Patients with an extraordinarily elevated serum ferritin: think of haemophagocytic lymphohistiocytosis.

Background: We retrospectively analysed charts of patients with blood ferritin level >5000 µg/l. The aim of the study was to look for the likelihood of haemophagocytic lymphohistiocytosis (HLH) in these patients.

Methods: Forty-two patients demonstrated hyperferritinaemia and could be evaluated.

Severe hyperkalemia and bilateral adrenal metastasis.

Adrenal metastases are a common finding in metastatic lung and breast cancer. Often there are no clinical symptoms suggesting them. In this paper, we present a case of a 66-year-old man with metastatic lung cancer suffering from severe hyperkaliemia due to hypoaldosteronism as a result of bilateral adrenal metastasis.

[The clinical autopsy--obsolete?].

Autopsy is important for clinicians in quality control of medicine, as a teaching tool, for collection of new postmortem data and to stimulate research. Discrepancies between pre- and post-mortem diagnosis does not necessarily mean clinical error. Although modern technology may add important information, the process of clinical reasoning is based on scientific knowledge, clinical experience and thus, decisions of probability.

Gastric pneumatosis following polychemotherapy.

Lung cancer is the most frequent cause of cancer deaths in the western world today. In our case, we present the history of a 62-year-old man with the diagnosis of the uncommon complication of an acute gastric pneumatosis following his palliative chemotherapy. This rare condition was first described more than 100 years ago and has since been described in several distinctive clinical settings.

Differential binding of ceramide to MEKK1 in glomerular endothelial and mesangial cells.

Previously, we have shown that ceramide is able to directly bind to and activate c-Raf and to trigger the downstream classical mitogen-activated protein kinase (MAPK/ERK) cascade in glomerular mesangial cells [Proc. Natl. Acad.

Adrenal function during coronary artery bypass grafting.

Objective: To assess adrenal function in patients undergoing coronary artery bypass grafting (CABG) by means of the low-dose (1 microg) ACTH test, and to correlate the adrenal function with clinical outcome.

Methods: During a 5-Month period we prospectively included 45 patients undergoing elective CABG with cardiopulmonary bypass and without symptoms of endocrine disease. Low-dose (1 microg) ACTH tests were performed on the day before surgery (day -1), immediately after the operation (day 0), on the two subsequent days in the intensive care unit (day 1 and day 2), and on the day of discharge from the hospital.

Cross-talk between nitric oxide and superoxide determines ceramide formation and apoptosis in glomerular cells.

Background: The modulation of cell signaling by nitric oxide (NO) and superoxide (O(-)(2)) is associated with apoptotic cell death in inflammatory kidney diseases. Recently, we have shown that NO induces ceramide production in glomerular mesangial and endothelial cells and the ratio of NO and O(-)(2) determines whether cells live or die.

Methods: Glomerular endothelial and mesangial cells were labeled with [(14)C]serine, the precursor of all sphingolipids, then stimulated with reactive oxygen species- or reactive nitrogen species-generating substances and subjected to lipid extraction.

Basic fibroblast growth factor selectively enhances TNF-alpha-induced apoptotic cell death in glomerular endothelial cells: effects on apoptotic signaling pathways.

Endothelial cell damage of glomeruli and kidney arterioles seems to play a pivotal role in several pathologic situations, such as Gram-negative sepsis, glomerulonephritis, and acute renal failure. Bacterial lipopolysaccharide (LPS) and tumor necrosis factor-alpha (TNF-alpha) have been identified as potent inducers of apoptotic cell death in bovine glomerular endothelial cells. Both agents elicited apoptotic DNA laddering within 12 to 24 h.