Comparison of intravesical prostatic protrusion, prostate volume and serum prostatic-specific antigen in the evaluation of bladder outlet obstruction

AIM: The aims of this study were to define the relationship between intravesical prostatic protrusion (IPP), prostate-specific antigen (PSA) and prostate volume (PV) and to determine which one of them is the best predictor of bladder outlet obstruction (BOO) due to benign prostatic enlargement. METHODS: A prospective study of 114 male patients older than 50 years examined between November 2001 and 2002 was performed. They were evaluated with digital rectal examination, International Prostate Symptoms Score, PSA, uroflowmetry, postvoid residual urine measurement, IPP and PV using transabdominal ultrasound scan. Statistical analysis included scatter plot with Spearman's correlation coefficients and nominal logistic regression RESULTS: Prostate volume, IPP and PSA showed parallel correlation. Although all three indices had good correlation with BOO index, IPP was the best. The Spearman rho correlation coefficients were 0.314, 0.408 and 0.507 for PV, PSA and IPP, respectively. Using receiver-operator characteristic curves, the areas under the curve for PV, PSA and IPP were 0.637, 0.703 and 0.772, respectively. The positive predictive values of PV, PSA and IPP were 65%, 68% and 72%, respectively. Using a nominal regression model, IPP remained the most significant independent index to determine BOO. CONCLUSIONS: All three non-invasive indices correlate with one another. The study showed that IPP is a better predictor for BOO than PSA or PV.     

Trihexyphenidyl Enhances Physostigmine Prophylaxis against Soman Poisoning in Guinea Pigs

Trihexyphenidyl Enhances Physostigmine Prophylaxis against SomanPoisoning in Guinea Pigs. LIM, D. K., HOSFCINS, B., and Ho,I. K. (1991). Fundam. Appl. Toxicol. 16, 482–489. Theprotective effects of simultaneous and continuous administrationof physostigmine and trihexyphenidyl against soman-induced toxicitywere studied in guinea pigs. Not only did trihexyphenidyl reducephysostigmine-induced toxicity when it was administered continuouslyto the animals along with physostigmine, the combination affordedgreater protection from soman lethality than did either agentadministered alone. The combination pretreatment also gave betterprotection against soman-induced body weight loss and decreasedwater consumption and attenuated the down-regulation of cholinergicreceptors which occurred when physostigmine alone was used.The onsets of other soman-induced toxicity signs were delayedsignificantly by the combination pretreatment regimen. Theseresults suggest that simultaneous administration of the combinationof physostigmine and trihexyphenidyl may be more useful thanphysostigmine alone as prophylaxis against soman poisoning.     

Clinical investigation of hearing loss in the elderly*

The prevalence of hearing loss increases with age. Epidemiological and histopathological studies relating hearing loss to age are reviewed and clinical evidence presented suggesting that hearing loss is due not only to age but also to disease processes known to be associated with hearing threshold deterioration. 80 elderly patients presenting with a hearing problem at hospital have been studied and compared with 287 ‘non-complainers’. 83% of the study group were found to have factors, additional to age, contributing to their hearing loss; 50% had a medical condition previously unrecognized; 30% were taking potentially ototoxic drugs. Audiometric measurements indicate that hearing thresholds of the elderly are influenced by numerous disease processes. Patients attending hospital with hearing impairment are at greater risk of having a vascular or biochemical abnormality than a group of elderly ‘non-complainers’. Elderly patients presenting with hearing loss should therefore be adequately investigated before being labelled as having presbyacusis.     

直接冠状动脉内支架术在急性冠状动脉综合征中的应用

目的　探讨急性冠状动脉综合征 (ACS)患者直接冠状动脉支架术治疗的可行性和安全性。方法　选择 ACS患者 6 8例 ,依据冠状动脉造影的结果采取直接支架术。用定量冠状动脉造影分析支架术前和术后即刻的造影结果 ,并随访观察术后近期临床疗效。结果　直接支架置入术成功率为 94 .1%。其中不稳定型心绞痛者成功率为96 .0 % ,急性心肌梗死成功率 88.9%。支架术后血管狭窄程度较术前明显减轻。慢复流的发生率为 7.8%。未发生与介入操作相关的严重并发症。术后近期随访无严重心血管事件发生。结论　对经选择的 ACS患者采取直接支架术治疗成功率高 ,并发症低 ,可以取得较满意的近期临床疗效     

Takayasu arteritis: burnt out or not?

We report a case of a 57‐year‐old woman with Takayasu arteritis. She had a long history of poorly controlled hypertension and now suffers from severe ischemic cardiomyopathy and lower limb claudication. She did not receive immunosuppressive treatment as there were no signs of inflammation clinically or biochemically. Inspite of the latter, her symptoms have progressed. This case highlights the importance of improved modes of detecting inflammation as well as the need for strict management of vascular risk factors to control atherosclerosis, which has an increased incidence in patients with Takayasu arteritis.