Datasets:
anupshaw
/
activeslr-picos-ner

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1768004
The incidence of cancer of the cardia is increasing. Surgical treatment, in a small percentage of patients in early stage, consists in esophagectomy and total gastrectomy, followed by colon interposition. The operation can be performed through the thorax or by an abdominal and cervical approach. From 1982 to 1989 twenty-five patients were operated on. Between 1980 and 1982 the cancer was resected opening the thorax in 9 patients (group A), while from 1983 to 1989 the esophagus was removed through diaphragmatic hiatus in 16 patients (group B). All cases were analyzed as for histology, staging and resection margin. Average clinical follow-up was 22 +/- 32.7 months (range 1-102). Morbidity was 77.7% in group A and 68% in group B. Mortality dropped to 14% in the last 7 patients. Mean survival time was 23 +/- 34 months in group A and 11.2 +/- 13.7 months in group B (p = N.S.). Follow-up controls showed that all patients, in whom the esophagus was replaced with colon, were able to feed adequately.
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3917415
Addition of calcium chloride to an egg homogenate of Strongylocentrotus purpuratus stimulates O2 consumption which is not inhibited by millimolar cyanide. Results strongly suggest that Ca2+-stimulated O2 consumption is at least partially the result of polyunsaturated fatty acid oxidation. First, addition of arachidonic acid (AA), or other polyunsaturated fatty acids, to the homogenate enhance Ca2+-stimulated O2 consumption; this enhancement, by AA, being coupled to its oxidation to a hydroxy fatty acid. Second, calcium stimulates a lipase activity in the homogenate that is capable of releasing free fatty acids. Third, Ca2+-stimulated O2 consumption and AA oxidation have virtually identical calcium requirements and pH optima. The sequence of events then is that upon calcium addition to the homogenate, lipase activity is increased which liberates free fatty acids. At the same time calcium also activates a polyunsaturated fatty acid oxygenase, possibly lipoxygenase, that converts the free fatty acids to hydroxy fatty acids. The possible physiological importance of this reaction is underscored by the high affinity for Ca2+ [approximately 10(-7)M], an ion known to increase above the required levels at fertilization. The pH activity profile also suggests possible physiological modulation because a pH change of 6.8 increasing to 7.2, as suggested to occur after fertilization, yields almost a twofold increase in O2 consumption. Egg homogenates from many other invertebrate species have the ability to oxidize AA in a Ca2+-dependent fashion. For the investigated species, the presence of Ca2+-stimulated O2 consumption and AA oxidation correlates with the presence of cyanide insensitive respiration in the intact egg.
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3899347
Sixty-four patients with disseminated breast cancer were treated with an aggressive chemotherapy program of prednisone, methotrexate, 5-fluorouracil, Adriamycin (doxorubicin) and cyclophosphamide (PM-FAC). A response rate of 76% was seen in 44 estrogen receptor (ER) negative patients, with 26% achieving complete responses. Forty-two percent of 20 ER positive and unknown patients demonstrated a response, but in none was a complete response achieved. Median response duration was 9 months for complete responders and 5 months for partial responders. The median survival for both groups of patients was 13 months. However, survival among the responding patients was inferior for the ER negative group (median, 14 versus 20 months; P = 0.05). These findings suggest selective sensitivity of ER negative breast cancer to Adriamycin-containing chemotherapy. Despite aggressive chemotherapy, no durable remissions were achieved. Relapse occurred at sites of known prior involvement, and in the central nervous system de novo, especially in the ER negative patients.
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3895224
Saccharomyces cerevisiae contains two RAS genes, RAS1 and RAS2. An insertion mutation in RAS2 (ras2::LEU2) does not affect growth on glucose based media but it does prevent growth on media with pyruvate or other noncarbohydrate carbon sources. This defect is pH sensitive and is most severe at pH 7 and above. The ras2::LEU2 mutation also causes markedly higher levels of glycogen in the derepressed phase of growth after glucose exhaustion. Selection for restoration of growth on pyruvate yields unlinked suppressor mutations. Some of the suppressors also reduce glycogen as well as trehalose (the other reserve carbohydrate in yeast) to levels much lower than those of wild-type strains. These suppressor mutations do not suppress the lethality of ras1 ras2 double mutants. The results indirectly accord with yeast RAS2 governing a G protein activity of adenylate cyclase.
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3895977
What digestive adaptations enable mammals to process much more food in much less time with equal or higher digestive efficiency than reptiles and thus to sustain much higher metabolic rates? To answer this question, we measured glucose and proline uptake in small intestinal sleeves of three mammal and three reptile species of similar body size and natural diet. All species exhibit saturable, stereospecific uptake of D-glucose and Na+-dependent L-proline uptake. Passive permeability to glucose is high in hamsters and low in the other species. Uptake increases with temperature up to a maximum around 45-50 degrees C. This temperature dependence may help explain why reptiles bask after meals and why their digestion is impaired if basking is prevented. The total uptake capacity of the small intestine for glucose and proline is seven times higher in mammals than similar-sized reptiles, mainly because the area of mammalian intestine is 4-5.5 times greater. Minor reasons for the higher uptake capacity of mammals are that the transport activity of mammal intestine normalized to quantity of tissue is up to twofold higher and that reptile intestine operates at a lower temperature at night. Vmax for glucose transport varies 10-fold among species, but apparent differences in Km values may be unstirred-layer artifacts. Carrier-mediated uptake of glucose and proline is measurable in the colon of at least three species, but the uptake capacity of the colon is less than 10% of that of the small intestine. An appendix presents a method for measuring the microscopic area of intestines with ridges rather than villi, applies this method to desert iguana intestine, and measures area amplification due to villi in wood rat intestine.
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3910159
Two treatments for fistula-in-ano were compared in a randomized trial. Times of healing were significantly shorter when the fistula was laid open (median 34 days, n = 26) than after excision (41 days, n = 21) (P less than 0.02). Revisional surgery was necessary before healing could be obtained in 3 of 26 patients after lay open operations and 2 of 21 after excision. Recurrence rates within 1 year were similar (3/24 and 2/21).
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3920837
We report on 3 patients suffering from allergic contact dermatitis to chloracetophenone, two of them policemen. Besides toxic local and systemic effects, one possible risk of using tear gas is sensitization.
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3916727
In S. cerevisiae, the synthesis of ureaamidolyase is subject to at least two different forms of regulation: nitrogen catabolite repression and induction by allophanate. Two positive regulatory genes DURM and DURL are involved in the induction process. We have measured the levels of mRNA homologous to the DUR2,1 gene in conditions of ureaamidolyase induction and in regulatory mutants. The amounts of DUR2,1 enzyme and messengers are well coordinated; moreover, the half life of DUR2,1 messengers is identical in the presence or absence of inducer. These data suggest that the ureaamidolyase production is probably controlled at the level of transcription. From a pool of hybrid plasmids carrying Sau3A fragments representing the entire yeast genome, a 13 kb DNA fragment containing the regulatory gene DURM was cloned by complementation of a durM mutation which prevents the growth on allantoin as sole nitrogen source. Cells containing the cloned DNA recover the inducibility of ureaamidolyase by allophanate. Four RNA transcripts have homology to this 13 kb DNA fragment but the study of subcloned restriction endonuclease fragments allowed us to map the DURM regulatory gene within a 4 kilobase pair region. This fragment encodes a 1 kb transcript. The level of this RNA is the same in induced and non-induced cells.
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3920965
Pseudomonas fluorescens P1 is a psychrotrophic bacterium isolated from milk. Proteinase P1, the main extracellular heat-stable proteinase fraction of P. fluorescens P1, has been purified to homogeneity. A procedure with a sandwich enzyme-linked immunosorbent assay, using microplates and alkaline phosphatase conjugate was shown to detect 0.25 ng of proteinase P1 in 1 ml of reconstituted skim milk or defatted cream. The method offers the combination of sensitivity and specificity for the detection of these enzymes in milk and dairy products. In reconstituted skim milk cultures proteinase P1 was detectable when the CFU approached 10(7)/ml. Cultures in milk diluted 1:10, 1:30, or 1:100 with water showed detectable proteinase at population densities close to 10(6) CFU/ml. Aeration stimulated proteinase production; thus, a skim milk culture with shaking at 5 degrees C had a proteinase level of 36,000 ng/ml after 7 days as compared to 80 ng/ml in a stationary culture. The rate of inactivation of proteinase P1 at 150 and 55 degrees C as expressed by residual antigenic activity determined by the enzyme-linked immunosorbent assay was somewhat different from the rate determined on the basis of residual proteolytic activity. The specificity of the enzyme-linked immunosorbent assay with proteinase P1 antibodies was identical for proteinase P1 and for enzymes from six other strains of P. fluorescens, one Chromobacterium strain, and one Flavobacterium strain. Some psychrotrophic strains produced immunologically unrelated proteinase(s). These preliminary observations indicate that proteinase P1-related enzymes are common among psychrotrophs appearing as spoilage bacteria in milk.
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3908619
The results of a randomized trial of polyadenylic-polyuridylic [poly(A).poly(U)] acid given as adjuvant treatment for operable breast cancer were reviewed after a mean follow-up period of 87 months. The overall survival was significantly improved in patients given the adjuvant (155 cases) as compared with the controls (145 cases). A significant benefit was observed in patients with invaded axillary nodes; the best results were obtained in the group of patients with up to three nodes involved, who showed a significant increase in both overall and relapse-free survival. The biological response modifications observed after treatment with poly(A).poly(U), namely, production of interferon and increase of natural killer cell activity, are described and their possible role in the mechanism of action of the complex is discussed. The results of a Phase I clinical tolerance study of the duplex in cancer patients will be reported. The aims and protocols of new clinical trials with adjuvant poly(A).poly(U) in different types of tumors will be presented.
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3896169
A total of 74 of 82 domestic Rhodnius prolixus from the same locality in eastern Colombia were found to be infected with Trypanosoma cruzi or T. rangeli. One of three domestic Triatoma dimidiata from Ecuador also showed T. cruzi infection. A total of 59 T. cruzi stocks from these and five other localities in Colombia were isolated from man, marsupials and triatomine bugs. Cellulose-acetate electrophoresis of nine or ten enzymes characterized all T. cruzi stocks as zymodeme 1 (reference clone Silvio X10/1). Differences in electrophoretic patterns between the newly isolated stocks and the zymodeme 1 standard were seen with the enzymes G6PD and HK. These results are in agreement with the previously described geographical distribution of T. cruzi zymodemes. Stocks were isolated from both low and high altitudes and there was no evidence of adaptative significance of T. cruzi enzyme polymorphism.
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3910673
A rapid and highly sensitive assay method for measuring PZ-peptidase activity in newborn rat brain is described. The method is based on monitoring the absorption at 320 nm of PZ-Pro-Leu enzymatically formed from the substrate, PZ-L-Pro-L-Leu-Gly-L-Pro-D-Arg, after separation by high-performance liquid chromatography using a reversed-phase column. This method is sensitive enough to measure PZ-Pro-Leu at concentrations as low as 5 pmol, and is able to make the column ready for the next injection within 10 min after the preceding injection. By using this method, PZ-peptidase activity was discovered in clonal osteoblastic cells derived from newborn mouse calvaria.
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1766508
We report a case of erosive arthropathies discovered radiologically before dialysis in a uremic patient with Alport syndrome. This patient had no hereditary amyloidosis or causes of acquired generalized amyloidosis (no chronic infections or inflammatory disease, neoplasia, lymphoma or monoclonal gammapathy). Erosive spondyloarthropathies of the cervical spine at the C5-C6 and C6-C7 levels, erosive arthropathy of the right acromioclavicular joint, metacarpal lacuna of the right hand, and lacuna of the left femoral neck were discovered 24 months before starting dialysis in this patient with chronic renal insufficiency of 17 years duration. Puncture of the vertebral disc before starting dialysis took a fragment showing amyloid deposits with permanganate-sensitive Congo red staining and positive staining with anti-beta 2-microglobulin antibodies. This observation suggests that beta 2-microglobulin amyloidosis in uremia may not be exclusively related to chronic kidney replacement therapy, but to uremia per se, especially when the latter is of long duration.
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3919056
We describe a patient who suffered from recurrent intraabdominal abscesses. The last two of the three abscesses were certainly caused by Salmonella paratyphi C. The time interval between the first and the second abscess was 25 years, and that between the second and the third abscess was 20 years. Single infection with this microorganism is very rare in Israel, with only four known cases in the last 20 years. The annual frequency in the United States is 0 to 2 cases per year. In recent years, this infection has also been very rare in other parts of the world. Our case is unique as it recurred two or three times. The infection was probably dormant for a very long time. During the dormant years, the patient was clinically healthy. To our knowledge a recurrent infection with this microorganism has not previously been reported in the literature.
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3895799
One daily dose of 0.05 mg ethinyl oestradiol was administered to 5 patients with Turner's syndrome (mean age +/- SEM = 16.4 +/- 0.7 years) for 10 days. The effects of acute stimulation with luteinizing hormone-releasing hormone (LRH) (0.1 mg iv) on biologically active and immunoreactive LH were analysed before therapy and at the end of oestrogen treatment. Bioactive LH (BIO-LH) was measured by a sensitive and specific in vitro bioassay based upon testosterone production by mechanically dispersed mouse Leydig cell preparations. Immunoreactive LH (RIA-LH) was evaluated by a double antibody RIA method. Prior to oestrogen treatment, LRH induced a prompt rise in BIO-LH and RIA-LH levels, which reached peak values at 30 and 45 min, respectively. After oestrogen treatment, a delayed response (with peak values at 120 min) was observed for both BIO-LH and RIA-LH. Before oestrogen treatment, the mean bioactivity to immunoreactivity (B/I) ratio of LRH-stimulated LH showed a significant decrease from basal values (P less than 0.05). In contrast, after ethinyl oestradiol administration the mean LH B/I ratio increased significantly from basal values in response to LRH (P less than 0.05). The mean relative maximum response (delta %) for BIO-LH was significantly higher (P less than 0.05) in oestrogen-treated than in untreated patients, whereas the mean BIO-LH delta area was significantly lower in the former group (P less than 0.01). Similarly, oestrogens decreased significantly the mean RIA-LH delta area (P less than 0.05), whereas they did not affect significantly the mean RIA-LH delta %. The results further emphasize that oestrogens may change the quality of circulating LH.
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3915712
Significant advances have been made in the therapy of ventricular arrhythmias. Many new antiarrhythmic drugs have expanded the medical armamentarium to treat ventricular tachycardia and ventricular fibrillation, and the use of intracardiac electrophysiologic studies has aided in predicting long-term drug efficacy. Major advances have also been made in the surgical treatment of arrhythmias. However, there remain a number of patients in whom ventricular arrhythmias remain a major therapeutic problem and, in some of these, electrical devices may aid in treatment. Overdrive pacing may prevent certain cases of ventricular arrhythmias, and antitachycardia devices may be useful in terminating paroxysmal ventricular tachycardia. In certain circumstances, internal cardioversion or defibrillation may be an alternative. At present, antitachycardia pacing and internal countershock must be considered as forms of therapy to be used when medical and surgical therapy are impractical or have failed. Careful selection is necessary to delineate patients in whom these forms of therapy may be indicated.
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3898546
A brief primer on synthetic fuels is given. The paper includes brief descriptions of generic conversion technologies that can be used to convert various raw materials such as coal, oil shale, tar sands, peat and biomass into synthetic fuels similar in character to petroleum-derived fuels currently in commerce. Because the subject is vast and the space is limited, references for additional information on synthetic fuel processes and products are also given in the paper.
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3917303
We describe a technique wherein an endotracheal tube is used as a sheath for a feeding tube, which has been placed through the wall of a gastrostomy catheter, to allow selective intubation of the duodenum.
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3908697
Sarcoidosis is a recently identified cause of functional asplenia that can be diagnosed by radionuclide imaging. A 31-year-old woman with a five-year history of histologically compatible sarcoidosis was found to have nonvisualization of the spleen on technetium 99m sulfur colloid (radiopharmaceutical) liver-spleen scan. This scintigraphic finding was accompanied by poikilocytosis and Howell-Jolly bodies in the peripheral blood smear. A subsequent gallium 67 citrate scan reflected an abnormal increase in concentration of activity in the spleen, suggesting an active inflammatory process.Based upon this constellation of findings, it was concluded that acquired functional asplenia is the result of reticuloendothelial cell replacement via infiltration of the spleen by epithelioid cell granulomas of active sarcoidosis. This case also illustrates the reversibility of functional asplenia of sarcoidosis following adrenocorticosteroid therapy. Functional asplenia in sarcoidosis is now found to have a recognizable radionuclide imaging pattern.
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1763622
Streptomycin was injected subcutaneously into guinea pigs (n = 12) with unilateral endolymphatic hydrops. In the unoperated ears, sensory cells were degenerated at the basal ends of all cochleas and to varying extents in the vestibular sense organs. Hydropic ears, in contrast, showed greater ototoxicity in the cochlear and saccular sensory cells, while the drug's effect on the utricular and cristae sensory cells was increased, but less remarkable. In another series of normal animals (n = 16), streptomycin was applied to a fenestra of the lateral semicircular canal. Sensory cells of all three canal cristae and utricular macula were degenerated frequently, but the sensory cells of the cochleas were rarely affected. The vestibular lesions resulting from the canal approach were greater than those produced by systemic injection. Comparison with a former gentamicin-lateral canal series revealed very little difference in action of the two drugs. However, in hydropic ears, gentamicin application to the lateral canal produced increased lesions in all sensory cells, particularly in the organ of Corti. Hydropic ears are vulnerable and a greater caution is needed in administering aminoglycosides by both the systemic and the canal route to patients with Meniere's disease.
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1765900
Artificial chylomicron remnants were investigated as a new drug carrier system for the targeting of hepatic parenchymal cells. The emulsions presented here are similar in particle size and composition to natural lipoproteins. The preparations contained triolein, phospholipid, cholesterol and cholesteryl oleate. Egg yolk lecithin was either used to form multilamellar or unilamellar liposomes or it was incorporated into a lipid film prior to emulsification. Typically the lipid film contained triolein, cholesterol and cholesteryl oleate. When multilamellar liposomes were used however, cholesterol and cholesteryl oleate were incorporated into the vesicles. The emulsions were prepared by ultrasonication or by means of a microemulsifier. The unilamellar liposomes used with the microemulsifier yielded the best particle distribution, i.e. in the range of 40-60 as determined by quasi-elastic light scattering. The advantage of the method results from the complete emulsification of the components. The particle size remained unchanged during storage, although flocculation was observed. The results show that the synthesis of artificial chylomicron remnants in a microemulsifier is possible and reproducible.
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3912451
Diagnosis and quantification of severity of carotid lesions were assessed by different procedures. Oculoplethysmography was of value only in cases of significant occlusive lesions. Ultrasound methods possessed enhanced sensitivity: Doppler velocimetry, ultrasound imaging and particularly spectral analysis of the Doppler signal. Efficacy of this exploratory method was assessed in a department of angiology, spectral analysis being rated as 5 different grades as a function of degree of arterial stenosis (fig. 1). It was routinely combined with Doppler velocimetry and ultrasound imaging in 35 patients, a total of 64 carotid bifurcations being analyzed. Digital subtraction venous angiography was performed in 28 of these cases. Study of the reading effect on interpretation of the spectral analysis showed 37 agreements and 27 divergences; among the latter the definition of normality in relation to grades I or II appears to be responsible. Greater significance was noted for the reading effect in cases explored by Doppler velocimetry and ultrasonography. Positive findings were obtained with spectral analysis in 41 of 64 patients, either by detection of non-significant lesions or by precise quantification of stenotic lesions. Results of digital subtraction angiography were debatable in 8 of 28 patients and were unconfirmed on ultrasound imaging. Spectral analysis of the Doppler signal has therefore an advantage over Doppler velocimetry and ultrasonography in that more precise data is obtained on stenotic lesions and that those of little significance are detected. It supplies an effective means of diagnosis and surveillance and it establishes the need for angiography. Lack of sensitivity and reproducibility of ultrasound and digital subtraction venous angiography raises the problem of an effective reference test.(ABSTRACT TRUNCATED AT 250 WORDS)
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3911690
An examination of patients with deformed muscular dystonia before and after stereotaxic surgery on the ventrolateral nucleus of the thalamus showed that prior to the surgery they had a certain difficulty in solving tasks involving mental manipulation with three-dimensional objects and constructive activity. It took them more time to accomplish these tasks and they made different mistakes as compared to normal. Changes in the object and image thinking differed, depending on the side of the destruction of the ventrolateral nucleus of the thalamus. Patients with right-side lesion were prone to overturn both a three-dimensional figure and a two-dimensional image, they showed greater changes in conducting tests on mental manipulation and constructive activity as against the patients who had left-side cryodestruction. It may be assumed that impairment of the complex forms of spatial functions manifested in mental manipulation with objects and in constructive activities is related to the work of the subcortical formations of the right hemisphere.
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3916483
In recent years, imaging modalities have realized the potential for digitizing images of the heart. These modalities include nuclear cardiology, echocardiography, digital subtraction angiography, computed tomography, positron emission tomography, and magnetic resonance imaging. Once the cardiac images have been digitized by the computer and formatted in a pixel array of data, the computer can perform mathematical operations on the input (original) images for the purpose of providing improved output (processed) images. The computer can also analyze the original (or processed) images for the purpose of extracting global, regional, or temporal measurements of cardiac perfusion and function. These processes include the restoration, enhancement, analysis, manipulation, and coding of images. These basic processes are implemented by a combination of image processing operations. These operations include pixel point processing, pixel group processing, frame processing, geometric processing, and information extraction. This article describes how these operations are used to perform processes, and how these processes are applied to cardiac imaging, currently and in the future.
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3916594
In this review, we have mainly included studies in which whole-body autoradiography was used. In lipid research, most studies have been done with fatty acids. These studies showed some common characteristics in the pattern of tissue distribution. A major uptake was seen in the brown fat, liver and adrenal cortex but also to some extent in other tissues with a high metabolic activity or high cell turn-over, e.g. the gastric and intestinal mucosa, diaphragm, kidney cortex and bone marrow. Low levels of radioactivity were generally found in the brain, testes, thymus, white fat, skeletal muscles, lungs and spleen. Most fatty acids showed some specific features, e.g the strong uptake of erucic, arachidonic and docosahexaenoic acid in myocardium and of eicosapentaenoic acid in the adrenal cortex. Studies with PGE1 and LTC3 showed that the liver and kidney and to a lesser degree the lungs were the major sites of metabolism. The distribution of free cholesterol and triolein emulsion labelled in the fatty acid moieties did show some similarities with respect to the general pattern found with most fatty acids. Specific for cholesterol was a very strong uptake in the adrenal cortex. There was also a significant uptake in the spleen whereas the uptake in the brown fat was not as marked as for most fatty acids. Specific for triolein was a marked uptake in the spleen and myocardium, in fed animals also in the white adipose tissue. These studies show that whole-body autoradiography can give much valuable information of the uptake and distribution of lipids that would be rather difficult to obtain with conventional methods. Combined with electron-microscopy, autoradiography can be used to study cellular and even subcellular distribution, and thus given further data on the metabolism of lipids in the body.
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1764709
External hydrocephalus (EH) was identified in 58 infants under 3 years of age during the period 1 June 1986 to 28 February 1990. Radiological images and clinical features were compared with 11 cases of cerebral atrophy (CA). Significant differences were found in delivery, head circumference, and the incidence of motor and developmental abnormalities. The population with EH was found to be quite heterogeneous, with a male preponderance. Intracranial pressure was normal in 15 cases in which lumbar puncture was done. The flow of cerebral spinal fluid was considered to be within the normal range in 6 cases. The results of a few cases examined with metrizamide cisternography are presented. The prognosis in our cases was not as benign as previously published, and use of the name EH is questioned. The less committal term "hypodense extracerebral images" is proposed when computed tomography (CT) is the only study done. The hypothesis that encephalocranial disproportion is the basic underlying entity for the CT images is proposed.
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3903770
Reduction of plasma cholesterol and apolipoprotein B concentrations can be expected and may appear to slow the rate of progression of the atherosclerotic process (Thompson, 1980). The usefulness of plasma exchange to the treatment of homozygous FH patients has been extended recently by Stoffel et al. (1981), who perfused plasma through an on-line anti-LDL sepharose column, which selectively removes LDL. Having theoretical advantages over plasma-exchange, this procedure avoids the loss of HDL and of other important plasma proteins. In short, plasma-exchange has proved to be a remarkably safe, well tolerated and effective means of treating homozygous FH.
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3918906
A new cell line, designated RC-K8, was established from the peritoneal effusion of a patient with histiocytic lymphoma. The RC-K8 had human male karyotype with 14q+ and was found to have B-cell (B1) and monocyte/macrophage (intracytoplasmic alpha subunit of S-100 protein) markers. A fibrin plate method demonstrated that RC-K8 cells release plasminogen activator in culture.
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3921958
The paper is concerned with the characteristics of morphological changes and insulin producing activity of neonatal pig islet cell initial cultures in health and in different glucose concentrations. The investigated cultures preserve morphological and functional differentiation within 4-5 weeks of growth. Insulin biosynthesis and secretion are raised by glucose injection at a dose of 300 mg%. An increase in the dose up to 600 mg% results in the suppression of insulocyte functional activity. The obtained cultures can be used for the treatment of diabetes mellitus.
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1768876
Self-assessment handicap scales are gaining recognition as objective measures of audiologic intervention, including benefit derived from hearing aid use. A short form of the Hearing Handicap Inventory for the Elderly (HHIE-S) comprised of 10 items (5 emotional and 5 social/situational) was administered to 91 new hearing aid users prior to and 3 weeks following hearing aid provision. A significant reduction in perceived emotional and social/situational effects of hearing impairment was observed following this brief interval of hearing aid use. The magnitude of hearing aid benefit was not affected by pure-tone sensitivity or word recognition ability. Further, a 95 percent confidence interval was established for the HHIE-S (9.3 points) in order to determine a true change in self-perceived handicap and pre- and post-hearing aid fitting for a given subject. Our findings support the use of the HHIE-S as an expedient approach for quantifying hearing aid benefit in a busy clinical practice.
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3895452
The following summary of the physiologic and epidemiologic evidence may help the clinician in making decisions when caring for persons with ISH: ISH is predominantly found in older age groups, being present in 1% to 4% of the population under age 40, 10% to 15% between ages 60 and 70, and 25% to 30% over age 70. ISH is more prevalent in women than in men. The development of ISH in the aged is associated with a decrease in arterial compliance. The relationship whereby ISH is both a cause and a result of atherosclerotic vessels needs further delineation. Neurohumoral factors also have a part in determining arterial compliance. An elevated SBP is an important contributor to the risk of developing coronary artery disease, and in persons over 45 years old it is a more powerful predictor of coronary events than DBP. SBP is a better discriminator of risk for strokes at all ages than DBP is. The relative risk in persons with ISH for the development of coronary artery disease and stroke is two to five times that of normotensive persons, but is no worse than the risk for these events among treated hypertensives. Although the relative risk of ISH is not strikingly large, the high prevalence of ISH among aged individuals, the increasing size of the population over 65 years old, and the high incidence rate of cardiovascular events in the aged give ISH a sizable attributable risk in the population (13 to 28 deaths per 1,000 individuals). It remains to be shown that lowering SBP in ISH removes the risk of ISH. Studies are needed that monitor the costs and adverse effects of therapy as well as the possible benefits when a condition such as ISH is most commonly seen in the aged.
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3895390
The specialised regions of the stomach include the cardia, fundus, body, antrum and the pylorus. Not only do these regions have specific secretory functions, but also, they have specific motor functions as well. For example, the proximal stomach is most important in regulating emptying of liquids and the distal stomach and pylorus, the emptying of solids. Disorders of gastric emptying can be classified into two major categories: mechanical obstruction due to increased resistance and functional obstruction (gastroparesis) due to pump failure. Gastroparesis is best diagnosed using a solid test meal which is labelled by a gamma-emitting radionuclide. Agents employed to treat gastroparesis include bethanechol, metoclopramide and domperidone. Entero-gastric reflux occurs when there are abnormalities in the duodeno-gastric pressure gradient or the duodeno-gastric resistance mechanism. Excessive entero-gastric reflux may be seen in patients with gastric ulcers, chronic obstructive pulmonary disease, post-cholecystectomy syndrome or post-operative entero-gastric reflux gastritis. The diagnosis of entero-gastric reflux gastritis depends upon typical symptoms and the demonstration of excessive entero-gastric reflux by scintigraphic techniques or the measurement of bile concentrations within the stomach. Medical treatment with bile chelating agents and surface coating agents has been disappointing. Surgical treatment should only be undertaken as a last resort.
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3907909
We describe a patient who developed persistant hypokalemia after renal transplantation that was initially attributed to diuretics and/or steroids. However after stopping the diuretic, the patient continued to have urinary losses of potassium (less than 30 mEq/day) at a time when the serum potassium was only 2.4 mEq/l and high urinary chloride (33 mEq/day) suggesting that the diuretics were not responsible for the hypokalemia and the metabolic alkalosis. The results of these simple laboratory tests and the presence of persistent severe hypokalemia prompted additional studies (peripheral renin activity; plasma aldosterone levels; and CT scan) that led to the diagnosis of left adrenal gland adenoma. Surgical removal of the adrenal adenoma led to the normalization of the serum potassium and a fall in the total CO2 content in plasma. To our knowledge this is the first report of a case of hypokalemia secondary to primary hyperaldosteronism in a renal transplant recipient.
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3922783
Steroidogenesis was investigated in Leydig cell-enriched fractions isolated from the testes of rats dosed dermally with 130 mg/kg/day hexafluoroacetone (HFA) for 14 days and from pair-fed control rats. Compared to controls, Leydig cells from HFA-treated rats exhibited decreased incorporation of [14C]acetate (78%) and [3H]mevalonate (41%) into sterols and steroids. Testosterone was decreased 50% in the testes of HFA-treated rats. Incubation of Leydig cells from untreated rats with 1.0 mM HFA did not affect steroidogenesis. HFA treatment led to the development of histopathological lesions in the testes within 24 hr after a single dose; with daily dosing the lesions became progressively more severe. Despite the development of severe lesions, HFA treatment did not affect the blood levels of luteinizing hormone or testosterone; however, follicle-stimulating hormone was slightly elevated (48%) after 14 days of treatment. The data indicate that steroidogenesis is inhibited in Leydig cells of HFA-treated rats; the inhibition is not due to a direct or immediate effect of HFA, nor does it appear to be hormonally mediated.
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1767662
We report a patient with type III Ehlers-Danlos syndrome, presenting with recurrent footdrop, who had electrophysiologic evidence of a conduction block of the common peroneal nerve followed by complete resolution. We feel that this case supports the possible link between Ehlers-Danlos syndrome and multiple pressure sensitive neuropathy (tomaculous neuropathy), alluded to by Schady and Ochoa (1984).
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3901716
Rest and exercise radionuclide angiography is a useful technique to study the cardiac adaptation during exercise in patients with coronary artery disease. Most patients with coronary artery disease have an abnormal EF response to exercise, although the magnitude of the change in EF may not correlate with the extent of coronary artery disease. The resting end-diastolic volume maybe the most important determinant of the presence and degree of left ventricular dilation during exercise in such patients. The exercise left ventricular EF improves after revascularization, but the EF response to exercise often remains abnormal. Evaluation of the regional and global left ventricular performance and the pressure-volume relationship during systole and diastole, as well as changes in these parameters after revascularization are possible. The exercise EF is also an important prognosticator in patients with known or suspected coronary artery disease.
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3901498
This article examines the use of the surgical mesenteric lymph node biopsy in cattle under field conditions. The surgical method and the complications which occurred are described. It is better not to give a sedative to an animal in advanced pregnancy. The site of the incision depended on the stage of pregnancy. In animals in advanced pregnancy in incision should be caudo-ventral in the right-hand flank. To prevent complications, the grid incision should be used then.
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3901843
Oxygen consumption (VO2) is often assumed to be fixed by metabolic demand, but some investigators have found VO2 linearly dependent on O2 delivery (QT-CaO2) during positive end-expiratory pressure (PEEP) trials for the adult respiratory distress syndrome. However, in those studies VO2 was calculated using the same cardiac output (QT) and O2 content measurements used to calculate the O2 delivery to which it was being compared. We therefore obtained independent measurements of VO2, QT, and oxygen contents under 3 conditions in 21 dogs: 14 normal dogs, each receiving varying degrees of PEEP or central venous obstruction, and 7 dogs receiving PEEP after developing pulmonary edema from intravenously infused oleic acid. In all groups, VO2 measured from expired gas analysis remained unchanged until QT-CaO2 was reduced to below 13 ml/kg/min. The VO2 was then linearly dependent on QT-CaO2. We conclude that this reduction in VO2 is due to severe QT-CaO2 reduction and not to any special effect of PEEP or lung injury.
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3902008
Conflicting data have been reported concerning the anomeric specificity of glucokinase. In the present study, liver hexokinase (Km for D-glucose 0.4 mM) displayed a higher affinity for but lower Vmax. with alpha- than with beta-D-glucose. The velocity of the reaction catalysed by liver glucokinase was higher with with beta- than with alpha-D-glucose, whatever the glucose concentration. The apparent Km of glucokinase was somewhat lower, however, with alpha- than with beta-D-glucose. Comparable results were obtained for the high-Km glucokinase-like enzymic activity present in normal pancreatic islets or insulin-producing tumoral cells. These results suggest that the anomeric specificity of glucokinase cannot account for the higher rate of glycolysis found in islets exposed to alpha- as distinct from beta-D-glucose.
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3904305
Binding of purified plasma fibronection to Crithidia luciliae kinetoplast DNA was demonstrated by fluorescence microscopy. The method was suitable for the detection of fibronectin in human plasma diluted 1:256 and 1 microgram/ml concentration of isolated fibronectin. Purified human Clq, monoclonal human myeloma proteins of IgG1 and IgG3 subclasses and calf thymus DNA inhibited the binding of fibronectin to kinetoplasts. The method can be used as a functional assay for fibronectin and for various materials containing fibronectin.
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3910916
The effect of acute and chronic administration of cyclosporine on systemic and renal hemodynamics was studied in conscious rats. Infusion of cyclosporine in a dose of 20 mg/kg (Cy 20) resulted in a significant fall in renal blood flow (RBF) (3.4 vs. 6.5 ml/min/g, P less than 0.05) and a rise in renal vascular resistance (RVR) (36.9 vs. 20.6 mm Hg/ml/min/g, P less than 0.05). Infusion of cyclosporine at a dose of 10 mg/kg (Cy 10) did not result in a significant change in RBF or RVR. Both doses of cyclosporine resulted in stimulation of plasma renin activity (PRA) from control values of 5.6 +/- 0.8 ng/ml/hr to 11.6 +/- 2.0 with 10 mg/kg and 26.7 +/- 5.6 with 20 mg/kg. Urinary 6-keto-PGF1 alpha excretion increased from control values of 14.0 +/- 2.0 ng/6 hr to 22.7 +/- 2.2 with 10 mg/kg and 25.0 +/- 2.0 with 20 mg/kg. Similar effects on RBF, RVR, PRA, and 6-keto-PGF1 alpha excretion were seen after chronic administration of cyclosporine (20 mg/kg i.p. for 7 days). Pretreatment of animals with captopril did not prevent the fall in RBF after cyclosporine, suggesting that the vasoconstriction was not mediated by angiotensin II. Animals treated with meclofenamate demonstrated reduction in RBF with 10 mg/kg cyclosporine (4.3 vs. 7.0 ml/min/g, P less than 0.05), suggesting that prostaglandins protect against the vasoconstrictor effect of cyclosporine. Administration of phenoxybenzamine after cyclosporine improved RBF (5.0 vs. 3.4 ml/min/g) and restored RVR to normal. Similarly, renal denervation dramatically reduced the fall in RBF after cyclosporine (innervated right kidney 3.6 vs. denervated left kidney 6.0 ml/min/g, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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3919095
Human peripheral blood adherent leukocytes incubated with interferon (IFN) of three different species (alpha, beta, or gamma) show an enhanced potential of IL 1 synthesis and secretion that can be revealed by a second signal provided by endotoxins or Poly IC. We have shown that recombinant IFN-gamma, compared with recombinant IFN-alpha or purified IFN-beta, has preferential effects on IL 1 secretion in fresh monocyte cultures. We have observed a progressive and profound loss of the ability of adherent cell cultures to secrete IL 1 upon aging for 4 to 12 days in vitro. IFN-gamma was found to be more efficient than IFN-alpha or -beta at maintaining (when added at the onset of the cultures) or reversing the loss (when added on the fourth day of culture) of the IL 1 secretory function. These observations suggest that the secretion of IFN-gamma during the course of immune responses may have a critical role in feeding back the cascade of interleukins in a loop of amplification, and may thereby regulate macrophage-T lymphocyte interactions.
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3900193
Using three different monoclonal antibodies against rat neurophysins (5), with protein A-gold as immunocytochemical marker (27), the murid hypothalamoneurohy-pophysial system was studied at the ultrastructural level. Postembedding staining was done on epoxy-embedded sections of supraoptic nuclei and posterior pituitaries. Specific immunolabeling of vasopressinergic and oxytocinergic neurosecretory granules was observed in tissues fixed with glutaraldehyde or glutaraldehyde mixtures (containing paraformaldehyde and picric acid), with or without osmium tetroxide postfixation and with or without sodium metaperiodate oxidation. Some autophagic vacuoles containing lysed neurosecretory granules were also neurophysin immunoreactive. Nonspecific background staining was extremely low. An attempt was made to appraise labeling intensities semiquantitatively by counting gold particles in relation to number of secretory granules per axonal varicosity. Immunoreactivity was measurably influenced by the mode of fixation, sodium metaperiodate oxidation, and titer and affinity of the antibody. The protein A-gold technique using monoclonal antibodies against neurophysins provides a superior means of ultrastructural analysis of the hypothalamoneurohypophysial system, both visually and morphometrically.
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1767244
The pathogenesis of the early development of atherosclerosis in sitosterolaemia is unknown. The effect of sitosterol on vascular endothelial cells in vitro was investigated by culturing human umbilical vein endothelial cells in the presence of up to 0.7 mmol l-1 of sitosterol. Liposomes were used to supply the high sterol concentrations. Exposure to 0.7 mmol l-1 of sitosterol for 72 h caused contraction of the endothelial cells and increased release of intracellular lactate dehydrogenase. After 96 h incubation the cells were partly detached from the substrate. At this time-point 0.35 mmol l-1 of sitosterol also caused perturbation of the endothelial cells. However, we could not confirm previous reports that tissue plasminogen activator production was enhanced by sitosterol.
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1767796
The presence of endothelin-1 (ET) and effect of Tokishakuyakusan (TS) on ET in rat corpora lutea (CL) was investigated in superovulated ovaries, induced with pregnant mare's serum gonadotropin and human chorionic gonadotropin. A high concentration of ET was found in the CL. The level of ET was significantly lower in the CL from TS-treated rats than that in TS-untreated rats (402.68 versus 575.60 pg/g wet weight, p less than 0.05). In contrast, the ET levels in plasma were by far lower than those in CL. These data indicate an inhibitory effect of TS on ET, an intraovarian peptide, production or accumulation in the CL.
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3920838
We present a comparative study concerning two cases of tuberculosis cutis luposa and cutaneous leishmaniasis, respectively. These two Turkish female patients had suffered from changes of the facial skin since 20 years (tuberculosis cutis luposa) and for 5 months (cutaneous leishmaniasis). The tuberculosis cutis luposa had been misdiagnosed as cutaneous leishmaniasis and surgically treated. Both cases showed an apple jelly-like color at the edges of the lesions with soft tissue. With tuberculosis cutis luposa, the lesions had a larger extension and a more hyperkeratotic picture. We discuss the different histopathologic changes of both cases. As bacteriologic culture revealed mycobacterium tuberculosis, on one hand, and histopathology leishmania species intrahistiocytically, on the other, we could finally make the corresponding diagnoses.
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3896611
This article reviews several autosomal recessive syndromes characterized by pigmentary retinopathy and, in many, combined with deafness, hypogonadism, and/or mental retardation. These syndromes are manifested in infancy and childhood. Although no specific treatment is available, an early diagnosis can be the first step in initiating symptomative management and preventive measures for the patient and family.
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1765697
A total of 1426 apparently healthy Saudi children, were subjected to clinical and laboratory investigations of blood, urine and stools. Lower means were observed for Hb concentration, Hot ratio, RBC and WBC counts. The MCV was in the range of Western levels. Of 1343 stool specimens 156 (11.6%) were positive for intestinal parasites (5.4% pathogenic and 6.3% commensals). The higher infection rate of commensals strongly suggests the presence of potentially infectious environmental sources and a public health problem. Giardia lamblia was the most common pathogenic parasite 3.6% and its high infection rate seemed to be associated with lower Hb level. So screening for parasitic infections especially among anaemic children is necessary as a part of the general health care programme.
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3916983
Monolayers of rat hepatocytes metabolize 0.25 mM 2-acetylaminofluorene (AAF) to various ether-extractable, water-soluble as well as covalently bound products. The major ether-extractable metabolite formed is 2-aminofluorene (AF), followed by 7-OH-AAF and 9-OH-AAF. Pretreatment of rats with the inducer Aroclor 1254 (PCB) increased the metabolism of AAF and caused an increased DNA repair synthesis in hepatocytes exposed to AAF or AF. With N-OH-AAF, a decreased genotoxic response in PCB-treated cells compared to control cells was seen. The addition of harman and norharman decreased the metabolism of AAF to ether-extractable metabolites, water-soluble metabolites and metabolites covalently bound to macromolecules. In contrast, the DNA-repair synthesis caused by the same concentrations of AAF was increased by harman. One explanation for this apparent discrepancy could be that the aromatic amines changed the metabolism of harman and norharman in such a way that these compounds were converted into genotoxic metabolites.
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3915653
An application of computer graphics technology to functional stereotactic neurosurgery is presented. Neuroanatomical images derived from a stereotactic atlas and information retrieved from a neurophysiological data base are drawn on a graphic monitor. The pictures are oriented and scaled according to appropriate landmarks. The aim of this work is to add confidence in the surgeon's selection of the probe trajectory and to improve the knowledge of sensory and motor organization within the thalamus.
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3917958
Previous investigations have shown that mononuclear cells present in human intestinal mucosa possess cytotoxic properties that are unique and different from those of cells circulating in the peripheral blood. We have further explored the cytolytic capacity of human intestinal mucosal mononuclear cells using both phenotypic and functional criteria. Using an immunoperoxidase technique on gut frozen sections, we failed to identify cells bearing surface markers displayed by natural killer cells and recognized by the monoclonal antibodies Leu7, Leu11, and Leu15. Freshly isolated human lamina proprial mononuclear cells (LPMC) were unable to lyse K562 target cells, even after using a variety of experimental conditions which included depletion of adherent cells, fractionation by Percoll gradients or panning with monoclonal antibodies, and treatment with a prostaglandin synthetase inhibitor or interferon-gamma. In contrast, when LPMC were cultured in the presence of the lymphokine interleukin 2 (IL 2), they displayed high levels of cytotoxicity against both K562 and Daudi target cells. Such cytolytic activity appeared after 1 or 2 days of culture, was dependent on the amount of IL 2 added to the cultures, was independent of plastic adherent cells, and could be inhibited by agents that block proliferation. Interferon-gamma, when used under experimental conditions identical to those adopted for IL 2, was unable to induce any significant cytotoxicity by LPMC or enhance the level of killing obtained by stimulation with IL 2 alone. This IL 2-induced, nonspecific cytotoxicity of LPMC probably represents a form of lymphokine-activated killer cell function similar to that recently described for human peripheral blood lymphocytes. In view of the absence of morphologic and functional evidence for natural killer cells in human intestinal mucosa, the phenomenon of lymphokine-activated killer cell activity displayed by LPMC may represent an alternate cytotoxic function potentially relevant to intestinal mucosa immunity.
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3911210
Ten beagles were exposed to total body X-irradiation (3 X 6 Gy) and rescued with cryopreserved fetal liver cells from DLA-identical siblings obtained around the 52nd day of gestation. Grafts contained 0.2-1.6 X 10(8) mononuclear cells/kg and 0.9-19.8 X 10(4) granulocyte-macrophage progenitor cells/kg. Hemopoiesis and immune functions were followed for up to one year after fetal liver transplantation (FLT). There was a prompt engraftment in all recipients. Bone marrow metaphases were always of donor origin, whereas some host lymphocytes circulated for 2-3 months. Blood granulocytes and monocytes rose to pre-treatment levels within 2-3 weeks of FLT and platelets and erythrocytes were normal within 3-4 and 5-6 weeks, respectively. The relative incidence of bone marrow CFU-GM was normal by day 14 and the absolute numbers of circulating CFU-GM remained elevated for one year after day 14. Blood lymphocytes reached control numbers between days 35 and 101 with a faster B cell than T cell recovery. Their response to mitogen stimulation was normal by day 75, while the mixed lymphocyte reaction tended to be reduced for one year. Serum levels of IgM (day 35) and IgG (day 49) recovered earlier than IgA levels (day 270). Thus, cryopreserved canine fetal liver cells can restore hemopoiesis and immunocompetence with considerable rapidity in histocompatible, adult siblings pre-treated with total body irradiation, and, since they lack mature T cells, may be used to analyze effector mechanisms that mediate rejection of T cell-depleted allografts under less favourable conditions.
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3912447
Ultrasound methods are well suited for the exploration of the carotid system. High resolution echography can visualize atheromatous defects on the vessels walls with a resolution better than one mm, whereas Doppler examination detects haemodynamic disturbances due to these plaques. Conventional Doppler examination can reveal moderate or severe stenosis (greater than 60%); the recent development of frequency analysis of the Doppler audio signal makes now possible the detection of very light haemodynamic disturbances due to low grade stenosis even as small as 15%. Spectral distribution abnormalities have been classified in four grades according to their amplitude. The combination of the morphological and functional data provided by echography and Doppler spectrum analysis has drastically increased the diagnostic possibilities of the ultrasound methods in the field of the extracranial vascular pathology. With a new duplex system which combines echography and C.W. Doppler examination (duplex probe) it is possible to detect, and quantify carotid stenosis (in percentage of the lumen reduction), and to evaluate blood flow volume in ml/mn.
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3907435
Effects of endotoxemia on lung water, hemodynamics, and gas exchange were determined in ponies breathing a mixture of halothane and 100% O2. Escherichia coli endotoxin was infused IV at 20 micrograms/kg of body weight for 1 hour followed by 10 micrograms/kg/hr the subsequent 4 hours. By 0.25 hour, endotoxin increased mean pulmonary artery pressure and pulmonary vascular resistance; this was followed by a return to base-line values by 0.5 and 1 hour, respectively. A 2nd increase in pulmonary vascular resistance occurred by 5 hours of endotoxemia. During the last 2 hours of endotoxin infusion, cardiac index was significantly (P less than 0.05) decreased. Hematocrit was increased from 1 to 5 hours of endotoxemia, whereas, the plasma protein concentration was increased from 2 to 4 hours, indicating a loss of plasma volume. The PaO2 and PaCO2 were unchanged. After 5 hours of endotoxemia, lung extravascular thermal volume, postmortem bronchoalveolar lavage albumin content, and extravascular lung water/extravascular dry weight ratio of bloodless lungs were not increased, indicating no increase in alveolar-capillary permeability or pulmonary edema.
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3902694
The authors review the evidence that cocaine exerts its rewarding effects through the acute activation of dopamine (DA) pathways in the brain. Chronic cocaine administration is hypothesized to lead to DA depletion, which results in cocaine craving and cocaine abstinence states. Treatment of these states with bromocriptine, a DA/antagonist, appears to have efficacy with acute and maintenance trials, and may represent a new adjunctive treatment for cocaine abuse. DA antagonists appear to exacerbate cocaine craving, which is consistent with the DA depletion hypothesis of chronic cocaine abuse. Theoretical issues relating to drug addiction and endogenous reward centers are discussed.
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1763891
We describe 2 unrelated patients with adult polyglucosan body disease (APBD) diagnosed by sural nerve biopsy. Both patients were offspring of consanguineous marriages. They presented clinically with late onset pyramidal tetraparesis, micturition difficulties, peripheral neuropathy, and mild cognitive impairment. Magnetic resonance imaging of the brain revealed extensive white matter abnormalities in both. In search of a possible metabolic defect, we evaluated glycogen metabolism in these patients and their clinically unaffected children. Branching enzyme activity in the patients' polymorphonuclear leukocytes was about 15% of control values, whereas their children displayed values of 50 to 60%, suggesting a possible autosomal recessive mode of transmission. This is the first report of an inherited metabolic defect in patients with adult polyglucosan body disease. We suggest that branching enzyme dysfunction may be implicated in the pathogenesis of some patients with adult polyglucosan body disease.
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3895874
Neonates are susceptible to infection since several elements of the immune system are deficient. At present, the most common pathogens are Group B streptococci and Escherichia coli. Prolonged rupture of membranes with amnionitis is a high-risk setting. Clinical signs suggesting neonatal sepsis include respiratory distress, poor feeding, hypothermia, seizures and hypotonia. After the sepsis work-up is completed, the initial choice of antibiotics is based on the prevailing organisms and antibiotic sensitivities within the community.
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3922281
A family is described with familial myoclonic epilepsy associated with mitochondrial myopathy. The disorder follows a maternal inheritance pattern consistent with a mitochondrial DNA (mtDNA) mutation. The large kindred permitted exclusion of autosomal dominant, recessive, and X-linked patterns of transmission. Several characteristics of the inheritance and variability of expression within the pedigree are consistent with recently acquired knowledge about the genetics of human mtDNA. The clinical spectrum of disease is compatible with a proportionality model of mutant and wild-type mtDNAs. Muscle biopsies of affected patients showed an increased number of abnormal muscle mitochondria. Serum levels of pyruvate or pyruvate and lactate were elevated. The most severely affected patient had constant myoclonic jerking, dementia, ataxia, spasticity, hearing loss, and hypoventilation. Cerebral dysfunction in patients with mild involvement was marked by prominent photic driving seen on electroencephalograms and high-amplitude visual and somatosensory evoked responses but no myoclonus, ataxia, or dementia. The individual clinical features of the disease worsen over time for all patients; however, mildly affected patients have not become moderately affected and moderately affected patients have not become severely affected.
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3909699
The gnotobiotic chicks infected with Eimeria tenella received an oral inoculation of Salmonella typhimurium 4 or 8 days after E. tenella infection. Chicks were necropsied one day after the salmonella infection. In the experiments 1 and 2, there were two groups; birds infected with S. typhimurium alone and birds infected with a combination of E. tenella and S. typhimurium. The number of S. typhimurium in the cecal contents was significantly greater in the concurrent infections than S. typhimurium infection alone. The S. typhimurium counts in the cecal wall of gnotobiotic chickens killed 5 days after E. tenella infection were significantly greater than those of chickens infected with S. typhimurium alone. In the experiment 3, the scanning electron microscopic study was made on damage of cecal mucosa. There were four groups; uninfected birds as control, birds infected with E. tenella, birds infected with S. typhimurium and birds infected with a combination of E. tenella and S. typhimurium. No damage was observed on the cecal mucosa of both the control and the S. typhimurium infection alone. The concurrent infections caused greater damage on the cecal mucosa than did the E. tenella infection alone.
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3896137
Variables of the effect of penicillin G on the numbers of viable group B streptococci in broth cultures were studied. One-fourth of the MIC was the lowest concentration that reduced the viable count compared with antibiotic-free controls. The rate of killing increased with the concentration of penicillin up to 4 X MIC, but no further. During the first 2 or 3 h, the bactericidal activity was more rapid than later on. The MIC and supraoptimal concentrations of penicillin killed an inoculum of 10(6) organisms more rapidly than an inoculum of 10(4) organisms. The MIC was not inoculum dependent. The reverse inoculum effect was revealed by the killing curves but not by the MBC. There were reproducible differences among strains as to the rate of killing by penicillin; these did not correlate with the rate of multiplication, which also varied among strains. Among the 11 strains tested, there were no tolerant ones.
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3918404
Proton magnetic resonance imaging (MRI) examinations were performed in six patients with seven acoustic neuromas, and the results were compared with conventional tomography of the internal auditory canals, contrast-enhanced computed tomography (CT), and air CT cisternography. All tumors were identified with MRI. The three largest tumors (greater than 1 cm diameter) looked similar to the tumors seen on CT scans, although the extent of the tumor was better seen with MRI in two cases. The four small (less than or equal to 1 cm diameter) cerebellopontine angle and intracanalicular tumors were well seen with MRI, with appearances corresponding to those seen with air CT cisternography. No side effects were encountered with the MRI examinations. MRI is an accurate, noninvasive alternative to contrast-enhanced CT and air CT cisternography in the diagnosis of acoustic neuromas.
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3911053
Bowel function of the spina bifida was studied by clinical assessment and anorectal manometric studies. Anorectal pressure profiles were well correlated with clinical assessment but not with recto-anal inhibitory reflexes. Early training of the defecation is emphasized to obtain good bowel function.
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3907838
A new way of processing the ultrasound Doppler spectrum is presented. By introducing a Disturbance Index (DI), based on a double Fourier transformation, the quantitative evaluation of blood flow disturbance is possible. The integral value of this index over the whole cardiac cycle can be used to quantify the degree of lower grade internal carotid artery (ICA) stenoses and plaques. In a preliminary study, this new method has been tested in 18 normal and 10 atherosclerotic carotid arteries against Duplex-scan and angiography. The results were compared with 5 alternative methods of processing the Doppler spectrum.
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1766989
The aim of these study was to evaluate if the inflammatory injury of parenchymal cells can lead to proliferation of fibroblasts and deposition of increased amounts of collagen, measured by the increased concentration of procollagen in blood, in patients with asthma and COPD. We evaluated 22 patients with asthma that has lasted more than 5 years, 18 patients with COPD and 20 healthy subjects. RIA-gnost method (Behring) was used to measure the procollagen peptide concentrations in blood. Our results showed that the concentration of procollagen peptide in blood samples from patients with asthma was 5.8 +/- 2.4, 4.9 +/- 1.8 in patients with COPD and 11.1 +/- 3.6 in healthy subjects. There was no significant difference between patients with asthma, COPD and healthy subjects (p less than 0.01). It can be concluded that there is no increased deposition of collagen in patients with long lasting asthma and COPD. Further studies of active collagen deposition in the early acute forms of these diseases are in progress.
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3907107
There are four factors that govern fluid movement to or from the pleural space: hydrostatic pressure, colloid osmotic pressure, filtration coefficient, and lymphatic function. When any of these factors are altered, fluid accumulates within the pleural space. Congestive heart failure, pancreatitis, neoplasia, hypoalbuminemia, and pulmonary thromboembolism can evoke pleural effusions by altering normal fluid transport mechanisms. This approach to pleural effusion helps to explain fluid accumulation. Chylothorax, hemothorax, and empyema are also covered in the article.
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3898833
Seventy-two patients with recently healed gastric ulcers were entered into a double-blind, placebo-controlled, six-month maintenance trial to assess whether sucralfate, 1 g in the morning and 2 g at night, reduces the propensity for recurrent ulceration. Patients were assessed clinically at 0, 6, 12, 18, and 24 weeks. Endoscopy was performed at the time of entry into the study and at 24 weeks, or earlier if clinical relapse occurred during this period. Eleven patients were excluded from the study because they defaulted or for other protocol violations. The other 61 patients were followed for six months or until evidence of ulcer relapse. Endoscopic recurrence was found in five of 31 patients (16 percent) randomly assigned to receive sucralfate and in 21 of 30 patients (70 percent) assigned to receive placebo. Most recurrences occurred during the first 12 weeks, with relapse rates of 10 percent and 53 percent, respectively for the sucralfate- and the placebo-treated groups. Three of the recurrences noted at 24 weeks were asymptomatic; two of these were in the sucralfate-treated group. The results indicate that a 3 g per day maintenance dose of sucralfate offers meaningful protection against recurrent gastric ulceration.
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3918707
Serum samples from 214 blood donors in the United Kingdom who were carriers of hepatitis B surface antigen (HBsAg) were examined for hepatitis B virus deoxyribonucleic acid (DNA) by DNA:DNA hybridisation and for hepatitis B e antigen (HBeAg) and its antibody. One fifth of the donors carried infectious virus in their circulation. The presence of hepatitis B virus DNA correlated well with that of HBeAg, although hepatitis B virus DNA was found in five serum samples that were negative for HBeAg. It is concluded that analysis of serum samples for hepatitis B virus DNA by hybridisation should be the method of choice for determining whether carriers of HBsAg are infectious.
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3921428
Using perturbation techniques, I determine the equilibrium of two-locus two-allele models with overdominance and weak epistasis. To lowest order, the allele frequencies, the mean fitness and the covariance between heterokaryotic and homokaryotic flies arising in the Sturtevant experimental design are independent of the recombination rate, r. The disequilibrium varies as one divided by the recombination rate, in contrast to neutral models. Although the disequilibrium generated by weak epistasis is small, too small to be experimentally detected, it can be large enough to have biological importance.
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3909120
Sixty-nine children younger than 13 years of age with urinary tract infection were evaluated to identify risk factors for treatable urologic problems; i.e. those requiring surgery or prolonged antibiotic prophylaxis. All children had a renal ultrasound, intravenous pyelogram and voiding cystogram performed 4 to 6 weeks after the infection. Eleven children with treatable problems were identified, 10 with vesicoureteral reflux and 1 with a ureterocele. For identification of treatable problems the predictive value of a positive test was: (1) fever, 10 of 24 (41.7%); (2) abnormal D-deaminoarginine vasopressin renal concentrating ability, 8 of 24 (33.3%); (3) serum C-reactive protein greater than or equal to 1.0, 8 of 25 (32.0%); (4) Elevated urine N-acetylglucosaminidase, 5 of 16 (31.2%); (5) erythrocyte sedimentation rate greater than or equal to 25, 6 of 21 (28.6%); and (6) age less than 5 years, 10 of 43 (23.3%). Absence of fever denotes a low risk (less than 3%) of finding a treatable problem. Afebrile girls older than 5 years of age can have radiologic evaluation deferred until infection recurs. The presence of fever indicates a high risk of treatable urologic problems (41.7%) and warrants complete radiologic evaluation with the first urinary infection.
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1763671
Over the last 25 years, the perceived clinical spectrum of primary hyperparathyroidism (HPT) has changed dramatically from a disorder characterized by severe bone and renal disease to one typically manifested by few or mild symptoms and little evidence of organ damage. Reasons for this change in spectrum include changing demographics (primary HPT is primarily a disease of the middle-aged and elderly), diffusion of medical knowledge leading to a higher index of suspicion, and improved clinical laboratory technology (especially inexpensive and accurate determination of serum calcium and parathyroid hormone). In the first 343 cases of primary HPT seen at the Massachusetts General Hospital, 57% had renal stones, 23% had hyperparathyroid bone disease, and less than 1% had no symptoms. By contrast, studies dating from the availability of automated serum calcium measurement found renal stones and hyperparathyroid bone disease in less than 5% of cases, and about half of cases had few or no symptoms. Most patients with primary HPT today have mild, nonspecific symptoms, such as weakness, fatigue, and mental depression, and such signs as arterial hypertension and osteopenia, and detection of their hypercalcemia is generally serendipitous. The mildness and slow progression seen in many cases of primary HPT has resulted in much controversy about appropriate management.
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3904379
The efficacy and safety of intravenous esmolol infusion was compared to that of intravenous propranolol injection in patients with supraventricular tachyarrhythmias (SVT) in a multicenter double-blind parallel study. A total of 127 patients were randomized to either the esmolol (n = 64) or propranolol (n = 63) group. Therapeutic response was achieved in 72% of esmolol and 69% of propranolol patients (p = NS). The average dose of esmolol in responders was 115 +/- 11 micrograms/kg/min. Therapeutic response was sustained in the 4-hour maintenance period in 67% of esmolol and 58% of propranolol patients (p = NS). Rate of conversion to normal sinus rhythm was similar in the two treatment groups. After discontinuation, rapid recovery from beta blockade (decrease in heart rate reduction) was observed in esmolol patients (within 10 minutes) compared to propranolol patients (no change in heart rate up to 4.3 hours). The principal adverse effect was hypotension, reported in 23 esmolol (asymptomatic in 19) and four propranolol (asymptomatic in three) patients. In the majority of esmolol patients, hypotension resolved quickly (within 30 minutes) after esmolol was discontinued. It was concluded that esmolol was comparable in efficacy and safety to propranolol in the treatment of patients with SVT. Unlike propranolol, because of the short half-life of esmolol, rapid control of beta blockade is possible with esmolol in clinical conditions when required.
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3920636
Nonesterified dolichols have been measured in the urinary sediment of 20 patients with the late infantile and juvenile forms of neuronal ceroid lipofuscinosis (Batten disease), in 15 patients with other storage and neurodegenerative disorders and in 10 control subjects. Dolichols were measured by a high performance liquid chromatographic method and were related to urinary creatinine concentration. The levels of dolichols in Batten disease were not significantly elevated when compared to the normal subjects or to patients with other neurodegenerative disorders. The highest levels seen were in two patients with mucopolysaccharidosis types II and IV, respectively. Measurement of dolichols in urinary sediment is of little value in the diagnosis of Batten disease or in furthering our understanding of the underlying primary defect.
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3910206
This review discusses the biological roles of steroid sulfotransferase enzymes (ST's) and steroid sulfate sulfohydrolases (sulfatases) mainly in mammalian tissues. In addition, some consideration is given to certain characteristics of these enzymes and, where possible, to their biological control. A considerable number of ST's of varying specificities, substrate affinities, and kinetics appear to exist. Several of these possess the properties of regulatory enzymes. ST's which act upon estrogen in reproductive tissues, such as uterus, are of particularly high affinity, appear to be under some biological control, and may exert important effects upon estrogen action. Although biosynthetic pathways involving steroid sulfate intermediates have been described, their importance is difficult to determine. The presence of an esterified sulfate group on a steroid molecule may markedly affect the action of enzymes, such as hydroxylases, upon the steroid structure in both a qualitative and quantitative sense. The number of different steroid sulfatases is not well understood. A sterol sulfatase present in the female reproductive tract appears capable of destabilizing the sperm head membrane by hydrolyzing sterol sulfates necessary for its integrity, and hence enabling the fusion of sperm and ovum. Other sulfatases may utilize blood-borne steroid sulfates for the ultimate production of estrogen which, in fetal membranes, could play a role in parturition and, in breast tumours, could function as a growth promoting agent. Brain sulfatases could possibly produce steroid hormones for purposes of tissue differentiation and (or) feedback control mechanisms, but this is not firmly established.
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3920173
There are 4 options available to the referring physician in considering radiodiagnostic examinations of patients with uncertain pregnancy status. In the first option, the referring physician in consultation with the radiologist may elect to perform a complete or modified examination, based on a complete evaluation of the risks and benefits of the procedure. Risks, in this case, would include the possibility of irreparable damage to an unsuspected conceptus. In the second option, the referring physician may cancel the examination altogether. In the third option, the referring physician may perform a pregnancy test before the examination to screen for the patients who are actually pregnant. The fourth option is to postpone the examination to the first half of the menstrual cycle when it is relatively certain that the patient is not pregnant (elective scheduling). The last 2 options are recommendations designed to minimize the occurrence of radiation exposures in unsuspected pregnancies. Using cost/benefit analysis and simple probability calculations, it is shown that, as general public policy, pregnancy tests and elective scheduling procedures are of little value and that the first 2 options are sufficient in deciding to perform the radiodiagnostic examination.
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3923714
Inhibitory effects of 3-hydroxypyridines and of some drugs on NADPH-dependent lipid peroxidation was studied in liver microsomes of rats using a spectrophotometric technique with continuous monitoring of accumulation of peroxidation products. At the same time, inhibition of fatty acyl peroxidation catalyzed by the NADPH-dependent system and lipoxygenase from soybean was studied. The data obtained suggest that peroxidation, catalyzed by enzymes of two different types, may be inhibited to different degree by the same chemical compounds.
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3908007
In this paper pharmacokinetic data of acylureidopenicillins (azlocillin and piperacillin) in pregnant women in the last trimenon are compared with those from nonpregnant controls. Four g of each drug was administered as slow bolus injection intravenously. The concentrations in serum and urine of both drugs were determined by polarographic and microbiological methods, for comparison. We used for evaluation of pharmacokinetic data a computer program based on the equations of a two-compartment open pharmacokinetic model. Our investigations show that there are not any different pharmacokinetic values of both antibiotics between pregnant women and healthy nonpregnant volunteers. We can state that both antibiotics are well determined by both analyzing methods which give us identical pharmacokinetic results.
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3918798
Two autoptic cases of chondroosteoplastic tracheopathy yielded features defining the lesion: continuous shrubby proliferation of the inner surface of tracheal cartilages developed bony lamellae in connection with cells of mucosa.
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1768859
The possibility that prolonged heat exposure resulting in a failure of central thermoregulatory mechanism may induce cellular damage in brain was examined in young rats. Children exposed to Indian summer heat can develop sudden pathophysiological symptoms. Subjection of young animals to similar acute systemic heat exposure at 38 degrees C (relative humidity, 46%) for 4 h resulted in a profound hyperthermia, and behavioral stress symptoms e.g. salivation and prostration. Subsequent morphological examination of the brain tissue revealed profound cellular changes. In the cerebral cortex, dark neurons, swollen astrocytes, and expanded white and gray matter were quite frequent. At the ultrastructural level, collapse of microvessels, perivascular edema, vacuolation and damage to postsynaptic membrane was very common. Thus, profound hyperthermia can induce cellular changes by some direct or indirect (e.g. neurochemical) mechanism.
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3922403
Glucose-6-phosphate dehydrogenase from Saccharomyces cerevisiae (bakers' yeast) reacts with acetylsalicylic acid, and this is accompanied by inactivation and modification of essentially one lysine residue per subunit. The amino acid sequence of an 11-residue tryptic peptide containing the reactive lysine residue of the yeast enzyme is given and establishes the existence of different subgroups of glucose-6-phosphate dehydrogenases. Thus, the labeled yeast structure has few similarities to the known structure around the reactive lysine residue of the enzyme from Leuconostoc mesenteroides, although it has extensive similarities with a structure in the human enzyme. It is further shown that amino acid sequences around reactive lysine residues of dehydrogenases in general vary, even though similarities occur around reactive lysine residues in 6-phosphogluconate, glutamate, and glyceraldehyde-3-phosphate dehydrogenases.
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3899921
By measuring in vitro migration of [3H]leucine-labeled granulocytes from agarose containing capillary tube fragments, the migration inhibitory activity of supernatants of Con A-Sepharose stimulated MNC cultures was tested. The sensitivity of the method was increased by using higher dilutions of granulocytes in agarose (from 10(7)/1 microliter to 10(7)/3-4 microliter). Serum-free assays have been used for characterizing the migration inhibitory activity in this system. The migration inhibitory activity was abolished by absorption on granulocytes or by heating (56 degrees C, 80 degrees C). Other factors such as L-fucose, N-acetyl-D-glucosamine, DFP or BAEE showed only moderate or insignificant impairing effects on migration inhibitory activity of crude supernatants of Con A-Sepharose stimulated MNC cultures.
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3900374
Radiology in a patient with non-traumatic myositis ossificans produced standard images suggestive of juxta-cortical osteosarcoma, the peripheral form of a chondrosarcoma or a synovial sarcoma. Ultrasound failed to provide a conclusive diagnosis, and a scan was the only means of suggesting the benign nature of the lesion by demonstrating integrity of bony cortex and characteristic disposition of calcifications.
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3914266
Oxytocin-containing neurons and axon terminals contacting the neurons of the rat paraventricular nucleus were investigated by the peroxidase-antiperoxidase technique for light and electron microscopy. At the light microscopic level the reaction product was seen to fill the somata, dendrites and axons of the neurons. At the ultrastructural level the immunoprecipitate was localized on cytoplasm (including ergastoplasm) and neurosecretory granules (NSG) of the somata; microtubules, ergastoplasm and NSG of the dendrites; and NSG of the axons. Axon terminals synapsing on the surface of the labelled somata and dendrites were exclusively unlabelled. The somata and dendrites were observed to receive both asymmetrical (Gray's type I) and symmetrical (Gray's type II) synapses with clear, mostly spherical and flattened vesicles, respectively. Frequently, pleomorphic vesicles and a few densecore vesicles occurred in both types of synapses. There also were present some unlabelled bridge-like axon terminals making 'double' synapses either on two labelled dendritic processes or on one unlabelled and one labelled dendrite. The present findings demonstrate that the somata and dendrites of the oxytocin-containing neurons receive diverse innervation. At the same time there was no evidence in this study for synaptic input to the labelled axons of the neurons.
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1769056
In a group of 60 men after myocardial infarction (IM) with primary hyperlipoproteinaemia (HLP), type IIA, IIB and IV the authors revealed on comparison with a control group of 71 men with similar types of HLP where ischaemic heart disease (IHD) was not detected, significantly higher concentrations of total plasma cholesterol (TC), low density lipoproteins (LDL-C), apolipoprotein (apo)B in LDL; in the hyperlipidaemic subjects after IM the concentration of HDL-C was significantly lower as well as the ratio of cholesterol and apo-B in the LDL fraction. In patients with hypercholesterolaemia (HLP IIA and IIB) for estimation of the risk of IHD LDL-C, HDL-C and apo-B in LDL are useful. In patients with hypertriglyceridaemia (HLP IIB and IV) subjects with a history of IM have in addition to a higher concentration of apo-B in LDL a lower ratio of cholesterol to apo-B in LDL and in those with HLP IV also a lower plasma concentration of apo-A-I. By the discriminating function the variable of which is in HLP IIB the apo-B concentration in LDL and in HLP IV apo-B in LDL and apo-A-I in plasma in HLP IIB 77.8% subjects and in HLP IV 82.9% subjects with an increased risk of IHD can be detected.
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3913160
Patients selected for neo-adjuvant therapy in this trial suffered from breast cancer stages T3/4, N0/+, M0. Selected patients were stratified and assigned to either pre- and post-operative chemotherapy (tamoxifen, fluorouracil, vincristine, methotrexate, cyclophosphamide, mitoxantrone) or radiotherapy by randomization. This interim report deals with side-effects and response rates of pre-operative therapy only. For this subgroup from 41 centres, 67 patients have so far been accepted for protocol treatment. 36 received peri-operative chemotherapy and 31 perioperative radiotherapy. We have completed reports of 66 pre-operative chemotherapeutic cycles pointing out only low side-effects in spite of a combination consisting of 5 different cytotoxic agents plus hormonal therapy. It is remarkable that 79% had no hair loss and 74% no gastrointestinal side-effects; in the chemotherapy-group 24 patients so far have been operated. Response rates were as follows: 1 (4%) complete remission, 9 (38%) partial remission, 7 (29%) minor response, 2 (8%) no response and 2 (8%) progression. In 2 patients response could not be determined. In the perioperative radiotherapy-group 10 patients have been operated with similar response rates. It is interesting to note, that both therapies influenced receptor values in different ways: Chemotherapy decreased receptor values, whereas radiotherapy insignificantly increased them. The purpose of this study is to establish a rational base for post-operative cytotoxic treatment of patients as only patients who objectively respond to preoperative treatment are likely to benefit from postoperative drug administration. The study is open for enrollment until a total of 200 patients is reached.
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3898560
Bacteriologic investigations were carried out with a total of 295 cattle of the Holstein-Zebu breed that responded positively to tuberculin. Mycobacterium bovis was isolated from 66 animals, and 12 species of atypical mycobacteria were isolated from 94 animals. Parallel studies were comparatively made of the intradermal reaction test and the bacterial findings. Three groups of calves were infected with various atypical mycobacteria, and their response was followed up with the use of the avian and the bovine type of tuberculin on the 100 th day of infection. It was found that the unspecific tuberculin response of cattle in Cuba were not uncommon, and the best proportion of such reactions were shown to be due to the involvement of atypical mycobacteria. The investigated cattle with a positive response to bovine tuberculin at a single intradermal test were harbouring M. bovis in 66 cases (22.3 per cent), atypical mycobacteria in 94 cases (32.1 per cent), and Actinomyces bovis in 7 cases (2.3 per cent). In 128 of the cases (43.3 per cent) both the morphologic and the bacteriologic findings were negative. The cases with a stronger response at the single intradermal tuberculin test in which the skin fold enlarged over 6.5 mm corresponded to a larger extent to the actual specific infection in the animals than to an infection caused by atypical mycobacteria, however, this could not be absolutely stated for all animals. Following a muscular as well as an oral infection of calves with atypical mycobacteria the allergic response was enhanced from the 40 th up to the 100 th day, the positive reaction to avian tuberculin becoming stronger than to bovine tuberculin.(ABSTRACT TRUNCATED AT 250 WORDS)
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3906532
Trauma kills and maims more children each year than infections and neoplasms combined, and 10 per cent of trauma-related deaths are due to abdominal injury. This article examines the various modalities used in evaluating abdominal trauma, and discusses the imaging findings of injury of the organs of the abdomen.
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3901211
Nineteen patients with pulmonary exacerbations of cystic fibrosis due to Pseudomonas aeruginosa were given imipenem/cilastatin for six to 10 days at dosages of 30-90 mg/kg per day. Mean Shwachman scores rose from 46.6 to 50.3 (P less than .001), clinical efficacy scores from 34.3 to 43.3 (P less than .001), vital capacity from 53.7% to 58.5% of the predicted value (P less than .01), forced expiratory volume in 1 sec from 39.5% to 42.6%, and partial pressure of oxygen in arterial blood from 68.2 mm Hg to 72.6 mm Hg. Treatment failed in only two instances. The concentration of P. aeruginosa in the sputum decreased to a modest extent (8.5 log10 cfu/ml on day 1, 8.1 log10 cfu/ml on day 10; P greater than .1). Four patients had imipenem-resistant strains of P. aeruginosa at the start of therapy, and 11 additional patients developed resistant strains during treatment; in eight patients greater than 90% of all Pseudomonas organisms in the sputum were resistant at the end of therapy. Six patients acquired Candida in their sputum. There was no correlation between bacteriologic improvement or the development of resistance to imipenem and either clinical outcome or improvement in pulmonary function. In summary, imipenem/cilastatin therapy is associated with a good clinical outcome in patients with cystic fibrosis, but resistance emerges rapidly.
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1766953
To examine whether the complicated method of body plethysmography can be replaced by non-plethysmographic methods, such as oscilloresistometry (Ros), the closing pressure method (Run) or the forced expiration volume method (FEV1), the authors studied the results obtained with 247 hospitalised patients between 18 and 81 years of age suffering from, or free from, airway obstruction. Although satisfactory correlations were obtained by linear and curvilinear regression analysis, considerable differences were seen in individual patients suffering from obstructions to a higher degree. Oscilloresistometry showed at the standard value limit of the airway resistance applicable in body plethysmography (0.30 kPa/l/s) a sensitivity of 89%, whereas the specificity was only 62%. Almost identical values of sensitivity (92%) and specificity (61%) were attained by the closing pressure method only if the standard value limit was set a little higher, namely, at 0.35 kPa/l/s. FEV1, which is easiest to measure, was able to objectivate an airway obstruction in a manner comparable to that of Ros and Run; there was in fact even a closer statistical correlation between the body plethysmographic resistance mographic methods are suitable for screening examinations on account of their sensitivity. However, if the results on the examination are not in keeping with the overall clinical findings, further diagnostic clarification must be sought by performing a body plethysmographic measurement.
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3895376
Two patients with dermatitis herpetiformis and one with linear IgA disease were examined. Two of the patients had oral lesions and all three showed IgA deposits detected by direct immunofluorescence in apparently normal buccal mucosa. To localize the target structures for IgA deposition, biopsy specimens were taken from normal appearing buccal mucosa for immunoelectron microscopy. The patients with dermatitis herpetiformis had distinct IgA deposits in the upper connective tissue. These were often associated with elastic fibers and occasionally also with capillary walls. In contrast, the patient with linear IgA disease had IgA deposition at the subbasal lamina. Though the clinical expressions may be similar the present immunoelectron microscopic findings in oral mucosa clearly differentiate dermatitis herpetiformis from liner IgA disease.
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3918817
Alginate obtained from a mucoid strain of Pseudomonas aeruginosa was shown to inhibit the phagocytosis of an isogenic non-mucoid revertant by rat alveolar macrophages. Phagocytosis of Staphylococcus albus, binding of sensitized sheep erythrocytes to Fc receptors and uptake of latex particles were also inhibited. These results suggest that the alginate acts as a barrier, surrounding the macrophage preventing the attachment of bacteria or other particles to the plasma membrane. This conclusion was supported by showing that alginic acid, a polysaccharide from seaweed structurally similar to alginate also inhibited the phagocytosis of non-mucoid Ps. aeruginosa. The alginate also inhibited opsonisation of the non-mucoid revertant by a non-agglutinating hyperimmune serum. It is proposed that alginate confers a selective advantage on mucoid producing forms of Ps. aeruginosa by impairing the host immune response by its action on alveolar macrophages and opsonization of bacteria.
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3899693
Synchronously and asynchronously growing chick embryo fibroblasts have been used to study the pattern of 5-bromodeoxyuridine (BrdU) incorporation into DNA. In the synchronous cell system, the density of unifilarly substituted DNA is about 0.010 g/ml higher during first half of S phase than during second half of S phase. The density of unifilarly substituted DNA isolated from asynchronously growing cells is similar to that of DNA synthesized during the second half of S phase of synchronously growing cells for a given concentration of analogue in culture medium. Reassociation kinetics experiments have shown the oversubstitution to occur at the level of early synthesized repeated and/or intermediate DNA sequences. It is then assumed that the oversubstitution is due to some metabolic changes caused by the synchronization procedure itself. As BrdU incorporation into early replicating DNA is known to induce alterations of the cell metabolism, the implication of this phenomenon is discussed at the level of the inhibition of transformation which takes place when chick embryo fibroblasts are infected with Rous sarcoma virus during G1 and subsequently treated with BrdU during early S phase.
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3904762
The pre-operative diagnosis of choledocholithiasis, or common bile-duct stones, is important in patients with cholelithiasis. Intraoperative cholangiography or choledochoscopy followed by exploration of the common bile duct could be limited to those patients with stones, if an adequate pre-operative diagnosis could be made. Many clinicians use pre-operative total alkaline phosphatase level alone or in combination with bilirubin level to determine the presence or absence of choledocholithiasis. Predictive value theory was used to analyze data reported by others to assess the value of alkaline phosphatase level alone or in combination with bilirubin level in identifying patients with choledocholithiasis. The authors conclude that alkaline phosphatase level is not useful either alone or in combination with bilirubin level in determining the presence of common bile duct stones in patients with cholelithiasis.
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3904511
To determine the neurobehavioral consequences of alcohol use during different periods in gestation, we compared the behavior of 103 neonates born to women who: drank a mean of 12 ounces of absolute alcohol per week throughout pregnancy; drank a mean of 14 ounces of absolute alcohol and were otherwise comparable to the first group but stopped drinking in the second trimester, and never drank at all during pregnancy. Low socioeconomic status, predominantly black women applying for prenatal care at a large inner city hospital were recruited in the second trimester of pregnancy, and those reporting alcohol use were advised to stop drinking. Neurobehavioral evaluation with the Brazelton Neonatal Behavioral Assessment Scale was conducted at 3 days postnatal age. As a group, infants exposed to alcohol at any time during gestation were found to have significant alterations in reflexive behavior, less mature motor behavior, and an increased activity level in comparison to unexposed infants. Infants whose mothers stopped drinking in the second trimester were superior to those whose mothers continued to drink throughout pregnancy in observed state control, need for stimulation, motor tone, tremulousness, and asymmetries in reflexive behavior. These results indicate that characteristic damage does occur to the central nervous system of a fetus exposed to alcohol throughout pregnancy, and that exposure during only the early part of pregnancy also seems to have measurable effects. Multivariate analysis indicated that neither amount of alcohol used per week nor cigarette use contributed significantly to these effects on infant behavior.
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3920450
Teaching hospitals have higher charges than nonteaching hospitals, and teaching patients within a single institution incur higher charges than do private patients. Teaching hospitals claim that these higher charges are due to caring for patients with more complex illnesses. Critics claim that the increased charges are primarily related to the hospitals' medical education function. Hospital charges and stay were compared across three physician groups: private patients with a community attending physician, teaching patients with a community attending physician, and teaching patients with a faculty attending physician. Severity of illness differences were controlled for by selecting patients from four Diagnosis Related Groups; refining these groups by surgical codes and age; identifying prehospital and inhospital severity of illness control variables; and omitting death and transfer cases in a second analysis. Least squares regression with logarithmic transformations of the dependent variables revealed that placement of patients on the teaching service with a faculty attending physician led to significantly higher charges as compared with private, nonteaching patients. The patients on the teaching service with a community attending physician did not incur significantly higher charges. It was also revealed that many severity of illness variables predicted a significant amount of variation in hospital charges, even after controlling for diagnostic group and teaching status of the patient.
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3902858
This study describes the preparation of a membrane subfraction from isolated nerve growth cone particles (GCPs) (see Pfenninger, K. H., L. Ellis, M. P. Johnson, L. B. Friedman, and S. Somlo, 1983, Cell, 35:573-584) and the identification in this fraction of a glycoprotein expressed during neurite growth. While approximately 40 major polypeptides are visible in Coomassie Blue-stained SDS polyacrylamide gels of pelleted (partially disrupted) GCPs, a salt-washed membrane fraction prepared from lysed, detergent-permeabilized GCPs contains only 14% of this protein and has an unusually simple polypeptide pattern of seven major bands. Monoclonal antibodies have been generated to GCP membranes isolated from fetal rat brain. These antibodies have been screened differentially with synaptosomes from adult rat brain in order to identify those which recognize antigens expressed selectively during neurite growth. One such antibody (termed 5B4) recognizes a developmentally regulated membrane glycoprotein that is enriched in GCP membranes and expressed in fetal neurons sprouting in vitro. The 5B4 antigen in fetal brain migrates in SDS polyacrylamide gels as a diffuse band of approximately 185-255 kD, is rich in sialic acid, and consists of a small family of isoelectric variants. Freezing-thawing and neuraminidase digestion result in the cleavage of the native antigen into two new species migrating diffusely around 200 and 160 kD. Prolonged neuraminidase digestion sharpens these bands at about 180 and 135 kD, respectively. In the mature brain, antibody 5B4 recognizes a sparse polypeptide migrating at approximately 140 kD. As shown in the following paper (Wallis, I., L. Ellis, K. Suh, and K. H. Pfenninger, 1985, J. Cell Biol., 101:1990-1998), the fetal antigen is specifically associated with regions of neuronal sprouting and, therefore, can be used as a molecular marker of neurite growth.
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3923828
Numerous hemostatic abnormalities have been associated with acute and chronic renal disease. The most common abnormalities are defective platelet aggregation, decreased platelet adhesiveness, decreased platelet factor-3 availability, and prolongation of the bleeding time. Among the above platelet function tests, the bleeding time is the single test that most closely correlates with clinical bleeding. The nature of the platelet defect in uremia is still not well understood. The pathophysiologic mechanisms which have been implicated include platelet inhibition by plasma metabolites, eg, urea, guanidinosuccinic acid, phenolic acid; increased vessel wall prostacyclin; abnormal platelet arachidonic acid metabolism; increased levels of parathyroid hormone (PTH); defective binding of the Factor VIII complex to platelets or defective binding of platelets to vessel wall subendothelium by the Factor VIII complex; decreased platelet-vessel wall-interaction due to severe anemia; platelet storage pool deficiency; defective fibrinogen binding to platelets. Dialysis remains the mainstay of the prevention and treatment of uremic bleeding although it is not always immediately effective. The availability of cryoprecipitate and DDAVP offers an alternative and effective treatment for the temporary reversal of uremic bleeding in patients who require urgent invasive procedures.
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3923158
Denzimol, a new anticonvulsant drug, is currently undergoing clinical evaluation. In this paper we report its use in six patients who were also taking carbamazepine and two patients taking phenytoin. There was a striking elevation of serum carbamazepine, carbamazepine-10, 11 epoxide and phenytoin concentrations in all patients on the addition of denzimol therapy. The interaction with carbamazepine is greater in severity than any other reported to date and denzimol's interaction with both carbamazepine and phenytoin is likely to prove of major clinical significance.
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3919483
Two boys with congenital periureteral bladder diverticula without vesicoureteral reflux but with severe hydronephrosis and ureteral obstruction are described. No bladder outflow obstruction was present. Urinary tract infection was the presenting symptom in both boys, and this is the most common presenting symptom of bladder diverticula. Diverticulectomy, ureteral tailoring, and reimplantation were performed. Three different mechanisms are proposed for the association of bladder diverticula and ureteral obstruction: compression of the extravesical ureter against the detrusor by the full, tense diverticulum, fibrosis resulting from peridiverticulitis, or primary hypomuscularity of the ureterovesical junction and distal ureter.
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3907910
Verapamil has proven effective in preventing acute renal failure in animal models if given prior to the insult and hence possibly has a role in the preservation of cadaveric renal tissue for transplantation. Twenty renal donors were randomly assigned to treatment (receiving verapamil 20 mg intravenously) and control groups. Recipients were monitored for renal failure by urine output and serum creatinines on days 1 and 7 and dialysis requirement to one week. Early urine outputs and serum creatinines (day 1) were significantly better in the treated than control group (p greater than 0.01, 0.05 respectively). We conclude therefore that verapamil may prevent post-transplant acute renal failure, but its optimal dosage and route of administration remain to be determined.
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3914060
The mortality of kidney transplantation generally amounts to 10% due to infections and GIT complications. Once grafting a Staphylococcus aureus and Streptococcus contaminated kidney the recipient had to undergo emergency surgery four times. Hence it has become our routine to sample the perfusate on blood culture media. Among 145 donor nephrectomies the microbiologic examination of the kidney perfusate in which the graft is stored and transported turned out to be positive in 28%. Four out of five germs isolated after incubation on blood culture media were of the non-pathogenic type seen in the normal flora of the skin. Making use of the CIT (24-30 hours) we cultured the perfusate on blood media. Since the temporary results of the microbiological examination are obtained within 12 hours we can initiate the first choice antibiotic therapy already at the time of transplantation. Though there was proof of highly pathogenic bacteria clinical infection occurred in none of our patients among a total of 114 grafts. The outstanding clinical importance of this diagnostic tool arises from the time sparing information of any contamination and the early hint at the first choice of antibiotics. The distinct application of antibiotics according to the result of the perfusate culture on blood culture media is superior to a general antibiotic cover.
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