The exact pathophysiologic mechanisms of spasmodic torticollis and other idiopathic torsion dystonias remain largely unknown. Thus, a variety of drugs have been used alone or in combination on an empirical basis to treat these disorders, but to date none have efficacy that is proven and consistent. The drugs in use include anticholinergics, benzodiazepines, dopaminergics and dopamine antagonists with variable degrees of clinical improvement. Botulinum toxin A injection treatment for spasmodic torticollis is safe and efficacious with minimal adverse effect. However, it is expensive and beneficial effects are short-lasting. Only when a spasmodic torticollis patient's symptoms are refractory to combined treatment, using various drugs and Botulinum toxin injections, should the patient be considered a candidate for neurosurgical procedures.
Benzodiazepines/therapeutic use ; Botulinum Toxins/*therapeutic use ; Dopamine Agents/therapeutic use ; Dopamine Antagonists ; Human ; Parasympatholytics/therapeutic use ; Spasm/*drug therapy ; Torticollis/*drug therapy

Dopamine ; therapeutic use ; Hepatorenal Syndrome ; blood ; therapy ; Humans ; Liver Transplantation ; Vasoconstrictor Agents ; therapeutic use

BACKGROUNDInconsistencies in the use of the vasoactive agent therapy to treat shock are found in previous studies. A descriptive study was proposed to investigate current use of vasoactive agents for patients with shock in Chinese intensive care settings.

METHODSA nationwide survey of physicians was conducted from August 17 to December 30, 2012. Physicians were asked to complete a questionnaire which focused on the selection of vasoactive agents, management in the use of vasopressor/inotropic therapy, monitoring protocols when using these agents, and demographic characteristics.

RESULTSThe response rate was 65.1% with physicians returning 586 valid questionnaires. Norepinephrine was the first choice of a vasopressor used to treat septic shock by 70.8% of respondents; 73.4% of respondents favored dopamine for hypovolemic shock; and 68.3% of respondents preferred dopamine for cardiogenic shock. Dobutamine was selected by 84.1%, 64.5%, and 60.6% of respondents for septic, hypovolemic, and cardiogenic shock, respectively. Vasodilator agents were prescribed by physicians in the management of cardiogenic shock (67.1%) rather than for septic (32.3%) and hypovolemic shock (6.5%). A significant number of physicians working in teaching hospitals were using vasoactive agents in an appropriate manner when compared to physicians in nonteaching hospitals.

CONCLUSIONSVasoactive agent use for treatment of shock is inconsistent according to self-report by Chinese intensive care physicians; however, the variation in use depends upon the form of shock being treated and the type of hospital; thus, corresponding educational programs about vasoactive agent use for shock management should be considered.

Data Collection ; Dobutamine ; therapeutic use ; Dopamine ; therapeutic use ; Humans ; Intensive Care Units ; statistics & numerical data ; Norepinephrine ; therapeutic use ; Shock ; drug therapy ; Shock, Cardiogenic ; drug therapy ; Shock, Septic ; drug therapy ; Surveys and Questionnaires ; Vasoconstrictor Agents ; therapeutic use ; Vasodilator Agents ; therapeutic use

This report describes the efficacy of combined use of aripiprazole in the treatment of a patient with clozapine induced enuresis. Aripiprazole acts as a potential dopamine partial agonist and the dopamine blockade in the basal ganglia might be one of the causes of urinary incontinence and enuresis. We speculate that aripiprazole functioned as a D2 agonist in hypodopaminergic state of basal ganglia caused by clozapine and maintained dopamine level that would improve enuresis ultimately.
Adult ; Antipsychotic Agents/*adverse effects ; Clozapine/*adverse effects ; Dopamine/metabolism ; Dopamine Agonists/*therapeutic use ; Drug Therapy, Combination ; Enuresis/chemically induced/*drug therapy ; Humans ; Male ; Middle Aged ; Piperazines/*therapeutic use ; Quinolones/*therapeutic use ; Schizophrenia, Paranoid/drug therapy

BACKGROUND/AIMS: It is unknown whether the prokinetics improve the quality of life in patients with functional dyspepsia. Thus, we evaluate the effect of the mosapride, selective 5-HT4 agonist, on the symptom and life quality of patients with functional dyspepsia using the Nepean dyspepsia index-Korean version (NDI-K), a reliable and validated disease-specific quality of life questionnaire. METHODS: A single, open trial was performed in 129 patients with functional dyspepsia. Patients were received mosapride 5 mg t.i.d before each meal for 4 weeks. The symptoms and quality of life were measured with the NDI-K at baseline and 4 weeks. The responsiveness of the NDI-K was evaluated by correlation with symptom scores. RESULTS: All the 15 symptom scores and the dyspepsia score decreased after treatment (p<0.05). The total symptom score decreased from 60.9 +/- 25.8 to 24.7 +/- 20.4 (p=0.001). Correlations were observed between the total symptom score and the NDI-K score (r=0.47, p=0.001), and between the total symptom score and each score in 5 subscales (r=0.25-0.44, p=0.001). The NDI-K score was significantly increased in the effective group whose dyspepsia score decreased more than 50% of the score at baseline, compared with that of ineffective group. Any significant adverse effect and prolongation of QT interval were not occurred in all patients. CONCLUSIONS: A prokinetic drug, mosapride improves the symptoms and the quality of life in patients with functional dyspepsia.
Adult ; Aged ; Benzamides/*therapeutic use ; Dopamine Antagonists/*therapeutic use ; Dyspepsia/diagnosis/*drug therapy ; English Abstract ; Female ; Gastrointestinal Agents/*therapeutic use ; Humans ; Male ; Middle Aged ; Morpholines/*therapeutic use ; *Quality of Life ; Questionnaires

PURPOSE: Levodopa is the most effective anti-Parkinsonian agent. It has also been known to exhibit analgesic properties in laboratory and clinical settings. However, studies evaluating its effects on neuropathic pain are limited. The aim of the present study was to examine the anti-allodynic effects of levodopa in neuropathic rats. MATERIALS AND METHODS: Sprague-Dawley male rats underwent the surgical procedure for L5 and L6 spinal nerves ligation. Sixty neuropathic rats were randomly divided into 6 groups for the oral administration of distilled water and levodopa at 10, 30, 50, 70, and 100 mg/kg, respectively. We co-administered carbidopa with levodopa to prevent peripheral synthesis of dopamine from levodopa, and observed tactile, cold, and heat allodynia pre-administration, and at 15, 30, 60, 90, 120, 150, 180, and 240 min after drug administration. We also measured locomotor function of neuropathic rats using rotarod test to examine whether levodopa caused side effects or not. RESULTS: Distilled water group didn't show any difference in all allodynia. For the levodopa groups (10-100 mg/kg), tactile and heat withdrawal thresholds were increased, and cold withdrawal frequency was decreased dose-dependently (p<0.01). In addition, levodopa induced biphasic analgesia. Different dosage of levodopa did not impact on the rotarod time (p>0.05). CONCLUSION: Levodopa reversed tactile, cold and heat allodynia in neuropathic rat without any side effects.
Animals ; Carbidopa/administration & dosage/adverse effects/therapeutic use ; Dopamine Agents/administration & dosage/adverse effects/*therapeutic use ; Hyperalgesia/*drug therapy ; Levodopa/administration & dosage/adverse effects/*therapeutic use ; Male ; Neuralgia/*drug therapy ; Rats ; Rats, Sprague-Dawley ; Rotarod Performance Test

Adenoma ; complications ; pathology ; Adult ; Antipsychotic Agents ; adverse effects ; therapeutic use ; Aripiprazole ; Benzodiazepines ; adverse effects ; therapeutic use ; Bromocriptine ; adverse effects ; therapeutic use ; Dopamine Antagonists ; adverse effects ; therapeutic use ; Female ; Hormone Antagonists ; adverse effects ; therapeutic use ; Humans ; Hyperprolactinemia ; complications ; etiology ; Piperazines ; adverse effects ; therapeutic use ; Pituitary Neoplasms ; complications ; pathology ; Quinolones ; adverse effects ; therapeutic use ; Risperidone ; adverse effects ; therapeutic use ; Schizophrenia ; drug therapy ; etiology ; pathology ; Serotonin Antagonists ; adverse effects ; therapeutic use ; Trifluoperazine ; adverse effects ; therapeutic use

PURPOSE: We investigated what kinds of neurotransmitters are related with electroacupuncture (EA) analgesia in an arthritic pain model of rats. MATERIALS AND METHODS: One hundred rats were assigned to six groups: control, EA, opioid, adrenergic, serotonin and dopamine group. A standardized model of inflammatory arthritis was produced by injecting 2% carrageenan into the knee joint cavity. EA was applied to an acupoint for 30 min in all groups except fo the control group. In the opioid, adrenergic, serotonin and dopamine groups, each receptor antagonist was injected intraperitoneally to their respective group before initiating EA. RESULTS: In the opioid receptor antagonist group, adrenergic receptor antagonist group, serotonin receptor antagonist group, dopamine receptor antagonist group and the control group weight-bearing force decreased significantly from 30 min to 180 min after EA in comparison with the EA group. CONCLUSION: The analgesic effects of EA are related to opioid, adrenergic, serotonin and dopamine receptors in an arthritic pain model of rats.
Acupuncture Analgesia/*methods ; Adrenergic Antagonists/therapeutic use ; Animals ; Arthritis/chemically induced/drug therapy/physiopathology/*therapy ; Carrageenan/toxicity ; Dopamine Antagonists/therapeutic use ; Electroacupuncture/*methods ; Male ; Neurotransmitter Agents/*metabolism ; Pain/drug therapy/metabolism ; Rats ; Rats, Sprague-Dawley ; Receptors, Adrenergic/metabolism ; Receptors, Dopamine/metabolism ; Receptors, Opioid/antagonists & inhibitors/metabolism ; Receptors, Serotonin/metabolism ; Serotonin Antagonists/therapeutic use

OBJECTIVETo study the protective effects of triptolide (Tri) on the lipopolysaccharide (LPS)-mediated degeneration of dopaminergic neurons in substantia nigra.

METHODSForty SD rats were randomly divided into four groups: the sham group, the LPS model group, the Tri group and the normal saline group, 10 in each group. Fourteen days later, the apomorphine-induced rotational behavior, the content of dopamine (DA) and its metabolites in the striatum of the injured side, the number of tyrosine-hydroxylase (TH) positive neurons and activation of microglia in rats were observed.

RESULTSInjection of LPS in substantia nigra could induce cerebral simulated immunoinflammatory reaction, leading to degeneration of dopaminergic neuron and induce ipsilateral directed rotational behavior of rats, which could be improved by Tri. Moreover, Tri could raise the lowered content of DA and its metabolites as well as the TH positive neurons in striatum, and suppress the activation of microglia significantly (P<0.01).

CONCLUSIONTri could protect the dopaminergic neurons from degeneration due to the inflammation mediated by LPS through inhibiting the activation of microglia.

Animals ; Diterpenes ; pharmacology ; therapeutic use ; Dopamine ; metabolism ; Epoxy Compounds ; pharmacology ; therapeutic use ; Female ; Inflammation Mediators ; pharmacology ; therapeutic use ; Lipopolysaccharides ; Neurons ; pathology ; Neuroprotective Agents ; pharmacology ; therapeutic use ; Parkinsonian Disorders ; chemically induced ; drug therapy ; pathology ; Phenanthrenes ; pharmacology ; therapeutic use ; Phytotherapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Substantia Nigra ; pathology

OBJECTIVETo discuss the standards for clinical functional gradation and preoperative preparation of pheochromocytoma.

METHODSAccording to the preoperative clinical manifestations and 24 hr urine catecholamine, 172 cases of pheochromocytomas were divided into 4 grades. Functionary grade 0 including 22 patients was given no volume expansion. Functionary Grade 1 consisted of 17 cases, 10 of which were given phenoxybenzamine orally 5 - 10 mg/d for 1 week (therapeutic group), the rest were control group; the results were analyzed by the chi(2) test. Functionary Grade 2 including 120 patients had phenoxybenzamine orally 30 - 240 mg/d for 4 weeks, hemodynamics and microcirculation image were standards for evaluating volume expansion. Functionary Grade 3 consisted of 13 patients including 1 with acute heart failure, 2 and 10 patients with past history of cerebral hemorrhage and hypertensive crisis respectively, they were treated with enough phenoxybenzamine and other emergent measures.

RESULTSThe perioperative blood pressure of Functionary Grade 0 had no fluctuation. The blood pressure of therapeutic group of Functionary Grade 1 had small range fluctuation (< 20 mm Hg), that of the control group was large (> 40 mm Hg). Chi(2) = 13.12, P < 0.01. The hemodynamics of Functionary Grade 2 and Grade 3 recovered within 24 hours postoperatively and no complications occurred.

CONCLUSIONAccording to the function of pheochromocytoma, it is safe and efficient to use different preoperative preparations. Hemodynamics and microcirculation image are golden standards for evaluating preoperative preparations.

Adrenal Gland Neoplasms ; diagnosis ; surgery ; Adult ; Blood Pressure ; Dopamine ; blood ; Epinephrine ; blood ; Female ; Humans ; Male ; Monitoring, Intraoperative ; Norepinephrine ; blood ; Phenoxybenzamine ; therapeutic use ; Pheochromocytoma ; diagnosis ; surgery ; Premedication ; Preoperative Care ; standards ; Vasodilator Agents ; therapeutic use