The PI3K-Akt network, which is activated by cytokines or growth factors, mediates intracellular signalsto regulate a variety of cellular responses, including antiapoptosis, proliferation, cell cycling, protein synthesis, glucose metabolism, and telomere activity. Genomic mutations, alterations of the PI3K-Akt regulatorynetwork, underlie such diseases as cancer, glucose intolerance (diabetes mellitus), schizophrenia, and/orautoimmune diseases. In addition to direct tumorigenesis involvement by genetically altering human cancer, the PI3K-Akt network underlies the clinical manifestation of different stages of tumorigenic viral infection, such as latent and chronic infection, and malignant transformation of Epstein-Barr, hepatitis C, hepatitis B, and human immunodeficiency virus (HIV) viruses. We summarize updated knowledge on the PI3K-AKTnetwork underlying different phathological viral and/or bacterial infections. Antiviral activity engenderedby suppressing of PI3K-Akt activity, rather than directly targeting anticancer activity via oncogenes, maythus open up ways to prevent malignant transformation by tumorigenic viral infection.

View full abstract

For establishment of a method for rapid diagnosis of Mycoplasma pneumoniae in clinical specimens, we designed and evaluated a loop-mediated isothermal amplification (LAMP) assay, using a set of primers targeting the SDC1 repetitive element of the M. pneumoniae genome.
The method showed rapid and specific amplification for all the strains of M. pneumoniae tested (Type Iand II), within 1hour at 65°C.
No cross-reactivity with the most common causative organisms bacterial pneumonia was observed.
The detection limit was shown as 6 copies, which was equal to or higher than that of the two nested PCRs used as references.
Two hundred four clinical samples, comprising sputum samples, throat swabs, etc., were tested by both LAMP and PCR, and determination of the correlations revealed complete agreement individually (24 posi-tives).
The LAMP assay, a simple procedure in a closed system, allowed rapid amplification and accurate de-tection consistently; therefore we considered that it could become an caeasily available diagnostic methodsuitable for clinical situations requiring quick and appropriate decisions for treatments and care.

View full abstract

An outbreak of aseptic meningitis caused by echovirus type 30 (E-30) occurred in the southern area of Fukushima Prefecture from March to September in 2004. The data of 54 patients with E-30 meningitis wereanalyzed. The median age was 7.3 years and the age range was 4 to 14 years. The male to female ratio was2.2: 1. The major symptoms of fever, headache and nausea/vomiting were observed more than 80% of thepatients. The mean cerebrospinal fluid cell count was 104/μL, and polymorphonuclear cells were predomi-nant in 61% of the cases. The clinical characteristics were not remarkably different from those in the out-break in the middle to southern region of Fukushima Prefecture in 1997. The phylogenetic analysis basedon the VP4 structural gene showed that the E-30 strains isolated in 2004 formed different clusters fromthose isolated during other time periods, suggesting that a variant genotype of E-30 was responsible for theoutbreak in Fukushima in 2004.

View full abstract

Urine samples collected from 422 males and 53 females visiting a clinic in Kawasaki City who were sus-pected to have sexually transmitted infection were tested for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae by BD ProbeTecET (SDA method). The detection rates of C. trachomatis by the SDAmethod and polymerase chain reaction (PCR) method (control) were as high as 98.1 % for C. trachomatis, andas high as 99.4% for N. gonorrhoeae, and the concordance rate of detection of both bacterial species was high.The detection sensitivity and specificity of the SDA method were 90.6 and 99.3%, respectively for C. trachomatis and 98.7% and 100% for N. gonorrhoeae, when PCR was used as the standard method. There wereno differences in these results between males and females. The number of patients showing a discrepancyof the results obtained between the SDA method and the PCR method was 9 for C. trachomatis and 1 for N.gonorrhoeae, but the results of redetermination by the SDA method tended to coincide with those of the PCRmethod. Urine samples tested by the SDA method were positive for N. gonorrhoeae even in patients in whomthe culture of secretions from the male urethra was negative for N. gonorrhoeae.
Based on these results, the BD Probe Tec ET (SDA method) was confirmed to have the equivalent capability to the PCR method for the detection of C. trachomatis and N. gonorrhoeae in urine samples.

View full abstract

We surveyed pediatric bacterial meningitis epidemiology from January 2005 to December 2006 in Ja-pan, with the following results. Bacterial meningitis cases numbered 246 -138 boys and 108 girls-, equivalentto 1.7-1.72 children of 1, 000 hospitalized in pediatrics per year. The age distribution for infection was highestin those under 1 year of age and decreased with increasing age. Haemophilus influenzae was the most com-mon infection causing the pathogen, followed by Streptococcus pneumoniae, group B streptococcus, and Escherichia coil. The relationship between causative pathogens and age distribution was as follows: group B streptococcus and E. coli were major pathogens in patients under 4 months old and H. influenzae and S. pneumoniae in those over 4 months old. Susceptibility tests at individual facilities showed 59.3% of H. influenzae isolates and 69.3% of S. pneumoniae isolates in 2004 to be drug-resistant.
Ampicillin and cephem antibiotics are effective against GBS, E. coli, and Listeria, so combined of ampicil-lin and cephem antibiotics are used as first-line antibiotics in many facilities in patients under 4 month oldand combined of carbapenem antibiotics effective against PRSP and cephem effective against H. influenzae were the first choice against childhood bacterial meningitis in patients over 4 month old.

View full abstract

We analyzed data on measles-specific serum IgM detection at a commercial diagnostic laboratory in outbreaks among youths in the greater Tokyo area in 2007. Trends in monthly numbers of IgM antibodypositive specimens from persons aged≥15 or<15 years from January 2000 to June 2007 corresponded well to weekly numbers of adult or pediatric patients per sentinel hospital or clinic as reported by the National Epidemiological Surveillance of Infectious Diseases (NESID). In 2007, the number of IgM-positive specimens greatly increased, mainly peaking at ages 0-1 and 18-30 years. The largest number occurred at 18 years, and the number of IgM-positive specimens in the≥15 years group was 41% larger among males than females. The proportion of IgM-positive specimens among hospitalized patients was 22% in the ≥15 years group and 11% in the<15 years group.

View full abstract

Cigar-shaped clostridia such as Clostridium clostridioforme and Clostridium symbiosum have been found in serious infections such as bacteremia. In Japan, however, these strains are unrecognized as clinically significant because they are overlooked as unidentified gram-negative rods. We isolated 60 strains of cigar-shaped Clostridium spp. from 48 clinical specimens treated at our laboratory from November 2004 to September 2006. Of these, 19 (39.6%) were primary infections and 29 (60.4%) postsurgical. Primary infections included infected decubitus ulcer (7), peritonitis, intra abdominal abscess, sepsis (2 cases in each group), pyometra, Bartholin's gland abscess, and Fournier's gangrene (1 case in each group). Secondary infections included 28 cases of surgical site infection and 1 case of pyothorax. CRP in 30 cases (62.5%) exeeded 10mg/dL. In 26 (54.2%), WBC exceeded 12, 000/pL. The 60 isolated strains were as follows by 16S rRNA sequencing: Clostridium hathewayi (26.7%), C. clostridioforme (16.7%), Clostridium bolteae (18.3%), Clostridium citroniae (10%), Clostridium aldenense (8.3%), and Clostridium symbiosum (20%). In antimicrobial susceptibility, strains of C. hathewayi showed relatively higher MIC for cefotaxime; (MIC₅₀ 64μg/mL, MIC₉₀; 128μg/mL). Three strains of C. bolteae were β-lactamase-producing and their MICs for ampicillin exceeded 128μg/mL.

View full abstract

We distributed a questionnaire to 209 patients who visited the Digestive Disease Center of Kurume University for liver disease treatment from October 2006 to April 2007 to determine whether patients with hepatitis C virus (HCV) or hepatitis B virus (HBV) disclosed their disease status to dental clinics personnel. We found that 59.8% (125/209) always did so, 12.0% (25/209) sometimes did so, and 28.2% (59/209) never did so. The main reason (71.2%) for nondisclosure was failure of dental healthcare workers to ask whether patients had systemic disease. Other reasons included fear of negative reactions from healthcare workers (11.9%) and not wanting dentists or staff to know their specific liver ailment (10.2%). Men were less likely than women to disclose status for these reasons.
It thus cannot be over emphasized that liver disease patients be advised by medical specialists to make known their HCV or HBV status when undergoing dental care. Above all, it is important for dental workers to take standard precautions with all patients to ensure medical safety and to prevent infection in dental practice. The government should take appropriate measures to encourage and support dentists who use precautions to prevent nosocomial infection.

View full abstract

Aspergillosis of the bone is rare and resistant to treatment. We report a case of Aspergillus infection of the masticator space including mandibular bone in a diabetic adult. After extraction of a posterior tooth, the patient began to suffer from facial pain. The pain worsened in spite of antibiotic treatment. The results of serum tests and biopsy showed an invasive aspergillosis of the left masticator space including the mandibular bone six months after the onset. Although invasive aspergillosis can be fatal, the infection in our case responded to itraconazole treatment. Even in diabetes mellitus, invasive aspergillosis may occur after surgical interventions such as tooth extraction.

View full abstract