Objectives: ：Neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), and platelet/lymphocyte ratio (PLR) are indicators of inflammation. Several studies have evaluated their relationship with bipolar disorder severity, but the results are controversial. Here, we investigate the relationship between inflammatory ratios and the severity and clinical characteristics of bipolar disorder. Methods: ：We retrospectively reviewed the medical records of bipolar disorder patients who met the inclusion criteria and admitted to Kosin University Gospel Hospital between January 2010 and August 2021. NLR, MLR and PLR were measured according to the complete blood count. Severity was assessed by the Young Mania Rating Scale (YMRS) in hypo/manic episode patients, the Hamilton Rating Scale for Depression (HAMD) in depressive episode patients. Patients are grouped by presence of two clinical features, current psychotic features and history of suicide attempts. Results: ：181 subjects, of whom 123 were women and 58 men, were included. Subjects with higher NLR had higher HAMD scores (N=36, r=0.337, p=0.045). We found no significant correlation between YMRS and the inflammatory biomarkers. Patients with previous suicide attempts exhibited a greater PLR than those without previous suicide attempts (N[SA+]=52, N[SA-]=129, p=0.035). There was no significant difference in inflammatory ratios with respect to psychotic features. Conclusions ：We found a possible correlation between the severity of bipolar depression and inflammatory indicators in the Korean population, in addition to correlation between previous suicidal attempt of bipolar disorder and inflammatory indicators. A well-designed prospective study involving a larger cohort is needed in the future.

Fibromyalgia is a disorder characterized by the core symptom of chronic widespread pain, along with fa-tigue, sleep disturbances, mood changes, and cognitive difficulties. The etiology of fibromyalgia involves a combination of biological factors, such as genetic vulnerability, alterations in pain processing and stress response system ; psychological factors, such as anxiety, depression, anger, and perceived stress ; environmentalfactors, such as infections, febrile diseases, and trauma. Central sensitization, which is amplified in the process of sensory stimulation, has been emphasized as a key etiological factor, as supported by enhanced wind-up, delayed aftersensation, decreased nociceptive flexion reflex threshold and functional imaging studies. Several guidelines recommend that a multimodal approach be used to treat fibromyalgia, including both pharmacologicaland non-pharmacological treatments, tailored to each individual, and that clinicians should provide an intellectual framework through sufficient education and emphasis on the importance of self-management. The prevalence of mood disorders, anxiety disorders, and other psychiatric problems is 7-9 times higher in patients with fibromyal-gia than in the general population ; moreover, the association between fibromyalgia and certain psychopatholo-gies or sleep problems has also been suggested. Since psychiatric problems, with shared vulnerabilities and risk factors, interact with fibromyalgia bidirectionally and also affect the disease course, an integrated management approach is needed to determine the risk of comorbidities.

Anaplastic thyroid cancers (ATC) are a rapid growing and highly lethal form of thyroid cancer. Distant metastases of ATC are detected in about half of patients. Clinically, it is very rare to metastasize to the kidney. The most common initial symptoms of ATC are a palpable neck mass and accompanying compression symptoms of the upper aerodigestive tract. A 68-year-old patient was referred with a huge renal mass, which was detected during the evaluation of abdominal pain. Left total nephrectomy was performed. Histologically, the kidney tumor was a metastatic anaplastic thyroid carcinoma. To our knowledge, it is the first case of occult ATC presenting as a huge renal mass.

Fibromyalgia is a disorder characterized by the core symptom of chronic widespread pain, along with fa-tigue, sleep disturbances, mood changes, and cognitive difficulties. The etiology of fibromyalgia involves a combination of biological factors, such as genetic vulnerability, alterations in pain processing and stress response system ; psychological factors, such as anxiety, depression, anger, and perceived stress ; environmentalfactors, such as infections, febrile diseases, and trauma. Central sensitization, which is amplified in the process of sensory stimulation, has been emphasized as a key etiological factor, as supported by enhanced wind-up, delayed aftersensation, decreased nociceptive flexion reflex threshold and functional imaging studies. Several guidelines recommend that a multimodal approach be used to treat fibromyalgia, including both pharmacologicaland non-pharmacological treatments, tailored to each individual, and that clinicians should provide an intellectual framework through sufficient education and emphasis on the importance of self-management. The prevalence of mood disorders, anxiety disorders, and other psychiatric problems is 7-9 times higher in patients with fibromyal-gia than in the general population ; moreover, the association between fibromyalgia and certain psychopatholo-gies or sleep problems has also been suggested. Since psychiatric problems, with shared vulnerabilities and risk factors, interact with fibromyalgia bidirectionally and also affect the disease course, an integrated management approach is needed to determine the risk of comorbidities.

Objectives: ：The purpose of this study is to identify differences between suicide attempters who used zolpidem and others who used different methods in emergency department. Methods: ：This study classified 2,734 suicide attempters, who went to emergency department from 2009 to 2018, into zolpidem user group, another drug user group and non-drug user group. For these three groups, chisquare test and logistic regression analysis were conducted regarding sociodemographic feature and clinical feature related with suicide. Results: ：In the result of logistic regression analysis of a variable, which showed meaningful difference between suicide attempter group who used zolpidem and the other group who did not use the drug, the occurrence of zolpidem-using suicide attempers was related with the case where anxiolytics/hypnotics was used or the case where lethality and intention was low. In the drug intoxication group which showed similar feature, there was also a relevance between anxiolytics/hypnotics and the occurrence of zolpidem-using suicide attempts. Conclusions ：This study identified significant difference of sociodemographic and clinical feature in suicide attempter group who used zolpidem and the other group. This result can contribute to plan further medicinal treatment in using zolpidem

OBJECTIVE: Previously, we identified that transketolase (Tkt), an important enzyme in the pentose phosphate pathway, is highly expressed at 2 hours of spontaneous maturation in oocytes. Therefore, this study was performed to determine the function of Tkt in meiotic cell cycle regulation, especially at the point of germinal vesicle breakdown (GVBD). METHODS: We evaluated the loss-of-function of Tkt by microinjecting Tkt double-stranded RNAs (dsRNAs) into germinal vesicle-stage oocytes, and the oocytes were cultured in vitro to evaluate phenotypic changes during oocyte maturation. In addition to maturation rates, meiotic spindle and chromosome rearrangements, and changes in expression of other enzymes in the pentose phosphate pathway were determined after Tkt RNA interference (RNAi). RESULTS: Despite the complete and specific knockdown of Tkt expression, GVBD occurred and meiosis was arrested at the metaphase I (MI) stage. The arrested oocytes exhibited spindle loss, chromosomal aggregation, and declined maturation promoting factor and mitogen-activated protein kinase activities. The modified expression of two enzymes in the pentose phosphate pathway, Prps1 and Rbks, after Tkt RNAi and decreased maturation rates were amended when ribose-5-phosphate was supplemented in the culture medium, suggesting that the Tkt and pentose phosphate pathway are important for the maturation process. CONCLUSION: We concluded that Tkt and its associated pentose phosphate pathway play an important role in the MI-MII transition of the oocytes' meiotic cell cycle, but not in the process of GVBD.
Cell Cycle ; Maturation-Promoting Factor ; Meiosis ; Metaphase ; Oocytes ; Pentose Phosphate Pathway ; Protein Kinases ; Ribosemonophosphates ; RNA Interference ; RNA, Double-Stranded ; Transketolase