Field Evaluation of a PCR Test for Schistosoma japonicum Egg Detection in Low-Prevalence Regions of China

Sensitive Schistosoma japonicum detection methods are needed to progress from schistosomiasis control to elimination. The sensitivity of the Kato-Katz thick smear and miracidium hatching tests decrease with infection intensity and serological tests cannot always identify current infections. We evaluated a fecal polymerase chain reaction (PCR) assay to detect S. japonicum infection in 106 humans and 8 bovines in China. PCR was highly sensitive, detecting S. japonicum DNA at 0.5 eggs/g of stool. Comparing PCR examination of a single stool sample to the miracidium hatching test using three consecutive stool samples, more humans were hatching test positive (20%) than PCR positive (15%). However, two individuals were PCR positive in a village where no infections were detected by coprological methods. The sensitivity of PCR makes it a promising tool for schistosomiasis diagnostics and screening, although egg shedding variability and stool sample size present challenges for any detection method in low-transmission areas.     

Elucidation of the electron energy structure of TiO2(B) and anatase photocatalysts through analysis of electron trap density

A clear understanding of the electron energy structure of TiO₂(B)/anatase is needed to study the related catalytic reactions and design new composite photocatalysts. In this study, the electron energy structures of TiO₂(B) and anatase were estimated by analyzing the energy-resolved distribution of electron traps measured by reversed double-beam photoacoustic spectroscopy. In the mixture of TiO₂(B) and anatase, interfacial charge-transfer excitation from anatase to electron traps of TiO₂(B) was suggested. By analyzing this for TiO₂(B), the electron level with a relatively high density of states was found to be located ∼0.07 eV deeper than that for anatase. Furthermore, a similar electron energy structure was suggested for a composite photocatalyst having a mixed phase of TiO₂(B) and anatase.

The electron energy structures of TiO₂(B) and anatase were estimated by analyzing the energy-resolved distribution of electron traps.     

Influence of molecular weight and concentration of carboxymethyl chitosan on biomimetic mineralization of collagen

The objective of the present study was to systematically investigate the influence of molecular weight (MW) and concentration of carboxymethyl chitosan (CMC), which served as non-collagenous protein (NCP) surrogates, on biomimetic mineralization of type I collagen. Supersaturated CMC-stabilized amorphous calcium-phosphate (CMC-ACP) dispersions containing different MWs (20 kDa, 60 kDa, 150 kDa) and concentrations (25, 50, 100, 200, 400 μg ml⁻¹) of CMC were prepared. After mineralization in the aforementioned dispersions for 7 days, the pattern and extent of biomimetic mineralization of collagen scaffolds were investigated. Our study showed that increasing CMC concentration resulted in increasing stability and decreasing particle size of CMC-ACP dispersions. Images from scanning and transmission electron microscopy revealed that intrafibrillar mineralization of collagen was obtained with 20k-200, 60k-100, 60k-200 and 150k-200 CMC-ACP dispersions, with hydroxyapatite (HAp) formation confirmed by Fourier transform infrared spectroscopy and X-ray diffraction measurements, whereas HAp formed extrafibrillar clusters in other collagen scaffolds. Thermogravimetric analysis showed that the combined effect of MW and concentration of CMC contributed to different extents of biomimetic mineralization, and was correlated with the stability and particle size of CMC-ACP dispersions, and the size-exclusion characteristics of type I collagen. The results of this work support the effective function of CMC as NCP analogs, and provide parameters of MWs and concentrations of CMC for applications in hard tissue engineering as well as insights into intersections of mechanisms in biomimetic mineralization.

The study systematically investigated the influence of molecular weight and concentration of CMC on CMC-ACP nanoparticles and biomimetic mineralization.     

Atypical Pneumocystis jiroveci pneumonia with multiple nodular granulomas after rituximab for refractory nephrotic syndrome

Background

Rituximab, an anti-CD20 antibody that targets B cells, is a promising agent against steroid-dependent and steroid-resistant nephrotic syndrome in children.

Case-Diagnosis/Treatment

We report a 3-year-old boy who presented with atypical Pneumocystis jiroveci pneumonia (PCP) following administration of rituximab for refractory nephrotic syndrome. He had received cyclosporine and daily prednisolone for over 1?year. Following rituximab therapy, a hazy shadow was observed on his chest X-ray. Chest-computed tomography revealed multiple nodular lesions in bilateral lungs, although his clinical symptoms were subtle. PCR analysis demonstrated the presence of Pneumocystis DNA in his bronchoalveolar lavage. Lung wedge resection of the nodular lesion exhibited granulomas containing a few cysts of P. jiroveci that primarily consisted of T cells and histiocytes and lacked B cells. A deficiency of B cells following rituximab treatment suggests a dramatic effect on the immune response and, therefore, could result in granulomatous PCP. Nodular granulomatous lesions of PCP comprise an emerging concept previously reported in adults with hematological disease, bone marrow transplant, or treatment with rituximab. We report the first pediatric case of nodular PCP. Granulomatous PCP can be life-threatening. Moreover, bronchoalveolar lavage often fails to demonstrate the presence of P. jiroveci DNA. Wedge biopsy is warranted for definitive diagnosis. Our patient fully recovered with sulfamethoxazole/trimethoprim treatment because of early detection.

Conclusions

The indication of rituximab for refractory nephrotic syndrome has increased recently. Therefore, recognition of the risk of atypical PCP is important. Our findings suggest that PCP prophylaxis should be considered following rituximab therapy.