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

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*

Neurocristopathy is characterized as having a common origin in aberrant neural crest development. Congenital central hypoventilation syndrome (Ondine's curse) is characterized by marked depression of respiratory drive during sleep and normal ventilation while awake because of no response to both hypercapnea and hypoxia. The girl was full-term, weighing 3020 grams. The girl had poor respiratory effort at birth, but improved with oxygen supply and stimulation. abdominal distention and calcification were noted. During laparotomy transitional zone was found at distal jejunum; a jejunostomy was constructed. Numerous attempts at extubation failed because of apnea. The results of an apnea work-up, including brain sonography, echocardiogram, were normal. The girl died of sepsis at 37 days of age. para-aortic ganglioneuroblastoma was found on autopsy. We experienced a newborn with congenital central hypoventilation syndrome, Hirschsprung's disease and congenital ganglioneuroblastoma representative of neurocristopathy.
Anoxia ; Apnea ; Autopsy ; Brain ; Depression ; Female ; Ganglioneuroblastoma* ; Hirschsprung Disease* ; Humans ; Hypoventilation* ; Infant, Newborn* ; Jejunostomy ; Jejunum ; Laparotomy ; Neural Crest ; Oxygen ; Parturition ; Sepsis ; Ventilation

Chronic rhinosinusitis (CRS) is a heterogeneous inflammatory disease with various underlying pathophysiologic mechanisms which translate to endotypes, in contrast to clinical phenotypes or histological subtypes. Defining endotypes can help clinicians predict disease prognosis, select subjects suitable for a specific therapy, and assess risks for comorbid conditions, including asthma. Therefore, with recent advancement of biologicals in CRS clinical trials, endotyping can be a breakthrough in treating recalcitrant CRS. CRS is caused by dysregulated immunologic responses to external stimuli, which induce various inflammatory mediators from inflammatory cells, including innate lymphoid cells (ILCs) and T lymphocytes as well as epithelial cells. Thymic stromal lymphopoietin (TSLP), interleukin (IL)-25, and IL-33, which are mainly secreted by epithelial cells in response to external stimuli, act on type 2 ILCs and T helper 2 (Th2) cells, inducing IL-4, IL-5, and IL-13. Local immunoglobulin E (IgE) production is also a signature event in nasal polyps (NP). These inflammatory mediators are novel potential therapeutic targets for recalcitrant CRS. This article reviews recent publications regarding endotypes and endotype-based therapeutic strategies in CRS and NP.
Asthma ; Cytokines ; Epithelial Cells ; Immunoglobulin E ; Immunoglobulins ; Interleukin-13 ; Interleukin-33 ; Interleukin-4 ; Interleukin-5 ; Interleukins ; Lymphocytes ; Nasal Polyps ; Phenotype ; Precision Medicine* ; Prognosis ; T-Lymphocytes

No abstract available
Dermatitis, Atopic* ; Eczema* ; Humans ; Nipples*

No abstract available.

BACKGROUND: In most brain operations, the endotracheal tube is kept in postoperatively for airway maintenance during radiologic examinations. But the endotracheal tube causes tracheal irritation and hemodynamic changes. Inhalation anesthetics can not be administered during transport, and minimal concentration is exhaled for several hours after the end of inhalation. The present study was designed : (1) to determine the end tidal isoflurane concentration after the end of administration ; (2) to investigate the effects of intravenous anesthetics in patients with tracheal intubation during radiologic examination postoperatively. METHODS: We selected forty adult patients who were scheduled for elective neurosurgical operation with postoperative brain CT (computerized tomography). The study was performed in 2 steps; in the step 1 (n = 10), end tidal isoflurane concentration was checked after ending inhalation. In the step 2 (n = 30), patients were divided into one of three groups according to anesthesia method; group I (using isoflurane), group P (change from isoflurane to propofol about an hour before operation end), group M (using midazolam instead of propofol, compared to group P). In each group, the frequency of bucking and incidence of hypertension were checked during postoperative radiologic examinations. RESULTS: Minimal concentrations of isoflurane were detected in exhaled gas for about 2 hours after the end of isoflurane inhalation. The frequency of bucking was significantly lower in the group P and M than in group I (P = 0.002). In group P, the incidence of hypertension was significantly reduced compared to group M and I (P = 0.031). CONCLUSIONS: These results suggest that the change of anesthetic technique (from inhalation to intravenous) in the late period of operation, provides postoperative hemodynamic stability, a more comfortable state and minimal environmental pollution in comparison to inhalation anesthesia only.
Adult ; Anesthesia ; Anesthesia, Inhalation ; Anesthesia, Intravenous* ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Brain ; Environmental Pollution ; Hemodynamics ; Humans ; Hypertension ; Incidence ; Inhalation ; Intubation ; Isoflurane ; Midazolam ; Propofol