Association of CT60 polymorphism of the CTLA4 gene with Graves' disease in Taiwanese children.

BACKGROUND: The CTLA4 gene is involved in the activity of T cells. AIM: To determine the association between Graves' disease (GD) susceptibility and CT60 polymorphism of the CTLA4 gene. PATIENTS: 189 children with GD and 620 healthy controls. METHODS: We determined the genotype with restriction fragment length polymorphism and compared results. RESULTS: Genotype G/G was significantly associated with GD (odds ratio [OR] = 1.71, 95% confidence interval [CI] 1.20-2.44, Pc = 0.006); however, allele A could reverse its effect. Allele G was significantly more frequent (OR = 1.61, 95% CI 1.18-2.19, Pc = 0.0049) but allele A (OR = 0.62, 95% CI 0.46-0.85, Pc = 0.0049) and phenotype A (OR = 0.58, 95% CI 0.41-0.83, Pc = 0.006) were less frequent in patients with GD than in controls. CONCLUSION: The CT60 SNP was associated with susceptibility to GD. The G allele increased the risk of GD.

Natural progression of hip dysplasia in newborns: a reflection of hip ultrasonographic screenings in newborn nurseries.

Hip screening is recommended for early detection of hip dysplasia; however, the strategy and efficacy were questioned. We performed ultrasonography to objectively observe the hip development in a group of infants and raise reflections on the efficacy of newborn ultrasonographic hip screening. A total of 1333 newborns (705 male and 628 female) received hip ultrasonography in the first week after birth. Clinical hip instability was detected by the Ortolani test. Hip dysplasia was defined by ultrasonography. A second survey of 90 babies was performed 1 month later on the babies with clinical hip instability or ultrasonographic Graf's type IIa, IIc, D, III, and IV hips. All the hip ultrasonographies were performed by the same investigator. Clinical instability was detected in 13 hips of 10 babies. Manual tests helped to detect unstable hips that had worse ultrasonographic measurements than those stable hips. Five Graf's type IIc hips and four type III hips were detected from the 2666 hips. At the age of 1 month, eight of the nine Graf's type IIc or III hips attained physiological status without treatment. A strong trend of spontaneous resolution in clinical hip instability and ultrasonographic dysplasia was observed in the newborns. The results did not support immediate treatment on the basis of newborn manual or ultrasound hip screening. We recommend manual testing in the newborn nursery to detect the hips at risk of dysplasia and ultrasonography after the first month after birth to confirm the diagnosis and judge the management.

Hyperthermia as an early sign of intracranial hemorrhage in full-term neonates.

BACKGROUND: Intracranial hemorrhage (ICH) in full-term infants is uncommon and is a rare cause of neonatal fever. This study was conducted to estimate the incidences of ICH and fever in a hospital-based population, and to determine if the clinical features of neonatal ICH with and without hyperthermia differ. METHODS: We selected 315 afebrile neonates who received cranial ultrasonography screening from 2003 to 2004 as the control group, and 153 neonates diagnosed with fever from 1998 to 2004 as the study group. During the same period, 28 full-term neonates with birth weights >2500g and ICH in the first week of life were enrolled retrospectively. They were divided into hyperthermia (n=11) and nonhyperthermia (n=17) groups. RESULTS: Three babies in the control group and 11 in the study group had ICH; the incidence of ICH in the hyperthermia group was significantly higher (3/315 vs. 11/153; p < 0.001). Compared with the nonhyperthermia group, the hyperthermia group had Less cyanosis (2/11 vs. 10/17; p = 0.04), Less lymphocyte predominance (33.7 vs. 80%; p = 0.032), higher neutrophil/lymphocyte ratio (1.9 vs. 0.3; p = 0.006), higher erythrocyte/leukocyte ratio (425 vs. 79.5; p = 0.05) in cerebrospinal fluid and an increased incidence of subarachnoid hemorrhage accompanied by intracerebral parenchymal hemorrhage (4/11 vs. 0/17; p = 0.016). CONCLUSION: The incidence of ICH was higher in febrile than in afebrile neonates. ICH presenting with hyperthermia might go unrecognized, because its other symptoms are subtle and a neutrophil predominance in the cerebrospinal fluid might result in a misdiagnosis of meningitis. ICH in the interior brain tended to manifest more commonly as hyperthermia than did ICH in the superficial brain. A cranial image examination should be considered in the evaluation of neonatal fever.

Hip circumference is an important predictor of plasma C-reactive protein levels in overweight and obese Taiwanese women.

OBJECTIVE: To investigate the relationship between serum levels of C-reactive protein (CRP) with obesity, insulin resistance and metabolic syndrome in overweight or obese Taiwanese women. MATERIALS AND METHODS: Analysis was performed on data from 59 overweight or obese women enrolled in a cross-sectional study. Pearson's correlation coefficients were determined between CRP and simple anthropometric indices, fasting insulin, homeostasis model assessment (HOMA) and serum lipid levels. Forward step-wise regression procedure was used to find a "best" subset of predictor variables for CRP. RESULTS: CRP was found to have significantly positive correlation with body weight, waist circumference, hip circumference, body mass index, log of fasting glucose levels, fasting insulin levels and HOMA. Forward stepwise regression procedure showed that the best predictor for CRP was hip circumference. CONCLUSION: The correlation between CRP and insulin resistance or abnormal lipid levels is attributed to their strong correlations with obesity.