The intergenerational production of depression in South Korea: results from a cross-sectional study.

BACKGROUND: Although a number of studies have uncovered relationships between parental capital and the manifestation of depression in their children, little is known about the mechanisms that undergird the relationships. This study investigates the intergenerational effects of the cultural and economic capitals of South Korean parents on depressive symptoms in their adult children and the degree to which the capitals of the adult children explain them. METHODS: We employed nationally representative cross-sectional survey data from the 2006 Korea Welfare Panel Study. A sample of 11,576 adults over thirty years of age was used to investigate the intergenerational production of depression in South Korea. We applied binary logistic regression modelling to the Center for Epidemiological Studies Depression Scale (CES-D). RESULTS: Parental education (institutionalized cultural capital) manifested an independent and statistically significant inverse association with depressive symptoms [OR = 1.680 (95% CI: 1.118-2.523) for men; OR = 2.146 (95% CI: 1484-3.102) for women]. Childhood economic circumstances (economic capital) had an independent and statistically significant inverse association with depressive symptoms among adult women only [OR = 2.009 (95% CI: 1.531-2.635)]. The education of the adult children themselves was strongly associated with depressive symptoms in the expected direction [OR = 4.202 (95% CI: 2.856-6.181) for men; OR = 4.058 (95% CI: 2.824-5.830)] and the most of the association between parental capitals and depressive symptoms was explained by the educational attainment of the children. Receipt of monetary inheritance from parents had a weak but statistically significant association with depression among men [OR = 1.248 (95% CI: 1.041-1.496)] but was unrelated to depression among women. A large portion of the association between respondent education and depressive symptoms was explained by household income. Finally, childhood economic circumstances were associated with depressive symptoms among women over and above the cultural and economic capitals held by the women themselves [OR = 1.608 (95% CI: 2.08-2.139)]. CONCLUSIONS: Our study illuminates the importance of the intergenerational transmission of capitals for the development of depressive symptoms among adults in South Korea.

Direct markers of organ perfusion to guide fluid therapy: when to start, when to stop.

Up until now, the discussion in the literature as to the choice of fluids is almost completely restricted to the composition, with little to no attention paid to the importance of hemodynamic end points to achieve a desired optimal volume. The determination of fluid volume is left to the discretion of the attending physician with only surrogate markers as guidance the initiation and cessation of fluid therapy. In this article, we aim to discuss the available literature on existing clinical and experimental criteria for the initiation and cessation of fluid therapy. Furthermore, we present recent data that have become available after the introduction of direct in vivo microscopy of the microcirculation at the bedside, and discuss its potential influence on the existing paradigms and controversies in fluid therapy.

Microcirculatory perfusion derangements during continuous hemofiltration with fixed dose of ultrafiltration in stabilized intensive care unit patients.

INTRODUCTION: Acute kidney injury (AKI) is a well-known complication in critically ill patients. Little is known about the timing and the ultrafiltration dose after initial resuscitation. In vivo microscopy of the microcirculation has been suggested as alternative for the assessment of volume status. Previous studies contribute to the understanding that intravascular hypovolemia is reflected by microcirculatory blood flow changes not detected by conventional methods. The aim of our study was to assess microcirculatory blood flow changes during negative fluid balance ultrafiltration in patients with oliguric AKI. MATERIALS AND METHODS: Patients with oliguric AKI on renal replacement therapy were included after hemodynamic stabilization. Target was a predefined negative fluid balance; subsequently, a stepwise decrease in amount of substitution fluid was achieved. The data were recorded at baseline and after each change. RESULTS: Fifteen patients were included in the study. Microcirculatory blood flow index did not change significantly between baseline and endpoint (2.90 [2.87-3.00] vs 2.90 [2.75-3.00], P=.57). During treatment, heart rate decreased from 96 (80-111) to 94 (79-110) beats per minute (P=.01), without a significant change in mean arterial blood pressure (80 [68-95 mm Hg] vs 79 [65-91 mm Hg], P=.5). CONCLUSION: Microcirculatory blood flow is not altered by reduced substitution during renal replacement therapy.

Synchronous Laparoscopic Radical Nephrectomy Left and Contralateral Right Hemicolectomy during the Same Endoscopic Procedure.

Synchronous renal cell carcinoma in patients with colorectal carcinoma is reported in various percentages ranging from 0.03 up to 4.85% (Halak et al. (2000), Capra et al. (2003)). When surgical treatment is indicated usually two separate operations are planned for resection. In open surgery, in such cases simultaneous resection is recommended if possible. Few reports have described the resection of colorectal and renal cell carcinoma in a single laparoscopic procedure. We have shown that combining left radical nephrectomy and right hemicolectomy is technically feasible, safe and that overall operative time can be limited. In our case operative time was 210 minutes, blood loss 100 milliliters, and duration of hospital stay was 8 days. Adequate port placement, preoperative scheduling, and surgical experience are essential to achieve this goal.

Endovascular treatment of a right-sided ureteroiliac fistula in a patient with a simultaneous left-sided ureteroileal fistula.

We describe an 80-year-old female with a left ureteroileal fistula and simultaneously a right ureteroiliac fistula. Her history highlights the predisposing factors of radiation, major surgery in the region, and presence of bilateral double-J-stents. She was successfully treated with an endovascular approach after being initially misdiagnosed. There seems to be an increase in reporting ureteral fistulas, however this entity remains a rare clinical condition that can lead to life-threatening situations. A fast and accurate diagnosis of an ureteroarterial fistula remains a challenge.

Potency values from the local lymph node assay: application to classification, labelling and risk assessment.

Hundreds of chemicals are contact allergens but there remains a need to identify and characterise accurately skin sensitising hazards. The purpose of this review was fourfold. First, when using the local lymph node assay (LLNA), consider whether an exposure concentration (EC3 value) lower than 100% can be defined and used as a threshold criterion for classification and labelling. Second, is there any reason to revise the recommendation of a previous ECETOC Task Force regarding specific EC3 values used for sub-categorisation of substances based upon potency? Third, what recommendations can be made regarding classification and labelling of preparations under GHS? Finally, consider how to integrate LLNA data into risk assessment and provide a rationale for using concentration responses and corresponding no-effect concentrations. Although skin sensitising chemicals having high EC3 values may represent only relatively low risks to humans, it is not possible currently to define an EC3 value below 100% that would serve as an appropriate threshold for classification and labelling. The conclusion drawn from reviewing the use of distinct categories for characterising contact allergens was that the most appropriate, science-based classification of contact allergens according to potency is one in which four sub-categories are identified: 'extreme', 'strong', 'moderate' and 'weak'. Since draining lymph node cell proliferation is related causally and quantitatively to potency, LLNA EC3 values are recommended for determination of a no expected sensitisation induction level that represents the first step in quantitative risk assessment.

Gene-selective developmental roles of general transcription factors.

Innumerable transcription factors integrate cellular and intercellular signals to generate a profile of expressed genes that is characteristic of the biochemical and cellular properties of the cell. This profile of expressed genes changes dynamically along with the developmental stage and differentiation state of the cell. The biochemical machinery upon which transcription factors integrate their signals is referred to as the general transcription machinery. However, this machinery is not of universal composition, and variants of the general transcription factors play specific roles in embryonic development, reflecting the constraints and requirements of developmental gene regulation.

Constitutive genomic methylation during embryonic development of Xenopus.

Methylation of CpG dinucleotides is a predominant modification of genomic DNA in many species, especially in vertebrates. This modification, generally associated with transcriptional repression, is rapidly and globally lost during mammalian pre-implantation development. This loss of methylation is gradually reversed during subsequent stages of development. Here we show that the amphibian Xenopus laevis maintains high levels of DNA methylation during early embryonic development. The methylation status of specific loci is independent of the temporal expression profile. The observations have profound implications for the regulation of early embryonic gene regulation and genome function.

Developmental toxicity of di-(C(7)-C(9) alkyl) phthalate and di-(C(9)-C(11) alkyl) phthalate in the rat.

Two phthalate esters, di-(C(7)-C(9) alkyl) phthalate (D79P) and di-(C(9)-C(11) alkyl) phthalate (D911P), have been assessed for their potential to cause developmental toxicity in the rat. Groups of 22 timed-mated Sprague-Dawley rats were administered 250, 500, or 1000 mg/kg D79P or D911P daily by oral gavage (5 ml/kg) between gestation days (GD) 1 and 19. Control animals received the vehicle (olive oil) alone. On GD20, the animals were sacrificed and the fetuses examined. Treatment resulted in no signs of maternal toxicity, as assessed by adjusted maternal bodyweight gain throughout gestation and clinical examinations, and no effects upon litter size, fetal survival or bodyweight. Pups of the high dose D79P and intermediate and high dose D911P groups showed increased incidences of supernumerary lumbar ribs. There was a significant increase in dilated renal pelves in pups of the low dose D79P and high dose D911P groups, but only for D911P was there a significant trend. Consequently, the no observed adverse effect level (NOAEL) for maternal toxicity for both D79P and D911P is 1000 mg/kg/day. The NOAEL values for developmental toxicity are 500 mg/kg/day D79P and 250 mg/kg/day D911P.

Distinct roles for TBP and TBP-like factor in early embryonic gene transcription in Xenopus.

The TATA-binding protein (TBP) is believed to function as a key component of the general transcription machinery. We tested the role of TBP during the onset of embryonic transcription by antisense oligonucleotide-mediated turnover of maternal TBP messenger RNA. Embryos without detectable TBP initiated gastrulation but died before completing gastrulation. The expression of many genes transcribed by RNA polymerase II and III was reduced; however, some genes were transcribed with an efficiency identical to that of TBP-containing embryos. Using a similar antisense strategy, we found that the TBP-like factor TLF/TRF2 is essential for development past the mid-blastula stage. Because TBP and a TLF factor play complementary roles in embryonic development, our results indicate that although similar mechanistic roles exist in common, TBP and TLF function differentially to control transcription of specific genes.

Social capital, SES and health: an individual-level analysis.

Stimulated by the finding (Kawachi et al., 1997) that social capital in communities may mediate the relationship between income inequality and health status, this article describes relationships between individual-level elements of social capital--trust, commitment and identity in the social-psychological dimension; participation in clubs and associations and civic participation in the action dimension--and self-rated health status, before and after controlling for human capital (socioeconomic status measured by income and education), using survey data collected in Saskatchewan, Canada (n = 534, 40% response rate). Income (P = 0.001) and education (P < 0.001) were related to health in the expected directions. Both income (P = 0.002) and education (P = 0.004) were related to health among the elderly; education (P = 0.035) to health among the middle-aged; and neither among the youthful respondents. Frequency of socialization with work-mates (P = 0.019) and attendance at religious services (P = 0.034) had the strongest (and positive) relationships with health of the social engagement questions, even after controlling for human capital, and participation in clubs and associations was positively related to health among the elderly (P = 0.009). But for commitment to one's own personal happiness (P = 0.039), trust, commitment and identification of various kinds were not significantly related to health. Civic participation was also unrelated to health. The main conclusion is that little evidence was found for compositional effects of social capital on health. Secondary findings are that the relationship between SES and health was the same for men and women and strongest among the elderly; that socialization with colleagues from work is relevant and that attendance at religious services and participation in clubs are related to health for the elderly.

Translation of maternal TATA-binding protein mRNA potentiates basal but not activated transcription in Xenopus embryos at the midblastula transition.

Early embryonic development in Xenopus laevis is characterized by transcriptional repression which is relieved at the midblastula stage (MBT). Here we show that the relative abundance of TATA-binding protein (TBP) increases robustly at the MBT and that the mechanism underlying this increase is translation of maternally stored TBP RNA. We show that TBP is rate-limiting in egg extract under conditions that titrate nucleosome assembly. Precocious translation of TBP mRNA in Xenopus embryos facilitates transcription before the MBT, without requiring TBP to be prebound to the promoter before injection. This effect is transient in the absence of chromatin titration and is sustained when chromatin is titrated. These data show that translational regulation of TBP RNA contributes to limitations on the transcriptional capacity before the MBT. Second, we examined the ability of trans-acting factors to contribute to promoter activity before the MBT. Deletion of cis-acting elements does not affect histone H2B transcription in egg extract, a finding indicative of limited trans-activation. Moreover, in the context of the intact promoter, neither the transcriptional activator Oct-1, nor TBP, nor TFIID enable transcriptional activation in vitro. HeLa cell extract, however, reconstitutes activated transcription in mixed extracts. These data suggest a deficiency in egg extract cofactors required for activated transcription. We show that the capacity for activated H2B transcription is gradually acquired at the early gastrula transition. This transition occurs well after the blastula stage when the basal transcription machinery can first be complemented with TBP.

Normal reproductive organ development in Wistar rats exposed to bisphenol A in the drinking water.

Bisphenol A (BPA) is a chemical used primarily as a monomer in the manufacture of numerous chemical products, such as epoxy resins and polycarbonate. The objective of this study was to evaluate potential effects of BPA on sexual development of male rats and was designed to clarify low-dose observations reported as preliminary results by Sharpe et al. (1996). The protocol for the present study followed the same treatment schedule as reported by Sharpe et al. (1995, 1996), but included more treatment groups, a greater number of animals per group, and a more comprehensive number of reproductive endpoints. Groups of 28 female Han-Wistar albino rats were exposed to drinking water that contained 0, 0.01, 0.1, 1.0, or 10 ppm BPA or 0.1 ppm diethylstilbestrol (DES), 7 days per week, for a total of 10 weeks. Treatment of the females began at 10 weeks of age and continued throughout a 2-week premating period, 2 weeks of mating (to untreated males), 21-22 days of gestation, and 22 days of lactation. Offspring weanling males were given untreated drinking water and maintained until 90 days of age when evaluations were made of various reproductive organs. Consistent with Sharpe et al. (1996) the female offspring were not evaluated. No treatment-related effects on growth or reproductive endpoints were observed in adult females exposed to any concentration of BPA. Similarly, no treatment-related effects were observed on the growth, survival, or reproductive parameters (including testes, prostate and preputial gland weights, sperm count, daily sperm production, or testes histopathology) of male offspring from dams exposed to BPA during gestation and lactation. DES administered in the drinking water at 0. 1 ppm resulted in decreased body weight, body weight change, and food consumption in adult females. In addition, an increase in the duration of gestation and a decrease in the number of pups delivered and number of live pups were also observed in animals exposed to DES. In conclusion, these results do not confirm the previous findings of Sharpe et al. (1996) and show that low doses of BPA had no effects on male sexual development in the rat.

Review of subchronic/chronic toxicity of antimony potassium tartrate.

Subchronic/chronic toxicity studies on antimony potassium tartrate (APT) have been reviewed. One of the older studies (H. A. Schroeder et al., 1970, J. Nutr. 100 (1), 59-68), on which are based the EPA reference dose value and a number of state, national, and international drinking water criteria for antimony, has severe inadequacies in study conduct making it uninterpretable and inappropriate for characterization of APT toxicity. In particular, the manner in which control data were generated and utilized in this study is considered invalid. More recent drinking water studies conducted by the NTP (1992, "NTP Technical Report on Toxicity Studies of Antimony Potassium Tartrate in F344/N Rats and B6C3F(1) Mice (Drinking Water and Intraperitoneal Injection Studies)," NTP Toxicity Report Series, No. 11) and Poon et al. (1998, Food Chem. Toxicol. 36, 20-35) showed antimony to be of low toxicity. The NOAEL in the 14-day NTP study was 2500 ppm by the oral route in both rats and mice, while Poon et al. (1998) suggested a NOAEL of 0.5 ppm in their 90-day study. However, upon close examination, it was determined that this value was based on subtle histological changes in the thyroid gland that were physiological, not toxicological, in nature. This conclusion is supported further by an absence of these changes in a well-conducted 13-week intraperitoneal exposure study in rats that utilized APT at much higher doses (NTP, 1992). Thus, the NOAEL by Poon et al. (1998) should more appropriately be 50 ppm. When regulatory criteria for antimony are established and/or reviewed, the findings in the NTP study and this critical reevaluation of the Poon et al. (1998) study should be considered when establishing a NOAEL for subchronic exposure to antimony in the future.

Normal reproductive organ development in CF-1 mice following prenatal exposure to bisphenol A.

Bisphenol A (BPA) is a monomer used in the manufacture of a multitude of chemical products, including epoxy resins and polycarbonate. The objective of this study was to evaluate the effects of BPA on male sexual development. This study, performed in CF-1 mice, was limited to the measurement of sex-organ weights, daily sperm production (DSP), epididymal sperm count, and testis histopathology in the offspring of female mice exposed to low doses of BPA (0, 0.2, 2, 20, or 200 microg/kg/day), by deposition in the mouth on gestation days 11-17. Male sexual development determinations were made in offspring at 90 days-of-age. Since this study was conducted to investigate and clarify low-dose effects reported by S. C. Nagel et al., 1997, Environ. Health Perspect. 105, 70-76, and F. S. vom Saal et al., 1998, Toxicol. Indust. Health 14, 239-260, our study protocol purposely duplicated the referenced studies for all factors indicated as critical by those investigators. An additional group was dosed orally with 0.2 microg/kg/day of diethylstilbestrol (DES), which was selected based on the maternal dose reported to have maximum effect on the prostate of developing offspring, by F. S. vom Saal (1996, personal communication), vom Saal et al. (1997, Proc. Natl. Acad. Sci. U S A 94, 2056-2061). Tocopherol-stripped corn oil was used as the vehicle for BPA and DES, and was administered alone to control animals. No treatment-related effects on clinical observations, body weight, or food consumption were observed in adult females administered any dose of BPA or DES. Similarly, no treatment-related effects on growth or survival of offspring from dams treated with BPA or DES were observed. The total number of pups born per litter was slightly lower in the 200-microg/kg/day BPA group when compared to controls, but this change was not considered treatment-related since the litter size was within the normal range of historical controls. There were no treatment-related effects of BPA or DES on testes histopathology, daily sperm production, or sperm count, or on prostate, preputial gland, seminal vesicle, or epididymis weights at doses previously reported to affect these organs or at doses an order of magnitude higher or lower. In conclusion, under the conditions of this study, the effects of low doses of BPA reported by S. C. Nagel et al., 1997 (see above) and F. S. vom Saal et al., 1998 (see above), or of DES reported by F. S. vom Saal et al., 1997 (see above) were not observed. The absence of adverse findings in the offspring of dams treated orally with DES challenges the "low-dose hypothesis" of a special susceptibility of mammals exposed perinatally to ultra-low doses of even potent estrogenic chemicals. Based on the data in the present study and the considerable body of literature on effects of BPA at similar and much higher doses, BPA should not be considered as a selective reproductive or developmental toxicant.

The Oct-1 POU domain directs developmentally regulated nuclear translocation in Xenopus embryos.

Early embryonic development in Xenopus is characterized by transcriptional repression which is relieved at the mid-blastula stage. Here we show that most of the maternally inherited POU domain transcription factor Oct-1 is retained in the cytoplasm during early development, and that it gradually translocates to the nucleus around the mid-blastula transition. Overexpressed epitope-tagged Oct-1 exhibits highly similar localization properties compared to endogenous protein. The amino acid sequence that directs this developmentally regulated nuclear translocation resides in the POU domain. Our findings may suggest that cytoplasmic retention of Oct-1 facilitates or contributes to the repression of Oct-1 target genes before the mid-blastula transition.

Different wor(l)ds: three approaches to health research.

This article describes three approaches to research in the social sciences: positivist, interpretivist and critical social science. It uncovers some of the philosophical assumptions these approaches adhere to and situates the discussion in the population health arena with respect to these assumptions. The issues under debate are as yet unsolved (and perhaps unsolvable), with long histories in philosophy and sophisticated rationales on all sides. The article advocates defining the underlying terms of discussion and making assumptions explicit to facilitate dialogue, and also encourages exploration of and tolerance for other approaches.

Population health in Canada: issues and challenges for policy, practice and research.

The population health movement has gained prominence in Canada and elsewhere with policy makers, program planners and researchers taking note that health is strongly influenced by factors that lie largely beyond the health-care system. The development of population health in Canada was the focus of the National Conference on Shared Responsibility for Health & Social Impact Assessments: Advancing the Agenda held May 2-3 1999 in Vancouver, Canada. A longer version of this paper was distributed to conference participants to provide some common knowledge and vocabulary. It also introduced and discussed definitional, normative, logistical, political, methodological, structural and resource considerations with respect to furthering the population health agenda in Canada.

Home is where the governing is: social capital and regional health governance.

The relationship between the civic nature of a community and effective political governance by regional health boards in Canada is explored. A model is proposed that identifies components of social capital such as trust, commitment and identity, associationalism, civic participation and collaborative problem-solving. These concepts are then theoretically linked to effective governance, in particular to reflection of health needs, policy implementation, population health, fiscal responsibility and administrative efficiency. The generalizability of this model is discussed, as are current research directions and policy implications for governments. The conclusion is that governments might want to incorporate a dual perspective encompassing both the political institutions and the community structure.

Methylated DNA and MeCP2 recruit histone deacetylase to repress transcription.

CpG methylation in vertebrates correlates with alterations in chromatin structure and gene silencing. Differences in DNA-methylation status are associated with imprinting phenomena and carcinogenesis. In Xenopus laevis oocytes, DNA methylation dominantly silences transcription through the assembly of a repressive nucleosomal array. Methylated DNA assembled into chromatin binds the transcriptional repressor MeCP2 which cofractionates with Sin3 and histone deacetylase. Silencing conferred by MeCP2 and methylated DNA can be relieved by inhibition of histone deacetylase, facilitating the remodelling of chromatin and transcriptional activation. These results establish a direct causal relationship between DNA methylation-dependent transcriptional silencing and the modification of chromatin.