Interleukin-10 correlates with oxidized low density lipoprotein in coronary culprit plaques

Inflammation and oxidation play crucial roles in plaque instability. We immunohistochemically assessed expression of the anti-inflammatory cytokine interleukin (IL)-10, and of oxidized low density lipoprotein (ox-LDL) in coronary atherectomy specimens from 19 and 18 patients with stable and unstable angina, respectively. Immunopositive areas for IL-10 and ox-LDL were significantly greater in the group with unstable angina (p < 0.05, each), and they positively correlated (r = 0.452, p < 0.005). These results suggest that IL-10 plays an anti-inflammatory role in atherosclerotic lesions and modulates the inflammatory process in unstable coronary plaque.

Conflict of interest

None     

Expression of sphingosine kinase 2 in synovial fibroblasts of rheumatoid arthritis contributing to apoptosis by a sphingosine analogue, FTY720

Gene expression profiles in synovial tissues from rheumatoid arthritis (RA) patients have yielded useful information on the pathogenetic process of the synovitis. In one group of them, sphingosine kinase 2 (SPHK2), a nuclear protein regulating cell proliferation, seemed to be highly expressed, undergoing a different pathogenetic process of synovitis. In the present study it was clarified that SPHK2 was expressed in the synovial fibroblasts of the synovial tissues obtained from the knee joints of the RA patients. In the cultured synovial fibroblasts from these patients, SPHK2 was more highly expressed than that in the human macrophage cell line, THP-1 and human dermal fibroblasts. SPHK2 was expressed in and around the nucleus and transferred to the cytoplasm and cell surface by the administration of epidermal growth factor, associated with the increased expression of sphingosine-1-phosphate. A sphingosine analogue, FTY720, which is activated by phosphorylation specifically by SPHK2, mediated apoptotic signaling of the cultured synovial fibroblasts. These findings suggest that SPHK2 may regulate the autonomous proliferation of synovial fibroblasts as one of the predisposing genes to RA and could be a target for a novel therapeutic strategy for RA.     

Surgical Strategy for Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombus Based on Prognostic Factors

Rationale  Surgical strategy for patients with hepatocellular carcinoma and portal vein tumor thrombus (PVTT) remains to be established. Methods  From 1990 to 2008, 48 hepatocellular carcinoma patients with PVTT detected by preoperative imaging underwent hepatic resection, and their clinical data were retrospectively analyzed. Possible prognostic factors for survival were analyzed with postoperative survival curves, and significant factors were determined by univariate and multivariate analysis. The frequency of postoperative severe complications was investigated for each prognostic factor. Results  Significant prognostic factors included patient age <60 years, serum total bilirubin (T-Bil) >0.8 mg/dl, serum aspartate aminotransferase >30 IU/L, serum alkaline phosphatase (ALP) >300 IU/L, tumor size >4 cm, PVTT in the main trunk (Vp4), and a surgical margin <1 mm by univariate analysis, and independent prognostic factors were serum T-Bil, ALP, and Vp4. No patient with Vp4 survived for more than 400 days after surgery, and frequency of postoperative severe complications in these Vp4 patients was significantly higher than in other Vp1–3 patients. Conclusion  Hepatic resection as a first-choice treatment should be carefully selected in patients with Vp4 unless emergent removal of the PVTT is required.     

Impact of Postoperative Infection on Long-Term Survival After Potentially Curative Resection for Gastric Cancer

We focused on the impact of postoperative infection on long-term survival after potentially curative resection for gastric cancer. Postoperative surgical and medical complications have been implicated as a negative predictor of long-term outcome in various malignancies. However, there have been no published reports assessing the impact of complications arising from postoperative infection on survival in gastric cancer. We studied a population of 1,332 patients who underwent curative resection for gastric cancer. These patients were divided into two groups based on the occurrence (141 patients, 10.6%) or absence (1,191 patients, 89.4%) of postoperative complications due to infection. We investigated the demographic and clinicopathological features of each patient with and without postoperative complications from infection, and thereby the impact of postoperative infection on long-term survival. Patients with postoperative infection had significantly higher frequency of males, upper side tumor location, and total gastrectomy as a surgical procedure, more advanced stage of gastric cancer, and greater age compared with those without postoperative infection. Patients with complications due to postoperative infection had significantly more unfavorable outcome compared with those patients without postoperative infection. Multivariate analysis demonstrated that age, preoperative comorbidity, blood transfusion, tumor depth, nodal involvement, and postoperative infection correlated with overall survival. We conclude that postoperative complications from infection are a predictor of adverse clinical outcome in patients with gastric cancer. However, further immunological study and prospective trials are necessary to confirm the biological significance of these findings.     

Use of a Matsui-Kitamura stent-graft for endovascular repair of patent ductus arteriosus in an adult patient

Open surgical repair of patent ductus arteriosus is difficult in the case of elderly patients because of calcification of the duct and the possibility of rupture. Furthermore, endovascular repair with the use of a coil or an occluding device poses problems such as residual shunt or migration of the device. We describe a case wherein closure of a large patent ductus arteriosus in an adult patient was achieved using a Matsui-Kitamura curved nitinol stent-graft.     

Type-I interferon receptor expression: Its circadian rhythm and downregulation after interferon-α administration in peripheral blood cells from renal cancer patients

Objectives:   To investigate the regulation of interferon-α (IFN-α) receptor expression in metastatic renal cell carcinoma (RCC) after IFN-α administration.
Methods:   Blood sampling was carried out in eight patients with metastatic RCC and six healthy volunteers. Flow-cytometric analysis using a monoclonal antibody against the active subunit of the type-I IFN-α receptor (IFNAR2) was carried out to examine the circadian rhythm of IFNAR2 expression in peripheral blood mononuclear cells (PBMC) as well as its downregulation after IFN-α administration.
Results:   According to its circadian rhythm IFNAR2 in PBMC had a peak expression at night. Once IFN-α is administered, IFNAR2 levels in PBMC showed downregulation within 48 h and recovered within another 48 h.
Conclusions:   Our findings might support the establishment of an optimal schedule for IFN-α administration.     

Carotid duplex ultrasonography during head-up tilt in patients with orthostatic hypotension

Orthostatic hypotension (OH) is defined by evaluating postural blood pressure (BP) change, but the correlation between postural BP decreases and OH-associated symptoms is poor. We examined carotid duplex ultrasonography during HUT in 27 patients with various neurological disorders. Nine patients were diagnosed to have OH, and 4 of them had symptoms associated with OH. Decreased end-diastolic velocity of common carotid artery in symptomatic OH patients (-24.5 +/- 4.2 cm/s) was significantly larger than that in asymptomatic OH patients (-11.0 +/- 8.0 cm/s; p = 0.0143), despite no significant differences in values and changes of BP between them. This may be useful for predicting the development of OH symptoms.     

Quantification of nicotinic acetylcholine receptors in Parkinson's disease with (123)I-5IA SPECT

We quantified in vivo brain nicotinic acetylcholine receptor (nAChR) distributions in patients with Parkinson's disease (PD) and evaluated correlations between nAChR distributions and clinical variables of the patients, especially dopaminergic medications. Ten patients with PD without dementia underwent 5-(123)I-iodo-3-(2(S)-azetidinylmethoxy)pyridine ((123)I-5IA) single photon emission computed tomography (SPECT) and the data were compared with those of 10 age-matched healthy volunteers. Correlation analyses between (123)I-5IA distribution volumes (DVs) in each brain region and clinical variables of the patients were also performed. The PD group showed a statistically significant decrease (20-25%) in the brainstem and frontal cortex as compared with the control group. Although age, duration of disease, daily dose of levodopa, duration of PD medication use, and scores on the motor section of Unified Parkinson's Disease Rating Scale were not significantly correlated with DV values in any brain regions, high daily doses of dopamine agonist showed a significant negative correlation with DVs in the cerebellum, and temporal, parietal and occipital cortices. These findings suggest that patients with PD without dementia can show reductions especially in the brainstem and frontal cortex. They also suggest that dopamine agonists can have a negative influence on the distribution of nAChRs.