Biomedical subjects
L Furman
Publications and source records attributed to L Furman.
The development of speech act comprehension in mentally retarded individuals and nonretarded children.
Understanding the speech act(s) a sentence conveys requires that a listener follow conversational rules and use clues provided by the sentence and the context in which it is spoken. To trace the development of speech act comprehension in mentally retarded and nonretarded school age children, we examined their responses to sentences such as Would you open the telephone book? and Could you roll the shoebox? These sentences can be intended as questions or as directives. Nonretarded adults follow the "answer obviousness" rule and interpret a sentence of this type as a question if the answer to the question is nonobvious to the speaker, but as a directive if the question has an obvious answer. We manipulated answer obviousness by varying both the context and linguistic properties of the interrogative. Retarded and nonretarded individuals at the nonverbal MAs of 5, 7, and 9 years were studied. Retarded and nonretarded individuals at all MAs followed the answer obviousness rule and used the contextual and linguistic clues available. There were only minor differences between MA-matched retarded and nonretarded subjects despite the fact that the retarded subjects had serious deficits in receptive linguistic competence. The implications for understanding the development of comprehension in retarded persons and for understanding the relations among language, cognition, and communication in general are considered.
Experimental Yersinia pestis infection in rodents after intragastric inoculation and ingestion of bacteria.
To clarify the pathogenesis of oral plague infection, we studied the susceptibility of three species of rodents to intragastric inoculation of Yersinia pestis, described the pathology and progression of infection, and measured antibody responses to fraction IA antigen of Y. pestis. The 50% lethal doses of bacteria by intragastric inoculation for Mus musculus, Zygodontomys pixuna, and Rattus rattus were log10 = 6.32, 5.46, and 9.62, respectively, which were at least 1,000-fold higher than the values obtained by subcutaneous inoculation. M. musculus was shown to be susceptible to lethal infection also when bacteria were ingested in drinking water. Microscopic pathology was consistent with heavy systemic infection. Quantitative cultures of tissues at different times after intragastric inoculation revealed that infections of blood, liver, and spleen preceded infections of Peyer's patches and mesenteric lymph nodes. Stool cultures were negative. The strain of Y. pestis used for inoculation was killed when exposed to a buffered solution at pH less than or equal to 3. Antibody responses were observed in some of the surviving rodents after intragastric challenge. These results showed that Y. pestis was an effective oral pathogen that produced fatal systemic infections and self-limited infections with immunity but did not produce enteric pathology or lead to fecal excretion of bacteria.
Clinical and cytokinetic aspects of remission induction of childhood acute lymphoblastic leukemia (ALL): addition of an anthracycline to vincristine and prednisone.
Fifty-six untreated patients with childhood with acute lymphoblastic leukemia (ALL) were randomized to receive one of three remission induction regimens: vincristine and prednisone (VP), vincristine, prednisone and daunorubicin (VPD), or vincristine, prednisone and adriamycin (VPA). The complete remission rate was similar for all three groups. Although the anthracycline regimens caused somewhat more rapid leukemic cell reduction than the VP only group, this difference was not significant. Labeling index reduction between study days 1 and 5 was significantly greater (p less than 0.001) with an anthracycline than for the VP group, but there was no difference between the two anthracyclines. Granulocytopenia during induction was significantly increased (p less than 0.05) in both the VPD and VPA groups as compared with VP alone. A significantly higher rate of infectious morbidity (p less than 0.01) was associated with the addition of either anthracycline, but to date no significant differences in remission duration or survival have been observed. The addition of anthracyclines to VP for remission induction in childhood ALL has theoretical advantages, but may be undesirable because of increased morbidity.
The role of irradiation in central nervous system treatment and prophylaxis for acute lymphoblastic leukemia.
The results of central nervous system (CNS) treatment with craniocervical irradiation and intrathecal methotrexate in 117 children with ALL achieved at the Joint Center for Radiation Therapy. The Children's Hospital Medical Center, and The Sidney Farber Cancer Center are presented. A classification related to meningeal disease which correlated with prognosis is presented and the patients are analyzed within these groups. Of 80 patients classified in the most favorable groups (I and II), no child has suffered primary CNS relapse. Of the remaining 37 patients in less favorable groups (III, IV, and V), eight patients have experienced CNS relapse, five following or in conjunction with bone marrow relapse. The technical features of irradiation are reviewed and related to success of the treatment.
Development of an effective treatment program for childhood acute lymphocytic leukemia: a preliminary report.
The development of an effective therapeutic regimen for acute lymphocytic leukemia (ALL) of childhood is described. By careful surveillance of toxicity and efficacy, positive modifications of treatment strategy were achieved without resorting to classically randomized trails. Teh resultant protocol utilizes vincristine-prednisone induction followed by asparaginase consolidation, intensive intermittent combination maintenance chemotherapy with adriamycin as a major component, and cranial radiotherapy plus intrathecal methotrexate for central nervous system prophylaxis. Preliminary analysis suggests that this regimen may result in prolonged continuous complete remission in at least 80% of children with ALL.
Adverse effects of intrathecal methotrexate in children with acute leukemia in remission.
A toxic syndrome characterized by fever, headache, and vomiting, lasting 2-5 days, occurred in 61% of 39 children with acute leukemia in complete remission, receiving central nervous system prophylaxis with intrathecal methotrexate, and in 14% of 34 children receiving the same plus cranial radiation. The syndrome was accompanied by pleocytosis with lymphocytes, monocytoid cells, and neutrophils. There was evidence of cumulative Mtx toxicity, since the toxic syndrome occurred mostly after the third and fourth dose and did not recur with longer intervals between doses. The incidence of the syndrome was significantly reduced by the use of Elliott's B solution as Mtx diluent, rather than water or normal saline. The occurrence of pleocytosis and toxic clinical syndrome was also significantly reduced in patients receiving concomitant cranial radiation, probably due to the lympholytic action of radiotherapy and the depressed cellular response of irradiated tissues. The use of Elliott's B solution as diluent for IT Mtx and an appropriate interval between Mtx doses are suggested for prevention of this toxic syndrome.
[Studies on food infections. I].
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Identifying speech acts from contextual and linguistic information.
We conducted an experiment to examine the comprehension of interrogatives such as Could you make the pencil roll?, which can be intended as yes-no questions, as directives to perform an action, or as both. Clark (1979) has claimed that the comprehension of such sentences is governed by, among other things, the answer obviousness rule; that is, listeners are more likely to interpret such a sentence as a question if the question posed is nonobvious to the speaker. One purpose of the present experiment was to test Clark's claim. A second purpose was to begin identifying the types of contextual information listeners use in comprehending speech acts. The final purpose was to provide data relevant to the controversy about whether listeners evaluate the syntactically direct, literal meaning of a sentence in the course of arriving at a syntactically indirect interpretation. We found that listeners follow an answer obviousness rule, utilize their knowledge of objects and the actions they allow as context for sentence interpretation, and do sometimes evaluate the syntactically direct reading of a sentence before arriving at an indirect speech act.
A developmental approach to weaning.
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