No abstract available.
Blast Crisis* ; Leukemia*

No abstract available.
Blast Crisis* ; Leukemia*

We report the first two cases of manic and hypomanic episodes respectively induced by risperidone treatment done to schizophrenics in Korea. One case was a 22-year-old woman with catatonic schizophrenia. Since 3 years ago, she had shown psychotic symptoms, but with was poor treatment compliance. She had mainly negative symptoms such as social withdrawal, decreased flood intake, mutism, and symptoms had been worsened since last 4-5 months. Prior to closed ward admission, she was prescribed 2mg/d of risperidone far a week at OPD. Two days after taking medicine totally 6-8mg, she revealed manic features. After hospitalization, risperidone was discontinued and then, lithium 900mg/d and high dosage of conventional antipsychotics(chlorpromazine 1200mg/d or haloperidol 20mg/d) were prescribed. About on the l0th day of hospitalization, there was limited improvement of her manic symptoms. The other case was a 29-year-old man with a 3-year history of paranoid schizophrenia. He was never exposed to antipsychotics before. His main symptoms were delusions of being poisoned and of persecution. His positive and also negative symptoms were alleviated by 38 days of risperidone 2mg/d trial. However, one week after dosage increment to 3mg/d, hypomanic symptoms appeared. Risperidone medication was discontinued and was replaced by chlorpromazine 300mg/d. The hypomanic episode was resolved over 5 days. In both of the two cases, manic episodes occurred by monotherapy of risperidone without mood stabilizer, and there were no history of substance abuse and other psychiatric disorders, family history of psychiatric disorders, and comorbid physical illnesses. It is hypothesized that the potent blockade effect on serotonin(5-HT2) receptor of risperidone causes antidepressant effect, as well as therapeutic effect for negative and affective symptoms in schizophrenia. Risperidone would induce manic or hypomanic features in schizophrenic patients. And there are few case reports of risperidone-induced mania or exacerbation of preexisting manic symptoms by risperidone treatment in mood disorder and schizoaffective disorder. Risperidone is being used more widely, even for obsessive-compulsive disorder and other psychiatric disorders. It is necessary for clinicians to recognize manic switch, one of psychiatric side effects by risperidon trial. It is recommended that the combination of mood stabilizer with risperidone or usage of the minimum effective dose of risperidone may bewefal especially in the patients with mood disorders or schizoaffective disorders. Clozapine which has mood-stabilizing properties is also beneficial in risk groups of risperidone-induced mania.
Adult ; Affective Symptoms ; Antipsychotic Agents ; Bipolar Disorder* ; Chlorpromazine ; Clozapine ; Compliance ; Delusions ; Female ; Haloperidol ; Hospitalization ; Humans ; Korea ; Lithium ; Mood Disorders ; Mutism ; Obsessive-Compulsive Disorder ; Psychotic Disorders ; Risperidone ; Schizophrenia ; Schizophrenia, Catatonic ; Schizophrenia, Paranoid ; Substance-Related Disorders ; Young Adult

BACKGROUND: Glycemic profile has traditionally been with the use of HbAlc over a 2 to 4 month period. Recently, serum fructosamine is highly sensitive to acute metabolic deterioration(period 2 to 3 weeks), and is suitable for automation, allowing multiple assays with minimal effort. In some report, despite evidence suggesting a reduction in serum albumin level with increasing age, serum fructosamine was strongly correlated with HbAlc in elderly diabetic patients. This study was conducted to define the correlation between fructosamine and other parameters in elderly diabetic patients. METHODS: The study group consisted of 56 elderly patients(age range : 66-85 years, group A) and 58 adult patients(age range: 18-64 years, group B), who were stable over recent 2 months in fasting glucose values and serum albumin levels. Fructosamine was measured in 114 diabetic patients. The measured levels were related to HbAlc and fructosamine/albumin index(FAI). RESULTS: 1) There was significant correlation between HbAlc and fructosamine in all diabetic patients(r=0.705, p=0.0001). The correlation between HbAlc and fructosamine was stronger in group A than in group B [group A: r=0.831, group B: r=0.367, p=0.0001](p<0.05). 2) The correlation between HbAlc and FAI was significantly stronger compared to that between HbAlc and fructosamine in elderly diabetic patients(p<0.05). 3) Glycation ratio provides a vector-like insight into the recent trend of glycemia, and Glycation ratio was stable in all diabetic patients. CONCLUSIONS: Our study suggests that correlation between HbAlc and fructosamine in elderly daibetic patients was significantly lower in adult diabetic patients. Further studies are needed to determine the ultimate values of this test in the clinical management of elderly patient with diabetes.
Adult ; Aged* ; Automation ; Fasting ; Fructosamine* ; Glucose ; Humans ; Serum Albumin

OBJECTIVES: This study was designed to evaluate differences in the quality of life(QOL) according to insight in patients with schizophrenia. The author speculated that insight might have an effect on individual's QOL, especially subjective QOL. METHOD: The study group consisted of patients with schizophrenia(N=55). Subjects were divided into two groups, patients with insight(N=22)and without insight(N=15), based on Scale of Unawareness of Mental Disorders(SUMD). All of the patients were administered the Quality of Life Interview (QOLI)by Lehman and compared in objective and subjective QOL between two groups. Additionally, they completed BDI and F scale on MMPI. RESULTS: The patients with insight showed a tendency of lower scores in total subjective QOLI scores and the safety issues compared to the patients without insight although not significant statistically. And they showed significantly less satisfaction with social relations. In objective QOL, there are no statistically significant differences between two groups. CONCLUSION: Such differences support the notion that schizophrenic patients with insight are less satisfied with their lives, especially in the aspect of interpersonal relations. It reflects the awareness of functional decline due to lifetime disability, disconnection from social relations, poor resources and supports, social stigma, and also depressive or anxiety symptoms. The authors propose that the treatment strategies for schizophrenia must include concern and support for domains of life with which patients feel themselves least satisfied, to increase effectiveness and efficacy of treatment and improve QOL.
Anxiety ; Humans ; Interpersonal Relations ; MMPI ; Quality of Life* ; Schizophrenia* ; Social Stigma

No abstract available.
Factor VII Deficiency* ; Factor VII*

OBJECTIVE: Pattern with essential hypertension generally shows the same circadian pattern as the normothensive person with a night-time reduction or "DIP" in blood pressure in sleep. The definition of "Dipper" and "Non-dipper" are assigned according to arbitrary criteria e.g. a night time average blood pressure which is at least 10% less than the average daytime blood pressure. Prospective evidence that the absence of an overnight dip is a strong adverse prognostic indicator for target organ damage .Thus we investigate circardian rhythm of blood pressure, related target organ damage, its frequency & drug in hypertensive subjects. Method : 24hr ambulatory blood pressure monitoring, history taking, physical examination, fundoscopy, ECG, chest X ray, dipstick urinanlysis, serum creatinine level are performed in essential hypertensive subjects. Exclusion criteria are duration of hypertension over 5 years, DM, renovascular hypertension & heart failure. RESULTS: Total 42 patients performed study.17 subjects classify dipper group,25 subjects classify non-dipper group. Between dipper & non-dipper group shows no significantly difference at stroke history, C/T ratio over 0.5 in chest X-ray, left ventrcular hypertrophy in ECG,ST-T change in ECG, proteinuria & serum creatinine level. Non-dipper group shows significantly difference to dipper group in frequency of hypertensive retinopathy and number of combined drug used subjects. CONCLUSION: Number of hypertensive retinopathy is significantly frequency in non-dipper group. Hypertensive retinopathy is atherosclerotic complication, thus we predict other target organ damage, therefore non-dipper type circardian rhythm of blood pressure is adverse prognostic factor for target organ damage of hypertensive subjects.
Blood Pressure Monitoring, Ambulatory ; Blood Pressure* ; Creatinine ; Electrocardiography ; Heart Failure ; Humans ; Hypertension ; Hypertension, Renovascular ; Hypertensive Retinopathy ; Hypertrophy ; Physical Examination ; Prospective Studies ; Proteinuria ; Stroke ; Thorax

BACKGROUND: Heart Rate Variability help us to diagnose the impairment of autonomic nervous system in patients with diabetes, hypertension, ischemic heart disease, chronic renal disease, and arrhythmia. Change of autonomic nervous system is related to circadian rhythm, stress, physical activity, and so on. Especially, impairment of vagal nervous system with age help us to expect sudden cardiac death, myocardial infarction, and arrhythmia. So we survey heart rate variability by using 24 hours holter monitoring to expect impairment of autonomic nervous system in elderly hypertensive patients. METHODS: In order to assess 24 hours heart rate variability, we use Del Mar Avionics 563 holter monitoring on 11 elderly hypertensive patients( > or =65 years), 12 younger hypertensive patients( <65 years), and 15 normal subjects. RESULTS: 1) Standard deviation of mean R-R interval, LF(low frequency), HF(high frequency), TPSD(total power spectral density) are more decreased in elderly hypertensive patients than in younger hypertensive patients in 24 hours health rate variability analysis(t-test p<0.05). 2) According to age, elderly control group had lower LF power spectral parameter than younger control group had, but other parameters were not decreased, and elderly hypertensive group had lower LF, HF, TPSD, SD of mean R-R interval than younger hypertensive group did(p<0.05). 3) In circardian rhythm, normal subjects had high HF power spectral parameter and low LF power spectral parameter at evening and night. On the other hand, elderly hypertensive group had constant low level of LF, HF power spectral parameter during the day and night. CONCLUSIONS: On heart rate variability analysis using by 24 hours Holter monitoring, heart rate variability was decreased, and impairment of autonomic nervous system was accelerated in elderly hypertensive patients.
Aged* ; Arrhythmias, Cardiac ; Autonomic Nervous System ; Circadian Rhythm ; Death, Sudden, Cardiac ; Electrocardiography, Ambulatory ; Hand ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Motor Activity ; Myocardial Infarction ; Myocardial Ischemia ; Nervous System ; Renal Insufficiency, Chronic

Chronic graft-versus-host disease (cGVHD) remains one of the major complications of allogeneic hematopoietic stem cell transplantation. Although cGVHD has various manifestations in almost all organs, cases of cGVHD involving skeletal muscle are rare. We experienced a 26-year-old man with polymyositis with no other concurrent cGVHD after HLA-matched myeloablative transplantation for acute myelogenous leukemia. He had a history of acute and chronic GVHD. The patient complained of fever and myalgia 3 years after transplantation. The serum creatine kinase (CK, 2,223 IU/L) and aldolase (87.6 sigmaU/mL) were elevated. The muscle biopsy and electromyographic findings were consistent with myositis with necrosis. His condition improved dramatically with immunosuppressive therapy. Although muscle involvement, alone, in cGVHD is very rare, early diagnosis and proper treatment are still important.
Adult ; Biopsy ; Bone Marrow ; Bone Marrow Transplantation ; Creatine Kinase ; Early Diagnosis ; Fever ; Fructose-Bisphosphate Aldolase ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myeloid, Acute ; Muscle, Skeletal ; Muscles ; Myositis ; Necrosis ; Polymyositis ; Transplants

The purpose of this study was to evaluate the accuracy of a mobile wireless digital automatic blood pressure monitor for clinical use and mobile health (mHealth). In this study, a manual sphygmomanometer and a digital blood pressure monitor were tested in 100 participants in a repetitive and sequential manner to measure blood pressure. The guidelines for measurement used the Korea Food & Drug Administration protocol, which reflects international standards, such as the American National Standard Institution/Association for the Advancement of Medical Instrumentation SP 10: 1992 and the British Hypertension Society protocol. Measurements were generally consistent across observers according to the measured mean ± SD, which ranged in 0.1 ± 2.6 mmHg for systolic blood pressure (SBP) and 0.5 ± 2.2 mmHg for diastolic blood pressure (DBP). For the device and the observer, the difference in average blood pressure (mean ± SD) was 2.3 ± 4.7 mmHg for SBP and 2.0 ± 4.2 mmHg for DBP. The SBP and DBP measured in this study showed accurate measurements that satisfied all criteria, including an average difference that did not exceed 5 mmHg and a standard deviation that did not exceed 8 mmHg. The mobile wireless digital blood pressure monitor has the potential for clinical use and managing one's own health.
Blood Pressure Monitors* ; Blood Pressure* ; Hypertension ; Korea ; Methods* ; Self Care* ; Sphygmomanometers ; Telemedicine