body. Bronchial washing for fungus culture identified Cryptococcus neoformans. Although analysis for serum cryptococcal antigen was negative, bronchoscopy led to a definitive diagnosis. Antifungal treatment improved the bronchial wall thickening. This is a rare case of endobronchial cryptococcosis caused by Cryptococcus neoformans without pulmonary parenchymal involvement in an immunocompetent host.

An unusual finding of giant fat-rich retroperitoneal masses in a patient with Graves' disease.

We report the case of a 48-year-old man who was unexpectedly found by abdominal ultrasonography to have large retroperitoneal masses accompanied by Graves' disease. Computed tomography and magnetic resonance imaging further demonstrated giant fat-rich soft masses arising within both renal sinuses. Histopathological examination of the mass was performed twice at 5-year intervals, with both examinations indicating fatty tissue cells with chronic fibrous panniculitis. Intravenous pulse therapy and successive oral glucocorticoid therapy were ineffective against Graves' ophthalmopathy or mass lesion. An antithyroid hormone regimen was followed by subtotal thyroid resection, leading to improvements in hyperthyroidism. Mass growth then attenuated slowly as the thyroid hormones returned to normal levels. The long-term follow-up of this patient should carefully monitor the appearance of warning signs such as mass effects.

Safety evaluation of a thermolysin enzyme produced from Geobacillus stearothermophilus.

Thermolysin is a zinc metalloprotease that has potential uses in the food industry. The safety of thermolysin has not been demonstrated before, and therefore a series of standard toxicological tests to assess its potential toxicity was undertaken. The thermolysin used in this study was derived from the thermophilic bacterium Geobacillus stearothermophilus, which had undergone chemical mutagenesis to generate strains with increased thermolysin production. Acute toxicity studies in rats and mice showed that thermolysin powder is not acutely toxic with an oral LD50 of more than 18,000 mg/kg (2520 mg/kg thermolysin protein) in rats and more than 24,000 mg/kg (3360 mg/kg protein) in mice. Subchronic feeding studies in rats for 91 days at doses up to 1000 mg/kg (390 mg/kg protein) revealed no significant differences between treated and non-treated groups and a No Observed Effect Level (NOEL) of 1000 mg/kg (390 mg/kg protein) per day was established. Results from genotoxicity tests such as in vitro chromosomal aberration assay and in vivo mouse micronucleus were negative. Allergenicity sequence analysis revealed no evidence suggesting that thermolysin is an allergen. The data presented in this study support the conclusion that thermolysin is safe for use in food production.

Similar changes in clinical and pathological parameters in Wistar Kyoto rats after a 13-week dietary intake of canola oil or a fatty acid composition-based interesterified canola oil mimic.

Canola oil (CO) given as a dietary fat deteriorates hypertension-related condition and shortens the life of stroke-prone spontaneously hypertensive rats (SHRSP). Although substances other than fatty acids have been presumed as causatives, CO mimics consisting of oils other than CO also shorten the life. In this study we intended to examine whether or not fatty acid composition unique to CO participates in the adverse effect. CO or an interesterified CO mimic (ICOM) consisting of safflower oil, flaxseed oil and erucic acid was fed as a dietary fat for 13 weeks to Wistar Kyoto (WKY) rats, and clinical and pathological signs were compared. WKY rats were used to avoid the difficulty in evaluating the results in SHRSP due to irregular deterioration in conditions by stroke. Compared to a standard diet, both diets containing CO or ICOM similarly elevated blood pressure, increased plasma lipids, activated hepatic glucose-6-phosphate dehydrogenase, decreased platelets, shortened blood coagulation times and induced abnormalities in the kidney. Thus, CO-specific fatty acid composition appeared to affect the pathophysiology of the rat and produce consequent aggravation of pathological status, especially in SHRSP. However, the existence of causative factors other than fatty acids was suggested by increased neutrophil count exclusively induced by CO.

Placing and imaging individual carbon nanotubes on Cu(111) clean surface using in situ pulsed-jet deposition-STM technique.

We report pulsed-jet deposition of single-wall and double-wall carbon nanotubes (SWNTs and DWNTs; CNTs) onto a clean Cu(111) surface and their scanning tunneling microscopy (STM) observations under ultra-high vacuum (UHV). The clean Cu(111) surface prepared by a repeated Ar-sputtering and annealing is introduced into a load-lock chamber kept at a 10(-5)-Pa range vacuum, and the CNTs dispersed in a chloroform solution by ultrasonication are pulse-injected onto the surface. Since the substrate is annealed at 700 K to remove the residual solvent molecules, high resolution lattice images of the CNTs are successfully observed by STM. High-resolution chirality-resolved images of the two SWNTs with a metal cluster are also observed, supporting the well accepted growth mechanism of the CNTs from the metal-catalyst cluster. The present pulsed-jet deposition in high-vacuum is superior to the conventional spin-coating or drop-coating techniques for preparing clean and well-defined CNTs on clean surfaces for high-resolution and contamination-free UHV-STM observation.

A flexible and wearable glucose sensor based on functional polymers with soft-MEMS techniques.

A novel biosensor for glucose measurement using functional polymers was fabricated and tested. The biosensor utilizes the physical and chemical functions of hydrophobic polydimethyl siloxane (PDMS) and hydrophilic 2-methacryloyloxyethyl phosphorylcholine (MPC) copolymerized with dodecyl methacrylate (DMA). The glucose sensor was constructed by immobilizing glucose oxidase (GOD) onto a flexible hydrogen peroxide electrode (Pt working electrode and Ag/AgCl counter/reference electrode). The electrodes were fabricated using microelectromechanical systems (MEMS) techniques onto those functional polymers. The sensor showed novel functions of flexibility and it was stretchable so that the sensor could normally work when it was released after expanding to 120% longer than that of normal length. Also, basic characteristics of the sensor were evaluated. The output current of the hydrogen peroxide electrode was linearly related to the hydrogen peroxide concentration in a range of 0.20-2.50 mmol/l, with a correlation coefficient of 0.998. GOD was then immobilized onto the surface of the sensor using MPC polymer. In this case, the current output of the glucose sensor related to the glucose level over a range of 0.06-2.00 mmol/l, with a correlation coefficient of 0.997. The calibration range includes the reported concentration of tear glucose in normal human subject (0.14 mmol/l).

Determination of optical isomers for left-handed or right-handed chiral double-wall carbon nanotubes.

The handedness relationship between adjacent layers in nested double-wall carbon nanotubes (DWNTs) has been investigated for the first time. Our high-resolution electron microscopy analysis on a series of specimen tilts can successfully tell the handedness of each constituent nanotube in a DWNT, and therefore the chiral indices (n, m) including their optical isomers [(n, m) or (m, n)] of inner and outer nanotubes can be uniquely determined. It is shown that right-handed and left-handed nanotubes are equally distributed for both the inner and outer nanotubes in the examined specimens and a preferable handedness relationship between the adjacent layers in DWNT may exist.

Imidapril-induced eosinophilic pleurisy. Case report and review of the literature.

We describe an unusual case of a patient with eosinophilic pleurisy associated with long-term administration of imidapril, an angiotensin-converting enzyme inhibitor (ACEI). An 81-year-old woman who had been given imidapril for the treatment of essential hypertension was admitted to our hospital for investigation of persistent low-grade fever, dry cough and difficulty in breathing. Left-sided eosinophilic pleurisy was diagnosed based on eosinophilic pleural effusion and peripheral eosinophilia. Soon after administration of imidapril was discontinued, her clinical symptoms subsided, and there was improvement in both diagnostic imaging and laboratory findings. So far, to our knowledge, this is the first reported case in which ACEI induced eosinophilic pleurisy.

The role of self-report questionnaire in the screening of postnatal depression- a community sample survey in central Tokyo.

BACKGROUND: Numerous studies have shown that health care professionals often experience difficulty in detecting postnatal depression. In Japan, where mental illness has traditionally been stigmatized, detection seems even more difficult. This study investigates the prevalence of postnatal depression in the community and its relation to screening methodology. METHODS: The Edinburgh Postnatal Depression Scale (EPDS) was distributed at community health centers in a district in central Tokyo. The results from both non-identifiable questionnaires and identifiable questionnaires were compared. Screening by EPDS and clinical judgment by community nurses were compared. RESULTS: Making the questionnaire identifiable did not change the score distribution pattern. Among mothers with 3- to 4-month-old babies in the community, 13.9% scored high (9 or above) on EPDS. In 51.1% of high scorers,nurses did not detect postnatal depression. Clinically, postnatal depression can be easily missed in the community health-check setting especially when there was hitherto no report of obstetric abnormality during pregnancy or delivery. CONCLUSION: The prevalence of high scorers is comparable to those reported in other countries. The use of the questionnaire was helpful in drawing the attention of mothers and health care professionals to issues of mental health.