Neonatal-Onset Chronic Intestinal Pseudo-Obstruction Syndrome with In Utero Urological Manifestation as Megacystis

SummaryObjectiveWe describe a case of neonatal-onset chronic intestinal pseudo-obstruction syndrome (CIPS) with in utero urological manifestation as congenital megacystis. Pitfalls in the interpretation of prenatal sonographic appearance, genetic counseling, and differential diagnosis are discussed.Case ReportA 28-year-old Taiwanese woman, gravida 6, para 3, was referred for further sonographic examination because of a suspected fetal abdominal cyst. Targeted ultrasound at 28 weeks' gestation showed megacystis filling the abdominal cavity. The renal parenchyma appeared normal, and there was no evidence of reflux hydroureteronephrosis. At 38 weeks of gestation, the patient spontaneously delivered a female infant weighing 3,350 g with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. At the age of 12 days, the infant still required Foley catheterization because of voiding difficulty, so reduction cystoplasty was performed. The infant presented with recurrent episodes of intestinal obstruction thereafter and underwent ileostomy and resections of segmental intestine loops (3 times) in the ensuing years. At the age of 6 years, she is orally fed with partial parenteral infusion support, and the voiding act is satisfactory.ConclusionAttention should be given to the prenatal diagnosis of neonatal-onset CIPS when fetal congenital megacystis with unknown etiology is first detected. Whether there is any relationship between the megacystismicrocolon-intestinal-hypoperistalsis syndrome, CIPS, and pure congenital megacystis requires further study

Acoustic cues to tonal contrasts in Mandarin: Implications for cochlear implants

The present study systematically manipulated three acoustic cues-fundamental frequency (f0), amplitude envelope, and duration-to investigate their contributions to tonal contrasts in Mandarin. Simplified stimuli with all possible combinations of these three cues were presented for identification to eight normal-hearing listeners, all native speakers of Mandarin from Taiwan. The f0 information was conveyed either by an f0-controlled sawtooth carrier or a modulated noise so as to compare the performance achievable by a clear indication of voice f0 and what is possible with purely temporal coding of f0. Tone recognition performance with explicit f0 was much better than that with any combination of other acoustic cues (consistently greater than 90% correct compared to 33%-65%; chance is 25%). In the absence of explicit f0, the temporal coding of f0 and amplitude envelope both contributed somewhat to tone recognition, while duration had only a marginal effect. Performance based on these secondary cues varied greatly across listeners. These results explain the relatively poor perception of tone in cochlear implant users, given that cochlear implants currently provide only weak cues to f0, so that users must rely upon the purely temporal (and secondary) features for the perception of tone. (c) 2008 Acoustical Society of America

Simulation and Measurement Analysis of an Integrated Flow Battery Energy-Storage System with Hybrid Wind/Wave Power Generation

This study aims to evaluate the power-system stability and the mitigation of fluctuations in a hybrid wind/wave power-generation system (HWWPGS) under different operating and disturbance conditions. This evaluation is performed by employing a vanadium redox flow battery-based energy storage system (VRFB-ESS) as proposed. The measurement results obtained from a laboratory-scale HWWPGS platform integrated with the VRFB-ESS, operating under specific conditions, are used to develop the laboratory-scale simulation model. The capacity rating of this laboratory-scale simulation model is then enlarged to develop an MW-scale power-system model of the HWWPGS. Both operating characteristics and power-system stability of the MW-scale HWWPGS power system model are evaluated through frequency-domain analysis (based on eigenvalue) and time-domain analysis (based on nonlinear-model simulations) under various operating conditions and disturbance conditions. The simulation results demonstrate that the fluctuations and stability of the studied HWWPGS under different operating and disturbance conditions can be effectively smoothed and stabilized by the proposed VRFB-ESS

The Clinical COPD Questionnaire Correlated with BODE Index-A Cross-Sectional Study

The Global initiative for Chronic Obstructive Lung Disease (GOLD) staging has widely used in the stratification of the severity of COPD, while BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index was proven superior to FEV1 in predicting mortality, exacerbation and disease severity in patients with COPD. Clinical COPD Questionnaire (CCQ), a questionnaire with ten items categorized into three domains (symptoms, functional state and mental state) was developed to measure health status of COPD patients. However, little is known about the relationship between CCQ score and BODE index. We performed a prospective study with the inclusion of 89 patients who were clinically stable after a 6-week-therapy for COPD symptoms comparing their health status assessed by CCQ, BODE index and GOLD staging. We found that the total CCQ score was correlated with BODE score (P < 0.001) and GOLD staging (P < 0.001); of three CCQ domains, the functional status correlated the most with BODE index (rS = 0.670) and GOLD staging (rS = 0.531), followed by symptoms (rS = 0.482; rS = 0.346, respectively), and mental status (rS = 0.340; rS = 0.236, respectively). Our data suggest that CCQ is a reliable and convenient alternative tool to evaluate the severity of COPD

Panax notoginseng Attenuates Bleomycin-Induced Pulmonary Fibrosis in Mice

Panax notoginseng (PN) is a traditional Chinese herb experimentally proven to have anti-inflammatory effects, and it is used clinically for the treatment of atherosclerosis, cerebral infarction, and cerebral ischemia. This study aimed to determine the anti-inflammatory effects of PN against bleomycin-induced pulmonary fibrosis in mice. First, in an in vitro study, culture media containing lipopolysaccharide (LPS) was used to stimulate macrophage cells (RAW 264.7 cell line). TNF-α and IL-6 levels were then determined before and after treatment with PN extract. In an animal model (C57BL/6 mice), a single dose of PN (0.5 mg/kg) was administered orally on Day 2 or Day 7 postbleomycin treatment. The results showed that TNF-α and IL-6 levels increased in the culture media of LPS-stimulated macrophage cells, and this effect was significantly inhibited in a concentration-dependent manner by PN extract. Histopathologic examination revealed that PN administered on Day 7 postbleomycin treatment significantly decreased inflammatory cell infiltrates, fibrosis scores, and TNF-α, TGF-β, IL-1β, and IL-6 levels in bronchoalveolar lavage fluid when compared with PN given on Day 2 postbleomycin treatment. These results suggest that PN administered in the early fibrotic stage can attenuate pulmonary fibrosis in an animal model of idiopathic pulmonary fibrosis

Study of the River Bed Variation after the Baling Check-Dam Failure

The study provides longitudinal and cross-sectional analysis of 8 pieces topography data collected from 1980 to 2011 and bed material particle size based on three investigations conducted between 2008 and 2012. The mainstream topography data in December 2007 shows that the head-cutting distance was about 3 kilometers after the dam broke. The topography data since 2008 displays that river the channel is stable as well. The topography data shows that the longitudinal section in the tributary had a head-cutting distance of about 3 kilometers after the dam broke, and the river channel still is showing adjustment behavior. The scour-and-fill analysis result of the mainstream cross-section shows that the transverse adjust changed significantly upstream from the dam location from 2006-2008. The particle size of the bed material has shown a trend from coarsening to fining according to different sampling points. Therefore, the river bed is still adjusting continuously. Finally, this study is based on a debris flow and sediment laden flow numerical model. The simulation result is fit for river-bed changes after dam-break.2007年石門水庫上游的巴陵防砂壩潰壩事件，導致上游河床沖刷約20公尺，下游最大淤積約10公尺。本文蒐集巴陵防砂壩1980至2011年潰壩前後8次地形測量資料與2008-2012年共進行三次河床質粒徑調查以分析潰壩對於河床變動及河床質粒徑變化的影響。結果顯示，巴陵壩潰壩3個月後河床已逐漸趨於動態平衡，河床質粒徑整體有粗化再細化的趨勢。最後，本文以適用於土石流及高含砂水流的數值模式進行潰壩事件模擬，並利用河床測量成果進行比較

Epidemiological investigation of a case of nosocomial Legionnaires' disease in Taiwan: implications for routine environmental surveillance

AbstractAn epidemiological investigation with Legionella and molecular subtyping was conducted to determine the source of a case of nosocomial Legionnaires' disease (LD) who was hospitalized in three hospitals within a month. Legionella pneumophila serogroup 3, an uncommon serogroup for infection, was isolated from the patient's sputum. Environmental surveillance revealed Legionella colonization in all three hospitals; the patient isolate matched the isolate from the first hospital by molecular typing. Culturing the hospital water supply for Legionella is a pro-active strategy for detection of nosocomial LD even in hospitals experiencing no previous cases

A Potential Antifungal Effect of Chitosan Against Candida albicans Is Mediated via the Inhibition of SAGA Complex Component Expression and the Subsequent Alteration of Cell Surface Integrity

Due to the high incidence of nosocomial Candida albicans infection, the first-line drugs for C. albicans infection have been heavily used, and the emergence of drug-resistant strains has gradually increased. Thus, a new antifungal drug or therapeutic method is needed. Chitosan, a product of chitin deacetylation, is considered to be potentially therapeutic for fungal infections because of its excellent biocompatibility, biodegradability and low toxicity. The biocidal action of chitosan against C. albicans shows great commercial potential, but the exact mechanisms underlying its antimicrobial activity are unclear. To reveal these mechanisms, mutant library screening was performed. ADA2 gene, which encodes a histone acetylation coactivator in the SAGA complex, was identified. Transmission electronic microscopy images showed that the surface of chitosan-treated ada2Δ cells was substantially disrupted and displayed an irregular morphology. Interestingly, the cell wall of ada2Δ cells was significantly thinner than that of wild-type cells, with a thickness similar to that seen in the chitosan-treated wild-type strain. Although ADA2 is required for chitosan tolerance, expression of ADA2 and several Ada2-mediated cell wall-related genes (ALS2, PGA45, and ACE2) and efflux transporter genes (MDR1 and CDR1) were significantly inhibited by chitosan. Furthermore, GCN5 encoding a SAGA complex catalytic subunit was inhibited by chitosan, and gcn5Δ cells exhibited phenotypes comparable to those of ada2Δ cells in response to chitosan and other cell surface-disrupting agents. This study demonstrated that a potential antifungal mechanism of chitosan against C. albicans operates by inhibiting SAGA complex gene expression, which decreases the protection of the cell surface against chitosan