[Clinical features and gene mutation analysis of patients with Alagille syndrome].

Objective: To analyze the clinical manifestations and gene mutations of patients with Alagille Syndrome (ALGS) to improve diagnosis and provide a boarder spectrum of gene mutagenesis. Methods: A retrospective study was performed in 18 ALGS patients admitted to Xi'an Children's Hospital from January 2016 to January 2020. Clinical characteristics, biochemical parameters, gene mutations and prognosis were collected and analyzed. Next-generation sequencing of liver disease-related gene panels or the whole exome was carried out for the probands. Mutations of candidate genes were verified by Sanger sequencing in their family members. Based on the comparison with a well-known database of disease, the harmfulness and structures of proteins with novel mutations were predicted, and the pathogenicity was evaluated. Results: There were 9 males and 9 females with ALGS in this study, and the age of initial diagnosis was 2.5 (1.9, 6.8) months. All patients initially presented with cholestasis, with other symptoms including 15 cases of special facial features, 11 cases of butterfly vertebrae, 10 cases of congenital heart disease, 5 cases of posterior corneal embryonic ring (among 16 cases with ophthalmological examination), and 1 case of polycystic kidney disease. A total of 14 JAG1 gene mutations and 6 NOTCH2 gene mutations were identified. Among these newly identified mutations, 6 were associated with JAG1 gene, including c.1213delA (p.T405Lfs*7), c.1270dupG(p.A424Gfs*5), c.1741dupG(p.A581Gfs*8), c.3045delC (p.I1016Ffs*20), c.2000-2A>C and c.625C>A(p.H209N); 4 were associated with NOTCH2 gene, including c.6961dupG(p.A2321Gfs*79), c.518G>T(p.G173V), c.6157C>T(p.R2053C) and c.710G>A(p.R237Q). Sixteen patients were followed up for (37.9±31.5) months. Among these cases, 2 died of liver failure (1 case underwent Kasai operation due to misdiagnosis with biliary atresia), 1 improved after liver transplantation, and 13 were in stable condition after medical treatment. Conclusions: The phenotypes of ALGS are diverse, genetic detection can help diagnosis. The JAG1 and NOTCH2 genes showed a wide array of mutations, with many novel mutations identified in this study.

[Pathological significance of NY-ESO-1 expression in the diagnosis of myxoid liposarcoma].

Objective: To detect the expression of New York esophageal squamous cell carcinoma antigen 1 (NY-ESO-1) in common types of mesenchymal myxoid tumors, and to investigate its significance in the diagnosis and differential diagnosis of myxoid liposarcoma. Methods: A total of 43 formalin-fixed paraffin-embedded samples of mesenchymal myxoid tumors from the Affiliated Hospital of Qingdao University and Qingdao Municipal Hospital ranging between 2010 and 2017 were selected. NY-ESO-1 expression was detected by immunohistochemical staining. DDIT3 gene status was detected by fluorescence in situ hybridization (FISH). NY-ESO-1 mRNA was detected by reverse transcription-PCR (RT-PCR). Results: Histopathology and FISH results confirmed that there were 11 cases of myxoid liposarcoma and 32 other types (including 7 cases of well-differentiated liposarcoma, 1 dedifferentiated liposarcoma, 3 lipomas, 2 lipoblastomas and 19 non-adipocytic tumors). Immunohistochemical staining showed that the positive expression propotion of NY-ESO-1 in myxoid liposarcoma was 11/11, and the positive location was the cytoplasm and nucleus of lipoblast cells. The expression intensity is higher in regions with round cell differentiation. Among the 32 cases of other mesenchymal myxoid tumors, only one well-differentiated liposarcoma showed positive immunoreactivity for NY-ESO-1. RT-PCR confirmed that 7 cases of myxoid liposarcoma (7/11) and one well-differentiated liposarcoma (1/7) had NY-ESO-1 mRNA expression. Conclusions: NY-ESO-1 is positively expressed in myxoid liposarcoma. It can be served as a useful marker for the diagnosis and differential diagnosis of myxoid liposarcoma.

First Report of Elm Yellows Phytoplasma Infecting Clover in China.

In the summer of 2008, phyllody and enlarged petioles resembling symptoms of phytoplasma infection were observed on clover (Trifolium repens) plants in lawns on the campus of Northwest A&F University. Typical phytoplasma-like bacteria were observed in the phloem cells when ultra-thin sections from leaf midrib tissues were examined with transmission electron microscopy. Nested PCR assays were used to verify the association of phytoplasma with the disease. Total DNA was extracted from the phloem of leaf midribs from 20 symptomatic plants and six symptomless plants using the modified CTAB method (1). Using the phytoplasma universal primer pair R16mF2/R16mR1 followed by specific primers R16F2n/R16R2 (4), PCR products of 1.4 and 1.2 kb were amplified, respectively, from symptomatic plants only. Jujube witches'-broom (JWB) and paulownia witches'-broom (PaWB) phytoplasma DNA samples served as controls and were used to study group relationships. After sequencing of the 16S rDNA fragment (GenBank Accession No. FJ436792), a BLAST search determined that the clover phytoplasma shared closest homology (99.6%) with JWB (GenBank Accession No. FJ154846) phytoplasmas compared with lesser identity (90.4%) with PaWB (GenBank Accession No. EF199937). Subsequent restriction fragment length polymorphism analysis of the PCR-amplified 1.2-kb 16S rDNA R16(1)F1/R1 fragment indicated that the phytoplasma associated with the disease belongs to subgroup 16SrV-B of the elm yellows phytoplasma group. Clover phyllody phytoplasma were previously reported to infect clover in Canada (GenBank Accession No. L33762) (3) and Italy (GenBank Accession No. X77482) (2). The phytoplasma reported here shared 86.7 and 90.0% identity with the clover phyllody phytoplasma above, respectively, much lower than that with Elm yellows phytoplasma group. To our knowledge, this is the first report of Elm yellows phytoplasma infecting clover in China. References:(1) E. Angelini et al. Vitis 40:79, 2001. (2) G. Firrao et al. Eur. J. Plant Pathol. 102:817, 1996. (3) N. A. Harrison et al. Plant Pathol. 52:147, 2003. (4) I.-M. Lee et al. Int. J. Syst. Bacteriol. 48:1153, 1998.

Inhibitory effects of molybdenum on esophageal and forestomach carcinogenesis in rats.

Male weanling inbred SD rats were given ad libitum a nutritionally adequate semipurified diet and demineralized drinking water without or with 100 or 200 ppm tungsten (W) or 2 or 20 ppm molybdenum (Mo) added to the drinking water. The animals were gastrically intubated with a solution of N-nitrososarcosine ethyl ester (NSEE) from the 4th week twice weekly for 2-8 consecutive weeks. The addition of Mo at either the 2- or 20-ppm level significantly inhibited NSEE-induced esophageal and forestomach carcinogenesis. The 200 ppm W significantly countered the inhibitory effect of a low level of Mo naturally occurring in the diet.

Effects of molybdenum and tungsten on mammary carcinogenesis in SD rats.

Virgin female rats of the SD strain were fed ad libitum a nutritionally adequate semipurified diet and demineralized water (groups 1 and 2), or the same diet with 10 ppm molybdenum (group 3) or 150 ppm tungsten (group 4) added to the drinking water. The animals in groups 2-4 received a single iv injection of 5 mg N-nitroso-N-methylurea (NMU; CAS: 684-93-5)/100 g body weight at 50 days of age. One hundred and twenty-five days after the NMU treatment, group 2 exhibited a 50.0% incidence of mammary carcinoma. Group 4 exhibited a significant increase in carcinoma incidence (79.2%) and the value for group 3 (45.5%) was not significantly different from that of group 2. The carcinoma incidence of group 3 (50.0%) was significantly lower than that of group 2 (90.5%) or group 4 (95.7%) 198 days after NMU treatment.

Characterization of the NIST seaweed Standard Reference Material.

The National Institute of Standards and Technology (NIST) Standard Reference Material (SRM) for seaweed was developed through an interlaboratory comparison with 24 participants from 16 countries. After evaluating different techniques to calculate certified values for the radionuclides, the median method was found to be the most representative technique. The certified values were provided for 13 radionuclides and information values were given for 15 more radionuclides. Results for the natural decay series showed disequilibrium in both the uranium and thorium series.

EB-virus latent membrane protein 1 potentiates the stemness of nasopharyngeal carcinoma via preferential activation of PI3K/AKT pathway by a positive feedback loop.

Our previous study reported that Epstein-Barr virus(EBV)-encoded latent membrane protein 1 (LMP1) could induce development of CD44(+/High) stem-like cells in nasopharyngeal carcinoma (NPC). However, the molecular mechanisms that underlie modulation of cancer stem cells (CSCs) in NPC remain unclear. Here, we show that LMP1 induced CSC-like properties through promotion of the expression of epithelial-mesenchymal transition-like cellular markers and through alterations in differentiation markers. Furthermore, LMP1 activated and triggered phosphoinositide 3-kinase/protein kinase B (PI3K/AKT) pathway, which subsequently stimulated expression of CSC markers, development of side population and tumor sphere formation. This suggests that PI3K/AKT pathway has an important role in the induction and maintenance of CSC properties in NPC. Similarly, PI3K/AKT pathway was also activated by phosphorylase in LMP1-induced CD44(+/High) cells. In addition, LMP1 greatly increased expression of miR-21 and downregulated expression of the miR-21 target, PTEN. Overexpression of miR-21 by transfection of miR-21 mimics into LMP1-transformed cells led to phosphorylase-mediated activation of the PI3K/AKT pathway and induction of CSCs. On the contrary, phosphorylation of the PI3K/AKT pathway and the expression of CSC were reversed by an miR-21 inhibitor. The specific inhibitor (Ly294002) of PI3K/AKT pathway significantly decreased expression of miR-21 and CSC markers and upregulated the expression of PTEN, which indicates that miR-21 and PTEN are the downstream effectors of PI3K/AKT and that expression of these two effectors are related to the development of NPC CSCs. Taken together, our novel findings indicate that LMP1, PI3K/AKT, miR-21 and PTEN constitute a positive feedback loop and have a key role in LMP1-induced CSCs in NPC.

Unresolved issues in the analysis of F2-isoprostanes, F4-neuroprostanes, isofurans, neurofurans, and F2-dihomo-isoprostanes in body fluids and tissue using gas chromatography/negative-ion chemical-ionization mass spectrometry.

F2-isoprostanes (F2-IsoPs) generated from arachidonic acid (AA) have been recognized as the most reliable marker of nonenzymatic lipid peroxidation in vivo. F2-IsoPs are initially produced in esterified form on phospholipids, and then released into body fluids in free form. The same mechanism can lead to generation of F4-neuroprostanes (F4-NPs) and F2-dihomo-IsoPs from docosahexaenoic acid (DHA) and adrenic acid, respectively. In addition, isofurans (IsoFs) and neurofurans (NFs) may be preferentially produced from AA and DHA, respectively, under high oxygen tension. The detection of F2-IsoPs using gas chromatography/negative-ion chemical-ionization mass spectrometry (GC/NICI-MS) has been widely employed, which is important for human body fluids containing low quantity of free-form F2-IsoPs. F4-NPs have also been detected using GC/NICI-MS, but multiple peaks need to be quantified. In this paper, we summarize the basic workflow of the GC/NICI-MS method for analyzing F2-IsoPs and F4-NPs, and various formats of assays conducted by different groups. We then discuss the feasibility of simultaneous analysis of IsoFs, NFs, and F2-dihomo-IsoPs with F2-IsoPs or F4-NPs. Representative GC chromatograms for analyzing these markers in human body fluids and rat brain tissue are demonstrated. Furthermore, we discuss several factors that may affect the performance of the analysis, such as those related to the sample processing steps, interference from specimens, types of GC liners used, and the addition of electron multiplier voltage in the method setting for the MS detector. Finally, we question the appropriateness of measuring total (free plus esterified) levels of these markers in body fluids.

Levels of F2-isoprostanes, F4-neuroprostanes, and total nitrate/nitrite in plasma and cerebrospinal fluid of patients with traumatic brain injury.

Several events occurring during the secondary damage of traumatic brain injury (TBI) can cause oxidative stress. F(2)-isoprostanes (F(2)-IsoPs) and F(4)-neuroprostanes (F(4)-NPs) are specific lipid peroxidation markers generated from arachidonic acid and docosahexaenoic acid, respectively. In this study, we evaluated oxidative stress in patients with moderate and severe TBI. Since sedatives are routinely used to treat TBI patients and propofol has been considered an antioxidant, TBI patients were randomly treated with propofol or midazolam for 72 h postoperation. We postoperatively collected cerebrospinal fluid (CSF) and plasma from 15 TBI patients for 6-10 d and a single specimen of CSF or plasma from 11 controls. Compared with the controls, the TBI patients exhibited elevated levels of F(2)-IsoPs and F(4)-NPs in CSF throughout the postsurgery period regardless of the sedative used. Compared with the group of patients who received midazolam, those who received propofol exhibited markedly augmented levels of plasma F(2)-IsoPs, which were associated with higher F(4)-NPs levels and lower total nitrate/nitrite levels in CSF early in the postsurgery period. Furthermore, the higher CSF F(2)-IsoPs levels correlated with 6-month and 12-month worse outcomes, which were graded according to the Glasgow Outcome Scale. The results demonstrate enhanced oxidative damage in the brain of TBI patients and the association of higher CSF levels of F(2)-IsoPs with a poor outcome. Moreover, propofol treatment might promote lipid peroxidation in the circulation, despite possibly suppressing nitric oxide or peroxynitrite levels in CSF, because of the increased loading of the lipid components from the propofol infusion.

Serum hormone concentrations and ovarian follicular wave emergence in Jilin sika deer (Cervus nippon hortulorum) after synchronization of estrous cycles.

The study was conducted to investigate the serum hormone concentrations and follicular dynamics present after synchronous treatment (CIDR) in female Jilin sika deer (n = 15) of estrous cycles. Blood samples were collected to analyze the FSH, LH, estradiol and progesterone during the estrous cycles. Manual transrectal ultrasonography examination was conducted at least thrice weekly to monitor the follicular wave. Ultrasonography showed that follicle development occurred in waves, and most estrous cycles in Jilin sika deer consist of one, two, or three waves. The largest follicles of the interwaves of two- and three-wave cycles were different (P < 0.05). The mean interovulatory interval was 15.0 ± 4.6 d. There was a surge in circulating FSH in two- and three-wave cycles. The emergence of the largest follicle was related to the peak of serum concentration of estradiol. Serum progesterone concentrations were not different between one- and three-wave cycles (P < 0.05). We concluded that FSH and estradiol concentration may have an important role in controlling follicular development, that the estrous cycle in Jilin sika deer is characterized by one, two, or three waves of follicular development after synchronization.

Bioavailability of selenium to residents in a low-selenium area of China.

For 8 wk 5 groups of 10 men each were given 0.5 g/day DL-methionine, 150 micrograms Se/day as sodium selenite with or without methionine or 150 micrograms Se/day as selenomethionine with or without methionine. Twenty subjects received placebo as controls. Initially plasma Se rose more rapidly than RBC Se. Increases in Se levels were significantly greater with selenomethionine than with the selenite supplement. In the placebo and methionine supplemented groups neither plasma nor RBC Se varied significantly over the course of the study. Supplementation with selenium resulted in marked increases in plasma and RBC GSH-Px within 2 and 4 wk, respectively. Plasma and RBC GSH-Px activity did not differ significantly between Se-supplemented groups. These studies suggest that selenomethionine-Se was more effective in raising plasma and RBC Se than was selenite-Se. Methionine supplements may increase the bioavailability of selenium in severely deficient subjects.

Selenium intake and metabolic balance of 10 men from a low selenium area of China.

Selenium intake and urinary and fecal Se excretion of 10 healthy men from a low Se area in China were determined for three consecutive days, in summer, fall, and winter of 1983, and the spring of 1984 while self-selected diets were being consumed. Mean daily Se intake was 8.8 micrograms/day with a range of 2.3-35.5 micrograms/day, and was far below the recommended range of safe and adequate Se intake of 50-200 micrograms Se/day (National Academy of Sciences/National Research Council). Mean urinary and fecal Se outputs were 3.7 and 3.4 micrograms Se/day, respectively. Mean Se balance during this time was +1.8 micrograms Se/day. Apparent absorption of Se approximated 57%. The low Se intake in this area is a cause for concern since the residents of Molimo may be at risk for Se deficiency diseases.

Analysis of microsatellite instability in cervical cancer.

Microsatellite instability was first reported in hereditary nonpolyposis colorectal cancer (HNPCC) as well as other cancers, including endometrial and ovarian cancers. Single base repeat markers of human MSH3 and MSH6 genes were found to precipitate the action of human MSH2. The marker BAT-26 was reported to be a simple, low-cost, and rapid marker for detection replication errors (RER) and the status of colorectal cancers. We analyzed di-nucleotide repeats of the microsatellite markers (D2 S123, D5 S82, D5S299, D10S197, D17S791, D18S34), single base repeat markers (DeltaP3, hMSH3, hMSH6, and TGFbeta-RII), and BAT-26 to evaluate microsatellite instability in cervical cancer. Altogether 80 paired cervical cancers were studied. Our results showed that microsatellite instability is not common in cervical cancer, and the mutation of the single base repeat of mismatch repair (MMR) genes (hMSH3 and hMSH6) is also uncommon. The BAT-26 is not a good marker to detect the RER status of cervical cancer.

Inhibition of the transforming ability of cigarette smoking condensate-treated human fetal lung DNA induced by oltipraz.

Rat-1 cells transfected by genomic DNA of human fetal lung explants treated with 100 micrograms/ml of oltipraz (5-(2-pyrazimyl)-4-methyl-1, 2-dithiol-3-thione) for 14 hr or 100 micrograms/ml of cigarette smoking condensate for 6 hr formed 0 to 8 transformation foci, respectively. If 100 micrograms/ml of oltipraz was added to culture of human fetal lung explants 8 hr prior to the treatment of cigarette smoking condensate, the Rat-1 cells transfected by genomic DNA of human fetal lung explants formed only two foci. In addition, the growth speed of Rat-1 cells transfected by genomic DNA of human fetal lung treated with both oltipraz and cigarette smoking condensate was lower than that transfected by cigarette smoking condensate-treated human fetal lung DNA. Our results indicate that oltipraz can block the irreversible change of human fetal lung DNA caused by cigarette smoking condensate, and the results suggest the possibility of using oltipraz as control in the experimental initiation of human lung carcinogenesis.

Specific overexpression of P53 in sarcoma derived from Rat-1 cells transformed by cigarette smoking condensate-treated human fetal lung DNA.

The p53 protein is highly expressed in fibrosarcoma derived from Rat-1 cells transfected with cigarette smoke condensate-treated human fetal lung DNA but expressed low in the counterparts of nitroso-N-methylurea and dimethyl sulfoxide groups. Our results denoted that a high expression of p53 protein specifically contributes to the initiation of human lung carcinogenesis induced by cigarette smoke condensate. High expression and missense mutation of p53 may probably be a potential biomarker of initiation of human lung carcinogenesis.

Enantioselective esterification of racemic naproxen by lipases in organic solvent.

Enantioselective esterification of naproxen, 2-(6-methoxy-2-naphthyl) propionic acid, was attempted by lipases in nearly anhydrous isooctane. The nature of the alcohol affects the reactivity and enantioselectivity of the lipase from Candida cylindracea. Alcohols containing a trimethylsilyl group are highly reactive and enantioselective to the S-isomer of the acid. An optimal temperature around 65 degrees C and an enzyme concentration less than 7 mg ml-1 were proposed to resolve the racemate, with trimethylsilyl methanol as nucleophile, from a consideration of the enantiomeric ratio, the ester formation, and the resistance of mass transfer for the substrate.

[Effect of molybdenum and tungsten on mammary carcinogenesis in Sprague-Dawley (SD) rats].

Virgin female rats of SD strain were given ad libitum a nutritionally adequate semipurified diet containing 0.026 ppm molybdenum and deionized water (groups 1-3) or the same diet with 150 ppm tungsten and the drinking water (group 4). Group 1 was used as control. After 15 days, all the animals in groups 2-4 received an intravenous injection of N-nitroso-N-methylurea (NMU) 5 mg/100 g body weight. One week after administration of carcinogen, 10 ppm Mo was added to the drinking water in group 3. After 125 days, the mammary cancer incidence in group 4 (79.2%) was significantly higher than that in group 2 (50.0%) or group 3 (45.5%) (P less than 0.05). After 198 days, the average number of mammary cancer in each animal and mammary cancer incidence in group 3 (1.5 and 50.0%) were obviously lower than those in group 2 (2.0 and 90.5%) or group 4 (2.6 and 95.7%). The first palpable mammary tumor was found in the W-supplemented group only 56 days after the injection of NMU, whereas in the W-unsupplemented and Mo-supplemented groups, the first mammary tumor was observed 71 and 85 days after NMU treatment. Of these 181 mammary tumors, 177 (97.8%) were adenocarcinoma or papillary carcinoma, only 4 (2.2%) fibroadenocarcinoma. The results of this study show, for the first time, the inhibitory effect of Mo on the mammary carcinogenesis and promoting effect of Tungsten, an antagonist of molybdenum, on the tumor growth.

[Influence of selenium supplement on cadmium metabolism in human].

38 subjects were randomly divided into 2 groups of 19 each. Group 1 consumed a selenium supplement (150 micrograms/d X 21) and Group 2 received only placebo(glucose). After supplementation, blood Se levels and plasma GSH-Px activities in Group 1 increased from 76 to 100 ng/ml (P less than 0.05) and 0.082 to 0.122 e.u./ml (P less than 0.01) respectively. All measured Se, GSH-Px values in Group 2, and high concentrations of lipid peroxides (greater than 4 nmol/ml as malonaldehyde) in both groups remained approximately the same. Se supplementation resulted in a marked decrease of RBC cadmium (Cd) from 32.3 to 25.4 micrograms/g Hb (P less than 0.001). Urinary and fecal Cd in 5 subjects of each group were analyzed every 4 days, and the results demonstrated that Cd was mainly excreted in feces after Se supplementation. One week after discontinuing of Se treatment, Cd content in urine and feces decreased to control levels. Theoretical evidence for chemoprevention of lung cancer with Se in this area was thus provided.

Diagnostic value of different patient positions during expiratory low-dose thin-layer MDCT for evaluating air trapping after allogeneic hematopoietic stem cell transplantation.

OBJECTIVE: To investigate the diagnostic value of different patient positions during expiratory low-dose thin-layer multidetector computed tomography (MDCT) for detecting air trapping after allogeneic hematopoietic stem cell transplantation (allo-HSCT). PATIENTS AND METHODS: Expiratory lung MDCT scanning was done for 51 post-allo-HSCT patients in both the supine and prone positions to determine if they had air trapping lesions. We assessed the volume fraction of an air trapping region (CT value of ≤700HU at expiratory phase) against the whole lung area with a GE workstation and graded these results. RESULTS: In the supine position, multiple air trapping lesions were found in 16 of 51 patients, which were scattered and mainly distributed in the dorsal sides of both lower lobes. In the prone position, in addition to these 15 patients, air trapping lesions were also found in 11 other patients, which were mainly distributed in the anterior load-bearing area of the lung lower lobes and lobe-connected areas. Compared with that in the supine position, the graded score of air trapping in the prone position was significantly different (p = 0.006). CONCLUSIONS: When performing expiratory thin-layer MDCT for patients with chronic rejection reactions after allo-HSCT, scanning in the prone position should also be performed, not only to more accurately observe lesions, but also for a preliminary evaluation of air trapping severity. This provides a basis for an early clinical diagnosis and treatment.

A nationwide population-based study of the risk of tuberculosis in different solid organ transplantations in Taiwan.

Advances in immunosuppressants for solid organ transplantation (SOT) have improved prevention and treatment of acute rejection as well as reduced the risk of chronic graft damage. However, SOT recipients are prone to developing opportunistic infections because of their long-term immunosuppressed status. Tuberculosis (TB) is a serious opportunistic infection that is associated with increased morbidity and mortality in SOT recipients. However, nationwide population-based research specifically focused on the associations between kidney transplantation (KTx), liver transplantation (LTx), and heart transplantation (HTx), and subsequent TB infection is lacking. This study was conducted using Taiwan's National Health Insurance Research Database, which provided claims data for SOT recipients from 2000 to 2009. Clinical features, treatment, and outcomes were analyzed to determine the risk for TB after SOT. In total, 153 (3.2%) RTx, 19 (1.1%) LTx, and 26 (2.8%) HTx recipients became infected with TB. Compared with non-TB patients, HTx recipients with TB had significantly higher prevalence of older age (P = .037), hypertension (P < .001), and coronary artery disease (CAD) (P = .002). There were also greater percentages of male sex (P = .018), diabetes (P = .029), hyperlipidemia (P = .016), CAD (P < .001), and chronic obstructive pulmonary disease (COPD) (P < .001) in RTx recipients with TB than in those without. In conclusion, posttransplantation TB is a serious problem worldwide, and a high index of suspicion is warranted to ensure early diagnosis and prompt initiation of treatment for TB among SOT patients. In this preliminary study, KTx recipients had a higher risk of TB infection than LTx and HTx recipients, and the high-risk factors were male sex, diabetes, hyperlipidemia, CAD, and COPD. The use of optimal immunosuppressive agents to minimize acute rejection, monitoring of high-risk recipients, prompt diagnosis, and appropriate treatment are required for the management of TB infection in endemic areas such as Taiwan.