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10,001,300 | Radioimmunoassay of thyroxine and 3,3',5'-triiodothyronine (reverse T3) in human amniotic fluid. | [
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10,001,301 | Measurement of amniotic fluid iodothyronine concentrations may enable antenatal detection of fetal thyroid abnormalities; however, the delineation of normal ranges is complicated by methodological problems associated with strong and highly variable protein-binding, and specificity of antisera. Improved radioimmunoassays of thyroxine (T4) and 3,3',5-triiodothyronine (reverse T3, rT3) have been developed to overcome these problems. In normal pregnancy, mean rT3 concentrations at less than 17 weeks, 17-22 weeks and 35-42 weeks gestation were 3.6 nmol/l (n = 21), 6.1 nmol/1 (n = 14) and 0.66 nmol/1 (n = 39) respectively; corresponding mean T4 concentrations were 2.4 nmol/1, 6.5 nmol/1 and 3.6 nmol/1. rT3 concentrations showed a strong positive correlation with T4 concentration in each age range; however, the molar ratio of rT3:T4 decreased progressively with gestational age, from 1.69 at less than 17 weeks to 0.19 at 35-42 weeks. In both mid- and late gestation, rT3 and T4 concentrations were strongly correlated with total amniotic fluid protein concentrations. | [
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10,001,302 | Preparation of creatine kinase-MM isoenzymes from canine and human tissues. | [
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] |
10,001,303 | The assay of glucocerebrosidase activity using the natural substrata. | [
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10,001,304 | We examined eight published methods for the assay of glucocerebrosidase using the natural substrate glucocerebroside and tabulated the variable components and conditions while comparing these methods to ours. In each case assays were performed using our 8000-fold, partially purified human placental enzyme, having a pH optimum of 5.4-5.6 and a Km of approximately 0.60 mmol per liter. Results were obtained by following the release of radioactive ceramide or of unlabelled glucose. In many cases published results had been based on a one- or two-hour incubation time. Apparent specific activities varied over a 70-fold difference between the various procedures. When we measured activities from the linear (15-30 min) portion of rate curves the values increased by 1.4 to 3 times but still ranged from 6 X 10(3) - 180 X 10(3) nmol . mg-1 protein . h-1. We obtained maximum velocity using 1.2 mmol glucocerebroside, 0.5% (w/v)crude taurocholate and 2 microgram enzyme protein/ml. Specific activities reported from different laboratories are not directly comparable. Conditions for assay should be optimized for the enzyme preparation to be studied. | [
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10,001,305 | Argininosuccinate synthetase activity in cultured skin fibroblasts of citrullinemic patients. | [
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10,001,306 | The activities and kinetic properties of argininosuccinate synthetase in cultured skin fibroblasts of three citrullinemic patients with qualitative or quantitative abnormalities of hepatic argininosuccinate synthetase were examined. The cultured skin fibroblasts of a citrullinemic patient with a low hepatic argininosuccinate synthetase activity showed low activity and abnormal kinetics similar to those of the hepatic enzyme. This suggests a similar genetic origin of the fibroblast argininosuccinate synthetase as of the hepatic enzyme. However, we found normal argininosuccinate synthetase activity in cultured fibroblasts of two citrullinemic patients who had a low hepatic enzyme activity resulting from decrease in the amount of enzyme protein but with normal kinetic properties. This suggests that part of the quantitative abnormality of hepatic argininosuccinate synthetase of citrullinemic patients may be due to an abnormal organ-specific gene expression in the liver. | [
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10,001,307 | The roles of C-apolipoproteins in the metabolism of triglyceride-rich lipoproteins. | [
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10,001,308 | Beta-adrenoceptor blockade and recovery from hypoglycaemia in diabetic subjects: normalization after lactate and glycerol infusions. | [
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10,001,309 | 1. Previous studied have shown that non-selective beta-adrenoceptor blockade attenuates the blood glucose recovery rate after hypoglycaemia in type I diabetes. Apart from possible effects on hepatic glycogenolysis propranolol also inhibits the release of the important gluconeogenic substrates lactate and glycerol. 2. To determine whether the effect of non-selective beta-adrenoceptor blockade on glucose recovery could be associated with diminished availability of gluconeogenic substrates, lactate and glycerol were infused during hypoglycaemia in four insulin-dependent diabetic patients. Comparisons were made of the blood glucose recovery on placebo, propranolol and propranolol combined with the infusion. 3. The blood glucose recovery rate after hypoglycaemia was less on propranolol than with placebo but was significantly improved and not different from placebo when propranolol treatment was combined with lactate and glycerol infusions. Thus, at least for type I diabetic patients, in whom gluconeogenesis is proportionally greater than in healthy subjects, non-selective beta-adrenoceptor blockade attenuates the glucose recovery rate from hypoglycaemia mainly by reducing the availability of gluconeogenic substrates. | [
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10,001,310 | Effect of noise on blood pressure and 'stress' hormones. | [
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] |
10,001,311 | 1. Noise stimulation (95 dBA) for 20 min caused a significant increase in diastolic (12%, P less than 0.001) and mean arterial pressure (7%, P less than 0.001) in 15 healthy normotensive male subjects. 2. There was no significant change in systolic blood pressure or heart rate during exposure to noise. 3. Adrenaline, noradrenaline, prolactin, cortisol and growth hormone concentration in venous plasma were not affected during noise stimulation. | [
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10,001,312 | Effect of acute vasopressin infusion on blood pressure and plasma angiotensin II in normotensive and DOCA-salt hypertensive rats. | [
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10,001,313 | 1. Arginine vasopressin was infused at 0.5, 2, 6, 18 or 54 ng min(-1) kg(-1) for 1 hr into normal, sham-operated and DOCA-salt hypertensive rats. Complete vasopressin/blood pressure dose-response curves were constructed from circulating plasma vasopressin concentrations measured at the end of each infusion. 2. DOCA-salt hypertensive rats had a higher basal plasma vasopressin concentration (11.1 +/- SD 3.7 fmol/ml) than either the normal (3.9 +/- 2.3, P less than 0.01) or the sham-operated rats (4.5 +/- 2.4, P less than 0.01). 3. The DOCA-salt hypertensive rats did not have my detectable enhancement of pressor sensitivity, compared with either of the two normotensive groups. 4. There was no significant increase in blood pressure in either the normal rats or sham-operated rats until vasopressin was infused at 2 ng min(-1) kg(1), when the plasma concentration was between 30 and 40 fmol/ml. 5. Subpressor infusion of vasopressin in the normal and sham-operated rats, which gave plasma concentrations of 22-23 fmol/ml, completely suppressed plasma angiotensin II to levels similar to the basal values found in the DOCA- salt hypertensive rats (10.5 +/- 2.3, 14.5 +/- 4.5 and 8.0 +/- 1.6 fmol/ml respectively). 6. These findings suggest that the mechanism of vasopressin involvement in DOCA-salt hypertension is as yet unclear, that short-term changes in vasopressin concentration appear unimportant in the regulation of normal blood pressure, that small physiological changes of vasopressin in normal rats may be important in the regulation of renin secretion, and that the increase in vasopressin concentration seen in DOCA-salt hypertension may contribute to the suppression of renin and angiotensin II in this state. | [
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10,001,314 | Efflux of noradrenaline from platelets in normotensive members of hypertensive families. | [
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10,001,315 | 1. Platelets have been used as a model of sympathetic neurons to study the storage of noradrenaline in normotensive individuals belonging to families with essential hypertension for at least two generations. 2. The initial efflux rate (k) of noradrenaline was determined in 44 young relatives (mean age 29.2 years), in 18 middle-aged relatives (mean age 46.7 years) and in 31 young controls with no known family history of essential hypertension (mean age 29.8 years). From the groups of relatives all those with definite hypertension had been excluded a priori. 3. k was significantly higher in the young relatives (22.7 +/- 7.9) than in the middle-aged relatives (17.7 +/- 6.4) and in the controls (15.6 +/- 5.1). Of the relatives 27.3% had higher k values than any of the controls. A significant correlation was found between k and diastolic blood pressure in controls but not in young relatives. | [
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] |
10,001,316 | Influence of the vagus nerve on changes in heart rate during sleep apnoea in man. | [
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10,001,317 | 1. The changes in heart rate surrounding a period of apnoeic asphyxia, produced by either central or obstructive sleep apnoea, are characteristically a progressive bradycardia during the apnoeic period followed by an abrupt reversal to tachycardia with resumption of lung inflation. 2. In a subject who had undergone bilateral pulmonary vagotomy with sparing of the cardiac branches on the left side, the bradycardia is still present during the apnoeic period; however, there is no abrupt response to lung inflation. 3. A subject who had undergone unilateral right-sided pulmonary vagotomy demonstrated a normal response, the increase in heart rate coinciding with resumption of airflow. 4. These findings are consistent with the hypothesis that the bradycardia of sleep apnoea is a hypoxia-induced chemoreflex and that reversal to tachycardia with resumption of lung inflation is a reflex with afferent fibres in the pulmonary vagus nerves. | [
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10,001,318 | Alterations in haem biosynthesis during the human menstrual cycle: studies in normal subjects and patients with latent and active acute intermittent porphyria. | [
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10,001,319 | Muscarinic acetylcholine receptors of the small intestine and pancreas of the rat: distribution and the effect of vagotomy. | [
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10,001,320 | 1. The distribution of muscarinic cholinergic receptors (mAChR), detected by atropine-inhibitable binding of [3H] quinuclidinyl benzilate, was examined in membrane fractions of pancreas, small intestinal muscle, mucosa, villi and crypts of sham-operated and vagotomized rats. 2. Specific (atropine inhibitable) [3H] quinuclidinyl benzilate binding was greater to the ileal mucosa than to jejunal mucosa or to duodenal mucosa, but binding crypt and villus fractions was not significantly different. This distribution of specific [3H] quinuclidinyl benzilate binding suggests that cholinergic mucosal innervation is more important in the ileum than the jejunum. 3. Vagotomy produced a decrease in the amount of specific [3H] quinuclidinyl benzilate binding to duodenal mucosa only, suggesting that parasympathetic denervation of the small intestine does not cause mucosal hypersensitivity to acetylcholine by an increase in mAChR. | [
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10,001,321 | Glucocorticoids decrease in conversion of thyroxine into 3, 5, 3'-tri-iodothyronine by isolated rat renal tubules. | [
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10,001,322 | 1. The effect of glucocorticoids on the deiodination of thyroxine (T4) to 3,5,3'-tri-iodothyronine (T3) was studied in rat renal tubules prepared by collagenase digestion. 2. In short-term (6h) experiments, cortisol and dexamethasone inhibited the conversion of T4 into T3 at concentrations of 2 X 10-4 mol/l and 2 X 10-5 mol/l respectively. The inhibition by cortisol and dexamethasone was time dependent and was prevented by actinomycin D and progesterone, suggesting that the inhibition is mediated by an effect on nuclear transcription dependent on binding to glucocorticoid receptors. 3. In long-term (16 h) experiments, cortisol and dexamethasone inhibited T4 to T3 conversion by the tubules at concentrations of 1 X 10-12 mol/l and above. In addition, physiological concentrations of corticosterone (1 X 10-8 mol/l) were able to decrease T3 generation from T4. 4. Our data provide strong evidence that physiological concentrations of glucocorticoids are able to affect T3 production from T4 directly and suggest that they may be important regulators of T4 deiodination.U | [
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10,001,323 | Calcium balance in osteoporotic patients on long-term oral calcium therapy with and without sex hormones. | [
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] |
10,001,324 | 1. The effect of a high calcium intake (1 mmol day-1 kg-1) alone or with the concomitant administration of oestradiol and testosterone derivatives was monitored by serial calcium balances in 48 patients with osteoporosis of various types. 2. On high calcium alone there was an increase (P less than 0.001) in both total calcium balance and net calcium absorption as compared with values on a simulated home intake. This effect was sustained for periods up to 10 years (mean 3.5 years) by the addition of the hormones. 3. Discontinuation of the hormones (only) produced a significant decrease in both calcium balance and nett absorption but both were still increased when compared with the initial values under simulated home calcium intake. 4. No significant change in the urinary calcium output was observed under any of the regimens. | [
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10,001,325 | The effect of knee injury on the number of muscle fibres in the human quadriceps femoris. | [
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10,001,326 | By means of ultrasound scanning, bilateral measurements of the cross-sectional area of the quadriceps muscle groups were made in 14 young adults with unilateral thigh muscle wasting after knee injury. Needle biopsy specimens from the lateral mass of the muscle were used to estimate the myofibre cross-sectional area for both quadriceps of each subject. 2. The cross-sectional area of the quadriceps of each patient's injured limb was always smaller than that of the contralateral muscle. The wasting was largely localized to the quadriceps, with relative sparing of the other thigh muscles. 3. None of the biopsies showed any abnormality apart from the reduction in fibre size. In each case, the injured limb's reduced quadriceps cross-sectional area was associated with a reduced mean fibre area. 4. The ratio of the cross-sectional area of a muscle to its mean fibre area is a reduced mean fibre area. 4. The ratio of the cross-sectional area of a muscle to its mean fibre area is a function of the number of fibres it contains. The ratio varied considerably from patient to patient but there was close agreement between the values obtained for the two limbs of each patient. 5. The quadriceps wasting produced by knee injury was due to muscle fibre atrophy. There was no evidence for a change in the number of fibres in the muscle. | [
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10,001,327 | Comparative effect of diuretics on renal water excretion in hyponatraemic oedematous disorders. | [
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10,001,328 | 1. The effects of intravenous chlorthiazid and frusemide on urinary osmolality were compared in 19 hyponatraemic oedematous patients. 2. Frusemide (1 mg/kg) caused production of a dilute urine (urine/plasma osmolality ratio, Uosm./Posm., 1.64-0.84, P less than 0.01) whereas chlorthiazid (10 mg/Kg) did not (Uosm./Posm, 1.54-1.34, not significant. 3. The Osmolar clearance (Cosm.) was higher after frusemide than after chlorthiazid (11.45 vs 4.99 ml/min, P less than 0.01). When the doses of frusemide (0.25-0.5 mg/Kg) and chlorthiazid (20 mg/Kg) were chosen to give a similar Cosm. (7.25 vs 7.48 ml/min, not significant), the Uosm./Posm. was still lower after frusemide (2.20-1.00, P less than 0.001) than after chlorthiazid (1.75-1.26, P less than 0.01). 4. Exogenous vasopressin did not increase the low Uosm./Posm. after frusemide (1.00-1.00, not significant) but increased the ratio after chlorthiazid (1.34-1.68, p less than 0.01). 5. These results indicate that frusemide, but not chlorthiazid, lead to the excretion of a dilute urine in hyponatraemic oedematous patients. This dilution is not due to a greater solution excretion but is associated with a resistance to the action of vasopressin. | [
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10,001,329 | Effect of locally applied subatmospheric pressure on subcutaneous blood flow during the course of acute myocardial infarction. | [
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] |
10,001,330 | 1. The effect of locally applied subatmospheric pressure on subcutaneous blood flow was studied in six patients with acute myocardial infarction. 2. Blood flow was measured by the local 133Xe washout technique. 3. Application of subatmospheric pressures of -80 and -150 mmHg to the labelled area induced no vasoconstriction on day 1. On day 7 pressures of -40, -80 and -150 mmHg induced a decrease in blood flow of about 40-50%. 4. The absence of a vasoconstrictor response to locally applied subatmospheric pressure on day 1 could not be due to decreased venous distensibility. The underlying mechanism may be neuronal inhibition, probably antidromic, in sympathetic fibres. | [
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10,001,331 | Sign-based short-term coding of American sign language signs and printed english words by congenitally deaf signers. | [
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10,001,332 | Illusory conjunctions in the perception of objects. | [
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10,001,333 | Postoperative pulmonary prophylaxis. Breathe deeply and read carefully. | [
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10,001,334 | Double porcine valve replacement in carcinoid heart disease. | [
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10,001,335 | Abnormal echoes in the left ventricular outflow tract caused by ruptured chordae tendineae of the mitral valve. | [
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10,001,336 | Primary chylopericardium. | [
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] |
10,001,337 | In a 23-year-old man with massive chylous pericardial effusion, oral administration of Sudan III and radio-active 131iodine-labelled triolein revealed an abnormal communication between the lymphatic system and the pericardial sac. Despite partial pericardiectomy and resection of the thoracic duct, the fluid reaccumulated, and a postoperative lymphangiogram showed an obstructed left thoracic duct. Resection of this left thoracic duct resulted in full recovery. This is the first reported case of this disease with a duplicate thoracic duct. Careful attention must be paid to the possibility of this variation before and during surgery. | [
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10,001,338 | Embolized disc from a Beall mitral valve prosthesis. Real-time echocardiographic identification. | [
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10,001,339 | Usefulness of two-dimensional echocardiography for detection of ventricular septal aneurysm with perforation after acute inferior myocardial infarction. | [
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10,001,340 | Idiopathic pulmonary hemorrhage. Ultrastructural and mineralogic study. | [
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10,001,341 | A nine-year-old girl was hospitalized because of hypoxemia and anemia. Antibasement-membrane antibodies were present in the serum, but there was no renal involvement suggestive of Goodpasture's glomerulonephritis. Biopsy of the lung showed pulmonary hemosiderosis. In ultrastructural analysis, no lesion of the alveolar basement membrane or capillary endothelial cells was found; however, ferritin-looking deposits were present on alveolar basement membranes and the elastic lamina of arterioles and venules. Mineralogic studies showed these deposits to be made of iron and calcium (this latter element was probably precipitated on altered basement membranes or elastic lamina). Hemosiderin inclusions in the macrophages contained iron but no detectable calcium. | [
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10,001,342 | Angiographic relief of coronary artery spasm with sublingual nifedipine. | [
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10,001,343 | Unanticipated response to alpha-adrenergic blockade in pulmonary hypertension. | [
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10,001,344 | Controlled trials and escape clauses. | [
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] |
10,001,345 | Sarcoidosis in the Chinese. | [
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10,001,346 | Measurement of functional residual capacity during mechanical ventilation for acute respiratory failure. A comparison between closed and an open-circuit helium dilution technique. | [
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10,001,347 | Regression, retardation of atherosclerosis progression, and collateral circulation. Their functional importance. | [
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10,001,348 | The transiency of oropharyngeal colonization with gram-negative bacilli in residents of a skilled nursing facility. | [
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10,001,349 | To determine the duration and persistence of gram-negative bacillary (GNB) oropharyngeal colonization over a specified period and the risk of subsequent GNB pneumonia developing in nursing home patients, we prospectively cultured for 31 weeks the oropharynges of patients in a skilled nursing facility. Over a 31-week period, an average of 13.8 percent of the patients showed colonization (weekly prevalence rates ranged from 0 to 29 percent). No patient had pneumonia during the study period. We concluded that the presence of GNB in the oropharynx of our patients is transient, continually changing over an extended period, and that GNB colonization as a transient occurrence is not directly associated with an increased risk of GNB pneumonia. Our data also emphasize the limitations of previously described single-culture survey studies in predicting the importance of GNB oropharyngeal colonization. | [
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] |
10,001,350 | Coronary atherosclerosis in mitral stenosis. | [
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10,001,351 | Eighty-two patients with mitral stenosis underwent cardiac catheterization with coronary angiography. Twenty-one patients (26 percent) had coronary artery disease. Characteristics of the mitral valve area, cardiac output, pulmonary artery pressure, pulmonary vascular resistance, left ventricular end-diastolic pressure, left ventricular ejection fraction, and atypical chest pain did not correlate with findings of angina pectoris or of coronary artery disease; however, there was correlation with sex, age, and angina. Coronary artery disease occurred only after the age of 40 years and was more frequent in males with angina. Coronary artery disease could not be ruled out in patients with mitral stenosis, especially those over age 40, without coronary arteriography. | [
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10,001,352 | The role of isoproterenol in the preoperative evaluation of high-pressure, high-resistance ventricular septal defect. | [
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10,001,353 | The experience we describe derives from the short-term administration of isoproterenol in 15 patients with ventricular septal defect (VSD) and severe pulmonary artery hypertension (PAH). For the whole study group, mean pulmonary artery pressure (PAP) was 68.5 +/- 2.6 mm Hg, pulmonary vascular resistance (Rp) was 11.6 +/- 0.9 U/m2, pulmonary vascular resistance/systemic vascular resistance ratio (Rp/Rs) was 0.9 +/- 0.03, and the pulmonary vascular gradient (PAd-PWP) was 45 +/- 3.5 mm Hg. Infusions of isoproterenol decreased PAP, Rp, Rp/Rs ratio, and PAd-PWP an average of 10.2 mm Hg, 2.88 U/m2, 0.13 and 6.6 mm Hg, respectively, for the whole group (P less than 0.001). On the basis of isoproterenol response, the patients could be divided into two groups: A (n = 4) and B (n = 11). In group A, the PAP decreased from 61.7 +/- 1 to 45 +/- 4 mm Hg, the Rp from 8.9 +/- 0.3 to 4.62 +/- 0.5 U/m2, the Rp/Rs from 0.84 +/- 0.02 to 0.55 +/- .05, and the PAd-PWP from 34.5 +/- 0.9 to 24 +/- 2 mm Hg (mean +/- 1 SE). In group B a less significant change in these measurements was observed. Group A patients underwent VSD repair, and the mean average postoperative decrease in PAP was 31 mm Hg (P less than 0.001). Our findings suggest that in patients with VSD and severe PAH, in whom surgical treatment is controversial, a trial with isoproterenol should be routinely attempted. If the preceding hemodynamic parameters improve significantly, the VSD repair should be performed. | [
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10,001,354 | Pulsus paradoxus in acute myocardial infarction. | [
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] |
10,001,355 | Sixteen patients, admitted no later than eight hours after the onset of the first stage of acute myocardial infarction, underwent systemic, pulmonary, and pulmonary wedge pressure measurements on admission and 24 and 48 hours after the first symptoms. A decrease in systolic blood pressure during inspiration equal to or greater than 15 mm Hg was found in 56 percent of the cases at admission, 53 percent at 24 hours, and 41 percent at 48 hours. No correlation could be found between this and: (1) pulmonary wedge pressure, (2) arteriovenous oxygen difference (volume percent), (3) location, and (4) extension of the necrosis. The last was indirectly assessed by the maximum levels of creatine phosphokinase attained. We discuss the previously postulated mechanisms causing pulsus paradoxus and formulate a theory to explain in acute uncomplicated myocardial infarction. | [
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10,001,356 | Preservation of active atrial transport; an important clinical consideration in cardiac pacing. | [
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10,001,357 | Loss or reversal of the normal sequence of atrioventricular contraction, such as occurs during ventricular pacing, can significantly reduce cardiac output. Opinions vary regarding the size of the pacemaker population that might benefit from preservation of active atrial transport during cardiac pacing. An assessment of 260 consecutive patients who underwent implantation of a permanent transvenous pacemakers by the authors between 1970 and 1979 revealed 19 patients who had clinical symptoms or hypotension when active atrial transport was lost. Thirteen patients were symptomatic with syncope, dizziness, shock, heart failure or cough; six were asymptomatic but had systolic blood pressures lowered to the 80-100 mm Hg range. In all instances but one, attempts were made to restore atrial transport by one or more of the following methods: replacement of the pulse generator with a slower, single rate generator to minimize pacer competition with the normal sinus mechanism; slowing the rate of a programmable unit; implantation of an atrial pacing system; implantation of an atrioventricular sequential pacemaker system. Restoration of the normal sequence of chamber activation by any of these methods eliminated the symptoms and stabilized arterial blood pressure. We conclude that preservation of active atrial transport was clinically important in 7.3 percent of our heterogeneous permanent pacemaker population. | [
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] |
10,001,358 | A simple echocardiographic method to detect atrioventricular dissociation. A useful aid in the differential diagnosis of regular tachycardia with wide QRS complexes. | [
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10,001,359 | Regular tachycardia with wide QRS complexes may be difficult to classify as supraventricular (SVT) or ventricular (VT) without electrophysiologic studies. We felt that hemodynamic differences between VT and SVT should allow their distinction by echocardiography. In this study, we utilized high speed M-mode echocardiography in the usual projections in eight patients during tachycardia. Two patients had spontaneous VT and three had spontaneous SVT with aberrant conduction. The remaining three were patients in sinus rhythm undergoing electrophysiologic studies in whom right ventricular (RV) pacing (induced VT), right atrial (RA) pacing (induced SVT) and sequential RV-RA pacing (induced VT with 1:1 retrograde conduction) were carried out. The echocardiographic parameters studied included: left ventricular internal dimensions, time during which the mitral valve remained open (MVOT), left ventricular ejection time (LVET) and pre-ejection period. We measured 20 consecutive beats and for each parameter defined its variability. During A-V dissociation (VT, RV pacing) there was always a striking beat-to-beat variability in the values of MVOT (68 percent to 129 percent) and in LVET (41 percent to 175 percent). In contrast, during A-V association (SVT, sequential RV-RA pacing, sinus rhythm) the maximal variability of MVOT and LVET was 22 percent and 12 percent, respectively. Variability during A-V dissociation could be explained by asynchronous timing of atrial systole. We conclude that echocardiography can readily identify atrioventricular dissociation, a feature heavily in favor of a diagnosis of VT. | [
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10,001,360 | Echocardiographic diastolic flutter of the pulmonary valve in isolated patent ductus arteriosus. | [
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10,001,361 | Tetracycline pleurodesis during active pulmonary-pleural air leak for prevention of recurrent pneumothorax. | [
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10,001,362 | Pleurodesis with a sclerosing agent was attempted in an animal model in which a pneumothorax with an active air leak was created. Adult rabbits had a small left thoracotomy and then a 1-cm controlled cut in the lung surface. Animals served as control, or tetracycline was administered. The chest tube was removed after the air leak stopped. Animals were sacrificed after 20 days. Group A was control rabbits (6); group B had powdered tetracycline placed at thoracotomy; group C, tetracycline solution, 2 ml/kg, 25 mg/ml (4); and group D, tetracycline solution, 1 ml/kg, 50 mg/ml (10). Control rabbits showed few adhesions, and the pleura appeared to be normal by histologic examination. There was a spectrum of results with tetracycline, but with the concentrated tetracycline solution (group D) histologic examination showed uniform pleurodesis and thickening of the pleura. In group D it took no longer for the pulmonary air leak to seal than with the group A (control) rabbits. We conclude that concentrated tetracycline solution is effective in causing pleurodesis even when an active air leak is present. The lung, however, must be kept expanded so that symphysis can occur between the visceral and parietal pleura. | [
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10,001,363 | Phonocardiographic characteristics of the St. Jude prosthesis in the aortic position. | [
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10,001,364 | Ventricular tachycardia "pleomorphism" induced by chest thump. | [
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10,001,365 | Roentgenogram of the month. Esophageal displacement secondary to blunt chest trauma. Traumatic transection of the descending thoracic aorta. | [
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10,001,366 | Baker's asthma (grain-dust-induced asthma). | [
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10,001,367 | A 48-year-old black male with no underlying atopy developed asthma after working nine years at a bakery. The attacks of wheezing were preceded by nasal symptoms and usually occurred after several hours of work. Skin testing revealed reactivity to dust, molds, and wheat extracts; serum level of IgE was normal, and a RAST screen to common allergens was negative. A bronchial provocation test using commercial wheat extract was negative, but the same test using the patient's own bakery flour resulted in an immediate positive reaction. The pathogenesis and management of grain-dust-induced asthma are discussed. | [
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10,001,368 | Computer-simulated conversion from intravenous to sustained-release oral theophylline. | [
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10,001,369 | A computer equipped with a pharmacokinetic program was used to theoretically determine the proper time to administer the first dose of a commonly prescribed, sustained-release oral theophylline product (Theo-Dur) in patients maintained on a continuous intravenous aminophylline infusion. Four conversion methods were tested. They included giving the first oral dose (1) immediately upon discontinuation of the iv infusion, (2) two hours after discontinuing the iv infusion, (3) four hours after discontinuing the iv infusion, and (4) two hours before discontinuing the iv infusion. Each of the four methods was simulated in three groups of patients: smokers, nonsmokers, and patients with cirrhosis. Results showed that, in most situations, given the first oral dose immediately upon discontinuation of the intravenous infusion provided minimal deviation from eventual steady-state levels. In addition, this computer simulation suggests that the initial 12-hour maintenance dose recommended by the FDA may result in toxicity in certain patient groups. | [
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] |
10,001,370 | Family practice pharmacy service: part II. | [
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] |
10,001,371 | A comparison of various types of patient instruction in the proper administration of metered inhalers. | [
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10,001,372 | The administration technique employed by 42 inpatients using metered inhalers were observed. Proper performance of the six steps recommended by the manufacturer provided the guidelines for correct administration. The degree of compliance with proper technique was defined as the number of steps correctly executed by the patient. The mean number of steps correctly performed was 2.9 out of the possible six (48.3 percent). Twenty-four patients were then randomized into one of three groups. Group I received the manufacturer's instruction sheet, Group 2 received counseling from a pharmacist, and Group 3 received both the manufacturer's instruction sheet and counseling from a pharmacist. There was a significant improvement in the postinstruction technique in Groups 2 and 3, while Groups 1 failed to demonstrate any significant improvement. Comparisons were then made among the three groups. No significant difference was found between Group 2 and Group 3. However, both Groups 2 and 3 were found to be significantly different (p less than 0.05) from Group 1. This study shows that pharmacist counseling can significantly improve the degree of patient compliance in the administration of metered inhalers. | [
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10,001,373 | Cancerphobia--or whatever happened to red M&Ms? | [
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10,001,374 | Desipramine-induced agranulocytosis. A case report. | [
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10,001,375 | A suspected case of nitrofurantoin pneumonitis. | [
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10,001,376 | Counseling patients with chronic obstructive lung disease in the use of bronchodilator aerosols. | [
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10,001,377 | Correction to article on aspirin bioavailability. | [
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10,001,380 | Minimal role of the high concentration of hepatic metallothionein in the newborn rat in the toxicity, distribution, and excretion of cadmium. | [
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10,001,381 | Role of metallothionein in transport of heavy metals. | [
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10,001,382 | The role of metallothionein in the systemic distribution of cadmium. | [
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10,001,383 | Role of metallothionein in zinc uptake from rat jejunum. | [
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10,001,384 | Renal damage and form of cadmium in subcellular fractions. | [
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10,001,385 | Studies on toxicity of metallothionein in rat kidney epithelial cell culture. | [
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10,001,386 | The effect of dexamethasone on the kinetics of jejunal zinc uptake and metallothionein synthesis in the rat. | [
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10,001,387 | Several studies have linked hepatic metallothionein (MT) synthesis to changes in zinc metabolism in response to various forms of stress and to administration of glucocorticoid hormones. There is also some evidence that the intestinal absorption of Zn is enhanced under such conditions. The present studies were designed to investigate the effect of dexamethasone on the kinetics of Zn uptake in an isolated segment of the adult rat jejunum, perfused through the lumen and maintained in situ. Dexamethasone administered to adrenalectomized rats was found to affect significantly one of the parameters of the equation describing 65Zn uptake. Because the observed effect was kinetically consistent with an increased synthesis of MT in the jejunal mucosa, the synthesis of MT was monitored with 35S-cystine in both the liver and intestine of adrenalectomized rats given dexamethasone. Under these conditions, MT synthesis was significantly increased in the liver but not in the jejunal mucosa. The results indicate that dexamethasone is able to alter the kinetics of Zn uptake in the jejunum, but does so without increased jejunal MT synthesis. | [
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10,001,388 | Induction and degradation of metallothionein and their relation to the toxicity of cadmium. | [
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] |
10,001,389 | Effects of hepatic disorder on the fate of cadmium in rats. | [
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10,001,390 | In order to test the possibility of metallothionein (MT) transfer from liver to kidney, experimental hepatic disorders produced by hepatotoxins were examined to study the release of MT from liver. 109Cd exposed rats were treated with carbon tetrachloride (CCl4) and the distribution of cadmium (Cd) in the body was studied. Hepatic Cd was significantly decreased corresponding to the dose of CCl4. Cd in plasma, kidney, and urine was increased remarkably in contrast with the decrease of hepatic Cd. No remarkable changes in Cd of other tissues and feces were observed. These phenomena were produced by other hepatotoxins like galactosamine and ethionine, and long-term administration of Cd, too. In every case that plasma Cd increased markedly, plasma levels of glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), and lactate dehydrogenase (LDH) rose simultaneously, and a significant, positive correlation between Cd concentration and each of enzyme activities in plasma was observed. Cd in hepatic supernatant of CCl4 treated rats was bound mostly to MT fraction, and in kidney, plasma or urine, Cd was also in the form of MT. These results suggest that hepatic MT can be released into blood in the same manner as hepatic enzymes and transported to kidney and urine in some types of hepatic disorders. | [
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10,001,391 | Metal-binding properties of metallothionein in extracellular fluids and its role in cadmium-exposed rats. | [
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10,001,392 | Role of metallothionein in zinc metabolism. | [
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10,001,393 | Turnover of metallothionein in mammalian cells. | [
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] |
10,001,394 | Critical concentration of cadmium estimated by studies on horse kidney metallothionein. | [
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10,001,395 | Tissue metallothioneins in rabbits chronically exposed to cadmium, with special reference to the critical concentration of cadmium in the renal cortex. | [
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10,001,396 | Metallothionein as a storage protein for cadmium: its toxicological implications. | [
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10,001,397 | Upon exposure to cadmium, the biosynthesis of metallothionein is increased in liver and kidneys. The protein sequesters a large fraction of the tissue cadmium, thereby making it less available for excretion. The primary function of the protein in cadmium metabolism, therefore, appears to be storage of the metal in a less toxic form. Low levels of metallothionein are found in plasma and urine upon cadmium exposure. The protein is cleared from the circulation and is reabsorbed by kidney. There it is rapidly degraded, releasing Cd2+ ions which are the probable cause of the proximal tubular damage. Circulating metallothionein can also induce the autoimmune response, resulting in the formation of soluble immune complexes which may deposit in glomeruli and affect their function as well. Therefore, due to its release into the circulation, the metallothionein-bound storage form of cadmium may in fact be responsible for both tubular and glomerular dysfunction observed after chronic cadmium exposure. | [
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10,001,398 | Zinc and copper metabolism in neonates: role of metallothionein in growth and development in the rat. | [
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10,001,399 | Role of hepatic metallothionein during perinatal development in the rat. | [
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