To investigate the usefulness of quenching probe polymerase chain reaction (Q-probe PCR) for the detection of macrolide-resistant Mycoplasma pneumoniae (MP), we retrospectively analyzed the clinical ...course of 21 children with MP infection. The rate of macrolide-resistant MP was 66.7%. The duration of pyrexia after the initial antibiotic treatment was longer in patients with macrolide-resistant MP infection than in those with macrolide-sensitive MP infection. The duration of pyrexia after Q-probe PCR was not significantly different between patients with macrolide-resistant and -sensitive MP infection. Antibiotic use based on qPCR may reduce the duration of pyrexia. Q-probe PCR is useful in determining the appropriate antibiotics and improves the clinical course of MP infections.
An ethylene glycol-based hexa-block copolymer with six different temperature-responsive blocks was prepared via a reversible addition-fragmentation chain transfer (RAFT) polymerization. ...2-(2-methoxyethoxy)ethyl methacrylate (MEO2MA) and oligo(ethylene glycol) methacrylate (OEGMA) were selected as the ethylene glycol-based monomers. Each block of the hexa-block copolymer has a different OEGMA content and thus exhibits a different lower critical solution temperature (LCST). The structures of the block copolymers are similar to gradient copolymers. The molecular weights of the copolymers increased with the number of blocks (first block (P(MEO2MA)): 2800 g/mol, di-block copolymer: 7400 g/mol, tri-block copolymer: 12,000 g/mol, tetra-block copolymer: 18,500 g/mol, penta-block copolymer: 26,800 g/mol, and hexa-block copolymer: 40,400 g/mol) with relatively narrow molecular weight distributions (1.18–1.42). Each block exhibits a different LCST in aqueous solution owing to their different OEGMA contents. To the best of our knowledge, this is the first report of a block copolymer containing more than four types of temperature-responsive blocks. The temperature-responsive properties of the prepared block copolymers were investigated by UV-vis spectroscopy, micro-differential scanning calorimetry, and scanning electron microscopy.
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) usually causes skin and soft tissue infections (SSTIs), but occasionally causes invasive infections with a broad range of ...manifestations. Virulence factors and pathogenesis of CA-MRSA have been investigated in details with genotype ST8/SCCmecIVa (USA300), which first emerged in the United States. However, CA-MRSA evolves rapidly, with different clones dominating in different world regions; their pathogenesis remains unclear. CA-MRSA with genotype ST8/SCCmecIVl (CA-MRSA/J) emerged in 2003 in Japan, spreading widely with a fatal case. We have studied the genetic characteristics of CA-MRSA/J, and during the course of this study, we found that CA-MRSA/J has bacteriophage-like spikes with or without a hexagonal cap (spikes X and Xc). Here, we report that CA-MRSA/J strain NN55 has non-phage-like, one-μm-long/jerky spikes with or without a hexagonal cap (LSX/LSXc), and also that LSX/LSXc forms (staphylococcal) interbacterial aggregate/net structures (SIAN). Regarding the phenomenon of SIAN, NN55 first formed single short spike X, followed by multiple molecules of long and jerky LSX/LSXc, leading to the interbacterial construction of SIAN, in colonies with high cell densities. The LSX/LSXc and SIAN structures have not been reported in S. aureus. NN55 was invasive in a HEp-2 cell assay, exhibiting SIAN. The novel SIAN structures may be foci-skeletons or toxic aggregates in NN55's invasive infections. The phenomenon of SIAN suggests novel staphylococcal cell-surface dynamism, providing a new structure-and-function relationship model and advancing the understanding of CA-MRSA pathogenesis.
Aim
Past hepatitis B virus (HBV) infection is considered a risk factor for hepatocarcinogenesis, but the clinicopathological characteristics of non‐B non‐C hepatocellular carcinoma (NBNC‐HCC) ...excluding past HBV infection have not been investigated. This study aimed to clarify the clinicopathological features of strictly defined NBNC‐HCC.
Methods
Among HCC patients who underwent surgical resection at our affiliated hospitals in Nagano prefecture, Japan, between 1996 and 2012, 77 were negative for serum anti‐HBV core/surface antibodies in addition to HBV surface antigen and anti‐hepatitis C virus antibody without signs of autoimmune liver disease, Wilson disease, or hemochromatosis. These patients were divided into the alcohol intake‐positive group (ethanol intake >20 g/day, n = 31), non‐alcoholic fatty liver group (steatosis >5% and ethanol intake <20 g/day, n = 30), and cryptogenic group (no ethanol intake or steatosis, n = 16). Preoperative clinical parameters, tumor and background liver pathology, and prognosis were analyzed.
Results
Advanced fibrosis and steatosis were detected in 64% and 60% of all patients, respectively. Approximately 85% of the alcohol intake‐positive patients had advanced fibrosis. Non‐alcoholic fatty liver HCC subjects had the highest body mass index and prevalence of diabetes, but 30–40% had none to mild fibrosis. The cryptogenic group of HCC patients had the lowest incidence of accompanying hepatic inflammation/fibrosis but the largest tumor size. Recurrence/survival rates were comparable among the groups.
Conclusions
Liver fibrosis and steatosis are risk factors of HCC regardless of past HBV infection and ethanol consumption. The present results also indicate the possibility of hepatocarcinogenesis independent of hepatic steatosis, inflammation and fibrosis, ethanol intake, and past HBV infection.
Background. A new agent, potassium-competitive acid blocker vonoprazan (VPZ) has potent acid-inhibitory effects and may offer advantages over conventional H. pylori eradication therapies. We aimed to ...compare the eradication rate between VPZ-based treatment and PPI-based one. Methods. This randomized controlled trial was designed to assign 141 patients with H. pylori-positive gastritis to VPZ group (VPZ 20 mg, amoxicillin 750 mg, and clarithromycin 200 or 400 mg twice daily for 7 days) or PPI group (rabeprazole 20 mg or lansoprazole 30 mg, amoxicillin 750 mg, and clarithromycin 200 or 400 mg twice daily for 7 days). Primary endpoints were eradication rates and adverse events. Results. Seventy of 72 patients in VPZ group and 63 of 69 patients in PPI group completed the treatment after 7 days. The eradication rate was significantly higher in VPZ group than PPI group by intention-to-treat analysis (95.8% versus 69.6%, P=0.00003, 95% confidence interval CI 88.3-99.1% versus 57.3-80.1%) and per-protocol analysis (95.7% versus 71.4%, P=0.0002, 95% CI 88.0-99.1% versus 58.7-82.1%). The incidence of adverse events was not different between the groups (26.3% in VPZ group versus 37.7% in PPI group, P=0.15). Conclusion. VPZ-based regimen is more useful than that PPI-based regimen as a first-line H. pylori eradication therapy.
Background: Serum C-reactive protein (CRP) is an established biomarker for acute inflammation and has been identified as a prognostic indicator for hepatocellular carcinoma (HCC). However, the ...significance of the serum CRP level, specifically in HCC patients treated with lenvatinib, remains unclear. Methods: We retrospectively analyzed 125 HCC patients who received lenvatinib treatment at six centers. Clinical characteristics were assessed to identify clinical associations between serum CRP and HCC prognosis. Results: The median overall serum CRP level was 0.29 mg/dL. The cohort was divided into two groups: the low-CRP group with a serum CRP < 0.5 mg/dL and the high-CRP group with a serum CRP ≥ 0.5 mg/dL. The low-CRP group exhibited significantly longer overall survival (OS) than the high-CRP group (22.9 vs. 7.8 months, p < 0.001). No significant difference was observed for progression-free survival (PFS) between the high- and low-CRP groups (9.8 vs. 8.4 months, p = 0.411), while time-to-treatment failure (TTF) was significantly longer in the low-CRP group (8.5 vs. 4.4 months, p = 0.007). The discontinuation rate due to poor performance status was significantly higher in the high-CRP group (p < 0.001). Conclusion: A baseline serum CRP level exceeding 0.5 mg/dL was identified as an unfavorable prognostic factor in HCC patients receiving lenvatinib treatment.
Carnitine plays an essential role in the transfer of long-chain fatty acids to the mitochondria for β-oxidation. No study has characterized carnitine in children with Kawasaki disease (KD). The ...objective of this study was to elucidate the characteristics of serum free carnitine (FC) in hospitalized pediatric patients with KD.
We retrospectively analyzed 45 patients with KD in whom serum FC levels were measured. We investigated the clinical and laboratory parameters before intravenous immunoglobulin was administered, including serum FC levels, according to the response to intravenous immunoglobulin (IVIG). We also analyzed the relationship among serum FC, laboratory data, and clinical variables.
IVIG was effective in 33 children (responders) and was ineffective in 12 children (non-responders). Serum FC levels were higher in non-responders than in responders: 35.3 μmol/L (range, 26.8-118.4 μmol/L) vs 31.4 μmol/L (range, 20.9-81.2 μmol/L), P <0.05. FC levels before IVIG in 80% of responders were below the normal range. The levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, and FC were higher in non-responders than in responders. FC levels were correlated with AST (R
= 0.364, P = 0.0015) and ALT (R
= 0.423, P < 0.001) levels.
Free carnitine levels were elevated in some patients with KD, especially in those who were refractory to IVIG. Additionally, FC levels in children with KD correlated with ASL and ALT levels.
Objectives
To describe clinical features and laboratory data of myocarditis after the mRNA COVID-19 vaccine in children.
Methods
We reviewed patients younger than 18 years of age, who visited our ...hospital because of myocarditis within 1 week after BNT162b2 from June 2021 to January 2022.
Results
We identified five male patients aged 12–16 years who presented to our hospital with myocarditis within 2–3 days after the second dose of BNT162b2 COVID-19 vaccination between June 2021 and January 2022. All patients experienced chest pain, and fever, pain other than chest pain, and shortness of breath were present in two, three, and two patients, respectively. The serum troponin I level was increased in all patients except one, and electrocardiogram (ECG) showed ST elevation in all patients. Echocardiography revealed pericardial effusion and decreased ejection fraction in three and one patients, respectively. In accordance with the Japanese guidelines for myocarditis, the patients were treated with colchicine and aspirin. Chest pain improved within a few days with no hemodynamic instability. The patients were discharged with no sequelae.
Conclusions
ST changes on ECG and elevated troponin I levels may aid the diagnosis of myocarditis after mRNA COVID-19 vaccination
Cervical lymphadenitis (CL) cannot be easily distinguished from Kawasaki disease (KD). We therefore explored whether brain natriuretic peptide (BNP) levels are useful in this context.
We ...retrospectively analyzed 14 children with CL and 177 children with KD. Patients with KD were divided into three groups according to their clinical symptoms at hospitalization - 97 patients had typical KD, 35 had node-first KD (NFKD), and 45 had KD without lymphadenopathy. We reviewed data on clinical and laboratory parameters, including serum BNP levels, at hospitalization together with factors that might distinguish KD from CL.
Patients with CL were older than those with KD. Serum BNP levels were higher in all the KD groups than in the CL group. Multivariate logistic regression analyses indicated that higher BNP levels were associated with NFKD (odds ratio: 1.12, 95% confidence interval: 1.01-1.25). The receiver operating characteristic curve yielded a BNP cutoff of 18.3 pg/mL, with a sensitivity of 0.680, a specificity of 0.857, and an area under the curve of 0.806 (95% confidence interval: 0.665-0.947).
Serum BNP levels can be used to distinguish KD from CL, especially in patients with NFKD.
Poly(2-(methacryloyloxy)ethyltrimethyl ammonium chloride) (METAC) and the gels were prepared and evaluated for their bactericidal and fungicidal activities. The antimicrobial properties of ...poly(METAC) were tested against
(
),
(
),
(
), methicillin-susceptible
(MSSA), methicillin-resistant
(MRSA),
(
), and
(
). Moreover, the structural forms of the linear and cross-linked poly(METAC) were investigated for their influences on bacterial aggregation, precipitation, and cell-death. To our knowledge, this is the first report on the comparison of the antimicrobial properties of poly(METAC) and poly(METAC)-gels. The bactericidal and fungicidal activities were evaluated by determining minimum inhibitory concentrations (MICs), UV⁻Vis spectroscopy, and fluorescence and confocal microscopies. The MICs were found to be 123 (MSSA), 123 (MRSA), 123 (
), 370 (
), 123 (
), 370 (
), and 370 μg/mL (
), as determined by broth dilution, and 370 (MSSA), 370 (MRSA), 370 (
), 3300 (
), 370 (
), 1100 (
), and >10,000 μg/mL (
), as determined by paper disc diffusion (on solid medium). The poly(METAC)-gels achieved rapid adsorption/precipitation of bacteria via the cationic surface charge. Thus, these poly(METAC)-based polymers can potentially be used as antibacterial materials.
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