Bone gentamicin concentration after intra-articular injection or regional intravenous perfusion in the horse

OBJECTIVE

To compare intra-articular (IA) and bone gentamicin concentrations achieved after intra-articular administration or regional intravenous perfusion (RIP).

STUDY DESIGN

Experimental study.

ANIMALS

Twelve healthy adult horses.

METHODS

Horses were assigned to 2 treatment groups (n = 6/group): Group 1, 1 g gentamicin administered simultaneously in both left and right metacarpophalangeal joints and group 2, 1 g gentamicin administered simultaneously in both left and right lateral palmar veins. Serum, synovial fluid, and bone biopsy specimens were collected. Gentamicin concentrations were determined by fluorescence polarization immunoassay. Bone, synovial fluid, and serum gentamicin concentrations were compared over time and between groups using 2-way ANOVA. Significance of all tests were evaluated at P <.05.

RESULTS

IA metacarpophalangeal joint administration resulted in higher concentration of gentamicin in synovial fluid than RIP administration. Synovial fluid concentration remained above minimum inhibitory concentration (MIC) for common pathogens for over 24 hours with IA and RIP administration. Bone gentamicin concentration remained above MIC for 8 hours with both methods; there was no significant difference in gentamicin concentration in bone with either method. Neither IA nor RIP administration had a significant effect on serum concentration of gentamicin.

CONCLUSIONS

In normal horses, there is no difference in bone gentamicin concentration obtained with IA or RIP administration.

CLINICAL RELEVANCE

Based on MIC for common equine pathogens, administration of gentamicin intra-articularly or by regional intravenous perfusion should be useful for treatment of osteomyelitis.

Human auditory brainstem response to temporal gaps in noise

Gap detection is a commonly used measure of temporal resolution, although the mechanisms underlying gap detection are not well understood. To the extent that gap detection depends on processes within, or peripheral to, the auditory brainstem, one would predict that a measure of gap threshold based on the auditory brainstem response (ABR) would be similar to the psychophysical gap detection threshold. Three experiments were performed to examine the relationship between ABR gap threshold and gap detection. Thresholds for gaps in a broadband noise were measured in young adults with normal hearing, using both psychophysical techniques and electrophysiological techniques that use the ABR. The mean gap thresholds obtained with the two methods were very similar, although ABR gap thresholds tended to be lower than psychophysical gap thresholds. There was a modest correlation between psychophysical and ABR gap thresholds across participants. ABR and psychophysical thresholds for noise masked by temporally continuous, high-pass, or spectrally notched noise were measured in adults with normal hearing. Restricting the frequency range with masking led to poorer gap thresholds on both measures. High-pass maskers affected the ABR and psychophysical gap thresholds similarly. Notched-noise-masked ABR and psychophysical gap thresholds were very similar except that low-frequency, notched-noise-masked ABR gap threshold was much poorer at low levels. The ABR gap threshold was more sensitive to changes in signal-to-masker ratio than was the psychophysical gap detection threshold. ABR and psychophysical thresholds for gaps in broadband noise were measured in listeners with sensorineural hearing loss and in infants. On average, both ABR gap thresholds and psychophysical gap detection thresholds of listeners with hearing loss were worse than those of listeners with normal hearing, although individual differences were observed. Psychophysical gap detection thresholds of 3- and 6-month-old infants were an order of magnitude worse than those of adults with normal hearing, as previously reported; however, ABR gap thresholds of 3-month-old infants were no different from those of adults with normal hearing. These results suggest that ABR gap thresholds and psychophysical gap detection depend on at least some of the same mechanisms within the auditory system.

Infants' sensitivity to broadband noise

Infants have higher pure-tone thresholds than adults. One explanation is that infants do not adopt the frequency-selective listening strategy that adults use when detecting tones. In contrast to other models of infants' immature sensitivity, the listening strategy account predicts that infants will be more sensitive to broadband sounds, relative to adults. Infants 7-9 months old were tested in two experiments to examine their sensitivity to broadband noise. Unmasked and masked thresholds for a 1000-Hz tone and for broadband noise were estimated adaptively for infants and adults using an observer-based behavioral procedure. The difference between infants and adults in unmasked threshold were 14 and 7 dB for tones and noise, respectively. The difference between infants and adults in masked threshold were 10 and 5 dB for tones and noise, respectively. Psychometric functions for detection of broadband noise were also obtained from some infants and adults. Infants' psychometric functions were similar to those obtained in tone detection with shallower slopes and lower upper asymptotes than adults'. This suggests that the relative improvement in infants' threshold for broadband noise is not due to greater attentiveness to the noise. A model of infants' sound detection invoking inattentiveness, listening strategy, and an unspecified source of internal noise may account for the characteristics of the infant psychometric function.

Illness fears in the general population

OBJECTIVES

Because relatively little is known about illness fears, we sought to estimate the prevalence, risk factors, and morbidity associated with such fears in the community.

METHODS

We conducted a brief telephone survey of persons aged 40 to 65 years from randomly selected households in the Johnson County, Iowa, area. Respondents were asked whether a series of illness and medical care items made them no more nervous, somewhat more nervous, or much more nervous than other people. Those who reported more discomfort were asked to what extent this interfered with medical care or caused impairment or distress. Information about demographic and health characteristics was also obtained.

RESULTS

Five hundred persons, 62% of those contacted, responded to the survey. A factor analysis revealed four fear dimensions: illness/injury, medical care, blood/needle, and aging/death. Five percent of respondents reported much more nervousness in relation to at least four of six illness/injury items, 4% indicated that such fears interfered with their medical care, and 5% reported some negative effect on their life. Similarly, 5% of respondents reported much more nervousness in relation to at least two of four medical care items. Illness/injury fears were somewhat more common in persons with lower income and education and in those with medical conditions.

CONCLUSIONS

This survey shows that fears of illness and medical care are common in the general population and indicates that lower socioeconomic status and experience with illness are associated with these fears. The findings also suggest that interference with care occurs among those with the strongest fears.

Forward masking among infant and adult listeners

Psychophysical forward-masked thresholds were estimated for 3- and 6-month-old infants and for adults. Listeners detected a repeated 1000-Hz probe, with 16-ms rise time, no steady-state duration, and 16-ms fall time. Unmasked thresholds were determined for one group of listeners who were trained to respond when they heard the probe but not at other times. In the masking conditions, each tone burst was preceded by a 100-ms broadband noise masker at 65 dB SPL. Listeners were trained to respond when they heard the probe and masker, but not when they heard the masker alone. The masker-probe interval, delta t, was either 5, 10, 25, or 200 ms. Four groups of subjects listened in the masked conditions, each at one value of delta t. Each listener attempted to complete a block of 32 trials including four probe levels chosen to span the range of expected thresholds. "Group" thresholds, based on average psychometric functions, as well as thresholds for individual listeners, were estimated. Both group and individual thresholds declined with delta t, as expected, for both infants and adults. Infants' masked thresholds were higher than those of adults, and comparison of masked to unmasked thresholds suggested that infants demonstrate more forward masking than adults, particularly at short delta t. Forward masking appeared to have greater effects on 3-month-olds' detection than on either 6-month-olds' or adults'. Compared to adults, 6-month-olds demonstrated more forward masking only for delta t of 5 ms. Thus, susceptibility to forward masking may be nearly mature by 6 months of age.

A Drosophila gene with predicted rhoGEF, pleckstrin homology and SH3 domains is highly expressed in morphogenic tissues

We have identified a Drosophila gene that has substantial sequence homology to a distinct class of proto-oncogenes that includes DBL, VAV, Tiam-1, ost and ect-2. It has predicted Rho or Rac guanine exchange factor (Rho/RacGEF) and pleckstin homology (PH) domains with the PH immediately downstream of the Rho/RacGEF. Rho/RacGEFs catalyze the dissociation of GDP from the Rho/Rac subfamily of Ras-like GTPases, thus activating the target Rho/Rac (Takai et al. (1995) Trends Biochem. Sci. 20, 227-231]. Members of the Rho/Rac subfamily regulate organization of the actin cytoskeleton, which controls the morphology, adhesion and motility of cells (Nobes et al. (1995) J. Cell Sci. 108, 225 233; Ridley and Hall (1992) Cell 70, 389-399; Ridley et al. (1992) Cell 70, 401-410]. Message from this gene is found throughout oogenesis and embryogenesis. Of particular interest, message is most abundant in furrows and folds of the embryo where cell shapes are changing and the cytoskeleton is likely to be undergoing reorganization.

Preliminary observations on the development of auditory sensitivity in infants with Down syndrome

OBJECTIVE

Hearing loss commonly is associated with Down syndrome, but little is known about the development of auditory sensitivity in individuals with Down syndrome. This study had two objectives: 1) to determine whether an observer-based procedure can be used to assess the behavioral sensitivity of infants with Down syndrome, and 2) to provide preliminary information about the early course of hearing development among infants with Down syndrome.

DESIGN

Behavioral measures of sensitivity were made in 16 infants with Down syndrome using an observer-based procedure. Ten of the infants were followed longitudinally between 2 and 12 mo of age. All infants passed a screening auditory brain stem response at 20 dB nHL during the study and completed screening tympanometry at each test session. The infants detected a 4000 Hz tone at levels ranging from 25 to 50 dB SPL; psychometric functions and thresholds for the tone were obtained.

RESULTS

Infants with Down syndrome completed 80% of the test sessions they began, a rate similar to that seen in normally developing infants in the same type of study. Performance improved with increasing stimulus level, as one would expect, and thresholds were obtained from 15 of 16 infants for at least one age. The performance of infants with Down syndrome generally improved with age. The sensitivity of 2- to 3-mo-olds was poorer than that of older infants, but little if any improvement in sensitivity occurred between 4 and 12 mo. This pattern is similar to that seen in normally developing infants. Thresholds of infants with Down syndrome were 10 to 25 dB higher than those reported for normally developing infants. The psychometric functions of infants with Down syndrome were shallower than the psychometric functions of normally developing infants, and the slope of the psychometric functions did not change with age. Infants with Down syndrome achieved only 75 to 80% correct at any of the levels tested, 5 to 10% poorer than reported for other infants. These characteristics of the psychometric functions of the infants with Down syndrome suggest that they are inattentive during testing more often than are normally developing infants.

CONCLUSIONS

An observer-based procedure can be used to obtain reasonable thresholds from infants with Down syndrome who are as young as 2 mo of age. Both sensory and nonsensory factors could contribute to the threshold elevation seen in infants with Down syndrome. At least on preliminary examination, the course of auditory sensitivity development of infants with Down syndrome is qualitatively similar to that seen in normally developing infants.

Infant psychometric functions for detection: mechanisms of immature sensitivity

Psychometric functions are described for individual 6- to 9-month-old infants and for individual adults for auditory detection of repeated, long- and short-duration tone bursts in quiet and for single, long-duration tone bursts in quiet and in noise. In general, infant psychometric functions have reduced upper asymptotes, shallower slopes, and poorer thresholds than adult psychometric functions. Infant-adult differences in slope and threshold are greater for short-duration tones than for other stimuli. Infant upper asymptotes are around 0.85 correct for all stimuli. One explantation for these findings is that infants are inattentive a certain proportion of time during the detection task. This model cannot account for the very shallow short-duration stimulus slope, nor can it account for infant-adult threshold differences for any stimulus. Other models of immature attention, or listening strategies, may be able to account for the slope and upper asymptote as well as the threshold of infant psychometric functions. Some combination of inattentiveness and primary neural immaturity may also account for the data. Although immaturities exist, some aspects of the detection process appear to be quantitatively similar in infants and adults.

The relationship between auditory brainstem response latencies and behavioral thresholds in normal hearing infants and adults

The relationship between behavioral thresholds and auditory brainstem response (ABR) latencies for 4 and 8 kHz tone pips were examined in normal-hearing 3-month-olds, 6-month-olds and adults. The latencies of waves I and V and the I-V interval of the ABR were analyzed. A linear latency-intensity function was also fit to each subject's latencies for each wave at several levels. The y-intercept of the latency-intensity function was used as a summary measure of latency to examine behavior-ABR correlations. The pattern of age-related change in behavioral threshold was not closely matched by age-related latency reduction for Wave I, Wave V or the I-V interval. However, 3-month-olds with higher behavioral thresholds had longer Wave V latencies and longer I-V intervals than 3-month-olds with lower behavioral thresholds. There was no significant difference in latency between 6-month-olds or adults with higher thresholds and 6-month-olds or adults with lower thresholds. There was also a significant correlation between the Wave V-Wave I latency-intensity intercept difference and behavioral threshold at both 4 and 8 kHz among 3-month-olds. The correlation was not significant among 6-month-olds or adults. These findings suggest that one of the factors responsible for immature behavioral thresholds at 3 months is related to transmission through the auditory brainstem. Because variability in hearing threshold among normal-hearing adults is low, it is not surprising that behavioral threshold is unrelated to ABR latency in this group. However, the lack of such a relationship among 6-month-olds implies that structures central to the auditory brainstem, either sensory or nonsensory, or both, must be responsible for immature behavioral thresholds after 6 months of age.

The relationship between auditory brainstem response and behavioral thresholds in normal hearing infants and adults

The nature of age-related improvements in auditory sensitivity was explored by comparing behavioral and auditory brainstem response (ABR) thresholds in 3- and 6-month-old infants and in adults. Thresholds were estimated for tone pips at 1, 4, and 8 kHz, presented at a rate of 13.3/s. The time course of development of the two response measures was compared, and the correlation between thresholds for individual subjects was examined. Infant ABR threshold was adultlike at all frequencies, even among 3-month-olds. Infant behavioral thresholds were elevated relative to adult thresholds. Between 3 and 6 months, significant improvement occurred in the 8-kHz behavioral threshold, but no improvement occurred at other frequencies. This difference between ABR and behavioral measures in developmental time course suggests that peripheral sensitivity is not a major determinant of behavioral threshold elevation during infancy. The correlation between behavioral and ABR thresholds was significant at 4 kHz for 3-month-olds and at 8 kHz for adults. This suggests that variability in sensory function at these frequencies contributes to both behavioral and ABR thresholds, although other factors are likely to be involved as well.

Infant auditory temporal acuity: gap detection

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.

Sources of auditory masking in infants: distraction effects

Previous work has demonstrated that infants' thresholds for a pure tone are elevated by a masker more than would be predicted from their critical bandwidths. The present studies explored the nature of this additional masking. In Experiment 1, detection thresholds of 6-month-old infants and of adults for a 1-kHz tone were estimated under three conditions: in quiet, in the presence of a 4- to 10-kHz bandpass noise at 40 dB SPL, and in the presence of the same noise at 50 dB SPL. The noise was gated on at the beginning of each trial. Adult thresholds were the same in all three conditions, indicating that little or no sensory masking took place in the presence of the noise. Infant thresholds were about 10 dB higher in the presence of the noise. We term this effect distraction masking. In Experiment 2, the effect of gating the noise on at trial onset was examined. Thresholds for the same tone were estimated in quiet and in the presence of the band-pass noise at 40 dB SPL, but the noise was presented continuously during the session. Under these conditions, distraction masking was still observed for infants. These findings suggest that a masker can have nonsensory effects on infants' performance in a psychoacoustic task.