Isolation and habitat analysis of Balamuthia mandrillaris from soil.

Balamuthia mandrillaris is a free-living amoeba that causes meningoencephalitis in mammals. Over 200 cases of infection were reported worldwide, with a fatality rate of over 95%. A clear route of infection was unknown for a long time until a girl died of granulomatous amoebic encephalitis (GAE) in California, USA, in 2003 due to infection with B. mandrillaris detected in a potted plant. Since then, epidemiological studies were conducted worldwide to detect B. mandrillaris in soil and other environmental samples. We previously reported the isolation of B. mandrillaris from the soil in Japan; however, the existing B. mandrillaris culture method with BM3 medium and COS-7 cells was unsuccessful. Therefore, in this study, we aimed to conduct soil analysis to determine the growth conditions of B. mandrillaris. B. mandrillaris-positive soils were defined as soils from which B. mandrillaris was isolated and environmental DNA was PCR-positive. Soils inhabited by B. mandrillaris were alkaline, with high electrical conductivity and characteristics of nutrient-rich soils of loam and clay loam. The results of this study suggest a possible reason for the high prevalence of GAE caused by B. mandrillaris among individuals employed in agriculture-related occupations.

Balamuthia mandrillaris amoebic encephalitis mimicking tuberculous meningitis.

A 76-year-old female with no apparent immunosuppressive conditions and no history of exposure to freshwater and international travel presented with headache and nausea 3 weeks before the presentation. On admission, her consciousness was E4V4V6. Cerebrospinal fluid analysis showed pleocytosis with mononuclear cell predominance, elevated protein, and decreased glucose. Despite antibiotic and antiviral therapy, her consciousness and neck stiffness gradually worsened, right eye-movement restriction appeared, and the right direct light reflex became absent. Brain magnetic resonance imaging revealed hydrocephalus in the inferior horn of the left lateral ventricle and meningeal enhancement around the brainstem and cerebellum. Tuberculous meningitis was suspected, and pyrazinamide, ethambutol, rifampicin, isoniazid, and dexamethasone were started. In addition, endoscopic biopsy was performed from the white matter around the inferior horn of the left lateral ventricle to exclude brain tumor. A brain biopsy specimen revealed eosinophilic round cytoplasm with vacuoles around blood vessels, and we diagnosed with amoebic encephalitis. We started azithromycin, flucytosine, rifampicin, and fluconazole, but her symptoms did not improve. She died 42 days after admission. In autopsy, the brain had not retained its structure due to autolysis. Hematoxylin and eosin staining of her brain biopsy specimen showed numerous amoebic cysts in the perivascular brain tissue. Analysis of the 16S ribosomal RNA region of amoebas from brain biopsy and autopsy specimens revealed a sequence consistent with Balamuthia mandrillaris. Amoebic meningoencephalitis can present with features characteristic of tuberculous meningitis, such as cranial nerve palsies, hydrocephalus, and basal meningeal enhancement. Difficulties in diagnosing amoebic meningoencephalitis are attributed to the following factors: (1) excluding tuberculous meningitis by microbial testing is difficult, (2) amoebic meningoencephalitis has low incidence and can occur without obvious exposure history, (3) invasive brain biopsy is essential in diagnosing amoebic meningoencephalitis. We should recognize the possibility of amoebic meningoencephalitis when evidence of tuberculosis meningitis cannot be demonstrated.

Development of an Automatic Chronological Record Creation System Using Voice AI to Facilitate Information Aggregation and Sharing in the Event of a Disaster.

OBJECTIVE: In the event of a disaster, the chain of command and communication of each relevant agency is important. In this study, a chronological record creation system using voice AI (V-CRS) was developed, and an experiment was conducted to determine whether the obtained information could be quickly and easily summarized in chronological order. METHODS: After a lecture by Japanese Disaster Medical Assistant (DMAT) Team members and 8 medical clerks on how to use the developed tool, a comparison experiment was conducted between manual input and V-CRS utilization of the time to compile disaster information. RESULTS: Results proved that V-CRS can collect information gathered at headquarters more quickly than handwriting. It was also suggested that even medical clerks who have never been trained to record information during disasters could record information at the same speed as trained DMAT personnel. CONCLUSION: V-CRS can transcribe audio information even in situations where technical terms and physical units must be recorded, such as radiation disasters. It has been proven that anyone can quickly organize information using this method, to some extent.

A Simple Survey of the Preparation Situation for Resident's Evacuation in Japanese Prefectures After the Fukushima Daiichi Nuclear Power Plant Accident.

The Japanese government formulated the Nuclear Emergency Response Guidelines in response to the Fukushima Daiichi Nuclear Power Plant accident (FDNPP accident) caused by the Great East Japan Earthquake in March 2011. Under these guidelines, Japan has established its current nuclear disaster response system. This manuscript outlines the transition of Japan's nuclear disaster response system before and after the FDNPP accident and also shows the results of a questionnaire survey on the level of preparation the prefecture currently has for the evacuation of residents at the time of a nuclear disaster. About 70% of the prefectures where nuclear facilities are located or adjacent have completed or are in the process of completing evacuation plans, and all except one indicated they have the equipment needed to perform radiation contamination inspections of residents. These results suggest that activities are taking place throughout Japan to build a new disaster response system. It will be important to verify whether the evacuation manuals prepared by prefectural governments are effective through large-scale training and to develop human resources for performing radiation contamination inspections of evacuating residents.

Blackcurrant (Ribes nigrum) Extract Prevents Dyslipidemia and Hepatic Steatosis in Ovariectomized Rats.

Estrogen is involved in lipid metabolism. Menopausal women with low estrogen secretion usually gain weight and develop steatosis associated with abnormal lipid metabolism. A previous study showed that blackcurrant (Ribes nigrum L.) extract (BCE) had phytoestrogen activity. In this study, we examined whether BCE improved lipid metabolism abnormalities and reduced liver steatosis in ovariectomized rats, as a menopausal animal model. Twelve-week-old ovariectomized (OVX) rats were fed a regular diet (Ctrl) or a 3% BCE supplemented diet while sham rats were fed a regular diet for three months. Body weight, visceral fat weight, levels of serum triglycerides, total cholesterol, and LDL cholesterol decreased in the BCE-treated OVX and sham rats, but not in OVX Ctrl rats. The results of hematoxylin and eosin staining revealed that BCE decreased the diameters of adipocytes and the nonalcoholic fatty liver disease activity score. Furthermore, quantitative RTPCR indicated a decreased expression of hepatitis-related genes, such as tumor necrosis factor-α, IL-6, and IL-1ß in OVX rats after BCE treatment. This is the first study that reported improvement of lipid metabolism abnormalities in OVX rats by BCE administration. These results suggest that the intake of BCE alleviated dyslipidemia and prevented nonalcoholic steatohepatitis during menopause in this animal model.

DETERMINATION OF GUT BACTERIAL METABOLITES IN RADIATION EXPOSED MICE.

Gut microflora (GM) impacts human health in various ways, both beneficial and detrimental. Recently, it has attracted attention for its application in treatment, as protective agents, and as biomarkers in radiation exposure. In this study, we focused on organic acids that have not yet been reported to be related to radiation exposure; we measured the pH and organic acid content in the faeces of 0, 2, 4 and 8 Gy-irradiated mice. A common trend of fluctuation of some organic acids was observed in each group, suggesting a correlation between radiation exposure and organic acid fluctuation. Lactate fluctuation was similar between 0 and 2 Gy-, and 4 and 8 Gy-irradiated mice. Based on this finding, we suggest that lactate may also be an organic acid that is greatly affected by irradiation.

Short-term follow-up of intestinal flora in radiation-exposed mice.

Some gastrointestinal bacteria, otherwise known as the 'intestinal flora', can cause severe gastrointestinal problems, including sepsis, which are strongly linked to lifestyle-related diseases, including cardiovascular diseases. Several investigations have focused on the long-term changes in the intestinal flora associated with radiation exposure; however, the short-term effects remain unknown. In this study, we tracked the short-term changes in the intestinal flora of mice exposed to different doses of X-ray irradiation (2 Gy and 4 Gy), focusing only on the lactic acid bacteria Bifidobacterium and Lactobacillus. A decrease in the Lactobacillus abundance was detected immediately after irradiation in individuals exposed to both 2 Gy and 4 Gy irradiation. However, mice exposed to 4 Gy of irradiation showed a remarkable increase in Bifidobacterium, indicating a potential role of these bacteria in regeneration of the intestinal epithelial tissue. Studies on changes in intestinal bacteria as a result of radiation exposure are limited. Therefore, continuation of this field of research is expected to provide important fundamental insight into the mechanisms by which radiation causes damage to the intestinal tissues, contributing to the development of sepsis.

Development of a method to extract protozoan DNA from black soil.

OBJECTIVES: Microorganisms in environmental samples are identified by sequential screening, isolation, and culture steps, followed by the verification of physiological characteristics and morphological classification. Isolation and purification of Amoebae from soil samples is extremely complex, laborious, and time-consuming and require considerable expertise for morphological evaluation. PCR testing of soil DNA seems to be an effective means for protozoa habitat screening. In this study, we added Acanthamoeba sp. (MK strain) to soil and developed a method of extracting protozoan DNA from the soil. METHODS: Soil allophane is a known DNA adsorbing substance that inhibits the PCR reaction. After comparing the soil properties and allophane contents of 7 soil samples, we attempted to combine multiple cell disruption and DNA purification methods to design an optimal soil DNA extraction method that can be used for downstream PCR analysis. RESULTS: We compared five different crushing/refining methods. Amplification of the gene was confirmed by Acanthamoeba specific PCR in protocol V where the concentration of Acanthamoeba in soil (1.0 × 102/g) was the detection limit of PCR. CONCLUSION: The soil DNA extraction method following protocol V allows DNA amplification of protozoa, including Amoeba, which is difficult to cultivate, thus simplifying the investigation of protozoa habitats and genetic analyses.

First report of the isolation of Balamuthia mandrillaris in the northern region of Japan.

Balamuthia mandrillaris is a free-living amoeba that lives in soil and water near human settlements. B. mandrillaris was first isolated from a mandrill baboon that died at the San Diego Zoo Wildlife Park in California in 1986, and the first human infection was reported in 1990. Although reported B. mandrillaris infections are often not properly characterized, it appears that B. mandrillaris invades the living body from the soil and water, either via a wound or the nasal cavity. Most confirmed infections have originated in South and North America. B. mandrillaris inhabits warm climates and is recognized as a pathogen in warm areas such as desert climates and tropical climates. B. mandrillaris has been isolated from environmental samples since 2000, most of which originated from warm areas such as step climates, tropical climates, and desert climates. However, B. mandrillaris may survive in diverse environments, although fewer granulomatous amebic encephalitis patients have been reported in colder Japanese and Northern European regions. In the present study, we conducted a survey of 13 soil samples in Aomori Prefecture located at the northernmost tip of Japan Honshu and successfully isolated one strain of B. mandrillaris from soil for the first time in Japan. In addition, B. mandrillaris gene was detected from several soils. This confirms that B. mandrillaris is capable of spreading to a wider climatic region.