Quantitative trait loci (QTL) associated with resistance of rainbow trout Oncorhynchus mykiss against the parasitic ciliate Ichthyophthirius multifiliis

The parasitic ciliate Ichthyophthirius multifiliis has a low host specificity eliciting white spot disease (WSD) in a wide range of freshwater fishes worldwide. The parasite multiplies rapidly whereby the infection may reach problematic levels in a host population within a few days. The parasite targets both wild and cultured fish but the huge economic impact of the protozoan is associated with mortality, morbidity and treatment in aquacultural enterprises. We have investigated the potential for genetic selection of WSD-resistant strains of rainbow trout. Applying the DNA typing system Affymetrix® and characterizing the genome of the individual fish by use of 57,501 single nucleotide polymorphisms (SNP) and their location on the rainbow trout chromosomes, we have genetically characterized rainbow trout with different levels of natural resistance towards WSD. Quantitative trait loci (QTL) used for the selection of breeders with specific markers for resistance are reported. We found a significant association between resistance towards I. multifiliis infection and SNP markers located on the two specific rainbow trout chromosomes Omy 16 and Omy 17. Comparing the expression of immune-related genes in fish-with and without clinical signs-we recorded no significant difference. However, trout surviving the infection showed high expression levels of genes encoding IgT, T-cell receptor TCRβ, C3, cathelicidins 1 and 2 and SAA, suggesting these genes to be associated with protection.

Drain or No Drain Following Pancreaticoduodenectomy: The Unsolved Dilemma

BACKGROUND AND AIMS

There is no consensus regarding the routine placement of intra-abdominal drains after pancreaticoduodenectomy. We aim to determine the effects of intraperitoneal drain placement during pancreaticoduodenectomy on 30-day postoperative morbidity and mortality.

METHODS

Patients who underwent pancreaticoduodenectomy for pancreatic tumors were identified from the 2014-2015 American College of Surgeons-National Surgical Quality Improvement Program Database. Univariate and multivariate analyses adjusting for known prognostic variables were performed. A subgroup analysis was performed based on the risk for development of postoperative pancreatic leak determined by the pancreatic duct caliber, parenchymal texture, and body mass index.

RESULTS

A total of 6858 patients with pancreatic tumors who underwent pancreaticoduodenectomy were identified in the 2014-2015 American College of Surgeons-National Surgical Quality Improvement Program Database dataset. In all, 87.4% of patients had intraperitoneal drains placed. A 30-day mortality rate was higher in the no-drain group (2.9% vs. 1.7%, P = 0.003). Patients in the drain group had a higher incidence of overall morbidity (49.5% vs. 41.2%, P = 0.0008), delayed gastric emptying (18.1% vs. 13.7%, P = 0.004), pancreatic fistulae (19.4% vs. 9.9%, P ⩽ 0.0001), and prolonged length of hospital stay over 10 days (43.7% vs. 34.9%, P < 0.0001). Subgroup analysis based on risk categories revealed a higher 30-day mortality rate in the no-drain group among patients with high-risk features (3.1% vs. 1.6%, P = 0.02). Delayed gastric emptying and pancreatic fistula development remained significantly higher in the drain group only in the high-risk category. Prolonged length of hospital stay and composite morbidity remained higher in the drain group regardless of the risk category.

CONCLUSION

To our knowledge, this is the largest study to date that aims at clarifying the pros and cons of the intraperitoneal drain placement during pancreaticoduodenectomy for pancreatic tumors. We showed a higher 30-day mortality rate if drain insertion was omitted during pancreaticoduodenectomy in patients with softer pancreatic textures, smaller pancreatic duct caliber, and body mass index over 25. Postoperative 30-day morbidity rate was higher if a drain was inserted regardless of the risk category. Further randomized controlled trials with prospective evaluation of stratification factors for fistula risk are needed to establish a clear recommendation.

Electronic characterization of silicon intercalated chevron graphene nanoribbons on Au(111)

The intrinsic electronic structure of chevron graphene nanoribbons are revealed through in situ silicon intercalation.

Hoarseness as the sole symptom of an impending thoracic aneurysm rupture?

Unilateral vocal cord palsy secondary to thoracic aortic aneurysm is a rare occurrence. Direct compression of the enlarging thoracic aneurysm on the left recurrent laryngeal nerve causes neuronal injury of the nerve, which is manifested as hoarseness. We present a rare case of unilateral vocal cord palsy in a 60-year-old healthy gentleman caused by a large thoracic aortic aneurysm. This rare presentation, with a serious underlying pathology might be misdiagnosed or delayed. Therefore, it is important for us to have high index of suspicion in cases with a rare presentation such as this.

An elderly man with acute anterior neck pain and odynophagia after a meal

The upper aerodigestive tract, specifically the cricopharyngeal area, is the most common site of foreign body impaction. Anatomically, this area is the first constriction of the oesophagus. Fish bones, one of the most common foreign bodies encountered in the throat, tend to get stuck in this area. The movement of this sharp-edged foreign body upon swallowing will induce odynophagia and an acute onset of neck pain. We report a case of a healthy elderly man who complained of sudden anterior neck pain and odynophagia after eating yellowtail scad fish.

First detection and sequence analysis of thebla-CTX-M-15 gene in Lebanese isolates of extended-spectrum-β-lactamase-producingShigella sonnei

The emergence in Shigella species of extended-spectrum beta-lactamases (ESBL) that impart resistance to third-generation cephalosporins is a growing concern world-wide. So far, however, ESBL-producing Shigella have only been reported seven times, albeit from seven different countries. In Lebanon, three ESBL-producing clinical isolates of S. sonnei were recovered from 30 cases of shigellosis diagnosed between July 2004 and October 2005. All three were found to be resistant to amoxycillin, cefotaxime, ceftazidime, aztreonam, trimethoprim/sulphamethoxazole, gentamicin, and kanamycin. Each harboured the bla-CTX-M gene, and the results of sequence analysis indicated this to be of the bla-CTX-M-15 type and encoded on a 70-kb plasmid, flanked by an insertion element (ISEcp1). The bla-TEM-1 gene was also detected on the chromosomes of two of the ESBL-producing isolates. Class-2 integrons containing dhfr1, aadA1 and sat1 genes were detected on the chromosomes of all three isolates but not on the plasmids. Fluoroquinolone-modifying factors [QnrA, QnrB, QnrS or AAC(6')-Ib-cr] were not detected. The results of RAPD analysis, combined with data on antimicrobial susceptibility, indicated that each isolate was unique. In conclusion, the emergence of ESBL-producing isolates of S. sonnei has been demonstrated for the first time in Lebanon. The resistance of these isolates to third-generation cephalosporins was mediated by the CTX-M-15 enzyme, which was plasmid-encoded.

Room-temperature ferromagnetism of all-epitaxial β-Fe-Ge/diamond-Ge/β-Fe-Ge trilayers

We report on the first all-epitaxial ferromagnet/inorganic semiconductor/ferromagnet hybrid heterostructure that exhibits (i) a Ge barrier of diamond crystal structure, (ii) room-temperature ferromagnetic electrodes and (iii) very smooth interfaces. Both bottom- and top-Fe-Ge electrodes exhibit tiny in-plane magnetic anisotropies dominated by a magnetocrystalline contribution of six-fold symmetry originating from the hexagonal symmetry of the B82 (Ni2In) β-Fe-Ge phase. A key result is the absence of any magnetic coupling between these soft-magnetic electrodes for Ge barrier thickness as low as ~2.5 nm, which allows us to easily tune the parallel and antiparallel magnetic alignments by applying suitably small magnetic fields. This confirms the beneficial use of H-surfactant in order to drastically reduce the roughness of the Ge barrier, as revealed by our scanning tunneling microscopy and transmission electron microscopy measurements. This new all-epitaxial ferromagnet/semiconductor hybrid system appears, therefore, to be a promising candidate for the realization of magnetic tunnel junctions with a single crystal semiconductor barrier that are fully compatible with Si-based technology.

Finger photoplethysmogram pulse amplitude changes induced by flow-mediated dilation

This study was conducted to investigate the utility and efficacy of finger photoplethysmogram pulse amplitude (PPG-AC) in comparison with the standard Doppler ultrasound in assessing an endothelial function via flow-mediated dilation (FMD). High-resolution B-mode scanning of the right brachial artery (BA) of 31 healthy subjects aged 39.7 +/- 11.3 (range 22-64) years and 52 risk subjects aged 47.7 +/- 10.8 (range 30-65) years were performed before and after 4 min of upper arm occlusion. Concurrent with the ultrasound measurement (where color Doppler imaging was used to enhance arterial boundary detection), PPG signals were recorded from both index fingers for cross evaluation and comparison. Our results show that the finger PPG-AC exhibits a similar response to that of the well-known BA dilation: following the release of pressure (cuff around the BA), the PPG-AC increases abruptly before slowly decreasing toward the baseline. The peak PPG-AC is reached significantly faster than the peak FMD measured by ultrasound among healthy and risk groups (P < 0.001). The proposed technique using a finger photoplethysmogram can be applied in a rapid and non-invasive assessment of peripheral vascular functions as an alternative low-cost and less operator-dependent tool compared to ultrasound.

Molecular characterisation of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. isolates at a tertiary-care centre in Lebanon

The prevalence of bla CTX-M, bla TEM and bla SHV genes among extended-spectrum beta-lactamase (ESBL)-producing clinical isolates of Escherichia coli (n = 50) and Klebsiella spp. (n = 50) from Lebanon was 96%, 57% and 67%, and 40%, 82% and 84%, respectively. Genotyping revealed that the clonal diversity was unrelated to the presence of bla genes. Sequence analysis of 16 selected isolates identified the bla CTX-M-15, bla TEM-1, bla OXA-1 and six bla SHV genes, as well as the gene encoding the quinolone-modifying enzyme AAC(6')-Ib-cr. The genes encoding CTX-M-15 and AAC(6')-Ib-cr were carried on a 90-kb plasmid of the pC15-1a or pCTX-15 type, which transferred both ESBL production and quinolone resistance from donors to transconjugants.

Adolescent's Attitudes Towards Health Warning Message on Cigarette Packs

A total of 190 secondary four male school students from three schools in Kota Bharu were surveyed on their smoking habits and their attitudes towards the health warning messages on cigarette packs. There were 57 (30.0%) students who were current smokers, 45 (23.7%) students who were ex-smokers and 88 (46.3%) students who have never smoked cigarettes. Nearly all current and ex-smokers (95.1%) as well as non-smokers (94.3%) knew the wording of the health warning message currently displayed on cigarette packs. Almost all the students (95.3%) also knew where the warning message was placed. There were more ex-smokers and non-smokers (70.5%) compared to current smokers (50.0%) who felt that there should be different health warning messages and each should be displayed concurrently on different cigarette packs. The students felt that the current health message was not effective to motivate smokers to quit (score=2.25). Alternative messages which the students felt may be more effective were 'Smoking is dangerous for pregnancy' (score = 3.3), 'Cigarette smoke is dangerous for your child' (score=3.11) and 'Smoking can kill you' (score=3.08). The current health message "Smoking is dangerous for your health' is eighth with a score of only 2.64. The students felt that the least effective message was 'Cigarettes are drugs' (score=2.22). Most of the students (80.0%) felt that the health warning message should be placed at the front instead of on the side of the cigarette pack to be more effective.

Anaemia during pregnancy in rural Kelantan

A retrospective study of anaemia in pregnancy in rural Kelantan was conducted. The study sample consist of 9,860 mothers who had antenatal care at one of the 102 rural health clinics selected and had delivered a live baby. Anaemia in pregnancy was determined by reviewing the antenatal records for the haemoglobin level recorded at the first and last antenatal visit. Estimation of haemoglobin was done either by photocalorimetric methods or the Sahli's method in these rural clinics. At the time of booking, 47.5% of the mothers were anaemic by WHO criteria (Hb < 11.0 g/dl), with 1.9% having less than 9.0 g/dl. Age of mother, parity and late gestational age at the first antenatal visit were associated with anaemia during pregnancy at the time of booking. However, practise of contraception by the mother did not show any association with anaemia in pregnancy. There were 594 mothers (6.0%) who delivered a baby weighing less than 2.5 kg. There was no association between the low birth weight of the child and the status of anaemia in the mother at the last antenatal visit.

Skin cancer caused by chronic arsenical poisoning--a report of three cases

The association of arsenical poisoning with the development of skin cancer is well-known. In Malaysia, arsenic has been shown to coexist with tin in tin-mining land. Our preliminary investigation has shown that the level of arsenic in well water from a tin-mining area is high. We report 3 patients with cutaneous lesions typical of chronic arsenical poisoning such as hyperpigmentation, keratoses and skin cancer. These patients have positive histories of previous domicility in tin-mining areas. We conclude that these patients developed chronic arsenical poisoning from drinking well water polluted with arsenic from the tin-mining soil.

Candida albicans--saprophyte or pathogen?

Skin scrapings taken from toe spaces of 200 healthy volunteers and from toe webs and groins of 150 pediatric patients were cultured for Candida albicans using the serum germ-tube test. The results showed that Candida albicans can be isolated in about 15% of normal toe spaces and 14% of children with normal groins. Although Candida albicans can be found in various grades of athlete's foot and also in some abnormal groins, we believe that it is not necessarily responsible for these conditions and is often present at these sites only as a saprophyte.