Ehrlichia (E.) canis is a Gram-negative obligate intracellular bacterium responsible for canine monocytic ehrlichiosis. Currently, the genetic diversity of E. canis strains worldwide is poorly defined. In the present study, sequence analysis of the nearly full-length 16S rDNA (1,620 bp) and the complete coding region (4,269 bp) of the gp200 gene, which encodes the largest major immunoreactive protein in E. canis, from 17 Taiwanese samples was conducted. The resultant 16S rDNA sequences were found to be identical to each other and have very high homology (99.4~100%) with previously reported E. canis sequences. Additionally, phylogenetic analysis of gp200 demonstrated that the E. canis Taiwanese genotype was genetically distinct from other reported isolates obtained from the United States, Brazil, and Israel, and that it formed a separate clade. Remarkable variations unique to the Taiwanese genotype were found throughout the deduced amino acid sequence of gp200, including 15 substitutions occurring in two of five known species-specific epitopes. The gp200 amino acid sequences of the Taiwanese genotype bore 94.4~94.6 identities with those of the isolates from the United States and Brazil, and 93.7% homology with that of the Israeli isolate. Taken together, these results suggest that the Taiwanese genotype represents a novel strain of E. canis that has not yet been characterized.
Amino Acid Sequence ; Animals ; Bacterial Proteins/chemistry/*genetics ; Dogs ; Ehrlichia canis/*classification/*genetics ; Genotype ; Molecular Sequence Data ; *Phylogeny ; RNA, Ribosomal, 16S/genetics ; Sequence Alignment ; Sequence Analysis, Protein ; Taiwan

Background/Aims: Laryngeal symptoms are largely treated with empiric proton pump inhibitor (PPI) therapy if no apparent pathology shown on ear, nose, and throat evaluation and reflux-related etiologies are suspected. However, treatment response remains unsatisfactory. This study aimed to investigate the clinical and physiological characteristics of patients with PPI-refractory laryngeal symptoms. Methods: Patients with persistent laryngeal symptoms despite PPI treatment for ≥ 8 weeks were recruited. A multidisciplinary evaluationcomprising validated questionnaires for laryngeal symptoms (reflux symptom index [RSI]), gastroesophageal reflux disease symptoms, psychological comorbidity (5-item brief symptom rating scale [BSRS-5]) and sleep disturbance (Pittsburgh sleep quality index [PSQI]), esophagogastroduodenoscopy, ambulatory impedance-pH monitoring, and high-resolution impedance manometry were performed.Healthy asymptomatic individuals were also recruited for comparison of psychological morbidity and sleep disturbances. Results: Ninety-seven adult patients and 48 healthy volunteers were analyzed. The patients had markedly higher prevalence of psychological distress (52.6% vs 2.1%, P < 0.001) and sleep disturbance (82.5% vs 37.5%, P < 0.001) than the healthy volunteers. There were significant correlations between RSI and BSRS-5 scores, and between RSI and PSQI scores (r = 0.26, P = 0.010, and r = 0.29, P = 0.004, respectively). Fifty-eight patients had concurrent gastroesophageal reflux disease symptoms. They had more prominent sleep disturbances (89.7% vs 71.8%, P < 0.001) than those with laryngeal symptoms alone but similar reflux profiles and esophageal motility. Conclusions PPI-refractory laryngeal symptoms are mostly associated with psychological comorbidities and sleep disturbances. Recognition of these psychosocial comorbidities may help optimize management in these patients.

BACKGROUNDThe change of anaerobic exercise abilities during and after a high-altitude expedition or hypoxic exposure is not well studied. To evaluate the effects of an extreme-altitude expedition on anaerobic performance, the 10-second supramaximal test and endocrine hormones were evaluated before and after an expedition to Peak Lenin.

METHODSFour subjects (3 male and 1 female, age (30.5 +/- 16.5) years) were recruited into the study. Three sets of tests were performed, including a basic test at sea level and 20 days before first arrival at the base camp (3600 m), a middle test done at day after returning from the summit to the base camp and the post test at the 10th day after return to the sea level. Both the supramaximal test, performed by a cycle ergometer, and body composition, performed by bioelectrical impedance analysis, were completed before the basic test and post test. The endocrine hormones including cortisol, growth hormone, testosterone, noradrenaline, adrenaline, dopamine, glucagon and beta-endorphin were measured at all tests.

RESULTSComparing the conditions before and after the expedition, the body measurement parameters were decreased after the expedition, i.e., body weight (-4.22%, P < 0.05), fat-free mass (-2.09%, P < 0.01) and body fat (-8.95%, P = 0.172). The peak power relative/body weight ratio (PP/BW) was similar ((9.70 +/- 1.97) vs (9.11 +/- 1.80) W/kg, P = 0.093), while mean power/body weight ratio (MP/BW) was reduced significantly after the expedition ((9.14 +/- 1.77) vs (8.33 +/- 1.74) W/kg, P < 0.05). Peak power/fat-free mass (PP/FFM), mean power/fat-free mass (MP/FFM) and fatigue index (FI) were significantly lower after the expedition (PP/FFM: (11.95 +/- 1.71) vs (10.99 +/- 1.59) W/kg, P < 0.05; MP/FFM: (11.26 +/- 1.50) vs (10.04 +/- 1.55) W/kg, P < 0.005; FI (85.55 +/- 4.17)% vs (77.25 +/- 4.40)%, P < 0.05). Hormone assays showed a significant increase of noradrenaline (basic vs middle, P < 0.05) as well as decrease of adrenaline (P < 0.05). Meanwhile, a trend towards an increase in dopamine (basic vs middle) and a decrease of beta-endorphin (basic vs post) were also noted.

CONCLUSIONSThese results suggested that an expedition to an extreme altitude may have negative effects on anaerobic performance. It showed that a significant increase of noradrenaline (basic vs middle) as well as decrease of adrenaline after the expedition to Peak Lenin had occurred. The real physiological significance needs to be further investigated.

Adaptation, Physiological ; physiology ; Adolescent ; Adult ; Altitude ; Anaerobic Threshold ; physiology ; Dopamine ; blood ; Epinephrine ; blood ; Exercise Test ; Female ; Glucagon ; blood ; Growth Hormone ; blood ; Humans ; Hydrocortisone ; blood ; Male ; Middle Aged ; Norepinephrine ; blood ; Testosterone ; blood ; Young Adult ; beta-Endorphin ; blood