BACKGROUND & AIMS: :We are reporting a case of pyrethroid poisoning with atypical presentation in a 21-month-old toddler who was transferred to us from a peripheral center. Signs and symptoms at presentation were predominantly of cardiopulmonary dysfunction contrary to more common presenting features of gastrointestinal and neurological impairment. The reason for this seems to be the aspiration pneumonitis as a consequence of vomiting induced by parents at home, rather than the toxin itself even though a rather rapid progression of lung injury does not rule out the possibility. He had developed decreased level of consciousness and increased work of breathing after ingestion, which had progressed to Acute Respiratory Distress Syndrome, septic shock, and multi organ failure. He even had a brief cardiac arrest with Return of Spontaneous Circulation after 5 min of cardiopulmonary resuscitation, immediately after arrival at our unit, which seemed more likely to be a consequence of inappropriate management during transfer of the child. In addition to antibiotics and vasopressors, he required high frequency oscillatory ventilation and prone positioning initially, and lung-protective conventional ventilation later. His cardiopulmonary status improved gradually and he was successfully extubated after 12 days. Other organ systems also showed complete recovery. Even though Magnetic Resonance Imaging of brain done a few days after cardiac arrest showed features suggestive of hypoxic-ischemic encephalopathy he showed complete neurological recovery. He was thriving well at three-month follow-up with no neurological deficits, good exercise tolerance, and normal renal and liver function. Atypical presentation of pyrethroid poisoning is associated with significant morbidities and there seems to no reliable parameters in children to identify the risk of the same. Considering that there is no specific antidote, prompt, and aggressive supportive therapy is necessary for a favorable outcome. This case highlights several important aspects in the care of the pediatric patient after ingestion of insecticides. First, attempt to induce emesis, especially outside of a healthcare facility is not only ineffective but also highly dangerous, and should not be done. Second, unstable patients require inter and intrahospital transfer by experienced and trained personnel; and lastly, management for these complex and atypical cases should be done as early as possible in a center which is equipped to provide high level of circulatory and ventilatory support while prioritizing neuro-protective measures, and neurologic recovery and rehabilitation.

背景与目标： : 我们报告了一名21个月大的小孩从外围中心转移到我们的拟除虫菊酯中毒，表现不典型。表现时的体征和症状主要是心肺功能障碍，与胃肠道和神经功能障碍的更常见表现特征相反。造成这种情况的原因似乎是由于父母在家中呕吐而引起的吸入性肺炎，而不是毒素本身，尽管肺损伤的快速发展并不排除这种可能性。摄入后，他的意识水平下降，呼吸工作增加，并发展为急性呼吸窘迫综合征，败血性休克和多器官衰竭。在到达我们的单位后，他甚至在心肺复苏5分钟后立即出现了短暂的心脏骤停，并恢复了自发循环，这似乎更可能是在儿童转移过程中管理不当的结果。除抗生素和血管升压药外，他最初需要高频振荡通气和俯卧位，后来需要肺保护性常规通气。他的心肺状况逐渐改善，并在12天后成功拔管。其他器官系统也显示出完全恢复。即使在心脏骤停后几天进行的脑部磁共振成像显示出提示缺氧缺血性脑病的特征，他仍显示出完全的神经功能恢复。他在三个月的随访中表现良好，没有神经功能缺损，运动耐受性良好，肾脏和肝脏功能正常。拟除虫菊酯中毒的非典型表现与严重的发病率有关，在儿童中似乎没有可靠的参数来确定同样的风险。考虑到没有特定的解毒剂，需要及时和积极的支持治疗才能获得良好的结果。该病例突出了摄入杀虫剂后儿科患者护理中的几个重要方面。首先，试图诱发呕吐，尤其是在医疗机构之外，不仅无效，而且非常危险，不应这样做。其次，不稳定的患者需要由经验丰富和训练有素的人员进行院内转移; 最后，应对这些复杂和非典型病例的管理应尽早在一个中心进行，该中心应提供高水平的循环和通气支持，同时优先考虑神经保护措施以及神经系统恢复和康复。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: OBJECTIVES:This study evaluated changes in cardiometabolic monitoring for children and adolescents who were prescribed an antipsychotic medication in a state mental health system before and after a quality improvement intervention. METHODS:The intervention included education for prescribers, auditing on metabolic monitoring, and feedback to mental health center leaders regarding their monitoring. Research staff extracted yearly data on cardiometabolic monitoring from randomly selected community mental health center records before and after the intervention. Pre- and postintervention changes in monitoring were assessed with chi-squared tests. RESULTS:Evidence of past year monitoring increased: for glucose 18.9%-42.1% (χ2 = 6.75, p < 0.001), for triglycerides 13.5%-31.0% (χ2 = 4.54, p = 0.033), for cholesterol 13.5%-33.1% (χ2 = 5.48, p = 0.019), and for weight 67.6%-84.1% (χ2 = 5.21, p = 0.022). Rates of monitoring for blood pressure and waist circumference increased but not significantly. In both years studied, weight was obtained most frequently and waist circumference was obtained least frequently. CONCLUSIONS:Monitoring rates significantly improved for four out of six parameters evaluated, but overall monitoring rates remained low at the end of the study period. Prescriber education with audit and feedback may improve cardiometabolic monitoring rates, but research is needed to evaluate barriers to monitoring in children.

背景与目标：

BACKGROUND & AIMS: :Protozoan parasites represent major public health challenges. Many aspects of their cell biology are distinct from their animal hosts, providing potential therapeutic targets. Toxoplasma gondii is a protozoan parasite that contains a divergent regulator of chromosome condensation 1 (TgRCC1) that is required for virulence and efficient nuclear trafficking. RCC1 proteins function as a guanine exchange factor for Ras-related nuclear protein (Ran), an abundant GTPase responsible for the majority of nucleocytoplasmic transport. Here we show that while there are dramatic differences from well-conserved RCC1 proteins, TgRCC1 associates with chromatin, interacts with Ran and complements a mammalian temperature-sensitive RCC1 mutant cell line. During the investigation of TgRCC1, we observed several unprecedented phenotypes for TgRan, despite a high level of sequence conservation. The cellular distribution of TgRan is found throughout the parasite cell, whereas Ran in late branching eukaryotes is predominantly nuclear. Additionally, T. gondii tolerates at least low-level expression of dominant lethal Ran mutants. Wild type parasites expressing dominant negative TgRan grew similarly to wild type in standard tissue culture conditions, but were attenuated in serum-starved host cells and mice. These growth characteristics paralleled the TgRCC1 mutant and highlight the importance of the nuclear transport pathway for virulence of eukaryotic pathogens.

背景与目标： : 原生动物寄生虫是主要的公共卫生挑战。他们的细胞生物学的许多方面与他们的动物宿主不同，提供了潜在的治疗靶标。弓形虫是一种原生动物寄生虫，含有一种不同的染色体凝聚调节剂1 (TgRCC1)，这是毒力和有效核贩运所必需的。RCC1蛋白是Ras相关核蛋白 (Ran) 的鸟嘌呤交换因子，Ras相关核蛋白是一种丰富的GTPase，负责大部分核质转运。在这里，我们表明，尽管保守的RCC1蛋白存在显着差异，但TgRCC1与染色质缔合，与Ran相互作用并补充哺乳动物温度敏感的RCC1突变细胞系。在TgRCC1的研究过程中，尽管序列保守性很高，但我们观察到了TgRan的几种前所未有的表型。在整个寄生虫细胞中发现了TgRan的细胞分布，而在晚期分支真核生物中Ran主要是核的。此外，弓形虫至少可以耐受显性致死Ran突变体的低水平表达。在标准组织培养条件下，表达显性负TgRan的野生型寄生虫的生长与野生型相似，但在血清饥饿的宿主细胞和小鼠中减弱。这些生长特征与TgRCC1突变体平行，并强调了核转运途径对真核病原体毒力的重要性。

BACKGROUND & AIMS: :We present a new case of a primary carcinoid tumour of the skin. The mitotic index (4/10 HPF) warrants classification of this case as atypical. The patient was a 58-year-old woman with a 1-year history of a mass on the scalp. Literature review showed this to be only the seventh case of primary carcinoid tumour of the skin. Importantly, the evolution has been favourable in all seven tumours, with a mean follow-up of 2.5 years for the previous six cases. Although the number of cases is too small to draw definitive conclusions, information to date suggests that this type of tumour can be expected to have a benign behaviour, despite the presence in some cases of criteria suggestive of uncertainty, such as the presence of mitosis.

背景与目标： : 我们提出了一个新的皮肤原发性类癌肿瘤病例。有丝分裂指数 (4/10 HPF) 保证将这种情况归类为非典型。该患者是一名58岁的女性，有1年的头皮肿块病史。文献综述显示，这仅是皮肤原发性类癌的第七例。重要的是，所有七个肿瘤的演变都是有利的，前六个病例的平均随访时间为2.5年。尽管病例数量太少，无法得出明确的结论，但迄今为止的信息表明，尽管在某些情况下存在暗示不确定性的标准，例如存在有丝分裂。

BACKGROUND & AIMS: :The differences among MRI findings were studied in schizophrenic psychoses. The schizophrenics and atypical psychotics had significant reductions in bilateral hippocampal volumes compared to controls, but the two patient groups did not differ from each other. As for ventricle volume, the schizophrenics showed significantly larger temporal horns and third ventricle than normal controls, whereas atypical psychotics did not. Moreover, the left temporal horn in the schizophrenics was significantly larger than that seen in the atypical psychotics. By cluster analysis, schizophrenics and atypical psychotics were found to have a tendency to be distributed in different groups. These results might be considered to support the classification of schizophrenic psychoses into schizophrenia and atypical psychoses.

背景与目标： : 研究了精神分裂症精神病患者MRI表现之间的差异。与对照组相比，精神分裂症患者和非典型精神病患者的双侧海马体积显着减少，但两个患者组之间没有差异。至于心室体积，精神分裂症患者的颞角和第三心室明显大于正常对照组，而非典型精神病患者则没有。此外，精神分裂症患者的左颞角明显大于非典型精神病患者的左颞角。通过聚类分析，发现精神分裂症和非典型精神病患者有分布在不同群体中的趋势。这些结果可能被认为支持将精神分裂症精神病分为精神分裂症和非典型精神病。

BACKGROUND & AIMS: BACKGROUND:Parkinson's disease (PD) and atypical parkinsonisms (APD) have overlapping symptoms challenging an early diagnosis. Diagnostic accuracy is important because PD and APD have different prognosis and response to treatment. We aimed to identify diagnostic inflammatory biomarkers of PD and APD in cerebrospinal fluid (CSF) using the multiplex proximity extension assay (PEA) technology and to study possible correlations of biomarkers with disease progression. METHODS:CSF from a longitudinal cohort study consisting of PD and APD patients (PD, n = 44; multiple system atrophy (MSA), n = 14; vascular parkinsonism (VaP), n = 9; and PD with VaP, n = 7) and controls (n = 25) were analyzed. RESULTS:Concentrations of CCL28 were elevated in PD compared to controls (p = 0.0001). Five other biomarkers differentiated both MSA and PD from controls (p < 0.05) and 10 biomarkers differentiated MSA from controls, of which two proteins, i.e. beta nerve growth factor (β-NGF) and Delta and Notch like epidermal growth factor-related receptor (DNER), were also present at lower levels in MSA compared to PD (both p = 0.032). Two biomarkers (MCP-1 and MMP-10) positively correlated with PD progression (rho > 0.650; p < 0.01). CONCLUSIONS:PEA technique identified potential new CSF biomarkers to help to predict the prognosis of PD. Also, we identified new candidate biomarkers to distinguish MSA from PD.

背景与目标：

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :The ability to induce several cytokines relevant to tuberculosis (TNF-α, IL-1β, IL-6, IL-12p40 and IL-23) by cord factor (trehalose dimycolate) from Mycobacterium alvei CR-21(T) and Mycobacterium brumae CR-270(T) was studied in the cell lines RAW 264.7 and THP-1, and compared to the ability of cord factor from Mycobacterium tuberculosis H37Rv, where this glycolipid appears to be implicated in the pathogenesis of tuberculosis. Details of the fine structure of these molecules were obtained by NMR and MS. The mycoloyl residues were identified as α and (ω-1)-methoxy in M. alvei CR-21(T) and α in M. brumae CR-270(T); in both cases they were di-unsaturated instead of cyclopropanated as found in M. tuberculosis. In RAW 264.7 cells, cord factors from M. alvei CR-21(T), M. brumae CR-270(T) and M. tuberculosis differed in their ability to stimulate IL-6, the higher levels corresponding to the cord factor from M. tuberculosis. In THP-1 cells, a similar overall profile of cytokines was found for M. alvei CR-21(T) and M. brumae CR-270(T), with high proportions of IL-1β and TNF-α, and different from M. tuberculosis, where IL-6 and IL-12p40 prevailed. The data obtained indicate that cord factors from the atypical mycobacteria M. alvei CR-21(T) and M. brumae CR-270(T) stimulated the secretion of several pro-inflammatory cytokines, although there were some differences with those of M. tuberculosis H37Rv. This finding seems to be due to their particular mycoloyl substituents and could be of interest when considering the potential adjuvanticity of these molecules.

背景与目标： : 在细胞系原始264.7和THP-1中研究了脐带因子 (海藻糖二CR-270) 诱导几种与结核病相关的细胞因子 (TNF-α，IL-1β，IL-6，IL-12p40和IL-23) 的能力，与结核分枝杆菌H37Rv的脐带因子的能力相比，该糖脂似乎与结核病的发病机理有关。通过NMR和MS获得了这些分子的精细结构的详细信息。菌酰基残基在CR-21(T) 中被鉴定为 α 和 (ω-1)-甲氧基，而在CR-270(T) 中被鉴定为 α; 在这两种情况下，它们都是二不饱和的，而不是在结核分枝杆菌中发现的环丙烷。在原始264.7细胞中，来自肺泡CR-21(T)，布鲁氏菌CR-270(T) 和结核分枝杆菌的脐带因子在刺激IL-6的能力上有所不同，较高水平对应于结核分枝杆菌的脐带因子。在THP-1细胞中，发现肺泡支原体CR-21(T) 和CR-270支原体 (T) 具有相似的细胞因子总体特征，IL-1β 和TNF-α 比例很高，与结核支原体不同，IL-6和IL-12p40盛行。获得的数据表明，来自非典型分枝杆菌CR-21(T) 和布鲁氏菌CR-270(T) 的脐带因子刺激了几种促炎细胞因子的分泌，尽管与结核分枝杆菌H37Rv有一些差异。这一发现似乎是由于它们特定的mycoloyl取代基，并且在考虑这些分子的潜在可调性时可能会引起关注。

BACKGROUND & AIMS: :Neuropsychiatric symptoms such as agitation and delusions occur commonly in elderly patients with dementia and often cause significant distress. Data on treatment efficacy are strongest for atypical antipsychotics, but these agents must be used with great caution. Adverse effects in patients with dementia include an increased risk of mortality and cerebrovascular events, as well as metabolic effects, extrapyramidal symptoms, falls, cognitive worsening, cardiac arrhythmia, and pneumonia. Conventional antipsychotics may pose an even greater safety risk. No clear efficacy evidence exists to support the use of alternative psychotropic classes (e.g., antidepressants, anticonvulsants), although they may be safer options. An antipsychotic trial is warranted when nonpharmacological intervention is unsuccessful and neuropsychiatric symptoms or associated behaviors cause severe distress or pose a significant safety risk. Before an atypical antipsychotic is started, a comprehensive assessment should be performed to rule out medical causes of the neuropsychiatric symptoms and to ascertain whether any contributing environmental or caregiver factors are present. Risks, benefits, and alternatives should be discussed with the patient and surrogate decision maker, with an opportunity given to ask questions. Dosages should be the lowest necessary, and metabolic parameters should be regularly monitored. Face-to-face visits are important to monitor response, tolerance, and the need for continued treatment. For patients in whom neuropsychiatric symptoms have been much improved or have been in remission for 3-6 months, a discontinuation trial should be considered. Through careful selection of appropriate patients for treatment, education of patients and caregivers, and close monitoring, safety risks can be minimized.

背景与目标： : 神经精神症状，如躁动和妄想，通常发生在老年痴呆症患者中，并经常引起明显的困扰。非典型抗精神病药的疗效数据最强，但必须谨慎使用这些药物。痴呆患者的不良反应包括增加死亡率和脑血管事件的风险，以及代谢影响，锥体外系症状，跌倒，认知能力恶化，心律不齐和肺炎。传统的抗精神病药可能会带来更大的安全风险。没有明确的疗效证据支持使用替代性精神药物类别 (例如抗抑郁药，抗惊厥药)，尽管它们可能是更安全的选择。当非药物干预不成功且神经精神症状或相关行为导致严重困扰或构成重大安全风险时，需要进行抗精神病药物试验。在开始使用非典型抗精神病药之前，应进行全面评估，以排除神经精神症状的医学原因，并确定是否存在任何有助于环境或护理的因素。风险，收益和替代方案应与患者和替代决策者讨论，并有机会提出问题。剂量应为最低必要剂量，并应定期监测代谢参数。面对面的访问对于监测反应，耐受性和持续治疗的需求很重要。对于神经精神症状已大大改善或已缓解3-6个月的患者，应考虑停止试验。通过精心选择合适的患者进行治疗，对患者和护理人员进行教育以及密切监控，可以将安全风险降至最低。

BACKGROUND & AIMS: :Of three patients with familial hypobetalipoproteinemia, a 42-yeear-old white woman, who was homozygous for this autosomal dominantly inherited disease, had no detectable serum betalipoprotein and had a marked retinal pigmentary degeneration characterized by ring scotomas by Goldmann perimetry, extinguished electroretinographic responses, delayed responses and elevated thresholds during dark adaptometry, and abnoramal cone thresholds. A 4-year-old daughter and a 28-year-old niece of the first patient, who wer heterozygous, had reduced but detectable levels of serum betalipoprotein and no significant retinal pigmentary degeneration. Unlike patients with autosomal recessively inherited abetalipoproteinemia (the Bassen-Kornzweig syndrome), none of our patients had significant neurologic of cardiac defects. Although the level of serum betalipoprotein might be correlated with retinal pigmentary degeneration in familial hypobetalipoproteinemia and abetalipoproteinemia, it appears that neurologic and cardiac defects are dependent on other factors.

背景与目标： : 在三名患有家族性低 β 蛋白血症的患者中，一名42岁的白人妇女因这种常染色体显性遗传疾病而纯合子，没有可检测到的血清 β 蛋白，并且具有明显的视网膜色素变性，其特征是通过Goldmann视野测定法进行的环形scotoma，消除了视网膜电图反应，延迟反应和黑暗适应测量期间的阈值升高，和abnoramal锥阈值。第一位患者的4岁女儿和28岁侄女是杂合的，血清 β 蛋白水平降低但可检测到，并且没有明显的视网膜色素变性。与常染色体隐性遗传性abetalipoproteinemia (Bassen-Kornzweig综合征) 的患者不同，我们的患者都没有明显的心脏缺陷神经系统。尽管在家族性低 β 蛋白血症和 β 蛋白血症中，血清 β 蛋白水平可能与视网膜色素变性相关，但似乎神经系统和心脏缺陷取决于其他因素。

BACKGROUND & AIMS: OBJECTIVES:The main objective was to evaluate the effect of five second-generation antipsychotics (amisulpride, quetiapine, olanzapine, risperidone, and zotepine) on prolactinaemia during 6 week therapy in 433 female in-patients with mainly schizophrenic disorders. Secondary objectives included identification of dynamics of change in serum prolactin levels and correlations of changes of prolactinaemia with some demographic and clinical parameters. METHODS:The trial was a prospective, open-label, single-center one with a flexible dosing of SGAs. The therapeutic effect of SGAs was assessed by a change of scores of CGI-S and CGI-I scales from a baseline to the endpoint. Blood samples were taken in the morning under fasting condition. RESULTS:Amisulpride and risperidone increased prolactinaemia significantly in 100% of patients, as early as after week 1 of the therapy. Quetiapine and zotepine relatively reduced prolactinaemia significantly, as early as from week 1 of the quetiapine treatment. Olanzapine led to a transient mild prolactin elevation. The much lower prevalence of hyperprolactinaemia over 2 000 mIU/l differentiates olanzapine from amisulpride and risperidone. Prolactin elevation did not correlate with age, menopausal condition, therapeutic efficacy, antipsychotic daily dose, serum levels of lipids and glucose. There was significant correlation with first vs. subsequent psychotic episodes, weight, EPS and serum levels of thyroid hormones. CONCLUSION:Amisulpride and risperidone had marked and early prolactin elevating effects, requiring, therefore, more frequent monitoring of prolactinaemia and associated undesirable effects and risks than olanzapine, quetiapine and zotepine.

背景与目标：

BACKGROUND & AIMS: AIM:To analyze the correlation of clinicopathologic prognostic parameters with atypical meningiomas (AMs) and recurrence development as well as progression-free survival (PFS). MATERIAL AND METHODS:The neuropathology archive and hospital records of 75 patients with AM who underwent surgery in our institution between 2010 and 2019 were retrospectively reviewed. The pathological revision was performed according to the 2016 World Health Organization (WHO) criteria. Other clinicopathological parameters, such as age, gender, tumor location, preoperative tumor size, degree of resection, Psammoma body, nuclear atypia, main histological pattern, Ki67 labeling index (LI), radiotherapy, and dura and bone invasion, were also analyzed. Statistically, univariate and multivariate analyses were assessed to determine their potential impact on recurrence-related prognostic factors. RESULTS:Recurrence occurred in 20 patients. The mean PFS and follow-up time were 38.9 and 44.8 months, respectively. In univariate analysis, clinical and pathological features such as age of ≤55 years, female sex, skull base tumor location, larger preoperative tumor size, increased mitotic count, small cells, hypercellularity, sheeting, necrosis, and dura and bone invasion were remarkable in patients with recurrence, but were not statistically significant. In multivariate analysis, increased mitotic activity and brain invasion either considered alone or combined were significantly associated with PFS. Nuclear atypia was also not associated with both tumor recurrence and PFS. However, clinical features did not significantly influence the PFS. CONCLUSION:This study found that recurrence could not be predicted by the presence of any of the clinicopathological features of AMs. We believe that molecular variables determined through routine neuropathological analysis will be needed in the future.

背景与目标：

BACKGROUND & AIMS: :Myelin oligodendrocyte glycoprotein (MOG) antibody disease is an autoimmune disease of the central nervous system associated with a serological antibody against MOG, a glycoprotein expressed on the outer membrane of myelin. It is solely found within the central nervous system in the brain, optic nerves and spinal cord. MOG antibody disease falls within the neuromyelitis optica spectrum disorders (NMOSD), however clinical characteristics appear distinct from aquaporin-4 antibody related disease and multiple sclerosis. It has predilection for causing recurrent optic neuritis and transverse myelitis. Accurate diagnosis is important to determine long term prognosis and suitable treatment. We describe the case of a 42 year old woman previously labelled as MS who demonstrated a variable presentation of MOG antibody disease.

背景与目标： : 髓磷脂少突胶质细胞糖蛋白 (MOG) 抗体疾病是一种与抗MOG的血清学抗体相关的中枢神经系统自身免疫性疾病，MOG是一种在髓磷脂外膜上表达的糖蛋白。它仅在大脑，视神经和脊髓的中枢神经系统中发现。MOG抗体疾病属于视神经脊髓炎谱系疾病 (NMOSD)，但是临床特征似乎与aquaporin-4抗体相关疾病和多发性硬化症不同。它容易引起复发性视神经炎和横贯性脊髓炎。准确的诊断对于确定长期预后和适当的治疗至关重要。我们描述了一名先前标记为MS的42岁女性的病例，该女性表现出MOG抗体疾病的可变表现。

BACKGROUND & AIMS: BACKGROUND:Antipsychotics (APs) are widely prescribed drugs, which are well known to cause reproductive adverse effects through mechanisms yet to be determined. The purpose of this study was to investigate the effect of antipsychotics on mitochondrial bioenergetics of rat ovarian theca cells as a possible mechanism of reproductive toxicity. METHODS:Isolated rat theca interstitial cells (TICs) were treated with two typical (chlorpromazine [CPZ] and haloperidol [HAL]) and two atypical APs (risperidone [RIS] and clozapine [CLZ]). The effects of these APs on TICs bioenergetics (ATP content, mitochondrial complexes I and III activities, oxygen consumption rates (OCRs), mitochondrial membrane potential (MPP) and lactate production) and on steroidogenesis (androstenedione and progesterone synthesis) were investigated. RESULTS:All APs resulted in a concentration-dependent decrease in the ATP content of TICs. All APs at their estimated IC50s (6μM, 21μM, 35μM and 37μM for CPZ, HAL, CLZ and RIS respectively) significantly decreased TICs OCRs (p<0.0001), MPP (p<0.0001) and significantly (p=0.0003) inhibited mitochondrial complex I activity. Only typical APs inhibited complex III (p=0.005). Also, APs at IC50s increased TICs lactate production to varying degrees. All APs used at their IC50s significantly inhibited progesterone (p=0.0022) and androstenedione (p=0.0027) production. Only CPZ was found to inhibit these hormones at the low concentration (1μM). CONCLUSION:All four antipsychotics seem to inhibit mitochondrial bioenergetics and steroidogenesis in rat's ovarian theca cells. These findings support the hypothesis that APs-induced reproductive toxicity may be through mechanisms involving mitochondrial insult>. Further research is required to establish the link between APs-induced mitochondrial dysfunction and disordered steroidogenesis.

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