Recently atypical antipsychotics have been used as first line agent in the treatment of schizophrenia, and also played a significant role in the treatment of many kinds of psychiatric disorders. The pharmacokinetic and pharmacodynamic properties of these newer antipsychotics are well know through preclinical and early clinical trials. However, it is important to note the limitations of the results due to its relatively short experience. Clozapine is eliminated principally by the hepatic P450 1A2 and 3A4 cytochrome enzymes. 1A2 inducers such as carbamazepine and smoking can reduce its half-life, while 1A2 inhibitors such as SSRIs especially fluvoxamine can increase its duration of action. Carbamazepine should be avoided in a patient on clozapine because of carbamazepine's potential effects on bone marrow. Benzodiazepines tend to increase the chances of sedation delirium and respiratory depression. Risperidone is metabolized to 9-hydroxyriperidone by the hepatic P450 2D6 cytochrome enzymes. Fluoxetine and paroxetine, 2D6 inhibitors interfere with metabolism, but 9-hydroxyrisperidone has similar biological activity as parental drug, so it has little affect on the outcome. Olanzapine shows minimal capacity to inhibit cytochrome P450 isoenzymes and shows minimal chance of drug interaction. It is eliminated principally by the hepatic P450 1A2 and 2D6 cytochrome enzymes.
Antipsychotic Agents* ; Benzodiazepines ; Bone Marrow ; Carbamazepine ; Clozapine ; Cytochrome P-450 Enzyme System ; Cytochromes ; Delirium ; Drug Interactions* ; Fluoxetine ; Fluvoxamine ; Half-Life ; Humans ; Isoenzymes ; Metabolism ; Parents ; Paroxetine ; Respiratory Insufficiency ; Risperidone ; Schizophrenia ; Smoke ; Smoking

Korean National Health Insurance (NHI) was established during only 12 yr from its inception (1977-1989), providing universal medical coverage to the entire nation and making a huge contribution to medical security. However, the program now faces many challenges in terms of sustainability. The low birth rates, aging population, low economic growth, and escalating demands for welfare, as well as unification issues, all add pressure to the sustainability of NHI. The old paradigm of low contribution - low benefits coverage - low NHI's fee schedule needs to be replaced by a new paradigm of proper contribution - adequate benefit coverage - fair NHI's fee schedule. This new paradigm will require reform of NHI's operating system, funding, and spending.
Health Care Reform ; Humans ; National Health Programs/*economics ; Program Evaluation ; Republic of Korea ; Risk Factors ; Universal Coverage/economics

No abstract available.
Humans ; Liver Cirrhosis* ; Liver* ; Sepsis* ; Vibrio cholerae* ; Vibrio*

PURPOSE: This study aimed at analyzing the causes of death of prisoners of war (POWs) during the Korean War (1950-1953) who fought for the Communist side (North Korea and the People's Republic of China). In 1998, the United States Department of Defense released new information about the prisoners including, 7,614 deaths of the POW during the Korean War. The data on the causes of death of the POWs during the Korean War provides valuable information on the both the public health and history of the conflict. MATERIALS AND METHODS: To analyze the causes of death of the POWs, we classified the clinical diagnosis and findings on 7,614 deaths into 22 chapters, as outlined in the International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10). Second, we traced changes in the monthly death totals of POWs as well as deaths caused by common infectious diseases and external causes of death including injury over time from August 1950 to September 1953. RESULTS: The most common category of causes of deaths of POWs was infectious disease, 5,013 (65.8%) out of 7,614 deaths, followed by external causes including injury, 817 (10.7%). Overall, tuberculosis and dysentery/diarrhea were the most common causes of death. Deaths caused by acute and chronic infection, or external causes showed different patterns of increases and decline over time during the Korean War. CONCLUSION: The information and data on POWs' deaths during the Korean War reflects the critical impact of the POWs' living conditions and the effect of public health measures implemented in POW camps during the war.
Adolescent ; Adult ; Aged ; *Cause of Death ; Child ; China/epidemiology ; Communicable Diseases/epidemiology ; Democratic People's Republic of Korea/epidemiology ; History, 20th Century ; Humans ; Korean War ; Middle Aged ; Prisoners of War/*history

In this study, we investigated the in vivo effect by intake of the irradiated foods such as mackerel and sesame seed which are high in unsaturated fatty acid through TBARS (thiobarbituric acid reactive subtance) and the tissue pathological and genotoxicological test. Thirty two ICR mice are divided into four groups, one non-irradiated (control) group and three irradiated (5, 10, 20 kGy, respectively) groups. Sesame seed and pulverized mackerel in modified AIN93M diet were mixed together then divided into four identical parts. Three parts of them were irradiated by doses of 5, 10, and 20 kGy. These experimental diet were fed to each group for 4, 8 and 16 weeks. The results of the study were as follows: No significant differences in weight gain were found in each group. Peroxide value of the irradiated diet was higher than that of the non-radiated one and also increased according to the storage period. TBA values in plasma, liver, kidney and Peyer's patch were not significantly different among 4 groups. DNA% in tail, tail length (TL) and tail moment (TM) values of the blood lymphocyte in 4, 8 and 16 week groups and the liver in 16 week group were much measured over the control. DNA% in tail of kidney of 8 week group was significantly larger than the control and TL and TM of 8 week and TM of 16 week groups showed a tendency of higher values. By Peyer's patch, DNA% in tail of 8 week group, DNA% in tail and TM of 16 week groups increased significantly over the control. Ultrastructural examination shows myeline figures and swollen mitochondria in parietal cells and intestinal epithelial cells of 8 and 16 weeks groups. After this study, we need further investigations on the safety of highly consumed foods which contai high contents of unsaturated fatty acid, largely imported and which are possible to be irradiated.
Animals ; Comet Assay ; Diet* ; Epithelial Cells ; Food Irradiation ; Kidney ; Liver ; Lymphocytes ; Mice* ; Mice, Inbred ICR ; Mitochondria ; Myelin Sheath ; Oxidative Stress* ; Perciformes ; Plasma ; Rabeprazole ; Sesamum ; Thiobarbituric Acid Reactive Substances ; Weight Gain

OBJECTIVE: This study evaluated the possible role of 2 additional tumor markers to CA125 in discriminating between benign and malignant ovarian tumors. METHODS: Serum samples from 1,346 patients were obtained on seven days before operation. All patients underwent surgery for ovarian tumors. Serum levels of 3 tumor markers were compared to histology. Concentrations of tumor markers (CA125, CA72-4, CA19-9) were detected by enzyme immuno- or immunoradiometric assays. Normal range of these markers was defined as CA125 Humans ; Immunoradiometric Assay ; Reference Values ; Sensitivity and Specificity ; Biomarkers, Tumor*

We report a case of infective endocarditis after flexible sigmoidoscopy. In addition to persistent bacteremia with methicillin-resistant Staphylococcus aureus (MRSA), we found an oscillating intracardiac mass on the tricuspid valve in this patient. The patient had no underlying heart disease or risk factor for the infection due to MRSA. Vancomycin treatment for 42 days was adequate for this case. The pathogen might colonize the patient's rectum and then invade through intestinal mucosa during the endoscopic procedure.
Bacteremia ; Colon ; Endocarditis* ; Heart Diseases ; Humans ; Intestinal Mucosa ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Rectum ; Risk Factors ; Sigmoidoscopy* ; Tricuspid Valve ; Vancomycin

In order to investigate the adolescent's beverage drinking pattern and its related ecological factors, a questionnaire survey was conducted with the subjects of 920 middle and high-school students, 450 boys and 470 girls, residing in 4 cities of the Chungnam area. Of the subjects 65% liked, or liked very much, beverages and only 3.7% did not like beverages. They drank beverages 4.3 +/- 4.0 times a week on average, but 10.4% of them drank beverages more than twice a day. Male students drank more frequently than the females. The intake frequency of carbonated drinks was 1.7 +/- 2.3 a week, which was about 40% of the total beverages. However, more students drank mainly ion beverages (33.6%) than carbonated drinks (28.7%). As the students took more balanced food and ate more regularly, their beverage drinking frequency decreased and those taking carbonated drinks also tended to decrease. The more frequent the students took fast food, the more frequent they drank carbonated beverages. The drinking frequencies for beverages or carbonated beverages were also less in students eating cooked rice with sidedishes as breakfast than in students eating others. The drinking frequency for carbonated drinks showed significant correlations with the students' activities such as the time spent using computers and watching TV got longer, the drinking frequency for soft drinks was also higher. When nutritional knowledge was higher, drinking frequency for carbonated drinks got lower. In conclusion, to make the adolescents improve their attitudes toward drinking beverages and to prevent excessive drinking of carbonated drinks, they should be educated not only on the nutritional knowledge and the proper intake of beverages, but also on good dietary habits including balance, regularity, and types of meals. Proper snacking and fast food consumption also should be taught. Since ion beverages were taken more frequently than carbonated drinks among adolescents, further study is recommended on the impact of excessive intake of ion beverages.
Adolescent* ; Beverages* ; Breakfast ; Carbonated Beverages ; Chungcheongnam-do* ; Drinking ; Fast Foods ; Female ; Food Habits ; Humans ; Male ; Meals ; Snacks

Glycogen synthase kinase 3 (GSK3) was recently suggested to be a potential target of psychotropics used in psychiatric illnesses such as schizophrenia and bipolar disorder. Relevant studies have found that antipsychotic drugs regulate GSK3 activity via an increase in either inhibitory serine phosphorylation or amount of GSK3 after acute or subchronic treatment. Recent evidence shows that GSK3 is regulated by dopaminergic or serotonergic systems implicated in the pathophysiology and treatment mechanisms of schizophrenia and bipolar disorder. Therefore, antipsychotics may regulate GSK3 via antagonizing dopaminergic or serotonergic activity. However, the signaling pathway that is involved in GSK3 regulation by dopaminergic or serotonergic systems has not been well established. Haloperidol is a typical antipsychotic with potent dopamine D(2) receptor antagonism. Clozapine is an atypical antipsychotic with potent serotonin 5HT(2) receptor antagonism. We injected rats with haloperidol or clozapine and examined the phosphorylation and amount of GSK3alpha/beta and its well-known upstream regulators Akt and Dvl in the rat frontal cortex by Western blotting. Both haloperidol and clozapine induced Ser21/9 phosphorylation of GSK3GSK3alpha/beta. Haloperidol increased the Ser473 phosphorylation of Akt transiently, whereas clozapine maintained the increase for 1 h. Haloperidol did not affect the phosphorylation and amount of Dvl, whereas clozapine increased both phosphorylation and the amount of Dvl. Our results suggest that GSK3 activity may be regulated by both typical and atypical antipsychotics and that Akt or Dvl, depending on the D(2)- or 5HT(2)- receptor antagonism properties of typical and atypical antipsychotics, mediate the regulation differently.
Adaptor Proteins, Signal Transducing/metabolism/*physiology ; Animals ; Antipsychotic Agents/*pharmacology ; Clozapine/*pharmacology ; Dopamine Antagonists/pharmacology ; Frontal Lobe/*drug effects/enzymology ; Glycogen Synthase Kinase 3/*metabolism ; Haloperidol/*pharmacology ; Male ; Phosphoproteins/metabolism/*physiology ; Phosphorylation ; Proto-Oncogene Proteins c-akt/metabolism/*physiology ; Rats ; Rats, Sprague-Dawley ; Serotonin Antagonists/pharmacology ; Signal Transduction

BACKGROUND: Vascular endothelial growth factor-C (VEGF-C) is a novel growth factor that regulates lymphangiogenesis and/or angiogenesis via binding to the vascular endothelial growth factor receptor-3 (VEGFR-3) or VEGFR-2. Recent studies have suggested that VEGF-C may play a role in lymph node metastasis. This study was conducted to examine whether the expression of VEGF-C is associated with the clinicopathologic parameters, and especially lymph node metastasis, of invasive ductal carcinoma. METHODS: Immunohistochemical staining was performed for VEGF-C and CD31 in the surgically resected specimens from 83 patients with invasive breast carcinoma. RESULTS: Of the 83 breast carcinomas, 61 (74%) cases showed cytoplasmic VEGF-C imunoreactivity. VEGF-C expression was associated with lymph node metastasis (p=0.03), but it did not correlate with tumor size, the histologic grade, and the presence of estrogen receptor or progesteron receptor. The mean microvessel density in the cases without VEGF-C expression was 51.9+/-30.1 and it was 72.9+/-33.0 in the cases with 2+ expression for VEGF-C (p=0.07). CONCLUSIONS: This study suggests that VEGF-C expression may have an association with lymph node metastasis in the patients with breast carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Cytoplasm ; Estrogens ; Humans ; Lymph Nodes ; Lymphangiogenesis ; Microvessels ; Neoplasm Metastasis ; Vascular Endothelial Growth Factor C* ; Vascular Endothelial Growth Factor Receptor-2 ; Vascular Endothelial Growth Factor Receptor-3