An echovirus type 18 outbreak in a neonatal intensive care unit

We describe an outbreak of echovirus type 18 infection involving 20 neonatal intensive care unit (NICU) patients and the results of virological investigations are presented. RT-PCR demonstrated a widespread transmission of the virus in NICU patients during the outbreak. Separation care and additional infection control measures seemed to be effective in preventing further spread of the virus.     

Successful treatment of metastatic alveolar rhabdomyosarcoma with MGMT gene promoter methylation by temozolomide‐based combination chemotherapy

A 3‐year‐old male presented with a large retroperitoneal mass and multiple metastases. Biopsy results suggested alveolar rhabdomyosarcoma bearing a methylated O6‐methylguanine‐DNA methyltransferase (MGMT) gene promoter. Serum microRNA‐206 levels were elevated and remained high after three cycles of vincristine, dactinomycin, and cyclophosphamide (VAC). Replacement of vincristine, irinotecan, and temozolomide (VIT) for VAC induced a marked tumor reduction and normalization of the miR‐206 levels. The patient completed 14 cycles of VIT with local radiotherapy and has been in remission for 31 months. Temozolomide could be effective for tumors with a methylated MGMT gene promoter. Individualized therapy is warranted for such patients.     

Gender difference in work-family conflict among Japanese information technology engineers with preschool children

Since the Family Policy Act, which requires companies to develop action plans to support their employees who have children in an attempt to reverse the declining birthrate in Japan, was enacted in 2003, many Japanese organizations and occupational health staff have become interested in work-family conflict (WFC), especially WFC in employees with young children. A cross-sectional survey of regularly employed information technology (IT) engineers with preschool children in Japan was conducted to examine the gender difference in WFC, relationship of WFC with outcomes, and predictors of WFC by gender. Data from 78 male and 102 female respondents were analyzed. There was no significant gender difference in total level of WFC. However, the level of work interference with family (WIF) was significantly higher in males than in females and the level of family interference with work (FIW) was significantly higher in females. Regarding outcomes, WIF was significantly related to depression and fatigue in both genders. Moreover, different predictors were related to WIF and FIW by gender. A family-friendly culture in the company was related to WIF only in males. To prevent depression and cumulative fatigue in employees with young children, occupational practitioners have to pay attention to not only employees' work stress but also their family stress or amount of family role in both genders.     

Detection and identification of pathogenic bacteria responsible for postoperative pneumonia after esophagectomy

Background

Surgical complications occur frequently after radical esophagectomy and one of its most serious complications is postoperative pneumonia. Preoperative or postoperative bacteriological assessment may be useful in predicting, preventing, and managing postoperative pneumonia.

Methods

One hundred and five consecutive patients undergoing any procedure that included subtotal esophagectomy from October 2009 to March 2011 were the subject of this study. Culture materials (pharyngeal swab, nasal swab, dental plaque, tongue coating, gastric juice, and sputum) retrieved from the 105 esophageal cancer patients before, during, and after the surgery were comprehensively investigated for an association with postoperative pneumonia.

Results

Twenty-one patients out of 105 (20%) were retrospectively diagnosed with postoperative pneumonia. The investigated culture studies were associated with the occurrence of postoperative pneumonia in only one respect: positive detection of pathogens in postoperative endotracheal sputum was associated with marginally increased pneumonia (P = 0.053). Among the 21 pneumonia patients, pathogens were frequently detected in gastric juice retrieved on the first postoperative day (8 out of 14) and postoperative endotracheal sputum (13 out of 17). The putative pathogens of postoperative pneumonia were detected in 7 out of 8 gastric juice specimens and 9 out of 11 in sputum.

Conclusions

Postoperative pneumonia could not be predicted by either preoperative or postoperative bacteriological studies. In the patients with postoperative pneumonia, the postoperative bacterial culture of the gastric juice and sputum may be useful in identifying the causative organisms of postoperative pneumonia and, thus, in selecting appropriate antibiotics.

     

Intravertebral pneumatocysts of the cervical spine

Introduction

The aim of this study was to investigate the prevalence of intravertebral pneumatocyst (IVP) of the cervical spine by age group, compared with that of intradiscal vacuum (IDV).

Methods

We investigated 500 consecutive patients who underwent cervical computed tomography (CT) from May 2012 to May2013 for various indications. CT datasets were assessed for the presence of IVPs and IDVs with stratification by age.

Results

IVPs of the cervical spine were detected in 8 % (7 of 86 subjects) of patients in their forties or below, 30 % (23 of 75) in their fifties, 49 % (67 of 136) in their sixties, 55 % (76 of 137) in their seventies, and 60 % (40 of 66) in their eighties or over. IDVs of the cervical spine were detected in 6, 25, 48, 54, and 57 %, respectively. Coexistence of both phenomena was identified in 4, 17, 33, 40, and 43 %, respectively.

Conclusion

IVPs of the cervical spine are a common incidental finding, increasing in prevalence with age and more common than IDV in all age groups.     

Reservations of the Spirit: The Development of a Culturally Sensitive Spiritual Beliefs Scale About Organ Donation

This study investigated whether spiritual beliefs offered any explanation for why participants from Korea (N?=?146), Japan (N?=?134), and the United States (N?=?146) were willing or reluctant to register as organ donors. A culturally appropriate measure of spiritual beliefs about organ donation, the Spiritual Beliefs Scale, was developed consisting of 2 factors: (a) Spiritual Connection and (b) Spiritual Concern. Spiritual Connection was a significant predictor of behavioral intention to become an organ donor for Korean respondents, whereas Spiritual Concern was a significant predictor of reluctance to become an organ donor for American respondents. Spiritual beliefs correlated as predicted with attitude toward organ donation and fear of bodily mutilation, showing that the Spiritual Beliefs Scale exhibited internal, external, and predictive validity. Across the 3-country sample, Spiritual Connection was associated with greater willingness to become an organ donor for women, whereas Spiritual Concern inhibited participation for men. Implications of these findings are discussed for developing culturally effective education and procurement campaigns.     

Prostate cancer stem‐like cells/cancer‐initiating cells have an autocrine system of hepatocyte growth factor

Prostate cancer cells include a small population of cancer stem‐like cells (CSCs)/cancer‐initiating cells (CICs) that have roles in initiation and progression of the cancer. Recently, we isolated prostate CSCs/CICs as aldehyde dehydrogenase 1‐highh (ALDH1^high) cells using the ALDEFLUOR assay; however, the molecular mechanisms of prostate CSCs/CICs are still elusive. Prostate CSCs/CICs were isolated as ALDH1^high cells using the ALDEFLUOR assay, and the gene expression profiles were analyzed using a cDNA microarray and RT‐PCR. We found that prostate CSCs/CICs expressed higher levels of growth factors including hepatocyte growth factor (HGF). Hepatocyte growth factor protein expression was confirmed by enzyme linked immunosorbent assay and Western blotting. On the other hand, c‐MET HGF receptor was expressed in both CSCs/CICs and non‐CSCs/CICs at similar levels. Hepatocyte growth factor and the supernatant of myofibloblasts derived from the prostate augmented prostasphere formation in vitro, and prostasphere formation was inhibited by an anti‐HGF antibody. Furthermore, c‐MET gene knockdown by siRNA inhibited the prostasphere‐forming ability in vitro and tumor‐initiating ability in vivo. Taken together, the results indicate that HGF secreted by prostate CSCs/CICs and prostate myofibroblasts has a role in the maintenance of prostate CSCs/CICs in an autocrine and paracrine fashion.     

Diagnosis of anal sphincter defects by three-dimensional transperineal ultrasound in women with anal incontinence

Purpose

To assess the utility of transperineal three-dimensional (3D) ultrasound for diagnosing anal sphincter defects and evaluating the function of the anal canal in women with anal incontinence.

Methods

The study subjects were 13 women with anal incontinence. Symptoms of fecal incontinence were assessed by Wexner score. The anal canal of each woman was examined ultrasonically with both a convex transperineal 3D scanner and a radial transanal scanner to compare the accuracy of the two approaches for diagnosis of anal sphincter defects. The anorectal angle and the length of the anal canal were also measured by utilizing the functionality of the transperineal 3D ultrasound.

Results

The mean age was 58.9?±?14.9?years (±SD), and the mean Wexner score was 8.4?±?5.6. In terms of ultrasound diagnosis of anal sphincter defects, the two methods showed consistent results in each woman. The length of the portion where both the internal and external anal sphincters were intact was significantly correlated with the Wexner score, whereas the total length of the anal canal was not.

Conclusions

Less invasive transperineal 3D ultrasound provides accurate evaluation of the internal and external anal sphincters in women with anal incontinence, and the method is potentially useful for detection of anal sphincter abnormalities.