Clinical characteristics of acute kidney injury in patients with glyphosate surfactant herbicide poisoning.

BACKGROUND: In this study, we investigated the clinical characteristics of acute kidney injury (AKI) in patients with glyphosate surfactant herbicide (GSH) poisoning. METHODS: This study was performed between 2008 and 2021 and included 184 patients categorized into the AKI (n = 82) and nonAKI (n = 102) groups. The incidence, clinical characteristics, and severity of AKI were compared between the groups based on the Risk of renal dysfunction, Injury to the kidney, Failure or Loss of kidney function, and End-stage kidney disease (RIFLE) classification. RESULTS: The incidence of AKI was 44.5%, of which 25.0%, 6.5%, and 13.0% of patients were classified into the Risk, Injury, and Failure categories, respectively. Patients in the AKI group were older (63.3 ± 16.2 years vs. 57.4 ± 17.5 years, p = 0.02) than those in the non-AKI group. The length of hospitalization was longer (10.7 ± 12.1 days vs. 6.5 ± 8.1 days, p = 0.004) and hypotensive episodes occurred more frequently in the AKI group (45.1% vs. 8.8%, p < 0.001). Electrocardiographic (ECG) abnormalities on admission were more frequently observed in the AKI group than in the non-AKI group (80.5% vs. 47.1%, p < 0.001). Patients in the AKI group had poorer renal function (estimated glomerular filtration rate at the time of admission, 62.2 ± 22.9 mL/min/1.73 m2 vs. 88.9 ± 26.1 mL/min/1.73 m2 , p < 0.001) on admission. The mortality rate was higher in the AKI group than in the non-AKI group (18.3% vs. 1.0%, p < 0.001). Multiple logistic regression analysis showed that hypotension and ECG abnormalities upon admission were significant predictors of AKI in patients with GSH poisoning. CONCLUSION: The presence of hypotension on admission may be a useful predictor of AKI in patients with GSH intoxication.

A Rare Case of Spinal Epidural Abscess Following Urinary Tract Infection Caused by Escherichia coli in a Patient with Pre-existing Stress Fractures of the Lumbar Spine.

Spinal epidural abscess (SEA) caused by Escherichia coli is an uncommon condition. It usually occurs secondary to urinary tract infection (UTI), following hematogenous propagation. Disruption of spinal anatomic barriers increases susceptibility to SEA. Although rarely, such disruption can take the form of lumbar spine stress fractures, which can result from even innocuous activity. Here, we describe a case of SEA secondary to UTI in a patient with pre-existing stress fractures of the lumbar spine, following use of an automated massage chair. Successful treatment of SEA consisted of surgical debridement and a six-month course of antibiotic therapy.

Clinical significance of hypoalbuminemia in patients with scrub typhus complicated by acute kidney injury.

BACKGROUND: This study aimed to investigate the clinical significance of hypoalbuminemia (HA) in patients with scrub typhus complicated by acute kidney injury (AKI). METHODS: From 2009 to 2018, 611 patients were diagnosed with scrub typhus. We divided the patients into two groups [normoalbuminemia (NA) vs. HA] based on the serum albumin level of 3.0 g/dL and compared the incidence, clinical characteristics, and severity of AKI based on the RIFLE classification between the two groups. RESULTS: Of the total 611 patients, 78 (12.8%) were categorized into the HA group. Compared to patients in the NA group, patients in the HA group were older (73 ± 9 vs. 62 ± 14 years, P<0.001). The HA group had a significantly longer hospital stay (9.6 ± 6.2 vs 6.2 ± 3.1 days, p<0.001) and a higher incidence of complications in respiratory and cardiovascular systems. Furthermore, AKI developed significantly more in patients in the HA group (58% vs. 18%, p<0.001) as compared to the NA group. The overall incidence of AKI was 23.1%; of which, 14.9%, 7.0%, and 1.2% of cases were classified as Risk, Injury, and Failure, respectively. The serum albumin level correlated with AKI severity (3.4 ± 0.5 vs 3.0 ± 0.5 vs 2.6 ± 0.3, p<0.05). In a multivariate logistic regression analysis for predicting AKI, age, presence of co-morbidities such as chronic kidney disease, total bilirubin, leukocytosis, and hypoalbuminemia were significant predictors for AKI. CONCLUSION: Serum albumin level is helpful to predict the development and severity of scrub typhus-associated AKI.

Urinary Exosomal microRNA-21 as a Marker for Scrub Typhus-Associated Acute Kidney Injury.

Background: Urinary microRNA (miRNA)-21 is a biomarker for acute kidney injury (AKI). We conducted this study to determine if a urinary exosomal analysis for this biomarker could serve as a novel diagnostic approach for detecting kidney disease. Materials and Methods: We investigated the clinical significance of urinary exosomal miRNA-21 levels for AKI in scrub typhus patients. We collected 138 urine samples from scrub typhus patients at the time of admission. Urinary exosomal miRNA-21 was assessed in 25 age- and sex-matched scrub typhus patients with and without AKI. Results: The total leukocyte count was higher in AKI patients than in non-AKI patients (10.40 × 103/mL vs. 6.40 × 103/mL, p < 0.01). Urinary exosomal miRNA-21 levels were higher in the AKI group than in the non-AKI group (20.1 ± 1.2 vs. 17.8 ± 1.8 ΔCt value of miRNA-21, p < 0.01). Additionally, the miRNA-21 levels correlated directly with the total leukocyte counts and inversely with the estimated glomerular filtration rate. A receiver operating characteristic curve analysis demonstrated good discriminative power for the diagnosis of scrub typhus-associated AKI, with an area under the curve value of 0.907. Conclusion: Urinary exosomal miRNA-21 could be a surrogate marker for scrub typhus-associated AKI diagnosis.

Clinical significance of abnormal chest radiographic findings for acute kidney injury in patients with scrub typhus.

BACKGROUND: Abnormal chest radiographs are frequently encountered in patients with scrub typhus. This study aimed to investigate whether chest radiography on admission is significant as a predictive factor for acute kidney injury (AKI) in patients with scrub typhus. METHODS: From 2010 to 2016, 467 patients were diagnosed with scrub typhus in our hospital. We divided the patients into two groups: normal chest radiograph (NCR) and abnormal chest radiograph (AbNCR), based on chest radiography findings. The incidence, clinical characteristics, and severity of AKI were compared between AKI and non-AKI groups according to the RIFLE classification. RESULTS: Of the 467 patients, 96 (20.6%) constituted the AbNCR group. Compared with NCR patients, AbNCR patients were older (71 ± 11 vs. 62 ± 13 years, P < 0.001) and had higher total leukocyte counts (9.43 × 103/mL vs. 6.98 × 103/mL, P < 0.001). The AbNCR group had significantly longer duration of hospital stay (8.9 ± 5.5 vs. 6.3 ± 2.8 days, P < 0.001) and higher incidence of AKI (46.9% vs. 15.1%, P < 0.001). The common abnormal chest radiographic findings were pulmonary abnormalities, such as pulmonary congestion and pleural effusion. The overall AKI incidence was 21.6%, of which 12.4%, 7.9%, and 1.3% cases were classified as risk, injury, and failure, respectively. In a multivariable logistic regression analysis for association with AKI, old age, presence of chronic kidney disease or hypertension, leukocytosis, hypoalbuminemia, and chest radiographic abnormalities on admission were significant predictors of AKI. CONCLUSION: Chest radiographic abnormalities on admission were independently associated with AKI in patients with scrub typhus.

Transplantation of a kidney from a donor with vancomycin-resistant Enterococci.

The colonization of vancomycin-resistant Enterococci before and after solid organ transplantation is associated with an increased risk of its infection. The prevalence of these bacterial colonies in renal transplant recipients are as high as that in intensive care unit patients. However, it is unclear whether donors with vancomycin-resistant Enterococci colonization can be considered in renal transplantation. Herein, we report a case wherein a kidney was transplanted from a deceased donor with vancomycin-resistant Enterococci colonies in urine and rectal swab. After transplant, the recipient had no vancomycin-resistant Enterococci infection and maintained relatively good renal function.

Pyridine: a Denaturant or Stabilizer of Spherical Nucleic Acids?

The spotlighted dual functions of pyridine as a denaturant and as a stabilizer for duplex DNA are thoroughly investigated using spherical nucleic acids (SNAs). At neutral pH, pyridine destabilizes the duplex interconnects of assembled SNAs, resulting in a gradual decrease in their melting temperature (Tm) as a function of the pyridine concentration. This result is in good agreement with the conventional role of pyridine as a powerful denaturant for free duplex DNA. On the contrary, the addition of pyridine dramatically increases the Tm of hybridized SNAs under acidic conditions, which could be a striking result of pyridine's stabilizing effect for DNA duplex as previously suggested on the basis of the pyridine-nucleobase interactions. After comprehensive and quantitative investigation based on the analysis of the sharp melting transitions of SNAs, however, we report that, in fact, the pH increase induced by pyridine is also an essential parameter accounting for pyridine's DNA-stabilizing effects under acidic conditions. Importantly, we prove that pyridine, particularly at a low concentration, does not increase the Tm of hybridized SNAs even under acidic conditions, if the pH increase by pyridine is corrected to maintain the same initial pH.

In-Plate and On-Plate Structural Control of Ultra-Stable Gold/Silver Bimetallic Nanoplates as Redox Catalysts, Nanobuilding Blocks, and Single-Nanoparticle Surface-Enhanced Raman Scattering Probes.

Noble metal bimetallic nanomaterials have attracted a great deal of attention owing to the strong correlation between their morphology and chemical and physical properties. Even though the synthetic strategies for controlling the shapes of monometallic nanomaterials such as gold (Au) and silver (Ag) are well-developed, limited advances have been made with Au/Ag bimetallic nanomaterials to date. In this work, we demonstrate a highly complex in-plate and on-plate structural control of Au/Ag bimetallic nanoplates (Au/AgBNPLs) in contrast to conventional, simply structured, 1D and 2D, branched, and polyhedral nanomaterials. The polymer used in the synthesis of seeds plays a critical role in controlling the structure of the Au/AgBNPLs. The Au/AgBNPLs exhibit exceptionally high chemical stability against various chemical etchants and a versatile catalytic reactivity with biologically and environmentally relevant chemical species. Significantly, the reversible assembly formation of the Au/AgBNPLs is demonstrated by carrying out the surface-functionalization of the materials with thiol DNA, emphasizing the potential applications of the Au/AgBNPLs in various diagnostic and therapeutic purposes. Finally, the surface-enhanced Raman scattering (SERS) properties of the Au/AgBNPLs are experimentally and theoretically investigated, demonstrating a substantial potential of the Au/AgBNPLs as single-nanoparticle SERS probes. Electron microscopy, UV-vis spectroscopy, selected area electron diffraction (SAED), and energy-dispersive X-ray (EDX) spectroscopy are employed to analyze the structure and composition of the Au/AgBNPLs at the atomic level.

Recent advances in chemical functionalization of nanoparticles with biomolecules for analytical applications.

The recent synthetic development of a variety of nanoparticles has led to their widespread application in diagnostics and therapeutics. In particular, the controlled size and shape of nanoparticles precisely determine their unique chemical and physical properties, which is highly attractive for accurate analysis of given systems. In addition to efforts toward controlling the synthesis and properties of nanoparticles, the surface functionalization of nanoparticles with biomolecules has been intensively investigated since the mid-1990s. The complicated yet programmable properties of biomolecules have proved to substantially enhance and enrich the novel functions of nanoparticles to achieve "smart" nanoparticle materials. In this review, the advances in chemical functionalization of four types of representative nanoparticle with DNA and protein molecules in the past five years are critically reviewed, and their future trends are predicted.

Colorimetric detection of acetylcholine with plasmonic nanomaterials signaling.

We have developed a highly sensitive and selective colorimetric method for detection of acetylcholine (ACh), using a tandem enzymatic reaction for biological target recognition and silver nanoplates (AgNPLs) for optical signal generation. The ACh molecules are enzymatically hydrolyzed and oxidized into betaine and hydrogen peroxide, the latter of which chemically oxidizes the AgNPLs to generate the "turn-on" signal. To optimize detection sensitivity, the chemical and biological properties of the detection mixtures containing the enzymes, ACh, and AgNPLs were thoroughly investigated with respect to component concentrations and reaction temperatures; a maximum sensitivity of 500 nM for colorimetric detection of ACh was achieved. We further directly compared the signaling profiles of (1) novel nanostructured and (2) conventional molecular chromogens, improving our understanding of the factors that should be considered when designing a detection system.

Synthesis of gold microstructures with surface nanoroughness using a deep eutectic solvent for catalytic and diagnostic applications.

We synthesized highly monodisperse gold microparticles (AuMPs) using a deep eutectic solvent (DES) which composed of choline chloride and malonic acid as both a reaction medium and structure-directing agent. These microparticles exhibit distinctive surface nanoroughness and highly defined diameters that can be precisely controlled over a range of a few micrometers under different reductive conditions. The internal and external structures of the particles are thoroughly investigated by electron microscopy, which is further analyzed in association with their optical properties. We also investigate the gold microparticle concentration-dependent catalytic property employing a reductive reaction of 4-nitrophenol to 4-aminopenol as a model system. Importantly, the gold microparticles are densely functionalized with DNA and reversibly assemble with DNA-gold nanoparticle conjugate probes for the colorimetric detection of target DNA sequences, demonstrating that these novel structures can be utilized as platforms that quickly regulate the optical properties of plasmonic nanoparticles for diagnostic applications.

Designed hybridization properties of DNA-gold nanoparticle conjugates for the ultraselective detection of a single-base mutation in the breast cancer gene BRCA1.

We have investigated the hybridization properties of DNA-gold nanoparticle conjugates and have discovered that the hybridization properties are dramatically affected by controlling various synthetic and environmental conditions. We have further demonstrated that moderate DNA loading instead of high loading per nanoparticle significantly enhances the hybridization rates of DNA-gold nanoparticle conjugates, which allows one to precisely design their hybridization properties to distinguish a single-nucleotide polymorphism (SNP). A diagnostic application for the colorimetric detection of an SNP associated with a mutation in the breast cancer gene BRCA1 has been carefully designed and demonstrated.

Assembly-based titration for the determination of monodisperse plasmonic nanoparticle concentrations using DNA.

We present a stoichiometric titration method to determine the concentration of nanoparticles of various materials, sizes, and shapes. We have discovered that the optical response associated with the assembly formation is maximized when two types of nanoparticles attractively interact at a specific ratio, regardless of the particle type. Based on the reversible hybridization properties of two cDNA sequences used to assemble the particles, the assembly-based titration of various nanoparticles of unknown concentrations is visually demonstrated with high accuracy and reliability, which is analogous to the classic molecular titration method.

Salt concentration-induced dehybridisation of DNA-gold nanoparticle conjugate assemblies for diagnostic applications.

We present the cooperative dehybridisation of DNA-gold nanoparticle conjugate (DNA-AuNP) assemblies induced by reduced salt concentration ([salt]), which can be precisely controlled by various conditions. The detection of Ag(+) based upon the [salt]-induced dehybridisation of DNA-AuNP assemblies is five times more sensitive than that achieved under conventional thermal melting conditions.