The thymus and activation-regulated chemokine (TARC) level in serum at an early stage of a drug eruption is a prognostic biomarker of severity of systemic inflammation

Background

In severe drug eruptions, precise evaluation of disease severity at an early stage is needed to start appropriate treatment. It is not always easy to diagnose these conditions at their early stage. In addition, there are no reported prognostic biomarkers of disease severity in drug eruptions. The aim of this study was to test whether the thymus and activation-regulated chemokine (TARC) level in serum at an early stage of a drug eruption can serve as a prognostic biomarker of systemic inflammation.

Subclavian steal syndrome associated with the right aortic arch in a patient with Peutz-Jeghers syndrome: case report

We report an adult case who presented vertigo attacks due to subclavian steal syndrome associated with the right aortic arch in a patient with Peutz-Jeghers syndrome. A 29-year-old male diagnosed as having Peutz-Jeghers syndrome developed frequent vertigo attacks and was admitted to our hospital. Blood pressure of the left arm was 20 mmHg lower than that of the right arm. Aortagraphy showed that he had a right aortic arch and isolation of the left subclavian artery. Right vertebral angiography opacified the left vertebral artery and the subclavian artery in retrograde fashion, suggesting subclavian steal phenomenon. Blood flow studies disclosed impaired reactivity to acetazolamide in the bilateral cerebellar hemispheres. We successfully carried out left common carotid artery-transverse cervical artery bypass. Postoperative angiography confirmed the patency of the graft and the disappearance of subclavian steal phenomenon. Vasoreactivity to acetazolamide normalized in the cerebellum. Vertigo attacks were not noted during the one-year follow-up period.     

Percutaneous retrograde recanalization of an occluded celiac artery complicating acute aortic dissection

A 79-year-old woman with a complaint of persistent upper abdominal pain was admitted to our hospital for the treatment of thrombosed acute type B aortic dissection. Computed tomography showed the complete static occlusion of the celiac artery. Because of progressive symptom with elevation of liver enzymes and metabolic acidosis 11?h after admission, endovascular revascularization was attempted on an emergent basis. After a failed catheterization of the celiac ostium in an antegrade fashion due to a hard occlusion, we succeeded in a retrograde recanalization through the pancreaticoduodenal arcade via the superior mesenteric artery with stent placement using a pull-through technique. This technique is useful and safe when an antegrade approach seems difficult.     

AT-1015, a novel serotonin2A receptor antagonist, improves resaturation of exercised ischemic muscle in hypercholesterolemic rabbits

OBJECTIVE: The effect of AT-1015, a serotonin(2A) receptor antagonist, on the resaturation of ischemic muscle in a hypercholesterolemic rabbit model was examined with near-infrared spectroscopy. METHODS: New Zealand White male rabbits were fed normal chow or cholesterol-rich chow. Ischemia was induced in the right hindlimb by ligation of the femoral artery, accompanied by balloon injury of the iliac artery. At 3 days after induction of ischemia, the bilateral gastrocnemius muscles were subjected to passive contraction for 2 minutes. The oxygen resaturation time of the gastrocnemius muscle after exercise was measured by near-infrared spectroscopy. AT-1015 was orally administered for 3 days after induction of ischemia. Assay of serotonin level in platelet-poor plasma and histologic examination of muscle and artery were performed in another set of rabbits. RESULTS: Oxygen resaturation time of the ischemic gastrocnemius was significantly prolonged in hypercholesterolemic rabbits compared with in normal rabbits without AT-1015, whereas there was no difference between both groups of rabbits that were administered AT-1015. Plasma level of serotonin in hypercholesterolemic rabbits was significantly increased compared with that in normal rabbits. No histologic differences were found in both muscle and artery among all groups. CONCLUSIONS: A serotonin(2A) receptor antagonist improved the oxygen resaturation of ischemic calf muscle after exercise in hypercholesterolemia. The interaction between plasma free serotonin and the serotonin(2A) receptor may play an important role in muscle oxygenation in ischemic limbs.     

High-resolution nuclear magnetic resonance spectroscopic study of metabolites in the cerebrospinal fluid of patients with cervical myelopathy and lumbar radiculopathy

There have been few reports describing substances related to oxidative and intermediary metabolism in the cerebrospinal fluid (CSF) in patients with spinal degenerative disorders. This study investigated whether the concentrations of metabolites in the CSF differed between patients with spinal degenerative disorders and controls, and whether the concentrations of these metabolites correlated with the severity of symptoms. CSF samples were obtained from 30 patients with cervical myelopathy (Group M), 30 patients with lumbar radiculopathy (Group R), and 10 volunteers (control). Metabolites in these CSF samples were measured by nuclear magnetic resonance spectroscopy. There were no differences in the concentrations of lactate, alanine, acetate, glutamate, pyruvate, or citrate between Groups M and R, between Group M and the control, or between Group R and the control. In Group M, neither symptom duration nor the Japanese Orthopaedic Association score correlated with the concentration of any metabolite. In Group R, the symptom duration positively correlated with the concentration of lactate, glutamate, and citrate in CSF. The duration of nerve root block showed a negative correlation with the concentrations of acetate in CSF of the patients in Group R. In patients with lumbar radiculopathy, there is a possibility of increased aerobic metabolic activity or decreased gluconeogenic activity in patients with shorter symptom duration, and increased aerobic metabolic activity in patients with severe inflammation around a nerve root.     

Association of serum NO x level with clustering of metabolic syndrome components in middle-aged and elderly general populations in Japan

Objectives The aim of this study was to determine whether the serum nitrite plus nitrate (NO _x ) level correlates with biomarkers that are known components of the metabolic syndrome (MetS). Methods Serum NO _x levels were measured using a commercial kit in 608 Japanese men and women between the ages of 39 and 85 years. Multivariate adjustments for age, smoking status, alcohol consumption and exercise were made in the analysis of covariance (ANCOVA). The components of the metabolic syndrome were defined based on the following criteria: body mass index (BMI) ≥25.0 kg/m², glycated hemoglobin (HbA1c) ≥5.6%, systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥85 mmHg, high-density lipoprotein-cholesterol (HDL-C) ≤1.03 mmol/l for men and ≤1.29 mmol/l for women and triglyceride ≥1.69 mmol/l. Results The logarithmically transformed age-adjusted serum NO _x (lnNO _x ) value was significantly higher in the low HDL-C group (1.76 ± 0.05 μmol/l; p < 0.05) than MetS component groups (1.65 ± 0.01 μmol/l) in men, but no difference was found in women. The means of serum lnNO _x after multivariate adjustment were 1.64, 1.65, 1.64, 1.66, and 1.81 μmol/l for 0, 1, 2, 3, and 4–5 MetS components for all subjects, respectively. The results of ANCOVA confirmed that the serum lnNO _x level was significantly correlated with the clustering of MetS components in both men and women (p < 0.0001 for trend). Conclusion Our results suggest that an increase in the clustering of MetS components was associated with the increase in serum NO levels in our general population.