RESUMEN
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.
Asunto(s)
Ritmo Circadiano/genética , Fibroblastos/metabolismo , Trastornos del Sueño del Ritmo Circadiano/genética , Trastornos del Sueño-Vigilia/metabolismo , Factores de Transcripción ARNTL/metabolismo , Adulto , Cronoterapia/métodos , Ritmo Circadiano/fisiología , Femenino , Humanos , Japón/epidemiología , Luciferasas/metabolismo , Masculino , Persona de Mediana Edad , Fenotipo , Trastornos del Sueño del Ritmo Circadiano/fisiopatología , Trastornos del Sueño del Ritmo Circadiano/terapia , Trastornos del Sueño-Vigilia/terapia , Resultado del TratamientoAsunto(s)
Artritis Reumatoide/tratamiento farmacológico , Inmunosupresores/efectos adversos , Mononucleosis Infecciosa/inducido químicamente , Metotrexato/efectos adversos , Anciano , Médula Ósea/patología , ADN Viral/análisis , Diagnóstico Diferencial , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Femenino , Estudios de Seguimiento , Herpesvirus Humano 4/genética , Humanos , Inmunosupresores/administración & dosificación , Mononucleosis Infecciosa/diagnóstico , Mononucleosis Infecciosa/virología , Metotrexato/administración & dosificación , Reacción en Cadena de la Polimerasa , Tomografía Computarizada por Rayos XAsunto(s)
Leucemia-Linfoma de Células T del Adulto/genética , Mutación , Receptores de Superficie Celular/genética , Factores de Transcripción/genética , Adolescente , Adulto , Anciano , Niño , Humanos , Leucemia-Linfoma de Células T del Adulto/diagnóstico , Leucemia-Linfoma de Células T del Adulto/metabolismo , Persona de Mediana Edad , Proteínas Nucleares/genética , Fragmentos de Péptidos , Reacción en Cadena de la Polimerasa , Polimorfismo de Nucleótido Simple , Receptor Notch1 , Eliminación de SecuenciaRESUMEN
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.
Asunto(s)
Etanol/efectos adversos , Nervio Mandibular , Bloqueo Nervioso/efectos adversos , Oftalmoplejía/inducido químicamente , Parálisis/inducido químicamente , Ganglio del Trigémino/efectos de los fármacos , Nervio Trigémino/efectos de los fármacos , Anciano , Blefaroptosis/inducido químicamente , Humanos , Persona de Mediana Edad , Pupila/efectos de los fármacos , Neuralgia del Trigémino/terapiaAsunto(s)
Nefritis/mortalidad , Nefrosis/mortalidad , Adolescente , Adulto , Factores de Edad , Anciano , Niño , Preescolar , Femenino , Humanos , Lactante , Japón , Masculino , Persona de Mediana Edad , Factores SexualesAsunto(s)
Neoplasias/mortalidad , Adolescente , Adulto , Factores de Edad , Anciano , Niño , Preescolar , Métodos Epidemiológicos , Femenino , Humanos , Lactante , Japón , Masculino , Persona de Mediana Edad , Factores SexualesRESUMEN
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.