The relationship between cognitive control and lexical conflict resolution in developmental dyslexia.

Previous studies have revealed that cognitive control functions contribute to the resolution of lexical interference. Both cognitive control (CC) deficits and reduced speed of lexical retrieval in Rapid Automatized Naming (RAN) tasks are characteristics of Developmental Dyslexia (DD), but it is still not fully understood how these deficits relate to each other and to reading problems. To examine this question, we tested adolescents with DD (n = 38), poor readers (PR; n = 25) and typical readers (TR; n = 33) matched on age and IQ, on CC functions with Stroop, Stop Signal, Simon, Backward Digit Span and n-back tasks and on lexical retrieval and lexical conflict resolution with RAN of pictures in semantically homogeneous vs. mixed trials. As expected, in the blocked RAN Task DD individuals showed longer naming times and a greater effect of lexical conflict resolution (indexed by difference scores of naming times in the homogeneous and mixed conditions) than TR participants. We also found significant group differences (TR = PR > DD) in CC measures. Naming time was associated with CC, while the lexical interference effect did not show any association with this set of abilities. These findings suggest that DD individuals show impairments in multiple cognitive functions, such as cognitive control, lexical retrieval and lexical conflict resolution. Our results also suggest that CC functions are involved in lexical retrieval, but we have not found evidence for their involvement in lexical conflict resolution processes.

Patient Attitudes Toward Transplantation as Preferred Treatment Modality in Different Stages of Renal Disease.

OBJECTIVE: Kidney transplantation is generally considered to be the best treatment for end-stage renal disease. Not every patient can be operated, but many of suitable patients refuse this possibility. We aimed to explore the attitudes of patients with chronic kidney disease towards renal replacement therapies to recognize motives, thoughts, and feelings concerning accepting or refusing the treatment. We studied the attitudes towards the illness and the treatment, the appearance of depression, and the disease burden during different stages of the disease. METHODS: For this study we implemented a questionnaire that we developed (which has been described in an earlier publication of this journal) with 99 pre-dialysis patients, 99 dialysis patients, and 87 transplantation patients. We completed the attitude questionnaire designed by our team to include disease burden and depression questionnaires. RESULTS: We used discriminant analysis to describe different stages of the disease. There was a significant difference in the following factors between the three patient groups: accepting the new kidney, lack of confidence in transplantation therapy, fear of surgery, accepting self-responsibility in recovery, dependency on the transplanted kidney, confidence in recovery, subjective burden of dialysis, and denial of personal responsibility in maintaining the transplanted kidney. Significant differences were also detected in these three groups regarding the level of depression and disease burden: we measured the highest value among the dialysis patients, and the lowest value among the pre-dialysis patients. Comparing patients accepting and refusing transplantation, we found a correlation between the refusal of transplantation and the attitudes towards the illness and treatment. CONCLUSIONS: Most patients remain unmotivated to change treatment modality and refuse transplantation. Misbelief about transplantation shows a correlation with the motive of refusal. Dissemination of information may facilitate a change in the situation.

Psychosocial characteristics and self-reported functional status in patients on maintenance dialysis in Hungary.

AIMS: This survey was conducted to assess psychosocial problems and functional status among patients on maintenance dialysis in Hungary. METHODS: All adult patients (n = 4,321) receiving maintenance dialysis in the 56 dialysis centers in Hungary in 2006 were approached to participate in a national, cross-sectional survey. Patients completed a brief self-reported questionnaire. Socio-demographic parameters, disease-related information and data about functional status were collected. Self-rated health and depressive symptoms were also assessed. RESULTS: Mean age was 62 ± 14 y; 52% were males. The prevalence of diabetes was 30%. 46% of participants reported having depressive symptoms. Significant functional limitation was frequent. In multivariable regression models, female gender, poor self-reported finances, less education, history of acute myocardial infarction (AMI) or cerebrovascular disease, the presence of visual or hearing impairment and difficulties with basic activities of daily living were independently associated with the presence of depressive symptoms. In a separate model, age, dialysis vintage, history of AMI or cerebrovascular disease, the presence of visual or hearing impairments, difficulties with basic activities of daily living and also having depressive symptoms were independently associated with self-rated health score. CONCLUSIONS: Chronic dialysis patients in Hungary have disadvantaged socioeconomic status, frequent depressive symptoms and many functional limitations. Professional psychosocial help would be particularly important for this underprivileged patient population in addition to high quality dialysis to optimize outcomes.

[Analgesics-induced chronic renal failure in patients on dialysis therapy in Hungary]. / Analgetikum-nephropathia elófordulása krónikus veseelégtelenség miatt dializált betegekben Magyarországon.

In recent years elaboration of the diagnosis of analgesic-nephropathy (ANP) with the help of imaging techniques significantly increased the possibility of diagnosing the disease. Therefore, evaluating the prevalence of ANP has become more accurate in our country as well. The prevalence of ANP has been investigated in patients who have newly been taken into the dialysis program due to renal disease of unknown aetiology in 22 dialysis centers between December 1994-December 1997. The diagnosis of ANP has been based on revealing chronic drug abuse in the history and positive results of renal imaging (decrease in length of both kidneys combined with either bumpy contours and/or papillary calcification). Among 284 patients dialysed with unknown diagnosis 42 (14.8% of all cases) proved to have ANP. All patients except 2 took analgesic mixtures containing phenacetin/paracetamol, phenason derivatives, acetilsalysilic acid, caffeine and/or codeine. According to their investigations, ANP is a common disease resulting in end-stage renal failure in Hungary as well.

Can sterile and pyrogen-free on-line substitution fluid be routinely delivered? A multicentric study on the microbiological safety of on-line haemodiafiltration.

BACKGROUND: Microbial contamination is characterized not only by the presence of bacteria, but also by high concentrations of biologically active by-products. They are potentially able to cross ultrafiltration and dialysis membranes and stimulate immunocompetent blood cells to synthesize cytokines. In turn, cytokine induction causes acute symptoms and has been incriminated in the long-term complications of haemodialysis patients. Infusion of large volumes of substitution fluids following ultrafiltration of microbially contaminated dialysis fluids may place patients on on-line therapies at particular risk. METHODS: In this study we evaluated 30 machines with a two-stage ultrafiltration system in routine clinical haemodiafiltration settings in six centres for 6 months. Microbiological safety was assessed monthly and at the last use of the filters by determining microbial counts, endotoxin concentration and cytokine-inducing activity. RESULTS: No pyrogenic episodes were observed during the study period. Double-filtration of standard dialysis fluid (range, <1-895 cfu/ml, 0.0028-4.6822 IU/ml) resulted in sterile substitution fluids with endotoxin concentrations well below the Ph.Eur. standard for haemofiltration solutions (range, 0.0014-0.0281 vs 0.25 IU/ml). Moreover, they did not differ from commercial haemofiltration solutions and depyrogenated saline. Likewise, there was no difference in the cytokine-inducing activity between the solutions tested. The high microbiological quality of the ultrafiltered dialysis fluid, which was in the same range as substitution fluid, translates into both the absence of cytokine induction by dialyser back-transport and a redundant safety mode of the on-line system by a second filtration step. CONCLUSION: On-line HDF treatment can routinely be provided with ultra-pure dialysis fluids and sterile substitution fluids at pyrogen-free levels. The online preparation of substitution fluids thus can be considered microbiologically safe.

Oxygen penetration in and release from lung surfactant.

The kinetics of oxygen penetration from the air into an oxygen free human BAL/saline and of its release from the oxygenated BAL/saline into a nitrogen environment was studied. Time-dependent oxygen concentration at constant temperature was monitored by recording the direct polarographic current of the second reduction wave of oxygen at a dropping mercury electrode. The obtained kinetic curves showed that not only uptake and release were quicker in BAL than in saline but also the corresponding equilibrium values were higher. Release and uptake curves in BAL were markedly different. The release was faster than the uptake but its maximal value was about 30% under the maximal uptake level. We suggest that the differences in oxygen uptake and release kinetics might contribute to explain the previously found accumulation of oxygen in BAL. The positive difference between the release and uptake kinetics at the beginning of the curves is consistent with a steady oxygen penetration through the BAL. The difference in the maximal oxygen uptake level and the maximal release level indicates a partial retention of the oxygen in the system.

Oxygen transport through a model lung surfactant surface layer: influence of the film compression on the kinetics.

The influence of the compression state of a model Lung Surfactant Surface Layer LSSL on the oxygen permeation kinetics was studied in vitro at 37 degrees C. In an attempt to mimic in vivo conditions, the oxygen from the air was allowed to cross a dipalmitoylphosphatidylcholine DPPC layer situated at an air/deaerated saline interface in an electrochemical vessel. The time dependent concentration change of the oxygen diffusing through this layer into the deaerated saline hypophase was measured electrochemically using a Hanging Mercury Drop Electrode HMDE, situated at a definite depth in the bulk of the saline. The surface pressure in the monolayer was monitored using a Wilhelmy balance. The oxygen permeability was measured through two differently compressed DPPC layers in which the area/phospholipid molecule differed by 30%. This is consistent with the difference in the alveolar area at the end-points of the compressed and expanded lung. The results, submitted to a linear regression analysis, showed that the DPPC film compression influences the oxygen permeation kinetics. The denser the lipid film, the slower the oxygen uptake by the deaerated hypophase. The results suggest that the LSSL might play an important role in the oxygen transport kinetics, the oxygen permeation through it being dependent on the actual lung area.

Oxygen transport through lung surfactant and the surfactant specific proteins.

At the very beginning of its migration pathway to any tissue, oxygen has to cross the lung surfactant surface layer (LSSL) and the underlying aqueous hypophase. The influence of human broncho-alveolar lavage and its lipid and specific protein components on oxygen transport were studied in vitro using sensitive electrochemical techniques. LSSL adsorbing from BAL at the dropping mercury electrode/saline interface shifted the peak potentials of oxygen reduction Ep towards more negative values. The magnitude of delta Ep was dependent on the quality of BAL. The kinetics of the oxygen transport were evaluated by measuring changes in the intensities of the reduction current. Storage of oxygen in BAL was several times higher than in saline and indicated the presence of one or more binding sites or promoters for oxygen among BAL components. The surfactant specific protein was found to be one of the binding sites (or promoters) for the oxygen. Since electron microscopic immuno-gold labelling demonstrated the presence of this protein in the LSSL, and electrochemically it proved to transport lipids from the surface layer to the subphase, it was suggested that Sp-A plays the role of an oxygen carrier.

Electrochemical study of oxygen behaviour with lung surfactant.

At the very beginning of its way to any tissue oxygen has to cross the lung surfactant surface layer LSSL. The influence of LSSL on oxygen was studied in vitro at model interfaces using sensitive d.c. electrochemical techniques. LSSL adsorbed from lung washings at the dropping mercury electrode/saline interface shifted the half-wave potential of oxygen reduction E1/2 towards more negative values. The magnitude of delta E1/2 was dependent on the lung washing concentration and showed a saturation tendency. The intensity of the reduction current was higher in saline samples with surfactant than without and had a rather rising tendency. Lipids extracted from lung washings or amniotic fluid being spread as a condensed multilayer at the saline/air interface and re-adsorbed on a hanging mercury electrode surface produced a several time bigger shift of oxygen reduction E1/2 towards negative potential values than the lung washings did. The surfactant specific 34 kD protein and lung washing proteins injected beneath the lipid layer produced a positive potential shift. Dust-treatment-caused changes in surfactant quality/quantity resulted in bigger delta E1/2 values. The data suggest that the LSSL represents a certain energetic barrier or even an one-way gate to the crossing oxygen the efficiency of which depends on the composition/structure of the LSSL and that the aqueous hypophase under the LSSL in the alveoli is a place of storage for the oxygen.

[Treatment of circumscribed scleroderma in childhood]. / Behandlung der umschriebenen Sklerodermie (U.S.) im Kindesalter.

17 children suffering from morphea were treated with penicillin and antimalaria drugs. The best effects were observed after the combination of penicillin and antimalaria drugs.

[Demonstration of soluble immune complexes in the serum of patients with skin diseases (author's transl)]. / Nachweise von löslichen Immunkomplexen im Serum bei Hautkrankheiten.

Two different methods: the physicochemical PEG-test and the biological TA-test were administered for measuring the circulating IC-es. The investigations were performed in patients with DLE, sclerodermia, drug-eruptions and vasculitis as well as in control persons. The results obtained by both methods were discussed.

[Pemphigus vulgaris, pregnancy, and childbirth (author's transl)]. / Pemphigus vulgaris und Schwangerschaft-Geburt.

Reported in this paper are the course of pregnancy and the delivery of a patient, 28 years of age, who suffered of pemphigus vulgaris. Reference is made to therapy, specific treatment during pregnancy, and supervision of delivery proper. Both the mother and her child were in good health eight months after birth.