Lewy体病患者损伤心肌对^123I-间碘苄胍的摄取情况：Lewy体型痴呆和帕金森病的比较

背景：^123I标记的间碘苄胍（^123I—MIBG）心肌闪烁扫描曾被用以评估Lewy体病（LBD）患者的心脏交感神经去神经支配，LBD包括帕金森病（PD）与Lewy体型痴呆（DLB）。LBD患者的心肌MIBG累积显著减少，表明患者的心脏交感神经系统严重损伤。然而，DLB和PD患者之间的闪烁扫描差异尚不确定。目的：本研究旨在对比在疾病的早期阶段采用^123I—MIBG闪烁扫描所测DLB和PD患者的心脏交感神经功能。方法：在22例早期DLB患者、41例早期原发性PD患者和15例正常对照受试者（年龄与病程与患者相匹配）中进行^123I—MIBG心肌闪烁扫描检查。计算心脏／纵隔对^123I—MIBG的摄取比（H／M）。结果：早期DLB患者心肌对^123I—MIBG的摄取明显低于对照者。DLB患者的平均H／M明显低于PD患者，并且不依赖于Hoehn和Yahr阶段。结论：本研究结果表明，DLB患者心脏交感神经功能即使在疾病的早期阶段就已经严重受损。     

A comparative study of terazosin and tamsulosin for symptomatic benign prostatic hyperplasia in Japanese patients

OBJECTIVE: To compare the efficacy and safety of an incremental-dose regimen of terazosin (1-2 mg daily) and a fixed-dose regimen of tamsulosin (0.2 mg daily), on Japanese patients with symptomatic benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: This multicentre, single-blind, randomized trial compared terazosin and tamsulosin over 4 weeks, in 61 patients with symptomatic BPH randomly assigned to terazosin (n = 31) or tamsulosin (n = 30). Terazosin 0.5 mg twice daily was administered for 2 weeks, followed by 1 mg twice daily for 2 weeks. Tamsulosin (0.2 mg) was administered once daily for 4 weeks. Symptoms were evaluated using the International Prostate Symptom Score (IPSS), and quality of life (QOL) was assessed subjectively before treatment, and again after 2 and 4 weeks of treatment. Objective measurements taken before and after the treatment period were the maximum (Qmax) and average (Qave) urinary flow rates, and the percentage residual urine volume. Improvement was defined as a 25% decrease from baseline in IPSS, > 1 point increase in QOL score, and > 2.5 mL/s increase in Qmax. Adverse reactions potentially related to the study drugs were recorded throughout the treatment period. RESULTS: Both terazosin and tamsulosin produced statistically significant improvements in subjective and objective variables. Neither treatment affected systolic or diastolic blood pressure or pulse rate. Adverse reactions were noted in four patients (three in the terazosin group and one in the tamsulosin group). However, there was no statistically significant difference in the incidence of adverse effects between the groups. CONCLUSIONS: Despite the limitations of small sample size and relatively short treatment periods, terazosin and tamsulosin were equally effective in the treatment of symptomatic BPH in Japanese patients, using relatively lower doses than those used in Western countries.     

Pheochromocytoma of the urinary bladder: a case report

We present a 66-year old female patient with pheochromocytoma of the urinary bladder. We performed transabdominal needle biopsy of the tumor without suspicion of pheochromocytoma because of her well-controlled blood pressure and no characteristic symptoms following administration of antihypertensive medication. Hypertensive crisis (260/130 mmHg) occurred just after the needle insertion. The diagnosis was pheochromocytoma. The norepinephrine level in the serum and her blood pressure normalized without antihypertensive medication after partial cystectomy. Pheochromocytoma should be suspected in cases of intramural bladder tumors, especially in a normotensive patients receiving antihypertensive medication.     

Discrimination of histamine H1 and muscarinic receptor-mediated signalling pathways by phorbol ester in human astrocytoma cells

1. Histamine H1 receptor-mediated signalling was compared with muscarinic receptor-mediated signalling in 1321N1 human astrocytoma cells. 2. Short-term (2 min) treatment of cells with phorbol 12-myristate 13-acetate (PMA) resulted in a reduction of increases in intracellular Ca2+ ([Ca2+]i) induced by carbachol or histamine. 3. Carbachol-induced increases in [Ca2+]i were 10-fold more sensitive to PMA than the histamine-induced increases. 4. When cells were treated with PMA for 48 or 72 h (long-term treatment), protein kinase C (PKC) was down-regulated and PMA did not inhibit carbachol-induced increases in [Ca2+]i. 5. Histamine-induced increases in [Ca2+]i were significantly reduced by long-term treatment with PMA. 6. These findings suggest that the signalling pathways mediated by histamine H1 and muscarinic receptors can be distinguished by using PKC in 1321N1 human astrocytoma cells.     

Phase II study of concurrent chemotherapy and radiotherapy for unresectable stage III non-small-cell lung cancer: Long-term follow-up results. Japan Clinical Oncology Group Protocol 8902

Background:Although chemoradiotherapy is standard treatment forunresectable stage III non-small-cell lung cancer (NSCLC), few long-termsurvival data exist. Patients and methods:Between October 1989 and December 1991, 74patients with histologically or cytologically proven NSCLC, unresectable stageIIIA or IIIB, were entered into this study. Seventy patients were eligible andevaluable for response, toxicity, and survival analysis. Chemotherapyconsisted of cisplatin (100 mg/m² on days 1, 29, and 57) andvindesine (3 mg/m² on days 1, 8, 29, 36, 57, and 64). Thoracicradiotherapy was administered for two weeks (2 Gy given 10 times, fivefractions per week), and after a 14-day rest period, the previous schedule ofradiotherapy was repeated for two weeks. A 10-Gy to 20-Gy dose of radiotherapywas administered during the third cycle of chemotherapy. Results:Of the 70 evaluable patients, 1 (1.4%) hada complete response (CR) and 51 (72.9%) had a partial response (PR).The median survival time was 14.8 months, and the five-year survival rate was14.8%. The major toxicity was leukopenia ( grade 3, 93%).Other toxicities grade 3 included anemia (34%),nausea/vomiting (27%), alopecia (7%), thrombocytopenia(4%), and serum creatinine elevation (1%). Treatment relateddeath occurred in two patients (2.8%). One patient died of pneumoniaand pneumothorax, and the other of hemoptysis. Conclusions:Concurrent chemotherapy and radiotherapy has thepotential to provide long-term survival with acceptable toxicities.     

Non-randomized study on the effects of preoperative radiotherapy and daily administration of low-dose cisplatin against those of radiotherapy alone for oral cancer--effects on local control, control of metastases, and overall survival

Cisplatin is a known radiation modifier. Our previous study suggested that daily administration of low-dose cisplatin enhanced the efficacy of radiotherapy against primary oral squamous carcinoma. In this paper, we follow the patients who participated in the previous study and survey the benefit of combination low-dose cisplatin in improving local control, prevention of metastases, and overall survival. This study included patients with surgically resectable advanced oral tumors. Ten patients underwent preoperative radiotherapy of 30-40 Gy/15-20 days with concomitant daily administration of low-dose cisplatin (5 mg/body or 5 mg/m2). Ten other patients received external radiotherapy alone. All patients then underwent a planned radical tumor resection. No significant difference was see in loco-regional control rates (primary: 86 vs. 88%, neck: 83 vs. 78% at 48 months) or incidence of metastasis (70 vs. 64%) between the two groups. Nor was there a significant difference in the overall survival rate (60 vs. 66%). The results of this study suggest that the concomitant use of daily administration of low-dose cisplatin with preoperative radiation brings no statistically significant benefit in improving local control and survival rate in patients with advanced resectable oral cancer.     

Clinical reevaluation of aztreonam (AZT) on urinary tract infections

The clinical effectiveness and safety of Aztreonam (AZT) were studied in 55 patients with complicated urinary tract infections. AZT was administered at a dose of 4 g/day for 5 days. The results as evaluated by the UTI criteria were excellent in 8 cases, moderate in 26 and poor in 21. The overall effectiveness rate was 61.8%. Out of 64 strains of bacteria isolated before treatment, 50 strains (78.0%) were eradicated by the treatment. Bacteriological eradication rates for gram negative rods and gram positive cocci were 79.6% and 66.7%, respectively. There were no obvious side effects, except for a temporary elevation of glutamic oxaloacetic transaminase, glutamic pyruvic transaminase alkalinephosphatase, and total bilirubin in some patients. The results indicate that AZT tablets are useful and safe for the treatment of complicated urinary tract infections.