Clostridioides difficile infection (CDI) is an infectious disease in which toxin-producing C. difficile causes enteritis and diarrhea. In cases in which antigen detection is positive for glutamate dehydrogenase (GDH) and negative for toxin, it is difficult to distinguish false-negative and non-producing strains, which makes it difficult to determine if the patient has CDI. For this reason, toxigenic culture or toxin gene detection is recommended. In this study, we investigated the use of toxigenic culture in a hospital setting. A total of 17 GDH-positive and toxin-negative specimens were cultured. Toxin antigen detection and PCR for toxin B using homemade reagents were performed on 14 specimens that developed colonies. After 48 hours of incubation, 7 of these 14 colonies were positive in PCR, while 6 were positive and 1 was not identified using toxin antigen detection. Toxigenic culture is used for CDI testing in hospitals for cases that are GDH-positive and toxin-negative in conventional antigen detection. Toxin detection performed by PCR may be useful for CDI diagnosis and treatment in such cases.

Classification based on the 2021 Abdominal Ultrasonography Examination Judgment Manual (Revised Edition) was examined in 1,521 patients who underwent physical examination by abdominal ultrasonography from April 2021 to March 2022. The results showed that the liver had the highest prevalence of findings by organ (76.0%), with fatty liver being the most common (581 cases). Follow-up of 32 patients with a thorough examination revealed that 20 of these patients had results that were concordant between the examination and ultrasonography, with the most common lesion being intraductal papillary mucinous neoplasm (IPMN), a pancreatic disease. In the 12 cases with discordant or normal results on a close examination, the most common findings were hepatic hemangioma and common bile duct dilation. The results of the study suggest that improvement of skills is needed to observe target organs in a short time using ultrasonography and to avoid missing lesions that require close examination, even if they can be visualized.