A brief history of psychiatry in Singapore

The development of psychiatric services in Singapore during the last 150 years can be divided into four distinct, albeit overlapping, phases: (1) the origins of the Lunatic Asylum; (2) the interruption caused by the Japanese Occupation, and the post-war years; (3) the training of local psychiatrists and mental health professionals; and (4) the development of general hospital psychiatry and community mental health services. Early psychiatry in Singapore was essentially British psychiatry as an outpost but modified by local conditions. Modern psychiatry in Singapore has its roots in Singapore's colonial past and is strongly influenced by Western psychiatry. It has come a long way since its humble beginnings when the first mental hospital was established in 1841.     

A brief history of levodopa

This article highlights some landmarks in the history of levodopa, beginning with its isolation in 1910–13 from seedlings of Vicia faba to the demonstration, in 1961, of its “miraculous” effect in patients with Parkinson’s disease (PD). Midway between these two time points, in 1938, l-dopa decarboxylase was discovered, the enzyme that produces dopamine (DA) from levodopa. In 1957, DA was shown to occur in the brain, and in 1959 it was found to be enriched in the basal ganglia. At that time the striatal localization of DA, together with studies done in 1957–58 in naive and reserpine-treated animals regarding DA in the brain and the central effects of levodopa, suggested its possible involvement in “extrapyramidal control” and “reserpine parkinsonism”. Following these discoveries, a study of (postmortem) brains of patients with basal ganglia disorders, including PD, was started, demonstrating, in 1960, a severe striatal DA deficit specifically in PD, thus furnishing a rational basis for the concept of “DA replacement therapy” with levodopa. Accordingly, in 1961, the first highly successful clinical trial with i.v. levodopa was carried out. In 1963, the DA deficit in the PD substantia nigra was found, indicative of a nigrostriatal DA pathway in the human brain, subsequently established in animal studies in 1964–65. In 1967, the chronic, high dose oral levodopa regimen was introduced in treatment of PD. Besides the above highlights in the history of levodopa, the article also cites critical opinions of world authorities in brain research of the time, harmful to the cause of DA, levodopa and PD. Today, the concept of DA replacement with levodopa is uncontested, with levodopa being the “gold standard” of modern drug treatment of PD.

     

A brief history of parkinsonism.

The growth of our knowledge of Parkinson's disease over the past 175 years represents an enormous and at times stormy intellectual voyage. It required the contributions of many scientists and clinicians in many disciplines, and its progress inevitably reflected the general progress of biomedical science over the past 2 centuries. The advances in the past half century clearly depended on the great advances achieved in that time in histochemistry, neurochemistry, and neuropharmacology as well as in clinical neurology and neuropathology. Advances in the future will similarly depend on progress in modern neuroscience.     

A brief history of brain iron research

We present a patient with transient global amnesia (TGA) whose diffusion-weighted imaging (DWI) study showed a high-intensity signal in the left retrosplenium of the corpus callosum. In previous studies, lesions in the retrosplenium caused permanent but not transient global amnesia, called retrosplenial amnesia, by involving the thalamocortical portion of the Papez' circuit. This is the first report indicating that TGA can be associated with acute infarction only in the left retrosplenium of the corpus callosum.