Efferent and afferent connections of the dorsal and ventral respiratory groups in the medulla of the cat were mapped by axonal transport of wheat germ agglutinin conjugated to horseradish peroxidase. Injections of wheat germ agglutinin-horseradish peroxidase into the dorsal respiratory group and the three principal subdivisions of the ventral respiratory group (caudal, rostral, and Bötzinger Complex) revealed extensive interconnections between these regions and with a limited number of other brainstem neuron populations. Major neuron populations with efferent projections to the regions of the dorsal and ventral respiratory groups include the parabrachial nuclear complex (medial parabrachial, lateral parabrachial, and Kölliker-Fuse nuclei), subregions of the lateral paragigantocellular reticular nucleus, subregions of the lateral and magnocellular tegmental fields, inferior central and postpyramidal nuclei of the raphe, and sensory trigeminal nuclei. A previously unidentified neuron population with extensive efferent projections to the dorsal and ventral respiratory groups was found near the ventral surface of the rostral medulla; we refer to this group as the retrotrapezoid nucleus. The results suggest that the dorsal and ventral respiratory groups form an extensively interconnected neuronal system receiving convergent inputs from the same brainstem nuclear groups, consistent with the hypothesis that the dorsal and ventral groups are primarily sites for integration of sensory and premotor respiratory drive inputs. Neuron populations in the rostral ventrolateral medulla with projections to both the dorsal and ventral respiratory groups, particularly the retrotrapezoid nucleus and neighboring subregions of the lateral paragigantocellular reticular nucleus, are candidate sites for participation in respiratory rhythmogenesis or other critical functions of the brainstem respiratory control system such as intracranial chemoreception.

Background In this investigation, we sought to assess the ability of pediatric attending anesthesiologists, resident anesthesiologists and mothers to predict anxiety during induction of anesthesia in 2 to 16-year-old children (n=125). Methods Anesthesiologists and mothers provided predictions using a visual analog scale and children's anxiety was assessed using a valid behavior observation tool the Modified Yale Preoperative Anxiety Scale (mYPAS). All mothers were present during anesthetic induction and no child received sedative premedication. Correlational analyses were conducted. Results A total of 125 children aged 2 to 16 years, their mothers, and their attending pediatric anesthesiologists and resident anesthesiologists were studied. Correlational analyses revealed significant associations between attending predictions and child anxiety at induction (rs= 0.38, p<0.001). Resident anesthesiologist and mother predictions were not significantly related to children's anxiety during induction (rs = 0.01 and 0.001, respectively). In terms of accuracy of prediction, 47.2% of predictions made by attending anesthesiologists were within one standard deviation of the observed anxiety exhibited by the child, and 70.4% of predictions were within 2 standard deviations. Conclusions We conclude that attending anesthesiologists who practice in pediatric settings are better than mothers in predicting the anxiety of children during induction of anesthesia. While this finding has significant clinical implications, it is unclear if it can be extended to attending anesthesiologists whose practice is not mostly pediatric anesthesia.

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HFOV may shorten the actual procedural time required to perform cryoablation, likely due to the elimination of renal movement during the procedure, thereby facilitating targeting and access to the renal mass. In this initial experience, patients tolerated HFOV without incident, and the operating surgeons found it easier to perform the procedures.

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