BACKGROUND/AIMS: Dyslipidemia is one of the major causes of cardiovascular disease in end-stage renal disease (ESRD) patients. Most of them are dyslipidemic despite the use of lipid-lowering agents. Ezetimibe is a novel chemical entity that inhibits the intestinal absorption of dietary and biliary cholesterol. This study evaluated the effects of ezetimibe on the lipid profile, inflammation markers, endothelial injury, and thrombogenesis in ESRD patients. METHODS: Sixty-five patients with serum low-density lipoprotein (LDL)-cholesterol levels > or =100 mg/d were recruited: 33 patients were on hemodialysis and 32 patients were on peritoneal dialysis. They were assigned randomly to the ezetimibe (10 mg) monotherapy group and the ezetimibe (10 mg) plus simvastatin (10 mg) combination therapy group. Both drugs were administered for 8 weeks. RESULTS: There were no significant differences in the baseline demographic and laboratory characteristics between the two groups. In the monotherapy group, the total and LDL-cholesterol levels were reduced by 14.7 and 21.9%, respectively. There were no changes in the high-density lipoprotein (HDL)-cholesterol or triglyceride levels. Fibrinogen increased significantly (p=0.04). In the combination therapy group, the total and LDL-cholesterol levels were reduced by 29.8 and 42.4%, respectively. There was an additional 15.1% reduction in total cholesterol and an additional 20.5% reduction in LDL cholesterol compared with monotherapy. Several patients complained of minor adverse effects and only one patient in the ezetimibe monotherapy group discontinued medication, because of diarrhea. CONCLUSIONS: In ESRD patients, ezetimibe used as combination therapy with a statin is more effective than ezetimibe monotherapy in ESRD patients.
Azetidines ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, LDL ; Dyslipidemias ; Fibrinogen ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Inflammation ; Intestinal Absorption ; Kidney Failure, Chronic ; Lipoproteins ; Peritoneal Dialysis ; Renal Dialysis ; Simvastatin ; Ezetimibe

PURPOSE: To evaluate the clinical and radiological results of intramedullary fixation using Kirschner wires (K-wires) for the treatment of unstable forearm fractures in children. MATERIALS AND METHODS: Forty-three children who underwent intramedullary fixation using K-wires for the treatment of a forearm bone fracture were evaluated. The rodiological results were based on the time to union and angular deformity at last follow-up. The clinical results were analyzed according to Price criteria. RESULTS: Average union time was 6.9 weeks. Preoperatively, average angular deformity of radius is 11.4 degrees in anteroposterior (AP) view and 15.3 degrees in lateral view. In case of the ulna, arerage angular deformity was 8.3 degrees in AP view and 12.7 degrees in lateral view. At last follow up, average angular deformity of radius was 1.5 degrees in AP view and 1.6 degrees in lateral view. In case of the ulna, arerage angular deformity was 1.3 degrees in AP view and 2.5 degrees in lateral view. According to the criteria of Price et al., 42 patients (97%) were excellent and one patient (3%) was good. No specific complication was observed. CONCLUSION: An intramedullary fixation using K-wires is an attractive treatment option for unstable forearm fractures in children in terms of safety, excellent cosmesis, short hospitalization, easy hardware removal, and providing excellent radiological and clinical results.
Bone Wires ; Child ; Congenital Abnormalities ; Follow-Up Studies ; Forearm ; Fractures, Bone ; Hospitalization ; Humans ; Radius ; Ulna

PURPOSE: To determine the efficacy of using the preferential hyperacuity perimeter (PHP) for the analysis of metamorphopsia following macular-off rhegmatogenous retinal detachment (RRD) surgical repair. METHODS: PHP examination was performed in those who complained of metamorphopsia after successful surgical reattachment of RRD. The subjective symptoms were evaluated based on a scale, ranging from 0 to 10, and were compared with the results of PHP examination. Patients age, duration of retinal detachment, pre and post-operative visual acuity, postoperative presence of subretinal fluid (SRF), surgical methods, presence of epiretinal membrane, and time from operation to PHP test were analyzed to find the correlation with the PHP results. RESULTS: Of the 19 eyes included in this study, nine eyes were found to have a hyperacuity defect upon PHP examination. In this group, the subjective level of metamorphopsia was significantly worse (p<0.01), the age was significantly higher (p=0.02), and SRF persisted in the macula more frequently at two months postoperatively (p=0.04), as compared to those without the defect. There were no significant differences in the other factors. CONCLUSIONS: Subjectively severe metamorphopsia after surgery for RRD could be confirmed objectively using PHP. In the case of older patients and persistent submacular fluid, metamorphopsia would develop more frequently due to displacement of the photoreceptors in the process of reattachment.
Displacement (Psychology) ; Epiretinal Membrane ; Eye ; Humans ; Retinal Detachment ; Subretinal Fluid ; Vision Disorders ; Visual Acuity

No abstract available.
Animals ; Dogs* ; Durapatite* ; Transplants*

Autism spectrum disorder (ASD) having core characteristics of social interaction problems and repetitive behaviors and interests affects individuals at varying degrees and comorbidities, making it difficult to determine the precise etiology underlying the symptoms. Given its heterogeneity, ASD is difficult to treat and the development of therapeutics is slow due to the scarcity of animal models that are easy to produce and screen with. Based on the theory of excitation/inhibition imbalance in the brain with ASD which involves glutamatergic and/or GABAergic neurotransmission, a pharmacologic agent to modulate these receptors might be a good starting point for modeling. N-methyl-D-aspartic acid (NMDA) is an amino acid derivative acting as a specific agonist at the NMDA receptor and therefore imitates the action of the neurotransmitter glutamate on that receptor. In contrast to glutamate, NMDA selectively binds to and regulates the NMDA receptor, but not other glutamate receptors such as AMPA and kainite receptors. Given this role, we aimed to determine whether NMDA administration could result in autistic-like behavior in adolescent mice. Both male and female mice were treated with saline or NMDA (50 and 75 mg/kg) and were tested on various behavior experiments. Interestingly, acute NMDA-treated mice showed social deficits and repetitive behavior similar to ASD phenotypes. These results support the excitation/inhibition imbalance theory of ASD and that NMDA injection can be used as a pharmacologic model of ASD-like behaviors.

Neurodevelopmental disorders are complex conditions that pose difficulty in the modulation of proper motor, sensory and cognitive function due to dysregulated neuronal development. Previous studies have reported that an imbalance in the excitation/ inhibition (E/I) in the brain regulated by glutamatergic and/or GABAergic neurotransmission can cause neurodevelopmental and neuropsychiatric behavioral deficits such as autism spectrum disorder (ASD). NMDA acts as an agonist at the NMDA receptor and imitates the action of the glutamate on that receptor. NMDA however, unlike glutamate, only binds to and regulates the NMDA receptor subtypes and not the other glutamate receptors. This study seeks to determine whether NMDA administration in mice i.e., over-activation of the NMDA system would result in long-lasting behavioral deficits in the adolescent mice. Both gender mice were treated with NMDA or saline at early postnatal developmental period with significant synaptogenesis and synaptic maturation. On postnatal day 28, various behavioral experiments were conducted to assess and identify behavioral characteristics. NMDAtreated mice show social deficits, and repetitive behavior in both gender mice at adolescent periods. However, only the male mice but not female mice showed increased locomotor activity. This study implies that neonatal exposure to NMDA may illicit behavioral features similar to ASD. This study also confirms the validity of the E/I imbalance theory of ASD and that NMDA injection can be used as a pharmacologic model for ASD. Future studies may explore the mechanism behind the gender difference in locomotor activity as well as the human relevance and therapeutic significance of the present findings.

Despite the various medications used in clinics, the efforts to develop more effective treatments for depression continue to increase in the past decades mainly because of the treatment-resistant population, and the testing of several hypotheses- and target-based treatments. Undesirable side effects and unresponsiveness to current medications fuel the drive to solve this top global health problem. In this study, we focused on neuroinflammatory response-mediated depression which represents a cluster of depression etiology both in animal models and humans. Several meta-analyses reported that proinflammatory cytokines such as interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α) were increased in major depressive disorder patients. Inflammatory mediators implicated in depression include type-I interferon and inflammasome pathways. To elucidate the molecular mechanisms of neuroinflammatory cascades underlying the pathophysiology of depression, we introduced hycanthone, an antischistosomal drug, to check whether it can counteract depressive-like behaviors in vivo and normalize the inflammation-induced changes in vitro. Lipopolysaccharide (LPS) treatment increased proinflammatory cytokine expression in the murine microglial cells as well as the stimulation of type I interferon-related pathways that are directly or indirectly regulated by Janus kinase-signal transducer and activator of transcription (JAK-STAT) activation. Hycanthone treatment attenuated those changes possibly by inhibiting the JAK-STAT pathway and inflammasome activation. Hycanthone also ameliorated depressive-like behaviors by LPS. Taken together, we suggest that the inhibitory action of hycanthone against the interferon pathway leading to attenuation of depressive-like behaviors can be a novel therapeutic mechanism for treating depression.

For a small hepatocellular carcinoma (HCC), liver resection shows most favorable outcome in case which liver transplantation is not available, although it has also substantial recurrence rate. Here, we report a case of recurred HCC with multiple intrahepatic metastasis at 5 months after surgical resection for small HCC was done. A 55-year-old man with chronic HBV infection received subsegmentectomy for HCC less than 2 cm. A follow-up computed tomography (CT) at 5 months from operation revealed that there were multiple enhancing nodules in entire remnant liver. Intra-arterial injections of adriamycin mixed lipiodol and gelfoam particles were instituted through hepatic artery. We assume that poorly differentiated cellular feature would be attributable to this kind of very early and aggressive recurrence of HCC.
Carcinoma, Hepatocellular* ; Doxorubicin ; Ethiodized Oil ; Follow-Up Studies ; Gelatin Sponge, Absorbable ; Hepatic Artery ; Humans ; Injections, Intra-Arterial ; Liver ; Liver Transplantation ; Middle Aged ; Neoplasm Metastasis ; Recurrence*

HemoHIM was used as a Korean traditional medicine for anti-inflammatory and antioxidant effects. However, there is no study on the effect of HemoHIM on fatigue. We examined the potential use of HemoHIM to determine whether it can induce anti-fatigue effects. Mice were administered with HemoHIM and VEH for 14 days. On the last day of treatment, mice were subjected to behavioral tests. Subsequently, their plasma and muscle were collected after the treadmill test to measure lactate, lactate dehydrogenase (LDH), ammonia, corticosterone, glycogen, and creatine kinase (CK). We found that HemoHIM moderately increased the running time (s) in the treadmill and mobility duration in the cold swimming tests. In addition, the VEH group showed a significant increase in lactate, LDH, and corticosterone levels in the plasma compared to the group that did not perform the test. However, this was moderately reduced in HemoHIM treatment. Moreover, the HemoHIMtreated group showed significant differences in LDH and glycogen levels, and showed significantly different CK levels in the muscle. HemoHIM is considered to be effective in improving fatigue, given the duration of cold swimming or running time on a treadmill. Also, HemoHIM treatment resulted in reduced concentrations of blood and muscle parameter analysis.

We report on a 45-year-old man with a confirmed diagnosis of acute myopericarditis associated with Mycoplasma pneumoniae. He visited our emergency department due to high fever (39degrees C) via a primary clinic. We made a diagnosis of myopericarditis based on symptoms, cardiac enzymes, electrocardiography, and transthoracic echocardiography. Serology (particle agglutination) testing for M. pneumoniae IgG antibody was also performed. The IgG antibody titer was 1:80 on the second day of admission, and increased to 1:2,560 by the 12th day of admission. Therefore, we confirmed the diagnosis of acute myopericarditis associated with M. pneumoniae and subsequently treated him with azithromycin. The symptoms and laboratory findings improved, and he recovered uneventfully.
Adult ; Azithromycin ; Echocardiography ; Electrocardiography ; Emergencies ; Fever ; Humans ; Immunoglobulin G ; Middle Aged ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma