Volume elastic modulus with exponential function of transmural pressure as a valid stiffness measure derived by photoplethysmographic volume-oscillometry in human finger and radial arteries: potential for arteriosclerosis screening.

Noninvasive and convenient measurement of vascular stiffness is of considerable importance for early detection and treatment of arteriosclerosis. Volume elastic modulus ([Formula: see text]) is one of representative measures reflecting effective vascular elasticity that is strongly dependent upon blood pressure (BP) or transmural pressure ([Formula: see text] = mean BP - (externally applied pressure)). However, its nonlinear nature in terms of functional form has not been fully investigated in human vasculature. This paper therefore seeks to clarify the functional form of [Formula: see text] in the human finger and radial arteries based on photoplethysmographic volume-oscillometry developed for novel indirect BP measurement. Using a smartphone-based instrument specially designed for this study, [Formula: see text] values at various [Formula: see text] levels were obtained in 11 male and female volunteers with various ages. It was demonstrated that [Formula: see text] showed an exponential behavior with respect to [Formula: see text] changes, expressed as [Formula: see text] ([Formula: see text], α; constant) with a high coefficient of determination, the validity of which was also supported through theoretical derivation. Conclusively, the [Formula: see text] is found to increase exponentially with arterial distending pressure, and the independent measures [Formula: see text] and α would be useful parameters to conveniently evaluate progressive changes of vascular stiffness among and/or within individuals, indicating that this measurement has potential for arteriosclerosis screening (200/200). Schematic diagram of overall configuration of the measurement system of arterial elasticity in the finger and the wrist, consisting of a measuring, signal processing and control (MSC) unit (surrounded by the dashed line) and a smartphone for data display and storage. An occlusive cuff and a photoplethysmographic placement of LED and PD for the finger and the wrist are shown in the upper middle part. Measurement scenes of the finger and the wrist are also inset in the upper left and in the upper right part, respectively.

Rapid Detection of Microbial Contamination in Intravenous Fluids by ATP-Based Monitoring System.

In this study, we investigated four clinical cases of microbial contamination of in-use intravenous infusion fluid, detected by measuring "Adenosine triphosphate (ATP) + adenosine monophosphate (AMP)" ("ATP+AMP") levels. High "ATP+AMP" values correlate with microbial contamination, and by utilizing these values as indicator for microbial contamination possibility, we were able to rapidly detect the contamination and recommend replacement of catheters and administration sets. In three out of four cases, changing the infusion fluid led to improvement in the condition of the patients. "ATP+AMP" levels can be used to confirm microbial contamination of in-use intravenous infusion fluids, as it is fast (several minites) and convenient to measure them.

A biomechanically derived minimum work model of the fish gill lamellar system exhibits its exquisite morphological arrangement and perfusate regulation for oxygen uptake from water.

To evaluate the efficiency of oxygen (O2) uptake from water through the fish gill lamellar system, a cost function (CF) representing mechanical power expenditure for water ventilation and blood circulation through the gill was formulated, by applying steady-state fluid mechanics to a homogeneous lamellar-channel model. This approach allowed us to express CF as the function of inter-lamellar water channel width (w) and to derive an analytical solution of the width (wmin) at the minimum CF. Morphometric and physiological data for rainbow trout in the literature were referred to calculate CF(w) curves and their wmin values at five intensity stages of swimming exercise. Obtained wmin values were evenly distributed around the standard measure of the width (ws = 24 µm) in this fish. Individual levels of CF(wmin) were also fairly close to the corresponding CF(ws) values within a 10% deviation, suggesting the reliability of approximating [CF(wmin) = CF(ws)]. The cost-performance of O2 uptake through the gill (ηg) was then assessed from reported data of total O2 uptake/CF(ws) at each intensity stage. The ηg levels at any swimming stage exceeded 95% of the theoretical maximum value, implying that O2 uptake is nearly optimally performed in the lamellar-channel system at all swimming speeds. Further analyses of O2 transport in this fresh water fish revealed that the water ventilation by the buccal/opercular pumping evokes a critical limit of swimming velocity, due to confined O2 supply to the peripheral skeletal muscles, which is avoided in ram ventilators such as tuna.

The Use of Electric Toilet Seats with Water Spray Is Efficacious in Maintaining Hand Hygiene in Experimental Model.

A simulation experiment was conducted to examine hand contamination from wiping the buttocks after the use and non-use of an electric toilet seat with water spray. A model of the buttocks was smeared with artificial diarrheal feces containing Serratia marcescens, and wiped by the participants wearing disposable gloves with 4 sheets of toilet paper after the use and non-use of the water spray of an electric toilet seat. Subsequently, the presence of S. marcescens on the surface of the gloves was quantified. After using the water spray, the mean count±standard deviation of S. marcescens was 0.067±0.249 colony-forming units (cfu)/glove, and it was 4,275±6,069 cfu/glove when water spray was not used. The cfu of S. marcescens was significantly lower when the water spray was used (p<0.00001) prior to wiping the artificial diarrheal feces. This result supports the effectiveness of water spray to prevent defecation-related hand contamination.

Lung Cancer Surgery in Partial Anomalous Pulmonary Venous Connection Patients.

We report pulmonary resections for lung cancers in 2 patients with partial anomalous pulmonary venous connection (PAPVC) identified preoperatively. In case 1, right upper lobectomy was performed as the definitive operation for both lung cancer and PAPVC in the same lobe. In case 2, because lung cancer and PAPVC existed in different lobes, cardiac catheterization was performed to evaluate the need for correction of the PAPVC. Then, left lower lobectomy was safely performed without correcting the PAPVC located in the left upper lobe. The treatment plan for patients with PAPVC who require pulmonary resection should be carefully considered.

A phase ΙI study of five peptides combination with oxaliplatin-based chemotherapy as a first-line therapy for advanced colorectal cancer (FXV study).

BACKGROUND: We previously conducted a phase I trial for advanced colorectal cancer (CRC) using five HLA-A*2402-restricted peptides, three derived from oncoantigens and two from vascular endothelial growth factor (VEGF) receptors, and confirmed safety and immunological responses. To evaluate clinical benefits of cancer vaccination treatment, we conducted a phase II trial using the same peptides in combination with oxaliplatin-based chemotherapy as a first-line therapy. METHODS: The primary objective of the study was the response rates (RR). Progression free survival (PFS), overall survival (OS), and immunological parameters were evaluated as secondary objective. The planned sample size was more than 40 patients for both HLA2402-matched and -unmatched groups. All patients received a cocktail of five peptides (3 mg each) mixed with 1.5 ml of IFA which was subcutaneously administered weekly for the first 12 weeks followed by biweekly administration. Presence or absence of the HLA-A*2402 genotype were used for classification of patients into two groups. RESULTS: Between February 2009 and November 2012, ninety-six chemotherapy naïve CRC patients were enrolled under the masking of their HLA-A status. Ninety-three patients received mFOLFOX6 and three received XELOX. Bevacizumab was added in five patients. RR was 62.0% and 60.9% in the HLA-A*2402-matched and -unmatched groups, respectively (p=0.910). The median OS was 20.7 months in the HLA-A*2402-matched group and 24.0 months in the unmatched group (log-rank, p=0.489). In subgroup with a neutrophil/lymphocyte ratio (NLR) of <3.0, patients in the HLA-matched group did not survive significantly longer than those in the unmatched group (log-rank, p=0.289) but showed a delayed response. CONCLUSIONS: Although no significance was observed for planned statistical efficacy endpoints, a delayed response was observed in subgroup with a NLR of <3.0. Biomarkers such as NLR might be useful for selecting patients with a better treatment outcome by the vaccination. TRIAL REGISTRATION: Trial registration: UMIN000001791.

A phase I study of combination vaccine treatment of five therapeutic epitope-peptides for metastatic colorectal cancer; safety, immunological response, and clinical outcome.

BACKGROUND: To evaluate the safety of combination vaccine treatment of multiple peptides, phase I clinical trial was conducted for patients with advanced colorectal cancer using five novel HLA-A*2402-restricted peptides, three peptides derived from oncoantigens, ring finger protein 43 (RNF43), 34 kDa-translocase of the outer mitochondrial membrane (TOMM34), and insulin-like growth factor-II mRNA binding protein 3 (KOC1), and the remaining two from angiogenesis factors, vascular endothelial growth factor receptor 1 (VEGFR1) and VEGFR2. METHODS: Eighteen HLA- A*2402-positive colorectal cancer patients who had failed to standard therapy were enrolled in this study. 0.5 mg, 1.0 mg or 3.0 mg each of the peptides was mixed with incomplete Freund's adjuvant and then subcutaneously injected at five separated sites once a week. We also examined possible effect of a single site injection of "the cocktail of 5 peptides" on the immunological responses. ELISPOT assay was performed before and after vaccinations in the schedule of every 4 weeks. RESULTS: The vaccine treatment using multiple peptides was well tolerated without any severe treatment-associated systemic adverse events. Dose-dependent induction of peptide-specific cytotoxic T lymphocytes was observed. The single injection of "peptides cocktail" did not diminish the immunological responses. Regarding the clinical outcome, one patient achieved complete response and 6 patients revealed stable disease for 4 to 7 months. The median overall survival time (MST) was 13.5 months. Patients, in which we detected induction of cytotoxic T lymphocytes specific to 3 or more peptides, revealed significantly better prognosis (MST; 27.8 months) than those with poorer immune responses (MST; 3.7 months) (p = 0.032). CONCLUSION: Our cancer vaccine treatment using multiple peptides is a promising approach for advanced colorectal cancer with the minimum risk of systemic adverse reactions. CLINICAL TRIAL REGISTRATION: UMIN-CTR number UMIN000004948.

Combination therapy for hypertension in patients with CKD: a subanalysis of the Combination Therapy of Hypertension to Prevent Cardiovascular Events trial.

The Combination Therapy of Hypertension to Prevent Cardiovascular Events (COPE) trial was a multicenter, randomized, three-arm comparative study (N=3293) undertaken to determine the optimal combination therapy, based on the occurrence of cardiovascular events in patients treated with an angiotensin II receptor blocker (ARB), a ß-blocker (BB) or a thiazide diuretic (TD) in addition to the calcium antagonist benidipine as baseline medication. This subanalysis was conducted to compare the efficacy of three combination therapies in a subset of 834 patients with chronic kidney disease (CKD) (287 patients treated with benidpine-ARB, 283 patients treated with benidipine-BB and 264 patients treated with benidipine-TD). The incidence of composite cardiovascular events as the primary end point did not differ among these three groups. The incidence of hard end points and cerebrovascular events among these groups did not differ either, although the incidence among all patients in the COPE trial was lower in the benidipine-TD group than in the benidipine-BB group. The incidence of new-onset diabetes mellitus was higher in the benidipine-TD group than in the benidipine-ARB group among patients with CKD. The estimated glomerular filtration rate (eGFR) was maintained even after 12 months of treatment in patients with a baseline eGFR <60 ml min(-1) per 1.73 m(2) regardless of the treatment group, although the eGFR decreased over time in all patients in the three groups. In conclusion, in patients with CKD, all of the tested combination therapies demonstrated comparable efficacy in terms of prevention of cardiovascular events as well as maintenance of eGFR.

Combination therapy for hypertension in the elderly: a sub-analysis of the Combination Therapy of Hypertension to Prevent Cardiovascular Events (COPE) Trial.

The Combination Therapy of Hypertension to Prevent Cardiovascular Events (COPE) trial demonstrated that the calcium-channel blocker benidipine-based combination therapies with an angiotensin-receptor blocker (ARB), a ß-blocker, or a thiazide diuretic (thiazide) were similarly effective in preventing cardiovascular events and achieving the target blood pressure (BP; <140/90 mm Hg). We further evaluated the efficacy and safety of these combination therapies in older (65 years) and younger (<65 years) hypertensive patients. In this sub-analysis of the COPE trial 3293 patients (153365 years old and 1760 <65 years old) were randomly assigned to receive benidipine-based therapy with an ARB, a ß-blocker or a thiazide. In each group, the average BP did not differ among the three treatment groups. The incidence of the primary cardiovascular composite end point in the older group was higher than in the younger group (12.7 vs. 8.3 per 1000 person-years, P=0.023). The primary composite cardiovascular end point, achievement (%) of target BP, and cardiovascular hard composite end points were similar among the three treatment groups. However, the hazard ratios and 95% confidence intervals in older patients were 2.74 (1.08-6.96; ß-blocker vs. thiazide, P=0.022) for fatal and non-fatal stroke, and 2.47 (1.03-5.91; ß-blocker vs. ARB, P=0.043) for new-onset diabetes. Thus, benidipine combined with an ARB, a ß-blocker, or a thiazide was similarly effective in preventing cardiovascular events and achieving the target BP in both older and younger hypertensive patients. Further studies will be necessary to evaluate the usefulness of benidipine combined with a ß-blocker in terms of the incidence of stroke and new-onset diabetes in older patients.

Effects of shear stress on the gene expressions of endothelial nitric oxide synthase, endothelin-1, and thrombomodulin in human retinal microvascular endothelial cells.

PURPOSE: Physiological shear stress is higher in the retinal microcirculatory network than in other organs. The effects of laminar shear stress on gene expression in human retinal microvascular endothelial cells (HRMECs) was investigated. METHODS: Cultured HRMECs on glass plates were exposed to a laminar shear stress of 0, 1.5, 6, 15, 30, 60, or 100 dyne/cm(2) for 24 hours and to 60 dyne/cm(2) for 0, 1, 3, 6, 12, 24, or 48 hours. The mRNA expressions of endothelial nitric oxide synthase (eNOS), endothelin-1 (ET-1), and thrombomodulin (TM) in the HRMECs were evaluated using real-time reverse transcription polymerase chain reaction. RESULTS: The HRMECs elongated and aligned parallel with the flow direction based on the shear stress and exposure times. The expression of eNOS mRNA gradually increased and became saturated at 60 dyne/cm(2); ET-1 mRNA expression increased at 1.5 dyne/cm(2) but decreased below that of the static control at shear stresses of 30 dyne/cm(2) or more. TM mRNA expression in response to shear stress increased linearly from 0 to 100 dyne/cm(2). A shear stress of 60 dyne/cm(2) for 6 hours or more promoted eNOS and TM mRNA expression but suppressed ET-1 mRNA expression in HRMECs. CONCLUSIONS: Long-term exposure to a physiological shear stress in the retinal arterioles up-regulated eNOS and TM mRNA expressions and downregulated ET-1 mRNA expression in HRMECs. These results suggest that shear stress may be associated with the vasoregulatory and antithrombotic properties of retinal vessels under physiological conditions present during retinal circulation.

Model combining hydrodynamics and fractal theory for analysis of in vivo peripheral pulmonary and systemic resistance of shunt cardiac defects.

The fractal state of the arterial vascular tree is considered to have a universal dimension related to the principle of minimum work rate, but can demonstrate the capacity to adapt to other dimensions in disease states such as congenital high-flow pulmonary hypertension (PH) by a process that is incompletely understood. To document and interpret fractal adaptation in patients with different degrees of PH, pulmonary and systemic vascular resistance was analyzed by a model that evaluated the fractal dimension, x, of the Poiseuille resistance contribution of the arterial vessel radius between 10 and 100µm, via the proportionality Q∝(R(peri)/BL)(-x/4), with Q, R(peri), and BL clinically observed variables representing total pulmonary or systemic blood flow, its peripheral arterial resistance, and body length, respectively. Identification of x in the pulmonary (P) and systemic (S) beds was evaluated from hemodynamic data of 213 patients, categorized into 7 groups by PH grade. In controls without PH, x(P)=2.2 while the dimension increased to 3.0, with the systemic dimension constant at x(S)=3.1. Our model predicts that severe grades of PH are associated with: a more elongated and hindered vessel in the periphery, and reductions in vessel numbers, as unit pulmonary resistive arterial trees (N(1)) and their component intra-acinar arteries (N(W)). These model network changes suggest a complex adaptive process of arterial network reorganization in the pulmonary circulation to minimize the work rate of high-flow congenital heart defects.

Prevention of cardiovascular events with calcium channel blocker-based combination therapies in patients with hypertension: a randomized controlled trial.

OBJECTIVES: Current guidelines recommend the use of multiple medications for hypertension. The present study was aimed at determining which combination was optimal to prevent cardiovascular events. METHODS: We conducted a prospective, randomized, open-label, blinded-endpoint trial. Hypertensive outpatients aged between 40 and 85 years who did not achieve target blood pressure (BP<140/90 mmHg) with calcium channel blocker (CCB) benidipine 4 mg/day were randomly assigned to receive angiotensin receptor blocker (ARB), ß-blocker, or thiazide diuretic in addition to benidipine. RESULTS: Among a total of 3501 patients (1167, benidipine-ARB; 1166, benidipine-ß-blocker; and 1168, benidipine-thiazide), 3293 patients (1110, 1089, and 1094, respectively) who received each combination treatment were included in the analysis. Median follow-up was 3.61 years. At the end of the treatment, 64.1, 66.9, and 66.0% of patients in the benidipine-ARB, benidipine-ß-blocker, and benidipine-thiazide groups achieved target BP, respectively. The cardiovascular composite endpoint occurred in 41 (3.7%), 48 (4.4%), and 32 (2.9%) patients, respectively: the hazard ratio was 1.26 in the benidipine-ARB (P  = 0.3505) and 1.54 in the benidipine-ß-blocker (P = 0.0567) groups compared with the benidipine-thiazide group. The secondary analyses revealed that benidipine and thiazide diuretic significantly reduced the incidence of fatal or nonfatal strokes (P = 0.0109) and benidipine and ARB significantly reduced new-onset diabetes (P = 0.0240) compared with benidipine and ß-blocker. All trial treatments were safe and well tolerated. CONCLUSION: CCB combined with ARB, ß-blocker, or thiazide diuretic was similarly effective for the prevention of cardiovascular events and the achievement of target BP.

Microbial contamination of disinfectants used for intermittent self-catheterization.

We investigated the microbial contamination of 0.02% benzalkonium chloride solution used in catheter kits for intermittent self-catheterization. Of 20 samples examined, 12 (60.0%) were contaminated with 8.8 x 10(2)-3.1 x 10(6) colony-forming units (cfu)/mL. The contaminants were Pseudomonas fluorescens, Burkholderia cepacia, and Aeromonas spp. These results showed that 0.02% benzalkonium chloride solution used for the lubrication/disinfection of catheters for self-catheterization is susceptible to contamination. Therefore, the lubricant/disinfectant for catheters for self-catheterization was changed from 0.02% benzalkonium chloride solution to 84-87% glycerin containing 0.02% benzalkonium chloride, and microbial contamination of the latter in catheter kits for self-catheterization was reinvestigated. Of 42 samples, 5 (11.9%) were contaminated with 20-2.0 x 10(4) cfu/mL. However, the rate of contamination of 84-87% glycerin containing 0.02% benzalkonium chloride was significantly lower than that of 0.02% benzalkonium chloride solution (P<0.0001). The contaminant of 84-87% glycerin containing 0.02% benzalkonium chloride was Bacillus spp. in all contaminated samples. In this survey, neither contaminants of 0.02% benzalkonium chloride solution nor the contaminant of 84-87% glycerin containing 0.02% benzalkonium chloride were the causative microbial species of urinary tract infection.

Microbial contamination of suction tubes attached to suction instruments and preventive methods.

We investigated the microbial contamination of suction tubes attached to wall-type suction instruments. Microbial contamination of suction tubes used for endoscopy or sputum suction in hospital wards was examined before and after their disinfection. In addition, disinfection and washing methods for suction tubes were evaluated. Suction tubes (n=33) before disinfection were contaminated with 10(2)-10(8) colony-forming units (cfu)/tube. The main contaminants were Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia. The suction tubes were disinfected with sodium hypochlorite (n=11) or hot water (n=11), or by an automatic tube cleaner (n=11). After 2-h immersion in 0.1% (1,000 ppm) sodium hypochlorite, 10(3)-10(7) cfu/tube of bacteria were detected in all 11 tubes examined. After washing in hot running water (65 degrees C), 10(3)-10(7) cfu/tube were detected in 3 of the 11 examined tubes. The bacteria detected in the suction tubes after disinfection with sodium hypochlorite or hot water were P. aeruginosa, A. baumannii, and S. maltophilia. On the other hand, after washing with warm water (40 degrees C) using the automatic tube cleaner, contamination was found to be <20 cfu/tube (lower detection limit, 20 cfu/tube) in all 11 tubes examined. These results suggest the usefulness of washing with automatic tube cleaners.

Efficacy of substance P and insulin-like growth factor-1 peptides for preventing postsurgical superficial punctate keratopathy in diabetic patients.

PURPOSE: The efficacy of eyedrops containing peptides based on substance P (FGLM-amide) and insulinlike growth factor-1 (SSSR) for prevention of superficial punctate keratopathy (SPK) after cataract surgery in individuals with type 2 diabetes was examined. METHODS: Twenty-nine patients (29 eyes) with diabetes were enrolled in a double-masked, prospective, randomized, placebo-controlled clinical study. They were randomly assigned to one of two groups that received eyedrops containing either FGLM-amide and SSSR (n = 14) or phosphate-buffered saline (n = 15) four times a day for 14 days starting 1 day after phacoemulsification. SPK scores (area, density, and combined area and density) were determined before as well as 1, 3, 7, and 14 days after surgery as main outcome measures. RESULTS: SPK scores did not differ between the two groups before surgery or before initiation of treatment. At day 2 after treatment initiation, all SPK scores were significantly lower in the FGLM-amide/SSSR group than in the control group. The density score was also significantly lower in the former group at day 7 after surgery. All scores returned to preoperative levels by day 14 after surgery in both groups. CONCLUSIONS: Eyedrops containing FGLM-amide and SSSR were effective for the prevention of SPK after cataract surgery in diabetic patients.

In vitro antimicrobial effects of aztreonam, colistin, and the 3-drug combination of aztreonam, ceftazidime and amikacin on metallo-beta-lactamase-producing Pseudomonas aeruginosa.

BACKGROUND: There are limited choice of antimicrobial agents to treat infection with metallo-beta-lactamase-producing Pseudomonas aeruginosa. We evaluate the antimicrobial effects of aztreonam alone, colistin alone and the 3-drug combination of aztreonam, ceftazidime and amikacin on 23 strains of metallo-beta-lactamase-producing P. aeruginosa by time-killing tests. METHODS: Strains used were from different hospitals in Japan and had different pulse-field gel electrophoresis patterns by restriction with SpeI. The minimum inhibitory concentrations of 11 antimicrobial agents (piperacillin, piperacillin/tazobactam, imipenem, meropenem, aztreonam, ceftazidime, amikacin, tobramycin, arbekacin, ciprofloxacin and colistin) were determined using the agar dilution test. The effects of aztreonam, colistin and the combination of aztreonam, ceftazidime and amikacin were determined by time-killing studies. RESULTS: Bacteriostatic effects after 6 hours of drug exposure were observed in 12 strains (52.2%) of 23 strains of metallo-beta-lactamase-producing P. aeruginosa with 48 mg/l aztreonam, in 19 strains (82.6%) with the 3-drug combination of 16 mg/l aztreonam, 16 mg/l ceftazidime, and 4 mg/l amikacin, and in 23 strains (100%) with 2 mg/l colistin. Bactericidal effects after 6 h drug exposure were observed in 1 strain (4.3%) with 48 mg/l aztreonam, in 8 strains (30.4%) with the 3-drug combination and in all 23 strains (100%) with 2 mg/l colistin. CONCLUSION: Evaluation of in vitro antimicrobial effects on metallo-beta-lactamase-producing P. aeruginosa revealed relatively good effects of the 3-drug combination of aztreonam, ceftazidime and amikacin and marked effects of colistin.

Antimicrobial effects of drugs against multidrug-resistant Pseudomonas aeruginosa.

We evaluated the effects of antimicrobial drugs on four strains of Pseudomonas aeruginosa that are resistant to eight widely used antipseudomonal drugs (piperacillin, piperacillin-tazobactam, imipenem, meropenem, ceftazidime, aztreonam, amikacin, ciprofloxacin) and colistin. In the killing test, colistin (2 microg/ml) was the most effective, followed by aztreonam (48 microg/ml), piperacillin-tazobactam (192-4 microg/ml), piperacillin (192 microg/ml), and a three drug combination of azetreonam (16 microg/ml), ceftazidime (16 microg/ml), and amikacin (4 microg/ml). Six hours after drug addition, colistin (2 microg/ml), aztreonam (48 microg/ml), piperacillin-tazobactam (192-4 microg/ml), piperacillin (192 microg/ml), and the above three drug combination had bacteriostatic effects on all four strains. Colistin, three time breakpoint of aztreonam, piperacillin, or piperacillin-tazobactam, and the three drug combination of aztreonam, ceftazidime, and amikacin were effective in vitro.

Microbial contamination of fruit and vegetables and their disinfection.

We evaluated the microbial contamination of 17 types of vegetable and 10 types of fruit after 30-s washing with tap water with and without subsequent disinfection by 10-min immersion in 0.01% (100 ppm) sodium hypochlorite. The mean microbial contamination level of 9 types of leafy vegetable was 2.8 x 10(5) colony-forming units (CFU)/g after washing with water and 3.4 x 10(4) CFU/g after washing followed by disinfection. The mean microbial contamination level of 8 types of nonleafy vegetable was 3.4 x 10(4) CFU/g after washing with water and 1.0 x 10(4) CFU/g after washing followed by disinfection. The mean microbial contamination level of 10 types of unpeeled fleshy fruit was 9.3 x 10(3) CFU/g after washing with water and 1.3 x 10(3) CFU/g after washing followed by disinfection. The contaminants in vegetables and unpeeled fruit were similar after washing and after washing followed by disinfection, including Pseudomonas fluorescens and Pseudomonas aeruginosa. The contamination did not markedly decrease even after disinfection with sodium hypochlorite. However, the flesh of each type of peeled fruit showed no or only low levels of contamination (

Microbiological safety of bottled mineral water in patients susceptible to infections.

We evaluated the microbiological safety of bottled mineral water products commercially available in Japan. Of 10 bottled mineral water products manufactured in Japan, no bacteria or fungi were detected in 9 (90%), but 1 (10%) contained 1.8x10(3) colony-forming units (cfu)/mL. Of 12 bottled mineral water products manufactured in the EU, 11 (91.7%) contained 23-3.5x10(4) cfu/mL. On the other hand, of 5 bottled mineral water products manufactured in North America, 2 (40%) contained 2.3x10(2)-2.5x10(3) cfu/mL. The detected microorganisms were glucose-nonfermentative Gram-negative bacilli such as Brevundimonas vesicularis, Moraxella spp., and Burkholderia cepacia, but Pseudomonas aeruginosa was not detected in any product. For immunocompromised host patients being managed in ultra-clean rooms, the examined bottled mineral water products manufactured in Japan, except 1, were microbiologically safe.

Differential gene responses in endothelial cells exposed to a combination of shear stress and cyclic stretch.

We developed a compliant tube-type flow-loading apparatus that allows simultaneous application of physiological levels of shear stress and cyclic stretch to cultured cells and examined gene responses to a combination of the two forces. Human umbilical vein endothelial cells were exposed to shear stress and/or cyclic stretch for 24h, and changes in the mRNA levels of endothelin-1 (ET-1), a potent vasoconstrictor, and endothelial nitric oxide synthase (eNOS), which catalyzes the production of a potent vasodilator, NO, were determined by reverse transcriptase/PCR. Cyclic stretch (10%, 1 Hz) alone increased ET-1 mRNA levels approximately 1.6-fold, but had no effect on eNOS mRNA levels. A shear stress of 7 dynes/cm(2) and 15 dynes/cm(2) alone decreased ET-1 mRNA levels to around 83% and 61%, respectively, of the basal level, but increased the eNOS mRNA level to around 2.2-fold and 3.2-fold, respectively. When cyclic stretch and shear stress were applied simultaneously, ET-1 mRNA levels did not change significantly, but the eNOS mRNA level increased to a level equivalent to the increase in response to shear stress alone. These results indicate that the response of endothelial genes to shear stress or cyclic stretch depends on whether the two forces are applied separately or together.