The pharmacotherapy of schizophrenia exhibit wide inter-individual variabilities in clinical efficacy and adverse effects. Recently. human genetic diversity has been known as one of the essential factors to the variation in human drug response. This suggests that drug therapy should be tailored to the genetic characteristics of the individual. Pharmacogenetics is the field of investigation that attempts to elucidate genetic basis of an individual's responses to pharmacotherapy, considering drug effects divided into two categories as pharmacokinetics and pharmacodynamics. The emerging field of pharmacogenomics. which focuses on genetic determinants of drug response at the level of the entire human genome, is important for development and prescription of safer and more effective individually tailored drugs and will aid in understanding how genetics influence drug response. In schizophrenia, pharmacogenetic studies have shown the role of genetic variants of the cytochrome P450 enzymes such as CYP2D6, CYP2C19, and CYP2A1 in the metabolism of antipsychotic drugs. At the level of drug targets, variants of the dopamine D_(2), D_(3) and D_(4), and 5-HT_(2A) and 5-HT(2C) receptors have been examined. The pharmacogenetic studies in schizophrenia presently shows controversial findings which may be related to the multiple involvement of genes with relatively small effects and to the lack of standardized phenotypes. For further development in the pharmacogenomics of schizophrenia, there would be required the extensive outcome measures and definitious, and the powerful new tools of genomics, proteomics and so on.
Antipsychotic Agents ; Cytochrome P-450 CYP2D6 ; Cytochrome P-450 Enzyme System ; Dopamine ; Drug Therapy ; Genetic Variation ; Genetics ; Genome, Human ; Genomics ; Humans ; Metabolism ; Outcome Assessment (Health Care) ; Pharmacogenetics* ; Pharmacokinetics ; Phenotype ; Prescriptions ; Proteomics ; Receptor, Serotonin, 5-HT2C ; Receptors, Dopamine ; Schizophrenia*

Topical fluorouracil therapy is an advanced treatment for actinic keratoses, Bowen's disease, multiple basal cell epithelioma and other precancerous skin lesions. Because of extensive and frequent use of 5-fluorouracil(5 F-U) cream, some untoward effects, mostly allergic contact dermatitis and irritation dermatitis, can be anticipated. We have experienced a case of crural ulcer after accidental application of 5 F-U cream for treating the tinea cruris at drug store. The patient was 21 year oid man who had suffered from erythema, erosion and shallow ulceration with oozing, serosanguinous discharge, buming and stinging sensation on the both groins and its adjacent area of the scrotum. The skin lesion was not well responded to topical corticosteroid but controlled by wet dressing and zinc oxide lotion within 10 days of hospitalization. At the 20th hospital day, the skin was healed with remained follicular hyperpigmentation. A few days later, the tinea cruris was confirmed by direct microsopic examination and culture. Generally, topical 5 F-U spares normal cell, while selectively destroying the more rapidly proliferating celI, but there are some possible factors to induce destruction of non-proliferating cell in the highly penetrating area The skin penetration can be different depending upon the anatomical location.
Bandages ; Bites and Stings ; Bowen's Disease ; Carcinoma, Basal Cell ; Dermatitis ; Dermatitis, Allergic Contact ; Erythema ; Fluorouracil ; Groin ; Hospitalization ; Humans ; Hyperpigmentation ; Keratosis, Actinic ; Scrotum ; Sensation ; Skin ; Tinea ; Ulcer* ; Zinc Oxide

In spite of the progress in techniques and materials of the prosthodontic rehabilitation of patients with complete edentulous arches, prosthodontists still face patients' complaints about dissatisfaction and discomfort from their dentures. In the past several decades, prosthodontists tried to find the factors that influence the patient's satisfaction with dentures. However the results are contraversial especially with the psychological factor. In this study using patient denture satisfaction questionnaire' and Hopkins Symptom Checklist, we tried to find the correlation between the patient's denture satisfaction and the patient's psychological aspects. 23 complete edentulous patients who have visited the Department of Prosthodontics, Yonsei University Dental Hospital from September 1998 to June 1999 for complete denture treatment were asked to complete the questionnaires 4 to 6 weeks after the upper and lower complete delivery. After the measurement of validity of the questionnaires, correlations between the patient's general satisfaction with their new upper and lower complete dentures and the other satisfaction questions including the satisfactions with esthetics, retention, mastication, speech, comfort and other peoples's opinion and between the patient's general satisfaction with their new upper and lower complete dentures and the 5 symptoms of Hopkins Symptoms Checklist including somatic, obsessivecompulsive, interpersonal sensitivity, depression and anxiety were analyzed. Among the several satisfaction questionnaire items, comfort with the lower denture showed highest relation to the patient's general satisfaction with dentures. However, only the anxiety scale of Hopkins Symptom Checklist among the other symptom scales was related to the patient's general satisfaction with dentures. The two questionaires used in this study turned out to be valid means of analyzing patient's denture satisfaction and psychological status before and after the complete denture treatment.
Anxiety ; Checklist ; Denture, Complete* ; Dentures ; Depression ; Esthetics ; Humans ; Mastication ; Patient Satisfaction* ; Prosthodontics ; Psychology ; Surveys and Questionnaires ; Rehabilitation ; Weights and Measures

No abstract available.

Malignant melanoma is rare in Asian and one of the poorer prognostic disease. Approximately 25% of all patients with malignant melanoma has been occured at the site of pigmented leasion. Primary location of melanome on palm is known to be 1.3% which is rarer than that of the other site. This report is a case of 65 year old man who has a walnut sized bluish-black tumor(4*5*3cm) on left palm which developed from the brownish black spot. According to the patients statement the spot was started since childhood and gradually increase in size since last 5 years. The mass, however, was rapidly growing with superficial ulceration since 3 months previously. No metastatic skin leasion was found around the tumor mass and left upper extremity. There were no palpable tymphnodes in the left axillary and epitrochlear area. Skin biopsy specimen showed findings consistent with malignant melanoma and cell composition was predominant in the fusiform cell than the cuboidal cell, and exillary lymphnode showed only dermatopathic changes. Bone X-ray of left hand and chest X-ray showed no abnormal findings and metastatic sign. B-E(bellow elbow) smputations on left foream was performed. During postoperativ he has had general and no metastatic signs.
Aged ; Asian Continental Ancestry Group ; Biopsy ; Hand ; Humans ; Juglans ; Melanoma* ; Skin ; Thorax ; Ulcer ; Upper Extremity

Frason' a new topical steroid ointment containing 0.05% 17-desoxymethason and 0.5 % framycetin, was in trial for several kinds of dermatoses. Total 40 patients including 8 cases of contact dermatitis, 6 seborrheic dermatitis, 4 atopic dermatitis, 4 pityriasis rosea, 4 acne vulgaris, 3 nummular eczema, 3 psoriasis vulgaris, 3 pustulosis palmaris et plantaris and 1 folliculitis were treated with Frason', and the results were as follows. 1) 29 patients revealed excellent or good therapeutic effects (72.5%) with unoccluded application of Frason ointment, 2 or 3 times daily, among the 40 patients. 2) In comparison with the 0.05% Frason' ointment and the 0.05% betamethasone- gentamycin cream, the 0.05% Frason' ointment was found to be slightly more effeetive in the aspect of anti-inflammatory and anti-bacterial action. 3) W/0 base of Frason' ointment had slightly irritating reaction compare to O/W base of betamethasone cream, There was no side effect except 1 patient who complained of buming sensation after initial application of Frason ointment.
Acne Vulgaris ; Betamethasone ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Eczema ; Folliculitis ; Framycetin ; Gentamicins ; Humans ; Pityriasis Rosea ; Psoriasis ; Sensation ; Skin Diseases

Epidermal nevus syndrome, which used to combine congenital abnormalities of the central nervous and skeletal system and others, are not ingrequently encountered. Until now fer cases of epidermal nevus with intemal malignancy were reported in the literatures, Since the report on this epidermal nevus associated with intemal malignancy, the newer finding was interested by dermatologist. A case of 3 and half months old boy who had nevus unius lateris and retroperitoneal leiomyosarcoma since at birth was seen at St. Mart's Hospital. He did not mongolian and cafe au lait spots on the vack which seemed to be a characteristicaign of epidermal nevus syndrome, His developmenta percmtile was 25 of his matched age group. He was bome with spontaneous normal delibery in the hospital. His parents were relatively healthy and his morher had no history of any kind of medicine taken during the pregnancy. There were no family history of epidermal nevuys like skin lesions and hereditary disorders.
Cafe-au-Lait Spots ; Congenital Abnormalities ; Humans ; Leiomyosarcoma ; Male ; Nevus* ; Parents ; Parturition ; Pregnancy ; Skin

No abstract available.
Surveys and Questionnaires*

PURPOSE: To evaluate the clinical characteristics, treatments and outcome of patients with hemorrhagic shock and encephalopathy(HSE) syndrome. METHODS: We performed a clinical study on 14 patients who were diagnosed as hemorrhagic shock and having encephalopathy syndrome in the Department of Pediatrics, from 1984 to 1998. Age, sex, clinical symptoms and physical findings at admission, the most deranged laboratory findings, radiologic findings, treatments and outcome were analyzed. RESULTS: The age of onset was 1.0+/-0.9 years and the male to female ratio was 1: 1.8. At admission, clinical findings included dehydration in 85.7%, shock in 85.7%, fever in 71.4%, vomiting in 71.4%, diarrhea in 64.3%, GI bleeding in 50%, convulsion in 42.9%, and edema in 35.7%. Altered mental state was found in 100%, hepatomegaly in 64.3%, and splenomegaly in 21.4%. Laboratory findings revealed D-dimer positive in 92.9%, the mean hemoglobin level 8.2+/-2.1g/dL, BUN 35.7+/-24.0mg/dL, creatinine 1.9+/-1.5mg/dL, AST 561.0+/-1,412.1IU/L, ALT 858.9+/-1,649.8IU/L, blood glucose 229.5+/-197.4mg/dL, ammonia 195.4+/-129.7pg/dL, and total bilirubin 4.9+/-8.2mg/dL. On serologic tests, rotavirus and Epstein-Barr virus was found in 1 patient(7.1%), respectively. The mortality rate was 78.6%. CONCLUSION: We found that shock and disseminated intravascular coagulation(DIC) played important roles in the pathogensis of HSE syndrome, and encephalopathy, hepatic and renal insufficiency, and respiratory failure were secondary complications resulting from shock and DIC. Despite vigorous treatment, the prognosis was very poor. We feel more efforts should be focused on investigating the etiology and pathophysiology of HSE to prevent as well as develop a specific therapy. (J Korean Pediatr Soc 2000;43:814-819)
Age of Onset ; Ammonia ; Bilirubin ; Blood Glucose ; Creatinine ; Dacarbazine ; Death, Sudden* ; Dehydration ; Diarrhea ; Edema ; Female ; Fever ; Hemorrhage ; Hepatic Encephalopathy ; Hepatomegaly ; Herpesvirus 4, Human ; Humans ; Infant* ; Male ; Mortality ; Pediatrics ; Prognosis ; Renal Insufficiency ; Respiratory Insufficiency ; Rotavirus ; Seizures ; Serologic Tests ; Shock ; Shock, Hemorrhagic* ; Splenomegaly ; Vomiting

No abstract available.
Humans ; Interferon-alpha* ; Interferons* ; Melanoma* ; Ulcer*