The supranuclear control of eye movement invo l ves the pathway extending from the cerebral cortex to theocular motor nuclei located in the brain stem. This paper de-scribes the normal supranuclear pathway, whichcontrols eye movement. We also include magnetic resonance imaging findings of the typical ocular manifestationscaused by disorders involving the supranuclear pathway, providing the anatomic ex-planations for certain clinicalsigns.
Brain Stem ; Cerebral Cortex ; Eye Movements ; Magnetic Resonance Imaging ; Ocular Motility Disorders*

Panic disorder is one of the chronic and disabling anxiety disorders. There has been evidence for either genetic heterogeneity or complex inheritance, with environmental factor interactions and multiple single genes, in panic disorder's etiology. Linkage studies have implicated several chromosomal regions, but no research has replicated evidence for major genes involved in panic disorder. Researchers have suggested several neurotransmitter systems are related to panic disorder. However, to date no candidate gene association studies have established specific loci. Recently, researchers have emphasized genome-wide association studies. Results of two genome-wide association studies on panic disorder failed to show significant associations. Evidence exists for differences regarding gender and ethnicity in panic disorder. Increasing evidence suggests genes underlying panic disorder overlap, transcending current diagnostic boundaries. In addition, an anxious temperament and anxiety-related personality traits may represent intermediate phenotypes that predispose to panic disorder. Future research should focus on broad phenotypes, defined by comorbidity or intermediate phenotypes. Genome-wide association studies in large samples, studies of gene-gene and gene-environment interactions, and pharmacogenetic studies are needed.
Catechol O-Methyltransferase/genetics ; Cholecystokinin/genetics ; Genetic Loci ; *Genome-Wide Association Study ; Humans ; Monoamine Oxidase/genetics ; Panic Disorder/*genetics

OBJECTIVE: IL-1beta is involved in the degradation of articular cartilage in various arthritides, including osteoarthritis (OA). Competitive inhibition of IL-1beta by IL-1 receptor antagonists (IL-1Ra) may represent a pathogenesis-based strategy for inhibiting degradation of the cartilage matrix. We investigated the hypothesis that controlled release of IL-1Ra using injectable, thermoreversible and complex coacervate combination gels as drug delivery systems might reduce matrix degradation in OA. METHODS: Thermoreversible combination gels that can be injected into joints were formed in aqueous solution by making a complex coacervate with recombinant human IL-1Ra (anakinra) and cationic macromolecules, and this was followed by co-formulation with methylcellulose as a negative thermosensitive polysaccharide. Gels containing anakinra were positioned in the upper insert of a transwell system and human OA chondrocytes were placed in the lower compartment and then they were stimulated with IL-1beta. The expression of matrix metalloproteinases (MMPs) was examined by performing real time PCR and ELISA. RESULTS: Complex coacervation between anakinra and protamine was successfully completed. IL-1Ra was released from the gels in a sustained release pattern for extended periods with minimal initial bursts. IL-1beta markedly enhanced the expression of MMP. The IL-1Ra released from the gels significantly inhibited the IL-1beta-induced MMP expression in the chondrocytes. CONCLUSION: We developed and optimized a novel injectable and thermoreversible gel system for the controlled release of IL-1Ra, and this drug delivery system effectively inhibited the IL-1beta-induced MMP expression of chondrocytes in a transwell system. Intra-articular local delivery of injectable and thermoreversible gels containing IL-1Ra into knees has the potential to provide prolonged therapy based on the pathophysiology of knee OA.
Arthritis ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Drug Delivery Systems ; Gels ; Humans ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-1 ; Joints ; Knee ; Matrix Metalloproteinases ; Methylcellulose ; Osteoarthritis ; Real-Time Polymerase Chain Reaction

OBJECTIVE: To induce a mouse model of scleroderma with repeated bleomycin injections for research into human scleroderma at our research laboratory. METHODS: The protocol of Yamamoto et al. was replicated to establish the bleomycin-induced mouse model of scleroderma. RESULTS: A mouse model of scleroderma was induced by repeated subcutaneous injections of bleomycin. The dermal thickness increased with homogeneous and thickened collagen bundles. Semiquantitative measurements of dermal fibrosis were prominent in bleomycin-treated mice. CONCLUSION: A mouse model of scleroderma was induced with repeated injections of bleomycin at our laboratory.
Animals ; Bleomycin ; Collagen ; Fibrosis ; Humans ; Injections, Subcutaneous ; Mice ; Models, Animal

OBJECTIVE: Gout is one of the most common forms of inflammatory arthritides among men, which is caused primarily by chronic hyperuricemia. Although pharmacological therapy is the mainstay treatment to manage gout, limiting the consumption of dietary purine is also important. Several epidemiological studies have reported that alcohol consumption is closely related to hyperuricemia and gout. The objective of this study was to determine the purine content in common Korean alcoholic beverages using high performance liquid chromatography (HPLC) to provide a dietary guideline for those with hyperuricemia or gout. METHODS: Thirty-five alcoholic beverages were analyzed. Blindly labeled samples of each alcoholic beverage were degassed and frozen. The sample preparation prior to HPLC followed the methods of Japanese researchers. HPLC was performed to analyze adenine, guanine, hypoxanthine, and xanthine content in the alcoholic beverages. RESULTS: The standard curves were linear for all purines. Purine contents were as follows: beer (42.26~146.39 micromol/L, n=12), medicinal wine (8.2 and 40.41 micromol/L, n=2), rice wine (13.19 micromol/L), Makgeolri (11.71 and 24.72 micromol/L, n=2), red wine (0, 6.03, and 17.9 micromol/L, n=3). No purines were found in fruit wine (n=2), Kaoliang (n=1), white wine (n=1), or distilled alcoholic beverages, such as soju (n=10) or whiskey (n=1). CONCLUSION: Among popular Korean alcoholic beverages, beer contained a considerable amount of purines, whereas distilled alcoholic beverages did not. Patients with either gout or hyperuricemia should avoid alcoholic beverages, especially those containing large amounts of purines.
Adenine ; Alcohol Drinking ; Alcoholic Beverages ; Alcoholics ; Arthritis ; Asian Continental Ancestry Group ; Beer ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Fruit ; Gout ; Guanine ; Humans ; Hyperuricemia ; Hypoxanthine ; Male ; Purines ; Wine ; Xanthine

No abstract available.

As extra-mammary Paget's disease is rare and usually diagnosed at early stage when it is highly curable with surgical resection, it is much rarer to see patients with recurrent metastatic disease. Thrombotic thrombocytopenic purpura in patients with metastatic solid cancer is also a rare disease and may result from bone marrow metastasis or bone marrow necrosis. For the latter, the majority of cases are not eligible for systemic chemotherapy for rapid disease progression and poor performance status. Herein, authors report a patient with thrombotic thrombocytopenic purpura associated with bone marrow necrosis complicating extra-mammary Paget's disease who was successfully treated with docetaxel and carboplatin combination chemotherapy.
Bone Marrow* ; Carboplatin ; Disease Progression ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Necrosis* ; Neoplasm Metastasis ; Paget Disease, Extramammary* ; Purpura, Thrombotic Thrombocytopenic* ; Rare Diseases

PURPOSE: The purpose of the study was to compare clinical, oncological outcomes between chondroblastoma and giant cell tumor. MATERIALS AND METHODS: This retrospective study reviewed 25 patients with histologically confirmed chondroblastoma of bone between 1998 and 2012. During the same period, 42 patients diagnosed as a giant cell tumor were also reviewed. We then analyzed clinical and oncological results of chondroblastoma compared with giant cell tumor. In chondroblastoma, 17 cases were male, and 8 cases were female, with a mean age of 20.6 years (range from 11 to 38 years). In giant cell tumor, 20 cases were male, and 22 cases were female, with a mean age of 39.26 years (from 17 to 75 years). All patients underwent surgical treatment that extended curettage with electrocauterization. After curettage, bony cavity was filled with autogenous bone, allogenic bone chip, bone cement, tricalcium phosphate, and so on. The results were compared in recurrence and metastatic rate. The minimum follow-up period was 1 year. RESULTS: In chondroblastoma, mean size was 2.18 cm (0.3 to 9.5 cm). Local recurrence and metastasis were absent. In giant cell tumors, mean size was 3.71 cm (0.3 to 11 cm). Local recurrence rate was 9.5% (4 of 42 cases) and there was one lung metastasis. CONCLUSION: Chondroblastoma is less invasive with better prognosis than giant cell tumor. Treatment of chondroblastoma and giant cell tumor is surgery. Electrocauterization as an adjuvant therapy showed good results.
Chondroblastoma* ; Curettage ; Female ; Follow-Up Studies ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Lung ; Male ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies

The clinical manifestations of leukemic patients who have temporal bone infiltration are acute mastoiditis, hearing impairment, tinnitus, dizziness, otorrhea, retro-auricular mass and facial nerve palsy. Otologic manifestations of leukemic patients have also been reported several times. However, reports about temporal bone infiltration by leukemic cells after complete remission have been rare, and there have not yet been any reports about both temporal bone infiltration that has been confirmed by mastoid biopsy after remission. We recently experienced a case of recurring acute myelogenous leukemia in both temporal bones after a complete remission and report it with a review of the literature.
Biopsy ; Dizziness ; Facial Nerve ; Hearing Loss ; Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Mastoid ; Mastoiditis ; Paralysis ; Temporal Bone* ; Tinnitus

BACKGROUND/AIMS: SKI306X, a mixed extract of three herbs, Clematis mandshurica (CM), Prunella vulgaris (PV), and Trichosanthes kirilowii (TK), is chondroprotective in animal models of osteoarthritis (OA). The objectives of this study were to investigate its effect on interleukin (IL)-1beta-induced degradation of glycosaminoglycan (GAG) and the basis of its action in human OA cartilage, as well as to screen for the presence of inhibitors of matrix metalloproteinase (MMP)-13 and a disintegrin and metalloprotease with thrombospondin motifs (ADAMTS)-4 in SKI306X and its component herbs, as well as in fractions from SKI306X. METHODS: Human OA chondrocytes and cartilage explants were obtained during total knee replacements and incubated with IL-1beta +/- oncostatin M with or without SKI306X or its component herb extracts. GAG degradation was assayed in cartilage explants using a commercial kit. Expression of genes involved in cartilage destruction was measured by real-time polymerase chain reaction using chondrocyte RNA. SKI306X was fractionated by preparative liquid chromatography to test for the presence of inhibitors of MMP-13 and ADAMTS-4. RESULTS: SKI306X and PV inhibited IL-1beta-induced GAG release from cartilage explants, and SKI306X, CM, PV, and TK inhibited IL-1beta-induced MMP gene expression. Unexpectedly, SKI306X greatly stimulated IL-1beta + oncostatin M-induced ADAMTS-4 gene expression, probably due to its TK component. Some fractions of SKI306X also inhibited ADAMTS-4 activity. CONCLUSIONS: SKI306X and its herbal components inhibit GAG degradation and catabolic gene expression in human OA chondrocytes and cartilage explants. SKI306X likely also contains one or more ADAMTS-4 inhibitor.
ADAM Proteins/antagonists & inhibitors ; Cartilage, Articular/*drug effects/*metabolism ; Cells, Cultured ; Chondrocytes/drug effects/metabolism ; Down-Regulation/drug effects ; Drugs, Chinese Herbal/*pharmacology ; Glycosaminoglycans/*metabolism ; Humans ; Interleukin-1beta/metabolism ; Matrix Metalloproteinase 13/metabolism ; Matrix Metalloproteinase Inhibitors/pharmacology ; Oncostatin M/metabolism ; Osteoarthritis, Knee/drug therapy/genetics/metabolism ; Procollagen N-Endopeptidase/antagonists & inhibitors