Sleep disorders represent multifaceted pathophysiological conditions beyond simple sleep duration or quality disruptions. They are frequently associated with neuropsychiatric symptoms, cognitive decline, and systemic health deterioration. Among them, insomnia and obstructive sleep apnea (OSA) are highly prevalent and chronic, with established links to reduced quality of life and an increased risk of neurodegenerative diseases. This review summarized recent findings from neuroimaging studies that used quantitative cerebral blood flow (CBF) techniques, including arterial spin labeling (ASL) and single-photon emission computed tomography (SPECT), to examine functional brain changes associated with these disorders. Both insomnia and OSA consistently showed perfusion abnormalities in regions such as the prefrontal cortex, cingulate cortex, and hippocampus—areas that are critical for the sleep-arousal cycle, emotional regulation, and cognitive control. These alterations may reflect underlying mechanisms that include hemodynamic dysregulation, impaired metabolic regulation, and reduced connectivity in large-scale brain networks.Collectively, the evidence suggested that sleep disorders should be understood not merely as disturbances of sleep architecture, but as conditions involving cerebral hemodynamic dysregulation. Brain perfusion metrics thus hold clinical promise as sensitive biomarkers for early diagnosis, risk stratification, and treatment monitoring in sleep disorders and support the development of precision-guided interventions based on quantitative neuroimaging.

Anosmia, characterized by the loss of smell, is associated not only with dysfunction in the peripheral olfactory system but also with changes in several brain regions involved in olfactory processing. Specifically, the orbitofrontal cortex is recognized for its pivotal role in integrating olfactory information, engaging in bidirectional communication with the primary olfactory regions, including the olfactory cortex, amygdala, and entorhinal cortex. However, little is known about alterations in structural connections among these brain regions in patients with anosmia. In this study, highresolution T1-weighted images were obtained from participants. Utilizing the volumes of key brain regions implicated in olfactory function, we employed a structural covariance approach to investigate brain reorganization patterns in patients with anosmia (n=22) compared to healthy individuals (n=30). Our structural covariance analysis demonstrated diminished connectivity between the amygdala and entorhinal cortex, components of the primary olfactory network, in patients with anosmia compared to healthy individuals (z=-2.22, FDR-corrected p=0.039). Conversely, connectivity between the orbitofrontal cortex—a major region in the extended olfactory network—and amygdala was found to be enhanced in the anosmia group compared to healthy individuals (z=2.32, FDR-corrected p=0.039). However, the structural connections between the orbitofrontal cortex and entorhinal cortex did not differ significantly between the groups (z=0.04, FDR-corrected p=0.968). These findings suggest a potential structural reorganization, particularly of higher-order cortical regions, possibly as a compensatory effort to interpret the limited olfactory information available in individuals with olfactory loss.

Cognitive dysfunction, a significant complication of type 2 diabetes mellitus (T2DM), can potentially manifest even from the early stages of the disease. Despite evidence of global brain atrophy and related cognitive dysfunction in early-stage T2DM patients, specific regions vulnerable to these changes have not yet been identified. The study enrolled patients with T2DM of less than five years’ duration and without chronic complications (T2DM group, n=100) and demographically similar healthy controls (control group, n=50). High-resolution T1-weighted magnetic resonance imaging data were subjected to independent component analysis to identify structurally significant components indicative of morphometric networks. Within these networks, the groups’ gray matter volumes were compared, and distinctions in memory performance were assessed. In the T2DM group, the relationship between changes in gray matter volume within these networks and declines in memory performance was examined. Among the identified morphometric networks, the T2DM group exhibited reduced gray matter volumes in both the precuneus (Bonferronicorrected p=0.003) and insular-opercular (Bonferroni-corrected p=0.024) networks relative to the control group. Patients with T2DM demonstrated significantly lower memory performance than the control group (p=0.001). In the T2DM group, reductions in gray matter volume in both the precuneus (r=0.316, p=0.001) and insular-opercular (r=0.199, p=0.047) networks were correlated with diminished memory performance. Our findings indicate that structural alterations in the precuneus and insular-opercular networks, along with memory dysfunction, can manifest within the first 5 years following a diagnosis of T2DM.

Purpose: This descriptive cross-sectional study aimed to examine the influence of nurses’ moral sensitivity and ethical values on their biomedical ethics awareness. Methods: The study participants included 140 registered nurses working at three hospitals in Jeollabuk-do Province over six months. The data were collected from June 22 to July 3, 2020, and were analyzed using descriptive statistics, an independent t-test, one-way ANOVA, Pearson correlation coefficients, and stepwise multiple regression analysis with the IBM SPSS/WIN 20.0 program. Results: As a result of an analysis using stepwise multiple regression, nurses’ biomedical ethics awareness was found to be significantly influenced by ethical values (β=.36, p<.001), moral sensitivity (β=.21, p=.007), and education in biomedical ethics (β=.16, p=.042) (adjusted R2=.21, p<.001). Conclusion These findings suggest that moral sensitivity and ethical values are key factors in hospital nurses’ development of biomedical ethics. Furthermore, the devising and implementing of a practical education program based on practical cases in medical situations to enhance nurses’ biomedical ethics awareness is needed.

Objective: This study aimed to compare the amount of tooth movement after multiple horizontal (MH) and single vertical (SV) micro-osteoperforations (MOPs), and evaluate the histological changes after orthodontic force application in rabbits. Methods: The mandibles of 24 white rabbits were subjected to two experimental interventions: MH and SV MOPs. Defect volume of the MOPs between the two groups was kept similar. A force of 100 cN was applied via a coil spring between the incisor teeth and the first premolars. The amount of tooth movement was measured. Differences in the amount of tooth movement and bone variables at three time points and between the two groups were evaluated using repeated-measures analysis of variance. Results: The first premolar showed a mesial movement of 1.47 mm in the MH group and 1.84 mm in the SV group, which was significantly different at Week 3 (p < 0.05). No significant difference was observed in bone volume and bone fraction between the groups. Tartrate-resistant acidic phosphatase-positive cell count was also significantly greater at Week 3 than at Week 1 in both the SV and MH groups. Conclusions The amount of tooth movement showed significant differences between Weeks 1 and 3 in the SV and MH MOP groups, but showed no differences between the two groups. Therefore, SV MOP could be considered an effective tool for enhancing tooth movement, especially for molar distalization, uprighting, and protraction to an edentulous area.

Objective: This study aimed to compare the amount of tooth movement after multiple horizontal (MH) and single vertical (SV) micro-osteoperforations (MOPs), and evaluate the histological changes after orthodontic force application in rabbits. Methods: The mandibles of 24 white rabbits were subjected to two experimental interventions: MH and SV MOPs. Defect volume of the MOPs between the two groups was kept similar. A force of 100 cN was applied via a coil spring between the incisor teeth and the first premolars. The amount of tooth movement was measured. Differences in the amount of tooth movement and bone variables at three time points and between the two groups were evaluated using repeated-measures analysis of variance. Results: The first premolar showed a mesial movement of 1.47 mm in the MH group and 1.84 mm in the SV group, which was significantly different at Week 3 (p < 0.05). No significant difference was observed in bone volume and bone fraction between the groups. Tartrate-resistant acidic phosphatase-positive cell count was also significantly greater at Week 3 than at Week 1 in both the SV and MH groups. Conclusions The amount of tooth movement showed significant differences between Weeks 1 and 3 in the SV and MH MOP groups, but showed no differences between the two groups. Therefore, SV MOP could be considered an effective tool for enhancing tooth movement, especially for molar distalization, uprighting, and protraction to an edentulous area.

The purpose of this study was to develop effective dental hygiene chews for cats based on the anatomical features of the dentition and patterns of chewing motion. All cats were volunteered for dental prophylaxis followed by dental impressions using yellow stone and alginate under general anesthesia. Twenty parameters related to dentition were defined in order to compare dental impressions using digital caliper. For the chewing motion study, patterns of chewing motion were identified based on recordings made with a digital camera. Ten cats (4 domestic shorthairs, 2 Russian blues, 1 American shorthair, 1 Persian, 1 Turkish Angora, and 1 Devon Rex) were recruited for the study. The parameters related to teeth and oral size were similar among the studied cats. Chewing motion can be described as more of a guillotine-like motion rather than a crushing motion, with cats chewing 3–7 times before swallowing. The chewing pattern of cats involves shearing for a short period of time followed by immediate swallowing. Therefore, the overall size of the dental hygiene chew could be determined based on the measurement of the oral size for inducing chewing. The surface details of the dental hygiene chew could be designed for prevention and removal of dental calculus and plaque in cats considering the anatomical teeth parameters. Dental hygiene chews customized for cats considering the different anatomical features of their teeth might be effective for oral care.
Anesthesia, General ; Animals ; Cats ; Deglutition ; Dental Calculus ; Dental Prophylaxis ; Dentition ; Gingiva ; Mastication ; Oral Hygiene ; Periodontal Diseases ; Tooth

Hypereosinophilia, defined as an absolute eosinophil count of >1,500/μL, can be caused by a number of allergic, infectious, paraneoplastic and neoplastic disorders. In cases of hypereosinophilia with lymphoid proliferation, pathological confirmation is essential to exclude either myeloid or lymphoid malignancy. A 38-year-old woman with both cervical lymphadenopathies and peripheral blood eosinophilia visited our clinic. She had already performed core biopsy of lymph nodes and diagnosed as Kimura disease at a regional hospital. At the time of our clinic visit, there were no palpable cervical lymph nodes. The blood test showed hypereosinophilia with a high total IgE level. There was no evidence of tissue infiltration of eosinophils except for duodenitis with eosinophilic infiltration. Based on these findings, she was diagnosed as Kimura disease. She treated with high-dose systemic corticosteroid (1 mg/kg) and additional immunosuppressants sequentially used cyclophosphamide and cyclosporine. However, her eosinophilia waxed and waned, and a left inguinal mass was newly found. Excisional biopsy findings showed large atypical lymphoid cells with numerous eosinophilis, and immunohistochemistry showed CD3+, CD20−, CD30+ and anaplastic lymphoma kinase (ALK). The final diagnosis was ALK-negative anaplastic large cell lymphoma. We report a case of anaplastic large cell lymphoma with marked peripheral eosinophilia misdiagnosed as Kimura disease. In the case of hypereosinophilia with lymphadenopathy, it is necessary to differentiate hematologic diseases through immunochemical staining.
Adult ; Ambulatory Care ; Angiolymphoid Hyperplasia with Eosinophilia* ; Biopsy ; Cyclophosphamide ; Cyclosporine ; Diagnosis ; Duodenitis ; Eosinophilia* ; Eosinophils ; Female ; Hematologic Diseases ; Hematologic Tests ; Humans ; Immunoglobulin E ; Immunohistochemistry ; Immunosuppressive Agents ; Lymph Nodes ; Lymphatic Diseases ; Lymphocytes ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic* ; Phosphotransferases

OBJECTIVE: This study investigated peripheral and central metabolites affecting depression, anxiety, suicidal ideation, and anger in complex regional pain syndrome (CRPS) patients. METHODS: Metabolite levels were determined in the right and left thalamus and insula, in 12 CRPS patients using magnetic resonance spectroscopy (MRS). RESULTS: There were positive correlations between valine (Val)/tNAA (N-acetylaspartate+N-acetylaspartylglutamate) and the anxiety, and a negative correlation between glutamine (Gln)/NAA and the depression. There were positive correlations between alanine (Ala)/Gln and the depression and suicidal ideation, between glutamate (Glu)/Gln and the depression and suicidal ideation, between N-acetylaspartylglutamate (NAAG)/Gln and the depression. There was a positive correlation between Ala/NAAG and the trait anger and a negative correlation between creatine (Cr)/N-acetylaspartate (NAA) and the trait anger. There was a negative correlation between Cr/Glx (Glu+Gln) and the trait anger. High hemoglobin and alkaline phosphatase were associated with low pain levels, but CO2 and chloride showed positive correlations with pain levels in CRPS patients. Peripheral glucose, CO2 and chloride were associated with depression, anxiety, anger and suicidal ideation. CONCLUSION: The specific central and peripheral metabolites were associated with psychological disorders including depression, anxiety, suicidal ideation and anger in CRPS patients, showing pathological interactions between a painful body and mind.
Alanine ; Alkaline Phosphatase ; Anger* ; Anxiety* ; Creatine ; Depression* ; Glucose ; Glutamic Acid ; Glutamine ; Humans ; Magnetic Resonance Spectroscopy* ; Pilot Projects* ; Suicidal Ideation* ; Thalamus ; Valine

Seizure is a temporary symptom or sign which is caused by an abnormal electrical stimulation of brain. Depending on whether a seizure has preceding factors or not, it can be further categorized into provoked and unprovoked seizure. In provoked seizure, it is important to find a cause for treatment. In this study, we would like to report a case of a 6 year-old male child with seizure caused by organophosphate poisoning. The patient's chief complaint was his decreased mental status accompanying seizure. Initially, status epilepticus was suspected but the response to anticonvulsants was not good, and resulted in prolonged respiratory failure. After 3 hours, the patient showed signs of cholinergic crisis. In response, atropine was administered and the condition improved. If respiratory failure or mental confusion persists even after cessation of seizure in status epilepticus, repetitive physical and neurological examinations should be carried out to find preceding factors. Even though the recent incidence of organophosphate poisoning has decreased, we would like to emphasize from our study that it should be considered as a preceding factor for seizure.
Anticonvulsants ; Atropine ; Brain ; Child* ; Electric Stimulation ; Humans ; Incidence ; Male ; Neurologic Examination ; Organophosphate Poisoning* ; Poisoning ; Respiratory Insufficiency ; Seizures* ; Status Epilepticus