The authors described a case of male schizophrenia who developed myoclonic jerk repeatedly and one episode of convulsive seizure during the treatment of clozapine. According to literatures and reported cases, myoclonic jerks induced in a small amount of clozapine may precede and predict the development of a convulsive seizure. Therefore clinicians have to pay attention to the development of a myoclonic jerk during the administration of clozapine. They may decrease the dosage of clozapine step by step at first in the convulsive state, and observe EEG changes of patients frequently.
Clozapine* ; Electroencephalography ; Humans ; Male ; Myoclonus ; Schizophrenia ; Seizures*

PURPOSE: To determine the clinical effect of radial optic neurotomy (RON) in central retinal vein occlusion (CRVO). METHODS: The retinal findings, visual acuity and complications were analyzed in patients who had undergone RON for the treatment of CRVO and were followed up 10 months or more after surgery. RESULTS: Of all 16 patients (16 eyes), the mean age was 55 years and the follow-up period was 14 months. Preoperative anterior segment and retinal neovascularization was observed in each three eyes. All eyes showed improvement in the retinal findings within two weeks after RON. The postoperative complications included vitreous hemorrhage in 1 eye, chorioretinal collateral circulation in 1 eye, neovascular glaucoma in 1 eye, vitreous hemorrhage and neovascular glaucoma in 1 eye. The visual acuity was counting fingers or less in 8 eyes preoperatively and in 2 eyes finally, and was less than 0.1 in 13 eyes preoperatively and in 10 eyes finally. The mean visual improvement in the 3.8 lines was in 11 eyes and a loss of 2.5 lines in 2 eyes. The maximum velocity of the blood flow of CRV improved with 1.95 +/- 0.93 cm/sec on the average in the 7 eyes examined by color doppler. CONCLUSIONS: RON appears to be safe and effective for improving the retinal findings, visual acuity and blood flow of CRV in CRVO. However, the visual recovery is limited.
Collateral Circulation ; Fingers ; Follow-Up Studies ; Glaucoma, Neovascular ; Humans ; Postoperative Complications ; Retinal Neovascularization ; Retinal Vein* ; Retinaldehyde ; Visual Acuity ; Vitreous Hemorrhage

Cholineacetyltrasnferase (ChAT) is a key enzyme that facilitates synthesis of acetylcholine affecting the memory, learning, awakening and sleep process of the cerebrum. The object of this study was to test the hypothesis that the ChAT-gene 2384G>A (rs3810950) polymorphism is associated with Alzheimer's disease (AD) susceptibility, and galantamine response. To elucidate a genetic predisposition of AD, we studied ChAT-gene 2384G>A (rs3810950) polymorphism in 52 AD patients in 93 normal controls. We also examined the association of this polymorphism and galantamine therapeutic response in 52 AD patients who received a 24-week galantamine treatment. There were no significant differences in the genotype or allele frequency of the ChAT polymorphism between the AD and control groups. However, we found that the allele-carrier distributions, allele frequency for the ChAT polymorphism differed significantly between responders and non-responders. The frequency of A-allele carriers (GA+AA) was higher in responders than in non-responders (chi-square=4.282, df=1, p=0.039), as was the A-allele frequency (chi-square=5.216, df=1, p=0.022). These results suggest that the ChAT-gene 2384G>A (rs3810950) polymorphism is associated with galantamine therapeutic response.
Acetylcholine ; Alzheimer Disease ; Cerebrum ; Galantamine ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Learning ; Memory

BACKGROUND: Myxoma makes up close to 50% of adult primary cardiac tumors, and this mainly occurs in the left atrium, and rarely in the right atrium or ventricle. The patients clinically present with symptoms of hemodynamic obstruction, embolization or constitutional changes. Diagnosis is currently established most appropriately with 2-D echocardiography. Surgical resection of myxoma is a safe and effective treatment. MATERIAL AND METHOD: We reviewed our clinical experience in the diagnosis and management of 57 cases of cardiac myxoma that were seen over a 20-year period from July 1984 to July 2004. RESULT: The mean age of the patients was 53.5+/-14.0 years (range: 12 to 76 years). There were 38 (67%) females and 19 (33%) males. The preoperative symptoms included dyspnea on exertion in 27 patients, palpitation in 4, chest pain in 9 and syncopal episode in 4. The diagnosis was made by echocardiography alone in 51, and by combination of echocardiography, CT and angiography in 6. The tumor attachment sites were the interatrial septum in 50, the mital valve annulus in 3 and the left atrial wall in cases. The tumor was excised successfully via biatriotomy in 33 (58%), left atriotomy in 15 (26%), the septal approach via right atriotomy in 3, Inverted T incision in 3 and the extended septal approach in 3. The follow-up time ranged from 1 to 229 months (mean follow-up: 84.0+/-71.3 months). There were no early and late deaths and no recurrence during the follow-up period except for follow-up loss in 5 patients. CONCLUSION: It's concluded that excision of cardiac myxoma is curative and the long-term survival is excellent. Immediate surgical treatment was indicated because of the high risk of embolization or of sudden cardiac death. Radical tumor excision may prevent recurrences.
Adult ; Angiography ; Chest Pain ; Death, Sudden, Cardiac ; Diagnosis ; Dyspnea ; Echocardiography ; Female ; Follow-Up Studies ; Heart Atria ; Heart Neoplasms ; Hemodynamics ; Humans ; Male ; Myxoma* ; Recurrence ; Syncope

Outcome following brain injury is influenced by several factors, including on early medical and rehabilitative intervention, an integrated interdisciplinary team approach to treatment, and the patient's motivation and ablility to cooperate in rehabilitation efforts. Methylphenidate(MP) is a central stimulant that blocks the reuptake of serotonin and norepinephrine, and also it has a dopaminergic activity by releasing the dopamine from dopamine stored vesicles. Dopamine plays an important role in cognitive and affective brain functions. Methylphenidate has been used in an attention deficit disorder with hyperactivity in the pediatric clinic and for various types of depression and narcolepsy. Clinical research has not irreputably proved or disproved the effectiveness of MP for the improvement of cognitive function in brain injured patients. This report presents five cases who were treated by MP for the improvement of cognitive function in brain injured patients. Among five cases, 3 cases suffered from hemorrhagic strokes and 2 cases from tranmatic brain injuries. Three cases were in drowsy stateand 2 cases were semicomatous. After MP(10 mg) was ingested per oral route before breakfast, we evaluated patients' cognitive function by the Functional Independence Measure(FIM), Rappaport Disability Rating Scale(DRS), Mimi-mental State Examination(MMSE), Galveston Orientation and Amnesia Test(GOAT) and the clinical state as well as side effects. Based on the results from the study we suggest cautionally that MP would be useful for the treatment of brain injured pateints who had decreased cognitive function to induce an early participation of rehabilitation programs. Further prospective study is required with a large control group and affected group, to confirm our preliminary results.
Amnesia ; Attention Deficit Disorder with Hyperactivity ; Brain Injuries ; Brain* ; Breakfast ; Depression ; Dopamine ; Humans ; Methylphenidate* ; Motivation ; Narcolepsy ; Norepinephrine ; Rehabilitation ; Serotonin ; Stroke

Frontotemporal dementia is a common cause of dementia and distinguished from Alzheimer's disease. Because its clinical symptoms are characterized by slow progressive social breakdown and change of personality before cognitive impairments become prominent, it may be diagosed as other psychiatric disease. We have presented three cases of frontotemporal dementia. They had typical clinical histories and symptoms which deserve to be considered frontotemporal dementia. They showed appropriate findings of frontotemporal dementia in the neuropsychological tests and brain imaging study with brain magnetic resonance imaging and 18F-FDG positron emission tomography. Their clinical histories and findings are thought to be helpful for clinician to give attention to and diagnose frontotemporal dementia.
Alzheimer Disease ; Brain ; Dementia ; Diagnosis ; Fluorodeoxyglucose F18 ; Frontotemporal Dementia* ; Magnetic Resonance Imaging ; Neuroimaging ; Neuropsychological Tests ; Positron-Emission Tomography

PURPOSE: To observe the pattern of glue cast formation when glue was injected into the different fow layersof a flow phantom, and to demonstrate the effect in an animal experiment. MATERIALS AND METHODS: A flow phantom model consisted of a circulating pump (Simon varistaltic pump, Manostat Corporation, U.S.A.) connected via a tygon tube with a specially designed glass tube. Flow of about 4ml/sec was maintained by saline. The glass tube consisted of (1) a small-caliber (2.4-3.2mm inner diameter) straight inflow portion (feeder), (2) a round, larg-caliber portion (nidus), and (3) a medium-caliber (6.7mm inner diameter) straight outflow portion (vein). Glue mixed with Lipiodol (glue: Lipiodol=1:1-3:1) was loaded into a 1cc syringe and slowly injected through a microcatheter ; cast formation along the glass tube was observed. The feeder and nidus portions were injected twelve times and the shape of the cast was compared. In an animal experiment, glue at various concentrations was used to stop rapid flow through a surgically-constructed arteriovenous fistula in porcine carotid artery. RESULTS: When mixture was injected into the straight inflow portion (1), it formed a cast along the wall of the glass tube, with a large cast in the nidus portion. Further injection caused enlargement of the cast in the nidus, but no change in the wall of the inflow portion. When mixture was injected into the nidus portion (2) of the glass tube, a cast formed continuously within the nidus. In the animal experiment, rapid injection of glue at a high conentration staunched flow through the arteriovenous fistula. CONCLUSION: Glue-Lipiodol mixture can be injected slowly and continuously under the surface of the polymerized glue cast which forms along the wall or slow flow portion (nidus) of the glass tube in an experimental flow phantom. However, the effect did not appear during rapid flow in the animal arteriovenous fistular model in which only rapid injection of glue which was either pure or at a glue concentration of more than 75% was effective.
Adhesives ; Animal Experimentation ; Animals ; Arteriovenous Fistula ; Carotid Arteries ; Ethiodized Oil ; Glass ; Polymers ; Syringes

OBJECTIVES: The aim of this study is to evaluate the effect of risperidone on attention and information-processing in schizophrenic patients after 8 weeks of treatment and to determine whether any improvement on cognitive function relates to improvement in psychopathology. METHODS: The subjects were 29 schizophrenic inpatients with active psychotic symptoms and the controls were 25 normal volunteers. Pre- and post-treatment clinical symptoms were assessed by Positive and Negative Syndrome Scale, Clinical Global Impression and Extrapyramidal Symptom Rating Scale. Vigilance, continuous atttention, the speed of information-processing and fine motor coordinations were assessed by standardized computerized neurocognitive function tests. RESULTS: At baseline, patients showed significantly poor vigilance and continuous attention than normal controls and these functions were not improved after treatment. The positive and negative symptoms and the general psychopathology were significantly improved. The only item of cognitive tasks signi-fica-ntly improved after treatment was decision time to complex audio-visual stimuli in information-processing task. This improvement was not related to the improvements in psychopathology. The level of extrapyramidal symptoms was not related with any of the cognitive fucntion tests items. CONCLUSIONS: Treatment with risperidone appeared to exert a favorable effect on the speed of information-processing and this appeared to be due to a direct pharmacodynamic characteristics of the drug.
Healthy Volunteers ; Humans ; Inpatients ; Psychopathology ; Risperidone* ; Schizophrenia*

PURPOSE: To establish the method of constructing an experimental aneurysm model in porcine carotid artery. MATERIALS AND METHODS: Fourteen aneurysms were created in the carotid arteries of eight pigs. After paramedian incision under intravenous anesthesia, the common carotid artery and external jugular vein were separated. A portion of the latter was cut to make an aneurysmal sac and this was sutured to the side wall of the common carotid arterial wall (end to side). Within one week, an arteriogram was obtained in all pigs and color Doppler study was performed in four. Digital subtraction arteriograms were serially obtained three images/sec, and these were analyzed to determine the size of the sac and the neck, flow pattern in the aneurysm, and stenosis in the common carotid artery. RESULTS: Arteriographic findings were obtained in ten of 14 aneurysms. Six aneurysms were saccular in shape, and the mean size of the sac and neck was 16x10 mm and 5.3 mm, respectively. Four aneurysms were lobulated, and in these cases, the mean size of the sac and neck was 9x3 mm and 3.7 mm, respectively. The mean size of the proximal common carotid artery was 4.5 mm, and at the operation site, mean stenosis was 40%. CONCLUSION: In 10/14 cases (71%), we successfully established an aneurysm model in the porcine carotid artery, and believe that it is suitable for use in interventional neuroradiology experiments.
Anesthesia, Intravenous ; Aneurysm* ; Animals ; Carotid Arteries* ; Carotid Artery, Common ; Constriction, Pathologic ; Jugular Veins ; Neck ; Swine*

PURPOSE: To determine the efficacy of metalic stents in the treatment of experimentally createdcarotid-jugular fistulas. MATERIALS AND METHODS: Carotid-jugular fistulas were constructed surgically in fourmongrel swines. Three Wallstents (Schneider, Bulbanch, Switzerland), 6mm in diameter and 23mm in length, and oneNir stent (Boston Scientific Corporation, Boston, U.S.A.), 3-5mm in diameter and 16mm in length, were placedendovascularly across the fistula holes within the carotid artery. Carotid angiography was performed before,immediately after, and 1-3 months after stent placement. Fistula specimens were ohtained after final angiographyand gross and microscopic examination was performed. RESULTS: Angiography demonstrated decreased flow through thefistula immediately after stent placement. During follow-up, flow through the fistula decreased progressively butcomplete closure did not occur. Carotid arteries p in which Wallstents were placed were patent throughout thefollow-up period. A carotid artery in which a Nir stent was used showed no decreased flow during follow-upangiography lasting two months. Pathologically, a thin layer of endothelium covered the stent wires;there was atransitional zone between the fibrous connective tissue of organizing thrombus, and endothelial proliferationoccurred in the overlying fistula hole. CONCLUSIONS: Stent placement effectively reduced flow through thefistulas but during the ensuing three months closure did not occur. Occlusion was then progressive.Pathologically, intimal proliferntion arose from the oranizing thrombus on the surface of the stent mesh.
Angiography ; Arteriovenous Fistula* ; Carotid Arteries ; Connective Tissue ; Endothelium ; Fistula ; Follow-Up Studies ; Stents* ; Swine ; Thrombosis