Addition of transcatheter arterial chemoembolization decreased local recurrence but had no survival benefit to percutaneous ethanol injection therapy for patients with small hepatocellular carcinoma: A multicenter randomized control study.

To assess the efficacy of the additional treatment of transcatheter arterial chemoembolization (TACE) to percutaneous ethanol injection (PEI) therapy for relatively small hepatocellular carcinomas (HCCs), a multicenter randomized control study (RCT) was performed. We conducted an RCT and follow-up study during the enrollment period from 1997 to 1999. Newly diagnosed patients with one to three HCC tumors measuring from 2 to 4 cm (4 cm maximum) in diameter were enrolled. A total of 30 patients initially underwent a combination TACE-PEI or PEI-alone therapies at eight randomly assigned Japanese hospitals. However, 3 patients withdrew. Of the 27 remaining patients, 13 were treated with the combination TACE-PEI therapy and 14 with PEI therapy alone. The patients were observed over several months [median (interquartile range) 33.2 (24.6) months]. There were no significant differences in the background of the patients between the two groups. Among the patients treated with TACE-PEI, the development of a local residual tumor was of significantly lower occurence, compared to the group receiving PEI alone (7.6 and 42.9%, respectively; P=0.024). However, the mean cancer-free time (absence of local or multiple nodule recurrence) or patient survival time was not significantly different between the two groups [PEI alone vs. TACE-PEI: cancer-free time 16.7 (95% CI 7.3-26.0) vs. 22.9 months (95% CI 12.4-33.4); survival time 57.2 (95% CI 37.2-77.2) vs. 42.4 months (95% CI 29.2-55.6)]. Although the combination of TACE and PEI had significant effects on the local tumor control, no efficacy of the addition of TACE to PEI was noted in the prognosis among patients with relatively small HCC tumors.

Synthesis and pharmacological evaluation of new 1-hydroxy-1-phenyl-2,3,4,5-tetrahydro-1H-3-benzazepines as norepinephrine potentiators.

4-Hydroxy-2-methyl-4-phenyl-1,2,3,4-tetrahydroisoquinoline (PI-OH) (1a) and its derivatives form a new class of compounds which possess norepinephrine (NE) potentiating activity. As a new series of compounds, 1-hydroxy-1-phenyl-2,3,4,5-tetrahydro-1H-3-benzazepines (2a--f) were synthesized by the intramolecular Barbier reaction of N-[2-(2-iodophenyl)ethyl]phenacylamines (6a--f) with n-BuLi as a key reaction step. The potentiating activities of the benzazepines 2a--f on the contraction of rat anococcygeus muscle induced by NE were tested. Among the compounds tested in this study, compound 2a showed moderate potentiating activity (the activity ratio was 7.3-fold at 3 x 10(-5) M).

Functional comparison of posterior cruciate-retaining versus posterior stabilized total knee arthroplasty.

A prospective, randomized comparison of posterior cruciate-retaining (PCR) and posterior stabilized (PS) total knee arthroplasties (TKAs) was conducted in 20 patients who underwent bilateral TKAs for osteoarthritis. All procedures were performed by a single surgeon. One knee was implanted with a PCR TKA, and a contralateral knee with a PS TKA. Both prosthetic designs were of the same TKA series, with comparable surface geometries. Patients had a clinical and radiographic evaluation at a mean of 31.7 months for PCR TKAs and 30.6 months for PS TKAs postoperatively. There were no significant differences between the PCR and PS TKAs in postoperative knee scores. However, postoperative improvement in range of motion was significantly superior in the PS group.