Prevalence of intimate partner violence and related factors in a local city in Japan

OBJECTIVES: This study sought to assess the prevalence of intimate partner violence in a local city of Fukui Prefecture, and whether the subjects' and their partners' demographic characteristics, alcohol use, and violence experienced in the families in which they were raised might be related risk factors. METHODS: We conducted a mail survey of 1,000 subjects aged 20-69 in the city randomly sampled from the population of 45,220 that were stratified by 10 years of age and sex and pulled 100 from each group. Data from two 248 respondents were eligible for analysis. The self-administered questionnaire included items on; 1) whether they were the victims of physical, sexual, social-economic and psychological violence from their intimate partners, and whether they perpetrated violence or not on their partners; 2) demographic characteristics of the subjects and their partners with information on gender, age, occupation, educational background, annual income, the cohabitants, and their alcohol use; 3) the subjects' experience of violence in the family in which they had grown up; exposure to violence between their parents, and being abused by them. RESULTS: Out of 248 subjects, men accounted for 41.5%. The prevalence rate of any violence experienced from intimate partners was 46.4%, and that of having perpetrated any violence on the partner was 43.1%. Women reported experiencing more "sexual violence" from their partners than did men. In addition, men admitted to more "physical, sexual, and psychological violence" on their partners than women. Those who had themselves been exposed to violence between parents or were victimized by their parents significantly had more experience of violence from their partners and perpetration than those who did not. CONCLUSION: The results suggest that questioning about the experience of violence in the family is useful for the early detection of intimate partner violence.     

Effect of moderate alcohol intake on nocturnal sleep respiratory parameters in healthy middle-aged men

Purpose  It is known that a moderate to large volume of alcohol produces deterioration in obstructive sleep apnea (OSA), however, no consensus has been achieved with respect to the influence of a moderate volume of alcohol on mild to moderate OSA. In this study, we investigated the influence of alcohol on OSA-associated parameters in healthy middle-aged males drinking a moderate volume of alcohol (<1 g alcohol/kg bodyweight per day). Methods  Subjects were 23 healthy males (mean age of 46.0) with a habitual ingestion of moderate a mounts of alcohol. Respiratory sleep parameters were measured through the fitting of an Apnomonitor III (Chest Inc.) and portable sleep monitoring device (Actiwatch: AMI Inc.) to subjects on three nights; an alcohol-free night, a night on which they drank alcohol with dinner, and a night on which they drank alcohol within 30 minutes before retiring to bed. The measurements were categorized into the early and late halves of assumed sleep for analysis. Results  The apnea-hypopnea index was significantly higher when drinking alcohol before retiring [mean (SD): 7.8 (8.2) events/hour] than the values on the alcohol-free day [2.9 (4.5) events/hour] and when drinking alcohol with dinner [3.8 (5.3) events/hour]. Furthermore, drinking alcohol before retiring resulted in lower arterial blood oxygen saturation (SpO₂) during the early half of sleep [94.8 (1.4) %] when compared to the values on the alcohol-free day [95.7 (1.3) %] and drinking alcohol with dinner [95.4 (1.6) %]. In addition, the percentage of time with SpO₂<92% (hypoxic event) during the early half of sleep [4.9 (9.3) %] was significantly higher than the values on the alcohol-free day [1.2 (1.8) %] and when drinking alcohol with dinner [1.4 (1.8) %]. Conclusion  These results suggest that moderate ingestion of alcohol within 30 minutes before retiring aggravates OSA-associated parameters in healthy males.     

Use of a homemade nylon loop for the prevention of postpolypectomy bleeding of large pedunculated polyps

To avoid bleeding after colonoscopic polypectomy, several procedures are being used. We describe a new method that consists of a homemade nylon loop that is applied and tied to the stalk of the pedunculated polyp and after which a conventional polypectomy is done. We have used this method in 15 patients and no complication was observed. The procedure is simple; the loop may be opened to large diameters to make it easier to use for large polyps. It has a low cost and seems to be safe and effective to prevent bleeding after endoscopic polypectomy.     

Oral presentation of epithelioid angiosarcoma with first sign in the scapula: report of a case and review of the literature

Occurrence of a primary or metastatic angiosarcoma in the oral cavity is extremely rare. The term "epithelioid angiosarcoma" (EA) has been used to designate a morphological variant of angiosarcoma characterized by poorly differentiated epithelial-like cells arranged in carcinoma-like fashion, but which still forms identifiable vascular channels. To our knowledge, EA in the oral region is extremely rare. Only two previous instances of EA in the maxilla have been reported. We present an additional oral case of EA in a 71-year-old man. Histology of the initial oral biopsy revealed suspicion of un-differentiated carcinoma. In order to confirm the diagnosis, immunohistochemical examinations were performed. The final diagnosis was EA. The patient died of multiple metastases shortly after the final diagnosis, implying an aggressive clinical course. This case showed that it was essential to use the vascular markers, such as FVIII-Rag and CD34, for a correct histological diagnosis of EA. The oral EA described here almost certainly represents a metastatic focus, rather than the primary site of tumor origin. This is because clinical history of EAs appears to arise in deep, rather than in more superficial tissues.     

Propofol inhibits long-term potentiation but not long-term depression in rat hippocampal slices

BACKGROUND: Although propofol is known to produce amnesia when used for anesthesia, mechanisms underlying its effects on memory are poorly understood. The current study was designed to examine the effects of propofol on forms of synaptic plasticity thought to contribute to memory processing. METHODS: Extracellular excitatory postsynaptic potentials were recorded from the CA1 region of rat hippocampal slices. Long-term potentiation (LTP) was induced using theta-burst stimulation (10 bursts of 4 pulses at 100 Hz, applied at 5 Hz) of the Schaffer-collateral pathway, while low-frequency stimulation (1 Hz x 900 pulses) was delivered to induce long-term depression. The authors also used higher-frequency stimulation (10 bursts of 4 pulses at 200 Hz, applied at 5 Hz) in the presence of MK-801 to examine the effects of propofol on an N-methyl-D-aspartate receptor-independent form of LTP. RESULTS: At 30 microM, propofol inhibited LTP induction produced by theta-burst stimulation but had less effect on LTP maintenance. Similarly, when LTP was induced by 200-Hz stimulation in the presence of MK-801, propofol also blocked LTP induction. Propofol did not block LTP induction in the presence of picrotoxin, a specific antagonist of gamma-aminobutyric acid type A receptors, suggesting that modulation of gamma-aminobutyric acid type A receptors participates in propofol-mediated LTP inhibition. Propofol did not inhibit long-term depression. CONCLUSIONS: Propofol inhibits LTP induction through modulation of gamma-aminobutyric acid type A receptors but not via inhibition of N-methyl-D-aspartate receptors. However, other factors also possibly contribute to propofol-mediated LTP inhibition.     

Randomized clinical trial of the effect of a saline-linked radiofrequency coagulator on blood loss during hepatic resection

BACKGROUND: Use of a saline-linked radiofrequency coagulator (dissecting sealer) has been suggested to reduce blood loss during hepatic resection. A randomized clinical trial was conducted to assess the effects of using the device on the amount of blood loss. METHODS: Patients scheduled to undergo hepatic resection were randomly assigned to either use of the dissecting sealer or the clamp crushing method. The primary outcome measure was blood loss during liver parenchymal division. Multivariate analysis was also performed. RESULTS: Ninety-four consecutive patients underwent hepatic resection and 40 patients were assigned to each group. There were no significant differences between the dissecting sealer and clamp crushing groups in blood loss during liver parenchymal division (median 373 versus 535 ml; P = 0.252) or total intraoperative blood loss (665 versus 733 ml; P = 0.450). Multivariate analysis revealed that use of the dissecting sealer offered no protection against blood loss compared with the clamp crushing method (odds ratio 1.17 (95 per cent confidence interval 0.39 to 3.53); P = 0.777), whereas number of resections, thoracotomy and type of resection had a significant effect. CONCLUSION: Use of a dissecting sealer offered no substantial benefit over the clamp crushing method in reducing blood loss during hepatic resection.