Testosterone effects on pain and brain activation patterns.

BACKGROUND: This study investigated whether pain and pain-related unpleasantness ratings were altered by blood testosterone levels. We also investigated whether activation of brain regions that represent pain intensity [primary somatosensory cortex (S1)] and pain-related unpleasantness [perigenual ACC (pACC) and orbitofrontal cortex (OFC)] were affected by blood testosterone levels. METHODS: Twenty-six healthy men were recruited. Blood testosterone levels were measured before fMRI scanning. The participants were classified into two groups (high vs. low testosterone) according to their blood testosterone level (each group n = 13). The middle finger was immersed in a 50°C water bath (50°C, 30 s, five times) to induce identical noxious stimulation in all participants. RESULTS: The low testosterone group showed statistically significantly higher pain (P = 0.047), unpleasantness (P = 0.047), anxiety (P = 0.015), and fear ratings (P = 0.01) than the high testosterone group. Fear rating increased as pain rating rose and as testosterone level decreased (P < 0.001). When participants received noxious stimulation, the pACC and OFC were more highly activated in the low testosterone group compared to the high testosterone group. Activation of S1, a region related to pain intensity, did not differ between both groups. CONCLUSION: Compared to the high testosterone group, the low testosterone group had significant activation in the pACC and OFC, regions that represent pain-related unpleasantness, but not in S1 that represents pain intensity, leading to higher pain ratings. These findings emphasize the importance of considering the effects of testosterone levels when treating patients.

Molecular detection by analysis of the 16S rRNA gene of fecal coliform bacteria from the two Korean Apodemus species (Apodemus agrarius and A. peninsulae).

Wild mouse feces can disseminate zoonotic microorganisms throughout a farm, which is a great threat to human health and can lead to economic loss through contaminated agricultural produce. To assess the microbial communities, especially fecal coliform bacteria, we used two methods. First, we isolated bacterial colonies onto the common media LB (lactose broth) agar, TSA (tryptic soy agar), and MRS (de Man, Rogosa, and Sharpe) agar, and then randomly select colonies from each plate and stocked them to the mother plate for genomic DNA isolation. Second, we analyzed bacterial colonies using the 16S rRNA gene molecular diagnostic method. Based on bacterial cultures and bacterial 16S rRNA gene markers, we detected four different bacterial species (Bacillus amyloliquefaciens, Escherichia coli, Staphylococcus xylosus, and Serratia liquefaciens) from fecal coliforms of the striped field mouse Apodemus agrarius and A. peninsulae in agricultural areas in South Korea. These results could help us to better understand the pathogen reservoirs of mice and initiate some preventive measures to mitigate the microbial risks associated with mouse fecal matter in agricultural production areas.

Complete mitochondrial genome and codon usage of the Nepalese whiskered bat Myotis muricola (Vespertilionidae).

We sequenced and characterized the complete mitogenome of the Nepalese whiskered bat Myotis muricola (Vespertilionidae) to provide more data for comparative mitogenomics and codon usage in the genus Myotis (Vespertilionidae). The mitogenome of M. muricola is a circular molecule of 17,224 bp, consisting of a control region and a conserved set of 37 genes containing 13 protein-coding genes (PCGs), 22 tRNA genes, and two rRNA genes (12S rRNA and 16S rRNA). The mitogenome of M. muricola is AT-biased, with a nucleotide composition of 33.6% A, 29.7% T, 23.3% C, and 13.4% G. The total length of the 13 mitochondrial PCGs, excluding stop codons, is 11,376 bp, or 3792 amino acids. The relative synonymous codon usage (RSCU) of codons ending in A/T was generally higher than that for codons ending in G/C. The most frequently used codons are CTA(Leu) and CGA(Arg), with RSCU values greater than 2.0. The most rarely used codons, all terminating in G, are TCG(Ser), CCG(Pro), GCG(Ala), AAG(Lys), TGG(Try), CGG(Arg), and ACG(Thr), with RSCU values below 0.2. TCG(Ser) occurs only five times, and has the lowest RSCU value (0.091). These results are valuable for a better understanding of the molecular evolution of mitogenomes in the genus Myotis.

Incidence of intravascular injection and the spread of contrast media during S1 transforaminal epidural steroid injection by two approaches: anteroposterior vs oblique.

The aim of this randomised study was to compare the incidence of intravascular injections during S1 transforaminal epidural steroid injection performed in the anteroposterior and oblique views. We also compared epidural spread patterns of contrast media, which included 201 injections at the S1 level. The overall incidence of intravascular injection during S1 transforaminal epidural steroid injection in the anteroposterior view was 29% (29/99), significantly higher than in the oblique view (11%, 11/102, p = 0.001). There were no significant differences between the two groups for epidural spread of contrast media in cases where intravascular injections did not occur (p = 0.77). Performing S1 transforaminal epidural steroid injection in the oblique view rather than the anteroposterior view reduces the risk of intravascular injections.

Evaluation of anatomic landmarks for axillary nerve block in the quadrilateral space.

BACKGROUND: Axillary nerve block (ANB) was recently introduced along with suprascapular nerve block as an alternative to inter-scalene brachial plexus block for post-operative pain control. However, the methods for performing ANB are variable. We studied the relationship between surface anatomy and the location of the axillary nerve in the quadrilateral space to ensure a technically safe and simple ANB. METHODS: Eighty-eight shoulders were included. All measurements were performed with the subjects seated and the shoulders in a neutral position. We located the posterior circumflex humeral artery (PCHA) using a vascular Doppler system and named this point 'AN'. We used this point to locate the axillary nerve, since this nerve is generally present with the PCHA in the quadrilateral space. We then examined the relationship between surface anatomic landmarks and AN. The depth of the medial side of the humerus at the AN (AN depth), which is at the lateral border of the quadrilateral space, was measured using ultrasonography. RESULTS: AN was located on the line between the posterolateral corner of the acromion (Ac) and the axillary fold (Axf) (Ac-Axf) in 77% of shoulders. The ratio of the distance from Ac to AN (Ac-AN) to Ac-Axf in all shoulders was 0.6 [standard deviation (SD), 0.1]. AN depth was 4.0 (SD, 0.5) cm in men and 3.6 (SD, 0.4) cm in women. CONCLUSION: Knowledge of the relationship between surface anatomy and AN, as well as estimated AN depth may aid in locating the axillary nerve in the quadrilateral space.

Suction-curettage with combination of two different cannulae in the treatment of axillary osmidrosis and hyperhidrosis.

OBJECTIVE: To investigate the efficacy and safety of suction-curettage with a combination of two different cannulae for treatment of axillary osmidrosis and hyperhidrosis. DESIGN: Retrospective analysis of patients who underwent surgery from September 2004 to September 2006. SETTING: Outpatient clinic for hyperhidrosis at a university-affiliated hospital. SUBJECTS: Sixty-five patients who were treated for axillary malodor and hyperhidrosis. INTERVENTIONS: Patients were sequentially treated with Fatemi and Cassio cannulae. MAIN OUTCOME MEASURES: Demographic data, severity data (assessment of malodor), degree of satisfaction, sweating, hair growth, scarring, recurrence and complications. RESULTS: Sixty of the 65 patients (96.9%) had excellent to fair results, and only 2 patients (3.1%) had poor results. Complications occurred in 4 patients (6.2%). Recurrence occurred in 3 patients (4.6%). CONCLUSIONS: This simplified and inexpensive method resulted in a high success rate with low complications and high satisfaction with minimal scarring and rapid recovery.

Topical glycopyrrolate for patients with facial hyperhidrosis.

BACKGROUND: Facial hyperhidrosis may negatively impact the quality of life. Although various conservative modalities have been suggested, the condition is not often treated successfully. OBJECTIVES: To examine whether topical glycopyrrolate could be an effective and safe treatment for facial hyperhidrosis. METHODS: Twenty-five patients with facial hyperhidrosis were enrolled and treated with 2% topical glycopyrrolate on one half of the forehead while the other half of the forehead was treated with a placebo. RESULTS: The sweat production rate of the half of the forehead treated with topical glycopyrrolate was significantly reduced to 37.6+/-2.8 mg min(-1) (mean+/-SEM) compared with 102.2+/-5.5 mg min(-1) at the placebo-treated half of the forehead (P<0.001). Patients evaluated their degree of anhidrosis as excellent in six (24%) patients, good in 16 (64%), fair in two (8%) and poor in one (4%). Twenty-four patients (96%) were partially or fully satisfied with their fair to excellent anhidrosis; only one patient (who developed a transient headache after treatment) was dissatisfied with its therapeutic effect. Only seven patients (28%) experienced recurrence within 1 day while 17 patients (68%) had recurrence within 2 days. One patient (4%) remained stable for up to 4 days. CONCLUSIONS: Topical glycopyrrolate application appears to be effective and safe for the treatment of excessive facial sweating in primary craniofacial and secondary gustatory hyperhidrosis following sympathectomy.

Layer-by-layer assembly of zeolite crystals on glass with polyelectrolytes as ionic linkers.

ZSM-5 crystals and glass plates tethered with trimethylpropylammonium iodide and sodium butyrate, respectively, (denoted as Z+, Z-, G+, and G-, respectively) were prepared. Treatment of G- with Z+ suspended in ethanol results in monolayer assembly of Z+ on G- (G-/Z+) with high surface coverage. The zeolite crystals have a strong tendency to closely pack and align with the b-axis normal to the glass plate, despite large positive zeta potentials. Subsequent treatment of G-/Z+ with Z- leads to second-layer assembly of Z- on G-/Z+ (G-/Z+/Z-), but with rather poor coverage. Sequential treatment of G+ with poly(sodium 4-styrenesulfonate)(Na+PSS-), poly(diallyldimethylammonium chloride) (PDDA+Cl-), and Na+PSS- followed by Z+ yields glass plates assembled with monolayers of Z+ with very high surface coverage through the composite polyelectrolyte linkers (G+/PSS-/PDDA+/PSS-/Z+). The zeolite crystals also have a strong tendency to closely pack and align with the b-axis perpendicular to the substrate plane. The binding strength between the zeolite crystals and glass plates is much higher in G+/PSS-/PDDA+/PSS-/Z+ than in G-/Z+. Repetition of the sequential PSS-/PDDA+/PSS-/Z+ layering for five cycles yields glass plates assembled with pentalayers of ZSM-5 crystals [G+/(PSS-/PDDA+/PSS-/Z+)(5)]. The observed degrees of coverage and alignment of zeolite crystals in each layer were very high up to the third layers despite the nonuniformity of the sizes and shapes of the zeolite crystals used in this study. This report thus demonstrates the feasibility of layer-by-layer assembly of micrometer-sized zeolite crystals on glass through electrostatic interaction between surface-bound, full-fledged ionic centers, especially by use of polyelectrolyes as the linkers.

Iodide-to-cation charge-transfer bands as a novel probe for evaluation of actual acceptor strengths of cations in zeolites and cation-dependent pore volume change.

Iodide-to-cation charge-transfer (ITC-CT) bands have been measured for the first time in zeolites X and Y exchanged with a series of alkali metal ions and the results show that the ITC-CT band progressively red shifts with increasing the size and the number of site III cations in the supercage, which indicates that the actual acceptor strength of the cation toward iodide increases with increasing the degree of protrusion of the cation into supercages and the number of cations, and overall, with decrease in supercage volume.

The effects of epidural blockade on the acute pain in herpes zoster.

OBJECTIVE: To evaluate the relief of acute pain and possible preventive effects on postherpetic neuralgia through the use of an epidural blockade in the acute stage of herpes zoster. DESIGN: Prospective, nonrandomized, comparative clinical trial. SETTING: A dermatologic clinic in a university hospital. PATIENTS: Sixty-five consecutive patients with pain due to acute herpes zoster were treated for a 7-day hospitalization period from July 1, 1996, through June 30, 1997. INTERVENTION: The consecutive patients were divided into 2 groups. Group A consisted of 30 patients who were seen from July 1, 1996, through December 31, 1996, and who were treated with intravenous acyclovir (5 mg/kg) for 7 days. Group B consisted of 35 patients who were seen from January 1, 1997, through June 30, 1997, and who were treated with intravenous acyclovir (5 mg/kg) and an epidural blockade for 7 days. The changes in the intensity of pain and the total duration of pain in both groups were assessed for 12 to 18 months. MAIN OUTCOME MEASURES: The number of days required for relief of pain and the total duration of pain. RESULTS: The mean +/- SD number of days required for relief of pain, which was rated on a scale of 100 (worst pain) to 0 (no pain), was significantly fewer in group B than in group A: it took 2.6 +/- 1.1 days to go from 100 to 50 on the relief-of-pain scale in group B, but 3.8 +/- 1.1 days in group A (P = .03), and 12.5 +/- 6.4 days to go from 100 to 10 in group B, but 20.1 +/- 14.6 days in group A (P = .04). The duration of late residual pain was significantly shorter in group B (5.9 +/- 5.8 days) than in group A (11.9 +/- 7.5 days) (P = .03). The total duration of pain was also significantly shorter in group B (18.5 +/- 9.3 days) than in group A (31.6 +/- 17.6 days) (P = .04). CONCLUSIONS: We believe that an epidural blockade combined with an antiviral agent is a very effective treatment modality for the pain of acute herpes zoster, and we recommend its use for the prevention of postherpetic neuralgia, with a view to shortening the total duration of pain, especially late residual pain.

Long-term outcome of percutaneous thermocoagulation for trigeminal neuralgia.

A retrospective analysis of long-term efficacy of percutaneous radiofrequency thermocoagulation of the trigeminal ganglion or root for the relief of trigeminal neuralgia was carried out in our unit. From the medical records and questionnaires, outcomes of 108 procedures performed in 81 patients from January 1986 to December 1990 were obtained with a follow-up period of 6-11 years. The initial success rate was 87% and the probability of remaining pain-free 1, 2 and 11 years after the procedure was 65, 49 and 26%, respectively. Patients with typical symptoms had a better long-term efficacy than those with atypical presentations, and patients who had not undergone a previous surgical procedure also had a better outcome. There was no mortality in this series. Common adverse effects included dysaesthesia in 20 patients, corneal numbness in 12 patients and masseter weakness in three patients.

Presence of emerinopathy in cases of rigid spine syndrome.

Rigid spine syndrome (RSS) shows clinical similarities to Emery-Dreifuss muscular dystrophy (EDMD). Differential diagnosis between EDMD and RSS is essential because EDMD is often associated with life-threatening cardiomyopathy that can be cured by an implantation of a cardiac pacemaker. To determine if any of the patients with RSS had mutations of the emerin gene (responsible gene for X-linked EDMD or emerinopathy), we screened the patients for mutations. We found seven patients with a clinical picture consistent with RSS in the 6500 diagnostic muscle biopsies in our National Center over the last 19 years. We identified a novel mutation in the gene (1-bp frame-shift deletion in the exon 1) in one of the seven patients with RSS. This mutation created a premature termination at codon 12 and was expected to produce a severely truncated emerin. Emerin was not detected in the skeletal muscle. The unaffected mother of the patient was a heterozygous carrier for the mutation. The remaining six patients with RSS had no mutation in the gene and showed normal expression of emerin in the skeletal muscle. Our results emphasize the presence of clinical overlap between possible RSS and EDMD, and reinforce the necessity of molecular genetic diagnosis of emerin to exclude emerinopathy in a patient population that has a clinical diagnosis of RSS.

Autoimmune progesterone dermatitis.

A 35-year-old woman had recurrent urticarial erythemas on her trunk and extremities for 3 years. The eruptions appeared regularly 3 to 5 days prior to menstruation and persisted for several days. The patient showed a positive skin test response to progesterone and had circulating antiprogesterone IgG antibodies. A speculative concept of the possible autoimmune damage to the ovary, the major organ producing progesterone, is discussed.