Percentage of urinary albumin excretion and serum-free light-chain reduction are important determinants of renal response in myeloma patients with moderate to severe renal impairment.

Reversal of renal dysfunction significantly affects the prognosis of multiple myeloma (MM) with renal impairment (RI). There is no reliable test for predicting reversibility of RI in MM patients. We postulated that MM with high albuminuria may reflect glomerular disease that is difficult to reverse. Here, we examined the impact of urinary albumin excretion. We retrospectively analyzed 279 patients admitted to our hospital from April 2000 to December 2013. Clinical variables and laboratory data that may affect myeloma treatment response were extracted. The results were examined for relationship to renal response by univariate and multivariate analysis. RI (estimated glomerular filtration rate ≦50 ml/min per 1.73 m(2)) was observed in 116 patients (46%) and renal responses of renal complete response, renal partial response, renal minor response and no response were obtained in 46 (40%), 15 (13%), 13 (11%) and 42 (36%) patients, respectively. Although renal recovery was significantly associated with Durie-Salmon 1 or 2 (P=0.02), myeloma response better than very good partial response (P=0.03), involved free light-chain (iFLC) reduction from baseline 80% at day 12 (P=0.005), ≧95% at day 21 (P<0.001) and urinary albumin ≦25% on admission (P<0.001) on univariate analysis, only reduction of iFLC 95% at day 21 (P=0.015) and urinary albumin ≦25% (P=0.007) remained significant for any renal response. Our observation indicates that increased urinary albumin excretion >25% and reduction of iFLC ≦95% on day 21 were associated with favorable renal recovery in MM patients with RI, and were considered as negative predictors for renal response.

Bacterial loads of Ureaplasma urealyticum contribute to development of urethritis in men.

Ureaplasma urealyticum could be a pathogen of non-gonococcal urethritis (NGU) in men. However, ureaplasma is often detected in men without NGU, and the proportion of cases possibly attributable to this pathogen is still undefined. We attempted to determine the bacterial loads of U. urealyticum significantly associated with NGU. The 16S rRNA genes of U. urealyticum were quantified by a real-time polymerase chain reaction-based assay in first-void urine (FVU) from 26 asymptomatic and 25 symptomatic men positive for U. urealyticum. The leucocyte counts in first-void urine (FVU) were determined as an objective measure of inflammatory response to ureaplasma in the hosts by automated quantitative urine particle analysis. Positive correlations were observed between copies of the 16S rRNA genes of U. urealyticum per ml and the leucocyte counts per µl in FVU (r = 0.49, p = 0.0003). Loads of ≥10(4) copies of the 16S rRNA gene of U. urealyticum/ml, corresponding to ≥5 × 10(3) cells of U. urealyticum/ml in FVU, were significantly associated with the presence of urethritis symptoms (p < 0.0001) and with higher leukocyte counts in FVU (p < 0.0001). The bacterial load of U. urealyticum, possibly of ≥5 × 10(3) cells of U. urealyticum/ml in FVU, could be significantly associated with the development of symptomatic NGU.

Mesenteric transection decreases expression of interstitial cells of Cajal in an experimental model.

BACKGROUND: After anterior resection for rectal carcinoma patients often complain of defaecatory dysfunction. The aim of this study was to examine the number of interstitial cells of Cajal (ICCs) and ganglion cells in the distal colon partially denervated by mesenteric transection in a rat model. METHODS: Four groups of rats were operated on, a control group and three experimental groups, with increasing degree of mesenteric transection to denervate the distal colon. Animals were killed after 3 months, and the denervated colon was investigated using immunohistochemistry with Kit and protein gene product 9.5 antibodies to detect ICCs and ganglion cells respectively. Reverse transcriptase-polymerase chain reaction for c-kit and histomorphometry of muscular thickness were performed. RESULTS: The total number of ICCs was significantly lower in the three operated models than in the control, particularly in the histological layers of the myenteric plexus and submucosal border. There was no difference in the number of ganglion cells or changes in muscular thickness between the models. CONCLUSION: The number of ICCs in rat distal colon denervated by mesenteric transection is decreased at 3 months after surgery.

Slug expression is an independent prognostic parameter for poor survival in colorectal carcinoma patients.

Slug, a member of the Snail family of transcription factors, plays a crucial role in the regulation of epithelial-mesenchymal transition (EMT) by suppressing several epithelial markers and adhesion molecules including E-cadherin. Recently, several studies have reported Slug to be expressed in breast carcinoma, oesophageal carcinoma accompanied with shorter survival. In this study, we first investigated expression of Slug mRNA in five colorectal carcinoma cell lines by reverse transcription-polymerase chain reaction. Furthermore, we investigated Slug and E-cadherin expression by immunohistochemistry in 138 patients with colorectal carcinoma. Slug mRNA was clearly expressed in four out of five colorectal carcinoma cell lines. Positive expression of Slug and E-cadherin was observed in 37 and 58% of cases, respectively. The positive expression of Slug was significantly associated with Dukes stage and distant metastasis (P = 0.0027 and 0.0007), and the positive expression of Slug had a significant impact on patient overall survival (P < 0.0001, log-rank test). Moreover, patients with positive expression of Slug and reduced expression of E-cadherin showed the worst prognosis (P < 0.0001, log-rank test). Multivariate analysis indicated that Slug expression was an independent prognostic factor. These results suggest that positive Slug expression in colorectal carcinoma patients may become a significant parameter of poor prognosis.

Relevance of abdominal gas analysis and transit study after colorectal cancer surgery.

BACKGROUND: Colon gas volume analysis using abdominal radiographs is an objective and reproducible method for evaluating functional bowel disorders. The aim of this study was to clarify the relevance of colon gas distribution and transit time in rectosigmoid cancer patients after surgery. METHODS: Segmental colon gas volume score was calculated using plain abdominal radiography and evaluated in 40 patients who had undergone sphincter-saving resection. Segmental colonic transit time was analysed using radiopaque markers in the same patients. RESULTS: Transit times in the right colon (RCT) were 15.3 +/- 1.1 h and in the left colon (LCT) 11.2 +/- 1.1 h. Gas volume scores in the RCS and LCS were 1.10 +/- 0.13% and 1.06 +/- 0.14%, respectively. Neither colonic transit time nor colon gas volume score correlated with the operation methods for rectosigmoid colon cancer. A positive correlation of RCS and a negative correlation of LCS/RCS with ageing were noted in male patients but not in female patients. There was no correlation between RCT and RCS (r = 0.028); however, LCT correlated with LCS (r = 0.318, P < 0.05). The ratio of colonic transit time (LCT/RCT) was 0.84 +/- 0.10, while that of colon gas volume score (LCS/RCS) was 1.29 +/- 0.21. There was a significant correlation between LCT/RCT and LCS/RCS (r = 0.541, P < 0.001). CONCLUSIONS: Analysis of colon gas volume is useful for evaluating colonic transit time in rectosigmoid cancer patients after sphincter-saving surgery.

[Theoretical impedance analysis of the intact rat lens with an ellipsoidal shells model].

We measured a.c. admittances for isolated rat lenses over a wide frequency range of 100 Hz to 500 MHz. In order to evade electrode polarization at low frequencies, we examined extracted lenses by direct semi-squeezing with Pt black-coated platinum electrodes. This gave rise to a 10(6) increment in permittivity at low frequencies, and two distinct dielectric dispersions were exhibited; dispersion 1 with a characteristic frequency (fc) of 2 kHz, and dispersion 2 with an fc of 2 MHz. In terms of loss tangent function, the two dispersions clearly dominated as two peaks. By curve fitting analysis with an allocated ellipsoidal-shells model based on ultrastructural features of the lens with a lens equivalent circuit, dispersion 1 was assigned to the equatorial cortex where regularly arranged lens fibers ran parallel to the applied electric field, and dispersion 2 to the nucleus of complicated fibers, combined with the polar cortex where lens fibers ran perpendicular to the electric field. Our results suggested that both lens dispersions were beta-dispersions attributable to bio-membranes.

[Dielectric behavior of rat lens and changes due to cold cataract].

To correlate the formation of cold cataract with changes in the passive electrical properties of the lens, we measured impedances of isolated rat lenses in the frequency range from 100 Hz to 500 MHz. Temperature-dependent, reversible changes were confirmed in the dielectric behavior as well as in the histological characteristics. The impedance of lenses showed two separate peaks (i.e. P1 and P2) when expressed in terms of loss tangent. At a low temperature of 4 degrees C, cytoplasmic "aggregates" characteristic of the cold cataract were formed inside the fiber cells of young rats with concomitant decreases in P2 (the peak value at higher frequencies), whereas no remarkable changes occurred in the control group. These results indicate that the lowering of P2 may reflect functional changes in the lens fiber membrane, an augmented heterogeneity in cytoplasm and/or decreases of protein-bound water. We conclude that the P2 is a useful dielectric index for the assessment of the nuclear opacity. This is the first report on the application of dielectric techniques to lenses with nuclear cataract. We suggest that dielectric spectroscopy may be applicable to a quantitative evaluation of cataract, not only of the cortical type but also of the nuclear type.