Neuroleptic malignant syndrome(NMS) is an uncommon but potentially fatal idiosyncratic reaction to neuroleptics, characterized by muscular rigidity, fever, autonomic dysfunction, and altered consciousness. The major theories to explain NMS is central dopaminergic blockade, but it is unclear. Risperidone is a new antipsychotic drug, a benzisoxazole derivative that blocks dopamine D2 receptor and serotonin type 2 receptor. The comparatively greater serotonin-blocking activity is believed to give risperidone the specific property of not causing any more extrapyramidal side effects than conventional antipsychotics at the optimal dose of 4-8mg/day. It is postulated that risperidone is unlikely to cause NMS. Here, we report a case of risperidone induced neuroleptic malignant syndrome.
Antipsychotic Agents ; Consciousness ; Fever ; Muscle Rigidity ; Neuroleptic Malignant Syndrome* ; Receptors, Dopamine D2 ; Risperidone ; Serotonin

A simple, rapid and selective liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) is developed and validated for quantification of venlafaxine in human plasma with simple liquid-liquid extraction step consisted of extraction with ether and dichloromethane for 10 min and mixing with 1 M sodium acetate in human plasma using fluoxetine as an internal standard (IS). The analyte are separated using an isocratic mobile phase consisted of acetonitrile and 5 mM ammonium formate (4/3, v/v) on a isocratic YMC hydrosphere C18 (2.0x50.0 mm, 3.0 microm) column and analyzed by MS/MS in the multiple reaction monitoring (MRM) mode using the transitions of respective [M+H](+) ions, m/z 278.2-->260.3 and m/z 310.1-->148.1 for quantification of venlafaxine and IS, respectively. The standard calibration curves showed good linearity within the range of 1.0-200.0 ng/mL (r2=0.9986, 1/chi2 weighting). The lower limit of quantification (LLOQ) was 1.0 ng/mL. The retention times of venlafaxine and IS were 0.6 min and 0.7 min that means the potential for the high-throughput potential of the proposed method. In addition, no significant metabolic compounds were found to interfere with the analysis. Acceptable precision and accuracy were obtained for the concentrations over the standard curve range. The validated method was successfully applied to bioequivalence study after 75-mg of venlafaxine sustained-release (SR) capsule in 24 healthy Korean subjects.
Ammonium Compounds ; Calibration ; Chromatography, Liquid ; Ether ; Fluoxetine ; Humans ; Ions ; Liquid-Liquid Extraction ; Methylene Chloride ; Pharmacokinetics ; Plasma* ; Sodium Acetate ; Tandem Mass Spectrometry ; Therapeutic Equivalency* ; Venlafaxine Hydrochloride

To evaluate the degree of competitive exclusion against Salmonella gallinarum(S. gallinarum) of Salmonella enteritidis(S. enteritidis) infected chickens, fifty-six, 4-week old Hyline layer suspected of S. enteritidis infection were challenged with S. gallinarum. All chickens were tested for S. enteritidis isolation using cloacal swabs and serum plate agglutination test using S. enteritidis Ag. before challenge and classified into four groups(SE isolated, SE nonisolated, SE seropositive and SE seronegative). None of the SE isolated and the SE seropositive groups died after challenge and the average weight gains were 245.5g and 254.6g, respectively. But in the SE nonisolated and the SE seronegative groups, mortality was 18.2% and 20.6% and the average weight gains were 150.1g and 111.2g. The incidence of reisolation of S. gallinarum of the SE isolated and the SE seropositive groups were 41.7% and 47.6% from liver, 33.3% and 47.6% from spleen and 8.3% and 14.3% from cecum, respectively, and the SE nonisolated and the SE seronegative group were 63.6% and 64.7% from liver, 84.1% and 88.2% from spleen and 47.7% and 52.9% from cecum. The serological response of the SE isolated and the SE seropositive groups hardly changed from 75.0 and 81.8% before challenge to 75.0 and 85.7% after. But, the other two groups were found to be significantly higher after challenge and increased from 0 and 18.2% to 100%. Consequently, S. enteritidis preinfected chickens were found to be significant different in terms of mortality, weight gain, reisolation of S. gallinarum and serological response compared to noninfected chickens. Moreover, our study shows that S. enteritidis infected chickens appear strong competitive exclusion against the colonization of S. gallinarum.
Animals ; Chickens ; Disease Outbreaks/veterinary ; Korea/epidemiology ; Oviposition ; Poultry Diseases/*microbiology ; Salmonella/*classification/*isolation & purification ; Salmonella Infections, Animal/*microbiology ; Salmonella enteritidis/*classification/*isolation & purification ; Serotyping ; Weight Gain

Due to the instability of intertrochanteric fractures in elderly patients, various methods of reduction and fixation were introduced to obtain stable reduction and solid union, But there have been many controversies regarding advantages between anatomical reduction group and non-anatomical reduction group. The authors analyzed the 68 unstable intertrochanteric fractures out of total 94 cases of intertrochanteric fractures treated from Jan. 1988 to Jan. 1994 with mean follow-up 17 months and evaluated the radiologic and clinical results between those two groups. The results were obtained as follows: 1. The most common cause was low energy injury and according to the Tronzo classification, the type III was most common in 54 cases (79.4%). 2. The average union time was 14.0wks (84%), the union rate was low in the medialized reduction group(A-P) and anterior displaced reduction group(A-P), anterior displaced and anatomical reduction groups(Lateral). 3. The compression length more than 10mm of lag screw was deep in medialized reduction group(A-P), another displaced and anatomical reduction groups(Lateral). 4. The average length of lag screw sliding was 9.2mm and depth sliding of 6.8mm (74%) was occurred within immediate postoperative 1 month.
Aged ; Classification ; Femur ; Follow-Up Studies ; Hip Fractures ; Hip ; Humans

Fractures involving both tibial plataeus result form high energy trauma such as a traffic accidents or falls, and it is frequently accompanied by soft tissue injuries. Thus it is very difficult to treat these fractures satisfactorily and severe complications can be caused. The purpose of study is to analyze the clinical results, complication and factors influencing the results after open reduction and internal fixation of tibial bicondylar fractures. Twenty cases(19 patients) of tibial bicondylar fractures which had been treated by open reduction and internal fixation from January 1989 to December 1994 were analyzed after 1 to 5 years follow-up. The results were as follows. 1. By AO classification, the most common type was C3(13 cases). 2. According to Blokker's criteria, 5 cases was unsatisfactory and all of these cases were C3. 3. Unsatisfactory results were 3 cases of reduction loss(angular deformity), one case of deep infection and one case of unresolved peroneal nerve palsy. 4. Tibial tubercle osteotomy, bone graft and medial buttress plate were important for anatomical reduction and maintenance.
Accidental Falls ; Accidents, Traffic ; Classification ; Follow-Up Studies ; Osteotomy ; Paralysis ; Peroneal Nerve ; Soft Tissue Injuries ; Tibia ; Transplants

PURPOSE: To evaluate the clinical effect of intravenous glutamine administration on patients admitted to the intensive care unit in general hospitals. METHODS: Patients with more than 7 days in an intensive care unit were evaluated. The experimental group was the patients who received intravenous glutamine administration for more than 3 days. The laboratory results, intensive care unit length of stay, hospital length of stay, 30 days mortality, and hospital mortality were evaluated with a comparative group. RESULTS: The mean number of administration days of intravenous glutamine was 10.12±8.93 days, and the average daily dose was 0.33±0.10 g/kg/day. No adequate improvement in the laboratory results of glutamine-treated group was observed. The intensive care unit length of stay (21.16±15.83 vs. 16.48±11.06, P=0.007), hospital length of stay (35.94±30.75 vs. 27.34±19.09, P=0.010), 30 days mortality (20.0% vs. 10.0%, P=0.034), and hospital mortality (26.3% vs. 13.0%, P=0.001) were higher in the glutamine-treated group. CONCLUSION: The use of intravenous glutamine on intensive care unit patients did not improve the clinical effect. Further large-scale multi-center studies will be needed to assess the proper administration of intravenous glutamine on intensive care unit patients.
Critical Care ; Glutamine ; Hospital Mortality ; Hospitals, General ; Humans ; Intensive Care Units ; Length of Stay ; Mortality

From January 1988 to December 1991, 39 fractures of the lateral condyle of humerus in children were treated at the Department of Orthopaedic Surgery, Sung-Ac General Hospital. It was possible to follow up from one year to four years and eleven months. The authors have analyzed the method of treatment on the basis of the degree of displacement in the change of Carrying angle and Baumann's angle. The results were as follows; 1. Of the 39 cases, the age incidence was confined to 2 to 12 years of age and the average age of the patients were 5 years. 2. Most fractures were Milch type II (29 cases) in contrast to Milch type I (10 cases). 3. According to the initial displacement of the fracture, 8 cases were Jokob's stage I, 21 cases of stage II & 10 cases of stage III. 4. There were no significant difference in the range of change of Carrying angle and Baumann's angle according to initial displacement of fracture site. However, significant difference in outcome were noticed from open reduction and internal fixation in comparison to closed reduction and percutaneous pinning. 5. In all 39 cases, lateral condylar overgrowth (10 cases), cubitus varus (1 cases) and cubitus valgus (3 cases) were noticed as complications but clinical significance was not noted. 6. The above results suggest that internal fixation is recommended for firm fixation although displacement is not severe. In case of Jakob's stage III, anatomical reduction is required in order to reduce additional damage on articular surface and epiphyseal plate caused by excessive manipulation.
Child ; Clinical Study ; Follow-Up Studies ; Growth Plate ; Hospitals, General ; Humans ; Humerus ; Incidence ; Methods

Congenital fibrosarcoma of neonate is a very rare malignant tumor prone to behave aggressively with a tendency to local recurrence without metastasis. It is characteristically composed of collagenous fibroblasts and herringbone pattern in histology. We experienced a case of congenital fibrosarcoma on the left thigh and report this case with some review in literature with 1½ year follow up.
Collagen ; Fibroblasts ; Fibrosarcoma ; Follow-Up Studies ; Humans ; Infant, Newborn ; Neoplasm Metastasis ; Recurrence ; Thigh

PURPOSE: To analysis the efficacy of MRI in assessing fracture configuration and frequency of associated soft tissue injuries in tibial plateau fractures. MATERIALS AND METHODS: In the plain films and MRI of 47 cases with tibial plateau fractures,every fracture was classified by findings on plain film and MRI respectively according to the Schatzker system and they were compared with each other. The degree of displacement and depression of the fracture fragments were measured on plain film and MRI. RESULTS: MRI was more accurate in determining the classification of the fracture and measuring the displacement and depression of fragments. Fracture classifications were changed in 12 cases. Especially in Schatzker VI cases, articular step off over 2 mm and articular fragments over 2X2 cm were revealed in detail by MRI. Evidence of internal derangement of the knee was found in 38 (80.8%) cases. CONCLUSION: Most of the cases with acute tibial plateau fracture were commonly associated with ligamentous and meniscal injuries. MRI can aid in accurate evaluation of tibial plateau fracture patterns and decision of treatment plan.
Classification ; Depression ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Soft Tissue Injuries

PURPOSE: Return of spontaneous circulation (ROSC) is closely related to a favorable treatment outcome in out-of-hospital cardiac arrest and is also a reliable treatment target in clinical trials. The aim of this study is the identification of major factors affecting field ROSC by analyzing the updated data encompassing the pre-hospital treatment processes. METHODS: This is a retrospective review of cardiopulmonary resuscitation (CPR) cases performed by 119 rescuers before hospital arrival from January 2012 to December 2014 in one province. Cases with traumatic cardiac arrest, unnecessary CPR, arrest occurred during transport, under age 14 years, and incomplete medical records were excluded. RESULTS: Of 1,832 patients enrolled in the study, ROSC was achieved in 99 cases (5.4%). Among them, 50 (50.5%) had ROSC at the event field and others achieved ROSC during the transport process, respectively. Total cases were divided into two groups based on ROSC before arrival at the hospital. Age, underlying cardiovascular illnesses, the event place, presence of a witness, bystander CPR, application of an automated external defibrillator (AED), the initial shockable rhythm, defibrillation, advanced airway, hydration, the arrival time of rescuer CPR, application time of AED, and defibrillation showed significant statistical differences. In multivariate analysis, age, defibrilOf 1,832 patients enrolled in the study, ROSC was achieved in 99 cases (5.4%). Among them, 50 (50.5%) had ROSC at the event field and others achieved ROSC during the transport process, respectively. Total cases were divided into two groups based on ROSC before arrival at the hospital. Age, underlying cardiovascular illnesses, the event place, presence of a witness, bystander CPR, application of an automated external defibrillator (AED), the initial shockable rhythm, defibrillation, advanced airway, hydration, the arrival time of rescuer CPR, application time of AED, and defibrillation showed significant statistical differences. In multivariate analysis, age, defibrillation, hydration, bystander CPR, and the call-to-rescuer CPR interval appeared to be correlated with field ROSC. CONCLUSION: To improve the survival rate through field ROSC, a public campaign to improve bystander CPR, prompt recognition of cardiac arrest, and rapid application of pre-hospital treatment and political support of the public institution are mandatory.
Cardiopulmonary Resuscitation ; Defibrillators ; Emergency Medical Services ; Heart Arrest ; Humans ; Medical Records ; Multivariate Analysis ; Out-of-Hospital Cardiac Arrest* ; Retrospective Studies ; Survival Rate ; Treatment Outcome