A survey of 165 sporotrichosis cases examined in Nagasaki prefecture from 1951 to 2012

A total of 165 sporotrichosis cases occurring in Nagasaki prefecture, and examined at Nagasaki University Hospital, were evaluated. Both males and females were equally affected, with no significant differences in the affected body regions. Lesions were frequently seen on the face (49 cases, 29.5%) and upper limbs (101 cases, 60.9%). The localised cutaneous type of sporotrichosis (105 cases, 62.9%) was much more frequent than the lymphocutaneous type (62 cases, 37.1%). The infection rate in patients over 50 years of age was 73.1%. The most frequent occupation among the patients was farming (52 cases, 37.4%), and 34 patients had a history of injury. Regarding the geographical distribution of sporotrichosis, 48 cases occurred in the Shimabara peninsula (31.2%) and this is much higher than expected for the population size. Before 1994, almost all sporotrichosis cases (112 cases, 96.5%) were treated with potassium iodide (KI). After 1995, the number of patients treated with KI decreased (nine cases, 23.1%), and itraconazole (ITZ) was used in 21 cases (59.0%) and terbinafine in six cases (15.3%). The time between ITZ and KI treatment and cure was 13.8 weeks and 12.5 weeks, respectively. All 116 cases, for which the outcome was known, were cured or improved.     

Efficacy and safety of cefditoren pivoxil for exacerbations of chronic obstructive pulmonary disease: A prospective multicenter interventional study

Oral antibiotic therapy for patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) usually involves an aminopenicillin with clavulanic acid, a macrolide, or a quinolone. To date, however, the clinical efficacy and safety of the oral cephalosporin cefditoren pivoxil has not been evaluated in Japanese patients with acute exacerbations of COPD. We conducted a prospective, multicenter, single arm, interventional study from January 2013 to March 2017 to determine the efficacy and safety of oral administration of 200 mg cefditoren pivoxil three times daily for 7 days in a cohort of 29 eligible patients from 15 hospitals. The mean age (SD) of participants was 73.1 (8.1) years and 28 had a smoking history (the mean [SD] of smoking index, 1426.7 [931.7]). The primary efficacy endpoint was clinical response (cure rate) at test of cure, which was set at 5–10 days after treatment ceased. Of the 23 patients finally analyzed, cure was achieved in 15 (65.2%), while 8 (34.8%) remained uncured. Previous experience of acute exacerbations significantly affected the cure rate: none of the three patients who had at least two prior exacerbations were cured, while 15 of the 20 patients with one or fewer prior exacerbations were cured (p = 0.032). The microbiological eradication rate was 88.9% at test of cure. During treatment, mild pneumonia was reported as an adverse event in one patient (3.4%) but resolved within 10 days of onset. We conclude that cefditoren pivoxil represents a viable alternative for antibiotic therapy in patients with few prior exacerbations.     

Bipedicled cervical skin flap for repair after resection of oral cancer

A technique for immediate reconstruction after resection of intraoral cancer, using a bipedicled cervical skin flap, is reported. This procedure does not necessitate a split-thickness skin graft, and the neck wound may be closed by primary approximation.     

Pharmacophysiological study on muscle treated with calcium ionophore A23187

Muscle treated with A23187, which raises intracellular free Ca2+ concentration, was studied to elucidate effects on membrane properties. The mean resting membrane potential was reduced; it was normally depolarized by ouabain but not significantly hyperpolarized by epinephrine and insulin. In the presence of ouabain, membrane depolarization was not provoked by insulin. The results imply a defect of active Na+-transport of the membrane after exposure to a calcium ionophore.     

Straight back syndrome. Clinical and hemodynamic study of 9 cases

Clinical, electrocardiographic, radiologic, and hemodynamic findings in 9 cases of straight back syndrome are described. In one case a small systolic pressure gradient was observed as the catheter was pulled back from the peripheral right pulmonary artery to the main pulmonary artery. To our knowledge, this is the first report of a gradient associated with this syndrome. The possible hemodynamic causes are discussed. It is re-emphasized that the cardiac findings in straight back syndrome frequently mimic those of certain mild congenital heart defects.     

Chromosomes in the chronic phase of chronic granulocytic leukemia

Chromosomal analysis of 66 cases with chronic granulocytic leukemia (CGL) was performed using Q- and G-banding techniques. In 65 of the 66 cases, a Philadelphia (Ph¹) chromosome with evidence of translocation was observed. Karyotypic abnormalities in addition to the Ph¹ were found in 21 cases. In 6 of these 21 cases, the chronic phase persisted for more than 1 year after the first appearance of these abnormalities; in the remaining 15 cases, the abnormalities appeared shortly before or during the acute phase. Of the 6 cases with karyotypic abnormalities in addition to the Ph¹ in the chronic phase, 3 cases had trisomy #8 and the other 3 cases had a double Ph¹, a translocation between chromosomes #4 and #9, and loss of the Y chromosome, respectively. In contrast to the 3 cases where trisomy #8 was found in the chronic phase and exhibited no other abnormalities besides the extra #8 and a Ph¹, all 5 cases whose trisomy #8 was found in the acute phase showed one or more additional chromosomal changes besides the extra #8 and the Ph¹. In the former 3 cases, the percentage of metaphases with trisomy #8 increased gradually throughout the chronic phase during low dose busulfan therapy. One patient in the chronic phase for more than 14 months had only one extra Ph¹. In contrast, all of the 7 cases with double Ph¹ chromosomes shortly before or in the acute phase showed one or more additional chromosomes in addition to double Ph¹. The significance of a double double Ph¹ in the chronic and acute phases appears to be similar to that of trisomy #8 in the respective phases. The observation of trisomy #8 and double Ph¹ might prove to be a useful clinical indicator of the progression of CGL.