There are numerous drug interactions related to many psychotropic and cardiovascular medications. Firstly, the principles in predicting drug interactions are discussed. Cytochrome P (CYP) 450 plays a significant role in the metabolism of these drugs that are substrates, inhibitors, or inducers of CYP450 enzymes. The two most significant enzymes are CYP2D6 and CYP3A4. The ability of psychotropic drugs to act as inhibitors for the enzymes may lead to altered efficacy or toxicity of co-administered cardiovascular agents as a substrate for the enzymes. The following is also a review of the known interactions between many commonly prescribed cardiovascular agents and psychotropic drugs. Most beta blockers are metabolized by CYP2D6, which may lead to drug toxicity when they use in combination with potent CYP2D6 inhibitors including bupropion, chlorpromazine, haloperidol, selective serotonin reuptake inhibitors, and quinidine. Concomitant administration of lithium with angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and diuretics may increase serum lithium concentrations and toxicity. Calcium channel blockers and cholesterol lowering agents are subject to interactions with potent inhibitors of CYP3A4, such as amiodarone, diltiazem, fluvoxamine, nefazodone, and verapamil. Prescribing antiarrhythmic drugs in conjunction with medications are known to prolong QT interval and/or inhibitors on a relevant CYP450 enzyme is generally not recommended, or needs watchful monitoring. Digoxin and warfarin also have warrant careful monitoring if co-administered with psychotropic drugs.
Amiodarone ; Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Anti-Arrhythmia Agents ; Bupropion ; Calcium Channel Blockers ; Cardiovascular Agents ; Chlorpromazine ; Cholesterol ; Cytochrome P-450 CYP2D6 ; Cytochrome P-450 Enzyme System ; Cytochromes ; Digoxin ; Diltiazem ; Diuretics ; Drug Interactions ; Drug Toxicity ; Fluvoxamine ; Haloperidol ; Lithium ; Psychotropic Drugs ; Quinidine ; Serotonin Uptake Inhibitors ; Triazoles ; Verapamil ; Warfarin

The SPECT radiopharmaceuticals labeled with I-123 for dopamine transporter imaging have been used to measure dopamine transporters in patients with movement disorders. However, a cyclotron produced I-123 limits its availiability and ease of use as a radioisotope to be labeled with pharmaceuticals in routine clinical diagnostic procedures. Recently, new radiopharmaceuticals for Tc-99m which has optimal characteristic for SPECT imaging have been developed to overcome the limits of using I-123. The purpose of this study was to compare the quality of [Tc-99m]TRODAT-1 with [I-123]IPT SPECT data and then to evaluate the usefulness of [Tc-99m]TRODAT-I SPECT by using three noninvasive simplified quantitative methods. TRODAT-1 labeled with Tc-99m(15.93+/-0.82 mCi) and IPT labeled with I-123(6.60+/-0.11 mCi) were injected into five normal controls. Dynamic [Tc-99m] TRODAT-I SPECT scans of brain were performed for 10 minutes each over 180 minnutes, and for 20 minutes at 4 hrs and 5 hrs. [I-123IPT SPECT scans were performed for 5 minutes each over 120 minutes. Time activity curves were generated for the left basal ganglia(LBG), right basal ganglia(RBG), and occipital cortex(OCC). Dopamine transporter parameters were obtained using (BG-OCC)/OCC, graphical method(Rv), and area ratio method(RA). TRODAT-1 and IPT SPECT imaging showed high uptake at the level of the basal ganglia. (BG-OCC)/OCC ratios for TRODAT-1 and IPT were 0.80+/-0.14, and 3.22+/-0.81, Rvs were 0.62+/-0.12, and 2.30+/-0.35, and RAs were 0.37+/-0.08 and 1.73+/-0.31, respectively. In conclusion, further improvement of [Tc-99m]TRODAT-I imaging characteris- tics may be required to estimate the dopamine transporter concentrations in human brains although it shows clear BG localization.
Basal Ganglia ; Brain ; Cyclotrons ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Humans ; Movement Disorders ; Radiopharmaceuticals ; Tics ; Tomography, Emission-Computed, Single-Photon*

Development of supervoltage treatment machine may minimize skin reaction by skin-sparing effect, but skin damage is still one of “the dose limiting factor” in radiation therapy. In spite of these importance, systemic histopathologic studies of skin in similar conditions which used in clinical treatment has not been performed so far. 60 mice were irradiated with conventional fraction (200x5/wk) and whole abdominal field (2x3 cm, from symphysis pubis to xyphoid process). Used machine was 250 KV, 24 mA. orthovoltage x-ray machine. Histopathological changes of acute skin reaction at the level of total irradiation dose were analyzed and possible mechanism of later chronic changes were investigated. Obtained results are as follows 1. In 1,000 rad irradiated group, only mild epidermal edema is noted. 2. In 2,000 rad irradiated group, slightly decreased number and size of hair follicles and appendages, dermal edema and scanty infiltration of inflammatory cells are visible. 3. In 3,000 rad irradiated group, marked increased capillary congestion and prominent infiltration of inflammatory cells are observed. 4. In 4,000 rad irradiated group, vascular wall thickening with proliferation of endothelial cells are prominent. Dermal thinning and hyalinization are newly developed. 5. In 5,000 rad irradiated group, complete desquamation of epidermis is not seen, despite of acceleration of all above mentioned changes.
Acceleration ; Animals ; Capillaries ; Edema ; Endothelial Cells ; Epidermis ; Estrogens, Conjugated (USP) ; Hair Follicle ; Hyalin ; Mice* ; Pubic Bone ; Skin*

Nucleolar organizer regions are DNA loops encoding rihbosomal RNA production and detectable by the argyrophilia of their associated proteins(AgNORs). AgNOR numbers correlate with cellular proliferating activity. Many studies have shown a significnt difference in AgNOR counts between benign and malignant tumors. AgNOR counts were also helpful in differential diagnosis. For the evaluation of its diagnostic utility in gastric lesions, a silver staining technique was carried out in paraffin sections of 5 control cases, 5 benign peptic ulcers, 7 hyperplastic polyps, 10 tubular adenomas, 16 early gastric adenocarcinomas and 15 advanced gastric adenocarcinomas. The results were as follows. The mean numbers of AgNORs in early and advanced gastric adenocarcinomas(1.94 and 2.16) were significantly higher than those of normal foveolar epithelium(1.43) and epithelia of benign gastric ulcers(1.54), hyperplastic polyps(1.64) and tubular adenomas(1.79). In malignancy, there was increased variability in size and shape of AgNORs. There was little differences in mean AgNOR numbers between early and advanced gastric adenocarcinomas. Differentiation of the tumor made no difference in AgNOR numbers. From the above results, the AgNORs count, if its morphologic change are taken into consideration, is helpful in differentiation between malignant and non-malignant lesions.
Diagnosis, Differential ; Adenocarcinoma

Menkes disease is an X-linked recessively inherited neurodegenerative disorder of copper metabolism leading to death in early childhood. This disease is characterized by low serum, liver and brain Cu levels, whereas the Cu content in nearly all other organs is increased. The main clinical features are irregular kinky hair, characteristic face, progresssive degeneration of the central nervous system, bone changes, arterial rupture and thrombosis, and instability of temperature. We have experienced a case of Menkes disease in a eight months old male patient, who manifested by seizure, developmental delay, hypotonia, characteristic hair and face along with low levels of serum copper and ceruloplasmin. We report the characteristic findings of cranial MRI and MR angiography in this Menke's patient. In cranial MRI, he showed progressive brain atrophy with subdural hemorrhage and effusion. MR angiography revealed tortuosity of vessels clearly obviating necessity of more invasive conventional arteriography in diagnosis of this disease. This study suggested that cranial MRI and especially MR angiography might be helpful in making early diagnosis of this disease.
Angiography ; Atrophy ; Brain ; Central Nervous System ; Ceruloplasmin ; Copper ; Diagnosis ; Early Diagnosis ; Hair ; Hematoma, Subdural ; Humans ; Liver ; Magnetic Resonance Imaging ; Male ; Menkes Kinky Hair Syndrome ; Metabolism ; Muscle Hypotonia ; Neurodegenerative Diseases ; Rupture ; Seizures ; Thrombosis

Obesity is pervasive from infancy to adulthood and presents a major challenge to healthcare systems worldwide. In children and adolescents, the prevalence of overweight and obesity continues to increase, especially in classes II and III, and in younger toddlers and preschool-aged children. Childhood obesity may be associated with comorbidities in all organ systems and increased cardiovascular risk, as it tracks into adolescent and adult obesity. Although intensive health and behavior lifestyle treatments form the foundation of obesity treatment, there are limitations in the extent and maintenance of weight loss with lifestyle modifications alone. The offering of obesity pharmacotherapy in adjunct to intensive lifestyle treatment in children aged > 12 years may improve outcomes in pediatric obesity. In this review, we discuss currently approved medications for childhood and adolescent obesity, focusing on orlistat, phentermine monotherapy, glucagon-like peptide-1 receptor agonists (liraglutide and semaglutide injections), and phentermine/topiramate combination.

Obesity is pervasive from infancy to adulthood and presents a major challenge to healthcare systems worldwide. In children and adolescents, the prevalence of overweight and obesity continues to increase, especially in classes II and III, and in younger toddlers and preschool-aged children. Childhood obesity may be associated with comorbidities in all organ systems and increased cardiovascular risk, as it tracks into adolescent and adult obesity. Although intensive health and behavior lifestyle treatments form the foundation of obesity treatment, there are limitations in the extent and maintenance of weight loss with lifestyle modifications alone. The offering of obesity pharmacotherapy in adjunct to intensive lifestyle treatment in children aged > 12 years may improve outcomes in pediatric obesity. In this review, we discuss currently approved medications for childhood and adolescent obesity, focusing on orlistat, phentermine monotherapy, glucagon-like peptide-1 receptor agonists (liraglutide and semaglutide injections), and phentermine/topiramate combination.

Obesity is pervasive from infancy to adulthood and presents a major challenge to healthcare systems worldwide. In children and adolescents, the prevalence of overweight and obesity continues to increase, especially in classes II and III, and in younger toddlers and preschool-aged children. Childhood obesity may be associated with comorbidities in all organ systems and increased cardiovascular risk, as it tracks into adolescent and adult obesity. Although intensive health and behavior lifestyle treatments form the foundation of obesity treatment, there are limitations in the extent and maintenance of weight loss with lifestyle modifications alone. The offering of obesity pharmacotherapy in adjunct to intensive lifestyle treatment in children aged > 12 years may improve outcomes in pediatric obesity. In this review, we discuss currently approved medications for childhood and adolescent obesity, focusing on orlistat, phentermine monotherapy, glucagon-like peptide-1 receptor agonists (liraglutide and semaglutide injections), and phentermine/topiramate combination.

Obesity is pervasive from infancy to adulthood and presents a major challenge to healthcare systems worldwide. In children and adolescents, the prevalence of overweight and obesity continues to increase, especially in classes II and III, and in younger toddlers and preschool-aged children. Childhood obesity may be associated with comorbidities in all organ systems and increased cardiovascular risk, as it tracks into adolescent and adult obesity. Although intensive health and behavior lifestyle treatments form the foundation of obesity treatment, there are limitations in the extent and maintenance of weight loss with lifestyle modifications alone. The offering of obesity pharmacotherapy in adjunct to intensive lifestyle treatment in children aged > 12 years may improve outcomes in pediatric obesity. In this review, we discuss currently approved medications for childhood and adolescent obesity, focusing on orlistat, phentermine monotherapy, glucagon-like peptide-1 receptor agonists (liraglutide and semaglutide injections), and phentermine/topiramate combination.

No abstract available.
Anxiety ; Cellular Phone ; Humans ; Impulsive Behavior