ABSTRACT
The gamma-aminobutyric acid-A (GABA(A)) and N-methyl-D-aspartate (NMDA) receptors mediate aspects of the behavioural effects of alcohol. Prior studies reported drugs that block NMDA receptors or facilitate GABA(A) receptor function produce ethanol-like effects in humans. The purpose of this study was to compare the ethanol-related effects of two pharmacological agents with known NMDA and GABA(A) receptor activity. As part of an ongoing, larger study, 28 subjects (age, 21-30) with no personal or family histories of alcoholism were administered subanesthetic doses of the GABA(A) receptor agonist thiopental, the NMDA receptor antagonist, ketamine and placebo on three separate test days. Various ethanol-related measures were administered. At doses of thiopental and ketamine that produced similar levels of sedation and cognitive effects, both agents produced significant ethanol-like effects and subjective intoxication. However, the intensity of the ethanol-like effects of ketamine was greater than that of thiopental. In addition, ketamine produced alterations in perception that were not produced by thiopental. These data provide further support for a model where GABA(A) receptor facilitation may contribute significantly to ethanol effects associated with social drinking, whereas NMDA receptor antagonism may contribute to relatively greater extent to features of ethanol 'intoxication'.
Subject(s)
GABA-A Receptor Agonists , Ketamine/pharmacology , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Thiopental/pharmacology , Adult , Alcohol Drinking/metabolism , Alcoholic Intoxication/metabolism , Double-Blind Method , Ethanol/pharmacology , Excitatory Amino Acid Antagonists/pharmacology , Female , GABA Modulators/pharmacology , Humans , Male , Young AdultABSTRACT
OBJECTIVE: To describe the association between acute choreoathetosis/ballismus and hypoglycemia related to pentamidine therapy in a patient with the acquired immunodeficiency syndrome. DESIGN: A single case report. MEASURES: Clinical observation, laboratory analysis of blood and cerebrospinal fluid, and magnetic resonance imaging of brain. RESULTS: No association was found apart from hypoglycemia. The abnormal movements and hypoglycemia did not recur following cessation of pentamidine. CONCLUSIONS: Hypoglycemia related to pentamidine therapy can cause neurologic disorders in patients with the acquired immunodeficiency syndrome.
Subject(s)
Acquired Immunodeficiency Syndrome/drug therapy , Athetosis/etiology , Chorea/etiology , Hypoglycemia/complications , Movement Disorders/etiology , Pentamidine/adverse effects , Acquired Immunodeficiency Syndrome/complications , Adult , Female , Humans , Hypoglycemia/chemically inducedABSTRACT
A few thoughts of a surgeon who does occasional stapedectomies are presented. A review of 10 years of occasional stapedectomies is reported on a total of 104 cases. A detailed statistical analysis is not attempted. Comparison of several stapedectomy techniques is made to show the evolution of the author's present technique.
