SECRETED TRYPTOPHANYL-tRNA SYNTHETASE 1 IS A PROGNOSTIC MARKER IN SEPSIS PATIENTS WITHOUT MONOCYTOPENIA.

ABSTRACT: Objective: This study aimed to test whether the prognostic value of tryptophanyl-tRNA synthetase 1 (WARS1) for 28-day mortality in patients with sepsis was affected by monocytopenia. Methods: A prospective analysis of retrospectively collected samples from 74 sepsis patients was performed. WARS1, C-reactive protein (CRP), and procalcitonin were measured at admission and 24 and 72 h after admission. The prognostic value of WARS1, CRP, and procalcitonin for 28-day mortality was compared using repeated measures analysis of variance and the area under the receiver operating characteristic curve (AUROC). All analyses were performed in patients with or without monocytopenia, defined as an absolute monocyte count less than 0.1 × 10 9 cells/L. Results: WARS1 levels differed significantly between survivors and nonsurvivors when all patients and patients without monocytopenia were assessed ( P = 0.008, P < 0.001, respectively). In contrast, the WARS1 level did not differ between survivors and nonsurvivors with monocytopenia. C-reactive protein and procalcitonin levels were not different between survivors and nonsurvivors regardless of whether they had monocytopenia. The AUROCs of WARS1 at admission and 24 h for mortality were significantly higher in patients without monocytopenia (0.830, 0.818) than in patients with monocytopenia (0.232, 0.196; P < 0.001, both). When patients without monocytopenia were analyzed, the AUROCs of WARS1 for mortality were 0.830 and 0.818 at admission and 24 h, respectively, which were significantly higher than those of CRP (0.586, 0.653) and procalcitonin (0.456, 0.453) at the same time points ( P = 0.024 and 0.034, respectively). Conclusion: WARS1 is a useful biomarker for prognosis in sepsis patients without monocytopenia.

Combination Therapy of Niacin and Apocynin Attenuates Lung Injury During Sepsis in Rats.

INTRODUCTION: Oxidative stress contributes to tissue injury through reactive oxygen species-dependent signaling pathways during sepsis. We studied therapeutic benefits of the combination therapy of niacin, which increased reduced glutathione levels, and apocynin, which suppressed reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (Nox) activity, in septic rats. MATERIALS AND METHODS: Polymicrobial sepsis was induced through cecal ligation and puncture (CLP) with antibiotics in male Sprague-Dawley rats (n = 189). The rats were randomly divided into sham, CLP, CLP + niacin, CLP + apocynin, and CLP + niacin + apocynin groups. Six hours after CLP, vehicle, niacin (360 mg/kg through the orogastric tube), and/or apocynin (20 mg/kg through intraperitoneal injection) were administered. The occurrence of mortality for 72 h after CLP was observed. Next, a separate set of animals was euthanized at 24 h post-CLP for lung tissue analyses. RESULTS: Combination therapy with niacin and apocynin significantly improved survival in rats with sepsis (75.0% versus 28.8%, P = 0.006) but monotherapy with niacin or apocynin did not. Monotherapy with niacin and apocynin appeared to increase NADPH levels and decrease Nox levels and activity, respectively, but failed to show statistical significances. However, combination therapy significantly decreased Nox levels and activity, increased NADPH and glutathione levels, decreased intranuclear nuclear factor-κB (NF-κB) p65 levels, reduced inflammatory cytokine expression and malondialdehyde levels, and attenuated histological lung injuries. CONCLUSIONS: Combination therapy with niacin and apocynin synergistically attenuated lung injuries and improved survival in rats with sepsis through niacin-induced glutathione redox cycle activation and apocynin-induced Nox suppression.

Endoscopy within 7 days after detecting high calprotectin levels can be useful for therapeutic decision-making in ulcerative colitis.

ABSTRACT: The aim of this study was to assess the appropriate time interval to identify the association between the fecal calprotectin (FC) test and endoscopic activity, and to evaluate whether the time interval affects the therapeutic plan adjustment in patients with ulcerative colitis (UC).This study included 103 patients who underwent FC tests and endoscopic examinations within the past three months. The FC test results classified cases into three groups as follows: moderate to severe (>200, >250, or >300 µg/g), mild (100-200, 100-250, or 100-300 µg/g), and inactive (<100 µg/g) activity. The Mayo endoscopic subscore was used to determine endoscopic activity. Therapeutic plan adjustment included the addition or increased dosage of anti-inflammatory drugs, steroids, immunomodulators, and biologics.Using the cutoff value for FC of 200 µg/g, the appropriate time interval for dividing the association and non-association between Mayo endoscopic subscore and FC was 7 days (sensitivity, 74.4%; specificity, 50.0%; area under the curve [AUC], 0.6032). When using FC 250 or 300 µg/g, the appropriate time interval was 5.5 days, with a sensitivity of 71.7% and specificity of 49.1 (AUC 0.5862) in FC 250 µg/g, a sensitivity of 69.6%, and a specificity of 47.4 (AUC 0.5549) for FC 300 µg/g. Therapeutic plans changed in 29.1% of patients. In patients with shorter intervals (≤7 days) between the FC test and endoscopy, significant therapeutic plan adjustments were observed in patients with UC (36.5% vs. 17.5%, P = .047).Although the need for endoscopy within 7 days after detecting high FC (≥ 200 µg/g) was not statistically supported, endoscopy within a shorter interval (≤7 days) in UC patients with high FC can help determine the therapeutic plan.

The Effect of Triangular Fibrocartilage Complex Tear on Wrist Proprioception.

PURPOSE: This study examined the influence of triangular fibrocartilage complex (TFCC) deep fiber tears on wrist proprioception. METHODS: The study involved 48 subjects: 24 with deep fiber TFCC tears and 24 with healthy wrists. A specially created sensor measured wrist proprioception in 3 axes of movement. Absolute differences between target and subject-reproduced angles were compared in injured and healthy wrists and in injured and contralateral patient wrists. A greater difference in reproduced angles was deemed to reflect a lesser ability to approximate a target angle. RESULTS: In wrists with TFCC injuries, 40° pronation and 60° pronation showed significantly greater differences between target and subject-reproduced angles compared with those in the control wrists. In wrists with TFCC injuries, 40° pronation demonstrated significantly greater differences between target and subject-reproduced angles than did those in patients' contralateral wrists. Proportions of outliers with absolute differences greater than 6° were significantly higher in 60° supination and 40° pronation in wrists with TFCC injuries. CONCLUSIONS: Deep TFCC fiber detachment may lead to decreased wrist proprioception in 60° and 40° forearm rotation. CLINICAL RELEVANCE: Deep TFCC fiber tear may contribute to decreased wrist rotational positioning sense and may have biomechanical importance in distal radioulnar joint stability.

Reduction of nitrate by resin-supported nanoscale zero-valent iron.

For environmental remediation of a contaminated groundwater, the use of nanosized zero-valent iron (nZVI) represents one of the latest innovative technologies. However, nZVI gets easily agglomerated due to its colloidal characteristics and has limited applications. To overcome this drawback, nZVI was immobilized on a supporting material. In this study, nZVI was formed and bound to ion-exchange resin spheres at the same time through the borohydride reduction of an iron salt. The pore structures and physical characteristics of the supported nZVI were investigated and its reactivity was measured using nitrate. The degradation of nitrate appeared to be a pseudo first-order reaction with the observed reaction rate constant of 0.425 h(-1) without pH control. The reduction process continued but at a much lower rate with a rate constant of 0.044 h(-1). When the simulated groundwater was used to assess the effects of coexisting ions, the rate constant was 0.078 h(-1) and it also reduced to 0.0021 h(-1) in later phase. The major limitation of ZVI use for nitrate reduction is ammonium production. By using a support material with ion-exchange capacity, this problem can be solved. The ammonium was not detected in our batch tests.

Enhanced reduction of nitrate by supported nanoscale zero-valent iron prepared in ethanol-water solution.

Nanoscale zero-valent iron is famous for its high reactivity originating from its high surface area, and has emerged as an extension of granular zero-valent iron technology. Due to its extremely small size, nanosized iron cannot be used as a medium in a permeable reactive barrier system, which is the most popular application of granular iron. To overcome this shortcoming, supported nanoscale zero-valent iron was created. In addition to this, the preparation solution was modified to enhance the reactivity. An ethanol/water solvent containing a dispersant of polyethylene glycol was used to synthesize nanoscale iron. This preparation was done in the presence of an ion-exchange resin as a supporting material. Nanoscale zero-valent iron was formed and bound to the granular resin at the same time through the borohydride reduction of an iron salt, and the resulting product was compared with that prepared in a conventional way of using water only. Switching the preparation solution increased the supported nanoscale iron's BET surface area and Fe content from 31.63 m2 g(-1) and 18.19 mg Fe g(-1) to 38.10 m2 g(-1) and 22.44 mg Fe g(-1), respectively. Kinetic analysis from batch tests revealed that a higher denitrification rate was achieved by the supported nanoscale zero-valent iron prepared in the modified way. The pseudo-first-order reaction constant of 0.462 h(-1) suggested that the reactivity of the supported iron, prepared in ethanol/water, increased by 61% compared with the one prepared in water. The higher rates of reaction, based on higher specific area and iron content, suggest that this new supported nanoscale iron can be used successfully for permeable reactive barriers.