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Naoki Yoshimura

Publications and source records attributed to Naoki Yoshimura.

At least 55 records · Page 3Linked to original sources
PubMed2005

Detrusor overactivity induced by intravesical application of adenosine 5'-triphosphate under different delivery conditions in rats.

OBJECTIVES: To investigate the effects of intravesical application of adenosine 5'-triphosphate (ATP) on bladder activity to elucidate the role of urothelial barrier function and ecto-ATPase activity in the ATP-mediated mechanism inducing detrusor overactivity. METHODS: Continuous cystometry by an intravesical catheter inserted from the bladder dome was performed in conscious female rats. RESULTS: ATP solutions adjusted to pH 6.0 did not elicit significant detrusor overactivity at a concentration of 60 mM. However, in bladders pretreated with protamine sulfate (10 mg/mL) to increase urothelial permeability, ATP solution (pH 6.0) induced detrusor overactivity by decreasing the intercontraction intervals. These irritant effects of ATP after protamine treatment were antagonized by P2X receptor antagonists, such as pyridoxal-5-phosphate-6-azophenyl-2',4'-disulfonic acid (70 micromol/kg) and 2',3'-O-(2,4,6, trinitrophenyl) ATP (30 micromol/kg). These were also suppressed in rats pretreated with systemic capsaicin (125 mg/kg subcutaneously). Alpha,beta-methylene ATP (5 mM, pH 6.0) or ATP (60 mM, pH6) after intravesical infusion of 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid (5 mM, pH 6.0), an ecto-ATPase inhibitor, induced detrusor overactivity without protamine pretreatment, but the reduction in intercontraction intervals was smaller compared with that with ATP after protamine treatment. CONCLUSIONS: Low permeability of bladder epithelium and ecto-ATPase activity can prevent ATP activation of subepithelial P2X receptors to induce bladder overactivity. Thus, enhanced penetration of endogenous ATP owing to urothelial damage may contribute to urinary frequency and bladder pain in hypersensitive bladder disorders such as interstitial cystitis.

Adenosine Triphosphatases↗
PubMed2005

Successful perinatal management of a very low birthweight infant with congenital complete atrioventricular block.

We report a very low birthweight infant with congenital complete atrioventricular block (CCAVB) who underwent delayed implantation of a permanent pacemaker without temporary pacing. The female infant was born at 30 weeks gestation and weighed 1422 g. After birth, the infant showed respiratory failure due to pleural effusion and respiratory distress syndrome at birth. The heart rate ranged between 50 and 55 bpm. The chest x-ray demonstrated dilated heart, but echocardiogram showed good systolic ventricular function. Respiratory failure was resolved after supportive treatment without temporary pacing. Mild heart failure due to low heart rate persisted, but was successfully managed by conventional heart failure therapy combined with nasal continuous positive airway pressure. She achieved a body weight gain to 1856 g at the age of 49 days and underwent implantation of a permanent pacemaker. We conclude that it is important to determine the timing of both delivery and pacemaker implantation for successful perinatal management of infants with CCAVB.

Adult↗
PubMed2005

Recent advances in the neurophysiology of stress urinary incontinence.

The purpose of this article is to highlight recent developments in the understanding of the neuropathophysiology of stress urinary incontinence (SUI). The innervation of the urethra and the role of the guarding reflex in maintaining continence will be reviewed and recent animal research regarding the physiological basis of SUI will be discussed.

Animals↗
PubMed2005

alpha1-Adrenergic mechanism in diabetic urethral dysfunction in rats.

PURPOSE: We investigated the contribution of alpha1-adrenoceptor mechanisms to urethral dysfunction associated with diabetes mellitus (DM) in rats. MATERIALS AND METHODS: Eight weeks after streptozotocin injection (65 mg/kg intraperitoneally) the effects of DM on urethral relaxation mechanisms were evaluated with subjects under urethane anesthesia by simultaneous recordings of intravesical pressure in isovolumetric conditions and urethral perfusion pressure (UPP). RESULTS: In diabetic rats the intravesical pressure thresholds for inducing urethral relaxation and the lowest urethral pressure (UPP nadir) during urethral relaxation were significantly higher by 142% and 86%, respectively, than in normal rats, while baseline UPPs were not significantly different. The mean rate of high frequency oscillations of urethral striated muscle in diabetic rats was also significantly lower by 23% than in normal rats. After alpha-bungarotoxin treatment (333 mug/kg intravenously) to eliminate striated muscle sphincter contractions the SD of baseline UPPs was significantly larger by 93% than in normal rats. Intravenous administration of terazosin (0.4 mg/kg), an alpha1-adrenoceptor antagonist, significantly decreased the UPP nadir, intravesical pressure thresholds inducing urethral relaxation and the SD by 41%, 87% and 138%, respectively, in diabetic rats but not in normal rats. In the 2 groups of animals after alpha-bungarotoxin treatment urethral relaxation during a reflex bladder contraction was inhibited by Nomega-nitro-L-arginine (40 mg/kg intravenously), a nitric oxide synthase inhibitor. CONCLUSIONS: During reflex bladder contractions streptozotocin induced diabetic rats showed smooth and striated muscle dysfunctions of the urethra. The inhibition of alpha1-adrenoceptors, which decreased the UPP nadir and UPP fluctuation, may be useful for treating urethral dysfunction in DM.

Animals↗
PubMed2005

Improvement in erectile dysfunction after neurotrophic factor gene therapy in diabetic rats.

PURPOSE: Erectile dysfunction (ED) is a common but difficult to treat complication of diabetes mellitus (DM). We have previously reported herpes simplex virus (HSV) vector mediated delivery of nerve growth factor into the bladder to treat diabetic cystopathy and neurotrophin-3 (NT3) gene transfer for pyridoxine treatment. Nerve growth factor and NT3 are neurotrophic factors that may protect nerves from mechanical and metabolic damage. We investigated the effects of HSV mediated delivery of NT3 for the treatment of diabetic ED. MATERIALS AND METHODS: Male Sprague-Dawley rats weighing 300 to 400 gm were injected with 65 mg/kg streptozotocin to induce DM. After 4 weeks 20 microl containing 5 x 10 pfu replication defective HSV vector expressing lacZ (6 rats) or NT3 (6) were injected directly into the cavernous nerve sheath with a 30 gauge needle. Four weeks later the animals underwent measurement of intracavernous pressure under electrical stimulation (20 Hz, 0.5 millisecond and 10 V) of the cavernous nerve. Staining for lacZ and neuronal nitric oxide synthase in the major pelvic ganglia was also performed. RESULTS: beta-Galactosidase staining revealed lacZ positive neurons in the major pelvic ganglia. Maximal intracavernous pressure induced by electrical stimulation showed statistically significant mean values +/- SEM of 15.1 +/- 2.1 and 43.8 +/- 11.1 cm H2O in the lacZ and NT3 vector injected groups, respectively (p = 0.03). The mean number of neuronal nitric oxide synthase positive neurons per section in the NT3 group was significantly higher than that in the lacZ control group at 3.33 +/- 0.23 and 0.64 +/- 0.14 neurons per high power field, respectively (p < 0.001). CONCLUSIONS: We report that gene therapy for the treatment of diabetic ED is feasible with HSV vectors. NT3 gene therapy may be applicable for the treatment of ED induced by DM.

Animals↗
PubMed2005

Differential effects of activation of peripheral and spinal tachykinin neurokinin(3) receptors on the micturition reflex in rats.

PURPOSE: We clarified the roles of tachykinin neurokinin (NK)3 receptors in the bladder or spinal cord for control of the micturition reflex in rats. MATERIALS AND METHODS: In female rats under urethane anesthesia repetitive bladder contractions were elicited by saline infusion into the bladder through intravesical bladder catheters. The effects of peripheral receptor activation were first examined by topical application of the tachykinin NK3 receptor agonist [MePhe]-NKB (Calbiochem, Darmstadt, Germany) in normal rats and rats pretreated with capsaicin (Sigma Chemical Co., St. Louis, Missouri) 4 days before the experiments. Subsequently the effects of spinal NK3 receptor activation were examined by intrathecal administration of [MePhe]-NKB via implanted intrathecal catheters. The effects of the tachykinin NK3 receptor antagonist SB235375 and the opioid receptor antagonist naloxone on changes in bladder activity induced by [MePhe]-NKB were also investigated. RESULTS: Topical application of [MePhe]-NKB onto the bladder surface decreased intercontraction intervals and bladder capacity, and increased baseline bladder pressure in dose dependent fashion. [MePhe]-NKB induced bladder overactivity was inhibited by simultaneous topical administration of SB235375 or by capsaicin pretreatment. In contrast, intrathecal injection of [MePhe]-NKB increased intercontraction intervals in dose dependent fashion and at a high dose it induced overflow incontinence or inefficient voiding. These inhibitory effects of [MePhe]-NKB in the spinal cord were antagonized by the intrathecal injection of SB235375 or naloxone. CONCLUSIONS: These results indicate that the tachykinin NK3 receptor mediated neural control of the micturition reflex has dual actions depending on the location of receptor activation. Activation of tachykinin NK3 receptors located in the bladder can induce bladder overactivity at least in part via the activation of capsaicin sensitive C-fiber afferents, while tachykinin NK3 receptor activation in the spinal cord can inhibit the micturition reflex through an opioid mechanism.

Acetates↗
PubMed2005

A tissue-engineered suburethral sling in an animal model of stress urinary incontinence.

OBJECTIVE: To create and evaluate the functional effects of a tissue-engineered sling in an animal model of stress urinary incontinence (SUI). MATERIALS AND METHODS: Twenty female Sprague-Dawley rats were divided into four equal groups: a control group (C) had no intervention before the leak-point pressure (LPP) was measured; a denervated group (D) had bilateral proximal sciatic nerve transection (PSNT) and periurethral dissection with no sling placed; group S had concomitant bilateral PSNT and a suburethral sling of small intestinal submucosa (SIS) placed; and group (M) had concomitant bilateral PSNT with implantation of a tissue-engineered sling. The suburethral sling was placed via a transabdominal approach with the sling sutured to the pubic bone. Tissue-engineered slings were prepared with muscle-derived cells obtained via the pre-plate technique and subsequently seeded for 2 weeks on a SIS scaffold. Suburethral slings were implanted 2 weeks before LPP testing, using the vertical-tilt method. RESULTS: Surgically placing a suburethral sling is feasible in the female rat, with few complications. LPPs from both sling groups (S and M) were not significantly different from untreated controls (C). The S, M and C groups all had significantly higher LPPs than group D. Importantly, no rat from either sling group (S and M) had signs of urinary retention. CONCLUSIONS: Placing tissue-engineered slings in an animal model of SUI resulted in LPP values that were not significantly different from those in untreated control or SIS (S) groups. These data show that incorporating muscle stem cells into SIS slings does not adversely alter the advantageous mechanical properties of the SIS sling in a model of SUI, and provide the basis for future functional studies of tissue-engineered sling materials with long-term retention.

Animals↗
PubMed2005

Elimination of rat spinal neurons expressing neurokinin 1 receptors reduces bladder overactivity and spinal c-fos expression induced by bladder irritation.

Substance P (SP) binding to neurokinin 1 receptors (NK1R) in the spinal cord reportedly plays an important role in the micturition reflex as well as in nociceptive responses. We therefore investigated the effect of ablation of NK1R-expressing neurons in the spinal cord using saporin, a ribosome-inactivating protein, conjugated with [Sar9, Met (O2)11]SP, a specific ligand of NK1R (SSP-saporin), on the micturition reflex in rats. In female Sprague-Dawley rats, SSP-saporin (1.0 or 1.5 microM) or saporin (1.5 microM) only was injected through an intrathecal catheter implanted at the L6-S1 level of the spinal cord. Three weeks after intrathecal administration of SSP-saporin, NK1R immunoreactivity in lamina I of the spinal cord was significantly reduced, but cystometric parameters in awake rats were not altered. Instillation of capsaicin (15 microM) into the bladder of normal rats induced bladder overactivity. This response to capsaicin was significantly suppressed in SSP-saporin-treated animals. SSP-saporin treatment also decreased c-fos expression in the dorsal horn of the spinal cord induced by instillation of capsaicin into the bladder. These data indicate that NK1R-expressing neurons in the superficial layer of the dorsal horn play an important role in transmission of nociceptive afferent information from the bladder to induce bladder overactivity and spinal c-fos expression elicited by bladder irritation. Toxin-induced damage of NK1R-expressing neurons in the lumbosacral spinal cord may provide an effective modality for treating overactivity and/or nociceptive responses in the bladder without affecting normal micturition.

Animals↗
PubMed2004

The role of bladder-to-urethral reflexes in urinary continence mechanisms in rats.

Urethral closure mechanisms during passive increments in intravesicular pressure (P(ves)) were investigated using microtip transducer catheters in urethane-anesthetized female rats. After a block of reflex bladder contractions by spinal cord transection at T8-T9, abruptly raising P(ves) to 20, 40, or 60 cmH(2)O for 2 min induced a bladder pressure-dependent contractile response in a restricted portion of the middle urethra (12.5-15 mm from the urethral orifice) that was abolished by cutting the pelvic nerves bilaterally. In pelvic nerve-intact rats, the bilateral transection of either the pudendal nerves, the nerves to the iliococcygeous/pubococcygeous muscles, or the hypogastric nerves significantly reduced (49-74%) the urethral reflex response induced by passive P(ves) increases, and combined transection of these three sets of nerves totally abolished the urethra-closing responses. In spinal cord-intact rats, similar urethral contractile responses were elicited during P(ves) elevation (20 or 40 cmH(2)O) and were also eliminated by bilateral pelvic nerve transection. After spinal cord and pelvic nerve transection, leak point pressures, defined as the pressure inducing fluid leakage from the urethral orifice during passive P(ves) elevation by either bladder pressure clamping in 2.5-cmH(2)O steps or direct compression of the bladder, were significantly lowered by 30-35% compared with sham-operated (spinal cord-transected and pelvic nerve-intact) rats. These results indicate that 1) passive elevation of P(ves) can elicit pelvic afferent nerve-mediated contractile reflexes in the restricted portion of the urethra mediated by activation of sympathetic and somatic nerves and 2) bladder-to-urethral reflexes induced by passive P(ves) elevation significantly contribute to the prevention of stress urinary incontinence.

Abdomen↗
PubMed2004

KW-7158 [(2S)-(+)-3,3,3-trifluoro-2-hydroxy-2-methyl-N-(5,5,10-trioxo-4,10-dihydrothieno[3,2-c][1]benzothiepin-9-yl)propanamide] enhances A-type K+ currents in neurons of the dorsal root ganglion of the adult rat.

Recent studies revealed that a new compound, KW-7158 [(2S)-(+)-3,3,3-trifluoro-2-hydroxy-2-methyl-N-(5,5,10-trioxo-4,10-dihydrothieno[3,2-c][1]benzothiepin-9-yl)propanamide], can depress the excitability of afferent pathways from the urinary bladder and reduce bladder overactivity induced by chemical irritation of the urinary tract with xylene, an agent that sensitizes capsaicin-sensitive, C-fiber afferent nerves. In the present experiments, we examined the mechanisms that might underlie the depressant effect of KW-7158 on primary afferent neurons by studying the actions of the compound on ion channels and firing in dissociated dorsal root ganglion (DRG) cells from adult rats using whole cell patch-clamp techniques. KW-7158 increased transient, A-type K+ currents at concentrations ranging from 50 nM to 1 microM (20-50% increases). Similar effects were seen in fast blue identified bladder afferent neurons. Low concentrations of KW-7158 shortened the action potential duration, produced a 5- to 10-mV hyperpolarization, and inhibited repetitive firing induced by either 4-AP (50 microM) or substance P (0.5 microM) in phasic firing DRG neurons. Above 1 microM, KW-7158 elicited a smaller enhancement of A-type K+currents and in high concentrations inhibited the currents. Tetraethylammonium (5-60 mM) and verapamil (50 microM), which block noninactivating K+ currents, did not prevent the facilitatory effects of KW-7158. High concentrations of 4-AP (5 mM) inhibited A-type K+ currents and prevented the facilitatory effect of KW-7158 on the remaining currents. These data suggest that KW-7158 enhances A-type K+ currents in DRG neurons. Because A-type K+ channels regulate afferent neuron excitability and firing properties, KW-7158 is a promising new compound for treatment of hyper-reflexic bladder conditions.

4-Aminopyridine↗
PubMed2004

A model of intrinsic sphincteric deficiency in the rat: electrocauterization.

AIMS: Intrinsic sphincteric deficiency (ISD) denotes a malfunction of the distal urethral sphincter. Our objective was to produce a durable model of ISD in the rat. METHODS: Surrounding tissues lateral to the mid-urethra were cauterized to produce sphincteric injury in 24 adult female Sprague-Dawley rats. The rats were divided into four groups of six rats each and followed for 2, 4, 6, and 16 weeks. Sphincteric function was studied by using the vertical tilt table/intravesical pressure clamp model to measure leak point pressures (LPPs). Muscle and nerve damage were assessed with hematoxylin and eosin (H&E) and anti-protein gene product (PGP) 9.5 staining, respectively. As a control, 12 rats underwent a sham operation and subsequent LPP testing at 2, 4, 6, and 16 weeks. RESULTS: The mean LPPs of the rats 2, 4, 6, and 16 weeks after cauterization were 18.7 +/- 0.8 cm H2O, 27.6 +/- 1.6 cm H2O, 24.3 +/- 1.7 cm H2O, and 19.1 +/- 2.2 cm H2O, respectively. The mean LPPs of the rats 2, 4, 6, and 16 weeks after the sham operation were 49.8 +/- 1.3 cm H2O, 51.2 +/- 1.5 cm H2O, 51.6 +/- 2.0 cm H2O, and 49.7 +/- 0.6 cm H2O, respectively. When compared to time-matched control groups, the decreased LPPs in each cauterized group were significantly lower (P < 0.001). Histological analysis showed muscle damage and fewer nerves in all cauterized groups. CONCLUSIONS: Cauterization of tissues lateral to the mid-urethra decreased LPP without affecting bladder function. This electrocauterization model produced low LPPs that, after 2 weeks, were maintained for up to 16 weeks. Histology suggests that damage to striated muscle and nerves might have contributed to the change in LPP in this model for ISD.

Animals↗
PubMed2004

Evaluation of heart fatty acid-binding protein as a rapid indicator for assessment of myocardial damage in pediatric cardiac surgery.

OBJECTIVES: Perioperative myocardial damage is a major determinant of postoperative cardiac dysfunction for congenital heart disease. Heart fatty acid-binding protein is reported to be a rapid marker of perioperative myocardial damage that peaks earlier than creatine kinase isoenzyme MB or cardiac troponin T in adults. The objective of this study was to assess the suitability of using serum concentrations of heart fatty acid-binding protein for evaluation of perioperative myocardial damage in pediatric cardiac surgery. METHODS: After institutional review board approval and informed consent, 100 children undergoing open procedures for congenital heart disease were prospectively enrolled in the study. Mean age at operation was 4.9 +/- 0.4 years. Serum concentrations of heart fatty acid-binding protein, creatine kinase isoenzyme MB, and cardiac troponin T were measured serially before operation and at 0, 1, 2, 3, and 6 hours after aortic declamping. Relationships between serum peak level of heart fatty acid-binding protein and intraoperative and postoperative clinical variables were evaluated. RESULTS: Serum heart fatty acid-binding protein reached its peak level at 1 hour after declamping in 95 patients (95%), which was significantly earlier (P <.01) than serum creatine kinase isoenzyme MB or cardiac troponin T. In addition, serum heart fatty acid-binding protein level immediately after declamping correlated strongly with serum peak heart fatty acid-binding protein level (r = 0.91, P <.01). The serum peak level of heart fatty acid-binding protein correlated with those of creatine kinase isoenzyme MB (r = 0.77, P <.01) and cardiac troponin T (r = 0.80, P <.01). In the forward stepwise multiple regression analysis, age (P <.0001), aortic crossclamp time (P <.0001), the presence of a ventriculotomy (P <.001), and the lowest hematocrit level during cardiopulmonary bypass (P <.05) were significant intraoperative variables that influenced the release of heart fatty acid-binding protein. There were significant relationships between serum peak heart fatty acid-binding protein level and postoperative inotropic support, duration of intubation, and intensive care unit stay (P <.01 for each). CONCLUSIONS: Heart fatty acid-binding protein is a rapid marker for assessment of myocardial damage and clinical outcome in pediatric cardiac surgery. In particular, serum heart fatty acid-binding protein level immediately after aortic declamping may be a potentially useful prognostic indicator of myocardial damage as well as clinical outcome in pediatric cardiac surgery.

Biomarkers↗
PubMed2004

Treatment of interstitial cystitis.

Although the symptoms of interstitial cystitis (IC)--a debilitating, chronic disease characterized by urinary urgency and frequency, and bladder and pelvic pain on bladder filling--are easily confused with those of urinary tract infections, there is an absence of an underlying infection, and antibiotic therapy is of no therapeutic benefit. Severe cases of this disorder, which affects mainly women, can have a great negative impact on the quality of life of patients because of extreme urinary frequency. The diagnosis of IC is difficult and should be based on patient history, physical examination, and cystoscopy. A large number of pharmacologic treatments have been used to treat this condition with limited success, including pentosan polysulfate, heparin, antihistamines, tricyclic antidepressants, intravesical dimethyl sulfoxide, and bacille Calmette-Guérin. Among the potentially effective new treatment modalities currently under investigation are suplatast tosilate, resiniferatoxin, botulinum toxin, and gene therapy to modulate the pain response. As knowledge of the pathogenesis of IC increases through intensified research, the ability to provide effective treatment to patients with this disease will improve.

Cystitis, Interstitial↗
PubMed2004

Tricuspid valve repair with papillary muscle shortening for severe tricuspid regurgitation in children.

We describe tricuspid valve repair using papillary muscle shortening for severe tricuspid regurgitation due to leaflet prolapse in children combined with De Vega annuloplasty. The papillary muscle was shortened until the prolapsed leaflet was at the same height as the other nonprolapsed leaflets. Although echocardiographic tricuspid regurgitation tends to increase over time, it rarely requires long-term intervention.

Abnormalities, Multiple↗
PubMed2004

Efficacy of a criterion-driven transfusion protocol in patients having pediatric cardiac surgery.

OBJECTIVES: Low-hematocrit bypass is one technique used to prevent allogeneic transfusion during cardiopulmonary bypass. The purpose of this study is to determine the efficacy of a criterion-driven transfusion protocol and the effect of low-hematocrit bypass with moderate hypothermia in pediatric cardiac surgery. METHODS: Seventy-five children who underwent cardiopulmonary bypass with low-hematocrit bypass for repair of congenital heart disease were studied. Criteria for red blood cell transfusion included anemia with a hematocrit level of less than 15% during bypass and 20% after bypass. During cardiopulmonary bypass, venous oxygen saturation, hematocrit values, and regional cerebral oxygenation were continuously monitored. Arterial lactate levels were measured postoperatively. RESULTS: All patients had an uncomplicated perioperative course, and no perioperative death occurred. Twenty-two patients (29.3%) received a transfusion, and 53 (70.7%) patients did not. The hematocrit levels before and after modified ultrafiltration in the transfused group (21.6 +/- 5.5%, 26.6 +/- 6.5%) were significantly higher than those in the nontransfused group (18.9 +/- 3.7%, 23.1 +/- 4.1%) (P <.05). There was no significant difference between the group's arterial lactate levels immediately after admission to the intensive care unit and 1 day after the operation. The arterial lactate levels 6 hours after the admission to the intensive care unit for the nontransfused patients were higher than with the transfused patients (4.3 +/- 3.0 versus 2.5 +/- 1.5 mmol/L, (P <.05). For arterial lactate level, the relation with patients' weight had the highest correlation (R = 0.678, P <.0001). CONCLUSIONS: A criterion-driven transfusion program can be effective, and low-hematocrit bypass with a hematocrit value below 20% may affect lactate production or clearance from the body.

Adolescent↗
PubMed2004

Selective granulocyte and monocyte adsorptive apheresis as a first-line treatment for steroid naïve patients with active ulcerative colitis: a prospective uncontrolled study.

Corticosteroid therapy of ulcerative colitis (UC) is associated with frequent adverse side effects and poor quality of life. Recently, adsorptive granulocyte and monocyte/macrophage apheresis has shown efficacy in patients with severe steroid refractory UC. The objective of this study was to investigate if, instead of corticosteroids, adsorptive leukocytapheresis has efficacy as the first-line therapy for steroid-naïve patients with active UC. Twenty patients, aged 15-49 years, with a mean clinical activity index (CAI) of 8.6 were recruited. Adsorptive leukocytapheresis was done with Adacolumn, which contains cellulose acetate beads as adsorptive carriers for granulocytes and monocytes (FcgammaR and complement receptors expressing leukocytes). Each patient received 6 to 10 leukocytapheresis sessions of 60-min duration, at 2 sessions/week. Efficacy was assessed 1 week after the last session. Post treatment, the mean CAI was 3.0 (P = 0001), and 17 of 20 patients (85%) were in remission. There were significant falls in C-reactive protein (P = 0.0003), total white cell counts (P = 0.003), neutrophils (P = 0.0029), and monocytes (P = 0.0038), an increase in lymphocytes (P = 0.001), and increases in the blood levels of soluble TNF-alpha receptors I (P = 0.0007) and II (P = 0.0045) in the column outflow (blood return to the patients). Further, at 8 months, 60% of patients had maintained their remission. No severe side effects were reported. In conclusion, adsorptive leukocytapheresis should reduce corticosteroid therapy in patients with moderate UC; cases with early-stage active disease may benefit most.

Adolescent↗