First Report of Tomato yellow leaf curl virus Infecting Cowpea in China

Tomato yellow leaf curl virus (TYLCV) is a devastating pathogen of tomato that causes significant yield losses in many tropical and subtropical regions (1). In China, this virus was first found in 2006 on tomato in Shanghai (2). In October 2008, chlorotic yellow leaves of cowpea (Vigna sinensis) were observed in Qingpu, Shanghai, China with 15 to 20% incidence in plants in high tunnels. Large populations of whiteflies were observed in association with the diseased cowpea. The disease agent was transmitted to cowpea (and tomato) by whiteflies, which resulted in chlorotic yellow leaves on cowpea (yellow leaf curl symptoms on tomato) that were identical to those observed in the field. On the basis of the suspected insect vector, symptomology, and severe epidemics of tomato yellow leaf curl disease (TYLCD) in Shanghai in recent years, Tomato yellow leaf curl virus was suspected as the causal agent. Total DNA was extracted from four symptomatic cowpea samples. PCR was performed with specific primers V416 (5'-CAAGGCACAAACAAGCGACG-3') and C1287 (5'-CTCAACTTCCGAATTTGGACGAC-3') to amplify a 872-bp DNA fragment of the viral coat protein (CP) gene and an amplicon of the expected size was obtained in all four samples but not from healthy leaf samples. The PCR products were sequenced and the sequences were identical among samples. Primers TYLCV-F (5'-CAGGAGGCAGCCAAGTATGAG-3') and TYLCV-R (5'-ACTAATGCCTGTTCYTTCATTCC-3') (Y = C or T/U) were designed on the basis of the sequence (Accession No. HM804856) and reported (Accession No. FM163463) CP gene to amplify the full-length viral DNA of cowpea isolate (CN:SH:Cowpea:08). The sequence was determined to be 2,781 nucleotides long (Accession No. GU434143). A comparison of the sequence with those in GenBank shows that the cowpea isolate has the highest nucleotide sequence identity (99%) with TYLCV isolate XH2 from tomato in Xinghua, Jiangsu, China (Accession No. GU111505). To our knowledge, this is the first report of TYLCV infecting cowpea in China and also the first report in the world. References: (1) H. Czosnek and H. Laterrot. Arch. Virol. 142:1391, 1997. (2) J. B. Wu et al. Plant Dis. 90:1359, 2006.

First Report of Cucurbit chlorotic yellows virus Infecting Melon in China

In October 2007, symptoms of chlorosis on the upper leaves and a bright yellow color on the lower leaves were observed sporadically on hami melon (Cucumis melo cv. Xuelihong) in a high tunnel in Nanhui of Shanghai, China. Disease progresses from initial mottling of leaves into leaves that are completely yellow with the veins remaining green. The oldest leaves develop symptoms first, so these leaves have a pronounced even yellow color. In October 2009, these symptoms were found in all melons produced in the suburbs of Shanghai. These symptoms were similar to those caused by Cucurbit yellow stunting disorder virus (CYSDV) and Cucurbit chlorotic yellows virus (CCYV) (1-3). Twelve samples from symptomatic melons were collected in the Jiading, Nanhui, Fengxian, and Chongming districts of Shanghai for virus diagnosis. Large populations of whiteflies were observed in association with the diseased cucurbit crops. Total RNA was extracted with Trizol reagents (Invitrogen, Carlsbad, CA). We used random primers (9-mer) for reverse transcription-PCR. Extracts were for CYSDV using specific primers CYSDV-CP-F (5'-ATGGCGAGTTCGAGTGAGAA-3') and CYSDV-CP-R (5'-TCAATTACCACAGCCACCTG-3') to amplify a 756-bp fragment of coat protein gene and CCYV using specific primers CCYV-HSP-F1 (5'-TGCGTATGTCAATGGTGTTATG-3') and CCYV-HSP-R1 (5'-ATCCTTCGCAGTGAAAAACC-3') to amplify a 462-bp fragment of the HSP gene (1). CYSDV was not found in all samples. The expected 462-bp target fragment of CCYV was obtained in all samples but not from any of the healthy controls. All the 462-bp PCR products were cloned to pGEM-T vector (Promega, Madison, WI) and sequenced. All sequences obtained were homologous. A comparison of the submitted sequence (GenBank Accession No. HQ148667) with those in GenBank showed that the sequence had 100% nucleotide identity to the Hsp70h sequences of (CCYV) isolates from Japan (Accession Nos. AB523789 and AB457591) (1,4), Taiwan (Accession No. HM120250) (2), and mainland of China (Accession Nos. GU721105, GU721108, and GU721110). CCYV is a new member of the genus Crinivirus, first discovered in Japan in 2004 (4) and reported in Taiwan in 2009 (2). To our knowledge, this is the first report of CCYV on melon in China. References: (1) Y. Gyoutoku et al. Jpn. J. Phytopathol. 75:109, 2009. (2) L.-H. Huang et al. Plant Dis. 94:1168, 2010. (3) L. Z. Liu et al. Plant Dis.94:485, 2010. (4) M. Okuda et al. Phytopathology 100:560, 2010.

Interleukin 4 and STAT6 gene polymorphisms are associated with systemic lupus erythematosus in Chinese patients

An imbalance between T Helper 1 (TH1) and T Helper 2 (TH2) cytokine production is important for the pathogenesis of systemic lupus erythematosus (SLE). We aimed to investigate gene—gene associations of TH1 and TH2 cytokines genes in Chinese patients with SLE. Twenty single nucleotide polymorphisms (SNPs) in eight cytokines genes were genotyped in 110 SLE patients and 138 healthy controls in a case—control association study. The minor allelic frequencies of interleukin4(IL4) -590 T/C, -33 T/C, 9241C/G, and IL10 -592 A/C were significantly increased in SLE patients compared with those in controls (p < 0.05). None of the separate 20 SNPs showed significant association with SLE after Bonferroni correction. An IL4 haplotype -590C/-33C/9241G/14965C was significantly associated with SLE (odds ratio 3.7, 95% confidence interval [CI] 1.5—8.9, p = 0.004, Bonferroni-corrected p = 0.024). A borderline significant three-locus gene—gene interaction among IL4 9241 C/G, IL4 -33 T/C, signal transducer and activator of transcription 6, IL4-induced (STAT6) 2892 C/T was detected by a multifactor dimensionality reduction test (p = 0.051). However, the presence of two at-risk genotypes lead to increased risk of SLE for two-locus interaction using logistic regression method. The risk of SLE increased significantly when a subject has two at-risk genotypes for IL4 -590C and STAT6 2892C (odds ratio, 3.24, 95% CI 1.5—7.0, p = 0.003, Bonferroni-corrected p = 0.009), IL4 -33C and STAT6 2892C (odds ratio 3.06, 95% CI 1.4— 6.7, p = 0.005, Bonferroni-corrected p = 0.015), as well as IL4 9241G and STAT6 2892C (odds ratio 3.34, 95% CI 1.6—7.1, p = 0.002, Bonferroni-corrected p = 0.006). Further, plasma IL-4 concentrations were significantly lower in SLE patients than in healthy controls (1.59 + 3.53 versus 5.67 + 11.28 pg/ml, p = 0.042). These results indicated that IL4 and STAT6 genes might be involved in the etiology of SLE and potentially increased SLE risk through their interaction effect in Chinese patients.

Ulcer size as a novel indicator marker is correlated with prognosis of ulcerative gastric cancer

AIMS

The objective of this study was to assess the significance of ulcer size for the survival of gastric cancer patients.

METHODS

A total of 260 patients with ulcerative gastric cancer who had undergone curative resection were reviewed. The diameter of the malignant ulcer was measured. Patients were divided into group U1 (< or =3 cm) and group U2 (>3 cm) according to the diameter of the ulcer. The prognostic significance of ulcer size was assessed by uni- and multivariate analyses.

RESULTS

Patient survival was correlated with age, gender, tumor location, tumor size, ulcer size, serosal invasion, node involvement and synchronism distant metastasis. The 5-year overall survival rate in U1 patients was 84.3% as compared with 67.5% in U2 patients (p < 0.001), and the 5-year recurrence-free survival rates were 82.9% for group U1 and 62.5% for group U2 (p = 0.001). Multivariate analysis revealed that ulcer size is an independently significant predictive factor for survival rates (overall: hazard ratio 1.222, p = 0.003; recurrence-free: hazard ratio 1.205, p = 0.006).

CONCLUSION

Ulcer size might be a potential indicator for advanced disease and the use of minimal local treatments must be considered carefully in larger ulcer size patients.

The antioxidant activities of natural sweeteners, mogrosides, from fruits ofSiraitia grosvenori

To search for antioxidant agents from natural resources, in this paper the in vitro antioxidant activities of two natural sweeteners, mogroside V and 11-oxo-mogroside V isolated from the fruits of Siraitia grosvenori, were determined using chemiluminescence (CL). The results showed that these sweet glycosides, having cucurbitane triterpenoid aglycon, exhibited significant inhibitory effects on reactive oxygen species (O2-, H2O2 and *OH) and DNA oxidative damage. 11-oxo-mogroside V showed a higher scavenging effect on O2- (concentration at which 50% of chemiluminescence intensity is inhibited [EC50] =4.79 microg/ml) and H2O2 (EC50 = 16.52 microg/ml) than those of mogroside V. However, mogroside V was more effective in scavenging *OH, with EC50 =48.44 microg/ml compared with that of 11-oxo-mogroside V (EC50 = 146.17 microg/ml). Further, 11 -oxo-mogroside V exhibited a remarkable inhibitory effect on *OH-induced DNA damage with EC50 = 3.09 microg/ml.

Genetic variants in COMT and neurocognitive impairment in families of patients with schizophrenia

This study examined the relations of genetic variants in catechol-O-methyltransferase (COMT) gene, including rs737865 in intron 1, rs4680 in exon 4 (Val158Met) and downstream rs165599, to schizophrenia and its related neurocognitive functions in families of patients with schizophrenia. Totally, 680 individuals from 166 simplex (166 affected members and 354 nonpsychotic first-degree relatives) and 46 multiplex families (85 affected members and 75 nonpsychotic first-degree relatives) were interviewed using Diagnostic Interview for Genetic Studies, administered Wisconsin Card Sorting Test (WCST) and Continuous Performance Test (CPT), and drawn for venous blood. Both categorical (dichotomizing families on affected members' neurocognitive performance) and quantitative approaches toward the WCST and CPT performance scores were employed using the family-based association test and the variance components framework, respectively. Both false discovery rate and permutations were used to adjust for multiple testing. The genotypes of rs4680 were associated with both the WCST and CPT performance scores in these families, but not with schizophrenia per se in either whole sample or subgroup analyses. Meanwhile, the other two single nucleotide polymorphisms were differentially associated with the two tasks. For WCST indexes, regardless of subgroup analyses or quantitative approach, only rs737865 exhibited moderate associations. For CPT indexes, rs737865 exhibited association for the subgroup with deficit on CPT reaction time, whereas rs165599 exhibited association for the subgroup with deficit on CPT d' as well as quantitative undegraded d'. Our results indicate that the genetic variants in COMT might be involved in modulation of neurocognitive functions and hence conferring increased risk to schizophrenia.

Characterization of apoptosis induced by grouper iridovirus in two newly established cell lines from barramundi, Lates calcarifer (Bloch)

Two new cell lines have been established from the muscle and swim bladder tissues of barramundi, Lates calcarifer, and designated as BM (barramundi muscle) and BSB (barramundi swimbladder), respectively. The cells multiplied well at 28 degrees C in Leibovitz's L-15 medium supplemented with 10% foetal bovine serum, and have been continuously subcultured more than 100 times to date. Morphologically, BM cells were mostly fibroblastic, whereas BSB were mostly epithelial. Both cell lines were susceptible to grouper iridovirus (GIV) and displayed characteristics of apoptosis after viral infection. The induction of apoptosis was further assayed in GIV-infected BM and BSB cells by various methods. The inhibition of cell growth by GIV was demonstrated by MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay. Morphological observations revealed typical apoptotic features in the infected cells, including cell shrinkage and rounding, chromosome condensation and formation of apoptotic body-like vesicles. Chromosome fragmentation was detected by DNA laddering and TUNEL assays. Finally, the appearance of phosphotidylserine on the outer leaflet of apoptotic cell membranes was confirmed by annexin V staining. This is the first report of apoptosis induced by GIV in fish cells.

More evidence supports the association of PPP3CC with schizophrenia

Calcineurin is a calcium/calmodulin-dependent protein phosphatase composed of two subunits, a regulatory subunit of calcineurin B (CNB) and a catalytic subunit of calcineurin A (CNA). PPP3CC is the gamma isoform of CNA located at the chromosome 8p21.3 region. To evaluate the association between PPP3CC and schizophrenia in the Taiwanese population, 10 single nucleotide polymorphism (SNP) markers across the gene were genotyped by the method of MALDI-TOF in 218 schizophrenia families with at least two affected siblings. One SNP (rs2272080) located around the exon 1 untranslated region was nominally associated with schizophrenia (P=0.024) and significantly associated with the expression of PPP3CC in lymphoblast cell line; the TT and TG genotype had significantly higher relative expression levels than the GG genotype (P=0.0012 and 0.015, respectively). In further endophenotype stratification, the single locus of rs2272080 and the haplotypes of both two-SNP haplotype (rs7833266-rs2272080) and seven-SNP haplotype (rs2461491-rs2469758-rs2461489-rs2469770-rs2449340-rs1482337-rs2252471) showed significant associations with the subgroup of schizophrenia with deficits of the sustained attention as tested by the continuous performance test (CPT, P<0.05) and the executive functioning as tested by the Wisconsin Card Sorting Test (WCST, P<0.05). The results suggest that PPP3CC gene may be a true susceptibility gene for schizophrenia.

Association evidence of schizophrenia with distal genomic region of NOTCH4 in Taiwanese families

Evidence for association with schizophrenia has been reported for NOTCH4, although results have been inconsistent. Previous studies have focused on polymorphisms in the 5' promoter region and first exon of NOTCH4. Our aim was to test the association of the entire genomic region of NOTCH4 in 218 families with at least two siblings affected by schizophrenia in Taiwan. We genotyped seven single nucleotide polymorphisms (SNPs) of this gene, with average intermarker distances of 5.3 kb. Intermarker linkage disequilibrium (LD) was calculated using gold software, and single-locus and haplotype association analyses were performed using transmit software. We found that the T allele of SNP rs2071285 (P= 0.035) and the G allele of SNP rs204993 (P= 0.0097) were significantly preferentially transmitted to the affected individuals in the single-locus association analysis. The two SNPs were in high LD (D' > 0.8). Trend for overtransmission was shown for the T-G haplotype of the two SNPs to affected individuals (P= 0.053), with the A-A haplotype significantly undertransmitted (P= 0.034). The associated region distributed across the distal portion of the NOTCH4 gene and overlapped with the genomic region of the G-protein signaling modulator 3 and pre-B-cell leukemia transcription factor 2. In summary, we found modest association evidence between schizophrenia and the distal genomic region of NOTCH4 in this Taiwanese family sample. Further replication for association with the distal genomic region of NOTCH4 is warranted.

Familial aggregation of metabolic syndrome among the Chinese: report from the Chin-Shan community family study

Genetic study on metabolic syndrome is a great challenge, due to its complex traits and the pleiotropic manifestation of atherosclerosis. Familial aggregation and recurrence risk ratio can provide the insight of possible genetic mechanism. The Chin-Shan community family study was based on adolescent probands and their relatives (1356 subjects) who were recruited from one junior high school in the community. Structured questionnaires and biochemical measures were obtained in standard procedures. Definition of metabolic syndrome was followed using the criteria defined by the third adult treatment panel, with a modification of the criteria for adolescent and Asian population. Grandmothers had the highest frequencies (70%) in metabolic syndrome and various atherosclerotic risks. Three factors were found and thus explained 68% of the overall variance. Estimated heritability was the highest in LDL and cholesterol factor (0.36 and 0.40), then blood pressure/obesity factor (0.27), and insulin resistance/dyslipidemia (0.27). Recurrence risk ratio among siblings was 2.95 (95% confidence interval [CI]: 1.39-6.26). The adjusted odds ratio (OR) of proband's metabolic syndrome status was 1.99 (95% CI: 1.08-3.66). The adjusted odds ratios for the three factors for predicting metabolic syndrome were all significant, with highest risk in blood pressure/obesity factor (OR: 1.27, CI: 1.22-1.33), then insulin resistance/dyslipidemia (OR: 1.29, CI: 1.16-1.23). This study demonstrated clearly familial aggregation and recurrence risk ratio of metabolic syndrome and components among the general ethnic Chinese population in Taiwan.

Patterns and clinical correlates of neuropsychologic deficits in patients with schizophrenia

BACKGROUND/PURPOSE

Neuropsychologic deficits are prevalent among schizophrenic patients and are closely associated with pathogenesis and outcome. The pattern, extent, severity and contributing factors to such deficits remain to be examined in Taiwanese schizophrenic patients.

METHODS

A total of 122 schizophrenic patients and 94 healthy subjects for comparison were assessed by a comprehensive neuropsychologic test battery covering the eight cognitive domains of verbal ability, visual spatial ability, abstraction/execution, verbal memory, visual memory, perceptual/motor ability, mental control and attention. The relationships among cognitive deficits, demographic characteristics, clinical historical variables and clinical symptoms were further explored by multivariate regression analysis.

RESULTS

A pattern of selective deficits superimposed on a generalized deficit was found for schizophrenic patients as a group. The mean overall deficit was 1.93 standard deviations below the control mean, and abstraction/execution, verbal memory, visual memory and attention were relatively impaired among the eight cognitive domains. However, there was also marked heterogeneity in individual performances in that 24.2%, 46.2% and 29.5% of patients performed at within normal range, moderately impaired and severely impaired levels, respectively. Duration of illness substantially affected the profile and severity of the deficits, suggesting a progressive deteriorating course in neuropsychological performance. The major predictors of cognitive deficits were number of formal years of education achieved and concurrent severity of disorganization symptoms.

CONCLUSION

In a large sample of schizophrenic patients who underwent comprehensive neuropsychologic evaluation, the current results confirmed that cognitive deficits were prevalent but not a universal feature within schizophrenia. The selective impairment pattern also confirmed that such deficits were mainly in frontal and frontotemporal related functions. Despite evidence suggesting that disease chronicity entailed a decline in selective cognitive domains, the trajectory of the neuropsychologic deficits remains to be examined by further longitudinal studies.

Calreticulin expression in neuroblastoma--a novel independent prognostic factor

BACKGROUND

Calreticulin (CRT), an endoplasmic reticulum protein, has been reported to be essential for the differentiation of neuroblastoma (NB) cells, suggesting that CRT may affect the tumor behavior of neuroblastoma. The aim of this study was to evaluate the association of clinicopathologic factors and patient survival with the expression of CRT in patients with NB.

PATIENTS AND METHODS

Sixty-eight NBs were investigated by immunohistochemical staining against CRT, and were divided into positive and negative immunostaining groups. Correlations between calreticulin expression, various clinicopathologic and biologic factors, and patient survival were studied. In seven tumor samples, CRT mRNAs and proteins were evaluated with real-time PCR and western blot, respectively, and correlated with immunohistochemical findings.

RESULTS

Among 68 NBs, 32 (47.1%) showed positive CRT expression. Positive CRT immunostaining strongly correlated with differentiated histologies, as well as known favorable prognostic factors such as detected from mass screening, younger age (< or =1 year) at diagnosis and early clinical stages, but inversely correlated with MYCN amplification. Kaplan-Meier analysis revealed that NB patients with CRT expression did have better survival. Multivariate analysis demonstrated CRT expression to be an independent prognostic factor. Moreover, CRT expression also predicted better survival in patients with advanced-stage NBs, and its absence predicted poorer survival in patients whose tumor had no MYCN amplification. The amount of CRT mRNAs and proteins in NB tumor samples tested correlated well with the immunohistochemical expressions.

CONCLUSIONS

CRT expression correlates with the differentiation of NB and predicts favorable survival, thereby suggesting CRT to be a useful indicator for planning treatment of NB.

Bilateral adrenocortical adenomas causing ACTH-independent Cushing's syndrome at different periods: a case report and discussion of corticosteroid replacement therapy following bilateral adrenalectomy

We report a rare case of bilateral adrenocortical adenomas causing ACTH-independent Cushing's syndrome at different periods 9 yr apart. The subject, a 24-yr-old woman, in June 1989 had a typical Cushingoid appearance. Her baseline plasma cortisol levels did not show a diurnal rhythm and she had a very low baseline plasma ACTH level. Plasma cortisol levels could not be suppressed by overnight low-dose or two-day high-dose dexamethasone suppression test. Marked uptake of 131I-6beta-iodomethyl-19-norcholesterol (NP-59) was observed in the right adrenal gland. Abdominal computed tomography (CT) showed a right adrenal tumor. The right adrenal gland with adenoma was removed. The non-tumorous part of the adrenal cortex was atrophic. By April 1998, she had experienced a weight gain of more than 20 kg over a two-yr period. The baseline plasma cortisol levels were at the lower limit of the normal range with loss of diurnal rhythmicity. The baseline plasma ACTH levels were very low. Neither a two-day low-dose nor a two-day high-dose dexamethasone suppression test could suppress serum cortisol or urinary free cortisol levels. NP-59 adrenal scan revealed increased uptake of the left adrenal gland at 72 h after intravenous injection of the tracer. Abdominal CT and magnetic resonance imaging (MRI) all demonstrated a left adrenal mass. Left adrenalectomy was performed in June 1998; histological features showed a cortical adenoma and atrophic change in the non-tumorous part of the adrenal cortex. Elevated plasma ACTH levels after bilateral adrenalectomy could be suppressed with conventional corticosteroid replacement therapy and overnight low-dose dexamethasone suppression test.

Seroprevalence of Chlamydia pneumoniae infection in Taiwan

OBJECTIVES

To survey the seroprevalence of Chlamydia pneumoniae (C. pneumoniae) infection in healthy subjects in Taiwan.

MATERIALS AND METHODS

We used microimmunofluorescence antibody assay to survey the prevalence of antibodies to C. pneumoniae in 620 serum samples from healthy subjects aged 6 months to 86 years in Taiwan.

RESULTS

The mean prevalence (+/-SD) of IgG antibodies against C. pneumoniae at titer greater than or equal 1:16 was 55.8% (range 7.8-81.8%). The antibody prevalence was low in children under the age of 10 years (7.8%), and increased rapidly with age. Most individual acquired infection during the second and third decades of life with highest antibody prevalence reached up to 81.8% at fifth decade of life and remained high (70%) thereafter.

CONCLUSIONS

Chlamydia pneumoniae infection is highly endemic in Taiwan. These data contribute to the understanding of asymptomatic infections with C. pneumoniae in general population and should serve as a basis for studies on the role of C. pneumoniae infections and their related diseases.

Minimally displaced intra-capsular femoral neck fractures in the elderly--comparison of multiple threaded pins and sliding compression screws surgical techniques

PURPOSE

To determine the outcome of treatment for minimally displaced femoral neck fractures using multiple threaded pins versus sliding compression screws for internal fixation.

METHODS

The medical records of 62 consecutive elderly patients with minimally displaced intra-capsular femoral neck fractures who underwent internal fixation of the fracture (37 with multiple threaded pins, and 25 with sliding compression screws) were reviewed. Clinical and radiological assessment of fracture healing at follow-up visits were noted.

RESULTS

In the 55 patients seen for follow-up at 3 months, 21.9% (n=7) of those treated by pinning demonstrated non-union of the fracture, and 0% of fractures treated with sliding compression screws (p=0.02). 46 patients were seen for follow-up at one year, with 10% (n=2) of those treated with sliding compression screws found to have osteonecrosis of the femoral head. The 2 fractures in the group treated by pinning demonstrating non-union at 3 months failed to unite by one year (p=0.11). 34 patients were seen for follow-up for at least 2 years, with no additional complications noted.

CONCLUSION

Using sliding compression screws to treat minimally displaced femoral neck fractures can achieve a higher union rate than using pinning. The reason may be the better stability in the osteoporotic bone. However, osteonecrosis of the femoral head may occur with use of sliding compression screws because of greater intramedullary vascular damage as a result of wider reaming.

One-stage revision surgery to treat hip infected nonunion after stabilization with a sliding compression screw

INTRODUCTION

Extracapsular hip infected nonunion after stabilization with a sliding hip screw (SCS) is uncommon and a convincing treatment method has not yet been reported in the literature.

PATIENTS AND METHODS

Thirteen consecutive patients who sustained such a disability were treated with removal of SCS, local radical debridement, vancomycin powder with or without gentamicin solution application, re-insertion of a new SCS, and autogenous cancellous bone grafting. Postoperatively, ambulation with regulated weight bearing was encouraged as early as possible. Infectious microorganisms in 76% (10/13) of the lesion sites were oxacillin-resistant staphylococcus aureus (ORSA).

RESULTS

Twelve patients were followed-up for at least 2 years (range, 2~6 years; median, 4 years) and all nonunions healed. The union rate was 100% (12/12) with a median union period of 4 months (range, 3~6 months). No wound infection recurred at the last follow-up. The satisfactory rate of hip function was 92% (11/12, P<0.001).

CONCLUSIONS

We, therefore, recommend this surgical procedure to treat all patients with a similar disability because of its high success rate and low complication rate.

Sustained attention deficits as markers of genetic susceptibility to schizophrenia

This article reviews recent evidence regarding the potential of the visual sustained attention deficits as measured by the Continuous Performance Test (CPT) as an endophenotype of the genetic susceptibility to schizophrenia. Findings in community subjects indicate that sustained attention develops during the primary school ages, reaches its maximum around early adolescence, and declines with age after adulthood. The assertion that CPT performance deficits, and especially on the more difficult versions, are reliable and valid genetic susceptibility indicators of schizophrenia is supported by the following results: 1) CPT deficits are present in schizophrenic patients, are particularly associated with negative and disorganized symptoms, and deficits on the more difficult CPT versions are not amenable to neuroleptic treatment; 2) subjects with schizotypal personality features also exhibit CPT deficits, which are specifically associated with the negative factor of schizotypy; 3) a substantial proportion of nonpsychotic relatives of schizophrenic patients (19-34%) have CPT deficits, which can also be predicted from their probands' CPT performance. Thus, using a CPT deficits as an endophenotype of schizophrenia would not only provide a valuable measure of genetic risk, but would also greatly enhance our understanding of etiology, and may help identify susceptibility genes for schizophrenia.

A multiobjective model for non-point source pollution control for an off-stream reservoir catchment

Phosphorus loads from agricultural non-point source pollution (NPSP) significantly degrade reservoir water quality, making adequate control of agricultural NPSP necessary for improving the water quality. Controlling NPSP is generally accomplished using various Best Management Practices (BMPs). The present study applies the Agricultural Non-Point Source Pollution (AGNPS) model to simulate NPSP loading and BMP efficiencies and establishes an enhanced multiobjective mixed-integer programming model for NPSP control strategy analyses based on these results. Cost, phosphorus load, sediment load and equity are the four major objectives considered. A case study for the Posan reservoir is presented. Four commonly proposed and applicable BMPs are chosen. Non-inferior solutions obtained using the constraint method and trade-off relationships among different control objectives are described and discussed. Compared with a previously proposed fertilizer control model, results show that the model established herein is more cost-effective and achieves better phosphorus and sediment loading reduction and equity goals. Furthermore, the current model is expected to facilitate decision-making analysis for development of an appropriate cost-sharing program to encourage adoption of appropriate BMPs by farmers.

Prevalence and clinical implications of hepatitis B virus genotypes in southern Taiwan

BACKGROUND

Hepatitis B virus (HBV) infection is a major health problem. HBV genotypes may be associated with progression of liver disease. The distribution and clinical implications of HBV genotypes in southern Taiwan are evaluated.

METHODS

We used a polymerase chain reaction-restriction fragment length polymorphism genotyping method to determine HBV genotypes.

RESULTS

The genotype distribution for 265 patients with chronic HBV infection was as follows: A, 3 (1%); B, 158 (60%); C, 90 (34%); D, 7 (2.5%); E, 0: F, 0; and unclassified, 7 (2.5%). Compared with genotype B patients, genotype C patients had a higher hepatitis B e antigen positive rate and higher fibrosis score. There was no significant difference in the mean age between genotype B and genotype C patients with hepatocellular carcinoma (HCC). However, when patients were stratified by age, the prevalence of genotype C was significantly higher in young HCC patients (<50 years of age) than in age-matched asymptomatic carriers (40% versus 10%, P < 0.001). Using multivariate analysis, the significant risk factors for advanced liver disease (cirrhosis or HCC) for patients with chronic HBV infection were old age, male gender and genotype C.

CONCLUSIONS

These results suggest that genotype C is associated with more severe liver diseases than the B variant.

Acute paraplegia due to thoracic extramedullary hematopoiesis in chronic myeloproliferative disorder--an unusual presentation

Spinal cord compression due to extramedullary hematopoiesis is a well-known complication in a number of hematological diseases. Most of the patients present with progressive paraparesis due to the slow expansion of the extramedullary hematopoietic tissue. The authors report a case of chronic myeloproliferative disorder with spinal extramedullary hematopoiesis presenting with acute paraplegia. Chronic myeloproliferative disorder is an uncommon cause of spinal cord compression, especially when associated with acute paraplegia. The authors discuss the pathomechanism of this unusual presentation.

Exchange nailing for aseptic nonunion of the femoral shaft

Thirty-six nonunions of the femoral shaft were treated by closed removal of previous nails, reaming of marrow cavity as widely as possible, and reinsertion of stable intramedullary nail. Indications included femoral shaft aseptic nonunions with inserted intramedullary nail, nonunions with a radiolucent line, without segmental bony defects, and less than 1 cm shortening. They were followed up for a median of 2.9 (1-6) years. Thirty-three nonunions healed uneventfully within a median period of 4 (3-8) months. Except for three persistent nonunions, no other significant complications occurred.

An epidemiological study of nocturnal enuresis in Taiwanese children

OBJECTIVE

To estimate the prevalence of primary nocturnal enuresis (PNE) in Taiwanese children, and to examine factors associated with PNE and its severity.

SUBJECTS AND METHODS

In all, 1683 questionnaires were sent to parents of schoolchildren aged 6-11 years randomly selected from three primary schools in Taipei City, Taiwan. The questionnaire was designed to collect information about the prevalence of and factors associated with PNE.

RESULTS

Of the questionnaires distributed, 1176 (70%) were completed. PNE was reported in 92 (8%) of the children; nine (10%) of these children were wet > 3 nights per week. Factors associated with PNE included male gender, deep sleep, divorced parents or separated family and a positive family history of enuresis. Of these factors, only those children with deep sleep were more likely to have > 3 wet nights per week.

CONCLUSION

The prevalence of and factors associated with PNE in Taiwan are similar to those reported in Western countries, but the percentage of children with severe enuresis is lower than in Sweden, France and Turkey. Deep sleepers are more likely to have severe enuresis.

Peripheral blood cells among community residents living near nuclear power plants

Information about hematopoieses as a result of exposure to very low levels of radiation is scarce. To investigate the human hematopoietic effect of very low level radiation exposure, measurements of peripheral blood components were performed among 3602 men and women, aged 35 and above, living in a community near two nuclear power installations in Chinshan, Taiwan. The radiation level that each individual was exposed to was represented by a surrogate level, '1/D2(1i) + 1/D2(2i)', a transformed distance from each individual's residence to the two power plants D1 and D2. In addition to comparing average hematology measurements, multiple regression analyses were done to include age, gender, smoking, drinking status and the surrogate radiation exposure level as independent variables. Univariate and bivariate analyses showed that the hematology measurements had significant associations with age, gender, smoking or drinking. The multiple regression analyses revealed that significant positive associations with '1/D2(1i) + 1/D2(2i)' were found for hemoglobin, hematocrit, platelet, white blood cell and red blood cell. The platelet count might increase for 208.7 x 10(3)/microl if the exposure from the nuclear plants increased by one exposure unit. This type of association implies that those who lived closer to the nuclear power installation had a higher blood cell count; we suspect that this could be a type of radiation hormesis.

Changes in bacterial concentration in the liver correlate with that in the hepaticojejunostomy after bile duct reconstruction: implication in the pathogenesis of postoperative cholangitis

Postoperative cholangitis is a frequent and unpredictable complication of unknown etiology following bile duct reconstruction (BDR), particularly for biliary atresia. This study was undertaken to correlate the growth of bacteria in the hepaticojejunostomy with that in the liver after BDR. Quantitative bacterial culture was done on the specimens taken from the liver and from the hepaticojejunostomy at 1 week (group 1, n = 7), 1 month (group 2, n = 7), and 2 months (group 3, n = 7) following BDR with Roux-en-Y hepaticojejunostomy in piglets after 2 weeks of common bile duct ligation. The histological examination of the liver and the hepaticojejunostomy, as well as serial monitoring of hemogram and liver function tests, were performed to correlate the findings with the bacterial concentration of the liver and the hepaticojejunostomy following BDR. The bacterial concentration of the hepaticojejunostomy, expressed as log10 colony-forming units per gram (log10 CFU/g) of the hepaticojejunostomy, showed a progressive decrease from 8.38 +/- 1.36 in group 1, 7.07 +/- 2.54 in group 2, to 3.56 +/- 1.31 in group 3 (p = 0.001). The log10 CFU/g of the liver also showed a progressive decrease from 5.02 +/- 1.59 in group 1, 3.16 +/- 1.56 in group 2, to 2.19 +/- 1.09 in group 3 (p = 0.006). There was a significant positive correlation of the log10 CFU/g of the liver (n = 21) with that of the hepaticojejunostomy (n = 21) following BDR (r = 0.600, p = 0.004). Most of the infectious pathogens isolated from the liver were also isolated from the hepaticojejunostomy. The changes in hemoglobin, bilirubin, albumin, and ammonia significantly correlated with the changes of the bacterial concentration of the liver. The results of the study suggests that hepatic bacterial proliferation after BDR is significantly affected by microbial overgrowth in the bilioenteric anastomosis and is associated with deteriorated liver function and hemogram.