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

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 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*

There have recently been many advances in obesity treatment, including lifestyle modifications and pharmacological and surgical treatments. Specifically, pharmacological strategies have improved significantly. However, the history of the development of medications aimed at weight loss is complicated. The Federal Drug Administration (FDA) withdrew anti-obesity drugs such as fenfluramine, dexfenfluramine, and phenylpropylamine due to their unwanted side effects. Moreover, sibutramine was voluntarily withdrawn from the market and a new drug, rimonabant, has been suspended in the middle of a clinical trial due to unacceptable side effects. The FDA has approved four new anti-obesity drugs in recent years. Lorcaserin is a selective 5-hydroxytryptamine receptor 2c (5-HT2c) agonist. The pharmacological mechanism of action of this drug is similar to fenfluramine and dexfenfluramine, but lorcaserin is specific for 5-HT2c, which are located almost exclusively in the central nervous system and are not found in heart valves. Three phase 3 clinical trials for lorcaserin have been published recently; weight reduction was successful and no side effects involving the heart were found. Furthermore, the FDA has also approved phentermine/topiramate controlled-release (PHEN/TPM CR), which is composed of a combination of immediate-release phentermine and controlled-release topiramate. Weight reduction achieved with PHEN/TPM CR was demonstrated to be better than all other anti-obesity drugs. Lastly, the combination therapy bupropion/naltrexone activates proopiomelanocortin neurons and inhibits opioid-mediated negative feedback by synergism. Similar to liraglutide, a long-acting analogue of the hormone glucagon-like peptide-1, this treatment showed significant weight loss and metabolic improvements. However, in addition to its efficacy, clinicians should consider its side effects before use.
Anti-Obesity Agents ; Central Nervous System ; Dexfenfluramine ; Fenfluramine ; Glucagon-Like Peptide 1 ; Heart ; Heart Valves ; Life Style ; Neurons ; Obesity* ; Phentermine ; Pro-Opiomelanocortin ; Serotonin ; Weight Loss ; Liraglutide

OBJECTIVE: Proopiomelanocortin (POMC) gene is involved in various neuroendocrine reproductive activities and its principal areas of expression are hypothalamus and pituitary gland. However, as it is known as low copy gene, detection of its expression by in situ hybridization is challenging. This study was to examine the degree of basal expression of POMC mRNA and anatomic localization of its expression in rat hypothalamus and pituitary gland as a preliminary study for related reproductive endocrine researches. METHODS: Hypothalamus and pituitary gland of ovariectomized female Spraque-Dawley rat (weight: 250-300 g) was obtained by decapitation with preservation of POMC mRNA by cardiac perfusion of 4% paraformaldehyde. Then, coronal sections of hypothalamus and horizontal sections of pituitary gland were made after paraffin embedding. For in situ hybridization, 35S-labeled antisense RNA probe was used and after in situ hybridization reaction and serial washing procedure, detection of its signal was made by emulsion autoradiography of slide and dark field microscopic examination was done for photographic documentation. Anatomic localization of various nucleus of hypothalamus was done by method proposed by Paxinos and Watson1. RESULTS: Strong expression signal of POMC mRNA was detected in the intermediate lobe of pituitary gland. Less strong, but evenly distributed signals were also detected in the anterior lobe of pituitary gland. In hypothalamic sections, entire area of arcuate nucleus from rostral to caudal direction (between bregma -2.80 mm to bregma -4.30 mm area) showed clear and strong signal of POMC mRNA expression. CONCLUSION: Though POMC gene is known as low copy gene, its basal mRNA expression in pituitary gland and hypothalamus in ovariectomized rat were detectable by in situ hybridization technique. As subpopulation of arcuate nucleus are under complex differential regulation, this in situ hybridization model would be helpful for understanding the effects of various regulatory factors on expression of POMC gene in the specific anatomic area of hypothalamus and pituitary gland.
Animals ; Arcuate Nucleus ; Autoradiography ; Decapitation ; Female ; Humans ; Hypothalamus* ; In Situ Hybridization* ; Paraffin Embedding ; Perfusion ; Pituitary Gland* ; Pituitary Gland, Anterior ; Pituitary Gland, Intermediate ; Pro-Opiomelanocortin* ; Rats* ; RNA, Antisense ; RNA, Messenger