The prevalence of metabolic syndrome and its association with alanine aminotransferase in clozapine-treated Korean patients with schizophrenia.

Widely ranging prevalence rates for metabolic syndrome (MetS) in patients taking clozapine have been reported on the basis of various criteria, and most studies have been carried out in non-Asian countries. Therefore, we examined the prevalence of MetS in Korean patients using three commonly applied criteria with two waist-circumference cutoff values. The indirectly standardized prevalence ratio (ISPR) was estimated using data from the Fourth Korean National Health and Nutrition Examination Survey (KNHNES, 2007) to compare the prevalence of MetS in patients with that in the general population. In addition, we also examined whether serum alanine aminotransferase (ALT) and aspartate aminotransferase levels serve as biochemical markers for the identification of MetS. We reviewed the electromedical records of patients with schizophrenia who had taken clozapine as the sole antipsychotic for 3 months or more. The prevalence of MetS ranged from 34.5 to 46.9%, and the ISPR ranged from 2.4 to 2.8, given the three definitions of MetS and the two waist-circumference cutoff points for women. The ISPR for MetS among those aged 18-30 years was the highest and decreased with age in both men and women. After adjusting for age, patients with normal serum ALT levels who were in the top third were significantly more likely to have MetS compared with those who were in the bottom third. Logistic regression analysis showed that serum ALT levels and use of antidepressants were significantly related to the presence of MetS. Korean patients with schizophrenia who were receiving clozapine as the sole antipsychotic showed a high prevalence of MetS. Although we found substantial differences in the prevalence according to criteria, the ISPR indicated significantly higher rates of MetS in this group than in the general population. In the general population, younger patients had a much higher risk for MetS than older patients. Elevated levels of serum ALT that were in the normal range were associated with the presence of MetS, which suggests the possibility of using serum ALT level as an early indicator for MetS in patients treated with clozapine.

Sodium nitroprusside selectively induces apoptotic cell death in the outer retina of the rat.

Sodium nitroprusside (SNP), an NO donor, was studied for its effects on apoptosis in rat retinal neurons. TUNEL-positive cells were observed in the outer nuclear layer (ONL), but not in the inner retina after SNP treatment. Inner retinal neurons died by necrosis. No photoreceptor cells were found in the ONL after seven days. Immunoblotting confirmed that neurnal NO synthase expression increased up to 5 days (approximately 170% of control levels), and then declined by 7 days, suggesting that NO induces apoptosis in the ONL, and that inner retinal neurons die by necrosis due to glutamate from damaged photoreceptors.

Pharmacologic profile of natural products used to treat psychotic illnesses.

Natural products have a long history of being the sources for therapeutic drugs in medicine. Investigations of natural products also have the potential for enhancing our understanding about the pathophysiology and treatment of various disorders. The screening assays described here were conducted on the phytochemical and pharmacological profiles of natural products used to treat psychotic illnesses in Korean traditional medicine, which are eligibly archived in Tongeuibogam, a traditional medicinal book in Korea. Two rounds of radioligand receptor binding assays on natural products demonstrated that many plants show potent selectivity to various receptors, especially monoamine receptors presumed to be involved in mental disorders. Further studies for the pharmacologic activity of active ingredients and in vivo behavioral profiles focusing on the central nervous system (CNS) effects are currently under way with these plant extracts. These investigations may lead to the development of new psychotropic drugs with no serious side effects, a major concern for modern psychopharmacology.

The role of transcutaneous electrical nerve stimulation in management of labour in obstetric patients.

The study evaluated the effect of transcutaneous electrical nerve stimulation (TENS) in the management of labour. It comprised of 125 subjects with 93 primiparae and 32 multiparae. They were divided into 3 groups. The first group received electrical stimulation from the TENS unit (TENS); the second group (placebo group) had the TENS machine connected but with no current from the TENS unit (TPL); whereas the third group had no machine application (control group). Analgesic requirements, pain assessment, labour duration, Obstetric outcome, and the comments from mother and midwife were analysed. No negative effects on the mothers and babies were reported. Neither was there any objective clinical significant differences demonstrated among the 3 groups.