Identification of the trehalose-6-phosphate synthase gene family in winter wheat and expression analysis under conditions of freezing stress

Trehalose plays an important role in metabolic regulation and abiotic stress tolerance in plants. Trehalose contents are potentially modulated by trehalose-6-phosphate synthase (TPS), which is a key enzyme in the trehalose biosynthetic pathway. Using available wheat expressed sequence tag sequence information from NCBI and two wheat genome databases, we identified 12 wheat TPS genes and performed a comprehensive study on their structural, evolutionary and functional properties. The estimated divergence time of wheat TPS gene pairs and wheat-rice orthologues suggested that wheat and rice have a common ancestor. The number of TPS genes in the wheat genome was estimated to be at least 12, which is close to the number found in rice, Arabidopsis and soybean. Moreover, it has been reported earlier in other plants that TPS genes respond to abiotic stress, however, our study mainly analysed the TPS gene family under freezing conditions in winter wheat, and determined that most of the TPS gene expression in winter wheat was induced by freezing conditions, which further suggested that wheat TPS genes were involved in winter wheat freeze-resistance signal transduction pathways. Taken together, the current study represents the first comprehensive study of TPS genes in winter wheat and provides a foundation for future functional studies of this important gene family in Triticeae.

Heparin protects BALB/c mice from mite-induced airway allergic inflammation

More and more studies have demonstrated the anti-inflammatory effects of heparin. However, in the aspect of allergic airway inflammation, data about its daily use in animal model is scarce. To evaluate the efficacy of 22-day intranasal heparin administration in mite-induced airway allergic inflammation in BALB/c mice, the murine model of house dust-mite allergen-induced asthma was used to assess the effect of heparin (h) and low molecular weight heparin (l mwh) administered intra-nasally (IN) throughout the full study period (22 days). Effects were monitored by histopathology, cell counts in broncho-alveolar lavage fluid (BALF), local cytokine production, serum, specific antibody levels, and airway resistance measurements. Compared to the positive control group, both hIN and lmwhIN groups had lower peri-bronchiolar/alveolar inflammatory pathology score and lower goblet cell scores (p less than 0.01); lower eosinophil and neutrophil counts in BALF (p less than 0.0001); and lower cytokine levels including IL-17A/F, IL-5, IL-13, IL-8 and eotaxin in lung tissue (p less than 0.001). Serum Der p-specific IgE level was also lower in heparin-treated groups (p less than 0.004). The two heparin-treated groups also revealed lower value of Penh after Mch stimulation. In conclusion, heparin and lmw heparin decrease serum Der p-specific IgE level and possess anti-inflammatory effects on mite-induced airway allergic inflammation model in BALB/c mice.

Dioscorin protects tight junction protein expression in A549 human airway epithelium cells from dust mite damage

BACKGROUND AND PURPOSE

In addition to being an allergen, the trypsin activity of dust mite extract also destroys the tight junctions of bronchial epithelium. Such damage can lead to airway leakage, which increases airway exposure to allergens, irritants, and other pathogens. Dioscorin, the storage protein of yam, demonstrates anti-trypsin activity, as well as other potential anti-inflammatory effects. This study investigated the protective role of dioscorin for tight junctions.

METHODS

The immunofluorescence stains of zonula occludens (ZO-1), E-cadherin (EC) and desmoplakin (DP) proteins were compared. A cultured A549 cell line was used as a control and A549 cells were incubated with mite extract 100 mg/mL for 16 h, with or without dioscorin 100 mg/mL pretreatment for 8 h and with dioscorin 100 mg/mL alone for 16 h. Western blot was performed to detect changes in ZO-1, EC, and DP in the treated A549 cell lines.

RESULTS

Loss of tight junction protein expression (ZO-1, EC, DP) was demonstrated after 16-h mite extract incubation. The defect could be restored if cells were pretreated with dioscorin for 8 h. In addition, dioscorin did not cause damage to the A549 cell lines in terms of cell survival or morphology. Western blot showed no change in the amount of tight junction protein under various conditions.

CONCLUSION

Dioscorin is a potential protector of airway damage caused by mite extract.

Comparison of the effects of two long-acting beta2-agonists on cytokine secretion by human airway epithelial cells

BACKGROUND AND PURPOSE

Long-acting beta2-agonists (LABAs) have proved to be useful in the management of asthma and prevention of exacerbations. LABAs can modulate inflammatory and repair processes in the airways of individuals affected by many respiratory disorders. This study assessed the effects of LABAs on the release of inflammatory mediators by bronchial epithelia.

METHODS

The effects of the LABAs salmeterol and formoterol on the synthesis of soluble interleukin-8 (IL-8), granulocyte-macrophage colony-stimulating factor (GM-CSF), and vascular endothelial growth factor (VEGF) in the human airway epithelial cell line A549 was investigated in vitro. Cells cultured for 8 h in the presence of an LABA were stimulated with tumor necrosis factor-alpha for 16 h and then enzyme-linked immunosorbent assays for IL-8, GM-CSF, and VEGF were performed on the supernatants.

RESULTS

Both salmeterol and formoterol significantly suppressed IL-8, GM-CSF, and VEGF secretion from tumor necrosis factor-alpha-stimulated A549 cells. Results indicated that formoterol was more potent than salmeterol in suppressing IL-8 and VEGF production. In contrast, salmeterol appeared to be more potent than formoterol in suppressing GM-CSF production.

CONCLUSION

LABAs have some anti-inflammatory effects on bronchial epithelia. The differences between salmeterol and formoterol and mechanisms for the observed effects need further evaluation.

Plasma soluble CD30 level correlates negatively with age in children

BACKGROUND AND PURPOSE

Atopic diseases are thought to be associated with cytokine-mediated immune dysregulation, for example, a T helper cell type 1/2 (Th1/Th2) imbalance. CD30 is proposed to be one of the surrogate markers for Th2 immunity. In this study, we investigated whether CD30 is a good marker for atopy and Th2 predominance in a pediatric population.

METHODS

This study included 61 children with atopy and 27 normal controls. The expression of CD30 on the surface of T and B lymphocytes and soluble CD30 (sCD30) in plasma was determined.

RESULTS

There was no difference in the surface expression of CD30 on B or T lymphocytes. Similarly, sCD30 levels in plasma were not different between the 2 groups. Nevertheless, we found a strong negative correlation between sCD30 and age in the control group (r = -0.72, p<0.001; sCD30 = 76.1 - 5.18 x age) as well as in the atopy group (r = -0.45, p<0.01; sCD30 = 61.1 - 3.56 x age).

CONCLUSIONS

An inverse relationship was found between age and sCD30 level in children. However, our findings suggest that CD30 is not a good marker for atopic disease and that further studies on sCD30 levels must take age into consideration.

Prevalence of atopy in children with type 1 diabetes mellitus in central Taiwan

BACKGROUND AND PURPOSE

Atopic diseases, including asthma, eczema and allergic rhinitis, are characterized by a chronic inflammatory reaction mediated by T helper 2 (Th2) cells, while type 1 diabetes mellitus (T1D) is mediated by T helper 1 (Th1) cells. The 'balance' between Th1 and Th2 cells appears to be vitally important. Hence, it is a plausible hypothesis that the prevalence in Th2-mediated disease would be lower in patients with Th1-mediated disease. The aim of this study was to compare the prevalence of atopic diseases between children with T1D and age-matched controls, and investigate possible factors that influence the prevalence of atopic disease.

METHODS

Parents of children with T1D in Taichung Veterans General Hospital were requested by pediatricians to complete the International Study of Asthma and Allergies in Childhood questionnaire on the prevalence of atopic diseases. Responses were compared with an age-matched control group.

RESULTS

Questionnaires were evaluated from 100 T1D patients and 194 controls. After age-matching, the questionnaires of 54 T1D patients were included. Symptoms of asthma, allergic rhinitis and eczema were reported less often in the group of children with T1D compared with the control group (wheeze with exercise, p=0.044; nasal symptoms with itching eyes in the past 12 months, p=0.048; nasal allergy ever, p=0.038; skin rash in the past 12 months, p=0.044). In addition, the proportion of T1D patients with any asthmatic symptom (such as wheezing once in life, wheezing in the past 12 months, wheezing with exercise and dry cough at night in the past 12 months) was significantly lower than in controls (20.4% vs 36.6%, p=0.036).

CONCLUSIONS

These results indicate that patients with T1D have a lower prevalence of atopic symptoms, especially asthma, which is consistent with the Th1/Th2 polarization concept. Environmental factors are another direct influence on the development of atopy in T1D patients.

Influence of cetirizine and loratadine on granulocyte-macrophage colony-stimulating factor and interleukin-8 release in A549 human airway epithelial cells stimulated with interleukin-1beta

BACKGROUND AND PURPOSE

In addition to being antagonists of histamine receptors, some antihistamines modulate the pathogenesis of allergic inflammation by reducing mediator release, adhesion molecule expression and, consequently, recruitment of inflammatory cells. The aim of this study was to explore the effects of 2 second-generation antihistamines, cetirizine and loratadine, on granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-8 (IL-8) secretions in human airway epithelial cells.

METHODS

A549 cells were pre-incubated with cetirizine (1, 5, 10 microM) or loratadine (1 microM) individually for 16 h followed by stimulation with IL-1beta for 8 h. The levels of GM-CSF and IL-8 were measured by an enzyme-linked immunosorbant assay.

RESULTS

Cetirizine (10 microM) and loratadine significantly reduced the release of GM-CSF, by 37% and 40%, respectively (p<0.05). Cetirizine (5, 10 microM) inhibited the production of IL-8 by 19% (p<0.05). However, cetirizine (1 microM) and loratadine (1 microM) did not appreciably inhibit IL-8 release.

CONCLUSIONS

These observations indicate that these 2 second-generation antihistamines inhibit the release of GM-CSF and IL-8 beyond their antagonistic histamine H1 receptor activity and may thus exert clinically relevant anti-inflammatory effects in inflammatory airway disorders.

Soluble CD26/30 levels before and after treatment with interferon-alpha and ribavirin combination therapy in a pediatric hepatitis C patient

Chronic hepatitis C virus (HCV) infection frequently leads to end-stage liver diseases and extrahepatic complications. Combination therapy with interferon-alpha (IFN-alpha) and ribavirin is now recommended as the first-line therapy for patients with chronic hepatitis C in adults. However, the benefit of such combination therapy in children with hepatitis C is still under investigation. We report here on a 6-year-old boy admitted with chronic active hepatitis C infection and treated with interferon-alpha and ribavirin. After treatment for 12 months, his serum showed negative HCV RNA, and normal alanine aminotransferase, and there was a sustained response. The patient's serum soluble CD30 (sCD30) level was higher than that of controls (>100 U/mL vs 46 +/- 11 U/mL) before combination therapy but there was no difference in soluble CD26 (sCD26) [103 ng/mL vs 119 +/- 28 ng/mL]. The sCD30 decreased and sCD26 increased at 6 months (45 U/mL and 188.3 ng/mL, respectively) using combined therapy as well as at 4 months after discontinuing it (33 U/mL and 167.8 ng/mL, respectively) in our patient. The results indicate that combined treatment with IFN-alpha and ribavirin may be used as the first-line treatment for children with chronic hepatitis C. The changes of sCD30 and sCD26 may be helpful in estimating of HCV infection activity.

Mycobacterium avium complex-associated hemophagocytic syndrome in systemic lupus erythematosus patient: report of one case

Hemophagocytic syndrome (HPS) in systemic lupus erythematosus(SLE) patients has not commonly been reported. In this case study, we report the first case of Mycobacterium avium complex (MAC)-associated hemophagocytic syndrome in a patient with systemic lupus erythematosus (SLE). This SLE patient, a 15-year-old girl, had been on a high dose of prednisolone (> 0.5mg/kg/day) for more than 3 years. She presented with a spiking fever, hepatosplenomegaly, pancytopenia, hyperferritinemia and adult respiratory distress syndrome. Bone marrow examination revealed hemophagocytosis as well as non-caseating granulomatosis. There was no indication of SLE fare-up. She responded poorly to initial treatment with methyl-prednisolone, intravenous immumoglobulin, etoposide, and drugs for Mycobacterium tuberculosis including rifampin, ethambutol, isoniazid and pyramide. However, gastric lavage culture revealed MAC. Following treatment with clarithromycin, ciprofloxacin and amikacin, her condition gradually improved and she was discharged 3 months after admission. In SLE patients with pancytopenia and hyperferritinemia, MAC-associated HPS should be considered in the differential diagnosis.

Intra-abdominal actinomycosis with hepatic pseudotumor and xanthogranulomatous pyelonephritis in a 6-y-old boy

We report the case of a 6-y-old boy with actinomycosis, presenting as xanthogranulomatous pyelonephritis (XGP), hepatic pseudotumor and abdominal abscess. Symptoms included intermittent fever, abdominal pain and significant weight loss. Hepatic and renal tumor masses were suspected on sonography and computerized tomography. XGP and actinomycosis were proven by pathology. The patient recovered well with antibiotic alone.

Psychiatric morbidity and post-traumatic symptoms among survivors in the early stage following the 1999 earthquake in Taiwan

This study reports the clinical psychiatric presentations and post-traumatic symptoms among 525 survivors at Yu-Chyr District in Nantou County who sought psychiatric service in the first month following the devastating earthquake that struck the central area of Taiwan. All subjects received psychiatric interviews and assessments using the 12-item Chinese Health Questionnaire (CHQ-12) and a checklist for post-traumatic symptoms. The most common psychiatric symptoms reported were insomnia, palpitations, nervousness, and dizziness with headache. Eleven percent of the subjects reported having thought of death or having suicidal ideation. The mean score on the CHQ-12 was 6.43 (S.D.=2.89). The rate of probable psychiatric morbidity as defined by a CHQ-12 score > or =3 was 89.9%. Post-traumatic symptoms were very prevalent, particularly symptoms of re-experiencing the earthquake and hyper-arousal. Factors significantly associated with high psychiatric morbidity were being female, serious destruction of property and house, and personality characteristics of nervousness and obsessiveness. Findings of this study suggest that early psychiatric intervention, including pharmacological treatment for acute stress disorder, is indicated during the early stages following a disastrous earthquake.

Limited cutaneous systemic sclerosis: report of one case

We report a case of systemic sclerosis, limited type, in a 5 year old boy in Taiwan. He presented with erythema, tight skin over his face and digits, subcutaneous calcification, telangiectasis, as well as Raynaud's phenomenon. The laboratory data showed weakly positive antinuclear antibody (ANA), and Topoisomerase 1 antibody (anti-Scl-70) titers. However his esophagogram, CO diffusion capacity, as well as cardiac and renal function were all normal. He suffered from the skin change for 2 to 3 years before visiting our pediatric clinic when he was 7 years old. We gave him Dipyridamole, D-penicillamine, Colchicine, and Nifedipine. There was some remission of the scleroderma and Raynaud's phenomenon after our treatment.

Clinical spectrum of Kawasaki disease in infants

BACKGROUND

Kawasaki disease is a common acquired heart disease in children. Only a few reports have been published concerning Kawasaki disease in infants. This study was performed to assess the clinical spectrum of Kawasaki disease in infants.

METHODS

Between January 1989 and December 1998, a total of 48 consecutive Kawasaki patients less than one year of age were enrolled and studied retrospectively. Coronary artery dilation was defined as the internal diameter of a coronary artery larger than 3 mm. All cases received 2 gm/Kg of intravenous immunoglobulin. We divided the patients into two groups; group I; coronary artery dilation (+) and group II; coronary artery dilation (-), and compared the clinical and laboratory data.

RESULTS

Of 273 patients with Kawasaki disease, 48 (17.5%) were less than one year of age. Among these patients (< 1 year old), the median age was 7.8 +/- 2.8 months (range 2 months to 12 months), and the male to female ratio was 1.52:1. The incidence of atypical Kawasaki disease was 31.2% (compared with an incidence of atypical Kawasaki disease among patient more than one year of age of 7.5%; p < 0.001), and that of coronary artery dilation was 35.4%. Clinical manifestations included fever 100%, extremity change 91.6%, skin rash 89.6%, conjunctivitis 89.6%, oral mucosa change 89.6%, and cervical lymphadenopathy 0%. Laboratory data revealed white blood cell count: 15,403 +/- 6,282/mm3, hemoglobin: 10.1 +/- 1.0 gm/dl, neutrophil: 59.2 +/- 13.7%, lymphocytes: 30.6 +/- 13.1%, platelet count: 456,3000 +/- 216,4000/mm3, and C-reactive protein 8.2 +/- 5.6 mg/dl. Patients with coronary artery dilation had a longer duration of diagnosis, higher incidence of atypical presentation, lower incidence of conjunctivitis, lower incidence of skin rash, lower incidence of extremity change, and lower C-reactive protein. The predictive value of coronary artery dilation based on the combination of atypical presentation, duration of diagnosis, and C-reactive protein was 81.2%.

CONCLUSIONS

Kawasaki disease in infants is associated with a high incidence of atypical presentation and increased risk of coronary artery dilation. We suggest that in an infant with insufficient diagnostic criteria for Kawasaki disease, care should be taken to avoid missing atypical Kawasaki disease. Echocardiography is an important tool for diagnosis of atypical Kawasaki disease.

Chronic granulomatous disease: a case report

Chronic granulomatous disease (CGD) is a rare inherited disorder caused by defects in the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex of phagocytic leukocytes. The leukocytes of the CGD patients cannot produce adequate amount of superoxide and other oxygen metabolites which are toxic to microorganisms. As a result, the phagocytes fail to kill the ingested microorganisms, especially those with catalase activity. Typically, CGD patients suffer from recurrent pyogenic infections starting from the first year of life. We report a young boy who had experienced recurrent perianal abscess, osteomyelitis and bacterial enterocolitis. Flow cytometric analysis revealed defects in the neutrophil respiratory burst pathway and defined the carrier state of his mother and younger sister. He received antimicrobial prophylaxis at our out-patient clinics and remained well at present. We try to make clinical physician keep in mind the diagnosis of CGD by presenting this typical case. In the meantime, we review the recent literature regarding the advances in diagnosis and management of CGD.

Levamisole in steroid-sensitive nephrotic syndrome children with steroid-dependency and/or frequent relapses

The study is to evaluate the effect of levamisole on steroid-sensitive nephrotic syndrome (SSNS) children with multiple relapses, from October 1996 through December 1998, we prospectively recruited 27 SSNS children. Eight children had minimal change nephrotic syndrome and nine had mesangial nephropathy proven by renal biopsy. The other 10 children had normal renal function and no secondary cause of nephrotic syndrome (NS). Nine were frequent relapsers (FR), (> 4 attack per year), nine were steroid-dependent (SD), and another nine were both FR and SD. The dosage of levamisole given was 2 to 3 mg/kg daily or every other day, depending on the patients' response. All were followed regularly at outpatient department. Follow-up items included a routine urinalysis every month, complete blood count (CBC) every 3 months and BUN/Cr, AST/ALT every 6 months. After 6 to 24 (mean 12.2) months of follow-up, the frequency of relapse (FoR) decreased (5.74 +/- 3.24 vs 1.91 +/- 2.0/year p < 0.05). Seven (26%) had no relapse at all. Nine (33.3%) had less than 1/3 the FoR; four (14.8%) had 1/3 to 1/2 the FoR; and seven (26%) still had more than 1/2 FoR as before levamisole. The oral prednisolone dosage also decreased (0.62 +/- 0.42 vs 0.21 +/- 0.35 mg/kg/day, p < 0.05). The levamisole response was independent of the age of NS onset, the interval between NS onset and initiation of levamisole, previous number of relapse, the FoR, and previous use of cytotoxic drug. There were 7 episodes of leukopenia, which returned to normal after discontinuing levamisole for 1 to 2 weeks in 4 patients. Two (7.5%) had reversible leukopenia for more than 4 weeks. No abnormal BUN/Cr, or ALT/AST levels were noted during follow-up. Levamisole is an effective and safe drug for children who have SSNS with FR and/or SD. Two thirds of patients obtain satisfactory control. The dosage can be 2 to 3 mg/kg daily or every other day. The most common side effect is transient leukopenia.

Infants of twin pregnancies with one twin demise in the uterus: a retrospective study

Many papers have reported that twin pregnancies with one twin demise in the uterus can cause complications in the surviving twin. We retrospectively reviewed charts from 1988 to 1997 at our hospital and found 17 of 302 twin deliveries with one twin intrauterine fetal death. The incidence of intrauterine death of a single twin was 5.7%. Six of the surviving twin (35.3%) had renal function impairment. One died due to acute renal failure. The other five patients recovered normal serum creatinine level. Five patients (29.4%) had abnormal brain imaging findings. One had multicystic encephalomalacia and microcephaly. Three of the five patients were complicated with cerebral palsy. After dividing the patients into complicated (n = 8, 47.1%) and non-complicated (n = 9, 52.9%) groups, we found that the patients with complication had lower Apgar score at 5 minutes and those with monochorionic diamniotic placenta had higher incidences of complication (62.5% vs 12.5%). We conclude that twin pregnancies with one fetal demise in the uterus do result in a higher incidence of complication in the surviving twin, especially if placentation type is monochorionic diamniotic. In managing the surviving twin of the monozygous twin pregnancies with one fetal demise in the uterus, we must be careful to monitor these patients. If complication was suspected, we should arrange the brain and kidney ultrasonography and manage these patients appropriately to decrease the complication risk.

Modulation of nigrostriatal dopaminergic transmission by antisense oligodeoxynucleotide against brain-derived neurotrophic factor

Brain-derived neurotrophic factor (BDNF) promotes the differentiation and growth of developing dopamine (DA) neurons and supports the survival of mature DA cells in culture. However, the neurotrophic role of endogenous BDNF in the adult DA system in vivo has not been well established. To investigate the hypothesis that blockade of endogenous BDNF expression results in DA dysregulation, we used an 18-mer antisense oligodeoxynucleotide (ODN) targeted to the first ATG codon of the BDNF transcript. The biological activity of the antisense ODN was initially tested in vitro. In cultured dopaminergic MES 23.5 cells, antisense BDNF (20 microM) effectively reduced BDNF protein expression and cell survival. Furthermore, in primary embryonic mesencephalic cultures, antisense BDNF reduced the number of tyrosine hydroxylase positive neurons and inhibited [3H]DA uptake in a time- and dose-dependent manner. The specificity of the antisense molecule was confirmed by comparing its effects with those of a control ODN having the same base composition but in scrambled sequence. In rats, two days following an intranigral or intrastriatal injection of antisense BDNF (0.5 microg), we observed a two-fold and five-fold increase in nigral DA levels, respectively, but no change in striatal DA content. Seven days after an intrastriatal antisense BDNF injection, DA levels were elevated in the striatum apparently due to decreased DA turnover. These observations suggest that inhibition of endogenous BDNF expression tends to augment rather than inhibit nigrostriatal DA transmission. Thus, the biological effects of endogenous BDNF on the nigrostriatal DA system in the adult organism merits further investigation.

Glutathione-related enzyme activities in human fetal adrenal, liver, and kidney

AIM

To understand the capacity of fetal adrenal to catalyze reaction metabolites.

METHODS

Subcellular fractions were prepared by differential centrifugation in fetal adrenal and liver. Glutathione (GSH)-transferase, reductase, and peroxidase were measured.

RESULTS

The mean values (mumol.min-1/g protein) of GSH-transferase activities in adrenal microsome (112 +/- 34), mitochondria (62 +/- 35), and cytosol (191 +/- 89) were 373%, 270%, and 167%, respectively, higher than those in the corresponding fractions of fetal liver. Adrenal microsomal GSH-transferase was positively correlated with adrenal microsomal P-450 (r = 0.821, P < 0.01), and with adrenal microsomal aminopyrine N-demethylase (r = 0.829, P < 0.01). The GSH reductase contents (mumol.min-1/g protein) in adrenal mitochondria (24 +/- 14), and in S9 (36 +/- 15) were almost 5 times higher, compared with that in liver. Selenium-dependent GSH peroxidase was present in all the adrenal.

CONCLUSION

Fetal adrenal, with greater capacities than those of liver in detoxifying reaction, may act as a drug-metabolizing organ during development.

Early detection of neonatal adrenal hemorrhage by ultrasonography

To investigate clinical features and course of neonatal adrenal hemorrhage (NAH) from July 1992 to August 1993, fifteen babies suffering from NAH born at Veterans General Hospital-Taipei were included. Portable ultrasound scanner was used for initial screening. The frequency of NAH was approximately 0.35% which is lower than other reports. The distribution of their birth weight was 3 cases lower than 3000 gm, 3 cases over 4000 gm and 9 cases within 3000 to 4000 gm. Only one was premature and another one post-term. Four of them had a history of either prenatal or perinatal asphyxia. Only one patient had a palpable abdominal mass. On the sonographic findings, eleven had bleeding in the right-side, two in the left-side and two in both sides. Only one had adrenal calcification. During their early life, no patient developed adrenal cortical insufficiency or secondary profuse bleeding. Two patients had pathologic jaundice. Two patients had severe anemia. After conservative treatment, none of them developed any severe complication. In conclusion, with the aid of renal sonoscreening in the newborn, we can discover NAH early and give adequate treatment at once. Severe complications also can be prevented.

Niemann-Pick disease type C presenting as neonatal hepatitis: report of one case

A three-month old Chinese male infant was a victim of neonatal hepatitis presenting with prolonged jaundice, poor body weight gain, progressive hepatosplenomegaly and extremely elevated serum alpha-fetoprotein level. Niemann-Pick disease (NPD) type C was confirmed by autopsy, which revealed sphingolmyelin deposition in multiple visceral organs, and normal sphingomyelinase activity in liver. This is the first case of NPD type C in Taiwan. In idiopathic neonatal hepatitis with hepatosplenomegaly here, NPD type C must be taken into consideration.

Intravesical ureterocele in children

Eighteen intravesical ureteroceles associated with single collecting system were found in 16 children over past 6 years. Hydronephrosis of varying severity, with hydroureter, was present in 10 patients. The ipsilateral kidney was nonfunctioning in 5 patients and normal in 1. The ureterocele was easily detected by ultrasound and usually revealed as a cystic mass in the bladder. On intravenous urogram the ureterocele usually showed a positive cobra-head dilatation. However, it may exhibit a negative filling defect when the function of the associated kidney is impaired. In this series, 9 patients were asymptomatic, and the condition was detected incidentally by ultrasound. 7 patients received surgery. The remaining 9 patients were followed up at an Outpatient Clinic.

Researcher's Workbench

The Researcher's Workbench, developed at the University of Utah College of Nursing, is a computer toolkit for nurse researchers. Workbench includes a set of software tools, most of which are commercially available, to support each stage of the research process. The tools reside on a Macintosh II desk-top computer (Apple Computer, Cupertino, CA) that houses processors to run both Macintosh and MS-DOS (Microsoft Corporation) software. The Workbench is available to all College of Nursing faculty, research associates, and graduate students. This article describes the purpose, methods, design, and implementation of the Workbench. The article assumes familiarity with personal computer terminology.

Estimating frequency of disease findings from combined hospital databases: a UMLS project

Merging data from the Salt Lake VA hospital database and the LDS hospital HELP system into a UMLS sponsored unified patient database has demonstrated that distribution of variables within a disease is hospital independent. Although disease prevalence is clearly not the same among hospitals, analysis of data within a disease group across hospitals can be done using such a merged database. This unified patient database would allow study of unusual diseases not possible using data from a single institution.