Isoflurane improves outcome against cerebral ischemia in the rat. However, the optimal neuroprotective concentration has not been defined. We examined the effects of different isoflurane concentrations on outcome from severe forebrain ischemia in the rat. Fasted rats were subjected to 0.5, 1.0, 1.5, 2.0, or 2.5 minimum alveolar concentration (MAC) isoflurane during 10 min bilateral carotid occlusion plus systemic hypotension. Each isoflurane concentration was administered only before ischemia. Arterial blood pressure was not pharmacologically manipulated. After ischemia, the anesthetic regimen was changed to fentanyl/nitrous oxide and maintained for 2 h. Pericranial temperature was maintained normothermic during the experiment. Neuromotor score, % dead hippocampal CA1 neurons, and cortical injury were measured 5 days postischemia. Preischemic arterial blood pressure decreased as MAC was increased. Animals administered >1.0 MAC frequently exhibited postischemic seizures resulting in increased mortality. There was no difference among MAC conditions for % dead CA1 neurons (93 approximately 95%). In the cortex, neuronal necrosis was less severe with 0.5 MAC and 1.0 MAC isoflurane relative to >1.0 MAC values. The neuromotor score in the 1.0 MAC isoflurane group was superior to the 2.5 MAC group. Dose-dependent effects of preischemic administration of isoflurane on histologic and behavioral outcome after severe forebrain ischemia were observed. Isoflurane MAC values <1.5 provided superior overall outcome relative to larger isoflurane concentrations.

BackgroundConsideration of medical costs as well as effectiveness and adverse events is rapidly been becoming an important factor in the selection of chemotherapy regimens. However, practical data on the costs of chemotherapy are scarce. We clinically estimated the medical costs of 6 adjuvant chemotherapy regimens for colorectal cancer on the basis of clinical and cost-related data and compared their cost-effectiveness by cost-minimization analyses.MethodsAll patients who received adjuvant chemotherapy for colorectal cancer between April 2012 and May 2015 at four hospitals affiliated with Showa University were studied retrospectively. Clinical and cost data related to adjuvant chemotherapy were collected from medical records and medical fee receipt data, respectively. Six adjuvant chemotherapy regimens were studied: capecitabine and oxaliplatin (CapeOX); 5-fluorouracil (5-FU), ℓ-leucovorin (LV), and oxaliplatin (modified FOLFOX6 [mFOLFOX6]); 5-FU and LV (5-FU/LV); tegafur and uracil (UFT), and LV (UFT/LV); capecitabine; and tegafur, gimeracil and oteracil (S-1). The regimens were divided into 2 groups according to whether or not they contained oxaliplatin because of the difference in effectiveness. Cost-minimization analyses, where relative costs of regimens showing equivalent effectiveness were simply compared, were performed to evaluate the cost-effectiveness of the regimens in each group.ResultsA total of 154 patients with colorectal cancer received adjuvant chemotherapy during the study period. Fifty-seven patients were treated with CapeOX, 10 with mFOLFOX6, 38 with UFT/LV, 20 with capecitabine, and 29 with S-1. No patient received 5-FU/LV. The total costs of oxaliplatin-containing regimens were significantly higher than those of oxaliplatin non-containing regimens. The high cost of oxaliplatin, but not the costs of drugs or various tests for the treatment of adverse events, was the primary reason for the higher costs of the oxaliplatin-containing regimens. The cost-effectiveness of the oxaliplatin-containing regimens CapeOX and mFOLFOX6 were comparable. Among the oxaliplatin non-containing regimens, the cost-effectiveness of S-1 and capecitabine was superior to that of UFT/LV.ConclusionThus, we provided the cost-effectiveness data of 5 adjuvant chemotherapy regimens for colorectal cancer based on practical clinical and cost data from Japanese patients. The results can be included as a factor in regimen selection because these results would represent the real world.Trial registrationThis study is a retrospective observational study and does not include any health care interventions. Therefore, we did not register the protocol of this study.

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Oxidative stress is one cause of atherosclerosis that makes it a lifestylerelated disease. Oxidized low-density lipoprotein OxLDL was previously found to be related to oxidative stress, measured using the diacron-reactive oxygen metabolites d-ROMs test and showed a negative correlation between biological antioxidant potential BAP test results and triglycerides TG. In addition, large gender differences exist among vascular disorders caused by arteriosclerosis. However, such gender differences and their correlation with oxidative stress and blood lipids have not been clari ed. In this study, gender differences in correlations between oxidative stress and blood lipids as factors in the development of atherosclerosis was addressed. Subjects were 149 individuals who underwent medical examinations conducted in Ashikaga Teishin Clinic in Tochigi, Japan 98 males and 51 females. A strong positive correlation was observed between d-ROMs test results and OxLDL in men R 0.480, P 0.0001 , but no correlation was seen in women. A strong negative correlation between BAP test results and TG was also noted in men R 0.571, P 0.0001 , and a moderate negative correlation was detected in women R 0.344, P 0.0133. A positive correlation between d-ROMs tests and OxLDL was seen in women under 50 years of age R 0.399, P 0.0393 , but this correlation was not present in women who were 50 years of age or older R 0.00656, P 0.976. Correlations between oxidative stress and OxLDL and between antioxidant potential and TG in men were more prominent than in women. This nding suggests that decreasing oxidative stress in the blood to prevent atherosclerosis is more important for men.