The brain consists of heterogeneous populations of neuronal and non-neuronal cells. The revelation of their connections and interactions is fundamental to understanding normal brain functions as well as abnormal changes in pathological conditions. Optogenetics and chemogenetics have been developed to allow functional manipulations both in vitro and in vivo to examine causal relationships between cellular changes and functional outcomes. These techniques are based on genetically encoded effector molecules that respond exclusively to exogenous stimuli, such as a certain wavelength of light or a synthetic ligand. Activation of effector molecules provokes diverse intracellular changes, such as an influx or efflux of ions, depolarization or hyperpolarization of membranes, and activation of intracellular signaling cascades. Optogenetics and chemogenetics have been applied mainly to the study of neuronal circuits, but their use in studying non-neuronal cells has been gradually increasing. Here we introduce recent studies that have employed optogenetics and chemogenetics to reveal the function of astrocytes and gliotransmitters.
Astrocytes* ; Brain ; In Vitro Techniques ; Ions ; Membranes ; Neurons ; Optogenetics*

OBJECTIVE: This study is a retrospective cost-benefit analysis of cervical anterior interbody fusion and cervical artificial disc replacement, which are the main surgical methods to treat degenerative cervical disc disease.METHODS: We analyzed 156 patients who underwent anterior cervical disc fusion and cervical artificial disc replacement from January 1, 2008 to December 31, 2009, diagnosed with degenerative cervical disc disorder. In this study, the costs and benefits were analyzed by using quality adjusted life year (QALY) as the outcome index for patients undergoing surgery, and a Markov model was used for the analysis. Only direct medical costs were included in the analysis; indirect medical costs were excluded. Data were analyzed with TreeAge Pro 2015™ (TreeAge Software, Inc, Williamstown, MA, USA).RESULTS: Patients who underwent cervical anterior fusion had a total cost of KRW 2501807/USD 2357 over 5 years and obtained a utility of 3.72 QALY. Patients who underwent cervical artificial disc replacement received 4.18 QALY for a total of KRW 3685949/USD 3473 over 5 years. The cumulative cost-effectiveness ratio of cervical spine replacement surgery was KRW 2549511/QALY (USD 2402/QALY), which was lower than the general Korean payment standard.CONCLUSION: Both cervical anterior fusion and cervical artificial disc replacement are cost-effective treatments for patients with degenerative cervical disc disease. Cervical artificial disc replacement may be an effective alternative to obtain more benefits.
Cervical Vertebrae ; Cost-Benefit Analysis ; Female ; Humans ; Quality-Adjusted Life Years ; Retrospective Studies ; Spinal Fusion ; Spine ; Total Disc Replacement

Scratching is a main behavioral response accompanied by acute and chronic itch conditions, and has been quantified as an objective correlate to assess itch in studies using laboratory animals. Scratching has been counted mostly by human annotators, which is a time-consuming and laborious process. It has been attempted to develop automated scoring methods using various strategies, but they often require specialized equipment, costly software, or implantation of device which may disturb animal behaviors. To complement limitations of those methods, we have adapted machine learning-based strategy to develop a novel automated and real-time method detecting mouse scratching from experimental movies captured using monochrome cameras such as a webcam. Scratching is identified by characteristic changes in pixels, body position, and body size by frame as well as the size of body. To build a training model, a novel two-step J48 decision tree-inducing algorithm along with a C4.5 post-pruning algorithm was applied to three 30-min video recordings in which a mouse exhibits scratching following an intradermal injection of a pruritogen, and the resultant frames were then used for the next round of training. The trained method exhibited, on average, a sensitivity and specificity of 95.19% and 92.96%, respectively, in a performance test with five new recordings. This result suggests that it can be used as a non-invasive, automated and objective tool to measure mouse scratching from video recordings captured in general experimental settings, permitting rapid and accurate analysis of scratching for preclinical studies and high throughput drug screening.
Animals ; Animals, Laboratory ; Behavior, Animal ; Body Size ; Complement System Proteins ; Decision Trees ; Drug Evaluation, Preclinical ; Humans ; Injections, Intradermal ; Machine Learning ; Methods ; Mice ; Motion Pictures as Topic ; Pruritus ; Research Design ; Sensitivity and Specificity ; Video Recording

BACKGROUND AND OBJECTIVES: It takes considerable time and effort to make decisions about management and follow up for the thyroid cancer. Also there are risks of incorrectness or confusion on the part of thyroid specialists. We developed a thyroid cancer calculator that does automatic thyroid cancer staging, prognosis predicting and suggesting follow-up strategies in order to reduce the burden of thyroid specialists who have to memorize a lot of guidelines and statistics, and to give consistency to the treatment plan. MATERIALS AND METHOD: An automatic thyroid cancer calculator was developed by using a computer program called 'Qt 5.2 version', based on patient demographics, diagnosis, treatment, and follow-up status. This partly cited the history of prior thyroid cancer or other cancer registration, and focused on the specification of differentiated thyroid cancer. RESULTS: The program consisted of survival, recurrence and, dynamic re-stratification with follow-up. The patient registration form consisted of identification number, name and operation date, and patients needed to enter their thyroid cancer status, including clinical and pathologic information after registration. The entered information could be easily accessed in a few seconds. The program helped to update patient's current status, promptly collect data for clinical studies of thyroid cancers and provide better patient care. This program was simple, convenient and time-saving for users as it specifically contained important thyroid cancer items. CONCLUSION: Although this program is still in its primitive stage, the Kosin thyroid calculator reduces the workload of thyroid specialists and prevents the loss of clinical data. Furthermore, it could be a useful tool for the management and research of thyroid cancer.
Demography ; Diagnosis ; Follow-Up Studies* ; Humans ; Neoplasm Staging ; Patient Care ; Prognosis* ; Recurrence ; Specialization ; Thyroid Gland ; Thyroid Neoplasms*

Kikuchi's disease (KD), histiocytic necrotizing lymphadenitis, isa benign and self-limited disease which mainly affects young women. KD has been rarely described in association with systemic lupus erythematosus (SLE), and its diagnosis can precede, postdate or coincide with the diagnosis of SLE. The tendency of flare-up of lupus activity with the onset of KD and the simultaneous occurrence of these two diseases suggest that they are not independent events. Herein, we report a case of KD associated with SLE in an 18-year-old female who showed tender erythematous papules on both upper extremities accompanied by cervical lymphadenopathy. The histopathologic examination of lymph nodes showed histiocytic necrotizing lymphadenitis.
Adolescent ; Female ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lupus Erythematosus, Systemic ; Lymph Nodes ; Lymphatic Diseases ; Upper Extremity

Background: Demographic change and advances in technology affect transurethral surgery and outpatient procedures in the urologic field. There are few population-based studies that accurately assess the trend of transurethral surgery and outpatient procedures including diagnostic tests. We investigated the recent epidemiologic trends in transurethral surgeries and urological outpatient procedures from 2009 to 2016 in Korea using the entire populationbased cohort. Methods: We analyzed medical service claim data of transurethral surgery, urological outpatient procedures submitted by medical service providers from the Health Insurance Review and Assessment Service from 2009 to 2016. Results: Transurethral ureter surgery increased by 134.9% from 14,635 in 2009 to 34,382 in 2016 (B = 2,698; R ² = 0.98; P < 0.001). The transurethral bladder surgery increased by 65.5% from 12,482 in 2009 to 20,658 in 2016 (B = 1,149; R ² = 0.97; P < 0.001). Over the 8-years period, there were not significant changes in transurethral prostate (B = 43; R ² = 0.04; P = 0.617) and urethral surgery (B = −12; R ² = 0.18; P = 0.289). The significantly increasing trends in cystoscopy (B = 5,260; R ² = 0.95; P < 0.001) and uroflowmetry (B = 53,942; R² = 0.99; P < 0.001) were observed during the 8-year period. There was no difference in bladder catheterization during the 8-year period. Urodynamic study (UDS: B = −2,156; R ² = 0.77; P = 0.003) and electrical stimulation treatment (EST: B = −1,034; R ²= 0.87; P < 0.001) significantly decreased. Conclusion In Korea, transurethral ureter surgery and transurethral bladder surgery have been continuously increasing. Transurethral prostate surgery and transurethral urethral surgery remained constant with no increase or decrease. Cystoscopy and uroflowmetry continue to increase, while UDS and EST continue to decrease.

Retroperitoneal fibrosis (RF) is a disorder characterized by the presence of a retroperitoneal mass and concurrent systemic inflammation. Some cases of RF are recognized as belonging to the spectrum of immunoglobulin G4-related disease (IgG4-RD). Glucocorticoids are highly effective for treatment of retroperitoneal fibrosis, although the optimal dose and duration of therapy have not been established. An initial dose of prednisone (40-60 mg) daily is usually administered with a tapering scheme. We report on a 55-year-old man diagnosed with IgG4-related RF and successfully treated with a 3-day course of daily 250 mg (4 mg/kg) intravenous methylprednisolone, which resulted in the prompt resolution of urinary obstruction and systemic symptoms.
Glucocorticoids ; Humans ; Immunoglobulins ; Inflammation ; Methylprednisolone ; Middle Aged ; Prednisone ; Retroperitoneal Fibrosis*

Splenosis refers to the heterotropic autotransplantation of splenic tissue. Sometimes splenosis after surgical resection is difficult to differentiate from recurrence or metastasis of cancer. A 49-year-old male patient was diagnosed with clear cell renal cell carcinoma of left kidney. As there was no evidence of metastasis, he underwent radical nephrectomy with splenectomy. On surveillance computed tomography, masses at nephrectomy site and pleura were found and both were initially considered to be recurrence. After several cycle of pazopanib administration, pleural mass decreased in size while mass at nephrectomy site did not respond at all. Spleen scan showed increased uptake of the mass and therefore the mass was revealed to be splenosis. To avoid unnecessary treatment and planning optimal treatment, considering the possibility of splenosis is important and spleen scan can be helpful.
Autografts ; Carcinoma, Renal Cell* ; Humans ; Kidney ; Male ; Middle Aged ; Neoplasm Metastasis ; Nephrectomy* ; Pleura ; Radionuclide Imaging ; Recurrence* ; Spleen ; Splenectomy ; Splenosis* ; Transplantation, Autologous

Anti-erythropoietin antibodies usually cross-react with all kinds of recombinant erythropoietins; therefore, erythropoiesis-stimulating agent (ESA)-induced pure red-cell aplasia (PRCA) is not rescued by different ESAs. Here, we present a case of ESA-induced PRCA in a 36-yr-old woman with chronic kidney disease, whose anemic condition improved following reintroduction of darbepoetin-alpha. The patient developed progressive, severe anemia after the use of erythropoietin-alpha. As the anemia did not improve after the administration of either other erythropoietin-alpha products or erythropoietin-beta, all ESAs were discontinued. Oxymetholone therapy failed to improve the transfusion-dependent anemia and a rechallenge with ESAs continuously failed to obtain a sustained response. However, her anemia improved following reintroduction of darbepoetin-alpha at 3 yr after the initial diagnosis. Interestingly, anti-erythropoietin antibodies were still detectable, although their concentration was too low for titration. In conclusion, darbepoetin-alpha can improve ESA-induced PRCA when the anti-erythropoietin antibody titer declines and its neutralizing capacity is lost.
Adult ; Anemia/drug therapy/etiology ; Antibodies/*blood/immunology ; Bone Marrow Cells/pathology ; Drug Hypersensitivity/immunology ; Erythropoietin/*analogs & derivatives/therapeutic use ; Erythropoietin, Recombinant/adverse effects/*immunology/therapeutic use ; Female ; Glomerulonephritis, IGA/complications ; Hematinics/adverse effects/immunology/*therapeutic use ; Humans ; Kidney Failure, Chronic/complications ; Oxymetholone/therapeutic use ; Red-Cell Aplasia, Pure/chemically induced/*drug therapy/immunology

Purpose: There are increased therapeutic usages of rituximab in kidney transplantation (KT). However, few studies have evaluated the effect of rituximab on cancer development following KT. This study aimed to evaluate the effect of rituximab on the cancer occurrence and mortality rate according to each type of cancer. Methods: Five thousand consecutive recipients who underwent KT at our center were divided into era1 (1990–2007) and era2-rit– (2008–2018), and era2-rit+ (2008–2018) groups. The era2-rit+ group included patients who received single-dose rituximab (200–500 mg) as a desensitization treatment 1–2 weeks before KT. Results: The 5-year incidence rates of malignant tumors after KT were 3.1%, 4.3%, and 3.5% in the era1, era2-rit–, and era2-rit+ group, respectively. The overall incidence rate of cancer after transplantation among the 3 study groups showed no significant difference (P = 0.340). The overall cancer-related mortality rate was 17.1% (53 of 310). Hepatocellular carcinoma (HCC) had the highest mortality rate (61.5%) and relative risk of cancer-related death (hazard ratio, 8.29; 95% confidence interval, 2.40–28.69; P = 0.001). However, we found no significant association between rituximab and the incidence of any malignancy. Conclusion Our results suggest that single-dose rituximab for desensitization may not increase the risk of malignant disease or cancer-related mortality in KT recipients. HCC was associated with the highest risk of cancer-related mortality in an endemic area of HBV infection.