Cardiac magnetic resonance and the need for routine cardiac catheterization in single ventricle patients prior to Fontan: a comparison of 3 groups: pre-Fontan CMR versus cath evaluation.

Objectives: This study investigated whether cardiac magnetic resonance (CMR) and echocardiography (echo) can replace catheterization (cath) for routine evaluation prior to Fontan and under what circumstances CMR and cath are used together.

Background: Routine cath prior to Fontan has been utilized for years; noninvasive methods, however, may be sufficient.

Methods: This study reviews clinical data in 119 consecutive patients investigating 3 groups: those who underwent CMR alone (MR; n = 41), cath alone (C; n = 41), or both cath and CMR (C+M; n = 37) prior to Fontan.

A reverse time-course method for transcriptional chase analyses of mRNA half-lives in cultured cells.

Standard methods for assessing mRNA stabilities in intact cells are labor-intensive and can generate half-life (t(1/2)) measures that are both imprecise and inaccurate. We describe modifications to a conventional tetracycline-conditional transcriptional chase method for analyzing mRNA stability that significantly simplify its conduct, while generating highly reproducible and accurate t(1/2) values. The revised method-which is conducted as a reverse time course, and which accounts for interval expansion in the number of cultured cells-is validated for the analyses of mRNAs with both short and long half-lives.

Amyloid deposition and advanced age fails to induce Alzheimer's type progression in a double knock-in mouse model.

It has been challenging to develop transgenic and gene-targeted mouse models that recapitulate all of the neuropathological features of Alzheimer's disease (AD). For example, in the APP/PS-1 double knock-in mutant mouse (DKI), frank neurodegeneration is not observed at middle age and synapse loss is pronounced only within amyloid plaques. Here, we investigated whether continued amyloid deposition and advanced age of 24-27 months lead to loss of neurons and synapses, tau hyperphosphorylation, and other pathological features of AD.

Astrocytic regulation of glutamate homeostasis in epilepsy.

Astrocytes play a critical role in regulation of extracellular neurotransmitter levels in the central nervous system. This function is particularly prominent for the excitatory amino acid glutamate, with estimates that 80-90% of extracellular glutamate uptake in brain is through astrocytic glutamate transporters. This uptake has significance both in regulation of the potential toxic accumulation of extracellular glutamate and in normal resupply of inhibitory and excitatory synapses with neurotransmitter.

De novo DNA methylation is required to restrict T helper lineage plasticity.

Naïve CD4+ T cells are highly plastic and can differentiate into discrete lineages with unique functions during an immune response. Once differentiated, helper T cells maintain a stable transcriptional memory of their initial lineage choice and resist redifferentiation. During embryogenesis, de novo DNA methylation operates on the hypomethylated genome of the blastocyst to achieve tissue-specific patterns of gene expression.

Open cranial vault remodeling: the evolving role of distraction osteogenesis.

In this article, we review some of the traditional techniques used to treat craniosynostosis. In addition to sharing our current approach to treating craniosynostosis with open techniques, we discuss our opinions on the evolving roles of newer modalities such as spring-assisted cranioplasty and cranial vault expansion using distraction osteogenesis.

Development of the Healthy Pathways Parent-Report Scales.

Purpose: To describe the development of the Healthy Pathways Parent-Report Scales, measures of health, illness, well-being, and achievement among youth in middle childhood and adolescence.

Methods: The Healthy Pathways Scales were derived from the Child Health and Illness Profile (CHIP) instruments. The CHIP domains of Comfort, Risk Avoidance, Satisfaction, and Resilience were modified to reflect advances in child health conceptualization.

Antidepressant combinations: widely used, but far from empirically validated.

This paper reviews the evidence on combining antidepressants (ADs) for treatment of major depressive disorder. Although widely used and usually safe, the efficacy of even the most widely prescribed combinations of ADs has not been established by properly controlled, adequately powered, clinical trials. This stands in contrast to several adjunctive strategies for AD nonresponders, including adjunctive lithium, thyroid hormone, or newer-generation antipsychotics.

Commentary: concentrating the mind.

Among numerous threats to the academic mission, diminishing funding for biomedical research attracts particular attention because it is so tangible and is likely to slow scientific progress in the near term. More dangerous still may be long-term adverse effects of reduced resources on the pipeline of physician-scientists. For pediatric departments, the impact may be accentuated by an already disproportionately low share of research funding and by well-recognized challenges in meeting parallel clinical demand for subspecialty services.

lines and bowl affect the specification of cyst stem cells and niche cells in the Drosophila testis.

To function properly, tissue-specific stem cells must reside in a niche. The Drosophila testis niche is one of few niches studied in vivo. Here, a single niche, comprising ten hub cells, maintains both germline stem cells (GSC) and somatic stem cells (CySC).

Weight lifting for women at risk for breast cancer-related lymphedema: a randomized trial.

Context: Clinical guidelines for breast cancer survivors without lymphedema advise against upper body exercise, preventing them from obtaining established health benefits of weight lifting.

Objective: To evaluate lymphedema onset after a 1-year weight lifting intervention vs no exercise (control) among survivors at risk for breast cancer-related lymphedema (BCRL).

Design, Setting, And Participants: A randomized controlled equivalence trial (Physical Activity and Lymphedema trial) in the Philadelphia metropolitan area of 154 breast cancer survivors 1 to 5 years postunilateral breast cancer, with at least 2 lymph nodes removed and without clinical signs of BCRL at study entry.

A potential regulatory role for mRNA secondary structures within the prothrombin 3'UTR.

The distal 3'UTR of prothrombin mRNA exhibits significant sequence heterogeneity reflecting an inexact 3'-cleavage/polyadenylation reaction. This same region encompasses a single-nucleotide polymorphism that enhances the normal post-transcriptional processing of nascent prothrombin transcripts. Both observations indicate the importance of 3'UTR structures to physiologically relevant properties of prothrombin mRNA.

Structural properties of HIV integrase. Lens epithelium-derived growth factor oligomers.

Integrase (IN) is the catalytic component of the preintegration complex, a large nucleoprotein assembly critical for the integration of the retroviral genome into a host chromosome. Although partial crystal structures of human immunodeficiency virus IN alone and its complex with the integrase binding domain of the host factor PSIP1/lens epithelium-derived growth factor (LEDGF)/p75 are available, many questions remain regarding the properties and structures of LEDGF-bound IN oligomers. Using analytical ultracentrifugation, multiangle light scattering, and small angle x-ray scattering, we have established the oligomeric state, stoichiometry, and molecular shapes of IN.

Impact of the Medicare Modernization Act of 2003 on utilization and spending for medicare part B-covered biologics in rheumatoid arthritis.

Objective: To examine changes in utilization and expenditures for infliximab in rheumatoid arthritis (RA) patients associated with the 2 changes implemented by the Medicare Prescription Drug Improvement and Modernization Act (MMA) of 2003, specifically 1) reductions in physician reimbursement for Part B drugs between 2003 and 2005 and 2) availability of alternative RA biologics in 2006.

Methods: Using 2002-2006 5% Medicare files, nationally representative estimates of infliximab use and expenditures were estimated in annual cross-sectional samples of RA beneficiaries. Infliximab initiation and continuation rates were estimated in 2-year longitudinal cohorts (2005-2006 versus 2002-2003, 2003-2004, and 2004-2005).

A new diagnosis grouping system for child emergency department visits.

Objectives: A clinically sensible system of grouping diseases is needed for describing pediatric emergency diagnoses for research and reporting. This project aimed to create an International Classification of Diseases (ICD)-based diagnosis grouping system (DGS) for child emergency department (ED) visits that is 1) clinically sensible with regard to how diagnoses are grouped and 2) comprehensive in accounting for nearly all diagnoses (>95%). The second objective was to assess the construct validity of the DGS by examining variation in the frequency of targeted groups of diagnoses within the concepts of season, age, sex, and hospital type.

Regulated payments for living kidney donation: an empirical assessment of the ethical concerns.

Background: Although regulated payments to encourage living kidney donation could reduce morbidity and mortality among patients waiting for a kidney transplant, doing so raises several ethical concerns.

Objective: To determine the extent to which the 3 main concerns with paying kidney donors might manifest if a regulated market were created.

Design: Cross-sectional study of participants' willingness to donate a kidney in 12 scenarios.

Comparison of the plating efficiencies and shelf lives of three different commercial buffered charcoal yeast extract media supplemented with alpha-ketoglutaric acid.

The plating efficiencies and shelf lives of locally made buffered charcoal yeast extract medium supplemented with alpha-ketoglutaric acid (BCYEalpha) were compared to those of media made by BD, Hardy, and Remel. Lung homogenates from guinea pigs infected with Legionella pneumophila were plated monthly onto different medium lots. All media performed equally well and had shelf lives of at least 12 months.

Clinical relevance of disturbances of sleep and vigilance in major depressive disorder: a review.

Objective: The primary objective of this article is to provide a concise review of the clinical relevance of sleep and vigilance in major depressive disorder.

Data Sources: PubMed was reviewed (1990-2009) and English-language articles were identified using the key words sleep and depression and sleep and antidepressants. Secondary searches included articles cited in sources identified by the primary search.

Clinical measures of dysarthria in Friedreich Ataxia.

Dysarthria in Friedreich Ataxia (FA) is difficult to quantify. This study evaluated a series of performance measures for speech in 22 patients with genetically confirmed FA and 16 age-matched controls. Tests included the PATA examination, the PATAKA examination, the Oral Motor component of the Boston Aphasia examination, the Boston Cookie Theft description task, and the Assessment of Intelligibility of Dysarthric Speech.

Informative inducement: study payment as a signal of risk.

In research involving human subjects, large participation payments often are deemed undesirable because they may provide 'undue inducement' for potential participants to expose themselves to risk. However, although large incentives may encourage participation, they also may signal the riskiness of a study's procedures. In three experiments, we measured people's interest in participating in potentially risky research studies, and their perception of the risk associated with those studies, as functions of participation payment amounts.

Inhaled nitric oxide in premature infants: effect on tracheal aspirate and plasma nitric oxide metabolites.

Objective: Inhaled nitric oxide (iNO) is a potential new therapy for prevention of bronchopulmonary dysplasia and brain injury in premature infants. This study examined dose-related effects of iNO on NO metabolites as evidence of NO delivery.

Study Design: A subset of 102 premature infants in the NO CLD trial, receiving 24 days of iNO (20 p.