The use of external, noninvasive pacing for the termination of supraventricular tachycardia in the emergency department setting

STUDY OBJECTIVE: To determine the potential feasibility of external cardiac pacing for the termination of sustained supraventricular tachycardia in the emergency department setting. TYPE OF PARTICIPANTS: Three men and two women (mean age, 34 years) who presented to the ED with a narrow-complex, hemodynamically stable tachycardia that was later proven to be supraventricular in origin. INTERVENTION: Each patient underwent external overdrive pacing using a modified external pacemaker at a pulse amplitude of 120 mA and a rate between 240 and 280 pulses per minute. RESULTS: In four patients, external cardiac pacing was able to successfully terminate the tachycardia without complication. In one patient, the pacemaker was not able to terminate the tachycardia. CONCLUSION: We conclude that external, noninvasive pacing is a feasible means of terminating supraventricular tachycardia in the ED setting.     

Service life planning and performance requirements

Service life planning comprises a model for the determination of a reasonable expected service life for buildings and components, and it establishes a routine for the assessment of design alternatives. A design option is considered reasonable when it meets or exceeds performance requirements over time that have been drawn up specifically for the specific project. Due to this assessment reference, there is a very evident link to the concept of performance-based building. Any stakeholder involved in the value chain or in the design process of the building, as well as regulators and building users, can express performance requirements. Identified requirements, both in relevance and in quality, will vary with the stakeholder and his/her perspective of interest. As building sector manufacturers develop most products with reference to standards rather than with reference to specific requirements, there is no direct link from user requirements to the product design. Instead, the building designer has the responsibility to ensure performance requirements are met by the performance of products integrated into the design. As these design decisions also have to be made at the material and component level, a performance-based building would benefit from an established rationale that enables the communication of performance requirements across the relevant system levels in the relevant design processes. A path for the connection of the established concepts of service life planning and performance-based building is presented. The aim is to identify key elements that need to be developed for the successful linkage of performance-based building with service life planning.     

Cerebral lateralization of function: From infancy through childhood.

This article addresses two fundamental questions concerning cerebral lateralization of functions in normal, right-handed, non-brain-damaged children, namely: Does cerebral specialization develop from an initial bilateral representation to a progressively more focalized specialization, or does it follow an invariant model? And, do sex differences exist? The results from five experimental paradigms were reviewed, including (a) dichotic listening, (b) tachistoscopic viewing, (c) electroencephalography, (d) haptic identification, and (e) somatosensory discrimination. The results from these five paradigms indicated that linguistic functions are localized in the left hemisphere from birth for children of both sexes. The results for functions lateralized in the right hemisphere were less straightforward. Some tasks showed no developmental changes or sex differences, whereas other tasks showed both developmental changes and sex differences. However, factors other than functional brain asymmetries were found to affect the results, challenging the validity of each paradigm. Directions for future research are suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lack of PPCA expression only partially coincides with lysosomal storage in galactosialidosis mice: indirect evidence for spatial requirement of the catalytic rather than the protective function of PPCA

Protective protein/cathepsin A (PPCA) is a pleiotropic lysosomal enzyme that complexes with beta-galactosidase and neuraminidase, and possesses serine carboxypeptidase activity. Its deficiency in man results in the neurodegenerative lysosomal storage disorder galactosialidosis (GS). The mouse model of this disease resembles the human early onset phenotype and results in severe nephropathy and ataxia. To understand better the pathophysiology of the disease, we compared the occurrence of lysosomal PPCA mRNA and protein in normal adult mouse tissues with the incidence of lysosomal storage in PPCA(-/-) mice. PPCA expression was markedly variable among different tissues. Most sites that produced both mRNA and protein at high levels in normal mice showed extensive and overt storage in the knockout mice. However, this correlation was not consistent as some cells that normally expressed high levels of PPCA were unaffected in their storage capability in the PPCA(-/-) mice. In addition, some normally low expressing cells accumulated large amounts of undegraded products in the GS mouse. This apparent discrepancy may reflect a requirement for the catalytic rather than the protective function of PPCA and/or the presence of cell-specific substrates in certain cell types. A detailed map showing the cellular distribution of PPCA in nomal mouse tissues as well as the sites of lysosomal storage in deficient mice is critical for accurate assessment of the effects of therapeutic interventions.