The results regarding an association between the polymorphism sites in the dopamine D1 receptor gene and schizophrenia compelled us to study the distribution of the polymorphism in Korean schizophrenia and controls. Eighty-eight schizophrenic patients and normal controls were examined by case-control study for distribution of the polymorphism of the dopamine D1 receptor gene in Korean popualtion to minimize the effect of racial differencies in gene frequencies. The frequencies of the B1 and B2 in schizophrenic patients were 0.11 and 9.89, respectively. And 0.10 and 0.90 in normal control. There was no significant differences in the frequencies in the allele B1 and 2 between schizophrenic patients and normal controls. The author present here the evidence of a lack of alleic association between the polymorphism of the dopamine D1 receptor gene and Korean schizophrenic. The assumption that the dopamine D1 receptor gene has genetic role in the development of schizophrenia was not supported by this case-control study.
Alleles* ; Case-Control Studies ; Dopamine* ; Gene Frequency ; Humans ; Receptors, Dopamine D1 ; Receptors, Dopamine D2 ; Schizophrenia*

Extramedullary hematopoiesis occurring in multiple organs such as thorax, liver and both kidneys is an unusual condition. We report the CT findings of this condition with review of literature. The lesions consisted of intrathoracic paravertebral masses, focal intrahepatic mass and masses of both pelvocalyceal systems on CT scans.
Biopsy ; Case Report ; Female ; Hematopoiesis, Extramedullary+ACo- ; Human ; Kidney/radiography ; Kidney/physiopathology ; Liver/radiography ; Liver/physiopathology ; Liver/pathology ; Mediastinum/radiography ; Mediastinum/physiopathology ; Middle Age ; Myelofibrosis/physiopathology+ACo- ; Thorax ; Tomography, X-Ray Computed

Extramedullary hematopoiesis occurring in multiple organs such as thorax, liver and both kidneys is an unusual condition. We report the CT findings of this condition with review of literature. The lesions consisted of intrathoracic paravertebral masses, focal intrahepatic mass and masses of both pelvocalyceal systems on CT scans.
Biopsy ; Case Report ; Female ; Hematopoiesis, Extramedullary+ACo- ; Human ; Kidney/radiography ; Kidney/physiopathology ; Liver/radiography ; Liver/physiopathology ; Liver/pathology ; Mediastinum/radiography ; Mediastinum/physiopathology ; Middle Age ; Myelofibrosis/physiopathology+ACo- ; Thorax ; Tomography, X-Ray Computed

OBJECTIVES: Schizophrenia manifests a variety of interindividual differences in therapeutic response to antipsychotics. This might be attributable to dopamine and serotonin receptors that a important target for various antipsychotics, and the D3 receptor(DRD3) alleles they carry. The purpose of our study was to investigate whether the plasma levels of homovanillic acid(HVA) and 5-hydroxyindoleacetic acid(HIAA), and the polymorphism of DRD3 can be held as a predictor of treatment response ni chronic schizophrenic patients. METHODS: Therapeutic response for 16 korean schizophrenia patient treated during 48 weeks were assessed by PANSS used as the clinical symptom rating scales. The levels of concentration of HVA and 5-HIAA were examined by HPLC at baseline and at 48 weeks. We classified the polymorphism of DRD3 receptor using amplifying by polymerase chain reaction(PCR). RESULTS: Neither concentrations of HVA and 5-HIAA nor genotype of dopamine 3 receptor were not significantly associated with the therapeutic response. But, the patients who has A1 alleles of DRD3 gene showed poor therapeutic responses. CONCLUSION: A1 allele of DRD3 gene is associated with poor prognosis of chronic schizophrenia.
Alleles ; Antipsychotic Agents ; Chromatography, High Pressure Liquid ; Dopamine* ; Genotype ; Homovanillic Acid ; Humans ; Hydroxyindoleacetic Acid ; Plasma* ; Prognosis ; Receptors, Dopamine D3* ; Receptors, Serotonin ; Schizophrenia ; Weights and Measures

OBJECTIVES: Risperidone and clozapine beling to a new generation of antipsychotics that are reportedly more effective and better tolerated than conventional neuroleptics. However, each of these agents costs far more per unit than conventional neuroletics. The purpose of our retrospective study was to ascertain the total cost and effectiveness of treatment before and after administration of risperidone and clozapine in 'revolving door' schizophrenia patients. METHOD: Data collected on revolving door schizophrenics for 2 years before clozapine and risperidone treatment and for at least 2 years after clozapine and risperidone treatment. Direct cost of inpatient and outpatient treatment was measured. Effectiveness was scaled as 'years of mild disability gained'. RESULT: Both risperidone and cloazpine result in higher costs and additional benefits to patients, for example, increased mild disability, reduced number of relapse, and reduced hospital length-of-stay. An ICER of risperidone was less than Rc and ICER of clozapine was greater than Rc. According to decision-analytic this model, risperidone had favorable cost-effectivenss ratios relative to clozapine. CONCLUSION: We have assumed that risperidone is more cost-effective than clozapine.
Antipsychotic Agents ; Clozapine* ; Cost-Benefit Analysis* ; Humans ; Inpatients ; Outpatients ; Recurrence ; Retrospective Studies ; Risperidone* ; Schizophrenia

Hyperosmolar nonketotic coma complicated in diabetes mellitus has been a rare cause of rhabdomyolysis, although increasingly reported recently. Acute renal failure can be complicated in 15 percent of rhabdomyolysis patients, but is rare in the case of rhabdomyolysis caused by diabetic hyperosomolar nonketotic coma. We report a 14 years-old boy with acute renal failure complicated by rhabdomyolysis caused by diabetic hyperosmolar coma.
Acute Kidney Injury* ; Adolescent ; Child* ; Coma* ; Diabetes Mellitus ; Humans ; Male ; Rhabdomyolysis*

OBJECTIVES: Epidemiological and clinical studies have suggested that low cholesterol levels or clinical trals to reduce cholesterol concentrations may be associated with suicide, violent behavior or depression. The aim of the present study was to determined i) whether suicidal psychiatric patients is characterized by decreased serum cholesterol concentration ; ii) whether significant difference of cholesterol levels might be present according to the psychiatric diagnosis, and iii) whether significant association between suicide severity and cholesterol levels might be present. METHOD: The subjects were 102 psychiatric patients who were admitted to emergency ward following an attempted suicide during the period from January 1994 to July 1997 and 102 age, and sex matched psychiatric controls who were consecutively admitted to a psychiatric ward during the same period, and 102 age, sex matched healthy normal controls. The suicide attempters were divided into 5 grades according to the suicide severity. Serum cholesterol concentrations were measured by a enzymatic method. RESULTS: The serum cholesterol level in suicidal attempters were found to be significantly lower compared with both psychiatric and normal controls. This significant relationship between suicidal attempt and low cholesterol level was observed only in depressive patients, but not in schizophrenics or personality disorder patients. Low cholesterol was significantly associated with the severity of the suicide. CONCLUSIONS: These results support the previous finding that low cholesterol level might be associated with an increased risk of suicide. The fact that the significant relationship was observed only in depressive disorder, but not in schizophrenia or personality disorder raises the possibility that the association between low serum cholesterol and suicidal behavior may have relevance to biological mechanisms in depression. It is hypothesized that low cholesterol levels would be associated with depression by modifying the serotonin, the production of interleukin 2 and melatonin metabolism.
Cholesterol* ; Depression ; Depressive Disorder ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Interleukin-2 ; Melatonin ; Mental Disorders ; Metabolism ; Personality Disorders ; Schizophrenia ; Serotonin ; Suicide* ; Suicide, Attempted

OBJECTIVES: In large-scale field trials, randomization by cluster is frequently used because of the administrative convenience, a desire to reduce the effect of treatment contamination, and the need to avoid ethical issues that might otherwise arise. Cluster randomization trials are experiments in which intact social unit, e.g., families, schools, cities, rather than independent individuals are randomly allocated to intervention groups. The positive correlation among responses of subjects from the same cluster is in matter in cluster randomization. This thesis is to compare the results of three randomization methods by standard error of estimator of treatment effect. METHODS: We simulated cholesterol data varing the size of the cluster and the level of the correlation in clusters and analyzed the effect of cholesterol-lowering agent. RESULTS: In intra-cluster randomization the standard error of the estimator of treatment effect is smallest relative to that in inter-cluster randomization and that in individual randomization. CONCLUSIONS: Intra-cluster randomization is the most efficient in its standard error of estimator of treatment effect but other factor should be considered when selecting a specific randomization method.
Cholesterol ; Ethics ; Humans ; Random Allocation*

Ciliated hepatic foregut cyst (CHFC) is a rare benign lesion consisting of ciliated pseudostratified columnar epithelium, loose subepithelial connective tissue, a smooth muscle layer, and an outer fibrous capsule. We encountered a patient with retroperitoneal and posterior mediastinal neurilemmoma and additional CHFC mimicking metastasis. Abdominal CT examination demonstrated that the posterior mediastinal and retroperitoneal lesions were lobulated, well-defined tumors with a neural foraminal extension that were pathologically confirmed as neurilemmomas. Unenhanced CT indicated that the additional lesion was a slightly hypodense mass relative to surrounding parenchyma at the medial segment of the left lobe of the liver, and after the IV ad-ministration of contrast material, the lesion did not show enhancement.
Connective Tissue ; Epithelium ; Humans ; Liver ; Muscle, Smooth ; Neoplasm Metastasis* ; Neurilemmoma ; Tomography, X-Ray Computed

We report a case of multiple myeloma with gastric involvement occurring in a patient who underwent an upper gastrointestinal series (UGIS), CT and MRI. UGIS depicted a luminal protruding mass, while contrast-enhanced CT demonstrated marked thickening of the gastric wall, with subtle contrast enhancement. At T1- and T2-weighted MR imaging, the mass showed iso- and intermediate signal intensity, respectively. After the administration of contrast material, subtle homogeneous enhancement was apparent.
Case Report ; Contrast Media/administration & dosage ; Human ; Magnetic Resonance Imaging ; Male ; Middle Age ; Multiple Myeloma/pathology/*radiography ; Stomach Neoplasms/pathology/*radiography ; Tomography, X-Ray Computed