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Abbreviations & AcronymsObjective: To comprehensively analyze the 5-year outcomes of tamsulosin treatment for patients with benign prostatic hyperplasia. Methods: Tamsulosin (0.2 mg/day) was given to 112 patients who had International Prostate Symptom Scores Ն8. They were prospectively followed for 5 years with periodic evaluation. If tamsulosin had to be discontinued, the reason was determined. Treatment failure was considered in the case of disease progression (postvoid residual urine volume Ն200 mL, acute urinary retention, febrile urinary tract infection or hydronephrosis as a result of bladder outlet obstruction), conversion to other a1-blockers or need for surgery. An intention-to-treat analysis was carried out. Results: A total of 34 patients (30.4%) continued the same medication for the overall study period, whereas 78 patients (69.6%) discontinued the medication. International Prostate Symptom Scores, Benign Prostatic Hyperplasia Problem Index and Quality of Life Index were significantly improved over the 5-year period. Treatment failure was observed in 21 patients (18.8%). Baseline prostate volume and postvoid residual urine volume were independent factors to predicting treatment failure. A total of 21 patients (18.8%) discontinued tamsulosin because of an improvement of symptoms. They were younger and had lower prostate-specific antigen levels than the remaining 91 patients. Their symptoms were stable even 1 year after termination of therapy. Conclusions: Long-term efficacy of tamsulosin was observed, although only a small portion of patients continued the treatment. a1-blocker monotherapy might be not appropriate for achieving a good long-term outcome in patients with a large prostate volume and a large amount of postvoid residual urine volume. Persistent improvement of symptoms, even after termination of tamsulosin, was observed in young patients with low prostate-specific antigen levels.

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We have isolated a cDNA encoding a human intestinal IS-kDa protein (I-ISP) from a human ileal i g t 11 cDNA library, using a full-length rat I-1SP cDNA. One clone encompassed 571 nucleotides and encoded a 128-amino-acid protein with a calculated molecular mass of 1435.5 Da. The deduced amino acid sequence of human I-1SP showed high similarity to the rat counterpart (78'%), mouse ileal lipidbinding protein (80%) and porcine gastrotropin (75%). It also exhibited 36% similarity to human liver fatty-acid-binding protein (L-FABP). Northern blot analysis of human 1-1 SP revealed a single transcript only in ileum. however, the reverse-transcription/PCR demonstrated expression in ovary and placenta, but it was much lower than in ileum. Transformation of Escherichia coli with the I-1SP cDNA resulted in the efficient expression of a protein that was identical to the ileal cytosolic 1-15P. In vitrz, binding studies revealed that the bacterially expressed recombinant I-1SP showed much lower affinities for palmitate and oleate than L-FABP. However, it showed similar affinity for taurocholate, compared with a control, BSA. Comparison of the structural features of human I-1SP and human L-FABP suggested that loss of a long a-helix region and hydrophobic profile of I-1SP may be attributable to a unique ligandbinding specificity of I-ISP.