Total Structure, Electronic Structure and Catalytic Hydrogenation Activity of Metal-Deficient Chiral Polyhydride Cu57 Nanoclusters

Accurate identifying and in-depth understanding of the defect sites in a working nanomaterial could hinge on establishing specific defect-activity relationships. Yet, atomically precise coinage-metal nanoclusters (NCs) possessing surface vacancy defects are scarce primarily owing to challenges in the synthesis and isolation of such defective NCs. Herein we report a mixed-ligand strategy to synthesizing an intrinsically chiral and metal-deficient copper hydride-rich NC [Cu57 H20 (PET)36 (TPP)4 ]+ (Cu57 H20 ). Its total structure (including hydrides) and electronic structure are well established by combined experimental and computational results. Crystal structure reveals Cu57 H20 features a cube-like Cu8 kernel embedded in a corner-missing metal-ligand shell of Cu49 (PET)36 (TPP)4 . Single Cu vacancy defect site occurs at one corner of the shell, evocative of mono-lacunary polyoxometalates. Theoretical calculations demonstrate that the above-mentioned point vacancy causes one surface hydride exposed as an interfacial capping μ3 -H- , which is accessible in chemical reaction, as proved by deuterated experiment. Moreover, Cu57 H20 shows catalytic activity in the hydrogenation of nitroarene. The success of this work opens the way for the research on well-defined chiral metal-deficient Cu and other metal NCs, including exploring their application in asymmetrical catalysis.

Controllable spontaneous resolution in ultrasmall Cu-Ag bimetallic cluster ion pairs from achiral components

Bimetallic cluster ion pairs containing a quaternary phosphonium and an ultrasmall Cu₂Ag₃ anionic cluster protected by thiolates: (PPh₃R'')[Cu₂Ag₃(SR')₆] (R'SH = cyclohexylthiol (CySH), R'' = Ph, 1; Me, 2; Et, 3; Pr, 4; R'SH = tert-butylthiol (^tBuSH) and R'' = Ph, 5) were reported. Without any chiral source, 1 crystallizes as conglomerate crystals with homochiral packings and spontaneous resolution occurs, while four other clusters 2-5 crystallize as racemic crystals with heterochiral packings. These results indicate that racemic and homochiral crystallization in the cluster system could be controlled through fine-tuning internal achiral structural components.

Observation of a bcc-like framework in polyhydrido copper nanoclusters

Cu is well-known to adopt a face-centered cubic (fcc) structure in the bulk phase. Ligand-stabilized Cu nanoclusters (NCs) with atomically precise structures are an emerging class of nanomaterials. However, it remains a great challenge to have non-fcc structured Cu NCs. In this contribution, we report the syntheses and total structure determination of six 28-nuclearity polyhydrido Cu NCs: [Cu₂₈H₁₆(dppp)₄(RS)₄(CF₃CO₂)₈] (dppp = 1,3-bis(diphenylphosphino)propane, RSH = cyclohexylthiol, 1; tert-butylthiol, 3; and 2-thiophenethiol, 4) and [Cu₂₈H₁₆(dppe)₄(RS)₄(CH₃CO₂)₆Cl₂] (dppe = 1,2-bis(diphenylphosphino)ethane, RSH = (4-isopropyl)thiophenol, 2; 4-tert-butylbenzenethiol, 5; and 4-tert-butylbenzylmercaptan, 6). Their well-defined structures solved by X-ray single crystal diffraction reveal that these 28-Cu NCs are isostructural, and the overall metal framework is arranged as a sandwich structure with a core-shell Cu₂@Cu₁₆ unit held by two Cu₅ fragments. One significant finding is that the organization of 18 Cu atoms in the Cu₂@Cu₁₆ could be regarded as an incomplete and distorted version of 3 × 2 × 2 "cutout" of the body-centered cubic (bcc) bulk phase, which was strikingly different to the fcc structure of bulk Cu. The bcc framework came as a surprise, as no bcc structures have been previously observed in Cu NCs. A comparison with the ideal bcc arrangement of 18 Cu atoms in the bcc lattice suggests that the distortion of the bcc structure results from the insertion of interstitial hydrides. The existence, number, and location of hydrides in these polyhydrido Cu NCs are established by combined experimental and DFT results. These results have significant implications for the development of high-nuclearity Cu hydride NCs with a non-fcc architecture.

New protective ligands for atomically precise silver nanoclusters

Atomically precise silver nanoclusters (NCs) have emerged as a hot topic attracting immense research interest. Protecting ligands are needed for direct capping on cluster surfaces in order to prevent aggregation and to stabilize NCs. It has been demonstrated that protective ligands are critical to determining the sizes, structures and properties of silver NCs. The past decades have witnessed conventionally used organic ligands (thiolates/selenols, phosphines and alkynyls) and inorganic ligands (chalcogens and halogens) being extensively used to passivate NC surfaces. However, only in the most recent years have new-type protecting ligands beyond the conventional ones begun to be introduced in the protecting sphere of new functional silver NCs. The present Frontier article covers the most recent examples of some new protective agents for well-defined silver NCs. We describe four classes of novel silver NCs stabilized by newly-developed surface ligands, namely, nitrogen-donor organic ligands, oxygen-donor inorganic ligands, metalloligands and macrocyclic hosts, paying attention to the synthesis, structures and properties of these silver NCs. This Frontier article will hopefully attract more cluster scientists to explore more freshly ligated atomically precise silver NCs with novel structures and properties in the years ahead. The literature survey in this review is based on publications up to February 2020. Some suggestions for future directions in this field are also given.

P2534Prevalence and risk factors of acquired LQTS among pregnancy: a single-center study

Background

Prolonged QT intervals have been observed in pregnant women, especially those with twin pregnancy, which predisposes them to a high risk of ventricular arrhythmias.

Purpose

To evaluate the prevalence of acquired long QT syndrome (aLQTS) in hospitalized parturient women with single and twin pregnancy and search for potential risk factors.

Methods

Information about age-matched parturient women with single and twin pregnancy were retrospectively collected in our hospital from January 2016 to June 2018. The prevalence of aLQTS was evaluated. The common risk factors for corrected QT (QTc) prolongation were compiled, and multivariable logistic regression analysis was used to evaluate how each factor was related to aLQTS in such population.

Results

Totally 293 parturient women (147 twin pregnancy, 50.17%) were included. The prevalence of aLQTS was 72.70% in all cases, 53.15% in the single pregnancy, 93.20% in the twin pregnancy. The proportion of severely prolonged QTc was 36.18% in all cases, 8.22% in the single pregnancy and 63.95% in the twin pregnancy. The QTc interval was much longer in the twin pregnancy than in the single pregnancy with significant difference. Differences in systolic blood pressure, diastolic blood pressure, total cholesterol, serum uric acid, fetal weight, QRS, RV5+SV1, Tp-Te, Tp-Te/QT have been revealed to be statistically significant between the QTc-prolongation group and the QTc-normal group. The incidence of gestational hypertension and twin pregnancy in the QTc-prolongation group were more prevalent than in the QTc-normal group with significant difference. In the multivariable logistic regression analysis, gestational hypertension, twin pregnancy, increase of diastolic blood pressure, high total cholesterol, high serum uric acid, and heavy fetal weight were identified to be associated with QTc prolongation in parturient women.

Table 1. Risk factors significantly correlated with QTc prolongation in parturient women Index P value OR (95% CI) DBP (mmHg) 0.033* 1.052 (1.004 to 1.101) TC (mmol/L) 0.001** 1.442 (1.165 to 1.785) UA (μmol/L) 0.007** 1.004 (1.001 to 1.008) Fetal weight (g) <0.001** 1.001 (1.001 to 1.001) Hypertention (%) 0.029* 2.561 (1.099 to 5.967) Twin (%) <0.001** 12.618 (6.145 to 25.909)

Conclusion

To our knowledge, this is the first clinical study to evaluate the prevalence of aLQTS between single and twin pregnancy. The prevalence of aLQTS is much higher in the parturient women, particularly in twin pregnancy.

Implementation of a Toffoli gate using an array of coupled cavities in a single step

The Toffoli gate (controlled-controlled-NOT gate) is one typical three-qubit gate, it plus a Hadamard gate form a universal set of gates in quantum computation. We present an efficient method to implement the Toffoli gate using an array of coupled cavities with one three-level atom in each cavity. The large detuning between atoms and classical (quantum) fields plays an important role and the gate is implemented in one-step. The quantum information is encoded into the low-lying states of identical atoms and it is convenient to address qubit individually. Based on the Markovian master equation, it is shown that the scheme to implement the Toffoli gate is robust against the decoherence.

[Intervention of systolic pressure and left ventricular hypertrophy in rats under cold stress]

OBJECTIVE

To investigate the effects of different drugs on systolic blood pressure (SBP) and left ventricular hypertrophy (LVH) in spontaneously hypertensive rats under cold stress.

METHODS

A total of 40 male spontaneously hypertensive rats aged 10 weeks (160~200 g) were given adaptive feeding for 7 days at a temperature of 20±1°C and then randomly divided into control group, cold stress group, metoprolol group, amlodipine group, and benazepril group, with 8 rats in each group. SBP, body weight, and heart rate were measured once a week. After the rats were sacrificed by exsanguination, left ventricular weight (LVW) was measured, and left ventricular weight index (LVWI; mg/g) was calculated. Radioimmunoassay was used to measure the concentrations of endothelin-1 (ET-1) and angiotensin-II (Ang-II) in plasma and myocardium, and the chemical method was used to measure the concentrations of nitric oxide (NO) in plasma and myocardium. RT-PCR was used to measure the mRNA expression of endothelin-A receptor.

RESULTS

Compared with the cold stress group, all medication groups showed significant reductions in SBP since week 5 (P<0.05). The cold stress group showed a significant increase in LVWI compared with the control group (3.38±0.27 mg/g vs 2.89±0.19 mg/g, P<0.05). The amlodipine group showed a significant reduction in LVWI compared with the cold stress group (2.98±0.28 mg/g vs 3.38±0.27 mg/g, P<0.05). The cold stress group showed a significant reduction in plasma NO concentration compared with the control group (104.9±19.5 μmol/L vs 129.3±17.8 μmol/L, P<0.05) ; compared with the cold stress group, all the medication groups showed significant increases in blood NO concentration (P<0.05). The cold stress group showed a significant increase in myocardial ET-1 concentration compared with the control group (6.3±1.5 pg/100 mg vs 4.5±1.9 pg/100 mg, P<0.05) ; compared with the cold stress group, the amlodipine group showed a significant reduction in myocardial ET-1 concentration (4.4±1.0 pg/100 mg vs 6.3±1.5 pg/100 mg, P<0.05). The cold stress group had significantly higher mRNA expression of endothelin-A receptor than the control group (0.86±0.23 vs 0.45±0.16, P<0.01) ; compared with the cold stress group, the amlodipine group showed a significant reduction in the mRNA expression of endothelin-A receptor (0.41±0.14 vs 0.86±0.23, P<0.01).

CONCLUSION

Amlodipine can reduce the increase in SBP and inhibit LVH in spontaneously hypertensive rats under cold stress.

Simple sequence repeat-based analysis of the genetic diversity and population genetic structure of populations of Siniperca chuatsi

In order to provide genetic information for the selective breeding of Siniperca chuatsi, 14 microsatellite DNA loci were used to evaluate the genetic diversity and structure of four farmed populations and one wild population in China. The four cultivated populations were Foshan (FS), Jiangmen (JM), Nanjing (NJ), and Hongze Lake (HZL), and the wild population was collected from the Hubei HuangGang section of the Yangtze River (HG). All five populations exhibited high genetic diversity (HE values of between 0.608 and 0.633); the highest was found in the wild population (HE = 0.633). Genetic differentiation within the populations was relatively low (FST < 0.15); 5.44% of the genetic variation was between the populations and 94.56% was within the populations. The greatest genetic distance was between JM and HG (0.1894), which had the lowest genetic identity (0.8725). NJ and HG had the shortest genetic distance (0.0365) and the highest genetic identity (0.9641). A phylogenetic analysis revealed that FS, JM, and HZL were clustered into one group, while NJ and HG were in another group, suggesting that the wild and NJ populations were closely related. Our results demonstrate that although the farmed populations have maintained a relatively high genetic diversity, they exhibit lower genetic diversity and higher genetic differentiation than the wild population. These results provide evidence that wild resources should be used for breeding, in order to maintain genetic diversity and ensure sustainable S. chuatsi farming.

Application value of multislice spiral computed tomography angiography in the evaluation of renal artery variation in living donor kidney transplantation

This study aims to investigate the accuracy and value of multislice spiral computed tomography (MSCT) angiography in the evaluation of renal artery variation in living donor kidney transplantation. Two hundred seventy-three kidney transplantation donors underwent preoperative MSCT scanning. Two doctors determined the running direction and variation of the renal artery through joint analysis of the preoperative original MSCT image and the recombination image using the blind reading method, compared the imaging results with the intraoperative results, and evaluated the accuracy and application value of MSCT angiography in the evaluation of renal artery variation in living donor kidney transplantation. CT angiography (CTA) can better show the renal artery and its variation. A total of 52 accessory renal arteries were found in the 273 kidney transplant operations, whereas 55 accessory renal arteries were found in preoperative MSCT. Four accessory renal arteries indicated in the MSCT were not found during the operation, and one accessory renal artery found during the operation was not indicated in the preoperative MSCT. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MSCT in the diagnosis of accessory renal arteries were 98.1, 98.2, 92.7, 99.5, and 98.2%, respectively. MSCT angiography can sensitively and accurately show the renal artery and its variation in living donor kidney transplantation, and has important clinical value for the formulation of the operative scheme before the transplantation.

Tetra-μ-acetato-κ4O:O′;κ3O,O′:O;κ3O:O,O′-bis[(acetato-κ2O,O′)(1,10-phenanthroline-κ2N,N′)europium(III)]

In the title centrosymmetric dinuclear complex, [Eu₂(CH₃CO₂)₆(C₁₂H₈N₂)₂], the Eu^III atom is nine-coordinated by two N atoms from a 1,10-phenanthroline ligand and seven O atoms from five acetate ligands (two bidentate, three monodentate). The crystal structure is stabilized by π–π stacking inter­actions between the pyridine and benzene rings of adjacent mol­ecules, with a centroid–centroid distance of 3.829 (2) Å.

Molecular epidemiology of nalidixic acid-resistant campylobacter isolates from humans and poultry by pulsed-field gel electrophoresis and flagellin gene analysis

To investigate the potential of poultry products as the source of human infections associated with quinolone-resistant campylobacters, 140 human and 75 poultry isolates of nalidixic acid-resistant campylobacters were collected between 1996 and 1998, and analysed by two molecular typing methods. By the analysis of restriction fragment length polymorphism of the flagellin gene, 33 distinct patterns were obtained, with 18 of which shared by both human (89%) and poultry (93%) isolates. By the pulsed-field gel electrophoresis of SmaI-restricted macrofragments, 105 different profiles were obtained, and 11 were found in both human (40%) and poultry (23%) isolates. When the two typing methods were combined, 112 unique genotypes were obtained, 11 of which were shared by both populations, including 53 (38%) human isolates and 14 (19%) poultry isolates. Although domestic poultry products are still important sources of the quinolone-resistant campylobacter infections in humans, there are other factors that might contribute to these increasing infections simultaneously. A more stringent policy in the use of antimicrobial agents in food animals can no longer be ignored.

Real-time quantitative PCR analysis for alpha-thalassemia-1 of Southeast Asian type deletion in Taiwan

Since homozygosity of the alpha-thalassemia-1 of Southeast Asian (SEA) type deletion results in hydrops fetalis, a novel protocol based on the real-time quantitating polymerase chain reaction (PCR) technique has been developed to quantify the intact and aberrant alpha-globin genes in adults. The ratio of the normal/SEA-bearing alpha-globin genes was expressed in cycle threshold (C(T)) values. Theoretically, a relative ratio of one to one was anticipated in individuals carrying the SEA type deletion. Twenty-five heterozygous and 20 normal cases were analyzed retrospectively with this protocol. Data showed that the CT values for the intact alpha-globin gene allele and the allele bearing the SEA type deletion in carriers were 28.74+/-1.49 and 26.46+/-2.05, respectively. Therefore, the ratio of normal/SEA type deletion-bearing alpha-globin genes in the carriers was 1.09+/-0.043. No ambiguous results were observed from other less common genotypes associated with alpha-thalassemia, such as the Philippine type deletion. Based on the results, we concluded that this protocol could provide a rapid method to mass screen carriers with alpha-thalassemia-1 of SEA type deletion in this region.

Secular trends in incidence and antimicrobial resistance among clinical isolates of Salmonella at a university hospital in Taiwan, 1983-1999

The incidence and antimicrobial resistance among clinical isolates of salmonella at a university hospital in Taiwan between 1983 and 1999 are summarized in this report. A total of 7986 isolates were analysed. Serogroup B has been the most prevalent over the years, with an apparently continuous decline after 1995. Concordant decrease was also found among S. choleraesuis and S. typhi isolates in recent years. In contrast, the proportion of serogroup D strains increased significantly after 1996. S. typhi remained relatively susceptible to most of the antimicrobial agents examined. For non-typhoidal isolates, antimicrobial resistance to ampicillin (62%), chloramphenicol (67%), and sulfamethoxazole-trimethoprim (37%) was relatively higher than that reported elsewhere. Newer generation cephalosporins and fluoroquinolones remained effective over the years, although emerging resistance to these drugs has been noticed since 1992. A more prudent selection and use of antimicrobial agents, in both humans and animals, and a continuous surveillance of resistance are essential in the future.

Importance of hyperhomocysteinemia as a risk factor for venous thromboembolism in a Taiwanese population. A case-control study

OBJECTIVE

To determine the current status of hyperhomocysteinemia, which is a known risk for venous thrombosis (DVT), in Taiwan.

SUBJECTS

101 unselected patients with a minimum of one episode of deep leg DVT, either initial inpatients or current compliant outpatients in a teaching hospital.

METHODS

Various thrombophilic risks, gene polymorphism and clinical predisposition were evaluated.

RESULTS AND CONCLUSIONS

Patients presented higher fast total plasma homocysteine (hcy) levels than age- and sex-matched controls did (14.1 vs. 9.94 microM). Based on the 95th percentile of control values, hyperhomocysteinemia had a four- to nine-fold risk for DVT, irrespective of clinical predisposition, as well as other thrombophilic risks surveyed. Polymorphism of a metabolizing enzyme, methylenetetrahydrofolate reductase (MTHFR), was not associated with DVT, although homozygous thermolabile mutation tended to have higher plasma hcy levels. Factor V Leiden was absent in analysis of 80 patients. In complete evaluation (hcy, antithrombin (AT), protein S (PS), protein C (PC), lupus anticoagulant (LA), anticardiolipin antibody) of a subset of 83 patients hyperhomocysteinemia was the most prevalent risk (33.7%), with PC or PS deficiencies following (22.9%). Thus, hyperhomocysteinemia is a prominent risk for DVT in Taiwan.

Search for immunomodulatory effects of blood transfusion in gastric cancer patients: flow cytometry of Th1/Th2 cells in peripheral blood

Allogeneic transfusion seems to drive the immune system toward a Th2 response and away from a Th1 response, providing a hypothetical mechanism for transfusion-induced immunomodulation. By means of an intracytoplasmic cytokine detection technique with flow cytometry, it is possible to measure Th1 and Th2 cells derived from peripheral blood mononuclear cells. This study evaluated the presence of transfusion-induced immunomodulation in 11 gastric cancer patients after gastrectomy with perioperative blood transfusion, compared to 11 gastric cancer patients who were treated by gastrectomy without transfusion. Lymphocytes subsets, including CD4 T cells, CD8 T cells, CD4/CD8 Ratio, CD2(+) T cells, CD3(+) T cells, and CD19(+) B cells, were measured in these patients, as well as variables that might suggest transfusion-induced immunomodulation, such as duration of antibiotic use, duration of hospital stay, and total hospital charges. This study also measured changes in the Th1/Th2 ratio. Th1 and Th2 lymphocytes were characterized by measuring intracellular expression of cytokines with flow cytometry. Cells were stimulated with phorbol myristate acetate and ionomycin in the presence of brefeldin-A. The results showed no significant differences in lymphocyte subsets, Th1/Th2 ratio, total hospital charges, or duration of antibiotic utilization between the groups of transfused and non-transfused gastric cancer patients after gastrectomy. The only significant difference was a longer hospital stay for transfused patients (mean 20.5 da) compared to non-transfused patients (mean 16.2 da). The anticipated finding of a Th2 response after blood transfusion was not observed. A larger group of patients may be needed to document such an effect, since many confounding variables affect the morbidity and outcome of surgery in these patients.

Outbreaks of nosocomial bloodstream infections associated with multiresistant Klebsiella pneumoniae in a pediatric intensive care unit

BACKGROUND

Between June and October 1997, and during April 1998, a cluster of nosocomial bloodstream infections (BSIs) associated with Klebsiella pneumoniae was observed in 8 premature neonates from 1 pediatric intensive care unit (TPICU) in a 4000-bed medical center in northern Taiwan. An investigation was conducted to identify the possible reservoirs and mode of transmission.

METHODS

Epidemiologic surveillance and infection control interventions were executed. The environment was checked by submitting several swab samples for microbiological studies. The antibiograms and results from 2 molecular typing methods (pulsed-field gel electrophoresis and infrequent-restriction site polymerase chain reaction) of all bacteremic and environmental isolates of K. pneumoniae were compared.

RESULTS

Totally 39 K. pneumoniae isolates, including 9 from bacteremia, 26 from the environment, and 4 controls, were analyzed. One major pattern was found in 21 isolates, which included 8 bacteremic isolates with identical antibiograms, a single isolate from rectal swab screening, 2 of 8 isolates from hand cultures of medical staff, and 10 of 17 isolates from swabs of sinks in the TPICU. All 21 isolates illustrated identical antibiograms, while the other 18 isolates shared 4 antibiograms and 15 unique patterns.

CONCLUSIONS

The nosocomial BSIs appeared to be an outbreak induced by 1 multiresistant K. pneumoniae strain. The sinks may have acted as reservoirs for this outbreak strain. During washing, splattered water droplets containing the bacterial particles may have contaminated the hands of medical personnel and were then further transmitted to patients.

Non-radioactive Southern hybridization for early diagnosis of alpha-thalassemia with southeast Asian-type deletion in Taiwan

Alpha-thalassemia has been estimated to account for over 60% of hydrops fetalis cases in Taiwan. The most common genotypic lesion found in alpha-thalassemia-1 cases in Taiwan is deletion of a large segment of the alpha-globin gene cluster, termed the Southeast Asian-type deletion (-SEA/; further referred to as SEA-type deletion). Seven chorionic villus samples (CVS) from pregnancies of couples both heterozygous for SEA-type deletion were studied. Non-radioactive Southern-blot hybridization using the dig-alkaline phosphatase detection system was developed to fulfill this purpose. The results were compared with corresponding polymerase chain reaction (PCR) data to elucidate the effectiveness of these two protocols in the diagnosis of the SEA-type deletion. The data showed that of the seven CVS, three demonstrated a distinctive band pattern, indicating their homozygous status of SEA-type deletion, whereas two showed heterozygous patterns, and the other two were free of the deletion. Homozygosity of the deletion was confirmed by Southern-blot hybridization performed on DNA samples extracted from the abortus tissue. However, two of the three cases with SEA-type deletion showed heterozygous PCR results. Maternal cell contamination could be responsible for the artifacts in the PCR results, but the influence due to the contamination is minimal in non-radioactive Southern-blot hybridization. We concluded that PCR is suitable for screening of carrier adults with SEA-type deletion, and non-radioactive Southern hybridization is ideal for early prenatal diagnosis of the SEA-type deletion.

Novel mutations, including a novel G659A missense mutation, of the FUT1 gene are responsible for the para-Bombay phenotype

Para-Bombay phenotype, with an estimated incidence of 1 in 8000 in Taiwanese residents based on serological analysis, is caused by aberrant alpha(1,2)-fucosyltransferase function and hence diminished H-antigen synthesis. In an individual with para-Bombay phenotype, DNA sequencing revealed two missense mutations previously reported C658T mutation and a novel G659A mutation. Haplotype analysis with restriction enzyme digestion showed that the two mutations are located on opposing alleles of the H (FUT1) gene and lead to compound heterozygosity. Since no other known genetic changes were evident, it appears that the new missense mutation, G659A, is deleterious to the alpha(1,2)-fucosyltransferase function encoded by the H (FUT1) gene.

Molecular investigation of two clusters of hospital-acquired bacteraemia caused by multi-resistant Klebsiella pneumoniae using pulsed-field gel electrophoresis and in frequent restriction site PCR. Infection Control Group

Two molecular typing methods, DNA macrorestriction analysis with XbaI resolved by pulsed-field gel electrophoresis (PFGE) and infrequent restriction site PCR (IRS-PCR) assay with adapters designed for XbaI and HhaI restriction sites, were used to investigate two clusters of hospital-acquired bacteraemia associated with multi-resistant Klebsiella pneumoniae which occurred in a paediatric intensive care unit (PICU). A total of 56 K. pneumoniae isolates were analysed. These included 10 bacteraemic isolates from eight patients, 26 isolates obtained during an epidemiological survey, and 20 epidemiologically non-related isolates incorporated as controls. One major pattern was demonstrated in 22 of the 56 isolates analysed. These included nine of the 10 bacteraemic isolates, a single rectal isolate, two hand culture isolates and 10 sink isolates. All of these 22 isolates illustrated identical antibiograms, whilst the other 34 isolates shared six antibiograms and 31 unique patterns by either PFGE or IRS-PCR assay. The two clusters of bacteraemia appeared to be outbreaks induced by the same strain of K. pneumoniae which may have utilized sinks as reservoirs and been transmitted through the hands of medical personnel to patients. IRS-PCR demonstrates concordant results with PFGE analysis in studying the genetic relationships among K. pneumoniae isolates, and serves as an excellent epidemiological tool for this bacterium.

RHD gene polymorphisms among RhD-negative Chinese in Taiwan

BACKGROUND AND OBJECTIVE

The rare occurrence of anti-D-associated hemolytic disease of the newborn among Chinese is attributable in part to the existence of the weak D phenotype Del among apparently RhD-negative individuals. While existing advances in the molecular genetics of the Rh blood group have been noted in recent years, the genomic structure of the Del phenotype has seldom been studied in the literature. We try to explore the genomic structure of the RhD gene among apparently Rh-negative Chinese in Taiwan in this study.

METHODS

Genomic DNA from 230 samples of apparently RhD-negative Chinese was studied using four polymerase chain reaction (PCR)-based RhD typing methods. These PCR methods amplified RHD and RHCE genes at exons 4, 5, 7 and 10. All nucleotides responsible for exofacial amino acid differences between RhD and RhCeEe peptides, including amino acids 169, 170, 172, 223, 226, 233, 238, 350, 353, and 354, were contained in these amplified DNA segments. Southern blot analysis using RHD cDNA fragments as probes was performed.

RESULTS

According to the serological study, 155 samples (67.4%) were genuinely RhD-negative and 75 samples (32.6%) were of the Del phenotype. Successful amplifications for RHD sequences were possible in all 75 Del samples using four PCR methods. Apparently, all Del individuals carried an intact RHD gene. While 145 individuals of 155 genuinely Rh-negative (63.0% of apparently RhD-negative individuals) had total deletion of their RHD genes, 10 individuals (4.3% of apparently RhD-negative individuals) were shown to have a preserved 3' noncoding region of the RHD exon 10 and a gross deletion of RHD exons 4-10.

CONCLUSIONS

Three classes of RhD-negative polymorphisms among Chinese in Taiwan were observed. These included Del with grossly intact RHD and weak RhD expression, genuinely RhD-negative with partial preservation of the RHD gene, and genuinely RhD-negative with total deletion of the RHD gene. A molecular study is warranted to clarify the mechanism responsible for the weak RHD gene expression in Del individuals.

DNA polymorphism of Mycobacterium abscessus analyzed by infrequent-restriction-site polymerase chain reaction

BACKGROUND

Mycobacterium abscessus is an important pathogen that has been increasingly associated with many clinical and nosocomial infections. A reliable molecular typing scheme is essential for the epidemiological study of this rapidly growing mycobacterium. Pulsed-field gel electrophoresis (PFGE), considered to be the gold standard among molecular typing methods, has failed to provide satisfactory results in the molecular typing of this bacterium. A newly developed molecular typing method, infrequent-restriction-site polymerase chain reaction (IRS-PCR), was examined in this study to determine its suitability for fingerprinting M. abscessus isolates.

METHODS

Eight clinical isolates of M. abscessus and two reference strains (M. abscessus ATCC 19977 and M. chelonae ATCC 35749) were studied by DNA macrorestriction analysis with XbaI resolved by PFGE, and IRS-PCR assay with adaptors designed for XbaI and HhaI restriction sites.

RESULTS

By PFGE, different banding patterns were found in two clinical isolates of M. abscessus; the other isolates yielded only broken DNA and could not be assessed. By IRS-PCR, unique patterns were noted for the 10 isolates; the 10 appeared to be genetically different.

CONCLUSION

IRS-PCR may be an efficient substitute for PFGE in analyzing the DNA polymorphism and epidemiology of M. abscessus.

Elevated serum chromogranin A is detectable in patients with carcinomas at advanced disease stages

Chromogranin A (CgA), a marker of neuroendocrine cells and an indicator for neuroendocrine differentiation, is associated with a poor prognosis when detected in tumor tissue, based on immunohistochemical techniques. We sought to determine whether it is possible to detect elevated serum CgA in patients with commonly occurring carcinomas of non-neuroendocrine origin. CgA was measured in both random and serial serum specimens, using a serum CgA assay developed in our laboratory. Elevated levels of serum CgA were detected in patients with carcinoma of the prostate, breast, ovary, pancreas, and colon. Serum CgA levels in patients with all types of carcinoma appeared to parallel the changes of serum dominant tumor markers and were found in sera containing highly elevated tumor markers. Based on these preliminary findings, perhaps we should monitor CgA, in addition to the routinely used tumor markers, during the treatment of patients with carcinomas to determine if CgA is useful as a prognostic marker in carcinomas other than prostatic cancer.

Development of a microplate assay for serum chromogranin A (CgA): establishment of normal reference values and detection of elevated CgA in malignant diseases

Chromogranin A (CgA), a marker for neuroendocrine cells, is associated with poor prognosis when detected by immunohistochemical technique in prostate tumors. We have developed an ELISA on microplates for serum CgA and established the normal reference range. We also attempted to find out whether elevated serum CgA levels could be found in patients with various malignant diseases. Because of non-Gaussian distribution, both medians and 97.5 percentiles of serum CgA levels for men and women of four different age groups were determined. For women, the median and 97.5 percentiles are 20.7 and 63.9 ng/mL for ages 20 to 50, and 32 and 93.8 for 50 to 80 years of age, respectively; for men, they are 27.9 and 78.4 ng/mL for ages 18 to 40 and 41.6 and 92 for 40 to 80 years old, respectively. Elevated serum concentrations of CgA were detectable in patients with prostate cancer not undergoing hormonal treatment, and in patients with various malignant diseases including nonendocrine carcinomas. Most elevated serum CgA levels were associated with sera containing highly elevated serum tumor markers. Drugs targeting neuroendocrine cells should be administered for cancer patients with elevated serum CgA levels.

Different patterns of serum chromogranin A in patients with prostate cancer with and without undergoing hormonal therapy

Elevated serum chromogranin A (CgA) levels have been detected in patients with prostate cancer who have developed resistance to hormonal therapy. We would like to reexamine these cases by using serial specimens to determine whether such elevated levels are also detectable in prostate cancer patients not undergoing hormonal therapy. Serum CgA was measured in both random and serial specimens from prostate cancer patients with and without undergoing hormonal therapy. We found that serum CgA levels became elevated much earlier than did the levels of serum PSA in approximately one-third of prostate cancer patients developing resistance to hormonal therapy. On the other hand, serum CgA levels became elevated at later, more advanced stages of the disease in patients not undergoing hormonal therapy. Elevated serum CgA levels were usually detected in specimens containing highly elevated PSA. The early rise of serum CgA levels provides an early signal allowing a change of therapy to be made before the disease progresses to a fatal stage. Drugs targeting neuroendocrine cells should be considered for prostate cancer patients with elevated serum CgA levels.

Genetic variation at nine STR loci in populations from the Philippines and Thailand living in Taiwan

In order to apply a set of nine STR loci and the amelogenin locus in forensic testing, we have performed a population study on individuals from the Philippines and Thailand living in Taiwan (273 Philippine and 146 Thai individuals were typed by commercially available kits and an automated sequencer). A total of 73 alleles for all systems for both populations could be observed in these two populations. No new intermediate fragments were found. Allele frequencies showed no deviation from Hardy-Weinberg equilibrium. The mean exclusion power (MEP) ranged from 0.327 (TPOX) to 0.706 (FGA), the discriminating power (DP) ranged from 0.790 (TPOX) to 0.963 (FGA) for Philippinos, MEP ranged from 0.247 (TPOX) to 0.723 (FGA), DP ranged from 0.761 (TPOX) to 0.968 (FGA) for Thais, the combined MEP is > 0.9988 and the combined DP is > 0.9999999993 for both Philippinos and Thais.

Subcutaneous panniculitic T-cell lymphoma developing in a child with idiopathic myelofibrosis

PURPOSE

Subcutaneous panniculitic T-cell lymphoma is reported in a child with idiopathic myelofibrosis. Both disease entities are rarely seen in children.

PATIENT AND METHODS

A girl aged 5 years and 9 months had pancytopenia and severe constitutional symptoms. Idiopathic myelofibrosis was subsequently diagnosed.

RESULTS

A transient response was achieved after treatment with a course of high-dose methylprednisolone therapy. However, proptosis and skin nodules developed during tapering of steroid therapy. A computed tomography scan of the orbit also revealed a mass lesion in the right lacrimal gland region. A skin biopsy specimen showed a subcutaneous panniculitic T-cell lymphoma. The clinical course was marked by high fever, profound pancytopenia, massive gastrointestinal bleeding, and severe, recurrent infections. Her condition rapidly deteriorated, and she died from polymicrobial sepsis 4 months after her initial examination.

CONCLUSIONS

Subcutaneous panniculitic T-cell lymphoma is a distinctive clinicopathologic entity that is rarely seen in children. The association of myelofibrosis and peripheral T-cell lymphoma as seen in this has been rarely reported.

Prognostic factors in node-negative breast cancer patients: the experience in Taiwan

BACKGROUND

Adjuvant chemotherapy has improved the length of disease-free survival and overall survival in node-negative breast cancer patients. It has been a common practice to select only the patients with higher rates of recurrence for adjuvant therapy. Therefore, it is essential to define the risk factors in node-negative breast cancer patients.

MATERIALS AND METHODS

Two hundred fifty-five patients with axillary node-negative breast cancers without adjuvant chemotherapy or hormonal therapy at Chang Gung Memorial Hospital between 1981 and 1986 were included in this study. Tissue blocks for DNA flow cytometry study was available in the tumors of 145 patients.

RESULTS

The median follow-up period was 121 months and the percentages of patients with 10 years of disease-free survival (DFS) and overall survival (OS) were 75.1% and 82.2%, respectively. The significant poor prognostic factors for 10 years of OS were a tumor size larger than 3 cm, negative estrogen and progesterone receptor status, and having a non-diploid tumor (p value = 0.0176, 0.048 and 0.016, respectively). The patients with frozen section, high mitotic rate, and Scarff-Blood-Richardson (SBR) grade II and III tumors had a worse prognosis than the others, but this trend did not reach statistical significance. The patients with positive estrogen receptor status had a 10-year disease-free rate (DFR) of 94%, and these with tumors less than 2 cm plus SBR grade I had a 10-year DFR of 92%.

CONCLUSION

The node-negative breast cancer patients with a low risk of recurrence were those who had estrogen receptor positive, tumor less than 2 cm with SBR grade I, and intraductal carcinomas. Adjuvant chemotherapy would be no benefit for these patients.

Bone marrow failure and myelofibrosis in a case of PVP storage disease

"PVP storage disease" is a disorder occurring in patients who have received high molecular weight polyvinylpyrrolidone (PVP), which cannot be excreted from the body. These large polymers deposit in the histiocytes and cause proliferation and infiltration of histiocytes in the reticuloendothelial system. There was usually no significant damage to these organs except that prolonged administration might cause bone destruction, skin lesions, arthritis, and polyneuropathy. We describe a patient who had received a large amount of PVP-containing solution for years. Severe bone marrow failure with extensive infiltration of bone marrow by foamy histiocytes occurred later. In addition, she suffered from multiple pathological fractures with spinal cord compression and arthritis of bilateral knee joints.

Microangiopathic hemolytic anemia as an initial presentation of metastatic cancer of unknown primary origin

Microangiopathic hemolytic anemia (MAHA) is a well-documented but rare complication of disseminated cancer; it usually occurs in the late or terminal stage of cancer. We describe a case of metastatic carcinoma of unknown origin in which MAHA was the initial presentation. A 36-year-old woman came to our hospital with lower back pain and progressive exertional dyspnea for 8 weeks. Hemolytic anemia, thrombocytopenia, and leukoerythroblastosis were found on admission. The peripheral blood smear revealed polychromasia, poikilocytosis, and many schistocytes. Bone marrow biopsy disclosed metastatic carcinoma. After careful workup, we failed to find the primary site of cancer. The anemia and thrombocytopenia responded dramatically to combination chemotherapy with 5-fluorouracil, mitomycin C, and cisplatin. This case indicates that metastatic carcinoma should be included in the differential diagnosis in previously healthy patients with MAHA.

The role of flow cytometry in non-resected cervical carcinoma

Flow cytometry (FCM) has a prognostic value for many malignant neoplasms in terms of treatment response rate and survival. However, its role in non-resected cervical carcinoma remains uncertain. We have collected 96 paraffin-embedded specimens taken from non-resected cervical cancer patients treated by radiotherapy (RT) alone between 1984 and 1986. Our data revealed that FCM has little correlation with patients' age, pathological grade and clinical stage. Ploidy pattern and clinical stage correlate significantly with complete remission (CR) rate (p = 0.001 and 0.03). Most diploid or low-stage tumours (IB to IIA) obtained CR after RT alone. The application of an intravaginal extension electron cone (IVEC) (p = 0.019) and CR status (p = 0.0001) yield significant better overall survival (OS) rates than their alternative groups. The Cox regression model has confirmed these two variables as having an independent influence on OS. We thus conclude that both ploidy pattern and S-phase fraction (SPF) predict neither pre-treatment biological behaviour of the tumours nor overall survival. However, ploidy pattern has an independent influence on CR rate.

Utilization and sources of blood components in Taiwan

A three-year survey program, sponsored by the Department of Health, Taiwan R.O.C., was conducted from 1990 to 1992 to investigate blood utilization and blood sources in Taiwanese hospitals. The survey covered the period from January 1989 to December 1991. The hospitals surveyed included nine to 12 medical centers, 40 to 48 regional hospitals, 148 to 163 community hospitals, and 363 to 451 specialty hospitals. Their respective response rates for three consecutive years were 75.0%, 87.9% and 84.1%. Approximately 86% (for 1988) to 98% (for 1991) of all units transfused in Taiwan were surveyed (unit of blood = 250 ml). Utilization of various blood components, ie, red blood cell (RBC) components, frozen plasma (FP), cryoprecipitate (CRYO) and platelets (PLT), showed a trend of continuous increase. In 1991, 12 medical centers and 48 regional hospitals consumed 81.4% of the RBC components, including whole blood (WB) and packed red blood cells (PRBC), while the remaining 18.6% was consumed by 138 community hospitals and 282 specialty hospitals. The average blood utilization of medical centers was 37,383 units of RBC components, 30,949 units of FP, 6,990 units of CRYO, and 21,353 units of PLT per hospital. Utilization of RBC components was 7,191 units per regional hospital, 1,012 units per community hospital, and 148 units per specialty hospital. In 1991, almost all other components consumed in Taiwan, namely FP, CRYO and PLT, were utilized by medical centers and regional hospitals. WB and PRBC sources showed a drastic decline in paid donation, a modest decrease in hospital blood drawn from voluntary donors and an increasing role of the BLood Donation Association (BDA) in volunteer blood donation.(ABSTRACT TRUNCATED AT 250 WORDS)

Deoxyribonucleic acid flow cytometric study in pheochromocytomas and its correlation with clinical parameters

OBJECTIVES

To study deoxyribonucleic acid flow cytometry (DNA-FC) in pheochromocytomas and its correlation with clinical parameters.

METHODS

Fifty cases of pheochromocytomas of a total of 58 cases were studied for DNA-FC from archival paraffin-embedded tissue blocks and were correlated with clinical parameters (ie, size of tumor, benign or malignant pathologic type, vanillymandelic acid [VMA] level in 24 hour urine, age, sex, duration of symptoms, symptom scores).

RESULTS

A total of 19 cases were diploid while 31 cases (62%) showed DNA aneuploidy with 21 cases tetraploid. Four cases were malignant. All of them were tetraploid. However, among the 46 benign cases, 10 were aneuploid and 17 were tetraploid. All 19 cases with DNA diploidy were benign. The DNA-FC did not correlate with other clinical parameters in our study.

CONCLUSIONS

We confirmed a high incidence of DNA aneuploidy in pheochromocytomas. All malignant pheochromocytomas were tetraploid and all cases with DNA diploidy were benign. Long-term follow-up of all cases, especially those with DNA aneuploidy (including tetraploidy), is mandatory.

Bone marrow necrosis in 38 adult cancer patients

From 1977 to 1990, 40 cases of bone marrow necrosis (BMN) were diagnosed among 10,856 (0.37%) consecutive bone marrow aspirations performed alone or with biopsy. All but two patients had underlying malignancies. Leukemia, nasopharyngeal cancer and cancer of unknown origin were the most common underlying diseases. Severe bone pain and fever were the predominant presenting symptoms. Anemia, schistocytes and leukoerythroblastosis were noted in the peripheral blood smears in 97% (37/38), 72% (22/32), and 66% (23/35) of the patients with cancer and BMN. Malignant cells were found in bone marrow aspirates or biopsy specimens in all but one of the patients. Varied degrees of disseminated intravascular coagulation were demonstrated in all of the 10 patients examined who displayed coagulation status. Four of seven patients with leukemia achieved complete remission after chemotherapy, and the survival time for the complete responders ranged from 10 months to eight years. The outcome of cancer patients with BMN who did not respond to chemotherapy was poor, with a median survival time of six weeks.

Angiosarcoma of the small intestine after radiation therapy: report of a case

A case of angiosarcoma of the small intestine is reported. The patient had a past history of cervical cancer, for which she had received radiotherapy eight years previously. She presented with an acute abdomen, and a distal jejunal perforation was found during emergency surgery. The patient expired due to reperforation of the bowel with peritonitis two months after discharge. The pathology of the resected bowel segment showed evidence of previous radiotherapy and infiltration by angiosarcoma involving all layers of the bowel, which had perforated. Submucosal fibrosis and angioectasia indicative of radiation therapy were also evident. The findings suggest that angiosarcoma of the small intestine may occur at sites of previous radiation therapy and may be causally related.

Apoxesis of primary tracheal tumor. A clinical analysis of 23 cases

During a 17-year period, 23 patients with primary tracheal tumors underwent surgical treatment in the Department of Thoracic Surgery, PUMC Hospital (11 cases of benign tumor of the trachea, 12 cases of low malignancies). Fourteen times of apoxesis were performed in 11 patients with benign tumors who were followed up for an average of 6.3 years. Fifteen operations were performed in 12 cases including local resection of the tracheal wall and tumor in 4, and curettage of tumor plus electric cauterization on the basis in 10. Eight of 9 patients with adenoid cystic carcinoma received postoperative adjuvant irradiation, with a 5-year postoperative survival rate of 75% (6/8) and 3 cases survived over ten years. The desirability of apoxesis and local resection of tracheal tumor is discussed. The authors suggest that these two surgical patterns can be regarded as a simple and effective treatment for patients with primary tracheal tumors.

Detection of beta-thalassemia carrier by direct analysis of beta-globin gene lesions

DNA was prepared from peripheral blood mononuclear cells of 114 Chinese with low erythrocyte mean corpuscular volume and analyzed by allele-specific DNA amplification for the presence of mutant alleles in the beta-globin gene that account for about 90% of beta-thalassemia in Chinese. A total of 9 mutations of the five most frequent mutant alleles were detected in 8 individuals. All mutant sequences were confirmed later by DNA sequencing. However, no mutation of these mutant alleles was detected in the remaining 106 individuals with low erythrocyte mean corpuscular volume including 22 who also had Hb A2 content of 6.0% or more. Our results seem to suggest that the presence of beta-thalassemia allele does not correlate very well with red blood cell indices and that direct DNA analysis by allele-specific DNA amplification is an accurate method to identify beta-thalassemia heterozygotes.

Therapeutic effect of carbon dioxide laser versus single application of trichloroacetic acid for koilocytic squamous papillae

This paper reports the treatment results of 50 symptomatic females who had clinical features of squamous papillae and histologic evidence of koilocytosis. Either a carbon dioxide laser or a single application of trichloroacetic acid (TCA) was used to treat these patients. All of the patients were alternately and prospectively randomized into one of two groups. Twenty-three of the 25 women treated by laser and 10 of the 25 women treated by TCA had resolution of either the symptoms or the vulvar lesions in a follow-up period ranging from six to 22 months. Hence, we were able to control the symptoms and lesions in 92% of the women following initial laser treatment and 40% of the women following a single application of TCA. In addition, cosmetic results were satisfactory, and complications were minimal in the laser-treated group of patients. However, human papillomavirus DNA was still detected three to four weeks after treatment in 24% of the women treated by laser and 64% of the women treated by TCA. Whether they are at a higher risk of recurrence as compared to those without detectable viral DNA remains to be determined.

The phenotype and gene frequencies of human platelet specific antigens among Chinese in Taiwan

Human platelet specific antigens (HPA) were serologically typed among 48 to 567 samples of blood from Chinese in Taiwan by using the mixed passive hemag-glutination method (MPHA). The prevalence found was: HPA-la (P1A1), > 99.9% (48/48); HPA-2b (Koa or Siba), 9.0% (51/567); HPA-3a (Baka), 84.8% (481/567); HPA-4a (Yukb), > 99.9% (567/567); HPA-4b (Yuka), 0.5% (3/567); HPA-5b (Br(a)), 32.6% (185/567); and Nak(a), 98.4% (558/567). The gene frequencies for these antigens were: HPA-la (P1A1), > 0.999; HPA-2b (Koa or Siba), 0.046; HPA-3a (Bak(a)), 0.611; HPA-4a (Yukb), 0.997; HPA-4b (Yuka), 0.003; HPA-5b (Br(a)), 0.179; and Nak(a), 0.874. The distribution of HPA's for Chinese differ from those for Caucasians and for Japanese. When compared to Caucasians, Chinese show a higher prevalence of HPA-la (P1A1), higher prevalence of HPA-5b (Br(a)), lower prevalence of HPA-2b (Koa or Siba) and lower prevalence of HPA-3a (Baka). Both Chinese and Japanese have a very high prevalence rate of HPA-la (P1A1), ie. close to 100%. However, the prevalence of HPA 2-2b (Koa or Siba) and HPA-4b (Yuka) is slightly lower in Chinese than in Japanese; and, the prevalence rate for HPA-3a (Baka) is slightly higher in Chinese than in Japanese.

Exclusion probabilities of red cell antigen systems for Chinese

Little data are available in the literature for Chinese people, regarding genotype frequencies of red cell antigen systems. Furthermore, no recommendations for proper selection of red cell antigen systems for paternity testing have been established for a Chinese population. Consequently, calculating a paternity index is impossible. Blood typing of 336-1919 samples of Taiwanese Chinese was undertaken to determine various red blood cell antigens. Gene frequencies and probabilities of exclusion (PE) for the red cell antigen systems were then analyzed. The distributions of the red cell antigens were quite homogeneous. The incidence of D, s, k, Fya and Lub antigens was high, 99.6%, 99.7%, 100%, 99.8% and 99.4%, respectively. On the contrary, that for the K antigen was very low. The PE for the ABO, Rh, MNSs, Kell, Duffy, Kidd, P, and Lutheran systems was 0.1910, 0.1961, 0.2237, 0.0003, 0.0444, 0.1870, 0.0806, and 0, respectively. The cumulative PE (CPE) using ABO, Rh, MNSs, Kell, Duffy, Kidd, P and Lutheran systems was 0.6394, while CPE for ABO, Rh, MNSs, Duffy, Kidd, and P systems was 0.6394. Thus, it appears that the Kell and Lutheran systems are not suitable for paternity testing because of their low probability of exclusions. Duffy system may also be excluded for its low PE. The CPE for ABO, Rh, MNSs, Kidd and P systems was 0.6226.

Serum hepatitis B virus DNA in hepatitis B virus seropositive and seronegative patients with normal liver function

The presence of hepatitis type B virus (HBV) DNA in serum specimens from 926 apparently healthy people with normal liver functions was determined by polymerase chain reaction; 41.2% of people with positive results for HBV surface antigen (HBsAg) (94 of 228) and 95.2% of people with positive results for HBV e antigen (HBeAg) (60 of 63) were found to have positive results for serum HBV DNA. On the other hand, serum HBV DNA was found in 11.0% (77 of 698) of HBsAg-negative people and in 13% (69 of 530) of those who had positive results for serum antibodies directed against HBsAg. The results seem to suggest that HBV DNA can be found in a significant portion of apparently healthy people with normal liver function who are either seronegative for HBsAg or seropositive for antibodies directed against HBsAg.

Flow cytometric DNA analysis of hepatocellular carcinoma: preliminary report

Flow cytometric DNA analysis was performed in 50 paraffin-embedded specimens of clinical hepatocellular carcinoma (HCC) after hepatic resections. The DNA distribution pattern was classified in two types, diploid and aneuploid, according to the degree of dispersion on the DNA histogram. The major DNA pattern of HCC in this report proved to be aneuploid (78%), although 22% of tumors revealed a diploid pattern. The serum alpha-fetoprotein level exceeded 40 ng/ml in 86.1% of the aneuploid tumors and in 13.9% of the diploid tumors (p less than 0.05). We found no correlation between DNA distribution and hepatitis B surface antigen positivity, the presence of liver cirrhosis or tumor size. Additionally we noted no significant correlation between the DNA pattern and survival rates in patients with HCC who underwent hepatic resection.

Evidence of human papillomavirus deoxyribonucleic acid in vulvar squamous papillomatosis

Squamous papillae of the vulva represent a controversial lesion. Forty-six women with histologically confirmed vulvar squamous papillae and koilocytosis were studied at Chang Gung Memorial Hospital. Vulvar washings were analyzed by the filter in-situ technique using biotin-labeled probes for typing human papillomavirus DNA. Forty of 46 women (87%) were symptomatic. Human papillomavirus (HPV) DNA was detected in 76% (35 of 46) of women, including type 6/11 in 21.7%, type 16/18/31/33 in 45.6%, and both types in 8.6%. Furthermore, intraepithelial neoplasia was found in the epithelium of squamous papillae in two women. This study suggests the potential value of histologic examination and HPV DNA typing in separating anatomic variation from pathologic squamous papillae. We suggest that those squamous papillae with histologic evidence of koilocytosis be designated as squamous papillomatosis.

Laser nephelometric quantitation of protein in urine and cerebrospinal fluid

We describe a rapid method for the routine determination of protein in cerebrospinal fluid (CSF) and in urine using laser nephelometer. The relative light scattering (RLS) resulting from the interaction of trichloroacetic acid (TCA) and protein is linearly related to the concentration of protein from 0.01 to 6.0 g/L. Precision studies indicate that the day-to-day coefficient of variation (CV) for two CSF controls (0.32 and 0.64 g/L) were 6.4% and 4.9%, respectively. The day-to-day CV's for two urine controls (0.39 and 0.84 g/L) were 5.8% and 2.9%, respectively. Correlation studies with a manual spectroturbidimetric method revealed a correlation coefficient of 0.99 for both CSF and urine specimens. The proposed method, which uses a smaller sample size, is fast and provides greater sensitivity at low ranges due to the ability to increase the sensitivity by the laser nephelometer.

Screening for hepatitis B virus in healthy blood donors by molecular DNA hybridization analysis

A DNA molecular hybridization technique employing a purified adw subtype hepatitis B virus (HBV) cloned DNA of 3.2 kilobase pairs as a probe was used to screen for the presence of HBV DNA in blood samples collected from 486 apparently healthy blood donors. Eighteen of 104 (17.3%) hepatitis B surface antigen (HBsAg) carriers and 7 of 382 (1.8%) HBsAg-negative individuals had circulating HBV DNA in their sera. Among the seven individuals who were positive for HBV DNA but negative for HBsAg, three had antibodies against both HBsAg (anti-HBsAg) and hepatitis B core antigen, one had only anti-HBsAg, one had both anti-hepatitis B core antigen and anti-hepatitis B e antigen and two were negative for all the above HBV markers. The results suggest that the absence of HBsAg in otherwise apparently healthy individuals may not be enough to ensure lack of circulating HBV.