Identification of distinct swallowing patterns for different bolus volumes.

OBJECTIVE: To investigate the time interval between glottic closure and the opening of upper esophageal sphincter during swallowing, by means of the coupling of electromyographical (EMG) recordings on the thyroarytenoid (TA) and the cricopharyngeus (CP) muscles. METHODS: TA-EMG and CP-EMG pause were recorded by concentric needle electrodes using time-locked delay-line circuitry of the EMG apparatus. EMG data obtained from a total of 273 swallows of saliva, 3, 5, 10 and 15 ml volumes of water, were compared. RESULTS: The relation between the onsets of TA-EMG activity and the CP-EMG pause demonstrated three different patterns of swallows. Pattern A was the delay of the onset of TA-EMG between 50-500 ms, and pattern B was the overlap of its activity with the CP-EMG pause. Pattern C was the earlier occurrence of the TA-EMG 50-550 ms before the CP-EMG pause. Pattern A was the most frequent type of swallows whereas the pattern C appeared during swallowing of larger volumes. CONCLUSIONS: Physiologically, there is a delay of the TA activation after the onset of CP-EMG pause during swallowing of small amounts in healthy subjects. SIGNIFICANCE: This physiological phenomenon could be a potential risk of aspiration in patients with neurogenic dysphagia.

Gabapentin reduces cardiovascular responses to laryngoscopy and tracheal intubation.

BACKGROUND AND OBJECTIVE: We have compared the effects of gabapentin on arterial pressure and heart rate at induction of anaesthesia and tracheal intubation in a randomized double-blind study. METHODS: Ninety normotensive patients (ASA I) undergoing elective surgery were divided into three groups of 30 patients each. Patients received oral placebo (Group I), 400 mg of gabapentin (Group II) or 800 mg of gabapentin (Group III) 1 h prior to surgery in the operating theatre. After induction of anaesthesia heart rate and mean arterial pressure were recorded at baseline 1, 3, 5, 10 and 15 min after intubation. RESULTS: Patients receiving placebo and 400 mg gabapentin showed a significant increase in blood pressure and heart rate associated with tracheal intubation compared to baseline levels and Group III. There was significant decrease in heart rate and arterial pressure in Group III after intubation 1, 3, 5 and 10 min (P < 0.001, P < 0.001, P < 0.05 and P < 0.05, respectively) compared to Groups I and II. CONCLUSION: Given 1 h before operation gabapentin 800 mg blunted the arterial pressure and heart rate increase in first 10 min due to endotracheal intubation. Oral administration of gabapentin 800 mg before induction of anaesthesia is a simple and practical method for attenuating pressor response to laryngoscopy and tracheal intubation after standard elective induction.

Biomonitoring of polycyclic aromatic hydrocarbons on hepatocellular carcinoma cell line.

Polycyclic aromatic hydrocarbons (PAHs) are not easily degradable and exist as persistent contaminants in water environments. In this study we collected surface sediments and water samples from five different ports around Seto Inland Sea during October 2003 to April 2004. Fifteen PAHs were detected by gas chromatography/mass spectrometer (GC-MS). Expression of CYP1A enzymes was measured by a biochemical activation of 7-ethoxy resorufin ortho-deethylase (EROD). Total water PAHs ranged from 2.5 ng/l to 132 ng/l, while sediment PAHs ranged from 296.3 ng/g to 3992.9 ng/g, which indicate low to high level of PAH pollution. Selected isomer ratios (fluoranthene/pyrene to phenanthrene/anthracene and, total molecular weight of 202/total molecular weight 202-278), and detected PAHs suggested that the origin of pollution could mostly be pyrogenic. The highest total sediment PAHs were observed at the Uno Port while the lowest were at the New Okayama Port. EROD activity implied that PAH extracted from sediment samples affected on CYP1A enzymes expression on the human hepatocellular carcinoma cell line in a short exposure time (12 hours). Relatively EROD activity showed good correlation between PAH concentration and CYP1A expression for sediment samples. The highest EROD values were observed for sediment samples at a dose of 5 ppm. In contrast water samples were at the low induction level even under the highest exposure concentration (50 ppm), except in Mizushima Port. Biomonitoring of water environments by EROD activity could be a necessary tool for understanding the effects of PAHs on living organisms at the base of cell defense.