bluuebunny/crossref_metadata_2025 huggingface dataset:
A study into the authenticity of the editorship of Lady Zhang Lihua under which Yutai xinyong comes out in the Chen Empire in the period of the Six Southern dynasties
Authors: Peiheng ZHANG
Published: October 2008

Yutai xinyong 玉台新咏 (The Original Poetic Compositions in The Jeweled Palace) is an overwhelmingly important anthology of poetry that was passed down from the period of the Six Southern dynasties (Liuchao 六朝). In the Song dynasty founded by the House of Zhao it was said that the anthology was compiled by Xu Ling 徐陵, and this point of view has thereupon been taken universally since the Yuan and Ming periods. In this article after the “Preface” (“Yutai xinyong xu” 玉台新咏序) by Xu Ling comes under rigorous scrutiny, a reasonable interpretation is brought to light, where it may have been revealed unmistakably in the “Preface” that the anthology was compiled by a beautiful imperial concubine who had basked in the supreme favor with the emperor, and possessed formidable talent. The present author works on the research studies to prove that it is unlikely for the viewpoint implied in the “Preface” to have been an artful pretext for the editorship. And to judge from the matters of the empresses and concubines in the Liang and Chen imperial harem, a valid conclusion follows in the research studies, where Yutai xinyong is most likely to have been edited by Lady Zhang Lihua 张丽华 (?–CE 589), the imperial concubine of the Last Emperor of Chen (Chen houzhu 陈后主) (CE 553–604). And in addition, to centre around the focal point, the close investigations have, in this connection, been pursued into such crucial questions as the editions of the anthology and the accounts written in former times of the anthology, so that further clarification could be given to break down the popular misconception about the editorship of the anthology.
Metal typography, stone lithography and the dissemination of Ming-Qing popular fictions in Shanghai between 1874 and 1911
Authors: Jianguo PAN
Published: October 2008

Based on historical documents concerning reprinted or illustrated editions of Ming-Qing popular fictions and the sequels to some of them, this article presents a study of the widespread use of typographic and lithographic printing in Shanghai between 1874 and 1911 and the dissemination of Ming-Qing popular fictions. The advent and widespread use of typographic and lithographic printing had both positive and negative effects on the dissemination of Ming-Qing popular fictions, which finalized the transformation of Chinese fiction written in the colloquial style from traditional popular fiction to new fiction or modern fiction in the late Qing period.
The traditional and modern conflicts of the literary innovation at the threshold of the 20th century
Authors: Aihe GUAN
Published: October 2008

As the greatest event in the historical development of Chinese literature in the 20th century, May Fourth literary revolution expedites the transition of the Chinese literature from tradition to modernity by advocating the reforms in literary concepts, genres and language. The so-called Tongcheng School which lasts more than two hundred years in the Qing dynasty turns out to be a sacrifice in the old and new conflicts of the literary revolution at the turn of the 20th century. The paper attempts to explore further the conflicts and difficulties during the process of this transition by analyzing the late Tongcheng School and its conflicts with the May Fourth new literature in the hope of deepening the understanding of the literary innovation.
The origin, features and evaluation of the May Fourth new vernacular
Authors: Jiayan YAN
Published: October 2008

The new vernacular, a literary language that narrows the gap between written and oral language, has played a vital role in the past more than four score years since its birth in the May Fourth new literature. However, the evaluation towards the new vernacular is still controversial and uncertain due to the constraints of research documents that can be available or because of the prejudice and stereotyped opinions held by scholars. This paper is written to explore the origin, features and some debates concerning the new vernacular and propose my personal views for the purpose of furthering this study in this field.
The hypotriglyceridemic effect of dietary n−3 FA is associated with increased β‐oxidation and reduced leptin expression
Authors: Ukropec J. , Reseland J. E. , Gasperikova D. , Demcakova E. , Madsen L. , Berge R. K. , Rustan A. C. , Klimes I. , Drevon C. A. , Sebökova E.
Published: October 2008

To study the mechanisms responsible for the hypotriglyceridemic effect of marine oils, we monitored the effects of high dietary intake of n−3 PUFA on hepatic and muscular β‐oxidation, plasma leptin concentration, leptin receptor gene expression, and in vivo insulin action. Two groups of male Wistar rats were fed either a high‐fat diet [28% (w/w) of saturated fat] or a high‐fat diet containing 10% n−3 PUFA and 18% saturated fat for 3 wk. The hypotriglyceridemic effect of n−3 PUFA was accompanied by increased hepatic oxidation of palmitoyl‐CoA (125%, P<0.005) and palmitoyl‐l‐carnitine (480%, P<0.005). These findings were corroborated by raised carnitine palmitoyltransferase‐2 activity (154%, P<0.001) and mRNA levels (91%, P<0.01) as well as by simultaneous elevation of hepatic peroxisomal acyl‐CoA oxidase activity (144%, P<0.01) and mRNA content (82%, P<0.05). In contrast, hepatic carnitine palmitoyltransferase‐1 activity remained unchanged despite a twofold increased mRNA level after n−3 PUFA feeding. Skeletal muscle FA oxidation was less affected by dietary n−3 PUFA, and the stimulatory effect was found only in peroxisomes. Dietary intake of n−3 PUFA was followed by increased acyl‐CoA oxidase activity (48%, P<0.05) and mRNA level (83%, P<0.05) in skeletal muscle. The increased FA oxidation after n−3 PUFA supplementation of the high‐fat diet was accompanied by lower plasma leptin concentration (−38%, P<0.05) and leptin mRNA expression (−66%, P<0.05) in retroperitoneal adipose tissue, and elevated hepatic mRNA level for the leptin receptor Ob‐Ra (140%, P<0.05). Supplementation of the high‐fat diet with n−3 PUFA enhanced in vivo insulin sensitivity, as shown by normalization of the glucose infusion rate during euglycemic hyperinsulinemic clamp.

Our results indicate that the hypotriglyceridemic effect of dietary n−3 PUFA is associated with stimulation of FA oxidation in the liver and to a smaller extent in skeletal muscle. This may ameliorate dyslipidemia, tissue lipid accumulation, and insulin action, in spite of decreased plasma leptin level and leptin mRNA in adipose tissue.
Interactive effects of dietary palm oil concentration and water temperature on lipid digestibility in rainbow trout, Oncorhynchus mykiss
Authors: Ng Wing‐Keong , Campbell Patrick J. , Dick James R. , Bell J. Gordon
Published: October 2008

An experiment was conducted to evaluate the interactive effects of dietary crude palm oil (CPO) concentration and water temperature on lipid and FA digestibility in rainbow trout. Four isolipidic diets with 0, 5, 10, or 20% (w/w) CPO, at the expense of fish oil, were formulated and fed to groups of trout maintained at water temperatures of 7, 10, or 15°C. The apparent digestibility (AD) of the FA, measured using yttrium oxide as an inert market, decreased with increasing chain length and increased with increasing unsaturation within each temperature regimen irrespective of CPO level fed to the fish. PUFA of the n−3 series were preferentially absorbed compared to n−6 PUFA in all diet and temperature treatments. Except for a few minor FA, a significant (P<0.05) interaction between diet and temperature effects on FA digestibility was found. Increasing dietary levels of CPO lead to significant reductions in the AD of saturates and, to a lesser extent, also of the other FA. Lowering water temperature reduced total saturated FA digestibility in trout regardless of CPO level. Based on the lipid class composition of trout feces, this reduction in AD of saturates was due in part to the increasing resistance of dietary TAG to digestion. Increasing CPO level and decreasing water temperature significantly increased TAG content in trout fecal lipids, with saturates constituting more than 60% of the FA composition. Total monoene and PUFA digestibilities were not significantly affected by water temperature in fish fed up to 10% CPO in their diet. The potential impact of reduced lipid and FA digestibility in cold‐water fish fed diets supplemented with high levels of CPO on fish growth performance requires further research.
Lack of stereospecificity in lysophosphatidic acid enantiomer‐induced calcium mobilization in human erythroleukemia cells
Authors: Nilsson Ulrika K. , Andersson Rolf G. G. , Ekeroth Johan , Hallin Elisabeth C. , Kondarsson Peter , Lindberg Jan , Svensson Samuel P. S.
Published: October 2008

Lysophosphatidic acid (LPA) is a lipid mediator that, among several other cellular responses, can stimulate cells to mobilize calcium (Ca2+. LPA is known to activate at least three different subtypes of G protein‐coupled receptors. These receptors can then stimulate different kinds of G proteins. In the present study, LPA and LPA analogs were synthesized from (R)‐ and (S)‐glycidol and used to characterize the ability to stimulate Ca2+ mobilization. The cytosolic Ca2+ concentration ([Ca2+]i) was measured in fura‐2‐acetoxymethylester‐loaded human erythroleukemia (HEL) cells. Furthermore, a reverse transcriptase polymerase chain reaction was used to characterize LPA receptor subtypes expressed in HEL cells. The results show that HEL cells mainly express LPA1 and LPA2, although LPA3 might possibly be expressed as well. Moreover, LPA and its analogs concentration‐dependently increased [Ca2+]i in HEL cells. The response involved both influx of extracellular Ca2+ and release of Ca2+ from intracellular stores. This is the first time the unnatural (S_‐enantiomer of LPA, (S)‐3‐O‐oleoyl‐1‐O‐phosphoryl‐glycerol, has been synthesized and studied according to its ability to activate cells The results indicate that this group of receptors does not discriminate between (R‐ and (S)‐enantiomers of LPA and its analogs. When comparing ether analogs having different hydrocarbon chain lengths, the tetradecyl analog (14 carbons) was found to be the most effective in increasing [Ca2+]i. Pertussis toxin treatment of the HEL cells resulted in an even more efficient Ca2+ mobilization stimulated by LPA and its analogs. Furthermore, at repeated incubation with the same ligand no further increase in [Ca2+]i was obtained. When combining LPA with the ether analogs no suppression of the new Ca2+ signal occurred. All these findings may be of significance in the process of searching for specific agonists and antagonists of the LPA receptor subtypes.
Lipid molarity affects liquid/liquid aroma partitioning and its dynamic release from oil/water emulsions
Authors: Rabe Swen , Krings Ulrich , Zorn Holger , Berger Ralf G.
Published: October 2008

Initial dynamic flavor release from oil/water emulsions containing different TAG phases was studied using a computerized apparatus and thermodesorption GC. A significant influence of lipid molarity on liquid/liquid partitioning and release of some flavor compounds was found. The release of the least hydrophobic compounds was not affected by any type of lipid. Hydrophobic compounds showed a positive correlation between their release and decreasing molarity of the lipid phase, that is, with increasing number of lipid molecules; only the most hydrophobic compounds did not show such a correlation. A strong linear correlation between low‐melting TAG/water partition coefficients and lipid phase molarity was validated by volatile partition data of C6, C11, and C16 alkane/water systems. Lipid phase transition from the liquid to solid state did not affect flavor partitioning and release. Neither experimental nor theoretical octanol/water partition coefficients agreed with experimental TAG/water and alkane/water partition coefficients.
Digalactosyldiacylglycerol is a major glycolipid in floral organs of Petunia hybrida
Authors: Nakamura Yuki , Arimitsu Hitomi , Yamaryo Yoshiki , Awai Koichiro , Masuda Tatsuru , Shimada Hiroshi , Takamiya Ken‐ichiro , Ohta Hiroyuki
Published: October 2008

In higher plants, glycolipids such as monogalactosyldiacylglycerol (MGDG) and digalactosyldiacylglycerol (DGDG) are major components of chloroplast membranes in leaves. A recent study identified an isoform of MGDG synthase that is expressed specifically in floral organs, suggesting a novel function for glycolipids in flowers. To elucidate the localization and developmental changes of glycolipids and their biosynthetic activities in flowers; we carried out a series of analytical studies with Petunia hybrida. The results showed that the biosynthetic activities of galactolipid synthesis, particularly for DGDG, increased during flower development. Among the floral organs, the pistil had the highest galactolipid synthetic activity. Its specific activity for incorporation of UDP‐galactose to yield galactolipids was estimated to be more than twice that of leaves, which are the major site of galactolipid synthesis in plant tissues. Analysis of lipid contents of pistils revealed that they contained higher amounts of galactolipids than other floral organs. Moreover, DGDG was more abundant than MGDG in both pistils and petals. These results show that DGDG is a major glycolipid in floral organs and that DGDG biosynthetic activity is highly upregulated in the pistils and petals of Petunia flowers.
Effects of Rice Bran Oil Enriched with n‐3 PUFA on Liver and Serum Lipids in Rats
Authors: Chopra Rajni , Sambaiah Kari
Published: October 2008

Lipase‐catalyzed interesterification was used to prepare different structured lipids (SL) from rice bran oil (RBO) by replacing some of the fatty acids with α‐linolenic acid (ALA) from linseed oil (LSO) and n‐3 long chain polyunsaturated fatty acids (PUFA) from cod liver oil (CLO). In one SL, the ALA content was 20% whereas in another the long chain n‐3 PUFA content was 10%. Most of the n‐3 PUFA were incorporated into the sn‐1 and sn‐3 positions of triacylglycerol. The influence of SL with RBO rich in ALA and EPA + DHA was studied on various lipid parameters in experimental animals. Rats fed RBO showed a decrease in total serum cholesterol by 10% when compared to groundnut oil (GNO). Similarly structured lipids with CLO and LSO significantly decreased total serum cholesterol by 19 and 22% respectively compared to rice bran oil. The serum TAGs level of rats fed SLs and blended oils were also significantly decreased by 14 and 17% respectively compared to RBO. Feeding of an n‐3 PUFA rich diet resulted in the accumulation of long chain n‐3 PUFA in various tissues and a reduction in the long chain n‐6 PUFA. These studies indicate that the incorporation of ALA and EPA + DHA into RBO can offer health benefits.
Simultaneous Quantification of Plant Glyceroglycolipids Including Sulfoquinovosyldiacylglycerol by HPLC–ELSD with Binary Gradient Elution
Authors: Yunoki Keita , Sato Mayumi , Seki Kazuto , Ohkubo Takeshi , Tanaka Yukihisa , Ohnishi Masao
Published: October 2008

Membrane lipids of photosynthetic organisms consist of glycerophospholipids and glyceroglycolipids. We investigated a method for the simultaneous quantitative analysis of neutral and acidic lipids using HPLC–ELSD, and quantified monogalactosyldiacylglycerol (MGDG), digalactosyldiacylglycerol (DGDG) and sulfoquinovosyldiacylglycerol (SQDG). Ten complex lipid classes were separated with a binary gradient system consisting of chloroform and methanol–acetone–water–acetic acid (30:60:9:1, v/v/v/v) with 0.3% triethylamine (pH 4), and were eluted within 16 min. The contents of SQDG in ten edible plants ranged from 3 to 101 mg/100 g, and were positively correlated to the neutral glyceroglycolipids contents.
Identification of Novel Acetylenic Alcohols and a New Dihydrothiopyranone from the Tropical Sponge Reniochalina sp.
Authors: Lee Hyi‐Seung , Lee Ji Hye , Won Hoshik , Park Song‐Kyu , Kim Hwan Mook , Shin Hee Jae , Park Heung Sik , Sim Chung J. , Kim Hye‐Kyeong
Published: October 2008

Two new acetylenic alcohols (1–2) and a new dihydrothiopyranone (3) were isolated from the tropical sponge Reniochalina sp. Their structures were determined by spectroscopic and chemical methods to be (3R)‐hydroxyoctatriacont‐(4E)‐en‐1‐yne (1), 5‐hydroxyheptatriacont‐(3Z)‐en‐1‐yne (2) and 2‐hexadecyl‐2,3‐dihydrothiopyran‐4‐one (3). The acetylenic alcohol (1) exhibited significant growth inhibitory effect against human tumor cell lines.
The Depressive Effects of 5,8,11‐Eicosatrienoic Acid (20:3n‐9) on Osteoblasts
Authors: Hamazaki Tomohito , Suzuki Nobuo , Widyowati Retno , Miyahara Tatsuro , Kadota Shigetoshi , Ochiai Hiroshi , Hamazaki Kei
Published: October 2008

In cases of essential fatty acid deficiency, 5,8,11‐eicosatrienoic acid (Mead acid, 20:3n‐9) is synthesized from oleic acid as a 20‐carbon analog of arachidonic acid. It was reported that 20:3n‐9 levels were markedly higher in human fetal cartilage than in the muscle, liver and spleen. We, therefore, hypothesized that 20:3n‐9 decreased osteoblastic activity. Goldfish scales were incubated either with 20:3n‐9 or with oleic acid at 15 °C for 6 and 18 h. Both osteoblastic and osteoclastic activities in the scale were assessed by measuring alkaline phosphatase (ALP) and tartrate‐resistant acid phosphatase, respectively. MC3T3‐E1 cells (an osteoblast cell line derived from the mouse) were incubated with 20:3n‐9 or oleic acid at 37 °C for 6 and 18 h. ALP activity in cell lysate was measured. In the case of experiments with scales, 20:3n‐9 (1–100 μM) significantly suppressed osteoblastic activity after 6 and 18 h of incubation, whereas oleic acid did not change this activity. Osteoclastic activity was not affected either by 20:3n‐9 or by oleic acid. In the case with the cell line, osteoblastic activity was again significantly decreased with 20:3n‐9 (10–30 μM) after 6‐h incubation but not after 18 h incubation. The presence of 20:3n‐9 in fetal cartilage may be important for the prevention of calcification in the cartilage. 20:3n‐9 could be applied to some clinical situations where bone formation should be inhibited.
Chemical Quality Evaluation of Damaged Jojoba Seeds (Simmondsia chinensis)
Authors: Gayol María F. , Labuckas Diana O. , Aparicio José , Oberti Juan C. , Grosso Nelson R. , Guzmán Carlos A.
Published: October 2008

The objective of the research was to characterize the quality of damaged and undamaged jojoba seeds. The study was performed on jojoba seeds grown in La Rioja, Argentina. Proximal composition, fatty acid composition, acid value, peroxide value, conjugated dienes and trienes and protein electrophoresis profiles were determined in undamaged (JS) and damaged jojoba seeds (DJS). The fat content (wax) was lower in DJS (39.11%) than in JS (50.82%). The values of acid, peroxide, conjugated dienes and trienes were higher in DJS than in JS. No difference in fatty acid composition was observed between DJS and JS. The protein content was not significantly different between JS and DJS. However, DJS had lower soluble protein values. In the electrophoresis profiles, the band located at 50 kDa disappeared in DJS and the intensity of the band located at 25 kDa decreased. The deterioration process in jojoba kernels significantly affects the chemical quality of their proteins and waxes.
Elevation of Intraocular Pressure After Intravitreal Injection of Triamcinolone Acetonide in Taiwanese Patients
Authors: Chang Yo‐Chen , Wu Wen‐Chuan
Published: October 2008

The purpose of this study was to investigate the incidence and timing of elevation in intraocular pressure (IOP) after intravitreal injection of triamcinolone acetonide (IVTA). This was a retrospective observational case series that included 52 eyes from 52 patients. All patients received intravitreal injection with 4 mg of triamcinolone acetonide. Significant IOP elevation was defined as pressure greater than 21 mmHg. There were 26 males and 26 females included in this study. The mean age was 59.4 years. The mean IOP at baseline and postoperative mean highest IOP were 14.6 mmHg and 21.5 mmHg, respectively. There were 19 (36.5%) patients who experienced significant IOP elevation at a mean of 26.0 days after IVTA. IOP was well‐controlled by topical antiglaucoma medication in 17 of these 19 patients. IOP elevation after intravitreal injection with 4 mg of triamcinolone acetonide is not a rare finding. This phenomenon usually starts approximately 1 month after IVTA. Patients considering this treatment should be fully informed of this known adverse effect.
Immunohistochemical Study of Scrub Typhus: A Report of Two Cases
Authors: Tseng Bo‐Yuan , Yang Hui‐Hua , Liou Ji‐Hung , Chen Li‐Kuang , Hsu Yung‐Hsiang
Published: October 2008

Scrub typhus is a zoonotic disease caused by Orientia tsutsugamushi, which is transmitted by chiggers. The target cells of this rickettsia are poorly defined in humans. Immunohistochemical staining of tissue sections of patients with scrub typhus is helpful in investigating the target cells of this rickettsia in different organs. We studied two autopsy specimens by immunohistochemical staining using a specific antibody against O. tsutsugamushi. Rickettsiae were located in endothelial cells in all of the organs evaluated, namely heart, lung, brain, kidney, appendix and skin, within cardiac muscle cells and renal tubular epithelial cells, and in macrophages located in the lymph node, liver and spleen. In conclusion, O. tsutsugamushi may disseminate into multiple organs through endothelial cells and macrophages, resulting in the development of fatal complications.
Emphysematous Prostatic Abscess Due to Candidiasis: A Case Report
Authors: Juan Yung‐Shun , Huang Chun‐Hsiung , Chang Ko , Wang Chii‐Jye , Chuang Shu‐Mien , Shen Jung‐Tsung , Wu Wen‐Jeng
Published: October 2008

Prostatic abscess is an uncommon condition and clinical diagnosis is difficult. The classical symptoms and signs of prostatic abscess are variable and nonspecific. Here, we report a rare case of emphysematous prostatic abscess due to candidiasis in a 68‐year‐old man with diabetes and liver cirrhosis. The diagnosis was confirmed by pelvic computed tomography (CT) and successfully treated by antibiotics and CT‐guided percutaneous abscess drainage. This case highlights the importance of early and accurate diagnosis of emphysematous prostatic abscess followed by appropriate treatment.
Proximal Tibial Bone Harvesting Under Local Anesthesia Without Intravenous Sedation in the Dental Office: A Case Report
Authors: Chen Chun‐Ming , Chen Pai‐Li , Wu Chung‐Wei , Huang I‐Yueh , Lee Kun‐Tsung
Published: October 2008

Maxillary sinus enlargement often occurs in the maxillary posterior edentulous area and reduces the available bone height for implantation. Therefore, maxillary sinus lift and bone graft procedures are necessary to provide sufficient available bone. Autogenous bone grafting is the best base for implant osseointegration. Recently, tibial bone has been recognized as an alternative extraoral donor site. We present a case in which we used a proximal tibia bone graft for maxillary sinus augmentation under local anesthesia without sedation in the dental office. During a 4‐year postoperative follow‐up, gait was not disturbed and the scar on the donor site remained unremarkable.
The‐1131T > C Polymorphism in the Apolipoprotein A5 Gene is Related to Hypertriglyceridemia in Taiwanese Aborigines
Authors: Huang Meng‐Chuan , Wang Tsu‐Nai , Wang Huan‐Sen , Sung Yi‐Ching , Ko Ying‐Chin , Chiang Hung‐Che
Published: October 2008

The prevalence of hypertriglyceridemia, considered to be an independent risk factor for the development of cardiovascular disease, is high in Taiwanese aborigines. This study was undertaken to examine the effect of the ‐1131T > C polymorphism in the apolipoprotein A5 gene on serum triglyceride levels in female Taiwanese aborigines. This was a cross‐sectional study, and a total of 316 unrelated female Taiwanese aborigines were genotyped at the ‐1131T > C polymorphism in apolipoprotein A5 using the polymerase chain reaction‐restriction fragment length polymorphism method. Serum triglyceride ≥150 mg/dL was defined as the hypertriglyceridemia group and triglyceride < 150 mg/dL was considered to be the control group. The frequency of the minor C allele was significantly higher in the hypertriglyceridemia group (0.53) than in the control group (0.35) (p < 0.001). The frequency of this rare allele was comparable to that in Japanese and Han Chinese, but was higher than that in Caucasians. In a multiple logistic model adjusted for possible confounders, C allele‐containing variants were independently associated with greater risks (CT genotype: OR = 3.28, 95% CI = 1.43–7.56; CC genotype: OR = 5.86, 95% CI = 2.15–15.99) of hyper‐triglyceridemia than the TT genotype (p < 0.01), notably with the CC homozygote exhibiting the greatest risks. The genotype polymorphisms were also associated with serum triglyceride concentrations in a linear fashion (for trend, p < 0.05). Our results indicate that the ‐1131T > C polymorphism of the Apo A5 gene influences serum triglyceride levels in female Taiwanese aborigines, and that differences exist in the frequency of the C allele among people of various ethnicities.
Potential Risk and Protective Factors for In‐Hospital Mortality in Hyperacute Ischemic Stroke Patients
Authors: Li Chien‐Hsun , Khor Gim‐Thean , Chen Chun‐Hung , Huang Poyin , Lin Ruey‐Tay
Published: October 2008

In the era of thrombolytic therapy for hyperacute ischemic stroke, most investigators have focused their attention on the factors influencing mortality and functional outcomes in patients treated with thrombolysis, but very few have focused on these factors among patients not receiving thrombolysis. The aim of this study was to investigate the prognostic factors for mortality in all hyperacute stroke patients with or without thrombolysis. In 2005, we enrolled 101 ischemic stroke patients (43 females, 58 males; mean age, 68 years) who were transported to the emergency department (ED) within 4 hours of symptom onset. The overall in‐hospital mortality rate was 17.8% (18/101). According to t test analysis, age (p = 0.034), time interval from neurologist consultation (p < 0.0001) and ED to ward admission (p = 0.001), Glasgow coma scale (GCS) (p = 0.001), National Institutes of Health Stroke Scale (NIHSS) (p < 0.0001) and the sum of major risk factors of cerebrovascular disease (CVD) (p < 0.0001) were significantly different between mortality and survivor groups. Further χ2 test analysis revealed significant differences in the presenting consciousness disturbance (p = 0.001), place of attack (p = 0.04), and referral transportation (p = 0.008) between these groups. In conclusion, old age, delay between neurologist consultation and ward admission, severity of stroke, and multiple risk factors of CVD are significant risk factors for in‐hospital mortality. Conversely, being free of initial consciousness disturbance, living in an urban area, and having direct transportation to a stroke center are protective factors in survivors. The concept of “brain attack” should be re‐emphasized among ED physicians. The interconnection between stroke centers and emergency medical systems (EMS) should be more tightly built to promote timely management for hyperacute stroke care.
Comparison of Percutaneous Nephrolithotomy and Ureteroscopic Lithotripsy in the Management of Impacted, Large, Proximal Ureteral Stones
Authors: Juan Yung‐Shun , Shen Jung‐Tsung , Li Ching‐Chia , Wang Chii‐Jye , Chuang Shu‐Mien , Huang Chun‐Hsiung , Wu Wen‐Jeng
Published: October 2008

The optimal treatment for large, impacted, proximal ureteral stones remains controversial. We report our experience and compare treatment outcomes in patients with single, impacted, proximal ureteral stones undergoing percutaneous nephrolithotomy (PCNL) and ureteroscopic lithotripsy (URSL). Between January 2005 and January 2006, a total of 53 consecutive patients with solitary, impacted, proximal ureteral stones > 15 mm in diameter who had undergone PCNL or URSL treatments were enrolled in this study. The mean age was 48.5 ± 11.8 years. PCNL and URSL were performed in 22 and 31 patients. Stone burdens in the PCNL and URSL groups were 232.8 ± 113.2 mm2 and 150.3 ± 70.3 mm2, respectively. The efficiency quotient (EQ) for the PCNL and URSL groups was 0.95 and 0.67, respectively. The stone‐free rate at the 1 month follow‐up was 95.4% in the PCNL group and 58% in the URSL group (p < 0.001). Two patients in the PCNL group had blood loss requiring transfusion. Eight patients had stones showing upward migration during the URSL procedure, and these stones were subsequently treated by extracorporeal shock wave lithotripsy and PCNL. For an impacted, proximal ureteral stone > 15 mm in diameter, PCNL had better stone‐free rates and could simultaneously treat coexisting renal stones. However, URSL had the advantages of shorter operative times, shorter postoperative hospital stays, and fewer postoperative complications.
Reflection and Critical Thinking of Humanistic Care in Medical Education
Authors: Shiau Shu‐Jen , Chen Chung‐Hey
Published: October 2008

The purpose of this paper is to stress the importance and learning issues of humanistic care in medical education. This article will elaborate on the following issues: (1) introduction; (2) reflection and critical thinking; (3) humanistic care; (4) core values and teaching strategies in medical education; and (5) learning of life cultivation. Focusing on a specific approach used in humanistic care, it does so for the purpose of allowing the health professional to understand and apply the concepts of humanistic value in their services.
Community‐oriented Curriculum Design for Medical Humanities
Authors: Tsai Duu‐Jian
Published: October 2008

Various recent surveys in Taiwan show physicians' decreasing satisfaction and increasing frustration with their working environment. Their major complaints are stress, long hours, salary, management's disrespect, and lack of trust from patients and society. To move towards restoration of social trust, this paper proposes incorporating the concept of “doctor as mediator in the changing relationship with patients” into the medical curriculum, as will be described in detail. This paper argues that structured community service for medical students facilitates self‐learning, and will not only motivate them to develop good clinical and communication skills, but will also lead them to realize that the essence of medicine must be social trust. These effects have been seen after several years of an experimental curriculum involving more than 800 students. A program using methodology for community empowerment has been realized in a two‐stage curriculum design. Students' self‐assessment of achievements in these courses included further improvement in communication skills, courage to express own position, appropriate planning in advance, management of human resources, ability to deal with limited space and time, and experience of a profoundly moving learning process. In conclusion, community‐based curriculum designs that facilitate self‐learning for medical students should be the key element of reformed humanities education in Taiwan medical schools. Moreover, medical humanities continues to be a key element contributing to ongoing intellectual movements in Taiwan for building civil society and rooting democracy in the community.
Physician Self‐directed Learning and Education
Authors: Tagawa Masami
Published: October 2008

Physicians are expected to be life‐long learners because updated and effective patient care should be provided while medical and clinical knowledge and skills and social requirements for patient care are rapidly changing. Also, qualified clinical competence needs long periods of training and each physician has to continually learn as long as he/she works as a professional. Self‐directed learning is an important factor in adult learning. Medical students' readiness for self‐directed learning is not high, and should be improved by medical school and postgraduate training curricula. Garrison proposed a comprehensive model of self‐directed learning, and it has dimensions of motivation (entering and task), self‐monitoring (responsibility), and self‐management (responsibility). To teach individual self‐directed learning competencies, the following are important: (1) situate learners to experience “real” problems; (2) encourage learners to reflect on their own performance; (3) create an educational atmosphere in clinical training situations. In 2005, a 2‐year mandatory residency program was implemented in Japan, and fewer medical school graduates took residency programs in medical school hospitals and advanced specialty programs provided by medical school departments. Medical school departments provide traditional, but life‐long clinical training opportunities. Under the new residency program, an additional postgraduate and continuing medical training system has to be built up to maintain and confirm a physician's competencies. If physicians do clinical work using a scholarly way of thinking with critical analysis of their own competencies and improvement by reflection, they will become an excellent life‐long learner.
Angiotensinogen and Angiotensin II Type 1 Receptor Gene Polymorphisms and Changes in Repolarization Parameters in Elderly Chinese: A 4‐Year Follow‐up Study
Authors: Lee Ya‐Ting , Chiu Herng‐Chia , Su Ho‐Ming , Voon Wen‐Chol , Lin Tsung‐Hsien , Lai Wen‐Ter , Sheu Sheng‐Hsiung
Published: October 2008

Ventricular repolarization abnormality plays a crucial role in cardiac arrhythmia. Polymorphisms in renin—angiotensin system genes are associated with occurrence of ventricular arrhythmia. We previously demonstrated that subjects carrying the angiotensin converting enzyme (ACE) D‐allele but not the angiotensinogen (AGT) M235T polymorphism had a higher magnitude of QT dispersion (QTd) prolongation. The aim of this study was to test whether the AGT [−6G > A] and angiotensin II type 1 receptor (AT1R) [1166A > C] polymorphisms influence repolarization parameters, including QTd and the peak and end of the T wave interval (Tpe). Of 1,500 people screened, 106 normotensive, non‐diabetic participants aged ≥60 were recruited. ECGs were recorded at baseline and in the second and fourth years. QTd and Tpe were manually calculated. Gene polymorphisms were analyzed by polymerase chain reaction. Mean age was 72.7 ± 4.1 years (range, 62.81 years). QTd and Tpe were significantly prolonged in the second and fourth years (all p < 0.001). Neither gene polymorphism was associated with the magnitudes of QTd and Tpe prolongations. This longitudinal study shows that the AT1R [1166A > C] and AGT [−6G > A] polymorphisms do not influence repolarization parameters in this Chinese population in Taiwan, and so are not suitable markers to identify individuals susceptible to changes in these parameters.
Refractive Status of Mountain Aborigine Schoolchildren in Southern Taiwan
Authors: Hsu Shiuh‐Liang , Chang Cheng‐Hsien , Lai Yu‐Hung , Wen Mei‐Hong , Cheng Kai‐Chun , Ho Chi‐Kung
Published: October 2008

Myopia is an epidemic health problem in Taiwan's schoolchildren. The prevalence of myopia has been increasing yearly, and the average age at which myopia develops has also become younger. Due to insufficient eye care in remote areas, the refractive status of aboriginal schoolchildren has not been well established. In 2005 and 2006, under the sponsorship of the Bureau of Health Promotion, we surveyed the ocular refraction of aboriginal schoolchildren in southern Taiwan mountain townships. From five primary schools in two townships, 371 children aged from 7 to 13 years of age were enrolled in our study. Refractive status under cycloplegia and subjective visual acuity were obtained. The crude prevalence of myopia (<−0.25 diopter [D]) was 25.6%. Although the prevalence increased with age, the annual change in mean refractive status was slower in the schoolchildren of mountain aborigines. The spherical equivalents of 93% of children were within ±1 D. The highest myopia was only −2.50 D. Seven children (1.82%) were refractive amblyopic, for which high hyperopia, astigmatism or anisometropia were the main causes. As aboriginal children were noted to be more myopic in this study than in the past, better eye care should be implemented in these remote areas.
Stress Analysis of Different Angulations of Implant Installation: The Finite Element Method
Authors: Lan Ting‐Hsun , Huang Heng‐Li , Wu Ju‐Hui , Lee Huey‐Er , Wang Chau‐Hsiang
Published: October 2008

Clinically, many implant cases with different angulation over the lower posterior area have been found. The purpose of this study was to analyze the bony stress with different implant tilting during normal masticatory load using the finite element method (FEM), with the hope of discovering a desirable installation of implant. Athree‐dimensional finite element method was employed to analyze the bony stress generated by different angulation designs (15°) of implant bodies. Eight solid models of the mandibular first and second molars were built up and then transferred to a mesh model in FEM (ANSYS) to perform a stress analysis. A simulated load (400N) was applied to the splinted crowns with vertical and horizontal forces. The loading sites were on the central fossa of the splinted crowns. For stress distribution, some designs will be better than a parallel installation. The results suggested that not all implant bodies tilting with the splinted crowns lead to stress concentration.
Prevalence of Obesity and Its Association with Cardiovascular Disease Risk Factors in Adolescent Girls from a College in Central Taiwan
Authors: Lu John Jenn‐Yenn , Jiang Donald Dah‐Shyong , Chou Shieu‐Ming , Hor Chang‐Bor , Lay Jong‐Ding , Wang Hsiang‐Ling
Published: October 2008

Although obesity is associated with important hemodynamic disturbances, little data exists on population‐wide cardiovascular risk factors in obese adolescent girls in Taiwan. This study measured the prevalence of overweight/obesity and related cardiovascular disease risk factors in adolescent females. This was a school‐based survey of a representative sample of 291 females aged 15 and 18 years in a public college in Central Taiwan. The main measures were height, body weight, systolic (SBP) and diastolic blood pressure (DBP), uric acid, cholesterol, triglyceride (TG) and high‐density lipoprotein cholesterol (HDL‐C). Obese (body mass index [BMI]≥25.3) and overweight (22.7≤BMI≤25.2) individuals were combined and labeled as overweight (BMI ≥22.7) to make communication of results clearer. Data gleaned from freshmen's health examinations were analyzed. The prevalence of obesity (BMI≥25.3) was 9.28% and of overweight (BMI≥22.7) was 21.31%. Being overweight was associated with higher SBP, DBP, uric acid and TG, and lower levels of HDL‐C, but was not associated with cholesterol. The 15‐year‐old group showed higher mean levels of uric acid, total cholesterol, TG and HDL‐C than the 18‐year‐old group (p < 0.05). All told, 3.1%, 15.12% and 2.1% of the girls showed abnormally elevated levels of uric acid, cholesterol and TG, respectively. In addition, 5.84% had abnormally lower HDL‐C levels, indicating that interventions should focus on reducing obesity and encouraging proper dietary habits and sufficient exercise, especially in subjects with lower HDL‐C levels and higher levels of cholesterol, TG and uric acid.
Tumor‐Associated Hypercalcemia in a Patient with Paget's Disease
Authors: Hung Hao‐Chang , Ou Horng‐Yih , Huang Jehn‐Shyun , Chuang Ming‐Che , Wu Ta‐Jen
Published: October 2008

Paget's disease of the bone, which is characterized by a focal region of highly exaggerated bone remodeling, is very rare in Asia. Most patients with Paget's disease are asymptomatic; they are normocalcemic and show elevated alkaline phosphatase levels. Hypercalcemia in patients with Paget's disease has rarely been reported. We report one Chinese patient with Paget's disease involving the maxilla bone with an initial presentation of facial cellulitis. Asymptomatic hypercalcemia with a low‐normal intact parathyroid hormone level developed 9 years later. After clodronate treatment, the level of alkaline phosphatase normalized, but the hypercalcemia did not respond adequately. After analysis of tumor markers and imaging studies, a clinical diagnosis of pancreatic adenocarcinoma with multiple hepatic and lung metastases with pleural effusion was made. We suggest that malignancy‐associated hypercalcemia should be considered as one of the causes of hypercalcemia in patients with Paget's disease.
Renal Collecting Duct Carcinoma and Concomitant Bladder Urothelial Carcinoma: A Case Report
Authors: Hsiao Hsi‐Lin , Yeh Hsin‐Chih , Chang Tu‐Hao , Ke Hung‐Lung , Lin Han‐Ching , Wu Wen‐Jeng , Huang Chun‐Hsiung , Lee Yung‐Chin
Published: October 2008

The simultaneous occurrence of renal collecting duct (Bellini duct) carcinoma and bladder urothelial carcinoma is very rare. A 68‐year‐old female patient with bladder urothelial carcinoma first received transurethral resection of the tumor. Left side nephrouretectomy and transurethral resection of the intramural ureter were performed 8 months later under the diagnosis of concomitant renal pelvic urothelial carcinoma. However, the final pathologic examination revealed collecting duct carcinoma. The patient received systemic chemotherapy after surgery, but distant metastasis was noted 6 months later. Here, we report a rare case of combined renal collecting duct carcinoma and bladder urothelial carcinoma confirmed by pathologic examination and immunohistochemical staining.
Host plant influence on susceptibility of Bemisia tabaci (Hemiptera: Aleyrodidae) to insecticides
Authors: Castle S.J. , Prabhaker N. , Henneberry T.J. , Toscano N.C.
Published: October 2008

A resistance monitoring program conducted for the polyphagous whitefly, Bemisia tabaci (Gennadius), in Imperial Valley, CA, USA generated a large set of LC50s for adults collected from broccoli, cantaloupe and cotton crops over a four-year period. A vial bioassay and, subsequently, a yellow-sticky card bioassay produced similar temporal profiles of relative susceptibilities to the pyrethroid insecticide bifenthrin. Both bioassays revealed that whiteflies collected from broccoli were significantly less susceptible to bifenthrin compared to the other two crops. A similar finding was observed for endosulfan and the mixture of bifenthrin+endosulfan in the yellow-sticky card bioassay. The possibility that seasonal differences contributed to the observed differences in susceptibility provided the impetus to conduct a reciprocal transfer experiment using broccoli (or kale) and cantaloupe grown simultaneously in the field and greenhouse. Whitefly adults collected from an organic farm over three consecutive weeks had significantly higher LC50s on kale than those collected the same day on cantaloupe. After culturing in the greenhouse on broccoli or cantaloupe and testing again, LC50s remained significantly higher on broccoli after one week and again at the F1 generation. In contrast, whiteflies originating on kale in the field and transferred to cantaloupes in the greenhouse had significantly reduced LC50s at the F1 generation. When tested against the bifenthrin+endosulfan mixture, significantly higher LC50s were generated for whiteflies reared on broccoli in the greenhouse at one week and the F1 compared to the field source from cantaloupes. The consistently higher LC50s for whiteflies on broccoli and other Brassica spp. crops, compared to cantaloupes or cotton, point to statistically significant host-plant influences that are expressed in both field-collected and greenhouse-reared populations of whiteflies.
Reproductive strategy of the Nearctic leafhopper Scaphoideus titanus Ball (Hemiptera: Cicadellidae)
Authors: Mazzoni Valerio , Prešern Janez , Lucchi Andrea , Virant-Doberlet Meta
Published: October 2008

Mating behaviour of Scaphoideus titanus Ball, the vector of the grapevine disease Flavescence dorée, was investigated in order to determine the role of substrate-borne vibrational signals in intra-specific communication and pair formation. Vibrational signals were recorded from grapevine leaves with a laser vibrometer. Signalling activity of single males changed throughout the day and the peak in activity was associated with twilight and early night when ‘call and fly’ behaviour was observed. Pair formation began with the spontaneous emission of male signals. The male calling signal consisted of a single series of pulses, partially accompanied with a ‘rumble’. The male courtship phrase consisted of four consecutive sections characterized by two sound elements, pulse and ‘buzz’. Female vibrational signals were emitted only in response to male signals. The female response was a single pulse that closely resembled male pulses and was inserted between pulses within the male signals. All recorded vibrational signals of S. titanus have a dominant frequency below 900 Hz. A unique feature of vibrational communication in S. titanus is well-developed intrasexual competition; males may use alternative tactics, in the form of disturbance signals, or silently approach duetting females (satellite behaviour). While the male-female duet appears to be essential for successful localization of females and copulation, it is also vulnerable to, and easily disrupted by, alternative tactics like masking.
Heritability of human hookworm infection in Papua New Guinea
Authors: BREITLING L. PH. , WILSON A. J. , RAIKO A. , LAGOG M. , SIBA P. , SHAW M.-A. , QUINNELL R. J.
Published: October 2008

Hookworms infect approximately 740 million humans worldwide and are an important cause of morbidity. The present study examines the role of additive genetic effects in determining the intensity of hookworm infection in humans, and whether these effects vary according to the sex of the host. Parasitological and epidemiological data for a population of 704 subjects in Papua New Guinea were used in variance components analysis. The ‘narrow-sense’ heritability of hookworm infection was estimated as 0·15±0·04 (P<0·001), and remained significant when controlling for shared environmental (household) effects. Allowing the variance components to vary between the sexes of the human host consistently revealed larger additive genetic effects in females than in males, reflected by heritabilities of 0·18 in females and 0·08 in males in a conservative model. Household effects were also higher in females than males, although the overall household effect was not significant. The results indicate that additive genetic effects are an important determinant of the intensity of human hookworm infection in this population. However, despite similar mean and variance of intensity in each sex, the factors responsible for generating variation in intensity differ markedly between males and females.
A phylogeny of members of the family Taeniidae based on the mitochondrial cox1 and nad1 gene data
Authors: LAVIKAINEN A. , HAUKISALMI V. , LEHTINEN M. J. , HENTTONEN H. , OKSANEN A. , MERI S.
Published: October 2008

The cestode family Taeniidae consists of 2 genera, Taenia and Echinococcus, which both have been the focus of intensive taxonomic and epidemiological studies because of their zoonotic importance. However, a comprehensive molecular phylogeny of this family has yet to be reconstructed. In this study, 54 isolates representing 9 Taenia species were characterized using DNA sequences in the mitochondrial cytochrome c oxidase subunit 1 (cox1) and NADH dehydrogenase subunit 1 (nad1) genes. Phylogenetic relationships within the family Taeniidae were inferred by combining cox1 and nad1 sequence data of the present and previous studies. In the phylogenetic analysis, the genus Echinococcus was shown to be monophyletic, but Taenia proved to be paraphyletic due to the position of T. mustelae as a probable sister taxon of Echinococcus. This indicates that T. mustelae should form a genus of its own. Taenia ovis krabbei was placed distant from T. ovis ovis, as a sister taxon of T. multiceps, supporting its recognition as a distinct species, T. krabbei. High intraspecific sequence variation within both T. polyacantha and T. taeniaeformis suggests the existence of cryptic sister species.