Objectives : A diverse range of adverse effects has been linked to the application of antidepressants for the treatment of depressive disorder. Recently, evidence has been emerging of the adverse metabolic effects of antidepressants. This study investigated the effects of antidepressants on plasma glucose and other factors in the fat and muscle tissue relating to metabolism. METHODS : Long-Evans-Tokushima-Ostuka (LETO) rats were used to evaluate the effects of different antidepressants. Amitriptyline, fluoxetine, and mirtazapine were administered to each of three subgroups for 4 weeks, between 11 and 15 weeks old, while a fourth subgroup was administered no antidepressant during the same period. Changes of weight and daily intake were monitored. Tissues and blood were collected at 15 weeks. RESULTS : The fluoxetine subgroup showed lower weight gain and lower food efficacy ratio than did the other subgroups. Blood glucose and other circulating factors showed no significant differences among groups, except for the leptin levels of the fluoxetine subgroup. However, the amitriptyline and mirtazapine subgroups showed similar patterns in the response of mRNA expression of peroxisome proliferator-activated receptors gamma cofactor-1 and uncoupling protein-1, 2, 3. CONCLUSION : These results could indicate possible differences in metabolic response based on the kind of antidepressant used.
Amitriptyline ; Animals ; Antidepressive Agents ; Blood Glucose ; Depressive Disorder ; Energy Metabolism ; Fluoxetine ; Glucose ; Leptin ; Mianserin ; Muscles ; Peroxisome Proliferator-Activated Receptors ; Plasma ; Rats ; RNA, Messenger ; Weight Gain

No abstract available.
Humans ; Positive-Pressure Respiration*

We present a patient who complained of excessive daytime sleepiness (EDS), which started three years ago. She had no other medical, neurological, and psychiatric disorders. Nocturnal polysomnography did not indicate any sleep disorders, which might cause daytime EDS, such as obstructive sleep apnea. The following multiple sleep latency test was not compatible for narcolepsy. Her laboratory findings were remarkable for subclinical hypothyroidism, although free T4 and T3 were within reference rage, she had elevated thyroid stimulating hormone. After four weeks of levothyroxine treatment, her EDS resolved. The hypersomnolence, as a presenting symptom of subclinical hypothyroidism, was optimally treated after thyroid hormone replacement.
Disorders of Excessive Somnolence* ; Humans ; Hypothyroidism* ; Narcolepsy ; Polysomnography ; Rage ; Sleep Apnea, Obstructive ; Sleep Wake Disorders ; Thyroid Gland ; Thyrotropin ; Thyroxine*

BACKGROUND: It is well known that the GABAergic inhibitory interneuronal system plays an important role in modulation of the noxious stimulation transmitted from the primary afferent input. Some studies have revealed the role that the GABA inhibitory interneuronal system plays in the modulation of pain transmission and the changes in the GABAergic interneurons that occur during the neuropathic pain. This study was conducted to evaluate the apoptosis of the GABAergic interneuron, which is assumed to contribute to neuropathic pain. METHODS: Male Sprague-Dawley rats weighing 290-310 g were used to create a CPIP (chronic post-ischemic pain) model, which was made by placing a tourniquet on the left hindpaw of the rats. The tourniquet was maintained for 3 hours, after which it was released to allow reperfusion. Thirty minutes prior to reperfusion, N-acetyl-L-cysteine (NAC group) or normal saline (control group) was injected. After reperfusion, mechanical allodynia and cold allodynia were measured. In addition, the release of cytochrome c into the cytosol was evaluated through western blot or immunohistochemistry of the spinal cord. RESULTS: Mechanical and cold allodynia developed and the number of GABA interneurons was reduced in the control group. Additionally, The cytochrome c from the GABA interneuron was released into the cytosol in the control group, but the amount released was reduced in response to treatment with NAC. CONCLUSIONS: The results of this study showed that the GABA interneuron in the Rexed laminae I, II released cytochrome c into the cytosol in CPIP neuropathic pain model, which is known to lead to apoptosis. However, treatment with N-acetyl-L-cysteine prevented this process.
Acetylcysteine ; Animals ; Apoptosis ; Blotting, Western ; Cold Temperature ; Complex Regional Pain Syndromes ; Cytochromes c ; Cytosol ; gamma-Aminobutyric Acid ; Horns ; Humans ; Hyperalgesia ; Immunohistochemistry ; Inositol Phosphates ; Interneurons ; Ischemia ; Male ; Neuralgia ; Prostaglandins E ; Rats ; Rats, Sprague-Dawley ; Reperfusion ; Spinal Cord ; Tourniquets

The objective of aneurysm surgery is to exclude the aneurysm from the circulation while preserving blood flow distal to the lesion. In certain situations, the aneurysm neck cannot be clipped safely or the parent vessel reconstructed, primarily in large or giant size with incorporation of parent vessels or perforating arteries, calcification at the aneurysm base, and fusiform or dissecting aneurysms. In such cases, occlusion of the parent vessel is a treatment of option. In many patients, however, sacrifice of the parent artery has an associated risk of ischemic stroke. Therefore, sacrifice of the parent vessel can be supplimented with distal revascularization to provide the necessary distal blood flow while allowing the aneurysm to be trapped. The indications, options, and surgical approaches are described with review of literatures. Finally the authors' experiences of revascularization in 7 patients with unclippable aneurysms are reported.
Aneurysm ; Aneurysm, Dissecting ; Arteries ; Humans ; Intracranial Aneurysm* ; Neck ; Parents ; Stroke

BACKGROUND: Role of cytochrome c (Cyt c) is an apoptogenic agent under certain conditions. The mitochondrial permeability transition pore (MPTP) plays an important role in cell death since it opens, leading to mitochondrial swelling and release of Cyt c, which initiates apoptosis. By inhibiting the opening of MPTP, cyclosporine A (CSA) may contribute to maintaining mitochondrial homeostasis. We investigate the effects of the partial sciatic nerve injury (PSNI)-induced neuropathic pain model on mitochondrial Cyt c release and the effects of CSA on neuroprotection by mitochondrial stabilizing activity in PSNI rats. METHODS: Rats were assigned to two groups that received different operations (Group P; PSNI operation, Group S; sham operation). The changes of cyt c and GABAergic neuron were evaluated in the spinal cord tissue. After which, PSNI rats randomly received CSA (Group C) or saline (Group S), and the changes of mechanical thresholds with Cyt c and GABAergic neuron were checked. RESULTS: PSNI in rats increased the release of cytosolic Cyt c. However, GABAergic cells were not decreased in the spinal cord level on the ipsilateral side to the PSNI. The second experiment reveal a reduction in Cyt c release, using CSA in PSNI model. Rats receiving CSA were afforded the antiallodynia without decrease of GABAergic cell. CONCLUSIONS: The Cyt c probably contributes to nerve dysfunction after PSNI. PSNI induced neuropathic pain was profoundly linked to mitochondrial stabilization. Thus, the potent neuroprotector, CSA, might produce antiallodynia through its capability to inhibit the opening of MPTP.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; Animals ; Apoptosis ; Cell Death ; Cyclosporine ; Cytochromes ; Cytochromes c ; Cytosol ; GABAergic Neurons ; Homeostasis ; Hyperalgesia ; Mitochondrial Membrane Transport Proteins ; Mitochondrial Swelling ; Neuralgia ; Permeability ; Rats ; Salicylamides ; Sciatic Nerve ; Spinal Cord

Aspergilloma and Allergic Bronchopulmonary Aspergillosis(ABPA) are different types of the pulmonary aspergillosis spectrum of diseases. ABPA is an inflammatory disease that causes hypersensitivity to Aspergillus spores growing in the bronchi, which is characterized by asthma, recurrent pulmonary infiltrations or mucoid impaction, eosinophilia and central bronchiectasis. Aspergilloma is a simple colonization of fungus within a cavitary lung lesion, but these diseases rarely coexist. A case of ABPA, coexistent with Aspergilloma, was experienced in a 31 year-old female. The diagnosis was confirmed by the immediate cutaneous reactivity to Aspergillus fumigatus, elevated total IgE antibodies, peripheral eosinophilia, bronchiectasis, growth of Aspergillus species in a sputum culture and radiographic infiltration. Treatment, with prednisone and itraconazole, led to improvement of the respiratory symptoms, reduction of the cavitary lesion and in the total serum IgE level.
Adult ; Antibodies ; Aspergillosis, Allergic Bronchopulmonary* ; Aspergillus ; Aspergillus fumigatus ; Asthma ; Bronchi ; Bronchiectasis ; Colon ; Diagnosis ; Eosinophilia ; Female ; Fungi ; Humans ; Hypersensitivity ; Immunoglobulin E ; Itraconazole ; Lung ; Prednisone ; Pulmonary Aspergillosis ; Spores ; Sputum

Distraction osteogenesis (DO) is a surgical method of bone formation that involves an osteotomy and sequential stretching of the healing callus by gradual movement and subsequent remodeling. DO is used to correct facial asymmetry, such as in patients with hemifacial microsomia, maxillary or mandibular retrusion, cleft lip and palate, alveolar defects, and craniofacial deficiency. It is accomplished with the aid of a distraction device, which is secured with screws placed directly into bone, for a predetermined length of time. Hemifacial microsomia is characterized by unilateral facial hypoplasia, often with unilateral shortening of the mandible and subsequent malocclusion. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, tilted occlusal plane, and short mandible. Early treatment is necessary to avoid subsequent impaired midfacial growth. The standard treatment of these malformations consists of the application of bone grafts, which can lead to unpredictable growth. The new bone-lengthening procedure represents a limited surgical intervention and opens up a new perspective for treatment, especially in younger children with severe deformities. This report describes a case of hemifacial microsomia (Type-II left-sided hemifacial microsomia). The patient, a 10-year-old child, visited our clinic for facial asymmetry correction. He had a hypoplastic mandible, displaced ear lobe, 10 mm canting on the right side, and malocclusion. We planned DO to lengthen the left mandible in conjunction with a Le Fort I osteotomy for decanting and then perform a right intraoral vertical ramus osteotomy (IVRO). Progressive distraction at a rate of 0.5 mm/12 hours was initiated 7 days postoperatively. The duration of DO was 17 days. The consolidation period was 3 months. Satisfactory results were obtained in our case, indicating that DO can be used successfully for functional, aesthetic reconstruction of the mandible. We report a case involving DO in conjunction with orthognathic surgery for correcting mandibular hypoplasia with a review of the literature.
Bony Callus ; Child ; Cleft Lip ; Congenital Abnormalities ; Dental Occlusion ; Ear ; Facial Asymmetry ; Goldenhar Syndrome* ; Humans ; Malocclusion ; Mandible ; Maxilla ; Orthognathic Surgery ; Osteogenesis ; Osteogenesis, Distraction* ; Osteotomy ; Palate ; Retrognathia ; Transplants

Objectives: The purpose of this study was to analyze several factors affecting the efficacy of epidural steroid injections as a nonoperative treatment modality in lumbar disc herniation patients.Summary of Literature Review: Despite several studies, the normal course of intervertebral disc herniation is not fully understood, and the optimal timing of surgery is unclear. Methods: From January 2017 to April 2019, among outpatients in our hospital, 64 patients diagnosed with 3-4 or 4-5 single-level lumbar disc herniation and followed up for at least 6 weeks were included. Epidural steroid injection was performed in all patients during their 1-week admission. Symptoms improved in 36 patients (group 1) and persisted or recurred in 28 patients (group 2), who were finally treated surgically. Demographic factors, magnetic resonance imaging findings, and clinical assessments were analyzed. Results: The only demographic factor with a significant difference between groups was symptom duration. In magnetic resonance imaging, significant differences were found in disc sequestration and the degree of the herniated disc. At 6 weeks after the injection, significant differences were found between the 2 groups in visual analog scale scores and the Korean version of the Oswestry Disability Index. Conclusions Several factors must be considered when treating patients with lumbar disc herniation. Of note, longer symptom duration was found to be associated with a lower effectiveness of conservative treatment. The effects of treatment could also be influenced by the disc form and the degree of disc herniation.