Unnamed: 0
int64 0
14.4k
| text
stringlengths 138
3.08k
| label
int64 0
4
|
|---|---|---|
200 | phase study repeated cycles highdose cyclophosphamide etoposide cisplatin administered without bone marrow transplantation fortytwo patients advanced malignancy judged unlikely respond standard treatment received highdose combination chemotherapy cyclophosphamide etoposide cisplatin phase trial twentytwo patients least partial response pr first cycle therapy received second cycle eight patients received three cycles therapy bone marrow replacement used maximumtolerated doses mtds cyclophosphamide 25 gm2 days 1 2 etoposide 500 mgm2 days 1 2 3 cisplatin 50 mgm2 days 1 2 3 hematologic toxicity doselimiting study design recovery absolute granulocyte count 100microl occurred median 9 days onset range 3 23 days mtd recovery delayed third cycle one patient third cycle failed recover peripheral blood counts died sepsis day 43 hematologic toxicity dosedependent nonhematologic toxicities included emesis fatigue alopecia diarrhea anorexia generally well tolerated doselimiting toxicities fatal pulmonary cardiac toxicities five nine patients treated highest dose level patients likely well selected tumor type response prior therapy performance status nine 36 assessable patients complete response cr 13 pr response rate 61 five patients 12 remain alive free disease 15 32 months repeated cycles doseintensive combination therapy produce longterm diseasefree remissions patients refractory tumor types toxicity regimen acceptable patients carefully selected | 0 |
201 | increase plasma cholesterol independent thyroid function longterm amiodarone therapy dosedependent relationship objective determine whether longterm amiodarone treatment associated rise plasma cholesterol analyze relation thyroid function design consecutive entry trial including cardiac patients initiated amiodarone medication excluding abnormal thyroid function defined peak thyroidstimulating hormone tsh response thyrotropinreleasing hormone trh less 28 greater 220 mul either amiodarone treatment patients twentythree patients remained euthyroid studied intervention oral administration amiodarone mean duration treatment 17 months range 6 30 months measurements fasting plasma lipids thyroid hormones peak tsh trh values recorded every 6 months amiodarone treatment results plasma cholesterol gradually increased 51 02 mmoll treatment 69 08 mmoll 30 months amiodarone medication p less 0001 peak tsh response trh change age sexspecific reference values applied 30 patients cholesterol values 75th percentile treatment number rose 69 2 years treatment rise plasma cholesterol associated equal increase apoprotein b plasma cholesterol related daily dose amiodarone plasma concentrations amiodarone desethylamiodarone thyroxine t4 triiodothyronine t3 reverse triiodothyronine rt3 linear regression analysis indicated positive relation plasma cholesterol cumulative dose amiodarone r 025 p less 005 conclusion longterm amiodarone treatment associated dosedependent increase plasma cholesterol independent thyroid function | 3 |
202 | orthostatic hypotension human immunodeficiency virus infection may result generalized autonomic nervous system dysfunction used autonomic nervous system ans testing battery determine generalized ans dysfunction present five human immunodeficiency viruspositive hiv patients presenting severe orthostatic hypotension oh five patients abnormal ans testing demonstrated sympathetic parasympathetic defects ie generalized ans dysfunction treatment fludrocortisone effectively reversed oh four five patients oh transient four patients believe important recognize oh may result generalized ans dysfunction hivpositive patients effectively treated | 3 |
203 | changes serum hepatitis b virus dna aminotransferase levels course chronic hepatitis b virus infection children followup period 32 16 1 86 yr 1087 serum specimens 230 hbsag carrier children tested hepatitis b virus markers dividing serum specimens four groups according status hbeag hepatitis b virus dna frequency abnormally elevated alt levels serum following order hbeaghepatitis b virus dna serum 60 hbeaghepatitis b virus dna serum 53 hbeaghepatitis b virus dna serum 41 hbeaghepatitis b virus dna serum 11 analysis data hbeag clearance showed high serum alt level low serum hepatitis b virus dna level correlated imminent clearance hbeag approximately two thirds children serum alt levels higher 100 iul cleared hbeag within following year clearance hbeag occurred within following year 65 13 20 cases serum hepatitis b virus dna level less equal 1000 pgml contrast 19 30 157 serum hepatitis b virus dna level greater 1000 pgml among 53 children lost hbeag hepatitis b virus dna followup nine cases identified period abnormal serum alt levels remaining 44 children abnormal serum alt levels fell normal clearance hbeag hepatitis b virus dna 33 children remained elevated remaining 11 cases seroconversion | 4 |
204 | false aneurysm formation great arteries arterial switch operation infant simple transposition great arteries underwent twostaged arterial switch operation mediastinal infection occurred continuous irrigation povidoneiodine solution performed 10 days patient experienced lifethreatening hemorrhage three times time second hemorrhage greater omental transfer performed postoperative day 109 false aneurysm recognized developed great arteries successful repair performed postoperative day 110 | 4 |
205 | intrinsic vasodilation protects wistar kyoto rats progressive glomerulosclerosis unilateral nephrectomy genetically determined differences functional structural determinants govern development progressive glomerulosclerosis gs studied aging shamoperated unilaterally nephrectomized male rats two strains wistar rats showed increase proteinuria gs age enhanced unilateral nephrectomy un contrast intact un wistar kyoto rats show increase proteinuria age 7 months un gs seen rats systemic blood pressure comparable strains affected un functional studies separate group rats 1 month un showed identical increase glomerular filtration rate strains compared shamoperated controls wistar rats show effect un renal plasma flow consequently increase filtration fraction contrast wistar kyoto rats showed increase renal plasma flow unchanged filtration fraction glomerular volume increased strains 1 month 7 months un mesangial expansion observed 1 month un either strain indicates decisive factor development gs data indicate genetically determined susceptibility development gs two rat strains may related degree vasoconstriction whereas glomerular volume expansion per se lead gs well consequence hyperfiltration studies concordant previous studies revealed role hemodynamics pathogenesis gs irrespective glomerular expansion | 4 |
206 | proximal gastric vagotomy followup 1020 years august 1969 december 1989 600 patients elective proximal gastric vagotomy duodenal ulceration operative mortality 02 per cent 372 patients surgery 10 years ago three hundred fortytwo patients survived 10 years prospective study 305 reviewed forming basis 1020year followup report fortysix 15 per cent recurrent ulceration 80 per cent developed symptoms within 5 years patient recurrence 13 years although 29 patients required reoperation recurrent ulceration current patient satisfaction rate visick grades ii 92 per cent two patients required reoperation gastric stasis concluded proximal gastric vagotomy safe satisfactory first choice operation duodenal ulceration | 1 |
207 | randomized control trial two cervical spatulas sampling efficacy ayre rocket cervical spatulas compared randomized controlled trial involving 533 women attending colposcopy clinic either investigation cytological abnormality review treatment cin smears compared respect presence cytological abnormality two types normal cervical epithelial cells endocervical immature metaplastic cells considered indicators adequate cytological sampling smears taken rocket spatula significantly less likely contain immature metaplastic cells 95 ci difference proportion 530 likely contain endocervical cells 95 ci 1636 significant difference found proportion smears containing one type indicator cell yield abnormal smears concluded rocket spatula offered advantage used circumstances study illustrates spurious conclusions sampling efficacy drawn one type indicator cell used endpoint | 4 |
208 | 1989 presidential address international society study vulvar disease major changes terminology vulvar disease taken place past 20 years influence members international society study vulvar disease major terminology changes made vulvar nonneoplastic disorders vulvar intraepithelial neoplasia superficially invasive squamous cell carcinoma | 0 |
209 | detection vascular complications renal allografts color doppler flow imaging one hundred ninetyfive color doppler flow cdf examinations performed 146 renal allografts assess capabilities technique detecting intra extrarenal vascular complications conventional angiography also performed 44 transplants group transplants angiographic correlation cdf sonography enabled correct identification 30 34 vascular complications cdf showed 10 11 significant stenoses renal artery one main branches two falsepositive renal artery stenoses one normal artery one 40 stenosis nine nine renal artery thromboses single pseudoaneurysm also identified within parenchyma cdf sonography demonstrated five five segmental infarcts two two postbiopsy arteriovenous fistulas three six segmental interlobar artery stenoses measurement peak systolic velocity showed significant difference p less 05 group n 8 significant stenosis renal artery one main branches mean 2152 cmsec 32 group n 14 without stenosis mean 992 cmsec 19 | 4 |
210 | social support cancer patient implications future research clinical care review assesses past progress current practices future needs research clinical practice involving social support needs cancer patients review given various conceptualizations social supportstress paradigm state art measuring social support current work field social support cancer considered argument made use social support measures relevant experiences cancer patient potential adaptations existing instrument dukeunc functional social support scale demonstrated taxonomy stages cancer would require additional types social support measures interventions outlined interventions discussed terms traditional support groups well interventions oncologist primary care physician argument made inclusion quality life functional measures outcomes clinical trials care cancer patient finally need address existential philosophic religious issues surrounding cancer treatment discussed | 0 |
211 | changing treatment patterns affected outcome operable breast cancer tenyear followup 1288 patients 1965 1978 1965 1978 1288 patients primary operable breast cancer treated senior author using extended radical erm radical rm modified radical mrm mastectomy operations exclusively results analyzed trends overall diseasefree survival patterns local distant relapse years 1965 1970 versus 1971 1974 versus 1975 1978 significant changes p less 000001 1965 1978 included progressively earlier stage disease less frequent use rm erm decline use postoperative radiotherapy introduction 1975 multidrug adjuvant chemotherapy tenyear diseasefree survival rates improved significantly patients 11 p 000004 nodenegative 12 p 00024 nodepositive 8 p 0012 clinical stage ii 15 p 00022 pathologic stage ii 12 p 0016 disease tenyear local recurrence patients 3 local 2 local distant metastasis survival date recurrence patients failing treatment increased two times p less 00001 patients treated recently primary surgical treatment breast cancer continues become moderate promise systemic adjuvant therapies realized continued emphasis earlier diagnosis maximal local control disease | 4 |
212 | acute leukemia related entities impact new technology twentyseven cases acute leukemia related entities evaluated morphologic examination cytochemical study terminal deoxynucleotidyltransferase study immunophenotyping cytogenetic analysis ultrastructural cytochemical study gene rearrangement analysis determine impact determination frenchamericanbritish fab classification definitive diagnosis definitive diagnosis contained prognostic diagnostic treatment information beyond fab classification affected disease course patient management diagnostic variables evaluated case labeled essential ambivalent supportive noncontributory except gene rearrangement analysis variables studied contributed essential data establish definitive diagnosis ambivalent findings rare could explained knowledge total data variables except cytochemical study whose results almost always essential contributed supportive data noncontributory data occurred cytogenetic analysis cases demonstrated normal karyotypes fab classification established 20 74 cases use morphologic examination cytochemical study terminal deoxynucleotidyltransferase study use variables however definitive diagnosis whose determination required data established 15 555 cases addition immunophenotyping increased definitive diagnosis 25 925 cases use ultrastructural myeloperoxidase platelet peroxidase analysis enabled us definitively diagnose remaining two cases 27 cases 100 cytogenetic analysis revealed four cases essential information added diagnosis however cytogenetic information usually immediately available result affect immediate diagnosis treatment surprisingly gene rearrangement studies yield essential data case cases contributed ambivalent data finding exclude gene rearrangement analysis selected cases however data always interpreted light clinical laboratory findings study clearly demonstrates importance multifaceted approach understanding acute leukemias related entities shows impact newer technologies reaching definitive diagnosis | 0 |
213 | synchronous diffuse welldifferentiated lymphocytic lymphoma gastric adenocarcinoma presenting splenomegaly iron deficiency anemia diffuse welldifferentiated lymphocytic lymphoma dwdll chronic lymphocytic lymphoma cll represent closely related neoplasms may indolent courses dating back one century reports associated second primary malignancies continue intrigue clinicians case synchronous dwdll gastric adenocarcinoma presenting splenomegaly iron deficiency anemia presented case literature reviewed | 4 |
214 | antibiotic use among children urban brazilian slum risk factor diarrhea published erratum appears j public health 1991 apr814417 among cohort children poor urban setting brazil relative risk occurrence new episode diarrhea two weeks following antibiotic use vs weeks 144 95 confidence interval ci 133 245 among children ever corrected exposed antibiotics odds ratio 134 95 ci 084 216 stratifying individual child controlling previous diarrhea research needed confirm whether antibiotics risk factor diarrhea settings | 1 |
215 | parathyroid hormonerelated peptide plasma patients hypercalcemia malignant lesions developed validated radioimmunoassay circulating human parathyroid hormonerelated peptide pthrp based commercial antiserum synthetic 134 fragment pthrp 125ityr degreespthrp134 radioligand prior extraction native peptide plasma c2 cartridges determined immunoreactive pthrp concentrations plasma samples 48 healthy persons mean sd 31 10 pmolliter range less 2 5 pmolliter 8 patients primary hyperparathyroidism 36 patients hypercalcemia concurrent malignant lesion 9 normocalcemic patients cancer increased serum levels carcinoembryonic antigen prostatespecific antigen pthrp normal samples patients primary hyperparathyroidism 32 11 pmolliter secondary hyperparathyroidism 25 13 pmolliter cancer without hypercalcemia 24 10 pmolliter contrast plasma immunoreactive pthrp levels increased 60 850 pmolliter 47 patients hypercalcemia cancer various types without bone metastatic lesions large amounts pthrp also found conditioned medium cultured human prostatic carcinoma cells thus pthrp may causative factor hypercalcemia associated malignant lesion least half cases measurement circulating pthrp may differential diagnostic help hypercalcemic states | 0 |
216 | posterior transfer adductors children cerebral palsy longterm study seventyeight posterior transfers adductors hip fortytwo children spastic cerebral palsy reviewed average 57 years operation range two 146 years results assessed basis patients ability walk range motion affected hip hips radiographic measurements 88 per cent patients transfer successful improving maintaining abduction extension functional walking stability hip failures patients unable walk spastic quadriplegia tenotomy iliopsoas tendon time transfer procedure resulted improved range motion hip | 2 |
217 | cancer registry problems classifying invasive bladder cancer slide review diagnostic pathologic tissue obtained 364 bladder cancer cases identified iowa surveillance epidemiology end results seer program 1983 classified 97 266 cases invasive bladder cancers findings contrasted sharply iowa seer program classification coded 289 794 cases invasive bladder cancers results validated hazard ratio 454 95 confidence interval 257 803 among invasive relative noninvasive bladder cancer cases slide review findings used contrast hazard ratio 170 95 confidence interval 076 379 iowa seer program findings used traditional method used national cancer institutes seer program deal problem described implications discussed | 0 |
218 | solitary isolated metastasis ewings sarcoma brain case report report case 30yearold woman developed intraparenchymal cerebral metastasis ewings sarcoma chest wall diagnosed treated 3 years earlier apparent remission time neurological presentation seizures case complicated spontaneous preoperative intratumoral hemorrhage occurred morning scheduled surgical resection caused left dense hemiparesis tumor hematoma removed patient improved surgical intervention postoperative course cranial irradiation followed systemic chemotherapy given nineteen months treatment patient remains diseasefree clinical radiological standpoint | 4 |
219 | sequence functional expression xenopus oocytes human insulinoma islet potassium channel regulation insulin secretion involves coordinated control ion channels betacell membrane isolated characterized cdna genomic clones encoding voltagedependent k channel isoform expressed human islets human insulinoma k channel isoform designated hpcn1 deduced amino acid sequence 613 residues mr 67097 related shaker family drosophila k channels hpcn1 homologous two human k channel isoforms isolated hpcn2 hpcn3 55 65 amino acid sequence identity respectively electrophysiological characteristics hpcn1 determined microinjection synthetic rna xenopus oocytes twomicroelectrode voltageclamp recordings oocytes injected hpcn1 rna revealed voltagedependent outward k current inactivated slowly time outward currents inhibited 4aminopyridine ki less 010 mm relatively insensitive tetraethylammonium ion ba2 delayed rectifier k channel hpcn1 could restore resting membrane potential beta cells depolarization thereby contribute regulation insulin secretion | 0 |
220 | learning unimanual motor skill partial commissurotomy patients series motor tests four chinese partial commissurotomy patients reported singlestage commissurotomy four patients included anterior commissures twothirds fourfifths section corpus callosum sparing splenium demonstrable ability transfer hand posture patients major evidence functional deconnexion newly learned task onehand knotting revealed right hand impairment four patients dyspraxia right hand overlearned objecthandling tasks patients suggested might right hemisphere specialisation initial acquisition unimanual objecthandling skills spared callosal fibres splenium alone insufficient mediate task control conditions supported finding one patients one right parietal lesion unable perform newly learned task either hand | 4 |
221 | linkage earlyonset familial breast cancer chromosome 17q21 human breast cancer usually caused genetic alterations somatic cells breast occasionally susceptibility disease inherited mapping genes responsible inherited breast cancer may also allow identification early lesions critical development breast cancer general population chromosome 17q21 appears locale gene inherited susceptibility breast cancer families earlyonset disease genetic analysis yields lod score logarithm likelihood ratio linkage 598 linkage breast cancer susceptibility d17s74 earlyonset families negative lod scores families lateonset disease likelihood ratios favor linkage heterogeneity among families ranged 20001 greater 1061 basis multipoint analysis four loci region | 0 |
222 | longterm followup asymptomatic microhematuria present 10 20year followup assessment 191 patients unexplained microhematuria including persons insignificant lesions genitourinary malignancies develop patients 128 alive 27 dead evaluated first diagnostic investigation patient physician compliance followup protocols poor currently recommend renal ultrasound cystoscopy first diagnostic survey abandoned routine periodic studies advise diagnostic studies patients symptoms develop | 4 |
223 | ocular manifestations onchocerciasis rain forest area west africa epidemiology natural history onchocerciasis ocular complications rain forest areas poorly understood present study conducted rubber plantation hyperendemic area rain forest liberia west africa 800 persons examined prevalence infection 84 overall 29 intraocular microfilariae 24 blind one eyes onchocerciasis cause binocular blindness onethird visual impairment half visual impairment caused onchocerciasis due posterior segment diseases chorioretinal changes present 75 people included intraretinal pigment clumping 52 retinal pigment epithelium atrophy 32 atrophy retinal pigment epithelium associated increasing age severity infection intraretinal pigment strongly associated anterior uveitis strong correlation uveitis inflammatory chorioretinal sequelae retinitis intraretinal pigment subretinal fibrosis optic neuropathy findings indicate considerable visual impairment associated rain forest onchocerciasis common due largely chorioretinal disease | 4 |
224 | cells immunoreactive neuropeptide human thymomas presence opioid peptides bombesin substance p investigated immunohistochemistry tissue sections six human thymomas number immunoreactive cells seemed vary one case another ultrastructural investigation showing presence desmosomes labelled cells allowed cells classified epithelial lineage cells occurrence cells containing neuropeptide thymomas suggest peptide molecules could modulated behaviour tumour given reported influence molecules immune functions growth promoting activity several cell types including mesenchymal epithelial cells | 0 |
225 | sphincter preservation rectal cancer local excision postoperative radiation therapy authors report preliminary results 14 patients localized mobile resectable rectal cancer treated local excision postoperative radiation therapy rt negative surgical resection margins two received 5fluorouracil 5fu median followup 29 months 443 months 3year actuarial survival 88 incidence local failure 7 site failure 21 component failure incidence local failure increased stage t1 03 0 t2 17 14 t3 24 50 tumor size greater 3 cm 33 versus less equal 3 cm 0 three patients developed local failure 6 15 21 months three underwent salvage abdominoperineal resection locally controlled 2 28 months following salvage surgery one patient underwent abdominoperineal resection clinically presumed local failure however tumor found specimen therefore 13 patients either initially locally controlled underwent salvage nonsalvage surgery evidence disease pelvis time last followup local excision postoperative rt may alternative standard surgery selected cases however additional followup experience needed order determine approach ultimately local control survival rates similar low anterior resection abdominoperineal resection | 0 |
226 | onestage laryngotracheoplasty article documents evolution approach repair subglottic stenosis infants increasing experience management subglottic stenosis using anterior cricoid split procedure extended procedure include older children led use onestage procedure repair severe mature subglottic stenosis present results surgical repair 13 patients extubation accomplished 12 13 patients using onestage laryngotracheoplasty | 4 |
227 | results transsphenoidal extirpation craniopharyngiomas rathkes cysts fourteen patients undergoing transsphenoidal extirpation craniopharyngiomas rathkes cysts underwent endocrinological evaluation surgery one patient died procedure uncontrollable arterial bleeding patients followed 16 years average 85 years one patient recurrence tumor 12 years surgery another patient one operated recurrent craniopharyngioma previous radiation therapy died 2 years transsphenoidal operation patient recovered pituitary functions lost surgery one patient isolated growth hormone deficiency another panhypopituitarism sustained antidiuretic hormone secretion change postoperatively preoperative endocrine status 11 patients lost pituitary function required pharmacological replacement one four pituitary hormones | 4 |
228 | breast cancer militarys experience wilford hall usaf medical center reviewed experience breast cancer wilford hall usaf medical center years 1978 1988 total 868 cases identified wilford hall tumor registry overall 5year 10year survivals 63 39 respectively infiltrating ductal carcinoma represented principal histologic category predominant variants included invasive lobular carcinoma lobular carcinoma situ ductal carcinoma situ recently patients 90 modified radical mastectomy definitive surgical therapy chemotherapy reserved primarily patients advanced disease | 0 |
229 | multiplexing studies effects rapid atrial pacing area slow conduction atrial flutter canine pericarditis model background report rapid atrial pacing interrupts atrial flutter orthodromic wave front pacing impulse blocked area slow conduction reentry circuit characterize area slow conduction atrial flutter rapid pacing studied 11 episodes induced atrial flutter mean cycle length 157 20 msec eight dogs sterile pericarditis methods results atrial electrograms recorded simultaneously 95 pairs right atrial electrodes interruption atrial flutter rapid atrial pacing mean cycle length 139 21 msec areas slow conduction atrial flutter demonstrated one three sites reentry circuit rapid pacing captured reentry circuit one area slow conduction either disappeared 10 episodes degree slow conduction area slow conduction decreased one episode changes association activation region wave front pacing impulse arrived direction different induced atrial flutter interruption atrial flutter rapid pacing occurred orthodromic wave front pacing impulse blocked area slow conduction either newly evolved rapid pacing seven episodes previously present four episodes conclusions areas slow conduction present atrial flutter rapid pacing atrial flutter functional depend atrial rate direction circulating wave fronts interruption atrial flutter rapid pacing results block orthodromic wave front pacing impulse area slow conduction reentry circuit | 4 |
230 | reduced atrial contribution left ventricular filling patients severe tricuspid regurgitation tricuspid valvulectomy doppler echocardiographic study patients undergoing valvulectomy isolated tricuspid valve endocarditis offer unique opportunity study effects acquired right ventricular volume overload left ventricular filling persons free pulmonary hypertension preexisting left heart disease eleven patients undergone total partial removal tricuspid valve compared 11 agematched control subjects doppler echocardiographic techniques used quantify changes left ventricular filling relate changes left ventricular left atrial geometry caused right ventricular right atrial distension late diastolic fractional transmitral flow velocity integral measure left atrial contribution left ventricular filling significantly decreased patients undergoing tricuspid valvulectomy compared control subjects 022 011 versus 032 009 p less 004 severe tricuspid regurgitation patients resulted marked right atrial distension reversal normal interatrial septal curvature compression left atrium left atrial area significantly smaller control subjects 59 22 versus 86 12 cm2m2 p less 0005 acting receiving chamber left ventricle maximally compressed volumeoverloaded right ventricle late diastole coincident timing atrial systole resulting significant increase left ventricular eccentricity index compared control subjects 135 014 versus 103 01 p less 0001 thus right ventricular volume overload due severe tricuspid regurgitation results left heart geometric alterations decrease left atrial preload impair left ventricular receiving chamber characteristics reduce atrial contribution total left ventricular filling | 4 |
231 | effects acute alcohol intake tolerance hypotension specific aim research test hypothesis intoxication alcohol results poor tolerance hemorrhage evaluated basis blood pressure cardiac output respiratory rate blood flow organs survival 4 hr hemorrhage four groups six swine per group used control intoxicated hemorrhage intoxicatedhemorrhage results revealed blood alcohol concentrations near 01 greatly reduced tolerance hemorrhage intoxicated animals subjected hemorrhage unable maintain adequate cardiac output blood pressure respiratory rate sustain life pigs tolerated higher blood alcohol concentrations 035 exposed hemorrhage also unintoxicated pigs able compensate severe hemorrhage one six pigs intoxicatedhemorrhage group survived 4 hr hemorrhage conclusion bodys ability compensate recover hemorrhage greatly reduced intoxication logical assume ability overcome numerous stressors may also reduced intoxication | 4 |
232 | elevated insulin norepinephrine neuropeptide hypertension investigate relationship insulin sympathetic activity plasma norepinephrine neuropeptide serum glucose insulin concentrations measured ten age weight sexmatched normotensive untreated hypertensive subjects fasting 2 h following ingestion 75 g oral glucose dose hypertensives higher fasting serum insulin 27 6 v 12 2 microuml p 02 plasma norepinephrine 356 38 v 235 35 pgml p 03 concentrations normotensives glucose load increased serum insulin p less 001 plasma norepinephrine concentrations p 001 groups hypertensives still higher postglucose insulin p 003 norepinephrine levels p 003 normotensives fasting neuropeptide higher hypertensives normotensives p 03 correlated age groups r 07 r 077 postglucose serum insulin correlated positively plasma norepinephrine r 075 p 013 normotensives parameters correlated negatively hypertensives r 07 p 036 hypothesize elevated plasma norepinephrine neuropeptide levels reflect increased level sympathetic nervous activity hypertensives turn may responsible abnormal relationship plasma ne insulin levels | 3 |
233 | angiographic technique threedimensional determination arterial supply patterns cadaver soft tissue method arterial tree mapping used cadaver soft tissue presented situ angiograms photographs supplemented profile angiograms relatively narrow bands tissue removed specimen described method better suited mapping course supply patterns softtissue arterial network either situ angiograms dissection practical problems encountered solutions used providing radiopacity structural support vessels pure barium sulfate found suitable filled vascular tree capillary level without leakage excision specimen | 4 |
234 | myocardial temperature cardiac operations influence right ventricular function maintenance right heart integrity frequently neglected coronary operations right ventricular dysfunction sometimes limits success surgical procedure however addition use cardioplegic solutions myocardial hypothermia ischemic cardiac arrest seems important factor guaranteeing right ventricular performance thereafter study designed measure myocardial temperature patients coronary artery disease significant stenosis right coronary artery comparison stenosis right coronary artery evaluate influence myocardial temperature right ventricular hemodynamics cardiopulmonary bypass right ventricular function assessed thermodilution technique allows measurement right ventricular ejection fraction right ventricular enddiastolic volume right ventricular endsystolic volume right ventricular temperature differed significantly two groups lowest value 151 degrees 18 degrees c group without stenosis right coronary artery value 222 degrees 21 degrees c group stenosis right coronary artery left ventricular septal temperatures without group differences within investigation period right ventricular hemodynamics impaired group stenosis right coronary artery decrease right ventricular ejection fraction 442 341 immediately termination bypass increase right ventricular enddiastolic volume index 38 right ventricular endsystolic volume index 70 cardiac index decreased group 225 analysis covariance revealed significant correlation changes right ventricular ejection fraction right ventricular enddiastolic volume right ventricular endsystolic volume course right myocardial temperature concluded right ventricular hypothermia difficult achieve patients diseased right coronary artery constant myocardial hypothermia however seems important guaranteeing right ventricular function easily evaluated thermodilution technique | 3 |
235 | headache acquired immunodeficiency syndrome acquired immunodeficiency syndrome aids virus neurotropic physicians continue see rise number neurologic complications syndrome much increase accompanied headache primary symptom hiv infection opportunistic disease also result diagnostic tests therapeutic efforts complete understanding ramifications headache aids important 1990s continue treat younger population usually affected benign vascular muscle contractiontype headache | 2 |
236 | treatment chronic liver disease caused 3 betahydroxydelta 5c27steroid dehydrogenase deficiency chenodeoxycholic acid deficiency 3 betahydroxydelta 5c27steroid dehydrogenase second enzyme sequence catalyses synthesis bile acids cholesterol leads chronic liver disease childhood well malabsorption fat fat soluble vitamins 4 year old boy condition successfully treated oral administration bile acidchenodeoxycholic acid jaundiced since birth grew poorly rickets severe pruritus plasma transaminase activities persistently raised chenodeoxycholic acid 125 mg twice daily two months 125 mg daily cured jaundice pruritus returned transaminase activities normal eliminated need calcitriol prevention rickets treatment far remained well two years diagnosis 3 betahydroxydelta 5c27steroid dehydrogenase deficiency considered child unexplained chronic hepatitis cirrhosis especially liver disease accompanied clinically obvious malabsorption fat soluble vitamins simple colorimetric test urine confirms diagnosis effective treatment started | 1 |
237 | effects antihypertensive therapy mechanics cerebral arterioles rats purpose study examine effects antihypertensive treatment structure mechanics cerebral arterioles incidence stroke strokeprone spontaneously hypertensive rats shrsp treatment hypertension begun 3 months age cilazapril 45 mgkgday angiotensin converting enzyme ace inhibitor hydralazine 18 mgkgday cilazapril hydralazine reduced systolic arterial pressure 195 8 125 5 148 3 mm hg respectively mean sem p less 005 examine structure mechanics cerebral arterioles measured pressure servonull external diameter crosssectional area vessel wall histologically pial arterioles normotensive wistarkyoto wky rats shrsp untreated treated 3 months cilazapril hydralazine arterioles maximally dilated edta wky rats cilazapril hydralazine alter pial arteriolar pressure external diameter crosssectional area vessel wall shrsp cilazapril hydralazine reduced crosssectional area vessel wall levels significantly different wky rats 1911 155 1244 101 1388 59 microns 2 respectively compared 1405 95 microns 2 untreated wky rats cilazapril effective hydralazine reducing pial arteriolar pressure 110 6 62 2 mm hg cilazapril versus 79 5 mm hg hydralazine compared 60 4 mm hg untreated wky rats cilazapril hydralazine attenuated reductions external diameter pial arterioles 91 4 100 4 microns cilazapril versus 91 3 microns hydralazine compared 107 3 microns untreated wky rats | 4 |
238 | quantitation g0 g1 phase cells primary carcinomas antibody m1 subunit ribonucleotide reductase shows g1 phase restriction point block human cancers apparent low growth fraction bulk cells presumed cycle g0 quiescent state due inability past distinguish g0 g1 cells allosteric m1 subunit ribonucleotide reductase m1rr constitutively expressed cycling cells ie g1 g2m acquired transition g0 g1 lost exit g0 thus distinguishes g0 g1 cells estimate proportion g0 g1 cells primary human breast n 5 colorectal n 12 adenocarcinomas used analytical dna flow cytometry adfc immunoperoxidase staining sections monoclonal antibody m1rr mab m1rr adfc fresh tumors revealed low percentage cells phase 40 34 immunoperoxidase staining m1rr revealed unexpectedly high proportion positive cells 524 127 g1 g2m phases indicating high g1 content primary human tumors thus human cancers blocked transition g1 predominantly g0 quiescent differentiated state block interpreted mean human cancers responding putative regulatory events restriction point g1 phase relative growth factor deficiency density inhibition antiproliferative cytokines gene products using flow cytometry dna m1rr content found human colon cancer cell lines arrest g1 g0 phase upon serum deprivation density inhibition similarly human breast cancer cell lines arrested g1 g0 phase medroxyprogesterone acetate mpa tamoxifen exposure findings match situ observations support concept restriction point block primary human tumors | 0 |
239 | elevated serum bromide concentrations following repeated halothane anaesthesia child 20monthold child received 25 brief halothane general anaesthetics fiveweek period allow cranial irradiation treatments posterior fossa ependymoma personality change last week treatment protocol raised question possible bromide intoxication serum bromide concentrations using gold chloride assay technique monitored time four sixweek intervals thereafter serum bromide concentrations demonstrated fourfold change period ranging peak levels 22 meql1 176 microgramskg1 fifth week treatment decreasing less 05 meql1 less 40 microgramsml1 six weeks following end treatments demonstrates possibility repetitive short halothane exposures result elevations serum bromide potential bromide intoxication paediatric neurooncology patients | 0 |
240 | prognostic value reduced heart rate variability myocardial infarction clinical evaluation new analysis method relation heart rate variability measured standard 24 hour electrocardiogram recordings patients convalescent myocardial infarction occurrence sudden death spontaneous symptomatic sustained ventricular tachycardia assessed consecutive series 177 patients admitted acute myocardial infarction surviving 7 days addition analysis heart rate variability occurrence nonsustained arrhythmias 24 hour electrocardiographic monitoring results clinical assessment signal averaged electrocardiography ejection fraction analysed related outcome median 16 months follow range 1030 months 17 end point events 11 62 sudden deaths six 34 episodes sustained ventricular tachycardia index width frequency distribution curve duration individual rr intervals used measure heart rate variability mean sd index significantly smaller end point events 168 80 without events 290 112 relative risk occurrence end point event heart rate variability index less 25 70 multivariate analysis showed variables examined reduced heart rate variability index single powerful predictor end point events measurement heart rate variability simple automated operatorindependent method provided useful information arrhythmic propensity patients convalescent myocardial infarction | 3 |
241 | oral labetalol hypertensive urgencies response incremental doses oral labetalol 16 patients hypertensive urgencies presented inadequate blood pressure control 20 mg intravenous furosemide patient received 300 mg oral dose labetalol subsequent oral doses labetalol 100 mg administered 2hour intervals diastolic blood pressure remained greater 100 mm hg maximum dose labetalol per patient 500 mg five patients required initial 300 mg dose labetalol two patients required therapy satisfactory blood pressure control mean arterial pressure fell 156 12 mm hg 123 14 mm hg | 4 |
242 | clinical problems followup patients conservative surgery radiotherapy patients treated conservative surgery radiotherapy earlystage breast carcinoma risk developing ipsilateral breast recurrence long period fortunately patients present inoperable recurrence simultaneous distant metastases salvage rates high may improved early detection although usually unambiguous physical examination treated breast may reveal changes attributable surgery radiotherapy mimic recurrent cancer also substantial overlap radiologic appearance benign malignant lesions may necessary perform biopsy question recurrence careful lifelong followup patients thus critical part care | 0 |
243 | recombinant epsteinbarr virus small rna eber genes deleted transforms lymphocytes replicates vitro strains epsteinbarr virus ebv deletions small rna eber genes made homologous recombination using ebv p3hr1 strain undergone deletion essential transforming gene encodes ebv nuclear antigen ebna2 dna fragment wild type ebna2 locus eber genes deleted even though eber ebna2 genes separated 40 kilobases selection transforming p3hr1 recombinants required restored ebna2 gene resulted 20 cotransfer eber deletion eberdeleted recombinants transformed primary b lymphocytes lymphoblastoid cell lines lcls indistinguishable form lcls transformed wildtype ebv proliferation latencyassociated ebv gene expression permissiveness ebv replication cycle gene expression eberdeleted virus infected lcl clones could infect growthtransform primary b lymphocytes procedures applicable construction ebv recombinants within 40 kilobases ebna2 gene eberdeleted ebv recombinants useful evaluating role ebers ebv infection | 0 |
244 | urinary tract infection women current role singledose therapy administration single dose antimicrobial agent acceptable therapy women uncomplicated lower urinary tract infections adequate information literature support clinical use singledose therapy although still need welldesigned sufficiently large studies compare singledose therapy abbreviatedcourse 3day traditional 7 14day therapy | 4 |
245 | hoarseness sole presenting symptom foramen magnum meningioma foramen magnum tumours rare may present bizarre symptoms mimic many conditions report presentation sole complaint hoarseness never previously described literature voice returned normal surgical removal foramen magnum meningioma | 4 |
246 | cryptic osteoid osteoma cranium case report osteoid osteoma uncommon benign tumor bone rarely involves cranium often causes local pain worse night characteristically relieved aspirin correlate size lesion diagnosis depends skull radiographs computed tomography report describes case radiographs showed nothing abnormal diagnosis operative localization accomplished radionuclide bone scanning thus possibility radiographically cryptic lesions must considered evaluation atypical head pain syndromes | 0 |
247 | postural hypotension pressor effect octreotide mediated norepinephrine orthostatic hypotension shydrager syndrome chronic incapacitating condition characterized lack appropriate increase plasma norepinephrine level response standing recently somatostatin analogue octreotide reported induce pressor response patients syndrome reported case shydrager syndrome octreotide effective rise blood pressure accompanied increase plasma norepinephrine level hence pressor effect octreotide mediated stimulation sympathetic nervous system probably splanchnic vasoconstriction | 3 |
248 | outcome among surviving low birthweight infants metaanalysis published outcome studies available source data morbidity among surviving low birthweight infants vlbw less 1500 g search carried 1136 references english language total 111 outcome studies found reported morbidity data cohorts vlbw infants born since 1960 methods used results obtained studies systematically assessed agreement exists definition study populations descriptive statistics measurement outcome follow ranged six months 14 years 85 cohorts incidence cerebral palsy recorded 106 disability studies followed infants longer time periods reported higher incidences disability studies united states reported higher incidences disability countries median incidence cerebral palsy among cohorts studied 77 median incidence disability 250 despite substantial improvements mortality vlbw infants poor outcomes among survivors common | 2 |
249 | circumflex artery ventricular fistula pseudoaneurysm mitral reoperation prosthetic mitral valve reoperation complicated atrioventricular groove pseudoaneurysm circumflex ventricular fistula presented ligation circumflex artery mitral valve replacement implicated review previous cardiac angiogram | 3 |
250 | efficacy azathioprine relapsingremitting multiple sclerosis randomized 59 patients relapsingremitting multiple sclerosis receive azathioprine aza 30 mgkg daily placebo doublemasked therapeutic trial analysis data predetermined primary outcome measures demonstrated significant difference favoring aza observed mean exacerbation rate 2 years therapy time deterioration ambulation index kurtzke expanded disability status scale score study confirms modest therapeutic benefit azathioprine previously reported investigators | 4 |
251 | persistent neutrophilic meningitis persistent neutrophilic meningitis unusual distinct clinical variant chronic meningitis characterized csf neutrophilia hypoglycorrhachia persists 1 week serial csf studies documented etiologies include selected bacteria higher bacteria brucella nocardia actinomyces well opportunistic fungi candida aspergillus zygomycetes pseudallescheria recognition syndrome important empiric therapy eg cotrimoxazole amphotericin b may differ significantly used classic chronic meningitis | 4 |
252 | changes highenergy phosphate metabolism cell morphology four models acute experimental pancreatitis previous studies using isolated ex vivo perfused canine pancreatitis preparation showed 4hour perfusion pancreatitis edema weight gain hyperamylasemia induced four different stimuli stimuli include intraarterial infusion oleic acid ffa 2hour period ischemia perfusion isch partial obstruction pancreatic duct secretin stimulation poss intraarterial infusion cerulein supramaximal doses cer present study changes highenergy phosphate metabolism determined nuclear magnetic resonance spectroscopy changes cellular structure determined light electron microscopy documented four models acute pancreatitis control preparations remained stable 4hour perfusion period decrease adenosine triphosphate atp levels ffa preparations atp decreased 36 baseline levels 4hour perfusion p less 0001 isch preparations atp decreased undetectable levels 2hour period ischemia recovered rapidly remained baseline levels perfusion atp levels remained stable remaining two models pancreatitis poss cer microscopy demonstrated initial injury located chiefly capillaries swollen endothelium intravascular thrombi ffa isch preparations poss cer preparations capillary changes minimal injury located chiefly acinar cells swollen endoplasmic reticulum zymogen granule depletion vacuolization poss preparations also showed striking dilation centroacinar lumens reflecting duct obstruction additional studies shown atp decline ffa preparations could significantly reduced pretreatment free radical scavengers morphologic changes could reduced free radical scavengers ffa isch preparations amelioration morphologic injury poss preparations obscured dilatation centroacinar lumens treated untreated groups morphologic changes cer preparations reduced treatment cholecystokinin inhibitor | 1 |
253 | identification ischemic hibernating myocardium feasibility postexercise f18 deoxyglucose positron emission tomography identification ischemic hibernating myocardium facilitates selection patients likely benefit revascularization study examined feasibility metabolic imaging using postexercise f18 deoxyglucose positron emission tomography fdgpet diagnosis ischemia hibernation 27 patients known coronary anatomy normal postexercise fdg uptake defined patient reference normal resting perfusion normal coronary supply abnormal elevation fdg ischemia hibernation compared 13 myocardial segments patient results dipyridamole stress perfusion imaging performed rubidium82 positron emission tomography rbpet myocardial ischemia diagnosed either fdgpet rbpet 34 segments subtended significant local coronary stenoses increased fdg uptake present 3234 94 reversible perfusion defect identified rbpet 2234 65 p less 01 3 patients ischemia identified metabolic imaging alone 16 patients previous myocardial infarction perfusion defects present rest 89 regions 30 34 demonstrated increased fdg uptake consistent presence hibernation increased postexercise fdg uptake appears sensitive indicator ischemia myocardial hibernation test may useful selecting postinfarction patients revascularization | 3 |
254 | mandibular involvement oral cancer difficult predict tumour invasion mandible oral cancer preoperatively consequently decision preserve sacrifice mandible largely individualistic present study 44 cases analyses reliability preoperative parameters assess mandibular involvement clinical radiological scintigraphic features compared detailed histology bone study confirms usefulness superior marginal resections lesions close involving mandible well superficial lesions actually seen involve mandible ct bone scans negative tumour invasion | 0 |
255 | mechanical factors large artery disease antihypertensive drugs hypertension may induce early alterations large arteries 2 mechanical stresses one related intravascular pressure blood flow dynamics distending pressure force acts circumferential direction inducing decreased arterial distensibility arterial distensibility evaluated humans measurement arterial compliance pulsewave velocity well established chronic hypertension age elevated pressure act together increase arterial rigidity blood flow dynamics induce frictional forces endothelial surfaces arteries forces expressed shear stress proportional viscosity blood velocity gradient arterial wall measurement blood viscosity evaluation velocity profile brachial arteries hypertensive subjects shown reduction wall shear rate stress despite elevation blood viscosity several studies shown drug therapy successfully reduces blood pressure necessarily improve arterial compliance contrast data available effects antihypertensive medication arterial wall shear humans arterial compliance wall shear stress 2 main therapeutic targets potential importance physiopharmacologic approach effects hypertension atherogenesis | 3 |
256 | effects fudr primarycultured colon carcinomas metastatic liver hepatic arterial infusion fluorodeoxyuridine fudr demonstrated efficacy treatment metastatic colorectal carcinoma liver study direct cytotoxic effect fudr measured ten metastatic two primarysite colorectal carcinomas primary culture assay system overall clinically achievable concentrations fudr 04 4 microm induced partial cell kill 75 tumors including greater 50 reduction viable tumor cell number two tumors less 50 remaining seven total cell kill observed tumor three tumors resistant fudr concentrations tumor sensitivity correlated size tumor growth fraction increasing exposure time fudr 3 7 days approximately doubled magnitude response 5flurouracil cisplatin clinically achievable concentrations toxic metastatic tumor cells fudr limited chemosensitivity metastatic colorectal tumor cells fudr vitro postulate mechanisms besides direct cytotoxicity contribute clinical efficacy fudr vivo | 0 |
257 | pseudotumor craniocervical junction longterm hemodialysis systematic study upper cervical spine performed using magnetic resonance imaging 25 patients 15 men 10 women undergoing hemodialysis 10 years seven pseudotumors periodontoid soft tissue disclosed similar pannus recently described rheumatoid arthritis bone cystic radiolucencies observed association pseudotumors 5 patients radiolucencies located atlas 1 lateral mass 1 anterior branch axis 3 odontoid process 1 vertebral body horizontal vertical atlantoaxial subluxation demonstrated features observed patients amyloid arthropathy could frequent yet thus far littlerecognized feature beta 2microglobulin amyloidosis | 4 |
258 | islet cell carcinoma pancreas presenting bleeding isolated gastric varices report case review literature gastrointestinal hemorrhage leftsided portal hypertension gastric varices unusual presentation islet cell carcinoma pancreas islet cell tumors pancreas rare present variety ways elaborate functional hormones cause specific neuroendocrine syndromes nonfunctional tumors characteristically present later symptoms metastatic disease result local enlargement present case islet cell carcinoma pancreas presenting recurrent gastrointestinal bleeding gastric varices review literature rare presentation emphasize importance careful initial diagnostic workup may enable curative surgery | 0 |
259 | efficacy acebutolol acute myocardial infarction apsi trial apsi investigators randomized placebocontrolled trial carried determine effectiveness acebutolol preventing late death highrisk patients surviving acute myocardial infarction mi average 1year mortality rate placebo groups 9 trials beta blockers postmi patients 72 compared 17 nonselected cohort patients survived least 7 days mi mandate trial based fact highrisk patients whose mortality rate exceeds 20 enrolled significant numbers previous trials remains proved whether betablocking therapy patient population beneficial selection highrisk patients inclusion trial based algorithm set essai de prevention secondaire de linfarctus du myocarde registry time second interim analysis mortality rate placebo group 12 lower expected greater equal 20 trial stopped time 309 patients allocated placebo 298 patients acebutolol therapy 318 days 17 deaths acebutololtreated group 34 placebo group reduction total mortality 48 p 0019 30 vascular deaths placebo group 12 acebutolol group thus cardiovascular mortality acebutolol reduced 58 p 0006 incidence cardiovascularrelated deaths lower acebutololtreated group total reduction mortality appear correlated secondary risk factors | 3 |
260 | protocol butalbital aspirin caffeine bac detoxification headache patients abuse combination drug containing butalbital 50 mg aspirin 325 mg caffeine 40 mg bac commonly recognized headache specialists causing headaches despite widespread problem published treatment regimen bac detoxification patients describe protocol used four times three patients patients fulfilled diagnostic criteria ihs headache classification headaches induced chronic substance abuse 82 analgesics abuse headache 822 patients took 150 420 bacmonth 215 years two patients previously undergone inpatient detoxification one patient unsuccessfully tried detoxification twice outpatient patients required psychological support prior hospitalization protocol bac discontinued pentobarbital challenge test corroborated butalbital dosage patients given phenobarbital caffeine tapered several days dihydroergotamine dhe metoclopramide used raskin propranolol 60 mg bid started narcotics permitted hospital discharge patients allowed continue subcutaneous dhe needed one patient restarted bac use 8 months without two patients still bac free 18 14 months detoxification | 2 |
261 | effect musclesparing versus standard posterolateral thoracotomy pulmonary function muscle strength postoperative pain increased interest alternative approaches thoracotomy developed considerable morbidity associated standard posterolateral technique conducted prospective randomized blinded study 50 consecutive patients compare postoperative pain pulmonary function shoulder strength range shoulder motion standard posterolateral muscle sparing thoracotomy techniques pulmonary function forced expiratory volume 1 second forced vital capacity shoulder strength range motion measured preoperatively 1 week 1 month postoperatively pain quantitated postoperative narcotic requirements visual analogue scale mcgill pain questionnaire morbidity mortality hospital stay compared standard posterolateral musclesparing techniques differences postoperative pulmonary function shoulder range motion extent lung resection surgical approach time mortality hospital stay significantly less postoperative pain musclesparing group narcotic requirement less first 24 hours p 00169 visual analogue scale scores significantly lower p less 005 throughout first postoperative week shoulder girdle strength decreased 1 week standard incision group whereas strength preserved musclesparing approach muscle strength returned preoperative levels 1 month groups morbidity identical two groups exception postoperative seromas prevalence seroma 23 musclesparing group 0 standard incision group p 00125 demonstrated musclesparing incision may reasonable alternative standard posterolateral approach | 4 |
262 | hepatocellular carcinoma presenting pyrexia leukocytosis report five cases past 26 years encountered five patients primary liver malignancy clinically characterized high remittent fever leukocytosis mimicking liver abscess two patients underwent exploratory laparotomy drainage carried another clinical courses went rapidly downhill liver cirrhotic two patients interior main mass almost totally necrotic four cases histologically malignant cells main portion resembled sarcoma areas cells appeared epithelial eosinophilic cytoplasm trabecular arrangement except one case subjected autopsy histological study inadequate extensive necrosis seems neoplasms poorly differentiated hepatocellular carcinomas rather combinations sarcoma hepatocellular carcinoma patients therefore may represent distinct clinicopathological type hepatocellular carcinoma rare japan perhaps common south africa similar cases clinically described larger numbers | 4 |
263 | coronary arteries truncus arteriosus origin distribution coronary arteries described 39 autopsy specimens truncus arteriosus ta specimens classified according number patterns truncal cusps position truncal cusps defined relation intracardiac structures namely atrioventricular orifices bicuspid truncal valves observed 8 cases 21 tricuspid 22 cases 56 quadricuspid 9 cases 23 tricuspid valves 2 anterior 1 posterior cusp great variability origin coronary arteries observed tendency right coronary artery arise anterior right quadrant left coronary artery arise anterior left quadrant tendency observed 50 bicuspid 59 tricuspid 66 quadricuspid valves anatomic right ventricle always observed vascularized right coronary artery anatomic left ventricle left coronary artery even cases single coronary trunk anterior surface right ventricle crossed right coronary artery 5 cases single coronary artery observed 7 cases 18 embryologic considerations offered especially regarding relation observed variability coronary artery patterns ta absence truncal septation | 3 |
264 | hemoperitoneum result coital injury without associated vaginal injury hemoperitoneum result coital injury without associated vaginal injury extremely rare entity evidence five cases reported medical literature date report five additional cases encountered two medical centers two ruptured corpus luteum cysts one laceration round ligament another laceration ovary fifth rupture serous cystadenoma diagnosis considered patients hemoperitoneum coitus | 0 |
265 | use cognitive behavior therapy normalizing rationale schizophrenia preliminary report sixtyfour consecutively referred patients schizophrenia treated cognitivebehavioral psychotherapy adjunct standard treatment destigmatizing rationale explain symptom emergence devised supplemented techniques proved safe use appeared acceptable patients relatives members group maintained low levels medication required minimal hospitalization techniques used described detail | 2 |
266 | decrease cerebral metabolic rate glucose highdose methotrexate childhood acute lymphocytic leukemia measured changes regional cerebral metabolic rate glucose rcmrglu using 18ffluorodeoxyglucose positron emission tomography assessment neurotoxicity childhood acute lymphocytic leukemia treated highdose methotrexate hdmtx therapy studied 8 children acute lymphocytic leukemia mean age 96 years treated hdmtx 200 mgkg 2000 mgm2 therapy cmrglu hdmtx therapy reduced 40 patient central nervous system leukemia treated largest total doses intrathecal mtx itmtx hdmtx cmrglu whole brain hdmtx therapy reduced average 21 p less 005 reductions cmrglu 8 patients correlated total doses itmtx r 0717 p less 005 systemic hdmtx r 0784 p less 005 cmrglu cerebral cortex especially frontal occipital cortex reduced noticeably basal ganglia white matter suggest measurement changes rcmrglu hdmtx therapy useful detecting accumulated mtx neurotoxicity | 0 |
267 | macrophage colonystimulating factor activity malignant pleural effusions augmentation intrapleural interleukin2 infusions activity endogenous colonystimulating factor csf malignant pleural effusions lung cancer patients daily intrapleural infusions recombinant interleukin2 il2 measured quantitatively colonyforming bioassay radioimmunoassay ria therapy malignant pleural effusions various levels csf activities csf activity neutralized almost completely antimcsf antibody ria also showed effusions contained various amounts mcsf daily intrapleural infusion recombinant il2 caused significant increase csf activities mcsf levels pleural effusions results indicate vivo treatment il2 induces production endogenous mcsf | 0 |
268 | histologic evaluation width soft tissue necrosis adjacent carbon dioxide laser incisions study evaluated width tissue necrosis lateral carbon dioxide laser incisions human intraoral excisional biopsy specimens measurements made specimens including epithelium muscle dense loose connective tissue salivary gland results showed mean width tissue necrosis 86 microns epithelium 85 microns muscle 51 microns loose connective tissue 96 microns dense connective tissue 41 microns salivary gland range thermal necrosis different tissue types probably based water content within type cellular partially homogenized zone reversible thermal damage 500 microns width visible adjacent zone thermal necrosis relatively narrow width tissue necrosis technique may account claimed superior properties laserinduced wounds compared created electrosurgery | 4 |
269 | clinical hemodynamic correlates sympathetic nerve activity normal humans patients heart failure evidence direct microneurographic recordings characterize neural excitatory state heart failure simultaneous measurements efferent sympathetic nerve activity muscle microneurography rest hemodynamics obtained 10 normal subjects age 25 2 years mean sem 29 patients heart failure age 49 2 years new york heart association functional class ii iv left ventricular ejection fraction 21 1 cardiac index 216 013 litersmin per m2 pulmonary capillary wedge pressure 23 2 mm hg sympathetic nerve activity significantly higher patients heart failure 547 45 burstsmin normal subjects 167 22 burstsmin p less 0001 multiple linear regression analyses indicated sympathetic activity human subjects strongly inversely correlated left ventricular stroke work index r 086 p less 00001 stroke volume index r 085 p less 00001 strong positive correlation sympathetic nerve activity pulmonary artery diastolic r 082 p less 00001 mean r 081 p less 00001 pressures similar correlations seen patients heart failure analyzed separately significant correlation sympathetic nerve activity mean arterial pressure left ventricular ejection fraction radionuclide ventriculography cardiac chamber size echocardiography arterial oxygen tension patients heart failure direct measurements sympathetic nerve activity correlated closely plasma norepinephrine r 072 p less 00001 patients heart failure thus sympathetic nerve activity rest parallels impairment cardiac performance patients heart failure | 3 |
270 | osteoid osteoma scapula case report review literature scapula rare location osteoid osteoma cases involve flat bones en bloc excision uncommon location problematic since surgical exposure difficult shoulder joint function affected lesion subchondral 18yearold man osteoid osteoma located subchondral area glenoid guided needle biopsy nidus resulted complete healing mode treatment proper followup examination acceptable benign lesion situated problematic location | 0 |
271 | high risk severe bleeding aged patients chronic idiopathic thrombocytopenic purpura purpose study estimate incidence establish factors associated increased risk hemorrhagic complications historic cohort 117 consecutive unselected patients chronic idiopathic thrombocytopenic purpura itp sixtyeight patients 58 underwent medical treatment andor splenectomy 33 48 treated achieved complete stable remission equivalent platelet count incidence major hemorrhagic complications significantly higher aged greater 60 years younger less 40 years patients 104 v 04pty relative risk 289 p less 01 previous hemorrhagic event identified another major risk factor hemorrhage relative risk 275 p less 0005 hypertension underlying disorders influence conclude age 60 years previous history bleeding major risk factors severe hemorrhages adults itp | 4 |
272 | retroviral promoter sufficient convert protosrc transforming gene distinct src gene rous sarcoma virus src genes four natural isolates avian sarcoma viruses differ cellular protosrc two genetic substitutions promoter cellular gene replaced retroviral counterpart least six codons 3 terminus replaced retroviral heterologous cellderived elements since virus constructs complete protosrc coding region failed transform avian cells acquired transforming function point mutations various codons proposed point mutation sufficient convert protosrc transforming gene however promoter substitution sufficient convert two protoonc genes protoras protomyc retroviral transforming genes view reexamined whether promoter substitution point mutation necessary convert protosrc retroviral transforming gene found recombinant virus rpsv src gene rous sarcoma virus rsv replaced complete coding region protosrc transformed quail chicken embryo cells oncogene rpsv differs src gene rsv three genetic properties weakereg transformed cells flatter ii slowereg focus formation takes 9 12 days compared 4 days rsv iii host range narrower rsveg subsets heterogeneous embryo cells transformed rpsv even weeks months replacement protosrc 3 terminus rpsv src rsv generates recombinant virus rpvsv equals rsv transforming function concluded retroviral promoter naturally substituted via illegitimate recombination retroviruses sufficient convert least three protoonc genes src myc ras retroviral transforming genes | 4 |
273 | two types abnormal somatosensory evoked potentials chronic cerebellar ataxias investigate subclinical sensory impairment spinocerebellar degenerations median nerve somatosensory evoked potentials seps examined 16 patients chronic cerebellar ataxia originally diagnosed clinical neurologists olivopontocerebellar atrophy opca two types abnormal sep patterns found six patients two patients sep pattern peripheral neuropathy also detected peripheral sensory nerve conduction studies four patients abnormal seps seen patients lesions central nervous system dorsal column medial lemniscus magnetic resonance imaging mri showed multiple sclerosis ms possible clinically diagnosed opca sometimes includes similar form friedreichs ataxia subclinical sensory fiber neuropathy detected seps peripheral sensory conduction studies cases lesions central nervous system demonstrated seps mri must followup order make final diagnosis cases alternative diagnosis ms must considered temporal profile symptoms signs characteristic ms observed | 4 |
274 | late outcome survivors outofhospital cardiac arrest left ventricular ejection fractions greater equal 50 without significant coronary arterial narrowing retrospective survey 1195 survivors outofhospital ventricular fibrillation 43 patients identified left ventricular ejection fraction greater equal 050 coronary artery stenosis greater equal 50 luminal diameter present thirteen 30 patients hypokinesia left ventriculography 20 patients 47 persistently abnormal electrocardiogram seven patients 16 recurrent outofhospital cardiac arrest average followup 86 54 months presence either wall motion electrocardiographic abnormalities defined patients severalfold higher risk recurrent cardiac arrest without abnormalities risk recurrent cardiac arrest within 5 years 30 abnormal electrocardiograms versus 5 others p less 003 age independent predictor recurrent cardiac arrest group p less 001 surprisingly recurrent cardiac arrest occurring often among younger patients although cardiac arrest unusual patients without major structural heart disease recurrence survivors common patients relatively high risk recurrent ventricular fibrillation identified youth abnormalities detected surface 12lead electrocardiogram contrast left ventriculography | 3 |
275 | injection heat probe bleeding ulcer prospective randomized trial performed compare efficacy endoscopic epinephrine injection heat probe treatment actively bleeding peptic ulcers emergency endoscopy 1758 patients 18month period identified 132 patients active ulcer bleeding randomized receive either endoscopic epinephrine injection heat probe treatment endoscopy patients transferred surgical gastroenterology ward managed surgeons unaware treatment option bleeding initially controlled 96 epinephrine injection 83 heat probe p less 005 significant difference outcome measured transfusion requirement 45 units vs 38 units emergency surgery 20 vs 22 hospital stay 8 days vs 7 days mortality 2 vs 4 injection group heat probe group two patients heat probe group experienced perforation conclude endoscopic epinephrine injection heat probe treatment effective stopping bleeding actively bleeding ulcers epinephrine injection technically easier perform higher initial success rate | 1 |
276 | management premature removal percutaneous gastrostomy percutaneous endoscopic gastrostomy peg become preferred method enteral access nutritional support increased use modality complications encountered frequently premature withdrawal inadvertent removal gastrostomy tube within first seven days insertion adherence gastric serosa parietal peritoneum indication laparotomy report describes treatment premature withdrawal immediate endoscopic replacement 18month period 271 patients underwent insertion peg five patients 18 inadvertently removed gastrostomy tube within seven days insertion treated immediate replacement using retrograde string technique avoiding laparotomy five pegs successfully replaced gastrostomy site despite presence pneumoperitoneum patient developed peritonitis septic complications premature gastrostomy tube withdrawal safely managed endoscopic replacement observation laparotomy unnecessary potentially meddlesome | 4 |
277 | transoesophageal echocardiography improves diagnostic value cardiac ultrasound patients carcinoid heart disease transthoracic transoesophageal cardiac echocardiography doppler investigations performed 31 consecutive patients malignant midgut carcinoid tumours transoesophageal images allowed measurement thickness atrioventricular valve leaflets superficial wall layers cavity side atria mean thickness anterior tricuspid leaflet significantly greater mitral valvea difference seen control group agematched patients without carcinoid tumours normal cardiac ultrasound findings addition edges tricuspid leaflets thickened giving clubbed appearance tricuspid incompetence detected transoesophageally 71 patients carcinoid compared 57 transthoracic investigation inner layer right atrial wall carcinoid patients significantly thicker left atrium atria controls furthermore patients signs severe carcinoid heart disease significantly thicker mean right atrial luminal wall layer less signs right heart disease transoesophageal cardiac ultrasound investigation improved diagnostic accuracy seemed show structural changes typical carcinoid heart disease established histopathological investigations | 0 |
278 | combined laryngeal framework medialization reinnervation unilateral vocal fold paralysis laryngeal frameworksilastic implant technique become increasingly attractive alternative teflon injection particularly fixation cricoarytenoid joint defect corrected larger usual restore ability change tension vocal fold unilateral vocal fold reinnervation overcome drawback used conjunction surgical medialization may offer return function close normal twentynine patients unrecovered unilateral vocal fold paralysis andor fixation cricoarytenoid joint managed use silastic implant combined unilateral vocal fold reinnervation complications voice improvement assessed preoperative postoperative voice recordings combined surgical techniques reinnervation modification silastic implantation via laryngeal framework approach reported | 4 |
279 | beneficial effect 13butanediol cerebral energy metabolism edema following brain embolization rats assessed effect 13butanediol cerebral energy metabolism edema inducing multifocal brain infarcts 108 rats intracarotid injection 50microns carbonized microspheres ethanol dimer induces systemic ketosis 25 mmolkg ip butanediol injected every 3 hours produce sustained increase plasma level betahydroxybutyrate treatment significantly attenuated ischemiainduced metabolic changes increasing concentrations phosphocreatine adenosine triphosphate glycogen reducing concentrations pyruvate lactate lactate concentration 2 6 12 hours embolization decreased 13 44 46 respectively brain water content increased 7863 six unembolized rats 8093 12 salinetreated 7957 seven butanedioltreated rats 12 hours embolization p less 005 decrease water content associated significant decreases concentrations sodium chloride antiedema effect butanediol could explained osmotic mechanism since equimolar doses urea ethanol ineffective results support hypothesis beneficial effect butanediol mediated cerebral utilization ketone bodies arising butanediol metabolism reducing rate glycolysis deleterious accumulation lactic acid ischemia | 2 |
280 | anatomy anal sphincters related structures continent women studied magnetic resonance imaging five anally continent nulliparas reproductive age studied magnetic resonance imaging internal external anal sphincters could easily delineated could intervening longitudinal musculature puborectalis muscle anococcygeal raphe anorectal lumen vagina uterus bladder urethra coccyx pubis shape sphincters nearly cylindrical anterior component averaging 183 mm thick 280 mm long fiftyfour percent anterior thickness attributable internal sphincter anorectal angle varied considerably mean 868 191 degrees range 60112 angle portion rectal lumen supported anococcygeal raphe levator plate plane puborectalis muscle consistent 1490 63 degrees 138154 finding anterior anal sphincters substantial thickness length contrasts markedly view often pictured literature female anal sphincter narrows anteriorly half posterior length forms small bundle muscle rather broad band knowledge relationships important primary repair obstetric sphincter lacerations well surgical correction anal incontinence | 1 |
281 | nature course olfactory deficits alzheimers disease objective aim study determine specific nature course olfactory deficits alzheimers disease previous studies noted impaired odor identification unanimity presence odor detection deficits method odor identification tested 55 patients alzheimers disease 57 elderly control subjects using university pennsylvania smell identification test odor detection assessed 46 subjects alzheimers disease 40 control subjects using forcedchoice threshold test geraniol odorant results significant deficits olfactory identification present subjects earliest stages cognitive impairment deficits increased alzheimers disease progressed overlap individual smell identification test scores cognitively impaired patients normal elderly subjects hand odor detection deficits appear alzheimers disease relatively advanced smell identification test scores correlated minimental state scores geraniol detection conclusions odor identification impaired early alzheimers disease may influenced cognitive status acuity odor detection altered later disorder pattern hyposmia alzheimers disease suggests disorder may begin nose theorized previously refinement olfactory testing may useful diagnostic evaluation early dementia | 2 |
282 | comparison perindopril nifedipine hypertensive normotensive diabetic patients microalbuminuria melbourne diabetic nephropathy study group objectiveto compare efficacy angiotensin converting enzyme inhibition calcium antagonism diabetic patients microalbuminuria designrandomised study diabetic patients microalbuminuria treated perindopril nifedipine 12 months monitored one three months stopping treatment depending whether hypertensive normotensive patients randomised separately according whether hypertensive normotensive settingdiabetic clinics three university teaching hospitals patients50 diabetic patients persistent microalbuminuria 43 completed study 30 normotensive 13 hypertensive 19 type diabetes 24 type ii diabetes interventionsfor 12 months 20 patients given perindopril 28 mg daily 23 given nifedipine 2080 mg daily main outcome measuresalbumin excretion rate blood pressure glomerular filtration rate resultsboth perindopril nifedipine significantly reduced mean blood pressure treatment significant difference treated perindopril treated nifedipine respect albuminuria mean blood pressure stopping treatment drugs associated sustained increase albuminuria mean blood pressure significant correlation mean blood pressure albuminuria also reduction mean blood pressure decrease albuminuria treatment drugs hypertensive patients drugs caused significant decreases mean blood pressure albuminuria normotensive patients significant reduction albuminuria either regimen conclusionsin diabetic patients microalbuminuria blood pressure seems important determinant urinary albumin excretion perindopril nifedipine similar effects urinary albumin excretion preventing increases albuminuria normotensive patients decreasing albuminuria hypertensive patients | 3 |
283 | acetazolamideresponsive vestibulocerebellar syndrome clinical oculographic features five patients presented longstanding episodic vertigo ocular motor signs localizing vestibulocerebellum patient episodic vertigo either abolished markedly decreased frequency severity acetazolamide therapy 4 family members identical symptoms signs syndrome 1 treatable causes chronic episodic vertigo | 2 |
284 | opiates suppress carrageenaninduced edema hyperthermia doses inhibit hyperalgesia study determined whether opiates alter vascular components inflammation hyperthermia edema plasma extravasation addition suppression hyperalgesia rats administered carrageenan one hind paw saline hind paw followed ip injection morphine 0250 mgkg saline 60 min testing 90 min hind paw injections morphine produced dosedependent reduction carrageenaninduced hyperalgesia 1753 hyperthermia 3953 edema 2436 morphine treatment alter temperatures contralateral salineinjected paws indicating opiate suppression hyperthermia confounded alterations systemic body temperature blood flow opiate effects inflammation stereospecific since levorphanol 1 mgkg dextrorphan 1 mgkg suppressed carrageenanevoked hyperalgesia hyperthermia edema pretreatment naltrexone 15 mgkg blocked effects 5 mgkg dose morphine sulfate hyperalgesia hyperthermia edema separate study iv injection morphine sulfate 2 mgkg reduced plasma extravasation 41 p less 001 morphine administration resulted significantly greater increases paw withdrawal latencies inflamed 38139 contralateral salinetreated paws 419 results indicate opiates exert moderate though significant reduction vascular signs inflammation addition reduction hyperalgesia mechanisms vascular effect involve inhibition vasodilation indicated decrease hyperthermia inhibition vascular permeability addition opiates exhibit enhanced antinociceptive effects inflamed paws even compared uninjured paws animal | 4 |
285 | dopamine highdose insulin infusion glucoseinsulinpotassium cardiac operation effects myocardial metabolism myocardial insulin resistance association surgical stress restricts availability carbohydrates increases load free fatty acids ffas heart theoretical grounds adrenergic drugs may expected aggravate situation whereas opposite expected insulin influence dopamine combination dopamine 7 microgramskg body weightmin highdose insulin 7 iukg myocardial energy metabolism studied 19 patients 4 6 hours coronary operation infusion dopamine 7 microgramskg body weightmin induced metabolic changes may unfavorable strained myocardium increase myocardial ffa load rise myocardial oxygen expenditure 60 70 changes however matched increase myocardial substrate uptake oxygen wastage ffa metabolism high circulating catecholamine levels suggested also signs suggesting amplified systemic trauma response systemic oxygen consumption increased 15 increase arterial levels ffas glucose ketones observed divergent metabolic effects dopamine insulin demonstrated prominent metabolic effects adding highdose insulin dopamine marked reduction arterial ffa levels shift toward myocardial carbohydrate utilization expense ffas myocardial uptake ffas ceased myocardial insulin resistance may thus significant extent overcome supraphysiological doses insulin even infusion adrenergic drugs | 3 |
286 | learning disabilities epilepsy neurophysiological aspects subclinical generalized spikewave discharges often accompanied transitory cognitive impairment demonstrable psychological testing eeg recording transitory cognitive impairment demonstrated readily difficult tasks generalized regular spikewave bursts lasting 3 also found briefer even focal discharges simply consequence global inattention shown fact focal discharges exhibit specificity leftsided focal spiking likely produce errors verbal tasks instance whereas rightsided discharges often accompanied impairment handling nonverbal material learning difficulties general specific abnormal patterns cognitive functioning well documented children epilepsy pronounced frequent interictal discharges however evidence intermittent cognitive impairment due discharges contributes significantly neurophysiological abnormalities significance transitory cognitive impairment accompanying subclinical eeg discharges everyday functioning uncertain experimental evidence subclinical discharges may accompanied disruption educational skills children impairment driving performance motorists individuals suppression discharges antiepileptic drugs demonstrably improved psychological function work required determine indications treatment | 2 |
287 | benzodiazepine tranquilizers risk accidental injury determine whether benzodiazepine tranquilizers increase risk accidental injury requiring medical attention used pharmacy claims submitted large thirdparty payer identify 4554 persons prescribed agents matched control group 13662 persons prescribed drugs benzodiazepines used diagnoses recorded claims submitted medical care providers identify accidentrelated care received persons three months firstobserved prescription benzodiazepine nonbenzodiazepine agent respectively six months subsequently found accidentrelated care likely among persons prescribed benzodiazepines among persons probability accidentrelated medical encounter higher months prescription benzodiazepine recently filled compared months persons filled three prescriptions agents six months following initiation therapy significantly higher risk accidentrelated medical event filled one prescription approximately twofold risks accidentrelated care found controlling age sex prior utilization | 4 |
288 | agerelated hypotensive effect placebo active treatment patients older 60 years european working party high blood pressure elderly elderly hypertensive patients randomly assigned active treatment n 365 placebo n 377 effects treatment blood pressure calculated subtracting pretreatment blood pressure blood pressure 3 months two treatment groups decrease systolic diastolic pressures pronounced older patients however slopes blood pressure change age significantly different two treatment groups systolic 047 037 mm hgyear activetreated placebo patients respectively diastolic 026 015 mm hgyear respectively thus proving observed agerelated hypotensive effect caused particular drug requires comparison control group placebo | 3 |
289 | femoropopliteal femorodistal bypass comparison situ reversed technique present report compares situ technique using reversed vein femoropopliteal bypass 1986 situ technique introduced clinic preferred method femoropopliteal bypass lower anastomosis knee femorodistal bypass forty patients operated situ technique compared equal number patients operated reversed technique 19831985 two groups comparable regarding concomitant cardiovascular pulmonary disease preoperative anklebrachial index level distal anastomosis patency 6 months significantly higher 84 situ grafts compared reversed veins 49 difference mainly caused significantly higher patency situ grafts anastomosed infrapopliteal arteries despite better patency rates situ group limb salvage 6 months groups operating time also similar groups concluded situ technique superior reversed technique least infrapopliteal reconstructions superior patency rate technical advantages without apparent disadvantages basis recommendation use situ technique femoropopliteal femorodistal bypass | 3 |
290 | choroidal osteoma osseous choristoma atypical case case choroidal osteoma presenting 22yearold girl reported tumour unilateral juxtapapillary site appeared markedly elevated retinal plane flat slightly elevated previous reports visual acuity affected complete absence subjective symptoms echography fluorangiography computerised tomography visual field tests performed echography best method identifying differentiating lesion malignant tumour | 0 |
291 | effect gastric mucus uptake carcinogen mnng gastric mucosal dna prostaglandin e2 pge2 pirenzepine indomethacinadministered rats incorporation nmethyl3hnnitronnitrosoguanidine methyl3hmnng gastric mucosal dna measured quantitatively liquid scintillation counting intragastric instillation methyl3hmnng amount incorporation 254 59 pmolmg dna control rats 117 38 pmolmg dna pge2administered rats 62 56 pmolmg dna pirenzepineadministered rats 429 144 pmolmg dna indomethacinadministered rats pge2 pirenzepine significantly decreased incorporation compared control group contrast indomethacin increased incorporation addition gastric mucosa drugtreated rats studied histochemically pge2 pirenzepine increased secretion gastric mucus whereas indomethacin decreased possible gastric mucus protective effect ulcerogenic agents also carcinogens considered gastric mucus plays important role defense mechanism carcinogenesis | 0 |
292 | cervical lymph nodes unknown primary tumor 190 patients 10 years 475 patients isolated lateral neck masses evaluated 190 lymph nodes unknown primary tumor lnup 188 neck lymphomas 78 benign tumors 10 sarcomas 9 chemodectomas study focused patients lnup 86 patients treated surgery plus radiotherapy patients treated radiotherapy 84 chemotherapy 13 treatment 7 overall population failures neck occurred 51 patients distant metastases 27 primary tumors appeared 16 survival rates 3 5 10 years 27 19 7 respectively overall population 45 35 19 respectively surgical group diagnosis therapeutic approach direct effect neck control failure neck occurred 7 47 patients 15 fine needle aspiration radical neck dissection radiotherapy performed 5 12 patients 42 fine needle aspiration modified neck dissection radiotherapy used 5 12 patients 42 adenectomy diagnosis radiotherapy treatment performed 6 11 patients 54 diagnosis incisional biopsy performed prior admission despite subsequent radical neck dissection radiotherapy treatment opinion panendoscopy fine needle aspiration firstline diagnostic approach cytologic diagnosis proves impossible secondline approach must consist cervical exploration frozen section examination excisional biopsy followed immediate appropriate treatment cases lnup radical neck dissection seems preferable | 4 |
293 | multivariate analysis prediction death hospital acute myocardial infarction prognostic factors patients acute myocardial infarction based clinical investigative data admission evaluated prospectively 111 consecutive patients seventeen patients 153 died hospital stay age previous infarct high killip class cardiomegaly high serum concentrations cardiac enzymes low ejection fraction high wall motion score index correlated significantly inhospital mortality whereas sex risk factors pericardial effusion multivariate analysis showed age wall motion score index best predictors death hospital wall motion detected cross sectional echocardiography may reflect extent myocardial involvement age wall motion score index predicted inhospital mortality sensitivity 765 specificity 915 predictive accuracy 892 age wall motion score index determined admission useful identifying patients high risk cardiac death might benefit early intervention | 3 |
294 | saltpeter ingestion 37yearold man presented emergency department attempt selftreat priapism saltpeter kno3 initially potassium 76 electrocardiographic changes markedly elevated co2 potassium carbon dioxide normalized less 24 hours standard treatment hyperkalemia hyperkalemia expected large oral potassium ingestion elevated co2 spurious caused misreading serum nitrates ektachrom 700 system ingestion kno3 added differential hyperkalemia markedly elevated co2 | 4 |
295 | clinicopathologic studies children die acute lower respiratory tract infections mechanisms death clinicopathologic correlations 71 cases fatal pneumonia children determined mechanism death patients multifactorial severe pneumonia alone accounted 11 deaths 155 pneumonia associated sepsis occurred 42 children 592 heart failure 85 hypovolemia 42 nosocomial infection 126 also seen children fatal acute lower respiratory tract infection extensive consolidation squamous metaplasia hyaline membranes present lungs children patients severe disease must receive addition antibiotics acute episodes individualized intensive respiratory supportive care since types care available poor communities vaccination measles vitamin supplementation malnourished children may ameliorate conditions appear predispose children severe fatal disease | 4 |
296 | castor bean intoxication report cases child ingested two castor beans two adults ingested four beans three patients developed severe gastroenteritis recovered without sequelae receiving iv fluids literature contains reports 424 cases castor bean intoxication symptoms intoxication include acute gastroenteritis fluid electrolyte depletion gastrointestinal bleeding hemolysis hypoglycemia delayed cytotoxicity reported 424 patients 14 died mortality rates 81 untreated 04 treated deaths due hypovolemic shock recommended treatment asymptomatic patients chewed one raw beans emergency department evaluation gastric decontamination administration activated charcoal observation four six hours ingestion discharge instructions return symptoms develop decontamination activated charcoal symptomatic patients require hospitalization treatment iv fluids supportive care monitoring hypoglycemia hemolysis complications hypovolemia monitoring delayed cytotoxicity unnecessary castor beans dust highly allergenic may cause anaphylaxis | 1 |
297 | obesityrelated hypertension less cardiovascular risk framingham study hypothesis obesityrelated hypertension relatively innocuous explored examination cardiovascular events 34 years followup related biennially measured weights blood pressures using timedependent covariate proportional hazards analysis 5209 participants also classified age cigarette smoking antihypertensive treatment four baseline examinations 8year followup periods period followup 978 cardiovascular events men 836 women risk cardiovascular morbidity mortality general chd particular strongly related hypertension levels body mass index also found apply adjustment made possible confounding cigarette smoking age smokingadjusted absolute risks cardiovascular events found higher hypertensive individuals high low bmis furthermore relative risk cardiovascular disease vary significantly bmi thus hypertension least dangerous obese lean persons ages either sex providing support hypothesis hypertension obese benign important since obesity predisposes hypertension hypertension obese report examines hypothesis cvd outcomes considered previous reports also subcategories cvd disease myocardial infarction stroke includes data men women young old | 3 |
298 | peritoneal closure nonclosure cesarean value peritoneal closure time cesarean birth evaluated prospectively two hundred fortyeight women undergoing low transverse cesarean pfannenstiel skin incision assigned one two groups peritoneum open n 127 peritoneum closed n 121 mean sem surgical time open group 481 12 minutes significantly less closed group 532 14 minutes p less 005 postoperative differences groups incidence wound infection dehiscence endometritis ileus length hospital stay study suggests leaving parietal peritoneum unsutured acceptable way manage patients cesarean delivery | 4 |
299 | embryonal carcinoma testis presenting left heart mass 31yearold man history intravenous drug abuse tooth abscess admitted evaluation possible infective endocarditis echocardiography showed left atrial mass mass removed left atrium histology primary embryonal carcinoma discovered right testicle hospitalization patient made smooth recovery surgical intervention chemotherapy believed first reported case metastasis embryonal carcinoma testis left side heart successfully removed surgery | 0 |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.