BACKGROUND: Postoperative maxillary cyst(POMC) occurs as a delayed complication following Caldwell-Luc(C-L) operation. Revisional C-L operation has been preferred by most surgeons. Recently, marsupialization with intranasal endoscope has been increased in the management of POMC. OBJECTIVES: The aim of this sutdy was to evaluate the clinical characteristics of POMC and the relationship between location of the cyst on axial PNS CT and surgical approaches. MATERIALS AND METHODS: The 24 patients(26 sides) were reviewed from 1990 to 1996. According to the classification methods of Nakamura, sixteen cases were located in medial, two cases in posterolateral and eight cases in anterolateral of the maxilla. RESULTS: The 22 cases including medial(16 cases), posterolateral(2 cases) and Anterolateral(4 cases) types were treated with marsupialization via intranasal endoscopic approach, 4 of 8 cases which were located in anterolateral type were treated with Caldwell-Luc approach. There was no complication and showed improvement in all patients. CONCLUSION: We think that the classification methods of cyst was useful in deciding surgical approaches. The endoscopic intranasal marsupialization is an effective therapeutic method of POMC especially in medial and posterolateral types.
Classification ; Endoscopes ; Humans ; Maxilla ; Pro-Opiomelanocortin

PURPOSE: The purpose of this study is to analyze the clinical features of postoperative maxillary cyst (POMC) according to the patient's medical history of previous sinus operation and symptoms with radiological characteristics. MATERIALS AND METHODS: The subjects of this study were 41 patients who had been diagnosed with POMC via clinical and histological examination from 2007 to 2016. RESULT: Thirty-five patients had medical histories of Caldwell-Luc procedures and four patients had maxillary sinus surgery, such as cyst enucleation and open reduction for maxillary bony fractures. From the computed tomography images, 25.6% (11/43) showed multilocular cysts and 74.4% (32/43) showed unilocular lesions. As for the treatment methods, cyst enucleation was conducted on 34 patients, and among them, three were treated previously with marsupialization. Their symptoms included diverse locations of pain and swelling. CONCLUSION: The clinical features of POMC varied from unilocular to multilocular and the symptoms included pain and swelling.
Humans ; Maxillary Sinus ; Pro-Opiomelanocortin ; Sinusitis

PURPOSE: The purpose of this study was to compare the accuracy of postoperative maxillary cyst (POMC) diagnosis by panoramic radiographs versus computed tomography (CT) and by oral and maxillofacial radiologists versus non-specialists. MATERIALS AND METHODS: Sixty-five maxillary sinuses with POMCs and 63 without any lesion were assessed using panoramic radiographs and CT images by five oral and maxillofacial radiologists and five non-specialists on a five-point scale. The areas under receiver operating characteristic (ROC) curves were analyzed to determine the differences in diagnostic accuracy between the two imaging modalities and between the two groups of observers. The intra-observer agreement was determined, too. RESULTS: The diagnostic accuracy of CT images was higher than that of panoramic radiographs in both groups of observers (p<0.05). The diagnostic accuracy of oral and maxillofacial radiologists for each method was higher than that of non-specialists (p<0.05). CONCLUSION: The use of CT improves the diagnosis of POMC, and radiological training and experience leads to more accurate evaluation.
Diagnosis ; Maxillary Sinus ; Pro-Opiomelanocortin ; Radiography, Panoramic ; ROC Curve

Cushing's syndrome that is caused by an adenoma of the corticotrape cells of the anterior pituitay or, rarely, by couticotrope hyperplasia is refered to as Cushing's disease. Cushings disease is usually characterized by chronic, moderate hypersecretion of ACTH and other POMC derived peptide. Most patients have ACTH-secreting anterior pituitary corticotrope microadenomas, but a small minority have a pituitary macroadenoma. We recently experenced two cases of Cushings disease due to pituitary macroadenoma. and report this cases with review of literatures.
Adenoma ; Adrenocorticotropic Hormone* ; Cushing Syndrome ; Humans ; Hyperplasia ; Pro-Opiomelanocortin

The social problems and medical burdens caused by obesity have become more serious in recent years. Obesity is mainly caused by the imbalance of energy intake and consumption in the body. The central nervous system and related neurons regulate the balance of energy metabolism. The hypothalamic arcuate nucleus (ARC) contains anorexigenic proopiomelanocortin (POMC) neurons and orexigenic neuropeptid Y(NPY)/agouti-related protein (AgRP) neurons that regulate the feeding behavior of body. High-fat diet induces phosphorylation of Rb protein in POMC neurons, and inactivation of Rb phosphorylation leads to re-entry of POMC neurons from the resting-state into the cell cycle, which rapidly shifts to apoptosis. High-fat diet also causes the inhibition of neuronal regeneration, induces inflammation and neuronal damage, loss of neuronal homeostasis, leptin resistance, and ultimately leads to obesity. This review discusses the relationship between loss of neuronal homeostasis and dietary obesity, as well as the underlying mechanisms, which might provide the evidence for prevention and treatment of these diseases.
Arcuate Nucleus of Hypothalamus ; Homeostasis ; Humans ; Leptin ; Obesity ; Pro-Opiomelanocortin

Opuntia ficus-indica var. saboten. is widely cultivated in Jeju Island (South Korea) for use in manufacture of health foods. This study described antidepressant effect of two flavonoids (kaempferol and quercitrin) isolated from the Opuntia ficus-indica var. saboten. The expression of the hypothalamic POMC mRNA or plasma beta-endorphin levels were increased by extract of Opintia ficus-indica var. saboten or its flavoniods administered orally. In addition, antidepressant activity was studied using tail suspension test (TST), forced swimming test (FST) and rota-rod test in chronically restraint immobilization stress group in mice. After restraint stress (2 hrs/day for 14 days), animals were kept in cage for 14 days without any further stress, bet with drugs. Mice were fed with a diet supplemented for 14 days and during the behavioral test period with kaempferol or quercitrin (30 mg/kg/day). POMC mRNA or plasma beta-endorphin level was increased by extract of Opintia ficus-indica var. saboten and its flavoniods. In addition, immobility time in TST and FST was significantly reduced by kaempferol or quercitrin. In rota-rod test, the time of permanence was maintained to the semblance of control group in turning at 15 rpm. Our results suggest that two flavonoids (kaempferol and quercitrin) isolated from the Opuntia ficus-indica var. saboten. show a potent antidepressant effect.
Animals ; beta-Endorphin ; Diet ; Flavonoids ; Hindlimb Suspension ; Immobilization ; Kaempferols ; Mice ; Opuntia ; Plasma ; Pro-Opiomelanocortin ; Quercetin ; RNA, Messenger ; Swimming ; Food, Organic

To understand the etiology of metabolic disorders, including obesity and type II diabetes, it is essential to gain better insight into how stored and available energy sources are monitored by the central nervous system. In particular, a comprehension of the fine cellular interplay and intracellular mechanisms that enable appropriate hypothalamic and consequent endocrine and behavioral responses to both circulating hormonal and nutrient signals remains elusive. Recent data, including those from our laboratories, raised the notion that reactive oxygen species (ROS) generation is not merely a by-product of substrate oxidation, but it plays a crucial role in modulating cellular responses involved in the regulation of energy metabolism. These review summarizes the published recent data on the effect of ROS levels in the regulation of neuronal function, including that of hypothalamic melanocortin neurons, pro-opiomelanocortin and neuropeptide Y-/agouti related peptide-neurons, in the modulation of food intake.
Central Nervous System ; Comprehension ; Eating ; Energy Metabolism ; Hypothalamus ; Neurons ; Neuropeptides ; Obesity ; Peroxisomes ; Pro-Opiomelanocortin ; Reactive Oxygen Species

Postoperative maxillary cyst (POMC) is relatively common complication among patients who underwent Caldwell-Luc surgery. Patients with POMC usually have no symptoms, although cyst extension can result in bone destruction or cystic infection with pain. The trigeminal nerve consists of the ophthalmic nerve, maxillary nerve, and mandibular nerve. Among these branches, the maxillary nerve runs to the lateral and frontal sides of the maxillary sinus wall. POMC can rarely lead to trigeminal neuropathy caused by cyst enlargement that compresses some branches of the trigeminal nerve. Recently, we experienced a case with trigeminal neuralgia due to POMC. The patient was successfully treated with inferior meatal antrostomy. We report this rare case with a literature review.
Humans ; Mandibular Nerve ; Maxillary Nerve ; Maxillary Sinus ; Ophthalmic Nerve ; Pro-Opiomelanocortin ; Trigeminal Nerve ; Trigeminal Nerve Diseases ; Trigeminal Neuralgia*

BACKGROUND: Metformin, an oral biguanide insulin-sensitizing agent, is well known to decrease appetite. Although there is evidence that metformin could affect the brain directly, the exact mechanism is not yet known. METHODS: To evaluate whether metformin induces anorexia via the hypothalamus, various concentrations of metformin were injected into the lateral ventricle of rats through a chronically implanted catheter and food intake was measured for 24 hours. The hypothalamic neuropeptides associated with regulation of food intake were also analyzed following 1 hour of intracerebroventricular (ICV) injections of metformin. RESULTS: An ICV injection of metformin decreased food intake in a dose-dependent manner in unrestrained conscious rats. Hypothalamic phosphorylated AMP-activated protein kinase (pAMPK) increased by 3 microg with metformin treatment, but there was no further increase in pAMPK with increases in metformin dosage. The hypothalamic phosphorylated signal transducer and activator of transcription 3 (pSTAT3) increased by 3 microg with metformin treatment, but, there was no further increase in pSTAT3 level following increases of metformin dosage. Hypothalamic proopiomelanocortin was elevated with metformin treatment, while neuropeptide Y was not significantly changed. CONCLUSION: Our results suggest that metformin induces anorexia via direct action in the hypothalamus and the increase in pSTAT3, at least in part, is involved in the process. However, hypothalamic pAMPK appears not to contribute to metformin-induced appetite reduction in normal rats. Further studies exploring new pathways connecting metformin and feeding regulation are needed.
AMP-Activated Protein Kinases ; Animals ; Anorexia ; Appetite ; Brain ; Catheters ; Eating ; Hypothalamus ; Lateral Ventricles ; Metformin ; Neuropeptide Y ; Neuropeptides ; Pro-Opiomelanocortin ; Rats ; STAT3 Transcription Factor

PURPOSE: Obesity is a well known risk factorfor erectile dysfunction, and metformin normalizes androgen levels in patients with polycystic ovary syndrome and decreases body fat and leptin concentration in normal weight men. Thus, we hypothesized that metformin may restore the neuroendocrine abnormalities associated with obesity and improve erectile dysfunction. MATERIALS AND METHODS: Obesity was induced by a high fat(HF) diet fed for 4 months, and then metformin(300 mg/kg/day) was administered for 4 weeks. Penile nitric oxide synthase(NOS) expression and luteinizing hormone (LH), follicle stimulating hormone(FSH), testosterone, leptin, corticotropin releasing factor(CRF), adrenocorticotropin (ACTH), and proopiomelanocortin(POMC) were evaluated in control and HF obese rats. RESULTS: Penile nNOS and eNOS were suppressed markedly, and serum leptin and FSH were increased in HF rats compared to controls. However, POMCexpression in the hypothalamus was decreased in HF rats compared to controls,despite slightly elevated cerebrospinal fluid(CSF) leptin concentration. Metformin treatment for 4 weeks restored penile nNOS and eNOS expression, decreased serum leptin, increased POMC expression in the hypothalamus, and decreased serum concentration of FSH and CRF in HF rats. Surprisingly, metformin increased CSF leptin concentration in both control and HF rats. CONCLUSIONS: These results suggested that NOS expression was suppressed by the HF diet, but restored by metformin treatment. The effect of metformin on NOS expression resulted from not only a leptin sensitizing effect but also through a normalizing effect on levels of endocrine factors.
Adipose Tissue ; Adrenocorticotropic Hormone ; Animals ; Diet ; Erectile Dysfunction ; Humans ; Hypothalamus ; Leptin ; Luteinizing Hormone ; Male ; Metformin* ; Nitric Oxide Synthase* ; Nitric Oxide* ; Obesity ; Polycystic Ovary Syndrome ; Pro-Opiomelanocortin ; Rats* ; Testosterone