THE DEVELOPMENT AND VALIDATION OF A SELF-REPORT MEASURE OF SELF-ACTUALIZATION

A self-report measure of actualization of potential (MAP) was developed as an alternative to the Personal Orientation Inventory (POI) for assessing successful and functioning individuals. Study 1 describes the item selection carried out by means of a literature review, an international panel of 28 experts and two focus groups. In Study 2 construct validity was established with a sample of 414 subjects. A principal component analysis with oblique rotation reduced the initial item pool to 27, yielding a 5-factor solution. A second-order factor analysis revealed two major components, “self-reference” and “openness to experience”. Study 3 achieved a full scale Cronbach's alpha of .90. Overall the new instrument provides both better theoretical and empirical evidence than the POI, and stronger psychometric properties.

Syntheses and molecular structures of 3-N, N-di-n-propylamino-2-chromanones as new analogues of dopamine

A series of 3-N,N-di-n-propylamino-2-chromanones were synthesized as dopamine analogues. The lactone ring was introduced as a means to reduce their propensity to cross the blood-brain barrier and to avoid central side effects, rendering these compounds potentially useful for the treatment of glaucoma. Pharmacological activities were determined in vitro on rat striatum, by examining their capacity to displace the specific binding of the labeled dopaminergic ligand 3H sulpiride or 3H spiperone and 3H SCH 23390 for D2 and D1 sites, respectively. Compound 6a showed a weak dopaminergic activity on D2-receptors and no affinity for D1-receptors, which can be explained, at least in part, by a weak pKa and the presence of an internal hydrogen bonding. Furthermore, computer molecular modelling studies showed that the aromatic ring of 6a was negatively charged in contrast to the classical D2-agonists aminotetralin derivatives, hampering a possible interaction with a negatively charged area of the D2-receptor. These results, taken together, can account for the moderate dopaminergic activities exhibited by these lactone derivatives.

Syntheses, activity and modeling studies of 3- and 4-(sulfo- and sulfonamidoalkyl)pyridine and piperidine-2-carboxylic acid derivatives as analogs of NMDA receptor antagonists

A series of 3- and 4-(sulfo- and sulfonamidoalkyl)pyridine and piperidine-2-carboxylic acid derivatives as analogs of NMDA receptor antagonists was prepared. Affinity for the NMDA receptor was determined by binding assays using the specific radioligand [3H] (2SR,4RS)-4-(phosphonomethyl)piperidine-2-carboxylic acid (CGS-19755). The 3-alkylsulfonyl moiety was introduced by selective reduction of a carboxylic acid function followed by bromination, substitution by Na2SO3 and catalytic reduction. For the 4-alkylsulfonic derivatives the crucial step was the introduction of the 2-cyano function and its further conversion to 2-carboxylic acid. The most potent compound of the series was the pyridine (11a) [4-(sulfomethyl)pyridine-2-carboxylic acid] with a modest IC50 of 40 microM. A molecular modeling study has been undertaken to understand the pharmacological results. In a first step, a comparative modeling study of the active pyridine and the poorly active piperidine sulfonic acid derivatives 11a and 10a [4-(sulfomethyl)piperidine-2-carboxylic acid] and of the phosphonic homologues was performed. We propose that the binding geometry of the sulfonic moiety within the NMDA receptor is different from that of the phosphonic containing antagonists. In order to test this assumption, we have made, in a second step, a complete conformational analysis of the sulfonic acid derivatives, as well as some analogs taken from the literature, either active or inactive as NMDA antagonists. A preferred conformation of the sulfonic acids is proposed.

Synthesis and vasodilator effects of 3- and 7-sulfonylurea-1,2,4-benzothiadiazin-1,1-dioxides on rat aorta

A series of substituted-1,2,4-benzothiadiazin-1,1-dioxide derivatives was designed and synthesized as potassium channel modulators. Various sulfonylurea moieties were introduced on positions 3 and 7 of the heterocycle without, or by means of, methylene and phenyl spacers. On rat aortic rings, several compounds displayed vasodilating activities, especially compound 24, which was more active than cromakalim and diazoxide at low doses (0.1 microM) and more active than diazoxide between 1 and 10 microM.

Renal artery aneurysm: treatment with percutaneous placement of a stent-graft

A stent-graft was placed percutaneously in the right renal artery of a 50-year-old woman with hypertension and a fibromuscular dysplastic lesion consisting of severe stenoses and a 1.5-cm saccular aneurysm with a wide neck. At 1-year follow-up with arteriography, arterial luminal diameter was normal and no aneurysm was depicted. The patient's blood pressure was normal without blood pressure medication.

The influence of family and social relationships on the consumption of psychotropic drugs by the elderly

Psychotropic drugs are the second most commonly used medication by Quebec's elderly. The objective of this study is to test a theoretical model of psychotropic drug use in the elderly. The principal hypothesis is that the quality of relationships the elderly person has with others, particularly with his or her children, has a direct influence on his or her psychological well-being, which, in turn, directly affects the consumption of psychotropic agents. A survey was conducted on a sample of 500 elderly people, aged 65-84 years, living at home. Of the respondents, 31.8% used psychotropic drugs during the 3-month period preceding the interview. Path analysis led to the elaboration of a modified model for the consumption of psychotropic drugs by the elderly which indicates that the best predictors of consumption are both the psychological well-being and the state of health of the individual. The more the psychological well-being is elevated, the lower the consumption of psychotropic drugs is, whereas a poor health condition increases it. The quality of an individual's social relationships has a direct influence on his or her psychological well-being, whereas family relationships are of lesser importance. Our model accounts for 13% of the predictors of psychotropic consumption by the elderly. Further studies will consider the personality of the user, the doctor-patient relationship, the prescribing habits of physicians and the influence of advertising by pharmacological industry.

The impact of a support group programme for care-givers on the institutionalisation of demented patients

Support group programmes have been proposed to alleviate the care-givers' burden and postpone institutionalisation of demented patients. Experimental studies on these programmes failed to detect any impact on care-givers' burden, but none have examined the effect on institutionalisation. The objective of this paper is to assess the impact of a support group programme for care-givers on the institutionalisation of demented patients. Forty-five care-givers of community-dwelling demented patients were allocated randomly to the study group (n = 24) and the control group (n = 21). Subjects in the study group attended a structured programme of 8 weekly sessions of 3 h each. Subjects assigned to the control group were referred to the informal monthly meetings of the Alzheimer's Society. Using survival analysis, the median length of time until institutionalisation was 30 months from the time of the entry into the study. At 24 months, the probability of being institutionalised was 0.33 in the study group and 0.45 in the control group. This difference was not statistically significant (log-rank test: chi2 = 1.02; P = 0.31). These results emphasize the lack of scientific evidence about efficacy of such programmes and the need for a large multi-centre study on this topic.

Use of the rabbit ear artery to serially assess foreign protein secretion after site-specific arterial gene transfer in vivo. Evidence that anatomic identification of successful gene transfer may underestimate the potential magnitude of transgene expression

BACKGROUND

The development of molecular strategies for the treatment of restenosis has been hindered by low efficiencies of in vivo arterial transfection. Expression of intracellular marker proteins is generally evident in < 1% of vascular smooth muscle cells after in vivo arterial transfection. Efforts to improve the efficiency of in vivo gene transfer have been further impeded by the use of transgenes encoding for intracellular marker proteins, necessitating tissue removal and limiting survey for expression to one point in time.

METHODS AND RESULTS

To study gene expression on a serial basis in vivo and determine the relation between a secreted gene product and transfection efficiency after in vivo arterial gene transfer, a method for performing and serially monitoring gene expression in vivo was developed using the central artery of the rabbit ear. Liposome-mediated transfection of plasmid DNA containing the gene for human growth hormone (hGH) was successfully performed in 18 of 23 arteries. Serum hGH levels measured 5 days after transfection ranged from 0.1 to 3.8 ng/mL (mean, 0.97 ng/mL); in contrast, serum drawn from the control arteries demonstrated no evidence of hGH production. Serial measurement of hGH from transfected arteries demonstrated maximum hGH secretion 5 days after transfection and no detectable hormone after 20 days. Despite these levels of secreted gene product documented in vivo, immunohistochemical staining of sections taken from the rabbit ear artery at necropsy disclosed only rare cells in which there was evidence of successful transfection.

CONCLUSIONS

These experiments demonstrate a useful method of performing serial in vivo analyses of gene expression after vascular transfection and that anatomic analyses of transfection efficiency may underestimate the potential magnitude of expression in the case of a secreted gene product. These findings have implications for the clinical application of somatic gene therapy because low-efficiency transfection with a gene encoding for a secreted protein may achieve therapeutic effects not realized by transfection with genes encoding for proteins that remain intracellular.

Increased gene expression after liposome-mediated arterial gene transfer associated with intimal smooth muscle cell proliferation. In vitro and in vivo findings in a rabbit model of vascular injury

Arterial gene transfer represents a novel strategy that is potentially applicable to a variety of cardiovascular disorders. Attempts to perform arterial gene transfer using nonviral vectors have been compromised by a low transfection efficiency. We investigated the hypothesis that cellular proliferation induced by arterial injury could augment gene expression after liposome-mediated gene transfer. Nondenuded and denuded rabbit arterial strips were maintained in culture for up to 21 d, after which transfection was performed with a mixture of the plasmid encoding firefly luciferase and cationic liposomes. In non-denuded arteries, the culture interval before transfection did not affect the gene expression. In contrast, denuded arteries cultured for 3-14 d before transfection yielded 7-13-fold higher expression (vs. day 0; P < 0.005). Transfection was then performed percutaneously to the iliac arteries of live rabbits with or without antecedent angioplasty. Gene expression increased when transfection was performed 3-7 d postangioplasty (P < 0.05). Proliferative activity of neointimal cells assessed in vitro by [3H]thymidine incorporation, and in vivo by immunostaining for proliferating cell nuclear antigen, increased and declined in parallel with gene expression. These findings thus indicate that the expression of liposome-mediated arterial gene transfer may be augmented in presence of ongoing cellular proliferation.

[Synthesis, biological activity and encapsulation of new adrenergic beta-amino alcohols in phospholipid liposomes]

New beta-amino-alcohols were synthesized and showed beta-blocking biological activity. These potential drugs, as well as natrium salicylate, have been entrapped in phospholipid liposomes. Drug-containing liposomes were prepared from egg lecithin and DPPC (Dipalmitoylphosphatidylcholine) by the injection method. Turbidity measurements and dynamic light scattering were used to characterise the liposome and to study their stability during storage. The entrapment efficiency of the drugs in liposomes was correlated to the partition coefficient of the drugs.

Relation between activated smooth-muscle cells in coronary-artery lesions and restenosis after atherectomy

BACKGROUND

Neointimal proliferation leading to restenosis frequently develops after coronary angioplasty. This process is associated with a change in vascular smooth-muscle cells from a contractile (quiescent) phenotype to a synthetic or proliferating (activated) one. We investigated whether the presence of activated smooth-muscle cells in coronary lesions at the time of coronary atherectomy predisposes patients to subsequent restenosis.

METHODS

We used in situ hybridization to study the expression of messenger RNA in coronary-atherectomy specimens from 20 patients. Plaque material was hybridized with a probe for the B isoform of human nonmuscle myosin heavy chain, a major nonmuscle myosin isoform in activated, but not quiescent, smooth-muscle cells. Angiographic follow-up data were obtained a mean (+/- SD) of 174 +/- 54 days after atherectomy in 16 of the 20 patients, and the extent of recurrent luminal narrowing was analyzed quantitatively. The presence of restenosis was assessed by exercise thallium scintigraphy in the other four patients.

RESULTS

Atherectomy specimens from 10 of the 20 patients showed hybridization with the probe, defined as the clustering of more than 20 silver grains per cell nucleus in more than 10 nuclei in five high-power fields (x250); specimens from the other 10 patients showed no such hybridization. At follow-up, restenosis had developed in 8 of the 10 patients with positive hybridization results, but was absent in 9 of the 10 patients with negative results (P = 0.007). The degree of late loss in luminal diameter was significantly higher in patients with positive hybridization results than in those with negative results (ratio of late loss to immediate gain after atherectomy, 0.76 +/- 0.3 vs. 0.36 +/- 0.3; P < 0.001).

CONCLUSIONS

We conclude that the expression of the B isoform of nonmuscle myosin heavy chain is increased in some coronary atherosclerotic plaques and that this increase in expression identifies a group of lesions at high risk for restenosis after atherectomy.

Direct myocardial transfection in two animal models. Evaluation of parameters affecting gene expression and percutaneous gene delivery

BACKGROUND

Gene therapy represents a novel approach to the treatment of a variety of disease states. Direct injection of pure untreated DNA into skeletal and cardiac muscle is sufficient to perform gene transfer in vivo. Little information is available, however, regarding the extent to which individual parameters of direct gene delivery affect the efficiency of myocardial transfection. Moreover, the fact that all previously reported studies of successful myocardial transfection were performed using open chest surgery to visualize the heart for direct injection of DNA constitutes a potential limitation to clinical applications of myocardial gene transfer. The objectives of the present study were: (a) to determine the extent to which gene expression is altered by varying the amount of DNA and the volume of the delivery vehicle; (b) to study whether protracted expression of DNA persists after direct myocardial transfection; and (c) to test the feasibility of percutaneous, transthoracic myocardial injection of DNA.

EXPERIMENTAL DESIGN

New Zealand white rabbits (N = 30) were transfected with the firefly (Photinus pyralis) luciferase reporter gene. Twenty-three rabbits were segregated into 5 groups according to the amount of DNA and volume of delivery vehicle injected. These rabbits were sacrificed at 5 days posttransfection to measure the level of luciferase gene expression. Three more rabbits were designated exclusively for in situ hybridization. Two rabbits were sacrificed at 5 and 6 months, respectively to evaluate long-term expression. Two additional rabbits were used as controls. Yucatan microswine (N = 4) were used to evaluate the feasibility of percutaneous, transthoracic myocardial transfection with beta-galactosidase or luciferase reporter genes. Microswine were sacrificed immediately post-sham transfection (N = 2), or 5 days postmyocardial transfection (N = 2).

RESULTS

Among 11 rabbits, transfection with 10 micrograms of DNA (N = 4), 25 micrograms of DNA (N = 3), and 50 micrograms of DNA (N = 4) in 100 microL of injectate yielded a step-wise but statistically insignificant increase in luciferase activity. Among 16 rabbits, transfection with 50 micrograms of DNA in injectate volumes of 50 microliters (N = 4), 100 microliters (N = 4), 150 microliters (N = 4), and 300 microliters (N = 4) yielded a statistically significant (p < 0.05) increase in luciferase activity in those hearts transfected with 300 microliters compared with those hearts transfected with either 50 or 100 microliters. Luciferase activity at 5 and 6 months postmyocardial transfection was 7.14 and 68.8 Turner light units, respectively. In situ hybridization confirmed that myocytes represented the site of luciferase expression. Percutaneous myocardial transfection was successfully accomplished with both reporter genes.

CONCLUSIONS

The results of the present study demonstrate that increasing the amount of DNA employed for direct myocardial transfection fails to produce a statistically significant increase in the level of gene expression. In contrast, increasing the volume of injectate used to directly transfect a constant amount of DNA (50 micrograms) produced significantly augmented expression of the reporter luciferase gene. Luciferase expression was detected 6 months posttransfection. Successful transfection after fluoroscopic-guided direct percutaneous delivery suggests that it may be feasible to deliver genetic material into the myocardium of patients in a similar fashion.