Ginsenoside Re Enriched Fraction (GS-F3K1) from Ginseng Berries Ameliorates Ethanol-Induced Erectile Dysfunction via Nitric Oxide-cGMP Pathway

Erectile dysfunction (ED) is a highly prevalent disorder that affects millions of men and considered to be an early symptom of atherosclerosis and a precursor of various systemic vascular disorders. The aim of the present study was to prepare ginsenoside Re enriched fraction (GS-F3K1, ginsenoside Re 10%, w/w) from ginseng berries flesh and to investigate the enhanced activities of GS-F3K1 on alcohol-induced ED. GS-F3K1 was prepared by the continuous liquid and solid separating centrifugation and circulatory ultrafiltration from ginseng berries flesh. GS-F3K1 was administered for 5 weeks in ethanol-induced ED rat by oral administration of 20% ethanol. To investigate the effects of GS-F3K1 on ED model, the levels of nitrite expression, cyclic guanosine monophosphate (cGMP) and erectile response of the penile corpus cavernosum of rat were measured. The erectile response of the corpus cavernosum was restored after GS-F3K1 administration, to a level similar to the normal group. The level of nitrite and cGMP expression in the corpus cavernosum of GS-F3K1-administered male rats was increased significantly compared to positive control group. GS-F3K1 from ginseng berries should effectively restore ethanol-induced ED in male rats and could be developed as a new functional food for the elderly men.

Arctiin inhibits adipogenesis in 3T3-L1 cells and decreases adiposity and body weight in mice fed a high-fat diet

BACKGROUND/OBJECTIVES: The purpose of this study was to examine the effects and associated mechanisms of arctiin, a lignan compound found in burdock, on adipogenesis in 3T3-L1 cells. Also, the effects of arctiin supplementation in obese mice fed a high-fat diet on adiposity were examined. MATERIALS/METHODS: 3T3-L1 cells were treated with arctiin (12.5 to 100 microM) during differentiation for 8 days. The accumulation of lipid droplets was determined by Oil Red O staining and intracellular triglyceride contents. The expressions of genes related to adipogenesis were measured by real-time RT-PCR and Western blot analyses. For in vivo study, C57BL/6J mice were first fed either a control diet (CON) or high-fat diet (HF) to induce obesity, and then fed CON, HF, or HF with 500 mg/kg BW arctiin (HF + AC) for four weeks. RESULTS: Arctiin treatment to 3T3-L1 pre-adipocytes markedly decreased adipogenesis in a dose-dependent manner. The arctiin treatment significantly decreased the protein levels of the key adipogenic regulators PPARgamma and C/EBPalpha, and also significantly inhibited the expression of SREBP-1c, fatty acid synthase, fatty acid-binding protein and lipoprotein lipase. Also, arctiin greatly increased the phosphorylation of AMP-activated protein kinase (AMPK) and its downstream target phosphorylated-acetyl CoA carboxylase. Furthermore, administration of arctiin significantly decreased the body weight in obese mice fed with the high-fat diet. The epididymal, perirenal or total visceral adipose tissue weights of mice were all significantly lower in the HF + AC than in the HF. Arctiin administration also decreased the sizes of lipid droplets in the epididymal adipose tissue. CONCLUSIONS: Arctiin inhibited adipogenesis in 3T3-L1 adipocytes through the inhibition of PPARgamma and C/EBPalpha and the activation of AMPK signaling pathways. These findings suggest that arctiin has a potential benefit in preventing obesity.

Factors Influencing Corneal Flap Thickness in Laser In Situ Keratomileusis with a Femtosecond Laser

PURPOSE: To evaluate factors responsible for the variability between intended and achieved corneal-flap thickness during femtosecond laser-assisted laser in situ keratomileusis (LASIK). METHODS: A prospective, nonrandomized, case study was performed on 35 eyes of 18 consecutive patients who underwent LASIK surgery using the 60 kHz femtosecond laser microkeratome. Eyes were assigned to three different thickness groups, with 110-, 120-, or 130-microm cut depths. Anterior segment optical coherence tomography was used to assess the morphology of 35 LASIK flaps at postoperative one week postoperatively. The flap thickness was assessed at seven measuring points across each flap. Patient age, preoperative spherical equivalent, manual keratometry, preoperative central pachymetry, and regional variability of the cornea were evaluated to determine where they influenced the achieved corneal flap thickness. RESULTS: Cuttings of all flaps were easily performed without any intraoperative complications. Flap-thickness measurements had a mean of 115.21 +/- 4.98 microm (intended thickness, 110 microm), 121.90 +/- 5.79 microm (intended, 120 microm), and 134.38 +/- 5.04 microm (intended, 130 microm), respectively. There was no significant difference between the 110-microm and 120-microm groups when compared with the 130-microm group (one-way analysis of variance test, p > 0.05). Patients' age, preoperative spherical equivalent, manual keratometry, and preoperative central pachymetry did not affect the achieved flap thickness (Pearson correlations test, p > 0.05). The reproducibility of flap thickness in the central 1.5-mm radius area was more accurate than that in the peripheral 3.0 to 4.0-mm radius area (paired samples t-test, p < 0.05). CONCLUSIONS: Femtosecond laser-assisted LASIK is likely to reproduce a reliable thickness of the corneal flap, which is independent of corneal shape factors or refractive status. Future studies should focus on variations in corneal biomechanical factors, which may also play an important role in determining flap thickness.

Uncontrolled Self-Medication with Venlafaxine in a Patient with Major Depressive Disorder

Antidepressants are known to have no significant ability to cause addiction. However, a recent study showed many individuals with mood disorders self-medicated with antidepressants to relieve symptoms. We report here a male physician, diagnosed five years ago with major depressive disorder, with insomnia, anxiousness, and chest heaviness. He began self-medicating with 150 mg of venlafaxine daily, without any monitoring. During his most recent severe depressive episode, he was taking up to 1,500 mg of venlafaxine daily. Without this medication, he experienced discontinuation syndrome, which included severe anxiety, chest heaviness, and breathing difficulty, and which he judged as indicating a more severely depressed state. He also experienced overdose symptoms, such as hypertension and tachycardia. He attempted suicide with drugs that he possessed. In conclusion, careful monitoring is needed when treating patients with venlafaxine, because its discontinuation syndrome is similar to symptoms of major depressive disorder, and suicidality may result from an overdose.

A Case of Bilateral Conjunctival Amyloidosis Treated with Mass Excision and Cryotherapy

PURPOSE: To report the treatment results of mass excision and cryotherapy in a case of bilateral conjunctival amyloidosis. CASE SUMMARY: A 72-year-old man with conjunctival mass and foreign body sensations in both eyes visited our clinic. He was previously diagnosed with conjunctival lymphoma after conjunctival biopsy at another hospital. A yellow-pink colored mass was observed in the bulbar conjunctiva. A repeated conjunctival biopsy revealed the mass to be amyloid, consistent with the cervical lymph node biopsy results, and the diagnosis was changed to primary systemic amyloidosis. The patient was treated with melphalan and prednisolone; however, the ocular pain, symblepharon, and conjunctival mass progressed. A 360 degree conjunctivoperiotomy, mass excision, and repeated cryotherapy were performed in the more severely affected left eye. The patient was followed for one year, and there were no complications or progression of the conjunctival lesion. CONCLUSIONS: Conjunctival amyloidosis requires local pathologic confirmation as well as a systemic work-up. If surgical removal is necessary despite systemic treatment, mass excision and cryotherapy may be effective.

Transventricular Biopsy of Brain Tumor without Hydrocephalus Using Neuroendoscopy with Navigation

OBJECTIVE: It is usually difficult to perform the neuroendoscopic procedure in patients without hydrocephalus due to difficulties with ventricular cannulation. The purpose of this study was to find out the value of navigation guided neuroendoscopic biopsy in patients with peri- or intraventricular tumors without hydrocephalus. METHODS: Six patients with brain tumors without hydrocephalus underwent navigation-guided neuroendoscopic biopsy. The procedure was indicated for verification of the histological diagnosis of the neoplasm, which was planned to be treated by chemotherapy and/or radiotherapy as the first line treatment, or establishment of the pathological diagnosis for further choice of the most appropriate treatment strategy. RESULTS: Under the guidance of navigation, targeted lesion was successfully approached in all patients. Navigational tracking was especially helpful in entering small ventricles and in approaching the third ventricle through narrow foramen Monro. The histopathologic diagnosis was established in all of 6 patients : 2 germinomas, 2 astrocytomas, 1 dysembryoplastic neuroepithelial tumor and 1 pineocytoma. The tumor biopsy sites were pineal gland (n = 2), suprasellar area (n = 2), subcallosal area (n = 1) and thalamus (n = 1). There were no operative complications related to the endoscopic procedure. CONCLUSION: Endoscopic biopsy or resection of peri- or intraventricular tumors in patients without hydrocephalus is feasible. Image-guided neuroendoscopic procedure improved the accuracy of the endoscopic approach and minimized brain trauma. The absence of ventriculomegaly in patients with brain tumor may not be served as a contraindication to endoscopic tumor biopsy.

Comparison of Short Term Clinical Results Between Epi-LASIK and Femtosecond LASIK

PURPOSE: To compare short-term clinical results of femtosecond LASIK with those of epi-LASIK. METHODS: Twenty subjects (40 eyes) underwent femtosecond LASIK and 20 subjects (40 eyes) underwent epi-LASIK for myopia with astigmatism. The results of each surgery were compared with regard to visual acuity, spherical equivalent, safety, efficacy, stability, predictability and high order aberration. RESULTS: Postoperative uncorrected visual acuities were 0.51 +/- 0.11, 0.95 +/- 0.08, and 0.97 +/- 0.08 for epi-LASIK and 0.76 +/- 0.19, 0.97 +/- 0.07, and 0.98 +/- 0.06 for femtosecond LASIK at one week, one month, and two months after surgery, respectively. Femtosecond LASIK showed faster improvement in visual acuity. Postoperative spherical equivalents were -0.83 +/- 0.24, -0.31 +/- 0.19, and -0.27 +/- 0.09 for epi-LASIK and -0.47 +/- 0.21, -0.28 +/- 0.15, and -0.25 +/- 0.12 for femtosecond LASIK. Safety, efficacy, stability, and predictability showed no differences between the two groups. High order aberrations were increased significantly; however, no significant difference between the two groups was found. CONCLUSIONS: Both epi-LASIK and femtosecond LASIK are effective for surgical correction of myopia with fast visual rehabilitation. In addition, epi-LASIK and femtosecond LASIK showed good safeties, efficacies, predictabilities, and stabilities.

An Association Study between Various Adrenergic Alpha 2 Receptor Polymorphisms and Treatment Response to Mirtazapine in Major Depression

OBJECTIVES: Genetic differences may contribute to the inter-individual differences in treatment response to antidepressants among patients suffering from major depression. This study investigated a possible association of treatment response to mirtazapine with various adrenergic alpha 2 receptor polymorphisms in major depressive patients. METHODS: A 6-week naturalistic treatment study with a blinded outcome examined 84 Korean patients with major depression. Treatment response to mirtazapine was defined as > or =50% decrease in HAM-D scores at six weeks. In this study, four genetic polymorphisms were selected ; ADRA2A MspI, ADRA2A DraI, alpha2BDel301-303, and alpha2CDel322-325. RESULTS: The Del/Del genotype of alpha2CDel322-325 exhibited a significant association with response to mirtazapine through multiple logistic regression. ADRA2A DraI, alpha2BDel301-303, and alpha2CDel322-325 did not showed a significant association with response to mirtazapine. CONCLUSION: Based on the finding that alpha2CDel322-325 polymorphism had an association with the mirtazapine response, we postulate that the polymorphism related to the mechanism of the antidepressant effect is important in predicting the response to antidepressants.

An Association Study between Various Adrenergic Alpha 2 Receptor Polymorphisms and Treatment Response to Mirtazapine in Major Depression

OBJECTIVES: Genetic differences may contribute to the inter-individual differences in treatment response to antidepressants among patients suffering from major depression. This study investigated a possible association of treatment response to mirtazapine with various adrenergic alpha 2 receptor polymorphisms in major depressive patients. METHODS: A 6-week naturalistic treatment study with a blinded outcome examined 84 Korean patients with major depression. Treatment response to mirtazapine was defined as > or =50% decrease in HAM-D scores at six weeks. In this study, four genetic polymorphisms were selected ; ADRA2A MspI, ADRA2A DraI, alpha2BDel301-303, and alpha2CDel322-325. RESULTS: The Del/Del genotype of alpha2CDel322-325 exhibited a significant association with response to mirtazapine through multiple logistic regression. ADRA2A DraI, alpha2BDel301-303, and alpha2CDel322-325 did not showed a significant association with response to mirtazapine. CONCLUSION: Based on the finding that alpha2CDel322-325 polymorphism had an association with the mirtazapine response, we postulate that the polymorphism related to the mechanism of the antidepressant effect is important in predicting the response to antidepressants.

CREB-Phosphorylation as a Predictor of Therapeutic Response to Antidepressants

OBJECTIVES: CREB (c-AMP response element binding protein) is known as a key mediator of the therapeutic response to antidepressants. We investigated the change of CREB-phosphorylation (pCREB) at the early point of the fluoxetine treatment to find out it can be a predictor for antidepressant response. METHODS: We evaluated the pCREB of T - lymphocyte nuclear extracts from 18 depressed patients at 0 and 1th week during fluoxetine treatment (20 mg/day). Responders were defined as the > or = 50% reduction of HAM-D score in 4 weeks. We compared the changes of pCREB at 0 and 1th week between responders and non-responders. RESULTS: The responders showed a significant increase of pCREB at week 1 compared with week 0. The HAM-D difference between week 0 and 4 was positively correlated with the change of pCREB response. CONCLUSION: These results suggest that the early change of pCREB in peripheral lymphocyte can predict the later response of antidepressant. The correlation showed pCREB directly reflects a response status to the antidepressant fluoxetine and clinical improvement.

CREB-Phosphorylation as a Predictor of Therapeutic Response to Antidepressants

OBJECTIVES: CREB (c-AMP response element binding protein) is known as a key mediator of the therapeutic response to antidepressants. We investigated the change of CREB-phosphorylation (pCREB) at the early point of the fluoxetine treatment to find out it can be a predictor for antidepressant response. METHODS: We evaluated the pCREB of T - lymphocyte nuclear extracts from 18 depressed patients at 0 and 1th week during fluoxetine treatment (20 mg/day). Responders were defined as the > or = 50% reduction of HAM-D score in 4 weeks. We compared the changes of pCREB at 0 and 1th week between responders and non-responders. RESULTS: The responders showed a significant increase of pCREB at week 1 compared with week 0. The HAM-D difference between week 0 and 4 was positively correlated with the change of pCREB response. CONCLUSION: These results suggest that the early change of pCREB in peripheral lymphocyte can predict the later response of antidepressant. The correlation showed pCREB directly reflects a response status to the antidepressant fluoxetine and clinical improvement.

The Changes in Extraocular Muscles in Horner's Syndrome of Rats

PURPOSE: The aim of this study was to understand the pathogenesis of the enophthalmos of Horner's syndrome. METHODS: We performed right cervical sympathectomy in 10 Sprague-Dawley rats weighing 200~300 grams at 8 weeks of age. We obtained bilateral extraocular muscle and fat from all 10 rats. These tissues were observed under light and electron microscopy. RESULTS: After 8 weeks, ptosis and enophthalmos were seen in the right eye in all rats. We found no change bilateral fat, but the right extraocular muscle fibers had smaller diameters than the left. The right intermuscular distance was longer than the left upon light microscopy and the right extraocular muscle contained fewer and smaller mitochondria than the left extraocular muscle upon electron microscopy. CONCLUSIONS: Based on these results, it is believed that enophthalmos resulted from extraocular muscle atrophy that resulted from decreasing metabolism of mitochondria in Horner's syndrome. However, enophthalmos in Horner's syndrome requires more intensive study.

Analysis of RNFL Thickness and Optic Nerve Head Measured with OCT in Children

PURPOSE: To analyze peripapillary retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) parameters with regard to age in children by using optical coherence tomography (OCT). METHODS: We analyzed RNFL thickness and ONH parameters by using Stratus OCT Model 3000 (Zeiss-Humphrey) in two-hundred eyes of 100 children ranging in age from 5 to 14 years, with 5 males and 5 females for each age. RESULTS: The RNFL thicknesses for 100 children (200 eyes) in total were as follows: Mean 104.67+/-9.07 micrometer, superior 131.84+/-18.71 micrometer, temporal 78.49+/-12.91 micrometer, nasal 73.85+/-14.26 micrometer, and Inferior 133.87+/-18.58 micrometer. The parameters of ONH for 100 children (200 eyes) in total were as follows: optic disc area 2.80+/-0.21 mm2, rim area 1.85+/-0.28 mm2, cup to disc area ratio 0.34+/-0.08, horizontal cup to disc diameter ratio 0.47+/-0.11, and vertical cup to disc diameter ratio 0.49+/-0.11. In analyzed RNFL thickness and ONH according to age, there was a significant negative correlation among mean RNFL, inferior RNFL, and age (r=-0.258, p=0.000, r=-0.464, p=0.000). There was a significant positive correlation between nasal RNFL and age (r=0.135, p=0.028). There was a significant positive correlation between disc area and age (r=0.528, p=0.000). There was a significant negative correlation among the cup to disc area ratio, the horizontal cup to disc diameter ratio, the vertical cup to disc diameter ratio, and age (r=-0.170, p=0.008, r=-0.266, p=0.000, r=-0.155, p=0.014). CONCLUSIONS: OCT can be used to measure RNFL thickness and ONH parameters in children. Age had an effect on RNFL thickness and ONH parameters in children.

A Case of Bilateral Endogenous Enterococcus Faecalis Endophthalmitis in Liver Abscess

PURPOSE: To report a case of bilateral endogenous Enterococcus faecalis endophthalmitis in liver abscess. METHODS: The patient was transferred for bilateral endophthalmitis because she had decreased bilateral visual acuity for three days. We performed bilateral pars plana vitrectomy, lensectomy, and intravitreal antibiotic injection. We determined the presence of Enterococcus faecalis in vitreous culture and liver abscess using abdomen computerized tomography. RESULTS: Thirty-four days after the operation, she was discharged with both eyes with flat retina and filled with silicone oil. Her vision was poor. CONCLUSIONS: Bilateral endogenous Enterococcus faecalis endophthalmitis has rapid progression and a poor visual prognosis.

A Case of Bilateral Endogenous Enterococcus Faecalis Endophthalmitis in Liver Abscess

PURPOSE: To report a case of bilateral endogenous Enterococcus faecalis endophthalmitis in liver abscess. METHODS: The patient was transferred for bilateral endophthalmitis because she had decreased bilateral visual acuity for three days. We performed bilateral pars plana vitrectomy, lensectomy, and intravitreal antibiotic injection. We determined the presence of Enterococcus faecalis in vitreous culture and liver abscess using abdomen computerized tomography. RESULTS: Thirty-four days after the operation, she was discharged with both eyes with flat retina and filled with silicone oil. Her vision was poor. CONCLUSIONS: Bilateral endogenous Enterococcus faecalis endophthalmitis has rapid progression and a poor visual prognosis.