Efficacy of a Latex Agglutination Test for Rapid Identification of Staphylococcus aureus: Collaborative Study

Fifteen laboratories completed a collaborative study comparing the efficacy of a latex agglutination kit (Aureus Test) with that of AOAC Official Method 987.09 (coagulase test for identification of Staphylococcus aureus). Each laboratory analyzed 240 strains of bacteria, including 160 isolates of S. aureus and 80 isolates of other bacteria. Upon receipt of cultures, collaborators subcultured each isolate on both tryptic soy agar (TSA) and Baird-Parker agar medium (BPA) to determine whether the growth medium has any effect on either method. For cultures grown on TSA, the latex test had sensitivity and specificity rates of 99.2 and 97.1 %, respectively, whereas the coagulase test had respective rates of 98.4 and 92.5%. For cultures able to grow on BPA, the latex test had sensitivity and specificity rates of 99.2 and 96.6%, respectively, while the coagulase test had respective rates of 98.3 and 91.3%. By using the McNemar pairwise comparison test of the 2 methods, the falsepositive and false-negative rates of the latex test were significantly lower (p < 0.01) than those of the coagulase test for strains grown either on TSA or BPA. The latex agglutination test for identification of S. aureus isolated from foods has been adopted by AOAC INTERNATIONAL.

Prevention of Postdental Procedure Bacteremia: A Network Meta-analysis

Postdental procedure bacteremia is common and troublesome. The comparative efficacy of multiple prophylactic interventions is unclear. We compared the efficacy of interventions for the prevention of postdental procedure bacteremia. We conducted a review of ClinicalKey, Cochrane CENTRAL, Embase, ProQuest, PubMed, ScienceDirect, Web of Science, and ClinicalTrials.gov from inception to December 4, 2018. Randomized controlled trials that evaluated prophylactic interventions for the prevention of postdental procedure bacteremia were eligible. The primary outcome was the incidence of postdental procedure bacteremia. A total of 24 trials were included with 2,147 participants. Our network meta-analysis demonstrated that intravenous administration of 1,000/200 mg of amoxicillin/clavulanate provided the least incidence of postdental procedure bacteremia among all the prophylactic interventions (odds ratio = 0.03, 95% CI = 0.00 to 0.63) as compared with the placebo/controls. Oral 3 g of amoxicillin had the least incidence of postdental procedure bacteremia among all oral or topical forms of prophylactic interventions (odds ratio = 0.10, 95% CI = 0.02 to 0.44) as compared with the placebo/controls. No serious adverse events, such as anaphylactic shock, mortality, and the development of antibiotic-resistant bacteria, were reported. None of the included subjects were of high risk of infectious endocarditis. Our network meta-analysis demonstrates that intravenous amoxicillin/clavulanate and oral amoxicillin might be the best prophylactic interventions in preventing postdental procedure bacteremia among all the oral/topical forms of interventions for the overall populations.

4-Hydroxybenzoic acid serves as an endogenous ring precursor for antroquinonol biosynthesis in Antrodia cinnamomea

Antrodia cinnamomea, an endemic fungus species of Taiwan, has long been used as a luxurious dietary supplement to enhance liver functions and as a remedy for various cancers. Antroquinonol (AQ), identified from the mycelium of A. cinnamomea, is currently in phase II clinical trials in the USA and Taiwan for the treatment of non-small-cell lung cancer. In the previous studies, we have demonstrated that AQ and 4-acetylantroquinonol B (4-AAQB) utilize orsellinic acid, via polyketide pathway, as the ring precursor, and their biosynthetic sequences are similar to those of coenzyme Q. In order to test 4-hydroxybenzoic acid (4-HBA), synthesized via shikimate pathway, is the ring precursor of AQ analogs, the strategy of metabolic labeling with stable isotopes was applied in this study. Here we have confirmed that 4-HBA serves as the ring precursor for AQ but not a precursor of 4-AAQB. Experimental results indicated that A. cinnamomea preferentially utilizes endogenous 4-HBA via shikimate pathway for AQ biosynthesis. Exogenous tyrosine and phenylalanine can be utilized for AQ biosynthesis when shikimate pathway is blocked by glyphosate. The benzoquinone ring of 4-AAQB is synthesized only via polyketide pathway, but that of AQ is synthesized via both polyketide pathway and shikimate pathway. The precursor-products relationships diagram of AQ and 4-AAQB in A. cinnamomea are proposed based on the experimental findings.

Detection of a novel HLA-A*11 variant, A*11:292, in a Taiwanese individual

One nucleotide substitution at residue 860 of HLA-A*11:01:01:01 results in a novel allele, HLA-A*11:292.

Detection of an HLA-C*03 variant, HLA-C*03:258, in a Taiwanese individual

One nucleotide substitution at residue 506 of HLA-C*03:02:01 results in a novel allele, HLA-C*03:258.

HLA-B*40:400, a novel HLA-B*40 variant, identified in a Taiwanese individual

One nucleotide substitution at residue 314 of HLA-B*40:01:01 results in a novel allele, HLA-B*40:400.

HLA-A*26:160, a novel variant of HLA-A*26, discovered in a Taiwanese individual

One nucleotide replacement at residue 755 of HLA-A*26:01:01:01 results in a novel allele, HLA-A*26:160.

A possible association of HLA-C*07:18:01:01 and HLA-B*58:01

HLA-C*07:18:01:01 is possibly in association on the same haplotype as HLA-B*58:01.

The novel HLA-DRB1*15:158 allele discovered in a Taiwanese individual

Three nucleotide substitutions in HLA-DRB1*15:01:01:01 result in a new allele, HLA-DRB1*15:158.

HLA-A*24:386, a novel variant of HLA-A*24, discovered in a Taiwanese blood donor

One nucleotide replacement at residue 181 of HLA-A*24:02:01:01 results in a novel allele, HLA-A*24:386.

Detection of an HLA-C*03 variant, HLA-C*03:187, in a Taiwanese individual

One nucleotide substitution at residue 527 of HLA-C*03:03:01:01 results in a novel allele, HLA-C*03:187.

Identification of an HLA-B*27 variant, B*27:120, by sequence-based typing in a Taiwanese bone marrow stem cell donor

One nucleotide substitution at residue 577 of HLA-B*27:04:01 results in a novel allele, HLA-B*27:120.

HLA-B*15:436, a novel variant of HLA-B*15, discovered in a Taiwanese individual

Nucleotide substitutions in codons 43 and 45 of HLA-B*15:18:01:01 result in a new allele, HLA-B*15:436.

HLA-DQB1*03:01:40, an HLA-DQB1*03:01 variant, identified in a Taiwanese individual

One nucleotide substitution at codon 106 of HLA-DQB1*03:01:01:01 results in a new allele, HLA-DQB1*03:01:40.

HLA-C*15:29, an HLA-C*15 variant, identified in a Taiwanese individual

One nucleotide substitution at codon 116 of HLA-C*15:02:01:01 results in a new allele, HLA-C*15:29.

HLA-B*40:55, an HLA-B*40 variant, identified in Taiwanese individuals

One nucleotide substitution at codon 248 of HLA-B*40:01:01 results in a new allele, HLA-B*40:55.

Detection of an HLA-B*15 variant, HLA-B*15:192, in a Taiwanese individual

One nucleotide replacement at codon 145 of HLA-B*15:01:01:01 results in a new allele, HLA-B*15:192.

Rapidly increasing liver progenitor cell numbers in human regenerating liver after portal vein ligation and liver partition

BACKGROUND

Liver regeneration is dependent on the proliferation of hepatocytes. Hepatic progenitor cells are intra-hepatic precursor cells capable of differentiating into hepatocytes or biliary cells. Although liver progenitor cell proliferation during the regenerative process has been observed in animal models of severe liver injury, it has never been observed in vivo in humans because it is unethical to take multiple biopsy specimens for the purpose of studying the proliferation of liver progenitor cells and the roles they play in liver regeneration. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a staged procedure for inducing remnant liver hypertrophy so that major hepatectomy can be performed safely. This staged procedure allows for liver biopsy specimens to be taken before and after the liver begins to regenerate.

CASE PRESENTATION

The liver progenitor cell proliferation is observed in a patient undergoing ALPPS for a metastatic hepatic tumour. Liver biopsy is acquired before and after ALPPS for the calculation of average number of liver progenitor cell under high magnification examination by stain of immunomarkers. This is the first in vivo evidence of growing liver progenitor cells demonstrated in a regenerating human liver.

Detection of a novel HLA-DRB1*12 variant, HLA-DRB1*12:68, in a Taiwanese individual

One nucleotide substitution at residue 628 of HLA-DRB1*12:01:01:01 results in a novel allele, HLA-DRB1*12:68.

Detection of a novel HLA-DRB1*12 variant, HLA-DRB1*12:67, in a Taiwanese individual

One nucleotide substitution at residue 266 of HLA-DRB1*12:02:01:01 results in a new allele, HLA-DRB1*12:67.

Discovery of a novel HLA-A*02 variant, HLA-A*02:684, in a Taiwanese individual

One nucleotide replacement at residue 728 of HLA-A*02:03:01 results in a new allele, HLA-A*02:684.

HLA-B*40:01:45, a novel variant of HLA-B*40:01, discovered in a Taiwanese hematopoitic stem cell donor

Two nucleotide replacements within HLA-B*40:01:01 result in the novel allele, HLA-B*40:01:45.

Identification of a novel HLA-B*27 variant, B*27:112, by sequence-based typing in a Taiwanese donor

One nucleotide substitution at residue 74 of HLA-B*27:04:01 results in a novel allele, HLA-B*27:112.

Detection of a novel HLA-A*30 variant, A*30:109, in a Taiwanese individual

One nucleotide substitution at residue 488 of HLA-A*30:01:02 results in a novel allele, HLA-A*30:109.

A novel HLA allele, HLA-C*15:02:01:04, identified in a Taiwanese individual

One nucleotide substitution at residue 1924 of HLA-C*15:02:01:01 results in a novel allele, HLA-C*15:02:01:04.

Risk of developing obstructive sleep apnea among women with polycystic ovarian syndrome: a nationwide longitudinal follow-up study

BACKGROUND

Previous cross-sectional studies have suggested a comorbid relationship between polycystic ovarian syndrome (PCOS) and obstructive sleep apnea (OSA). However, the temporal association between these two distinct diseases has not yet been investigated.

METHODS

Using the Taiwan National Health Insurance Research Database, 4595 women with PCOS and 4595 (1:1) age-/sex-matched controls were enrolled into the present study between 1998 and 2009, and followed to the end of 2011. Those who developed OSA during the follow-up were identified.

RESULTS

Women with PCOS had a greater incidence of developing OSA (1.71 vs 0.63 1000 person-years, p < 0.001) than those without PCOS. The Cox regression analysis after adjusting for demographic data and medical comorbidities showed that women with PCOS had an elevated likelihood of subsequent OSA (hazard ratio: 2.63, 95% CI 1.57-4.04) during the follow-up compared to the controls.

DISCUSSION

Women with PCOS were associated with an increased risk of developing OSA in later life. Further studies would be required to investigate the underlying pathophysiology between PCOS and OSA, and to clarify whether prompt intervention for PCOS would reduce the risk of OSA.

Identification of a novel HLA-A*02:01:01 variant, HLA-A*02:01:01:09, in a Taiwanese bone marrow donor

An intronic mutation in intron 3 of A*02:01:01:01 leads to the formation of A*02:01:01:09.

HLA-A*11:256Q, a novel HLA-A*11 variant, detected in a Taiwanese individual

Nucleotide deletions from residues 409 to 417 of HLA-A*11:02:01 results in a novel allele, HLA-A*11:256Q.

Detection of a novel HLA-C*03 variant, HLA-C*03:227, in a Taiwanese individual

One nucleotide substitution at residue 19 of HLA-C*03:03:01:01 results in a novel allele, HLA-C*03:227.

The novel HLA-DRB1*15:140 allele discovered in a Taiwanese unrelated hematopoietic stem cell donor

One nucleotide substitution at residue 91 of HLA-DRB1*15:02:01:01 results in a new allele, HLA-DRB1*15:140.

HLA-C*07:566, a novel HLA-C*07 variant, detected in a Taiwanese hematopoietic stem cell donor

One nucleotide replacement in codon 334 of HLA-C*07:02:01:01 results in a novel allele, HLA-C*07:566.

Identification of a novel HLA-C allele, HLA-C*15:134, in a Taiwanese hematopoietic stem cell donor

One nucleotide substitution in codon 17 of HLA-C*15:02:01:01 results in a novel allele, HLA-C*15:134.

Detection of a novel HLA-A*11 variant, A*11:255, in a Taiwanese individual

One nucleotide substitution at residue 532 of HLA-A*11:02:01 results in a novel allele, HLA-A*11:255.

HLA-B*15:414, a novel variant of HLA-B*15, discovered in a Taiwanese individual

One nucleotide replacement at residue 221 of HLA-B*15:18:01:01 results in a new allele, HLA-B*15:414.

A dispermic chimerism detected in a Taiwanese potential unrelated hematopoietic stem cell donor

Chimerism is defined as the presence of 2 or more than 1 genetically distinct cell populations in an organism. Dispermic chimeras are derived from the fertilization of 1 or 2 matured nuclei by 2 sperms. We here report detection of a healthy and phenotypically normal female with normal ABO red blood cell typing in whom dispermic chimerism was suspected after 3 alleles were identified at multiple human leukocyte antigen (HLA) loci using molecular HLA analysis. Molecular HLA typing showed the donor to have 3 HLA-A, -B, -C, -DRB1, -DQB1 and -DPB1 alleles in blood, saliva and nail samples. In addition, 3 of her 9 short tandem repeat loci also showed to have 3 distinct alleles in blood, nail and saliva specimens. In all investigations, the third alleles were attributed to a dual paternal contribution. This case represents a dispermic chimerism, with 2 paternal and 1 maternal haplotypes variably distributed throughout body tissues in a healthy and phenotypically normal female without abnormalities in erythrocyte ABO blood group. The origin of this chimerism is probably due to the fertilization of a single egg and its polar body, or a parthenogenetic egg, by 2 sperms.

Biosynthesis of Antroquinonol and 4-Acetylantroquinonol B via a Polyketide Pathway Using Orsellinic Acid as a Ring Precursor in Antrodia cinnamomea

Antroquinonol (AQ) and 4-acetylantroquinonol B (4-AAQB), isolated from the mycelium of Antrodia cinnamomea, have a similar chemical backbone to coenzyme Q (CoQ). Based on the postulation that biosynthesis of both AQ and 4-AAQB in A. cinnamomea starts from the polyketide pathway, we cultivated this fungus in a culture medium containing [U-¹³C]oleic acid, and then we analyzed the crude extracts of the mycelium using UHPLC-MS. We found that AQ and 4-AAQB follow similar biosynthetic sequences as CoQ. Obvious [¹³C₂] fragments on the ring backbone were detected in the mass spectrum for [¹³C₂]AQ, [¹³C₂]4-AAQB, and their [¹³C₂] intermediates found in this study. The orsellinic acid, formed from acetyl-CoA and malonyl-CoA via the polyketide pathway, was found to be a novel benzoquinone ring precursor for AQ and 4-AAQB. The identification of endogenously synthesized farnesylated intermediates allows us to postulate the routes of AQ and 4-AAQB biosynthesis in A. cinnamomea.

HLA-C*07:544, a novel HLA-C*07 variant, detected in a Taiwanese bone marrow donor

One nucleotide exchange at residue 768 of the HLA-C*07:02:01:01 results in a novel allele, HLA-C*07:544.

Identification of a novel HLA-B*07 variant, B*07:269, by sequence-based typing in a Taiwanese bone marrow stem cell donor

One nucleotide replacement at residue 559 of HLA-B*07:05:01:01 or B*07:06:01 results in a novel allele, HLA-B*07:269.

HLA-B*15:388, a novel variant of HLA-B*15, discovered in a Taiwanese individual

One nucleotide replacement at residue 47 of HLA-B*15:18:01:01 results in a new allele, HLA-B*15:388.

Detection of a novel HLA-B*46:01 variant, HLA-B*46:01:22, in a Taiwanese individual

One nucleotide replacement at residue 606 of HLA-B*46:01:01 results in a new allele, HLA-B*46:01:22.

Identification of a novel HLA-A*02 variant, HLA-A*02:621, in a Taiwanese bone marrow donor

One nucleotide replacement at residue 169 of HLA-A*02:01:01:01 results in a new allele, HLA-A*02:621.

Discovery of HLA-B*58:80, a novel HLA-B*58 variant, in a Taiwanese bone marrow donor

One nucleotide substitution at residue 133 of HLA-B*58:01:01:01 results in a novel allele, HLA-B*58:80.

Discovery of a novel HLA-DRB1*09 variant, HLA-DRB1*09:28, in a Taiwanese individual

One nucleotide substitution at residue 332 of HLA-DRB1*09:01:02 results in a novel allele, HLA-DRB1*09:28.

Alterations in brain metabolism and function following administration of low-dose codeine phosphate: 1H-magnetic resonance spectroscopy and resting-state functional magnetic resonance imaging studies

The aim of the present study was to identify alterations in brain function following administration of a single, low-dose of codeine phosphate in healthy volunteers using resting-state functional magnetic resonance imaging (fMRI). In addition, the metabolic changes in the two sides of the frontal lobe were identified using ¹H-magnetic resonance spectroscopy (¹H-MRS). A total of 20 right-handed healthy participants (10 males, 10 females) were evaluated, and a Signa HDx 1.5T MRI scanner was used for data acquisition. An echo planar imaging sequence was used for resting-state fMRI, whereas a point resolved spectroscopy sequence was used for ¹H-MRS. Regional Saturation Technique, Data Processing Assistant for Resting-State fMRI, and Statistical Parameter Mapping 8 were used to analyze the fMRI data. The ¹H-MRS data were analyzed using LCModel software. At 1 h after oral administration of codeine phosphate (1.0 mg/kg), the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity were altered in different brain areas. The choline content was significantly increased in the right and left frontal lobes following codeine phosphate administration (P=0.02 and P=0.03, respectively), whereas the inositol content was significantly decreased in the left frontal lobe (P=0.02). There was no change in the glutamic acid content in the frontal lobes. In conclusion, the functions of different brain regions can be affected by a single, low-dose administration of codeine phosphate. The alterations in metabolite content in the two frontal lobes may be associated with changes in brain function, whereas the ALFF in the globus pallidus may have an effect on codeine phosphate addiction. Finally, glutamic acid may be useful in the estimation of codeine dependence.

A novel HLA-B*38 variant, B*38:15, detected in a Taiwanese individual

One nucleotide substitution at residue 346 of HLA-B*38:02:01 results in a novel allele, HLA-B*38:15.

Recognition of a novel HLA-A*11 variant, HLA-A*11:196, in a Taiwanese unrelated bone marrow stem cell donor

One nucleotide substitution at residue 484 of HLA-A*11:01:01:01 results in a novel allele, HLA-A*11:196.

HLA-A*11:235Q, a novel HLA-A*11 variant, detected in a Taiwanese individual

Nucleotide deletions from residue 120 to 125 of HLA-A*11:01:01:01 result in a novel allele, HLA-A*11:235Q.

Discovery of a novel HLA-B*13:01 variant, HLA-B*13:01:12, in a Taiwanese bone marrow stem cell donor

One nucleotide substitution at codon 189 of HLA-B*13:01:01 results in a novel allele, HLA-B*13:01:12.