[Perioperative adverse respiratory events in overweight and obese children]. / Atemwegskomplikationen bei übergewichtigen und adipösen Kindern.

BACKGROUND: Overweight and obesity are increasing problems in pediatric anesthesia. This observational study was designed to examine how airway-related complications occur in overweight children and adolescents during general anesthesia and if this is a relevant problem in Germany. METHODS: From October 2008 until August 2009, at the university clinic in Leipzig, 504 in- and outpatients, aged 2-18 years, ASA I-III, undergoing elective procedures (ENT and pediatric surgery), were observed. With the aid of special data sheets, the following parameters were determined: Mallampati Score, difficult mask ventilation and intubation, use of a Guedel/Wendl tube, Cormack-Lehane Score, number of intubation attempts, airway obstructions (broncho- and laryngospasms), coughing as a sign of airway irritation, and decreases in oxygen saturation >10 %. RESULTS: Overweight and obese children had a significantly higher Mallampati Score and a significantly higher prevalence of coughing (p < 0.05). None of the other parameters showed any significant differences between the groups. However, the incidence of desaturation was 9.5 % in overweight children and 6.3 % in children of normal weight, and that of airway obstructions was 4.1 vs 2.7 %. CONCLUSION: This study demonstrated a very low incidence of respiratory problems, which may be caused by the low proportion of morbidly obese children and the older age of overweight children in comparison with other studies.

Loss of function of the ALS protein SigR1 leads to ER pathology associated with defective autophagy and lipid raft disturbances.

Intracellular accumulations of altered, misfolded proteins in neuronal and other cells are pathological hallmarks shared by many neurodegenerative diseases including amyotrophic lateral sclerosis (ALS). Mutations in several genes give rise to familial forms of ALS. Mutations in Sigma receptor 1 have been found to cause a juvenile form of ALS and frontotemporal lobar degeneration (FTLD). We recently described altered localization, abnormal modification and loss of function of SigR1 in sporadic ALS. In order to further elucidate the molecular mechanisms underlying SigR1-mediated alterations in sporadic and familial ALS, we extended our previous studies using neuronal SigR1 knockdown cell lines. We found that loss of SigR1 leads to abnormal ER morphology, mitochondrial abnormalities and impaired autophagic degradation. Consistent with these results, we found that endosomal trafficking of EGFR is impaired upon SigR1 knockdown. Furthermore, in SigR1-deficient cells the transport of vesicular stomatitis virus glycoprotein is inhibited, leading to the accumulation of this cargo protein in the Golgi apparatus. Moreover, depletion of SigR1 destabilized lipid rafts and associated calcium mobilization, confirming the crucial role of SigR1 in lipid raft and intracellular calcium homeostasis. Taken together, our results support the notion that loss of SigR1 function contributes to ALS pathology by causing abnormal ER morphology, lipid raft destabilization and defective endolysosomal pathways.

[Various aspects of cognitive activities of schizophrenics. III. Maladjustment assimilation/accommodation and generalization of reasoning]. / Quelques aspects des activités cognitives du schizophrène. III, déséquilibre assimilation/accommodation et généralisation du raisonnement.

Paranoid schizophrenics are unable to balance affirmation and negation. Using the terms of Jean Piaget, they therefore only partially achieve the "équilibrations majorantes" of level II and never those of level III. In their thinking, they have access to the "généralisations inductives" (often excessive ones), but rarely to the "généralisations constructives complétives". They do not have access to the "généralisations synthétisantes" or to the feeling that logic is necessary. They oscillate between the positivist need to measure or verify and absolute beliefs issued from magical thinking.

[The speech of hebephrenic patients (maladjustment between assimilation and accommodation)]. / Quelques aspects de la langue des hébéphrènes (déséquilibre assimilation/accommodation).

Previous studies indicate that schizophrenic thought processes show a disturbance in the balance between assimilation and accommodation, as Piaget uses these terms. The authors postulated that this phenomenon could also account for the typical language disorders of hebephrenics, particularly semantic slippage. Every fourth word was deleted from linguistic material produced by eight controls and thirteen hebephrenics (Silverman). Three judges were then asked to fill in the blanks. The deleted words used by the subjects were compared with the replacement words chosen by the judges. The comparison revealed such disorders in hebephrenic speech as semantic alteration (metaphorical and metonymic) of the linguistic tropic type and syntax disorders including inhibition of the expansion of phrases introduced by functional monemes (morphemes), whether primary or secondary. These observations confirm those of other authors, more especially those of Roch Lecours et al. On the basis of Martinet's functional linguistics, Chomsky's generative grammar and Piaget's cognitive psychology, the authors conclude that the psychopathology underlying hebephrenic speech is a disturbance of language rather than of parole and that hebephrenic syntactical distortions are linked to the disturbance in the balance between assimilation and accommodation characteristic of schizophrenic thought processes.