The effect of typical and atypical antipsychotic drugs on the mRNA expression of rat mesencephalic D2 receptor

Recently various types of dopamine receptors have been proved to exist in human central nervous system. And the understanding of the of specific function is expected to improve therapeutic effect as well as to reduce undesirable side-effect of current antipsychotic and antiparkinson treatment. Since the dopamine autoreceptor is known to be more sensitive to dopaminergic drugs, there is a growing concern about its functional role in neuropsyhiatric disease. Besides ligand binding studies, recent advances in molecular biology make it possible to quantitate mRNA coding for specific receptors which gives more direct information about its rate of synthesis at the gene level. It is documented that chronic antipsychotics treatment enhances the sensitivity of dopamine autoreceptor, but changes in its mRNA expression have never been investigated yet. Using male Sprague-Dawley rats, 6-hydroxydopamine was injected into left median forebrain bumdle to test whether D2 receptoe mRNA found in midbrain is coding for autoreceptors. And antipsychotic drugs, haloperidol, sulpiride, and clozapine, were administered daily for 2 weeks in order to evaluate their effect on dopamine autoreceptor mRNA, expression. The quantitation of mRNA expression was performed using ribonuclease protection assay. After 6-hydroxydopamine injection, significant reduction in D2, both D2L and D2S, receptor mRNA expression was observed in left midbrain compared with right side. The ratios of D2L/beta-actin and D2S/beta-actin- mRNA in left midbrain were 23.3% and 21.6% of that in right side respectively. Significant expression was demonstrated after repetitive haloperidol and sulpiride, but not after clozapine treatment ; D2S mRNA was increased after haloperidol treatment, while sulpiride enhanced D2L mRNA expression. However, the relative ratio of D2L and D2S mRNA expression in rat midbrain was not changed after repetitive administration of antipsychotic drugs used in this study. These result suggest ; first, the major proportion of mesencephalic D2 receptor mRNA is coding for autoreceptor ; second, the D2 receptor mRNA expression is increases after chronic haloperidol and sulpiride, ut not after clozapine treatment, which may be related to development of extrapyramidal side to alter the relative ratio of D2L and D2S mRNA expression in rat midbrain.

Clinical features of olivary hypertrophic degeneration in brain magnetic resonance image

Olivary hypertrophic degeneration (OHD) is caused by lesions in dentato-rubro-olivary pathway(myoclonic triangle) and responsible for palatal myoclonus and other involuntary movements. We report the clinical features and magnetic resonance imaging(MRI) findings of 5 patients with OHD. All patients had previous brainstem hemorrhage mainly involving pontine tegmentum in four patients and right superior cerebellar peduncle in one patient T2-weighted MR] revealed round or oval shaped high signal area in the ventral or ventrolateral portion of the medulla. Their clinical presentations were as followings: palatal myoclonus (4 case), ocular myoclonus (3 case), pharyngeal and laryngeal myoclonus (2 case), limb myoclonus (2 case), head shaking (I case) and perioral tremulous movement (1 case). The frequency of myoclonus was 70-170/minute and the median time interval between the insult of the primary lesion and the onset of myoclonic symptoms was 2 months. OHD shown as hyperintense lesions on T2 weighted MRI should be differentiated from ischemic, neoplastic or other pathologic lesions. The characteristic clinical presentations and the location of primary lesions involving myoclonic triangle may be helpful in differential diagnosis from primary medullary lesions.

Choreoathetosis after cardiopulmonary bypass with deep hypothermia

A 9-year-old boy showed orofacial dyskinesia and psychic symptoms shortly after open heart surgery with deep hypothemia and cardiopulmonary bypass for congenital cyanotic heart disease. The choreothetosis progressed to be generalized and accompanied by mental deterioration. This involuntary movement partially responded only to repetitive administration of sedatives. After 3 month the patient expired with sudden development of ventricular tachycardia and cardiogenic shock.

Intra-carotid thrombolytic therapy in acute ischemic stroke of carotid arterial territory

Intra-carotid urokinase (UK) infusion in 20 patients with acute internal carotid artery (ICA) territorial ischemic stroke achieved immediate recanalization in 45% and the clinical outcome in patients with recanalization was superior to that of patients without recanalization. The procedure was most effective in patients with smaller arterial occlusions: 7 of 10 patients with MCA branch occlusions (M2 to M4) achieved recanalization compared to only 2 of 10 with distal ICA or M1 occlusions, which should be an important issue for the critical evaluation of the efficacy of thrombolytic therapy (TT). Hemorrhagic transformation was observed in 9 patients on CT scan; petechial hemorrhage in 5 and intraparenchymal hematoma formation in 4. Among 4 patients with hematoma formation, clinical deterioration was seen in 3 cases and the angiography at the immediate end of the UK infusion showed recanalization in only one patient. The average dose of UK in patients with parenchymal hematoma formation was higher than that of patients without hemorrhagic transformation (123.3 x 10(4) units vs 101 x 10(4) units). The administration of a large dose of UK, probably more than 100 x 10(4) units, and the absence of immediate recanalization seemed to increase the risk of parenchymal hematoma formation. Despite the effort of investigators, the in-hospital time delay for the TT was significant which was mainly related to the time consuming preparation for angiography especially during night. A more effective system for the earlier intervention of acute ischemic stroke needs to be developed.

A Clinical Features of Recurrent Cerebrovascular Accidents

Despite of high recurrenre rate of oerebrovascular accidents(CVA), little attntion had been given to the features of its' recurrence. Of 167 patients with recurrent CVA between March, 1985 and Febnuary, 198.103 patients wer included in this study. Sixty of them were men and 43 of them were women, Their ages ranged from 29 to 8 years(mean. 6.5 ears), with the peak inidence in the sixth and seventh decades .The mean interval between first and second CVA was 23.4 months(range, 1to 144 months) Eighty-one patients had at least more tha one of isk factors, but onl 3 had been received proper treatment. There were tendencies to recur same type and site with the first attack, The patient with history of heart disase. Abnormal eletrocardiographic features, increased fasting bloo sugar(p<0.01), high diastolic bloo pressres (p<0.05)had poo prognois And, the patients ith embolism or hemorrhage revealed poo prognosis than the patients with trombosis(p<.05).