Evaluation of cutoff scores for the Parkinson's disease sleep scale-2.

BACKGROUND: The Parkinson's Disease Sleep Scale (PDSS)-2 is a recently developed tool for evaluating disease-related nocturnal disturbances in patients with Parkinson's disease (PD). However, its cutoff score has not been clinically assessed. We determined the optimal cutoff score of the Japanese version of the PDSS-2. METHODS: Patients with PD (n = 146) and controls (n = 100) completed the PDSS-2 and the Pittsburgh Sleep Quality Index (PSQI). Poor sleepers were defined as having global PSQI scores >5. Optimal cutoff scores for determining poor sleepers were assessed using the receiver operating characteristic curve. RESULTS: A PDSS-2 total score ≥ 14 exhibited 82.0% sensitivity and 70.6% specificity, whereas a PDSS-2 total score ≥ 15 provided 72.1% sensitivity and 72.9% specificity in distinguishing poor sleepers (PSQI score >5) from good sleepers (PSQI ≤ 5). Nocturnal disturbances were more frequently observed in patients with PD than in controls (PDSS-2 total score ≥ 14 or ≥ 15; 51.4% vs 20%; 45.9% vs 19%). Nocturnal disturbances were associated with higher Hoehn and Yahr stages and Unified Parkinson's Disease Rating Scale motor scores, impaired quality of life, daytime sleepiness, and depressive symptoms. CONCLUSION: We suggest that PDSS-2 total scores ≥ 15 are useful for detecting poor sleepers among patients with PD.

[A case report of radiation-induced cancer of the buccal mucosa, effectively treated with CF therapy].

We report favorable effect of combination chemotherapy with CDDP and 5-FU for a case of radiation-induced cancer of the left buccal mucosal membrane. A 71-year-old man underwent external-beam radiotherapy for a squamous cell carcinoma of the tongue. He developed left buccal mucosal cancer 13 years after the start of this radiotherapy. One course of the therapeutic regimen consisted of CDDP 70 mg/m2/day drip infusion for 2 hours (day 1) and 5-FU 700 mg/m2/day drip infusion for 120 hours (days 1-5). The patient underwent 4 courses. A partial response was achieved after 1 course, after which additional treatment with the same regimen was made with favorable effect. Four years after the treatment, 2 courses of the same chemotherapy were performed because of a recurrence of radiation-induced cancer, with a complete response. No serious side effects appeared. A histopathological examination of the lesion showed no cancer tissue. The patient was alive and cancer free 4 years after the treatment, and has been followed.

[A case report of tongue cancer presenting with SSD type brain embolism induced by chemotherapy with CBDCA and 5-FU].

We report a case of tongue cancer presenting with SSD type brain embolism induced by chemotherapy with CBDCA and 5-FU (CF Therapy) A 35-year-old woman underwent CF therapy for squamous cell carcinoma of the tongue. Immediately after CF therapy, aphasia and serious exercise paralysis appeared. However, symptoms disappeared 2 days later and no abnormality was found by brain CT. We report that SSD type brain embolism is one of the noteworthy side effects of CF therapy.