Membranoproliferative glomerulonephritis

Membranoproliferative glomerulonephritis is an uncommon kidney disorder characterized by mesangial cell proliferation and structural changes in glomerular capillary walls. It can be subdivided into idiopathic and secondary forms, which are differentially diagnosed by a review of clinical features, laboratory data, and renal histopathology. Three types—I, II, and III—have been defined by pathologic features. All three types are associated with hypocomplementemia, but they manifest somewhat different mechanisms of complement activation. Type II, also known as “dense deposit disease”, is associated with the presence of C3-nephritic factor. Membranoproliferative glomerulonephritis primarily affects children and young adults, with patients presenting with nephrotic or nephritic syndrome or with asymptomatic renal disease. This type of glomerulonephritis often progresses slowly to end-stage renal disease, and it tends to recur after renal transplantation, especially type II. The efficacy of various forms of treatment remains controversial; however, long-term steroid treatment seems to be effective in children with nephrotic-range proteinuria. Improvement in renal outcomes largely relies on the evaluation of more selective agents in carefully controlled studies.     

Outcome of unicompartmental knee arthroplasty in patients receiving worker's compensation

Nineteen patients with a worker's compensation board (WCB) claim treated by unicompartmental knee arthroplasty for medial compartment osteoarthritis were compared to 20 patients who had no WCB claim. In WCB patients, the mean Knee Society Score (KSS) improved from 47.4 to 76.9; the mean Knee Society function score, from 43.8 to 75; and the mean Knee society pain score, from 6.9 to 29.4. In non-WCB patients, the mean KSS improved from 43.3 to 90.7; the mean Knee Society function score, from 44.7 to 90; and the mean Knee Society pain score, from 3.6 to 41.7. The difference in improvement of KSS between the two groups was significant (P = .008). The postoperative KSS in the non-WCB patients was significantly higher than that of the WCB group (P = .007). There was no difference between the incidences of conversion to total knee arthroplasty.     

Is cystic fibrosis-related diabetes an apoptotic consequence of ER stress in pancreatic cells?

Cystic fibrosis-related diabetes (CFRD) has emerged in the last thirty years as a critical complication of cystic fibrosis (CF) and is present in about 15% of CF patients with increasing prevalence with age approaching 50 for over 30 year olds. The mechanism of diabetes development in this group of patients is not very well defined but it seems to involve pancreatic insufficiency and loss of beta-cells in the pancreas. I propose that loss of beta-cell mass and thus the development of diabetes in CF patients is likely due to an apoptotic mechanism in pancreatic beta-cells resulting from chronic endoplasmic reticulum stress due to the presence of malfolded CFTR in islet cells. The proposed mechanism is supported by several pieces of evidence including: (1) the absolute essentiality of an intact unfolded protein response (UPR) machinery for survival of pancreatic beta-cells, (2) the high susceptibility of beta-cells to prolonged ER stress leading to induction of pro-apoptotic factors and apoptosis pathways in beta-cells, (3) CF patients with mutations in CFTR gene that are engaging the ER quality control system (ERAD) and hence UPR signalling are twenty time more likely to develop diabetes than those with other types of CF-causing mutations, and (4) the high levels of CFTR gene expression in pancreatic islet cells. Establishing the exact mechanism underlying the development of diabetes in CF patients is likely to have positive implications for the treatment and the development of prevention strategies of this condition. Furthermore, this paper offers a testable hypothesis to enhance our understanding of the mechanism of CFRD.     

Health related quality of life measures by demographics and common health risks, Jordan 2004

Objective:  

To measure health-related quality of life (HRQOL) in Jordan     

Oxazolone-induced delayed type hypersensitivity reaction in the adult yucatan pigs. A useful model for drug development and validation

The purpose of this study was to establish a model of delayed type hypersensitivity (DTH) reaction in the ear skin of large animals such as adult Yucatan pigs, which may aid in evaluating the efficacy of therapeutic modalities of newly developed anti-inflammatory drugs. The pigs were sensitized with oxazolone, re-challenged with the same irritant six days later, and dosed with either vehicle or with cyclosporine A (CsA) before and after challenge. CsA reduced the redness, inhibited the accumulation of ear fluid and inflammatory cells, as well as the release of the inflammatory mediators. Further, CsA inhibited the proliferation of T cells collected from the spleens or PBMCs of CsA-treated pigs when these cells were stimulated in vitro with PMA plus Ionomycin. These results indicate that pig skin can be used to evaluate modalities for the purpose of developing drugs that may be used to treat DTH in humans.     

Cardiac Arrest Following Adjustment of a Gastric Band

Laparoscopic adjustable gastric banding is an established and popular technique for achieving weight loss in the morbidly obese. It is however not without risks of morbidity and even mortality. The authors present a case report of a 46-year-old female who had a cardiac arrest after adjustment of a gastric band. The pathomechanisms to explain this event are explored and a review of the available literature is undertaken.