ABSTRACT
OBJECTIVE: To investigate functional magnetic resonance imaging (fMRI) in pediatric cochlear implantation candidates with residual hearing who are under sedation for evaluation of auditory function. DESIGN: During fMRI, subjects heard a random sequence of tones (250-4000 Hz) presented 10 dB above hearing thresholds. Tones were interleaved with silence in a block-periodic fMRI design with 30-second on-off intervals. Twenty-four axial sections (5 mm thick) covering most of the brain were obtained every 3 seconds for a total acquisition time of 5.5 minutes. SETTING: Single tertiary academic medical institution. PATIENTS: Severely to profoundly hearing-impaired children (n=10; mean age, 49.1 months). During fMRI, subjects were awake (n=2) or sedated with pentobarbital sodium if their weight was 10 kg or greater (n=4) or chloral hydrate if their weight was less than 10 kg (n=4). MAIN OUTCOME MEASURES: Detection of brain activation by fMRI in the primary auditory cortex (A1) in hearing-impaired patients under sedation, and correlation of A1 activation with hearing levels measured after cochlear implantation. RESULTS: In most subjects, fMRI detected significant levels of activation in the A1 region before cochlear implantation. The improvement in hearing threshold after cochlear implantation correlated strongly (linear regression coefficient, R=0.88) with the amount of activation in the A1 region detected by fMRI before cochlear implantation. CONCLUSIONS: Functional MRI can be considered a means of assessing residual function in the A1 region in sedated hearing-impaired toddlers. With improvements in acquisition, processing, and sedation methods, fMRI may be translated into a prognostic indicator for outcome after cochlear implantation in infants.
Subject(s)
Audiometry, Pure-Tone , Auditory Cortex/pathology , Cochlear Implantation , Hearing Loss, Sensorineural/surgery , Magnetic Resonance Imaging , Acoustic Stimulation , Auditory Threshold , Child, Preschool , Chloral Hydrate/administration & dosage , Evoked Potentials, Auditory , Female , Humans , Hypnotics and Sedatives/administration & dosage , Image Processing, Computer-Assisted , Linear Models , Male , Pentobarbital/administration & dosage , Postoperative Period , Preoperative CareABSTRACT
Cardiovascular disorders are influenced by genetic and environmental factors. The TIGR rodent expression web-based resource (TREX) contains over 2,200 microarray hybridizations, involving over 800 animals from 18 different rat strains. These strains comprise genetically diverse parental animals and a panel of chromosomal substitution strains derived by introgressing individual chromosomes from normotensive Brown Norway (BN/NHsdMcwi) rats into the background of Dahl salt sensitive (SS/JrHsdMcwi) rats. The profiles document gene-expression changes in both genders, four tissues (heart, lung, liver, kidney) and two environmental conditions (normoxia, hypoxia). This translates into almost 400 high-quality direct comparisons (not including replicates) and over 100,000 pairwise comparisons. As each individual chromosomal substitution strain represents on average less than a 5% change from the parental genome, consomic strains provide a useful mechanism to dissect complex traits and identify causative genes. We performed a variety of data-mining manipulations on the profiles and used complementary physiological data from the PhysGen resource to demonstrate how TREX can be used by the cardiovascular community for hypothesis generation.
Subject(s)
Databases, Genetic , Disease Models, Animal , Genomics , Heart Diseases/genetics , Hematologic Diseases/genetics , Lung Diseases/genetics , Animals , Gene Expression Profiling , Genetic Variation , Genomics/methods , Heart Diseases/physiopathology , Hematologic Diseases/physiopathology , Hypoxia/chemically induced , Internet , Lung Diseases/physiopathology , Male , Microarray Analysis , Myocardium/metabolism , Rats , Rats, Inbred BN , Rats, Inbred Dahl , Regulatory Sequences, Nucleic Acid/geneticsSubject(s)
Biotechnology/ethics , Empathy , Human Body , Social Justice , Embryo Research/ethics , Human Characteristics , Human Rights , Humans , Social Values , Stem CellsSubject(s)
Bioethical Issues , Catholicism , Social Justice , Social Problems , Abortion, Induced/ethics , Delivery of Health Care/ethics , Developing Countries , Embryo Research/ethics , Female , Global Health , Humans , Politics , Pregnancy , Social Problems/ethics , Social Responsibility , United States , Value of LifeABSTRACT
Recent years have witnessed a concern among theological bioethicists that secular debate has grown increasingly "thin," and that "thick" religious traditions and their spokespersons have been correspondingly excluded. This essay disputes that analysis. First, religious and theological voices compete for public attention and effectiveness with the equally "thick" cultural traditions of modern science and market capitalism. The distinctive contribution of religion should be to emphasize social justice in access to the benefits of health care, challenging the for-profit global marketing of research and biotechnology to wealthy consumers. Second, religion and theology have been and are still socially effective in sponsoring activism for practical change, both locally and globally. This claim will be supported with specific examples; with familiar concepts like subsidiarity and "middle axioms"; and with recent analyses of "participatory democracy" and of emerging, decentralized forms of global governance.
Subject(s)
Bioethics , Biotechnology/ethics , Interdisciplinary Communication , Religion and Science , Resource Allocation/ethics , Social Change , Social Justice , Theology , Capitalism , Christianity , Community Participation , Democracy , Developing Countries , Food, Genetically Modified , Genetic Research/ethics , Global Health , Humans , Internationality , Policy Making , Politics , Religion and Medicine , SecularismSubject(s)
Ethics Committees, Clinical , Ethics Committees , Religion , Bioethics , Cultural Diversity , Philosophy , Secularism , Social Values , United StatesSubject(s)
Abortion, Induced , Catholicism , Public Policy , Sexuality , Social Values , Women's Rights , Beginning of Human Life , Consensus , Cultural Diversity , Decision Making , Dissent and Disputes , Embryonic and Fetal Development , Ethics , Female , Fetus , Freedom , Group Processes , Homicide , Humans , Individuality , Life , Marriage , Maternal-Fetal Relations , Men , Morals , Parent-Child Relations , Personal Autonomy , Personhood , Politics , Poverty , Pregnancy , Pregnant Women , Social Justice , Social Welfare , United States , Value of Life , WomenSubject(s)
Beginning of Human Life , Embryo, Mammalian , Fetus , Individuality , Life , Personhood , Philosophy , Religion , Theology , Abortion, Induced , Catholicism , Consensus , Decision Making , Embryo Research , Embryonic and Fetal Development , Fertilization in Vitro , Humans , Research , Twinning, Monozygotic , Twins , Value of LifeABSTRACT
Lisa Sowle Cahill takes up the methodological issue of how substantive religious perspectives can be communicated in a pluralistic society. Cahill sees public discourse about bioethics as embodying a commitment to dialogue among traditions, religious and nonreligious, that have common concerns.
