Proximal Binaural Sound Can Induce Subjective Frisson.

Auditory frisson is the experience of feeling of cold or shivering related to sound in the absence of a physical cold stimulus. Multiple examples of frisson-inducing sounds have been reported, but the mechanism of auditory frisson remains elusive. Typical frisson-inducing sounds may contain a looming effect, in which a sound appears to approach the listener's peripersonal space. Previous studies on sound in peripersonal space have provided objective measurements of sound-inducing effects, but few have investigated the subjective experience of frisson-inducing sounds. Here we explored whether it is possible to produce subjective feelings of frisson by moving a noise sound (white noise, rolling beads noise, or frictional noise produced by rubbing a plastic bag) stimulus around a listener's head. Our results demonstrated that sound-induced frisson can be experienced stronger when auditory stimuli are rotated around the head (binaural moving sounds) than the one without the rotation (monaural static sounds), regardless of the source of the noise sound. Pearson's correlation analysis showed that several acoustic features of auditory stimuli, such as variance of interaural level difference (ILD), loudness, and sharpness, were correlated with the magnitude of subjective frisson. We had also observed that the subjective feelings of frisson by moving a musical sound had increased comparing with a static musical sound.

Clinical importance of Stenotrophomonas maltophilia nosocomial pneumonia due to its high mortality in hemodialysis patients.

Patients undergoing hemodialysis are immunocompromised and can suffer from pneumonia with various pathogens in nosocomial conditions. We investigated the fundamental information on the characteristics of hemodialysis inpatients and nosocomial pneumonia. We surveyed 1803 hemodialysis patients admitted to our university hospital between 2001 and 2007. The mean patient age was 64.8 years and the average period of hospitalization was 28.1 days, which was considerably longer than the average stay in our hospital (14.2 days). Patients were admitted to many different departments and for various reasons. We isolated 391 microorganisms from the sputum of 120 pneumonia patients undergoing hemodialysis, including Candida albicans, methicillin-resistant Staphylococcus aureus, and Staphylococcus epidermidis, which were the leading three isolates. From these 120 patients, a total of 199 pathogens were identified as being responsible for the pneumonia. Multi-drug resistant Stenotrophomonas maltophilia was found to be susceptible to a new fluoroquinolone, but is resistant to older generation quinolones. Out of the 120 patients with pneumonia, 12 out of 18 patients infected with S. maltophilia died, indicating the highest fatality rate for this pathogen. In this survey, we found that hemodialysis patients were hospitalized for long periods, and for various reasons in many departments. They suffered from nosocomial pneumonia caused by multi-drug resistant pathogens, including S. maltophilia. For pneumonia due to S. maltophilia, new generation fluoroquinolones can be the treatment of choice, although S. maltophilia-related pneumonia should be treated very carefully because of its high fatality rate.

Surgical site infection risk factors identified by multivariate analysis for patient undergoing laparoscopic, open colon, and gastric surgery.

BACKGROUND: Surgical site infection (SSI) is an important clinical indicator of quality of patient care and infection control; therefore, we aimed to assess risk factors SSI in colon and gastric surgeries. METHODS: SSI was assessed according to the National Nosocomial Infection Surveillance (NNIS) system (1999). Risk factors examined included operative approach, operative procedure, duration of operation, diabetes mellitus (DM), body mass index (BMI), age, and sex. RESULTS: Among 3152 operated patients, 1675 patients were included in the study. The univariate analysis showed that male sex, high BMI, and long duration of operation were significant risk factors for colon surgery and that advanced age, presence of DM and long duration of operation were significant risk factors for gastric surgery. The multivariate analysis indicated that significant risk factors for SSI were BMI of 25 or above, open surgery, and long duration of operation for colon surgery and open surgery for gastric surgery. The SSI rate of laparoscopic colon surgery was 40%, less than that of open colon surgery, and that of laparoscopic gastric surgery was 75%, less than that of open gastric surgery. CONCLUSION: The risk factors for SSI depend on whether the operation is laparoscopic or open and duration of operation. In addition, BMI (25 or above) and age (70 years or above) are risk factors for colon and gastric surgery, respectively.

Macular degeneration in a Japanese patient with aceruloplasminemia.

PURPOSE: To characterize the clinical features of a Japanese patient with macular degeneration in aceruloplasminemia. METHODS: The clinical features were evaluated by visual acuity measurements, fluorescein angiography, electroretinography, and kinetic visual field testing. RESULTS: We observed a Japanese patient with macular degeneration in aceruloplasminemia. This patient also had diabetes mellitus and neurodegeneration. Ocular examination showed macular degeneration, which included yellow deposits around the macula area and no foveal reflex. CONCLUSION: It has been reported that Japanese patients with aceruloplasminemia have atrophy of the retinal pigment epithelium in the midperipheral area and yellowish discoloration of the fundus. However, the retinal findings and results of fluorescein angiography in our case were very similar to those for a white patient. We suggest that retinal degenerations in Japanese patients with aceruloplasminemia have clinical variability. We believe that impairment of iron metabolism caused by iron overload in the retina led to retinal degeneration in this case.

Surgical site infection surveillance after open gastrectomy and risk factors for surgical site infection.

Surgical site infection (SSI) surveillance was examined in gastric cancer patients who had undergone an open gastrectomy between 1997 and 2003 at Keio University Hospital in Tokyo, Japan. National Nosocomial Infections Surveillance (NNIS) reports and several studies have discussed SSI risk factors, but only open gastrectomy was analyzed by regression analysis. The purpose of this study was to examine these issues by performing a regression analysis for the prediction of SSI. SSI was defined by the surgical patient component according to the NNIS system (1999) produced by the Centers for Disease Control and Prevention. Patients undergoing an open gastrectomy were followed up and monitored for SSIs. Risk factors for SSI, after all factors were considered, were studied using single and multivariate analysis. The study enrolled 984 patients who had undergoing an open gastrectomy. Using multivariate and logistic regression analysis, the duration of the operation was identified as a [corrected] risk factor for SSI at open gastrectomy. Although numerous potential risk factors in surgical patients were examined, the duration of the operation was the only significant risk factor for SSIs after open gastrectomy.

Introduction of the Low Vision Evaluator (LoVE) for children.

PURPOSE: To determine whether the Low Vision Evaluator (LoVE) can grade the visual acuity of young children with light perception and hand movement acuity into finer acuity steps and at what age reliable measurements can be obtained. METHODS: Two hundred twenty children were tested with the LoVE. Each eye was tested separately, and each stimulus magnitude (intensity x duration) was presented three times. Three catch trials per eye also were presented. RESULTS: Scores ranged from -8 to -1 on variable-duration tests and from 22.5 to 37.5 dB on fixed-duration tests for four children with hand movement vision. Scores ranged from -12 to 0 on variable-duration tests and from 12.5 to 40 dB on fixed-duration tests for five children with light perception vision. Reliable measurements were obtained at different times on different days. Mean scores for children with counting finger vision or better were significantly better than scores for eyes with light perception and hand movement (P < .001 and P < .01, respectively). Reliability was less for children younger than age 4 years. CONCLUSIONS: The LoVE is capable of grading the visual function of children with light perception and hand movement vision into finer steps. Reliable measurements can be obtained for children age 4 years and older.

Axenic cultivation of Entamoeba dispar in newly designed yeast extract-iron-gluconic acid-dihydroxyacetone-serum medium.

Yeast extract-iron-gluconic acid-dihydroxyacetone-serum medium that allows axenic cultivation of Entamoeba dispar was designed based on casein-free yeast extract-iron-serum (YI-S) medium, and the usefulness of the medium was assessed. The main differences from YI-S medium are replacement of glucose by gluconic acid, addition of dihydroxyacetone and D-galacturonic acid monohydrate, and sterilization by filtration. This medium promoted the axenic growth of 5 strains of E. dispar (2 strains of nonhuman primate isolates and 3 strains of human isolates). In addition, to clarify the biological basis for the growth of E. dispar in this medium, analyses of relevant enzymes on the glycolytic pathway of the amoebae as well as of the protozoans that are the best culture supplement for amoebae are being performed.

Branch retinal artery occlusion: a complication of iron-deficiency anemia in a young adult with a rectal carcinoid.

We report a case of branch retinal artery occlusion (BRAO) in a patient with iron-deficiency anemia. Various ophthalmological and laboratory studies were performed. A 32-year-old man had a sudden decrease of vision in his left eye to counting fingers at 30 cm two days ago. The left fundus showed a cherry-red spot and milky-white edema, except for the upper temporal region of the macula, and an optic disc malformation. Fluorescein angiography revealed leakage from the disc and a slightly delayed filling time in the left eye but an arterial filling defect was not noted. The differential diagnosis in this young patient includes polycythemia, hypercoagulopathy, coagulation abnormalities, trauma, hypertension, and autoimmune diseases such as systemic lupus erythematosus. Laboratory examinations revealed no abnormalities except for iron-deficiency anemia. The patient was treated with stellate ganglion block, hyperbaric oxygen, and ferrous sulfate. His visual acuity never recovered to better than 0.08. He had a coincidental rectal carcinoid and the tumor was excised surgically. No metastasis was observed. BRAO can be a complication of anemic retinopathy and can lead to severe visual loss without early medication.