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A new myxosporean parasite, Ortholinea nupchi n. sp. (Myxozoa; Bivalvulida), was isolated from the urinary bladder of the olive flounder Paralichthys olivaceus cultured on Jeju Island, Korea. Mature spores were subspherical in the valvular and apical views and ellipsoidal in the sutural view. The spores measured 7.6 ± 0.5 μm in length, 6.7 ± 0.3 μm in thickness, and 7.3 ± 0.5 μm in width. Two pyriform polar capsules measured 3.2 ± 0.1 μm in length and 2.7 ± 0.1 μm in width and were located at the same level at the anterior half of the myxospores. The suture line was straight in the middle of the spores, and the surface ridges ranged between five and seven, forming an intricate pattern. The result of the 18S rDNA comparison showed ≤ 93.0% similarity with other Ortholinea species. The phylogenetic tree demonstrated that O. nupchi n. sp. was closest to O. auratae and clustered with oligochaete-infecting myxosporeans (OIM) having urinary system infection tropism. Based on the comparison of environmental and host factors in the phylogenetic groups of the OIM clade, we propose that the infection of O. nupchi n. sp. originated from marine oligochaetes., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflicts of interest., (Copyright © 2023. Published by Elsevier B.V.)

Miamiensis avidus causes scuticociliatosis in cultured olive flounders (Paralichthys olivaceus), leading to economic losses in aquaculture in Korea. Quantitative evaluation of the viability of M. avidus is important to develop an effective vaccine or chemotherapeutic agent against it. We used a colorimetric assay based on the reduction of 2-(4-Iodophenyl)-3-(4-nitrophenyl)-5-(2,4-disulfophenyl)-2H-tetrazolium (WST-1) to quantify the viability of M. avidus. Using this method, we investigated the effect of protease inhibitors on the viability of M. avidus. The assay showed a clear difference in the optical density (OD) of over 10 4 ciliates, and the metalloprotease inhibitors 1, 10-phenanthroline and ethylenediaminetetraacetic acid (EDTA) reduced the viability of M. avidus by more than 90% when used at concentration of 5 mM and 100 μM, respectively. However, different morphological changes in the parasite were observed when exposed to these two inhibitors. These results indicate that the WST-1 assay is a simple and reliable method to quantify the viability of M. avidus, and metalloproteases are excellent targets for the development of agents and vaccines to control M. avidus infection., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objectives: This study aimed to assess the hypothesis that mitral annular disjunction (MAD) is associated with abnormal annular dynamics due to decoupling of annular-ventricular function., Background: MAD, defined as a separation between the atrial wall-mitral valve (MV) junction and left ventricular (LV) attachment, is a structural abnormality occurring in MV prolapse (MVP). Few data exist on the 3-dimensional (3D) geometry of MAD and its functional implication., Methods: A total of 156 subjects including 101 MVP patients (58 ± 11 years), 30 subjects with normal MV (57 ± 15 years), and 25 heart failure patients with functional mitral regurgitation (66 ± 10 years) were studied using real-time 3D transesophageal echocardiography. The spatial relation between atrial wall, MV, and LV attachment was examined for MAD. The 3D extent of MAD and annular dynamics were quantitatively assessed. The LV global longitudinal strain and basal circumferential strains were measured by speckle tracking echocardiography., Results: MAD was evident in 42 MVP patients (42%), measuring 8.9 mm (6.3 to 10.7 mm), circumferentially spanning 87 ± 41°. Dynamically, normal and nondisjunctive annulus contracted and increased in a saddle shape during systole. In heart failure patients with functional mitral regurgitation, mitral annulus was dilated and relatively adynamic, probably related to poor LV function. In contrast, disjunctive annulus displayed paradoxical systolic expansion and flattening (p < 0.0001), despite preserved and comparable LV strains with normal patients. The 3D extent of MAD correlated significantly with abnormal annular dynamics and larger regurgitant orifice (p < 0.0001). In MVP patients without MAD, the LV global longitudinal strain correlated inversely with change in height (r = -0.61; p < 0.0001), whereas LV basal circumferential strain correlated with change in area (r = 0.61; p < 0.0001), but not in patients with MAD (p > 0.05)., Conclusions: MAD is a common anatomic abnormality in MVP. The disjunctive annulus is decoupled functionally from the ventricle, leading to paradoxical annular dynamics with systolic expansion and flattening, and may thus require specific intervention., (Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Background: Quantitative analysis of mitral valve morphology with three-dimensional (3D) transesophageal echocardiography (TEE) provides anatomic information that can assist clinical decision-making. However, routine use of mitral valve quantification has been hindered by tedious workflow and high operator-dependence. The purpose of this paper was to evaluate the feasibility, accuracy and efficiency of a novel computer-learning algorithm using anatomical intelligence in ultrasound (AIUS) to automatically detect and quantitatively assess the mitral valve anatomy., Methods: A novice operator used AIUS to quantitatively assess mitral valve anatomy on the 3D TEE images of 55 patients (33 with mitral valve prolapse, 11 with functional mitral regurgitation, and 11 normal valves). The results were compared to that of manual mitral valve quantification by an experienced 3D echocardiographer and, in the 24 patients who underwent mitral valve repair, the surgical findings. Time consumption and reproducibility of AIUS were compared to the manual method., Results: AIUS mitral valve quantification was feasible in 52 patients (95%). There were excellent agreements between AIUS and expert manual quantification for all mitral valve anatomic parameters (r=0.85-0.99, p<0.05). AIUS accurately classified surgically defined location of prolapse in 139 of 144 segments analyzed (97%). AIUS improved the intra- [intraclass-correlation coefficient (ICC)=0.91-0.99] and inter-observer (ICC=0.86-0.98) variability of novice users, surpassing the manual approach (intra-observer ICC=0.32-0.95; inter-observer ICC=0.45-0.93), yet requiring significantly less time (144±24s vs. 770±89s, p<0.0001)., Conclusion: Anatomic intelligence in 3D TEE image can provide accurate, reproducible, and rapid quantification of the mitral valve anatomy., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Introduction: In functional mitral regurgitation (FMR), effective regurgitant orifice area (EROA) displays a dynamic pattern. The impact of dynamic changes of annulus dysfunction and leaflets tenting on phasic EROA was explored with real-time three-dimensional transesophageal echocardiography (RT3D-TEE)., Methods: RT3D-TEE was performed in 52 FMR patients and 30 controls. Mitral annulus dimensions and leaflets tenting were measured throughout systole (TomTec, Germany). Phasic EROA was measured by proximal isovelocity surface area (PISA) method., Results: Mitral annulus had the minimal area and an oval shape with saddle configuration during early systole in controls, which enlarged and became round and flattened towards mid and late systole (P<0.05). In contrast, annulus in FMR was significantly larger, rounder and flatter (P<0.001), which further dilated and became more flattened at late systole (P<0.05 vs control). Leaflet tenting height in FMR decreased in mid systole and remains unchanged towards late systole. The leaflet tenting volume peaked at early and late systole with a mid-systolic trough in both FMR and controls. But tenting volume of patients with FMR was significantly larger than that of controls (all P<0.001 vs control in whole systole). Further analysis demonstrated that early tenting volume (β value=0.053, P<0.05) was a predictor of early EROA, whereas late tenting volume (β value=0.031, P<0.05) and late annular displacement velocity were predictors of late EROA., Conclusions: The early and late peak EROAs of FMR was primarily contributed by tenting volume at early systole and late systole respectively. These findings would be of value to consider in interventions aimed at reducing the severity of FMR., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Cardiac auscultation by stethoscope is widely used but limited by low sensitivity and accuracy. Phonocardiogram was developed in an attempt to provide quantitative and qualitative information of heart sounds and murmurs by transforming acoustic signal into visual wavelet. Although phonocardiogram provides objective heart sound information and holds diagnostic potentials of different heart problems, its examination procedure is time-consuming and it requires specially trained technicians to operate the device. Acoustic cardiography (AUDICOR, Inovise Medical, Inc., Portland, OR, USA) is a major recent advance in the evolution of cardiac auscultation technology. The technique is more efficient and less operator-dependent. It synchronizes cardiac auscultation with ECG recording and provides a comprehensive assessment of both mechanical and electronic function of the heart. The application of acoustic cardiography is far beyond auscultation only. It generates various parameters which have been proven to correlate with gold standards in heart failure diagnosis and ischemic heart disease detection. Its application can be extended to other diseases, including LV hypertrophy, constrictive pericarditis, sleep apnea and ventricular fibrillation. The newly developed ambulatory acoustic cardiography is potentially used in heart failure follow-up in both home and hospital setting. This review comprehensively summarizes acoustic cardiographic research, including the most recent development., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

The histophagous scuticociliate Philasterides dicentrarchi causes fatal scuticociliatosis in farmed olive flounder Paralichthys olivaceus. The average monthly prevalence of scuticociliatosis with P. dicentrarchi infections was very high from May to July (40+/-3 to 79+/-2%) in olive flounder at farms of Jeju Island, South Korea, from 2000 to 2004. The prevalence of mixed infection along with Vibrio spp. infection was higher (49+/-8%) than that of scuticociliatosis alone. To date no effective control measure for P. dicentrarchi infection has been described and large economic losses continue. In the present study 3 chemotheraputants (formalin, hydrogen peroxide and Jenoclean) were used. Among these, bath treatment with Jenoclean at a low concentration of 50ppm proved effective; the results were confirmed with in vitro motility assessments and morphological changes in P. dicentrarchi. A similar trend was noted following hydrogen peroxide treatment. However, formalin was only moderately effective at this concentration. Therefore, hydrogen peroxide and Jenoclean are the promising compounds effective at low concentrations with short application time.

Recently, mass mortality due to histophagous scuticociliate, Philasterides dicentrarachi in olive flounder, Paralichthys olivaceus occurred in aquaculture farms of Jeju Island, South Korea. We have artificially induced infection through immersion on day 12, the density of ciliates slowly decreased in the experimental tanks; on day 28 to 2300cells/ml in 3cm group and 1800cells/ml in 5cm group. The survival rate of P. olivaceus on days 24 and 28 of infection in the 3cm group was decreased to 4 and 6, respectively; however, no mortality was recorded in the 5cm group. In the control group 100% survival in the chosen period of both groups occurred except in the 3cm group whereas on days 24 and 28 the death rate was 1 and 2, respectively. Many ciliates with ingested red blood cells were observed in the gills, skeletal muscle, skin, fins and brains of infected flounder. The parasites were also observed in the lamina propria of the digestive tract, pharynx, peritoneal fluid, cerebrospinal fluid and cornea. Histopathological and inflammatory changes were characterized by swelling and generalized erythema and muscle tissue necrosis. Affected fish showed varying levels of tissue damage including severe epidermal and dermal necrotic lesions. Loss of scales, appearance of bleached spots that coalesced to form brownish patches, haemorrhagic and severe dermal necrotic lesions were the major clinico-pathological manifestations. The parasite was also seen distributed extensively in the entire brain causing widespread nerve necrosis after a prolonged period of infection. These results appear to support the hypothesis that the P. dicentrarchi may be penetrating via the gills or the skin, and then travel via the bloodstream to other parts of the body, including the body cavity.