No abstract available.
Sulpiride*

There is no doubt that dopamine plays a critical role in the etiopathogenesis of schizophrenia. However, there appeared some limitations in explaining the complex phenomena of schizophrenia. Recent research data suggest that dysfunction in serotonergic system may be involved Before the dopamine hypothesis of schizophrenia became established, the interest in serotonin(5-ydroxytryptamine, 5-HT) as an etiological substrate of this illness occurred. Recently the importance and extent of 5-HT's involvement in the pathophysiology and mechanism of action of antipsychotic drug is actively investigated. In recent years, therapeutic success of clozapine and risperidones has increased attention on the interaction between the 5-HT and dopamine systems in schizophrenia. This led to the serotonin-dopamine for antipsychotic. The authors review the evidence for the role of 5-HT in schizophrenia and serotonin-dopamine interaction.
Clozapine ; Dopamine ; Schizophrenia* ; Serotonin*

No abstract available.
Dexamethasone* ; Psychotic Disorders*

The authors tried to confirm the significant changes of plasma homovanillic acid(HVA) concentration after insulin administration in comparison with those of usual diurnal variation in the same subjects. Male patients with schizophrenia taking neuroleptics were participated in a study of diurnal variation and insulin induced dopaminergic perturbation, with multiple samplings at baseline. 30minutes, 60minutes and 90minutes after insulin administration(n=18). Ten patients were sampled at baseline and 60minutes after insulin administration. There was a diurnal variation of plasma HVA concentrations, which decreased gradually from 8 am to 9 : 30 am. We confirmed that regular insulin(0.1 unit/kg) blocked the normal diurnal variations and increased plasma HVA concentrations. This pattern was not correlated with clinical variables, such as age, onset age, duration of illness and presence of family history. Schizophrenic patients were grouped by the positive and negative syndrome scale. In contrast to our previous study, the concentrations of positive and negative groups were similar at baseline. The HVA concentrations of negative group after insulin administration were higher than those of positive group without statistical significance. We have a plan modify the current insulin-HAV method. In the near future, we will try to confirm whether the modified insulin-HVA method can be used as a biological indicator for the elucidation of complex clinical manifestations of schizophrenia.
Age of Onset ; Antipsychotic Agents ; Homovanillic Acid* ; Humans ; Insulin ; Male ; Plasma* ; Schizophrenia

PURPOSE: To evaluate the efficacy of percutaneous microwave coagulation therapy (PMCT) combined with transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Twenty-five nodular HCCs [long diameter of 1.2 -10 (mean, 3.4) cm] in 19 patients (15males and 4 females) were treated by PMCT 4-138 days after TACE. Under ultrasound guidance, the carcinomas were punctured with a 14-G guideneedle through which a microwave electrode(25.0 cm in length, 1.6mm in diameter) was inserted. To coagulate the HCCs and surrounding hepatic parenchyma, microwave irradiation at 60W for 45 -60 seconds was then applied. One to three sessions of PMCT were performed at intervals of 2-6 days, and one week to 29 months later, the therapeutic effect was evaluated by spiral CT, angiography, and serum alpha-fetoprotein. RESULTS: Eighteen of 25 HCCs (72.0%) were necrotized completely, but seven (28.0%) recurred. Ninety percent of HCCs smaller than 4 cm in long diameter showed complete remission, but all those larger than 4 cm recurred. Alpha-fetoprotein levels decreased markedly in five patients (26.3%), while in 12 (63.2%), asparate aminotransferase (AST)/alanine aminotransferase (ALT) showed transient elevation. Minor complications occurred after PMCT (mild abdominal pain in 8 patients, fever in 7, pleural effusion in 3, portal vein thrombosis in 1, and hepatic abscess in 1), but in no case was this serious. CONCLUSION: PMCT combined with TACE provides effective and safe treatement for nodular HCCs with a long diameter of less than 4 cm.
Abdominal Pain ; alpha-Fetoproteins ; Angiography ; Carcinoma, Hepatocellular* ; Fever ; Humans ; Liver Abscess ; Microwaves* ; Pleural Effusion ; Tomography, Spiral Computed ; Ultrasonography ; Venous Thrombosis

BACKGROUND: The 24-hr urine protein excretion test is regarded as a standard for quantitative urinary protein analysis; however, collection of urine over 24 hr is troublesome and errors may occur during the process. We obtained a test index reflecting diluted or concentrated urine by coupling the results of a simple and rapid routine urine analysis and evaluated its usefulness as a marker that quantitatively reflects the 24-hr urine protein excretion. METHODS: The estimated urine protein-osmolality ratio (Pro/Osm) was obtained by two linear regression equations between urine dipstick protein and natural logarithm of the protein concentration, and between urine specific gravity (SG) and urine osmolality (Osm). Sensitivity and specificity of 'estimated urine Pro/Osm' and the widely used urine protein-creatinine ratio were evaluated for their efficiency in diagnosing pathological proteinuria and nephrotic proteinuria based on 24-hr urine protein excretion. RESULTS: Moderate correlations were noted between protein concentration determined by the urine dipstick protein assay and natural logarithm of protein concentration (r=0.86) and between urine SG and urine Osm (r=0.74). The receiver operating characteristics analysis showed that an estimated urine Pro/Osm value of 0.045 had a sensitivity of 91.1% and a specificity of 88.6% for diagnosing pathological proteinuria, and a value of 0.204 had a sensitivity of 100% and a specificity of 80.4% for diagnosing nephrotic proteinuria. CONCLUSIONS: Coupling the results of urine dipstick protein and urine SG determined by the routine analysis will provide additional useful information that will make the screening of renal diseases more cost-effective.
Linear Models ; Mass Screening* ; Osmolar Concentration ; Proteinuria ; ROC Curve ; Sensitivity and Specificity ; Specific Gravity*

We analyzed the central islands in corneal topography after excimer laser photo refractive keratectomy(VISX Twenty/Twenty B(R) with VisionKey(TM) VISX, Inc. Santa Clara, CA, USA) to evaluate the prevalence of central island and the factors associated with their occurrence, prospectively. Corneal topographic analysis using Corneal Analysis System(EyeSys Technologies, Inc. Houston, TX, USA) was performed in 94 eyes of 77 patients at the postoperative 1-, 3- and 6-months after excimer laser PRK. Central islands were seen in 27%(25/92), 10%(8/79) and 8%(5/64) of patients at postoperative 1-, 3- and 6-months, respectively. There was statistically significant decrease in the occurrence of central island between postoperative 1 and 3 months follow-up groups(p<0.01). In consequence, central islands tended to resolve with time. There was no association between island prevalence and type of procedure(Photorefractive keratectomy vs Photorefractive astigmatic keratectomy), the amount of attempted correction (6D down vs 6D up), age or sex(All: p>0.05). We found that there was no demonstrable effect of central islands on the decrease of best spectacle corrected visual acuity at postoperative 1 month(p>0.05). Occurrence was statistically significantly decreased in the patients treated with the version 4.01 of central island removal software(1 month: p<0.01, 3 months: p<0.05). We suggest that the version 4.01 software of VISX 20/20B(R) was very effective to reduce the prevalence of central island after excimer laser PRK. In conclusion, if the software would be adjusted to increase the number of pulses centrally, this might reduce the prevalence of central island. New strategies and algorithms might be developed to reduce the prevalence of central islands.
Cornea ; Corneal Topography ; Follow-Up Studies ; Humans ; Islands* ; Lasers, Excimer* ; Myopia* ; Prevalence* ; Prospective Studies ; Visual Acuity

For the study of the applicability of predictive equation of subjective symptoms of workers using organic solvents, 67 male workers using organic solvents were selected. The predictive equation was quotated from previous Cheon's study. All the datas of necessary variables were gained. The predictive values and observed values were compared. The results were summarized as below; 1. The difference between predictive values and observed values were characteristically large. The coefficient of determination between the two values was 0.0024. 2. The R2 value of multiple stepwise regression equation derived from present study was 0.2827.
Humans ; Male ; Solvents*

OBJECTIVES: The authors investigated the possibility of homovanillic acid (HVA) and 3-methoxy-4-hydroxyphenylglycol (MHPG) concentrations in plasma to be biological markers before and after the pharmacological treatment of schizophrenia. METHODS: Twenty-six patients with schizophrenia were enrolled after two week washout of neuroleptics. Baseline sampling was done after washout. Consequent samplings were done at two and four week time-points after neuroleptic treatment. The concentrations of HVA and MHPG were analysed with clinical variables, such as age, age of onset, duration of illness, period of hospitalization, and changes of clinical state. The HVA and MHPG were assayed using high pressure liquid chromatographyelectrochemical detection method. RESULTS: A significant association was observed between the age of onset and plasma HVA concentration in washout state of antipsychotics. The earlier onset group had lower plasma HVA concentration than the late onset group. A significant association was observed between the age of onset and plasma MHPG concentration in washout state of antipsychotics. The earlier onset group had lower plasma MHPG concentration than the late onset group. CONCLUSIONS: The present findings suggest that the activities of dopamine and norepinephrine are different with respect to age of onset in the neuroleptic-naive schizophrenia. Plasma HVA and MHPG concentration can be biological markers for the subgrouping of schizophrenia.
Age of Onset* ; Antipsychotic Agents ; Biomarkers ; Dopamine ; Homovanillic Acid* ; Hospitalization ; Humans ; Methoxyhydroxyphenylglycol ; Norepinephrine ; Plasma* ; Schizophrenia*

OBJECTIVE: To establish the reference values of the sensory conduction for all the digits in the hand, conduction studies were performed using the standard technique. METHOD: One hundred hands of fifty neurologically healthy adults with mean age of 45 years (range, 23~69) were tested. Depending on ages, the 50 adults were devided into three groups: group 1, 20~45 years old; group 2, 46~60 years old; group 3, 61~ years old. Antidromic sensory nerve conduction techniques using a fixed distance were performed. The onset latency and baseline to peak amplitude of the sensory nerve action potentials (SNAPs) were measured. During the test, the skin temperature of the hand was maintained at 34 degrees C or above. These variables from SNAPs were compared according to age, gender, side, and recording digits. RESULTS: Comparison of the median and ulnar SNAPs between age groups revealed longer onset latency and smaller amplitude in the elderly group. The amplitude of SNAPs was larger in females than in males and the left side than the right side. Comparison of the latencies and amplitudes between the second and third digits showed no significant difference statistically. Also, the latencies and amplitudes of the median and ulnar nerves recorded from the fourth digits showed no significant difference statistically. CONCLUSION: Based on these results, the reference values for sensory conductions from all the digits were obtained. These values would be helpful in evaluation of CTS or unspecified finger pain or upper extremity neuropathy.
Action Potentials ; Adult ; Aged ; Female ; Fingers ; Hand ; Humans ; Male ; Median Nerve ; Neural Conduction* ; Reference Values ; Skin Temperature ; Ulnar Nerve ; Upper Extremity