OBJECTIVES: Several studies suggest that psychotropic drugs may affect on lipid metabolism and body weight. And the differences of levels of seam lipids were observed in patients with several psychiatric disorders. Hence, in order to elucidate the effects of psychotropic drugs on serum lipid, lipoprotein and apolipoprotein, the authors estimated the serum lipid profile in the psych op harmacological treatment. METHODS: Thirty six patients with schizophrenia and 42 patients with depressive disorder or anxiety disorder were recruited from the inpatient psychiatric units and withdrawn from all psychotropic drugs at least far 3 months. The levels of seam total cholesterol, high-density lipoprotein cholesterol(HDL-C), trighlyceride, apolipoprotein A, apolipoprotein B, and lipoprotein(a) were measured before the treatment and after 2, 4, 8 and 12 weeks of the treatment. RESULTS: No statistically significant change was found on all serum lipid profiles in the antipsychotics group. However, the changes on serum total cholesterol, low-density lipoprotein (LDL-C), apolipoprotein A, and apolipoprotein B from the baseline to the following weeks have been observed in tricyclic antidepressants group. And the serum total cholesterol and apolipoprotein B have been observed to be changed from the baseline to the following weeks in the selective serotonin reuptake inhibitors poop. The changes on seam lipoprotein(a) were proved not to be statistically significant during all the psychotropic drugs treatment. CONCLUSION: These results implicate that all psychotropic drugs might affect on the lipid metabolism, especially for tricyclic antidepressants. Therefore, this implication could be important in clinical situation because the changes on serum lipid profiles may be related to the cardiovascular disease especially in psychiatric patients with the cardiovascular risk factor.
Antidepressive Agents, Tricyclic ; Antipsychotic Agents ; Anxiety Disorders ; Apolipoproteins* ; Body Weight ; Cardiovascular Diseases ; Cholesterol ; Depressive Disorder ; Humans ; Inpatients ; Lipid Metabolism ; Lipoprotein(a) ; Lipoproteins* ; Psychotropic Drugs ; Risk Factors ; Schizophrenia ; Serotonin Uptake Inhibitors

The general consensus of the treatment for ankle fracture is anatomical reduction and restoration of the distal tibiofibular relationship. In general, stabilization of the disrupted syndesmosis may be achieved by repairing ruptured ligament; fixing associated fractures of the fibular, avulsed tubercles, and medial malleolus; or by placing a screw between the tibia and the fibular to hold the syndesmosis in position until some degree of syndesmotic ligament healing can occur. However, the managements of syndesmosis remain controversial. The purpose of this study is to evaluate the effect of the syndesmotic fixation in the ankle fractures. The patients with syndesmotic disrupted ankle fracture, who were treated operatively between 1990 and 1995 at St. Benedict Hospital, were divided into the two groups based on whether trans-syndesmotic screw was used or not. The group I included 42 ankle fractures that were treated with trans-syndesmotic screw, while the group II included 28 ankle fractures that were treated without syndesmotic screw. The results obtained from this study were as follows. 1). There was no significant difference of the clinical result between the two groups. 2).When the diastasis was satisfactorily reduced after rigid, anatomic medial and lateral fixation, syndesmotic screw fixation was not required to maintain the integrity of the tibiofibular joint.
Ankle Fractures* ; Ankle* ; Consensus ; Humans ; Joints ; Ligaments ; Tibia

To investigate the cardioyascular effects of 1 MAC-and 2 MAC-isoflurane anesthesia, eight Mongrel dogs were anesthetized with intravenous thiopental sodium and maintained with endotracheal nitrous oxide (2 l/min) -oxygen(2 l/min) -isoflurane-pancuronium. Dogs were kept normothermic by the use of Aqua-Therm and normocapneic with controlled ven-tilation employing Airshield Ventimeter with frequent measurements of PaCO2. An 18G Medicut was inserted in the left femoral artery, a Swan Ganz catheter was passed into the pulmonary artery through the right femoral vein, and cardiovascular parameters were measured during control, 1 MAC-and 2 MAC isoflurane administration. The results are as follows : 1) Heart rate, mean arterial pressure, cardiac output, cardiac index, stroke volume, left ventricular stroke work index and left ventricular dp/dt max decreased during both MAC isoflurane anesthesia. These decreases were more prominent during 2 MAC-isoflurane administration. 2) Pulmonary capillary wedge pressure and pulmonary vascular resistance did not change significantly during the 1 MAC phase, but did during the 2 MAC phase. 3) Mean pulmonary arterial pressue decreased slighter during both phases. 4) Central venous pressure and srstemic vascular resistance did not change significantly throught the experiment. The above findings indicate that isoflurane does directly depress the myocardium and the hemodynamic function, and it is important to decrease isoflurane concentration acccordingly with the use of nitrous oxide.
Anesthesia ; Animals ; Arterial Pressure ; Cardiac Output ; Catheters ; Central Venous Pressure ; Dogs* ; Femoral Artery ; Femoral Vein ; Heart Rate ; Hemodynamics ; Isoflurane* ; Myocardium ; Nitrous Oxide ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Stroke ; Stroke Volume ; Thiopental ; Vascular Resistance

Marchiafa-Bignami disease(MBD) is a rare complication of chronic alcoholism and is pathologically characterized by a symmetrical primary demyelination of the corpus callosum with or without focal necrosis. The clinical features of the disease are quite variable, and the course is usually progressive and fatal. We present a case with characteristic clinical features and imaging findings, including SPECT, of MBD. A 51-year-old man was admitted due to mental confusion, violent behavior, and slowness of motion for 2 months. He had been a heavy alcoholic for about 20 years. He was in a stuporous state for 1 week beginning 2 weeks after his admission.. He then showed alertness but was still in a mute state. His cooperation and responses to noxious stimuli were very poor. A brain MRI showed focal cystic change in the enlarged corpus callosum and diffused high-signal intensity in the subcortical white matter, thalamus, and corpus callosum in T2WI. 99mTc-ECD SPECT revealed diffusely decreased cerebral perfusion in both frontal, temporal and pari-eto-occipital lobes.
Alcoholics ; Alcoholism ; Brain ; Corpus Callosum ; Demyelinating Diseases ; Humans ; Magnetic Resonance Imaging ; Marchiafava-Bignami Disease* ; Middle Aged ; Necrosis ; Perfusion ; Stupor ; Thalamus ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: While asthma control is defined as the extent to which the various manifestations of asthma are reduced by treatment, current guidelines of asthma recommend assessment of asthma control without consideration of airway inflammation. Our aim was to investigate the relationships between fractional exhaled nitric oxide (FeNO), a reliable marker of airway inflammation, and levels of asthma control in patients treated with inhaled corticosteroids (ICS). METHODS: We enrolled 71 adult patients with asthma who had been treated with ICS for more than four months. FeNO was measured and spirometry was performed at the time of enrollment. Asthma control was assessed (a) by the physician based on the Global Initiative for Asthma guidelines, (b) by the patients, and (c) by using the Asthma Control Test (ACT). Statistical analyses were done to analyze the relationships between (i) FeNO and (ii) measures of asthma control and clinical indices for asthma manifestations. RESULTS: There was no significant difference in FeNO levels between the three groups according to levels of asthma control (controlled, partly controlled and uncontrolled) as determined by the physician (p=0.81), or by the patients (p=0.81). In addition, FeNO values were not significantly correlated with the ACT scores (r=0.031, p=0.807), while FeNO showed a correlation with peripheral blood eosinophil counts (p<0.001). CONCLUSION: These findings demonstrate that FeNO levels are not associated with measures of asthma control in patients treated with ICS. Information on airway inflammation from FeNO concentrations seems to be unrelated to levels of asthma control.
Adrenal Cortex Hormones ; Adult ; Asthma ; Eosinophils ; Humans ; Inflammation ; Nitric Oxide ; Spirometry

PURPOSE: To report a case of Vogt-Koyanagi-Harada (VKH) disease in a pregnant patient treated with intravitreal triamcinolone injection. CASE SUMMARY: A 21-year-old female in the 19th week of gestation presented with bilateral blurring of vision associated with mild headache and tinnitus. Her initial best corrected visual acuity was 0.15 in the right eye and 0.3 in the left eye. Multiple serous retinal detachment and anterior chamber inflammation were observed, and VKH disease was diagnosed. Because of her pregnancy, the patient did not want high-dose systemic prednisolone therapy which may cause an abortion or low birth weight infant when used in a pregnant patient. Therefore, an intravitreal triamcinolone (4 mg/0.1 ml) injection was given in the right eye and topical steroid eye drops were used in the left eye. After 1 day, serous retinal detachment was significantly decreased and anterior chamber inflammation disappeared in the right eye. After 1 week, no serous retinal detachment was observed. In the left eye, serous retinal detachment was decreased after using steroid eye drops. After 10 days, serous retinal detachment disappeared but anterior chamber inflammation was still observed. After 1 month, best corrected visual acuity was 1.0 in both eyes and serous retinal detachment had not recurred. On follow-up, VKH disease had not recurred and a healthy normal weight infant was delivered. CONCLUSIONS: Intravitreal triamcinolone injection is an effective and safe treatment for VKH disease in pregnant women.
Anterior Chamber ; Eye ; Female ; Follow-Up Studies ; Headache ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Inflammation ; Ophthalmic Solutions ; Prednisolone ; Pregnancy ; Pregnant Women ; Retinal Detachment ; Tinnitus ; Triamcinolone* ; Uveomeningoencephalitic Syndrome* ; Vision, Ocular ; Visual Acuity ; Young Adult

BACKGROUNDS: Assessment of the presence and degree of reversibility of airflow obstruction is clinically important in patients with asthma or chronic obstructive pulmonary disease. The measurement of peak expiratory flow(PEF) is a simple, fast, and cheap method to assess the severity of obstruction and its degree of reversibility. Assessing the reversibility of airflow obstruction by peak expiratory flow(PEF) measurements would be is practicable in general practice, but its usefulness has not been well investigated. We compared PEF and FEV1 in assessing reversibility of airflow obstruction in patients with chronic obstructive pulmonary disease or asthma and developed a practical criterion for assessing the presence of reversibility in general practice. METHODS: PEF measurements were performed (Spirometry) in 80 patients(aged 24-78) with a history of asthma or chronic obstructive lung disease before and after the inhalation of 200 mg salbutamol. The change in PEF was compared with the change in forced expiratory volume in one second(FEV1). Reversible airflow obstruction was analysed analyzed according to American Thoracic Society(ATS) criteria. RESULTS: When defined as a 12% A 12% increase above the prebronchodilator value and a 200ml increase in either FVC or FEV1 reversibility was were observed in 45%(36) of the patients. Relative operating characteristic(ROC) analysis showed that an absolute improvement in PEF of 30l/min gave optimal discrimination between patients with reversible and irreversible airflow obstruction(the sensitivity and specificity of an increase of 30l/min in detecting a 12% increase above the prebronchodilator value and a 200ml increase in either FVC or FEV1 were 72.2% and 72.7% respectively, with a positive predictive value of 68.4%) CONCLUSIONS: Absolute changes in PEF can be used to diagnose reversible airflow obstruction.
Albuterol ; Asthma ; Discrimination (Psychology) ; Forced Expiratory Volume ; General Practice ; Humans ; Inhalation ; Pulmonary Disease, Chronic Obstructive

BACKGROUNDS: In the absence of distant metastasis, small cell lung cancer (SCLC) patients presenting with supraclavicular lymph node (SCLN) involvement and pleural effusion can benefit from thoracic radiotherapy. But there are some debate as to the prognostic significance of both SCLN involvement and pleural effusion. The purpose of this study was to determine the prognostic significance of SCLN involvement and pleural effusion in SCLC. METHODS: Two Hundred and fifteen patients with histologically confirmed small cell lung cancer, who were treated either at the Keimyung university Dongsan hospital and Kyungpook national university hospital from January 1994 to June 1998, were evaluated retrospectively. The patients were classified as having either limited or extensive stage using the Veterans Administration staging system. RESULTS: SCLN was presented in 10.5% of patients(n=21). The median survival was 247 days for patients with SCLN(n=21) and 264 days for patients without(n=194) (p=0.52). After treatment, the median survival was 298 days for patients with SCLN(n=13) and 348 days for patients without(n=115) (p=0.52). SCLN involvement was not correlated with the presence of distant metastases. Medican survival was 459 days for patients with a limited stage without SCLN(n=66), 650 days for those with a limited stage with SCLN (n=7) (p=0.96). Pleural effusion was presented in 24.7% of patients(n=52). The median survival was 198 days for patients with pleural effusion(n=52) and 275 days for patients without(n=163) (p<0.05). After treatment, the median survival was 294 days for patients with a pleural effusion(n=25) and 286 days for patients without(n=103) (p=0.39). The presence of pleural effusion was not correlated with that of distant metastases. The median survival was 395 days for patients with a limited stage without a pleural effusion(n=63), 451 days for those with a limited stage with pleural effusion(n=10) (p=0.92). CONCLUSIONS: In this study, SCLN involvement does not explain the poor survival rate and the relevance to extensive staged disease. Furthermore, the existence of a pleural effusion did not correlated with the presence of distant metastases. However, the presence of a pleural effusion appears to be a minor prognostic factor in our study. Therefore supraclavicular lymph node justify any amendment to the staging system currently used.
Gyeongsangbuk-do ; Humans ; Lymph Nodes* ; Neoplasm Metastasis ; Pleural Effusion* ; Radiotherapy ; Retrospective Studies ; Small Cell Lung Carcinoma* ; Survival Rate ; United States Department of Veterans Affairs

Inhalation anesthetics, particularly the hydrocarbons and cyclopropane. lower the threshold to the arrhythmogenic activity of catecholamines. This interaction is of concern during the resection of a pheochromocytoma when the surgically-induced release of large amounts of norepinephrine and epinephrine from tumors sets the stage for ventricular arrhythmia by a direct effect on the myocardium together with an increase in blood pressure. In this communication, anesthesia was performed with N2,O-O2,-halothane. In addition patient was managed successfully, using d-tubocurarine, phentolamine (Regitine) and propranolol (Inderal). For the next same case, enflurane is recommended because of absence of flammability, arrhythmogenic activity and nephrotoxity. etc.
Anesthesia ; Anesthetics, Inhalation ; Arrhythmias, Cardiac ; Blood Pressure ; Catecholamines ; Enflurane ; Epinephrine ; Humans ; Hydrocarbons ; Myocardium ; Norepinephrine ; Phentolamine ; Pheochromocytoma* ; Propranolol ; Tubocurarine

PURPOSE: Percutaneous peripheral balloon angioplasty and stent insertion are used for the treatment of peripheral arterial obstructions and stenosis. In this study, we assessed the efficacy of peripheral balloon angioplasty and stent insertion in patients with peripheral arterial disease. METHOD: We performed a retrospective review of patients who underwent peripheral balloon angioplasty or stent insertion in obstructive or stenotic peripheral arterial lesions between July 2003 and November 2006. Follow-up study was performed using lower extremity multi-directional computed tomography (MDCT) or lower extremity angiography. Mean follow-up was 22.8 months. RESULT: A total of 30 patients (47 lesions) were treated. The mean age was 66.8 years, and the ratio of male to female patients was 29 to 1. Calf claudication was the most common chief complaint, and 19 patients had hypertension. Obstructive lesions were found in the common iliac artery (CIA) (18), external iliac artery (EIA) (11), superficial femoral artery (SFA) (15), and anterior tibial artery (ATA) (3). Peripheral balloon angioplasty was performed for 8 lesions, and stent insertion was performed for 39 lesions. Re-stenosis occurred in 9 lesions (3 in the CIA, 5 in the SFA, 1 in the ATA) during follow-up. CONCLUSION: Peripheral balloon angioplasty and stent insertion are useful modalities for the treatment of obstruction or stenosis in lower extremity peripheral arteries. Close follow-up is necessary to improve long-term outcomes.
Angiography ; Angioplasty, Balloon ; Arteries ; Constriction, Pathologic ; Female ; Femoral Artery ; Follow-Up Studies ; Humans ; Hypertension ; Iliac Artery ; Lower Extremity ; Male ; Peripheral Arterial Disease ; Retrospective Studies ; Stents ; Tibial Arteries