We demonstrated a significant endocrine stress response in infants with well compensated congenital cardiac disease undergoing cardiac surgery, but without adverse postoperative outcome. The use of large-dose fentanyl, with or without midazolam, with the intention of providing "stress free" anesthesia, does not appear to be an important determinant of early postoperative outcome.

The lipoprotein complexing activity of glycosaminoglycans (GAG) prepared from human aortas with iipoprotein Lp(a) in comparison to low density lipoproteins (LDL) was determined tubidimetrically in the presence of Ca ++ . In control experiments, purified chondroitin-6 sulfate and proteoglycans (PG) were used. Lp(a) exhibited approximately a threefold higher reactivity. Analyzing the chemical composition of the complexes, we found that Lp(a) had greater than fourfold higher binding capacity for GAG. The binding capacity of Lp(a) to PG was 3.4-fold higher as compared to LDL. The binding capacity of both lipoproteins for chondroitin-6 sulfate was only 50% in comparison to GAG, but again Lp Its plasma concentration is under genetic control, and evidence is accumulating that a plasma level above 25 to 30 mg/dl must be considered as an independent risk factor for atherosclerosis and myocardial infarction. 234 Size, morphology, and lipid composition of Lp(a) is similar to low density lipoprotein (LDL). 5 The most striking difference between the two lipoproteins is the presence of an additional apolipoprotein (apo) in the Lp(a) particle. This protein is called apo a or Lp(a) specific antigen. Apo a may be dissociated from Lp(a) by treating with disulfide reducing agents, 6 leaving "Lp(a-)", a lipoprotein that is chemically and immunochemically similar to LDL Apo a exhibits a considerable size heterogeneity ranging from 300 to 700 kD. 7 The carbohydrate content, notably that of M. Bihari Varga and E. Gruber are at the Second Department of Pathology, Semmelweis Medical University, Budapest, Hungary. M. Rotheneder, R. Zechner, and G. M. Kostner are at the Medical Biochemistry Department, University of Graz, Graz, Austria.These studies were partly supported by Grant P 5891 from the Austrian Research Foundation.Address for correspondence: Professor Dr. G.M. Kostner, Medical Biochemistry Department, University of Graz, A-8010 Graz, Austria.Received November 12,1987; revision accepted July 18,1988. sialic acids of apo a, is considerably higher than that of apo B. To shed more light on the possible molecular mechanisms of atherogenicity, Lp(a) and LDL from the same donor were made to interact with GAG and proteoglycans (PG), and their capabilities to induce cholesteryl ester accumulation in mouse peritoneal macrophages (MPM), were compared. Major emphasis was given to lipoprotein-GAG complexes, because free GAG, but little PG, is found in circulating plasma.7 . 1011 Methods Isolation and Characterization of LipoproteinsLDL and Lp(a) were prepared from pooled plasma of donors with Lp(a) levels of >40 mg/ld. In most cases, LDL and Lp(a) prepared from identical pools were compared. For a control, LDL was also prepared from individuals who were apparently Lp(a)-negative.

Deserts are increasing in extent globally, but existing deserts are decreasing in health. The basic biology and ecology of foundation plant species in deserts are limited. This is a direct study that provides an estimate of the capacity for a locally dominant foundation shrub species in California to recover from damage. Desert shrubs are cleared and damaged by humans for many purposes including agriculture, oil and gas production, and sustainable energy developments; we need to know whether foundation species consistently facilitate the abundance and diversity of other plants in high‐stress ecosystems and whether they can recover. A total of 20 Ephedra californica shrubs were clipped to the ground at a single site and systematically resampled for regrowth 2 years later. These shrubs were damaged once and regrew rapidly, and relatively, larger shrubs were not more resilient. This study provides evidence for what we termed the “Groot Effect” because smaller individuals of this shrub species can recover from significant aboveground damage and continue to have positive effects on other plant species (similar to the popular culture reference to a benefactor tree species). The density of other plant species was consistently facilitated while effects on diversity varied with season. These findings confirm that E. californica is a foundation species that can be an important restoration tool within the deserts of California in spite of extreme cycles of drought and physical damage to its canopy.

Thoracic epidural anesthesia with bupivacaine 0.25% does not impair ventilatory mechanics and inspiratory respiratory muscle strength in severely limited chronic obstructive pulmonary disease patients. Thus, thoracic epidural anesthesia can be used safely in patients with end-stage chronic obstructive pulmonary disease.

Working memory deficits are found in different psychiatric populations and are most pronounced in schizophrenia. There is preliminary evidence from pharmacological studies that the verbal and visuospatial subcomponents of working memory are subject to differential neurotransmitter modulation. Here, we investigated the impact of well-known polymorphisms of the dopamine transporter gene (SLC6A3, DAT) and the catechol-O-methyl-transferase gene (COMT) as well as the serotonin transporter gene (SLC6A4, 5-HTT) on these specific working memory subcomponents in a mixed sample of patients and healthy individuals. Twenty healthy subjects and 80 patients diagnosed with schizophrenia, bipolar I disorder, or obsessive-compulsive disorder underwent genotyping for the DAT variable number of tandem repeats (VNTR), the COMT val/met-, and the 5-HTT promoter length polymorphism (5-HTTLPR) and neuropsychological testing using a battery of well-characterized, brain circuit–specific working memory tasks. DAT genotype revealed a significant and selective effect on visuospatial working memory, while there was no effect on verbal working memory functioning. 5-HTT genotype, by contrast, exerted a significant and selective effect on verbal working memory task performance. COMT genotype did not show any influence on either working memory domain. The results of the present study provide evidence for a differential impact of genetic polymorphisms of the dopaminergic and serotonergic systems on verbal and visuospatial working memory functioning. Together with prior evidence suggesting the existence of subgroups of schizophrenia patients exhibiting isolated deficits in only one working memory domain, this finding further supports the idea of endophenotypically and pathophysiologically distinct subgroups of schizophrenia with implications for personalized therapeutic approaches.