Pharmacotherapy of bipolar disorder is a rapidly evolving field. Mood stabilizers and anticonvulsants have varying biochemical profiles which may predispose them to different adverse effects and drug-drug interactions. Several of the new anticonvulsants appear less likely to have the problems with drug-drug interaction. To provide more effective combination pharmacotherapies, clinicians should be allowed to anticipate and avoid pharmacokinetic and pharmacodynamic drug-drug interactions. We reviewed the role of cytochrome P450 isozymes in the metabolism of the drugs and their interactions. The drug-drug interactions of several classes of drugs which used as mood stabilizers and new anticonvulsants, some of which may have psychotropic profiles, are discussed mainly in this article. Finally, potential pharmacokinetic interactions between the benzodiazepines and other coadministered drugs are discussed briefly.
Anti-Anxiety Agents* ; Anticonvulsants ; Benzodiazepines ; Bipolar Disorder ; Cytochrome P-450 Enzyme System ; Drug Therapy ; Isoenzymes ; Metabolism

Phosphoinositide-specific Phospholipase C (PI-PLC) is a second messenger of signal transducer on cell membrane. In the previous study, PLC of bovine brain has been purified three isozymes. In this paper, uterus and seminal vesicle have been purified. Two peaks of PI-PLC activity were resolved when bovine uterus and seminal vesicle proteins were chromatographed on a DEAE and phenyl TSK 5PW HPLC column. Each two peak was compared with PI-PLC I, II and III from bovine brain and we got the retention time on HPLC. The peak fractions with PLC activity were tested homogeneity with brain PLC monoclonal antibodies (Mab). Mab-labeled affigels were bounded in the range of 73.8%~97.5% with PLC I, II and III. Homogeneity of fractions were revealed that DEAE F-1 and phenyl F-1-I were highest level of PLC III in uterus and seminal vesicle and DEAE F-2 and phenyl F-2-I were mixed PLC I and II.
Antibodies, Monoclonal ; Brain* ; Cell Membrane ; Chromatography, High Pressure Liquid ; Isoenzymes* ; Phospholipases* ; Second Messenger Systems ; Seminal Vesicle Secretory Proteins ; Seminal Vesicles* ; Transducers ; Type C Phospholipases* ; Uterus*

Mental illnesses were understood for centuries as affliction of spirit or mind. There were many efforts to reveal the nature of mind. In the past century, however, physicians recognized that psychiatric disorders are primarily diseases of the brain and that many mental illnesses are caused by abnormalities in the brain. For the evolution and development of psychiatry in the New Millenium, understanding the relationship between the brain and mind is inevitable. To understand the nature of mind, we must understand the nature of brain. The more we know the brain, the better understood are the truth of mind and it's disorders.
Brain Diseases* ; Brain*

Four cases of intracerebral hemorrhage remote from the site of initial supratentorial craniotomy are presented. Traumatic cases are excluded in this report and all cases developed after uneventful elective craniotomy. Two patients had ruptured aneurysm and the other two had giant supratentorial tumors, one craniophayrngioma and one ependymoma. All patients were operated on supine position and no patient had preoperative hypertension. Two had hematoma in the sucortical white matter, one in the cerebellar hemisphere and the other one showed hematoma both in the cerebellar hemisphere and the supratentorial subcortical area. The size of hematoma ranged from 8-20cc in volume. No definite cause could be found except one in which the blood pressure was transiently elevated during induction of anesthesia. A possible cause might be the sudden changes of blood pressure during induction and recovery from anesthesia, overdrainage of CSF, continuous CSF drainage and sudden changes in intracranial dynamics by removal of a huge intracranial mass. One patient with intracerebellar hemorrhage needed emergency suboccipital craniectomy for removal of the hematoma. One patient shows no improvement due to aspiration pneumonia and subsequent lung abscess. Although rare, these conditions may occur after any craniotomy and surgeons should always be alert to the possibilities of such comlication, especially when intracranial pressure(ICP) was elevated.
Anesthesia ; Aneurysm, Ruptured ; Blood Pressure ; Cerebral Hemorrhage ; Craniotomy ; Drainage ; Emergencies ; Ependymoma ; Hematoma* ; Hemorrhage ; Humans ; Hypertension ; Lung Abscess ; Pneumonia, Aspiration ; Supine Position ; Supratentorial Neoplasms

OBJECTIVE: A Comparison of QTc prolongation for various antipsychotics and an analysis of QTc prolongation for the various types of serotonin transporter polymorphism were performed. METHOD: EKG was checked, followed by QTc measurement as Bazett's correction, and the serotonin transporter polymorphism was examined in 110 chronic schizophrenia patients were performed EKG before 24 weeks ago. We defiened QTc prolongation as over 450ms. The risk factor of sudden cardiac death were defiend as QTc prolongation and or 60ms in delta value. RESULT: The prevalence of QTc prolongation in this study was 7.3%, and the prevalence of over 60ms was 4.5%. Patients who had the risk factors were 10(9.1%). 6/52 who prescribed atypical antipsychotics and 2/58 who prescribed haloperidol showed QTc prolongation. The prevalence who had the risk factor of sudden cardiac death were 16% in atypical antipsychotics group, 3.4% in haloperidol group. QTc prolongation were observed more frequently in l/l type than s/s type. l allele frequency were 50% in QTc prolongated group, 19% in not prolongated group. l allele had an association with QTc prolongation(p<0.01). CONCLUSION: The prevalence of QTc prolongatin was frequent in chronic schizophrenia patients who were prescribed atypical antipsychotics. It has strong association with l allele of 5-HTTLPR.
Alleles ; Antipsychotic Agents ; Death, Sudden, Cardiac ; Electrocardiography ; Gene Frequency ; Haloperidol ; Humans ; Prevalence ; Risk Factors ; Schizophrenia ; Serotonin Plasma Membrane Transport Proteins

OBJECTIVES: The purpose of present study was to determine the prevalence rate of tardive dyskinesia and to search for its risk factors in chronically institutionalized schizophrenic subjects. We also examined the relationship between tardive dyskinesia and both negative symptoms and cognitive impairments in the same subjects. METHODS: Subjects were 271 in-patients (174 males, 97 females) at Masan Dongsuh Hospital. They met DSM-IV criteria for schizophrenia and had been taking fixed doses of antipsychotics for at least 3 months. Tardive dyskinesia was assessed by Abnormal Involuntary Movement Scale (AIMS). Cases of tardive dyskinesia were ascertained by the criteria of Schooler and Kane (1982) and DSM-IV. The rating of psychopathology was acquired using Brief Psychiatric Rating Scale (BPRS) and Schedule for the Deficit Syndrome (SDS) and the assessment of cognitive function using Mini-Mental State Examination (MMSE). RESULTS: The prevalence of tardive dyskinesia is 50.9% and the frequency of tardive dyskinesia was high est in male above the age of fifty. But there was no statistically significant relationship between the frequency of tardive dyskinesia and both the length of hospitalization and the daily dose of antipsychotics. The frequency order of abnormal movement in the patients with tardive dyskinesia was as follows: tongue, upper extremities, lips and perioral area. We couldn't find any significant difference in the total and subscale scores of BPRS between the groups with and without tardive dyskinesia. There were no differences in MMSE scores between the groups with and without tardive dyskinesia. CONCLUSION: This study gave us that the prevalence of tardive dyskinesia was high in chronically institutionalized schizophrenic inpatients and that age was the most significant risk factor of tardive dyskinesia. The relationship between tardive dyskinesia and both negative symptoms and cognitive impairment, however, was not revealed.
Antipsychotic Agents ; Appointments and Schedules ; Brief Psychiatric Rating Scale ; Diagnostic and Statistical Manual of Mental Disorders ; Dyskinesias ; Hospitalization ; Humans ; Inpatients ; Lip ; Male ; Movement Disorders* ; Prevalence ; Psychopathology ; Risk Factors ; Schizophrenia ; Tongue ; Upper Extremity

OBJECTIVES: Much interest has recently been focused on the possibility of the involvement of unstable DNA in the etiology of schizophrenia following several publications that reported increases in frequency of large CAG repeats in affected individuals. Tardive dyskinesia(TD), an involuntary movement disorder following pharmacological treatment of schizophrenia, shares a great deal of common clinical and biological features with Huntington's disease, a representative movement disorder with CAG repeat expansions. The authors studied for a possible CAG repeat expansions in patients with schizophrenia and TD. METHODS: TD was diagnosed by the Abnormal Involuntary Movement Scale. Using repeat expansion detection(RED), a method in which a thermostable ligase is used to detect repeat expansions directly from genomic DNA, subjects with schizophrenia with/without TD(n=79/n=75) and normal controls (n=72) were studied for the presence of the CAG repeat expansions were analyzed. RESULTS: No significant size differences were detected in the(CTG)17 ligation products between schizophrenic cases and controls using RED(X(2)=2.907, df=2, p=0.234). CONCLUSIONS: This finding does not support the hypothesis that CAG repeat expansions contributes to the susceptibility for schizophrenia and TD.
DNA ; Dyskinesias ; Humans ; Huntington Disease ; Ligation ; Movement Disorders* ; Schizophrenia

The author reviewed a series of 48patients who underwent lumbo-peritoneal shunt operation at Taegu Catholic University Hospital during recent five years. Among them, 10 cases were excluded in this study because of their poor neurologic status which was not adequate to estimate the operative result. In our series, lumbo-peritoneal shunt was done in 34 cases of communicating hydrocephalus due to aneurysmal subarachnoid hemorrhage, head injury, spontaneous intracerebral hemorrhage with/without intraventicular hemorrhage and brain tumor, 2 cases of pseudomeningocele and 2 cases of normal pressure hydrocephalus. The results of this review demonstrate clinical improvement in 28 cases(73.7%), 10 cases(26.7%) of no clinical improvement. There were 9 complications including 8 shunt dysfunction and 1 infection. Among the 8 cases of shunt dysfunction, 5 cases showed postoperative early clinical improvement but revealed shunt dysfunction of delayed onset. In conclusion, lumbo-peritoneal shunt was considered as a good initial CSF diversion procedure in the treatment of communicating hydrocephalus and pseudomeningocele.
Brain Neoplasms ; Cerebral Hemorrhage ; Craniocerebral Trauma ; Daegu ; Hemorrhage ; Hydrocephalus ; Hydrocephalus, Normal Pressure ; Subarachnoid Hemorrhage

OBJECTIVES: Thioredoxin peroxidase(TPx), which does not exhibit similar activity and amino acid sequence homology to conventional antioxidant enzymes has been purified from S cerevisiae and bovine brain. Natural killer enhancing factor-A(NKEF-A)/ proliferation associated gene(PAG), natural killer enhancing factor-B(NKEF-B)/TPx and MER5 which has sequence homology to yeast TPx has been recently characterized biochemically, Prosperi has reported that the level of PAG in HL-60 cells was increased after serum stimulation and decreased after differentiation induced by DMSO treatment. It is well known that thioredoxin, the electron donor to thioredoxin peroxidase, also implicated in cell proliferation via protein kinase C pathway. Disturbed balance of reactive oxygen species and antioxidant in tumor tissue could enhance the cancer promotion This study was designed to investigate the distribution of NKEF-A/FAG, NKEF-B/TPx and MER5 in various tissues, and the expression of NKEF-A/PAG, NKEF-B/TPx and MER5 in human cancers. METHODS: We used antibodies against the purified recombinant protein of NKEF-A/PAG and NKEF-B/TPx and C-terminus amino acids(SP-TASKEYFEKVHO) of MER5, We separated cytosole and mitochondria from rat liver and prepared crude extract from these. We prepared crude extract of various tissues from rat and cancer tissue from lung, stomach and breast and paired normal tissue. Immunoblot analysis of these crude extracts was performed. RESULTS: 1) NKEF-A/PAG and NKEF-B/TPx existed in cytosolic fraction as Cu, Zn-SOD and MER5 mainly exist mainly in mitochondrial fraction as Mn-SOD. Although the level of NKEF-AIPAG, NKEF-B/TPx and MER5 was different, all tissues exhibited NKEF-A/PAG, NKEF-B/TPx and MER5 immunoreactive bands. The adrenal gland had relatively strong band of MEK. 2) The expression of NKEF-A/PAG in HL-60 cell was increased after serum stimulation and decreased after cell differentiation induced by DMSO treatment. 3) The expression of NKEF-A/PAG was increased in lung and breast cancer tissues compaired to paired normal tissues but was not changed in stomach cancer tissues and the expression of NKEF-B/TPx and MER5 was not changed in lung, stomach and breast cancer tissues compaired to paired normal tissues. 4) The level of NKEF-A/PAG, NKEF-B/TPx and MER5 was not different among various lung cancer cell lines. CONCLUSION: The NKEF-A/PAG, NKRF-B/TPx and MER5 are present in the cytosol and mitochondria of various tissues. The NKEF-A/PAG, in particular, is associated with cell proliferation and differentiation and overexpressed in lung and breast cancer.
Adrenal Glands ; Animals ; Antibodies ; Brain ; Breast ; Breast Neoplasms ; Cell Differentiation ; Cell Line ; Cell Proliferation ; Complex Mixtures ; Cytosol ; Dimethyl Sulfoxide ; HL-60 Cells ; Humans* ; Liver ; Lung ; Lung Neoplasms ; Mitochondria ; Peroxidases* ; Peroxiredoxins ; Protein Kinase C ; Rats ; Reactive Oxygen Species ; Saccharomyces cerevisiae ; Sequence Homology ; Sequence Homology, Amino Acid ; Stomach ; Stomach Neoplasms ; Superoxide Dismutase ; Thioredoxins* ; Tissue Donors ; Yeasts

OBJECTIVE: In this study we examined the effects of quetiapine on the immobilization stress-induced brain-derived neurotrophic factor (BDNF) and corticotropin-releasing factor (CRF) expression in rat brain. We also assessed the antidepressant activity of quetiapine. METHOD: We used in situ hybridization to examine the effects of chronic administration of quetiapine in gene transcription. This study also examined the influence of quetiapine in an animal model of depression, the forced swimming test (FST). RESULTS: 1) Repeated immobilization stress (2 hr daily for 3 weeks) decreased mRNA levels of BDNF in the hippocampus (p<0.01), parietal cortex (p<0.01) and pyriform cortex (p<0.05). 2) Repeated immobilization stress increased mRNA levels of CRF in the hypothalamic paraventricular nucleus (PVN)(p<0.01). 3) Chronic quetiapine (10 mg/kg) treatment (daily for 3 weeks) alone significantly increased BDNF mRNA expression in the dentate gyrus of hippocampus when compared to controls under basal conditions (p<0.01), whereas no such effect was observed in the neocortex. 4) Chronic pretreatment of quetiapine also markedly increased the stress-induced decrease of BDNF mRNA expression in the hippocampus (p<0.01) and neocortex (p<0.01). 5) Moreover, the stress-induced elevation of CRF mRNA expression was blocked by chronic quetiapine pretreatment in PVN (p<0.01) although chronic quetiapine treatment alone did not significantly reduce CRF mRNA levels in comparison to controls under basal condition. 6) When rats received acutely quetiapine, quetiapine did reduce the immobility time at 10 mg/kg, as compared with the control group (p<0.05). CONCLUSION : These results suggest that quetiapine has not only potentially an antidepressant effect but also a neuroprotective action in schizophrenia and this effect may be related to its antipsychotic effect in patients with schizophrenia.
Animals ; Antipsychotic Agents ; Brain* ; Brain-Derived Neurotrophic Factor* ; Corticotropin-Releasing Hormone ; Dentate Gyrus ; Depression ; Hippocampus ; Humans ; Immobilization* ; In Situ Hybridization ; Models, Animal ; Neocortex ; Paraventricular Hypothalamic Nucleus ; Physical Exertion ; Rabeprazole ; Rats* ; RNA, Messenger ; Schizophrenia ; Quetiapine Fumarate