OBJECTIVES: Daytime drowsiness or sedation and changes in night sleep are commonly seen in patients treated with clozapine. There is, however, very limited informatio on their degree and nature during the course of treatment. The purpose of this study was to understand the sleep patterns in chronic schizophrenic patients with clozapine treatment over a period of 24 weeks. METHOD: The sleep pattern was evaluated using a set of 5-point scale questionnaire, to record subjective impressions of the night sleep induction, maintenance and quality, and daytime drowsiness and fatigue. In addition, unusual experiences associated with night sleep were recorded. The sleep questionnaire was repeatedly administered at baseline and at 1, 2, 4, 8, 12 and 24 weeks of drug treatment. At present, data on 12 patients has been collected. RESULTS: All the components of night sleep were significantly improved in th 1st through the 12 th week after treatment with clozapine. Daytime drowsiness was significantly higher in the 1st to the 2nd week after the treatment and fatigue was also significantly higher in the 1st to the 4th week after the treatment. Eight patients experienced noticeable increases in salivation during night sleep, and of these, one also reported frequent nocturnal urination and even enuresis. However, all these adverse factors did not affect the major sleep patterns. CONCLUSIONS: These finding suggest that the beneficial effects of clozapine on night sleep might last much longer than the undesirable effect of daytime drowsiness and fatigue. In other words, tolerance of the hypnotic action of clozapine might develop late and tolerance of the daytime drowsiness and fatigue might be evident earlier.
Clozapine* ; Enuresis ; Fatigue ; Humans ; Surveys and Questionnaires ; Salivation ; Sleep Stages ; Urination

The tibial pilon fracture has been described as difficult fracture to manage. We have reviewed 23 cases of tibial pilon fractures from Mar. 1987 to Feb. 1993 at our hospital. 1. The fractures were classified into five types according to the system of Ovadia and Beals and the methods of treatment were divided into two groups; 9 cases were treated with Ilizarov device(Group I). 6 cases out of Group I were type 3, 4 and 5. Other methods were performed in 14 cases(Group II). 8 cases out of Group II were type 3, 4, and 5. 2. In type 3, 4 and 5 fractures, there were 86 per cent good and fair radiographic results in Group I and 63 per cent good and fair results in Group II. 3. Satisfactory results were obtained by the treatment of Ilizarov method especially in type 3, 4 and 5 fractures. The advantages of Ilizarov device were its primary reduction with ligamentotaxis, easy open reduction due to proximal and distal stabilization, minimal soft tissue injury and minimal internal fixation.
Ilizarov Technique ; Soft Tissue Injuries

No abstract available.
Catheters* ; Renal Dialysis*

Chusid et al proposed diagnostic criteria of hypereosinophilic syndrome (HES) that remain valid today. These were, (1) a sustained peripheral blood eosinophil count of more than 1500/L present for longer than 6 months ; (2) no evidence of other apparent causes for eosinophilia, and (3) presumptive signs of parenchymal organ involvement. Any organ system may be affected in HES, but the most severe clinicopathological involvements are of the heart and nervous system. Although multiple organ systems may be involved, the most common cause of morbidity and mortality is cardiac involvement with extensive fibrous thickening of the endomyocardium and overlying thrombus. We report a case of acute peri-myocarditis with eosinophilia, which was confirmed as eosinophilic myocarditis by endomyocardial biopsy, with literature review.
Biopsy ; Edema* ; Eosinophilia ; Eosinophils* ; Heart ; Hypereosinophilic Syndrome ; Mortality ; Myocarditis* ; Nervous System ; Thrombosis

Chusid et al proposed diagnostic criteria of hypereosinophilic syndrome (HES) that remain valid today. These were, (1) a sustained peripheral blood eosinophil count of more than 1500/L present for longer than 6 months ; (2) no evidence of other apparent causes for eosinophilia, and (3) presumptive signs of parenchymal organ involvement. Any organ system may be affected in HES, but the most severe clinicopathological involvements are of the heart and nervous system. Although multiple organ systems may be involved, the most common cause of morbidity and mortality is cardiac involvement with extensive fibrous thickening of the endomyocardium and overlying thrombus. We report a case of acute peri-myocarditis with eosinophilia, which was confirmed as eosinophilic myocarditis by endomyocardial biopsy, with literature review.
Biopsy ; Edema* ; Eosinophilia ; Eosinophils* ; Heart ; Hypereosinophilic Syndrome ; Mortality ; Myocarditis* ; Nervous System ; Thrombosis

The purpose of this study were 1) to determine the earliest pathological changes of germanium dioxide (GeO2)-induced myopathy; 2) to determine the pathomechanism of GeO2-induced myopathy; and 3) to determine the minimal dose of GeO2 to induce myopathy in rats. One hundred and twenty five male and female Sprague-Dawley rats, each weighing about 150 gm, were divided into seven groups according to daily doses of GeO2. Within each group, histopathological studies were done at 4, 8, 16, and 24 weeks of GeO2 administration. Characteristic mitochondrial myopathy was induced in the groups treated daily with 10 mg/kg of GeO2 or more. In conclusion, the results were as follows: 1) The earliest pathological change on electron microscope was the abnormalities of mitochondrial shape, size and increased number of mitochondria; 2) The earliest pathological change on light microscope was the presence of ragged red fibers which showed enhanced subsarcolemmal succinate dehydrogenase and cytochrome c oxidase reactivity; 3) GeO2 seemed to affect the mitochondrial oxidative metabolism of muscle fibers; 4) GeO2 could induce mitochondrial myopathy with 10 mg/kg of GeO2 for 4 weeks or less duration in rats.
Animal ; Cytochrome-c Oxidase/metabolism ; Female ; Germanium/toxicity* ; Histocytochemistry ; Male ; Mitochondrial Myopathies/pathology ; Mitochondrial Myopathies/enzymology ; Mitochondrial Myopathies/chemically induced* ; Muscles/ultrastructure ; Muscles/enzymology ; Rats ; Rats, Sprague-Dawley ; Succinate Dehydrogenase/metabolism

No abstract available.
Plasma* ; Prostate* ; Prostatic Neoplasms* ; Stomach Neoplasms*

No abstract available.
Bone Marrow* ; Granulocyte Precursor Cells*

OBJECTIVES: Tianeptine, a novel tricyclic antidepressant, is known to increase the pre-synaptic uptake of serotonin while paradoxically having antidepressant and anxiolytic effects. The purpose of this study was to get information on the effects of tianeptine on daytime sleepiness, performance and nocturnal sleep in healthy, young, adult volunteers. METHODS: Twelve young healthy male volunteers visited the study center 1 day a week for 3 weeks. On each visit day, each subject received 1 of the 3 treatments with: tianeptine(12.5mg t.i.d.), amitriptyline(25mg b.i.d. and placebo at midday) or placebo(t.i.d.), in a double-blind, random latin square sequence, cross-over design. All the drugs and placebo were prepared in identical gelatin capsules. A battery of performance tests(digit cancellation, arithmatic addition, digit span, digit symbol substitution, word list memory), was carried out in the afternoons(at 1hr after the second dose). Subjective assessments of the daytime sleepiness and unwanted effects of drug were made, using a modified Epworth Sleepiness Scale and a modified Uscandinavian Kociety of Usypharmacology side-effects rating scale(UKU Scale), in late evenings (at 0.5 hr before the last dose). Sleep on the night of the treatment day was evaluated by a post-sleep questionnaire on rising the following morning. RESULTS: Compared to placebo, tianeptine showed no evidence of impairment on any performance test and did not affect the daytime alertness/drowsiness level and nocturnal sleep. Amitriptyline, however, produced considerable impairment of performance, associated with severe daytime sleepiness. Also, amitriptyline significantly affected nocturnal sleep by quicker induction, more restful maintenance and longer period relative to placebo. Adverse events were significantly more often and severe after amitriptyline than after tianeptine or placebo treatments. CONCLUSION: These results confirmed the previous observations that tianeptine is not accompanied by significant daytime sedation, nocturnal sleep change or performance impairment. And they also suggest that tianeptine could be a useful option for the depressive patient, in particular for the ambulatory out-patient or the elderly.
Adult ; Aged ; Amitriptyline* ; Anti-Anxiety Agents ; Capsules ; Cross-Over Studies ; Gelatin ; Humans ; Male ; Outpatients ; Surveys and Questionnaires ; Serotonin ; Volunteers ; Young Adult*

OBJECTIVES: In order to evaluate the possible relationship between sleep and personality characteristics, it is desirable to adopt the personality theory with biological basis because sleep is a physiological phenomenon. The purpose of this study was to investigate their possible relationship using the personality dimensions of Eysenck, which is well known as a biological personality theory. METHODS: Sleep Questionnaires regarding the weekday sleep habits and the sleep disorders and Eysenck's Personality Questionnaire were administered to 532 university students. Data analysis was based on 509 students who gave reliable information. Firstly, the descriptive statistics of the scores on four personality dimensions(psychoticism, neuroticism, extraversion, lie)and sleep characteristics were obtained. Secondly, the possible relationships between each personality dimension and sleep characteristics (the weekday sleep habits and sleep disorders)were tested by calculating Pearson's product moment correlations. RESULTS: The four personality dimensions' scores and weekday sleep habits of subjects were within a normal range. The highest frequency of sleep disorder was induction difficulty of sleep and the lowest was sleep walking. Psychoticism was positively correlated with bedtime, rise time, sleep latency, number of awakening, regularity of sleep, frequency and duration of nap and doze, frequency of sleep disorders, while negatively correlated with the quality of sleep, and the score of circadian rhythm. The correlations between neuroticism and sleep characteristics were similar to those of psychoticism. Extraversion was positively correlated with the quality of sleep and the score of circadian rhythm, while not correlated with sleep disorders. Lie was positively correlated with the score of circadian rhythm, but negatively correlated with sleep latency, regularity of sleep, frequency and duration of nap and doze, and sleep disorders. CONCLUSIONS: The higher psychoticism and neuroticism, the poorer sleep habits and the higher frequency of sleep disorders. The higher extraversion, the better quality of sleep and the closer morningness. The higher lie, the closer morningness, the more regularity of sleep, the less sleepiness of daytime, and the less frequency of sleep disorders. These findings suggest that there exist the close relationships between Eysenck's personality dimensions and sleep characteristics.
Circadian Rhythm ; Extraversion (Psychology) ; Humans ; Physiological Phenomena ; Surveys and Questionnaires ; Reference Values ; Sleep Wake Disorders ; Somnambulism ; Statistics as Topic