Hirohito Tsuboi

Depressive symptoms are independently correlated with lipid peroxidation in a female population: Comparison with vitamins and carotenoids

OBJECTIVE Lipid peroxidation (LPO) is involved in oxidative tissue injuries. The present investigation examined the association between LPO and psychological depressive symptoms. METHODS A cross-sectional study was conducted on 66 female volunteers aged 38-70. Lipid peroxides (LOOH) in serum were evaluated by hemoglobin-methylene blue (Hb-MB) method; additionally, serum antioxidants were also detected. To assess depressive symptoms, the Center for Epidemiologic Studies Depression (CES-D) Scale and a subscale in the 28-item General Health Questionnaire (GHQ) were applied. RESULTS LOOH concentration displayed a significant positive correlation with CES-D and GHQ depression scores. Multiple regression analysis was performed in which LOOH concentration served as a dependent variable and CES-D scores and antioxidants as independent variables. Consequently, CES-D scores demonstrated significant positive correlation with LOOH. CONCLUSIONS The positive relationship between depressive symptoms and LPO in a female population may support the hypothesis that LPO may affect depressive symptoms.

Associations of depressive symptoms with serum proportions of palmitic and arachidonic acids, and α-tocopherol effects among male population--a preliminary study.

BACKGROUND & AIMS Recent years, inflammation and oxidative stress have been addressed in relation to interactions between fatty acid (FA) and depression. To study the associations between FAs and depressive symptoms in men, serum FA proportion was compared with perceived depression. We also measured α-tocopherol (a-Toc) levels to investigate the associations with FA functions. METHODS A cross-sectional study was performed on 113 male workers recruited from a software development company in Japan. Depressive symptoms were assessed according to the 20-item Center for Epidemiologic Studies Depression (CES-D) scale. Twenty-four FAs in the serum from the peripheral blood were examined. RESULTS CES-D scores were significantly positively correlated with the serum percentage of palmitic acid (PA), while they were negatively correlated with arachidonic acid (AA). The CES-D scores were not correlated with the serum ratio of docosahexaenoic acid or eicosapentaenoic acid (n-3 poly-unsaturated FAs (PUFAs)). CES-D scores were significantly negatively correlated with a-Toc/PA ratio (correlation: adjusting for possible confounders). CONCLUSIONS Although no associations were found between depressive symptoms and n-3 PUFA proportions in male population, depressive symptoms were positively correlated with PA percentages and negatively correlated with AA percentages. PA may increase neural vulnerability and AA may decrease the severity of depression. Moreover, a-Toc may have protective effects against depressive symptoms.

A cross-sectional investigation of the quality of selected medicines in Cambodia in 2010

BackgroundAccess to good-quality medicines in many countries is largely hindered by the rampant circulation of spurious/falsely labeled/falsified/counterfeit (SFFC) and substandard medicines. In 2006, the Ministry of Health of Cambodia, in collaboration with Kanazawa University, Japan, initiated a project to combat SFFC medicines.MethodsTo assess the quality of medicines and prevalence of SFFC medicines among selected products, a cross-sectional survey was carried out in Cambodia. Cefixime, omeprazole, co-trimoxazole, clarithromycin, and sildenafil were selected as candidate medicines. These medicines were purchased from private community drug outlets in the capital, Phnom Penh, and Svay Rieng and Kandal provinces through a stratified random sampling scheme in July 2010.ResultsIn total, 325 medicine samples were collected from 111 drug outlets. Non-licensed outlets were more commonly encountered in rural than in urban areas (p < 0.01). Of all the samples, 93.5% were registered and 80% were foreign products. Samples without registration numbers were found more frequently among foreign-manufactured products than in domestic ones (p < 0.01). According to pharmacopeial analytical results, 14.5%, 4.6%, and 24.6% of the samples were unacceptable in quantity, content uniformity, and dissolution test, respectively. All the ultimately unacceptable samples in the content uniformity tests were of foreign origin. Following authenticity investigations conducted with the respective manufacturers and medicine regulatory authorities, an unregistered product of cefixime collected from a pharmacy was confirmed as an SFFC medicine. However, the sample was acceptable in quantity, content uniformity, and dissolution test.ConclusionsThe results of this survey indicate that medicine counterfeiting is not limited to essential medicines in Cambodia: newer-generation medicines are also targeted. Concerted efforts by both domestic and foreign manufacturers, wholesalers, retailers, and regulatory authorities should help improve the quality of medicines.

Effects of packaging and storage conditions on the quality of amoxicillin-clavulanic acid – an analysis of Cambodian samples

BackgroundThe use of substandard and degraded medicines is a major public health problem in developing countries such as Cambodia. A collaborative study was conducted to evaluate the quality of amoxicillin–clavulanic acid preparations under tropical conditions in a developing country.MethodsAmoxicillin-clavulanic acid tablets were obtained from outlets in Cambodia. Packaging condition, printed information, and other sources of information were examined. The samples were tested for quantity, content uniformity, and dissolution. Authenticity was verified with manufacturers and regulatory authorities.ResultsA total of 59 samples were collected from 48 medicine outlets. Most (93.2%) of the samples were of foreign origin. Using predetermined acceptance criteria, 12 samples (20.3%) were non-compliant. Eight (13.6%), 10 (16.9%), and 20 (33.9%) samples failed quantity, content uniformity, and dissolution tests, respectively. Samples that violated our observational acceptance criteria were significantly more likely to fail the quality tests (Fisher’s exact test, p < 0.05).ConclusionsImproper packaging and storage conditions may reduce the quality of amoxicillin–clavulanic acid preparations at community pharmacies. Strict quality control measures are urgently needed to maintain the quality of amoxicillin–clavulanic acid in tropical countries.

Lesions in Lateral Hypothalamic Areas Increase Splenocyte Apoptosis

Objective: The lateral hypothalamic area (LHa) is involved in various functions such as feeding, drinking, sexual and reward behavior, among others. Recently, we demonstrated that the LHa can regulate cellular immunity in the spleen. In experiments involving the LHa, it was noticed that the spleen shrinks noticeably after LHa destruction. To explore this phenomenon further, the effect of LHa lesioning on splenocyte apoptosis was investigated. Methods: Male Wistar-King-Aptekman rats underwent bilateral lesioning of their LHa and consequent spleen weights, splenocyte numbers and apoptosis were measured. For the detection of splenocyte apoptosis, both ELISA, which measures DNA fragmentation within the splenocytes, and flow cytometry, which measures the percentage of apoptotic lymphocytes in the spleen, were used. Results: In the LHa-lesioned rats, spleen weights and the number of splenocytes decreased significantly within 24 h. Additionally, in the spleen, lymphocyte apoptosis significantly increased compared to the control after 6 h. Conclusion: These results suggest that the LHa may play a role in immunoregulation by affecting lymphocytes in the spleen through apoptosis and may be relevant to the pathway of stress-induced apoptosis.

Giving social support to outside family may be a desirable buffer against depressive symptoms in community-dwelling older adults: Japan gerontological evaluation study

BackgroundDepression is the leading cause of impaired quality of life and burden upon societies. Social supports can buffer against depressive symptoms effectively. The aim of this study is to determine the type of social support to have a positive relationship with depressive symptoms in healthy population.Methods11,869 male and 12,763 female residents within the age range of 65–100 were analyzed cross-sectionally with regard to depressive symptoms (evaluated by the Japanese version of the 15-item Geriatric Depression Scale), social supports (four dimensions: giving or receiving, emotional or instrumental), and covariates utilizing data collected by the Japan Gerontological Evaluation Study. Analyzed　participants were GDS scores ≤ 10 and independence in ADL, who could give and receive supports well. Multiple linear models were applied for the analysis.ResultsAll supports between husband and wife were significantly associated with lower depressive degrees. In comparison with the differences between receiving and giving supports in predictive effects on depressive degrees, giving social supports to outside family, emotional or instrumental, were associated with fewer depressive symptoms.ConclusionsThere is a possibility that not only supports between husband and wife but giving social supports to outside family accounts for psychological benefits against depression, in addition to supports between husband and wife.

Val1483Ile polymorphism in the fatty acid synthase gene was associated with depressive symptoms under the influence of psychological stress

BACKGROUND To study the association between lipid-metabolism and depressive symptoms, genetic polymorphisms in serotonin transporter linked promoter region (5-HTTLPR) and fatty acid synthase gene (FASN) were investigated. METHOD A cross-sectional study was conducted on 177 women (n = 166) and men (n = 15) recruited from workers in a hospital and nursing homes in Japan. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression (CES-D) scale and perceived psychological stress was measured using visual analogue scale (VAS). The genotypes of 5-HTTLPR (insertion/deletion; L/S), and FASN (Val1483Ile) were determined by the PCR methods. Linear regression analysis was performed, in which CES-D scores served as a dependent variable, and VAS scores, gene polymorphism, and confounders as independent variables. RESULTS Under the influence of perceived stress, S/S carriers of the 5-HTTLPR gene showed significantly higher CES-D scores in comparison with L/L+L/S carriers (F = 8.2, standardised β = 0.15, p < 0.05). Regression analysis also confirmed that CES-D scores in participants with Ile/Ile+Val/Ile genotypes of the FASN gene were significantly higher than those with Val/Val genotype (F = 8.4, standardised β = 0.16, p<0.05). In relation to physical features, BMI among participants with S/S genotype of 5-HTTLPR was significantly lower compared with those with L/L+L/S genotypes. CONCLUSIONS The Val1483Ile polymorphism in the FASN was associated with depressive symptoms under the influence of psychological stress. The S variant of 5-HTTLPR was related with less obese.

Investigation Into the Antinfluenza Agent Oseltamivir Distributed via the Internet in Japan

This study evaluated the quality and authenticity of the anti-influenza agent oseltamivir acquired via the Internet in Japan. The brand name drugs Tamiflu and Antiflu were obtained via the Internet using a search engine. The authenticity and legitimacy of the medicines were verified with the samples’ manufacturers and the regulatory authorities of the country of origin, respectively. In addition, quantitative and dissolution tests were carried out using high-performance liquid chromatography. No counterfeits were detected among the samples. Additionally, all samples passed qualitative and quantitative tests according to the US Pharmacopeia monograph. However, different sorts of mismanagement were observed in the distribution channels. Through the Internet, oseltamivir can be purchased in quantities larger than the permissible amount in Japan. Furthermore, maintenance of medicine quality cannot be guaranteed. In addition, insufficient information and lack of quality control in some samples may cause unwanted health problems in patients.

Erroneous formulation of delayed-release omeprazole capsules: alert for importing countries

BackgroundPoor drug quality is a matter of serious concern, especially in countries where drug regulation and law enforcement are constrained by limited resources. This study was carried out to investigate the cause of quality failure of omeprazole in Cambodia in 2010 and Myanmar in 2014.MethodsWe conducted pharmacopoeial quantity, content uniformity and dissolution tests of 156 samples of omeprazole capsules collected in Cambodia in 2010 and Myanmar in 2014. High failure rates were found, especially in dissolution testing, and detailed investigation of several unacceptable samples was carried out by means of in-vitro dissolution profiling, scanning electron microscopy (SEM) and X-ray computed tomography (X-ray CT) to identify the cause of failure.ResultsDissolution profiling with and without the acid stage showed that acid caused premature omeprazole release, indicating that the enteric coating of the omeprazole granules was ineffective. SEM examination of two failed samples revealed cracked and broken granules mixed with apparently intact omeprazole granules in the capsule. X-ray CT examination indicated that some granules of failed samples completely lacked enteric coating, and others had incomplete and non-uniform enteric coating or malformation.ConclusionsOmeprazole capsules collected in Myanmar and Cambodia showed high failure rates in pharmacopoeial tests, especially dissolution tests. Some samples were found to have ineffective or absent enteric coating of the granules, resulting in premature dissolution and degradation in acidic conditions. This is a potentially serious public health issue that needs to be addressed by regulatory authorities in Cambodia and Myanmar, possibly through a collaborative initiative with manufacturers.

Investigation of Antibiotic Use at a Dental Teaching Hospital in Yogyakarta, Indonesia: A Review from Guidelines

Objective: To investigate prescription of antibiotics by dental practitioners at a dental teaching hospital in Yogyakarta, Indonesia, and to establish whether it conforms to major guidelines. Methods: A cross-sectional study of adult outpatients’ medical records was conducted in order to scrutinize antibiotic prescriptions. The results were compared with recommendations in four published guidelines. Results: Dental practitioners prescribed a wide range of antibiotics to treat 121 diagnoses. Amoxicillin (78.8%) was most commonly prescribed, followed by clindamycin (9.9%), metronidazole (5.0%), and lincomycin (2.1%). Among all prescriptions, 79.5% were for generic antibiotics. The most common diagnoses were dental pulp gangrene followed by dental pulp necrosis (26.7% and 8.8%, respectively). According to guidelines-1 through-4, the percentages of antibiotic prescriptions that were evaluated as appropriate for the reported diagnosis were 15.1%, 7.2%, 7.5%, and 16.3%, respectively. However, 9.9%, 84.0%, 83.7% and 67.8% of prescriptions could not be classified as appropriate or inappropriate because the respective guidelines neither listed the antibiotic nor gave statement regarding appropriate indications. Conclusion: Our results suggest that significant inappropriate antibiotic prescribing occurred at a dental teaching hospital in Yogyakarta, Indonesia, according to major antibiotics guidelines. However, the four guidelines failed to list some antibiotics, failed to list indications for prescription in some cases, and were inconsistent in their recommendations. There is a need to introduce specific institutional guidelines. Our findings should be helpful for developing public health policy guidelines to minimize inappropriate antibiotic prescribing at dental hospitals.