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Biomedical subjects

R J Ruben

Publications and source records attributed to R J Ruben.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Traumatically acquired conditioned dysphagia in children.

A new diagnosis identifying a nonorganic basis of dysphagia is proposed in relation to behavioral conditioning processes and thereby labeled "conditioned dysphagia" (CD). Literature review of both animal and human studies documents that rapidly acquired and persistent avoidance responses are learned when autonomic functions are contiguous with traumatic physical events. Three case studies with primary diagnoses of TE fistula, congenital heart disease and pseudobulbar palsy demonstrated an association between CD and early childhood incidence of trauma involving the esophagus. Successful treatment was achieved by operant deconditioning therapy. Results of a pilot epidemiological study of 28 postpharyngeal flap surgery children and 47 controls showed significantly higher incidence of mild to moderate CD in the surgery group.

Avoidance Learning↗
PubMedDate not supplied

Plasticity of the developing auditory system.

Anatomical, physiological and behavioral data indicate that the auditory system matures from the periphery centrally, ie, centripetally. There is now information which shows that the developing auditory system can be modified by anatomical changes which have their greatest effect during early development. Anatomical, physiological and behavioral changes can also be brought about by the quality of the auditory stimuli which th auditory system experiences. Evidence for the plasticity of the developing auditory system has come from studies of a number of different species. The plasticity of the auditory system is of theoretical and clinical significance.

Animals↗
PubMedDate not supplied

Histopathology of acquired subglottic stenosis. A documented case report.

The history of a 2,900 g infant who had no stridor at birth and developed subglottic stenosis is presented in detail. The laryngeal lumen, which accepted a 3 mm endotracheal tube at one day of age, diminished to total occlusion at 15 months of age. There was an 8-day intubation and tracheotomy at nine months. At 19 months the patient expired from associated cardiac problems; the larynx was obtained at autopsy and was serially sectioned in the horizontal plane. A series (Imm-Tracer) of 12 sections through the stenotic area is presented. It demonstrates gross distortion of the cricoid cartilage with ossification extending into the right paraglottic larynx.

Glottis↗
PubMedDate not supplied

Recurrent middle ear effusion in childhood: implications of temporary auditory deprivation for language and learning.

Eighteen healthy, normal hearing (PTA greater than or equal to 15dB, better ear), neurologically intact, 8 to 11-year-old children who had documented histories of middle ear effusion (MEE) before the age of five years were evaluated by a battery of audiological, psychological, language and achievement tests. Each was compared to his/her non-MEE sibling who was tested at the same age. All the children (n = 36) tested in the bright normal range of verbal ability (WISC-R) and none had been diagnosed previously as learning disabled. Paired comparison of sibling data revealed that the effusion subjects had deficits in verbal ability, auditory decoding and spelling skills when compared with their control siblings. Significant strength in visual sequential memory in the MEE subjects suggests the availability of compensatory strategies for auditory deficits. Data analysis on the basis of sex and/or birth order differences could not explain the differences between siblings.

Achievement↗
PubMedDate not supplied

Home care of the pediatric patient with a tracheotomy.

Forty-seven infants and children with tracheotomies were cared for at home for a follow-up period of 1,581 months. There were two relevant fatalities which gave a death rate of 0.13 deaths per 100 months. The average age at the time of tracheotomy was 13 months and the tracheotomy was in place for an average of 33 months per patient. The ability to care for these children was provided through coordinated, intensive training and a home-care program in which the inpatient nurse, nurse practitioner, social worker, pediatrician, and otorhinolaryngologist worked as a team.

Child↗
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Clinical-pathological correlates of congenital subglottic hemangiomas.

One hundred thirty-six cases of subglottic hemangioma in infants have been reported in the English -language literature; four additional cases are reported here. The clinical presentations, diagnostic work-ups, treatments, and outcomes are analyzed. Twenty-one patients died, 17 of whom underwent autopsy. The histology of the laryngeal pathology from seven of these patients was reviewed by the authors. Possible correlation between the pathological findings and the clinical presentation is made. Approaches to diagnosis and treatment are suggested based on these findings.

Autopsy↗
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Natural cytotoxicity and interferon production in patients with recurrent respiratory papillomatosis.

The observation that interferon (IFN) therapy causes regression of lesions in some patients with recurrent respiratory papillomatosis (RRP) raises the possibilities that these patients may have abnormalities in endogenous IFN production or in antitumor immune responses stimulated by IFN. We have measured IFN production and natural cytotoxicity (NK activity) in nine patients with RRP, three of whom were receiving exogenous IFN at the time of testing. Production of IFN-gamma induced by the T cell mitogen Staphylococcus enterotoxin A was normal in all patients. Production of IFN-alpha induced by two viruses (Sendai and Newcastle disease viruses) was normal in the six untreated patients, but significantly lower in the patients on IFN therapy. Natural cytotoxicity against K562 target cells, both spontaneous and IFN-stimulated, was normal in all RRP patients tested. Thus, we have shown that the NK-IFN system was intact in untreated patients with RRP. IFN-alpha production in the RRP patients on IFN therapy was low. The significance of these findings is discussed.

Adolescent↗
PubMedDate not supplied

Neurotrophic interactions during in vitro development of the inner ear.

The objective of this study was to explore the hypothesis that developing labyrinthine sensory receptors attract ingrowing neurites by chemotaxis. Cocultured otic explants which shared a single statoacoustic nerve (VIIIn) ganglion were explanted from 11-, 12.5-, and 14-day-old mouse embryos. Heterotypic ganglion explants consisted of 12-day-old otic explants which had their VIIIn replaced by a 10.5-day-old trigeminal nerve (Vn) ganglion. All cultures were grown to the equivalent of 20 days of gestation. Neurites of the (+) VIIIn explants grew into the sensory areas of both the (+) and (-) VIIIn cocultured explants. Neurites of the 14-day-old cocultured otic explants were only found in association with sensory areas within the (+) VIIIn explant. Neurites of nerve V of the heterotypic ganglion explants were found in association with the sensory areas of these otic explants. These results support the hypothesis that a limited period of chemotaxis (nonspecific in nature) is a possible mechanism for the establishment of the pattern of neurite ingrowth to the areas of the inner ear sensory receptors.

Animals↗
PubMedDate not supplied

Hypernasal speech following adenotonsillectomy.

Extensive study of 120 patients with hypernasal speech following adenotonsillectomy showed that 48 had no evidence of abnormal speech prior to surgery and 41 had minor speech anomalies exacerbated postoperatively. Thirty-five patients had the classical stigma of submucous cleft palate and another 20 had occult submucous clefts. Fifty-seven of the patients had adenotonsillectomies because of recurrent middle ear effusions, but in the majority of these cases, recurrent middle ear disease continued even after surgery, probably secondary to palatal abnormalities.

Adenoidectomy↗
PubMedDate not supplied

A possible embryonic mechanism for the establishment of innervation of inner ear sensory structures.

The objective of this study was to explore the hypothesis (Van De Water, 1976) that differentiating sensory receptors of the inner ear may attract ingrowing neurites of the statoacoustic (VIIIn) ganglion by chemotaxis. Co-cultured embryonic inner ears which shared a single VIIIn ganglion were grown "in vitro" to the equivalent of 20 days gestation and then processed histologically to show both cytodifferentiation of sensory structures and the presence of neural elements. Specimens of both 11- and 12.5-day-old co-cultured otocysts showed that VIIIn ganglion neurites grew into sensory receptors of both(+) with and (-) without ganglion inner ear explants. Fourteen-day-old co-cultured inner ears revealed that only the (+) ganglion inner ear explants received VIIIn ganglion neurites into the sensory areas, and that neurites were not attracted into the (-) ganglion explants. The results were found to support the hypothesis of a limited period of chemotaxis as being a possible mechanism for the establishment of the pattern of innervation of inner ear sensory receptors by its VIIIn ganglion.

Animals↗
PubMedDate not supplied

A prospective study of otitis media in infants born at very-low birthweight.

Forty-six infants born at very-low birthweight were followed prospectively for a one-year period after their discharge from a neonatal intensive care unit. Pneumatic otoscopy was used to diagnose otitis media at periodic visits to a medical/developmental follow-up program. Twenty-one normal, full-term infants routinely cared for in a well-baby nursery served as control subjects and were followed similarly for the same time period. No difference was found between the two infant groups for the either the percentage of visits infants were considered to have normal middle ears bilaterally or otitis media unilaterally or bilaterally. Further, for the premature infants, no relationship was found between gestational age at birth, birthweight, or length of stay in the intensive care unit and percent-visits with otitis media during the first year.

Birth Weight↗