Divergent effects of lithium and sodium valproate on brain-derived neurotrophic factor (BDNF) production in human astrocytoma cells at therapeutic concentrations.

Mood stabilizers such as lithium (Li) or valproic acid (VPA) are used in the therapy of bipolar disorders, but the mechanisms by which these medicines work is unclear. Recently, neuroprotection has attracted attention as a potential action for VPA and Li. The close spatial relationship of the pre- and post-synapse with an astrocyte process within a 'tripartite synapse' suggests that mood stabilizer actions on astrocytes may be important. Therefore, we examined the effect of Li and VPA, at therapeutic concentrations, on brain-derived neurotrophic factor (BDNF) production in cultured human astrocytoma cells over an extended period of exposure. Released (extracellular) and intracellular BDNF was measured with sandwich-ELISA. Intracellular BDNF mRNA was also quantified using RT-PCR. VPA treatment potentiated the level of extracellular BDNF, whereas Li reduced it. Furthermore, VPA caused increased intracellular levels of BDNF protein and mRNA, while exposure to Li led to no significant differences compared to control cells. We suggest the possibility that VPA and Li have divergent effects on astrocyte BDNF production. Mood stabilizers play an essential role in regulating BDNF not only in neurons, but also in astrocytes. These findings could form the basis of a new astrocyte-targeted approach towards developing effective medications to treat bipolar disorders.

Effects of fluvoxamine on behavioral and psychological symptoms of dementia in Alzheimer's disease: a report of three cases.

OBJECTIVE: To report 3 cases of severe behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD) with fluvoxamine treatment and to discuss the treatment implications for use of the drug. CASE SUMMARY: An 83-year-old woman was diagnosed with AD. Before treatment, she showed sudden irritation and excitement. Her BEHAVE-AD score was 40. She was started on fluvoxamine and quetiapine. Eight weeks later, she was friendly and thankful towards the staff. Her BEHAVE-AD score was 10. The second case was a 79-year-old woman diagnosed with AD. Before treatment, she attempted to leave our hospital and wandered and shouted throughout the day. Her BEHAVE-AD score was 42. She was started on fluvoxamine, and the dosage was gradually increased. Eight weeks later, the shouting and excitement disappeared almost completely. Her BEHAVE-AD score was 13. The third case was a 79-year-old man diagnosed with AD. Before treatment, we put him in a private, locked room because he was extremely agitated and violent because of delusions. His BEHAVE-AD score was 42. He was started on fluvoxamine and sodium valproate. Eight weeks later, the delusion became mild and did not affect his mood or behavior. His BEHAVE-AD score at this point was 4. DISCUSSION: Fluvoxamine was effective in controlling BPSD with AD. This finding shows that the pathophysiology of BPSD due to AD may occur because of a hyposerotonergic state in the brain. CONCLUSION: These cases show that fluvoxamine appears to be effective in the control of BPSD with AD.

[Mycobacterium shinshuense isolated from cutaneous ulcer lesion of right lower extremity in a 37-year-old woman].

PURPOSE: Second clinical infection case of Mycobacterium shinshuense was presented, we tried the identification of M. shinshuense that is isolated from skin. OBJECT: Mycobacteria species isolated from cutaneous ulcer lesion of right lower extremity in a 37-year-old woman. METHOD: Identification by DNA-DNA Hybridization, 16S rRNA and rpoB method as genomic level and conventional method. RESULT: It did not grow on 1% Ogawa's slant medium at both 37 degrees C and 42 degrees C, but grew at 28 degrees C. It formed yellowish colonies in the dark. It was difficult to distinguish M. shinshuense from M. ulcerans and M. marinum by DNA-DNA hybridization (DDH) and DNA sequencing. To identify that it is M. shinshuense, growth rate, temperature range of mycobacterial growth, light coloration reaction, biochemical and biological tests, and drug susceptibility testing were further explored. Finally it was identified as M. shinshuense based on these CONSIDERATION: For Mycobacteria species which grow 2 weeks after inoculation at 28 degrees C, and which is identified as M. marinum by DDH method, it is necessary to identify with sequence and conventional method.

Influence of mandibular residual ridge shape on masticatory efficiency in complete denture wearers.

PURPOSE: The purpose of this study was to investigate the influence of mandibular residual ridge shape on masticatory efficiency in complete denture wearers. MATERIALS AND METHODS: Twenty-eight complete denture wearers (mean age 75.6 years, SD 4.8) who received their complete denture treatment by one of the authors and had no troubles in daily use were selected. The mandibular residual ridge was evaluated by using a replica of the ridge obtained with heavy-body silicone impression material. The basal area of the replica was measured by a digitizer. The volume and the height of the replica were calculated. Masticatory efficiency in each subject was measured by the sieving method. RESULTS: There was a significant correlation between the masticatory efficiency and basal area, volume, and height of the residual ridge. The basal area showed the strongest correlation. CONCLUSION: The basal area of the denture foundation greatly influenced the masticatory efficiency, suggesting that the masticatory efficiency in complete denture wearers was limited by their own residual ridges and that clinicians should inform their patients about the limitation of the recovery of masticatory ability before the beginning of denture treatment.