The neurophysiological performance of visuospatial working memory in children with developmental coordination disorder

Aim The objective of this study was to investigate the mechanisms underlying the deficit in visuospatial working memory (VSWM) seen in children with developmental coordination disorder (DCD) and to compare brain activity while performing a VSWM task in children with DCD and typically developing children. Method Behavioural performance and event‐related potentials (ERPs) were recorded in 24 children (12 males, 12 females; mean age 139mo, SD 4mo) with DCD (as determined by a score <5th centile on the Movement Assessment Battery for Children – Second Edition) and in 30 age‐ and sex‐matched typically developing children (15 males; 15 females; mean age 140mo, SD 5mo) recruited from local schools, while performing one spatial non‐delay and two time‐delayed spatial memory tasks. Results Compared with typically developing children, children with DCD exhibited longer reaction times (p = 0.022; partial η²=0.10) and lower accuracy rates (p < 0.001; partial η² = 0.35) on the two spatial memory tasks. Electrophysiological indices also showed distinct modulatory effects, with children with DCD exhibiting smaller P3 (p < 0.001; partial η² = 0.26) and positive slow wave (pSW; p = 0.003; partial η² = 0.16) amplitude and a smaller area under the curve of P3 and pSW components (p = 0.002; partial η² = 0.17). Interpretation The combined analysis of behavioural performance and ERP data suggests that children with DCD have deficits of visuospatial working memory owing to fewer resources being allocated to comparison of spatial locations, less effort allotted to the response selection, and less neural processing employed during the retrieval process phase.     

Expression of caspase‐3‐dependent apoptosis in mural thrombi leukocytes

Failure of arteriovenous access is mostly due to graft thrombosis and multifactorial, with medical and surgical etiologies. Apoptosis of blood cells, such as macrophages, lymphocytes and eosinophils, may play an important role in thrombus formation. We also investigated caspase‐3‐dependent apoptosis in thrombi. We recorded clinical parameters in 43 consecutive patients with vascular access failure (13 men, 30 women; mean age±SD, 64.6±14.2 years) who underwent surgical thrombectomy. Major presentations included absent (92%) and/or near near‐absent (16%) flow through the access during hemodialysis. Cardiovascular risk factors were hypertension (70%), hyperlipidemia (47%), diabetes mellitus (47%), chronic obstructive pulmonary disease (12%), heart failure (12%), coronary artery disease (21%), and stroke (16%). Laboratory data included hemoglobin level of 100±17 g/L, total white blood cell count of 7.65±2.14×10⁹/L, and platelet count of 205.6±57.9 1000/ìL. Abnormal biochemistry data included elevated blood urea nitrogen level of 63.5±24.4 mg/dL and creatinine level of 8.6±4.0 mg/dL (normal <1.4 mg/dL). Thrombi were characterized by apoptosis (32%) in a caspase‐dependent pathway in all types of leukocytes. Thrombi in arteriovenous access failure demonstrate apoptosis by means of the caspase‐3 pathway in white blood cells.     

Radiofrequency Catheter Ablation of Septal Accessory Pathways within the Triangle of Koch: Importance of Energy Titration Testing Other than the Local Electrogram Characteristics for Identifying the Successful Target Site

Radiofrequency (RF) catheter ablation of accessory atrioventricular (AV) connections in the proximity of His bundle or AV node is at high risk of developing complete heart block. A safe and effective protocol has not been well established. Nineteen consecutive patients with 19 septal accessory pathways within the triangle of Koch underwent a protocol with power-titrated RF energy testing to identify the target site for successful catheter ablation. At every potential target site preselected by local electrogram characteristics, RF energy was started at 5 W for 10 seconds, with an increment of 5 W (duration remained at 10 s) until maximally 30 W or the observation of transient interruption of accessory pathway conduction. By this stepwise RF energy testing, we successfully localized and ablated 18 (94.7%) of the 19 septal accessory pathways, 10 close to His bundle (zone I) and 8 away from it (zone II). The test-effective RF power was 20 W or less in 9 of all 11 septal accessory pathways in zone I, and 5 of the 8 in zone II (P = 0.68). Meanwhile, the final RF power for successful ablation was 30 W or less in 9 of the 10 zone I and 6 of the 8 zone II septal accessory pathways (P = 0.83). One patient with an accessory pathway in zone I was complicated with complete AV block after final ablation at 30 W. None of the local electrogram characteristics except continuous electrical activity during retrograde mapping was helpful in the prediction of ablation outcome. Careful RF energy titration testing could effectively help identify the target site for successful RF catheter ablation of septal accessory pathways within the triangle of Koch. The dependence on local electrogram manifestations could be frustrated by a low probability of success.     

Results of surgical treatment of 107 patients with complications of pulmonary tuberculosis

Abstract The objective of this study was to evaluate the results of surgical intervention performed on 107 patients with pulmonary tuberculosis complications. Between September 1988 and December 1995, 107 patients underwent a total of 126 operations for major complications of pulmonary tuberculosis. One hundred and twenty-six operations consisted of lobectomies only or plus other lung resections performed in 55 cases, pneumonectomies in 20 cases, segmentectomies in 18 cases, wedge resections in two cases, tracheobronchoplasties in four cases, decortications in two cases, cavernostomies with concomitant muscle transpositions in seven cases, thoracoplasties reserved for the previously failed operations or to be a supplement for pulmonary resections in 18 cases. The operative mortality rate was of 1.8%, and the major complication rate was of 16.8%. Twenty-eight (26.1%) patients with tuberculosis bacilli in sputum before operation have converted except one diabetic patient. In conclusion, surgery is indicated in pulmonary tuberculosis complications that are life-threatening or unresponsive to chemotherapy. Pulmonary resection is the procedure of choice for most cases that require surgery.     

Surgical results of 23 patients with tracheobronchial injuries

Abstract The objective of this study was to evaluate the surgical results of tracheobronchial injuries. Between July 1988 and March 1996, tracheobronchial surgery was performed on 23 injured patients. According to the aetiology, the injuries were categorized as blunt injury ( n = 13), cutting or penetrating injury ( n = 5), and corrosive injury ( n = 5). Blunt injuries included three complete laryngotracheal disruptions, one tracheal laceration, and eight bronchial ruptures. Cutting or penetration injuries included four laryngotracheal ruptures and one tracheal cutting wound. Corrosive injuries included one tracheal necrosis, one tracheal stenosis and three esophago- respiratory fistulae. Operative procedures that were performed on the tracheobronchus included tracheoplasty ( n = 12), bronchoplasty ( n = 7), sleeve resection of the trachea ( n = 2) and bronchus ( n = 2). Two hospital deaths were encountered, with a mortality rate of 8.7%. One patient with caustic injuiy died of bronchopleural fistula and empyema. The other patient died with multiple injuries from multiple organ failure which was unrelated to the bronchoplasty. One postoperative complication was restenosis of the trachea in a caustic injured patient, which was treated by a T-tube insertion. In conclusion, tracheobronchoplasty is an effective life-saving emergency procedure for the patients with tracheobronchial injuries.     

REDUCTION OF β-ENDORPHIN CONTENT IN THE RAT PITUITARY AFTER DEHYDRATION AND ADRENALECTOMY

Both dehydration and adrenalectomy of rats caused a significant reduction of immunoreactive β-endorphin in the pituitary gland. β-Endorphin in hypothalamus, however, was not altered in either dehydrated or adrenalectomized rats.