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Only 1.1 per cent of the patients had PCNL. URS was used in 20.8 per cent of patients with ureteric calculi.

Open operations were required in 32.6 per cent and 53.6 per cent of patients with renal and ureteric calculi

respectively. Nephrectomy was required in 4.8 per cent16.0 per cent of patients with renal calculi.

Certain considerations have been put forward to appraise the situation concerning urinary stone therapy

in Thailand.

No. 59

Authors :

Chanpattana W, Chakrabhand MLS, Kongsakon R, Techakasem P, Buppanharun W.

Title :

Short-term effect of combined ECT and neuroleptic therapy in treatment-resistant schizophrenia.

Source :

Journal of Ect. 15(2):129-39, 1999(Jun).

Keywords :

Electroconvulsive therapy, Neuroleptics, Stabilization period, Efficacy, Short-term effect,

Continuation treatment study, Schizophrenia, Treatment-resistant, Symptoms, Positive,

Negative, Electroconvulsive-therapy, Haloperidol, Clozapine, Chlorpromazine

Abstract :

Treatment-resistant schizophrenia (TRS) is a critical public health concern. Short-term treatment with

electroconvulsive therapy (ECT), combined with neuroleptics, may increase the response rate in patients

with TRS, when compared with either treatment alone. We conducted an opentrial study in 59 patients with

TRS with acute exacerbations, by using bilateral ECT combined with flupenthixol (dose range, 12-24 mg/

day). After the first sign of clinical improvement, all patients had to pass a 3-week stabilization period during

which their clinical improvement had to be sustained. The patients had to receive at least 20 ECT treatments

before being considered unresponsive to ECT. Thirty-one patients were ECT responders by our criteria, 19

were non-responders, and nine were dropouts. The responder group had more male patients, paranoid type,

of younger age, shorter duration of illness and duration of the current episode, less family history of

schizophrenia, and higher pretreatment GAF scores. They receive d a lesser number of ECT treatments,

a less electrical charge used, and lower doses of flupenthixol (p < 0.05). Both positive and negative

symptoms improved (p < 0.05), but positive symptoms responded to a greater extent. This study supports

the therapeutic efficacy of combined treatment with ECT and neuroleptic drugs. A consensus in the

definition of TRS is urgently required.

No. 60

Authors :

Chanpattana W, Chakrabhand S, Sackeim HA, Kitaroonchai W, Kongsakon R, Techakasem P,

Buppanharun W, Tuntirungsee Y, Kirdcharoen N.

Title :

Continuation ECT in treatment-resistant schizophrenia: A controlled study.

Source :

Journal of Ect. 15(3):178-92, 1999(Sep).

Keywords :

Treatment-resistant schizophrenia electroconvulsive therapy, Stabilization period, Controlled study,

Prospective study, Combined ECT and neuroleptic treatment continuation ECT, Maintenance ECT,

Positive and negative symptoms, Predictive factors for ECT response, Maintenance

electroconvulsive-therapy, Schizoaffective disorder, Symptoms, Neuroleptics, Haloperidol,

Threshold, Clozapine

Abstract :

In patients with treatment-resistant schizo phrenia (TRS), this study compared the efficacy of continua-

tion treatment with flupenthixol alone, continuation electroconvulsive therapy (ECT) alone, and com-

bined continuation ECT and flupenthixol. One hundred fourteen TRS patients received acute treatment

(Phase I) with bilateral ECT and flupenthixol (12-24 mg/day). Fifty-eight-patients met remitter criteria,

including clinical stability during a 3-week stabilization period, and were eligible for the continuation

treatment study (Phase II). Fifty-one patients enrolled in the single-blind Phase II continuation trial, and

were randomized to the three treatment groups. The duration of the Phase II study was 6 months. Assess-

ments of outcome included the Brief Psychiatric Rating Scale, Global Assessment of Functioning, and the

Mini-Mental State Examination. Forty-five patients either relapsed or completed the Phase II study, and six

patients dropped out. Among completers, 6 of 15 (40%) patients relapsed in the combined continuation

ECT and flupenthixol group. In both the group treated with continuation ECT alone and that with

flupenthixol alone, 14 of 15 (93%) patients relapsed. Analyses of intent-to-treat and completer samples

demonstrated a marked advantage for the combination treatment condition in relapse prevention.

Furthermore, all eight patients who received maintenance ECT combined with neuroleptic medication

(Phase III study) maintained the rapeutic benefits during the follow-up period of 3-17 months after the

continuation treatment study. Among TRS patients who respond to acute combination treatment with ECT

and neuroleptic therapy, continuation of this combination treatment is more effective in relapse prevention

than use of ECT or neuroleptic therapy alone.

No. 61

Authors :

Chanprasertyothin S, Ongphiphadhanakul B, Rajatanavin R, Piaseu N, Chailurkit LO, Puavilai G.

Title :

Correlation of apolipoprotein E gene polymorphism to serum lipid concentrations in healthy Thais.

Source :

Journal of the Medical Association of Thailand. 83(10):1233-9, 2000(Oct).

Keywords :

Apolipoprotein E, Genetic polymorphism, Serum lipids, Atherosclerosis

Abstract :

This study determined the genotype distribution of apolipoprotein E (apo E) gene and its relation

to serum lipids in 217 healthy Thais consisting of 79 males and 138 females. Serum total cholesterol (TC),