Steroid pulse therapy impaired endothelial function while increasing plasma high molecule adiponectin concentration in patients with IgA nephropathy.

BACKGROUND: Decreased plasma adiponectin is associated with impaired endothelial function and, thereby, increased risk for cardiovascular events. Glucocorticoid (GC) affects vascular endothelial cells either favourably or harmfully depending upon the dosages and duration. We examined the effect of GC pulse therapy on vascular endothelial function. METHODS: Fourteen young patients with IgA nephropathy were evaluated for flow-mediated vasodilation (FMD), plasma levels of adiponectin both in high molecular weight (HMW adiponectin) form and in single molecular form (total adiponectin), hepatocyte growth factor (HGF), asymmetric dimethylarginine (ADMA), and high-sensitive C-reactive protein, before and after a course of GC pulse therapy. RESULTS: GC pulse therapy significantly decreased FMD (from 7.2 +/- 2.6 to 5.7 +/- 2.5%, P < 0.01). Meanwhile, plasma adiponectin levels were significantly augmented (total adiponectin: from 10.2 +/- 4.0 to 12.1 +/- 6.3 microg/ml, P < 0.05; HMW: from 6.5 +/- 3.2 to 7.7 +/- 3.3 microg/ml, P < 0.05). In parallel, elevated concentrations of serum HGF (from 0.28 +/- 0.12 to 0.63 +/- 0.38 ng/ml, P < 0.01) and plasma ADMA (from 0.45 +/- 0.07 to 0.53 +/- 0.04 nmol/ml, P < 0.05) were observed. CONCLUSIONS: GC pulse therapy impaired endothelial function while increasing plasma adiponectin levels, which may in turn restore the endothelial function in patients with IgA nephropathy.     

Correction to: Efficient photodynamic therapy against drug-resistant prostate cancer using replication-deficient virus particles and talaporfin sodium

Lasers in Medical Science - After publication of this paper, the authors determined an error in Fig.&nbsp;1.     

p53 negativity, CDC25B positivity, and metallothionein negativity are predictors of a response of esophageal squamous cell carcinoma to chemoradiotherapy

AIM: Esophageal squamous cell carcinoma is generally sensitive to chemoradiotherapy (CRT), but some cases are not. Using a retrospective analysis, we aimed to identify the predictors of the response by esophageal squamous cell carcinoma to definitive CRT. METHODS: The intensities of expression of,p53, Ki67, Bcl-2, Bax, cyclin D1, VEGF, CDC25B, and metalbthionein (MT) were evaluated immunohistochemically in the bfopsy specimens obtained before CRT, and the intensities of their expression were tested for correlations with the clinical effects of CRT. RESULTS: The esophageal squamous cell carcinomas with negative p53, positive CDC25B, and negative MT expression were found to be significantly more sensitive to CRT. In addition, p53 positivity and CDC25B positivity respomd well to CRT. CONCLUSION: Esophageal squamous cell carcinomas with negative p53,positive CDC25B, and negative MT expressions respond well to CRT. Even with p53 positivity, if with CDC25B positivity, CRT can be expected.     

Reductive effect of hot-water extracts from woody ear (Auricularia auricula-judae Quel.) on food intake and blood glucose concentration in genetically diabetic KK-Ay mice

Genetically diabetic (type II) KK-Ay mice, male and 5 wk of age, were divided into four groups and fed test diets containing 2 (2F), 5 (5F), 10 (10F), or 20 (20F)% fat for 4 wk, and then the 5F group and one-half of the 20F group continued to be fed the corresponding diet and the other half of the latter group was given the 20F (20FHWE) diet with 5% hot-water extracts (HWE) from woody ear (Auricularia auricula-judae Quel.) for a further 3 wk. Remarkable changes in body weight were unfound among the dietary groups. The food intake generally decreased according to the increase in dietary fat content, but the energy expenditure was hardly different among the dietary groups except for the 20FHWE group. That of the 20FHWE group was further decreased compared to the 20F group. Water consumption dropped in the order of the 20F, 5F, and 20FHWE groups. The plasma glucose concentration was the highest in the 20F group, followed in order by the 10F and 5F groups, and the lowest in the 2F and 20FHWE groups. The contents of dietary fat were most positively correlated with the plasma glucose level. The present results using KK-Ay mice confirm that dietary fat levels control postprandial glycaemia, and suggest that the hypoglycemic effect of HWE is primarily caused by a reduction in food ingestion.     

Life-threatening veno-occlusive disease after living-related liver transplantation

Veno-occlusive disease (VOD) can develop in association with the administration of cytotoxic chemotherapeutic agents and irradiation. In solid-organ transplant settings, azathioprine has been implicated as a predisposing factor. VOD with fatal outcome occurred in a post liver-transplant recipient who had never been exposed to any agents that have the potential to induce VOD. At onset, the disease manifested clinically as gross ascites and progressive jaundice and was observed after clinically diagnosed acute graft rejection. The disease was confirmed by histologic examinations. Histologic studies of biopsy samples from this patient revealed that most small hepatic veins less than 300 microm in diameter were affected, exhibiting concentric intimal thickening with sparse inflammatory cells. A few of the hepatic veins exhibited active endotheliitis with occasional extension of inflammation to neighboring centrilobular areas. Despite intensified immunosuppression, the observed fibrous obliterative changes were irreversible. Although the cause of VOD in this patient is tentative, the damage to the endothelium, associated with acute rejection, is likely to be attributable. VOD deserves recognition as one of the causes for liver dysfunction and persistent ascites after liver transplantation.     

Ruptured Dissecting Aneurysm in Bilateral Iliac Arteries Caused by Ehlers-Danlos Syndrome Type IV: Report of a Case

Ehlers-Danlos syndrome (EDS) is an inherited disorder of connective tissue characterized by hyperextensible skin, hypermobile joints, and ab-normalities of the cardiovascular system. Ten types and several subtypes of EDS have so far been recognized based on genetic, clinical, and biochemical characteristics. The spectrum of the disorder varies from mild to life-threatening vascular complications. EDS type IV is a particularly dangerous form with a lethal spontaneous rupture of the major arteries and aneurysmal formation. We present herein a case of a ruptured dissecting aneurysm in the bilateral iliac arteries caused by EDS type IV. A previously healthy 33-year-old man without any physical features of this connective tissue disorder experienced a metachronous vascular rupture two times. Successful synthetic bypass grafting was performed with great difficulty. The diagnosis of EDS type IV was made afterwards based on an electrophoresis analysis of a skin biopsy specimen which revealed a lack of type III collagen. Surgical intervention in cases of arterial complications in EDS type IV patients have been reported to be both difficult and frequently unsuccessful. The early clinical recognition of this syndrome is therefore of great importance due to the hazards of such surgical therapies. Received: November 16, 1999 / Accepted: July 25, 2000     

Changes in the localization of ileal P-glycoprotein induced by intestinal ischemia/reperfusion

P-glycoprotein is one of the most important transporters in the ATP binding cassette transporter. Moreover, it is well known that the efficacy of immunosuppressants, which are used after organ transplantation, is controlled by P-glycoprotein (P-gp). We investigated how ischemia/reperfusion (I/R), which occurs after transplantation, influences the expression level and function of P-gp. To clarify the influence of intestinal I/R on the localization of P-gp, an intestinal ischemia model was produced using a spring scale and surgical sutures for 1 h, followed by reperfusion for 24 h. The expression levels of mRNA and protein of P-gp were examined. The protein expression levels of P-gp in ileal homogenate and the brush border membrane (BBM) were significantly decreased until 3 h after reperfusion. While the protein expression level of P-gp in homogenate showed a tendency to increase, that in the BBM continued to significantly decrease until 24 h after reperfusion. In contrast, the protein expression level of P-gp in the basolateral membrane (BLM) increased significantly until 24 h after reperfusion. While no significant change in multidrug resistance (mdr)-1a mRNA was found, the levels of mdr-1b and mdr-2 significantly increased during intestinal I/R. In addition, the levels of inflammatory cytokines mRNA and nitric oxide (NO) also significantly increased. It was shown that mdr-1b and mdr-2 mRNA strongly participate in the recovery of P-gp protein level after intestinal I/R. We detected the abnormal localization of P-gp in the ileal membrane during intestinal I/R, suggesting NO and/or inflammatory cytokines participate in the abnormal localization of P-gp.     

Focal nodular hyperplasia of the liver: A patient with two concurrent lesions that manifested different behavior on radiographic imaging tests

Focal nodular hyperplasia (FNH) of the liver is a relatively uncommon pathology, with only 68 cases having been documented to date in Japan. Here, we describe an interesting case; the patient had two concurrent lesions of FNH in segments three (S3) and five (S5), respectively. The two lesions differed from each other in their behavior on various radiographic imagings, i.e., computed tomography, magnetic resonance imaging, and hepatic angiography, leading to a misdiagnosis of hepatocellular carcinoma for the S3 lesion. The patient underwent left lateral hepatic resection, along with excision of the S5 lesion. Histological examination confirmed that these two lesions were FNH. Retrospective assessment of the correlation between the radiographic imagings and the morphological architecture suggested that the architectural differences between the two lesions (i.e., that, in the S3 lesion, the central scar was more developed than in the S5 lesion and was more prominent in the periphery than in the central area of the lesion) had contributed to the misdiagnosis.