Direct application of the PCR restriction analysis method for identifying NTM species in AFB smear-positive respiratory specimens

The early differentiation of Mycobacterium tuberculosis from non-tuberculous mycobacteria (NTM) and the identification of NTM species are crucial for the proper management of patients with smear-positive sputum. We evaluated the usefulness of a polymerase chain reaction restriction analysis (PRA) method based on the rpoB gene for identifying NTM species in a study of 121 smear-positive respiratory specimens with presumed NTM. The PRA method amplified mycobacterial DNA in 72 specimens (60%) and differentiated NTM species correctly in 68 (94%). The PRA method could be a useful and rapid method for identifying NTM species in smear-positive respiratory specimens when urgent clinical decisions are required.

Expression of N-methyl-d-aspartate receptor 1 in rats with chronic ocular hypertension

High levels of glutamate can be toxic to retinal ganglion cells (RGCs). This study investigated the relationship between the N-methyl-d-aspartate receptor 1 (NR) and RGC death in a rat model of chronic ocular hypertension (COHT). COHT was induced in one eye of each rat by episcleral vein cauterization. Retinal protein expression was evaluated at 1, 3, 5 and 9 weeks after cauterization. Quantitative real-time polymerase chain reaction and Western blot analysis showed that NR1 expression was significantly increased in cauterized retinae. NR1 immunoreactivity was observed in the inner nuclear layer (INL) and ganglion cell layer (GCL) in the retina of rats with COHT. RGC density was evaluated after retrograde labeling with fluoro-gold (FG) and 4-di-10-ASP (DiA). A significant decrease in RGC density was observed in ocular hypertensive eyes, and NR1 expression in the GCL suggested an important role of NR1 in the death of RGCs. Memantine (10 mg/kg), an N-methyl-d-aspartate receptor antagonist, was administered orally once daily for up to 5 weeks, while rats in the control group received vehicle phosphate-buffered saline only. Treatment with memantine resulted in a significant reduction in RGC loss and NR1 expression in the eyes of rats COHT. These findings suggest that excessive expression of NR1 is involved in RGC death in glaucoma.

Molecular characterization of enteroviruses isolated from patients with aseptic meningitis in Korea, 2005

Enteroviruses are the most common causative agents of aseptic meningitis. In 2005, an outbreak of aseptic meningitis occurred in Seoul, Korea, which appeared to be caused by certain enterovirus strains. This study analyzed the clinical isolates from 24 different aseptic meningitis patients at our center from January to September 2005. Serotyping using type-specific antisera, RT-PCR, and direct sequencing of the 5' noncoding and VP1 regions were carried out. The serotyping study identified 15 coxsackievirus B5 (CBV5), 4 coxsackievirus B1 (CBV1), 1 coxsackievirus B3 (CBV3) and 4 echovirus 9 (ECV9). Phylogenic analysis of the VP1 region revealed CBV5 to be the most predominant strain (15 strains). Twelve of these strains were grouped together with recent strains isolated in China and France. The 12 CBV5 strains contained a novel amino acid change in the BC-loop (the 90th and 91st, AY --> GN) compared to the reference strain (1954/UK/85). The amino acid changes in the BC-loop in some recent CBV5 strains tend to be located in the C-terminal part, and these changes suggest some antigenic significance.

Pulmonary TB and NTM lung disease: comparison of characteristics in patients with AFB smear-positive sputum

OBJECTIVE

To compare the clinical and radiographic features of pulmonary tuberculosis (PTB) and non-tuberculous mycobacteria (NTM) lung disease in patients with acid-fast bacilli (AFB) positive sputum specimens.

DESIGN

The initial clinical and radiographic features of 229 PTB patients were compared with those of 70 patients with NTM lung disease. The most commonly involved organisms in the NTM lung disease cases were Mycobacterium avium complex (n = 38, 54%) and M. abscessus (n = 26, 37%).

RESULTS

Clinical and radiographic findings that were more common in patients with NTM lung disease than in PTB patients were: older age (P < 0.001), non-smoker (P < 0.001), history of previous TB treatment (P < 0.001), absence of pleural effusion (P = 0.017), involvement of middle and/or lower lung zones (P = 0.007), and bilateral disease (P = 0.005). Multivariate analysis showed that older age (> or = 40 years), non-smoker, previous TB treatment, absence of pleural effusion and involvement of middle and/or lower lung zones were significant independent predictors for NTM lung disease.

CONCLUSIONS

There is considerable overlap in the clinical and radiographic appearances of PTB and NTM lung disease. The isolation and identification of causative organisms are mandatory for a correct diagnosis in patients with AFB-positive sputum specimens.

Rapid helper T-cell recovery above 200 × 106/l at 3 months correlates to successful transplant outcomes after allogeneic stem cell transplantation

The current study evaluates the role of quantitative measurement of peripheral lymphocyte subsets, especially CD4+ helper T-cell recovery, in predicting transplant outcomes including overall survival (OS) and non-relapse mortality (NRM) after allogeneic stem cell transplantation. A total of 69 allogeneic recipients were included with following diagnoses: acute myeloid leukemia 42, acute lymphoblastic leukemia 5, chronic myeloid leukemia 15, non-Hodgkin's lymphoma 5 and high-risk myelodysplastic syndrome 2. The peripheral lymphocyte subset counts (CD3+ T cells, CD3+4+ helper T cells, CD3+8+ cytotoxic T cells, CD19+ B cells, and CD56+ natural killer cells) were measured at 3, 6 and 12 months. The CD4+ helper T-cell reconstitution at 3 months was strongly correlated with OS (P<0.0001), NRM (P=0.0007), and opportunistic infections (P=0.0108) at the cutoff value of 200 x 10(6)/l CD4(+) helper T cells. Rapid CD4+ helper T-cell recovery was also associated with a higher CD4+ helper T-cell transplant dose (P=0.006) and donor type (P<0.001). An early CD4+ helper T-cell recovery at 3 months correlated with a subsequent faster helper T-cell recovery until 12 months, yet not with B-cell recovery. In a multivariate analysis, rapid recovery of CD4+ helper T cells at 3 months was a favorable prognostic factor together with higher CD34+ cell transplant dose in terms of OS (P=0.001) and NRM (P=0.005).

Protective role of interleukin-10 promoter gene polymorphism in the pathogenesis of invasive pulmonary aspergillosis after allogeneic stem cell transplantation

The current study attempted to evaluate the association between the IL-10 promoter gene single nucleotide polymorphism (SNP) and invasive pulmonary aspergillosis (IPA) after allogeneic stem cell transplantation (SCT) in 105 patients. Three single-nucleotide polymorphisms were investigated in the proximal region of the IL-10 promoter gene (-1082/-819/-592). Two haplotypes (1082*A/819*T/592*A [ATA] and 1082*A/819*C/592*C [ACC]) were found in the current study. The overall incidence of IPA was estimated as 14.1+/-4.5% with a median onset at 186 days post-transplant (62 approximately 405 days). An increased occurrence of IPA was noted dependent on the IL-10 haplotype (0% vs 11.5+/-6.4% vs 19.7+/-7.7% for ACC/ACC vs ATA/ACC vs ATA/ATA haplotype, P=0.0307 when comparing ACC with non-ACC haplotype). In a multivariate survival analysis using Cox's proportional hazard model, the IL-10 promoter gene SNPs were identified as an independent predictive factor for the development of IPA (P=0.012, hazard ratio (HR) 9.3), along with an histocompatibility leukocyte antigen (HLA)-identical donor (P=0.005, HR 16.3), the CD34+ cell dose transplanted (P=0.004, HR 26.5), and time-dependent chronic graft-versus-host disease (GVHD; P=0.049, HR 16.0). The IL-10 ACC haplotype was found to have an apparent protective role in the development of IPA after allogeneic transplantation, regardless of HLA-disparity or chronic GVHD.

Prognostic significance of platelet recovery pattern after allogeneic HLA-identical sibling transplantation and its association with severe acute GVHD

Thrombocytopenia (TP) is a frequent complication after allogeneic stem cell transplantation (SCT) and regarded as a poor prognostic factor when assessed beyond day 100. However, little is known about the clinical significance of the platelet recovery pattern before chronic graft-versus-host disease (GVHD) develops. Eighty-five patients undergoing HLA-identical sibling SCT were stratified according to their platelet recovery pattern between day +30 and +90 and the transplant outcomes analyzed, along with the association of each component of the acute GVHD grading system. Fifteen patients (18%) were classified with persistent TP, 33 patients (39%) with unstable TP, and 37 patients (43%) as non-TP. Persistent TP, which was strongly associated with severe acute GVHD (P<0.001), exhibited the worst 2-year OS (P<0.0001) and highest NRM (P<0.0001) and opportunistic infection rates (P<0.0001). In multivariate analyses, the platelet recovery pattern was identified as an independent prognostic factor (P=0.02) together with the disease risk (P=0.02) in terms of OS, and the only independent prognostic factor in terms of NRM (P=0.005) and the incidence of infectious events (P<0.001). Persistent TP was strongly associated with the development of extensive chronic GVHD (P=0.03). The platelet recovery pattern between day +30 and +90 can be used to predict the prognosis of SCT recipients.

Recovery rate of NTM from AFB smear-positive sputum specimens at a medical centre in South Korea

OBJECTIVE

To investigate the recovery rate of non-tuberculous mycobacteria (NTM) from acid-fast bacilli (AFB) smear-positive sputum specimens at a tertiary care medical centre in South Korea with a high pulmonary tuberculosis (PTB) burden.

DESIGN

Retrospective analysis of data from AFB smear- and culture-positive sputum specimens collected between January 1998 and December 2001.

RESULTS

Over 4 years, 1328 sputum specimens collected from 616 patients were AFB smear- and culture-positive. NTM were recovered from 9.1% (121/1328) of the smear-positive sputum specimens, and from 8.1% (50/616) of patients with smear-positive sputum. NTM were isolated at least twice in 94% (47/50) of the patients from whom NTM was recovered. The most common organism found was Mycobacterium avium complex, followed by M. abscessus.

CONCLUSION

These results suggest that a substantial proportion of patients at a tertiary care medical centre in South Korea with AFB smear-positive sputum specimens may have NTM lung disease rather than PTB.

Risk factors for late cytomegalovirus infection after allogeneic stem cell transplantation using HLA-matched sibling donor: donor lymphocyte infusion and previous history of early CMV infection

An increased incidence of late cytomegalovirus (CMV) infection has been reported during the last decade since the introduction of ganciclovir (GCV) prophylaxis or GCV pre-emptive therapy. Given that a donor lymphocyte infusion (DLI) can induce more severe GVHD, this may predispose a patient to late CMV infection. In all, 64 patients (median age 36, M/F 38/26) underwent allogeneic stem cell transplantation (SCT) using a matched sibling donor with bone marrow (n=9) or peripheral blood stem cells (n=55). The overall incidence of CMV infection, early and late CMV infection was 46.9 (30/64), 42.2 (27/64), and 16.4% (9/55), respectively. Early CMV infection was treated with GCV pre-emptive therapy that produced a 92.6% success rate. Among the 20 patients who received 35 DLIs, late CMV infection developed in eight (42.1%) of 19 evaluable cases with a median onset at 127 days post transplant. Risk factors for late CMV infection in a logistic regression analysis included DLIs (P=0.001) and a previous history of CMV infection (P=0.006). In conclusion, late CMV infection was strongly associated with DLIs and a previous history of early CMV infection. Accordingly, extended surveillance of CMV antigenemia is recommended for patients receiving DLIs or who have a previous history of CMV infection.

Effect of infusing lactoferrin hydrolysate into bovine mammary glands with subclinical mastitis

The therapeutic effect of administering lactoferrin hydrolysate (LFH) into the mammary glands of cows with subclinical mastitis was evaluated. Seven millilitres of a preparation of LFH (7% protein) was infused into 35 quarters of 25 cows with subclinical mastitis. The numbers of bacteria in the milk from infected quarters decreased, and bacteria disappeared by the 14th day after the administration of LFH. The mean somatic cell counts (SCC) peaked one day after administration of LFH and the counts were significantly p < 0.01) decreased on days 7, 14 and 21 compared to those before the administration of LFH. The mean lactoferrin concentration in the milk peaked on days 2 or 3 and then gradually decreased to day 14, returning to the level before the administration of LFH. It appears that administration of LFH may have a therapeutic effect when infused into the quarters of cows with subclinical mastitis.

A pilot study of cytoreductive chemotherapy combined with infusion of additional peripheral blood stem cells reserved at time of harvest for transplantation in case of relapsed hematologic malignancies after allogeneic peripheral blood stem cell transplant

Reharvesting leukocytes from donors for a donor leukocyte infusion (DLI) is inconvenient and occasionally impossible in case of unrelated donors. It is well known that the effect of a growth factor-primed DLI is comparable to that of a nonprimed DLI. In total, 42 patients with hematologic malignancies and a high risk of relapse were allocated, on an intent-to-treat basis, a peripheral blood stem cell transplantation (PBSCT) from HLA-matched sibling donors, and then at the time of harvest, additional peripheral blood stem cells (PBSCs) were also reserved for a therapeutic primed DLI in case of relapse. In all, 12 patients who relapsed after allogeneic PBSCT were treated with mainly cytarabine-based chemotherapy followed by a cryopreserved PBSC infusion. The median dose of CD3+ and CD34+ cells for the primed DLIs was 1.43 x 10(8)/kg and 4.75 x 10(6)/kg, respectively. Six of the 12 relapsed patients exhibited a complete response after the primed DLI, plus their 1-year survival rate was 33%. The new development or progression of graft-versus-host disease after a primed DLI was observed in 50% of the patients. Overall, the survival at 1 year was 16.7%. Accordingly, the induction of a graft-versus-leukemia effect through a primed DLI, using additional PBSCs reserved at the original time of harvest, would appear to be feasible for patients with relapsed hematologic malignancies. Furthermore, this approach is also more convenient for donors.

Impact of transplanted CD34+ cell dose in allogeneic unmanipulated peripheral blood stem cell transplantation

The impact of the CD34+ cell dose on chronic graft-versus-host disease (cGVHD) and the clinical outcome was analyzed in 41 consecutive adult patients submitted to allogeneic peripheral blood stem cell transplantation from HLA-identical siblings. The patients were classified into 'low' or 'high' CD34+ cell dose groups based on whether they received less or more than a median CD34+ cell dose of 10.5 x 10(6)/kg, respectively. There was a significant difference in the incidence of extensive cGVHD (low vs high group, 25.0 vs 66.7%, P=0.021) and relapse (47.6 vs 20.0%, P=0.049) between the two groups. With a median follow-up of 335 days, the 3-year survival estimate for the whole population was 47.9%, while that for the low and high groups was 29.9 and 67.8%, respectively (P=0.0434). An inverse relation was noted between the relapse rate and the incidence of extensive cGVHD (P=0.043). It would appear reasonable that the optimal dose of CD34+ cells should be determined based on the disease status or aggressiveness of the malignant cells in each patient. Yet, in the case of patients with a high risk of relapse, transplantation with a CD34+ cell dose of >10.5 x 10(6)/kg would seem to be acceptable to minimize the risk of relapse.

Pseudomonas aeruginosa as a potential cause of antibiotic-associated diarrhea

Although Pseudomonas aeruginosa is not generally considered as a cause of antibiotic-associated diarrhea, several cases of diarrhea caused by P. aeruginosa have been reported. We experienced seven cases of nosocomial diarrhea presumably caused by P. aeruginosa, which was the predominant organism isolated from stool cultures. Clostridium difficile toxin was also positive in one patient. No other potential or recognized enteropathogens were identified from stools. All patients had underlying diseases and had been receiving antibiotics before the diarrheal onset. All of the seven P. aeruginosa isolates were resistant to previously given antibiotics. Diarrhea stopped three days after withdrawal of probable offending antibiotics without specific treatment in two patients. The other five patients having continuous diarrhea despite withdrawal of probable offending antibiotics, were successfully treated with antipseudomonal agents. The median duration of diarrhea after the initiation of treatment was 6.3 days. These data suggest that P. aeruginosa can be a potential cause of antibiotic-associated diarrhea. Further investigations are warranted to evaluate the possible etiologic role of P. aeruginosa in antibiotic-associated diarrhea.

Image reconstruction using the wavelet transform for positron emission tomography

We conducted positron emission tomography (PET) image reconstruction experiments using the wavelet transform. The Wavelet-Vaguelette decomposition was used as a framework from which expressions for the necessary wavelet coefficients might be derived, and then the wavelet shrinkage was applied to the wavelet coefficients for the reconstruction (WVS). The performances of WVS were evaluated and compared with those of the filtered back-projection (FBP) using software phantoms, physical phantoms, and human PET studies. The results demonstrated that WVS gave stable reconstruction over the range of shrinkage parameters and provided better noise and spatial resolution characteristics than FBP.

Carriage of antibiotic-resistant pneumococci among Asian children: a multinational surveillance by the Asian Network for Surveillance of Resistant Pathogens (ANSORP)

To investigate the nasal carriage of antibiotic-resistant pneumococci by children, anterior nasal swabs were done for 4963 children <5 years old in 11 countries in Asia and the Middle East. In total, 1105 pneumococci isolates (carriage rate, 22.3%) were collected, 35.8% of which were found to be nonsusceptible to penicillin. Prevalence of penicillin nonsusceptibility was highest in Taiwan (91.3%), followed by Korea (85.8%), Sri Lanka (76.5%), and Vietnam (70.4%). Penicillin resistance was related to residence in urban areas, enrollment in day care, and a history of otitis media. The most common serogroups were 6 (21.5%), 23 (16.5%), and 19 (15.7%). The most common clone, as assessed by pulsed-field gel electrophoresis, was identical to the Spanish 23F clone and to strains of invasive isolates from adult patients. Data in this study documented the high rate of penicillin or multidrug resistance among isolates of pneumococci carried nasally in children in Asia and the Middle East and showed that this is due to the spread of a few predominant clones in the region.

Production of recombinant bovine lactoferrin N-lobe in insect cells and its antimicrobial activity

Lactoferrin is a multifunctional, iron-binding glycoprotein found in physiological fluids of mammals. In the present study, a gene encoding the N-terminal half (N-lobe) of bovine lactoferrin was cloned and expressed in cultured insect cells using a baculovirus expression system. One mutation was found in the lactoferrin N-lobe gene, but it resulted in no amino acid substitution. The recombinant lactoferrin N-lobe was secreted into the culture medium and partially purified by means of an immobilized heparin column. The recombinant lactoferrin N-lobe secreted was not glycosylated, but it possessed antimicrobial activity toward Escherichia coli O111. The recombinant product synthesized and accumulated in the host cells exhibited greater electrophoretic mobility on SDS-PAGE than the secreted product and showed no potency to inhibit the growth of bacteria. It is thought that the product accumulated intracellularly lacks antimicrobial ability due to its degradation in the host cells or due to disruption of the active conformation.

Epidemiological usefulness of anti-opacity factor antibody screening in schoolchildren

The presence of the anti-opacity factor (anti-OF) antibody (Ab) in the serum used for identifying the OF antigen (Ag) type represents previous or current infection with group A streptococci (GAS) of the OF Ag type. Throat cultures were taken from 172 elementary schoolchildren in Chinju, Korea, and venous blood samples were collected at the same time to screen for the frequency of the anti-OF Ab. After isolation of GAS, the OF Ag of each GAS was identified by inhibition of the opacity reaction with recognized anti-OF sera. The anti-OF Abs in the sera were screened with the six most common OF Ag types. OF22 and OF28 were high in prevalence (28.2 and 20.5%, respectively) among OF Ag types, while anti-OF types 4, 28, and 22 were frequently identified (39.5, 29.7, and 15.7%, respectively) in the sera. Thirty-two of 39 (82.1%) OF Ag-producing GAS carriers, 25 of 34 (73.5%) GAS carriers not producing OF Ag, and 72 of 99 (72.7%) throat culture-negative children harbored the anti-OF Ab. Forty-five (26.2%) of 172 children had two different anti-OF Abs, and 11 (6.4%) had more than three anti-OF Abs. Seventy-five percent of 172 elementary schoolchildren were shown to be previously or currently infected with GAS. The percentages of children positive for the anti-OF Ab were very high regardless of the result of throat culture or OF Ag production of GAS. We could also demonstrate (i) that the prevalent strains of GAS changed according to the time span by determining the difference between the frequencies of OF Ag and anti-OF Ab and (ii) that repeated infections were not uncommon in schoolchildren, as one-third had more than two different anti-OF Abs.

Wavelet methods for inverting the Radon transform with noisy data

Because the Radon transform is a smoothing transform, any noise in the Radon data becomes magnified when the inverse Radon transform is applied. Among the methods used to deal with this problem is the wavelet-vaguelette decomposition (WVD) coupled with wavelet shrinkage, as introduced by Donoho (1995). We extend several results of Donoho and others here. First, we introduce a new sufficient condition on wavelets to generate a WVD. For a general homogeneous operator, whose class includes the Radon transform, we show that a variant of Donoho's method for solving inverse problems can be derived as the exact minimizer of a variational problem that uses a Besov norm as the smoothing functional. We give a new proof of the rate of convergence of wavelet shrinkage that allows us to estimate rather sharply the best shrinkage parameter needed to recover an image from noise-corrupted data. We conduct tomographic reconstruction computations that support the hypothesis that near-optimal shrinkage parameters can be derived if one can estimate only two Besov-space parameters about an image f. Both theoretical and experimental results indicate that our choice of shrinkage parameters yields uniformly better results than Kolaczyk's (1996) variant of Donoho's method and the classical filtered backprojection method.

Korean Nationwide Surveillance of Antimicrobial Resistance of Bacteria in 1998

Antimicrobial resistance surveillance can provide information needed for empirical therapy of antimicrobial agents and for control of resistance. To determine the trend of antimicrobial resistance in Korea, in vitro susceptibility data in 1998 were collected from 25 hospitals participating to a program of Korean Nationwide Surveillance of Antimicrobial Resistance (KONSAR). The data were analyzed based upon hospital location and bed capacity. The results showed that cefoxitin-resistant E. coli and K. pneumoniae and 3rd-generation cephalosporin-resistant K. pneumoniae were prevalent, that 3rd-generation cephalosporin-resistant E. cloacae, S. marcesens and A. baumannii had increased, and ampicillin-resistant S. enterica were not rare. Oxacillin-resistant S. aureus, penicillin-non-susceptible pneumococci and beta-lactamase-producing H. influenzae were prevalent even smaller hospitals surveyed, and an increase of imipenem-resistant P. aeruginosa and vancomycin-resistant E. faecium is a new obvious threat. In general, resistance rates to some old antimicrobial agents, i.e., E. coli to ampicillin and S. aureus to oxacillin were high and did not vary greatly between the different levels of hospitals, while the rates to some of the newer ones, i.e., P. aeruginosa to imipenem, was quite variable and depended on the hospitals, probably reflecting difference in selective pressure.

Molecular characterization of multidrug-resistant Streptococcus pneumoniae isolates in Korea. The Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study Group

Pulsed-field gel electrophoresis, ribotyping, and fingerprinting analysis of 22 invasive isolates of multidrug-resistant (MDR) pneumococci from Korea showed that 59 to 82% were genetically related. DNA sequencing of the PBP 2B gene showed relatively uniform alterations in nucleotides (5.4 to 7.8%) and amino acids (3.0 to 4. 3%), while Asn-276-->Lys, Arg-285-->Cys and Ser-305-->Phe substitutions were unique to Korean MDR strains, suggesting the spread of a few epidemic clones of resistant pneumococci within Korea.

Biological deodorization of hydrogen sulfide using porous lava as a carrier of Thiobacillus thiooxidans

Biological deodorization of hydrogen sulfide (H2S) was studied using porous lava as a carrier of Thiobacillus thiooxidans in a laboratory-scale biofilter. Three different samples of porous lava, A, B, and C, which were obtained from Cheju Island in Korea, were used. The water-holding capacities of samples A, B and C were 0.38, 0.25, and 0.47 g-H2O/g-lava, respectively. The pHs and densities of the lava samples ranged from 8.25-9.24 and 920-1190 kg/m3, respectively. The buffering capacities, expressed as the amount of sulfate added to lower the pH to 4, were 60 g-SO4(2-)/kg-lava for sample A, 50 g-SO4(2-)/kg-lava for B, and 90 g-SO4(2-)/kg-lava for C. To investigate the removal characteristics of H2S by the lava biofilters, T. thiooxidans was immobilized on the lava samples. Biofilters A and C showed a removal capacity of 428 g-S.m(-3).h(-1) when H2S was supplied with 428 g-S.m(-3).h(-1) of inlet load at a space velocity (SV) of 300 h(-1). At the same inlet load and SV, the removal capacity of biofilter B was 396 g-S.m(-3).h(-1). The H2S critical loads of biofilters A, B and C at a SV of 400 h(-1) were 396, 157 and 342 g-S.m(-3).h(-1), respectively. It is suggested that natural, porous lava is a promising candidate as a carrier of microorganisms in biofiltration.

Skin temperature and skin blood flow affect bioelectric impedance study of female fat-free mass

PURPOSE

This study examined the effects of skin temperature (Ts) and skin blood flow (SKBF) on bioelectrical impedance (BIA) measurements of body composition in healthy young females.

METHODS

The Lukaski (FFM(LUK)) and Guo (FFM(GUO)) BIA equations for measuring female fat-free mass (FFM) were used. All subjects (N = 20, age = 18-22 yr) underwent the following measurements under three ambient temperatures (T(amb)): Ts and SKBF for the calf, thigh, biceps, and chest; oral temperature (T(OR)); and the BIA measures of resistance (R) and reactance (Xc). The three T(amb) were 17, 25, and 35 degrees C which were considered as cold (CT), neutral (NT), and hot (HT) conditions, respectively. Their underwater weighing (UWW), lung residual volume, and skinfold thickness were measured in the NT. Data were analyzed using repeated measures of ANOVA and Tukey post-hoc test.

RESULTS

We observed that in the CT mean SKBF and Ts decreased (P < 0.05) and R and Xc increased (P < 0.05), compared with those in both NT and HT. However, in the HT both SKBF and Ts increased and R deceased, but Xc remained unchanged relative to the NT. In these subjects, a net change in Ts of 17 degrees C resulted in a net change in the BIA measure of R of 46 ohms or 2.5 ohms per degree C. These changes affected the estimate of FFM(LUK) between CT, NT, and HT, but not the estimate of FFM(GUO) Regarding the two BIA equations for estimating FFM, the Guo equation underestimated FFM(UWW) (P < 0.05) in the CT, NT, and HT, and the Lukaski equation underestimated FFM(UWW) (P < 0.05) only in the CT, compared with that in the UWW technique.

CONCLUSIONS

Ambient temperature affects Ts and SKBF which in turn influence the BIA measures of R and Xc, especially in the cold ambient temperature; the Guo BIA equation consistently underestimated FFM of young nonobese Chinese women in all temperatures; and the Lukaski equation closely approximates the FFM in the neutral and hot conditions compared with the FFM(UWW).

Role of genotypic analysis of the thymidine kinase gene of herpes simplex virus for determination of neurovirulence and resistance to acyclovir

Mutations in the thymidine kinase (TK) gene of herpes simplex virus (HSV) have been associated with resistance to acyclovir (ACY) and possible recognition of neurotropic strains. We sequenced a 335-bp segment of the TK gene to determine the frequency of mutations in HSV strains recovered from dermal, genital, and cerebrospinal fluid (CSF) specimens (n = 200; 102 HSV type 1 [HSV-1] 98 HSV-2 strains). Four polymorphic sites were detected in HSV-1 strains; C513T, A528G, C575T, and C672T. Among the polymorphisms, only C575T resulted in a change of amino acid sequence (residue 192, Ala-->Val). For HSV-2 strains, only one polymorphism (G420T) which resulted in an amino acid substitution (residue 139, Leu-->Phe) was detected. Phenotypic determination of resistance to ACY by a plaque reduction assay of 48 HSV isolates was not correlated with the sequence results of 11 strains in that 7 of these with genotypic polymorphisms were susceptible to the drug in vitro. In addition, of 32 ACY-resistant HSV strains, 28 (87.5%) had no polymorphisms detected in the 335-bp amplicon of the TK gene. There was no statistical difference in the frequency of polymorphisms according to the source of the specimens. We conclude that the detection of nucleic acid polymorphisms in a previously implicated 335-bp segment of the TK gene cannot be interpreted as indicative of either ACY resistance or neurotropism of HSV strains from dermal, genital, and CSF sources.

Clinical characteristics of acute viral lower respiratory tract infections in hospitalized children in Seoul, 1996-1998

This study was performed to investigate the etiologic agents, age distribution, clinical manifestations and seasonal occurrence of acute viral lower respiratory tract infections in children. We confirmed viral etiologies using nasopharyngeal aspirates in 237 patients of the ages of 15 years or younger who were hospitalized for acute lower respiratory tract infection (ALRI) from March 1996 to February 1998 at Samsung Seoul Hospital, Seoul, Korea. The overall isolation rate was 22.1%. The viral pathogens identified were adenovirus (12.7%), influenza virus type A (21.1%), -type B (13.9%), parainfluenza virus type 1 (13.5%), -type 2 (1.3%), -type 3 (16.0%) and respiratory syncytial virus (21.5%). The occurrence of ALRIs was highest in the first year of life, although parainfluenza virus type 1 infection occurred predominantly in the second year of life and influenza virus caused illnesses in all age groups. The specific viruses are frequently associated with specific clinical syndromes of ALRI. The respiratory agents and associated syndromes frequently have characteristic seasonal patterns. This study will help us to estimate the etiologic agents of ALRI, and establish a program for the prevention and treatment. An annual nationwide survey is necessary to understand the viral epidemiology associated with respiratory illnesses in Korea.

Spread of drug-resistant Streptococcus pneumoniae in Asian countries: Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

Antimicrobial susceptibility of 996 isolates of Streptococcus pneumoniae from clinical specimens was investigated in 11 Asian countries from September 1996 to June 1997. Korea had the greatest frequency of nonsusceptible strains to penicillin with 79.7%, followed by Japan (65.3%), Vietnam (60.8%), Thailand (57.9%), Sri Lanka (41.2%), Taiwan (38.7%), Singapore (23.1%), Indonesia (21.0%), China (9.8%), Malaysia (9.0%), and India (3.8%). Serotypes 23F and 19F were the most common. Pulsed-field gel electrophoresis (PFGE) of 154 isolates from Asian countries showed several major PFGE patterns. The serotype 23F Spanish clone shared the same PFGE pattern with strains from Korea, Japan, Singapore, Taiwan, Thailand, and Malaysia. Fingerprinting analysis of pbp1a, pbp2x, and pbp2b genes of 12 strains from six countries also showed identical fingerprints of penicillin-binding protein genes in most strains. These data suggest the possible introduction and spread of international epidemic clones into Asian countries and the increasing problems of pneumococcal drug resistance in Asian countries for the first time.