OBJECTIVE: Some patients with schizophrenia may need mirtazapine augmentation to improve negative and cognitive symptoms. However there have been a few studies about the tolerability of mirtazapine augmentation to antipsychotics such as akathisia, extrapyramydal symptoms, weight gain, and body mass index (BMI). METHODS: This study was an eight-week double-blind, randomized controlled trial (RCT) of mirtazapine augmentation to risperidone. Twenty-one stabilized participants diagnosed with schizophrenia and undergoing treatment with risperidone were randomized to adjunctive treatment with mirtazapine (15 mg/day for the first two weeks, 30 mg/day for the next six weeks) or placebo. Eleven patients were assigned to the mirtazapine group, and nine patients were given placebo. RESULTS: There was no significant difference between the mirtazapine and placebo groups with respect to Barnes Akathisia rating Scale (BAS) and Sympsom-Angus Scale (SAS). However, the mirtazapine group exhibited a statistically significant increase in weight and BMI (p<0.05). CONCLUSION: These results suggest that mirtazapine augmentation can be tolerable in schizophrenic patients treated with risperidone; however, we should pay attention to the weight gain with mirtazapine. Our results should be replicated in a large-scale lengthy trial.
Antipsychotic Agents ; Body Mass Index ; Humans ; Mianserin ; Neurobehavioral Manifestations ; Psychomotor Agitation ; Risperidone ; Schizophrenia ; Weight Gain

BACKGROUND/AIMS: Cholestatic jaundice caused by a juxtapapillary diverticulum can be treated by excision of the diverticula or endoscopic sphincterotomy(EST). The aim of this study is to evaluate the effectiveness of EST for cholestatic jaundice in patient with juxtapapillary diverticulum with absence of common bile duct stones. METHODS: We recruited patients who underwent Endoscopic Retrograde Cholangio Pancreatography(ERCP) between September 2000 and May 2005. The presence of Juxtapapillary diverticula was seen in 92(29.3%)) out of 315 patients underwent ERCP. Cholestatic jaundice associated with juxtapapillary diverticula was considered when patients have jaundice, elevated serum bilirubin and alkaline phosphatase more than normal, and there are no other obstructive lesion on abdominal ultrasonography or computed tomography(CT) scan. The number of the patients were 13 who had cholestatic jaundice associated with juxtapapillary diverticula without common bile duct stones. All 13 patients underwent EST and had no complications. The patients were followed up to visit outpatient department or interviewed on the telephone. RESULTS: Of the 13 patients, 10 were male and 3 were female. The mean age was 70.4 years and mean duration of follow-up were 28.9 months. All 13 patients who had gallbladder presented RUQ discomfort and jaundice. Seven patients presented gallstone pancreatitis with jaundice. Nine patients had GB stone, 1 patients had GB sludge. In the follow-up period, from 1month to 46 months after EST, 1 patient died of unknown cause within 1 year. One patient had recurred gall stone pancreatitis with jaundice 12 months later. CONCLUSIONS: EST can be considered as a useful therapeutic modality especially in eldery patients with cholestatic jaundice and gallstone pancreatitis associated with juxtapapillary diverticulum.
Alkaline Phosphatase ; Bilirubin ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Diverticulum* ; Female ; Follow-Up Studies ; Gallbladder ; Gallstones ; Humans ; Jaundice ; Jaundice, Obstructive* ; Male ; Outpatients ; Pancreatitis ; Sewage ; Telephone ; Ultrasonography

PURPOSE: Injuries are the third leading cause of death in Korea. Isolated chest injury is not uncommon and shows high mortality and morbidity. Several scoring systems are used for triage and stratification for trauma patients, but no standard system is accepted. We aimed to analyze the accuracy of identification of isolated chest injury by using several scoring systems. METHODS: We reviewed a total of 75 patients admitted with isolated chest injury between January 2005 and October 2005. Medical records were reviewed by using the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma and Injury Severity Score (TRISS). The scoring systems were compared by using statistics methods. RESULTS: The overall predictive accuracy of the TRISS was 12.5%, 12.0% greater than those of the RTS and the ISS. By using the area under the receiver operating characteristic (AUROC) curve, the TRISS showed an excellent discriminative power (AUROC 0.931) compared to the ISS (AUROC 0.926) and the RTS (AUROC 0.872). CONCLUSION: Compared with the RTS and the ISS, the TRISS is an easily applied tool with excellent prognostic abilities for isolated chest trauma patients. However, the TRISS, the ISS, and the RTS showed high specificity and low sensitivity, so another scoring system is required for triage and stratification of isolated chest injury patients.
Cause of Death ; Humans ; Injury Severity Score ; Korea ; Medical Records ; Mortality ; ROC Curve ; Sensitivity and Specificity ; Thoracic Injuries* ; Thorax* ; Triage

No abstract available.

Eosinophilic granuloma of bone well-documented in the literature. This lytic bone disease most commonly occurs in children, but a fraction of the cases does occurs in adult. When the disease occurs in adults, the bone most often affected include the skull, ribs, mandible, clavicle, pelvis, and long bone of the extremities. We report the case of a 31-year old woman with isolated eosinophilic granuloma of the thoracic spine. She had a 1-month history of progressive back pain that radiated to the right anterior chest. Authors performed resection of vertebral body lesion and soft tissue lesion and anterior fusion from T7 to T9. Immunochemical staining showed a positive S100 protein stain. EM demonstrated characteristic Birbeck granule. Postoperatively, the patient underwent a 5-day course of RT to the T6-T10 spine with 200cGY fractions (total dose 1000cGY). Postoperatively, the patient's back and chest pain had disappeared. There is no evidence of local recurrence or distant metastasis at 18 months follow-up. Though rare, eosinophilic granuloma of the adult spine could be considered in the differential diagnosis of osteolytic lesions.
Adult* ; Back Pain ; Bone Diseases ; Chest Pain ; Child ; Clavicle ; Diagnosis, Differential ; Eosinophilic Granuloma* ; Eosinophils* ; Extremities ; Female ; Follow-Up Studies ; Humans ; Mandible ; Neoplasm Metastasis ; Pelvis ; Recurrence ; Ribs ; Skull ; Spine* ; Thorax

Fracture healing in the hand is not an isolated goal. The functional end result is of paramount importance. When the correct techniques are used, miniplate fixation for metacarpal and phalangeal fractures of the hand provides rigid internal fixation, stabilizes the skeleton, preserves the gliding tissue, and therefore allowing immediate active range of motion exercise as well as minimizing joint and tendon complications. The authors have reviewed 39 patients, 52 cases of metacarpal and phalangeal fractures of the hand which were treated with miniplate in the department of orthopaedic surgery, Chang Ang Gil hospital from Sep. 1989 to Feb. 1993. The following results were obtained. 1. Miniplate fixation, in terms of fracture reduction and maintenance, allows on accurate anatomic reduction with rigid fixation which in turn affords on early mobilization without loss of reduction alignment. 2. The roentgenographic union was obtained within 15.1 weeks in average. The mean total acitve motion at the fractured finger was 230°. The complication rate was 11.5%. 3. In the treatment of metacarpal and phalangeal fractures of the hand, especially fractures of metacarpal bones, fixation with miniplate is considered to be an useful method in terms of getting fracture union and good range of motion with relative low complication rates.
Early Ambulation ; Fingers ; Fracture Healing ; Hand ; Humans ; Joints ; Metacarpal Bones ; Methods ; Range of Motion, Articular ; Skeleton ; Tendons

No abstract available.
Calcinosis* ; Humans ; Infant, Newborn*

No abstract available.
Femur* ; Hip Fractures*

No abstract available.
Femur* ; Tibia*

Authors has analyzed 75 cases of the femoral shaft fractures in children, treated by 90-90 skeletal traction methods at Jung Ang Gil General Hospital during last six years, from March 1982 to April 1988. The results were as follows :1. The 90-90 Skeletal traction can be widely applicable to the age group ranging from 3 to 13 years, while other traction methods have a certain age limits. 2. Maintenance of initial reduction snd correction of angular and rotational deformity of femoral shaft fracture were easily achieved. In addition, later angular deformity can also be easily corrected. In angular deformity and instability type, the correction and maintenance of deformity and instability were helped by use of 2 cast slabs. 3. Follow-up observation as well as wound care of open fracture and associated soft tissue injury were relatively easy. 4. The period of immobilization necessory after fracture was not longer than the other methods of treatment, and during treatment, evaluation of bony alignment and union was possible by direct palpation and inspection with out the help of X-ray. 5. The limitation of knee motion as well as circulatory and neurogenic complication were not found. Therefore, these results revealed that 90-90 skeletal traction was the easy, safe and effective method in treatment of femoral shaft fractures in childeren.
Child ; Clinical Study ; Congenital Abnormalities ; Femur ; Follow-Up Studies ; Fractures, Open ; Hospitals, General ; Humans ; Immobilization ; Knee ; Methods ; Palpation ; Soft Tissue Injuries ; Traction ; Wounds and Injuries