Emerging in December, 2019, SARS-CoV-2 is spreading worldwide, endangering the citizens of the globe The authors sought to develop a feasible real-time RT-PCR method to detect RNA of the virus The fluorescent probe the authors designed proved its potency and utility, by detecting in vitro transcribed RNA sequence at an estimated concentration approximating a single copy per reaction, used along with 3 sets of primers that flank the probe sequence Though not tested against actual viral RNA, or clinical specimens, this method can serve as another choice of rapid detection of the plague-causing virus
Rapid recognition of bacteremia is important for critical care, especially in patients with suspected bloodstream infections. Procalcitonin and presepsin are widely used biomarkers in point-of care medical testing for identifying infectious diseases and sepsis; however, the diagnostic accuracy for the prediction of bacteremia is not well established. Therefore, this study aimed to evaluate the diagnostic accuracy of procalcitonin and presepsin for the prediction of bacteremia in patients with suspected bacteremia. We performed a prospective observational study at our hospital. A total of 210 patients (307 samples) who had been admitted from December 2014 through September 2016 with a suspected infection were included. Presepsin and procalcitonin were tested simultaneously with blood cultures and routine laboratory tests. One hundred and four blood samples were obtained at the emergency room (ER). Others were obtained during hospital admission. Blood cultures were positive in 34 samples; 25 samples were obtained in the ER. Presepsin and procalcitonin levels were significantly higher in patients with positive blood cultures than in those with negative blood cultures (1028.5 pg/mL vs. 485.0 pg/mL, P < 0.001 and 4.53 ng/mL vs. 0.33 ng/mL, P < 0.001, respectively). For predicting bacteremia, receiver operating characteristic curve analysis for presepsin showed an area under the curve (AUC) of 0.718 and negative predictive value (NPV) of 95%. The analysis for procalcitonin showed an AUC of 0.778 and NPV of 94.8%. C-reactive protein tests and the quick Sequential Organ Failure Assessment score in the ER failed to be useful tools for predicting bacteremia. Based on our results, procalcitonin and presepsin showed good diagnostic accuracy and NPV for predicting bacteremia among patients with suspected infection. Therefore, these biomarkers may be useful for ruling out bacteremia in patients with suspected infection. doi:10.11482/KMJ-E201945027 (Accepted on June 8, 2019)
Chronic inflammation plays a key role in the pathogenesis of malignant pleural mesothelioma as a result of asbestos exposure. Signal transducer and activator of transcription 3 (STAT3) signaling is a major pathway for cancer inflammation. The purpose of this study was to investigate the effectiveness of a new STAT3 inhibitor, BBI608, on mesothelioma cells in vitro and in vivo . The results showed that BBI608 blocked STAT3 phosphorylation, with and without suppression of IL-6. The effects of BBI608 on STAT3 downstream target genes such as cyclin D1 and survivin involved a decrease in cell viability with induction of apoptosis and cell cycle arrest. Nuclear translocation of phosphorylated STAT3 was blocked by BBI608. In addition, the agent showed significant antitumor activity in xenograft mouse models implanted with mesothelioma cells. These findings suggest that BBI608 may be a novel agent for malignant mesothelioma. doi:10.11482/KMJ-E201945061 (Accepted on July 16, 2019)
Serratus-intercostal plane block (SPB) is performed in thoracic surgery and breast cancer surgery because it is safer and easier to perform than epidural anesthesia. However, the effect of SPB on stress hormones has not been investigated. Patients with lung cancer who were scheduled to undergo video-assisted thoracoscopic surgery (VATS) during the period from September 2017 to April 2018 were included in this single-center randomized trial. The institutional ethics committee approved this study (approval No. 2802-1). Patients were assigned to group B (SPB) or group E (epidural anesthesia). Levobupivacaine was administered as a local anesthetic to either the epidural space or serratus plane space. Blood samples were taken to measure levels of stress hormones including adrenaline, noradrenaline, dopamine, cortisol, and glucose at the induction of anesthesia and on the day following surgery. Sixteen patients were included in the current study. Seven of those patients were assigned to group B and the other 9 patients were assigned to group E. Plasma adrenaline level in group B was significantly higher than that in group E postoperatively (P = 0.007). However, other markers were not different between the two groups, and there was no difference in pain scores between the two groups. In conclusion, SPB is an alternative analgesic method to epidural anesthesia in patients undergoing VATS. doi:10.11482/KMJ-E201945053 (Accepted on June 17, 2019)
There is growing evidence that ventricular diastolic dysfunction is a major pathological factor in heart failure. Although many basic and clinical studies have been reported, there is little information available about the comparative and evolutionary aspects of the diastolic properties of vertebrate ventricles. Cardiac tissues in extant vertebrates are roughly divided into two types; compact myocardium in mammals and aves, and spongious myocardium in amphibians and some of reptilians. Here we compared the mechanical properties of both whole ventricles and the biochemical properties of isolated cardiomyocytes (including intracelluar Ca ([Ca]i) handling, and the lengths of elastic regions of connectin, a protein that determines elasticity of cardiomyocytes) between spongious ventricles of turtles (Trachemys scripta elegans) and compact ventricles of Wister rats. Ventricular diastolic function is composed of active relaxation and passive compliance. We investigated ventricular compliance by analyzing normalized end-diastolic pressure-volume relationship (EDPVR) of diastolic-arrested ventricles to compare different-sized hearts and ventricular relaxation by determining logistic time constants of pressure decay. We measured [Ca]i handling using isolated cardiomyocytes. Stiffness constants obtained from exponential curve fitting were significantly larger in rat left ventricles (LVs) compared with turtle ventricles (99.0 ± 7.3 and 2.07 ± 0.62, respectively) showing that rat LVs were much stiffer than turtle ventricles. Normalization of EDPVRs revealed that the turtle ventricle and rat LV exhibit species-specific characteristics in ventricular compliance. At the cellular level, the initial normalized stiffness of rat cardiomyocytes (8.03 ± 1.33 kPa) was 2.8 times higher than in those of the turtle (2.82 ± 0.38 kPa), showing that turtle cardiomyocytes were much more compliant than those of rats. With respect to relaxation, the time constant of isovolumic relaxation in the rat LV pressuretime curve was significantly smaller than that in turtle ventricles (10.7 ± 0.96 and 67.4 ± 3.55 ms, respectively), resulting in early-phase-dominant ventricular filling patterns in rats. The time to peak [Ca]i and the decay time after peak [Ca]i in turtle cardiomyocytes were significantly 〈Regular Article〉 2 Kawasaki Medical Journal
Effective treatment of neuropathic pain is challenging as its underlying mechanism remains largely unknown. Recently, the participation of brain-derived neurotrophic factor (BDNF) in neuropathic pain has been attracting increased attention. BDNF binds to a member of the tyrosine kinase receptor family, the TrkB receptor, that is specific for BDNF and is the transmembrane receptor on the posterior horn of spinal cord. In the present study, we purified two proteins that included the BDNF-binding domain of TrkB (eTrkB) and eTrkB coupled with a liposomal outer surface (liposomal eTrkB) in order to inhibit the BDNF-TrkB pathway in neuropathic pain. Results of the pull-down assay showed that eTrkB was bound to BDNF. We investigated the neuropathic pain suppression effect of this purified protein by its intrathecal administration in a rat neuropathic pain model. Mechanical and thermal hyperalgesia induced by L5 lumbar nerve ligation was markedly suppressed by treatment with eTrkB protein. Furthermore, we showed a prolonged algetic inhibition by liposomal eTrkB protein treatment. In conclusion, this study suggests that eTrkB, which sequesters endogenous BDNF and inhibits the BDNF-TrkB pathway, may prove to be a novel analgesic to treat neuropathic pain.
Matrix-producing carcinoma (MPC) of the breast is relatively rare. We report on a case of MPC of the breast during lactation. A female in her 30s noticed a lump in the upper inner and outer quadrants of her left breast 9 months into her pregnancy. She came hospital at one month after delivery. Ultrasonography revealed a hypoechoic tumor with an unclear border region. An MRI revealed a breast tumor approximately 19 mm in size, with dynamic studies demonstrating early contrast and ring enhancement. A core needle biopsy was performed, resulting in an histopathological diagnosis of invasive carcinoma [Estrogen receptor-, Progesterone receptor-, Human epidermal growth factor receptor 2(HER2)-; stage I, T1cN0M0]. Breast-conserving surgery and a sentinel lymph node biopsy (SLNB) were performed. The SLNB was negative for cancer. Chemotherapy (FEC100, DTX75) and radiotherapy were performed as adjuvant therapies. Seventeen months after surgery, the patient is recurrence-free. doi:10.11482/KMJ-E43(1)21 (Accepted on February 22, 2017)
