The ascomycete fungus Mycosphaerella graminicola (synonym Zymoseptoria tritici) is an important pathogen of wheat causing economically significant losses. The primary nutritional mode of this fungus is thought to be hemibiotrophic. This pathogenic lifestyle is associated with an early biotrophic stage of nutrient uptake followed by a necrotrophic stage aided possibly by production of a toxin or reactive oxygen species (ROS). In many other fungi, the genes CREA and AREA are important during the biotrophic stage of infection, while the NOXa gene product is important during necrotrophic growth. To test the hypothesis that these genes are important for pathogenicity of M. graminicola, we employed an over-expression strategy for the selected target genes CREA, AREA, and NOXa, which might function as regulators of nutrient acquisition or ROS generation. Increased expressions of CREA, AREA, and NOXa in M. graminicola were confirmed via quantitative real-time PCR and strains were subsequently assayed for pathogenicity. Among them, the NOXa over-expression strain, NO2, resulted in significantly increased virulence. Moreover, instead of the usual filamentous growth, we observed a predominance of yeast-like growth of NO2 which was correlated with ROS production. Our data indicate that ROS generation via NOXa is important to pathogenicity as well as development in M. graminicola.
Ascomycota ; Fungi ; Life Style ; NADPH Oxidase ; Reactive Oxygen Species* ; Real-Time Polymerase Chain Reaction ; Triticum ; Virulence*

PURPOSE: To investigate the effect of bevacizumab (Avastin; Genentech, San Francisco, CA, USA) on vascular endothelial growth factor (VEGF) expression and inflammation in fibrovascular membranes in patients with proliferative diabetic retinopathy (PDR). MATERIALS AND METHODS: Fibrovascular membranes from 19 eyes of 18 patients with PDR were studied using immunohistochemistry and analyzed in the following 3 groups; group 1: 4 inactive PDR eyes, group 2: 10 active PDR eyes treated preoperatively with adjunctive intravitreal bevacizumab, group 3: five active PDR eyes not treated preoperatively with bevacizumab. Immunohistochemical staining for VEGF, CD31 and CD68 were done. RESULTS: The immunoreactivity to VEGF and CD 31-positive blood vessels was significantly higher in membranes from group 3 than group 1 (p = 0.007 for VEGF, 0.013 for CD 31-positive vessels). Intravitreal bevacizumab caused a reduction in VEGF expression and vascular densities in 4 out of 10 (40%) excised membranes from eyes with PDR. However, six membranes (60%) in group 2 still demonstrated relatively strong VEGF expression and high vascular density. Infiltration of macrophages was observed in 16 out of the 19 membranes, and the density of macrophages was increased in group 2 compared with group 1 (p = 0.043). CONCLUSION: Intravitreal bevacizumab injections caused some reduction in VEGF expression and vascular densities in a limited number of active PDR patients. A single intravitreal bevacizumab injection may not be enough to induce complete blockage of VEGF and pathologic neovascularization in active PDR patients. Repeated injections, panretinal photocoagulation and/or PPV may be necessary following intravitreal bevacizumab to reinforce the anti-VEGF effect of the drug.
Adult ; Angiogenesis Inhibitors/*therapeutic use ; Antibodies, Monoclonal/*therapeutic use ; Diabetic Retinopathy/*drug therapy/*metabolism ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Vascular Endothelial Growth Factor A/*metabolism

PURPOSE: A pep27 mutant may be able to elicit mucosal immunity against pneumococcal diseases, and could be employed as an inexpensive attenuated vaccine. However, this particular mutant contains an erythromycin-resistance marker. The purpose of the current study is to develop a markerless pep27 mutant and assess whether this inactivated mutant is able to induce mucosal immunity. MATERIALS AND METHODS: Mice were vaccinated intranasally with the inactivated markerless pep27 mutant every 2 weeks for a total of three times, after which time serum samples were analyzed for antibody titers. The mice were then challenged with a lethal D39 strain and their survival time was measured. The cross-reactivity of the antisera against pep27 was also compared to other mutant serotypes. RESULTS: Intranasal immunization of mice with the inactivated markerless pep27 mutant provides effective protection and rapidly cleared bacterial colonization in vivo. Moreover, antisera raised against the pep27 mutant may cross-react with several other serotype strains. CONCLUSION: Intranasal immunization with the inactivated pep27 mutant may be able to provide mucosal immunity, and could represent an efficient mucosal vaccine.
Animals ; Colon ; Immune Sera ; Immunity, Mucosal ; Immunization ; Mice ; Sprains and Strains ; Streptococcus pneumoniae

PURPOSE: The purpose of this study was to explore and describe the meanings of hands among clinical nurses.METHODS: A descriptive qualitative study design was used. Participants were 1,048 nurses working in a tertiary hospital in G city. From April to May 2018, an open-ended survey on how nurses felt about their hands and what their hands meant to them was conducted. The collected data were analyzed using MAXQDA 2018 version as well as content analysis.RESULTS: A total of 1,048 pieces of data were analyzed, and 2,094 units of analysis were categorized based on their attributes, resulting in physical, emotional, and social domains. The data in the social domain were reported in a narrative format; thus, they were analyzed using content analysis. Three themes and eight sub-themes were elicited. The three themes included “meaning as an instrument,” “meaning of infection control,” and “meaning of caring.”CONCLUSION: Nurses imbue essential meanings of caring on their hands even though they face negative skin symptoms. Furthermore, nurses understand the importance of hand hygiene on infection control. The findings of this study provide an in-depth look into nurses' perceptions of their hands.
Empathy ; Hand Disinfection ; Hand Hygiene ; Hand ; Infection Control ; Skin ; Tertiary Care Centers

BACKGROUND AND OBJECTIVES: Multi-detector CT (MDCT) is becoming more commonly used as a diagnostic tool for various cardiac diseases, and this modality can also incidentally detect a significant number of non-cardiac findings during cardiac work-ups. The objectives of this study were to evaluate the incidence of non-cardiac findings during cardiac MDCT and to compare them with chest CT. SUBJECTS AND METHODS: We enrolled 1,007 consecutive subjects (mean age: 49+/-10 years, males: 63%) who underwent both cardiac and chest CT (64-slice MDCT) as a part of a routine health check-up. The subjects were evaluated for the incidence of non-cardiac findings and the therapeutic consequences according to the CT protocols during the mid-term follow-up (average length of mid-term follow-up: 533+/-39 days). RESULTS: Eight hundred sixty incidental non-cardiac findings were identified in 627 patients (62%) with cardiac CT. Forty-three subjects (4%) had clinically significant lesions that required additional diagnostic work-up or radiological follow-up, and these lesions were 23 cases of non-calcified nodule, 2 cases of ground glass opacity, 6 cases of pneumonia, 1 case of active tuberculosis, 2 cases of focal bronchiolitis, 3 cases of arterial lesion, 1 case of liver cirrhosis and 5 cases of extra-pulmonary masses. Five subjects (0.5%), including 2 cases (0.2%) of malignancy, had therapeutic consequences during their follow-up. Compared with chest CT, 68% (40/59) of the significant intrathoracic lesions and 67% (4/6) of the intrathoracic lesions with therapeutic consequences were documented by cardiac CT. CONCLUSION: In the present study, 4% of the asymptomatic patients who underwent cardiac MDCT were found to have significant non-cardiac findings that required further work-up. To avoid missing a number of clinically important findings, physicians who analyze cardiac MDCT scans should carefully evaluate not only the heart, but all the other organs that are within the scan range.
Bronchiolitis ; Follow-Up Studies ; Glass ; Heart ; Heart Diseases ; Humans ; Incidence ; Liver Cirrhosis ; Lung ; Pneumonia ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis

Few cases of macrophage activation syndrome (MAS) or reactive hemophagocytic lymphohistiocytosis (HLH) during the acute febrile phase of Kawasaki disease (KD) have been reported. We report on a case of a 19 month-old girl with MAS or reactive HLH during the course of KD. Despite immunoglobulin and steroid therapy, she showed persistent fever with hepatosplenomegaly and evidence of hemophagocytosis in the bone marrow. A high index of suspicion for clinical features associated with MAS is necessary for KD patients in order to provide appropriate treatment.
Bone Marrow ; Fever ; Humans ; Immunoglobulins ; Lymphohistiocytosis, Hemophagocytic ; Macrophage Activation ; Macrophage Activation Syndrome ; Macrophages ; Mucocutaneous Lymph Node Syndrome ; Organic Chemicals

Background: There is an incomplete understanding of the natural course of mild to moderate aortic stenosis (AS). We aimed to evaluate the natural course of patients with mild to moderate AS and its association with coronary artery disease (CAD). Methods: We retrospectively analyzed 787 patients diagnosed with mild to moderate AS using echocardiography between 2004 and 2010. Cardiac death and aortic valve replacement (AVR) for AS were assessed. Results: A median follow-up period was 92 months. Compared to the general population, patients with mild to moderate AS had a higher risk of cardiac death (hazard ratio [HR], 17.16; 95% confidence interval [CI], 13.65–21.59; P < 0.001). Established CAD was detected in 22.4% and associated with a significantly higher risk of cardiac mortality (adjusted HR, 1.62; 95% CI, 1.04–2.53; P = 0.033). The risk of cardiac death was lower when patients were taking statin (adjusted HR, 0.64; 95% CI, 0.41–0.98; P = 0.041), which was clear only after 7 years. Both patients with CAD and on statin tended to undergo more AVR, but the difference was not statistically significant (the presence of established CAD; adjusted HR, 1.63; 95% CI, 0.51–3.51; P = 0.214 and the use of statin; adjusted HR, 1.86; 95% CI, 0.76–4.58; P = 0.177). Conclusion Mild to moderate AS does not have a benign course. The presence of CAD and statin use may affect the long-term prognosis of patients with mild to moderate AS.

Background: There is an incomplete understanding of the natural course of mild to moderate aortic stenosis (AS). We aimed to evaluate the natural course of patients with mild to moderate AS and its association with coronary artery disease (CAD). Methods: We retrospectively analyzed 787 patients diagnosed with mild to moderate AS using echocardiography between 2004 and 2010. Cardiac death and aortic valve replacement (AVR) for AS were assessed. Results: A median follow-up period was 92 months. Compared to the general population, patients with mild to moderate AS had a higher risk of cardiac death (hazard ratio [HR], 17.16; 95% confidence interval [CI], 13.65–21.59; P < 0.001). Established CAD was detected in 22.4% and associated with a significantly higher risk of cardiac mortality (adjusted HR, 1.62; 95% CI, 1.04–2.53; P = 0.033). The risk of cardiac death was lower when patients were taking statin (adjusted HR, 0.64; 95% CI, 0.41–0.98; P = 0.041), which was clear only after 7 years. Both patients with CAD and on statin tended to undergo more AVR, but the difference was not statistically significant (the presence of established CAD; adjusted HR, 1.63; 95% CI, 0.51–3.51; P = 0.214 and the use of statin; adjusted HR, 1.86; 95% CI, 0.76–4.58; P = 0.177). Conclusion Mild to moderate AS does not have a benign course. The presence of CAD and statin use may affect the long-term prognosis of patients with mild to moderate AS.