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Publications and source records attributed to D Brackett.
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When parents are told their child has a hearing loss they not only have to cope with the loss, they must also decide which communication and educational option is best for them. The purpose of this article is to discuss the different communication modalities available for hearing-impaired children. Whether parents choose auditory/oral, sign language, or cued speech they must be committed to the chosen modality. It is important that families are presented with all the communication options available in an unbiased manner. Parents need to research each option carefully and decide which is best, not only for the child, but also for the entire family.
The effects of cocaine administration during acute ethanol withdrawal on both the cardiovascular system and cocaine pharmacokinetics are unclear. This study demonstrated differences in the cardiovascular effects of i.v.-administered cocaine during acute ethanol withdrawal in awake, freely moving rats. The altered responses to cocaine while in acute ethanol withdrawal compared to control animals included: enhanced increases in mean arterial pressure and systemic vascular resistance, attenuated heart rate decreases, and enhanced cardiac index and stroke volume decreases. These results may suggest that acute ethanol withdrawal disrupts myocardial contractility when the myocardium is subjected to a large increase in blood pressure. Serial arterial blood sampling in additional groups of rats were done to assess plasma cocaine concentrations and to confirm the absence of ethanol in the blood. Plasma cocaine concentrations were not effected by acute ethanol withdrawal. These results indicate that the altered cardiovascular responses to cocaine during acute ethanol withdrawal were not a result of differences in cocaine plasma concentrations.
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OBJECTIVE: This study aimed to document the communicative outcomes of early implantation. HYPOTHESIS: It is hypothesized that by implanting children between the ages of 2 and 5 years, it would be possible to capitalize on the critical period of language learning that occurs in the preschool years and thus positively effect communicative outcomes. STUDY DESIGN: Thirty-three children who were between 2 and 5 years at the time of implantation were followed longitudinally. They were administered a battery of speech perception (closed and open set), speech production, and oral language (vocabulary and syntax) tests at five test intervals across a 3-year span. RESULTS: Open-set speech perception was attained by 24 months with mean scores of 70% correct phonemes by the end of year 3. Speech production improved to mean scores of 90% for suprasegmental features and 88% and 69% for vowels and consonants, respectively, by 3 years postimplant. These children made 33 months' gain in receptive vocabulary and 48 months' gain in expressive vocabulary in 36 months' time. Syntactically, they progressed from simple vocalization to simple sentences with some grammatical elements present. Repeated measures analysis of variance showed no significant differences between the subjects implanted between 2 and 3 years of age and those implanted between 3 and 5 years of age at any period. Within groups, the scores obtained for each test period were significantly different from each other. CONCLUSIONS: Rapid improvement was noted in speech production and language acquisition after improved speech perception for these children implanted before 5 years of age, at levels that exceed those reported in the literature for children implanted at older ages.
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Spin trapping of nitric oxide (NO.) in vivo in liver, small intestine, kidney, and plasma of intact rats was accomplished using diethyldithiocarbamate (DETC) administered intraperitoneally. DETC combines with Fe2+ to form (DETC)2-Fe and is an excellent trapping agent for nitric oxide. DETC distribution and uptake by the organs of interest was determined and the formation of the active trapping agent (DETC)2-Fe was assayed in the various organs and plasma. The capacity of this spin trap to capture NO. in vivo was demonstrated by administering sodium nitroprusside to the animals. The trapping procedure was then used to assess the course of NO. generation during a 6 h period in animals that had been treated with endotoxin. The rate of NO. generation/gram tissue was determined during the last 15 min of each time period. The results indicate that induction of nitric oxide generation begins earliest in the small intestine, then in the liver, and still later in the kidney and plasma. Nitric oxide production was most intense in the liver and was still increasing at the end of the experiment. Control animals receiving the spin trapping agent showed only little or no evidence of nitric oxide production except for the small intestine. The results show that induction of NO. generation caused by endotoxin begins at different times in different organs.
Endotoxin-induced cytokines such as interleukin-1 (IL-1) and tumor necrosis factor (TNF) are thought to contribute to the proinflammatory effects of endotoxin in gram-negative infections. Using a conscious rat model of sepsis, induced by intravenous challenge with LD95 doses of endotoxin (n = 24) or live Escherichia coli (E. coli) (n = 24), we examined frozen sections of kidney at various intervals for evidence of IL-1 alpha and TNF alpha expression. A transient glomerular endothelial IL-1 alpha expression was demonstrated at 30 and 90 min after initiation of the sepsis in both endotoxin and E. coli-treated animals using immunohistochemistry. The endothelial IL-1 alpha expression as determined by immunohistochemistry occurred at the same time as IL-1 alpha mRNA expression, as determined by Northern blot analysis. The glomerular endothelial IL-1 alpha expression coincided with a slight but significant increase in the number of the glomerular polymorphonuclear leukocytes as identified by naphthol AS-D chloroacetate esterase enzyme histochemical reaction. Glomerular endothelial IL-1 alpha expression was virtually absent by 180 and 360 min. No TNF alpha expression was detected in the renal tissues at any time interval. Neither alpha-naphthyl acetate esterase-positive nor acid phosphatase-positive monocytes/macrophages were identified in the glomeruli. Our findings provide direct in vivo evidence that the IL-1 alpha gene product is expressed locally in the kidney by glomerular endothelial cells in this septic rat model.
Nine children received the Nucleus multichannel cochlear prosthesis. The preoperative evaluation consisted of assessments of auditory function, speech recognition, linguistic skills, and speech production. There were no surgical complications, and recovery in all patients was uneventful. The device was programmed 4 to 5 weeks following surgery, and all children were conditioned to the task. Postoperative training began immediately following device stimulation and is ongoing. Auditory skills and speech production scales were devised to monitor each child's progress. All children have shown varying degrees of improvement in auditory skills and speech production using the implant alone.
The effect of aerosolized ketamine hydrochloride was investigated by measuring airway resistance with a two-compartment plethysmograph in guinea pigs challenged with histamine. In the first phase of the study, treatment with ketamine prior to histamine challenge did not protect against elevation of airway resistance. In the second phase of the study, ketamine inhalation after histamine challenge did not significantly diminish airway resistance. Aerosolized ketamine is not recommended for use in human subjects with asthma.
The educators of the deaf, the audiologists, and other similar professional groups appear to have reasonably clearly delineated roles to play in the management of the hearing-impaired child. Not so with the speech-language pathologist. This paper specifies such a role and offers a model for the delivery of speech-language pathology services to the hearing-impaired infant.
The objective of this study was to evaluate the ability of troglitazone (a thiazolidinedione) and Wy-14,643 (a clofibrate) to inhibit progression of non-detectable and detectable mammary tumors in rats induced by 7,12 dimethylbenz(a)anthracene (DMBA) when compared to those receiving no treatment or tamoxifen. Although not as effective as tamoxifen in decreasing overall tumor incidence, Wy-14,643 reduced the percentage and number of malignant tumors that developed when compared to both troglitazone and control. Treatment of detectable tumors with either Wy-14,643 or troglitazone induced regression or stasis of total tumor volume in 40-50% of the animals, compared to only 10% in control and 65% in tamoxifen treated animals. Moreover, each PPAR ligand was as effective as tamoxifen in preventing additional tumor development. In summary, both PPAR ligands were more effective than no treatment in preventing tumor progression once detected. However, only the PPAR-alpha activator, Wy-14,643 was able to reduce the development of malignant tumors when administered prior to detection.