Hypertrophic cardiomyopathy (HCM) is characterized by ventricular wall hypertrophy with diastolic dysfunction. Pediatric HCM is distinguished from the adult in many aspects. Most children with HCM do not present clinically until the adolescent period, even when they are born with genetic mutations. Some infants with early-onset HCM present with massive progressive myocardial hypertrophy in the first few months of life, which is often fatal. The mortality of pediatric HCM peaks during the infantile and adolescent periods. These periods roughly correlate with children's growth spurt. Non-sarcomeric causes of HCM are more frequent in pediatric HCM, while sarcomeric causes are more common in adults. From the perspective of cardiac development, the fetal heart has immature cardiomyocytes, which are characterized by proliferation and exit their cell cycles with a decreased regenerative property after birth. In the perinatal period, there is a dynamic change in maturation of cardiomyocytes from immature to mature cells. Infants who are treated with steroids or born to mothers with diabetes or hyperthyroidism often show phenotypes of HCM, which gradually resolve. With remarkable advancement of molecular biology, understanding on maturation of cardiomyocytes has increased. Neonates undergo abrupt environmental changes during the transitional circulation, which is affected by oxygen, metabolic and hormonal fluctuations. Derangement in physiological transition to the normal postnatal environment may influence maturation of proliferative immature cardiomyocytes during early infancy. This article reviews updates of infantile HCM and recent molecular studies related to maturation of cardiomyocytes from the clinical point of view of identifying distinct characteristics of infantile HCM.

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MicroRNAs

Hypertrophic cardiomyopathy (HCM) is characterized by ventricular wall hypertrophy with diastolic dysfunction. Pediatric HCM is distinguished from the adult in many aspects. Most children with HCM do not present clinically until the adolescent period, even when they are born with genetic mutations. Some infants with early-onset HCM present with massive progressive myocardial hypertrophy in the first few months of life, which is often fatal. The mortality of pediatric HCM peaks during the infantile and adolescent periods. These periods roughly correlate with children's growth spurt. Non-sarcomeric causes of HCM are more frequent in pediatric HCM, while sarcomeric causes are more common in adults. From the perspective of cardiac development, the fetal heart has immature cardiomyocytes, which are characterized by proliferation and exit their cell cycles with a decreased regenerative property after birth. In the perinatal period, there is a dynamic change in maturation of cardiomyocytes from immature to mature cells. Infants who are treated with steroids or born to mothers with diabetes or hyperthyroidism often show phenotypes of HCM, which gradually resolve. With remarkable advancement of molecular biology, understanding on maturation of cardiomyocytes has increased. Neonates undergo abrupt environmental changes during the transitional circulation, which is affected by oxygen, metabolic and hormonal fluctuations. Derangement in physiological transition to the normal postnatal environment may influence maturation of proliferative immature cardiomyocytes during early infancy. This article reviews updates of infantile HCM and recent molecular studies related to maturation of cardiomyocytes from the clinical point of view of identifying distinct characteristics of infantile HCM.

We estimated the burden of diseases in Korea especially caused by major cancers using DALY (disability adjusted life year) measurement. Firstly, the burden of disease due to premature death was estimated by using YLLs (years life lost due to premature death) measurement developed by the global burden of disease study group. Secondly, for the calculation of the YLD (years lived with disability), the following parameters were estimated in the formula; incidence rate, case fatality rate and disability weight of major cancers. Thirdly, we estimated DALY of major cancers by adding YLLs and YLDs. The burden of major cancers for male per 100,000 population was attributed mainly to liver cancer (528.8 person-year), stomach cancer (451.4 person-year), and lung cancer (374.9 person-year). The burden of major cancers for female per 100,000 population was attributed mainly to liver cancer (140.0 person-year), stomach cancer (259.7 person-year), and lung cancer (125.2 person-year). Each of these cancers was responsible for the loss of over 100 person-year per 100,000 population based on our DALY measurement. We found the DALY method employed was appropriate to quantify the burden of disease. Thereby, it would provide a rational bases to plan a national health policy regarding the burden of disease caused by major cancers in Korea.
Adult ; Aged ; Female ; Health Policy ; Humans ; Korea/epidemiology ; Liver Neoplasms/epidemiology/mortality ; Lung Neoplasms/epidemiology/mortality ; Male ; Middle Aged ; Neoplasms/*epidemiology/mortality ; Quality-Adjusted Life Years ; Stomach Neoplasms/epidemiology/mortality

OBJECTIVE: In this study, we aimed to produce basic data on the prenatal environmental risk factors of low birth weight infants at a community level. METHODS: In 2000, we conducted the direct interview using questionnaire about prenatal environmental risk factors with low birth weight infant-delivered mothers and normal weight infant-delivered mothers in Asan-city, Chungcheongnamdo Province, Korea. The questions given to the mothers included past pregnancy history, menstrual status, disease history before and during the pregnancy, family history, environmental risk factors and exposure history. The responses of the two groups were compared to calculate the prenatal environmental risk factors of each group. RESULTS: Mothers' smoking was significantly associated with low birth weight infants (adjusted odds ratio (AOR) 3.27; 95% confidence interval (CI) 1.25-8.56) and preterm baby (AOR 4.20; 95% CI, 1.21-14.61). Other environmental risk factors were not significantly different between the two groups. CONCLUSION: Smoking of mothers can be a risk factor for the delivery of low birth weight infants. These results could provide the basic data on prenatal environmental risk factors of mothers of low birth weight infants and suggest research topics for further community-based evaluation.
Chungcheongnam-do* ; Environmental Exposure ; Female ; Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Korea ; Maternal Exposure ; Mothers* ; Odds Ratio ; Pregnancy ; Reproductive History ; Risk Factors* ; Smoke ; Smoking ; Surveys and Questionnaires

µ-opioid receptor (MOR) is a class of opioid receptors with a high affinity for enkephalins and beta-endorphin. In hippocampus, activation of MOR is known to enhance the neuronal excitability of pyramidal neurons, which has been mainly attributed to a disinhibition of pyramidal neurons via activating Gαi subunit to suppress the presynaptic release of GABA in hippocampal interneurons. In contrast, the potential role of MOR in hippocampal astrocytes, the most abundant cell type in the brain, has remained unexplored. Here, we determine the cellular and subcellular distribution of MOR in different cell types of the hippocampus by utilizing MOR-mCherry mice and two different antibodies against MOR. Consistent with previous findings, we demonstrate that MOR expression in the CA1 pyramidal layer is co-localized with axon terminals from GABAergic inhibitory neurons but not with soma of pyramidal neurons. More importantly, we demonstrate that MOR is highly expressed in CA1 hippocampal astrocytes. The ultrastructural analysis further demonstrates that the astrocytic MOR is localized in soma and processes, but not in microdomains near synapses. Lastly, we demonstrate that astrocytes in ventral tegmental area and nucleus accumbens also express MOR. Our results provide the unprecedented evidence for the presence of MOR in astrocytes, implicating potential roles of astrocytic MOR in addictive behaviors.
Animals ; Antibodies ; Astrocytes* ; Behavior, Addictive ; beta-Endorphin ; Brain ; Carisoprodol ; Enkephalins ; gamma-Aminobutyric Acid ; Hippocampus ; Interneurons ; Mice ; Microscopy, Electron ; Neurons ; Nucleus Accumbens ; Presynaptic Terminals ; Pyramidal Cells ; Receptors, Opioid ; Synapses ; Ventral Tegmental Area

Background: There has been no comparison of the determinants of admission route between acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We examined whether factors associated with direct versus transferred-in admission to regional cardiocerebrovascular centers (RCVCs) differed between AIS and AMI. Methods: Using a nationwide RCVC registry, we identified consecutive patients presenting with AMI and AIS between July 2016 and December 2018. We explored factors associated with direct admission to RCVCs in patients with AIS and AMI and examined whether those associations differed between AIS and AMI, including interaction terms between each factor and disease type in multivariable models. To explore the influence of emergency medical service (EMS) paramedics on hospital selection, stratified analyses according to use of EMS were also performed. Results: Among the 17,897 and 8,927 AIS and AMI patients, 66.6% and 48.2% were directly admitted to RCVCs, respectively. Multivariable analysis showed that previous coronary heart disease, prehospital awareness, higher education level, and EMS use increased the odds of direct admission to RCVCs, but the odds ratio (OR) was different between AIS and AMI (for the first 3 factors, AMI > AIS; for EMS use, AMI < AIS). EMS use was the single most important factor for both AIS and AMI (OR, 4.72 vs. 3.90). Hypertension and hyperlipidemia increased, while living alone decreased the odds of direct admission only in AMI;additionally, age (65–74 years), previous stroke, and presentation during non-working hours increased the odds only in AIS. EMS use weakened the associations between direct admission and most factors in both AIS and AMI. Conclusions Various patient factors were differentially associated with direct admission to RCVCs between AIS and AMI. Public education for symptom awareness and use of EMS is essential in optimizing the transportation and hospitalization of patients with AMI and AIS.