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地域文化創造プロジェクト「ENIWA 学」（共同研究）は，文化活動を通した地域創成の在り方を研究する実践的研究である．今回は，大学と隣接する文化遺産「カリンバ遺跡」（国指定遺跡）をテーマとし，持続可能な地域社会の実現にむけて地域と交流することをふまえ，ワークショップを通じて地域創成にかかわる遺跡のデザイン化を目指した．本稿では，縄文後期の「カリンバ遺跡」を象徴するベンガラ朱を活用したワークショップの創出過程を明らかにし，本ワークショップの意義をアクションリサーチと参与観察，そして質問紙調査，さらには画像資料をもとに考察した．ワークショップの題材設定では，まず「協同で成される」こと「一過性でおわらない」ことを念頭に置いた．また，主題については，染色家の橘内美貴子や本学学生の協力を得ながら検討した．そして，材料についての理解を深めながら参加する児童の発達段階も考慮した内容となった．制作過程の考察から，ワークショップが「オープンエンド」で「抽象的な行為主体」，そして「未知な体験」としての活動であることが，参加者の地域文化活動への参画をポジティブなものにし多様性が重んじられる時代の 持続可能な地域づくりにとって必要であることを示唆した．また，制作後の参加者の様子や，恵庭市社会教育委員の発言から，地域資源を活用した表現活動が今までにない形でベンガラ朱が可視化され，知識的な理解を超えて感性的な次元での共感に繋がったことが示唆された．

本研究では，教員のなり手不足解消を目的とした，北海道教育委員会が企画する「草の根教育実習」に参加する学生の参加意識と，地方自治体の受け入れ意識に着目し，その関係性を明らかにすることを目的とした． 本学学生及び自治体関係者に対する質問紙調査及びインタビュー調査によって, 明らかとなった点は以下の通りである. すなわち，将来の赴任地として地方を選ぶと答えた学生は, 都市部を選ぶとする学生よりも多い傾向にある．だが，現段階で学生が思い描く「教師の魅力」は, 地域との関係ではなく，子どもとの関係での一般的なものにすぎない．つまり，学生が抱く「教師の魅力」と,自治体との意向は, 現段階では乖離する面がある. 自治体が「縦割り行政」から脱し，特に関係人口創出に取り組む部署と, 教育委員会及び学校とが，「横の連携」を見出すことにより，若い教員と地域をつなぐ道が見えてこよう．その姿勢は，地域創生に貢献する教員のあらたな魅力として学生の目に映じ，教員確保に向けた地方教育行政の取り組みの新たな展開につながるものと考えられる．

本研究は，北海道鷹栖町の公園，「パレットヒルズ」における「地域おこし協力隊」のマネジメントに焦点をあて，地域再生に向けた新しい価値の創造の観点から，その意義と課題を明らかにすることを目的とする．研究の結果明らかになった点は以下三点である．第一，パレットヒルズ（「モノ」）の活用をめぐり，「よそ者」である隊員B 氏の活動によって，役場職員A 氏も含め，地元住民が今まで気づかなかった「モノ」の価値に気づいたこと，第二，その「気づき」を含めて，住民がパレットヒルズで展開される多彩なアクティビティに新たな形で参加するようになったこと，第三，そもそもパークゴルフ場と桜の花見会場以外には町民の活用はほとんどなかったパレットヒルズが，多彩なアクティビティがくり広げられる場として，地元のみならず，他の地域からの関係人口をも誘引したことを明らかにした． 一方，本研究の課題は，第一，今回調査した隊員が，地元住民とどのようにして関係を築き，広げたのか，その詳細な方法を明らかにすること，第二，一方で，地元住民自身は，パレットヒルズの新しい活用法に，どのような価値を見出しているのかを明らかにすることである．

本稿では，北海道文教大学における教育改革プロジェクト「ENIWA 学」の実践，特に地域のホールにおいて，地域の自然と歴史を題材とした『漁川物語』を朗読劇として上演する文化活動を対象とし，その活動過程における学生の経験と，教員の支援のあり方を，各種の記録をもとに分析し，明らかにした．その結果，第一，学生は地域の歴史や文化に接し，朗読劇を上演する活動を通して，地域の人々と交流し，地域に対する認識を深めた．第二，第一と関連し，その経験を通して学生は，上演という目的に向かって仲間と力を合わせ協働するモチベーションを徐々に高めていった．第三，プロジェクトの実施により，大学教育を地域に開かれ，文化を創造していくための場とする方法を示した．次に，研究の結果明らかになった教員の支援に関する課題を，以下二点にまとめる．第一，学生がより一層主体的に地域文化の創造に参画するための支援のあり方を検討していくこと．第二，学生が地域文化の創造に向かって，モチベーションと協働性をさらに高めていくことができるような支援を構築していくことである．具体的には準備段階から地域の人々と連携していく機会を増やしていく支援の実践に課題がある．

Additional file 2.

Additional file 3.

Additional file 4.

Supplemental material, sj-docx-1-jet-10.1177_15266028221079772 for Early Clinical Outcomes of Initial Launch of the Zenith Alpha Abdominal Endovascular Graft in Japan by Naoki Fujimura, Shigeo Ichihashi, Hideaki Obara, Toshihisa Asakura, Masatoshi Komooka, Seiji Onitsuka, Yoshihiko Kurimoto, Hiroaki Kato and Takao Ohki in Journal of Endovascular Therapy

Additional file 1. Supplemental figures.

Approximately 70% of the territory affected by the Fukushima Daiichi accident is covered by forest (Fig. 5.1) [5.1]. Forests in Fukushima prefecture consist of about 0.34 million ha of forest plantations and 0.58 million ha of natural/semi natural forest. In this section, radiocaesium interception by tree canopy, transfer to tree and forest products (sansai, mushrooms and game animals), and mobility in tree and soil are described.

ホタルは，発光基質であるルシフェリンと酸素がATP，Mgイオンの存在下に酵素ルシフェラーゼの触媒作用により反応することによって黄緑色に発光することが知られている．近年，岩野らによって合成されたアカルミネというルシフェリン類似物は，ルシフェリンの代わりにルシフェラーゼ反応に供与すると赤色に発光する．この発光色の違いが，発光基質とルシフェラーゼとの相互作用の違いによるものなのか，あるいは，発光基質の化学的な性質の違いによるのかは不明である．そこで我々は，アカルミネとルシフェラーゼの反応後の複合体の立体構造をX 線結晶構造解析により決定し，ルシフェリンの場合と比較することでこの問題への解答を行った．その結果，反応に関わる両基質と酵素の官能基の原子間の立体的な位置関係は，ほとんど同じであった．このことから，基質? 酵素間の相互作用はほぼ同じと考えられ，発色の違いは，アカルミネとルシフェリン，それぞれの化学的性質の違いによることが示唆された． Fireflies generate a yellow-green light from the oxygenation of the luminescent substrate, d-luciferin, using molecular oxygen. This reaction is catalyzed by the enzyme luciferase in the presence of ATP and Mg2+ ions. A luciferin analog called AkaLumine emits a red light when subject to the same luciferase-catalyzed reaction. Whether the difference in emitted color is due to a difference in reaction mechanisms or to the different chemical properties of these two substrates remains unclear. To address the question, we determined the X-ray crystal structure of the complex formed between luciferase and the reaction products derived from AkaLumine at 2.5A resolution. Comparing the crystal structures obtained from the AkaLumine-derived complex with that previously obtained from d-luciferin revealed a common threedimensional arrangement of the functional groups participating in the reaction in luciferase as well as in both substrates. Our results indicate that the reaction mechanism of AkaLumine is almost identical to that of d-luciferin. Therefore, we propose that the red light emitted from AkaLumine is due to a difference in its chemical properties compared with d-luciferin.

主論文ファイル公開を要約ファイル公開に切替：2020年6月26日

Additional file 1: Figure S1. Fission yeast Hsp70 proteins and their homologs. (A) Phylogenic tree of Hsp70 proteins. Scale-bar unit indicates the number of amino acid substitutions per site. Names of proteins are associated with two-letter abbreviations and color-coded to indicate the species: “sp” for Schizosaccharomyces pombe (red), “sc” for Saccharomyces cerevisiae (black), and “dm” for Drosophila melanogaster (blue). (B) Domain structure of Hsp70 proteins. Protein names are depicted as in (A) and their amino acid lengths are shown. Protein domains are drawn as boxes according to the CATH-Gene3D classification. The N-terminal ATPase domains (ATPase) are composed of three internal domains that belong to the CATH superfamilies 3.30.420.40, 3.30.30.30, and 3.90.640.10. Substrate-binding domains (SB) belong to the 2.60.34.10 superfamily. The C-terminal lid domains (Lid) belong to the 1.20.1270.10 superfamily. Predicted localization signals for mitochondria (TargetP-M) and for the endoplasmic reticulum or beyond (TargetP-S) are shown as shaded boxes. Locations of the proteins in the cell are indicated. For clarity, D. melanogaster Hsp70 proteins other than Hsc70-4 are omitted. Figure S2. Hsp40 family proteins in fission yeast. Domain structure of all 26 fission yeast Hsp40 proteins are shown. Protein names and amino acid lengths are indicated. Protein domains are drawn as boxes according to the CATH-Gene3D, Pfam, and Prosite classifications. Predicted localization signals are shown as in Additional file 1: Figure S1. Predicted trans-membrane helix regions (TMhelix) are indicated as gray boxes. The DnaJ domains belong to the CATH superfamily 1.10.287.110. Type-I Hsp40 proteins are characterized by C-terminal (purple) and central (pink) domains that belong to the CATH superfamilies 2.60.260.20 and 2.10.230.10, respectively. The type-II Hsp40 protein Psi1 also contains the C-terminal domain but lacks the central domain. The other proteins are classified as the type-III Hsp40 proteins. Figure S3. Fission yeast type-I and -II Hsp40 proteins and their homologs. (A) Phylogenic tree of Hsp40 proteins. Scale-bar unit indicates the number of amino acid substitutions per site. Names of proteins are depicted as in Additional file 1: Figure S1. (B) Domain structure of Hsp40 proteins. Protein names are depicted as in (A) and amino acid lengths are shown. Protein domains and predicted localization signals are drawn as in Additional file 1: Figure S2. Locations of proteins in the cell are indicated. For clarity, D. melanogaster Hsp40 proteins other than Droj2 are omitted. Figure S4. Schematic representation of marker integration sites. The ade6+ and ura4+ marker genes were located in the SphI site of otr1R (otr1R(SphI)::ade6+) and in the NcoI site of imr1L (imr1L(NcoI)::ura4+), respectively. Figure S5. Hsp90 and Mas5 are dispensable for red pigment formation. Cells were spotted on normal YES plates (YES) and YES containing limited amount of adenine (Low adenine), and incubated at 30°C for six days. Figure S6. Derepression of marker genes inserted in the pericentromere. (A) Cells were serially diluted, spotted on normal EMMS plates and EMMS lacking adenine (EMMS - adenine) or uracil (EMMS - uracil), and incubated at 30°C for 6 days. (B) Strand-specific RT-qPCR for the ura4 marker gene. Values are normalized to that of the sense strand of ribosomal 28S RNA, and are presented as means + SD (n = 3). (C) Strand-specific RT-qPCR for the ade6 and ura4 genes located in the endogenous loci (ade6+ and ura4+) and in the pericentromere (otr1R::ade6+ and imr1L::ura4+). Values are normalized to that of the sense strand of ribosomal 28S RNA, and are presented as means + SD (n = 3). **P

本論文は2013 年4 月に上演された札幌Ｋ高等学校演劇部『Ｋ版 星の王子さま』（サン＝テグジュペリ原作）の生成過程を分析対象とし教師の支援を反省的に検討したものである。検討の結果，創造的活動を行うための生徒と生徒，教師相互の対話空間の形成に関する教師の支援に関し，以下の三点を仮説的な理論として提示した。第一に，教師は，生徒個々人の言葉に耳を傾け思いを受け止めると同時に，上演を見据えた総合的な見地から判断することの必要性を強調し生徒に向き合うことが必要である。第二に，教師は生徒に話し合いを行わせ，原作の主題を自分たちの感覚に合ったものに変換するように支援することが必要である。第三に，教師は生徒相互，あるいは生徒と教師の対話の場面を注意深く観察し，フォーマル，インフォーマルな形に限らず柔軟な形でそれが形成されるように支援することが必要である。, The Purpose of this paper is to examine the process of the teacher-assisted theatre performance of the K-version of Le Petit Prince presented by Sapporo K-high school drama club students. This production was performed on April 2013 in the auditorium of the K-high school and the city hall of Sapporo K Ward. In this paper I’d like to make an analysis of teacher’s support for creating an interaction among students in the process of producing drama by using a method of Action Research. Action research is one of the means of Qualitative Research which is composed of planning, practice, observation and reflection. I analyzed an interaction among students by using ten kinds of text data. The main data consist of following three records. First, the record of my own practice about teaching students; Second, the journal of activities recorded by students; Third, the descriptive answers to a questionnaire concerning about activities of drama production by general observers. On the basis of the results of this reflection of my own practice, I’d like to present three hypotheses about the teacher’s support to the creating an interaction among high school students through making drama production. First, a teacher should support students by listening carefully to their views; Second, a teacher should encourage them to discuss the themes of the original story, which would make them closer to the story; Third a teacher should prompt them to form the interaction among students, as well as between students and a teacher in a formal and informal way.

内容の要旨・審査結果の要旨 / 三重大学大学院医学系研究科 生命医科学専攻 病態解明医学講座 腫瘍集学治療学分野

Fireflies are glowing by a bioluminescent reaction carried out by the enzyme luciferase. The change in bioluminescence color caused by subtle structural differences in luciferase has attracted much research interest. We solved the crystal structures of wild-type and red mutant (S286N) luciferases from the Japanese Genji-botaru (Luciola cruciata) in complex with a high-energy intermediate analogue. Comparing these structures to those of the wild-type luciferase complexed with a substrate and with products revealed a significant conformational change that was observed in the high-energy state of the wild-type enzyme, but not in the red mutant. A series of the structures indicates that the extent of molecular rigidity of the excited state of a product, oxyluciferin, which is controlled by a transient movement of Ile288, determines the color of the bioluminescence during the emission reaction.

1)ヒトセミノーマ移植腫瘍モデルにおける転移巣形成の結果より, セミノーマ細胞にはlymphophilic characteristicsがあることが示唆された.2)動物実験モデルならびに臨床検体を用いた検討より, マトリックスメタロプロテアーゼごとにMMP-2の発現とリンパ節転移との関連が示唆された, To investigate the factors related to lymph node metastasis of testicular germ cell tumors, we first established a seminoma orthotopic model with lymph node metastasis in SCID mice by inoculating small fragments from subcutaneous xenografts. Second, we compared the expression patterns of metastasis-related genes of the seminoma xenografts and of the TCam-2 cells which were established as a seminoma cell line from a primary testicular seminoma. Third, we immunohistochemically analyzed human germ cell tumors (25 seminomas, 17 nonseminomas) using monoclonal antibodies to CD34, VEGF, VEGF-C, Flt-4, MMP-2 and E-cadherin. Testicular seminoma xenografts grew in 32/32 (100%) of the inoculated mice, of which 15 (47%) developed macroscopic metastasis to the renal hilar lymph node. Circulating tumor cells were detectable by using a PCR assay for the human beta-globin gene in 25/32 (78%) mice, although metastatic foci were not histologically evident in the visceral organs, including lungs, liver, kidneys and spleen. This may reflect the lymphophilic characteristics of the seminoma cells used. Regarding mRNA expression of metastasis-related genes, an increased expression of MMP-2 and VEGF compared with that in the s.c. xenografts was demonstrated by RT-PCR assay in the testicular seminoma xenografts. In addition, uPAR, MMP-1, MMP-2, MT1-MMP and MT3-MMP showed a a stronger expression and PAI-2 a weaker expression in the seminoma xenografts than did TCam-2 cells. These results suggest a higher metastatic potential of the seminoma xenografts, especially testicular xenografts, as compared with TCam-2 cells. In the immunohistochemical study, a significant correlation was found between MMP-2 expression and lymph node metastasis, which is compatible with the results for the metastasis-related gene expression from the seminoma xenografts.

平成23年度スペースプラズマ研究会(2012年2月27-28日. 宇宙航空研究開発機構宇宙科学研究所(JAXA)(ISAS)相模原キャンパス), 相模原市, 神奈川県, Space Plasma Conference FY2011 (February 27-28, 2012. Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency(JAXA)(ISAS)Sagamihara Campus), Sagamihara, Kanagawa Japan, 資料番号: SA6000079017

平成22年度スペースプラズマ研究会(2011年3月3-4日. 宇宙航空研究開発機構宇宙科学研究所(JAXA)(ISAS)相模原キャンパス), 相模原市, 神奈川県, Space Plasma Conference FY2010 (March 3-4, 2011. Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency(JAXA)(ISAS)Sagamihara Campus), Sagamihara, Kanagawa Japan, 資料番号: SA6000080013

We have made high-field magnetization measurements for some Mn alloys : ε-Mn_Ga with δ= -0.30, ε-(Mn_Fe_x)_3Sn with x=0.1 and 0.3, Fe_3Mn_4Ge_ and γ-(Mn_Fe_x)_Ga_y with x=0.44 and y=0.27. The ε-Mn_Ga has the hexagonal D0_ type structure and a distorted triangular antiferromagnetic spin structure. The hexagonal lattice is slightly distorted to an orthorhombic lattice at T_d of about 290 K with large magnetization. Pseudo-binary ε-(Mn_Fe_x)_3Sn has also the D0_ type structure, and the alloys with x has an hp13-type structure, and shows an antiferromagnetism below 470 K. The isothermal magnetization at 77 K shows a steep increase around 110 kOe, suggesting the metamagnetic transition. The γ-(Mn_Fe_x)_Ga_y is face centered cubic. The alloys with x=0.4～0.5 and y=0.27 show coexistence of an antiferromagnetic state and a ferromagnetic state below Neel temperature (T_N～300K), and a typical ferromagnetic behavior above T_N ( Curie temperature T_C>550 K). The magnetization of the coexisting state at 77 K in a field of 150 kOe was comparable to that of the ferromagnetic state at 300 K.

General method of calculating magnetization curves in ternary system R-Fe-X is given, where R is a rare-earth element and X a non-magnetic element such as B. In this method the ferromagnetism of Fe sublattice is treated phenomenologically, while exchange and crystal field acting on R ions are exactly taken into account. Experimental data on R_2Fe_B and R_2Fe_N_x systems are summarized in comparison with the calculated curves. Detailed analyses have shown that in the light R compounds the inter-multiplet mixing via the R-Fe exchange interaction is important especially for the first-order magnetization process, which often occurs at low temperatures with external fields along the hard direction.

The magnetization curves of the reentrant-spin-glass Fe_Mn_TiO_3 have been observed at 4.2 K and 1.4 K in applied fields with various sweep rates. Depending on the sweep rates and temperatures, the anomalous jumps of the magnetizations towards the values of the field-cooled-magnetization M^ are observed. This phenomenon is interpreted to be closely related to the properties of the spin-glass state.

Pz-peptidase A, from the thermophilic bacterium Geobacillus collagenovorans MO-1, hydrolyzes a synthetic peptide substrate, 4-phenylazobenzyloxycarbonyl-Pro-Leu-Gly-Pro-D-Arg (Pz-PLGPR), which contains a collagen-specific tripeptide sequence, -Gly-Pro-X-, but does not act on collagen proteins themselves. The mammalian enzyme, thimet oligopeptidase (TOP), which has comparable functions with bacterial Pz-peptidases but limited identity at the primary sequence level, has recently been subjected to x-ray crystallographic analysis; however, no crystal structure has yet been reported for complexes of TOP with substrate analogues. Here, we report crystallization of recombinant Pz-peptidase A in complex with two phosphinic peptide inhibitors (PPIs) that also function as inhibitors of TOP and determination of the crystal structure of these complexes at 1.80-2.00 Å resolution. The most striking difference between Pz-peptidase A and TOP is that there is no channel running the length of bacterial protein. Whereas the structure of TOP resembles an open bivalve, that of Pz-peptidase A is closed and globular. This suggests that collagenous peptide substrates enter the tunnel at the top gateway of the closed Pz-peptidase A molecule, and reactant peptides are released from the bottom gateway after cleavage at the active site located in the center of the tunnel. One of the two PPIs, PPI-2, which contains the collagen-specific sequence, helped to clarify the exquisite structure and reaction mechanism of Pz-peptidase A toward collagenous peptides. This study describes the mode of substrate binding and its implication for the mammalian enzymes.

平成21年度スペースプラズマ研究会(2010年3月11-12日, 宇宙航空研究開発機構宇宙科学研究本部), Space Plasma Conference(March 11-12, 2010, Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Sagamihara, Japan), 形態: カラー図版あり, 形態: CD-ROM1枚, Physical characteristics: Original contains color illustrations, Note: One CD-ROM, 資料番号: AA0064740019

A 73-year-old man with prostatic cancer with cystic degeneration is reported. He visited our clinic for postoperative examination of left metastatic lung cancer and treatment of prostatic hypertrophy. When the prostatic biopsy was performed, bloody fluid was aspirated and prostate size on digital examination was reduced. The obtained specimen consisted of scar tissue. Urethrography showed an elongation of prostatic urethra in addition to the compression of urinary bladder from the rear. CT scan demonstrated a prostatic cyst approximately 8 cm in diameter with an irregular margin. Following the transurethral resection of the prostate, the prostatic cyst was opened and papillary tumor observed. Histological examination revealed a well differentiated medullary cancer which coincided with the pathological finding of left metastatic lung cancer. He died from dyspnea caused by pleuritis carcinomatosa 6 years later. Nine cases of prostatic cancer with cystic degeneration in the Japanese literature are reviewed.

A 32-year-old female visited our clinic with the chief complaints of macroscopic hematuria and pollakisuria in February 18, 1987. Cystoscopic examination revealed findings of cystitis but bleeding from the ureteral orifice was not observed. IVP showed right non visualized kidney and retrograde pyelography demonstrated right ureteral stenosis on the lower ureter and right hydronephrosis. Total hysterectomy, right oophorectomy and right ureterolysis were carried out in March 5. Right lower ureter was buried in the fibrous tissue approximately over 2 cm above the crossing with iliac vessels. Dark reddish colored small tumor was noticed in the stenosed ureter and resected. The histological diagnosis confirmed endometriosis. A total of 37 cases of ureteral endometriosis in the Japanese literature was reviewed.

A 62-year-old male visited our department complaining of left flank pain and urinary retention on November 6, 1989. Intravenous pyelography showed small stone shadows in bilateral ureters and lower calyx of kidney and the left kidney was not visualized. Endoscopically, calculi were seen in bilateral ureteral orifice. An ureteral catheter could not be passed up from there bilaterally. On November 13, 1989, January 24 and 26, 1990, calculi were passed out spontaneously. Analysis of the stones revealed silica calculus. The patient had a past history of duodenal ulcers. He was administered magnesium silicate and magnesium alminometasilicate as an anti-acid drug for ten years. Sixteen cases of silica calculus in Japan are reviewed.

A 58-year-old woman was introduced to our department complaining of lower abdominal pain and macrohematuria in March, 1978. Intravenous pyelography revealed stenosis and a ureteral stone on the right distal ureter. In May, 1983, she visited our department again. Endoscopically, bleeding from the right ureteral orifice was observed. Retrograde pyelography demonstrated the right hydronephrosis and irregular margin of the right lower ureter. However, the urine cytology was negative, and CT scan and ureteroscopy showed no tumorous lesion on the portion. On 7 August, 1989, partial ureterectomy and end to end anastomosis was performed. Histopathological examination by H-E and Congo red stain proved amyloid deposition. Postoperative course was uneventful. A total of 40 cases of amyloidosis of the ureter in the world are reviewed.

TUR-Pによる治療を施行した前立腺肥大症患者25例に対してCMNX 1 gをone shot静注し, 1時間後の血清, 前立腺組織内濃度について検討した.1) CMNXの血清濃度は69.17±17.47 μg/ml前立腺組織内濃度は5.33±2.33 μg/g, P/S ratioは8.18±4.45%であった.2)血清濃度と前立腺組織内濃度との間には, 相関は認められなかった.3)前立腺組織内濃度と臨床分離株に対するMIC90との比較により, グラム陰性桿菌が起炎菌である細菌性前立腺炎やTUR-P前後の感染症や感染予防に有効であると考えられた, Carumonam (CRMN), the first monobactam antibiotic in Japan, has excellent activity against gram-negative bacteria and is useful in the treatment of urinary tract infections. However, it may be insufficient in the treatment of complicated urinary tract infections because of the increase in isolation of gram-positive bacteria, and it may be necessary to co-administer antibiotics active against gram-positive organisms to achieve a broader spectrum of coverage in connection with severe infections. The combination of CRMN and fosfomycin (FOM) was evaluated for its effectiveness and safety at the Department of Urology, Yamagata University Hospital and 7 affiliated hospitals. Clinical efficacy was assessed on 64 patients with complicated urinary tract infection according to the Criteria for Clinical Evaluation of Antimicrobial Agents in UTI (3rd. ed.) recommended by the Japan UTI Committee. Clinical efficacy was evaluated as excellent in 16, moderate in 32, poor in 16, with an overall clinical effectiveness rate of 75.0%, which is superior compared with CRMN alone. Of the total of 92 bacterial strains isolated, 66 (71.7%) were eradicated. Subjective adverse reaction was seen in 1 patient (1.4%), as nausea and anorexia. Slight increases in serum GOT and GPT ware recorded in 5 patients (7.1%). These findings disappeared after the termination of administration without treatment. The combination of CRMN and FOM might therefore be useful in the treatment of complicated urinary tract infections.