Current treatment strategies for levodopa-induced psychosis in advanced Parkinson's disease have had limited success. Reduction or discontinuation of levodopa and coadministration with dopamine-blocking neuroleptics may attenuate the psychotic symptoms, but these strategies are associated with worsening of parkinsonian symptoms. Administration of 5-HT3 receptor antagonist ; ondansetron, a newer strategy to attenuate psychosis of Parkinson' disease without motor deterioration was introduced. A 41-year-old young-onset male, who was diagnosed as Parkinson's disease 7 years ago, was treated with levodopa therapy, and had levodopa-induced psychosis(delusion, hallucination, paranoid, insomnia). After trial of ondansetron, he showed improvement in the Brief Psychiatric Rating Scale(from 21 points to 9 points) in spite of increasing the dosage of levodopa. With ondansetron, we could increase the dosage of levodopa without psychotic complications(esp, hallucination), and he showed improvement in the motor fluctuation.
Adult ; Antipsychotic Agents ; Hallucinations ; Humans ; Levodopa ; Male ; Ondansetron ; Parkinson Disease ; Psychotic Disorders* ; Receptors, Serotonin, 5-HT3

No abstract available.
Lupus Erythematosus, Systemic* ; Polyarteritis Nodosa*

BACKGROUND & OBJECTIVES: Depression is one of the most common neuropsychiatric sequelae of stroke, and depression is a serious disorder that can compromise the quality of life and overall rehabilitating process. The aim of this study was to investigate the frequency of depression in acute stroke patient and to compare with nondepressive patients in terms of demographic data, lesion site, pathology and the days of hospitalization. METHOD: Total 200 stroke patients admitted in Korea university hospital from Jan. 1993 to Dec. 1994 were included in this study. Data was collected from the medical records retrospectively and analyzed by means of statistics. RESULT: The frequency of depressive episode was 17% (34/200). The pathologic lesion was more frequently located in the right hemisphere (no statistical significance) and patients with depressive episode showed a higher frequency of lesions in anterior areas of the left hemisphere and posterior areas of the right hemisphere. The hospitalization days of depressive group was longer than that of non-depressive group (student t-test, p<.05). The age of depressive group was younger than that of non-depressive group (student t-test, p<.05). There was a positive correlation between the hospitalization days and the severity of depression(r=0.41). There also was a positive correlation between NIH stroke scale and the severity of depression (r=0.4988). CONCLUSION: In patients with depressive episode after acute stroke, it was more frequently developed in right posterior hemispheric lesion and their hospitalization days was longer in the depressive group than in nondepressive patients.
Depression* ; Hospitalization ; Humans ; Korea ; Medical Records ; Pathology ; Quality of Life ; Retrospective Studies ; Stroke

OBJECTIVE: Employee Assistance Programs have recently been introduced to Korea as a potential solution to relieve workers's stress and improve their mental health. This study was conducted to determine the needs of EAPs among manufacturing industry workers in Gyeongsang-do Korea. METHODS: Responses to structured survey questionnaires were received from 556 workers at 7 mediumsized manufacturing factories. RESULTS: Among the 556 workers who responded to the questionnaire 'Prevention & management of work stress', 'Mental health & management of daily life stress', 'Physical exercise health promotion program'. 'Elderly care', 'Outplacement', 'Financial support for leisure activities', and 'Ensuring leisure time'were raised as the main issues and services that they expected to be provided by the company. CONCLUSION: EAPs have recently been introduced in Korean companies. The study results will be helpful to clarify the needs of individual Korean workers and to determine what EAP services should be provided.
Health Promotion ; Korea ; Leisure Activities ; Mental Health ; Questionnaires

INTRODUCTION: Although it is well known that medical students are not getting an adequate amount of sleep, there have been only a few studies on the sleep patterns of medical students and the related factors. Therefore, the present study aimed to investigate the medical students' sleep patterns and the related factors. METHODS: A questionnaire package was administered to the 1st to 4th year medical students at one medical school. It consisted of questions asking about their lifestyles as well as Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), global assessment of recent stress scale (GASS), the center for epidemiologic studies-depression scale (CES-D), and Moudsley obsessive-compulsive inventory (MOCI). A total of 352 students (206 males and 146 females) responded to the survey and the result was analyzed using the independent t-test, the chi-square test, the paired t-test, Pearson's correlation and ANOVA. p-values of less than 0.05 were considered statistically significant in analyses. RESULTS: The weekend bedtime was significantly delayed (0 : 49 on weekday ; 1 : 34 on weekend ; t=-5.23, p<0.001), the weekend rise time was delayed (6 : 58 on weekday ; 9 : 30 on weekend ; t=-24.48, p<0.001) and the total sleep time was increased on weekends (5 : 36 on weekday ; 7 : 39 on weekend ; t=15.94, p<0.001). The PSQI score of all subjects was 6.43+/-2.64. PSQI was positively correlated with ESS (r=0.383, p<0.001), GASS (r=0.326, p<0.001), CES-D (r=0.393, p<0.001), and MOCI (r=0.247, p<0.001), but not with GPA (r=0.072, p=0.228. The more senior students had lower PSQI, GASS, CES-D, and MOCI score (p<0.05). CONCLUSION: Medical students were experiencing a lack of sleep during weekdays as they have a later bedtime and earlier rise time, and consequently had more hours of sleep on weekends. Overall, the medical students were experiencing poor sleep quality and sleep deprivation. Poor sleep quality is associated with psychological problems (daytime sleepiness, stress, depression, and obsessive tendency).
Depression ; Humans ; Life Style ; Male ; Surveys and Questionnaires ; Schools, Medical ; Sleep Deprivation ; Students, Medical*

PURPOSE: Kindling refers to a process whereby repeated applications of an initially subconvulsive electrical or chemical stimulus to animals lead to persistent epileptogenic in generalized seizures. Metabotropic glutamate receptors (mGluRs) have been shown to be involved in many brain functions. Widespread distribution of the mGluRs suggests glutamate may be the primary modulator of G-protein coupled signal transduction in the central nervous system. To investigate the role of mGluRs in kindling, we studied the changes of mRNA gene expressions of mGluR1 and 5 on the hippocampus, amygdala, and basal ganglia in PTZ-induced kindled rats. METHODS: Male Wistar rats (n=6-4) were kindled by repeated administration, 5 times a week, by a subconvulsant dose of PTZ (35 mg/kg). After completion of kindling, the brains were analysed for mRNA gene expression of mGluR1 and 5 using reverse transcripted polymerase chain reaction (RT-PCR). RESULTS: The kindling score was significantly increased after 8 injections and the definitive kindling score (more than 4 point) was obtained after 10 injections. mRNA gene expressions of mGluR1 in hippocampus, amygdala, and basal ganglia were increased by 180.1+/-4.4%, 130.2+/-6.1%, 148.6+/-1.4% compared to controls (p<0.05), but those of mGluR5 were not significantly increased. CONCLUSIONS: Although the mRNA gene expression of mGluR5 did not show any marked changes in kindled rat brain, that of mGluR1 showed significant increase in hippocampus and amygdala. From these results, high density of mGluR1 may suggests glutamatergic systems plays a role in PTZ-induced kindling. But our results would not exclude the possibility that changes of mRNA gene expressions of mGluR1 and 5 are due to repeated seizure activity alone.
Amygdala ; Animals ; Basal Ganglia ; Brain ; Central Nervous System ; Gene Expression ; Glutamic Acid* ; GTP-Binding Proteins ; Hippocampus ; Humans ; Male ; Polymerase Chain Reaction ; Rats* ; Rats, Wistar ; Receptors, Glutamate* ; Receptors, Metabotropic Glutamate* ; RNA, Messenger ; Seizures ; Signal Transduction

BACKGROUND: The possible role of apolipoprotein E (APOE for gene, apoE for protein) allele in atherosclerotic diseases is not clearly understood. For the putative role of APOE genotypes, we examined APOE polymorphism among patients with stroke. METHODS: A total of 202 ischemic stroke patients were involved in this study. The genotype DNA was isolated from whole blood and the APOE alleles were determined by polynicrase chain reaction. RESULTS: The genotype of APOE epsilon3/3 was the most common allele in the stroke group and the control group. The frequencies of APOE epsilon2, epsilon3, epsilon4 allele in stroke group were 0.052, 0.851, and 0.097, respectively. There was no significant difference in APOE genotypes between the stroke group and the control group. No significant associations lions were found for the APOE genotypes and the serum lipid profiles. CONCLUSION: These findings suggest that APOE was not related to the stroke,
Alleles ; Apolipoprotein E2 ; Apolipoproteins E ; Apolipoproteins* ; DNA ; Genotype ; Humans ; Lions ; Stroke

A single coronary artery is a rare congenital anomaly. The right coronary artery, originating from distal left circumflex, is an extremely rare variety of a single coronary artery. Our report is accompanied by a brief review of the literature.
Coronary Vessel Anomalies ; Coronary Vessels*

PURPOSE: Application of a laparoscopic technique to common bile duct explorations has been limited due to technical difficulty. With increased experience and technique, laparoscopic surgery has become a possible option for the treatment of common bile duct stones. The purpose of this study was to assess the usefulness of laparoscopic surgery in the treatment of common bile duct stones. METHODS: Between March 1997 and August 1999, 35 patients with choledocholithiasis were treated with laparoscopic common bile duct exploration (4 had a previous biliary operative history). Intraoperative choledochoscopy was used to remove common bile duct stones. The stones were retrieved by using a saline flush, a basket, or a Fogarty catheter. The impacted stones were destroyed using electrohydraulic lithotripsy. RESULTS: Successful laparoscopic stone clearance was achieved in 33 cases (94.3%), and conversion to open surgery occurred in one case (2.9%). The morbidity was 5.7% without mortality. Two cases of retained stone were treated with postoperative choledochoscopic removal via fistula tract and postoperative endoscopic extraction. CONCLUSION: Laparoscopic common bile duct exploration is feasible and safe in most patients. With increased of experience, laparoscopic common bile duct exploration could be used widely.
Catheters ; Choledocholithiasis ; Common Bile Duct* ; Conversion to Open Surgery ; Fistula ; Humans ; Laparoscopy* ; Lithotripsy ; Mortality

A 38-year-old woman with systemic lupus erythematosus had developed a cutaneous lesion of linear scleroderma on the forehead 4 years after the diagnosis of lupus erythematosus. This case of coexistence of the two diseases can be regarded as a clinical variant of the connective tissue disease-overlap syndrome.
Adult ; Female ; Humans ; Korea ; Lupus Erythematosus, Systemic/*complications ; Scleroderma, Localized/*complications