An international outbreak of Shiga toxin-producing Escherichia coli O157 infection due to lettuce, September-October 2007.

Between 14 September and 20 October 2007, an outbreak of Shiga toxin-producing Escherichia coli (STEC) O157 simultaneously occurred in the Netherlands and Iceland. A total of 50 laboratory-confirmed cases were reported with a STEC O157 infection caused by the same clone. The strain was of type O157:H-, PT8, positive for stx1, stx2, eae and e-hly, and sorbitol negative. The most probable cause of this international outbreak was contaminated lettuce, shredded and pre-packed in a Dutch food processing plant. Samples of the environment, raw produce and end products, taken at several vegetable growers and processing plants all tested negative for STEC O157. However, the only epidemiological link between the cases in the Netherlands and in Iceland was the implicated Dutch processing plant. In Europe, food products are often widely distributed posing the risk of potential spread of food borne pathogens simultaneously to several countries. This international outbreak emphasises the importance of common alert and surveillance systems in earlier detection of international outbreaks and better assessment of their spread.

[Hirschprung' disease in Iceland 1969-1998.].

INTRODUCTION: Hirschprung s disease (HD) is a congenital disease characterized by the absence of myenteric and submucosal ganglion cells in the distal alimentary tract and results in decreased motility in the affected bowel segment. The purpose of this study was to review the incidence, presentation, treatment and operative results in children with Hirschprung's disease in Iceland. MATERIAL AND METHODS: Thirteen infants with Hirschprung s disease (11 boys and two girls) were treated in Landspítalinn University Hospital between January 1969 and December 1998. The records of these patients were reviewed retrospectively. RESULTS: The incidence of Hirschprung's disease in Iceland is 1/10,000 and 85% of those are boys. All the infants were born full term. No family history and no associated abnormalities were noted. The mean age at first admission was 20 (1-136) days and mean age at diagnosis was 166 (5-623) days. Swenson's pull-through (two- or three-stage procedure) was carried out in all patients at the mean age of 18.6 months. The extent of aganglionosis was rectosigmoid colon in 10 patients (77%) and one patient had total colonic aganglionosis. Postoperative complications occurred in seven patients (53%), adhesion ileus being the most common complication. Long term bowel function was satisfactory in 85% of the patients. CONCLUSIONS: The incidence of Hirschprung's disease in Iceland is low. Mean age at diagnosis is six months. Sixty percent of the children are discharged with a wrong diagnosis after first admission to hospital and this could be improved by diagnosing the disease at an earlier stage. Postoperative complications are common but no deaths occurred. Bowel function following definitive correction is good compared to other studies.

CPH 82 (Reumacon) in refractory inflammatory arthritis.

In this retrospective analysis of the DMARD CPH 82 in 44 Icelandic patients with severe refractory arthritis, clinical tolerance was good and serious side effects absent, although the majority were using the drug in combination with other DMARDS. Side effects leading to discontinuation were seen in 16% and the three year drug-survival was 51%.

Methazolamide 1% in cyclodextrin solution lowers IOP in human ocular hypertension.

PURPOSE: To formulate aqueous eye drops containing methazolamide 1% in cyclodextrin solution and to evaluate their effect on intraocular pressure (IOP) in a double-blind randomized trial in humans. Methazolamide, a carbonic anhydrase inhibitor (CAI), has been used in oral doses in the treatment of glaucoma but hitherto has not been successfully formulated in eye drops. In this study the effects of methazolamide are compared with those of dorzolamide (Trusopt). METHODS: Methazolamide 1% was formulated in a 2-hydroxypropyl-beta-cyclodextrin with hydroxypropyl methylcellulose in aqueous solution. Eight persons with ocular hypertension were treated with the methazolamide-cyclodextrin eye drops and eight persons with dorzolamide (Trusopt), both groups at dosages of three times a day for 1 week. IOP was measured before treatment was begun and on days 1, 3, and 8 at 9 AM (peak) and 3 PM (trough). RESULTS: After 1 week of treatment, the peak IOP in the methazolamide group had decreased from 24.4 +/- 2.1 mm Hg (mean +/- SD) to 21.0 +/- 2.0 mm Hg, which is a 14% pressure decrease (P: = 0.006). In the dorzolamide group, the peak IOP decreased from 23.3 +/- 2.1 mm Hg to 17.2 +/- 3.1 mm Hg, which is a 26% pressure decrease (P: < 0.001). On average, the IOP declined 3.4 +/- 1.8 mm Hg after methazolamide administration and 6.1 +/- 3.6 mm Hg after dorzolamide. CONCLUSIONS: Through cyclodextrin complexation, it is possible to produce topically active methazolamide eye drops that lower IOP. This is the first double-blind clinical trial that demonstrates the efficacy of the classic CAIs in eye drop formulation.

"With the rule" astigmatism is not the rule in the elderly. Reykjavik Eye Study: a population based study of refraction and visual acuity in citizens of Reykjavik 50 years and older. Iceland-Japan Co-Working Study Groups.

PURPOSE: To study refractive state and visual acuity in citizens of Reykjavik 50 years and older. METHODS: 1700 persons were randomly selected from the national population census. 1379 could be located and qualified whereof 1045 participated. Evaluation of refraction was performed using Nidek ARK 900 autorefracto-keratometer. Visual acuity was tested on a Snellen chart. RESULTS: The prevalence of hypermetropia increases with age by 0.3 D in five years. The prevalence of "against the rule" astigmatism increased on average 5.3% and oblique 3.9% in five years. Analysis of corneal astigmatism measured by keratometer shows an "against the rule" change with age. CONCLUSIONS: Hypermetropia increases by age. The prevalence of astigmatism increases and the axis turns to "against the rule". The changes in total astigmatism and corneal astigmatism is almost parallel which might indicate that the "against the rule" change is related to changes in the cornea.

Isolation and characterization of two cDNAs from Atlantic cod encoding two distinct psychrophilic elastases.

The cDNAs encoding two different Atlantic cod elastases have been isolated and sequenced. The predicted amino acid sequences revealed two preproelastases, consisting of a signal peptide, an activation peptide and a mature enzyme of 242 and 239 amino acids. Amino acid sequence identity between the two cod elastases was 60.1% and identity with mammalian elastases ranged from 50-64%. The two cod elastases contain all the major structural features common to serine proteases, such as the catalytic triad His57, Asp102 and Ser195. Both cod elastases have a high content of methionine, consistent with previous findings in psychrophilic fish enzymes.

Isolation and characterization of cDNAs from Atlantic cod encoding two different forms of trypsinogen.

The cDNAs encoding two different anionic forms of Atlantic cod trypsinogen have been isolated and sequenced. The nucleotide sequences include the 5'-noncoding and 3'-noncoding regions in addition to preproenzymes of 241 amino acids. These consist of hydrophobic signal peptides, activation hexapeptides and trypsins of 222 amino acid residues. The cod trypsins contain all the major structural features common to trypsins such as the catalytic triad His57, Asp102 and Ser195. Furthermore, the obligatory Asp189 and the six disulphide bonds are conserved. Eight amino acid residues are different between the isozymes, leading to a difference of four charges. Both cod trypsins are one-amino-acid-residue shorter than most mammalian trypsins as a result of deletion of proline at position 152, and have a high methionine content. In addition, the cod preproenzyme signal and activation peptides differ markedly from their mammalian analogues. The amino acid identity between the cod and bovine trypsins is approximately 60%.

Combined effects of age and dietary fat on beta 1-receptors and Ca2+ channels in rat hearts.

Male Wistar rats were fed a standard diet or diets supplemented with 10% butter, 10% corn oil, or 10% cod liver oil from the age of 2 mo. At 7 and 24 mo of age, the fatty acid composition of total phospholipids was determined in ventricular crude sarcolemma preparations; binding capacity and affinity (1/Kd) of [3H]dihydroalprenolol and [3H]nitrendipine binding were also determined. The arachidonic acid level was significantly higher at 24 mo than at 7 mo of age in the membrane phospholipids in rats fed no extra fat, but in rats fed fat-supplemented diets, age had no effect. Affinity of Ca2+ channels for [3H]nitrendipine decreased significantly in all dietary groups between 7 and 24 mo of age, whereas the affinity of beta 1-receptors for [3H]dihydroalprenolol increased in corn oil-fed rats. Density of beta 1-receptors decreased significantly in corn oil- and butter-fed rats and rats fed no extra fat between 7 and 24 mo of age, whereas the density of Ca2+ channels decreased significantly in corn oil-fed rats. We conclude that the antagonist binding properties of Ca2+ channels and beta 1-adrenergic receptors in rat hearts may change with age depending on the dietary fat.

Influence of dietary cod liver oil on fatty acid composition of plasma lipids in human male subjects after myocardial infarction.

A randomized crossover study was carried out to investigate the fatty acid profile and concentrations of plasma lipids in male patients with myocardial infarction (MI) who supplemented their diet with 20 ml cod liver oil daily for 6 weeks. Subjects were divided into two groups, A and B. Group A received cod liver oil daily for 6 weeks after hospital discharge, but none for the subsequent 6 weeks. Group B did not start taking cod liver oil until 6 weeks after hospital discharge, and they then took cod liver oil for 6 weeks. Diet, medication or smoking habits were kept as constant as possible during the study. During the period of cod liver oil intake, eicosapentaenoic acid (20:5 (n-3), EPA) and docosahexaenoic acid (22:6 (n-3), DHA) increased significantly in phospholipids (PL), triglycerides (TG) and cholesterol esters (CE), whereas linoleic acid (18:2 (n-6), LA), dihomo-gamma-linolenic acid (20:3 (n-6), DHGLA) and arachidonic acid (20:4 (n-6), AA) were significantly decreased in phospholipids. The plasma level of TG was significantly decreased during the cod liver oil intake. Total cholesterol, high density lipoprotein (HDL) cholesterol, and levels of apolipoproteins A1 and B were not affected by cod liver oil in these MI patients.