Francisella tularensis, the causative agent of tularemia, is transmitted by arthropod vectors within mammalian hosts. The detailed mechanisms contributing to growth and survival of Francisella within arthropod remain poorly understood. To identify novel factors supporting growth and survival of Francisella within arthropods, a transposon mutant library of F. tularensis subsp. novicida (F. novicida) was screened using an F. novicida–silkworm infection model. Among 750 transposon mutants screened, the mltA-encoding membrane-bound lytic murein transglycosylase A (MltA) was identified as a novel growth factor of F. novicida in silkworms. Silkworms infection with an mltA deletion mutant (ΔmltA) resulted in a reduction in the number of bacteria and prolonged survival. The ΔmltA strain exhibited limited intracellular growth and cytotoxicity in BmN4 silkworm ovary cells. Moreover, the ΔmltA strain induced higher expression of the antimicrobial peptide in silkworms compared to the wild-type strain. These results suggest that F. novicida MltA contributes to the survival of F. novicida in silkworms via immune suppression-related mechanisms. Intracellular growth of the ΔmltA strain was also reduced in human monocyte THP-1 cells. These results also suggest the contribution of MltA to pathogenicity in humans and utility of the F. novicida–silkworm infection model to explore Francisella infection.
We report a case of prolonged bilateral lateral humeral epicondylitis with pain catastrophizing and depression whose symptoms improved with pectoralis major stretching. [Participant and Methods] The case was a male patient in his 40s who had had bilateral lateral humeral epicondylitis for more than 2 years. In the initial evaluation, the Numerical Rating Scale, Kraushaar & Nirschl classification, Disabilities of the Arm, Shoulder and Hand (DASH) score, Pain Catastrophizing Scale, Hospital Anxiety and Depression Scale, and elbow and wrist joint range of motion (ROM) were assessed. In the interim evaluation, shoulder ROM, the Horizontal Flexion Test, and scapula abduction rate were added to the initial evaluation items. The final evaluation was the same as the interim evaluation. [Results] All of the evaluation points were significantly improved by pectoralis major stretching.[Conclusion] Pectoralis major stretching reduces the internal rotation of the upper limbs and the scapula abduction rate, is effective at improving the ROM of internal rotation of the shoulder joint, and is considered useful for lateral humeral epicondylitis. The psychological evaluation items also improved as pain was reduced.
The present paper reports the results of placing an Iritani-method plantar plate in the tabi of a dancer suffering prolonged hallux pain after surgery. [Participant and Methods] A female patient in her 50s had metatarsophalangeal joint pain in the right hallux when crouching for more than one and a half years after surgery for Lisfranc arthrodesis. The Numerical Rating Scale (NRS), Brief Pain Inventory (BPI), crouching motion, Selfadministered Foot Evaluation Questionnaire (SAFE-Q), Pain Catastrophizing Scale (PCS), and Hospital Anxiety and Depression Scale (HADS) were evaluated before and after the plantar plate prescription. [Results] NRS, BPI, crouching behavior, and SAFE-Q improved while PCS and HADS improved slightly. [Conclusion] Placing an Iritanimethod plantar plate in the dancer's tabi was effective, and we consider it is useful for improving foot symptoms in activities that do not use shoes such as dance.
An Iritani method simple pad was prescribed for a runner with knee joint pain and its effectiveness at improving symptoms and ease of use were investigated. [Participant and Methods] The subject was a male runner in his 40s, who had left knee osteoarthritis with residual pain after exercise therapy. After prescribing the Iritani method simple pad, a pain evaluation and a questionnaire concerning the pad's usefulness were conducted.[Results] After prescribing the Iritani method simple pad, NRS significantly reduced, and "satisfactory" was the answer given for all the pad questionnaire items. [Conclusion] The Iritani method simple pad prescribed in this case, which can be attached to the back of an existing insole, is considered to be highly useful because it not only reduces pain but is also easy to use.
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