N-terminal pro-brain natriuretic peptide predicts hospitalization for ischemic stroke in Japanese hemodialysis patients

Clinical and Experimental Nephrology - The association between N-terminal pro-brain natriuretic peptide (NT-proBNP) and stroke in Japanese hemodialysis (HD) outpatients is unclear. Therefore, in...     

Three cases of Candida fermentati fungemia following hematopoietic stem cell transplantation

Bloodstream infection with non-Candida albicans Candida species is one of the serious complications among patients with hematological malignancies who receive long-term prophylactic antifungal agents. Here we describe three cases of Candida fermentati (C. fermentati) candidemia after allogeneic stem cell transplantation for hematological malignancies. Case 1 is fluconazole-breakthrough C. fermentati fungemia, which was well controlled with liposomal amphotericin B. Case 2 and 3 were caspofungin-breakthrough C. fermentati fungemia. In case 2, blood culture turned negative for Candida responding to liposomal amphotericin B. Although in vitro susceptibility data for the isolated pathogen suggested the efficacy of both caspofungin and liposomal amphotericin B in all three cases, clinically liposomal amphotericin B seemed to have been more effective for eradication of the pathogen from blood stream. C. fermentati needs to be considered as a possible cause for breakthrough candidemia among post-transplant patients with prolonged antifungal prophylaxis. Discrepancy between in vitro and in vivo susceptibility to antifungals, especially to echinocandins, might provide a clue for the optimal choice of antifungals for C. fermentati infections.     

Depth of cure and hardness of an indirect composite polymerized with three laboratory curing units

This study determined the hardness and curing depth of a light-activated indirect composite polymerized with three laboratory light-polymerizing units for the purpose of comparing the curing performance of the three units. A light-activated composite material for indirect application (Vita Zeta) was polymerized with three light-polymerizing units equipped with the following light sources: 1) one halogen lamp and two fluorescent lamps (alpha-Light II); 2) three halogen lamps (Twinkle HLG); and 3) one metal halide lamp (Twinkle LI). Knoop hardness and curing depth were determined for groups of five specimens using standardized testing methods. The results were compared using analysis of variance (ANOVA) and Scheffé's S intervals (alpha = 0.05). The Knoop hardness number (KHN) generated with the halogen-fluorescent unit (12.5 KHN) was significantly (P < 0.05) lower than those produced by the halogen unit (13.9 KHN) and the metal halide unit (14.2 KHN). Of the three units, the halogen-fluorescent unit exhibited the lowest depth of cure. Both the hardness and curing depth of the composite were influenced by the laboratory polymerizing units employed.     

A 9-year-old girl with Kawasaki disease and pulmonary nodules

Clinical Rheumatology -     

A Receptor-Independent Effect of Estrone Sulfate on the hERG Channel

We recently reported that physiological concentrations of 17β-estradiol partially down-regulate cardiac rapidly-activating delayed rectifier K⁺ currents (hERG currents) independently of estrogen-receptor signaling. To determine if other estrogens have the same effect as that of 17β-estradiol, we investigated receptor-independent effects of estrone, estrone 3-sulfate, and estriol on hERG currents in patch-clamped estrogen-negative HEK293 cells. Only estrone 3-sulfate partially suppressed hERG currents in a receptor-independent manner by modifying the gating. The concentration-dependence of estrone 3-sulfate revealed that physiological levels of circulating estrone 3-sulfate can modulate hERG currents to the maximal extent in both women and men at any age.     

An infant case of macroprolactinemia with transient idiopathic central precocious puberty

Macroprolactinemia was recognized more than a decade ago as a cause of hyperprolactinemia and the prevalence of macroprolactinemia is thought to be 10%-26% of patients with hyperprolactinemia. However, there are few published reports about macroprolactinemia in childhood. We report a 7-year-and-1-month-old girl with hyperprolactinemia due to macroprolactinemia with the complication of transient idiopathic central precocious puberty (ICPP). At the age of 6 years and 9 months, she was diagnosed with ICPP at another clinic, on the basis of isolated mammary development and increased height velocity with slightly advanced bone age. At that time, the unexpected finding of high PRL level was also observed. Four months later, she was referred to our clinic for persistently high PRL level. At this time, other endocrinological data showed prepubertal stage and we demonstrated macroprolactinemia and the presence of anti-PRL autoantibody. After other causes of hyperprolactinemia such as prolactinoma and stress were ruled out, we finally diagnosed her with hyperprolactinemia due to macroprolactinemia. Because most patients with macroprolactinemia are symptom-free despite hyperprolactinemia and drug therapy would not be indicated, macroprolactinemia should be suspected even in children to avoid unnecessary examinations and treatments.     

Seroconversion of acute hepatitis B by antiretroviral therapy in an HIV-1 infected patient

A 33-year-old man with human immunodeficiency virus type1 (HIV-1) infection was admitted because of acute hepatitis B. His serum alanine aminotransferase level was 1200 IU/mL and CD4 cells count was 268/mm3. Antiretroviral therapy including tenofovir and emtricitabine, which suppresses both HIV and hepatitis B virus (HBV) replication, was initiated. The liver enzymes decreased dramatically. The viral loads of both HIV-1 and HBV were suppressed below detectable limits. Seroconversion from hepatitis B surface antigen to hepatitis B surface antibody was acquired 19 weeks later. In this case, the initiation of antiretroviral therapy with anti-HBV activity during the acute phase of hepatitis B had a favourable effect on HBV serostatus.     

Effects of an hERG Activator,ICA-105574, on Electrophysiological Properties of Canine Hearts

In short QT syndrome, inherited gain-of-function mutations in the human ether a-go-go-related gene (hERG) K⁺ channel have been associated with development of fatal arrhythmias. This implies that drugs that activate hERG as a side effect may likewise pose significant arrhythmia risk. hERG activators have been found to have diverse mechanisms of activation, which may reflect their distinct binding sites. Recently, the new hERG activator ICA-105574 was introduced, which disables inactivation of the hERG channel with very high potency. We explored characteristics of this new drug in several experimental models. Patch clamp experiments were used to verify activation of hERG channels by ICA-105574 in human embryonic kidney cells stably-expressing hERG channels. ICA-105574 significantly shortened QT and QTc intervals and monophasic action potential duration (MAP₉₀) in Langendorff-perfused guinea-pig hearts. We also administered ICA-105574 to anesthetized dogs while recording ECG and drug plasma concentrations. ICA-105574 (10 mg/kg) significantly shortened QT and QTc intervals, with a free plasma concentration of approximately 1.7 μM at the point of maximal effect. Our data showed that unbound ICA-105574 caused QT shortening in dogs at concentrations comparable to the half maximal effective concentration (EC₅₀, 0.42 μM) of hERG activation in the patch clamp studies.     

Voice rehabilitation for laryngeal cancer after radiotherapy: a systematic review and meta-analysis

European Archives of Oto-Rhino-Laryngology - We aimed to determine whether voice rehabilitation after radiotherapy improves the quality of life (QOL), voice function, and self-rated voice function...