Synergistic effects of MDMA and ethanol on behavior: Possible effects of ethanol on dopamine D2 -receptor-related signaling.

Polydrug abuse is common among drug abusers. In particular, psychostimulants are often taken with ethanol, and the combination of 3,4-methylenedioxymethamphetamine (MDMA) and alcohol is one of the most common forms of polydrug abuse. However, the mechanism by which these drugs influence behavior remains unclear. The present study was designed to delineate the mechanisms that underlie the effects of the interaction between MDMA and ethanol on behavior in rodents. The combination of MDMA with ethanol enhanced their locomotor-increasing, rewarding, and discriminative stimulus effects without enhancing their effects on the release of dopamine from the nucleus accumbens in rodents. In addition, ethanol potently enhanced locomotor activity produced by the dopamine receptor agonist apomorphine in mice. In antagonism tests, the dopamine D1 -receptor antagonist SCH23390, but not the D2 -receptor antagonist haloperidol, completely suppressed hyperlocomotion induced by MDMA. However, hyperlocomotion induced by the co-administration of MDMA and ethanol was potently suppressed by haloperidol. These results suggest that the synergistic effects of MDMA and ethanol are mediated through dopamine transmission, especially through postsynaptical regulation of D2 -receptor-mediated functions.

The Change of Oxidative Stress in Maternal Blood During Pregnancy.

Oxidative stress (OS) is a state in which the oxidative capacity exceeds the antioxidant capacity in vivo. OS is associated with various perinatal diseases. There have been few reports about OS during pregnancy, such as OS changes that occur during gestation, normal maternal OS dynamics, and OS levels in umbilical cord blood. We here examined the oxidative and antioxidant capacity in maternal blood as well as in umbilical cord vein blood during normal pregnancy. Pregnant women managed from early pregnancy to the postpartum period in our hospital, from April 2018 to March 2019, were included. We obtained maternal blood at 12, 24, and 36 weeks of gestation and obtained umbilical cord blood at delivery. The OS (derivatives of reactive oxygen metabolites [d-ROMs]) and antioxidant capacity (biological antioxidant potential [BAP]) of blood samples were measured. D-ROMs and BAP were compared across gestational weeks. Moreover, d-ROMs and BAP were compared between mothers with and without disease. We analyzed 100 pregnancies (651 specimens). Eleven patients developed hypertensive disorder of pregnancy (HDP)/preeclampsia (PE). The median maternal age was 35 years, and the median gestational age at delivery was 39 weeks. Thirty-one women had undergone fertility treatments. D-ROM values were significantly higher and BAP values were significantly lower in mid- and late pregnancy than in early pregnancy. D-ROM and BAP showed no significant differences between HDP/PE and non-hypertensive groups. During pregnancy, maternal OS increases, and antioxidant capacity decreases with advancing gestational age.

Infectious sacroiliitis due to group A streptococcus infection during pregnancy: a case report.

BACKGROUND: Group A streptococcus infection during pregnancy can be concerning. It may cause toxic shock syndrome, which can be fatal. Here, we report a rare case of a pregnant woman who developed infectious sacroiliitis due to group A streptococcus infection. To the best of our knowledge, this case is the first of its kind to be reported. CASE PRESENTATION: A 32-year-old multiparous Japanese woman presented with fever and right buttock pain at 28 weeks of gestation. Based on our clinical findings and investigations, she was diagnosed with group A streptococcus bacteremia and infectious sacroiliitis caused by group A streptococcus. A cardiotocography performed to assess the fetal status showed fetal tachycardia. To prevent the patient from progressing to toxic shock syndrome caused by group A streptococcus, we performed an emergency cesarean section. The patient and her infant had a good course after the cesarean section. CONCLUSION: A pregnant woman diagnosed with group A streptococcus infection needs to be monitored closely because a timely decision to deliver the fetus before rapid deterioration to toxic shock syndrome is crucial.

Early menopause and a low body mass index are associated with an increased risk of coronary heart disease in Japanese women.

OBJECTIVE: The primary objective was to investigate the association between early menopause and cardiovascular disease (CVD) prevalence in Japanese women. The secondary objective was to ascertain the association with CVD risk factors. METHODS: In this cross-sectional study, 7,239 naturally menopausal women from the Yamagata Cohort Study who completed an annual health visit and questionnaire between 2009 and 2015 were divided into three groups according to their age at menopause (women experiencing menopause at <45, 45-49 y, and ≥ 50 y). The diagnosis of coronary heart disease (CHD) and stroke were made by self-report, while hypertension, hyperlipidemia, and diabetes mellitus, were diagnosed by vital signs and laboratory parameters. Logistic regression analysis was used to estimate the associations between age at menopause and CVD prevalence and CVD risk factors. RESULTS: A total of 354 (4.9%) and 156 (2.2%) women reported a history of CHD and stroke, respectively. Women experiencing menopause at <45 years had a higher prevalence of CHD than those experiencing menopause at ≥50 years (OR 1.77, 95% CI 1.07-2.90; P = 0.023). Stroke, hypertension, diabetes mellitus, and hyperlipidemia were equally prevalent among the three groups. Significant interactions were observed between age at menopause and body mass index (BMI) (P = 0.025) and parity (P = 0.025). Among those with a BMI < 18.5 or parity ≥2, women experiencing menopause at <45 years had a significantly higher prevalence of CHD than those experiencing menopause at ≥50 years. CONCLUSION: Early menopause and low BMI were associated with CHD in Japanese women.

Squamous cell carcinoma arising from a mature cystic teratoma of the ovary: Successful treatment with carboplatin, paclitaxel, and bevacizumab.

Ovarian mature cystic teratomas (MCT) are usually benign. However, squamous cell carcinoma (SCC) develops in 0.17-2% of MCT. Because of its low frequency, the optimal treatment for this disease is unclear. We present a case of SCC arising from MCT. Our patient was a 30-year-old nulliparous woman complaining of right lower abdominal pain, who was referred to our hospital for a pelvic solid mass with suspected malignant ovarian tumor. A diagnosis of SCC arising from MCT was suspected based on the elevation in SCC antigen and the imaging. After surgery to remove the tumor, the diagnosis was confirmed based on the pathology. Although the surgery by radical cytoreduction was optimal, the tumor showed early recurrence. Therefore, we administrated combination chemotherapy, consisting of carboplatin, paclitaxel, and bevacizumab, followed by maintenance therapy with bevacizumab. Response to the chemotherapy regimen was complete and the patient was alive with no evidence of recurrence for 45 months after starting the initial surgery. We discuss the clinical characteristics of the malignant transformation of MCT and the treatment of SCC arising from MCT.

Successful laparoscopic resection of virilizing ovarian steroid cell tumor, not otherwise specified, in a 22-year-old woman: a case report and evaluation of the steroidogenic pathway.

OBJECTIVE: Ovarian steroid cell tumor (SCT) is a rare tumor with steroid-producing ability. We report a 22-year-old woman with secondary amenorrhea and hirsutism caused by an ovarian SCT-not otherwise specified (NOS), who underwent successfully laparoscopic resection of the tumor. CASE REPORT: A 22-year-old null gravida woman presented to a hospital, having amenorrhea for 18 months and increasing facial hair. Physical examination revealed obesity (body mass index, 37.3 kg/m2) with evident facial and trunk hair. Total and free serum testosterone, and dehydroepiandrosterone sulfate levels were found to be elevated. Levels of serum adrenocorticotropic hormone, gonadotropins, cortisol, aldosterone, and ovarian steroids were observed to be within reference intervals. Although polycystic ovaries were not found, a hyperechogenic solid tumor (3 cm) was detected on transvaginal ultrasonography. Laparoscopic resection of the tumor was performed. One month post-surgery, total and free testosterone levels were observed to have decreased, and menstruation resumed two months thereafter. The patient was histologically diagnosed with ovarian SCT-NOS. Expression of ovarian steroidogenic enzymes, which are related to hyperandrogenism, was observed. No disease recurrence has been reported for more than 5 years post-surgery.