No abstract available.

As the clinical practice of using more than one drug at a time increase, the clinician is faced with ever-increasing number of potential drug interactions. Although many interactions have little clinical significances, some may interfere with treatment or even be life-threatening. This review provides a better understanding of drug-drug interactions often encountered in pharmacotherapy of depression. Drug interactions can be grouped into two principal subdivisions : pharmackinectic and pharmacodynamic. These subgroups serve to focus attention on possible sites of interaction as a drug move from the site of administration and absorption to its site of action. Pharmacokinetic processes are those that include transport to and from the receptor site and consist of absorption, distribution on body tissue, plasma protein binding, metabolism, and excretion. Pharmacodynamic interactions occur at biologically active sites. In this review, emphasis is placed on antidepressant medications, how they are metabolized by the P450 system, and how they alter the metabolism of other drugs. When prescribing antidepressant medications, the clinician must consider the drug-drug interactions that are potentially problematic.
Absorption ; Antidepressive Agents* ; Catalytic Domain ; Depression ; Drug Interactions* ; Drug Therapy ; Metabolism ; Plasma ; Protein Binding

As numbers of serotonin's function are so many, studies of serotonin are numerous nowadays. In the beginning, concentration of metabolites such as 5-HIAA was a key issue, but recent studies have been challenged for serotonin receptor genes and their relation to mood disoder. Serotonin transporter(5-HTT) gene is a strong candidate gene of mood disoder for following reason. Serotonin transporter is a key protein in the serogonin pathway as it regulate the concentration of serotonin in the synaptic clept and essential pathophysiology of depression is dysregulation of 5-HTT so that all antidepressants have effect of 5-HTT antagonist. The decrease of 5-HTT in the platelet and in brain of the depressive patients is much consistent results in the studies of the pathophysiology of mood disorder till now. By this, we will be able to develop simple and easy marker for diagnosis type. and treatment monitoring of depression. Many psychiatrists have sought the independent genes in relation to depression or schizophrenia. Obviously, the hereditary vulnerability contributes to etiology of mood disorders, but it is difficult to discriminate the independent genes because of many environmental factors. Moreover, in the hereditarily complex diseases such as mood disorder, the only vulnerability of gene can not sufficiently explain the etiology. In the future, to exclude the role of the gene-environmental interaction the methods such as gene transfer can be considered. in the opposite direction, by usion the gene destruction method the role of target genes can be examined. As yet the concept of the gene expression, neural plasticity, neurogenesis and etc is the elementary stage. The development of this field will help to establish the treatment strategy of chronic and refractory mood disorders.
Antidepressive Agents ; Blood Platelets ; Brain ; Depression ; Diagnosis ; Gene Expression ; Humans ; Hydroxyindoleacetic Acid ; Mood Disorders* ; Neurogenesis ; Plastics ; Psychiatry ; Schizophrenia ; Serotonin Plasma Membrane Transport Proteins ; Serotonin*

Advances in molecular biology contribute to the understanding genetic mechanism of psychiatric disorders. They have renewed hope for the discovery of disease relevant gene. However, the results somewhat confused. And we will wait for a long time for the application of gene therapy in schizophrenia. Fortunately we could classified the schizophrenia with genotypes of dopamine and serotonin receptors. It is expected that this genetic classification could provide key strategy for the therapeutic application in biological treatment for schizophrenia. The purpose of this article is to call attention of the institute participants to linkage. association. mRNA expression. genotypic classification and to the need for more systemic research. The author summarized the modified methods which were done in his laboratory in appendix.
Appendix ; Classification ; Dopamine ; Genetic Therapy ; Genotype ; Hope ; Molecular Biology* ; Receptors, Serotonin ; RNA, Messenger ; Schizophrenia

Polypharmacotherapy, both psychotropic and nonpsychotropic, is widespread in various situations including psychiatric hospitals and general hospitals. As the clinical practice of using more than one drug at a time increase, the clinical is faced with ever-increasing number of potential drug interactions. Although many interactions have little clinical significances, some may interfere with treatment or even be life-threatening. The objective of this review is evaluation for drug-drug interactions often encountered in psychiatric consultation. Drug interactions can be grouped into two principal subdivisions : pharmacokinetic and pharmacodynamic. These subgroups serve to focus attention on possible sites of interaction as a drug moves from the site of administration and absorption to its site of action. Pharmacokinetic processes are those that include transport to and from the receptor site and consist of absorption, distribution on body tissue, plasma protein binding, metabolism, and excretion. Pharmacodynamic interactions occur at biologically active sites. In psychiatric consultation, these two subdivisions of drug interactions between psychotropic drugs and other drugs are likely to happen. We gathered informations of the drugs used in physically ill patients who are consulted to psychiatric department in Korea University Hospital. And we reviewed the related literatures about the drug-drug interactions between psychotropic drugs and other drugs.
Absorption ; Catalytic Domain ; Drug Interactions ; Hospitals, General ; Hospitals, Psychiatric ; Humans ; Korea* ; Metabolism ; Plasma ; Protein Binding ; Psychotropic Drugs

The fluoxetine is one of the most frequently prescribed drugs for the treatment of depression and obsessive-compulsive disorder(OCD). This has been know as one of the most safest medication. But since the advent of this drug, there have been several reports of side effects-the mania and suicidal ideation-encountered during coadministration of fluoxetine with or without other psychotropic drugs. We experienced a case of 20 years old male OCD patient who developed into abrupt manic state and also was preoccupied with intense suicidal ideation following fluoxetine use. He was a only child in his family and his father had a history of alcoholism about 15 years ago. Our patient's obsessive-compulsive symptoms have been occured since puberty. His OCD symptoms and anxiety were aggravated since joining the army. Beside these facts, we could not find any other psychiatric history such as depressive disoder and bipolar disorder. We used the fluoxetine starting dosage of 20mg and increased to 40mg at second week. About 3 weeks after the treatment, he developed sudden manic symptom and more aggravated suicidal ideation without any OCD symptoms. He felt vitalized and energetic without having enough sleep and food. These symptoms were ceased over two weeks by stopping medication. Up to this point, the reason why fluoxetine induces mania and suicidal preoccupation is unclear. But somehow the fluoxetine has effects on serotonin receptor and serotonin-dopamine regulations, thus we could make an assumption that fluoxetine can induce mania, extrapyramidal symptoms(EPS) and suicidal ideation in some part of the serotonin unbalanced patients. We think this would be the first report to remark on fluoxetine's suicidal and manic side effects in Korea. So here we present the case with the summary of reviewed articles.
Adolescent ; Alcoholism ; Anxiety ; Bipolar Disorder* ; Depression ; Fathers ; Fluoxetine ; Humans ; Korea ; Male ; Obsessive-Compulsive Disorder* ; Only Child ; Psychotropic Drugs ; Puberty ; Serotonin ; Social Control, Formal ; Suicidal Ideation* ; Suicide ; Young Adult

No abstract available.
Hernia, Inguinal*

To evaluate the expression of ras, neu oncoprotein a.nd epidermal growth factor receptor (EGFR) on uterine cervieal carcinoma, imimunohistochemieal staining was performed on 9 cases of dysplasia, 39 cases of careinoma in situ(CIS), 32 cases of microinvasive earcinoma(WIC) and 60 cases of frankly invasive carrinoma(FIC). The results obtained were as follows: Ras p21 protein was positive in 29.5% of total cases, and it was very low in dysplasia lesion(12. 5%) and CLS(17.9%) while it was high in MIC(31.3%) and FIC(38.9%). In CIS, parabasal cell type showed positive reaction in only 8.7%, but pleomorpkic type showed 60.0% positivity. Invasive carcinoma showed no significant differences between histolegic types. Expression of neu protein was very high in caneerous group(around 95%) and slight,ly lower in dysp]asia(75.0%). No differences were found depending on histologic types and stages. EGFR was expressed in 51.8% of total cases; 12.5% of dysplasia; 54.2% of all cases of carcinoma. Keratinizing type of CIS showed highest positive reaction(90,0%), of which tendency were also noted in keratinizing type of i.nvasvie cinoma(76.2%). The results suggested that ras and EGFR could be used as a factor of prognostic value.
Epidermal Growth Factor* ; Receptor, Epidermal Growth Factor*

New antidepressants have become available for clinical use in the 1990s. Before this decade, the drugs available to treat depression consisted essentially of monoamine oxidase inhibitors, tricyclic antidepressants, and lithium. Following the introduction of SSRIs, the options have expanded and now include SSRIs nefazodone, venlafaxine, mirtazapine, reboxetine, tianeptine. Newer antidepressants possess a variety of pharmacological characteristics that are relevant to the choice of an antidepressant for clinical use. This review summarizes some of the major pharmacological characteristics among the drugs.
Antidepressive Agents ; Antidepressive Agents, Tricyclic ; Depression ; Lithium ; Monoamine Oxidase Inhibitors ; Venlafaxine Hydrochloride

This study investigated the antidepressant efficacy and it's impact on the quality of life of depressed patients. We performed Hamilton Depression Rating Scale(HDRS), and Montgomery-Asberg Depression Rating Scale(MADRS), and Health-related Quality of Life Questionnaire(HQLQ) to both tricyclic antidepressant(TCA) and sertraline groups. There were 16 subjects in the study. The tricyclic group had 9 subjects and the sertraline group had 7. The TCA and sertraline produced a similar degree of response. Both groups experienced a reduction of 70% or more in mean HDRS and MADRS total score after 6wks. In HQLQ, the TCAs group also showed improved bed disability days, alertness behavior, and social interaction, the sertraline group showed improved health perception, alertness behavior, home management, and social interaction. We suggested that the improvement of "Quality of life" were not in proportion to the clinical symptom's improvement. Therefore, clinicians should consider the benefit of antidepressant treatment in terms of quality of life.
Depression ; Humans ; Interpersonal Relations ; Quality of Life* ; Sertraline