In order to determine whether flexible plastic ankle foot orthoses (AFOs) really have functional advantage for children with spastic diplegia (CP children). Six CP children (13.2 +/- 1.9 years) who showed moderate spasticity walked on a treadmill at relative speeds that ranged from slow to fast for three minutes at each speed. While walking with and without flexible plastic AFOs, oxygen uptake (VO2) was measured. Then an energy expenditure index (EEI) was calculated by taking the VO2 value divided by walking speed. A curve EEI-walking speed relationship was approximated to a parabolic curve. Then, the lowest value of EEI, as an economical EEI, was derived from the curve. In four of the six CP children, the EEI while walking with flexible plastic AFOs were larger than without flexible plastic AFOs. The economical EEI while walking with and without flexible plastic AFOs was 0.56 +/- 0.26 ml/kg/m and 0.42 +/- 0.14 ml/kg/m, respectively. The ambulation with flexible plastic AFOs required more energy than without flexible plastic AFOs (p < 0.05). From these results, flexible plastic AFOs do not seem to provide a functional advantage for CP children.
Two hundred and forty-nine healthy women at 36 weeks gestation and 38 women with pregnancy induced hypertension (PIH) underwent urinalysis for urinary calcium excretion to obtain the calcium/creatinine ratio. This ratio was significantly lower in the women with PIH than in the healthy pregnant women, and it was especially low in those with PIH who had no family history of hypertension. Three hundred forty-eight healthy women at 20 weeks of gestation underwent urinalysis to determine their calcium/creatinine ratio as a means to predict PIH in patients showing no symptoms. In the primiparous group with no family history 58% of the patients with a low calcium/creatine ratio eventually developed PIH. Using a receiver operator curve, we calculated a predictive threshold calcium value for PIH of 0.06 at six month's pregnancy. Thus urinary calcium excretion may be a useful early marker for PIH.
Escherichia coli was isolated from wild and captive Japanese macaques (Macaca fuscata) to investigate the risk of zoonotic infections and the prevalence of antimicrobial-resistant Escherichia coli in the wild macaque population in Shimokita Peninsula, a rural area of Japan. We collected 265 fresh fecal samples from wild macaques and 20 samples from captive macaques in 2005 and 2006 for E. coli isolation. The predominant isolates were characterized by serotyping, virulence gene profiling, plasmid profiling, pulsed-field gel electrophoresis (PFGE), and microbial sensitivity tests. In total, 248 E. coli strains were isolated from 159 fecal samples from wild macaques, and 42 E. coli were isolated from 17 samples from captive macaques. None of the virulence genes eae, stx, elt, and est were detected in any of the isolates. The relatedness between wild- and captive-derived isolates was low by serotyping, PFGE, and plasmid profiling. Serotypes O8:H6, O8:H34, O8:H42, O8:HUT, O103:H27, O103:HNM, and OUT:H27 were found in wild macaque feces; serotypes O157:H42 and O119:H21 were recovered from captive macaques. O-and H-serotypes of the 26 isolates were not typed by commercial typing antisera and were named OUT and HUT, respectively. Twenty-eight isolates had no flagellar antigen, and their H-serotypes were named HNM. Similarity of PFGE patterns between wild-derived isolates and captive-derived isolates was <70%. No plasmid profile was shared between wild-derived and captive-derived isolates. The prevalence of antimicrobial-resistant E. coli was 6.5% (n=62) in wild macaques, and these isolates were resistant to cephalothin. We conclude that wild Japanese macaques in Shimokita Peninsula were unlikely to act as a reservoir of pathogenic E. coli for humans and that antimicrobial-resistant E. coli in wild macaques may be derived from humans.
‹Background› In Japan, emergency departments (ED) receive a large proportion of elderly patients each year. As such, injuries in the elderly are a common reason for presentation to the ED. Knowledge about the characteristics of injuries presenting to the ED would be invaluable in devising strategies to prevent injury in the elderly. ‹Objective› To analyze the characteristics of injuries in the elderly presenting to the ED and compare them with those of the younger population. ‹Setting› The ED at Keio University Hospital, a large inner city teaching hospital located in Tokyo. ‹Method› A retrospective analysis of data extracted from the ED database of the Keio University Hospital. Information regarding patients aged 65 years or above presenting with injury was analyzed and compared with those aged less than 65 years. Prehospital triage by emergency personnel was adopted as the severity of patients, namely "life-threatening" or "non life-threatening". ‹Results› 20% of all ED presentations of elderly patients were injury related compared to 39% of non-elderly. Compared to the non-elderly, elderly patients presenting to the ED with injury were more likely to be female, sustained injury from trauma unrelated to motor vehicle accidents (MVA) and requiring hospital admission as a result of "non life-threatening" injuries. They were less likely to have injuries from MVA or burns. The number of "life-threatening" injury cases and mortality in both groups were similar. There was evidence that the number of ED presentations relating to injury is increasing in the elderly population. ‹Conclusion› Elderly injury patients are a distinct group with distinctive demographics, mechanism of injury and outcomes. This information would be useful in the planning of injury prevention programs, with particular emphasis on elderly females and MVA-unrelated trauma.
A total of 270 food samples were obtained from twelve free markets (149 samples) and seven supermarkets (121 samples) in Thailand from September 2010 to February 2012. The samples were divided as follows: 51 meat, 37 fish/seafood, 38 vegetable, 11 fermented food and 133 tofu samples. The samples were examined for the presence of Salmonella spp.. Salmonella spp. were detected in 28% of the free market samples and in 7% of the supermarket samples. Meat samples had the highest contamination rates: 78% of the free market and 40% of the supermarket samples. Of the fish/seafood, vegetable, fermented food and tofu samples from the free markets, 41%, 6%, 25%, and 7%, respectively, tested positive for Salmonella spp., whereas the corresponding contamination rates were 5%, 5%, 0% and 0% for the supermarket samples. The resistance of the isolates towards sixteen antibiotics was tested. A high percentage of the isolates were resistant to streptomycin, tetracycline or ampicillin: 78%, 59% and 51%, respectively. In total, 152 isolates were resistant to at least one antibiotic, and of these, 98 (64%) were resistant to at least three antibiotics (multidrug-resistant). The most frequently isolated serovars were Corvallis, Rissen and O4: i:-. Random Amplified Polymorphic DNA (RAPD) was used for grouping 149 isolates into five groups. The grouping of the isolates is baseline information to emphasize the usefulness of subtyping Salmonella spp. isolated from several categories of retail foods obtained from free markets and supermarkets by using antibiotic resistance studies and RAPD grouping.
Single photon emission computed tomography (SPECT) with 133Xe gas inhalation method enables measurement of regional cerebral blood flow (rCBF) quantitatively. But this method is inferior to the method with 99mTc-HMPAO or 123I-IMP in the quality of images. Efficient administration of 133Xe gas more than usual is supposed to improve quality of SPECT images. In this study we designed bolus inhalation method, a new method to efficiently administer 133Xe gas of usual dose (1,850 MBq), and examined its fundamental aspects and clinical feasibility. The method was initiated by bolus administration of 133Xe gas synchronously in inspiration phase via a small tube connected to a mouthpiece and was followed by steady breathing of the gas in a closed circuit with a spiro-bag. Introduction of this method provided almost twofold increase in count ratio at the head in comparison with a conventional inhalation method. Consequently, considerable improvement in the quality of rCBF images was achieved by optimization of a reconstruction filter of SPECT.
In this study, 2 methods of DNA extraction were evaluated for use in conjunction with the screening system Rapid Foodborne Bacterial Screening 24 (RFBS24), which employs multiplex real-time SYBR Green polymerase chain reaction (SG-PCR) and can simultaneously detect 24 target genes of foodborne pathogens in fecal DNA samples. The QIAamp DNA Stool mini kit (Qkit) and Ultra Clean Fecal DNA Isolation Kit (Ukit) were used for bacterial DNA extraction from fecal samples artificially inoculated with Clostridium perfringens, Staphylococcus aureus, Salmonella Typhimurium, and Campylobacter jejuni. SG-PCR and simplex real-time quantitative PCR (S-qPCR) analyses revealed higher copy numbers (8–234 times) of DNA in samples obtained using Ukit compared with those obtained using Qkit, resulting in lower cycle threshold values for the Ukit samples of the 4 bacteria on SG-PCR analysis. Fecal DNA samples from patients infected during foodborne outbreaks of Salmonella and Campylobacter were also prepared by Qkit and Ukit methods and subjected to RFBS24 analyses. Higher numbers of RFBS24 bacterial target genes were detected in DNA samples obtained using Ukit compared with those obtained using Qkit. Thus, the higher DNA extraction efficiency of the Ukit method compared with Qkit renders the former more useful in achieving improved detection rates of these 4 bacteria in fecal samples using SG-PCR.
