Self-esteem in Children with Psychosomatic Symptoms: Examination of Low Self-esteem and Prognosis

Self-esteem is the evaluative feelings one holds for oneself and the sense that one has essential worth. It is evaluated as the difference between the actual self and the ideal self. Healthy self-esteem supports psychological stability and positive social activity and is an essential element in the psychological development of children. The purpose of this study was to evaluate self-esteem in children with psychosomatic symptoms and elucidate a strategy for using such evaluations in therapy. We evaluated self-esteem in 56 patients at the Department of Pediatrics of Okayama University Hospital who were undergoing outpatient therapy for psychosomatic symptoms, using Pope's 5-scale test of self-esteem for children. We examined patient attributes, course of therapy, and social adjustment. Patients with low self-esteem on multiple scales at the first visit were all female, and these patients had a significantly higher frequency of family function problems, such as a family member with a psychiatric disorder, economic hardship, or experience of child abuse. Moreover, the prognosis for these patients was poor regardless of their social adjustment at the first visit

A Study of Psycho-pathology and Treatment of Children with Phagophobia

Phagophobia is a disorder characterized by a conditioned excessive fear of eating and is initiated by an event such as vomiting or choking. During childhood, vomiting often occurs as a result of infection or overeating, and painful experiences bring about maladaptive eating behavior like food refusal. There have been few reports of phagophobia, and patients have sometimes been misdiagnosed with anorexia nervosa (AN). The objective of this study was to elucidate the psycho-pathology and current treatment of patients with phagophobia by analyzing case studies. We describe 6 cases with phagophobia. Patients with strong obsessions were refractory to treatment, indicating that evaluation of premorbid personality is crucial to the prognosis. It is important to classify this disorder according to psycho-pathology into "post-traumatic type" and "gain-from-illness type" to make a treatment plan. A solution focused approach is also effective for patients and their family. Paying close attention to these conditions and to the diagnostic concept referred as "hagophobia" is useful in achieving these aims

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

A new dynamic myocardial phantom for the assessment of left ventricular function by gated single-photon emission tomography.

Gated myocardial perfusion single-photon emission tomography (SPET) has been used for the measurement of left ventricular (LV) function and validated by means of comparison with other imaging modalities. We have designed a new dynamic myocardial phantom in order to validate the LV function as assessed by the use of gated myocardial perfusion SPET. The phantom consists of two half-ellipsoids (an endocardial surface and an epicardial surface) and a thorax. The myocardial space is filled with a radioactive solution. The endocardial surface moves continuously towards and away from the epicardial surface in the longitudinal axis to vary the LV volume [143 ml at end-diastole (ED), 107 ml at end-systole (ES)] and thickness (apex 8 mm at ED and 26 mm at ES, midplane 8 mm). The mean values of wall motion (WM) for the apical midplane region and the basal midplane region were 5 mm and 2 mm, respectively. Gated myocardial SPET was performed during 8 and 16 intervals. These projection data sets were processed using a Butterworth filter with an order of 5 and a critical frequency of 0.34 cycles/cm. LV function was calculated using the quantitative gated SPET (QGS) algorithm. The LV function values estimated by gated SPET during 16 intervals [22% for ejection fraction (EF), 3.7 mm for WM of the apical midplane, 1.7 mm for WM of the basal midplane] closely resembled actual LV functions [25% for EF, 5 mm for WM of the apical midplane, 2 mm for WM of the basal midplane]. However, the estimated values during 8 intervals were smaller than those during 16 intervals (19% for EF, 3.3 mm for WM of the apical-midplane, 1.1 mm for WM of the basal-midplane). The estimated LV volumes closely correlated with the actual volumes (r=0.99 for 16 intervals, r=0.95 for 8 intervals). Utilizing this phantom, LV function estimated using gated myocardial SPET can be compared with actual values

Upregulation of miR-30d in Persistent AF

Background: Atrial fibrillation (AF) begets AF in part due to atrial remodeling, the molecular mechanisms of which have not been completely elucidated. This study was conducted to identify microRNA(s) responsible for electrical remodeling in AF. Methods and Results: The expression profiles of 1205 microRNAs, in cardiomyocytes from patients with persistent AF and from age-, gender-, and cardiac function-matched control patients with normal sinus rhythm, were examined by use of a microRNA microarray platform. Thirty-nine microRNAs differentially expressed in AF patients’ atria were identified, including miR-30d, as a candidate responsible for ion channel remodeling by in silico analysis. MiR-30d was significantly upregulated in cardiomyocytes from AF patients, whereas the mRNA and protein levels of CACNA1C/ Cav1.2 and KCNJ3/Kir3.1, postulated targets of miR-30d, were markedly reduced. KCNJ3/Kir3.1 expression was downregulated by transfection of the miR-30 precursor, concomitant with a reduction of the acetylcholine-sensitive inward-rectifier K+ current (IK.ACh). KCNJ3/Kir3.1 (but not CACNA1C/Cav1.2) expression was enhanced by the knockdown of miR-30d. The Ca2+ ionophore, A23187, induced a dose-dependent upregulation of miR-30d, followed by the suppression of KCNJ3 mRNA expression. Blockade of protein kinase C signaling blunted the [Ca2+]i-dependent downregulation of Kir3.1 via miR-30d. Conclusions: The downward remodeling of IK.ACh is attributed, at least in part, to deranged Ca2+ handling, leading to the upregulation of miR-30d in human AF, revealing a novel post-transcriptional regulation of IK.ACh