Up-titration of vardenafil dose from 10 mg to 20 mg improved erectile function in men with spinal cord injury

AIM: Vardenafil is a highly selective phosphodiesterase type-5 inhibitor for the treatment of erectile dysfunction (ED). Efficacy of vardenafil has been demonstrated in various ED populations, but that in Japanese patients with spinal cord injury (SCI) has not been assessed. METHODS: This was an open-label, multicenter, flexible dose, 12-week study in patients with ED due to SCI. Following a 4-week observation period, patients received vardenafil 10 mg for 4 weeks, and based on efficacy, tolerability and patient preference, doses for the remaining 8 weeks were decided by investigators. The primary efficacy parameter was erectile function domain score of the International Index of Erectile Function. RESULTS: Ten patients took 10 mg all through the study, while 22 patients took 20 mg after completing 4 weeks' treatment with 10 mg. The erectile function domain score increased from 12.2 at baseline to 25.0 at Last Observation Carried Forward (LOCF) in the former group and from 10.3 to 22.5 in the latter group, respectively. Importantly, there was a 5.0 point increase in erectile function domain score after up-titration in the latter group. Drug-related adverse events were observed in 22% of patients including hot flushes (9%) and headache (6%), but these were transient and mild in intensity. Serious adverse events and adverse events leading to discontinuation of the study drug were not reported. CONCLUSIONS: Vardenafil 10 and 20 mg was well tolerated and improved erectile function in patients with SCI. Of interest, erectile function was further improved by 20 mg in patients who were not sufficiently treated with 10 mg.     

A Case of Acute Organoaxial Gastric Volvulus Treated by Endoscopic Reduction and Fixation with the Use of Percutaneous Endoscopic Gastrostomy Device

Abstract: Acute organoaxial gastric volvulus with paraesophageal hernia was detected by upper gastrointestinal endoscopy in a 75-year-old female patient. Endoscopic reduction of gastric volvulus was initially performed and a nasogastric tube was inserted into the jejunum. The introduction of oral intake resulted in vomiting and a barium meal study suggested recurrence of gastric volvulus. Endoscopic reduction was then performed, and a percutaneous endoscopic gastrostomy tube was inserted to anchor the stomach to the anterior abdominal wall. The tube was removed 15 weeks later, and the patient has remained asymptomatic to date.     

Randomized controlled trial to investigate how acrylic‐based resilient liner affects on masticatory ability of complete denture wearers

Summary The aim of this study was to determine the effects of an acrylic‐based resilient liner (ARL) on masticatory ability by verifying the null hypothesis that masticatory performance and mandibular movements do not differ between people who wear mandibular complete dentures with ARL and those who wear complete dentures with conventional acrylic resin (CAR). From April 2004 to July 2006, we conducted a randomized controlled trial study at two centres. After written informed consent was obtained from 74 edentulous patients, they were randomly allocated to either the ARL group or CAR group. Masticatory performance and mandibular movement at the lower incisal point during chewing were measured as the outcomes. We did not observe significant differences in both outcomes between the groups. The chewing cycles were significantly different during the initial, middle, and final phases of mastication. Within the limitations of the current study, the results indicate that the acrylic‐based resilient denture liners used have no clinical impact on the masticatory ability of complete denture wearers.     

A Novel Missense Mutation Causing a G487R Substitution in the S2–S3 Loop of Human ether‐à‐go‐go‐Related Gene Channel

hERG(G487R) Channel . Introduction: Mutations of human ether‐à‐go‐go‐related gene (hERG), which encodes a cardiac K⁺ channel responsible for the acceleration of the repolarizing phase of an action potential and the prevention of premature action potential regeneration, often cause severe arrhythmic disorders. We found a novel missense mutation of hERG that results in a G487R substitution in the S2–S3 loop of the channel subunit [hERG(G487R)] from a family and determined whether this mutant gene could induce an abnormality in channel function. Methods and Results: We made whole‐cell voltage‐clamp recordings from HEK‐293T cells transfected with wild‐type hERG [hERG(WT)], hERG(G487R), or both. We measured hERG channel‐mediated current as the “tail” of a depolarization‐elicited current. The current density of the tail current and its voltage‐ and time‐dependences were not different among all the cell groups. The time‐courses of deactivation, inactivation, and recovery from inactivation and their voltage‐dependences were not different among all the cell groups. Furthermore, we performed immunocytochemical analysis using an anti‐hERG subunit antibody. The ratio of the immunoreactivity of the plasma membrane to that of the cytoplasm was not different between cells transfected with hERG(WT), hERG(G487R), or both. Conclusion: hERG(G487R) can produce functional channels with normal gating kinetics and cell‐surface expression efficiency with or without the aid of hERG(WT). Therefore, neither the heterozygous nor homozygous inheritance of hERG(G487R) is thought to cause severe cardiac disorders. hERG(G487R) would be a candidate for a rare variant or polymorphism of hERG with an amino acid substitution in the unusual region of the channel subunit. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1246–1253, November 2012)     

Biological activity of synthetic analogs of serum thymic factor*

A series of analogs of serum thymic factor (Facteur Thymique Sérique; FTS) devoid of C- and N-terminal few residues were synthesized and their ability to induce Thy-1 (θ) antigen in vitro on mouse T lymphocyte precursors was examined. The pentapeptide moiety (Lys-Ser-Gln-Gly-Gly) seems to be important for the expression of agonistic activity. Some of the short chain peptides showed antagonistic properties. Synergistic activation by two inactive analogs was observed.     

Morbidity and mortality of infants born at the threshold of viability: Ten years'' experience in a single neonatal intensive care unit, 1991–2000

BACKGROUND: The purpose of the present paper was to evaluate the mortality and morbidity of infants born at 22-24 weeks gestation. METHODS: A total of 78 infants born at 22-24 weeks gestation, who were admitted between January 1991 through December 2000, were retrospectively studied. RESULTS: Seventy-one of 78 infants were enrolled in the present study. One year survival rates at 22, 23 and 24 weeks were 40.0% (2/5), 61.1% (11/18), and 50.0% (24/48), respectively. Failure of response to surfactant and air leak were associated with death in infants born at 23 weeks gestation. Low Apgar score, intraventricular hemorrhage (> or =III), and sepsis were correlated with death in infants born at 24 weeks gestation. The handicap rates of survivors born at 22, 23, and 24 weeks gestation were 100, 36.4, and 26.1%, respectively. CONCLUSIONS: The present study indicates that infants born at 22 weeks gestation, in whom pulmonary structure is established, that is, a viable lung that can exchange gas with exogenous surfactant, have a chance to survive, but neurological outcome is still poor. Every possible effort should be made to extend gestation beyond 22 weeks.