BACKGROUND & OBJECTIVES: Glutamate is a major neurotrammitter in corticostriatal, subthalamopallidal, and subthalamonigral pathways and interacts with other neurotrammitters. The study was done to investigate the effects of NMDA blockade on dopaminergic responses. METHODS: We made a unilateral Parkinson model in rats by injecting 6-hydroxydopamine into the substantia nigra. Rotational behavior was observed using apomorphine (mixed Dl/D2 agonist, 0. 5 mg/kg), SKF 38393 (Dl agonist, 1. 5 mg/kg), LY-171555 (D2 agonist, 0. I mg/kg), MK-801 (uncompetitive NMDA blocker, 0. 067 mg/kg), and memantine (non competitive NMDA blocker, 10 mg/kg). RESULTS: Contralateral rotation was induced by apomorphine (total turns for 2 hours, 1160+/-154), SKF 38393 (total turns for 3 hours, 1374+/-400), and LY 171555 (total turns for 3 hours 2316+/-395). NMDA antagonists per se induced mild ipsilateral rotation (MK 801; 587+/-131, memantine; 166+36). Apomorphine induced rotation was potentiated by MK 801 (1683+/-186, p<0.05) and memantine (170+/-264, p<0.05). SKF 38393 induced rotation tended to be potetiated by MK-801 (2451+/-741, p=0.08) and memantine (1794+/-450, p=0.21), though not statistically significant. However, LY 171555 induced rotation was reduced by MK-801 (1153+/-284, p<0.05) ad memantine (22.1+/-42.5, p<0.05). CONCLUSION: NMDA blockers act synergistically with Dl- and antagonistically with D2-mediated behavioural responses, suggesting that glutamate has different interactions with Dl- and D2 pathway.
2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-benzazepine ; Animals ; Apomorphine ; Dizocilpine Maleate ; Glutamic Acid ; Hydroxydopamines* ; Memantine ; N-Methylaspartate* ; Oxidopamine ; Rats* ; Substantia Nigra

Despite significant progress in audiology, there is no definitive treatment option for Ménière disease due to its multifactorial etiology.Current Concepts: The primary treatment goal for Ménière disease is first, to decrease the frequency of symptoms and, second, to minimize the severity of vertigo and hearing loss. Concurrently, the preservation of vestibular and auditory functions should be prioritized. The protection of vestibular and auditory functions should also be considered. Treatment options for Ménière disease include lifestyle modifications, medical treatment, and surgical intervention. Recent treatment algorithms aim to gradually escalate the invasiveness of the treatment to assist in developing a more uniform treatment approach.Nanomaterials, including nanoparticles and nanocarriers, offer an array of novel diagnostic and therapeutic applications for achieving effective drug delivery into the inner ear of patients with Ménière disease. New treatment drugs, such as SPI-1005 (Sound Pharmaceuticals) are currently under clinical trial. Furthermore, drugs are also being repurposed and investigated for their potential in treating Ménière disease.Discussion and Conclusion: Developing new drugs and investigating the pathophysiology of Ménière disease for subtyping is emerging. These may direct the future diagnosis and treatment of the disease and facilitate a better understanding of disease mechanisms. Patients with different subtypes of Ménière disease may require different treatment strategies, which can be achieved by personalized therapy, accurate prognosis prediction, and even, disease prevention.

OBJECTIVE: The purpose of this study was to investigate the risk factors of adhesive capsulitis and the effect of intra-articular steroid injection in spinal cord injured patients. METHOD: Fifty spinal cord injured patients participated in this study. The risk factors of adhesive capsulitis were compared between fourteen patients with adhesive capsulitis and thirty-six patients without one. Methylprednisolone acetate 40 mg mixed with 0.5% lidocaine 2 ml was given into glenohumeral joint space in adhesive capsulitis group and their pain and range of motion (ROM) were analyzed. RESULTS: 1) The incidence of adhesive capsulitis was higher in patients with higher injury level, older age and delayed start of rehabilitation therapy. 2) 10 cm visual analogue scale scores were significantly decreased after intra-articular steroid injection (p<0.01). 3) The shoulder ROM was increased after intra-articular steroid injection. The shoulder ROM at pre-injection was 126o in flexion, 113o in abduction, 64o in external rotation and 51o in internal rotation. The shoulder ROM at 4 weeks after injection was 138o in flexion, 131o in abduction, 74o in external rotation and 77o in internal rotation. CONCLUSION: There was a trend that the incidence of adhesive capsulitis was higher in patients with higher injury level, older age and delayed start of rehabilitation therapy. Further, it was suggested that intra-articular steroid injection was effective for reducing pain and improving ROM.
Adhesives* ; Bursitis* ; Humans ; Incidence ; Lidocaine ; Methylprednisolone ; Range of Motion, Articular ; Rehabilitation ; Risk Factors ; Shoulder ; Shoulder Joint ; Spinal Cord Injuries ; Spinal Cord*

Adrenal myelolipoma is an uncommon non-functioning tumor that is composed of variable amounts of mature adipose tissue and scattered islands of hematopoietic elements, including erythroid, myeloid, lymphoid series, and megakaryocytes. Adrenal myelolipoma should be differentiated from other fat-containing adrenal masses, such as teratoma, lipoma, and liposarcoma. This case report describes a 50-year-old adult who was raised as a male and developed giant adrenal myelolipomas that presented as symptomatic adrenal masses, and which were misdiagnosed as liposarcoma on radiologic examination. The patient had been raised as a male despite ambiguous genitalia, and a thorough investigation was never carried out because of his poor socioeconomic status. Physical examination showed profound short stature (<-3.0 standard deviation score), hyperpigmentation, and a micropenis without palpable gonads. Both a uterus and ovaries were evident in the pelvic cavity on abdominopelvic computed tomography. Adrenocorticotropic hormone stimulation tests confirmed adrenal insufficiency. Steroid replacement therapy was initiated before bilateral adrenalectomy and the histologic findings indicated myelolipoma. The patient's karyotype was 46, XX and mutation analysis of the CYP21A2 gene identified compound heterozygosity consisting of p.I173N and p.Q319*. The patient was treated with once-daily 0.5 mg dexamethasone and once-daily 0.1 mg fludrocortisone. Because the subject had been raised as a male, additional procedures such as an oophorohysterectomy are currently under consideration. We here describe an adrenal myelolipoma in this case that was complicated by a 21-hydroxylase deficiency. We conclude from our analysis that patients with congenital adrenal hyperplasia should be screened for incidental adrenal masses to avoid unnecessary surgical procedures.
Adipose Tissue ; Adrenal Glands ; Adrenal Hyperplasia, Congenital ; Adrenal Insufficiency ; Adrenalectomy ; Adrenocorticotropic Hormone ; Adult ; Dexamethasone ; Disorders of Sex Development ; Female ; Fludrocortisone ; Genital Diseases, Male ; Gonads ; Humans ; Hyperpigmentation ; Islands ; Karyotype ; Lipoma ; Liposarcoma ; Male ; Megakaryocytes ; Myelolipoma ; Ovary ; Penis ; Physical Examination ; Social Class ; Steroid 21-Hydroxylase ; Teratoma ; Uterus

OBJECTIVE: Stenting of symptomatic intracranial stenosis has recently become an alternative treatment modality. However, urgent intracranial stenting in patients with intracranial stenosis following a transient ischemic attack (TIA) or minor stroke is open to dispute. We sought to assess the feasibility, safety, and effectiveness of urgent intracranial stenting for severe stenosis (>70%) in TIA or minor stroke patients. METHODS: Between June 2009 and October 2010, stent-assisted angioplasty by using a balloon-expandable coronary stent for intracranial severe stenosis (>70%) was performed in 7 patients after TIA and 5 patients after minor stroke (14 stenotic lesions). Technical success rates, complications, angiographic findings, and clinical outcomes were retrospectively analyzed. RESULTS: Stenting was successful in all 12 patients. The mean time from symptom onset to stenting was 2.1 days (1-8 days). Post-procedural angiography showed restoration to a normal luminal diameter in all patients. In-stent thrombosis occurred in one patient (n=1, 8.3%), and was lysed with abciximab. No device-related complications, such as perforations or dissections at the target arteries or intracranial hemorrhaging, occurred in any patient. The mortality rate was 0%. No patient had an ischemic event over the mean follow-up period of 12.5 months (range, 7-21 months), and follow-up angiography (n=7) revealed no significant in-stent restenosis (>50%). CONCLUSION: Urgent recanalization with stenting is feasible, safe, and effective in patients with TIA or acute minor stroke with intracranial stenosis of > or =70%.
Angiography ; Angioplasty ; Antibodies, Monoclonal ; Arteries ; Constriction, Pathologic ; Dissent and Disputes ; Follow-Up Studies ; Humans ; Immunoglobulin Fab Fragments ; Intracranial Arteriosclerosis ; Ischemic Attack, Transient ; Phenobarbital ; Retrospective Studies ; Stents ; Stroke ; Thrombosis

The effects of ethylene glycol monoethyl ether (EGEE) on testicular cell populations in pubertal (5 weeks old) and adult (9 weeks old) male rats were investigated by a flow cytometric method. A total of 50 rats (in number, 25 pubertal and 25 adult rats) was divided into 5 experimental groups including 0 (control), 50, 100, 200, and 400 mg EGEE/kg of body weight. The animals were administered by gavage for 4 weeks. In adult rats, the treatment of EGEE at the dose of 400 mg/kg of body weight decreased significantly the populations of haploid, while it increased those of diploid and tetraploid cells. In pubertal rats, the treatment of EGEE at the dose of 400 mg/kg of body weight caused only minimal changes in the relative percent of testicular cell types. These results suggest that the effects of EGEE on testicular function in pubertal rats appear to be less pronounced than in adult rats.
Animals ; Dose-Response Relationship, Drug ; Ethylene Glycols/*toxicity ; Male ; Organ Size/drug effects ; Rats ; Sexual Maturation/*drug effects ; Solvents/*toxicity ; Spermatogenesis/*drug effects ; Testis/drug effects/*pathology ; Time Factors

A renal cell carcinoma with tumor thrombus extension into the inferior vena cava occurs in approximately 5 percent of cases. Despite invasion of the inferior vena cava, an aggressive surgical approach for these neoplasms is recommended, but pulmonary and tumor embolisms have been common complications. Therefore, the prevention of tumor emboli during operation is necessary. Placement of a suprarenal filter in the inferior vena cava has become the procedure of choice for preventing tumor emboli during a radical nephrectomy.
Carcinoma, Renal Cell* ; Neoplastic Cells, Circulating ; Nephrectomy* ; Thrombosis ; Vena Cava Filters ; Vena Cava, Inferior*

Renal artery stenosis (RAS) is defined as a narrowing of main renal artery or its major branches over 50%, and can be the cause of pulmonary edema, renal failure, malignant hypertension and cerebrovascular diseases. The renin-angiotensin-aldosterone system works as a key role. In this paper, we report a case of a 53 year-old patient with left middle cerebellar peduncle infarction, who showed malignant hypertension and RAS. The RAS was diagnosed by renal artery computed tomography angiography and treated with renal artery angioplasty, stenting and antihypertensive medication. In a young patient with ischemic stroke who has refractory hypertension against antihypertensive medications, RAS should be suspected and evaluated.
Angiography ; Angioplasty ; Cerebral Infarction ; Humans ; Hypertension ; Hypertension, Malignant ; Hypertension, Renovascular ; Infarction ; Pulmonary Edema ; Renal Artery ; Renal Artery Obstruction ; Renal Insufficiency ; Renin-Angiotensin System ; Stents ; Stroke

OBJECTIVE: This study had three objectives: 1) to investigate the rehabilitation professionals' way of thinking on physical, psychological and social characteristics of older patients: 2) to assess their actual knowledge level about aging; and, 3) to deduce and analyze the influences that cause these different kinds of perceptions and attitudes. METHOD: Total 239 rehabilitation professionals (including rehabilitation doctors, nurses, physical therapists, occupational therapists, speech therapists, social workers, psychologists, prosthetists & orthotists) responded to our questionnaire were included in this study. Self-addressed questionnaires were composed of two categories: 1) the perception of older patients compared with younger patients: and 2) the actual knowledge level about aging. RESULTS: 1) There were significant (p<0.05) differences by job classification on a speculative disposition with the physical characteristics, motive of treatment, emotional characteristics, and discharge problem of older patients. 2) There were also significant (p<0.05) differences by job classification in the actual knowledge level about aging by job classification. A higher score on the questionnaire correlated with a more optimistic view of the motive of treatment, emotional characteristic and discharge problem. CONCLUSION: Many rehabilitation professionals have a misconceptions about older patients due to insufficient knowledge on aging. Therefore we propose an objective understanding of older patients along with proper education on aging to provide an effective rehabilitation treatment.
Aging* ; Classification ; Education ; Humans ; Physical Therapists ; Psychology ; Surveys and Questionnaires ; Rehabilitation* ; Social Workers ; Sociology ; Thinking

OBJECTIVE: The purpose of this study was to evaluate the short- and long-term effects of exercise on neuropathic pain. METHOD: Pain responses between rats in the exercise and control groups were compared to evaluate the effects of exercise in neuropathic pain. Materials consisted of 30 male Sprague-Dawley rats (8 weeks old, 180~200 g), which were divided into an exercise group (n=15) and a control group (n=15). Neuropathic pain was produced by partially injuring the nerve innervating the tail. Running exercise was given on a Rota-rod treadmill exercise machine for 3 weeks (3.1 Km/day, 6 cycle of 9 minutes exercise and 1 minute rest). Behavioral reactions to mechanical allodynia were checked using a von Frey hairs of 2.0 g (19.6 mN) bending force at 10 minutes, 1 hour and 24 hours post-exercise to evaluate the short term effects of exercise. Behavioral reactions to mechanical and thermal allodynia with 4 degrees C or 40 degrees C were evaluated 7, 14, 21 and 28 days following exercise. RESULT: The exercise group exhibited less tail-flick frequencies to mechanical stimulation from 58.8+/-6.8% to 41.1+/-5.4%, 37.6+/-13.2% at 1 and 24 hours post-exercise compared to the control group, but there was no significant difference between the groups at weeks 1 through 4. In the exercise group, the decrease of tail-flick frequencies were blocked by naloxone (2 mg/kg i.p.). It is suggested that long-lasting muscle exercise (e.g. running) which influences central endorphin mechanisms giving analgetic effects. CONCLUSION: The results of this study support the hypothesis that the exercise can reduce neuropathic pain in the acute stage.
Animals ; Endorphins ; Hair ; Humans ; Hyperalgesia ; Male ; Models, Theoretical* ; Naloxone ; Neuralgia* ; Peripheral Nervous System Diseases* ; Rats ; Rats, Sprague-Dawley ; Running ; Tail