ADENOSINE DIPHOSPHATE RIBOSE PYROPHOSPHOHYDROLASE IN HUMAN SKIN

Adenosine diphosphate ribose (ADPR) pyrophosphohydrolase (ADPR-PPase), which catalyzes the hydrolysis of ADPR to yield adenosine monophosphate (AMP) and ribose-5'-phosphate, was assayed in human penile foreskin. Since ADPR is formed from nicotinamide adenine dinucleotide (NAD) by NAD glycohydrolase (NADase), NADase was also assayed in human skin. The skin tissue obtained by circumcision was separated into three layers; epidermis of the outer prepuce, epidermis of the inner prepuce, and dermis. ADPR-PPase was found to be present in all of the three layers with nearly equal activity. NADase was also present in the epidermis of both the outer and inner prepuce, being about two times higher in the latter, but no activity was found in the dermis. When expressed in units of the same specific activity; i.e., micromoles product formed per hour per mg protein, the ADPR-PPase of human skin had two to five times greater activity than did NADase. The ADPR-PPase of human skin was activated by Mg(+2), but inhibited by AMP and ATP. These results suggest that the breakdown of NAD occurs in human skin via ADPR to AMP and ribose-5'-phosphate by sequential action of NADase and ADPR-PPase.

Fatal scedosporiosis in multiple solid organ allografts transmitted from a nearly-drowned donor

Scedosporium spp. is the most common mold infection in pneumonia resulting from near-drowning. Three fatal scedosporiosis cases developed after solid organ transplantation, probably transmitted from the nearly-drowned donor. One heart transplant recipient and two kidney transplant recipients developed fatal scedosporiosis following deceased donor transplantation from the same donor, a nearly-drowned victim of a suicide attempt. Genotypically, indistinguishable strains of Scedosporium auratiacum were recovered from the three recipients. Two liver transplant recipients from the same donor received prophylactic voriconazole without any subsequent signs of infection. To determine the safety of donation from nearly-drowned donors, a national traceback investigation was also performed of the causes of deaths in all transplant recipients who received organs from drowned donors between 2001 and 2013. Over 13 years, 2600 deceased donor transplants were performed in Korea. Among these 2600 deceased donor transplants, 27 (1%) victims of drowning donated their organs. From these 27 donors, 84 patients received organ transplants and 18 died, including the above three. We found no microbiologic evidence of invasive mold transmission from the nearly-drowned donors to the other 15 recipients. Although disseminated infection in the donor could not be demonstrated by culture, undiagnosed disseminated donor infection and transmission of Scedosporium spp. should be considered in near-drowning events.

Clinical significance of surveillance culture in liver transplant recipients

BACKGROUND

Routine microbiologic surveillance is a method of infection control, but its clinical significance in transplant recipients is not known. We analyzed microbiologic data to evaluate the influence of cultured microorganisms between the point of surveillance and infectious episodes in liver transplant recipients.

METHODS

We performed surveillance culture for sputum and peritoneal fluid in liver transplant recipients from January 2009 to December 2011, at the time of transplantation (T1), 5 days (T2), and 10 days (T3) postoperatively.

RESULTS

Of the 179 recipients, 32.9% had a positive sputum culture result and 37.4% had a positive peritoneal culture result during surveillance. In the culture surveillance of sputum, 37 organisms were isolated from 35 recipients at T1, and the most common organism was Staphylococcus aureus (n = 13). At T2, 45 organisms were isolated from 39 recipients, including Klebsiella pneumoniae (n = 10), S aureus (n = 8), and Acinetobacter baumannii (n = 6). At T3, 18 organisms were isolated from 15 patients, including Stenotrophomonas maltophilia (n = 5) and K pneumonia (n = 4). In the peritoneal fluid, 11 organisms were isolated from 10 recipients at T1, including Pseudomonas aeruginosa (n = 2) and Enterococcus species (n = 2). At T2, 39 organisms were isolated from 36 recipients, including coagulase-negative Staphylococcus species (CNS; n = 8) and Enterococcus species (n = 7). At T3, 54 organisms were isolated from 51 recipients, including CNS (n = 17) and Candida species (n = 8). Among the 59 patients with positive culture results for sputum surveillance, 16.9% developed pneumonia caused by the same organisms. Among the 67 patients with positive peritoneal fluid culture, 16.4% developed an intra-abdominal infection caused by the same organisms cultured. The recipients with positive surveillance culture had a higher risk of pneumonia (20.3% [12/59] vs 1.6% [2/120]; P < .001) and intra-abdominal infection (31.3% [21/67] vs 18.7% [21/112]; P = .05).

CONCLUSIONS

Periodic microbiologic surveillance may be useful in the prediction of post-transplantation pneumonia and intra-abdominal infection and could offer a potential target for empirical antimicrobial therapy in cases of infection.

Comparison of the treatment performance of hybrid constructed wetlands treating stormwater runoff

This study was conducted to compare the treatment performance of two hybrid constructed wetlands (CWs) in treating stormwater runoff. The hybrid CWs were composed of a combination of free water surface (FWS) and horizontal subsurface flow (HSSF) CWs. Based on the results, strong correlation exists between potential runoff impacts and stormwater characteristics; however, the low correlations also suggest that not only the monitored parameters contribute to stormwater event mean concentrations (EMC) of pollutants, but other factors should also be considered as well. In the hydraulic and treatment performance of the hybrid CWs, a small surface area to catchment area (SA/CA) ratio, receiving a high concentration of influent EMC, will find it hard to achieve great removal efficiency; also a large SA/CA ratio, receiving low concentration of influent EMC, will find it hard to achieve great removal efficiency. With this, SA/CA ratio and influent characteristics such as EMC or load should be considered among the design factors of CWs. The performance data of the two CWs were used to consider the most cost-effective design of a hybrid CW. The optimum facility capacity (ratio of total runoff volume to storage volume) that is applicable for a target volume reduction and removal efficiency was provided in this study.

Usefulness of the Doppler flow of the ophthalmic artery in the evaluation of carotid and coronary atherosclerosis

BACKGROUND AND OBJECTIVES

There is little information about the relationship between the Doppler flow of the ophthalmic artery (OA) and carotid and coronary atherosclerosis. The aim of the investigation was to assess the clinical usefulness of the Doppler flow of the OA to estimate the severity of carotid and coronary atherosclerosis.

SUBJECTS AND METHODS

The study was a retrospective analysis of the findings in 140 patients (mean age: 60 years, male: 64%) who underwent coronary angiography (CA) for the evaluation of typical angina between July 2010 and October 2011 in our single center. The severity of coronary artery stenosis was based on the Gensini score (GS). Significant coronary artery disease (CAD) was defined as the obstruction of over 75% of the major coronary arteries confirmed with CA. The pulsed Doppler flow of the OA and carotid ultrasound were performed before CA.

RESULTS

The mean systolic velocity/mean diastolic velocity (MSV/MDV), pulsatile index and resistance index in the Doppler flow of the OA were identified as significant and independent correlations with carotid intima-media thickness, and MSV/MDV was identified to have a significant and independent correlation with the GS. MSV/MDV >2.1 was the independent predictor for significant CAD {odds ratio (OR) 3.8, 95% confidence interval (CI) 1.5-9.7, p=0.005} and carotid plaque (OR 2.8, 95% CI 1.1-7.0, p=0.028), after adjustment for CAD-associated factors.

CONCLUSION

The Doppler flow of the OA might be a useful predictor of the severity of carotid and coronary atherosclerosis.

Thermoelectric characteristics of the p-type (Bi, Sb)2Te3 nanocomposites processed with silicon nanodispersion

The p-type (Bi0.2Sb0.8)2Te3 powders were mechanically alloyed and hot pressed at 500 degrees C for 30 minutes with dispersion of Si nanopowders up to 3 vol%. The thermal conductivity of the (Bi0.2Sb0.8)2Te3 nanocomposite was substantially reduced with dispersion of 0.3-3 vol% Si nanopowders due to the enhanced phonon scattering. The maximum dimensionless figure-of-merit of 1.32 at 75 degrees C was obtained for the (Bi0.2Sb0.8)2Te3 nanocomposite dispersed with 1 vol% Si nanopowders, compared to 1.08 of the specimen without Si nanopowder dispersion.

Single nucleotide polymorphisms in IL-10-mediated signalling pathways in Korean patients with Behçet's disease

OBJECTIVES

Previous genome-wide association studies have demonstrated an association between the IL-10 region and Behçet's disease (BD) in Turkish and Japanese populations. Our aim was to fully examine the relationship between IL-10 and BD, the associations between BD and single nucleotide polymorphisms (SNPs) in IL-10-mediated signalling pathways (JAK1, TYK2, and STAT3) were examined in Korean patients with BD.

METHODS

DNA samples were obtained from 223 patients who met the international study group criteria for BD and from 222 age- and sex-matched healthy controls. Twenty-four tag SNPs in JAK1, STAT3, and TYK2 were selected for genotyping based on the Japanese panel of international HapMap data with a minor allele frequency >5% and r2 >0.8.

RESULTS

The allele-based analysis showed that the T allele of rs310245 in JAK1 was associated with BD (odds ratio [95% confidence interval] = 1.34 [1.03-1.76], p=0.031), which lost statistical significance after permutation-based correction for multiple testing. In the genotype-based analysis, the JAK1 rs310245 TT homozygote (1.79 [1.14-2.82], p=0.012) and the STAT3 rs2293152 GG homozygote (2.01 [1.16-3.47], p=0.011) showed associations with BD. However, these associations did not achieve significance after correction for multiple testing. We did not observe any genetic interaction between the JAK1 rs310245 TT homozygote and the STAT3 rs2293152 GG homozygote. In the haplotype analysis, GT haplotype at rs17127024 and rs310245 (1.34 [1.03-1.74], p=0.032), and the AA haplotype at rs2256298 and rs3818753 (1.41 [1.03-1.92], p=0.034) in JAK1 were associated with BD, but lost statistical significance after correction for multiple testing.

CONCLUSIONS

There was no significant association between BD and SNPs in IL-10-mediated intracellular signalling in Korean patients.

Therapeutic effect of anti-C-X-C motif chemokine 10 (CXCL10) antibody on C protein-induced myositis mouse

INTRODUCTION

C-X-C motif chemokine 10 (CXCL10) is a chemokine that plays a critical role in the infiltration of T cells in autoimmune diseases and is reported to be expressed in muscle tissue of polymyositis. To determine the therapeutic efficacy of CXCL10 blockade, we investigated the role of CXCL10 and the effect of anti-CXCL10 antibody treatment in C protein-induced myositis (CIM), an animal model of polymyositis.

METHODS

CIM was induced with human skeletal muscle C protein fragment in female C57BL/6 mice. Immunohistochemistry of CXCL10 and C-X-C motif chemokine receptor 3 (CXCR3) and measurement of serum CXCL10 were performed. Cell surface markers and interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α) in CIM lymph node cells was investigated by flow cytometry. Mice with CIM were treated with anti-CXCL10 antibody or control antibody (anti-RVG1) and the inflammation in muscle tissue was assessed.

RESULTS

Immunohistochemistry showed increased expression of CXCL10 and CXCR3 in the inflammatory lesions of muscle in CIM. Especially, CD8+ T cells invading myofiber expressed CXCR3. Serum level of CXCL10 was increased in CIM compared to the level in normal mice (normal mouse, 14.3 ± 5.3 pg/ml vs. CIM, 368.5 ± 135.6 pg/ml, P < 0.001). CXCR3 positivity in CD8+ T cells was increased compared to that of CD4+ T cells in the lymph node cells of CIM (CXCR3+ among CD8+ T cell, 65.9 ± 2.1% vs. CXCR3+ among CD4+ T cell, 23.5 ± 4.7%, P <0.001). Moreover, IFN-γ+ cells were increased among CXCR3+CD8+ T cells compared to CXCR3-CD8+ T cells (CXCR3+CD8+ T cell, 28.0 ± 4.2% vs. CXCR3-CD8+ T cell, 9.5 ± 1.5%, P = 0.016). Migration of lymph node cells was increased in response to CXCL10 (chemotactic index was 1.91 ± 0.45). CIM mice treated with anti-CXCL10 antibody showed a lower inflammation score in muscles than those with anti-RVG1 (median, anti-CXCL10 treatment group, 0.625 vs. anti-RVG1 treatment group, 1.25, P = 0.007).

CONCLUSIONS

CXCL10/CXCR3 expression was increased in the inflammation of CIM model and its blockade suppressed inflammation in muscle.

Feasibility of using auto Mod-MPI system, a novel technique for automated measurement of fetal modified myocardial performance index

OBJECTIVES

To evaluate the reproducibility of measurement of the fetal left modified myocardial performance index (Mod-MPI) determined using a novel automated system.

METHODS

This was a prospective study of 116 ultrasound examinations from 110 normal singleton pregnancies at 12 + 1 to 37 + 1 weeks' gestation. Two experienced operators each measured the left Mod-MPI twice manually and twice automatically using the Auto Mod-MPI system. Intra- and interoperator reproducibility were assessed using intraclass correlation coefficients (ICCs) and the manual and automated measurements obtained by the more experienced operator were compared using Bland-Altman plots and ICCs.

RESULTS

Both operators successfully measured the left Mod-MPI in all cases using the Auto Mod-MPI system. For both operators, intraoperator reproducibility was higher when performing automated measurements (ICC = 0.967 and 0.962 for Operators 1 and 2, respectively) than when performing manual measurements (ICC = 0.857 and 0.856 for Operators 1 and 2, respectively). Interoperator agreement was also better for automated than for manual measurements (ICC = 0.930 vs 0.723, respectively). There was good agreement between the automated and manual values measured by the more experienced operator.

CONCLUSIONS

The Auto Mod-MPI system is a reliable technique for measuring fetal left Mod-MPI and demonstrates excellent reproducibility.

HIV-associated neurocognitive disorder in HIV-infected Koreans: the Korean NeuroAIDS Project

OBJECTIVES

HIV-associated neurocognitive disorder (HAND) is an independent predictor of early mortality and is associated with many difficulties in activities of daily living. We sought to determine the prevalence of and risk factors for HAND in HIV-infected Koreans. In addition, we investigated the performance of screening tools and components of neuropsychological (NP) tests for diagnosing HAND.

METHODS

HIV-infected patients were enrolled consecutively from two different urban teaching hospitals in Seoul, South Korea between March 2012 and September 2012. Participants completed a detailed NP assessment of six cognitive domains commonly affected by HIV. The Frascati criteria were used for diagnosing HAND. Four key questions, the International HIV Dementia Scale (IHDS) and Montreal Cognitive Assessment (MoCA)-K were also assessed as potential tools for screening for HAND.

RESULTS

Among the 194 participants, the prevalence of HAND was 26.3%. Asymptomatic neurocognitive impairment and minor neurocognitive disorder accounted for 52.9 and 47.1% of the patients with HAND, respectively. In multivariate analysis, haemoglobin (Hb) level ≤ 13 g/dL (P = 0.046) and current use of a protease inhibitor-based regimen (P = 0.031) were independent risk factors for HAND. The sensitivity and specificity of the IHDS were 72.6 and 60.8%, and those of MoCA-K were 52.9 and 73.4%, respectively. The IHDS (P < 0.001) and MoCA-K (P < 0.001) were both useful for screening for HAND. Among NP tests, the sensitivity and specificity of the Grooved Pegboard Test were 90.2 and 72.0%, and those of the Wisconsin Card Sorting Test were 61.2 and 84.4%, respectively.

CONCLUSIONS

HAND is a prevalent comorbidity in HIV-infected Koreans. Active screening and diagnosis with effective tools, such as the IHDS, MoCA-K and Grooved Pegboard Test, could be used to identify this important complication.

Incidence of and risk factors for active tuberculosis in human immunodeficiency virus-infected patients in South Korea

BACKGROUND

In South Korea, a high-income country with an intermediate tuberculosis (TB) burden and low human immunodeficiency virus (HIV) prevalence, studies on incidence and risk factors of TB in HIV-infected persons have rarely been reported.

OBJECTIVE

To investigate the incidence of and risk factors for active TB in HIV-infected persons in South Korea.

METHODS

A retrospective analysis was conducted of 1265 HIV-1 infected patients who visited four hospitals in South Korea between 1985 and 2012. We analysed the incidence of TB during the follow-up period. To investigate risk factors associated with active TB, we conducted a 1:2 matched case-control study of HIV-infected patients with newly active TB and controls without active TB who had similar CD4(+) T-cell counts and dates of first visit.

RESULTS

Over a total of 4457 person-years (py), 185 (14.6%) subjects were diagnosed with active TB; the incidence was 4.2 cases/100 py. In multivariate analysis, low body mass index (P = 0.033) and current smoking (P = 0.003) were independent risk factors for TB in HIV-infected patients.

CONCLUSION

Further strategies on prevention and treatment of active TB among HIV-infected patients should be implemented in South Korea. Encouraging smoking cessation and supporting good nutrition may be ways to reduce the incidence of active TB in HIV-infected patients.

Prognostic significance of the interval between the initiation of antiretroviral therapy and the initiation of anti-tuberculosis treatment in HIV/tuberculosis-coinfected patients: results from the TREAT Asia HIV Observational Database

OBJECTIVES

We evaluated the effect of the time interval between the initiation of antiretroviral therapy (ART) and the initiation of tuberculosis (TB) treatment on clinical outcomes in HIV/TB-coinfected patients in an Asian regional cohort.

METHODS

Adult HIV/TB-coinfected patients in an observational HIV-infected cohort database who had a known date of ART initiation and a history of TB treatment were eligible for study inclusion. The time interval between the initiation of ART and the initiation of TB treatment was categorized as follows: TB diagnosed while on ART, ART initiated ≤ 90 days after initiation of TB treatment ('early ART'), ART initiated > 90 days after initiation of TB treatment ('delayed ART'), and ART not started. Outcomes were assessed using survival analyses.

RESULTS

A total of 768 HIV/TB-coinfected patients were included in this study. The median CD4 T-cell count at TB diagnosis was 100 [interquartile range (IQR) 40-208] cells/μL. Treatment outcomes were not significantly different between the groups with early ART and delayed ART initiation. Kaplan-Meier analysis indicated that mortality was highest for those diagnosed with TB while on ART (3.77 deaths per 100 person-years), and the prognoses of other groups were not different (in deaths per 100 person-years: 2.12 for early ART, 1.46 for delayed ART, and 2.94 for ART not started). In a multivariate model, the interval between ART initiation and TB therapy initiation did not significantly impact all-cause mortality.

CONCLUSIONS

A negative impact of delayed ART in patients coinfected with TB was not observed in this observational cohort of moderately to severely immunosuppressed patients. The broader impact of earlier ART initiation in actual clinical practice should be monitored more closely.

The impact of post-transplant hemoglobin level on renal allograft outcome

BACKGROUND

Anemia is a common complication of chronic renal disease and renal transplantation. Early post-transplant anemia is the consequence of blood loss, immunosuppressant therapy, and failure to produce sufficient erythropoietin. Late post-transplant anemia has been attributed to drug therapy, renal dysfunction, and infection. The effect of post-transplant anemia on renal allograft survival and acute rejection rates is not established. The aim of this study was to examine the impact of post-transplant anemia on renal function and allograft outcomes.

MATERIALS AND METHODS

We included 411 patients who underwent living or deceased donor renal transplantations in our center from April 1990 to March 2010. The patients were divided into 2 groups according to their postoperative hemoglobin level at 1 month: anemic group (<12.0 g/dL in men, <11.0 g/dL in women) and nonanemic group (≥ 12.0 g/dL in men, ≥ 11.0 g/dL in women). The outcome measures included postoperative serum creatinine levels at 12 and 36 months, acute and chronic rejection rates, as well as long-term graft survival.

RESULTS

The acute and chronic rejection rates were significantly higher in the anemic group: 28.1% versus 19.7% (P = .000) and 24.1% versus 19.7% (P = .027), respectively. Postoperative serum creatinine levels at 12 and 36 months were not significantly different in patients with functioning grafts regardless of their anemia status (P = .530 and P = .430, respectively). Graft survival was lower with anemia: 85.4% versus 93.8% at 5 years, and 74.8% versus 83.5% at 10 years (P = .040).

CONCLUSIONS

Post-transplant anemia was associated with poorer renal function at 12 months, higher acute rejection rates, and worse long-term renal allograft outcomes compared with subjects displaying normal hemoglobin levels.

The optical properties of quantum transition on ZnS and Ge of electron-piezoelectric interaction system under two circularly oscillating fields

We study optical quantum transition line shapes (QTRSs) and optical quantum transition line widths (QTLWs) in relation to magnetic-field dependence properties of the electron-piezoelec potential phonon interaction system. We consider two systems-one is subject to right circularly oscillating external fields and the other is subject to left circularly oscillatory external fields. The main purpose of this work is to compare QTLSs, which indicate absorption power, in the two oscillating external fields. Our results indicate that the QTLSs of right circularly oscillating external fields is larger than the QTLSs of left circularly oscillating external fields, while the opposite result is obtained for the QTLWs. Through the analysis of this work, we found the increasing properties of QTLW and QTLS of ZnS and Ge with the temperature and the magnetic fields. We also found the dominant scattering processes are the phonon emission transition process.