Trim21 deficiency in mice increases HCC carcinogenesis in a NASH context and is associated with immune checkpoint upregulation.

The global pandemic of metabolic diseases has increased the incidence of hepatocellular carcinoma (HCC) in the context of non-alcoholic steatohepatitis (NASH). The downregulation of the E3 ubiquitin ligase TRIM21 has been linked to poor prognosis in different cancers including HCC. In order to investigate the role of TRIM21 in liver cancer progression on NASH, Trim21+/+ and Trim21-/- male mice were injected with streptozotocin at the neonatal stage. The hypoinsulinemic mice were then fed with a high-fat high-cholesterol diet (HFHCD) for 4, 8 or 12 weeks. All mice developed NASH which systematically resulted in HCC progression. Interestingly, compared to the Trim21+/+ control mice, liver damage was worsened in Trim21-/- mice, with more HCC nodules found after 12 weeks on HFHCD. Immune population analysis in the spleen and liver revealed a higher proportion of CD4+PD-1+ and CD8+PD-1+ T cells in Trim21-/- mice. The liver and HCC tumors of Trim21-/- mice also exhibited an increase in the number of PD-L1+ and CD68+ PD-L1+ cells. Thus, TRIM21 limits the emergence of HCC nodules in mice with NASH by potentially restricting the expression of PD-1 in lymphocytes and PD-L1 in tumors.

Tailoring the wrap: intraoperative functional lumen imaging probe (FLIP) during hiatal hernia repair.

INTRODUCTION: The introduction of the functional lumen imaging probe (FLIP) has provided objective, real-time feedback on the geometric variations with each component of a hiatal hernia repair (HHR). The utility of this technology in altering intraoperative decision-making has been scarcely reported. Herein, we report a single-center series of intraoperative FLIP during HHR. METHODS: A retrospective review of electronic medical records between 2020 and 2022 was conducted and all patients undergoing non-recurrent HHR with FLIP were queried. Patient and hernia characteristics, intraoperative FLIP values and changes in decision-making, as well as early post-operative outcomes were reported. Both diameter and distensibility index (DI) were measured at 40 ml and 50 ml balloon inflation after hiatal dissection, after hiatal closure, and after fundoplication when indicated. RESULTS: Thirty-three patients met inclusion criteria. Mean age was 62 ± 14 years and mean BMI was 28 ± 6 kg/m2. The majority (53%) were type I hiatal hernias. The largest drop in DI occurred after hiatal closure, with minimal change seen after fundoplication (mean DI of 4.3 ± 2. after completion of HH dissection, vs 2.7 ± 1.2 after hiatal closure and 2.3 ± 1 after fundoplication when performed). In 13 (39%) of cases, FLIP values directly impacted intraoperative decision-making. Fundoplication was deferred in 4/13 (31%) patients, the wrap was loosened in 2/13 (15%); the type of fundoplication was altered to achieve adequate anti-reflux values in 2/13 (15%) patients, and in 1/13 (3%) the wrap was tightened. CONCLUSION: FLIP measurements can be used intraoperatively to guide decision-making and alter management plan based on objective values. Long-term outcomes and further prospective studies are required to better delineate the value of this technology.

Esophageal impedance planimetry during per-oral endoscopic myotomy guides myotomy extent.

INTRODUCTION: Peroral endoscopic myotomy (POEM) is the standard treatment for achalasia. Functional luminal imaging probe (FLIP) technology enables objective measurement of lower esophageal sphincter (LES) geometry, with literature linking specific values to improved post-POEM outcomes. Our study assesses FLIP's intraoperative use in evaluating myotomy extent in real-time. METHODS: Retrospective data from all patients undergoing POEM with intraoperative FLIP measurements were extracted from June 2020 to January 2023. The primary endpoint was intraoperative FLIP measurements, management changes, and symptom improvement (Eckardt score). RESULTS: Fourteen patients (age 56 ± 14 years, BMI 28 ± 7 kg/m2) were identified. Most patients were female (64%). Predominantly, patients presented with type II achalasia (50%). FLIP measurements were taken before and after myotomy, demonstrating increases in mean distensibility index (DI) 1.6 ± 1. 4 to 5.4 ± 2.1 mm2/mmHg (p < 0.05) and mean diameter (Dmin) 6 ± 1.8 to 10.9 ± 2.3 mm (p < 0.05) at 50 ml balloon fill. Additional myotomy was performed in one patient when an inadequate increase in FLIP values were noted. Mean operative time was 98 ± 28 min, and there were no intraoperative complications. At the 30-day follow-up, median Eckardt score decreased from mean a preoperative score of 7 ± 2 to a post-operative mean of 2 ± 3, with 10 patients (78%) having a score ≤ 2. In total, four patients experienced symptom recurrence, with repeat FLIP values revealing a significant decrease in DI from 7 ± 2.2 post-POEM to 2.5 ± 1.5 at recurrence. FLIP technology identified LES pathology in 3 out of 4 (75%) patients, facilitating referral to LES-directed therapy. CONCLUSION: Our study adds to the literature supporting the use of FLIP technology during the POEM procedure, with most patients achieving ideal values after a standard-length myotomy. This suggests the potential benefits of shorter myotomies guided by FLIP to achieve comparable outcomes and reduce postoperative GERD risk. Collaborative standardization of study designs and outcome measures is crucial for facilitating prospective trials and cross-setting outcome comparisons.

The Fast and Reliable Detection of Multiple Narrowband FH Signals: A Practical Framework.

Frequency hopping (FH) is a well-known technique that is commonly used in communication systems owing to its many advantages, including its strong anti-jamming capability. In this technique, basically, radio signals are transmitted by switching the carrier between different frequency channels. As a result, the FH signal is not stationary; hence, its spectrum is expected to change over time. Therefore, the task of detection and parameter estimation of FH signals is very challenging in practice. To address this challenge, the study presented in this article proposes a method that detects and estimates the parameters of multiple narrowband FH signals. In the proposed method, first, short-time Fourier transform (STFT) is utilized to analyze FH signals, and a practical binarization process based on thresholding is used to detect FH signals. Then, a new algorithm is proposed to ensure that the center frequencies of the detected signals are successfully separated. Next, another algorithm is proposed to estimate the parameters of the detected signals. After estimating the parameters for the entire spectrum, an approach is used to detect FH signals. Lastly, the hop-clustering process is applied to separate the hops into groups without time overlap. The simulation results show that the proposed method can be an efficient way for the fast and accurate parameter estimation and detection of multiple narrowband FH signals.

Dietary protein and muscle wasting in chronic kidney disease: new insights.

PURPOSE OF REVIEW: Muscle wasting is an important health problem in chronic kidney disease (CKD) patients. Protein restriction in the diet can be one of the main causes of muscle wasting in this population. In this review, we aimed to investigate the relationship between dietary protein intake and muscle wasting in CKD patients according to recent literature. RECENT FINDINGS: The one of the main mechanisms responsible for the muscle wasting is the disturbances in skeletal muscle protein turnover. Muscle wasting primarily occurs when the rates of muscle protein breakdown exceed the muscle protein synthesis. Dietary protein intake represents an important role by causing a potent anabolic stimulus resulting a positive muscle protein balance. Compared to studies made in healthy populations, there are very limited studies in the literature about the relationship between dietary protein intake and muscle wasting in the CKD population. Majority of the studies showed that a more liberal protein intake is beneficial for muscle wasting in especially advanced CKD and hemodialysis population. SUMMARY: Although evaluating muscle wasting in CKD patients, the amount of protein in the diet of patients should also be reviewed. Although excessive protein intake has some negative consequences on this patient group, a more liberated dietary protein intake should be taken into account in this patient group with muscle wasting and especially in dialysis patients.

Does bioabsorbable mesh reduce hiatal hernia recurrence rates? A meta-analysis.

INTRODUCTION: The use of bioabsorbable mesh at the hiatus is controversial. Long-term data are scant. We evaluated the world literature and performed a meta-analysis to determine if these meshes were effective in reducing recurrence. METHODS: A literature search was performed using PubMed, MEDLINE, and ClinicalKey. We evaluated articles reporting on both Bio-A™ (polyglycolic acid:trimethylene carbonate-PGA:TMC) and Phasix™ (poly-4-hydroxybutyrate-P4HB) used at the hiatus. The DerSimonian-Laird random effects model was used to estimate the overall pooled treatment effect along with a 95% confidence interval (CI). Similar analysis was conducted to compare the clinical outcomes, i.e., recurrence rate, mean surgical time, mean hospital stays and mean follow-up duration between non-Mesh and Mesh group. The I2 statistic was computed to assess the heterogeneity in effect sizes across the studies. RESULTS: A total of 21 studies (12 mesh studies with 963 subjects and 9 non-mesh studies with 617 subjects) were included to conduct the meta-analysis. There was one article reporting outcomes on P4HB mesh (73 subjects) and 11 on PGA:TMC mesh (890 subjects). The bioabsorbable mesh group had a significantly lower recurrence rate compared to the non-mesh group (8% vs. 18%; 95%CI 0.08-0.17), pooled p-value < 0.0001. Surgery time was shorter in the mesh group compared to the non-mesh group (136.4 min vs. 150 min) but not statistically significant (p = 0.54). There tended to be a more extended follow-up period after surgery in the non-mesh group compared to the mesh group (27 vs. 25.8 months, range 10.8-54 months); but not statistically significant (ES: 27.4; 95%CI 21.6-33.3; p = 0.92). CONCLUSIONS: Hiatal hernia repair with bioabsorbable mesh is more effective at reducing hernia recurrence rate in the mid-term than simple suture cruroplasty. Further studies investigating the long-term outcomes and P4HB mesh are needed.

Modelling and Design of Pre-Equalizers for a Fully Operational Visible Light Communication System.

Nowadays, Visible Light Communication (VLC) has gained much attention due to the significant advancements in Light Emitting Diode (LED) technology. However, the bandwidth of LEDs is one of the important concerns that limits the transmission rates in a VLC system. In order to eliminate this limitation, various types of equalization methods are employed. Among these, using digital pre-equalizers can be a good choice because of their simple and reusable structure. Therefore, several digital pre-equalizer methods have been proposed for VLC systems in the literature. Yet, there is no study in the literature that examines the implementation of digital pre-equalizers in a realistic VLC system based on the IEEE 802.15.13 standard. Hence, the purpose of this study is to propose digital pre-equalizers for VLC systems based on the IEEE 802.15.13 standard. For this purpose, firstly, a realistic channel model is built by collecting the signal recordings from a real 802.15.13-compliant VLC system. Then, the channel model is integrated into a VLC system modeled in MATLAB. This is followed by the design of two different digital pre-equalizers. Next, simulations are conducted to evaluate their feasibility in terms of the system's BER performance under bandwidth-efficient modulation schemes, such as 64-QAM and 256-QAM. Results show that, although the second pre-equalizer provides lower BERs, its design and implementation might be costly. Nevertheless, the first design can be selected as a low-cost alternative to be used in the VLC system.

Deep Learning-Based Vehicle Classification for Low Quality Images.

This study proposes a simple convolutional neural network (CNN)-based model for vehicle classification in low resolution surveillance images collected by a standard security camera installed distant from a traffic scene. In order to evaluate its effectiveness, the proposed model is tested on a new dataset containing tiny (100 × 100 pixels) and low resolution (96 dpi) vehicle images. The proposed model is then compared with well-known VGG16-based CNN models in terms of accuracy and complexity. Results indicate that although the well-known models provide higher accuracy, the proposed method offers an acceptable accuracy (92.9%) as well as a simple and lightweight solution for vehicle classification in low quality images. Thus, it is believed that this study might provide useful perception and understanding for further research on the use of standard low-cost cameras to enhance the ability of the intelligent systems such as intelligent transportation system applications.

Glenzocimab does not impact glycoprotein VI-dependent inflammatory haemostasis.

Not available.

Relationship between daily testosterone production and bispectral index (BIS) values in patients who underwent septoplasty operation.

AIM: The study aimed to investigate the effect of varying testosterone levels in the morning and evening on the depth of anaesthesia in patients who underwent a septoplasty. MATERIALS AND METHODS: Male patients who underwent septoplasty under general anaesthesia between September 2016 and September 2017 were included in the study. The patients were divided into two groups. The first group consisted of patients who were operated on in the morning hours (between 8.00 and 10.00) when the testosterone level was the highest and the second group consisted of patients who had the lowest testosterone level in the afternoon (between 14.00 and 16.00). Blood was taken from the brachial vein to measure the testosterone level of the patients and blood testosterone levels were measured by mass spectrometry before the induction of anaesthesia. RESULTS: Sixty patients were included in the study. The mean age of the patients was 33.77 ± 10.98 years. The rocuronium and propofol doses used in the morning group were significantly higher (P = .012 for propofol, P = .002 for rocuronium, P < .001 for rocuronium dose) (Table 2). Additionally, the time to reach saturation of sevoflurane doses in expirium and inspiration was later in the morning group (morning group at 15th minute, evening group at 10th minute). CONCLUSIONS: Sedation anaesthesia applied in patients who underwent septoplasty operation was associated with testosterone level and it was more difficult for patients to switch to sedation with increased testosterone level.

An eleven-year cohort of bloodstream infections in 552 febrile neutropenic patients: resistance profiles of Gram-negative bacteria as a predictor of mortality.

Antimicrobial stewardship is of major importance in patients with febrile neutropenia (FN). In this study, we aimed to investigate the trends in resistance and the relationship with mortality rates in patients with FN. The single-center surveillance data of inpatients with FN and diagnosed as microbiologically confirmed bloodstream infections (BSIs) between 2006 and 2016 were reviewed retrospectively. A total of 950 episodes in 552 patients with BSIs were analyzed. Of whom, 55.9% were male, the median age was 43 years, and 35.6% had acute myeloid leukemia. In total, 1016 microorganisms were isolated from blood cultures. Gram-negatives accounted for 42.4% (n = 403) of the episodes. Among Gram-negatives, Enterobacteriaceae accounted for 346 (86%) (E. coli, n = 197; 34% extended-spectrum ß-lactamases (ESBL) producers, and Klebsiella spp., n = 120; 48.3% ESBL producers). Also, 24 (20.0%) of Klebsiella spp. had carbapenemase activity. There were 6 (5.0%) colistin-resistant Klebsiella spp. Thirteen (26.5%) of Pseudomonas spp. and 17 (60.7%) of Acinetobacter spp. had carbapenemase activity. There were 2 (5.6%) colistin-resistant Acinetobacter spp. The 30-day mortality rates were 12.0%, 21.5%, 34.6%, and 29.0% in BSIs due to Gram-positive, Gram-negative bacterial, fungal, and polymicrobial etiology respectively (p = 0.001). BSIs with ESBL-producing (p = 0.001) isolates, carbapenem (p < 0.001), and colistin-resistant isolates (p < 0.001) were associated with increased mortality risk. The tremendous rise in resistance rates among Gram-negatives is dreadfully related to increasing mortality and leads to sharp shifts toward extreme restrictions of unnecessary antibiotic uses. Antimicrobial stewardship in patients with FN requires vigilance and tailoring of treatment upon local surveillance data.

Characterization of New Fengycin Cyclic Lipopeptide Variants Produced by Bacillus amyloliquefaciens (ET) Originating from a Salt Lake of Eastern Algeria.

Fengycin antibiotic displays a strong antifungal activity and inhibits the growth of a wide range of plant pathogens especially filamentous fungi. The main objective of the present study is to characterize fengycin variants produced by B. amyloliquefaciens strain (ET). LC-MS analysis of fengycin extracts has shown several molecular ion peaks corresponding to conventional fengycin homologues (MH + : m/z 1463.9; 1491.9; 1506) and some new ones (MH + : m/z 1433; 1447; 1461; and 1477). Further characterization of these precursor ions was carried out by LC-MS.MS analysis. Reporter fragment ions were observed (named A and B), they correspond to the cleavage of Orn2-Tyr3 (A), Glu1-Orn2 (B), and used for identifying fengycin variants. The reporter fragment couple ions [A/B] at [m/z 966.5/1080.5] and [m/z 994.4 /1108.5] represent fengycin A and B, respectively. The diagnostic ions at ([m/z 980/1094]) may correspond to fengycin C3, D, S or B2. Interestingly, unknown diagnostic product ions at [m/z 951/1065] and [m/z 979/1093] were detected for the first time in this study which prove that they correspond to new fengycin variants, named fengycin X and fengycin Y, respectively. The fengycin X results from a substitution of the glutamine amino acid (Q), at position 8 of the fengycin A peptide part, by an isoleucine (I) or a leucine (L) residue. This mutation should be the same in fengycin Y but compared to fengycin B.

On the Performance of Variational Mode Decomposition-Based Radio Frequency Fingerprinting of Bluetooth Devices.

Radio frequency fingerprinting (RFF) is one of the communication network's security techniques based on the identification of the unique features of RF transient signals. However, extracting these features could be burdensome, due to the nonstationary nature of transient signals. This may then adversely affect the accuracy of the identification of devices. Recently, it has been shown that the use of variational mode decomposition (VMD) in extracting features from Bluetooth (BT) transient signals offers an efficient way to improve the classification accuracy. To do this, VMD has been used to decompose transient signals into a series of band-limited modes, and higher order statistical (HOS) features are extracted from reconstructed transient signals. In this study, the performance bounds of VMD in RFF implementation are scrutinized. Firstly, HOS features are extracted from the band-limited modes, and then from the reconstructed transient signals directly. Performance comparison due to both HOS feature sets is presented. Moreover, the lower SNR bound within which the VMD can achieve acceptable accuracy in the classification of BT devices is determined. The approach has been tested experimentally with BT devices by employing a Linear Support Vector Machine (LSVM) classifier. According to the classification results, a higher classification performance is achieved (~4% higher) at lower SNR levels (-5-5 dB) when HOS features are extracted from band-limited modes in the implementation of VMD in RFF of BT devices.

Effects of adenosine triphosphate on vandetanib induced skin damage in rats.

PURPOSE: Vandetanib is a wide spectrum tyrosine kinase inhibitor used for the treatment of metastatic medullary thyroid cancer (MTC) and various other cancer types. Although it is usually well-tolerated it has been linked to a variety of severe dermatologic reactions. Our study aimed was to investigate adenosine 5'-triphosphate (ATP) on vandetanib-induced skin damage. MATERIALS AND METHODS: A total number of 18 rats were divided into three equal groups as vandetanib group (VDB), vandetanib plus ATP group (VAT), and healthy group (HG); 25 mg/kg ATP was injected intraperitoneally (ip) to the VAT group. Normal saline was given to the HG and VDB groups as solvent via intraperitoneally. One hour later, 25 mg/kg vandetanib was applied orally via an orogastric catheter in the VAT and VDB groups. This procedure was repeated once daily for 4 weeks. After that period, all animals were sacrificed and their skin tissues removed. Malondialdehyde (MDA), total glutathione (tGSH), total oxidant status (TOS), total antioxidant status (TAS) levels in rats' skin tissues were evaluated with histopathological analyses. RESULTS: MDA and TOS levels measured higher in the VDB group compared to the VAT and HG groups (p < 0.001). tGSH and TAS levels of the VDB group measured lower than the VAT and HG groups (p < 0.001). The structure and morphology of skin tissue were normal in the control group. In the VDB group, skin tissue damage with thinner epitelium, ruptured and degenerated hair follicles, abnormal accumulation of abnormal keratin on the epithelium and oedematous areas in the dermis was observed. In the VAT group, these findings were significantly improved. CONCLUSION: We demonstrated that adenosine triphosphate can prevent vandetanib-induced skin toxicity in rats for the first time. The promising results denote that further studies testing this agent in other animal models and in humans are warranted.

Metformin in tuberculosis: beyond control of hyperglycemia.

Two global epidemics, diabetes mellitus (DM) and tuberculosis (TB), have converged making their control even more challenging. We herein have reviewed metformin's (MTF) effect on patients with active and latent TB, as well as discussed its newly discovered biological mechanisms in mycobacteria. Mounting evidence suggests that MTF provides better outcomes in TB patients, especially those with DM. The mechanisms by which MTF produces its benefits are multiple. Though metformin's potential has been proven in patients with DM, larger and more thorough clinical trials, in DM and non-DM-TB patients, need to be conducted. MTF could be added to the arsenal of anti-TB drugs, aiding in the goal of TB eradication worldwide.

Relationship between Serum Vitamin D Levels and Health-Related Quality of Life in Maintenance Hemodialysis Patients.

OBJECTIVES: Aim of the study was investigating the effect of serum vitamin D levels on health-related quality of life in hemodialysis patients. METHOD: One-hundred and twenty-three maintenance hemodialysis patients were enrolled in this cross-sectional study. Patients divided into 2 groups according to serum vitamin D levels. A serum 25-hydroxyvitamin D (25[OH] D) level of < 20 ng/mL was identified as vitamin D deficiency (n = 78), and a serum level of ≥20 ng/mL was identified as normal (n = 45). Kidney Disease Quality of Life 36 (KDQOL-36) survey was used for quality of life measurement. Scores of the all of 5 subscales of KDQOL-36 were calculated. Multiple linear regression analyses were used to define independent risk factors affecting the survey. RESULTS: Mean age of patients was 62 and 56% of patients were male. Mean 25(OH) D levels were 11.86 and 29.57 ng/mL, respectively, in 2 groups. There was statistically significant difference between age and Kt/V levels between 2 groups (p = 0.008 and p = 0.041). Age and gender were found as significant predictors of vitamin D deficiency (p = 0.026 and p = 0.021). In symptom and problem list subscale, gender and comorbidity were detected as independent risk factors (p = 0.050 and p = 0.032). Comorbidity was the only independent risk factor for effect of kidney disease subscale (p < 0.001). Independent risk factors associated with burden of kidney disease subscale were comorbidity and serum 25 (OH) D levels (p = 0.003 and p = 0.023). Serum 25(OH) D, gender, and comorbidity were independently associated with physical component summary (PCS) subscale (p < 0.001, p = 0.008, and p = 0.011). The only independently associated factor with mental component summary (MCS) was serum 25(OH) D (p < 0.001). CONCLUSION: We first showed the relationship between serum vitamin D levels and KDQOL-36 in hemodialysis patients. Lower serum vitamin D levels were negatively associated with burden of kidney disease, PCS, and MCS subscales.

Postmetalated Zirconium Metal Organic Frameworks as a Highly Potent Bactericide.

Metal-organic frameworks (MOFs) have emerged as an important class of hybrid organic-inorganic materials. One of the reasons they have gained remarkable attention is attributed to the possibility of altering them by postsynthetic modification, thereby providing access to new and novel advanced materials. MOFs have been applied in catalysis, gas storage, gas separation, chemical sensing, and drug delivery. However, their bactericidal use has rarely been explored. Herein, we developed a two-step process for the synthesis of zirconium-based MOFs metalated with silver cations as a potent antibacterial agent. The obtained products were thoroughly characterized by powder X-ray diffraction, scanning electron microscopy, UV-visible, IR, thermogravimetric, and Brunauer-Emmett-Teller analyses. Their potency was evaluated against E. coli with a reported minimal inhibitory concentration and minimal bactericidal concentration of as low as 6.5 µg/mL of silver content. Besides the novelty of the system, the advantage of this strategy is that the MOFs could be potentially regenerated and remetalated after each antibacterial test, unlike previously reported frameworks, which involved the destruction of the framework.

Pulmonary Function in Patients with End-Stage Renal Disease: Effects of Hemodialysis and Fluid Overload.

BACKGROUND Respiratory system disorders are one of the most prevalent complications in end-stage renal disease patients on hemodialysis. However, the pathogenesis of impaired pulmonary functions has not been completely elucidated in these patients. We designed a study to investigate acute effects of hemodialysis treatment on spirometry parameters, focusing on the relationship between pulmonary function and fluid status in hemodialysis patients. MATERIAL AND METHODS We enrolled 54 hemodialysis patients in this study. Multifrequency bioimpedance analysis (BIA) was used to assess fluid status before and 30 min after the midweek of hemodialysis (HD). Overhydration (OH)/extracellular water (ECW)% ratio was used as an indicator of fluid status. Fluid overload was defined as OH/ECW ≥7%. Spirometry was performed before and after hemodialysis. RESULTS Forced vital capacity (FVC), FVC%, and forced expiratory volume in the first second (FEV1) levels were significantly increased after hemodialysis. FVC, FVC%, FEV1, FEV1%, mean forced expiratory flow between 25% and 75% of the FVC (FEF25-75), FEF25-75%, peak expiratory flow rate (PEFR), and PEFR% were significantly lower in patients with fluid overload than in those without. OH/ECW ratio was negatively correlated with FVC, FVC%, FEV1, FEV1%, FEF25-75, FEF25-75%, PEFR, and PEFR%. Stepwise multiple regression analysis revealed that male sex and increased ultrafiltration volume were independently associated with higher FVC, whereas increased age and OH/ECW ratio were independently associated with lower FVC. CONCLUSIONS Fluid overload is closely associated with restrictive and obstructive respiratory abnormalities in HD patients. In addition, hemodialysis has a beneficial effect on pulmonary function tests, which may be due to reduction of volume overload.

The Relationship of Fluid Overload as Assessed by Bioelectrical Impedance Analysis with Pulmonary Arterial Hypertension in Hemodialysis Patients.

BACKGROUND Pulmonary arterial hypertension (PAH) is common disease among hemodialysis (HD) patients and is associated with increased morbidity and mortality. However, its pathogenesis has not been completely elucidated. We aimed to evaluate the frequency of PAH in HD patients, as well as the relationship between fluid status and PAH. MATERIAL AND METHODS We enrolled 77 HD patients in this study. Multifrequency bioimpedance analysis (BIA) was used to assess fluid status. BIA was performed before and 30 min after the midweek of HD. Overhydration (OH)/extracellular water (ECW)% ratio was used as an indicator of fluid status. Fluid overload was defined as OH/ECW ≥7%. Echocardiographic examinations were performed before and after the HD. Pulmonary arterial hypertension was defined as systolic pulmonary artery pressure at rest (sPAP) higher than 35 mmHg. RESULTS PAH was found in 33.7% of the HD patients. OH/ECW and the frequency of fluid overload were significantly higher in HD patients with PAH than those without PAH, whereas serum albumin and hemoglobin levels were significantly lower. sPAP level was significantly higher in HD patients with fluid overload than in those without fluid overload after hemodialysis session. Furthermore, sPAP, OH/ECW levels, and the frequency of PAH were significantly reduced after HD. We also found a significant positive correlation between sPAP and OH/ECW. Multivariate logistic regression analysis demonstrated fluid overload to be an independent predictor of PAH after HD. CONCLUSIONS PAH is prevalent among HD patients. This study demonstrated a strong relationship between fluid overload and PAH in HD patients.

Adsorption of cinnabarinic acid from culture fluid with magnetic microbeads.

In this study, antimicrobial pigment cinnabarinic acid (CA) was produced from Pycnoporus cinnabarinus in laboratory-scale batch cultures. Magnetic poly(ethylene glycol dimethacrylate-N-methacryloyl-l-tryptophan methyl ester) [m-poly(EGDMA-MATrp)] beads (average diameter = 53-103 µm) were synthesized by copolymerizing of N-methacryloyl-l-tryptophan methyl ester (MATrp) with ethylene glycol dimethacrylate (EGDMA) in the presence of magnetite (Fe3O4) and used for the adsorption of CA. The m-poly(EGDMA-MATrp) beads were characterized by N2 adsorption/desorption isotherms (Brunauer Emmet Teller), X-ray photoelecron spectroscopy, scanning electron microscopy, infrared spectroscopy, thermal gravimetric analysis, electron spin resonance and swelling studies. The efficiency of m-poly(EGDMA-MATrp) beads for separation of CA from culture fluid was evaluated. The effects of pH, initial concentration, contact time and temperature on adsorption were analyzed. The maximum CA adsorption capacity of the m-poly(EGDMA-MATrp) beads was 272.9 mg g(-1) at pH 7.0, 25 °C. All the isotherm data can be fitted with the Langmuir, Freundlich and Dubinin-Radushkevich isotherm models. The adsorption process obeyed pseudo-second-order kinetic model. Thermodynamic parameters ΔH = 5.056 kJ mol(-1), ΔS = 52.44 J K(-1) mol(-1) and ΔG = -9.424 kJ mol-(1) to -11.27 kJ mol-(1) with the rise in temperature from 4 to 40 °C indicated that the adsorption process was endothermic and spontaneous.