Mycobacterium szulgai pulmonary infection: case report of an uncommon pathogen in Korea

Mycobacterium szulgai (M. szulgai) is an unusual pathogen in a human non-tuberculous mycobacterial infection. Pulmonary infection due to M. szulgai may be clinically and radiologically confused with active pulmonary tuberculosis. In contrast to other non-tuberculous mycobacteria, M. szulgai infection is well controlled by combination antimycobacterial therapy. Most of the previously reported cases of M. szulgai pulmonary infection showed cavitary upper lobe infiltrates. We herein describe a case of pulmonary M. szulgai infection that shows clinical and radiological presentations similar to active pulmonary tuberculosis.

Plant regeneration of Korean wild ginseng (Panax ginseng Meyer) mutant lines induced by γ-irradiation ((60)Co) of adventitious roots

An efficient in vitro protocol has been established for somatic embryogenesis and plantlet conversion of Korean wild ginseng (Panax ginseng Meyer). Wild-type and mutant adventitious roots derived from the ginseng produced calluses on Murashige and Skoog (MS) medium supplemented with 0.5 mg/L 2,4-dichlorophenoxyacetic acid and 0.3 mg/L kinetin; 53.3% of the explants formed callus. Embryogenic callus proliferation and somatic embryo induction occurred on MS medium containing 0.5 mg/L 2,4-dichlorophenoxyacetic acid. The induced somatic embryos further developed to maturity on MS medium with 5 mg/L gibberellic acid, and 85% of them germinated. The germinated embryos were developed to shoots and elongated on MS medium with 5 mg/L gibberellic acid. The shoots developed into plants with well-developed taproots on one-third strength Schenk and Hildebrandt basal medium supplemented with 0.25 mg/L 1-naphthaleneacetic acid. When the plants were transferred to soil, about 30% of the regenerated plants developed into normal plants.

Successful prevention of recurrent anaphylactic events with anti-immunoglobulin E therapy

Anaphylaxis is a fatal and systemic allergic reaction, which can be prevented by avoiding exposure to a causative agent. However, the causative agent cannot be identified in all cases and may be hardly avoided. A 41-year-old man, diagnosed with idiopathic anaphylaxis, experienced 6 anaphylactic events over 7 months, requiring 4 emergency department (ER) visits and 3 epinephrine self-injections. Anti-immunoglobulin E (IgE) therapy was introduced to prevent further anaphylactic events. He experienced no anaphylactic events during 13 months of 4 monthly injections from the beginning until his most recent ER visit because of a similar anaphylactic event. We report a patient who experienced recurrent anaphylactic events that were prevented effectively by anti-IgE therapy with omalizumab. Anti-IgE therapy might be considered as an option to prevent anaphylactic events in patients for whom the causative agent(s) cannot be identified or avoided.

Usefulness of sputum induction with hypertonic saline in a real clinical practice for bacteriological yields of active pulmonary tuberculosis

Background

Mycobacterial identification in active pulmonary tuberculosis (APTB) is confirmative, even though successful rates using self-expectorated sputum are limited. Sputum specimens collected by hypertonic saline nebulization showed higher bacteriologic diagnostic sensitivities over those of self-expectoration, mostly studied in smear-negative or sputum-scarce patients. The efficacy of induced sputum was rarely assessed in real clinical settings.

Methods

A prospective randomized case-control study was performed in one hospital. The subjects highly suspicious of APTB were asked to provide 3 pairs of sputum specimens in 3 consecutive days. The first pairs of the specimens were obtained either by self-expectoration (ES) from the next day of the visit or sputum induction with 7% saline nebulization in clinic (SI), and the other specimens were collected in the same way. The samples were tested in microscopy, culture, and polymerase chain reaction (PCR). The outcomes of the bacteriological diagnosis were compared.

Results

Seventy six patients were assigned to either ES (38 subjects, median age of 51, 65.8% male) or SI (38 subjects, median age of 55, 52.6% male). APTB was clinically confirmed in 51 patients (70.8%), 27 in ES and 24 in SI. Among the APTB, more adequate specimens were collected from SI (41/65, 63.1%) than ES (34/80, 42.5%) (p=0.01). Bacteriological confirmation was achieved in 14 (58.3%) patients in SI, and 13 (48.1%) in ES (p=0.46). In the same-day bacteriological diagnosis with microscopy and PCR, there were positive results for 9 patients (37.5%) in SI and 7 patients (25.9%) in ES (p=0.37).

Conclusion

Sputum induction improves sputum specimen adequacy. It may be useful for the same-day bacteriological diagnosis with microscopic examination and PCR.

Seasonal phenology of Amphorophora agathonica (Hemiptera: Aphididae) and spread of viruses in red raspberry in Washington

Amphorophora agathonica (Hottes) is the primary vector of aphid-transmitted viruses in red raspberry in the Pacific Northwest region of the United States. To better understand the biology of the aphid, we estimated the lower developmental threshold and studied the seasonal activity of A. agathonica in commercial fields in northern Washington state. In addition, we monitored the spread of raspberry viruses (raspberry latent virus and raspberry leaf mottle virus, RLMV) to determine how rapidly fields became infected and whether there was a relationship between aphid presence and infection. The lower developmental threshold of A. agathonica was estimated to be 2.7°C. In the field, apterous and alate aphid populations began rapidly increasing at ≍800 growing degree-days and peaked at 1,050 growing degree-days. RLMV spread rapidly, with 30-60% of plants in four different commercial fields testing positive after three growing seasons. There was no discernible relationship between the presence or abundance of aphids based on 10 leaves sampled per plant location, and the odds of that plant becoming infected with RLMV.

Development of biological control of Tetranychus urticae (Acari: Tetranychidae) and Phorodon humuli (Hemiptera: Aphididae) in Oregon hop yards

The temporal development of biological control of arthropod pests in perennial cropping systems is largely unreported. In this study, the development of biological control of twospotted spider mite, Tetranychus urticae Koch, and hop aphid, Phorodon humuli (Schrank), in a new planting of hop in Oregon is described over a period of 9 yr (2005-2013). Both the abundance and diversity of natural enemies increased over time. Known predators of hop aphid (Coccinellidae and Anthocoridae) were present in all years; however, stable biological control of hop aphid was not achieved in most years and aphicides were required to suppress populations at commercially acceptable levels in 5 of 9 yr. Populations of aphidophagous coccinellids developed synchronously with hop aphid populations, and temporal correlations indicated these are the primary predatory insect associated with hop aphid regulation. However, sampling methods did not assess levels of aphid parasitoids and hyperparasitoids and their contribution to biological control was unquantified. Spider mite biological control was associated primarily with predatory mites (Phytoseiidae) and Stethorus spp. (Coccinellidae). The magnitude of temporal correlations of abundance of these predators with spider mites was found to be greatest on the same sampling dates and at lags of 7-14 d. Stable biological control of spider mites occurred after four field seasons, suppressing spider mites to levels similar to those commonly achieved with chemical control. A survey of 11 commercial hop yards in Oregon documented pest and natural enemy densities under commercial management practices over a period of 4 yr (2008-2011). Natural enemy abundance in commercial hop yards was similar to that of a 2- to 3-yr-old hop yard with limited disturbance. Whereas total reliance on biological control for hop aphid is unlikely to be successful, there appears to be unrealized potential for biological control of spider mites in commercial production. Dynamic action thresholds that consider the value of natural enemies are needed for both pests.

Partial purification and properties of a cysteine protease from citrus red mite Panonychus citri

Several studies have reported that the citrus red mites Panonychus citri were an important allergen of citrus-cultivating farmers in Jeju Island. The aim of the present study was to purify and assess properties of a cysteine protease from the mites acting as a potentially pathogenic factor to citrus-cultivating farmers. A cysteine protease was purified using column chromatography of Mono Q anion exchanger and Superdex 200 HR gel filtration. It was estimated to be 46 kDa by gel filtration column chromatography and consisted of 2 polypeptides, at least. Cysteine protease inhibitors, such as trans poxy-succinyl-L-leucyl-amido (4-guanidino) butane (E-64) and iodoacetic acid (IAA) totally inhibited the enzyme activities, whereas serine or metalloprotease inhibitors did not affect the activities. In addition, the purified enzyme degraded human IgG, collagen, and fibronectin, but not egg albumin. From these results, the cysteine protease of the mites might be involved in the pathogenesis such as tissue destruction and penetration instead of nutrient digestion.

Healthcare-Associated Pneumonia among Hospitalized Patients: Is It Different from Community Acquired Pneumonia?

BACKGROUND

The increasing number of outpatients with multidrug-resistant (MDR) pathogens has led to a new category of pneumonia, termed healthcare-associated pneumonia (HCAP). We determined the differences in etiology and outcomes between patients with HCAP and those with community-acquired pneumonia (CAP) to clarify the risk factors for HCAP mortality.

METHODS

A retrospective study comparing patients with HCAP and CAP at Jeju National University Hospital. The primary outcome was 30-day mortality.

RESULTS

A total of 483 patients (208 patients HCAP, 275 patients with CAP) were evaluated. Patients with HCAP were older than those with CAP (median, 74 years; interquartile range [IQR], 65-81 vs. median, 69 years; IQR, 52-78; p<0.0001). Streptococcus pneumoniae was the major pathogen in both groups, and MDR pathogens were isolated more frequently from patients with HCAP than with CAP (18.8% vs. 4.9%, p<0.0001). Initial pneumonia severity was greater in patients with HCAP than with CAP. The total 30-day mortality rate was 9.9% and was higher in patients with HCAP based on univariate analysis (16.3% vs. 5.1%; odds ratio (OR), 3.64; 95% confidence interval (CI), 1.90-6.99; p<0.0001). After adjusting for age, sex, comorbidities, and initial severity, the association between HCAP and 30-day mortality became non-significant (OR, 1.98; 95% CI, 0.94-4.18; p=0.167).

CONCLUSION

HCAP was a common cause of hospital admissions and was associated with a high mortality rate. This increased mortality was related primarily to age and initial clinical vital signs, rather than combination antibiotic therapy or type of pneumonia.

Clinical characteristics of gastroallergic anisakiasis and diagnostic implications of immunologic tests

Purpose

Recent studies have used the term "gastroallergic anisakiasis" to describe incidental gastrointestinal infection with Anisakis spp. larvae, proposed as a causative agent of food hypersensitivity. However, it is unknown whether this condition represents an independent disease entity distinguishable from acute gastric anisakiasis. To better understand the role of the allergic response in Anisakis infections we examined the clinical and immunological implications of Anisakis-specific IgE.

Methods

A prospective study was performed in a geographic region where the consumption of raw seafood is common. Case subjects who had been clinically diagnosed with gastroallergic anisakiasis were selected, along with controls who frequently ate raw seafood but had never experienced gastroallergic anisakiasis-like symptoms. Clinical and immunological features were compared based on atopic status, sensitization rates to Anisakis, and serum titer of Anisakis-specific IgE.

Results

Seventeen case subjects and 135 controls were included in this study. The case subjects had experienced gastrointestinal symptoms after raw seafood ingestion, along with additional mucocutaneous, respiratory, or multisystemic symptoms. Case subjects were significantly sensitized to Anisakis excretory-secretory product and crude extract compared with controls (76.5% vs 19.3%, P<0.001, and 88.2% vs 30.3%, P<0.001, respectively). Anisakis-specific serum IgE titers were also significantly higher in case subjects than in controls. Both the results of skin prick tests and elevated Anisakis-specific IgE titers (>17.5 kU/L) were found to be reliable indicators for the diagnosis of gastroallergic anisakiasis.

Conclusions

Among patients presenting acute gastric anisakiasis-like symptoms, a diagnosis of gastroallergic anisakiasis may be strongly supported by a high Anisakis-specific IgE titer.

Acapsular clinical Staphylococcus aureus isolates lack agr function

Staphylococcus aureus is a major human pathogen causing community- and hospital-acquired infections. Capsule production of S. aureus confers protection against host defence. There is a lack of information concerning the association of capsular polysaccharide (CP) expression and activity of the accessory gene regulator (agr) in clinical S. aureus isolates. Production of CP and agr expression were assessed in 195 S. aureus isolates from infected patients at a German University Hospital. Northern blot analysis revealed that S. aureus strains with a non-functional agr locus were more likely to be CP-negative than strains with a functional agr locus.

Early plasma soluble receptor for advanced glycation end-product levels are associated with bronchiolitis obliterans syndrome

Early epithelial injury after lung transplantation may contribute to development of bronchiolitis obliterans syndrome (BOS). We evaluated the relationship between early postoperative soluble receptor for advanced glycation end-product (sRAGE) levels, a marker of type I alveolar cell injury and BOS. We performed a cohort study of 106 lung transplant recipients between 2002 and 2006 at the University of Pennsylvania with follow-up through 2010. Plasma sRAGE was measured 6 and 24 h after transplantation. Cox proportional hazards models were used to evaluate the association between sRAGE and time to BOS, defined according to ISHLT guidelines. Sixty (57%) subjects developed BOS. The average time to BOS was 3.4 years. sRAGE levels measured at 6 h (HR per SD of sRAGE: 1.69, 95% CI: 1.11, 2.57, p = 0.02) and 24 h (HR per SD of sRAGE: 1.74, 95% CI: 1.14, 2.65, p = 0.01) were associated with an increased hazard of BOS. Multivariable Cox regression indicated this relationship was independent of potential confounders. Elevated plasma sRAGE levels measured in the immediate postoperative period are associated with the development of BOS. Early epithelial injury after transplantation may contribute to the development of fibrosis in BOS.

Disassembly and physical separation of electric/electronic components layered in printed circuit boards (PCB)

Although printed circuit boards (PCBs) contain various elements, only the major elements (i.e., those with content levels in wt% or over grade) of and precious metals (e.g., Ag, Au, and platinum groups) contained within PCBs can be recycled. To recover other elements from PCBs, the PCBs should be properly disassembled as the first step of the recycling process. The recovery of these other elements would be beneficial for efforts to conserve scarce resources, reuse electric/electronic components (EECs), and eliminate environmental problems. This paper examines the disassembly of EECs from wasted PCBs (WPCBs) and the physical separation of these EECs using a self-designed disassembling apparatus and a 3-step separation process of sieving, magnetic separation, and dense medium separation. The disassembling efficiencies were evaluated by using the ratio of grinding area (E(area)) and the weight ratio of the detached EECs (E(weight)). In the disassembly treatment, these efficiencies were improved with an increase of grinder speed and grinder height. 97.7% (E(area)) and 98% (E(weight)) could be accomplished ultimately by 3 repetitive treatments at a grinder speed of 5500 rpm and a grinder height of 1.5mm. Through a series of physical separations, most groups of the EECs (except for the diode, transistor, and IC chip groups) could be sorted at a relatively high separation efficiency of about 75% or more. To evaluate the separation efficiency with regard to the elemental composition, the distribution ratio (R(dis)) and the concentration ratio (R(conc)) were used. 15 elements could be separated with the highest R(dis) and R(conc) in the same separated division. This result implies that the recyclability of the elements is highly feasible, even though the initial content in EECs is lower than several tens of mg/kg.

Excessive Wnt/β-catenin signaling disturbs tooth-root formation

BACKGROUND AND OBJECTIVE

Wingless-type MMTV integration site family (Wnt)/β-catenin signaling plays an essential role in cellular differentiation and matrix formation during skeletal development. However, little is known about its role in tooth-root formation. In a previous study, we found excessive formation of dentin and cementum in mice with constitutive β-catenin stabilization in the dental mesenchyme. In the present study we analyzed the molar roots of these mice to investigate the role of Wnt/β-catenin signaling in root formation in more detail.

MATERIAL AND METHODS

We generated OC-Cre:Catnb(+/lox(ex3)) mice by intercrossing Catnb(+/lox(ex3)) and OC-Cre mice, and we analyzed their mandibular molars using radiography, histomorphometry and immunohistochemistry.

RESULTS

OC-Cre:Catnb(+/lox(ex3)) mice showed impaired root formation. At the beginning of root formation in mutant molars, dental papilla cells did not show normal differentiation into odontoblasts; rather, they were prematurely differentiated and had a disorganized arrangement. Interestingly, SMAD family member 4 was upregulated in premature odontoblasts. In 4-wk-old mutant mice, molar roots were about half the length of those in their wild-type littermates. In contrast to excessively formed dentin in crown, root dentin was thin and hypomineralized in mutant mice. Biglycan and dentin sialophosphoprotein were downregulated in root dentin of mutant mice, whereas dentin matrix protein 1 and Dickkopf-related protein 1 were upregulated. Additionally, ectonucleotide pyrophosphatase/phosphodiesterase 1 was significantly downregulated in the cementoblasts of mutant molars. Finally, in the cementum of mutant mice, bone sialoprotein was downregulated but Dickkopf-related protein 2 was upregulated.

CONCLUSION

These results suggest that temporospatial regulation of Wnt/β-catenin signaling plays an important role in cell differentiation and matrix formation during root and cementum formation.