human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose The efficacy of a loading dose of α1-adrenoreceptor antagonist for patients with benign prostate hyperplasia who did not improve at a low dose has not been determined . We performed a prospect i ve study to estimate the efficacy of incremental naftopidil administration . Methods The efficacy of naftopidil was examined based on changes in the International Prostate Symptom Score ( IPSS ) . We defined a “ responder ” as a patient who improved by ≥5 points in IPSS total score . All patients were administered naftopidil at 50 mg/day for 12 weeks , and nonresponders at 50 mg/day were increased to 75 mg/day . Efficacy was finally evaluated after an additional 12 weeks of administration at 75 mg/day . Results Among 122 patients whose data could be analyzed , the efficacy rate after administration at 50 mg/day was 52.5 % . In all IPSS items except urgency score , the responders had significantly higher ( poorer ) values than nonresponders before the start of treatment . Of 40 patients whose dose was increased to 75 mg/day and whose data could be analyzed  , prostate volume in the responder group ( 9 patients ) was significantly smaller than that in the nonresponder group ( 31 patients ) . Multivariate analysis showed that patients with improved IPSS total score , voiding symptoms , urgency , and weak stream after administration of 50 mg/day naftopidil were more likely to improve after a dose increase . Conclusions A dose increment of naftopidil to 75 mg/day may be useful in patients with BPH who did not improve at 50 mg/day OBJECTIVES To examine the effect of alpha 1D/A adrenoceptor inhibitor naftopidil on health-related quality of life ( QOL ) in men with benign prostatic hyperplasia ( BPH ) . METHODS A total of 56 newly diagnosed patients with symptomatic BPH were prospect ively enrolled and treated with 50 mg naftopidil daily for more than 12 weeks . All underwent pre-treatment documentation of lower urinary tract symptoms , QOL assessment using the international prostate symptom score ( IPSS ) and King 's Health Question naire ( KHQ ) , and uroflowmetry . A post-treatment assessment was performed at 12 weeks . RESULTS IPSS scores as well as QOL index showed a significant improvement after naftopidil administration . Similarly , all seven domains except general health perceptions and social limitations in the KHQ question naire were significantly improved . When dividing the patients into overactive bladder ( OAB ) and non-OAB groups , only the OAB group showed significant improvement in almost all the domains of KHQ . Change ratios of the IPSS were not associated with those of KHQ domain scores in the OAB group . On the other h and , in the non-OAB group more domains presented improvements , which were associated with those of IPSS scores . CONCLUSIONS Twelve-week treatment with naftopidil for symptomatic BPH patients is associated with significant improvement in the IPSS , QOL index , maximum urinary flow rate , post-void residual urine volume ( PVR ) and almost all domains in KHQ . KHQ is useful for the evaluation of clinical response in BPH patients , particularly in those with associated OAB This was a multicenter r and omized trial to investigate the clinical efficacy and the impact on sexual function of alpha-1A selective silodosin and alpha-1D selective naftopidil for treatment of benign prostatic hyperplasia . A total of 97 patients with lower urinary tract symptoms/benign prostatic hyperplasia who had an International Prostate Symptom Score of 8 or more were r and omly assigned to receive silodosin ( 8 mg/day , n = 53 ) or naftopidil ( 75 mg/day , n = 44 ) . Before and 4 , 8 and 12 weeks after treatment , International Prostate Symptom Score and its quality of life score were used to assess lower urinary tract symptoms . Also , International Index of Erectile Function-5 , and an original question naire were used to evaluate erectile function and ejaculation for sexually active patients , respectively . The silodosin group showed advantages in terms of voiding symptoms and quality of life of International Prostate Symptom Score when compared with the naftopidil group . Both silodosin and naftopidil showed no significant effect on International Index of Erectile Function-5 . A total of 23 sexually active patients in the silodosin group experienced more ejaculatory impairment than 21 patients in the naftopidil group , with a decrease of ejaculation volume ( 87 % vs 40 % , P = 0.003 ) , prolonged time to ejaculation ( 56 % vs 33 % , P = 0.027 ) and decrease of orgasm ( 50 % vs 39 % , P = 0.027 ) . These results suggest that alpha-1A selective blockers are more effective for voiding symptoms , whereas alpha-1D selective blockers offer a minor degree of ejaculatory dysfunction Naftopidil , approved only in Japan , is an α1-adrenergic receptor antagonist ( α1-blocker ) used to treat lower urinary tract symptoms ( LUTS ) suggestive of benign prostatic hyperplasia ( BPH ) . Different from tamsulosin hydrochloride and silodosin , in that it has higher and extremely higher affinity respectively , for the α1A-adrenergic receptor subtype than for the α1D type , naftopidil has distinct characteristics because it has a three times greater affinity for the α1D-adrenergic receptor subtype than for the α1A subtype . Although well- design ed large-scale r and omized controlled studies are lacking and the optimal dosage of naftopidil is not always completely determined , previous reports from Japan have shown that naftopidil has superior efficacy to a placebo and comparable efficacy to other α1-blockers such as tamsulosin . On the other h and , the incidences of ejaculatory disorders and intraoperative floppy iris syndrome induced by naftopidil may be lower than for tamsulosin and silodosin having high affinity for the α1A-adrenergic receptor subtype . However , it remains unknown if the efficacy and safety of naftopidil in Japanese is applicable to white , black and Hispanic men having LUTS/BPH in western countries Objectives To examine the mechanism underlying improvements in nocturia by α1-blockers , we investigated whether the α1-blocker naftopidil acts on nocturia with sleep disturbance using a frequency/volume chart ( FVC ) . Methods A total of 56 male patients with lower urinary tract symptoms were enrolled . The inclusion criteria were as follows : eight or more points on the I-PSS ; three or more points on the I-PSS score for nocturia ; and prostate volume larger than 20 ml . Patients received 50 mg of naftopidil once daily for 4 weeks , and non-responders received 75 mg for another 4 weeks . All patients were examined , and their data entered into FVC for 2 days before and after administration of naftopidil . Quality of sleep was also evaluated using modified Pittsburgh sleep quality index ( PSQI ) . Results Patients  with sleep quality scores of three or four were assigned to sleep disturbance group ( n = 33 ) , while those with scores of less than three were assigned to non-disturbance group ( n = 23 ) . After administration of naftopidil , total I-PSS decreased and nocturia score decreased from 3.5 to 2.6 ( P < 0.01 ) . Total mean score of modified PSQI in sleep disturbance group became significantly lower after administration of naftopidil ( from 16.9 to 14.0 ; P < 0.01 ) . Naftopidil significantly decreased nocturnal urine volume , result ing in a decrease in the nocturnal polyuria index in both sleep disturbance and non-disturbance groups . Conclusion These results suggest that α1-blockers have the ability to normalize sleep disorders . Naftopidil  improved nocturnal polyuria regardless of the presence of sleep disturbance , meaning that it might directly reduce nocturnal urine production Objectives . To examine the feature of men who benefit from dose escalation of naftopidil for lower urinary tract symptoms ( LUTSs ) . Methods . Based on the IPSS , men reporting LUTS were prospect ively studied using 50 mg/day of naftopidil for the first 4 weeks ; satisfied patients continued its 50 mg/day ( n = 11 ) , and those reporting unsatisfactory improvement received its 75 mg/day ( n = 35 ) for the next 4 weeks . Results . The 75 mg group showed improvement in the total IPSS and QOL score in a dose-dependent manner ( at 4 weeks : P < .001 , at 4 weeks versus 8 weeks : P < .05 ) . In the 50 mg group , both scores reduced at 4 weeks , thereafter unchanged . The baseline slow stream score alone was higher in the 75 mg group ( P = .013 ) . The rate of change in the QOL score during the initial 4 weeks ( ΔQOL ) and Δnocturia was smaller in the 75 mg group ( P < .05 ) . Conclusions . Men with high slow stream score and unsatisfactory improvement in nocturia may benefit from dose escalation of naftopidil PURPOSE We examined the correlation between the expression of alpha1-adrenoceptor subtype mRNA in the prostate and the clinical efficacy of subtype selective alpha1-adrenoceptor antagonists . We discuss the possibility of individualizing drug therapy in patients with benign prostatic hyperplasia . MATERIAL S AND METHODS A total of 33 patients r and omized to the tamsulosin group and 28 r and omized to the naftopidil group were enrolled in this study . Each group of patients was administered 0.2 mg tamsulosin hydrochloride or 50 mg naftopidil daily for 12 weeks . Four prostate needle biopsy specimens were obtained from the transition zone to examine the expression of alpha-adrenoceptor subtypes . Specimens were stored at -80 C until used for TaqMan quantitative reverse transcriptase-polymerase chain reaction , which was performed after 12 weeks of treatment . RESULTS Based on the results of quantitative reverse transcriptase-polymerase chain reaction the tamsulosin and naftopidil groups were grouped into alpha1a-adrenoceptor dominant ( 22 and 12 patients ) and alpha1d-adrenoceptor dominant ( 11 and 16 , respectively ) subgroups . The efficacy of tamsulosin hydrochloride and naftopidil differed depending on the dominant expression of the alpha1-adrenoceptor subtype in the prostate . Tamsulosin hydrochloride was more effective in patients with dominant expression of the alpha1a-adrenoceptor subtype , whereas naftopidil was more effective in those with dominant expression of the alpha1d-adrenoceptor subtype . CONCLUSIONS The expression level of alpha1-adrenoceptor subtype mRNA in the prostate could be a predictor of the efficacy of subtype selective alpha1-adrenoceptor antagonists in patients with benign prostatic hyperplasia . This result implies that genetic differences are responsible for the diverse responses to these drugs OBJECTIVES The clinical usefulness of naftopidil was evaluated in 122 patients with benign prostatic hyperplasia for urinary tract symptoms and signs , focused in particular on nocturia . METHODS A total of 122 patients with BPH whose symptoms did not improve after 6 weeks of tamsulosin administration were enrolled . After the treatment was followed by a washout period with placebo , patients were prescribed 75 mg of naftopidil to be taken after dinner for 6 weeks , and the efficacy was re-evaluated . All the drugs used were unidentified , and attention was given to not have the patients recognize the change in the drug given . The primary purpose of this study was the improvement of nocturia in patients with a poor response to tamsulosin . The clinical efficacy of naftopidil was defined as significant improvement in International Prostate Symptom Score , quality -of-life index , and maximal urinary flow rate . RESULTS After 6 weeks of naftopidil administration , significant improvements in daytime and nighttime frequency , International Prostate Symptom Score , quality -of-life index , maximal flow rate , average flow rate , and bladder compliance were examined . On the International Prostate Symptom Score question naire , improvement in the sensation of the bladder not emptying and a reduction in nighttime frequency stood out . Moreover , detrusor overactivity was observed in 40 patients before the start of treatment and was eliminated in 31 . The effective rate of this study was 69.7 % ( 85/122 ) . CONCLUSIONS Naftopidil has novel effects in patients with BPH whose main complaints are storage and voiding symptoms , especially that of nocturia of > or=3 times , as well as in patients with a low compliance bladder and detrusor overactivity , who did not respond to tamsulosin AIM The aim of this study was to compare the efficacy and safety of alpha1-adrenoceptor ( alpha1-AR ) antagonist monotherapy with combination therapy using alpha1-AR antagonist and anticholinergic agent for benign prostatic hyperplasia ( BPH ) with storage symptoms as the chief complaint . METHODS In this prospect i ve comparative study , either 25 - 75 mg/day of naftopidil monotherapy ( monotherapy group ) or combination therapy using 25 - 75 mg/day of naftopidil and an anticholinergic agent ( 10 - 20 mg/day of propiverine hydrochloride or 2 - 6 mg/day of oxybutynin hydrochloride ; cotherapy group ) were administered for 12 weeks to 101 BPH patients with storage symptoms . RESULTS International prostate symptom score ( IPSS 
    Output:
    
agent
Although additional well design ed , worldwide , placebo-controlled and r and omized studies are necessary to confirm the long-term outcomes of naftopidil pharmacotherapy , current data suggest that naftopidil administration in BPH patients provides comparable improvements in total IPSS , QoL , and urinary symptoms from baseline relative to 0.2 mg/d tamsulosin and 8 mg/d silodosin .
However , improvements in Qmax are generally less with naftopidil than with tamsulosin .
Reported adverse effects related to naftopidil administration are negligible and usually mild .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose The efficacy of a loading dose of α1-adrenoreceptor antagonist for patients with benign prostate hyperplasia who did not improve at a low dose has not been determined . We performed a prospect i ve study to estimate the efficacy of incremental naftopidil administration . Methods The efficacy of naftopidil was examined based on changes in the International Prostate Symptom Score ( IPSS ) . We defined a “ responder ” as a patient who improved by ≥5 points in IPSS total score . All patients were administered naftopidil at 50 mg/day for 12 weeks , and nonresponders at 50 mg/day were increased to 75 mg/day . Efficacy was finally evaluated after an additional 12 weeks of administration at 75 mg/day . Results Among 122 patients whose data could be analyzed , the efficacy rate after administration at 50 mg/day was 52.5 % . In all IPSS items except urgency score , the responders had significantly higher ( poorer ) values than nonresponders before the start of treatment . Of 40 patients whose dose was increased to 75 mg/day and whose data could be analyzed  , prostate volume in the responder group ( 9 patients ) was significantly smaller than that in the nonresponder group ( 31 patients ) . Multivariate analysis showed that patients with improved IPSS total score , voiding symptoms , urgency , and weak stream after administration of 50 mg/day naftopidil were more likely to improve after a dose increase . Conclusions A dose increment of naftopidil to 75 mg/day may be useful in patients with BPH who did not improve at 50 mg/day OBJECTIVES To examine the effect of alpha 1D/A adrenoceptor inhibitor naftopidil on health-related quality of life ( QOL ) in men with benign prostatic hyperplasia ( BPH ) . METHODS A total of 56 newly diagnosed patients with symptomatic BPH were prospect ively enrolled and treated with 50 mg naftopidil daily for more than 12 weeks . All underwent pre-treatment documentation of lower urinary tract symptoms , QOL assessment using the international prostate symptom score ( IPSS ) and King 's Health Question naire ( KHQ ) , and uroflowmetry . A post-treatment assessment was performed at 12 weeks . RESULTS IPSS scores as well as QOL index showed a significant improvement after naftopidil administration . Similarly , all seven domains except general health perceptions and social limitations in the KHQ question naire were significantly improved . When dividing the patients into overactive bladder ( OAB ) and non-OAB groups , only the OAB group showed significant improvement in almost all the domains of KHQ . Change ratios of the IPSS were not associated with those of KHQ domain scores in the OAB group . On the other h and , in the non-OAB group more domains presented improvements , which were associated with those of IPSS scores . CONCLUSIONS Twelve-week treatment with naftopidil for symptomatic BPH patients is associated with significant improvement in the IPSS , QOL index , maximum urinary flow rate , post-void residual urine volume ( PVR ) and almost all domains in KHQ . KHQ is useful for the evaluation of clinical response in BPH patients , particularly in those with associated OAB This was a multicenter r and omized trial to investigate the clinical efficacy and the impact on sexual function of alpha-1A selective silodosin and alpha-1D selective naftopidil for treatment of benign prostatic hyperplasia . A total of 97 patients with lower urinary tract symptoms/benign prostatic hyperplasia who had an International Prostate Symptom Score of 8 or more were r and omly assigned to receive silodosin ( 8 mg/day , n = 53 ) or naftopidil ( 75 mg/day , n = 44 ) . Before and 4 , 8 and 12 weeks after treatment , International Prostate Symptom Score and its quality of life score were used to assess lower urinary tract symptoms . Also , International Index of Erectile Function-5 , and an original question naire were used to evaluate erectile function and ejaculation for sexually active patients , respectively . The silodosin group showed advantages in terms of voiding symptoms and quality of life of International Prostate Symptom Score when compared with the naftopidil group . Both silodosin and naftopidil showed no significant effect on International Index of Erectile Function-5 . A total of 23 sexually active patients in the silodosin group experienced more ejaculatory impairment than 21 patients in the naftopidil group , with a decrease of ejaculation volume ( 87 % vs 40 % , P = 0.003 ) , prolonged time to ejaculation ( 56 % vs 33 % , P = 0.027 ) and decrease of orgasm ( 50 % vs 39 % , P = 0.027 ) . These results suggest that alpha-1A selective blockers are more effective for voiding symptoms , whereas alpha-1D selective blockers offer a minor degree of ejaculatory dysfunction Naftopidil , approved only in Japan , is an α1-adrenergic receptor antagonist ( α1-blocker ) used to treat lower urinary tract symptoms ( LUTS ) suggestive of benign prostatic hyperplasia ( BPH ) . Different from tamsulosin hydrochloride and silodosin , in that it has higher and extremely higher affinity respectively , for the α1A-adrenergic receptor subtype than for the α1D type , naftopidil has distinct characteristics because it has a three times greater affinity for the α1D-adrenergic receptor subtype than for the α1A subtype . Although well- design ed large-scale r and omized controlled studies are lacking and the optimal dosage of naftopidil is not always completely determined , previous reports from Japan have shown that naftopidil has superior efficacy to a placebo and comparable efficacy to other α1-blockers such as tamsulosin . On the other h and , the incidences of ejaculatory disorders and intraoperative floppy iris syndrome induced by naftopidil may be lower than for tamsulosin and silodosin having high affinity for the α1A-adrenergic receptor subtype . However , it remains unknown if the efficacy and safety of naftopidil in Japanese is applicable to white , black and Hispanic men having LUTS/BPH in western countries Objectives To examine the mechanism underlying improvements in nocturia by α1-blockers , we investigated whether the α1-blocker naftopidil acts on nocturia with sleep disturbance using a frequency/volume chart ( FVC ) . Methods A total of 56 male patients with lower urinary tract symptoms were enrolled . The inclusion criteria were as follows : eight or more points on the I-PSS ; three or more points on the I-PSS score for nocturia ; and prostate volume larger than 20 ml . Patients received 50 mg of naftopidil once daily for 4 weeks , and non-responders received 75 mg for another 4 weeks . All patients were examined , and their data entered into FVC for 2 days before and after administration of naftopidil . Quality of sleep was also evaluated using modified Pittsburgh sleep quality index ( PSQI ) . Results Patients  with sleep quality scores of three or four were assigned to sleep disturbance group ( n = 33 ) , while those with scores of less than three were assigned to non-disturbance group ( n = 23 ) . After administration of naftopidil , total I-PSS decreased and nocturia score decreased from 3.5 to 2.6 ( P < 0.01 ) . Total mean score of modified PSQI in sleep disturbance group became significantly lower after administration of naftopidil ( from 16.9 to 14.0 ; P < 0.01 ) . Naftopidil significantly decreased nocturnal urine volume , result ing in a decrease in the nocturnal polyuria index in both sleep disturbance and non-disturbance groups . Conclusion These results suggest that α1-blockers have the ability to normalize sleep disorders . Naftopidil  improved nocturnal polyuria regardless of the presence of sleep disturbance , meaning that it might directly reduce nocturnal urine production Objectives . To examine the feature of men who benefit from dose escalation of naftopidil for lower urinary tract symptoms ( LUTSs ) . Methods . Based on the IPSS , men reporting LUTS were prospect ively studied using 50 mg/day of naftopidil for the first 4 weeks ; satisfied patients continued its 50 mg/day ( n = 11 ) , and those reporting unsatisfactory improvement received its 75 mg/day ( n = 35 ) for the next 4 weeks . Results . The 75 mg group showed improvement in the total IPSS and QOL score in a dose-dependent manner ( at 4 weeks : P < .001 , at 4 weeks versus 8 weeks : P < .05 ) . In the 50 mg group , both scores reduced at 4 weeks , thereafter unchanged . The baseline slow stream score alone was higher in the 75 mg group ( P = .013 ) . The rate of change in the QOL score during the initial 4 weeks ( ΔQOL ) and Δnocturia was smaller in the 75 mg group ( P < .05 ) . Conclusions . Men with high slow stream score and unsatisfactory improvement in nocturia may benefit from dose escalation of naftopidil PURPOSE We examined the correlation between the expression of alpha1-adrenoceptor subtype mRNA in the prostate and the clinical efficacy of subtype selective alpha1-adrenoceptor antagonists . We discuss the possibility of individualizing drug therapy in patients with benign prostatic hyperplasia . MATERIAL S AND METHODS A total of 33 patients r and omized to the tamsulosin group and 28 r and omized to the naftopidil group were enrolled in this study . Each group of patients was administered 0.2 mg tamsulosin hydrochloride or 50 mg naftopidil daily for 12 weeks . Four prostate needle biopsy specimens were obtained from the transition zone to examine the expression of alpha-adrenoceptor subtypes . Specimens were stored at -80 C until used for TaqMan quantitative reverse transcriptase-polymerase chain reaction , which was performed after 12 weeks of treatment . RESULTS Based on the results of quantitative reverse transcriptase-polymerase chain reaction the tamsulosin and naftopidil groups were grouped into alpha1a-adrenoceptor dominant ( 22 and 12 patients ) and alpha1d-adrenoceptor dominant ( 11 and 16 , respectively ) subgroups . The efficacy of tamsulosin hydrochloride and naftopidil differed depending on the dominant expression of the alpha1-adrenoceptor subtype in the prostate . Tamsulosin hydrochloride was more effective in patients with dominant expression of the alpha1a-adrenoceptor subtype , whereas naftopidil was more effective in those with dominant expression of the alpha1d-adrenoceptor subtype . CONCLUSIONS The expression level of alpha1-adrenoceptor subtype mRNA in the prostate could be a predictor of the efficacy of subtype selective alpha1-adrenoceptor antagonists in patients with benign prostatic hyperplasia . This result implies that genetic differences are responsible for the diverse responses to these drugs OBJECTIVES The clinical usefulness of naftopidil was evaluated in 122 patients with benign prostatic hyperplasia for urinary tract symptoms and signs , focused in particular on nocturia . METHODS A total of 122 patients with BPH whose symptoms did not improve after 6 weeks of tamsulosin administration were enrolled . After the treatment was followed by a washout period with placebo , patients were prescribed 75 mg of naftopidil to be taken after dinner for 6 weeks , and the efficacy was re-evaluated . All the drugs used were unidentified , and attention was given to not have the patients recognize the change in the drug given . The primary purpose of this study was the improvement of nocturia in patients with a poor response to tamsulosin . The clinical efficacy of naftopidil was defined as significant improvement in International Prostate Symptom Score , quality -of-life index , and maximal urinary flow rate . RESULTS After 6 weeks of naftopidil administration , significant improvements in daytime and nighttime frequency , International Prostate Symptom Score , quality -of-life index , maximal flow rate , average flow rate , and bladder compliance were examined . On the International Prostate Symptom Score question naire , improvement in the sensation of the bladder not emptying and a reduction in nighttime frequency stood out . Moreover , detrusor overactivity was observed in 40 patients before the start of treatment and was eliminated in 31 . The effective rate of this study was 69.7 % ( 85/122 ) . CONCLUSIONS Naftopidil has novel effects in patients with BPH whose main complaints are storage and voiding symptoms , especially that of nocturia of > or=3 times , as well as in patients with a low compliance bladder and detrusor overactivity , who did not respond to tamsulosin AIM The aim of this study was to compare the efficacy and safety of alpha1-adrenoceptor ( alpha1-AR ) antagonist monotherapy with combination therapy using alpha1-AR antagonist and anticholinergic agent for benign prostatic hyperplasia ( BPH ) with storage symptoms as the chief complaint . METHODS In this prospect i ve comparative study , either 25 - 75 mg/day of naftopidil monotherapy ( monotherapy group ) or combination therapy using 25 - 75 mg/day of naftopidil and an anticholinergic agent ( 10 - 20 mg/day of propiverine hydrochloride or 2 - 6 mg/day of oxybutynin hydrochloride ; cotherapy group ) were administered for 12 weeks to 101 BPH patients with storage symptoms . RESULTS International prostate symptom score ( IPSS 
    Output:
    