Handling and packaging of medical bags at acute disaster sites under high-temperature conditions.

OBJECTIVE: After the large-scale earthquake in 2011, the disaster medical assistance team (DMAT) was made responsible for medical activities during the hyperacute phase of a disaster or accident in Japan. The medicines to be administered at the disaster sites, packaged in medical bags, may be affected by the temperatures there. This study aimed at establishing a method to handle drug bags in high-temperature situations by determining the temperature changes in medical bags subject to high temperatures and examining the effect of opening the bag and using heat-insulating material (HIM) and coolants. RESULTS: Closed and semi-opened bags limited the temperature increase in the central part of the bag at both 35 and 40 °C to a greater extent than opened bags. When coolant and HIM were used in closed and semi-opened bags, the internal temperatures were significantly lower than in the opened state at 40 °C. In high-temperature disaster sites, medical bags should be maintained in a semi-opened or closed state using a HIM and coolant.

Incidence survey of acute otitis media in children in Sado Island, Japan--Sado Otitis Media Study (SADOMS).

BACKGROUND: Acute otitis media (AOM) is one of the most common forms of bacterial infection and cause for clinic visits in children. The incidence of AOM was 0.9-1.2 episodes per person-year during the first 2 years of life in previous reports conducted before 2000. The aim of this study was to 1) evaluate the latest AOM incidence in pediatric outpatients and 2) identify the bacterial pathogens from these patients and ascertain their serotypes and resistance. METHODS: The study was conducted in a closed population, involving all pediatricians and otolaryngologists in Sado Island allowing accurate determination of AOM incidence. In each month, one week was assigned as "surveillance week", and all outpatients with acute illness aged 0-18 years examined during the surveillance weeks were enrolled. AOM was diagnosed on the basis of otoscopic findings and clinical symptoms were recorded. Specimens were collected from the nasopharynx or middle ear cavity of AOM patients and examined for bacteria. Antimicrobial susceptibilities, serotypes, and molecular typing for resistance were determined among Streptococcus pneumoniae and Haemophilus influenzae. RESULTS: In total, 8,283 clinic visits were conducted, and 354 episodes (4.3%, 95% CI: 3.9-4.7%) among 312 children were diagnosed as AOM. The incidence of AOM was highest in children of 1 year of age (0.54 episodes/child/year, 95% CI: 0.44-0.64). Serotype coverage of 7- and 13-valent pneumococcal conjugate vaccines in this study were 38.0% (95% CI: 29.3-47.3) and 62.8% (95% CI: 53.6-71.4), respectively. Of 122 H.influenzae isolates available for typing, 120 were nontypeable and 2 were type b. A high proportion of S. pneumoniae isolates (46%) showed resistance to penicillin. Approximately half of H. influenzae isolates had genetic markers for beta-lactamase-negative ampicillin-resistance. CONCLUSIONS: Approximately 4-5% of pediatric outpatients, even without AOM-related symptoms, had AOM in our study. Pediatricians as well as otolaryngologists should check the tympanic membrane findings of all pediatric outpatients.

Radiological features of germinoma arising from atypical locations.

Three cases of intracranial germinoma arising from atypical locations occurred in 13-, 22-, and 28-year-old males. The location of the tumor was the corpus callosum (2 cases) and the temporal lobe. Computed tomography and magnetic resonance imaging showed all three tumors had a largest dimension, including the internal cyst, of over 6 cm, and the cysts were larger than 2.5 cm. Radiotherapy and chemotherapy caused all tumors to disappear. Large tumor and large cyst are features of germinoma arising from atypical locations.

E, N-cadherins and beta-catenin expression in medulloblastoma and atypical teratoid/rhabdoid tumor.

Cadherins are cell-surface glycoproteins that mediate Ca2+-dependent, homophilic cell-cell adhesion. The classical cadherins, E- and N-cadherins, bind to beta-catenin, the lining protein. Dysfunctional expression of these factors seems to be related to tumor invasion and metastasis. This study examined the relationship between changes in E- and N-cadherins, and catenin expression, and biological behavior in medulloblastomas and atypical teratoid/rhabdoid tumors. Specimens of 13 medulloblastomas and two atypical teratoma/rhabdoid tumors were collected and stained immunohistochemically to detect E- and N-cadherins, and beta-catenin. None of the medulloblastomas were immunoreactive for E-cadherin, but both atypical teratoma/rhabdoid tumors were immunoreactive for E-cadherin at the cell-cell borders where epithelial differentiation occurred. In contrast, N-cadherin and beta-catenin were present at the cell-cell borders in 12 of the 13 medulloblastomas and both atypical teratoma/rhabdoid tumors. Nuclear beta-catenin staining was not present in the medulloblastomas or atypical teratoma/rhabdoid tumors. There was no significant difference in the Ki-67 staining index between patients with medulloblastomas showing high and low immunoreactivity for N-cadherin and beta-catenin. Moreover, immunoreactivity for N-cadherin and beta-catenin increased with dissemination in the medulloblastomas. Low immunoreactivity in medulloblastomas tended to be associated with a better prognosis. These results suggest that expression of E-cadherin is useful for the differential diagnosis of atypical teratoma/rhabdoid tumor and medulloblastoma, and the expression of N-cadherin or beta-catenin may be related to the biological behavior of medulloblastomas.

Nickel-Catalyzed Tandem Coupling of alpha,beta-Enones, Alkynes, and Alkynyltins for the Regio- and Stereoselective Synthesis of Conjugated Enynes.

The nickel-catalyzed reaction of alpha,beta-enones 2 with alkynes 1, alkynyltins 6, and Me(3)SiCl was carried out by the successive construction of two carbon-carbon bonds to give enol silyl ethers 5, which were then hydrolyzed to conjugated enynes 7, with high regio- and stereoselectivities (isomeric purities: 92-98%).