Optimal Propofol Plasma Concentration during Upper Gastrointestinal Endoscopy in Young, Middle-aged, and Elderly Patients

Background: Suitable propofol plasma concentrations during gastroscopy have not been determined for suppressing somatic and hemodynamic responses in different age groups.

Methods: Propofol sedation at target plasma concentrations from 0.5 to 4.0 [mu]g/ml were performed randomly in three groups of patients (23 per group) who were undergoing elective outpatient gastroscopy: ages 17-49 yr (group 1), 50-69 yr (group 2), and 70-89 yr (group 3). Plasma propofol concentration in which 50% of patients do not respond to these different stimuli were determined by logistic regression: verbal command (Cp50ls), somatic response to gastroscopy (Cp50endo), and gag response to gastroscopy (Cp50gag). Hemodynamic responses were also investigated in the different age groups.

Results: Cp50ls concentrations were 2.23 [mu]g/ml (group 1), 1.75 [mu]g/ml (group 2), and 1.40 [mu]g/ml (group 3). The Cp50endo values in groups 1 and 2 were 2.87 and 2.34 [mu]g/ml, respectively, which were significantly higher than their respective Cp50ls values. Cp50endo value in group 3 was 1.64 [mu]g/ml, which was close to its Cp50ls value. Because of a high degree of interpatient variability, Cp50gag could not be defined. Systolic blood pressure response decreased with increasing propofol concentrations.     

Combination chemotherapy of oxaliplatin and 5-fluorouracil may be an effective regimen for mucinous adenocarcinoma of the ovary: A potential treatment strategy

Resistance of ovarian mucinous adenocarcinoma to standard chemotherapy with paclitaxel and carboplatin is associated with poor prognosis, and an effective treatment is needed. The present study aimed to identify an effective chemotherapy for ovarian mucinous adenocarcinoma. Five human ovarian mucinous adenocarcinoma cell lines (MN-1, OMC-1, RMUG-L, RMUG-S, TU-OM-1) were used in this study. Sensitivity of the cells to the anticancer agents was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, and we assessed drug sensitivity by calculating the assay area under the curve for each agent. Protein expression was confirmed by Western blot analysis. We also examined the efficacy of combination chemotherapy on survival in a xenograft model of nude mice. The IC₅₀ to anticancer agents ranged widely. The assay area under the curve indicated that two of five cell lines (MN-1, TU-OM-1) were sensitive to oxaliplatin, 5-fluorouracil and etoposide, and only one (TU-OM-1) was sensitive to 7-ethyl-10-hydroxycamptothecin, which is an active metabolite of camptothecin. All cell lines were resistant to cisplatin and paclitaxel. The combination of oxaliplatin and 5-fluorouracil resulted in additive or synergistic effects on all cell lines. The combination of oxaliplatin and 5-fluorouracil significantly prolonged survival in a ovarian mucinous adenocarcinoma xenograft model of nude mice. Protein expression levels of the excision repair cross-complementation group 1 were lower in oxaliplatin sensitive cell lines. Exposure to 5-fluorouracil down-regulated cross-complementation group 1 expression in ovarian mucinous adenocarcinoma cells. We conclude that combination chemotherapy consisting of oxaliplatin and 5-fluorouracil was an effective treatment for ovarian mucinous adenocarcinoma and may be a pivotal candidate for a novel treatment strategy. ( Cancer Sci 2009; 100: 546–551)     

Screening for genetic heterogeneity in the interferon sensitivity determining region of the hepatitis C virus genome by polymerase chain reaction with melting curve analysis

BACKGROUND: Although mutations in the interferon (IFN) sensitivity determining region (ISDR) of hepatitis C virus (HCV) have been reported to be useful as a predictive viral factor for IFN therapy in patients infected with HCV-1b, such laboratory research has not been favorably translated into the clinic. To promote such translation, we attempted the establishment of a rapid and simple polymerase chain reaction (PCR) combined with melting curve analysis (MCA) to screen for mutations in the ISDR and for the monitoring of HCV quasispecies. METHODS: A PCR-MCA protocol was established using in-house primers and hybridization probes designed according to the results of direct sequencing of 34 HCV-1b samples. Then, the performance of PCR-MCA was verified by comparing with mutation profiles obtained by direct sequencing and sequencing after cloning. RESULTS: The MCA assay revealed that melting temperature (Tm) was inversely correlated with the number of nucleotide (nt) and amino acid substitutions in the ISDR deduced on the basis of the results of direct sequencing. A boundary Tm of 58.0 degrees C allowed us to discriminate HCV genomes into two groups: one with a Tm >58.0 degrees C had no or a low number of nt substitutions, while the other genomes with a Tm <58.0 degrees C had a high number of nt substitutions, corresponding to wild-type in the former and mutant-type in the latter in respect of a clinical setting for IFN therapy. Moreover, this MCA assay provided precise discrimination of Tm between clones, reflecting the degree of the genetic complexity of HCV genomes. CONCLUSIONS: This study indicates that the MCA assay is useful to rapidly and simply screen the mutational status of the ISDR of HCV, as well as in using the ISDR as one of the targets for discriminating the genetic complexity of HCV genomes. The MCA assay could also be applicable as a convenient and useful screen of the genetic heterogeneity of clones relating to HCV quasispecies.     

Psychological Intervention Can Partly Alter P300-Amplitude Abnormalities in Schizophrenics

Abstract: In the present study, we investigated whether psychological interventions can alter P300-abnormalities, specifically enhancing reduced P300-amplitudes, in schizophrenics. A three-tone discrimination task was employed for recording P300s, in which psychological intervention to facilitate target detection was performed through delivering a buzzer sound one second after each designated target tone that informed its occurrence. This procedure was done exclusively during the third and fourth sessions among the six sessions in total. When the data for all the patients were analyzed as a whole, no significant change was observed. However, when the patients were broken down into two groups based on the P300-amplitudes in the first and second sessions, significant effects of the intervention emerged. The group with smaller P300-amplitudes showed a significant increase in P300-amplitudes as well as improved performance levels during and after the intervention sessions. On the contrary, the group with larger P300-amplitudes displayed a significant decrease in P300-amplitudes in these sessions. Interestingly, the above results were consistent with the subjective difficulty changes experienced by the patients through the sessions. Overall, the above results indicate that psychological interventions can partly enhance reduced P300-amplitudes in schizophrenics.     

Formation of an ipsilateral corticospinal tract after ablation of cerebral cortex in neonatal rat.

The formation of an aberrant ipsilateral corticospinal tract after unilateral cerebral cortical ablation during the neonatal period has been confirmed in the rat. The tract was chronologically studied using the antegrade horseradish peroxidase (HRP) tracing method. An aberrant ipsilateral tract is not observed 3 days after the operation. However, ipsilateral HRP positive fibers become apparent on day 7 and progressively more prominent until day 14. These results suggest that the ipsilateral corticospinal tract is composed of collateral axons originating from pyramidal neurons in the healthy ipsilateral cerebral cortex. These results also indicate that, when cerebral cortex has the damage during early postnatal life, the remaining cortical neurons which have been freed from the damage show considerable plasticity in terms of the collateral axons.