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and 42 patients with depressive disorder or anxiety disorder were recruited from the inpatient psychiatric units and withdrawn from all psychotropic drugs at least far 3 months.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: 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

Approximately one-third of all patients with renal cell carcinoma have metastasis at the time of diagnosis. Metastatic lesions of renal cell carcinoma are most commonly seen in the lung, and they are frequently seen in the bone and liver. However, spleen and rectal metastases are extremely rare. A 63-year-old man had undergone left radical nephrectomy for renal cell carcinoma. About 22 months later, computed tomography revealed multiple enhanced masses in the spleen. Spleen metastasis was suspected and splenectomy was then performed. One year later, the patient visited with complaints of voiding difficulty. A huge pelvic mass was detected by performing prostate ultrasonography and MRI. The mass was 13cm in diameter and it was between the rectum and the prostate. Removal of the pelvic mass and lower anterior resection with end colostomy was done. Histologically, the resected specimens were diagnosed as metastases from the renal cell cancer. Herein, we report on a case of metachronous splenic and rectal metastasis from renal cell carcinoma.
Carcinoma, Renal Cell* ; Colostomy ; Diagnosis ; Humans ; Liver ; Lung ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Metastasis* ; Nephrectomy ; Prostate ; Rectum ; Spleen ; Splenectomy ; Ultrasonography

OBJECTIVES: The anthors examined health-seeking behavior about using herbal medicine in psyciatric and other clinical patients. The effect, side effect and motives in selecting herbal medicine were examined also. This study aimed at presenting treatment guide for psychiatric patients hereafter. METHOD: Subjects were consisted of 277 patients who were 93 medical, 81 surgical, and 102 psyhiatric patients. We made a questionnaire checking circumstances on taking herbal medicine. The investigating psychiatrist conducted person to person semi-structured interview using this questionnaire. RESULTS: Psychiatric patients preferred herbal medicine to western medicine, as other clinical patients did. In their health seeking behavior, classical illness model of oriental herbal medicine occupied a central position. In addition, psychiatric patients not only regarded herbal medicine as a more symtom-specific therapeutic medication, but also accepted side effects of herbal medicine uncritically than other clinical patients. CONCLUSIONS: As it is known that many psychiatric patients take both oriental and western medical treatment, we should not have exclusive attitude to emphasize one side between oriental and western medicine. Rather, we should deepen our understandings about oriental herbal medicine.
Herbal Medicine ; Humans ; Medicine, East Asian Traditional ; Psychiatry ; Surveys and Questionnaires

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

OBJECTIVE: The purpose of this study was to determine whether the results of fractal analysis can be used as criteria for midpalatal suture maturation evaluation. METHODS: The study included 131 subjects aged over 18 years of age (range 18.1–53.4 years) who underwent cone-beam computed tomography. Skeletonized images of the midpalatal suture were obtained via image processing software and used to calculate fractal dimensions. Correlations between maturation stage and fractal dimensions were calculated using Spearman's correlation coefficient. Optimal fractal dimension cut-off values were determined using a receiver operating characteristic curve. RESULTS: The distribution of maturation stages of the midpalatal suture according to the cervical vertebrae maturation index was highly variable, and there was a strong negative correlation between maturation stage and fractal dimension (−0.623, p < 0.001). Fractal dimension was a statistically significant indicator of dichotomous results with regard to maturation stage (area under curve = 0.794, p < 0.001). A test in which fractal dimension was used to predict the resulting variable that splits maturation stages into ABC and D or E yielded an optimal fractal dimension cut-off value of 1.0235. CONCLUSIONS: There was a strong negative correlation between fractal dimension and midpalatal suture maturation. Fractal analysis is an objective quantitative method, and therefore we suggest that it may be useful for the evaluation of midpalatal suture maturation.
Cervical Vertebrae ; Cone-Beam Computed Tomography ; Evaluation Studies as Topic* ; Female ; Fractals* ; Methods ; ROC Curve ; Skeleton ; Sutures*