Objective: We investigated the frequency of depressive disorders in the elderly with normal cognition (NC), mild cognitive impairment (MCI) and dementia patients living in the community to find out the association between cognitive disorders and depressive disorders in the community dwelling elderly. Methods: 6,262 baseline study subjects from November 2010 through October 2012 were enrolled based on the Korean longitudinal study on cognitive aging and dementia which is the first nationwide multi-center population based prospective cohort study in Korea. Diagnosis of MCI, dementia, major depressive disorder (MDD), minor depressive disorder (mDD) and subsyndromal depression (SSD) was made by psychiatrists with expertise in dementia based on the appropriate diagnostic criteria. Results: 4,303 NC, 1,737 MCI, 222 dementia were enrolled. The frequency of MDD, mDD, SSD were highest in dementia and lowest in NC and showed significant difference among three groups. The odds ratio also increased significantly in MCI and dementia compared with NC showing highest odds ratio in dementia. Conclusion Our findings propose that MCI and dementia in the community dwelling elderly were significantly associated with various types of depressive disorders showing highest association tendency in dementia.

Immunologic responses of infants and younger children differ from those of adults. Therefore, application of different pretransplant strategies for antibody depletion in younger ABO-incompatible transplant recipients is appropriate. A 12-month-old male infant with end stage renal disease after acute tubular necrosis was scheduled to undergo kidney transplantation from an ABO-incompatible living donor. He did not undergo pretransplant plasmapheresis, as the titer of the anti-ABO antibody was less than 1:4. After kidney transplantation, posttransplant renal function and anti-ABO titers were stable until posttransplant 2 years.
Adult ; Child ; Humans ; Infant ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Living Donors ; Male ; Necrosis ; Plasmapheresis* ; Transplantation

PURPOSE: The inhibition of phosphodiesterase 5 produces an antinociception through the increase of cyclic guanosine monophosphate (cGMP), and increasing cGMP levels enhance the release of gamma-aminobutyric acid (GABA). Furthermore, this phosphodiesterase 5 plays a pivotal role in the regulation of the vasodilatation associated to cGMP. In this work, we examined the contribution of GABA receptors to the effect of sildenafil, a phosphodiesterase 5 inhibitor, in a neuropathic pain rat, and assessed the hemodynamic effect of sildenafil in normal rats. MATERIALS AND METHODS: Neuropathic pain was induced by ligation of L5/6 spinal nerves in Sprague-Dawley male rats. After observing the effect of intravenous sildenafil on neuropathic pain, GABAA receptor antagonist (bicuculline) and GABAB receptor antagonist (saclofen) were administered prior to delivery of sildenafil to determine the role of GABA receptors in the activity of sildenafil. For hemodynamic measurements, catheters were inserted into the tail artery. Mean arterial pressure (MAP) and heart rate (HR) were measured over 60 min following administration of sildenafil. RESULTS: Intravenous sildenafil dose-dependently increased the withdrawal threshold to the von Frey filament application in the ligated paw. Intravenous bicuculline and saclofen reversed the antinociception of sildenafil. Intravenous sildenafil increased the magnitude of MAP reduction at the maximal dosage, but it did not affect HR response. CONCLUSION: These results suggest that sildenafil is active in causing neuropathic pain. Both GABAA and GABAB receptors are involved in the antinociceptive effect of sildenafil. Additionally, intravenous sildenafil reduces MAP without affecting HR.
Animals ; Baclofen/analogs & derivatives/pharmacology ; Bicuculline/pharmacology ; Blood Pressure/drug effects ; Dose-Response Relationship, Drug ; Heart Rate/drug effects ; Hemodynamics/drug effects ; Male ; Neuralgia/*drug therapy ; Pain Threshold/drug effects ; Phosphodiesterase Inhibitors/*therapeutic use ; Piperazines/*therapeutic use ; Purines/therapeutic use ; Rats ; Rats, Sprague-Dawley ; Receptors, GABA-A/antagonists & inhibitors/physiology ; Receptors, GABA-B/antagonists & inhibitors/physiology ; Sulfones/*therapeutic use

BACKGROUND: Experimental evidence indicates that ginseng modulate the nociceptive transmission. Authors examined the role of adrenergic and cholinergic receptors on the antinociceptive action of Korean red ginseng against the formalin-induced pain at the spinal level. METHODS: Catheters were inserted into the intrathecal space of male Sprague-Dawley rats. Fifty microl of 5% formalin solution was injected to the hindpaw for induction of pain and formalin-induced pain (flinching response) was observed. The role of spinal adrenergic and cholinergic receptors on the effect of Korean red ginseng was assessed by antagonists (prazosin, yohimbine, atropine and mecamylamine). RESULTS: Intrathecal Korean red ginseng produced a dose-dependent suppression of the flinching response in the rat formalin test. All of prazosin, yohimbine, atropine and mecamylamine antagonized the antinociception of Korean red ginseng. CONCLUSIONS: Spinal Korean red ginseng is effective against acute pain and facilitated pain state evoked by formalin injection. All of alpha 1, alpha 2, muscarinic and nicotinic receptors may play an important role in the antinociceptive action of Korean red ginseng at the spinal level.
Acute Pain ; Animals ; Atropine ; Catheters ; Formaldehyde ; Humans ; Male ; Mecamylamine ; Pain Measurement ; Panax ; Prazosin ; Rats ; Rats, Sprague-Dawley ; Receptors, Cholinergic ; Receptors, Nicotinic ; Spinal Cord ; Yohimbine

BACKGROUND: Traditionally, ginseng has been widely used to manage various types of diseases. In particular, the analgesic effect of ginsenosides has been reported for inflammatory pain. However, the effect of ginsenosides on neuropathic pain has not been determined. The aim of this study was to examine the effect of ginsenosides on neuropathic pain in the spinal cord. METHODS: Neuropathic pain was induced by ligation of the lumbar 5, 6 spinal nerves in male Sprague-Dawley rats. Intrathecal catheters were placed into the subarachnoid space of rats that presented with mechanical allodynia. Mechanical allodynia was evaluated by measuring the withdrawal threshold to a von Frey filament applied to the plantar surface of rats. The analgesic effect of intrathecal ginsenosides was observed at 15, 30, 60, 90, 120, 150 and 180 min after delivery of the ginsenosides. RESULTS: After nerve ligation, the paw withdrawal threshold was significantly decreased at the ligated site. At the doses used in this study, intrathecal ginsenosides did not alter the withdrawal threshold in the ligated paw during the entire observation period. However, a dose of intrathecal ginsenosides greater than 1,500microg caused motor impairment. CONCLUSIONS: These results suggest that ginsenosides may not have a direct modulatory role in the transmission of neuropathic pain at the spinal level.
Analgesia ; Animals ; Catheters ; Ginsenosides ; Humans ; Hyperalgesia ; Ligation ; Male ; Neuralgia ; Panax ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; Spinal Nerves ; Subarachnoid Space

PURPOSE: Previously, Epstein-Barr virus (EBV) infection was diagnosed by serological examination; currently, many EBV antigen detection methods have been developed and applied clinically for diagnosing EBV infection. To delineate the clinical characteristics of EBV infection, clinical and laboratory findings were evaluated for patients who tested positive in EBV polymerase chain reaction (PCR). METHODS: EBV PCR was conducted in 352 patients admitted to the pediatric ward from January 2004 to December 2006, with more than 2 clinical signs such as fever (> or =37.5degrees C), exudative throat infection, lymphadenopathy, hepatitis of unknown etiology, and splenomegaly. The EBV viral gene was detected by PCR in 115 patients (32%), and the clinical characteristics of these patients were evaluated. Laboratory findings such as leukocytosis, thrombocytopenia, atypical lymphocyte, and alteration in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in peripheral blood were examined. The EBV-specific immunoglobulin M antibody (EBV-IgM Ab) was also tested. RESULTS: Most of the children were younger than 8 years (89%), and the male to female ratio was 1.3:1. Exudative throat infection and fever (> or =37.5degrees C) were observed in all patients. Cervical lymph node enlargement was seen in 36 patients (31%); leukocytosis (WBC> or =10,000/mm3), in 54 patients (47%); and atypical lymphocyte (> or =20%), in 28 patients (24%). EBV-IgM Ab was positive in 33 patients (29%). The younger patients had higher ALT levels and higher incidence of positive EBV-IgM Ab than the older patients. CONCLUSION: The cumulative number of patients diagnosed to have EBV infection by PCR increased markedly for those under 8 years. ALT was higher and EBV-IgM Ab was detected more in younger patients with EBV infection.
Alanine Transaminase ; Aspartate Aminotransferases ; Child ; Epstein-Barr Virus Infections ; Female ; Fever ; Genes, Viral ; Hepatitis ; Herpesvirus 4, Human ; Humans ; Immunoglobulin M ; Incidence ; Leukocytosis ; Lymph Nodes ; Lymphatic Diseases ; Lymphocytes ; Male ; Pharynx ; Polymerase Chain Reaction ; Splenomegaly ; Thrombocytopenia

The possible characteristics of spinal interaction between sildenafil (phosphodiesterase 5 inhibitor) and morphine on formalin-induced nociception in rats was examined. Then the role of the opioid receptor in the effect of sildenafil was further investigated. Catheters were inserted into the intrathecal space of male Sprague-Dawley rats. For induction of pain, 50 microliter of 5% formalin solution was applied to the hindpaw. Isobolographic analysis was used for the evaluation of drug interaction between sildenafil and morphine. Furthermore, naloxone was intrathecally given to verify the involvement of the opioid receptor in the antinociception of sildenafil. Both sildenafil and morphine produced an antinociceptive effect during phase 1 and phase 2 in the formalin test. The isobolographic analysis revealed an additive interaction after intrathecal delivery of the sildenafil-morphine mixture in both phases. Intrathecal naloxone reversed the antinociception of sildenafil in both phases. These results suggest that sildenafil, morphine, and the mixture of the two drugs are effective against acute pain and facilitated pain state at the spinal level. Thus, the spinal combination of sildenafil with morphine may be useful in the management of the same state. Furthermore, the opioid receptor is contributable to the antinocieptive mechanism of sildenafil at the spinal level.
Analgesics/*administration & dosage ; Analgesics, Opioid/*administration & dosage ; Animals ; Behavior, Animal/drug effects ; Dose-Response Relationship, Drug ; Drug Synergism ; Formaldehyde/toxicity ; Injections, Spinal ; Male ; Morphine/*administration & dosage ; Naloxone/administration & dosage ; Narcotic Antagonists/administration & dosage ; Pain/chemically induced/therapy ; Pain Measurement/drug effects ; Phosphodiesterase Inhibitors/*administration & dosage ; Piperazines/*administration & dosage ; Purines/administration & dosage ; Rats ; Rats, Sprague-Dawley ; Sulfones/*administration & dosage ; Time Factors

BACKGROUND: A phosphodiesterase 5 inhibitor, sildenafil, has been effective against nociception. Several lines of evidence have demonstrated the role of the GABAergic pathway in the modulation of nociception. The impact of the GABA receptors on sildenafil was studied using the formalin test at the spinal level. METHODS: Male SD rats were prepared for intrathecal catheterization. The formalin test was induced by subcutaneous injection of formalin solution. The change in the activity of sildenafil was examined after pretreatment with GABA receptor antagonists (GABAA receptor antagonist, bicuculline; GABAB receptor antagonist, saclofen). RESULTS: Intrathecal sildenafil dose-dependently attenuated the flinching observed during phase 1 and 2 in the formalin test. The antinociceptive effect of sildenafil was reversed by the GABAB receptor antagonist (saclofen) but not by the GABAA receptor antagonist (bicuculline) in both phases. CONCLUSIONS: Intrathecal sildenafil suppressed acute pain and the facilitated pain state. The antinociception of sildenafil is mediated via the GABAB receptor, but not the GABAA receptor, at the spinal level.
Acute Pain ; Animals ; Bicuculline ; Catheterization ; Catheters ; Cyclic Nucleotide Phosphodiesterases, Type 5 ; Formaldehyde* ; GABA Antagonists ; Humans ; Injections, Subcutaneous ; Male ; Nociception ; Pain Measurement* ; Rats* ; Receptors, GABA ; Sildenafil Citrate