Decrease in the proportion of CD24hi CD38hi B cells and impairment of their regulatory capacity in type 1 diabetes patients.

B10 cells restore immune balance by producing interleukin (IL)-10. Impaired B10 cell responses are related to numerous autoimmune diseases. However, the function of B10 cells in type 1 diabetes (T1D) patients is controversial. We hypothesized that there are numerical and functional defects of B10 cells in T1D. Sixty-two patients with T1D and 74 healthy volunteers were included in our study. We showed that B10 cells in human peripheral blood belong to a CD24hi CD38hi B cell subpopulation. CD24hi CD38hi B cells from healthy individuals possessed regulatory capacity, suppressed interferon (IFN)-γ, tumor necrosis factor (TNF)-α and IL-17A production and promoted IL-4 production and forkhead box protein 3 (FoxP3) expression in CD4+ T cells through an IL-10-dependent mechanism. Compared to healthy controls, B10 cell percentages in T1D were significantly lower (5·6 ± 3·5 versus 6·9 ± 3·3%; P < 0·05), produced less IL-10 (15·4 ± 4·3 versus 29·0 ± 4·5%; P < 0·001) and lacked regulatory capacity. In addition, Pearson's correlation analysis showed that the frequency of circulating B10 cells was negatively correlated with the frequency of CD4+ IFN-γ+ and CD4+ TNF-α+ T cells (r = -0·248 and r = -0·283, P = 0·008 and P = 0·017, respectively), positively correlating with the frequency of CD4+ CD25+ FoxP3+ T cells (r = 0·247, P = 0·001). These data offer direct proof that there is a deficiency of circulating CD24hi CD38hi B cells in peripheral blood of patients with T1D, which participate in the T1D immune imbalance involved in the development of T1D.

Adverse health outcomes and health concerns among survivors of various childhood cancers: Perspectives from mothers.

Advanced therapies have improved outcomes and also resulted in a growing risk of long-term adverse health events. This study intends to estimate incidences of adverse health events and examine differences in adverse health events among childhood cancer survivors, and to understand the concerns of mothers after their child has completed cancer treatment. An explanatory sequential mixed-method was used. A total of 201 paediatric cancer survivors' mothers with mean age 43.6 years were recruited. Of the survivors, 12.4% experienced five or more adverse health events. The incidence of adverse health events of altered body image, fatigue and neurocognitive problems were 31.54%, 14.77% and 12.53% respectively. Among survivors, significant differences in adverse health events of pain, endocrine problems and altered body image issues were identified. Survivors receiving radiotherapy, bone marrow transplants or completing treatment after 6-10 years experienced significantly more adverse health events. Maintaining health was the greatest concern for mothers, and the qualitative reports of their concerns could be categorised: living in uncertainty, and keeping forward-looking. Childhood brain tumour survivors were identified as experiencing more adverse health events than other survivors. The need for healthcare teams to consider mothers' health concerns was highlighted.

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

BACKGROUND: Liver regeneration is dependent on the proliferation of hepatocytes. Hepatic progenitor cells are intra-hepatic precursor cells capable of differentiating into hepatocytes or biliary cells. Although liver progenitor cell proliferation during the regenerative process has been observed in animal models of severe liver injury, it has never been observed in vivo in humans because it is unethical to take multiple biopsy specimens for the purpose of studying the proliferation of liver progenitor cells and the roles they play in liver regeneration. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a staged procedure for inducing remnant liver hypertrophy so that major hepatectomy can be performed safely. This staged procedure allows for liver biopsy specimens to be taken before and after the liver begins to regenerate. CASE PRESENTATION: The liver progenitor cell proliferation is observed in a patient undergoing ALPPS for a metastatic hepatic tumour. Liver biopsy is acquired before and after ALPPS for the calculation of average number of liver progenitor cell under high magnification examination by stain of immunomarkers. This is the first in vivo evidence of growing liver progenitor cells demonstrated in a regenerating human liver.

Dynamic real-time monitoring of chloroform in an indoor swimming pool air using open-path Fourier transform infrared spectroscopy.

This study used open-path Fourier transform infrared (OP-FTIR) spectroscopy to continuously assess the variation in chloroform concentrations in the air of an indoor swimming pool. Variables affecting the concentrations of chloroform in air were also monitored. The results showed that chloroform concentrations in air varied significantly during the time of operation of the swimming pool and that there were two peaks in chloroform concentration during the time of operation of the pool. The highest concentration was at 17:30, which is coincident with the time with the highest number of swimmers in the pool in a day. The swimmer load was one of the most important factors influencing the chloroform concentration in the air. When the number of swimmers surpassed 40, the concentrations of chloroform were on average 4.4 times higher than the concentration measured without swimmers in the pool. According to the results of this study, we suggest that those who swim regularly should avoid times with highest number of swimmers, in order to decrease the risk of exposure to high concentrations of chloroform. It is also recommended that an automatic mechanical ventilation system is installed to increase the ventilation rate during times of high swimmer load.

TRANSCRIPTION. Recruitment of RNA polymerase II by the pioneer transcription factor PHA-4.

Pioneer transcription factors initiate cell-fate changes by binding to silent target genes. They are among the first factors to bind key regulatory sites and facilitate chromatin opening. Here, we identify an additional role for pioneer factors. In early Caenorhabditis elegans foregut development, the pioneer factor PHA-4/FoxA binds promoters and recruits RNA polymerase II (Pol II), often in a poised configuration in which Pol II accumulates near transcription start sites. At a later developmental stage, PHA-4 promotes chromatin opening. We found many more genes with poised RNA polymerase than had been observed previously in unstaged embryos, revealing that early embryos accumulate poised Pol II and that poising is dynamic. Our results suggest that Pol II recruitment, in addition to chromatin opening, is an important feature of PHA-4 pioneer factor activity.

Left endobronchial intubation with a double-lumen tube using direct laryngoscopy or the Trachway® video stylet.

We compared direct laryngoscopy with a Macintosh blade vs indirect bronchoscopy with a Trachway® stylet, for endobronchial intubation with a left-sided double-lumen tube. We allocated participants scheduled for thoracic surgery and who had normal predicted laryngoscopy, 30 to each group. The mean (SD) intubation times with laryngoscope and Trachway were 48 (11) s vs 28 (4) s, respectively, p < 0.001. The rates of hoarseness on the first postoperative day, categorised as none/mild/moderate/severe, were 10/12/7/1 and 22/6/2/0, respectively, p = 0.008, without differences on subsequent days. Left endobronchial intubation with a double-lumen tube is slower using direct laryngoscopy and causes more hoarseness than indirect bronchoscopy with a Trachway stylet.

Head mirror versus headlight: illumination, visual identification and visual acuity for otolaryngological examination.

OBJECTIVE: To investigate and compare the performance of head mirrors and headlights during otolaryngological examination. METHODS: The illuminance and illumination field of each device were measured and compared. Visual identification and visual acuity were also measured, in 13 medical students and 10 otolaryngology specialists. RESULTS: The illuminance (mean ± standard deviation) of the LumiView, Kimscope 1 W and Kimscope 3 W headlights and a standard head mirror were 352.3 ± 9, 92.3 ± 4.5, 438 ± 15.7 and 68.3 ± 1.2 lux, respectively. The illumination field of the head mirror (mean ± standard deviation) was 348 ± 29.8 grids, significantly greater than that of the Kimscope 3 W headlight (183 ± 9.2 grids) (p = 0.0017). The student group showed no statistically significant difference between visual identification with the best headlight and the head mirror (score means ± standard deviations: 56.2 ± 9 and 53.3 ± 14.1, respectively; p = 0.3). The expert group scored significantly higher for visual identification with head mirrors versus headlights (59.7 ± 3.3 vs 55.2 ± 5.8, respectively; p = 0.0035), but showed no difference for visual acuity. CONCLUSION: Despite the advantages of headlight illumination, head mirrors provided better, shadow-free illumination. Despite no differences amongst students, head mirrors performed better than headlights in experienced hands.

Comparison of the GlideScope® videolaryngoscope and the Macintosh laryngoscope for double-lumen tube intubation.

Intubation with a double-lumen tube is important for achieving one-lung ventilation and facilitating thoracic surgery. The GlideScope(®) videolaryngoscope (Verathon Inc., Bothell, WA, USA) is designed to assist tracheal intubation for patients with a difficult airway. We wished to compare the GlideScope and direct laryngoscopy for double-lumen tube intubation. Sixty adult patients requiring a double-lumen tube for thoracic surgery and predicted uncomplicated laryngoscopy were randomly assigned to a direct Macintosh laryngoscopy group (n = 30) or a GlideScope group (n = 30). The mean (SD) duration of intubation was longer in the Macintosh group (62.5 (29.7) s) than in the GlideScope group (45.6 (10.7) s; p = 0.007). There was no difference in the success of the first attempt at intubation (26/30 (87%) and 30/30 (100%) for Macintosh and GlideScope groups, respectively; p = 0.112). The incidence of sore throat and hoarseness was higher in the Macintosh group (18 (60%) and 14 (47%), respectively) than in the GlideScope group (6 (20%) and 4 (13%), respectively; p = 0.003 and 0.004). We conclude that double-lumen tube intubation in patients with predicted normal laryngoscopy is easier using the GlideScope videolaryngoscope than the Macintosh laryngoscope.

Chloroform in indoor swimming-pool air: monitoring and modeling coupled with the effects of environmental conditions and occupant activities.

Human exposure to chloroform in indoor swimming pools has been recognized as a potential health concern. Although environmental monitoring is a useful technique to investigate chloroform concentrations in indoor swimming-pool air, in practice, the interpretations of measured data would inevitably run into difficulties due to the complex interactions among the numerous variables, including environmental conditions and occupant activities. Considering of the relevant variables of environmental conditions and occupant activities, a mathematical model was first proposed to predict the chloroform concentration in indoor swimming-pool air. The developed model provides a straightforward, conceptually simple way to predict the indoor air chloroform concentration by calculating the mass flux, J, and the Péclet number, Pe, and by using a heuristic value of the indoor airflow recycle ratio, R. The good agreement between model simulation and measured data demonstrates the feasibility of using the presented model for indoor air quality management, operational guidelines and health-related risk assessment.

First Report of Capsicum chlorosis virus Causing Yellow Stripes on Calla Lilies in Taiwan.

Tomato spotted wilt virus (TSWV) and Calla lily chlorotic spot virus (CCSV) are two recognized species of the Tospovirus genus in the family Bunyaviridae infecting calla lily (Zantedeschia spp.). During 2005, 15 virus isolates were collected from different calla lily plants exhibiting yellow stripes on their leaves in Ho-Li, a major calla lily-production township in Taiwan. After three successive local lesion passages on Chenopodium quinoa Willd., diseased leaf tissues individually infected by these isolates were preserved in liquid nitrogen and used for subsequent identification studies. Using the tospovirus genus-specific primers gL3637 and gL4435c designed from the L RNA, an 800-bp DNA fragment was amplified in reverse transcription-PCR from all 15 isolates. Moreover, leaf extracts of the diseased calla lilies and the C. quinoa plants inoculated with the 15 virus isolates reacted with antisera against the nucleocapsid proteins (NP) of Capsicum chlorosis virus (CaCV)-gloxinia and Watermelon silver mottle virus (WSMoV), but not to monoclonal antibodies against the NP of TSWV, CCSV, Peanut chlorotic fan-spot virus (PCFV), or Impatiens necrotic spot virus (INSV) in indirect ELISA. These results indicate that the 15 virus isolates are tospoviruses belonging to the WSMoV serogroup. Additionally, we amplified and sequenced the full-length N gene from these tospovirus isolates using primers WN2328 (5'-CCATTGGTTTGCCTCCG-3') and WN3534 (5'-CGTCGACAGAGCAATCGAGGC-3') designed from the S RNA of WSMoV. The deduced amino acid sequences of the N protein from these 15 tospovirus isolates showed a greater than 92% identity to that of CaCV (GenBank Accession No. NC-008301). Furthermore, results of phylogenetic analysis of the 15 isolates on the basis of amino acids sequences, both genetic distance and parsimony trees indicated that they were all genetically clustered within CaCV using INSV, TSWV, and WSMoV as outgroups. The results indicate that the virus causing yellow stripes in calla lilies is a strain of CaCV. To our knowledge, this is the first evidence that CaCV can naturally infect calla lilies and cause yellow stripe symptoms. Reference: (1) F.-H. Chu et al. Phytopathology 91:361, 2001.

Impact of liver donation on quality of life and physical and psychological distress.

UNLABELLED: Our objectives were to assess the characteristics of donors for living-donor liver transplantation (LDLT) and to examine the impact of donation on LDLT donor quality of life (QOL) regarding physical and psychological distress. METHODS: Data were collected from a mailed survey or an interview using a cross-sectional prospective study design. We used the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF), Physical Symptom Disturbance Scale, and Psychological Distress Scale. LDLT donors were recruited from a teaching hospital located in a metropolitan area of northern Taiwan. RESULTS: The 35 LDLT donors have a mean age 34.0 +/- 8.6 years and were recruited at a median of 25.9 months after donation (range, 0.6-92 months). The average scores in the four domains of the WHOQOL-BREF scale ranged from 13.5 to 14.9. LDLT Donors reported higher QOL scores in social and environment domains but lower scores in physical and psychological domains than healthy adults. Numbers of physical symptoms experienced by each donor ranged from one (n = 4) to 27 (n = 2). Feeling throbbing, itching or numbness around the wound was the most common physical symptom disturbance reported by donors (n = 26, 74%). Approximately 40% of the donors reported having one to three metrics of psychological distresses. "Easily feel distress and angry" was the most common psychological distress reported by 57% (n = 20) of donors. CONCLUSIONS: This study indicated that liver donation had a mild negative impact on donors physical and psychological facets of QOL. These results may assist professionals to provide appropriate clinical management.

Attitude toward living donor liver transplantation in Taiwan.

OBJECTIVES: The purpose of this study was to investigate the attitudes and characteristics of donors for living donor liver transplantation (LDLT). METHODS: This retrospective study was performed by a mailing or by telephone using a questionnaire. LDLT donors were recruited from a teaching hospitals located in a metropolitan area of northern Taiwan. The 11-item attitude questionnaire was specifically developed from the literature review with coordinator, physician, and donor feedback. Donors were asked to rate the queries on a 5-point Likert intensity scale. RESULTS: The 47 LDLT donors included 28 (60%) women and 19 (40%) men. Most of the LDLT donors were aged less than 30 years old (n = 24, 51%) with (n = 12, 26%) between 31 and 40 years, and 11 (23%) more than 41 years. Self-perceived health status was poor (n = 4, 9%), not bad (n = 22, 47%), good (n = 19, 40%), or very good (n = 2, 4%). The top five LDLT donor attitudes were recognition of liver donation (n = 42, 89%), recognition of brain donation (n = 41, 88%), a hero (n = 35, 75%), honor to be a donor (n = 35, 5%), and improved relationship with recipient after donation (n = 33, 70%). The best person to suggest organ donation to a family was ranked as the doctors related to transplantation (n = 41, 88%), transplantation nurse coordinator (n = 40, 85%), social worker (n = 23, 49%), and doctor unrelated to transplantation (n = 17, 17%). CONCLUSION: This study revealed positive attitudes toward donation. Some data afford insight to the decision-making procedure. Donor concerns may help professionals provide better interventions in the future.

Mesenteric injury caused by minor blunt abdominal trauma.

The authors present an unusual case of mesenteric injury caused by minor blunt abdominal trauma and also provide a review of the literature.

A New Natural Host of Lisianthus necrosis virus in Taiwan.

Lisianthus necrosis virus (LNV) was first identified as a fungus-borne virus that induced systemic necrosis in lisianthus (Eustoma russellianum) in Japan (2). In Taiwan, LNV causes systemic bright yellow chlorosis followed by necrosis in lisianthus (1). The disease was able to spread through the infested soil. Isolation of a fungus vector was attempted but was not successful (1). Calla lilies (Zantedeschia spp.) showing symptoms of systemic necrosis were observed in the fields of central Taiwan. A virus culture was established through single-lesion isolation from a local lesion host, Chenopodium quinoa, and maintained in Nicotiana benthamiana. Mechanical inoculation of the virus resulted in systemic infection in E. russellianum and Datura stramonium and local infection in Celosia argentea, Gomphrena globosa, Chenopodium amaranticolor, Zinnia elegans, Cucumis melo, Cucumis sativus, Cucurbita pepo, Vigna angularis, and Petunia hybrida. Electron microscopic examination of ultrathin sections of infected plant tissues revealed the presence of spherical viral particles approximately 33 nm in diameter. Scattered and aggregated virion particles were frequently observed in the cytoplasm of infected cells. Results of enzyme-linked immunosorbent assay, western blotting, and immunoelectron microscopy indicate that the virus is serologically related to LNV (1). Reverse transcription-polymerase chain reaction (RT-PCR) with degenerate primers (forward primer 5'-ATGGAAATCGTTAGG and reverse primer 5'-CTATAGCAATGTTGC) for LNV coat protein gene produced a cDNA of approximately 1.1 kb. The RT-PCR product was cloned into pGEM-T vector (Promega, Madison, WI) and sequenced. Sequence analysis showed that the cloned fragment (GenBank Accession No. DQ523229) was 1,167 bp long and shared 99% identity at the nucleotide and deduced amino acid levels with that of the LNV isolated from lisianthus (GenBank Accession No. DQ011234). To our knowledge, this is the first report of the natural occurrence of LNV infection in calla lily. References: (1) C. C. Chen et al. Plant Dis. 84:506, 2000. (2) M. Iwaki et al. Phytopathology 77:867, 1987.

A Chlorotic Spot Disease on Calla Lilies (Zantedeschia spp.) Is Caused by a Tospovirus Serologically but Distantly Related to Watermelon silver mottle virus.

A new tospovirus, Calla lily chlorotic spot virus (CCSV), was isolated from calla lilies (Zantedeschia spp.) in Taiwan. Chlorotic spots, ranging from light green to yellow, appear on the middle leaves of the affected plants. Virions measuring 75 to 105 nm, similar in size to tospovirus particles, were present in crude extracts and ultrathin sections of diseased leaves. Of 35 plant species inoculated mechanically, 24, including wax gourd (Benincasa hispida) and zucchini squash (Cucurbita pepo), were susceptible to the virus. CCSV was transmitted from infected wax gourd by Thrips palmi to healthy wax gourd and zucchini squash. The virus was weakly related to Watermelon silver mottle virus (WSMoV) in enzyme-linked immunosorbent assay (ELISA) and western blot tests. WSMoV-specific N gene primers, however, failed to produce DNA fragments from total RNA extracts of CCSV-infected plants in reverse transcription-polymerase chain reaction (RT-PCR). Results of RT-PCR show that the conserved regions of the L genes of tospoviruses are present in CCSV.