OBJECTIVES: There have been several evidences that the central nervous system defect is one of the etiologic factors in schizophrenia and high nailfold plexus visibility can reflect indirectly. These are particularly related to the negative symptoms of schizophrenia. In this study, we examined the relationship between nailfold plexus visibility and various clinical variables in schizophrenia. METHODS: Forty patients(20 males, 20 females) satisfying the DSM-IV criteria for schizophrenia and forty normal controls(20 males, 20 females) were measured for Plexus Visualization Score(PVS) by using capillary microscopic examination. We used Positive and negative Syndrome Scale(PANSS). Uimann-Giovannoni Process-Reactive Questionnaire(PRQ), Phillips Premorbid Adjustment Scale(PAS). Continuous Performance Test, and Backward Masking for psychopathology and clinical variables. RESULTS: There was no significant relationship between schizophrenic subjects and normal controls in PVS. PVS was correlated with PANSS positively except negative symptom subscore. PVS was correlated with PRQ score negatively, and with PAS score positively. CONCLUSIONS: This study shows high PVS are associated with more severe psychotic symptoms and with clinical variables, such as disease process and premorbid adjustment, in some schizophrenics.
Adult* ; Capillaries ; Central Nervous System ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Male ; Masks ; Psychopathology ; Schizophrenia

OBJECTIVE: There have been several evidences that the central nervous system deflect is one of the etiologic factor in schizophrenia and minor physical anomalies can reflect these deflects indirectly. These central nervous deflects are particularly related to the negative symptoms of schizophrenia. In this study, we examined the relationship between minor physical anomalies and psychopathology in schizophrenia. METHODS: Forty-four patients(22 males, 22 females) satisfying the DSM-IV criteria for schizophrenia were measured for minor physical anomalies by using Waldrop Anomaly Scale(WS) and we used Positive and Negative Syndrome Scale(PANSS), Ulmann-Giovannoni Process-Reactive Questionnaire(PRQ), and Phillips Premorbid Adjustment Scale(PAS) for evaluating psychopathology and clinical variables. RESULTS: Schizophrenic patients had a higher group mean WS score than that found in the control group. Score of WS was correlated with PANSS and PAS score positively, and with PRQ score negatively. CONCLUSION: This study shows minor physical anomalies are associated with clinical variables with regard to symptom severity, poor premorbid adjustment and process of illness in at least some schizophrenics.
Adult* ; Central Nervous System ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Male ; Psychopathology ; Schizophrenia

No abstract available.
Carbamazepine* ; Haloperidol*

A parallel group double-blind comparative trial was conducted to study the efficacy and safety of risperidone compared with haloperidol. After a one-week wash-out, 35 chronic schizophrenic patients (17 males, 18 females) were randomly assigned to one of two groups for eight weeks of double-blind treatment. The patients' psychopathology was assessed by means of the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) and the Clinical Global Impression (CGI). Safety assessments included the Extrapyramidal Symptom Rating Scale (ESRS), the UKU Side Effect Rating Scale, vital signs, body weight, ECG and laboratory screening. Thirty-two patients completed the trial: there were 3 dropouts in the risperidone group. The results on the PANSS and CGI indicate that the mean changes from baseline on the total PANSS score and on the total BPRS score were comparable in both treatment groups. The number of patients where a clinical improvement at least 20% reduction in baseline score was also similar in both treatment groups. Risperidone caused less extrapyramidal symptoms and less side effects in UKU scale than haloperidol. No significant ECG changes were induced, no relevant changes in blood pressure or clinical laboratory parameters were observed. This study has demonstrated that the combined serotonin 5-HT2 and dopamine-D2 antagonist risperidone is an antipsychotic as potent as haloperidol. Risperidone causes less extrapyramidal symptoms, and is better tolerated than haloperidol.
Adolescent ; Adult ; Chronic Disease ; Comparative Study ; Double-Blind Method ; Female ; Haloperidol/*therapeutic use ; Human ; Isoxazoles/*therapeutic use ; Male ; Middle Age ; Piperidines/*therapeutic use ; Risperidone ; Schizophrenia/*drug therapy

OBJECTIVES: The aim of this study was to evaluate the morphometric changes in neuroforamen in grade I isthmic spondylolisthesis by anterior lumbar interbody fusion (ALIF). METHODS: Fourteen patients with grade I isthmic spondylolisthesis who underwent single level ALIF with percutaneous pedicle screw fixation were enrolled. All patients underwent standing lateral radiography and magnetic resonance imaging (MRI) before surgery and at 1 week after surgery. For quantitative analysis, the foraminal height, foraminal width, epidural foraminal height, epidural foraminal width, and epidural foraminal area were evaluated at the mid-portion of 28 foramens using T2-weighted sagittal MRI. For qualitative analysis, degree of neural compression in mid-portion of 28 foramens was classified into 4 grades using T2-weighted sagittal MRI. Clinical outcomes were assessed using Visual Analogue Sale (VAS) scores for leg pain and Oswestry disability index before surgery and at 1 year after surgery. RESULTS: The affected levels were L4-5 in 10 cases and L5-S1 in 4. The mean foraminal height was increased (p<0.001), and the mean foraminal width was decreased (p=0.014) significantly after surgery. The mean epidural foraminal height (p<0.001), epidural foraminal width (p<0.001), and epidural foraminal area (p<0.001) showed a significant increase after surgery. The mean grade for neural compression was decreased significantly after surgery (p<0.001). VAS scores for leg pain (p=0.001) and Oswestry disability index (p=0.001) was decreased significantly at one year after surgery. CONCLUSION: Foraminal stenosis in grade I isthmic spondylolisthesis may effectively decompressed by ALIF with percutaneous pedicle screw fixation.
Commerce ; Constriction, Pathologic ; Humans ; Leg ; Magnetic Resonance Imaging ; Radiography ; Spondylolisthesis*

We present a case of perivascular epithelioid cell tumors (PEComas) in the abdominal cavity at the falciform ligament. A 30-yr-old Korean man visited to hospital for the evaluation of a growing, palpable abdominal mass. He had felt the mass growing over 6 months. There was no family or personal history of tuberous sclerosis. The resected specimen showed a mass of 8.0x7.0x5.5 cm in size. Histological examination showed sheets of spindle-to-epithelioid cells with clear-to-eosinophilic cytoplasm. Immunohistochemically, tumor cells were positive for HMB-4 (gp100) and smooth muscle actin. They were also positive for the S-100, which is a marker of neurogenic and melanocytic tumors. Patient was treated with radical resection of tumor without any adjuvant therapy. He is well and on follow-up visits without tumor recurrence.
Abdominal Neoplasms/*diagnosis/pathology/surgery ; Actins/metabolism ; Adult ; Antigens, Neoplasm/metabolism ; Humans ; *Ligaments/pathology ; Male ; Neoplasm Proteins/metabolism ; Perivascular Epithelioid Cell Neoplasms/*diagnosis/pathology/surgery ; S100 Proteins/metabolism ; Tomography, X-Ray Computed

As a solution about many problems of pharmacotherapy for Korean patients with major psychiatric disorders, Korean Medication Algorithm Project for Major Psychiatric Disorders (KMAP) was launched. Recently, a medication algorithm for schizophrenic patients was developed and distributed. This review article showed the designs, processes and methods for developing this algorithm. Also we compared the development of Korean algorithm for schizophrenics with other foreign representative algorithms or clinical practice guidelines. We hope that this review elicit the productive criticism about the rigour, the system of development and the objectivity of content. The limitations and problems of Korean algorithm are also discussed in this review.
Drug Therapy ; Hope ; Humans ; Schizophrenia

BACKGROUND/AIMS: Recent studies have shown good performance for the detection of sources of gastrointestinal bleeding using multi-detector row computed tomography (MDCT). However, there are limited reports about the role of MDCT for localization of acute lower gastrointestinal (GI) bleeding. The purpose of this study was to evaluate the role of MDCT for detection and localization of acute lower gastrointestinal bleeding. METHODS: A total of 49 patients underwent MDCT examination for the evaluation of acute lower GI bleeding were investigated prospectively. Sensitivity, specificity, positive and negative predictive values of MDCT for the detection of acute lower GI bleeding were assessed. Colonoscopy, angiography, RBC scan or postoperative results were adopted as the reference standard. RESULTS: Sensitivity, specificity, positive and negative predictive values of MDCT for the detection of acute lower GI bleeding were 72.7%, 80%, 93.9% and 25%, respectively. Eighteen patients experienced massive bleeding and 5 of them could not undergo the colonoscopic examination due to massive bleeding. MDCT detected the bleeding focuses in all of 5 patients. CONCLUSIONS: MDCT is useful for the localization of acute lower GI bleeding. The procedure is brief, less invasive, and relatively accurate diagnostic method. Moreover, positive finding will allow directed therapeutic procedure such as angiography.
Acute Disease ; Angiography ; Gastrointestinal Hemorrhage/etiology/*radiography ; Humans ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; *Tomography, Spiral Computed

Epithelial ovarian carcinoma rarely metastasizes to the parenchyma of the stomach. A 55-years-old woman presented with epigastric pain and a feeling of fullness for one month. A subsequent contrast-enhanced CT scan demonstrated a 4.5 x 4 cm submucosal mass with focal ulceration in the gastric antrum, and this finding was suggestive of GIST. After gastric antrectomy, the final pathology showed metastatic gastric tumor from a primary ovarian serous carcinoma. Because epithelial ovarian carcinoma is usually spread along the peritoneal surface, stomach involvement is rare. Furthermore, transmural gastric metastasis is very rare in a patient with primary ovarian carcinoma. Until now, there has been no reported case of stomach involvement at presentation in a patient with primary ovarian carcinoma. We present here a case of ovarian carcinoma with gastric metastasis that mimicked GIST.
Female ; Gastrointestinal Stromal Tumors ; Humans ; Hydrazines ; Neoplasm Metastasis ; Pyloric Antrum ; Stomach ; Ulcer

OBJECTIVE: The efficacy, tolerability and safety of quetiapine in schizophrenia patients diagnosed by the diagnostic criteria of schizophrenia of the Diagnostic Statistical Manual 4th edition was studied in psychiatric department of 4 hospital in Korea. METHODS: Sixty-four patients (male 31, female 33;age 34.2+/-10.4 years; illness duration 8.1+/-8.3 years) who showed acute exacerbation, partial response, or intolerable adverse event to previous antipsychotic drugs were recruited. Doses of quetiapine were adjusted to maximize efficacy and minimize adverse events. Efficacy was assessed by the Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) scale. Tolerability and safety were assessed by reports of adverse events, clinically significant abnormal laboratory values and changes from the baseline to week 8 in the Abnormal Involuntary Movement Scale (AIMS) and Simpson-Angus total score as index of extrapyramidal symptoms (EPS). RESULTS: Fiftythree patients completed the 8 weeks trial. The clinical symptoms indexed by BPRS were significantly improved (baseline score=37.9+/-13.0, score at the end=24.3+/-13.6;F=41.5, d.f.=2.4, p=0.000). The CGI score of severity of illness was also significantly reduced (baseline score=4.7+/-1.1, score at the end= 3.6+/-1.2;F=27.6, d.f.=2.2, p=0.000). The frequencies of the worsening of AIMS and Simpson-Angus scores at the end of study were 7.5% and 4.2%, respectively. The most common adverse events of at least moderate intensity were EPS (9.3%), constipation (6.3%), and sedation (4.7%). CONCLUSION: The results of this study suggest that quetiapine is effective, may have a favorable EPS, and has overall safe tolerability in the patients with schizophrenia, and schizophreniform disorder.
Antipsychotic Agents ; Brief Psychiatric Rating Scale ; Constipation ; Dyskinesias ; Female ; Humans ; Korea ; Psychotic Disorders ; Schizophrenia* ; Quetiapine Fumarate