Newer antidepressants are commonly used in clinical practice to treat psychiatric disorder and psychosomatic disorder including chronic pain syndrome, fibromyalgia, headache. However there are many unexpected adverse effects of these drugs such as nausea and vomiting, weight gain, sexual dysfunction. These are 3 most well-recognized common adverse effects of newer antidepressant and are most common causes of treatment failure. I reviewed mechanisms, epidemiology, and pharmacological management of these adverse effects of newer antidepressants. In this paper, newer antidepressants include selective serotonin reuptake inhibitor(fluoxetine, fluvoxamine, citalopram, escitalopram, sertraline, paroxetine), serotonin norepinephrine reuptake inhibitor(venlafaxine, duloxetine), norepinephrine and dopamine reuptake inhibitor(bupropion), noradrenergic and specific serotonergic antidepressant(mirtazapine), and reversible inhibitor of MAO-A(moclobemide). I suggest that psychiatrists and clinicians in the psychosomatic field should know mechanisms, epidemiology, and management of these common and well-recognized adverse effects of newer antidepressants. Therefore it will be helpful to recognize easily and treat well for patients with psychiatric disorder and psychosomatic disorder using newer antidepressants.
Antidepressive Agents ; Chronic Pain ; Citalopram ; Dopamine ; Epidemiology* ; Fibromyalgia ; Fluvoxamine ; Headache ; Humans ; Nausea* ; Norepinephrine ; Psychiatry ; Psychophysiologic Disorders ; Serotonin ; Sertraline ; Treatment Failure ; Vomiting* ; Weight Gain*

Recently new tumor marker, MG7-Ag has been introduced for screening of gastric cancer. In this study MG7-Ag and CEA in sera of 50 normal healthy Koreans and 48 patients with gastric cancer group were determined to elucidate the clinical usefulness for gastric cancer screening. Commercial Enzyme Immuno Assay kits were used for analysis of above two markers. Sensitivity of MG7-Ag and CEA in patient group were found to be 43.8% and 41.7%, respectively. When the two markers were used combind, sensitivity increased to 62.5%. The concentration of MG7-Ag in patients (9.2+11.7 U/mL) was five times higher than normal control group (1.81+1.63 U/mL). CEA was 31.2+46.5 ng/mL in patients and 2.24+0.98 ng/mL (MeanSD) in normal control group. From this results, combination assay of MG7-Ag and CEA is more useful in clinical laboratories for screening gastric cancer than using one marker.
Humans ; Mass Screening ; Stomach Neoplasms*

No abstract available.

No abstract available.

We are report on three cases of typical clinical characterstics and treatment response in neuroleptic maligant syndrome(NMS), and reviewed the literatures of NMS. NMS was first recognized as a life-threatening complication of dopamine receptor antagonists, and defined as a catatonic-like states associated with fever, obtundation, muscle rigidity, and unstable vital sign in patients taking neuroleptic agents. Concepts of NMS have changed because medications other than classic neuroleptic drugs have been implicated as triggering agents and syndromes identical to NMS have been observed in other conditions. The important neurochemical features are probably functional dopamine deficiency and ensuing hyperactivity of excitatory amino and neurotransmission in the basal ganglia and hypothalamus. Recognition of NMS and early discontinuation of neuroleptics are the most important step in its management. Supportive care includes management of hyperthermia and fluid replacement. Contraversial therapeutic measures include the application of dopamine receptor agonists, excitatory amino acid antagosists, or dantrolene. Psychiatric patients with a history on NMS and psychotic relapse necessitating antipsycotics do not commonly redevelop NMS.
Antipsychotic Agents ; Basal Ganglia ; Dantrolene ; Dopamine ; Dopamine Agonists ; Dopamine Antagonists ; Excitatory Amino Acids ; Fever ; Humans ; Hypothalamus ; Muscle Rigidity ; Neuroleptic Malignant Syndrome* ; Recurrence ; Synaptic Transmission ; Vital Signs

We described a giant chroioangioma of the placenta that caused premature rupture of membranes at 31 weeks of gestation in a 31-year-old primiparous woman and a subsequent neonatal death of the baby. The placental mass, weighing 820 gm and measuring 21.5x15x4.5 cm, was easily shelled out from a edematous 1280 gm-placenta. The mass had a thin fibrous capsule and a solid fibromatous appearance. The infant, weighed 2175 gm, appeared edematous oon the whole body and had Apgar scores of 4 and 5 at 1 and 5 minutes respectively. The baby expired 4 days after birth due to high output cardiac failure and respiratory failure. Postmortem examination revealed markedly dilatated umbilical vein, inferior vena cava and right atrium with patent froamen ovale, congestive hepatosplenomegaly, pulmonary hemorrhages, and meconium aspiration pneumonia. Microscopically, the mass revealed a variety of histologic patterns, reflecting entire spectrums of villous vasculogenesis from loose myxomatous connective tissue and undifferentiated hemangioblastic cell nests to well-developed capillaries with hematopoietic cells in the lumen.
Infant ; Male ; Female ; Infant, Newborn ; Humans

Routine use of commercially available antisera against hepatitis B core antigen(HBcAg) has permitted a reevaluation of the histochemical distribution of the antigen in liver tissue. HBcAg, classically described almost exclusively in the nucleus, was found with a very high frequency in the cytoplasm of liver cells as well. To elucidate the biologic significance of HBcAg expression and its relation to the natural course of hepatitis B virus(HBV) infection, the patterns of activity in 33 needle liver biopsies of HBsAg carriers were analysed. A good correlation of liver HBcAg with disease activity was demonstrated. HBcAg was present in the hepatocyte nuclei(nHBcAg) or cytoplasm(cHBcAg), or in both(mixed). Pure nHBcAg was seen mainly in non-aggressive reactive liver tissue and cHBcAg was predominantly associated with chronic active hepatitis(95%). The results suggest that expression of HBcAg correlates with the liver pathology and the possibility of HBcAg to be an immunological target for T cell mediated hepatocyte damage.
Biopsy

No abstract available.
Multiple Myeloma* ; Osteosclerosis*

No abstract available.

Microvascular anastomosis has become an essential technique in reconstructive surgery. A lot of techniques have been developed to improve patency rate and reduce operation time. But interrupted suture technique is still most widely used because of limited indication and inconvenience of other methods. A comparative study was undertaken to evaluate new microvasular anastomosis technique using fibrin glue. In this report 40 femoral arteries of Sprague-Dawley rats were anastomosed by utilizing four stay sutures which were placed 90 degrees apart and the intervals covered with fibrin glue, and by conventional eight suture method served as control. The patency rate(immediate postoperative, postoperative two weeks), time needed for vascular anastomosis, and microscopic evaluation were compared to those of conventional microvascular suture technique. Postoperative patency rate was 100% and 85% by fibrin glue technique compared to 100% and 90% by conventional technique at immediate postoperative and postoperative two weeks. Less time consumed with fibrin glue technique by 16 minutes compared to conventional technique by 21 minutes. Microscopically reendothelization was complete with smooth and less injured inner lining and also less inflammatory response by fibrin glue technique compared to conventional technique.
Femoral Artery ; Fibrin Tissue Adhesive* ; Fibrin* ; Rats, Sprague-Dawley ; Suture Techniques ; Sutures