An elderly patient with advanced non-small-cell lung cancer that responded remarkably to combination chemotherapy of vinorelbine and gemcitabine

A 73-year-old man was admitted to our hospital because of hemoptysis in November 1999. A chest CT revealed a mass shadow in the right upper lobe and enlarged hilar and pretracheal lymph nodes. Bone scintigraphy showed a bone metastasis in right middle rib. He was treated with vinorelbine (25 mg/m2 days 1,8) and gemcitabine (800 mg/m2 days 1,8) every 3 weeks from December 1999. After 4 courses of chemotherapy, the primary tumor and hilar lymph node were remarkably reduced in size, and his hemoptysis disappeared and body weight increased. It is suggested that combination chemotherapy with vinorelbine and gemcitabine is effective for elderly patients with non-small-cell lung cancer with good performance status.     

Low-dose cisplatin and UFT for hormone refractory prostate cancer

OBJECTIVES: Biochemical modulation (BM) was initially used to enhance the effect of 5-fluorouracil (5-FU) by modulating its pharmacological action with the addition of other drugs. BM with low-dose cisplatin and 5-FU or UFT has been examined in cases of advanced gastric or pancreas cancer and 30 to 40% response rates have been reported. In the present study, the effect of BM on hormone refractory prostate cancer (HRPC) patients was examined. METHODS: BM consisting of 5 mg/body of cisplatin 3 times per week and 300-450 mg of UFT/day was given to 30 HRPC patients (median and range of age: 66 and 52-72, respectively). The ECOG performance status was 0 to 1. Gleason score was 7 in 8 patients, 8 in 10 patients and 9 in 12 patients, respectively. The metastatic site was bone in 29 patients (extent of disease on bone scan [EOD] grade 1: 10, 2: 10, 3: 8, 4: 1), lymph node in 8 and liver in 1. RESULTS: Among the 29 patients assessable for bone metastasis, 5 (17%) obtained marked improvement on bone scan. One was EOD grade 4 (super bone scan) and 4 were EOD grade 1-3. Eight (28%) were stable and 16 (55%) progressed on bone scan. Among 8 patients with lymph node metastasis, 4 (50%) showed partial response and 4 (50%) progression. One patient with liver metastasis showed complete response. Fourteen (47%) out of 30 patients showed a PSA decline of 50% or greater. Their median response duration was 8 months (range; 2 to 44 months). Among the 25 patients assessable for bone pain, 7 (28%) improved, 12 (48%) remained stable and 6 (24%) progressed. A side effect of Grade II anemia was seen in one patient. CONCLUSION: BM is effective in almost half of hormone refractory prostate cancer patients.     

中药白芷的基原植物研究 Ⅲ.中药白芷及其野生近缘植物的香豆素类成分比较

目的 :为确认中药白芷的基原植物提供化学成分方面的资料。方法 :运用高效液相及与标准品对照的方法对 4类栽培白芷 (川、杭、祁、禹白芷 )和 3种近缘野生植物 (兴安白芷、台湾白芷、雾灵当归 ) ,以及另外 2种当归属野生植物 (黑水当归、芷叶白芷 )进行了香豆素类成分的比较分析。结果 :4类栽培白芷和 3种近缘野生植物的香豆素类成分无论在化合物种类还是在含量方面都相当近似 ,而与另外 2种当归属野生植物差别较大。结论 :从香豆素类成分特征来看 ,4类栽培白芷和 3种近缘野生植物可分为 3个类群 ,即 :①川、杭、祁、禹 4类白芷和台湾白芷。②兴安白芷。③雾灵当归。台湾白芷与中药白芷更为接近     

Thrombin inhibition attenuates neurodegeneration and cerebral edema formation following transient forebrain ischemia

The disturbance of microcirculation following cerebral ischemia leads to an enlargement of cerebral infarct volume. Endogenous thrombin may play a role in this disturbance of microcirculation following cerebral ischemia. Therefore, the inhibition of thrombin may improve neurodegeneration and the accumulation of cerebral edema following cerebral ischemia in gerbils. The effects of thrombin inhibitor (argatroban) on cerebral ischemia were investigated in comparison with thromboxane A2 synthase inhibitor (ozagrel) and cyclooxygenase inhibitor (aspirin) following bilateral common carotid artery occlusion and reperfusion (CCA:O/R) in male Mongolian gerbils. This study consisted of three experiments: (1) morbidity and survival ratio (n=40 for each), (2) histopathology (n=12 for each), and (3) mean arterial blood pressure, local cerebral blood flow (CBF), and cerebral specific gravity (n=8 for each). Argatroban treatment improved survival ratio and stroke index, and decreased ischemically injured cell numbers in cortex and hippocampus and cerebral edema in cortex compared with aspirin and saline, in concert with the fast recovery of local CBF without reactive hyperemia following bilateral CCA:O/R. Ozagrel treatment also improved those factors compared with saline, in concert with the fast recovery of local CBF with reactive hyperemia. Aspirin treatment improved survival ratio and stroke index, and decreased ischemically injured cell numbers in cortex. Thrombin inhibition with argatroban decreases neurodegeneration and cerebral edema following bilateral CCA:O/R in gerbils.     

Estimation of measles vaccine coverage needed to prevent transmission in schools

Background: The aim of the present study was to produce the first estimation in Japan of the basic reproduction number (R₀) and the minimum level of vaccine coverage needed to prevent measles outbreaks (P_c).
Methods: A questionnaire survey was conducted during two measles outbreaks among 12–15-year-old middle school students in one prefecture in spring, from the end of February to the beginning of May 2002, and a stochastic mathematical model was constructed to calculate vaccine effectiveness (VE) and the basic reproduction number (R₀). P_c was calculated from R₀ and VE.
Results: In outbreak 1 (school A), 62 (94%) of 66 patients responded to the questionnaire. Of a total of 601 students, 534 (88.9%) responded. Of these, 82.6% (441/534) had previously received measles vaccine. In outbreak 2 (school B), 20 (99%) of 21 patients responded. Of a total of 375 students, 373 (99.5%) responded. Of these, 317 (85.0%) received measles immunization. Mathematical analysis was as follows: in outbreak 1 R₀ was 7.40 (95% confidence interval [CI]: 7.36–7.44) and VE was 76.55% (95%CI: 53.24–87.54). In outbreak 2, R₀ was 18.89 (95%CI: 18.88–18.90) and VE was 98.54% (95%CI: 94.89–99.73). Consequently, P_c was 112.97% (95%CI: 92.29–145.52) in outbreak 1 and 96.11% (95%CI: 93.81–98.53) in outbreak 2.
Conclusion: Because of the lower VE in outbreak 1, measles virus transmission could not have been stopped even if all students received a single dose of vaccine. In outbreak 2, with higher VE, the outbreak could have been prevented by increasing the proportion of students who had been vaccinated.     

Umbilical cord ulceration and intestinal atresia

Umbilical ulceration is an extremely rare complication in the perinatal period. We encountered a case of intestinal atresia complicated by massive intrauterine hemorrhage due to the umbilical cord ulceration. This is the fifth reported case demonstrating an association between the umbilical cord ulceration and intestinal atresia.     

The influence of dorsal neck proprioceptive inputs on vestibular compensation--by three-dimensional analysis of neck-induced nystagmus

The influence of dorsal neck proprioceptive inputs on vestibular compensation was investigated in 21 patients with unilateral vestibular dysfunction. Subjects neither had history of spontaneous nystagmus nor of disequilibrium, indicating that they were in a good compensated stage. However, marked nystagmus was induced by applying vibratory stimulation to the dorsal neck of the patients, using a vibrator with a frequency of 110 Hz. The nystagmus was three-dimensional as analyzed by applying computerized eye movement analysis system. Twelve of 21 patients (57%) demonstrated three components of eye movement. All subjects showed a horizontal component directed towards the contralateral side of the vestibular lesion. Vertical and torsional components of the nystagmus were exhibited by 18 and 14 subjects, respectively. The average percentages of slow phase velocity of the horizontal, vertical and torsional components were 57%, 23% and 20%, respectively. No tendency towards any of the three components was observed. Furthermore, in order to investigate the relation between dorsal neck proprioceptive inputs and vestibular outputs, especially semicircular canal outputs, the author compared the direction of the nystagmus with the orientation of the semicircular canals. Normalized average velocity vectors of the nystagmus were calculated. In most subjects, the velocity vectors of the nystagmus were related to the horizontal semicircular canal. These results suggest that by controlling the neck proprioceptive inputs, neck vibration can cause discompensation in vestibularly well-compensated subjects with unilateral dysfunction secondary to vestibular lesion, and that neck proprioceptive inputs have a great influence on the horizontal vestibulo-ocular reflex pathways. However, in a few subjects the average vectors of the nystagmus were related to the vertical semicircular canals. This suggests that the proprioceptive inputs may also be related to the vertical vestibulo-ocular reflex pathways.     

High-dose growth hormone (GH) treatment in prepubertal GH-deficient children

Two clinical studies were conducted to determine the effect of different doses of growth hormone (GH) on prepubertal growth in GH-deficient boys. In one study, GH doses of 1.0 and 1.5 IU/kg/week (0.33 and 0.5 mg/kg/week) were given to groups of five children and compared with a conventional Japanese dose of 0.5 IU/kg/week (0.17 mg/kg/week) in 15 children. A significant dose-dependent increase in height velocity occurred in the first year of treatment, but differences between doses were not significant thereafter. In a second study, GH was administered to ten boys at a dose of 0.5 IU/kg/week for the first year, 0.75 IU/kg/week for the second year, 1.0 IU/kg/week for the third year and 0.5 IU/kg/week for the fourth and subsequent years (0.17, 0.25, 0.33 and 0.17 mg/kg/week, respectively). During the second and third years of GH treatment, these boys had significantly higher growth rates than controls, who were given GH at 0.5 IU/kg/week (0.17 mg/kg/week) throughout, indicating successful reduction in 'waning' of the treatment effect. At the end of the fourth year, the different protocols from the two studies had both resulted in a greater height SDS than the controls, and did not advance bone maturation. In conclusion, these protocols may be effective in increasing prepubertal height gain in children with GH deficiency.