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D J Anderson

Publications and source records attributed to D J Anderson.

At least 19 recordsLinked to original sources

Electrocochleography and experimentally induced loudness recruitment.

The relationship between changes in loudness and the cochlear whole-nerve potential following experimentally produced deafness was studied in an animal model. Reaction time of a subject's response to an auditory stimulus has been shown to be an index of loudness in human experiments and has been adapted to nonhuman primates. In a series of experiments, four macaque monkeys were operantly conditioned to respond to 8-kHz tones over a range of 3--80 dB SPL, and their reaction times to pure tone stimuli were measured. Whole-nerve cochlear action potentials were recorded from chronic inner-ear electrodes. The relationship between behavioral and electrical measures of loudness recruitment were examined in animals with both temporary and permanent noise-induced hearing loss. Loudness recruitment was demonstrated experimentally after a 1-h exposure to a high-intensity 8-kHz octave band of noise. Excellent agreement was observed between the reaction time function and the action potential input-output function at intervals of 0.5, 12, 24, 48, and 84 h after exposure. Permanent hearing loss was produced in some of these animals by a much longer duration of exposure to the 8-kHz octave band of noise. Recruitment was observed in both the behavioral and the electrical measures. Histological studies of these damaged cochleas revealed primarily outer hair cell destruction, with a relative sparing of inner hair cells and nerve supply. The findings of this study are interpreted as strong support for the clinical electrocochleogram as an objective indicator of the presence of loudness recruitment.

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Delivery of essential services to alcoholics through the "continuum of care".

To provide for the delivery of essential and comprehensive services for alcoholics, a well-developed continuum of care encompasses the following services: an information and referral, or diagnostic, center; detoxification or receiving center; primary rehabilitation; extended rehabilitation; residential intermediate care; outpatient care; a family program; and an after-care program. All of these services are geared toward the ultimate goal of assisting the alcoholic to live independently in the community and to utilize a variety of positive coping devices while remaining abstinent from beverage alcohol.

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A clinicopathologic study of prosthetic valve endocarditis in 22 patients: morphologic basis for diagnosis and therapy.

Although endocarditis is a frequently lethal complication of prosthetic valve replacement, there is little pathological information on which to base diagnosis and treatment. We have studied the clinical and pathological features of 22 patients with prosthetic valve endocarditis seen at The Johns Hopkins Hospital over the past 17 years. Five patients developed endocarditis within two months of operation and 17 between two and 48 months (average 12) after operation. Patients dying early had a more fulminant course and their endocarditis was less often recognized during life. Late deaths, tending to present with fever and bacteremia unmasked by postoperative problems, were more readily recognized. Mitral and aortic prosthetic endocarditis generally led to a different type of prosthetic valve dysfunction: nine of 14 aortic valve prostheses with endocarditis developed incompetence and one other stenosis; five of seven patients with mitral valve prostheses developed stenosis and one, a homograft, developed incompetence. Prosthetic valve dysfunction led to death in 10 patients (45 per cent) and embolic events in five (23 per cent), including four cerebrovascular accidents. Ring infection, often believed to be universally present, and a contraindication to surgery, was found only in 50 per cent of these patients. In four patients (18 per cent) the endocarditis was sterilized by antibiotics but death occurred from valve dysfunction or emboli. These findings suggest that early surgical intervention combined with antibiotics has a chance of providing effective therapy for prosthetic valve endocarditis.

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