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Amyotrophic lateral sclerosis (ALS) is a progressive debilitating neurodegenerative disease with a life expectancy of 3-5 years from initial symptoms. We report a case of ALS who received autologous adipose-derived mesenchymal stem cells (ADSC) and was followed up for 7 years.

A 46-year-old man noticed weakness of his legs, difficulties on going down the stairs and coughing during eating in 2009. After complete workout, a diagnosis of ALS was confirmed. His ALS Functional Rating Scale-R (ALSFS-R) was 43. Symptoms rapidly progressed and he coughed and choked during eating. Starting in 2013, the patient received a total of six intravenous infusions of autologous ADSC. Changes in electromyogram, nerve conduction, and ALSFS-R were assessed.

Soon after the administration, he noticed that he did not cough during conversation or eating food. Although he had difficulty in walking down the stairs, he remained well without coughing, dysarthria, or dysphagia. His ALSFS-R increased up to 45. Fascicular potentials were not detected in any muscles examined including trapezius muscle and rectus femoris muscles. The patient was well for 7 years after ADSC therapy by the time of this report and more than 10 years from the time of onset.

The present case suggests that autologous ADSC can be administered safely and may be potentially useful in patients with ALS. Further investigations are warranted in order for the results to be generalized to other ALS patients.

The present case suggests that autologous ADSC can be administered safely and may be potentially useful in patients with ALS. Further investigations are warranted in order for the results to be generalized to other ALS patients.

Coronary computed tomography angiography (CCTA) is becoming increasingly useful for the diagnosis of coronary artery disease (CAD). Coronary calcium score (CCS), epicardial fat volume (EFV), and number of coronary plaques (NoP) add important information for the risk stratification and prognosis prediction of these patients. However, evidence about their ability to predict obstructive CAD is limited. We sought to evaluate the ability of CCTA parameters in predicting obstructive CAD.

We conducted a cross-sectional, single-center study on patients at risk to develop CAD. CAD was defined as coronary stenosis > 50% after the other one (CCS, EFV and NoP were determined by CCTA). CCS was then ranked 5 severity groups 0, 1-99, 100-399,400-999, and ≥1000. NoPs were classified in four categories no plaques, 1-5, 6-10 and ≥10. Logistic regression analyses were performed, and statistical analysis was considered significant if p<0.05.

Of all 540 patients (55.8±11.1 years) who met the enrolment criteria, 98 hadveloping a novel scoring system.

Takotsubo syndrome, also known as stress cardiomyopathy, is predominantly reported in postmenopausal women and it is often triggered by a physical or emotional stressor.

We present the case of a 44-year-old Caucasian woman admitted to the emergency department after voluntary intake of 20 tablets of flecainide 150 mg to commit suicide. During the in-hospital stay in the Cardiac Intensive Care Unit, the patient developed Takotsubo syndrome.

The relative role of flecainide as a possible trigger of the syndrome is discussed in the context of the current literature evidence.

The relative role of flecainide as a possible trigger of the syndrome is discussed in the context of the current literature evidence.

Atherosclerosis is one of the leading causes of disability and mortality worldwide. Inflammation, including monocytes, T and B cells, plays a key role in its pathogenesis. Our purpose was to evaluate plasma cells’ presence in a large series of carotid artery plaques and the clinical association.

Forty-eight consecutive patients treated with carotid endarterectomy were retrospectively analyzed to assess plasma cells’ presence inside the plaque. A semiquantitative grading score was applied, ranging from absence, scattered, clusters of 5-10, and sheets of >10 plasma cells. Plasma cell’s location, as intraplaque, subendothelial or peri-adventitial, was also defined.

In 75% of plaques analyzed, plasma cells were detected scattered in 63.9%, in clusters in 22.2%, and in sheets in 13.9% of cases. In all cases, plasma cells were observed only inside the plaque. In 13.9% and in 11.1% of cases, plasma cells showed, respectively, a concomitant subendothelial or peri-adventitial distribution. In 5.6% of plaques, there was a simultaneous distribution in subendothelial, peri-adventitial layer, and intraplaque. Association between the presence of symptoms and plasma cells infiltrate was found.

Our results suggest that plasma cells could be a key parameter linked to plaque instability. Some types of configurations are significantly associated with the occurrence of cerebrovascular symptoms.

Our results suggest that plasma cells could be a key parameter linked to plaque instability. Some types of configurations are significantly associated with the occurrence of cerebrovascular symptoms.

Buerger’s disease is a rare disease that causes critical limb ischemia; however, the underlying pathophysiological mechanism remains unclear. Therefore, we investigated the interaction between interleukin (IL)-17 and high-mobility group protein B 1 (HMGB1) and determined whether A disintegrin and metalloproteinase 10 (ADAM10) inhibit this interaction.

The study population included 15 patients with Buerger’s disease and 10 healthy donors without a history of giving peripheral blood samples. Cytokine levels were measured using a luminex multiplex assay in plasma. Flow cytometry was used to analyze the subtypes of helper T (Th) cells among peripheral blood mononuclear cells (PBMCs). The effect of ADAM10 on PBMCs was analyzed in vitro.

The levels of inflammatory cytokines and production of pathogenic Th cells were found to be higher in Korean patients with Buerger’s disease. IL-17 treatment induced HMGB1 associated molecules. HMGB1 also induced IL-17 and Th17 associated transcription factors in Buerger’s patients. We observed that ADAM10 regulates the interaction between IL-17 and HMGB1 via advanced glycation end products (RAGE)/nuclear factor-kappa B (NF-kB) pathway in patients with Buerger’s disease.

This study suggests that IL-17 and HMGB1 cytokines contribute to the pathogenesis of Buerger’s disease. These results indicate that ADAM10 alleviates inflammation in Buerger’s disease via the HMGB1 and RAGE/NF-κB signaling pathway and provides insights into the molecular basis of and a potential therapeutic strategy for Buerger’s disease.

This study suggests that IL-17 and HMGB1 cytokines contribute to the pathogenesis of Buerger’s disease. These results indicate that ADAM10 alleviates inflammation in Buerger’s disease via the HMGB1 and RAGE/NF-κB signaling pathway and provides insights into the molecular basis of and a potential therapeutic strategy for Buerger’s disease.

The DECAF (Dyspnea, Eosinopenia, Consolidation, Acidemia, Atrial Fibrillation) score is a widely used system for predicting the survival of patients with acute aggravation of chronic obstructive pulmonary disease (COPD). Evaluations of the predictive accuracy of DECAF have shown differing results. We performed this meta-analysis to evaluate the DECAF score as a survival predictor in patients with COPD.

We have included the studies examining the accuracy of DECAF scoring system as index test with occurrence of events (mortality and need for invasive/non-invasive ventilation) as reference standards irrespective of the study design employed, type of participants and severity of the condition. We conducted a systematic search for all studies reporting the predictive accuracy of DECAF scores in the databases of PubMed Central, Scopus, Medline, Embase, and Cochrane from inception until September 2020. We have used the quality assessment of diagnostic accuracy studies-2 (QUADAS-2) tool to evaluate the risk of biAF score for in-hospital mortality among patients with AECOPD. Most studies included were of high quality according to the QUADAS-2 tool. Despite these strengths, our review had some limitations. We found a significant between-study variability in our analysis that can limit its value for inferring or interpreting the pooled findings. The predictive accuracy of the scoring system depends on many factors such as the ethnicity of the participants or patients, the timing of the scoring system assessment, and the AECOPD severity. We could not assess the influence of these variables in our study. Despite these shortcomings, our findings provide valuable information and important implications for the clinical practice involving patients with AECOPD. We found that the DECAF score can predict in-hospital and 30-day mortalities with satisfactory sensitivity and specificity.

Inflammation and platelet activation play a role in the pathogenesis of obstructive sleep apnea syndrome (OSAS). In this study, it was aimed to investigate the effectiveness of the systemic inflammation markers, the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and WMR (white blood cell count (WBC) to mean platelet volume (MPV) ratio), in determining the severity of OSAS.

The study included 207 patients who visited the pulmonology polyclinic between 1 and 31 January 2020 with complaints of snoring, apnea periods during sleep and sleepiness and were assessed with polysomnography (PSG) with the indication of hospitalization. The patients were grouped based on their apnea-hypopnea index (AHI) scores as 54 patients with AHI<5 as the control group, 41 patients with AHI=5-15 as the mild, 54 patients with AHI=15-30 as the moderate and 58 patients with AHI>30 as the severe OSAS groups. From the complete blood counts of the patients, NLR, PLR and WMR were calculated. The demographic char it is needed to plan new studies without losing time over these markers in the diagnosis of OSAS, determination of its severity and its monitoring.

In our study, where OSAS severity and complete blood count parameters assessed as inflammatory markers were examined, it was identified that the NLR and PLR levels were not very determinant in predicting either OSAS or its severity, and among these parameters, WMR was more significant, and it was determinant in distinguishing severe OSAS. Therefore, we believe it is needed to plan new studies without losing time over these markers in the diagnosis of OSAS, determination of its severity and its monitoring.

The present study aimed to investigate the effect and molecular mechanism of the PKM2 small molecule agonist TEPP-46 on the development of methionine choline-deficient (MCD) diet-induced nonalcoholic steatohepatitis (NASH) in mice.

In this study, C57BL/6 mice were fed an MCD diet for 15 days to establish a NASH model. The protein expression levels of pyruvate kinase M2 (PKM2), PKM1, hypoxia-inducible factor-1α (HIF-1α) and NLRP3 in liver Kupffer cells (KCs) were measured by Western blotting. Immunofluorescence analysis was used to analyze the nuclear translocation of PKM2 in KCs, and the levels of IL-1β and TNF-α in mouse serum and the cell polarization indexes were determined. The MCD diet-fed mice were injected with 30 mg/kg of TEPP-46 intraperitoneally every 5 days. After 15 days, the liver tissue and peripheral blood were collected for analysis.

We found the NASH model was successfully established after the mice were fed an MCD diet for 15 days. MCD feeding promoted the expression of the PKM2 monomer/dimer and inhibited the expression of the PKM2 tetramer in KCs.