Resistin is closely related to systemic inflammation in obstructive sleep apnea.

BACKGROUND: Obstructive sleep apnea (OSA) is closely related to systemic inflammation. Resistin is an adipocyte-derived cytokine (adipokine) that may link obesity with inflammation. OBJECTIVE: We aimed to investigate whether incremental changes in OSA severity, from normal to severe, primarily affect the levels of resistin and other adipokines. METHODS: Serum levels of resistin, interleukin-6 (IL-6) and leptin were examined in 31 men with OSA and 10 men without OSA, matched for age, body mass index (BMI) and several metabolic profiles. In 11 of the 31 men with OSA, these mediators were reexamined after 3 months of nasal continuous airway pressure (nCPAP) therapy. RESULTS: Levels of resistin and IL-6 were simultaneously elevated in men with OSA compared with those in men without OSA (p < 0.05), while levels of leptin did not differ. The resistin and IL-6 levels tended to increase with increasing disease severity (p < 0.05), which was based on the apnea-hypopnea index (AHI). The average oxyhemoglobin saturation during sleep (p < 0.01) and IL-6 (p < 0.05) emerged as significant determinants of resistin, even after adjustments for age, BMI, leptin levels and metabolic risk factors. After nCPAP therapy, the elevated levels of resistin and IL-6 decreased, reaching almost baseline levels of controls. Before treatment, AHI correlated positively with the reduction rate in resistin (p < 0.05). CONCLUSION: In OSA patients, resistin production can be enhanced by hypoxic stress during sleep, possibly mediating systemic inflammatory processes. nCPAP therapy may play a beneficial role in the control of resistin production.

Renal abscess with Morganella morganii complicating leukemoid reaction.

We report a case of leukemoid reaction (LR) complicating renal abscess caused by Morganella morganii infection in an 80-year-old man. On administration, laboratory tests revealed white blood cell count of 76160 /microL and C reactive protein 3.09 mg/dL. Although chronic myeloid leukemia was suspected, bcr/abl fusion transcript was not observed. Contrast enhanced computer tomography imaging of the abdomen showed abscess in the right kidney. M. morganii was detected repeatedly in material of liquid from the abscess and arterial blood culture. To our knowledge, this is the first case of M. morganii infection complicating LR.

[Primary lung cancer with myocardial metastasis mimicking acute myocardial infarction].

A 78-year-old man was admitted to our hospital because of chest and back pain. Fourteen months previously his chest X-ray showed a tumor shadow with cavitation in the left middle field. On admission cardiomegaly was found. Chest CT without contrast enhancement did not detect an intra-myocardial tumor. The electrocardiogram and serological examination suggested acute onset of myocardial infarction. However, emergency coronary angiography detected neither significant stenosis nor occlusion. Thereafter, chest CT with contrast medium demonstrated an intra-myocardial tumor. There wes no pericardial effusion. We clinically diagnosed a myocardial tumor metastatic from lung cancer. He received symptomatic treatment, but died on the 31st hospital day. Autopsy revealed that most of the myocardium had been replaced by lung cancer cells. They did not invading the pericardium directly. These findings supported the clinical diagnosis that myocardial tumor was hematogenous metastasis from lung cancer.