乳腺癌组织中 miR-21的表达及意义

目的 对乳腺癌组织及其相应癌旁组织中miR-21进行定量检测,分析其表达与临床病理特征的及意义.方法 采用茎环实时荧光逆转录聚合酶链反应(RT-PCR)检测60例乳腺癌及其对应癌旁组织中miR-21的表达量,分析其表达与肿瘤大小、TNM分期、组织学类型、淋巴结转移、雌激素受体(ER)、孕激素受体(PR)等临床病理特征的关系.结果 实时RT-PCR方法 检测miR-21表达的敏感性和特异性良好.miR-21在乳腺癌组织中的表达明显高于癌旁组织(P＜0.001);miR-21的高表达还与较高的TNM分期,淋巴结转移及PR的表达程度有关(各分组间P＜0.01及＜0.05);miR-21的表达在"三阴性乳腺癌"(ER,PR,CerbB-2均为阴性)和"非三阴性乳腺癌"之间的表达存在统计学差异(P=0.029).结论 miR-21在乳腺癌组织中高表达,其水平可能与乳腺癌的恶性程度有关.     

结直肠疾病的诊疗进展(摘译)

血清miR-21作为结直肠癌的诊断和预后生物标志物 Serum miR-21 asa diagnostic and prognostic biomarker in colorectal cancer[J].[日本]Toiyama Y,Tokahashi M,Hur K,et al.J Natl Cancer Inst,2013,105(12):849-859. 背景致癌性微小RNA miR-21和miR-31为负调节抑癌基因.其能否作为血清生物标志物用于人类结直肠癌的探查仍未确定.方法 为了测定miR-21和miR-31是否是分泌性miRNA,笔者筛查了2株结直肠癌细胞系的培养基中miRNA的表达,并分析了12例结直肠癌患者和12例对照受试者的血清中的miRNA表达.并在186例结直肠癌患者、60例术后患者、43例高危腺瘤患者和53例对照受试者的血清样品中验证了候选miRNA的表达.笔者分析了166例配对原发性结直肠癌组织中miR-21的表达,以测定血清miR-21是否可以反映结直肠癌.     

微小RNA在糖尿病肾病患者血清中的表达及临床意义

目的 探讨糖尿病肾病发生、进展过程中血清微小RNA (microRNA,miRNA)表达谱及其临床意义.方法 应用miRNA基因芯片检测10例糖尿病肾病患者、10例糖尿病尿蛋白正常患者及10例健康对照者血清miRNA表达谱.实时荧光定量PCR法对66例糖尿病肾病(微量蛋白尿者36例,大量蛋白尿者30例)、40例糖尿病尿蛋白正常者及40例健康对照者进行血清miRNA表达谱验证,分析血清差异表达的miRNA与糖尿病肾病临床参数的关系.结果 实时荧光定量PCR法验证得到miR-150-5p、miR-155-5p、miR-30e-5p及miR-3196在糖尿病微量蛋白尿患者组(n=36)、糖尿病尿蛋白正常者组(n=40)及健康对照组(n=40)血清样本中表达差异有统计学意义(P＜0.05).miR-150-5p (P=0.005)和miR-155-5p (P=0.006)在糖尿病微量蛋白尿组(n=36)及糖尿病大量蛋白尿组(n=30)血清中表达差异有统计学意义.大量蛋白尿组血清miR-150-5p和miR-155-5p表达水平分别是微量蛋白尿组的2.3倍、1.5倍.同时发现,miR-150-5p和miR-155-5p与糖尿病肾病患者的估算肾小球滤过率和尿蛋白排泄率具有明显相关性.结论 miR-150-5p和miR-155-5p可能参与糖尿病肾病发生及发展的病理过程;血清miR-150-5p和miR-155-5p有望成为DN早期诊断及判断预后的潜在分子标志物.     

狼疮肾炎患者循环miRNA表达谱研究及循环miR-130b-3p的临床意义

目的分析处于不同进展阶段的狼疮肾炎(LN)患者循环miRNA的表达变化并探讨其可能存在的临床意义。 方法本研究共94份血清标本,包括58例LN患者和36名健康体检者(作为对照组)。挑选出其中性别、年龄匹配的12份血清标本用于循环miRNA表达谱筛选,包括早期LN组4份(CKD 1～3期),晚期LN组4份(CKD分期4～5期)及对照组4份作为芯片组,使用miRNA PCR芯片检测血清miRNA变化;剩余50例LN患者(40例早期LN患者、10例晚期LN患者)及32名对照者血清样本作为验证组,用于验证miRNA表达谱筛选结果;以Nanodrop 2000检测血清总RNA抽提浓度;选择miR-130b-3p和miR-1233-3p作为验证对象;进行Spearman相关性分析。 结果芯片组结果显示,与对照组相比,早期LN组中7个表达上升的miRNA差异具有统计学意义,分别是：miR-1233-3p (P＝0.019)、miR-130b-3p (P＝0.021)、miR-18a-3p (P＝0.021)、miR-628-3p (P＝0.023)、miR-1260b (P＝0.030)、miR-1539 (P＝0.041)和miR-378e (P＝0.047);晚期LN组分别与对照组及早期LN组比较,未发现表达上调大于2倍或者上调差异具有统计学意义的miRNA。验证组结果显示：晚期LN组患者分别与对照组、早期LN组比较,血清总RNA浓度下降(U＝4.5,P<0.001;U＝18.0,P<0.001);早期LN组与对照组比较,血清中miR-130b-3p表达升高[IQR 16.2(8.7,42.7)与9.6(4.8,17.4), U＝405.5,P＝0.008];晚期LN组分别与对照组及早期LN组比较,MiR-130b-3p和miR-1233-3p表达均下降(U＝69.0、P＝0.008,U＝46.0、P<0.001;U＝80.0、P＝0.019,U＝70.0、P＝0.002);相关性分析显示循环miR-130b-3p的相对表达量与24 h尿蛋白(r＝0.404,P＝0.010)、肾脏慢性活动指数(r＝0.389,P＝0.013)、甘油三酯(r＝0.376,P＝0.017)呈正相关。 结论严重肾功能衰竭患者可能存在循环miRNA广泛表达下调,循环miRNA-130b-3p在早期LN患者中表达升高并与肾脏损伤和血脂调节异常相关,在LN发生发展中可能起作用。     

MiR-183 及 let-7 家族在肝癌患者血清中的表达

目的:检测肝癌及良性肝病患者血清中miR-182、miR-96及let-7a、let-7b、let-7c、let-7e的表达量及其临床意义。方法:收集肝癌、肝硬化、肝炎患者和健康对照组的血清标本各58例、30例、40例、40例,采用荧光定量PCR分析各组间6种miRNA的相对表达量,分析肝癌组的相对表达量与临床病理因素间有无关系。结果:肝癌患者血清中miR-182和miR-96表达量均高于肝硬化血清、肝炎血清以及正常对照组(P0.01);肝硬化组血清miR-182和miR-96水平均大于肝炎组及正常对照组(P0.01)。肝炎组血清miR-96大于正常对照组(P0.01)。肝癌组血清中let-7a的表达量低于肝硬化组、肝炎组及正常对照组(P0.01)。肝癌组血清let-7c表达量大于肝炎组(P0.01)。肝癌血清中let-7e的表达量大于肝硬化组(P0.05)。结论:血清中miR-182及miR-96可能对肝癌有诊断价值,并可能预测肝癌的恶性程度及预后;血清中let-7家族对肝癌的诊断意义不显著。     

胃癌中微小RNA表达谱及miR-429表达水平的研究

目的 检测胃癌组织及胃癌细胞中微小RNA (miRNA)表达谱,并测定胃癌组织及胃癌细胞中miR-429的表达水平.方法 采用基因芯片技术检测胃癌组织、癌旁正常胃组织标本及胃癌细胞株( SGC-7901)、正常人胃上皮细胞(GES-1)中miRNAs的表达.挑选基因芯片结果中胃癌组织表达显著下调的miR-429,并采用实时定量聚合酶链反应(qRT-PCR)检测7例正常胃组织、52例胃癌组织、胃癌细胞SGC-7901、GES-1中miR-429的表达.结果 基因芯片结果表明,胃癌组织中有23个miRNA上调,如miR-21、miR-30b等,31个下调如miR-429、miR-200等.qRT-PCR检测显示,miR-429在胃癌组织中下降约63.4％ (P＜0.01),在胃癌细胞株SGC7901中下降约76.2％(P＜0.01).结论 miR-429在胃癌组织中表达显著下调,可能作为胃癌特异性miRNA,在胃癌的发生发展过程中有重要作用.     

微小RNA-10b在胃癌组织中的表达及其临床意义

目的 探讨胃癌组织和癌旁组织中微小RNA(miR)-10b的表达差异及其临床意义.方法 采用SYBR Green Ⅰ荧光定量聚合酶链反应(FQ-PCR)法检测78例胃癌患者手术切除癌组织及配对癌旁组织标本中miR-10b的表达水平.结果 miR-10b在胃癌组织中的相对表达水平(6.758±2.301)显著高于其在配对癌旁组织中的表达(8.516±1.870),差异有统计学意义(P＜0.01).胃癌组织中miR-10b的表达水平与临床TNM分期(P＜0.01)、肿瘤大小(P＜0.01)、淋巴结转移(P＜0.01)以及肿瘤浸润深度(P＜0.01)密切相关,而与年龄、性别、分化程度无明显相关(P＞0.05).结论 胃癌组织中miR-10b的高表达可能与胃癌的发生、发展、侵袭、转移相关.     

miR-155和miR-21在乳腺癌组织中的表达

微小RNA(miRNA)是近年来发现的一类新型内源性小分子非编码RNA[1],参与调控许多细胞生理过程,它们的异常表达与癌症发生密切相关[2].本研究旨在探讨miRNA家族成员miR-155及miR-21在乳腺癌组织中的表达及其与乳腺癌临床病理学特征的关系. 一、材料和方法 1.标本收集:收集2007年7月至2007年12月于复旦大学附属中山医院普外科住院治疗、资料完整的36例女性乳腺癌的乳腺组织标本,包括肿瘤组织、癌旁组织和正常组织.     

微小RNA在结肠慢传输型便秘病变组织中的差异表达

目的 观察微小RNA(miRNA)在结肠慢传输型便秘(STC)病变结肠组织和正常结肠组织中的差异表达.方法 收集6例STC病变结肠组织和正常结肠组织标本,应用miRNA芯片检测miRNA在STC病变结肠组织和正常结肠组织中的表达.结果 5种miRNA在STC病变结肠组织正常结肠组织中的表达差异有统计学意义(P＜0.05).与正常结肠组织比较,miR-20b、miR-27b、miR-30b、miR-128及miR-129-3p在STC结肠组织中表达下调,统计学组间差异倍数均在1.2倍以上,其中miR-128及miR-129-3p下调明显,统计学组间差异倍数大于2倍.结论 部分miRNA在STC结肠组织和正常结肠组织中存在差异表达,可能参与了STC发生的分子机制.     

调节青少年特发性脊柱侧凸患者椎旁肌改变的关键微RNA

目的探寻调节青少年特发性脊柱侧凸(AIS)患者椎旁肌改变的关键微RNA(miRNA)。方法对3例女性AIS患者凹侧与凸侧椎旁肌组织进行RNA高通量测序,获得差异表达miRNA。使用27例AIS手术患者的椎旁肌组织采用实时荧光定量PCR法验证测序的质量和差异,并将miRNA的相对差异表达量与患者临床参数进行相关性分析。结果 AIS患者凹侧与凸侧椎旁肌组织存在18个差异表达miRNA。实时荧光定量PCR法检测结果显示,miR-516、miR-517、mi R-495的表达差异具有统计学意义(P 0.05)。两侧椎旁肌miR-516相对表达量差值与患者发病年龄呈负相关(r=-0.452),miR-517相对表达量差值与侧凸Cobb角呈负相关(r=-0.378)。结论 AIS患者两侧椎旁肌miR-516、miR-517、miR-495存在不对称表达,其中miR-516、miR-517的不对称表达与发病年龄和侧凸角度相关。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Is the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?

Background: The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. Methods: In 50 patients anaesthetised with thiopental, isoflurane and fentanyl, the effect of bolus doses of 0.15 or 0.25 mg . kg^?1 mivacurium (MIV 15, MIV 25), 0.3 or 0.5 mg . kg^?1 atracurium (ATR 30, ATR 50) and 0.06 or 0.1 mg . kg^?1 vecuronium (VEC 06, VEC 10) were measured on both arms (evoked response of the adductor pollicis to train-of-four stimulation every 12 s), a tourniquet being applied on one arm just before and during 3 min after the muscle relaxant bolus. Results: Tourniquet inflation of 3 min almost abolished the neuromuscular effect of mivacurium. In the vecuronium groups and in the ATR 50 group, tourniquet inflation did not modify the maximum degree of depression of the twitch response. Also, the duration of action of vecuronium was unaffected by the tourniquet. In the ATR 30 group, times to return of the twitch response to 25% (duration 25%) and 75% (duration 75%) of control response were significantly shorter in the cuffed arm, 23 min vs 27 min, and 41 min vs 45 min, respectively. In the ATR 50 group, only duration 25% was significantly shorter in the cuffed arm (41 min vs 45 min). Conclusion: The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.     

Membranes in Artificial Organs

Abstract: Membrane processes play a pivotal and enabling role in modern replacement therapy for acute and chronic organ failure and in the management of immunologic diseases. In fact, virtually all contemporary extracorporeal blood purification methods employ membrane devices, and the next generation of artificial organs and tissue engineering therapies are almost certain to be similarly grounded in membrane technology. In this short essay, we comment on the similarities and differences among synthetic membranes and their natural counterparts and also provide a critical overview of the demographics and technology of hemodialysis, hemofiltration, apheresis, oxygenation, and emerging membrane technologies and applications.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Intrathecal administration of sameridine to patients subjected to arthroscopic knee joint surgery

Background: Sameridine, a new substance with both local anesthetic and opioid effects, was administered intrathecally for the first time to humans, i. e. in patients subjected to arthroscopic knee joint surgery.
Method: A dose-escalating (10, 15, 20 and 25 mg), open study was performed in 33 patients. Only two patients were included in the 25 mg group.
Results: Sameridine provided good quality of surgical anesthesia in all patients except those receiving 10 mg. The maximum level of sensory block, Th5–Th7, was reached within 30 min with a median duration of 3.6–3.9 h. The motor block was more profound with increasing dose, but never lasted longer than the sensory block. The influence on heart rate and blood pressure was minor and atropine and ephedrine were needed in four patients. No clinically significant ECG-changes were detected and no arrhythmias were recorded. Oxygen saturation and respiratory rate did not decrease in a clinically significant way and were not affected by concomitant morphine given i. v. postoperatively. There were few side-effects, the most frequent being mild pruritus (10/33).
Conclusion: Sameridine provided clinically adequate anesthesia for the patients receiving the doses of 15, 20 and 25 mg. Further studies are needed to evaluate the substance and it is of great interest to clinically investigate the opioid component with respect to postoperative analgesia.     

Reduction of Plasma Fibrinogen, Immunoglobulin G, and Immunoglobulin M Concentrations by Immunoadsorption Therapy with Tryptophan and Phenylalanine Adsorbents

Abstract Immunoadsorption (1A) therapy with tryptophan (TR-350) or phenylalanine (PH-350) adsorbents has been used to reduce the concentration of serum antibodies in human lymphocyte antigen (HLA)-immunized patients. Other forms of plasma purification have been reported to reduce the level of fibrinogen, which affects the blood properties. In this study we investigated the effects of IA therapy using both adsorbents on plasma fibrinogen and immunoglobulins G and M in 13 patients (8 patients were treated with TR-350, and 5 patients were treated with PH-350). During each session 1 plasma volume (2.8 ± 0.4 L of plasma) was processed through the immunocolumn and then returned to the patient together with the blood cells. Compared with the pretreatment values, the plasma fibrinogen, IgG, and IgM concentrations were significantly reduced after IA therapy (p < 0.01 for TR-350; p < 0.04 for PH-350). There was a positive correlation between the degree of reduction of plasma proteins and the number of IA treatments given. A nonpara-metric test (Wilcoxon's signed-rank test or the Mann-Whitney test) was used for statistical analysis. We conclude from our study that IA therapy effectively lowers the plasma levels of fibrinogen, IgG, and IgM and thus can be considered a valuable alternative to other blood purification methods.