335 research outputs found

    1992: A Year to Rediscover the Best Interests of the Child

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    Paediatrician\u27s guide to post-operative care for functionally univentricular CHD: A review

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    IMPORTANCE: Single ventricle CHD affects about 5 out of 100,000 newborns, resulting in complex anatomy often requiring multiple, staged palliative surgeries. Paediatricians are an essential part of the team that cares for children with single ventricle CHD. These patients often encounter their paediatrician first when a complication arises, so it is critical to ensure the paediatrician is knowledgeable of these issues to provide optimal care. OBSERVATIONS: We reviewed the subtypes of single ventricle heart disease and the various palliative surgeries these patients undergo. We then searched the literature to detail the general paediatrician\u27s approach to single ventricle patients at different stages of surgical palliation. CONCLUSIONS AND RELEVANCE: Single ventricle patients undergo staged palliation that drastically changes physiology after each intervention. Coordinated care between their paediatrician and cardiologist is requisite to provide excellent care. This review highlights what to expect when these patients are seen by their paediatrician for either well child visits or additional visits for parental or patient concern

    De novo CCND2 mutations leading to stabilization of cyclin D2 cause megalencephaly-polymicrogyria-polydactyly-hydrocephalus syndrome

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    Activating mutations in genes encoding phosphatidylinositol 3-kinase (PI3K)-AKT pathway components cause megalencephaly-polymicrogyria-polydactyly-hydrocephalus syndrome (MPPH, OMIM 603387). Here we report that individuals with MPPH lacking upstream PI3K-AKT pathway mutations carry de novo mutations in CCND2 (encoding cyclin D2) that are clustered around a residue that can be phosphorylated by glycogen synthase kinase 3β (GSK-3β). Mutant CCND2 was resistant to proteasomal degradation in vitro compared to wild-type CCND2. The PI3K-AKT pathway modulates GSK-3β activity, and cells from individuals with PIK3CA, PIK3R2 or AKT3 mutations showed similar CCND2 accumulation. CCND2 was expressed at higher levels in brains of mouse embryos expressing activated AKT3. In utero electroporation of mutant CCND2 into embryonic mouse brains produced more proliferating transfected progenitors and a smaller fraction of progenitors exiting the cell cycle compared to cells electroporated with wild-type CCND2. These observations suggest that cyclin D2 stabilization, caused by CCND2 mutation or PI3K-AKT activation, is a unifying mechanism in PI3K-AKT–related megalencephaly syndromes

    Forward estimation of movement state in posterior parietal cortex

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    During goal-directed movements, primates are able to rapidly and accurately control an online trajectory despite substantial delay times incurred in the sensorimotor control loop. To address the problem of large delays, it has been proposed that the brain uses an internal forward model of the arm to estimate current and upcoming states of a movement, which are more useful for rapid online control. To study online control mechanisms in the posterior parietal cortex (PPC), we recorded from single neurons while monkeys performed a joystick task. Neurons encoded the static target direction and the dynamic movement angle of the cursor. The dynamic encoding properties of many movement angle neurons reflected a forward estimate of the state of the cursor that is neither directly available from passive sensory feedback nor compatible with outgoing motor commands and is consistent with PPC serving as a forward model for online sensorimotor control. In addition, we found that the space–time tuning functions of these neurons were largely separable in the angle–time plane, suggesting that they mostly encode straight and approximately instantaneous trajectories
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