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1.
Phys Rev Lett ; 130(11): 113001, 2023 Mar 17.
Article in English | MEDLINE | ID: mdl-37001086

ABSTRACT

We experimentally show that the 1s^{2}2s^{2}2p_{1/2}-1s2s^{2}2p_{1/2}^{2} transition in Pb^{77+} emitted in dielectronic recombination of Pb^{78+} is strongly polarized, although it is an intrinsically unpolarized J=1/2 to 1/2 transition. This unanticipated polarization is shown to be due to quantum interference with radiative recombination. The interference effect has been studied on an asymmetric resonance profile but has never been studied on polarization. In this Letter, we show that the effect on polarization can arise from a different cross term than that responsible for asymmetry, resulting in unexpectedly large polarization even for a nearly symmetric resonance suggesting a small interference.

2.
Phys Chem Chem Phys ; 24(40): 24714-24726, 2022 Oct 19.
Article in English | MEDLINE | ID: mdl-36128743

ABSTRACT

A light-harvesting strategy is crucial for the utilisation of solar energy. In this study, we addressed the expanding light-harvesting (LH) wavelength of photosynthetic LH complex 2 (LH2, from Rhodoblastus acidophilus strain 10050) through covalent conjugation with extrinsic chromophores. To further understand the conjugation architecture and mechanism of excitation energy transfer (EET), we examined the effects of the linker length and spectral overlap integral between the emission and absorption spectra of the energy donor and acceptor pigments. In the former case, contrary to the intuition based on the Förster resonance energy transfer (FRET) theory, the observed energy transfer rate was similar regardless of the linker length, and the energy transfer efficiency increased with longer linkers. In the latter case, despite the energy transfer rate increases at higher spectral overlaps, it was quantitatively inconsistent with the FRET theory. The mechanism of EET beyond the FRET theory was discussed in terms of the higher-lying exciton state of B850, which mediates efficient EET despite the small spectral overlap. This systematic investigation provides insights for the development of efficient artificial photosynthetic systems.


Subject(s)
Photosynthetic Reaction Center Complex Proteins , Light-Harvesting Protein Complexes/chemistry , Photosynthesis , Fluorescence Resonance Energy Transfer
4.
Photosynth Res ; 143(2): 115-128, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31620983

ABSTRACT

Enhancing the light-harvesting potential of antenna components in a system of solar energy conversion is an important topic in the field of artificial photosynthesis. We constructed a biohybrid light-harvesting complex 2 (LH2) engineered from Rhodobacter sphaeroides IL106 strain. An artificial fluorophore Alexa Fluor 647 maleimide (A647) was attached to the LH2 bearing cysteine residue at the N-terminal region (LH2-NC) near B800 bacteriochlorophyll a (BChl) assembly. The A647-attached LH2-NC conjugate (LH2-NC-A647) preserved the integrity of the intrinsic chromophores, B800- and B850-BChls, and carotenoids. Femtosecond transient absorption spectroscopy revealed that the sequential energy transfer A647 → B800 → B850 occurs at time scale of 9-10 ps with monoexponential dynamics in micellar and lipid bilayer systems. A B800-removed conjugate (LH2-NC[B800(-)]-A647) exhibited a significant decrease in energy transfer efficiency in the micellar system; however, surprisingly, direct energy transfer from A647 to B850 was observed at a rate comparable to that for LH2-NC-A647. This result implies that the energy transfer pathway is modified after B800 removal. The results obtained suggested that a LH2 complex is a potential platform for construction of biohybrid light-harvesting materials with simple energy transfer dynamics through the site-selective attachment of the external antennae and the modifiable energy-funnelling pathway.


Subject(s)
Energy Transfer , Light-Harvesting Protein Complexes/metabolism , Rhodobacter sphaeroides/metabolism , Amino Acid Sequence , Light-Harvesting Protein Complexes/chemistry , Lipid Bilayers/chemistry , Micelles , Solutions , Spectrometry, Fluorescence , Time Factors
5.
Psychiatry Clin Neurosci ; 73(12): 731-737, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31353759

ABSTRACT

AIMS: In this study, we implemented the Illness Management and Recovery (IMR) program for middle-aged and older patients with schizophrenia hospitalized for long periods and assessed the effect of the IMR program on psychiatric symptoms and psychosocial function. The effects of the IMR program on brain structure were also evaluated. METHODS: The IMR program was implemented for 19 patients with schizophrenia; 17 patients with schizophrenia receiving treatment as usual (TAU) were also recruited as controls. In all patients, mean age was 61.4 years (range, 50-77 years) and mean hospitalization duration was 13.1 years (range, 1-31 years) at enrollment. Structural magnetic resonance images and Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF) scores as clinical variables were obtained at the beginning and end of the IMR program. Longitudinal analyses were performed to compare the effects of the IMR program on clinical symptoms and cortical thickness in the superior temporal gyrus (STG) between the IMR and TAU groups. RESULTS: Significant improvements in GAF scores and the total, Insight and Judgment, and Positive components of the PANSS were found in the IMR group compared with the TAU group. Cortical thickness in the left STG was preserved in the IMR group compared with the TAU group. CONCLUSIONS: This is the first report demonstrating the effectiveness of the IMR program for improving psychotic symptoms and psychosocial function and protecting brain structure in middle-aged and older inpatients with schizophrenia hospitalized for long periods.


Subject(s)
Combined Modality Therapy/methods , Disease Management , Schizophrenia/pathology , Schizophrenia/therapy , Schizophrenic Psychology , Temporal Lobe/pathology , Aged , Atrophy/pathology , Female , Humans , Inpatients/psychology , Magnetic Resonance Imaging , Male , Middle Aged , Neuroimaging , Program Development
6.
Phys Rev Lett ; 108(7): 073002, 2012 Feb 17.
Article in English | MEDLINE | ID: mdl-22401199

ABSTRACT

We report the experimentally determined angular distribution of the [1s2s(2)2p(1/2)](1)→[1s(2)2s(2)](0) transition in dielectronic recombination of Li-like Au. Recently, Fritzsche et al. [Phys. Rev. Lett. 103, 113001 (2009)] predicted that the Breit interaction plays a dominant role in the angular distribution of this transition. However, the predicted phenomenon has not yet been observed experimentally due to technical difficulties in conventional methods. To overcome the difficulties, we combine two different measurements with an electron beam ion trap (EBIT) to obtain the x-ray angular distribution. One is the x-ray measurement at 90° and another is the integral resonant strength measurement through the ion charge abundance in the EBIT. Our measurements agree well with the theoretical prediction and confirm the dominance of the Breit interaction.

7.
Psychiatr Serv ; 61(11): 1157-61, 2010 Nov.
Article in English | MEDLINE | ID: mdl-21041359

ABSTRACT

OBJECTIVE: This study investigated the feasibility and outcomes of the illness management and recovery program in Japan. METHODS: Thirty-five patients with schizophrenia were recruited. Participants were assigned (not randomly) to the intervention and wait-list comparison groups. Symptom severity, functioning, activation level in self-management, quality of life, satisfaction, self-efficacy in community living, and satisfaction with services were measured before and after the intervention. RESULTS: Over two years 25 patients completed the intervention (some after being wait-listed). In the pre-post comparison, they showed significant improvement in symptoms and functioning, self-reported activation in self-management, quality of life, satisfaction, and self-efficacy in community living. Compared with the ten participants in a wait-list comparison group, the eight participants in the first intervention group showed an increased quality of life in social functioning, satisfaction in living, and self-efficacy for social relationships in community living. CONCLUSIONS: Findings suggest that the program is effective for participants with severe mental illness in Japan.


Subject(s)
Community Mental Health Services/organization & administration , Health Plan Implementation/organization & administration , Schizophrenia/therapy , Activities of Daily Living/psychology , Adult , Ambulatory Care/organization & administration , Female , Humans , Japan , Male , Patient Satisfaction , Quality of Life/psychology , Schizophrenia/rehabilitation , Treatment Outcome
8.
Neuropsychobiology ; 59(2): 130-4, 2009.
Article in English | MEDLINE | ID: mdl-19390224

ABSTRACT

BACKGROUND: Some reports have suggested the involvement of the D2 dopaminergic function in the expression of suicidal behavior. Here, we examined associations between suicide attempts and two kinds of functional polymorphisms in the dopamine D2 receptor (DRD2) gene, namely, TaqIA and -141C Ins/Del. METHODS: Subjects included 120 suicide attempters and 123 unrelated volunteers. Those who attempted suicide were severely injured and were transferred to the emergency unit in our university hospital. To determine each genotype, we performed polymerase chain reaction and restriction fragment length polymorphism analyses. RESULTS: We found significant differences in genotypic and allelic frequencies of -141C Ins/Del and TaqIA polymorphisms between suicide attempters and healthy controls (-141C Ins/Del, p = 0.01; TaqIA,p = 0.036). The Ins allele of -141C Ins/Del was significantly more frequent in suicide attempters (p = 0.011), as well as the A2 allele of TaqIA (p = 0.017). Haplotype analysis revealed no significant linkage disequilibrium between -141C Ins/Del and TaqIA polymorphisms (D' = 0.226, r(2) = 0.016, p = 0.10). CONCLUSIONS: These findings suggest that DRD2 gene polymorphisms may be involved in the biological susceptibility to suicide.


Subject(s)
Asian People/genetics , Polymorphism, Genetic , Receptors, Dopamine D2/genetics , Suicide, Attempted , Case-Control Studies , Female , Gene Frequency , Genome-Wide Association Study , Genotype , Haplotypes , Humans , Male
9.
Rev Sci Instrum ; 79(10): 10E519, 2008 Oct.
Article in English | MEDLINE | ID: mdl-19044501

ABSTRACT

An experimental technique to investigate fast ion confinement based on charge exchange spectroscopy of H(alpha)-light was applied to evaluate the confinement property of perpendicular fast ions in large helical device (LHD). Sensitivities of the H(alpha) spectra to the pitch angles of injected neutral beams (NBs) and these to the angle between the sight line of the measurement and NB injection path are examined. The energy dependence of the charge exchange cross section significantly affects the observed spectra since the driving NB is injected perpendicular to the magnetic field lines in the geometry of LHD. The measured spectra are compared to the spectra of GNET simulation results and the simulated spectra agreed well with the experimental measurement when we take into account the contribution of halo neutrals. Although it is difficult to obtain the fast ion distribution functions directly, this technique provides useful experimental data in benchmarking simulation codes.

10.
Phys Rev Lett ; 100(7): 073203, 2008 Feb 22.
Article in English | MEDLINE | ID: mdl-18352549

ABSTRACT

Resonant strengths have been measured for dielectronic recombination of Li-like iodine, holmium, and bismuth using an electron beam ion trap. By observing the atomic number dependence of the state-resolved resonant strength, clear experimental evidence has been obtained that the importance of the generalized Breit interaction (GBI) effect on dielectronic recombination increases as the atomic number increases. In particular, it has been shown that the GBI effect is exceptionally strong for the recombination through the resonant state [1s2s(2)2p(1/2)](1).

11.
Palliat Support Care ; 5(4): 351-4, 2007 Dec.
Article in English | MEDLINE | ID: mdl-18044412

ABSTRACT

OBJECTIVES: Complications of neuropsychiatric disorders are often detected in cancer patients. Adjustment disorders, depression, or delirium are common psychiatric disorders in these patients, and drug-induced neuropsychiatric problems are sometimes referred for psychiatric consultation. Prochlorperazine and other antiemetic drugs that are phenothiazine derivates are also reported to cause akathisia due to the blockade of the dopamine receptor in the central nervous system, but the, prevalence of akathisia in patients undergoing cancer treatment has not been reported. This study seeks to explore the prevalence of such drug-induced syndromes (e.g., akathisia) in this population. METHODS: This present study was a prospective study. The subjects of this study were 483 consecutive patients with cancer who had been referred to the Department of Psychiatry in Kanagawa Prefecture Cancer Center from February 1, 2004, to November 30, 2005. Trained psychiatrists conducted a nonstructured psychiatric interview and neurologic examination to establish psychiatric diagnoses according to DSM-IV and the presence or absence of drug-induced extra pyramidal symptoms. The past and current medications used in their cancer treatment were also examined in detail for an accurate evaluation. RESULTS: A psychiatric diagnosis was made in 420 (87.0%) of the 483 cancer patients examined, and akathisia, a drug-induced movement disorder, was unexpectedly prevalent among the patients; 20 of 420 (4.8%) patients had developed akathisia from an antiemetic drug, prochlorperazine. SIGNIFICANCE OF RESULTS: Diagnosing such adverse drug reactions may be difficult due to complicating factors in cancer treatment, and the inner restlessness observed in akathisia is likely to be regarded as a symptom of a primary psychiatric disorder. The authors suggest that oncologists should optimize the use of antiemetic drugs and be aware of akathisia as a possible complication of cancer treatment.


Subject(s)
Akathisia, Drug-Induced/epidemiology , Antiemetics/adverse effects , Neoplasms/physiopathology , Prochlorperazine/adverse effects , Akathisia, Drug-Induced/etiology , Antiemetics/administration & dosage , Female , Humans , Male , Middle Aged , Palliative Care , Prevalence , Prochlorperazine/administration & dosage , Prospective Studies
12.
BMC Psychiatry ; 7: 64, 2007 Nov 07.
Article in English | MEDLINE | ID: mdl-17986359

ABSTRACT

BACKGROUND: The incidence of suicide has increased markedly in Japan since 1998. As psychological autopsy is not generally accepted in Japan, surveys of suicide attempts, an established risk factor of suicide, are highly regarded. We have carried out this study to gain insight into the psychiatric aspects of those attempting suicide in Japan. METHODS: Three hundred and twenty consecutive cases of attempted suicide who were admitted to an urban emergency department were interviewed, with the focus on psychosocial background and DSM-IV diagnosis. Moreover, they were divided into two groups according to the method of attempted suicide in terms of lethality, and the two groups were compared. RESULTS: Ninety-five percent of patients received a psychiatric diagnosis: 81% of subjects met the criteria for an axis I disorder. The most frequent diagnosis was mood disorder. The mean age was higher and living alone more common in the high-lethality group. Middle-aged men tended to have a higher prevalence of mood disorders. CONCLUSION: This is the first large-scale study of cases of attempted suicide since the dramatic increase in suicides began in Japan. The identification and introduction of treatments for psychiatric disorders at emergency departments has been indicated to be important in suicide prevention.


Subject(s)
Mental Disorders/epidemiology , Suicide, Attempted/psychology , Adult , Age Factors , Aged , Aged, 80 and over , Cross-Sectional Studies , Emergency Service, Hospital/statistics & numerical data , Female , Hospitals, Urban/statistics & numerical data , Humans , Japan , Male , Mental Disorders/ethnology , Middle Aged , Risk Factors , Sex Factors , Suicide, Attempted/ethnology , Suicide, Attempted/statistics & numerical data , Urban Population
13.
Eur J Clin Pharmacol ; 63(11): 991-6, 2007 Nov.
Article in English | MEDLINE | ID: mdl-17701031

ABSTRACT

OBJECTIVE: Neuroleptic malignant syndrome (NMS) is one of the most serious adverse reactions to antipsychotic medications. We accumulated data on Japanese NMS patients and, in a study designed to examine the effects of drug metabolism on the occurrence of NMS, tested the possibility of association between NMS and CYP2D6 polymorphisms. METHODS: We studied 53 patients who had experienced NMS and 112 healthy individuals. We determined what drugs the patients with NMS had been given and retrospectively identified candidates for drugs causing NMS. We screened the prevalence of CYP2D6 genotypes using polymerase chain reaction and restriction fragment length polymorphism analyses. RESULTS: The prevalence of *5 alleles in the group of all patients with NMS was higher than that in the controls, though this difference was not statistically significant (10.4% vs. 5.4%; P = 0.107; odds ratio (OR) 2.05; 95% confidence interval (CI) 0.87-4.80). No association was found between the frequency of *10 alleles and the occurrence of NMS. We found *4 and duplicated alleles in only one patient each among the patients with NMS. A total of 29 patients appeared to have developed NMS as a result of having taking CYP2D6 substrates. The prevalence of *5 alleles in these 29 patient was significantly higher than that in the controls (15.5% vs. 5.4%; P = 0.020; OR 3.25; 95% CI 1.30-8.13). CONCLUSION: Our findings suggest that the CYP2D6*5 allele is likely to affect vulnerability to development of NMS.


Subject(s)
Antipsychotic Agents/adverse effects , Cytochrome P-450 CYP2D6/genetics , Neuroleptic Malignant Syndrome/genetics , Polymorphism, Genetic , Adolescent , Adult , Aged , Alleles , Antipsychotic Agents/pharmacokinetics , Asian People/genetics , Case-Control Studies , Child , Cytochrome P-450 CYP2D6/metabolism , Female , Gene Deletion , Genotype , Humans , Japan , Male , Middle Aged , Odds Ratio , Polymorphism, Restriction Fragment Length , Prevalence , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction
14.
Prog Neuropsychopharmacol Biol Psychiatry ; 31(1): 308-10, 2007 Jan 30.
Article in English | MEDLINE | ID: mdl-16887250

ABSTRACT

Huntington's disease (HD) is a hereditary disorder clinically characterized by involuntary movements, cognitive decline and psychiatric symptoms. We report on a patient with HD, whose involuntary movements and psychiatric symptoms were clinically improved with perospirone, a second-generation antipsychotic agent with antagonistic effects on serotonin 5-HT(2A) and dopamine D(2) (D(2)) receptors, as well as a unique agonistic effect on serotonin 5-HT(1A) (5-HT(1A)) receptors. The fact that perospirone antagonizes D(2) receptors could explain its effects on the hyperkinetic syndrome, while its agonistic effects on 5-HT(1A) receptors may explain the amelioration of psychiatric symptoms (fear and anxiety) in this patient. Future studies would be valuable to elucidate the utility of perospirone for the treatment of involuntary movements and psychiatric symptoms in HD.


Subject(s)
Antipsychotic Agents/therapeutic use , Huntington Disease/drug therapy , Indoles/therapeutic use , Thiazoles/therapeutic use , Aged , Antipsychotic Agents/adverse effects , Anxiety/complications , Anxiety/drug therapy , Dopamine Antagonists/pharmacology , Female , Humans , Huntington Disease/genetics , Huntington Disease/psychology , Indoles/adverse effects , Isoindoles , Mental Disorders/drug therapy , Mental Disorders/etiology , Neuropsychological Tests , Serotonin Antagonists/pharmacology , Thiazoles/adverse effects
15.
Psychiatry Clin Neurosci ; 60(5): 558-62, 2006 Oct.
Article in English | MEDLINE | ID: mdl-16958938

ABSTRACT

Japan has one of the highest suicide rates in the world. Suicides numbered 32,863 in 1998 and have exceeded 30,000 in every subsequent year. Education of those involved in general and psychosocial patient care can contribute greatly to suicide prevention. The authors administered a brief knowledge and attitude assessment questionnaire concerning suicide to students in their first, third, and fifth years at a Japanese medical school. Participants numbered 160 (94 men with a mean age of 21.8 years, SD = 3.01, and 66 women with a mean age of 21.2 years, SD = 2.64); 59 first year, 52 third year, and 49 in their fifth year. The questionnaire consists of eight multiple-choice questions asking knowledge of suicide and one open-ended question asking attitude. In the knowledge part, only about half of the items were answered correctly (mean score was 4.21, SD = 1.28). A significant difference was observed in prevalence of attitudes as categorical variables between student years (P = 0.001). Sympathetic comments increased along with student years, while critical comments decreased. Given the frequent and interventional opportunities of primary-care medical contacts, poor understanding of suicide from the medical viewpoint was of concern. Moreover, judgmental attitudes were common, especially in earlier school years. Better informed, more understanding physicians and other health professionals could contribute greatly to prevention.


Subject(s)
Students, Medical/psychology , Suicide/psychology , Adult , Attitude of Health Personnel , Data Collection , Female , Humans , Japan , Male , Risk Factors , Surveys and Questionnaires , Suicide Prevention
16.
Prog Neuropsychopharmacol Biol Psychiatry ; 30(6): 1170-2, 2006 Aug 30.
Article in English | MEDLINE | ID: mdl-16682107

ABSTRACT

Patients with dementia with Lewy bodies (DLB) are particularly vulnerable to adverse effects of neuroleptics; this sensitivity is included among the clinical diagnostic criteria for DLB. Recently atypical neuroleptics, which carry less risk of extrapyramidal side effects than typical agents, have come into increasing use in treating psychotic symptoms and behavioral disturbances related to DLB. The present report is the first to describe a DLB patient who developed neuroleptic malignant syndrome (NMS) induced by quetiapine, an atypical neuroleptic known to have relatively infrequent extrapyramidal side effects in DLB patients. Physicians should be aware of the possibility of the occurrence of NMS in DLB even when atypical neuroleptics are administered.


Subject(s)
Antipsychotic Agents/adverse effects , Dibenzothiazepines/adverse effects , Lewy Body Disease/complications , Neuroleptic Malignant Syndrome/etiology , Aged , Antipsychotic Agents/therapeutic use , Dibenzothiazepines/therapeutic use , Humans , Lewy Body Disease/drug therapy , Lewy Body Disease/psychology , Male , Neuroleptic Malignant Syndrome/physiopathology , Psychiatric Status Rating Scales , Quetiapine Fumarate
18.
Psychiatry Clin Neurosci ; 59(4): 504-7, 2005 Aug.
Article in English | MEDLINE | ID: mdl-16048458

ABSTRACT

Neuroleptic malignant syndrome (NMS) is a potentially fatal adverse reaction to psychopharmacologic treatment. Reported herein are two NMS patients with schizophrenia who were found to possess a CYP2D6 gene deletion allele (CYP2D6*5). The deletion results in decreased CYP2D6 activity, possibly leading to drug accumulation. Both patients with NMS had been treated with neuroleptics, including CYP2D6 substrates. Polymerase chain reaction (PCR) followed by restriction fragment length polymorphism analyses and long PCR were performed to detect CYP2D6 genotype. One patient was found to possess *5/*10; the other had a *1/*5 genotype. The present preliminary report suggests that pharmacokinetic factors cannot be excluded and the CYP2D6 polymorphism is possibly associated with the etiology of NMS.


Subject(s)
Antipsychotic Agents/adverse effects , Cytochrome P-450 CYP2D6/genetics , Gene Deletion , Neuroleptic Malignant Syndrome/genetics , Adult , Alleles , Antipsychotic Agents/therapeutic use , DNA/genetics , Female , Humans , Male , Middle Aged , Polymorphism, Restriction Fragment Length , Reverse Transcriptase Polymerase Chain Reaction , Schizophrenia/complications , Schizophrenia/drug therapy
20.
Palliat Support Care ; 3(1): 51-3, 2005 Mar.
Article in English | MEDLINE | ID: mdl-16594195

ABSTRACT

OBJECTIVE: Neuroleptic malignant syndrome (NMS) is a life-threatening reaction to neuroleptics. Several prospective studies have reported NMS occurrence rates ranging from 0.07% to 2.2% of patients receiving neuroleptics. However, few occurrences of NMS have been reported in cancer patients despite frequent complications of cancer and its treatment by mental disorders managed with neuroleptic drugs. Exhaustion, dehydration, and malnutrition are considered risk factors for NMS, and cancer patients represent a high risk group for NMS. METHODS: We describe a patient with metastatic chondrosarcoma who had received frequent neuroleptic injections prior to brain surgery and developed NMS in the intensive care unit immediately after surgery. The patient showed delirium, hyperpyrexia, tachycardia, diaphoresis, and extrapyramidal symptoms. After a diagnosis of NMS was made, supportive care and careful monitoring were carried out, and the patient recovered over an interval of 11 days. RESULTS AND SIGNIFICANCE OF THE RESEARCH: Clinical NMS studies have been conducted mainly in psychiatric units, but NMS can occur wherever psychotropic drugs are administered. NMS can be difficult to diagnose due to multiple complicating factors in cancer treatment, but the diagnosis is highly important given the risk of death. Recognition of prodromal NMS symptoms can facilitate actions to decrease morbidity and mortality. It is suggested that special attention to cancer patients undergoing psychopharmacologic treatment is required in clinical oncologic practice.


Subject(s)
Antipsychotic Agents/adverse effects , Brain Neoplasms/drug therapy , Chondrosarcoma/drug therapy , Neuroleptic Malignant Syndrome/diagnosis , Adult , Antipsychotic Agents/administration & dosage , Bone Neoplasms/pathology , Brain Neoplasms/secondary , Brain Neoplasms/therapy , Chondrosarcoma/secondary , Chondrosarcoma/therapy , Diagnosis, Differential , Humans , Male , Neuroleptic Malignant Syndrome/etiology , Neuroleptic Malignant Syndrome/therapy
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