To determine whether the ethlenbisdithiocarbamate fungicides, zineb, manzeb and maneb affect the N-methyl-D-aspartate (NMDA) receptor in rat brain membranes, we performed a binding assay using [3H]MK-801, a noncompetitive NMDA receptor antagonist. Displacement studies were conducted using well washed membranes to exclude the effect of endogenous acidic amino acids on the binding of [3H]MK-801. In both the presence or absence of added glutamate and glycine in the assay buffer, the dose-response curve indicated that zineb enhanced the binding in a concentration range of 100-500 μM. However, the displacement curves indicated that manzeb and maneb inhibited the binding in a concentration range of 10-500 μM. The addition of 50 μM glutamate and glycine to the assay medium increased binding by 5-20% above the control in a concentration range of 0.1-100 μM. No rats injected with zineb, manzeb, maneb (100 mg/kg, ip) showed any characteristic toxic signs or any significant weight changes within 24 hrs. Estimation of [3H]MK-801 binding to unwashed membranes from intoxicated rat brains revealed no marked change in Bmax or Kd values for 24 hrs following fungicide administration.
binding ; Upper case emm ; Fungicide, NOS ; MK-801 ; assay

Background: The demand for palliative care in Japan has risen over recent years, and training of palliative care physicians is an important problem. However, little is known about unmet needs for education and training systems as well as career development among young physicians who wish to specialize in palliative care. Purpose: To explore unmet needs among palliative care physicians in training. Method: We held group discussions in a forum for physicians of postgraduate year≦15, and analyzed their opinion on topics such as "what are unmet needs?" using theme analysis. Results: Forty physicians participated. Theme analysis revealed the following unmet needs among young physicians; "securing of manpower", "securing of quality of training programs/education", "improvement of network", "removal of many barriers to keeping on a palliative care physician", and "establishment of career models for a specialist". Conclusions: We should discuss solutions for the unmet needs to secure more palliative care physicians.

Delirium occurs in 30-40% of patients with terminal cancer, and 90% of patients are delirious immediately before death. Symptoms such as agitation and hallucination are often refractory to the standard pharmacological therapy. Also, the medication options for delirium in terminally ill patients are often limited due to a difficulty in swallowing or a lack of intravenous access. We herein report a case series of six patients with terminal cancer whose derilium symptoms were treated by asenapine sublingual tablets during the intervention period by the palliative care team. Asenapine was selected when other antipsychotics were ineffective or unavailable for agitation caused by delirium. All patients suffered dyspnea or choking sensations due to dysphagia or respiratory dysfunction. Sedative effect was observed among all patients without apparent adverse events. Sublingual asenapine could be an option for the management of restlessness due to terminal delirium when both oral and intravenous drug administration routes are not available.