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

Cerebral Palsy ; Cleft Palate ; Humans ; Muscles ; Nasopharynx ; Nervous System Diseases ; Oropharynx ; Palate ; Palate, Soft ; Parkinson Disease ; Pharynx ; Sclerosis ; Stroke

Respiratory failure is the most serious manifestation and usual cause of death in acute organophosphate poisoning, and is common in acute cholinergic crisis. But the respiratory failure may appear suddenly in a patient who is recovering from the cholinergic crisis, even while receiving conventional therapy. These are case report of 37 years old male and 24 years old female with intermediate syndrome in organophosphate poisoning. The two patients ingested organophosphate(fenthion and mixture of DDVP with chlorpyrifos respectively) incidentally and in a sucide attempt respectively. After apparent recovery from the cholinergic crisis with a conventional therapy but before the expected onset of delayed polyneuropathy , the respiratory failure appeared suddenly with a muscular weakness, affecting predominantly the proximal limb muscles, neck flexors, territories of several motor cranial nerves. The two patients needed mechanical ventilatory support and recovery from the intermediate syndrome was complete in both patients, although one subsequently developed hypoxic encephalopathy. The clinical manifestation and electrophysiologic study support the clinical diagnosis of intermediate syndrome. The syndrome carries a risk of death, because of respiratory paralysis, if not recognized early and treated adequatedly. Prompt endotrachial intubation and mechanical ventilatory support is the cornerstone of treatment of the intermediate syndrome. Therefore, all patient should be observed in a hospital for up to 5 days after poisoning.
Adult ; Cause of Death ; Chlorpyrifos ; Cranial Nerves ; Diagnosis ; Dichlorvos ; Extremities ; Female ; Humans ; Hypoxia, Brain ; Intubation ; Male ; Muscle Weakness ; Neck Muscles ; Organophosphate Poisoning* ; Poisoning ; Polyneuropathies ; Respiratory Insufficiency* ; Respiratory Paralysis ; Young Adult

Malignant melanoma is a relatively rare tumor. It represents 1.4-15.7% of all malignant tumors. Melanin-containing cells are normally found in the pia mater of adult human subjects. A wide variety of disorders ranging from a simple increase in normal leptomeningeal pigmentstion to highly malignant melanoma may be encountered. However, whether benign or malignant, primary melanoma of the nervous system are extremely rare. The diagnosis was confirmed by operation and biopsy. This case, which we have experienced recently, is reported with a review of the literatures.
Adult* ; Biopsy ; Diagnosis ; Humans ; Melanoma ; Nervous System ; Nevus* ; Pia Mater

OBJECTIVES: Weight gain and glucose intolerance are the most common symptoms of metabolic syndrome. Certain patients complain of weight-change and hyperglycemia after receiving antidepressants. Our study evaluated the effects of antidepressants on serum glucose and energy metabolism. METHODS: Subjects were 32 Otsuka Long-Evans Tokushima Fatty (OLETF) and 35 wild-type Long-Evans Tokushima Otsuka (LETO) rats. From age 11 weeks, the rats were divided into 4 subgroups within each strain. We administered the designated antidepressant-amitriptyline, fluoxetine, or mirtazapine-to these subgroups, allocating the fourth as the control. After exactly 4 weeks' medication, we sacrificed the animals and checked their weight, glucose, insulin, leptin, adiponectin, and expression of adiponectin receptor mRNA. RESULTS: Fluoxetine subgroups in both strains gained the least weight. The glucose, triglyceride, and cholesterol levels of all OLETF antidepressant subgroups did not differ from the controls. Adiponectins in amitriptyline- and mirtazapine-subgroups were higher than control. All antidepressant subgroups showed elevated expressions of adiponectin receptor mRNA in fat, muscle, and the pancreas. CONCLUSION: Amitriptyline and mirtazapine seem to regulate adiponectin and expression of adiponectin receptor mRNA. Even though the underlying mechanisms were different, we conclude none of the antidepressants would have negative influences on energy metabolism in diabetogenic animals.
Adiponectin ; Amitriptyline ; Animals ; Antidepressive Agents ; Cholesterol ; Energy Metabolism ; Fluoxetine ; Glucose ; Glucose Intolerance ; Humans ; Hyperglycemia ; Insulin ; Leptin ; Mianserin ; Muscles ; Pancreas ; Rats ; Receptors, Adiponectin ; RNA, Messenger ; Sprains and Strains ; Weight Gain

Purpose: This study evaluated the treatment outcomes of benign and malignant tumors of the foot to establish the treatment guidelines for foot tumors. Materials and Methods: Eighty-three (41 male and 42 female) cases were included in the study. All patients were treated in a single institution from January 2006 to December 2022. The mean age was 43 years (range, 12–92). The mean follow-up period was 91 months (range, 5–208 months). The location of the tumor, recurrence following surgery, histologic diagnosis, overall five-year survival rate, and disease-specific five-year survival rate were evaluated. The oncologic results were analyzed at the final follow-up. Results: Benign tumors were found in 60 cases and malignant tumors were found in 23 cases. The 41 male cases composed 25 cases of benign tumors and 16 cases of malignant tumors. The 42 female cases composed 35 cases of benign tumors and seven cases of malignant tumors. The tumor locations were 61 cases in the forefoot, five in the midfoot, and 17 in the hindfoot. Reoperation was performed in two cases due to recurrence. An un-planned excision was done in two cases, which led to secondary wide resections. The overall five-year survival rate was 65.9% (58.3% in males and 85.7% in females). The disease-specific five-year survival rate was 62.3% (62.5% in males and 66.7% in females). The oncologic outcomes of 23 malignant cases were continuous disease-free in 16 cases and died of disease in seven cases at the final follow-up. Conclusion Benign foot tumors were dominant (72%) in this study. The preferred location was the forefoot, with statistical significance (p<0.05). There were no statistical significant differences between males and females (p>0.05). This study provides the guidelines for treating benign and malignant foot tumors by analyzing the treatment and oncologic outcomes.

Purpose: This study evaluated the treatment outcomes of benign and malignant tumors of the foot to establish the treatment guidelines for foot tumors. Materials and Methods: Eighty-three (41 male and 42 female) cases were included in the study. All patients were treated in a single institution from January 2006 to December 2022. The mean age was 43 years (range, 12–92). The mean follow-up period was 91 months (range, 5–208 months). The location of the tumor, recurrence following surgery, histologic diagnosis, overall five-year survival rate, and disease-specific five-year survival rate were evaluated. The oncologic results were analyzed at the final follow-up. Results: Benign tumors were found in 60 cases and malignant tumors were found in 23 cases. The 41 male cases composed 25 cases of benign tumors and 16 cases of malignant tumors. The 42 female cases composed 35 cases of benign tumors and seven cases of malignant tumors. The tumor locations were 61 cases in the forefoot, five in the midfoot, and 17 in the hindfoot. Reoperation was performed in two cases due to recurrence. An un-planned excision was done in two cases, which led to secondary wide resections. The overall five-year survival rate was 65.9% (58.3% in males and 85.7% in females). The disease-specific five-year survival rate was 62.3% (62.5% in males and 66.7% in females). The oncologic outcomes of 23 malignant cases were continuous disease-free in 16 cases and died of disease in seven cases at the final follow-up. Conclusion Benign foot tumors were dominant (72%) in this study. The preferred location was the forefoot, with statistical significance (p<0.05). There were no statistical significant differences between males and females (p>0.05). This study provides the guidelines for treating benign and malignant foot tumors by analyzing the treatment and oncologic outcomes.

Purpose: This study evaluated the treatment outcomes of benign and malignant tumors of the foot to establish the treatment guidelines for foot tumors. Materials and Methods: Eighty-three (41 male and 42 female) cases were included in the study. All patients were treated in a single institution from January 2006 to December 2022. The mean age was 43 years (range, 12–92). The mean follow-up period was 91 months (range, 5–208 months). The location of the tumor, recurrence following surgery, histologic diagnosis, overall five-year survival rate, and disease-specific five-year survival rate were evaluated. The oncologic results were analyzed at the final follow-up. Results: Benign tumors were found in 60 cases and malignant tumors were found in 23 cases. The 41 male cases composed 25 cases of benign tumors and 16 cases of malignant tumors. The 42 female cases composed 35 cases of benign tumors and seven cases of malignant tumors. The tumor locations were 61 cases in the forefoot, five in the midfoot, and 17 in the hindfoot. Reoperation was performed in two cases due to recurrence. An un-planned excision was done in two cases, which led to secondary wide resections. The overall five-year survival rate was 65.9% (58.3% in males and 85.7% in females). The disease-specific five-year survival rate was 62.3% (62.5% in males and 66.7% in females). The oncologic outcomes of 23 malignant cases were continuous disease-free in 16 cases and died of disease in seven cases at the final follow-up. Conclusion Benign foot tumors were dominant (72%) in this study. The preferred location was the forefoot, with statistical significance (p<0.05). There were no statistical significant differences between males and females (p>0.05). This study provides the guidelines for treating benign and malignant foot tumors by analyzing the treatment and oncologic outcomes.

Gastric CD30-positive anaplastic large-cell lymphoma is a very rare disease. It is sometimes difficult to distinguish it from undifferentiated carcinoma, sarcoma and so on. We report here on a case of primary gastric anaplastic large-cell lymphoma. A 50-yr-old woman complained of epigastric pain and severe chest pain for 1 week. The gastroendoscopic examination revealed geographic mucosal irregularities with shallow ulceration at the antrum. She underwent a total gastrectomy. The gross finding of the resected stomach was an 8 x 4.5 cm sized ulceroinfiltrative lesion at the pyloric antrum along the lesser curvature. The microscopic examination revealed diffuse and solid proliferations of large atypical cells with pleomorphic nuclei. Immunohistochemically, the tumor cells were positive for CD30, vimentin and CD3, and this was a finding compatible with anaplastic large-cell lymphoma. To the best of our knowledge, this is the first such reported case in Korea.
Antigens, CD30/*metabolism ; Female ; Humans ; Immunohistochemistry ; Korea ; Lymphoma, Large-Cell/enzymology/*immunology/*pathology ; Middle Aged ; Protein-Tyrosine Kinase/metabolism ; Stomach Neoplasms/enzymology/*immunology/*pathology

The ingestion of foreign bodies into the gastrointestinal tract is common, and most are passed out spontaneously without causing any problems. However, a perforation can cause a variety of complications involving considerable morbidity and mortality. Moreover, clinical presentation of a perforation can vary and patients are often unaware of the episode. Hence, a pre-operative diagnosis is difficult under these circumstances. We report an unusual case of a liver abscess that developed secondary to a toothpick that had penetrated the gastric wall and migrated to the liver. The liver abscess was treated successfully with internal drainage by inserting an endoscopic pigtail catheter through the hepato-gastric fistula. The toothpick was removed using an endoscopic snare.
Mortality