Phenotype-genotype correlation in patients with typical and atypical branchio-oto-renal syndrome.

Some patients have an atypical form of branchio-oto-renal (BOR) syndrome, which does not satisfy the diagnostic criteria, despite carrying a pathogenic variant (P variant) or a likely pathogenic variant (LP variant) of a causative gene. P/LP variants phenotypic indices have yet to be determined in patients with typical and atypical BOR syndrome. We hypothesized that determining phenotypic and genetic differences between patients with typical and atypical BOR syndrome could inform such indices. Subjects were selected from among patients who underwent genetic testing to identify the cause of hearing loss. Patients were considered atypical when they had two major BOR diagnostic criteria, or two major criteria and one minor criterion; 22 typical and 16 atypical patients from 35 families were included. Genetic analysis of EYA1, SIX1, and SIX5 was conducted by direct sequencing and multiplex ligation-dependent probe amplification. EYA1 P/LP variants were detected in 25% and 86% of atypical and typical patients, respectively. Four EYA1 P/LP variants were novel. Branchial anomaly, inner ear anomaly, and mixed hearing loss were correlated with P/LP variants. Development of refined diagnostic criteria and phenotypic indices for atypical BOR syndrome will assist in effective detection of patients with P/LP variants among those with suspected BOR syndrome.

Correction to: Risk factors for vancomycin nephrotoxicity and time course of renal function during vancomycin treatment.

After online publication, we found a typographical error in Table 2. We consider correcting "VCM trough concentration > 20 g/mL" to "VCM trough concentration > 20 µg/mL".

Risk factors for vancomycin nephrotoxicity and time course of renal function during vancomycin treatment.

PURPOSE: Vancomycin (VCM) is used for the treatment of methicillin-resistant Staphylococcus aureus. Although the risk factors for VCM nephrotoxicity have been evaluated, the time course of renal function during VCM treatment is unknown. We assessed risk factors for VCM nephrotoxicity and how renal function varied over time. METHODS: We conducted a retrospective analysis of patients receiving intravenous VCM treatment between June 2015 and August 2017 at Tokyo Women's Medical University, Medical Center East. VCM nephrotoxicity was defined as an increase in serum creatinine levels > 50%. We performed multivariate logistic regression analysis to assess risk factors for VCM nephrotoxicity. The time course of renal function with VCM nephrotoxicity was compared and stratified by risk factors for VCM nephrotoxicity. Clinical course of VCM nephrotoxicity and VCM trough concentration were assessed. RESULTS: In total, 42 (17.3%) of 243 patients developed VCM nephrotoxicity. Risk factors for VCM nephrotoxicity were VCM trough concentration > 20 µg/mL and concomitant use of renal hypoperfusion medications (angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, loop/thiazide diuretics, and non-steroidal anti-inflammatory drugs). Although time course of renal function stratified by renal hypoperfusion medications was comparable, the time course of renal function significantly deteriorated in patients with loop/thiazide diuretics. Focusing on patients continuing VCM treatment, VCM nephrotoxicity recovered in 40% of the patients and VCM trough concentration improved to 10-20 µg/mL in 75% of the patients. CONCLUSIONS: VCM trough concentration > 20 µg/mL and concomitant use of renal hypoperfusion medications are associated with VCM nephrotoxicity. Recovery of VCM nephrotoxicity was poor compared to the improvement of VCM trough concentration.

Two-Point Method for Measuring the Temporal Modulation Transfer Function.

OBJECTIVE: The temporal modulation transfer function (TMTF) has been proposed to estimate the temporal resolution abilities of listeners with normal hearing and listeners with hearing loss. The TMTF data of patients would be useful for clinical diagnosis and for adjusting the hearing instruments at clinical and fitting sites. However, practical application is precluded by the long measurement time of the conventional method, which requires several measurement points. This article presents a new method to measure the TMTF that requires only two measurement points. DESIGN: Experiments were performed to estimate the TMTF of normal listeners and listeners with hearing loss to demonstrate that the two-point method can estimate the TMTF parameter and the conventional method. Sixteen normal hearing and 21 subjects with hearing loss participated, and the difference between the estimated TMTF parameters and measurement time were compared. RESULTS: The TMTF parameters (the peak sensitivity Lps and cutoff frequency fcutoff) estimated by the conventional and two-point methods showed significantly high correlations: the correlation coefficient for Lps was 0.91 (t(45) = 14.3; p < 10) and that for fcutoff was 0.89 (t(45) = 13.2; p < 10). There were no fixed and proportional biases. Therefore, the estimated values were in good agreement. Moreover, there was no systematic bias depending on the subject's profile. The measurement time of the two-point method was approximately 10 min, which is approximately one-third that of the conventional method. CONCLUSION: The two-point method enables the introduction of TMTF measurement in clinical diagnosis.

Frequency and specific characteristics of the incomplete partition type III anomaly in children.

OBJECTIVES/HYPOTHESIS: To determine the frequency of the incomplete partition type III anomaly and the genetic and clinical features associated with POU3F4 mutations in children with hearing loss. STUDY DESIGN: Retrospective case series from 2000 to 2014 at the National Hospital Organization Tokyo Medical Center and collaborating hospitals. METHODS: A total of 1,004 patients (from 938 families) who had hearing loss by 10 years of age and had undergone computed tomography scanning of their temporal bones were enrolled in this genetic, clinical, and radiological study. RESULTS: The incomplete partition type III anomaly was identified in six patients (0.6%), each of whom had an enlargement of the vestibular aqueduct at the end close to the vestibule. The six patients also had POU3F4 variants, and a genetic analysis revealed frameshift deletions in three patients, a missense variant in two patients of the same family, and a large deletion in one patient. Three of the six patients with POU3F4 variants were sporadic cases, and in one patient the genetic mutation occurred de novo. CONCLUSIONS: It was indicated that POU3F4 mutations can be predicted by incomplete partition type III anomaly by radiological examination of the inner ear. All six of the patients showed mixed hearing loss, but none showed fluctuations in hearing, which may be related to the lack of vestibular aqueduct enlargement at the operculum. LEVEL OF EVIDENCE: 4 Laryngoscope, 127:1663-1669, 2017.

Enhancement of anti-cholinesterase activity of aqueous samples by hypochlorite oxidation for monitoring traces of organophosphorus pesticides in water.

A reproducible method for monitoring traces of cholinesterase (ChE) inhibitors in aqueous samples is described: the method is based on chemical oxidation and a ChE inhibition assay. Chlorine was tested as an oxidizing reagent for conversion of various thiophosphorus pesticides (P=S compounds) into their P=O analogs, which have higher ChE-inhibiting activity. After treating buffered pesticide solutions (pH 6.0) with chlorine (final concentration less than 10 mg/l) of at 25°C for 15 min, the ChE-inhibiting activities and detection limits for each pesticide were determined. Greater ChE-inhibiting activities, leading to lower detection limits (ppb levels), were observed for the chlorine-treated solutions fortified azinphos methyl, diazinon, isoxathion and ronnel etc. No changes in the ChE-inhibiting activities were observed for carbamate pesticide solutions tested before and after chlorination, but an additive effect showed against ChE when these compounds were mixed with paraoxon in water. This combination of oxidative derivatization and ChE inhibition assay was applied successfully to the detection and determination of ChE inhibitors in natural and drinking water samples.

Mutagenic potentials of Amberlite XAD-2-resin extracts obtained from river and drinking waters in the Northwest district of Chiba, Japan.

Amberlite XAD-2 resin extracts of river and drinking water sampled from the Northwest district of Chiba Prefecture in each month during the period from January to December 2008 were investigated to characterize and determine their mutagenic potentials and polycyclic aromatic hydrocarbon (PAH) levels. The extracts from the river water were shown to be mutagenic in Salmonella typhimurium TA98 (a flameshift mutagen) without S9 mix, with higher mutagenic responses in summer and early fall seasons. While the drinking water extracts exhibited weak mutagenicity in both the TA98 and TA100 strains (a base-pair substitution mutagen) without S9 mix, with high mutagenic responses in fall and early winter seasons. GC/MS determinations of the water concentrates showed some seasonal scatter in PAH levels in river water. In contrast, comparatively high concentrations of PAHs were observed for drinking water samples collected during warmer seasons. Statistical studies revealed that there is a lower correlation between the levels of flameshift mutagenicity and the concentrations of PAH in the river water concentrations, but a higher correlation between them in the drinking water samples.