No abstract available.
Hormone Replacement Therapy ; Humans ; Incheon* ; Osteoporosis* ; Physicians, Primary Care* ; Primary Health Care*

OBJECTIVES: Decreased pain sensitivity to the external stimuli was sought by measuring the pressure pain thresholds in patients with schizophrenia. In the case of the pain insensitivity(PI) being confirmed, the relationship between psychiatric symptoms and PI was to evaluated. METHODS: 21 schizophrenic and 23 healthy controls were enrolled. Pressure pain thresholds(PPT) were measured by pressure algometer on initial and recovered phase, and positive and negative symptoms by PANSS(Positive and Negative Symptoms Scale)(Stanley et al. 1991) were obtained in patient group. The confounding factor induced by antipsychotics to the PPT was controlled for. Comparisons of PPT between two groups, and correlations of PPT and psychiatric symptoms in patient group were tested. RESULTS: 1) Schizophrenic patients with active psychotic symptoms showed higher PPT compared to healthy controls. 2) When psychiatric symptoms were improved, PPT was decreased to the level of healthy controls. 3) Only the subscale of delusion in PANSS was closely correlated with PPT in patients with schizophrenia. 4) The dose of antipsychotics did not influence the PPT of the patient group. CONCLUSIONS: A part of patients with schizophrenia revealed they had higher pressure pain thresholds, which suggested PI in active symptom phase. However, PPT were restored almost to the level of normal controls when psychotic symptoms were improved. Thus, PI seemed to be a transient phenomenon rather than a persistent one. Changes of pain sensitivity to the external stimuli in schizophrenics would be associated with severity of delusion based upon reversible changes of brain function. Decreased attention due to delusion or lack of motivation seemed to be causal factors of PI. Clinicians should give attention to PI in schizophrenic patients to prevent physical illness and serious injuries in them.
Antipsychotic Agents ; Brain ; Delusions ; Humans ; Motivation ; Pain Threshold* ; Schizophrenia*

PURPOSE: The purpose of this study was to assess the relative diagnostic capability of magnetic resonance angiography(MRA) and CT angiography(CTA) in the evaluation of intracranial aneurysm. MATERIALS AND METHODS: MRA and CTA were performed in 14 intracranial aneurysms (Including four which were ruptured) confirmed in the II patients involved by conventional angiography(CA). The size(in largest dimension) of the aneurysms ranged between 3 mm and 20 mm and the mean was 10.5 mm. For MRA, the 3D TOF method, with magnetization transfer suppression, wasused at 1.5T. For CTA, twenty seconds after beginning the injection of contrast media(100mL with use of a power injector at the rate of 3 mL/sec), CT scanning(30-second exposure and 60-mm length) was performed with a table speed of 2 mm/sec and a section thickness of 2mm. The resulting data were reformatted by MIP. MRA and CTA were compared with regard to the detection of aneurysms and their neck, size, shape, direction, intensity and relationship to adjacent bony structures or vessels. RESULTS: All aneurysms were clearly visualized with CTA. Inone case with a 3-mm aneurysm, however, this was not defined on MRA. Of the 13 aneurysms demonstrated by both MRA and CTA, eight were seen equally well with both modalities. CTA was considered to be superior to MRA in fivecases, either because calcification in the aneurysm wall was seen only on CTA(n = 3) or because the relationship with adjacent bony structures were seen better with CTA(n = 2). With CTA, the intensities of the aneurysm were homogeneous in all cases ; with MRA, however, the intensities of three large aneurysms were different. CONCLUSION: MRA and CTA may be useful in the evaluation of intracranial aneurysm, CTA has specific advantages over MRA inthe evaluation of large aneurysms, calcification of aneurysm wall and relationship with adjacent bony structure.
Aneurysm ; Angiography* ; Cerebral Angiography ; Intracranial Aneurysm* ; Magnetic Resonance Angiography* ; Neck

Many drugs can result in a variety of pathologic reactions in the lung, especially the cytotoxic drugs. Amongcytotoxic drugs bleomycin is a prototype. Bleomycin-related pulmonary toxicity is usually known as dose-dependent and can be enhanced with concurrent oxygen therapy, irradiation, or other chemotherapeutic agents. The incidence of bleomycin-induced pulmonary toxicity has been reported as varying from 2 to 46%, and 1% of fatal lung disease. We describe the radiographic and HRCT findings of bleomycin-related pulmonary toxicity developed in two patients: one in ovarian teratocarcinoma, the other malignant lymphoma patient. Chest radiographs and HRCT of these patients showed ground-glass opacities, consolidation, linear and reticular opacities, and interlobular septal thickening. These abnormalities were bilateral, and symmetrical and were found predominantly in the area of mid-and lower-lung zone.
Bleomycin ; Humans ; Incidence ; Lung Diseases ; Lung* ; Lymphoma ; Oxygen ; Radiography, Thoracic ; Teratocarcinoma

The authors report two cases of clozapine-induced acute hepatitis. Two patients developed asymptomatic hepatitis and got better with conservative care. We decreased the dosage of clozapine and added hepatic protectors, resulting in normalized laboratory findings. The authors also reviewed side effects of clozapine in this report. We reviewed the suggested mechanism of either clozapine or chlorpromazine-induced hepatitis. Clozapine influences the liver cell via cytochrome P 450 and chlorpromazine does so via mild cholestasis. There may be a possibility that a patient who has experienced drug-induced hepatitis is vulnerable to clozapine-induced acute hepatitis. In this respect, those who have experienced drug-induced hepatitis must be observed more closely.
Chlorpromazine ; Cholestasis ; Clozapine ; Cytochrome P-450 Enzyme System ; Drug-Induced Liver Injury ; Hepatitis* ; Humans ; Liver

BACKGROUND AND OBJECTIVES: The purposes of this study were to provide evidence of any correlation between the endothelial dysfunction and the extent of coronary atherosclerosis, and the relationship between the endothelial function and individual atherosclerosis risk factors in patients with significant coronary artery stenosis. SUBJECTS AND METHODS: The endothelial function was measured by hyperemia induced brachial artery dilation, using high resolution ultrasound, in 284 consecutive patients (mean age 59 years, men: 176) having undergone coronary angiography. The subjects were divided into four groups according to the number of coronary arteries narrowed by more than 50%; 0 (n=88), 1 (n=98), 2 (n=54) and 3 (n=44). The endothelial functions were compared to see if significant coronary artery disease was present, according to the groups and the presence of individual atherosclerosis risk factors. RESULTS: There were no significant differences in the endothelial dysfunction between the narrowed and normal coronary artery groups (4.66+/-2.45% vs. 4.43+/-1.53% p>0.05) or between the four groups. The endothelial function in patients with significant coronary artery stenosis (n=196) was significantly lower when coupled with hypertension (n=84, 2.99+/-2.4% vs. 4.20+/-2.4%, p<0.05), diabetes (n=44, 4.07+/-2.7% vs. 4.84+/-2.5%, p<0.05) and hypercholesterolemia (n=82, 4.26+/-1.9% vs. 4.95+/-2.7%, p<0.05), but not with smoking. CONCLUSION: The endothelial function showed no difference according to the extent of coronary atherosclerosis. Risk factors of atherosclerosis, such as hypertension, diabetes mellitus and hypercholesterolemia, can deteriorate the endothelial function further, even in the patients with significant coronary artery stenosis.
Atherosclerosis ; Brachial Artery ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels ; Diabetes Mellitus ; Endothelium, Vascular ; Humans ; Hypercholesterolemia ; Hyperemia ; Hyperlipidemias ; Hypertension ; Male ; Risk Factors ; Smoke ; Smoking ; Ultrasonography

Distraction osteogenesis refers to the biological process responsible for new bone formation between bone segments by gradual distraction after osteotomy. For the past several years, various inconveniences including a protracted consolidation period that requires patients to wear a distractor frame longer, as well as higher medical costs, have not been remedied by improvements in osteotomy, distraction rate and monitoring system. Furthermore, side effects such as pin tract infections and soft tissue swelling may arise due to the long treatment period. These drawbacks form the rationale of this study which purports to seek a method by which the consolidation period can be reduced. This paper examines how platelet-rich plasma (PRP), known to facilitate osteogenesis, influences bone formation when applied in distracted area. Ten mongrel dogs, which were made to wear external distractor frames after osteotomy in both sides of the mandible, were used as subjects. After a 7day period of latency, distraction was carried out at a rate of 1mm/day for 14 consecutive days. After the onset of distraction, 2ml of PRP and a mixture of calcium gluconate and thrombine were injected into the center of the distracted callus on the left side of the mandible. The left was injected with PRP while the right side was set as the control site without PRP treatment. Execution at the onset of distraction and in 2 weeks, 4 weeks and 8 weeks after the consolidation period, clinical and radiographic tests, bone mineral density examination, histological examination and histomorphometric analysis were conducted to compare both sides. The results are summarized as follows: 1. Based on the clinical examination at two weeks, more remarkable cortical bone formation was found on the buccal and lingual side of the distracted area in the PRP treatment site than in the control site. No visual difference was found between the PRP treatment site and the control site at four and eight weeks. 2. Based on the radiological examination, a distinct increase in the radiopaque appearance of the PRP treatment site was revealed at two weeks, but this increase appeared to slow down at four and eight weeks. 3. Examination of bone mineral density revealed a significant difference at two weeks with the PRP treatment site yielding density two times higher than the control site. This difference lessened after four weeks, and disappeared at eight weeks. 4. The histomorphometric examination revealed that about 20% more bony trabeculae area (20% higher) was formed in the PRP treatment site than in the control site. In conclusion, it can be said that PRPs effect on stimulating bone formation in the PRP treatment site manifest as early as two weeks. Trabeculae formation likewise increased throughout the whole period. If this result can be applied to humans, the consolidation period can be reduced by injecting PRP into the distracted area.
Animals ; Biological Processes ; Bone Density ; Bony Callus ; Calcium Gluconate ; Dogs ; Humans ; Mandible* ; Osteogenesis* ; Osteogenesis, Distraction ; Osteotomy ; Platelet-Rich Plasma* ; Thrombin

PURPOSE: Authors compare clinical and radiological results of internal fixation group and hemiarthroplasty group for comminuted proximal humerus fracture to find out which the treatment method have to be chose for comminuted proximal humerus fractures. MATERIALS AND METHODS: Patients who were treated from March 2005 to March 2007 and available for 2 years follow-up were targets of this study. The internal fixation group had 38 cases, and hemiarthroplasty group included 26 cases. The results were analyzed both clinically and radiologically. RESULTS: On average, Bone union took 15.6 weeks in the internal fixation group. Constant score between the internal fixation and hemiarthroplasty groups were on average 75+/-6.5 points and 70+/-7.4 points (p=0.034). In 3-part fracture, Constant score between both groups were 78+/-5.4 points from the former and 71+/-2 points, respectively (p=0.028). In 4-part fracture group, Constant score were 72+/-8 points for the internal fixation group and 69+/-9.2 points for the hemiarthroplasty group (p=0.041). CONCLUSION: Internal plate fixation can gain better outcome than hemiarthroplasty in 4-part fracture as well as 3-part fracture of proximal humerus by careful dissection for preservation of blood supply for humeral head and optimal reduction.
Follow-Up Studies ; Hemiarthroplasty ; Humans ; Humeral Head ; Humerus

Background: Direct immunofluorescence (DIF) is a histochemical technique used to detect tissue-bound autoantibodies and diagnose various immune-mediated skin diseases. Objective: This study aimed to evaluate the sensitivity of DIF for each disorder, and the consistency between clinical, histopathological, and DIF results. Methods: A retrospective study was conducted in 194 patients who underwent skin biopsy and DIF testing at our hospital between January 2011 and December 2021. An antibody panel against immunoglobulin G (IgG), IgA, IgM, C3, C1q, and fibrinogen was used. The concordance rate and κ-coefficient between the clinical, histopathological, and DIF results were evaluated. Results: DIF was observed to be positive in 87 cases; 51 cases of immune-mediated bullous diseases, seven cases of connective tissue diseases (CTDs), 25 cases of vasculitis, and four cases of other diseases. The overall sensitivity of DIF for immune-mediated bullous diseases was 71.8%, which was higher than that of histopathology (64.8%). In CTDs and vasculitis, the overall sensitivities of DIF were 30.4% and 65.8%, respectively, which were lower than those of histopathology (73.9% and 84.2%, respectively). In addition, good concordance among the clinical, histological, and DIF results was observed. Conclusion DIF is a useful diagnostic method, especially for immune-mediated bullous diseases, lupus erythematosus, and Henoch-Schonlein purpura. However, in other CTDs and vasculitis cases, the sensitivity of DIF is relatively low. Therefore, the diagnostic value of DIF along with clinical and histopathological findings will be maximized only when the DIF test is performed for appropriate diseases.