The first multi-centre point-prevalence survey in four Japanese university hospitals.

BACKGROUND: The Japanese government adopted a national action plan on antimicrobial resistance, which aims to reduce drug-resistant pathogens and antimicrobial use. A point-prevalence survey (PPS) is a useful surveillance method to gain information about hospital epidemiology; however, no multi-centre PPS has previously been performed in Japan. AIM: To investigate general information about hospital epidemiology, healthcare-associated infections (HCAIs), and antimicrobial use in multiple Japanese university hospitals. METHODS: In July 2016, a multi-centre PPS was conducted using a standardized protocol at four university hospitals in Japan. FINDINGS: A total of 3199 patients were included. Median age and duration of hospital stay were 64 years and 10 days, respectively. A total of 246 (7.7%; 95% confidence interval (CI): 6.8-8.7) patients had 256 active HCAIs, and 933 (29.2%; 95% CI: 27.6-30.8) patients received 1318 antimicrobials. Pneumonia and gastrointestinal system infection were the most common HCAIs (N = 42, 16.4%), and Enterobacteriaceae (N = 49, 30.8%) were the predominant causative organisms. Carbapenems (N = 52, 17.8%), anti-MRSA medications, and cephems with antipseudomonal activity were the most frequently prescribed antimicrobials for HCAIs. As surgical prophylaxis, 46 of 278 antimicrobials (16.5%) were administered orally. Proportions of HCAI and antimicrobial use in each hospital ranged from 4.8% to 9.5% and 19.3%-35.0%, respectively. CONCLUSION: This multi-centre PPS recorded detailed HCAI data and distinct antimicrobial use in Japanese university hospitals. Further surveillance is necessary to reduce HCAIs and formulate feasible plans to achieve the national action plan on antimicrobial resistance.

[Total aortic arch replacement for ruptured aortic arch aneurysm in a 93-year-old woman].

Semi-emergency total aortic arch replacement was performed in a 93-year-old woman with rupture of a true saccular aneurysm at the distal aortic arch. The patient had lived by herself before surgery. She was successfully treated and showed no post-operative cerebral complications. Total aortic arch replacement must be carefully planned, because this surgery is highly invasive and is associated with a high rate of complications. This surgery is sometimes inevitably performed as a life-saving procedure in very old patients. The surgical outcome however, is less favorable. Although we used the "Eaves" technique during surgery to decrease post-operative bleeding, the surgical invasiveness itself was not reduced. Further effort is needed to develop innovative procedures.

Enhancement of Lead-Barium Exchangeability of Barium Hydroxyapatite.

In order to improve lead-barium exchangeability of barium hydroxyapatite (BaHAp), the effects of the recycle employment of BaHAp and the introduction of HCl into the exchange solution have been investigated at 293 K. The ion exchange capacity of BaHAp was evidently improved by use of the recycle experiments to reach levels approximately twice that obtained via the batch experiment. XPS analyses revealed that the ion exchange appears to proceed from the surface to the bulk of the apatite. The addition of HCl to the exchange solution also resulted in the enhancement of the ion exchangeability of BaHAp. Based on the apparent solubility of BaHAp, which was estimated from the dissolution of BaHAp for 4 h, together with the results of that experiment, it is suggested that the dissolution-precipitation mechanism appears to be possible for ion exchange. Copyright 2001 Academic Press.

Interdependence of Anion and Cation Exchanges in Calcium Hydroxyapatite: Pb(2+) and Cl(-).

The ion exchange of Pb(2+) and Cl(-) into calcium hydroxyapatite from aqueous solutions is studied at 293 K. Although the exchange of Cl(-) into CaHAp and PbHAp was not observed, in the presence of both Pb(2+) and Cl(-) in aqueous solution the exchange of both Pb(2+) and Cl(-) into CaHAp occurred, and, at least at intermediate concentrations of HCl, a proportionality between the sorbed quantities of these two ions was observed. The dissolution of CaHAp is shown to be dependent upon the pH, while the quantity of Pb(2+) exchanged into the solid is not a function of the proton content; consequently, the exchange is not primarily a dissolution-precipitation process. Copyright 1999 Academic Press.

Iron fortification of rice seed by the soybean ferritin gene.

To improve the iron content of rice, we have transferred the entire coding sequence of the soybean ferritin gene into Oryza sativa (L. cv. Kita-ake) by Agrobacterium-mediated transformation. The rice seed-storage protein glutelin promoter, GluB-1, was used to drive expression of the soybean gene specifically in developing, self-pollinated seeds (T1 seeds) of transgenic plants, as confirmed by reverse transcription PCR analysis. Stable accumulation of the ferritin subunit in the rice seed was demonstrated by western blot analysis, and its specific accumulation in the endosperm by immunologic tissue printing. The iron content of T1 seeds was as much as threefold greater than that of their untransformed counterparts.

A simple and efficient gene transfer system of trifoliate orange (Poncirus trifoliata Raf.).

A simple and efficient gene transfer system of trifoliate orange (Poncirus trifoliata Raf.) was developed using epicotyl segments. The segments were infected with Agrobacterium harboring the binary vector pBI121 or pBI101-O12-p1. Both vectors contained the neomycin phosphotransferase II (NPTII) and the ß-glucuronidase (GUS) genes. In the plasmid pBI101-O12-p1, the GUS gene was directed to the promoter region of ORF12 (rolC) of the Ri plasmid. On a selection medium containing 100 or 200 µg/ml kanamycin, adventitious shoots were formed from 21.7-44.6% of the segments. Histochemical GUS assay showed that 55.4-87.7% of the shoots expressed the GUS gene. The stable integration of this gene was also confirmed by polymerase chain reaction (PCR) analysis and by Southern blot analysis. When the pBI101-O12-p1 plasmid was used, the GUS activity was found to be located in phloem cells of leaf, stem and root. More than 100 transformed plants were obtained using this method within 2-3 months.