A study on the efficacy of the recombinant Yersinia adhesin A vaccine against yersiniosis in the early phase.

Yersinia pseudotuberculosis (Y. ptb) is a zoonotic pathogenic bacterial species of the family Enterobacteriaceae and causes yersiniosis, an acute intestinal infection in humans and animals. Y. ptb is often implicated in lethal epidemics in zoo animals and reductions in the breeding population, but a valid prevention method has not been established. Therefore, this study aimed to develop a vaccine for yersiniosis control. The immunogenicity of one of the adhesion factors involved in pathogenic mechanisms of Y. ptb, Yersinia adhesin A (YadA), was investigated. BALB/c mice were divided into 3 groups: in group 1, mice received insoluble recombinant YadA (rYadA) produced in genetically engineered Escherichia coli (100 µg/dose); in group 2, mice received inactivated Y. ptb with strong expression of YadA (20 mg/dose);and in group 3, mice received phosphate-buffered saline (0.2 ml/dose). All interventions were administered subcutaneously twice at an interval of 1 week. One week after the second administration, Y. ptb (107 cells/mouse) was inoculated orally. As a result, the survival rate was 100% in group 1, 60% in group 2, and 0% in group 3. The anti-YadA antibody titer increased in a stepwise fashion in groups 1 and 2. The present study results suggest that rYadA shows promise as a protective antigen against yersiniosis. This study concluded that vaccination against Y. ptb may become available as a new method to prevent lethal epidemics in animals.

Genetic Phagocyte NADPH Oxidase Deficiency Enhances Nonviable Candida albicans-Induced Inflammation in Mouse Lungs.

Patients with chronic granulomatous disease (CGD) have mutated phagocyte NADPH oxidase, resulting in reduced production of reactive oxygen species (ROS). While the mechanism underlying hyperinfection in CGD is well understood, the basis for inflammatory disorders that arise in the absence of evident infection has not been fully explained. This study aimed to evaluate the effect of phagocyte NADPH oxidase deficiency on lung inflammation induced by nonviable Candida albicans (nCA). Mice deficient in this enzyme (CGD mice) showed more severe neutrophilic pneumonia than nCA-treated wild-type mice, which exhibited significantly higher lung concentrations of interleukin (IL)-1ß, tumor necrosis factor (TNF)-α, and keratinocyte-derived chemokine (KC). Neutralization of these proinflammatory mediators significantly reduced neutrophil infiltration. In vitro, production of IL-1ß and TNF-α from neutrophils and that of KC from macrophages was enhanced in nCA-stimulated neutrophils from CGD mice. Expression of IL-1ß mRNA was higher in the stimulated CGD neutrophils than in the stimulated wild-type cells, concomitant with upregulation of nuclear factor (NF)-κB and its upstream regulator extracellular-signal regulated kinase (ERK) 1/2. Pretreatment with an NADPH oxidase inhibitor significantly enhanced IL-1ß production in the wild-type neutrophils stimulated with nCA. These results suggest that lack of ROS production because of NADPH oxidase deficiency results in the production of higher levels of proinflammatory mediators from neutrophils and macrophages, which may at least partly contribute to the exacerbation of nCA-induced lung inflammation in CGD mice.

[Relationship between cutaneous temperature and hand edema and allodynia after stroke--the etiology of shoulder-hand syndrome].

The etiology of shoulder-hand syndrome is as yet unknown. We hypothesized that it may be due to damaged unmyelinated fibers in front of the subscapular muscle. We examined the existence of edema and hypersensitivity to pain in the hands of stroke patients during the subacute stage and their relationships to cutaneous temperatures of the index fingertips in 75 hemiplegic patients (23 without edema, 32 with only edema, and 20 with edema plus allodynia). Patients were placed into two groups (comfortable and warm) depending on room temperature (22.2-25.6°C and 25.7-30°C, respectively). Of the patients with hand edema plus allodynia, 75% had a large lesion in the capsula, cortical white matter, and putamen. It was previously reported that the cutaneous temperature of the arm on the paralysis side of patients with lesions of the capsula or putamen was lower than that on the non-paralysis side. In the edema plus allodynia group, the temperature of the index fingertip on the affected side was higher than that of their contralateral fingers; the differences were smaller under warm conditions possibly due to blockade of the sympathetic nerves in the peripheral nerve. By contrast, in patients in the edema group, there were no differences in cutaneous temperatures of their two index fingers. Thus, it appears that patients with mild cases of shoulder-hand syndrome have conduction blocks in the posterior cord of the brachial plexus, while those with severe cases have both conduction blocks and neurogenic inflammation in both the lateral and posterior cords.

Evaluation of skilled arm movements in patients with stroke using a computerized motor-skill analyser for the arm.

To study the utility of a new computerized motor-skill analyser (CMSA) for evaluating visuo-motor skilled movements of the arm, we examined (1) the reproducibility of measurement with the CMSA for the arm in 13 healthy participants and 14 patients with stroke and (2) the correlation between motor skills of the affected arm evaluated with the CMSA and clinical tests for upper extremity function in 20 patients with stroke. The CMSA for the arm was used to calculate the accuracy in tracking with the hand. The inter-class correlation coefficients for lap time, geometric trajectory error, trajectory error integrated over time and the marker trajectory error integrated over time were 0.45 (NS)-0.91 (P<0.01) in healthy participants and 0.62 (P<0.05)-0.90 (P<0.01) in patients with stroke. The trajectory error integrated over time and the geometric errors of the affected arm in stroke patients were negatively correlated with the Brunnstrom stage and the simple test for evaluating hand function. The marker trajectory error integrated over time in stroke patients was negatively correlated with the simple test for evaluating hand function. These results suggest that the CMSA for the arm is useful for quantitatively evaluating delicate visuo-motor skills of the arm.

Discordant twin: marked vascular communication between separated dichorionic diamniotic placentas.

We report on a woman who gave birth to dichorionic diamniotic twins with a birthweight discordancy of 30%. Her placenta exhibited characteristic features. The placental villous tissues were completely separated, but there was marked vascular communication between the two placentas. The lighter twin received less blood than the heavier twin via these vascular communications. Although the details are unknown, this abnormal placental structure may have caused the weight discordancy in this case. Clinicians must pay attention to placental vascular communication as one possible cause of twin discordancy in not only monochorionic but also dichorionic twins.

Efficacy of intrathecal morphine for analgesia following elective cesarean section: comparison with previous delivery.

PURPOSE: To determine the effect of intrathecal injection of morphine 0.2 mg on postoperative analgesia, activity and satisfaction after elective cesarean section. METHOD: Forty-five parturients who had previously undergone cesarean section with spinal anesthesia without intrathecal morphine were enrolled in this randomized, double-blinded study. Group 1 received hyperbaric bupivacaine 10 mg intrathecally (IT) and group 2 received morphine 0.2 mg IT in addition to hyperbaric bupivacaine 10 mg IT. All subjects received 20 mg piroxicam rectally at the end of surgery and 18 hours after surgery. Side effects in the first 24 hours after delivery were recorded by a trained nurse. Pain, nausea, pruritus, and satisfaction during the first 24 hours were self-rated using a visual analog scale. Subjects also recorded their memories of these symptoms after their previous cesarean sections. The time to first request for additional analgesics (30 mg pentazocine intramuscularly), total dose of pentazocine within 24 hours postoperatively and nurse observations of walking status within 24 hours postoperatively were also recorded. RESULTS: In the present cesarean sections, the duration of complete analgesia and the time to first request for additional analgesics were longer in group 2 than in group 1. Group 2 had higher satisfaction scores than group 1 in spite of their more severe pruritus and nausea during the first 24 hours after surgery. The percentage of patients who could not walk during the first 24 hours after cesarean section was higher in group 1 than in group 2. CONCLUSION: The addition of morphine 0.2 mg to hyperbaric bupivacaine 0.5% by intrathecal injection reduced postoperative pain and analgesic use, and increased patient satisfaction following cesarean section. The combination of intrathecal injection of morphine and preventive NSAIDs can be easily administered in most hospitals, and is substantially less expensive than the new pain management technologies currently in use.

Analysis of factors associated with multinucleate formation in human IVF.

This study was carried out to analyse if some of the sperm parameters assessed by computer-aided sperm analysis (CASA) are associated with multinucleate formation in human in vitro fertilization (IVF). In the present study, 137 IVF-embryo transfer (ET) treatment cycles in which pronucleate formation could be observed were enrolled. Sperm parameters after swim-up were assessed using CASA and strict criteria. Thirty-two (2.3%) of 1368 oocytes fertilized were judged as multinucleate formation, which occurred in 25 of 137 IVF-ET treatment cycles, giving the incidence of 18.2%. The factors associated with multinucleate formation were analysed. There were significant differences of the numbers of oocytes collected (13.9 vs. 9.2; p=0.028), fertilization rate (88.8% vs. 71.9%; p=0.011), curvilinear velocity (VCL) (162.7 microm/sec vs. 149.1 microm/sec; p=0.034), average path velocity (VAP) (100.3 microm/sec vs. 93.1 microm/sec; p=0.016), and amplitude of lateral head displacement (ALH) (5.9 microm vs. 5.3 microm; p=0.046) between 25 cycles with multipronucleate formation and 112 cycles with two pronucleate formations. However, there were no significant differences of women's age or the number of sperm inseminated between the two groups. These findings suggest that prediction of multinucleate formation in human IVF might be possible in patients when the number of oocytes collected is higher and sperm motility parameters after swim-up are faster. However, prevention of multinucleate formation seems to be unnecessary because a higher successful IVF-ET outcome is expected as a result of the excellent fertilization rate in these patients.