Tachyarrhythmia in patients with congenital heart disease: inevitable destiny?

The prevalence of patients with congenital heart disease (CHD) has increased over the last century. As a result, the number of CHD patients presenting with late, postoperative tachyarrhythmias has increased as well. The aim of this review is to discuss the present knowledge on the mechanisms underlying both atrial and ventricular tachyarrhythmia in patients with CHD and the advantages and disadvantages of the currently available invasive treatment modalities.

Fractionation of renatured repetitive human DNA according to thermal stability, sequence length, and renaturation rate.

Renatured repetitive human DNA sequences have been fractionated according to three criteria: length, thermal stability, and rate of renaturation. Satellite sequences are found in the long repetitive sequence fractions and renatured satellite sequences are well base paired by the criterion of thermal stability. No satellites are observed in short repeated sequences. Short repeated sequences are interspersed with single copy sequences and are poorly base paired. This implies satellite components are relatively homogeneous in base sequence whereas short interspersed repeated sequences are inexact copies of each other. A method for isolating satellite DNAs based on their high thermal stabilities is discussed.

Obesity due to high fat diet decreases the sympathetic nervous and cardiovascular responses to intracerebroventricular leptin in rats.

Obesity is associated with an increase in plasma leptin levels primarily derived from enhanced expression of the leptin gene in the adipose tissue. Leptin levels and expression are higher in females than males. The main functions of leptin are to decrease food intake and increase sympathetic nerve activity, especially in the brown adipose tissue. The high levels of leptin in obese, female rats suggest leptin resistance. In this article we describe experiments designed to investigate the effect of the intracerebroventricular (i.c.v.) administration of leptin on lumbar sympathetic nerve activity (LSNA) and cardiovascular parameters in female rats fed a low fat diet (control), a high fat diet (obese), or high fat diet followed by a period of food restrictions (reduced). The i.c.v. leptin administration increased LSNA in control rats, but decreased it in obese rats. In weight reduced animals the LSNA response to leptin returned to control levels. The i.c.v. leptin increased the mean arterial pressure in control and wt. reduced rats, but not in obese animals. The heart rate did not respond to leptin in any animal group. These results suggest that obesity decreases the central nervous system (CNS)-mediated lumbar sympathetic nervous and cardiovascular responses to leptin and that these responses recover following food restriction and wt. reduction. We conclude that obesity is associated with a decreased CNS response to leptin leading to a decrease in leptin effects to increase the activities of the autonomic nervous and cardiovascular systems.

The special/general education integration initiative for students with specific learning disabilities: a "snapshot" of program change.

As part of a broader investigation, this study sought to (a) provide a statewide "snapshot" of educators' views regarding the current status of and process associated with increased integration efforts for serving students with specific learning disabilities (SLD) in Virginia, and (b) document factors serving as the basis of or creating reluctance toward such efforts. Survey respondents included the population of special education supervisors and samples of general education supervisors, building principals, general secondary and elementary education teachers, and LD teachers (N = 788). Results suggest active efforts to increase the amount of time students with SLD spend in general classroom settings; however, limited program change-related guidelines or category-specific outcome-monitoring measures were reported. Across groups, participants expressed doubts regarding the adequacy of general education teachers' skills for making needed instructional adaptations. Over half of the respondents tended to disagree or disagreed that general education teachers were willing to make needed adaptations for students with SLD. Differences in the views expressed by the different respondent groups were examined.

Written expression of students with and without learning disabilities: differences across the grades.

This study compares the written expression of 48 students with learning disabilities (LD) and 48 normally achieving (NA) students (Grades 4, 8, and 11). Productivity, syntactic maturity, vocabulary, and mechanics were examined using writing samples obtained in response to a standard stimulus. Results indicate that, compared to their NA peers, students with learning disabilities write fewer words and sentences, write more words per sentence, produce fewer words with seven letters or more and fewer sentence fragments, and have a higher percentage of capitalization and spelling errors. No group differences were found for the number of T-units produced or the number of morphemes per T-unit. Comparison of group differences at each grade level and differences by groups across the grades reveals persistent written expression difficulties and signals a need for a careful review of current instructional practices and how they can be improved.

Special education supervisors' perceptions of secondary LD programs: a comparison with LD teachers' views.

Perceptions of secondary LD program supervisors were identified and compared with views of secondary LD teachers regarding the presence of specific program features, field-related issues, and suggestions for program improvement. Responses indicated that the supervisors were more positive and, in many cases, held significantly different views than LD teachers.

Students with learning disabilities in the university environment: a study of faculty and student perceptions.

This study examines faculty and student perceptions regarding university students with learning disabilities, sensitivity to such students' special needs, accommodations, and the perceived impact of a learning disability. Results reveal a general sensitivity to the special needs of students with learning disabilities; however, group differences suggest several areas warranting further attention.

The effectiveness of aerosolized intraperitoneal bupivacaine in reducing postoperative pain in children undergoing robotic-assisted laparoscopic pyeloplasty.

OBJECTIVE: To assess the effectiveness of aerosolized intraperitoneal bupivacaine in reducing postoperative pain in children. Laparoscopic surgery has decreased the severity of postoperative pain in children. However, children often experience abdominal and shoulder pain requiring significant amounts of opioids, potentially prolonging their hospitalization. METHODS: Forty-one consecutive patients undergoing unilateral robotic-assisted pyeloplasty between December 2005 and December 2007 were retrospectively reviewed to assess perioperative opioid requirements and length of hospitalization. RESULTS: In addition to standard-of-care perioperative analgesia, five patients received intraperitoneal aerosolized bupivacaine just prior to trocar removal, 17 patients received aerosolized bupivacaine just prior to incising the perirenal fascia, and 19 patients received no intervention. There was a significant reduction in postoperative opioid utilization when bupivacaine was administered at the beginning of the surgery (0.1mg/kg vs 0.4mg/kg, P=0.04), but not at the end (0.3mg/kg, P=0.25), as compared to controls. All patients receiving aerosolized bupivacaine had a significantly shorter time in hospital (2.4 vs 1.4 days, P=<0.01). CONCLUSIONS: The administration of intraperitoneal aerosolized bupivacaine just prior to incising the perirenal fascia appears to be a simple, effective and low-cost method to reduce postoperative pain in children undergoing laparoscopic pyeloplasty.

An open-label pilot study of fluvoxamine for mixed anxiety-depression.

The syndrome of mixed anxiety and depression (MAD) has been described and is familiar to both general psychiatrists and nonpsychiatrists. It was included in the DSM-IV appendix as a syndrome proposed for further study. Fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) approved for the treatment of obsessive-compulsive disorder, was studied for its effectiveness in treating anxiety and depression simultaneously during an 8-week, open-label trial of patients with MAD. Thirteen patients were included in the final, intent-to-treat, analysis. Fluvoxamine showed moderately strong effectiveness in improving anxiety and depression with a greater effect on the depressive component. Nausea, insomnia, delayed ejaculation, and nervousness were the most common side effects reported, with no serious adverse events occurring. Future double-blind placebo-controlled studies will give more conclusive results.

The evolution of a family of short interspersed repeats in primate DNA.

Human DNA contains 300 nucleotide interspersed repeated sequences which mostly belong to a single family of sequences called the Alu family. This work examines the evolution of this family of sequences in primates. Bonnet monkey (Macaque radiata) DNA contains a predominant family of 300 nucleotide repeats which has nearly the same restriction map as the human Alu family and which hybridizes to human Alu family repeats under Southern blotting conditions. Prosimian (Galago crassicaudatus pangeniesis) DNA also contains a prominent group of 300 nucleotide long repeated sequences which does not have the same restriction sites as the human Alu family but which does hybridize to the human Alu family under reduced stringency conditions.

A microassay for detection of DNA and RNA in small numbers of plant cells.

A microtechnique for the detection of DNA or RNA in small numbers of plant cells (1-50) has been developed using cauliflower mosaic virus (CaMV) infection of turnip as a model system. Both DNA and RNA extracted from 10 mesophyll protoplasts from CaMV-infected plants can be detected by hybridization using a radioactive probe made from cloned CaMV DNA (pCaMV10). No hybridization above background was detected in extracts of protoplasts from uninfected plants. At least 0.15 pg (11 000 molecules) of purified pCaMV10 DNA can be detected. This method is superior to existing 'macro' techniques for nucleic acid detection as smaller amounts of tissue are required and the detection is approximately 100-fold more sensitive. re]19850326 rv]19850530 ac]19850611.

Regulation of metallocarboxypeptidase inhibitor gene expression in tomato.

Tomato fruits contain a metallocarboxypeptidase inhibitor (MCPI) the sequence of which has already been determined. Here we report the isolation of a tomato cDNA clone that encodes the mature MCPI protein as well as an N-terminal signal peptide for entry into the secretory system and an eight amino acid carboxyterminal extension. MCPI RNA is present at very high levels in anthesis stage ovaries and decreases quite rapidly during fruit development. MCPI protein accumulation reflects the pattern of MCPI RNA accumulation in fruit, consistent with a transcriptional control of MCPI gene activity. In leaves, the levels of MCPI RNA and protein are very low. Wounding of the leaves causes a dramatic (100-fold) increase in steady-state level of MCPI RNA without a concomitant increase in MCPI protein level suggesting a control at the post-transcriptional or translational level of gene expression. Genomic DNA blot hybridization data indicate that MCPI in tomato may be encoded by a single gene.

A functional map of the fruit-specific promoter of the tomato 2A11 gene.

The 5' region of the fruit-specific tomato gene, 2A11, contains both positive and negative regulatory elements. We divided the 5' promoter region of the 2A11 gene into small fragments, ranging in size from 211 to 634 bp and used these short DNA fragments in in vitro protein-binding studies. These studies revealed the presence of at least four fruit-specific and one leaf- and fruit-active protein-binding domains. These promoter fragments, as well as other overlapping fragments, were tested for their ability to enhance expression from a truncated heterologous promoter in transgenic plants. This analysis showed the presence of four fruit-specific and three general or leaf-active positive regulatory elements. Comparison of the results obtained with these two approaches allowed us to draw a functional map of the 2A11 promoter.