Alteration in the Sensitivity of GABAA Receptors to Allosteric Modulatory Drugs in Rat Hippocampus After Chronic Intermittent Ethanol Treatment

Chronic intermittentethanol (CIE)-treated rats exhibited a kindlinglike persistent increase in withdrawal hyperexcitability. The alteration of GABA_A receptor (QABA_AR) function in the hippocampus was suggested as a possible mechanism underlying the hyperexcitability observed in CIE rats, because (1) GABA_AR agonist (muscimol)-evoked ³⁸Cl- efflux was decreased; (2) paired-pulse inhibition in the CA1 area, predominantly due to GABA_AR-mediated recurrent inhibition, was persistently decreased; and (3) GABA_AR subunit expression was altered in the hippocampus from CIE rats. To further characterize the functional alteration of GABA_AR after CIE treatment, their sensitivity to acute ethanol, a steroid anesthetic (alphaxalone), and a benzodiazepine inverse agonist (DMCM; methyl-6, 7-dimethoxy-4-ethyl-β-carboline-3-carboxylate) were studied using either synaptically evoked GABA_AR responses or exogenously applied muscimol-evoked responses in hippocampal slices. Bath application of ethanol (60 mM) enhanced the area of GABA_AR-mediated inhibitory postsynaptic potentials in the hippocampal CA1 region from control and CIE rats, and this potentiation was significantly (p = 0.027) greater in CIE rats (98%) than in control rats (53%). The positive modulatory effect of alphaxalone (1 μM) on GABAAR-inhibitory postsynaptic potentials was not significantly different between control and CIE rats (p = 0.375), whereas alphaxalone allosterically increased [³H]flunitrazepam binding in the CA1 area only in CIE rats (by 20 to 25%, p < 0.01), but not in controls. On the other hand, the negative modulatory effect of DMCM (1 μM) on muscimol-evoked responses was significantly larger in CIE rats (p = 0.002). These results suggest that the sensitization of GABA_AR to acute ethanol and benzodiazepine inverse agonists, and possibly neurosteroids, may underlie ethanol dependence after multiple ethanol withdrawal episodes. These altered pharmacological properties are most consistent with changes in the subunit composition in the CA1 area of this rat model of alcohol dependence.     

Comparison of skin sensory thresholds using pre-programmed or single-frequency transcutaneous electrical nerve stimulation

[Purpose] The purpose of the present study was to compare the sensory thresholds of healthy subjects using pre-programmed or single-frequency transcutaneous electrical nerve stimulation. [Subjects] Ninety healthy adult subjects were randomly assigned to pre-programmed or single-frequency stimulation groups, each consisting of 45 participants. [Methods] Sensory thresholds were measured in the participants’ forearms using von Frey filaments before and after pre-programmed or single-frequency transcutaneous electrical nerve stimulation, and the result in values were analyzed. [Results] Significant increases in sensory threshold after stimulation were observed in both groups. However, there were no significant differences between the two groups in sensory thresholds after stimulation or in the magnitude of threshold increases following stimulation. [Conclusion] Our results show that there are no differences between sensory threshold increases induced by pre-programmed and single-frequency transcutaneous electrical nerve stimulation.Key words: Pre-programmed TENS, Sensory threshold, Single-frequency TENS     

ISPD Cardiovascular and Metabolic Guidelines in Adult Peritoneal Dialysis Patients Part I – Assessment and Management of Various Cardiovascular Risk Factors

Cardiovascular disease contributes significantly to the adverse clinical outcomes of peritoneal dialysis (PD) patients. Numerous cardiovascular risk factors play important roles in the development of various cardiovascular complications. Of these, loss of residual renal function is regarded as one of the key cardiovascular risk factors and is associated with an increased mortality and cardiovascular death. It is also recognized that PD solutions may incur significant adverse metabolic effects in PD patients. The International Society for Peritoneal Dialysis (ISPD) commissioned a global workgroup in 2012 to formulate a series of recommendations regarding lifestyle modification, assessment and management of various cardiovascular risk factors, as well as management of the various cardiovascular complications including coronary artery disease, heart failure, arrhythmia (specifically atrial fibrillation), cerebrovascular disease, peripheral arterial disease and sudden cardiac death, to be published in 2 guideline documents. This publication forms the first part of the guideline documents and includes recommendations on assessment and management of various cardiovascular risk factors. The documents are intended to serve as a global clinical practice guideline for clinicians who look after PD patients. The ISPD workgroup also identifies areas where evidence is lacking and further research is needed.     

Immediate effects of an end-range mobilization technique on shoulder range of motion and skin temperature in individuals with posterior shoulder tightness

[Purpose] This study investigated the effects of an end-range mobilization technique on the range of motion of the glenohumeral internal rotation and the skin temperature of the shoulder in individuals with posterior shoulder tightness. [Subjects] Thirteen subjects with posterior shoulder tightness who had glenohumeral internal rotation deficit ≥ 15° participated. [Methods] All subjects underwent glenohumeral joint end-range mobilization intervention. The internal rotation range of motion of the glenohumeral joint was measured by a goniometer and the shoulder skin temperature was measured by a digital infrared thermographic imaging device before and immediately after the intervention. Paired t-tests were used to analyze the differences in these parameter pre and post-intervention. [Results] The glenohumeral internal rotation range of motion and skin temperature of the posterolateral shoulder in increased significantly post-intervention. [Conclusion] The end-range mobilization technique is effective for increasing the glenohumeral internal rotation range of motion and skin temperature of the shoulder in individuals with posterior shoulder tightness.Key words: End-range mobilization, Glenohumeral internal rotation deficit, Posterior shoulder tightness     

Effects of mechanical horseback riding on the balance ability of the elderly

[Purpose] This study was conducted to evaluate the effect of mechanical horseback riding exercise on the balance ability of the elderly. [Subjects and Methods] Ten elderly patients were assigned to an experimental group, and they performed 15 min of horseback riding. Another 10 elderly patients were assigned to a control group, and they performed 15 min of one-leg standing exercise. Both exercises were repeated five times a week for a total of six weeks. The participants’ balance ability was evaluated. [Results] The horseback-riding group showed significant differences between the pre-and post-test balance abilities as assessed by the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test. [Conclusion] Horseback riding effectively improves the balance ability of the elderly. Horseback riding should be considered as a therapeutic method for the physical therapy of the elderly.Key words: Balance ability, Elderly, Mechanical horseback riding     

Case-Control Study of the Risk Factors for Acquisition of Pseudomonas and Proteus Species during Tigecycline Therapy

Tigecycline is an important agent in clinical practice because of its broad-spectrum activity. However, it has no activity against Pseudomonas or Proteus species. We conducted a case-control study to analyze risk factors for the acquisition of Pseudomonas or Proteus spp. during tigecycline therapy. Placement of suction drainage at infected wound sites, ICU stay, and neurologic disease were identified as independent risk factors for the acquisition of Pseudomonas and Proteus spp.