OBJECTIVES: Risperidone is a new antipsychotic drug developed to overcome the therapeutic limitation of conventional antipsychotics. It responses to negative as well as positive symptoms by blocking both dopaminergic and serotonergic receptors, causing no significant side effects such as agranulocytosis and seizure. It is, however, not known whether it induces any serious cardiovascular side effects as evoked by other conventional antipsychotic drugs. The aims of this study were to evaluate the effect of risperidone on cardiovascular function, and to discuss the factors affecting the cardiovascular function. METHODS: For 42 patients(22 males and 20 females) diagnosed as schizophrenia, schizophreniform disorder or schizoaffective disorder according to the DSM-IV classification, the cardiovascular fuctions such as heart rate, systolic and diastolic blood pressure, PR interval, QRS interval and QT inerval were successively checked before and after 2 weeks and 4 weeks risperidone administration. Furthermore, variables such as body weight, Brief Psychiatric Rating Scale(BPRS), Clinical Global Impression(CGE), Extrapyramidal Symptom Rating Scale(ESRS), Anticholinergic Rating Scale(ARS), serum cholesterol level, serum triglyceride level, serum high-density-lipoprotein level, serum WBC, serum Hb, serum platelet level, prothrombin time and partial thromboplastin time were also analyzed before and after 2 weeks and 4 weeks risperidone administration. RESULTS: 1) Risperidone treatment resulted in a significantly decreased heart rate and increased QT interval after 4 weeks administration(p<0.005 respectively). 2) The scores of BPRS and CGI were significantly decreased after 2 weeks and 4 weeks risperidone adminisration as compared with baseline(p<0.001 respectively). The scores of ESRS and ASRS were significantly increased after 2 weeks and 4 weeks risperidone administration as compared with baseline(p<0.001 respectively). 3) There were positive correlations between heart rate after 4 weeks and total dose(p<0.05). Blood pressure was significantly(p<0.05) correlated with sex(higher in male) and significantly(p<0.05) positive correlated with body weight. QT interval was significantly(p<0.05) correlated with sex(longer in female) and smoking history(shorter in smokers). CONCLUSIONS: Risperidone could induce significant change in heart rate and Q-T interval. Therefore, the cardiovascular safety for risperidone should be reconsidered according to the duration and dosage increase.
Agranulocytosis ; Antipsychotic Agents ; Blood Platelets ; Blood Pressure ; Body Weight ; Cholesterol ; Classification ; Diagnostic and Statistical Manual of Mental Disorders ; Heart Rate ; Humans ; Male ; Partial Thromboplastin Time ; Prothrombin Time ; Psychotic Disorders ; Risperidone* ; Schizophrenia ; Seizures ; Smoke ; Smoking ; Triglycerides

No abstract available.
Factor VIII* ; Hemophilia A* ; Humans

BACKGROUND: Doxylamine succinate(DS) is an antihistamine commonly used as an over-the-counter medication to relieve insomnia and frequently involved in overdoses. Its overdoses are dominated by anticholinergic effect. Recently it was revealed that DS had a direct effect on muscle, while its exact mechanism is not clear yet. We evaluated the patients with rhabdomyolysis induced by DS overdose for patients disposition based upon clinical decision, especially by creatinine phosphokinase(CPK). METHODS: We reviewed retrospectively the medical records of patients admitted by DS overdose from Jan. 1998 to Oct. 1999. Seventy and nine cases of DS overdose were evaluated with respect to age and sex distribution, amount ingested, clinical symptomatology, time from ingestion to visit, pattern of CPK, amount of bicarbonate used as therapy, complication and prognosis, especially in patients complicated rhabdomyolysis. RESULTS: Rhabdomyolysis, diagnosed as more than 1,000I. U/L of CPK, has been noted in 25(31.6%) of 79 cases of DS overdose visited to our emergency department(ED). In patients diagnosed rhabdomyolysis, the number of man was 10 cases(40%) and the number aged between 20 and 40 years was 22 cases(88%). The average time from DS ingestion to ED visit was 459 minutes. The amount of DS ingested was 500-5,000mg(mean, 1,980mg). 13(52%) cases ingested less than 2,250mg of DS. The initial levels of CPK(range, 48-14900I. U/L; normal range, 26-200I. U/L) after admitting to our emergency department were normal in 15 cases(60%) of rhabdomyolysis patients. The range of peak CPK levels after ingestion was 607 to 412,500I. U/L(mean, 33,550I. U/L). Its peak time was 6 to 96 hours(mean, 28.96 hours). In 14 cases(67%) of 21 visiting within 24 hours after ingestion, peak time of CPK ranged 12 to 24 hours after ingestion. The amount of bicarbonate used as therapy of rhabdomyolysis ranged 100 to 2,740mEq(mean, 656mEq) and all patients was discharged after improvement without other complication including acute renal failure. CONCLUSIONS : Although patients ingested less than 2,250mg of DS, emergency physicians should observe them more than 24 hours after DS ingestion with CPK follow-up after gastric irrigation and charcoal administration.
Acute Kidney Injury ; Charcoal ; Creatinine ; Doxylamine* ; Eating ; Emergencies ; Emergency Service, Hospital ; Follow-Up Studies ; Gastric Lavage ; Humans ; Medical Records ; Prognosis ; Reference Values ; Retrospective Studies ; Rhabdomyolysis* ; Sex Distribution ; Sleep Initiation and Maintenance Disorders ; Succinic Acid*

The authors have experienced a case of granulomatous polyp in larynx following endotracheal intubation. The patient had a polyp on the posterior one third of left vocal cord somedays after endotracheal intubation. The microscopic study of the polyp disclosed a granulomatous polyp in larynx.
Humans ; Intubation, Intratracheal* ; Larynx* ; Polyps* ; Vocal Cords

Plasma levels of growth hormone(GH), luteinizing hormone(LH) and cortisol were determined by radioimmunoassay following radiofrequency(RF) stimulation or coagulation of various nuclei in thalamus and hypothalamus. RF stimulation or coagulation of many nuclei in thalamus and hypothalamus consisted of pulvinar and dorsomedial nucleus in thalamus and anterior and posterior hypothalamic nuclei in hypothalamus. Anterior thalamic stimulation resulted in highly significant increase of plasma LH, GH, cortisol and TH levels. However thalamic stimulation resulted no change in the level of various plasma hormones. Hypothalamic lesion produced significantly decreased plasma LH, GH and cortisol levels. Plasma cortisol and LH levels were highest 2 hours after stimulation while GH levels did not increased until 6 hours and TH until 72 hours respectively after stimulation. The significant difference in latency for beginning of hormone secretion suggests that GH, cortisol and LH may be controlled by several separate neuronal networks. Plasma GH and cortisol levels were lowest 72 hrs after coagulation of the anterior hypothalamic area, while GH, cortisol and LH levels did not change following stimulation or coagulation of posterior hypothalamic nucleus and thalamic nucldi. It was also noted that the anterior hypothalamic stimulation or coagulation caused increased or decreased in GH, cortisol, and LH than that observed from stimulation or coagulation of other hypothalamic and thalamic nuclei respectively.
Anterior Hypothalamic Nucleus ; Hydrocortisone ; Hypothalamus* ; Lutein ; Mediodorsal Thalamic Nucleus ; Neurons ; Plasma ; Pulvinar ; Radioimmunoassay ; Thalamic Nuclei ; Thalamus*

The authors have experienced a case of entire lung collapse on the right side which appeared after upper abdominal operation under endotracheal general anesthesia. It has been rarely reported in the literature.
Anesthesia, General ; Lung* ; Pulmonary Atelectasis*

The SGO-T and SGP-T values were studied among 19 non-biliary surgical patients for control and 21 biliary tract surgical patients from Feb. to August 1969 in Chung Nam Medical Centor. The results obtained are as follows: 1. The SGO-T and SGP-T evels in the non-biliary surgical patients was in the normal range during pre-operative and postoperative days. 2. In patients with biliary disease SGO-T and SGP-T level were high beyond normal range on the pre-operative day. On the 1st postoperative day, these values were more elevated about 20 % and 11 %, respectively, but decreased gradually on the second and third postoperative days. 3 In biliary patients, the values were lower than pre-operative level on the 3rd postoperative day. On the other hand, values had not dropped to pre-operative level on the 3rd postoperative day in non-biliary patients.
Alanine Transaminase* ; Biliary Tract ; Hand ; Humans ; Reference Values

BACKGROUND: Abnormal over-expression or gene amplification of epidermal growth factor receptor (EGFR) is important in the prognosis of non-small cell lung cancer (NSCLC). We investigated the frequency of EGFR protein expression and gene amplification, and the correlation between EGFR status and survival in NSCLC. METHODS: We examined 360 cases of microarrayed NSCLC tissues for the EGFR protein expression and EGFR gene amplification using immunohistochemistry and fluorescent in situ hybridization. RESULTS: EGFR protein expression and EGFR gene amplification occurred in 110 cases (30.6%) and 24 cases (6.7%), respectively. EGFR protein expression and gene amplification were more frequent in squamous cell carcinoma than in adenocarcinoma. Differences in EGFR protein expression did not dramatically affect survival curves (p=0.740), but differences in gene amplification did (p<0.05): EGFR gene amplification was associated with a lower 5-year survival rate. CONCLUSION: EGFR protein expression and gene amplification showed moderate correlation with each other. EGFR gene amplification predicted a poor prognosis, whereas EGFR protein expression did not.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Epidermal Growth Factor* ; Gene Amplification ; Gene Expression* ; Genes, erbB-1 ; Immunohistochemistry ; In Situ Hybridization ; In Situ Hybridization, Fluorescence ; Prognosis ; Receptor, Epidermal Growth Factor* ; Survival Analysis* ; Survival Rate

We heraby report 10 cases of cardiac arrest associated with general anesthesia at Chungnam Medical Center during the period of Jan. 1967 through June 1972 as follows. (1) Among 10 cases, 3 cases recovered without complications and 7 cases expired. (2) Two pediatric patients showed remarkable recovery with treatment. (3) The expired 7 cases had been in very poor physical condition and recovery from cardiac arrest was delayed. The cause of death in one case was presumed to be air embolism.
Anesthesia, General* ; Cause of Death ; Chungcheongnam-do ; Embolism, Air ; Heart Arrest* ; Humans

No abstract available.
Osteomyelitis*