Since periodontal infections are suggested as risk factors for the development of cardiovascular diseases, the present study was performed to evaluate the T cell immune responses specific to Porphylomonas gingivalis(P. gingivalis) heat shock protein(hsp) 60 and T-cell and B-cell epitope specificities for P. gingivalis hsp60 in atherosclerosis. Anti-P. gingivalis IgG antibody titers were elevated in all patients. We could establish P. gingivalis hsp-specific T cell lines from the atheroma lesions, a mixture of CD4+ and CD8+ cells producing the cytokines characteristic of both Th1 and Th2 subsets. of 108 overlapping synthetic peptides spanning whole P. gingivalis hsp60 molecule, ten peptides with common epitopes specificities for both T-cell and B-cell were identified. it was concluded that P. gingivalis hsp60 might be involved in the immunoregulatory process of atherosclerotic diseases with epitope specificities.
Atherosclerosis* ; B-Lymphocytes* ; Cardiovascular Diseases ; Cell Line ; Cytokines ; Epitopes ; Epitopes, B-Lymphocyte ; Heat-Shock Proteins* ; Hot Temperature* ; Humans* ; Immunoglobulin G ; Peptides ; Plaque, Atherosclerotic ; Porphyromonas gingivalis* ; Porphyromonas* ; Risk Factors ; Sensitivity and Specificity* ; Shock ; T-Lymphocytes*

Leptin is one of the adipocytokines produced from adipose tissue but its functions in periodontal tissue have not previously been investigated. In our current study, we examined the effects of leptin on the expression of interleukin (IL)-6 and IL-8 in periodontal ligament (PDL) cells and gingival fibroblasts. Leptin receptor expression was evaluated by RT-PCR and the production of cytokines was measured by ELISA. The phosphorylation of Akt and Erk1/2 was assessed by western blotting. mRNA of long and short form leptin receptors were detected in both PDL cells and gingival fibroblasts. Leptin was found to increase the production of IL-6 and IL-8 in both of these cell types, an effect which was not blocked by polymyxin B, an inhibitor of lipopolysaccharide (LPS). Leptin did not alter the production of IL-6 and IL-8 induced by LPS in PDL cells but increased Akt and Erk1/2 phosphorylation in these cells. These results suggest that leptin acts as an inducer of IL-6 and IL-8 in PDL cells and gingival fibroblasts.
Adipokines ; Adipose Tissue ; Blotting, Western ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts ; Interleukin-6 ; Interleukin-8 ; Interleukins ; Leptin ; Periodontal Ligament ; Phosphorylation ; Polymyxin B ; Receptors, Leptin ; RNA, Messenger

PURPOSE: Globular adiponectin (gAd) is a type of adipocytokine, which is mainly produced by adipose tissue. It has been reported that gAd acts as a pro- as well as an anti-inflammatory factor. Interleukin (IL)-6 and IL-8 are pro-inflammatory cytokines. To investigate the role of gAd on periodontal tissues, the expression of adiponectin receptor 1 (AdipoR1) and the effect of gAd on the expression of IL-6 and IL-8 were investigated in periodontal ligament (PDL) and gingival fibroblasts. METHODS: PDL and gingival fibroblasts were cultured from human periodontal tissues. gAd derived from Escherichia coli and murine myeloma cells were used. The expression of AdipoR1 was estimated by reverse transcription-polymerase chain reaction and western blot. The expression of cytokines was measured by enzyme-linked immunosorbent assay. RESULTS: PDL and gingival fibroblasts expressed both mRNA and protein of AdipoR1. gAd derived from E. coli increased the production of IL-6 and IL-8, but polymyxin B, an inhibitor of lipopolysaccharide (LPS), inhibited IL-6 and IL-8 production induced by gAd in both types of cells. gAd derived from murine myeloma cells did not induce IL-6 and IL-8 production in those cells. gAd derived from E. coli contained higher levels of LPS than gAd derived from murine myeloma cells. LPS increased production of IL-6 and IL-8 in PDL and gingival fibroblasts, but pretreatment of cells with gAd derived from murine myeloma cells did not inhibit LPS-induced IL-6 and IL-8 expression. CONCLUSIONS: Our results suggest that PDL and gingival fibroblasts express AdipoR1 and that gAd does not act as a modulator of IL-6 and IL-8 expression in PDL and gingival fibroblasts.
Adiponectin ; Adipose Tissue ; Blotting, Western ; Cytokines ; Escherichia coli ; Fibroblasts ; Humans ; Interleukin-6 ; Interleukin-8 ; Interleukins ; Periodontal Ligament ; Polymyxin B ; Receptors, Adiponectin ; RNA, Messenger

Cryoglobulinemia is the presence of globulins in the serum that precipitate on exposure to cold temperatures (cryoglobulins). Pulmonary complications of cryoglobulinemia include interstial infiltration, impaired gas exchange, small airway disease and pleurisy. Only one other acute respiratory distress syndrome(ARDS) case has been described in patients with cryoglobulinemia. A 55-years old man was admitted with dyspnea. He had been diagnosed as being a hepatitis B virus antigen carrier 15 years age. On the first admission, chest radiography showed a bilateral pleural effusion and a patchy infiltration on both lungs. On protein-and immuno-electrophoresis, cryoglobulinemia was confirmed. The patient was treated with corticosteroid and plasmapheresis. Forty-five days after the diagnosis, the patient complained of progressive dyspnea and showed a diffuse bilateral pulmonary infiltration on chest radiography. Despite intensive care with mechanical ventilation, the patient died as consequence of hypoxemia and multiple systemic organ failure. On a pathologic examination of the postmortem lung biopsy, multiple necrotizing vasculitis and increased infiltration of the lymphocytes and monocytes were observed. In conclusion, ARDS developed as a result of pulmonary hemorrhage due to cryoglobulinemia-associated vasculitis.
Anoxia ; Biopsy ; Cold Temperature ; Cryoglobulinemia ; Diagnosis ; Dyspnea ; Globulins ; Hemorrhage ; Hepatitis B virus ; Humans ; Critical Care ; Lung ; Lymphocytes ; Monocytes ; Plasmapheresis ; Pleural Effusion ; Pleurisy ; Radiography ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult* ; Thorax ; Vasculitis

A 38-year-old woman presented with facial edema with neck vein engorgement for about 45 days. Chest roentgenography showed bulging soft tissue opacities in the right superoanterior mediastinum and a lobulated intraluminal mass was noted in the superior vena cava on the venacavogram. The superior vena cava was incised and the tumor located from the junction of the superior vena cava and internal jugular vein to the right atrial inlet was excised. Grossly, the tumor was myxoid or gelatinous in appearance. A combination of microscopic and immunohistochemical features showed myxoid leiomyosarcoma arising from the wall of the superior vena cava.
Adult ; Bays ; Edema ; Female ; Gelatin ; Humans ; Jugular Veins ; Leiomyosarcoma* ; Mediastinum ; Neck ; Radiography ; Superior Vena Cava Syndrome* ; Thorax ; Veins ; Vena Cava, Superior*

Break of a stent delivery catheter and subsequent stent loss (SL) has been a rare event in the drug-eluting stent (DES) era. We here report a case of successful retrieval of a stent after a break if the delivery catheter and SL from a balloon catheter at a culprit lesion. We finally resolved this situation using a simple balloon technique for both the broken stent catheter inside of the guide catheter and the unexpanded stent in the culprit lesion. Thus balloons are an important weapon in our armamentarium in the cardiac catheterization laboratory for urgent retrieval of a lost stent. Their apt use definitely allowed our patient to avoid undergoing emergency cardiovascular thoracic surgery.
Angioplasty ; Cardiac Catheterization ; Cardiac Catheters ; Catheters ; Dimaprit ; Drug-Eluting Stents ; Emergencies ; Humans ; Stents ; Thoracic Surgery

BACKGROUND/AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is an operator-dependent procedure and has significant procedure-related morbidity and mortality. Magnetic resonance cholangiopancreatography (MRCP) is a safe noninvasive method for pancreatobiliary imaging. The aims of this study were to evaluate the potential impact of MRCP on performing ERCP and to evaluate the decision-making value of MRCP in patients suspicious for pancreatobiliary diseases. METHODS: Two hundreds twelve patients (M:F 108:104, mean age 59.3+/-13.7) who underwent MRCP due to clinical or sonographic suggesting pancreatobiliary disease were included. We divided patients into four groups according to their presumptive diagnosis: biliary stone (group 1), biliary tumor (group 2), gallstone pancreatitis (group 3) and other biliary diseases (group 4). RESULTS: Numbers of cases in group 1, 2, 3 and 4 were 145, 43, 17 and 7, respectively. In 144 cases (67.9%), ERCP was unnecessary and 76 cases (35.8%) required neither ERCP nor any other treatment. Thereafter, these cases were thought to be a patient group in whom the workload of performing ERCP could be reduced. CONCLUSIONS: MRCP can reduce the number and efforts doing ERCP and is helpful in decision-making for the treatment of pancreatobiliary disease. Therefore, MRCP could be the primary diagnostic tool before choosing ERCP.
Aged ; Biliary Tract Diseases/*diagnosis ; Cholangiopancreatography, Endoscopic Retrograde ; *Cholangiopancreatography, Magnetic Resonance ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Diseases/*diagnosis

Background/Aims: Cardiorespiratory fitness (CRF), as measured by maximal oxygen consumption (VO2max), is an important independent predictive factor of cardiovascular outcomes in patients with heart failure (HF). However, it is unclear whether conventional equations for estimating CRF are applicable to patients with HF with preserved ejection fraction (HFpEF). Methods: This study included 521 patients with HFpEF (EF ≥ 50%) whose CRF was directly measured by cardiopulmonary exercise test using a treadmill. We developed a new equation (Kor-HFpEF) for half of the patients in the HFpEF cohort (group A, n = 253) and validated it for the remaining half (group B, n = 268). The accuracy of the Kor-HFpEF equation was compared to that of the other equations in the validation group. Results: In the total HFpEF cohort, the directly measured VO2max was significantly overestimated by the FRIEND and ACSM equations (p < 0.001) and underestimated by the FRIEND-HF equation (p <0.001) (direct 21.2 ± 5.9 mL/kg/min; FRIEND 29.1 ± 11.8 mL/kg/min; ACSM 32.5 ± 13.4 mL/kg/min; FRIEND-HF 14.1 ± 4.9 mL/kg/min). However, the VO2max estimated by the Kor-HFpEF equation (21.3 ± 4.6 mL/kg/min) was similar to the directly measured VO2max (21.7 ± 5.9 mL/kg/min, p = 0.124), whereas the VO2max estimated by the other three equations was still significantly different from the directly measured VO2max in group B (all p < 0.001). Conclusions Traditional equations used to estimate VO2max were not applicable to patients with HFpEF. We developed and validated a new Kor-HFpEF equation for these patients, which had a high accuracy.