Exogenous insulin promotes the expression of B-cell translocation gene 1 and 2 in chicken pectoralis.

B-cell translocation genes (BTG) have been proved to play important roles in carbohydrate metabolism through modifying insulin homeostasis and glucose metabolism. This study, therefore, was conducted to investigate the effects of exogenous insulin on the expression of BTG1 and BTG2 in chickens. Twenty-four-day-old broilers and layers were fasted for 16 h and randomly assigned to insulin treatment group (subcutaneously injected with 5 IU/kg body weight) or control group (received an equivalent volume of phosphate-buffered saline). Blood glucose concentration was measured, and it showed that the blood glucose concentrations in the layers were significantly (P < 0.05) higher than that in the broilers under fasting state. Response to exogenous insulin, the blood glucose concentrations were greatly reduced in both breeds. Of note, the blood glucose concentration restored to 62% of the basal state at 240 min (P < 0.05) after insulin stimulation in layers, whereas it was still in low level until 240 min in broilers (under fast state). Tissue profiling revealed that both BTG1 and BTG2 were abundantly expressed in the skeletal muscles of broilers. A negative correlation was observed between blood glucose and BTG1 (ρ = -0.289, P = 0.031) /BTG2 (ρ = -0.500, P < 0.001) in pectoralis, and BTG1 (ρ = -0.462, P < 0.001) in pancreas. As blood glucose decreased due to exogenous insulin administration (under fast state), the expression of both BTG1 and BTG2 notably upregulated in birds' pectoralis at 120 min and/or 240 min, meanwhile pancreas BTG1 was also upregulated. Re-feeding at 120 min elevated the blood glucose and reduced the expression of BTG genes in pectoralis generally. In addition, the change of BTG1 and BTG2 expression showed distinct difference between layers and broilers at 120 min and 240 min after insulin stimulation in pectoralis, pancreas and heart tissue; even after re-feeding at 120 min, BTG2 expression at 240 min after insulin injection was downregulated in the pectoralis of layers, while it was upregulated in that broilers. Collectively, these results indicated that response to exogenous insulin, chicken blood glucose exhibited breed-specific dynamic change, and meanwhile the expressions of both BTG1 and BTG2 genes in chickens were significantly altered by exogenous insulin in a breed- and tissue-specific manner. BTG1 and BTG2 genes may negatively regulate bird's blood glucose by promoting the glucose uptake corporately in pectoralis, and through regulating the insulin secretion in pancreas (especially BTG1).

Platycodin D alleviates proliferation and extracellular matrix accumulation in TGF-beta1 induced pulmonary fibroblasts.

AIM: Platycodin D (PD), an oleanane kind of triterpenoid saponin, possesses various pharmacological activities. We aimed to investigate the effects of PD in pulmonary fibrosis. METHOD: MRC-5 cells were induced by transforming growth factor-beta1 (TGF-ß1) to simulate the pulmonary fibrosis in vitro. Cell viability was determined using a CCK-8 kit in the absence or presence of PD. Then, the expression of proliferation-related proteins was detected using immunofluorescence assay or western blot analysis. Moreover, the levels of inflammatory factors were examined. Subsequently, the ability of cell migration was evaluated using wound healing assay. Additionally, western blot analysis was employed to determine migration- and extracellular matrix accumulation (ECM)-related proteins expression. RESULTS: Results indicated that PD exposure significantly dose-dependently inhibited TGF-ß1 induced proliferation in MRC-5 cells. Additionally, the contents of inflammatory factors were notably inhibited with PD treatment. Furthermore, significant decrease in migration of TGF-ß1-stimulated MRC-5 cells was observed after PD intervention. Afterwards, PD remarkably suppressed the expression of alpha smooth muscle actin (α-SMA), collagen I (Col I), collagen III (Col III) and E-cadherin (E-cad). CONCLUSIONS: PD attenuated proliferation and ECM accumulation in TGF-ß1 induced lung fibroblasts, providing experimental support for the clinical application of PD in the treatment of pulmonary fibrosis (Fig. 6, Ref. 33).

Pre-treatment quality of life as a predictor of distant metastasis-free survival and overall survival in patients with head and neck cancer who underwent free flap reconstruction.

PURPOSE: This study examined the prognostic associations of pre-treatment quality of life (QoL) with overall survival (OS) and distant metastasis-free survival (DFMS) among patients with head and neck cancer (HNC) who underwent free flap reconstruction. METHODS: A cohort of 127 HNC patients who received free flap reconstruction between November 2010 and June 2014 at a hospital were recruited. Pre-treatment QoL was measured by the University of Washington Quality of Life Questionnaire, which contains six physical domains, including speech, swallowing, appearance, saliva, taste and chewing, as well as the six social-emotional domains of pain, activity, recreation, shoulder, mood, and anxiety. Cox regression analyses were performed. RESULTS: Results showed that pre-treatment QoL was predictive of OS and DMFS. Of the domains, swallowing, chewing, speech, taste, saliva, pain and shoulder were demonstrated to be significant predictors of OS. Additionally, swallowing, chewing, speech, pain and activity were demonstrated making significant contributions to DMFS. CONCLUSION: Our data supported that physical domains of pre-treatment QoL were predictors for OS and DFMS in HNC patients with free-flap reconstruction. Longitudinal studies are warranted to clarify the prognostic abilities of social-emotional domains. Information on pre-treatment QoL should be taken into account to individualize care plan for these patients, and hence prolong their survival.

Xylella taiwanensis sp. nov., causing pear leaf scorch disease.

A Gram-stain-negative, nutritionally fastidious bacterium (PLS229T) causing pear leaf scorch was identified in Taiwan and previously grouped into Xylella fastidiosa. Yet, significant variations between PLS229T and Xylellafastidiosa were noted. In this study, PLS229T was evaluated phenotypically and genotypically against representative strains of Xylellafastidiosa, including strains of the currently known subspecies of Xylellafastidiosa, Xylella fastidiosa subsp. multiplex and 'Xylella fastidiosasubsp.pauca'. Because of the difficulty of in vitro culture characterization, emphases were made to utilize the available whole-genome sequence information. The average nucleotide identity (ANI) values, an alternative for DNA-DNA hybridization relatedness, between PLS229T and Xylellafastidiosa were 83.4-83.9 %, significantly lower than the bacterial species threshold of 95 %. In contrast, sequence similarity of 16S rRNA genes was greater than 98 %, higher than the 97 % threshold to justify if two bacterial strains belong to different species. The uniqueness of PLS229T was also evident by observing only about 87 % similarity in the sequence of the 16S-23S internal transcribed spacer (ITS) between PLS229T and strains of Xylellafastidiosa, discovering significant single nucleotide polymorphisms at 18 randomly selected housekeeping gene loci, observing a distinct fatty acid profile for PLS229T compared with Xylellafastidiosa, and PLS229T having different observable phenotypes, such as different susceptibility to antibiotics. A phylogenetic tree derived from 16S rRNA gene sequences showed a distinct PLS229T phyletic lineage positioning it between Xylellafastidiosa and members of the genus Xanthomonas. On the basis of these data, a novel species, Xylella taiwanensis sp. nov. is proposed. The type strain is PLS229T (=BCRC 80915T=JCM 31187T).

High prevalence of human herpesvirus type 8 infection in patients with pulmonary tuberculosis in Taiwan.

Blood samples were collected from 101 untreated pulmonary tuberculosis (TB) patients and 101 age- and sex-matched healthy control subjects. TB patients had lower lymphocyte and a higher monocyte counts than control subjects (p <0.0001 for both). The seropositive rate of human herpesvirus (HHV) type 8 antibody was higher in patients (30/101) than in control subjects (15/101) (p = 0.01). Antibody titres in patients also exceeded those in control subjects (p 0.006). Lymphocyte and monocyte counts between seronegative and seropositive subjects were not different. Four patients were positive for HHV-8 DNA. The study revealed a significantly higher HHV-8 seroprevalence in untreated pulmonary TB patients than in general population.

High seroprevalence of human herpesvirus type 8 in patients with hepatocellular carcinoma.

Cirrhosis patients have immunologic insufficiency and a high seroprevalence of human herpesvirus type 8 (HHV-8). Nearly all hepatocellular carcinoma (HCC) patients are cirrhotic and have immunoabnormalities. This study aimed to assess the HHV-8 seroprevalence and hemograms in HCC patients. Blood samples from 95 HCC patients, 95 age-, sex-, and Child-Pugh class-matched cirrhotics, and 95 age- and sex-matched healthy controls were analyzed for anti-HHV-8 antibodies, HHV-8 DNA, and lymphocyte, monocyte, and platelet counts. HCC patients had lower lymphocyte and platelet counts and a higher monocyte count than the healthy controls (each p < 0.0001). HCC patients, and particularly those with a severe Child-Pugh class, had higher platelet counts than the corresponding cirrhosis patients (p = 0.003 and 0.002, respectively). HHV-8 seropositivity and antibody titers in HCC patients were comparable with values in cirrhosis patients and were much higher than in controls (both p < 0.0001). HCC patients, but not cirrhosis patients, had a higher prevalence of high anti-HHV-8 antibody titers (≥ 1:160) than healthy controls (p = 0.003). HCC patients with lymphopenia or thrombocytopenia had lower HHV-8 seropositivity than those without lymphopenia and thrombocytopenia (p = 0.04 and 0.01, respectively). One each of HCC and cirrhosis patients were positive for HHV-8 DNA. HCC patients seemed to suffer from less severe or shorter duration of portal hypertension compared with Child-Pugh class-matched cirrhosis patients. HCC patients had a high HHV-8 seroprevalence, which seemed to be inversely associated with lymphopenia and thrombocytopenia.

Ocular manifestations of patients receiving heart transplants: a single-center experience of 311 consecutive cases.

PURPOSE: The purpose of this study was to investigate ocular manifestations of patients undergoing heart transplantations. METHOD: We retrospectively reviewed the clinical data of 311 patients who underwent orthotropic heart transplantations from January 1989 to December 2007, including the demographic data, general conditions, medications, as well as the basic ophthalmic examinations, ophthalmic diagnosis, and management. RESULTS: Of the 311 heart transplant recipients, common diagnoses included cataract (96 cases; 30.87%), dry eye syndrome (24 cases; 7.72%), allergic conjunctivitis (78 cases; 25.08%), and glaucoma (19 cases; 6.11%). The patients after heart transplantation had much lower incidences of severe opportunistic infections than patients undergoing the same procedure one decade ago. However, autoimmune-related endocrinopathy such as diabetes and Graves' disease became more prevalent. Diabetes-related complications were unexpectedly frequent, including nonproliferative diabetic retinopathy (6 cases; 1.93%), proliferative diabetic retinopathy (6 cases; 1.93%), retinal vein occlusion (6 cases; 1.93%), and neovascular glaucoma (4 cases; 1.29%). The occurrence of cataract formation and steroid glaucoma was often due to post-transplantation steroid use. CONCLUSION: Ophthalmologists and cardiac surgeons should collaborate and perform regular ophthalmic examinations, especially for those who have new-onset diabetes and difficulty tapering off steroids.

Draft Genome Sequence of Xylella fastidiosa Pear Leaf Scorch Strain in Taiwan.

The draft genome sequence of Xylella fastidiosa pear leaf scorch strain PLS229, isolated from the pear cultivar Hengshan (Pyrus pyrifolia) in Taiwan, is reported here. The bacterium has a genome size of 2,733,013 bp, with a G+C content of 53.1%. The PLS229 genome was annotated and has 3,259 open reading frames and 50 RNA genes.

Tanshinone IIA inhibits human prostate cancer cells growth by induction of endoplasmic reticulum stress in vitro and in vivo.

BACKGROUND: Tanshinone IIA (Tan-IIA) is one of the major lipophilic components isolated from the root of Salviae Miltiorrhizae Radix. We explored the mechanisms of cell death induced by Tan-IIA treatment in prostate cancer cells in vitro and in vivo. METHODS: Cells were treated with Tan-IIA and growth inhibition was assessed. Cell cycle profiles after Tan-IIA treatment were determined by flow cytometry. Expression levels of cell cycle regulatory proteins and apoptosis-related proteins were determined after Tan-IIA treatment. Expression levels of endoplasmic reticulum (ER) stress-regulated genes were determined to investigate their role in Tan-IIA-induced cell death. GADD153 expression was knocked down by small interfering RNA (siRNA) transfection. Rate of cell death and proliferation was obtained by 3-(4,5-dimethyl thizol-2-yl)-2,5-diphenyl tetrazolium bromide assay. Antitumor activity of Tan-IIA was performed in LNCaP xenograft model. RESULTS: Our results showed that Tan-IIA caused prostate cancer cell death in a dose-dependent manner, and cell cycle arrest at G0/G1 phase was noted, in LNCaP cells. The G0/G1 phase arrest correlated with increase levels of CDK inhibitors (p16, p21 and p27) and decrease of the checkpoint proteins. Tan-IIA also induced ER stress in prostate cancer cells: activation and nuclear translocation of GADD153/CCAAT/enhancer-binding protein-homologous protein (CHOP) were identified, and increased expression of the downstream molecules GRP78/BiP, inositol-requiring protein-1α and GADD153/CHOP were evidenced. Blockage of GADD153/CHOP expression by siRNA reduced Tan-IIA-induced cell death in LNCaP cells. Tan-IIA also suppressed LNCaP xenograft tumor growth, causing 86.4% reduction in tumor volume after 13 days of treatment. CONCLUSIONS: Our findings suggest that Tan-IIA causes G0/G1 cell cycle arrest in LNCaP cells and its cytotoxicity is mediated at least partly by ER stress induction. These data provide evidence supporting Tan-IIA as a potential anticancer agent by inducing ER stress in prostate cancer.

Mutations in the CYP1B1 gene may contribute to juvenile-onset open-angle glaucoma.

PURPOSE: Glaucoma is one of the leading causes of blindness in the world. Juvenile-onset open-angle is a subtype of glaucoma. In this context, we investigate the possible mutations in the promoter and coding regions of the CYP1B1 gene among patients suffering juvenile-onset open-angle glaucoma (JOAG). METHODS: The CYP1B1 gene was analysed for mutations in 61 unrelated Taiwanese probands with JOAG and in 100 healthy control subjects. Genomic DNA was extracted from peripheral blood leukocytes and then subjected to PCR. The amplified products were screened for base mutations by autosequence. Next, data from the two groups were compared using the χ(2) test. Additionally, three-dimensional (3D) modelling of the human wild-type and p.R390H mutation was performed using SWISS-MODEL, an automated homology modelling program. Finally, the figure was prepared for the modelled structures by using the Accelrys ViewerLite 5.0 program. RESULTS: Analysis results indicated two CYP1B1 mutations and five polymorphisms. The prevalence of CYP1B1 gene mutations in this study was 4.92% (3/61). The mutations included a missense mutation (p.Arg390His; 2/3) and a mutation in the 5'-untranslated region (c.1-313A>C; 1/3). Moreover, computer-assisted modelling revealed that this p.R390H mutation affects the intra-molecular interaction in the hydrogen-bonding interaction with Glu387 and Asn428, thus altering significantly the efficiency of the haem-binding and proper folding of the molecule. CONCLUSIONS: As a result, the p.Arg390His mutation might affect the protein structure and, ultimately, the normal function of CYP1B1. Therefore, we suggest that the c.1169G>A (p.Arg390His) mutation of CYP1B1 may be a risk factor for the development of JOAG.

First Report of a 16SrII-A Subgroup Phytoplasma Associated with Purple Coneflower (Echinacea purpurea) Witches'-Broom Disease in Taiwan.

Purple coneflower (Echinacea purpurea), widely grown as an ornamental and medicinal plant, is a perennial flowering plant that is native to eastern North America. In July 2011, symptoms indicative of phytoplasma disease, including floral virescence, phyllody, and witches'-broom (WB), were observed to be affecting plants in coneflower fields in Wufeng, Taichung City, Taiwan. Incidence of infected plants was estimated to be greater than 90% within a single field. Phytoplasmas previously associated with purple coneflower WB disease have all been classified as aster yellows group (16SrI) strains (GenBank Accession Nos. EU333395, AY394856, EU416172, and EF546778) except for pale purple coneflower (Echinacea pallida) WB in Australia, which was identified as a subgroup 16SrII-D member (2). Three diseased plants were uprooted and transplanted in a greenhouse for further study. Transmission electron microscopy revealed clusters of phytoplasma cells ranging from 170 to 490 nm in diameter in phloem sieve elements of virescent and phylloid flowers and stems from diseased plants. Comparable tissues from symptomless plants were devoid of phytoplasma. Total DNA was extracted from plant tissue samples (50 to 100 mg each) including stems, leaves, and flowers by a modified CTAB method (1) from three symptomatic plants as well as from three asymptomatic coneflower plants seedlings. Analyses by a nested PCR using universal primer pairs P1/P7 followed by R16F2n/R16R2 were performed to detect putative phytoplasma (2). Each primer pair amplified a single PCR product of either 1.8 or 1.2 kb, respectively, from diseased plant tissues only. The nested PCR products (1.2 kb) amplified from phylloid flowers of the three diseased plants were cloned separately and sequenced (GenBank Accession Nos. JN885460, JN885461, and JN885462). Blast analysis of the sequences revealed a 99.7 to 99.8% sequence identity with those of Echinacea WB phytoplasma strain EWB5 and EWB6 (GenBank Accession Nos. JF340076 and JF340080), which reportedly belonged to the 16SrII-D subgroup (2). Moreover, iPhyClassifier software (3) was used to perform sequence comparison and generate the virtual restriction fragment length polymorphism (RFLP) profile. The 16S rDNA sequences share a 99.4 to 99.5% similarity with that of the 'Candidatus Phytoplasma australasiae' reference strain (Y10097) and the RFLP patterns are identical to that of the 16SrII-A subgroup. Taken together, these results indicated that the phytoplasma infecting purple coneflower in Taiwan is a 'Ca. Phytoplasma australasiae'-related strain and belongs to the 16SrII-A subgroup. To our knowledge, this is the first report of a 16SrII-A subgroup phytoplasma causing WB disease on purple coneflower in Taiwan. The occurrence of phytoplasma on purple coneflower could have direct implication for the economically important ornamental, medicinal plant, and floral industry in Taiwan, especially to the growers and breeders that eagerly promote the purple coneflower industry. References: (1) T. M. Fulton et al. Plant Mol. Biol. Rep. 13:207, 1995. (2) T. L. Pearce et al. Plant Dis. 95:773, 2011. (3) Y. Zhao et al. Int. J. Syst. Evol. Microbiol. 59:2582, 2009.

210Pb deposition in the far East Asia: controlling factors of its spatial and temporal variations.

In order to better understand the behavior of (210)Pb deposition in Far East Asia, comprehensive data of monthly (210)Pb deposition, which includes several time-series and spatial distribution data at 14 stations in Japan and 2 stations in Taiwan, were analyzed. Pb-210 deposition at most of the sites exhibited a typical seasonal change with higher values in winter and lower values in summer; especially, the greatest (210)Pb deposition in the world occurred in winter at sites beside the Japan Sea. The deposition behavior of (210)Pb in Far East Asia differed between winter and summer. The meteorological phenomenon peculiar to winter of the Japan Sea side, i.e., formation of the Japan Sea convergence zone, might cause the high (210)Pb concentration in rainwater, as may heavy snowfall. The (210)Pb concentration in rainwater showed long-term variability, although this differed between winter and summer. This long-term variability may be related to climatological factors such as El Niño.

Human herpesvirus type 8 in patients with cirrhosis independent of thrombocytopenia.

BACKGROUND: High seroprevalence of human herpesvirus type 8 (HHV-8) in patients with cirrhosis has been reported to be associated with thrombocytopenia. Severe cirrhosis is always complicated with ascites. HHV-8 DNA levels in effusion from patients with primary effusion lymphoma has been reported to be significantly greater than in blood. The status of HHV-8 antibody and DNA in cirrhotic ascites is unclear. AIMS: To assess the status of HHV-8 antibody and DNA in cirrhotic ascites compared to that in cirrhotic plasma. METHODS: Plasma and ascites samples were collected from 85 patients with cirrhosis. HHV-8 antibody and DNA were detected by immunofluorescence assay and PCR, respectively. RESULTS: Male patients seropositive for HHV-8 antibody were significantly younger than seropositive female patients (p=0.0039). The seropositive rate in patients with cirrhosis was not associated with thrombocytopenia (p=0.6860). Both positive rate and titres of antibody in plasma were much greater than in ascites (p<0.0001). More male or Child-Pugh class C than female or class B seropositive patients were positive for ascites. No hepatitis C virus-related ascites were positive for antibody. Neither plasma nor ascites samples from any subject were positive for HHV-8 DNA. CONCLUSIONS: In patients with cirrhosis, the seropositive rate for HHV-8 antibody is independent of thrombocytopenia. The positive rate for HHV-8 antibody in cirrhotic ascites seems to be associated with sex, disease severity and disease aetiology.

Compliance of sildenafil treatment for erectile dysfunction and factors affecting it.

To assess the compliance of treatment, its affecting factors, and reasons for dropout, a questionnaire was mailed to a cohort of 2139 subjects who received sildenafil prescriptions for erectile dysfunction (ED) at our institution from 1999 to 2002. A total of 726 subjects (34%) with a mean age of 67 years answered the questionnaires. The response rate for sildenafil treatment was 67%. Of these sildenafil responders, 43% reported that they continued using sildenafil while 57% did not, in a mean follow-up of 3 years. Common reasons for discontinuation were effect below expectations, high cost, loss of interest in sex, and inconvenience in obtaining sildenafil. The continuers showed a higher rate than the discontinuers (P < 0.05) of having tried other treatments, dose titration, and a dose higher than 50 mg. The discontinuers reported having a lower mean responding dose and improvement score post sildenafil treatment than the continuers. In conclusion, effect below expectations was the leading reason for discontinuation of sildenafil treatment. How ED subjects tried the medication and the adequacy of education in the initial treatment period may impact the compliance of sildenafil treatment.

Immunohistochemical and molecular assessment of human herpesvirus type 8 in gastrointestinal tumours.

BACKGROUND: Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract, histologically identified as highly cellular spindle or epithelioid cell tumours, and often positive for CD34 (60-70%). Kaposi's sarcomas (KSs) are similar to GISTs: they are most often found in the gastrointestinal tract (although cutaneous lesions do occur), they are also composed of spindle or epithelioid cells (although erythrocytes are also seen), and the tumour cells are nearly all positive for CD34. Human herpesvirus type 8 (HHV-8) DNA has been found consistently in all types of KS, in particular in CD34 positive KS tumour cells. However, the association between HHV-8 and GIST has not been investigated. AIMS: To assess the presence of HHV-8 in GISTs. METHODS: Paraffin wax embedded tissues of 86 primary GISTs and their recurrent or metastatic tumours were analysed immunohistochemically for the CD34 antigen and HHV-8 latent nuclear antigen 1 (LNA-1) and by means of the nested polymerase chain reaction (PCR) and real time PCR for HHV-8 DNA. RESULTS: None of the 86 GISTs contained HHV-8 DNA sequences or LNA-1 positive cells. CONCLUSIONS: These results demonstrate the lack of HHV-8 infection in GIST tumour cells. HHV-8 does not appear to play a role in the pathogenesis of GIST, irrespective of the status of the tumour.

QTL detection for eating quality of cooked rice in a population of chromosome segment substitution lines.

The genetic mechanism underlying six palatability properties of cooked rice and three physico-chemical traits was dissected in 66 BC(3)F(2) chromosome segment substitution lines (CSSLs), using a complete linkage map in three successive years. The CSSLs showed transgressive segregation for all traits studied. Significant correlation was detected among most palatability traits. A total of 25 QTLs for the nine traits were identified on nine chromosomes, and many QTLs affecting different quality traits were mapped in the same regions. Six QTLs--qLT-8 for luster, qTD-6 and qTD-8 for tenderness, qIVOE-6 and qIVOE-8 for integrated value of organoleptic evaluation, and qAC-8 for amylose content--were repeatedly detected across the 3 years. Phenotypic values were significantly different between the recurrent parent, cultivar Asominori, and the CSSLs harboring any of the six QTL alleles across the three environments, indicating that these six QTLs were non-environment-specific and could be used for marker-assisted selection in rice quality improvement.

Distribution of fallout radionuclides (7Be, 137Cs, 210Pb and 239,240Pu) in soils of Taiwan.

Depth profiles and cumulative deposition of four fallout radionuclides (7Be, 137Cs, 210Pb and 239,240Pu) were determined in presumably undisturbed soils in Taiwan. Inventories of these radionuclides in different areas correlate significantly with each other (except 7Be) and with mean annual rainfall, providing a necessary condition for the development of soil erosion studies in Taiwan. However, the data show very large spatial variability between and within landscape units, reflecting the steep topographic and meteorological gradients in the island. Thus, the application of fallout radionuclides to study soil conservation in Taiwan is expected to be a demanding task; it will call for dense sampling even at undisturbed reference sites.

Impact of introduction of sildenafil on other treatment modalities for erectile dysfunction: a study of nationwide and local hospital sales.

We assess the impact of introduction of sildenafil on alprostadil injection and penile implant surgery for the treatment of erectile dysfunction (ED) at our institution and in Taiwan. The data of national sales of sildenafil, alprostadil injection and penile implant were provided by industry companies. In the meanwhile, we analyzed the users of the above-mentioned three treatments at our institution. The national sales of sildenafil grew 136% from 0.8 million tablets in 1999 to 1.6 million tablets in 2002, while those of alprostadil injection dropped 33% after the marketing of sildenafil and of penile implant dropped 40% after the marketing of alprostadil injection and sildenafil. The market share of drugstores for sildenafil rose from 41% in 1999 to 72% in 2002. The trend of sales of sildenafil at our institution was similar to that of national sales from hospitals. Mean age of the sildenafil new users was becoming younger in the past 4 y (P<0.001). Of the new users of alprostadil injection and the recipients of penile implant, the commonest age group shifted from the range of 60-69 y before the launch of sildenafil to that of over 70 y after (P<0.05). In conclusion, the introduction of sildenafil has prompted more men as well as younger men with ED to seek treatment. Part of the roles of alprostadil injection and penile implants in this field are substituted by sildenafil and the commonest age group of their users becomes older than before.

Ultrasound diagnosis of paratesticular rhabdomyosarcoma.

Rhabdomyosarcoma is the most common tumour of the lower genitourinary tract in children in the first two decades. Paratesticular rhabdomyosarcoma is associated with a significantly better outcome than lesions elsewhere in the genitourinary tract. Although ultrasound is considered the imaging modality of choice for evaluating intrascrotal pathology, the ultrasound appearance of paratesticular rhabdomyosarcoma has rarely been reported and may be confused with other disease entities such as epididymitis, adenomatoid tumour and leiomyoma. We present the ultrasound features of a paratesticular rhabdomyosarcoma, discussing the clinical features and differential diagnosis.