In vivo acceleration of heart relaxation performance by parvalbumin gene delivery.

Defective cardiac muscle relaxation plays a causal role in heart failure. Shown here is the new in vivo application of parvalbumin, a calcium-binding protein that facilitates ultrafast relaxation of specialized skeletal muscles. Parvalbumin is not naturally expressed in the heart. We show that parvalbumin gene transfer to the heart in vivo produces levels of parvalbumin characteristic of fast skeletal muscles, causes a physiologically relevant acceleration of heart relaxation performance in normal hearts, and enhances relaxation performance in an animal model of slowed cardiac muscle relaxation. Parvalbumin may offer the unique potential to correct defective relaxation in energetically compromised failing hearts because the relaxation-enhancement effect of parvalbumin arises from an ATP-independent mechanism. Additionally, parvalbumin gene transfer may provide a new therapeutic approach to correct cellular disturbances in calcium signaling pathways that cause abnormal growth or damage in the heart or other organs.

Characteristic clinical features associated with aggressive posterior retinopathy of prematurity.

PurposeTo identify the risk factors for, and clinical features and treatment outcomes of aggressive posterior retinopathy of prematurity (APROP) in Korean infants.MethodsAmong 770 premature infants who underwent screening, 105 infants (198 eyes, 13.63%) received treatment for ROP. A total of 24 infants (48 eyes, 3.12%) developed APROP while 81 infants (150 eyes, 10.52%) developed non-APROP treatment-requiring type. The medical records of ROP-treated infants were reviewed retrospectively. The associated systemic and maternal risk factors were analyzed and anatomical outcomes were compared according to the severity of ROP and treatment modalities.ResultsThe mean gestational age and birth weight at birth in the APROP group were significantly lower than those in the non-APROP group (P=0.019, P<0.001, respectively). Infants who were born small for their GA developed APROP more frequently than non-APROP patients (P<0.001). Chorioamnionitis-positive infants also showed higher incidence rate of APROP (APROP vs non-APROP; P<0.001 and zone I APROP vs posterior zone II APROP; P=0.036, respectively). Infants with APROP required heavier laser treatment with a higher retreatment rate compared to infants with non-APROP. Favorable anatomical outcomes were achieved in 95.3% from treatment-requiring non-APROP group, 85.7% from zone I APROP and 84.6% from posterior zone II APROP group.ConclusionIntrauterine growth restriction and chorioamnionitis were associated with development of APROP. These findings suggest that perinatal maternal environment inhibiting normal retinal vascular growth in utero may contribute to increasing the risk of APROP in premature infants.

Glucocorticoids may alter antioxidant enzyme capacity in the brain: baseline studies.

Glucocorticoids (GCs), the adrenal steroids secreted during stress, have been shown to increase the vulnerability of hippocampal neurons to metabolic insults, potentially by altering the neuronal defense capacity against oxidative damage. These experiments assessed the effect of long term in vivo GC supplementation on basal activity of the antioxidant enzymes copper/zinc superoxide dismutase (Cu/Zn SOD), manganese superoxide dismutase (Mn SOD), catalase, and glutathione peroxidase (GSPx). Kinetic enzyme studies were done using brain tissue from the hippocampus, cortex, cerebellum, and also from liver as a peripheral control. Cu/Zn SOD activity was significantly lower in all brain regions of GC-treated rats, but higher in the liver. Mn SOD activity was unaffected by treatment. Catalase in the brain appeared largely unaffected by GC treatment, although liver catalase was significantly decreased. GSPx activity was significantly decreased by GCs at high peroxide levels in all tissues. These results indicate that the presence of GCs may lower the antioxidant capacity of tissues in a region-specific manner, and that the deficit may not appear until the tissue is challenged with supranormal levels of oxidative products (as seen with GSPx).

Comparative study of the behavioral and neuropsychologic characteristics of tic disorder with or without attention-deficit hyperactivity disorder (ADHD).

To study the nature of the comorbidity of tic disorder and attention-deficit hyperactivity disorder (ADHD), patients with tic disorder with or without ADHD were compared on the basis of clinical ratings and neuropsychologic tests. Seventy-eight children were involved in this study: 16 with tic disorder, 19 with comorbid tic disorder and ADHD, 21 with ADHD, and 22 normal controls. Rating scales for ADHD, the Child Behavior Checklist and the Yale Global Tic Severity Scale, were completed in clinical groups. To identify differences in neuropsychologic function among the four groups, the results of seven neuropsychologic tests of global cognitive abilities, attention, information-processing capacity, and fine motor skill were compared. On most behavioral and neuropsychologic tests, the tic disorder with ADHD and the ADHD groups demonstrated similar performance patterns and marked deficits compared with the tic disorder and the control groups, whereas in most of the attention tests, the ADHD group made more commission errors than the tic disorder with ADHD group. These findings suggest that the tic disorder with ADHD group has marked cognitive deficits and behavioral disturbance similar to the ADHD group, whereas the tic disorder group is more similar to the controls. The tic disorder with ADHD group might represent a true comorbidity of the two disorders.

Psychiatric morbidity of second and third grade primary school children in Korea.

This study was undertaken to identify psychiatric morbidity among Korean second and third elementary school children using an objective diagnostic interview tool. Data from 5,118 (2,723 boys, 2,395 girls; mean age = 8.41 years (SD = 0.66)) second and third grade schoolchildren were drawn from 28 elementary schools. After initial screening assessments using the 28-item Child Problem-Behavior Screening Test for parents, 672 primary caregivers were subjected to secondary screening using the Korean version of the CBCL. Two hundred and seventy-one high-risk children selected according to the K-CBCL results, 138 (50.9%) children and their primary caregivers were interviewed using the Korean version of K-SADS-PL for objective DSM-IV psychiatric diagnoses. Sixty-four (46.4%) of the hundred and thirty eight children were determined to have at least one psychiatric disorder. More boys were diagnosed as psychiatric patients than girls (46 males, 18 females; OR = 2.21). The most frequently diagnosed disorder was ADHD (46/64; 71.9%), followed by tic disorder, anxiety disorders, mental retardation, oppositional defiant disorder, and separation anxiety disorder. Two or more comorbid psychiatric disorders were found in 22 (34.4%) of the 64 patients. The computed crude percentage of psychiatric patients in this study was 4.12%, which is similar to previously published data.

National culture vs professional culture: a comparative study of psychiatric educators in two countries.

A survey of the literature in medicine and in comparative education finds virtually no reports of systematic studies of professional education across national boundaries. This paper describes the use of the Priority Sort of Educational Objectives in Mental Health with samples of psychiatric and psychiatric nurse educators in the United States and South Korea. The data suggests a somewhat different pattern of cultural influences in professional education priorities between these disciplines in the two countries. The relative impact of the culture of a profession and of national culture are examined through the data generated on these populations of educators in two culturally dissimilar countries. Despite these differences of culture there has been a great impact of professional education from one country to the other. The resulting data suggest a stronger impact of professional culture with one profession, psychiatry, and a greater impact of national culture with the psychiatric nurse educators.

Chromosomal abnormalities in child psychiatric patients.

To determine the frequency of chromosomal abnormalities in a child psychiatric population, and to evaluate possible associations between types of abnormalities and patient's clinical characteristics, cytogenetic examination was performed on 604 patients. Demographic data, reasons for karyotyping, clinical signs, and other patient characteristics were assessed and correlated with the results from karyotyping. Chromosomal abnormalities were found in 69 patients (11.3%); these were structural in 49 cases and numerical in 20. Inversion of chromosome nine was found in 15 subjects, trisomy of chromosome 21 in 11, and fragile X in five patients. When karyotyping was performed because of intellectual impairment or multiple developmental delay, significantly more abnormalities were found than average; when performed because autistic disorder was suspected, the number of abnormalities was significantly fewer. There were no differences in clinical variables between structural and numerical abnormalities, nor among nine types of chromosomal abnormalities, except that numerical abnormalities and polymorphism were found at a later age, and that walking was more delayed and IQ was lower in patients with Down syndrome. Clinicians should be aware of the possible presence of chromosomal abnormalities in child psychiatric populations; the close collaboration with geneticists and the use of more defined guidelines for cytogenetic investigation are important.