Virulence and genotypes of white spot syndrome virus infecting Pacific white shrimp Litopenaeus vannamei in north-western Mexico.

White spot syndrome virus (WSSV) has caused substantial global economic impact on aquaculture, and it has been determined that strains can vary in virulence. In this study, the effect of viral load was evaluated by infecting Litopenaeus vannamei with 10-fold serial dilution of tissue infected with strain WSSV Mx-H, and the virulence of four WSSV strains from north-western Mexico was assessed along with their variable number of tandem repeat (VNTR) genotypes in ORF75, ORF94 and ORF125. The LD50 of the Mx-H strain was a dilution dose of 10-7.5 ; the mortality titre was 109.2 LD50 per gram. In shrimp injected with 102.5 to 106.5 LD50 , no significant virulence differences were evident. Using mortality data, the four WSSV strains grouped into three virulence levels. The Mx-F strain (intermediate virulence) and the Mx-C strain (high virulence) showed more genetic differences than those observed between the Mx-G (low-virulence) and Mx-H (high-virulence) strains, in ORF94 and ORF125. The application of high-viral-load inocula proved useful in determining the different virulence phenotypes of the WSSV strains from the Eastern Pacific.

Long-term outcome of transanal irrigation for children with spina bifida.

STUDY DESIGN: Experimental, prospective study. OBJECTIVES: We evaluated the long-term clinical efficacy of transanal irrigation (TAI) and its effect on the quality of life of spina bifida children and their caregivers. SETTING: Republic of Korea. METHOD: Forty-four spina bifida pediatric patients with constipation, fecal incontinence or both, underwent a TAI program at our spina bifida clinic between December 2010 and October 2013. The children and their caregivers were evaluated using a self-administered questionnaire before TAI and at 3 months and 3 years after initiation of the program. RESULTS: Successful treatment outcome was achieved in 38 (86.4%) children after a mean follow-up duration of 33 months (range, 30-36). The mean number of fecal incontinence episodes per week, the number of diaper changes and the total time for bowel care per day before the program decreased at the latest follow-up examination from 7.3 to 0.4 (P<0.001), 1.6 to 0.2 (P<0.001) and 29.2 to 19.4 min (P=0.038), respectively. These results remained constant from short-term follow-up at 3 months to 3 years. Caregivers and children could go out more often (P=0.002), and the emotional impact of bowel care on caregivers decreased (P<0.001). The reported mean overall satisfaction with TAI was 8/10. The common adverse effect during TAI was abdominal discomfort (60.5%). CONCLUSION: We observed a sustained significant improvement in defecation symptoms and quality of life for 3 years in spina bifida children who underwent continuous TAI.

Association of CXCL1 promoter polymorphism with ischaemic stroke in Korean population.

This is a pilot study analysing association of chemokine gene polymorphisms (CXCL1, rs3117604; CXCL2, rs3806792; CCL2, rs2857656 and rs3760396; CCL5, rs2107538) in Korean patients with ischemic stroke (IS) (n = 120) and age-matched controls (n = 267). The CXCL1 gene and particularly T allele of rs3117604 was associated with IS.

Atypical upswing at initial part of phase III in capnograms due to technical cause.

We sporadically experienced three paediatric cases of atypical upswing at the initial part of phase III in the capnograms via side-stream capnometer immediately following endotracheal intubation and mechanical ventilation. No fault was found in the monitor or anaesthetic system including breathing circuits, carbon dioxide (CO2 ) sampling tube, water trap, and unidirectional valves. The upsurge of CO2 disappeared with increasing the respiratory rate; however, it reappeared with decreasing the respiratory rate and vice versa. We experimentally reproduced the phenomenon of overshooting CO2 measurement after the luer lock connection of the sample gas line at the water trap had been unscrewed a little bit.

Prevalence, phenotypic traits and molecular characterization of emetic toxin-producing Bacillus cereus strains isolated from human stools in Korea.

AIMS: To investigate the prevalence and genotypic/phenotypic characters of emetic toxin-producing Bacillus cereus strains isolated from sporadic food poisoning cases in Korea. METHODS AND RESULTS: The prevalence of emetic B. cereus was determined in 56 899 stool samples from sporadic food poisoning cases in Korea between 2004 and 2006. We assessed toxin profiles, phenotypic traits and antibiotic resistance. The molecular subtyping was ascertained using an automated repetitive sequence-based PCR (rep-PCR) system, DiversiLab™, with these emetic strains isolated from sporadic food poisoning cases and other emetic strains isolated from an outbreak and food samples. Emetic B. cereus was present in 0·012% of sporadic food poisoning cases. The prevalence of nheABC, hblCDA, cytK and entFM enterotoxin genes among emetic strains was 100, 14·3, 14·3 and 100%, respectively. Most emetic strains were negative for salicin hydrolysis (100%), starch fermentation (85·7%) and haemolysis (85·7%). One emetic isolate, VK7, exhibited several unique traits, such as harbouring the hbl gene and ability to hydrolyse starch. All isolated strains were highly resistant to ß-lactam antibiotics. All emetic strains except VK7 exhibited an identical rep-PCR banding pattern, while nonemetic strains were classified into various pulsotypes. CONCLUSIONS: Most emetic strains except one isolate exhibited similar genotypic/phenotypic traits and subtyping pattern. Automatic rep-PCR (DiversiLab™) may be used to discriminate emetic strains from nonemetic strains, although we could not distinguish between most emetic strains using that. SIGNIFICANCE AND IMPACT OF THE STUDY: Result of this study may contribute an extended database on the prevalence and toxigenic traits of emetic B. cereus strains isolated from Korea.

Comparison of 2 types of broths and 3 selective agars for the detection of Campylobacter species in whole-chicken carcass-rinse samples.

In this study, we compared the effectiveness of 2 types of Bolton broths and 3 selective media for isolating Campylobacter spp. from naturally contaminated whole-chicken carcass-rinse samples. One hundred chickens were rinsed with buffered peptone water, and the rinses were added to 2× Bolton broth (with or without blood supplementation). The samples were incubated and then streaked onto Preston agar, modified cefoperazone charcoal deoxycholate agar (mCCDA), and Campy-Cefex agar, which was followed by incubation under microaerobic conditions. No statistical differences were observed (P > 0.05) in isolation rate and selectivity between the 2 types of Bolton broths. Among the 3 selective agars, Preston agar yielded a significantly (P < 0.05) better isolation rate and selectivity. The Campy-Cefex agar, which is recommended by many food authorities for its high quantitative detection ability, showed extensive contamination with competing microorganisms and exhibited the lowest isolation rate and selectivity.

Evaluation of selective enrichment broths and chromogenic media for Salmonella detection in highly contaminated chicken carcasses.

We evaluated the effectiveness of 2 selective enrichment broths, Rappaport-Vassiliadis Soy (RVS) and Muller-Kauffmann tetrathionate with novobiocin (MKTTn), for the isolation of Salmonella from chicken carcasses obtained from 3 different types of retail markets. We also compared a chromogenic agar, chromID Salmonella agar (SM-ID 2), with a classic plating medium, xylose lysine deoxycholate agar (XLD). Salmonella were isolated from 118 of the 180 samples (65.5%). Salmonella were detected in 105 samples (88%) plated on XLD and 111 samples (94%) plated on SM-ID 2 when RVS broth was used for enrichment, and 43 samples (36.4%) plated on XLD and 67 samples (56.8%) plated on SM-ID 2 when the MKTTn broth was used. The highest sensitivity was found in the RVS-XLD combination (0.99), followed by RVS-SM-ID 2 (0.97). The specificity of the RVS-SM-ID 2 combination was the highest (0.89), but that of the MKTTn-XLD combination was zero. The results of this study indicate that the selective enrichment broths had a great effect on the sensitivity and specificity of plating media, and our study confirms that the RVS broth is the most suitable enrichment for the investigation of Salmonella in chicken carcasses. This observation suggests that use of RVS broth for selective enrichment and SM-ID 2 for selective isolation may be the best combination to determine the presence of Salmonella in chicken carcasses.

Biological Aging and Periodontal Disease: Analysis of NHANES (2001-2002).

INTRODUCTION: Periodontitis is a chronic inflammatory disease caused by multiple potential contributing factors such as bacterial biofilm infection of the tissues surrounding the teeth and environmental determinants and a dysregulated host response for modifying and resolving the inflammation. Because periodontal disease is a major public health concern with substantial increases in the prevalence and severity in aging populations, previous studies of periodontitis tended to approach the disease as an age-associated outcome across the life span. However, few investigations have considered that, as a chronic noncommunicable disease, periodontitis may not simply be a disease that increases with age but may contribute to more rapid biologic aging. OBJECTIVES: Increasing population data supports the potential disconnect between chronological aging and biologic aging, which would contribute to the heterogeneity of aging phenotypes within chronologic ages across populations. Thus, our aim was to test whether periodontal disease affects biological aging across the life span. METHODS: The prevalence of periodontitis in the adult US population is a portion of the assessment of the National Health and Nutrition Examination Survey (NHANES), which has been ongoing since 1971 through 2-y cycles sampling populations across the country. We used NHANES 2001-2002 to test the hypothesis that the presence/severity of periodontal disease as an exposure variable would negatively affect telomere length, a measure of biological aging, and that this relationship is modified by factors that also affect the progression of periodontitis, such as sex, race/ethnicity, and smoking. RESULTS: The data demonstrated a significant impact of periodontitis on decreasing telomere lengths across the life span. These differences were modulated by age, sex, race/ethnicity, and smoking within the population. CONCLUSION: The findings lay the groundwork for future studies documenting broader effects on biological aging parameters as well as potential intervention strategies for periodontitis in driving unhealthy aging processes. KNOWLEDGE TRANSFER STATEMENT: Periodontitis is a chronic inflammatory disease and dysregulated host response. Shortening of telomeres is a reflection of biologic aging. Decreased telomere lengths with periodontitis are seemingly related to chronic infection and persistent local and systemic inflammation. These findings suggest that periodontitis is not simply a disease of aging but may also transmit chronic systemic signals that could affect more rapid biological aging. Clinicians can use this outcome to recognize the role of periodontitis in driving unhealthy aging processes in patients.

Perkinsus marinus in Crassostrea gigas in the Gulf of California.

To determine the agent responsible for the massive mortalities of the Pacific oyster Crassostrea gigas in northwest Mexico, 30 oysters were sampled after a severe mortality event in 2006 along the Sonoran coast. Histological analyses revealed the presence of a protozoan and Ray's fluid thioglycollate medium (RFTM) assays showed the presence of Perkinsus sp., identified as P. marinus from the DNA sequence of the internal transcribed spacer (ITS) of the ribosomal RNA (rRNA) gene complex. PCR analyses for Marteilia refringens, M. sydneyi, and Haplosporidium costale were negative. P. marinus presence in the Pacific oyster may be responsible for massive mortalities of the oyster, along with other environmental factors in the Gulf of California.

Comparison of the isolation rates and characteristics of Salmonella isolated from antibiotic-free and conventional chicken meat samples.

Salmonella contamination in chicken samples can cause major health problems in humans. However, not only the effects of antibiotic treatment during growth but also the impacts of the poultry slaughter line on the prevalence of Salmonellae in final chicken meat sold to consumers are unknown. In this study, we compared the isolation rates and antimicrobial resistance of Salmonellae among antibiotic-free, conventional, conventional Korean native retail chicken meat samples, and clonal divergence of Salmonella isolates by multilocus sequence typing. In addition, the distribution of extended-spectrum ß-lactamase (ESBL) genes in ESBL-producing Salmonella isolates was analyzed. A total of 72 retail chicken meat samples (n = 24 antibiotic-free broiler [AFB] chickens, n = 24 conventional broiler [CB] chickens, and n = 24 conventional Korean native [CK] chickens) was collected from local retail markets in Seoul, South Korea. The isolation rates of Salmonellae were 66.6% in AFB chickens, 45.8% in CB chickens, and 25% in CK chickens. By analyzing the minimum inhibitory concentrations of ß-lactam antibiotics with the disc-diffusion test, we found that 81.2% of Salmonella isolates from AFB chickens, 63.6% of isolates from CB chickens, and 50% of isolates from CK chickens were ESBL producers; all ESBL-positive isolates had the CTX-M-15 genotype. Interestingly, all ESBL-producing Salmonellae were revealed as ST16 by multilocus sequence typing and had the genetic platform of blaCTX-M gene (IS26-ISEcp1-blaCTX-M-15-IS903), which was first reported in Salmonellae around the world. The Salmonella ST33 strain (S. Hadar) isolated in this study has never been reported in South Korea. In conclusion, our findings showed that antibiotic-free retail chicken meat products were also largely contaminated with ESBL-producing Salmonellae and that their ESBL genes and genetic platforms were the same as those isolated from conventional retail chicken meat products.

Percutaneous vertebroplasty for vertebral compression fractures with and without intravertebral clefts.

We present the clinical and radiological results of percutaneous vertebroplasty in the treatment of 58 vertebral compression fractures in 51 patients at a minimum follow-up of two years. Group 1 consisted of 39 patients, in whom there was no associated intravertebral cleft, whilst group 2 comprised 12 patients with an intravertebral cleft. The Oswestry disability index (ODI) and visual analogue scale (VAS) scores were recorded prospectively. The radiological evidence of kyphotic deformity, vertebral height, leakage of cement and bone resorption around the cement were studied retrospectively, both before and after operation and at the final follow-up. The ODI and VAS scores in both groups decreased after treatment, but the mean score in group 2 was higher than that in group 1 (p = 0.02 (ODI), p = 0.02 (VAS)). There was a greater initial correction of the kyphosis in group 2 than in group 1, although the difference was not statistically significant. However, loss of correction was greater in group 2. Leakage of cement was seen in 24 (41.4%) of 58 vertebrae (group 1, 32.6% (15 of 46); group 2, 75% (9 of 12)), mainly of type B through the basal vertebral vein in group 1 and of type C through the cortical defect in group 2. Resorption of bone around the cement was seen in three vertebrae in group 2 and in one in group 1. There were seven adjacent vertebral fractures in group 1 and one in group 2. Percutaneous vertebroplasty is an effective treatment for osteoporotic compression fractures with or without an intravertebral cleft. Nonetheless, higher rates of complications related to the cement must be recognised in patients in the presence of an intravertebral cleft.

White spot syndrome virus (WSSV) in Litopenaeus vannamei captured from the Gulf of California near an area of extensive aquaculture activity.

For the shrimp farming industry of Mexico, disease outbreaks caused by white spot syndrome virus (WSSV) are relatively recent. Efforts to control the virus are assisted by monitoring for its prevalence in aquaculture systems, but few attempts have been made to search for it in carriers from coastal waters. To search for WSSV carriers in the Gulf of California, we made surveys off the coast of Sinaloa, Mexico, in March 2001, November 2001, and September 2003 using polymerase chain reaction (PCR) assays and histopathology. WSSV-positive shrimp were detected only in November 2001, after hurricane Julliete. This suggested possible dispersal of WSSV to the marine environment from infected shrimp farms.

Effects of cocaine-induced seizures during pregnancy in the rabbit.

The effects of chronic administration of cocaine to pregnant rabbits on maternal seizures and on pregnancy outcome were studied. Cocaine (2, 3 or 4 mg/kg/injection) or saline was administered, I.V., twice daily, from gestation Day 8 (G8) to G29. There were no significant differences in maternal weight gain or pregnancy outcome between saline control animals and animals given a cocaine dose of 2, 3 or 4 mg/kg/injection. Generalized tonic-clonic seizures (GTCSs) were occasionally elicited by the highest dose (4 mg/kg). There were significant individual differences in vulnerability to cocaine-elicited GTCSs in animals given 4 mg/kg/injection. Of this group, 18% were classified as having high vulnerability to seizures, and they experienced a range from 3 to 27 GTCSs. Postnatal mortality of their offspring was significantly increased. The incidence and temporal patterns of GTCSs elicited by chronic, I.V. cocaine in rabbits, at the doses used, are similar to those reported in human cocaine use. These GTCSs may involve different mechanisms from seizures elicited in other animal studies, in which high doses of cocaine are administered I.P. or S.C. Nevertheless, in our animal model, the GTCSs elicited by prenatal cocaine exposure had no detectable effects on pregnancy outcome (except in the highly vulnerable subgroup).

Reconstruction with tenodesis in an adult flatfoot model. A biomechanical evaluation of four methods.

Six fresh-frozen adult cadaveric specimens were mounted in an Instron materials testing machine with use of a cemented intramedullary rod. Angular relationships between the first metatarsal and the talus were recorded with a sonic digitizer. A flatfoot deformity was created by dividing the talonavicular joint capsule (superiorly, medially, and inferiorly), the spring ligament, the anteromedial aspect of the subtalar joint capsule, and the plantar fascia. Angular displacement in the sagittal and transverse planes was recorded at no load and at 100, 350, and 700-newton plantar loads. Each specimen was subjected to four different reconstructions with tenodesis, and the angular relationship between the first metatarsal and the talus was measured at the four levels of load. A reconstruction with use of the peroneus longus tendon was performed by preserving its insertion into the first metatarsal, rerouting the tendon and passing it from medial to lateral through a calcaneal bone tunnel, and anchoring it to the lateral aspect of the calcaneus. A reconstruction with the tibialis tendon was performed by passing the medial third of the tendon from dorsal to plantar through the navicular and from medial to lateral through the calcaneal bone tunnel and securing it to the lateral aspect of the calcaneus. The reconstruction with the tibialis anterior tendon was repeated with the tendon graft routed along the medial aspect of the navicular, directly through the calcaneal bone tunnel. The fourth reconstruction was done with use of an Achilles tendon allograft.(ABSTRACT TRUNCATED AT 250 WORDS)

Culture results and amputation rates in high-pressure paint gun injuries of the hand.

High-pressure paint gun injuries have been well described in the literature, and the use of antibiotics is recommended as part of their management. However, there is no scientific evidence to support the use of antibiotics. In addition, the type of paint injected (water- versus oil-based) has never been investigated to determine the extent of morbidity resulting from these injuries. This study examines the organisms cultured in wounds resulting from these injuries and whether the type of paint injected had an influence on amputation rates. Charts of 35 patients with high-pressure paint gun injuries to their hands were reviewed. The amputation rate was 50% with oil-based paints and 0% with water-based paints. Forty-seven percent of wound cultures were positive, with gram-negative bacteria found in 58% of isolates. Our findings support the use of antibiotics, which should cover both gram-positive and gram-negative organisms.

The effects of surgery type and duration of tourniquet inflation on body temperature.

OBJECTIVE: To identify factors related to the decrease in core body temperature after deflation of a pneumatic tourniquet during unilateral knee surgery under general anaesthesia. METHODS: This observational study recruited 30 patients scheduled for arthroscopic surgery (group A) and 30 patients scheduled for open surgery (group O). Intraoperative oesophageal temperature was measured during tourniquet inflation and every minute for 10 min after deflation. RESULTS: Core temperature decreased significantly after tourniquet deflation in both groups, the decrease being significantly greater in group A than in group O. Duration of tourniquet inflation and type of surgery were correlated with the temperature decrease. CONCLUSIONS: In knee surgery using a tourniquet, the decrease in core body temperature after tourniquet deflation was closely related to the duration of tourniquet inflation and to arthroscopic rather than open surgery. Further studies are required to determine the effect of surgery type on temperature changes, independently of the duration of tourniquet inflation.