Outbreaks of Streptococcus gallolyticus subsp. pasteurianus in Goslings Characterized by Central Nervous Symptoms.

The present report describes outbreaks of Streptococcus gallolyticus subsp. pasteurianus in young geese flocks in Austria. The flocks, comprising 160-1450 goslings of 2-3 wk of age, experienced increased mortalities The clinical signs were characterized by severe central nervous symptoms, namely leg paddling and torticollis. The postmortem investigation revealed hepatitis, splenitis, and a low amount of liquid fluid in the coelomic cavity. Livers were of fragile texture, with white necrotic areas. The latter were also found in spleens. No macroscopic lesions were seen in brains. Bacteriologic investigation followed by bacterial identification by matrix-assisted laser desorption time-of-flight mass spectrometry and phylogenetic analysis of the partial 16S rRNA region revealed the presence in heart, liver, spleen, and brain of S. gallolyticus subsp. pasteurianus. Histologic investigation revealed multifocal necrosis in liver and spleen samples together with infiltration of mononuclear cells and heterophilic granulocytes. Furthermore, in the lesions, coccoid bacteria could be identified. No histopathologic changes were observed in brain samples from goslings, except in one bird in which accumulation of coccoid bacteria in blood vessels of the brain samples was present. Antibiotic sensitivity tests revealed identical profiles for all strains, which were susceptible to penicillins, cephalosporins, chloramphenicol, imipenem, and tylosin. However, resistance was found against quinolones, aminoglycosides, tetracycline, and trimethoprim-sulfamethoxazole, which are commonly used to treat infections with gram-positive bacteria.

Reporte de caso­Brotes de Streptococcus gallolyticus subsp. pasteurianus en gansitos caracterizados por síntomas nerviosos centrales. El presente informe describe brotes de Streptococcus gallolyticus subsp. pasteurianus en parvadas de gansos jóvenes en Austria. Las bandadas, que comprendían entre 160 a 1450 gansos de 2 a 3 semanas de edad, experimentaron aumento de la mortalidad. Los signos clínicos se caracterizaron por síntomas severos del sistema nervioso central, incluyendo, movimientos de pataleo y tortícolis. La investigación post mórtem reveló hepatitis, esplenitis y la presencia de líquido en la cavidad celómica en poca cantidad. Los hígados presentaron textura frágil, con áreas necróticas blancas. Estos últimos también se encontraron en bazos. No se observaron lesiones macroscópicas en el cerebro. La investigación bacteriológica seguida de la identificación bacteriana mediante espectrometría de masas MALDI-TOF y el análisis filogenético de la región parcial de ARNr 16S revelaron la presencia en el corazón, el hígado, el bazo y en el cerebro de S. gallolyticus subsp. pasteurianus. La investigación histológica reveló necrosis multifocal en muestras de hígado y bazo junto con infiltración de células mononucleares y granulocitos heterófilos. Además, en las lesiones se pudieron identificar bacterias de morfología cocoide. No se observaron cambios histopatológicos en muestras de cerebro de los gansitos, excepto en un ave en la que se observó acumulación de bacterias cocoides en los vasos sanguíneos de las muestras de cerebro. Las pruebas de sensibilidad a los antibióticos revelaron perfiles idénticos para todas las cepas, que eran susceptibles a penicilinas, cefalosporinas, cloranfenicol, imipenem y tilosina. Sin embargo, se encontró resistencia contra quinolonas, aminoglucósidos, tetraciclina y trimetoprim-sulfametoxazol, que se usan comúnmente para tratar infecciones con bacterias grampositivas.

The micro-structural analysis of lumbar vertebrae in alcoholic liver cirrhosis.

Although vertebral fracture is more common among alcoholic liver cirrhosis patients when compared to general population, current data on three-dimensional micro-architecture are scarce. Our study showed significant trabecular deterioration in lumbar vertebrae obtained from alcoholic liver cirrhosis donors, suggesting that they should be advised to undergo early-stage screening for osteoporosis. PURPOSE: Recent studies showed an increased incidence of vertebral fractures in alcoholic liver cirrhosis (ALC) patients, while data about vertebral micro-structure are still limited. The aim of this study was to compare trabecular and cortical micro-architecture of lumbar vertebrae between ALC patients and healthy age- and sex-matched controls. METHODS: Our study included lumbar vertebral samples of male cadaveric donors, divided into ALC (n = 20, age: 59 ± 6 years) and control group (n = 20, age: 59 ± 8 years). Following pathohistological verification of liver cirrhosis, trabecular and cortical bone micro-architecture was analyzed by micro-computed tomography (micro-CT). RESULTS: Micro-CT evaluation of the trabecular bone in lumbar vertebrae showed a significant decrease in bone volume fraction, trabecular thickness, trabecular number, and connectivity (p < 0.01). In contrast to trabecular deterioration, prominent alteration in cortical parameters was not observed in lumbar vertebrae of ALC patients (p > 0.05). CONCLUSIONS: Our data indicate that susceptibility to non-traumatic fractures in ALC patients could be explained by alterations in trabecular bone micro-architecture. Thus, we genuinely recommend osteological screening of the lumbar spine for all ALC patients in order to evaluate individual fracture risk. Graphical abstract.

Electroencephalographic Neurofeedback to up-regulate frontal Theta rhythms: Preliminary results.

Retrieval of positive Autobiographical Memory (AM) has been reported to increase positive emotions in healthy population. Evidence suggests that positive AM retrieval tasks are correlated with synchronisation of frontal Theta rhythms (4-8Hz). The present study has developed the Electroencephalography (EEG) based Neurofeedback (NF) protocols to promote voluntary elevation or up-regulation of positive AM retrieval related Theta rhythms over F3, Fz, F4 electrode sites (10-20 System). The protocols were evaluated with a human participant in 10-day NF training. It observed that the average amplitude of observed Theta rhythms in each NF regulation block gradually increased over days of training and most was prominent at Fz electrode site. Furthermore, a larger peak at 6Hz was present in the spectrum of the observed Theta with later trial day suggesting up-regulation of Frontal Midline Theta (FmT) rhythms.

Riemerella anatipestifer outbreaks in commercial goose flocks and identification of isolates by MALDI-TOF mass spectrometry.

Several outbreaks of Riemerella anatipestifer in commercial geese occurred within a short time period. A serious disease was recognized in the affected birds, mainly characterized by depression and severe neurologic disturbances. The morbidity ranged from 20 to 30% and the mortality from 5 to 20%. Generally, the clinical signs started at the age of 8 to 10 days. Post-mortem examination revealed fibrinous pericarditis, perihepatitis and airsacculitis in all birds. Some of the birds also had synovitis of the tibio-tarsal joints and oedematous swelling of the subcutaneous tissues around these joints and metatarsus. Histology revealed a characteristic severe inflammation with heterophilic granulocytes in different organs. Bacteriological investigation was made from several organs and R. anatipestifer could be isolated from all birds investigated. The identification of these clinical isolates, done for the first time by matrix-assisted laser desorption ionization-time-of-flight mass spectrometry, confirmed the aetiology. Sequence analysis showed 100% similarity between the clinical isolates, indicating a common source of infection.

Multifocal and multicentric breast cancer: is breast conserving surgery acceptable?

PURPOSE: The purpose of our study was to evaluate the significance of multifocal (MF) and multicentric (MC) breast cancer in the diagnosis and treatment of this condition. METHODS: This retrospective study was a combination of clinical and laboratory data. The patient population consisted of 274 women operated on with Madden mastectomy for breast cancer. Assessed were the following parameters: age, menstrual status, histopathological parameters, HER-2 status, estrogen receptor (ER) and progesterone receptor (PR) status, disease stage, quadrant(s) in which breast cancer was detected and axillary lymph nodes status. RESULTS: Of 274 patients 206 (85%) has unifocal disease, 41 (15%) suffered of MF (n=27; 9.9%)/MC (n=14; 5.1%) disease. MC disease was associated with metastatic axillary lymph nodes in 92.9% of the cases. MF/MC cases were primarily dependent on histology. MF/MC cancer was best related to the lobular type (85.7% of the cases), while ductal histological type was characteristic of unifocal tumors. CONCLUSION: Quadrantectomy as a form of conservative breast surgery is acceptable in cases of MF tumors, because all tumor foci can be removed. We suggest radical surgical treatment in all cases of suspected MC tumors because they are most often associated with metastasis to the axillary lymph nodes. Lobular histology characterizes MC breast cancer.

Risk factors for Toxoplasma infection in pregnant women in FYR of Macedonia.

The aim of the study was to identify risk factors for Toxoplasma gondii infection in pregnant women in FYR of Macedonia. Retrospective analysis of serological and epidemiological data in a series of 235 pregnant women from Macedonia, tested for Toxoplasma infection between January 2004 and December 2005, showed an overall prevalence of infection of 20.4%. Exposure to transmission factors significantly increased the risk of infection (RR = 1.989, 95 % CI = 1.041-3.800, p = 0.037). The single infection transmission factor that was a predictor of infection in the whole series was exposure to soil (RR = 1.946, 95% CI = 1.026-3.692, p = 0.041). Based on prevalence and the established risk factors for Toxoplasma infection in Macedonia, the health education programme as a sustainable measure for the prevention of congenital toxoplasmosis should focus on educating women of generative age to avoid contact with soil (farming, gardening), and/to adhere to strict hygienic practices afterwards.

Paraneoplastic bleeding disorder due to isolated hypofibrinogenemia: a case report.

An 80 years old male patient was admitted in our hospital with massive haematomas in the left forearm, chest and abdominal wall accompanied by intense back pain symptoms. Laboratory evaluation showed anemia, mild thrombocytopenia and elevated lactate dehydrogenase and alkaline phosphatase levels and normal concentrations of all the other biochemical parameters. Study of the coagulation status demonstrated prolonged thrombin time (TT), low fibrinogen levels--0.98 g/l while plasminogen, antithrombin III (AT III) and protein C levels were found to be within normal range. Computed tomography scans of the head, chest and abdomen showed an enlarged infiltrative prostate, osteolytic bone lesions in vertebras L5-S1 and a large haematoma of the abdominal wall as the only pathologic findings. Very high levels of the prostate specific antigen indicated the possible existence of a prostate carcinoma with metastases to the vertebral column that resulted in elevated alkaline phosphate and lactate dehydrogenase levels. There were no signs of liver involvement and impaired hepatic synthetic function. Based on the results of the laboratory tests we concluded that the cause of the bleeding disorder in our patient was an acquired hypofibrinogenemia, which is a very rare paraneoplastic phenomenon. The patient was treated with daily transfusions of cryoprecipitate with no long-term improvement. Then the specific anti-tumor therapy (ciproteron acetate) was initiated, and two weeks later, fibrinogen concentration and TT returned to normal values.

Antiproliferative and antimicrobial activity of traditional Kombucha and Satureja montana L. Kombucha.

PURPOSE: To carry out a preliminary investigation of the biological activity of Kombucha beverages from Camellia sinensis L. (black tea) and Satureja montana L. (winter savory tea), that have consuming acidity. MATERIALS AND METHODS: Cell growth effect was measured by sulforhodamine B colorimetric assay on HeLa (cervix epithelioid carcinoma), HT-29 (colon adenocarcinoma), and MCF-7 (breast adenocarcinoma). Antimicrobial activity to bacteria, yeasts and moulds was determined by agar-well diffusion method. RESULTS: Consuming Kombuchas had the most expressive antimicrobial activity against all investigated bacteria, except Sarcina lutea, while unfermented tea samples had no activity. Traditional Kombucha showed higher activity against Staphylococcus aureus and Escherichia coli than acetic acid, while both neutralized Kombuchas had bacteriostatic activity on Salmonella enteritidis. Examined Kombuchas did not stimulate cell proliferation of the investigated cell lines. Antiproliferative activity of winter savory tea Kombucha was comparable to that of traditional Kombucha made from black tea. Furthermore, in HeLa cell line Satureja montana L. Kombucha induced cell growth inhibition by 20% (IC20) at lower concentration compared to the activity of water extract of Satureja montana L. obtained in our previous research. CONCLUSION: Presence of more active antiproliferative component(s) in Satureja montana L. Kombucha compared to Satureja montana L. water extract and antimicrobial component(s) other than acetic acid in both Kombuchas is suggested.

Single-center prospective, randomized analysis of conventional and eversion carotid endarterectomy.

AIM: Several studies, comparing early and long-term results of the conventional carotid endarterectomy (CEA) and eversion carotid endarterectomy (EEA), were conducted for past 10 years. Nevertheless, it still remaining difficult to choose optimal endarterectomy technique. Choice yet mainly depends of experience of attending surgeon. The aim of this study was the comparison early and long-term results of the EEA and CEA. METHODS: Randomly, 103 patients were operated on in the eversion, and 98 patients in the conventional technique; 97 (48.3%) patients were asymptomatic and 104 (51.7%) had symptomatic lesions. All patients underwent preoperative cervical duplex scanning and neurological examination. The surgical procedure was carried out under general anesthesia. In cases with retrograde blood pressure less than 20 mmHg shunt was used; 78.6% of all CEA were finished up with ''patch'' angioplasty and 21.4% by primary suture. The primary outcomes were perioperative and late mortality, perioperative and late central neurological complications, a long-term survival rate and late restenosis incidence. RESULTS: The mean follow-up was 38 months. Mortality and long-term survival rate were similar in compared groups. The perioperative central neurological complications incidence were comparable in study groups (3.9% vs 12.1% , odds ratio 3.45, 95% confidence interval 1.1-11.1; P=0.029). The late restenosis incidence was significantly lower in eversion group (0.0% vs 6.1%). CONCLUSION: EEA has an advantage over the conventional procedure. The authors recommend CEA in cases when retrograde pressure indicated the use of the intraluminal shunting.

Modelling and design of extremely low frequency uniform magnetic field exposure apparatus for in vivo bioelectromagnetic studies.

Helmholtz coils are regularly utilised for various extremely low frequency (ELF) bioelectromagnetic experiments. The evaluation was conducted for the Helmholtz coil magnetic field frequency and uniformity, characterised by frequency-domain and geometric ELF magnetic exposure characteristics. An established approach which consisted of the mathematical calculations of the geometric parameters, computational modeling, and experimental development measurements of the Helmholtz coil's magnetic field frequency and uniformity, improved the quality of magnetic field uniformity and minimised the magnetic field intensity losses.

Inter and intra-hemispheric EEG coherence responses to visual stimulations.

This study investigated whether the visual stimulation at extremely low frequency (ELF) could possibly induce changes in the electroencephalographic (EEG) responses. The functional connectedness was examined between the brain regions when the Minimum Variance Distortion-less Response (MVDR) coherence algorithm together with Wilcoxon signed-ranks test statistical method was applied. The results showed that functional significance of EEG alpha rhythms at parietal, and occipital cortex, respond to oscillatory 13 Hz and 16.66 Hz light stimulation, respectively.

Modified extended end-to-end repair of coarctation in neonates and infants.

Although the classic extended end-to-end repair is the procedure of choice in most neonates and infants with coarctation of the aorta, there is a problem of distance despite extensive mobilization and impairment of growth of the arch because of scarring in some patients. Since December 1999, 15 neonates and infants without significant arch hypoplasia have undergone a modified extended end-to-end repair of coarctation of the aorta at our institution. The anastomosis was performed between the posterior wall of the isthmus and base of the subclavian artery and anterior wall of the descending aorta, resulting in an anastomosis that was usually 1(1/2) times the diameter of the descending aorta. All patients survived and were followed up to 57 months (average, 34). Two patients developed significant gradients 3 months and 1 year postoperatively, respectively, probably from luxurious tissue growth at the suture line. Both were treated successfully with balloon dilatation. The modified extended end-to-end repair provides another option for repair of coarctation in neonates and infants. It requires less mobilization of the arch and descending aorta. It is particularly useful in patients with long isthmus.

Comparison of the effects of continuous and pulsed mobile phone like RF exposure on the human EEG.

It is not clear yet whether Global System for Mobiles (GSM) mobile phone radiation has the ability to interfere with normal resting brain function. There have been reports that GSM exposure increases alpha band power, and does so only when the signal is modulated at low frequencies (Huber, R., Treyer, V., Borbely, A. A., Schuderer, J., Gottselig, J. M., Landolt, H.P., Werth, E., Berthold,T., Kuster, N., Buck, A and Achermann, P. Electromagnetic fields, such as those from mobile phones, alter regional cerebral blood flow and sleep and waking EEG. J Sleep Res 11, 289-295, 2002.) However, as that research employed exposure distributions that are not typical of normal GSM handset usage (deep brain areas were overexposed), it remains to be determined whether a similar result patterning would arise from a more representative exposure. In this fully counterbalanced cross-over design, we recruited 12 participants and tried to replicate the modulation linked post exposure alpha band power increase described above, but with an exposure source (dipole antenna) more closely resembling that of a real GSM handset. Exposures lasted for 15 minutes. No changes to alpha power were found for either modulated or unmodulated radiofrequency fields, and thus we failed to replicate the above results. Possible reasons for this failure to replicate are discussed, with the main reason argued to be the lower and more representative exposure distribution employed in the present study. In addition we investigated the possible GSM exposure related effects on the non-linear features of the resting electroencephalogram using the Approximate Entropy (ApEn) method of analysis. Again, no effect was demonstrated for either modulated or unmodulated radiofrequency exposures.

Influence of sinusoidally modulated visual stimuli at extremely low frequency range on the human EEG activity.

The purpose of this study was to investigate whether sinusoidally modulated visual stimuli at extremely low frequencies (ELF) of 50, 16.66, 13, 10, 8.33 and 4Hz could influence the changes in EEG activity in 33 human subjects. An improved design of visual stimulator system has addressed an issue of electrical interference from electrical signals driven by LED arrays onto simultaneously recorded EEG. A comparison between 1 and 3-Way ANOVA was performed in order to evaluate whether visual stimuli at ELFs could influence the EEG in humans to compliment the currently active medical research in seasonal affective disorder (SAD) and photic driving. The results revealed that under evaluation of 1 and 3-Way repeated-measures ANOVA tests, the Theta, Alpha2 and Gamma EEG bands exhibited a common significant difference between ELF visual stimuli.

Alterations in human EEG activity caused by extremely low frequency electromagnetic fields.

This study has investigated whether extremely low frequency (ELF) electromagnetic fields (EMFs) can alter human brain activity. Linearly polarised magnetic flux density of 20 muT (rms) was generated using a standard double Helmholtz coils and applied to the human head over a sequence of 1 minute stimulations followed by one minute without stimulation in the following order of frequencies 50, 16.66, 13, 10, 8.33 and 4 Hz. We collected recordings on 33 human volunteers under double-blind counter-balanced conditions. Each stimulation lasted for two minutes followed by one minute post-stimulation EEG recording. The same procedure was repeated for the EMF control sessions, where the order of control and exposure sessions was determined randomly according to the subject's ID number. The rest period between two conditions (exposure and control) was 30 minutes. The results indicate that there was a significant increase in Alpha1, Alpha2, and Beta1 at the frontal brain region, and a significant decrease in Alpha2 band in parietal and occipital region due to EMF exposure.

Late relapse of pediatric medulloblastoma.

Medulloblastoma (MB), the most common malignant brain tumor of childhood, is classified according to pathomorphologic characteristics in the group of central nervous system embryonal tumors, but both its pathogenesis and biologic behavior remain unknown. In addition, the relationship of MB to other embryonal brain tumors is debated and response to therapy is difficult to predict. The authors report an uncommon case of unfavorable late relapse, local as well as distant, in a 26-year old male patient, who was free of disease and without treatment-related morbidity for fifteen years after combined therapy for pediatric MB.

Congenital myopathy with uniform type 1 fibers.

Congenital myopathy with uniform type 1 fibers is a rare form of nonprogressive congenital neuromuscular disease. We report a 40 year old woman with proximal muscle weakness, waddling gait and decreased deep tendon reflexes. The serum creatine kinase level was decreased. Peripheral nerve conduction velocity as well as electrocardiogram and echocardiogram were normal. The electromyogram showed myopathic changes. A biopsy specimen from the left deltoid muscle revealed a uniformity of type 1 fibers. This is the first case of congenital myopathy with uniform type 1 fibers reported in Serbia.

Allylthiosulfinate: beta-cyclodextrin inclusion complex: preparation, characterization and microbiological activity.

An allylthiosulfinate: beta-cyclodextrin inclusion complex was synthesized and characterized using X-ray crystallography, IR spectroscopy, thermal analysis and nuclear magnetic resonance. The microbiological activity of the complex was tested on available fungi (Candida albicans ATCC 10231, Aspergillus niger ATCC 16404) and bacteria (Staphylococcus aureus ATCC 6538, Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 9027). In small concentrations, the complex inhibited the growth of the microorganisms tested. The most susceptible microorganism was Candida albicans ATCC 10231, and the least susceptible Pseudomonas aeruginosa ATCC 9027.

Mechanism and kinetics of synthesis of allicin.

Allicin, allyl-thiosulfinate, a pharmacologically active compound with considerable fungicidal, bactericidal, antioxidant and anticarcinogenic effects, was obtained by oxidizing allyl disulfide with acid hydrogen peroxide. The synthesis mechanism was studied by the ESR spin trap method. The kinetics of allicin synthesis was ascertained by determination of the concentration of the limiting reactant during the synthesis using HPLC and it was found that the allicin synthesis reaction was of zero order. The allicin obtained was determined using UV, FT-IR, MS, 1H and 13C NMR analysis.

The modulatory effect of estradiol benzoate on superoxide dismutase activity in the developing rat brain

The sensitivity of copper,zinc (CuZn)- and manganese (Mn)-superoxide dismutase (SOD) to exogenous estradiol benzoate (EB) was investigated in Wistar rats during postnatal brain development. Enzyme activities were measured in samples prepared from brains of rats of both sexes and various ages between 0 and 75 days, treated sc with 0.5 æg EB/100 g body weight in 0.1 ml olive oil/100 g body weight, 48 and 24 h before sacrifice. In females, EB treatment stimulated MnSOD activity on days 0 (66.1 percent), 8 (72.7 percent) and 15 (81.7 percent). In males, the stimulatory effect of EB on MnSOD activity on day 0 (113.6 percent) disappeared on day 8 and on days 15 and 45 it became inhibitory (40.3 and 30.5 percent, respectively). EB had no effect on the other age groups. The stimulatory effect of EB on CuZnSOD activity in newborn females (51.8 percent) changed to an inhibitory effect on day 8 (38.4 percent) and disappeared by day 45 when inhibition was detected again (48.7 percent). In males, the inhibitory effect on this enzyme was observed on days 0 (45.0 percent) and 15 (28.9 percent), and then disappeared until day 60 when a stimulatory effect was observed (38.4 percent). EB treatment had no effect on the other age groups. The sensitivity of MnSOD to estradiol differed significantly between sexes during the neonatal and prepubertal period, whereas it followed a similar pattern thereafter. The sensitivity of CuZnSOD to estradiol differed significantly between sexes during most of the study period. Regression analysis showed that the sensitivity of MnSOD to this estrogen tended to decrease similarly in both sexes, whereas the sensitivity of CuZnSOD showed a significantly different opposite tendency in female and male rats. These are the first reports indicating hormonal modulation of antioxidant enzyme activities related to the developmental process