Acoustic reflex threshold and loudness discomfort level: relationships in children with profound hearing losses

Acoustic reflex thresholds (ART) and loudness discomfort levels (LDL) were obtained from 51 ears of 34 deaf children using broad band noise and pure tones. Both thresholds and levels were recorded using the psychophysical method of tracking. Results indicate that the relationship between ART and LDL is at variance with similar data for normal hearing individuals. Specifically, in over 39% of these deaf children LDL was obtained at a lower intensity than ART. Implications for hearing aid fitting with deaf children are discussed.     

Congenital deformities

Forty years ago Denis Browne wrote that the medical world was ignoring an important distinction among birth defects. There were, he said, a large group of abnormalities caused not by genetic errors or teratogens but simply by fetal constraint. These abnormalities, if recognized early, could be readily ameliorated with simple, conservative forms of therapy. Today the full range and frequency of deformations are still not well appreciated and yet the recognition of these deformities may be more important than ever. The public is becoming increasingly aware of environmental hazards and genetic risks to their unborn children. They know of the difficult problems faced by families when malformed children are born. The physician who can rapidly and accurately diagnose deformities treats a good deal more than the problems of aberrant fetal molding.     

Outcome of unsuspected pneumococcemia in children not initially admitted to the hospital

The records were reviewed of 97 episodes of unsuspected pneumococcemia in children not initially admitted to the hospital. Antimicrobial agents were prescribed at the first visit for 46 children; at the second visit 37 of them were improved and nine were not. No antimicrobial agents were prescribed at the first visit for 51; at the second visit 16 of these patients were improved and 35 were not. Pneumococcemia persisted in two treated children and in 13 untreated children. Meningitis was identified later in four children (two treated and two untreated). Although pneumococcemia in children may be a transient event, it may also persist or result in meningitis or other localized infections.     

Chlorpropamide-induced thrombocytopenia

Thrombocytopenia is a rare complication of chlorpropamide therapy. An immunological mechanism is generally held responsible, but has never previously been proved. In the present case the existence of such a mechanism has been established.     

Synchronous period-doubling in flicker vision of salamander and man

Periodic flashes of light have long served to probe the temporal properties of the visual system. Here we show that during rapid flicker of high contrast and intensity the eye reports to the brain only every other flash of light. In this regime, retinal ganglion cells of the salamander fire spikes on alternating flashes. Neurons across the entire retina are locked to the same flashes. The effect depends sharply on contrast and flash frequency. It results from a period-doubling bifurcation in retinal processing, and a simple model of nonlinear feedback reproduces the phenomenon. Pharmacological studies indicate that the critical feedback interactions require only cone photoreceptors and bipolar cells. Analogous period-doubling is observed in the human visual system. Under bright full-field flicker, the electroretinogram (ERG) shows a regime of period-doubling between 30 and 70 Hz. In visual evoked potentials from the occiput, the subharmonic component is even stronger. By analyzing the accompanying perceptual effects, we find that retinal period-doubling begins in the periphery of the visual field, and that it is the cause of a long mysterious illusory flicker pattern.     

Increased density of microtubule associated protein 2-immunoreactive neurons in the prefrontal white matter of schizophrenic subjects

Recent studies have suggested that schizophrenia may be related to prenatal disturbances in the cortical subplate, a transient but essential structure in the formation of cerebral cortical circuitry. Although most subplate neurons die during later development, some remain as the interstitial neurons of the adult white matter. In this study we used a monoclonal antibody against the cytoskeletal protein, microtubule associated protein-2 (MAP2), to quantify the density and distribution of labeled neurons in postmortem brain specimens containing the prefrontal white matter from five schizophrenic cases and matched controls. In both schizophrenics and matched controls, the density of white matter neurons decreased with increasing white matter depth. However, the mean density of MAP2-immunoreactive neurons was greater in the superficial white matter of the schizophrenic subjects compared to the matched controls. In contrast, no difference in the density of labeled neurons was seen in the deeper white matter. These findings are consistent with an abnormality in the development of the cortical subplate in at least some cases of schizophrenia.     

Cytotoxicity of bile in human Hep G2 cells and in primary cultures of rat hepatocytes

There has been increasing interest in the development of a hepatocyte bioreactor for the treatment of acute hepatic failure; however, little is known about the effect of hepatocyte byproducts on the viability of the cells in the bioreactor environment. We investigated the effects of increasing concentrations of bile on the growth and viability of the human hepatoma cell line Hep G2 and on the cytochrome P-450 content and dependent mixed function oxidase (MFO) activities, reduced glutathione (GSH) content, and glutathione S-transferase (GST) activity of primary cultures of rat hepatocytes. Our purpose was to determine whether or not it would be necessary to pretreat the plasma from patients with acute liver failure to remove elevated bile concentrations which might be toxic to the hepatocytes in an artificial liver device. Bile was found to inhibit Hep G2 cell growth at concentrations as low as 0.1% and to decrease viability at concentrations above 0.5%. The cytochrome P-450 and GSH contents and the activities of the MFO system and of GST were decreased in the primary cultures of hepatocytes following 24 h treatment with concentrations of bile at and above 0.5%. The MFO activities associated with different cytochrome P-450 isoenzymes decreased to different extents in the presence of bile with the O-dealkylation of pentoxyresorufin being more labile than that of ethoxyresorufin. Our data indicate that elevated bile concentrations are cytotoxic to liver cells, and it may be necessary to pretreat patient plasma to decrease its bile content to protect the cells during the clinical operation of a hepatocyte bioreactor device.