Pretreatment HBeAg level and an early decrease in HBeAg level predict virologic response to entecavir treatment for HBeAg-positive chronic hepatitis B

There are few reports on hepatitis B e antigen (HBeAg) titres during nucleos(t)ide analogues treatment. We investigated the changes in HBeAg levels in patients treated with entecavir and the usefulness of HBeAg quantification for predicting antiviral response. Ninety-five consecutive HBeAg-positive patients treated with entecavir for more than 48 weeks were enrolled. Serum levels of hepatitis B surface antigen (HBsAg), HBeAg and HBV DNA were assessed at 4-week intervals to week 24 and thereafter at 12-week intervals. Virologic response (Y1VR) was defined as an undetectable HBV DNA level at week 48 of therapy. During 48 weeks, HBeAg and HBV DNA level decreased significantly in a biphasic manner and HBsAg level tended to decease. Fifty-three patients (55.8%) attained Y1VR. Pretreatment HBeAg levels were significantly lower in the Y1VR group than in no Y1VR group. At week 4 and 12 of therapy, 25% and 41.4% of patients showed a decrease of HBeAg levels with >0.5 log(10) and >1.0 log(10) from baseline, respectively. These patients achieved more Y1VR than those with less decrease of HBeAg levels (97.7%vs 22.2% and 86.2%vs 29.3%, respectively). HBeAg level at week 12 had higher predictive values for Y1VR than HBV DNA level. Multivariate analysis revealed that a pretreatment HBeAg level of <360 PEIU/mL and the reduction in HBeAg level >1.0 log(10) at week 12 were associated with Y1VR. These results suggest that pretreatment HBeAg level and an early decrease in HBeAg level are useful measurements for predicting one-year virologic response during entecavir treatment.

First Report of Kalanchoe Leaf Scorch Caused by Stemphylium xanthosomatis in Korea

Kalanchoe (Kalanchoe blossfeldiana Poelln.) is widely cultivated in Korea as an ornamental houseplant and succulent garden plant because of its ease of propagation, low water requirements, and wide variety of flower colors. In August 2010, suspected nursery-stage kalanchoe leaf scorch was found at a grower's greenhouses located in Gimhae, Korea. In some greenhouses, 20 to 30%, and occasionally as much as 50%, of the plants were affected. Symptoms on kalanchoe include browning of the leaf margins and yellowing or darkening of tissues between the main leaf veins. As the disease progresses, affected leaves dried up, turned brown, and became brittle. A velvety, blackish olive mold formed on the surface of the dead tissue, followed by plant defoliation. Fresh leaf specimens were collected from infected plants and the causal pathogen was purified with a single-spore isolation technique and transferred onto potato dextrose agar (PDA). Colonies on PDA developed a gray or grayish brown, hairy, velvety mycelium that was mostly immersed and also formed conidia. Conidia were pale to mid brown, oblong, smooth or verruculose, with three to five transverse and one to two longitudinal septa in two to three transverse divisions, and 32 to 55 × 11 to 18 μm. Conidiophores were pale to mid brown, solitary or in fascicles, unbranched or occasionally branched, straight or flexuous, more or less cylindrical but enlarged slightly at one to three apical percurrent proliferations, septate, and 80 to 300 × 2 to 5 μm. A representative isolate of the pathogen was inoculated on kalanchoe leaves for pathogenicity testing. Cultures grown on PDA were flooded with sterile distilled water and after rubbing with an artist's paintbrush with hair bristles, the resulting suspensions were filtered through sterile cheesecloth. Conidial suspensions were adjusted to 2.5 × 10⁴ conidia/ml with sterile distilled water. The leaves of five 1-month-old potted plants were wounded by applying pressure with forceps having serrated teeth, bruising the tissue. Wounded plants were sprayed with a conidial suspension until runoff. Five plants sprayed with sterile distilled water served as controls. The plants were maintained for 48 h at 25°C in a humidity chamber with 100% relative humidity and were then moved to a greenhouse. Symptoms similar to those observed in the farmer's greenhouse developed on wounded leaves within 9 days. The causal pathogen was reisolated from the lesions to prove Koch's postulates. To confirm the identity of the fungus, the complete internal transcribed spacer (ITS) rDNA and glyceraldehyde 3-phosphate dehydrogenase (gpd) gene were amplified and sequenced (1). Amplification of the ITS region generated a 579-bp sequence (GenBank Accession No. HQ840713) and gpd was 558 bp (GenBank Accession No. JF776462). The ITS and gpd sequences were 100% similar to the sequences of Stemphylium xanthosomatis (GenBank Accession Nos. AF442804 and AF443903, respectively). On the basis of symptoms, mycological characteristics, pathogenicity, and molecular data, this fungus was identified as S. xanthosomatis. The type culture of the fungus is stored at the Korean Agricultural Culture Collection (KACC 45812), National Academy of Agricultural Science, Korea. To our knowledge, this is the first report of leaf scorch caused by S. xanthosomatis on kalanchoe in Korea. Reference: (1) M. P. S. Câmara et al. Mycologia 94:660, 2002.

First Report of Root Rot Caused by Sclerotium rolfsii on Daucus carota var. sativa in Southern Korea

Carrot (Daucus carota var. sativa DC.), an important root vegetable, is cultivated widely because of its dietary fiber and beta carotene. In June 2009 and June 2010, a disease suspected as root rot of carrot caused by Sclerotium rolfsii occurred in a 5-ha field in Jinju, Korea. Early symptoms consisted of water-soaked lesions on root and lower stem tissue near the soil line. Infected plants gradually withered and white mycelial mats appeared on the surface of roots. Numerous sclerotia were often produced on stem and root surfaces in contact with the soil. The heavily infected carrots became rotted and blighted and the whole plant eventually died. The freshly isolated pathogenic fungus was grown on potato dextrose agar (PDA) and examined microscopically. Optimum temperature for mycelia growth or sclerotia formation was 25 to 30°C. Numerous globoid sclerotia formed on the PDA after 18 days of mycelial growth. The sclerotia (1 to 3 mm in diameter) were white at first and then gradually turned dark brown. Aerial mycelia usually formed, consisting of many narrow hyphal strands 3 to 9 μm wide. The white mycelium formed a typical clamp connection after 5 days of growth at optimum temperature. To fulfill Koch's postulates, 10 carrot seedlings were inoculated with colonized agar discs (6 mm in diameter) of the causal fungus directly on the root and incubated in a humid chamber at 25°C for 24 h. Ten carrot seedlings were inoculated similarly with agar discs as the control treatment. After this period, the inoculated and noninoculated plants were maintained in a greenhouse. Eight days after inoculation, the disease symptoms seen in the field were reproduced and the fungus was reisolated from the artificially inoculated plants. To confirm identity of the causal fungus, the complete internal transcribed spacer (ITS) rDNA region of the causal fungus was amplified using the primers ITS1 and ITS4 (2) and sequenced. The resulting sequence of 684 bp was deposited in GenBank (Accession No. JF342557). The sequence was 99% similar to sequences of Athelia rolfsii (Sclerotium rolfsii) in GenBank. Cultures of S. rolfsii have been deposited with the Korean Agricultural Culture Collection (KACC 45154), National Academy of Agricultural Science, Korea. On the basis of symptoms, fungal colonies, the ITS sequence, and the pathogenicity test on the host plant, this fungus was identified as S. rolfsii Saccardo (1). To our knowledge, this is the first report of root rot of carrot caused by S. rolfsii in Korea. This disease is highly dependent upon environmental conditions, including warm weather and high humidity. Recent occurrence of the disease suggests that S. rolfsii could spread widely. References: (1) J. E. M. Mordue. CMI Descriptions of Pathogenic Fungi and Bacteria. No. 410, 1974. (2) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. M. A. Innis et al., eds. Academic Press, Inc., New York, 1990.

Serum hepatitis B surface antigen levels in the natural history of chronic hepatitis B infection

BACKGROUND  The production of hepatitis B surface antigen (HBsAg) may evolve during long-lasting virus-host interactions in chronic hepatitis B (CHB). The impact of age on HBsAg production remains unclear. AIM  To determine the age-specific distribution patterns of HBsAg and related factors during the natural course of CHB infection. METHODS  Seven hundred and sixty-eight untreated HBsAg carriers were enrolled in the study. The parameters and distribution patterns of HBsAg were evaluated in relation to age and immune phases. RESULTS  The HBsAg levels were significantly lower in the HBeAg-negative stage, with the lowest levels in inactive carriers. The HBsAg tended to decrease from hepatitis to cirrhosis and to hepatocellular carcinoma, and from Child-Pugh class A to B and to C. Age and HBV DNA were independently associated with HBsAg levels. In HBeAg-positive patients, the HBsAg levels were distributed in a triphasic-like decline pattern by 2 logs across age strata. For HBeAg-negative patients, the titres in inactive carriers exhibited a 2-log reduction, but remained unchanged over age strata in patients with HBeAg-negative hepatitis. The ratios of HBsAg/HBV-DNA were highest, but steadily decreased with age in inactive carriers, whereas the levels remained largely unchanged over the entire age strata in patients with HBeAg-negative hepatitis. CONCLUSIONS  Age and HBV DNA levels are independent parameters of HBsAg levels. During the natural course of CHB infection, HBsAg levels decrease with age and disease progression, but the patterns are significantly different between the immune phases of CHB. This information may contribute to our understanding of the immunopathogenesis of chronic hepatitis B and management involving HBsAg quantification.

Genetic analyses of avian influenza viruses in Mongolia, 2007 to 2009, and their relationships with Korean isolates from domestic poultry and wild birds

The present study was conducted to monitor wild birds based on the concern that they could disseminate avian influenza virus (AIV) between Mongolia and Korea, which shares the same migratory flyway. Of 1,528 fecal samples analyzed, 21 low-pathogenic AIV were isolated from 2007 to 2009. Nineteen AIV-positive fecal samples were identified as Anseriformes by DNA bar coding. The most frequently isolated subtype was H3 (61.9%), and the most prevalent hemagglutinin/neuraminidase combination was H3N8 (52.4%). Phylogenetic analysis was performed to assess their genetic relationships with those of domestic poultry and wild birds in Korea. The H3 and H7 surface genes belonged to the Eurasian lineage and clustered together in a group with Korean wild birds and poultry. Most N8 genes clustered phylogenetically with viruses isolated in Eurasia, whereas 1 of the Mongolian viruses and some Korean viruses belonged to the North American lineage. The polymerase acidic protein of the internal gene was not distinguishable from the H5N1 highly pathogenic AIV of the goose/Guangdong/1/1996 (Gs/Gd)-like virus. Our study suggests that Mongolian AIV isolates have evolved with genetically multiple genotypes and are closely related to those of AIV in poultry as well as in wild birds in Korea.

Characterization of Escherichia coli isolates from laying hens with colibacillosis on 2 commercial egg-producing farms in Korea

The present study reports on layer chickens with colibacillosis in 2 commercial egg-producing farms (referred to as farm A and farm B, which were managed by the same owner and were about 1 km apart) in the middle region of the Korean peninsula. The 2 flocks were infected at the initiation of egg laying. They were characterized by no previous clinical signs but sudden mortality (2.7-4.0%), with severe lesions of septicemia and fibrinous polyserositis. Escherichia coli was isolated from the lesions of the infected birds. Serotyping tests identified isolates that belonged to somatic groups O1 (12/17), O46 (2/17), O78 (1/17), and O84 (1/17) or that were unidentified (1/17). Thirteen of 17 E. coli isolates (76.4%) obtained from 11 birds in the 2 flocks showed similar pulsed-field gel electrophoresis patterns that were arbitrarily designated as pattern A. The isolates had high frequencies of putative virulence genes including 100% [fimC (type 1 fimbriae), iucD (aerobactin synthesis), and iss (increased serum survival)], 94.1% [cva/cvi (structural genes of colicin V operon) and vat (vacuolating autotransporter toxin)], 88.2% [irp2, iron-repressible protein (yersinia bactin) synthesis, and fyuA, ferric yersinia uptake], and 82.3% [tsh (temperature-sensitive hemagglutinin)]; astA (encoding a heat-stable cytotoxin associated with enteroaggregative E. coli) was not associated with the enteric disorder. These data suggest that all chickens with colibacillosis on farms A and B were likely infected by E. coli strains that are highly pathogenic in avian species.

First Report of Flyspeck Caused by Zygophiala wisconsinensis on Sweet Persimmon Fruit in Korea

Sweet persimmon (Diospyros kaki L.), a fruit tree in the Ebenaceae, is cultivated widely in Korea and Japan, the leading producers worldwide (2). Sweet persimmon fruit with flyspeck symptoms were collected from orchards in the Jinju area of Korea in November 2010. The fruit had fungal clusters of black, round to ovoid, sclerotium-like fungal bodies with no visible evidence of a mycelial mat. Orchard inspections revealed that disease incidence ranged from 10 to 20% in the surveyed area (approximately 10 ha) in 2010. Flyspeck symptoms were observed on immature and mature fruit. Sweet persimmon fruit peels with flyspeck symptoms were removed, dried, and individual speck lesions transferred to potato dextrose agar (PDA) and cultured at 22°C in the dark. Fungal isolates were obtained from flyspeck colonies on 10 sweet persimmon fruit harvested from each of three orchards. Fungal isolates that grew from the lesions were identified based on a previous description (1). To confirm identity of the causal fungus, the complete internal transcribed spacer (ITS) rDNA sequence of a representative isolate was amplified and sequenced using primers ITS1 and ITS4 (4). The resulting 552-bp sequence was deposited in GenBank (Accession No. HQ698923). Comparison with ITS rDNA sequences showed 100% similarity with a sequence of Zygophiala wisconsinensis Batzer & Crous (GenBank Accession No. AY598855), which infects apple. To fulfill Koch's postulates, mature, intact sweet persimmon fruit were surface sterilized with 70% ethanol and dried. Three fungal isolates from this study were grown on PDA for 1 month. A colonized agar disc (5 mm in diameter) of each isolate was cut from the advancing margin of a colony with a sterilized cork borer, transferred to a 1.5-ml Eppendorf tube, and ground into a suspension of mycelial fragments and conidia in a blender with 1 ml of sterile, distilled water. The inoculum of each isolate was applied by swabbing a sweet persimmon fruit with the suspension. Three sweet persimmon fruit were inoculated per isolate. Three fruit were inoculated similarly with sterile, distilled water as the control treatment. After 1 month of incubation in a moist chamber at 22°C, the same fungal fruiting symptoms were reproduced as observed in the orchards, and the fungus was reisolated from these symptoms, but not from the control fruit, which were asymptomatic. On the basis of morphological characteristics of the fungal colonies, ITS sequence, and pathogenicity to persimmon fruit, the fungus was identified as Z. wisconsinensis (1). Flyspeck is readily isolated from sweet persimmon fruit in Korea and other sweet persimmon growing regions (3). The exposure of fruit to unusual weather conditions in Korea in recent years, including drought, and low-temperature and low-light situations in late spring, which are favorable for flyspeck, might be associated with an increase in occurrence of flyspeck on sweet persimmon fruit in Korea. To our knowledge, this is the first report of Z. wisconsinensis causing flyspeck on sweet persimmon in Korea. References: (1) J. C. Batzer et al. Mycologia 100:246, 2008. (2) FAOSTAT Database. Retrieved from http://faostat.fao.org/ , 2008. (3) H. Nasu and H. Kunoh. Plant Dis. 71:361, 1987. (4) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. M. A. Innis et al., eds. Academic Press, Inc., New York, 1990.

Survival rate of H5N1 highly pathogenic avian influenza viruses at different temperatures

The survival rate of Korean H5N1 highly pathogenic avian influenza (HPAI) viruses was investigated at different temperatures under the laboratory conditions. The estimated survival days for a starting viral concentration of 10(6.5) 50% egg infectious dose/0.1 mL were 930, 1,042, and 3,213 d at 4 degrees C; 226, 232, and 293 d at 20 degrees C; and 51, 55, and 58 d at 30 degrees C for A/chicken/Korea/ES/03, A/chicken/Korea/IS/06, and A/chicken/Korea/Gimje/08 (Gimje/08) viruses, respectively. The stability of the Gimje/08 virus was statistically significant compared with the other 2 viruses except for the data between Gimje/08 and A/chicken/Korea/IS/06 virus at 30 degrees C. This result indicated that the survival rate of 3 Korean HPAI viruses is different at various temperatures, which might have partially influenced the large scale of HPAI outbreak in Korea in 2008.

The susceptibility of magpies to a highly pathogenic avian influenza virus subtype H5N1

Korean wild magpies (Pica pica sericea) were intranasally inoculated with highly pathogenic avian influenza (A/Chicken/Korea/ES/03 virus) (H5N1), which was classified as clade 2.5. We estimated viral replication, death after infection, and histology and immunohistochemistry. This species was highly susceptible to severe infection; 100% of birds died within 5 to 8 d. The virus was detected from oropharyngeal (1 to 5 d postinfection) and cloacal (3 to 5 d postinfection) swabs from infected magpies. At necropsy, the prominent lesions were coalescing necrosis of the pancreas with enlargement of livers and spleens. Microscopically, pancreas, brain, heart, adrenal gland, and kidney were most consistently affected with necrotic and inflammatory changes, and viral antigen was frequently demonstrated in the parenchyma of these organs. As a result, Korean wild magpies were very susceptible to avian influenza (H5N1) virus.

Development of a stabilizer for lyophilization of an attenuated duck viral hepatitis vaccine

The live attenuated vaccine against duck viral hepatitis currently available in Korea requires special freezers for storage and transportation with extra costs involved. The development of a lyophilization stabilizer for live attenuated duck viral hepatitis virus (DHV) vaccines, therefore, has been highly recommended for the wider application of the vaccines. Four conventional vaccine stabilizer formulations containing a disaccharide, such as lactose, trehalose, or sucrose, and new formulations containing sorbitol were tested for their efficacy in stabilizing a new attenuated DHV type 3 vaccine candidate under different storage temperatures, 4 and 37 degrees C. The vaccine virus and each stabilizer formulation were combined and submitted to lyophilization and the viability of the virus was measured in 7-d-old specific-pathogen-free chicken embryos by determining the 50% egg lethal dose. Stabilizer formulations containing 2, 4, or 8% sorbitol preserved the viability of the vaccine virus much better than the other stabilizer formulations and 2% sorbitol was the optimal concentration in a standard stabilizing buffer, phosphate glutamate gelatin (0.0038 M KH2PO4, 0.0071 M K2HPO4, 0.0049 M monosodium L-glutamate, and 0.5% gelatin). The results demonstrate that the stabilizer formulation containing 2% sorbitol and 0.5% gelatin can be used for convenient storage and transportation of live DHV vaccines.

CT features of lobular capillary hemangioma of the nasal cavity

BACKGROUND AND PURPOSE

Lobular capillary hemangioma is a benign capillary proliferation of unknown etiology. To our knowledge, no comprehensive review of imaging findings of LCHNC has been presented. Thus, we investigated characteristic CT features of LCHNC.

MATERIALS AND METHODS

This retrospective study included 6 patients (2 men and 4 women; age range, 30-65 years; mean age, 49.2 years) with histologically proved LCHNC. We evaluated the size, site of origin, attenuation on NECT, degree and pattern of enhancement, and bony changes.

RESULTS

The LCHNC lesion was 13.0-45.0 mm (average, 25.0 mm) in diameter. These lesions arose from the inferior turbinate in 5 (83.3%) patients and the anterior nasal septum in 1 (16.7%). Compared with the masticator muscles, the LCHNC lesion was hypoattenuating in 2 (33.3%) and isoattenuating on NECT in 4 (66.7%) patients. In 5 (83.3%) patients, the LCHNC lesion consisted of 2 distinct areas on CECT: a lobular intensely enhancing mass and an iso- or hypoattenuating cap of variable thickness around the intensely enhancing mass. Bony changes included erosion in 3 (50.0%) and displacement in 2 (33.3%) patients.

CONCLUSIONS

CT features of LCHNC consist of an intensely enhancing mass and an iso- or hypoattenuating cap on CECT. The inferior turbinate seems to be a common site of origin, and bony changes are not uncommon features of LCHNC. CT is useful not only in identifying the site of origin and assessing the extent but also in suggesting the nature of LCHNC.

Cancer patients' awareness of clinical trials, perceptions on the benefit and willingness to participate: Korean perspectives

To understand patients' perceptions of clinical trials (CTs) is the principal step in the enrolment of patients to CTs. However, these perceptions in eastern countries are very rare. From 12 February 2007 to 13 April 2007, we consecutively distributed the questionnaire to 842 cancer patients who initiated a first cycle of chemotherapy regardless of each treatment step in the Seoul National University Hospital. Younger age, higher educational degree, higher economic status, and possession of private cancer insurance were related with significantly higher awareness of CTs (P=0.001, P=0.006, P=0.002, and P=0.009, respectively). However, unlike awareness, perceptions on benefits of CTs were not changed according to age, educational degree, and economic status (P=0.709, P=0.920, and P=0.847, respectively). Willingness was also not changed according to age, educational degree, economic status, and private cancer insurance (P=0.381, P=0.775, P=0.887, and P=0.392, respectively). Instead, males and heavily treated patients had more positive perceptions on benefits (P=0.002 and P=0.001, respectively) and more willingness to participate in CTs (OR=1.17, 1.14–2.75: OR=1.59, 1.01–2.51, respectively). In summary, cancer patients' awareness of CTs, perceptions on the benefit in CTs, and willingness to participate are differently influenced by diverse medical and social conditions. This information would be very helpful for investigators to properly conduct CTs in eastern cancer patients.

Asp-Tyr-Leu-Lys tetrapeptide inhibits airway inflammation in toluene-2,4-diisocyanate-induced asthma mice

BACKGROUND

Airway inflammation and remodelling contribute to chronic airway obstruction of asthma. Currently, no medication effectively controls airway remodelling and related vascular changes. Therefore, new strategies need to be developed. The kringle 5 domain has anti-angiogenic activity resulting from the tetrapeptide Lys-Leu-Tyr-Asp (KLYD).

OBJECTIVE

To investigate the therapeutic effect of KLYD and its inverse form Asp-Tyr-Leu-Lys (DYLK) on the inflammation and remodelling of toluene-2,4-diisocyanate (TDI)-sensitization/challenged mice.

METHODS

Cell numbers were measured in the presence of various concentrations of KLYD and DYLK using in vitro endothelial cell proliferation assay. The changes of cell number and the level of vascular endothelial growth factor (VEGF) in bronchoalveolar lavage (BAL) fluid and response to methacholine (MCh) were measured using the in vivo TDI-sensitized/challenged mice model. Muc5ac, smooth muscle actin (SMA) and proliferating cell nuclear antigen (PCNA) protein expression was analysed on trachea and intrapulmonary bronchi using immunohistochemical stain.

RESULTS

Compared with KLYD, DYLK had a greater inhibitory effect on endothelial cell proliferation (P<0.05). Pre-treatment of DYLK showed dose-dependent reduction in the response to MCh (P<0.05) and numbers of inflammatory cells in BAL fluids of TDI-sensitized/challenged mice. TDI induced increases in Muc5ac, SMA and PCNA protein expression and VEGF levels, which were also abolished by DYLK treatment.

CONCLUSIONS

Local administration of DYLK effectively inhibits the airway inflammation and airway remodelling of TDI-sensitized/challenged mice via down-regulation of VEGF. These findings suggest that anti-angiogenic peptide therapies, such as local administration of DYLK, are an effective strategy for the treatment of remodelling in asthma.

Anomalous double peak structure in superconductor/ferromagnet tunneling density of states

We have experimentally investigated the density of states (DOS) in Nb/Ni (S/F) bilayers as a function of Ni thickness, d(F). Our thinnest samples show the usual DOS peak at +/- Delta(0), whereas intermediate-thickness samples have an anomalous "double-peak" structure. For thicker samples (d(F) > or =3.5 nm), we see an inverted DOS, which has previously only been reported in superconductor or weak-ferromagnet structures. We analyze the data using the self-consistent nonlinear Usadel equation and find that we are able to quantitatively fit the features at +/- Delta(0) -- in particular the thickness at which the inversion occurs -- only if we include a large amount of spin-orbit scattering in the model. Interestingly, we are unable to reproduce the subgap structure through the addition of any parameter(s). Therefore, the observed anomalous subgap structure represents new physics beyond that contained in the present Usadel theory.

Feed contaminated with classical swine fever vaccine virus (LOM strain) can induce antibodies to the virus in pigs

In November 2004, antibodies to classical swine fever virus (csfv) were detected in finishing pigs during the annual serological surveillance in Jeju Province, Korea. In addition, csf vaccine viruses (lom strain) had recently been isolated from pigs raised on farms known to have csfv antibody-positive pigs. In contrast with mainland Korea, Jeju Province had been csf free and its pigs had not been vaccinated against csf for more than five years. An epidemiological investigation team from the National Veterinary Research and Quarantine Service investigated the current status of csf prevention on the Korean mainland and in Jeju Province to determine possible routes of introduction of the virus into the province. It was concluded that improperly processed blood meals, manufactured on mainland Korea, had been contaminated with the csf vaccine lom strain, and that the lom strain had been transmitted to pigs fed feed or feedstuffs containing the contaminated meal.

Fluoroscopically guided percutaneous jejunostomy: outcomes in 25 consecutive patients

AIM

To assess the feasibility and safety of fluoroscopically guided percutaneous jejunostomy.

MATERIAL AND METHODS

Between May 1999 and August 2006 percutaneous jejunostomy was attempted in 25 patients. A 5 F vascular catheter (n=20) or a 7.5 F multifunctional coil catheter (n=5) was used to insufflate the jejunum. The distended jejunum was punctured using a 17 G needle (n=19) or a 21 G Chiba needle (n=6) with the inserted catheter as a target. A 12 or 14 F loop feeding tube was inserted after serial dilations. The technical success, complications, 30-day mortality, and in-dwelling period of the feeding tube placement were evaluated.

RESULTS

The technical success rate was 92% (23/25). Technical failures (n=2) resulted from the inability to insufflate the jejunum secondary to failure to pass the catheter through a malignant stricture at the oesophagojejunostomy site and thus subsequent puncture of the undistended jejunum failed, or failure to introduce the Neff catheter into the jejunum. Pericatheter leakage with pneumoperitoneum was a complication in three patients (12%) and was treated conservatively. The 30-day mortality was 13% (3/23); however, there was no evidence that these deaths were attributed to the procedure. Except for four patients who were lost to follow-up and two failed cases, 15 of the 19 jejunostomy catheters were removed because of patient death (n=12) or completion of treatment (n=3), with a mean and median in-dwelling period of 231 and 87 days, respectively.

CONCLUSIONS

Fluoroscopically guided percutaneous jejunostomy is a feasible procedure with a high technical success and a low complication rate. In addition to a 17 G needle, a 21 G needle can safely be used to puncture the jejunum.

Recent Korean isolates of duck hepatitis virus reveal the presence of a new geno- and serotype when compared to duck hepatitis virus type 1 type strains

Duck hepatitis was first reported in 1985 in Korea. The complete nucleotide sequence of two past Korean isolates, DHV-HS and DHV-HSS, isolated in 1994 and 1995, and four recent Korean isolates, AP-03337, AP-04009, AP-04114 and AP-04203 isolated in 2003 and 2004, were determined. Phylogenetic analysis using the 3D protein sequence confirmed that the previously characterized duck hepatitis virus type 1 strains and the six Korean isolates described here constitute a monophyletic group and form two clades/genotypes in which all except the four recent Korean isolates form one group (A) and the recent Korean isolates of 2003 and 2004 constitute a second group (B). Phylogenetic analysis of the VP1 protein supported the division into two different groups. Antisera raised against viruses of group A showed significant neutralizing cross-reaction against a member of the same genotype but not to a strain of group B and vice versa. These results demonstrated that the two genotypes also could be regarded as two different serotypes.

Effects of Homologous and Heterologous Neuraminidase Vaccines in Chickens Against H5N1 Highly Pathogenic Avian Influenza

The 2004 Asian H5N1 epizootic outbreak indicates the urgent need for vaccines against highly pathogenic avian influenza (HPAI) virus. The manufacture of inactivated whole-virus vaccines from HPAI viruses by traditional methods is not feasible for safety reasons as well as technical issues. The low pathogenic avian influenza A/wild bird feces/CSM2/02 (H5N3) virus was used as a heterologous neuraminidase vaccine, and HPAI A/CK/Korea/ES/03 (H5N1) virus was used as a homologous neuraminidase vaccine. Protection efficacy of both vaccines was evaluated by clinical signs, mortality rates, and virus shedding from oropharynx and cloaca of vaccinated chickens after challenge with HPAI A/CK/Korea/ES/03 (H5N1) virus. One dose of 128 hemagglutinin (HA) homologous H5N1 vaccine induced 100% protection in mortality and prevented viral shedding completely after lethal dose virus challenge, whereas one dose of 64 HA unit of heterologous H5N3 vaccine only induced 50% protection in mortality, and it did not prevent viral shedding. However, two doses at a 3-wk interval of 64 HA unit of heterologous H5N3 vaccine as well as one dose of 1024 HA unit of heterologous H5N3 vaccine induced 100% survival rate and could prevent viral shedding completely. Furthermore, we could differentiate the sera of infected birds from those of vaccinated birds by indirect immunofluorescent antibody test. These results suggest that heterologous neuraminidase H5N3 vaccine could be a useful tool for the control of H5N1 HPAI epidemic in poultry.

Retroanastomotic hernia after gastrojejunostomy: US and CT findings with an emphasis on the whirl sign

BACKGROUND

We reviewed ultrasound (US) and computed tomographic (CT) findings of retroanastomotic hernia and established whether such findings are characteristic of retroanastomotic hernia in patients who have undergone gastrojejunostomy.

METHODS

During a recent 10-year period, we encountered 13 consecutive cases of retroanastomotic hernia. Of the patients involved, 11 underwent US, 10 underwent CT, and three underwent small bowel followthrough imaging. The US and CT scans were retrospectively reviewed to determine abnormal findings. Surgical proof was available in all cases.

RESULTS

The efferent loop was herniated through the defect created behind the anastomosis in 10 cases, the efferent and afferent loops in two cases, and the afferent loop in one case. Retroanastomotic hernia was prospectively suggested in 12 of these 13 cases. Among the 10 cases of efferent loop herniation, US and CT signs of retroanastomotic hernia included whirling of mesenteric vessels, jejunal loops, and mesentery in the periumbilical abdomen (10 of 10); mural thickening of herniated bowel loops (six of 10); dilatation of herniated bowel loops (four of 10); decreased peristalsis of herniated bowel loops on US (three of nine); and decreased contrast enhancement of herniated bowel loops on CT (one of seven). In one case, US and CT signs of retroanastomotic hernia of the afferent loop included its dilatation and whirling of a short length of afferent loop behind the anastomosis. In two cases, US and CT signs of retroanastomotic hernia of the afferent and efferent loops included findings of afferent and efferent loop herniations. Three of 13 cases had reversible bowel ischemia, and one had bowel necrosis.

CONCLUSION

Retroanastomotic hernia is an important condition, and the US and CT findings we have described might suggest its diagnosis.

Studies on the development of functional powder from citrus peel

The suitability of citrus peels, generated as a by-product of the juice industry, as a source of antioxidants was investigated. Citrus peel powder was prepared by lyophilizing 70% ethanol extract from citrus peels. Extraction was carried out at room temperature (20 degrees C) for 72 h. The extract was subjected to gamma-irradiation treatment (20 kGy). The aqueous solutions of citrus peel powder were examined for color characteristics and antioxidant potential in terms of 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging, beta-carotene bleaching and nitrite scavenging activities. There were significant changes in Hunter color values due to irradiation. The a*- and b*-values decreased due to radiation treatment. DPPH radical scavenging, beta-carotene bleaching and nitrite scavenging activities were not affected by irradiation treatment. Nitrite scavenging activity was the highest in the extract at pH 1.2 followed by pH 4.2 and 6.0. These functional properties of the aqueous solution were found to be stable in heat treatment. It could significantly improve oxidative stability of lipids in fish meat system. Based on these results there may be opportunities to use citrus peel powder as a functional component in the food processing industry with gamma irradiation treatment improving its color characteristics without adversely influencing the functional properties.

Highly Pathogenic Avian Influenza in Magpies (Pica pica sericea) in South Korea

Highly pathogenic avian influenza (HPAI) is an extremely infectious, systemic viral disease of birds that produces high mortality and morbidity. HPAI was diagnosed in the three dead magpies (Pica pica sericea) submitted to the National Veterinary Research and Quarantine Service. At necropsy, the prominent lesions were multifocal or coalescing necrosis of the pancreas with enlargement of the livers and spleens. Microscopically, there were severely necrotizing pancreatitis and lymphocytic meningoencephalitis. Influenza viral antigen was also detected in areas closely associated with histologic lesions. Avian influenza virus was isolated from cecal tonsils and feces of the magpies. The isolated virus was identified as a highly pathogenic H5N1, with hemagglutinin proteolytic cleavage site deduced amino acid sequence of QREKRKKR/GLFGAIAG. To determine the pathogenicity of the isolate, eight 6-wk-old specific-pathogen-free chickens were inoculated intravenously with the virus, and all birds died within 24 hr after inoculation. This is the first report of HPAI in magpies.

A pilot study on accelerated sludge degradation by a high-concentration membrane bioreactor coupled with sludge pretreatment

A new sludge treatment process combining a high MLSS membrane bioreactor with sludge pretreatment techniques was studied in pilot-scale experiments. The membrane bioreactor (MBR) was adopted for high efficiency aerobic digestion. The combination of alkaline-ozone treatment of the mixed liquor in the MBR reactor accelerated the biodegradation process by enhancing biodegradability of the sludge. The hydraulic retention time (HRT) of the reactor was set as 3.1 days and the DO level was 1 mg/L on average. After 5 months of operation, the accumulative total solids reduction was more than 70%. Removal efficiency of volatile solids and non-volatile solids were 76% and 54%, respectively. It was found that a considerable portion of the non-volatile solids was dissolved into ions and then flushed out with the effluent. Also, about 41% and 28% of T-N and T-P in the raw sludge were removed although no biological nutrient removal process was adopted. The experiment was run smoothly without significant membrane fouling, even at the relatively high levels of MLSS concentration (11,000-25,000 mg/L). It is concluded that the newly proposed process can significantly increase the sludge reduction efficiency with much shorter retention times.

Acidic and hydrogen peroxide treatment of polyaluminum chloride (PACL) sludge from water treatment

The water treatment sludge including coagulants cannot be easily removed by conventional dewatering methods. The possibility of hydrogen peroxide (H2O2) oxidation as a pretreatment to enhance the dewaterability of polyaluminum chloride (PACl) sludge from water works was investigated. H2O2 treatment alone was not effective but H2O2 treatment under acidic condition significantly reduced both the cake water content and specific resistance to filtration (SRF), indicating the enhancement of dewaterability and filterability. The filterability after acid/H2O2 treatment was comparable to polymer conditioning and even more dewatered cake than polymer conditioning was produced. By H202 combined with sulfuric acid (H2SO4), leached iron caused Fenton's reaction, which showed a potential to significantly reduce the amount of solids mass and to produce more compact cake with higher filterability.

The Vulnerable Attachment Style Questionnaire (VASQ): an interview-based measure of attachment styles that predict depressive disorder

BACKGROUND

The Vulnerable Attachment Style Questionnaire (VASQ) was developed to provide a brief self-report tool to assess adult attachment style in relation to depression and validated against an existing investigator-based interview (Attachment Style Interview--ASI). This paper describes the development and scoring of the VASQ and its relationship to poor support and major depression.

METHOD

Items for the VASQ reflected behaviours, emotions and attitudes relating to attachment relationship style, drawn directly from the ASI. The VASQ was validated against the ASI for 262 community-based subjects. Test-retest was determined on 38 subjects.

RESULTS

Factor analysis derived two factors, labelled 'insecurity' and 'proximity-seeking'. The VASQ insecurity dimension had highest mean scores for those with interview-based Angry-dismissive and Fearful styles and was significantly correlated with degree of interview-based insecurity. The proximity-seeking VASQ scores had highest mean for those with Enmeshed interview attachment style and was uncorrelated with ASI insecurity. VASQ scores were highly correlated with a well-known self-report measure of insecure attachment (Relationship Questionnaire) and text-retest reliability of the VASQ was satisfactory. The total VASQ score and the insecurity subscale proved highly related to poor support and to depressive disorder. This was not the case for the proximity-seeking subscale.

CONCLUSION

The VASQ is a brief self-report measure that distinguishes individuals with attachment styles vulnerable for depressive disorder. The use of the measure for screening in research and clinical contexts is discussed.