Field-induced Bose-Einstein condensation in zigzag spin chain KGaCu(PO4)2

Single crystals of GaKCu(PO4)2were synthesized using the hydrothermal method, and subsequent measurements of specific heat, magnetic susceptibility, and high-field magnetization were performed. A broad peak is observed in the magnetic susceptibility and specific heat curves, with the maximum values appearing at about 11.5 K and 5.29 K, respectively. The highest maximum peak value of susceptibility is observed when the magnetic field is applied along thec-axis, followed by thea-axis,b-axis, and polycrystalline samples. These indicate that the system exhibits one-dimensional magnetism and the magnetic easy axis is thecaxis. The magnetization at 2 K reveals the occurrence of a field-induced Bose-Einstein condensation (BEC) phase within the magnetic field range of approximately 8-12 T. High-field magnetization up to 40 T indicates that the compound reaches magnetization saturation as the field exceedsHs= 12 T. Through systematic measurements, a field-temperature (H-T) phase diagram was constructed, and dome-like phase boundaries were observed. The findings suggest that GaKCu(PO4)2is a spin gap system and a promising candidate for studying BEC of magnons due to its phase transition boundary occurring at low magnetic fields.

Risk factor for interstitial pregnancy following ipsilateral salpingectomy? A retrospective matched case control study

BACKGROUND

Interstitial pregnancy may still happen even after ipsilateral salpingectomy, resulting in massive hemorrhage. Therefore, the purpose of the study is to identify risk factors associated with interstitial pregnancy following ipsilateral salpingectomy and discuss possible prevention.

METHODS

We conducted a retrospective cohort study in a single, large, university-affiliated hospital. Data of 29 patients diagnosed with interstitial pregnancy following ipsilateral salpingectomy from January 2011 to November 2020 were assigned into the case group (IP group). Whereas there were 6151 patients with intrauterine pregnancy after unilateral salpingectomy in the same period. A sample size of 87 control patients was calculated to achieve statistical power (99.9%) and an α of 0.05. The age, BMI and previous salpingectomy side between the two group were adjusted with PSM at a ratio of 1:3. After PSM, 87 intrauterine pregnancy patients were successfully matched to 29 IP patients.

RESULTS

After PSM, parous women were more common and intrauterine operation was more frequent in the IP group compared with control group (P<0.05). There was only one patient undergoing IVF-ET in the IP group as compared with 29 cases in the control group (3.4% vs. 33.3%, P<0.05). Salpingectomy was performed on 5 patients in the IP group and 4 patients in the control group due to hydrosalpinx (P<0.05). Logistic regression indicated that hydrosalpinx was the high risk factor of interstitial pregnancy following ipsilateral salpingectomy (OR = 8.175).

CONCLUSIONS

Hydrosalpinx appears to be an independent factor contributing to interstitial pregnancy following ipsilateral salpingectomy in subsequent pregnancy.

[Establishment and digital simulation of upper airway in patients with adenoid hypertrophy]

Objective: To analyze the flow field characteristics of the upper airway in patients with different adenoid hypertrophy using computational fluid dynamics (CFD). Methods: From November 2020 to November 2021, the cone-beam CT (CBCT) data of 4 patients [2 males and 2 females,age range 5-7 years, mean (6.0±1.2) years] with adenoid hypertrophy who were hospitalized in the Department of Orthodontics and the Department of Otolaryngology at Hebei Eye Hospital were selected. The degree of adenoid hypertrophy in the 4 patients was divided into normal S1 (A/N<0.6), mild hypertrophy S2 (0.6≤A/N<0.7), moderate hypertrophy S3 (0.7≤A/N<0.9) and severe hypertrophy S4 (A/N≥0.9) according to the ratio of adenoid thickness to the width of nasopharyngeal cavity (A/N). The CFD model of the upper airway was established using ANSYS 2019 R1 software, and the internal flow field of the CFD model was numerically simulated. Eight sections were selected as observation and measurement planes for flow field information. Relevant flow field information includes airflow distribution, velocity variation, and pressure variation. Results: In the S1 model, the maximum pressure difference occurred in the 4th and 5th observation planes (ΔP=27.98). The lowest pressures and the maximum flow rates of S2 and S3 were located in the 6th observation plane. The airflow in S1 and S2 models completely passed through the nasal cavity. In the S3 model, the mouth-to-nasal airflow ratio was close to 2∶1. In S4 model, the airflow completely passed through the mouth; in the S1 and S2 models, hard palates were subjected to a downward positive pressure with a pressure difference of 38.34 and 23.31 Pa, respectively. The hard palates in S3 and S4 models were subjected to a downward negative pressure with a pressure difference of -2.95 and -21.81 Pa, respectively. Conclusions: The CFD model can objectively and quantitatively describe the upper airway airflow field information in patients with adenoid hypertrophy. With the increasing degree of adenoid hypertrophy, the nasal ventilation volume gradually decreased, whereas the oral space ventilation volume gradually increased, and the pressure difference between the upper and lower surfaces of the palate gradually decreased until the pressure became negative.

High-field magnetization and electronic spin resonance study in the twisted honeycomb latticeα-Mn2V2O7

We report the single-crystal growth of Mn₂V₂O₇and the results of magnetic susceptibility, high-field magnetization up to 55 T and high-frequency electric spin resonance (ESR) measurements for its low-temperatureαphase. Two antiferromagnetic (AFM) ordering at 17.5 K and 3 K and obvious magnetic anisotropy are observed inα-Mn₂V₂O₇upon cooling. In pulsed high magnetic fields, the compound reaches the saturation magnetic moment of ∼10.5μ_Bfor each molecular formula at around 45 T after two undergoing AFM phase transitions atH_c1≈ 16 T,H_c2≈ 34.5 T forH//[11-0] andH_sf1= 2.5 T,H_sf2= 7 T forH//[001]. In these two directions, two and seven resonance modes are detected by ESR spectroscopy, respectively. Theω₁andω₂modes ofH//[11-0] can be well described by two-sublattice AFM resonance mode with two zero-field gaps at 94.51 GHz and 169.28 GHz, indicating a hard-axis feature. The seven modes forH//[001] are partially separated by the critical fields ofH_sf1andH_sf2, displaying the two signs of spin-flop transition. The fittings ofω_c1andω_c2modes yield zero-field gaps at 69.50 GHz and 84.73 GHz forH//[001], confirming the axis-type anisotropy. The saturated moment and gyromagnetic ratio indicate the Mn²⁺ion inα-Mn₂V₂O₇is in a high spin state with orbital moment completely quenched. A quasi-one-dimensional magnetism with a zig-zag-chain spin configuration is suggested inα-Mn₂V₂O₇, due to the special neighbor interactions caused by a distorted network structure with honeycomb layer.

Postoperative reproductive results of infertile patients with intrauterine adhesions: A retrospective analysis

OBJECTIVE

To explore the reproductive outcomes after hysteroscopic separation of intrauterine adhesions (IUA) in infertile patients due to IUA.

METHODS

This retrospective study enrolled patients with fertility requirements and infertility due to IUA. Data were collected from the hospital medical records and by follow-up by telephone. The impact on pregnancy and pregnancy outcome of preoperative adhesion, menstrual conditions before and after surgery and postoperative re-adhesion was analysed.

RESULTS

A total of 106 patients (median age, 28 years) were enrolled in the study. There was a significant correlation between preoperative menstrual patterns and pregnancy rate. There were 56 pregnancies (pregnancy rate 52.83%) after the operation. Patients with improved menstruation after the operation had a significantly higher pregnancy rate (pregnancy rate 56.25%; 45 of 80 patients) compared with the patients that did not experience any improvement in their postoperative menstrual status (pregnancy rate 21.43%; three of 14 patients). Of the 56 pregnancies, 40 (71.43%) resulted in live births and six (10.71%) patients had miscarriages. A total of 54 of 56 patients (96.43%) became pregnant within 2 years.

CONCLUSION

Pregnancy after intrauterine adhesion separation has a high rate of miscarriage and obstetric complications, so close monitoring of the patient is required.

Unusual magnetization process and magnetocaloric effect in α-CoV2O6driven by pulsed magnetic fields

In low-dimensional Ising spin systems, an interesting observation is the presence of step magnetization at low temperatures. Here we combine both DC and pulsed magnetic fields to study the 1/3 magnetization plateau and multiple steps in the Ising spin-chain material α-CoV₂O₆. Magnetization in pulsed fields is quite different from that in DC fields, showing multiple steps in an intermediate range of 4.2-6 K, inverted hysteresis below 4.2 K and asymmetric magnetization in negative fields below 11 K. We demonstrate that these unusual behaviors in magnetization are caused by the spin dynamics and the anomalous magnetocaloric effect (MCE) in α-CoV₂O₆, i.e., abrupt changes of sample temperature in adiabatic conditions. We successfully separate the influence between the intrinsic slow spin dynamics and the quasi-extrinsic temperature change. From the MCE, we find that some irreversible behavior is originated from the slow spin dynamics. Two different slow dynamics associated with the metastable steps are observed: one is sensitive to the slow field sweep rate at the order of ∼mT s^-1and weakly depends on temperature, while the other responds to the rapid field sweep rate of ∼kT s^-1and dominates at lowest temperature. We also distinguish that the metastable transition atH₄is the first order and crucial for the ferrimagnetic to ferromagnetic transition. This study is useful to the understanding of multistep magnetization in α-CoV₂O₆and sheds light on recent experimental findings of related compounds.

Effects of fine particulate matter (PM2.5) on ovarian function and embryo quality in mice

Fine particulate matter (PM_2.5) has an adverse effect on reproductive function, in particular causing reduced male reproductive function, but relatively few studies have directly targeted its effects on female reproduction. To investigate the effects of PM_2.5 exposure on female reproduction, we exposed female mice to PM_2.5 by intratracheal instillation for 28 days, and evaluated apoptosis of ovarian granulosa cells and oocytes and the quality embryos after insemination. Our results showed increased numbers of apoptotic granulosa cells and oocytes after exposure to elevated concentrations of PM_2.5, which had adverse effects on female fertility via compromising embryo development and quality. We conclude that PM_2.5 induced apoptosis of ovarian granulosa cells and oocytes leading to disrupted embryo development and female fertility in mice.

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 &lt; 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.

[Canceration of inflammatory myofibroblastic tumor of the larynx:a case report]

Summary Inflammatory myofibroblastic tumor（IMT） is a rare spindle neoplasm with malignant potentials of local invasion, recurrence and metastasis. Here, we present an extremely unusual case of the larynx IMT that was recurred three times and transformed into laryngeal squamous cell carcinoma.

Field-induced magnetic transitions and strong anisotropy in α-CoV2O6 single crystal

The Ising-like antiferromagnet α-CoV₂O₆ has received considerable interests because of stabilized 1/3 magnetization plateau around 5 K under magnetic field applied along magnetic easy c-axis. In this work, this magnetization plateau was studied by varying temperature or rotating magnetic field. As temperature decreased, this stabilized plateau collapsed, and additional magnetic transitions were observed. As a result, a rich magnetic phase diagram was constructed and extended to temperature lower than previously reported. When magnetic field moved from the c to b (or a) axis, the magnetization plateau developed with field directions and vanished finally when the field was restricted in the ab plane. An impressive observation is that this 1/3-plateau can be stabilized and remain robust even when magnetic field deviated from the c axis, accompanied by the evolutions of the magnetic moments and the critical transition fields. We suppose that the origins of these temperature and angular dependences of the 1/3 magnetization plateau are related to strong spin-orbital coupling. Indeed, electron spin resonance (ESR) measurement gives large Landé factor of 8.9, evidencing that there exists strong spin-orbital coupling.

[Cervical pharyngeal syndrome: a case report]

Summary Cervical pharyngeal syndrome is characterized by the symptom such as sore throat, foreign body sensation or swallowing discomfort which caused by the pathological changes of cervical intervertebral disc and intervertebral structure nonspecific injury. Because of the lack of obvious specificity, it is easy to misdiagnose. Here, we reported a case of cervical pharyngeal syndrome. The symptom were obviously improved after conservative treatment, but the follow-up time is short, and further follow-up is needed. In the process of diagnosis and treatment, in order to reduce misdiagnosis and mistreatment, we should strengthen the understanding of the disease, broaden the clinical thinking, and understand the anatomical relationship between the pharynx and the surrounding organs.

[Efficacy of Weitan Waifu patch on the postsurgical gastroparesis syndrome of gastrointestinal cancer: a multi-center trial]

Objective: To investigate the safety and efficacy of the Weitan Waifu patch on the postsurgical gastroparesis syndrome (PGS) of gastrointestinal cancer. Methods: The multi-center, double-blind, randomized controlled trial was conducted with superiority design. Patients with PGS of gastrointestinal cancer diagnosed in 4 AAA hospitals and the abdominal symptom manifested as cold syndrome by Chinese local syndrome differentiation were recruited. These patients were randomly divided into two groups according to 1∶1 proportion. Placebo or Weitan Waifu patch was applied in control group or intervention group, respectively, based on the basic treatments, including nutrition support, gastrointestinal decompression, promoting gastric dynamics medicine.Two acupuncture points (Zhongwan and Shenque) were stuck with placebo in control group or patch in treatment group. The intervention course was 14 days or reached the effective standard. Results: From July 15, 2013 to Jun 3, 2015, 128 participants were recruited and 120 eligible cases were included in the full analysis set (FAS), and 60 cases in each group. 88 cases were included in the per-protocol set (PPS), including 45 cases in the treatment group and 43 cases in the control group. In the FAS, the clinical effective rate in the treatment group was 68.3%, significantly superior than 41.7% of the control group (P=0.003). The medium time of effective therapy in the treatment group was 8 days, significantly shorter than 10 days in the control group (P=0.017). In the FAS, 3 adverse events occurred in the treatment group, including mild to moderate decrustation, pruritus and nausea. The incidence rate of adverse events was 5.0% (3/60) and these symptoms were spontaneously remitted after drug withdrawal. No severe adverse events were observed in the control group. There was no significant difference between these two groups (P=0.244). Conclusion: Weitan Waifu patch is a safely and effectively therapeutic method for patients with PGS (cold syndrome) of gastroenterological cancer. Trial registration: International Standard Randomized Controlled Trial Number Register, ISRCTN18291857.

Effects of Prenatal PM10 Exposure on Fetal Cardiovascular Malformations in Fuzhou, China: A Retrospective Case-Control Study

BACKGROUND

Maternal exposure to ambient air pollution has been associated with an increased risk of congenital heart defects in offspring; however, the results are inconsistent.

OBJECTIVES

We investigated whether there is an association between prenatal exposure to particulate matter with diameter ≤10μm (PM₁₀) during early pregnancy and fetal cardiovascular malformations.

METHODS

The gravidae from a hospital-based case–control study in Fuzhou, China, during 2007–2013 were assigned 10-d or 1-mo averages of daily PM₁₀ using an air monitor–based inverse distance weighting method during early pregnancy. A total of 662 live-birth or selectively terminated cases and 3,972 live-birth controls were enrolled. The exposure was considered as a categorical variable. A multivariable logistic regression model was constructed to quantify the adjusted odds ratios (aORs) of the exposure to PM₁₀ and the risks of fetal cardiovascular malformations.

RESULTS

PM₁₀ levels were positively associated with the risks of atrial septal defect (aORs ranging from 1.29 to 2.17), patent ductus arteriosus [aORs = 1.54, 1.63; 95% confidence intervals (CIs): 1.17, 2.23; 1.06, 3.24], overall fetal cardiovascular malformations (aOR = 1.28; 95% CI: 1.03, 1.61), ventricular septal defect (aOR = 1.19; 95% CI: 1.00, 1.43), and tetralogy of Fallot (aOR = 1.44; 95% CI: 1.01, 2.19) in the various observed periods scaled by 10 d or 1 mo in the first and second gestation months. The strongest associations were observed for exposure to PM₁₀ in the second quartile, whereas the associations were attenuated when higher concentrations of PM₁₀ in the third and fourth quartiles of the exposure were evaluated. No correlations of PM₁₀ levels with these cardiovascular malformations in the other time periods of gestation were observed.

CONCLUSIONS

Our findings suggest some positive associations between maternal exposure to ambient PM₁₀ during the first two months of pregnancy and fetal cardiovascular malformations. https://doi.org/10.1289/EHP289.

Dynamic relationship between SIPA1 gene and protein expression and the development of gastric cancer

Association of signal-induced proliferation-associated 1 (SIPA) gene and protein expression with gastric cancer development was examined. SIPA1 mRNA and protein levels were determined by real-time quantitative polymerase chain reaction and western blot, respectively, in 40 gastric tumor and tumor-adjacent normal tissues. SIPA1, VEGF-A, and FVIII levels in 60 gastric tumor and 40 tumor-adjacent normal tissues were examined by immunohistochemical staining. Correlations between SIPA1, VEGF-A, and microvessel density (MVD) were analyzed. SIPA1 mRNA levels were significantly lower in tumor tissues than in tumor-adjacent normal tissues (P < 0.05). Similarly, protein levels were significantly lower in tumor tissues (0.3043 ± 0.1062) than in tumor-adjacent normal tissues (0.5423 ± 0.0682, P < 0.05). Positive staining rates of SIPA1 (48.3%) and VEGF-A (36.7%) were lower and higher, respectively, in tumor tissues than in tumor-adjacent normal tissues (65.0 and 2.5%, P < 0.05). Positive protein staining rates in tumor tissues correlated with the degree of differentiation, lymph node metastases, and clinical grading (P < 0.05) and not with sex, age, or tumor size (P > 0.05). Significantly higher MVD (57.4 ± 9.3) was observed in tumor tissues displaying positive SIPA1 staining than in tumor-adjacent normal tissues (41.2 ± 5.7, P < 0.05). SIPA1 and VEGF-A expression in tumor tissues were negatively correlated (r = -0.736, P < 0.05). SIPA1 and its protein may play important roles in gastric cancer invasion, metastasis, and biological behavior. Low SIPA1 levels in gastric cancer may accelerate tumor development and progression by promoting VEGF-A expression to increase vascular density.

MicroRNA-215 functions as a tumor suppressor and directly targets ZEB2 in human pancreatic cancer

It has been shown that microRNA-215 (miR-215) is dysregulated in several human malignancies, and this correlates with tumor progression. However, its expression and function in pancreatic cancer is still unclear. The aim of this study was to explore the effects of miR-215 on pancreatic cancer formation and progression. Using quantitative RT-PCR, we detected miR-215 expression in pancreatic cancer cell lines and primary tumor tissues. The association of miR-215 expression with clinicopathological factors and prognosis was also analyzed. We then observed the effects of miR-215 on the biological behavior of pancreatic cancer cells. Lastly, the potential regulatory function of miR-215 on ZEB2 expression was investigated. miR-215 expression levels were significantly downregulated in pancreatic cancer samples and cell lines. Decreased miR-215 expression was significantly associated with large tumor size, advanced TNM stage, lymph node metastasis, vessel invasion, and lower overall survival. Multivariate regression analysis corroborated that downregulation of miR-215 was an independent unfavorable prognostic factor. Overexpression of miR-215 inhibited pancreatic cancer cell proliferation, invasion, and migration; promoted cell apoptosis in vitro; and suppressed tumorigenicity in vivo. Further, ZEB2 was confirmed as a direct target of miR-215 by using a luciferase reporter assay. These findings indicate that miR-215 may act as a tumor suppressor in pancreatic cancer cells, and could serve as a novel therapeutic target for miR-based therapy.

QM/MM studies on the catalytic mechanism of phenylethanolamine N-methyltransferase

Epinephrine is a naturally occurring adrenomedullary hormone that transduces environmental stressors into cardiovascular actions. As the only route in the catecholamine biosynthetic pathway, Phenylethanolamine N-methyltransferase (PNMT) catalyzes the synthesis of epinephrine. To elucidate the detailed mechanism of enzymatic catalysis of PNMT, combined quantum-mechanical/molecular-mechanical (QM/MM) calculations were performed. The calculation results reveal that this catalysis contains three elementary steps: the deprotonation of protonated norepinphrine, the methyl transferring step and deprotonation of the methylated norepinphrine. The methyl transferring step was proved to be the rate-determining step undergoing a SN2 mechanism with an energy barrier of 16.4kcal/mol. During the whole catalysis, two glutamic acids Glu185 and Glu219 were proved to be loaded with different effects according to the calculations results of the mutants. These calculation results can be used to explain the experimental observations and make a good complementarity for the previous QM study.

Receptor-based QSAR study for a series of 3,3-disubstituted-5-aryl oxindoles and 6-aryl benzimidazol-2-ones derivatives as progesterone receptor inhibitors

Receptor-based comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA) were performed on a series of 54 progesterone receptor (PR) inhibitors. The established CoMFA model from the training set gives statistically significant results with the cross-validated q (2) of 0.534 and non-cross-validated [Formula: see text] of 0.947. The best CoMSIA model was derived by the combination of steric field and hydrophobic field with a q (2) of 0.615 and [Formula: see text] of 0.954. A test set of 18 compounds was used to validate the predictive ability of the two models. The predicted correlation coefficients [Formula: see text] are 0.681 and 0.677 for CoMFA and CoMSIA models, respectively. Based on the CoMFA maps, the key structural characters of progesterone receptor inhibitors are identified. Moreover, the binding modes of oxindoles and benzimidazol-2-ones are also given by the quantum mechanical/molecular mechanical (QM/MM) calculations. This may provide useful information for drug design.

[Impacts of suspended solids on "tailing" phenomenon in disinfection of sewage with chlorine]

The impacts of suspended solids in secondary effluent on "tailing" phenomenon in disinfection of E. coli with chlorine were investigated using kinetic disinfection curves. Higher SS concentration led to earlier beginning of "tailing" region with lower inactivation level. Comparison between lg-lg regression analyses of disinfection curves demonstrated that the SS concentration correlated with overall inactivation rate, which decreased by 10 times while SS concentration increased from 6 to 85 mg/L. The results of segmental modeling of disinfection curves showed that the SS concentration (at a range of 10-55 mg/L) correlated with the starting time of "tailing" region as well as the log-kill at the starting point of tailing region (R2 > 0.99). The starting time was shortened from 330 min to 55 min, and the log-kill dropped from 5.8 down to 0.8 with SS concentration increasing. Better removal of SS will improve the lg-kill of E. coli at tailing region and the inactivation rate, resulting in lower cost of construction and running. In addition, higher chlorine dosage and lower pH value could slightly enhance the log-kill in the "tailing" region.

The role of traditional Chinese medicine in colorectal cancer treatment

Surgery, chemotherapy and radiotherapy have been the mainstay of colorectal cancer treatment. There is however current intense research on traditional Chinese medicine (TCM) as novel or additional treatment methods for colorectal cancer. This article reviews the current use of TCM in colorectal cancer so as to increase the awareness of colorectal surgeons. The pathogenesis of colorectal cancer according to TCM is discussed. TCM has been used successfully during the perioperative period to relieve intestinal obstruction, reduce postoperative ileus and reduce urinary retention after rectal surgery. Good results have been reported in the treatment of the complications of chemotherapy and radiation enterocolitis. Favourable results have also been shown in the use of TCM either alone or in combination with chemotherapy to treat advanced colorectal cancer. Molecular studies have shown some TCM compounds to reduce tumour cell proliferation and induce apoptosis. Although the reported results of TCM have been exciting thus far, problems of lack of consensus on treatment regimes and questions on the reliability, validity and applicability of published studies prevent its widespread use. There is now an urgent need for colorectal surgeons to work with TCM physicians in the continuing research on this 6,000-year-old art so as to realize its full potential for our patients.

[Long-term efficacy of vaccination against hepatitis B in newborns: 13 years' follow-up]

OBJECTIVE

To evaluate long-term efficacy of hepatitis B vaccination in newborns.

METHODS

In the past 13 years we followed up the children who had been immunized with hepatitis B vaccine at birth in 1986 every other year. At each follow-up visit, every child was tested for HBsAg, anti-HBs and anti-HBc.

RESULTS

HBsAg positive rate of these birth cohort was low (range between 0.46% and 0.98%) during 13 years' follow-up. Long-term efficacy of the vaccination in preventing HBsAg carriage was confirmed.

CONCLUSIONS

Thirteen years later no booster was after needed.

[Prevalence of mutants in the determinant region of hepatitis B surface antigen among Chinese carriers after receiving only active postexposure immunoprophylaxis]

OBJECTIVE

To determine the frequency of hepatitis B surface antigen (HBsAg) mutations in the alpha determinant region among children who developed chronic hepatitis B virus (HBV) infection after receiving only active postexposure immunoprophylaxis.

METHODS

HBsAg mutations were determined by PCR-directed nucleotide sequencing and sequence-specific solid-phase PCR analysis(SS-SPPCR) for 97 Chinese carrier cases after hepatitis B vaccination, for 88 children born aged women controls, and for 95 population based children controls.

RESULTS

Prevalence of amino acid substitutions as detected by direct sequencing among carrier cases, women controls, and children controls were 30.9%, 10.2%, and 5.3%, respectively. The most frequent amino acid substitutions observed were at residues 145, 126, and 133. However, there was no difference in the prevalence of 145 and 126 amino acid mutants as detected by a sensitive SS-SPPCR method between carrier cases and controls. The prevalence of 145 Arg and 145 Ala mutants that were detected by SS-SPPCR was 39.2%, 33.0% and 32.6% among carrier cases, women controls, and children controls, respectively. The total odds ratio was 5.41 for mutants detected by direct sequencing. Odds ratio were 34.55 and 33.39 among adw2 subtype and genotype B subjects for mutants detected by direct sequencing, respectively.

CONCLUSIONS

The results show that hepatitis B virus mutants in the determinant are fairly consistent observed but without immune selective pressures; HBV variant strains may pre-existent as minor quasispecies. The prevalence of mutants is related to HBV subtypes and genotypes.

Supracondylar extension fracture of the humerus in children. Manipulative reduction, immobilisation and fixation using a U-shaped plaster slab with the elbow in full extension

We present a method of manipulative reduction, immobilisation and fixation using a U-shaped plaster with the elbow in extension for extension-type supracondylar fractures of the humerus in children. When the elbow is in full extension, both the extensor and the flexor muscles are neutralised during manipulative reduction and the carrying angle can be easily assessed thus preventing cubitus varus, the most common complication. In order to evaluate the efficiency of this method, we compared the clinical results of the new method with those of conventional treatment. In a group of 95 children who sustained an extension-type supracondylar fracture of the humerus, 49 were treated by the new method and 46 by the conventional method, reduction and immobilisation in a plaster slab with the elbow in flexion. Reduction and immobilisation were easily achieved and reliably maintained by one manipulation for all the children treated by the new method. In 12 children treated by the conventional method, the initial reduction failed and in seven secondary displacement of the distal fragment occurred during the period of immobilisation in plaster. All required a second or third manipulation. Of the 46 children, 28 (60.9%) had developed cubitus varus at a mean follow-up of 4.6 years when treated by the conventional method. None of the children treated by the new method developed cubitus varus. The mean score, according to the Hospital for Special Surgery (HSS) elbow scoring system, was 91 points using the new method and 78 with the conventional method. The results were statistically significant with regard to the incidence of cubitus varus and the elbow score (p < 0.01) suggesting that the new method is reliable and gives a satisfactory outcome.

[Cerebral arterial aneurysm in a child with acquired immunodeficiency syndrome: case report]

Cerebral aneurysmal arteriopathy of the circle of Willis is an uncommon manifestation of acquired human immunodeficiency virus (HIV) infection and up to now only 15 cases have been published in the literature. For this reason we add our experience of this rare case, and review the most important aspects related to this entity. The patient is a 6 year old male with perinatal transmitted AIDS, tetraparethic, developed symptoms characterized by episodes of dystonic postures. The computed tomography of the brain showed aneurismal arteriopathy of the circle of Willis. He had a previous normal examination. The review of the literature shows the pathological abnormalities of the affected vessels are mainly medial fibrosis, with destruction of the internal elastic lamina and intimal hyperplasia. The etiology for the vasculitis is unknown. Varicela zoster virus, as well as HIV by itself, can be related to the physiopathology of the vasculitis. On conclusion, it can be said that although uncommon, such complications are of great importance by the fact that the patients with vascular aneurismal arteriopathy are in high risk for vascular accidents, and once a diagnosis was made, death occurs in less than 6 months, according to the literature.

[Acceptance check and quality control of SPECT]

This paper explains the testing of SPECT, especially the new SPECT with double digital detector and spiral scanning frames that has been introduced to China recently, in the acceptance check, proceeding from the physical functions of the system to its mechanical functions, to the NEMA standard functions, and then to the computer hardware specified in the contract. A brief introduction is also given of the quality control of SPECT in terms of its spatial resolution, energy resolution, spatial linearity, sensitivity, and center of rotation.

A comparative study of light transmission aggregometry and automated bedside platelet function assays in patients undergoing percutaneous coronary intervention and receiving abciximab, eptifibatide, or tirofiban

Platelet inhibition is central to the efficacy of glycoprotein (GP) IIb-IIIa antagonist therapy, but is not routinely measured during percutaneous coronary intervention (PCI). Data directly comparing the antiplatelet effects of these agents are also limited. Therefore, we compared ex vivo platelet function by standard light transmission aggregometry (LTA) and two automated bedside platelet function assays in 36 patients undergoing PCI with GP IIb-IIIa inhibitors. At baseline and 10 min following clinically recommended bolus and infusion of abciximab (0.25 mg/kg, 0.125 microg/kg/min), eptifibatide (180 microg/kg, 2 microg/kg/min), or tirofiban (10 microg/kg, 0.1 microg/kg/min), we measured 20 microM ADP- and 1.9 mg/mL collagen-induced platelet aggregation using LTA. Platelet function was also assessed using the bedside Accumetrics Ultegra-Rapid Platelet Function Assay (RPFA) and the Xylum Clot Signature Analyzer (CSA). The degree of platelet inhibition, as assessed by LTA, varied significantly between the clinically recommended doses of these GP IIb-IIIa antagonists. RPFA measurements agreed closely with LTA for abciximab, but tended to overestimate the degree of platelet inhibition for small molecules. CSA demonstrated profoundly inhibited shear-induced platelet function, but lacked sensitivity to discriminate between agents. These findings may have implications for the results of trials comparing the efficacy of these agents in patients undergoing PCI.

[The development of a SPECT processing system for reports with both graphics and text]

A computer designed for writing reports is connected to the Ethernet of SPECT. In the System, the remote FTP registration and the coping of SPECT graphics are used to obtain, at low cost SPECT reports with both graphics and a text, which are printed by a color printer and could provide adequate medical informations for clinical needs.

Analysis of mechanisms involved in the prevention of gamma irradiation-induced apoptosis by hGM-CSF

Human granulocyte-macrophage colony-stimulating factor (hGM-CSF) induces proliferation and sustains viability of the mouse interleukin (IL)-3 dependent lymphoid cell line BA/F3 expressing the hGM-CSF receptor. Caspase-3 like enzyme activity and DNA fragmentation were augmented by depletion of this factor from the cell, and exposure to gamma irradiation accelerated kinetics of these events. Anti gamma irradiation-induced apoptosis occurred through various mutant GM-CSF receptors and only the box1 region was essential while the C terminal region, including tyrosine residues which are required for MAPK cascade activation, was dispensable. Consistent with this notion, the addition of PD98059 had no effect on this activity thereby indicating that activation of MAPK is not essential for the activity. As expected, gamma irradiation increased p53 protein and bax mRNA levels and the presence of hGM-CSF dramatically modulated bax/bcl-X(L) ratio. The PI-3K specific inhibitor wortmannin did not affect hGM-CSF dependent anti gamma irradiation induced apoptosis nor bcl-X(L) induction, thus bcl-X(L) but not PI-3K pathway seems to be involved in hGM-CSF dependent anti gamma irradiation-induced apoptosis. It is well documented that the boxl region is essential for GM-CSF dependent activation of JAK2 and JAK2 specific inhibitor AG490 suppressed anti gamma, irradiation-induced apoptosis by hGM-CSF. An artificial JAK2 activating molecule in which extracellular and the transmembrane of beta(c) fused with whole JAK2 can sustain BA/F3 cells survival and proliferation mIL-3 independently, but these cells are susceptible to gamma irradiation. Furthermore GyrB/Jak2, which can activate STAT5 but not the MAPK cascade nor survival of BA/F3 cells, also could not prevent gamma irradiation-induced apoptosis. Although JAK2 is essential for hGM-CSF dependent anti gamma irradiation-induced apoptosis, it appeared that JAK2 does not seem sufficient for the activity.

Anatomic basis of iliac crest flap pedicled on the iliolumbar artery

This paper presents the anatomy and clinical applications of an iliac crest flap pedicled on the iliolumbar artery. 54 iliolumbar arteries were filled with pink plastic in 27 adult cadavers. Their origin, course and branches, and the surroundings were investigated, and the external diameter, length of segments and terminal distribution were measured. The iliolumbar artery was constant, but with a few variations. Its length was 7.0 +/- 3.9 cm, and the outer diameter 2.0 +/- 0.4 mm at the lateral edge of the psoas major muscle. Based on the anatomic findings, the surgical technique for a bone flap based on the iliolumbar artery was designed. Its clinical applications included both free bone grafting (in 2 patients) and pedicled bone transfer (in another 2 patients). The clinical results were satisfactory. The iliac crest flap pedicled on the iliolumbar artery is a reliable bone flap for clinical usage.

Recombinant adenovirus vectors for cytokine gene therapy in mice

BACKGROUND

Adenoviruses have several specific features useful for gene therapy. They infect various lineages of cells irrespective of cell cycle status. However, the exact mechanism of their infection and in vivo kinetics as a gene expression vector have not been elucidated.

OBJECTIVE

Using adenovirus vectors expressing marker genes, we examined the infectivity of these vectors (including cellular and tissue tropism), the duration and intensity of transgene expression, and the side effects.

METHODS

Various cells were infected with adenovirus expressing LacZ gene at various doses, and beta-galactosidase activity was measured and compared in relation with dose, time course, and cellular vitronectin receptor. Mice were injected with adenoviruses expressing LacZ, luciferase and GM-CSF, and in vivo gene expression was examined.

RESULTS

Adenovirus infection induced viral dose-dependent transgene expression that persisted for 2 weeks. Adherent cells were infected much more efficiently than nonadherent cells, probably because the former expressed much higher levels of the vitronectin receptor, one of the main receptors for adenovirus. Studies performed in mice with luciferase-expressing adenovirus revealed that the liver was the main target organ after intravenous injection and showed that the intravenous route was superior to other routes with regard to transgene expression. After intravenous injection of adenovirus expressing human GM-CSF, there was a transient and dose-dependent increase in the serum level of this cytokine. Administration of adenovirus expressing mouse GM-CSF enhanced hematopoiesis in the spleen and bone marrow.

CONCLUSION

These results indicated that adenoviruses can be used for in vivo cytokine gene therapy but suggested the necessity of taking into consideration the route of administration, the duration of transgene expression, the toxic dose, and host immune reactions.

Constitutive activation of JAK2 confers murine interleukin-3-independent survival and proliferation of BA/F3 cells

The Janus tyrosine kinase 2 (JAK2) plays an essential role of cytokine receptor signaling, including that of the human granulocyte-macrophage colony-stimulating factor (GM-CSF) receptor. We reported earlier that the activation of JAK2 is essential for all the examined signals induced by human GM-CSF through the box1 region of betac, such as promotion of cell survival and proliferation. To elucidate the role of JAK2 in cell survival and proliferation, we generated an artificial activation system by constructing a chimeric molecule (beta/JAK2) consisting of betac extracellular and transmembrane regions fused with JAK2, and we analyzed various signaling events in interleukin-3-dependent mouse pro-B cell, BA/F3. The beta/JAK2 was constitutively phosphorylated in the absence of human GM-CSF and murine interleukin-3, and this led to proliferation and cell survival. Western blot analysis showed that STAT5, Shc, and SHP-2 were not phosphorylated in the cells, and the consistent activation of beta-casein and c-fos promoters was not enhanced. In contrast, c-myc transcription was constitutively activated. We propose that the activation of beta/JAK2 suffices for survival and proliferation and that the activation of STAT5 and mitogen-activated protein kinase cascade is not required for these activities in BA/F3 cells.

Strategies for the improvement of salidroside production in cell suspension cultures of Rhodiola sachalinensis

Strategies of elicitation and precursor feeding were applied to improve salidroside production in cell suspension cultures of Rhodiola sachalinensis. Of the seven elicitors examined, that extracted from Aspergillus niger was the most effective, increasing the salidroside content by five-fold when added on the day of inoculation 40 mg carbohydrate is medium. Three possible precursors for salidroside synthesis, L-phenylalanine, L-tyrosol and L-tyrosine were added to the cultures. A high content of salidroside (1.440%) was attained with an initial L-tyrosol concentration of 0.5 mM in the medium. Combined application of the two strategies resulted in a significantly high salidroside content of 1.734%, corresponding to a salidroside yield of 200 mg/l.

Total body bone mineral content in small-for-gestational -age, appropriate-for-gestational -age, large-for-gestational -age term infants and appropriate-for-gestational -age preterm infants

BACKGROUND

Metabolic bone disease is a recognized complication in very low birth weight infants. Inadequate postnatal intake of calcium and phosphorus is probably important in the pathogenesis of bone disease in the newborn. A few studies have shown lower bone mineral content at birth in small for gestational age (SGA) than in appropriate for gestational age (AGA) infants. The present study was designed to compare total body bone mineral (TBBM) content in AGA, SGA, and large for gestational age (LGA) term infants. Also, it was designed to evaluate extrauterine changes in TBBM in preterm infants.

METHODS

Ten SGA [mean +/- S.D. birth weight (B.W.) was 1.7 +/- 0.2 Kg, gestational age (G.A.), 39.0 +/- 0.8 weeks], ten AGA (B.W.; 3.3 +/- 0.4 Kg; G.A.: 39.3 +/- 1.4 weeks), ten LGA (B.W.: 4.4 +/- 0.3 Kg; G.A.: 40.4 +/- 0.9 weeks) term infants and ten AGA preterm infants (B.W.: 1.6 +/- 0.3 Kg; G.A.: 31.9 +/- 1.9 weeks) were enrolled in this study. TBBM content was measured using dual-photon-absorptiometry at 1 week postnatally in SGA, AGA, LGA term infants and in preterm infants at 1, 6, 12 weeks postnatally. Serum total calcium, phosphorus, magnesium, alkaline phosphatase activity (alk-p), parathyroid hormone (PTH), 25-hydroxyvitamin D (25-OHD) and urinary calcium, phosphorus, creatinine were measured at 1 week postnatally in all studied infants and 6, 12 weeks, postnatally in preterm infants. Preterm and SGA term infants received premature formula enriched with calcium, phosphorus and vitamin D.

RESULTS

There was no significant difference (p > 0.05) in serum calcium, phosphorus, magnesium, alk-p, PTH, 25-OHD and urinary calcium, phosphorus, creatinine values among SGA, AGA and LGA term infants at one week of age. Also, there was no significant difference in serum biochemical values in preterm infants at 1, 6, 12 weeks postnatally. Significantly lower (p < 0.05) urinary phosphorus values were found in preterm than in term infants. TBBM content was lower (p < 0.05) in SGA term infants than in AGA and LGA term infants. Premature infants had lower (p < 0.01) TBBM values than term AGA infants; however, TBBM values increase with postnatal age in preterm infants.

CONCLUSIONS

Biochemical or marked radiological evidence of metabolic bone disease did not develop in any of the studied preterm infants. It appears that feeding permature infants with formula enriched with phosphorus, calcium and vitamin D may provide sufficient mineral for bone mineralization.

Spontaneous rupture of the liver associated with pregnancy: a report of two cases

Spontaneous rupture of the liver associated with pregnancy is a rare and grave complication, usually occurring in preeclampsia or eclampsia. Two cases of ruptured subcapsular hematoma of the right liver during pregnancy are reported. The first case was a 19-year-old woman who had suffered from epigastralgia and absent fetal heart beat in the 32nd week of gestation. The second case was a 31-year-old female who complained of nausea and right upper quadrant pain in the 35th week of pregnancy. Both had preeclampsia, and developed shock with disseminated intravascular coagulation soon after admission. Both received surgery and were found to have ruptured hematoma over the right liver. Finally, the first patient died of renal failure, but the second survived because preoperative diagnosis had been exact. Greater suspicion, then awareness of diagnosis can lead to better timing of surgery and an improved prognosis for mother and child.

cDNA cloning of c33-c antigen gene derived from NS3 region of Chinese HCV genome, expression in Escherichia coli and development of HCV EIA second-generation diagnostic kit

A cDNA fragment of about 860 bp corresponding to the c33-c gene in the non-structural region 3 (NS3) of HCV genome was obtained from one plasma derived from a Chinese HCV carrier who came from Tai' an of Shandong Province, China by the application of reverse transcription (RT) and polymerase chain reaction (PCR) techniques. After the sequence of the cDNA fragment was determined and compared with the equivalent region of the HCV-I (HCV-US) and HCV-II (HCV-BK) genomes, the nucleotide/amino acid sequence homologies were found to be 79.2%/91.3%/ and 91.3%/93.9%, respectively. The prokaryotic expression vector pBV220 was employed for the overproduction of c33-c native recombinant protein in E. coli cells. The expression products were detected by enzyme-linked immunosorbent assay (ELISA) and Western blotting with antisera of chronic hepatitis C patients, and a molecular weight 31 kD of c33-c viral protein was shown to account for 14% of the total cellular soluble proteins. This product was extracted from the bacterial lysate by lysozyme, Triton X-100 and urea treatment, and purified through ion exchange chromatography. The purified c33-c protein combined with a branch peptide MAP-C-19 representing immunodominant epitopes on the nucleocapsid region of HCV genome was used to develop a Chinese HCV EIA 2nd-generation diagnostic kit for the detection of anti-HCV antibodies. Its specificity, sensitivity and reproducibility were all in keeping with the indexes of the national standard for the quality control of the HCV diagnostic kit. The agreement rate between our kit and Abbott company's HCV EIA second-generation diagnostic kit was 99.33%, and the identified rate of positive anti-HCV of our kit was 2% more than that of the Abbott company's kit.

Epidemiologic investigation on an outbreak of hepatitis C

An outbreak of hepatitis in plasma donors occurred in a village of Hebei Province in the period of September to October 1985. The morbidity rate was 40.0% (26/65) in the plasma donors, which was significantly higher than that in whole blood donors (1/88) and in persons who were not blood donors (1/400). One to one paired survey was carried out, and the incidence was 46.4% (26/56) in the plasma donors, while there were no such outbreak in the control group. The distribution of cases showed positive correlation with the number of plasma donors from the production brigade. No secondary infection was found in their families. The peak of outbreak was about 2 months later than the peak of plasma donation. 26 cases of hepatitis in plasma donors all showed negative results for anti-HAV IgM, HBsAg, anti-HBC IgM, anti-CMV IgM and anti-EBV IgM. Sera of 25 cases were selected and sent to CDC, USA to confirm with Chiron C100 reagent. 24 cases were anti-HCV positive. This outbreak of hepatitis was demonstrated to be related to cross contamination during plasma donation.

Epidemiology of hepatitis E in China

A total of 9 hepatitis E epidemics have been documented in China since 1982. Five of them were waterborne and four foodborne, and they occurred in 6 of 30 provinces or autonomous regions in the country. The disease most frequently affects young adults, with fewer cases in children and the elderly. A relative male excess of cases has been observed. However, the fatality rate in female patients with hepatitis E is significantly higher than in males. The disease has a distinctive autumn seasonality in endemic areas. A peak of fecal excretion of hepatitis E virus is found at the late incubation period and early acute phase. The incubation period of the disease ranges from 15 to 75 days, with a mean of 36 days. A randomized double-blind and controlled study showed that human immune serum globulin had no prophylactic effects on hepatitis E.

A serological study of hepatitis C infection in plasmapheresis donors

An epidemic of parenterally transmitted non-A, non-B hepatitis (PT-NANBH) occurred in plasmapheresis donors in Guan County, Hebei Province, China, in 1985. PT-NANBH was diagnosed by epidemiological studies and serological exclusion of HAV, HBV, CMV and EBV infections. Recently, 163 sera samples of 108 patients with PT-NANBH and 65 sera samples of 49 cases with elevated alanine aminotransferase (ALT) levels collected during the epidemic were tested by anti-HCV EIA (Chiron C100). The positive rates of anti-HCV in these two groups were 89.8% (97/108) and 93.9% (46/49), averaging 90.8%. The figures increased with the course of illness and persistance of ALT elevation, i.e., 17.6% and 55.6% within 1 month, 88.9% and 87.5% at 6 months and 100% and 100% after 2 years. Five patients with PT-NANBH and 1 with elevated ALT levels were followed up for 3 to 4 years. We demonstrated that anti-HCV remained positive after the disease had resolved and ALT levels had normalized.

Urinary beta 2-microglobulin and N-acetyl-beta-D-glucosaminidase (NAG) as early markers of renal tubular dysfunction in sick neonates

Urinary beta 2-microglobulin, creatinine, N-acetyl-beta-D-glucosaminidase (NAG), sodium, potassium and plasma beta 2-microglobulin, and creatinine were measured in 34 healthy neonates (including 15 term, 12 prematures with a birth weight between 1.5 and 2.5 kg, 7 prematures with a birth weight less than 1.5 kg), 29 sick neonates (including 6 term, 10 prematures with a birth weight between 1.5 and 2.5 kg, 13 prematures with a birth weight less than 1.5 kg), and 13 term neonates born with meconium-stained amniotic fluid at 1, 3, and 5 days of age. Our data revealed that urinary beta 2-microglobulin, NAG, NAG index (NAG/creatinine), and the sodium concentration were significantly higher in sick preterm and term neonates than in healthy neonates (p less than 0.05). Urinary concentrations of beta 2-microglobulin and NAG were also higher in neonates born with meconium-stained amniotic fluid than in healthy neonates. We conclude that sick neonates have a higher incidence of acute tubular injury. The elevated levels of urinary beta 2-microglobulin and NAG in neonates born with meconium-stained amniotic fluid indicate the existence of tubular dysfunction, probably due to perinatal distress.

Nonassociation of aflatoxin with primary liver cancer in a cross-sectional ecological survey in the People's Republic of China

A comprehensive cross-sectional survey was undertaken in The People's Republic of China of possible risk factors for primary liver cancer (PLC) to include 48 survey sites, an approximately 600-fold aflatoxin exposure range, a 39-fold range of PLC mortality rates, a 28-fold range of hepatitis B virus surface antigen (HBsAg+) carrier prevalence, and estimation of exposures for a large number of other nutritional, dietary, and life-style features. PLC mortality was unrelated to aflatoxin intake (r = -0.17) but was positively correlated with HBsAg+ prevalence (P less than 0.001), plasma cholesterol (P less than 0.01), frequency of liquor consumption (P less than 0.01), and mean daily intake of cadmium from foods of plant origin (P less than 0.01). Multiple regression analyses for various combinations of risk factors showed that aflatoxin exposure consistently remained unassociated with PLC mortality regardless of variable adjustment. In contrast, associations of PLC mortality with HBsAg+, plasma cholesterol, and cadmium intake remained, regardless of model specification, while the association with liquor consumption was markedly attenuated (was nonsignificant) with adjustment for plasma cholesterol. The sharp contrast between the findings of no aflatoxin effect upon PLC prevalence in this survey and the positive correlation reported for previous but more restricted surveys is discussed. Based on the results of this survey and the data of laboratory animal and in vitro studies, an explanatory model for the etiology of PLC is proposed, taking into consideration the role of nutrition in the etiology of this disease.

Effect of a Chinese medicine "kyushin" on serum digoxin concentration measurement in dogs

The effect of the Chinese medicine kyushin administered orally on serum digoxin measurement was studied in an animal model. Administration of 6 pills of kyushin caused a significant increase in the serum concentration of a digoxin-like immunoreactive substance (DLIS). The DLIS concentration increased to a peak value of 1.14 ng/ml at 11/2 hours and declined to 0.5 ng/ml after 24 hours. A one-week administration of 10 pills of kyushin a day produced a steady-state DLIS concentration ranging from 0.91 to 1.07 ng/ml. Among the 7 different kyushin ingredients, toad venom (ch'an-su in Chinese) was the only drug that produced DLIS in the dogs' serum. The similarity in structures of digoxin and toad venom most likely plays an important role in producing a cross-reactivity of DLIS with immunoassay antibody to digoxin. Although these findings require confirmation in human beings, they suggest that this nonprescription drug may seriously compromise the accuracy and interpretation of digoxin concentration measurements.

[Fatal septicemia due to Chromobacterium violaceum]

A 2-year old boy was suffered from an infection caused by Chromobacterium violaceum. This is the first case of C. violaceum infection reported in Taiwan. The boy was treated with chloramphenicol and gentamicin but died after one month of illness due to the incooperation of patient's family. The causative agent was isolated from patient's blood and scar. Complete bacteriologic characteristics and antimicrobial susceptibility pattern of this isolate are reported.

Prevention of perinatal acquisition of hepatitis B virus carriage using vaccine: preliminary report of a randomized, double-blind placebo-controlled and comparative trial

Hepatitis B is a serious disease of global significance. In developing countries, hepatitis B virus (HBV) infection and its sequelae rank among the public health problems of highest priority. Infants born to mothers who are chronic carriers of HBV are at particularly high risk of acquiring infection and becoming chronic HBV carriers. The efficacy of hepatitis B vaccine alone in preventing the transmission of HBV to infants born to HBV carrier mothers was determined in a double-blind placebo-controlled trial. Infants received plasma-derived vaccine at birth, 1 month, and 6 months of age. Of 180 infants born to hepatitis B surface antigen (HBsAg)-positive mothers, equal numbers received National Institute of Allergy and Infectious Disease (NIAID) vaccine, Beijing Institute of Vaccine and Serum (BIVS) vaccine, and placebo. The cumulative seroconversion to the vaccines at 1 year of age was 95% and 75%, respectively. Vaccine efficacy as measured by the prevention of HBsAg-positive events was 88% for the NIAID vaccine and 51% for the BIVS vaccine. Vaccine efficacy was similar among infants born to hepatitis Be antigen-positive mothers. Because of the low efficacy of the BIVS vaccine, an additional group of 28 infants was given vaccine and hepatitis B immune globulin at birth. The resulting efficacy was 83%. The results of this trial indicate that hepatitis B vaccine alone can substantially reduce perinatally acquired HBV infection and the resulting chronic carrier state.