Tuberculosis mortality trends in Taiwan: a resurgence of non-respiratory tuberculosis

SETTING

Population-based study in Taiwan.

OBJECTIVE

To determine the tuberculosis (TB) mortality trends in Taiwan by site and age.

DESIGN

Mortality data for the years 1972 to 2001 were used to calculate the age/site-specific mortality rate (deaths per 100000 population). The year of change in the slope of mortality trends was estimated by iterative piecewise regression analysis.

RESULTS

A levelling off in mortality trends was noted in the late 1980s for all age groups except those aged 75 and above. Except in the age group 25-44 years, the trends in respiratory TB mortality showed a smooth decline. However, for non-respiratory TB mortality, a reversal of the decline was noted for all age groups since 1994-1995. A twofold increase in the number of deaths from central nervous system (CNS) and 'other' TB was noted. A marked increase in the number of deaths from old TB was noted since 1992-1996.

CONCLUSION

TB mortality trends in Taiwan have not declined as expected over the past decade. The slowing down of the decline in TB mortality was mainly attributable to a levelling off of respiratory TB mortality in the age group 25-44 and a reversal of non-respiratory TB mortality trends, especially in the 25-44 and > or =65 years age groups.

Inhibitory effect of seven Allium plants upon three Aspergillus species

Antifungal activity and minimal fungicidal concentration (MFC) of extracts of garlic, bakeri garlic, Chinese leek, Chinese chive, scallion, onion bulb and shallot bulb against Aspergillus niger, A. flavus and A. fumigatus were examined. These Allium plants possessed antifungal activity, with garlic showing the lowest MFC. With the exception of scallion, the inhibitory effect of Allium plants against three Aspergillus species decreased with increasing incubation and heating temperature (P < 0.05). Acetic acid treatments of the extracts increased the inhibitory effect for all plants against three fungi (P < 0.05), and there was no significant difference in this effect among the three pH (2, 4, 6) treatments (P > 0.05) investigated. Acetic acid, at pH = 4, plus heat treatments of the extracts resulted in a greater inhibitory effect for all Allium plants against the three fungi than heat treatment alone (P < 0.05). Treatments of the extracts with NaCl, at concentrations of 0.2 and 0.4 M, did not affect the inhibitory effect of the plant extracts. The combination of acetic acid plus Allium plants was indicated to be an effective way to inhibit fungal growth.

Mosquito cathepsin B-like protease involved in embryonic degradation of vitellin is produced as a latent extraovarian precursor

Here we report identification of a novel member of the thiol protease superfamily in the yellow fever mosquito, Aedes aegypti. It is synthesized and secreted as a latent proenzyme in a sex-, stage-, and tissue-specific manner by the fat body, an insect metabolic tissue, of female mosquitoes during vitellogenesis in response to blood feeding. The secreted, hemolymph form of the enzyme is a large molecule, likely a hexamer, consisting of 44-kDa subunits. The deduced amino acid sequence of this 44-kDa precursor shares high similarity with cathepsin B but not with other mammalian cathepsins. We have named this mosquito enzyme vitellogenic cathepsin B (VCB). VCB decreases to 42 kDa after internalization by oocytes. In mature yolk bodies, VCB is located in the matrix surrounding the crystalline yolk protein, vitellin. At the onset of embryogenesis, VCB is further processed to 33 kDa. The embryo extract containing the 33-kDa VCB is active toward benzoyloxycarbonyl-Arg-Arg-para-nitroanilide, a cathepsin B-specific substrate, and degrades vitellogenin, the vitellin precursor. Both of these enzymatic activities are prevented by trans-epoxysuccinyl-L-leucylamido-(4-guanidino)butane (E-64), a thiol protease inhibitor. Furthermore, addition of the anti-VCB antibody to the embryonic extract prevented cleavage of vitellogenin, strongly indicating that the activated VCB is involved in embryonic degradation of vitellin.

Krukenberg tumor in pregnancy with delivery of a normal baby: a case report

Successful termination of a pregnancy and delivery of a normal infant in a young woman with Krukenberg tumor is reported. This association has rarely been described previously. The persistent gastrointestinal symptoms mimicking the early nausea and vomiting of pregnancy mask the presentation of a tumor in the stomach. Growth of the fetus leading to abdominal distension masks the presence of the metastatic ovarian tumor in the pelvic cavity. Thus, early diagnosis of the tumor may be delayed. We emphasize the importance of differentiation between physiological morning sickness and unusual persistent gastrointestinal symptoms in pregnant women. Persistent unusual gastrointestinal symptoms need careful evaluation by panendoscopic examination.