The 5-HT2A receptor is of great interest for research into schizophrenia and psychopharmacology in light of the observation that schizophrenic patients has 5-HT cortical-subcortical imbalance and atypical antipsychotic clozpine has 5-HT2A antagonists properties. An significant association between schizophrenia and the T102C polymorphism of the gene for 5-HT2A receptor has been reported. In this study, we investigated an association between schizophrenia and the T102C polymorphism of the gene for 5-HT2A receptor in Korean schizophrenic patients. The subjects consisted of 139 schizophrenic patients and 88 normal controls. Genomic DNA was amplified by PCR and digested with MsPI. The uncutt product identified allele 1(nucleotide sequence TCT) ; digested products of 216bp and 156bp identified allele 2(nucleotide sequence TCC). The allele frequencies and the genotypic distribution of 5-HT2A receptor gene were not significantly different between schizophrenic patients and normal controls. Since allele frequencies of the T102C polymorphism may differ between individuals of different ethnic backgrounds, it needs to be conducted in an advanced research.
Alleles ; DNA ; Gene Frequency ; Humans ; Polymerase Chain Reaction ; Psychopharmacology ; Receptor, Serotonin, 5-HT2A ; Schizophrenia* ; Serotonin ; Serotonin 5-HT2 Receptor Antagonists

OBJECTIVES: The authors have intended to know the drug interaction of fluoxetine and haloperidol when coadministering two drugs to the chronic schizophrenics by assessing the changes of positive, negative symptoms and extrapyramidal symptoms. METHOD: We selected 38 patients, the chronic schizophrenics with no physical problems. they are randomly assigned to placebo group and drug group. And then, placebo or fluoxetine 20mg were administered to the subjects of each group during 8 week period. We have assessed their psychopathology and extrapyramidal symptoms using positive and Negative Syndrome Scale(PANSS), Clinical Global Impression(CGI), Simpson-Angus Scale at o, 2, 4, 6, 8 week during the period. RESULTS: 38 patients have completed the study during 8 week. 1) PANSS, CGI : no significant difference between groups and no significant change according to the times. 2) Simpson-Angus Scale : no significant changes. CONCLUSION: When co-administering fluoxetine and haloperidol, there were no significant changes of psychopathology and extrapyramidal symptoms. There results suggest that it is safe to coadminister fluoxetine to schizophrenic with haloperidol treatment.
Drug Interactions ; Fluoxetine* ; Haloperidol* ; Humans ; Psychopathology*

Pneumocystis carinii is the most common cause of diffuse pulmonary infiltrates in the immunocompromised patients. Microscopically, Pneumocystis carinii pneumonia(PCP) shows characteristic frothy intraalveolar exudate and interstitial lymphocytic and plasma cell infiltrate. However, sometimes the only histologic finding of PCP on routine hematoxylin-eosin stain is that of diffuse alveolar damage(DAD), when we can miss the diagnosis without aid of special stains. We report a case of Pneumocystis carinii pneumonia presenting as DAD in a 50-year old man after chemotherapy due to malignant lymphoma. Open lung biopsy specimen reveals the early stage of DAD without any characteristic findings, such as foamy exudate. However many cysts of Pneumocystis carinii were found on Gomori's methenamine silver(GMS) stain. Therefore, GMS stain should be routinely performed on all biopsy specimens obtained from immunocompromised patients.
Male ; Humans ; Cysts ; Biopsy

OBJECTIVES: Risperidone and clozapine beling to a new generation of antipsychotics that are reportedly more effective and better tolerated than conventional neuroleptics. However, each of these agents costs far more per unit than conventional neuroletics. The purpose of our retrospective study was to ascertain the total cost and effectiveness of treatment before and after administration of risperidone and clozapine in 'revolving door' schizophrenia patients. METHOD: Data collected on revolving door schizophrenics for 2 years before clozapine and risperidone treatment and for at least 2 years after clozapine and risperidone treatment. Direct cost of inpatient and outpatient treatment was measured. Effectiveness was scaled as 'years of mild disability gained'. RESULT: Both risperidone and cloazpine result in higher costs and additional benefits to patients, for example, increased mild disability, reduced number of relapse, and reduced hospital length-of-stay. An ICER of risperidone was less than Rc and ICER of clozapine was greater than Rc. According to decision-analytic this model, risperidone had favorable cost-effectivenss ratios relative to clozapine. CONCLUSION: We have assumed that risperidone is more cost-effective than clozapine.
Antipsychotic Agents ; Clozapine* ; Cost-Benefit Analysis* ; Humans ; Inpatients ; Outpatients ; Recurrence ; Retrospective Studies ; Risperidone* ; Schizophrenia

OBJECTIVES: This study was performed to investigate the incidence and the clinical significance of inlet patch of heterotopic gastric mucosa in Koreans. This lesion can be found by close observation around the upper esophageal sphincter during upper gastrointestinal endoscopy. METHODS: From March 1, 1996 to July 8, 1996, at Kwak's hospital, randomly selected 271 patients undergoing routine diagnostic upper gastrointestinal endoscopy were included in this study. Patients with the inlet patch were confirmed by histology. Clinical symptoms observed through medical history were recorded. RESULTS: Twenty-six cases(9.6%) of the 271 patients studied had heterotopic gastric mucosa which was found at or just below the upper esophageal sphincter, varing from 3 to 30mm in diameter. It was velvety red in color and distinct from the surrounding normal squamous esophageal mucosa, resembling the Z-line at the esophagogastric junction. Parietal cells were identified in all 18 cases in which biopsy specimen contained deep glands, and chief cells were found in 14 cases. Histologically, fundic gland type was most frequent. The symptoms were relatively mild, 5 out of 6 patients who complained of throat discomfort were relieved by H2 antagonists. CONCLUSION: In Koreans the incidence of heterotopic gastric mucosa in the upper esophagus was similar to the reports from western countries unlike Barrett's esophagus. The etiology of these patches appeared to be congenital rather than acquired from reflux of gastric acid. This was supported by its location in the proximal esophagus and lack of correlation with reflux esophagitis. It must be considered as one of the differential diagnosis of a patient who complains of throat discomfort during diagnostic upper gastrointestinal endoscopy. Attention needs to be paid to find possible development of complications such as stricture and adenocarcinoma in patients with the inlet patch of heterotopic gastric mucosa.
Adenocarcinoma ; Barrett Esophagus ; Bays* ; Biopsy ; Constriction, Pathologic ; Diagnosis, Differential ; Endoscopy, Gastrointestinal ; Esophageal Sphincter, Upper ; Esophagitis, Peptic ; Esophagogastric Junction ; Esophagus ; Gastric Acid ; Gastric Mucosa* ; Humans ; Incidence* ; Mucous Membrane ; Pharynx ; Rabeprazole

A choledochocele is an expanded sac of the duodenal side of the distal common bile duct (CBD), and is categorized as a type III choledochal cyst. Unlike other choledochal cysts, it can be easily overlooked because of its very low prevalence, non-specific clinical symptoms, and lack of distinctive radiological findings. However, a patient having a repeated pancreaticobiliary disorder with an unknown origin, frequent abdominal pain after cholecystectomy, or repeated non-specific gastrointestinal symptoms can be suspected as having a choledochocele, and a more accurate diagnosis can be achieved via endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound. Because it rarely becomes malignant, a choledochocele can be treated via endoscopic sphincterotomy (EST) and surgical treatment. The authors were able to diagnose choledochocele accompanied by a stone in a patient admitted to the authors' hospital due to cholangitis and pancreatitis. The patient's condition was suspected to have been caused by a distal CBD stone detected via multiple detector computed tomography and ERCP, and was successfully treated via EST.
Abdominal Pain ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystectomy ; Choledochal Cyst* ; Common Bile Duct* ; Diagnosis ; Gallstones ; Humans ; Pancreatitis ; Prevalence ; Sphincterotomy, Endoscopic ; Ultrasonography

No abstract available.
Lasers, Solid-State* ; Papilloma*

The depressive symptoms are frequent and important ones in the elderly population. We studied the various factors affecting the severity of depressive symptoms in the elderly population. The Korean elderly (more than 65 years old; n=490) in Seoul area (city) were studied on the identifying data and medical and psychiatric history, Mini-Mental State Examination (MMSE) Geriatric Depression Scale (GDS) Korean Depression Scale(KDS: under development)were also administered. In our study, the significant effect of sex, age, education, marital status, and the status of medical security on the severity of depressive symptoms were not found. Significantly higher GDS and KDS scores were found in the elderly who have more than one physical illness, subjective memory complaints, and seven life events. To examine the strength of association of these variables of depression, we conducted logistic regression. Depressive symptoms were associated with 1)the loss of spouse, 2)a current physical illness, and 3)low socioeconomic status. These results showed that depression in the elderly may be correlated with the loss of spouse, a current physical illness, and low socioeconomic status.
Aged* ; Depression* ; Education ; Humans ; Logistic Models ; Marital Status ; Memory ; Seoul ; Social Class ; Spouses

A case of iridoschisis was reported. The 67-year-old man showed a typical iridoschisis with angle closure glaucoma in his left eye. The intraocular pressure was 30mmHg and grade I narrow angle was noted. Intraocular pressure was lowered to 16mmHg by beta blocker instillation only.
Aged ; Glaucoma, Angle-Closure* ; Humans ; Intraocular Pressure

PURPOSE: Prolonged duration of cardiopulmonary bypass aggravates the degree of inflammation and coagulopathy. We investigated the influence of 6% hydroxyethyl starch (HES) 130/0.4 on coagulation and inflammation compared with albumin when used for both cardiopulmonary bypass priming and perioperative fluid therapy in patients undergoing complex valvular heart surgery. MATERIALS AND METHODS: Fifty four patients were randomly allocated into albumin-HES, albumin-nonHES, and HES-HES groups. The cardiopulmonary bypass circuit was primed with 5% albumin in the albumin-HES and albumin-nonHES group, and with HES in the HES-HES group. As perioperative fluid, only plasmalyte was used in the albumin-nonHES group whereas HES was used up to 20 mL/kg in the albumin-HES and albumin-HES group. Serial assessments of coagulation profiles using the rotational thromboelastometry and inflammatory markers (tissue necrosis factor-alpha, interleukin-6, and interleukin-8) were performed. RESULTS: Patients' characteristics and the duration of cardiopulmonary bypass (albumin-HES; 137+/-34 min, HES-HES; 136+/-47 min, albumin-nonHES; 132+/-39 min) were all similar among the groups. Postoperative coagulation profiles demonstrated sporadic increases in clot formation time and coagulation time, without any differences in the actual amount of perioperative bleeding and transfusion requirements among the groups. Also, inflammatory markers showed significant activation after cardiopulmonary bypass without any differences among the groups. CONCLUSION: Even in the presence of prolonged duration of cardiopulmonary bypass, HES seemed to yield similar influence on the ensuing coagulopathy and inflammatory response when used for priming and perioperative fluid therapy following complex valvular heart surgery compared with conventional fluid regimen including albumin and plasmalyte.
Aged ; Blood Coagulation/drug effects ; Cardiac Surgical Procedures/*methods ; Cardiopulmonary Bypass/methods ; Female ; Humans ; Hydroxyethyl Starch Derivatives/*therapeutic use ; Male ; Middle Aged