Hepatitis B virus transmission in pre-adolescent schoolchildren in four multi-ethnic areas of England.

The aim of this study was to estimate the amount of childhood hepatitis B virus transmission in children born in the UK, a very low-prevalence country, that is preventable only by universal hepatitis B immunization of infants. Oral fluid specimens were collected from schoolchildren aged 7-11 years in four inner city multi-ethnic areas and tested for the presence of antibody to hepatitis B core antigen (anti-HBc). Those found positive or indeterminate were followed up with testing on serum to confirm their hepatitis B status. The overall prevalence of anti-HBc in children was low [0.26%, 95% confidence interval (CI) 0.14-0.44]. The estimated average annual incidence of hepatitis B was estimated to be 29.26/100 000 children (95% CI 16.00-49.08). The total incidence that is preventable only by a universal infant immunization programme in the UK was estimated to be between 5.00 and 12.49/100 000. The study demonstrates that the extent of horizontal childhood hepatitis B virus transmission is low in children born in the UK and suggests that schools in the UK are an uncommon setting for the transmission of the virus. Targeted hepatitis B testing and immunization of migrants from intermediate- and high-prevalence countries is likely to be a more effective measure to reduce childhood transmission than a universal infant immunization programme.

Global transcription and metabolic flux analysis of Escherichia coli in glucose-limited fed-batch cultivations.

A time series of whole-genome transcription profiling of Escherichia coli K-12 W3110 was performed during a carbon-limited fed-batch process. The application of a constant feed rate led to the identification of a dynamic sequence of diverse carbon limitation responses (e.g., the hunger response) and at the same time provided a global view of how cellular and extracellular resources are used: the synthesis of high-affinity transporters guarantees maximal glucose influx, thereby preserving the phosphoenolpyruvate pool, and energy-dependent chemotaxis is reduced in order to provide a more economic "work mode." sigma(S)-mediated stress and starvation responses were both found to be of only minor relevance. Thus, the experimental setup provided access to the hunger response and enabled the differentiation of the hunger response from the general starvation response. Our previous topological model of the global regulation of the E. coli central carbon metabolism through the crp, cra, and relA/spoT modulons is supported by correlating transcript levels and metabolic fluxes and can now be extended. The substrate is extensively oxidized in the tricarboxylic acid (TCA) cycle to enhance energy generation. However, the general rate of oxidative decarboxylation within the pentose phosphate pathway and the TCA cycle is restricted to a minimum. Fine regulation of the carbon flux through these pathways supplies sufficient precursors for biosyntheses. The pools of at least three precursors are probably regulated through activation of the (phosphoenolpyruvate-)glyoxylate shunt. The present work shows that detailed understanding of the genetic regulation of bacterial metabolism provides useful insights for manipulating the carbon flux in technical production processes.

Sonography of the hand and foot in foreign body detection.

To evaluate the possibility that sonography might be effective in the clinical detection of foreign bodies in the soft tissues, we used high-resolution sonography to study 10 patients with suspected foreign bodies in the hand and foot. Using ultrasound, we detected foreign bodies (glass, metal wire) in the sole of the foot of two patients and glass in the hand of another. Seven patients were proved to be free of foreign bodies. In an experimental model to ascertain which types of foreign bodies could be detected by ultrasound, wood, glass, and metallic foreign bodies 2.5 cm in length that had been inserted into the flesh of a chicken breast were immediately identified by high-resolution sonography. Ultrasound also pinpointed the surface beneath which the foreign bodies lay and localized all precisely as to depth from the surface. While detection of a foreign body is important, precise localization is crucial to avoid miscalculation of surgery leading to increased tissue damage, blood loss, and an increased risk of complications. This initial study suggests that high-resolution sonography has applicability in both the detection and the precise localization of foreign bodies in the soft tissues, but the sensitivity and specificity of the procedure remains to be determined.