Thirty-two novel HLA-A alleles identified during intermediate resolution testing

Thirty-two novel human leukocyte antigen-A alleles are described: four A*01 (*0110, *0112, *0113 and *0117), four A*02 (*0263, *0280, *0292 and *9201), two A*03 (*0316 and *0325), four A*11 (*111502, *1117, *1122 and *1123), five A*24 (*2441, *2450, *2455, *2456 and *2457), one A*26 (*2627), two A*29 (*2909 and *2914), two A*30 (*3013 and *3016), one A*32 (A*3213), two A*34 (*3407 and *3408) and five A*68 (*6828, *6829, *6830, *6831 and *6834). Seventeen of the variants are single-nucleotide substitutions from their most homologous allele, which results in amino acid changes (A*0117, *0263, *0292, *0316, *0325, *1122, *1123, *2455, *2456, *2457, *2627, *2909, *3016, *3407, *6828, *6831 and *6834), and only one is silent substitution (A*111502). The remaining alleles differ from their most similar alleles by two to six nucleotide substitutions.

Searching for HLA-DRB1*1206 in volunteer marrow donors in four US population groups

The frequencies of DRB1*12 alleles were determined in four US population groups by DNA sequencing. Only DRB1*120101 (or DRB1*1206 or *1210) and DRB1*120201 alleles were identified, the latter primarily in the Asian American population. Additional testing of a subset of samples to detect the presence of DRB1*1206 found all of the alleles to be DRB1*120101 (or DRB1*1210). Retesting of six samples previously typed as DRB1*1206 found only DRB1*120101 (or DRB1*1210).

HLA-A, -B, -C, -DRB1 allele and haplotype frequencies in an African American population

Sequence-based typing was used to identify human leukocyte antigen (HLA)-A, -B, -C, and -DRB1 alleles from 564 consecutively recruited African American volunteers for an unrelated hematopoietic stem cell registry. The number of known alleles identified at each locus was 42 for HLA-A, HLA-B 67, HLA-C 33, and HLA-DRB1 44. Six novel alleles (A*260104, A*7411, Cw*0813, Cw*1608, Cw*1704, and DRB1*130502) not observed in the initial sequence-specific oligonucleotide probe testing were characterized. The action of balancing selection, shaping more 'even' than expected allele frequency distributions, was inferred for all four loci and significantly so for the HLA-A and DRB1 loci. Two-, three-, and four-locus haplotypes were estimated using the expectation maximization algorithm. Comparisons with other populations from Africa and Europe suggest that the degree of European admixture in the African American population described here is lower than that in other African American populations previously reported, although HLA-A:B haplotype frequencies similar to those in previous studies of African American individuals were also noted.

Kinematic analysis of upper extremity joint motion in children using posterior walkers

This study applies an upper extremity model to analyze motion in 25 children with cerebral palsy using posterior walkers. The study indicates that throughout a gait cycle, the shoulders and wrist are in extension and the elbows are flexed. It also reveals that the elbows are the most asymmetrical joint of the upper extremities during walker-assisted ambulation.

Twenty-three novel HLA-B alleles identified during intermediate-resolution testing

Twenty-three novel human leukocyte antigen-B alleles are described: B*070204, *0738, *0742, *0821, *130202, *1312, *1575, *1598, *1599, *270507, *2728, *350104, *3558, *3811, *3931, *3932, *4045, *4107, *420501, *4812, *510106, *5520, and *5616. Thirteen of the variants are single-nucleotide substitutions from their most homologous allele, eight resulting in amino acid changes (B*0742, *1312, *1598, *1599, *3558, *3931, *4107, and *5616) and five with silent substitutions (B*070204, *130202, *270507, *350104, and *510106). Three alleles (B*0738, *4812, and *5520) differ by five nucleotide changes, altering four amino acids. The remaining seven alleles differ from their most similar alleles by two to three nucleotides, altering from one to two amino acids.

Strategies for evaluating B*18 allelic diversity by sequence-based typing applied to studies of a population from Singapore and African-Americans

Strategies to resolve B*18 alleles which carry a deletion in intron 1 close to the 5' end of exon 2 relative to other HLA-B alleles or a null allele mutation in exon 1 and to resolve ambiguities among allele combinations including B*18 are described. B*18 allele frequencies from volunteer donors recruited for two hematopoietic stem cell registries show the presence of two alleles, B*180101 and B*1802, in a population from Singapore and only B*180101 in African-Americans.

Differentiation between African populations is evidenced by the diversity of alleles and haplotypes of HLA class I loci

The allelic and haplotypic diversity of the HLA-A, HLA-B, and HLA-C loci was investigated in 852 subjects from five sub-Saharan populations from Kenya (Nandi and Luo), Mali (Dogon), Uganda, and Zambia. Distributions of genotypes at all loci and in all populations fit Hardy-Weinberg equilibrium expectations. There was not a single allele predominant at any of the loci in these populations, with the exception of A*3002 [allele frequency (AF) = 0.233] in Zambians and Cw*1601 (AF = 0.283) in Malians. This distribution was consistent with balancing selection for all class I loci in all populations, which was evidenced by the homozygosity F statistic that was less than that expected under neutrality. Only in the A locus in Zambians and the C locus in Malians, the AF distribution was very close to neutrality expectations. There were six instances in which there were significant deviations of allele distributions from neutrality in the direction of balancing selection. All allelic lineages from each of the class I loci were found in all the African populations. Several alleles of these loci have intermediate frequencies (AF = 0.020-0.150) and seem to appear only in the African populations. Most of these alleles are widely distributed in the African continent and their origin may predate the separation of linguistic groups. In contrast to native American and other populations, the African populations do not seem to show extensive allelic diversification within lineages, with the exception of the groups of alleles A*02, A*30, B*57, and B*58. The alleles of human leukocyte antigen (HLA)-B are in strong linkage disequilibrium (LD) with alleles of the C locus, and the sets of B/C haplotypes are found in several populations. The associations between A alleles with C-blocks are weaker, and only a few A/B/C haplotypes (A*0201-B*4501-Cw*1601; A*2301-B*1503-Cw*0202; A*7401-B* 1503-Cw*0202; A*2902-B*4201-Cw*1701; A*3001-B*4201-Cw*1701; and A*3601-B*5301-Cw*0401) are found in multiple populations with intermediate frequencies [haplotype frequency (HF) = 0.010-0.100]. The strength of the LD associations between alleles of HLA-A and HLA-B loci and those of HLA-B and HLA-C loci was on average of the same or higher magnitude as those observed in other non-African populations for the same pairs of loci. Comparison of the genetic distances measured by the distribution of alleles at the HLA class I loci in the sub-Saharan populations included in this and other studies indicate that the Luo population from western Kenya has the closest distance with virtually all sub-Saharan population so far studied for HLA-A, a finding consistent with the putative origin of modern humans in East Africa. In all African populations, the genetic distances between each other are greater than those observed between European populations. The remarkable current allelic and haplotypic diversity in the HLA system as well as their variable distribution in different sub-Saharan populations is probably the result of evolutionary forces and environments that have acted on each individual population or in their ancestors. In this regard, the genetic diversity of the HLA system in African populations poses practical challenges for the design of T-cell vaccines and for the transplantation medical community to find HLA-matched unrelated donors for patients in need of an allogeneic transplant.

Entrapped mixed microbial cell process for combined secondary and tertiary wastewater treatment

An entrapped mixed microbial cell (EMMC) process was investigated for simultaneous removal of carbon and nitrogen from a synthetic wastewater in a single bioreactor. The influent had a soluble chemical oxygen demand (SCOD)/nitrogen ratio varying from 4 to 15 and an alkalinity of 140 and 230 mg/L as calcium carbonate. An alternating schedule of intermittent aeration was used for two sizes of carriers: 10 x 10 x 10 mm3 and 20 x 20 x 20 mm3. The medium carrier (10 x 10 x 10 mm3) was found to achieve higher removals of nitrogen, chemical oxygen demand, and 5-day biochemical oxygen demand of 92, 95, and 97%, respectively. These higher removal rates occurred at a 12-hour hydraulic retention time (HRT), an aeration/ nonaeration ratio of 0.5:2 hours, and an SCOD/nitrogen ratio of 15 in the influent. Influent alkalinity concentrations of 140 and 230 mg/L as calcium carbonate were found to have minimum effect on the removal of carbon and nitrogen. However, the oxidation-reduction potential, ranging from -100 to 400 mV (during air-off period), provides better nitrogen removal efficiency to maintain the total nitrogen (nitrate, nitrite, and ammonium) less than 10 mg/L when an SCOD/nitrogen ratio of 10 or 15 is maintained in the influent. Nitrogen removal efficiency increased with increasing ratios of SCOD/nitrogen in the influent (i.e., SCOD/ nitrogen ratio of 15 > 10 > 7 > 4.0). The results of actual wastewater operation based on a study of synthetic wastewater show that organics removal efficiencies (94.6 and 94.2%) and nitrogen removal efficiencies (61.0 and 60.9%) are similar for reactors packed with medium and large carriers, respectively, when they are operated with a 9-hour HRT, an air on/air off ratio of 1 hour:2 hours and an SCOD/nitrogen ratio of 4.6.

Treatment of aplastic anemia by the kidney-tonifying and mediating method

In this series of 65 cases of aplastic anemia, 26 cases were treated by the kidney-tonifying and mediating method, 19 cases by western drugs, and the remaining 20 cases only by tonifying the kidney as controls. The results showed that the kidney-tonifying and mediating method was significantly superior in the total effective rate to the method of western drugs and that of tonifying the kidney alone (P < 0.01), and it was also superior in the improvement of symptoms, myelogram, and peripheral blood count to the other two methods.

[The intraoperative application of neural response telemetry with the nucleus CI24M cochlear implant]

OBJECTIVE

To test device integrity and objective auditory reaction for cochlear implant patients intraoperatively.

METHODS

Our protocol for intraoperative testing of the implant device includes device electrode impedance test and neural response telemetry (NRT), which measures the electrically evoked auditory nerve compound action potentials (ECAP).

RESULTS

We completed electrode integrity tests and NRT intraoperatively on 40 patients with the Nucleus CI24M cochlear implant. We have measured normal implant function on all 40 patients and obtained ECAP results from 39 patients. Out of 33 patients with normal inner ear, typical ECAPs were recorded in 195 electrodes in all 198 testing electrodes(98.5%). In 7 patients with inner ear Mondini dysphasia, affirmative ECAP waveforms were recorded in 26 electrodes in all 42 testing electrodes. The basal electrode ECAP threshold was higher than that of the epical one.

CONCLUSIONS

The intraoperative measurements of device function and NRT are quite simple, quick and with high accuracy. Inner ear malformation is an important factor that may affect NRT results.

Immunologic and virologic analyses of an acutely HIV type 1-infected patient with extremely rapid disease progression

The immunologic and virologic factors that impact on the rate of disease progression after acute infection with human immunodeficiency virus (HIV) type 1 are poorly understood. A patient with an extraordinarily rapid disease course leading to AIDS-associated death within 6 months of infection was studied intensively for the presence of anti-HIV immune reactivities as well as changes in the genetic and biologic properties of virus isolates. Although altered humoral responses were evident, the most distinctive immunologic feature was a nearly complete absence of detectable HIV-specific CTL responses. In addition to a rapid decline in CD3+CD4+ cells, elevated percentages of CD8+CD45RA+ and CD8+CD57+ cells and diminished CD8+CD45R0+ and CD8+CD28+ cells were evident. Primary viral isolates recovered throughout the course of infection exhibited limited sequence diversity. Cloned viral envelopes were found to have unusually broad patterns of coreceptor usage for cell-cell fusion, although infectivity studies yielded no evidence of infection via these alternative receptors. The infectivity studies demonstrated that these isolates and their envelopes maintained an R5 phenotype throughout the course of disease. The absence of demonstrable anti-HIV CTL reactivities, coupled with a protracted course of seroconversion, highlights the importance of robust HIV-specific immune responses in the control of disease progression.

Apolipoprotein E polymorphism in the early onset of coronary heart disease

OBJECTIVE

To assess the relationship between apolipoprotein E (apoE) polymorphism and the early onset of coronary heart disease (CHD) and the effect of apoE on lipids and lipoproteins in healthy Chinese subjects.

METHODS

Sixty-eight patients with CHD younger than 55 years (CHD1), 136 patients with CHD older than 65 years (CHD2), and 136 healthy subjects were enrolled, and their plasma levels of triglyceride (TG), total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C) were determined. The apoE genotypes were identified by polymerase chain reaction-restriction fragment length polymorphism.

RESULTS

apoE 3/4 genotype and E4 allele frequency in the CHD1 group were higher than those in the CHD2 group and healthy subjects, while no differences were found between CHD2 and healthy subjects. Meanwhile, the plasma levels of TC and low density lipoprotein cholesterol (LDL-C) were higher in the CHD2 group than in both CHD1 group and healthy subjects. Each apoE isoprotein has variable TC and LDL-C levels that is E2 (E2/2 + E2/3) < E3(E3/3) < E4(E4/4 + E3/4).

CONCLUSION

apoE is one of the genetic factors that affect TC and LDL-C levels, and apoE 4 has a very close relation to CHD, suggesting that apoE 4 is an independent genetic factor of the early onset of CHD.

Analysis of the frequencies of HLA-A, B, and C alleles and haplotypes in the five major ethnic groups of the United States reveals high levels of diversity in these loci and contrasting distribution patterns in these populations

The HLA system is the most polymorphic of all human genetic systems. The frequency of HLA class I alleles and their linkage disequilibrium patterns differ significantly among human populations as shown in studies using serologic methods. Many DNA-defined alleles with identical serotypes may have variable frequencies in different populations. We typed HLA-A, B, and C loci at the allele level by PCR-based methods in 1,296 unrelated subjects from five major outbred groups living in the U.S.A (African, AFAM; Caucasians, CAU; Asian, ORI; Hispanic, HIS, and North American Natives, NAI). We detected 46, 100 and 32 HLA-A, B, and C alleles, respectively. ORI and HIS presented more alleles at each of these loci. There was lack of correlation between the levels of heterozygosity and the number of alleles detected in each population. In AFAM, heterozygosity (>90%) is maximized at all class I loci. HLA-A had the lowest heterozygosity in all populations but CAU. Tight LD was observed between HLA-B and C alleles. AFAM had weaker or nonexistent associations between alleles of HLA-A and B than other populations. Analysis of the genetic distances between these and other populations showed a close relationship between specific US populations and a population from their original continents. ORI exhibited the largest genetic distance with all the other U.S. groups and were closer to NAI. Evidence of admixture with CAU was observed for AFAM and HIS. HIS also had significant frequencies of AFAM and Mexican Indian alleles. Differences in both LD and heterozygosity levels suggest distinct evolutionary histories of the HLA loci in the geographical regions from where the U.S. populations originated.

Insights into psoriasis and other inflammatory diseases from large-scale gene expression studies

Approximately 2% of the Caucasian population is affected by psoriasis (PS); a chronic inflammatory skin disease triggered by both genetic and environmental risk factors. In addition to a major contribution from the HLA class I region, PS susceptibility loci have been mapped to a number of regions including 1q21, 3q21, 4qter, 14q31-q32, 17q24-q25, 19p13.3 and 20p. Some of these overlap with loci implicated in other autoimmune/inflammatory diseases. Global gene expression studies are beginning to provide insights into the etiology of these and other complex diseases. We used Affymetrix oligonucleotide arrays comprising approximately 12 000 known genes to initiate a more comprehensive analysis of the transcriptional changes that occur in involved and uninvolved skin of 15 psoriatic patients versus six normal controls. Expression levels of the transcripts detected on the arrays were first used to determine the relationship of samples to each other using hierarchical clustering. This analysis clearly differentiated involved psoriatic skin from uninvolved and normal skin. Clusters of differentially expressed genes with similar expression patterns in the same samples were then identified. Six out of 32 clusters contained a total of 177 transcripts that were differentially expressed in involved psoriatic skin versus normal skin. These differences were independent of the gender, age, skin site and HLA class I status of the patient. Ten of the 177 genes were also differentially expressed in uninvolved skin, and several mapped to regions previously shown to harbor psoriasis susceptibility loci.

Sequence-based typing of HLA class I alleles in Alaskan Yupik Eskimo

In comparison to South America, native North Americans tend to be less diverse in their repertoire of HLA class I alleles. Based upon this observation, we hypothesized that the Yupik Eskimo would exhibit a limited number of previously identified class I HLA alleles. To test this hypothesis, sequence-based typing was performed at the HLA-A, -B and -C loci for 99 Central Yupik individuals from southwestern Alaska. Two new class I alleles, A*2423 and Cw*0806, were identified. While A*2423 was observed in only one sample, Cw*0806 was present in 26 of the 99 individuals and all of the Cw*0806 samples contained B*4801. Allele Cw*0806 differs from Cw*0803 by a single nucleotide substitution such that Cw*0803 may be the progenitor of Cw*0806. Allele Cw*0803 was originally characterized as unique to South America, but detection of Cw*0803 in the Yupik indicates that Cw*0803 was a founding allele of the Americas. The presence of new alleles and previously unrecognized founding alleles in the Yupik population show that natives of North America are more diverse than previously envisioned.

On-line Sample Preparation for High Throughput Reversed-phase LC / MS Analysis of Combinatorial Chemistry Libraries

An on-line sample preparation method utilizing a time-programmed autosampler is described for high throughput liquid chromatography/mass spectrometry (LC/MS). This approach is particularly helpful for the LC/MS analysis of samples which require solvents incompatible with HPLC in the sample preparation process. The on-line sample preparation approach minimizes a bottleneck in throughput and improves sample recovery under some circumstances.

High and intermediate resolution DNA typing systems for class I HLA-A, B, C genes by hybridization with sequence-specific oligonucleotide probes (SSOP)

DNA typing systems for alleles of the HLA class I loci A, B, C at intermediate (IR) and high resolution (HR) levels were developed. The approaches combine locus-specific amplification of genomic DNA by the polymerase chain reaction (PCR) and hybridization with sequence-specific oligonucleotide probes (SSOP). The SSOP were designed to match nucleotide sequences at all polymorphic sites of exons 2 and 3 at these loci. Alleles and genotypes for these loci are assigned by their unique hybridization patterns. Some genotypes with particular allele combinations resulted in the same hybridization pattern. These genotype ambiguities were resolved by performing additional group-specific amplifications with appropriate GSA primers and hybridization with informative SSOP. At intermediate resolution level, many groups of alleles of HLA-A and B with the same serologic equivalence resulted in the same hybridization pattern. Both HR and IR typing approaches required the design, validation and testing of locus- and group-specific primers and sequence-specific oligonucleotide probes (SSOP). Single locus-specific amplification and hybridization with sets of 67 SSOP for HLA-A, 99 for HLA-B and 57 for HLA-C allowed us to identify unequivocally the majority of A, B, C alleles at HR level. To resolve ambiguous genotypes at HLA-B, we performed 4 GSA with 5' primers at codon 45-46 and hybridization with selected sets of SSOP. About 22,415 high resolution typing results were obtained (4,953A, 6,621B, 10,841C). In these samples, 63 HLA-A, 170 HLA-B and 40 HLA-C alleles were observed. In the course of these studies, more than 30 new alleles have been identified. In IR testing, sets of 39 SSOP for HLA-A typing and 59 SSOP for HLA-B typing allowed us to obtain maximal resolution of the majority of common genotypes. To achieve IR level, the majority of SSOP selected were those that span codons encoding amino acid residues located in the alpha helical segments of the class I molecules. A total of 50,522 samples were typed for HLA-A and B at IR level. Approximately 2.0% of them carried ambiguous genotypes associated with alternative switches of Bw4/w6 related sequences. All these ambiguities were resolved by Bw4/Bw6 GSA by 2 primer pairs (77N-IALR-83/3B.1; 77S-DLRG-83/3B.1) and hybridization with 9 selected SSOP Testing was performed by individual hybridization of replicate dot blot membranes with the SSOP of the corresponding set. The approach was robust and cost-effective in large-scale HLA class I molecular typing. The resolution provided by HLA-A, B IR reached serologic split-level or higher. The description of primers and probes for HLA class I typing may be utilized as starting elements for development of second generation methods with a more rapid turn around time.

Clinical and familial study of arrhythmogenic right ventricular cardiomyopathy

OBJECTIVE

To explore the characteristics of arrhythmogenic right ventricular cardiomyopathy (ARVC).

METHODS

Seven patients with arrhythmogenic right ventricular cardiomyopathy and 34 members of three families were studied. All patients and family members underwent history collection, clinical examination, electrocardiogram (ECG), two-dimensional echocardiography (2-DE) and a signal averaging electrocardiogram. Programmed ventricular stimulation was performed in five patients.

RESULTS

All patients and family members had normal morphologic characteristics and normal function of the left ventricular by 2-DE. Fourteen persons had abnormal findings indicating ARVC. Five had enlargement of the right ventricular with diffused hypocontractility, eight had thin and systolic bulging in the focal anterior wall with hypokinesia and one had bulging of the inferior wall. Twenty-five persons (seven patients and 18 family members) had abnormal findings in ECG. Positive ventricular late potential was recorded in 13 persons (six patients). Two to three monomorphic ventricular tachycardia (VT) with left bundle branch block (LBBB) configurations were induced in five patients. Ventricular fibrillation was induced in two patients during the electrophysiologic study (EPS). Five patients had very high pacing threshold and/or ineffective pacing in one or many regions of the right ventricle. Two members of one family died suddenly. One member was a dwarf with ARVC. Spontaneous VT with a left bundle branch block (LBBB) configuration was recorded in five patients, polymorphic VT with extremely short coupling interval in one, and premature ventricular complexes with LBBB configuration in 12 (six patients).

CONCLUSION

Our familial study strongly suggests that ARVC may be a hereditary disease and it is helpful in the diagnosis and detection of ARVC. The most common manifestations were abnormal structure and function of the right ventricle and abnormal ECG of repolarization and ventricular arrhythmia which originates from the right ventricle.

Transcatheter closure of secundum atrial septal defect with a new self-expanding nitinol double disk device (Amplatzer device): experience in Nanjing

PURPOSE

Various devices have been developed for the transcatheter closure of secundum atrial septal defect (ASD II) to avoid the morbidity, discomfort, and thoracotomy scar associated with surgical closure. The purpose of this study was to evaluate the safety and efficacy of the Amplatzer septal occluder for transcatheter closure of ASD II.

PATIENTS AND METHODS

Only patients who were clinically diagnosed with ASD II were selected. The anatomy of ASD had to meet certain echocardiographic criteria. Under the guidance of echocardiography and fluoroscopy, the implantation of the device was accomplished as recommended by the manufacturer.

RESULTS

Thirty patients (median age 18.4 years) with an ASD II underwent transcatheter closure. Procedure time ranged from 30-200 minutes and fluoroscopy time from 10-50 minutes. The diameter of the ASD measured by echocardiography ranged from 13-25 mm, while both the stretched diameters of the ASDs and the sizes of the devices ranged from 18-34 mm. The successful placement rate was 100%. The residual shunt rate was 100% immediately after device implantation and 10% after 24 hours. After 3 months, 3.3% of the patients had a (trivial) residual shunt. The device did not affect the surrounding structures of ASD. No embolization of the device occurred.

CONCLUSION

The Amplatzer device designed for the closure of ASD II can be implanted easily and also is retrievable. Due to a low ratio of residual shunt and few complications, this device is a good choice for transcatheter closure of ASD II. Long-term follow-up will be required for widespread clinical use.

HLA diversity, differentiation, and haplotype evolution in Mesoamerican Natives

Genetic variation of the Human Leukocyte Antigen region (HLA) in three Amerindian populations from the Southern Mexican state of Oaxaca, the Zapotec, Mixtec and the Mixe is examined. Individuals were typed using PCR-SSOP for four class II loci (DRB1, DQA1, DQB1, DPB1) and three class I loci (HLA-A, -B, and -C). Based on known HLA distributions, European admixture ranged from 1% to 10%. Individuals with European alleles were excluded from subsequent analysis. New alleles were revealed at each of the class I loci. In general, genotype frequencies were in Hardy-Weinberg equilibrium, although some deviations were detected. Allele frequency distributions at the DRB1, DQA1, DQB1 and HLA-A loci in all populations were more even than expected under neutrality, supporting a model of balancing selection at these loci. A history of directional selection for DPB1 in all three populations was indicated, as homozygosity values were significantly above expected values. Allele frequency distributions at HLA-B and HLA-C did not differ significantly from neutrality expectations. The data also provide evidence from linkage disequilibrium that strong haplotypic associations are present across the entire HLA region in each of the populations. Significant overall linkage disequilibrium exists between all pairs of loci typed in these populations, except those which include the DPB1 locus. These associations exist despite the fact that the recombination fraction between HLA-A, in the class I region, and DQB1, in the class II region, may exceed 0.02. One explanation is that selective pressures are maintaining the relationships between particular alleles at these loci in these populations. These relationships are maintained in general across the entire HLA region in the Oaxacan Amerindians, with the exception of DPB1.

Traceless solid-phase synthesis of substituted benzimidazoles via a base-cleavable linker

[figure: see text] A solid-phase route to substituted benzimidazoles has been developed using a modified base-labile linker strategy to release the final products in a traceless manner. This approach permits the synthesis of diverse compounds in moderate yields and high purity.

Characterization and reconstitution of Drosophila gamma-tubulin ring complex subunits

The gamma-tubulin ring complex (gammaTuRC) is important for microtubule nucleation from the centrosome. In addition to gamma-tubulin, the Drosophila gammaTuRC contains at least six subunits, three of which [Drosophila gamma ring proteins (Dgrips) 75/d75p, 84, and 91] have been characterized previously. Dgrips84 and 91 are present in both the small gamma-tubulin complex (gammaTuSC) and the gammaTuRC, while the remaining subunits are found only in the gammaTuRC. To study gammaTuRC assembly and function, we first reconstituted gammaTuSC using the baculovirus expression system. Using the reconstituted gammaTuSC, we showed for the first time that this subcomplex of the gammaTuRC has microtubule binding and capping activities. Next, we characterized two new gammaTuRC subunits, Dgrips128 and 163, and showed that they are centrosomal proteins. Sequence comparisons among all known gammaTuRC subunits revealed two novel sequence motifs, which we named grip motifs 1 and 2. We found that Dgrips128 and 163 can each interact with gammaTuSC. However, this interaction is insufficient for gammaTuRC assembly.

Effect of resveratrol on intimal hyperplasia after endothelial denudation in an experimental rabbit model

The ability of resveratrol to inhibit vascular intimal thickening was tested in an experimental model in which endothelial denudation was performed in the normal rabbit iliac artery. Resveratrol (2 approximately 4mg/ kg/d) was administered intragastrically for 5 weeks beginning 1 week before denudation. At the higher concentration of resveratrol, the intimal hyperplasia of injured vascular wall was effectively inhibited; the intimal proliferation index also was significantly less than that in the untreated control group (0.28 +/- 0.07 vs 0.41 +/- 0.13, respectively, p<0.01); the relative luminal area increased from 0.38 +/- 0.06 in the untreated control group to 0.53 +/- 0.10 in the resveratrol treatment group (p < 0.001); and the count of smooth muscle cells in the thickened intima was statistically significantly reduced in the high dose resveratrol treatment group than that in the untreated group (1,115 +/- 510 vs 1,796 +/- 963, respectively, p < 0.05). Resveratrol added to the culture media of cultured rabbit vascular smooth muscle cells inhibited DNA synthesis in a dose-dependent manner. These results showing that resveratrol is capable of inhibiting intimal hyperplasia of injured artery raise the possibility that this polyphenol might have clinical potential in prevention and treatment of restenosis after angioplasty.

[The use of muscle autograft or nerve allograft denatured by microwave for repair of gaps in rat facial nerve]

OBJECTIVE

Attempt to enhance recovery of rat facial nerve through different grafts.

METHODS

Rats facial nerve mandible branch gap was repaired using different grafts, either muscle autograft or sural nerve allograft denatured by microwave. Axonal regeneration was studied in 10th week after insertion of the denatured muscle autografts or sural nerve allografts and compared with results found in autologous sural nerve grafts used as controls. Axonal regeneration, Schwann cell behavior and efficacy of nerve and muscle were quantified using CB-HRP retrograde trace, HE staining, Flamming staining and electromyography.

RESULTS

Denatured nerve allografts and muscle autografts supported the higher rates and volumes of axonal regeneration. Nerve allografts had the higher degree of myelin sheath developing.

CONCLUSION

Nerve autograft and muscle autograft denatured by microwave are convenient, source sufficient, higher efficient grafts for repairing facial nerve gap and have potential clinical use.

A gain-of-function phenotype conferred by over-expression of functional subunits of the COP9 signalosome in Arabidopsis

The COP9 signalosome is a conserved cellular regulator present in diverse organisms. To understand the structural and functional relationship of the COP9 signalosome with its subunits, we expressed in wild-type and mutant Arabidopsis backgrounds two orthologues of subunit 1, rice FUS6 (rFUS6) and human GPS1, and Arabidopsis subunit 8 (COP9). In Arabidopsis, rFUS6 can functionally replace Arabidopsis endogenous FUS6 to form the COP9 signalosome complex and rescue the null fus6-1 mutant phenotype. Moreover, light-grown rFUS6 over-expression seedlings displayed longer hypocotyls and reduced anthocyanin accumulation in comparison to wild-type seedlings, which is opposite to the fus6/cop11 mutant phenotype. The long-hypocotyl phenotype was also observed in transgenic seedlings over-expressing Arabidopsis COP9. This finding indicates that over-expression of a functional subunit 1 or subunit 8 of the COP9 signalosome confers a gain-of-function phenotype relative to the complex. Human GPS1, when expressed in the fus6-1 null mutant of Arabidopsis, can assemble into a chimeric COP9 signalosome at low efficiency, demonstrating the structural conservation of the complexes between human and Arabidopsis. This low-abundancy chimeric complex is insufficient to fully rescue the mutant but is able to attenuate the mutant severity.

Characterization of novel glutathione adducts of a non-nucleoside reverse transcriptase inhibitor, (S)-6-chloro-4-(cyclopropylethynyl)-4-(trifluoromethyl)-3, 4-dihydro-2(1H)-quinazolinone (DPC 961), in rats. Possible formation of an oxirene metabolic intermediate from a disubstituted alkyne

The postulated formation of oxirene-derived metabolites from rats treated with a disubstituted alkyne, (S)-6-chloro-4-(cyclopropylethynyl)-4-(trifluoromethyl)-3, 4-dihydro-2(1H)-quinazolinone (DPC 961), is described. The reactivity of this postulated oxirene intermediate led to the formation of novel glutathione adducts whose structures were confirmed by LC/MS and by two-dimensional NMR experiments. These metabolites were either excreted in rat bile or degraded to mercapturic acid conjugates and eliminated in urine. To demonstrate the oxidation of the triple bond, an analogue of DPC 961 was synthesized, whereby the two carbons of the alkyne moiety were replaced with (13)C stable isotope labels. Rats were orally administered [(13)C]DPC 961 and glutathione adducts isolated from bile. The presence of an oxygen atom on one of the (13)C labels of the alkyne was demonstrated unequivocally by NMR experiments. Administration of (14)C-labeled DPC 961 showed that biliary elimination was the major route of excretion with the 8-OH glucuronide conjugate (M1) accounting for greater than 90% of the eliminated radioactivity. On the basis of radiochemical profiling, the glutathione-derived metabolites were minor in comparison to the glucuronide conjugate. Studies with cDNA-expressed rat enzymes, polyclonal antibodies, and chemical inhibitors pointed to the involvement of P450 3A1 and P450 1A2 in the formation of the postulated oxirene intermediate. The proposed mechanism shown in Scheme 1 begins with P450-catalyzed formation of an oxirene, rearrangement to a reactive cyclobutenyl ketone, and a 1,4-Michael addition with endogenous glutathione to produce two isomeric adducts, GS-1 and GS-2. The glutathione adducts were subsequently catabolized via the mercapturic acid pathway to cysteinylglycine, cysteine, and N-acetylcysteine adducts. The transient existence of the alpha,beta-unsaturated cyclobutenyl ketone was demonstrated by incubating the glutathione adduct in the presence of N-acetylcysteine and monitoring the formation of N-acetylcysteine adducts by LC/MS. Epimerization of GS-1 to GS-2 was also observed when N-acetylcysteine was omitted from the incubation.

[Clinical study of prophylactic cranial irradiation for small-cell lung cancer]

OBJECTIVE

To study the influence of prophylactic cranial irradiation (PCI) on survival and brain metastases in patients with limited small-cell lung cancer (SCLC).

METHODS

Fiftyone patients with limited SCLC under complete remission after chemoradiotherapy were randomly divided into prophylactic cranial irradiation (PCI) group (n = 26) and control group (n = 25). Patients in PCI group received irradiation at a dose of 25.2-30.6 Gy. Survival rates were analyzed and compared by life table and Long-Rank, incidence of cranial metastases by chi 2 test.

RESULTS

The clinical features of patients such as age, sex, effect of treatment before PCI were similar between the two groups. The incidence of cranial metastases was 3.8% in PCI group in contrast to 28% in the control group (P < 0.05). The 1, 2, 3-year survival rate was 84.6%, 73.1%, 42.3% respectively in PCI group and 72%, 40%, 32% respectively in the control group. The differences between the two groups of petients were statistically insignificant. No serious sequela was observed in patients receiving PCI.

CONCLUSION

PCI decreases the incidence of cranial metastases for patients with limited SCLC following complete response to chemoradiotherapy, but it does not improve survival.

Characterization and transcriptional profiles of two rice MADS-box genes

The plant MADS-box gene family plays a key role in plant development, especially in flower development. We designed degenerate primer according to the MADS-box conserved region and isolated two cDNA from rice, FDRMADS6 and FDRMADS7, which are homologous to AP1. RT-PCR expression analyses by using total RNA isolated from root, shoot and flower showed that the FDRMADS6 transcript was detectable only in flower while FDRMADS7 was expressed in all three tissues. In situ hybridization experiments indicated that at the early stage of rice flower development, the transcripts of FDRMADS6 and FDRMADS7 were detected in the spikelet apical meristem, which were same as AP1. At the late stage, when flower organ primordia started differentiating, the expression of FDRMADS6 appeared to be specifically localized in developing stamens and the pistil primordia, while the transcripts of FDRMADS7 were detectable abundantly throughout the organ primordia. Our results suggest the two MADS-box genes may be members of the AP1 family, but may have different functions.

Prevalence and risk factors of hepatitis C virus infection among Koreans in rural area of Korea

In a Korean rural area with a high incidence of liver cancer, a molecular epidemiological study was conducted to estimate the prevalence of hepatitis C virus (HCV) infection and to determine the distribution of HCV genotype and transmission routes of HCV infection. The study population is those who volunteered to participate in a health survey in 1993 and were over 10 years of age. Those who were anti-HCV-positive and 20 of their spouses were re-examined in 1995 and tested for HCV genotype. A phylogenetic tree was constructed after sequencing analysis of core and envelope regions from the subjects with genotype 2a without a blood transfusion history. The age- and sex-standardized prevalence of anti-HCV was 5.52%. In a multivariate analysis, transfusion history was not associated with anti-HCV-positivity, but a history of acupuncture (adjusted odds ratio=2.2, 95% confidence interval=1.0, 4.7) and a history of surgical operation (adjusted odds ratio=2.0, 95% confidence interval=1.0, 4.1) were associated. The prevalence of HCV genotype 2a was the highest, and genotype 1b was less frequent. The phylogenetic tree showed strong homology among our samples with Japanese HCV strains. The present study suggests that there is a highly endemic area of HCV infection in Korea and that this endemicity is probably associated with a parenteral source of HCV infection other than blood transfusion. The study also suggests that some of the HCV infection was spread through non-sterilized or non-disposable acupuncture needles in this HCV endemic area.

[Automatic modulation of refractoriness of His-Purkinje system during atrioventricular nodal reentrant tachycardia]

OBJECTIVE

To illustrate the automatic modulation of refractoriness of His-Purkinje system during atrioventricular nodal reentrant tachycardia (AVNRT) and to discuss the possible mechanisms.

METHODS

Programmed electrical stimulations were performed in high right atrium (HRA) in 8 patients with AVNRT before ablation to induce tachycardia and electrocardiagraphic recordings were done synchronically when AVNRT appeared.

RESULTS

All the patients had 2:1 atrioventricular (A-V) conduction when AVNRT began, 2 of whom were blocked below His bundle, 5 above His bundle and 1 unclear. After a duration of 14.03 +/- 10.03 s of 2:1 A-V conduction, 1:1 A-V conduction with bundle banch block appeared, 3 of which were right bundle branch block (RBBB), 3 left bundle branch block (LBBB), and 2 with both. Bundle branch block disappeared after a duration of 6.87 +/- 11.26 s.

CONCLUSION

Effective refractory period (ERP) of His-Purkinje system at the beginning of AVNRT was modulated automatically within less than 30-60 s and thus facilitated nodal-ventricular conduction. The mechanism of this is electrical remodeling.

[Speech recognition and language development in prelingually deafened children with multichannel cochlear prosthesis]

OBJECTIVE

To assess the development of hearing and language in prelingually deafened children with implanted multichannel cochlear prosthesis from the mandarin-speaking area, and to explore the basic pattern of speech recognition and language development as well as influencing factors.

METHODS

Twenty-five prelingually deafened children and youths with cochlear implant participated in this study. Using "Evaluating method on hearing and speech rehabilitation in deafened children" as a test material. These materials consist of speech and environment sound discrimination, closed-set and open-set speech recognition and language development tests.

RESULTS

All patients had the ability to hear sound and could discriminate different categorical sounds. Results indicated that the score of closed-set test exceeded the chance level. The correct recognition rate was escalating with prolonging the implanted time. Contrarily, the correct recognition rate was de-escalating as implanted age increased. Subjects having significant open-set speech recognition half year after the operation, indicated that the cochlear implant can promote prelingually deafened children to develop their speech level.

CONCLUSION

Once the diagnosis of profoundly sensorineural hearing loss is made, the optimal treatment of choices is cochlear implant and speech rehabilitation.

Effects of resveratrol on oxidative modification of human low density lipoprotein

OBJECTIVE

To determine the antioxidative effects of resveratrol (RES), a polyphenolic compound in red wine, on the oxidation of human low density lipoprotein (LDL) using two different oxidation systems.

METHODS

Oxidation of LDL was induced by adding either Cu2+ or an azo compound. The extent of LDL modification was assessed by measuring the formation of thiobarbituric acid reactive substances (TBARS), the relative electrophoretic mobilities (REM), and the amount of oxidized LDL degradation by macrophages.

RESULTS

During Cu(2+)-induced oxidation, RES reduced TBARS formation in LDL by 70.5%, REM of LDL by 42.3% and the amount of macrophage degradation by 65.7%, respectively. The lag phase of LDL oxidation was also delayed by adding RES both in the copper ion and azo compound-induced oxidation systems.

CONCLUSION

RES can protect LDL against both Cu(2+)-induced and azo compound-initiated oxidative modification in vitro, which might be due to its free radical scavenging capacity.

Isolation and mapping of rFUS6, a rice orthologue of Arabidopsis thaliana FUS6

COP9 complex is one of the most important components that act in repressing photomorphogenesis in Arabidopsis thaliana. FUS6 has been identified as one of eight subunits of the COP9 complex in Arabidopsis. Using Arabidopsis Fus6 cDNA as a probe, we screened a rice root cDNA library and a rice genomic library. A 1730-bp cDNA was obtained, which has an open reading frame corresponding to 441-amino-acid. This 441 amino acids putative protein has 67% identity with Arabidopsis COP11/FUS6 (AtFUS6) and 40% identity with human GPS1, an AtFUS6 orthologue. So we designated this novel gene as rFUS6. The 6.2-kb genomic sequence of rFUS6 was also obtained. Sequence comparison showed that the rFUS6 gene had six exons and five introns. Sequence inspection of the 5'-flanking region revealed the presence of some potential light-regulated cis-elements such as a G-box, GT-1 binding sites, and a TGACG motif. Southern hybridization with rice total DNA showed that rFUS6 was perhaps a single copy gene. The rFUS6 locus was mapped by hybridization with a rice BAC library membrane and the results showed that rFUS6 had a locus at 16.3 cM of chromosome 1.

Changes in serum cardiac troponin I levels after percutaneous transluminal coronary angioplasty

OBJECTIVE

To evaluate the possible effect of percutaneous transluminal coronary (PTCA) on myocardium.

METHODS

Serum cTnl and CK-MB were measured in 60 patients with coronary artery disease (CAD) who underwent PTCA before and at the 6th, 12th, 24th, 48th and 72nd hour after the interventional procedure respectively.

RESULTS

The serum cTnl levels began to increase at 6 hours (9.65 +/- 6.27 micrograms/L) in 18 patients, reached the peak levels during 12-24 hours (20.43 +/- 11.28 micrograms/L, 18.52 +/- 9.52 micrograms/L), and returned to normal range till 48-72 hours (7.35 +/- 7.62 micrograms/L, 5.51 +/- 3.13 micrograms/L) after PTCA. The serum cTnl and CK-MB levels were kept normal range pre- and post-PTCA in 30 cases. The levels of cTnl in 12 cases were over baseline either before or after the procedure, while for CK-MB, only in 3 cases were over normal range after PTCA. Compared with normal cTnl group, elevated cTnl levels were related to total inflation times and dilated times (P < 0.05).

CONCLUSIONS

PTCA may cause some minor damage in myocardium, serum cTnl level was more sensitive and specific for monitoring myocardial injury.

Suppression of mitogenesis and regulation of cell cycle traverse by resveratrol in cultured smooth muscle cells

Resveratrol (3,5,4'-trihydroxystilbene), a natural product derived from grapes, has been reported to exert a plethora of biological functions. Recent studies suggest that resveratrol could act as a cardioprotective agent by controlling the oxidation of low density lipoproteins, as well as the proliferation of endothelial cells. Since migration and proliferation of smooth muscle cells (SMCs) in the intima of susceptible vessels is also widely accepted as a requisite for atherogenesis, we investigated the effects of resveratrol on proliferation and cell cycle control of cultured smooth muscle cells. Results of these experiments are reported herein. Resveratrol reduces SMC proliferation in a dose-dependent manner, with 50-100 microM resveratrol resulting in 70-90% reduction of SMC proliferation induced by such diverse mitogens as serum, endothelin and PDGF. The anti-mitogenic effects of resveratrol are not mediated by the induction of apoptosis, but appear to relate to a G1-->S block in cell cycle traverse. These results give further support to the hypothesis that resveratrol holds promise as an anti-atherosclerotic agent.

Prevalence of TT virus and GBV-C infections among patients with liver diseases and the general population in Shanghai, China

To determine the prevalence of TT virus (TTV) and GB virus C/hepatitis G virus (GBV-C) infections among patients with liver disease and the general population in Shanghai, China, we studied 90 patients with liver diseases (acute hepatitis, 28; chronic hepatitis, 27; liver cirrhosis, 20; hepatocellular carcinoma, 15) and 90 age, sex matched healthy blood donors as controls. There were no significant differences in the clinical and demographic characteristics between the two groups, except for liver function test values. There was a statistical difference between the patient group and the control group with regard to the prevalence of TTV DNA (23.5% in patient group, 11.1% in control group, P < 0.05), although no differences in clinical features could be found between TTV DNA-positive and negative subjects. Also, no differences in TTV DNA prevalence among various categories of liver diseases were noted (P = NS). The prevalence of HBsAg was significantly different between the patient group (36.7%) and the control group (3.3%) (P0.01), whereas the prevalence of anti-HCV and GBV-C RNA were not significantly different between the two groups. The nucleotide sequences were determined in the TTV DNA-positive samples and evaluated using phylogenetic analysis which suggested that they could be divided into two main genotypes designated as genotype 1 and 2. There were five samples clustered into 3 hitherto unknown subtypes of genotype 2. We concluded that (1) although TTV infection is widespread among both groups and there is a statistical difference of TTV infection between them, no hepatic damaging evidence and correlation with certain liver disease could be found in this study, suggest that TTV may not be major cause of liver disease, (2) GBV-C infection is frequent, but the virus is not the cause of liver diseases, and (3) new subtypes of TTV may exist in Shanghai, China.

A novel calmodulin-like protein gene in rice which has an unusual prolonged C-terminal sequence carrying a putative prenylation site

A rice cDNA encoding a novel calmodulin-like protein was identified. It has 38 additional amino acids at the C-terminus of a complete, typical calmodulin (CaM) sequence of 149 amino acids. The four C-terminal amino acid residues form a CAAL motif which could be a site for protein prenylation and may subsequently cause the protein to become membrane associated. RT-PCR analysis confirmed that such a combined protein gene truly exists in rice. Sequence analysis of its genomic counterpart showed that there is an intron located at junction of the normal CaM sequence and the 38 C-terminal amino acids. This introduces a potential stop codon for normal CaM if an alternative splicing mechanism is involved. Southern blot analysis of rice genomic DNA revealed that there is only one locus for this gene. The northern blot analysis showed that this gene is highly expressed in rice roots, shoots and flowers. The distribution of this protein demonstrates the functional importance of this novel CaM-like protein in rice.

TT virus infection among IVDUs in south western China

To elucidate the prevalence and clinical implications of infection with the newly described TT virus (TTV) among intravenous drug users (IVDUs) in Yunnan, southwest China, serum samples from 158 IVDUs (129 M, 29 F; mean age 26.1 +/- 5.5 years) were examined for TTV DNA by semi-nested polymerase chain reaction (PCR) using primers derived from the open reading frame (ORFI) of TTV DNA. The seroprevalence of viral markers of HIV, HBV, HCV and GB virus C/hepatitis G virus (GBV-C) infection was also examined. A molecular evolutionary analysis was performed. Thirty one (20%) of the IVDUs were positive for TTV DNA, and 34 (22%), 6 (4%), 98 (62%), 76 (48%), 136 (86%) and 65 (41%) were positive for anti-HIV, HBsAg, anti-HBs, anti-HBc, anti-HCV and GBV-C RNA, respectively. When all the subjects were classified according to TTV DNA positivity, no significant differences were observed in demographic, biochemical or virological characteristics between the 2 groups. TTV infection was in all cases associated with co-infection with 1 or more of the other aforementioned viruses. There were no significant differences in the various combinations of co-infection between TTV positive and negative groups. Phylogenetic analysis revealed that the TTV isolates obtained in the study could be grouped mainly into TTV genotype 1, and that some of the isolates belonged to subgroups other than those previously described. These results indicate that: 1) TTV infection is prevalent among IVDUs in China; 2) TTV probably has minor liver pathogenicity; and 3) new subgroups of genotype 1 and 2 exist in China.

[Comparison of AutoSet with polysomnography in the diagnosis of sleep apnea syndrome]

OBJECTIVE

To evaluate the validation of the AutoSet system in the diagnosis of sleep apnea syndrome(SAS).

METHODS

One hundred and twenty patients were studied simultaneously performed both with the AutoSet and the polysomnography(PSG). The apnea index(AI) and apneas + hypopneas index (AHI) were compared between the two methods by Bland and Altmen method.

RESULTS

A significant correlation was found between the AHI assessed by the AutoSet and by the PSG (r = 0.92, P < 0.001). The respiratory irregularity index (RII) of the AutoSet was well correlated with the arousal index (Ai) from the PSG (r = 0.72, P < 0.001). The sensitivity and specificity of the AutoSet in diagnosing sleep apnea were 94% and 80% for AHI > or = 5/hour, 92% and 85% for AHI > or = 10/hour, 91% and 92% for AHI > or = 15/hour, 91% and 91% for AHI > or = 20/hour.

CONCLUSIONS

The AutoSet system is a sensitive and valuable tool for identifying patients with sleep apnea and can make a diagnosis of sleep apnea for these patients with AHI > or = 30/hour, but has some limits especially for mild to moderate sleep apnea.

[Vestibular potentials evoked by electrical stimulation]

OBJECTIVE

To identify the evoked potentials (VsEPs) by electrical stimulation were from vestibule.

METHODS

The stimulating electrode was set on the round window of guinea pig. Constant current shocks of 0.05 ms (0.25-1.2 mA) were used to evoke VsEPs by means of vertex-pinna skin electrodes.

RESULTS

These potentials were short latencies of (0.973 +/- 0.086) ms, (1.618 +/- 0.176) ms and (2.416 +/- 0.274) ms respectively, which reflected true potentials and were not from electrical stimulus artefacts. It was pure vestibular origin. As being masked with a continuous white noise (120 dB SPL) or removed ipsilateral auditory nerve, and even after facial neurectomy, waves were still existing, but disapeared after selective vestibular neurectomy. The twitching responses in the facial region had never been detected during the whole test. These potentials were bioelectric responses in the vestibular sensory pathway, characterized by threshold saturation, adaptability of excitation, dependent on intact vestibular nerve.

CONCLUSIONS

We have set up animal model of recording VsEPs evoked by electrical stimulation on the round window of guinea pigs.

[Rate discrimination and tone recognition in mandarin-speaking cochlear-implant listeners]

OBJECTIVE

To explore the relationship between the rate discrimination and the tone recognition with psychophysical method, and provide a basis for evaluating the results from mandarin-speaking cochlear implantees who used multi-channel cochlear implant and designing new speech coding strategies of the speech processor.

METHODS

Four postlingually-deafened adults with cochlear implant participated in this study. We used the method of constant stimuli to measure the rate discrimination as a function of the standard rate at 50, 100, 200, 400 Hz on electrode pairs (E1, E3), (E7, E9), (E14, E16), and (E20, E22), respectively. We also measured tone recognition in 25 consonant-vowel syllables, each of which has four tonal variations, resulting in a total of 100 words. These words were recorded by a male talker and were presented five times each to the implant users via their speech processors. The tone recognition results were scored in overall percent correct and analyzed by error patterns in the confusion matrix and fundamental frequency.

RESULTS

The rate discrimination thresholds, defined at the 75% correct level, varied greatly among individuals and ranged from several Hz to hundreds of Hz. A three-way ANOVA indicated significant effect (P < 0.05) on rate discrimination for the standard rate, electrode position, and patient variable. The tone recognition ranged from 40% to 80% and tones 1 and 3 were more easily identified than tones 2 and 4. Preliminary analysis using linear regression revealed highly significant correlation between rate discrimination and tone recognition.

CONCLUSION

These results suggest that identification of tones relies on good rate discrimination in cochlear implant listeners. Clinical rehabilitation strategies in improving rate discrimination were discussed.

GB virus C/hepatitis G virus infection among patients with hepatocellular carcinoma in the inshore area of the Yangtze River, China

To investigate the association between GB virus C/hepatitis G virus (GBV-C/HGV) infection and the development of hepatocellular carcinoma (HCC) in H city, in the inshore area of the Yangtze River, where high prevalence of HCC has been reported, we determined hepatitis B virus (HBV) and hepatitis C virus (HCV) markers, GBV-C/HGV-RNA and GBV-C/HGV E2 antibody (anti-HG E2) among 114 HCC patients and the same number of age- and sex-matched controls. There were no significant differences in the clinical and demographic characteristics between them, except for serum alanine aminotransferase level and history of liver diseases. There was a significant difference of hepatitis B virus surface antigen (HBsAg) prevalence between the HCC patients (75.4%) and the controls (20.2%; P<0.01). Hepatitis C virus antibody was detected in 4.4% of the HCC patients, compared with 1.7% of the controls. GB virus-C/HGV-RNA and anti-HG E2 were detected in 14.9 and 1.7% of the HCC patients, respectively, compared with 7.0 and 1.7% of the controls, respectively. Nucleotide sequences and molecular evolutionary analysis showed the strains of GBV-C/HGV-RNA were classified into genotype 2 and 3 (HG and ASIA type). An effect analysis showed an odds ratio (OR) for developing HCC from GBV-C/HGV infection among HBsAg-positive subjects was 14.9, with a 95% CI of 4.9-45.4. HBsAg infection alone was 13.83 (95% CI 7.4-25.9) and GBV-C/HGV infection alone, 3.74 (95% CI 1.1-13.1), respectively. These data indicate that HBV infection is considered to be one of the major risk factors in patients with HCC and although GBV-C/HGV infection was observed in both the HCC and the control groups, it might not play an important role in the development of HCC in this area.