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Biomedical subjects

D A Trauner

Publications and source records attributed to D A Trauner.

At least 37 records · Page 2Linked to original sources

Comprehension and expression of affect in language-impaired children.

Eight children with developmental language impairment (LI) and eight age-, sex-, socioeconomic-status-, and I.Q.-matched controls were given tests of comprehension and expression of affective intent in spoken language and through facial expression. The LI children performed significantly more poorly than did controls in both comprehension and spontaneous expression of vocal affect. On tasks involving emotional facial expression, the opposite results were observed: The LI children were more dramatic in their expression of facial affect than were the controls. Children with language impairment appear to have a deficit in affective comprehension and expression that is modality-specific, i.e., limited to vocal affect. The heightened range of affective facial expression that they demonstrate may be a compensatory mechanism to offset their difficulties with vocal affect.

Adolescent↗

Neurophysiologic studies of the peripheral nervous system in nephropathic cystinosis.

Cystinosis is an autosomal recessive metabolic disorder in which nonprotein cystine accumulates within most body tissues due to a defect in lysosomal cystine transport. Neurologic declarations are only recently being recognized. We studied 13 cystinotic subjects (aged 5 to 21 years old), determining median motor and sensory nerve conduction velocities, F waves, peroneal motor nerve conduction velocities, sural sensory nerve conduction velocities, median sympathetic skin response, electrocardiogram R-to-R variability, and blink reflex analysis. The results were normal. We conclude that neurophysiologic testing suggests relative sparing of the peripheral nervous system in nephropathic cystinosis.

Adolescent↗

Maturation of human cerebrum observed in vivo during adolescence.

In the present study using magnetic resonance imaging (MRI), age changes in the morphology of the cerebral cortex, greatest in the frontal and parietal convexities, were observed during adolescence. Results suggest that increases in cerebrospinal fluid (CSF) within the sulci of these cortical regions accompany grey matter decreases. Smaller reductions in volume are also observed in subcortical grey matter nuclei. These apparent grey matter volume reductions presumably reflect processes of late brain maturation. The changes may be related to decreasing neural plasticity.

Adolescent↗

Inhibition of fatty acid beta oxidation by influenza B virus and salicylic acid in mice: implications for Reye's syndrome.

Injection of concentrated influenza B/Lee/40 virus into 4-week-old Balb C mice resulted in 60% inhibition of 14C-palmitate oxidation in isolated hepatic mitochondria. Oral feeding of carnitine to infected mice prevented the inhibition of fatty acid oxidation. High concentrations of salicylic acid given orally also inhibited 14C-palmitate oxidation. Serum free fatty acid concentrations of infected mice and of those fed salicylic acid were significantly higher than in control mice. A combination of low-dose virus and low-dose salicylic acid inhibited palmitate oxidation, suggesting an additive effect on the metabolic derangement when the two agents were present simultaneously.

Animals↗

Therapeutic effects of a ketogenic diet in Rett syndrome.

Seven girls (age 5 to 10 years) with Rett syndrome were investigated extensively. In 6 patients elevations of blood pyruvate were found. Blood lactate levels were marginally elevated. Two patients had variably elevated blood glucose levels. Metabolic studies were otherwise normal apart from minimally elevated blood ammonia levels in 3 of 5 patients tested, 2 of whom were on valproic acid. All 7 patients had anticonvulsant resistant seizures. EEG changes included generalized slowing and multifocal spike wave discharges, and pseudo-periodic burst-suppression patterns during sleep. Respiratory monitoring revealed apneic episodes only during the waking record. Six patients were below the 5th centile for weight despite normal caloric intake. Treatment with ketogenic diets, using medium chain triglyceride (MCT) oil when possible, has improved seizure control in the 5 patients who could tolerate the diet. Slight behavioral and motor improvement has occurred in these 5 patients and 6 of 7 patients on high fat diets have gained weight. With a possible defect in carbohydrate metabolism and a difficult seizure disorder, use of a ketogenic diet is logical and appears to produce clinical benefit in patients with Rett Syndrome.

Ammonia↗

Olivopontocerebellar atrophy with dementia, blindness, and chorea. Response to baclofen.

Olivopontocerebellar atrophy is a hereditary disorder that has variable clinical manifestations. Five types have been described, as well as a sixth that contains sporadic cases. This report describes a family with three affected members who demonstrate a composite of types III and V. Their features include progressive spasticity, ataxia, dementia, visual loss with retinal pigmentation, dysarthria, ophthalmoplegia, and chorea. This family might represent an additional category of the disease. In the two family members who developed chorea, baclofen resulted in marked improvement with abolition of the choreiform movements. Response has been sustained for several years in the mother and for eight months in the daughter. Neither has experienced any return of chorea while receiving treatment. When attempts were made to discontinue baclofen, choreiform movements returned promptly and with their original severity. Baclofen, a gamma-aminobutyric acid analogue, may be useful in the treatment of other forms of chorea as well.

Adolescent↗

Medium-chain triglyceride (MCT) diet in intractable seizure disorders.

Seventeen patients with intractable seizures have been treated with the medium-chain triglyceride (MCT) diet. All had frequent (often daily) seizures despite multiple medications. Age range was 12 months to 13 years. Types of seizures included myoclonic, akinetic, focal motor, atypical absence, generalized tonic, and tonic-clonic. Five patients achieved total seizure control, and anticonvulsants were decreased or stopped. Five others had some improvement in seizure control. No change was seen in two. In two cases, parents could not deal with the diet, even though total control had been achieved in one case. The diet had to be discontinued in three others because of side effects (diarrhea, vomiting, irritability). Intractable seizures of all types may respond to treatment with the MCT diet. This mode of therapy has few side effects, is tolerated well in most instances, and can result in reduction or discontinuation of anticonvulsant medications.

Adolescent↗

Detection of urea cycle enzymopathies in childhood.

Inborn errors of ureagenesis must be considered in the differential diagnosis of recurrent vomiting and lethargy in childhood. Elevations of liver enzyme levels are often present during these episodes and may lead to an erroneous diagnosis of hepatic encephalopathy. We studied two cases of urea cycle defects.

Amino Acid Metabolism, Inborn Errors↗

Reye's syndrome.

Reye's syndrome (encephalopathy with fatty infiltration of the viscera) is an acute illness of childhood that produces hepatic dysfunction and metabolic encephalopathy. The disease is fatal in as many as 40% of cases. The cause is unknown. Several environmental agents, particularly salicylates and aflatoxin, have been implicated as possible toxins in this disorder. Treatment is directed at controlling intracranial pressure, reversing metabolic abnormalities and providing intensive supportive care. Normal neurologic function returns in most survivors.

Adolescent↗

Stroke in neonates.

Five neonates with large cerebral infarctions of arterial origin are presented. Four had severe focal seizures on the first day of life. The fifth, a premature infant, was asymptomatic. The diagnoses were made by computed tomography (CT) scans between 5 and 12 days of life; CT scans obtained in the first few days of life were normal. In the fifth infant, the infarct was hemorrhagic and was also noted by cranial ultrasound. Three of the infants had a history of trauma to the head or neck during labor and birth. Only one was severely asphyxiated at birth. Two apparently are doing well at 1 year of age. Cerebral infarcts of arterial origin in neonates probably have been missed in living patients in the past, but now are recognized in the newborn period by properly timed CT examination.

Cerebral Hemorrhage↗

Reye's syndrome.

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Adolescent↗

Pathologic changes in a rabbit model of Reye's syndrome.

Continuous infusion of the short-chain fatty acid sodium octanoate into rabbits produces pathologic changes after 4 h. Principal abnormalities include microvesicular fatty accumulation in liver, and to a lesser extent in kidney, heart, and lungs. Ultrastructural changes include swelling and pleiomorphism of mitochondria in liver, and less consistently swelling of astrocytic foot processes in brain, suggesting early cerebral edema. These changes are similar to the pathologic abnormalities observed in patients with Reye's syndrome.

Animals↗