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Molecular epidemiological survey of penicillin-resistant Streptococcus pneumoniae from Asia, Europe, and North America.

One hundred penicillin-resistant Streptococcus pneumoniae (PRSP) strains from Asia, Europe, and North America were analyzed using pulsed-field gel electrophoresis; fingerprinting of penicillin binding protein (pbp) genes; and BOX PCR. Results show that six PFGE patterns (three patterns comprising > or = 2 serotypes) were found widespread and accounted for 64 of the 100 PRSP strains.

Anti-Bacterial Agents↗

Pathogen occurrence and antimicrobial resistance trends among urinary tract infection isolates in the Asia-Western Pacific Region: report from the SENTRY Antimicrobial Surveillance Program, 1998-1999.

Worldwide surveillance of antimicrobial resistance among urinary tract pathogens is useful to determine important trends and geographical variation for common Gram-positive and -negative species. The most common causative uropathogens often have intrinsic or acquired resistance mechanisms which include ESBL production among enteric bacilli, multi-drug resistant staphylococci and non-fermentative Gram-negative bacilli such as Pseudomonas aeruginosa and Acinetobacter spp. and vancomycin-resistant Enterococcus spp. This study evaluates pathogen frequency and the resistance rates among urinary tract infection (UTI) pathogens in 14 medical centres in the Asia-Pacific region between 1998 and 1999. The isolates were referred to a central monitor for reference NCCLS broth microdilution testing, identification confirmation and patient demographic analysis. Over 50% of the 958 pathogens were Escherichia coli and Klebsiella spp. followed by P. aeruginosa, Enterococcus spp. and Enterobacter spp. Susceptibility for the three enteric bacilli was high for carbapenems (100%), 'fourth-generation' cephalosporins (cefepime 94.9-98.6%) and amikacin (> or = 93.0%). Beta-lactamase inhibitor compounds were more active against E. coli (piperacillin/tazobactam; > 90% susceptible) than the other two enteric species and all other tested agents had a narrower spectra of activity. The rank order of anti-pseudomonal agents was amikacin (91.5% susceptible)> imipenem > piperacillin/tazobactam > tobramycin > ceftazidime and cefepime (77.4 and 76.4% susceptible, respectively). Susceptibility to quinolones for the P. aeruginosa isolates was only 63.2-67.0%. Only one vancomycin-intermediate Enterococcus spp. (van C phenotype) was detected among the 103 strains tested. Newer fluoroquinolones (gatifloxacin; MIC(50), mg/l) were more potent against enterococci than ciprofloxacin (MIC(50), 2 mg/l) and high-level resistance to aminoglycosides was common (41.7%). The data presented are compared to studies of similar design from other areas which are part of the SENTRY surveillance network.

Anti-Bacterial Agents↗

Male circumcision and penis enhancement in Southeast Asia: matters of pain and pleasure.

This paper reviews some uniquely male sexual health concerns in Southeast Asia, with particular attention to Indonesia. These include various forms of male circumcision, different types of 'penis enhancement' carried out across the region and the use of dry sex by women. These practices appear to be motivated by specific notions of sexual pleasure, based on indigenous gender constructs. Although they may or may not pose a serious public health problem, as markers of misguided or exploitative gender relations they do reveal important aspects of social psychology related to sexuality and sexual health. Male circumcision provides an ideal opportunity to consider male reproductive health needs and risks in Indonesia, Malaysia and the Philippines. Practices that involve cutting the male genitals need to be addressed in ways that stress the importance of sexual relationships based on mutual respect and open communication. Penis implants and inserts and other penis augmentation devices, as well as dry sex practices, are potentially dangerous to both men and women, and of questionable value in bringing pleasure to either, and should be discouraged.

Asia, Southeastern↗

Radiation protection and quality assurance in diagnostic radiology--an IAEA coordinated research project in Asia and eastern Europe.

The International Atomic Energy Agency currently has two parallel Coordinated Research Projects (CRP) running in Asia and Eastern Europe. The main objective of the CRPs is to raise the level of awareness in participating countries about the need for radiation protection for patients undergoing diagnostic radiology procedures. This is to be achieved by first assessing the status quo in a sample of hospitals and X-ray rooms in each participating country. A program of optimization of radiation protection for patients is then introduced by means of a comprehensive quality assurance program and the implementation of appropriate dose reduction methods, taking into account clinical requirements for diagnostically acceptable images. Patient dose assessment and image quality assessment are to be performed both before and after the introduction of the quality assurance program. The CRP is divided into two phases--the first is concerned with conventional radiography, while the second involves fluoroscopy and computed tomography. The CRP is still running, restricting the scope of this paper to a discussion of the approach being taken with the project. The project will be completed in 1998, with analysis to follow.

Asia↗

The final report of the project 'AMINE' the Asia Pacific Medical Information Network using with ETS-V.

Volunteer groups led by the Tokai University School of Medicine and the Telemedicine Society of Japan (a Non-Governmental Organization) worked from 1992 to 1996 to successfully develop a medical network spanning the Asia Pacific region using the ETS-V Satellite. The effort was part of the Partners project, sponsored by the Ministry of Posts and Telecommunications (MPT) and the National Space Development Agency of Japan. From 25 ground stations, links to the telemedical network were installed at medical institutions at no cost. The stations included five in Papua New Guinea, five in Thailand, four in Cambodia, four in Fiji, one in China, and six in Japan. Designed exclusively for medical applications, the network was operated free of charge for users at these sites. While the 16-kHz FM-based (Frequency Modulation-based) network limited applications to the transmission of color still images and audio and packet networking, the project still achieved impressive results. The network allowed liberal and independent use of international communications, local communications, teleconferences, and teleconsultations, without requiring a hub station.

Asia↗

Parent to child transmission of HIV: policy considerations in the Asia-Pacific region.

BACKGROUND: As HIV spreads through many countries in Asia and the Pacific, women of reproductive age are becoming infected and we can expect increasing numbers of infants to be infected. Rapid advances in knowledge about mother to child transmission (MTCT), new findings from intervention studies, recognition of complex ethical implications, and changing attitudes and behaviours combine to create uncertainty for policy makers. OBJECTIVE: Policy makers need sound advice but MTCT and its prevention are complicated topics. We aim to provide an overview of MTCT of HIV and suggest some key points to consider in the allocation of resources. STUDY DESIGN: This is a policy analysis based on review of the literature, consultation with policy makers and researchers, and observations in the context of projects in developing countries. RESULTS: The risk of MTCT is between 15 and 40%, but the use of antiretroviral prophylaxis, elective caesarean section, and replacement of breastfeeding can reduce this to less than 4%. But most infected women in developing countries are unaware that they are HIV-infected and do not yet have access to these 'test-dependent' interventions (interventions based on testing for HIV infection). Population-based strategies that address known influences on the risk of MTCT can be implemented with benefits for the health of both men and women. The test-dependent interventions can have adverse effects as well as benefits, careful preparation is necessary before they are introduced in resource poor settings. The public health impact of test-dependent interventions is limited by difficulties in achieving wide coverage and because they miss women who become infected late in pregnancy or during lactation who have the highest risk of MTCT. CONCLUSIONS: We argue for a broad response to the problems raised by MTCT of HIV that includes gathering information to inform the introduction of strategies that do not depend on testing for HIV infection as well as the test-dependent interventions, community education that reaches men as well as women; strengthening of reproductive health services; and mobilising communities to care for infected women, their families, and orphans.

Adolescent↗

Temperature tolerance of the diamondback moth, Plutella xylostella (Lepidoptera: Yponomeutidae) in tropical and temperate regions of Asia.

Temperature tolerance was investigated in nine populations of Plutella xylostella Linnaeus from tropical and temperate regions of Asia. At all rearing temperatures between 15 and 35 degrees C, no clear differences were observed in female egg production or larval development between tropical and temperate populations. Thus, tropical populations did not show a high-temperature tolerance superior to that of the temperate populations. In all populations, the net reproductive rate (number of new females born per female) largely depended on the number of eggs laid per female, and egg production significantly decreased with increasing temperature (P < 0.001). Larval developmental rate also showed a significant positive correlation with temperature (P < 0.001). Per cent hatch of eggs and larval survival did not show a significant correlation with temperature: hatching was constant between 15 and 32.5 degrees C, but considerably lower at 35 degrees C. Larval survival was similar between 15 and 30 degrees C, appreciably lower at 32.5 degrees C and declined to 0% at 35 degrees C. Based on these results, environmental conditions under which P. xylostella can maintain a high population density throughout the year in tropical and subtropical regions are discussed.

Animals↗

Trimethoprim resistance gene in Shigella dysenteriae 1 isolates obtained from widely scattered locations of Asia.

Trimethoprim-resistance genes of Shigella dysenteriae 1 strains, isolated from a different location of six different countries of Asia over a 5-year period were characterized by using three different dihydrofolate reductase (DHFR) gene probes. The trimethoprim-resistant (TMPR) strains hybridized only with the type I DHFR gene probe by colony hybridization. None of the strains hybridized with types II and III DHFR gene probes. Southern blot experiments using plasmid DNA extracted from these resistant strains indicated that the type I DHFR genes were either on a 20 MDa plasmid or might be located on the chromosome. None of the other plasmids present in S. dysenteriae 1 strains hybridized with the probe. This indicates that the TMP resistance in these S. dysenteriae 1 strains are mediated by type I DHFR enzyme, and there may be transposition of this type I DHFR gene occurs between the 20 MDa plasmid and the chromosome in this serotype of shigella.

Asia↗

Frequency of post-traumatic stress disorder among relief force workers after the tsunami in Asia: do rescuers become victims?

OBJECTIVE: The objective of this study was to evaluate the frequency of posttraumatic stress disorder (PTSD) among the participants of the Turkish Red Crescent Disaster Relief Team after the Tsunami in Asia. METHODS: The Clinician Administered PTSD Scale-1 (CAPS-1) was administered to 33 of 36 team members one month after their Disaster Relief Team duty. Along with the CAPS-1 interview, demographic features, profession, previous professional experience, previous experience with traumatic events and disasters also were recorded. To be classified as present, a symptom must have a frequency score of "1" and an intensity score of "2" at the CAPS-1 interview. For a diagnosis of PTSD, at least one re-experiencing, three avoidance and numbing, and two increased arousal symptoms should be present. RESULTS: The PTSD was diagnosed in eight of the 33 (24.2%) participants. No significant difference was detected in the distribution of PTSD diagnosis according to gender, age, profession, professional experience, previous disaster experience, and/or previous experience of traumatic events. However, the severity of PTSD symptoms as measured by the CAPS-1 score was significantly higher in women, nurses, and participants with <3 previous disaster duty experiences. CONCLUSION: Post-traumatic stress disorder is prevalent within disaster teams and healthcare workers, and measures should be taken to prevent PTSD within this group.

Adult↗

Organic and elemental carbon measurements during ACE-Asia suggest a longer atmospheric lifetime for elemental carbon.

During the ACE-Asia intensive field campaign (March 14-April 20, 2001), PM1.0 organic (OC) and elemental carbon (EC) concentrations were measured onboard the NOAA R/V Ronald H. Brown over the Northwest Pacific Ocean using a semi-continuous automated carbon analyzer downstream of a carbon-impregnated filter denuder. This OC and EC measurement achieved a mean time resolution of about 200 min over the Pacific Ocean, substantially lower than that achieved previously (24 h). The semi-continuous measurements, in which the adsorption artifact was substantially reduced using the denuder, showed good agreement with integrated artifact-corrected measurements made without a denuder. Mean particulate OC and EC concentrations were 0.21 and 0.09, 0.70 and 0.29, 1.00 and 0.27, and 2.43 and 0.66 microg of C m(-3) over the background Pacific Ocean, Asian-influenced Pacific Ocean, offshore of Japan, and Sea of Japan, respectively. On April 11, 90-min average OC and EC concentrations peaked at 4.0 and 1.3 microg of C m(-3), respectively, offshore of Korea over the Sea of Japan. The OC/EC ratio of 3.7 over the Sea of Japan and offshore of Japan was substantially higher than that of 2.5 over the Asian-influenced Pacific Ocean, even though backward air mass trajectories put the "Asian-influenced Pacific Ocean" sample downwind. The OC/EC ratio decreased with increasing time since the air mass encountered the source regions of China, Japan, and Korea. This suggests a longer atmospheric residence time for EC than for OC.

Aerosols↗

Epidemiology of germ cell tumors in Asia of pineal region tumor.

A higher incidence of pineal region tumors in Asian countries compared to Western countries has been reported. In the Brain Tumor Registry of Japan (BTRJ), there were 38,273 primary brain tumors except those of unknown histology (1123 cases) registered in the period between 1984 and 1993, in which 807 pineal region tumors with 104 unknown histology were registered in BTRJ. Of these pineal region tumors, germ cell tumors had the highest frequency, 70.3%, followed by pineal parenchymal tumors, 12.0%; pineocytoma in 7.8% and pineoblastoma in 4.2%. Limited to germ cell tumors, germinoma was 68.0%, then teratoma including malignant teratoma, had the second high frequency, 14.7% in pineal region. While data reported by Allaire et al. and Edwards et al. revealed that the incidence of germinoma was 88.6%, 52.4% of germ cell tumors in pineal region in France and in USA, respectively. Although number of cases is very small, it is suggested that the percentage of germinoma in germ cell tumors in the pineal region might be almost the same in Western countries as in Asian countries, and the occurrence of germ cell tumors in the pineal region was much higher than those in Asia. Age and gender distribution of pineal region tumors indicated that germ cell tumors and pineocytoma showed a high incidence in males and in children. Most of malignant pineal region tumors other than germinomas showed poor prognosis, but recent progress in surgical techniques and effective chemotherapy will improve the prognosis.

Adolescent↗

Molecular analyses of the HGO gene mutations in Turkish alkaptonuria patients suggest that the R58fs mutation originated from central Asia and was spread throughout Europe and Anatolia by human migrations.

Alkaptonuria (AKU) is a rare metabolic disorder of phenylalanine catabolism that is inherited as an autosomal recessive trait. AKU is caused by loss-of-function mutations in the homogentisate 1,2-dioxygenase (HGO) gene. The deficiency of homogentisate 1,2-dioxygenase activity causes homogentisic aciduria, ochronosis and arthritis. We present the first molecular study of the HGO gene in Turkish AKU patients. Seven unrelated AKU families from different regions in Turkey were analysed. Patients in three families were homozygous for the R58fs mutation; another three families were homozygous for the R225H mutation; and one family was homozygous for the G270R mutation. Analysis of nine intragenic HGO polymorphisms showed that the R58fs, R225H and G270R Turkish AKU mutations are associated with specific HGO haplotypes. The comparison with previously reported haplotypes associated with these mutations from other populations revealed that the R225H is a recurrent mutation in Turkey, whereas G270R most likely has a Slovak origin. Most interestingly, these analyses showed that the Turkish R58fs mutation shares an HGO haplotype with the R58fs mutation found in Finland, Slovakia and India, suggesting that R58fs is an old AKU mutation that probably originated in central Asia and spread throughout Europe and Anatolia during human migrations.

Adolescent↗

LIDAR measurements of the vertical aerosol profile and optical depth during the ACE-Asia 2001 IOP, at Gosan, Jeju Island, Korea.

In order to investigate the characteristic of optical properties of Asian dust particles, the atmospheric aerosol vertical profile was measured with the multi-wavelength LIDAR system, at the Gosan super site (33 degrees 17'N, 126 degrees 10'E) in Jeju Island, Korea, during the ACE-Asia intensive observation period, 11 March-4 May 2001. An air mass backward trajectory analysis, using Hysplit-4, was carried out to track the aerosol plume, with high mass loading, from the Chinese desert regions during the period of Asian dust storm events. Vertical atmospheric aerosol profiles on three major Asian dust storm event days, 22 March and 13 and 26 April 2001, have been analyzed. The LIDAR-derived aerosol optical depth values were compared with those measured by a collocated sunphotometer.

Aerosols↗

Analysis of HLA genes and haplotypes in Ainu (from Hokkaido, northern Japan) supports the premise that they descent from Upper Paleolithic populations of East Asia.

The Ainu people are assumed to be the descendants of pre-agricultural native populations of northern Japan, while the majority of population of present-day Japan (Hondo-Japanese) is considered to have descended mainly from post-neolithic migrants. Sequence-level polymorphisms of the HLA-class I (HLA-A and HLA-B) genes were investigated in DNA samples of 50 Ainu living in Hidaka district, Hokkaido. HLA-A*2402, A*0201, A*0206, A*2601, A*3101, B*1501, B*5101, B*3901, and B*3501 were observed at frequencies of more than 10% and most of these have previously been found in populations of not only Asians but also North and South American Indians. A*68012, which has not so far been detected in Hondo-Japanese, was found in the Ainu (3%). On the other hand, several alleles common in Hondo-Japanese, including HLA-A*3303, A*1101, B*4403, B*5201, B*5401, B*4601, and B*0702 were infrequent in Ainu (0-1%). Correspondence and neighbor-joining analyses of various populations based on HLA-A, -B and -DRB1 gene frequencies enabled distinction between Asian, Native South American, European, and African populations. The Ainu, as well as Tlingit (Na-Dene), were placed midway between other East Asians, including Hondo Japanese, and Native South Americans (Amerindians) in the correspondence analysis. Furthermore, several HLA-A-B and HLA-B-DR-DQ haplotypes common in the Ainu, are shared with some Native American populations. These observations strongly suggest a unique place for the Ainu as descendants of some Upper Paleolithic populations of East Asia, from whom some Native Americans may have descended.

Alleles↗

Measures of child and adolescent psychopathology in Asia.

This article reviews measures of child and adolescent psychopathology used in Asian cultures. Sixteen imported measures from the West are identified and their psychometric equivalence across cultures is reviewed; 2 new measures are briefly introduced. Although initial evidence is generally promising, more studies are needed to support their use in Asia. One recently developed Singapore measure cannot be considered genuinely indigenous. Culture-specific items proposed for imported measures could be grouped into existing diagnostic constructs. There is, as yet, no strong theoretical support for culture-bound diagnostic constructs in Asian cultures.

Adolescent↗

The state of psychological assessment in Asia.

The collection of articles in this special section provides a much-needed examination of the state of psychological assessment in various Asian countries or societies. In particular, the contributors review and critique assessment of personality, depression and anxiety, children and adolescents, and neuropsychological evaluation. The reviews cover the use of, and research on, imported measures (Western derived) as well as indigenous measures that were developed locally. The articles make a valuable contribution toward understanding not only the state of assessment in Asia but also larger issues such as the universal applicability of assessment instruments and the cross-cultural validity of models of human behavior.

Adolescent↗

Early Homo and associated artefacts from Asia.

The site of Longgupo Cave was discovered in 1984 and excavated in 1985-1988 by the Institute of Vertebrate Paleontology and Paleoanthropology (Beijing) and the Chongqing National Museum (Sichuan Province). Important finds include very archaic hominid dental fragments, Gigantopithecus teeth and primitive stone tools. Palaeomagnetic analysis and the presence of Ailuropoda microta (pygmy giant panda) suggested that the hominid-bearing levels dated to the earliest Pleistocene. In 1992, joint Chinese-American-Canadian geochronological research corroborated the age using electron spin resonance (ESR) analysis. We report here that the hominid dentition and stone tools from Longgupo Cave are comparable in age and morphology with early representives of the genus Homo (H. habilis and H. ergaster) and the Oldowan technology in East Africa. The Longgupo dentition is demonstrably more primitive than that seen in Asian Homo erectus. Longgupo's diverse and well preserved Plio-Pleistocene fauna of 116 species provide a sensitive contextual base for interpreting the early arrival of the genus Homo in Asia.

Africa, Eastern↗