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*

We report a case of acute interstitial nephritis associated with carbamazepine in a 45-year-old woman who developed acute renal failure. The patient has been taken valproic acid and carbamazepine to control the recurrent episodes of seizure after the surgery for meningioma. The patient developed acute renal failure with fever and skin rash. The patient stopped all medications except valproic acid, and was examined by ultrasonography, gallium scan and renal biopsy. Renal biopsy revealed severe interstitial infiltration of neutrophils in glomeruli without inflammation. After discontinuation of carbamazepine, acute renal failure of the patient improved and serum creatinine returned to normal.
Acute Kidney Injury ; Biopsy ; Carbamazepine ; Creatinine ; Exanthema ; Female ; Fever ; Gallium ; Humans ; Inflammation ; Meningioma ; Middle Aged ; Nephritis, Interstitial* ; Neutrophils ; Seizures ; Ultrasonography ; Valproic Acid

No abstract available.
Hemangiosarcoma*