The Role of , , and in the Regulation of the Class A Carbapenemase NmcA in .

Various carbapenemases have been identified in the Enterobacteriaceae. However, the induction and corresponding regulator genes of carbapenemase NmcA has rarely been detected in the complex (ECC). The NmcA-positive isolate ECC NR1491 was first detected in Japan in 2013.

Diabetes care providers' manual for disaster diabetes care.

To ensure that experiences and lessons learned from the unprecedented 2011 Great East Japan Earthquake are used to improve future disaster planning, the Japan Diabetes Society (JDS) launched the "Research and Survey Committee for Establishing Disaster Diabetes Care Systems Based on Relevant Findings from the Great East Japan Earthquake" under the supervision of the Chairman of the JDS. The Committee conducted a questionnaire survey among patients with diabetes, physicians, disaster medical assistance teams (DMATs), nurses, pharmacists, and nutritionists in disaster areas about the events they saw happening, the situations they found difficult to handle, and the needs that they felt required to be met during the 2011 Great East Japan Earthquake. A total of 3,481 completed questionnaires were received.

Diabetes Care Providers' Manual for Disaster Diabetes Care.

To ensure that experiences and lessons learned from the unprecedented 2011 Great East Japan Earthquake are used to improve future disaster planning, the Japan Diabetes Society (JDS) launched the "Research and Survey Committee for Establishing Disaster Diabetes Care Systems Based on Relevant Findings from the Great East Japan Earthquake" under the supervision of the Chairman of the JDS. The Committee conducted a questionnaire survey among patients with diabetes, physicians, disaster medical assistance teams (DMATs), nurses, pharmacists, and nutritionists in disaster areas about the events they saw happening, the situations they found difficult to handle, and the needs that they felt required to be met during the 2011 Great East Japan Earthquake. A total of 3,481 completed questionnaires were received.

Prozone-like phenomenon found in chemiluminescent enzyme immunoassay using magnetic particles for measurement of serum anti-single stranded DNA antibody titers: Definition and management.

Background: Serum anti-single stranded DNA antibody (anti-ssDNAab) is used as a marker for systemic lupus erythematosus. We found a 'prozone-like phenomenon,' which was different from an original prozone phenomenon, in chemiluminescent enzyme immunoassay using magnetic particles for the measurement of serum anti-ssDNAab titers. We investigated mechanisms of the prozone-like phenomenon and countermeasures to prevent it from being overlooked.

Decrease of Plasma Soluble (Pro)renin Receptor by Bariatric Surgery in Patients with Obstructive Sleep Apnea and Morbid Obesity.

Background: Plasma concentrations of soluble (pro)renin receptor [s(P)RR], which are elevated in patients with obstructive sleep apnea (OSA), have not been studied in morbid obesity. The aim of this study is to clarify effects of bariatric surgery on plasma s(P)RR concentrations and identify associated factors for their changes in OSA patients with morbid obesity.

Methods: Twenty-three patients with OSA complicated by morbid obesity (10 men and 13 women; body mass index, 40.

[Achieving ISO 15189 Certification -Iwate Medical University Hospital's Approaches -].

International clinical trials need to achieve ISO 15189 Certification. However, there are a large number of challenges to be addressed before the achievement. While the retirement of experienced staff may result in insufficient knowledge, technology, quality assurance, or reliability, approaches to achieve ISO 15189 Certifi- cation are useful for human resource development and quality assurance.

Rapid species identification and epidemiological analysis of carbapenem-resistant Acinetobacter spp. by a PCR-based open reading frame typing method.

The spread of carbapenem-resistant Acinetobacter spp. has become a global problem. In this study, 18 carbapenem-resistant Acinetobacter calcoaceticus-baumannii (ACB) complexes, identified using a conventional biochemical method at our hospital during 2004-2013, were studied for species identification and epidemiological analyses.

[Epidemiological Survey of the Extended-spectrum β-lactamase-producing Bacteria in Hospitals and Nursing Homes in Morioka Secondary Medical Area Zone of Iwate Prefecture].

The spread of ESBL-producing bacteria (ESBLs) in local communities is a crucially important issue related to infection control. We investigated the relevance of isolation of ESBLs and the risk factors influencing the isolation rates of these organisms at medical facilities (4 rural hospitals, A-D; 4 nursing homes, a-d) located in the Morioka medical area. The isolation rates of ESBLs at 4 hospitals were estimated from the patient medical records from April 2013 to March 2014.

[Respiratory Function Tests as Physiological Examination in Home Health Care -Pulse Oximeter, Peak Flow Meter, and NO Measurement Apparatus.].

Daily monitoring of patients with chronic respiratory failure or bronchial asthma to prevent their disease deterioration is required. In home health care, the pulse oximeter for chronic respiratory failure during home oxygen therapy and the peak flow meter or the expiratory nitric oxide (NO) measurement apparatus for bronchial asthma are important. As there are many pitfalls in interpreting the test results, appropriate in- formation needs to be conveyed from the physicians to patients.

Elevated Plasma Levels of Soluble (Pro)Renin Receptor in Patients with Obstructive Sleep Apnea Syndrome in Parallel with the Disease Severity.

(Pro)renin receptor ((P)RR), a receptor for renin and prorenin, is implicated in the pathophysiology of diabetes mellitus, hypertension and their complications. Soluble (P)RR (s(P)RR) is composed of extracellular domain of (P)RR and thus exists in blood. We have reported that plasma concentrations of s(P)RR were elevated in male patients with obstructive sleep apnea syndrome (OSAS).

Linezolid-resistant Staphylococcus aureus isolated from 2006 through 2008 at six hospitals in Japan.

Limited use of linezolid for treating methicillin-resistant Staphylococcus aureus (MRSA) infection was approved in Japan in 2006. We report here the status of linezolid-resistant MRSAs in Japan. Eleven linezolid-resistant clinical isolates from 11 patients at six hospitals were collected from 2006 through 2008.

[How to establish a medical team for patients with critical bleeding].

The medical guidelines for critical bleeding were published by several medical societies, and they declared the importance of approaches by teams composed of various kinds of medical staff. A medical team dealing with critical bleeding is characterized as an ad hoc type team, since the team is inactivated after its individual work is finished. Its characteristics are: 1)it is hard to predict when to be organized, 2) extremely rapid responses are required, and 3) staff outside the hospital,such as the Red Cross Society, are involved.

[Team approaches to critical bleeding (massive bleeding and transfusion) - chairmen's introductory remarks. Questionnaire survey on current status of hospital clinical laboratories evaluating critical hemorrhage].

In 2007, "the Guidelines for Actions against Intraoperative Critical Hemorrhage" were established by the Japanese Society of Anaesthesiologists and the Japanese Society of Blood transfusion and Cell Therapy. The documentation of in-hospital procedures for critical hemorrhage, especially about how to select RBC units, has widely standardized hospital practice. Patients with intraoperative critical hemorrhage sometimes suffer from massive blood loss.

[Points of revision of the guideline JSLM 2012].

The revised version of the guideline JSLM 2012 was published in December 2012 by the Japanese Society of Laboratory Medicine. This version included new sections, such as blood gas analysis, sleep apnea syndrome, interstitial lung disease, liver and pancreas cancer, chronic kidney disease, acute kidney disease, gout and hyperuricemia, bone metabolism abnormality, malignant lymphoma, and rheumatoid arthritis. The guideline committee was composed of specialists in each field of internal medicine, who were responsible for selecting and requesting the authors and also in promoting and proofreading the manuscripts.

[Laboratory Medicine and Medical Team Approaches--Opening Remarks from the Chair].

Recently, medical team approaches were pointed out to be important in the field of laboratory medicine. The staff working in laboratory medicine needs to participate in various kinds of medical team such as ICT or NST. With such a background, the working group for medical teams was established in the Japanese Society of Laboratory Medicine in January 2012.

[Nationwide surveillance of parenteral antibiotics containing meropenem activities against clinically isolated strains in 2012].

The nationwide surveillance of antibacterial susceptibility to meropenem (MEPM) and other parenteral antibiotics against clinical isolates during 2012 in Japan was conducted. A total of 2985 strains including 955 strains of Gram-positive bacteria, 1782 strains of Gram-negative bacteria, and 248 strains of anaerobic bacteria obtained from 31 medical institutions were examined. The results were as follows; 1.

[Susceptibilities of bacteria isolated from patients with lower respiratory infectious diseases to antibiotics (2006)].

From October 2006 to September 2007, we collected the specimen from 356 patients with lower respiratory tract infections in 14 institutions in Japan, and investigated the susceptibilities of isolated bacteria to various antibacterial agents and patients' characteristics. Of 414 strains that were isolated from specimen (mainly from sputum) and assumed to be bacteria causing in infection, 407 strains were examined. The isolated bacteria were: Staphylococcus aureus 64, Streptococcus pneumoniae 96, Haemophilus influenzae 87, Pseudomonas aeruginosa (non-mucoid) 52, P.

[Examination for deep vein thrombosis in the Iwate Sanriku coastal area stricken by the Great East Japan Earthquake Disaster in 2011--measurement of D-dimer using POCT apparatus].

After the Great East Japan Earthquake Disaster in 2011, examinations for below the-knee deep vein thrombosis (BK-DVT) were carried out to prevent victims from secondary health damage by Iwate Prophylactic Examination Organization from economy-class syndrome. In this examination, D-dimer was measured using cobas h 232, a point-of-care testing (POCT) apparatus, in addition to medical interview, blood pressure measurement, and lower limb vein sonography. In the BK-DVT examination carried out in Tanohata in October and in Miyako in November 2012, the BK-DVT-positive number(percentage) in lower limb vein sonography was six (13.

Effects of CPAP treatment interruption due to disasters: patients with sleep-disordered breathing in the Great East Japan Earthquake and tsunami area.

Introduction: The 2011 Great East Japan Earthquake caused major disruptions in the provision of health care, including that for patients with sleep-disordered breathing (SDB) using a nasal continuous positive airway pressure (nCPAP) device. This study investigated the ability of SDB patients to continue using the nCPAP device in the weeks immediately following the earthquake, whether inability to use the nCPAP device led to symptom relapse, and measures that should be taken to prevent disruptions in nCPAP therapy during future disasters. Hypothesis If nCPAP devices cannot be used during disasters, SDB patients' health will be affected negatively.

Identification of Sec14-like 3 as a novel lipid-packing sensor in the lung.

Pulmonary surfactant, a complex composed primarily of lipids and associated proteins, is synthesized in alveolar type II (ATII) cells and secreted into alveoli to prevent collapse during respiration. Although numerous studies have clarified the fundamental roles of pulmonary surfactant, the molecular mechanisms of transport and secretion of pulmonary surfactant remain totally unknown. Thus, we screened candidate genes by comparing genes with the expressed sequence tag (EST) libraries of embryonic and adult lungs by using the digital differential display method in the National Center for Biotechnology Information (NCBI) database.

The Asian project for collaborative derivation of reference intervals: (2) results of non-standardized analytes and transference of reference intervals to the participating laboratories on the basis of cross-comparison of test results.

Background: The 2009 Asian multicenter study for derivation of reference intervals (RIs) featured: 1) centralized measurements to exclude reagent-dependent variations; 2) inclusion of non-standardized analytes (hormones, tumor makers, etc.) in the target; and 3) cross-check of test results between the central and local laboratories. Transferability of centrally derived RIs for non-standardized analytes based on the cross-check was examined.

[Current states and future aspects of graduate schools for adult graduate students: experiences of the master's course as a medical technologist].

The educational system for medical technologists (MTs) has gradually shifted from a three-year technical school system to a four-year university system. It is worthwhile for MTs to advance to a graduate school, in order to improve their routine-work skills, performances, and also to advance their own research as well as to learn how to direct younger MTs. Recently, MTs who advance to the graduate school as adult graduate students are increasing.

Diverse carbapenem-resistance mechanisms in 16S rRNA methylase-producing Acinetobacter baumannii.

Multidrug-resistant Acinetobacter baumannii has become a global problem. This study characterized amikacin-resistant A. baumannii isolated from eight patients during April 2010-March 2011 in our university hospital and examined the possible mechanisms in three cases in which carbapenem susceptibility changed to carbapenem resistance during treatment of the patients.