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Biomedical subjects

A D Murray

Publications and source records attributed to A D Murray.

At least 55 records · Page 3Linked to original sources
PubMed1991

Early botulinum toxin treatment of acute sixth nerve palsy.

Eight patients with total sixth nerve palsy were treated with botulinum toxin injection to the antagonist non-paretic medical rectus, within eight weeks of the onset of the palsy. Within a few days seven of the eight gained fusion without the necessity of a marked head turn, and none complained of confusing reversal of diplopia. The same seven recovered full function. The mean follow-up period after the last injection was 20 months. Seven palsies were the result of head trauma and one was due to cerebro-vascular disease. This preliminary report suggests that early botulinum toxin injection of patients with recent onset sixth nerve palsy is beneficial. Although all of the patients may possibly have recovered full lateral rectus function without treatment, the aetiologies of their palsies were of the type that frequently do no resolve. A randomised double-blind study is necessary more precisely to determine the effectiveness of this form of therapy.

Abducens Nerve↗
PubMed1990

Acute scleritis in porphyria cutanea tarda.

We examined three patients who had dermatologic and biochemical manifestations of porphyria cutanea tarda and localized thinning or excavation in the sun-exposed interpalpebral sclera, adjacent to the cornea. All three patients had signs of acute scleritis. The acute scleritis responded to oral indomethacin in one patient, but systemic corticosteroids were required to control the inflammation in the other two patients. Phlebotomy, protection from sunlight, and refraining from alcohol played an important part in the treatment of the patients.

Acute Disease↗
PubMed1990

Fine-tuning of utterance length to preverbal infants: effects on later language development.

The purpose of this study was to determine (1) whether mothers simplify their speech during the second half of the first year of development when infants begin to comprehend words and use gestures to communicate intentionally, and (2) whether individual differences in mothers' speech adjustments influence their infants' later language acquisition. The subjects for the study were 14 mother-infant pairs from a medically low risk sample who were followed longitudinally. Mothers' mean length of utterance (MLU) was calculated from transcripts of face-to-face interaction when the infants were 0:3, 0:6, and 0:9 in age. Mothers who provided responsive and stimulating environments, as indicated by HOME scores, also reduced their MLU over the age range studied. Moreover, mothers' MLU adjustments during the first year were more predictive than the HOME scale in forecasting receptive language development at 1:6. In contrast, expressive language abilities at 1:6 were unrelated to the environmental variables measured but were predicted by child characteristics such as the infant's sex. These results suggest that a mother's ability to 'fine-tune' her early linguistic input may be predictive of her child's later receptive language functioning. Precursors of fine-tuning, such as maternal beliefs in reciprocity and infant object orientation, are discussed.

Female↗
PubMed1989

Granulomatous uveitis in Crohn's disease. A clinicopathologic case report.

Recurrent episodes of uveitis occurred in a young male patient with clinical as well as radiologic and histologic evidence of Crohn's ileocolitis. His left eye became blind and painful, and was enucleated. Histopathologic examination of the eye revealed a panuveitis with evidence of granuloma formation in the choroid. While granulomatous inflammation has previously been demonstrated in extraintestinal sites, to our knowledge, this is the first histopathologic evidence of granuloma formation within the eye in Crohn's disease.

Adult↗
PubMed1989

Early and late botulinum toxin treatment of acute sixth nerve palsy.

Ten patients with sixth nerve palsy were treated with botulinum toxin injection to the antagonist nonparetic medial rectus. All patients were followed for a minimum of 14 months after the last injection. Six patients were treated within eight weeks of the onset of the palsy. Within a few days five of the six gained fusion, without the necessity of a marked head turn and none complained of confusing reversal of diplopia. The same five recovered full function. Four patients with no medial rectus contracture on forced duction testing were treated six months or longer after the onset of the palsy and none recovered full function. One of the four patients was permanently over-corrected despite persistent weakness of the lateral rectus. This preliminary report suggests that early botulinum toxin injection of patients with recent onset (acute) sixth nerve palsy is beneficial. Since some patients may recover spontaneously a randomised double-blind study is necessary to more precisely determine the effectiveness of this form of therapy. Botulinum toxin does not appear to be effective in facilitating recovery in those cases with poor lateral rectus function six months or longer after the onset of the palsy, even when there is no contracture of the medial rectus.

Abducens Nerve↗
PubMed1988

Variable expressivity of autosomal dominant microcornea with cataract.

Autosomal dominant microcornea with a cataract, previously described in four families, was documented in a seven-generation family. Eighteen family members had microcornea and a cataract, and an additional six had sclerocornea or Peters' anomaly. Most individuals with microcornea had a corneal diameter of less than 11 mm in both meridians, with moderately steep corneal curvatures. The inherited cataract progressed to form a total cataract after visual maturity had been achieved. In the four affected children who had not undergone cataract extraction, the common abnormality was a posterior polar lens opacity. The variability of expressivity of the dominant gene would suggest that the embryological origins of microcornea and sclerocornea are similar.

Adolescent↗
PubMed1988

Newborn auditory brainstem evoked responses (ABRs): longitudinal correlates in the first year.

The purpose of this study was to determine the degree to which auditory brainstem evoked responses (ABRs) measured in newborns may predict delayed or impaired development during the first year of life. 93 high- and low-risk infants with normal and abnormal newborn ABRs were evaluated at 3, 6, and 9 months of age. Newborns with abnormal ABRs were further grouped according to diagnoses of sensorineural hearing loss (N = 11) or neuromaturational delay (N = 16). Data collected included measures of mental, motor, neurological, auditory, and speech/language development. After adjusting for risk-group membership, infants with abnormal newborn ABRs were found to differ from those with normal ABRs on summary handicap ratings and on individual measures of functioning. Measures of motor development and communicative development were most strongly associated with abnormalities in the newborn ABR. Developmental outcome for the sensorineural group was the poorest, with the performance of the maturational delay group falling between the sensorineural and normal groups on most measures. The predictive accuracy of the newborn ABR was moderate for detecting sensorineural hearing impairment and low to moderate for detecting deviant neurobehavioral development. We conclude that abnormalities in the newborn ABR may indicate diffuse CNS dysfunction in addition to deficits specific to the auditory system.

Brain Stem↗
PubMed1988

Newborn auditory brainstem evoked responses (ABRs): prenatal and contemporary correlates.

A literature review and new data on correlates of newborn auditory brainstem evoked responses (ABRs) are presented. Although there has been documentation of the importance of maturation, pathology, postnatal complications, and sex as determinants of the ABR, few investigators have adopted a multivariate approach, resulting in a confounding of maturation with pathological and other factors. In the present study, the ABR was recorded and the I-V interwave latency at 80 dB was computed for 88 newborns (60 neonatal intensive care unit survivors and 28 low-risk babies). 29 variables describing background characteristics, age, pregnancy and delivery complications, and postnatal illnesses were factor analyzed, and the obtained factors were entered into a stepwise regression. Conceptual age was the strongest predictor of the I-V interwave latency, followed by sex and prenatal obstetric complications, although the correlations obtained were low. We concluded that disorders of the central components of the ABR may be more of prenatal than of postnatal origin. In addition, the I-V interval had low but reliable correlations with 4 of 11 Brazelton scale variables. These data show the usefulness of the ABR for monitoring neurologic function in high-risk neonates and foreshadow its potential usefulness as a predictor of developmental outcome.

Child Development↗
PubMed1982

Acoustic features of infant vocalic utterances at 3, 6, and 9 months.

Recordings were obtained of the comfort-state vocalizations of infants at 3, 6, and 9 months of age during a session of play and vocal interaction with the infant's mother and the experimenter. Acoustic analysis, primarily spectrography, was used to determine utterance durations, formant frequencies of vocalic utterances, patterns of f0 frequency change during vocalizations, variations in source excitation of the vocal tract, and general properties of the utterances. Most utterances had durations of less than 400 ms although occasional sounds lasted 2 s or more. An increase in the ranges of both the F1 and F2 frequencies was observed across both periods of age increase, but the center of the F1-F2 plot for the group vowels appeared to change very little. Phonatory characteristics were at least generally compatible with published descriptions of infant cry. The f0 frequency averaged 445 Hz for 3-month-olds, 450 Hz for 6-month-olds, and 415 Hz for 9-month-olds. As has been previously reported for infant cry, the vocalizations frequently were associated with tremor (vibrato), harmonic doubling, abrupt f0 shift, vocal fry (or roll), and noise segments. Thus, from a strictly acoustic perspective, early cry and the later vocalizations of cooing and babbling appear to be vocal performances in continuity. Implications of the acoustic analyses are discussed for phonetic development and speech acquisition.

Age Factors↗
PubMed1981

Effects of epidural anesthesia on newborns and their mothers.

The effects of epidural anesthesia on newborns were studied using a sample of babies from mothers having (a) little or no medication during childbirth (N = 15), (b) epidurals with bupivacaine (N = 20), and (c) epidurals in combination with oxytocin to stimulate labor (N = 20). Outcome measures included assessments of neonatal behavior (Brazelton Scale), mother-baby interaction during feeding, and mothers' perceptions of their babies' behavior during the first month after delivery. Effects of drugs on the neonatal behavior were strongest on the first day. By the fifth day, there was evidence of behavioral recovery, but the medicated babies continued to exhibit poor state organization. At 1 month, examiners observed few differences between groups, but unmedicated mothers reported their babies to be more sociable, rewarding, and easy to care for, and these mothers were more responsive to their babies' cries. The importance of the first encounters with a disorganized baby in shaping maternal expectations and interactive styles was discussed.

Anesthesia, Epidural↗
PubMed1979

Method of delivery and developmental outcome at five years of age.

A controlled follow-up study examined the impact of delivery method on developmental outcome of the child. The modes of delivery investigated were low forceps delivery (188 infants), midcavity forceps delivery (51 infants), forceps rotation with forceps delivery (57 infants), manual rotation with forceps delivery (67 infants), elective caesarean section (101 infants) and spontaneous delivery (control, 207 infants). Breech presentation (100 infants) was separately compared with the vertex presentation groups. Sample selection controlled for complications during pregnancy and low birthweight and was restricted to married English-speaking mothers. The children were assessed at the age of five years on verbal and non-verbal subtests of a standardized intelligence scale, tests of gross motor coordination, and auditory and visual tests. A full paediatric examination was also performed. Breech presentation children performed less well on tests of balance and fine motor coordination and on visual acuity and stereopsis testing than children who presented in the vertex position. No deleterious effect of delivery method was found. In the absence of other complicating events (like a poor antenatal history, prematurity, and a disorganized home environment) delivery complication constitutes an early risk factor which the growing child is able to overcome.

Cesarean Section↗
PubMed1975

Sub-cellular location of mercury in yeast grown in the presence of mercuric chloride.

The distribution of 203Hg in Saccharomyces cerevisiae grown in the presence of mercuric chloride has been examined by physical and chemical fractionation procedures and autoradiography. The major fraction of the bound mercury is tightly bound to the wall. A significant quantity of mercury penetrates to the cytoplasm but only a minor fraction is present as low molecular weight components. The wall associated mercury is not readily released by extraction with sodium hydroxide or ethylenediamine but a major fraction is solubilized by pronase and Helicase treatment. Isolated walls are capable of binding their own weight of mercury to high-affinity adsorption sites. The major role of the cell envelope in the in vivo binding of mercury and the penetration to the cytoplasm of mercury was confirmed by autoradiography.

Adsorption↗
PubMed1975

Maternal employment reconsidered: effects on infants.

Studies of the effects of variations in infant care are reviewed in relation to maternal employment. The research suggests that maternal employment may be a contributory factor in hindering the development of an optimal caretaker-infant relationship. Suggestions for further research, particularly in areas related to the formulation of social policy, are presented.

Child Care↗
PubMedDate not supplied

Quantitative analysis of major, minor and trace elements in gallbladder bile of patients with and without gallstones.

The concentration of 25 major, minor and trace elements in human bile was determined by inductively coupled plasma atomic emission spectrometry. Gallbladder bile was obtained during surgery from patients with cholesterol gallstones, pigment stones and with no biliary tract abnormalities (controls). Comparison of the concentration of elements (microgram per gram of solids) did not reveal any significant differences among the three patient groups. The in vitro nucleation time was not related to the concentration of any element measured.

Bile↗
PubMedDate not supplied

Visual loss with dancing extremities and mental disturbances.

A case is reported of a teenage girl, who presented with a profound loss of vision in the right eye, secondary to retinal vasculitis. During the preceding year, a gradual change in her personality had been noted, associated with a deterioration in her intellect. She developed an area of pigment epithelial disturbance in the macular region of the right eye, and subsequently, optic atrophy. One year after this, she had a similar, but more localized episode in the left eye. She later developed involuntary movements, and two years after initial presentation, a diagnosis of subacute sclerosing panencephalitis was made. Subsequently her clinical condition deteriorated rapidly and she died. Post-mortem examination confirmed the diagnosis of subacute sclerosing panencephalitis. This case demonstrates the insidious nature of the disease and suggests that the diagnosis of subacute sclerosing panencephalitis should be considered in any child or young adult who presents with unexplained retinal vasculitis, maculopathy or chorioretinitis.

Adolescent↗
PubMedDate not supplied

Therapeutic shock device (TSD): clinical evaluation with self-injurious behaviors.

A man with profound mental retardation and multiple topographies of severe self-injurious behavior (SIB) had been receiving contingent shock for SIB for 2 years before the study started. Shock was being delivered with a handheld shock stick (Hot Shot Sabre Six), which produced burns to the man's skin. SIB rate, without a shock contingency, was 10 responses/min. The Therapeutic Shock Device (TSD), worn by the client and remotely operated by a radio frequency signal, provided superior control of SIB (0.02 responses/min) compared with the shock stick (0.06 responses/min) without causing tissue damage. TSD treatment was introduced in a mixed multiple baseline design across times, settings, and behaviors. The client did not appear to find the TSD aversive. To the contrary, his behaviors indicated that he preferred to wear it. The TSD appeared to provide a substitute for restraint, the hypothesized reinforcer for the man's most frequent form of SIB.

Adult↗