Laurence H. Beck, Jr read ., M.D., Ph.D., Ramon G.B. Bonegio, M.D.D., David M. Beck, B.A., David W. Powell, Ph.D., Timothy D. Cummins, M.S., Jon B. Klein, M.D., Ph.D., and David J. Salant, M.D.: M-Type Phospholipase A2 Receptor as Focus on Antigen in Idiopathic Membranous Nephropathy Idiopathic membranous nephropathy, a common reason behind the nephrotic syndrome in adults, is an organ-particular autoimmune disease. Despite intensive investigation, a focus on antigen provides been elusive. Studies of membranous nephropathy in a rat model founded that the subepithelial immune deposits that characterize the disease are produced in situ, because of capping and shedding of the target antigen, megalin, from the basal surface of podocytes when it forms a complex with circulating antimegalin antibodies.1-8 Although megalin is not expressed on human podocytes, we hypothesized that a similar process, albeit with an unidentified antigen, is operative in human membranous nephropathy.
PCI was performed when persistent occlusion or substantial stenosis of the infarct-related artery was present. Among patients designated to the standard-treatment group, 12-lead electrocardiography was repeated 60 to 90 minutes after randomization; patients with persistent ST-segment elevation and chest pain or with hemodynamic instability had been transferred to another hospital for rescue PCI. All the patients in the standard-treatment group remained at their presenting medical center for at least a day. It was recommended that patients undergo cardiac catheterization within 14 days after randomization, an approach that is in keeping with the criteria of practice at participating sites. Stents were implanted during PCI whenever technically possible, and the use of Multi-Link Multi-Link and Vision Mini Eyesight cobalt chromium bare-metallic stents, provided cost-free by Abbott Vascular Canada, was encouraged.