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Objective: To determine whether the serum level of Krebs von den Lungen-6 (KL-6), a circulating high-molecular weight glycoprotein and a diagnostic biomarker of interstitial lung diseases, is a clinically useful biomarker for detecting chronic aspiration in children with severe motor and intellectual disabilities (SMIDS).Study Design: Children with SMIDS undergoing videofluorography for assessment of dysphagia were prospectively evaluated. Based on the videofluorography results, the participants were classified into aspiration and non-aspiration groups. Age, sex, white blood cell count, and serum levels of C-reactive protein, lactate dehydrogenase, albumin, and KL-6 were compared between the 2 groups. Binary logistic regression was performed to identify factors independently associated with the presence of aspiration.Results: A total of 66 patients participated in this study, 37 who were classified as the aspiration group and 29 as the non-aspiration group. The serum KL-6 level in the aspiration group was significantly higher than that in the non-aspiration group (median, 344 U/mL vs 207 U/mL, P < .01). Logistic regression modeling showed that the number of prescribed antiepileptic drugs (OR, 1.978; 95% CI, 1.217, 3.214; P < .01) and serum KL-6 level (OR, 1.012; 95% CI, 1.005, 1.019; P < .01) were independent predictors of aspiration.Conclusions: The study demonstrated that the KL-6 level is significantly higher in children with SMIDS who aspirate than in those who do not. KL-6 shows promise as a biomarker for chronic lung disease due to aspiration in these children. [ABSTRACT FROM AUTHOR]

Abstract: Reaction of 1,4,7,10-tetraazacyclododecane (cyclen) and Cu(ClO4)2·6H2O with nucleobases (adenine, hypoxanthine, xanthine, theophylline, cytosine, or uracil) under alkaline conditions gave four ternary cyclen–metal–nucleobase complexes, [Cu(cyclen)(adeninato)]·ClO4·2H2O (1), [{Cu(cyclen)}2(hypoxanthinato)]·(ClO4)3 (2), [Cu(cyclen)(theophyllinato)]3·(ClO4)3·2H2O (3), and [Cu(cyclen)(xanthinato)]·(0.7ClO4)·(0.3ClO4)·3H2O·(0.5H2O)3 (4), whose crystal structures were determined by X-ray diffraction. In the adenine complex 1, a cyclen-capped square–pyramidal Cu2+ ion binds to an adeninato ligand through N(9) with the formation of an intramolecular interligand hydrogen bond between the secondary amino nitrogen of cyclen and N(3) of the base. In the hypoxanthine complex 2, two cyclen-capped Cu2+ ions bind to a hypoxanthinato ligand, one through N(7) with the formation of an intramolecular N(cyclen)–H···O(6) hydrogen bond and the other through N(9) to form an intramolecular N(cyclen)–H···N(3) hydrogen bond. Similarly, in both the theophylline complex 3 and the xanthine complex 4, each cyclen-capped Cu2+ ion binds to a theophyllinato or xanthinato ligand through N(7) with the formation of an intramolecular N(cyclen)–H···O(6) hydrogen bond. However, unlike in 2, steric constraints between amino group(s) of cyclen and the methyl group at N(3) of theophylline in 3 or the proton attached to N(9) of xanthine in 4 preclude the metal bonding to N(9) in 3 or N(3) in 4. The significance of intramolecular interligand interaction as a factor that affects metal-binding site(s) on nucleobases is emphasized. [Copyright &y& Elsevier]

Abstract: Purpose: This study was designed to quantify the heterogeneity of cerebral perfusion on SPECT images in elderly controls and Alzheimer''s disease (AD) patients in mild stage using a three-dimensional fractal analysis (3D-FA). Material and method: Seventy-five patients with possible and probable AD based on the NINCDS/ADRDA criteria, and thirty-one elderly controls underwent 99mTc-HMPAO SPECT scanning. Dementia severity was assessed using the clinical dementia rating (CDR). Patients with CDR scores of 0.5 (n =33) were classified as “very early” and those with CDR 1 (n =42) as “early”. We delineated the SPECT images using 2 cutoffs (35% and 50% cutoffs of the maximal voxel radioactivity) and measured the number of voxels in the areas included by the contours obtained with each cutoff level. The fractal dimension (FD) was calculated by relating the logarithms of cutoff level and the number of voxels. Posterior limbic images were reconstructed at 30° positive to the coronal plane, and posterior limbic FD was calculated. Result: Posterior limbic FD for early AD, very early AD, and control groups were 1.03±0.16, 1.02±0.17, and 0.87±0.14 (P =0.001 versus early AD group, P =0.001 versus very early AD). Use of the posterior limbic FD and the ratio of posterior limbic FD to total FD separated very early AD patients from controls with a sensitivity of 76% and a specificity of 81%. Conclusion: 3D-FA indicated significant differences in the heterogeneity of CBF distribution between patients with AD in mild stage and elderly controls. Posterior limbic FD may be useful for easily and objectively distinguishing patients with very early AD from aging people. [Copyright &y& Elsevier]