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0 | tissue changes around loose prostheses canine model investigate effects antiinflammatory agent aseptically loosened prosthesis provided means investigating vivo vitro activity cells associated loosening process seven dogs cells isolated maintained culture sufficient periods time biologic activity could studied well effect different agents added cells vivo vitro biologic response determined interleukin1 prostaglandin e2 activity paralleled roentgenographic appearance loosening technetium images observations made time revision surgery correlation clinical roentgenographic histologic biochemical loosening indicates canine model suitable investigating mechanisms prosthetic failure canine model permits study possible nonsurgical therapeutic interventions ultimate hope stopping slowing loosening process | 4 |
1 | neuropeptide neuronspecific enolase levels benign malignant pheochromocytomas neuronspecific enolase nse isoform enolase glycolytic enzyme found neuroendocrine system neuropeptide npy peptide recently discovered peripheral central nervous systems serum nse plasma npy levels reported increased patients pheochromocytoma authors evaluated whether measurement molecules could help discriminate benign malignant forms pheochromocytoma nse levels normal patients benign pheochromocytoma n 13 elevated one half malignant pheochromocytoma n 13 plasma npy levels average significantly higher malignant 1771 389 pmoll n 16 benign forms disease 157 389 pmoll n 24 however difference percentage patients elevated npy levels results show determination serum nse may useful distinguishing malignant benign pheochromocytoma measurement plasma npy useful differentiating two kinds tumors | 0 |
2 | sexually transmitted diseases colon rectum anus challenge nineties past two decades explosive growth prevalence types sexually transmitted diseases occurred 55 percent homosexual men anorectal complaints gonorrhea 80 percent patients syphilis homosexuals chlamydia found 15 percent asymptomatic homosexual men one third homosexuals active anorectal herpes simplex virus addition host parasites bacterial viral protozoan rampant homosexual population furthermore global epidemic aids produced plethora colorectal manifestations acute cytomegalovirus ileocolitis common indication emergency abdominal surgery homosexual aids population along cryptosporidia isospora patient may present colorectal surgeon bloody diarrhea weight loss diagnosis human immunodeficiency virus hiv disease patients may present colorectal kaposis sarcoma anorectal lymphoma consequently found seropositivity hiv however addition protean manifestations one third patients aids consult colorectal surgeon either condylomata acuminata anorectal sepsis proctitis diagnosis hiv disease although aggressive anorectal surgery associated reasonable surgical results asymptomatic hiv positive patients procedures aids symptomatic hiv positive patients often met disastrous results incumbent upon surgeon therefore recognize manifestations hiv disease diagnose conditions accordingly | 1 |
3 | lipolytic factors associated murine human cancer cachexia identified lipolytic factor extracts cachexiainducing murine carcinoma mac16 shows characteristics acidic peptide appears composed three fractions apparent molecular weights corresponding 3 kd 15 kd 07 kd determined exclusion chromatography material identical chromatographic molecular weight characteristics also present serum patients clinical cancer cachexia absent normal serum even conditions starvation mac16 lipid factor injected animals bearing noncachexiainducing tumor mac13 capable inducing weight loss without significant reduction food intake similar lipolytic material although lower concentration also found mac13 tumor extracts findings suggest cachexia may arise enhanced expression lipolytic factor associated tumor cells | 0 |
4 | carotid restenosis predict increased risk late symptoms stroke death identification carotid restenosis unexpected late complication carotid endarterectomy prompted concerns regarding importance source new cerebral symptoms stroke death investigate concerns analyzed consecutive series 507 patients undergoing 566 carotid endarterectomies documented technically satisfactory postoperative duplex doppler examination data 3 days 1 3 6 12 months annually thereafter 484 arteries 855 permitted classification arteries according severe degree postoperative stenosis normal n 306 1 19 n 89 20 50 n 40 50 n 49 including 8 occluded incidence 50 restenosis 145 female 77 male patients p 0003 life table analyses 10 years revealed significantly greater life expectancy among restenosis p 005 stroke also less likely patients restenosis although difference reach statistical significance survival stroke endpoints likelihood patients 50 restenosis remaining alive stroke free also greater less 20 stenotic group p 003 thus patients carotid restenosis less likely patients normal postoperative scans late symptoms stroke early death | 2 |
5 | shoulder multiple epiphyseal dysplasia one hundred shoulders assessed 50 patients multiple epiphyseal dysplasia onethird found bilateral symptoms two distinct clinical radiological groups emerged minor epiphyseal abnormalities developed painful osteoarthritis middle age retained shoulder movement secondary changes advanced hatchet head shoulders likewise became painful fifth sixth decades minimal glenohumeral movement early stage | 2 |
6 | management postoperative chylous ascites case report literature review chylous ascites remains rare complication surgical intervention although therapeutic manoeuvres control chylous ascites developed past 20 years pathophysiology poorly understood conservative approaches involving dietary restriction longchain triglycerides salt together multiple paracenteses still therapies choice persistent chylous ascites may treated surgically ligation leaking lymphatics implantation peritoneovenous shunt lymphatic anatomy defined preoperative investigations report case chylous ascites developing laparotomy duodenotomy obscure gastrointestinal bleeding respond adequately medical therapy successfully managed insertion peritoneovenous shunt | 1 |
7 | pharmacomechanical thrombolysis angioplasty management clotted hemodialysis grafts early late clinical results results pharmacomechanical thrombolysis angioplasty 121 thrombosed hemodialysis grafts reviewed initial pharmacomechanical method used 65 cases employed clot maceration hookshaped catheters clot lacing highly concentrated urokinase current technique used 56 cases consisted pulsedspray injection urokinase clot fully treated grafts 117 cases underwent complete nearcomplete thrombolysis 93 remained patent 1 day mean time pulsedspray lysis 46 minutes 21 one patient less 1 gastrointestinal bleeding received transfusion minor complications occurred 3 patients primary secondary graft patency rates methods 1 year 26 51 respectively graft age results angioplasty influence future graft patency shorter intervals graft thromboses predictive earlier subsequent graft failure results suggest pharmacomechanical thrombolysis angioplasty provide rapid consistent safe recanalization clotted hemodialysis grafts represent promising additional therapeutic approach longterm graft management | 3 |
8 | color doppler diagnosis mechanical prosthetic mitral regurgitation usefulness flow convergence region proximal regurgitant orifice prosthetic paravalvular prosthetic mitral regurgitation transthoracic color doppler flow mapping sometimes fail detect regurgitant jet within left atrium shadowing prosthetic valve overcome limitation assessed utility color doppler visualization flow convergence region fcr proximal regurgitant orifice 20 consecutive patients mechanical prosthetic mitral regurgitation documented surgery cardiac catheterization 13 20 patients addition studied 33 patients normally functioning mitral prostheses doppler studies performed apical subcostal parasternal longaxis views fcr detected 95 19 20 patients prosthetic mitral regurgitation jet area left atrium detected 60 12 20 patients 18 19 patients dopplerdetected fcr site leak correctly identified observing location fcr trivial jet area detected eight patients normally functioning mitral prosthesis none fcr identified thus color doppler visualization fcr proximal regurgitant orifice superior jet area diagnosis mechanical prosthetic mitral regurgitation moreover fcr permits localization site leak good accuracy | 4 |
9 | noninvasive diagnosis rightsided extracardiac conduit obstruction combined magnetic resonance imaging continuouswave doppler echocardiography rightsided extracardiac conduits frequently complicated obstruction time compared utility twodimensional doppler echocardiography magnetic resonance imaging diagnosis postoperative rightsided obstruction cardiac catheterization angiography 10 patients xenograft homograft conduits correlation r 095 continuouswave doppler estimates catheter pullback pressure gradients across conduits excellent echocardiography could visualize five 10 conduits entirety magnetic resonance imaging visualized conduits showed statistically significant kappa 058 agreement angiography localization estimation severity variety rightsided obstructions patients however flow voids created metallic ring around xenograft valves led false negative diagnosis valvular stenosis four patients magnetic resonance imaging used alone doppler studies correctly indicated obstruction patients combination magnetic resonance imaging studies continuouswave doppler echocardiography useful noninvasively evaluate rightsided obstruction postoperative patients rightsided extracardiac conduits | 4 |
10 | sodium sensitive sodium retaining hypertension differences sodium sensitive sodium retaining hypertension theoretically considered using water tank model body fluid volumeblood pressure regulation outlet valve attached tank base area corresponding reciprocal total peripheral resistance tpr water poured tank rate corresponding amount na intake equilibrium achieved certain water level volume output outlet represent mean arterial pressure map cardiac output co urinary na excretion height outlet tank bottom size crosssectional area outlet correspond xintercept slope renal function pressurenatriuresis curve respectively nonsodium sensitive hypertension due shift curve toward higher blood pressure level elevated height outlet without change slope size outlet sodium sensitive hypertension due depressed slope curve reduced outlet size map water level also co water volume increased resulting sodium retaining hypertension tpr reciprocal base area remained unchanged co relatively unchanged resulting nonsodium retaining hypertension tpr elevated thus map sensitivity sodium intake determined renal function curve since body fluid volume determined renal function curve tpr however changes tpr development hypertension major factor determining whether body fluid volume change small amount large amount therefore sodium sensitivity blood pressure sodium retention must considered separately | 3 |
11 | imaging bone tumors 1990s progress bone tumor management occurred result cooperation among surgeons oncologists pathologists radiologists 1990s radiologists contribute care patients bone tumors major ways tumor detection preliminary diagnosis accomplished radiography tumor local extent assessed magnetic resonance imaging mri lesser degree computed tomography ct distant spread malignancy documented radionuclide scintigraphy skeleton ct lungs combined estimate local extent distant spread assure adequate staging definitive management decisions preoperative closed percutaneous biopsy histologic diagnosis accomplished outpatient basis fluoroscopic ct guidance arteriography employed delivery local chemotherapy combination arteriography mri mr spectroscopy used evaluate tumor response limbsalvage surgery mri sequentially assess tumor bed bone scintigraphy ct detect skeletal pulmonary metastases radiologists role undergo continuous redefinition | 0 |
12 | closure bronchopleural fistula bronchoscopic instillation tetracycline persistent bronchopleural fistulas bpf due infection trauma thoracic surgical procedures often difficult manage report patient fulminant staphylococcus aureus pneumonia complicated chronic bpf formation prevented weaning mechanical ventilation due severe air leak fistula closure obtained instillation tetracycline fistula via fiberoptic bronchoscope using balloon catheter blood clot occlusion technique closed bpf allowed successful weaning mechanical ventilation | 4 |
13 | utility frozensection evaluation lymph nodes staging bronchogenic carcinoma mediastinoscopy thoracotomy conducted retrospective analysis utility frozensection diagnoses determining lymph node status mediastinoscopy 122 consecutive patients bronchogenic carcinoma thirtyfive 122 patients one lymph nodes frozensection evaluation positive metastatic carcinoma subsequent nodal sections original frozensection study revealed metastatic carcinoma two additional patients falsenegative rate 16 sensitivity 946 predictive value negative frozensection evaluation results 977 falsepositive frozensection results specificity predictive value positive results frozensection evaluation 100 statuses individual lymph nodes 122 patients also evaluated six hundred twenty lymph nodes sampled mediastinum mediastinoscopy frozensections 47 lymph nodes positive subsequent nodal sections original frozensections examination revealed metastatic carcinoma four additional lymph nodes falsenegative rate 06 sensitivity 922 predictive value negative results frozensection evaluation 993 falsepositive frozensection results specificity predictive value positive results frozensection examination 100 conclude frozensection evaluation lymph nodes mediastinoscopy reliably indicates lymph node status thus enabling physician decide whether proceed thoracotomy thus staging carcinoma definitive surgery accomplished single anesthetic procedure combining mediastinoscopy thoracotomy frozensection diagnostic control also reduces length cost hospitalization | 0 |
14 | antihypertensive drugs glucose metabolism comparison diuretic betablocker felodipine new calcium antagonist subjects arterial hypertension diabetes felodipine new antihypertensive calcium antagonist compared metoprolol betablocker hydrochlorothiazide diuretic respect glucose tolerance randomized doubleblind crossover study consisting 11 patients age range 5070 years developed diabetes antihypertensive treatment treatment period lasted 10 weeks blood pressure similar irrespective treatment serum glucose levels oral glucose tolerance test significantly lower patients treated felodipine taking hydrochlorothiazide serum insulin levels appeared decrease earlier stage test patients treated felodipine calcium antagonist two antihypertensive substances suggests glucose tolerance impaired lesser extent treatment calcium antagonist glucose tolerance never completely normalized drugs tested | 3 |
15 | gallbladder perforation correlation cholescintigraphic sonographic findings niemeier classification retrospectively analyzed cholescintigrams sonograms 36 consecutive patients gallbladder perforation determine sensitivity preoperative detection gallbladder perforation b correlate findings modified niemeier classification cholescintigraphic criteria perforation free spill pericholecystic hepatic activity scintigraphic gallstone ileus sign detected 14 28 50 cases sonographic criteria perforation pericholecystic fluid pneumobilia gallstones present 18 4 22 patients p less 005 cholescintigraphic patterns perforation associated niemeier classification type acute free perforation 3 7 scans demonstrated free spill type ii subacute pericholecystic abscess 9 19 scans showed pericholecystic activity type iii chronic cholecystoenteric fistula 1 3 scans showed scintigraphic gallstone ileus thus although cholescintigraphy appears superior sonography modalities relatively insensitive detection gallbladder perforation | 1 |
16 | left ventricular fibroma echocardiographic diagnosis successful surgical excision three cases management three patients left ventricular fibromas outlined asymptomatic children routine chest radiography suggested cardiac masses mmode twodimensional echocardiography valuable adjuncts conventional angiography assessing children electrocardiographic changes present cases shown regress postoperatively stress importance noninvasive aids initial investigation outline operative methods reconstruction | 0 |
17 | tongue ischemia softdrink report case young girl brought emergency department tongue became entrapped drinking aluminum softdrink dental drill used remove tongue observed 48 hours ischemic area recovered spontaneously | 3 |
18 | vitro vivo effects within coronary sinus nonarcing arcing shocks using new system lowenergy dc ablation dc shocks within coronary sinus abandoned risk cardiac rupture tamponade catheter ablation using dc energy electrodes straddling ostium coronary sinus used clinically reported result cardiac tamponade many 16 patients new system energy delivery maximizes voltage decreasing undesirable effects caused barotrauma system includes 1 lowenergy ablation power supply brief timeconstant capacitive discharge delivers 40 j 3000 v 2 lowenergy ablation catheter contoured distal electrode performed vitro vivo studies new system compared arcing shocks nonarcing shocks ablations performed using unipolar distal shocks unipolar shocks electrodes made electrically common pd vitro studies done large tank filled physiological saline recording voltage current pressure highspeed cinematography 32000 framessec shocks 1040 j permitted detailed analysis vapor globe anodal shocks less 20 j showed arcing minimal vapor globe formation pd anodal shocks 40 j diameters vapor globe 31 22 mm respectively corresponding pressure recordings 11 49 atm pressure rise lasted less 50 mu sec vivo studies involved 18 dogs received nonarcing shocks one six shocks 15 j 18 dogs received arcing shocks one three shocks 40 j group divided pd shocks catheter ablation performed mean sem distance 294 092 cm within coronary sinus dogs tolerated procedure without cardiac rupture tamponade killed 24 days later dogs edema hyperemia hemorrhage area coronary sinus compared effects multiple three six nonarcing shocks effects one three arcing shocks disruption rupture coronary sinus within epicardial fat space occurred two 12 dogs 17 multiple nonarcing shocks 13 18 dogs 72 arcing shocks p less 0003 occlusion coronary sinus occurred two 12 dogs 17 multiple nonarcing shocks nine 18 dogs 50 arcing shocks p less 006abstract truncated 400 words | 4 |
19 | chondrosarcoma jaws clinical findings histopathology treatment three cases chondrosarcoma involving jaws presented one maxilla two mandible salient points clinical presentation elucidated series cases widened periodontal ligament space present chondrosarcomas well osteosarcomas slowly increasing diastema may earliest clinical sign important lesson learned histopathology one accept diagnosis benign cartilaginous tumor jaws treatment lesions consist wide surgical excision consideration adjunctive palliative radiotherapy especially maxilla also noted recurrences may develop 10 20 years later followup lifelong | 0 |
20 | ear involvement yellow nail syndrome recognized features yellow nail syndrome include yellow nails lymphedema pleural effusions report patient additional feature keratosis obturans may manifestation syndrome external ear | 4 |
21 | modified rhombic transposition flap application dermatology modified rhombic transposition flap based around circular primary defect described found versatile design produces good cosmetic results low incidence postoperative complications become frequently used transposition flap dermatologic practice | 0 |
22 | hepatic injury associated small bowel bacterial overgrowth rats prevented metronidazole tetracycline susceptible rat strains develop hepatobiliary injury following surgical creation selffilling blind loops cause small bowel bacterial overgrowth luminal bacteria cell wall polymers implicated pathogenesis lesions shamoperated rats rats selfemptying blind loops slightly increased bacterial counts develop hepatic injury study antibiotics different spectra activities continuously administered starting 1 day 22 days surgery determine intestinal flora may responsible development hepatic injury rats small bowel bacterial overgrowth four weeks following surgery lewis rats selffilling blind loops receiving antibiotics elevated liver histology scores 82 13 vs 07 04 plasma aspartate aminotransferase levels 269 171 vs 84 24 compared shamoperated rats p less 0001 oral gentamicin well oral intraperitoneal polymyxin b binds endotoxin prevent hepatic injury rats selffilling blind loops however oral metronidazole tetracycline therapy continuously administered beginning 1 day surgery diminished hepatic injury histology score 30 18 29 11 aspartate aminotransferase 87 25 98 34 respectively p less 0001 compared selffilling blind loops receiving antibiotics metronidazole also protected wistar rats require 12 weeks develop hepatic injury following experimentally induced small bowel bacterial overgrowth compared rats selffilling blind loops received antibiotic treatment histology score 104 13 vs 07 11 aspartate aminotransferase 273 239 vs 76 20 p less 0001 rats started metronidazole therapy 22 days selffilling blind loop surgery elevated aspartate aminotransferase values decreased normal next 77 days final histology scores normal rats selffilling blind loops negative peritoneal liver spleen blood cultures approximately 75 mesenteric lymph node cultures positive irrespective antibiotic treatment bacteroides species implicated causing vitamin b12 disaccharidase deficiencies rats selffilling blind loops documented presence absence organisms blind loops using selective culture techniques metronidazole tetracycline eliminated bacteroides sp blind loops polymyxin b gentamicin notabstract truncated 400 words | 4 |
23 | clear cell adenocarcinoma vagina cervix report central netherlands registry emphasis early detection prognosis central netherlands registry cnr women vaginal cervical clear cell adenocarcinoma ccac established 1985 overview presented clinical pathologic data 55 patients registered cnr july 1 1988 netherlands departments pathology ndp maintain patient registry 95 institutes connected central archive via computer network histologic slides clinical status reviewed cnr twentyfive tumors classified vaginal carcinoma 30 cervical carcinoma mean age patients 22 years fiftyfive percent patients 63 patients known maternal history exposed diethylstilbestrol des utero majority cases initially diagnosed 1980 cytologic examination initial histologic diagnosis indicated cervical tumors detected 80 cases vaginal tumors detected 33 cases concluded examination desexposed women consist colposcopic inspection cervix vagina cytologic examination cervix four quadrants vagina careful palpation cervix entire vaginal wall important prognostic parameter patients ccac stage grade nuclear atypia results statistical analysis showed features effective distinguish nonsurvivors patients surviving 5 years | 0 |
24 | polyneuropathy ophthalmoplegia leukoencephalopathy intestinal pseudoobstruction polip syndrome describe 5 individuals three separate families progressive neurological disorder characterized sensorimotor peripheral polyneuropathy cranial neuropathies external ophthalmoplegia deafness syndrome chronic intestinal pseudoobstruction magnetic resonance imaging showed widespread abnormality cerebral cerebellar white matter 2 patients studied autopsy examination 3 revealed widespread endoneurial fibrosis demyelination peripheral nervous system possibly secondary axonal atrophy poorly defined changes cerebral white matter leukoencephalopathy cranial nerves spinal roots less severely involved neurons brainstem spinal cord intact fatal gastrointestinal dysmotility due severe visceral neuropathy suggest patients manifested hereditary disorder distinctive clinical radiological neuropathological features propose acronym polip emphasize distinctive tetrad polyneuropathy ophthalmoplegia leukoencephalopathy intestinal pseudoobstruction | 4 |
25 | insulin resistance noncirrhotic idiopathic portal hypertension explore pathogenesis glucose intolerance insulin resistance observed patients cirrhosis portal hypertension studied 35yearold woman presinusoidal portal hypertension without cirrhosis due nodular regenerative hyperplasia liver oral glucose ingestion glucose tolerance remained normal however occurred expense markedly hyperinsulinemic plasma response suggesting presence insulin resistance examine question directly performed stepwise euglycemic insulin clamp study combination infusion 63hglucose 114cpalmitate indirect calorimetry ability insulin promote total body primarily muscle glucose uptake markedly impaired whereas effect suppress hepatic glucose production normal compared results obtained nine healthy subjects moreover insulin failed normally suppress plasma free fatty acid turnover oxidation patient informative case demonstrates portal hypertension alone without hepatic dysfunction cirrhosis associated impaired insulinmediated glucose plasma free fatty acid metabolism may also play predominant role development insulin resistance many cirrhotic patients | 1 |
26 | effects lactulose lactitol protein digestion metabolism conventional germ free animal models relevance results use treatment portosystemic encephalopathy protein digestion metabolism studied laboratory rats miniature pigs investigate mechanisms action lactulose lactitol used treatment patients portosystemic encephalopathy lactulose betadgalactopyranosyl14betadfructofuranose lactitol betadgalactopyranosyl14dglucitol increased excretion nitrogenous material faeces decreased nitrogen excretion urine similar degree reported human patients studies germ free rats given lactulose effect observed suggesting lactulose least effects mediated gut flora measurement alpha epsilondiaminopimelic acid content faeces confirmed enhancement faecal nitrogen due increased contribution bacteria similarity results lactulose lactitol suggests perspective protein metabolism lactitol acts similar way lactulose treatment portosystemic encephalopathy | 2 |
27 | splenic artery aneurysm rupture published erratum appears j emerg med 1991 mar92205 splenic artery aneurysms rare usually asymptomatic however rupture produce severe abdominal pain prove lethal two cases ruptured splenic artery aneurysm presented one cocaine injection occurred immediately prior onset symptoms may precipitated event | 3 |
28 | acute gastroenteritis infants 6 months old sixty two babies age 6 months admitted gastroenteritis completed study gradual refeeding compared abrupt refeeding period rehydration difference incidence recurrence diarrhoea due lactose intolerance effect weight duration hospital stay twenty six babies 42 recurrence diarrhoea refeeding settled introduction lactose free soya based formula well nourished babies 6 months age mild moderately severe gastroenteritis fed immediately full strength milk feeds rehydration introduction lactose free soya based preparation may provide alternative repeated attempts regrading cows milk feeds patients lactose intolerance | 1 |
29 | dilatation duplex kidney 3 unusual cases dilatation upper limb duplex ureter usually secondary obstruction may associated ureterocele contrast vesicoureteric reflux usual cause dilated lower moiety ureter report 3 cases unusual complex causes dilatation 1 limb duplex ureter demonstrated | 0 |
30 | pregnancy patient treated wilsons disease case report pregnancy successful outcome patient treated wilsons disease complications excluded conception chelating treatment must maintained although concern teratogenicity describe course pregnancy patient followed department | 2 |
31 | dialysisinduced alterations left ventricular filling mechanisms clinical significance quantitative twodimensional 2d doppler echocardiography used determine whether hemodialysis results alterations left ventricular lv diastolic filling might contribute dialysisinduced hypotension well assess whether hemodynamic variables indices diastolic filling might used identify patients greatest risk becoming hemodynamically unstable dialysis sixteen male patients undergoing routine maintenance hemodialysis endstage renal disease prospectively studied hemodialysis following hemodialysis significant prolongation p less 005 lv isovolumetric relaxation time ivrt well significant reduction rate extent early rapid ventricular filling p less 0005 contrast late atrialassisted filling change significantly multiple stepwise linear regression analysis predialysis hemodynamic parameters noninvasive indices lv filling showed significant independent inverse relationship frequency dialysisrelated hypotensive episodes duration early lv filling r 081 p less 0001 results suggest hemodialysis results discrete alterations early lv filling significant compensatory increase late atrialassisted ventricular filling patients shortest early lv filling times appeared greatest predilection becoming hemodynamically unstable dialysis | 3 |
32 | ptychotropism cutaneous feature child syndrome hallmark child syndrome unilateral ichthyosiform nevus displays pronounced affinity body folds phenomenon term ptychotropism proposed expression composed greek words ptyche fold trope turning concluded cutaneous lesions child nevus determined two factors lyonization ptychotropism phenomenon ptychotropism constitutes additional argument distinguish child nevus inflammatory linear verrucous epidermal nevus latter ptychotropic | 4 |
33 | microcystic adnexal carcinoma following radiotherapy childhood 36yearold man treated radiotherapy tinea capitis many years discovery microcystic adnexal carcinoma mac patients refusal surgical intervention able follow natural course tumor 13 years case emphasizes typical slow development mac implication association mac radiotherapy discussed | 0 |
34 | feasibility digital teleradiology imaging evaluation patients acute right upper quadrant abdominal pain assess utility commercially available digital teleradiology system evaluating patients acute pain right upper quadrant hardcopy images 100 examinations 50 hepatobiliary scintigrams 50 sonograms right upper quadrant digitized transmitted via standard telephone lines viewed remotely video monitor video hardcopy interpretations compared degree concordance scintigraphic studies hardcopy video images equal demonstrating gallbladder bile duct activity video images failed depict presence bowel activity one case gallstones depicted equally well hardcopy video sonographic images video interpreters overestimated presence abnormal hepatic parenchyma overlooked one case right hydronephrosis video interpretations scintigrams sonograms showed overall error rate 4 comparable rate obtained radiographs interpreted remotely digital teleradiology systems | 1 |
35 | longterm followup comparing subclavian flap angioplasty resection modified oblique endtoend anastomosis definitive surgical procedure correction aortic coarctation remains controversial therefore retrospectively reviewed total 56 children 4 years age coarctation repair 1977 1986 thirtyfour subclavian flap angioplasty technique 22 resection oblique endtoend anastomosis group subdivided include 23 infants less 3 months ageeight infants resection oblique endtoend anastomosis less equal 3ete 15 infants subclavian flap angioplasty greater equal 3sfa remaining 33 patients older 3 months age divided 14 patients resection oblique endtoend anastomosis greater 3ete 19 patients subclavian flap angioplasty technique greater 3sfa overall mortality significantly different techniques postoperative hypertension significantly prevalent endtoend anastomosis subclavian flap angioplasty technique p less 001 seven patients recurrent coarctation 6year actuarial freedom recoarctation 93 6 less equal 3sfa group compared 53 20 less equal 3ete group p less 002 significant difference children operated later age regarding type coarctation repair therefore recommend subclavian flap angioplasty patients less 3 months age older 3 months either procedure safe risk recoarctation similar | 4 |
36 | catheterization coronary artery bypass graft descending aorta increasing frequency reoperation coronary artery disease led use variety grafts report describes catheter technique selective opacification saphenous vein graft descending thoracic aorta posterior coronary circulation | 3 |
37 | improved survival reduced myocardial necrosis cardiopulmonary bypass reperfusion canine model coronary occlusion cardiac arrest study question cardiopulmonary bypass cpb improve resuscitation rates limit infarct size cardiac arrest acute myocardial infarction design controlled randomized trial animals undergoing left anterior descending coronary artery occlusion subsequent ventricular fibrillation resuscitation animals supported four hours resuscitation intensive care setting intervention group 1 eight resuscitated standard external cpr advanced life support group 2 eight resuscitated cpb measurements main results group hemodynamic resuscitation variables number resuscitated number fourhour survivors compared ischemic necrotic myocardial weights determined histochemical staining techniques fourhour survivors infarct size measured ratio necrotic weight ischemic weight significantly fewer dogs resuscitated group 1 four eight group 2 eight eight p less 05 group 2 survivors required significantly less epinephrine lidocaine group 1 survivors p less 05 higher aortic diastolic coronary perfusion pressures cpb p less 001 ratio myocardial necrotic weight ischemic weight four hours 082 025 group 1 022 025 group 2 p less 05 however collateral blood flow measured study conclusion pilot study substantiates improvement resuscitation rates obtainable cpb cpb may also limit infarct size postresuscitation period requires study | 3 |
38 | psychosomatic factors borderline hypertensive subjects offspring hypertensive parents psychosomatic factors sympathoneural sympathoadrenal well cardiovascular mechanisms studied 24 patients 1824 years age borderline hypertension 50 agematched normotensive offspring hypertensive parents 49 controls family history hypertension compared projective questionnairebased psychological tests circulatory neurohormonal reactivity mental stroop colorword conflict test arithmetic test physical stressors orthostasis bicycle ergometry test measured borderline hypertensive subjects externalized aggression less p less 005 internalized p less 005 submissive p less 005 compared controls offspring hypertensive parents showed similar weaker pattern risk groups reported positive interactions parents genetic risk subjects versus controls p less 005 borderline hypertensive patients versus controls p 008 higher stateanxiety levels p less 005 subjective symptoms betaadrenergic receptormediated functions eg tachycardia tremor borderline hypertensive subjects offspring hypertensive parents elevated heart rates analysis repeated measures p less 0001 enhanced plasma norepinephrine concentrations p less 005 compared controls findings subjects risk development hypertension suggest psychosomatic factors sympathetic overactivity involved early phase hypertension | 3 |
39 | therapy renal cell carcinoma interleukin2 lymphokineactivated killer cells phase ii experience hybrid bolus continuous infusion interleukin2 regimen fortyseven patients metastatic unresectable renal cell carcinoma treated interleukin2 il2 lymphokineactivated killer lakcell therapy using hybrid il2 regimen il2 administered initially intravenous bolus 105 ukg cetus corp emeryville ca every 8 hours 3 days priming phase subsequently continuous infusion 3 x 106 um2 6 days second treatment period vitrogenerated lak cells administered despite selection patients good performance status ps 29 ps 0 18 ps 1 prior nephrectomy 43 47 patients low tumor burden response rate low two complete crs two partial responses prs overall objective response rate 9 toxicity comparable experienced highdose bolus regimen results suggest dose schedule il2 administration may influence likelihood response il2 renal cell carcinoma | 0 |
40 | clinical radiographic hemodynamic correlations chronic congestive heart failure conflicting results may lead inappropriate care purpose clinical radiographic examinations commonly used estimating severity titrating therapy chronic congestive heart failure purpose study establish relationship findings history physical examination chest roentgenogram pulmonary capillary wedge pressure pcwp patients methods fiftytwo consecutive patients chronic congestive heart failure referred evaluation heart transplantation studied patients underwent history physical examination upright chest roentgenogram cardiac catheterization mean left ventricular ejection fraction 019 006 patients divided three groups according pcwp group 1 normal pcwp less equal 15 mm hg n 19 group 2 mild moderately elevated pcwp 16 29 mm hg n 15 group 3 markedly elevated pcwp greater equal 30 mm hg n 18 results physical radiographic signs congestion common groups higher pcwp could used reliably separate patients different filling pressures physical findings orthopnea edema rales third heart sound elevated jugular venous pressure radiographic signs cardiomegaly vascular redistribution interstitial alveolar edema poor predictive value identifying patients pcwp values greater equal 30 mm hg findings poor negative predictive value exclude significantly elevated pcwp greater 20 mm hg radiographic pulmonary congestion absent eight 53 patients group 2 seven 39 group 3 patients group 2 3 without radiographic congestion better new york heart association functional class 35 05 versus 28 06 p less 001 good correlation right atrial pressure pcwp r 064 p less 0001 normal right atrial pressure predictive value pressure greater 10 mm hg seen one patient pcwp value greater 20 mm hg conclusion clinical radiographic hemodynamic evaluations chronic congestive heart failure yield conflicting results absence radiographic physical signs congestion ensure normal pcwp values may lead inaccurate diagnosis inadequate therapy known whether therapy aimed normalizing pcwp superior relieving clinical radiographic signs congestion | 4 |
41 | prognostic significance type iv collagen laminin immunoreactivity urothelial carcinomas bladder invasion carcinoma involves degradation penetration subepithelial basement membrane bm phenomenon might used histopathologic evaluation neoplasms bladder authors studied clinicopathologic data tissue specimens 125 cases urothelial carcinomas collected prospectively penetration bm evaluated immunohistochemical staining bm components laminin type iv collagen use parameter prognostic indicator bladder cancer assessed 5year survival rate patients tumors interrupted absent bm significantly lower patients tumors intact bm rate progression greater tumors interrupted absent bm tumors intact bm association found bm status recurrence however significant correlation tumor stage bm staining found correlation also found ploidy bm staining well histologic grade bm staining pattern evaluating histologic grade stage ploidy age bm score prognostic parameters stage bladder carcinomas turned important factor predicting survival rate progressionfree survival however bm staining found value early identification microinvasion helpful correct staging urothelial carcinomas | 0 |
42 | protein phosphorylation ischemia many investigations shown calcium adenosine triphosphate crucial central nervous system functions probable alterations substances central nervous system ischemia involved processes cause irreversible neural damage calcium regulates several protein kinases responsible phosphorylation proteins vital many central nervous system functions using rabbit spinal cord ischemia model found protein kinase c calciumcalmodulindependent kinase severely affected first hour ischemia protein kinase significantly affected time course lost protein kinase c enzyme activity closely corresponded irreversible loss neurologic function evidence protein kinase c inhibitor activity generated also drugs inhibit protein kinase c increased neurologic damage administered early phases ischemia results suggest protein phosphorylation particularly protein kinase c critical maintenance neurologic function | 3 |
43 | bimanual simultaneous motor performance impaired ability shift attention parkinsons disease ability share time shift attention bimanual simultaneous motor tasks studied 18 patients parkinsons disease pd 19 age intelligencematched controls task consisted drawing triangles dominant hand squeezing rubber bulb nondominant hand motor performance measured using variables amplitude squeezing frequency squeezing velocity drawing triangles eliminating variance due baseline differences singlehanded performance bimanual simultaneous performance pd controls turned similar frequency squeezing velocity drawing triangles amplitude squeezing however differed two groups significantly reduced pd arguably disturbance bimanual performance pd patients due disorder time sharing decreased ability shift attention visually cued task non visually cued task results agree current evidence pd patients impaired rely upon internal control regulation shifting attention external cues available | 2 |
44 | use neurolepticinduced extrapyramidal symptoms predict future vulnerability side effects objective susceptibility neurolepticinduced extrapyramidal syndromes varies widely even within age sex subgroups individual vulnerability extrapyramidal syndromes assumed explain utility past history predicting future occurrence extrapyramidal syndromes studied extensively investigation undertaken determine whether patients previous histories extrapyramidal syndromes predict future episodes extrapyramidal syndromes compare importance predictive factor patient age sex neuroleptic dose anticholinergic dose predictors extrapyramidal syndromes methods charts 62 schizophrenic patients multiple neuroleptic treatment episodes reviewed extrapyramidal syndromes neuroleptic drug doses anticholinergic drug doses first 21 days treatment episode recorded results previous extrapyramidal syndromes correctly predicted extrapyramidal syndromes subsequent treatments 84 patients variations neuroleptic potency neuroleptic dose anticholinergic dose partially explained incorrect predictions conclusions results support hypothesis patients history extrapyramidal syndromes greater risk future extrapyramidal syndromes confirmed results strongly support individual susceptibility major predictor extrapyramidal syndromes indicate prophylaxis extrapyramidal syndromes considered patients previously suffered extrapyramidal syndromes similarly prescribed neuroleptic therapy | 4 |
45 | alltrans retinoic acid acute promyelocytic leukemias ii vitro studies structurefunction relationship alltrans retinoic acid induces leukemic cells patients acute promyelocytic leukemia m3 differentiate vitro mature granulocytes express cd15 antigen capable respiratory burst function 35 m3 samples one failed respond eight cases compared efficacy two naturally occurring isomers retinoic acid alltrans ra 13cis ra isomers induce maximal differentiation 106 moll maximal response maintained 107 moll alltrans 13cis ra also observed metabolites 4oxoalltrans 4oxo13cis effective 106 moll 1 order magnitude difference vitro differentiating potencies alltrans ra 13cis ra blasts promyelocytic leukemias predicts difference clinical efficacy two drugs | 4 |
46 | metabolic consequences washed cardiopulmonary bypass pumppriming fluid children undergoing cardiac operations substrate load pumppriming fluid especially glucose lactate major influence metabolic response children cardiac operations may detrimental neurologically possible cleanse priming fluid excess substrates ultrafiltration followed addition balanced electrolyte solution used technique bypass management nine children 1 year age weighing less 18 kg studied induction anesthesia 6 hours postoperatively frequent blood samples taken measurement electrolytes intermediary metabolites stressrelated hormones throughout study period electrolyte concentrations maintained within physiologic range changes blood glucose lactate minimized compared matched historical controls previous studies period cardiopulmonary bypass mean serum glucose concentrations varied 44 77 mmoll peaked 107 mmoll skin closure mean serum lactate concentration exceed 23 mmoll period studied thus ultrafiltration priming fluid replacement balanced electrolyte solution results delivery patient reasonably physiologic substrate load reflected improved control mean plasma intermediary metabolite concentrations method may form basis clinical studies determine specific aspects metabolic stress response children | 4 |
47 | cystic medionecrosis coronary arteries fatal coronary vasospasm histopathological basis coronary vasospasm well defined report patient directly observed coronary artery spasm cystic medionecrosis coronary arteries great vessels myxomatous degeneration mitral valve evident suggest myxoid connective tissue lesions heart may linked coronary vasospasm | 3 |
48 | cognitive behavioural impairment among elderly people institutions providing different levels care objective compare prevalence degree cognitive behavioural impairment elderly patients institutions providing different levels care design prevalence study setting nursing home home aged psychogeriatric wards provincial psychiatric hospital patients subjects 65 years age older eligible inclusion random sample selected comprising 25 residents nursing home home aged 119 asked participate 95 agreed 44 nursing home 51 home aged 50 psychogeriatric wards agreed participate main outcome measures minimental state examination mmse kingston dementia rating scale kdrs results mmse score less 24 cognitive impairment given 37 84 residents nursing home 43 84 home aged 48 96 patients psychiatric hospital corresponding numbers kdrs score 0 cognitive impairment 41 93 48 94 50 100 seven patients receiving highest level care home aged special care behavioural problems psychiatric hospital p less 0001 conclusions cognitive behavioural impairment widespread three institutions regardless level care planning services allocating resources government funding agencies consider degree prevalence impairment among elderly people institutions | 2 |
49 | mapping locus xlinked cardioskeletal myopathy neutropenia abnormal mitochondria barth syndrome xq28 xlinked cardioskeletal myopathy neutropenia abnormal mitochondria clinically characterized congenital dilated cardiomyopathy skeletal myopathy recurrent bacterial infections growth retardation analyzed linkage disease locus xchromosomal markers family seven carriers four patients eight unaffected sons carriers highest lod scores obtained twopoint linkage analysis 270 st141 dxs52 taqi recombination fraction zero 253 cpx67 dxs134 recombination fraction zero multipoint linkage analysis resulted maximum lod score 524 position st35691 dxs305 distal recombination detected family located markers ii10 dxs466 dx13 dxs15 data indicate location mutated gene xq28 | 4 |
50 | overdose reperfusion blood cardioplegic solution preventable cause postischemic myocardial depression reperfusion warm blood cardioplegic solution useful minimizing reperfusion damage ischemia study tests hypothesis overzealous administration blood cardioplegic solution reperfusion counteracts benefits lead prevalence depressed ventricular performance mortality similar seen normal blood reperfusion thirtyone dogs underwent 45 minutes 37 degrees c global ischemia vented bypass six received normal blood reperfusion 25 reperfused warm aspartateglutamateenriched blood cardioplegic solution eight received highdose 3600 600 ml 17 received limiteddose 1180 120 ml blood cardioplegic reperfusion 10 20 minutes highdose blood cardioplegic perfusion 5100 200 ml without prior ischemia tested additional five dogs highdose blood cardioplegia without preceding ischemia alter ventricular function peak stroke work index 96 control ischemia normal blood reperfusion cardioplegia resulted marked left ventricular dysfunction peak stroke work index 36 control p less 005 versus control 33 mortality rate 26 died highdose cardioplegic reperfusion yielded marginal recovery stroke work index 40 control p less 005 versus control 25 mortality rate 28 died contrast limiteddose reperfusion blood cardioplegic solution allowed 100 survival 1717 restored stroke work index 90 control 13 versus 145 gmmkg conclude reperfusion damage avoided initial reoxygenation limited doses substrateenriched blood cardioplegic solution conversely highdose reperfusion blood cardioplegic solution offsets benefit reduces recovery substantially may lethal | 3 |
51 | primary intratemporal tumours facial nerve diagnosis treatment benign primary tumours facial nerve uncommon slowly progressive facial palsy considered result nerve tumour proven otherwise improvements diagnostic imaging techniques temporal bone increased possibility correct preoperative diagnosis facial nerve tumours remain frequently ignored misdiagnosed entity consequence subtle protean clinical manifestations series 12 cases primary facial nerve tumours presented clinical features diagnostic modalities treatment discussed relation review literature | 2 |
52 | palliation malignant esophageal obstruction progressive dysphagia common patients advanced esophageal carcinoma multiple nonsurgical techniques available provide palliation improved nutrition simple dilatation oldest technique newer methods may offer greater efficacy laser therapy provides excellent opportunity treat obstructing tumors placement esophageal prosthesis may become particularly useful dilatation must performed frequently become ineffective patient esophagealpulmonary fistula newer techniques including bicap tumor probe intracavitary radiotherapy absolute alcohol injection offer promise review discusses advantages disadvantages different palliative techniques patients extremely poor prognosis associated esophageal cancer | 1 |
53 | coronary trapping complement activation product c3a desarg myocardial reperfusion openheart surgery accumulation complement factors found occur myocardium infarction studied possibility complement activation product c3a desarg trapped within coronary circulation reperfusion ischemic myocardium 11 patients undergoing routine coronary artery bypass grafting arterial blood sampled cardiopulmonary bypass blood drawn coronary sinus concomitantly arterial blood sampling 5 30 min release aortic crossclamp n 10 preoperative value 92 13 ngml c3a desarg rose cpb maximum 1816 393 end cpb following reperfusion 5 min c3a desarg 1284 232 ngml arterial 1106 100 coronary sinus blood significant difference p less 005 amount c3a desarg trapped heart 5min reperfusion showed positive correlation arterial concentration p less 005 significant difference found 30 min reperfusion complement activation products trapped heart early reperfusion period may play pathogenetic role myocardial ischemiareperfusion injury | 3 |
54 | preventing colorectal cancer knowledgeable patients die colorectal cancer increasing intake dietary fiber decreasing fat consumption increasing use modern technology detect adenomatous polyps early cancer greatly decrease mortality associated colorectal cancer | 0 |
55 | male breast cancer male breast cancer uncommon important diagnosis easily made breast biopsy patients presenting earlier course disease past despite patients often first seen tumors metastasized axillary nodes markedly decreases survival rate therapy localized disease includes simple excision modified radical mastectomy radical mastectomy consensus operation appropriate radiation therapy strongly considered patients metastases axillary nodes role adjuvant hormonal therapy chemotherapy unclear treatment disseminated disease tamoxifen seems replacing orchiectomy favorable response rate especially patients estrogenreceptorpositive tumors lack side effects high level patient acceptability make attractive therapeutic choice | 0 |
56 | alterations muscarinic acetylcholine receptors nasal mucosa allergic patients comparison nonallergic individuals cholinergic nasal hyperresponsiveness nasal allergy may due changes characteristics muscarinic cholinergic receptors radioligand receptor binding vitro autoradiographic studies nasal mucosa nonallergic na allergic patients performed investigate hypothesis heterogeneous na group subdivided control individuals patients chronic sinusitis vasomotor rhinitis 3hquinuclidinylbenzilate binding muscarinic receptors human nasal mucosa membranes saturable high affinity groups significant differences could demonstrated subgroups na patients allergic patients dissociation constants receptor densities significantly decreased comparison na control individuals differences agonist binding coupling muscarinic receptor effector system via g protein could observed allergic patients vitro autoradiographic experiments demonstrated specific 3hquinuclidinylbenzilate labeling glandular acini na allergic patients specific labeling could observed epithelium blood vessels connective tissue conclusion increased sensitivity decreased muscarinic receptor number may reflect cholinergicinduced hypersecretion nasal allergy probably small explain complex allergic reaction | 4 |
57 | ischemic colitis everchanging spectrum ischemic colitis properly colonic ischemia became clear clinical entity past 25 years yet early diagnosis disease various presentations remains difficult task 10year review hospital identified 38 patients colonic ischemia comparison authors previous experience data literature several important factors emerge 1 twice many cases occurred operations 34 series vs 16 past probably fewer fewer spontaneous cases hospitalized 2 sixteen patients required operative intervention colonic ischemia mortality 62 per cent treated nonoperatively mortality 14 per cent seven eight postoperative patients required second operative procedure colonic ischemia died high clinical suspicion necessary postoperative patient colonic ischemia appears severe among patients moreover high incidence associated cardiovascular disease indicates early diagnosis well monitoring atrisk patient needed improvement survival occur new monitoring methods tonometry may help accomplish goal | 4 |
58 | observations pathophysiology nelsons syndrome report three cases nelsons syndrome generally regarded unusual sequela primary bilateral adrenalectomy performed cushings disease classically defined cutaneous hyperpigmentation considerably elevated adrenocorticotropic hormone acth levels enlarged sella turcica report present three cases initially treated transsphenoidal sellar exploration cushings disease two cases remission hypercortisolism occur initial pituitary exploration microadenomectomy performed one case microadenoma found nelsons syndrome occurred adrenalectomy second transsphenoidal operation radiotherapy required control tumor growth another case transsphenoidal adenomectomy acthsecreting tumor initially led remission hypercortisolism 4 years recurrent cushings disease necessitated adrenalectomy nelsons syndrome occurred documentation preexisting acthsecreting basophilic pituitary microadenoma adrenalectomy seen two cases previously reported observations nonclassical courses major implications pathophysiology nelsons syndrome | 0 |
59 | coronary angioplasty diffuse coronary artery disease january 1983 december 1987 98 patients underwent angioplasty least one diffusely diseased coronary artery diffuse coronary disease described group narrowing greater equal 50 involved entire vessel 40 patients group ii long lesions greater equal 2 cm length 39 patients group iii three lesions vessel 19 patients 65 men 33 women mean age 60 years 64 patients 65 unstable angina 23 patients 23 diabetic 31 32 prior myocardial infarctions 12 prior bypass surgery multivessel disease present 89 patients angioplasty diffusely diseased vessel performed 41 patients additional vessels dilated 57 patients overall 396 lesions four per patient 197 vessels two per patient attempted success achieved 382 lesions 96 187 vessels 95 angiographic success achieved 112 120 diffusely diseased vessels 93 clinical success achieved 91 patients 93 overall complication rate death myocardial infarction urgent bypass surgery 8 8 98 six patients 6 myocardial infarction one q wave five nonq wave one patient 1 urgent bypass surgery two patients 2 died one bypass surgery majority complications 7 8 87 including two deaths occurred group patients 175 rate versus 25 group ii 0 group iii p less 0002 | 3 |
60 | angiotropic intravascular largecell lymphoma malignant angioendotheliomatosis report case review literature present case angiotropic largecell lymphoma review literature order define neurologic features rare disorder first report gadoliniumdtpa imaging angiotropic largecell lymphoma demonstrates infarcts multiple ages well striking meningeal enhancement angiotropic largecell lymphoma suspected patients clinical evidence small large cerebral vessel disease diagnosis requires skin liver renal meningeal brain biopsy single modality treatment using either radiation therapy steroids ineffective new findings lymphomatous origin neoplasm suggest combination chemotherapy may indicated | 0 |
61 | phenobarbital cerebral blood flow hypertension newborn beagle phenobarbital sodium used anticonvulsant concentrations 15 40 microgramsml serum premature newborns attempts prevent periventricular intraventricular hemorrhages although clinical usefulness regard controversial phenobarbital treatment shown reduce periventricular intraventricular hemorrhages hypertensive insult newborn beagles study cerebral blood flow values steady state phenylephrineinduced hypertension without phenobarbital pretreatment measured newborn beagles anticonvulsant dosage phenobarbital sodium decreased mean arterial blood pressure transiently steady state significantly reduced total cerebral blood flow phenylephrineinduced hypertension without reducing mean arterial blood pressure phenobarbital sodium effect cerebral blood flow great presence acidosis initial hypotensive effect phenobarbital sodium sustained longer period time acidosis phenobarbital sodium may reduce incidence hemorrhages newborn brain providing protection isolated hemodynamic stresses characterized acute increases cerebral blood flow without increased mean arterial blood pressure | 3 |
62 | endosonography perianal pericolorectal fistula andor abscess crohns disease transcolorectal endosonography es performed 36 patients crohns disease suspected clinically fistula abscess hypoechoic anechoic ductlike lesion immediately adjacent anorectal lumen compatible fistula found 32 patients communication fistulous tract adjacent structures skin anal canal vagina detected 32 patients anechoic cavity adjacent communicating fistula visualized 29 36 patients fistula visualized remaining seven patients evidence abscess anechoic cavity compatible abscess surgically confirmed 14 17 patients judged extent configuration abnormalities clearly visualized es results compared fistulography five patients es complications conclude es preferred diagnostic procedure patients perirectal pathology low risk bacterial dissemination low incidence patient discomfort utilizing es nonsurgical treatment successful 19 patients documentation response therapy | 4 |
63 | acceleration luteinizing hormone pulse frequency functional hypothalamic amenorrhea dopaminergic blockade constellation neuroendocrine secretory aberrations including reduced lh pulse frequency prl concentrations documented women functional hypothalamic amenorrhea fha pituitary function preserved aberrations attributed alteration hypothalamic neuromodulation investigate participation dopaminergic system genesis reduced lh pulse frequency suppressed prl levels fha studied six women fha six cyclic women early follicular phase obtaining blood samples 15min intervals 48 h sequential 24h infusions saline dopamine receptor blocker metoclopramide mcp hypothalamic vs pituitary site action inferred pulsatility characteristics mcp consistently elicited increase lh pulse frequency women fha 73 12 se 105 13 pulses24 h p less 0005 contrast eumenorrheic women show significant change lh pulse frequency response mcp 152 10 143 09 pulses24 h prl concentrations significantly lower fha group infusion saline p less 0001 mcp p less 0005 relative increases prl mcp similar groups acceleration lh pulse frequency blockade dopamine receptors implies increased hypothalamic dopaminergic inhibition gnrh pulse frequency women fha | 4 |
64 | early frequent detection hbxag andor antihbx hepatitis b virus infection clarify significance x gene hepatitis b virus tested antihbx serum hbxag liver different stages natural history hepatitis b virus infection sera screened enzymelinked immunosorbent assay positive results confirmed immunoblot purified recombinant ms2 polhbx fusion protein used target assays among serial sera patients nonfulminant acute hepatitis 24 64 patients 375 positive antihbx fulminant cases 15 36 patients 42 antihbx chronic hepatitis patients high rates hepatitis b virus replication found significantly p less 001 higher prevalence antihbx 14 25 patients 56 low replication 14 66 patients 21 among asymptomatic hbsag carrier blood donors 20 126 16 without detectable hepatitis b virus replication p less 00001 highest prevalence antihbx found hbsag carriers cirrhosis 41 54 patients 76 andor hepatocellular carcinoma 18 33 patients 54 findings suggest antihbx appears common early marker hepatitis b virus infection transient selflimited hepatitis persisting progression chronicity chronic hepatitis prevalence antihbx correlated intensity duration hepatitis b virus replication neither severity liver disease malignant transformation per se | 4 |
65 | immunogenetic heterogeneity rheumatoid disease illustrated different mhc associations dq dw c4 articular extraarticular subsets genetic variants drb1 dw subtypes dqb c4 loci compared rheumatoid disease subjects without extraarticular feature feltys syndrome major vasculitis dr4 positive subjects rheumatoid arthritis alone showed preferential associations dqb dw variants c4 null alleles feltys subjects showed associations dqb encoded dqw7 allele c4b null allele preferential associations dw subtype dr4 contrast dr4 rheumatoidvasculitic subjects showed associations dw14 well dqw7 c4a null allele different mhc associations different clinical disease subsets show rheumatoid disease immunogenetically heterogeneous suggest mhc genes outside drb1 locus may also influence susceptibility modify expression rheumatoid disease process | 3 |
66 | skin epidural recording spinal somatosensory evoked potentials following median nerve stimulation correlation absence spinal n13 impaired pain sense clinical lesion study intraoperative epidural recordings made test origin clinical significance spinal n13 p13 somatosensory evoked potentials sep follow median nerve stimulation intraoperatively respective peak latencies spinal p13 n13 coincided n1 component dorsal cord potential phase reversed positivity ventral dorsal sides cervical epidural space maximal amplitude c5 vertebral level nerve input c6 dermatome main contributor modality sensory impairment hand dermatome examined selected patients cervical lesions showed normal conventional sep components erb n9 farfield p9 p11 p14 n18 cortical n20 without loss spinal n13 statistically loss spinal n13 associated decrease pain sensation c6 dermatome interpreted due damage central grey matter cord including dorsal horn results suggest spinal n13 p13 originate source c6 spinal cord segment good indicators detection centromedullary cervical cord damage | 2 |
67 | assay serum cardiac myosin heavy chain fragments patients acute myocardial infarction determination infarct size longterm followup evaluate correlation myosin heavy chain release necrosis mass serum levels myosin heavy chain fragments determined serially 55 patients acute myocardial infarction eight patients successfully treated thrombolytic agents others treated myosin titration applied sera 25 dogs experimental myocardial infarction six dogs successfully treated thrombolytic agents time courses myosin concentrations typical monophasic patients noncomplex myocardial infarction values kinetic parameters myosin release comparable previously reported determined cumulative myosin release significantly correlates cumulative creatine kinase ck ckmb lactate dehydrogenase release well thallium201 distribution determined different patient groups thrombolytic treatment seem qualitatively upset myosin kinetics results obtained dogs without thrombolysis conclusively indicate myosin release quantitative index necrosis mass practical point view serial determinations serum levels myosin heavy chains enough estimate necrosed mass patients acute myocardial infarction generally serum myosin titration could useful detecting cardiac disturbance involving myocardial injury resulting membrane leakage cardiac cells | 4 |
68 | systemic hemodynamic cardiac function changes patients undergoing orthotopic liver transplantation objective study determine changes systemic hemodynamics systemic vascular resistance svr cardiac output co systemic blood pressure sbp cardiac function pulmonary artery pressure pap pulmonary wedge pressure pwp 96 hours following orthotopic liver transplantation olt correlate changes hepatic renal function patient outcome study took place 12bed medical respiratory intensive care unit large teaching hospital twentyone patients olt performed 215month period january 1988 october 15 1989 end stage liver disease esld variety causes flowdirected right heart catheter indwelling arterial cannula inserted hemodynamic monitoring 96hour postoperative period liver renal function studies total serum calcium serum albumin fluid balance determined daily svr increased significantly 128 06 u 48 hours compared immediate less 8 hours postoperative levels p less 005 remained elevated 96 hours co fell progressively significantly lower baseline values 64 96 hours significant inverse correlation increase svr fall co r 85 p less 001 sbp stable except small significant fall 16 24 hours postoperatively pwp increased significantly baseline value 125 09 mm hg 15 09 mm hg 32 hours remained elevated 96 hours p less 005 serum bilirubin level fell progressively postoperatively prothrombin time partial thromboplastin time ptt shortened significantly bile flow increased progressively 107 120 ml24 hours end first 24 hours 188 125 ml24 hours 96 hours postoperatively five patients died nine 43 days postoperatively patients hemodynamic parameters significantly different patients survived successful olt associated rapid increase svr fall co without changes sbp findings tend parallel improvement found results liver function tests however correlation improvement hemodynamic state longterm survival | 1 |
69 | urinary excretion bile acid glucosides glucuronides extrahepatic cholestasis recently formation bile acid glucosides described novel conjugation mechanism vitro vivo 10 patients extrahepatic cholestasis caused carcinoma head pancreas investigated excretion rates profiles urinary bile acid glucosides urinary bile acid glucosides comparison bile acid glucuronides extracted characterized according established methods controls total urinary bile acid glucoside excretion 022 003 mumol24 hr mean semin range bile acid glucuronide excretion 041 006 mumol24 hr mean sem gas chromatographymass spectrometrycharacterized trihydroxy bile acid glucoside stillunknown hydroxyl positions accounted 65 total urinary bile acid glucosides extrahepatic cholestasis total urinary bile acid glucoside excretion 052 013 mumol24 hr mean sem yet significantly lower bile acid glucuronide excretion 153 013 mumol24 hr mean sem p less 0001 cholestasis primary bile acid derivatives cholic chenodeoxycholic acid glucosides amounted 90 whereas trihydroxy bile acid glucoside decreased 5 total bile acid glucoside excretion indicating alteration enterohepatic circulation data establish composition quantity urinary bile acid glucosides healthy controls cholestasis constitute quantitative comparison another glycosidic conjugation reaction bile acid glucuronidation | 0 |
70 | de vega tricuspid annuloplasty perioperative mortality long term followup one hundred fiftythree patients undergoing de vega tricuspid annuloplasty without associated cardiac procedures january 1979 june 1987 evaluated 136 hospital survivors followup 981 complete mean 37 yearspatient operative mortality 111 preoperative nyha class length cpb significant risk factors perioperative mortality actuarial survival operative survivors 9 years 735 118 7 late cardiac deaths among total 12 late deaths eleven patients required reoperation 21 06 patientyear seven patients necessary recurrence tricuspid regurgitation six also mitral prosthesis malfunction periprosthetic leak residual tricuspid regurgitation judged mild moderate severe 299 119 43 patients respectively de vega tricuspid annuloplasty method choice mild moderate tricuspid insufficiency selected cases severe degree regurgitation better results could achieved different surgical approach | 3 |
71 | arterial oxygen desaturation gastrointestinal endoscopy prospective study evaluated incidence severity arterial oxygen desaturation gastrointestinal endoscopy following pulmonary function testing 115 male patients underwent esophagogastroduodenoscopy egd colonoscopy colonoscopy followed egd continuous recording arterial oxygen saturation sao2 patients 80115 70 showed arterial oxygen desaturation greater 4 decrease baseline sao2 severe arterial oxygen desaturation sao2 less equal 85 reflecting hypoxemia pao2 less equal 50 mm hg noted onethird patients overall 37115 32 severe arterial oxygen desaturation occurred 962 egd patients 15 2346 colonoscopy patients 50 47 patients colonoscopy followed egd 57 arterial oxygen desaturation occurs frequently gastrointestinal endoscopy often severe data support concept continuous monitoring sao2 standard procedure gastrointestinal endoscopic procedures | 4 |
72 | extracapsular cataract surgery lens implantation diabetics without proliferative retinopathy retrospective study examined diabetics 66 operated eyes equal number nondiabetic matched controls underwent extracapsular cataract extracation ecce intraocular lens iol implantation twoyear period ending december 1987 diabetic patients 76 eyes improved least two lines snellen acuity postoperatively patients 68 eyes control eyes 83 achieved acuity 612 better diabetics visual outcome depended state retinopathy particular maculopathy diabetic group greater incidence postoperative inflammation major complications related continuing neovascularisation early postoperative laser photocoagulation may help prevent proliferative complications provided large adequate capsulotomy performed capsular thickening presence iol interfere photocoagulation also advise early postoperative assessment treatment necessary maculopathy diabetic retinopathy longer regarded contraindication intraocular lens insertion | 4 |
73 | cholesterol screening 5719 selfreferred elderly subjects assess frequency hypercholesterolemia potential major public health problem elderly studied 5719 selfreferred subjects greater age 60 11890 less equal 60 years whose nonfasting capillary blood cholesterol levels measured 18month screening cincinnati area grocery stores followed national cholesterol education program guidelines serum cholesterol less 200 mgdl desirable 200239 borderlinehigh greater equal 240 mgdl high 4011 6170 yearolds 19 capillary blood total cholesterol less 200 38 200239 43 greater equal 240 mgdl 1493 aged 7180 years 20 total cholesterol less 200 36 levels 200239 44 greater equal 240 mgdl 215 subjects 81 29 total cholesterol less 200 36 200239 35 greater equal 240 mgdl application nonage nonrace nonsex specific national cholesterol education program guidelines elderly may necessitate followup perhaps therapy 7181 subjects suggesting appropriate intervention approach general populationoriented rather individual detection diagnosis treatment approach presents huge expensive load relatively unprepared health care community | 3 |
74 | molecular pathologic study human papillomavirus infection inverted papilloma squamous cell carcinoma nasal cavities paranasal sinuses nasal inverted papilloma rare benign tumor occasionally associated squamous cell carcinoma determine etiological role human papillomavirus inverted papilloma clarify relationship human papillomavirus malignant transformation benign tumor retrospectively analyzed inverted papillomas 26 patients 7 squamous cell carcinoma used immunohistochemical method molecular pathologic techniques dotblot hybridization dna extracted paraffinembedded tissues situ hybridization polymerase chain reaction human papillomavirus detected 5 26 patients 19 3 patients human papillomavirus 11 2 patients human papillomavirus 16 latter 2 patients inverted papillomas associated squamous cell carcinoma speculate human papillomavirus may related malignant transformation inverted papillomas | 0 |
75 | surgical treatment brain metastases malignant melanoma authors report results retrospective review 13 patients underwent 19 craniotomies resection metastatic malignant melanoma university colorado denver co 1983 1989 preoperative evidence extracranial disease 11 patients eight patients one intracranial metastasis operation intraoperative ultrasound used 18 19 craniotomies minimize surgical trauma brain 30day mortality zero 30day morbidity minimal patient acquired new neurologic deficit result surgery patients regained least preoperative level functioning six patients living time review followed 4 25 months median 75 months seven patients dead time review survived 4 18 months median 10 months results compare favorably survival untreated patients metastatic melanoma brain median 1 month patients treated radiation therapy alone median 24 months treated chemotherapy alone median 24 months excision metastatic melanoma brain although curative may increase survival patients problem little morbidity mortality even presence metastases | 0 |
76 | family recovery vascular surgery twentyone families observed 3month study assess family coping major vascular surgery recovery analysis family measures data family apgar family inventory resource management family crisis oriented personal evaluation scales combined grounded theory method assess family responses time recovery outcomes containment emerged major conceptual category grounded theory containment refers constellation constructed meanings events behavioral responses used families regulate impact surgical crisis reduce family disruption contained coping pattern manifested families avoidant behaviors narrow definitions problem defined situation terms surgical repair cure rather palliative intervention chronic progressive disease situational factors insidious development illness primary focus care providers hospital surgical care allowing families narrow definitions situation remain unchallenged also contributed containment containment resulted poor risk factor management major recovery outcome isolation family conflict evident throughout recovery period concerns generated continued evidence morbidity recovery contributed developing awareness underlying disease diminishing containment growing awareness openly shared within family significant findings family measures analysis compared grounded theory qualitative data corroborated key dimensions | 4 |
77 | neuropsychological aspects learning disabilities epilepsy cognitive impairment regarded link epileptic conditions inability learn school neuropsychological approach learning disabilities epilepsy therefore first concentrates analyzing differential effects epileptic factors cognitive function impact seizure activity localization epileptogenic foci antiepileptic treatment cognitive functioning evaluated based upon results continuous assessment computerized neuropsychological test system second learning disabilities may evaluated observations made classroom performance three issues seem predominate learning studies among disabled children epilepsy testretest variability deterioration supposed specificity learning disabilities | 4 |
78 | reoperative versus conservative management gastrointestinal fistulas development fistula serious complication necessary identify anatomic pathologic features influence outcome treatment independent primary disease electrolyte abnormalities addressed volume deficits restored sepsis common cause death patients fistulas must controlled skin must protected reoperation conservative management opposing forms therapy rather complementary | 4 |
79 | delayed rupture pseudoaneurysm costocervical trunk treatment therapeutic embolization fourteen days removal internal jugular catheter inserted prior renal transplantation patient presented brisk arterial hemorrhage insertion site hemorrhage caused ruptured pseudoaneurysm costocervical trunk controlled transcatheter embolization gelatin particles one year later patient reported problems related pseudoaneurysm management | 4 |
80 | effect microwave ionizing radiation patients recurrent laryngeal carcinoma study describes treatment survival 54 patients gross recurrent laryngeal carcinoma radiotherapy twentysix patients treated local ultrahigh frequency hyperthermia combination radiotherapy chemotherapy hrch twentyeight control patients treated radiotherapy chemotherapy rch eight patients 33 per cent hrch showed three year survival patient rch group two years 18 patients 75 per cent hrch two 7 per cent rch survived | 0 |
81 | magnetic resonance imaging congenital heart disease pediatric patient current stateoftheart mr imaging offers high resolution evaluation cardiac anatomy child congenital heart disease although echocardiography remains standard initial evaluation modality mr imaging plays key role supplementing information pediatric thorax although applications modality continue defined indications become clear future mr imaging promises better spatial resolution faster image acquisition times vivo spectroscopic capabilities | 4 |
82 | soluble histocompatibility antigen class breast cancer patients relation tumor burden serum beta2 microglobulin b2m levels studied 365 breast cancer patients 210 agematched controls patients divided three groups group new patients diagnosis group b patients followup group c metastatic patients mean b2m breast cancer patients plus minus one standard deviation 35 12 range 11 59 significantly higher normal controls 129 049 range 03 23 p less 0005 three patient groups compared mean b2m level group 30 15 range 09 69 similar group c 422 11 range 20 64 mean b2m groups c significantly higher group b 238 102 range 04 54 p less 0001 group mean b2m decreased significantly 12month period reached mean level group b normal controls patients group b analyzed stage disease diagnosis significant difference stages ii significant difference mean b2m levels stages iii relapsing patients mean b2m levels increased findings suggest serum b2m levels may reflect tumor burden even patients followup occult tumor cells may activate immune system | 0 |
83 | effect indomethacin pain relief thoracotomy effect indomethacin postoperative pain studied 60 adult patients undergoing thoracotomy prospective randomized doubleblind manner patients receiving indomethacin required significantly less opioid operation significantly lower pain scores compared control group pain movement coughing reduced also major adverse effects encountered | 4 |
84 | intravital detection skin capillary aneurysms videomicroscopy indocyanine green patients progressive systemic sclerosis related disorders conventional capillaroscopy infrared fluorescence videomicroscopy indocyanine green performed nailfold 12 healthy controls 38 patients microangiopathy due systemic sclerosis related disorders saccular aneurysms featuring head neck type 1 aneurysmatic enlargements type 2 defined microaneurysms located apex near apex capillary loops significantly common patients controls p less 002 type 1 p less 0001 type 2 combination two lesions found patients appears valuable new diagnostic sign presence microangiopathy comparison conventional capillaroscopy twice many microaneurysms detected videomicroscopy indocyanine green coupling almost completely plasma proteins new technique allows visualization capillary aneurysms even filled plasma | 3 |
85 | isotretinoin refractory lupus erythematosus describe six patients cutaneous manifestations lupus erythematosus treated isotretinoin 1 mgkgday case cutaneous lesions proved resistant systemic corticosteroids antimalarial therapy treatment isotretinoin resulted rapid clinical improvement cases recurrences similarly rapid drug discontinued side effects minimal easily controlled adjustments dose use lubricants | 4 |
86 | expert testimony based decision analysis malpractice case report objective expert testimony malpractice cases often subjective biased decisionanalytic techniques might provide objective basis testimony design case report article reports case patient chest pain resulted malpractice suit alleging delay diagnosis coronary artery disease setting case occurred private practice expert witnesses decision analysis originated university teaching hospital methods decision tree threshold analysis used define thresholds disease probability either testing treatment implemented expert testimony two witnesses exercise stress testing standard care compared results decision analysis main results decision analysis supported view cardiac catheterization would appropriate test conclusions techniques decision analysis provide structured quantitative basis empirical judgment may help minimize current problems expert testimony | 4 |
87 | effect alcohol isolated blunt splenic trauma effect alcohol trauma patients controversial numerous authors citing difference mortality acutely intoxicated patients purpose study retrospectively investigate effect alcohol adult patients isolated blunt splenic injury 1980 1989 47 adult patients splenic trauma major injury admitted trauma service 37 males ten females mean age 29 years range 15 61 motor vehicle accidents responsible 44 94 injuries group 1 consisted 24 patients mean blood alcohol level 185 mgdl range 15 380 group 2 23 patients without detectable blood alcohol statistically significant differences two groups age abbreviated injury severity score initial hematocrit grade splenic injury hypotension present 13 patients 55 group 1 versus six patients 26 group 2 p less 005 significant abnormalities clotting studies present admission six patients 25 alcoholdetected group versus one group p less 005 blood transfusion requirements first 24 hours significantly greater group 1 mean 39 units versus group 2 mean 05 units p less 0001 alcohol present much less chance splenic conservation 18 patients 75 underwent splenectomy versus seven patients 30 nonalcohol group p less 005 one death occurred patient acutely intoxicated suffered cerebral infarct | 3 |
88 | arterial switch procedure adult arterial switch procedure shown offer anatomic physiologic correction infants children transposition great arteries ventricular septal defect believe adults may also benefit circumstances evidenced case 22yearold man underwent successful operation initially undergone pulmonary artery banding transposition ventricular septal defect 1967 5 months age | 3 |
89 | clinical performance st jude medtronichall prostheses randomized comparative study newer improved models mechanical prostheses regularly added surgeons armamentarium study designed compare clinical performance two used current models mechanical prostheses august 1983 july 1985 182 white patients prospectively randomized implantation st jude medical 95 patients medtronichall 87 patients prostheses 84 mitral 85 aortic 13 double mitral aortic valve replacements differences two groups regard sex distribution age functional class emergency operation site implantation early mortality 32 patients st jude valve 57 medtronichall p ns survivors followed 3 5 years mean 42 06 years cumulative followup 559 patientyears late mortality 71patientyear st jude group 32patientyear medtronichall group p less 005 however valverelated mortality equal 14patientyear groups noncardiac causes accounted difference st jude medtronichall groups 25patientyear 04patientyear respectively cases thrombotic obstruction whereas serious systemic thromboembolism occurred rate 18patientyear 5 episodes st jude group 25patientyear 7 episodes medtronichall group p significant another nine episodes systemic embolism left sequelae three patients st jude 2 medtronichall 1 aortic valve replacement required reoperation 05patientyear prosthetic endocarditis two deaths | 3 |
90 | function athymic nude mice parathyroid heterografts patients primary hyperparathyroidism secondary hyperparathyroidism heterotransplantation adenomatous parathyroid glandular tissue humans primary hyperparathyroidism athymic nude mice creates unique animal model disease mice manifest high concentrations midregioncterminal human parathyroid hormone biologically active intact human parathyroid hormone relative either mice implants mice received normal human parathyroid tissue secretion substances maintained mice least 9 13 months implantation addition animals experienced implantation exhibit characteristics associated human primary hyperparathyroidism including relative hypercalcemia increased renal 25hydroxyvitamin d1 alphahydroxylase activity also measured parameters group nude mice received transplantation similar mass hyperplastic parathyroid tissue obtained patients uremic secondary hyperparathyroidism although hypothesized level human parathyroid hormone secretion implants would fall time response normal host environment hormone levels remained high recipients adenomatous heterografts even 9 13 months moreover similar biologic effect excess parathyroid hormone ie relative hypercalcemia hyperphosphatasemia increased 125dihydroxyvitamin biosynthesis detected animal models prove extremely useful supplementing understanding hyperparathyroid disorder man | 4 |
91 | occult cancer patients deep venous thrombosis systematic approach authors prospectively studied 113 consecutive patients deep venous thrombosis lower extremities determine appropriate workup study searching hidden cancer careful physical examination following routine tests performed erythrocyte sedimentation rate esr whole blood counts biochemistry carcinoembryonic antigen cea levels chest radiograph upper gastrointestinal endoscopy abdominal ultrasound computed tomography ct scan malignant lesion suspected appropriate studies performed discharge periodic followup performed patients outpatient clinic malignant neoplasm detected 12 patients 12 patients six asymptomatic exception experiencing thrombophlebitis cancer found commonly patients idiopathic deep vein thrombosis dvt 7 31 versus 5 82 patients secondary dvt p 0012 patients abnormal lactic dehydrogenase ldh levels 6 23 versus 6 90 p 0007 abnormal cea levels allowed diagnosis two cases colonic cancer colonoscopy ultrasound ct scan abdomen showed two cases urinary bladder carcinoma early stage furthermore two cases adenomatous polyps colon found condition considered authors colorectal cancer precursor addition five patients large benign pelvic tumors two patients absent inferior vena cava striking finding cases cancer early stage concluded blood cell counts ldh cea chest radiograph abdominal ultrasonography ct scan routinely performed patients deep venous thrombosis particularly idiopathic dvt malignancy would recognized patients tests performed | 3 |
92 | prolonged burner syndrome course single football season six players evaluated medical staff burners displayed prolonged neurologic recovery players examined subsequently evaluated isokinetic testing electrodiagnostic studies elucidate better shortterm natural history prolonged burner syndrome evidence muscular weakness 72 hours postinjury best correlated positive electrodiagnostic findings correlation found initial physical examination findings results electrodiagnostic testing isokinetic strength evaluation demonstrated many relative strength differences difficult discern manual muscle testing return player athletic competition following injury largely based clinical examination | 4 |
93 | capillary hemangiomas treatment flash lamppumped pulsed dye laser strawberry capillary hemangiomas common vascular neoplasms incidence approximately 26 neonates usually develop first weeks life 1 month 1 year incidence rises 87 101 lesions may grow quite large first year life may ulcerate obstruct vital organ function great majority spontaneously regress first year life parents often alarmed sight hemangiomas need reassurance great majority regress spontaneously treatments cryosurgery irradiation radium instillation corticosteroid therapy surgical excision often ineffective cause significant morbidity describe 10 children capillary hemangiomas treated flash lamppumped pulsed dye laser patients ranged age 7 weeks 55 years beginning laser therapy patients underwent 31 1 mean sd laser treatments mean regression lesions 699 45 patients demonstrated diminution size color hemangiomas treatments ill effects ulceration hemorrhage infection scarring evidence hyperpigmentation hypopigmentation pulsed dye laser therapy considered option treatment capillary hemangiomas preferably prior full evolution also useful therapeutic approach hemangiomas slow regress older children | 0 |
94 | effects mk801 recovery sensorimotor cortex lesions histologic evidence suggests drugs acting noncompetitive antagonists nmethyldaspartate receptor beneficial pathologic effects central nervous system neurons present experiments examined effects mk801 recovery behavioral function unilateral lesions rat somatic sensorimotor cortex first experiment rats unilateral sensorimotor cortex lesions given either mk801 1 mgkg saline 1216 hours surgery additional injections given postoperative days 2 4 6 behavioral tests measured somatosensory asymmetries ie bilateral tactile stimulation tests forelimb placing creation sensorimotor cortex lesions rats showed ipsilateral somatosensory bias impairment placing contralateral forelimb rats treated mk801 recovered slightly faster salinetreated animals measured bilateral tactile stimulation test p less 005 contrast significant difference groups recovery forelimb placing second experiment rats sensorimotor cortex lesions treated single injection mk801 behavioral recovery twenty hours mk801 injection rats sensorimotor cortex lesions showed reinstatement placing deficits impairment endured least 7 days injection behavioral data support idea mk801 either beneficial detrimental effects administered brain damage | 2 |
95 | mucoid vasculopathy unknown etiology new vascular disorder generalized deposition abnormal amounts acid mucopolysaccharide amps material arteries veins vasanervorum observed large number autopsies authors institution unlike known vascular diseases emerged distinct disorder vascular connective tissue named mucoid vasculopathy unknown etiology hitherto unreported entity described | 3 |
96 | importance cytogenetic studies adult acute lymphocytic leukemia purpose prognostic importance pretreatment bone marrow cytogenetic studies adults acute lymphocytic leukemia treated single institution identical treatment program described patients methods total 105 patients documented morphologic diagnosis acute lymphocytic leukemia reviewed purpose analysis patients extensive workup presentation cytogenetic analysis performed 103 patients using giemsa banding technique trypsin pretreatment 24hour cultured cells results specific cytogenetic classification 103 patients karyotypic analysis follows diploid 27 philadelphia chromosomepositive 13 hyperdiploid 12 bcell karyotype 6 6q 14q abnormalities 4 pseudodiploid 8 hypodiploid 2 insufficient metaphases 28 bcell 6q 14q philadelphia chromosomepositive karyotypes tended correlate known negative prognostic factors patients diploid hyperdiploid pseudodiploid hypodiploid karyotypes insufficient metaphases could combined one group favorable prognosis group remission rate induction chemotherapy 89 median complete remission duration 26 months median survival 25 months 3year survival rate 45 patients philadelphia chromosomepositive bcell 6q 14q abnormalities collectively unfavorable prognosis response rate induction chemotherapy 65 median response duration 7 months median survival 8 months 3year survival rate less 10 conclusion conclude pretreatment bone marrow karyotype important part evaluation adults acute lymphocytic leukemia provides significant prognostic information | 0 |
97 | smooth muscle cell proliferation restenosis stand alone coronary excimer laser angioplasty shown coronary excimer laser angioplasty remove atherosclerotic intracoronary tissue stand alone coronary excimer laser angioplasty successfully performed 53 year old white man 90 stenosis left anterior descending coronary artery exertional angina canadian cardiovascular society class iii lesion reduced 30 residual stenosis use 12 mm subsequently 18 mm diameter laser catheter early followup angiography 24 h later revealed persistent patency unchanged lesion diameter target vessel patient free symptoms 2 month followup period died suddenly playing tennis tournament 63 days procedure postmortem histologic examination revealed 80 restenosis lesion site without plaque disruption thrombosis specific staining histologic specimen smooth muscle cells using alphaactin revealed significant smooth muscle cell proliferation site coronary excimer laser angioplasty however vessel narrowing appeared due underlying fibrotic plaque result insufficient tissue ablation probably related size currently available catheters small create large channel | 4 |
98 | late effects treatment wilms tumor report national wilms tumor study group national wilms tumor study nwts initiated 1969 one objectives modulate treatments according risk factors minimize number severity treatmentrelated shortterm longterm iatrogenic complications nwts therefore incorporated long term followup study ltfs within framework monitor late effects ltfs confined relapsefree survivors alive 5 years longer initial surgery data collected using specifically designed forms total 787 patients registered nwts1 nwts2 1969 1979 eligible 680 86 available analysis regarding musculoskeletal cardiovascular neuropsychologic status presence benign malignant tumors patients earlystage disease treated radiation scoliosis reported along musculoskeletal abnormalities 32 versus 2 nearly seven times often members cohort population undergo radiation 35 57 versus 5 53 respectively difference cardiovascular problems recorded survivors receive adriamycin adria laboratories columbus oh 24 versus 11 per 100person years risk borderline statistical significance p 006 excess neuropsychologic events reported given neurotoxin vincristine considering patients disease stages 5 second malignant tumors occurred 623 patients underwent radiation rt patients benign tumors also frequent rt patients patients undergo radiation 41 486 8 versus 4 194 2 continuing study unique body patients needed especially given adriamycin known long interval needed latent cardiomyopathy become clinically manifest patients | 3 |
99 | diagnosis oral hairy leukoplakia ultrastructural examination exfoliative cytologic specimens lingual exfoliative cytologic specimens scrapings obtained 18 patients positive human immunodeficiency virus clinical oral hairy leukoplakia buccal mucosal scrapings obtained 12 patients specimens processed examination transmission electron microscopy tem sixteen 89 lingual specimens revealed infection keratinocytes herpestype virus evidence virus infection 12 buccal mucosal scrapings fungal hyphae seen tem 14 78 lingual scrapings two 17 buccal scrapings one exfoliative specimen two biopsy specimens stained epsteinbarr virus dna dna probe demonstration herpestype virions tem keratinocytes lesion clinically suspected hairy leukoplakia provides direct objective diagnosis furthermore use exfoliative cytologic specimens provides clinically simple noninvasive technique | 0 |
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