Plasma adiponectin as a predictive factor of survival after a bypass operation for peripheral arterial disease

ObjectiveWe investigated an association between adiponectin and long-term survival in patients requiring an arterial bypass operation for peripheral arterial disease.MethodsAn enzyme-linked immunosorbent assay kit was used to measure plasma adiponectin levels in 49 patients (38 men, 11 women) before they underwent an arterial bypass operation. Median patient age was 70 years (range, 49-90 years). The study excluded patients with hemodialysis requirement, heart failure, malignant neoplasm, or collagen disease. The symptoms at the first visit were severe intermittent claudication in 27 patients (55%) and critical limb ischemia with rest pain or ulcer, or both, in 22 (45%).ResultsPlasma adiponectin levels were a mean 7.8 ± 5.3 μg/mL (range, 1.0-25.2 μg/mL). Multiple regression analyses revealed that plasma adiponectin was positively correlated with age (r = 0.49, P = .0003) and negatively correlated with body mass index (r = −0.51, P = .0002) and systolic blood pressure (r = −0.41, P = .0059). The Cox proportional hazards model revealed that plasma adiponectin (hazard ratio, 1.30; P = .03) and critical limb ischemia (hazard ratio, 16.67; P = .047) were significant independent predictors of patient survival after a bypass operation.ConclusionPlasma adiponectin could be indicative of mortality after a bypass operation for patients with advanced peripheral arterial disease

Interactions between CKD and MetS and the Development of CVD

Metabolic syndrome (MetS) consists of a combination of metabolic disorders, including increased abdominal circumference, hyperglycemia, elevated blood pressure, and lipid disorders. MetS is now widely accepted as a crucial risk factor for the development of cardiovascular disease (CVD) and mortality. In addition, persistent proteinuria indicating chronic kidney disease (CKD) is well known as a powerful risk factor for the progression of end-stage renal disease and CVD. In recent years, patients with CKD and MetS appear to be increasing along with increasing incidence of CVD in industrial countries

Up-regulation of activation-induced cytidine deaminase and its strong expression in extra- germinal centres in IgG4-related disease

Immunoglobulin (Ig) G4-related disease (IgG4-RD) is a systemic disorder involving benign mass formation due to fibrosis and intense lymphoplasmacytosis; the chronic inflammation associated with the disease might also contribute to oncogenesis. Activation-induced cytidine deaminase (AID), normally expressed in germinal centre activated B-cells, is an enzyme that edits DNA/RNA and induces somatic hypermutation and Ig class switching. AID expression is strictly controlled under physiological conditions; however, chronic inflammation and some infectious agents induce its up-regulation. AID is overexpressed in various cancers and may be important in chronic inflammation-associated oncogenesis. We examined AID expression in IgG4-related sialadenitis (n = 14), sialolithiasis (nonspecific inflammation, n = 13), and normal submandibular glands (n = 13) using immunohistochemistry and quantitative real-time polymerase chain reaction (qPCR). Immunohistochemistry revealed significantly more AID-expressing cells in IgG4-related sialadenitis than in sialolithiasis or normal submandibular gland samples (P = 0.02 and P < 0.01, respectively); qPCR yielded similar results. Thus, AID was significantly more up-regulated and had higher expression in extra-germinal centres in IgG4-RD than in non-specific inflammation or normal conditions. This report suggests that IgG4-RD has several specific causes of AID up-regulation in addition to inflammation. Furthermore, chronic inflammation-associated AID-mediated oncogenesis is possible in IgG4-RD

Upregulated Expression of Activation-Induced Cytidine Deaminase in Ocular Adnexal Marginal Zone Lymphoma with IgG4-Positive Cells

Immunoglobulin G4-related disease (IgG4-RD) is a systemic disorder characterized by tissue fibrosis and intense lymphoplasmacytic infiltration, causing progressive organ dysfunction. Activation-induced cytidine deaminase (AID), a deaminase normally expressed in activated B-cells in germinal centers, edits ribonucleotides to induce somatic hypermutation and class switching of immunoglobulin. While AID expression is strictly controlled under physiological conditions, chronic inflammation has been noted to induce its upregulation to propel oncogenesis. We examined AID expression in IgG4-related ophthalmic disease (IgG4-ROD; n = 16), marginal zone lymphoma with IgG4-positive cells (IgG4+ MZL; n = 11), and marginal zone lymphoma without IgG4-positive cells (IgG4- MZL; n = 12) of ocular adnexa using immunohistochemical staining. Immunohistochemistry revealed significantly higher AID-intensity index in IgG4-ROD and IgG4+ MZL than IgG4- MZL (p < 0.001 and = 0.001, respectively). The present results suggest that IgG4-RD has several specific causes of AID up-regulation in addition to inflammation, and AID may be a driver of oncogenesis in IgG4-ROD to IgG4+ MZL

Gastric Ulcer Associated with Cytomegalovirus in an Immunocompetent Patient: Method for Diagnosis

Cytomegalovirus (CMV)-associated gastric ulcers can be found not only in immunocompromised hosts but also in normal individuals. The accurate endoscopic diagnosis of CMV ulcers is not easy because of the absence of characteristic morphological features. We present a case of CMV-associated gastric ulcer in an immunocompetent patient. He was a 33-year-old male with epigastralgia. Upper gastrointestinal endoscopy showed multiple erupted papules and a large irregularly shaped shallow ulcer. We did not find intracellular inclusion bodies characteristic of CMV in hematoxylin-eosin-stained gastric biopsy specimens, while CMV antigens corresponding to intracellular inclusion bodies were confirmed using an immunoperoxidase method with the monoclonal CMV antibody. If CMV ulcers are suspected, it is important to examine for inclusion bodies using not only hematoxylin-eosin staining, but also CMV immunohistochemistry for a sensitive diagnosis

Therapeutic angiogenesis by transplantation of induced pluripotent stem cell-derived Flk-1 positive cells

<p>Abstract</p> <p>Background</p> <p>Induced pluripotent stem (iPS) cells are the novel stem cell population induced from somatic cells. It is anticipated that iPS will be used in the expanding field of regenerative medicine. Here, we investigated whether implantation of fetal liver kinase-1 positive (Flk-1⁺) cells derived from iPS cells could improve angiogenesis in a mouse hind limb model of ischemia.</p> <p>Results</p> <p>Flk-1⁺cells were induced from iPS cells after four to five days of culture. Hind limb ischemia was surgically induced and sorted Flk-1⁺cells were directly injected into ischemic hind limbs of athymic nude mice. Revascularization of the ischemic hind limb was accelerated in mice that were transplanted with Flk-1⁺cells compared with control mice, which were transplanted with vehicle, as evaluated by laser Doppler blood flowmetry. Transplantation of Flk-1⁺cells also increased expression of VEGF mRNA in ischemic tissue compared to controls.</p> <p>Conclusions</p> <p>Direct local implantation of iPS cell-derived Flk-1⁺cells would salvage tissues from ischemia. These data indicate that iPS cells could be valuable in the therapeutic induction of angiogenesis.</p

Penggunaan Tenaga Kerja Asing Oleh Perseroan Terbatas Penanam Modal Asing Yang Berinvestasi Di Indonesia

A number of foreign workers who are currently working in Indonesia is not in accordance with the legislation that exists. The foreign workers doing menial jobs and do not have immigration documents are complete. They are working on a number of foreign investors in a number of business sectors, especially in construction and infrastructure. The type of research that is done is the normative legal research i.e. Research which focuses on positive form of legal norms and regulations. Types of data used include primary law, secondary legal materials and legal materials tertiary. The use of foreign labor by a limited liability foreign investors who invest in Indonesia must comply with the legislation that exists. The foreign workers are only allowed to occupy positions as commissioners, directors, and experts who are accompanied by a complete immigration administrative documents

Transformed diffuse large B-cell lymphoma from marginal zone lymphoma in the anterior mediastinum: A case report and review of the literature

Marginal zone lymphoma (MZL) arising from the anterior mediastinum is rare. In the majority of reported cases, the tumor was incidentally discovered, reflecting its indolent clinical features. We present a 38-year-old woman who had no medical history, and presented with a bulky anterior mediastinal tumor complicated by life-threatening compression of the vasculature and bronchi. Biopsy specimens of the neoplasm suggested transformed diffuse large B-cell lymphoma (DLBCL) from MZL. To our best knowledge, this is the first case report of anterior mediastinum MZL associated with an aggressive clinical course and life-threatening complications likely due to transformation to DLBCL