OBJECT: Risperidone, unlike other atypical antipsychotics, is thought to elevate prolactin levels. This paper examines the relationship of risperidone-induced hyperprolactinemia and the sexual dysfunctions of the patients in the real clinical practice. METHODS: Forty nine patients (male 22, female 27) with 6 month-over risperidone medication were assigned and serum prolactin was assayed in serum by radioimmunometric assay. In the distinction of sex, six adverse events possibly associated with increased prolactin levels were determined by interviewing the patients (poor erection, ejaculatory dysfunction, galactorrhea, decreased libido, orgasmic dysfunction and obesity in male;amenorrhea, vaginal dryness, galactorrhea, decreased libido, orgasmic dysfunction and obesity in female). RESULTS: In 49 patients, thirty six patients (male 15;56%, female 21;95%) showed hyperprolactinemia and twenty two patients (male 13;48%, female 8;36%) had sexual side-effects. Both risperidone dosage per day and duration were not correlated with prolactin levels and adverse events. There was no significant direct correlation between serum prolactin levels and sexual adverse events. CONCLUSION: The risperidone-associated increase in serum prolactin levels was not significantly directly correlated with the emergence of possible prolactin-related adverse events in the real clinical practice. However, our results suggest that risperidone-induced hyperprolactinemia may play a role in sexual dysfunction of female patients.
Antipsychotic Agents ; Female ; Galactorrhea ; Humans ; Hyperprolactinemia* ; Libido ; Obesity ; Orgasm ; Pregnancy ; Prolactin ; Risperidone

OBJECTIVES: To explore the naturalistic outcome of the schizophrenics, we evaluated key clinical outcome-drop-out rate and readmission rate among the 33 risperidone and 17 conventional antipsychotics(such as haloperidol, chlorpromazine, mesoridazine) treated patients who met DSM-IV diagnostic criteria for schizophrenia at psychiatric department of a university hospital. METHOD: Outcome data was extracted from the charts of 50-schizophrenic patients who were more than 2 years after initiation of treatment with risperidone and conventional anti-psychotics. RESULTS: During over the 2-year period, the drop-out rate of the conventional antipsychotics treated schizophrenics was significantly higher than that of risperidone treated patients. But no significant factors(such as age, education level, duration of illness) were found between these two differently treated groups. Among the risperidone treated patients, the percentage of readmission was 18.2% at 12 months and 45.5% at 24 months. CONCLUSIONS: Reduced drop-out and rehospitalization rate suggest that risperidone was better than conventional antipsychotics among schizophrenic patients in a university hospital. Our data may contribute essential functional outcome information to assist the clinician in long-term, comparative treatment evaluation in 'real' clinical practice.
Antipsychotic Agents* ; Chlorpromazine ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Haloperidol ; Humans ; Outcome Assessment (Health Care)* ; Risperidone* ; Schizophrenia

Delusional parasitosis is characterized by the unshakeable belief of being infested with tiny (microscopic) insects. Patients spend much time trying to get rid of the bugs and suffer from these symptoms. Patients prefer to go to dermatologists because they have a strong conviction over the presence of a somatic disease and do not accept any psychiatric advice for their complaints. 'Folie a deux' or shared psychotic disorder (SPD) is a relatively rare syndrome, which has long attracted clinical attention. Delusional parasitosis is associated in 5-15% of SPD and can run within a family. We experienced delusional parasitosis as 'Folie a Deux' between a mother and her son and successfully treated them through early psychiatric intervention. We believe that attention should be drawn to DP with SPD.
Adult ; Delusions/*diagnosis/*psychology ; Ectoparasitic Infestations/psychology ; Female ; Human ; Male ; Middle Aged ; Paranoid Disorders/diagnosis/psychology ; Shared Paranoid Disorder/*diagnosis/*psychology ; Social Isolation

OBJECTIVES: While most neurological models of schizophrenia have focused on cerebral functions, cerebellar abnormality, especially in cerebellar vermis has been repeatedly reported in schizophrenic patients from brain imaging and lesion studies. And cerebellar vermis has been implicated for adaptive control of saccadic eye movements, which has not been studied in schizophrenics to our knowledge. METHOD: We investigated saccadic adaptation using double-step paradigm in 5 patients with a DSM-IV diagnosis of schizophrenia and 5 age and sex-matched normal controls. Gaze and head movements were recorded with scleral search coil method in head-free condition. RESULTS: Time course of adaptation in schizophrenics was similar to that of normal control but it never reached to the complete level of adaptation seen in control, and accordingly gaze gain (gaze amplitude/target amplitude) was low even after 600 adaptive trials. Head contribution to gaze saccade was relatively low and time to peak head velocity was longer in schizophrenics. CONCLUSIONS: Our results suggested that schizophrenic patients used a different strategy of gaze control and some schizophrenics might have cerebellar abnormality. Variability across patients in adaptation parameters need to be further investigated in combination with cerebellar volumetry. This study was supported by "In-san Schizophrenia Research Grant" from the Research Institute of Korean Neuropsychiatric Association in 1997.
Academies and Institutes ; Cerebellum ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Eye Movements* ; Head ; Head Movements ; Humans ; Models, Neurological ; Neuroimaging ; Saccades ; Schizophrenia

Posterior reversible encephalopathy syndrome (PRES) is a newly described adverse effect possibly associated with gonadotropin-releasing hormone (GnRH) agonist therapy. We report a case of PRES after 2 doses of depot GnRH agonists in a 44-year-old woman with a huge myoma uteri and iron-deficiency anemia. Brain magnetic resonance imaging showed high signal lesions in both occipital lobes on fluid-attenuated inversion-recovery (FLAIR) images, compatible with PRES. After treatment with anticonvulsant, she recovered both radiographically and clinically. The association between PRES and GnRH agonist use is still enigmatic, and thus should be further clarified.
Adult ; Anemia, Iron-Deficiency ; Brain ; Brain Diseases ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Leuprolide ; Magnetic Resonance Imaging ; Myoma ; Occipital Lobe ; Posterior Leukoencephalopathy Syndrome* ; Uterus

Objective: This study aimed to investigate the level of chewing and swallowing function (CSF) and the factors related to CSF among elderly vendors in a conventional market. Methods: The cross-sectional study was conducted between August 10 through September 8, 2020, using a self-reporting questionnaire to collect data. The study sample comprised 61 elderly vendors aged 65 years and over, from a conventional market at Jeju-si. CSF was measured using the Questionnaire for Chewing and Swallowing Function of the elderly, and depression was assessed by applying the Center for Epidemiologic Studies Depression Scale. Results: Chewing and swallowing dysfunctions were reported by 34.4% of elderly vendors. CSF was significantly associated with the current smoking status (β=0.39, P=0.001) and depression (β=0.33, P=0.006). Conclusion These results indicate that current smoker and depression are significant factors affecting CSF. The factors determined in this study may be used in community health programs for preventing and managing chewing and swallowing dysfunction among the elderly vendors in a conventional market.

Inter-individual pharmacokinetic variation of H2-receptor antagonist is related to genetic polymorphism of CYP2C19. We investigated the frequency of CYP2C19 genetic polymorphism and the treatment duration of cimetidine by CYP2C19 genotypes in functional dyspeptic patients without definite causes who were treated with cimetidine in Korea. One hundred subjects with functional dyspepsia participated in this study from March 1, 2010 to June 30, 2011. They were tested by upper gastrointestinal endoscopy and treated for their dyspepsia with cimetidine. The single nucleotide polymorphisms (SNPs) of CYP2C19 were genotyped using the Seeplex CYP2C19 ACE Genotyping system. There were no significant differences in the demographic, clinical, or laboratory findings among the CYP2C19 subgroups which are wild type homozygote (W/W), heterozygote (W/V), and variant homozygote (V/V). The frequencies of CYP2C19 subgroups were 33 (33%) in W/W, 49 (49%) in W/V, and 18 (18%) in V/V, respectively. The mean duration of cimetidine treatment (in weeks) was the shortest in the V/V among the CYP2C19 genotypes (W/W: 5.1+/-1.5, W/V: 4.0+/-1.7, V/V: 2.1+/-0.7; p<0.001). This study can also act as a basis for further investigation to identify the underlying genetic, epigenetic, or environmental factors in CYP2C19 enzyme activity.
Cimetidine ; Cytochrome P-450 Enzyme System ; Cytochromes ; Dyspepsia ; Endoscopy, Gastrointestinal ; Epigenomics ; Genotype ; Heterozygote ; Homozygote ; Humans ; Korea ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide

Purpose: Despite research efforts, current fall rates are still higher than expected. To approach this problem, we developed guidelines on preventing falls in hospitals. Methods: Four guidelines were selected by the K-AGREE II process. Recommendations from each guideline were retrieved and evaluated based on the quality of evidence and the strength of the recommendations. Recommendations followed the grading system of the Korean Hospital Nurses Association’s Guideline Adaptation Manual. In the external review, 13 practice nurses from 5 hospitals and 13 panel experts including doctors, nursing managers, and pharmacists participated. Results: The final guideline consisted of 5 sections and 341 recommendations. The first two sections were composed of recommendations for institutional readiness for change process and management, and Section 3 was divided into assessment of risk factors, preventive intervention and post-fall management. The summary of falls risk factors included seven components. Multifaceted interventions were modeled into six strategies. The final sections consisted of recommendations for implementing fall improvement programs and for sustaining effective prevention programs. Conclusion Given that falls result from various combinations of risk factors, the present guideline contains multifaceted assessments and interventions including risk-targeted strategy. This guideline will contribute to decreasing fall rates in hospitals by stimulating compliance with evidence-based practice.