Reversion of anergy signatures in clonal CD21 B cells of mixed cryoglobulinemia after clearance of HCV viremia.

Hepatitis C virus (HCV) causes mixed cryoglobulinemia (MC) by driving clonal expansion of IgMCD27 B cells. These cells display both the features of anergy induced by continual engagement of the B-cell receptor (BCR), such as high expression of phosphorylated extracellular signal-regulated kinase (pERK) and reduced lifespan, and of virus-specific exhaustion, such as CD21 phenotype and a defective response to ligation of BCR and Toll-like receptor 9 (TLR9). MC usually regresses after eradication of HCV with interferon, whose immunomodulatory activity might contribute to this effect.

History of reconstruction after total gastrectomy.

Nearly a century has passed since Schlatter carried out the first successful total gastrectomy and antecolic end-to-side oesophagojejunostomy in 1897 in Zurich. Actually, fourteen years before, Conner attempted a total gastrectomy, but his patient died on the operating table. From the first success, a large number of different procedures have populated the worldwide literature, with a lot of papers reporting "original' techniques or data about the functional outcome.