OBJECTIVES: This randomized, multicenter, open-label, parallel clinical trial was carried to compare the therapeutic efficacy and the proportion of successful switch between 'direct switching method' and 'start-tapering switching method' when switching an antipsychotic to olanzapine. METHODS: This study included both inpatients and outpatients who fulfilled the criteria for schizophrenia as defined in the ICD-10 from 13 hospitals, and were in need to be appropriate for switching antipsychotics. Subjects were randomly assigned to one of the two switching methods. For 'direct switching method' group, previous antipsychotics were abruptly discontinued and 10mg of olanzapine was administered, whereas for 'start-tapering switching method' group, initially 10mg of olanzapine was administered and previous antipsychotics was gradually tapered for 2 weeks. Olanzapine was used for 6 weeks and the dose was adjusted within the range of 5-20mg. The therapeutic efficacy was measured with PANSS, BPRS, and CGI-Severity. A successful switching was defined as the completion of the 6 week trial without either worsening of the symptom(i.e. CGI-S score becomes worse twice consecutively) or the exacerbation of extrapyramidal symptoms(i.e. Simpson-Angus Scale scores becomes worse). RESULTS: 103 schizophrenic patients were participated in this study. There were no differences in baseline characteristics such as the demographic variables, the severity of symptoms, the history of previous antipsychotics treatments, the dosage of olanzapine used and the compliance between two groups. The proportion of successful switch was 71.1% for "direct switching method" and 82.2% for "start-tapering switching method", and there was no significant difference between the two switching methods. Also response rates to olanzapine based on total PANSS total scores were not different between the two groups(26.9% vs. 31.1%). At the time of completion of the trial, the scores of PANSS total, PANSS subscales, CGI-S and BPRS have significantly decreased after switching to olanzapine. But the changes of all scales measuring therapeutic efficacy in both endpoint and weekly analyses were not significantly different between the two switching methods. CONCLUSION: Although this study trial has many limitations and problems as an open clinical trial, the results may suggest that there were no significant differences between the two switching methods in the therapeutic efficacy. It was also found that the additional therapeutic benefits could be obtained by switching their antipsychotics to olanzapine.
Antipsychotic Agents ; Compliance ; Humans ; Inpatients ; International Classification of Diseases ; Outpatients ; Schizophrenia ; Weights and Measures

No Abstract Available.
Endothelium, Corneal* ; Lidocaine*

The delayed adjustable strabismus surgery may be desirable because the angle of strabismus can be changed after the strabismus surgery. We have studied the effect of 2% cyclosporin A on the delayed adjustable strabismus surgery in rabbits. Two percent cyclosporin A was soaked for 5 minutes for group 4 and 10 minutes for group 5 between the conjunctiva and sclera during the adjustable strabismus surgery on the eyes of New Zealand white rabbits. The eyes in group 1 received only adjustable strabismus surgery, and those in group 2 and 3 received the surgery including 5 minutes and 10 minutes soaking with castor oil, respectively. We evaluated the time of adjustability and measured the traction force and length during adjustment after the adjustable strabismus surgery. We could adjust in all of the 6 eyes in group 4 and 5 two weeks after the surgery. At 1 week, the traction forces were 30.7+/-14.0 (mean+/-SD), 42.0+/-39.6, 31.7+/-7.5, 24.0+/-7.5, and 21.8+/-6.0 gm in group 1, 2, 3, 4, and 5, respectively. The forces in group 4 and 5 were not significantly different from those in group 1, 2, and 3. At 2 weeks, the degrees of adhesion between the conjunctiva and superior rectus muscle, and those between the muscle and sclera were significantly lower in group 4 and 5 than those in group 1, 2, and 3. These results suggest that 2% cyclosporin A soaking is useful to obtain the better results due to the delayed adjustment by decreasing the adhesion around the muscle (J KoreanOphthalmol Soc 41:2115~2123, 2000).
Castor Oil ; Conjunctiva ; Cyclosporine* ; Rabbits* ; Sclera ; Strabismus* ; Traction

OBJECTIVE: This open prospective study was performed to investigate the therapeutic efforts and side effects profiles of nemonapride in the schizophrenic patients, and was compared with one of typical anti-psychotics, haloperidol. METHOD: Sixty male or female schizophrenic patients were treated for 12 weeks with nemonapride(n=32) and haloperidol(n=28). The overall clinical therapeutic effects were assessed at baseline, 1st week, 2nd week, 4th week, 8th week and 12th week using the PANSS, the BPRS and the CGI scale. Also, the overall clinical side effects were assessed in the same time period using ESRS, UKU side effect rating scale and global assessment for side effect scale. RESULTS: There were not a significant differences in PANSS score(total, positive, negative and general psychopathology subscale), BPRS(total score), CGI scale score between nemonapride and haloperidol trial groups. And also, there were not a significant differences in the ESRS, the UKU side effect rating scale, the Global assessment far side effect stale score between nemonapride and haloperidol trial groups. 59% of the nemonapride-treated patients(n=32) were categorized as treatment responders, who showed at least a 20% decrease in total PANSS score at baseline state, was compared with 64% of haloperidol-treated patients(n=28). 72% of the nemonapride-treated patients were categorized as treatment responders, who showed at least a 20% decrease in total BPRS score at baseline state, compared with 68% of haloperidol-treated patients. There were not significant differences in these both treatment responder groups. CONCLUSION: There were no significant differences in the therapeutic effects and side effects profiles of nemonapride and haloperidol groups.
Female ; Haloperidol* ; Humans ; Male ; Prospective Studies ; Psychopathology ; Schizophrenia

The purpose of this study was to evaluate the susceptibility of various intraocular lenses(IOLs) of different optic material to Nd:YAG laser in vitro. Four models of IOLs manufactured by different companies were selected and ten IOLs for each model were used for this study. Two models had lathe-cut polymethylmethacrylate(PMMA) optic, one silicone compound optic, and one acrylate/methacrylate copolymer optic. Q-switched Nd: YAG laser(7901 Nd-YAG laser, Coherent, Palo Alto, CA, USA) was used. The He-Ne aiming beam was focused on the posterior surface of optic, 2mm apart from the center of optic, and sixteen shots were applied to each optic with energy levels ranging from 0.3 to 2.0mJ with increment of 0.1 or 0.2mJ in a circular pattern. The spots were examined under phase contrast microscope and scanning electron microscope. The averages(+/-SD) of energy threshold at which damage was detected were 0.49+/-0.12mJ in silicone compound optic, 0.67+/-0.19mJ in acrylate/methacrylate copolyer optic, and 0.72+/-0.11mJ and 0.89+/-0.09mJ in lathe-cut PMMA optics. All interclass differences were statistically significant except the difference between lathe-cut PMMA optic with lower damage threshold and acrylate/methacrylate copolymer optic(Mann-Whitney test, p<.05). In conclusion, silicone compound and acrylate/methacrylate copolymer optics are more susceptible to Nd:YAG laser than PMMA optic in vitro and this suggests that in patients with high risk of developing severe posterior capsular opacification after cataract surgery, implantation of IOLs with PMMA optic is preferable and early Nd:YAG laser posterior capsulotomy with low energy is recommended in cases of implantation of foldable IOLs.
Cataract ; Humans ; Lasers, Solid-State* ; Lenses, Intraocular* ; Polymethyl Methacrylate ; Posterior Capsulotomy ; Silicones

To examine the effects of 0.5% apraclonidine on optic nerve head (ONH) and peripapillary microcirculation, scanning laser Doppler flowmetry was performed before and 1 honr, and 3 hours after administration of 0.5% apraclonidine in 10 healthy subjects. In each occasion, 3 scans were obtained. Hemodynamic parmeters (volume, flow, and velocity0 were found at 8 locations, 4 in the neural rim and 4in the peripapillary retina. The intraocular pressure was reduced significantly in apraclonidine-treated eyes by 15.4% (p<.05) at 1 hour and 30.1% (p<.01)at 3 hours after administration. There was no significant change in the volume, flow or velocity of ONH and peripapillary retinal blood flow after apraclonidine administration. In conclusion, single-dose of topical apraclonidine 0.5% in healthy subjects does not have adverse effects on the microcirculation in ONH and peripapillary retina.
Hemodynamics ; Intraocular Pressure ; Laser-Doppler Flowmetry ; Microcirculation* ; Optic Disk* ; Optic Nerve* ; Retina ; Retinaldehyde*

To define the distribution of normal corneal topographic patterns of Korean adults and compare them with previously published western data, computerized corneal topography was performed on the randomly selected eye of 232 normal subjects using TMS-1(Computed Anatomy). Recruited subjects were 116 females and 118 males. Mean age of the subjects was 50.5 yr. (range 17 to 86 yr.). The color-coded videokeratographs were classified by a masked observer according to the Bogan et al's classification such as round, oval, symmetric bow tie, asymmetric bow tie, and irregular. The results revealed 16 eyes (6.9%) had round. 31 (13.4%) oval, 42 (18.1%) symmetric bow tie, 99 (42.7%) asymmetric bow tie, and 44 (19.0%) irregular pattern. There was no statistically significant difference in the distribution of topographic pattern between male and female and among the age groups. Our results of topographic patterns show the tendency of more irregular and less round topographic pattern in Korean adults, as compared to that of western adults.
Adult* ; Classification ; Corneal Topography ; Female ; Humans ; Male ; Masks

This animal study was conducted to investigate the effect of holmium:YAG laser thermokeratoplasty on correction of hyperopic astigmatism. A pulsed holmium:YAG laser emitting a wavelength of 2.06 micrometer was used. Arcuate, reverse arcuate, linear patterns of laser burn were applied along the flat corneal meridian and their effects on the rabbit corneal curvature were studied. Keratometric measurements and cycloplegic refractive error were determined preoperatively, one, two, and three months after operation. The changes of refractive astigmatism in three patterns of laser burn were 0.8130, 3.0243, 0.8437 diopter, respectively, compared to that of the control group on postoperative three months. The changes of keratometric astigmatism were 1.1719, 3.0737, 0.7812 diopter, respectively, compared to that of the control group on postoperative three months. We found that holmium:YAG laser thermokeratoplasty is effective in steepening flat corneal meridian, and the most effective pattern is reverse arcuate type. In future holmium:YAG laser thermokeratoplasty might be clinically applicable as a operation of hyperopic astigmatism correction.
Animals ; Astigmatism* ; Burns ; Rabbits* ; Refractive Errors

The primary overaction of the inferior oblique(IO) muscle is of unknown cause, whereas the secondary overaction of IO is usually related to the palsy of the ipsilateral superior oblique or contralateral superior rectus. To understand the cause of the primary overaction of the IO, an ultrastructural study on primary and secondary overacting IO muscles was performed by electron microscopy. The most striking abnormalities were aggregations of mitochondria, degeneration of mitochondrial profiles, and increased vacuolization in primary and secondary overacting muscles. These changes were more severe in cases of primary overaction thitn in those of secondary overaction. Many muscle fibers were in different stages of atrophy. Hypertrophy and regeneration of muscle fibers were sometimes visible. The primary and the secondary overacting IO muscles showed similar morphologic alterations. These results suggest that the primary overacting IO muscle might be the result of a paresis of the superior oblique muscle.
Atrophy ; Hypertrophy ; Microscopy, Electron ; Mitochondria ; Muscles* ; Paralysis ; Paresis ; Regeneration ; Strikes, Employee

The primary overaction of the inferior oblique(IO) muscle is of unknown cause, whereas the secondary overaction of IO is usually related to the palsy of the ipsilateral superior oblique or contralateral superior rectus. To understand the cause of the primary overaction of the IO, an ultrastructural study on primary and secondary overacting IO muscles was performed by electron microscopy. The most striking abnormalities were aggregations of mitochondria, degeneration of mitochondrial profiles, and increased vacuolization in primary and secondary overacting muscles. These changes were more severe in cases of primary overaction thitn in those of secondary overaction. Many muscle fibers were in different stages of atrophy. Hypertrophy and regeneration of muscle fibers were sometimes visible. The primary and the secondary overacting IO muscles showed similar morphologic alterations. These results suggest that the primary overacting IO muscle might be the result of a paresis of the superior oblique muscle.
Atrophy ; Hypertrophy ; Microscopy, Electron ; Mitochondria ; Muscles* ; Paralysis ; Paresis ; Regeneration ; Strikes, Employee