OBJECTIVE: Atypical antipsychotics have been reported to induce the elevation of serum transaminase frequently in Korea, although most of them don't cause severe liver injury. Some hepatoprotectants are commonly prescribed in order to reduce the serum level of transaminase in patients with schizophrenia. We performed the chart review retrospectively for investigating the effect of two hepatoprotectants, biphenyl dimethyl dicarboxylate+garlic oil combination (BDD), and silymarin+silybin combination (SMR14) on the serum transaminase (AST/ALT) elevated by atypical antipsychotics. METHODS: We reviewed the clinical records of 54 schizophrenic patients who experienced the elevation of serum AST/ALT after the treatment with atypical antipsychotics. Patients with preexisting liver disease or elevated AST/ALT above in-house normal limitation at admission were excluded. We obtained the level of serum AST/ALT at the time of hepatoprotectants administration, 1 week, 2 weeks and 4 weeks after the administration. Repeated Analyses of variance were conducted in order to identify sequential change of serum AST/ALT level, and Fisher's exact test were performed to compare the number of patients whose AST/ALT levels were normalized after 4 weeks between two groups. RESULTS: 33 males and 21 females were included in this study and the mean age of those subjects was 36.28+/-10.92. Among all the patients, 35 were treated with BDD and 19 were treated with SMR14. After administration of hapatoprotectants, both serum AST and ALT level were significantly reduced during 4 weeks (F=10.56, p<0.001;F=17.92, p<0.001). BDD was superior to SMR14 in the number of patients whose ALT level reduced below in-house upper limitation after 4 weeks of treatment with hepatoprotectants (p=0.012), but there was no difference between BDD and SMR14 in aspect to AST level. CONCLUSION: Both hepatoprotectants, BDD and SMR14 were effective in reducing serum AST/ALT level which had been elevated by atypical antipsychotics. BDD was superior to SMR14 in normalizing serum ALT level within 4 weeks. Increased liver enzyme is prevalent in patients during the treatment with atypical antipsychotics. More research will be needed in this field.
Antipsychotic Agents* ; Female ; Humans ; Korea ; Liver Diseases ; Liver* ; Male ; Retrospective Studies ; Schizophrenia

BACKGROUND: We conducted this study to verify whether a mechanical ventilator is adequate for cardiopulmonary resuscitation (CPR). METHODS: A self-inflating bag resuscitator and a mechanical ventilator were used to test two experimental models: Model 1 (CPR manikin without chest compression) and Model 2 (CPR manikin with chest compression). Model 2 was divided into three subgroups according to ventilator pressure limits (P(limit)). The self-inflating bag resuscitator was set with a ventilation rate of 10 breaths/min with the volume-marked bag-valve procedure. The mode of the mechanical ventilator was set as follows: volume-controlled mandatory ventilation of tidal volume (Vt) 600 mL, an inspiration time of 1.2 seconds, a constant flow pattern, a ventilation rate of 10 breaths/minute, a positive end expiratory pressure of 3 cmH2O and a maximum trigger limit. Peak airway pressure (P(peak)) and Vt were measured by a flow analyzer. Ventilation adequacy was determined at a Vt range of 400-600 mL with a P(peak) of < or = 50 cmH2O. RESULTS: In Model 1, Vt and P(peak) were in the appropriate range in the ventilation equipments. In Model 2, for the self-inflating bag resuscitator, the adequate Vt and P(peak) levels were 17%, and the P(peak) adequacy was 20% and the Vt was 65%. For the mechanical ventilator, the adequate Vt and P(peak) levels were 85%; the P(peak) adequacy was 85%; and the Vt adequacy was 100% at 60 cmH2O of P(limit). CONCLUSIONS: In a manikin model, a mechanical ventilator was superior to self-inflating bag resuscitator for maintaining adequate ventilation during chest compression.
Cardiopulmonary Resuscitation* ; Manikins* ; Models, Theoretical ; Positive-Pressure Respiration ; Thorax ; Tidal Volume ; Ventilation* ; Ventilators, Mechanical*

Phakomatosis pigmentova.scularis is a disease complex with dermal melanocyto sis such as nevus of Ota, nevus of Ito, or Mongolian spots and extensive hemangiomatous change such as nevus flammeus, which are associated with systemic organ involvement. We report a 23-year-old female, who showed bilateral nevus of Ota and nevus of Ito with widespread nevus flammeus and Mongolian spots since birth. She was also associated with megalocornea due to congenitol glaucoma and cataract.
Cataract ; Female ; Glaucoma ; Humans ; Mongolian Spot ; Neurocutaneous Syndromes* ; Nevus ; Nevus of Ota ; Parturition ; Port-Wine Stain ; Young Adult

We report a case of congenital vellus hamartoma, which consists of numerous matured vellus hair follicles and sebaceous glands. This patient is 4-month-old male with multiple, variable sized nodules on the right epicanthsl fold area since birth. Histopathologically, some of the infundibular portion of the vellus hair shows irregular and reticulated hyperplasia. There are numerous well-formed vellus hair follicles surrounded with thick fibrous sheath and some of them are associated with rudiment sebaceous glands.
Hair ; Hair Follicle ; Hamartoma* ; Humans ; Hyperplasia ; Infant ; Male ; Parturition ; Sebaceous Glands

Mixed tumor of the skin (chondroid syringoma) is a rare benign tumor composed of epithelial elements intermingled with myxoid or cartilagenous stroma which is not separated by basement membrane. It had been believed to originate from the eccrine gland but recently, it was described to be of apocrine gland origin in case of showing apparent apocrine secretion. We report on a 63-year-old man with a tumor on the right upper eyelid showing typical microscopic features of mixed tumor of the skin. Many apocrine decapitation secretions were seen in tubular structures and follicular differentiations were also seen, which represents the common origin of folliculo-sebaceous-apocrine unit.
Adenoma, Pleomorphic ; Apocrine Glands ; Basement Membrane ; Decapitation ; Eccrine Glands ; Eyelids ; Humans ; Middle Aged ; Skin

Blue nevus is a benign melanocytic neoplasm and represents itself usually as a solitary blue or blue-black papule. It rarely occurs as multiple lesions grouped in a circumscribed area. How-ever, non-grouped disseminated blue nevi are exceedingly rare. We report a patient with acquired multiple blue nevi that was distributed over the entire body discretely and showed an increase in the number of the nevi without any causal factors.
Humans ; Nevus ; Nevus, Blue*

No abstract available.
Nose*

We performed this study to analyse the morbidity and mortality of stoma formation in infants and children over a 17-year period. Thirty-seven stoma formations were performed in 37 patients: 21 for anorectal malformation, 9 for Hirschsprung's disease, 3 for necrotizing enterocolitis, 2 for multiple ileal atresia, 1 for volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation. There were 26 boys and 11 girls with a mean age of 0.4 years. Complications after stoma formation were encountered in 12 patients(32.4%) and included stomal prolapse, stenosis, retraction, dysfunction, skin excoriation and parastomal hernia. Four patients(10.8%) required stomal revision. The incidence of complications was neither related to the age nor to the primary indication for the stoma formation, but sigmoid colostomy was associated with a lower complication rate compared to transverse colostomy(22.1% versus 42.1%, P<0.05). Five patients died, but only one(2.7%) was dead, which was directly related to stoma formation. Eighteen of these children subsequently underwent stoma closure which was associated with complications in six patients(33.3%). The most common complication after stoma closure was wound sepsis in 4 children. In conclusion, because the significant morbidity of stoma formation still exists the refinements in surgical technique may help in reducing the incidence of complications and a sigmoid loop colostomy should be used whenever possible.
Child* ; Colon ; Colon, Sigmoid ; Colostomy ; Constriction, Pathologic ; Enterocolitis, Necrotizing ; Female ; Hernia ; Hernia, Diaphragmatic ; Hirschsprung Disease ; Humans ; Incidence ; Infant* ; Intestinal Volvulus ; Mortality ; Prolapse ; Sepsis ; Skin ; Wounds and Injuries