OBJECTIVES: This study was designed to investigate the effect of antipsychotic drugs (chlorpromazine, haloperidol and clozapine) on the cerebral hemodynamics including the changes in regional cerebral blood flow(rCBF) and the pill arteriolar diameter of male Sprague-Dawley rats. METHODS: The changes in rCBF were determined by laser-Doppler flowmetry, and the changes in diameter of pill arteriole were measured through a closed cranial window. RESULTS: Clozapine(0.1~10 microgram/kg, i.v. or 0.03~3 micrometer caused an increase in rCBF in association with a vasodilation of pill arteriole in a dose-dependent miner, whereas chlorpromazine and haloperidol(5~500 microgram/kg, i.v., or respectively) were without effect on rCBF. Clozapine-induced increases in rCBF were significantly blocked by topical pretrfatment with NMDA receptor blockers(MgCl(2), MK-801, ketamine and D(-)-2-amino-5-phosphonopentanoic acid). Constitutive nitric oxide synthase inhibitors (N(G)-nitro-L-arginine, 7-nitroindazole and diphenyleneiodonium) markedly inhibited the clozapine-induced increases in rCBF. However, aminoguanidine, an inducible nitric oxide synthase inhibitor did not affect the clozapine-induced increases in rCBF. Inhibitors of soluble guanylyl cyclase(methylene blue and 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one) significantly attenuated the clozapine-induced increases in rCBF. CONCLUSION: These results suggest that typical antipsychotic drugs are without effect on rCBF, but atypical antipsychotir drug clozapine exerts an increase in rCBF with pial arteriolar dilation via mediation of NMDA receptor stimulation, and thereby, leading to activation of neuronal and endothelial nitric oxide synthases and increase in cyclic GMP formation.
Animals ; Antipsychotic Agents* ; Arterioles ; Chlorpromazine ; Clozapine ; Cyclic GMP ; Dizocilpine Maleate ; Haloperidol ; Hemodynamics* ; Humans ; Ketamine ; Laser-Doppler Flowmetry ; Male ; N-Methylaspartate ; Negotiating ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Rats* ; Rats, Sprague-Dawley ; Vasodilation

Two cases showing severe combustion, especially, of the abdomen are presented in this report. The corpse were found in the outdoor field. Their head and four extremities showed relatively weak combustion with their original contour. But, their abdomen including lumbar vertebrae almost totally became ash. Gasoline and Kerosine had been used in each case. At the time of autopsies, I did not understand exactly why these corpse showed peculiar findings like this. Recently one scientist had performed an experiment with pig. The result of the combustion in this reference is same with my cases. According to this experiment, the melted fat leaked from the splitted skin acted as fuel and the burned clothes or blanket acted as a wick. The total combustion of the abdomen is not a suspicious finding of previous open wound before fire. This knowledge is beneficial for the practitioners in the forensic field.
Abdomen ; Autopsy ; Burns ; Cadaver ; Extremities ; Fires ; Gasoline ; Head ; Kerosene ; Lumbar Vertebrae ; Skin ; Wounds and Injuries

It was aimed to investigate the effect of 5-HT2C receptor modulation on the rat behavioral responses induced by 1-(m-chlorophenyl) piperazine(mCPP), a major metabolite of trazodone. The animal activities(ambulation, stereotypy and total activity) were measured for 3 hours following mCPP administration, using an animal activity meter which accumulates the frequency of light beam interruption. mCPP(1-10 mg / kg, i.p.) induced dose-dependent decreases in ambulation and stereotypy, consequently leading to hypoactivity. The hypoactivity induced by mCPP(1mg / kg, i.p.) was significantly inhibited by pretreatment with mianserin(1mg / kg, i.p.), an antagonist with high affinity for 5-HT2C receptor, whereas pretreatment with 5-HT2 antagonists, ketanserin and ritanserin(1mg / kg, i.p., respectively) was without effect. Furthermore, long-term pretreatment with imipramine(10mg / kg, i.p., b.i.d. for 2 weeks) markedly attenuated the mCPP-induced hypoactivity. Mianserin and imipramine in the absence of mCPP did not increase the animal activity. Taken together, these results indicate that the mCPP-induced hypoactivity is mediated by 5-HT2C receptor, and that selective 5-HT2C antagonists and down regulation of 5-HT2C receptor might be useful for inhibiting the mCPP-induced hypoactivity.
Animals ; Down-Regulation ; Imipramine ; Ketanserin ; Mianserin ; Rats ; Receptor, Serotonin, 5-HT2C* ; Serotonin 5-HT2 Receptor Antagonists ; Trazodone ; Walking

In order to investigate the factors associated with family burdens of schizophrenics, 92 primary caregivers and 68 siblings of 92 persons with schizophrenia were examined by means of self-report scales about the effect of positive and negative symptom behaviors, clinical and sociodemographic variables, and guilty feelings toward patient on the objective and subjective burden. The results were as follows. 1) There was no difference in the objective and subjective burden scores between the primary caregivers and siblings, even though the former showed a higher scores compared to the latter. 2) Burden scores were significantly affected by the factors such as age of patients, duration of illness, total duration of hospitalizations, monthly family income, and the experience of family education in the primary caregivers or siblings of schizophrenics. 3) Objective and subjective burden were related to both the severity of positive, negative, and the other symptom behaviors in the primary caregivers and siblings. The positive and negative symptom behaviors were more related to subjective burdens compared to objective burdens in the primary caregivers and siblings. The positive symptom behaviors were more related to perceived objective and subjective burdens compared to negative symptom behaviors in the siblings. 4) The correlations between guilty feelings toward patient and burden scores was significant only in the primary caregivers. These results could be used as useful datas to develop the more effective family intervention for reducing family burden.
Caregivers* ; Education ; Hospitalization ; Humans ; Schizophrenia ; Siblings* ; Weights and Measures

OBJECTIVES: The present study assessed the effect of trazodone on the cerebral hemodynamics of male Sprague-Dawley rats. METHOD: The changes of regional cerebral blood flow(rCBF) and pill arterial diameter were measured by laser-Doppler flowmetry and by a videomicroscopy, respectively. The changes in vascular tone and intracellular free Ca2+ concentration ([Ca2+]i) of isolated basilar artery were simultaneously measured using a small vessel myograph and a cation measurement system, respectively. RESULT: Both the rCBF and the pill arterial diameter were dose-dependently decreased by systemic administration of trazodone(0.3-10 mg/kg, i.v.), but not by topical application of trazodone(10-300 micrometer). Pretreatment with 5-HT(2A/2C) receptor antagonist(ketanserin or ritanserin, 1 mg/kg, i.v., respectively) significantly blocked the changes in rCBF induced by trazodone. m-Chlorophenylpiperazine(mCPP ; 0.1-3 mg/kg, i.v. or 5-500 micrometer topical), a major active metabolite of trazodone, also dose-dependently decreased the rCBF as well as the pial arterial diameter. The mCPP-induced decreases in rCBF were significantly blocked by ketanserin. Pretreatment with itraconazole(1 mg/kg, p.o.), a selective inhibitor of CYP3A4, a subfamily of cytochrome P450, markedly attenuated the trazodone-induced changes in rCBF. In an isolated rat basilar arterial strip loaded with fura-2/AM, mCPP(5-500 micrometer caused a vasoconstriction in association with increases in [Ca2+]i, in a concentration-dependent manner. Pretreatment with 1 micrometerketanserin strongly blocked the effects of mCPP on the vascular tone as well as on the [Ca2+]i, of rat basilar artery. CONCLUSION: These results suggest that trazodone decreases rCBF through stimulation of 5-HT(2A/2C) receptors by its active metabolite, mCPP.
Animals ; Basilar Artery ; Cytochrome P-450 Enzyme System ; Hemodynamics* ; Humans ; Ketanserin ; Laser-Doppler Flowmetry ; Male ; Microscopy, Video ; Rats* ; Rats, Sprague-Dawley ; Ritanserin ; Trazodone* ; Vasoconstriction

OBJECTIVE: In Korea, direct lateral interbody fusion (DLIF) was started since 2011, using standard cage (6degrees lordotic angle, 18mm width). Recently, a new wider cage with higher lordotic angle (12degrees, 22mm) was introduced. The aim of our study is to compare the clinical and radiologic outcomes of the two cage types. METHODS: We selected patients underwent DLIF, 125 cases used standard cages (standard group) and 38 cases used new cages (wide group). We followed them up for more than 6 months, and their radiological and clinical outcomes were analyzed retrospectively. For radiologic outcomes, lumbar lordotic angle (LLA), segmental lordoic angle (SLA), disc angle (DA), foraminal height change (FH), subsidence and intraoperative endplate destruction (iED) were checked. Clinical outcomes were compared using visual analog scale (VAS) score, Oswestry disability index (ODI) score and complications. RESULTS: LLA and SLA showed no significant changes postoperatively in both groups. DA showed significant increase after surgery in the wide group (p<0.05), but not in the standard group. Subsidence was significantly lower in the wide group (p<0.05). There was no difference in clinical outcomes between the two groups. Additional posterior decompression was done more frequently in the wide group. Postoperative change of foraminal height was significantly lower in the wide group (p<0.05). The iED was observed more frequently in the wide group (p<0.05) especially at the anterior edge of cage. CONCLUSION: The new type of cage seems to result in more DA and less subsidence. But indirect foraminal decompression seems to be less effective than standard cage. Intraoperative endplate destruction occurs more frequently due to a steeper lordotic angle of the new cage.
Decompression ; Humans ; Korea ; Retrospective Studies ; Visual Analog Scale

OBJECTIVE: The purpose of this study was to evaluate the validity and reliability of Korean version of Addiction Severity Index for the systematic diagnosis and evaluation of alcoholism. METHODS: The authors selected 65 alcoholic patients with the criteria of DSM-VI. RESULTS: The results were as follows: 1) The exception of the significant correlation between psychiatric and the family/social problem area, the 6 sections of ASI were mutually independent. 2) There was significant inter-rater reliability in all sections of ASI. 3) In medical, alcohol use, family/social and psychiatry section, the calculation of composite score showed reasonable level of item consistency. In all sections, there was significant correlation between composite scores and severity ratings of corresponding section. 4) The important items of each section were most highly correlated with their corresponding severity ratings except two sections. 5) In the multiple regression analysis, the amount of variance accounted far by the most important 4 items were 83% in medical section, 45% in employment/support,43% in alcohol use section, 55% in legal section,53% in family/social section and 84% in psychiatric section. 6) Severity rating of psychiatric section was significantly correlated with the scores of MMFI, MAST and SCL-90-R. CONCLUSION: The result suggests that Korean version of the ASI showed relatively reasonable reliability and validity and it can be used in treatment and study of alcoholic patients.
Alcoholics* ; Alcoholism ; Diagnosis ; Humans ; Reproducibility of Results*

OBJECTIVES: Psychotic Symptom Rating Scale (PSYRATS) is an assessment tool to measure the severity of different dimensions of auditory hallucinations and delusions. The reliability and validity of the Korean version of PSYRATS (K-PSYRATS) were examined in Korean patients with major psychosis. METHODS: The inter-rater reliability of the K-PSYRATS was determined from the videotaped interviews of the five schizophrenic patients. To measure validity and internal consistency reliability, the 109 patients with auditory hallucinations or delusions were assessed using the K-PSYRATS, Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Severity (CGI-S) scale. RESULTS: K-PSYRATS was found to have excellent inter-rater reliability (intra-class correlation coefficient of auditory hallucination= 0.81, p<.001, intra-class correlation coefficient of delusion=0.97, p<.001) and internal consistency reliability (Cronbach's alpha of auditory hallucination=0.77, Cronbach's alpha of delusion=0.76). Significant correlation was found between K-PSYRATS and positive syndrome subscale of PANSS and CGI. CONCLUSION: K-PSYRATS is a useful assessment instrument for psychotic symptoms in Korea.
Delusions ; Hallucinations ; Humans ; Korea ; Psychotic Disorders ; Reproducibility of Results*

Several types of soft tissue masses occur in the lower extremities. A mass associated with blood vessels is often difficult to diagnose. A 15-year-old male patient visited the author’s hospital with discomfort and edema in his right calf that had persisted for six months. A physical examination showed no palpable mass other than mild edema. Three masses were found during the ultrasound scan along the small saphenous vein. The masses had a cyst-like appearance and were filled with thrombus. In duplex ultrasound, vascular reflux was represented inside the masses. During surgery, it was suspected that vascular deformation occurred in the small saphenous vein, and simple ligation and resection treatments were performed. The patient was finally diagnosed with venous aneurysms accompanied by thrombosis based on the histology tests. The symptoms disappeared after surgery, and there were no recurrences or unusual findings at the follow-up one year later. Venous aneurysms occurring in the superficial veins of the lower extremities are rarely reported, but treatment and diagnosis are important. This paper reports a case of an aneurysm on the small saphenous vein.

OBJECTIVES: The aim of this study was to investigate the relationship between metabolic syndrome and cognitive functions among chronic schizophrenia patients. METHODS: The survey participants were 105(40 metabolic syndrome and 65 non-metabolic syndrome) chronic schizophrenia patients at Yang-san Hospital. Each score of cognitive test(A Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet, stroop test), Positive and Negative Syndrome Scale, Hamilton rating scale for Depression were assessed. Statistical analysis of the relationship between various tests of A Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet and metabolic syndrome were performed using ANCOVA and logistic regression. RESULTS: Schizophrenia patients with lower score on construction praxia were likely to be included in Metabolic syndrome group. However, there were no significant relationships in other tests between the two groups. CONCLUSION: This study found metabolic syndrome caused cognitive decline in chronic schizophrenia patients, especially Construction praxia. This study could be a basis to show metabolic syndrome has to be treated appropriately in schizophrenia patients and suggests the necessity of following longitudinal designed study.
Alzheimer Disease ; Depression ; Humans ; Logistic Models ; Schizophrenia*