No abstract available.
Mass Screening* ; Uterine Cervical Neoplasms*

The entity of nonketotic hyperglycemic hyperosmolar coma(NHHC) was described as a severe and often fatal complication in 1957 (Sament and Schwartz), but since then it has been observed as a complication of various primary diseases, both in diabetic and nondiabetic patients. Various predisposing factors in its development include administration of prolonged mannitol, steroid, Dilantin, hyperosmolar tube feeding, dehydration, and diabetes. Combination of these factors are frequently used I the management of patients with neurological disorders and cerebral edema, consequently, a higher prevalence of NHHC might be expected in these patients. We have recently experienced a case of typical NHHC, in whom treated by mannitol, steroid, and Dilantin after emergency craniotomy for head injury.
Brain Edema ; Causality ; Coma* ; Craniocerebral Trauma ; Craniotomy ; Dehydration ; Emergencies ; Enteral Nutrition ; Humans ; Mannitol ; Nervous System Diseases ; Phenytoin ; Prevalence

The entity of nonketotic hyperglycemic hyperosmolar coma(NHHC) was described as a severe and often fatal complication in 1957 (Sament and Schwartz), but since then it has been observed as a complication of various primary diseases, both in diabetic and nondiabetic patients. Various predisposing factors in its development include administration of prolonged mannitol, steroid, Dilantin, hyperosmolar tube feeding, dehydration, and diabetes. Combination of these factors are frequently used I the management of patients with neurological disorders and cerebral edema, consequently, a higher prevalence of NHHC might be expected in these patients. We have recently experienced a case of typical NHHC, in whom treated by mannitol, steroid, and Dilantin after emergency craniotomy for head injury.
Brain Edema ; Causality ; Coma* ; Craniocerebral Trauma ; Craniotomy ; Dehydration ; Emergencies ; Enteral Nutrition ; Humans ; Mannitol ; Nervous System Diseases ; Phenytoin ; Prevalence

Background: Osteoporotic vertebral compression fractures (OVCFs) are often associated with delayed myelopathy. Surgical treatment of delayed myelopathy following an OVCF comprises spinal canal decompression and stable fixation of the vertebral column with an acceptable sagittal alignment. However, such surgical methods are not usually feasible because of medical comorbidities and osteoporosis. We devised a novel, simple technique to decompress the spinal canal and reconstruct the middle column by translating the fractured vertebral body anteriorly through a posterior approach and verified the validity of the new technique. Methods: We conducted a single-center, retrospective study. Patients who underwent vertebral body anterior translation (VBaT) between 2014 and 2017 due to delayed myelopathy after OVCFs were included. Through a posterior approach, discs between the fractured vertebra and the adjacent vertebrae were released. The fractured vertebra was translated anteriorly with pedicle screws and rods to realign the middle column. Radiological and functional improvement was analyzed. Results: There were 12 consecutive patients. The mean age was 70.3 ± 9.4 years. There were 8 female and 4 male patients. Follow-up period was 35.9 ± 13.1 months. Nine patients had pedicle screw augmentation with polymethyl methacrylate. The mean number of fusion segments was 3.4 (range, 2–4). There were 3 types of spinal canal invasion. Five patients had vertebral body vacuum clefts with posterior wall fractures. Five patients had vertebral body angulation with endplate protrusion. Two patients had 3 column fractures. In radiological analysis, the regional kyphotic angle was 35.1° ± 9.1° preoperatively and improved to 8.8° ± 6.8° postoperatively and 9.8° ± 6.1° at the final follow-up (p < 0.001). The anterior vertebral body height ratio was 27.6% ± 7.0% preoperatively and improved to 80.5% ± 13.7% postoperatively and 83.7% ± 12.5% at the final follow-up (p < 0.001). The spinal canal invasion ratio was 52.6% ± 9.1% preoperatively and improved to 25.2% ± 10.4% postoperatively (p < 0.001). Neurological deficit was improved in all patients by 1–3 grades according to Nurick’s grading system. Conclusions In delayed myelopathy following an OVCF, although the posterior cortex invades the spinal canal, it is usually already in the union state. Therefore, it can bear compression force as a middle column if realigned to be in line with the adjoining vertebrae. VBaT demonstrated satisfactory reduction of kyphosis and maintenance of stability until the last follow-up.

OBJECTIVE: The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. METHOD: This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points: at baseline, and 1,2,4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. RESULTS: 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action: a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. CONCLUSIONS: This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.
Dyskinesias ; Dystonia ; Electrocardiography ; Hospitalization ; Hospitals, University ; Humans ; Parkinsonian Disorders ; Risperidone* ; Schizophrenia* ; Vital Signs ; Weights and Measures