Unusual presentation of basilar artery stroke secondary to patent foramen ovale: a case report.

Introduction: We report a case of a patient presenting with neuropsychiatric manifestations secondary to paradoxical embolism

Case Presentation: Unexplained rapid onset of confusion with amnesia and minimal neurological deficits can be a manifestation of various systemic causes of which stroke, either ischemic or hemorrhagic, is one. Thorough and systematic evaluation of these patients can be highly rewarding in terms of optimizing patient outcome. We report the case of a 45-year-old woman whose initial presentation was with acute onset of confusion, memory loss with personality change and headaches.

Management of heart disease in the elderly in the Plymouth Health District.

In the light of a report from the Royal College of Physicians, the management of heart disease in the elderly (> 70 years) was studied in the Plymouth Health District in 1992. A survey of general practitioners was undertaken to assess how they would handle particular aspects of heart disease in their elderly patients. The admissions of older patients to the coronary care unit following an acute myocardial infarction and their outcome were detailed.

Phaeochromocytoma presenting as acute circulatory collapse and abdominal pain.

Phaeochromocytomas may present as an acute emergency with a perplexing variety of symptoms. We report a case which presented with abdominal pain and severe respiratory distress due to a ruptured haemorrhagic phaeochromocytoma. The severe cardiorespiratory collapse which precipitated admission to the intensive care unit was managed with high doses of dobutamine and noradrenaline and the patient was stable during the operative resection.

The pharmacokinetics and sputum penetration of ampicillin and amoxycillin following simultaneous i.v. administration.

Five patients with exacerbation of chronic bronchitis received as a single iv injection 500 mg of ampicillin and 500 mg of amoxycillin. Blood and sputum samples were collected at timed intervals following dosing and the concentrations of the two antibiotics present in the samples were determined by HPLC analysis. No statistically significant differences were observed between the serum concentrations of ampicillin and amoxycillin, and the pharmacokinetics of the two drugs were almost identical, with half lives of 93 min (amoxycillin) and 103 min (ampicillin).

Thalamic control of dopaminergic functions in the caudate-putamen of the rat--III. The effects of lesions in the parafascicular-intralaminar nuclei on D2 dopamine receptors and high affinity dopamine uptake.

Dopamine receptor binding in the caudate-putamen was studied following bilateral lesions of the thalamostriatal pathway. Receptor binding was assayed using [3H]spiperone and defined with both (+)-butaclamol and S(-)-sulpiride. Radiofrequency lesions resulted in an increase in the Bmax of [3H]spiperone binding defined with both (+)-butaclamol and S(-)-sulpiride between 7 and 14 days following surgery.

Retinal neurotransmission.

The mammalian retina is classically divided into ten layers which contain the neuronal elements identified as photoreceptors, horizontal cells, bipolar cells, amacrine cells and ganglion cells. Using various neuroscientific techniques possible neurotransmitter substances have been assigned to each of these cell types. Thus the localization of transmitter synthesizing enzymes and storage vesicles, the demonstration of release of transmitter in response to specific stimuli, the observation of post-synaptic events mimicked or blocked by the iontophoretic application of exogenous transmitter/agonist or antagonist drug respectively, and the identification of efficient transmitter inactivation mechanisms synaptically add evidence for the association of certain proposed transmitter substances with specific neuronal elements.

Evidence that thalamic efferent neurones are non-cholinergic: a study in the rat with special reference to the thalamostriatal pathway.

Controversy surrounds the question as to whether some fibres of the thalamostriatal projection, are cholinergic. The present experiments show that lesions of the parafascicular-intralaminar thalamus produced no reductions in choline acetyltransferase (ChAT) activities in any area of microdissected rat caudate-putamen complex or dorsolateral frontal cortex. We conclude that thalamostriatal projections are entirely non-cholinergic.

Tyramine-induced noradrenaline release from rat brain slices: prevention by (-)-deprenyl.

Clorgyline (1 and 10 microM) and (+)-deprenyl (10 microM) both significantly potentiated the tyramine (100 microM)-induced release of [3H]-noradrenaline from rat cerebral cortex slices. (-)-Deprenyl (50 microM) significantly reduced it, while lower concentrations had no effect on noradrenaline release. However, in combination, 1 microM (-)-deprenyl blocked the release-facilitating action of 1 microM clorgyline, and 10 microM (-)-deprenyl that of 10 microM (+)-deprenyl.

Studies on the interaction between cerebral 5-hydroxytryptamine and gamma-aminobutyric acid in the mode of action of diazepam in the rat.

The effect of the benzodiazepine, diazepam, administered for 7 days in doses between 1.25 and 5 mg kg-1 was studied on the turnover of 5-hydroxytryptamine (5-HT) in rat cerebral cortex. 5-HT turnover was assessed by calculating the ratio of the concentration of the major metabolite 5-hydroxyindoleacetic acid (5-HIAA) to that of 5-HT (i.

Interactions of dopamine and the release of [3H]-taurine and [3H]-glycine from the isolated retina of the rat.

1 The dose-related, calcium-dependent, potassium-stimulated release of preloaded [(3)H]-dopamine from the superfused rat retina has been demonstrated.2 A high-affinity uptake system for dopamine exists in rat retina in vitro; K(m) value was calculated as 1.89 muM, V(max) value as 1.

An investigation into the interaction between ethanol at low doses and the benzodiazepines nitrazepam and temazepam on psychomotor performance in normal subjects.

Ten healthy male volunteers received, in randomized order, temazepam 20 mg, nitrazepam 5 mg or placebo in combination with ethanol 0.1, 0.2 or 0.

Differential actions of diazepam on the release of [3H]5-hydroxytryptamine from cortical and midbrain raphe slices in the rat.

The possible interaction of the benzodiazepine diazepam with synaptic mechanisms of the central neurotransmitter 5-hydroxytryptamine (5-HT) has been studied in the rat using the superfusion in vitro release technique. The effect of diazepam (1-100 microM) on the spontaneous and potassium-induced release of radioactivity from superfused slices preloaded with [3H]5-HT prepared from cerebral cortex (fronto-parietal) and midbrain raphe region was monitored and compared. The results demonstrate a differential action of diazepam on the release of cortical and raphe 5-HT.

Potassium-stimulated release of radiolabelled taurine and glycine from the isolated rat retina.

The release of preloaded [3H]glycine and [3H]taurine in response to a depolarising stimulus (12.5-50 mM KCl) has been studied in the superfused rat retina. High external potassium concentration immediately increased the spontaneous efflux of [3H]glycine, the effect of 50 mM K+ apparently being abolished by omitting calcium from the superfusing medium.

Behavioural and biochemical changes following chronic administration of L-dopa to rats.

Rats were given powdered diet containing L-DOPA (together with the peripheral decarboxylase inhibitor carbidopa) for a period of 6 months. The estimated daily intake was in the range 20-30 mg/kg. Initially, at 1 week and 1 month, L-DOPA-fed rats exhibited enhanced spontaneous locomotor activity, but this fell to within the control range by 3 and 6 months, although (+)-amphetamine-induced hyperactivity was greater at 6 months in L-DOPA-treated animals than in control rats.

Lesions of the superior colliculus in the rat differentiate between nigrostriatal and mesolimbic dopamine systems.

Bilateral electrolytic lesions of the superior colliculus in rats increased spontaneous locomotor activity, enhanced amphetamine-induced hyperactivity and attenuated apomorphine-induced biting. These lesions were associated with an increased rate of turnover of dopamine in the nucleus accumbens, but not in the striatum. Similarly concentrations of the dopamine metabolites homovanillic acid and 3,4-dihydroxyphenylacetic acid were elevated in accumbens tissue but not in striatum in rats with bilateral collicular lesions.

Dopamine neurones of the ventral tegmentum project to both medial and lateral habenula. Some implications for habenular function.

Using the techniques of microdissection and microradiochemical assay for catecholamines, it has been shown that a specific subgroup of ventral tegmental area (VTA) dopamine neurones project to the medial sector of lateral habenula. In addition a new dopamine pathway, arising from midline VTA neurons, has been shown to project to the medial sector of medial habenular. These findings are discussed and some implications for habenular functions are stated.

Motor effects following application of putative excitatory amino acid antagonists to the region of the mesencephalic dopamine cell bodies in the rat.

The excitatory amino acid antagonists 2-amino-5-phosphonovalerate and gamma-D-glutamylglycine have been applied focally to the ventral tegmental area and both the pars compacta and pars reticulata of the substantia nigra of the rat. The injections were performed under halothane anaesthesia so that behavioural effects could be observed 5 min afterwards. Bilateral application of either antagonist to the ventral tegmental area and the pars compacta of the substantia nigra induced enhanced locomotor activity in an open field.

Increased central 5-hydroxytryptamine receptor mechanisms in rats after chronic neuroleptic treatment.

1 The behavioural responses of drugs known to act through central 5-hydroxytryptamine (5-HT) mechanisms have been investigated in rats receiving a neuroleptic (trifluoperazine) in their drinking water for 4 to 6 months.2 5-Hydroxytryptophan (5-HTP) induced 5-HT-dependent behaviours including head bobbing and lateral head weaving, reciprocal forepaw treading, tremor, backward walking, body writhing and ;wet-dog' shakes. In doses of 50 to 150 mg/kg, 5-HTP induced more intense behavioural effects in neuroleptic-treated rats than in the control animals.

A comparison of stereospecificity at central and peripheral 'muscarine-sensitive' acetylcholine receptors: observations with the enantiomeric forms of procyclidine and tricyclamol.

1 Procyclidine resembles hyoscine in enhancing the effects of amphetamine on ipsiversive turning by mice with a unilateral central dopamine lesion. 2 The stereospecific index for procyclidine is not greater than 10, in contrast to 173 for acetylcholine receptors in ileum from the same mice. 3 This suggests that although the central effects of procyclidine in this test involve acetylcholine receptors similar to those at peripheral sites, they cannot be identical with them unless there are differences at some secondary site, for example, if the weaker enantiomer were a stronger inhibitor of dopamine uptake or if there were a stereoselective uptake process for procyclidine itself.