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14,400 | end diastolic flow velocity beneath aortic isthmus assessed pulsed doppler echocardiography new predictor aortic regurgitant fraction end diastolic flow velocity beneath aortic isthmus measured within 72 hours cardiac catheterisation pulsed doppler echocardiography 30 controls 61 patients aortic regurgitation end diastolic flow velocity determined peak r wave simultaneously recorded electrocardiogram controls reverse flow end diastole beneath aortic isthmus patients aortic regurgitation end diastolic flow velocity correlated well angiographic grade regurgitation r 081 regurgitant fraction r 082 mean sd values 63 52 122 43 221 57 343 93 cms patients regurgitant fraction less 20 20 40 41 60 greater 60 respectively end diastolic flow velocity greater 18 cms predicted regurgitant fraction greater equal 40 sensitivity 885 specificity 96 study suggests pulsed doppler derived end diastolic flow velocity useful index routine noninvasive assessment severity aortic regurgitation | 3 |
14,401 | multiple sclerosis narcolepsy possible similar genetic susceptibility studied 2 patients multiple sclerosis narcolepsy patients dr 2 histocompatibility antigen positive patients diagnosis narcolepsy confirmed polygraphic testing | 4 |
14,402 | carcinosarcoma lung hypertrophic pulmonary osteoarthropathy carcinosarcoma lung rare malignancy endobronchial parenchymal variants classically described clinicopathological features often related anatomical location case lung neoplasms case report details surgical management carcinosarcoma patient seen pulmonary osteoarthropathy | 0 |
14,403 | vitrectomy retinotomy aspiration biopsy choroidal tumors used investigational technique biopsy intraocular tumors aid diagnosis three choroidal tumors threeport transpars plana vitrectomy performed conjunction retinotomy tumor biopsy endophotocoagulation airfluid exchange vitrectomy used decrease amount traction secondary retained vitreous intraocular surgery retinotomy sites chosen microscopic control avoid large caliber retinal vessels modified tumoraspiration technique together endophotocoagulation aspiration intraoperative vitreous hemorrhages provided opportunity sample tumor tissue continually varied depths added standard vitreous surgery concepts techniques instrumentation produce vitrectomy retinotomy aspiration biopsy choroidal tumors | 4 |
14,404 | hydroxyethyl starch pretreatment bacteremic sheep live bacteria infused chronic ovine lung lymph model determine preceding infusion colloid hydroxyethyl starch hes exaggerated cardiopulmonary dysfunction impaired removal bacteria macrophages pulmonary circulation hes infused 3 mlkghr n 6 24 12 hr bacteria decreased plasma protein content increased pulmonary lymph plasma protein concentration oncotic properties ringers lactate 2 mlkghr given stopping hes also control group n 6 infusion live ps aeruginosa 25 x 108 psmin approximately 30 min induced equivalent pulmonary hypertension increased pulmonary microvascular permeability cardiovascular depression two groups removal bacteria lungs affected indicating measurement function mononuclear phagocytic system impaired preceding hes | 3 |
14,405 | nitrous oxide epinephrineinduced arrhythmias asked whether sympathomimetic effect nitrous oxide n2o predisposed patients receiving n2o arrhythmias response epinephrine administration also asked whether aging contributed development arrhythmias without n2o one hundred patients transsphenoidal hypophysectomy randomly assigned receive anesthesia including n 49 excluding n 51 n2o patients given injection epinephrine 1200000 05 lidocaine produce hemostasis using intermittent 12lead continuous lead ii electrocardiography determined incidence premature ventricular contraction isorhythmic atrioventricular av dissociation changes twave morphology patients given n2o significantly higher incidence isorhythmic av dissociation 612 vs 412 trend toward higher incidence multiple premature ventricular contractions 163 vs 78 statistically significant anesthetic groups high incidence postoperative changes twave morphology 469 n2o group vs 509 group given n2o aging alone affect incidence ventricular ectopic beats isorhythmic av dissociation changes electrocardiographic morphology correlated development ventricular ectopy n2o anesthesia conclude use n2o correlated higher incidence isorhythmic av dissociation response injection epinephrine lidocaine | 4 |
14,406 | diffusion binding monoclonal antibody tnt1 multicellular tumor spheroids tumor spheroids ht29 human colon adenocarcinoma a375 melanoma established investigate uptake clearance kinetics tnt1 monoclonal antibody targets necrotic cells tumors data reveal rapid uptake tnt1 fab2 fragment spheroid models whereas antibody irrelevant specificity lym1 fab2 fragment bound poorly spheroids unlike previously reported monoclonal antibodies tumor cellsurface antigens tnt1 showed 1 linear uptake increased time without saturation tumor spheroids 2 unexpected uptake subpopulation cells viable outer rim spheroids preclinical studies provide important information concerning therapeutic potential tnt monoclonal antibodies treatment cancer micrometastases | 0 |
14,407 | relationships among umbilical artery velocimetry fetal biophysical profile placental inflammation preterm premature rupture membranes relationships among umbilical artery velocimetry fetal biophysical profile placental inflammation 44 consecutive patients preterm premature rupture membranes determined patients followed daily fetal biophysical profiles systolicdiastolic ratios delivery placental pathologic examination histologic evidence infection umbilical vasculitis performed cases according standard protocol longitudinal trends fetal biophysical profile scores systolicdiastolic ratios analyzed patients without umbilical vasculitis analysis longitudinal trend period 2 7 days delivery showed differences biophysical scores systolicdiastolic ratios either group however last examination within 24 hours delivery patients umbilical vasculitis higher systolicdiastolic ratios lower biophysical profile scores compared previous examinations addition biophysical profile score last examination 24 hours delivery patients umbilical vasculitis found significantly lower compared patients without umbilical vasculitis mean sd 66 23 versus 82 24 respectively data suggest subclinical stages infection associated biophysical alterations fetoplacental unit ie simultaneous decrease fetal biophysical activities increase systolicdiastolic ratios daily umbilical artery systolicdiastolic ratios conjunction biophysical profiles may useful follow patients preterm premature rupture membranes | 4 |
14,408 | urothelial hyperplasia neoplasia iii detection nitrosamine production different bacterial genera chronic urinary tract infections rats various agents implicated inducing urothelial cancer although drugs occupational environmental carcinogens widely accepted playing major role urothelial carcinogens several investigations suggest bacteria may play role mechanism bacteria may interact host augment development urothelial carcinoma well understood clinically investigators linked development infection urinary stones indwelling catheters urothelial cancer investigators suggested mechanism may related production carcinogenic compounds nitrosamines detected urinary tract infection laboratory showed rats chronic urinary tract infections produced increasing urinary levels nn dimethylnitrosamine 24 week period production correlated hyperplasia early neoplasia bladder epithelium three bacterial genera used two escherichia coli protein sp showed production increasing levels urinary nitrosamine correlated infection purpose current study determine bacterial genera strains also produce similar increasing nitrosamine levels rat model chronic urinary tract infection thus provide evidence number bacterial genera strains produce nitrosamines vivo also histology chronically infected bladder examined hyperplasia neoplasia | 4 |
14,409 | mec4 gene member family caenorhabditis elegans genes mutate induce neuronal degeneration three dominant mutations mec4 gene needed mechanosensation cause touchreceptor neurons caenorhabditis elegans degenerate deg1 another c elegans gene mutate induce neuronal degeneration similar sequence mec4 defines new gene family crosshybridizing sequences detectable species raising possibility degenerative conditions organisms may caused mutations similar genes three dominant mec4 mutations affect amino acid effects aminoacid substitutions position suggest steric hindrance may induce degenerative state | 4 |
14,410 | synthesis 70k stress protein human leukocytes effect exercise heat determine whether reinduction 70000da 70k stress protein synthesis could used assay thermal history andor cellular levels 70k stress protein hyperthermic humans leukocytes obtained 2 h exercise incubated 37 41 degrees c five healthy males completed 2 h treadmill exercise consisting running 46 kmh 3045 min followed 7590 min walking 210 grade exercise bout performed two subjects hot 46 degrees c 15 relative humidity five subjects cooler 30 degrees c 40 relative humidity environmental conditions exercise resulting rectal temperature tre less 40 degrees c alter amount 70k stress protein synthesized leukocytes incubated 41 degrees c contrast exercise resulting tre greater 40 degrees c reduced amount 70k stress protein synthesized leukocytes incubated 41 degrees c protein immunoblot probed antibody specific inducible 72k stress protein showed reduction 35slabeled 70k stress protein postexercise leukocyte samples occurred without marked elevations protein vitro incubation human leukocytes 40 degrees c 15120 min reduced timedependent manner amount 70k stress protein synthesized subsequent 41 degrees c heat stress reduction 70k stress protein synthesis 41 degrees ctreated leukocytes abolished cycloheximide present 40 degrees c preincubation | 4 |
14,411 | esophageal verrucous carcinoma histologically lowgrade malignancy clinically fatal disease 76yearold woman verrucous carcinoma esophagus fistula left main bronchus discuss case together eleven patients verrucous carcinoma esophagus reported previously differentiation tumor squamous cell papilloma often difficult central cores fibrous tissue verrucous carcinoma heavily infiltrated inflammatory cells accounts stenosis often found mortality verrucous carcinoma esophagus 67 even though histologically lowgrade malignancy | 0 |
14,412 | impact physician compliance screening mammography older women screening mammography underutilized even women older 50 years general consensus regular annual screening appropriate necessary evaluate reasons underutilization studied random sample 517 women los angeles calif older 50 years women found underscreened especially women older 65 years example approximately 35 women 50 64 years old 47 women aged 65 years older never even one mammogram analyses revealed important factor predicted whether women ever mammogram whether physician talked mammography women four 12 times likely depending age group mammogram time physicians discussed discussions need lengthy complex results indicate physicians need know discussing screening mammography patients major impact breast cancer screening behaviors | 0 |
14,413 | hepatopathythrombocytopenia syndromea complication dactinomycin therapy wilms tumor report united kingdom childrens cancer study group observed hepatopathy associated thrombocytopenia children receiving chemotherapy wilms tumor studied hepatopathythrombocytopenia syndrome hts patients enrolled united kingdom childrens cancer study group ukccsg wilms tumor trials ukw1 ukw2 time study 501 patients completed therapy treatment flow sheets examined evidence hepatopathy hepatomegaly abnormal liver function tests severe thrombocytopenia platelet count less 25 x 109l child developed syndrome received irradiation hts seen five 355 14 patients treated combination chemotherapy none 146 patients treated vincristine alone instance onset less 10 weeks diagnosis two children hepatopathy severe jaundice ascites transaminases greater 1000 iul prolongation prothrombin time average hts lasted 12 days resolved supportive treatment recovery children tolerated chemotherapy mostly reduced dosage without recurrence evident longterm morbidity dactinomycin probable cause syndrome conclude hts rare important complication dactinomycincontaining combination chemotherapy wilms tumor children developing isolated thrombocytopenia following dactinomycin risk developing fullblown syndrome treatment modified accordingly | 4 |
14,414 | hemodynamic effects nasal cpap examined doppler echocardiography effects incremental application nasal continuous positive airway pressure 0 15 cm h2o heart rate pulmonary artery pressure cardiac index studied noninvasively doppler echocardiography twoway analysis variance within two groups 19 normal volunteers six sleep apnea patients significant effects heart rate pulmonary artery pressure ventricular size cardiac index could found increasing positive intrathoracic pressures consequent lung hyperinflation subjects normal cardiac function nasal cpap safe hemodynamic viewpoint simple repeatable noninvasive technique may used assess clinical safety efficacy prescribed nasal cpap cardiac hemodynamics individual patients | 2 |
14,415 | simplified technique control femoral arterial bleeding coronary angioplasty method achieving arterial control inserting embolectomy catheter femoral introducer sheath patient femoral arterial bleeding ptca described herein approach allows quick control less dissection negligible blood loss | 4 |
14,416 | effects neurodevelopmental treatment orthoses knee flexion gait singlesubject design interactive effects neurodevelopmental treatment inhibitive ankleheight orthoses gait examined via singlesubject research design knee flexion gait initial contact midstance heeloff midswing measured 2yearold girl diplegia use goniometer freezeframe videography treatment treatmentorthoses phases decrease excessive knee flexion noted changes trend time greater 3week treatment phase 3week treatmentorthoses phase changes level initiation treatmentorthoses phase greater treatment phase described neurodevelopmental treatment activities conducted correctly 92 time according independent observer interrater reliability goniometric data measured videography 93 using intraclass correlation coefficients results study suggest methods treatment used decrease excessive knee flexion gait child diplegia | 4 |
14,417 | determination hepatitis b virus dna serum using polymerase chain reaction clinical significance correlation serological biochemical markers sera 98 patients various stages chronic hepatitis b virus infection studied determine clinical significance hepatitis b virus dna serum detected polymerase chain reaction patients divided three groups according hbsag hbeag status group n 31 detectable hbsag hbeag group ii n 46 hbsag hbeag group iii n 21 consisted patients chronic hepatitis b virus carriers lost hbsag followup group patients usually significant liver disease raised serum aminotransferases higher titers hbsag infected hepatitis b virus shorter period patients two groups patients group hepatitis b virus dna detectable polymerase chain reaction 94 sufficient hepatitis b virus dna present detection dotblot hybridization group ii patients lower mean serum aminotransferase activities titers hbsag group serum hepatitis b virus dna detectable polymerase chain reaction 78 30 group ii patients dotblot hybridization group ii patients hepatitis b virus dna detectable polymerase chain reaction mean serum aminotransferase levels within normal range younger mean age hepatitis b virus dna group iii patients generally evidence active liver disease | 4 |
14,418 | diagnosis acute rupture quadriceps tendon magnetic resonance imaging case report quadriceps tendon rupture occurred 56yearold man receiving anticoagulant therapy diagnosis inconclusive magnetic resonance imaging mri used delineate rupture site clearly mri useful adjunct diagnosis softtissue injuries cases swelling softtissue abnormalities obscure examination preclude use routine diagnostic modalities | 4 |
14,419 | local failure related complications definitive treatment carcinoma prostate irradiation surgery authors review institutions experience failure definitive treatment achieve local tumor control distant dissemination local morbidity associated failure causes local failure various incomplete resection implantation spilled cells possibly selective implantation circulating tumor cells traumatized tissues surgery totally partially resistant cells new tumors radiologic misses radiation treatment local failure may prophylactic therapeutic differs depending stage disease failure control tumor locally presence distant metastases alter length survival profoundly affect quality survival | 0 |
14,420 | vaginal bleeding childhood adolescence vaginal bleeding early childhood regardless duration quantity always clinical importance article discusses examination child adolescent reviews various causes vaginal bleeding patient groups | 4 |
14,421 | prospective clinical evaluation autogenous vein grafts used nerve conduit distal sensory nerve defects 3 cm less purpose study determine efficacy autogenous vein grafts nerve grafts avnc bridging small peripheral sensory nerve gaps compared direct repair conventional nerve grafting techniques ang patients painful neuroma segmental nerve injury 3 cm chosen test group amenable direct repair classified controls 1982 1988 total 22 patients enrolled study total 34 nerves repaired 15 venous nerve conduit 4 sural nerve graft 15 direct repair significant symptom relief satisfactory sensory function return uniformly observed twopoint discrimination measurements indicated superiority direct repair probably conventional nerve grafting however universally favorable patient acceptance return measurable twopoint discrimination indicates effectiveness autogenous vein grafts nerve conduits selectively applied bridge small nerve gap less equal 3 cm nonessential peripheral sensory nerves | 0 |
14,422 | premature alveolar bone loss erdheimchester disease erdheimchester disease rare histiocytosis also known lipoid granulomatosis oral findings reported previously knowledge case report documents evidence oral sequelae erdheimchester disease patient whose course followed 10 years national institutes health premature alveolar bone resorption underwent fullmouth extraction age 29 years severe periodontitis histopathologic evidence erdheimchester disease demonstrated periodontal soft tissues ensuring years accelerated resorption residual ridges precluded use conventional dentures recommend early preventive dental management patients erdheimchester disease | 4 |
14,423 | changes cardiovascular homeostasis injury mediated tissue damage haemorrhage treatment injured patient assumed cardiovascular responses follow recognized physiological principles studies humans shown injury causes profound suppression arterial baroreflex function alters normal relationship heart rate blood pressure casts doubt assumption investigate mechanism baroreflex suppression studied effects two major components injury blood loss tissue damage baroreflex function healthy volunteers baroreflex function assessed using suction stimulation carotid sinus loss 500 ml blood effect baroreflex sensitivity human laboratory model tissue injury reduced ability baroreflex compensate rise blood pressure p less 005 wilcoxon signed rank test conclude tissue damage rather hypovolaemia appears mediate effect injury baroreflex function injured blockade neural signals damaged tissue may role treatment injury | 4 |
14,424 | malignant melanoma oral cavity case report oral cavity rare location development primary malignant melanoma less 2 malignant melanomas develop region case report presented illustrating management site palate together review relevant literature | 0 |
14,425 | heart failure prevented delayed reversed review clinical course chronic heart failure demonstrates current outcomes remain highly unsatisfactory mortality perhaps important morbidity extraordinary satisfactory functional responses seen patients undergo cardiac transplantation clearly identify primary cause status heart whatever pathophysiologic adjustments neuroendocrine system interventions wide variety drugs since donor hearts unlikely available even younger sufferers clinical syndromes prevention must hallmark protection viability myocytes acute myocarditis acute infarction essential myocardial collagen undergoes continual synthesis production greatly stimulated presence hypertrophy caused increased wall stress possible excess collagen intimately involved diastolic ventricular dysfunction may reversible process collagenproducing stimulus removed thus reduction wall stress reversibility ventricular hypertrophy appear promising directions however limit catastrophic effects chronic heart failure early recognition precursors syndromes prevention progression surgical intervention valvular heart disease optimal point time essential | 3 |
14,426 | coronary angiographic patterns hypertensive compared normotensive patients patients study assessed coronary angiography classic effort angina positive exercise test patients 320 untreated primary hypertension 320 similar age gender distribution normotensive patients coronary angiography documented least one major epicardial branch restricted 50 prevalence single doublevessel disease fourth fifth decades life similar two populations tended decline age prevalence triplevessel disease also similar two populations fourth fifth decades either population rose age reached peak seventh decade life percentages hypertensive patients sixth seventh decades triplevessel disease significantly p less 001 greater 40 50 respectively corresponding values normotensive individuals 25 31 respectively left main coronary artery significantly involved high blood pressure group pressure moderately similarly raised age hypertension serum cholesterol triglyceride levels blood glucose smoking habits comparable two populations results suggest hypertension accelerate appearance significant coronary narrowing multiple vessel involvement starting sixth decade natural agerelated evolution coronary disease seems aggravated hypertensive subjects reflected augmented number diseased vessels process probably related high blood pressure whether severity hypertension might also exert influence deducible study | 3 |
14,427 | limbbody wall complex complete absence external genitalia vitro fertilization first case limbbody wall complex combination body wall defect neural tube defect limb abnormalities ivf described third reported patient complex anomaly associated complete absence external genitalia possible pathogenic mechanisms discussed | 2 |
14,428 | simple method improve accuracy noninvasive ultrasound selecting tia patients cerebral angiography prospective study reported ability b mode ultrasound imaging continuous wave doppler flow studies detect different degrees stenosis extracranial internal carotid artery ica 186 arteries 99 patients transient ischaemic attacks tia minor ischaemic stroke simple mathematical equation developed combines image flow data provide single predictor degree angiographic stenosis advantages either ultrasonic modality used alone sensitivity specificity predictive model detection stenosis greater equal 25 73 98 stenosis greater equal 50 90 93 stenosis greater equal 75 65 99 occlusion 100 94 respectively principal clinical value ultrasound screening spare patients nonsignificant stenosis risk unnecessary angiography thus simple measure duplex screening tests performance proportion strokes occurring complication angiography avoided changing investigation policy angiograms carotid tia minor ischaemic stroke patients angiograms patients abnormal ultrasound results duplex scanning used select patients likely significant abnormality angiography depending degree stenosis detected 5285 angiographic strokes might avoided predictive equation used 6288 angiographic strokes might avoided | 2 |
14,429 | relationship ischemic heart disease sudden death clinicopathological synthesis presented relationship ischemic heart disease sudden cardiac death immediate pathophysiological process responsible sudden cardiac death lethal arrhythmia usually ventricular fibrillation although significant coronary atherosclerosis present cases naturally occurring sudden death available evidence indicates several mechanisms operative pathogenesis fatal event 1 acute myocardial infarction minority cases 2 myocardial ischemia without infarction initiated either exertioninduced increase myocardial oxygen demand b acute coronary event often involving plaque degeneration platelet aggregation 3 primary arrhythmia usually resulting altered electrical conduction setting previous myocardial infarction | 4 |
14,430 | multifactorial analysis mortality morbidity perforated peptic ulcer disease perforated peptic ulcer disease remains source considerable morbidity mortality suggested methods surgical therapy diverse reviewed course 113 patients treated surgically identified 14 factors influenced morbidity mortality rates multiple regression analysis showed number coexisting medical conditions lower mean blood pressure level duration acute perforation independent risk factors death age use bronchodilator lower mean blood pressure level number coexisting medical conditions correlated positively complications duodenal site independently favorable respect complications type operation performed either simple closure vagotomy drainage resection influence morbidity mortality severely ill patients also benefit particular type operation short term long term results improved definitive operation measured visick classification need reoperations definitive operations recommended virtually patients perforated peptic ulcer | 3 |
14,431 | myocardial protein turnover patients coronary artery disease effect branched chain amino acid infusion regulation protein metabolism human heart previously studied 10 postabsorptive patients coronary artery disease heart protein synthesis degradation estimated simultaneously extraction intravenously infused lring263hphenylalanine phe dilution specific activity across heart isotopic steady state subsequently examined effect branched chain amino acid bcaa infusion heart protein turnover myocardial balance amino acids branched chain ketoacids bcka patients postabsorptive state net release phenylalanine arterialcardiac venous phe 171 032 nmolml p less 0001 balance 116 21 nmol phemin p less 0001 reflecting protein degradation 142 40 nmol phemin excess synthesis 24 42 nmol phemin net myocardial protein catabolism bcaa infusion protein synthesis increased equal degradation rate 106 24 106 28 nmol phemin respectively phenylalanine balance shifted p 001 negative neutral arterialcardiac venous phe 007 036 nmolml balance 2 25 nmol phemin bcaa infusion stimulated myocardial uptake bcaa p less 0005 ketoacid conjugates p less 0001 proportion circulating concentrations net uptake bcaa greatly exceeded essential amino acids suggesting role bcaa bcka metabolic fuels plasma insulin levels cardiac double product coronary blood flow myocardial oxygen consumption unchanged results demonstrate myocardium postabsorptive humans negative protein balance indicate primary anabolic effect bcaa human heart | 3 |
14,432 | evaluating oxygen delivery oxygen utilization mixed venous oxygen saturation monitoring case study approach three cases studies presented demonstrate clinical application mixed venous oxygen saturation svo2 monitoring critical care nursing practice examples critically ill patients used demonstrate svo2 monitoring used clinical practice reflect imbalance oxygen delivery oxygen utilization first case patient problem oxygen delivery continuous svo2 data aided nurses guiding adjusting assessing therapy second case demonstrates svo2 monitoring provide early sign lifethreatening complication final case one patient problem oxygen utilization cases continuous svo2 data provided important information balance oxygen delivery oxygen utilization | 2 |
14,433 | management aortobronchial fistula graft replacement omentopexy massive hemoptysis due recurrent aortobronchial fistula repair thoracic aortic aneurysm developed 64yearold woman infected aortic tissue resected replaced situ dacron graft covered omentum patient alive well 15 months later | 3 |
14,434 | tuberculous psoas muscle abscess following chemoprophylaxis isoniazid patient human immunodeficiency virus infection 34yearold man human immunodeficiency virus infection disseminated mycobacterium avium mycobacterium intracellulare infection developed right psoas muscle abscess due mycobacterium tuberculosis abscess occurred 18 months completion 12month course chemoprophylaxis isoniazid given positive reaction purified protein derivative tuberculin adjacent vertebrae appear involved abscess drained percutaneously inserted catheter received standard antituberculous chemotherapy three weeks therapy second drainage catheter required isolation two mycobacteria patient apparent failure chemoprophylaxis isoniazid noted | 4 |
14,435 | clinical evaluation highfrequency ultrasonic mechanical debridement surgical treatment calcific aortic stenosis repair aortic valve stenosis due calcific degeneration may lead hemodynamic clinical improvement without problems inherent prosthetic valves evaluated use device capable debriding calcium cavitron ultrasonic aspirator cusa adjunct mechanical debridement repair calcific aortic stenosis ten patients five women ages 63 83 years studied mmode twodimensional doppler echocardiography average 26 range 3 124 days procedure degree calcification valve cusps clearly reduced maximal cusp excursion increased 07 01 cm preoperatively 15 04 cm postoperatively p 0006 peak aortic gradient fell 80 36 mm hg 28 10 mm hg p 00007 mean aortic gradient fell 53 20 mm hg 16 5 mm hg p less 00001 aortic valve area calculated continuity equation increased 06 02 cm2 16 06 cm2 p 00009 patient mild aortic insufficiency preoperatively postoperatively color doppler flow mapping revealed severe aortic insufficiency two patients seven patients echocardiographic evaluation 99 range 33 196 days procedure studies revealed development severe aortic insufficiency additional four patients four patients severe symptomatic aortic insufficiency eventually underwent aortic valve replacement pathology revealed scarring retraction aortic cusps widening commissures responsible severe aortic insufficiency | 3 |
14,436 | antitumor activity liposomeencapsulated doxorubicin advanced breast cancer phase ii study previous studies animals demonstrated liposomeencapsulated doxorubicin led substantially less cardiac toxicity free doxorubicin retains antitumor activity phase clinical study led maximum tolerated dose 90 mgm2 doselimiting toxicity considered reached granulocytopenia produced used led treat 20 patients advanced measurable breast cancer led given doses 6075 mgm2 every 3 weeks intravenous infusion regression disease objectively measured nine patients five patients complete regression index lesion occurred mean duration responses 7 months hematologic toxicity consisted grade 12 leukopenia patients gastrointestinal toxicity mucositis generally mild tolerable alopecia occurred patients usually complete twelve patients received cumulative doses led greater 400 mgm2 evaluated radionuclide ventriculograms eight patients cumulative dose greater 500 mgm2 five endomyocardial biopsies four biopsy results billingham grade 0 one cumulative led dose 750 mgm2 showed grade 1 changes mild myofibrillar loss dilatation sarcoplasmic reticulum involving less 5 cardiac myocytes two patients decreases left ventricular ejection fraction one patients received total dose led 630 mgm2 decline 13 left ventricular ejection fraction clinical evidence congestive heart failure billingham grade 0 endomyocardial biopsy | 0 |
14,437 | unusual venous anomaly placenta authors present unusual vascular anomaly placenta placenta large weighing 1490 g fetal surface numerous dilated tortuous vessels observed chorionic membrane three branches arose vein connected umbilical vein one 5 x 25 cm aneurysmal dilatation three secondary branches arose venous channels dilated tortuous longest secondary branch 133 cm length 12 cm mean diameter led placenta multiple severely coiled straight small branches arising vessels also observed vascular tangles smaller vessels also led placenta abnormal vessels veins umbilical cord also normal except membranous insertion placenta unremarkable except large size | 3 |
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