132 In extrinsic disorders, such as jet lag and shift work, the unnatural temporal demands of modern society impose on a completely normal circadian and sleep-wake physiology to produce such impairments. For some individuals, such as airline flight crew, the jet lag problem may be chronic and severe. Jet lag could produce dysphoria, anergia, apathy, sleep disturbances, increased

irritability, anxiety, and psychosomatic disturbances, ie, symptoms overlapping depressive disorders. The possibility of a connection between jet lag and Inhibitors,research,lifescience,medical psychiatric disorders has been postulated.133 Clinical and pathophysiological indications suggest that jet lag is a Inhibitors,research,lifescience,medical possible trigger in the exacerbation of existing affective disorders and in the appearance of de novo mood disturbances in predisposed persons. Depressive symptoms are more frequent subsequent to flights from east to west,134 supporting the phase-advance hypothesis for depression.135 In the other sense, eastbound flights, which can be see as a kind of sleep deprivation, can precipitate mania.136 Inhibitors,research,lifescience,medical Psychotic symptoms occurring during

long-distance trips (referred to as “travel paranoia”) have been also reported in the literature.137 The most plausible explanation is that longdistance flights, which involve abrupt environmental changes, can represent a severe crisis situation for predisposed individuals. However, circadian rhythm abnormalities

have not received much attention in studies of psychosis, and conclusions in this field are inconsistent. Individuals engaged Inhibitors,research,lifescience,medical in shift work experience disturbed sleep and excessive sleepiness due to the fact that their behavioral sleep-wake schedules are out of phase and often in direct opposition to their endogenous Inhibitors,research,lifescience,medical circadian rhythms. In a recent large study that aimed to determine the prevalence and consequences of shift work sleep disorder in a sample of rotating and permanent night workers, Drake et al138 showed greater rates of buy Rapamycin depression and somatic diseases (gastrointestinal ulcers and cardiovascular diseases), elevated work absenteeism, impaired social and domestic aspects of quality of life, and more accidents, mainly related to symptoms of insomnia or daytime sleepiness. These findings are in accordance with previous studies Carnitine palmitoyltransferase II showing copious behavioral, health, and social morbidity associated with shift work.139-141 In intrinsic disorders, the pathology of the circadian system itself is responsible for the symptoms. DSPS is characterized by sleep onset and wake times, which are delayed in comparison to conventional sleep-wake times. Enforced ”conventional“ wake times may result in chronically insufficient sleep and excessive daytime sleepiness, and can be associated with irritability and poor performance.

6). On the other hand, what would happen in the case of subepicardial dysfunction? Ganetespib Rotation of the subepicardium would probably decrease, resulting in hypo-rotation of the ventricle. Fig. 6 Hyper-rotation in the presence of subendocardial dysfunction. Apical rotation is shown as in Fig. 3. When there is subendocardial dysfunction, RT1′ becomes smaller than RT1. Inhibitors,research,lifescience,medical Then, because of RT2 >> RT1′, hyper-rotation is produced. Subendocardial dysfunction is well known to appear

with myocardial ischemia, hypertension, and many other diseases. Hyper-rotation found in patients suspected of having any of these diseases may indicate subendocardial dysfunction. In other words, measurement of rotation could possibly lead to early detection of such disease. Diastolic heart failure (heart failure with preserved ejection fraction) has been increasing in recent years.14) Park et al.15) measured rotation and twist in cases of diastolic heart failure, and Inhibitors,research,lifescience,medical compared the results with normal subjects. Rotation and twist both showed higher values in the abnormal relaxation (grade 1) group than in the normal group, Inhibitors,research,lifescience,medical and values showed a progressive decrease as the degree of diastolic dysfunction

advanced to pseudonormalization (grade 2) and restrictive pattern (grade 3) (Fig. 7). Hyper-rotation in the group with abnormal relaxation, which is early-stage diastolic dysfunction, was probably a manifestation of subendocardial dysfunction. Rotation or twist greater than normal values, even with normal ejection fraction, should probably Inhibitors,research,lifescience,medical be regarded as an initial stage of diastolic dysfunction. Wang et al.16),17) showed that twisting and untwisting do not decrease with diastolic dysfunction. They measured twisting and untwisting

in subjects with contraction disorder, diastolic disorder with preserved ejection fraction, and normal hearts, and found that Inhibitors,research,lifescience,medical while values for both twisting and untwisting were low in cases of contraction disorder, these values were not significantly different from normal subjects in diastolic dysfunction cases. Thus, untwisting is not impaired in diastolic dysfunction, at least Rolziracetam in its early stage. This means untwisting does not reflect ventricular relaxation. This may make readers confusing because I wrote “untwisting is a good index of ventricular relaxation” above. I think this contradiction may be explained by the difference of disease. Dong et al.11) and Notomi et al.12) observed significant relationship between tau and untwisting velocity in dogs with systolic dysfunction that was created by esmolol. While Park et al.15) and Wang et al.16),17) observed preserved untwisting velocity in patients with diastolic dysfunction with preserved ejection fraction. We probably have to treat differently patients with systolic dysfunction and those with diastolic dysfunction when we try to evaluate diastolic function from untwisting velocity. Fig.

Mood disorders in the context of medical illness Several studies have suggested a potential role of learn more hypogonadism in the mood symptoms and low energy present in some women with human immunodeficiency virus (HIV) infection.166-168 Trials of DHEA in women and other androgens such as testosterone in men with HIV have reported mood improvements.166,169,170 Inhibitors,research,lifescience,medical Although these reports may suggest a psychotropic effect of

gonadal steroids in these subjects, the improved mood may also reflect the anabolic effects of these steroids. Improved muscle strength and weight changes in these subjects may improve energy level and, therefore, Inhibitors,research,lifescience,medical indirectly improve mood.170,171 Potential mechanisms of antidepressant action of gonadal steroids Several mechanisms may underlie the antidepressant effects of reproductive therapies in women. First, gonadal steroid supplements may correct a pathological deficiency of a particular gonadal steroid. However, in the majority of studies

where gonadal steroids have been reported to be effective, the condition is neither associated with a particular abnormality of reproductive hormones nor are levels of reproductive Inhibitors,research,lifescience,medical hormones predictive of subsequent response to the therapeutic intervention. Nonetheless, local tissue metabolism of gonadal steroids (eg, aromatization of androgens) may produce a wide range of gonadal steroid levels within specific tissues. Thus, local and tissue-specific “relative”

deficiencies of reproductive hormones could exist and cause symptoms, but not be identified by simply measuring plasma Inhibitors,research,lifescience,medical hormone levels. Second, studies of the Inhibitors,research,lifescience,medical effects of ERT in osteoporosis172 suggest the presence of a threshold of circulating estradiol above which therapeutic effects are observed, and it is possible that a similar phenomenon (ie, critical threshold) is operational in reproductive hormone-related effects on mood. For example, in women with premenstrual syndrome, a threshold of gonadal steroid levels may exist above which mood instability occurs, and, therefore, ovarian suppression with low level gonadal steroid replacement may produce mood stability. Additionally, there may be a critical threshold of estradiol MRIP or DHEA levels below which symptoms develop in some women, and the replacement of these hormones may elevate hormone levels sufficiently to produce a mood-enhancing effect. Third, the rate of change in hormone level may convey information and trigger mood changes in women who have a differential sensitivity to increasing (eg, PM.S) or decreasing (eg, perimenopausal or postpartum depression) levels of gonadal steroids.

001, tables 1,​,22 and ​and33). Table 1 Surgical results of the patients undergoing the Knapp procedure Table 2 Surgical results of the patients undergoing IRR Table 3 Surgical results of the patients undergoing combined procedure The mean postoperative vertical SRT1720 cell line deviation was 6.11±7.9 PD. Compared to preoperative measurements, there was a mean correction of 19.7 PD in the

amount of hypotropia in primary gaze position. Discussion In this case series, we performed different Inhibitors,research,lifescience,medical surgical procedures based on the results of the FDT in patients with MED and evaluated the results based on ocular alignment in primary position. The pathophysiology of MED is poorly understood. The early description of this condition was thought to be due to a combination of SR and inferior oblique muscle palsy (called double elevator palsy). Studies have shown that only 30% of cases are caused by this problem, and the FDT has demonstrated that 70% is caused by IR restriction.5 Magnetic resonance imaging (MRI) Inhibitors,research,lifescience,medical may be a useful adjunct to saccadic velocity

assessment in differentiating between primary IR restriction, primary SR paresis, and congenital supranuclear elevation deficiency.6 In our study, MED had similar predilection for the right Inhibitors,research,lifescience,medical eye and left eye involvement: 9 patients had right eye and 9 had left eye involvement. A predilection to right side involvement has been reported in MED in the series reported by Ziffer et al.7 and Kucak and co-workers.8 On the other hand, Khawam and Younis9 and also Bagheri et al.10 reported more instances of left eye involvement. Inhibitors,research,lifescience,medical Considering the mentioned studies and ours, it seems that the laterality of the condition provides no particular diagnostic information. The

goal of surgery in MED associated with ptosis or pseudoptosis is the management of combined hypotropia and blepharoptosis. For surgical correction of MED, the procedure of choice is determined by the FDT, which ascertains whether the cause is paretic or restrictive. In the presence of SR palsy (paretic form), the procedure employed is a Knapp transposition. The transposition procedure is not recommended Inhibitors,research,lifescience,medical in the presence of IR restriction. Therefore, it is important to perform FDT prior to surgery. In our series, Chlormezanone the mean amount of correction with the Knapp procedure alone was 20.0 PD. In his original work, Knapp3 reported 15 patients with MED and good results were obtained in 14 out of the 18 patients (93%). Correction of hypotropia in his study ranged from 21 to 55 PD with a mean of 38 PD. Others have found similar amounts of correction. Barsoum-Homsy11 observed an average correction of 31.7 PD and Watson12 in his series observed a mean correction of 30.5 PD after the Knapp procedure. Cooper and Greenspan13 reported 26.6 PD correction of hypotropia after this procedure. Scott14 performed the Knapp procedure in 19 patients and observed 21.1 PD corrections. Bandyopadhyay et al.15 reported a correction of 29.4 PD of vertical deviation.

Table V shows magnetic resonance imaging (MRI) neuroimaging techniques. Nevertheless, significant challenges exist, in terms of summarizing existing findings and translating data to improve clinical practice. Studies often involve diverse cohorts (eg, mild TBI, combat, veterans), and employ different paradigms (symptom provocation, cognitive activation) and modalities (eg, diffusion tensor imaging [DTI], functional magnetic resonance imaging [fMRI],

single photon emission computed tomography [SPECT]).50 As such, findings have varied. Peskind and colleagues noted that Inhibitors,research,lifescience,medical fluorodeoxyglucose positron emission tomography (FDG-PET) abnormalities in those with PTSD versus those without this disorder have been “limited and conflicting” (p 5).51 In terms of validation, experiments supporting newer functional imaging techniques often rely on neuropsychological paradigms. For example, in response to findings regarding Inhibitors,research,lifescience,medical the positive relationship between DTI results and neuropsychological test performance among those with mild, moderate, and severe injuries, Kraus ct al3 suggested that white matter load may be a “useful index.“ Much work is being conducted to support, these new imaging techniques, and findings are

increasing our knowledge regarding those with TBI and/or PTSD. Table V. Magnetic resonance imaging (MRI) Inhibitors,research,lifescience,medical neuroimaging techniques. BOLD, blood oxygen level dependent; DTI, diffusion tensor imaging, fMRI, functional MRI; MRS, magnetic resonance spectroscopy; PW-MRI, perfusion weighted MRI; SWI, susceptibility-weighted imaging … TBI Although newer techniques have begun to allow clinicians to explore questions regarding pathogenesis, natural history, neuroplasticity, and treatment, response,52 historically, neuroimaging has been used to identify Inhibitors,research,lifescience,medical and manage acute modcratc-to-sevcre TBI. Less sophisticated structural imaging techniques such as computed tomography (CT) or MRI have been useful in identifying skull fractures or more severe injuries (eg contusion, intraparaenchymal hemorrhage); however, they generally fail to adequately Inhibitors,research,lifescience,medical detect DAI or brain volume loss. Moreover, in combat, or deployment,

settings these generally common diagnostic tools may not be available only to the clinician.53 Research among both Veteran and civilian populations selleck chemicals suggests that, use of CT and MRI has limited utility in confirming acute or post-acute mild TBI.54-56 In looking at MRI results of veterans long postTBI, Brenner and colleagues55 found that those with moderate to severe TBI were significantly more likely to have trauma-related findings (physical) than those with mild TBI. In specific, 11 out of 16 veterans with moderate to severe TBI versus 0 out 16 with mild TBI had MRI findings. Research regarding newer functional imaging techniques (eg, FDG-PET, DTI, SPECT) suggests that in the future they may be of significant clinical utility, particularly in the context of mild TBI and/or post-acute injuries.

For example, the child that screams in the grocery store may be bothered by the fluorescent lights or by the AZD8055 in vivo loudness in the store. Indeed, Reese, Richman, Zarcone, and Zarcone52 reported that attempts to escape uncomfortable sensory situations explained disruptive behavior in 14% of the children with ASD in their sample. Clinically, atypical sensory processing has been attributed to three overlapping dimensions—hyperresponsiveness,

hyporesponsiveness, and sensory seeking. However, little research has supported these dimensions. Recently, Brock and colleagues53 identified Inhibitors,research,lifescience,medical sensory hyporesponsiveness in preschool-aged children with ASD. Despite the fact that it is commonly recognized that challenging behaviors are often exacerbated by atypical sensory processing Inhibitors,research,lifescience,medical in children with ASD, very little intervention research has been conducted in this area. Lang and colleagues54 conducted a review of all research on sensory integration therapy (SIT). Only three of 25 studies included Inhibitors,research,lifescience,medical in the review considered SIT to be an effective therapy based on posttreatment measures. In contrast, 14 of the studies saw no improvement in children with ASD who had received SIT. Thus, to date the most effective approaches for decreasing

behavior problems due to sensory sensitivities may be aimed at reducing the anxiety that Inhibitors,research,lifescience,medical usually arises as a result of these sensitivities. Other considerations for utilizing caregiver-mediated behavioral interventions It is important to consider family social and cultural factors that may impact the successful use of caregivermediated approaches. The requirements of an intervention approach often conflict with the caregiver’s other time demands including workplace, siblings, spouse, and extended family. Further

family cultural values must be considered, as any attempt to modify the caregiver’s behavior without attending to cultural factors may be ineffective.7 Further, the chronicity of ASD and its impact of caregiver stress should be considered. Inhibitors,research,lifescience,medical Because behavior problems often arise from the underlying symptoms of ASD, caregivers are likely to face a lifetime of behavior management challenges. Thus, it is important to consider the impact of long-term caregiver stress on effective intervention implementation.12 Indeed, raising a child with ASD DNA ligase is associated with higher levels of caregiver stress and psychological distress than raising a child with typical development or a child with another developmental disability.55 Weiss and colleagues55 reported that the relationship between child behavior problems and parent mental health is mediated by psychological acceptance. That is, those parents who were able to accept the challenges of living with a child with ASD showed fewer negative mental health consequences.

However, these scales would not be sufficient to assess remission, as pointed out by the ACNP task force on response

and remission in major depressive disorders.43 The authors postulate that remission implies that the signs and symptoms of the illness must be absent or close to it, with return to the TWS119 clinical trial day-to-day function that was typical to the patient before the occurrence of depression. Inhibitors,research,lifescience,medical The Task Force recommends that remission refer only to the nine criterion domains of the DSM-IV diagnosis of depression. Interestingly, they also specify that neither sad mood nor loss of interest or pleasure should be present in the remitted state, because the presence of sadness would be associated with a worse prognosis. Their definition of remission implies that rating scales used to assess remission would assess the nine domains of interest in the DSM-IV, but they also recommend not to use total scores with severity thresholds for the assessments, but rather to evaluate the presence Inhibitors,research,lifescience,medical or absence of the criteria, in which sadness takes an important part. They emphasize Inhibitors,research,lifescience,medical the limitations of the MADRS and HAM-D scales, but at the same time propose that a HAM-D total score <5 be used as a criterion for remission, when researchers wish to evaluate this.43 Conclusions Sadness is a clinical main component of the depressive syndrome, though its presence is neither sufficient nor required for the diagnosis of depression. However, it is a frequent clinical feature in

the disease, and its clinical correlates, such as suicide

and level of daytime functioning, are of importance Inhibitors,research,lifescience,medical for the patients. With this perspective, some authors have decided to use it as a criterion for clinical studies of antidepressant efficacy, even if its assessment alone seems insufficient in comparison with standardized evaluations. Though further studies assessing its sensitivity are strongly warranted, its use in clinical practice as a therapeutic target appears to be justified. The prognostic Inhibitors,research,lifescience,medical importance of its alleviation for remission has been particularly emphasized. Given the heterogeneity of the depressive clinical presentation, Chlormezanone one should not reduce depression to sadness; at the same time it is justifiable to consider it as a clinical core symptom of depression, and to properly assess and trcat.it. Contributor Information Sabine Mouchet-Mages, Service Hospitalo-Universitaire, Hôpital Sainte Anne, Paris, France; Université Paris Descartes, Faculté de Médecine Paris Descartes, INSERM U894, Paris, France. Franck J. Baylé, Service Hospitalo-Universitaire, Hôpital Sainte Anne, Paris, France; Université Paris Descartes, Faculté de Médecine Paris Descartes, INSERM U894, Paris, France.
Anecdotally, there are many examples of striking associations between creativity and mood disorders, and particularly bipolar disorder. For example, Vincent. Van Gogh suffered from mood disorder during much of his short, adult, life, prior to committing suicide at. age 37.

Nevertheless, there is sufficient promise in results that continued investigation and the hope for a clearer understanding of mechanisms underlying observed effects is warranted. Acknowledgments This work was supported by the National Institute on Aging at the National Institutes of Health (5R37AG-006265-25 and (NIA grant 5R01AG026589-05).
Of the

seasons of the year, the autumn is most melancholy… (Burton, 1621)1 Inhibitors,research,lifescience,medical As a science matures, it pays more attention to the temporal dynamics of its target phenomena. The relatively young discipline of psychiatry shows exactly this trajectory, with the temporal dimension receiving growing research interest. This development is quite obvious Inhibitors,research,lifescience,medical in the domain of mood disorders, where time features in the diagnostic description, phenomenology, and increasingly our causal understanding of the disorders. It is therefore timely to provide an overview of this expanding area. The aims of this article, are fourfold. First, we introduce some philological considerations about the relationship between time and mood. Secondly, we review the (largely European) clinical literature which has focused Inhibitors,research,lifescience,medical on the sense

of time in mood disorder phenomenology. Thirdly, we provide a synopsis of the range of empirical evidence indicating that biological timing (particularly circadian rhythms and sleep/wake processes) is critical in the etiology of mood disorders. Finally, we present nonlinear dynamical approaches applied to the analysis of the measures related to psychological Inhibitors,research,lifescience,medical time series. The intent of the article is to encourage an open, multidisciplinary approach to generate testable hypotheses about temporality in the mood disorders. Contributions of philology and natural philosophy As often

happens in the evolution of theoretical concepts relevant Inhibitors,research,lifescience,medical to psychopathology, early intuitions and illuminating insights can often be found in ancient mythology, philosophy, and art.2 Since ancient times in Western culture, melancholia and mania have been related to characterological and temperamental constellations of the Greek god, Kronos, and of his Latin counterpart, Saturn. Later, the implacable influence of the planet Saturn was often invoked as a symbolic representation of older religious those archetypes, even as naturalistic approaches to the study of mood disorders emerged selleck chemicals during the Renaissance.3 The Kronos-Saturn hybrid can be summed up as a quintessential ambivalent coexistence of contradictory forces of light and darkness, life and death, rationality and folly, of the highest and most sublime spiritual contemplations and most miserable and lowest confinements of the world, or even the netherworld. The concept was conceived of as the “absolute master of time,” the mighty principle of cosmologic unity, the “One that devours and consumes everything.

58-60 A recent study suggests that mutations in NGLN4Y might also result in an ASD.34 Disruption of Nlgn4x in mice leads to deficits in reciprocal social interactions and communication.61 It has been reported that introducing the R451C mutation in murine NlgnS was reported to result in impaired social interactions with an increase in inhibitory synaptic transmission62; however.these behavioral deficits were not seen in an independent study.63 CNTNAP2 Cortical dysplasia-focal epilepsy syndrome

was first described in 2006 in Amish children displaying cortical dysplasia, focal epilepsy, relative macrocephaly, diminished deep-tendon reflexes, Inhibitors,research,lifescience,medical language regression, MR, and ASD.64 The disorder is recessive and caused by mutations in the CNTNAP2 gene, which codes for contactin-asso ciated protein-like 2 (CASPR2) that is involved in localization

of voltage -gated potassium channels (K(v)l .1) at the juxtaparanodes of the nodes of Ran Inhibitors,research,lifescience,medical vier. Three recent studies assessed this gene in ASDs. First, following up on a linkage result of a language-related autism QTL, it was suggested Inhibitors,research,lifescience,medical that common variants of CNTNAP2 may increase risk for ASDs in male-only families, and it was shown that CNTNAP2 is expressed in language- and cognition-related circuits.65 This finding was also observed in a related study using overlapping AG RE families.66 Finally, rare Inhibitors,research,lifescience,medical variants of the CNTNAP2, and particularly the I869T variant, also show some association with ASD.67 PTEN Our own studies on PTEN mutations in ASD can serve to highlight the clinical value of identifying mutations in ASD.68 Mutations in the PTEN gene are associated with a broad spectrum of disorders, including Cowden syndrome (CS), Bannayan-Riley-Ruvalcaba syndrome, Proteus syndrome, and Lhermitte-Duclos disease, as well as ASDs (reviewed in ref 68). We surveyed head circumference information from hundreds Inhibitors,research,lifescience,medical of subjects with ASD and sequenced the PTEN gene in 88 individuals showing macrocephaly (defined as a head

circumference ≥2 standard deviations above the mean). We identified a de novo missense mutation (D326N) in a highly conserved amino why acid in a 5-year-old boy with autism, MR, language delay, and extreme macrocephaly (+9.6 SD).The identification of this mutation can give important information to the family with regard to recurrence risk, and also improve the care of the affected boy because an appropriate selleck chemicals surveillance strategy for P’FfiW-mutation-related conditions can be initiated. Etiological yield in ASDs The importance of evaluating ASD-associated syndromes in the clinical context needs to be emphasized. A recent study used a three-tiered neurogenetic evaluation scheme to evaluate 32 patients with a behavioral diagnosis of an ASD.

Results All the ROCK inhibitor patients with PCOS had infertility for more than

a year, 30 (85.7%) had hirsutism, 17 (46.7%) suffered from acne, and 17 (46.7%) had obesity. Whereas 3 out of the 35 patients (8.6%) were positive for ANAs before electrocauterization, none of the controls was positive. The number of ANA-positive cases rose following electrocauterization (3 out of 35 [8.6%] before vs. 10 out of 35 Inhibitors,research,lifescience,medical [28.6%] after the procedure). Of the ANA-positive samples, ten samples (three samples before electrocauterization and 7 after electrocauterization) were studied for ANA subtyping. One case that became positive for ANAs after electrocauterization revealed to have all the 8 different subtypes of ANAs in her postoperative sample, while another one disclosed to have only SS-A subtype. In addition, two cases that were positive both in pre and postoperative settings, as well as a preoperative positive case that became negative postprocedurally, revealed to

have SS-A subtype only. The other 5 samples were in the negative ranges for ANA Inhibitors,research,lifescience,medical subtypes. Discussion The results of the present study showed a high number of ANA-positive cases among patients with PCOS in comparison to healthy fertile subjects. Elevated serum Inhibitors,research,lifescience,medical levels of autoantibodies, including anti-histone, anti-dsDNA, and smooth muscle antibodies (SMAs), have already been reported in PCOS.9,10 Production of ANAs in PCOS might be the result of the activation of self-reaction responses to intracellular antigens, suggestive of an autoimmune etiology in the pathogenesis of PCOS. Chiming in with this finding, there are plenty of data available in the existing literature

which link PCOS to autoimmune Inhibitors,research,lifescience,medical markers.9,10 Increased inflammatory responses and over expression of immune modulators have already been reported in these patients.11 Fulghesu et al.12 recently reported that monocytes of patients with insulin-resistant PCOS produce significant amounts of interleukin-6 (IL6), a potent inflammatory cytokine, in response to lipopolysaccharide (LPS). Low levels of progesterone in patients with PCOS have also been suggested Casein kinase 1 to be another reason for Inhibitors,research,lifescience,medical immune over-stimulation.13 These data, in conjunction with our finding, suggest that patients with PCOS have raised levels of ANAs, most likely in consequence of immune hyperactivation and inflammation increment. Further studies seem to be necessary to determine the significance of ANAs in these patients. In laparoscopic ovarian drilling, a laser or electrocautery is used to destroy parts of the ovaries. Our results demonstrated that following ovary electrocauterization, the number of ANA-positive cases had an increase. Although the exact mechanism remains to be elucidated, this finding may imply that the manipulation of the ovarian tissue and/or cauterization-induced inflammation may release the normally-occult nuclear antigens and consequently augment autoimmune reactions.