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10,002,300
Stomatitis associated with zomepirac.
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10,002,301
Spermicides and birth defects.
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10,002,302
The flip side of obesity: those who undereat.
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10,002,303
The gallbladder in polycystic liver disease.
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10,002,304
Old problems with new names.
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10,002,305
Iodine in mother's milk.
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10,002,306
The 'growth disease' in American institutional medicine. An open letter to physicians and hospital board members.
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10,002,307
Temporal arteritis associated with normal sedimentation rate.
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10,002,308
Hyponatremia in the syndrome of inappropriate secretion of antidiuretic hormone. Rapid correction with urea, sodium chloride, and water restriction therapy.
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10,002,309
In the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), rapid elevation of serum sodium concentration may be imperative to correct neurological symptoms. Seven patients with hyponatremia secondary to SIADH were treated by oral intake of two to three doses of 30 g of urea over 24 hours or infusion of 80 g of urea as a 30% solution of over six hours, water restriction (500 mL/24 hr), and sodium supplements (120 to 360 mmole/24 hr). Serum sodium concentration increased from 117 +/- 2 to 126 +/- 1.4 mmole/L (mean +/- SEM) after eight hours, to 130 +/- 1.3 mmole/L after 12 hours, and to 134.5 +/- 1.2 mmole/L after 24 hours. The normalization of serum sodium was secondary to osmotic diuresis and to sodium retention induced by urea. Use of urea should be considered when symptomatic hyponatremia in SIADH must be quickly corrected.
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10,002,310
Detection of neonatal sepsis of late onset.
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10,002,311
Five tests have been used in combination to diagnose neonatal sepsis. This study describes their use in 56 infants evaluated between 8 and 60 days of age, who had nonspecific signs of infection at presentation, as well as further evidence in 524 infants evaluated in the first week after birth. When two or more of the five tests had abnormal results (leukocyte count less than 5,000/ cu mm; immature/total neutrophils greater than or equal to 0.2; ESR greater than or equal to 15 mm/hr; latex C-reactive protein, positive; and latex haptoglobin, positive), a "sepsis screen" was considered positive. A positive screen was found in 23 infants, ten of whom had proved sepsis, and only two had no evidence of infection. With the addition of a leukocyte count greater than 20,000/cu mm, the remaining two cases of sepsis would have been detected. In those with a negative screen (n = 33), 26 had no evidence of infection. The sepsis screen seems to be a useful adjunct in the diagnosis of neonatal sepsis during and beyond the first week.
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10,002,312
Cyclosporin A for posterior uveitis?
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10,002,313
Endorphin-mental illness link far from proved.
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10,002,314
Diagnostic delay in Duchenne's muscular dystrophy.
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10,002,315
Treatment of isoniazid overdose.
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10,002,316
Intercurrent hepatitis A in chronic B viral hepatitis.
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-0.06840193271636963, -0.03584366664290428, -0.025467824190855026, 0.026701834052801132, -0.05323177948594093, -0.04488652944564819, 0.012991847470402718, -0.038185104727745056, 0.027706200256943703, 0.007972694002091885, 0.028281748294830322, 0.036423489451408386, 0.05197007209062576, -0.029688145965337753, -0.024970639497041702, -0.01068718358874321, -0.09695280343294144, 0.03060094639658928, -0.07542386651039124, 0.05188890919089317, 0.01237340085208416, -0.028278417885303497, 0.01308524888008833 ]
10,002,317
Forecasting motherhood.
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10,002,318
Postural substitution in Duchenne's muscular dystrophy.
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10,002,319
Maternal age and births in the 1980s.
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10,002,320
Projections from the US Bureau of the Census show that as the large "baby boom" cohort ages in the 1980s, the percentage of births to women 35 years or older will increase by 37%, while the percentage of births to teenaged women, the small post-baby-boom cohort, will decrease by 32%. Between 1980 and 1990, for women aged 35 to 44 years, fertility rates are projected to increase modestly, whereas for teenagers aged 15 to 19 years, fertility rates are projected to decrease modestly. Assuming that half of pregnant women aged 35 years or older request prenatal chromosomal diagnosis, an estimated 1.1 million pregnant women aged 35 years or older will request this service during the 1980s, increasing substantially the demand for it. Simultaneously, demand for prenatal care for teenagers will decrease, due to the decrease in births to teenagers.
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10,002,321
Prevalence and incidence of benign asbestos pleural effusion in a working population.
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10,002,322
Benign asbestos effusion was defined by (1) exposure to asbestos, (2) confirmation by roentgenograms or thoracenteses, (3) no other disease related to pleural effusion, and (4) no malignant tumor within three years. There were 34 benign effusions among 1,135 exposed workers compared with no otherwise unexplained effusions among 717 control subjects. Prevalence was dose related with 7.0%, 3.7%, and 0.2% effusions with severe (III), indirect (II), and peripheral (I) exposure, respectively. The latency period was shorter than for other asbestos-related disorders. Benign effusion was the most common asbestos-related abnormality during the first 20 years after exposure. Incidence studies showed 9.2 effusions per 1,000 person-years for level III exposure, 3.9 for level II, and 0.7 for level I. Most effusions were small; 28.6% recurred, and 66% were asymptomatic. There was one mesothelioma six years after effusion. Asbestos exposure should be carefully searched for in patients with "idiopathic" pleural effusion.
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10,002,323
Pulsing electromagnetic field treatment in ununited fractures and failed arthrodeses.
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10,002,324
Pulsing electromagnetic fields (PEMFs) induce weak electric currents in bone by external coils on casts or skin. This surgically noninvasive, outpatient method, approved by the Food and Drug Administration in November 1979, produced confirmed end results in 1,007 ununited fractures and 71 failed arthrodeses, worldwide. Overall success at Columbia-Presbyterian Medical Center was 81%; internationally, 79%; and in other patients in the United States, 76%. Treatment with PEMFs was effective in 75% of 332 patients (a subset) with an average 4.7-year disability duration, an average of 3.4 previous operative failures to produce union, and a 35% rate of infection. Eighty-four percent of carpal naviculars and 82% of femoral neck-trochanteric nonunions were united. After attempted arthrodeses could not salvage a failed total-knee prosthesis, PEMFs promoted healing in 85% of patients. When coils were unsuccessful alone, combining them with surgical repair was effective.
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10,002,325
Why patients with Parkinson's disease fall.
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10,002,326
Endometrial cancer, epidemiology, and medical practice.
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10,002,327
Nosocomial sinusitis.
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10,002,328
During a 24-month period, 34 cases of nosocomial sinusitis associated with nasopharyngeal instrumentation were identified in 32 severely traumatized patients, accounting for 5% of all nosocomial infections. Diagnosis was based on roentgenographic findings consistent with acute sinusitis and either purulent material aspirated from the involved sinus or purulent nasal discharge. All patients had fever and most had leukocytosis. Forty-one pathogens, mostly Gram-negative bacilli, were recovered from 25 patients by aspiration of their sinuses; 14 infections were polymicrobic. Possible predisposing factors were nasotracheal tubes, nasogastric tubes, nasal packing, high-dose corticosteroids, prior antibiotic therapy, and facial and cranial fractures. With treatment and removal of the nasal tube, 20 patients had clinical resolution of their disease. Seven, although asymptomatic, had persistent radiological abnormalities consistent with chronic sinusitis. Five patients died of intercurrent disease before resolution of their sinusitis. Sinusitis should be ruled out as a cause of infection in febrile intensive care patients with an indwelling nasal tube.
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10,002,329
Truth telling in medicine.
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10,002,330
The viewpoints of L.J. Henderson, Sissela Bok, and Joseph Ellin on the nature and importance of truthfulness in the physician-patient relationship are examined in relation to various types of specific medical situations. While the theoretical models of Henderson and Ellin would more frequently justify deception by physicians for benevolent purposes, the author thinks that their approach may appear to work simply because many patients have been conditioned not to ask physicians confrontational questions.
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10,002,331
Duchenne's muscular dystrophy.
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10,002,332
Subacute chlamydial endocarditis.
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10,002,333
Tarsorrhaphy from accidental instillation of cyanoacrylate adhesive in the eye.
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10,002,334
Electromagnetic fields and bones.
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10,002,335
Management of ventricular tachyarrhythmias. Part I.
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10,002,336
Ultrasonic diagnosis of Cruveilhier-Baumgarten syndrome.
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10,002,337
Mikamo lectures. Genetics and cardiovascular disease--1981.
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10,002,338
The effect of pericardium on the diastolic properties of the heart--experimental studies on volume load and on acute ischemia in open chest dogs.
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10,002,339
We studied the effect of the pericardium on the end-diastolic pressure-segment length (P-L) relation in volume loading (Experiment I) and in acute ischemia (Experiment II). Experiment I: In 6 open chest dogs, segment length of left and right ventricles were measured using ultrasonic crystals during blood infusion. Drawing end-diastolic pressure (P, on ordinate) against segment length (L, on abscissa), the P-L curve with pericardium positioned upward compared to that without pericardium. The slopes (b) of the exponential curve (P = aebL) with pericardium were steeper than those without pericardium in both ventricles. The difference between the slopes with and without pericardium was significantly larger in the right ventricle (RV, 0.30 +/- 0.10, mean +/- SEM) than in the left ventricle (LV, 0.05 +/- 0.02, p less than 0.05). These results show that the pericardium inhibits the distensibility of the free wall more in RV than in LV, and enhances a mechanical coupling of both ventricles during volume over-load. Experiment II: In 8 open chest dogs, segment lengths of ischemic and non-ischemic regions in LV were measured after left circumflex coronary occlusion. When the segment lengths and LV pressure became stable, a pericardiectomy was performed. After the pericardiectomy, whereas heart rate and LV systolic pressure did not change, end-diastolic segment length in the ischemic region further lengthened (12.0 +/- 0.2 to 12.5 +/- 0.2 mm, p less than 0.01) and that in the non-ischemic region did not change despite the concomitant fall in LV end-diastolic pressure (EDP, 11.9 +/- 0.6 to 9.8 +/- 0.6 mmHg, p less than 0.01). These results suggest that the pericardium alters the LV end-diastolic pressure-volume relation and is one of the factors contributing to an increase in LVEDP during acute ischemia.
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10,002,340
Left ventricular diastolic suction as a mechanism of ventricular filling.
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10,002,341
Physiological role of "suction" in diastolic ventricular filling is still controversial. In order to determine whether the beating intact heart induces negative left ventricular (LV) pressure, indicative of LV suction when the ventricular filling is prevented, we transiently prevented LV filling by occluding the mitral orifice in open chest dogs. In more than 80% of all runs with various hemodynamic conditions the minimal diastolic LV pressure (LVPmin) decreased below zero immediately after the mitral valve occlusion and remained negative throughout diastole. The negativity was augmented with a decrease in end-systolic volume and an increase in inotropic state. The diastolic pressure-volume relationships of the non-filling beating ventricle in control condition and high inotropic state (Ca++ infusion) demonstrated that LVPmin correlated with LV volume and intropic state. These results indicate that the negative diastolic LV pressure is augmented by a decrease in end-systolic volume and by an increase in contractility and thus, LV suction may play an important role in LV diastolic filling.
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10,002,342
Total venous capacity in two-kidney, one clip Goldblatt hypertensive rats.
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10,002,343
To assess possible time-related changes in total venous capacity, mean circulatory filling pressure (MCFP) and blood volume (BV, Evans blue) were determined in conscious rats with early, intermediate and chronic phases of two-kidney, one clip Goldblatt hypertension. MCFP, and index of whole-body venous activity, was measured while the circulation was arrested by the brief inflation of a balloon inserted into the right atrium. Compared with shamoperated control rats, Goldblatt rats showed unchanged MCFP and BV in early phase, unchanged MCFP with marginally (0.05 less than p less than 0.10) decreased BV in intermediate phase, and significantly (p less than 0.05) increased MCFP with unchanged BV in chronic phase. Thus, decreased total venous capacity, which is reflected in increased MCFP relative to BV, occurred with a continuation of hypertension. MCFP/BV curves, obtained by measuring MCFP before and after rapid BV change, appeared to shift toward the pressure axis in all Goldblatt groups. There were no significant differences in total vascular compliance, which is the inverse of the slope of this curve and is an index of total venous compliance, between Goldblatt and control groups at any time-period studied. These results suggest that decreased venous capacity observed in chronic hypertensive rats may be a secondary hemodynamic state and may not be related to decreased venous compliance.
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10,002,344
Symposium on heart mechanics in diastole. Opening remarks.
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10,002,345
Assessment of left ventricular relaxation in the diseased heart in man.
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10,002,346
To examine the exponential nature of the left ventricular pressure (LVP) fall during isovolumic relaxation (IRP) in 59 patients (normal (N), 6; angina pectoris (AP), 13; myocardial infarction (MI), 24; and congestive (CCM, 6) and hypertrophic (HCM, 10) cardiomyopathies), LVP and dP/dt were measured by a Millar's catheter-tipped transducer. In P vs time relation during IRP was reasonably fitted by a straight line (r greater than 0.97) in all cases. Time constant (msec) in CCM (56.9 +/- 10.7), HCM (44.8 +/- 12.4) and MI (43.8 +/-7.4 higher (p less than 0.05) than in N (30.3 +/- 5.5), and peak (-) dP/dt (mmHg/sec) was lower (841 +/- 171, 1152 +/- 397 and 1270 +/- 211, respectively; p less than 0.05) than in N (1885 +/- 150), suggesting impaired LV relaxation in these groups. However, (-) dP/dt upstroke pattern was exponential only in both N and 8 of the AP. The (-) dP/dt upstroke in the remaining groups lost its exponential nature, showing rather a down ward-convex curvature which was especially prominent in CCM. This indicates non-exponential fall of LVP during IRP. Thus, the present results suggest that impaired relaxation disturbs the exponential nature of LV relaxation.
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10,002,347
Cineangiographic evaluation of diastolic properties of the left ventricle in man.
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10,002,348
Diastolic properties of the left ventricle were evaluated cineangiographically in 110 patients with various heart diseases (19 normal cases, 13 mitral stenosis, 19 left ventricular volume overload, 18 coronary artery diseases without myocardial infarction, 27 myocardial infarction, 6 hypertrophic cardiomyopathy, 5 congestive cardiomyopathy and 3 chronic constrictive pericarditis). Early diastolic ventricular filling was assessed by diastolic maximal circumferential relaxation velocity (maxVcf), diastolic maximal dV/dt, volume change during early 1/3 of ventricular filling (V1/3), rapid filling time and isovolumic relaxation time; myocardial stiffness constant K was calculated at end-diastole. Increase in myocardial stiffness constant was not necessarily associated with abnormal indices measured during the early diastolic period but well correlate with isovolumic relaxation time. During the isovolumic relaxation period, the affected left ventricular segments where myocardial infarction or myocardial hypertrophy existed, showed reduced and delayed relaxation resulting in a total increase in the isovolumic relaxation period. Calcium antagonist was effective in improving the delayed relaxation in patients with left ventricular hypertrophy, suggesting a role of calcium on delayed myocardial relaxation in the hypertrophied heart.
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10,002,349
Treadmill stress test using body surface mapping in coronary artery disease--the clinical significance of ST depression.
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10,002,350
In this study we assessed in 27 patients with coronary artery disease whether the size of the ST-depression area, which was measured by body surface maps recorded before and after treadmill exercise, could be a useful indicator for evaluating coronary artery disease (CAD) quantitatively. The patients were divided into 3 groups on the basis of the findings of the left ventriculograms: patients with anterior asynergy (n = 6), those with inferior asynergy (n = 6) and those with no asynergy (n = 15). Coronary arteriograms were evaluated according to Pujadas, and epsilon Grade, as an index of the severity of CAD, was developed by adding the grade numbers of the 4 main coronary stems (right coronary artery, main trunk of the left coronary artery, left anterior descending artery and left circumflex artery). Patients with inferior asynergy and with no asynergy have ST-depression areas in proportion to their epsilon Grade (r = 0.845, p less than 0.001), whereas none of the patients with anterior asynergy showed ST-depression areas regardless of their epsilon Grade. Of 6 patients who had anterior asynergy, 5 (83%) had pathologic Q waves in the left anterior chest leads. These findings emphasize the clinical value of the ST-depression are for the quantitative and non-invasive diagnosis of CAD, especially in patients without pathologic Q waves in the left anterior chest leads.
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10,002,351
The diastolic pressure-volume relationship of the left ventricle--studied by canine isovolumetric contracting left ventricle.
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10,002,352
Variable incidence of amyloidosis in familial Mediterranean fever among different ethnic groups.
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10,002,353
Streptococcus pneumoniae bacteremia without an identifiable focus in adults.
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10,002,354
Reiter's syndrome.
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10,002,355
Drug management in chronic schizophrenia.
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10,002,356
In vitro correlates of endothelial injury and repair.
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0.016380872577428818, -0.017891839146614075, 0.05337537080049515, 0.06420823186635971, -0.01228276826441288, 0.026588549837470055, -0.020747128874063492, 0.09921577572822571, 0.031939297914505005, -0.05990859866142273, -0.08998991549015045, -0.021262841299176216, 0.008142075501382351, -0.08598687499761581, -0.031678199768066406, -0.1495669186115265, -0.02253543585538864, -0.05811275169253349, 0.014552348293364048, 0.11331919580698013, -0.03159686550498009, -0.06570760905742645, 0.054307956248521805, 0.09293985366821289, 0.06189903989434242 ]
10,002,357
The effects of immune complexes, microbial components, and glomerular basement membrane on cultured human umbilical endothelial cells were assessed in vitro using phase contrast microscopy, cell counts, 51Cr release, and terminal tritiated thymidine-labeling assays. Neither heat-aggregated IgG nor bovine serum albumin-antibovine serum albumin immune complexes altered endothelial cell growth as measured by cell counts, thymidine labeling, and phase contrast microscopy, nor did immune complexes induce cytotoxicity as measured by 51Cr release. Some microbial components appeared cytotoxic to endothelial cells, other microbial components had no effect, and one, clostridial neuraminidase, induced proliferation of endothelial cells as measured by phase contrast microscopy, cell counts, and thymidine labeling. Native and glycosidase-altered glomerular basement membrane also enhanced endothelial cell thymidine labeling. These studies show that microbial components directly alter endothelial cell growth in vitro, whereas immune complexes by themselves do not. Thus, in vivo microbial components by themselves may directly affect endothelial cells and cause vascular pathology, whereas immune complexes presumably must recruit other inflammatory systems to affect endothelial cells. Alterations of basement membrane during inflammation may also affect endothelial growth and, thus, vascular pathology.
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10,002,358
Significance of mesangial IgM deposition in "minimal change" nephrotic syndrome.
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10,002,359
During a 6-year period, 64 patients with a nephrotic syndrome, shown histologically to result from minimal change nephropathy, were studied for a mean of 4.5 years. Fifty of the patients showed no glomerular immunoglobulin on immunofluorescent or immunoperoxidase study, but 14 had mesangial deposits of IgM. The onset characteristics, response to treatment, and long-term course were similar in the two groups. We conclude that IgM deposition in the mesangium in patients with minimal change nephrotic syndrome is of no prognostic value, and our data do not suggest that this group of patients, although a histopathologic entity, represent a clinically distinct group.
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10,002,360
Factors that improve the preservation of nephron morphology during cold storage.
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10,002,361
Light and electron microscopy were used to evaluate the nephron morphology of rat kidneys that were perfused and stored at 0 to 2 degrees C. for up to 48 hours in preservation solutions which (1) contained different osmotic agents, (2) were adjusted to different levels of osmolality, and (3) which had different ionic compositions (e.g., intracellular-like, extracellular-like). Storage in an enriched phosphate-buffered isotonic culture medium that contained very little effective osmotic agent (i.e., medium 199) results in significant necrosis of glomeruli and uriniferous tubules with 12 to 24 hours. Storage in Collins solution that has an intracellular-like ionic composition and that contains dextrose as an osmotic agent results in significantly better preservation of kidney nephrons. When the dextrose in Collins solution is replaced with mannitol or sucrose, there is dramatic improvement in the preservation of glomeruli and uriniferous tubules. Overall, sucrose appears to be the most effective osmotic agent in preventing degeneration of the nephron during cold storage. Further improvement in nephron preservation is seen when the osmolality of Collins solution is raised (i.e., 400 to 600 mOsmoles) by adding more of the osmotic agents. Finally, storage in simple sodium phosphate-buffered solutions containing either dextrose, mannitol, or sucrose results in the same quality of morphologic preservation as seen with Collins intracellular-like solutions containing similar amounts of these osmotic agents. It appears, therefore, that the selection of an effective osmotic agent (e.g., sucrose) and making the preservation solution hypertonic with this osmotic agent are of primary importance in preserving nephron morphologic integrity during cold storage. The presence of an intracellular-like ionic composition in the preservation solution, however, does not appear to influence morphologic preservation. The effects of the above variables on the ultrastructural morphology of different segments of the uriniferous tubules and the renal corpuscles are described and illustrated.
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10,002,362
Electron microscopic examination of the inflammatory response to Legionella pneumophila in guinea pigs.
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10,002,363
We have described the ultrastructural morphology of splenic and pulmonary exudates from guinea pigs infected intranasally and intraperitoneally by Legionella pneumophila. Legionella pneumophila produced pneumonia and splenitis by both routes of inoculation. The microbe was also disseminated to other organs. Within neutrophils, Legionella pneumophila typically displayed degenerating forms, suggesting that this intracellular environment is somewhat hostile to the bacterium. By contrast, macrophages tended to contain intact forms, located within organelles morphologically identical with rough endoplasmic reticulum. Some bacteria were replicating at this site. In macrophages containing greater than 25 microbes per section, Legionella pneumophila was usually dispersed within the cytoplasm outside of organelles, and many of the heavily infected macrophages exhibited ultrastructural features of injury. Neutrophils phagocytosed Legionella pneumophila, but we found no ultrastructural evidence of either ingestion of Legionella pneumophila by macrophages or of localization of the microbe to primary or secondary phagosomes of macrophages. Our findings support the contention that Legionella pneumophila is an intracellular parasite of macrophages. The homing of Legionella pneumophila to cytoplasmic organelles morphologically indistinguishable from rough endoplasmic reticulum has no bacteriologic parallel. It remains to be determined how Legionella pneumophila enters this organelle, whether this structure is, in fact, functional rough endoplasmic reticulum and whether this site is actively involved in replication of the bacterium. The animal models used herein seem suitable for further delineation of these questions.
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10,002,364
Structure of alveolar epithelial cells in patients with fibrotic lung disorders.
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0.040137581527233124, 0.024218570441007614, 0.044488776475191116, -0.01777256652712822, -0.01105338055640459, 0.0033018195535987616, 0.053131379187107086, -0.016704898327589035, 0.05616901442408562, -0.03838314861059189, -0.0002780879440251738, -0.07001826912164688, -0.046995166689157486, -0.06383863836526871, -0.12305591255426407, 0.10699555277824402, -0.07454849034547806, -0.027696778997778893, 0.03816148266196251, 0.003862267592921853, -0.04621811583638191, 0.05011703446507454, 0.011431134305894375, 0.05109625309705734 ]
10,002,365
Ultrastructural studies were made of the types of alveolar epithelial cells in fibrotic lungs from 34 patients, including 20 with idiopathic pulmonary fibrosis, five with collagen-vascular diseases, six with sarcoidosis, one with lymphangioleiomyomatosis, one with histiocytosis X, and one with chronic eosinophilic pneumonia. In 28 patients, proliferation of type II alveolar epithelial cells was recognized on the basis of lamellar bodies in the cytoplasm, microvilli in the luminal surface, focal microfoldings of the basal plasma membrane, close interaction with underlying mesenchymal cells, and unilayered arrangement. Two types of cuboidal epithelial cells were recognized and were considered to be derived from bronchiolar basal cells (type A cuboidal cells) and from cuboidal cells in respiratory bronchioles (type B cuboidal cells). Type A cuboidal cells frequently contained large numbers of cytoskeletal filaments, and their basal plasma membranes possessed hemidesmosomes in close association with anchoring fibrils. Type B cells lacked hemidesmosomes and anchoring fibrils, Proliferation of either or both types of cuboidal cells was found in 30 patients. In 10 patients (average degree of fibrosis = 3.5 on a scale of 0 to +4), the proliferation involved type A cells; in 10 other patients (average degree of fibrosis = 2.5), type B cells in nine patients (average degree of fibrosis = 3.4), both type A and type B cells; in one patient cuboidal cells were identified only by light microscopy. In 17 patients, proliferating cuboidal cells formed foci of epithelial pseudostratification. Type II alveolar epithelial cells did not participate in the process of multilayering. Thus, type II alveolar epithelial cells and two types of cuboidal epithelial cells are sources of epithelial renewal in damaged alveoli in fibrotic lungs. Type II cells proliferate mainly in areas of less severe degrees of fibrosis; cuboidal cells become the main source of epithelial renewal in areas of very severe lung damage.
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10,002,366
Myocardial capillary density in hypertensive rats.
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10,002,367
The density of myocardial capillaries was determined in spontaneous hypertensive (SHR) and age-matched normotensive Wistar-Kyoto (WKY) rats. Standard procedures were used to determine the systolic blood pressure of the animals. Specimens for light microscopic studies were sampled from the middle portion of the left ventricular free wall of in situ K+-arrested, glutaraldehyde-fixed hearts. The heart weight of SHR rats did not reveal significant hypertrophy as compared to WKY rats, despite the high systolic blood pressure recorded in the SHR. The mean capillary density was found to be 18,514 +/- 341 in SHR and 18,128 +/- 362 in WKY. Transmural gradient was apparent in the left ventricular free wall of both animal groups. The capillary density declined with age in both SHR and WKY. The data indicate that the myocardium of both normotensive and hypertensive rats contain a high capillary density per sq. millimeter. In addition, the data suggest that: (1) the number of capillaries per unit area is unchanged in spontaneous hypertension, and (2) pressure overload of modest magnitude does not induce detectable myocardial hypertrophy.
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10,002,368
Correlation of fatty acyl composition of mitochondrial and microsomal phospholipid with growth rate of rat hepatomas.
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10,002,369
This paper presents fatty acyl compositions of phospholipids derived from mitochondria and microsomes isolated from two Morris hepatomas, one with slow (9618A) and another with intermediate (7794A) growth rate, and from corresponding host livers. These were compared with previous data from our laboratory for the fast-growing Morris hepatoma 7777. In this group of three hepatomas of widely differing growth rate and differentiation, the faster the growth rate of the tumor, the larger the sum of the contents of 16:1, 18:1, and 18:2 and the smaller the sum of the contents of all polyunsaturated fatty acids with four or more double bonds per molecule. The former sum was generally higher and the polyunsaturate content lower in hepatoma organelles than in corresponding host liver organelles. The 18:0/18:1 ratio observed in hepatoma organelles was always significantly less than that in host or control liver organelles.
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10,002,370
Proximal tubular necrosis associated with maleic acid administration to the rat.
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10,002,371
Administration of maleic acid to the rat is used as an experimental model of Fanconi's syndrome. To determine the site and extent of morphologic injury within the kidney after maleic acid administration, we systematically examined renal tissue using light, transmission electron, and scanning electron microscopy. Tissue was studied either immediately or 24 hours after rats received maleic acid, 200 mg. or 400 mg. per kg. of body weight, and was compared with tissue from controls. In kidneys of maleic acid-treated rats, evidence of injury was observed only in cells of the late pars convoluta and the pars recta in the medullary rays of the cortex and in the outer stripe of the medulla. Injured cells were characterized by an increase in cytoplasmic density, accumulation of numerous small vesicles in the apical region of the cells, abnormal-appearing mitochondria with compressed cristal membranes and flocculent densities, and focal loss of microvilli. Injury was apparent immediately after maleic acid administration and progressed to extensive necrosis by 24 hours after either the 200- or 400-mg. per kg. dose. Except for the presence of granular and hyaline casts in the lumena, the loops of Henle and distal convoluted tubules were normal. Collecting ducts in the outer medulla, but not in the cortex, medullary rays, or inner medulla, had significantly increased numbers of dark cells per total cell population when compared with controls (p less than 0.005). This increase in dark cells may represent an adaptive response of the medullary collecting duct to the functional abnormalities of maleic acid-induced Fanconi's syndrome. Collecting ducts showed no evidence of cell injury or necrosis. These observations provide evidence that maleic acid, like many other renal toxins, produces tubular injury and necrosis only in the proximal tubules, primarily in the medullary rays, and outer stripe of the medulla, and not in the distal tubules.
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10,002,372
Pathology of motor neurons in accelerated hereditary canine spinal muscular atrophy.
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10,002,373
Hereditary canine spinal muscular atrophy is a dominantly inherited lower motor neuron disease with three phenotypic variants: accelerated, intermediate, and chronic. Pups with the accelerated disease develop weakness by 1.5 months and are quadriparetic by 3 months. The motor neurons of selected brainstem nuclei and ventral horn of the spinal cord are characterized by chromatolysis and by neurofibrillary abnormalities in perikarya, dendrites, and, most strikingly, proximal axons. Dendrites and axons are segmentally enlarged by accumulations of maloriented fascicles of neurofilaments; the axonal swelling usually involve internodes and are delimited by the initial segment or nodes of Ranvier. The disorganized neurofilaments appear to entrap mitochondria and other particular organelles. We have hypothesized that the neurofibrillary changes in this genetic disorder in dogs is associated with an abnormality of the cytoskeletal constituents of motor neurons. Hereditary canine spinal muscular atrophy shows features in common with human motor neuron disease.
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10,002,374
Polytetrafluoroethylene or saphenous vein as a femoropopliteal bypass graft?
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10,002,375
Gastric motor response to sympathetic nerve stimulation.
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10,002,376
Continuous canine epidural morphine analgesia with an implanted drug infusion pump.
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10,002,377
Tissue oxygen exchange and reactive hyperemia following microembolization.
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10,002,378
Effects of cholecystokinin on the primate sphincter of Oddi.
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10,002,379
Mechanical performance of the working rat heart: response to calcium.
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10,002,380
Intraportal splenic autotransplantation in rats: feasibility and effectiveness.
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10,002,381
The effect of a traditional preparation of copper, tamrabhasma, on experimental ulcers and gastric secretion.
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10,002,382
Use of a traditional preparation of copper, tamrabhasma, has been suggested in Ayurvedic texts for peptic ulcer. The anti-ulcerogenic effect of copper per se has not been reported in the literature. In the present study the anti-ulcerogenic effect of tamrabhasma was observed in 8-h immobilised, 4-h pylorus-ligated, and aspirin-induced gastric ulcers in rats. The anti-ulcerogenic effect of the drug was also studied in histamine-induced gastric and duodenal ulcers in male guinea pigs. The minimal oral effective anti-ulcerogenic dose of tamrabhasma has been determined to be 1 mg/kg. The drug in this dose caused a decrease in the total acid and pepsin output and an increase in the carbohydrate/protein ratio, indicating increased mucus secretion in the gastric secretion of rats. Acute (1 g/kg, orally) and sub-acute (100 mg/kg, orally, for 7 days) toxicity studies did not show any toxicity including any histological or biochemical evidence of liver or kidney toxicity. The results of the present experimental studies thus lend credence to the suggested use of tamrabhasma in amplapitta, a condition resembling peptic ulcer.
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10,002,383
Significance of positive superior mediastinal nodes identified at mediastinoscopy in patients with resectable cancer of the lung.
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10,002,384
Spontaneous pneumothorax associated with tuberous sclerosis.
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10,002,385
Tuberous sclerosis is a rare hereditary anomaly of variable penetrance characterized by adenoma sebaceum, mental retardation, and epilepsy. Pulmonary disease with spontaneous pneumothorax is a rare complication with this disease. We have recently seen two patients with this complication. A review of the literature reveals 17 other patients with spontaneous pneumothorax and tuberous sclerosis. Eight of these died of pneumothorax. Fifty-three percent of the patients, including all those who died, had normal intelligence. The pathological and roentgenographic findings of the disease are discussed. Recommendations for therapeutic management are given.
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10,002,386
Inward stent-post bending of a porcine bioprosthesis in the mitral position: cause of bioprosthetic dysfunction.
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10,002,387
Clinical study of blood trauma during perfusion with membrane and bubble oxygenators.
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10,002,388
This clinical study was designed to show differences in hemostasis after perfusion with membrane (MO) or bubble (BO) oxygenators in cardiopulmonary bypass. These differences, however, may be obscured by other damaging factors, such as cardiotomy suction, various perfusion durations, or different types of operations. Therefore, only patients undergoing coronary artery bypass grafting were studied. During such operations, rather equal perfusion durations can be expected and mainly apex vent suction is used. Data on postoperative blood loss and transfusions were collected from two groups: one comprising 49 patients perfused with the Travenol TMO membrane oxygenator (MO group) and the other composed of 25 patients with the Polystan VT 5000 bubble oxygenator (BO group). In 10 patients of each group, blood samples were taken at frequent intervals for blood cell counts, for the determination of platelet function, hematocrit, hemoglobin, and plasma hemoglobin, for several coagulation tests, and for the assessment of kidney and liver function. Significant differences between the two groups were found for postoperative blood loss and transfusions, both higher in the BO group. Platelet function was better maintained in the MO group until the moment of releasing the aortic cross-clamp, after which it decreased concurrently with a doubling of the amount of suction. After protamine administration, an additional drop of platelet function occurred and there was virtually no platelet function left in either groups; however, it recovered 90 minutes after bypass, mainly in the MO group. This study shows that hemostasis is better preserved with MO perfusion. Still further improvements may be achieved by preventing the damage of suction and by a correct protamine dose.
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10,002,389
The temperature dependence of recovery of metabolic function following hypothermic potassium cardioplegic arrest.
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10,002,390
A study was performed to define the influence of reperfusate temperature on the recovery of high-energy phosphate compounds following hypothermic ischemic cardioplegic arrest. Two groups, each consisting of six pigs, were subjected to 1 hour of hypothermic potassium cardioplegic arrest (myocardial temperature 10 degrees to 15 degrees C). In one group, the arrest period was followed by a 30 minute period of normothermic reperfusion (37 degrees C) followed by a second hour of hypothermic cardioplegic arrest and a second 30 minute normothermic reperfusion period. The second group of pigs was reperfused after the first hour of arrest for 30 minutes with a cold blood (10 degrees to 14 degrees C) followed by an additional hour of hypothermic cardioplegic arrest and a second 30 minute hypothermic reperfusion period. Myocardial biopsy specimens for adenosine triphosphate (ATP) and creatine phosphate (CP) were obtained at the beginning of perfusion (control studies), at the end of each hour of the arrest interval, and at the end of each 30 minutes of reperfusion. The ATP and CP levels were significantly higher after normothermic reperfusion than after hypothermic reperfusion. After normothermic reperfusion the CP level exceeded control; following hypothermic reperfusion CP remained less than 70% of the control level. On the basis of these results, it is proposed that hypothermic reperfusion does not permit the same level of high-energy phosphorylation that is provided with normothermic reperfusion and may therefore adversely affect hemodynamic recovery of the heart after cardioplegic arrest.
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10,002,391
Acute coronary artery occlusion secondary to blunt chest trauma.
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10,002,392
Two patients suffered an acute transmural MI due to complete occlusion of the proximal LAD after blunt chest trauma. One developed a rupture of the ventricular septum with a ventricular aneurysm and the other an acute ventricular aneurysm, both accompanied by congestive heart failure. Neither had a history of ischemic heart disease; both had normal right and circumflex coronary arteries by arteriography. An intimal tear or subintimal hemorrhage with luminal thrombosis, or both, are the suggested mechanisms of coronary artery occlusion. Both patients were operated upon successfully. Patient 1 underwent closure of the VSD and resection of the ventricular aneurysm. The LAD had returned to normal and required no aortocoronary bypass graft. Patient 2 underwent arteriotomy of the LAD with Fogarty catheter embolectomy and aortocoronary bypass graft, combined with resection of the ventricular aneurysm. We recommend that patients who suffer blunt chest trauma and show ECG changes should undergo cardiac catheterization and coronary arteriography, followed by the pertinent treatment.
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10,002,393
Constrictive epicarditis as a cause of delayed or absent response to pericardiectomy: a clinicopathological study.
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10,002,394
It is widely held that constrictive pericarditis is curable by pericardiectomy, and failure to respond reflects an underlying myocardial disease. Fibrous epicarditis could account for residual cardiac constriction, and delayed hemodynamic response in some patients is an alternative explanation. To examine this, we studied the 12 consecutive patients with otherwise normal hearts treated with extensive pericardiectomy for constrictive pericarditis over the past 7 years. Three hemodynamic responses to pericardiectomy were observed: (1) rapid response, where central venous pressure (CVP) fell below 10 cm H2O by 24 hours in two patients; (2) delayed response, where CVP fell below 10 cm H2O by 48 hours in six patients; and (3) no response of CVP in four patients. The CVPs remained critically elevated (greater than 25 cm H2O) in three patients with delayed response until a sclerotic epicardial peel was resected. Another patient whose CVP of 30 cm H2O showed no change after parietal pericardiectomy was thought to have amyloid cardiomyopathy but instead at autopsy had constrictive epicardial sclerosis not recognized at parietal pericardiectomy. Histologic features of parietal pericardium had no correlation with hemodynamic response, whereas epicardial histology did correlate with hemodynamic response in four patients. The data showed a spectrum of postpericardiectomy delayed hemodynamic responses, which in some patients may be due to a slowly resolving or fixed component of fibrous epicarditis that may be clinically misconstrued as a cardiomyopathy. Interruption of visceral pericardial tissue may be as important as resection of the parietal pericardium in patients with epicardial sclerosis.
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10,002,395
Sinus and atrioventricular nodal function: Preoperative and early postoperative assessment in children.
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10,002,396
Ninety-three rapid atrial pacing studies were performed in 38 children to compare preoperative and early postoperative function of the sinus and atrioventricular (AV) nodes. The interval between the preoperative and postoperative studies was under 6 months in the majority of patients. Postoperative studies were performed within 48 hours of operation and between 4 and 8 days after operation. Sinus nodal function as measured by sinus nodal recovery time (SNRT) was an unreliable index in determining depression since the number who improved postoperatively (10/55) was nearly equal to the number that worsened (12/55). The majority who had abnormal function postoperatively demonstrated a junctional rather than sinus recovery focus. This finding appears a more definitive and more reproducible indicator of sinus node depression in the postoperative patient. Postoperative AV nodal function was decreased (as measured by the cycle length [CL] at which Wenckebach periodicity occurred) in 15 of 55 studies (27%) of the entire group. There was nearly an equal chance for improvement (24%) in function. This also applied to those patients who had sequential studies. Therefore, this method of assessment for AV nodal function was unreliable, or else the operation did not affect the node significantly. The latter is unlikely in view of late postoperative data. The greatest utility of this test was to determine the capability for AV conduction in certain patients with slow escape rhythms in the absence of surface P waves, and to differentiate complete heart block from AV dissociation when atrial activity was absent. Despite the variability of effects on the sinus and AV nodes in these patients, those who demonstrated depression had a significantly higher incidence of dysrhythmias (80% of patients with sinus nodal depression and 100% of patients with AV nodal depression).
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10,002,397
Partial reconstruction of right ventricular outflow tract without cardiopulmonary bypass.
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10,002,398
Anatomic correction of transposition of the great arteries.
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10,002,399
Two-dimensional ultrasound and cardiac operations.
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