Fine Structure of Remodeling Sites on Iliac Cancellous Bone in Senile Osteoporosis: A Study by Scanning Electron Microscopy Using an Improved Organic Specimen Preparation Method

We improved on the organic specimen preparation method in order to investigate the details of the functional state of bone in osteoporosis at high magnification level. The usefulness and possibilities of this method are discussed showing fine structural images of remodeling sites. Iliac bones of senile osteoporotic patients obtained by transilial biopsies were studied by scanning electron microscopy (SEM) using the improved preparation method. Excepting the region near the corticoendosteal surface, most of the iliac cancellous bone was composed of thin rod-shaped trabeculae. Remodeling sites on trabeculae appeared as concavities of various sizes and were easily distinguished from inert surfaces. The region near the cortico-endosteal surface showed a higher remodeling activity as compared with other regions. The morphological analysis of remodeling site by SEM made it possible to know its functional state. Five areas of different stages were distinguishable in remodeling sites, each corresponding to a different stage in the remodeling cycle: area in resorbing phase, in reversal phase, in early forming phase, in late forming phase, and in resting phase. The distribution patterns of the five areas in remodeling sites were investigated. More than half of the remodeling sites showed the heterogeneous composition: they were occupied by plural areas in different phases. Some remodeling sites were entirely occupied by a single area in reversal phase or in forming phase or resting phase. The remodeling site occupied by an area in resorbing phase alone was not found

Intraprostatic Botulinum Neurotoxin Type A Injection for Benign Prostatic Hyperplasia:Preliminary Results with a Newly Purified Neurotoxin

Several studies have demonstrated the efficacy of intraprostatic injection of botulinum neurotoxin type A (BoNT/A) against symptomatic benign prostatic hyperplasia (BPH). The most commonly used BoNT/A product, Botox®, forms large complexes and composed of neurotoxin (NTX) as well as non-toxic components. We purified NTX lacking non-toxic components. We investigated the efficacy of this newly purified NTX for men with BPH. Ten male patients (mean age, 70.0 years) with BPH received 100 units (prostate volume [PV] ＜30ml) or 200 units (PV ｧ30ml) of NTX injected into the prostate via a minimally invasive outpatient technique. Evaluation included uroflowmetry, postvoid residual urine volume (PVR), PV, and International Prostate Symptom Score (IPSS) measured at baseline and 1, 3, 6, and 12 months post-treatment. The status of 7 of the 10 patients examined was found to have improved within 1 month of treatment. The mean IPSS decreased from 23.8±7.0 to 16.3±10.3 (p＝0.0093) at 1 month, to 14.9±8.2 (p＝0.0074) at 3 months, and to 16.9±7.3 (p＝0.018) at 12 months. The mean PV decreased from 47.8±21.2 to 39.2±19.5ml (p＝0.0076) at 3 months. The PVR improved at 3 and 6 months post-treatment. Intraprostatic NTX injection induces prostate shrinkage and is effective in men with BPH

Effect of Ethanol in Paclitaxel Injections on the Ethanol Concentration in Exhaled Breath

BACKGROUND: Ethanol is included in certain injectable preparations of anticancer drugs to increase their solubility. Since the volume of ethanol in these preparations is approximately half of the total injection volume, the potential inhibitory effects of ethanol on the central nervous system cannot be disregarded, especially considering that patients may drive immediately after administration of the medication. Therefore, the concentration of ethanol was examined in exhaled breath after administration of paclitaxel, an anticancer medication containing ethanol. METHODS: The ethanol concentration in exhaled breath immediately after an intravenous infusion of paclitaxel was measured in 30 patients, using a balloon-type gas detector tube. Correlations between the concentration of ethanol in exhaled breath and the total amount of ethanol administered or the intravenous infusion speed were calculated. RESULTS: The mean ethanol concentration in exhaled breath was 0.028 ± 0.015 mg/L. The correlation between the ethanol concentration in exhaled breath and the total dose of ethanol was weak (R(2) = 0.25; p = 0.055), while the intravenous infusion speed showed a stronger positive correlation with the concentration of ethanol in the breath (R(2) = 0.49; p = 0.11). The maximum concentration of ethanol measured in exhaled breath (0.06 mg/L) was equivalent to 40% of the threshold for drunk driving, as specified in the Road Traffic Act in Japan. CONCLUSION: In this study, no patient had a breath ethanol concentration exceeding the legal threshold for drunk driving. However, it is still advisable for patients to avoid driving after receiving paclitaxel injections. When driving cannot be avoided, patients should wait for a sufficient time after receiving the injection before driving