Biomedical subjects
Publications and source records attributed to J M Gillenwater.
Acquired Brown's syndrome is a disorder of ocular mobility characterized by the inability to elevate the affected eye in full adduction owing to inflammatory tenosynovitis of the superior oblique tendon. We describe a child who developed Brown's syndrome as a complication of poststreptococcal reactive arthritis.
OBJECTIVE: To improve characterization and recognition of inflicted pediatric submersions. DESIGN: Retrospective case series, records review. SETTING: A regional children's hospital and the King County (Washington) Medical Examiner's office. PATIENTS: Children younger than 19 years who sustained submersion injury between 1983 and 1991 and were hospitalized or autopsied. OUTCOME MEASURES: Two pediatricians, using preestablished criteria, categorized abstracted case scenarios as either inflicted or unintentional events. The two groups were compared. RESULTS: Of 205 submersions, 16 (8%) were judged to have been inflicted. Objective physical signs of abuse and incompatibilities between the history and the child's stage of development or physical findings were common (69% and 50%, respectively). Inflicted submersion victims were likely to be young (median age, 2.1 years). They tended to be the youngest sibling in a large (three or more children) household. Social and demographic attributes of inflicted and unintentional submersion victims did not differ significantly. Bathtubs were the most common site for inflicted submersions (9/16 [56%]), and submersions in bathtubs were frequently inflicted (9/34 [26%]). Compared with unintentional submersion victims, children who were inflicted submersion victims were less likely to be revived by bystanders (relative risk, 0.10; confidence interval, 0.01 to 0.72) and were more likely to die (relative risk, 4.32; confidence interval, 1.40 to 21.43). CONCLUSIONS: Enough childhood submersions are inflicted to warrant careful case evaluation. Bathtub submersion victims and children with physical and historical findings common to other forms of abuse are most likely to be the victims of inflicted submersion.
The development of auditory temporal acuity during infancy was examined in 3-, 6-, and 12-month-old infants and in adults using the gap detection paradigm. Listeners detected a series of gaps, or silent intervals, or variable duration in a broadband noise. In order to vary the acoustic frequencies available to the listener, a high-pass noise was used to mask frequencies above specified cutoffs. High-pass maskers with cutoffs of 500, 2,000, and 8,000 Hz were used. The minimum detectable gap was determined using the Observer-based Psychoacoustic Procedure. The thresholds of 3- and 6-month-olds were considerably poorer than those of the adults, although the effect of masker condition was about the same for these 3 groups. The thresholds of 12-month-olds were significantly worse than the adults when the stimulus was unmasked or when the masker cutoff frequency was 2,000 or 8,000 Hz. When the masker cutoff frequency was 500 Hz, 12-month-olds fell into 2 groups: some had gap thresholds that were about the same as 3- and 6-month-olds, while some had gap thresholds that approached those of adults. In a second experiment, a larger group of 12-month-olds were tested with a 500-Hz masker cutoff. Average performance of 12-month-olds was about the same as that of 3- and 6-month-olds in Experiment 1. Some infants attained thresholds close to those of adults. Thus, gap detection thresholds are quite poor in infants, although the similarity of the effect of frequency on performance in infants and adults suggests that the mechanisms governing temporal resolution in infants operate qualitatively like those in adults.