We have reported a novel bovine rotavirus, the AzuK-1 (G21P [29]) strain, isolated from an asymptomatic calf. We isolated another bovine rotavirus, the Dai-10 strain, bearing new G24P [33] genotypes, assigned by the Rotavirus Classification Working Group (RCWG), from an asymptomatic cow in Hyogo Prefecture, Japan in 2007. To gain an insight into the origins and evolution of these strains, we determined the complete ORF sequences of all 11 genes of the two strains. The NSP3 genes of both strains were confirmed to belong to a new NSP3 genotype, T9, by the RCWG. Genotype determination of AzuK-1 and Dai-10 strains revealed that eight gene segments of both strains possessed genotypes typically observed in bovine rotaviruses, with the exception of VP4, VP7 and NSP3 gene segments. Unexpectedly, phylogenetic analyses showed that VP6 and NSP2 gene segments of the AzuK-1 and Dai-10 strains were clustered with those of simian or canine/feline rotaviruses, rather than with those of bovine rotaviruses. These findings indicate the possibility that both strains originated by interspecies transmission and multiple reassortment events involving bovine, simian and canine/feline rotaviruses, resulting in the introduction of some genes into the genetic background of bovine rotaviruses. INTRODUCTIONGroup A rotaviruses are the major pathogens causing acute gastroenteritis in infants and a wide range of animals, including birds. Rotavirus-induced diarrhoea is a serious public health problem worldwide, responsible for more than 600 000 child deaths each year (Parashar et al., 2006). Likewise, in domestic animals, rotavirus-induced diarrhoea is a major problem causing significant economic losses (Dhama et al., 2009;Martella et al., 2010).Rotaviruses are members of the family Reoviridae. Rotaviruses possess a genome of 11 segments of dsRNA, which encode six viral structural proteins (VP1-VP4, VP6 and VP7) and six non-structural proteins (NSP1-NSP6). Because of the segmented nature of the genome, a reassortment event can occur in cells co-infected with two or more different strains (Estes & Kapikian, 2007;Palombo, 2002;Ramig, 1997). The rotavirus virion is a triple-layered icosahedral particle. The outer capsid is composed of VP7 and VP4. They elicit neutralizing antibodies independently. In a dual classification system, rotaviruses are classified into 24 G genotypes and 32 P genotypes based on the nucleotide sequences of VP7 and VP4 genes, respectively (Collins et al., 2010; Esona et al., 2010;Matthijnssens et al., 2006Matthijnssens et al., , 2008a Schumann et al., 2009; Solberg et al., 2009;Ursu et al., 2009). Recently, a new classification system has been established using nucleotide sequences of all of the 11 genomic RNA segments by the Rotavirus Classification Working Group (RCWG) (Matthijnssens et al., 2008b). In this system, the The GenBank/EMBL/DDBJ accession numbers for the sequences reported in this paper are AB513836-AB513838 and AB573070-AB573086.Supplementary material is available with the online version of this paper. , 2...

We report three cases of intracranial aspergillosis originating in the sphenoid sinus in immunocompetent patients. The patients presented with an orbital apex syndrome in that a unilateral loss of vision and cranial nerve III palsy were seen in all cases and a contralateral involvement was also seen in one case. Despite the initial treatment with a conventional dose of itraconazole (ITCZ, 200 mg/day), the neurological deficits failed to improve and the granulomatous inflammation was not suppressed. Therefore, we treated with a combination of a high dose of ITCZ at 500-1000 mg/day (16-24 mg/ kg/day) and amphotericin B (AMPH-B) at 0.5 mg/kg/day, in conjunction with a pulse dose of methylprednisolone at 1000 mg/day. Two cases responded favorably in that the ocular movements completely recovered, and their maximum serum concentrations of the hydroxy ITCZ were 7816 ng/ml and 5370 ng/ml. However, the other case worsened, despite ITCZ treatment at 16 mg/kg/day, and the serum concentration of the hydroxy ITCZ was 3863 ng/ml. The surgical decompression of the cavernous sinus via an extradural approach was performed, and the dose of ITCZ was increased to 24 mg/kg/day. The resulting serum concentration of the hydroxy ITCZ was 4753 ng/ml, and the outcome of this case has been favorable. These results suggest that a high blood level of the hydroxy ITCZ (more than 4500 ng/ml) is a prerequisite for the successful treatment of intracranial aspergillosis and that the combination treatment of ITCZ with AMPH-B would be preferred. The concomitant use of steroid and/or surgical decompression should be considered, if the invasiveness is not wellcontrolled in spite of intensive medical therapy. intracranial aspergillosis; itraconazole; antifungal therapy; fungus infection

ObjectiveTo identify mutations in vacuolar protein sorting 13A (VPS13A) for Japanese patients with suspected chorea-acanthocytosis (ChAc).MethodsWe performed a comprehensive mutation screen, including sequencing and copy number variation (CNV) analysis of the VPS13A gene, and chorein Western blotting of erythrocyte ghosts. As the results of the analysis, 17 patients were molecularly diagnosed with ChAc. In addition, we investigated the distribution of VPS13A gene mutations and clinical symptoms in a total of 39 molecularly diagnosed Japanese patients with ChAc, including 22 previously reported cases.ResultsWe identified 11 novel pathogenic mutations, including 1 novel CNV. Excluding 5 patients with the unknown symptoms, 97.1% of patients displayed various neuropsychiatric symptoms or forms of cognitive dysfunction during the course of disease. The patients carrying the 2 major mutations representing over half of the mutations, exon 60–61 deletion and exon 37 c.4411C>T (R1471X), were localized in western Japan.ConclusionsWe identified 13 different mutations in VPS13A, including 11 novel mutations, and verified the clinical manifestations in 39 Japanese patients with ChAc.

A 49-year-old man presented with fever and pain, redness, swelling, and difficulty in walking. The serum C-reactive protein (CRP), creatin kinase (CK), and endotoxin levels were elevated. A blood culture revealed Edwardsiella tarda(E. tarda). Computed tomography (CT) showed subfascial and subcutaneous low-density areas in the lower legs, suggesting focal abscesses and edema. The patient was likely to have necrotizing fasciitis or cellulitis. He was successfully treated with several antibiotics and discharged after 43 days. Because E. tarda causes sepsis and fulminating necrotizing fasciitis with a high mortality rate in patients with an underlying illness, it should be considered a potentially important pathogen. The lack of an underlying illness may be a factor for a good outcome in this case.

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