Nocturnal enuresis has been recognized as an adverse effect of clozapine treatment. We reported 3 chronic schizophrenic patients who had showed nocturnal enuresis following clozapine treatment. Oxybutynin hydrochloride on clozapine-induced enuresis was very effective in 3 patients. The dose in our patients was 5 to 10mg/day. This medication was well tolerated. It is suggested that oxybutynin hydrochloride is a effective therapeutic option in clozapine-induced nocturnal enuresis.
Clozapine* ; Enuresis ; Humans ; Nocturnal Enuresis* ; Schizophrenia

OBJECTIVES: Behavioral problem and functional impairment in addition to cognitive impairment are induced, and the medical comorbidity is common in dementia patients. Thus the evaluation of these domains is needed for the management of dementia patients. This study presents a method practically and easily assessing above all dimensions, and analyzes the results. METHODS: The multidimensional evaluating method consists of one general staging measure (GDS) and four measures(MMSE, B-ADL, BEHAVE-AD, GMHR) evaluating four domains;cognition, activities of daily living, behavior, and medical comorbidity. These measures are administered to 29 dementia patients(Alzheimer's dementia 21, mixed or vascular dementia 9) admitted in a long-term care residence of dementia patients. The correlation of measures and the difference of the type of dementia, sex, and age are analysed by Pearson correlation coefficient and independent t-test respectively. RESULTS & CONCLUSIONS: In the correlation of scales, the score of MMSE was significantly correlated to the score of B-ADL in Alzheimer's dementia patient group(p<0.05). The score of B-ADL was significantly higher(p<0.05) and the score of GMHR was statistically insignificantly higher in Alzheimer's dementia patient group than mixed or vascular dementia patient group. The sex and age was unrelated to cognitive or functional ability. This multidimensional evaluating method, including the assessment of the medical comorbidity, is thought to be convenient to apply in the long-term care residence of dementia patients, and be of practical help to the management of dementia patients.
Activities of Daily Living ; Comorbidity ; Dementia* ; Dementia, Vascular ; Humans ; Long-Term Care ; Weights and Measures

The surgical closure of VSD in patient with severe pulmonary hypertension has been considered a difficult problem for surgeons, because sudden hemodynamic change after closure of the defect could bring on high perioperative mortality. Recently, it was reported that UVP (unidirectional valve patch), which allows some blood to flow from right to left in case of acute right heart failure, is effective in improving the postoperative hemodynamics after closing septal defects. This 42-year old woman had suffered from VSD for 20 years and recently complained of worsening exertional dyspnea for three months, and was diagnosed of a large VSD (2.0 cm in diameter) with severe pulmonary hypertension (116/38 mm Hg), equal to systemic arterial pressure. We could successfully close VSD with severe pulmonary hypertension using one UVP and the other UVP for the creative ASD to be prepared against possible acute right heart failure. She was discharged on the fourteenth postoperative day and has been well for twelve months with spontanenous closure of UVP patch at the ninth postopeative month.
Adult ; Arterial Pressure ; Dyspnea ; Female ; Heart Failure ; Heart Septal Defects ; Heart Septal Defects, Ventricular* ; Hemodynamics ; Humans ; Hypertension, Pulmonary* ; Mortality

MATERIALS AND METHODS: Between 1979 and 1996, 27 patients with primary cardiac tumor underwent surgery at Catholic University Medical College. Mean age of patient was 45.1+/-3.03 ranging from 21 to 67 years old. Twenty-four cases were myxomas, 2 cases were chondrosarcoma, and remained case was angiosarcoma. Diagnosis was confirmed by echocardiography, cardiac angiography, CT scan, and MRI. The most common site of tumor origin was fossa ovalis limbus area (17cases:63%). A biatrial operative approach was commonly used in 15 cases and the tumor was removed through left atriotomy site. Complete excision of the tumor with a cuff of normal tissue was performed. All heart chambers were carefully explored for evidence of multicentric myxomas or other tumor debris. Most of the patients were improved on postoperative period compared to preoperative NYHA functional class. RESULTS: There was one operative death due to low cardiac output syndrome. Follow up period was 3 months to 17 years. There was 2 late deaths due to local recurrences. CONCLUSION: complete surgical excion is important for increasing cure rate. Malignancy cannot be ruled out even though preoperative echocardiography suggests benign nature. Chest CT or MRI is effective for further evalution in addition to echocardiography. In suspicious of malignancy, more extensive resection is essential and postoperative chemotheraphy or radiotherapy is useful.
Aged ; Angiography ; Cardiac Output, Low ; Chondrosarcoma ; Diagnosis ; Drug Therapy ; Echocardiography ; Follow-Up Studies ; Heart ; Heart Neoplasms* ; Hemangiosarcoma ; Humans ; Magnetic Resonance Imaging ; Myxoma ; Postoperative Period ; Radiotherapy ; Recurrence ; Tomography, X-Ray Computed