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Antidepressant-Induced Adverse Effects and Management Strategy - Focused on Sexual Dysfunction - (항우울제의 부작용과 대처 방안(1) - 성기능 장애를 중심으로 -)

  • Kim, Jeong-Gee;Lee, Soo Jin
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.252-259
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    • 2006
  • Sexual dysfunction is a relatively common adverse effect in the use of antidepressants. The sexual side effects may result in a lack of compliance with the prescribed antidepressants. The author reviewed the prevalence and updated treatment for the antidepressant-induced adverse effects focusing on sexual dysfunction. The incidence of sexual dysfunction is reported to exceed more than 50% especially with SSRIs. In order to obtain a quantified baseline and as an ongoing evaluation tool, clinicians may use some of the established questionnaires and validated instruments such as the Arizona Sexual Experience scale and Changes in Sexual Functioning Questionnaire. Clinicians should be aware that delayed ejaculation and orgasm, symptoms most frequently associated with antidepressants, are not usually associated with depression itself. Although many antidotes have been proposed, few have been subjected to double-blind trials. Some evidences have suggested that bupropion and buspiron may be the effective antidotes for SSRI induced sexual dysfunction. Additional trials will be requied to define what role, if any, bupropion and buspiron might have in the treatment of SSRI-induced sexual side effects. The available evidence is rather limited, with only small number of trials assessing each strategy. While further randomized data is awaited, for men with antidepressant induced erectile dysfunction, the addition of sidenafil or tadalafil may appear to be an effective strategy.

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Congenital Esophageal Atresia with Tracheoesophageal Fistula -A Case Report- (선천성 식도폐쇄 및 기관식도루 -1례 보고-)

  • Lee, Mun-Geum;Jang, Un-Ha
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.489-493
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    • 1994
  • Our patient was a 2.3 kg, male of 33 weeks gestation and spontaneous vaginal delivery. Copious salivary secretion, mild aspiration pneumonia episode due to tracheoesophageal fistula and intermittent cyanotic appearance due to hypoxia were noted shortly after birth. Head up position, frequent upper pouch suction, and adequate fluid and antibiotic therapy were done in incubator. Combined Chest and abdominal film was revealed gas in the stomach and an haziness in right chest with mediastinal shift to the right side. Esophagogram revealed markedly dilated proximal esophagus as blind pouch, and Two dimensional echocardiography showed the Ventricular Septal Defect. The conclusion was congenital esophageal atresia with tracheoesophageal fistula, Vogt-Gross type C, Waterston Risk Category B. Surgical correction with Beardmore anastomosis was performed extrapleurally through 3rd rib bed after the cannulation of umbilical vein and preliminary gastrostomy. The fistula was closed by triple ligation and the upper pouch was then brought down to the presenting surface of the lower esophageal segment that incised, and end to side anastomosis was underwent using interrupt suture placed through the full thickness of both upper pouch and lower esophageal segment. The postoperative patient was well tolerated and recovered uneventfully, permitted feeding on 7th postoperative day after esophagogram.

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Optical Vehicle to Vehicle Communications for Autonomous Mirrorless Cars

  • Jin, Sung Yooun;Choi, Dongnyeok;Kim, Byung Wook
    • Journal of Multimedia Information System
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    • v.5 no.2
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    • pp.105-110
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    • 2018
  • Autonomous cars require the integration of multiple communication systems for driving safety. Many carmakers unveil mirrorless concept cars aiming to replace rear and sideview mirrors in vehicles with camera monitoring systems, which eliminate blind spots and reduce risk. This paper presents optical vehicle-to-vehicle (V2V) communications for autonomous mirrorless cars. The flicker-free light emitting diode (LED) light sources, providing illumination and data transmission simultaneously, and a high speed camera are used as transmitters and a receiver in the OCC link, respectively. The rear side vehicle transmits both future action data and vehicle type data using a headlamp or daytime running light, and the front vehicle can receive OCC data from the camera that replaces side mirrors so as not to prevent accidents while driving. Experimental results showed that action and vehicle type information were sent by LED light sources successfully to the front vehicle's camera via the OCC link and proved that OCC-based V2V communications for mirrorless cars can be a viable solution to improve driving safety.

A Double-Blind Comparison of Paroxetine and Amitriptyline in the Treatment of Depression Accompanied by Alcoholism : Behavioral Side Effects during the First 2 Weeks of Treatment (주정중독에 동반된 우울증의 치료에서 Paroxetine과 Amitriptyline의 이중맹 비교 : 치료초기 2주 동안의 행동학적 부작용)

  • Yoon, Jin-Sang;Yoon, Bo-Hyun;Choi, Tae-Seok;Kim, Yong-Bum;Lee, Hyung-Yung
    • Korean Journal of Biological Psychiatry
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    • v.3 no.2
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    • pp.277-287
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    • 1996
  • Objective : It has been proposed that cognition and related aspects of mental functioning are decreased in depression as well as in alcoholism. The objective of the study was to compare behavioral side effects of paroxetine and amitriptyline in depressed patients accompanied by alcoholism. The focused comparisons were drug effects concerning psychomotor performance, cognitive function, sleep and daytime sleepiness during the first 2 weeks of treatment. Methods : After an alcohol detoxification period(3 weeks) and a washout period(1 week), a total of 20 male inpatients with alcohol use disorder (DSM-IV), who also had a major depressive episode(DSM-IV), were treated double-blind with paroxetine 20mg/day(n=10) or amitriptyline 25mg/day(n=10) for 2 weeks. All patients were required to have a scare of at least 18 respectively on bath the Hamilton Rating Scale far Depression(HAM-D) and Beck Depression Inventory(BDI) at pre-drug baseline. Patients randomized to paroxetine received active medication in the morning and placebo in the evening whereas those randomized to amitriptyline received active medication in the evening and placebo in the morning. All patients performed the various tasks in a test battery at baseline and at days 3, 7 and 14. The test battery included : critical flicker fusion threshold for sensory information processing capacity : choice reaction time for gross psychomotor performance : tracking accuracy and latency of response to peripheral stimulus as a measure of line sensorimotor co-ordination and divided attention : digit symbol substitution as a measure of sustained attention and concentration. To rate perceived sleep and daytime sleepiness, 10cm line Visual analogue scales were employed at baseline and at days 3, 7 and 14. The subjective rating scales were adapted far this study from Leeds sleep Evaluation Questionnaire and Epworth Sleepiness Scale. In addition a comprehensive side effect assessment, using the UKU side effect rating scale, was carried out at baseline and at days 7 and 14. The efficacy of treatment was evaluated using HAM-D, BDI and clinical global impression far severity and improvement at days 7 and 14. Results : The pattern of results indicated thai paroxetine improved performance an mast of the lest variables and also improved sleep with no effect on daytime sleepiness aver the study period. In contrast, amitriptyline produced disruption of performance on same tests and improved sleep with increased daytime sleepiness in particular at day 3. On the UKU side effect rating scale, mare side effects were registered an amitriptyline. The therapeutic efficacy was observed in favor of paroxetine early in day 7. Conclusion : These results demonstrated thai paroxetine in much better than amitriptyline for the treatment of depressed patients accompained by alcoholism at least in terms of behavioral safety and tolerability, furthermore the results may assist in explaining the therapeutic outcome of paroxetine. For example, and earlier onset of antidepressant action of paroxetine may be caused by early improved cognitive function or by contributing to good compliance with treatment.

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Complex Infinite Impulse Response Filter Equalization for Digital Vestigial Side Band Signals

  • Chung Won-Zoo
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.31 no.9C
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    • pp.876-881
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    • 2006
  • In this paper, we propose a complex-valued IIR filter for digital VSB signals based on CMA in order to efficiently mitigate multipath distortions, especially the leakage from the quadrature component. The proposed equalizer overcomes the drawback of the conventional real-valued IIR equalizers that it attempts to equalize Hilbert transform of quadrature component. We demonstrate via simulation that the proposed complex IIR filter successfully mitigates the leakages from the quadrature component, while the conventional real IIR filter requires a longer IIR filter to achieve the same performance. We present cost function analysis for a simple two-tap case showing that the proposed IIR equalizer with CMA for VSB signals has a global minimum at the desired location.

Overlap Tensile Strength testing of Waterproofing Sheet used in Concrete Bridges (콘크리트 교면에 적용되는 시트방수재의 접합 인장강도 확인)

  • An, Ki-Won;Kang, Hyo-Jin;Seon, Yun Suk;Kim, Chun-Hag;Oh, Sang-Keun
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2018.05a
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    • pp.335-336
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    • 2018
  • This study discusses the development of asphalt based waterproofing sheet applied on the blind side of the concrete substrate. The inorganic coating membrane is applied on top of the waterproofing sheet surface for protection, and adhesive bond to the concrete substrate surface is secured via hydration reaction the cement. The study reveals the experimental results of the overlap section tensile strength to observe the effects of the adhesion strength of this material.

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Comparison of Effects of Zolpidem, Triazolam, and Placebo on the Insomnia of Schizophrenic Inpatients. (Zolpidem, Triazolam 및 위약이 입원한 정신분열병 환자의 불면에 미치는 영향에 대한 비교연구)

  • Park, So-Young;Sohn, Jin-Wook
    • Sleep Medicine and Psychophysiology
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    • v.4 no.2
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    • pp.181-190
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    • 1997
  • Zolpidem is a relatively new, short-acting, rapid onset, and nonbenzodiazepine hypnotics. Zolpidem selectively binds to the central benzodiazepine 1 (BZI) receptor subtype. The present study was designed to compare the hypnotic effects of zolpidem (10 mg), triazolam (0.25 mg), and placebo in 22 schizophrenic inpatients. Zolpidem, triazolam, and placebo were administered orally in a randomized, double-blind design. Compared with placebo, zolpidem and triazolam significantly decreased sleep latency (p<0.05), increased total sleep time (p<0.05), and increased improvement of satisfaction of sleep (p<0.05). Zolpidem decreased the number of awakenings significantly in comparison with placebo (p<0.05), but triazolam did not. In addition, both drugs were well tolerated and did not produce severe side effects. These results suggest that zolpidem is effective for transient insomnia of schizophrenic inpatients and zolpidem is superior to triazolam in hypnotic effect.

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Influence of Ketamine on the Analgesic Effect of Epidural Bupivacaine and Fentanyl after a Transabdominal Hysterectomy (전자궁적출술 후 경막외 Bupivacaine과 Fentanyl에 첨가된 Ketamine이 술 후 통증에 미치는 영향)

  • Jung, Jai Yun;Bang, Kyung Ho;Kim, Sang Hyon;Kim, Yong Ik
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.138-141
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    • 2005
  • Background: There have been many attempts to alleviate pain after surgery, but there is no common approach to the control of postoperative pain. The use of epidural opioids, with local anesthetics, has been a widely employed formula to date. Ketamine, an N-methyl-d-aspartate receptor antagonist, has an excellent analgesic effect. Although there have been many reports on the dose and route of administrating analgesics, there have been few concerning the continuous epidural infusion of ketamine with fentanyl. We designed this study to find the effects of ketamine compared to those of epidurally injected bupivacaine and fentanyl, and used this trial to study any potential side effects. Methods: In a double blind trial, 55 patients received either fentanyl, $0.3{\mu}g/kg/h$ (Group F), or fentanyl, $0.3{\mu}g/kg/h$, and ketamine, 0.1 mg/kg/h (Group FK), added to 0.125% bupivacaine, at rates as high as 2 ml/h, for patient controlled epidural analgesia (PCEA) following a transabdominal hysterectomy. Ten minutes before the operation, patients received 10 ml of 0.125% bupivacaine, with either 0.5 mg/kg ketamine or the same amount of normal saline with $50{\mu}g$ fentanyl added. The pain scores and the side effects were recorded at 1, 3, 6 and 24 hour post operation. Results: There were no differences in the pain scores or side effects between the two groups. Conclusions: We failed to find any effect of the addition of epidural ketamine compared to the that of the bupivacaine and fentanyl formula. However, it is suggested that further investigations will be required on the dose and route of administration.

Anesthetic efficacy and safety of 2% lidocaine hydrochloride with 1:100,000 adrenaline and 4% articaine hydrochloride with 1:100,000 adrenaline as a single buccal injection in the extraction of maxillary premolars for orthodontic purposes

  • Deshpande, Nupoor;Jadhav, Anendd;Bhola, Nitin;Gupta, Manan
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.4
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    • pp.233-240
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    • 2020
  • Background: Palatal injection of local anesthetics is the most painful injection. To obviate the need for palatal injections, local anesthetic agents with diffusibility are being investigated. Hence the present study was designed to analyze the anesthetic efficacy of 2% lidocaine hydrochloride (HCl) with 1:100,000 adrenaline and 4% articaine hydrochloride (HCl) with 1:100,000 adrenaline using single buccal infiltration for the extraction of maxillary premolars. Methods: A prospective, double-blind, crossover, randomized clinical study was performed on 60 consecutive systemically healthy patients with an age range of 15-30 years, requiring extraction of asymptomatic bilateral maxillary premolars for orthodontic purposes. They received 1ml buccal infiltration of 4% articaine HCl with 1:100,000 adrenaline on one side and 2% lidocaine HCl with 1:100,000 adrenaline on the other side. The extraction procedure on either side was scheduled 14 days apart. Parameters assessed were the time of onset of anesthesia, intraoperative discomfort, hemodynamic parameters, and the duration of analgesia. Analysis of the data was done using the Mann-Whitney test, the Wilcoxon test, the Kruskal-Wallis ANOVA test, and the chi-square test. Statistical significance was established at P < 0.05. Results: Articaine showed a faster time of onset and longer duration of analgesia than lidocaine. However, the difference in the intraoperative discomfort and hemodynamic parameters was statistically insignificant. Conclusion: Within the limitations of the study, it can be concluded that the extraction of maxillary premolars can be performed with a single buccal infiltration of 2% lidocaine HCl with 1:100,000 adrenaline, which is one of the most commonly used local anesthetic agent.

A Study on Daylight Control Method for Securing Visual Comfort and Reducing Lighting Loads on Interior Lighting Environment (실내조명환경의 시각적 쾌적성 확보 및 조명부하 저감을 위한 채광제어방법에 관한 연구)

  • Han, Sang-Pil
    • Journal of the Korean Solar Energy Society
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    • v.32 no.6
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    • pp.100-105
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    • 2012
  • In previous study, to investigate the impression of the compound lighting based on the AC-Model at the full-size room, the impressions of various compound lighting were completed as compared with that of the uniform lightings through the comparison method (a paired comparison) by Semantic Differential scaling. Also, we examined the effect of the supplementary lighting type increasing the lights at the side of the window and the blind-control lighting type, and they were compared with the existing compound lighting type. In results, pared comparison of the compound lighting and the uniform lighting, indicates that the impression of the compound lighting is generally similar to that of the uniform lighting when there are same ratios of the light from the window. Based on these results, we suggest that the AC-Model might be applied to various conditions. And we also introduce the method for daylighting that it is possible to reduce discomfort glare and to improve visual impressions as the supplementary type and blind-control type on the compound lighting. And it was found that electric power consumption of the compound lighting room was lower than that of the uniform lighting room when as same lighting ratio of the compound lighting and the uniform lighting from the window was provided or there was the lighting distribution simulated to same light ratio from the window. Since the method of the ACModel was described in the experimental condition, additional studies should be performed to determine if this model could be applied to different window configurations, lighting layout and types of a room.