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The aim of this study was to compare the quality of dynamic wave arc (DWA) and coplanar volumetric modulated arc therapy (co-VMAT) plans for the treatment of localized prostate cancer. The planning target volume (PTV)-rectum, a section of the PTV comprising the PTV minus that of the rectum, received 78 Gy in 39 fractions as the mean dose to the PTV-rectum. The DWA and co-VMAT plans were generated for each patient using the RayStation treatment planning system for the Vero4DRT system. The PTV-rectum dose (D95%: the percent dose irradiating 95% of the volume), homogeneity index (HI), conformity index (CI), as well as doses to the bladder wall, rectum wall (V10–70 Gy: the percent volume receiving 10–70 Gy), and bilateral femoral heads of the DWA and co-VMAT plans were compared. The output monitor unit (MU) and delivery time obtained for each set of plans were also investigated. In terms of target coverage, the DWA plans provided an average D95% of 75.5 Gy, which was comparable to the co-VMAT-plan D95% of 75.2 Gy (p

Purpose We investigated the interfractional variation in the tumor position during lung stereotactic body radiotherapy (SBRT) under expiratory-phase breath hold (BH) using cone-beam computed tomography (CBCT). Methods A total of 79 patients with lung cancer were treated with lung SBRT, wherein the Abches system under expiratory-phase BH was used to study interfractional variation. The tumors were located in the upper lobe in 31 cases, in the middle lobe in 11 cases, and in the lower lobe in 37 cases. Planning CTs were scanned under expiratory-phase BH with the Abches system. The 3-degrees-of-freedom (DOF) tumor-based setup using CBCT images under expiratory-phase BH was performed after a 6-DOF bony vertebrae-based setup using an ExacTrac X-ray system. Interfractional variation in the lung tumor position was defined as the difference in the position of the lung tumor relative to the bone anatomy in the left-right (LR), antero-posterior (AP), and craniocaudal (CC) directions represented as absolute values. Results The interfractional variation in the lung tumor position was very similar in all the lung regions, and its mean ± standard deviation values in all patients were 1.0 ± 1.1, 1.6 ± 1.9, and 1.6 ± 1.9 mm in the LR, AP, and CC directions, respectively. Further, 99.1%, 92.4%, and 92.7% of all the fractions for the interfractional tumor positional variation in the LR, AP, and CC directions were less than 5 mm, respectively. Conclusion The interfractional variation in the tumor position was small for lung cancer patients treated with the Abches system under expiratory-phase BH.

To improve the homogeneity and conformity of the irradiation dose for postoperative breast cancer including regional lymph nodes, we planned Hybrid volumetric-modulated arc therapy (VMAT), which combines conventional tangential field mainly for the chest area and VMAT mainly for the supraclavicular area and marginal zone. In this study, we compared the dosimetric impact between traditional 3D conformal radiotherapy (3DCRT) and Hybrid VMAT and observed toxicities following Hybrid VMAT. A total of 70 patients indicated between October 2016 and December 2017 were included. The prescribed dose was 50 Gy/25 fractions. For the dosimetric impact, 3DCRT and Hybrid VMAT plans were compared in each patient with respect to the dosimetric parameters. Toxicities were followed using the Common Terminology Criteria for Adverse Events version 4.0. The median follow-up duration was 319 days. For the dosimetric impact, the homogeneity index (HI) and conformity index (CI) of PTV were significantly improved in the Hybrid VMAT plan compared with that in the 3DCRT plan (HI, 0.15 ± 0.07 in Hybrid VMAT vs 0.41 ± 0.19 in 3DCRT, P

Background Few studies have assessed hydrogel spacer shrinkage during external-beam radiation therapy following brachytherapy for localized high-risk prostate cancer. This case presentation evaluated the changes in hydrogel spacer appearance by magnetic resonance imaging during external-beam radiation therapy after brachytherapy for prostate cancer and analyzed the effect of this shrinkage on the dose distribution in four cases. Case presentation In all cases, we implanted 125I sources using a modified peripheral loading pattern for seed placement. The prescribed dose for each implant was 110 Gy. After delivering the sources, a hydrogel spacer was injected. All cases underwent external-beam radiation therapy approximately 1–2 months after brachytherapy. The prescribed dose of external-beam radiation therapy was 45 Gy in 1.8-Gy fractions. Magnetic resonance imaging was performed for evaluation on the day following seed implantation (baseline), at external-beam radiation therapy planning, and during external-beam radiation therapy. The median hydrogel spacer volume was 16.2 (range 10.9–17.7) cc at baseline, 14.4 (range, 9.4–16.1) cc at external-beam radiation therapy planning, and 7.1 (range, 2.0–11.4) cc during external-beam radiation therapy. The hydrogel spacer volume during external-beam radiation therapy was significantly lower than that at external-beam radiation therapy planning. The rectum V60–80 (rectal volume receiving at least 60–80% of the prescribed dose of external-beam radiation therapy) during external-beam radiation therapy was significantly higher than that at external-beam radiation therapy planning. Conclusions The potential reduction in hydrogel spacer size during external-beam radiation therapy following brachytherapy can lead to unexpected irradiation to the rectum. This case presentation would be helpful for similar cases.

Purpose We aimed to evaluate the magnetic resonance imaging (MRI) appearance changes during stereotactic radiotherapy (SRT) for large sized brain metastases, and analyze the lesions necessitating treatment plan modification. Materials and methods A total of 23 patients (27 lesions, >2 cm in tumor diameter) underwent SRT and all lesions were evaluated the appearance changes which had the necessity of the treatment plan modification. The appearance change of tumor during SRT was evaluated using gadolinium-enhanced MRI. The reasons of the modification were classified into tumor reduction, tumor enlargement, displacement, and shape change. Results Among the 27 lesions, 55.6% required the treatment plan modification. The reasons were tumor reduction in six lesions, tumor enlargement in three lesions, displacement in three lesions, and shape change in three lesions. The planning target volume (PTV) size changed up to 43.0% and the shift of center of PTV was a maximum of 1.7 mm. The pathological status (adenocarcinoma vs others) and timing of steroid administration (prior vs after SRT start) were the predictive factors of tumor changes required the modification. Conclusions As tumor changes might occur even during short period of SRT, the treatment plan evaluation and modification were important in SRT for large brain metastases.

Purpose The detection of intestinal/rectal gas is very important during image-guided radiation therapy (IGRT) of prostate cancer patients because intestinal/rectal gas increases the inter- and intra-fractional prostate motion. We propose a deep convolutional neural network (DCNN) to detect intestinal/rectal gas in the pelvic region. Material and methods We selected 300 anterior-posterior kilo-voltage (kV) X-ray images from 30 prostate cancer patients. Thirty images were randomly chosen for a test set, and the remaining 270 images used as the training set. The intestinal/rectal gas was manually delineated on kV X-ray images and segmented. The training images were augmented by applying artificial shifts and fed into a DCNN. The network models were trained to keep the quality of the output image close to the quality of the input image by pooling and upsampling. The training set was used to adjust the parameters of the DCNN, and the test set was used to assess the performance of the model. The performance of the DCNN was evaluated using a fivefold cross-validation procedure. The dice similarity coefficient (DSC) was calculated to evaluate the detection accuracy between the manual contour and auto-segmentation. Results The DCNN was trained within approximately 17 min with a time step of 20 s/epoch. The training and validation accuracy of the models after 50 epochs were 0.94 and 0.85, respectively. The average ± standard deviation of the DSC for 30 test images was 0.85 ± 0.08. Conclusions The proposed DCNN method can automatically detect the intestinal/rectal gas in kV images with good accuracy.

Thermoplastic masks, used along with surgical masks, enable immobilization methods to reduce the risk of infection in patients undergoing intracranial stereotactic radiosurgery and stereotactic radiotherapy (SRS/SRT) during the COVID‐19 crisis. The purpose of this study was to investigate the feasibility of thermoplastic mask immobilization with a surgical mask using an ExacTrac system. Twelve patients each with brain metastases were immobilized using a thermoplastic mask and a surgical mask and only a thermoplastic mask. Two x‐ray images were acquired to correct (XC) and verify (XV) the patient’s position at a couch angle of 0°. Subsequently, the XC and XV images were acquired at each planned couch angle for non‐coplanar beams. When the position errors were detected after couch rotation for non‐coplanar beams, the errors were corrected at each planned couch angle until a clinically acceptable tolerance was attained. The position errors in the translational and rotational directions (vertical, lateral, longitudinal, pitch, roll, and yaw) were retrospectively investigated using data from the ExacTrac system database. A standard deviation of XC translational and rotational position errors with and without a surgical mask in the lateral (1.52 vs 2.07 mm), longitudinal (1.59 vs 1.87 mm), vertical (1.00 vs 1.73 mm), pitch (0.99 vs 0.79°), roll (1.24 vs 0.68°), and yaw (1.58 vs 0.90°) directions were observed at a couch angle of 0°. Most of patient positioning errors were less than 1.0 mm or 1.0° after the couch was rotated to the planned angle for non‐coplanar beams. The overall absolute values of the translational and rotational XV position errors with and without the surgical mask were less than 0.5 mm and 0.5°, respectively. This study showed that a thermoplastic mask with a surgical mask is a feasible immobilization technique for brain SRS/SRT patients using the ExacTrac system.

A tick infestation is one of the most common arthropod-related skin diseases in Hokkaido, the northernmost island of Japan. Ticks also act as an infectious disease vector for humans. Tick-borne encephalitis (TBE), a highly mortal central nervous system infection caused by TBE virus (TBEV), has sporadically occurred there recently. However, there have been no epidemiological data on the current surveillance of human tick bites and the prevalence of TBEV in human-feeding ticks. This study was performed to clarify those indeterminate issues. One hundred and fifty-three ixodid ticks feeding on humans were collected from 150 outpatients in Hokkaido during the season of April to August 2018. None of the cases showed any infectious symptoms. These ticks were morphologically identified to species, and a cytopathic assay on baby hamster kidney cells was carried out to detect TBEV from each tick. The tick collection consisted of 108 Ixodes persulcatus (one nymph and 107 adult females), 44 female Ixodes ovatus, and one female Haemaphysalis japonica. No tick extracts showed positive results of the cytopathic assay, suggesting the non-existence of TBEV in the present specimens. However, the survey to detect TBEV from human-feeding ticks is still important to monitor the occurrence of TBE, because human tick bites by I. ovatus, a possible vector of TBEV, are increasing even in the northern and eastern areas of Hokkaido.

Purpose To improve the hybrid VMAT treatment plan robustness for postoperative breast cancer patients considering small patient motion shifts during treatment using a 3D-CRT with a dose gradient in the junction region. Methods Locoregional supraclavicular nodes of breast cancer patients were planned using 3D-CRT and VMAT. A 3D-CRT plan with a dose gradient on the cranial side was applied by shifting the jaw to reduce hot or cold spots. The VMAT plan was optimized based on the results of the 3D-CRT plan calculation. Hybrid plans were created by the sum of the 3D-CRT and VMAT plans. To simulate patient motion, the plans were recalculated with the VMAT plan simulating isocenter superiorly (separation) or inferiorly (overlap) shifted by 1, 2, and 3 mm. The shifted plans were compared with the non-shifted plans considering the clinical target volume (CTV) (D98% or D2%). Results The D2% value of the CTV with perfectly aligned fields for the hybrid VMAT plan with high- or low-dose gradients on the 3D-CRT plan increased from 102.8%/102.9–107.2%/105.7%, 114.9%/110.9%, and 122.2%/115.5% for each 1 mm, 2 mm, and 3 mm overlapped shift, respectively. The value of D98% to the CTV with perfectly aligned fields decreased from 95.7%/95.6–90.0%/93.1%, 81.2%/88.4%, and 72.8%/83.5% for each 1 mm, 2 mm, and 3 mm separated shift, respectively. Conclusions By employing a 3D-CRT plan with a low dose gradient on the cranial side, the dose differences can be decreased. A more robust treatment delivery option can be achieved for breast cancer treatment using our proposed hybrid VMAT.

A case of small bowel obstruction caused by Bolbosoma sp. infection is reported. A 27-year-old woman admitted with abdominal pain was diagnosed as small bowel obstruction. Laparoscopic surgery revealed induration in jejunum at ca. 120 cm distal to the ligament of Treiz, attributed to a band connecting the serosa to the ascending mesocolon. Resected band contained an acanthocephalan accompanying foreign body reaction with abscess formation. The parasite belonged to the genus Bolbosoma, of which identification was made by DNA sequence analysis. This is the eighth case of Bolbosoma infection in humans, and the first one causing an ileus.

PURPOSE/OBJECTIVE(S) This study evaluated the current status, quality assurance (QA) and technique of intensity-modulated radiotherapy (IMRT) in Japan. MATERIALS/METHODS IMRT is a new technique, introduced in the late 1990s. Since 2000, the number of institutions providing IMRT has increased. Therefore, to recognize the current status of IMRT in Japan, a nation-wide survey was conducted by the Japan 3-Dimensional Conformal External Beam Radiotherapy Group (J-CERG). The questionnaires, which consists of the clinical part and physics part, was sent by mail or e-mail to 835 institutions. By the end of Feb. 2021, 427 institutions and 534 institutions responded to the clinical part and physics part, respectively. RESULTS In the clinical part, Two-hundreds and ninety-two (68%) institutions indicated that they have used IMRT technique for 44,409 cases out of 177,285 total in a year of 2019. Among these patients, 10,905 (25%) were prostate cancer, 7,772(18%) were head & neck cancer, 2,621 (6%) brain tumor, 2,027 (5%) lung tumor for SBRT, followed by liver tumor for SBRT, GYN cancer, esophageal cancer, breast cancer and GI tumor. The percentage of IMRT in all treatment was 75-100% in 18 institutions (6%), 50-75% in 22 institutions (8%), 20-50% in 144 institutions (49%), 10-20% in 68 institutions (23%), 5-10% in 28 institutions (10%), 5-1% in 11 institutions (4%) and < 1% in 2 institutions (1%). Target and OAR delineation was done by physician in 92% institutions and 69% institutions, respectively. In the physics part, 340 institutions (64%) use IMRT technique, and 80 institutions (24%) have commissioned their treatment planning systems with the beam data provided by the manufacturer. The measurement-based patient specific IMRT QAs are performed by 99% of institutions. The dose distribution measurement on films, 3D arrays, and 2D arrays are 42%, 41%, and 16%, respectively. CONCLUSION The updated status of IMRT in 2019 in Japan was surveyed. The number of institutions where IMRT was started continuously increased in number.

Taenia saginata is the most common species of tapeworm infecting humans. Infection is acquired by eating cysticercus larvae in undercooked beef. A closely related species, T. asiatica, is found in eastern and southeastern Asia. The larvae of T. asiatica develop in viscera of pigs. In northern Russia, there is a third member of this morphologically indistinguishable group. Cysticerci of so-called northern T. saginata are found in cerebral meninges of reindeer, and the unique life cycle is dependent on a native custom of eating raw reindeer brain. We report the winding history of this mysterious tapeworm from the first reports to the present time. In addition, we confirm the position of this parasite as a strain of T. saginata by analyzing a mitochondrial DNA sequence of an archival specimen. The origin of this strain might date back to reindeer domestication and contacts between cattle-herding and reindeer-herding peoples in Asia.

The accuracy of computed tomography number to electron density (CT‐ED) calibration is a key component for dose calculations in an inhomogeneous medium. In a previous work, it was shown that the tolerance levels of CT‐ED calibration became stricter with an increase in tissue thickness and decrease in the effective energy of a photon beam. For the last decade, a low effective energy photon beam (e.g., flattening‐filter‐free (FFF)) has been used in clinical sites. However, its tolerance level has not been established yet. We established a relative electron density (ED) tolerance level for each tissue type with an FFF beam. The tolerance levels were calculated using the tissue maximum ratio (TMR) and each corresponding maximum tissue thickness. To determine the relative ED tolerance level, TMR data from a Varian accelerator and the adult reference computational phantom data in the International Commission on Radiological Protection publication 110 (ICRP‐110 phantom) were used in this study. The 52 tissue components of the ICRP‐110 phantom were classified by mass density as five tissues groups including lung, adipose/muscle, cartilage/spongy‐bone, cortical bone, and tooth tissue. In addition, the relative ED tolerance level of each tissue group was calculated when the relative dose error to local dose reached 2%. The relative ED tolerances of a 6 MVFFF beam for lung, adipose/muscle, and cartilage/spongy‐bone were ±0.044, ±0.022, and ±0.044, respectively. The thicknesses of the cortical bone and tooth groups were too small to define the tolerance levels. Because the tolerance levels of CT‐ED calibration are stricter with a decrease in the effective energy of the photon beam, the tolerance levels are determined by the lowest effective energy in useable beams for radiotherapy treatment planning systems.

Tumor geometric reproducibility for lung stereotactic body radiotherapy (SBRT) is an important issue in the breath-hold (BH) technique. We investigated the inter-BH reproducibility of the tumor position in expiratory BH using our proposed vector volume histogram (VVH) method. Subjects comprising 14 patients with lung cancer who were treated with lung SBRT under expiratory BH conditions were monitored by the Abches system. Multiple computed tomography (CT) scans were performed to evaluate the inter-BH reproducibility of the tumor position at the expiratory BH in the simulation session. Gross tumor volume was delineated by a physician. Deformable image registration was used to deform the images from the 3 expiratory BH-CTs to the treatment planning expiratory BH-CT. To evaluate the inter-BH reproducibility of the tumor positions, we measured the largest motion extent within the organ of 3 dimensions (left-right, LR; anterior-posterior, AP; cranio-caudal, CC) and a 3D vector using the VVH method. The average and standard deviations of the inter-BH reproducibility of the tumor position in the LR, AP, and CC directions, and the 3D vector were 1.7 ± 0.5, 2.0 ± 0.7, 2.1 ± 0.7, and 2.7 ± 0.7 mm, respectively. Ten patients exhibited inter-BH displacements of the lung tumor >3 mm in the 3D vector. No displacement >5 mm was observed in any direction for all patients. Our study indicated that the inter-BH variation of the tumor position was small for lung cancer patients, using the Abches system and the VVH method.

In the conventional procedure for accurate Monte Carlo simulation of radiotherapy, a CT number given to each pixel of a patient image is directly converted to mass density and elemental composition using their respective functions that have been calibrated specifically for the relevant x-ray CT system. We propose an alternative approach that is a conversion in two steps: the first from CT number to density and the second from density to composition. Based on the latest compilation of standard tissues for reference adult male and female phantoms, we sorted the standard tissues into groups by mass density and defined the representative tissues by averaging the material properties per group. With these representative tissues, we formulated polyline relations between mass density and each of the following; electron density, stopping-power ratio and elemental densities. We also revised a procedure of stoichiometric calibration for CT-number conversion and demonstrated the two-step conversion method for a theoretically emulated CT system with hypothetical 80 keV photons. For the standard tissues, high correlation was generally observed between mass density and the other densities excluding those of C and O for the light spongiosa tissues between 1.0 g cm(-3) and 1.1 g cm(-3) occupying 1% of the human body mass. The polylines fitted to the dominant tissues were generally consistent with similar formulations in the literature. The two-step conversion procedure was demonstrated to be practical and will potentially facilitate Monte Carlo simulation for treatment planning and for retrospective analysis of treatment plans with little impact on the management of planning CT systems.

Purpose The aim of this study was to perform a comparison between robust optimization and planning target volume (PTV)-based optimization plans using volumetric modulated arc-therapy (VMAT) by evaluating perturbed doses induced by localization offsets for setup uncertainties in larynx cancer radiation therapy. Methods Ten patients with early-stage (T1-2N0) glottis carcinoma were selected. The clinical target volume (CTV), carotid arteries, and spinal cord were contoured by a radiation oncologist. PTV-based and robust optimization plans were normalized at D50% to the PTV and D98% to the CTV, respectively. Both optimization plans were evaluated using perturbed doses by specifying user defined shifted values from the isocenter. CTV dose (D98%, D50%, and D2%), homogeneity index (HI) and conformity index (CI95%, CI80%, and CI50%), as well as doses to the carotid arteries and spinal cord were compared between PTV-based and robust optimization plans. Results The robust optimization plans exhibited superior CTV coverage and a reduced dose to the carotid arteries compared to the PTV-based optimization plans (p 0.05). The robust optimization plans showed better CI80% and CI50% compared to the PTV-based optimization plans (p Conclusions The robust optimization plan may be a suitable treatment method in radiotherapy for larynx cancer patient.

Dose conformity in thoracic and abdominal ion-beam radiotherapy is degraded by respiratory motion. To improve conformity, an image-guided respiration-gated system can be used in the treatment room. The purpose of this study was to estimate the organ doses and effective doses to patients from an image-guided respiration-gated system. Glass dosemeters were inserted into an adult anthropomorphic phantom and were attached to the surface on the phantom. The phantom was placed on the treatment couch, and the imaging dose from fluoroscopy was evaluated. In addition to the organ doses, the effective doses were also estimated according to the ICRP Publication 103. The irradiation time is over 3-5 min per beam angle. When image acquisition conditions were assumed for thoracic treatment, the effective doses and maximal skin doses were 0.48-0.79 mSv and 5.9-9.9 mGy, respectively. The estimated doses can be the base data for considering radiological protection in the radiotherapy.

Hydatid cysts of Echinococcus felidis are described from the hippopotamus (Hippopotamus amphibius) from Mpumalanga Province, South Africa. Among six hippopotami investigated, hepatic hydatids were found in three. The identification was based on mitochondrial and nuclear DNA sequences. In addition, the rostellar hook morphology was analysed. This is the first morphological description of the metacestode of E. felidis, and the first molecularly confirmed report of the intermediate host of E. felidis in South Africa. The definitive host of E. felidis in South Africa is the lion (Panthera leo).

We confirmed infection of 2 patients with Borrelia miyamotoi in Japan by retrospective surveillance of Lyme disease patients and detection of B. miyamotoi DNA in serum samples. One patient also showed seroconversion for antibody against recombinant glycerophosphodiester phosphodiesterase of B. miyamotoi. Indigenous relapsing fever should be considered a health concern in Japan.

Echinococcosis is a serious helminthic zoonosis in humans, livestock and wildlife. The pathogenic organisms are members of the genus Echinococcus (Cestoda: Taeniidae). Life cycles of Echinococcus spp. are consistently dependent on predator-prey association between two obligate mammalian hosts. Carnivores (canids and felids) serve as definitive hosts for adult tapeworms and their herbivore prey (ungulates, rodents and lagomorphs) as intermediate hosts for metacestode larvae. Humans are involved as an accidental host for metacestode infections. The metacestodes develop in various internal organs, particularly in liver and lungs. Each metacestode of Echinococcus spp. has an organotropism and a characteristic form known as an unilocular (cystic), alveolar or polycystic hydatid. Recent molecular phylogenetic studies have demonstrated that the type species, Echinococcus granulosus, causing cystic echinococcosis is a cryptic species complex. Therefore, the orthodox taxonomy of Echinococcus established from morphological criteria has been revised from the standpoint of phylogenetic systematics. Nine valid species including newly resurrected taxa are recognised as a result of the revision. This review summarises the recent advances in the phylogenetic systematics of Echinococcus, together with the historical backgrounds and molecular epidemiological aspects of each species. A new phylogenetic tree inferred from the mitochondrial genomes of all valid Echinococcus spp. is also presented. The taxonomic nomenclature for Echinococcus oligarthrus is shown to be incorrect and this name should be replaced with Echinococcus oligarthra.

Bovine cysticercosis causing damage to the beef industry is closely linked to human taeniasis due to Taenia saginata. In African countries, Taenia spp. from wildlife are also involved as possible sources of infections in livestock. To identify the aetiological agents of bovine cysticercosis in Ethiopia, cysticerci were collected from 41 cattle slaughtered in the eastern and central areas during 2010–2012. A single cysticercus per animal was subjected to the polymerase chain reaction (PCR)-based DNA sequencing of mitochondrial cytochrome c oxidase subunit 1 gene, and the resultant sequence was compared with those of members of the genus Taenia. Although 38 out of 41 cysticerci (92.7%) were identified as T. saginata, three samples (7.3%) showed the hitherto unknown sequences of Taenia sp., which is distantly related to Taenia solium, Taenia arctos and Taenia ovis. Old literatures suggest it to be Taenia hyaenae, but morphological identification of species could not be completed by observing only the larval samples.

International audience; A serological assessment was undertaken on pigs from the Kubu and Abang sub-districts of Karangasemon the island of Bali, Indonesia, where earlier studies had detected patients with cysticercosis. Antigenspurified from Taenia solium cyst fluid by cation-exchange chromatography were used to evaluate antibodyresponses in the pigs and the serological tests were also evaluated using sera from pigs experimentallyinfected with T. solium eggs. A total of 392 serum samples from naturally exposed pigs were tested usingan ELISA that could be read based on both a colour change perceptible by the naked eye and an ELISAbased on absorbance values. Twenty six (6.6%) pigs were found seropositive by the naked-eye ELISA and were categorized into three groups: strongly positive (absorbance values >0.8, n = 6), moderatelypositive (absorbance values between 0.2 and 0.8, n = 7), and weakly positive (absorbance values

Multilocus sequence typing of Borrelia garinii isolates from humans and comparison with rodent and tick isolates were performed. Fifty-nine isolates were divided into two phylogenetic groups, and an association was detected between clinical and rodent isolates, suggesting that, in Japan, human-pathogenic B. garinii comes from rodents via ticks.

Human diphyllobothriosis is caused by at least 14 species of cestodes belonging to the genus Diphyllobothrium. Molecular analysis by sequencing of nuclear and mitochondrial targets identifies some species at inter- and intra-specific level, and helps to reconstruct their phylogenetic relationships. Nevertheless, the suitability of further molecular targets deserves to be widened, and the comparison of samples of different geographical origin could allow their intra-specific characterization, which could also be useful for epidemiological purposes. In this study, we investigated inter- and intra-specific variability among tapeworms of the genus Diphyllobothrium, with focus on Diphyllobothrium latum, originated from Switzerland. Samples were analyzed by comparing the sequences of two nuclear and two mitochondrial DNA targets. We analyzed 27 samples belonging to 4 species (D. latum, Diphyllobothrium nihonkaiense, Diphyllobothrium dendriticum and Diphyllobothrium ditremum), 15 of which isolated from clinical cases (adults and eggs), 2 from wild canines, and 2 from fish of Swiss lakes (plerocercoid larvae); 8 samples of homologous species from other geographic origins were also sequenced and compared with the Swiss ones. Sequences of partial small subunit ribosomal RNA (18S rRNA) gene and partial internal transcribed spacers 1 and 2 (ITS1-2) were not useful even in inter-specific identification, whereas sequences of complete cytochrome c oxidase subunit 1 (cox1) and cytochrome b (cob) genes allowed us to assess inter- and intra-specific variations among the samples. Cox1 and cob could differentiate 3 and 5 haplotypes within the species D. latum. The results are discussed in the light of the anamneses provided by part of the patients.

Copyright © American Society for Microbiology, Journal of Clinical Microbiology, 47(10), 3191-3196, 2009, Two cases of alveolar echinococcosis (AE) with multiple-organ involvement (the liver, lungs, and bone) were monitored by imaging and serology for 20 years. Resection of the bone lesion was complete in one case but incomplete in the other case. Albendazole treatment was markedly to moderately effective against hepatic and pulmonary AE lesions in both cases, whereas it had almost no effect against the bone lesion in one case. The results of the serological tests with recombinant Em18 antigen coincided with the clinical findings in each case. An enzyme-linked immunosorbent assay for the detection of immunoglobulin G (IgG) responses, especially IgG4 responses, is expected to be a real-time indicator of the dynamics of active AE.

author, Paragonimiasis is a common parasitic zoonosis in Cameroon and neighbouring countries in Western Africa. Serum, sputum and faecal samples were collected in an endemic area of South West Province, Cameroon, after administration of a questionnaire to identify individuals with appropriate symptoms and histories. Microscopic examination revealed eggs in sputum from 16 people, but none in any faecal sample. These 16 were among the 25 and 26 people, respectively, positive by ELISA and by immunoblot using Paragonimus africanus crude antigens. Copro-DNA detection was attempted using 23 faecal samples (18 from sputum egg-negative and five from sputum egg-positive individuals). Copro-DNA was detected in four of the five sputum egg-positive individuals. These results strongly suggest that: (1) serology is much more sensitive than sputum examination for diagnosis of paragonimiasis; and (2) a copro-DNA test may be more sensitive than a microscopic search for eggs in faeces. Molecular sequence data from ITS2 and cox1 genes confirmed that adult worms experimentally raised in cats were P. africanus and that eggs from sputum or other worm products from human faeces also belonged to this species. Based on these results, 26 of 168 persons (15.5%) were diagnosed as suffering from paragonimiasis.

Copyright © American Society for Microbiology, Journal of Clinical Microbiology, volume 47, 168-174, 2009, Rapid detection and differentiation of Taenia species are required for the control and prevention of taeniasis and cysticercosis in areas where these diseases are endemic. Because of the lower sensitivity and specificity of the conventional diagnosis based on microscopical examination, molecular tools are more reliable for differential diagnosis of these diseases. In this study, we developed and evaluated a loop-mediated isothermal amplification (LAMP) assay for differential diagnosis of infections with Taenia species with cathepsin L-like cysteine peptidase (clp) and cytochrome c oxidase subunit 1 (cox1) genes. LAMP with primer sets to the cox1 gene could differentiate between three species, and LAMP with primer sets to the clp gene could differentiate Taenia solium from Taenia saginata/Taenia asiatica. Restriction enzyme digestion of the LAMP products from primer set Tsag-clp allowed the differentiation of Taenia saginata from Taenia asiatica. We demonstrated the high specificity of LAMP by testing known parasite DNA samples extracted from proglottids (n = 100) and cysticerci (n = 68). LAMP could detect one copy of the target gene or five eggs of T. asiatica and T. saginata per gram of feces, showing sensitivity similar to that of PCR methods. Furthermore, LAMP could detect parasite DNA in all taeniid egg-positive fecal samples (n = 6). Due to the rapid, simple, specific, and sensitive detection of Taenia species, the LAMP assays are valuable tools which might be easily applicable for the control and prevention of taeniasis and cysticercosis in countries where these diseases are endemic.

The performance of 3 PCR assays for the identification of the G1 sheep genotype of Echinococcus granulosus was evaluated using tissue and canid fecal samples. The "Dinkel" and "Stefanić" primers were the most sensitive in detecting E. granulosus DNA in feces of necropsied dogs (73.7% and 100%, respectively). The "Abbasi" primers detected 52.6% of E. granulosus infected dogs but were the most species-specific, cross-reacting only with Echinococcus shiquicus (tissue 90.9%; feces 75%). The Stefanić primers were the least specific (tissue, 27.3%; feces, 25%) for E. granulosus. The Dinkel primers also showed inter-species cross-reactivity (tissue, 63.6%; feces, 100%) but were found to be strain-specific for the E. granulosus G1 sheep genotype. Improvement of PCR tests for Echinococcus species and subspecific variants should rely on the use of less-conserved genes and development of protocols that improve the quality and quantity of DNA extracted from feces.

This is the author-created version of Springer, Minoru, Nakao ; Davaajav, Abmed ; Hiroshi, Yamasaki ; Akira, Ito, Parasitology Research, 101(1), (2007), (233-236). The original publication is available at www.springerlink.com. author, Mitochondrial DNA (mtDNA) sequences of the human broad tapeworms Diphyllobothrium latum and Diphyllobothrium nihonkaiense have been totally determined. Both of them are closed circular molecules (total length 13720 bp in D. latum and 13747 bp in D. nihonkaiense) containing genes for 12 proteins, 22 transfer RNAs and two ribosomal RNAs. All the genes are coded on T-rich strand. The gene order of Diphyllobothrium mtDNAs is completely identical with that of Taenia and Echinococcus mtDNAs. The overall A+T contents of the genomes are 68.3% in D. latum and 67.8% in D. nihonkaiense. The pairwise divergence values of nucleotide sequences between these tapeworms ranged from 0.069 to 0.152 in protein-coding genes, demonstrating that D. nihonkaiense is a distinct species. The sequences determined in this study may provide useful marker systems for diagnostic, epidemiological and phylogeographical studies of human diphyllobothriasis.

publisher, Survey on secondary data of taeniasis/cysticercosis was carried out in Mongolia in 2002–2006. A total of 118 taeniid proglottids, a diphyllobothriid segment, and 59 serum samples from 118 taeniasis cases were collected at National Center for Communicable Diseases, Ulaanbaatar, Mongolia. In 2006, 14 serum samples were collected from local people who had histories of epileptic seizures in Selenge Province where pig husbandry was the main business. The 118 proglottids were confirmed to be Taenia saginata by mitochondrial DNA analysis using cytochrome c oxidase subunit 1 and cytochrome b genes. T. saginata taeniasis was widely distributed at least in 10 of 21 provinces. No variation in the nucleotide sequences of the two genes was observed among T. saginata isolates from Mongolia. There was no evidence of Taenia solium taeniasis/cysticercosis or Taenia asiatica taeniasis. A diphyllobothriid segment was confirmed to be Diphyllobothrium latum by mitochondrial DNA analysis.

Cestode zoonosis cases confirmed by PCR-based mitochondrial DNA analysis were investigated. The cestodiosis included taeniasis, cysticercosis, alveolar echinococcosis, cystic echinococcosis, sparganosis mansoni, diphyllobothriasis and diplogonoporiasis. DNA samples were extracted from the ethanol-fixed, formalin-fixed, paraffin-embedded sections, HE-stained, and the PAS- or acetocarmine-stained samples submitted for histopathology. For PCR-based analysis, cytochrome c oxidase subunit 1 and⁄or cytochrome b genes were amplified by multiplex PCR or conventional PCR coupled with DNA sequencing. Although DNA molecules were degraded in most formalin-fixed samples, smaller gene fragments were successfully amplified and the species causing cestodiosis could be identified by DNA sequence analysis of the amplicons. This review describes cestode zoonosis cases in which mitochondrial DNA analysis was useful not only for routine and retrospective diagnosis, but also for genetic polymorphism analysis and molecular identification of the species associated with pathogenicity. The significance of molecular diagnosis using histopathological specimens for cestode zoonoses is also discussed.

publisher, We confirmed sympatric occurrence of Taenia solium, T. saginata, and T. asiatica in western Thailand. DNA analysis of morphologically identifi ed T. saginata, in a dual infection with T. solium, indicated it was T. asiatica. To our knowledge, this report is the first of T. asiatica and a dual Taenia infection from Thailand.

Food-borne zoonotic cestode infections by Diphyllobothrium spp. and Spirometra spp. are relatively uncommon in Indonesia. So far, only one case of diphyllobothriasis was confirmed in 2004 in Jakarta, whereas there were 4 sparganosis cases in Indonesia. Morphology of eggs and gravid proglottids revealed the first case to be caused by Diphyllobothrium species. However, molecular identification of the species was not successful. Sparganosis may not be particularly rare in Indonesia, since Spirometra species have often been found in cats and other animals. These topics in Indonesia are briefly overviewed with reference to historical records and socio-cultural background information.

Three human taeniid species, Taenia solium, Taenia saginata and Taenia asiatica are distributed in Indonesia. A field survey conducted in Bali from 2002 to 2006 showed that the prevalence of taeniasis was highly variable among four districts (1.1-27.5%), and only two cysticercosis cases due to T. solium infection were detected. All tapeworms (n = 66) expelled from 66 tapeworm carriers were confirmed to be T. saginata by mitochondrial DNA analysis. A total prevalence of 13.0% (19⁄146) for T. solium taeniasis was found in Jayawijaya District, Papua (Irian Jaya). It included 14 of 88 (15.9%) in 1999 and 5 of 58 (8.6%) in 2001, while the seroprevalence of cysticercosis in humans by sub-district in Papua ranged from 0.0% in a non-endemic area to 48.5% in an endemic area from 1996 to 2005. The seroprevalence of cysticercosis in pigs and dogs in Jayawijaya ranged from 8.5% to 70.4% (1998-1999) and 4.9% to 33.3% (2000-2002), respectively. A 2003-2006 survey of 371 local people in Samosir island, north Sumatra revealed 6 of 240 (2.5%) to be infected with T. asiatica; 2 of 58 (3.4%) and 4 of 182 (2.2%) cases were detected in 2003 and 2005, respectively. This brief review summarizes the present situation of taeniasis and cysticercosis, the distribution of three human taeniid species, and the risk factors⁄transmission aspects of these tapeworm infections in Bali, Papua, and north Sumatra regions of Indonesia.

Fasciolosis is an economically important disease of livestock caused by Fasciola hepatica, Fasciola gigantica, and aspermic Fasciola flukes. The aspermic Fasciola flukes have been discriminated morphologically from the two other species by the absence of sperm in their seminal vesicles. To date, the molecular discrimination of F. hepatica and F. gigantica has relied on the nucleotide sequences of the internal transcribed spacer 1 (ITS1) region. However, ITS1 genotypes of aspermic Fasciola flukes cannot be clearly differentiated from those of F. hepatica and F. gigantica. Therefore, more precise and robust methods are required to discriminate Fasciola spp. In this study, we developed PCR restriction fragment length polymorphism and multiplex PCR methods to discriminate F. hepatica, F. gigantica, and aspermic Fasciola flukes on the basis of the nuclear protein-coding genes, phosphoenolpyruvate carboxykinase and DNA polymerase delta, which are single locus genes in most eukaryotes. All aspermic Fasciola flukes used in this study had mixed fragment pattern of F. hepatica and F. gigantica for both of these genes, suggesting that the flukes are descended through hybridization between the two species. These molecular methods will facilitate the identification of F. hepatica, F. gigantica, and aspermic Fasciola flukes, and will also prove useful in etiological studies of fasciolosis.

出版社版, Neurocysticercosis (NCC), which is caused by accidental ingestion of eggs of the pork tapeworm, Taenia solium, was common in Bali, Indonesia until the early 1990s. However, improved education on hygiene and sanitation, a move to keeping pigs indoors, and improvement of economic and living conditions have substantially reduced the occurrence of NCC in Bali. Since 2011, T. solium tapeworm carriers (T. solium taeniasis) and heavily infected pigs and dogs have exclusively been detected from villages in mountainous regions of northeastern Bali where NCC and ocular cysticercosis (OCC) cases have also been identified. In response to this continued area of high infection, a one-day workshop was convened to discuss how to prevent and control this potentially lethal zoonotic parasitic infection in Bali. This review presents an overview of the current status of T. solium taeniasis and cysticercosis in Indonesia and proposes a strategy for the prevention and control of this zoonosis in Bali.

CC BY-NC-ND, An adult hymenolepidid tapeworm was recovered from a 52-year-old Tibetan woman during a routine epidemiological survey for human taeniasis/cysticercosis in Sichuan, China. Phylogenetic analyses based on sequences of nuclear 28S ribosomal DNA and mitochondrial cytochrome c oxidase subunit 1 showed that the human isolate is distinct from Hymenolepis diminuta and Hymenolepis nana, the common parasites causing human hymenolepiasis. Proglottids of the human isolate were unfortunately unsuitable for morphological identification. However, the resultant phylogeny demonstrated the human isolate to be a sister species to Hymenolepis hibernia from Apodemus mice in Eurasia. The present data clearly indicate that hymenolepidid tapeworms causing human infections are not restricted to only H. diminuta and H. nana.