Firearm fatalities. A preliminary study report from Iran

During the one-year period from March 2002 to March 2003 there were 89 firearm fatalities investigated by the Legal Medicine Organization of Iran in Tehran. We determined the characteristics of these 89 firearm deaths which comprised 0.83% of all postmortem examinations. Of these, 60.7% were homicides, 30.3% suicides, 4.5% accidental, and 4.5% unclassifiable. Most victims were young male. Military rifles were responsible for almost all suicides, whereas in homicide handguns were the preferred weapons. The most common site of entrance wounds in suicides were the under the chin (37%) and chest (25.9%). In homicide group, 42.6% of entrance wounds were located in the head. The suicidal gunshots were fired from contact/near contact range in 84.6% while this was the case in only two cases of the homicides. All but one of the suicides were committed at the garrisons or police stations. The unique pattern of suicide that was found in this series was not similar to that reported in earlier studies. We believe our pattern of firearm fatalities must be in great part due to the Iran's strict gun control regulations and cultural background.

Induction of apoptosis and inhibition of proliferation in human tumor cells treated with extracts of Uncaria tomentosa

Growth inhibitory activities of novel water extracts of Uncaria tomentosa (C-Med-100) were examined in vitro using two human leukemic cell lines (K562 and HL60) and one human EBV-transformed B lymphoma cell line (Raji). The proliferative capacities of HL60 and Raji cells were strongly suppressed in the presence of the C-Med-100 while K562 was more resistant to the inhibition. Furthermore, the antiproliferative effect was confirmed using the clonogenic assay, which showed a very close correlation between C-Med-100 concentration and the surviving fraction. The suppressive effect of Uncaria tomentosa extracts on tumor cell growth appears to be mediated through induction of apoptosis which was demonstrated by characteristic morphological changes, internucleosomal DNA fragmentation after agarose gel electrophoresis and DNA fragmentation quantification. C-Med-100 induced a delayed type of apoptosis becoming most dose-dependently prominent after 48 hours of exposure. Both DNA single and double strand breaks were increased 24 hours after C-Med-100 treatment, which suggested a well-established linkage between the DNA damage and apoptosis. The induction of DNA strand breaks coupled to apoptosis may explain the growth inhibition of the tumor cells by Uncaria tomentosa extracts. These results provide the first direct evidence for the antitumor properties of Uncaria tomentosa extracts to be via a mechanism of selective induction of apoptosis.

Multiple mechanisms of action of the benzamides and nicotinamides as sensitizers of radiotherapy: opportunities for drug design

The benzamides and nicotinamides are a well-known class of drugs that contain many analogs having radio- and chemosensitizing properties. This study reports on a structural analysis in order to explain the chemical features important to their mechanisms of action. In general, N-substituted analogs are distinguished from the non-N-substituted analogs because they (i) are susceptible to radiolysis, (ii) induce cytotoxicity by apoptosis but not necrosis, (iii) inhibit cell proliferation, (iv) activate poly adenosine diphosphate ribosyl transferase (poly ADPRT), and (v) have a much-reduced effect on microregional tumor blood perfusion. It was concluded that the mechanism of action of N-substituted analogs is shifted from primary effects on tumor vascularization as is seen with the non-N-substituted analogs to one where radiosensitization can be explained by selective induction of apoptosis via radiolysis and accumulation of DNA damage. This knowledge may be useful in the design of drugs possessing multiple mechanisms of radiosensitizing action.

Pharmacokinetics, toxicity, side effects, receptor affinities and in vitro radiosensitizing effects of the novel metoclopramide formulations, sensamide and neu-sensamide

Metoclopramide is a drug which has experienced worldwide use in the clinic for over 30 years as an antiemetic. Recently, it has also been shown to possess radio- and chemosensitizing properties in both animal tumour models and humans at the higher dose of 2 mg/kg. Two new metoclopramide formulations are being clinically developed and they differ mainly in whether the pH of their formulations are acidic (pH 2.5-3.5) or neutral (pH 6.5-7.0). Here we report that intramuscular administration of neutral metoclopramide is about 100% bioavailable, safer and with reduced side effects compared to acidic metoclopramide delivered by intramuscular injection to rats within the dose range of 3.5 to 14 mg/kg. The intramuscular administration of metoclopramide was also about 100% bioavailable compared to the intravenous route of administration. Furthermore, neutral metoclopramide had significantly decreased affinity for dopamine D2 receptors and increased affinity for 5-hydroxytryptamine, receptors, but the radiosensitizing potency was the same, when compared to equimolar concentrations of acidic metoclopramide. Taken together these data support the continued development of neutral metoclopramide for high dose intramuscular administration of metoclopramide for future clinical use as both an antiemetic and radiosensitizer.

Nicotine-induced hypothermia through an indirect dopaminergic mechanism

The effect of nicotine on core body temperature was studied in mice. Intraperitoneal (i.p.) injection of nicotine (0.5, 1 and 2 mg/kg) induced a dose-dependent hypothermia. The response was inhibited by reserpine (5 mg/kg), the centrally active nicotinic receptor antagonist mecamylamine (0.1-1 mg/kg) and the D-2 dopamine receptor antagonist sulpiride (25-100 mg/kg). The β-adrenoceptor antagonist propranolol (5 and 10 mg/kg) and the serotonergic blocker methysergide (5 and 10 mg/kg) did not inhibit but increased the nicotine response. The α-adrenoceptor antagonist phenoxybenzamine, the antimuscarinic agent atropine, the D-1 dopamine receptor antagonist SCH 23390, the peripheral dopamine antagonist domperidone and the peripheral nicotinic antagonist hexamethonium did not alter the nicotine-induced hypothermia. It is concluded that nicotine may cause a fall in core body temperature through a central dopaminergic mechanism.

Coronary artery disease in a patient with a congenital pericardial defect

This case report summarizes our experience with a 43 year old male patient with congenital pericardial defect, involving the left ventricular part of the pericardium, and additionally 2-vessel coronary-artery disease in the absence of any coronary risk factors. This patient underwent coronary-artery bypass grafting. Intraoperatively the heart was found to be rotated and herniated into the left pleural cavity, strangulated by the remaining pericardium causing a bridle stricture of the right as well as the left margin of the heart, with a subsequent local narrowing of the ventricle in these areas. Furthermore, assessment of the coronary arteries at operation by external palpation showed the location of an RCA- and LAD-stenosis to match exactly with the stricture area.

[Effect of thyroxine on distribution of lactate dehydrogenase isoenzymes and content of pyruvic and lactic acids in tissues of rats of various ages]

Distribution of lactate dehydrogenase (LDH) isoenzymes and content of lactic and pyruvic acids were studied in the heart, kidneys and skeletal muscle of rats at the age of 1, 3, 12 and 24 months at normal state and after thyroxine administration. With age the activity of aerobic isoenzymes of LDH increases and that of hybrid anaerobic isoenzymes of LDH decreases in the heart and kidneys; in the skeletal muscle the activity of LDH5 increases and that of LDH3 and LDH4 decreases, the content of the studied acids in the heart, kidneys and skeletal muscle changes irregularly. Under the effect of thyroxine the activity of aerobic isoenzymes of LDH increases in the heart of one-month animals and in the kidneys of one- and three-month animals, as well as in the skeletal muscle of 24-month rats; the activity of LDH5 rises in the skeletal muscle of one- and three-month animals. Thyroxine causes an increase in the content of pyruvic acid in the tissues of all the studied rats.