Objective: This study tried to observe clinical benefit of aripiprazole augmentation (ARPA) treatment for major depressive disorder with anxious distress (MDDA) in routine practice. Methods: Retrospective chart review (n = 41) was conducted for clinical benefit of ARPA in patients with MDDA in routine practice. The primary endpoint was the mean change of Hamilton Anxiety Rating scale (HAMA) total scores from baseline to the endpoint. Additional secondary endpoints were also retrieved. Results: The changes of primary endpoint HAMA (t = 5.731, −4.6, p = 0.001), and secondary endpoints including Hamilton Depression Rating scale (HAMD, t = 4.284, −3.4, p ＜ 0.001), Clinical Global Impression-Clinical Benefit (CGI-CB, −0.9, t = 1.821, p = 0.026), and Clinical Global Impression Score-Severity (CGI-S, t = 3.556, −0.4, p ＜ 0.001) scores were also significantly improved during the study. No significant adverse events were observed. Conclusion This study has shown additional benefit of ARPA treatment for MDDA patients in routine practice. However, adequately-powered and well-controlled studies are necessary for generalization of the present findings.

Objective: To evaluate the diagnostic performance and image quality of 1.5-mm slice thickness MRI with deep learningbased image reconstruction (1.5-mm MRI + DLR) compared to routine 3-mm slice thickness MRI (routine MRI) and 1.5-mm slice thickness MRI without DLR (1.5-mm MRI without DLR) for evaluating temporal lobe epilepsy (TLE). Materials and Methods: This retrospective study included 117 MR image sets comprising 1.5-mm MRI + DLR, 1.5-mm MRI without DLR, and routine MRI from 117 consecutive patients (mean age, 41 years; 61 female; 34 patients with TLE and 83 without TLE). Two neuroradiologists evaluated the presence of hippocampal or temporal lobe lesions, volume loss, signal abnormalities, loss of internal structure of the hippocampus, and lesion conspicuity in the temporal lobe. Reference standards for TLE were independently constructed by neurologists using clinical and radiological findings. Subjective image quality, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were analyzed. Performance in diagnosing TLE, lesion findings, and image quality were compared among the three protocols. Results: The pooled sensitivity of 1.5-mm MRI + DLR (91.2%) for diagnosing TLE was higher than that of routine MRI (72.1%, P < 0.001). In the subgroup analysis, 1.5-mm MRI + DLR showed higher sensitivity for hippocampal lesions than routine MRI (92.7% vs. 75.0%, P = 0.001), with improved depiction of hippocampal T2 high signal intensity change (P = 0.016) and loss of internal structure (P < 0.001). However, the pooled specificity of 1.5-mm MRI + DLR (76.5%) was lower than that of routine MRI (89.2%, P = 0.004). Compared with 1.5-mm MRI without DLR, 1.5-mm MRI + DLR resulted in significantly improved pooled accuracy (91.2% vs. 73.1%, P = 0.010), image quality, SNR, and CNR (all, P < 0.001). Conclusion The use of 1.5-mm MRI + DLR enhanced the performance of MRI in diagnosing TLE, particularly in hippocampal evaluation, because of improved depiction of hippocampal abnormalities and enhanced image quality.

Objective: This study tried to observe additional benefit of agomelatine (AGO) treatment for major depressive disorder (MDD) in routine practice. Methods: Retrospective chart review (n = 63) was conducted for additional benefit of combination with or switching to AGO in MDD patients without full remission. The primary endpoint was the mean change of Clinical Global Impression-Clinical Benefit (CGI-CB) total scores from baseline to the endpoint. Additional secondary endpoints were also collected. Results: The changes of CGI-CB (Z = −3.073, p = 0.002) and Montgomery-Åsberg Depression Rating Scale (Z = −3.483, p ＜ 0.001) total scores were significantly decreased from baseline to the endpoint, respectively. At the endpoint, the remission rate was 22.6% (n = 18) and 28.6% of patient had improvement in CGI-CB total scores at the endpoint.No significant adverse events were observed. Conclusion This study has shown additional benefit of AGO treatment as combination or switching agent for MDD patients without full remission in routine practice. However, adequately-powered and well-controlled studies are necessary for generalization of the present findings.

Objective: We report the results of pharmacogenomics-based antidepressant treatment (PGXt) results in treating treatment-resistant major depressive disorder (TRD) patients in real practice. Methods: Nine patients were prescribed NeuropharmagenⓇ for selection of antidepressants for individual patient and their clinical outcomes were followed. Results: After treatment by PGXt results from current antidepressants, substantial reduction of depressive symptoms was observed at some point and maintained during observation period in six patients. Conclusion Our case series potentially shows the clinical utility and benefit of PGXt for treatment of TRD patients.

Objective: There has been a lack of data regarding the usefulness and clinical characteristic between patients-treated with and without antidepressants (Pw/Pwo ADs). Methods: One hundred and eighty inpatients were recruited and observed for a 6-month. The depressive, cognitive, daily activity, and motor symptoms were evaluated at baseline and tracked at month 6, with the use of rating scales including Beck Depression Inventory (BDI), Mini Mental State Examination (MMSE), Global Deterioration Scale (GDS), modified Rankin Scale (MRS), modified Barthel Index (MBI), and Berg Balance Scale (BBS). Results: Among 178 patients, 84 (47.2%) were treated with ADs. PwAD had numerically or significantly higher depressive cognitive, and motor symptoms along with daily activity impairment (8.3 point higher in BDI score, p ＜ 0.001;3.6 point lower in MMSE, p = 0.003; 0.8 point higher in GDS score, p = nonsignificant; 8.2 point lower in BBS score, p = 0.053, and 0.4 point higher in MBI score, p = nonsignificant) than PwoAD. Psychiatric consultation was also significantly higher in PwAD than in PwoAD (p ＜ 0.001). The numbers need to treat for good clinical outcomes between PwAD and PwoAD were 5.8, 6.0, and 7.5, respectively, by MRS, MBI, and BBS scores. Conclusion Our findings suggest the potential utility of AD treatment and different clinical parameters between patients-treated with and without ADs. Adequately-powered and well-controlled further studies are mandatory to confirm and fully elaborate such association.

Objective: To test clinical effectiveness and tolerability of Korean Red Ginseng augmentation (RGA) in major depressive disorder (MDD) patients with difficult-to-treat. Methods: Thirty six patients were enrolled in this 6 weeks, prospective, clinical trial. Rating scales were MontgomeryÅsberg Depression Rating Scale (MADRS), Patient Health Questionnaire-15, Clinical Global Impression-improvement (CGI-I), and Patient Satisfaction Score. The primary endpoint was a remission rate measured by MADRS score at the end of study (≤ 10). Clinical outcomes and tolerability were assessed at baseline, week 2, and week 6. Results: Among 36 patients, 26 patients completed the study and 28 patients had post-baseline visit data. The remission rate by MADRS score was 39.3% (11/28) and 57.1% by CGI-I scores of 1 or 2 at the end of the study. The mean change of MADRS score was significantly decreased by 44.4% from baseline to the end of study. The most frequent adverse events were headache (7/28, 25.0%) during the study. Conclusion Our study indicates the putative effectiveness and tolerability of RGA for treating MDD with difficult-to-treat in clinical practice. However, adequately powered, randomized, controlled trials will be needed to confirm these results.

PURPOSE: To overcome several drawbacks of chemically-crosslinked collagen membranes, modification processes such as ultraviolet (UV) crosslinking and the addition of biphasic calcium phosphate (BCP) to collagen membranes have been introduced. This study evaluated the efficacy and biocompatibility of BCP-supplemented UV-crosslinked collagen membrane for guided bone regeneration (GBR) in a rabbit calvarial model. METHODS: Four circular bone defects (diameter, 8 mm) were created in the calvarium of 10 rabbits. Each defect was randomly allocated to one of the following groups: 1) the sham control group (spontaneous healing); 2) the M group (defect coverage with a BCP-supplemented UV-crosslinked collagen membrane and no graft material); 3) the BG (defects filled with BCP particles without membrane coverage); and 4) the BG+M group (defects filled with BCP particles and covered with a BCP-supplemented UV-crosslinked collagen membrane in a conventional GBR procedure). At 2 and 8 weeks, rabbits were sacrificed, and experimental defects were investigated histologically and by micro-computed tomography (micro-CT). RESULTS: In both micro-CT and histometric analyses, the BG and BG+M groups at both 2 and 8 weeks showed significantly higher new bone formation than the control group. On micro-CT, the new bone volume of the BG+M group (48.39±5.47 mm3) was larger than that of the BG group (38.71±2.24 mm3, P=0.032) at 8 weeks. Histologically, greater new bone area was observed in the BG+M group than in the BG or M groups. BCP-supplemented UV-crosslinked collagen membrane did not cause an abnormal cellular reaction and was stable until 8 weeks. CONCLUSIONS Enhanced new bone formation in GBR can be achieved by simultaneously using bone graft material and a BCP-supplemented UV-crosslinked collagen membrane, which showed high biocompatibility and resistance to degradation, making it a biocompatible alternative to chemically-crosslinked collagen membranes.

PURPOSE: This study was designed to observe the resorption pattern of biphasic calcium phosphate (BCP) used for maxillary sinus augmentation over a 3- to 6-year healing period, and to investigate factors affecting the resorption of BCP. METHODS: A total of 47 implants placed in 27 sinuses of 22 patients were investigated. All patients had residual bone height less than 5 mm at baseline. The modified Caldwell-Luc approach was used to elevate the maxillary sinus membrane, and the sinus cavity was filled with BCP (70% hydroxyapatite and 30% β-tricalcium phosphate). Implant placement was done simultaneously or in a staged manner. Serial radiographic analysis was performed up to 6 years postoperatively. RESULTS: During the follow-up period, no implant loss was reported. The mean reduced height of the augmented sinus (RHO) was 0.27±1.08 mm at 36 months, and 0.89±1.39 mm at 72 months postoperatively. Large amounts of graft material (P=0.021) and a long healing period (P=0.035) significantly influenced the amount of RHO. In particular, there was a significant relationship between a healing period longer than 40 months and RHO. CONCLUSIONS: BCP can achieve proper dimensional stability with minimal reduction of the graft height in a 3- to 6-year healing period after maxillary sinus augmentation. The healing period and the amount of graft material influenced the resorption of BCP.
Bone Substitutes ; Calcium ; Dental Implants ; Durapatite ; Follow-Up Studies ; Humans ; Maxillary Sinus ; Membranes ; Sinus Floor Augmentation ; Transplants

PURPOSE: The purpose of this study was to assess the adhesiveness and cytotoxicity of 3, 4-dihydroxyphenylalanine (DOPA), and to evaluate the role of collagen membrane with DOPA in the guided bone regeneration. MATERIALS AND METHODS: Peel resistance and cell cytotoxicity test were performed. Four defect types in nine rabbit calvaria were randomly allocated: i) control, ii) membrane, iii) deproteinized porcine bone mineral (DPBM) covered by membrane with DOPA, and iv) DPBM covered by membrane with cyanoacrylate. Animals were sacrificed at 2 (n=4) and 8 weeks (n=5) for microcomputed tomography and histomorphometric analysis. DOPA showed low peel resistance but high cell viability. RESULT: Cyanoacrylate and DOPA groups showed significantly higher mineralized tissue volume (MTV) compared to control and membrane groups at 2 weeks (P < 0.05). At 8 weeks, DOPA group showed the highest MTV. Significantly higher new bone area was found in DOPA group at 8 weeks (P < 0.05). Bone formation increased from 2 to 8 weeks in DOPA group (P < 0.05). CONCLUSION: DOPA showed high cell viability and in vivo study revealed predictable performance in bone regeneration.
Adhesiveness ; Adhesives ; Animals ; Bone Regeneration ; Cell Survival ; Collagen ; Cyanoacrylates ; Dihydroxyphenylalanine ; Membranes ; Miners ; Osteogenesis ; Skull ; X-Ray Microtomography

OBJECTIVE: Despite numerous atypical antipsychotics (AAP) available, many patients with schizophrenia still experience lack of efficacy and persistent side-effects. Switching from one AAP to another with a different side-effect profile has become a common clinical strategy. We aimed to investigate effect of switching to amisulpride in patients who showed suboptimal effect and/or tolerability to current antipsychotics treatment. METHODS: This was a 6-week, prospective, multicenter, open-label, flexible-dose study in patients with schizophrenia. Switching to amisulpride was achieved using cross-titration within 7 days (day 1: 300 mg on day 1 then flexibly dosed 400–800 mg/day). The primary end-point measure was proportion of patients achieving improvement in clinical benefit at week 6 based on Clinical Global Impressions-Clinical Benefit (CGI-CB). Secondary endpoints included change in scores in CGI-CB, CGI-Severity (CGI-S), Subjective Satisfaction Scores (SSS), Brief Psychiatric Rating Scale (BPRS), and Simpson and Angus Rating Scale. RESULTS: Among 37 patients switched to amisulpride, 76% completed study and 56.8% had clinical benefit measure by CGI-CB. CGI-CB and CGI-S scores showed significant improvement at week 6 compared to baseline (mean changes of CGI-CB and CGI-S scores: −1.7+1.0, p<0.0001 and −0.6±0.0, p=0.001, respectively). SSS scores also improved significantly (mean change: 2.1±2.6, p<0.0001). Mean weight of patients significantly lowered compared to baseline (mean change: −1.2±2.0, p<0.0001). CONCLUSION: Patients with schizophrenia who showed suboptimal efficacy or tolerability with their current antipsychotics and thereby switched to amisulpride resulted in clinical benefit in terms of both improved efficacy and tolerability. The small sample size limits generalizability of the study results.
Antipsychotic Agents* ; Brief Psychiatric Rating Scale ; Humans ; Prospective Studies ; Sample Size ; Schizophrenia