Genetic variations of CD36 and low platelet CD36 expression - a risk factor for lipemic plasma donation in Taiwanese apheresis donors.

BACKGROUND: New CD36 mutations are constantly being identified, although no study has specifically targeted a Taiwanese population. CD36 deficiency can result in dyslipid state and slow clearance of chylomicron. This could be linked to more frequent lipemic donations. STUDY DESIGN AND METHODS: We used flow cytometric methods to study the CD36 deficiency in 640 regular volunteer platelet apheresis donors from Taipei blood centre. The coding exons of CD36 gene were sequenced in CD36-deficient individuals, and the allele frequencies of CD36 variants were determined in the larger population by mutation-specific PCR and oligonucleotide hybridization. Visual inspection of lipemic plasma was routinely performed on samples taken before commencement of apheresis. Individuals found to have lipemic plasma are deferred until next donation. We investigated the link between positive lipemic deferral record and low platelet CD36 expression status. RESULTS: We found four donors (0·6%) with type I CD36 deficiency (both platelets and monocytes CD36(null) ) and six (1·0%) with type II CD36 deficiency (PLT: CD36(null) , monocyte: CD36(low) ). Six CD36 genetic variants were identified, two of them were novel, all but one are found exclusively in CD36(null) and CD36(low) expressors. Subjects with CD36 genetic variants also displayed deficient or reduced CD36 on monocytes. Donors with null or low PLT CD36 expression were more likely to have a lipemic deferral record than control subjects with normal PLT CD36 expression (X(2) = 27·36, odds ratio = 2·6, 95% conference interval: 1·8-3·8, P < 0·0001). CONCLUSION: Through this study, we established a donor registry to supply CD36-negative platelets for patients in need.

The impact and recovery of asteroid 2008 TC(3).

In the absence of a firm link between individual meteorites and their asteroidal parent bodies, asteroids are typically characterized only by their light reflection properties, and grouped accordingly into classes. On 6 October 2008, a small asteroid was discovered with a flat reflectance spectrum in the 554-995 nm wavelength range, and designated 2008 TC(3) (refs 4-6). It subsequently hit the Earth. Because it exploded at 37 km altitude, no macroscopic fragments were expected to survive. Here we report that a dedicated search along the approach trajectory recovered 47 meteorites, fragments of a single body named Almahata Sitta, with a total mass of 3.95 kg. Analysis of one of these meteorites shows it to be an achondrite, a polymict ureilite, anomalous in its class: ultra-fine-grained and porous, with large carbonaceous grains. The combined asteroid and meteorite reflectance spectra identify the asteroid as F class, now firmly linked to dark carbon-rich anomalous ureilites, a material so fragile it was not previously represented in meteorite collections.

Epidemiology of pediatric facial trauma in Chile: a retrospective study of 7,617 cases in 3 years.

OBJECTIVES: To describe the epidemiology of facial trauma injuries in a group of Chilean children aged 15 years or less. STUDY DESIGN: Retrospective study of case series. Between 2006 and 2009, clinical records of 293,090 patients were reviewed. Data of patients with trauma injuries to the face were collected and evaluated for: age, sex, day and month of hospital admission, cause of injury, anatomical location, type of injury and presence of associated injuries. RESULTS: A total of 7,617 patients with 8,944 injuries were found. Boy to girl ratio was 1,7:1. Preschool age children were most frequently affected. Main cause of injury were falls, soft tissue injuries the most common type of injury. Associated injuries occurred in 11% of cases. CONCLUSIONS: Facial trauma presents a significant frequency in the group of Chilean children studied. Preeschool age boys were prone to present facial trauma of mild severity associated to falls.

Effects of Lactobacillus kefiranofaciens M1 isolated from kefir grains on enterohemorrhagic Escherichia coli infection using mouse and intestinal cell models.

A potential probiotic strain, Lactobacillus kefiranofaciens M1, was previously isolated from kefir grains, which are used to manufacture the traditional fermented drink kefir. The aim of this study was to investigate the effects of Lb. kefiranofaciens M1 on enterohemorrhagic Escherichia coli (EHEC) infection, using mice and intestinal cell models. BALB/c mice were daily administrated with either phosphate buffered saline or Lb. kefiranofaciens M1 at 2×10(8) cfu/mouse per day intragastrically for 7 d. Intragastric challenges with EHEC (2×10(9) cfu/mouse) were conducted on d 0, 4, and 7 after treatment. Administration of Lb. kefiranofaciens M1 was able to prevent EHEC infection-induced symptoms, intestinal damage, renal damage, bacterial translocation, and Shiga toxin penetration. Furthermore, the mucosal EHEC-specific IgA responses were increased after Lb. kefiranofaciens M1 administration in the EHEC-infected mouse system. Additionally, in vitro, Lb. kefiranofaciens M1 was shown to have a protective effect on Caco-2 intestinal epithelial cells and Caco-2 intestinal epithelial cell monolayers; the bacteria limited EHEC-induced cell death and reduced the loss of epithelial integrity. These findings support the potential of Lb. kefiranofaciens M1 treatment as an approach to preventing EHEC infection and its effects.

Determination of the Co valence in bilayer hydrated superconducting NaxCoO2 · yH2O by soft x-ray absorption spectroscopy.

We addressed the so-far unresolved issue concerning the Co valence in the superconducting bilayer hydrated Na(x)CoO(2) · yH(2)O (x∼0.35, y∼1.3) using soft x-ray absorption spectroscopy at the Co-L(2,3) and O-K edges. We find that the valence state of the Co lies in a narrow range from +3.3 to +3.4 for all studied Na(x)CoO(2) · yH(2)O samples and their deuterated analogue with T(c)'s ranging from 3.8 to 4.7 K. These valence values are far from the often claimed +3.7, the number based on the Na content only. We propose to modify the phase diagram accordingly, where the basic electronic structure of the superconducting phase is very close to that of the Na(0.7)CoO(2) system, suggesting that the presence of in-plane spin fluctuations could play an important role for the superconductivity.

Orofacial cleft management by short-term surgical missions in South America: literature review.

There is a growing demand for surgical care in South America, particularly for patients with congenital orofacial clefts (OFCs). Short-term surgical missions (STSMs) have emerged as a means to deliver surgical expertise and alleviate this demand. The aim of this study was to review the quantity and quality of peer-reviewed reports on OFC repairs performed by STSMs in South America. A literature search was conducted using the PubMed, Embase, Web of Science, and SciELO databases. The search was limited to articles published in English and Spanish. Descriptive statistics were used for the data analysis. The search yielded 65 studies related to OFCs. Eight (12.3%) were selected for full-text review. Only five (7.7%) articles met the inclusion criteria. The diverse study designs and heterogeneous types of data assessment among the selected studies hindered a comparison between them. This review found a sparse number of publications pertaining to OFC missions to South America. The articles that were included demonstrated inconsistencies in reporting patient care data. There is a need for a more efficient, streamlined method of reporting humanitarian missions for OFC repairs in order for healthcare professionals to fulfill research and ethical obligations and offer the best practices in patient-centered care.

Vegetable consumption, serum retinol level, and risk of hepatocellular carcinoma.

A cohort of 8436 men in Taiwan was recruited with personal interview and blood sample collection between 1984 and 1986. During the 5-year follow-up period, 50 incident cases of hepatocellular carcinoma (HCC) were identified. Retinol levels were measured for 35 HCC patients whose serum samples were available and 140 matched controls randomly selected from cohort members without HCC. Lower vegetable intake was significantly associated with an increased risk of HCC after adjustment for other HCC risk factors (P = 0.006). The effect of low vegetable intake on HCC risk was limited to hepatitis B virus chronic carriers and cigarette smokers. As compared with subjects who had a weekly vegetable consumption frequency of six or more meals, the multivariate-adjusted relative risk of HCC for subjects who had a frequency of less than six meals was 4.7 (95% confidence interval, 2.0-11.1; P = 0.0004) among chronic hepatitis B virus carriers and 3.8 (95% confidence interval, 1.7-8.5; P = 0.001) among cigarette smokers. There was an inverse dose-response relationship between the prediagnostic serum retinol level and the development of HCC (trend test, P = 0.003). The odds ratio of HCC for men with a retinol level in the lowest tertile was 9.0 (95% confidence interval, 2.1-39.1) compared with those with a level in the highest tertile. The relation remained after multivariate adjustment for cigarette smoking, habitual alcohol drinking, and either the seropositivity of hepatitis B virus surface antigen and/or anti-hepatitis C virus antibody or the past history of liver diseases through conditional logistic regression analysis. The association was more striking for men 55 years or younger and for those who smoked 10 or more cigarettes/day. There was a significant synergistic effect of hepatitis B virus surface antigen carrier status and low serum retinol level on the development of HCC. These data suggest a potential role of retinol in the chemoprevention of HCC.

Help-seeking behaviors in relatives of schizophrenics in Taiwan.

Despite its merits, the Western-style psychiatric community rehabilitation model is not well accepted by caregivers in Taiwan. We examined factors affecting the utilization of community rehabilitation programs in Taiwan. Our stepwise logistic regression revealed that psychoeducation regarding the biological cause of schizophrenia emerged as the major factor for increasing utilization treatment modality. Eighty-nine pairs of schizophrenic patients (who had been recommended for rehabilitation) and their relatives were divided into two groups, the rehabilitation group and the nonrehabilitation group. Both groups were surveyed on help-seeking behavior scales and mental function measurements. The results showed no significant differences in patients' psychopathology, though the rehabilitation group had higher employment rates. As for caregivers, the rehabilitation group scored significantly better on some cognitive appraisals, whereas the nonrehabilitation group was more inclined to institutionalize the patients for life. No significant differences were noticed on rejection attitude, subjective care burden, or expressed emotion measures. Improving caregiver's knowledge about the disease, providing activities that lend emotional, physical, and financial support and thereby reduce the burden and increase the satisfaction of caregivers may be useful. Besides making the Western-style psychiatric community rehabilitation model more effective and accessible for patients and caregivers in Taiwan, cultural adaptation is also needed.

Stabilizing mechanisms of the loaded and unloaded knee joint.

Knee specimens were placed in an apparatus which imposed cyclic anterior-posterior or rotatory forces, with various compressive loads applied to the joint. Force-displacement graphs or torque-rotation graphs were automatically plotted, giving the laxity under various conditions. The ligaments, capsule, and menisci provided joint stability under no-load conditions. However, under compressive loads, the conformity of the condylar surfaces was an important factor in stabilizing the knee. The mechanism proposed was the uphill movement of the femur as the femur and the tibia were displaced or twisted relative to one another.

Conformity in condylar replacement knee prosthesis.

Experiments were carried out to determine the optimum conformity between the femoral and tibial condyles in condylar replacement knee prostheses. Wear tests and observations from removed prostheses indicated that both high and low conformity produced characteristic abrasion and fatigue. Partly conforming condyles provided stability under load-bearing but allowed laxity to occur. Fixation to resist the various forces on the tibial components was enhanced by a short central intramedullary peg. Partial conformity is proposed as the optimum configuration between femoral and tibial components.

Choriocarcinoma presenting as a unilateral renal mass and gross hematuria in a male: report of a case.

Choriocarcinoma of the kidney, either primary or metastatic, is rarely reported in the literature. We encountered a male patient with choriocarcinoma of the right kidney. The patient initially presented with fever, gross hematuria and flank pain. He had initially been unsuccessfully treated for bilateral renal stones for four months before an accurate diagnosis was made. The disease was verified only after a resection of the right kidney and meticulous examination of microscopic sections of the tumor. Further immunohistochemical study strongly supported the diagnosis of choriocarcinoma. The tumor responded briefly to Cisplatinum, Vinblastine and Bleomycin (PVB) treatment. The patient died of brain metastasis and respiratory failure four months after starting systemic chemotherapy.

Low oxygenation index and pulmonary artery hypertension in predicting early death from adult respiratory distress syndrome (ARDS).

Hemodynamic and respiratory parameters were continuously monitored in 45 septic shock patients, 15 of whom developed adult respiratory distress syndrome (ARDS). Low oxygenation index (OI = PaO2/FIO2), pulmonary artery hypertension (high mean pulmonary artery pressure, MPAP) and elevated pulmonary vascular resistance (PVR) were observed in all ARDS, as well as in non-ARDS septic patients, as a baseline. These same pulmonary factors were compared between those who survived and those who died during the first few days (early fatalities) in both the ARDS group (5 patients) and the non-ARDS group (8 patients). The results showed that the early fatalities in the ARDS group had a significantly lower (p less than 0.001) OI than the survivors, as well as a lower MPAP (p less than 0.01). In the non-ARDS group, the MPAP of the early fatalities was significantly lower (p less than 0.01) than that of survivors, but their OI was not significantly lower. PVR, when compared between groups (ARDS versus non-ARDS) or between subgroups within each group, was elevated concurrently with the elevation of MPAP. It is concluded that patients with septic shock and ARDS who show a severely depressed OI and a modestly elevated MPAP and PVR during the first few days can be predicted to have a poor outcome.

Risk factors for renal allograft survival in patients receiving cyclosporine immunosuppression.

BACKGROUND AND PURPOSE: Although cyclosporine (CsA) has been widely used in renal transplantation for more than 10 years, no large series of renal transplant patients has been studied in southern Taiwan. The purpose of this retrospective cohort study was to investigate the risk factors for graft survival in renal transplant recipients. METHODS: From August 1987 to January 1998, 101 primary cadaveric renal transplantations were performed. The minimum follow-up period was 1 year. CsA and prednisolone were initially used as immunosuppressive agents in all patients. Use of lower doses of CsA to reduce CsA trough level (50-99 ng/mL) in hepatitis B surface antigen (HBsAg)-positive recipients was attempted at 6 months after transplantation. RESULTS: Graft actuarial survival rates at 1, 5, and 10 years posttransplantation were 89%, 75%, and 57%, respectively. Acute rejection and increased recipient age were found to be significant risk factors (p < 0.05) affecting graft survival, with hazard ratios of 5.20 and 1.74, respectively, by multivariate analysis using a Cox proportional hazards model. Hepatitis B and/or hepatitis C infection had no influence on graft survival. CONCLUSIONS: In this series of cadaveric renal allograft patients, the risk factors affecting allograft survival were acute rejection and recipient age.

Methotrexate, vinblastine, adriamycin and cisplatin (M-VAC) for advanced TCC of urothelium.

After the introduction of methotrexate, vinblastine, adriamycin and cisplatin combination (M-VAC) chemotherapy for transitional cell carcinoma (TCC) of the urothelium, the reported response and survival rates improved when compared with the previous regimens. From July 1989 to March 1991, 43 consecutive cases of invasive or metastatic TCC that had received at least one course of M-VAC treatment were collected by a computer-assisted search and analyzed. The overall response rate, including complete response (CR) and partial response (PR), was 44% (CR, 16%; PR, 28%). Tumors originating from the renal pelvis or bladder responded better than those from the ureter (kidney, 57%; bladder, 42%; and ureter 30%). Lymph node, soft tissue, lung metastases and local recurrent tumors had a greater chance of response than bone or liver metastases. Although patients from the blackfoot disease endemic area seemed to respond better than those from the nonendemic area, there was no statistically significant survival benefit. The duration of follow-up ranged from nine to 38 months. The length of survival of nonresponders ranged from one month to 19 months (median, eight months; mean, seven months). Ten of the 19 responders relapsed, and the others were still responding. Three patients (7%) survived two years, disease-free. Although the response rate improved, the chance of long-term survival was still unsatisfactory in our study.

Spin blockade, orbital occupation, and charge ordering in La1.5Sr0.5CoO4.

Using Co-L2,3 and O-K x-ray absorption spectroscopy, we reveal that the charge ordering in La1.5Sr0.5CoO4 involves high spin (S=3/2) Co2+ and low spin (S=0) Co3+ ions. This provides evidence for the spin-blockade phenomenon as a source for the extremely insulating nature of the La2-xSrxCoO4 series. The associated e{g}{2} and e{g}{0} orbital occupation accounts for the large contrast in the Co-O bond lengths and, in turn, the high charge ordering temperature. Yet, the low magnetic ordering temperature is naturally explained by the presence of the nonmagnetic (S=0) Co3+ ions. From the identification of the bands we infer that La1.5Sr0.5CoO4 is a narrow band material.

Determining the crystal-field ground state in rare earth heavy fermion materials using soft-x-ray absorption spectroscopy.

We infer that soft-x-ray absorption spectroscopy is a versatile method for the determination of the crystal-field ground state symmetry of rare earth heavy fermion systems, complementing neutron scattering. Using realistic and universal parameters, we provide a theoretical mapping between the polarization dependence of Ce M(4,5) spectra and the charge distribution of the Ce 4f states. The experimental resolution can be orders of magnitude larger than the 4f crystal-field splitting itself. To demonstrate the experimental feasibility of the method, we investigated CePd2Si2, thereby settling an existing disagreement about its crystal-field ground state.