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Zoospores of the filamentous actinomycete Actinoplanes missouriensis swim vigorously using flagella and stop swimming to initiate germination in response to nutrient exposure. However, the molecular mechanisms underlying swimming cessation remain unknown. A protein (FtgA) of unknown function encoded by a chemotaxis gene cluster (che cluster-1) was found to be required for flagellar rotation arrest; the zoospores of ftgA-knockout mutants kept swimming awkwardly after germination. An ftgA-overexpressing strain exhibited a non-flagellated phenotype. Isolation of a suppressor strain from this strain and further in vivo experiments revealed that the extended N-terminal region of FliN, a component of the C-ring of the flagellar basal body, was involved in the function of FtgA; FliN-P101S canceled the flagellar rotation arrest by FtgA, as well as the negative effect of ftgA-overexpression on flagellation. Furthermore, bacterial two-hybrid assays suggested that FtgA interacted not only with the C-terminal core region of FliN but also with chemotaxis regulatory proteins CheA1 and CheW1-2, which are encoded by che cluster-1. We propose the following working model of motility regulation in A. missouriensis zoospores: the chemotaxis sensory complex initially captures FtgA to allow zoospores to swim and then releases FtgA to stop flagellar rotation (i.e., swimming) in response to external nutrient signals. The actinomycete Actinoplanesmissouriensis produces flagellated zoospores that stop swimming before germination. A genetic study has revealed that a hypothetical protein encoded by a chemotaxis gene cluster is required for flagellar rotation arrest. [ABSTRACT FROM AUTHOR]

A hospital information system (HIS) is an information system developed to manage the administrative, financial and clinical aspects of a hospital. Introduced in the 2000's in large-scale hospitals, HIS has resulted in a dramatic change in the the clinical environment. HIS stores all the histories of clinical activities in a hospital, including electronic patient records, laboratory data, and X-rays, for example. The advantage of HIS is that all the data are input through the network service and can be retrieved from the terminals inside the hospital. Two of the most important roles of HIS is to transfer clinical orders issued by doctors and nurses to other division and to store results of executed orders. Thus, the numbers of issued and executed orders will reflect the clinical activities in large hospitals. This paper proposes a visualization technique, called order trajectory analysis which visualize the temporal sequences of the number of orders. We applied this technique to monitoring clinical workflow: comparison of order trajectories of different divisions confirmed a problem with issuance of orders in one division. We developed the solutions to the problems and used the order trajectories to check whether the problem was solved or not. Transitions of order trajectories show that the proposed technique can be used for monitoring whether the solution is effective or not. [ABSTRACT FROM AUTHOR]

Hospital information systems (HIS) are service-oriented systems that focus on payment for medical services. Because all HIS coding for diseases and clinical processes are payment-oriented, they may differ from clinicians' concepts of diseases and processes. HIS in large-scale hospitals in Japan utilize Diagnostic Procedure Combination (DPC) codes, a disease-coding system that focuses on the use of medical resources. Although DPC codes are very precise for diseases requiring surgery, such as cataracts and lung cancer, classification codes for diseases that do not require surgery, such as cerebral infarction, are less precise, with a single category often covering many subtypes with different clinical courses. This paper proposes a preprocessing method that splits DPC codes into subgroups prior to the application of dual clustering-based clinical pathway mining. This method applies expectation–maximization (EM) clustering to the length of patient stay in the hospital using Akaike Information Criteria (AIC) to select the number of clusters. A dual mining method is subsequently applied to the datasets of subgroups and the meanings of subtype clusters are explored using a text mining method. The proposed method was evaluated using datasets from an HIS at Shimane University hospital as preprocessing for clinical pathway mining. The experimental results showed that the proposed method correctly generated subgroups from the more generalized DPC codes and that the clinical pathways identified after this preprocessing capture the characteristics of processes in real clinical settings. [ABSTRACT FROM AUTHOR]

One of the most important tasks of data mining in a hospital is to discover structured knowledge about decision-making, which is useful for the management of clinical processes. However, most of the data in a hospital information system are stored without classification labels or the meaning of clinical actions. Thus, unsupervised learning techniques are required for analysis. This paper proposes a method which induces a clinical pathway using sample and attribute clustering of the histories of nursing orders stored in a hospital information system. The method consists of the following ve steps: first, frequencies of nursing orders are extracted from a hospital information system as a dataset in which each row and column represents nursing orders and days of the week. Second, orders are classified into several groups using sample clustering. Then, attributes clustering is applied to the data for feature selection. Fourth, for each sample and attribute clustering, the number of clusters is obtained from the sequence of the height values, and following the results of attribute clustering, the original dataset is decomposed into sub-tables. Then, the second-to-fourth steps are repeated in a recursive way until the grouping of attributes (days) are stable. Finally, a new pathway will be constructed from all the induced results. The proposed method was evaluated on datasets extracted from a hospital information system. The experiment results show that the method is useful for the construction of a clinical pathway when the distribution of length of stay is uni-modular. [ABSTRACT FROM AUTHOR]

Background: Only a few studies have reported treatment options for stenosis after endoscopic submucosal dissection (ESD) for gastric neoplasms. This study aimed to identify the risk factors for and evaluate the management of stenosis after ESD for gastric epithelial neoplasms in the cardia and antrum. Methods: We retrospectively reviewed 1218 patients (1447 gastric epithelial neoplasms) who underwent ESD at Tonan Hospital from June 2004 to November 2015. Post-ESD stenosis was defined when a standard endoscope could not be passed through the site. Results: Post-ESD stenosis occurred in 10 (21.3%) of the 47 cardia cases and 14 (3.2%) of the 432 antrum cases. A wide resection of more than three fourths of the circumferential extent was the sole significant risk factor related to post-ESD stenosis in both cardia and antrum. Prophylactic endoscopic balloon dilation (EBD) was performed in 3 of 10 patients with cardiac stenosis and 4 of 14 with antral stenosis. Post-EBD bleeding occurred in one cardia (10%) and one antrum (7.1%) case each and was endoscopically treated. Perforation during EBD occurred in two (14.3%) antrum cases, both of which required emergency open surgery. All complications were observed in patients with conventional EBD, and no complications were associated with prophylactic EBD. Conclusions: A wide resection of more than three fourths of the circumferential extent was the significant risk factor for post-ESD stenosis in both cardia and antrum, and prophylactic EBD could be a promising procedure for the management of post-ESD stenosis. [ABSTRACT FROM AUTHOR]

Background: Only a few studies have reported long-term outcomes for endoscopic submucosal dissection (ESD) of early gastric cancer (EGC) in elderly patients. The aim of this study was to evaluate the efficacy of ESD for EGC in elderly patients ≥75 years with respect to both short- and long-term outcomes. Methods: We reviewed the clinical data of elderly patients ≥75 years who had undergone ESD for EGC at Tonan Hospital from January 2003 to May 2010. Results: A total of 177 consecutive patients, including 145 with curative resection (CR) and 32 with noncurative resection (non-CR), were examined. Of the 32 patients with non-CR, 15 underwent additional surgery, and lymph node metastases were found in 3 patients. The remaining 17 patients were followed without additional surgery because of advanced age or poor general condition. Procedure-related complications, such as post-ESD bleeding, perforation and pneumonia, were within the acceptable range. The 5-year survival rates of patients with CR, those with additional surgery after non-CR, and those without additional surgery after non-CR were 84.6, 73.3, and 58.8 %, respectively. No deaths were attributable to the original gastric cancer; patients succumbed to other illnesses, including malignancy and respiratory disease. Conclusions: In elderly patients, ESD is an acceptable treatment for EGC in terms of both short- and long-term outcomes. Careful clinical assessment of elderly patients is necessary before ESD. After ESD, medical follow-up is important so that other malignancies and diseases that affect the elderly are not overlooked. [ABSTRACT FROM AUTHOR]

Hospital information has become an intelligence infrastructure in large-scale hospitals, and incremental software development is important for improving service quality. This paper introduces a statistical estimation of a service log to measure the differences between responsive time before and after a new interface has been introduced. The results show that even simple statistical methods can compare system performances using the log recorded in the hospital information system. [ABSTRACT FROM AUTHOR]

The complete complementary DNA sequences of genes presumably coding for opine dehydrogenases from Arabella iricolor (sandworm), Haliotis discus hannai (abalone), and Patinopecten yessoensis (scallop) were determined, and partial cDNA sequences were derived for Meretrix lusoria (Japanese hard clam) and Spisula sachalinensis (Sakhalin surf clam). The primers ODH-9F and ODH-11R proved useful for amplifying the sandworm was obtained using primers constructed from the amino acid sequence of tauropine dehydrogenase, the main opine dehydrogenase in A. iricolor. The complete cDNA sequence of A. iricolor, H. discus hannai, and P. yessoensis encode 397, 400, and 405 amino acids, respectively. All sequences were aligned and compared with published databank sequences of Loligo opalescens, Loligo vulgaris (squid), Sepia officinalis (cuttlefish), and Pecten maximus (scallop). As expected, a high level of homology was observed for the cDNA from closely related species, such as for cephalopods or scallops, whereas cDNA from the other species showed lower-level homologies. A similar trend was observed when the deduced amino acid sequences were compared. Furthermore, alignment of these sequences revealed some structural motifs that was possibly related to the binding sites of the substrates. The phylogenetic trees derived from the nucleotide and amino acid sequences were consistent with the classification of species resulting from classical taxonomic analyses. [ABSTRACT FROM AUTHOR]

We describe a rare case of a tumor resembling dysembryoplastic neuroepithelial tumor. A 3-year-old girl had a generalized convulsion as the initial symptom, without other neurological deficits. Computed tomography showed a hypodense lesion with calcific hyperdensity in the left frontal lobe associated with deformity of the overlying calvarium. Four months later, she had a second seizure, and computed tomographic scan showed that the lesion had increased in size. Subtotal removal of the tumor was performed, and the postoperative course was uneventful without radiation therapy. Histological examination revealed a cortical lesion in which an oligodendrocyte-like area and an astrocyte-like area with cytological atypia were observed. Although the clinical course and the radiological findings closely resembled those of dysembryoplastic neuroepithelial tumor, specific glioneuronal elements were not found histologically. Daumas-Duport reported a complex form of dysembryoplastic neuroepithelial tumor that contained glial nodules in addition to a specific glioneuronal element. The histological findings of the glial nodules in this case were quite similar to those she described. We conclude that this could be an unclassified tumor closely resembling dysembryoplastic neuroepithelial tumor without a specific glioneuronal element. [ABSTRACT FROM AUTHOR]

Presents information on a study which confirmed superconductivity in the non-magnetic state of iron under pressure. Information on ferromagnetism; Methodology; Findings.