Lipo-prostaglandin E1 Research Articles

突発性難聴におけるパルクスの使用経験

We studied the clinical effectiveness of Lipo-prostaglandin E1 (Lipo-PGE1), which has vasodilating activity on microvessels and anti-platelet properties, in patients with sudden deafness. Fifty-five patients were treated with steroids (group I ) and forty-three patients were treated with Lipo-PGE1 plus steroids (group II). In group I, 10 patients (18.2%) presented with a complete recovery, 9 patients (16.4%) presented with a marked improvement, 20 patients (36.4%) presented with an improvement and 16 patients (29.1%) presented with no change. In group II, 19 patients (44.2%) presented with a complete recovery, 4 patients (9.3%) presented with a marked improvement, 9 patients (20.9%) presented with an improvement and 11 patients (25.6%) presented with no change. It was concluded that combined therapy with steroids plus Lipo-PGE1 was more effective in patients with sudden deafness, especially in severe cases.

Effects of Intravenous Lipoprostaglandin E1 on Neurogenic Intermittent Claudication

Circulation disturbances in the cauda equina and nerve roots have been implicated in the genesis of neurogenic intermittent claudication (NIC) in patients with lumbar spinal stenosis (LSS). We report the clinical results of lipoprostaglandin E1 (lipo-PGE1) treatments in patients with NIC. Lipo-PGE1 was administered intravenously for 10 consecutive days to 40 patients, 31 of whom showed a response to the treatment. Of the clinical symptoms examined, walking ability and leg numbness were significantly improved with an average effective period of 2.5 months. However, patients with radicular pain and severely affected patients did not respond well. Nerve root circulation in eight patients who subsequently underwent surgery was measured with a laser Doppler flowmeter. We observed increased blood flow in seven of these eight patients, after the intraoperative administration of lipo-PGE1. Lipo-PGE1 produced symptomatic improvement for a limited period in the treatment of NIC associated with LSS. The drug appeared to exert its effects through an increase in the circulation of blood in the nerve roots and the cauda equina.

Effects of lipo-prostaglandin E1 on blood flow and oxygen pressure in lumbo-sacral nerve roots

Lipo-prostaglandin E1 (lipo-PGE1) is reported to be effective in the treatment of intermittent neurogenic claudication associated with lumbar spinal stenosis. However, the underlying mechanisms by which lipo-PGE1 improves the neurological symptoms have not been fully clarified. We examined the effects of lipo-PGE1, on blood flow and oxygen pressure in the lumbar nerve roots in cats and in patients with lumbar spinal stenosis. In anesthetized cats, blood flow and oxygen pressure in the L7 nerve root were measured with a laser-Doppler flowmeter and a Polarographie oxygen monitor, respectively. Lipo-PGE1, (0.075 and 0.15 μg/kg, i.v.) significantly increased blood flow and oxygen pressure in the nerve roots, following transient decreases. When the dural tube was compressed by a balloon at the L6 level, lipo-PGE1 (0.15μg/kg) significantly increased blood flow and oxygen pressure in the nerve roots. Lipo-PGE1, also increased the intraoperative nerve-root blood flow in seven of ten patients with lumbar spinal stenosis. The results suggest that one of the favorable effects of lipo-PGE1, on neurogenic claudication is to increase nerve-root blood flow and oxygen pressure.

マイクロサージャリーを用いた血管吻合術に対する静注用ＰＧＥ１（Ｐｒｏｓｔａｇｌａｎｄｉｎ Ｅ１）製剤の臨床的効果の比較検討

Prostaglandin E1 (PGE1) has already been shown to improve vascular patency in experimental microvascular anastomosis. It is also widely used following clinical microvascular anastomosis. We designed a prospective study to compare the efficacy of Lipo PGE1 and PGE1-CD (PGE1-α-cyclodextrin) in 34 patients (14 free tissue transfers and 20 digital replantations). Dosage of Lipo PGE1 was 10μg daily for an average of 8 days and that of PGE1-CD was 120μg (60μg×2) for an average of 6 days. Success in microvascular anastomosis was evaluated by survival of the flap or replanted finger after 2 weeks. The success rate of free tissue transfers for the lipo PGE1 group was 100% and that of the PGE1-CD group was 75%. The success rate of digital replantations for the lipo PGE1 group was 88% and that of the PGE1-CD group was 75%. There was no significant difference between the two groups. Four of the 16 patients receiving PGE1-CD complained of vascular pain during injection, whereas, none complained of vascular pain in the group receiving lipo PGE1. Lipo PGE1 showed at least the same efficacy on patency after microvascular surgery as PGE1-CD with less vascular pain.

Effects of lipo-prostaglandin E1 on random pattern flaps in rabbits.

The effects of lipo-prostaglandin (PG) E1, which are lipid microspheres containing PGE1, were examined using 2 x 12 cm random pattern skin flaps on the backs of five rabbits. Five rabbits acted as controls. Both surviving length (8.5 (3.1) compared with 4.9 (1.8) cm) and surviving area (22.1 (9.3) compared with 11.5 (6.1) cm2) of the skin flap were significantly increased (p < 0.03 in each case). In three additional rabbits the blood flow on the distal side of the skin flap, where it was poor, was measured using a laser image blood flowmeter. Blood flow was improved five to 15 minutes after injection of lipo-PGE1 and was maintained for at least 60 minutes. In conclusion, lipo-PGE1 increased the blood flow of the random skin flaps, resulting in significant enlargement of the surviving area of skin flaps.

The effects of lipo-prostaglandin E1 on axial pattern flaps in rabbits.

The effects of lipo-prostaglandin E1 (lipo-PGE1), lipid microspheres containing PGE1, on axial pattern flaps were examined using 12 x 20 cm axial pattern flaps based on the right superficial inferior epigastric vessels on the abdomens of rabbits. The surviving area of the skin flap in the lipo-PGE1 group (0.197 +/- 14.1 cm2; n = 10) was significantly increased (p < 0.02) compared with the saline control group (110.4 +/- 5.5 cm2; n = 10). Changes in pedicle blood flow after lipo-PGE1 administration were determined using an ultrasonic pulsed Doppler flowmeter (n = 5). Blood flow in the artery was increased immediately after administration, and it was maintained for 40 minutes. The surface blood flow at the caudal end of the flap on the nonpedicle side, where it was poor, was measured using laserflowgraphy. Blood flow in the skin flap surface was improved 5 to 15 minutes after lipo-PGE1 administration, and it was maintained for as long as 60 minutes. Venous occlusion of the skin flap was also improved (n = 3). In conclusion, lipo-PGE1 increased the blood flow in the axial pattern flaps, resulting in significant enlargement of the surviving skin flap area.

リポＰＧＥ１を用いた耳鳴治療 特に老人性難聴に伴う耳鳴について

Severe tinnitus in 32 patients wtih senile deafness was treated with Lipoprostaglandin E1 10μg i. v. once a week. The tinnitus score was significantly decreased from 10 to 3.9±2.4. Slight to marked improvement was recorded in 90.6% of the patients. Early treatment, within 4 weeks of the onset of tinnitus, was more effective than later treatment. There were 4 patterns of improvement. No severe side effect was observed.The results of this study suggest that Lipoprostaglandin E1 is very useful in the treatment of tinnitus.

腰部脊柱管狭窄症に対するＬｉｐｏ ｐｒｏｓｔａｇｌａｎｄｉｎ Ｅ１の効果について 脊髄鏡による観察

Eight cases of lumbar spinal canal stenosis were investigated by myeloscope in order to observe the change of blood vessels on the cauda equinae before and after intravenous injection of Lipo Prostaglandin E1 (Lipo PGE1).In 5 cases, dilatation of vessels on the cauda equinae was seen after administration of Lipo PGE1. Severe side effects were not recognized.It was suggested that Lipo PGE1 improved the blood circulation on the cauda equinae, thereby improving symptoms of lumbar spinal canal stenosis.

THE EFFECT OF HYDRATION AND PROSTAGLANDIN E1 FOR RENAL INSUFFICIENCY IN ARTERIOSCLEROSIS OBLITERANS

The effect of hydration for preventing from renal dysfunction after major angiographies was studied in patients with arteriosclerosis obliterance, especially those associated with impaired renal function. Five protocols of hydration (On condition that 1000 ml of fluid transfusion were administrated on the day of angiography in all cases, group A: 500 ml/day, for more than 3 days before angiography, group B: no other fluid transfusion, group C: 500 ml/day, for each 5 days before and after angiography, group D: 500 ml/day, for 5 days after angiography, group E: Lipo-prostaglandin E1, 10μg/body, was injected just before aortography fromthe catheter in suprarenal aorta)were compaired with each other to establish the most effective hydration. Compairing creatinine clearance (Ccr) on the 7th day after angiography with that of preangiography, Ccr values were reduced by 3.7±18.3%, 10.9±23.9% and 15.0±16.3% in group A, B and D respectively while Ccrs were improved by 8.0±11.2%, and 4.6±11.4% in Group C, and E.Transfusion of 500 ml extracellular fluid/day for each 5 days before and after angiography or administration of Lipo-prostaglandin E1 just before angiography should be performed for preexisting renal insufficient patients (Ccr<50 ml/min) of ASO. If both of them are performed, the incidence of acute renal dysfunction after major angiography will decrease remarkably.

実験的急性肝不全モデルに対するＬｉｐｏ ｐｒｏｓｔａｇｌａｎｄｉｎ Ｅ１の及ぼす影響

When heat-killed Propionibacterium aches is intravenously injected into mice and seven days later, a small amount of gram-negative lipopolysaccharide (LPS) is also intravenously injected, most of the mice die of massive hepatic cell necrosis. However, when Lipo prostaglandin E1 was administered during this experimental induction of acute hepatic failue, the viability of the mice increased and the histological changes of the liver remarkably improved.These results suggested that Lipo prostaglandin E1 was effective in our experimental acute hepatic failure model. Since there is no difinite treatment method for fluminant hepatitis at present, Lipo prostaglandin E1 may be useful as a clinical treatment in future.

リウマチ因子陰性の慢性関節リウマチに難治性皮膚かいようとＩｇＡじん症を伴った１例

A 70-year-old woman was admitted to the hospital because of multiple leg ulcers, peripheral edema and pleurisy.Laboratory data were the following. Acute phase reactants increased slightly. Rheumatoid factors, antinuclear antibodies and serum immune complex were not detected. Serum complements were within normal limits. Urinalysis showed microscopic hematuria and proteinuria (<5g per day) . Histology of the kidney revealed mesangial proliferative glomerulonephritis (IgA nephropathy) . Oral glucose tolerance test was normal pattern.There was a 2-year-history of polyarthritis. Within a year after first admission she experienced subcutaneous nodules and pericardial effusion. While serological tests for rheumatoid factors had been negative, she was diagnosed to have classical rheumatoid arthritis according to the ARA's criteria and was thought to have rheumatoid vasculitis. 10μg Lipo prostaglandin E1 i.v. daily infusion was performed and six weeks later her ulcers healed completely, while conventional prostaglandin E1 therapy for a month in another hospital had been not effective for them. We did not use corticosteroids because pleurisy and pericardial effusion also disappeared with rest.This was a rare case of seronegative rheumatoid vasculitis with IgA nephropathy.