The diagnostic value of immunohistochemical staining of the interstitial vascular C4d complement in membranous nephropathy

Abstract Membranous glomerulonephritis (MGN) is the most common cause of adulthood nephrotic syndrome. Diagnosis of membranous nephritis is based on light electron immunofluorescence microscopy and clinical signs. Immune complex deposition against podocyte antigens such as phospholipase A2 receptor (PLA2R) activates the complement system. Of this, complement Component C4d (C4d) is involved in the classical and lectin pathways. This marker may be used by immunohistochemistry to diagnose MGN when other methods are not available. In this work, C4d expression was monitored by immunohistochemical analysis in the glomerular capillaries of patients with primary MGN (study group, N=33) versus patients with minimal change disease (MCD, control group, N=20) in a cross-sectional evaluation performed based on the diagnosis confirmed by light microscopy and immunofluorescence. There was no significant demographic difference between the two groups except for age (P=0.002). C4d immune-expression was positive in glomerular capillary (2+ to 4+) in most of the MGN patients, while it was negative in the MCD group. The sensitivity and specificity of C4d immunostaining were 95% and 100%, respectively. The Pearson correlation coefficient was 0.74 between C4d (immunohistochemistry) and immunoglobulins (IgG; immunofluorescence) and 0.65 between C4d (immunohistochemistry) and the C3 complement product (immunofluorescence). Immunohistochemical evaluation of C4d is, therefore, a sensitive and specific method that has a high correlation with IgG immunofluorescence.

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Histochemical and Morphometric Evaluation of Skeletal Muscle from Horses with Exertional Rhabdomyolysis (Tying-up)

Veterinary Pathology ◽

10.1177/030098588602300409 ◽

1986 ◽

Vol 23 (4) ◽

pp. 400-410 ◽

Cited By ~ 33

Author(s):

S. A. McEwen ◽

T. J. Hulland

Keyword(s):

Skeletal Muscle ◽

Clinical Signs ◽

Gluteus Medius ◽

Control Group ◽

Type Ii ◽

Cross Sectional ◽

Gluteus Medius Muscle ◽

Exertional Rhabdomyolysis ◽

Exercise Period ◽

Type Ii Fibers

Thirteen horses with histories of exertional rhabdomyolysis were exercised for 20 minutes to induce clinical signs of lameness, elevated serum creatine kinase (CK), and aspartate aminotransferase (AST) activities and skeletal muscle morphologic lesions. The clinical signs exhibited by affected horses included trembling, sweating, increased rate of respiration, and restricted limb movement. Serum CK reached maximal activity between 4 and 8 hours after the exercise period and serum AST activity peaked between 24 and 48 hours. Histologically, the skeletal muscle lesions in muscle biopsies 24 hours after the exercise period consisted of segmental muscle fiber degeneration. Damaged muscle fibers were repaired by myoblastic regeneration. Horses with moderate (>1,500 U/liter) to severe (>5,000 U/liter) elevations of serum CK activity accompanied by clinical signs of muscle soreness induced by exercise, had visible muscle fiber degeneration microscopically. Frozen sections of biopsies of the gluteus medius muscle from affected ( n = 13) and control ( n = 11) groups of horses were processed to demonstrate myofibrillar ATPase activity. These sections were then used to determine fiber types, area percentages, and mean cross sectional fiber sizes. The mean type I, type II, and intermediate fiber sizes were significantly larger in the affected group than in the control group. In the gluteus medius muscles of the affected group, there was a significantly greater percentage of intermediate fibers and a significantly greater percentage of area occupied by intermediate fibers than in the control group. In the muscle samples with acute lesions of exertional rhabdomyolysis, type II fibers were selectively but not exclusively affected. In one horse which was subsequently necropsied 24 hours after the exercise period, lesions were present in several postural muscles, the masseter muscle and the heart. We conclude that the gluteus medius muscle fibers of affected horses are larger in cross sectional area than those of control horses and that there is preferential degeneration of type II fibers in acute lesions of exertional rhabdomyolysis.

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Homocysteine, trace elements and oxidant/antioxidant status in mild cognitively impaired elderly persons: a cross-sectional study

Romanian Journal Of Internal Medicine ◽

10.1515/rjim-2015-0043 ◽

2015 ◽

Vol 53 (4) ◽

pp. 336-342 ◽

Cited By ~ 1

Author(s):

Hajar Negahdar ◽

Seyed Reza Hosseini ◽

Hadi Parsian ◽

Farzan Kheirkhah ◽

Abbas Mosapour ◽

...

Keyword(s):

Trace Elements ◽

Cognitive Impairment ◽

Antioxidant Status ◽

Clinical Signs ◽

Cross Sectional Study ◽

Control Group ◽

Elderly Persons ◽

Effective Parameters ◽

Cross Sectional ◽

Significant Difference

Abstract Introduction. Mild cognitive impairment (MCI) is the prodromal stage of Alzheimer’s disease (AD), so identification of the related risk factors can be helpful. There are controversial data regarding the serum oxidant/antioxidant status, trace elements and homocysteine (Hcy) as effective parameters in this disease, therefore the status of these factors was determined in this study. Methods. One hundred-twenty elderly persons with cognitive impairment and 120 elderly healthy persons who were differentiated using Mini-mental state examination (MMSE) participated in this study. The patients were divided into mild and moderate-to-severe cognitive impairment group. Serum antioxidant/oxidant, copper (Cu), manganese (Mn), zinc (Zn) and Hcy concentrations were measured using routine methods. Results. Oxidant and antioxidant levels increased and decreased based on the severity of the disease and were higher and lower in patients than in control group, respectively (p<0.001). With adjusting for age, gender and education, significant difference in Hcy levels was not observed. There was no significant difference in trace elements levels among groups. Conclusions. Results confirmed the association between oxidative damage with increasing the severity of cognitive impairment. These factors may be involved in the etiology of cognitive impairment and AD. Identification of such biomarkers is important to select appropriate treatment goals before the onset of irreversible clinical signs.

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Expression Level, Correlation, and Diagnostic Value of Serum miR-127 in Patients with Acute Respiratory Distress Syndrome

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/2257764 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Hui Lin ◽

Lingxiang Jiang ◽

Yiqun Ren ◽

Fen Sheng ◽

Luxi Wang ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Molecular Marker ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Pearson Correlation ◽

Diagnostic Value ◽

Control Group ◽

Observation Group ◽

Severe Group

Objective. To analyze the expression of miR-127 in the serum of patients with acute respiratory distress syndrome (ARDS) and to explore its correlation with the severity of ARDS patients and its value as a molecular marker for diagnosis of ARDS. Methods. 70 patients with ARDS admitted to our hospital from September 2017 to September 2019 were selected as the observation group, and 60 healthy persons with physical examination were collected as the control group. RT-PCR was used to detect the serum miR-127 levels of all subjects, and the serum miR-127 levels of the observation group and control group were compared. The oxygenation index (PaO2/FiO2) of ARDS patients was recorded and divided into three subgroups: mild group, moderate group, and severe group. Serum miR-127 levels of patients in the mild group, moderate group, and severe group were compared. Pearson correlation was used to analyze the relationship between serum miR-127 levels and the severity of ARDS patients. The receiver operating characteristic curve (ROC) was drawn, and the area under the ROC curve (AUC) was used to evaluate the diagnostic value of miR-127 in patients with ARDS. Results. The serum level of miR-127 (10.15 ± 1.03) in the observation group was significantly higher than that in the control group (3.09 ± 0.62). And in the three subgroups of mild, moderate, and severe, the serum miR-127 level in the moderate group (10.43 ± 0.71) and the severe group miR-127 level (11.05 ± 1.26) were significantly higher than those in the mild group level (9.38 ± 1.24). Pearson correlation analysis showed that the serum miR-127 level was negatively correlated with PaO2/FiO2 (r = −0.715, P < 0.05 ), that is, the serum miR-127 level was positively correlated with the severity of ARDS patients. The area under the curve (AUC) of the diagnostic value of serum miR-127 for ARDS was 0.732 (95% CI 0.607–0.858). When the optimal cutoff value was 0.380, the sensitivity was 59.1% and the specificity was 78.6%, which suggested that miR-127 can be used as a marker for ARDS diagnosis. Conclusion. There is an increase in miR-127 levels in the serum of ARDS patients. The serum miR-127 level is positively correlated with the severity of ARDS. The higher the level of miR-127, the worse the condition of ARDS, which is positively correlated with the severity of the condition. It suggests that the serum miR-127 level is an important indicator for evaluating the severity of ARDS patients. It can be used as a molecular marker for clinical diagnosis of ARDS.

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A diagnostic model for minimal change disease based on biological parameters

PeerJ ◽

10.7717/peerj.4237 ◽

2018 ◽

Vol 6 ◽

pp. e4237 ◽

Cited By ~ 2

Author(s):

Hanyu Zhu ◽

Qiuxia Han ◽

Dong Zhang ◽

Yong Wang ◽

Jing Gao ◽

...

Keyword(s):

Minimal Change Disease ◽

Density Lipoprotein ◽

Diagnostic Value ◽

Minimal Change ◽

Lipoprotein Cholesterol ◽

Control Group ◽

Diagnostic Model ◽

Thrombin Time ◽

Biological Parameters ◽

Phospholipase A2 Receptor

Background Minimal change disease (MCD) is a kind of nephrotic syndrome (NS). In this study, we aimed to establish a mathematical diagnostic model based on biological parameters to classify MCD. Methods A total of 798 NS patients were divided into MCD group and control group. The comparison of biological indicators between two groups were performed with t-tests. Logistic regression was used to establish the diagnostic model, and the diagnostic value of the model was estimated using receiver operating characteristic (ROC) analysis. Results Thirteen indicators including Anti-phospholipase A2 receptor (anti-PLA2R) (P = 0.000), Total protein (TP) (P = 0.000), Albumin (ALB) (P = 0.000), Direct bilirubin (DB) (P = 0.002), Creatinine (Cr) (P = 0.000), Total cholesterol (CH) (P = 0.000), Lactate dehydrogenase (LDH) (P = 0.007), High density lipoprotein cholesterol (HDL) (P = 0.000), Low density lipoprotein cholesterol (LDL) (P = 0.000), Thrombin time (TT) (P = 0.000), Plasma fibrinogen (FIB) (P = 0.000), Immunoglobulin A (IgA) (P = 0.008) and Complement 3 (C3) (P = 0.019) were significantly correlated with MCD. Furthermore, the area under ROC curves of CH, HDL, LDL, TT and FIB were more than 0.70. Logistic analysis demonstrated that CH and TT were risk factors for MCD. According to the ROC of “CH+TT”, the AUC was 0.827, with the sensitivity of 83.0% and the specificity of 69.8% (P = 0.000). Conclusion The established diagnostic model with CH and TT could be used for classified diagnosis of MCD.

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The Optimum Cut-off Value of the Nelwan Score to Diagnose Typhoid Fever in Adults

10.1101/2021.02.22.432239 ◽

2021 ◽

Author(s):

Erni Juwita Nelwan ◽

Luh Putu Listya Paramita ◽

Robert Sinto ◽

Fransiscus Nikodemus Hosea ◽

Pringgodigdo Nugroho ◽

...

Keyword(s):

Typhoid Fever ◽

Clinical Presentation ◽

Clinical Signs ◽

Gastrointestinal Symptoms ◽

Signs And Symptoms ◽

Diagnostic Value ◽

Cross Sectional Study ◽

Cross Sectional ◽

Clinical Signs And Symptoms ◽

Sensitivity Specificity

AbstractIntroductionTyphoid fever can be challenging to diagnose since clinicians often depend merely on clinical presentation. Clinical scores are useful to provide more accurate diagnosis. Variables in Nelwan Score are derived from clinical signs and symptoms of suspected cases for typhoid. Diagnostic value of Nelwan Score based on a cut-off value has never been evaluated.MethodsA cross sectional study was conducted between July 2017 and January 2018 in five hospitals and two Primary Health Centers in Jakarta and Tangerang. The inclusion criteria were patients with 3-14 days of fever and gastrointestinal symptoms between July 2017 and January 2018. Diagnosis are confirmed by blood culture, rectal swab culture, or PCR. Cut-off analysis was performed by using Receiver Operating Characteristic (ROC) curve and diagnostic value was analyzed to generate sensitivity, specificity, predictive value and likelihood ratio.ResultFrom 233 subjects involved, 4.72% of them were confirmed to have typhoid fever. The optimal cut-off value of Nelwan Score is 10 with AUC 71.3%. This cut-off value has sensitivity 81.8%, specificity 60.8%, PPV 9.3%, NPV 98.5%, LR + 2.086, and LR – 0.299.ConclusionNelwan Score with cut-off value of 10 provides a good diagnostic performance as a screening tool for patients with suspected typhoid fever clinical presentation.

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Vascular deformation in human atherosclerotic carotid artery evaluated by 2D analysis of ultrasonography

Vascular ◽

10.1177/1708538119890163 ◽

2020 ◽

Vol 28 (4) ◽

pp. 441-449

Author(s):

Mehravar Rafati ◽

Mehrdad Rafati-Rahimzadeh ◽

Hassan Moladoust ◽

Mohammadreza Sehhati

Keyword(s):

Carotid Artery ◽

Pearson Correlation ◽

Intima Media Thickness ◽

Cross Sectional Study ◽

Control Group ◽

Severe Stenosis ◽

Cross Sectional ◽

Automated Method ◽

Age Range ◽

Male Subjects

Objectives Common carotid artery (CCA) remodelling in the atherosclerosis process is an inherent necessary element that decreases the progress of significant lumen compromise. The present study used a semi-automated method to assess relationships of intima-media thickness (IMT), lumen diameter (LD) and inter-adventitial diameter (IAD) using ultrasound B-mode images of atherosclerotic carotid artery. Methods In the cross-sectional study, 120 male subjects (age range: 40–60 years) were classified into four research groups namely control, mild, moderate, and severe stenosis. The maximum near and far wall IMT, mean of both walls’ IMT and IAD, and also LD of the left CCA were extracted for all participants. Pearson correlation coefficient was utilized to investigate relationships of IMT, LD, and IAD. Results Results revealed that the maximum far and near wall IMT, mean of both walls’ IMT and IAD in the CCA were significantly different in stenosis patients and the control group ( p< 0.001). However, there were no significant differences among the four studied groups in terms of LD of CCA ( p = 0.65). There was a stronger correlation between mean of both walls’ IMT and IAD in comparison with mean far wall IMT and IAD ( p < 0.001). Conclusions Results indicated that changes of IAD in the left CCA were associated with carotid deformation, and thus it can be considered as a predictor of atherosclerosis process.

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Comparison of lactate values obtained from different sites and their clinical significance in patients with severe sepsis

Sao Paulo Medical Journal ◽

10.1590/s1516-31802011000100003 ◽

2011 ◽

Vol 129 (1) ◽

pp. 11-16 ◽

Cited By ~ 14

Author(s):

Ana Paula Metran Nascente ◽

Murillo Assunção ◽

Carla Janaina Guedes ◽

Flávio Geraldo Rezende Freitas ◽

Bruno Franco Mazza ◽

...

Keyword(s):

Severe Sepsis ◽

Pearson Correlation ◽

Venous Blood ◽

Venous Catheter ◽

University Hospital ◽

Therapeutic Interventions ◽

Control Group ◽

Central Venous ◽

Cross Sectional ◽

Arterial Blood

CONTEXT AND OBJECTIVE: The ideal site for lactate collection has not been clearly established. This study aimed to evaluate associations between lactate levels in arterial blood (Lart), peripheral venous blood (Lper) and central venous blood (Lcen) in patients with severe sepsis or septic shock. DESIGN AND SETTING: Cross-sectional analytical study in an tertiary university hospital. METHOD: Samples from patients with a central venous catheter and from healthy volunteers (control group) were collected. Blood was drawn simultaneously for measurements of Lart, Lper and Lcen, and the first sample was collected less than 24 hours after the onset of organ dysfunction. The results were analyzed using Pearson correlation, Bland-Altman and McNemar tests. RESULTS: A total of 238 samples were collected from 32 patients. The correlation results were r = 0.79 (P < 0.0001) for Lart/Lper and r = 0.84 (P < 0.0001) for Lart/Lcen. Bland-Altman showed large limits of agreement: -3.2 ± 4.9 (-12.8 to 6.4) and -0.8 ± 5.9 (-12.5 to 10.8), for Lper and Lcen respectively. In the control group, there was greater correlation (r = 0.9009, P = 0.0004) and agreement: -0.7 ± 1.2 (-3.1 to 1.7). Regarding clinical intervention, there was good agreement between Lart/Lcen (96.3%; three disagreements), with worst results for Lart/Lper (87.0%) with 10 cases of disagreement (P = 0.04). In eight patients (80.0%) Lper was higher than Lart. CONCLUSION: Lcen, and not Lper, can replace Lart with good correlation and clinical agreement. Lper tends to overestimate Lart, thus leading to unnecessary therapeutic interventions

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Manganese Superoxide Dismutase Gene Polymorphism (V16A) is Associated with Diabetic Retinopathy in Slovene (Caucasians) Type 2 Diabetes Patients

Disease Markers ◽

10.1155/2008/940703 ◽

2008 ◽

Vol 24 (1) ◽

pp. 59-64 ◽

Cited By ~ 31

Author(s):

Mojca Globočnik Petrovič ◽

Ines Cilenšek ◽

Daniel Petrovič

Keyword(s):

Oxidative Stress ◽

Type 2 Diabetes ◽

Superoxide Dismutase ◽

Diabetic Retinopathy ◽

Manganese Superoxide Dismutase ◽

Clinical Signs ◽

Control Group ◽

Enos Gene ◽

Cross Sectional

Substantial data indicate that oxidative stress is involved in the development of diabetic retinopathy. Two candidate genes that affect the oxidative stress are manganese mitochondrial superoxide dismutase (Mn-SOD) and endothelial nitric oxide synthase (eNOS). The aim of the present study was to examine the role of the V16A polymorphism of the Mn-SOD gene and the 4a/b polymorphism of the eNOS gene in the development of diabetic retinopathy in Caucasians with type 2 diabetes.In this cross sectional case-control study 426 unrelated Slovene subjects (Caucasians) with type 2 diabetes mellitus were enrolled: 283 patients with diabetic retinopathy and the control group of 143 subjects with type 2 diabetes of duration of more than 10 years who had no clinical signs of diabetic retinopathy.A significantly higher frequency of the VV genotype of the V16A polymorphism of the Mn-SOD was found in patients with diabetic retinopathy compared to those without diabetic retinopathy (OR=2.1, 95% CI = 1.2–3.4;p= 0.006), whereas the 4a/b polymorphism of the eNOS gene failed to yield an association with diabetic retinopathy.We may conclude that the VV genotype of the V16A polymorphism of the Mn-SOD gene was associated with diabetic retinopathy in Caucasians with type 2 diabetes, therefore it might be used as a genetic marker of diabetic retinopathy in Caucasians.

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Value of Resistin in Early Onset Neonatal Sepsis

Journal of Child Science ◽

10.1055/s-0037-1608713 ◽

2017 ◽

Vol 07 (01) ◽

pp. e146-e150

Author(s):

Abdurrahman Ozdemir ◽

Yusuf Elgormus

Keyword(s):

Neonatal Sepsis ◽

Early Onset ◽

Neonatal Intensive Care ◽

Clinical Signs ◽

Area Under The Curve ◽

Scoring Systems ◽

Diagnostic Value ◽

Sepsis Group ◽

Control Group ◽

Reactive Protein

AbstractThe diagnosis of neonatal sepsis is usually difficult because the sign and symptoms are nonspecific. Although C-reactive protein (CRP) and procalcitonin (PCT) are the most commonly used auxiliary tests, they are not reliable enough markers to be used for diagnosis of neonatal sepsis. This study aimed to evaluate the efficacy of resistin in diagnosing early onset neonatal sepsis and to compare its effectiveness to CRP and PCT. This prospective study was performed in the neonatal intensive care unit of Medicine Hospital between June and September 2016. Twenty-nine infants in the sepsis group and 33 infants in the control group were recruited. The Töllner scoring system was used for clinical signs. The hematologic parameters were evaluated using the Manroe and Rodwell scoring systems. The blood samples for CRP, PCT, and resistin were collected at admission (T0), and at 72 hours (T3). Mean plasma resistin level at T0 was 54.20 ± 39.3 ng/mL in the sepsis group and 34.92 ± 6.9 ng/mL in the control group. The sensitivity at T0 for resistin was 76%, and the specificity was 67%. The values of area under the curve (AUC) for CRP, PCT, and resistin were 0.84, 0.66, and 0.72, respectively. We found the diagnostic value of resistin to be lower than CRP, although its plasma levels were elevated. Therefore, we propose that resistin has limited value in diagnosis and follow-up of early-onset neonatal sepsis.

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Craniofacial Morphology of Dutch Patients with Bilateral Cleft Lip and Palate and Noncleft Controls at the Age of 15 Years

The Cleft Palate-Craniofacial Journal ◽

10.1597/07-166.1 ◽

2008 ◽

Vol 45 (6) ◽

pp. 661-666 ◽

Cited By ~ 22

Author(s):

Geer M. van den Dungen ◽

Edwin M. Ongkosuwito ◽

Irene H. A. Aartman ◽

Birte Prahl-Andersen

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Pearson Correlation ◽

Correlation Coefficients ◽

Craniofacial Morphology ◽

Control Group ◽

Class Iii ◽

Cross Sectional ◽

Significant Difference ◽

Bilateral Cleft Lip

Objective: Comparison of craniofacial morphology in bilateral cleft lip and palate patients to that of a noncleft control group at the age of 15 years. Design: A cross-sectional study of cephalometric data. Subjects and Methods: Cephalometric records of 41 consecutive patients (32 boys and 9 girls) with nonsyndromic complete bilateral cleft lip and palate born between 1973 and 1987. The patients were treated by the cleft teams of the Erasmus Medical Centre in Rotterdam and the VU University Amsterdam. The control group of normal Dutch subjects was followed in the Nijmegen Growth Study. From this population, mean cephalometric data were used. Differences in cephalometric measurements and other variables were calculated between the bilateral cleft lip and palate group and the control group. Results: Independent-sample t tests indicated that there was a statistically significant difference between the mean of the cephalometric values of the bilateral cleft lip and palate patients and the control group with respect to all cephalometric variables. Pearson correlation coefficients calculated between angle ANB and the number of operators, number of surgical procedures before 15 years of age, and the year of birth were not significant. Conclusions: Bilateral cleft lip and palate patients treated in the Amsterdam and Rotterdam cleft centers differed significantly from the control group in all measurements. A Class III development due to a less forward positioned maxilla was observed. The vertical measurements indicated a more divergent growth pattern in bilateral cleft lip and palate patients (Ans-Me/N-Me, GoGn-SN, and SN-FFH).

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