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100 | coagulation studies syndrome haemolysis elevated liver enzymes low platelets presence disseminated intravascular coagulation dic syndrome haemolysis elevated liver enzymes low platelets hellp debated assessed occurrence decompensated compensated dic using predefined criteria 15 consecutive nulliparous pregnant patients gestational hypertension combined hellp syndrome 12 consecutive nulliparous controls pregnancy induced hypertension pih without hellp syndrome combination routine coagulation assays revealed absence decompensated dic studied patients however using specific sensitive coagulation assays compensated dic observed hellp patients three patients control group mean values antithrombin iii thrombinantithrombin iii complexes protein c hellp control group 66 vs 87 p 00004 21 vs 8 ngml p 00008 57 vs 90 p 00018 respectively conclude hellp patients show evidence compensated dic may pathophysiological significance observed organ damage | 4 |
101 | human doseresponse relationship decompression endogenous bubble formation doseresponse relationship decompression magnitude venous gas emboli vge formation humans examined pressure exposures 138 150 164 kpa 12 16 205 ft seawater gauge pressure conducted underwater habitat 48 h 111 human male volunteer subjects ascended directly surface less 5 min monitored vge continuouswave doppler ultrasound device precordium subclavian veins regular intervals 24h period signs symptoms consistent decompression sickness occurred however large incidence vge detection noted data combined previously reported experiments higher pressures data fit hill doseresponse equation nonlinear leastsquares maximum likelihood routines highly significant fits precordial vge incidences obtained hill equation saturation depth pressure 50 probability detectable vge dvge50 150 12 kpa subclavian monitoring increased sensitivity vge detection resulted leftward shift dvge50 135 2 kpa bestfit curve conclude reduction pressure necessary produce bubbles humans much less previously thought 50 humans expected generate endogenous bubbles decompression steadystate pressure exposure 135 kpa 11 ft seawater may significant implications decompression schedule formulation altitude exposures currently considered benign results also imply endogenous bubbles arise preexisting gas collections | 3 |
102 | development antibodies thrombin factor v recurrent bleeding patient exposed topical bovine thrombin 65 year old patient exposed topical bovine thrombin cardiac surgery developed markedly prolonged clotting times severe bleeding diathesis mixing studies normal plasma failed correct clotting times platelet transfusions immunosuppressive immunomodulatory therapies ineffective plasmapheresis effective decreasing clotting times resolution clinical bleeding events patients purified igg reacted bovine thrombin immunoblotting enzymelinked immunosorbent assay elisa however igg reacted minimally human thrombin view severe bleeding coexisting inhibitor sought patients factor v activity 1 normal corrected mixing normal plasma demonstrating presence inhibitor factor v patients igg reacted bovine human factor v immunoblotting localized site antibody binding light chain activated bovine factor v detectable amounts bovine factor v found commercial bovine thrombin preparations elisa data suggest patients exposed topical bovine thrombin may develop antibodies thrombin factor v antithrombin antibodies may mask coexisting factor v inhibitors responsible clinical bleeding | 4 |
103 | extracranial repair cerebrospinal fluid fistulas technique results 37 patients although neurosurgeons traditionally preferred intracranial repair management cerebrospinal fluid csf fistulas approach associated complications craniotomy anosmia high incidence recurrent fistulas extracranial repair hand produces central nervous system morbidity preserves olfaction associated low incidence recurrence although several reports extracranial repair csf fistulas otorhinolaryngologists approach received scant mention neurosurgical literature report experience 37 patients csf rhinorrhea otorrhea underwent extracranial repair etiology fistula postoperative 22 traumatic 6 spontaneous 9 fistulas repaired using one four techniques external ethmoidsphenoid 18 patients transmastoid 9 transseptosphenoid 7 osteoplastic frontal sinusotomy 3 32 37 patients 86 fistulas successfully repaired initial procedure 5 patients requiring second operation fistula successfully closed 4 overall success rate 97 complications consisted transient facial paresis patient undergoing transmastoid repair one death meningitis authors conclude low morbidity mortality high success rate closing fistulas extracranial repair preferred technique operative management csf rhinorrhea otorrhea | 4 |
104 | 18f2deoxy2fluorodglucose uptake human tumor xenografts feasibility studies cancer imaging positronemission tomography positronemitting glucose analogue 18f2fluoro2deoxydglucose fdg evaluated accretion following subcutaneous human tumor xenografts nude mice bcell lymphoma namalwa raji ovarian carcinoma htb77 colon cancer sw948 choriocarcinoma bewo bladder cancer umuc2 renal cell carcinoma umrc3 neuroblastoma mey melanoma htb63 small cell lung carcinoma nci69 two hours postinjection tumor uptakes ranged 0027 colon cancer 0125 kg injected doseg melanoma greater 0085 namalwa lymphomas renal cell carcinomas tumorblood ratios 231 seen 2 hours postinjection melanoma mean tumorblood ratio tumors 123 18 uptake tumors intermediate evaluated tumor uptake slightly greater 1 2 hours postinjection although targetbackground ratios generally higher 2 hours postinjection compound fdg may broad applicability tracer positronemission tomographic imaging many human malignancies | 0 |
105 | magnetic resonance imaging tomographic evaluation occlusal appliance treatment advanced internal derangement temporomandibular joint study evaluates positional relationship disc mandibular condyle patients late opening clicks treated appliance therapy total 30 joints 18 patients studied twentyseven 30 joints treated appliance joints silent auscultation patients evaluated axial corrected tomography magnetic resonance imaging mri centric occlusion position bite appliance svedtype place comparisons made condyle position centric occlusion appliance place magnetic resonance imaging used evaluate disc positional changes imaging procedure made sagittal plane changes condyle positioning could identified evidence disc repositioning appliance place seen three mri examinations remaining 27 joints continued exhibit disc displacement various changes disc morphology concluded concept disc capture clinical term perceived clinical success lead assumption actual change intraarticular anatomic relationships occurred joint noises may decrease joint space increased allowing smoother condylar translation beyond disc surface irregularities positional abnormalities | 2 |
106 | therapy acute infectious diarrhea children article reviews current recommendations therapy antidiarrheal compounds antimicrobial agents acute infectious diarrhea children infants children acute infectious diarrhea treatment antidiarrheal compounds indicated many compounds interfere identification enteropathogens stool specimens antimotility class overdose potential antimicrobial therapy given reduce symptoms prevent spread infection decreasing fecal shedding organisms although effective therapy available patients enteric viruses cryptosporidium microsporidium therapy useful children amebiasis antimicrobialassociated colitis cholera giardiasis various forms escherichia coli diarrhea salmonella disease isosporiasis shigellosis strongyloidiasis several conditions antimicrobial therapy questionable benefit infection campylobacter jejuni yersinia enterocolitica intestinal salmonellosis enterohemorrhagic e coli infection compounds fluoroquinolones effective treatment acute infectious diarrhea adults approved use children potential side effects many bacterial viral parasitic organisms cause acute infectious diarrhea appropriate antimicrobial therapy requires accurate rapid identification offending enteropathogen children underlying illness acquired immunodeficiency syndrome manifestations may prolonged severe recurrent despite appropriate therapy | 1 |
107 | parathyroid hormonerelated peptide lactation umbilical cord blood parathyroid hormonerelated peptide pthrp expressed lactating rat mammary glands suckling result increases prolactin rather suckling per se addition pthrp produced fetal parathyroid glands placenta may responsible stimulation placental calcium transport current study used radioimmunoassay human pthrp measure levels peptide 1 human breast milk cows milk two infant formulas 2 sequential plasma samples prepartum postpartum lactating women 3 women pathologic hyperprolactinemia 4 human umbilical cord blood normal subjects plasma pthrp levels ranged less 2 5 pmolliter contrast human breast milk contained substantially increased levels immunoreactive pthrp similar elevations found cows milk one infant formula column chromatography breast milk demonstrated pthrp immunoreactivity included region adenylate cyclase stimulating activity consistent presence biologically active pthrp plasma prepartum pthrp values differ corresponding postpartum values lactating women women hyperprolactinemia mean plasma pthrp value highnormal range umbilical cord blood considerably suppressed parathyroid hormone values pthrp levels indistinguishable normal human plasma thus pthrp present high concentrations breast milk apparently gain access maternal circulation significant amounts addition women pathologic hyperprolactinemia seem increased levels circulating pthrp | 2 |
108 | primary renal lymphoma lymphoma arising kidney rare although 31 cases reported literature likely neoplasms arise kidney report describes two cases primary renal lymphoma compares clinical presentation diagnostic modalities treatment survival previously reported patients satisfied criteria diagnosis primary renal lymphoma | 0 |
109 | deceptive bizarre stromal cells polyps ulcers gastrointestinal tract clinical pathologic features 33 pseudomalignant lesions gastrointestinal tract bizarre stromal cells reported deceptive histologic changes identified ulcers seven patients inflammatory polyps 26 misdiagnosis malignant neoplasm made six 33 patients three polyps three ulcers history gastrointestinal bleeding andor inflammatory bowel disease common bizarre stromal cells usually distributed beneath ulcerated mucosa within granulation tissue stained strongly vimentin 20 23 cases bizarre cells also stained muscle specific actin seven 23 cases cells appear reactive fibroblasts myofibroblasts followup information obtained 24 33 patients including four six cases initially diagnosed malignant revealed 22 patients alive without evidence malignant neoplasm average followup 13 months two patients died causes correct recognition bizarre stromal cells gastrointestinal ulcers inflammatory polyps prevent potentially serious diagnostic pitfall | 4 |
110 | new chemotherapies ovarian cancer systemic intraperitoneal podophyllotoxins epipodophyllotoxin derivatives etoposide teniposide evaluated intermittently possible use treatment ovarian cancer conflicting studies suggest variables dose prior treatment major influence outcome response rates ranged 0 40 five series teniposide less 10 overall response rate greater 10 complete response rate nine studies etoposide one study documented activity oral etoposide however patients received various prior chemotherapies firm conclusions regarding activity etoposide could drawn results expectation synergy etoposide cisplatin led several studies combined etoposide platin compounds systemic intraperitoneal ip routes various studies used intravenous drug combinations agents previously treated untreated patients one study used carboplatin instead cisplatin reported seven failures among 26 previously untreated patients conversely prominent toxicities reported another study discouraging responses exceed might expected cisplatin alone studies analogous combinations administered ip ongoing favorable experience initially reported university california san diego group confirmed investigators prompted incorporation etoposide firstline strategies pharmacologic advantage etoposide ip route related high protein binding may provide appropriate dose intensity ip disease sparing systemic toxicities finally systemic dose intensity autologous bone marrow support indicates promise etoposide combination highdose alkylating drugs | 0 |
111 | clinicopathological study paraneoplastic neuromuscular syndromes associated lung cancer highest incidence remote neuromuscular disorders cancer previously reported lung carcinoma clinical incidence neuromuscular disorder estimated correlated muscle histology histological type lung tumour 100 patients lung carcinoma studied prospectively thirtyfive patients small cell carcinoma 65 patients nonsmall cell lung cancer clinically 33 patients polymyopathy 18 cachectic myopathy 15 proximal myopathy two patients lamberteaton myasthenic syndrome one presented dermatomyositis one evidence ectopic acth production cachexia common nonsmall cell cancer proximal myopathy common small cell cancer ninetynine patients abnormal muscle histology 74 type ii atrophy 12 type ii atrophy one type atrophy 12 necrosis majority patients affected subclinically clinical entities cachectic proximal myopathy correspond previous pathological classifications atrophy related duration tumour symptoms ageing clinical type myopathy histological type lung tumour statistically different seen controls qualitatively presence weight loss muscle wasting metastatic disease factors development atrophy similarly necrosis related type lung tumour presence metastases ageing weight loss muscle wasting duration tumour symptoms clinical form myopathy study demonstrates lung carcinoma direct effect motor unit including atrophy necrobiotic myopathy lamberteaton myasthenic syndrome clinical assessment accurately assess remote neuromuscular effects cancer motor unit | 0 |
112 | parental history independent risk factor coronary artery disease framingham study family history cad defined parental death cad found significant independent predictor cad logistic regression model controlling standard risk factors length followup among 5209 participants framingham study persons positive parental history 29 increased risk cad strength association parental history cad similar found standard risk factors systolic blood pressure cholesterol level cigarette smoking evidence found persons family history cad decreased capacity cope deleterious effects known risk factors significant interaction found risk factors parental history cad among men low risk cad riskfactor profile ie nonsmoking thin nonhypertensive persons two thirds experience cad positive parental history study suggests cad among persons predicted low risk standard risk factors may substantial genetic component risk associated parental history may reduced modification factors nevertheless among persons positive family history favorable risk profile substantially less risk cad unfavorable risk profile | 3 |
113 | razorblade surgery razor blade valuable tool performance many minor surgical procedures extremely sharp flexible inexpensive readily available easy use technique specific applications reviewed discussed | 0 |
114 | strabismus caused melanoma metastatic extraocular muscle nonocular melanoma rarely metastasizes orbit report case melanoma presumably arising axillary lymph node sinus metastasized left medial rectus muscle causing proptosis diplopia reduced saccadic velocity measurements clinical radiographic histopathologic data presented discussed | 0 |
115 | randomized controlled trial prophylactic ganciclovir cytomegalovirus pulmonary infection recipients allogeneic bone marrow transplants city hopestanfordsyntex cmv study group background cytomegalovirus cmvassociated interstitial pneumonia major cause death allogeneic bone marrow transplantation conducted controlled trial ganciclovir recipients bone marrow transplants asymptomatic pulmonary cmv infection also sought identify risk factors development cmv interstitial pneumonia methods bone marrow transplantation 104 patients evidence respiratory disease underwent routine bronchoalveolar lavage day 35 40 patients positive cultures cmv randomly assigned either prophylactic ganciclovir observation alone ganciclovir 5 mg per kilogram body weight intravenously given twice daily two weeks five times per week day 120 results 20 culturepositive patients received prophylactic ganciclovir 5 25 percent died cmv pneumonia day 120 compared 14 20 culturepositive control patients 70 percent treated prophylactically relative risk 036 p 001 patient received full course ganciclovir prophylaxis went cmv interstitial pneumonia four patients treated ganciclovir maximal serum creatinine levels greater equal 221 mumol per liter 25 mg per deciliter compared none controls p 0029 55 cmvnegative patients could evaluated 12 22 percent cmv pneumoniaa significantly lower rate untreated cmvpositive control patients relative risk 033 p 0003 strongest predictors cmv pneumonia lavagefluid culture positive cmv cmvpositive blood culture specimens obtained day 35 conclusion recipients allogeneic bone marrow asymptomatic cmv infection lung major risk factor subsequent cmv interstitial pneumonia prophylactic ganciclovir effective preventing development cmv interstitial pneumonia patients asymptomatic infection | 0 |
116 | pharmacological versus nonpharmacological prophylaxis recurrent migraine headache metaanalytic review clinical trials order generate information relative effectiveness widely used pharmacological nonpharmacological interventions prophylaxis recurrent migraine ie propranolol hcl combined relaxationthermal biofeedback training metaanalysis used integrate results 25 clinical trials evaluating effectiveness propranolol 35 clinical trials evaluating effectiveness relaxationbiofeedback training 2445 patients collectively metaanalysis revealed substantial similar improvements obtained propranolol relaxationbiofeedback training daily recordings used assess treatment outcome propranolol relaxationbiofeedback yielded 43 reduction migraine headache activity average patient improvements assessed using outcome measures eg physiciantherapist ratings improvements observed treatment 20 greater cases improvements observed propranolol relaxationbiofeedback significantly larger improvement observed placebo medication 14 reduction untreated patients reduction metaanalysis thus revealed substantial empirical support effectiveness propranolol relaxationbiofeedback training revealed support contention two treatments differ effectiveness results suggest greater attention paid determining relative costs benefits widely used pharmacological nonpharmacological treatments | 2 |
117 | results treatment displaced patellar fractures partial patellectomy results partial patellectomy treatment displaced patellar fractures assessed retrospectively use clinical radiographic isokinetic strengthtesting criteria forty patients followed average 84 years studied extremity operated mean active range motion 94 per cent circumference thigh 100 per cent strength quadriceps 85 per cent measurements contralateral extremity overall result rated excellent twenty patients good eleven fair six poor three significant statistical correlation type fracture outcome results study indicate partial patellectomy effective treatment selected patellar fractures | 2 |
118 | predictors morbidity mortality neonates herpes simplex virus infections national institute allergy infectious diseases collaborative antiviral study group background controlled trial comparing acyclovir vidarabine treatment neonatal herpes simplex virus hsv infection found significant difference treatments adjusted mortality morbidity hence sought define entire cohort n 202 clinical characteristics best predicted eventual outcome neonates methods data gathered prospectively 27 centers 1981 1988 infants less one month age virologically confirmed hsv infection examined outcomes multivariate analyses 24 variables disease classified one three categories based extent involvement entry trial infection confined skin eyes mouth encephalitis disseminated infection results conclusions deaths among 85 infants localized hsv infection mortality rate significantly higher 46 neonates disseminated infection 57 percent 71 encephalitis 15 percent addition risk death increased neonates near coma entry relative risk 52 disseminated intravascular coagulopathy relative risk 38 premature relative risk 37 babies disseminated disease hsv pneumonitis also associated greater mortality relative risk 36 survivors morbidity frequent infants encephalitis relative risk 44 disseminated infection relative risk 21 seizures relative risk 30 infection hsv type 2 relative risk 49 hsv infection limited skin eyes mouth presence three recurrences vesicles associated increased risk neurologic impairment compared two fewer recurrences | 2 |
119 | management pseudomyxoma peritonei management nine patients pseudomyxoma peritonei reviewed aggressive surgical resection tumor standard treatment many patients requiring multiple laparotomies chemotherapy including use cisplatin effective longterm nutritional support provides better quality survival select patients | 1 |
120 | transscleral application semiconductor diode laser used diode laser output power 1 w fiberoptic light pipe 200 microns diameter deliver laser energy sclera pigmented rabbits ciliary body destruction occurred energy levels 300400 mw exposure time 05 sec retinal photocoagulation achieved energy levels 200500 mw 05 sec histologic examination acute lesions demonstrated thermal destruction ciliary body processes retina chorioretinal scar formation observed clinically histologically within 23 weeks data indicate transscleral diode laser may used destruction ciliary body processes peripheral retinal coagulation pigmented eyes | 4 |
121 | dosedependent reduction myocardial infarct size perfluorochemical fluosolda perfluorochemical fluosolda shown reduce infarct size however doseresponse relationship agent unknown perfluorochemicals pfc potentially saturate reticuloendothelial system decrease carbon clearance well cause transient elevation liver enzymes present study conducted determine lowest effective dose new zealand white rabbits n 73 randomly selected prior infarction receive 10 15 20 25 30 mlkg pfc equivalent volume 5 dextran control intravenously animals underwent 30 minutes coronary artery occlusion pfc dextran infused 30minute period starting 20 minutes occlusion animals put death 24 hours infarct size determined histologically quantitated computerized planimetry neutrophil infiltration ischemic myocardium evaluated semiquantitatively hemodynamic differences noted within groups infarct size similar controls animals treated 10 15 mlkg pfc significant infarct size reduction however noted animals treated 20 25 30 mlkg pfc versus controls p 005 004 002 respectively maximal infarct size reduction seen 30 mlkg pfc 35 neutrophil infiltration significantly decreased groups treated pfc results show intravenous fluosolda significantly reduces infarct size minimal dose 20 mlkg | 3 |
122 | sudden death caused coronary artery aneurysms late complication kawasaki disease authors describe three cases two blacks one latin american sudden death caused late complications kawasaki disease mucocutaneous lymph node syndrome autopsy heart contained multiple coronary artery aneurysms luminal stenosis caused intimal hyperplasia thrombi although virtually fatal cases kawasaki disease occur within six months onset symptoms reported deaths 14 years acute illness coronary artery aneurysms kawasaki disease may persist cause death years acute illness | 3 |
123 | small noncleavedcell lymphoma undifferentiated lymphoma burkitts type american adults results treatment designed acute lymphoblastic leukemia purpose small noncleavedcell lymphoma sncl burkitts type rapidly growing lymphoma rare among adults united states greatly increased incidence acquired immunodeficiency syndrome epidemic report details results treatment adult sncl series protocols originally designed treatment acute lymphoblastic leukemia patients methods july 1973 may 1987 29 adults newly diagnosed sncl treated memorial hospital intensive chemotherapy originally designed cyclophosphamide l2 l10 l17 l20 protocols nine patients positive serologies human immunodeficiency virus hiv infection one patient measurable disease resected evaluable response results sixteen 28 evaluable patients 57 achieved complete remission treatment followup long 153 months median 47 months 50 patients 59 patients negative unknown hiv serologies survived probably cured patients initial serum lactic acid dehydrogenase ldh level greater 500 ul significantly shortened survival compared lower serum ldh pretreatment patient characteristics associated shortened survival borderline statistical significance high national cancer institute stage c bone marrow involvement results similar lymphoblastic lymphoma comparable american sncl literature conclusions approximately one half adults sncl curable intensive chemotherapy intensive chemotherapy hematopoietic growth factor andor autologous bone marrow peripheral stem cell support may increase curability | 4 |
124 | seizure outcome anterior complete corpus callosotomy eighty patients underwent anterior corpus callosotomy treatment generalized seizures patients mean age 183 years range 4 53 years mean age seizure onset 527 years range 01 27 years mean intelligence quotient iq 41 testable patients 7112 range less 30 114 seizure outcome follows 13 seizurefree 65 significantly improved 22 unchanged ten patients subsequently underwent second operation complete callosal sectioning resulted additional seizure improvement five five complications resulted 90 operations two epidural hematomas one delayed subdural hematoma one boneflap infection one postcallosotomy disconnection syndrome two patients died younger age onset seizures higher iq generalized tonicclonic atonic complexpartial mixed seizure types associated improved seizure outcome | 4 |
125 | high incidence antibodies htlvi tax blood relatives adult cell leukemia patients adult cell leukemia atl caused human cell leukemia virus type htlvi although mechanisms leukemogenic process unknown tax gene may role process clustering occurs htlvi atl members atl families examined antibodies tax protein compared matched htlvipositive blood donors investigate antibody response protein plasmid pbhx4 constructed express recombinant tax protein rtax atl patients htlvi antibodypositive blood relatives rate seroreactivity rtax protein 673 3552 compared 516 97188 htlvi antibodypositive control blood donors p less 05 difference direct offspring atl patients matched htlvi blood donors even greater 842 1691 vs 442 4295 p less 005 thus tax antibody positivity direct offspring atl patients may reflect differences time route htlvi infection alternatively might reflect genetic differences host susceptibility virus strain | 0 |
126 | intrapericardial infusion 5fluorouracil unusual complication hickman catheter venous access devices vad become important tool management patients cancer multiple complications occur consequence insertion vad authors report case hickman catheter perforating wall superior vena cava pericardium resulting accidental intrapericardial infusion 5fluorouracil 5fu pericarditis cardiac arrhythmias developed patient cardiac tamponade recovered event without apparent chronic cardiac dysfunction | 0 |
127 | coumadininduced gastrointestinal hemorrhage associated ileal duplication 31yearold man recurrent gastrointestinal hemorrhage aortic valve replacement initiation anticoagulation therapy coumadin radionuclide bleeding scan subsequent contrast angiogram demonstrated site hemorrhage distal ileum surgery 18cm spherical duplication found histologic examination duplication lined normal ileal mucosa near mouth duplication inflammatory ulceration proved site hemorrhage young patient anticoagulationassociated gastrointestinal hemorrhage alimentary tract duplication considered | 4 |
128 | response rates relapsed wilms tumor need new effective agents three hundred eightyone children wilms tumor treated united kingdom childrens cancer study group wt1 study 1982 1986 seventyone patients relapses treatment surgery chemotherapy radiation therapy depending stage histologic characteristics fortynine patients evaluable disease response secondline chemotherapy alone evaluation response chemotherapy impossible remaining patients either surgery radiation therapy used time relapse secondline combination chemotherapy included ifosfamide etoposidevm26 cisplatincarboplatin bleomycin melphalan thiotepa lederle laboratories pearl river ny five complete responses 12 partial responses patients favorable histologic findings six nine stage five ten stage ii none 11 stage iii three 16 stage iv one five stage v disease survived two survivors treated chemotherapy alone others received combined treatment chemotherapy radiation therapy andor surgery unfavorable histologic findings stage two 20 survived authors conclude even patients localized disease favorable histologic findings salvage rate little 50 stages histologic findings likelihood cure relapse remote clearly need additional effective chemotherapeutic agents patients | 0 |
129 | prostatic urethra dilatation gianturco selfexpanding metallic stent feasibility study cadaver specimens dogs effort develop transcatheter technique dilatation prostatic urethra without use balloons feasibility using gianturco selfexpanding stents evaluated initially eight human cadaveric prostatic urethras stented evaluate ability stent dilate lumen cases device attained unconstrained diameter immediately placement subsequently stents placed prostatic urethra 12 dogs followed 1 month four dogs 3 months one dog 6 months seven dogs five bare straightend prostheses one nyloncovered straightend device six flaredend stents used three bare straightend stents migrated followup whereas nyloncovered flaredend stents stent diameters greater 13 times urethral diameter caused moderate marked edema inflammation 6 months white deposits found solder points presumably electrolysis experience suggests placement gianturco selfexpanding stents may useful method dilating maintaining luminal diameter prostatic urethra although care must taken select proper stent size | 4 |
130 | reverse coitus mechanism urethral injury male partner reverse coitus rarely used sexual position makes male urethra vulnerable injury pubic arch symphysis pubis female partner severe pain bleeding immediate detumescence observed 3 patients lesion usually occurred fossa navicularis responded well conservative management hinder micturition potency well preserved 3 patients | 4 |
131 | vitro anticolon antibody production mucosal peripheral blood lymphocytes patients ulcerative colitis published erratum appears gut 1991 apr324460 serum anticolon antibody vitro anticolon antibody production peripheral blood mucosal lymphocytes investigated patients ulcerative colitis frequency serum anticolon antibody 71 41 patients ulcerative colitis estimated enzyme linked immunosorbent assay elisa using isolated rat colon epithelial cells finding confirms previous report frequency serum anticolon antibody detected flow cytometry analysis estimated frequencies igg anticolon antibody secreting cells 15125106 cells colonic mucosa 0105106 cells peripheral blood patients ulcerative colitis epsteinbarr virus ebv used b cell polyclonal activator poisson analysis limiting dilution culture showed one per 140 igg cells colonic mucosa synthesised anticolon antibody two monoclonal igg antibodies obtained ebv transformed anticolon antibody secreting cells limiting dilution method one reacted goblet cells intestine reacted mainly colonic epithelial cells results suggest heterogeneous anticolon antibodies present patients ulcerative colitis colonic mucosa may main source anticolon antibody local autoimmune reaction might important role causing inflammation colonic mucosa disease | 1 |
132 | low birth weight children behavior problems school difficulty national sample addressed three questions concerning behavioral academic status low low birth weight infants secondary analysis 1981 national health interview surveychild health supplement 1 children born low birth weight risk behavior problems school difficulty compared heavier low birth weight normal birth weight children 2 correlates school difficulty 3 behavior problems associated school difficulty variables controlled correlates analysis revealed 34 low birth weight children could characterized school difficulty compared 20 14 groups respectively likely higher scores hyperactive subscale behavior problems index although broad array sociodemographic factors correlated school difficulty low birth weight hyperactivity scores contributed independently risk academic problems conclude low birth weight infants risk school problems part associated hyperactive behavior | 4 |
133 | postischemic seizures necrotizing ischemic brain damage neuroprotective effect postischemic diazepam insulin insulin recently shown experimentally modify ischemic brain damage administered either episode ischemia controlled studies rat high doses insulin greater equal 8 iukg result seizures early death present study undertaken determine whether diazepam potent centrally penetrating gabamimetic alone combination insulin could mitigate postischemic seizures regional selective neuronal necrosis infarction forebrain ischemia induced rats 10 12 minutes carotid clamping hypotension animals observed clinically elective perfusionfixation quantitative pathologic examination 1week recovery diazepam either alone insulin reduced regional brain necrosis reduced seizure rate insulin alone also led reduced regional necrosis however combination diazepam plus insulin yielded greatest proportion undamaged brains hippocampus thalamus midbrain neocortex diazepamonly group showed greatest number normal hemispheres hypothalamic infarction eliminated three treatments seizures per se associated increased damage cerebral cortex thalamus brainstem irrespective treatment group findings indicate ischemic brain necrosis mitigated diazepam insulin treatment begun immediate postischemic period | 2 |
134 | dietary intake patients acquired immunodeficiency syndrome aids patients aidsrelated complex serologically positive human immunodeficiency virus patients correlations nutritional status one major clinical manifestations acquired immunodeficiency syndrome aids aidsrelated complex arc development cachexia likely results multifactorial interplay poor diet malabsorption altered metabolism assess potential role nutrient intake development persistence malnutrition detailed analysis performed 72hr diet record clinically stable patients aids n 18 arc n 12 human immunodeficiency virus hiv seropositive controls without significant manifestations disease n 13 total calorie intake 391 132 kcalkgday aids patients vs 346 78 kcalkgday arc patients 319 177 kcalkgday hiv seropositive cases p ns likewise mean protein intakes similar among groups exceeded recommended daily dietary allowance rda guidelines mean body weight changes inception illness 11 1 aids 6 7 arc vs 3 2 hivseropositiveonly cases p less 005 vs aids arc dietary vitamin mineral analysis revealed 88 aids 88 hiv seropositive 89 arc patients ingesting less 50 rda least one nutrient mean number deficiencies per patient 18 13 aids 38 35 arc 29 25 hivseropositiveonly cases p less 005 aids vs arc significant correlations specific anthropometric measurements dietary intakes protein fat | 4 |
135 | measurement ddimer plasma diagnostic aid suspected pulmonary embolism potential plasma measurement ddimer dd specific derivative crosslinked fibrin diagnosis exclusion pulmonary embolism investigated prospective series 171 consecutive patients attended emergency department suspected pulmonary embolism diagnosis made excluded means clinical decisionmaking process included clinical evaluation ventilationperfusion vq lung scan indicated pulmonary angiography venography noninvasive examination leg veins pulmonary embolism diagnosed process 55 32 170 patients sufficient data 1 55 patients dd concentration 500 microgramsl sensitivity specificity cutoff concentration presence pulmonary embolism 98 39 respectively give positive negative predictive values 44 98 among 115 patients 68 inconclusive vq scans 31 diagnosed pulmonary embolism 29 remaining 84 patients without pulmonary embolism dd concentrations 500 microgramsl means diagnostic procedures could avoided quarter patients inconclusive vq scans sensitivity plasma measurement dd remained high even 3 7 days presentation 96 93 plasma measurement dd therefore definite place diagnostic procedure suspected acute pulmonary embolism attenders emergency departments concentration 500 microgramsl rules diagnosis | 4 |
136 | renal function obstructive jaundice man cholangiocarcinoma model renal function respect water clearance renal hemodynamics studied 15 patients obstructive jaundice due cholangiocarcinoma results compared control normal subjects change renal function patients mild moderate jaundice total serum bilirubin 80 151 mgdl increased urinary sodium excretion decreased free water negative water clearances observed patients severe jaundice total serum bilirubin 270 404 mgdl normal serum albumin renal blood flow normal creatinine clearance decreased severely jaundiced patients serum bilirubin 305 401 mgdl hypoalbuminemia urinary sodium excretion free water clearance negative water clearance renal blood flow creatinine clearance decreased salt water retention group findings suggest severe jaundice inhibition sodium chloride reabsorption thick ascending limb henles loop adh increased hydraulic conductivity collecting tubules possibly contribute decreased free water clearance severely jaundiced patients hypoalbuminemia salt losing effect converted salt retention increased proximal tubular reabsorption sodium | 4 |
137 | treatment congenital coronary arteriovenous malformations microparticle embolization successful treatment symptomatic coronary arteriovenous malformation cavm percutaneous embolization technique microparticles described objective evidence ischemia subsequent disappearance embolization presented embolization technique possible indications contraindications discussed | 3 |
138 | immunohistochemical detection pglycoprotein endometrial adenocarcinoma pglycoprotein pgp emerged central mediator classic multidrug resistance model systems vitro high levels pgp also detected many normal human tissues tumors role clinical drug resistance currently investigation recently significant levels pgp localized gravid secretory endometrium demonstrated combination estrogen progesterone sufficient induce high levels pgp mrna pgp uterine secretory epithelium findings suggest increased pgp expression also may present hormoneresponsive malignancies endometrial adenocarcinoma determine whether pgp expressed endometrial adenocarcinoma 36 endometrial adenocarcinomas grade n 17 grade ii n 6 grade iii n 13 investigated retrospectively avidinbiotincomplex immunohistochemical procedure using three murine monoclonal antibodies mab mab c219 mab c494 mab jsb1 recognize spatially distinct cytoplasmic epitopes pgp seventytwo percent tumors showed positive immunostaining least one mab 67 showed immunostaining mab c219 50 mab c494 62 mab jsb1 fortysix percent tumors immunoreactive two 29 three antibodies membranous golgiparanuclear type staining patterns observed overall intensity immunostaining varied one sample another given tumor type considerable heterogeneity expression commonly seen within given tumor strong moderate immunoreactivity seen diffusely infiltrating adenosquamous serous papillary carcinomas general immunoreactivity mab c494 weaker mab c219 mab jsb1 adenomatous nonneoplastic endometrium adjacent tumors displayed strong membranous immunostaining mab jsb1 endometrial capillaries showed weaktomoderate immunostaining three antibodies concluded pgp commonly expressed endometrial adenocarcinoma may significant factor responsible drugresistant nature subject modulation progesterone | 0 |
139 | acute dissection internal mammary artery fatal complication coronary artery bypass grafting case acute traumatic dissection right internal mammary artery presented patient imas grafted recurrent angina 10 years initial vein coronary revascularisation event mistaken spasm severe circulatory collapse time available treat patient appropriately purpose report facilitate early recognition avoidance potentially fatal complication | 4 |
140 | protection small intestine irradiation means removable prosthesis radiation therapy tumors several techniques used prevent injury intestinal loops purpose drive intestine external beam understanding disadvantages present temporary prosthesis effectively protects small bowel easy remove developed device 600 1000 ml silicone rubber expandable balloon implanted pelvis retroperitoneal cavity filled balloon displaces intestinal loops pelvic irradiation field may remain either filled empty irradiation session due particular elliptical shape empty balloon removed 3 cm incision local peridural anesthesia completion radiotherapy eleven patients recurrent 8 primary 3 cancer implanted protective effect evaluated successive biologic tests performed treatment problem related prosthesis alteration biologic tests bowel injury observed several months followup device suitable preventing intestinal complications therapy allowing higher dose radiations cases | 0 |
141 | chromosomes childhood acute lymphoblastic leukaemia karyotypic patterns disease subtypes define clinical importance cytogenetic analysis acute lymphoblastic leukaemia prospective study performed 139 unselected children analyses considered adequate 104 35 normal 69 clonal abnormalities abnormalities categorised according banded chromosome analysis well chromosome count karyotypes correlated clinical laboratory features diagnosis survival successful analyses thirty five 34 children abnormalities group contained excess cell disease twenty five 24 characteristic hyperdiploid karyotype group lower presenting white counts tendency cd10 periodic acid schiff positivity blast cells smaller spleens none infant one 10 years old seven 7 children t9 22 t8 14 t4 11 translocations grouped together specific translocations collectively significantly worse prognosis remainder nine children developed central nervous system relapse six either t4 11 abnormalities 9p 19p descriptive classification taking account chromosome bonding pattern cytogenetically appropriate may clinically useful grouping children simply chromosome number knowledge techniques improve classification cytogenetic abnormalities need kept frequent review | 0 |
142 | variceal rebleeding portosystemic shunting strategies solutions vexing problem purpose review discuss approach treatment recurrent bleeding esophageal gastric varices portosystemic shunt clinical experience well others appears reestablishment portal decompression offer best chance longterm survival luckily innovations angiographic technique allowed attainment goal without inordinate risk operative procedure however patients situations amenable treatment operative decompression portal venous system carried anatomic area previously untouched patients decompression possible direct endoscopic treatment varices offer alternative albeit temporizing approach | 1 |
143 | increased risk leukemia relapse highdose cyclosporine allogeneic marrow transplantation acute leukemia eightyone patients acute myeloid leukemia anll n 44 acute lymphoblastic leukemia n 37 aged 10 50 years randomized receive 1 mgkg per day n 41 group 5 mgkg per day n 40 group b cyclosporine cya day 1 day 20 bone marrow transplant bmt patients received cya orally thereafter patients prepared cyclophosphamide cy 120 mgkg fractionated total body irradiation tbi received unfractionated bm hlaidentical sibling two groups comparable diagnosis disease status frenchamericanbritish fab classification wbc count diagnosis cytogenetic abnormalities extramedullary disease bmt donorrecipient age sex number cells infused number days intravenous iv cya median followup surviving patients group 983 v 632 days group b patients group lower serum levels cya 295 v 686 ngml p 004 lower bilirubin levels 19 v 26 mgdl p 07 lower creatinine levels 09 v 14 mgdl p 06 lower proportion cd8 cells peripheral blood pb within day 21 19 v 28 p 07 first day 05 x 109l neutrophils comparable two groups 13 v 14 days p 1 cox model actuarial risk acute graftvhost disease gvhd grade ii stratification age less 20 years greater significantly lower group b patients 054 p 04 actuarial risk developing chronic gvhd comparable p 9 actuarial transplantrelated mortality trm 240 days 28 26 p 8 group b major cause death gvhd group p 02 multiorgan toxicity group b p 07 actuarial risk relapse 2 years overall 20 group 52 group b p 001 9 v 43 respectively patients first remission p 0001 48 v 63 patients nonfirst complete remission cr p 1 actuarial 2year diseasefree survival dfs group b 58 v 32 p 02 patients 71 v 35 p 01 first remissions 30 v 23 p 2 advanced diseaseabstract truncated 400 words | 0 |
144 | intermittent pneumatic compression prevent proximal deep venous thrombosis total hip replacement prospective randomized study compression alone compression aspirin compression lowdose warfarin prospective randomized study effectiveness intraoperative postoperative use intermittent pneumatic compression alone combination oral administration either aspirin lowdose warfarin done consecutive series patients total hip replacement thirtynine years old patients began walking third postoperative day one hundred ninetysix patients 217 total hip arthroplasties included twentyeight per cent procedures revisions previous total hip replacement endoprosthesis remainder primary arthroplasties patients randomized type prophylaxis received intermittent pneumatic compression alone seventysix hips intermittent pneumatic compression aspirin seventytwo hips intermittent pneumatic compression lowdose warfarin sixtynine hips discharge hospital average seven days operation patients evaluated presence proximal deepvein thrombosis either venography side operation bilateral venous ultrasonography relative frequency thrombosis occurred proximal vein significantly different three groups overall relative frequency 10 per cent intermittent compression operation effectively reduces rate proximalvein thrombosis total hip replacement number patients study effectiveness technique could shown augmented oral administration either aspirin lowdose warfarin | 3 |
145 | venous infarction following interhemispheric approach patients acute subarachnoid hemorrhage postoperative venous infarction following aneurysm surgery studied 48 patients anterior communicating artery aneurysms operated interhemispheric approach acute stage subarachnoid hemorrhage sah 23 patients whose bridging veins sacrificed surgery 11 478 showed venous infarction frontal lobes contrast one 59 17 patients whose bridging veins preserved developed cerebral edema none eight patients operated day 11 day sah defined day 0 showed complication although bridging veins sacrificed six venous infarction following acute aneurysm surgery tended occur frequently patients higher sah grade andor advanced age correlations significant however correlation sacrifice veins venous infarction significant p less 0025 potential complication may compromise benefit acute aneurysm surgery cause damage important preserve venous system instances select another surgical approach based pattern venous drainage frontal lobe | 2 |
146 | breast cancer pregnancy lactation breast cancer frequently seen cancer pregnancy lactation incidence low disease seen approximately 003 pregnancies 1 2 breast cancer overall diagnosed pregnancy lactation evidence implicate pregnancy lactation either etiology progression breast cancer careful breast examination early pregnancy important find solid masses require biopsy breast engorgement hides therapeutic options vary depending stage disease stage pregnancy operable disease first 6 7 months pregnancy treated mastectomy irradiation contraindicated late pregnancy lumpectomy axillary dissection done irradiation delayed delivery general anesthesia safe usual precautions taken compensate physiologic changes induced pregnancy unfortunately delay diagnosis common 70 89 patients operable primary lesions positive axillary lymph nodes late stage appears reason generally worse prognosis patients stage stage course similar nonpregnant patients adjuvant chemotherapy considered late pregnancy usually delayed delivery patients locally advanced metastatic cancer diagnosed early pregnancy chemotherapy radiation therapy would normally recommended consideration must given termination pregnancy evidence termination pregnancy improves outlook patients permit standard aggressive therapy advanced disease | 0 |
147 | restoration liver function gunn rats without immunosuppression using transplanted microencapsulated hepatocytes microencapsulation cells within synthetic semipermeable membranes novel technique enables transplantation cell cultures without need immunosuppression previously shown transplanted isolated encapsulated hepatocytes provide sufficient shortterm metabolic support improve survival animals galactosamineinduced fulminant hepatic failure demonstrated feasibility isolated encapsulated hepatocyte transplantation providing longterm metabolic liver support gunn rats gunn rats congenital inability conjugate bilirubin thus exhibit lifelong hyperbilirubinemia studied feasibility isolated encapsulated hepatocyte transplantation restoring specific liver function free hepatocytes isolated male wistar rats microencapsulated collagen within trilayered sodium alginatepolyllysinesodium alginate membrane using techniques developed laboratory total 45 gunn rats underwent intraperitoneal transplantation free hepatocytes 5 x 107 isolated encapsulated hepatocytes 5 x 107 control empty microcapsules transplant untreated controls serum bilirubin levels monitored daily 10 days transplantation subsequent weekly samples obtained 1 mo microcapsules studied light electron microscopy 1 mo transplantation first week transplantation mean maximum reduction serum bilirubin levels isolated encapsulated hepatocytes free hepatocytes control microcapsule transplanted groups 457 186 143 respectively 1 mo thereafter mean reduction serum bilirubin levels respective groups 348 135 33 | 1 |
148 | successful control bleeding gastric antral vascular ectasia watermelon stomach laser photocoagulation report case gastric antral vascular ectasia patient primary biliary cirrhosis chronic blood loss major problem required repeated blood transfusions complicated reactions still persistent anaemia treated laser phototherapy form quadrantic photocoagulation neodynium yttriumaluminiumgarnet laser greatly improved endoscopic appearance gastric lesions effectively controlled blood loss required transfusions bleeding recurred 11 months controlled laser photocoagulation | 1 |
149 | stress response protein srp27 determination primary human breast carcinomas clinical histologic prognostic correlations expression estrogenregulated protein known 27000d heatshock stressresponse protein srp27 evaluated human breast carcinomas established breast cancer cell lines results obtained northern western blot analyses immunohistochemical methods concordant immunohistochemical assessment srp27 expression 300 breast carcinomas median patient followup 8 years performed twentysix percent lymph nodenegative 45 lymph nodepositive tumors overexpressors univariate analysis demonstrated significant correlations srp27 overexpression estrogen receptor er content ps2 protein expression nodal metastases advanced stage lymphaticvascular invasion shorter diseasefree survival period shorter overall survival study population whole regression tree analysis showed srp27 expression independent prognostic indicator diseasefree survival patients one three positive lymph nodes cox proportional hazards model confirmed independent prognostic significance nodal involvement stage er content failed recognize srp27 overexpression significant independent parameter predictive patient outcome patient population whole observed associations srp27 overexpression aggressive tumors suggest biologic role srp27 human breast carcinomas | 0 |
150 | largescale neurocognitive networks distributed processing attention language memory cognition comportment subserved interconnected neural networks allow highlevel computational architectures including parallel distributed processing cognitive problems resolved sequential hierarchical progression toward predetermined goals instead simultaneous interactive consideration multiple possibilities constraints satisfactory fit achieved resultant texture mental activity characterized almost infinite richness flexibility according model complex behavior mapped level multifocal neural systems rather specific anatomical sites giving rise brainbehavior relationships localized distributed network contains anatomically addressed channels transferring information content chemically addressed pathways modulating behavioral tone approach provides blueprint reexploring neurological foundations attention language memory frontal lobe function | 2 |
151 | medroxyprogesterone acetate lowers plasma corticotropin cortisol suppress anterior pituitary responsiveness human corticotropin releasing factor endocrine action medroxyprogesterone acetate mpa claimed glucocorticoidlike nature upon clinical observation mpa shown improve life quality overall wellbeing patients advanced breast cancer renal carcinoma prostatic carcinoma uterine adenocarcinoma authors evaluated mpa endocrine action administration human corticotropin releasing factor hcrf 90minute assay 15 patients advanced breast cancer renal cell carcinoma initiation oral highdose mpa treatment 1000 mg mpa well least 10 days therapy curves corticotropin betaendorphin cortisol responses hcrf tumor patients tested initiation mpa treatment parallel curves healthy control group probands tested equal conditions although significantly higher respective hormone levels patients malignant disorders assayed mpa administration basal peak hormone levels found comparable values obtained healthy controls conclusion mpa appeared act suprapituitary level since pituitary responsiveness hcrf preserved mpa treatment moreover appeared mpa brought hormonal stress state found patients malignant tumors back normal | 0 |
152 | ultrasound screening firstdegree relatives patients abdominal aortic aneurysm pedigrees constructed 43 patients probands underwent resection abdominal aortic aneurysm seven probands 162 firstdegree relative parent sibling child known abdominal aortic aneurysm multiplex family determine prevalence undiagnosed abdominal aortic aneurysm ultrasound screening firstdegree relatives age 40 years undertaken 202 eligible relatives 103 510 screened occult abdominal aortic aneurysm defined infrarenal aortic diameter greater 30 cm infrarenalsuprarenal aortic diameter ratio greater 15 incipient abdominal aortic aneurysm defined clear focal bulge infrarenal aorta less 30 cm greatest diameter four 103 relatives 39 found occult abdominal aortic aneurysm agesex 57m 60m 62f 65m three 29 found incipient abdominal aortic aneurysm agesex 56m 60m 67f smaller abdominal aortic aneurysms patients younger operated probands average age men 67 years women 69 years six seven individuals families previously considered simplex increasing actual multiplex family frequency 162 279 seven new abdominal aortic aneurysms found 49 siblings age 55 years older abdominal aortic aneurysms found 39 relatives age 55 years 14 children ages 50 59 years one parent therefore siblings age 55 years older 520 men 250 229 women 69 found previously undiagnosed abdominal aortic aneurysm | 3 |
153 | captoprilstimulated renal vein renin hypertensive patients without renal artery stenosis examine efficacy usefulness captoprilenhanced renal vein renin rvr measurements detecting functional significance renal artery stenosis found hypertensives compared values 22 patients arteriographically documented renovascular hypertension due unilateral urvh 14 patients bilateral renal artery stenosis brvh 8 patients 12 patients high renin essential hypertension eht captopril administration rvr ratio less 15 8 patients 364 renovascular hypertension patients 100 eht captopril enhanced lateralization renal vein renin renovascular hypertension postcaptopril rvr ratio greater 20 18 patients 818 greater 15 patients 100 hand rvr ratio remained unchanged patients eht significant difference postcaptopril rvr ratios urvh brvh however postcaptopril rvr ratio higher atherosclerosis 10 patients fibromuscular dysplasia 11 patients p less 05 captopril also elucidated contralateral renin suppression expressed contralateralperipheral renin ratio less 10 associated favorable outcome unilateral surgical intervention captoprilstimulated rvr indices valuable detecting functionally significant renal artery stenosis predicting surgical curability renovascular hypertension | 3 |
154 | hemodynamic effects new right ventricular assist device right ventricular assist device vad based principle counterpulsation developed institution device valveless pneumatically actuated 40 cc sactype pump single inletoutlet port right ventricular support uniport pump anastamosed endtoside pulmonary artery previous experimental trials device shown impart minimal trauma blood components study biventricular failure induced eight holstein calves normothermic ischemia cardiopulmonary bypass piercedonachy left vad lvad used left ventricular support following ischemic insult hemodynamic measurements obtained throughout study animal served control significant increase post injury cardiac output 335 114 obtained use uniport lvad compared use lvad alone p less equal 0005 hemodynamic parameters right heart failure including right atrial pressure rap pulmonary artery pressure pap left atrial pressure lap significantly affected data suggest uniport right ventricular assist device significantly improves cardiac output model moderate right ventricular failure additional studies required however optimize pump stroke volume define performance envelope device | 3 |
155 | peptic ulcer disease ct evaluation authors retrospectively describe computed tomographic ct findings 35 patients peptic ulcer disease three eight patients gastritis duodenitis bowelwall thickening ten remaining 27 patients ct evidence ulcer perforation n 2 penetration n 8 four cases unsuspected clinically patients acute free perforation pneumoperitoneum one showed free extravasation orally administered contrast material precise site perforation could established either case ct eight patients ulcer penetration ct evidence bowelwall thickening n 3 inflammatory changes adjacent soft tissues organs n 8 including pancreas n 4 liver n 1 lesser omentum n 1 ulcer craters seen two ct findings penetration mimic disease processes ct useful detecting uncomplicated peptic ulcer disease | 1 |
156 | transitional cell carcinomatous meningitis mvac methotrexate vinblastine doxorubicin cisplatin chemotherapy mvac methotrexate vinblastine doxorubicin cisplatin regimen utilized two institutions treat 17 patients advanced stage transitional cell carcinoma bladder report 2 cases carcinomatous meningitis resulting metastatic transitional cell carcinoma occurred patients treated mvac review literature suggests experience central nervous system metastases unique treatment advanced stage transitional cell carcinoma bladder mvac may enhance incidence meningeal metastases carcinomatous meningitis although rare rapidly fatal manifestation metastatic transitional cell carcinoma left untreated however prompt diagnosis early aggressive therapy may result palliation stabilization neurologic status review pathophysiology diagnosis treatment transitional cell carcinomatous meningitis | 2 |
157 | intraoperative coronary artery endarterectomy excimer laser compared continuouswave lasers excimer lasers exhibit several vitro advantages nonthermal ablation process linear relation number pulses depth crater 308 nm 20 nsec pulse duration 1 5 repetition rate laser specifically designed clinical application time cardiopulmonary bypass 10 symptomatic patients bypass grafting 1 mm diameter core specifically ultraviolettipped fiberoptic scope introduced via coronary arteriotomy placed upstream seven patients downstream three patients contact stenosis laser power increasingly delivered clearing stenosis occlusion quality angioplasty controlled calibration neolumen cardioplegic solution output lasertreated segment eighth day sixth month coronary arteriogram first three patients studied eighth day lasertreated coronary artery segments showed early parallellinked patent neolumen despite competitive bypass graft flow patients studied 6 months recanalized segments patent except one one patient venous graft occluded upstream laser angioplasty patent main limitation method lies fact laser coronary recanalization confined fiber core diameter conclude 1 excimer laser angioplasty may safe efficient surgical procedure 2 catheter flexibility remains critical problem assuming appropriate tool multifiber system suitable intraoperative well percutaneous routes | 3 |
158 | chinesewhite differences distribution occlusive cerebrovascular disease distribution cerebrovascular lesions affected race blacks japanese intracranial occlusive cerebrovascular disease whites extracranial disease despite high incidence stroke china formal studies distribution vascular occlusive disease chinese populations compared clinical angiographic features 24 white 24 chinese patients symptomatic occlusive cerebrovascular disease symptomatic vascular territories whites severe greater equal 50 stenosis extracranial lesions chinese severe intracranial lesions counted mild severe lesions symptomatic territory whites extracranial lesions chinese intracranial lesions combined symptomatic asymptomatic territories whites extracranial lesions chinese intracranial lesions white patients reported transient ischemic attacks distribution lesions however explained differences incidence transient ischemia hypertension diabetes hypercholesterolemia ischemic heart disease groups preponderance intracranial vascular lesions chinese patients similar seen blacks japanese racial differences occurrence extracranial intracranial lesions raise possibility different underlying pathophysiology 2 locations | 2 |
159 | neurologic abnormalities patient human ehrlichiosis human ehrlichiosis tickborne rickettsial disease characterized fever headache myalgias anorexia occasionally rash patient changes mental status upper motor neuron signs cerebrospinal fluid pleocytosis increased serum protein levels found association serologically confirmed ehrlichiosis likely due vasculitis involving central nervous system intraleukocytic inclusions although observed case infrequently found reported cases ehrlichiosis | 3 |
160 | exercise thallium201 imaging complete left bundle branch block prevalence septal perfusion defects determine prevalence septal defects generalized referral population records 93 consecutive patients complete left bundle branch block bbb underwent symptomlimited treadmill exercise testing thallium201 myocardial imaging 3year period reviewed segmental analysis planar thallium201 images performed blinded fashion agreement consensus computerized quantitative analysis images also independently performed correlated visual interpretations fortyseven patients 51 normal images 46 49 defects greater equal 2 segments abnormal studies 13 patients 14 total population septal defects much higher number patients 33 39 inferior apical defects coronary angiography performed 6 patients septal defects significant narrowing left anterior descending coronary artery found 4 patients narrowed right coronary artery found 1 normal coronary arteries seen patient conclusion whereas previous studies suggested high percentage falsepositive septal defects patients left bbb study demonstrates low prevalence 14 septal defects large population unselected patients presenting exercise thallium201 imaging therefore exercise thallium201 imaging remains useful procedure evaluating patients complete left bbb | 3 |
161 | changes basal dendrites cortical pyramidal cells alcoholic patientsa quantitative golgi study although variety pathological changes described brains chronic alcoholic patients studies addressed question alterations cortical neuronal dendritic arborisation loss neurons superior frontal gyrus shrinkage neurons superior frontal gyrus motor cortex documented chronic alcoholic patients areas chosen study using modified rapid golgi technique basal dendritic arborisation layer iii pyramidal neurons compared 15 male alcoholic patients 15 agematched male controls parameters measuring basal dendritic arborisation significantly less alcoholic cases superior frontal motor cortices changes arbor terminal branches consistent models dendritic plasticity changes may explain permanent reversible functional deficits chronic alcoholic patients | 1 |
162 | effect neurotransmitterselective drugs mice selected differential sensitivity hypothermic actions ethanol mice selectively bred resistance hot sensitivity cold hypothermic effect etoh tested hypothermic response neurotransmitterspecific drugs effect drugs etoh induced hypothermia ht drugs administered opiate drugs morphine levorphanol u50488h dopamine agonists apomorphine ly171535 skf38393 dopamine antagonist chlorpromazine alpha adrenergic agonist st587 cholinergic agonist nicotine amphetamine increases release catecholamines drugs tested exception skf38393 amphetamine induced hypothermic response hot cold mice skf38393 effect body temperature ht produced etoh amphetamine caused ht low doses hyperthermia high doses cold mice sensitive hot mice hypothermic effect morphine levorphanol muopiate agonists u50488h relatively specific kappa agonist drugs tested approximately equally potent hot cold mice results suggest differential sensitivity hot cold mice etohinduced ht may partially mediated genetic changes opiate mechanisms | 4 |
163 | heart rate variability myocardial infarction conscious dogs high low risk sudden death heart rate variability demonstrated experimentally clinically prognostic importance determining mortality myocardial infarction however paired studies reported examine heart rate variability myocardial infarction hypothesis tested low values heart rate variability provided risk assessment myocardial infarction use established canine model sudden cardiac death risk sudden death assessed 1 month myocardial infarction protocol exercise myocardial ischemia combined dogs developed ventricular fibrillation classified high risk sudden death susceptible survivors considered low risk resistant resistant dogs myocardial infarction affect measure heart rate variability 1 mean rr interval 2 standard deviation mean rr interval 3 coefficient variance standard deviationrr interval contrast myocardial infarction susceptible dogs showed significant decrease measures heart rate variability myocardial infarction differences seen susceptible resistant dogs however 30 days infarction epidemiologic analysis coefficient variance showed high sensitivity specificity 88 80 respectively predicting susceptibility therefore results analysis 30 min beat beat heart period rest 30 days myocardial infarction highly predictive increased risk sudden death | 3 |
164 | splitthickness skin grafting myelomeningocele defect subset risk late ulceration appropriate method timing management myelomeningocele defect prompted considerable discussion use splitthickness skin grafts acutely accomplished wound closure low morbidity mortality study designed address question longterm suitability technique splitthickness skin grafting myelomeningocele patient incidence late andor severe skin ulceration presence gibbus deformity correlated method skin closure longterm followup revealed higher incidence chronic skin ulceration splitthickness skin graft group compared primary closure group skin breakdowns appeared presence gibbus deformity gibbus deformity prevalent splitthickness skin graft group incidence skin ulceration gibbus deformity sitedependent thoracic thoracolumbar myelomeningocele repair splitthickness skin graft significantly likely complicated skin problems defect lumbar lumbosacral sacral region relationship secondary frequency gibbus deformity cephalad defects defects caudad treatment plan outlined based primary variable location myelomeningocele secondarily defect size | 4 |
165 | effects stress gastric mucosal prostaglandin generation intact adrenalectomized shamoperated rats study effects cold restraint stress b adrenalectomy association cold restraint stress gastric mucosal ulceration prostaglandin generation performed two experiments first 40 rats divided four groups 10 rats unstressed b stressed 05 h c stressed 2 h stressed 4 h second experiment another 80 rats divided four groups 20 rats adrenalectomy plus cold restraint stress 2 h b adrenalectomy plus stress c sham operated plus 2 h stress sham operated plus stress experiments recorded ulcer index measured mucosal generation prostaglandin e2 pge2 prostaglandin i2 6ketopgf1a conclusion cold restraint stress associated timedependent decrease gastric mucosal pge2 generation change 6ketopgf1a generation increase mucosal injury maximal 2 h b adrenalectomy augments effects stress mucosal injury effect prostaglandin generation thus ulcerogenic effect adrenalectomy appears independent effect prostaglandin generation | 4 |
166 | evaluation vigabatrin addon drug management severe epilepsy effects addition vigabatrin new antiepileptic drug therapy 128 patients severe medically refractory epilepsy reported forty two 33 patients experienced side effects predominantly neurotropic 28 22 drug withdrawn side effects commonest side effects drowsiness behavioural change remaining 100 patients followed mean 30 weeks range 1275 forty one patients showed marked improvement seizure frequency 50 reduction compared pretrial period nine 7 rendered seizure free apparent tolerance effects drug noted five patients exacerbation seizures may occur drug withdrawn quickly vigabatrin appears promising new antiepileptic drug | 2 |
167 | fatty liver hepatitis steatohepatitis obesity autopsy study analysis risk factors steatohepatitis fatty liver hepatitis histologically identical alcoholic disease occurs obese patients jejunoileal bypass similar lesion occurs rarely obese patients without bypass surgery risk factors poorly understood hepatic steatosis steatohepatitis fibrosis sought 351 apparently nonalcoholic patients autopsy various risk factors evaluated incidence steatosis steatohepatitis correlated degree obesity steatohepatitis found 185 markedly obese patients 27 lean patients additional risk factors steatohepatitis type ii diabetes weight loss preterminal period shortly death intravenous glucose therapy last week life severe fibrosis found 138 markedly obese patients 66 lean patients difference largely explained higher prevalence diabetes obese groups risk factors defined study known associated abnormalities free fatty acid metabolism obesity type ii diabetes intravenous glucose therapy associated hyperinsulinemia may inhibit fatty acid oxidation obesity weight loss increase presentation fatty acids liver similar metabolic changes may occur obese patients jejunoileal bypass surgery thus study supports hypothesis fatty acids role hepatocellular necrosis found obese individuals | 1 |
168 | platelet norepinephrine epinephrine concentration patients pheochromocytoma platelet plasma catecholamine concentrations determined 17 patients surgically proven pheochromocytoma mean age 423 years 31 patients borderline hypertension mean age 353 years 9 healthy controls mean age 393 years platelet norepinephrine epinephrine significantly increased patients pheochromocytoma compared hypertensive control groups p less 001 correlation platelet plasma catecholamines detected studied groups diagnostic accuracy platelet catecholamine pheochromocytoma limited since increased platelet norepinephrine found 355 increased platelet epinephrine found 194 patients essential hypertension | 0 |
169 | diaphragmatic force substrate response resistive loaded breathing piglet inspiratory resistive loaded irl breathing results hypoventilation diaphragmatic fatigue piglet studied effects 6 h irl ten 1moold piglets load adjusted increase spontaneously generated transdiaphragmatic pressure five six times baseline six 1moold piglets acted controls identically instrumented subjected irl measurements ventilation blood gases ph diaphragmatic electromyogram forcefrequency curve blood flow endexpiratory lung volume obtained hourly diaphragmatic muscle samples obtained 6 h determination atp phosphocreatine lactate glycogen levels changes occurred control animals irl resulted significant decrease ventilation increase diaphragmatic emg onset abdominal expiratory muscle activity fall endexpiratory lung volume 1 h forcefrequency curve adjusted lung volume change fell 20 frequencies stimulation 1 h 40 6 h blood flow costal crural diaphragm increased 51 141 respectively differences noted atp phosphocreatine lactate glycogen control irl animals concluded submaximal spontaneous contractions piglet diaphragm 6h period cause substantial decrease maximal forcegenerating capacity related substrate depletion | 4 |
170 | rapid baroreceptor resetting dahl saltsensitive rats dahl saltsensitive rats rapidly become hypertensive exposed high salt diet dahl saltresistant rats maintain normal blood pressure high salt diet defect baroreceptor afferents thought play key role low sensitivity baroreceptor reflexes dahl saltsensitive rats even prehypertensive stage low salt treatment present study tested whether differences rapid resetting ability might contribute differences baroreceptor function dahl rats four groups rats tested saltsensitive saltresistant rats low salt high salt diets 015 80 nacl compared rapidly resetting responses baroreceptors group using vitro preparation rapid resetting assessed aortic baroreceptor n 46 linear fit relation pressure threshold conditioning mean arterial pressure group wide range resetting ratios slope resetting relation despite higher initial pressure thresholds saltsensitive rats high salt diet resetting ratios among four groups similar thus ability dahl saltsensitive baroreceptors rapidly reset preserved despite high dietary salt genetic predisposition dysfunction present findings dahl rats reinforce results recent studies rapid resetting spontaneous renal hypertension suggests rapid resetting process remarkably resistant factors compromise baroreceptor function | 3 |
171 | spontaneous renal rupture pregnancy spontaneous rupture renal parenchyma renal pelvis pregnancy previously reported 16 cases case describe report patient initially right flank pain nausea 48 hours progressed severe abdominal symptoms necessitated exploratory laparotomy cystoscopic placement ureteral stent relieved obstruction allowed spontaneous healing renal pelvis dilatation urinary collecting system commonly occurs pregnancy spontaneous rupture renal parenchyma renal pelvis however unusual often associated diseased kidneys case 8th one spontaneous rupture renal collecting system identifiable underlying pathologic condition 17th case spontaneous renal rupture overall | 4 |
172 | isolation sequences span fragile x identification fragile xrelated cpg island published erratum appears science 1991 apr 262525005494 yeast artificial chromosomes yacs obtained 550kilobase region contains three probes previously mapped close locus fragile x syndrome yacs spanned fragile site xq273 shown fluorescent situ hybridization internal 200kilobase segment contained four chromosomal breakpoints generated induction fragile x expression single cpg island identified cloned region markers dxs463 dxs465 appears methylated mentally retarded fragile x males nonexpressing male carriers mutation normal males cpg island may indicate presence gene involved clinical phenotype syndrome | 2 |
173 | invasive squamous cell carcinoma patient epidermodysplasia verruciformis patient epidermodysplasia verruciformis died intracranial invasion squamous cell carcinoma scc biopsy clinically normal skin revealed perineural invasion malignant keratinocytes sccs arising patients epidermodysplasia verruciformis may biologically aggressive best excise careful control surgical tissue margins | 0 |
174 | natural history thrombocytopenia associated preeclampsia sixtyone 375 women hypertension preeclampsia 48month period thrombocytopenia postpartum day 3 90 women rising platelet counts day 4 59 61 women counts greater 100000mm3 two exceptions pathologic conditions addition preeclampsia thrombocytopenia associated preeclampsia resolve postpartum day 4 | 3 |
175 | patients mental disorders work mental illness devastate persons intellectually emotionally maintenance therapy however certain patients chronic mental illnesses capable holding variety jobs total population psychiatric patients va outpatient clinic 87 gainfully employed identified determine common factors among affective disorders predominant diagnoses among patients worked schizophrenia common among alcoholism diagnosed approximately 25 working nonworking groups | 4 |
176 | bilateral familial carotid body paragangliomas report case dna flow cytometric cytogenetic analyses case study bilateral familial carotid body paragangliomas dna flow cytometric cytogenetic analyses presented analysis tumor cell nuclear dna content flow cytometry revealed aneuploid cell populations tumors standard cytogenetic analysis giemsabanding technique used right carotid body paraganglioma showed evidence numerical structural abnormalities describe parameters currently used predict biological behavior tumors | 0 |
177 | serum tissue magnesium concentrations patients heart failure serious ventricular arrhythmias objective compare magnesium concentrations serum tissue patients heart failure two groups patients compared without serious ventricular arrhythmias design consecutive enrollment blinded laboratory analyses setting referral inpatient service cardiology division university hospital patients twentythree patients idiopathic dilated cardiomyopathy mild moderately severe congestive heart failure new york heart association functional class ii iv divided two groups 9 patients sustained ventricular tachycardias 14 patients without serious ventricular arrhythmias control interventions medications heart failure withdrawn 12 hours study antiarrhythmic therapy continued throughout study measurements main results patients skeletal muscle biopsies myocardial biopsies blood sampling analysis magnesium concentrations statistically significant differences mean magnesium concentrations serum circulating mononuclear cells skeletal muscle myocardium found 9 patients ventricular arrhythmias compared 14 control patients without serious ventricular arrhythmias conclusions general ambulatory sample patients heart failure magnesium depletion serum tissue appear occur commonly patients serious ventricular arrhythmias patients without serious ventricular arrhythmias | 3 |
178 | malignancy associated chronic empyema radiologic assessment radiologic findings six cases malignancy associated chronic empyema 539 years duration reviewed pathologic examination confirmed three bcell nonhodgkin lymphomas one roundcell sarcoma one mesothelioma one adenocarcinoma retrospective findings plain chest radiographs suggested occurrence malignancy increased radiopacity thoracic cavity softtissue bulgings andor unsharpness fat planes chest walls destruction bone near empyema extensive medial deviation calcified pleurae computed tomography delineated masses softtissue attenuation clearly radiography cases magnetic resonance images three cases informative empyema cavities surrounded lowintensity rims two showed signal intensity different necrotic tumors scintigraphy revealed increased uptake gallium cases ultrasonography useful biopsy guidance every radiologist know entity observation chest radiographs obtained patients chronic empyema radiologic assessment aggressive biopsy recommended malignancy suspected | 0 |
179 | deficiencies coagulationinhibiting fibrinolytic proteins outpatients deepvein thrombosis background isolated deficiencies antithrombin iii protein c protein plasminogen implicated cause deepvein thrombosis assumed patients recurrent familial juvenile thrombosis likely deficiency methods studied prevalence isolated deficiencies proteins 277 consecutive outpatients venographically proved acute deepvein thrombosis compared 138 agematched sexmatched controls without deepvein thrombosis calculated positive predictive value history recurrent familial juvenile venous thromboembolism presence deficiency results overall prevalence deficiencies proteins patients venous thrombosis 83 percent 23 277 patients 95 percent confidence interval 54 124 compared 22 percent controls 3 138 subjects 95 percent confidence interval 05 61 p less 005 comparison groups positive predictive values presence isolated protein deficiency patients recurrent familial juvenile deepvein thrombosis defined proportion patients clinical finding deficiency one proteins 9 16 12 percent respectively conclusions cause acute venous thrombosis outpatients 917 percent cannot explained abnormalities coagulationinhibiting fibrinolytic proteins information obtained medical history concerning recurrent familial venous thrombosis onset disease young age useful identification patients protein deficiencies | 4 |
180 | clinical utility carotid duplex scanning retrospectively compared results duplex scanning ds contrast angiography evaluation 119 patients whose 238 carotid arteries evaluated methods within fourweek period results patients categorized two different definitions severity stenosis category classified 129 stenosis mild 3069 stenosis moderate 7099 diameter reduction severe stenosis category b defined mild stenosis 119 lumen diameter reduction moderate 2049 stenosis severe 5099 stenosis findings classification compared 60 patients hemispheric symptoms 59 patients nonspecific symptoms gold standard exhibited greater sensitivity specificity accuracy predictive values ds carotid arteries 70 stenosis identified ds greater specificity accuracy predictive values arteries 50 stenoses sensitivity comparable categorizations b 80 83 parameters measurement superior patients hemispheric symptoms ds alone cannot substitute selecting patients carotid endarterectomy error rate exceeded acceptable rates complications carotid artery surgery false positive rate ds 4 ds failed diagnose 7 19 carotid artery occlusions 9 11 ulcerated plaques 7 119 instances aortic arch disease 13 cases severe intracranial artery stenosis | 3 |
181 | long survival prognostic factors hepatocellular carcinoma studied survival prognostic factors cases hepatocellular carcinoma seen midwestern teaching hospital 1947 1986 70 cases 56 diagnosed life 14 autopsy 47 males 23 females age diagnosis ranging 14 88 median survival 56 patients diagnosed life 106 days 11 patients lived longer one year two patients long survivors presumed cured one living 27 years diagnosis surgical treatment 19 years cox regression model showed young age diagnosis low stage disease diagnosis significant predictors long survival white patients survived nearly twice long black patients difference significant gender year diagnosis appear important determinants survival pathologic material still available one two long survivors histology fibrolamellar carcinoma young adults | 0 |
182 | affects continence anterior resection rectum functional results anterior rectal resections commonly considered satisfactory variable percentages postoperative incontinence often reported continence evaluated 20 low anterior resections lar 13 high anterior resections har means clinical assessment anorectal manometry evacuation proctography whereas har patients perfect continence 10 patients 50 percent lar group occasional episodes soiling liquid feces 5 patients 25 percent frequent soiling occasional incontinence solid feces 1 patient 5 percent frequent solid stool loss requiring surgical treatment anal canal resting pressure 3 4 cm anal verge significantly lower lar group p less 002 p less 005 respectively har group however maximum voluntary contraction differ two groups rectoanal inhibitory reflex found present 17 20 patients lar patients har volume anal sphincter continuously inhibited significantly reduced lar group p less 0001 also conscious rectal sensibility volumes found significantly reduced threshold constant maximum tolerated volume threshold volume internal sphincter relaxation lower threshold volume rectal sensation patients lar could allow postoperative fecal soiling rectal compliance decreased p less 0001 lar group evacuation proctography performed six lar patients affected major soiling solid stool loss revealed abnormal obtuse anorectal angle pathologic lowering perineum rest defecation concomitance internal sphincter impairment reduction rectal compliance previous pelvis floor muscle damage postulated cause affecting continence patients underwent lar | 1 |
183 | bmode imaging histomorphometric evaluation carotid atherosclerosis quantitative qualitative evaluation atherosclerotic lesions ultrasonography presented several problems determination accuracy reproducibility methodology humans present study aims evaluated results bmode imaging extracranial carotid arteries patients selected surgery compared histologic results observations samples obtained endarterectomy shrinkage effects histologic samples taken consideration several bidimensional images atherosclerotic lesions obtained ultrasound different incident angles used establish maximum thickness maximum degree vessel stenosis calculated ultrasound showed high correlation 047x 424 se 011 r 05 p less 0001 compared one obtained histology imaging methodology provided however mean overestimation stenosis 7 relationships among amount calcium p less 003 necrotic core p less 0056 echogenic types ie soft mixed hard suggested statistical trend results suggested vascular lumen due advanced atherosclerotic lesions qualitative interpretation atherosclerosis bmode imaging ie morphologic characteristics seem present value investigations depth needed | 3 |
184 | n18ffluoroacetyldglucosamine potential agent cancer diagnosis positron labeled substrates sugars amino acids nucleosides investigated invivo evaluation biochemical processes cancerous tissue hexosamines obligatory structural components many biologically important macromolecules including membrane glycoproteins mucopolysaccharide evaluated new synthesized pharmaceutical n18ffluoroacetyldglucosamine 18ffag structural analog nacetyldglucosamine c3hhemsnrs mice bearing spontaneous hepatomas used tissue distribution study 60 min injection high uptakes found tumor 516 mean value doseg liver 371 kidney 327 tumor uptake 18ffag showed highest value tissue pet study vx2 carcinoma rabbit clearly visualized preliminary results suggest 18ffag potential new agent tumor imaging | 0 |
185 | dissociation pain autonomic disturbances cluster headache relationship pain autonomic disturbances cluster headache studied 54 patients whose attack always recurred side 7 others whose attack affected either side different occasions one seven patients facial flushing ocular sympathetic deficit observed original side headaches patients orbital region warmer painful side three cases region cooler attacks lacrimation rhinorrhoea common severe attacks temperature difference orbits increased increasing severity pain findings support view certain autonomic disturbances cluster headache provoked pain residual autonomic dysfunction could influence autonomic activity cluster headache residual dysfunction painfree side could explain dissociation autonomic disturbances pain observed cases | 2 |
186 | pancreaticopleural fistula report 7 patients review literature pancreaticopleural fistula uncommon clinical condition presentation often confusing paucity clues suggestive pancreatic disease preponderance pulmonary symptoms signs patients alcoholics onehalf clinical history previous pancreatitis pleural effusions large recurrent highly exudative nature many patients go extensive pulmonary evaluation pancreas identified site primary pathology elevated serum amylase may first clue diagnosis however key diagnosis dramatically elevated pleural fluid amylase effusions association acute pancreatitis esophageal perforation thoracic malignancy important consider differential diagnosis elevated pleural fluid amylase usually easy exclude computed tomography excellent defining pancreatic abnormalities first abdominal imaging study suspected cases endoscopic retrograde cholangiopancreatography ercp used diagnostic tool confusing cases although systematic study evaluates medical versus surgical therapy recommend initial 2 4week trial medical therapy including allowance oral intake total parenteral nutrition chest tube thoracostomy possibly regimen somatostatin analogs major complication patients superinfection results significant morbidity mortality failure medical therapy considered failure pleural effusions clear recurrence reinstatement oral intake superinfection patients fail benefit medical therapy surgery indicated | 4 |
187 | epidermoid tumors 4th ventricle report seven cases epidermoid tumors occur rarely 4th ventricle discuss history clinical course surgical results seven patients one patient remittal symptoms probably due emergence tumor 4th ventricle cisterna magna total removal capsule possible youngest patient present four patients mean followup 6 years enjoy good general neurological health | 0 |
188 | contribution transesophageal echocardiography patient diagnosis treatment prospective analysis capability transesophageal tee versus transthoracic tte echocardiography diagnostic tool clinical practice prospectively examined 86 consecutive cases conclusive diagnosis possible 95 tee whereas result achieved 48 tte specifically tee provided conclusive diagnosis 14 16 cases infective endocarditis tte gave result 4 16 cases p less 0001 similarly tee allowed conclusive diagnosis 11 11 instances aortic dissection tte gave indication two cases p less 0001 tee similarly effective eight eight cases atrial thrombi whereas tte gave diagnosis three eight cases p less 001 five subjects intracardiac masses tee gave conclusive diagnosis five whereas tte able diagnose conclusively one subject p less 002 seven patients mitral regurgitation tee gave conclusive diagnosis seven tte able provide information four p ns tee able provide conclusive diagnosis four patients aortic insufficiency tte gave information two four p ns 14 patients prosthetic valve dysfunction tee gave diagnosis 12 tte gave eight patients p ns methods gave conclusive diagnosis 13 13 cases mitral stenosis p ns also tee provided conclusive diagnosis eight eight patients adult congenital heart disease tte gave information four p ns | 3 |
189 | echographic diagnosis dural carotidcavernous sinus fistulas used standardized ophthalmic echography identify specific abnormalities four patients lowpressure lowflow dural arteriovenous malformations patients bscan ultrasonography showed engorgement ipsilateral vertical vein ascan ultrasonography dynamically imaged rapid blood flow superior ophthalmic vein enlargement culpable ocular muscles patients restrictive ophthalmopathy 30degree test distinguished venous engorgement optic nerve sheath apical compression optic nerve enlarged ocular muscles | 4 |
190 | people health conscious longitudinal study one community secular changes cardiovascular health awareness knowledge behavior observed four biennial crosssectional surveys cohort survey new england community changes related health promotion activities social milieu respondents likely due national mass media health campaigns effects may influence outcomes communitybased cardiovascular disease prevention studies | 3 |
191 | roles renal vascular renin spontaneous hypertension switching mechanism upon nephrectomy lack hypotensive effects inhibition renin converting enzyme angiotensin ii receptor blocker bilateral nephrectomy inhibitors angiotensin converting enzyme renin angiotensin ii ang ii receptor lower blood pressure spontaneously hypertensive rats shr used model essential hypertension since plasma renin levels normal subnormal renin vascular tissue considered play key role maintenance hypertension clarify source localization renin shr antirenin antibodies converting enzyme inhibitors delapril enalapril ang ii receptor antagonist dup 753 administered intact bilaterally nephrectomized shr normotensive controls efficient hypotensive action renin antibody indicated renin renal origin dominant factor gradual complete disappearance antihypertensive action inhibitors reninangiotensin system upon bilateral nephrectomy indicated importance membraneassociated renin renal origin angiotensin converting enzyme maintenance spontaneous hypertension | 3 |
192 | intraoperative anaphylaxis association latex sensitivity latex products recently identified cause severe intraoperative anaphylactic reactions identified group pediatric patients appear increased risk reactions fifteen patients either spina bifida congenital urologic abnormalities experienced 19 intraoperative anaphylactic reactions patients frequent previous exposures rubber materials since infancy part management andor investigative procedures seven 15 patients previous history local skin reactions rubber four patients atopic patients undergone multiple two 26 operative procedures reactions onset ranged 40 290 minutes induction anesthesia reactions varied intensity urticaria severe cardiorespiratory collapse patients subsequently positive allergy skin tests positive rast latex antigen conclude group risk exposed latex intraoperatively result frequent past exposure materials allergic evaluation latex allergy may assist preoperative evaluation similar patients sensitized patients appropriate prophylactic measures particularly avoidance latex required | 3 |
193 | autopeep cpr occult cause electromechanical dissociation 64yearold man severe copd developed refractory nonperfusing sinus rhythm intubation positivepressure ventilation fifteen minutes resuscitative efforts halted patient noted spontaneous respirations blood pressure suggesting dynamic hyperinflation responsible observed electromechanical dissociation emd recommend brief trial apnea patients copd emd conventional measures unsuccessful | 3 |
194 | chronic arterial occlusion pge1resistant skin lesions treated glycosaminoglycan compoundcase reports authors report 2 patients chronic arterial occlusion intravenous administration glycosaminoglycan compound fpfd 101 markedly effective one patient suffered thromboembolic episodes left hand peripheral circulatory impairment related collagen disease patients oral administration anticoagulants antiplatelet agents combination intravenous infusion prostaglandin e1 adequately effective however addition intravenous injection fpfd 101 resulted marked improvement symptoms fpfd 101 anticoagulant effect also inhibits platelet aggregation seems useful treatment prevention chronic arterial occlusion combined drugs anticoagulants antiplatelet agents vasodilators | 3 |
195 | spontaneous bacterial peritonitis due salmonella enteritidis cirrhotic ascites spontaneous bacterial peritonitis due salmonella uncommon report three patients ascites infected salmonella three patients advanced chronic liver disease typically cirrhosis portal hypertension salmonella enteritidis grew ascite fluid culture three patients clinical microbiological evidence salmonella infection ascitic fluid one patient died antibiotic treatment started two treated different combinations antimicrobial drugs one died fourteenth day hospitalization survived | 4 |
196 | retroviral expression transforming growth factoralpha transform fibroblasts keratinocytes transforming growth factor alpha tgf alpha peptide named helps impart anchorageindependent growth normal rat kidney nrk cells vitro secreted many rodent human tumor cells directly investigate transforming properties factor constructed replicationdefective murine retrovirus expresses human sequence coding tgf alpha infection nih3t3 cells tgf alpha retrovirus led integration transcriptionally active provirus overexpression biologically active tgf alpha failed induce morphologic transformation similarly tgf alpha retrovirus failed induce morphologic transformation five types rodent fibroblasts also investigated effect tgf alpha expression growth balbmk mouse keratinocytes require epidermal growth factor egf proliferation show exogenously added tgf alpha extremely potent mitogen balbmk cells however retroviral expression tgf alpha balbmk cells failed relieve dependence exogenously added egf tgf alpha cell growth results suggest overexpression tgf alpha transform rodent fibroblasts keratinocytes | 4 |
197 | rising incidence adenocarcinoma esophagus gastric cardia analyses cancer incidence data nine areas united states revealed steadily rising rates 1976 1987 adenocarcinomas esophagus gastric cardia increases among men period ranged 4 10 per year thus exceeded type cancer contrast relatively stable trends squamous cell carcinoma esophagus slight declines adenocarcinoma distal portions stomach adenocarcinomas esophagus gastric cardia disproportionately affected white men rarely occurred among women mid1980s among white men adenocarcinomas accounted one third esophageal cancers cardia cancers accounted one half stomach cancers specified subsites rising incidence rates similar demographic patterns point need investigation causes poorly understood cancers | 0 |
198 | radical prostatectomy clinical stage t12n0m0 prostatic adenocarcinoma longterm results total 441 stage t12n0m0 11 stage t12n0m0 cancer patients elevated acid phosphatase level 18 stage t12nm0 cancer patients underwent radical prostatectomy analysis 441 stage t12n0m0 cancer patients demonstrated failure survival function disease organconfined specimenconfined marginpositive 10year failure rates 12 30 60 respectively patients positive margins 44 79 irradiated postoperatively postoperative radiation produced survival advantage difference interval failure survival could identified 105 patients whose disease diagnosed transurethral resection 328 palpable abnormality eleven patients negative bone node findings elevated acid phosphatase level 8 patients treated immediate androgen deprivation failed within 36 months | 0 |
199 | current management varicoceles spite written varicocele still clear benefit occlusion spermatic vein improvement semen takes place patients others fertility usually assessed framework couple trying establish pregnancy important evaluate partners making recommendations regarding therapy man found varicocele semen analyses indicate deficits either quantity quality sperm surgical ligation transvenous occlusion considered one appropriate form therapy varicocele ligation embolotherapy performed outpatient procedure minimal morbidity equal effectiveness regarding pregnancy outcome cost procedures done outpatient facility approximately equal obvious benefits percutaneous technique slightly lower recurrence rate rapid return full physical activity surgical procedure described marmar associates appears similar rate recurrence short postoperative period recovery greater experience urologists using technique needs gained compare adequately methods described varicocele ligation inguinal retroperitoneal routes familiar urologists require operating microscope special instruments greater understanding venous anatomy careful dissection persistence recurrence rate acceptably low postoperative recovery relatively rapid smooth | 4 |
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