Linkage analysis of alternative anxiety phenotypes in multiply affected panic disorder families.

BACKGROUND: The choice of phenotype definitions for genetic studies of panic and phobic disorders is complicated by family, twin, and neurobiological data indicating both distinct and shared risk factors as well as heterogeneity within categories. We have previously reported a genome scan in 120 multiplex panic disorder (PD) families using a phenotype that closely adhered to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., PD definition. Here, we extend this work by carrying out exploratory linkage analyses in this same pedigree set using ten additional literature-based panic and phobia-related phenotypes that take into account aspects of these hypothesized complexities. METHODS: Multiply affected families (>2 individuals with PD) were recruited from clinical and nonclinical sources, evaluated by a clinician-administered semistructured interview and a subsequent blind consensus best estimate procedure. Each phenotype was analyzed under dominant and recessive models using parametric two-point (homogeneity and heterogeneity), multipoint, and nonparametric methods. Empirically based permutations were used to estimate model-specific and global (across all phenotypes) P-values. RESULTS: The highest score was a two-point lod (4.27, global P<0.08) on chromosome 13 (D13S793, 76 cM) for the phenotype 'specific or social phobia' under a recessive model and conditions of homogeneity. There was minimal support for linkage to any of the remaining nine phenotypes. CONCLUSION: Although the interpretation of findings is limited by the sample size and the large number of phenotypes and models analyzed, these data suggest a region on chromosome 13 as a potential site for further exploration in relation to the risk for specific and social phobias.

MethylomeDB: a database of DNA methylation profiles of the brain.

MethylomeDB (http://epigenomics.columbia.edu/methylomedb/index.html) is a new database containing genome-wide brain DNA methylation profiles. DNA methylation is an important epigenetic mark in the mammalian brain. In human studies, aberrant DNA methylation alterations have been associated with various neurodevelopmental and neuropsychiatric disorders such as schizophrenia, and depression. In this database, we present methylation profiles of carefully selected non-psychiatric control, schizophrenia, and depression samples. We also include data on one mouse forebrain sample specimen to allow for cross-species comparisons. In addition to our DNA methylation data generated in-house, we have and will continue to include published DNA methylation data from other research groups with the focus on brain development and function. Users can view the methylation data at single-CpG resolution with the option of wiggle and microarray formats. They can also download methylation data for individual samples. MethylomeDB offers an important resource for research into brain function and behavior. It provides the first source of comprehensive brain methylome data, encompassing whole-genome DNA methylation profiles of human and mouse brain specimens that facilitate cross-species comparative epigenomic investigations, as well as investigations of schizophrenia and depression methylomes.

Genome-wide divergence of DNA methylation marks in cerebral and cerebellar cortices.

BACKGROUND: Emerging evidence suggests that DNA methylation plays an expansive role in the central nervous system (CNS). Large-scale whole genome DNA methylation profiling of the normal human brain offers tremendous potential in understanding the role of DNA methylation in brain development and function. METHODOLOGY/SIGNIFICANT FINDINGS: Using methylation-sensitive SNP chip analysis (MSNP), we performed whole genome DNA methylation profiling of the prefrontal, occipital, and temporal regions of cerebral cortex, as well as cerebellum. These data provide an unbiased representation of CpG sites comprising 377,509 CpG dinucleotides within both the genic and intergenic euchromatic region of the genome. Our large-scale genome DNA methylation profiling reveals that the prefrontal, occipital, and temporal regions of the cerebral cortex compared to cerebellum have markedly different DNA methylation signatures, with the cerebral cortex being hypermethylated and cerebellum being hypomethylated. Such differences were observed in distinct genomic regions, including genes involved in CNS function. The MSNP data were validated for a subset of these genes, by performing bisulfite cloning and sequencing and confirming that prefrontal, occipital, and temporal cortices are significantly more methylated as compared to the cerebellum. CONCLUSIONS: These findings are consistent with known developmental differences in nucleosome repeat lengths in cerebral and cerebellar cortices, with cerebrum exhibiting shorter repeat lengths than cerebellum. Our observed differences in DNA methylation profiles in these regions underscores the potential role of DNA methylation in chromatin structure and organization in CNS, reflecting functional specialization within cortical regions.

A novel analytical framework for dissecting the genetic architecture of behavioral symptoms in neuropsychiatric disorders.

BACKGROUND: For diagnosis of neuropsychiatric disorders, a categorical classification system is often utilized as a simple way for conceptualizing an often complex clinical picture. This approach provides an unsatisfactory model of mental illness, since in practice patients do not conform to these prototypical diagnostic categories. Family studies show notable familial co-aggregation between schizophrenia and bipolar illness and between schizoaffective disorders and both bipolar disorder and schizophrenia, revealing that mental illness does not conform to such categorical models and is likely to follow a continuum encompassing a spectrum of behavioral symptoms. RESULTS AND METHODOLOGY: We introduce an analytic framework to dissect the phenotypic heterogeneity present in complex psychiatric disorders based on the conceptual paradigm of a continuum of psychosis. The approach identifies subgroups of behavioral symptoms that are likely to be phenotypically and genetically homogenous. We have evaluated this approach through analysis of simulated data with simulated behavioral traits and predisposing genetic factors. We also apply this approach to a psychiatric dataset of a genome scan for schizophrenia for which extensive behavioral information was collected for each individual patient and their families. With this approach, we identified significant evidence for linkage among depressed individuals with two distinct symptom profiles, that is individuals with sleep disturbance symptoms with linkage on chromosome 2q13 and also a mutually exclusive group of individuals with symptoms of concentration problems with linkage on chromosome 2q35. In addition we identified a subset of individuals with schizophrenia defined by language disturbances with linkage to chromosome 2p25.1 and a group of patients with a phenotype intermediate between those of schizophrenia and schizoaffective disorder with linkage to chromosome 2p21. CONCLUSIONS: The findings presented are novel and demonstrate the efficacy of this approach in detection of genes underlying such complex human disorders as schizophrenia and depression.

Association and linkage analysis of candidate genes GRP, GRPR, CRHR1, and TACR1 in panic disorder.

Panic disorder (PD) is a debilitating anxiety disorder, characterized by recurrent episodes of intense fear that are accompanied by autonomic and psychological symptoms leading to behavioral impairment. Basic research implicates neuropeptide-signaling genes in the modulation of anxiety and stress. The genes encoding corticotropin releasing hormone receptor 1 (CRHR1), tachykinin receptor 1 (TACR1), gastrin releasing peptide (GRP), and gastrin releasing peptide receptor (GRPR) were selected as candidates for PD based on their biology. Linkage and association analysis in 120 multiplex U.S. PD pedigrees was performed using 21 single nucleotide polymorphisms (SNPs). Parametric and non-parametric linkage tests in pedigrees, for single point and multipoint analysis, revealed limited support for genetic linkage to TACR1 (parametric and non-parametric lod scores approximately 1). The family-based association test (FBAT) generated nominal support for allelic association in TACR1 (P = 0.02), and GRP (P = 0.02), findings which must be considered in the light of multiple comparisons. Further exploration of the GRP and TACR1 findings in large case-control PD samples may provide more definitive evidence implicating these loci in the genetic etiology of PD.

A third-pass genome scan in panic disorder: evidence for multiple susceptibility loci.

BACKGROUND: Panic disorder (PD) is a common illness with a definite but "complex" genetic contribution and estimated heritability of 30-46%. METHODS: We report a genome scan in 120 multiplex PD pedigrees consisting of 1591 individuals of whom 992 were genotyped with 371 markers at an average spacing of 9cM. Parametric two-point, multipoint, and nonparametric analyses were performed using three PD models (Broad, Intermediate, Narrow) and allowing for homogeneity or heterogeneity. The two-point analyses were also performed allowing for independent male and female recombination fractions (theta). Genome-wide significance was empirically evaluated using simulations of this dataset. RESULTS: Evidence for linkage reached genome-wide significance in one region on chromosome 15q (near GABA-A receptor subunit genes) and was suggestive at loci on 2p, 2q and 9p using an averaged theta. Analyses allowing for sex-specific theta's were consistent except that support at one locus on 2q increased to genome-wide significance and an additional region of suggestive linkage on 12q was identified. However, differences in male and female recombination fractions predicted by the sex-specific approach were not consistent with current physical maps. CONCLUSIONS: These data provide evidence for chromosomal regions on 15q and 2q that may be important in genetic susceptibility to panic disorder. Although we are encouraged by the findings of analyses using sex-specific recombination fractions, we also note that further understanding of this analytic strategy will be important.

A single nucleotide polymorphism chip-based method for combined genetic and epigenetic profiling: validation in decitabine therapy and tumor/normal comparisons.

Progress on several unresolved issues in cancer epigenetics will benefit from rapid and standardized methods for profiling DNA methylation genome-wide. In the area of epigenetic therapy, the demethylating drug decitabine (5-aza-2'-deoxycytidine) is increasingly used to treat acute myelogenous leukemia and myelodysplastic syndrome, but the mechanisms of its anticancer activity have remained unclear. Given the clinical efficacy of decitabine and the uncertainties about its mode of action, it will be useful to optimize methods for following DNA methylation as a biochemical response in individual patients. Here, we describe a single nucleotide polymorphism (SNP) chip-based method (MSNP) for profiling DNA methylation. Using this procedure, the extent of demethylation in bone marrow aspirates from patients with leukemia receiving decitabine can be assessed genome-wide using commercially available (Affymetrix) SNP chips. We validated the accuracy of MSNP by comparing the results with combined bisulfite restriction analysis and by sequencing cloned PCR products from bisulfite-converted DNA. We further validated MSNP in a Wilms' tumor/normal kidney comparison, comparing the results with methylation-sensitive Southern blotting. MSNP simultaneously detects aberrations in DNA copy number and loss of heterozygosity, making it a generally useful approach for combined genetic and epigenetic profiling in tissue samples from cancer patients.

Desarrollo sustentable: economía y tecnología para el bienestar humano

Los autores sostienen que la sustentabilidad es, en sí misma, una aspiración, lo que es en cambio una realidad, es la existencia de trayectorias más o menos sustentables

Desarrollo sustentable: economía y tecnología para el bienestar humano

Los autores sostienen que la sustentabilidad es, en sí misma, una aspiración, lo que es en cambio una realidad, es la existencia de trayectorias más o menos sustentables

[Spontaneous bleeding from renal cyst as a cause of acute anemia]. / Sangramiento espontáneo de un quiste renal como causa de anemia aguda.

OBJECTIVE: To report a case of a simple left renal cyst in a patient who presented with spontaneous pain and acute anemia due to intracystic hemorrhage. METHODS: Diagnostic imaging techniques such as assessment of the urinary tract with contract medium, ultrasound CT and MRI were utilized for correct preoperative diagnosis and surgical management. RESULTS: The patient was able to return to normal active work. CONCLUSIONS: Rarely as in the case described renal cysts can collect blood at the expense of the renal parenchayma. Ultrasound and CT are very useful diagnostic imaging techniques in renal pathologies.

Sangramiento espontáneo de un quiste renal como causa de anemia aguda / Acute anemia caused by spontaneous hemorrhage of a cesarean section

OBJETIVOS: Presentar un enfermo con quiste renal simple izquierdo que comenzando con dolor espontáneo presenta anemia aguda por sangramiento intraquístico. MÉTODO: Utilizamos en el diagnóstico medios imagenológicos como estudios contrastados del sistema urinario, ultrasonido, tomografía axial computarizada y resonancia magnética que permitió un diagnóstico preoperatorio correcto y una intervención quirúrgica adecuada. RESULTADOS: Se logró reincorporar al enfermo a la vida laboral activa. CONCLUSIONES: Excepcionalmente como el caso mostrado los quistes renales pueden coleccionar sangre a expensas del parénquima renal, comprobamos que el ultrasonido y la tomografía axial computarizada tienen gran valor en el diagnóstico de afecciones renales (AU)

Epilepsia: estudio retrospectivo / Epilepsy: retrospective study

Analiza retrospectivamente un grupo de 133 pacientes epilépticos diagnosticados en el Servicio de Neurología del Hospital Abel Gilbert Pontón con el propósito de mostrar una visión clara de lo que es la epilepsia y cómo se debe tratar. La edad más frecuente de presentación es entre los 0 y 19 años con el 66.9 por ciento; la mayor parte de los casos 94.7 por ciento procedieron del área urbana; el hallazgo etiológico más frecuente fue la epilepsia idiopática o familiar. Del total estudiado, el 88.7 por ciento fueron crisis generalizadas y de ellas el 94 por ciento fueron tónico-clónicas. La sintomatología asociada fueron las manifestaciones vegetativas. El 84.3 por ciento de los enfermos tuvieron un rendimiento intelectual normal. Finalmente se debe puntualizar que el 66 por ciento de los pacientes fueron controlados con monoterapia y el seguimiento clínico durante 1 año demostró que el 72.9 por ciento de los pacientes se controlaron en forma absoluta.