Natural outbreak of Streptococcus agalactiae (GBS) infection in wild giant Queensland grouper, Epinephelus lanceolatus (Bloch), and other wild fish in northern Queensland, Australia.

Ninety-three giant Queensland grouper, Epinephelus lanceolatus (Bloch), were found dead in Queensland, Australia, from 2007 to 2011. Most dead fish occurred in northern Queensland, with a peak of mortalities in Cairns in June 2008. In 2009, sick wild fish including giant sea catfish, Arius thalassinus (Rüppell), and javelin grunter, Pomadasys kaakan (Cuvier), also occurred in Cairns. In 2009 and 2010, two disease epizootics involving wild stingrays occurred at Sea World marine aquarium. Necropsy, histopathology, bacteriology and PCR determined that the cause of deaths of 12 giant Queensland grouper, three wild fish, six estuary rays, Dasyatis fluviorum (Ogilby), one mangrove whipray, Himantura granulata (Macleay), and one eastern shovelnose ray, Aptychotrema rostrata (Shaw), was Streptococcus agalactiae septicaemia. Biochemical testing of 34 S. agalactiae isolates from giant Queensland grouper, wild fish and stingrays showed all had identical biochemical profiles. The 16S rRNA gene sequences of isolates confirmed all isolates were S. agalactiae; genotyping of selected S. agalactiae isolates showed the isolates from giant Queensland grouper were serotype Ib, whereas isolates from wild fish and stingrays closely resembled serotype II. This is the first report of S. agalactiae from wild giant Queensland grouper and other wild tropical fish and stingray species in Queensland, Australia.

The imaging of coeliac disease and its complications.

Coeliac disease is a malabsorption syndrome in which dietary gluten damages the small bowel mucosa. Gluten contains gliadin, the primary toxic component that is primarily found in wheat, barley and rye products. The initial diagnosis of coeliac disease is usually made by endoscopic biopsy of the jejunum although sometimes imaging features can suggest the diagnosis. Once a diagnosis is made, patients need to be diet compliant and monitored for potential complications. Many complications are more common when dietary compliance is poor. Complications include intussusception (usually intermittent), ulcerative jejunitis, osteomalacia, cavitating lymph node syndrome and an increased risk of malignancies such as lymphoma, adenocarcinoma and squamous cell carcinoma. Radiological evaluation is central in the evaluation of these complications. Imaging may assist both in the diagnosis and staging of complications as well as enabling radiological guided percutaneous biopsy for complications of coeliac disease such as lymphoma. As coeliac disease is a relatively common disorder, it is likely that most radiologists will encounter the disease and its potential complications. The aim of this review article is to discuss and illustrate the role of modern radiology in evaluating the many presentations of this complex disease.

A novel technique in selective venous sampling in the localization of parathyroid tumours utilizing a micro-wire and standardized catheter.

Selective venous sampling (SVS) is a useful technique to localize a number of hormone-producing tumours, such as parathyroid tumours, when other imaging techniques are inconclusive. Typically, a 5 French selective single end-hole catheter and standard hydrophilic wire are utilized to access the required vessels and an attempt made to withdraw blood. However, most interventional radiologists are familiar with the difficulty and limited success in withdrawing venous blood through an end-hole catheter. We describe a simple, cheap and novel technique utilizing a micro-wire that we have developed in our interventional suite to overcome this common problem. Having reached the target site with the selective end-hole catheter, a Tuohy Borst adapter is attached to the catheter end. A 0.018-inch micro-wire is then inserted through the selective end-hole catheter such that the distal wire tip exits the distal catheter tip. The purpose of the micro-wire exiting the catheter is to both straighten the catheter tip to a position parallel to the vessel, allowing easier aspiration as well as physically preventing blockage of the catheter by the vein intimal wall collapse on suction. The 5-ml sample required for PTH assay is then successfully obtained via the Tuohy Borst adapter.