Objective: This study was performed to evaluate the efficacy and safety of lurasidone (160 mg/day) compared to quetiapine XR (QXR; 600 mg/day) in the treatment of acutely psychotic patients with schizophrenia. Methods: Patients were randomly assigned to 6 weeks of double-blind treatment with lurasidone 160 mg/day (n=105) or QXR 600 mg/day (n=105). Primary efficacy measure was the change from baseline to week 6 in Positive and Negative Syndrome Scale (PANSS) total score and Clinical Global Impressions severity (CGI-S) score. Adverse events, body measurements, and laboratory parameters were assessed. Results: Lurasidone demonstrated non-inferiority to QXR on the PANSS total score. Adjusted mean±standard error change at week 6 on the PANSS total score was -26.42±2.02 and -27.33±2.01 in the lurasidone and QXR group, respectively. The mean difference score was -0.91 (95% confidence interval -6.35–4.53). The lurasidone group showed a greater reduction in PANSS total and negative subscale on week 1 and a greater reduction in end-point CGI-S score compared to the QXR group. Body weight, body mass index, and waist circumference in the lurasidone group were reduced, with significantly lower mean change compared to QXR. Endpoint changes in glucose, cholesterol, triglycerides, and low-density lipoprotein levels were also significantly lower. The most common adverse drug reactions with lurasidone were akathisia and nausea. Conclusion Lurasidone 160 mg/day was found to be non-inferior to QXR 600 mg/day in the treatment of schizophrenia with comparable efficacy and tolerability. Adverse effects of lurasidone were generally tolerable, and beneficial effects on metabolic parameters can be expected.

OBJECTIVE: The primary purpose of this study was a replication of the effectiveness and tolerability of risperidone in the treatment of patients with acute mania in very larger cohort in naturalistic treatment setting to extend the data on the effect and tolerability of risperidone in the treatment of patients with acute mania to Asian population. METHODS: A total of 909 patients with DSM-IV criteria of bipolar disorder current manic and hypomanic episode, entered this large, open, multicentre study. The Young Mania Rating Scale (YMRS), Clinical Global Impression (CGI) and Simpson-Angus Rating Scale (SARS) were measured at baseline and weeks 1, 3 and 6, for the assessment of effectiveness and extrapyramidal symptom (EPS). RESULTS: This study showed statistically significant reduction of scores on the YMRS and CGI-s (mean change=-23.5+/-11.8, p<0.0001;mean change=-2.7+/-1.5, p<0.0001, respectively) from the baseline to the endpoint (week 6). Number of patients with 50% reduction or more in the YMRS and CGI-s scores was 693 (77.8%) and 630 (70.7%) at endpoint, respectively. There were no statistically significant increments of scores on SARS. Risperidone was generally well tolerated. CONCLUSION: The present larger open study demonstrates that risperidone add-on therapy is effective and tolerable in treatment of bipolar disorder, replicating results in various controlled and uncontrolled studies from Western countries.
Asian Continental Ancestry Group ; Bipolar Disorder* ; Cohort Studies ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Risperidone*

40-years old) was 1.80+/-0.52mm and 1.51+/-0.58mm in younger age(<40-years old). The period between L2-and L3 showed significant changes in marginal bone oss(p<0.05). In conclusion, the marginal bone loss in L2-L3 period was most severe. Thus, the intensive care and follow-up in this period will be required to prevent excessive bone loss.]]>
Female ; Follow-Up Studies ; Heart ; Humans ; Critical Care ; Male ; Transplants

BACKGROUND: The relative frequency and clinicopathologic characteristics of lymphomas vary according to geography and race. Data on the features of cutaneous lymphoma in Korea are limited. OBJECTIVE: The aim of this study was to document the relative occurrence, the clinical and histopathological features of cutaneous lymphomas in Korea. METHODS: The Korean Dermatopathology Research Group conducted a review of nationwide collection of 80 cutaneous lymphomas, diagnosed at 23 institutes over recent 3-year period. Clinical records and pathology slides of the patients were reviewed retrospectively. RESULTS AND CONCLUSION: Korea has a higher rate of T-cell lymphoma and NK/T cell lymphoma and a much lower rate of cutaneous B cell lymphoma. The relative frequency of the major diagnostic group according to WHO classification was as follows: mycosis fungoides/Sezary syndrome, 42.5%; anaplastic large cell lymphoma, 19%; nasal and nasal type NK/T cell lymphoma, 15%; subcutaneous panniculitis-like T cell lymphoma, 11%; peripheral T cell lymphoma, unspecified, 7.5%; follicular lymphoma, 3%; marginal zone lymphoma, 1%; angioimmunoblastic lymphadenopathy, 1%. Compared with Western countries, the rate of nasal and nasal-type NK/T cell lymphoma and subcutaneous panniculitis-like T cell lymphoma were much higher. Therefore, The EORTC classification is not effective in dealing with Korean cases of cutaneous lymphoma. We consider the principles of the WHO classification are applicable to the Korean cases of cutaneous lymphoma.
Academies and Institutes ; Classification ; Continental Population Groups ; Geography ; Humans ; Immunoblastic Lymphadenopathy ; Korea* ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Follicular ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Pathology ; Retrospective Studies

BACKGROUND: Malignant melanoma in Korea has been increasing as in other countries, but there is no nationwide survey of malignant melanoma in Korea. OBJECTIVE: The aim of this study was to document the clinical and histopathological features of cutaneous melanoma in Korea. METHODS: The Dermatopathology Research Group conducted a review of nationwide collection of 109 primary cutaneous melanomas, diagnosed at 23 institutes over a recent 3-year period. Clinical records and pathology slides of the patients were reviewed retrospectively. RESULTS AND CONCLUSION: The peak age was the 7th decade with the mean age of 58.1 years. Korea has a higher rate of acral melanoma and much lower rate of lentigo maligna melanoma. .Major component tumor cell was spindle cell type. Clark level of tumor was III or more and Breslow depth was 2mm or more at the time of the first diagnosis in many cases (62%). Pre-existing melanocytic nevus was present in a few cases (3 cases). All these features suggest that the racial difference between the Korean and the Caucasian is evident. We also suggest that an early detection program is very important to cure this malignant tumor.
Academies and Institutes ; Diagnosis ; Humans ; Hutchinson's Melanotic Freckle ; Korea* ; Melanoma* ; Nevus, Pigmented ; Pathology ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Cardiac performance is dependent on both the preceding RR interval (RR-1) and the prepreceding RR interval (RR-2) in atrial fibrillation (AF). We reported a new method for improving the relation between the two RR intervals and cardiac performance in AF of various causes. The aim of this study was to re-evaluate the method and its relationship in AF without organic heart disease. SUBJECTS AND METHODS: The beat to beat variation in the left ventricular outflow peak ejection velocity (Vpe) was measured by pulsed Doppler ultrasound in 28 consecutive patients with lone AF. The relations between the RR-2 and the Vpe were obtained before and after the exclusion of coordinates with the RR-1<0.5 second. The association of the Vpe with the RR-1 was adjusted by the RR-2 using an equation obtained from the relation between the RR-2 and the Vpe. RESULTS: The RR-2 was found to have a weak, negative, association with the Vpe. The mean squared correlation coefficient (r2) between the RR-2 and the Vpe was 0.14+/-0.13, which was improved to 0.23+/-0.21 (p=0.007) following the exclusion of coordinates with a RR-1<0.5 second. The RR-1 was positively associated with the Vpe. The mean r2 between the RR-1 and the Vpe was 0.55+/-0.15, which became stronger, at 0.68+/-0.12 (p<0.001), following adjustment with the RR-2. A multiple stepwise regression analysis revealed that the mean and standard deviation of the RR interval, and the duration of AF were independently associated with the modified r2 between the RR-2 and the Vpe. CONCLUSION: Simple modification could improve the relationship of both the RR-1 and the RR-2 with the cardiac performance in AF without organic heart disease, as with AF of various causes.
Atrial Fibrillation* ; Echocardiography, Doppler, Pulsed ; Electrocardiography ; Heart Diseases* ; Heart* ; Humans ; Stroke Volume ; Ultrasonography

An aneurysm of the pulmonary artery is a rare entity, but has a potentially fatal prognosis. We report a case of a 28 year-old asymptomatic woman, with an idiopathic pulmonary artery aneurysm. She was admitted to our hospital because of an abnormal bulging contour of the left hilum on chest X-ray. A computed tomographic scan and pulmonary angiography showed dilatation of the main and proximal left pulmonary arteries. She has a stable, non-progressive condition without treatment during the 8 month follow-up period.
Adult ; Aneurysm* ; Angiography ; Dilatation ; Female ; Follow-Up Studies ; Humans ; Prognosis ; Pulmonary Artery* ; Thorax

Linear focal elastosis is characterized clinically by horizontal yellowish palpable striae on the lower back and histologically fragmentation or aggregation of elastic fibers. We herein report four cases of linear focal elastosis in male patients. They were 12 to 17 years old and the disease duration was 1 to 3 years. We suggest linear focal elastosis is a variant of striae distensae affecting elastic fibers.
Adolescent ; Elastic Tissue ; Humans ; Male ; Striae Distensae

BACKGROUND: The effect of 3-hydroxy 3-methyl glutaryl CoA reductase inhibitor (statin) on the concentration of lipoprotein (a) [Lp(a)] is controversial. Most studies evaluated the effect of statin administered for less than 2 years. We were to analyze the effect of long-term treatment of statin on the concentration of Lp(a) retrospectively. METHODS: A total 93 cases were enrolled and divided into two groups; statin group (20 mg of lovastatin, n=33) and control group (n=60). Lp(a) and lipid profiles were measured before and after the medication for at least 2 years. RESULTS: Between two groups, there were no differences in baseline clinical variables and in biochemical parameters except total cholesterol and low density lipoprotein-cholesterol (LDL-C) levels. Mean duration of follow-up was similar between control and statin groups (58.7+/-15.0 vs. 54.7+/-16.4 months, p=0.24). Lp(a) levels did not change in both statin group (30.1+/-29.6 mg/dL vs. 28.2+/-23.1 mg/dL, p=0.89) and control group (p=0.49). The change of Lp(a) was not different between two groups (p=0.43). Statin was also ineffective in cases with Lp(a) level over 10 mg/dL. Total cholesterol and LDL-C levels decreased in statin group by 26.4% (p=0.000) and 40.5% (p=0.000) respectively. The elevation of HDL-C was similar between two groups. CONCLUSION: Long-term treatment of lovastatin did not modify Lp(a) level in retrospective study. To clarify the effect of statin precisely, prospective study might be needed.
Cholesterol ; Follow-Up Studies ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Lipoprotein(a)* ; Lipoproteins* ; Lovastatin ; Oxidoreductases* ; Retrospective Studies

BACKGROUND: The effect of 3-hydroxy 3-methyl glutaryl CoA reductase inhibitor (statin) on the concentration of lipoprotein (a) [Lp(a)] is controversial. Most studies evaluated the effect of statin administered for less than 2 years. We were to analyze the effect of long-term treatment of statin on the concentration of Lp(a) retrospectively. METHODS: A total 93 cases were enrolled and divided into two groups; statin group (20 mg of lovastatin, n=33) and control group (n=60). Lp(a) and lipid profiles were measured before and after the medication for at least 2 years. RESULTS: Between two groups, there were no differences in baseline clinical variables and in biochemical parameters except total cholesterol and low density lipoprotein-cholesterol (LDL-C) levels. Mean duration of follow-up was similar between control and statin groups (58.7+/-15.0 vs. 54.7+/-16.4 months, p=0.24). Lp(a) levels did not change in both statin group (30.1+/-29.6 mg/dL vs. 28.2+/-23.1 mg/dL, p=0.89) and control group (p=0.49). The change of Lp(a) was not different between two groups (p=0.43). Statin was also ineffective in cases with Lp(a) level over 10 mg/dL. Total cholesterol and LDL-C levels decreased in statin group by 26.4% (p=0.000) and 40.5% (p=0.000) respectively. The elevation of HDL-C was similar between two groups. CONCLUSION: Long-term treatment of lovastatin did not modify Lp(a) level in retrospective study. To clarify the effect of statin precisely, prospective study might be needed.
Cholesterol ; Follow-Up Studies ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Lipoprotein(a)* ; Lipoproteins* ; Lovastatin ; Oxidoreductases* ; Retrospective Studies