Palliative effect of lafutidine on oral burning sensation.

UNLABELLED: Lafutidine is a unique histamine H(2)-receptor antagonist (H2RA) that has a sensitizing effect on capsaicin-sensitive afferent neurons (CSAN). This effect may make lafutidine useful for the treatment of burning mouth syndrome (BMS). METHODS: To evaluate the efficacy and safety of lafutidine in patients with oral burning sensation, a randomized controlled trial was performed. Patients who had been receiving other H2RAs with no sensitizing effect on CSAN were randomly assigned to receive lafutidine 10 mg twice daily for 12 weeks, instead of the previous H2RAs, plus gargling with azulene sulfonate sodium (ASS) (lafutidine group, n = 36) or to continue to receive the previous H2RAs plus ASS gargling (control group, n = 35). The intensity of burning sensation was scored by means of a visual analog scale (VAS). RESULTS: Thirty-four patients in the lafutidine group and 30 in the control group completed the study. In the lafutidine group, the rate of improvement in the VAS score as compared with the baseline value was significant after 4, 8, and 12 weeks of treatment (P < 0.05). The improvement rate was consistently higher in the lafutidine group than in the control group; the differences between the groups were significant (P < 0.05) after 4, 8, and 12 weeks of treatment. Only two mild abdominal adverse events occurred in the lafutidine group, but neither required the termination of treatment. CONCLUSION: Oral lafutidine is very safe and effective for reducing the intensity of oral burning sensation and may therefore be a viable option for the treatment of BMS.

A peptide isolated from alpha B-crystallin is a novel and potent inhibitor of platelet aggregation via dual prevention of PAR-1 and GPIb/V/IX.

BACKGROUND: The ability of low-molecular-weight heat shock protein (HSP) to modulate thrombin-induced platelet aggregation has been investigated. OBJECTIVES: We examined the inhibitory effects on platelet aggregation of nine amino acid sequences isolated from HSP20 or alpha B-crystallin and their various derivatives. METHODS AND RESULTS: Platelet aggregation induced by various agonists was performed. These findings indicated that a peptide (Trp-Ile-Arg-Arg-Pro-Phe-Phe-Pro-Phe) from alpha B-crystallin significantly inhibits platelet aggregation induced by thrombin, TRAP (a protease activated receptor-1 agonist) and botrocetin, ristocetin (a stimulator of the platelet glycoprotein Ib/V/IX-von Willebrand factor axis), but not a protease-activated receptor-4 agonist, collagen and ADP. The inhibitory activity against thrombin or botrocetin is mainly linked to Arg-Arg-Pro-Phe or Trp-Ile-Arg-Arg-Pro, respectively, among nine amino acids. Additionally, during in vivo experiments, Trp-Ile-Arg-Arg-Pro-Phe-Phe-Pro-Phe shows a significant antithrombotic effect without marked bleeding. CONCLUSION: Our results provide the basis for a potential new aspect of antiplatelet compound for the therapy of thrombosis and cardiovascular disease.

Fluoride uptake in human dentine from glass-ionomer cement in vivo.

The purpose was to examine F uptake and distribution in dentine from a F-containing glass-ionomer cement in vivo. Nine volunteers were selected from dental students who were scheduled for extraction of their third molars. Two cavities were prepared on the same occlusal surface of the third molars for each subject; one was restored with glass-ionomer cement (Virtabond), the other with zinc phosphate cement as a control. After 3 months the teeth were extracted. F profiles in the dentine from the cavity floor to the pulpal surface were determined in tissue immediately adjacent to the restorations. An abrasive micro-sampling technique was used. The F concentration of the dentine was highest immediately beneath glass-ionomer cement filling, decreasing towards the pulpal surface. Overall F concentrations were greater in the dentine beneath the glass-ionomer cement than in that beneath the zinc phosphate cement. It was concluded that the glass-ionomer cement markedly enhanced fluoride uptake by underlying dentine in vivo.

[The effectiveness of steroid as adjunctive therapy in the management of two patients with febrile reaction due to antituberculous drugs].

Antituberculous treatment could be continued by using steroid as adjunctive therapy in two patients showing febrile reaction to antituberculous drugs in spite of desensitization therapy. Case 1 (39-year-old man) was admitted to our hospital with positive sputum-smear and bilateral cavitary tuberculosis (b II 2) on chest X-ray. He showed fever of 38-39 degrees C after 8 days of HREZ treatment. Desensitization therapy of RFP with the combined use of prednisolone was enforced, since the exothermic reaction continued in spite of stopping the 4 medicines, and the treatment became possible. Case 2 (40-year-old woman) was admitted with positive sputum-smear and bilateral cavitary tuberculosis (b II 2) on chest X-ray. The administration of drugs was stopped as temperature rose to 38-39 degrees C after 12 days of HREZ treatment. Though the DLST of INH was positive, the treatment with INH became possible by the combined use of PSL.

[Implementation and evaluation of public relations activity in a community health program].

OBJECTIVE: This study evaluated public relations activity in a community health program in order to develop effective strategies to attract the public attention for the program. METHODS: An intervention study was conducted on public relations for "Nutrition Seminar for Citizens," sponsored by the Health Department of Machida City, Tokyo, in October, 1999. One ward in the city was selected as an intervention area, and another ward which had similar demographic and geographic characteristics was chosen as a control area. Two target populations were defined; one was women in their 20s to 60s (#1) and the other was those who had previously never utilized community health programs sponsored by the city (#2). Handbills were used as the medium for public relations for the seminar. These announced the time, place and content of the nutrition seminar and were designed by authors with special attention to catchphrases, colors and fonts. Handbills were distributed in the intervention area through elementary schools, local voluntary organizations and local health volunteers. In addition, the authors directly handed them out to people in front of two supermarkets in the town. The sources of seminar information were requested from the participants of the Nutrition Seminar with a self-administered questionnaire. RESULTS: 1. The percentage of participants who received the seminar information from handbills was higher than that of those who used monthly newsletters from the city as a source of information. 2. The percentage of participants from the intervention area was higher than that from the control area. 3. Regarding target populations #1 and #2, there were no differences in participation rates between the intervention and control area. 4. Among the four distribution routes, the local voluntary organization route was the most effective for attracting participants. CONCLUSIONS: The results show that handbills can be an effective medium for pubic relations to increase the number of participants in community health programs. Also, local voluntary organizations can play a crucial role in information transfer in the community because of their high credibility. On the other hand, we could not reach specified target populations with the medium. Further surveys are needed to establish optimal media and routes to reach appropriate target populations in health programs.

[Solitary hemangioma of the rib; report of a case].

A case of solitary hemangioma which occurred in the rib. Tumor located in the right seventh rib, incidentally taken X-ray film demonstrated bone tumor, but she had no symptoms. Four years after, chest pain occurred and taken X-ray film, tumor size was inceeced. Computed tomography (CT) showed an expansile, well demarcated lesion, with thin corices and fine trabeclae. Chest wall, from the sixth rib to the eighth rib resection was performed and surgical margin was 4 cm. This case were diagnosed hemangioma of the rib. Hemangiomas of the bone are rare benign vascular tumors that account for less than 1% of all bony neoplasms. These lesions are most often occurring in the vertebral column or in the skull. The localization to the ribs is even more rare, with only sporadic case reports in the literature.

Endoscopic ureteral incision using the holmium:YAG laser.

BACKGROUND: We reviewed the results of endoscopic ureteral incision for benign ureteral stricture, ureteropelvic junction obstruction and ureteroenteroanastomotic stricture using the holmium laser. METHODS: We carried out endoscopic ureteral incision using the holmium laser through an 8-Fr semirigid or 6.9-Fr flexible ureteroscope on 17 ureters in 15 patients. Balloon dilatation was not necessary before insertion of the ureteroscope. The stricture was incised with the holmium laser using a 200-365 microm fiber through the working channel of the ureteroscope. After completion of the incision, a 12-Fr double-J catheter was left for 6 weeks. Thereafter patients were followed by renal scan and/or ultrasound and excretory urography at 3-6 month intervals. RESULTS: The mean operative time was 65 min (18-135 min). The stricture resolved completely in 86.7% of cases at an average follow up of 20.5 months (11-32 months). CONCLUSIONS: The holmium laser endoscopic ureteral incision was associated with a good outcome in our series. We recommend this procedure to be employed initially because it is less invasive and has a favorable outcome.

[A case of myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) related glomerulonephritis associated with systemic sclerosis treated by steroid pulse therapy: a case report].

A 57-year-old woman had been diagnosed as systemic sclerosis (SSc) with Raynaud's phenomenon, acrosclerosis and polyarthritis since 1995. She admitted to our hospital in July 1996 because of general fatigue, hemosputa and progressive renal insufficiency. On admission, the blood pressure was normal and laboratory findings showed elevation of the serum creatinin level and a high titer of the myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) (> 1000 EU). The renal biopsy revealed crescentic glomerulonephritis. Both renal insufficiency and high titers of MPO-ANCA improved remarkably after methylpredonisolone pulse therapy. This case was suggestive of elucidating the pathogenesis of SSc and MPO-ANCA related glomerulonephritis.

[Progression of coronary artery stenosis and compensatory development of collaterals: analysis of data of 25 patients who developed complete occlusion].

The correlation between progression of atherosclerotic lesions and the compensatory development of collaterals which prevent ischemic events, particularly myocardial infarction, were examined in patients who underwent repeated coronary angiography (CAG) after medical therapy. Twenty-five patients with lesions in their coronary arteries perfusing the viable myocardium during the first study, which progressed to total occlusion in the second study, were evaluated. The subjects' mean age was 55.1 years, and the mean time interval between the two studies was 44.1 months. CAG was performed in the chronic stage of myocardial infarction or the stable phase of angina pectoris, but three patients underwent repeated CAG studies during the acute phase of myocardial infarction. The percent diameter of the narrowing in the lesion was assessed according to the AHA system. Concerning the sites of lesions with progression to complete occlusion, 14 (56%) were located in the proximal segment of the left anterior descending artery (segment 6 or 7), and six lesions were in the main trunk of the right coronary artery (segment 1, 2 or 3). In 11 patients with stable angina, associated lesions showed progression from 90 or 99% stenosis to complete occlusion. Seven patients with lesions exhibiting 99% stenosis had collaterals, and four patients with lesions exhibiting 90% stenosis had no collaterals during the first study. However, good collaterals were demonstrated in all patients in the second study. Seven patients had episodes of newly developed unstable angina. The lesions in five of the seven patients progressed from 75% or 90% stenosis to complete occlusion, and in one patient with triple vessel disease the lesion progressed from 99% stenosis to complete occlusion in the second study. The former five patients did not have collaterals in the first study, but development of collaterals was demonstrated in all seven patients in the second study. Seven patients had episodes of myocardial infarction, and in six of these, the lesions progressed from 75% or less stenosis to complete occlusion.(ABSTRACT TRUNCATED AT 400 WORDS)

[Outcomes of noninvasive positive-pressure ventilation in patients with acute hypercapnia complicating chronic respiratory failure].

We used noninvasive positive-pressure ventilation to treat hypercapnea due to acute exacerbations of chronic respiratory failure (21 episodes in 19 patients; COPD, 4; pulmonary tuberculosis sequelae, 4; silicosis, 3; silicotuberculosis, 3; bronchiectasis, 3; others, 2). All patients had acute onsets of severe hypercapnea (PaCO2 > 45 Torr), acute decreases in pH (< 7.35), and tachypnea, paradoxical breathing or both. During the first 2 to 4 hours of bi-level positive airway pressure, PaCO2 decreased from 72 to 61 Torr (p < 0.0005), pH increased from 7.26 to 7.31 (p < 0.001), and respiratory rate decreased from 30 to 25 breaths/min (p < 0.005). In three cases leakage of air through the mouth prevented improvement in the patients' conditions, but in two of those a face mask was then used successfully. In 17 of the 21 episodes (81%) gas exchange improved and intubation was not necessary. In those 17, the mean duration of noninvasive positive-pressure ventilation was 6.3 days. We conclude that noninvasive positive-pressure ventilation can improve gas exchange in patients with acute hypercapnea complicating chronic respiratory failure.

Possible contribution of green tea drinking habits to the prevention of stroke.

Among 5910 nondrinking and nonsmoking women (of greater than or equal to 40 years of age) in a prefectural city of Sendai, and two villages of Taijiri and Wakuya in Miyagi prefecture, Japan, medical history of stroke was less frequently observed among those who took more green tea in daily life. No relation with tea drinking was observed for hypertension history. The uneven distribution of stroke history was detectable even after the effects of age, location of residence, and high salt intake were ruled out. The incidence of stroke and cerebral hemorrhage during a 4-year follow-up of the study population was twice or more times higher in those who took less green tea (less than 5 cups a day) than in those who took more (greater than or equal to 5 cups daily).