Cardiopulmonary functional capacity in Taiwanese children with atrial septal defects.

BACKGROUND: Most existing studies measure atrial septal defect (ASD) outcomes based on morbidity rates such as atrial arrhythmias and heart failure rather than the functional assessment of physical capacity postprocedure. Few studies have evaluated cardiopulmonary function in ASD children. This study represents the largest sample population in the current research, encompassing a total of 122 Taiwanese children with ASD who had undergone treatment, to evaluate cardiopulmonary functional capacity through the implementation of cardiopulmonary exercise testing (CPET), and to investigate whether variations in treatment may impact their cardiopulmonary function. METHODS: This is a retrospective cohort study with the data collected from January 2010 to December 2021. All patients and controls (age-, sex-, and body mass index-matched) underwent CPET and pulmonary function testing. RESULTS: In total, 122 ASD patients (surgically closed ASDs 27, transcatheter-closed ASDs 48, and follow-up unrepaired ASD 47) and 244 healthy controls were recruited. The ASD group exhibited lower peak metabolic equivalent (MET), peak oxygen consumption (VO 2 , p < 0.001), and peak minute ventilation ( p = 0.028) along with MET and VO 2 at the anaerobic threshold (AT) ( p = 0.012) compared to the control group. No statistically significant differences were observed in the pulmonary function test. Among surgically closed, transcatheter closed and unrepaired ASD subgroups, no significant variances were seen in CPET and pulmonary function tests. CONCLUSION: Taiwanese ASD children exhibited diminished exercise capacity and cardiopulmonary performance compared to their healthy counterparts. Differences among specific ASD treatments in cardiopulmonary tests were non-significant.

The Pre-Discharge Oxygen Uptake Efficiency Slope Predicts One-Year Cardiovascular Events in Acute Decompensated Heart Failure Patients.

(1) Background: Heart failure is a complex disease leading to functional disability. Cardiopulmonary exercise testing (CPET) is the gold standard in assessing aerobic capacity and formulating function-based prognostic stratification; however, patients with acute heart failure after medical treatment usually remain with markedly reduced exercise capacity, leading to early termination of CPET with submaximal testing results. The current study aimed to assess the cardiorespiratory fitness and characteristics of CPET variables of patients after acute heart failure treatment and determine potential CPET variables with prognostic value. (2) Methods: We recruited patients during hospitalization after management of acute heart failure, and pre-discharge CPET was performed. All enrolled patients were followed for one year for major adverse cardiovascular events (MACE). (3) Results: 85 patients were enrolled, with average left ventricular ejection fraction of 30.52%, and peak oxygen consumption of 10.85 mL/min/kg at baseline. The one-year MACE was 50%. Oxygen uptake efficiency slope (OUES) was a significant event predictor, with lower one-year MACE in those with OUES ≥ 1.25 (p < 0.001). Cox regression analysis showed a 5.421-fold increased risk of MACE in those with OUES < 1.25 (p = 0.004). (4) Conclusions: The current results suggested OUES is a significant prognostic indicator in patients with acute heart failure. This also emphasized the critical role of CPET in patients with heart failure for prognostic stratification.

High Levels of Serum Adipocyte Fatty Acid-binding Protein Predict Cardiovascular Events in Coronary Artery Disease Patients.

Background: Adipocyte fatty acid-binding protein (A-FABP) is a cardiometabolic predictor of cardiovascular (CV) disease in humans. We evaluated the association between serum A-FABP levels and future CV events in patients with coronary artery disease (CAD). Methods: A total of 106 CAD patients were enrolled in this study between January and December 2012 and were followed-up until June 30, 2017. The primary endpoint was the incidence of major adverse CV events. Results: During a median follow-up period of 53 months, 44 CV events occurred. Patients with CV events presented higher systolic blood pressure (p = 0.020), total serum cholesterol (p = 0.047), and serum A-FABP levels (p < 0.001) compared with patients without CV events. Kaplan-Meier analysis showed that the cumulative incidence of CV events in the high A-FABP group (median A-FABP concentration of >17.63 ng/mL) was higher than that in the low A-FABP group (log-rank p < 0.001). Multivariate Cox analysis showed that triglycerides (hazard ratio (HR): 1.008, 95% confidence interval (CI): 1.001-1.016, p = 0.026) and serum A-FABP levels (HR: 1.027, 95% CI: 1.009-1.047, p = 0.004) were independently associated with CV events. Conclusion: Serum A-FABP level is a biomarker for future CV events in patients with CAD. Further prospective studies are needed to confirm the mechanisms underlying this association.

Recurrent juvenile fibroadenoma of the breast in an adolescent: A case report.

RATIONALE: Most breast masses are benign and are rare in adolescent girls. The most frequent tumor is fibroadenoma. Juvenile fibroadenoma is a rare variant of fibroadenoma and is characterized by rapidly enlarging, painless, and unilateral masses occurring at ages between 10 and 18 years. PATIENT CONCERNS: A 17-year-old girl who first presented to a hospital due to a left breast tumor. DIAGNOSES: Juvenile fibroadenoma of the left breast. INTERVENTIONS: She underwent fibroadenoma excision, but she complained of a mass that presented in her left breast 3 months after surgery. After 2 years of observation, the mass became tender and enlarged. We conducted a wide excision of the tumor. Recurrent juvenile fibroadenoma with hypercellular fibromyxoid stroma of the breast was noted. OUTCOMES: The patient is in good general condition without tumor relapses during the 4 months of follow-up. LESSONS: Recurrent fibroadenomas, particularly those of a large size with a rapid growth rate, in the same breast suggest a high possibility of transformation. We recommend wide tumor resection.

Association of hyperleptinemia with peripheral arterial disease in hypertensive patients.

OBJECTIVE: Hypertension is a risk factor for peripheral artery disease (PAD). Serum leptin plays an important role in promoting endothelial dysfunction. The aim of this study is to investigate whether the leptin level is associated with PAD in hypertensive patients. MATERIALS AND METHODS: Ninety-eight hypertensive patients were enrolled in this study. Ankle-brachial index (ABI) values were measured using an automated oscillometric device. Patients with an ABI value <0.9 were considered the low ABI group. C-reactive protein (CRP) was measured using standard enzymatic automated methods. Serum levels of human leptin were determined using a commercially available enzyme immunoassay. RESULTS: Eighteen (18.4%) hypertensive patients were included in the low ABI group. Hypertensive patients in the low ABI group had higher serum creatinine (P < 0.001), CRP (P = 0.003), and leptin (P < 0.001) levels, higher prevalence of diabetes (P = 0.036), and current smoking (P = 0.034) than patients in the normal ABI group. Univariate linear regression analyses revealed that body weight (P = 0.014), waist circumference (P = 0.010), body mass index (P = 0.002), and logarithmically transformed CRP (log-CRP, P = 0.001) were positively correlated with serum log-leptin levels in hypertensive patients. Multivariate stepwise linear regression analysis showed that log-leptin (ß = 0.439, adjusted R2 change = 0.224, P < 0.001) was also an associated factor of PAD in hypertensive patients. CONCLUSION: A higher log-leptin value is an independent predictor of PAD in hypertensive patients.

Positive correlation of serum adipocyte fatty acid binding protein levels with metabolic syndrome in kidney transplantation patients.

Adipocyte fatty acid binding protein (A-FABP) is significantly expressed in white and brown adipose tissue, monocytes, and macrophages and is a central regulator of systemic insulin sensitivity. Metabolic syndrome (MetS) is a risk factor for post-transplant diabetes mellitus (PTDM), chronic graft dysfunction, graft loss, and patient death in kidney transplantation (KT) patients. This study was undertaken to evaluate the relationship between MetS and fasting serum A-FABP concentration in KT patients. Fasting blood samples were obtained from 70 KT patients. Serum A-FABP levels were measured using a commercial enzyme-linked immunosorbent assay kit. MetS and its components were defined using the diagnostic criteria of the International Diabetes Federation. Twenty-two patients (31.4%) had MetS. KT patients with hypertension (P = 0.011), diabetes (P = 0.002), body weight (P = 0.004), body mass index (BMI, P = 0.001), waist circumference (P < 0.001), body fat mass (P < 0.001), systolic blood pressure (SBP, P = 0.017), total cholesterol (TCH, P = 0.028), triglycerides (TG, P = 0.001), blood urea nitrogen (BUN, P = 0.003), insulin (P < 0.001), homeostasis model assessment of insulin resistance (HOMA-IR, P < 0.001), and A-FABP level (P < 0.001) were higher, while high-density lipoprotein cholesterol (HDL-C, P = 0.010) was lower in KT patients with MetS. Moreover, SBP (ß = 0.347, adjusted R2 change = 0.108, P = 0.001) and logarithmically transformed triglycerides (log-TG, ß = 0.393, adjusted R2 change = 0.189, P < 0.001) were associated with A-FABP levels in a multivariable forward stepwise linear regression analysis among KT patients. The results of our study showed that the fasting A-FABP level was positively associated with MetS in KT patients. SBP and log-TG were independent predictors of the serum A-FABP level among KT patients.

Using thermal desorption electrospray ionization mass spectrometry to rapidly determine antimicrobial preservatives in cosmetics.

RATIONALE: Characterization and quantification of permitted preservatives are important inspections to prevent the overuse of preservatives in authentic formulations. However, the complexity of sample matrices makes preservative determination in cosmetics a tedious process. A rapid analytical strategy to identify preservatives would insure large numbers of products are in compliance with government regulations. METHODS: Thermal desorption electrospray ionization mass spectrometry (TD-ESI-MS) was used to directly detect preservative compounds in authentic formulations without sample pretreatment. The technique employs a metal probe, which was configured for sampling cosmetics in their original states and was inserted in a closed preheated oven to thermally desorb analytes. The desorbed analytes were then carried by a nitrogen gas stream into an ESI plume, where the formed ions were subsequently detected by the mass analyzer. RESULTS: The TD-ESI mass and tandem mass spectra of different classes of preservative standards were rapidly obtained, and the limits of detection were far below the legal limit of their respective concentrations. The preservatives were also directly detected in different types of authentic formulations in the absence of sample preparation, and within a few seconds per sample. Calibration curves for preservatives in four common formulations yielded good linearity in the regulation-allowed range. CONCLUSIONS: Due to its sensitivity, short analysis time, repeatability, and quantitative ability, TD-ESI-MS may serve as a suitable tool for large-scale screening of cosmetic preservatives to assure product safety. Copyright © 2016 John Wiley & Sons, Ltd.

Cordyceps s.l. (Ascomycetes) Species Used as Medicinal Mushrooms are Closely Related with Higher Ability to Produce Cordycepin.

Cordyceps s.l. (sensu lato) species have been used as herbal medicines; one of their main constituents is cordycepin. As genome sequencing techniques have become more cost-effective and more popular, more entomogenous fungal genomes have been sequenced and published. Here, we constructed a phylogenetic tree based on 18S rRNA sequences from Cordyceps species and analyzed the copy number of the key enzymes involved in biosynthesis of cordycepin from related fungal genomes that have been published. The sequences of the 18S rRNA gene were examined, and seven single nucleotides were found that could represent the evolutionary history of Cordyceps s.l. and which perfectly fit the phylogenetic tree. Their evolution was influenced mainly by host factors, rather than geographical location. The Cordyceps s.l. species that are used as herbal medicines are closely related in the phylogenetic tree. The major species for Chinese pharmaceutical markets, such as C. militaris and C. sinensis, have higher copy numbers of 5'-nucleotidase and adenylate kinase, and ribonucleotide reductases (RNRs), respectively. Moreover, absence of an RNR inhibitor may cause cordycepin accumulation. Presence of an RNR inhibitor may lead to lower cordycepin levels in fungal species in which no medicinal applications have been described. Cordycepin is not only an important secondary metabolite that is used as an herbal medicine, but it also has significance for understanding the evolution of these entomogenous species.

The ham-5, rcm-1 and rco-1 genes regulate hyphal fusion in Neurospora crassa.

Mutants of Neurospora crassa unable to participate in vegetative hyphal fusion (anastomosis) were isolated and characterized. From this analysis, three genes, rcm-1, rco-1 and ham-5, were identified and shown to be required for hyphal fusion. The rcm-1 and rco-1 genes are homologues of the Saccharomyces cerevisiae SSN6 and TUP1 genes, which encode a dimeric transcription factor in yeast. We demonstrate that in N. crassa the rcm-1 and rco-1 genes are required for hyphal fusion and normal hyphal morphology, and influence both asexual and sexual development. The ham-5 gene encodes a 1686 amino acid protein with two putative WD40 domains, which might participate in protein-protein interactions. ham-5 deletion mutants had a reduced rate of hyphal extension and altered hyphal morphology, and were unable to produce the conidial anastomosis tubes that are required for hyphal fusion during colony initiation.

Glutathione S-transferase interacting with far-red insensitive 219 is involved in phytochrome A-mediated signaling in Arabidopsis.

Far-red (FR) insensitive 219 (FIN219) was previously shown to be involved in phytochrome A-mediated FR light signaling. To further understand its function and regulatory relation with other light-signaling components, a yeast two-hybrid approach was used to isolate FIN219-interacting partners. Here, we demonstrate that FIN219-interacting protein 1 (FIP1) interacts with FIN219 in vitro and in vivo and is composed of 217 amino acids that belong to the tau class of the large glutathione S-transferase gene family. FIP1 was further shown to have glutathione S-transferase activity. The gain of function and partial loss of function of FIP1 resulted in a hyposensitive hypocotyl phenotype under continuous FR (cFR) light and a delayed flowering phenotype under long-day conditions, which suggests that FIP1 may exist in a complex to function in the regulation of Arabidopsis (Arabidopsis thaliana) development. In addition, FIP1 mRNA was down-regulated in the suppressor of phytochrome A-105 1 mutant and differentially expressed in constitutive photomorphogenic 1-4 (cop1-4) and cop1-5 mutants under cFR. Intriguingly, FIP1 expression was up-regulated in the fin219 mutant under all light conditions, except cFR. Furthermore, promoter activity assays revealed that FIP1 expression was light dependent, mainly associated with vascular tissues, and developmentally regulated. Subcellular localization studies revealed that the beta-glucuronidase-FIP1 fusion protein was localized in the nucleus and cytoplasm. Taken together, these data indicate that FIP1 may interact with FIN219 to regulate cell elongation and flowering in response to light.