RESUMO
We evaluated the circadian phenotypes of patients with delayed sleep-wake phase disorder (DSWPD) and non-24-hour sleep-wake rhythm disorder (N24SWD), two different circadian rhythm sleep disorders (CRSDs) by measuring clock gene expression rhythms in fibroblast cells derived from individual patients. Bmal1-luciferase (Bmal1-luc) expression rhythms were measured in the primary fibroblast cells derived from skin biopsy samples of patients with DSWPD and N24SWD, as well as control subjects. The period length of the Bmal1-luc rhythm (in vitro period) was distributed normally and was 22.80±0.47 (mean±s.d.) h in control-derived fibroblasts. The in vitro periods in DSWPD-derived fibroblasts and N24SWD-derived fibroblasts were 22.67±0.67 h and 23.18±0.70 h, respectively. The N24SWD group showed a significantly longer in vitro period than did the control or DSWPD group. Furthermore, in vitro period was associated with response to chronotherapy in the N24SWD group. Longer in vitro periods were observed in the non-responders (mean±s.d.: 23.59±0.89 h) compared with the responders (mean±s.d.: 22.97±0.47 h) in the N24SWD group. Our results indicate that prolonged circadian periods contribute to the onset and poor treatment outcome of N24SWD. In vitro rhythm assays could be useful for predicting circadian phenotypes and clinical prognosis in patients with CRSDs.
Assuntos
Ritmo Circadiano/genética , Fibroblastos/metabolismo , Transtornos do Sono do Ritmo Circadiano/genética , Transtornos do Sono-Vigília/metabolismo , Fatores de Transcrição ARNTL/metabolismo , Adulto , Cronoterapia/métodos , Ritmo Circadiano/fisiologia , Feminino , Humanos , Japão/epidemiologia , Luciferases/metabolismo , Masculino , Pessoa de Meia-Idade , Fenótipo , Transtornos do Sono do Ritmo Circadiano/fisiopatologia , Transtornos do Sono do Ritmo Circadiano/terapia , Transtornos do Sono-Vigília/terapia , Resultado do TratamentoAssuntos
Artrite Reumatoide/tratamento farmacológico , Imunossupressores/efeitos adversos , Mononucleose Infecciosa/induzido quimicamente , Metotrexato/efeitos adversos , Idoso , Medula Óssea/patologia , DNA Viral/análise , Diagnóstico Diferencial , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Seguimentos , Herpesvirus Humano 4/genética , Humanos , Imunossupressores/administração & dosagem , Mononucleose Infecciosa/diagnóstico , Mononucleose Infecciosa/virologia , Metotrexato/administração & dosagem , Reação em Cadeia da Polimerase , Tomografia Computadorizada por Raios XAssuntos
Leucemia-Linfoma de Células T do Adulto/genética , Mutação , Receptores de Superfície Celular/genética , Fatores de Transcrição/genética , Adolescente , Adulto , Idoso , Criança , Humanos , Leucemia-Linfoma de Células T do Adulto/diagnóstico , Leucemia-Linfoma de Células T do Adulto/metabolismo , Pessoa de Meia-Idade , Proteínas Nucleares/genética , Fragmentos de Peptídeos , Reação em Cadeia da Polimerase , Polimorfismo de Nucleotídeo Único , Receptor Notch1 , Deleção de SequênciaRESUMO
Total sensory loss, ptosis, ocular muscle palsy and pupil dilatation were noted after alcohol injection into mandibular nerve for idiopathic trigeminal neuralgia (in the right 2. and 3. division). The diagnosis was made that the injected alcohol induced the Gasserian palsy and oculomotor palsy. The oculomotor palsy was fully recovered except slight pupil dilatation after four months. The mechanism and prophylaxis of these complications are discussed.
Assuntos
Etanol/efeitos adversos , Nervo Mandibular , Bloqueio Nervoso/efeitos adversos , Oftalmoplegia/induzido quimicamente , Paralisia/induzido quimicamente , Gânglio Trigeminal/efeitos dos fármacos , Nervo Trigêmeo/efeitos dos fármacos , Idoso , Blefaroptose/induzido quimicamente , Humanos , Pessoa de Meia-Idade , Pupila/efeitos dos fármacos , Neuralgia do Trigêmeo/terapiaAssuntos
Nefrite/mortalidade , Nefrose/mortalidade , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Japão , Masculino , Pessoa de Meia-Idade , Fatores SexuaisAssuntos
Neoplasias/mortalidade , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Métodos Epidemiológicos , Feminino , Humanos , Lactente , Japão , Masculino , Pessoa de Meia-Idade , Fatores SexuaisRESUMO
The first pain clinic in Japan was organized and operated by anesthesiologists at the University of Tokyo. Today, many universities and large hospitals have set up pain clinics in their anesthetics department and have made great progress in the management of diseases in this filed. Almost all those institutions use oriental methods like acupuncture, ryodoraku and kyo in addition to standard methods. At our pain clinic, nerve block has been the sole method from the beginning. Neither drugs (except carbamazepine, imipramine and ergotamine) nor oriental methods have been used. The pain clinic ought to be separated from the anesthetics department and operated independently, having its own wards.
