In vitro production of bilirubin photoisomers by light irradiation using neoBLUE

BACKGROUND: The light-emitting diode is used as one of the new light sources for phototherapy. NeoBLUE (Atom Medical, Tokyo, Japan) incorporates blue light-emitting diodes for the treatment of neonatal hyperbilirubinemia. The authors compared the in vitro efficacy of neoBLUE with conventional phototherapy devices. METHODS: The three light devices used included neoBLUE and two conventional phototherapy devices with six blue-white (BW) or six green (GR) fluorescent tubes. A bilirubin/human serum albumin solution (15 mg/dL) in 200 x 300 mm elliptical bag was irradiated with each three light device. The average light intensity of neoBLUE, BW and GR was 22.5, 10.2 and 2.6 microW/cm(2) per nm, respectively, for the irradiated area. Bilirubin photoisomers and native bilirubin were measured by high-performance liquid chromatography. RESULTS: In neoBLUE, BW and GR, the respective production rate of cyclobilirubin was 6.0, 3.7 and 3.9 x 10(-2) mg/dL/min, and the respective (4Z, 15E)-bilirubin/(4Z, 15Z)-bilirubin ratio after irradiation was 0.44, 0.33 and 0.12; the (4Z, 15Z)-bilirubin reduction rate at 20 min after irradiation was 60, 68 and 82%, respectively. The reduction rate of (4Z, 15Z)-bilirubin correlated with the (4Z, 15E)-bilirubin/(4Z, 15Z)-bilirubin ratio. CONCLUSION: Phototherapy using the neoBLUE under high level may be clinically more effective than therapy using the conventional light source from the results of the production rate of cyclobilirubin.     

Probucol inhibits intercellular adhesion molecule-1 expression on cultured rat mesangial cells

SUMMARY: Interleukin-1 (IL-1) has been reported to participate in the progression of glomerulonephritis by, in part, up-regulating intercellular adhesion molecule-1 (ICAM-1) expression in experimental glomerulonephritis. In the present study, we examined whether probucol, an antihyperlipidemic agent, inhibited IL-1-induced inflammatory processes in mesangial cells in culture. Northern blot analysis demonstrated that 200 U/mL IL-1 up-regulated ICAM-1 messenger RNA (mRNA) expression with its peak at 4-6 h after stimulation. Ten μg/mL lipopolysaccharide (LPS), a stimulant to release IL-1 from mesangial cells, induced ICAM-1 mRNA expression by five-fold within 6 h and 10 μg/mL probucol notably reduced this induction. Immunoblotting also confirmed that LPS increased ICAM-1 protein by two-fold within 24 h and probucol inhibited this increase. IL-1 receptor antagonist (IL-1ra; 1–100 ng/mL) suppressed LPS-induced ICAM-1 mRNA expression in a dose-dependent manner and 100 ng/mL IL-1ra completely inhibited ICAM-1 induction, indicating that LPS increased ICAM-1 expression through the action of secreted IL-1. Interleukin-1 activity in culture media, measured by thymocyte proliferation assay, was significantly enhanced by LPS and inhibited by probucol. However, neither LPS nor probucol substantially affected IL-1 mRNA expression, suggesting that the IL-1 activity might be regulated at post-translational level. These results suggest that probucol may act as an anti-inflammatory drug by suppressing IL-1 activity from mesangial cells in the progression of glomerulonephritis.     

New therapeutic strategies of molecular intervention in glomerulonephritis

Summary: Recent progress of genetic engineering allows us to create animal models expressing the new genetic phenotype and also indicates a sure future for clinical use of gene therapy. We applied HVJ-liposome method for manipulation of transforming growth factor (TGF)-β gene expression in anti-Thy-1 experimental glomerulonephritis. Either the glomerular introduction of TGF-β antisense oligodeoxynucleotides or transfection of gene for decorin, a natural inhibitor of TGF-β, into the skeletal muscle could suppress the extracellular matrix (ECM) expansion in glomerulonephritis. Thus, these results may suggest the potential of gene therapy as a novel treatment for fibrotic diseases caused by TGF-β.     

A clinicopathological study of adult Japanese IgA nephropathy patients: Early stage cases and cases with exacerbation

Summary: Most cases of adult type IgA nephropathy (IgAN) have an insidious onset and asymptomatic course. However, some patients reveal recurrent macroscopic haematuria following episodes of respiratory or urinary tract infections. In order to clarify the correlation between clinical features and histological alterations or prognosis, 42 cases of early stage IgAN and 40 cases with acute exacerbation episodes were investigated and compared with a control group. Early stage cases were defined as having had a renal biopsy within 1 year after the first detection of urinary abnormalities, and had normal urinary findings within the 12 months before the first detection of urinary abnormalities. Acute exacerbation cases were defined as macroscopic haematuria or worsening of urinary abnormalities after acute infectious episodes and undergoing a renal biopsy within 120 days after the onset of these episodes. the early stage cases had better renal function and lower systolic and diastolic blood pressure than that of control group. They also showed milder changes in mesangial cell proliferation, mesangial matrix increase, totally sclerotic glomeruli, and tubulo-interstitial changes. However, it is important to note that glomerular and interstitial sclerotic changes were observed even in early stage cases. Endothelial detachment was noticed more frequently in the early stage cases. Acute exacerbation cases revealed lesions of endocapillary proliferation, mesangiolysis and endothelial detachment more frequently, although these changes were segmental in each glomerulus. There was no statistical difference in disease prognosis between cases with and without acute exacerbation. These data indicated that there are characteristic histological changes in early stage cases and acute exacerbation cases of IgAN.     

A Case of Early Gastric Carcinoma with Lymphoid Stroma: Diagnostic Usefulness of Endosonography

Abstract: A case of early gastric carcinoma with lymphoid stroma (GCLS) showing features of submucosal tumor is reported here. A characteristic endoscopic ultrasonographic (EUS) finding was helpful for preoperative diagnosis. The patient, a 75-year-old woman without any previous complaints, visited our hospital for detailed examination of a small gastric lesion. Upper Gl studies revealed a submucosal tumor-like lesion measuring about 1.8 cm with a central slight depression on the greater curvature of the middle gastric body. Histologic findings of the specimens obtained by conventional biopsy indicated a poorly differentiated adenocarcinoma, although the possibility of malignant lymphoma was not completely ruled out. EUS examination was, therefore, performed in order to obtain further detailed information about the tumor. EUS disclosed that the tumor, which existed in the third layer, was composed of many small round clustered lesions, the echogenicity of which was lower than that of the muscle layer, and was almost covered with a normal mucosal layer. Taking these findings into consideration, a gastric cancer with lymphoid stroma whose invasion would be limited within the submucosa was highly suspected. It was proven by histological analysis of a surgically resected specimen that this peculiar multiple small round hypoechoic lesion was equivalent to the lymphoid aggregates infiltrating the GCLS. Since it has been reported that the prognosis of GCLS is better than that of common gastric cancers, accurate diagnosis is important for the selection of optimal treatment. While it is still not definitively proven that EUS is useful for diagnosis of GCLS, this procedure may potentially provide an excellent image of this special tumor and be of use for preoperative diagnosis.     

Analysis of the articulation after glossectomy

Rehabilitation of the oral cancer patient should aim to achieve not only morphological restoration but also post-operative functions. However, there are few reports describing quantitative evaluation of the latter. The authors have attempted quantitative evaluation of post-operative articulatory function after glossectomy, and report the evaluation of it by speech intelligibility, electropalatography (EPG), and acoustical analysis. Subjects were five directly sutured patients and five patients reconstructed with forearm flap, all after glossectomy. The target syllable was /ta/ from among speech intelligibility test samples. The speech intelligibility and acoustical analysis were investigated pre-operation, and 1, 6 and 12 months post-operation. EPG data were collected by DP-01(RION) at 6 months post-operation. Acoustical analyses were carried out by consonant frequency characteristics and formant variance from consonant to vowel transitions. As a result, subjects reconstructed with a forearm flap showed higher restorative tendency than directly sutured subjects. Articulatory characteristics expected from acoustical analysis were more in agreement with the results of EPG than with the results of the speech intelligibility test. From the results, it was suggested that the acoustical analysis used for this research could reveal changes in articulatory movement and will be useful for quantitatively evaluating post-operative articulatory functions.     

Prevalence of prostatitis-like symptoms in Japanese men: Population-based study in a town in Hokkaido

AIM: To determine the prevalence of prostatitis-like symptoms in Japanese men living in one town. METHODS: A cross-sectional and population-based study was performed in a town that had 6385 men aged from 20 to 79 years. We sent two questionnaires, the validated Japanese version of the National Institutes of Health Chronic Prostatitis Symptom Index and the International Prostate Symptom Score (I-PSS) with questions about individual medical information, to 1424 randomly selected community-indwelling men. Subjects were defined as having prostatitis-like symptoms if they complained of perineal and/or ejaculatory pain or discomfort and their total pain score was four or greater. RESULTS: A total of 512 men (36%) responded completely to the questionnaires. Of the 512 responders, 25 men (4.9%) were identified as having prostatitis-like symptoms. Prevalence of symptoms was the same in men aged younger than 50 years (5.0%) as those 50 years and older (4.8%). The I-PSS score was 10.8 in men with prostatitis-like symptoms, which was higher than in those without symptoms. CONCLUSIONS: Prevalence of prostatitis-like symptoms was 4.9% in randomly selected men. International comparison of prevalence of the symptoms may contribute to further understanding of chronic prostatitis.