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OBJECTIVETo probe a better method for treatment of trigeminal neuralgia. Methods One hundred and four cases of trigeminal neuralgia were randomly divided into a treatment group (n=57) and a control group (n=47). The treatment group were treated witb acupoint injection of 2000 microg of VitB12, with Xiaguan (ST 7) selected as main point, and the control group witb oral administration of Carbamazepine. The therapeutic effect were analyzed after 3 tberapeutic courses.

RESULTSTbe cured and markedly effective rate and the effective rate were 82.5% and 98.2% in the treatment group, and 57.4% and 8O.9% in the control group, with a very significant difference between the two groups (P < 0.01). After treatment, there was a very significant difference in the cumulative score of pain between the two groups (P < 0.01).

CONCLUSIONAcupoint injection of VitB12 has a better therapeutic effect than that of oral administration of Carbamazepine.

Acupuncture Points ; Adult ; Aged ; Female ; Humans ; Injections ; Male ; Middle Aged ; Trigeminal Neuralgia ; therapy ; Vitamin B 12 ; administration & dosage

BACKGROUND: The lateral radiograph-based system described by Tsuyama is used widely to classify ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. However, OPLL is a complex 3-dimensional (3-D) lesion, not a simple and uniplanar one, which is often difficult to identify on a lateral radiograph. Furthermore, its reliability among spine surgeons has not been investigated. Given the popularity of a reconstructed computed tomography (CT), this study examined the inter- and intra-observer reliability of lateral radiograph-based OPLL classification using that modality. METHODS: Five spine surgeons independently reviewed the lateral radiograph, axial CT, 2-D (sagittal) and 3-D reconstructed CT images of 108 OPLL patients on 2 separate occasions. Based on these images, the reviewers classified each OPLL case according to the Tsuyama's system. The kappa values were used to assess the statistical reliability. RESULTS: The inter- and intra-observer kappa values were only 0.51 and 0.67 for the lateral radiograph, even in combination with the axial CT images, 0.70 and 0.85 for 2-D CT images, and 0.76 and 0.86 for 3-D CT images, respectively. These kappa values showed a good-to-excellent range for the 2-D and 3-D reconstructed CT images while those of the lateral radiograph indicated a fair range. According to the OPLL types, the inter- and intra-observer reliability was low in the continuous type and high in the circumscribed type on the lateral radiograph. However, the low reliability of the continuous type on lateral radiograph was overcome somewhat using 2-D and 3-D reconstructed CT images. CONCLUSIONS: The inter- and intra-observer kappa values were only 0.51 and 0.67 for the lateral radiograph, even in combination with the axial CT images, 0.70 and 0.85 for 2-D CT images, and 0.76 and 0.86 for 3-D CT images, respectively. These kappa values showed a good-to-excellent range for the 2-D and 3-D reconstructed CT images while those of the lateral radiograph indicated a fair range. According to the OPLL types, the inter- and intra-observer reliability was low in the continuous type and high in the circumscribed type on the lateral radiograph. However, the low reliability of the continuous type on lateral radiograph was overcome somewhat using 2-D and 3-D reconstructed CT images.
Adult ; Aged ; Cervical Vertebrae/radiography ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Observer Variation ; Ossification of Posterior Longitudinal Ligament/*classification/*radiography ; *Tomography, X-Ray Computed

Objective To observe the changes of serum and fecal taurine-conjugated bile acid levels and its association with glucose metabolism during the spontaneous development of type 2 diabetes in OLETO rats.Methods Twenty male OLETF rats(4 weeks old)were included and 10 male LETO rats of the same age were used as the normal control group.OLETF rats were fed with high fat diet whereas LETO rats were fed with normal diet.Serum and fecal taurine-conjugated bile acid levels of OLETF rats were tested at different stage of diabetes including baseline, normal glucose tolerance, impaired glucose tolerance and diabetes periods, and the association of taurine-conjugated bile acid level with body weight, blood glucose, and glucose-regulating hormones were also investigated.Results Compared with LETO rats, the baseline serum levels of taurine-conjugated bile acid in OLETF rats did not change, but the levels of fecal taurine-conjugated bile acid including taurine-conjugated chenodeoxycholic acid(TCDCA), taurocholic acid(TCA)and taurine-conjugated deoxycholic acid(TDCA)were significantly decreased [(14.25±7.18 vs 0.90±0.31)mg/kg,(7.12±4.14 vs 1.30±0.35)mg/kg,(4.30±1.78 vs 1.02±0.14)mg/kg, all P<0.01].During the development of diabetes, the fecal levels of TCDCA, TCA and TDCA were still lower than those in the control rats.TDCA was negatively associated with the level of fasting blood glucose(r=-0.470, P=0.032),but positively associated with the serum level of glucagon-like peptide(GLP)-l(r=0.406, P=0.044).Conclusion The decrease of intestinal taurine-conjugated bile acid level is involved in the development of diabetes in OLETF rats.Intestinal TDCA may regulate the secretion of GLP-1 by paracrine pathway.

The change of kirenol, darutigenol and darutoside in Siegesbeckia and its first to ninth processed products were studied, and the ten fingerprints were compared, which provided the experimental basis for the study of Siegesbeckia processing tech- nology. The samples were analysed by HPLC on a SunFire-C18 column (4.6 mm x 150 mm, 5 μm) with gradient elution of acetonitrile (0.1% formic acid)-water (0.1% formic acid) at a flow rate of 1.0 mL x min(-1). Column temperaturewas 30 °C and the detected wavelength was 215, 320 nm. The calibration curves of kirenol, darutigenol and darutoside were linear in the range of 2.180-26.16, 2.900-34.80, and 1.012-6.072 mg x L(-1), respectively, and the average recoveries were 96.4%, 97.2% and 96.3% wit RSD 2.2%, 1.7% and 2.4%. This method was simple, the result was stable and had good repeatability, recovery and precision. The re- sult was the basis of the chemical contents variation in the processing of Siegesbeckia Herbs and further clarifying the effect of the changing.
Asteraceae ; chemistry ; Chemistry, Pharmaceutical ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Temperature

PURPOSE: We report a rare case of ocular siderosis with delayed-onset secondary glaucoma occurring 10 years after cataract and iron foreign body removal. CASE SUMMARY: A 47-year-old male who suffered an ocular injury with an iron material to his left eye 3 years prior to his initial visit was treated in our clinic for a cataract with siderosis lentis. Ten years after he underwent cataract surgery he developed secondary open-angle glaucoma. Trabecular block taken during trabeculectomy showed no iron material, however, a fibrosclerotic change was observed. CONCLUSIONS: In patients with a history of traumatic siderosis lentis, a potential risk of siderosis remains for a long period.
Cataract* ; Foreign Bodies ; Glaucoma* ; Glaucoma, Open-Angle ; Humans ; Iron ; Male ; Middle Aged ; Siderosis* ; Trabeculectomy

OBJECTIVES: Neurobiological models for obsessive-compulsive disorder(OCD) have consistently implicated prefrontal-striatal circuits in the pathophysiology of this disorder. But, prior studies have inconsistently found alteration in caudate and frontal lobe volumes in patients with OCD. This study was undertaken in the hope that semi-automated linear transformation methods would elucidate the morphometric differences of various parts of brain between OCD and normal control group. METHODS: Thirteen patients meeting the DSM-IV criteria for OCD, and 9 psychiatrically normal comparison subjects participated in the study. 3-D brain MRIs using Spoiled gradient-recalled (SPGR) sequence were acquired for each subjects. After spatially normalized according to Talairach and Tournoux's coordinates, the gray and white matters were segmented by semiautomated methods using fuzzy algorithm. Each lobal volumes was measured according to Talairach and Tournoux's coordinates, and the region of interests of caudate nuclei was manually traced. The frontal lobe was divided into 3 subregions; dorsolateral prefrontal cortex, orbital frontal cortex, mesial frontal cortex accoring to the coordinates and Broadman's cytoarchitectonics. RESULTS: Only the volume of left and right frontal gray matter showed a significant difference between OCD and normal subjects. In OCD, the frontal gray matter volume was increased in tendency. There's no difference in laterality and no coorelation with clinical severities. CONCLUSION: Findings of increased frontal gray matter volumes in patients implicate a structural abnormality of these brain regions in the pathophysiology of OCD. The increased frontal gray matter volumes reflect a epiphenomena due to increased cerebral blood flows and metabolic rates before the structural changes may occur.
Brain* ; Caudate Nucleus ; Diagnostic and Statistical Manual of Mental Disorders ; Frontal Lobe ; Hope ; Humans ; Magnetic Resonance Imaging* ; Obsessive-Compulsive Disorder* ; Orbit ; Prefrontal Cortex

It has been known that antidepressants have calcium antagonist-like action in neuronal tissues. However, their mechanisms are still obscure. For the study of neurochemical machanism of antidepressants, the authors examined the effects of antidepressants(1-100 microM ) on the intracellular Ca2+ concentration ([Ca2+]i) and the membrane potential in PCl2 cells using fluorescent dyes, fura-2/AM and bisoxonol, respectively. The results were as follows : 1) Sertraline, a selective serotonin reuptake inhibitor (SSRI), inhibited the increment of [Ca2+]i induced by high 60 mM KCI and 100 microM ATP with an IC50 value of 2.5 microM and 5.4 microM, respectively. 2) SSRIs(sertraline, paroxetine and fluoxetine) and tricyclic antidepressants(imipramine and amitriptyline) had strong effects on the inhibition of both voltage-dependent Ca2+ channel and receptor-dependent Ca2+ channel, whereas atypical antidepressant(trazodone) and MAO inhibitor(moclobemide) had lisle effects. 3) Sertraline itself depolarized the membrane potential in a sustained manner depending on its own concentration and it also increased the basal level of [Ca2+]i. 4) The increment of [Ca2+]i might be induced partly by the release from the intracellular calcium store, but mostly induced by the calcium transport through membrane. 5) Among those antidepressants tested, sertraline was the most potent one. Other SSRIs(paroxetine and fluoxetine) and tricyclic antidepressants(imipramine and amitriptyline) were moderately potent. Atypical antidepressant(trazodone) had little effects, and MAO inhibitor (moclobemide) had no effect on the depolarization. 6) External application of ATP induced temporary depolarization. This effect was blocked by prior treatment with sertraline with an IC50 value of 30 microM. 7) The increment of [Ca2+]i through voltage-dependent Ca2+ channel was almost inhibited by a selective calcium channel blocker(nimodipine). However, the ATP-induced increment of [Ca2+]i was partially inhibited by nimodipine. These inhibitory effects were potentiated by the addition of sertraline. In the light of these results, it is likely that SSRIs and tricyclic antidepressants could show the blocking effects on both voltage-dependent and receptor-dependent calcium channel by depolarizing neuronal cell membrane potential in a sustained manner and by increasing intracellular free calcium level.
Adenosine Triphosphate ; Antidepressive Agents* ; Antidepressive Agents, Tricyclic ; Calcium Channels ; Calcium* ; Cell Membrane ; Fluorescent Dyes ; Inhibitory Concentration 50 ; Membrane Potentials ; Membranes ; Monoamine Oxidase ; Neurons ; Nimodipine ; Paroxetine ; Serotonin ; Sertraline*

PURPOSE: The aim of this study was to assess the clinical characteristics of hypertensive encephalopathy according to the underlying etiologies in children. METHODS: We retrospectively evaluated 33 pediatric patients who were diagnosed as having hypertensive encephalopathy in Chonbuk National University Children's Hospital. Among the patients, 18 were excluded because of incomplete data or because brain magnetic resonance imaging (MRI) was not performed. Finally, 17 patients were enrolled and divided into a renal-origin hypertension group and a non-renal-origin hypertension group according to the underlying cause. We compared the clinical features and brain MRI findings between the 2 groups. RESULTS: The renal group included renal artery stenosis (4), acute poststreptococcal glomerulonephritis (2), lupus nephritis (2), and acute renal failure (1); the nonrenal group included essential hypertension (4), pheochromocytoma (2), thyrotoxicosis (1), and acute promyelocytic leukemia (1). The mean systolic blood pressure of the renal group (172.5±36.9 mmHg) was higher than that of the nonrenal group (137.1±11.1 mmHg, P<0.05). Seizure was the most common neurologic symptom, especially in the renal group (P<0.05). Posterior reversible encephalopathy syndrome (PRES), which is the most typical finding of hypertensive encephalopathy, was found predominantly in the renal group as compared with the nonrenal group (66.6% vs. 12.5%, P<0.05). CONCLUSION: We conclude that the patients with renal-origin hypertension had a more severe clinical course than those with non-renal-origin hypertension. Furthermore, the renal-origin group was highly associated with PRES on brain MRI.
Acute Kidney Injury ; Blood Pressure ; Brain ; Brain Diseases ; Child ; Glomerulonephritis ; Humans ; Hypertension ; Hypertensive Encephalopathy* ; Jeollabuk-do ; Leukemia, Promyelocytic, Acute ; Lupus Nephritis ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Pheochromocytoma ; Posterior Leukoencephalopathy Syndrome ; Renal Artery Obstruction ; Retrospective Studies ; Seizures ; Thyrotoxicosis