A 28 year-old man with chronic hepatitis B was administered interferon-alpha (5 x 10(6) IU) intramuscularly once a day for 28 days. Eight days after the end of interferon treatment, he showed signs of inability to sit still for ten seconds and walked around constantly. His akathisia symptoms worsened thereafter. Clonazepam, thioridazine, beta-blockers, anticholinergics, and bromocriptine did not ameliorate his akathisia. Two days' administration of levomepromazine 100 mg led him to a coma for 2 days. Intravenous levodopa 25 mg ameliorated his akathisia symptoms drastically. He became completely premorbid 2 weeks after administration of levodopa. The present report illustrates a rare case of refractory akathisia after interferon-alpha treatment and also that levodopa treatment would be theoretically and practically useful in reducing the neurotoxicity associated with interferon-alpha.

Adult↗

PubMedDate not supplied

Prophylactic chemolipiodolization for postoperative hepatoma patients.

BACKGROUND/AIMS: The efficacy of prophylactic chemolipiodolization following hepatic resection in patients with hepatocellular carcinoma was studied. METHODOLOGY: Forty-four of 67 consecutive patients with hepatocellular carcinoma who underwent hepatectomy between 1980 and 1997 were divided into two groups: group A (n = 21), in which prophylactic chemolipiodolization was performed during postoperative follow-up (2.4 times on average using a 39 mg mean dose of epirubicin or doxorubicin); and group B (n = 23), without prophylactic chemolipiodolization. The clinicopathological background and patient survival were compared retrospectively. RESULTS: There were no differences in the clinicopathological background between the two groups. Multiple intrahepatic recurrence was frequently observed in group B (P < 0.02). The recurrence-free survival rates in group A (54.4% and 31.1% at 3 and 5 years, respectively) were significantly higher than those in group B (15.7% and 7.9%, respectively). The survival rates of group A (95.2% and 80.4% at 3 and 5 years, respectively) were significantly higher than those in group B (40.1% and 22.9%, respectively). CONCLUSIONS: Our data suggest that postoperative prophylactic chemolipiodolization can be an effective treatment in reducing intrahepatic recurrence and may prolong survival for hepatocellular carcinoma patients following hepatic resection.

Aged↗

PubMedDate not supplied

Pharmacokinetics, N1-glucuronidation, and N4-acetylation of sulfa-6-monomethoxine in humans.

Sulfamonomethoxine (S) is metabolized by O-dealkylation, N4-acetylation, and N1-glucuronidation. In humans, only N1-glucuronidation (12%) and N4-acetylation (36%) takes place. The N1-glucuronide is directly measured by HPLC. When N4-acetylsulfamonomethoxine (N4) is administered as the parent drug, N1-glucuronidation does not occur. After an oral dose, fast and slow acetylators show a similar t1/2 for S (25.0 +/- 4.6 hr vs. 29.8 +/- 4.8 hr; p = 0.459), and the t1/2 of the N4-acetyl conjugate is also similar in fast and slow acetylators (25.0 +/- 4.64 hr vs. 29.8 +/- 4.8 hr, p = 0.459). The intrinsic mean residence time of N4 is 7.1 +/- 2.3 hr. The mean total body clearance of S is 5.0 +/- 1.3 ml/min, the renal clearance is 0.84 +/- 0.26 ml/min, and the volume of distribution at steady state is 11.7 +/- 3.4 liters. The renal clearance of N4 is 17.89 +/- 4.19 ml/min. No measurable concentrations of the N1-glucuronide of S are found in plasma. The protein binding of S is 92%. N1-glucuronidation results in an 80% reduction in the protein binding of S (11%). N4 shows a high protein binding of 98%. Approximately 60% of the oral dose of S is excreted in the urine.

Acetylation↗

PubMedDate not supplied

Clinical usefulness of electrically elicited pain-related evoked potentials.

In 14 patients with sensory disturbance, the clinical usefulness of electrical pain-related evoked potentials (EPREPs) were studied. In four patients with deep sensation disturbance, conventional somatosensory evoked potentials (SEPs) were abnormal. However, EPREPs were abnormal only in one of the patients. In nine patients with pain-temperature sensation disturbance, SEPs were normal except for only one patient and EPREPs were abnormal in seven of the nine patients. In a patient with herpes zoster myelitis, EPREPs elicited by electrical stimulation below the disturbed spinal level were delayed. After symptomatic improvement, EPREPs recovered. EPREPs are useful in the clinical field.

Adult↗