The Effect of Carbamazepine-Controlled Release on the Congnitive Function

We evaluated the effect of carbamazepine-controlled release (CR) on the cognitive function. By using monotherapy study, we investigated the effects of carbamazepine on cognitive function in 10 epileptic patients and 17 normal controls. The evaluations were conducted before and one and six months after therapy using neuropsychological batteries(BUSCHKE SELECTIVE REMINDING TEST BSRT, REY OSTERRIETH COMPLEX FIGURE TEST ROCFT, CONCENTRATION ENDURANCE TEST d2 test, REY VISUAL DESIGN LEARNING TEST RVDLT, FINGER TAPPING TEST). In the patients treated with carbamazepine-CR monotherapy, follow up studies were made in one and six months later, respectively. It was found that the cognitive function determined in the three tests(consistent long-term retrieval : one item of BSRT, d2 test, and ROCFT : P 0.05). The mean anticonvulsant blood levels on the day of cognitive function tests were 6.48mg/ml (SD=l. 87) and 6.53mg /ml (SD=l.97) in one and six months respectively. This study showed carbamazepine-CR monotherapy had an adverse effect on the cognitive function.

Clinical Profile and Localization of Ataxic Hemiparesis as a Lacunar Syndrome

Ataxic hemiparesis is a stroke syndrome in which the main features are unusual combination of weakness and cerebellar-like ataxia involving the limb on the same side. We describe an analysis of 17 patients with ataxic hemiparesis who underwent magnetic resonance imaging or computed tomography. Ten patients had lacunar infarction in the contralateral pons. In six, lesions were found in the contralateral thalamus and the posterior limb of internal capsule. In one patient, infarct was located in the contralateral midbrain, They showed different clinical manifestations depending on the sites of lesion. This study may suggest that variable sites of lesion can cause ataxic hemiparesis and different clinical manifestations.

A Clinico-Radiological Analysis of the Lacunar Infarction

Lacune is small infarct located in the deeper part of the brain and developed by occlusion of small branch of the large cerebral arteries. It occupies 10-30% of infarction in western countries but 53.1% in our study. We investigated 181 cases of lacunar infarction confirmed by clinical features and neuroimaging study. We analyzed lacunar stroke into 13 groups of symdrome based on the clinical features. The frequent lacunar syndromes were pure motor stroke (35.4%), sensori-motor stroke (26.5%), ataxic hemiparesis (11.6%), and pure sensory stroke (6.1%). The frequent sites for lacune were pons (25.4%), corona radiata (24.9%), and thalamus (18.2%). The major contributing risk factors were hypertension (65.8%) and diabetes (19.3%). The incidence of multiple lacune was 67.4%. The determining factor for clinical presentation of lacune was not the size of lesion but the location of lesion.

The Effect of MPTP in The Mouse Brain in Relation to Aging: Immunocytochemical Analysis

The effect of MPTP on catecholamine neurons in young (4-6 weeks) and aging (10-12 months) C57BL/6 mice was studied using immunocytochemical techniques. Both groups of mice received 4 repeated dosages of 10mg/kg of MPTP given 12 hours apart. We compared the number of tyrosine hydroxylase (TH)-positive cell bodies using immunocytochemical technique in substantia nigra (SN), ventral tegmental area(VTA) and locus ceruleus (LC) 7 days after the last injection of MPTP. There was a significant decrease in the number of TH-positive cell bodies in the SN of young mice, but not in VTA or LC. In aging mice, there was a significant decrease in the number of TH-positive cell bodies in VTA as well as in SN. It is concluded that aging mice are more sensitive to MPTP and show more widespread damage in the catecholamine neurons than young mice, suggesting that MPTP-treated aging mice provide a more useful model for studing anatomical characteristics of Parkinson's disease than young mice.

Behavioral and Histochemical Changes in MPTP-treated C57BL/6 Mice: A Model for Parkinson's Disease

The effects of 1-methyl-4-phenyl-1, 2. 3, 6-tetrahydropyridine (MPTP) on behavioral and histochemical changes were investigated in C57BL/6 mice. For immunocytochemis try, one group of mice received a dose of 2X30mg/kg of MPTP given 12hours apart and the other group 30mg/kg/day of MPTP for 7days. Locomotor activit,v was measured during 120minutes after a single injection of 30mg/kg of MPTP. We compared the numbers of tyrosine hydroxylase (TH)-positive cell bodies using immunocytochemical technique in the substantia nigra, ventral tegmental area and locus ceruleus 10 days after the last injection of MPTP. There was a significant decrease in locomotor activity during 100minutes after injection of MPTP and the number of TH-positive cell bodies in the substantia nigra of the mice which received the dose of 30mg/kg/day for 7 days, but not in the ventral tegmental area or the locus ceruleus. But 30mg/kg of MPTP given 12 hours apart failed to produce a significant decrease in the number of TH-positive cell bodies in any three catecholamine nuclei examined. It is concluded that MPTP-treated C57BL/6 mice provide a useful model for studying characteristics of Parkinson's disease and the dose of 30mg/kg/day for 7 days is more effective in the animal model for Parkinson s disease in C57BL/6 mice.

POEMS syndrome: a case report

POEMS syndrome is a multisystem disorder associated with polyneuropathy, organomegaly, endocrinopathy, a monoclonal protein (M-protein), and skin changes. The authors describe a patient with POEMS syndrome who had osteosclerotic myeloma confirmed by open bone biopsy. Magnetic resonance imaging (MRI) showed discrete lesions of low signal intensity in both T1 and T2-weighted images. This patient is now being successfully treated with melphalan and prednisone with much improvement in skin thickening and sensory change in the lower extremities.

The Diagnosis of Tuberculous Meningitis by Polymerase Chain Reaction

Polymerase chain reaction (PCR) method is a proced.ure for in vitro enzymatic ampli fication of a specific segment of DNA. PCR method was used to detect any M. tuberculi DNA in the 16 cerebrospinal fluid specimens from 6 patients clinically diagnosed as tuberculous meningitis. We synthesized two oligonucleotide primers derived from the sequence of a gene that codes for the 65-kilodalton antigen of M. tuberculosis. The amplified 165bp genomic DNA of M. tuberculosis was detected in 3 specimens (18.5%) with polyacrylamide gel electrophoresis. A following southem blot analysis confirmed these mycobacterial DNAs and detected another amplified DNA (25%) that was not seen on the polyacrylamide gels. Conventional detection methods such as smear and culture for M. tuberculosis found these specimens to be negative. Now we recommend PCR and combined southem blot analysis as a useful tool for early and rapid diagnosis of tuberulous meningitis.

A Case of Crossed Aphasia in a Dextral

A strictly right handed patient showed aphasia and left hemiplegia following a deep infarct of the right hemisphere. He had no personal or family history o{ left-handedness. His aphasia was persistent and global in nature without right limb apraxia which was tested by serial Modified Western Aphasia Battery There was a deep subcortical infarc tion of the territoy supplied by the right middle cerebral artery without any lesion or .perfusion defect in the left hemisphere on brain CT and SPECT. The frequency of persistent aphasia in the right hemispheric lesion in dextrals has been known to be very low and there was no reported case in Korea So we report a case of crossed aphasia in a dextral with review of literature.

Mesencephalothalamic Lacunar Syndrome Due to Neurocysticercosis

A 45-year-old male with meningeal neurocysticercosis presented with mesence-phalothalamic syndrome as a variant of lacunar syndrome. Brain magnetic resonance imaging showed bilateral paramedian thalamic and mesencephalic infarction with cystic dilatation of the third ventricle. Cerebrospinal fluid analysis confirmed the diagnosis as it showed active inflammation and positive immunologic reactions to cysticercosis.