Remnant Preservation of the Primary Vertical Graft in Revision Anterior Cruciate Ligament Reconstruction

Background

The remnant preservation of a primary vertical graft in revision anterior cruciate ligament reconstruction (ACLR) can benefit anteroposterior stability. However, studies that address this concept are rare.

Purpose

To evaluate clinical outcomes of remnant preservation of primary vertical graft in revision ACLR.

Study Design

Cohort study; Level of evidence, 3.

Methods

A total of 74 patients with revision ACLR were included in this retrospective study. Remnant preservation revision ACLR was performed only in patients with primary vertical grafts. The patients were divided into 2 groups according to whether the primary remnant vertical graft was preserved (remnant group; n = 48) or absent or sacrificed (no-remnant group; n = 26). The remnant group was further divided according to the degree of remnant tissue: sufficiently preserved subgroup (graft coverage, ≥50%; n = 25) and insufficiently preserved subgroup (graft coverage, <50%; n = 23). Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) subjective form, Lysholm score, Tegner activity scale, manual laxity tests, and side-to-side difference in anterior tibial translation on Telos stress radiographs.

Results

The mean time to final follow-up was 40.7 ± 16.8 months. The remnant group showed more improved results in the postoperative Lachman test and Telos side-to-side difference than did the no-remnant group (P = .017 and .016, respectively). The post hoc test revealed that the side-to-side difference in laxity in the sufficiently preserved subgroup significantly outperformed that in the no-remnant group (P = .001), although no significant difference existed between the insufficiently preserved and no-remnant subgroups (P = .850). The postoperative IKDC subjective form, Lysholm score, and Tegner activity scale did not show significant differences between the 2 groups (P = .480, .277, and .883, respectively).

Conclusion

The remnant preservation of the primary vertical graft in revision ACLR may result in better anteroposterior stability. However, subjective outcomes in the remnant group did not exceed that of the no-remnant group. The subgroup analysis revealed that only sufficiently preserved remnants demonstrated better anteroposterior stability.

Indirect Decompression Using Oblique Lumbar Interbody Fusion Revision Surgery Following Previous Posterior Decompression: Comparison of Clinical and Radiologic Outcomes Between Direct and Indirect Decompression Revision Surgery

OBJECTIVE

This study compared the radiological and clinical outcomes with transforaminal lumbar interbody fusion (TLIF) to evaluate the effect of indirect decompression through oblique lumbar interbody fusion (OLIF) as revision surgery.

METHODS

We enrolled patients who underwent single-level fusion with revision surgery at the same level as the previous decompression level. We retrospectively reviewed 25 patients who underwent OLIF from 2017 to 2018 and 25 who received TLIF from 2014 to 2018. Radiologic and clinical outcomes were evaluated by cross-sectional area (CSA) of the spinal canal, thickness and area of ligamentum flavum (LF), subsidence, disc height, fusion rate, Oswestry Disability Index (ODI), and visual analogue scale (VAS).

RESULTS

Compared with OLIF, the thickness and area of the LF after surgery were significantly less in TLIF, and the resulting CSA extension was also significantly higher. However, both groups showed improvement in ODI and VAS after surgery, and there was no difference between the groups. Complications related to the posterior approach in TLIF were 4 cases, and in OLIF, there were 2 cases that underwent additional posterior decompression surgery and 6 cases of transient paresthesia.

CONCLUSION

Since complications associated with the posterior approach can be avoided, OLIF is a safer and useful minimally invasive surgery. Therefore, appropriate indications are applied, OLIF is a good alternative to TLIF when revision surgery is considered.

Timing of antibiotics in septic patients: a prospective cohort study

OBJECTIVES

To evaluate the effect of timing and appropriateness of antibiotics administration on mortality in patients diagnosed with sepsis according to the Sepsis-3 definition.

METHODS

This prospective cohort study was conducted in patients diagnosed with sepsis according to the Sepsis-3 definition at the emergency department of Korea University Ansan Hospital from January 2016 to January 2019. The time to antibiotics was defined as the time in hours from emergency department arrival to the first antibiotic administration. Cox proportional hazards regression analysis was used to estimate the association between time to antibiotics and 7-, 14- and 28-day mortality.

RESULTS

Of 482 patients enrolled onto this study, 203 (42.1%) of 482 and 312 (64.7%) of 482 were diagnosed with septic shock and high-grade infection respectively. The median time to receipt of antibiotic therapy was 115 minutes. Antibiotics were administered within 3 and 6 hours in 340 (70.4%) of 482 and 450 (93.2%) of 482 patients respectively. Initial appropriate empirical antibiotics were administered in 375 (77.8%) of 482 patients. The time to and appropriateness of the initial antibiotics were not associated with 7-, 14- and 28-day mortality in multivariate analysis. The Sequential Organ Failure Assessment (SOFA) score (adjusted hazard ratio (aHR) 1.229, 95% confidence interval (CI) 1.093-1.381, p 0.001) and initial lactate levels (aHR 1.128, 95% CI 1.034-1.230, p 0.007), Charlson comorbidity index (aHR 1.115, 95% CI 1.027-1.210, p 0.014), 2-hour lactate level (aHR 1.115, 95% CI 1.027-1.210, p 0.009) and SOFA score (aHR 1.077, 95% CI 1.013-1.144, p 0.018) affected 7-, 14- and 28-day mortality respectively. Subgroup analysis with septic shock, bacteraemia and high-grade infection did not affect mortality rates.

CONCLUSIONS

Time to receipt of antibiotics may not affect the prognosis of patients with sepsis if a rapid and well-trained resuscitation is combined with appropriate antibiotic administration within a reasonable time.

CAU-11-COOH with a V-Shaped Linker as a Catalyst for the Solvent-Free Synthesis of Cyclic Carbonates from CO₂ and Epoxides

An Al₃₊-based metal-organic framework (MOF), CAU-11-COOH, with a V-shaped ligand, DPSDA (3,3'-4,4'-diphenylsulfonetetracarboxylic dianhydride), was prepared using the solvothermal method, and was characterized using powder X-ray diffraction, Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, scanning electron microscopy, elemental analysis, thermogravimetric analysis, Brunauer-Emmett-Teller analysis, and CO₂ adsorption. The catalytic efficiency of CAU-11-COOH was investigated in the solvent-free cycloaddition of carbon dioxide with epoxides, which yielded five-membered cyclic carbonates under mild reaction conditions. CAU-11-COOH with a co-catalyst, tetrabutylammonium bromide (TBAB), gave higher than 98% yield of epichlorohydrin carbonate at 80 °C without a solvent. A plausible reaction mechanism in which the Lewis acidic metal center, an uncoordinated carboxyl group, and a nucleophilic bromide anion operate synergistically is proposed. The CAU-11-COOH catalysts were found to exhibit high thermal stability and could be reused more than four times without any significant reduction in activity.

Water-Tolerant DUT-Series Metal-Organic Frameworks: A Theoretical-Experimental Study for the Chemical Fixation of CO2 and Catalytic Transfer Hydrogenation of Ethyl Levulinate to γ-Valerolactone

A series of highly thermally and hydrolytically stable porous solids with intriguing properties of zirconium- and hafnium-based metal-organic frameworks (MOFs) [Dresden University of Technology (DUT) series] was synthesized. The DUT MOFs were found to be effective catalysts for both epoxide-CO₂ cycloaddition reactions and the catalytic transfer hydrogenation (CTH) of ethyl levulinate (EL). In particular, 12-connected DUT-52(Zr) showed higher catalytic activity than eight- and six-connected catalysts in the synthesis of cyclic carbonates as well as in the production of γ-valerolactone (GVL). The secondary building unit connectivity, coexistence of a moderate number of acidic and basic sites, Brunauer-Emmett-Teller surface area, and combined effects of the pores of the MOFs seem to influence the catalytic activity. The reaction mechanism for the DUT-52(Zr)-mediated cycloaddition reaction of CO₂ and the CTH reactions were investigated in detail by using periodic density functional theory calculations. To the best of our knowledge, this is the first detailed computational study for the formation of GVL from EL by using MOF as the catalyst. In addition, grand canonical Monte Carlo simulations predicted the strong interaction of CO₂ molecules with the DUT-52(Zr) framework. Remarkably, the DUT-series catalysts possess extraordinary tolerance toward water. Further, DUT-52(Zr) is recyclable and is an efficient catalyst for cycloaddition and CTH reactions for at least five uses without obvious reductions in the activity or structural integrity.

Ionic-Liquid-Functionalized UiO-66 Framework: An Experimental and Theoretical Study on the Cycloaddition of CO2 and Epoxides

A facile approach for modifying the UiO-66-NH₂ metal-organic framework by incorporating imidazolium-based ionic liquids (ILs) to form bifunctional heterogeneous catalysts for the cycloaddition of epoxides to CO₂ is reported. Methylimidazolium- and methylbenzimidazolium-based IL units (ILA and ILB, respectively) were introduced into the pore walls of the UiO-66-NH₂ framework through a condensation reaction to generate ILA@U6N and ILB@U6N catalysts, respectively. The resultant heterogeneous catalysts, especially ILA@U6N, exhibited excellent CO₂ adsorption capability, which makes them effective for cycloaddition reactions producing cyclic carbonates under mild reaction conditions in the absence of any cocatalyst or solvent. The significantly enhanced activity of ILA@U6N is attributed to the synergism between the coordinately unsaturated Lewis acidic Zr⁴⁺ centers and Br^- ions in the bifunctional heterogeneous catalysts. The size effect of the ILs on coupling between the epoxide and CO₂ was also studied for ILA@U6N and ILB@U6N. A periodic DFT study was performed to provide evidence of possible intermediates, transition states, and pathways, as well as to gain deeper insight into the mechanism of the ILA@U6N-catalyzed cycloaddition reaction between epichlorohydrin and CO₂ .

Serial measurement of S100B and NSE in pediatric traumatic brain injury

PURPOSE

Increased serum biomakers, such as S100 calcium-binding protein B (S100B) and neuron-specific enolase (NSE), are associated with traumatic brain injury (TBI). The purpose of this study is to investigate the serum levels of S100B and NSE in pediatric TBI patients and to predict a clinical outcome.

METHODS

Peripheral venous blood was collected within 6 h of injury and at 1 week to measure S100B and NSE. The serum S100B and NSE levels were measured using commercially available enzyme-linked immunosorbent assay kits. The authors divided participants into two groups at admission: a favorable group (patients with Glasgow Coma Scale [GCS] scores of 10-15) and an unfavorable group (patients with GCS scores of less than 9). Both S100B and NSE levels were compared between the two groups at the time of admission and 1 week later.

RESULTS

Ten pediatric patients were enrolled (5 in the favorable group, 5 in the unfavorable group). The median serum S100B level of 134.21 pg/ml (range, 51.00-789.65 pg/ml) in patients with TBI at admission dropped to 41.49 pg/ml (range, 25.65-260.93 pg/ml) after 1 week, with significant differences between the traumatic event and 1 week later (p = 0.007). The median serum NSE level of 14.76 ng/ml (range, 6.48-21.23 ng/ml) in patients with TBI at admission was higher than that after 1 week (4.96 ng/ml, range, 3.01-31.21 ng/ml), with significant differences (p = 0.015). A significant difference was observed in S100B after 1 week between patients in the favorable and unfavorable groups (p = 0.047). One patient whose serum S100B and NSE levels were elevated 1 week after TBI eventually died.

CONCLUSIONS

Elevated serum S100B and NSE levels in pediatric TBI patients decreased 1 week after traumatic events. The serum S100B level 1 week after TBI was related to the severity of brain damage. These results indicated that serum S100B and NSE might play a role in predicting the prognosis and monitoring ongoing brain injury in pediatric TBI patients.

Fabrication of hierarchically porous MIL-88-NH2(Fe): a highly efficient catalyst for the chemical fixation of CO2 under ambient pressure

A hierarchically micro- and mesoporous MIL-88-NH₂ metal organic framework was prepared through an easy template directed methodology.

Influence of Synthetic Parameters on the Particle Size and Distribution of Pd in Pd/Al₂O₃ Catalysts

The increasing role of catalysis by noble metals coupled with their high price requires the development of cheaper and more effective catalysts, e.g., highly dispersed supported catalyst. Herein, Pd supported on Al2O3 catalysts prepared by deposition-precipitation under different conditions were subjected to X-ray diffraction, N2-physisorption, NH3/CO2 temperature programmed desorption, CO-chemisorption, and field-emission transmission electron microscopy analyses, which revealed that the size and distribution of Pd particles were influenced by Al2O3 support type (particle size and phase transition) and preparation conditions (metal precursor type, pH value, and solution temperature). The Pd/Al2O3 catalysts were prepared using type A (particle size = 3 micron) or type B (particle size = 20 nm) as a support and PdCl2 (PC) or Pd(NO3)2·2H2O (PN) as a Pd precursor, respectively. In XRD results, type A (particle size = 3 micron) Al2O3 had γ and  phase, and type B (particle size = 20 nm) Al2O3 had only thermally stable γ phase. In addition, Pd dispersion and crystallite size showed an obvious dependence on pH value, solution temperature and attractive/repulsive forces between the functional groups of Al2O3 and Pd precursors. Optimal results were obtained using PdCl2 (PC) as a Pd precursor and type B (particle size = 20 nm) as a support at 60 °C and pH 5.5.

Central Serous Chorioretinopathy in Two Families

Purpose and Methods.

The reported occurrence of central serous chorioretinopathy (CSCR) in families is rare. We report two families (five patients) who have been diagnosed with CSCR. The diagnosis of CSCR was made on clinical and fluorescein angiographic findings.

Results

Three members of the first family and two members of the second family had CSCR. Affected individuals were all males.

Conclusions

CSCR has been associated with psychological and emotional stress and the occurrence of CSCR in families may be due to similar inherited psychological and physiological characteristics and responses that predispose these families to the development of CSCR.

Bifunctional Pyridinium-Based Ionic-Liquid-Immobilized Diindium Tris(diphenic acid) Bis(1,10-phenanthroline) for CO2 Fixation

A pyridinium-based ionic-liquid-decorated 1 D metal-organic framework (MOF; IL-[In₂ (dpa)₃ (1,10-phen)₂ ]; IL=ionic liquid; dpa=diphenic acid; 1,10-phen=1,10-phenanthroline) was developed as a bifunctional heterogeneous catalyst system for CO₂ -oxirane coupling reactions. An aqueous-microwave route was employed to perform the hydrothermal reaction for the synthesis of the [In₂ (dpa)₃ (1,10-phen)₂ ] MOF, and the IL-[In₂ (dpa)₃ (1,10-phen)₂ ] catalyst was synthesized by covalent postfunctionalization. As a result of the synergetic effect of the dual-functional sites, which include Lewis acid sites (coordinatively unsaturated In sites) and the I^- ion in the IL functional sites, IL-[In₂ (dpa)₃ (1,10-phen)₂ ] displayed a high catalytic activity for CO₂ -epoxide cycloaddition reactions under mild and solvent-free conditions. Microwave pulses were employed for the first time in MOF-catalyzed CO₂ -epoxide cycloaddition reactions to result in a high turnover frequency of 2000-3100 h^-1 . The catalyst had an excellent reusability and maintained a continuous high selectivity. Furthermore, only a small amount of leaching was observed from the spent catalyst. A plausible reaction mechanism based on the synergistic effect of the dual-functional sites that catalyze the CO₂ -epoxide cycloaddition reaction effectively is proposed.

Measurement of levels of fractional exhaled nitric oxide in patients with pulmonary tuberculosis

SETTING

The role of fractional exhaled nitric oxide (FeNO) in the diagnosis and treatment of pulmonary tuberculosis (PTB) is uncertain.

OBJECTIVE

To examine the value of FeNO as a biomarker for PTB.

DESIGN

Baseline FeNO levels were compared in 69 PTB patients and 118 healthy controls. The correlation between baseline FeNO levels and clinical variables of tuberculosis were studied. FeNO levels were checked twice in the PTB group, at diagnosis and after 2 months of anti-tuberculosis medication, and factors affecting changes in FeNO levels after treatment were analysed.

RESULTS

FeNO levels were not significantly different in the PTB group and controls (mean ± standard deviation 27.7 ± 17.6 parts per billion [ppb] vs. 27.0 ± 10.8 ppb, P = 0.531). In a multivariate regression analysis, no variable was shown to affect FeNO levels at diagnosis. FeNO levels did not significantly change after 2 months of treatment (26.8 ± 18.3 ppb vs. 24.0 ± 10.7 ppb, P = 0.257). Only PTB with a high FeNO level (>25 ppb) was related to a decline in FeNO levels after 2 months of treatment.

CONCLUSION

FeNO levels do not appear to be affected in PTB patients.

Microwave-induced synthesis of a bimetallic charge-transfer metal organic framework: a promising host for the chemical fixation of CO2

Ni–Co bimetallic MOF was prepared and used as a catalyst for epoxide-CO₂ cycloaddition.

The effect of low-volatile organic compounds, water-based paint on aggravation of allergic disease in schoolchildren

Whether indoor painting aggravates preexisting allergic diseases remains unclear. We aimed to evaluate the impact of new classroom painting on aggravation of asthma, allergic rhinitis (AR), and atopic dermatitis (AD) in children. Studied school was previously painted with conventional water-based paint 20 years ago and had natural ventilation system. We identified a total of 172 children aged 10-12 years with allergic diseases in 17 classrooms, which were allocated to newly painted rooms with low-volatile organic compounds (VOC), water-based paint, or existing rooms. After painting, there was no intervention or internal airflow to influence indoor air environment in both classrooms. We prospectively assessed the symptom severity and serious events of allergic diseases between both classrooms at baseline and after one and eight weeks after painting. At one and eight weeks, there were no significant changes in the Childhood Asthma Control Test scores, the fractional nitric oxide levels, lung function in asthmatic children in either classroom. There were also no significant changes in the severity score of AR or AD, or serious events in all allergic diseases. These findings suggest classroom painting with this new paint at the levels encountered in this study might not be a major aggravating factor for school-aged children with allergic diseases.

Rapid, Microwave-Assisted Synthesis of Cubic, Three-Dimensional, Highly Porous MOF-205 for Room Temperature CO2 Fixation via Cyclic Carbonate Synthesis

A dual-porous, three-dimensional, metal-organic framework [Zn₄O(2,6-NDC)(BTB)_4/3] (MOF-205, BET = 4200 m²/g) has been synthesized using microwave power as an alternative energy source for the first time, and its catalytic activity has been exploited for CO₂-epoxide coupling reactions to produce five-membered cyclic carbonates under solvent-free conditions. Microwave synthesis was performed at different time intervals to reveal the formation of the crystals. Significant conversion of various epoxides was obtained at room temperature, with excellent selectivity toward the desired five-membered cyclic carbonates. The importance of the dual porosity and the synergistic effect of quaternary ammonium salts on efficiently catalyzed CO₂ conversion were investigated using various experimental and physicochemical characterization techniques, and the results were compared with those of the solvothermally synthesized MOF-205 sample. On the basis of literature and experimental inferences, a rationalized mechanism mediated by the zinc center of MOF-205 for the CO₂-epoxide cycloaddition reaction has been proposed.

Catalytic Performance of Microwave Functionalized NH2-MIL-53 for Cyclic Carbonate Synthesis from CO2 and Epoxides

The efficacy of microwave irradiation in the quaternization of amino-functionalized MIL-53 metal-organic framework (MOF) as well as the catalytic activity of the resultant MOF in the cycloaddition of carbon dioxide with epoxides under solvent-free conditions has been studied. A series of NH2-MIL-53 were synthesized and quaternized by reacting alkyl halide of various alkyl chains and anions under microwave irradiation. The post-functionalized F-MIL-53-AXs were characterized through solid-state XRD, FT-IR, XPS, and TGA. F-MIL-53-Mel prepared by microwave method showed higher AGC yield than that by the conventional heating method. F-MIL-53-AXs with iodide anion exhibited the best catalytic activity irrespective of the alkyl chain length, in agreement with the generally accepting order of nucleophilicity, Cl<Br<I. A plausible mechanism in which Lewis acidic metal center and quaternary ammonium functional group operate synergistically is proposed. The F-MIL-53-AX catalysts were found to exhibit high thermal stability and were reusable over than three times, without any significant lowering of activity.

A sustainable protocol for the facile synthesis of zinc-glutamate MOF: an efficient catalyst for room temperature CO2 fixation reactions under wet conditions

A water stable zinc-MOF (ZnGlu) catalyst was facilely prepared from the proteinogenic amino acid, l-glutamic acid at room temperature in aqueous medium. CO2 fixations were promoted by the ZnGlu catalyst's inherently coordinated water and externally added water in yielding cyclic carbonate and cyclic urethane at room temperature. This eliminates the need for catalyst activation, making ZnGlu a ready-to-use catalyst. The enhanced CO2 cycloaddition with added water hints at the application of ZnGlu in wet flue gas conversions. This is the first reported attempt for the use of an MOF in the cycloaddition of aziridine and CO2.

A computational study of the mechanistic insights into base catalysed synthesis of cyclic carbonates from CO2: bicarbonate anion as an active species

The role of the bicarbonate ion as a catalyst species in CO₂ fixation via cyclic carbonate synthesis is investigated.

A sustainable protocol for the facile synthesis of zinc-glutamate MOF: an efficient catalyst for room temperature CO2fixation reactions under wet conditions

A water-stable zinc-glutamate-MOF catalyst, prepared using a facile and eco-friendly method at room temperature, was employed for room temperature wet CO₂fixation reactions.

Comparison of Inner Ear Contrast Enhancement among Patients with Unilateral Inner Ear Symptoms in MR Images Obtained 10 Minutes and 4 Hours after Gadolinium Injection

BACKGROUND AND PURPOSE

Recently 4-hour delayed-enhanced 3D-FLAIR MR imaging has been used in pathophysiologic analysis of the inner ear in many auditory diseases, including sudden sensorineural hearing loss, but comparison among different time points is not clear in patients with unilateral inner ear symptoms. We compared the signal-intensity ratios of the inner ears in patients with unilateral inner ear symptoms on 10-minute delayed-enhanced and 4-hour delayed-enhanced 3D-FLAIR MR images after IV gadolinium injection.

MATERIALS AND METHODS

The 10-minute delayed-enhanced and 4-hour delayed-enhanced 3D-FLAIR MR images were retrospectively analyzed. Signal-intensity ratios between the cerebellum and inner ear structures, such as the cochleae, vestibules, and vestibulocochlear nerve were assessed. Multiple comparisons were performed.

RESULTS

Signal-intensity ratios of the affected cochleae, vestibules, and vestibulocochlear nerve were higher than those of unaffected sides in both 10-minute delayed-enhanced and 4-hour delayed-enhanced images. At the affected side, signal-intensity ratios of the vestibulocochlear nerve were higher in patients with nonsudden sensorineural hearing loss than in those with sudden sensorineural hearing loss on both 10-minute delayed-enhanced and 4-hour delayed-enhanced images. The signal-intensity ratios of some affected inner ear structures were higher than those of the unaffected sides in a group of 30 patients with sudden sensorineural hearing loss and 20 patients with nonsudden sensorineural hearing loss on 10-minute delayed-enhanced and 4-hour delayed-enhanced images.

CONCLUSIONS

Signal-intensity ratios of the inner ear show statistically significant increases in many diseases, especially neuritis, in 10-minute delayed-enhanced and 4-hour delayed-enhanced images. The 4-hour delayed-enhanced images may be superior in neural inflammatory-dominant conditions, while 10-minute delayed-enhanced images may be superior in neural noninflammatory-dominant conditions.

Mesoporous silica-giant particle with slit pore arrangement as an adsorbent for heavy metal oxyanions from aqueous medium

A newly synthesized giant mesoporous silica particle has been used for arsenate and chromate adsorption studies.

Catalytic performance of functionalized IRMOF-3 for the synthesis of glycerol carbonate from glycerol and urea

A functionalized isoreticular metal organic framework material, F-IRMOF-3, having a quaternary ammonium group was prepared by fast precipitation and solvothermal method. The synthesized MOFs exhibited good catalytic performance in the synthesis of glycerol carbonate (GC) from glycerol and urea. F-IRMOF-3 having a larger alkyl chain structure and a more nucleophilic counter anion than the synthesized congeners, exhibited better reactivity in the synthesis of GC. The introduction of a ZnO defect into the F-IRMOF-3 structure by fast precipitation was more advantageous for the glycerolysis of urea than the conventional solvothermal method because of the incorporation of acid-base bifunctional active sites by the former method. The effects of reaction parameters such as temperature, reaction time, catalyst loading, and degree of vacuum on the reactivity were also investigated. The F-IRMOF-3 catalyst can be easily recovered and reused without considerable loss of its initial activity.

Organic-inorganic hybrids of imidazole complexes of zinc (II) for catalysts in the glycerolysis of urea

Bis(alkylimidazole) complexes of zinc, (RIm)2ZnX2, were prepared by a metal insertion reaction. The synthesized (RIm)2ZnX2 exhibited good catalytic performance during synthesis of glycerol carbonate (GC) from glycerol and urea. (HEIm)2ZnCl2 with a hydroxyl group exhibited the highest GC yield during glycerolysis of urea owing to incorporation of acid-base bifunctional active sites. (EIm)2ZnX2 catalysts based on different halide anions showed increased reactivity as Cl- < Br- < I-, which is the order of nucleophilicity. The effects of reaction parameters such as temperature, reaction time, catalyst loading, and degree of vacuum on the reactivity were also investigated.

Ten years of experience in the prevention of mother-to-child human immunodeficiency virus transmission in a university teaching hospital

PURPOSE

Administration of antiretroviral drugs to mothers and infants significantly decreases mother-to-child human immunodeficiency virus (HIV) transmission; cesarean sections and discouraging breastfeeding further decreases this risk. The present study confirmed the HIV status of babies born to mothers infected with HIV and describes the characteristics of babies and mothers who received preventive treatment.

METHODS

This study retrospectively analyzed medical records of nine infants and their mothers positive for HIV who gave birth at Korea University Ansan Hospital, between June 1, 2003, and May 31, 2013. Maternal parameters, including HIV diagnosis date, CD4+ count, and HIV ribonucleic acid (RNA) copy number, were analyzed. Infant growth and development, HIV RNA copy number, and HIV antigen/antibody test results were analyzed.

RESULTS

Eight HIV-positive mothers delivered nine babies; all the infants received antiretroviral therapy. Three (37.5%) and five mothers (62.5%) were administered single- and multidrug therapy, respectively. Intravenous zidovudine was administered to four infants (50%) at birth. Breastfeeding was discouraged for all the infants. All the infants were negative for HIV, although two were lost to follow-up. Third trimester maternal viral copy numbers were less than 1,000 copies/mL with a median CD4+ count of 325/µL (92-729/µL). Among the nine infants, two were preterm (22.2%) and three had low birth weights (33.3%).

CONCLUSION

This study concludes that prophylactic antiretroviral therapy, scheduled cesarean section, and prohibition of breastfeeding considerably decrease mother-to-child HIV transmission. Because the number of infants infected via mother-to-child transmission may be increasing, studies in additional regions using more variables are necessary.

Clinical characteristics predicting early clinical failure after 72 h of antibiotic treatment in women with community-onset acute pyelonephritis: a prospective multicentre study

In patients with community-onset acute pyelonephritis (CO-APN), assessing the risk factors for poor clinical response after 72 h of antibiotic treatment (early clinical failure) is important. The objectives of this study were to define those risk factors, and to assess whether early clinical failure influences mortality and treatment outcomes. We prospectively collected the clinical and microbiological data of women with CO-APN in South Korea from March 2010 to February 2012. The numbers of cases in the early clinical success and early clinical failure groups were 840 (79.1%) and 222 (20.9%), respectively. Final clinical failure and mortality were higher in the early clinical failure group than in the early clinical success group (14.9% vs 2.3%, p <0.001; 6.8% vs 0.1%, p 0.001, respectively). In a multiple logistic regression model, the risk factors for early clinical failure among the total 1062 patients were diabetes mellitus (OR 1.5; 95% CI 1.1-2.1), chronic liver diseases (OR 3.3; 95% CI 1.6-6.7), malignancy (OR 2.2; 95% CI 1.1-4.4), Pitt score ≥2 (OR 2.5; 95% CI 1.6-3.8), presence of azotaemia (OR 1.8; 95% CI 1.2-2.7), white blood cell count ≥20 000/mm(3) (OR 2.5; 95% CI 1.6-4.0), serum C-reactive protein level ≥20 mg/dL (OR 1.7; 95% CI 1.2-2.4), and history of antibiotic usage within the previous year (OR 1.5; 95% CI 1.1-2.2). Analysing the subgroup of 743 patients with CO-APN due to Enterobacteriaceae, fluoroquinolone resistance of the uropathogen was another factor associated with early clinical failure (OR 1.7; 95% CI 1.1-2.5). Simple variables of underlying diseases, previous antibiotic usage and initial laboratory test outcomes can be used to decide on the direction of treatment in CO-APN.

Natural amino acids/H2O as a metal- and halide-free catalyst system for the synthesis of propylene carbonate from propylene oxide and CO2under moderate conditions

Amino acid/H₂O catalytic system (metal- and halide-free) for the synthesis of propylene carbonate from propylene oxide and CO₂.

Molecular cloning and expression analysis of interleukin (IL)-15 and IL-15 receptor α from rock bream, Oplegnathus fasciatus

Mammalian interleukin (IL)-15 plays an important role in the activation of CD8(+) T cells and natural killer (NK) cells along with its receptor α (IL-15Rα). To understand the potential roles of IL-15 and IL-15Rα in fish, we identified IL-15 and IL-15Rα cDNA from rock bream (Oplegnathus fasciatus) and investigated their gene expression profiles after bacterial and viral infection. Coding regions of rock bream (Rb) IL-15 and RbIL-15Rα cDNAs were 534 and 402 bp encoding 177 and 133 amino acid residues, respectively. The sushi domain of IL-15Rα was highly conserved between rock bream and other species. Unlike other IL-15Rαs, RbIL-15Rα does not have a transmembrane region. Gene expression of RbIL-15 and RbIL-15Rα was widely expressed in different tissues of healthy fish, especially immune-related tissues. RbIL-15 and RbIL-15Rα were highly induced in the kidney and spleen after infection with Edwardsiella tarda, Streptococcus iniae and red seabream iridovirus. Gene expression patterns of RbIL-15 and RbIL-15Rα were similar in the kidney and spleen after pathogen infection. However, these genes were differentially induced in the liver after pathogen infection. These results suggest that the different responses of RbIL-15 and RbIL-15Rα to pathogen infection may be induced by different tissues or cell types.

Clinical characteristics of community-acquired acute pyelonephritis caused by ESBL-producing pathogens in South Korea

OBJECTIVES

The aim of this study was to determine the risk factors and clinical characteristics of community-acquired acute pyelonephritis (CA-APN) caused by extended-spectrum β-lactamase (ESBL)-producing organisms.

METHODS

From March 2010 to February 2011, patients with CA-APN were recruited in 11 hospitals in South Korea. Clinical and microbiological data were collected prospectively, and the ESBLs and multilocus sequence types of the ESBL-producing Escherichia coli were characterized. Comparison between CA-APN caused by ESBL-producing Enterobacteriaceae and those by non-ESBL-producing organisms was performed.

RESULTS

A total of 566 patients were recruited. Enterobacteriaceae were detected in 526 patients. Forty-six isolates (46/526, 8.7 %) were positive for ESBLs. Clinical and microbiological failure did not differ between the two groups, despite there being fewer patients with ESBL-positive isolates provided with appropriate antibiotics initially (19.6 vs. 93.8 %, p < 0.001). However, the duration of hospitalization was longer in the ESBL group (10.5 vs. 7.0 days, p = 0.012). In a logistic regression model, Charlson score ≥1 point [odds ratio (OR) 3.4, 95 % confidence interval (CI) 1.6-7.0, p = 0.001], antibiotics usage during the previous year (OR 3.1, 95 % CI 1.4-7.2, p = 0.008), and urinary catheterization during the previous month (OR 4.4, 95 % CI 1.1-17.6, p = 0.035) were associated with the risks of CA-APN by ESBL producers. CTX-M-15 (48 %) and CTX-M-14 (38 %) were the most common ESBLs. ST131 was the most common clone (7/24, 29.1 %), which was more frequently resistant to cefepime, fosfomycin, and temocillin.

CONCLUSIONS

The risk factors for CA-APN by ESBL producers were Charlson score ≥1 point, antibiotics usage during the previous year, and urinary catheterization during the previous month.

Functionalized IRMOF-3: an efficient heterogeneous catalyst for the cycloaddition of allyl glycidyl ether and CO2

Functionalized metal organic framework F-IRMOF-3 having quaternary ammonium group was prepared by a fast precipitation and solvothermal method. They showed good catalytic performance for the cycloaddition of allyl glycidyl ether (AGE) and carbon dioxide without any solvent. F-IRMOF-3 with a larger alkyl chain structure and more nucleophilic anion exhibited better reactivity for the cycloaddition reaction. The introduction of a defective ZnO to F-IRMOF-3 by the fast precipitation method becomes more advantageous than the conventional solvothermal method for the cycloaddition reaction due to acid-base bifunctional active sites. The F-IRMOF-3 can be easily recovered and reused without any considerable loss of initial activity.

Hybrid inorganic-organic framework as efficient heterogeneous catalyst for the synthesis of allyl glycidyl carbonate from CO2 and allyl glycidyl ether

A mixed-linker nanoporous coordination polymer Zn2(HIP)2(bipy)(H2O)2 x H2O (ZnHipBipy) constructed from polyfunctional linker 5-hydroxy isophthalic acid (HIP) and exo-bidentate ligand 4,4'-bipyridyl (bipy) was employed as heterogeneous catalyst for allyl glycidyl carbonate (AGC) synthesis from CO2 and allyl glycidyl ether (AGE) under solventless conditions. Besides being the organic linker, 5-hydroxy isophthalic acid enriches the functionality of the material through accessible hydroxyl group capable of contributing extensive hydrogen bonding interactions. The cycloaddition of CO2 and epoxide was catalyzed through a synergistic pathway offered by inherent hydroxyl group together with the catalytically active metal centre. Method of synthesis and texture of the catalyst were key factors in determining the conversion and selectivity. The effects of reaction parameters like catalyst amount, temperature, CO2 pressure and reaction time on the yield of AGC were also studied.