The results regarding an association between the polymorphism sites in the dopamine D1 receptor gene and schizophrenia compelled us to study the distribution of the polymorphism in Korean schizophrenia and controls. Eighty-eight schizophrenic patients and normal controls were examined by case-control study for distribution of the polymorphism of the dopamine D1 receptor gene in Korean popualtion to minimize the effect of racial differencies in gene frequencies. The frequencies of the B1 and B2 in schizophrenic patients were 0.11 and 9.89, respectively. And 0.10 and 0.90 in normal control. There was no significant differences in the frequencies in the allele B1 and 2 between schizophrenic patients and normal controls. The author present here the evidence of a lack of alleic association between the polymorphism of the dopamine D1 receptor gene and Korean schizophrenic. The assumption that the dopamine D1 receptor gene has genetic role in the development of schizophrenia was not supported by this case-control study.
Alleles* ; Case-Control Studies ; Dopamine* ; Gene Frequency ; Humans ; Receptors, Dopamine D1 ; Receptors, Dopamine D2 ; Schizophrenia*

Alloplastic implants are known to be inert for many years, though complications are infrequently reported many years after their insertion. We report the case of a patient who had undergone a blow-out fracture repair five years before the discovery of a hematic cyst. He had been free of symptoms for the first five years after his orbital floor repair but then developed pain on eyeball movement and persistent vertical diplopia, which finally led to surgical intervention. At surgery, a hematic cyst was found to have formed around the implanted silastic plate. When alloplastic material is used in orbital fracture repair, we should be alert for late complications which may occur many years after surgery.
Adult ; Biocompatible Materials ; *Blood ; Bone Cysts/diagnosis/*etiology ; Humans ; Male ; Orbital Diseases/diagnosis/*etiology ; Orbital Fractures/diagnosis/*surgery ; Postoperative Complications ; Prostheses and Implants/*adverse effects ; Reoperation ; Silicone Elastomers/*adverse effects ; Tomography, X-Ray Computed

Stuttering as a side effect of antipsychotics is rare. There are only 4 reports of neuroleptic-induced stuttering. Most reports of neuroleptic-inducted stuttering involved low-potency drugs that have high intrinsic antimuscarinic activity. Risperidone is high potent drug and often referred to as 'atypical' antipsychotic agent due to fewer extrapyramidal side effects and efficacy on negative symptoms of schizophrenia. We experienced a case of risperidone-induced stuttering in a young male schizophrenic patient, and report this case.
Antipsychotic Agents ; Humans ; Male ; Risperidone ; Schizophrenia ; Stuttering*

No abstract available.
Animals ; Rats* ; Urinary Bladder*

OBJECTIVES: Schizophrenia manifests a variety of interindividual differences in therapeutic response to antipsychotics. This might be attributable to dopamine and serotonin receptors that a important target for various antipsychotics, and the D3 receptor(DRD3) alleles they carry. The purpose of our study was to investigate whether the plasma levels of homovanillic acid(HVA) and 5-hydroxyindoleacetic acid(HIAA), and the polymorphism of DRD3 can be held as a predictor of treatment response ni chronic schizophrenic patients. METHODS: Therapeutic response for 16 korean schizophrenia patient treated during 48 weeks were assessed by PANSS used as the clinical symptom rating scales. The levels of concentration of HVA and 5-HIAA were examined by HPLC at baseline and at 48 weeks. We classified the polymorphism of DRD3 receptor using amplifying by polymerase chain reaction(PCR). RESULTS: Neither concentrations of HVA and 5-HIAA nor genotype of dopamine 3 receptor were not significantly associated with the therapeutic response. But, the patients who has A1 alleles of DRD3 gene showed poor therapeutic responses. CONCLUSION: A1 allele of DRD3 gene is associated with poor prognosis of chronic schizophrenia.
Alleles ; Antipsychotic Agents ; Chromatography, High Pressure Liquid ; Dopamine* ; Genotype ; Homovanillic Acid ; Humans ; Hydroxyindoleacetic Acid ; Plasma* ; Prognosis ; Receptors, Dopamine D3* ; Receptors, Serotonin ; Schizophrenia ; Weights and Measures

OBJECTIVES: Risperidone and clozapine beling to a new generation of antipsychotics that are reportedly more effective and better tolerated than conventional neuroleptics. However, each of these agents costs far more per unit than conventional neuroletics. The purpose of our retrospective study was to ascertain the total cost and effectiveness of treatment before and after administration of risperidone and clozapine in 'revolving door' schizophrenia patients. METHOD: Data collected on revolving door schizophrenics for 2 years before clozapine and risperidone treatment and for at least 2 years after clozapine and risperidone treatment. Direct cost of inpatient and outpatient treatment was measured. Effectiveness was scaled as 'years of mild disability gained'. RESULT: Both risperidone and cloazpine result in higher costs and additional benefits to patients, for example, increased mild disability, reduced number of relapse, and reduced hospital length-of-stay. An ICER of risperidone was less than Rc and ICER of clozapine was greater than Rc. According to decision-analytic this model, risperidone had favorable cost-effectivenss ratios relative to clozapine. CONCLUSION: We have assumed that risperidone is more cost-effective than clozapine.
Antipsychotic Agents ; Clozapine* ; Cost-Benefit Analysis* ; Humans ; Inpatients ; Outpatients ; Recurrence ; Retrospective Studies ; Risperidone* ; Schizophrenia

PURPOSE: Primary pulmonary lymphoma(PPL) arising in the lung as the initial site is very rare. Authors experienced two cases of PPL and report the radiologic findings and clinical characteristics with a brief reviewof the literature. METHODS AND MATERIALS: Plain chest radiograph and enhanced axial CT scan of the chest were taken. We analyzed radiologic findings of the two cases and correlated with broncoscopic and pathologic findings. RESULTS: Plain chest radiograph showed a mass like consolidative lesion on RML without peripheral atelectasis. Chest CT scan revealed a mass like consolidation with airbronchogram and the absence of a hilar mass or thoracic adenopathy. Percutaneous needle aspiration and biopsy(PCNA and PCNB) of the RML mass confirmed B-cell lymphoma, in both cases. CONCLUSION: PPL must be included in the differential diagnosis of chronic alveolar consolidation such as bronchioloalveolar cell carcinoma.
Diagnosis, Differential ; Lung ; Lymphoma* ; Lymphoma, B-Cell ; Needles ; Pulmonary Atelectasis ; Radiography, Thoracic ; Thorax ; Tomography, X-Ray Computed

BACKGROUND: During one-lung ventilation (OLV) for thoracic surgery, hypoxic pulmonary vasoconstriction (HPV) may reduce venous admixture and ameliorate the decrease in arterial oxygenation by diverting blood from the non-ventilated to the ventilated lung. Volatile anesthethics are the drugs of choice in thoracic surgery despite numerous experimental data showing their inhibiting effect on the HPV. The object of the present study was to compare the effects of propofol with those of isoflurane on oxygenation and shunt during two lung ventilation (TLV) and OLV in human volunteers. METHODS: Thirty patients who needed OLV for an elective thoracic surgery were randomly assigned to receive either isoflurane (1 MAC isoflurane + fentanyl + vecuronium, n = 15) or propofol (2 - 3ng/ dl propofol + fentanyl + vecuronium, n = 15) with 100% oxygen in separate groups. Systemic hemodynamic data was recorded, and blood gas values were obtained 30 min after the start of TLV (TLV-30) and 30, 45 and 60 min after the start of OLV (OLV-30, 45, 60) in the lateral position. RESULTS: A significant reduction in PaO2 and increase in shunt fractions at all study times after the start of OLV compared with TLV were observed in both groups at OLV-30, 45 and 60. Percent changes of PaO2 and shunt of OLV-60 to those of TLV-30 were less in the propofol group than the isoflurane group. Other blood gas data (SaO2, SO2, PaCO2, PCO2, pH, Hb, CaO2 and CO2) and systemic hemodynamics (mean arterial blood pressure, heart rate and central venous pressure) were not different after the start of OLV compared with TLV in either group. CONCLUSIONS: TIVA with propofol was superior than isoflurane anesthesia in terms of arterial blood oxygenation and pulmonary shunting during OLV for lung surgery.
Anesthesia* ; Arterial Pressure ; Fentanyl ; Healthy Volunteers ; Heart Rate ; Hemodynamics ; Humans ; Hydrogen-Ion Concentration ; Isoflurane* ; Lung* ; One-Lung Ventilation* ; Oxygen ; Propofol* ; Thoracic Surgery ; Vasoconstriction ; Vecuronium Bromide ; Ventilation

OBJECTIVES: Epidemiological and clinical studies have suggested that low cholesterol levels or clinical trals to reduce cholesterol concentrations may be associated with suicide, violent behavior or depression. The aim of the present study was to determined i) whether suicidal psychiatric patients is characterized by decreased serum cholesterol concentration ; ii) whether significant difference of cholesterol levels might be present according to the psychiatric diagnosis, and iii) whether significant association between suicide severity and cholesterol levels might be present. METHOD: The subjects were 102 psychiatric patients who were admitted to emergency ward following an attempted suicide during the period from January 1994 to July 1997 and 102 age, and sex matched psychiatric controls who were consecutively admitted to a psychiatric ward during the same period, and 102 age, sex matched healthy normal controls. The suicide attempters were divided into 5 grades according to the suicide severity. Serum cholesterol concentrations were measured by a enzymatic method. RESULTS: The serum cholesterol level in suicidal attempters were found to be significantly lower compared with both psychiatric and normal controls. This significant relationship between suicidal attempt and low cholesterol level was observed only in depressive patients, but not in schizophrenics or personality disorder patients. Low cholesterol was significantly associated with the severity of the suicide. CONCLUSIONS: These results support the previous finding that low cholesterol level might be associated with an increased risk of suicide. The fact that the significant relationship was observed only in depressive disorder, but not in schizophrenia or personality disorder raises the possibility that the association between low serum cholesterol and suicidal behavior may have relevance to biological mechanisms in depression. It is hypothesized that low cholesterol levels would be associated with depression by modifying the serotonin, the production of interleukin 2 and melatonin metabolism.
Cholesterol* ; Depression ; Depressive Disorder ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Interleukin-2 ; Melatonin ; Mental Disorders ; Metabolism ; Personality Disorders ; Schizophrenia ; Serotonin ; Suicide* ; Suicide, Attempted

BACKGROUND: Carbon dioxide (CO2) has different biophysical properties under different thermal conditions, which may affect its rate of absorption in the blood and the related adverse events. The present study was aimed to investigate the effects of heating of CO2 on acid-base balance using Stewart's physiochemical approach, and body temperature during laparoscopy. METHODS: Thirty adult patients undergoing laparoscopic major abdominal surgery were randomized to receive either room temperature CO2 (control group, n = 15) or heated CO2 (heated group, n = 15). The acid-base parameters were measured 10 min after the induction of anesthesia (T1), 40 min after pneumoperitoneum (T2), at the end of surgery (T3) and 1 h after surgery (T4). Body temperature was measured at 15-min intervals until the end of the surgery. RESULTS: There were no significant differences in pH, PaCO2, the apparent strong ion difference, the strong ion gap, bicarbonate ion, or lactate between two groups throughout the whole investigation period. At T2, pH was decreased whereas PaCO2 was increased in both groups compared with T1 but these changes were not significantly different. Body temperatures in the heated group were significantly higher than those in the control group from 30 to 90 min after pneumoperitoneum. CONCLUSIONS: The heating of insufflating CO2 did not affect changes in the acid-base status and PaCO2 in patients undergoing laparoscopic abdominal surgery when the ventilator was set to maintain constant end-tidal CO2. However, the heated CO2 reduced the decrease in the core body temperature 30 min after the pneumoperitoneum.
Absorption ; Acid-Base Equilibrium ; Adult ; Anesthesia ; Bicarbonates ; Body Temperature ; Carbon Dioxide ; Heating ; Hot Temperature ; Humans ; Hydrogen-Ion Concentration ; Insufflation ; Lactic Acid ; Laparoscopy ; Pneumoperitoneum ; Ventilators, Mechanical