From May 1985 through July 1990, 28 episodes of Vibrio vulnificus infection in 27 patients were encountered in five major hospitals in Taiwan. The ages of patients ranged from 19 to 76 years; the ratio of male to female patients was 2:1. Eighteen episodes manifested as bacteremia and eight as wound infections alone. One patient each developed gastroenteritis and pneumonia after nearly drowning. Twenty-three patients exhibited skin manifestations. Twenty patients had underlying diseases. All patients were treated with antibiotics, and 14 also underwent some form of surgical treatment (incision and drainage, fasciotomy, debridement, or amputation). Thirteen of the 28 episodes were preceded by precipitating factors; most were due to ingestion of seafood or exposure of abraded skin to salt water. Ten of the 18 septicemic patients died--most within 48 hours of hospitalization. One patient without bacteremia who had a wound infection died. Results of in vitro susceptibility studies suggested that ampicillin or a third-generation cephalosporin would be effective. Susceptibility to aminoglycosides was observed for greater than 90% of isolates. We recommend combined therapy with a third-generation cephalosporin or ampicillin and an aminoglycoside along with appropriate surgical therapy for the treatment of V. vulnificus infection.

A survey of 2985 apparently healthy Taiwanese in southern Taiwan revealed a high prevalence (18.2%) of hepatitis B surface antigen (HBsAg). It was significantly higher in males (22.3%) than in females (13.6%), but no correlation with family origin, socioeconomic status or residence was established. About one-third of the breeding female HBsAg carriers were HBeAg-positive, and these may be an important source in the spread of HBV. Subtyping of HBsAg in 63 subjects showed adw to be dominant in this area, and 8 subjects with suspicious results had overlapping heterotypic HBV's (7 adwr and 1 adyw) in addition to 2 subjects in which coexistence of HBsAg and anti-HBs was recognized. The association between HBsAg positivity and serum transaminase elevation was significant, especially in the older groups who had a higher abnormal rate. Hepatitis A virus infection was serious too, with nearly 100% of people above 20 years of age being anti-HA antibody positive.

Objective: Chronic hepatic disease caused by hepatitis B virus (HBV) is a serious threat to health in worldwide. There is evidence that the change of N-glycan is involved in the mechanism of hepatic fibrosis, liver cirrhosis (LC) and hepatocellular carcinoma (HCC) in patients with hepatitis B. The level of serum alpha-fetoprotein (AFP) is elevated in many patients with hepatitis B infection. AFP is not only a fetal carrier protein and tumor marker, but also participates in the regulation of a variety of important cellular functions, such as cell growth, differentiation, apoptosis, angiogenesis and immune regulation. However, the mechanism between AFP and N-glycan is not clear. The study investigated the association of N-glycan and AFP in Hepatitis B associated hepatic disease.Patients and Methods: Sixty patients with Hepatitis B associated hepatic diseases and twenty healthy individuals were selected in this study. Serum AFP, N-glycan, hematological parameters, and clinical data were assessed in this cohort. The Spearman rank method was used to evaluate the associations among them. The study was designed as a retrospective cross-sectional study. Results：Serum levels of N-glycan and AFP were significantly higher in Patients with hepatic disease compared with the controls; levels of both were elevated with development of the disease. In patients with hepatic disease, N-glycan was positively correlated with AFP, Age, AST, GGT, PT, CA125, while negatively correlated with ALB, CHE, RBC (P < 0.05 for all). AFP was positively correlated with HBV DNA, TBIL, DBIL, AST, ALT, ALP, GGT (P < 0.05 for all), while negatively correlated with ALB and CHE in hepatic disease patients (P < 0.05 for both). In addition, there was a trend of increasing N-glycan with elevated AFP level in the combined hepatic disease group. In LC, the level of N-glycan in the decompensatory was significant higher than in the control (P = 0.007), and AFP level in the compensatory increased than the controls (P = 0.003). In HCC, levels of both N-glycan and AFP in the compensatory and decompensatory groups elevated than those in the control (P < 0.001 and P = 0.004 for N-glycan and P < 0.001 for both in AFP, respectively).Conclusion: Our data suggest that high AFP levels in Hepatitis B related hepatic disease are closely related to the development of liver disease through interaction with N-glycan.

A sero‐epidemiological study was made of 6863 apparently healthy randomly selected volunteers from various parts of Taiwan. It revealed an 18% incidence of hepatitis B surface antigen (HBsAg) carriers amongst the general population, the prevalence being significantly higher in males than females (21.7% vs 14.1%). The Takasago natives showed the highest HBsAg carrier rate (27.0%). Those who are primarily derived from Ming Nan had a significantly higher prevalence (19.0%) than those from Hakka (14.7%) and recent immigrants from Mainland China (14.6%). About one‐third of female carriers of child‐bearing age in southern Taiwan were positive for e antigen (HBeAg) in a limited study; they may be an important source of HB virus (HBV) infection. The positivity rate for HBeAg was significantly higher in subjects below 40 years of age (36.7%) than those above 40 years (7.5%). There was a significant association between HBsAg positivity and elevated serum transaminase levels, especially in males; 20.3% of carriers had elevated transaminase in comparison with 11.1% of female carriers. Among HBsAg seronegative individuals, the frequency of abnormal transaminase increased with age with an overall abnormality rate of 10.6% in males and 5.0% in females, suggesting that factors other than HBV may also contribute to liver disease in Taiwan. Altogether, 9.3% had elevated transaminase. Out of 82 randomly selected HBsAg carriers who were evenly distributed in geography, serum antidelta antibody was positive in only five men (6.1%), of whom four had a mild elevation of transaminase levels (< 100 KU). The overall positivity rate for anti‐hepatitis A (HA) antibody was 93.0% in southern Taiwan, indicating poor sanitation. These findings indicate that HB and HA virus infections are highly endemic in Taiwan and that delta infection is infrequent despite a high prevalence of HB virus infection.