Nefazodone, a newer antidepressant is a phenylpiperazine derivative that inhibits the reuptake of both norepinephrine and serotonin, and antagonizes 5-HT2A and alpha1 adrenergic receptors. Compared with SSRIs nefazodone caused the fewer activating symptoms, adverse gastrointestinal effects(nausea, diarrhea, anorexia) and adverse effects of sexual function, but is associated with the more dizziness, dry mouth, constipation, visual disturbances and confusion. We report on 4 cases of visual disturbances and hallucinations in patients taking nefazodone. 1) Nefazodone, as a 5-HT2A antagonist, might induce visual disturbances. 2) mCPP, metabolite of nefazodone might contribute to the hallucination through action on 5-HT receptor. 3) Dopaminergic enhancing activity of nefazodone might cause hallucination. The case report raises the possibility that dose-related perceptual disturbances may exist with nefazodone. The fact emphasizes the need to pay close attention to all possible drug interactions, particularly in patients treated with multiple psychoactive agents, older patients, and patients with decreased hepatic function.
Constipation ; Diarrhea ; Dizziness ; Drug Interactions ; Hallucinations ; Humans ; Mouth ; Norepinephrine ; Psychotropic Drugs ; Receptors, Adrenergic ; Serotonin ; Serotonin 5-HT2 Receptor Antagonists

No abstract available.
Carbon*

ERCP was performed in 34 cases of obstructive janndice at Busan National University Hospital between June 1981 and October 1982, and those findings were compared with the final surgical operative diagnoses. The results were as follows: 1) The ratio of male to female was about l. 6: 1 and most of them were in the 5th decade to 7th decade, 2) Upper abdominal pain and tenderness were the cardinal symptom and sign, 3) Successful ERCP was obtained in 32 cases among the total of 34 cases(94.1%)Selective success rates by indications were 77.8%(21/27) in suspected biliary lesions and 85.7%(6/7) in suspected panceatic lesions. 4) ERCP diagnoses were biliary stone(11 cases), eholangiocarcinoma(6 cases), pancreatic head ca. (4 cases), Ampulla of Vater ca. (2 cases), normal cholangiogram(2 cases), and normal parcreatogram(2 cases). 5) Eighteen cases out of 24 surgical operative cases were diagnosed by ERCP alone, The diagnostic rates of ERCP by surgical operation in obstructive jaundce was 75%. Complications of ERCP were not clinically significant. It suggests that ERCP is a very useful diagnostic method in the differential diagnosis of obstructive jaundice.
Abdominal Pain ; Ampulla of Vater ; Busan ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Diagnosis, Differential ; Female ; Head ; Humans ; Jaundice, Obstructive* ; Male

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

Pulmonary Langerhans' cell histiocytosis is an uncommon granulomatous disorder of unknown cause. The authors retrospectively evaluated radiographs and computed tomographic findings of five patients with biopsy-proven pulmonary Langerhans' cell histiocytosis. The main structural abnormalities consisted of small nodules and cystic air spaces, but one case showed only pneumothorax due to bullae rupture. Its distribution has been known predominently in the upper lung fields, but in our cases, the lung lesions were distributed in the entire lung fields or predominently in the lower lung fields. We propose that pulmonary Langerhans' cell histiocytosis is extremely variable of its structural abnormalities and distribution.
Histiocytosis* ; Humans ; Lung ; Pneumothorax ; Retrospective Studies ; Rupture

PURPOSE: To evaluate the effect of a single intravitreal injection of 4.0 mg/0.1ml triamcinolone acetonide on intraocular pressure (IOP). METHODS: Retrospective studies were conducted by reviewing the charts of 26 eyes of 24 patients that were followed up for 16 weeks after intravitreal triamcinolone injection. The IOPs before and after triamcinolone injection were measured with Goldmann applanation tonometer. RESULTS: Within 16 weeks after intravitreal triamcinolone acetonide injection, 23 of 26 eyes (88.5%) demonstrated an increment in IOP of 5 mmHg or greater, and 6 of 26 (23.1%) had an increment of 10 mmHg or greater. The mean duration of the increase in IOP of 5 mmHg or greater was 5.5 weeks (standard deviation=4.4), and the mean time to reach maximum IOP was 6.6 weeks (standard deviation=4.4). The difference between the mean pre-injection IOP (14.12 mmHg, n=26) and the maximum post-injection IOP (24.65 mmHg, n=26) was statistically significant (P<0.001). All eyes that needed treatment responded to topical glaucoma medication. CONCLUSIONS: An increment in IOP is a common complication after a single intravitreal injection of 4.0 mg/0.1ml triamcinolone acetonide and despite this serious increment in IOP, it was controlled by topical glaucoma medication.
Glaucoma ; Humans ; Intraocular Pressure* ; Intravitreal Injections ; Retrospective Studies ; Triamcinolone Acetonide* ; Triamcinolone*

BACKGROUND: Tensiomyography (TMG) is a relatively new technique that assesses the contractile properties of muscles in response to a single electrical stimulus. This study aimed to evaluate the contractile properties of the gastrocnemius and tibialis anterior (TA) muscles in amateur soccer players using TMG. METHODS: We recruited 41 male soccer players (high school group, n=21; college group, n=20). The gastrocnemius medialis (GM), gastrocnemius lateralis (GL), and TA muscles of both lower extremities were assessed using TMG. The maximal displacement (Dm), delay time, contraction time (Tc), sustained time, and half-relaxation time were obtained and compared between the two groups. RESULTS: First, both groups showed low Dm for the GM and TA muscles, which indicated high stiffness of the muscle tone. Second, the Tc and contraction velocity (Vc) were high for all muscles, except for the GL showing lower speed than the other muscles, which represented the sports-specific characteristics of the soccer players. Third, there were no significant differences in the measurement variables between the dominant and non-dominant sides, except for the Tc of the GM in high school athletes and Vc of the TA in college athletes. CONCLUSIONS These results reflected the sports-specific needs and characteristics of soccer players. A risk of injury is associated with a high degree of stiffness, and various methods for preventing it should be considered.

BACKGROUND: Tensiomyography (TMG) is a relatively new technique that assesses the contractile properties of muscles in response to a single electrical stimulus. This study aimed to evaluate the contractile properties of the gastrocnemius and tibialis anterior (TA) muscles in amateur soccer players using TMG. METHODS: We recruited 41 male soccer players (high school group, n=21; college group, n=20). The gastrocnemius medialis (GM), gastrocnemius lateralis (GL), and TA muscles of both lower extremities were assessed using TMG. The maximal displacement (Dm), delay time, contraction time (Tc), sustained time, and half-relaxation time were obtained and compared between the two groups. RESULTS: First, both groups showed low Dm for the GM and TA muscles, which indicated high stiffness of the muscle tone. Second, the Tc and contraction velocity (Vc) were high for all muscles, except for the GL showing lower speed than the other muscles, which represented the sports-specific characteristics of the soccer players. Third, there were no significant differences in the measurement variables between the dominant and non-dominant sides, except for the Tc of the GM in high school athletes and Vc of the TA in college athletes. CONCLUSIONS: These results reflected the sports-specific needs and characteristics of soccer players. A risk of injury is associated with a high degree of stiffness, and various methods for preventing it should be considered.
Athletes ; Elasticity Imaging Techniques ; Humans ; Lower Extremity ; Male ; Muscle Contraction ; Muscle, Skeletal ; Muscles ; Soccer

The transforaminal epidural injection (TFEI) has been preferred in many cases because it can deliver the injected dose of medication closer to the nerve root and better facilitate ventral epidural flow compared to other methods. However, in patients with deformities not demonstrated on fluoroscopic imaging, the needle may enter unwanted locations. We treated two cases of intradiscal injection of contrast dye, during the TFEI, in patients with lumbar disc herniation.
Congenital Abnormalities ; Discitis ; Humans ; Injections, Epidural ; Needles

Background: The anti-oxidative, anti-inflammatory, and anti-apoptotic effects of erythropoietin may provide neuroprotective effects. Erythropoietin also modulates autophagy signaling that may play a role in anesthesia-induced neurotoxicity (AIN). Herein, we investigated whether AIN can be attenuated by the neuroprotective effect of erythropoietin in the Caenorhabditis elegans (C. elegans). Methods: Synchronized worms were divided into the control, Iso, EPO, and EPO-Iso groups. The chemotaxis index (CI) was evaluated when they reached the young adult stage. The lgg-1::GFP-positive puncta per seam cell were used to determine the autophagic events. The erythropoietin-mediated pathway of autophagy was determined by measuring the genetic expression level of let-363, bec-1, atg-7, atg-5, and lgg-3. Results: Increased lgg-1::GFP puncta were observed in the Iso, EPO, and EPO-Iso groups. In the Iso group, only the let-363 level decreased significantly as compared to that in the control group (P = 0.009). bec-1 (P < 0.001), atg-5 (P = 0.012), and lgg-3 (P < 0.001) were expressed significantly more in the EPO-Iso group than in the Iso groups. Repeated isoflurane exposure during development decreased the CI. Erythropoietin could restore the decreased CI by isoflurane significantly in the EPO-Iso group. Conclusions Erythropoietin showed neuroprotective effects against AIN and modulated the autophagic pathway in C. elegans. This experimental evidence of erythropoietin-related neuroprotection against AIN may be correlated with the induced autophagic degradation process that was sufficient for handling enhanced autophagy induction in erythropoietin-treated worms.