Improvement of cerebral blood flow following stereotactic surgery in patients with putaminal haemorrhage

Summary Changes in cerebral blood flow (CBF) after CT guided stereotactic aspiration of putaminal haematoma were investigated in 13 patients with Xe-133 inhalation and single photon emission computed tomography. The interval from onset to operation ranged from 13 to 82 days (mean 30 days). The mean estimated haematoma volume ranged from 20 to 50 ml (mean 31.9 ml). The percentage of haematoma aspirated ranged from 75 to 98% (mean 86.8%). Postoperative CBF in two thirds of the patients was improved even though all cases were operated on in the subacute stage. Both the mean hemispheric and regional CBF in the anterior territory of the middle cerebral artery and in the region of the thalamus and basal ganglia in the affected hemisphere were increased postoperatively. Also in the nonaffected hemisphere, regional CBF in the region of the thalamus and basal ganglia was improved.This study was presented in part at the 9th Meeting of the World Society of Stereotactic and Functional Neurosurgery, July 4–7, 1985, in Toronto, Canada.     

Candida-induced histamine release from basophils: relationship to house dust- and anti-IgE-induced secretion

Candida albicans-induced histamine release from basophils was studied in 54 patients with bronchial asthma in comparison with the release caused by house dust and anti-IgE. The release of histamine induced by C. albicans and that induced by house dust were closely related to the serum levels of specific IgE antibodies as expressed by RAST scores. A correlation of C. albicans-induced histamine release with the release caused by anti-IgE was not generally observed. On the other hand, a close correlation was found between house dust- and anti-IgE-induced histamine release. It was suggested from these results that the differences between C. albicans- and house dust-induced histamine release might be due to the different antigenicity of the two allergens.     

Wound,pressure ulcer and burn guidelines – 1: Guidelines for wounds in general,second edition

The Japanese Dermatological Association prepared the clinical guidelines for the “Wound, pressure ulcer and burn guidelines”, second edition, focusing on treatments. Among them, “Guidelines for wounds in general” is intended to provide the knowledge necessary to heal wounds, without focusing on particular disorders. It informs the basic principles of wound treatment, before explanations are provided in individual chapters of the guidelines. We updated all sections by collecting references published since the publication of the first edition. In particular, we included new wound dressings and topical medications. Additionally, we added “Question 6: How should wound-related pain be considered, and what should be done to control it?” as a new section addressing wound pain, which was not included in the first edition.     

Wound,pressure ulcer and burn guidelines – 6: Guidelines for the management of burns,second edition

“Wound, pressure ulcer and burn guidelines – 6: Guidelines for the management of burns, second edition” is revised from the first edition which was published in the Japanese Journal of Dermatology in 2016. The guidelines were drafted by the Wound, Pressure Ulcer and Burn Guidelines Drafting Committee delegated by the Japanese Dermatological Association, and intend to facilitate physicians’ clinical decisions in preventing, diagnosing and treating burn injury. All sections are updated by collecting documents published since the publication of the first edition. Especially, the recommendation levels of dressing materials newly covered by the Japanese national health insurance are mentioned. In addition, the clinical questions (CQ) regarding the initial treatment of electrical (CQ15) and chemical burns (CQ16), and also the use of escharotomy (CQ22), are newly created.     

Phase I/II Study of Cisplatin plus Nab‐Paclitaxel with Concurrent Thoracic Radiotherapy for Patients with Locally Advanced Non‐Small Cell Lung Cancer

Lessons Learned

• The combination of cisplatin plus nab‐paclitaxel with concurrent thoracic radiotherapy in unresectable stage III non‐small cell lung cancer is a promising therapeutic strategy.
• Further investigation is warranted.

BackgroundWe conducted a phase I/II trial of cisplatin plus nab‐paclitaxel with concurrent thoracic radiotherapy for locally advanced non‐small cell lung cancer (NSCLC) to determine the recommended dose (RD) of nab‐paclitaxel and to evaluate the safety and efficacy of this regimen.MethodsIn the phase I study, escalating doses of weekly nab‐paclitaxel were administered together with cisplatin at 75 mg/m² every 3 weeks and concurrent radiotherapy. In the phase II study, nab‐paclitaxel was administered at the RD.ResultsIn the phase I study, whereas no dose‐limiting toxicity (DLT) was observed with nab‐paclitaxel at 50 or 60 mg/m², one of six patients experienced DLT (esophagitis of grade 3) at 70 mg/m², determined as the RD. Twenty‐four patients at RD were evaluable for safety and efficacy in phase II. Common toxicities included esophagitis (87.5%) and leukopenia (79.2%). Pneumonitis and treatment‐related deaths were not observed, but 20 patients (83.3%) experienced radiation pneumonitis, with one case of grade 3 and four of grade 2, after completion of concurrent chemoradiotherapy. The 2‐year overall survival and progression‐free survival rates were 73.9% and 56.5% (95% confidence interval [CI], 34.3%–74.7%), respectively.ConclusionConcurrent chemoradiation with nab‐paclitaxel at 70 mg/m² and cisplatin at 75 mg/m² every 3 weeks showed encouraging feasibility and activity for locally advanced NSCLC.