Aim:The present study was a 52-week, noncomparative, open-label study of flexible dose paroxetine (20-40 mg) in 52 Japanese post-traumatic stress disorder (PTSD) patients in order to obtain clinical experience regarding efficacy and safety in regular clinical practice.

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In the diagnosis of early cancer, there are differences in the pathological criteria used by Western and Asian (Japanese) pathologists. The Vienna classification advocated by pathologists offers standard pathological criteria common to all endoscopists, and it has clarified the indications for the treatment of superficial lesions, including high-grade dysplasia and mucosal cancer. Endoscopic mucosal resection (EMR) is increasingly being used in the treatment of early cancer. Experience with EMR in the treatment of Barrett's esophagus with cancer has been reported, and the preliminary results are encouraging. Some technical variations and improvements in EMR procedures have been described. As an injection agent, the use of mucinous substances such as sodium hyaluronate has been reported. A cutting knife with an insulated tip has been designed, making the use of the precutting technique much safer. Studies have been conducted comparing the freehand technique with the cap technique for EMR, and it was found that the cap technique is generally better. Ablative treatment has also been used in many cases, with satisfactory results. In advanced cancer, self-expanding metallic stents have been used for palliative treatment, with generally satisfactory results. The range of applications for therapeutic endoscopy has continued to expand during the last two years in the treatment of esophageal and gastric tumors.

TA-993, a new 1,5-benzothiazepine derivative having a l-cis configuration, has a selective increasing action on limb blood flow, in addition to an antiplatelet aggregating action. The cardiovascular action of TA-993 is quite different from diltiazem, which is a well-known 1,5-benzothiazepine derivative having a d-cis configuration. Therefore, we compared the cardiovascular actions of d-cis and l-cis isomers of TA-993 with those of diltiazem. l-cis-Diltiazem, as well as TA-993, progressively increased femoral, brachial and common carotid blood flow with little change in arterial pressure or vertebral blood flow. However, the peak response to l-cis-diltiazem (20 min after the administration) was observed earlier than that to TA-993 (60 min after the administration). On the other hand, d-cis-TA-993, as well as diltiazem, caused transient hypotension, tachycardia and increases in vertebral, brachial, femoral and common carotid blood flow. Furthermore, their peak effects were observed immediately after the administration. Potency ratios of the vasorelaxing effects of TA-993, l-cis-diltiazem and d-cis-TA-993 to diltiazem in the isolated and K+-contracted canine femoral artery were 0.096, 0.032 and 1.209, respectively. pA2 values for TA-993 and diltiazem against Ca2+-induced contractions in the isolated and K+-depolarized canine saphenous artery were 5.50+/-0.11 and 7.12+/-0.18, respectively. These results indicate that TA-993 shares a common profile with l-cis-diltiazem, and suggest that 1,5-benzothiazepine derivatives of a l-cis configuration are a different class of drug from that of the d-cis configuration.

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