[The diagnostic value of eosinophilic and eosinophilic cationic proteins in blood and nasal secretions for allergic rhinitis]

Objective:To compare the diagnostic value of eosinophil and eosinophil cationin protein（ECP） in blood and nasal secretions for allergic rhinitis（AR）. Method:Collecting the blood samples of 33 patients with AR （AR group） and 40 healthy people（control group）, and test the concentration of ECP in serum and the percentage of eosinophil in blood. At the same time, collecting the nasal secretions samples of 33 patients with AR and 24 healthy people, and test the concentration of ECP and the percentage of eosinophils in nasal secretions. Using receiver operating characteristic curve（ROC） analysis, calculate the area under the curve（AUC） for each parameter and determine their predictive capabilities, then analyzing the correlation between each indicator and clinical symptom scores. Result:Compared with the healthy control group, the concentration of ECP and the percentage of eosinophil in blood and nasal secretion increased significantly（P<0.001） in patients with AR. The AUG of ECP concentration in nasal secretions was 0.965 9, when the cut-off value was 3.634, 100% sensitivity and 88% specificity were obtained; the AUG of eosinophil percentage in blood was 0.9087, and when its cut-off value was 4.6, 95% sensitivity and 73% specificity were obtained; the ECP concentration in serum had an AUG of 0.903, and when the cut-off value was 0.866, 90% sensitivity and 76% specificity were obtained; the AUG of nasal secretion eosinophil's percentage was 0.863 6, when its cut-off value is 0.72, 100% sensitivity and 73% specificity were obtained. Conclusion:For allergic rhinitis, ECP concentrate in nasal secretions is the ideal auxiliary diagnosis marker, and has the best predictive capability.

The interactive bending wrinkling behaviour of inflated beams

A model is proposed based on a Fourier series method to analyse the interactive bending wrinkling behaviour of inflated beams. The whole wrinkling evolution is tracked and divided into three stages by identifying the bifurcations of the equilibrium path. The critical wrinkling and failure moments of the inflated beam can then be predicted. The global-local interactive buckling pattern is elucidated by the proposed theoretical model and also verified by non-contact experimental tests. The effects of geometric parameters, internal pressure and boundary conditions on the buckling of inflated beams are investigated finally. The results reveal that the interactive buckling characteristics of an inflated beam under bending are more sensitive to the dimensions of the structure and boundary conditions. We find that for beams which are simply supported at both ends or clamped and simply supported, boundary conditions may prevent the wrinkling formation. The results provide significant support for our understanding of the bending wrinkling behaviour of inflated beams.

Analysis of factors associated with varicella-zoster virus susceptibility among children 0–12 years old in Taiwan

OBJECTIVES

Varicella is a highly infectious disease caused by varicella-zoster virus (VZV). The aim of this study was to explore the geographical difference of VZV antibody seroprevalence among children in private vaccination areas in Taiwan, controlling for potential factors relating to varicella susceptibility.

PATIENTS AND METHOD

A cross-sectional survey of the seroprevalence of VZV antibodies among children 0-12 years of age was conducted in Taiwan between August and December 2003. Sera of children visiting the outpatient unit of the participating hospitals around the island were collected. Six hundred and fifty-six parents among those of the 931 children studied agreed to answer the self-administered questionnaire regarding the possible factors associated with varicella susceptibility. IgG antibodies to VZV were measured using an enzyme-linked immunosorbent assay kit, Enzygnost anti VZV/IgG.

RESULTS

The susceptibility was the highest at age 1 year, and then decreased as the age increased. Children living in southern and eastern Taiwan showed higher susceptibility to varicella than those living in northern area (odds ratio (OR) = 2.71 and 2.10, respectively). Prior history of varicella infection, varicella vaccination, and contact with cases remained to be associated with the susceptibility after multivariate analysis.

CONCLUSIONS

Children who lived in tropical and rural regions and those who had no history of varicella infection, varicella vaccination, and contact with cases, might be more susceptible to varicella. Island-wide VZV seroprevalence surveillance is required to examine whether the geographical difference of susceptibility in Taiwan will become less significant or disappear after the mass varicella vaccination program initiated in 2004.

Varicella epidemiology and cost-effectiveness analysis of universal varicella vaccination program in Taiwan

Varicella zoster virus is highly contagious and affects people worldwide. In this study, we collected local epidemiological data and evaluated the cost-effectiveness of varicella vaccination program in Taiwan. To examine the economical consequences of universal vaccination, a model of the incidence and the associated costs in a hypothetical cohort was created each year for 30 years. The incidence increased sharply after the infancy and peaked in children aged 5 years. The hospitalization rate among cases was the highest in infants, followed by adults 30 to 44 years old. The benefit-cost analysis showed that one dollar invested in the program would cost extra 46 cents in direct medical expense, but would save extra 45 cents considering the societal expenses. Substantial economical benefits can occur due to the averted unproductive days for parents. Sensitive surveillance of both varicella and zoster is essential in countries that have implemented or are about to implement varicella vaccination.

A seroepidemiology study of varicella among children aged 0-12 years in Taiwan

The epidemiology pattern of varicella appears to vary among regions with different climates, population densities, and degrees of development. This study investigated the age-specific varicella zoster virus (VZV) seroprevalence in children aged 0 to 12 years in Taiwan and compared these seroprevalences between free and private vaccination areas. Residual sera were collected from 13 hospitals with 1,401 valid samples. Immunoglobulin G antibodies to VZV were measured by enzyme-linked immunosorbent assay. Parents of 656 children answered questions about the varicella incidence and varicella vaccination history of their children. In the 8-12 year-olds, the seroprevance ranged between 88.0-93.8% in northern, central, and eastern, while it was only 76.1% in southern Taiwan. The seroprevalence of children 0-5 years old were significantly different between free and private vaccination areas. Seropositive children who reported no history of varicella or receiving varicella vaccine accounted for 26.1-59.3% of the total positive cases. Our findings suggest the possible effects of climate, geographical conditions, and lifestyle on the seroepidemiology of VZV in Taiwan. The efforts of implementing a varicella vaccination program in Taiwan should focus on reaching high levels of coverage.

The incidence of varicella in southern Taiwan: a life table method estimation among susceptible population

Previous studies have failed to estimate the size of population at risk and underestimated the incidence of varicella among susceptible population. In this study, we calculated the incidence of varicella and its complications in Taiwan based on a life table method, in which the size of population at risk was taken into account. Population-based data were obtained from the Bureau of National Health Insurance. The age-specific incidences estimated by the uncorrected and corrected methods were compared. The incidence of varicella increased sharply after infancy and peaked at 16.7% in children aged 5 years. A correction which assumes the introduction of varicella vaccine resulted in a higher incidence of 19.5% in children aged 5 years. The lifetime cumulative incidence increased to around 76%. Sensitive surveillance of varicella and correct incidence estimate among susceptible population are essential in countries that have implemented or are about to implement varicella vaccination.

[The study of the nasal airway reactivity in specific nasal provocation test]

OBJECTIVE

To explore efficient evaluation method for specific nasal provocation test(SNPT) and to observe the pathogenic process and patho-physiological changes of allergic rhinitis.

METHOD

30 patients with perennial allergic rhinitis(patients group) and 14 normal adults(controls group) were challenged unilaterally with the Coca's solution and/or the solution for allergen extracts. The nasal resistance variations in all subjects were monitored with active anterior rhinomanometry and the nasal symptoms were observed.

RESULT

The symptoms of nasal stiffness, sneezing and rhinorrhea appeared in most patients between 0.5 and 3 minutes after provocation. The ratio of continual sneezes above 5 in patients group(83.3%) was significantly higher than in controls group (21.4%) (P < 0.01). The increased ratio of total nasal resistance and unilaterally-challenged nasal resistance were significantly higher in patients group than in controls group (P < 0.05) and no difference between coca's solution in patients group and controls group.

CONCLUSION

Positive SNPT was indicated if obvious nasal symptoms appeared and the unilaterally-challenged nasal resistance increased 100% as well as the total nasal resistance increased 40% after SNPT.

[Study of the relationship between sIgE of dust mite in serum and nasal secretion of allergic rhinitis]

OBJECTIVE

To search for the relationship between specific IgE of Dermatophagoides farinae in the serum and that in the local secretion of perennial allergic rhinitis patients.

METHOD

The serum and nasal secretion of suspected patients were collected, then test the concentration of mite sIgE in the serum as well as that in the secretion. The results were analyzed at last.

RESULT

The relationship of mite sIgE concentration and logarithm of the concentration between the serum and the local secretion is obvious (relative coefficient is 0.675 and 0.846 respectively.)

CONCLUSION

Dertermining the Dermatophagoides farinae sIgE in the serum can reflect the local condition of suspected patients fairly well. While for some patients whose local condition is not according to the serum sIgE, testing the local sIgE is necessary to get a correct diagnose.