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400 | serum ca 125 levels menstrual cycle serum concentrations ca 125 measured different phases menstrual cycle 16 women ovulatory 12 women anovulatory cycles ca 125 levels significantly elevated menstruation groups women anovulatory cycles ovulatory cycles ca 125 levels already increased premenstrual phase negative correlation found serum ca 125 progesterone concentrations premenstrual phase cycle suggest premenstrual elevation serum ca 125 women anovulatory cycles related premature endometrial vascular changes result low serum progesterone concentration leading insufficient endometrial control thus effect progesterone seems indirect rather direct effect ca 125 synthesis ca 125 assay used diagnosis cancer sampling done immediately menstruation physiological elevation ca 125 levels may give false positive results | 0 |
401 | acceleration scrapie trisomy 16diploid aggregation chimeras studied susceptibility prion infection trisomy 16diploid chimeric mouse putative model syndrome weanling chimeras inoculated intracerebrally scrapie prions time appearance first symptoms scrapie reduced 17 days mean control time 153 days time death reduced 30 days control time 170 days results trisomy 16 chimeras argue susceptibility central nervous system degeneration caused prions modulated chromosome imbalance | 4 |
402 | carcinosarcoma spindle cell carcinoma lung clinicopathologic immunohistochemical studies examined pulmonary carcinomas prominent sarcomalike lesions clinicopathologically immunohistochemically grossly two tumors predominantly endobronchial growths four bulky parenchymal growths two endobronchial parenchymally mixed growths eight patients six tumors completely resected one patient given irradiation one patient died early postoperative period basis specific differentiation sarcomalike lesions tumors separated three groups two true sarcoma differentiated soft tissues striated muscle osteoid tissue three fibromatous sarcoma resembling atypical pseudosarcomatous stroma three spindle cell carcinoma evidence epithelial differentiation prognosis poor tumors specific differentiation rhabdomyosarcoma chondrosarcoma spindle cell carcinoma progressed rapidly fibromatous sarcoma fibromatous sarcomalike lesions found relate longer survival time patients wish emphasize distinction sarcomatous components made regard assessing prognosis pulmonary carcinoma sarcomalike lesions | 0 |
403 | sotalol versus quinidine maintenance sinus rhythm direct current conversion atrial fibrillation open parallelgroup study compares quinidine sotalol treatment maintenance sinus rhythm direct current conversion patients chronic atrial fibrillation patients 15 centers sweden randomized sotalol 98 patients quinidine 85 patients 2 hours sinus rhythm direct current conversion according primary efficacy assessment 52 patients sotalol group 48 patients quinidine group remained sinus rhythm following 6month treatment period ns furthermore 34 patients treated sotalol 22 patients treated quinidine relapsed atrial fibrillation ns heart rate relapsing atrial fibrillation higher patients treated quinidine 109 beatsmin patients treated sotalol 78 beatsmin p less 0001 patients treated sotalol found less symptomatic time relapse compared relapsing patients quinidine group terms safety patients withdrawn quinidine sotalol treatment 26 vs 11 p less 005 sotalol generally better tolerated quinidine twentyeight percent patients treated sotalol 50 patients treated quinidine reported side effects p less 001 difference primarily result early within first month treatment gastrointestinal skin side effects group patients treated quinidine | 3 |
404 | characterization spontaneous termination sustained ventricular tachycardia associated coronary artery disease characterize change cycle length qrs morphology spontaneous termination sustained ventricular tachycardia vt electrocardiograms recorded vt cycle length measured periods 31 21 11 1 beats termination 55 episodes 28 patients coronary artery disease beats 31 21 designated period stable arrhythmia served reference changes occurring termination fortyfour episodes vt occurred setting antiarrhythmic drug therapy 11 episodes occurred patients treated antiarrhythmic drugs variability cycle length indexed standard deviation mean cycle length percentage consecutive cycles varying greater equal 40 ms greater equal 40 ms greater variability termination standard deviation mean cycle length 258 ms greater equal 40 ms 167 stable period standard deviation mean cycle length 85 ms greater equal 40 ms 54 p less 0001 true irrespective antiarrhythmic drug use although differences standard deviation mean cycle length beats 11 1 beats 31 21 greater antiarrhythmic drug group 296 vs 89 ms p less 0001 group receiving antiarrhythmic drugs 110 vs 67 ms difference significant specific patterns cycle length variability characteristic vt termination found | 3 |
405 | febrile status epilepticus part study status epilepticus children maytal j shinnar moshe sl alvarez la pediatrics 1989 83323331 44 children febrile convulsions lasting 30 minutes followed mean 28 months range 4 72 thirty children followed prospectively children prior afebrile seizures evidence acute central nervous system infection excluded nine 20 children prior neurological deficits duration febrile seizure 05 1 hour 41 cases 85 1 2 hours 5 10 greater 2 hours 2 children 5 child died developed new neurological deficits following seizures risk recurrent seizures increased group prior neurological abnormality six 66 children subsequent febrile seizures compared 12 34 normal children p 08 three 33 recurrent febrile status epilepticus compared 1 3 normal child p 023 2 children prospective arm study recurrent febrile status epilepticus neurologically abnormal p 035 3 children subsequently afebrile seizures 2 prospective neurologically abnormal p 006 overall p 035 prospective concluded occurrence febrile status epilepticus neurologically impaired child risk factor subsequent febrile well afebrile seizures occurrence febrile status epilepticus otherwise normal child significantly increase risk subsequent febrile brief prolonged afebrile seizures first years following episode | 4 |
406 | pyoderma gangrenosum complicating feltys syndrome case 54yearold woman feltys syndrome whose course complicated mucocutaneous lesions clinically typical pyoderma gangrenosum described necrotizing sinusitis saddle nose deformity distinctive clinical features lymphocytic vasculitis rheumatoid nodule formation observed within panniculus base cutaneous lesion nasal mucosal lesion unexpected histopathologic findings | 4 |
407 | endometrial carcinoma pathologic evaluation 142 cases without associated endometrial hyperplasia association cases endometrial carcinoma ec hyperestrogenism well known prognostic significance concomitant endometrial hyperplasia eh ec evaluated 142 patients clinical stage ec lymph node assessment carried 121 patients presence eh significantly associated better differentiated tumor lesser degrees myometrial invasion low segmentadnexallymphovascular space pelvicparaaortic lymph node involvement however presence eh significantly associated less virulent histologic subtypes possible existence two types eca hormonaldependent ec associated eh independent ec associated ehis discussed prognostic significance concomitant eh stressed | 0 |
408 | penile implants treatment peyronies disease treatment peyronies disease remains controversial patients fail conservative therapy may require surgical intervention restore ability sexual intercourse plaque excision dermal grafting universally successful alternate procedures rely placement penile prosthesis gained popularity reviewed experience 35 patients advanced peyronies disease treated penile prosthesis preoperatively 55 patients unable engage intercourse due pain angulation penis 25 unable achieve erection postoperatively mean followup 69 years 88 patients able engage intercourse satisfied results obtained selected patients advanced disease implantation penile prosthesis remains highly successful satisfying alternative treatment peyronies disease | 4 |
409 | genetic flanking markers refine diagnostic criteria provide insights genetics von hippel lindau disease von hippel lindau disease vhl hereditary syndrome associated tumors cysts multiple organ systems whose expression age onset highly variable availability genetic test early reliable detection individuals carrying defective gene would beneficial vhl patients relatives since many manifestations vhl successfully treated detected early stages complications undetected disease devastating previously shown vhl gene maps chromosome 3p provide genetic markers development reliable diagnostic test narrow eventually clone vhl defect generated dna markers chromosome 3p markers performed multipoint genetic linkage analysis 28 vhl pedigrees comprising 470 individuals 164 affected vhl report identification tightly linked markers including flanking markers bracket vhl gene small region chromosome 3p25p26 finding several major implications visceral cysts kidney pancreas epididymis commonly found vhl considered diagnostic criteria disorder also occur general population presence cysts unaccompanied typical lesions retinal cerebellar hemangioblastoma may therefore represent major diagnostic problem leading errors assessment disease status application flanking markers vhl gene presymptomatic diagnostic testing confirms epididymal cysts indeed suitable diagnostic criterion disorder pheochromocytomas occur nonuniformly vhl families may also associated hereditary tumor syndromes genetic studies imply phenotype vhl families without pheochromocytomas caused defects within gene absence presence tumor type therefore due pleiotropic expression single gene rather existence several different genes vhl region chromosome 3p13p14 known contain several chromosomal translocation breakpoints families pure familial renal cell carcinoma quite proximal vhl locus 3p25p26 identified chromosome 3p may therefore contain two loci renal cell carcinoma one gene genes 3p13p14 vhl gene 3p25p26 whose aberration also associated typical manifestations vhlabstract truncated 400 words | 2 |
410 | native valve endocarditis due pseudallescheria boydii patient aids case report review 53yearold man aids developed mitral valve endocarditis due infection fungus pseudallescheria boydii limited number cases prosthetic valve endocarditis caused organism described report unique case pseudallescheria infection native valve describe disease patient aids | 3 |
411 | pneumocystis carinii pneumonia associated profound lymphopenia abnormal tlymphocyte subset ratios treatment earlystage breast carcinoma two women stage ii breast carcinoma treated lumpectomy followed breast irradiation adjuvant chemotherapy developed pneumocystis carinii pneumonia receiving cytotoxic chemotherapy neither woman evidence immunosuppression therapy profound lymphopenia reversed cd4cd8 ratios normal peripheral blood total leukocyte counts time infections women seronegative human immunodeficiency virus type 1 risk factors infection patients cd4 lymphocyte counts increased chemotherapy breast carcinoma discontinued thus appears therapy received may caused severe tlymphocyte mediated immunosuppression | 0 |
412 | rehabilitation pediatric patient neuromuscular disease rehabilitation program patient neuromuscular disease developed accurate diagnosis established diagnosis ramifications suggest natural course disease hoped improved upon rational realistic program program best developed interdisciplinary team including pediatric neurologist greatest understanding patients problem ultimately responsible implementation monitoring program child cerebral palsy commonly requires services physical occupational therapists well knowledgeable orthopedists program appropriate consider childs potential well limitations child traumatic brain injury requires addition psychological intervention intensive educational program child family need help mental health professionals child motor unit disease duchennes muscular dystrophy requires addition services philosophy care child ever ambulate independently cost necessary child reach potential including items orthoses adaptive equipment respirator care become necessary issues must addressed form care established one program children programs must individualized meet needs patient family point cannot overemphasized | 2 |
413 | biliary sludge critical update biliary sludge many years poorly defined entity usually low amplitude nonshadowing echoes within dependent part gallbladder shift influence postural changes sonographic point view detection sludge implies coexistence smallsized solid components gellike embedding material chemical nature biliary sludge recently recognized predominantly composed coaggregate cholesterol monohydrate crystals liquid crystalline droplets cases obstructive jaundice symptomatic liver diseases bilirubin granules embedded gel matrix mucous glycoproteins pathogenic point view biliary sludge often associated biliary stasis conditions characterized impaired gallbladder contraction prolonged total parenteral nutrition fasting pregnancy causes include mucus hypersecretion may favor cholesterol nucleation crystal growth bile infection sludge may intermediate step formation different types stones epidemiological point view sludge quite rare asymptomatic freeliving population may common selected series symptomatic patients clinical point view sludge often fluctuating course including frequent disappearances reappearances suggesting early stages gallstone formation reversible | 1 |
414 | antivenom therapy russells viper bite bleeding renal failure two main manifestations responsible high morbidity mortality untreated russells viper bite victims study effort find prognostic factors practical therapeutic approach care patients early detection abnormalities clot quality test andor evidence systemic bleeding followed immediate correction clotting defects using specific antivenom reduce morbidity russells viper envenomation | 2 |
415 | computed tomography staging paranasal sinuses chronic hyperplastic rhinosinusitis study computed tomography scans 100 patients chronic hyperplastic rhinosinusitis reviewed establish clinical staging system fourteen percent patients classified stage singlefocus disease 36 stage ii multifocal disease responsive conservative therapy 32 stage iii diffuse disease partially responsive medication 16 stage iv diffuse disease associated bony changes poorly responsive conservative treatment incidence recurrent persistent disease ranged 13 stage ii 30 stage iv stage iii patients 13 18 recurrence rates respectively computed tomography staging shown useful outlining operative strategies reliable prognosticator disease process | 4 |
416 | primary ct diagnosis abdominal masses pacs environment whether display mediumfilm versus cathode ray tube crtaffects observer performance interpretation computed tomographic ct images important research issue times implementation growth picture archiving communications systems radiology authors performed multiobserver receiver operating characteristic roc study determine performance radiologists read abdominal ct studies displayed film well highresolution workstation video monitor made use three different display modes total 166 examinations evaluated eight radiologists recorded ordinal confidence ratings demonstration presence absence abdominal masses roc analysis showed small differences confidence ratings assigned individual readers detection interpretation tasks results group whole showed significant reduction improvement observer performance ratings one workstation display modes analyzed results study demonstrate current crt display technology adequate enabling primary detection abdominal masses ct examinations | 0 |
417 | multiple myeloma vmcpvbap alternating combination chemotherapy superior melphalan prednisone even highrisk patients efficacy alternating vincristine melphalan cyclophosphamide prednisonevincristine carmustine doxorubicin prednisone vmcpvbap polychemotherapy compared prednisone mp regimen induction treatment multiple myeloma mm three hundred four mm patients entered study march 1983 july 1986 analysis performed december 1989 treatment groups show significant differences respect major prognostic factors median overall survival 338 months vmcpvbap mp arms 12 induction chemotherapy cycles 590 473 p less 068 patients achieved component reduction greater 50 significant difference observed two treatment arms terms remission duration 213 v 196 months p less 66 survival 316 v 370 months p less 28 patients younger 65 years show advantage alternating polychemotherapy diagnosis plasma cell labeling index li serum beta2 microglobulin beta 2m evaluated 173 183 patients respectively significantly reduced survival observed patients li greater equal 2 164 months beta 2m greater equal 6 mgl 204 months even poorrisk subgroups vmcpvbap superior mp | 0 |
418 | relationship blood plasma prostaglandin e2 liver lung metastases colorectal cancer relationship prostaglandin e2 large amount produced various neoplasms hematogenous distant metastases investigated total 44 colorectal cancer patients varied pathophysiologic potentials authors found significantly high levels pge2 local venous blood draining carcinoma peripheral blood cases liver lung metastasis well significantly large amount pge2 production carcinoma tissue results suggest increased local blood pge2 could enhance metastasis formation increased peripheral blood pge2 may useful detection metastasis colorectal cancer | 0 |
419 | prognostic factors hepatocellular carcinoma west multivariate analysis 206 patients investigate prognostic factors western patients hepatocellular carcinoma 206 patients confirmed diagnoses hepatocellular carcinoma studied terms survival patients diagnosed 1983 1987 multivariate survival analysis cox regression model using clinical biochemical ultrasonographical pathological data obtained diagnosis disclosed bilirubin p 00001 ascites p 00001 toxic syndrome defined presence weight loss greater 10 premorbid weight malaise anorexia p 0009 blood urea nitrogen p 0025 tumor size p 0001 gammaglutamyltranspeptidase p 00006 age p 00005 serum sodium p 0003 presence metastases p 0002 independent predictors survival according contribution factors final model prognostic index constructed allowing division patients different groups according relative risk death rrd exp age x 003 ascites x 08281 bun x 00137 serum sodium x 00538 gammaglutamyltranspeptidase x 00019 bilirubin x 00734 tumor size x 033 toxic syndrome x 04965 metastases x 055 results facilitate stratification hepatocellular carcinoma patients design evaluate future controlled trials | 0 |
420 | cheilitis granulomatosa report six cases review literature six cases cheilitis granulomatosa rare inflammatory disorder unknown origin reported condition produces nontender persistent swelling one lips affects primarily young adults histologically nonnecrotizing granulomatous inflammation seen clinical findings results therapy six cases presented one patient treated hydroxychloroquine sulfate plaquenil stabilized process one patients vesicularappearing lesions microscopic examination showed lesions dilated superficial lymphatic channels finding knowledge previously described | 4 |
421 | predicting radionuclide bone scan findings patients newly diagnosed untreated prostate cancer prostate specific antigen superior clinical parameters presently standard staging evaluation prostate cancer includes digital rectal examination measurement serum tumor markers radionuclide bone scan evaluate ability local clinical stage tumor grade serum acid phosphatase serum prostatic acid phosphatase pap serum prostate specific antigen psa predict bone scan findings retrospective review 521 randomly chosen patients mean age 70 years range 44 92 years newly diagnosed untreated prostate cancer performed local clinical stage tumor grade acid phosphatase pap psa correlated positively bone scan findings p less 00001 using receiver operating characteristic curves however psa best overall correlation bone scan results median serum psa concentration patients positive bone scan 1580 ngml whereas men negative bone scan median serum psa level 113 ngml p less 00001 using multivariate logistic regression analysis local clinical stage tumor grade acid phosphatase pap evaluated combination psa assess whether parameters increased ability psa alone predict bone scan findings none clinical parameters irrespective combination used contributed appreciably predictive power psa alone probability plot 95 confidence intervals constructed allows practicing urologist estimate individual basis probability positive bone scan given serum psa value significant finding study however negative predictive value low serum psa concentration bone scan findings 306 men serum psa level 20 ngml less 1 psa 182 ngml positive bone scan negative predictive value 997 finding would suggest staging radionuclide bone scan previously untreated prostate cancer patient low serum psa concentration may necessary | 0 |
422 | vaginal epithelial abnormalities patients cin clinical pathological features management 4147 women cin treated laser regional gynaecological oncology centre queen elizabeth hospital gateshead 103 25 coexisting vaginal epithelial abnormalities cin 3 histological diagnosis often associated vaginal lesions upper vagina almost always involved 67 lesion cervix appeared confluent vagina even lesions confluent biopsies form cervical vaginal components always show grade intraepithelial neoplasia biopsies showed different lesions laser treatment appears effective vaginal lesions therefore recommended although selected patients careful follow alone may suffice | 0 |
423 | progress report stroke prevention atrial fibrillation study stroke prevention atrial fibrillation study recently found reported spaf investigators n engl j med 1990322863868 beneficial effect warfarin aspirin compared placebo primary prevention ischemic stroke systemic embolism patients nonvalvular atrial fibrillation among warfarineligible patients event rates 16yr receiving active antithrombotic therapy warfarin aspirin 83yr receiving placebo p less 000005 risk reduction 81 95 confidence interval 5691 ironically find beneficial effect aspirin warfarinineligible patients basis results study reshaped directly compare two antithrombotic agents insight apparent aspirin unresponsiveness noted patients also sought interpretation preliminary results reshaping study made complex continued blinding investigators certain portions data presented account study inception recent redesign | 2 |
424 | regional obesity risk cardiovascular disease framingham study risk cardiovascular events determined 24 years surveillance relation general adiposity reflected relative weight regional obesity estimated skinfolds waist girth per inch height upper quintile values relative weight subscapular skinfolds waist girth associated increased risks cardiovascular disease sexes risk total cardiovascular events increased degree regional central abdominal obesity mortality cardiovascular disease also increased increased relative weight central obesity associated increased risk factors including cholesterol blood pressure glucose uric acid changes weight mirrored changes risk factors linear trends 15 lb range weight fluctuations subscapular skinfold ratio subscapulartotriceps skinfold measures central obesity either sex also associated increased probability coronary attacks particular subscapular skinfold contributed chd risk independent body mass index bmi multivariate analyses taking risk factors account indicate independent effect abdominal obesity stroke cardiac failure cardiovascular allcause mortality men women subscapulartotriceps skinfold ratio independently contributes chd cardiovascular cause mortality regional obesity appears independent contributor cardiovascular disease given level general adiposity effect partially mediated promotion known risk factors data suggest cardiovascular disease closely linked abdominal general adiposity | 3 |
425 | cardioprotective effects authentic nitric oxide myocardial ischemia reperfusion background methods purpose study determine effects nitric oxide believed endotheliumderived relaxing factor reperfusion injury myocardial ischemia mi effects investigated 6hr model mi reperfusion openchest anesthetized cats solution containing infused iv starting 30 min occlusion left anterior descending coronary artery continuing reperfusion 1 hr later lasting 55 hr estimated concentration circulation 1 2 x 109 results areasatrisk expressed percentage total left ventricular weights significantly different among either mi groups however necrotic area expressed percentage myocardial areaatrisk significantly p less 01 lower notreated mi cats compared mi vehicle group cardiac myeloperoxidase activities indicated significantly p less 05 fewer neutrophils attracted necrotic zone notreated mi cats compared mi cats receiving vehicle sodium nitrate nano2 ph 74 major breakdown product failed exert protective effect model mi reperfusion conclusions appears provide significant myocardial protection ischemia reperfusion may afford cardioprotection incorporation circulating blood cells ie neutrophils platelets thereby inhibiting accumulation adherence ischemic region direct cardiac cytoprotective effect studies using donors rather would appropriate clinically relevant mode treatment mi | 3 |
426 | prevalence severity premenstrual syndrome effects foods beverages sweet high sugar content objective study evaluate whether certain foods beverages high sugar content taste sweet related prevalence severity premenstrual syndrome specifically sought evaluate whether consumption junk foods chocolate caffeinefree cola fruit juices alcoholic beverages might exert effect premenstrual syndrome apart effects daily consumption beverages high caffeine caffeinecontaining coffee tea colas study based 853 responses questionnaire probing menstrual premenstrual health certain daily dietary practices mailed female university students oregon analysis data revealed consumption chocolate junk foods related prevalence premenstrual syndrome among women severe premenstrual symptoms likewise consumption alcoholic beverages alcoholic beverages beer related prevalence premenstrual syndrome among women severe symptoms fruit juice caffeinefree soda none associations substantially altered daily consumption beverages high caffeine content controlled taken together data suggest consumption foods beverages high sugar content taste sweet associated prevalence premenstrual syndrome | 4 |
427 | selective intestinal decontamination prevents spontaneous bacterial peritonitis prospective randomized study selective intestinal decontamination norfloxacin performed hospitalization 32 cirrhotic patients low ascitic fluid total protein levels incidence infections compared control group 31 nontreated cirrhotic patients similar characteristics found significantly lower incidence infections 132 31 vs 1331 419 p less 0005 spontaneous bacterial peritonitis 032 0 vs 731 225 p less 005 patients receiving norfloxacin lower incidence extraperitoneal infections 132 31 vs 731 225 p 0052 treated group reach statistical significance incidence infections 128 36 vs 922 409 p less 001 spontaneous bacterial peritonitis 028 0 vs 522 227 p less 005 cirrhotic patients admitted ascites also significantly lower treated group decrease rate mortality observed group undergoing selective intestinal decontamination reach statistical significance data show selective intestinal decontamination useful prevent spontaneous bacterial peritonitis extraperitoneal infections hospitalized cirrhotic patients low ascitic fluid total protein levels | 1 |
428 | factors affecting enterohepatic circulation oral contraceptive steroids oral contraceptive steroids may undergo enterohepatic circulation relevant estrogens compounds directly conjugated liver animal studies show convincing evidence importance enterohepatic circulation studies humans much less convincing importance route rate metabolism ethinyl estradiol reviewed antibiotics reported anecdotally reduce efficacy oral contraceptive steroids controlled studies confirmed observation although gut flora altered oral antibiotics blood levels ethinyl estradiol reduced one antibiotic least cotrimoxazole enhances activity ethinyl estradiol | 1 |
429 | towards true prevalence peptic ulcer sorreisa gastrointestinal disorder study study designed overcome methodological problems inherent earlier prevalence studies peptic ulcer carried municipality northern norway included total population 2027 aged 2069 years comprised questionnaire search previously diagnosed peptic ulcers local medical records subjects additional endoscopy subjects dyspepsia matched healthy controls n 619 overall prevalence 105 men 95 women sex ratio close one higher duodenalgastric ratio previously reported region substantial 1 prevalence asymptomatic ulcers also observed | 1 |
430 | repair transposition great arteries intact ventricular septum left ventricular outflow tract obstruction repair transposition great arteries patients intact ventricular septum fixed left ventricular outflow tract obstruction restricted atrial baffle procedures without attempts relieve bypass left ventricular outflow obstruction however suboptimal results procedures coupled excellent functional results arterial switch operation patients without obstruction made anatomic correction goal repairing anomalies report technique anatomic correction transposition great arteries intact ventricular septum fixed left ventricular outflow tract obstruction consideration difficult cases advocated | 3 |
431 | familial hypobetalipoproteinaemia complicated cerebellar ataxia steatocystoma multiplex 55yearold man cerebellar ataxia steatocystoma multiplex found reduced serum concentrations total cholesterol betalipoprotein apolipoprotein b computed tomography revealed atrophy cerebellum brain stem six family members examined four hypobetalipoproteinaemia one mild ataxia similar skin lesions noted five male relatives case represents rare combination familial hypobetalipoproteinaemia cerebellar ataxia steatocystoma multiplex | 0 |
432 | clinical analyses shortterm prognoses neonates subependymal cysts twentyone neonates subependymal cysts detected neurosonography soon birth prospectively examined clinical cranial sonographic findings evaluated respect shortterm prognosis prognosis poor 6 patients congenital viral infection 4 cytomegalovirus infection 2 rubella infection five patients also neurodevelopmental abnormalities 2 neonatal epileptic seizures 2 chromosomal abnormalities 1 lissencephaly remaining 10 patients normal psychomotor development incidence congenital viral infection statistically correlated poor neurodevelopmental outcome correlation exist shortterm prognosis clinical factors cranial sonographic findings evidence suggests investigation possible subependymal cyst etiologies required careful longterm followup period | 2 |
433 | cerebral venous oxygen content measure brain energy metabolism increased intracranial pressure hyperventilation order test hypothesis cerebral arteriovenous oxygen difference avdo2 venous oxygen content vo2 could used monitor brain energy metabolism setting increased intracranial pressure icp 12 cats studied 31pmagnetic resonance spectroscopy six cats subjected intracranial hypertension cisternal infusion saline energy failure occurred average avdo2 84 32 vol standard deviation range 47 147 vol vo2 point metabolic failure averaged 145 06 vol extended narrower range 10 29 vol additional six cats icp raised threshold metabolic failure hyperventilation instituted pco2 10 18 torr five six cats experienced drop vo2 hyperventilation two animals hyperventilation resulted vo2 11 vol less metabolic failure evidenced fall phosphocreatine concluded vo2 less 2 vol correlated brain ischemia safety hyperventilation setting increased icp monitored use vo2 | 2 |
434 | cervical rotation flaps midface resurfacing midface long served focus creativity surgical reconstruction fullthickness skin grafts splitthickness grafts distal flaps long used attempt reduplicate existing anatomy area recent reconstruction efforts focused creative use microvascular free flaps purpose article reports use extensively developed regional rotation flaps excellent reconstructive modality use area face details surgical incisional planning given nuances surgical creation flaps rotation suspension place given cases done using technique past 3 years reviewed present indications use flaps limitations given | 4 |
435 | cerebral glucose utilization sleep landaukleffner syndrome pet study three righthanded male children aged 5 6 11 years signs symptoms andor history syndrome acquired aphasiaepilepsy landaukleffner syndrome studied druginduced electroencephalographically eegmonitored sleep positronemission tomography pet 18ffluorodeoxyglucose fdg method data demonstrate landaukleffner syndrome cerebral glucose utilization normal sleep metabolic pattern varied children metabolic disturbances always predominated temporal lobes rightsided leftsided bilateral two first patients eeg recordings showed continuous spikeandwave discharges sleep rightgreaterthanleft asymmetry observed temporal areas patient 1 asymmetry associated relative increase glucose utilization right posterior temporal region patient 2 glucose utilization relatively decreased left anterotemporal left perisylvian regions patient 3 sleep eeg showed discharge significant asymmetry observed however glucose utilization temporal lobes decreased lower metabolic rates subcortical structures cortex also noted three children metabolic pattern may related maturation central nervous system cns | 4 |
436 | assessment biliary tract liver transplantation tube cholangiography iodida scanning biliary tract obstruction anastomotic leakage common problems following liver transplantation sequential study 31 patients liver transplant investigated 99mtciodida iodida scanning tube cholangiography ttc results compared clinical outcome seven patients extrahepatic biliary obstruction one patient biliary leak detection biliary complications ttc iodida scanning similar terms sensitivity 63 per cent ttc better specificity 79 per cent versus 60 per cent accuracy 74 per cent versus 60 per cent iodida scanning liver function taken account diagnostic efficacy tests patients bilirubin levels less 200 mumoll similar levels greater 200 mumoll greater number false positive results iodida scanning 12 per cent versus 54 per cent significant biliary leak clearly detected ttc iodida scanning ttc remains effective way evaluating biliary tract transplantation iodida scanning limited value bilirubin levels elevated may provide additional information blood supply hepatocyte function intrahepatic cholestasis | 4 |
437 | neurologic complications tryptophanassociated eosinophiliamyalgia syndrome case tryptophanassociated eosinophilia central nervous system complications multiple white matter lesions magnetic resonance imaging presented eosinophilia regardless cause included within differential patients exhibiting periventricular white matter lesions | 2 |
438 | cardiac rhythm disturbances early orthotopic heart transplantation prevalence clinical importance observed abnormalities precisely define incidence type consequences cardiac arrhythmias early heart transplantation 25 cardiac transplant recipients monitored continuously 728 days day surgery discharge death subset 15 patients sinus node function studies overdrive suppression performed weekly time endomyocardial biopsy results revealed sinus bradycardia 10 patients 40 junctional bradycardia 6 24 supraventricular tachycardia form atrial tachycardia atrial fibrillation atrial flutter occurred 11 patients 44 ventricular tachycardia occurred 15 patients 60 nonsustained cardiac pacing 1403 h used nine patients pulse rate less 50 beatsmin seven recovered permanent pacing instituted two subgroup sinus node function studies seven patients identified clinical bradyarrhythmia abnormal sinus node recovery time greater 1400 ms abnormal corrected sinus node recovery time greater 525 ms least one study seven patients also significantly prolonged ischemic time 236 26 versus 159 68 min p less 001 conclusion cardiac arrhythmias particularly ventricular tachycardia bradyarrhythmia occur commonly early orthotopic heart transplantation previously reported sinus node dysfunction due prolonged organ ischemic time antiarrhythmic drug use surgical trauma alone combination may contribute arrhythmias | 3 |
439 | vector shortlatency somatosensoryevoked potentials median nerve stimulation new method developed recording shortlatency somatosensoryevoked potentials median nerve stimulation negative electrical forces recorded three orthodiagonal bipolar electrodes neck direction opposite impulse conduction proximal peripheral cervical somatosensory pathway sequential tracings vectors opposite electrical forces made threedimensional display thus reproducing actual time sequence electrical events structures fixed generators subcortical nuclei also analyzed technique multiple generators n13 potential n13a n13b visualized technique may useful functional evaluation somatosensory pathway cervical cord | 2 |
440 | followup infants treated extracorporeal membrane oxygenation newborn respiratory failure followup studies conducted assess medical developmental outcome 92 infants treated extracorporeal membrane oxygenation university michigan 118 nearterm greater 34 weeks gestation infants received extracorporeal membrane oxygenation 103 87 surviving available followup 1 7 years age ninetytwo children seen least one occasion visit included history physical examination evaluation physical therapist developmental testing pediatric psychologist medical outcome year 1 found 31 children rehospitalized primarily respiratory illness outpatienttreated lower respiratory tract illness seen additional 31 children new nonstatic neurologic problems noted 6 children abnormal growth year 1 occurred 26 children last clinic visit 16 children exhibited moderatetosevere neurologic abnormalities 8 moderatetosevere cognitive delay sensorineural hearing loss occurred 4 children nine percent children receiving speech language therapy screening tests showed additional 6 speech language delay overall last visit 16 20 children exhibited type handicap review literature followup studies nonextracorporeal membrane oxygenationtreated infants persistent pulmonary artery hypertension produced impairment rate 185 outcome postextracorporeal membrane oxygenation appears similar seen less ill cohorts infants treated conventional therapy longterm followup infants remains essential | 3 |
441 | successful fontantype operation nonresectable right ventricular tumor large intracavitary right ventricular tumor 24yearold patient considered nonresectable involved interventricular septum free ventricular walls tricuspid valve surgical palliation consisted closure tricuspid pulmonary valves right atrium anastomosed pulmonary artery bifurcation patient asymptomatic 7 years operation neoplasm rhabdomyoma increased size | 0 |
442 | long term followup descending thoracic aortoiliacfemoral bypass prospective study 26 patients undergoing descending thoracic aortoiliacfemoral dtaif bypass conducted 13year period average follow 53 months reasons selecting procedure occluded aortic bifurcation grafts 9 patients hostile abdomen 6 infected aortic graft 1 microaorta 10 surgeons preference 8 patients juxtarenal aortic occlusion operative mortality 38 1 patient late mortality 36 due myocardial infarction 1 lung carcinoma 2 renal failure 4 stroke 1 pulmonary insufficiency 1 graft failure occurred 4 patients 23 26 54 109 months respectively primary cumulative patency 86 statistically valid 42 months dtaif bypass recommended selected patients conventional approaches aorta considered unduly hazardous | 3 |
443 | free radical inhibition serial chemiluminescence evolving experimental pancreatitis oxygen free radical activity inhibition examined experimental pancreatitis twentyfive rats randomized five groups controls received intravenous saline simulate pancreatitis one group received intravenous caerulein 5 micrograms kg1 h1 three groups received sodium taurocholate via pancreatic duct 02 ml 5 per cent either alone following allopurinol immediately superoxide dismutase chemiluminescence phenomenon based emission light chemical reactions dependent oxygen free radical activity used index oxygen free radical activity measured tissue samples 5min intervals following induction pancreatitis control meansem serum amylase level 1 h induction pancreatitis 63513 units significantly elevated caeruleininduced pancreatitis 1833118 units p less 005 exceeded 3000 units taurocholateinfused animals meansem chemiluminescence ranged 44 8 mv 100 mg1 time zero 404113 mv 100 mg1 1 h controls caeruleininduced pancreatitis meansem chemiluminescence peaked 20 min 1399239 mv 100 mg1 p less 002 taurocholateinduced pancreatitis 15 min 231695 mv 100 mg1 p less 0004 superoxide dismutase significantly reduced chemiluminescence hyperamylasaemia taurocholate groups increasing oxygen free radical activity paralleled evolving pancreatitis superoxide dismutase may therapeutic role pancreatitis | 1 |
444 | hyperhomocysteinemia independent risk factor vascular disease background hyperhomocysteinemia arising impaired methionine metabolism probably usually due deficiency cystathionine betasynthase associated premature cerebral peripheral possibly coronary vascular disease strength association independence risk factors cardiovascular disease uncertain studied extent association could explained heterozygous cystathionine betasynthase deficiency methods first established diagnostic criterion hyperhomocysteinemia comparing peak serum levels homocysteine standard methionineloading test 25 obligate heterozygotes respect cystathionine betasynthase deficiency whose children known homozygous homocystinuria due enzyme defect levels 27 unrelated age sexmatched normal subjects level 240 mumol per liter 92 percent sensitive 100 percent specific distinguishing two groups peak serum homocysteine levels normal subjects compared 123 patients whose vascular disease diagnosed 55 years age results hyperhomocysteinemia detected 16 38 patients cerebrovascular disease 42 percent 7 25 peripheral vascular disease 28 percent 18 60 coronary vascular disease 30 percent none 27 normal subjects adjustment effects conventional risk factors lower 95 percent confidence limit odds ratio vascular disease among patients hyperhomocysteinemia compared normal subjects 32 geometricmean peak serum homocysteine level 133 times higher patients vascular disease normal subjects p 0002 presence cystathionine betasynthase deficiency confirmed 18 23 patients vascular disease hyperhomocysteinemia conclusions hyperhomocysteinemia independent risk factor vascular disease including coronary disease instances probably due cystathionine betasynthase deficiency | 2 |
445 | postocclusive hyperemic response patients systemic sclerosis investigated postischemic hyperreactive cutaneous blood flow patients primary raynauds phenomenon raynauds phenomenon secondary systemic sclerosis ssc reactive hyperemia measured locally warmed area skin using laser doppler flowmeter following 5 minutes suprasystolic occlusion blood flow found patients primary raynauds phenomenon normal postischemic blood flow compared normal controls contrast patients ssc reduced levels baseline peak blood flow compared either primary raynauds phenomenon patients normal subjects infusion carbaprostacyclin potent prostacyclin analog vasodilator increase blood flow ssc patients restore reactive hyperemic response findings consistent hypothesis patients nonvasoconstricted condition ssc fixed structural defects limit cutaneous microvascular blood flow | 3 |
446 | trends thirty years vaginal hysterectomy vaginal hysterectomy currently performed university vienna first described halban 1932 1955 1985 total 9967 hysterectomies performed vaginal route used 6078 609 per cent procedures sixtyfour per cent women operated upon multiparous 27 per cent uniparous 8 per cent nulliparous comparison periods 1955 1975 1976 1985 revealed following trends incidence uterine myomas 306 271 per cent situ carcinoma cervix 65 79 per cent endometrial carcinoma 14 06 per cent remained largely constant past decade indications positional abnormalities uterine descent prolapse encountered often 276 416 per cent first observation period incidence recurrent metrorrhagia found decline 339 228 per cent common complications included hemorrhage operation lesions bladder hemorrhage 48 hours surgical treatment hemorrhage days 2 14 postoperatively around 05 per cent respectively second observation period postoperative fistulas developed two instances tubal prolapse seen laparotomy done four 6078 instances two patients died septic complications whenever possible prefer vaginal hysterectomy low complication rate low mortality rate low postoperative morbidity | 4 |
447 | comparison goode ttube armstrong tube children chronic otitis media effusion treatment otitis media effusion focused reaeration middle ear cavity achieving longterm aeration insertion ventilation tubes long duration stay beneficial results presented trial goode ttube compared armstrong tube fifteen children treated 1981 1986 ttube one ear conventional tube results different regard duration stay tympanic membrane reinsertions necessary 47 per cent armstrong group 20 per cent ttube group otorrhoea occurred 20 per cent armstrong 13 per cent ttube intubated ears persistent perforation present 6 per cent ears groups concluded goode ttube indicated primarily cases longterm ventilation needed | 4 |
448 | ultrasonographic assessment placental abnormalities current ultrasonographic techniques offer novel approach identification wide variety placental abnormalities usually described postnatally pathologist placental vascular lesions placental tumors abnormal placentation potentially associated perinatal complications diagnosis utero may influence pregnancy management ultrasonographic classification placental lesions based location size echogenicity number proposed repeated ultrasonographic examination together biologic investigations important prenatal differential diagnosis lesions full understanding pathophysiologic characteristics significance | 3 |
449 | effects heparin versus saline solution intermittent infusion device irrigation purpose study compare effectiveness 1 ml 09 sodium chloride 10 units heparin 1 ml sodium chloride solution containing benzyl alcohol maintaining patency reducing incidence phlebitis patients intermittent infusion devices subjects n 32 randomly assigned doubleblind experimental design repeatedmeasures analysis variance revealed significant difference groups phlebitis patency variables results controlled study would suggest 09 sodium chloride effective 10 units heparin sodium chloride solution maintaining intermittent infusion device patency preventing phlebitis | 3 |
450 | moustache appearance craniopharyngiomas unique magnetic resonance imaging computed tomographic findings perifocal edema report describes two cases craniopharyngioma perifocal edema patients computed tomography magnetic resonance imaging mri revealed tumors occupied suprasellar cistern invaginated floor 3rd ventricle tightly adherent ventricular walls intraventricular portions tumors cystic containing proteinrich fluid suggested mri confirmed operative findings perifocal edema hypothalamus adjacent intraventricular tumor optic tracts posterior limbs internal capsules resembling shape moustache axial computed tomographic mri scans perifocal edema subsided treatment intraventricular tumor surgical resection radiation therapy moustache appearance seems unique characteristic feature perifocal edema observed infrequently certain craniopharyngiomas | 0 |
451 | oslerweberrendu disease pulmonary arteriovenous fistulas deterioration embolotherapy pregnancy several reports implicated pregnancy cause deterioration patients pulmonary arteriovenous fistulas report 27yearold woman multiple pulmonary arteriovenous fistulas required coil spring embolotherapy 24th week pregnancy due spontaneous hemothorax hypoxemia | 4 |
452 | surgical approach retrocrural lymph nodes removal retrocrural lymph nodes requires approach infradiaphragmatic retroperitoneal access generally used surgical management testicular tumours transperitoneal route given access best origin superior mesenteric artery advanced testicular tumours occasionally require retrocrural node dissection describe useful surgical approach nodes underlying anatomy | 0 |
453 | prenatal diagnosis fetal intracranial calcifications case presented wherein fetal intracranial calcifications result intrauterine cytomegalovirus infection visualized computed tomography magnetic resonance imaging 36 weeks gestation diagnosis utero cytomegalovirus infection made isolation virus amniotic fluid symptomatic abnormality noted neonatal period except periventricular calcifications | 2 |
454 | primary lymphoma bone clinicopathologic study 25 cases reported 10 years twentyfive cases primary lymphoma bone plb reported 10year period reviewed presenting symptom related involvement single bone without regional nodal disease none showed dissemination lymphoma subsequent six months patients affected 765 years age equal predilection axial appendicular skeleton noted histologically commonest subtype diffuse histiocytic lymphoma dhl 17 cases whereas four poorly differentiated lymphocytic pdl type another four unclassifiable followup available 18 25 patients periods ranging 7 months 8 years clinicopathologic correlation found 75 diseasefree patients dhl whereas 60 alive disease pdl study reiterates view plb good prognosis dhl subtype especially amenable complete eradication | 0 |
455 | oral contraceptives breast cancer among women general risk breast cancer 59 years age appear affected appreciably use oral contraceptives nonetheless concern continues expressed effects early age first use longterm duration use formulation variety factors thought influence breast cancer risk presence oral contraception number recent studies restricted young women suggest longterm use may increase risk disease occurring early present lack consistent findings wellconducted epidemiologic studies prevents certain conclusion regard causeandeffect however increased risk indeed present plausible interpretation longterm oral contraception promotes earlier clinical manifestation breast cancer women net impact lifetime risk disease | 0 |
456 | adjuvant therapy nodenegative breast cancer use prognostic factors selecting patients patients invasive breast cancer pathologically negative lymph nodes favorable 10year survival rate particularly small less 1 cm primary tumors overall however 20 35 experience recurrence local therapy adjuvant chemotherapy tamoxifen prolonged diseasefree survival dfs overall survival os unanswered questions optimal end point dfs os risk treating many benefit prompted clinicians use prognostic indicators facilitate treatment recommendations currently readily available accurate information comes tnm staging pathologic features hormone receptors ploidy sphase fraction her2neu amplification overexpression cathepsind may useful prognostic indices precise system weighing several prognostic variables developed decision recommend adjuvant systemic therapy generally good prognosis group thoughtfully considered patient physician whenever possible patients encouraged enter clinical trials | 0 |
457 | primary ewing sarcoma followup ga67 scintigraphy avid accumulation gallium67 citrate technetium99m methylene diphosphonate mdp occurs initially cases primary ewing sarcoma uptake therapy less well defined thirty patients ewing sarcoma underwent ga67 bone scintigraphy diagnosis completion therapy relapse 1978 1988 evaluated 30 patients showed less primary site ga67 activity following therapy twentythree 28 patients underwent corresponding bone scintigraphy showed less uptake residual activity usually intense ga67 avid reaccumulation ga67 occurred four five patients primary site relapse patients underwent bone scintigraphy showed less change concluded greater decrease ga67 tc99m mdp uptake often occurs patients successfully treated primary ewing sarcoma information obtained ga67 scintigraphy likely helpful results bone scintigraphy remain abnormal occult relapse suspected | 0 |
458 | evaluation abdominal aorta howto cardiac sonographers thorough evaluation abdominal aorta readily achieved use standard views echocardiographic examination ultrasound evaluation abdominal aorta represents logical extension standard echocardiographic examination adult patient article provides information needed carry complete ultrasound examination abdominal aorta including anatomy vascular disease steps involved accomplishing ultrasound examination abdominal aorta | 3 |
459 | abnormal cardiovascular reactivity borderline mild essential hypertension cardiovascular hemodynamic reactivity evaluated mmode echocardiography phonocardiography carotidography correlation circulating catecholamine levels 25 normotensive subjects 15 borderline hypertensive patients 42 mildly hypertensive patients isometric exercise 30 maximum force 3 minutes rest norepinephrine epinephrine levels significantly higher cardiac index similarly increased groups hypertensive patients cardiac mass index significantly increased mildly hypertensive group isometric exercise sympathoadrenal reactivity well pressor chronotropic responses similar normotensive subjects groups hypertensive patients however variations blood pressure achieved totally different hemodynamic mechanisms normotensive subjects hypertensive patients normotensive subjects increase blood pressure could linked mainly increase cardiac contractility performance whereas either group hypertensive patients increase blood pressure mainly associated increase peripheral resistance observations consistent hypothesis blunted betaadrenergic reactivity predominance alphaadrenergic vascular reactivity borderline mildly hypertensive patients phenomenon appears unrelated age severity hypertension could important mechanism underlying development hypertension humans | 3 |
460 | high urinary camp hypertensives despite careful drug treatmentan epidemiological study dalby population correlation serum calcium sca plasma parathyroid hormone ppth hypertension determined populationbased crosssectional study carefully treated hypertensives n 391 diastolic blood pressure 902 mmhg 57 years compared normotensive controls n 328 diastolic blood pressure 821 mmhg 57 years levels urinary cyclicadenosinemonophosphate ucamp plasma camp pcamp higher p less 0001 hypertensives controls case regardless type drug treatment blood pressure level reached ucamp correlated adrenaline multivariate analyses sca levels higher p less 0001 smg levels lower p less 0001 hypertensives controls explained thiazide treatment thus despite adequate blood pressure reduction substantial differences sca smg ucamp still exist hypertensives normotensive controls | 3 |
461 | pseudocyst auricle case report world literature review treated patient pseudocyst auricle reviewed 113 cases previously published world literature pseudocyst auricle asymptomatic noninflammatory cystic swelling involves anthelix ear results accumulation fluid within unlined intracartilaginous cavity occurs predominantly men 93 patients characteristically one ear involved 87 patients lesion usually located within scaphoid triangular fossa anthelix previous trauma involved ear uncommon diagnosis may suggested clinical features analysis aspirated cystic fluid andor histologic examination lesional biopsy specimen confirm diagnosis therapeutic intervention maintains architecture patients external ear used treatment benign condition | 0 |
462 | fibrin fibrinogenrelated antigens patients venous disease venous ulceration abnormalities systemic fibrinolysis implicated pathogenesis venous ulceration patients venous disease prolonged euglobulin lysis time elevated plasma fibrinogen levels yet little known metabolism fibrinogen fibrin patients study used technique involves electrophoresis densitometric analysis captured fibrinrelated antigens measure concentration proportions individual fibrin fibrinogen degradation products patients venous disease lower extremity group patients venous disease markedly elevated levels total fibrinrelated antigen ddimer terminal degradation product crosslinked fibrin levels dmonomer breakdown product fibrinogen noncrosslinked fibrin monomer measure fibrinogenolysis normal patients patients ulcers levels ddimer disproportionately higher expected fibrin monomer levels individual basis significant elevations ddimer present six 55 11 patients venous disease ulcers three 43 seven patients venous disease without ulcers conclude patients venous disease uniform evidence enhanced fibrin formation evidenced elevated levels total fibrinrelated antigen ddimer regardless whether venous disease accompanied ulceration | 3 |
463 | thermographic findings craniofacial pain work assesses differences thermographic findings craniofacial neck areas normal individuals patients craniofacial pain headache investigates influence muscle contraction findings thermographic records taken 10 healthy subjects 47 patients suffering craniofacial pain headache different kinds patients painful episodes record taken attacks normal subjects 19 patients lateral thermograms also taken maximal tooth clenching three minutes majority patients compared normal group showed thermal alterations asymmetry alterations seem due vascular instability muscle contraction two factors may variably superimposed different conditions patients cluster headache chronic paroxysmal hemicrania presence symptomatic side cold spot along supraorbital area andor inner orbital canthus constant finding conclude thermography useful additional diagnostic means patients head face pain clenching test may increase amount information provided | 4 |
464 | implementation cancer prevention guidelines clinical practice data several sources including consumer surveys physician surveys medical record audits indicate consumers receive cancer screening tests recommended national cancer institute american cancer society us preventive services task force performance rates consistently published standards tests except pap tests major reasons physicians perform recommended tests include physician forgetfulness disagreement recommendations lack time patient refusal physicians also tend overestimate performance rates barriers screening test performance categorized patient factors physician factors test factors health care delivery system factors interventions computerized reminder systems physician audits feedback patient education reminders effective promoting performance screening interventions target physician patient may particularly effective | 0 |
465 | triiodothyronine recovery stunned myocardium dogs two groups dogs subjected 15minute period regional myocardial ischemia snaring left anterior descending coronary artery proximal first diagonal branch release snare dogs given either placebo group 1 n 7 triiodothyronine t3 therapy group 2 n 6 dose t3 given 02 microgramkg 30minute intervals total six doses plasma free t3 level fell significantly ischemic period groups continued fall reperfusion group 1 groups cardiac function deteriorated significantly period ischemia rapidly returned control level reperfusion 90 minutes reperfusion however deterioration left ventricular function observed group 1 significantly worse group 2 hemodynamic function maintained fact improved levels superior control suggested t3 therapy may worthy trial patients reperfusion myocardium takes place relatively short ischemic period stunned myocardium | 4 |
466 | two urogenital sinus syndromes interstitial cystitis focal vulvitis fortysix young women unusual presumably noninfectious disorders unknown etiology involving tissues derived embryonic urogenital sinus urogenital sinus syndromes ten women interstitial cystitis 25 focal vulvitis eleven women interstitial cystitis focal vulvitis affected groups similar demographic characteristics white mid20s unusual conditions occurred woman often could expected chance observation suggests common perhaps autoimmune mechanism may involved etiology syndromes | 4 |
467 | manifestations migraine migraine disorder multiple manifestations affecting circulation gastrointestinal tract central nervous system involvement autonomic nervous system responsible many clinical features attack migraine vary fragment clinical spectrum one several phases potentially permanent sequelae | 2 |
468 | strokes asians pacificislanders hispanics native americans stroke asian pacificislander populations remains principal cause death among adults incidence united states approximates caucasians although controversial uncontrolled hypertension certain population groups eg northern japanese high dietary saturated fat others eg pacificislanders believed responsible high stroke incidence rates recent reduction stroke frequency rates areas thought result better hypertension control nihonsan study level hypertension frequency similar hawaii japan ischemic infarction intracerebral hemorrhage less frequent hawaii reduced meat fat intake may contribute small vessel disease japan stroke third major cause death among hispanicamericans native americans yet paucity information especially stroke subgroups populations also considerable ignorance controversy risk factors stroke populations need additional research urgent | 2 |
469 | ileal pouchanal anastomosis emory university experience ileal pouchanal anastomosis become practical alternative proctocolectomy treatment ulcerative colitis polyposis coli evaluate success emory university affiliated hospital experience february 1984 march 1989 retrospectively reviewed total 50 patients identified 84 per cent ulcerative colitis 16 per cent polyposis coli familial polyposis gardners syndrome majority patients underwent twostage operation onethird required threestage procedure due difficulty mucosal proctectomy toxic megacolon jpouch construction performed 72 per cent patients spouch construction 14 per cent straight ileoanal anastomosis 8 per cent lateral isoperistaltic ileoanal anastomosis 6 per cent 50 patients 36 72 closure temporary ileostomy fourteen patients ileostomy closure due change diagnosis crohns disease operative complications ileostomy closure pending combined operative morbidity per patient ileal pouchanal anastomosis closure ileostomy 32 per cent included bowel obstruction 16 per cent pelvic abscess 6 per cent ileoanal separation 4 per cent followup patients ileostomy closure ranged 6 months 4 years mean 13 years stool frequency 59 stools per 24 hours 6 months improved time followup period patients eventually completely continent stool day became completely continent stool night | 4 |
470 | floppy infant recent advances understanding disorders affecting neuromuscular junction clinician often asked evaluate floppy infant numerous conditions cause hypotonia infancy briefly outlined article conditions may affect brain spinal cord motor unit several disorders neuromuscular transmission including four distinct recently described congenital myasthenic syndromes infant botulism discussed thereafter | 2 |
471 | reliability clinical electromyographic examination tendon reflexes reliability clinical examination tendon reflexes examined studying interobserver agreement twenty patients examined three neurologists briskness tendon reflexes arms legs scored ninepoint scale 28 160 examined reflexes observations disagreed 2 scale units disagreement presence asymmetry occurred 45 80 reflex pairs 15 one observer judged reflex pair symmetrical another observer found asymmetry least 2 scale units second experiment clinical observation apparently asymmetrical quadriceps reflexes compared measurement surface electromyography significant semilogarithmic relationship found clinical scores measured reflex amplitudes measured reflex asymmetry always agreed clinical asymmetry magnitudes rightleft amplitude differences correlated magnitude clinically observed asymmetry bedside examination tendon reflexes subject considerable interobserver disagreement | 4 |
472 | transesophageal echocardiography diagnosis left atrial appendage aneurysm intrapericardial left atrial appendage aneurysm rare describe transthoracic transesophageal echocardiographic findings 42yearold man atrial arrhythmia abnormal left atrial appendage chest roentgenogram presence intrapericardial left atrial appendage aneurysm confirmed surgery | 3 |
473 | intraventricular diamorphine via ommaya shunt intractable cancer pain describe two patients diamorphine administered intraventricular space via ommaya reservoir producing excellent pain relief use technique long term administration analgesia reviewed | 0 |
474 | effect lowdose warfarin risk stroke patients nonrheumatic atrial fibrillation boston area anticoagulation trial atrial fibrillation investigators background nonrheumatic atrial fibrillation increases risk stroke presumably atrial thromboemboli uncertainty efficacy risks longterm warfarin therapy prevent stroke methods conducted unblinded randomized controlled trial longterm lowdose warfarin therapy target prothrombintime ratio 12 15 patients nonrheumatic atrial fibrillation control group given warfarin could choose take aspirin results total 420 patients entered trial 212 warfarin group 208 control group followed average 22 years prothrombin times warfarin group target range 83 percent time 10 percent patients assigned receive warfarin discontinued drug permanently 2 strokes warfarin group incidence 041 percent per year compared 13 strokes control group incidence 298 percent per year reduction 86 percent risk stroke warfarincontrol incidence ratio 014 95 percent confidence interval 004 049 p 00022 37 deaths altogether death rate markedly lower warfarin group control group 225 percent compared 597 percent per year incidence ratio 038 95 percent confidence interval 017 082 p 0005 one fatal hemorrhage group frequency bleeding events led hospitalization transfusion essentially groups warfarin group higher rate minor hemorrhage control group 38 vs 21 patients conclusions longterm lowdose warfarin therapy highly effective preventing stroke patients nonrheumatic atrial fibrillation quite safe careful monitoring | 3 |
475 | value retesting subjects positive hemoccult screening colorectal cancer within prospective randomized screening study early detection colorectal cancer rehydrated hemoccult ii test possibility increasing specificity test retesting patients initially positive hemoccult ii test investigated offered test 3561 626 per cent returned positive 210 cases 59 per cent repeat test performed 184 patients positive 68 19 per cent positive initial test rectosigmoidoscopy 60 cm double contrast enema carcinoma found one seven patients positive retest one 100 patients negative retest p less 0001 specificity test therefore increased 95 per cent 98 per cent sensitivity unchanged rescreening offered later date increased numbers available 7147 patients returned test 369 52 per cent positive test repeated 360 patients 118 17 per cent positive colorectal neoplasm found one three positive repeat test compared one seven negative repeat test conclusion screening early detection colorectal cancer rehydrated hemoccult ii test may followed investigation patients positive retest procedure reduce workload 60 per cent without reducing sensitivity | 0 |
476 | probe angioplasty total coronary occlusion using probing catheter technique coronary angioplasty ptca total coronary occlusion limited inability guidewires conventional dilating catheters cross lesions new technique therefore prospectively evaluated ptca lesions using ultralowprofile probe balloon wire device intracoronary probing catheter used facilitate crossing stenosis guidewire deliver probe obstruction balloon dilatation technique utilized 64 consecutive patients absolute coronary occlusions demonstrating angiographically detectable antegrade coronary flow successful dilatation achieved 47 73 among 33 occlusions less 3 mo duration 31 94 successfully dilated whereas 16 31 chronic occlusions dilated p less 01 chronic occlusions tapered morphology located 1 cm branch point frequently dilatable serious complications including vessel perforations technique probing catheter technique offers safe effective method dilatation recent coronary occlusions using balloon wire technology | 3 |
477 | amenorrhea amenorrhea lack menstruation gynecologic disorder may arise variety causes logical orderly schema followed correct diagnosis appropriate management plan formulated | 4 |
478 | unilateral hydrocephalus adults authors report 14 cases unilateral hydrocephalus adults headache common presenting symptom unilateral hydrocephalus documented patient computed tomography scans magnetic resonance imaging also used seven patients latter part series unilateral hydrocephalus caused tumor seven patients venous angioma one patient ependymal cyst one patient postinflammatory gliosis one patient idiopathic four patients primary surgical treatment craniotomy fenestration septum pellucidum relieved symptoms eight nine patients longterm followup data available | 2 |
479 | symptomatic pericardial effusion breast cancer patients role fluid cytology clinical cytologic findings 21 breast cancer patients symptomatic pericardial effusion presented etiology pericardial effusion definitely malignant cytologyhistology 13 patients 62 suspected malignant cytology 2 patients 9 one patient 5 definitely nonmalignant pericardial effusion cytology found histologically positive autopsy 5 patients 24 histologicalcytological evidence malignancy radiation pericarditis could etiology 4 5 patients median time diagnosis breast cancer development symptomatic pericardial effusion 60 months range 1219 months ten patients developed cardiac tamponade treated either pericardiocentesis pericardiectomy mean survival patients negative cytologyhistology 12 months patients suspicious cytology mean survival 9 months patients malignant effusion treated pericardiectomy mean survival 223 months patients malignant pericardial effusion subjected surgery mean survival 47 months concluded etiology symptomatic pericardial effusion breast cancer patients always malignant emphasizes role fluid cytology establishing definite diagnosis survival probability function extent extracardiac disease among patients malignant pericardial effusion selected pericardiectomy longer average survival | 3 |
480 | analysis interferoninducible genes cells chronic myeloid leukemia patients responsive resistant interferonalpha treatment recombinant human interferonalpha ifnalpha induce hematologic remission patients chronic myeloid leukemia however patients resistant others develop late resistance ifnalpha treatment understand molecular mechanism resistance analyzed expression 10 ifninducible genes cells three resistant patients two responsive patients six healthy controls northern blot hybridizations showed genes induced vitro ifnalpha treated peripheral blood cells patients healthy controls genes also inducible peripheral blood bone marrow cells two two resistant patients administered injection ifnalpha conclude resistance ifnalpha treatment chronic myeloid leukemia patients studied due 1 absence induction 10 ifninducible genes studied including lowmolecularweight 25oligoadenylate synthetase 2 presence antagonist ifnalpha peripheral blood bone marrow cells 3 presence neutralizing antiifnalpha antibodies | 0 |
481 | hemodynamic determinants subdiaphragmatic venous return closedchest cpr canine cardiac arrest model objective assess hemodynamic determinates peripheral subdiaphragmatic venoustorightheart return closedchest cpr model seven anesthetized dogs subjected electrically induced ventricular fibrillation five minutes interventions conventional closedchest cpr closedchest cpr continuous abdominal binding chest compression rate 60 per minute compressiontorelaxation ratio 5050 ventilationtocompression ratio 15 methods solidstate catheters positioned ascending aorta right atrium ra inferior vena cava ivc cannulating electromagnetic flow probes inserted ivc carotid artery analogtodigital conversion performed electronically five minutes ventricular fibrillation induced interventions performed alternating sequence systolic diastolic mean pressures flows measured compared statistical methods twotailed unpaired test applied equal sample size linear regression analysis multiple regression analysis results abdominal binding cpr significantly increased p less 05 measured systolic diastolic cpr intravascular pressures compared cpr without abdominal binding affect ivctorightheart venous return conventional cpr without abdominal binding venous return dependent diastolic ivc pressure r 86 p 014 mean ivc pressure r 80 p 03 carotid blood flow r 99 p 001 ivctora pressure gradient abdominal binding venous return correlated study hemodynamic variable including peripheral venoustora pressure gradient conclusion venous return subdiaphragmatic venous bed cpr dependent venous pressure peripheral venoustorightheart pressure gradient abdominal binding cpr affect venous return venous return cpr diastole highly dependent central venous capacitance left heart outflow cpr systole | 3 |
482 | comparison symptom characteristics indwelling ureteral catheters signs symptoms produced 4 different types 7f double pigtail catheters including cook polyurethane pigtail stent surgitek silitek uropass cook cflex vantec soft stent analyzed prospectively stents placed 45 men 28 women ranging age 23 72 years old total 44 catheters suture attached bladder end catheter exited urethral meatus facilitate removal remaining 29 catheters suture attached symptoms evaluated 2 6 days insertion 1 week following removal catheter included urinary frequency nocturia hematuria flank pain suprapubic pain dysuria pain removal catheter frequency nocturia evaluated minutes pain graded subjective scale 0 pain 10 severe pain dysuria hematuria assessed qualitatively significant differences among 4 types catheters terms frequency nocturia hematuria flank pain suprapubic pain dysuria addition significant difference urinary symptoms catheters without suture either 2 6 days insertion difference pain removal catheters mean 39 without mean 50 suture found catheter composition use suture facilitate removal significantly affect patient morbidity | 4 |
483 | tumoral thrombosis cerebral venous sinuses preoperative diagnosis using magnetic resonance phase imaging intracranial duralbased neoplasms infrequently invade adjacent venous sinuses therefore preoperative diagnosis venous invasion important alter surgical approach lesion magnetic resonance imaging noninvasive means visualizing cerebral venous sinuses preoperative diagnosis venous thrombosis however difficult confusing conventional spinecho magnetic resonance imaging variable appearances produced blood clot degradation products well flowing blood phase magnetic resonance imaging simple method acquired simultaneously conventional spinecho sequences based primarily whether protons stationary moving context venous sinus occlusion phase imaging demonstrate presence absence blood flow easily spinecho imaging three cases duralbased neoplasms presented demonstrate utility phase imaging diagnosing tumoral occlusion venous sinuses | 2 |
484 | achalasia elderly effects aging clinical presentation outcome clinical manometric data 13 elderly subjects idiopathic achalasia mean age 79 2 years compared findings younger subjects disease n 79 see aging altered presentation outcome motor disorder fewer elderly subjects complained chest pain 27 vs 53 pain significantly less severe p less 001 presenting features including sex duration symptoms presence severity dysphagia differ groups across patients age weakly inversely correlated residual postdeglutitive lower esophageal sphincter les pressure r 034 residual pressure significantly lower older subjects 80 13 mm hg vs 119 08 mm hg p 002 differences basal les pressure esophagealbody contraction amplitudes present groups initial success pneumatic dilation similar two subject groups number older subjects available analysis small draw strong conclusions results indicate aging decreases elevation les residual pressure occurs achalasia elderly achalasia patients also present less chest pain findings may interrelated | 1 |
485 | blood transfusion recurrence colorectal cancer role platelet derived growth factors efforts explain possible effects blood transfusion recurrence colorectal cancer based entirely immunosuppressive effects blood transfusion however relationship solid tumour development immune system inconclusive investigated alternative mechanism involving potential role growth factors phenomenon using human fibroblast 125ideoxyuridine uptake mitogenesis assay relative amounts growth factor plasma stored blood measured progressive increase mitogenesis day 0 n 6 day 28 n 6 p less 0001 mannwhitney u test effect growth factors development liver intraperitoneal metastases studied hooded lister rats following intraportal injection 105 mc28 tumour cells experimental group n 25 received 2 ml syngeneic serum intravenously 4 days likewise colonic anastomoses performed omentectomized rats peritoneal cavity seeded 103 cells experimental groups n 20 received either 2 ml serum intravenously repeatedly 3 ml serum intraperitoneally n 19 significant increase liver metastases peritoneal disease following intravenous infusion serum serum delivered intraperitoneally resulted significant increase tumour 22 per cent controls 89 per cent study group p less 001 growth factors released platelets following blood loss peritoneal cavity may important enhancing local recurrence colorectal cancer | 0 |
486 | power drills fenestrate exposed bone stimulate wound healing power drills used stimulate formation granulation tissue exposed cortical bone tools allow rapid fenestration selective abrasion large areas exposed bone fenestration abrasion create multiple bleeding points essential production granulation tissue granulation tissue thus produced allowed grow holes cover bone procedure performed outpatient setting usually without need either local general anesthesia particularly useful patients considered poor risks general anesthesia healing granulation tissue somewhat slow process high success rate causes complications produces good cosmetic results two cases illustrate method fenestration exposed cranial bone stimulate granulation tissue specific instructions describe needed care exposed bone | 0 |
487 | recurrent thoracic outlet syndrome recurrent symptoms develop 15 20 patients undergoing either first rib resection scalenectomy thoracic outlet syndrome past 22 years 134 operations recurrence performed 97 patients four operations used transaxillary first rib resection 26 supraclavicular first rib resection neurolysis 15 scalenectomy neurolysis 58 brachial plexus neurolysis 35 complications included temporary plexus injury 07 temporary phrenic palsy 37 permanent phrenic palsy 14 combined primary success rate four operations recurrence 84 first 3 months fell 59 1 2 years 50 3 5 years 41 10 15 years significant difference found results four operations used recurrence recurrence caused trauma results reoperations better recurrence spontaneous primary success rates three initial operations thoracic outlet syndrome compared secondary success rates improved reoperation use lifetable methods reoperation improved 5 10year success rate transaxillary first rib resection 69 86 scalenectomy 69 84 reoperation successful cases recurrent thoracic outlet syndrome better recurrence result neck injury | 2 |
488 | angiographic progression total coronary occlusion hyperlipidemic patients acute myocardial infarction posch group progression coronary artery stenosis total occlusion assessed 413 hyperlipidemic patients previous myocardial infarction coronary angiograms recorded baseline 3 n 312 5 years n 248 initial study analyzed 2 independent readers 177 43 patients 1 130 31 2 61 15 3vessel disease greater equal 50 diameter narrowing whereas 45 11 significant disease within major coronary vessel baseline new finding total occlusion occurred 4 30 748 7 40 605 major coronary artery segments 3 5 years respectively risk progression total occlusion higher initial stenosis greater 60 compared lesions less equal 60 3 years 19 143 13 vs 11 605 2 p less 0001 5 years 27 91 30 vs 13 514 3 p less 0001 frequency occlusion highest right coronary artery 5 years 18 167 11 right vs 8 225 4 circumflex vs 14 213 7 left anterior descending coronary arteries p less 002 clinical laboratory data revealed myocardial infarction associated new total occlusion 23 patients 7 30 3 years 64 25 39 5 years | 3 |
489 | diastolic dysfunction hypertrophic cardiomyopathy effect active force generation systole tested hypothesis intracellular ca cai overload underlies diastolic dysfunction patients hypertrophic cardiomyopathy myocardial tissue obtained time surgery transplantation patients hypertrophic cardiomyopathy compared control myocardium obtained patients without heart disease isometric contractions electrophysiologic properties myocardial specimens recorded standard techniques cai measured bioluminescent calcium indicator aequorin contrast controls action potentials ca transients isometric contraction relaxation markedly prolonged hypertrophic myocardium ca transients consisted two distinct components 38 degrees c 1 hz pacing frequency state relative ca overload appeared develop produced rise enddiastolic cai incomplete relaxation fusion twitches resultant decrease active tension development also found drugs increase cai digitalis exacerbated abnormalities whereas drugs lower cai verapamil agents increase cyclic amp forskolin prevented results may explain patients hypertrophic cardiomyopathy tolerate tachycardia poorly may important implications regard pharmacologic treatment patients hypertrophic cardiomyopathy | 3 |
490 | intrahepatic arterioportal fistula blunt hepatic trauma case reports intrahepatic arterioportal fistula apf found five 65 consecutive patients following blunt hepatic trauma four patients fistula located peripherally blood flow small fistulas closed spontaneously within 3 months however centrally located fistula early visualization trunk portal vein persisted one patient necessitated transcatheter embolization apf patient caused portal dilatation detectable ct scan conclude spontaneous closure expected apf located peripherally shunt flow small centrally located apf large flow require active treatment preferably transcatheter embolization apf detectable ct scan suggests need intervention | 4 |
491 | decreasing risk human immunodeficiency virus hepatitis b virus infection endoscopic surgery risk transmission human immunodeficiency virus hepatitis b virus infection small finite urological surgeons exposed needle punctures open surgery splashes endoscopic surgery safety glasses difficult use endoscopic surgery offer complete protection sterishield facial shield designed fixed endoscope described | 1 |
492 | morbidity mortality quality life patients treated levothyroxine population study 1462 middleaged women initiated 1968 1969 identified 29 women treated levothyroxine 1 28 years 12year followup 1980 1981 investigated subjects endpoint myocardial infarction diabetes mellitus stroke cancer death status 997 initial participants established women treated levothyroxine showed increase morbidity mortality 24 women still receiving levothyroxine 1980 1981 22 serum thyrotropin triiodothyronine concentrations within reference limits individuals compared 968 women population study history thyroid disease appeared identical laboratory clinical data exception slightly higher body mass taller stature lower serum cholesterol concentration treated group differ life quality estimate based 19 questions regarding life satisfaction sensory function conclude levothyroxinetreated woman suffers side effects lifelong therapy | 2 |
493 | ischemic heart disease platelet aggregation caerphilly collaborative heart disease study caerphilly collaborative heart disease study based large cohort men 2398 aged 4966 years time study platelet aggregation induced collagen thrombin adp measured fasting blood samples related prevalent angina past myocardial infarction electrocardiographic evidence ischemic heart disease number subjects taken aspirin nonsteroidal antiinflammatory drugs drugs affecting platelet aggregation 7 days blood sample collection exclusion subjects data available 1811 men relations demonstrated angina significant relations shown past myocardial infarctions electrocardiographic evidence ischemia adpinduced aggregation primary secondary electrocardiographic evidence ischemia thrombininduced aggregation strongest relation indicated twofold increase odds past myocardial infarction subjects highest fifth adpinduced primary platelet aggregation compared lowest fifth significant relations detected collageninduced aggregation accounting number possible confounding factors relatively small impact relations platelet aggregation ischemic heart disease evidence including wellestablished effect aspirin reducing incidence ischemic heart disease indicates relations describe unlikely simply effect ihd platelets | 3 |
494 | etiology mechanisms acute infectious diarrhea infants united states infectious diarrhea caused wide variety viral bacterial parasitic pathogens common reason morbidity hospitalization children united states overall rotavirus common cause acute diarrheal disease infants salmonella shigella campylobacter frequently isolated bacterial pathogens giardia cryptosporidium parasites commonly produce acute infectious diarrhea mechanisms enteropathogens cause diarrhea highly variable include crypt cell proliferation cellular invasion elaboration enterotoxins cytotoxins enteroadhesion infants incidence diarrheal disease higher severity illness greater older children adults increased rate exposure enteropathogens result fecaloral contamination may explain increased incidence diarrhea infants however agespecific differences host defense mechanisms may also account increased susceptibility severity certain enteric infections infants | 1 |
495 | therapeutic considerations elderly hypertensive role calcium channel blockers hypertension extremely common problem elderly optimum antihypertensive agent use population certain paper factors influencing choice antihypertensive therapy reviewed include efficacy safety comorbidity utility special populations drug interaction dosage schedule cost mechanisms action drug pathophysiology patients hypertension calcium channel blockers effective safe elderly improve conditions frequently seen population exception cardiac conduction abnormalities associated calcium channel blockers adversely affect comorbid diseases work well together antihypertensives vasodilators may specifically appropriate elderly hypertensives whose hypertension associated reduced cardiac output increased peripheral vascular resistance twiceaday preparations available foster compliance calcium channel blockers expensive | 3 |
496 | parascapular free flaps head neck reconstruction report experience singlestage primary reconstruction head neck 29 consecutive patients using parascapular free flaps commonest indications craniofacial defects 9 oropharyngeal soft tissue defects 10 combined mandibular soft tissue losses 4 ablative surgery performed squamous carcinoma 22 melanoma 2 malignant fibrous histiocytoma 2 seven patients died recurrent disease 3 12 year followup seven patients alive recurrence flap complications included total loss 2 due unsalvageable microvascular thrombosis wound breakdown oropharyngeal fistula 2 mandibular osteomyelitis 1 trismus 2 neck contracture 1 donor site wound dehiscence 1 overall success reconstruction 93 primary wound healing general rule lower morbidity reconstructive techniques flap thin pliable conforms well threedimensional defects lateral border scapula incorporated vascular pedicle singlestage mandibular reconstruction muscle sacrificed posterior donor defect added advantage parascapular flap first choice reconstruction major defects head neck | 0 |
497 | antiepileptic drug intoxication factors significance retrospective chart review 19791985 performed identify probable causes intoxication antiepileptic drugs aeds identified 141 patients meeting clinical laboratory criteria intoxication 17 clinical signs serum concentrations within therapeutic range majority epileptic patients almost half treated monotherapy phenytoin pht causes intoxication epileptic patients iatrogenic 41 inappropriate dose selfadjustment 34 suicide attempt 18 inappropriate caretaker dose adjustment 9 accidental ingestion 8 unrecognized drug interaction 6 association intercurrent illness 2 twentytwo patients one probable cause intoxication nonepileptic patients causes suicide attempt 50 accidental ingestion 27 iatrogenic 23 patients signs ocularmotor vestibulocerebellar dysfunction rarely described manifestations intoxication seizures choreoathethosis observed patients average hospital stay 69 days mortality patients recovered fully conclude aed intoxication major preventable cause morbidity suicide attempts important underrecognized contributor epileptic nonepileptic patients | 4 |
498 | modified technique pringles maneuver resection liver crushing hepatic parenchyma hepatic clamps minimize blood loss resection liver leads mechanical damage hepatocytes pringles maneuver may precipitate liver failure hepatic warm ischemia well therefore controlled bleeding surface resection using light compression hepatic parenchyma band applying hepatic arterial clamp hepatic hilus vascular control method done portal pressure onetenth hepatic artery pressure provides efficient harmless transection liver | 1 |
499 | effects pressure volume receiving chamber spatial distribution regurgitant jets imaged color doppler flow mapping vitro study regurgitant jet dimensions imaged color doppler flow mapping used evaluate severity valvular insufficiency clinical studies study effect pressure volume within receiving chamber magnitude spatial distribution regurgitant jets assessed color doppler techniques designed simple constantflow model jet driven known orifice 15 mm2 compliant receiving chamber steadyflow pump distal tube outflow closed system maintained volume chamber constant pump operation varied flow rate 60 270 mlmin elastic balloons different static compliances 1 2 45 9 mlmm hg pressures 57 28 18 8 mm hg respectively balloons served receiving chambers constant volume 150 ml also evaluated effect different volumes receiving chamber 110 130 150 ml pressures 5 15 24 mm hg static compliance 2 mlmm hg range flow rates different balloons jet area correlated linearly jet velocity across orifice r 098 099 098 097 also flow rate r 097 099 098 099 flow rate volume receiving chamber however jet area imaged color doppler decreased pressure receiving chamber increased although receivingchamber volume constant | 3 |
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