Search for nucleon decay via n→ν[over ¯]π0 and p→ν[over ¯]π+ in Super-Kamiokande.

We present the results of searches for nucleon decay via n→ν[over ¯]π0 and p→ν[over ¯]π+ using data from a combined 172.8 kt·yr exposure of Super-Kamiokande-I,-II, and-III. We set lower limits on the partial lifetime for each of these modes: τn→ν[over ¯]π0>1.1×10(33) years and τp→ν[over ¯]π+>3.9×10(32) years at a 90% confidence level.

Search for dinucleon decay into kaons in Super-Kamiokande.

A search for the dinucleon decay pp → K+ K+ has been performed using 91.6 kton·yr data from Super-Kamiokande-I. This decay provides a sensitive probe of the R-parity-violating parameter λ112''. A boosted decision tree analysis found no signal candidates in the data. The expected background was 0.28±0.19 atmospheric neutrino induced events and the estimated signal detection efficiency was 12.6%±3.2%. A lower limit of 1.7×10(32) years has been placed on the partial lifetime of the decay O16 → C14K+ K+ at 90% C.L. A corresponding upper limit of 7.8×10(-9) has been placed on the parameter λ112''.

Evidence for the appearance of atmospheric tau neutrinos in super-Kamiokande.

Super-Kamiokande atmospheric neutrino data were fit with an unbinned maximum likelihood method to search for the appearance of tau leptons resulting from the interactions of oscillation-generated tau neutrinos in the detector. Relative to the expectation of unity, the tau normalization is found to be 1.42 ± 0.35(stat)(-0.12)(+0.14)(syst) excluding the no-tau-appearance hypothesis, for which the normalization would be zero, at the 3.8σ level. We estimate that 180.1 ± 44.3(stat)(-15.2)(+17.8) (syst) tau leptons were produced in the 22.5 kton fiducial volume of the detector by tau neutrinos during the 2806 day running period. In future analyses, this large sample of selected tau events will allow the study of charged current tau neutrino interaction physics with oscillation produced tau neutrinos.

Search for differences in oscillation parameters for atmospheric neutrinos and antineutrinos at Super-Kamiokande.

We present a search for differences in the oscillations of antineutrinos and neutrinos in the Super-Kamiokande-I, -II, and -III atmospheric neutrino sample. Under a two-flavor disappearance model with separate mixing parameters between neutrinos and antineutrinos, we find no evidence for a difference in oscillation parameters. Best-fit antineutrino mixing is found to be at (Δm2,sin2 2θ)=(2.0×10(-3) eV2, 1.0) and is consistent with the overall Super-K measurement.

The role of neutrophils in the pathogenesis of idiopathic pulmonary fibrosis.

STUDY OBJECTIVES: The prognostic value of the neutrophil count in BAL fluid (BALF) has been controversial. The role of neutrophils in this inflammatory lung disease, therefore, was evaluated in this study by additional measures. MATERIALS AND METHODS: We performed BAL in 22 patients with idiopathic pulmonary fibrosis (IPF) diagnosed by open lung biopsy specimen. Percent polymorphonuclear leukocyte (PMN) in BALF and absolute neutrophil counts were compared with those of normal nonsmokers. Elastase complexed to alpha-1-proteinase inhibitor (alpha1-PI) in plasma and BALF was measured as a marker of elastase burden, and neutrophil distribution in 22 lung tissues was observed by immunohistochemistry using antineutrophil elastase antibody. RESULTS: Percent PMN and absolute neutrophil counts in BALF did not increase in patients with IPF as compared with normal nonsmokers (n=15); the plasma elastase-alpha1-PI complex value (mean+/-SE) of patients with IPF (668.5+/-112.4 ng/mL) was significantly high as compared with that of normal nonsmokers (130.3+/-21.3, p<0.001). In addition, the BALF elastase-alpha1-PI complex value (mean+/-SE) of patients with IPF was also significantly high (333.1+/-87.0 ng/mg albumin) as compared with that of normal nonsmokers (83.1+/-29.3 ng/mg albumin, p<0.05). Immunohistochemistry demonstrated considerable numbers of neutrophils infiltrating the lung parenchyma in biopsy specimens obtained by open lung biopsy. CONCLUSIONS: These results suggested that although the neutrophil count in BALF could not represent the distribution of neutrophil in the lung, high levels of neutrophil elastase were demonstrated in lung parenchyma and also in both BALF and sera. Therefore, neutrophils might indeed play an important role in the pathogenesis of IPF.

Investigation of nosocomial infection caused by arbekacin-resistant, methicillin-resistant Staphylococcus aureus.

An outbreak of coagulase VII-producing, arbekacin (ABK)-resistant, methicillin-resistant Staphylococcus aureus (MRSA) occurred between September 1994 and December 1995, involving five different wards. Twenty-one patients developed skin, wound, drainage, or respiratory tract colonization with coagulase VII-producing, (ABK)-resistant MRSA. Phenotypic characteristics (production of enterotoxin and TSST-1, antimicrobial susceptibility) and molecular-typing procedure (plasmid DNA profile, pulsed-field gel electrophoresis [PFGE] and arbitrarily primed polymerase chain reaction [AP-PCR] of chromosomal DNA) in isolated strains were compared. Plasmid analysis identified four different profiles and 19 of 22 strains recovered had identical patterns. PFGE of chromosomal DNA identified three different subtypes and 18 (81.8%) isolates shared the same subtype. AP-PCR also demonstrated that most strains had the same phenotypic characteristics. Although traditional epidemiological methods; for example, coagulase typing, plays a central role in hospital infection control, combination of plasmid DNA profile, AP-PCR, and PFGE may prove to be a particularly informative means of tracking the nosocomial spread of MRSA.

Clinical features of non-tuberculous mycobacterial disease: comparisons between smear-positive and smear-negative cases, and between Mycobacterium avium and Mycobacterium intracellulare.

OBJECTIVE: To evaluate the differences in clinical symptoms and radiological findings between smear-positive non-tuberculous mycobacteria (NTM) and smear-negative, culture-positive NTM. Also, to evaluate the differences in clinical symptoms and radiological findings between Mycobacterium avium and M. intracellulare. DESIGN: A retrospective study was performed of 200 cases with positive pulmonary cultures for NTM between January 1989 and December 1996. It was determined whether or not pulmonary disease was caused by NTM using the 1990 criteria recommended by the American Thoracic Society. Clinical symptoms and radiological findings were compared between groups. RESULTS: Fever and hemoptysis were more frequently observed in smear-positive patients (26/50, 52%, and 24/50, 48%, respectively) than in smear-negative, culture-positive patients (8/38, 21.1%, P < 0.005, 8/38, 21.1%, P < 0.01, respectively). In addition, cavity formation was more frequently observed in chest computed tomography scans of smear-positive patients (19/36, 52.8%) than in smear-negative patients (6/31, 19.4%, P < 0.005). Finally, cavity formation tended to be more frequently observed with M. avium than with M. intracellulare. CONCLUSION: The present study demonstrates differences in clinical symptoms and radiological findings between smear-positive and smear-negative NTM cases, as well as between M. avium and M. intracellulare.

Successive follow-up of chest computed tomography in patients with Mycobacterium avium-intracellulare complex.

The aim of this study was to evaluate the changes in chest CT findings examined successively in patients with Mycobacterium avium-intracellulare complex (MAC) infection. We carried out a retrospective study of 25 patients with MAC infection who had serial CT scans. Patients included 18 women and seven men with a median age of 66 years. Mean (+/- SE) follow-up interval between the first and second CT was 27.5 +/- 4.2 months. The serial chest CT scans were reviewed with consensus reading by two observers. At the first chest CT examination, we found the following: bronchiectasis (in 133 of 250 fields), cavity formation (11 of 250 fields), centrilobular nodules (167 of 250 fields), air-space disease (30 of 250 fields) and nodules (81 of 250 fields). The middle lobe and lingula were frequently involved. Centrilobular nodule scores improved in seven patients; disease progressed in nine patients and was stable in nine patients. In addition, bronchiectasis scores improved in four patients; disease progressed in 15 patients and was stable in six patients. The score of bronchiectasis in the second CT was significantly higher than in the first CT. In conclusion, our data suggest that centrilobular nodules and bronchiectasis are frequent observations in patients with MAC. In addition, progression of bronchiectasis appeared to be caused by MAC infection.

Reirradiation therapy for brain metastases from small cell lung cancer.

Three patients with recurrence of brain metastases from small cell lung cancer were treated with whole brain reirradiation therapy. A total dose of 20 Gy was administered to two patients with hyperfractionation (20 fractions) and to one with conventional fractionation (10 fractions). Two cases achieved PR and the other NC. Survival after reirradiation was four months for all patients. Two patients died of progressive brain metastases and one patient of liver metastases. No radiation injury was observed during follow-up. Whole brain reirradiation at a dose of 20 Gy in 10 or 20 fractions was therefore considered useful and safe for brain recurrence of small cell lung cancer.

[Clinical study on a concomitant therapy with fluconazole and human recombinant granulocyte colony stimulating factor in the treatment of systemic fungal infections with hematological disorders].

The clinical efficacy and the safety of concomitant therapy with fluconazole and recombinant human granulocyte colony stimulating factor (rhG-CSF) was compared with fluconazole monotherapy in neutropenic patients with hematological disorders. The clinical efficacy rate was 73.5% (25/34) in the combination therapy and 48.1% (37/77) in monotherapy. The difference between the two is statistically significant. Side effects were not observed in the combination group, but laboratory abnormalities were found in 6 patients with an incident rate of 11%. The combination therapy with fluconazole and rhG-CSF may be selected as empiric therapy for systemic fungal infection associated with hematological disorders, since this combination therapy showed high efficacy and low incident of side effects. Some patients, however, did not show increased neutrophil counts in spite of rhG-CSF administration.

[Cesarean section in a patient with uncontrolled hyperthyroidism, preeclampsia, and congestive heart failure].

A case of a pregnant woman who underwent urgent cesarean section is presented. The patient had severe hyperthyroidism, preeclampsia, and congestive heart failure, which had not been treated until 36 weeks of gestational age. At 38 weeks, fetal distress occurred and an urgent cesarean section was performed successfully under epidural anesthesia with preoperative treatments using iodide, hydrocortisone and propylthiouracil. The patient required postoperative intensive care for heart failure. Thyroid function of the neonate was almost normal. No abnormality was observed except low birth weight.

Carrier status of leptospirosis among cattle in Sri Lanka: a zoonotic threat to public health.

Leptospirosis is a zoonotic disease of global importance and one of the notifiable diseases in Sri Lanka. Recent studies on human leptospirosis have suggested that the cattle could be one of the important reservoirs for human infection in the country. However, there is a dearth of local information on bovine leptospirosis, including its implications for human transmission. Thus, this study attempted to determine the carrier status of pathogenic Leptospira spp in cattle in Sri Lanka. A total of 164 cattle kidney samples were collected from the meat inspection hall in Colombo city during routine inspection procedures conducted by the municipal veterinary surgeons. The DNA was extracted and subjected to nested PCR for the detection of leptospiral flaB gene. Amplicons were sequenced, and phylogenic distances were calculated. Of 164 samples, 20 (12.2%) were positive for flaB-PCR. Sequenced amplicons revealed that Leptospira species were deduced to L. borgpetersenii (10/20, 50%), L. kirschneri (7/20, 35%) and L. interrogans (3/20, 15%). The results indicate that a high proportion of the sampled cattle harbour a variety of pathogenic Leptospira spp, which can serve as important reservoirs for human disease.

Gender differences of suicide in Japan, 1947-2010.

BACKGROUND: The effects of socio-economic factors on suicide were gender-dependent. Japanese suicide mortality gender ratio (male: female) had gradually increased during the twentieth century. METHODS: With the data covering 1947-2010 collected from Japanese official websites, we conducted non-parametric rank test, curve estimations, spearman ranking correlation and quantile regression in succession with Stata version 12.0. RESULTS: The suicide mortality rate in male with a "U" shape had been always higher than that in female with a "J" shape. The male suicide mortality peaked around in 1955 (38.5 per 100,000 populations), dropped quickly afterwards until the 1970s; it increased in the 1980s with another peak in 2003 (33.2 per 100,000 populations). For female, an overall decreasing trend was seen with a peak during the 1950s (23.5 per 100,000 populations in 1958). It dropped gradually afterwards with small variations in 1970s and 80s, and was stabilized after 1995 (9.3 per 100,000 populations). The unemployment rate could be used as a single positive predictor of suicide mortality for men (p<0.01), while the total fertility rate (TFR) (p<0.01) and divorce rate (p<0.01) were significantly associated positively and negatively with women's suicide, respectively. LIMITATIONS: The impact of mental disorders was not analyzed and age-specific analysis was not conducted. CONCLUSION: The findings of these gender differences in, and the associated factors with, suicide in Japan, warranted further studies including delineation of the implications of differential economic pressure between genders, as well as child-rearing pressure and marriage satisfaction.

Search for proton decay via p-->e+pi0 and p-->micro+pi0 in a large water Cherenkov detector.

We have searched for proton decays via p-->e;{+}pi;{0} and p-->micro;{+}pi;{0} using data from a 91.7 kt.yr exposure of Super-Kamiokande-I and a 49.2 kt.yr exposure of Super-Kamiokande-II. No candidate events were observed with expected backgrounds induced by atmospheric neutrinos of 0.3 events for each decay mode. From these results, we set lower limits on the partial lifetime of 8.2 x 10;{33} and 6.6 x 10;{33} years at 90% confidence level for p-->e;{+}pi;{0} and p-->micro;{+}pi;{0} modes, respectively.

Measurement of atmospheric neutrino flux consistent with tau neutrino appearance.

A search for the appearance of tau neutrinos from nu(mu) <--> nu(tau) oscillations in the atmospheric neutrinos has been performed using 1489.2 days of atmospheric neutrino data from the Super-Kamiokande-I experiment. A best fit tau neutrino appearance signal of 138+/-48(stat)-32(+15)(syst) events is obtained with an expectation of 78+/-26(syst). The hypothesis of no tau neutrino appearance is disfavored by 2.4 sigma.

[Prognosis of primary pulmonary hypertension and its determinants].

Most patients with primary pulmonary hypertension (PPH) die within two to four years of the onsets of their symptoms. However, several reports have described patients with PPH who have lived more than 10 years including a case with regression. We studied prognoses and the various determinants in 21 patients (7 men and 14 women; 18 deceased and three living) with PPH to elucidate its pathophysiology. Age at the onset of the disease varied from 12 to 73 years, with a mean of 29 years. All causes of death were of right heart failure, except for two cases of non-cardiac deaths. The prognoses were as follows: less than one year, two cases; 1-2 years, seven (one living); 2-3 years, five; 3-4 years, two; 4-5 years, one; more than six years, four (two living), with a mean of three years and five months. Pulmonary artery pressure decreased 10 years later (mean pressure, from 54 to 41 mmHg) in one patient, who lived for 13 years, followed by a non-cardiac death. Various clinical and pathological factors, including age at the onset of disease, sex, relationship to pregnancy, immunological abnormalities (4, positive; 17, negative), patent foramen ovale (five, patent; 16, not patent), PaO2, hemodynamic parameters, treatments, pathological subtypes (10, plexogenic pulmonary arteriopathy; two, pulmonary micro-thromboembolism; one, pulmonary veno-occlusive disease) numbers of plexiform lesion/cm2 were examined for prognostic correlations. None of the above factors were found to correlate significantly with prognoses. The only significant correlation was between the cardiac index (r = 0.981, p less than 0.001, n = 6), and total pulmonary resistance (r = -0.894, p less than 0.02, n = 6) in patients with pregnancy-related PPH. There was variability in the state of progression, namely, from rapid progression to regression. Clinically as well as pathologically, PPH may consist of several subgroups. However, whether it is due to differences in etiology or reactions of the disease is not clear. The pregnancy-related cases may comprise a homogenous subgroup within PPH.

Effects of selective alpha 1-adrenoceptor blockade in dogs with hypoxic pulmonary vasoconstriction.

The acute effects of the selective alpha 1-blocker, E-643 (Bunazosine), on experimental pulmonary hypertension (PH) caused by hypoxic pulmonary vasoconstriction (HPV) in mongrel dogs were examined. Ninety second ventilation with 5% O2 and 95% N2 was used for hypoxic stimulation. The effects of E-643 were evaluated at doses of 1, 5, 10, 20 and 50 micrograms/kg in this order until the systemic arterial mean pressure (SAm) had decreased by 20 mmHg when compared with the control value during room air ventilation. PaO2 and PaCO2 decreased by 64.6 +/- 11.0 Torr and 2.4 +/- 2.5 Torr, respectively, and the pH increased by 0.031 +/- 0.012 during hypoxic ventilation. These blood gas changes affected during hypoxic stimulation were almost the same before E-643 administration. Progression of arterial blood hypoxemia due to E-643 administration during room air ventilation was not observed. SAm decreased by 8.0 +/- 11.9 mmHg after E-643 administration, while left atrial mean pressure (LAm) and cardiac output (CO) did not change significantly. Prior to E-643 administration, mean pulmonary arterial pressure (PAm) and pulmonary vascular resistance (PVR) increased by 6.4 +/- 3.3 mmHg and 6.2 +/- 3.8 HRU, respectively, during the 90 sec hypoxic ventilation period. After E-643 administration, the increases in PAm and PVR were 3.9 +/- 1.7 mmHg and 3.3 +/- 2.3 HRU, respectively. The suppression of increases in PAm and PVR was significant. The conclusion is that E-643, a selective alpha 1-blocker, is effective at restraining HPV in the dog model.