Cocaine: evidence for NMDA-, β-carboline- and dopaminergic-mediated seizures in mice

The present study was undertaken to examine the role of the benzodiazepine/GABA and N-methyl-d-aspartate (NMDA) systems in the convulsive effect of cocaine in mice. When cocaine (3.5 mg/ml) solution was infused into the tail vein at a rate of 0.3 ml/min, mice showed clonic and tonic convulsions. These seizures were not affected by low doses of bicuculline or picrotoxin, a GABA_A receptor antagonist and a Cl ion channel blocker, respectively. Aminooxyacetic acid (AOAA), a GABA deaminase inhibitor, and phenobarbital, a Cl ion channel activator, and baclofen, a GABA_B receptor agonist, also had no effect on these convulsions. Benzodiazepine inverse agonist β-DMCM, at a dose which by itself had no convulsive effect lowered the convulsive threshold of cocaine. This lowered convulsive threshold was reversed by flumazenil, a benzodiazepine inverse antagonist, and diazepam, a benzodiazepine full agonist, which by themselves did not inhibit cocaine seizure. It is likely that cocaine seizure involves a benzodiazepine (β-carboline) recognition site other than the benzodiazepine/GABA_A receptor–Cl ionophore complex system. CPP and MK-801, competitive and noncompetitive NMDA receptor antagonists, respectively, inhibited cocaine seizures. The inhibitory effects of CPP on cocaine convulsion were reversed by a low dose of NMDA, which by itself did not induce seizure. A dopamine D₁ receptor agonist SKF38393 enhanced both clonic and tonic convulsions, while a dopamine D₂ receptor agonist bromocriptine inhibited these convulsions. These stimulatory and inhibitory effects were reversed by the D₁ and D₂ receptor antagonists, SCH23390 and haloperidol, respectively. These results suggest that the cocaine-induced convulsion may involve an activation of the NMDA–Ca ionophore complex system, which is mediated by the dopaminergic system, and a β-carboline recognition site other than the benzodiazepine/GABA_A receptor–Cl ionophore complex system.     

Using Multidetector Row Computed Tomography to Evaluate Baggy Eyelid

Background  

Baggy eyelids, formed by intraorbital fat herniation in the lower eyelids, are a sign of aging observed in the midface. This study aimed to identify the cause of baggy eyelids by evaluating the relationship between orbicularis oculi muscle thickness, orbital fat prolapse length, and age using multidetector row computed tomography (MDCT).     

Evaluating educational media using traditional folk songs ('lam') in Laos: a health message combined with oral tradition

In the Lao People's Democratic Republic (Laos), health education is clearly a core aspect of the health service and is vital in improving people's lives through good health. However, there are many obstacles to conducting effective health education. The development of effective educational media is one solution to these problems. In Laos, traditional folk songs (lam) are preserved as part of the local communication media, and recently this communication medium has been used for health education. The aim of this study is to evaluate the effectiveness of educational media using lam. For this purpose, we conducted focus group discussions with 48 participants. The reactions of the participants towards a lam, developed for preventing HIV/AIDS, were analysed using the KJ (Kawakita Jiro) method. The analysis showed there were eight areas of concern: (1) interest in a lam talking about HIV/AIDS; (2) knowledge and perception related to HIV infection routes; (3) expressing a willingness for preventing HIV/AIDS; (4) togetherness with people living with HIV/AIDS; (5) HIV/AIDS education for children; (6) improving educational methods; (7) characteristics and effectiveness of the lam and (8) song preferences. The reactions of the participants, such as gaining knowledge and expressing individual attitudes and community actions for preventing HIV/AIDS, were promoted by the characteristics and effectiveness of the lam such as oral tradition, artistry and cultural values. In particular, the oral tradition represented by lam is useful for the Lao people in memorizing and communicating information.     

The presence of steatosis and elevation of alanine aminotransferase levels are associated with fibrosis progression in chronic hepatitis C with non-response to interferon therapy

BACKGROUND/AIMS: Interferon (IFN) therapy leads to regression of hepatic fibrosis in chronic hepatitis C patients who achieve a sustained virologic response (SVR), while the beneficial effect is limited in those who fail to do so. The aim of the present study was to define factors associated with progression of fibrosis in patients who do not achieve a SVR. METHODS: Fibrosis staging scores were compared between paired liver biopsies before and after IFN in 97 chronic hepatitis C patients who failed therapy. The mean interval between biopsies was 5.9 years. Factors associated with progression of fibrosis were analyzed. RESULTS: Fibrosis progressed in 23%, remained unchanged in 47% and regressed in 29%. Steatosis and a high average alanine aminotransferase (ALT) between biopsies were independent factors for progression of fibrosis with risk ratios of 5.53 and 4.48, respectively. Incidence and yearly rate of progression of fibrosis was 64% and 0.22+/-0.29 fibrosis units per year in those with both risk factors compared to 8% and -0.04+/-0.17 fibrosis units per year in those negative for both factors. CONCLUSIONS: Hepatic steatosis and elevated ALT levels are risk factors for progression of fibrosis in chronic hepatitis C patients who fail to achieve a SVR to IFN therapy and therefore may be therapeutic targets to halt the potentially progressive disease.     

Evaluation of preferable insertion routes for esophagogastroduodenoscopy using ultrathin endoscopes

AIM:To evaluate the discomfort associated with esophagogastroduodenoscopy(EGD)using an ultrathin endoscope through different insertion routes.METHODS:This study(January 2012-March 2013)included 1971 consecutive patients[male/female(M/F),1158/813,57.5±11.9 years]who visited a single institute for annual health checkups.Transnasal EGD was performed in 1394 patients and transoral EGD in 577.EGD-associated discomfort was assessed using a visual analog scale score(VAS score:0-10).RESULTS:Multivariate analysis revealed gender(M vs F:4.02±2.15 vs 5.06±2.43)as the only independent predictor of the VAS score in 180 patients who underwent EGD for the first time;whereas it revealed gender(M vs F 3.60±2.20 vs 4.84±2.37),operator,age group(A:<39 years;B:40-49 years;C:50-59years;D:60-69 years;E:>70 years;A/B/C/D/E:4.99±2.32/4.34±2.49/4.19±2.31/3.99±2.27/3.63±2.31),and type of insertion as independent predictors in the remaining patients.Subanalysis for gender,age group,and insertion route revealed that the VAS score decreased with age regardless of gender and insertion route,was high in female patients regardless of age and insertion route,and was low in males aged over60 years who underwent transoral insertion.CONCLUSION:Although comprehensive analysis revealed that the insertion route may not be an independent predictor of the VAS score,transoral insertion may reduce EGD-associated discomfort in elderly patients.     

The Associations Between Smoking Habits and Serum Triglyceride or Hemoglobin A1c Levels Differ According to Visceral Fat Accumulation

Background

Whether smokers and former smokers have worse lipid profiles or glucose levels than non-smokers remains unclear.

Methods

The subjects were 1152 Japanese males aged 42 to 81 years. The subjects were divided according to their smoking habits (nonsmokers, former smokers, and current smokers) and their visceral fat area (VFA) (<100 cm² and ≥100 cm²).

Results

The serum triglyceride (TG) levels of 835 males were assessed. In the VFA ≥100 cm² group, a significantly greater proportion of current smokers (47.3%) exhibited TG levels of ≥150 mg/dL compared with former smokers (36.4%) and non-smokers (18.8%). The difference in TG level distribution between former smokers and non-smokers was also significant. However, among the subjects with VFA of <100 cm², the TG levels of the three smoking habit groups did not differ. The serum hemoglobin A1c (HbA1c) levels of 877 males were also assessed. In the VFA <100 cm² group, significantly higher proportions of current smokers (17.9%) and former smokers (14.9%) demonstrated HbA1c levels of ≥5.6% compared with non-smokers (6.3%). In contrast, in the VFA ≥100 cm² group, significantly fewer former smokers displayed HbA1c levels of ≥5.6% compared with non-smokers and current smokers. Furthermore, the interaction between smoking habits and VFA was associated with the subjects’ TG and HbA1c concentrations, and the associations of TG and HbA1c concentrations and smoking habits varied according to VFA.

Conclusions

Both smoking habits and VFA exhibited associations with TG and HbA1c concentrations. The associations between smoking habits and these parameters differed according to VFA.Key words: smoking habits, visceral fat, interaction, serum triglycerides, hemoglobin A1c