Detection of infectious spleen and kidney necrosis virus (ISKNV) and turbot reddish body iridovirus (TRBIV) from archival ornamental fish samples.

Although infections caused by megalocytiviruses have been reported from a wide range of finfish species for several decades, molecular characterisation of the viruses involved has been undertaken only on more recent cases. Sequence analysis of the major capsid protein and adenosine triphosphatase genes is reported here from formalin-fixed, paraffin-embedded material from 2 archival ornamental fish cases from 1986 and 1988 in conjunction with data for a range of genes from fresh frozen tissues from 5 cases obtained from 1991 through to 2010. Turbot reddish body iridovirus (TRBIV) genotype megalocytiviruses, previously not documented in ornamental fish, were detected in samples from 1986, 1988 and 1991. In contrast, megalocytiviruses from 1996 onwards, including those characterised from 2002, 2006 and 2010 in this study, were almost indistinguishable from infectious spleen and kidney necrosis virus (ISKNV). Three of the species infected with TRBIV-like megalocytiviruses from 1986 to 1991, viz. dwarf gourami Trichogaster lalius (formerly Colisa lalia), freshwater angelfish Pterophyllum scalare and oscar Astronotus ocellatus, were infected with ISKNV genotype megalocytiviruses from 2002 to 2010. The detection of a TRBIV genotype isolate in ornamental fish from 1986 represents the index case, confirmed by molecular sequence data, for the genus Megalocytivirus.

Risk of stroke and transient ischaemic attack after herpes zoster.

We assessed the association of herpes zoster (HZ) with stroke/transient ischaemic attack (TIA) in the general population according to age with controlling risk factors for stroke, using a nationwide representative cohort. The study was based on a prospective dynamic cohort consisting of 1 million Koreans representing all age groups, genders and geographical areas in the Korea Health Insurance Database. New events of stroke/TIA and HZ were identified using the diagnostic codes in the International Classification of Diseases, tenth revision. The risk for stroke/TIA after HZ was compared with HZ-free stroke/TIA individuals according to age group. A total of 766 179 adults were followed up for 11 years from 2003. The incidence of the first-diagnosed HZ cases was 9.40 per 1000 person-years, and that of the first-diagnosed stroke/TIA cases was 9.77 per 1000 person-years. The risk for stroke/TIA was higher in patients who had previous HZ episodes than in those who had never experienced HZ (incidence rate ratio 1.90; 95% CI 1.85-1.95). In addition, this risk persisted for several years after HZ. The risk of stroke/TIA after HZ gradually decreased with age; adjusted hazard ratio (HR) 2.04 in 18- to 30-year-olds, HR 1.74 in 30- to 40-year-olds, HR 1.43 in 40- to 50-year-olds, HR 1.23 in 50- to 60-year-olds, HR 1.24 in 60- to 70-year-olds, and HR 1.29 in those >70 years old, after controlling risk factors for stroke/TIA. Our findings provide evidence that HZ carries an increased risk of stroke or TIA and that the effect of HZ on stroke decreases with increasing age.

Family history of diabetes and the risk of subclinical atherosclerosis.

AIM: This study investigated the influence of a family history of diabetes on the risk of subclinical coronary atherosclerosis according to coronary computed tomography angiography (CCTA) in asymptomatic individuals. METHODS: A total of 6434 consecutive asymptomatic individuals with no prior history of coronary artery disease voluntarily underwent CCTA evaluation as part of a general health examination. Coronary atherosclerotic plaque and significant coronary artery stenosis (degree of stenosis ≥50%) on CCTA were assessed. Logistic regression analysis was used to determine the association between a family history of diabetes and atherosclerotic plaque or significant coronary artery stenosis according to the degree of diabetes (normal, prediabetic and diabetic). RESULTS: Mean age of study participants was 53.7±7.6 years, and 4694 (73.0%) were male. A total of 1593 (24.8%) participants had a family history of diabetes in a first-degree relative. Among the study participants, 1115 (17.3%), 3122 (48.5%) and 2197 (34.1%) were categorized as diabetic, prediabetic and normal, respectively. In diabetic participants, after stepwise adjustments for clinical and laboratory variables, a family history of diabetes was significantly associated with non-calcified plaque (P<0.05 for all), but did not appear to be associated with either calcified or mixed plaques or with significant coronary artery stenosis (P>0.05 for all). In prediabetic and normal participants, a family history of diabetes was not associated with either atherosclerotic plaque or significant coronary artery stenosis (P>0.05 for all). CONCLUSION: In asymptomatic diabetic individuals, a family history of diabetes is consistently associated with non-calcified coronary plaque after adjusting for risk factors.

A prospective longitudinal study evaluating the usefulness of a T-cell-based assay for latent tuberculosis infection in kidney transplant recipients.

We evaluated whether ELISPOT assay can predict tuberculosis (TB) development in kidney-transplantation (KT) recipients with a negative tuberculin skin test (TST). All adult patients admitted to a KT institute between June 2008 and December 2009 were enrolled; TB development after KT was observed between June 2008 and December 2010. Isoniazid (INH) was given to those patients with positive TST or clinical risk factors for latent TB infection (LTBI). ELISPOT assay was performed on all patients, and TB development after KT was observed by a researcher blinded to the results of ELISPOT. A total of 312 KT recipients including 242 (78%) living-donor KT were enrolled. Of the 312 patients, 40 (13%) had positive TST or clinical risk factors for LTBI and received INH; none developed TB after KT. Of the remaining 272 patients, 4 (6%) of 71 with positive ELISPOT assay developed TB after KT, whereas none of the 201 patients with negative (n = 171) or indeterminate ELISPOTs (n = 30) developed TB after KT (rate difference between positive and negative/indeterminate ELISPOT, 3.3 per 100 person-years [95% CI 1.4-5.1, p<0.001]). Positive ELISPOT results predict subsequent development of TB in KT recipients in whom LTBI cannot be detected by TST or who lack clinical risk factors for LTBI.

Characterization of liver metastases: the efficacy of biphasic magnetic resonance imaging with ferucarbotran-enhancement.

AIM: To retrospectively evaluate the efficacy of biphasic magnetic resonance imaging (MRI) of the liver with ferucarbotran-enhancement for the characterization of hepatic metastases. MATERIALS AND METHODS: Thirty-six patients underwent MRI of the liver with separate acquisition of double-contrast enhancement consisting of gadolinium and ferucarbotran. A total of 106 focal hepatic lesions (51 metastases, 31 cysts, 23 haemangiomas, and one eosinophilic abscess) were included. Two sets of MRI were analysed: (1) ferucarbotran set: ferucarbotran-enhanced T1-weighted (T1W) dynamic imaging combined with ferucarbotran-enhanced T2*-weighted (T2*W) delayed imaging and (2) double set: gadolinium-enhanced T1W dynamic imaging combined with ferucarbotran-enhanced T2*W delayed imaging. The diagnostic accuracy of the two sets was evaluated using alternative free-response receiver operating characteristic curve analysis. Sensitivity and specificity were compared using the McNemar test. The enhancement pattern of focal hepatic lesions was analysed on gadolinium and ferucarbotran-enhanced T1W dynamic imaging. RESULTS: There was no significant difference in the accuracy of characterizing hepatic metastases between the two sets. Sensitivity and specificity were not significantly different between the sets (p>0.05). Peripheral rim enhancement was exhibited in 57% of metastatic lesions on ferucarbotran-enhanced T1W dynamic imaging. The majority (96%) of hepatic haemangiomas demonstrated typical peripheral nodular enhancement with progression on ferucarbotran-enhanced T1W dynamic imaging and were easily differentiated from metastases. CONCLUSION: Biphasic MRI of the liver with ferucarbotran-enhancement alone provided comparable diagnostic efficacy to double-contrast MRI for the characterization of hepatic metastases.

Allogeneic hematopoietic cell transplantation for myelodysplastic syndrome: prognostic significance of pre-transplant IPSS score and comorbidity.

We analyzed the clinical significance of pre-transplant International Prognostic Scoring System (IPSS) score and comorbidity in 68 patients who underwent allogeneic hematopoietic cell transplantation (HCT) for myelodysplastic syndrome (MDS) (n=48) or acute myeloid leukemia evolved from MDS (n=20) between December 1995 and January 2008 in a single institute. During a median follow-up period of 41.0 months (range, 3.2-132.0 months), 27 patients died, and 7 relapsed. The 5-year probabilities of overall survival (OS) and event-free survival (EFS) were 60.0 and 57.4%, respectively, and the 5-year cumulative incidences of non-relapse mortality (CINRM) and relapse were 32.7 and 9.9%, respectively. OS, EFS, and CINRM were significantly different according to pre-transplant IPSS score and presence of pre-transplant comorbidity, which were independent risk factors along with Karnofsky performance score in multivariate analyses. In conclusion, pre-transplant IPSS score and comorbidity may stratify the risk of post transplant outcomes in MDS.

Rapid appearance of new cerebral microbleeds after acute ischemic stroke.

BACKGROUND: It is unknown whether the development of cerebral microbleeds (MBs), small areas of signal loss on T2*-weighted gradient-echo imaging (GRE), follows a slow or a rapid process. We hypothesized that MBs may develop rapidly after certain critical events, such as strokes, and investigated the frequency, location, and factors associated with the formation of new MBs after acute ischemic stroke. METHODS: We retrospectively examined 237 consecutive acute ischemic stroke patients who underwent MRI within 24 hours and follow-up MRI during the week after symptom onset. We defined new MBs as MBs that newly appeared on follow-up GRE outside the infarcted area. We examined the association of new MBs with demographics, risk factors, laboratory data, baseline MBs, and small vessel disease (SVD; leukoaraiosis and lacunar infarctions). RESULTS: Seventy-five patients (31.6%) had baseline MBs, and 30 (12.7%) developed new MBs. Multiple logistic regression analysis indicated that the presence of baseline MBs (odds ratio [OR] 5.72, 95% confidence interval [CI] 2.12-15.42, p = 0.001) and severe SVD (OR 2.94, 95% CI 1.12-7.77, p = 0.03) independently predicted the development of new MBs. Of the 56 new MBs, 29 (51.8%) appeared in the lobar location, 17 (30.4%) appeared in the deep location, and 10 (17.9%) appeared in the infratentorial location. CONCLUSIONS: This study suggests that new microbleeds (MBs) can develop rapidly after acute ischemic stroke. Baseline MBs and severe small vessel disease are predictors for the development of new MBs. Further studies will be needed to investigate the clinical implications and mechanisms of these findings.

The CYP3A4*18 genotype in the cytochrome P450 3A4 gene, a rapid metabolizer of sex steroids, is associated with low bone mineral density.

Osteoporosis is influenced by genetic factors. The interindividual variability in the activity of CYP3A, the metabolic enzyme of sex hormones, may result from genetic polymorphisms. In a study of 2,178 women of ages 40-79 years, the presence of the CYP3A4*18 variant was found to be significantly associated with low bone mass. In vitro functional analyses indicate that CYP3A4*18 is a gain-of-function mutation in sex steroid metabolism, resulting in rapid oxidation of estrogens and testosterone; in vivo pharmacokinetics using midazolam (MDZ) verify the altered activity of the CYP3A4*18, showing lower metabolic turnover in the mutant than in the wild type. Molecular modeling reveals the structural changes in the substrate recognition sites of CYP3A4*18 that can cause changes in enzymatic activity and that potentially account for the difference between the catalytic activities of estrogen and MDZ, depending on the genotype. The results indicate that a genetic variation in the CYP3A4 gene--as a gain-of-function mutation in the metabolism of certain CYP3A substrates, including sex steroids--may predispose individuals to osteoporosis.

Enzyme-linked immunosorbent assay, single radial immunodiffusion, and indirect methods for the detection of failure of transfer of passive immunity in dairy calves.

BACKGROUND: Confirmatory tests for failure of transfer of passive immunity (FTPI) in dairy calves require direct measurements of the serum immunoglobulin G concentration. Enzyme-linked immunosorbent assay (ELISA) has advantages over single radial immunodiffusion (SRID) in terms of cost and time. OBJECTIVES: To evaluate the agreement between ELISA and SRID, and to compare the diagnostic performance of ELISA with indirect methods, in the detection of FTPI in calves. ANIMALS: One hundred and fifteen dairy calves (aged 0-10 days) from 23 calf-rearing facilities. METHODS: Prospective, observational study. The agreement between SRID and ELISA was determined by the Bland-Altman method. Fixed bias (SRID - ELISA) was calculated. For comparison of the diagnostic performance of ELISA with indirect methods, sensitivity, specificity, and area under the curve (AUC) of receiver operating characteristic (ROC) curves were calculated at cut-off values of 500 and 1,000 mg/dL. RESULTS: The agreement between SRID and ELISA was 94%. Fixed bias (SRID - ELISA) was 140 +/- 364 mg/dL. The AUC and sensitivity of ELISA at the cut-off value of 1,000 mg/dL were higher than those of indirect methods (P<.004). The specificity of ELISA at the cut-off value of 1,000 mg/dL was not higher than that of indirect methods, except for serum total protein concentration assay. CONCLUSION AND CLINICAL IMPORTANCE: ELISA exhibited good diagnostic performance and good agreement with SRID. ELISA is an adequate method for both screening and confirmatory tests for FTPI in dairy calves at the cut-off value of 500 mg/dL.

Detection of CSF leak in spinal CSF leak syndrome using MR myelography: correlation with radioisotope cisternography.

BACKGROUND AND PURPOSE: Spinal CSF leak syndrome is a unique disorder caused by spinal CSF leak. In this study, we attempted to determine whether MR myelography (MRM) can detect the leakage site in the spine. MATERIALS AND METHODS: We performed both MRM and radioisotope cisternography (RIC) in 15 patients with spinal CSF leak syndrome. Patients were included in this study if they had at least 2 of the following criteria: 1) orthostatic headache, 2) low CSF opening pressure, and 3) diffuse pachymeningeal enhancement on brain MR imaging. For comparison, we performed MRM in 15 subjects without symptoms of spinal CSF leak syndrome. MRM was performed with the 2D turbo spin-echo technique in the entire spine by using a 1.5T scanner. Two blinded radiologists evaluated the MRM findings in a total of 30 cases, composed of patient and control groups, with regard to the presence of leakage and the level of leakage if present. RIC was performed only in the patient group and was assessed by consensus among 3 physicians experienced in nuclear medicine. The diagnostic performance of MRM and RIC was evaluated on the basis of the clinical diagnosis of spinal CSF leak syndrome. RESULTS: The sensitivity, specificity, and accuracy of MR myelography for detecting CSF leak was 86.7%, 86.7%, and 86.7% for reader 1, respectively, and 80.0%, 93.3%, and 86.7% for reader 2, respectively. The sensitivity of RIC was 93.3%. Agreement between the 2 techniques for the detection of CSF leak was substantial in reader 1 and moderate in reader 2 (kappa = 0.634 and 0.444, respectively). CONCLUSION: MRM is an effective tool for detecting CSF leak in the spine in patients with spinal CSF leak syndrome.

First Report of Hypocotyl and Root Rot Disease Caused by Pythium deliense on Soybean Sprouts in Korea.

Soybean (Glycine max Merr.) sprouts have been a traditional Korean food for at least 1,000 years. During the summers of 2000 and 2001, severe hypocotyl and root rot occurred on fully grown soybean sprouts, especially in commercial recirculating mass production systems. Brown rot on water-soaked hypocotyls and roots of soybean sprouts caused a 10 to 20% loss in production yield. To investigate the cause, 180 sections of tissue were surface sterilized for 30 s in 75% ethanol and plated on potato dextrose agar (PDA). A fungus with white, aerial mycelia and cultural characteristics of Pythium sp. was isolated consistently. The fungal isolates were identified as Pythium deliense Meurs based on various mycological characteristics (2) on corn meal agar (CMA) and sucrose-asparagine bentgrass leaf culture medium (1). P. deliense oogonia were spherical, smooth, 19 to 23 µm in diameter, and their stalks bent toward the antheridia. The antheridia were the shape of a straw hat, curved club-shaped, terminal or intercalary, monoclinous, occasionally diclinous, 12 to 15 × 8 to 11 µm, and 1 per oogonium (2). In pathogenicity tests, soybean sprouts and the fungus were cultured simultaneously in containers (30 × 30 × 50 cm [W × L × H]) with a daily 3-h showering period at 25°C. There were 8,000 to 10,000 seeds per container inoculated with four plugs of agar inoculum (2 × 2 cm). Inoculum was prepared from 5-day-old fungal cultures grown on PDA. After 6 days, the inoculated soybean sprouts showed the same symptoms as described above, whereas the noninoculated sprouts remained healthy. The fungal pathogen was reisolated from all the inoculated sprouts. P. deliense has never been reported as a pathogen of soybean sprouts. To our knowledge, this is the first report of hypocotyl and root rot disease caused by Pythium deliense on soybean sprout in Korea. References: (1) J.-W. Kim and E.-W. Park. Kor. J. Mycology 25:276, 1997. (2) A. J. Van der Plaatis-Niterink. Monograph of the genus Pythium. Vol. 21, Studies in Mycology. Centraalbureau voor Schimmelcultures, Inst. R. Neth. Acad. Sci. Lett. The Netherlands, 1981.

Simulation of 1-year-old Populus tremuloides response to ozone stress at Ithaca, USA, and Suwon, Republic of Korea.

The growth of 1-year-old aspen was simulated using TREGRO, a computer simulation model of individual tree growth, to assess potential effects of ozone (O3). TREGRO was parameterized using information from a field experiment conducted at Ithaca, NY, USA; the model was then applied using environmental information from Suwon, Korea, where O3 exposures of aspen had not been conducted. In the parameterization at Ithaca, the simulated and measured total biomass differed by about 3% and the differences between measured and simulated biomass gain of leaf, shoot, and root were 15.4, 8.3, and 4.4%, respectively. Simulating growth at Suwon required adjustment in growth rates to match measured growth due to the different weather conditions at the two cities. The assimilated carbon was evenly distributed to each tissue (foliage, branch, stem, coarse, fine roots) in Suwon, whereas it was mainly allocated to vigorous stem growth in Ithaca. The vigorous growth under Suwon conditions resulted in less total non-structural carbon and perhaps trees more vulnerable to O3 stress. Although the ambient O3 in Suwon (1.2 ppm.h of sum of the hourly concentrations greater than 0.06 ppm [SUM06]) was lower than that in Ithaca (2.1 ppm.h of SUM06), a reduction of 8% of total assimilated carbon was found compared to simulation without O3. Severe effects on root growth at elevated O3 (1.7 times ambient) were predicted; however, the effects on leaf growth would not be as severe.