Fibroblast growth factor 23 (FGF23) is a bone-derived hormone that regulates renal phosphate reabsorption and vitamin D synthesis in renal proximal tubules. High circulating FGF23 levels are ...associated with increased mortality in patients with chronic kidney disease and those on dialysis. Current data also suggest higher circulating levels of FGF23 are associated with cardiovascular mortality, vascular calcification, and left ventricular hypertrophy; however, evidence on the role of FGF23 in patients on dialysis is incomplete, and some of the data, especially those on cardiovascular disease (CVD), are controversial. This study aimed to evaluate factors associated with FGF23 in hemodialysis patients with or without CVD. Randomly selected 76 patients on maintenance hemodialysis at a single hemodialysis center were enrolled. After the exclusion of eight patients with extremely outlying FGF23 levels, 68 patients, including 48 males and 46 patients with a CVD history, were included in the study. The mean age was 64.4 ± 12.1 years, and the mean dialysis duration was 12.7 ± 7.1 years. Dialysis duration, time-averaged concentration of urea (TAC-urea), ultrafiltration rate (UFR), blood pressure during hemodialysis session, laboratory data, and echocardiographic parameters including interventricular septum thickness (IVST), left ventricular mass indices (LVMI), and ejection fraction were included in univariate and multivariate analyses. The median lgFGF23 levels in the overall cohort and in those with and without CVD were 2.14 (interquartile range, IQR − 0.43 to − 4.23), 2.01 (− 0.52 to 4.12), and 2.59 (0.07 to 4.32), respectively, and there was no difference between the patients with and without CVD (
p
= 0.14). The univariate analysis revealed that FGF23 was significantly associated with age (
r
= − 0.12,
p
< 0.01), duration of hemodialysis (
r
= − 0.11,
p
< 0.01), TAC-urea (
r
= 0.29,
p
= 0.01), UFR (
r
= 0.26,
p
= 0.04), alkaline phosphatase (ALP;
r
= − 0.27,
p
= 0.03), corrected serum calcium (cCa;
r
= 0.32,
p
< 0.01), serum phosphate (iP,
r
= 0.57,
p
< 0.01), intact parathyroid hormone (iPTH;
r
= 0.38,
p
< 0.01), IVST (
r
= 0.30,
p
= 0.01), and LVMI (
r
= 0.26,
p
= 0.04). In multivariate regression analysis, FGF23 was significantly associated with cCa (F = 25.6,
p
< 0.01), iP (
F
= 22.5,
p
< 0.01), iPTH (
F
= 19.2,
p
< 0.01), ALP (
F
= 5.34,
p
= 0.03), and UFR (
F
= 3.94,
p
= 0.05). In addition, the univariate analysis after the categorization of patients according to CVD indicated that FGF23 was significantly associated with cCa (
r
= 0.34,
p
= 0.02), iP (
r
= 0.41,
p
< 0.01), iPTH (
r
= 0.39,
p
= 0.01), and TAC-urea (
r
= 0.45,
p
< 0.01) in patients with CVD, whereas only IVST (
r
= 0.53,
p
= 0.04) was associated with FGF23 in those without CVD. FGF23 levels in hemodialysis patients were extremely high and associated not only with mineral bone disease-related factors but also with UFR. Additionally, dialysis efficacy might be associated with lower FGF23 levels in patients with CVD.
A new treatment for coronavirus disease (COVID-19), REGN-COV2, a cocktail consisting of two neutralizing antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been ...approved for patients at a risk of developing more severe disease.
We retrospectively reviewed patients recently diagnosed with COVID-19 with risk factors for severe infection, who were treated with the REGN-COV2 antibody cocktail between July and September 2021. The REGN-COV2 antibody cocktail was administered to patients within 7 days of disease onset, with an oxygen saturation of >93%, and with at least one comorbidity. We investigated the percentage of patients with COVID-19-related hospitalization or death, the duration of symptoms after treatment, and the adverse effects of treatment.
A total of 108 patients were reviewed. Of them, 64% were aged ≥50 years, 31% had obesity, 36% had hypertension, and 18% had diabetes. In addition, 49% had multiple risk factors for severe COVID-19. Overall, 12 patients (11%) needed COVID-19-related hospitalization. No adverse effects of treatment were observed.
This study shows that treatment with the REGN-COV2 antibody cocktail is safe and beneficial in patients at a risk of developing severe COVID-19.
Primary and metastatic malignancies arising in the sinuses are rare and histologically diverse. The role of fine-needle aspiration cytology (FNAC) and the cytomorphologic characteristics of these ...tumors have not been specifically addressed. We described two cases of suspected malignant maxillary sinus tumors in 85- and 90-year-old patients with comorbid conditions, both of whom underwent tissue biopsies that failed to yield a definitive diagnosis. We performed FNAC after imaging confirmed that the malignant tumors were outside the maxillary sinus. The 85- and 90-year-old patients were diagnosed with squamous cell carcinoma (SCC) and adenocarcinoma, respectively. In the latter, the cell block method was used to prepare the specimen, rendering individual cells identifiable. Atypia of the histological structure was confirmed without the influence of cell duplication, a known weakness of FNAC. Thus, the diagnosis was made quickly. We believe that FNAC would be utilized more frequently for the definitive diagnosis of sinonasal tumors as the technique and diagnostic technology improve further.
Background
Cardiovascular disease is the leading cause of morbidity and mortality in patients receiving hemodialysis. Systemic metabolic perturbation is one of the hallmark abnormalities in patients ...at high cardiovascular risk. We sought to determine the relationship between circulating ketone body and clinical outcomes in patients with prevalent hemodialysis.
Methods and Results
We retrospectively assessed the relationship between serum β‐hydroxybutyrate (βOHB), the most abundant ketone body in the circulation, and prognosis in 405 stable hemodialysis patients. During a mean follow‐up of 3.2±0.9 years, there were 54 major adverse cardiovascular events (defined as cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and hospitalization attributed to heart failure) and 67 all‐cause deaths. Major adverse cardiovascular events rates increased from 11.1 per 1000 person‐years in the lowest βOHB quintile (<89 μmol/L) to 80.1 per 1000 person‐years in the highest quintile (>409 μmol/L). After adjusting for demographic characteristics, coronary artery disease, and atrial fibrillation, the highest βOHB quintile was associated with increased risk of major adverse cardiovascular events compared with the lowest quintile (hazard ratio, 10.2; 95% confidence interval 3.35–44.0; P<0.001). Increased quintiles of βOHB were independently and incrementally associated with major adverse cardiovascular events over the model based on an established risk score (the second Analyzing Data, Recognizing Excellence and Optimizing Outcomes cohort score) and N‐terminal pro‐B‐type natriuretic peptide (chi square 39.9 versus 21.7; P<0.001; c‐statistics, 0.713). Sensitivity analyses also confirmed the robustness of association between βOHB and all‐cause death.
Conclusions
Increased serum βOHB levels were independently associated with cardiovascular events and all‐cause death in patients receiving hemodialysis. These results highlight the need for future studies to understand the mechanisms underlying these observations.
Recently, the usefulness of serum uromodulin (sUmod) as a novel renal biomarker has been attracting attention. Clinical evidence regarding sUmod measurements has been accumulated by analyzing ...cross-sectional data. However, little is known about the longitudinal data on sUmod. Therefore, we decided to investigate the variability of sUmod in patients with acute kidney injury due to different causes. High concentrations of sUmod have been observed in patients with acute tubular injury (ATI) and/or acute interstitial nephritis (AIN). sUmod could be used as an auxiliary diagnostic tool for ATI and AIN.
Control of local wetting by microscopic particles Mu, Lizhong; Yoshikawa, Harunori N.; Kondo, Daichi ...
Colloids and surfaces. A, Physicochemical and engineering aspects,
10/2018, Letnik:
555
Journal Article
Recenzirano
The interaction of liquid with an array of objects produces successive accelerations of the MCL. The velocity gains Vmax/V0 produced by the second and third particles are significantly larger than ...that produced by the first particle. The velocity of the MCL decreases quickly after reaching the maximum velocity. If the inter-particle distance is small, the MCL accelerated by a particle would reach the next particle at a large speed and the MCL could be accelerated to a large velocity. Besides the successive accelerations, an array of micro-objects can be used for guiding liquid along the array. This may be used to realize a directional liquid transport.
Fig. (a) Variation of the MCL velocity induced by three spheres of a diameter 50 μm aligned along the direction of an advancing MCL. The inset shows a top view image of the three spherical particles at t = 0. The distance between adjacent sphere centers was about 270 μm. The distance between the needle tip and the nearest sphere was 5 mm. (b) Local directional motion of liquid induced by multi-particle interactions. The inter pillar distance is 200 μm. The height of pillar is 120 μm with the diameter of 50 μm. Scale bar: 100 μm.
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We perform experiments to investigate how particles of micro-meter size modify the wetting of a completely wettable solid surface. The motion of a macroscopic contact line (MCL) is observed to be altered in the region surrounding the particles. The MCL is accelerated locally by a single particle to advance approximately 10 times faster than that in the absence of the particle. Different geometrical arrangements of particles produce different wetting speeds and different MCL shapes through multiple MCL-particle interactions. These results suggest a method to control the wetting without surface patterning by chemical treatment.
Muscular control during walking is believed to be simplified by the coactivation of muscles called muscle synergies. Although significant corticomuscular connectivity during walking has been ...reported, the level at which the cortical activity is involved in muscle activity (muscle synergy or individual muscle level) remains unclear. Here we examined cortical correlates of muscle activation during walking by brain decoding of activation of muscle synergies and individual muscles from electroencephalographic signals. We demonstrated that the activation of locomotor muscle synergies was decoded from slow cortical waves. In addition, the decoding accuracy for muscle synergies was greater than that for individual muscles and the decoding of individual muscle activation was based on muscle-synergy-related cortical information. These results indicate the cortical correlates of locomotor muscle synergy activation. These findings expand our understanding of the relationships between brain and locomotor muscle synergies and could accelerate the development of effective brain-machine interfaces for walking rehabilitation.
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•We examined relationships of brain and locomotor muscle synergies by brain decoding•Locomotor muscle synergy activation was successfully decoded from EEG signals•Single muscle activation was decoded based on muscle-synergy-related EEG signals•The cortical correlates of locomotor muscle synergy may contribute to BMI for gait
Human Physiology; Neuroscience; Biomechanics
Wound infection is a major complication after supracricoid partial laryngectomy with cricohyoidoepiglottopexy (CHEP) for radiation therapy failure. A 60-year-old man received chemoradiotherapy for a ...glottic carcinoma. CHEP, reusing the thyroid gland flap (TF), was performed because the cancer recurred after a salvage vertical partial laryngectomy following radiation therapy failure. The TF was sutured to the supraglottis and cricoid cartilage mucosa to minimize mucosal defects before the hyoid bone and cricoid cartilage were sutured. Wound healing after CHEP was good without infection. After decannulation, oral food intake was possible without aspiration, and speech function was comparable to that of other patients who had supracricoid partial laryngectomies. Histopathological examination revealed a close connection between the TF and its surrounding tissues without fibrous scarring. TF may improve wound healing after CHEP for radiation failure by minimizing mucosal defects.
Novel organic–inorganic hybrid liposomes, so‐called coordination polymersomes (CPsomes), with artificial domains that exhibit strong lateral cohesion were prepared by a three‐step procedure that ...formed a coordinative interaction leading to a lipid bilayer. First, the lipophilic complex (dabco‐C18)Mn(N)(CN)4(dabco‐C18) (1; dabco‐C18+=1,4‐diazabicyclo2,2,2octane‐(CH2)17CH3 cation), was synthesized. 1 has a lipophilic alkyl tail part and a tetracyanometallate head group, which can be used for an expansion to two‐dimensional coordination networks. Second, 1 and 1,2‐dipalmitoyl‐sn‐glycero‐3‐phosphocholine were mixed to prepare the liposomes. Finally, CPsomes were obtained by the addition of transition‐metal ions (M) to form unilamellar faceted liposomes with plain CP raft domains with MnCNM linkages. The concentration of 1 influences the size of the CP raft domains and the shape of the CPsomes. The synthesis of coordination polymers in lipid bilayers is a novel approach for the construction of artificial architectures as raft domains, for example, in cell membranes.
The sequential synthesis of coordination polymers on lipid bilayers provides novel organic–inorganic hybrid liposomes, so‐called coordination polymersomes (CPsomes), which formed unilamellar faceted spheres with plain coordination polymer raft domains that consist of cyanide‐bridged linkages based on a lipophilic building unit. This is a novel approach for the construction of artificial raft domains and for creating composite soft materials.
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