Intramuscular Hemangioma of the Temporalis Muscle With Incidental Finding of Bilateral Symmetric Calcification of the Basal Ganglia: A Case Report

We report an 11-year-old boy whose brain computed tomography findings incidentally revealed bilateral basal ganglia calcification. He was symptom-free and had no abnormal neurological findings. He was diagnosed with Fahr's disease based on radiological findings and after excluding other etiologies such as infection, metabolic disorders, congenital malformation and malignancies. Most of the reported cases display an autosomal dominant mode of inheritance. Although Fahr's disease is a rare cause of basal ganglia calcification in children, this disease should be considered in children with a family history of neuropsychiatric disorders

Biosynthetic studies of lincomycin A, a thiosugar-containing natural product

The dissertation describes biosynthetic studies of lincomycin A, a thiosugarcontaining natural product. Lincomycin A was isolated from Streptomyces lincolnensis and has been used clinically as an effective antibiotic for more than 30 years. The structure of lincomycin A contains an N-methyl-4-propyl-L-proline moiety and a thiooctose. Although the clinical importance of lincomycin A has led to extensive efforts to optimize the fermentation conditions for its production, how it is biosynthesized, especially the construction of the thiooctose, remains poorly understood. The goal of my thesis research aims to identify the biosynthetic precursors of lincomycin and investigate the mechanism of the transformations involved in the biosynthetic pathway. Based on the results of early feeding experiments and bio-informatic analysis of the biosynthetic gene cluster, a biosynthetic pathway of lincomycin could be proposed. The enzymes predicted to be involved in the biosynthetic pathway were purified in order to examine their functions. Organic synthesis was utilized to construct the proposed sugar substrates and the anticipated products to support the activity and the structural confirmation of the enzymatic products. With this approach, ribose and fructose were found to be the precursors that are assembled in a transaldol condensation reaction catalyzed by LmbR to yield the eight-carbon sugar backbone of lincomycin. The stereochemistry of the enzymatic products was confirmed by the comparison with various synthetic stereoisomers. The later parts of this research focus on the subsequent modifications of the octose precursor. Our studies led to the identification of a key intermediate, guanosine diphosphate-activated octose, which was formed through a kinasephosphatase cascade reaction, catalyzed by LmbP (kinase), LmbK (phosphatase) and LmbO (guanylyltransferase). Further transformations of this GDP-sugar intermediate including epimerization, dehydration and transamination were also demonstrated via the catalysis of enzymes LmbM, LmbL/Z and LmbS, respectively. How the C-1 sulfur is incorporated into the highly decorated GDP-octose is the most intriguing question in the biosynthesis of lincomycin A. Sequence analysis of the lincomycin gene cluster showed the presence of a putative S-glycosyltransferase, which likely catalyzes the displacement of GDP with an appropriate sulfur donor. This proposal has been verified recently by others. In addition, the amide bond formation between the proline moiety and thiooctose was shown to be catalyzed by a protein complex consisted of LmbC, LmbN and LmbD. This process resembles the biosynthesis of nonribosomal peptides. In conclusion, this work unravels the biosynthetic origins of lincomycin A and also characterizes the full sequences of the enzymatic transformations of the octose intermediate. The significance of such biosynthetic studies of glycosylated natural products like lincosamide derivatives is due to the fact that these natural products are bioactive and pharmaceutically useful. Knowing their biosynthetic pathways gives us the opportunity to manipulate the biosynthetic machineries. Modifying the structure of the sugar components holds promise for varying their biological activities. Moreover, the information about the biosynthetic precursors and the intermediates is useful for the optimization of the fermentation conditionChemistr

"An Econometric Analysis of SARS and Avian Flu on International Tourist Arrivals to Asia"

This paper compares the impacts of SARS and human deaths arising from Avian Flu on international tourist arrivals to Asia. The effects of SARS and human deaths from Avian Flu will be compared directly according to human deaths. The nature of the short run and long run relationship is examined empirically by estimating a static line fixed effect model and a difference transformation dynamic model, respectively. Empirical results from the static fixed effect and difference transformation dynamic models are consistent, and indicate that both the short run and long run SARS effect have a more significant impact on international tourist arrivals than does Avian Flu. In addition, the effects of deaths arising from both SARS and Avian Flu suggest that SARS is more important to international tourist arrivals than is Avian Flu. Thus, while Avian Flu is here to stay, its effect is currently not as significant as that of SARS.

A New Seamless Bitstream Switching Scheme for H.264 Video Adaptation with Enhanced Coding Performance

[[abstract]]In this paper, we propose a new seamless bitstream switching scheme to improve the coding performance of H.264 SP-frames for rate adaptation. Our method removes one of the two re-quantization blocks in the SP-frame encoders so as to significantly improve coding performance. The seamless switching property of SP-frames is retained by properly restructuring the primary and secondary switching frame codecs. Experimental results show that our proposed scheme achieves close coding performance to that of regular H.264 P-frames and significantly better performance than that of SP-frames. The proposed method also provides the advantage of using a single secondary switching bitstream for both switching-up and switching-down processes[[fileno]]2030144030014[[department]]電機工程學

BIOMECHANICAL ANALYSIS DURING COUNTERMOVEMENT JUMP IN CHILDREN AND ADULTS

This study was to examine the biomechanical characteristics of children and adults during countermovement jump. Seven children and seven adult males were recruited to the study. A Peak high-speed camera (120Hz) synchronized with a force plate (600Hz) were used to record vertical jumping action. The kinetic parameters were calculated by using inverse dynamic method. Results showed that the children had both immature joint function prior to propulsion and inadequate knee and ankle joints function during propulsion. It is concluded that a lack of form in jumping strategy was performed during vertical jumpings in the children's group in terms of the kinetic methods was performed. This information may be used in following studies about countermovement jump, avoiding some important information needed only by kinematic analysis, it will be more complete to apply kinetic analysis for children movement researches

Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the Elderly

SummaryToday we are faced with an aging society that may develop malnutrition because of dysphagia related to dementia, stroke, and malignancy seen often in the elderly. The preferred form of nutritional supplementation for this group is enteral nutrition, and the most appropriate long-term method is by use of a gastrostomy. Percutaneous endoscopic gastrostomy (PEG) was first introduced in 1980 as an alternative to the traditional operative procedure and rapidly became the preferred procedure. In geriatric patients, the principal indications are neurological dysphagia and malnutrition, related to an underlying disease or anorexia-cachexia in very elderly. PEG is contraindicated in the presence of respiratory distress, previous gastric resection, total esophageal obstruction, coagulation disorders and sepsis in the elderly. Common complications include wound infection, leakage, hemorrhage, and fistula in the general population, but aspiration pneumonia is the major case of death in this group. Risks and complications of PEG must be discussed with patients and their families; and the decision for percutaneous endoscopic gastrostomy insertion should only be made after careful consideration and discussion between managing physicians, allied health professionals, and the patient and/or family. Four ethical principles may help make feeding decisions: beneficence, non-maleficence, autonomy and justice. Attentive long-term care after tube replacement is mandatory. Acceptance of percutaneous endoscopic gastrostomy placement by patients and their families tends to increase once favorable outcomes are offered

Effectiveness of influenza vaccination in patients with end-stage renal disease receiving hemodialysis: a population-based study.

BackgroundLittle is known on the effectiveness of influenza vaccine in ESRD patients. This study compared the incidence of hospitalization, morbidity, and mortality in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD) between cohorts with and without influenza vaccination.MethodsWe used the insurance claims data from 1998 to 2009 in Taiwan to determine the incidence of these events within one year after influenza vaccination in the vaccine (N = 831) and the non-vaccine (N = 3187) cohorts. The vaccine cohort to the non-vaccine cohort incidence rate ratio and hazard ratio (HR) of morbidities and mortality were measured.ResultsThe age-specific analysis showed that the elderly in the vaccine cohort had lower hospitalization rate (100.8 vs. 133.9 per 100 person-years), contributing to an overall HR of 0.81 (95% confidence interval (CI) 0.72-0.90). The vaccine cohort also had an adjusted HR of 0.85 [95% CI 0.75-0.96] for heart disease. The corresponding incidence of pneumonia and influenza was 22.4 versus 17.2 per 100 person-years, but with an adjusted HR of 0.80 (95% CI 0.64-1.02). The vaccine cohort had lowered risks than the non-vaccine cohort for intensive care unit (ICU) admission (adjusted HR 0.20, 95% CI 0.12-0.33) and mortality (adjusted HR 0.50, 95% CI 0.41-0.60). The time-dependent Cox model revealed an overall adjusted HR for mortality of 0.30 (95% CI 0.26-0.35) after counting vaccination for multi-years.ConclusionsESRD patients with HD receiving the influenza vaccination could have reduced risks of pneumonia/influenza and other morbidities, ICU stay, hospitalization and death, particularly for the elderly