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With recent advancement in amyloid imaging, diagnostic application of this new modality has become a great interest among researchers. New ligands, such as 18F- florbetaben, florbetapir and flutemetamol, have been discovered to overcome limitations of preexisting ligand Pittsburgh compound B. We report here a case of a 37-year-old male patient whose initial complaints comprised of gradual cognitive decline, apraxia, disorientation and sleep disturbances. 18F-Florbetaben amyloid imaging of the patient showed diffuse amyloid retention with prominent striatal uptake. This finding supports the clinical utility of amyloid imaging in diagnostic process of early-onset AD. Moreover, striatal dominant uptake pattern demonstrated in this patient include some meaningful clinical implications that warrant special attention among clinicians.

A series of ABC triblock copolypeptoids [i.e., poly(N-allyl glycine)-b-poly(N-methyl glycine)-b-poly(N-decyl glycine) (AMD)] with well-defined structure and varying composition have been synthesized by sequential primary amine-initiated ring-opening polymerization of the corresponding N-substituted N-carboxyanhydride monomers (Al-NCA, Me-NCA, and De-NCA). The ABC block copolypeptoids undergo sol-to-gel transitions with increasing temperature in water and biological media at low concentrations (2.5-10 wt %). The sol-gel transition is rapid and fully reversible with a narrow transition window, evidenced by the rheological measurements. The gelation temperature (Tgel) and mechanical stiffness of the hydrogels are highly tunable: Tgel in the 26.2-60.0 °C range, the storage modulus (G') and Young's modulus (E) in the 0.2-780 Pa and 0.5-2346 Pa range, respectively, at the physiological temperature (37 °C) can be readily accessed by controlling the block copolypeptoid composition and the polymer solution concentration. The hydrogel is injectable through a 24 gauge syringe needle and maintains their shape upon in contact with surfaces or water baths that are kept above the sol-gel transition temperature. The hydrogels exhibit minimal cytotoxicity toward human adipose derived stem cells (hASCs), evidenced from both alamarBlue and PicoGreen assays. Furthermore, quantitative PCR analysis revealed significant up-regulation of the Col2a1 gene and down-regulation of ANGPT1 gene, suggesting that the hydrogel exhibit biological activity in inducing chondrogenesis of hASCs. It was also demonstrated that the hydrogel can be used to quantitatively encapsulate water-soluble enzymes (e.g., horseradish peroxidase) by manipulating the sol-gel transition. The enzymatic activity of HRP remain unperturbed after encapsulation at 37 °C for up to 7 d, suggesting that the hydrogel does not adversely affect the enzyme structure and thereby the enzymatic activity. These results suggest that the polypeptoid hydrogel a promising synthetic platform for tissue engineering or protein storage applications.

Background Although there is substantial evidence of associations between frontal-striatal circuits and cerebral vascular burden in late-onset depression (LOD), relationships between vascular burden and hippocampal subfields are not clear. The purpose of this study was to investigate relationships between cerebral vascular burden and hippocampal subfield volume in LOD patients. Methods Fifty subjects with LOD and 50 group-matched healthy control subjects underwent magnetic resonance imaging scanning. Hippocampal subfields volumes were measured and compared between the groups. In addition, association patterns between white matter hyperintensity (WMH) volumes, clinical measures and hippocampal subfield volumes were investigated in the LOD group. Results Subjects with LOD exhibited significant hippocampal volume reductions in the total hippocampus, cornu ammonis (CA) 1 and 3 and dentate gyrus (DG) areas compared with healthy subjects. Total WMH volume was negatively correlated with left total hippocampal volume and CA1 in the LOD group. In addition, depression severity was negatively associated with left and right CA3 volumes in the LOD group. Limitation Our findings of distinctive relationships between WMH and hippocampal subfields demonstrate a simple correlation, but do not prove causation Conclusion This study is the first to elaborate distinctive association patterns between hippocampal subfield volumes and cerebral vascular burden in LOD. These structural changes in the hippocampal CA1, CA3 and DG areas might be at the core of the underlying neurobiological mechanisms of hippocampal dysfunction in LOD. However, longitudinal studies will be needed to identify the mechanisms of these structural changes.

Objective Depressive symptoms are common in Alzheimer's disease (AD) and they might influence the course and prognosis of AD. Depression could appear anytime in the course of the disease, and could either last considerably long or disappear easily. This study is intended to investigate the occurrence of depression in the course of AD and the risk factors of incidence. Methods This study targeted 1,272 AD patients without depressive symptoms at the start of this study in Korea. A total of 775 subjects completed the study, and the occurrence of depression was assessed after 12 months. Demographic information of subjects was collected and cognitive functions, overall functions, and depression severity were assessed at the start of this study and after 12 months. Results Among the 775 subjects, 103 subjects (13.29%) developed depression 12 months later. The MMSE-KC scores showed significant changes in both groups that developed depression and did not. In the univariate analysis, significant differences in the incidence of depression were found in terms of gender, the administration of the antidepressant at the baseline, the SGDS-K score, and the GDS score. The multiple logistic regression analysis showed that the increase in the incidence of depression was associated with a female, in the increase in SGDS-K score and the GDS score. Conclusion The incidence of depression in the subjects who completed the 12-month follow-up observation was 13.29%. Moreover, in the multivariate analysis, a female gender and the severity of dementia, including the overall functions, seemed associated with the occurrence of depression.

Polypeptoids have recently emerged as a subject of scientific interest due to their structural resemblance to existing pseudo-peptidic polymers including poly(α-peptide)s, poly(β-peptide)s, poly(2-oxazoline)s, and poly(N-substituted acrylamide)s. With demonstrated backbone degradability, biocompatibility, and thermal processability, polypeptoids are potentially useful in a variety of biotechnological applications. Before those applications can be realized, it is important to develop their synthesis and understand their fundamental properties. In this Perspective, we will review recent advances in the synthesis and characterization of polypeptoids and their copolymers as well as the development of polypeptoid-based functional and structured materials. We will conclude by discussing the future prospects for this nascent class of pseudo-peptidic polymers.

Despite a growing body of research on resilience and its clinical significance in depression and anxiety disorders, relatively little is known about contributing factors for resilience in patients with these illnesses. We aimed to find characteristics of patients having low resilience for elucidating its clinical implications in depression and/or anxiety disorders, primarily focused on potentially modifiable variables.A total of 121 outpatients diagnosed with depression and/or anxiety disorders completed questionnaires measuring socio-demographic, clinical, and positive psychological factors. We divided patients into the three groups based on their Connor-Davidson resilience scale scores and investigated predictors of the low- and medium- versus high-resilience groups using multinomial logistic regression analysis.In the final regression model, low spirituality was revealed as a leading predictor of lower-resilience groups. Additionally, low purpose in life and less frequent exercise were associated with the low- and medium-resilience groups, respectively. Severe trait anxiety characterized the low- and medium-resilience groups, although it was not included in the final model.Spirituality, purpose in life, and trait anxiety contribute to different levels of resilience in patients with depression and/or anxiety disorders. Our results would deepen the understanding of resilience and provide potential targets of resilience-focused intervention in these patients.

Although a few automated hippocampal subfield segmentation methods have been developed, the effects of amnestic mild cognitive impairment (aMCI) on the hippocampal subfield volumes on magnetic resonance imaging (MRI) are not clear. The aim of this study was to investigate the hippocampal subfield volume changes and their relationships with various neuropsychological tests in aMCI using an automated hippocampal subfield segmentation technique. Forty-five subjects with aMCI and 49 group-matched healthy control subjects underwent 3-tesla MRI scanning, and hippocampal subfield volumes were measured and compared. Additionally, we explored the correlation pattern between hippocampal subfield volumes and the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) neuropsychological test scores in aMCI subjects. Subjects with aMCI exhibited significant hippocampal volume reductions in the presubiculum, subiculum and cornu ammonis 2-3 areas compared with healthy subjects. In addition, we also found significant positive correlations between presubiculum and subicular area volumes and the CERAD-K verbal and visuospatial delayed recall scores in aMCI. This study was the first to explore the relationships between hippocampal subfield volumes and various types of cognitive performances in aMCI. These structural changes might be at the core of the underlying neurobiological mechanisms of hippocampal dysfunction in aMCI.

OBJECTIVES The objectives of this 12-week multicenter, open-label, noncomparative study were to evaluate the overall effectiveness of paliperidone extended release (ER), the feasibility of maintaining patients on the initial dose of 6 mg, and the relationship between dose pattern and treatment response in schizophrenic patients with inadequate responses to initial treatment in a natural setting. METHODS All patients received 6 mg of paliperidone ER during the first 2 weeks, and subsequently, the dose was adjusted at each visit based on the patient response. We examined the response rate and the effectiveness of different dose patterns of paliperidone ER such as "early increase (dose increased to 9 mg at week 2)," "late increase (dose increased to 9 mg at week 4)," and "maintenance group." RESULTS The response rate based on the Clinical Global Impression of Improvement or Severity response criteria was 33.6% or 61.7%, respectively. The proportion of patients who stayed with the initial dose of 6 mg was 44.5% and the response rate of these patients was 79.8%. When the treatment response to the initial dose of 6 mg is inadequate (Clinical Global Impression of Improvement ≥ 4 at week 2), an early increase in the dose seems to be more effective than maintenance or late increase of the initial dose. CONCLUSIONS This study suggests that paliperidone ER may be an effective and well-tolerated antipsychotics in the treatment of patients with schizophrenia.

Single-walled carbon nanotubes (SWCNTs) have been functionalized with poly(γ-benzyl-L-glutamate)s (PBLGs) having well-defined polymer molecular weight (Mn = 7.5–21.1 kg·mol−1) and molecular weight distribution (PDI = 1.05–1.20) by a graft-to method. Toluene solutions containing 5 wt % free PBLG and variable amounts of PBLG-functionalized SWCNTs (PBLG-SWCNTs) form gels at room temperature. Differential scanning calorimetry (DSC) analysis reveals that the gelation occurs thermoreversibly, in accord with previous studies on the pristine PBLG/toluene gels. The heat of gel melting (ΔHm) is slightly elevated for the composite gels compared with the pristine gel, which suggests enhanced interactions between PBLGs in the former. But the gelation temperatures of the composites are unaffected by the presence of PBLG-SWCNTs. Small-angle X-ray scattering (SAXS) analysis of the composite and pristine gels at different temperatures by the Guinier method suggests that PBLG-SWCNTs promote interactions between PBLG rods, as indicated by the larger PBLG bundle size with increasing PBLG-SWCNT content in the gel and the melt state. W/SAXS analysis of the dry gels reveals that PBLG-SWCNTs induce significant changes in the PBLG packing order, resulting in a nematic phase, in contrast to a weakly ordered smectic C phase containing tilted PBLG rods that is observed in the pristine gel. © 2011 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem, 2011

We investigated the prevalence of dementia and mild cognitive impairment (MCI) and the factors associate with risk of dementia from a representative nationwide sample of Korean elders. 8,199 randomly-sampled Koreans aged 65 years or older were invited to participate in the Phase I screening assessment using Mini-Mental State Examination by door-to-door home visit, and 6,141 subjects (response rate = 74.9%) responded. Among them, 2,336 subjects were invited to participate in the Phase II diagnostic assessment for dementia and MCI, and 1,673 subjects responded (response rate = 71.6%). Diagnostic assessments were administered using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K) Clinical Assessment Battery. The CERAD-K Neuropsychological Assessment Battery was used for diagnosing MCI. Age-, gender-, education-, and urbanicity-standardized prevalence of dementia was estimated to be 8.1% (95% CI = 6.9-9.2) for overall dementia and 24.1% (95% CI = 21.0-27.2) for MCI. Alzheimer's disease (AD) was the most prevalent type (5.7%) followed by vascular dementia (2.0%). Amnestic subtype (20.1%) was much more prevalent than nonamnestic subtype in MCI (4.0%). Older age, being male, lower education level, illiteracy, smoking, and histories of head trauma or depression were associated with increased dementia risk, and alcohol use and moderately intense exercise were associated with decreased dementia risk. We expect numbers of dementia patients to double every 20 years until 2050 in Korea and expect AD to account for progressively more dementia cases in the future.

This study aimed to validate the TICS and modified TICS (TICSm) in Korean elderly population and to compare MCI and dementia screening ability between TICS and TICSm. TICS and TICSm were administered to 70 cognitively normal (CN), 75 MCI, and 85 dementia subjects, with mini-mental state examination (MMSE) and other cognitive and functional measures. TICS and TICSm scores were highly correlated with other global cognitive and functional scores. The CN vs. dementia discrimination ability of both instruments was as excellent as that of MMSE (sensitivity/specificity at optimal cutoff: 87.1/90.1 for TICS; 88.2/90.0 for TICSm). Although their CN vs. MCI discrimination performances were comparable to that of MMSE, they were far from perfect (sensitivity/specificity: 69.3/68.6 for TICS; 73.3/67.1 for TICSm). There was no significant difference in dementia or MCI screening accuracy between TICS and TICSm. Both of them also showed high test-retest reliability. Our findings indicate that TICS and TICSm are reliable and as valid as MMSE in regard of screening cognitively impaired elderly. In terms of the comparison between TICSm and TICS, however, TICSm has little advantage over TICS for screening dementia and even MCI, in spite of longer administration time and more efforts required.

South Korea is a country with one of the highest suicide rates in the world, and the suicide rate is still on the rise. The purpose of this study was to determine the sociodemographic and clinical characteristics of suicide attempts and risk factors related to suicide attempts among depressed patients in South Korea. Among the 1183 participants, 21.4% had a history of a suicide attempt. When the severity of depression was controlled, the risk factors for patients who attempted suicide included younger age, experienced significant life events before 12 years of age, psychotic symptoms, and previous depressive episodes. The characteristics of attempted suicide in depressed patients in South Korea can be summarized as a high suicide attempt rate with no difference in the number of suicide attempts and lethality between males and females. This unique tendency is probably related to the sociodemographic and cultural characteristics of South Korea.

Post-menopausal women experience variable biological and psychological changes. The effect of reduced levels of estrogen can effect on post-menopausal depression. Estrogen triggers physiological responses by binding to the estrogen receptor (ER). Two subtypes of ER, ERa and ERb are now known. We investigated the significance of ERa and ERb polymorphisms and post-menopasal depression in this study. Forty three women with post-menopausal depression and 63 post-menopausal women without depression as normal controls were recruited. Polymerase chain reaction-restriction fragment length polymorphism method was used to investigate genotypes of ERa and ERb polymorphisms. Genotypes of PvuII and XbaI polymorphism of ERa receptor were significantly different in patients with post-menopausal depression comparing with controls. Genotypes of ERb did not show association with post-menopausal depression. Our study showed that ERa receptor polymorphism had an association with depression in post-menopausal women. It suggests that investigation of ER genes and their functions might be important for understanding pathophysilogical mechanism of post-menopausal depression.

This study aimed to find the most sensitive brain region of APP-PS1 mice in early-stage Alzheimer's disease (AD) and to compare the findings with wild-type mouse brain using (1)H high resolution magic angle spectroscopy (HR-MAS). At 18 and 35 weeks of age, the object recognition test was performed with both APP-PS1 and wild-type mice, and the metabolite concentrations were measured in six brain regions at 38-42 weeks using (1)H HR-MAS. Compared to that of wild-type mice, the memory index of the APP-PS1 mice at 18 weeks was not significantly different; however, the memory index of the APP-PS1 mice at 35 weeks was significantly lower. Similar to the results of the (1)H HR-MAS, the [N-acetyl aspartate (NAA)+acetate (Acet)] level in APP-PS1 mice was decreased in the hippocampus and temporal cortex, and the myo-inositol (mIns) level was increased in the entire brain. In addition, scyllo-inositol (sIns) was also elevated in the frontal, occipital, and parietal cortices, hippocampus and thalamus. These findings demonstrated that the behavioral abnormalities of the APP-PS1 mice started at about 30 weeks of age and that the hippocampus and temporal cortex were the most sensitive regions during early-stage AD. In addition, the results of this study confirmed that an increase of mIns and sIns precedes the reduction of the NAA level. These findings demonstrated that the metabolism of the APP-PS1 mouse was associated with early-stage AD. Furthermore, the regional neurochemical profile of APP-PS1 mouse can be used to investigate the pathophysiological mechanisms associated with AD.

A facile approach to prepare thiol-terminated poly(styrene-ran-vinyl phenol) (PSVPh) copolymers and PSVPh-coated gold nanoparticles is reported with the goal of creating stabilizing ligands for nanoparticles with controlled hydrophilicity. Dithioester-terminated poly(styrene-ran-acetoxystyrene) copolymers were synthesized via RAFT polymerization using cumyl dithiobenzoate as a chain transfer agent. These copolymers were converted to thiol-terminated PSVPh copolymers by a one step hydrazinolysis reaction using hydrazine hydrate to simultaneously convert dithioester-terminal and acetoxy-pendant groups to thiol-terminal and hydroxyl-pendant groups, respectively. Spectroscopic observations including NMR and IR confirm end- and pendant-group conversion. PSVPh-coated gold nanoparticles were synthesized in the presence of a mixture of thiol-terminated PSVPh and PSVPh copolymers containing disulfides as stabilizing ligands in a water/toluene, two-phase system. The size and size distribution of core gold nanoparticles were determined by TEM and image analysis. The hydrodynamic radius of PSVPh-coated gold nanoparticles was also determined by dynamic light scattering experiment, which confirms the particle analysis by TEM. This procedure provides a facile technique to control the polarity and hydrophilicity of metal nanoparticle surfaces and could prove critical in advancing the control of nanoparticle placement in biological and hierarchically ordered systems, such as diblock copolymers.

The magnetic field has been regarded as both harmful and beneficial for its applications on human brains including transcranial magnetic stimulation (TMS), but its effects still remain in question. Here, we determined using single photon emission computed tomography (SPECT) if 0.3-T static magnetic field could alter regional cerebral blood flow (rCBF) in target and other brain regions in healthy subjects. The permanent static magnet (0.3 T, unipolar, disk shaped, 4 cm diameter and 1 cm thick) was placed on the right frontotemporal region of the brain for each of 14 healthy subjects. Tc-99m ECD perfusion SPECT was taken to compare the CBF patterns in the subjects exposed to the static magnet field with those of the resting and sham conditions. We found that the rCBF was significantly increased in the right frontal and parietal regions and the right insula. On the other hand, rCBF was rather decreased in the left frontal and left parietal regions (P

Gold-catalyzed reactions of 3-silyloxy-1,4-enynes with alcohols afford primary, secondary, and tertiary pent-2-en-4-ynyl ethers in moderate to excellent yields. The substitution proceeds with high regioselectivity. An initial cyclization providing five-membered carbocycles instead was not observed under the reaction conditions. Control experiments show that these reactions are also catalyzed by Bronsted- and Lewis-acids, although scope and yields are markedly reduced.

Polymer nanocomposites composed of poly(styrene-ran-vinyl phenol) (PSVPh) copolymers and 5 wt % multi-walled carbon nanotubes (MWNTs) were prepared by three different methods, including melt-mixing and precipitation. The MWNTs were either oxidized to incorporate oxygenated defects or utilized as received. The mechanical properties of the nanocomposites were measured by dynamic mechanical analysis (DMA), and the extent of intermolecular hydrogen bonding between MWNTs and PSVPh was quantified by infrared (IR). Our DMA results suggest that melt-mixing leads to more stable morphologies of the final nanocomposites than precipitation. Additionally, the IR analysis of the nanocomposites indicates melt-mixing can result in the formation of more intermolecular hydrogen bonding between the MWNTs and PSVPh than precipitation, and thus suggests that melt-mixing leads to more reproducible mechanical properties than precipitation. Our DMA and IR results may provide guidelines to realize the desired morphologies and to improve the properties of polymer carbon nanotube nanocomposites by optimizing intermolecular interactions between MWNTs and polymers using processing. © 2008 Wiley Periodicals, Inc. J Polym Sci Part B: Polym Phys 46: 1747–1759, 2008

With the improvement of industrial society, the high quality electrical energy, simplification of operation and maintenance, ensuring reliability are being required. We request urgently change a for an environment friendly gas insulation material. In this paper the experiments of breakdown characteristics by pressure and gap change of Imitation-Air in model GIS(Gas Insulated Switchgear) were described. Also assess of breakdown characteristics about Imitation-Air and . It is considered in this paper that the results are fundamental data for electric insulation design of Distribution Power Facilities which will be studied and developed in the future. The pressure to be confronted to gas 1[atm] for Distribution Power Facilities is Imitation-Air 3[atm]. And we could make an environment friendly gas insulation material with maintaining dielectric strength by Imitation-Air which generates a lower level of the global warming effect.

Impaired working memory processing is one of the broad range of cognitive deficits in patients with Alzheimer’s disease (AD). We aimed to elucidate the differences in brain activities involved in the process of working memory between AD patients and healthy comparison subjects. Twelve patients with AD were recruited along with 12 healthy volunteers as a comparison group. Functional magnetic resonance imaging was employed to assess cortical activities during the performance of a 1-back working memory paradigm using the Korean alphabet as mnemonic content. Subsequently, the difference in neural activities between the 2 groups was analyzed. The AD group performed the tasks with reduced accuracy. Group comparison analysis revealed that the AD group showed decreased brain activity in the left frontal pole (Brodmann area, BA, 10), the left ventrolateral prefrontal cortex (BA47), the left insula (BA13) and the right premotor cortex (BA6) compared to the control group. The AD group showed increased activation in the left precuneus (BA7) compared to the control group. A decreased level of activation in the prefrontal cortex and an increased level of activation in the parietal neural networks from the patient group may document an altered verbal working memory process in the patients with AD.

Objectives: The primary objective of this study was to compare the safety and tolerability of a rapid initiation of quetiapine with the conventional initiation approved by the U.S. Food and Drug Administration (FDA). The secondary objectives included assessment of the efficacy of a rapid initiation of quetiapine compared with a conventional initiation approved by the FDA. Method: Patients with acute schizophrenia were randomly assigned in a 3:1 ratio to the rapid-initiation group (200 mg on day 1, 400 mg on day 2, 600 mg on day 3, and 800 mg on day 4) or to the conventional-initiation group (50 mg on day 1, 100 mg on day 2, and increased in 100 mg/day increments to reach 400 mg on day 5). The tolerability measures were Barnes Akathisia Scale (BAS) and Simpson-Angus Scale (SAS) as well as all adverse events at day 1, 2, 3, 4, 5, 6, and 7 and at day 14. Standard efficacy measures were administered at baseline, day 1, day 4, day 5, day 7, and day 14. These measures consisted of the Positive and Negative Syndrome Scale (PANSS), PANSS-Excited Component (EC), and Clinical Global Impressions-Severity of Illness (CGI-S) scale. Results: Forty patients were randomly assigned to treatment. The mean (SD) dose of quetiapine at study end point was 763.3 (106.6) and 600.0 (249.4) mg/day in the rapid-initiation group and conventional-initiation group, respectively. The most common side effects were sedation and dizziness, with no significant differences in frequency between groups. Only 2/30 patients from the rapid-initiation group discontinued treatment due to an adverse event (both for sedation), and 1/10 patients from the conventional-initiation group discontinued before receiving quetiapine. Neither serious adverse events nor differences between groups in vital signs, laboratory assessments, ECG measures, or weight changes were reported. Rapid initiation of quetiapine was generally well-tolerated and was associated with a faster onset of action than conventional initiation as measured by improvement in psychotic symptoms at days 4 and 5. Conclusion: This study may offer preliminary evidence for tolerability and effectiveness in rapid dose initiation of quetiapine in the treatment of schizophrenia.

OBJECTIVE: Antidepressant drug efficacy is partially under genetic control and a number of gene variants have been associated with antidepressants efficacy over the last few years. In the search for further genes influencing antidepressant response we focused on the dysbindin gene (dystrobrevin-binding-protein 1, DTNBP1). BASIC METHODS: One hundred and four Korean inpatients affected by major depressive disorder were treated with various antidepressants at standard therapeutic daily doses and rated with the 10-items Montgomery-Asberg Depression rating scale (MADRS) at baseline and discharge. Five DTNBP1 variants (rs3213207 A/G, rs1011313 C/T, rs2005976 G/A, rs760761 C/T and rs2619522 A/C) were analysed for all patients. RESULTS: Rs2005976 was found to be significantly associated with final MADRS scores, with the rarest A allele associated with higher final scores (P=0.00055), rs760761 also showed a significant association (P=0.0058) and rs2619522 showed a positive trend (P=0.025). Markers were not significantly associated with Clinical Global Impression Scale scores. Five marker haplotypes were mildly associated with MADRS final scores but when considering the block composed of the three single nucleotide polymorphisms individually associated with response (rs2005976, rs760761 and rs2619522), results were more marked (P=0.0096), with the more frequent G-C-A haplotype associated with a positive outcome. CONCLUSIONS: Despite limitations due to the sample size and the mild antidepressant response, we observed a significant association between DTNBP1 variants and antidepressant response.

Parkinson's disease dementia (PDD) is notorious for its debilitating clinical course and high mortality rates. Consequently, various attempts to investigate predictors of cognitive decline in Parkinson's disease (PD) have been made. Here we report a case of a 75-year-old female patient with PD who visited the clinic with complaints of recurrent visual hallucinations and cognitive decline, whose symptoms were ameliorated by the titration of rivastigmine. Imaging results showed pronounced diffuse cortical amyloid deposition evidenced by 18F-florbetaben amyloid positron emission tomography (PET) imaging. This observation suggests that pronounced amyloid deposition and visual hallucinations in PD patients could be clinically significant predictors of cognitive decline in PD patients. Future research should concentrate on accumulating more evidence for possible predictors of cognitive decline and their association with PD pathology that can enable an early intervention and standardized treatment in PDD patients.

The purpose of this study was to compare differences of the psychological burdens between young male transsexuals and age-gender matched non-transsexuals with standardized psychiatric rating scales in Korea. A total of 43 biologically unrelated young male transsexuals and 49 age-gender matched non-transsexuals participated in the study. All subjects completed Beck's Depression Inventory (BDI), Social Avoidance and Distress Scale (SADS), Self-Esteem Scale (SES) and Family Adaptability and Cohesion Evaluation Scale (FACES-III). The transsexuals showed significantly higher scores on the BDI (P < 0.0001) and SADS (P = 0.002) and lower scores on the SES (P < 0.0001) and Adaptability and Cohesion subscales (P = 0.016 and P < 0.0001, respectively) of the FACES-III than those of the non-transsexuals. The present study found young male transsexuals may be potentially vulnerable to develop psychiatric and familial problems in comparison with non-transsexuals, at least in Korea, although methodological limitations exist. Further well-designed researches should be launched to confirm this preliminary study.

The objective of the present study was to identify brain centers, whose activity changes are related to erotic visual stimuli in healthy, heterosexual, middle aged males. Ten heterosexual, right-handed males with normal sexual function were entered into the present study (mean age 52 years, range 46-55). All potential subjects were screened over 1 h interview, and were encouraged to fill out questionnaires including the Brief Male Sexual Function Inventory. All subjects with a history of sexual arousal disorder or erectile dysfunction were excluded. We performed functional brain magnetic resonance imaging (fMRI) in male volunteers when an alternatively combined erotic and nonerotic film was played for 14 min and 9 s. The major areas of activation associated with sexual arousal to visual stimuli were occipitotemporal area, anterior cingulate gyrus, insula, orbitofrontal cortex, caudate nucleus. However, hypothalamus and thalamus were not activated. We suggest that the nonactivation of hypothalamus and thalamus in middle aged males may be responsible for the lesser physiological arousal in response to the erotic visual stimuli.

Objectives It has been suggested that oxidative injuries have an important role in the pathogenesis of Alzheimer's disease (AD). In this study, we assess whether the plasma levels of albumin, bilirubin, and uric acid would be altered in the AD patients compared to those of the healthy controls. Furthermore, we tried to find the correlations between plasma antioxidant levels and the cognitive function in AD patients. Methods The plasma albumin, bilirubin, and uric acid levels were measured by standard methods in 101 AD patients and 101 healthy controls. The Korean version of the Mini Mental Status Examination (MMSE-K) was used to evaluate the cognitive functions of AD patients. Results A significant reduction in the albumin, bilirubin, and uric acid levels in the AD group was found compared to those of the control group. The scores of MMSE-K showed the positive correlation with albumin level in the AD group after adjusting confounding factors such as body mass index, gender and age. Conclusion This study showed that oxidative injuries could be involved in the pathogenesis of AD, as well as indicating that some antioxidant might be associated with the cognitive functions in AD. Copyright © 2006 John Wiley & Sons, Ltd.

The aim of this study was to evaluate the effectiveness and tolerability of both amisulpride and risperidone for treating the behavioral and psychological symptoms of dementia in patients with dementia of the Alzheimer type (DAT). Twenty-eight patients with DAT were randomly assigned to treatment with either amisulpride or risperidone for 8 weeks. The effectiveness of the treatments was assessed with the Neuropsychiatric Inventory (NPI) and the Clinical Global Impression-Severity of Illness (CGI-S) scale. The Simpson-Angus Rating Scale, the Barnes Akathisia Rating Scale and the Abnormal Involuntary Movement Scale were used for the assessment of side effects. The NPI and CGI-S scores were significantly decreased over time in both treatment groups without any significant group difference and time by treatment group interaction effect (F = 71.85, p < 0.0001). There were no serious adverse events in both groups. This study showed that either amisulpride or risperidone would be effective and tolerable for treating patients with DAT. Adequately powered studies with a head-to-head comparison design will be mandatory to draw any definite conclusion.

Objective: To investigate the effect of the apolipoprotein E (ApoE) ε4 allele on the efficacy and tolerability of galantamine treatment. Methods: A total of 202 patients with mild to moderate Alzheimer’s disease participated in a 16-week, prospective, multi-center, randomized, double-blind galantamine trial in a Korean population. Patients were assessed at baseline and after 4, 8 and 16 weeks of randomized treatment using the 11-item cognitive subscale of the Alzheimer’s Disease Assessment Scale (ADAS-cog/11), the Clinician’s Interview-Based Impression of Change plus Caregiver Input (CIBIC-plus), the Disability Assessment for Dementia Scale (DAD), the Behavioural Pathology in Alzheimer’s Disease Rating Scale (BEHAVE-AD) and adverse events. ApoE genotypes were determined for all subjects. Results: Of the 202 subjects, 115 carried at least one ApoE ε4 allele and 87 did not. In both ApoE ε4 carriers and ApoE ε4 noncarriers, significant improvements were detected relative to baseline on ADAS-cog/11, CIBIC-plus, DAD and BEHAVE-AD. ApoE ε4 noncarriers showed better improvement in mean total BEHAVE-AD score and mean psychosis (delusions and hallucinations) subscale score than ApoE ε4 carriers. The incidence of weight loss was significantly higher in ApoE ε4 carriers (n = 11; 9.6%) than in ApoE ε4 noncarriers (n = 1; 1.2%) during this 16-week study, even though 92% of patients who complained of weight loss completed this 16-week trial successfully. Conclusion: ApoE ε4 genotype does not affect galantamine-related improvements in cognition, global rating, function and behavior. Longer prospective studies with larger patient populations are required to confirm these new findings.

A hangover is characterized by the unpleasant physical and mental symptoms that occur between 8 and 16 hours after drinking alcohol. After inducing experimental hangover in normal individuals, we measured the methanol concentration prior to and after alcohol consumption and we assessed the association between the hangover condition and the blood methanol level. A total of 18 normal adult males participated in this study. They did not have any previous histories of psychiatric or medical disorders. The blood ethanol concentration prior to the alcohol intake (2.26+/-2.08) was not significantly different from that 13 hours after the alcohol consumption (3.12+/-2.38). However, the difference of methanol concentration between the day of experiment (prior to the alcohol intake) and the next day (13 hours after the alcohol intake) was significant (2.62+/-1.33/l vs. 3.88+/-2.10/l, respectively). A significant positive correlation was observed between the changes of blood methanol concentration and hangover subjective scale score increment when covarying for the changes of blood ethanol level (r=0.498, p

The present trial was designed as a pilot study to re-examine how fast the dose of quetiapine in combination with mood stabilizers can be titrated upward in acutely ill patients with bipolar mania. Patients were assigned to either a rapid titration group (RTG) or a conventional titration group (CTG). Quetiapine was administered twice daily in a 3-day period in the RTG (200 mg/day on day 1; 400 mg/day on day 2; and 600 mg/day on day 3) and in a 5-day period in the CTG (50 mg/day on day 1; 100 mg/day on day 2; 200 mg/day on day 3; 300 mg/day on day 4; and 400 mg/day on day 5). The Young Mania Rating Scale (YMRS) and Clinical Global Impression-Severity (CGI-S) scores were assessed at days 1 (baseline), 3, 5, 7, 14 and 21. The Barnes Akathisia Rating Scale and Simpson-Angus Rating Scale (SARS) were assessed at days 1, 2, 3, 4, 5, 6, 7, 14 and 21. RTG and CTG showed significant improvement on the scores of YMRS and CGI-S during the study without group differences. Both treatments were well tolerated without clinically significant differences in tolerability measures. Treatment was not limited by adverse events in the two groups. This study demonstrates the potential benefit and tolerability of rapid titration of quetiapine in the treatment of acutely ill bipolar disorder. This preliminary study proposes that rapid titration of quetipaine in combination with a mood stabilizer for the treatment of bipolar mania is effective and tolerable in comparison with conventional titration. A controlled study with a larger cohort should be performed.

Objectives: Functional MRI (fMRI) has become an important imaging modality for analyzing the neural mechanisms underlying schizophrenia. Earlier studies indicate that patients with schizophrenia tend to generate involuntary and unnecessary head motion during visual tasks. Since head motion can deteriorate the quality of fMRI data, an investigation was needed to examine the type and extent of head motion from patients with schizophrenia undergoing fMRI. Methods: Patients with schizophrenia and demographically-matched healthy comparison subjects underwent fMRI examination involving visual working memory tasks. We obtained head movement parameters (three translational and three rotational) through mathematical realignment of the volumetric image data, and transformed these parameters into head displacement indices to quantify the subject's head motion in space. Results: We found no group difference in displacement indices between the two groups. Group comparison of movement parameters indicated that the patient group showed reduced head motion along the superior–inferior direction when compared to healthy individuals. Conclusion: These results suggest that cognitive fMRI examination in patients with schizophrenia can be successfully conducted without the deteriorative effects of head motion.

This study measured the cerebral glucose metabolism in patients suffering from corticobasal degeneration (CBD) and progressive supranuclear palsy (PSP). The aim was to determine if there is a different metabolic pattern using (18)F-labeled 2-deoxyglucose ((18)F-FDG) positron emission tomography (PET). The regional cerebral glucose metabolism was examined in 8 patients diagnosed clinically with CBD (mean age 69.6 +/- 7.8 years; male/female: 5/3), 8 patients with probable PSP (mean age 67.8 +/- 4.5 years; male/female: 4/4) and 22 healthy controls. The regional cerebral glucose metabolism between the three groups was compared using statistical parametric mapping (SPM) with a voxel-by-voxel approach (p < 0.001, 200-voxel level). Compared with the normal controls, asymmetry in the regional glucose metabolism was observed in the parietal, frontal and cingulate in the CBD patients. In the PSP patients, the glucose metabolism was lower in the orbitofrontal, middle frontal, cingulate, thalamus and mid-brain than their age matched normal controls. A comparison of the two patient groups demonstrated relative hypometabolism in the thalamus, the mid-brain in the PSP patients and the parietal lobe in CBD patients. These results suggest that when making a differential diagnosis of CBD and PSP, voxel-based analysis of the (18)F-FDG PET images using a SPM might be a useful tool in clinical examinations.

This retrospective study aimed to compare differences in hepatic enzyme elevation during treatment with either risperidone or olanzapine alone in patients with psychotic disorders. The charts were reviewed for six hundred and sixty-seven (667) inpatients with psychotic disorders who were treated with either risperidone (n=289) or olanzapine (n=145) alone at a university-affiliated hospital between 1998 and 2002. Frequencies of elevation greater than the reference level in any enzyme among aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphotase (ALP) were higher in the olanzapine-treated group (26.9%) than in the risperidone-treated group (14.2%) [odds ratio (OR)=2.225, 95% confidence interval (CI)=1.362-3.638, P=0.002]. Frequencies of elevation greater than the reference level in ALT were higher in the olanzapine-treated group than in the risperidone-treated group (OR=2.182, P=0.004), as were frequencies with two-fold (OR=3.064, P=0.017) and three-fold (OR=2.883, P=0.039) elevation. Recovery time was longer in the olanzapine-treated group than in the risperidone-treated group (P=0.0059), as was latency time (P=0.0044). These results suggest that there are potential differences in antipsychotic-associated hepatic enzyme alterations between risperidone and olanzapine treatment. Controlled, prospective studies should be conducted to identify the risk factors associated with an alteration in hepatic enzymes related to treatment with risperidone and olanzapine.

With the Korean population rapidly aging and the number of Koreans with Alzheimer's disease(AD) steadily growing, treatment of AD is becoming an increasing concern. Galantamine hydrobromide, a dual acetylcholinesterase inhibitor and allosteric modulator of nicotinic receptors, is being studied in the treatment of the disease.This study compared the efficacy and tolerability of 3 doses of galantamine in a Korean population with mild to moderate AD.In this prospective, multicenter, double-blind, community-controlled, comparative study, patients with mild to moderate AD were randomized to receive galantamine 8, 16, or 24 mg/d; patients were evaluated at baseline (week 0) and after 4, 8, and 16 weeks of treatment. A 4-week dose-titration schedule was used in the 16-and 24-mg/d groups. Also included were patients with AD from a community control group who were untreated and assessed at baseline and week 16. The primary efficacy outcome was change in cognitive function, as measured with the Korean version of the AD Assessment Scale-11-item cognitive subscale (ADAS-cog/11-K); secondary efficacy measures included changes in functional capacity, behavioral symptoms, and global impression (clinical response), as measured with the Korean versions of the Disability Assessment for Dementia Scale (DAD-K), Behavior Pathology in AD Rating Scale (BEHAVE-AD-K), and Clinician's Interview-Based Impression of Change plus Caregiver Input (CIBIC-plus-K).A total of 300 patients (228 women, 72 men) were enrolled (76, 78, 80, and 66 patients in the 8-, 16-,24-mg/d and community control groups, respectively). Significant differences in demographic characteristics were found between the galantamine and community control groups for age, sex, and duration of formal education (P = 0.042, P = 0.049, and P0.001, respectively). Results demonstrated a robust dose-response relationship between ADAS-cog/11-K and galantamine dosage compared with baseline and controls at 16 weeks. Mean (SE) improvements ranged from 3.7 (0.8) to 5.6 (0.8) points in the galantamine groups, whereas the control group deteriorated by 4.7 (0.5) points (P0.001). Similarly, significant improvements in all 3 treatment groups were observed in mean DAD-K, BEHAVE-AD-K, and CIBIC-plus-K scores (P0.001, P0.005, and P0.001, respectively). Galantamine was relatively well tolerated.This study found that galantamine effected significant benefits on the cognitive, functional, and behavioral symptoms of mild to moderate AD in this population of Korean patients. The tolerability results suggest that galantamine is well tolerated in these patients. Inc.

The association between Glutathione S-Transferase M1 gene (GSTM1) polymorphism and schizophrenia was examined. One hundred and eleven in-patients with schizophrenia and 130 healthy controls were enrolled in this study. Genotyping was performed using a polymerase chain reaction-based method. The GSTM1 null genotype was significantly more frequent in the schizophrenia patients than in the controls (P=0.014, odds ratio=1.93, 95% confidence interval=1.115-3.351). On the other hand, the GSTM1 genotype variants were not associated with tardive dyskinesia or total abnormal involuntary movement scale scores. This study suggests that, at least in the Korean population, the GSTM1 polymorphism may confer susceptibility to the development of schizophrenia but not to tardive dyskinesia.

Membrane phospholipid abnormalities have been proposed to be involved in the pathogenesis of mood disorders, and in signal transduction and neurotransmitter uptake. Cytosolic phospholipase A2 (cPLA2) is not only an essential enzyme in the metabolism of fatty acids but also in signaling process. Therefore, we examined the association between the BanI polymorphism of the cPLA2 gene and mood disorders. Sixty-two patients with major depressive disorder (MDD), 50 patients with bipolar I disorder (BID) and 117 healthy controls participated in this study. Genotyping was performed by using PCR-based methods. Genotype and allele distributions in MDD patients were significantly different from those of the controls. In particular, the A2 allele was associated with increased risk of MDD development (p = 0.007, odds ratio = 1.827; confidence interval = 1.141–2.927). However, the polymorphism was not different between BID patients and controls in genotype and allele distribution. This preliminary study indicates the need for further studies on the potential role of the cPLA2 gene polymorphism in the susceptibility to mood disorders.

Localized in vivo proton magnetic resonance spectroscopy (MRS) was performed to evaluate metabolic alterations in the right and left frontal lobe before and after antipsychotic treatment of schizophrenic patients (n = 24) and a group of healthy normal subjects (n = 20). Proton metabolic ratios obtained from the 8 cm3 voxels in the right and left frontal lobes were compared with the clinical assessment for each subject. There was no significant difference in the metabolic ratios between the right and the left frontal lobes in either the schizophrenic group or the control group, indicating no laterality. Compared with those of the normal control group, NAA/Cr ratio of the schizophrenic patients showed significantly lower value. The NAA/Cr ratio of the schizophrenic patients was not changed after antipsychotic treatment. The present study supports the ‘hypofrontality’ hypothesis of schizophrenia.

This study aimed to test the association of the tyrosine hydroxylase (TH) gene with schizophrenia in the Korean population. 334 patients with schizophrenia and 391 healthy volunteers were included. Intron 1 VNTR polymorphism of TH gene was genotyped using polymerase chain reaction techniques. The genotype and allele distribution between patients and controls were not significantly different. However, the positive score of the Positive and Negative Syndrome Scale (PANSS) was higher in the group expressing the TH10 allele (t = 2.245, p = 0.02), although no significant differences were present in the distribution of age of onset, degree of improvement using Brief Psychiatric Rating Scale (BPRS) change, total PANSS score and negative score. This finding suggests that the TH10 allele may be a liability factor for positive schizophrenia in the Korean population.

This study was aimed to test the association between schizophrenia and a functional serotonin polymorphism (5-HTTLPR) in the upstream regulatory region. Genomic DNA analysis with polymerase chain reaction was used for 5-HTTLPR genotyping. One hundred and eleven patients with schizophrenia and 208 healthy individuals participated in this study. There were significant differences in the negative score and general psychopathology score of the positive and negative syndrome scale according to 5-HTTLPR genotypes and alleles, although no significant differences in allele or genotype frequencies between the two groups were found. These results suggest that 5-HTTLPR may contribute to the susceptibility to the symptomatology of schizophrenia but not to the development of the disorder itself, at least in the Korean population.

Information regarding pulmonary edema in obstetric patients is limited, especially its natural history as most cases are from tertiary care centers. The incidence, etiology, and course of pulmonary edema in all obstetric patients at a primary-secondary care center was studied prospectively among 29,621 obstetric cases in the past 3.5 years. Pulmonary edema developed in 18 cases (0.06%) of all obstetric patients that were associated with pre-eclampsia-eclampsia and tocolysis with beta-mimetics. The onset of pulmonary edema was 1-8 days postpartum in 12 patients, 1 day antepartum in 3 patients, and 26-32 gestational weeks in 3 patients. The cause was mainly cardiogenic, and the mean time taken for resolution was 2.2 days. Unilateral pulmonary edema occurred in 4 patients and there was delayed resolution compared with bilateral pulmonary edema because of delayed treatment. Pulmonary edema associated with pregnancy developed in 0.06% of cases, mainly during the peripartum, and resolved rapidly. Unilateral pulmonary edema was not uncommon.

Background: Although the basal ganglia (BG) are involved in the earlier pathological changes of the Alzheimer’s disease, little is known about the functional and structural changes of BG in the amnestic mild cognitive impairment (aMCI). The aim of this study is to explore the structural, functional changes of BG and their inter-dependencies in aMCI.Methods:A total of 50 aMCI subjects and 50 group matched healthy controls underwent the structural and resting state functional magnetic resonance imaging (MRI). We measured the volume and deformations of the BG of subjects. The functional connecitivities (FC) of the BG were also investigated with the caudate, the putamen and the pallidum seeds. In addition, we also tried to explore the distinctive relationships between the morphological changes and functional network changes using graph theory analysis. Results: We found that deformations of the ventrocaudal part of the putamen and pallidum, and rostal part of the caudate were more prominent in the aMCI group compared with the controls. The caudate seed revealed decreased FC in the frontal region including superior medial and orbital in the aMCI group relative to the controls. On the other hand, the putamen and the pallidum seed revealed the increased FC in the middle and superior orbital frontal and suprmargial gyrus the anterior cingulate, precuneus, angular gyrus and insular in the aMCI group compared to the controls. The volumes of the basal ganglia of the aMCI group were negatively correlated with the nodal betweenness based on the FC of each basal ganglia node. Conclusions: As BG were connected to the important functional hub structures of the brain, structural and functional alterations of these structures in the aMCI subjects might be related to the serious cognitive and behavioral impairment in aMCI subjects. However, the further longitudinal study might be needed to confirm these hypotheses.

Refusing to attend school is a serious problem that could lead to psychopathology. We aimed to: (1) prospectively observe the actual development of school refusal behavior according to a history of separation anxiety symptoms (SAS) and (2) explore factors for predicting school refusal behavior in children who were just beginning primary school. The participants were 277 children, aged 6–7 years, who were expected to enter primary school in 2 months. The parents were surveyed about the child׳s history of SAS and their behavior. The children were questioned about anxiety symptoms. The children were surveyed about whether school refusal behavior developed or not after they entered primary school. Of the 248 children who responded to the follow-up survey, 7.66% of children met the criteria for school refusal behavior during the 3 months after entering school. We found no significant differences in the occurrence of school refusal behavior according to the children׳s SAS history. Familial risk factors for school refusal behavior included low parental educational level and a working mother. School refusal behavior by first graders cannot be fully explained by the expression of SAS and could be implicated in a more complex psychopathology.