Antipsychotics are a pharmacologically heterogeneous group of compounds, but all act as D2 dopamine receptor antagonists, an action linked to their antipsychotic effect. Today, sixty years on since 1952, we have the FGAs and the SGAs. These medications continue to be useful, and continue to have some troubling adverse effects. As a class, the FGAs are more likely to be associated with EPS but this is primarily true of medications that bind tightly with D2 neuroreceptors, such as haloperidol, and less true of medications that bind weakly, such as chlorpromazine. Anticholinergic effects are especially prominent with weaker-binding FGAs, as well as with the SGA clozapine. As a class, the SGAs, especially clozapine and olanzapine generally tend to cause more problems relating to the metabolic syndrome, such as obesity and type 2 diabetes mellitus. All antipsychotic medications are associated with an increased likelihood of sedation, sexual dysfunction, postural hypotension, prolonged QT interval and sudden death. Primary care physicians need to be familiar with the individual adverse effect profiles of these medications.

No abstract available.
Cumulative Trauma Disorders*

PURPOSE: To prove whether the arterioportal shunt, especially transvasal shunt is one of the cause of the hypovascular hepatocellular carcinoma. MATERIALS AND METHODS: We evaluated the early phase images of table incremental dynamic CT and hepatic angiography in 20 cases of hepatoceltular carcinomas with transvasal arterioportal shunt. RESULTS: In hepatic arteriography, 18 cases were hypovascular and the remained 2 cases showed hypervascular tumor staining than surrounding normal hepatic parenchyme. In the early phase dynamic CT, 18 cases were hypodense(including 4 cases of focal hyperdensity in hypodense background), one was isodense and remaining one was hyperdense. CONCLUSION: Arterioportal shunt, especially transvasal shunt may make originally hypervasular hepato-cellular carcinoma to hypovascular lesion in the early phase dynamic CT or hepatic arteriography. In attempt to differentiate hepatic masses by tumor vascularity in recently widely used table incremental dynamic CT, the vascular patterns of the mass should be considered by close evaluation of vascular pattern of the liver, such as morphology of perfusion abnormality and arterioportal shunt, etc.
Angiography ; Carcinoma, Hepatocellular* ; Liver ; Perfusion

PURPOSE: The purpose of this study was to evaluate alterations of regional cerebral blood flow (CBF) and cerebrovascular reserve (CVR), and correlation between these alternations and cognitive dysfunction in patients with chronic traumatic brain injury (TRI) and normal brain MRI findings. MATERIALS AND METHODS: Thirty TBI patients and 19 healthy volunteers underwen1 rest/acerazolamide brain SPECT using Tc-99m HMPAO. Korean-Wechsler Adult Intelligence scale test was also performed in the patient group. Statistical analysis was performed with statistical parametric mapping software (SPM97), RESULTS: CBF was diminished in the left hemisphere including Wernicke's area in all patients with lower verbal scale scores. In addition, a reduction in CBF in the right frontal, temporal and parietal cortices was related with depressed scores in information, digital span, arithmetic and similarities, In patients with lower performance scale scores. CBF was mainly diminished in the right hemisphere including superior temporal and supramarginal gyri, premotor, primary somatomotor and a port of prefrontal cortices, left frontal lobe and supramarginal gyrus. CVR was diminished in sixty-four Brodmann's areas compared to control. A reduction in CVR was demonstrated bilaterally in the frontal and temporal Iobes in patients with lower scores in both verbal and performance tests, and in addition, both inferior parietal and occipital lobes in information subset. CONCLUSION: Alterations of CBF and CVR were demonstrated in the symptomatic TBI patients with normal MRI finding. These alterations were correlated with the change of intelligence, of which the complex functions are subserved by multiple interconnected cortical structures.
Adult ; Brain ; Brain Injuries* ; Frontal Lobe ; Healthy Volunteers ; Humans ; Intelligence* ; Magnetic Resonance Imaging ; Occipital Lobe ; Rabeprazole ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon

The cholestasis are defined as blockade or secretory distrubance of bile and appearance of bile in hepatocytes, Kupffer cells and biliary passages, usually associated with dilated bile canaliculi. Intra-and extraheptic cholestasis were induced by 17-ethinyl estradiol, or chlorpromazine hydrochloride and by ligation of bile duct to investigate the mechanism of the hepatic injury, ultrastructural changes of liver and alterations of liver function. The results obtained were as follows. 1) Functional and histological changes of intra-and extrahepatic cholestasis differed in various experimental groups. The liver weight is increased in 17-ethinyl estradiol treated group and ligation of bile duct group (5.6+/-0.15, P<0.001, 5.3+/-0.19 gm/100 gm body weight, P<0.001). The common features of intra-and extrahepatic cholestasis were double membrane bounded amorphous vesicular material infiltrations in the cytoplasm of hepatocyte, partial loss of microvilli of bile canaliculi, anf focal thickening of pericanalicular ectoplasm on electron microscopy. 2) Intrahepatic cholestasis induced by 17-ethinyl estradiol show significantly increased serum level of alkaline phosphatase and total bile aicd (134.0+/-16.82 IU/L, 29.5+/-4.68 umol/l). Kupffer cell proliferation and focal cytoplasmic degradation with myelin figures are characteristic features on electron microscopy. Chlorpromazine hydrochloride induced intrahepatic cholestasis show increased serum level of AST, ALT, Cholesterol and bilirubin (156.9+/-11.32, 49.0+/-2.83 IU/L, 59.3+/-6.73 mg/dl, 1.8+/-.043 mg/dl). Inflammatory cell infiltration, chiefly lymphocytes and esoinophils are seen in periportal area. Prominent vesiculation and vacuolations of smooth endoplasmic reticulum are characteristic feature on electron microscopy. 3) Extrahepatic cholestasis induced by ligation of bile duct show increase serum level of AST, ALT, GGT, cholesterol, total bile acid, and bilirubin (290.2+/-50.24, 171.5+/-47.17, 159.3+/-24.54, 33.7+/-1.47 IU/L, 86.6+/-9.18 mg/dl, 246.6+/-27.34 umol/l, 13.9+/-0.83 mg/dl). Light microscopically, morphologic alterations are feathery degeneration of hepatocytes, proliferation of bile ducts, bile infarct and prominent intracytoplasmic lipid droplets. Electron microscopically, electron dense acidophilic body, bile casts and complete loss of microvilli are seen in dilated bile canaliculi. Also noted are hypertrophy of cannalicular ectoplasm. Finely granular materials are infiltrated in degenerative cytoplasm.
Rats ; Animals

Schneiderian papillomas are papillary lesions of the nasal cavity paranasal sinuses that arise from the Schneiderian membrane, a membrane of ectodermal origin embryologically derived from the nasal placodes. This membrane is characterized by transitional type epithelium, similar to bladder urothelium, with admixed microcysts or mucin droplets. It has a tendency to recur after removal and transform into malignancy even though rare. Total 27 cases of Schneiderian papillomas were examined in the Chosun University medical college, which were collected from 1978 to 1986. The results obtained were as follows: 1) There were 19 male and 8 female patients, and mean age at diagnosis was 50.5+/-12.0 (SD) year (27-74 years). 2) Nasal obstruction or perception of nasal mass was the most common presenting symptom; Mean duration of symptoms was 25.8+/-15.0 (SD) month (4-48 months). 3) Numbers of papillomas had predominantly endophytic (inverted, n=17) and predominantly exophytic (fungiofrom n=6) patients, and four had mixed pattern. 4) In 27 patients, recurrences developed in 9, local invasion in one (with an inverted papilloma), and epidermoid carcinoma in one (with an inverted papilloma).
Female ; Male ; Humans

A 51-year-old man had multiple nonspecific subcutaneous nodules and small red hemorrhagic papules on his trunk. Histopathologically, the subcutaneous nodules were shown to be lobular capillary hemangiomas with edematous stroma throughout the entire subcutaneous fat. Multiple subcutaneous granuloma pyogenicum is a rare variant of granuloma pyogenicum. The addition of cherry angioma in the same patient also makes it a very unusual case.
Granuloma* ; Granuloma, Pyogenic* ; Hemangioma* ; Humans ; Middle Aged ; Subcutaneous Fat

No abstract available.
Cell Line* ; Colorectal Neoplasms* ; Eflornithine* ; Humans*

The myoepithelioma is a rare salivary gland tumor composed nearly exclusively of myoepithelial cells. A case occuring on the parotid gland of a 51 year-old female is reported. Light microscopy finding revealed plasmacytoid cells. Ultrastructurally, the most of the neoplastic cells had polygonal outlines and showed eccentric, round to ovoid nuclei with even contours, peripherally distributed heterochromatin and to three small nuceoli. Their cytoplasms were almost completly filled with thin filaments, arranged in parallel strains and exhibiting "dense bodies". The neoplastic cells showed positive immunostaining for S-100 protein and cytokeratin.
Female ; Humans

The myoepithelioma is a rare salivary gland tumor composed nearly exclusively of myoepithelial cells. A case occuring on the parotid gland of a 51 year-old female is reported. Light microscopy finding revealed plasmacytoid cells. Ultrastructurally, the most of the neoplastic cells had polygonal outlines and showed eccentric, round to ovoid nuclei with even contours, peripherally distributed heterochromatin and to three small nuceoli. Their cytoplasms were almost completly filled with thin filaments, arranged in parallel strains and exhibiting "dense bodies". The neoplastic cells showed positive immunostaining for S-100 protein and cytokeratin.
Female ; Humans