National trends in the prevalence of hepatitis B and C in South Korea, before and during the COVID-19 pandemic (2007-2021) - a nationwide representative study

OBJECTIVE

Due to the various changes caused by the COVID-19 pandemic, some infectious diseases showed different epidemiology and prevalence during the pandemic. However, there is a lack of comprehensive studies on trends in the prevalence of hepatitis B and C related to the pandemic. Thus, we compared the prevalence of hepatitis B and C before and during the COVID-19 pandemic in South Korea.

SUBJECTS AND METHODS

We conducted a comprehensive trend analysis with a nationwide serial cross-sectional survey from 2007 to 2021 (n=86,931) using the Korea National Health and Nutrition Examination Survey (KNHANES). The changes in the prevalence of hepatitis B and C were evaluated using a weighted regression model to assess the impact of the COVID-19 pandemic.

RESULTS

From 2007 to 2021, 86,931 Korean adults aged 19 or older were included in the KNHANES data. The prevalence of hepatitis B showed a declining trend until the onset of the pandemic (1.80% in 2007-2009; 1.08% in 2016-2019; and 1.01% in 2020), at which point this trend reversed (1.39% in 2021). The prevalence of hepatitis C remained stable (0.14% in 2007-2009 and 0.18% in 2016-2019), with no particular surge related to the COVID-19 pandemic (βdiff, -0.002; 95% CI, -0.761 to 0.756). For hepatitis B, old age was identified as a pandemic-related vulnerable factor (ratio of odds ratio, 1.68; 95% CI, 1.05-2.70).

CONCLUSIONS

In this study, unlike other infectious diseases, hepatitis B and C did not show a decreasing trend during the pandemic. In particular, hepatitis B showed a rebound trend during the pandemic, which was noticeable in those aged 60 or older. Further studies are needed to support these findings.

Embedding Financial Services in Frequented, Trusted Settings: Building on Families' Pre-existing Economic Mobility Efforts

OBJECTIVE

The aim of this study was to understand parents'/guardians' experiences and aspirations around economic mobility and their impact on the acceptability and use of financial services embedded in frequented, trusted settings such as schools and pediatric clinics.

METHOD

We recruited 18 English-speaking guardians with at least 1 child enrolled in a school for low-income families and eligible for Internal Revenue Service-sponsored free tax preparation. Each participant completed a semistructured interview before tax filing; a subset completed follow-up interviews. We used grounded theory analysis.

RESULTS

We developed the following theoretical model based on our key thematic findings to describe the acceptability and use of financial services within the context of guardians' lived experiences and pre-existing efforts to build economic mobility: Families experience multilevel barriers to economic mobility. Despite these barriers, guardians are proactively working to build economic mobility by empowering the next generation with knowledge, skills, and assets and resiliently pursuing economic goals. As a result, guardians will accept empowering, nonjudgmental, expert, and trustworthy financial services that contribute to their existing efforts. To move from acceptance to use, financial services must be effectively publicized, accessible, and supportive.

CONCLUSION

Financial services may be more acceptable and used if they are embedded in trusted organizations and have expert, supportive staff with lived experience who empower guardians to work toward their economic goals, accessible platforms, and effective publicity. These characteristics may facilitate uptake and economic mobility. Trusted organizations serving young families can partner with financial services to test these findings and help families build economic mobility.

Perceived COVID-19-related anti-Asian discrimination predicts post traumatic stress disorder symptoms among Asian and Asian American young adults

OBJECTIVE

This study investigates the prevalence of COVID-19-related discrimination and the extent to which COVID-19-related discrimination is associated with mental health symptoms among Asians and Asian American (A/AA) young adults during the first three months of the COVID-19 pandemic.

METHODS

We used data from the COVID-19 Adult Resilience Experiences Study (CARES), a cross-sectional online survey conducted in the U.S. Out of 1,001 respondents, 211 A/AA young adults were analyzed for this study.

RESULTS

Sixty-eight percent of A/AA young adults reported that they or their family have experienced COVID-19-related discrimination and approximately 15% of respondents reported verbal or physical assaults. After controlling for covariates including predisposing factors, lifetime discrimination, and pre-existing mental health diagnoses, COVID-19-related discrimination was significantly associated with an increased level of symptoms of posttraumatic stress disorder (PTSD), but not of anxiety or depression. Our study results suggest that COVID-19-related discrimination may contribute to PTSD symptoms among A/AA young adults.

LIMITATIONS

This was cross-sectional data which was collected through online and self-report rather than clinical evaluation.

CONCLUSION

This finding adds greater urgency to develop and implement policy- and individual-level interventions to reduce race-based discrimination among A/AA.

Experiences of COVID-19-related anti-Asian discrimination and affective reactions in a multiple race sample of U.S. young adults

Background

Little remains known about both Asian and Asian American (A/AA) and non-Asian young adults’ experiences and affective reactions regarding COVID-19 anti-Asian discrimination. To our knowledge, this is the first study that explores the nature and impact of COVID-19 anti-Asian discrimination within a multi-racial sample.

Methods

This study uses qualitative open-ended responses from a sub-sample of Wave I of the COVID-19 Adult Resilience Experiences Study (CARES) data collected between March to September 2020. Thematic analysis was used to explore two open-ended questions: “Are there experiences we missed in the survey so far that you wish to describe?” and “What are your thoughts about the current social climate?” The data analysis for this study focused on 113 discrimination or racism-related comments.

Results

A total of 1331 young adults completed an online survey of which 611 provided comments; a multi-racial sample of 95 individuals (65.3% non-Asians, 24.7% A/AA) contributed 113 COVID-19 anti-Asian discrimination or racism-related comments. Two overarching themes were: types of discrimination (societal, interpersonal, intrapersonal) and affective reactions to discrimination (fear, anxiety/distress, hopelessness/depression, and avoidance). Not only did both A/AA and non-Asian participants report witnessing or hearing reports of anti-Asian discrimination, but both groups described having negative affective reactions to anti-Asian discrimination.

Conclusion

Anti-Asian discrimination in the face of COVID may be more widespread than initial reports indicate. Our finding suggests that anti-Asian discrimination is a societal illness that impacts all populations in the U.S. This calls for cross-racial coalitions and solidarity in the fight against discrimination and racism.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11559-1.

Parkinson's disease and the risk of osteoporotic vertebral compression fracture: a nationwide population-based study

Patients with Parkinson's disease (PD) were at higher risk of osteoporotic vertebral compression fractures (OVCF) compared to controls and had elevated mortality rates. Compared to conservative treatment, surgical treatment for OVCF in PD patients seemed to be associated with better outcomes.

INTRODUCTION

The purpose of this study was to evaluate the risk of OVCF in patients with PD.

METHODS

Data from patients over the age of 60 years who were diagnosed with PD were collected between 2004 and 2013 from the Korean National Health Insurance Database (n = 3370). The comparison group (non-PD) consisted of randomly selected patients (five per patient with PD; n = 16,850) matched to the PD group, who were newly diagnosed annually according to age and sex. Cox proportional hazard regressions were used to examine the relationships between osteoporosis, OVCF, surgery for OVCF, and PD. Household income and residential area of patients were also assessed. Overall survival rates were calculated after adjusting for confounding factors, such as hypertension, diabetes mellitus, and chronic kidney disease.

RESULTS

OVCF was developed in 12.5% of patients in the PD group and in 7.4% of patients in the control group. PD was associated with increased risk of osteoporosis (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.21-1.43; p < 0.001), OVCF (HR 1.66; 95% CI, 1.47-1.87; p < 0.001), and surgery for OVCF (HR 2.69; 95% CI, 1.78-4.08; p < 0.001). Household income was not significantly related with development of osteoporosis, incidence of OVCF, or surgery for OVCF. Residential area was statistically associated with osteoporosis, OVCF, and surgery for OVCF. The mortality rate of the PD group was about 1.7 times higher than that of the non-PD group after adjusting for potential confounders, and the mortality rate of the PD with OVCF group was higher than that of the non-PD group, but not significantly (p = 0.09). The survival rate of the PD group with surgery for OVCF showed a trend toward a more positive prognosis compared with that of the PD group with conservative treatment.

CONCLUSIONS

Patients with PD had significantly increased risk of osteoporosis and OVCF. Surgical treatment for OVCF in PD patients was associated with a better prognosis than conservative treatment.

Counting and Surveying Homeless Youth: Recommendations from YouthCount 2.0!, a Community-Academic Partnership

Communities across the United States are increasing efforts to find and count homeless youth. This paper presents findings and lessons learned from a community/academic partnership to count homeless youth and conduct an in depth research survey focused on the health needs of this population. Over a 4 week recruitment period, 632 youth were counted and 420 surveyed. Methodological successes included an extended counting period, broader inclusion criteria to capture those in unstable housing, use of student volunteers in health training programs, recruiting from magnet events for high risk youth, and partnering with community agencies to disseminate findings. Strategies that did not facilitate recruitment included respondent driven sampling, street canvassing beyond known hotspots, and having community agencies lead data collection. Surveying was successful in gathering data on reasons for homelessness, history in public systems of care, mental health history and needs, sexual risk behaviors, health status, and substance use. Youth were successfully surveyed across housing types including shelters or transitional housing (n = 205), those in unstable housing such as doubled up with friends or acquaintances (n = 75), and those who were literally on the streets or living in a place not meant for human habitation (n = 140). Most youth completed the self-report survey and provided detailed information about risk behaviors. Recommendations to combine research data collection with counting are presented.

Longitudinal Trajectories of Food Insecurity Among Children of Immigrants

Although research consistently points to higher rates of food insecurity (FI) among children of immigrants (COI), this is the first study to examine longitudinal trajectories of FI for this group. We used growth curve modeling and data from the 1998 Early Childhood Longitudinal Study-Kindergarten Cohort to compare trajectories of FI for COI and children of U.S.-born parents. After controlling for socioeconomic status and participation in nutrition programs, first- and second-generation COI had significantly higher initial and ongoing rates of FI compared to children of U.S.-born parents. Additional analyses found that all differences between COI and children of U.S.-born parents occurred for families in poverty. We find that COI from poor families have higher rates of FI, with some differences among COI by immigrant generation. Policymakers may need to focus on avenues other than public assistance to reduce FI among COI living in poverty.

Potentiation of Porcine Circovirus 2-induced Postweaning Multisystemic Wasting Syndrome by Porcine Parvovirus Is Associated with Excessive Production of Tumor Necrosis Factor-α

This study investigated the potentiation of porcine circovirus 2 (PCV2)-induced postweaning multisystemic wasting syndrome by porcine parvovirus (PPV) and found it was associated with excessive production of tumor necrosis factor-α (TNF-α). Colostrum-deprived conventional pigs were inoculated intranasally with PCV2 or PPV alone or in combination (PCV2 and PPV). In vitro assay of TNF-α, obtained from alveolar macrophages coinfected with PCV2 and PPV, showed a significant increase in TNF-α compared to single infection of macrophages with either PCV2 or PPV alone ( P < 0.05). All pigs inoculated with PCV2 and PPV developed severe postweaning wasting syndrome, whereas clinical signs (e.g., weight loss) were present but perhaps less severe in either PCV2- or PPV-inoculated pigs. Compared to the pigs inoculated with PCV2 or PPV alone, pigs inoculated dually with PCV2 and PPV showed significantly ( P < 0.05) increased levels of TNF-α. Levels of TNF-α in the sera were reversely correlated with the body weight in pigs experimentally infected with dual inoculation of PCV2 and PPV ( rs = -0.92, P < 0.001). These data suggest that a potentiation of PPV in PCV2-induced PMWS is associated with the excessive production of TNF-α.

Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas)

OBJECTIVES

Serous cystic neoplasm (SCN) is a cystic neoplasm of the pancreas whose natural history is poorly known. The purpose of the study was to attempt to describe the natural history of SCN, including the specific mortality.

DESIGN

Retrospective multinational study including SCN diagnosed between 1990 and 2014.

RESULTS

2622 patients were included. Seventy-four per cent were women, and median age at diagnosis was 58 years (16-99). Patients presented with non-specific abdominal pain (27%), pancreaticobiliary symptoms (9%), diabetes mellitus (5%), other symptoms (4%) and/or were asymptomatic (61%). Fifty-two per cent of patients were operated on during the first year after diagnosis (median size: 40 mm (2-200)), 9% had resection beyond 1 year of follow-up (3 years (1-20), size at diagnosis: 25 mm (4-140)) and 39% had no surgery (3.6 years (1-23), 25.5 mm (1-200)). Surgical indications were (not exclusive) uncertain diagnosis (60%), symptoms (23%), size increase (12%), large size (6%) and adjacent organ compression (5%). In patients followed beyond 1 year (n=1271), size increased in 37% (growth rate: 4 mm/year), was stable in 57% and decreased in 6%. Three serous cystadenocarcinomas were recorded. Postoperative mortality was 0.6% (n=10), and SCN's related mortality was 0.1% (n=1).

CONCLUSIONS

After a 3-year follow-up, clinical relevant symptoms occurred in a very small proportion of patients and size slowly increased in less than half. Surgical treatment should be proposed only for diagnosis remaining uncertain after complete workup, significant and related symptoms or exceptionally when exists concern with malignancy. This study supports an initial conservative management in the majority of patients with SCN.

TRIAL REGISTRATION NUMBER

IRB 00006477.

Exploring Contextual Factors of Youth Homelessness And Sexual Risk Behaviors: A Qualitative Study

CONTEXT

HIV disproportionately affects homeless youth, and interventions to date have had minimal success in reducing sexual risk behaviors in this population. Few qualitative studies have been conducted to provide insight into the influence of homelessness-related factors on sexual risk behaviors.

METHODS

A qualitative study with a quantitative component was conducted with a nonprobability sample of 64 homeless youth aged 14-24; participants were recruited from a variety of venues in Houston between October 2013 and March 2014. Thirteen focus group discussions were conducted; thematic analysis was used to identify themes related to HIV risk.

RESULTS

Participants were predominantly black (75%), sheltered (67%) and aged 18 or older (77%). Youth discussed how the circumstances of their homelessness and the struggle to meet their immediate needs led to behaviors and experiences that put them at risk for HIV. Three themes emerged: Homeless youth frequently engage in risky sexual behavior, sometimes as a way to cope with stress; they often trade sex, either voluntarily or involuntarily, for such necessities as money or a place to sleep; and many experienced childhood sexual victimization or have been victimized since becoming homeless. Youth also described how stress, stigma and self-reliance contributed to their involvement in HIV risk behaviors.

CONCLUSIONS

HIV prevention methods that target stress and stigma while respecting youths' self-reliance may help reduce sexual risk behaviors. Further research is needed to determine suitable behavioral change techniques to address these potentially modifiable factors.

Barriers and facilitators to shelter utilization among homeless young adults

Rates of shelter use among homeless youth are low compared to use of other supportive services, yet research on barriers to shelter use has been conducted in limited regions, specifically in West Coast or Midwest cities. Additionally, while studies have generally focused on barriers to shelter use, studies on what might facilitate shelter use are lacking. This study explores barriers and facilitators to shelter use among homeless young adults from a large city in the Southwest region. Focus groups were conducted with a diverse sample of 49 homeless young adults ages 18-24. Drawing on models of health service use, findings were categorized into two domains--attitudinal and access. Themes related to attitudinal barriers include stigma/shame and self-reliance/pride. Attitudinal facilitators include the desire to extricate themselves from street life and turn their lives in a new direction. Access-related themes include barriers such as a lack of shelters and services available to meet the needs of youth, adverse shelter conditions, staff attitudes that are not acceptable to youth, restrictive shelter rules, restrictive definitions of homelessness, and a desire to differentiate themselves from older homeless individuals. Certain characteristics or circumstances (e.g., being pregnant), having supportive others, and shelters' ability to connect them to other services emerged as access facilitators to shelter use. Implications for policymakers, service providers, and future research are discussed.

Endoplasmic reticulum stress-regulated CXCR3 pathway mediates inflammation and neuronal injury in acute glaucoma

Acute glaucoma is a leading cause of irreversible blindness in East Asia. The mechanisms underlying retinal neuronal injury induced by a sudden rise in intraocular pressure (IOP) remain obscure. Here we demonstrate that the activation of CXCL10/CXCR3 axis, which mediates the recruitment and activation of inflammatory cells, has a critical role in a mouse model of acute glaucoma. The mRNA and protein expression levels of CXCL10 and CXCR3 were significantly increased after IOP-induced retinal ischemia. Blockade of the CXCR3 pathway by deleting CXCR3 gene significantly attenuated ischemic injury-induced upregulation of inflammatory molecules (interleukin-1β and E-selectin), inhibited the recruitment of microglia/monocyte to the superficial retina, reduced peroxynitrite formation, and prevented the loss of neurons within the ganglion cell layer. In contrast, intravitreal delivery of CXCL10 increased leukocyte recruitment and retinal cell apoptosis. Inhibition of endoplasmic reticulum (ER) stress with chemical chaperones partially blocked ischemic injury-induced CXCL10 upregulation, whereas induction of ER stress with tunicamycin enhanced CXCL10 expression in retina and primary retinal ganglion cells. Interestingly, deleting CXCR3 attenuated ER stress-induced retinal cell death. In conclusion, these results indicate that ER stress-medicated activation of CXCL10/CXCR3 pathway has an important role in retinal inflammation and neuronal injury after high IOP-induced ischemia.

Systematic review with meta-analysis: non-invasive assessment of non-alcoholic fatty liver disease--the role of transient elastography and plasma cytokeratin-18 fragments

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) affects 15-40% of the general population. Some patients have non-alcoholic steatohepatitis (NASH) and progressive fibrosis, and would be candidates for monitoring and treatment.

AIM

To review current literature on the use of non-invasive tests to assess the severity of NAFLD.

METHODS

Systematic literature searching identified studies evaluating non-invasive tests of NASH and fibrosis using liver biopsy as the reference standard. Meta-analysis was performed for areas with adequate number of publications.

RESULTS

Serum tests and physical measurements like transient elastography (TE) have high negative predictive value (NPV) in excluding advanced fibrosis in NAFLD patients. The NAFLD fibrosis score comprises of six routine clinical parameters and has been endorsed by current American guidelines as a screening test to exclude low-risk individuals. The pooled sensitivities and specificities for TE to diagnose F ≥ 2, F ≥ 3 and F4 disease were 79% and 75%, 85% and 85%, and 92% and 92% respectively. Liver stiffness measurement often fails in obese patients, but the success rate can be improved with the use of the XL probe. A number of biomarkers have been developed for the diagnosis of NASH, but few were independently validated. Serum/plasma cytokeratin-18 fragments have been most extensively evaluated and have a pooled sensitivity of 66% and specificity of 82% in diagnosing NASH.

CONCLUSIONS

Current non-invasive tests are accurate in excluding advanced fibrosis in NAFLD patients, and may be used for initial assessment. Further development and evaluation of NASH biomarkers are needed.

Prevalence of porcine circovirus types 2a and b in pigs with and without post-weaning multi-systemic wasting syndrome

The objective of this study was to determine the prevalence of porcine circovirus (PCV) type 2 genotypes in pigs with post-weaning multi-systemic wasting syndrome (PMWS) and in pigs that that did not have the disease. Nested PCR was used to analyse tissue from 540 formalin-fixed, paraffin-embedded lymph nodes. The number of PCV2a-positive pigs that had (χ(trend)(2)=54.584, P<0.001) and did not have (χ(trend)(2)=70.066, P<0.001) PMWS decreased significantly between the years 2000 and 2008. However, over this time-period, there was a significant increase in the number of animals infected with PCV2b that had (χ(trend)(2)=31.356, P<0.001) and did not have (χ(trend)(2)=9.494, P<0.001) PMWS. The findings demonstrate a significant overall increase in PCV2b infection in pigs that both have and do not have PMWS. Further studies will be required to determine the potential relationship between PCV2b infection and the increasing incidence of PMWS in Korea.

Expression of interferon-alpha and Mx protein in the livers of pigs experimentally infected with swine hepatitis E virus

Expression of interferon-alpha (IFN-alpha) and Mx protein in the livers of pigs experimentally infected with swine hepatitis E virus (HEV) was examined immunohistochemically. Five infected and five non-infected pigs were killed at 3, 7, 14, 21, 29 and 50 days post-inoculation (dpi). Tissues were collected from each pig at necropsy. Multifocal lymphoplasmacytic hepatitis (P=0.042) and focal hepatocellular necrosis (P=0.037) were significantly more frequent in the swine HEV-infected pigs than in the non-infected control pigs. Immunohistochemical analysis detected expression of IFN-alpha and Mx protein by macrophages/Kupffer cells, lymphocytes and hepatocytes in the livers of infected pigs.

Simultaneous detection of Acidovorax avenae subsp. citrulli and Didymella bryoniae in cucurbit seedlots using magnetic capture hybridization and real-time polymerase chain reaction

To improve the simultaneous detection of two pathogens in cucurbit seed, a combination of magnetic capture hybridization (MCH) and multiplex real-time polymerase chain reaction (PCR) was developed. Single-stranded DNA hybridization capture probes targeting DNA of Acidovorax avenae subsp. citrulli, causal agent of bacterial fruit blotch, and Didymella bryoniae, causal agent of gummy stem blight, were covalently attached to magnetic particles and used to selectively concentrate template DNA from cucurbit seed samples. Sequestered template DNAs were subsequently amplified by multiplex real-time PCR using pathogen-specific TaqMan PCR assays. The MCH multiplex real-time PCR assay displayed a detection threshold of A. avenae subsp. citrulli at 10 CFU/ml and D. bryoniae at 10(5) conidia/ml in mixtures of pure cultures of the two pathogens, which was 10-fold more sensitive than the direct real-time PCR assays for the two pathogens separately. Although the direct real-time PCR assay displayed a detection threshold for A. avenae subsp. citrulli DNA of 100 fg/microl in 25% (1/4 samples) of the samples assayed, MCH real-time PCR demonstrated 100% detection frequency (4/4 samples) at the same DNA concentration. MCH did not improve detection sensitivity for D. bryoniae relative to direct real-time PCR using conidial suspensions or seed washes from D. bryoniae-infested cucurbit seed. However, MCH real-time PCR facilitated detection of both target pathogens in watermelon and melon seed samples (n = 5,000 seeds/sample) in which 0.02% of the seed were infested with A. avenae subsp. citrulli and 0.02% were infested with D. bryoniae.

Effects of a modified live CSFV vaccine on the development of PMWS in pigs infected experimentally with PCV-2

The objective of this study was to determine the effect of vaccination against classical swine fever virus (CSFV) on the development of postweaning multisystemic wasting syndrome (PMWS) in conventional pigs infected experimentally with porcine circovirus type 2 (PCV-2). The pigs infected with PCV-2 and immunised with modified live CSFV developed mild to moderate PMWS, whereas none of the pigs infected with PCV-2 alone or immunised with modified live CSFV alone developed PMWS. Lesions histologically characteristic of PMWS were observed in lymph nodes from the pigs infected with PCV-2 and immunised with modified live CSFV vaccine, and extensive replication of PCV-2 was detected in the nodes by in situ hybridisation.

Detection of porcine circovirus 2 in mammary and other tissues from experimentally infected sows

The aim of this study was to determine whether porcine circovirus 2 (PCV2) may infect the mammary gland of sows and be shed in the milk. Six pregnant sows were inoculated intranasally with PCV2 three weeks before their expected farrowing date and two further sows acted as uninfected controls. The animals remained clinically healthy and farrowed normally. Milk samples were collected from all sows on the first, second and third days of lactation. PCV2 DNA was detected in the milk of infected sows from day 1 of lactation but not in the milk of uninfected controls. PCV2 antigen and DNA were detected in the mammary gland and other tissues by immunohistochemistry and in-situ hybridization, respectively. Simultaneous detection of viral protein and DNA provided molecular evidence of PCV2 infection and replication within these tissues.

Reproduction of Postweaning Multisystemic Wasting Syndrome in Pigs by Prenatal Porcine Circovirus 2 Infection and Postnatal Porcine Parvovirus Infection or Immunostimulation

Postweaning multisystemic wasting syndrome (PMWS) was reproduced in prenatally porcine circovirus 2 (PCV2)-infected pigs by either postnatal infection with porcine parvovirus (PPV) or by immunostimulation. Twenty-four randomly selected piglets from 3 sows, which had been experimentally infected during gestation with PCV2, were randomly divided into 3 groups; group 1 (prenatal PCV2 infection, with postnatal PPV infection), group 2 (prenatal PCV2 infection, with postnatal keyhole limpet hemocyanin, emulsified in incomplete Freund's adjuvant [KLH/ICFA] injection), and group 3 (prenatal PCV2 infection only). Twenty-four randomly selected piglets from 3 uninfected sows were randomly divided into 3 groups; group 4 (no prenatal infection, with postnatal PCV2 and PPV infection), group 5 (no prenatal infection, with postnatal PCV2 infection), and group 6 (negative control pigs). Body weight in negative control pigs (group 6) was increased significantly compared with pigs in groups 1, 2, and 4 at 49, 52, 56, 59, and 63 days of age. The granulomatous inflammatory reaction and lymphoid depletion that are typical lesions in pigs with PMWS were observed in the lymph node of piglets in groups 1, 2, and 4 at 63 days of age. Pigs in group 3 had significantly fewer PCV2-positive cells than those from groups 1,2,4, or 5. When the prenatally PCV2-infected pigs were infected with PPV or injected with immunostimulant in the postnatal period, they developed PMWS. Thus, factors that potentiate the progression of prenatal PCV2 infection to PMWS are postnatal infection with PPV or immune stimulation.

Comparison of a new synthetic, peptide-derived, polyclonal antibody-based, immunohistochemical test with in situ hybridisation for the detection of swine hepatitis E virus in formalin-fixed, paraffin-embedded tissues

A synthetic, peptide-derived, polyclonal antibody-based, immunohistochemical test was developed to detect swine hepatitis E virus (HEV) and was compared with in situ hybridisation for the detection of HEV in formalin-fixed, paraffin-embedded tissues from experimentally infected pigs. Solid-phase peptide synthesis was used to generate peptides from swine HEV open reading frame 2, and the purified peptides were injected into rabbits to produce polyclonal antibodies. The specificity and sensitivity of the test were both 100%. Liver was most consistently positive for swine HEV antigen and RNA by immunohistochemistry and in situ hybridisation, respectively, but both were detected much less frequently in extrahepatic tissues such as lymph node, tonsil, spleen, and intestine. Swine HEV antigen and RNA showed a similar distribution in virus-infected hepatocytes in serial sections. The novel test developed in this study is suitable for consistently detecting swine HEV antigen in formalin-fixed, paraffin-embedded tissues.

Evidence of shedding of porcine circovirus type 2 in milk from experimentally infected sows

Detection of porcine circovirus type 2 (PCV2) was to evaluate the milk from experimentally infected sows using polymerase chain reaction (PCR) and virus isolation. Six pregnant sows were inoculated intranasally with PCV2 at 93 days of gestation, and milk samples were collected from all sows at 1, 3, 6, 9, 12, 15, 18, 21, 24, and 27 days of lactation. PCV2 was detected in milk as early as day 1 of lactation in all six sows. Thereafter, all infected sows remained positive by PCR for PCV2 in milk until 27 days of lactation. In addition, PCV2 itself was isolated from milk collected from a virus-infected sows. These results suggest that PCV2 may be shed in milk following infection of pregnant sows by the virus.

Localisation of swine hepatitis E virus in experimentally infected pigs

The distribution of intravenously inoculated swine hepatitis E virus (HEV) was assessed by in situ hybridisation for a period of 50 days. Evidence of apparent clinical disease was found in only one pig in the HEV infected group. The only gross lesion observed was mildly enlarged mesenteric lymph nodes at 50 days post infection (dpi). Histopathologically, mild lymphoplasmacytic infiltration and focal hepatocellular necrotic lesions were found in HEV-infected pigs. Swine HEV nucleic acids were detected by RT-PCR in the faeces at 3 dpi in 100% of the 18 pigs infected with the virus. Thereafter, the number of positives declined. The most consistent and intense signal was found in the liver of infected animals using in situ hybridisation. The positive cells were hepatocytes, Kupffer cells, bile epithelial cells and interstitial lymphocytes. Swine HEV RNA was localised in the cytoplasm of the hepatocytes, with a slightly granular pattern of staining, but hybridisation signals were not observed in degenerative or vacuolated hepatocytes. HEV was much less frequently detected in extrahepatic tissues such as lymph nodes, tonsil, spleen and small and large intestine. It was concluded that swine HEV had replicated primarily in the hepatocytes and infection resulted in subclinical infection with minimal histopathological changes in the liver.

The effects of transplacental porcine circovirus type 2 infection on porcine epidemic diarrhoea virus-induced enteritis in preweaning piglets

The effects of transplacental porcine circovirus type 2 (PCV2) infection on porcine epidemic diarrhoea virus (PEDV)-induced enteritis were examined in neonatal piglets. Six pregnant sows were randomly allocated to an infected (n = 3) or control group (n = 3). Three pregnant sows were inoculated intranasally with 6 mL of tissue culture fluid containing 1.2 × 10⁵ tissue culture infective doses 50% (TCID₅₀)/mL of PCV2 strain SNUVR000470 three weeks before the expected farrowing date. Three control pregnant sows were similarly exposed to uninfected cell culture supernatants. Thirty piglets from PCV2-infected sows were randomly assigned to two groups (A and B) of 15 piglets each. Another 30 piglets from noninfected sows were randomly assigned to two groups (C and D) of 15 piglets each. The piglets in groups A and C were dosed orally at three days of age with 2 mL of virus stock (1 × 10^6.5 TCID₅₀/mL) of the PEDV strain, SNUVR971496, at the third passage.

The mean villous height and crypt depth (VH:CD) ratio in PEDV-infected piglets from PCV2-infected sows (group A) were significantly different from those of the PEDV-infected piglets from PCV2 negative sows (group C) at 36, 48, and 72 h post-inoculation (hpi) (P < 0.05). In PEDV-infected piglets from PCV2-infected sows (group A), significantly more PEDV nucleic acid was detected in the jejunal tissues (P < 0.05) at 24 hpi than in the same tissues of the PEDV-infected piglets from PCV2 negative sows (group C). Thereafter, at 36, 48, 60, and 70 hpi significantly more PEDV nucleic acid (P < 0.05) was detected in the jejunal tissues of the PEDV-infected piglets from PCV2 negative sows (group C) than those of the PEDV-infected piglets from the PCV2-infected sows (group A). It is concluded that the clinical course of PEDV disease was markedly affected by transplacental infection of PCV2.

Expression of inflammatory cytokines in pigs experimentally infected with Mycoplasma hyopneumoniae

The expression of interleukin-1 (IL-1), tumour necrosis factor-alpha (TNF-alpha) and IL-6 were studied over a period of 35 days in the lungs of pigs experimentally infected with Mycoplasma hyopneumoniae, by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR), morphometric analysis and in-situ hybridization. Fifteen colostrum-deprived pigs aged 14 days were inoculated intranasally with M. hyopneumoniae. IL-1, TNF-alpha and IL-6 were detected by RT-PCR in the lungs of the infected pigs from 7 days post-inoculation (dpi) onwards, but not in the uninfected control pigs. Concurrent expression of all three cytokines was always observed, in association with lung lesions. Inflammatory cytokine-positive cells were detected in the lungs at 7 dpi, their number increasing at 21dpi, and decreasing thereafter. The results suggest that such cytokines play a role in mediating and regulating inflammation in M. hyopneumoniae infection.

Development of in-situ hybridization for the detection of Mycoplasma haemosuis (Eperythrozoon suis) in formalin-fixed, paraffin wax-embedded tissues from experimentally infected splenectomized pigs

Mycoplasma haemosuis DNA was detected in experimentally infected splenectomized pigs by in-situ hybridization (ISH) with a nonradioactive digoxigenin-labelled DNA probe. An 839 base pair DNA probe targeting a 16S rRNA gene was generated by the polymerase chain reaction. Eight 6-week-old pigs were inoculated intraperitoneally with 6 ml of M. haemosuis-infected pig blood and eight negative control pigs were inoculated intraperitoneally with 6 ml of M. haemosuis-free blood. Two pigs from each group were killed for examination at 3, 7, 15 and 30 days post-inoculation (dpi). Red blood cells infected with M. haemosuis were first detected by light microscopy at 3 to 7 dpi. No M. haemosuis was observed in negative control pigs. Hybridization signals were evident in blood from the infected pigs at 3 dpi. The ISH method developed in this study was useful for the detection of M. haemosuis DNA in formalin-fixed, paraffin wax-embedded tissues and may be valuable for studying the pathogenesis of M. haemosuis infection.

Functional recovery after human umbilical cord blood cells transplantation with brain-derived neutrophic factor into the spinal cord injured rat

There have been many efforts to recover neuronal function from spinal cord injuries, but there are some limitations in the treatment of spinal cord injuries. The neural stem cell has been noted for its pluripotency to differentiate into various neural cell types. The human umbilical cord blood cells (HUCBs) are more pluripotent and genetically flexible than bone marrow neural stem cells. The HUCBs could be more frequently used for spinal cord injury treatment in the future. Moderate degree spinal cord injured rats were classified into 3 subgroups, group A: media was injected into the cord injury site, group B: HUCBs were transplanted into the cord injury site, and group C: HUCBs with BDNF (Brain-derived neutrophic factor) were transplanted into the cord injury site. We checked the BBB scores to evaluate the functional recovery in each group at 8 weeks after transplantation. We then, finally checked the neural cell differentiation with double immunofluorescence staining, and we also analyzed the axonal regeneration with retrograde labelling of brain stem neurons by using fluorogold. The HUCBs transplanted group improved, more than the control group at every week after transplantation, and also, the BDNF enabled an improvement of the BBB locomotion scores since the 1 week after its application (P<0.05). 8 weeks after transplantation, the HUCBs with BDNF transplanted group had more greatly improved BBB scores, than the other groups (P<0.001). The transplanted HUCBs were differentiated into various neural cells, which were confirmed by double immunofluorescence staining of BrdU and GFAP & MAP-2 staining. The HUCBs and BDNF each have individual positive effects on axonal regeneration. The HUCBs can differentiate into neural cells and induce motor function improvement in the cord injured rat models. Especially, the BDNF has effectiveness for neurological function improvement due to axonal regeneration in the early cord injury stage. Thus the HUCBs and BDNF have recovery effects of a moderate degree for cord injured rats.

Synthetic Peptide-derived Antibody-based Immunohistochemistry for the Detection of Porcine Circovirus 2 in Pigs with Postweaning Multisystemic Wasting Syndrome

Porcine circovirus 2 (PCV2) was detected consistently in formalin-fixed paraffin wax-embedded lymph node and spleen from experimentally and naturally infected pigs by synthetic peptide-derived polyclonal antibody-based immunohistochemistry. Synthetic peptides were generated from open reading frame 2 of PCV2 by solid-phase peptide synthesis, purified by high performance liquid chromatography, and injected into rabbits to produce polyclonal antibody. Positive cells had large nuclei with abundant cytoplasm, and resembled macrophages. In serial sections, a similar distribution of PCV2 antigen and DNA was confirmed in virus-infected cells by immunohistochemistry and in-situ hybridization, respectively. The immunohistochemical method described was successfully applied to formalin-fixed, paraffin wax-embedded tissues and should prove helpful in diagnosing postweaning multisystemic wasting syndrome.

Birth abnormalities in pregnant sows infected intranasally with porcine circovirus 2

Six pregnant sows were inoculated intranasally at 3 weeks before the expected farrowing date with porcine circovirus 2 (PCV2). The PCV2-inoculated sows showed abortion and premature farrowing, whereas two uninfected negative control sows remained clinically healthy and farrowed normally. PCV2 antigen and DNA were detected by immunohistochemistry and in-situ hybridization, respectively, in lymph node, spleen, thymus, lung, tonsil and liver from both stillborn and liveborn piglets. Simultaneous detection of viral protein and DNA provided molecular evidence of PCV2 infection and replication. The experiment suggested that PCV2 is capable of crossing the placenta, replicating primarily in lymphoid tissues, and inducing reproductive failure.

Expression of mRNA encoding interleukin (IL)-10, IL-12p35 and IL-12p40 in lungs from pigs experimentally infected with Actinobacillus pleuropneumoniae

The expression of mRNA encoding interleukin (IL)-10, IL-12p35 and IL-12p40 was studied, by reverse transcription-polymerase chain reaction and by in situ hybridization with a non-radioactive digoxigenin-labelled cDNA probe, in formalin-fixed, paraffin-wax-embedded lung tissue from pigs experimentally infected with Actinobacillus pleuropneumoniae. Forty-eight 7-week-old colostrum-deprived pigs were randomly allocated to infected (n = 24) or control (n = 24) groups. Three pigs from each group were euthanized at 3, 6, 9, 12, 24, 36, 48 and 60 h post inoculation (hpi). IL-10 mRNA was detected in the lung at 3 hpi, numbers of cells positive for IL-10 increasing at 36 hpi. IL-12p35 mRNA was detected in the lung at 3 hpi, numbers of cells positive for IL-12p35 increasing at 36 and 48 hpi and rapidly decreasing thereafter whereas IL-12p40 mRNA was constitutively expressed at low levels during the experiment. Hybridization signals for IL-10, IL-12p35 and IL-12p40 were always associated with inflammation, in particular with macrophages and neutrophils within alveolar spaces. Expression of these cytokines was minimal in non-lesional lung of A. pleuropneumoniae-infected pigs and in normal lung from control pigs. In situ hybridization of A. pleuropneumoniae and these cytokines in serial sections of lung tissues indicated close co-localization of A. pleuropneumoniae and these cytokines in pleuropneumonia. The results suggest that the expression of IL-10 and IL-12 play a role in pathogenesis of A. pleuropneumoniae infection.

Preliminary analysis of amphibian red cell M ferritin in a novel tetragonal unit cell

The ferritins are a multigene family of proteins that concentrate and store iron in all prokaryotic and eukaryotic cells. 24 monomeric subunits which fold as four-helix bundles assemble to form a protein shell with 432 cubic symmetry and an external diameter of approximately 130 A. The iron is stored inside the protein shell as a mineralized core approximately 80 A in diameter. Recombinant amphibian red cell M ferritin crystallizes in approximately 2 M (NH(4))(2)SO(4) at pH 4.6 in a space group that has not been reported previously. Electron microscopy, precession photography, Patterson and Fourier maps of the native protein and a UO(2)(2+) derivative, and simulations were used to determine that the unit-cell dimensions are a = b = 169.6, c = 481.2 A, alpha = beta = gamma = 90 degrees and the space group is P4(1)2(1)2 or P4(3)2(1)2. A preliminary model of the structure was obtained by molecular replacement, with amphibian red cell L ferritin as the model. In contrast to previously determined ferritin crystal structures which have intermolecular contacts at the twofold and threefold molecular axes, M ferritin crystals have a novel intermolecular interaction mediated by interdigitation of the DE loops of two molecules at the fourfold molecular axes.

Pathogenesis of Swine Influenza Virus Subtype H1N2 Infection in Pigs

The purpose of this study was to elucidate pathogenesis and viral distribution in pigs infected with swine influenza virus subtype H1N2, over a period of 10 days, by morphometric analysis and in-situ hybridization. Fifteen colostrum-deprived pigs aged 3 weeks were inoculated intranasally with virus. Pneumonia was severe at 1 day post-inoculation (dpi), moderate at 3 and 5 dpi, and mild at 7 and 10 dpi. The pulmonary lesion score was correlated with the score of cells positive by in-situ hybridization for swine influenza virus (r(s)= 0.9114, P< 0.05). The distribution of swine influenza virus varied according to the duration of infection. At 1 and 3 dpi, hybridization signals were detected mainly in the bronchial and bronchiolar epithelial cells, but they were detected mainly in the pneumocytes and macrophages (alveolar and interstitial) at 7 and 10 dpi. The results confirmed that swine influenza virus subtype H1N2, isolated in Korea, is a virulent pathogen causing severe pneumonia.

Identification of porcine circovirus type 2 in retrospective cases of pigs naturally infected with porcine epidemic diarrhoea virus

The identification of porcine circovirus type 2 (PCV2) was studied in fresh intestinal tissues by polymerase chain reaction (PCR) and in formalin-fixed, paraffin-wax-embedded intestinal tissues by in situ hybridisation. The tissues came from pigs naturally infected with porcine epidemic diarrhoea virus (PEDV). A total of 35 (32.7%) of 107 small intestinal samples from pigs naturally infected with PEDV were found to be positive using PCR. Positive signals for PCV2 were detected in 32 (29.9%) of 107 small intestinal samples from pigs naturally infected with PEDV by in situ hybridisation. The distribution of positive cells in the jejunum and ileum was multifocal or patchy. Distinct positive labelling was found throughout the lamina propria in the small intestines. The results of this study indicate that PCV2 is highly prevalent in pigs naturally infected with PEDV.

H1 and H7 influenza haemagglutinin structures extend a structural classification of haemagglutinin subtypes

Comparing the structures of H3, H5 and H9 subtype haemagglutinins, we deduced a structural basis for including all 15 influenza subtypes in four clades. H3, H5 and H9 represent three of these clades; we now report the structure of an H7 HA as a representative of the fourth clade. We confirm the structure of the turn at the N-terminus of the conserved central alpha-helix of HA2, and the combination of ionisable residues near the "fusion peptide" as clade-specific features. We compare the structures of three H1 HAs with H5 HA in the same clade, to refine our previous classification and we confirm the division of the clades into two groups of two. We also show the roles of carbohydrate side chains in the esterase-fusion domain boundaries in the formation of clade-specific structural markers.

Antiviral effect of Saccharomyces cerevisiae beta-glucan to swine influenza virus by increased production of interferon-gamma and nitric oxide

The aim of these experiments was to investigate the potential antiviral effect of Saccharomyces cerevisiae beta-glucan on the pneumonia induced by swine influenza virus (SIV). Forty colostrum-deprived 5-day-old piglets were randomly divided into four groups of 10. The 20 pigs in groups 1 and 2 were administered Saccharomyces cerevisiae beta-glucan orally (50 mg/day/pig; En-Bio Technology Co., Ltd) for 3 days before SIV infection and those in groups 3 and 4 were given culture medium/diluent alone. Groups 1 and 3 were inoculated intranasally with 3 ml of tissue culture fluid containing 2 x 10(6) tissue culture infective doses 50% (TCID(50))/ml of SIV and those in groups 2 and 4 were exposed in the same manner to uninfected cell culture supernatant. The microscopic lung lesions induced by SIV infection (group 1 pigs) were significantly more severe than those induced by infection in animals pre-administered beta-glucan (group 3) (P < 0.05). Significantly more SIV nucleic acid was detected in the lungs of pigs experimentally infected with SIV only (group 1) at 5, 7 and 10 days post-inoculation (dpi) compared with lungs from pigs pre-administered beta-glucan and infected with SIV (group 3) (P < 0.05). The concentrations of interferon-gamma (IFN-gamma) and nitric oxide (NO) in bronchoalveolar lavage fluid from pigs pre-administered beta-glucan and infected with SIV (group 3) were significantly higher than for any other group at 7 and 10 dpi for IFN-gamma, and at 5, 7 and 10 dpi for NO (P < 0.05). Saccharomyces cerevisiae beta-glucan reduced the pulmonary lesion score and viral replication rate in SIV-infected pigs. These findings support the potential application of beta-glucan as prophylactic/treatment agent in influenza virus infection.

Genotypic Prevalence of the Adhesin Involved in Diffuse Adherence in Escherichia coli Isolates in Pre-weaned Pigs with Diarrhoea in Korea

A total of 1002 Escherichia coli strains isolated from pre-weaned pigs with diarrhoea on 1114 swine farms were screened for the presence of the adhesin involved in diffuse adherence (AIDA) gene by polymerase chain reaction (PCR). Escherichia coli isolates that carried AIDA genes were also tested by PCR for the detection of five fimbriae (F4, F5, F6, F18 and F41), heat-stable (STa, STb) and heat-labile (LT) enterotoxin, enteroaggregative E. coli heat-stable enterotoxin 1 (EAST1), and Shiga toxin 2 oedema disease (Stx2e) genes. Twenty-three (2.3%) of the 1002 E. coli isolates carried the gene for AIDA. Among 23 isolates shown to carry genes for AIDA, three carried the AIDA gene as the only shown virulence factor. Other isolates carried other virulence factor genes in addition to AIDA. Four isolates carried genes for at least one of the fimbrial adhesins and enterotoxins. Sixteen isolates carried genes for enterotoxins only. The AIDA may represent an additional virulence determinant in pre-weaned pigs with diarrhoea.

The Structure and Receptor Binding Properties of the 1918 Influenza Hemagglutinin

The 1918 influenza pandemic resulted in about 20 million deaths. This enormous impact, coupled with renewed interest in emerging infections, makes characterization of the virus involved a priority. Receptor binding, the initial event in virus infection, is a major determinant of virus transmissibility that, for influenza viruses, is mediated by the hemagglutinin (HA) membrane glycoprotein. We have determined the crystal structures of the HA from the 1918 virus and two closely related HAs in complex with receptor analogs. They explain how the 1918 HA, while retaining receptor binding site amino acids characteristic of an avian precursor HA, is able to bind human receptors and how, as a consequence, the virus was able to spread in the human population.

Reinduced expression of developmental proteins (nestin, small heat shock protein) in and around cerebral arteriovenous malformations

Intermediate filament (IF) nestin and small heat shock protein (sHSP) are developmentally regulated proteins. Nestin is highly expressed on proliferating neuroepithelial stem cells of the developing central nervous system (CNS). During the developmental neurulation stage, nestin is replaced by mature neuronal (neurofilament) or glial cell-specific IFs (glial fibrillary acidic protein, GFAP). Several pathologic states induce astrocytes to synthesize nestin transiently in the mature brain. However, the exact nature of the embryonic conversion from nestin to mature cytoskelton is unclear. In an attempt to define the effect of ischemic hemodynamic stress caused by cerebral arteriovenous malformation (AVM) on the brain parenchyma, we examined the synthesis and cellular distribution of sHSP and nestin in vascular elements of AVMs and in the gliotic area surrounding AVMs. Ten consecutively collected surgical specimens meeting the histological criteria for AVM were immunohistochemically stained using primary antibodies for nestin, HSP27 and alphaB-crystallin. Nestin, HSP27 and alphaB-crystallin mRNA expressions were examined by reverse transcriptase-polymerase chain reaction (RT-PCR). Nestin expression is reinduced not only in reactive astrocytes, but also in endothelial cells in the surrounding gliotic tissue of the cerebral AVM. These cells also expressed sHSP (HSP27, alphaB-crystallin) that maintain the integrity of the IF network and prevent unfolding of cellular proteins induced by various stresses. RT-PCR showed the increased expression of sHSP and nestin mRNA in the AVM specimens. These results indicate that embryonic reversion of the mature cytoskeleton to nestin and the increased expression of sHSP in response to cerebral injury are associated with increased wall tension caused by dilating AVM vessels and with the hemodynamic stress that surrounds AVMs.

Intermediate filament nestin expressions in human cord blood monocytes (HCMNCs)

OBJECTS

Nestin is an intermediate protein and a well-known specific neural stem cell antigen. Some bone marrow stem cells can generate not only blood cells but also neurons and glial cells under specific culture conditions. Furthermore, in vitro cultured bone marrow stem cells also express nestin antigen. However, it is unclear whether cord blood cells also differentiate into neural cells or not. In this study, we investigated the expression of nestin on human cord blood monocytes (HCMNCs) and we discuss the relevance of this finding upon future therapeutic applications of HCMNCs in neurological diseases.

METHODS

HCMNCs were prepared from normal placenta after full-term normal delivery. Immunocytochemical staining and reverse transcriptase polymerase chain reaction (RT-PCR) for nestin and CD133 antigen were performed to confirm nestin and CD133 antigen expression in the HCMNCs.

RESULTS

Some nestin expressing HCMNCs were found. Immunocytochemical staining showed that some of the blood stem cell marker CD133 expressing cells co-expressed nestin. RT-PCR demonstrated nestin and CD133 mRNA in HCMNCs, but not in adult blood monocytes. Approximately, 60 +/- 8% of CD133 expressing cells expressed nestin.

CONCLUSION

In the present study, we found that more than 60% of CD133 expressing HCMNCs also express nestin antigen in their cytoplasm, which supports the idea that cord blood stem cells can adopt a neuronal fate.