Efficacy of macrolides on gastric motility in extremely low birth weight infants

BACKGROUND

The efficacy of macrolide treatment on gastrointestinal motility and acquirement of feeding tolerance in extremely low birth weight (ELBW) infants are controversial. This study aimed to evaluate clinical effects of parenterally administered erythromycin (EM) and clarithromycin (CAM) on gastrointestinal motility in ELBW infants.

METHODS

ELBW infants treated in Tokyo Medical University Hospital were retrospectively studied. Several outcomes of ELBW infants treated with EM or CAM were compared with those recognized before initiation of the medication, as well as with those of patients with no macrolide treatment. The primary outcomes included average gastric residual volume that was evaluated 3 hours after enteral feeding. Secondary outcomes were the number of patients who developed feeding intolerance, stool frequency, and other adverse events, such as respiratory comorbidities and pyloric stenosis.

RESULTS

Among a total of 53 infants, 20 and 13 were treated with EM and CAM, respectively, whereas 20 infants were not administered macrolides. The gastric residual volume was significantly decreased after initiation of medication compared with before medication in the EM group, whereas that of the untreated group showed no change. When the EM and CAM groups were combined, the gastric residual volume was also significantly decreased after treatment compared with before treatment. An increase in stool frequency and pyloric stenosis were not observed in the groups.

CONCLUSION

EM might be effective for acquiring feeding tolerance in ELBW infants. A future prospective study with a larger population is required to determine the efficacy of CAM.

Long-term investigation of phosphorus removal by iron electrocoagulation in small-scale wastewater treatment plants

Small-scale wastewater treatment plants (SWTPs), called Johkasou, are widely used as decentralized and individual wastewater treatment systems in sparsely populated areas in Japan. Even in SWTPs, nutrients should be removed to control eutrophication. An iron electrolysis method is effective to remove phosphorus chemically in SWTPs. However, it is necessary to determine the precise conditions under which phosphorus can be effectively and stably removed in full scale SWTPs for a long period. Therefore, long-term phosphorus removal from SWTPs was investigated and optimum operational conditions for phosphorus removal by iron electrolysis were analyzed in this study. Efficient phosphorus removal can be achieved for a long time by adjusting the amount of iron against the actual population equivalent. The change of the recirculation ratio had no negative effect on overall phosphorus removal. Phosphorus release to the bulk phase was prevented by the accumulated iron, which was supplied by iron electrolysis, resulting in stable phosphorus removal. The effect of environmental load reduction due to phosphorus removal by iron electrolysis was greater than the cost of power consumption for iron electrolysis.

Role of Toll-like Receptor 4 Expressed by Fibroblasts in Allograft Fibrosis in Mouse Orthotopic Tracheal Transplantation

Development of chronic lung allograft dysfunction involves various alloimmune-independent insults including those mediated by Toll-like receptor (TLR) signaling, which is known to activate alloimmune responses. We hypothesized that TLR signaling may also contribute to the activation of fibroblasts and promoting allograft airway fibrosis. Mouse orthotopic tracheal transplants were conducted between major histocompatibility complex (MHC)-mismatched Balb/c donor and wild-type C3H or C3H-derived TLR4 mutant recipients (nonfunctional TLR4). Immunohistochemistry on day 21 showed significantly smaller alpha-smooth muscle actin (α-SMA)-positive areas in TLR4 mutant recipients than wild-type recipients (P = .01). No difference was found for CD3+ T-cell infiltration. Proliferation of alloreactive T cells derived from the recipient spleen showed no difference between TLR4 mutant and wild-type recipients in a mixed lymphocyte reaction. The effect of TLR4 signaling was examined in primary pulmonary fibroblast cultures both with lipopolysaccharide (LPS) and transforming growth factor (TGF)-β1. Stimulation with LPS significantly increased expression of α-SMA mRNA in wild-type fibroblasts cultured with TGF-β1 compared with the control without LPS (P = .001). Taken together, these findings suggest disruption of TLR signaling leads to reduced activation of fibroblasts without affecting T-cell infiltration and proliferation in this model. TLR4-mediated activation of fibroblasts may be a potentially important mechanism of allograft remodeling.

Improvement of phosphorus removal by calcium addition in the iron electrocoagulation process

Small-scale wastewater treatment plants (SWTPs) are widely used as decentralized wastewater treatment systems in sparsely populated areas of Japan. Iron electrolysis, an electrocoagulation technology, is installed in these SWTPs for phosphorus removal. Phosphorus can be removed via the formation of an insoluble compound containing phosphate and iron, such as FePO₄; however, it was necessary to determine the conditions under which phosphorus can be effectively and stably removed in actual SWTPs. According to previous studies using iron compounds, improved phosphorus removal was obtained by Ca addition. It is therefore thought that calcium addition may also be effective in improving the phosphorus removal during iron electrolysis in SWTPs. It is also important to determine the chemical state of iron to understand the phosphorus removal mechanism during iron electrolysis. In this study, laboratory-scale batch experiments with the iron electrolysis method were conducted to investigate the effect of phosphorus removal using treated wastewater from actual SWTPs without or with Ca addition. The results indicated that the addition of Ca improved the phosphorus removal performance. Furthermore, phosphorus removal was inhibited in the presence of high dissolved organic carbon (DOC). The X-ray absorption fine structure measurements of the produced particulates in the experiments showed no substantial change in the chemical state of iron without or with Ca addition. The statistical analyses revealed the range of improving or inhibiting effects on phosphorus removal due to the Ca and DOC. Thus, the results of this study provided useful information pertaining to the influence of coexisting substances on phosphorus removal and the chemical state of iron in the produced particulates.

De novo EEF1A2 mutations in patients with characteristic facial features, intellectual disability, autistic behaviors and epilepsy

Eukaryotic elongation factor 1, alpha-2 (eEF1A2) protein is involved in protein synthesis, suppression of apoptosis, and regulation of actin function and cytoskeletal structure. EEF1A2 gene is highly expressed in the central nervous system and Eef1a2 knockout mice show the neuronal degeneration. Until now, only one missense mutation (c.208G > A, p.Gly70Ser) in EEF1A2 has been reported in two independent patients with neurological disease. In this report, we described two patients with de novo mutations (c.754G > C, p.Asp252His and c.364G > A, p.Glu122Lys) in EEF1A2 found by whole-exome sequencing. Common clinical features are shared by all four individuals: severe intellectual disability, autistic behavior, absent speech, neonatal hypotonia, epilepsy and progressive microcephaly. Furthermore, the two patients share the similar characteristic facial features including a depressed nasal bridge, tented upper lip, everted lower lip and downturned corners of the mouth. These data strongly indicate that a new recognizable disorder is caused by EEF1A2 mutations.

A facile transphosphatidylation reaction using a culture supernatant of actinomycetes directly as a phospholipase D catalyst with a chelating agent

An attempt was made to use the phospholipase D (PLD)- containing culture supernatants of actinomycetes directly as catalysts for the transphosphatidylation reaction of phosphatidylcholine (PC) to phosphatidylethanolamine (PE) in a biphasic system. Of the five actinomycetes (three Streptomyces sp. and two Streptoverticillium sp.) examined, three (St. mediocidicus, Stv. cinnamoneum and Stv. hachijoense) exhibited good PLD production performance, but the selectivity (ratio of transphosphatidylation to hydrolysis) of the PLDs in the culture supernatant of all three actinomycetes were significantly low. However, the addition of EDTA to the reaction mixture as a chelating agent remarkably improved the selectivity of the PLDs, which approached 100% in all the culture supernatants. Commercially available PLDs were also investigated and classified into two types. The PLDs of one type had high selectivity and no metal was required for the enzyme activity, while those of the other type showed low selectivity and a metal was necessary for the enzyme to be activated. From this finding, it was considered that the culture supernatants used in this study contained several PLDs of both types. When the chelating agent was added to the reaction mixture, the hydrolysis due to PLDs with low selectivity was suppressed by removal of the essential metal, resulting in an increased in the overall selectivity of the PLDs in the culture supernatant. Repeated batch transphosphatidylation reactions were performed 20 times, reusing the PLDs in the aqueous phase by centrifugation; the reaction rate gradually decreased to 60% of that of batch 1 by batch 20. This suggests that the transphosphatidylation reaction using a culture supernatant has potential for industrial application. (c) 1994 John Wiley & Sons, Inc.