From January 1987 through December 1998, Penicillium marneffei infection (23 patients) or colonization (1 patient) was diagnosed in a total of 24 patients in Taiwan. Of these 24 patients, 16 (67%) had AIDS and 20 (83%) had disseminated P. marneffei infection. The majority (63%) of the infections were considered indigenous. The number of cases has increased markedly in recent years, with 17 of the 24 cases diagnosed from 1996 through 1998. Twenty preserved isolates of P. marneffei, recovered from 11 patients treated at National Taiwan University Hospital during the period of January 1996 through December 1998, were studied to determine the epidemiology of P. marneffei infections. Among the 20 isolates, a total of 8 strains (highly related isolates) were identified on the basis of tests for susceptibility to 5 antifungal agents, for chromosomal DNA restriction fragment-length polymorphism types, and for randomly amplified polymorphic DNA patterns. One of the strains (6 isolates) was isolated from 4 patients treated in 1997 and 1998. Strain spreading of P. marneffei may partially contribute to the increased number of infections caused by this organism in immunosuppressed patients in Taiwan.

TG defects have an important role in severe thyroidal dyshormonogenesis (pretreatment, or after a 3-wk T(4) withdrawal, plasma T(4) < or = 30 nmol/liter) in Taiwanese. Its genetic characteristics are markedly different from those described in other populations presenting with mutations of the TG gene.

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The authors present a case of citrullinemia with a genotype of argininosuccinate synthetase (ASS1), c.380 G>A (p.R127Q)/c.380 G>A (p.R127Q), in two alleles. A 3-day-old female infant presented with status epilepticus and coma. Laboratory data showed hyperammonemia and marked lactic acidosis in the blood and cerebrospinal fluid; electroencephalography showed severely suppressed cerebral activity and focal paroxysmal volleys of slow and sharp waves (< 1Hz) over the left hemisphere. Real-time transcranial Doppler ultrasonography showed a brain edema and high peaked systolic and low diastolic flows in basal, anterior, and middle cerebral arteries; however, immediately after a blood exchange transfusion, systolic flows were lower and diastolic flows were higher. The resistance indices were significantly different (means: 0.58 vs. 0.37; p=0.01). The patient was placed on diet therapy. After six blood exchange transfusions and peritoneal dialysis, her neurologic examination results and serum ammonia and lactate values were normal. The authors found that electroencephalography and transcranial Doppler ultrasonography were useful for the diagnosis and follow-up treatment of neonatal citrullinemia.

Due to human over-exploitation, global wetland areas have been degraded and are disappearing due to human over-exploitation. The service value of wetland ecosystems has no market and is frequently ignored. Jinshan Qing Shui Wetland is in the north corner of Taiwan. It is a private inland wetland that is at risk of flooding. With the Jinshan Qingshui Wetland as a case study, the ARIES model was used as a research tool to select 4 types of currently well-established ecosystem service projects: "sediment regulation, soil carbon storage, net value of pollination, and net value of outdoor recreation." The results estimate that the annual value of "sediment regulation" is about US$26,915; the annual value of "soil carbon storage" is about US$1,246,370; the annual value of "net value of pollination" is about US$182,100; and the annual value of "net value of outdoor recreation" can reach US$1,199,253. The estimated value of the four items is about US$2.65 million. In addition, focus interviews with water conservancy experts, chiefs, and NGO groups were conducted; the Likert scale was used to analyze the views of different stakeholders on wetlands. Through evaluating the social, economic, and environmental value of wetlands, and through integrating the opinions of all stakeholders, this research provides the government with reference points to an overarching management plan of wetlands, with potential ecosystem service value.