• Title/Summary/Keyword: impression evaluation

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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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Statistical Analysis of Patients Referred to Pediatric Cardiology Clinic for Diagnosis of Heart Disease (심장질환의 진단을 위해 의뢰된 환아들에 대한 자료 분석)

  • Choi, Kwang-Hae;Lee, Young-Hwan
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.49-54
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    • 2000
  • Background: Echocardiography is rapidly establishing itself as the primary diagnostic technique for investigation of children with heart diseases, and referrals are increasing to the pediatric cardiology clinic for investigation. However, because there is a lack of analyzed data on the patients referred to the pediatric cardiology clinics, we have proceeded to compare and analyze their characteristics to provide basic data base. Methods: From Oct. 1, 1998 to Jul. 10, 1999, total 443 cases referred to the pediatric cardiology clinic of Yeungnam University Hospital were studied retrospectively by medical records, chest X-ray, EKG and echocardiography, etc. Results: The results were as follows. 1. The proportion of male was 61.0%(261 cases) and that of female was 39.0%(67 cases). The ratio of male to female was 1.6:1. The proportion infants less than 1 year-old was 62.6% (26R cases) of all patients. 2. Cardiac murmur was present in 248 cases(57.9%), which was the most common case of referral ed to the pediatric cardiology clinic. The impression at referral was more congenital heart disease(70.6%) than acquired heart disease(17.8%) and arrhythmia01.6%). 3. The final diagnosis was as follows : congenital heart disease was present in 212 cases(49.5%), acquired heart disease, 59 cases(13.9%); arrhythmia. 13 cases(3.0%); normal heart. 144 cases(33.6%). Conclusion: Among the patients referred to pediatric cardiology clinic, 33.6%(144 cases) had normal hearts and why these patients were referred may be possibly due to more dependence on echocardiography than on auscultation instruction. Therefore, clinical and auscultatory skill should be emphasized to minimize dependence on expensive echocardiography for evaluation of pediatric heart disease.

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Chronic Hereditary Tyrosinemia Type I with Novel Mutation in FAH Gene (FAH gene novel mutation을 가진 만성형 Hereditary tyrosinemia 1형)

  • Yang, Sungmin;Choi, Hyo Won;Kang, Yun Koo;Lee, Jin-Sung;Namgoong, Mee Kyung
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.20 no.2
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    • pp.55-62
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    • 2020
  • A 22-month-old girl who had taken iron supplements due to iron deficiency anemia, presented bloody mucoid stool for one month. She had a bruise at the right periorbital area due to minor trauma and hepatosplenomegaly. Laboratory studies showed anemia, thrombocytopenia, elevated alkaline phosphatase (ALP), hypophosphatemia, decreased haptoglobin, hypocomplementemia, negative direct/indirect Coomb's test, normal vitamin D3 level and high PTHi. Wrist x-ray showed no signs of rickets. The abdominal ultrasound showed only accessory spleen. Tandem mass spectrometry was normal. During follow up, bloody stool regressed after seven days of withdrawal of iron supplement and cow milk, and the total CO2 level had been within 15-20 mEq/L with normal anion gap. NGS (next generation sequencing) panel test for evaluation of renal tubular acidosis showed negative results. After low dose steroid and vitamin D supplements under the impression of hypocomplementemic vasculitis, thrombocytopenia, C3/C4, decreased haptoglobin, and elevated ALP level became normal. At 57 months of age, laboratory findings showed elevated liver enzyme, ALP and gamma-glutamyl transferase again. And liver cirrhosis with splenomegaly and diffuse renal disease were reported with abdomen CT scan. Liver biopsy reported macro- and micronodular cirrhosis. Urine organic acid profile showed elevated succinylacetone level. Whole exome sequencing revealed novel compound heterozygous mutations (NM_00137.2:c.107T>C, NM_00137, 2:c.614T>C) in FAH gene and confirmed by Sanger sequencing. Consequently, the patient was diagnosed as chronic hereditary tyrosinemia type I. She started low phenylalanine/tyrosine diet and nitisinone treatment. Our case had presented symptoms very slowly, which is the first case of chronic tyrosinemia type I in South Korea.

Comparison of marginal and internal fit of 3-unit monolithic zirconia fixed partial dentures fabricated from solid working casts and working casts from a removable die system (가철성 다이 시스템으로 제작된 작업 모형과 솔리드 작업 모형 상에서 제작된 지르코니아 3본 고정성 치과 보철물의 변연 및 내면 적합도 비교)

  • Wan-Sun Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.40 no.2
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    • pp.72-81
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    • 2024
  • Purpose: This study aimed to assess the marginal and internal fit of 3-unit monolithic zirconia fixed partial dentures (FPDs) fabricated via computer-aided design and computer-aided manufacturing (CAD/CAM) from solid working casts and removable die system. Materials and Methods: The tooth preparation protocol for a zirconia crown was executed on the mandibular right first premolar and mandibular right first molar, with the creation of a reference cast featuring an absent mandibular right second premolar. The reference cast was duplicated using polyvinyl siloxane impression, from which 20 working casts were fabricated following typical dental laboratory procedures. For comparative analysis, 10 FPDs were produced from a removable die system (RD group) and the remaining 10 FPDs from the solid working casts (S group). The casts were digitized using a dental desktop scanner to establish virtual casts and design the FPDs using CAD. The definitive 3-unit monolithic zirconia FPDs were fabricated via a CAM milling process. The seated FPDs on the reference cast underwent digital evaluation for marginal and internal fit. The Mann-Whitney U test was applied for statistical comparison between the two groups (α = 0.05). Results: The RD group showed significantly higher discrepancies in fit for both premolars and molars compared to the S group (P < 0.05), particularly in terms of marginal and occlusal gaps. Color mapping also highlighted more significant deviations in the RD group, especially in the marginal and occlusal regions. Conclusion: The study found that the discrepancies in marginal and occlusal fits of 3-unit monolithic zirconia FPDs were primarily associated with those fabricated using the removable die system. This indicates the significant impact of the fabrication method on the accuracy of FPDs.