A nationwide cross-sectional study using a web-based questionnaire survey of the duration of isolation of COVID-19 inpatients with cancer at Japanese cancer centers.

There is no clear consensus regarding the optimal isolation duration for immunocompromised patients with coronavirus disease 2019 (COVID-19). Therefore, we conducted a questionnaire survey at eight Japanese cancer centers to investigate the practices of infectious disease specialists regarding the duration of isolation for COVID-19 inpatients with cancer. For asymptomatic to severely ill COVID-19 inpatients without severe immunodeficiency, four centers reported at least 10 days of isolation without testing, and two reported at least 20 days. Two centers incorporated polymerase chain reaction (PCR) as a criterion for terminating the isolation of inpatients without severe immunodeficiency. For severely immunocompromised COVID-19 inpatients, at least 20 days of isolation were required in seven facilities, regardless of illness severity. Additionally, seven centers had implemented Ct or antigen quantification test values as criteria for de-isolating severely immunocompromised inpatients. No cases caused nosocomial outbreaks after isolation was terminated based on each facility's criteria for isolation termination. Thus, cancer patients required longer isolation periods than the general population in most facilities, and for those with severe immunodeficiency, the isolation periods were longer and more tightly controlled with tests.

Adaptive feedforward control of closed orbit distortion caused by fast helicity-switching undulators.

A new correction algorithm for closed orbit distortion based on an adaptive feedforward control (AFC) has been developed. At SPring-8, two helicity-switching twin-helical undulators (THUs) had been implemented with conventional feedforward corrections. However, the validity of these corrections turned out to be expiring due to unforeseen variation in the error magnetic fields with time. The developed AFC system has been applied to the THUs dynamically updating the feedforward table without stopping the helicity switching amid user experiments. The error sources in the two THUs are successfully resolved and corrected even while the two THUs are switching simultaneously with the same repetition period. The actual operation of the new AFC system enables us to keep the orbit variations suppressed with an accuracy at the sub-micrometre level in a transparent way for light source users.

Immunohistochemical study for the expression of leukocyte adhesion molecules, and FGF23 and ACE2 in P. gingivalis LPS-induced diabetic nephropathy.

OBJECTIVE: The present study aims to examine the expression of leukocyte adhesion molecules and renal metabolic factors in diabetic mouse kidneys with periodontal pathogen Pg-LPS-induced nephropathy. BACKGROUND: We recently reported that the glomerular endothelium expresses toll-like receptor (TLR)2 and TLR4 in diabetic environments and TLR2/4 ligand Porphyromonas (P.) gingivalis lipopolysaccharides (Pg-LPS) induce nephropathy in diabetic mice. It is thought that Pg-LPS promotes the chronic inflammation with the overexpression of leukocyte adhesion molecules and renal-specific metabolic enzymes by the recognition of Pg-LPS via TLR in the diabetic kidneys. There have been no reports of the effects of periodontopathic bacteria on the expression of leukocyte adhesion molecules and the accumulation of physiologically active substances in the kidney. METHODS: The immunohistochemical investigation was performed on diabetic mouse kidney with Pg-LPS-induced nephropathy with glomerulosclerosis in glomeruli. RESULTS: There were no vessels which expressed vascular cell adhesion molecule-1 (VCAM-1), E-selectin, or fibroblast growth factor (FGF) 23 in streptozotocin (STZ)-induced diabetic ICR mice (STZ-ICR), or in healthy ICR mice administered Pg-LPS (LPS-ICR). However, in diabetic ICR mouse kidneys with Pg-LPS-induced nephropathy (LPS-STZ) the expression of VCAM-1 and the accumulation of FGF23 were observed in renal tubules and glomeruli, and the expression of E-selectin was observed in renal parenchyma and glomeruli. The angiotensin-converting enzyme 2 (ACE2) was detected in the proximal tubules but not in other regions of ICR, STZ-ICR, or LPS-ICR. In LPS-STZ ACE2 was detected both in renal tubules as well as in glomeruli. The Mac-1 and podoplanin-positive cells increased in the renal parenchyma with diabetic condition and there was the distribution of a large number of Mac-1-positive cells in LPS-STZ. CONCLUSIONS: The Pg-LPS may induce diabetic renal inflammation such as glomerulosclerosis and tubulitis with infiltration of Mac-1/podoplanin positive macrophages via glomerular overexpression of VCAM-1 and E-selectin, resulting in accumulation of both ACE2 and FGF23 which were unmetabolized with the inflammation-induced kidney damage under the diabetic condition. Periodontitis may be a critical factor in the progress of nephropathy in diabetic patients.

Pulmonary Histoplasmosis in a Japanese Man Infected During Travel to Mexico and Management of His Wife's Condition: A Case Report.

We report herein on the case of a 33-year-old Japanese man in whom an abnormal shadow was detected on chest radiography during a medical checkup after a 1-year-stay in Mexico. Chest computed tomography showed a nodule in the left lower lobe adjacent to the visceral pleura. Histopathologic examination of a thoracoscopic partial pulmonary resection specimen showed coagulation necrosis with a number of yeast-like forms on Grocott staining. In addition, serum anti-Histoplasma antibody positivity was detected with an enzyme-linked immunosorbent assay, and Histoplasma-specific nested real-time polymerase chain reaction results were positive in the pulmonary region. Finally, pulmonary histoplasmosis was diagnosed, and treatment with itraconazole was initiated. The patient's wife who had accompanied him to Mexico was asymptomatic and was not found to have histoplasmosis based on diagnostic imaging and serological findings. Although rare in Japan, histoplasmosis should be considered in the differential diagnosis of pulmonary lesions in patients who have returned from travel to endemic areas.

Candidemia Diagnosed from Peripheral Blood Smear: Case Report and Review of Literature 1954-2013.

BACKGROUND: Yeast with pseudohyphae or those that have been phagocytized by white blood cells are coincidentally found in peripheral blood smears. The clinical diagnostic value and outcome of candidaemia diagnosed from peripheral blood smears (CPBSs) are unclear. CASE PRESENTATION: A 45-year-old man with diabetes and panhypopituitarism for 20 years received 10 mg of hydrocortisone and 100 µg of levothyroxine sodium hydrate daily. He has been admitted seven times because of adrenal failure triggered by infections and was admitted for pneumonia. On day 56, some budding yeast was found microscopically in a peripheral blood smear with May-Giemsa staining. Some of them were phagocytized by white blood cells. The two blood cultures yielded Candida parapsilosis. Despite antifungal treatment and removal of an intravenous catheter, on day 98 (42 days after the candidaemia diagnosis), the patient died. CONCLUSION: We analysed 36 cases including the present case. Almost all CPBS patients (96.5 %, n = 29) were using an intravenous catheter. The most frequently isolated species was C. parapsilosis (35.1 %), followed by C. albicans (29.7 %). The overall mortality rate was 53.6 % (n = 28). The time from the discovery of yeast-like pathogens using peripheral blood smears to death ranged from a few hours to 93 days (median 19 days). The present results suggest that intravenous catheter use and the underlying conditions of patients are responsible for CPBSs. The detection of yeast in peripheral blood smears suggests advanced infections with uncontrollable complications, which means a poor prognosis. Rapid detection methods besides blood culture are needed.

Edwardsiella tarda bacteremia. A rare but fatal water- and foodborne infection: Review of the literature and clinical cases from a single centre.

BACKGROUND: Edwardsiella tarda bacteremia (ETB) can be a fatal disease in humans. OBJECTIVES: To determine the significant risk factors associated with death caused by ETB, and to examine the geographical, seasonal, environmental and dietary factors of the disease. METHODS: A retrospective, observational, case control study was performed. The PubMed MEDLINE and Japanese Medical Abstract Society (www.jamas.or.jp) databases were searched for ETB case reports and meeting abstracts. In additon, retrospective chart reviews of patients with ETB at the Tokyo Women's Medical University Hospital (Tokyo, Japan) were conducted to evaluate the risk factors associated with death using multivariate analyses. RESULTS: The literature search yielded 46 publications, comprising 72 cases from the English (n=30), French (n=1), Spanish (n=1) and Japanese (n=14) literature. Five cases at the Tokyo Women's Medical University Hospital were also included. Of the included 77 cases, the mean age was 61 years and 39% of patients were female; 77.2% of the cases occurred between June and November, and 45.5% were reported in Japan. Dietary factors (raw fish/meat exposure) were reported for 10.4% of patients and 12.9% reported environmental (ie, brackish water) exposure. The overall mortality rate was 44.6%; however, this rate increased to 61.1% for ETB patients with soft tissue infections. Liver cirrhosis was determined to be an independent risk factor associated with death (OR 12.0 [95% CI 2.46 to 58.6]; P=0.00213) using multivariate analyses. DISCUSSION: To our knowledge, the present analysis was the first and largest multi-language review of ETB. Clinical characteristics of ETB resemble those of Aeromonas, typhoid fever and Vibrio vulnificus infections, in addition to sharing similar risk factors. CONCLUSION: ETB should be categorized as a severe food- and waterborne infection, which results in high mortality for patients with liver cirrhosis.

HISTORIQUE: Chez les humains, la bactériémie à Edwardsiella tarda (BET) peut être mortelle. OBJECTIFS: Déterminer les facteurs de risque importants liés aux décès causés par la BET et examiner les facteurs géographiques, saisonniers, environnementaux et diététiques de la maladie. MÉTHODOLOGIE: Les chercheurs ont effectué une étude castémoins d'observation rétrospective. Ils ont fait des recherches dans les bases de données MEDLINE de PubMed et de la Société japonaise de communications médicales (www.jamas.or.jp) pour trouver les comptes rendus de BET et les communications de cas lors de colloques et congrès. Ils ont également procédé à une analyse rétrospective des dossiers de patients atteints d'une BET à l'hôpital universitaire de Tokyo pour femmes, au Japon, pour évaluer les facteurs de risque liés aux décès à l'aide d'analyses multivariées. RÉSULTATS: L'analyse bibliographique a permis d'extraire 46 publications, soit 72 cas tirés de publications anglophones (n=30), francophones (n=1), espagnoles (n=1) et japonaises (n=14). Cinq cas de l'hôpital universitaire de Tokyo pour femmes étaient également inclus. Les 77 cas avaient un âge moyen de 61 ans, et 39 % étaient de sexe féminin, 77,2 % s'étaient déclarés entre les mois de juin et novembre et 45,5 % provenaient du Japon. Chez 10,4 % des patients, des facteurs diététiques (poisson cru, exposition à la viande) étaient en cause, tandis que 12,9 % présentaient une exposition environnementale (eau saumâtre). Le taux de mortalité globale s'élevait à 44,6 %, mais passait à 61,1 % chez les patients atteints d'une BET et d'infections des tissus mous. D'après les analyses multivariées, la cirrhose était un facteur de risque indépendant de décès (RC 12,0 [95 % IC 2,46 à 58,6]; P=0,00213). EXPOSÉ: En autant que nous le sachions, il s'agissait de la plus vaste analyse sur la BET et de la première à être multilingue. Les caractéris-tiques cliniques de la BET ressemblent à celles des infections à Aeromonas et à Vibrio vulnificus et de la typhoïde en plus de partager des facteurs de risque similaires. CONCLUSION: La BET devrait être classée parmi les graves infections d'origine hydrique et alimentaire qui entraînent des taux de mortalité élevés chez les patients atteints d'une cirrhose.

Fournier's gangrene caused by Listeria monocytogenes as the primary organism.

A 70-year-old man with a history of tongue cancer presented with Fournier's gangrene caused by Listeria monocytogenes serotype 4b. Surgical debridement revealed undiagnosed rectal adenocarcinoma. The patient did not have an apparent dietary or travel history but reported daily consumption of sashimi (raw fish). Old age and immunodeficiency due to rectal adenocarcinoma may have supported the direct invasion of L monocytogenes from the tumour. The present article describes the first reported case of Fournier's gangrene caused by L monocytogenes. The authors suggest that raw ready-to-eat seafood consumption be recognized as a risk factor for listeriosis, especially in cases of skin and soft tissue infection.

Un homme de 70 ans ayant des antécédents de cancer de la langue s'est présenté avec une gangrène de Fournier causée par un Listeria monocytogenes de sérotype 4b. Le débridement chirurgical a révélé un adénocarcinome rectal non diagnostiqué. Le patient n'avait pas d'antécédents alimentaires ou de voyage apparents, mais a déclaré consommer des sashimis (poisson cru) tous les jours.L'âge avancé et l'immunodéficience causée par l'adénocarcinome rectal ont peut-être favorisé l'invasion directe du L monocytogenes par la tumeur. Il s'agit du premier cas déclaré de gangrène de Fournier attribuable au L monocytogenes. Les auteurs proposent d'inclure la consommation de fruits de mer crus prêt-à-manger dans les facteurs de risque de listériose, notamment en cas d'infections de la peau et des tissus mous.

Mycobacterium tuberculosis infection in cancer patients at a tertiary care cancer center in Japan.

The characteristics of active tuberculosis in cancer patients in Japan and the effects of this infection on cancer treatment have not yet been clarified. The records of all consecutive patients with microbiologically documented Mycobacterium tuberculosis infection diagnosed between September 2002 and March 2008 at Shizuoka cancer center (a 557-bed tertiary care cancer center in Japan) were reviewed. There were 24 cancer patients with active tuberculosis during the study period. Of these, 23 had solid-organ tumors, and the most common site of the underlying malignancy was the lung. Most of the patients had pulmonary tuberculosis. Among 15 patients followed up for more than 2 months prior to the diagnosis of pulmonary tuberculosis, 12 had healed scars suggestive of old tuberculosis lesions, as shown by chest imaging obtained at the time of the initial evaluation. Discontinuation of cancer therapy or more than a month's delay in surgery occurred in 10 patients with pulmonary tuberculosis. Development of active tuberculosis can delay cancer treatment in Japanese centers. Cancer patients with scars suggestive of old tuberculosis disease lesions as shown by chest imaging should be screened for active tuberculosis and carefully followed up. In some cases, prophylactic treatment should be considered.

Proximity effect of emergent field from spin ice in an oxide heterostructure.

Geometrical frustration endows magnets with degenerate ground states, resulting in exotic spin structures and quantum phenomena. Such magnets, called quantum magnets, can display non-coplanar spin textures and be a viable platform for the topological Hall effect driven by "emergent field." However, most quantum magnets are insulators, making it challenging to electrically detect associated fluctuations and excitations. Here, we probe magnetic transitions in the spin ice insulator Dy2Ti2O7, a prototypical quantum magnet, as emergent magnetotransport phenomena at the heterointerface with the nonmagnetic metal Bi2Rh2O7. Angle-dependent longitudinal resistivity exhibits peaks at the magnetic phase boundaries of spin ice due to domain boundary scattering. In addition, the anomalous Hall resistivity undergoes a sign change with the magnetic transition in Dy2Ti2O7, reflecting the inversion of the emergent field. These findings, on the basis of epitaxial techniques, connect the fundamental research on insulating quantum magnets to their potential electronic applications, possibly leading to transformative innovations in quantum technologies.

Acute muscle loss assessed using panoramic ultrasound in critically ill adults: a prospective observational study.

PURPOSE: Panoramic ultrasound is one of the recently introduced ultrasound evaluation techniques. We herein examined the relationship between the cross-sectional area of the rectus femoris muscle on panoramic ultrasound and its volume based on the gold standard computed tomography (CT) evaluation. METHODS: This was a single-center prospective observational study. A panoramic ultrasound assessment of the cross-sectional area of the rectus femoris muscle and a simple CT evaluation of its volume were performed on days 1 and 7 of hospitalization. Physical functions were assessed at discharge. RESULTS: Twenty patients were examined. The rate of change in the cross-sectional area of the rectus femoris muscle on panoramic ultrasound correlated with that in its volume on CT (correlation coefficient 0.59, p = 0.0061). In addition, a correlation was observed between the absolute value for the rectus femoris muscle cross-sectional area on panoramic ultrasound and physical functions at discharge. Rectus femoris muscle distances did not correlate with either. CONCLUSION: In the acute phase of critical illness, the cross-sectional area of the rectus femoris muscle on panoramic images correlated with its volume on CT and, thus, it is a valid method for assessing muscle mass.

Correlation between antibiotic use and antibiotic resistance: A multicenter study using the Japan Surveillance for Infection Prevention and Healthcare Epidemiology (J-SIPHE) system in Hokkaido, Japan.

BACKGROUND: The Japan Surveillance for Infection Prevention and Healthcare Epidemiology (J-SIPHE) system aggregates information related to antimicrobial resistance (AMR) measures in participating medical institutions nationwide and is intended to be used for promotion of AMR measures in participating facilities and their communities. This multicenter study aimed to determine the usefulness of the J-SIPHE system for evaluating the correlation between antibiotic use and antibiotic resistance in Hokkaido, Japan. METHODS: Data on antibiotic use and detection rate of major resistant Gram-negative bacteria at 19 hospitals in 2020 were collected from the J-SIPHE system, and data correlations were analyzed using JMP Pro. RESULTS: The detection rate of carbapenem-resistant Pseudomonas aeruginosa was significantly positively correlated with carbapenem use (Spearman's ρ = 0.551; P = .015). There were significant positive correlations between the detection rate of fluoroquinolone-resistant Escherichia coli and the use of piperacillin/tazobactam, carbapenems, and quinolones [ρ = 0.518 (P = .023), ρ = 0.76 (P < .001), and ρ = 0.502 (P = .029), respectively]. CONCLUSIONS: This is the first multicenter study to investigate the correlation between antibiotic use and antibiotic resistance using the J-SIPHE system. The results suggest that using this system may be beneficial for promoting AMR measures.

Analysis of clinical features of non-HIV Pneumocystis jirovecii pneumonia.

Pneumocystis jirovecii pneumonia (PCP) is classified as PCP with human immunodeficiency virus (HIV) and non-HIV PCP, and the two forms differ in progression and prognosis. Although early treatment is necessary, the diagnosis of non-HIV PCP is often difficult because of the underlying diseases. However, the outcome with treatment delay remains unclear because there are no concrete data indicating a worsened clinical situation or increased complications related to delayed therapy initiation. We retrospectively examined patients with non-HIV PCP admitted to Tokyo Women's Medical University Hospital from November 2008 to October 2010. The relationship between intubation with mechanical ventilation (within 1 week after starting treatment) and treatment delay was investigated. Treatment delay was defined as the period, in days, from onset to therapy initiation. In total, 24 confirmed non-HIV PCP cases were included. Median treatment delay was 7 ± 4.83 days (1-20 days). Twelve of 24 cases (50 %) were intubated, and 11 (45.8 %) died of their underlying diseases within 90 days. Treatment delay was more than 7 days in the intubation group, but was within 7 days in 9 of 12 nonintubation cases. The difference in treatment delay was significant (p = 0.0071) between the intubation and nonintubation groups, but there were no significant differences in survival rate at 90 days or other findings. We conclude that starting treatment within 7 days after onset is important because intubation and mechanical ventilation may be avoided in many cases.

Disseminated cryptococcosis in a non-Hodgkin's lymphoma patient with late-onset neutropenia following rituximab-CHOP chemotherapy: a case report and literature review.

Rituximab-related late-onset neutropenia (R-LON) is an adverse event associated with rituximab. A 65-year-old woman presented with diffuse large B-cell lymphoma of the kidney without bone marrow involvement. She was treated with 4 cycles of CHOP chemotherapy consisting of doxorubicin, cyclophosphamide, vincristine, and prednisolone at 4-week intervals. Rituximab was also administrated of the second, third, fourth CHOP cycles. She developed a high fever of 38°C, nausea, and severe neutropenia following the four cycles of R-CHOP chemotherapy. Her leukocyte count was 160/µl without neutrophils. Initially, a blood and pleural fluid and cerebrospinal fluid cultures were positive for Cryptococcus neoformans. Once she became asymptomatic following treatment with fluconazole and neutropenia was recovered with lenograstim, she had neck stiffness and admitted soon. Cerebro-spinal fluid (CSF) culture was positive for Cryptococcus neoformans. Treatment with amphotericin B(AMPH-B) and flucytosine(5-FC) was initiated as diagnosis of cryptococcus meningitis. Lenograstim was administrated for 9 months, and amount of dose was 9,750 µg. Cryptococcosis with malignant lymphoma is rare disease, and previously 17 cases were reported. Of note, mortality of disseminated cryptococcosis with malignant lymphoma is 54%. The more and more rituximab is widely used; the cases of severe infection in R-LON may increase.

Grip Strength Correlates with Mental Health and Quality of Life after Critical Care: A Retrospective Study in a Post-Intensive Care Syndrome Clinic.

Post-intensive care syndrome (PICS) is characterized by several prolonged symptoms after critical care, including physical and cognitive dysfunctions as well as mental illness. In clinical practice, the long-term follow-up of PICS is initiated after patients have been discharged from the intensive care unit, and one of the approaches used is a PICS clinic. Although physical dysfunction and mental illness often present in combination, they have not yet been examined in detail in PICS patients. Grip strength is a useful physical examination for PICS, and is reported to be associated with mental status in the elderly. We herein investigated the relationship between grip strength and the mental status using data from our PICS clinic. We primarily aimed to analyze the correlation between grip strength and the Hospital Anxiety and Depression Scale (HADS) score. We also analyzed the association between grip strength and the EuroQol 5 Dimension (EQ5D) score as quality of life (QOL). Subjects comprised 133 patients who visited the PICS clinic at one month after hospital discharge between August 2019 and December 2020. Total HADS scores were 7 (4, 13) and 10 (6, 16) (p = 0.029) and EQ5D scores were 0.96 (0.84, 1) and 0.77 (0.62, 0.89) (p ≤ 0.0001) in the no walking disability group and walking disability group, respectively. Grip strength negatively correlated with HADS and EQ5D scores. Correlation coefficients were r = -0.25 (p = 0.011) and r = -0.47 (p < 0.0001) for HADS and EQ5D scores, respectively. Grip strength was a useful evaluation that also reflected the mental status and QOL.

[Two cases of bacteremic pneumonia caused by Pseudomonas aeruginosa in solid-organ cancer patients].

Pseudomonas aeruginosa, the leading nosocomial pneumonia pathogen in immunocompromised patients, has Recently become typically presented as slowly progressive ventilator-associated pneumonia. We report two cases of bacteremic pneumonia due to Pseudomonas aeruginosa in non-neutropenic solid-organ cancer. Both subjects had sudden sepsis or septic shock but few respiratory symptoms. Chest radiography showed a diffuse unilateral decrease in permeability, becoming necrotizing pneumonia and lung abscess in 7-10 days. Conventional literature describe fulminant pseudomonas bacteremic pneumonia in non-neutropenic immunocompromised hosts as the initial presentation with septic shock and interstitial lung opacity, leading lung abscess.

[Non disseminated pulmonary cryptococcosis with very marked eosinophilia in solid-organ cancer].

Cryptococcal lung disease is usually diagnosed by chest X-ray abnormalities. Although no treatment exists for asymptomatically immunocompetent patients, a case with central nervous system (CNS) involvement as cryptococcus dissemination had a new chest X-ray abnormality during marked eosinophilia diagnosed as pulmonary cryptococcosis by lung biopsy. Eosinophilia may thus be associated with pulmonary cryptococcosis. We had seen reports of disseminated cryptococcosis with eosinophilia, so we conducted lumbar puncture and blood culture, but found no disseminated lesion or CNS involvement. Eosinophilia association with disseminated cryptococcosis has been reported, but not pulmonary cryptococcosis with solitary localized lung lesion with marked eosinophilia, making our case the first, in so far as we know reported of pulmonary cryptococcosis with a solitary localized lung lesion with marked eosinophilia.

Evolution of ferroelectricity in ultrathin PbTiO3 films as revealed by electric double layer gating.

Ferroelectricity in ultrathin films is destabilized by depolarization field, which leads to the reduction of spontaneous polarization or domain formation. Here, thickness dependence of remnant polarization in PbTiO3 films is electrically revealed down to 2.6 nm by controlling the polarization direction with employing an electric double layer gating technique to suppress leakage current in ultrathin films. The remnant polarization for a 17 nm-thick film is similar to bulk value ~ 60 µC cm-2 and reduces to ~ 20 µC cm-2 for a 2.6 nm-thick film, whereas robust ferroelectricity is clearly observed in such ultrathin films. In-situ X-ray diffraction measurements under an external electric field reveal that the reduced tetragonality in ultrathin films is mostly recovered by cancelling out the depolarization field. Electric double layer gating technique is an excellent way for exploring physical properties in ultrathin ferroelectric films.

Selective Detection of DNA from Viable Mycobacterium tuberculosis Complex Strains Using the EMA-PCR Method.

In this study, the ability to discriminate viable from dead cells of Mycobacterium tuberculosis complex (MTC), using an ethidium monoazide (EMA) treatment-dependent viable bacteria selection PCR kit was examined. Detection of dead bacteria was possible for bacterial concentrations in the range 1.5 × 107-3.0 × 107 CFU/mL, which was equivalent to McFarland No. 0.05-0.10. There was a significant difference between the results for viable and dead bacteria, and the sensitivity and specificity of this method for culture-negative samples from patients were 83% and 100%, respectively. To the best of our knowledge, this is the first successful selective detection of DNA from viable cells of MTC by EMA-PCR, using the viable bacteria selection kit for PCR (gram-positive), an EMA treatment kit. We believe that application of this method could promote earlier discharge of patients undergoing tuberculosis treatment by discriminating dead from viable cells.

Osseous changes of the mandibular condyle affect backward-rotation of the mandibular ramus in Angle Class II orthodontic patients with idiopathic condylar resorption of the temporomandibular joint.

Objective: To evaluate whether osseous changes of the temporomandibular joint (TMJ) condyle affect backward rotation of the mandibular ramus in Angle Class II orthodontic patients with idiopathic condylar resorption (ICR). Methods: Twenty Japanese women with Class II malocclusion with ICR (ICR group) and 24 women with Class II malocclusion without ICR (non-ICR group) were examined. Pre-treatment panoramic radiographs were used to measure condylar ratios. Pre-treatment lateral cephalograms were used to evaluate maxillofacial morphology. Results: The ICR group had a significantly smaller condylar ratio, greater backward rotation of the ramus, less labially inclined upper incisors, and a steeper occlusal plane. The increased backward rotation of the ramus in the ICR group was significantly associated with a smaller condylar ratio. Conclusion: Angle Class II patients with ICR had shorter condylar height attributable to osseous changes of the TMJ condyle, and the shorter condylar height may affect subsequent backward rotation of the ramus.

tRNA Genes Affect Chromosome Structure and Function via Local Effects.

The genome is packaged and organized in an ordered, nonrandom manner, and specific chromatin segments contact nuclear substructures to mediate this organization. tRNA genes (tDNAs) are binding sites for transcription factors and architectural proteins and are thought to play an important role in the organization of the genome. In this study, we investigate the roles of tDNAs in genomic organization and chromosome function by editing a chromosome so that it lacked any tDNAs. Surprisingly our analyses of this tDNA-less chromosome show that loss of tDNAs does not grossly affect chromatin architecture or chromosome tethering and mobility. However, loss of tDNAs affects local nucleosome positioning and the binding of SMC proteins at these loci. The absence of tDNAs also leads to changes in centromere clustering and a reduction in the frequency of long-range HML-HMR heterochromatin clustering with concomitant effects on gene silencing. We propose that the tDNAs primarily affect local chromatin structure, which results in effects on long-range chromosome architecture.