Two Cases of Severe Complications Due to an Esophageal Fish Bone Foreign Body.

Cases of foreign body ingestion are encountered relatively often in clinical settings; however, serious complications are rare. In such cases, mediastinal abscess due to esophageal perforation can become a life-threatening complication. We encountered two cases of severe complications due to an esophageal fish bone foreign body. The first case was a 40-year-old male with an intramural esophageal abscess due to a fish bone after eating fish five days before visiting the hospital. The patient underwent surgical treatment, but the esophageal abscess did not improve; so, the abscess was drained through endoscopic mucosal dissection, and the abscess improved. In the second case, a 64-year-old male, who had eaten fish three days before visiting the hospital, had esophageal perforation by a fish bone, and abscess formation in the mediastinum and the lesser sac in the abdominal cavity were observed. Although surgical treatment was performed, the intra-abdominal abscess formation was not controlled; so, percutaneous drainage (PCD) was inserted, and the abscess improved. Both patients were discharged without any complications. Here, we report two cases that were improved through surgical treatments and additional treatments such as endoscopic dissection and PCD.

Spirosoma radiotolerans sp. nov., a gamma-radiation-resistant bacterium isolated from gamma ray-irradiated soil.

A Gram-negative, short-rod-shaped bacterial strain with gliding motility, designated as DG5A(T), was isolated from a rice field soil in South Korea. Phylogenic analysis using 16S rRNA gene sequence of the new isolate showed that strain DG5A(T) belong to the genus Spirosoma in the family Spirosomaceae, and the highest sequence similarities were 95.5 % with Spirosoma linguale DSM 74(T), 93.4 % with Spirosoma rigui WPCB118(T), 92.8 % with Spirosoma luteum SPM-10(T), 92.7 % with Spirosoma spitsbergense SPM-9(T), and 91.9 % with Spirosoma panaciterrae Gsoil 1519(T). Strain DG5A(T) revealed resistance to gamma and UV radiation. Chemotaxonomic data showed that the most abundant fatty acids were summed feature C(16:1) ω7c/C(16:1) ω6c (36.90 %), C(16:1) ω5c (29.55 %), and iso-C(15:0) (14.78 %), and the major polar lipid was phosphatidylethanolamine (PE). The DNA G+C content of strain DG5A(T) was 49.1 mol%. Together, the phenotypic, phylogenetic, and chemotaxonomic data supported that strain DG5A(T) presents a novel species of the genus Spirosoma, for which the name Spirosoma radiotolerans sp. nov., is proposed. The type strain is DG5A(T) (=KCTC 32455(T) = JCM19447(T)).

Etiology and Outcomes of Patients with Extreme Hyperbilirubinemia in Korea: A Retrospective Cohort Study.

Background/Aim: Extreme hyperbilirubinemia is occasionally observed in intensive care unit (ICU) and non-ICU settings. This study examined the etiologies of extreme hyperbilirubinemia (bilirubin level ≥12 mg/dL) and the factors associated with the 30-day mortality. Methods: This retrospective observational cohort study identified 439 patients with extreme hyperbilirubinemia at the Gyeongsang National University Changwon Hospital between 2016 and 2020. The patients were classified into three groups and 11 diseases according to their etiology. The risk factors associated with 30-day mortality at the baseline were investigated using the Cox proportional hazards model. Results: Of 439 patients with extreme hyperbilirubinemia, 287, 78, and 74 were in the liver cirrhosis/malignancy group, the ischemic injury group, and the benign hepatobiliary-pancreatic etiological group, respectively, with corresponding 30-day mortality rates of 42.9%, 76.9%, and 17.6%. The most common disease leading to hyperbilirubinemia was a pancreatobiliary malignancy (28.7%), followed by liver cirrhosis (17.3%), hepatocellular carcinoma (10.9%), and liver metastases (8.4%). The etiologies of hyperbilirubinemia, obstructive jaundice, infection, albumin level, creatinine level, and prothrombin time-international normalized ratio were independently associated with the 30-day mortality. Conclusions: This study suggests three etiologies of extreme hyperbilirubinemia in the ICU and non-ICU settings. The prognosis of patients with extreme hyperbilirubinemia depends largely on the etiology and the presence of obstructive jaundice.

Association of the etiology and peak level of markedly elevated aminotransferases with mortality: a multicenter study.

BACKGROUND: Markedly elevated aminotransferase levels are commonly encountered among hospitalized patients. However, data regarding the trajectory of enzyme elevation and disease-specific prognosis are limited. METHODS: This study included 3237 patients with at least one episode of aspartate aminotransferase or alanine aminotransferase level being higher than 400 U/L between January 2010 and December 2019 at 2 centers. Patients were classified into 5 groups comprising 13 diseases according to etiology. Factors associated with 30-day mortality were evaluated using a logistic regression analysis. RESULTS: The most common disease leading to markedly elevated aminotransferase level was ischemic hepatitis (33.7%), followed by pancreatobiliary disease (19.9%), DILI (12.0%), malignancy (10.8%), and viral hepatitis (7.0%). The 30-day all-cause mortality rate was 21.6%. The mortality rate for patients from the pancreatobiliary, hepatocellular, extrahepatic, malignancy, and ischemic hepatitis groups was 1.7%, 3.2%, 13.8%, 39.9%, and 44.2%, respectively. Age, etiology, and peak aminotransferase levels were independently associated with 30-day mortality. CONCLUSIONS: In patients with markedly elevated liver enzymes, the etiology and peak AST level are significantly associated with mortality.

Case report of laryngeal infection by Clinostomum complanatum 24 days after ingestion of raw fish.

RATIONALE: Clinostomum complanatum is a laryngeal fluke whose hosts include birds and mammals.[1] In humans, infection occurs accidentally during the consumption of raw freshwater fish.[1,2]. PATIENT CONCERNS: A 59-year-old female presented to our hospital with throat pain and globus sensation. The patient had been prescribed Proton Pump Inibitor for 3 weeks at another hospital. The patient continued the medication, but the discomfort persisted, and she was admitted to our hospital for further examination. The patient had eaten raw fish 24 days before, and the symptoms occurred after eating the raw fish. Endoscopy under sedation showed a fluke, with an approximate length of 8.0 mm and width of 3.2 mm, on the interaryepiglottic fold, with active motility on the mucosa. DIAGNOSIS INTERVENTIONS: It was extracted from the larynx using biopsy forceps and identified as C complanatum. OUTCOMES: After the fluke was removed, symptoms improved, and the patient was discharged. The globus symptoms completely resolved at the last follow-up visit. LESSONS: To the best of our knowledge, this is an endoscopically diagnosed and treated case of human infection by C complanatum in Korea after the longest period of infection. This suggests that C complanatum can survive for up to 3 weeks or more in the gastrointestinal tract. Endoscopy is a useful tool for the diagnosis and treatment of patients with atypical extraesophageal symptoms who do not respond to Proton Pump Inibitors.

Dual-color imaging of magnesium/calcium ion activities with two-photon fluorescent probes.

We report two-photon probes (FMg1 and FMg2) that can selectively detect intracellular free Mg(2+) ([Mg(2+)](i)) in live cells and tissues by two-photon microscopy. Combined with BCaM, a two-photon probe for near-membrane Ca(2+) ([Ca(2+)](m)), FMg2 allows dual-color imaging of Mg(2+)/Ca(2+) activities in live cells and [Mg(2+)](i) /[Ca(2+)](m) distributions in live tissues at a depth of 100-200 µm.

A small-molecule two-photon probe for nitric oxide in living tissues.

Two-photon microscopy (TPM) has become an indispensable tool in the study of biology and medicine due to the capability of this method for molecular imaging deep inside intact tissues. For the maximum utilization of TPM, a variety of two-photon (TP) probes for specific applications are needed. In this article, we report a small-molecule TP probe (ANO1) for nitric oxide (NO) that shows a rapid and specific NO response, a 68-fold fluorescence enhancement in response to NO, and a maximum TP-action cross-section of 170 GM (GM: 10(-50) cm(4) photon(-1)) upon reaction with excess NO. This probe can be easily loaded into cells and tissues and can real-time monitor NO in living tissues at 100-180 µm depth for longer than 1200 s through the use of TPM, with minimum interference from other biologically relevant species.

Measurement of pH values in human tissues by two-photon microscopy.

pH values go live! A ratiometric two-photon (TP) probe (NP1, see scheme) that has a significant TP action cross-section, high photostability, negligible toxicity, and can estimate pH values in live cells and human tissues by two-photon microscopy is described. NP1 can detect the difference in pH between live cells from the gastroesophageal junction (GEJ) and the lower esophageal sphincter of patients with and without esophagitis.

Markedly Elevated Aspartate Aminotransferase from Non-Hepatic Causes.

There have been no reports on mortality in patients with markedly elevated aspartate aminotransferase (AST) levels from non-hepatic causes to date. This study aimed to determine the etiologies of markedly elevated AST levels > 400 U/L due to non-hepatic causes and to investigate the factors associated with mortality in these cases. This retrospective study included 430 patients with AST levels > 400 U/L unrelated to liver disease at two centers between January 2010 and December 2021. Patients were classified into three groups according to etiology: skeletal muscle damage, cardiac muscle damage, and hematologic disorder. Binary logistic regression analysis was performed to evaluate the factors associated with 30-day mortality. The most common etiology for markedly elevated AST levels was skeletal muscle damage (54.2%), followed by cardiac muscle damage (39.1%) and hematologic disorder (6.7%). The 30-day mortality rates for the skeletal muscle damage, cardiac muscle damage, and hematologic disorder groups were 14.2%, 19.5%, and 65.5%, respectively. The magnitude of the peak AST level significantly correlated with 30-day mortality, with rates of 12.8%, 26.7%, and 50.0% for peak AST levels < 1000 U/L, <3000 U/L, and ≥3000 U/L, respectively. In the multivariate analysis, cardiac muscle damage (odds ratio [OR] = 2.76, 95% confidence interval [CI] = 1.31−5.80), hematologic disorder (OR = 9.47, 95% CI = 2.95−30.39), peak AST < 3000 U/L (OR = 2.94, 95% CI = 1.36−6.35), and peak AST ≥ 3000 U/L (OR = 9.61, 95% CI = 3.54−26.08) were associated with increased 30-day mortality. Our study revealed three etiologies of markedly elevated AST unrelated to liver disease and showed that etiology and peak AST level significantly affected the survival rate.

A mitochondrial-targeted two-photon probe for zinc ion.

We report a two-photon probe (SZn-Mito) for mitochondrial zinc ions ([Zn2+]m). This probe shows a 7-fold enhancement of two-photon-excited fluorescence in response to Zn2+ with a dissociation constant (Kd(TP)) of 3.1 ± 0.1 nM and pH insensitivity in the biologically relevant range, allowing the detection of [Zn2+]m in a rat hippocampal slice at a depth of 100−200 µm without interference from other metal ions through the use of two-photon microscopy.

Ratiometric detection of mitochondrial thiols with a two-photon fluorescent probe.

We report a ratiometric two-photon probe (SSH-Mito) for mitochondrial thiols. This probe shows a marked blue-to-yellow emission color change in response to RSH, a significant two-photon cross section, good mitochondrial thiol selectivity, low cytotoxicity, and insensitivity to pH over the biologically relevant pH range, allowing the direct visualization of RSH levels in live cells as well as in living tissues at 90-190 µm depth without interference from other biologically relevant species through the use of two-photon microscopy.

Two-photon Lysotrackers for in vivo imaging.

We report two-photon Lysotrackers (CLT-blue and CLT-yellow) that can be excited by 750-840 nm femtosecond laser pulses and emit at 470 and 550 nm, respectively. They can be easily loaded into cells and tissue slices for visualization of lysosomes in live cells and tissues for a long period of time through two-photon microscopy. When combined with appropriate two-photon probes for other biological targets, these novel probes would greatly facilitate the two-photon microscopy colocalization experiments.

Endophytic Isaria javanica pf185 Persists after Spraying and Controls Myzus persicae (Hemiptera: Aphididae) and Colletotrichum acutatum (Glomerellales: Glomerellaceae) in Pepper.

This study endeavored to sustainably control aphids and anthracnose after spraying endophytic Isaria javanica pf185 under field conditions. Under two different tents; one batch of seedlings was sprayed with a 107 conidia/mL I. javanica pf185 suspension; while another was sprayed with 0.05% Tween 80® in distilled water. Six leaf discs from the top; middle; and bottom part of the plant canopy were weekly collected and placed on moistened filter paper in a Petri dish for insecticidal and antifungal bioassays against Myzus persicae and Colletotrichum acutatum. Differences were noticed from the 18th day after spraying with mortality (86.67 ± 0.57% versus 36.67 ± 0.64%) and leaf damage (13.45 ± 0.03% versus 41.18 ± 0.06%) on fungus-treated and controlled, respectively. The corrected insecticidal efficacy was 20.43, 39.82, 72.32, 66.43 and 70.04%, while the corrected fungicidal efficacy was 26.07, 38.01, 53.35, 29.08 and 41.81% during five successive weeks. A positive correlation was evident between insecticidal efficacy and relative humidity (r2 = 0.620) and temperature (r2 = 0.424), respectively. No correlation was found between antifungal activity and relative humidity (r2 = 0.061) and temperature (r2 = 0), respectively. The entomopathogenic fungus survived on leaf surface area and in tissues after spraying.

A two-photon fluorescent probe for thiols in live cells and tissues.

We report a two-photon fluorescent probe (ASS) that can be excited by 780 nm femtosecond pulses and detect thiols in live cells and living tissues at a 90-180 microm depth without interference from other biologically relevant species by two-photon microscopy.

Biological Control of Gom-chwi (Ligularia fischeri) Phytophthora Root Rot with Enterobacter asburiae ObRS-5 to Suppress Zoosporangia Formation and Zoospores Germination.

Gom-chwi (Ligularia fischeri) is severely infected with Phytophthora drechsleri, the causal organism of Phytophthora root rot, an economically important crop disease that needs management throughout the cultivation period. In the present study, Phytophthora root rot was controlled by using bacterial isolates from rhizosphere soils collected from various plants and screened for antagonistic activity against P. drechsleri. A total of 172 bacterial strains were isolated, of which, 49 strains showed antagonistic activities by dual culture assay. In the seedling assay, six out of the 49 strains showed a predominant effect on suppressing P. drechsleri. Among the six strains, the ObRS-5 strain showed remarkable against P. drechsleri when treated with seed dipping or soil drenching. The ObRS-5 strain was identified as Enterobacter asburiae based on 16S ribosomal RNA gene sequences analysis. The bacterial cells of E. asburiae ObRS-5 significantly suppressed sporangium formation and zoospore germination in P. drechsleri by 87.4% and 66.7%, respectively. In addition, culture filtrate of E. asburiae ObRS-5 also significantly inhibited sporangium formation and zoospore germination by 97.0% and 67.6%, respectively. Soil drenched bacterial cells, filtrate, and culture solution of E. asburiae ObRS-5 effectively suppressed Phytophthora root rot by 63.2%, 57.9%, and 81.1%, respectively. Thus, E. asburiae ObRS-5 could be used as a potential agent for the biological control of Phytophthora root rot infecting gom-chwi.

Dibutyl succinate, produced by an insect-pathogenic fungus, Isaria javanica pf185, is a metabolite that controls of aphids and a fungal disease, anthracnose.

BACKGROUND: An entomopathogenic fungus, Isaria javanica pf185, causes mortality in nymphs of the green peach aphid and inhibits the growth of fungal plant pathogens. However, the metabolites of pf185 involved in these antifungal and aphicidal activities are unknown. This study was performed to identify the metabolites with these activities. RESULTS: An antifungal metabolite was purified by repetitive column chromatography and preparative high-performance liquid chromatography. Based on data from mass spectrometry and nuclear magnetic resonance, the active metabolite was identified as dibutyl succinate. The minimum concentration of dibutyl succinate to inhibit germination of conidia of the cause of anthracnose, Colletotrichum acutatum, was 4 mg mL-1 . Dibutyl succinate at 2 µg mL-1 inhibited mycelial growth. It also had strong aphicidal activity against the nymphs of the green peach aphid, Myzus persicae, median lethal concentration (LC50) of 306 mg L-1 at 24 h exposure, and median lethal time (LT50) of 14.5 h at 388 mg L-1 exposure. CONCLUSION: This is the first report indicating that a single metabolite, dibutyl succinate, from the beneficial fungus I. javanica, has potential for use in integrated pest management to inhibit both insect and fungal plant pathogens. © 2018 Society of Chemical Industry.

Effect of acupuncture on anxiety-like behavior during nicotine withdrawal and relevant mechanisms.

Acupuncture, likely the most well-known 'alternative' medical treatment, has been shown to have effects in several types of animal model of drug dependence, including nicotine addiction. We investigated the effect of acupuncture on anxiety-like behavior and corticotrophin-releasing factor (CRF) and neuropeptide Y (NPY) mRNA expression in the amygdala during nicotine withdrawal. Rats were given repeated nicotine injections (0.1mg/kg s.c., once daily for 7 days) or saline. Acupuncture groups were treated with acupuncture at acupoint HT7 or ST36 during withdrawal. The anxiogenic response was measured at 72h after the termination of nicotine injection using an elevated plus maze. CRF and NPY mRNA levels were also evaluated using reverse transcription polymerase chain reaction (RT-PCR) analysis at this time. Rats undergoing nicotine withdrawal (NW) were less likely to explore the open arms of the plus maze compared with the saline-treated controls. The percentage of open arm entries in the HT7 acupuncture group, but not in the ST36 acupuncture group, was significantly increased compared with the NW group. Consistent with this behavior, CRF mRNA levels in the NW group were increased compared with the control group. CRF mRNA levels in the HT7 acupuncture group were significantly decreased compared with the NW group. However, NPY mRNA levels were not different among the groups. These findings indicate that increases in CRF may be involved in the negative affect state associated with nicotine withdrawal and that acupuncture may attenuate anxiety-like behavior following nicotine withdrawal by modulating CRF in the amygdala.

Dual Biocontrol Potential of the Entomopathogenic Fungus, Isaria javanica, for Both Aphids and Plant Fungal Pathogens.

Dual biocontrol of both insects and plant pathogens has been reported for certain fungal entomopathogens, including Beauveria bassiana and Lecanicillum spp. In this study, we demonstrate, for the first time, the dual biocontrol potential of two fungal isolates identified by morphological and phylogenetic analyses as Isaria javanica. Both these isolates caused mortality in the greater wax moth, and hence can be considered entomopathogens. Spores of the isolates were also pathogenic to nymphs of the green peach aphid (Myzus persicae), with an LC50 value of 107 spores/mL 4 days after inoculation and an LT50 of 4.2 days with a dose of 108 spores/mL. In vitro antifungal assays also demonstrated a strong inhibitory effect on the growth of two fungi that are pathogenic to peppers, Colletotrichum gloeosporioides and Phytophthora capsici. These results indicate that I. javanica isolates could be used as novel biocontrol agents for the simultaneous control of aphids and fungal diseases, such as anthracnose and Phytophthora blight, in an integrated pest management framework for red pepper.

Cryptophyte gene regulation in the kleptoplastidic, karyokleptic ciliate Mesodinium rubrum.

Photosynthesis in the ciliate Mesodinium rubrum is achieved using a consortium of cryptophyte algal organelles enclosed in its specialized vacuole. A time-series microarray analysis was conducted on the photosynthetic ciliate using an oligochip containing 15,654 primers designed from EST data of the cryptophyte prey, Teleaulax amphioxeia. The cryptophycean nuclei were transcriptionally active over 13 weeks and approximately 13.5% of transcripts in the ciliate came from the sequestered nuclei. The cryptophyte nuclei and chloroplasts could divide in the ciliate, which were loosely synchronized with host cell division. A large epigenetic modification occurred after the cryptophyte nuclei were sequestered into the ciliate. Most cryptophyte genes involved in the light and dark reactions of photosynthesis, chlorophyll assimilation, as well as in DNA methylation, were consistently up-regulated in the ciliate. The imbalance of division rate between the sequestered cryptophyte nuclei and host nuclei may be the reason for the eventual cessation of the kleptoplastidy.