Background: Despite a plethora of research on the topic, there is still no solid evidence that pharmacological treatment actually reduces the risk of suicide in patients with mental illness.In this study, we aimed to assess the effect of psychotropic medications on suicidal ideation in patients with major depressive disorder (MDD) and bipolar disorder (BPD) in two age groups: less than 25 years and 25 years and older. Methods: We analyzed 312 patients with mood disorders with current suicidal thoughts or recent suicide attempts. We followed the participants from baseline for 6 months and assessed changes in suicidal ideation with Columbia-Suicide Severity Rating Scale (C-SSRS).The effect of psychotropic drug administration on suicidal ideation over time was analyzed using a linear mixed model. Results: In patients aged 25 years and older with mood disorders, suicidal ideation was more severe when using psychotropic drugs than when not using them. However, suicidal ideation decreased rapidly over time. The time-dependent reduction in suicidal ideation was accelerated when using antidepressants and sedatives/hypnotics in adult MDD, and when using mood stabilizers in adult BPD. However, this effect was not observed in participants aged less than 25 years. Conclusion Adequate psychotropic medication may reduce suicidal ideation in patients with mood disorders aged 25 years and older. Additional research on psychotropic drugs is needed to effectively reduce the risk of suicide among children and adolescents with mood disorders.

The Committee on Pediatric Bone Health of the Korean Society of Pediatric Endocrinology has newly developed evidence-based clinical practice guidelines for optimizing bone health in Korean children and adolescents. These guidelines present recommendations based on the Grading of Recommendations, which includes the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. These guidelines include processes of bone acquisition, definition, and evaluation of low bone mineral density (BMD), causes of osteoporosis, methods for optimizing bone health, and pharmacological treatments for enhancing BMD in children and adolescents. While these guidelines provide current evidence-based recommendations, further research is required to strengthen these guidelines.

In this study, we investigated the effects of pelargonidin, an anthocyanidin found in many fruits and vegetables, on endothelium-independent vascular contractility to determine the underlying mechanism of relaxation. Isometric contractions of denuded aortic muscles from male rats were recorded, and the data were combined with those obtained in western blot analysis. Pelargonidin significantly inhibited fluoride-, thromboxane A2-, and phorbol ester-induced vascular contractions, regardless of the presence or absence of endothelium, suggesting a direct effect of the compound on vascular smooth muscles via a different pathway. Pelargonidin significantly inhibited the fluoride-dependent increase in the level of myosin phosphatase target subunit 1 (MYPT1) phosphorylation at Thr-855 and the phorbol 12,13-dibutyrate-dependent increase in the level of extracellular signal-regulated kinase (ERK) 1/2 phosphorylation at Thr202/Tyr204, suggesting the inhibition of Rho-kinase and mitogen-activated protein kinase kinase (MEK) activities and subsequent phosphorylation of MYPT1 and ERK1/2. These results suggest that the relaxation effect of pelargonidin on agonist-dependent vascular contractions includes inhibition of Rho-kinase and MEK activities, independent of the endothelial function.
Animals ; Anthocyanins ; Aorta* ; Blotting, Western ; Endothelium* ; Fluorides ; Fruit ; Humans ; Isometric Contraction ; Male ; Muscle, Smooth, Vascular ; Muscles ; Myosin-Light-Chain Phosphatase ; Phosphorylation ; Phosphotransferases ; Protein Kinases ; Rats* ; Relaxation ; rho-Associated Kinases ; Vasoconstriction* ; Vegetables

BACKGROUND AND OBJECTIVES: This study aimed to analyze the prevalence of superior semicircular canal dehiscence (SSCD) in the coronal images of high-resolution temporal bone computed tomography (TBCT) and to evaluate the diagnostic accuracy of coronal images for SSCD syndrome. SUBJECTS AND METHOD: We retrospectively reviewed high-resolution TBCT scans of 217 patients (434 ears) with SSCD due to various causes. The dehiscence ratio (slices showing dehiscence/total slices showing the superior semicircular canal) in the coronal images of TBCT was calculated, and the optimal cutoff value for the diagnosis of SSCD syndrome was determined using the receiver operating characteristics (ROC) curve. RESULTS: Of the 434 ears, 64 (14.7%) presented SSCD in more than one slice of the coronal images of TBCT, but only three patients (0.7%) were confirmed with SSCD syndrome. Based on the ROC curve analysis for the dehiscence ratio of 64 ears, the optimal cutoff value for the diagnosis of SSCD syndrome was 0.67 with 100% sensitivity and 90.2% specificity. CONCLUSION: The majority of cases diagnosed with SSCD syndrome using the coronal images of TBCT were asymptomatic or false-positive. The dehiscence ratio in the coronal images of TBCT combined with a typical symptom can be a highly sensitive and specific diagnostic tool for SSCD syndrome.
Diagnosis ; Ear ; Humans ; Methods ; Prevalence* ; Retrospective Studies ; ROC Curve ; Semicircular Canals* ; Sensitivity and Specificity ; Temporal Bone*

A comprehensive collection of proteins senses local changes in intracellular Ca²⁺ concentrations ([Ca²⁺](i) and transduces these signals into responses to agonists. In the present study, we examined the effect of sphingosine-1-phosphate (S1P) on modulation of intracellular Ca²⁺ concentrations in cat esophageal smooth muscle cells. To measure [Ca²⁺](i) levels in cat esophageal smooth muscle cells, we used a fluorescence microscopy with the Fura-2 loading method. S1P produced a concentration-dependent increase in [Ca²⁺](i) in the cells. Pretreatment with EGTA, an extracellular Ca²⁺ chelator, decreased the S1P-induced increase in [Ca²⁺](i), and an L-type Ca²⁺-channel blocker, nimodipine, decreased the effect of S1P. This indicates that Ca²⁺ influx may be required for muscle contraction by S1P. When stimulated with thapsigargin, an intracellular calcium chelator, or 2-Aminoethoxydiphenyl borate (2-APB), an InsP₃ receptor blocker, the S1P-evoked increase in [Ca²⁺](i) was significantly decreased. Treatment with pertussis toxin (PTX), an inhibitor of G(i)-protein, suppressed the increase in [Ca²⁺](i) evoked by S1P. These results suggest that the S1P-induced increase in [Ca²⁺](i) in cat esophageal smooth muscle cells occurs upon the activation of phospholipase C and subsequent release of Ca²⁺ from the InsP₃-sensitive Ca²⁺ pool in the sarcoplasmic reticulum. These results suggest that S1P utilized extracellular Ca²⁺ via the L type Ca²⁺ channel, which was dependent on activation of the S1P₄ receptor coupled to PTX-sensitive G(i) protein, via phospholipase C-mediated Ca²⁺ release from the InsP₃-sensitive Ca²⁺ pool in cat esophageal smooth muscle cells.
Animals ; Calcium ; Cats* ; Egtazic Acid ; Fura-2 ; Methods ; Microscopy, Fluorescence ; Muscle Contraction ; Muscle, Smooth* ; Myocytes, Smooth Muscle* ; Nimodipine ; Pertussis Toxin ; Phospholipases ; Sarcoplasmic Reticulum ; Thapsigargin ; Type C Phospholipases

OBJECTIVE: To simulate the B₁-inhomogeneity-induced variation of pharmacokinetic parameters on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). MATERIALS AND METHODS: B₁-inhomogeneity-induced flip angle (FA) variation was estimated in a phantom study. Monte Carlo simulation was performed to assess the FA-deviation-induced measurement error of the pre-contrast R₁, contrast-enhancement ratio, Gd-concentration, and two-compartment pharmacokinetic parameters (K(trans), v(e), and v(p)). RESULTS: B₁-inhomogeneity resulted in −23–5% fluctuations (95% confidence interval [CI] of % error) of FA. The 95% CIs of FA-dependent % errors in the gray matter and blood were as follows: −16.7–61.8% and −16.7–61.8% for the pre-contrast R₁, −1.0–0.3% and −5.2–1.3% for the contrast-enhancement ratio, and −14.2–58.1% and −14.1–57.8% for the Gd-concentration, respectively. These resulted in −43.1–48.4% error for K(trans), −32.3–48.6% error for the v(e), and −43.2–48.6% error for v(p). The pre-contrast R₁ was more vulnerable to FA error than the contrast-enhancement ratio, and was therefore a significant cause of the Gd-concentration error. For example, a −10% FA error led to a 23.6% deviation in the pre-contrast R₁, −0.4% in the contrast-enhancement ratio, and 23.6% in the Gd-concentration. In a simulated condition with a 3% FA error in a target lesion and a −10% FA error in a feeding vessel, the % errors of the pharmacokinetic parameters were −23.7% for K(trans), −23.7% for v(e), and −23.7% for v(p). CONCLUSION: Even a small degree of B₁-inhomogeneity can cause a significant error in the measurement of pharmacokinetic parameters on DCE-MRI, while the vulnerability of the pre-contrast R₁ calculations to FA deviations is a significant cause of the miscalculation.
Brain ; Gray Matter ; Magnetic Resonance Imaging* ; Monte Carlo Method ; Phantoms, Imaging

α-Synuclein (α-Syn) has a critical role in microglia-mediated neuroinflammation, which leads to the development of Parkinson's disease (PD). Recent studies have shown that bee venom (BV) has beneficial effects on PD symptoms in human patients or 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) toxin-induced PD mice. This study investigated whether treatment with BV-derived phospholipase A2 (bvPLA2) would improve the motor dysfunction and pathological features of PD in human A53T α-Syn mutant transgenic (A53T Tg) mice. The motor dysfunction of A53T Tg mice was assessed using the pole test. The levels of α-Syn, microglia and the M1/M2 phenotype in the spinal cord were evaluated by immunofluorescence. bvPLA2 treatment significantly ameliorated motor dysfunction in A53T Tg mice. In addition, bvPLA2 significantly reduced the expression of α-Syn, the activation and numbers of microglia, and the ratio of M1/M2 in A53T Tg mice. These results suggest that bvPLA2 could be a promising treatment option for PD.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; alpha-Synuclein* ; Animals ; Bee Venoms* ; Bees* ; Fluorescent Antibody Technique ; Humans ; Mice ; Mice, Transgenic* ; Microglia* ; Parkinson Disease* ; Phenotype ; Phospholipases A2* ; Phospholipases* ; Spinal Cord

BACKGROUND AND OBJECTIVES: Acceptable noise level (ANL) test has been developed as a method to measure the background noise acceptance when listening to speech presented at the most comfortable level. The study was aimed to investigate normal-hearing in young subjects’ performance on ANL test and to evaluate the relationship between ANL and auditory evoked potentials. SUBJECTS AND METHOD: Fifty-three young adults (23 male and 30 female; aged 21 to 39 years) with normal hearing participated in this study. ANL and auditory brainstem response (ABR) tests were administered to subjects who were certified by pure tone audiometry that they had normal hearing threshold. RESULTS: The ANL test showed a large inter-subject variability in the acceptance of back-ground noise, ranging from -5 to 15 dB with the mean of ANL of 5.0±4.1 dB (4.5±4.5 dB in male and 5.4±3.8 dB in female). The mean most comfortable listening level was 35.2±5.3 dB, and the mean background noise level was 30.2±6.1 dB. There were no significant differences between male and female in the parameters of ANL test. There were no differences between the subjects with low versus high ANLs and ABR latencies. CONCLUSION: We obtained the normative data of the ANL test administered to Korean young adults with normal hearing. There is no relationship between ANL and the latency of ABR in this study population.
Audiometry ; Evoked Potentials, Auditory ; Evoked Potentials, Auditory, Brain Stem* ; Female ; Hearing* ; Humans ; Male ; Methods ; Noise* ; Young Adult

BACKGROUND AND OBJECTIVES: To analyze the 125 Hz pure-tone thresholds in patients with acute low frequency sensorineural hearing loss (LFHL) and to investigate the value of 125 Hz thresholds for the assessment of LFHL. SUBJECTS AND METHOD: Hearing tests including 125 Hz pure-tone were performed in 91 patients with acute LFHL ≤500 Hz and in 46 subjects with normal hearing. Patients with sudden sensorineural hearing loss or Meniere's disease were excluded. Inter-group and intra-group comparison of 125 Hz was made between LFHL and the control groups. RESULTS: There was a significant difference of mean pure-tone thresholds at 125 Hz between the acute LFHL and the normal groups (39.8±8.9 vs. 14.3±6.7 dB). Eight (8.8%) patients in the LFHL group showed normal thresholds at 125 Hz, but all other subjects were normal at 125 Hz in the control group. None with the average hearing thresholds at 250 and 500 Hz ≥40 dB had normal threshold at 125 Hz. There was a significant correlation between 125 Hz and other low frequencies in the LFHL group (250 Hz; r=0.81, 500 Hz; r=0.63). CONCLUSION: Not all patients with acute LFHL show abnormal hearing threshold at 125 Hz although every subject with normal hearing is within the normal limits at 125 Hz. Threshold assessment should be made at 125 Hz when a mild LFHL exists in the conventional pure tone audiometry.
Audiometry ; Audiometry, Pure-Tone ; Auditory Threshold ; Hearing ; Hearing Loss, Sensorineural* ; Hearing Tests ; Humans ; Meniere Disease ; Methods

Bilateral sudden sensorineural hearing loss (SSNHL) is very uncommon. Unlike unilateral SSNHL, bilateral SSNHL is more closely associated with serious systemic diseases and shows a more severe degree of hearing loss, poorer hearing prognosis and more significant impairment in morbidity. Although meningitis is one of possible causes of bilateral SSNHL, only a few cases were reported. We present a case of fatal Klebsiella meningitis accompanied by bilateral SSNHL with a literature review.
Hearing ; Hearing Loss ; Hearing Loss, Sensorineural* ; Klebsiella* ; Meningitis* ; Prognosis