OBJECTIVE: This study was designed to investigate the effects of long term clozapine treatment on changes of weight, glucose and cholesterol levels and their relation to clozapine and its metabolite blood levels in outpatients with chronic schizophrenia. METHODS: Among outpatients diagnosed with schizophrenia according to the DSM-IV criteria, 19 consented subjects receiving long-term treatment of clozapine, its dosage level had been constant for last one month, were selected for the study. The serum level of clozapine, metabolites as well as body weight, BMI, glucose level, cholesterol level, insulin, and c-peptide were gathered and analyzed before and after the use of clozapine. RESULTS: Glucose increase after clozapine treatment was statistically meaningful but it was due to two patients who got diagnosed with diabetes. Glucose levels of other patients are all below 120 mg/dl. Cholesterol level showed significant increase after the treatment. Weight and BMI changes over the treatment are not statistically meaningful overall, but 8 out of 17 showed more than 7% increase. The changes of weight and BMI were positively correlated with weight and BMI of pre-treatment. Mean serum level of clozapine, metabolites were not correlated with glucose, cholesterol level, insulin, and C-peptide. CONCLUSIONS: Results indicate that long term treatment of clozapine is correlated with increase of glucose and cholesterol level and weight gain of the patients. Clinicians should be aware of the potential risks of diabetes, hyperlipidemia, and weight gain in patients taking clozapine.
Blood Glucose* ; Body Mass Index ; Body Weight* ; C-Peptide ; Cholesterol ; Clozapine* ; Diagnostic and Statistical Manual of Mental Disorders ; Glucose ; Humans ; Hyperlipidemias ; Insulin ; Outpatients ; Schizophrenia* ; Weight Gain

This study inrestigated the dietary behavior, nutritional intake, and health status of industrial workers. Two hundred seventy workers(165 men and 105 women) in Masan, who were provided food services were selected as survey subjects. They were given questionnaires on nutrition knowledge, food frequency questionnaires, and blood analysis were conducted through an annual health examination from May to August 1998. The average age of the subjects was 35.7+/-11.8 years, and 80% the of women were in their teens and 20's and 80% of men were in their 30's and 40's. The nutrition knowledge score was higher in women than in men, while food habit score was higher in men than in women. As age increase, the degree of life stress became lower and food habit score was higher in men than in women. As age increases, the degree of life stress became lower and food habit was improved. In women, all nutrient intakes were avobe the recommended dictary allowances(RDA), and in men intakes of only vitamin E and calcium were under RDA. Levels of serum total cholesterol, triglyceride, and blood glucose, blood pressure, body mass index were positively related to age. The number of subjects suspected of havins chronic disease was the highest for those in their 40's. The results indicate that nutritional status of industrial workers in the present study was fairly good probably due to food services, but their health status should be supervised as their age increases.
Adolescent ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Calcium ; Cholesterol ; Chronic Disease ; Female ; Food Habits ; Food Services ; Humans ; Male ; Nutritional Status* ; Stress, Psychological ; Triglycerides ; Vitamin E ; Vitamins ; Surveys and Questionnaires

Morning sickness during pregnancy is a very common functional problem with different kinds of symptom, but little data are available concerning the nutrition intervention program for pregnant women in local area. A total of 152 pregnant women who had experienced morning sickness were surveyed to investigate the relationships between morning sickness, nutrient intakes and pregnancy outcome. The results showed that prevalent symptoms were nausea (68.4%), heartburn (59.2%), morning sickness (48.7%), vomiting (42.1%), and constipation (44.7%). The onset of the symptom occurred during the first 3 months (9.3 +/- 2.3 weeks); 21.1% of the subjects was experienced two symptom at the same time. This significantly correlated with vomiting (p < 0.01), nausea (p < 0.001), morning sickness (p < 0.001), and heartburn (p < 0.01) with pregnancy weight. There were also correlations between the four symptoms and nutrient intakes. Mean birth weight of 21 newborns was 3.06 +/- 0.42 kg, and the one and five minutes of Apgar scores were 7.74 +/- 0.99 and 8.84 +/- 0.69, respectively. There were negative correlations between vomiting and pregnancy outcomes (p < 0.05). Our data support that morning sickness, especially vomiting during pregnancy is associated with Apgar score and body weight of newborn.
Apgar Score ; Birth Weight ; Body Weight ; Constipation ; Female ; Heartburn ; Humans ; Infant, Newborn* ; Morning Sickness ; Nausea ; Nutritional Status* ; Pregnancy Outcome ; Pregnancy* ; Pregnant Women ; Vomiting

BACKGROUND: The pathogenesis of melasma has not yet been clearly demonstrated. But, clinical manifestations such as remarkable lesional symmetry and the distribution related to trigeminal nerves, suggest that the neural system could play a pathogenic role in melasma. OBJECTIVE: This study was carried out to examine the expression of some neuropeptides and their receptors, which are well known to be major contributors of neuroinflammation in many dermatoses, in melasma lesions. METHODS: Skin biopsies were obtained from the lesional and non-lesional facial skin of 6 Korean women with melasma. Immunofluorecence staining and confocal laser scanning microscopy were performed. RESULTS: In our results, no difference could be detected with regard to the intensity of immunoreactivity for vasoactive intestinal peptide (VIP), calcitonin gene-related peptide (CGRP), calcitonin gene-related peptide receptor (CGRPR), substance P (SP), substance P receptor (SPR), somatostatin (SOM), pituitary adenylate cyclase activating peptide (PACAP) and pituitary adenylate cyclase activating peptide receptor (PACAPR) in the lesional skins compared with the non-lesional skins. CONCLUSION: These results suggest that neuroinflammation induced by neuropeptides such as substance P, calcitonin gene-related peptide, vasoactive intestinal peptide, and somatostatin and their receptors included in this study, are not directly associated with melasma pathogenesis.
Adenylyl Cyclases ; Biopsy ; Calcitonin Gene-Related Peptide ; Female ; Humans ; Melanosis ; Microscopy, Confocal ; Neuropeptides ; Receptors, Neurokinin-1 ; Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide ; Skin ; Skin Diseases ; Somatostatin ; Substance P ; Trigeminal Nerve ; Vasoactive Intestinal Peptide

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease that's influenced by many genetic and environmental factors. Various treatment modalities are being applied for AD, including phototherapy, topical applicants and systemic agents. However, there has been no mass survey in Korea concerning the compliance of patients' to use their prescribed medication, which might influence the clinical efficacy of the physicians' treatment. OBJECTIVE: The purpose of the present study is to evaluate the efficacy, safety and patient compliance with using topical pimecrolimus to treat AD. METHODS: We reviewed the medical recordings, laboratory profiles, clinical severity scoring and photographs of AD patients at 9 general hospitals in Seoul and the local area of Korea. Interviews with the patients and a telephone survey were also done. Those patients who weren't perscribed topical applicants or those who did not use topical pimecrolimus or steroid within 6 months were excluded from this study. RESULTS: Topical pimecrolimus cream effectively controlled AD with a reduction of the EASI score from baseline 13.75 to 11.39 at 2 weeks and 4.46 at 10 weeks of topical pimecrolimus application. When topical pimecrolimus cream was applied for more than 12 months it significantly suppressed the recurrence and reactivation of AD (p<0.05). Although 22.6% of the patients complained of adverse effects, these were all transient and they did not evoke significant medical problems. Using topical pimecrolimus cream did not show significant adverse effects or complications. CONCLUSION: Topical pimecrolimus might well be an effective treatment modality for treating AD when patients show good compliance for applying the cream.
Compliance ; Dermatitis, Atopic ; Hospitals, General ; Humans ; Korea ; Medical Records ; Patient Compliance ; Phototherapy ; Recurrence ; Skin Diseases ; Tacrolimus ; Telephone

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease that's influenced by many genetic and environmental factors. Various treatment modalities are being applied for AD, including phototherapy, topical applicants and systemic agents. However, there has been no mass survey in Korea concerning the compliance of patients' to use their prescribed medication, which might influence the clinical efficacy of the physicians' treatment. OBJECTIVE: The purpose of the present study is to evaluate the efficacy, safety and patient compliance with using topical pimecrolimus to treat AD. METHODS: We reviewed the medical recordings, laboratory profiles, clinical severity scoring and photographs of AD patients at 9 general hospitals in Seoul and the local area of Korea. Interviews with the patients and a telephone survey were also done. Those patients who weren't perscribed topical applicants or those who did not use topical pimecrolimus or steroid within 6 months were excluded from this study. RESULTS: Topical pimecrolimus cream effectively controlled AD with a reduction of the EASI score from baseline 13.75 to 11.39 at 2 weeks and 4.46 at 10 weeks of topical pimecrolimus application. When topical pimecrolimus cream was applied for more than 12 months it significantly suppressed the recurrence and reactivation of AD (p<0.05). Although 22.6% of the patients complained of adverse effects, these were all transient and they did not evoke significant medical problems. Using topical pimecrolimus cream did not show significant adverse effects or complications. CONCLUSION: Topical pimecrolimus might well be an effective treatment modality for treating AD when patients show good compliance for applying the cream.
Compliance ; Dermatitis, Atopic ; Hospitals, General ; Humans ; Korea ; Medical Records ; Patient Compliance ; Phototherapy ; Recurrence ; Skin Diseases ; Tacrolimus ; Telephone

Lung volume reduction surgery, resecting the most severely affected regions of emphysema, was designed to improve quality of life for selected patients with severe emphysema. We report a case of a 72 year old severe emphysema patient who received bilateral lung volume reduction surgery and showed marked improvement of quality of life and lung function.
Aged ; Emphysema* ; Humans ; Lung* ; Pneumonectomy* ; Quality of Life

BACKGROUND: Atopic dermatitis is a chronic, relapsing, inflammatory skin disease, with genetic and environmental background. Successful management of atopic dermatitis requires a multipronged approach. However, standardized guidelines for the management of Korean atopic dermatitis patients do not exist. OBJECTIVE: This study was performed to provide a standardized treatment guideline for atopic dermatitis in Korea. METHODS: On the basis of treatment guidelines proposed by the ADRG (Atopic Dermatitis Research Group), we consider the characteristic provocation factors reported in previous Korean cases and the new modalities which have recently been introduced. RESULTS: Management should compromise of a disease-adapted treatment which combines adjuvant basic therapy, symptomatic relief and, if needed, anti-inflammatory treatment and the identification and avoidance of trigger factors. New therapies such as topical calcineurin inhibitors are also considered to be good alternatives for the long-term control of atopic dermatitis. CONCLUSION: The algorithm contained within the article was presented as the basis for a guideline of clinical practice that could be used to facilitate the treatment of atopic dermatitis at any stage in Korea.
Calcineurin ; Dermatitis ; Dermatitis, Atopic* ; Humans ; Korea ; Skin Diseases

BACKGROUND: Interplay of numerous constitutional and precipitating factors are involved in the development of atopic dermatitis (AD). Most of these etiologic factors are not controllable, but barrier dysfunction can be managed. Correction of barrier abnormalities has been accepted as a first-line therapy with effective anti-inflammatory therapy. OBJECTIVE: We wished to establish standardized skin care guidelines for Korean patients who suffer from atopic dermatitis. METHODS: The skin care guidelines were proposed by the Korean Atopic Dermatitis Association (KADA), with a particular emphasis for barrier dysfunction in AD from a review of more than 100 published studies and related documents in the clinical literature by a task force team (TFT) of the KADA. The TFT also evaluated the reliability of the studies based on scientific evidence and the size of the study populations. The TFT disregarded controversial findings and summarized all of the collected studies. RESULTS: Skin care guidelines were proposed by the KADA, particularly for barrier dysfunction in AD. A warm bath for approximately 20 minutes was recommended once daily. Soap can be used two or three times per week and aggressive skin scrubbing should be avoided. A topical moisturizer should be applied at least twice a day. Immediate application of emollient is required after bathing. The donning of clothing made of cotton is recommended. Nails should be cut short to reduce skin damage caused by a skin scratch. CONCLUSION: Application of moisturizer immediately after appropriate bathing may be the most important treatment for skin care. A topical steroid should be used whenever AD develops. Nail care and proper clothing are also be helpful for the prevention of dermatitis aggravation. Proper ways to bathe, use of moisturizer and topical steroids and nail care and appropriate clothing were considered.
Advisory Committees ; Baths ; Clothing ; Dermatitis ; Dermatitis, Atopic ; Humans ; Nails ; Precipitating Factors ; Skin ; Skin Care ; Soaps ; Steroids

BACKGROUND: Sarcoidosis is a systemic noncaseating granulomatous disorder of unknown origin, which can involve any organs including the skin. OBJECTIVE: The purpose of this study is to investigate the clinical characteristics of sarcoidosis in patients in Seoul and Gyeonggi-do. METHODS: A total of 62 patients with sarcoidosis, where sarcoidosis was confirmed by histopathologic examinations at seven university hospitals in Seoul and Gyeonggi-do from 2000 to 2006, were enrolled in this study. The clinical characteristics were analyzed by a thorough review of medical records, histopathologic and radiologic examinations. RESULTS: Man to woman ratio was 1 : 1.48 and 42% of the patients were in their fifth decade. The most frequent chief complaints were cutaneous symptoms (37%), followed by respiratory symptoms (31%). The most frequently involved organs were intrathoracic organs (84%), followed by the skin (37%), peripheral lymph nodes (13%), bones (11%), spleen (8%) and eyes (5%). The most common cutaneous lesion was subcutaneous nodule (74%), followed by papule (13%). Extremities (65%) were the most frequent sites of cutaneous lesions. Systemic organ involvements were observed in 70% of patients with cutaneous sarcoidosis. Among them, the most frequently involved organs were intrathoracic organs (81%), followed by bones (25%), eyes (19%), and peripheral lymph nodes (19%). CONCLUSION: The results were generally similar with the previous domestic reports. Compared with the foreign reports, cutaneous involvement was more frequent and ophthalmic involvement was less frequent. Subcutaneous nodule was the most frequent cutaneous lesion which seems to be a unique feature of this study.
Extremities ; Female ; Gyeonggi-do ; Hospitals, University ; Humans ; Lymph Nodes ; Medical Records ; Sarcoidosis* ; Seoul ; Skin ; Spleen