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Patrick RE, Dickinson RA, Gentry MT, Kim JU, Oberlin LE, Park S, Principe JL, Teixeira AL, Weisenbach SL. Treatment resistant late-life depression: A narrative review of psychosocial risk factors, non-pharmacological interventions, and the role of clinical phenotyping. J Affect Disord 2024; 356:145-154. [PMID: 38593940 DOI: 10.1016/j.jad.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Treatment resistant depression (TRD) is a subset of major depressive disorder (MDD) in which symptoms do not respond to front line therapies. In older adults, the assessment and treatment of TRD is complicated by psychosocial risk factors unique to this population, as well as a relative paucity of research. METHODS Narrative review aimed at (1) defining TRLLD for clinical practice and research; (2) describing psychosocial risk factors; (3) reviewing psychological and non-pharmacological treatments; (4) discussing the role of clinical phenotyping for personalized treatment; and (5) outlining research priorities. RESULTS Our definition of TRLLD centers on response to medication and neuromodulation in primary depressive disorders. Psychosocial risk factors include trauma and early life adversity, chronic physical illness, social isolation, personality, and barriers to care. Promising non-pharmacological treatments include cognitive training, psychotherapy, and lifestyle interventions. The utility of clinical phenotyping is highlighted by studies examining the impact of comorbidities, symptom dimensions (e.g., apathy), and structural/functional brain changes. LIMITATIONS There is a relative paucity of TRLLD research. This limits the scope of empirical data from which to derive reliable patterns and complicates efforts to evaluate the literature quantitatively. CONCLUSIONS TRLLD is a complex disorder that demands further investigation given our aging population. While this review highlights the promising breadth of TRLLD research to date, more research is needed to help elucidate, for example, the optimal timing for implementing risk mitigation strategies, the value of collaborative care approaches, specific treatment components associated with more robust response, and phenotyping to help inform treatment decisions.
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Affiliation(s)
- Regan E Patrick
- Department of Neuropsychology, McLean Hospital, Belmont, MA, United States of America; Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America.
| | - Rebecca A Dickinson
- Department of Neuropsychology, McLean Hospital, Belmont, MA, United States of America; Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, United States of America
| | - Melanie T Gentry
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States of America
| | - Joseph U Kim
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States of America
| | - Lauren E Oberlin
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, United States of America; AdventHealth Research Institute, Neuroscience, Orlando, FL, United States of America
| | - Soohyun Park
- Department of Psychiatry, Tufts Medical Center, Boston, MA, United States of America
| | - Jessica L Principe
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States of America
| | - Antonio L Teixeira
- Department of Psychiatry & Behavioral Sciences, UT Health Houston, Houston, TX, United States of America
| | - Sara L Weisenbach
- Department of Neuropsychology, McLean Hospital, Belmont, MA, United States of America; Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
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Kanwar MK, Blumer V, Zhang Y, Sinha SS, Garan AR, Hernandez-Montfort J, Khalif A, Hickey GW, Abraham J, Mahr C, Li B, Sangal P, Walec KD, Zazzali P, Kataria R, Pahuja M, Ton VANK, Harwani NM, Wencker D, Nathan S, Vorovich E, Hall S, Khalife W, Li S, Schwartzman A, Kim JU, Vishnevsky OA, Trinquart L, Burkhoff D, Kapur NK. Pulmonary Artery Catheter Use and Risk of In-hospital Death in Heart Failure Cardiogenic Shock. J Card Fail 2023; 29:1234-1244. [PMID: 37187230 DOI: 10.1016/j.cardfail.2023.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/29/2023] [Accepted: 05/02/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Pulmonary artery catheters (PACs) are increasingly used to guide management decisions in cardiogenic shock (CS). The goal of this study was to determine if PAC use was associated with a lower risk of in-hospital mortality in CS owing to acute heart failure (HF-CS). METHODS AND RESULTS This multicenter, retrospective, observational study included patients with CS hospitalized between 2019 and 2021 at 15 US hospitals participating in the Cardiogenic Shock Working Group registry. The primary end point was in-hospital mortality. Inverse probability of treatment-weighted logistic regression models were used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CI), accounting for multiple variables at admission. The association between the timing of PAC placement and in-hospital death was also analyzed. A total of 1055 patients with HF-CS were included, of whom 834 (79%) received a PAC during their hospitalization. In-hospital mortality risk for the cohort was 24.7% (n = 261). PAC use was associated with lower adjusted in-hospital mortality risk (22.2% vs 29.8%, OR 0.68, 95% CI 0.50-0.94). Similar associations were found across SCAI stages of shock, both at admission and at maximum SCAI stage during hospitalization. Early PAC use (≤6 hours of admission) was observed in 220 PAC recipients (26%) and associated with a lower adjusted risk of in-hospital mortality compared with delayed (≥48 hours) or no PAC use (17.3% vs 27.7%, OR 0.54, 95% CI 0.37-0.81). CONCLUSIONS This observational study supports PAC use, because it was associated with decreased in-hospital mortality in HF-CS, especially if performed within 6 hours of hospital admission. CONDENSED ABSTRACT An observational study from the Cardiogenic Shock Working Group registry of 1055 patients with HF-CS showed that pulmonary artery catheter (PAC) use was associated with a lower adjusted in-hospital mortality risk (22.2% vs 29.8%, odds ratio 0.68, 95% confidence interval 0.50-0.94) compared with outcomes in patients managed without PAC. Early PAC use (≤6 hours of admission) was associated with a lower adjusted risk of in-hospital mortality compared with delayed (≥48 hours) or no PAC use (17.3% vs 27.7%, odds ratio 0.54, 95% confidence interval 0.37-0.81).
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Affiliation(s)
- Manreet K Kanwar
- Cardiovascular Institute at Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Vanessa Blumer
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, Ohio
| | - Yijing Zhang
- The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts
| | - Shashank S Sinha
- Inova Heart and Vascular Institute, Inova Fairfax Campus, Falls Church, Virginia
| | - Arthur R Garan
- Beth Israel Deaconess Medical Center, Boston, Massachusetts'
| | | | - Adnan Khalif
- Cardiovascular Institute at Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Gavin W Hickey
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Jacob Abraham
- Center for Cardiovascular Analytics, Research and Data Science, Providence Heart Institute, Portland, OR
| | - Claudius Mahr
- University of Washington Medical Center, Seattle, Washington
| | - Borui Li
- The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts
| | - Paavni Sangal
- The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts
| | - Karol D Walec
- The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts
| | - Peter Zazzali
- The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts
| | - Rachna Kataria
- Lifespan Cardiovascular Institute, Brown University, Providence, Rhode Island
| | - Mohit Pahuja
- University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - VAN-Khue Ton
- Massachusetts General Hospital, Boston, Massachusetts
| | - Neil M Harwani
- The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts
| | - Detlef Wencker
- Baylor Scott & White Advanced Heart Failure Clinic, Dallas, Texas
| | | | | | - Shelley Hall
- Baylor Scott & White Advanced Heart Failure Clinic, Dallas, Texas
| | | | - Song Li
- University of Washington Medical Center, Seattle, Washington
| | | | - J U Kim
- Houston Methodist Research Institute, Houston, Texas
| | | | - Ludovic Trinquart
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston and Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA
| | | | - Navin K Kapur
- The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts.
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3
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Kim JU, Bessette KL, Westlund-Schreiner M, Pocius S, Dillahunt AK, Frandsen S, Thomas L, Easter R, Skerrett K, Stange JP, Welsh RC, Langenecker SA, Koppelmans V. Relations of gray matter volume to dimensional measures of cognition and affect in mood disorders. Cortex 2022; 156:57-70. [PMID: 36191367 PMCID: PMC10150444 DOI: 10.1016/j.cortex.2022.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 04/05/2022] [Accepted: 06/21/2022] [Indexed: 11/03/2022]
Abstract
Understanding the relationship between brain measurements and behavioral performance is an important step in developing approaches for early identification of any psychiatric difficulties and interventions to modify these challenges. Conventional methods to identify associations between regional brain volume and behavioral measures are not optimized, either in scale, scope, or specificity. To find meaningful associations between brain and behavior with greater sensitivity and precision, we applied data-driven factor analytic models to identify and extract individual differences in latent cognitive functions embedded across several computerized cognitive tasks. Furthermore, we simultaneously utilized a keyword-based neuroimaging meta-analytic tool (i.e., NeuroSynth), restricted atlas-parcel matching, and factor-analytic models to narrow down the scope of search and to further aggregate gray matter volume (GMV) data into empirical clusters. We recruited an early adult community cross-sectional sample (Total n = 177, age 18-30) that consisted of individuals with no history of any mood disorder (healthy controls, n = 44), those with remitted major depressive disorder (rMDD, n = 104), and those with a diagnosis of bipolar disorder currently in euthymic state (eBP, n = 29). Study participants underwent structural magnetic resonance imaging (MRI) scans and separately completed behavioral testing using computerized measures. Factor-analyzing five computerized tasks used to assess aspects of cognitive and affective processing resulted in seven latent dimensions: (a) Emotional Memory, (b) Interference Resolution, (c) Reward Sensitivity, (d) Complex Inhibitory Control, (e) Facial Emotion Sensitivity, (f) Sustained attention, and (g)Simple Impulsivity/Response Style. These seven dimensions were then labeled with specific keywords which were used to create neuroanatomical maps using NeuroSynth. These masks were further subdivided into GMV clusters. Using regression, we identified GMV clusters that were predictive of individual differences across each of the aforementioned seven cognitive dimensions. We demonstrate that a dimensional approach consistent with core principles of RDoC can be utilized to identify structural variability predictive of critical dimensions of human behavior.
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Kim JU, Khizar MH, D’Cruz R, Glasser M, Rochford A. 1063 THE CHALLENGES OF PROVIDING ADEQUATE AND APPROPRIATE NUTRITION AND HYDRATION CARE TO HOSPITAL MEDICAL INPATIENTS. Age Ageing 2022. [DOI: 10.1093/ageing/afac126.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Nutrition and hydration are essential components of hospital inpatient care. Inadequate provision has been shown to be linked to poorer outcome. We performed a cross-sectional study of nutritional care in a London teaching hospital.
Method
Data collection was undertaken in October 2021 across two medical wards. Data for demographics; morbidity factors including: Charlson Comorbidity index (CCI), length of stay (LoS), cognitive score (AMTS); nutrition parameters and their recorded accuracy including: weight, ‘MUST’ score, fluid balance, food chart, and evidence of dietetic referral and review were examined.
Results
52 patients were assessed [male 24/52 (46.15%), median age 80.5 (IQR 61.75–85.25, range 30–98)]. The median CCI score was 5, corresponding to 21.36% estimated 10-year mortality, with median LoS of 8 days (IQR 3–15.25). AMTS was recorded in 12/52 (23.08%). Variable recording of nutrition parameters was observed (weight: 57.69%, ‘MUST’ score 23.1%, fluid balance 63.5%, food chart 15.4%). Only 54.6% of the recorded fluid balance charts were clinically accurate. Where oral nutritional supplement (ONS) was prescribed, 57.1% (8/14) of patients had not received a dietetic review. Upon comparison the care of the elderly ward demonstrated a significantly higher accuracy of fluid balance chart (60% vs 46%, p < 0.001).
Discussion
Supporting patients to meet nutrition and hydration goals is a core component of clinical care. Our results demonstrate that nutrition and hydration care is poorly documented across several parameters, and by inference, poorly delivered irrespective of age, co-morbidity or cognitive impairment. Less than 1/3 of patients had a formal nutrition screen suggesting that identification of patients at risk of malnutrition should be the priority for future work. An electronic health record allows easy access to data that can be used for improvement. As an achievable first step, an improvement in awareness of nutritional scores, such as MUST, will be important in identification of malnutrition.
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Affiliation(s)
- J U Kim
- Department of Respiratory Medicine, Royal Free Hospital , Pond Street, London, NW3 2QG
| | - M H Khizar
- Department of Geriatric Medicine, Royal Free Hospital , Pond Street, London, NW3 2QG
| | - R D’Cruz
- Department of Respiratory Medicine, Royal Free Hospital , Pond Street, London, NW3 2QG
| | - M Glasser
- Department of Geriatric Medicine, Royal Free Hospital , Pond Street, London, NW3 2QG
| | - A Rochford
- Department of Gastroenterology, Royal Free Hospital , Pond Street, London, NW3 2QG
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5
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Wright HM, Fuessel-Hermann D, Pazdera M, Lee S, Ridge B, Kim JU, Konopacki K, Hilton L, Greensides M, Langenecker SA, Smith AJ. Preventative Care in First Responder Mental Health: Focusing on Access and Utilization via Stepped Telehealth Care. Front Health Serv 2022; 2:848138. [PMID: 36925868 PMCID: PMC10012773 DOI: 10.3389/frhs.2022.848138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022]
Abstract
First responders are at high risk for disorders that arise from repeat exposure to stress and trauma (Post Traumatic Stress Disorder, depression, and problematic alcohol use). Although mental health treatments are available, first responders often do not access them, anchored by barriers that include: lack of knowledge, stigma, negative experience with mental health providers, and time-based burdens. In this study, we designed an intervention to address these barriers, extending a Planned-Action framework. Step 1 involved self-report screening for four mental health risks (PTSD, depression, anxiety, and alcohol use risk), delivered to all personnel electronically, who were free to either consent and participate or opt-out. The detection of risk(s) in Step 1 led to scheduling a Step 2 telehealth appointment with a trained clinician. We report descriptive statistics for participation/attrition/utilization in Steps 1 and 2, rates of risk on four mental health variables, and rate of adherence to follow-up treatment recommendations. Step 1: In total, 53.3% of personnel [229 of 429 full-time employees (221 males; eight females; 95% White; 48% paramedic or Emergency Medical Technician; 25% captain; 19% engineer; 7% other)] initially opted-in by consenting and completing the brief remote screening survey. Among those who opted-in and completed (n = 229), 43% screened positive for one or more of the following mental health risks: PTSD (7.9%); depression (9.6%); anxiety (13.5%); alcohol use (36.7%). Step 2: A maximum of three attempts were made to schedule "at risk" individuals into Step 2 (n = 99). Among the 99 who demonstrated a need for mental health treatment (by screening positive for one or more risk), 56 (56.6%) engaged in the telehealth appointment. Of the 56 who participated in Step 2 clinical appointments, 38 were recommended for further intervention (16.6% of full-time personnel who participated). Among the 38 firefighters who were recommended to seek further mental health services, 29 were adherent/followed through (76.3% of those who received recommendations for further services). Taken together, evidence-based, culturally conscious, stepped care models delivered via the virtual/telehealth medium can promote access, utilization, and cost-effective mental health services for first responders. Implications are for informing larger, more rigorous dissemination and implementation efforts.
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Affiliation(s)
- Hannah M Wright
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States
| | | | - Myah Pazdera
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States
| | - Somi Lee
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States
| | - Brook Ridge
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States
| | - Joseph U Kim
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States.,Salt Lake City Veterans Affairs (VA) Medical Center, Salt Lake City, UT, United States
| | - Kelly Konopacki
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States
| | - Layne Hilton
- United Fire Authority, Salt Lake City, UT, United States
| | | | - Scott A Langenecker
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States
| | - Andrew J Smith
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States.,Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, United States.,Lyda Hill Institute for Human Resilience, University of Colorado, Colorado Springs, CO, United States
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Dotson VM, McClintock SM, Verhaeghen P, Kim JU, Draheim AA, Syzmkowicz SM, Gradone AM, Bogoian HR, Wit LD. Depression and Cognitive Control across the Lifespan: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2020; 30:461-476. [PMID: 32385756 DOI: 10.1007/s11065-020-09436-6] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 03/15/2020] [Indexed: 12/19/2022]
Abstract
Depression has been shown to negatively impact neurocognitive functions, particularly those governed by fronto-subcortical networks, such as executive functions. Converging evidence suggests that depression-related executive dysfunction is greater at older ages, however, this has not been previously confirmed by meta-analysis. We performed a systematic review and meta-analysis, using three-level models, on peer-reviewed studies that examined depression-related differences in cognitive control in healthy community-dwelling individuals of any age. We focused on studies of cognitive control as defined by the National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) framework, which centers on goal-directed behavior, such as goal selection (updating, representations, maintenance), response selection (inhibition or suppression), and performance monitoring. In 16,806 participants aged 7 to 97 across 76 studies, both clinical depression and subthreshold depressive symptoms were associated with cognitive control deficits (Hedges' g = -0.31). This relationship was stronger in study samples with an older mean age. Within studies with a mean age of 39 years or higher, which represents the median age in our analyses, the relationship was stronger in clinical compared to subthreshold depression and in individuals taking antidepressant medication. These findings highlight the importance of clinicians screening for cognitive control dysfunction in patients with depression, particularly in later stages of adulthood.
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Affiliation(s)
- Vonetta M Dotson
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA. .,Gerontology Institute, Georgia State University, Atlanta, GA, USA.
| | - Shawn M McClintock
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Paul Verhaeghen
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Joseph U Kim
- Department of Psychiatry, University of Utah School of Medicine, Lake City, UT, USA
| | - Amanda A Draheim
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Sarah M Syzmkowicz
- Department of Neurological Services, University of Nebraska Medical Center, Omaha, NE, USA
| | - Andrew M Gradone
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Hannah R Bogoian
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Liselotte De Wit
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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7
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Kim JU, Weisenbach SL, Zald DH. Ventral prefrontal cortex and emotion regulation in aging: A case for utilizing transcranial magnetic stimulation. Int J Geriatr Psychiatry 2019; 34:215-222. [PMID: 30259580 PMCID: PMC6345398 DOI: 10.1002/gps.4982] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 07/12/2018] [Indexed: 01/29/2023]
Abstract
OBJECTIVES The ventrolateral prefrontal cortex (vlPFC) has been speculated to play an important role in complex processes that allow emotional factors to influence human cognition. Accumulating evidence from human neuroimaging studies, in conjunction with studies of patients with lesions and animal models, shed light on the role of the vlPFC in emotion regulation (ER). This review aims to discuss and integrate recent findings related to vlPFC's role in ER in the context of aging, drawing from diverse sources, and suggest future directions for research utilizing transcranial magnetic stimulation (TMS). METHODS/DESIGN We summarize findings from the existing literature investigating the neural basis of frontal-lobe mediated ER and then highlight major findings from recent studies directly comparing healthy younger and older adult groups. We conclude by pointing to unaddressed questions worth pursuing in future research. RESULTS AND DISCUSSION We propose future research directions utilizing TMS to answer key unaddressed questions. Moreover, we discuss the potential advantages, challenges, and limitations of using TMS as a complement to the existing neuroimaging methods in ER.
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Affiliation(s)
- Joseph U. Kim
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - Sara L. Weisenbach
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
- VA Salt Lake, Salt Lake City, UT, USA
| | - David H. Zald
- Department of Psychological Science, Vanderbilt University, Nashville, TN, USA
- Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN, USA
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8
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McClintock SM, Kallioniemi E, Martin DM, Kim JU, Weisenbach SL, Abbott CC. A Critical Review and Synthesis of Clinical and Neurocognitive Effects of Noninvasive Neuromodulation Antidepressant Therapies. Focus (Am Psychiatr Publ) 2019; 17:18-29. [PMID: 31975955 PMCID: PMC6493152 DOI: 10.1176/appi.focus.20180031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There is a plethora of current and emerging antidepressant therapies in the psychiatric armamentarium for the treatment of major depressive disorder. Noninvasive neuromodulation therapies are one such therapeutic category; they typically involve the transcranial application of electrical or magnetic stimulation to modulate cortical and subcortical brain activity. Although electroconvulsive therapy (ECT) has been used since the 1930s, with the prevalence of major depressive disorder and treatment-resistant depression (TRD), the past three decades have seen a proliferation of noninvasive neuromodulation antidepressant therapeutic development. The purpose of this critical review was to synthesize information regarding the clinical effects, neurocognitive effects, and possible mechanisms of action of noninvasive neuromodulation therapies, including ECT, transcranial magnetic stimulation, magnetic seizure therapy, and transcranial direct current stimulation. Considerable research has provided substantial information regarding their antidepressant and neurocognitive effects, but their mechanisms of action remain unknown. Although the four therapies vary in how they modulate neurocircuitry and their resultant antidepressant and neurocognitive effects, they are nonetheless useful for patients with acute and chronic major depressive disorder and TRD. Continued research is warranted to inform dosimetry, algorithm for administration, and integration among the noninvasive neuromodulation therapies and with other antidepressant strategies to continue to maximize their safety and antidepressant benefit.
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Affiliation(s)
- Shawn M McClintock
- Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas (UT) Southwestern Medical Center, Dallas, Texas (McClintock, Kallioniemi, Martin); Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (McClintock); Black Dog Institute, Sydney, Australia, and School of Psychiatry, University of New South Wales, Sydney (Martin); Department of Psychiatry, University of Utah School of Medicine, Salt Lake City (Kim, Weisenbach); VA Salt Lake City, Mental Health Program (Weisenbach); Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque (Abbott)
| | - Elisa Kallioniemi
- Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas (UT) Southwestern Medical Center, Dallas, Texas (McClintock, Kallioniemi, Martin); Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (McClintock); Black Dog Institute, Sydney, Australia, and School of Psychiatry, University of New South Wales, Sydney (Martin); Department of Psychiatry, University of Utah School of Medicine, Salt Lake City (Kim, Weisenbach); VA Salt Lake City, Mental Health Program (Weisenbach); Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque (Abbott)
| | - Donel M Martin
- Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas (UT) Southwestern Medical Center, Dallas, Texas (McClintock, Kallioniemi, Martin); Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (McClintock); Black Dog Institute, Sydney, Australia, and School of Psychiatry, University of New South Wales, Sydney (Martin); Department of Psychiatry, University of Utah School of Medicine, Salt Lake City (Kim, Weisenbach); VA Salt Lake City, Mental Health Program (Weisenbach); Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque (Abbott)
| | - Joseph U Kim
- Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas (UT) Southwestern Medical Center, Dallas, Texas (McClintock, Kallioniemi, Martin); Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (McClintock); Black Dog Institute, Sydney, Australia, and School of Psychiatry, University of New South Wales, Sydney (Martin); Department of Psychiatry, University of Utah School of Medicine, Salt Lake City (Kim, Weisenbach); VA Salt Lake City, Mental Health Program (Weisenbach); Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque (Abbott)
| | - Sara L Weisenbach
- Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas (UT) Southwestern Medical Center, Dallas, Texas (McClintock, Kallioniemi, Martin); Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (McClintock); Black Dog Institute, Sydney, Australia, and School of Psychiatry, University of New South Wales, Sydney (Martin); Department of Psychiatry, University of Utah School of Medicine, Salt Lake City (Kim, Weisenbach); VA Salt Lake City, Mental Health Program (Weisenbach); Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque (Abbott)
| | - Christopher C Abbott
- Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas (UT) Southwestern Medical Center, Dallas, Texas (McClintock, Kallioniemi, Martin); Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (McClintock); Black Dog Institute, Sydney, Australia, and School of Psychiatry, University of New South Wales, Sydney (Martin); Department of Psychiatry, University of Utah School of Medicine, Salt Lake City (Kim, Weisenbach); VA Salt Lake City, Mental Health Program (Weisenbach); Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque (Abbott)
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Shin KY, Lee TB, Jin SO, Choi SH, Yoo SK, Huh Y, Kim JU, Kim JY. Characteristics of the pulse wave in patients with chronic gastritis and the healthy in Korean medicine. Annu Int Conf IEEE Eng Med Biol Soc 2013; 2012:992-5. [PMID: 23366061 DOI: 10.1109/embc.2012.6346100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Chronic gastritis is a disease that occurs in one in every 10 persons in Korea. Endoscopic examination is needed to diagnose chronic gastritis in western medicine, but it causes patients pain, long period of examinations and financial burden. In KM (Korean Medicine), on the other hand, it can be known whether stomach is abnormal or not through a pulse diagnosis. The 'Guan' position of the right wrist is related to a stomach in KM. Thus, the pulse wave of the right-hand "Guan" of patients with chronic gastritis and the healthy were measured. Then, the diagnostic parameter and features to distinguish between the patients with chronic gastritis and the healthy were discovered. Through P-H curve, consequently, it can be concluded that the pulse waves of patients with chronic gastritis appear as a floating pulse, whereas the pulse waves of the healthy appear as a normal pulse.
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Affiliation(s)
- K Y Shin
- Korea Electrotechnology Research Institute, Ansan, Korea.
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10
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11
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Yang YB, Jeon YM, Kim JU, Cho J. Diblock and triblock copolymer thin films on a substrate with controlled selectivity. Eur Phys J E Soft Matter 2012; 35:86. [PMID: 22972228 DOI: 10.1140/epje/i2012-12086-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2012] [Revised: 08/01/2012] [Accepted: 08/02/2012] [Indexed: 06/01/2023]
Abstract
Using self-consistent field theory (SCFT), morphology development in symmetric linear ABC triblock copolymer films on neutral and selective substrates has been studied, and it is compared with the triblock copolymer morphologies in bulk. In particular, the effects of the substrate preferable to B (interior) block on nanopattern formation of the copolymer films are of our central interest. Here, we report various nanopatterns with tunable square morphologies. The domain patterns are much more diverse than those parallel to the substrate with substrate selectivity for end-block or those vertical to the substrate without substrate selectivity. Furthermore, in order to figure out an economical and efficient way to fabricate useful passive pattern transfer layers, which have potential applications in microelectronic processes and ultrahigh density storage media, we propose a two-step strategy and scrutinize the conditions for generating square symmetries using cylinder-forming or lamella-forming AB diblock copolymers deposited on substrates created from ABC triblock copolymer films. It is found that a thinner film with weak incompatibility can produce square patterns.
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Affiliation(s)
- Y-B Yang
- School of Mechanical and Advanced Materials Engineering, UNIST, Ulsan, Korea
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12
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Matsen MW, Kim JU, Likhtman AE. Finite-N effects for ideal polymer chains near a flat impenetrable wall. Eur Phys J E Soft Matter 2009; 29:107-115. [PMID: 19440742 DOI: 10.1140/epje/i2009-10454-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2009] [Accepted: 03/25/2009] [Indexed: 05/27/2023]
Abstract
This paper addresses the statistical mechanics of ideal polymer chains next to a hard wall. The principal quantity of interest, from which all monomer densities can be calculated, is the partition function, G(N)(z) , for a chain of N discrete monomers with one end fixed a distance z from the wall. It is well accepted that in the limit of infinite N , G(N)(z) satisfies the diffusion equation with the Dirichlet boundary condition, G(N)(0) = 0, unless the wall possesses a sufficient attraction, in which case the Robin boundary condition, G(N)(0) = - xi G(N)(')(0), applies with a positive coefficient, xi. Here we investigate the leading N(-1/2) correction, Delta G (N)(z). Prior to the adsorption threshold, Delta G(N)(z) is found to involve two distinct parts: a Gaussian correction (for z approximately <or= aN(1/2) with a model-dependent amplitude, A, and a proximal-layer correction (for z approximately <or= a described by a model-dependent function, B(z).
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Affiliation(s)
- M W Matsen
- Department of Mathematics, University of Reading, Reading RG6 6AX, Whiteknights, UK.
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13
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Park HW, Wang JH, Kim JU, Koo SW, Kwon HJ, Jang YJ. Does isoflurane enhance rhinovirus replication and virus-induced cytokine secretion in airway epithelial cells? Acta Anaesthesiol Scand 2008; 52:1046-50. [PMID: 18840102 DOI: 10.1111/j.1399-6576.2008.01691.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND There have been no previous studies regarding the effect of volatile anesthetics on human rhinovirus (RV) infection in airway epithelial cells of patients with an upper respiratory infection (URI). We have therefore evaluated in vitro the effect of isoflurane on RV infection in airway epithelial cells. METHODS A549 cells and RV-infected A549 cells were treated with isoflurane for 2 or 4 h. Surface expression of intercellular adhesion molecule-1 (ICAM-1) was assessed by flow cytometry, and effects on the secretion of interleukin (IL)-6 and IL-8 were measured by ELISA. The effect on RV replication in the cells was determined by viral titer. RESULTS Isoflurane treatment for 2 or 4 h had no significant effect on ICAM-1 expression and secretion of IL-6 and IL-8 in control cells. Isoflurane also had no significant additional effect on RV-induced ICAM-1 expression and secretion of IL-6 and IL-8. Viral titers were not significantly influenced by isoflurane. CONCLUSION Isoflurane treatment showed no additional effects with RV on ICAM-1 expression, secretion of IL-6 and IL-8, and viral titer in A549 cells. These results suggest that isoflurane itself may not increase further RV infections, inflammations, and viral replication in patients with a viral URI.
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Affiliation(s)
- H-W Park
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kim JU, Matsen MW. Finite-stretching corrections to the Milner-Witten-Cates theory for polymer brushes. Eur Phys J E Soft Matter 2007; 23:135-44. [PMID: 17551667 DOI: 10.1140/epje/i2007-10188-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2007] [Accepted: 05/04/2007] [Indexed: 05/12/2023]
Abstract
This paper investigates finite-stretching corrections to the classical Milner-Witten-Cates theory for semi-dilute polymer brushes in a good solvent. The dominant correction to the free energy originates from an entropic repulsion caused by the impenetrability of the grafting surface, which produces a depletion of segments extending a distance mu proportional to L(-1) from the substrate, where L is the classical brush height. The next most important correction is associated with the translational entropy of the chain ends, which creates the well-known tail where a small population of chains extend beyond the classical brush height by a distance xi proportional to L(-1/3). The validity of these corrections is confirmed by quantitative comparison with numerical self-consistent field theory.
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Affiliation(s)
- J U Kim
- Department of Mathematics, University of Reading, Whiteknights, Reading RG6 6AX, UK.
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Panksepp JB, Jochman KA, Kim JU, Koy JJ, Wilson ED, Chen Q, Wilson CR, Lahvis GP. Affiliative behavior, ultrasonic communication and social reward are influenced by genetic variation in adolescent mice. PLoS One 2007; 2:e351. [PMID: 17406675 PMCID: PMC1831495 DOI: 10.1371/journal.pone.0000351] [Citation(s) in RCA: 217] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2007] [Accepted: 03/13/2007] [Indexed: 11/18/2022] Open
Abstract
Social approach is crucial for establishing relationships among individuals. In rodents, social approach has been studied primarily within the context of behavioral phenomena related to sexual reproduction, such as mating, territory defense and parental care. However, many forms of social interaction occur before the onset of reproductive maturity, which suggests that some processes underlying social approach among juvenile animals are probably distinct from those in adults. We conducted a longitudinal study of social investigation (SI) in mice from two inbred strains to assess the extent to which genetic factors influence the motivation for young mice to approach one another. Early-adolescent C57BL/6J (B6) mice, tested 4–6 days after weaning, investigated former cage mates to a greater degree than BALB/cJ (BALB) mice, irrespective of the sex composition within an interacting pair. This strain difference was not due to variation in maternal care, the phenotypic characteristics of stimulus mice or sensitivity to the length of isolation prior to testing, nor was it attributable to a general difference in appetitive motivation. Ultrasonic vocalization (USV) production was positively correlated with the SI responses of mice from both strains. Interestingly, several USV characteristics segregated with the genetic background of young mice, including a higher average frequency and shorter duration for the USVs emitted by B6 mice. An assessment of conditioned place preference responses indicated that there was a strain-dependent difference in the rewarding nature of social contact. As adolescent mice aged, SI responses gradually became less sensitive to genetic background and more responsive to the particular sex of individuals within an interacting pair. We have thus identified a specific, genetic influence on the motivation of early-adolescent mice to approach one another. Consistent with classical theories of motivation, which propose a functional relationship between behavioral approach and reward, our findings indicate that reward is a proximal mechanism through which genetic factors affect social motivation during early adolescence.
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Affiliation(s)
- Jules B. Panksepp
- Neuroscience Training Program, University of Wisconsin, Madison, Wisconsin, United States of America
- * To whom correspondence should be addressed. E-mail: (JP); (GL)
| | - Kimberly A. Jochman
- Department of Surgery, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Joseph U. Kim
- Department of Surgery, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Jamie J. Koy
- Undergraduate Program in Religious Studies, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Ellie D. Wilson
- Undergraduate Program in Biological Sciences, University of Wisconsin, Madison, Wisconsin, United States of America
| | - QiLiang Chen
- Undergraduate Program in Biological Sciences, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Clarinda R. Wilson
- Undergraduate Program in Biological Sciences, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Garet P. Lahvis
- Department of Surgery, University of Wisconsin, Madison, Wisconsin, United States of America
- Waisman Center for Developmental Disabilities, University of Wisconsin, Madison, Wisconsin, United States of America
- * To whom correspondence should be addressed. E-mail: (JP); (GL)
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Kang SH, Kim JU, Imm JY, Oh S, Kim SH. The effects of dairy processes and storage on insulin-like growth factor-I (IGF-I) content in milk and in model IGF-I-fortified dairy products. J Dairy Sci 2006; 89:402-9. [PMID: 16428610 DOI: 10.3168/jds.s0022-0302(06)72104-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The effects of several dairy processes on insulin-like growth factor-I (IGF-I) concentrations in milk and the storage stability of IGF-I-fortified dairy products were examined. The IGF-I content in raw milk determined by radioimmunoassay was significantly changed by the strength of heat treatments. In commercial manufacture of whole milk dry powder, IGF-I concentration was not significantly changed. A significant reduction in IGF-I content was found as the result of fermentation with a commercial starter culture. The IGF-I content in fortified milk and dried milk powder exhibited no significant changes over the tested storage periods (12 d for milk, 4 wk for dried milk powder), but the IGF-I content in the yogurt decreased significantly during storage. The use of IGF-I was varied by lactic strains and was apparent in the viable cells. When IGF-I was encapsulated using the surface-reforming process, the remaining IGF-I content after fermentation was significantly higher compared with that of the untreated control. Therefore, enteric coating of IGF-I before fermentation might be an effective method for the prevention of IGF-I degradation during fermentation.
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Affiliation(s)
- S H Kang
- Institute of Dairy Food Research, Seoul Dairy Cooperative, Ansan 425-838, Korea
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Chang HK, Jang WC, Park SB, Han SM, Nam YH, Lee SS, Kim JU, Lee HS. Association between interleukin 6 gene polymorphisms and Behcet's disease in Korean people. Ann Rheum Dis 2005; 64:339-40. [PMID: 15647448 PMCID: PMC1755342 DOI: 10.1136/ard.2004.024208] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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18
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Kim JU, Hafz N, Suk H. Electron trapping and acceleration across a parabolic plasma density profile. Phys Rev E Stat Nonlin Soft Matter Phys 2004; 69:026409. [PMID: 14995568 DOI: 10.1103/physreve.69.026409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2003] [Indexed: 05/24/2023]
Abstract
It is known that as a laser wakefield passes through a downward density transition in a plasma some portion of the background electrons are trapped in the laser wakefield and the trapped electrons are accelerated to relativistic high energies over a very short distance. In this study, by using a two-dimensional (2D) particle-in-cell (PIC) simulation, we suggest an experimental scheme that can manipulate electron trapping and acceleration across a parabolic plasma density channel, which is easier to produce and more feasible to apply to the laser wakefield acceleration experiments. In this study, 2D PIC simulation results for the physical characteristics of the electron bunches that are emitted from the parabolic density plasma channel are reported in great detail.
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Affiliation(s)
- J U Kim
- Korea Electrotechnology Research Institute, Center for Advanced Accelerators, 28-1 Seongju-dong, Changwon 641-120, Korea.
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19
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Chang HK, Kim JU, Lee SS, Yoo DH. Lack of association between angiotensin converting enzyme gene polymorphism and Korean Behçet's disease. Ann Rheum Dis 2004; 63:106-7. [PMID: 14672905 PMCID: PMC1754730 DOI: 10.1136/ard.2003.011007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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20
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Lim BS, Kim JU, Park HD. Improvement of existing nightsoil treatment plant for nitrogen removal. Water Sci Technol 2004; 49:273-279. [PMID: 15137434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This study was performed to increase the treatment efficiency and to reduce operation and maintenance costs of the existing nightsoil treatment plant. The existing nightsoil plant was not established by the nitrogen removal process, and was operated ineffectively with deterioration of treatment efficiency rate, and according to the demand of many operators, the expenses of operation and maintenance have become excessive. Modified plant has been changed through two steps. The first step, liquid decayed tank using closed oxidation ditch is operated to increase retention time only for nitrification. The second step, modified liquid decayed tank including anoxic tank is operated, it has an excellent nitrogen removal rate. In first step, when HRT was increased from 10 days to 13 days in liquid decayed tank including aeration tank using closed oxidation ditch, TN concentration of effluent appeared below 51 mg/L less than discharge limit, 60 mg/L. In second step, when anoxic tank and oxic tank were installed, HRT has been increased to 13 days and 26 days, respectively. Then average TN concentration of effluent was detected less than 13 mg/L for over one year. The simple process modified the existing two processes resulted in the reduction of costs for operation and maintenance in the personnel, chemical, and filter change sphere.
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Affiliation(s)
- B S Lim
- Department of Environmental Engineering, Daejeon University, 96-3 Yongun-dong, Dong-gu, Daejeon, 300-716, Korea.
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Kim JU, Chang HK, Lee SS, Kim JW, Kim KT, Lee SW, Chung WT. Endothelial nitric oxide synthase gene polymorphisms in Behçet's disease and rheumatic diseases with vasculitis. Ann Rheum Dis 2003; 62:1083-7. [PMID: 14583572 PMCID: PMC1754357 DOI: 10.1136/ard.62.11.1083] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To assess potential associations between Korean Behçet's disease (BD) or other rheumatic diseases with vasculitis and two polymorphisms of the endothelial nitric oxide synthase (eNOS) gene, which include the Glu298Asp polymorphism in exon 7 and a variable number of tandem repeats (VNTR) polymorphism in intron 4. METHODS 65 patients with BD, 27 with rheumatic diseases with vasculitis, and 80 controls were studied. Analyses of the Glu298Asp polymorphism in exon 7 and VNTR polymorphism in intron 4 of the eNOS gene were made by the polymerase chain reaction (PCR)-restriction fragment length polymorphism technique and PCR genotyping, respectively. Additionally, HLA-B51 typing was performed in the BD group and controls by a two step PCR sequence-specific primers method. RESULTS Significant differences in Glu298Asp genotype frequencies were found between the BD or vasculitis groups and the controls (BD group v controls: p(corr)=0.006; vasculitis group v controls: p<0.001). The Asp298 frequency was much higher in the BD and vasculitis groups than in the controls. Even after stratification of the BD group based on the results of HLA-B51 testing, a significant association of the Glu298Asp polymorphism was still found (p=0.002, Mantel-Haenszel weighted odds ratio 4.3, 95% confidence interval 1.7 to 10.9). Distribution of the genotype frequencies in two eNOS gene polymorphisms was similar in connective tissue diseases-associated vasculitis and primary vasculitic syndromes. In contrast, distribution of alleles and genotypes of VNTR polymorphism did not differ between BD or vasculitis groups and the controls. CONCLUSION The Glu298Asp polymorphism in exon 7 of the eNOS gene seems to be a susceptibility gene for Korean BD and other rheumatic diseases.
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Affiliation(s)
- J U Kim
- Department of Laboratory Medicine, Ulsan University, Kangnung, South Korea
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Chang HK, Lee SS, Kim JW, Jee YK, Kim JU, Lee YW, Yoon BY. The prevalence of atopy and atopic diseases in Behçet's disease. Clin Exp Rheumatol 2003; 21:S31-4. [PMID: 14727456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
OBJECTIVE The prevalence of Th-2 cell-mediated diseases, such as atopic diseases, has been noted to be low in Th-1 cell-mediated diseases. This study was undertaken to assess the prevalence of atopy and atopic diseases in Behçet's disease (BD), a Th-1 cell-mediated disease, and to investigate the clinical association between the atopy and the development of severe manifestations in BD. METHODS We examined 70 consecutive BD patients and 113 controls without BD or other inflammatory rheumatic diseases. The cumulative history of severe manifestations in BD patients was investigated during the disease course. A skin prick test was performed in all the subjects, and atopy was defined as present when the size of one or more allergen-induced wheals was equal to or larger than that caused by histamine. Atopic diseases were defined as present when there were relevant responses for atopic diseases on the questionnaires in the subjects with atopy. In addition, serum IgE levels and peripheral blood eosinophil counts were measured. RESULTS The prevalence of atopy and atopic diseases was significantly lower in BD patients than in controls. Other atopy parameters, such as serum IgE levels and peripheral blood eosinophil counts, were also significantly lower in BD patients when compared with controls. However, atopy, serum IgE levels, and peripheral blood eosinophil counts did not differ significantly between BD patients with and without severe manifestations. CONCLUSION The prevalence of Th-2 cell-mediated conditions, such as atopy and atopic diseases, appeared to be lower in BD, a Th-1 cell-mediated disease. In addition, a Th-1 and Th-2 balance may not influence the development of severe manifestations in BD.
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Affiliation(s)
- H K Chang
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Dankook University, 16-5 Anseo-Dong, Cheonan, Chungcheong Nam Do, 330-715, South Korea.
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Park JK, Kim SZ, Kim JU, Kim YG, Kim SM, Cho KW. Comparison of effects of angiotensin peptides in the regulation of clitoral cavernosum smooth muscle tone. Int J Impot Res 2002; 14:72-80. [PMID: 11979320 DOI: 10.1038/sj.ijir.3900824] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2001] [Revised: 08/09/2001] [Accepted: 11/21/2001] [Indexed: 01/23/2023]
Abstract
The isometric tension measurement and in vitro autoradiography were used in clitoral cavernosum smooth muscle (CSM). Angiotensin ANG III, ANG IV, ANG II and ANG I induced contractions in clitoral CSM strips. ANG III and ANG I- induced contraction was five times less active than ANG II, whereas ANG IV-induced contraction was 1181-fold less potent than ANG II. Contractile responses to ANG III, ANG IV, ANG II and ANG I were significantly inhibited by type 1 ANG II (AT 1) receptor antagonist Dup 753 but not by type 2 ANG II (AT2) receptor antagonist PD 123,319. Pre-treatment with Nomega-nitro-L-arginine methyl ester, nitric oxide (NO) synthase inhibitor accentuated force of contraction induced by ANG III, ANG IV and ANG II. Amastatin, an aminopeptidase inhibitor enhanced ANG III- and ANG IV-induced contractions. Specific binding sites for 125I-ANG II were found in the clitoral CSM. Specific binding of 125I-ANG II was displaced by unlabeled ANG peptides. This study suggests that the contractile responses to all four peptides of the ANG family are mediated via AT1 receptors but not AT2 receptors. Further, the rank order of potency of contraction was as follows, ANG II> ANG I>ANG III>ANG IV. It is also suggested that peptides of the ANG family have a cross-talk with the NO system and aminopeptidase is involved in the modulation of the tone of clitoral CSM by ANG III and ANG IV.
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Affiliation(s)
- J K Park
- Department of Urology, Chonbuk National University Medical School, Keum-Am-Dong-San, Chonju, South Korea.
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Hwang JH, Hwang KS, Kim JU, Choi IC, Park PH, Han SM. The interaction between intrathecal neostigmine and GABA receptor agonists in rats with nerve ligation Injury. Anesth Analg 2001; 93:1297-303. [PMID: 11682418 DOI: 10.1097/00000539-200111000-00054] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
UNLABELLED Nerve ligation injury may produce a pain syndrome that includes tactile allodynia. Reversal effects on tactile allodynia have been demonstrated after the intrathecal administration of gamma-aminobutyric acid (GABA) receptor agonists or cholinesterase inhibitors in rats. We examined the drug interactions between neostigmine and muscimol or baclofen in a rat model of nerve ligation injury. Rats were prepared with tight ligation of the left L5-6 spinal nerves and chronic intrathecal catheter implantation. Tactile allodynia was measured by applying von Frey filaments ipsilateral to the lesioned hindpaw. Thresholds for paw withdrawal were assessed. Neostigmine (0.3-10 microg), muscimol (0.1-10 microg), and baclofen (0.1-3.0 microg) were administered to obtain the dose-response curve and the 50% effective dose (ED(50)). Fractions of ED(50) values were administered intrathecally to establish the ED(50)s of drug combinations (neostigmine-muscimol and neostigmine-baclofen). The drug interactions were performed. Intrathecal neostigmine, muscimol, baclofen, and their combinations produced a dose-dependent increase in withdrawal threshold of the lesioned hindpaw. Both analyses revealed a synergistic interaction for the neostigmine-muscimol combination, whereas the effect of the neostigmine-baclofen combination was additive. These results suggest that the activation of both muscarinic and GABA(A) receptors is required for synergistic interaction. IMPLICATIONS This study indicates that drug interaction is synergistic for the neostigmine-muscimol combination, whereas the effect of the neostigmine-baclofen combination is additive. In a rat model of nerve ligation injury, neostigmine, muscimol, baclofen, and their combinations provide an antagonism on touch-evoked allodynia at the spinal level.
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Affiliation(s)
- J H Hwang
- Department of Anesthesiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
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Koh JT, Choi HH, Ahn KY, Kim JU, Kim JH, Chun JY, Baik YH, Kim KK. Cardiac Characteristics of Transgenic Mice Overexpressing Refsum Disease Gene-Associated Protein within the Heart. Biochem Biophys Res Commun 2001; 286:1107-16. [PMID: 11527414 DOI: 10.1006/bbrc.2001.5510] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Arrhythmia is a common cardiac symptom of Refsum disease. Recently, we identified a novel neuron-specific PAHX-associated protein (PAHX-AP1), which binds to the Refsum disease gene (PAHX). In this report, we developed heart-targeted transgenic (TG) mice under the control of alpha-myosin heavy chain promoter to determine whether cardiac overexpression of PAHX-AP1 provokes cardiac involvement symptoms. Northern and in situ hybridization analyses revealed PAHX-AP1 transcript was overexpressed in TG atrium, especially in the sinoatrial node. TG mice showed tachycardia, and tachyarrhythmia was observed in 20% of TG mice. Isolated TG atria showed higher frequency beating and were more sensitive to aconitine-induced tachyarrhythmia than the wild-type, and 40% of the TG atria showed irregular beating. Action potential duration in TG atrial fiber was shortened much more than the wild-type. Systemic administration of arrhythmogenic agents induced arrhythmia in TG mice, while no arrhythmia with the same dose in nonTG mice. Our results indicate that the chronic atrial tachycardia by overexpressed neuron-specific PAHX-AP1 transgene in atrium may be responsible for the increased susceptibility to arrhythmia.
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Affiliation(s)
- J T Koh
- Dental Science Research Institute, Chonnam National University, Kwangju, 501-190, South Korea
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Chang HK, Kim JU, Cheon KS, Chung HR, Lee KW, Lee IH. HLA-B51 and its allelic types in association with Behçet's disease and recurrent aphthous stomatitis in Korea. Clin Exp Rheumatol 2001; 19:S31-5. [PMID: 11760395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE This case-control study was undertaken to evaluate the association of HLA-B51 antigen and its allelic types with Behçet's disease (BD) and with recurrent aphthous stomatitis (RAS), to investigate the degree of this association with diagnostic types and clinical variables of BD. METHODS The DNA typing of HLA-B51 by nested PCR-SSP was performed in 61 patients with BD, 56 patients with RAS, and in 70 healthy controls. Also, blind quality control study was done to assess the accuracy of nested PCR-SSP in HLA-B51-positive and negative BD patients on the microlymphocytotoxicity. In addition, direct DNA sequencing analysis was carried out in HLA-B51-positive individuals. RESULTS The outcome of nested PCR-SSP showed 100% concordance with those of the microlymphocytotoxicity. The prevalence of HLA-B51 in patients with BD was 55.7%, 16.1% in patients with RAS, and 15.7% in healthy controls. According to the diagnostic types of BD, all ten patients with complete BD had HLA-B51 antigen, and 47.1% in patients with incomplete BD (p = 0.002). In addition, the prevalence of HLA-B51 was statistically significant in patients with BD who had uveitis (p = 0.003) or erythema nodosum (p = 0.042). Direct DNA sequencing analysis revealed that the major allelic types in BD, RAS, and in healthy control were mostly HLA-B*51011. CONCLUSIONS Compared to patients with RAS or healthy controls, prevalence of HLA-B51 in the Korean patients with BD was much higher. The BD patients with B51 seemed to be susceptible for manifesting uveitis, erythema nodosum, and the full-blown syndrome as complete BD. Therefore the presence of HLA-B51 antigen in BD patients would be a genetic marker for the severe disease. In addition, there was no difference on the major allelic types of HLA-B51 in BD, RAS, and in healthy control.
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Affiliation(s)
- H K Chang
- Department of Internal Medicine, Asan Kangnung Hospital, Ulsan University, Kangnung.
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Abstract
Kaposi's sarcoma (KS) appears to develop in association with kidney transplantation, but unlikely with dialysis. We report two cases of classic KS that occurred in patients receiving short-term (less than 3 yr) dialysis. They have been suffering from chronic renal failure due to tuberculosis and diabetes mellitus, respectively. Several to multiple, reddened-violaceous patches, plaques and nodules were found on the hand and the lower extremities. Laboratory studies showed no evidence suggesting immunosuppressed state and there was no history of taking immunosuppressive agents. The biopsies of the two cases revealed proliferation of spindle-shaped cells focally arranged in bundles and multiple dilated vascular spaces outlined by an attenuated endothelium with intravascular and extravasated erythrocytes. The specimens expressed positivity with CD34 antigen. Human herpesvirus 8 (Kaposi's sarcoma-associated herpesvirus) was detected in one case by polymerase chain reaction method.
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Affiliation(s)
- H Herr
- Department of Dermatology, Asan-Foundation Kangnung Hospital, Korea.
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Abstract
Hyperphosphorylation of tau is a characteristic feature of the neurodegenerative pathology in Alzheimer's disease (AD). Okadaic acid (OA) is currently used in models of AD research to increase the phosphorylation of tau. Using immunocytochemistry and fluorescent study, we found that markers of oxidative activity such as nitrotyrosine, c-jun, 2',7'-dichlorofluorescein diacetate (DCF), and heme oxygenase-1 (HO-1) were altered in OA-treated culture. Immunoreactivity of nitrotyrosine and c-jun, and DCF-oxidation were increased in degenerating neurons, while HO-1 expression was increased in astrocyte in response to OA. The data suggest that tau phosphorylation and oxidative damage be implicated in OA-induced neurodegeneration.
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Affiliation(s)
- D Kim
- Department of Anatomy and Cell Biology, College of Medicine, University of Ulsan, 388-1 PoongNap-Dong, SongPa-Gu, 138-736, Seoul, South Korea.
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Abstract
Behçet's disease (BD) is a chronic inflammatory condition involving several organs, such as skin, mucous membrane, eye, joint, intestine, lung and central nervous system. Ankylosing spondylitis (AS) is a prototype of seronegative spondyloarthropathy, and a chronic systemic inflammatory disorder of the axial skeleton, mainly affecting the sacroiliac joint and spine. In the latter, systemic complications may develop in addition to joint involvement. The coexistence of BD and AS has been rarely reported in the literature. The inclusion of BD among seronegative spondyloarthritides and whether sacroiliitis (SI) develops in BD are still being debated. We describe a 28-year-old man who has fulfilled the diagnostic criteria for BD and AS as well.
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Affiliation(s)
- H K Chang
- Department of Internal Medicine, Asan-Foundation Kangnung Hospital, Kangnung, Korea
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Abstract
We present an unique case of pachyonychia congenita associated with steatocystoma multiplex. A 33-year-old Japanese man had thickening and gray-brown dicoloration of all nails and a large number of nodules or tumors over his entire skin. No palmar and plantar hyperkeratosis, leukokeratosis of the mucous membranes, or follicular keratosis were observed. Histology of these tumors revealed the typical features of steatocystoma multiplex.
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Affiliation(s)
- J U Kim
- Department of Dermatology, Tokyo Women's Medical College, Japan
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Lin JW, Wyszynski M, Madhavan R, Sealock R, Kim JU, Sheng M. Yotiao, a novel protein of neuromuscular junction and brain that interacts with specific splice variants of NMDA receptor subunit NR1. J Neurosci 1998; 18:2017-27. [PMID: 9482789 PMCID: PMC6792910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/1997] [Revised: 12/17/1997] [Accepted: 12/23/1997] [Indexed: 02/06/2023] Open
Abstract
The molecular machinery underlying neurotransmitter receptor immobilization at postsynaptic sites is poorly understood. The NMDA receptor subunit NR1 can form clusters in heterologous cells via a mechanism dependent on the alternatively spliced C1 exon cassette in its intracellular C-terminal tail, suggesting a functional interaction between NR1 and the cytoskeleton. The yeast two-hybrid screen was used here to identify yotiao, a novel coiled coil protein that interacts with NR1 in a C1 exon-dependent manner. Yotiao mRNA (11 kb) is present modestly in brain and abundantly in skeletal muscle and pancreas. On Western blots, yotiao appears as an approximately 230 kDa band that is present in cerebral cortex, hippocampus, and cerebellum. Biochemical studies reveal that yotiao fractionates with cytoskeleton-associated proteins and with the postsynaptic density. With regard to immunohistochemistry, two anti-yotiao antibodies display a somatodendritic staining pattern similar to each other and to the staining pattern of NR1. Yotiao was colocalized by double-label immunocytochemistry with NR1 in rat brain and could be coimmunoprecipitated with NR1 from heterologous cells. Thus yotiao is an NR1-binding protein potentially involved in cytoskeletal attachment of NMDA receptors. Consistent with a general involvement in postsynaptic structure, yotiao was also found to be specifically concentrated at the neuromuscular junction in skeletal muscle.
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Affiliation(s)
- J W Lin
- Howard Hughes Medical Institute and Department of Neurobiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA
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Weitzer G, Milner DJ, Kim JU, Bradley A, Capetanaki Y. Cytoskeletal control of myogenesis: a desmin null mutation blocks the myogenic pathway during embryonic stem cell differentiation. Dev Biol 1995; 172:422-39. [PMID: 8612961 DOI: 10.1006/dbio.1995.8070] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A differentiating system based on embryonic stem (ES) cell-derived embryoid bodies (EBs) which recapitulates the in vivo cardiac, skeletal, and smooth muscle myogenesis of mouse embryos was developed and used to investigate the effects of the disruption of the desmin gene on muscle cell differentiation. Wild-type, heterozygous, and homozygous cell lines with the mutated desmin allele were evaluated. Skeletal myogenesis was totally inhibited in desmin null mutant EBs, as manifested by the absence of myotube formation, contractility, and myoD, myogenin, myf5, and myosin heavy chain expression. Smooth muscle formation was also completely blocked in the absence of desmin. On the other hand, there were no obvious effects on cardiomyocyte differentiation in these desmin null mutant EBs. However, reduced desmin expression in EBs heterozygous for the desmin mutation leads to partial inhibition of cardiac muscle formation. These data suggest that in contrast to early cardiocyte differentiation, desmin is indispensable for skeletal and smooth muscle formation.
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Affiliation(s)
- G Weitzer
- Department of Cell Biology, Baylor College of Medicine, Houston, Texas 77030, USA
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