Pulmonary Sequestration Causing Congestive Heart Failure in Infancy: A Report of Two Cases and Review of the Literature

Congestive heart failure as a presenting symptom in infants with pulmonary sequestration is rare, and the cases of only 3 such patients have been reported. The clinical features, hemodynamics, and management of two additional patients are described. Both were seen in severe congestive heart failure in the absence of any associated cardiac anomalies. The physical findings, plain roentgenograms, electrocardiograms, and echocardiograms may provide some diagnostic clues, but cardiac catheterization is the essential diagnostic investigation. In 1 patient, pneumonectomy was performed because of extensive changes throughout the affected lung. In the other, ligation of the anomalous systemic artery to the sequestered lobe was the only surgical procedure. Both patients are doing well 15 months and 18 months after operation. Success with the latter surgical approach has not been reported previously.     

Risk factors for coronary heart disease among Jerusalem schoolchildren: Preliminary findings

The presence of risk factors for cardiovascular diseases was investigated in 7- and 11-year-old schoolchildren (808 subjects). Data analysis was performed according to sex, age, and country of origin of the father. The following variables were investigated: weight, height, total plasma cholesterol (TCH), high density lipoprotein cholesterol (HDL), plasma triglycerides, and systolic and diastolic blood pressure. Significant differences were found between sex, age, and origin groups for most variables. The prevalence of hypercholesterolemia (>180 mg/dl) varied between 9.6 and 14.1%, in the different sex and age groups, and that of low HDL cholesterol (<40 mg/dl), 6.8–12.1%. Elevated systolic blood pressure (>130 mm Hg) was found in 4.4–6.7% of the 7-year-old children, and in 13.4–18.6% of the 11-year-olds. Elevated diastolic blood pressure (>85 mm Hg) was found predominantly in the 11-year-old children, 6.2–9.1%. These findings demonstrate the necessity to initiate health programs related to prevention of cardiovascular diseases in childhood.     

Rosenthal fibers formation in the central nervous system its relation to Alexander's disease

Summary Subpial and subependymal gliosis with abundant Rosenthal fiber (RF) formation are described in two patients. In one, the process appeared as a narrow band over the entire neuraxis and was not accompanied by neurologic manifestations. In the other, the changes were mostly restricted to the lower medulla and upper cervical cord and displayed invasive features. The glial proliferation with RF in the second patient was associated with an inflammatory component, dense collagen deposition, perivascular Schwannosis and demyelination. Involvement of some of the medullary nuclei and their tracts may explain the patient's vague bulbar symptomatology. The underlying cause which led to astrocytic proliferation with excessive RF in these two patients remains elusive. Possible factors contributing to this phenomenon are discussed in the context of Alexander's disease.This work is supported in part by grant NS-07098     

Singularities in the inverse modeling of 2AFC contrast discrimination data

Analytical calculations show that two-alternative force-choice data are not always suitable for specifying the parameters of the underlying discrimination model. Experimentally, we show here that in the case of contrast discrimination in humans, a variety of models spanning a large range of parameters can explain the data within an experimental error. Monte-Carlo simulations indicate that the number of trials in psychophysical experiments is not the limiting factor in estimating the parameters in contrast discrimination. These results can therefore explain the contradictory conclusions made by different groups about the relationship between the response to contrast and the noise amplitude.     

Temporal asymmetry of collinear lateral interactions

The visibility of a target improves when the target is presented simultaneously or with a delay between two collinear flankers. Here we tested the temporal properties of lateral facilitation by manipulating the timing of both onsets and offsets of the target and flankers. The results show that lateral facilitation critically depends on the order of presentation of the target and flankers. A typical pattern of lateral interactions was observed when the flankers preceded the target, or were presented simultaneously with it, but not when the target preceded the flankers. This result is incompatible with a feedforward account of lateral interactions, according to which the two temporal effects are linearly summed within a higher level receptive field. We propose that both facilitation and masking are the result of excitatory and inhibitory interactions within neuronal networks. The temporal asymmetry can be accounted for by assuming different time courses for the excitatory and the inhibitory interactions. Although the excitation is slow to develop, lagging behind the stimulus both in onset and offset, inhibition is rapid and follows the onset and offset of the stimulus more closely. Such a network exhibits fast transitions between slow processes.     

A link between perceptual learning, adaptation and sleep

Between-sessions gains in the texture discrimination task have been attributed to memory consolidation. A strong dependence of consolidation on sleep was suggested though not always supported by experimental results. Here we suggest that the interaction between consolidation and sleep depends on the adaptation level obtained during the training session. We find that both discrimination thresholds and learning depend on the number of trials used during training, with more trials producing higher discrimination thresholds due to suppressive processes related to adaptation. In addition, while learning benefits from increasing number of trials, a further increase in number of trials reduces learning. Consolidation may benefit from between-session sleep in the adapted states.     

Pterygium surgery: fibrin glue versus Vicryl sutures for conjunctival closure

PURPOSE: To compare the short-term results of conjunctival closure in pterygium surgery using fibrin adhesive versus Vicryl sutures with respect to operative time, postoperative ocular signs and symptoms, and overall patient satisfaction. METHODS: A comparative prospective randomized clinical trial was performed in 65 patients (65 eyes) with primary nasal pterygium. Surgery in all patients consisted of the bare sclera technique combined with intraoperative mitomycin C. Patients were randomized to undergo conjunctival closure with a fibrin tissue adhesive (Quixil; n = 39) or 8-0 Vicryl absorbable interrupted sutures (n = 26). Clinical assessment was performed on days 1, 3, 10, and 21 after surgery. Patients completed a questionnaire at each follow-up visit, grading pain, discomfort, and satisfaction with the procedure. The groups were compared for operative time, ocular signs and symptoms, and overall satisfaction. RESULTS: Average operative time was 16 minutes (range, 14-16 minutes) in the fibrin glue group and 20 minutes (range, 20-29 minutes) in the Vicryl suture group (P < 0.05). Significantly less pain, photophobia, foreign body sensation, irritation, epiphora, itching, local hyperemia, conjunctival chemosis, and dry eye were noted in the subjects treated with glue than in controls (P < 0.05). There were no complications during the 3-week follow-up period in the glue-treated patients. One of the patients in the suture group had a medically treatable corneal delle. CONCLUSION: The use of fibrin glue in pterygium surgery significantly reduces operative time and patient symptoms, pain, and discomfort. A longer follow-up is needed to evaluate the influence of fibrin glue on rate of recurrence and long-term complications.     

Does trade affect child health?

Frankel and Romer [Frankel, J., Romer, D., 1999. Does trade cause growth? American Economic Review 89 (3), 379-399] documented positive effects of geographically determined trade openness on economic growth. At the same time, critics fear that openness can lead to a "race to the bottom" that increases pollution and reduces government resources for investments in health and education. We use Frankel and Romer's gravity model of trade to examine how openness to trade affects children. Overall, we find little harm from trade, and potential benefits largely through slightly faster GDP growth.     

Myeloma protein synthesis within the CNS by plasma cell tumors

Two patients had centrl nervous system involvement from plasma cell tumor, onr with leptomeningeal infiltraion and the other with solitary intracranial plasmacytoma. In both, cerebrospinal fluid (CSF) electrophoresis revealed IgG index consistent with local synthesi of the myeloma protein. the CSF findings were helpful in the diagnosis and evaluation of tumor recurrence.