OBJECTIVES: Mechanisms of clinical synergistic effects, induced by co-treatments of lithium and valproate, are unclear. Extracellular signal-regulated kinase (ERK) has been suggested to play important roles in mechanisms of the action of mood stabilizers. In this study, effects of co-treatments of lithium and valproate on the ERK1/2 signal pathway and its down-stream transcription factors, ELK1 and C-FOS, were investigated in vitro. METHODS: PC12 cells, human pheochromocytoma cells, were treated with lithium chloride (30 mM), valproate (1 mM) or lithium chloride + valproate. The phosphorylation of ERK1/2 was analyzed with immunoblot analysis. Transcriptional activities of ELK1 and C-FOS were analyzed with reporter gene assay. RESULTS: Single treatment of lithium and valproate increased the phosphorylation of ERK and transcriptional activities of ELK1 and C-FOS, respectively. Combined treatments of lithium and valproate induced more robust increase in the phosphorylation of ERK1/2 and transcriptional activities of ELK1 and C-FOS, compared to those in response to single treatment of lithium or valproate. CONCLUSIONS: Co-treatments of lithium and valproate induced synergistic increase in the phosphorylation of ERK1/2 and transcriptional activities of its down-stream transcription factors, ELK1 and C-FOS, compared to effects of single treatment. The findings might suggest potentiating effects of lithium and valproate augmentation treatment strategy.
Animals ; Genes, Reporter ; Humans ; Lithium Chloride ; Lithium* ; PC12 Cells* ; Pheochromocytoma ; Phosphorylation* ; Phosphotransferases ; Signal Transduction ; Transcription Factors ; Valproic Acid*

BACKGROUND AND OBJECTIVES: Ambulatory arterial stiffness index (AASI) is well known as a predictor of cardiovascular mortality in hypertensive patients. Mathematically, AASI reflect the standard deviation (SD) of blood pressure (BP) variation. AASI is measured higher levels in non-dipper than dipper. Thus, AASI has a possibility of not only reflecting arterial stiffness but also BP variability and/or autonomic nervous dysfunction. SUBJECTS AND METHODS: Consecutive data from 418 untreated hypertensive patients were analyzed retrospectively. We examined the association between the 24-hour ambulatory BP monitoring (ABPM) parameters and AASI. RESULTS: AASI had a simple correlation with age (R=0.189, p<0.001), relative wall thickness (RWT) (R=0.115, p=0.019), left ventricular mass index (LVMI) (R=0.192, p<0.001), average systolic BP (SBP) (R=0.232, p<0.001), average pulse pressure (PP) (R=0.363, p<0.001), SD of diastolic BP (DBP) (R=-0.352, p<0.001), SD of PP (R=0.330, p<0.001), SD of heart rate (HR) (R=-0.268, p<0.001), and nocturnal dipping (R=-0.137, p=0.005). In multiple linear regression analysis model including clinical parameters and 24 hour-ABPM parameters, independent predictors of AASI were SD of PP (beta=1.246, p<0.001), SD of DBP (beta=-1.067, p<0.001), SD of SBP (beta=-0.197, p<0.001), and non-dipper (beta=0.054, p=0.033). CONCLUSION: AASI is closely correlated with BP variability. The result of this study shows that AASI is not only a parameter for arterial stiffness, but also a parameter for BP variability.
Autonomic Nervous System Diseases ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Heart Rate ; Humans ; Linear Models ; Retrospective Studies ; Vascular Stiffness

OBJECTIVE: cDNA microarray is a convenient molecular technology that enables to search for gene expression in large scale. To explore the effect of antipsychotics on the gene expression in the brain, we applied cDNA microarray and searched for differentially expressed genes in the olanzapine-treated rat frontal cortex. METHODS: We administered olanzapine (4 mg/kg/day, IP) to S-D rats for 14days, and dissected the frontal cortex to examine. We analyzed altered gene expression from microarray, and screened up- or down-regulated genes. Their changes were confirmed by RT-PCR. RESULTS: Three down-regulated and one up-regulated genes were screened by triplicate cDNA microarray analysis. Among them, translocase of the inner mitochondrial membrane 23 (TIM23) was confirmed in RT-PCR. The expression of TIM23 mRNA was significantly increased in olanzapine-treated rat frontal cortex. CONCLUSION: This is the first report of up-regulated gene expression of TIM23 by antipsychotics in the rat brain. TIM23 is the essential component of mitochondrial biogenesis. From this result, we suggest that antipsychotic effect may be related to the improvement of mitochondrial dysfunction in the brain.
Animals ; Antipsychotic Agents ; Brain ; DNA, Complementary* ; Gene Expression* ; Mitochondrial Membranes ; Organelle Biogenesis ; Oligonucleotide Array Sequence Analysis* ; Rats* ; RNA, Messenger ; Schizophrenia

BACKGROUND: Clinical syndrome of leptospirosis in Korea which accompanied by hemoptysis, pulmonary hemorrhage, respiratory failure was quite different from that of typical Weil's disease. The death rate in the early stage of disease has relationship with chest X-ray findings and acid-base disturbances resulted from hypoxia and asphyxia. We've come to consider chest X-ray findings and arterial blood gas findings as factors influencing the prognosis of the disease. METHODS: Forty one cases of leptospirosis diagnosed by acute febrille illness symptoms and serologic tests were graded for chest X-ray findings and grouped according to acid-base abnormalities. Retrospectively, we attempted to correlate the acid-base disturbances and chest X-ray findings with morbidity and mortality of the disease. RESULTS: The result were as follows. 1) Abnormal chest X-ray findings were observed in 30 cases(73%). Mortalities according to the chest X-ray findings were 0(0%), 2(17%), 3(0%), 4(0%), 5(33%), 6(50%) and chest X-ray findings influenced the mortality with statistical significance(p<0.05). 2) Acid-base abnormalities were observed in 39 cases(95%) and the types were divided to six groups . Respiratory alkalosis was the most common acid-base disturbance(44%). Five cases were died. Two of five were respiratory alkalosis, two cases were mixed respiratory metabolic acidosis and another case was mixed respiratory-metabolic alkalosis. As shown, acid-base abnormality influenced the mortality and mixed acid-base disturbances were showed high mortality with statistical significance (p<0.05). 3) Total mortality was 12%(five of forty-one). The chest X-ray score, morbidity, pH, pCO2, pO2, and HCO3 were 5.0 +/- 0.8, 3.4 +/- 1,3, 7.16 +/- 0.17, 32.5 +/- 1.1, 43.3 +/- 13.4 and 17.6 +/- 3.1 in died group, 2.4 +/- 0.4, 12.7 +/- 1.0, 7.46 +/- 0.01, 48.8 +/- 13.4, 65.4 +/- 3.7 and 23.4 +/- 0.9 in recovery group, respectively. There was difference between two groups with statistical significance. CONCLUSION: In this study, we concluded that chest X-ray findings and acid-base abnormalities influenced the mortality of leptospirosis. The factors above mentioned make us consider chest X-ray and blood gas analysis are essential to the patient hospitalized for the suspicion of leptospirosis. Especially, these factors pointed out the patient having chest X-ray abnormalities and mixed acid-base disturbances needed intensive care in the early stage of leptospirosis.
Acidosis ; Alkalosis ; Alkalosis, Respiratory ; Anoxia ; Asphyxia ; Blood Gas Analysis ; Hemoptysis ; Hemorrhage ; Humans ; Hydrogen-Ion Concentration ; Critical Care ; Korea ; Leptospirosis* ; Mortality ; Prognosis ; Respiratory Insufficiency ; Retrospective Studies ; Serologic Tests ; Thorax* ; Weil Disease

Williams syndrome is a progressive and multisystemic disorder. We experienced one case of Willams syndrome which was characterized by elfin facies, mental retardation, diffuse aortic hypoplasia, mitral regurgitation and chronic nonparoxysmal sinus tachycardia. The tachycardia has been managing with beta-blocker successfully. We presented a case of unusual form of Williams syndrome with a reivew of literatures.
Facies ; Intellectual Disability ; Mitral Valve Insufficiency ; Tachycardia ; Tachycardia, Sinus ; Williams Syndrome*

Two-dimensional Doppler echocardiographic velocity profiles of four cardiac valves in a group of 85 infants and children with left to right shunt lesions(VSD, ASD and PDA) are presented. Velocities were obtained before operation and 10 days afterward. The results were as follows ; 1) VSD(type 2) Peak velocities of mitral valve were significantly decreased when compared preop. with postop. echocardiogram(n=37, preop 132+/-24, postop 98+/-16 cm/sec, p<0.0005). Peak velocities of tricuspid valve were also significantly decreased(n=30, perop 60+/-21, postop 50+/-17cm/sec, p<0.01). Peak velocities of aortic valve were decreased(n=18, perop 120+/-20, postop 108+/-26cm/sec, 0.010.05). Peak velocities of pulmonic valve were significantly decreased(n=17, perop 168+/-46, postop 104+/-51cm/sec, p<0.0005). 3) PDA Peak velocities of mitral valve were significantly decreased when compared perop. with postop. echocardiogram(n=29, perop 138+/-28, postop 111+/-19cm/sec, p<0.0005). Tricuspid valve velocities showed no significant changes between preop. and postop. echocardiogram (n=15, perop 47+/-12, postop 44+/-10cm/sec, p>0.05). Aortic valve velocities showed no significant changes (n=10, perop 134+/-23, postop 121+/-25cm/sec, p>0.05). Peak velocities of pulmonic valve were significantly decreased(n=28, perop 138+/-37, postop 107+/-27cm/sec, p<0.005). This study demonstrates that Doppler echocardiographic assessment of velovity changes are correlated with known hemodynamic data and also will be a good index in the evaluation of operation.
Aortic Valve ; Child ; Echocardiography* ; Echocardiography, Doppler ; Heart Valves* ; Hemodynamics ; Humans ; Infant ; Mitral Valve ; Tricuspid Valve

No abstract available.
Empyema, Subdural* ; Haemophilus influenzae* ; Haemophilus* ; Meningitis*

No abstract available.
Heart*

No abstract available.
Aorta, Thoracic* ; Child* ; Echocardiography, Doppler* ; Humans

Thirty - five cases of coarctation of aorta, diagnosed by cardiac catheterization and angiography during the period of 1980-1984, at the department of Pediatrics of Seoul National University Hospital, were studied on the clinical features and management. The followoing results were obtained : 1) The incidence of coartation of aorta was 1.2% of congenital heart disease and sex ratio of male to female was 2.2 : 1. 2) The anatomical type of coarctation was preductal in 19 cases, juxtaductal in 15 cases and postductal in 1 case. Most of preductal coarctation (89.5%) were associated with aortic arch or isthmus hypoplasia. 3) All of these patients had various type of additional cardiac anomalies and among them, PDA was the most common associated lesion and followed by VSD. 4) Significant BP gradient between upper and lower extremies and weak femoral pulsation were noticed in 15 cases(42.8%). 5) Congestive heart failure was present in all but one patient less than 1 year old, while only 3 cases(15%) had congestive heat failure in patients older than one year. 6) Overall surgical mortality was 31.8%, but significant decrease in surgical mortality was found since 1983.
Angiography ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Cardiac Catheterization ; Cardiac Catheters ; Estrogens, Conjugated (USP) ; Female ; Heart Defects, Congenital ; Heart Failure ; Hot Temperature ; Humans ; Incidence ; Male ; Mortality ; Pediatrics ; Seoul ; Sex Ratio