China ; epidemiology ; Escherichia coli Infections ; epidemiology ; microbiology ; Escherichia coli O157 ; classification ; isolation & purification ; metabolism ; Humans ; Shiga Toxin 1 ; biosynthesis ; isolation & purification ; Shiga Toxin 2 ; biosynthesis ; isolation & purification ; Sorbitol

This study was conducted to investigate the presence of Escherichia (E.) coli O157 and E. coli O157:H7 and stx1 and stx2 genes on cattle carcasses and in rectal samples collected from Samsun Province of Turkey. A total of 200 samples collected from cattle carcasses and the rectal contents of 100 slaughtered cattle from two commercial abattoirs were tested using the immunomagnetic separation technique and multiplex PCR methods. E. coli O157 and E. coli O157:H7 were detected in 52 of the 200 samples (26%) tested. Of the positive samples, 49 were E. coli O157 and three were E. coli O157:H7. The E. coli O157 strain was isolated from 24 carcasses and 25 rectal samples, while E. coli O157:H7 was isolated from two carcasses and one rectal sample. Of the 49 samples positive for E. coli O157, 32 were from the rectal and carcass samples of the same animal, while two E. coli O157:H7 isolates were obtained from rectal swabs and carcasses of the same animal. The stx1 and stx2 genes were both detected in 35 E. coli O157 isolates and one E. coli O157:H7 isolate, but the stx2 gene was only detected alone in two E. coli O157 isolates. Overall, 16 carcasses tested positive for E. coli O157 and one carcass tested positive for E. coli O157:H7 based on both carcass and rectal samples. Overall, the results of this study indicate that cattle carcasses pose a potential risk to human health due to contamination by E. coli O157 and E. coli O157:H7 in the feces.
Abattoirs ; Animals ; Cattle ; Escherichia coli O157/*genetics/isolation & purification ; *Immunomagnetic Separation ; Meat/microbiology ; *Polymerase Chain Reaction ; Rectum/microbiology ; Shiga Toxin 1/*genetics ; Shiga Toxin 2/*genetics ; Turkey

PURPOSE: To investigate the efficacy, and identify predictors of success of selective laser trabeculoplasty (SLT) in open-angle glaucoma (OAG) patients after adjusting for intraocular pressure (IOP) changes in the untreated fellow eye. METHODS: This retrospective chart review included 52 eyes of 52 OAG patients who underwent SLT in one eye and were followed-up for at least 1 year after the procedure. The IOP was measured before the treatment, at 1, 2, and 3 months posttreatment, and every 3 months thereafter. To account for the possible influence of IOP fluctuations on laser outcomes, post-laser IOP values of the treated eye of each patient were also analyzed, after adjusting for IOP changes in the untreated fellow eye. Success was defined as an IOP decrease ≥20% of the pretreatment IOP. The success rate was determined based on Kaplan-Meier survival analysis and factors predictive of success were analyzed using the Cox proportional hazard model. RESULTS: The mean pretreatment IOP was 23.17 ± 6.96 mmHg. The mean IOP reduction was 5.59 ± 4.78 mmHg (29.7%) and the success rate was 65.4% at 1 year. The adjusted mean IOP reduction was 4.70 ± 4.67 mmHg (23.9%) and the adjusted success rate was 53.9%. Pretreatment IOP was associated with SLT success; the higher the pretreatment IOP, the greater the post-laser IOP reduction (p = 0.025). Age and mean deviation index did not show a significant association with SLT success (p = 0.066 and p = 0.464, respectively). CONCLUSIONS: SLT is a safe and effective alternative method of IOP reduction in OAG patients. Herein, pretreatment IOP was the only factor significantly associated with SLT success. IOP fluctuations of the untreated eye should be considered for a better understanding of the impact of treatment.
Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Methods ; Proportional Hazards Models ; Retrospective Studies ; Shiga Toxin 1 ; Trabeculectomy

PURPOSE: To compare the effect and safety of two regimens of Selective Laser Trabeculoplasty (SLT), SLT on 180degrees of trabecular meshwork and SLT with 100 laser spots on 360degrees of trabecular meshwork in patients with primary open-angle glaucoma and ocular hypertension. METHODS: In a retrospective clinical study, the authors compared the pressure-lowering effects of SLT in two groups of patients; group 1 (83 patients) received SLT on 180degrees, group 2 (30 patients) on 360degrees of trabecular meshwork. The clinical outcome indicators included intraocular pressure (IOP) at one day, one week, one month, two months, three months and six months after SLT, and the anterior chamber reaction at post-laser one day. RESULTS: There was no statistically significant difference in the IOP reduction between these two regimens after six months. The anterior chamber reactions in the two groups were significantly different (group 1; 0.61 +/- 0.64, group 2; 1.25 +/- 0.83, p = 0.001). The success rate of group 2 (43.3%) was not different from that of group 1 (31.3%; p = 0.23). CONCLUSIONS: SLT on 180degrees of trabecular meshwork had a similar effect compared to that of SLT on 360degrees of trabecular meshwork in terms of IOP reduction. The authors of the present study suggest that 180degrees SLT is the safest procedure with regard to success rate and complications.
Anterior Chamber ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Ocular Hypertension ; Retrospective Studies ; Shiga Toxin 1 ; Trabecular Meshwork ; Trabeculectomy

A total of 156 Shiga-like toxin producing Escherichia coli (STEC) were isolated from fecal samples of Korean native (100/568, 18%) and Holstein dairy cattle (56/524, 11%) in Korea between September 2010 and July 2011. Fifty-two STEC isolates (33%) harbored both of shiga toxin1 (stx1) and shiga toxin2 (stx2) genes encoding enterohemolysin (EhxA) and autoagglutinating adhesion (Saa) were detected by PCR in 83 (53%) and 65 (42%) isolates, respectively. By serotyping, six STEC from native cattle and four STEC from dairy cattle were identified as O-serotypes (O26, O111, O104, and O157) that can cause human disease. Multilocus sequence typing and pulsed-field gel electrophoresis patterns highlighted the genetic diversity of the STEC strains and difference between strains collected during different years. Antimicrobial susceptibility tests showed that the multidrug resistance rate increased from 12% in 2010 to 42% in 2011. Differences between isolates collected in 2010 and 2011 may have resulted from seasonal variations or large-scale slaughtering in Korea performed to control a foot and mouth disease outbreak that occurred in early 2011. However, continuous epidemiologic studies will be needed to understand mechanisms. More public health efforts are required to minimize STEC infection transmitted via dairy products and the prevalence of these bacteria in dairy cattle.
Animals ; Anti-Bacterial Agents/pharmacology ; Cattle/microbiology ; Drug Resistance, Multiple, Bacterial ; Electrophoresis, Gel, Pulsed-Field/veterinary ; Escherichia coli Infections/epidemiology/microbiology/*veterinary ; Female ; Genes, Bacterial/genetics ; Latex Fixation Tests/veterinary ; Microbial Sensitivity Tests/veterinary ; Multilocus Sequence Typing/veterinary ; Prevalence ; Republic of Korea/epidemiology ; Shiga Toxin 1/genetics ; Shiga Toxin 2/genetics ; *Shiga-Toxigenic Escherichia coli/drug effects/genetics

A multiplex loop-mediated isothermal amplification (mLAMP) assay was developed for simultaneous detection of the stx1 and stx2 genes and applied for detection of shiga toxin-producing Escherichia coli (STEC) in cattle farm samples. Two target genes were distinguished based on T m values of 85.03 +/- 0.54degrees C for stx1 and 87.47 +/- 0.35degrees C for stx2. The mLAMP assay was specific (100% inclusivity and exclusivity), sensitive (with a detection limit as low as 10 fg/microL), and quantifiable (R 2 = 0.9313). The efficacy and sensitivity were measured to evaluate applicability of the mLAMP assay to cattle farm samples. A total of 12 (12/253; 4.7%) and 17 (17/253; 6.7%) STEC O157, and 11 (11/236; 4.7%) non-O157 STEC strains were isolated from cattle farm samples by conventional selective culture, immunomagnetic separation, and PCR-based culture methods, respectively. The coinciding multiplex PCR and mLAMP results for the types of shiga toxin revealed the value of the mLAMP assay in terms of accuracy and rapidity for characterizing shiga toxin genes. Furthermore, the high detection rate of specific genes from enrichment broth samples indicates the potential utility of this assay as a screening method for detecting STEC in cattle farm samples.
Animals ; Cattle ; Cattle Diseases/epidemiology/microbiology ; Escherichia coli Infections/epidemiology/microbiology/*veterinary ; Feces/microbiology ; Multiplex Polymerase Chain Reaction/veterinary ; Nucleic Acid Amplification Techniques/*veterinary ; Shiga Toxin 1/*genetics/isolation & purification ; Shiga Toxin 2/*genetics/isolation & purification ; Shiga-Toxigenic Escherichia coli/*genetics/isolation & purification

PURPOSE: To report a case of hyphema after selective laser trabeculoplasty (SLT) in a patient with pseudoexfoliative glaucoma. CASE SUMMARY: A 77-year-old female was referred for elevation of intraocular pressure (IOP). Previously, she had been diagnosed with pseudoexfoliative glaucoma in the right eye and was using topical IOP-lowering agents. The best corrected visual acuity was 20/100 in the right eye and 20/40 in the left eye. IOP, measured with Goldmann applanation tonometer, was 32 mm Hg in the right eye and 20 mm Hg in the left eye. Gonioscopy revealed open-angle glaucoma with +2 trabecular meshwork pigmentation but without peripheral anterior synechiae or neovascularization. SLT was performed in the right eye. Two days later, the patient had sudden onset of blurred vision and pain in the right eye. Visual acuity was limited to light perception, and IOP was 34 mm Hg in the right eye. Slit-lamp examination revealed 1.1 mm hyphema with 4+ red blood cell count in the anterior chamber. Three weeks after the SLT, hyphema in the right eye disappeared, but IOP was measured to be 42 mm Hg. The patient underwent trabeculectomy in the right eye. CONCLUSIONS: SLT is an effective means of lowering IOP with low risk of complications. However, hyphema can rarely occur after SLT and can affect the outcome of the treatment.
Aged ; Anterior Chamber ; Erythrocyte Count ; Female ; Glaucoma ; Glaucoma, Open-Angle ; Gonioscopy ; Humans ; Hyphema* ; Intraocular Pressure ; Pigmentation ; Shiga Toxin 1 ; Trabecular Meshwork ; Trabeculectomy* ; Visual Acuity

PURPOSE: Infection with Shiga-like toxin (SLT)-producing Escherichia coli, an emerging human pathogen found particularly in young children under 5 years of age, causes a spectrum of illnesses with high morbidity and mortality, ranging from diarrhea to hemorrhagic colitis and hemolytic uremic syndrome. Host mediators play an important role in the pathogenesis of SLT-I toxicity. The experiments described here were designed to investigate the effect of SLT-I on TNF- alpha production and to understand the effect of TNF-alpha on GB3 expression. We also further examine the relationship between the Gb3 level and the differential susceptibility of cells to the cytotoxic action of SLT-I. METHODS: The effect of purified SLT-1 from E. coli O157 : H7 (ATCC 43890) on tumor necrosis factor-alpha (TNF- alpha) production in Raw264.7 cells was investigated. Many mediators regulate endothelial cell membrane expression of the glycolipid globotriaosyleramide (Gb3), which serves as the toxin receptor, suggesting that the host response to the toxin or other bacterial products may contribute to pathogenesis by regulating target cell sensitivity to the toxins. Therefore, the relationships between Gb3 expression and cytotoxicity against SLT-I on three types of cells were evaluated. RESULTS: Detectable levels of TNF-alpha were produced as early as six hours after induction and continued to increase during 48 hours by SLT-I. It was also found that Vero cells and dendritic cells (DC2.4 cells) expressed high levels of Gb3, 83% and 68%, respectively, and that Raw264.7 cells had a low level of Gb3 (29%) and appeared refractory to cytotoxicity against SLT-I. Vero cells and DC2.4 cells expressing high levels of Gb3 were highly susceptible to SLT-I. Furthermore, macrophages showed a resistance to SLT-I cytotoxicity, despite the fact that Gb3 expression was enhanced. CONCLUSION: These results strongly suggest that the expression of Gb3 is necessary but not sufficient to confer sensitivity of macrophages to SLT-I and further underpin the important role of SLT-I and its Gb3 receptors in the pathogenesis of E. coli O157 infection.
Child ; Colitis ; Dendritic Cells ; Diarrhea ; Endothelial Cells ; Escherichia coli ; Hemolytic-Uremic Syndrome ; Humans ; Macrophages ; Membranes ; Mortality ; Shiga Toxin 1* ; Tumor Necrosis Factor-alpha ; Vero Cells

Escherichia (E.) coli serotype O157:H7 is a globally distributed human enteropathogen and is comprised of microorganisms with closely related genotypes. The main reservoir for this group is bovine bowels, and infection mainly occurs after ingestion of contaminated water and food. Virulence genetic markers of 28 O157:H7 strains were investigated and multilocus enzyme electrophoresis (MLEE) was used to evaluate the clonal structure. O157:H7 strains from several countries were isolated from food, human and bovine feces. According to MLEE, O157:H7 strains clustered into two main clonal groups designated A and B. Subcluster A1 included 82% of the O157:H7 strains exhibiting identical MLEE pattern. Most enterohemorrhagic E. coli (EHEC) O157:H7 strains from Brazil and Argentina were in the same MLEE subgroup. Bovine and food strains carried virulence genes associated with EHEC pathogenicity in humans.
Animals ; Argentina/epidemiology ; Brazil/epidemiology ; Cattle ; Cattle Diseases/epidemiology/*microbiology ; Enterohemorrhagic Escherichia coli/genetics/*isolation & purification/pathogenicity ; Escherichia coli O157/*genetics/*isolation & purification/pathogenicity ; Food Microbiology ; Gene Expression Regulation, Bacterial/physiology ; Genetic Markers ; Humans ; Polymerase Chain Reaction/veterinary ; Shiga Toxin 1/genetics/metabolism ; Shiga Toxin 2/genetics/metabolism ; Virulence

PURPOSE: Split liver transplantation (SLT) offers an effective way of increasing the donor pool. However, it is often difficult to perform SLT under current allocation system. We retrospectively analyzed the outcome of the patients who had undergone SLT in Seoul National University Hospital. METHODS: From the first case of SLT in Korea on November 4, 1998, 8 patients underwent SLT in our center. Three adult patients received extended right liver graft and five child patients received left lateral section graft. All liver were split by in-situ method. RESULTS: All adult patients were alive. One adult patient developed hepatic artery thrombosis one month after SLT and underwent retransplantation due to graft failure. Another patient developed biliary leakage and had to undergo operative bile duct revision. Two of child patients were died of pneumonia and hepatic failure due to HBV hepatitis, respectively. One child patient suffered from hepatic venous stricture and persistent ascites and received interventional therapy. Overall 3-year patient survival rate was 87.5% and graft survival rate was 75.0%. No primary nonfunction developed and three patients (37.5%) suffered form vascular or biliary complications. CONCLUSION: The results of SLT were similar to that of conventional deceased donor liver transplantation. Although SLT is technically difficult and increase the risk of vascular or biliary complications just like living donor liver transplantation (LDLT), its result might be acceptable and it could be a successful method to expand the donor pool if it would be performed in the center experienced in LDLT.
Adult ; Ascites ; Bile Ducts ; Child ; Constriction, Pathologic ; Graft Survival ; Hepatic Artery ; Hepatitis ; Humans ; Korea ; Liver Failure ; Liver Transplantation* ; Liver* ; Living Donors ; Pneumonia ; Retrospective Studies ; Seoul ; Shiga Toxin 1 ; Survival Rate ; Thrombosis ; Tissue Donors ; Transplantation ; Transplants