Kawasaki disease without changes in inflammatory biomarkers: A case report.

BACKGROUND: Kawasaki disease (KD) is diagnosed based on clinical features. Blood tests and other tests are auxiliary diagnostic tools. Since KD is a disease caused by arterial inflammation, many patients with KD have elevated levels of inflammatory biomarkers, such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and serum amyloid A protein (SAA) in blood tests. We report our experience of a patient with KD who did not have elevated levels of inflammatory biomarkers. CASE SUMMARY: A 1-year-old boy presented with a 3-day history of fever. Five of the six symptoms of KD were observed, except for changes in the lips and oral cavity. Blood tests revealed no elevation in CRP, ESR, or SAA levels. Although the blood test results were atypical, the patient was diagnosed with KD based on clinical symptoms and was admitted to the hospital for treatment. The patient was administered intravenous immunoglobulin (IVIG) and aspirin. Despite commencing treatment, the fever persisted; therefore, additional IVIG was administered, the dosage of aspirin was increased, and ulinastatin was added. Three doses of IVIG were administered and the fever resolved on day 11 of KD symptoms started. Blood tests performed during hospitalization showed normal levels of inflammatory biomarkers. We examined leucine-rich alpha-2-glycoprotein 1 - a protein that is elevated during the acute phase of KD. The protein levels did not increase during hospitalization. CONCLUSION: This case suggests the need to identify criteria and biomarkers for detecting KD conditions that do not require KD treatment.

Remote sensing of vital signs by medical radar time-series signal using cardiac peak extraction and adaptive peak detection algorithm: Performance validation on healthy adults and application to neonatal monitoring at an NICU.

BACKGROUND AND OBJECTIVE: Continuous monitoring of vital signs plays a pivotal role in neonatal intensive care units (NICUs). In this paper, we present a system for monitoring fully non-contact medical radar-based vital signs to measure the respiratory rate (RR), heart rate (HR), I:E ratio, and heart rate variability (HRV). In addition, we evaluated its performance in a physiological laboratory and examined its adaptability in an NICU. METHODS: A non-contact medical radar-based vital sign monitoring system that includes 24 GHz radar installed in an incubator was developed. To enable reliable monitoring, an advanced signal processing algorithm (i.e., a nonlinear filter to separate respiration and heartbeat signals from the output of radar), template matching to extract cardiac peaks, and an adaptive peak detection algorithm to estimate cardiac peaks in time-series were proposed and implemented in the system. Nine healthy subjects comprising five males and four females (24 ± 5 years) participated in the laboratory test. To evaluate the adaptability of the system in an NICU setting, we tested it with three hospitalized infants, including two neonates. RESULTS: The results indicate strong agreement in healthy subjects between the non-contact system and reference contact devices for RR, HR, and inter-beat interval (IBI) measurement, with correlation coefficients of 0.83, 0.96, and 0.94, respectively. As anticipated, the template matching and adaptive peak detection algorithms outperformed the conventional approach. These showed a more accurate IBI close to the reference Bland-Altman analysis (proposed: bias of -3 ms, and 95% limits of agreement ranging from -73 to 67 ms; conventional: bias of -11 ms, and 95% limits of agreement ranging from -229 to 207 ms). Moreover, in the NICU clinical setting, the IBI correlation coefficient and 95% limit of agreement in the conventional method are 0.31 and 91 ms. The corresponding values obtained using the proposed method are 0.93 and 21 ms. CONCLUSION: The proposed system introduces a novel approach for NICU monitoring using a non-contact medical radar sensor. The signal processing method combining cardiac peak extraction algorithm with the adaptive peak detection algorithm shows high adaptability in detecting IBI the time series in various application settings.

Simple determination of urine cefazolin concentration in pediatric patients with urinary tract infections using high-performance liquid chromatography.

Recently, global health concerns regarding increasing multidrug resistance have arisen. This study aimed to develop a simple, inexpensive and rapid high-performance liquid chromatography-ultraviolet (HPLC-UV) method for determining urinary concentrations of a first-generation cephem antibiotic in pediatric patients with urinary tract infections (UTIs). HPLC-UV was used to analyze urinary cefazolin concentrations at a detection wavelength of 254 nm. The assay used contained 10-fold diluted urine with an internal standard (cephapirin). The standard calibration curve for cefazolin was linear in the concentration range of 31.25-500 µg/ml (r2  > 0.999). The retention times of cefazolin and the internal standard were 4.2 and 4.9 min, respectively. The within- and between-day coefficients of variation were in the concentration ranges 1.2-15.2 and 5.5-19.2%, respectively. The urinary cefazolin concentration of a pediatric patient with a UTI was 1,476.6 µg/ml, which was over 700-fold higher than the minimum inhibitory concentration of cefazolin (≤2 µg/ml). The developed method is applicable to the confirmation of appropriate use for UTI treatment as therapeutic drug monitoring of cefazolin. Therefore, the findings of this study may contribute to the appropriate use of antibiotics to prevent antimicrobial resistance in pediatric patients with UTIs.

Discovery, primary, and crystal structures and capacitation-related properties of a prostate-derived heparin-binding protein WGA16 from boar sperm.

Mammalian sperm acquire fertility through a functional maturation process called capacitation, where sperm membrane molecules are drastically remodeled. In this study, we found that a wheat germ agglutinin (WGA)-reactive protein on lipid rafts, named WGA16, is removed from the sperm surface on capacitation. WGA16 is a prostate-derived seminal plasma protein that has never been reported and is deposited on the sperm surface in the male reproductive tract. Based on protein and cDNA sequences for purified WGA16, it is a homologue of human zymogen granule protein 16 (ZG16) belonging to the Jacalin-related lectin (JRL) family in crystal and primary structures. A glycan array shows that WGA16 binds heparin through a basic patch containing Lys-53/Lys-73 residues but not the conventional lectin domain of the JRL family. WGA16 is glycosylated, contrary to other ZG16 members, and comparative mass spectrometry clearly shows its unique N-glycosylation profile among seminal plasma proteins. It has exposed GlcNAc and GalNAc residues without additional Gal residues. The GlcNAc/GalNAc residues can work as binding ligands for a sperm surface galactosyltransferase, which actually galactosylates WGA16 in situ in the presence of UDP-Gal. Interestingly, surface removal of WGA16 is experimentally induced by either UDP-Gal or heparin. In the crystal structure, N-glycosylated sites and a potential heparin-binding site face opposite sides. This geography of two functional sites suggest that WGA16 is deposited on the sperm surface through interaction between its N-glycans and the surface galactosyltransferase, whereas its heparin-binding domain may be involved in binding to sulfated glycosaminoglycans in the female tract, enabling removal of WGA16 from the sperm surface.

Bis(ß-lactosyl)-[60]fullerene as novel class of glycolipids useful for the detection and the decontamination of biological toxins of the Ricinus communis family.

Glycosyl-[60]fullerenes were first used as decontaminants against ricin, a lactose recognition proteotoxin in the Ricinus communis family. A fullerene glycoconjugate carrying two lactose units was synthesized by a [3 + 2] cycloaddition reaction between C60 and the azide group in 6-azidohexyl ß-lactoside per-O-acetate. A colloidal aqueous solution with brown color was prepared from deprotected bis(lactosyl)-C60 and was found stable for more than 6 months keeping its red color. Upon mixing with an aqueous solution of Ricinus communis agglutinin (RCA120), the colloidal solution soon caused precipitations, while becoming colorless and transparent. In contrast, a solution of concanavalin A (Con A) caused no apparent change, indicating that the precipitation was caused specifically by carbohydrate-protein interactions. This notable phenomenon was quantified by means of sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), and the results were discussed in terms of detection and decontamination of the deadly biological toxin in the Ricinus communis family.

Pig sperm membrane microdomains contain a highly glycosylated 15-25-kDa wheat germ agglutinin-binding protein.

A highly glycosylated protein, which has unique, novel features in localization, structure, and potential function, is found in pig sperm, and named WGA-gp due to its high binding property with wheat germ agglutinin (WGA). WGA-gp is localized mainly in flagella and enriched in membrane microdomains or lipid rafts. It is not detected by ordinary protein staining methods due to a high content of both N- and O-glycans consisting of neutral monosaccharides. Interestingly, WGA-gp may be involved in intracellular Ca(2+) regulation. Treatment of sperm with anti-WGA-gp antibody enhances the amplitude of Ca(2+) oscillation without changing the basal intracellular Ca(2+) concentrations. All these features of WGA-gp, except for different carbohydrate structures occupying most part of the molecules, are similar to those of flagellasialin in sea urchin sperm, which regulates the intracellular Ca(2+) concentration. Presence of carbohydrate-enriched flagellar proteins involved in intracellular Ca(2+) regulation may be a common feature among animal sperm.

Structural properties of metallic nanostructures prepared using organ-metal solutions.

In this study, metallic nanostructures were prepared on silicon substrates using organ-metal solutions by a heating process. The size and shape of the metallic nanostructures on the silicon substrates were investigated by two-dimensional and three-dimensional scanning electron microscopy (SEM). The results suggest that the size and shape of metallic nanostructures can be controlled by the heating temperature. In addition, the XRD and X-ray photoelectron spectroscopy (XPS) measurement results suggest that the crystallinity and atomic components of metallic nanostructures can also be controlled by the heating temperature, and the boundary of the change is nearly 800 degrees C. The results also suggest that the oxidation mechanism may get affected by the heating temperature.