Melricflash/CW_MedAbstractsAlt huggingface dataset:
Pharyngeal shape and dimensions in healthy subjects, snorers, and patients with obstructive sleep apnoea. To characterise the relation between pharyngeal anatomy and sleep related disordered breathing, 17 men with complaints of snoring were studied by all night polysomnography. Ten of them had obstructive sleep apnoea (mean (SD) apnoea-hypopnoea index 56.3 (41.7), age 52 (10) years, body mass index 31.4 (5.3) kg/m2); whereas seven were simple snorers (apnoea-hypopnoea index 6.7 (4.6), age 40 (17) years, body mass index 25.9 (4.3) kg/m2). The pharynx was studied by magnetic resonance imaging in all patients and in a group of eight healthy subjects (age 27 (6) years, body mass index 21.8 (2.2) kg/m2, both significantly lower than in the patients; p less than 0.05). On the midsagittal section and six transverse sections equally spaced between the nasopharynx and the hypopharynx several anatomical measurements were performed. Results showed that there was no difference between groups in most magnetic resonance imaging measurements, but that on transverse sections the pharyngeal cross section had an elliptic shape with the long axis oriented in the coronal plane in normal subjects, whereas in apnoeic and snoring patients the pharynx was circular or had an elliptic shape but with the long axis oriented in the sagittal plane. It is suggested that the change in pharyngeal cross sectional shape, secondary to a reduction in pharyngeal transverse diameter, may be related to the risk of developing sleep related disordered breathing. 

Category: general pathological conditions
Total parathyroidectomy and autotransplantation in hyperplasia of the parathyroid gland. Hyperparathyroidism caused by multiple-gland hyperplasia has traditionally been treated by subtotal parathyroidectomy. Excellent results have been reported by some, particularly in primary hyperparathyroidism, but other have reported a significant incidence of recurrent hyperparathyroidism. Since 1979, we have chosen to avoid the possibility of remedial exploration of the neck and its attendant risks by treating all patients with primary and secondary hyperplasia with total parathyroidectomy and heterotopic autotransplantation. A total of 20 patients were studied. There were no failures of grafts and no operative complications. We conclude that this procedure is a reliable and safe alternative in the treatment of primary or secondary hyperplasia of the parathyroid gland. 

Category: general pathological conditions
Haemorheological changes in patients with retinal vein occlusion after isovolaemic haemodilution. In 83 patients with central retinal vein occlusion and branch vein occlusion we measured the haematocrit (HCT), plasma viscosity (PV), red cell aggregation (RCA), red cell filterability (RCF) and apparent whole blood viscosity (WBV). A control group (n = 41) was matched for sex, age, and cardiovascular risk factors. Measurements were performed before and after treatment with isovolaemic haemodilution (IHD). We found no significant differences between patients with retinal vein occlusion (RVO) and control subjects in haematocrit, plasma viscosity, red cell aggregation, and red cell filterability and no increased whole blood viscosity in the patient group. Patients with ischaemic retinal vein occlusion and non-ischaemic retinal vein occlusion did not show different haemorheological parameters either. After treatment with haemodilution, only the haematocrit and whole blood viscosity were significantly decreased, and there were no changes in plasma viscosity, red cell aggregation or red cell filterability. 

Category: cardiovascular diseases
Free alpha subunit of the pituitary glycoprotein hormones. Measurement in serum and tissue of patients with pituitary tumors. A solid-phase radioimmunoassay was developed that measures the free alpha subunits of pituitary glycoprotein hormones (alpha PGpHs) and has negligible cross-reactivity with the intact hormones (less than 0.014% for thyroid-stimulating hormone [TSH], less than 0.1% for human chorionic gonadotropin [hCG], 0.8% for luteinizing hormone [LH], and 2.0% for follicle-stimulating hormone [FSH]). The assay is standardized with the alpha subunit of hCG but also reacts well with the alpha subunits of the other glycoprotein hormones (84% for alpha TSH, 77% for alpha FSH, and 64% for alpha LH). Concentrations as low as 0.3 micrograms/L can be reliably measured, and the 97.5% reference range in 27 healthy adults, including postmenopausal females, is less than or equal to 1.2 micrograms/L. Elevated preoperative alpha PGpH concentrations were found in 45 (9.4%) of 479 sera from patients with pituitary adenoma and 3 (4.5%) of 66 patients with nonadenomatous sellar lesions. Postoperative alpha PGpH levels were lower in 30 of 39 adenoma patients and 2 of 3 nonadenoma patients. In five (1%) of the patients with pituitary adenomas, alpha PGpH was the only elevated serum hormone marker. Serum values of alpha PGpH correlate weakly with alpha subunit immunocytochemical staining--95% of those with negative staining have normal alpha PGpH values, but only 18% of those with positive staining have elevated alpha PGpH values. 

Category: neoplasms
The incidence and prognostic significance of humoral hypercalcemia in renal cell carcinoma. This retrospective study was conducted to evaluate the incidence and prognostic significance of humoral hypercalcemia in 218 renal cell carcinoma patients during the last 20 years. Of 218 patients 20 (9.2%) were hypercalcemic, with serum calcium levels ranging from 10.7 to 16.0 mg./dl. The respective incidence of humoral hypercalcemia was 3% in patients with stage I, 5.9% with stage II, 14.1% with stage III and 18.9% with stage IV disease without bone metastasis. The survival curves between the hypercalcemic and eucalcemic groups among stages I to III cancer patients showed no statistical significance (p greater than 0.05). The survival curve deteriorated significantly in stage IV cancer patients with humoral hypercalcemia (p less than 0.005), with a median survival of 45.0 +/- 39.7 days versus 286.4 +/- 27.6 days in eucalcemic patients. No specific correlation was found between pathological cell type and humoral hypercalcemia. 

Category: neoplasms
Autologous implant of peritoneal mesothelium in rabbits and man. With the purpose of studying peritoneal physiology, original biopsy methods were devised and human and rabbit peritoneal mesothelial cells cultured and characterized. It was then decided to verify whether these cells could be implanted autologously during peritoneal dialysis in cases of acute loss of mesothelial surface. Staphylococcal peritonitis was induced in 12 rabbits and after 4 days of antibiotics, 6 of them were autoimplanted with cultured mesothelial cells, previously marked in 3 cases with thymidine (H3TdR). Implanted rabbits sacrificed after 3 and 6 days showed taking of the new mesothelial cells both by direct morphological observation and by autoradiography. Four uremic CAPD patients recovering from severe peritonitis were implanted with 300 million of their own peritoneal mesothelial cells, previously cultured and frozen. Morphological signs of taking were evident by laparoscopy and from peritoneal biopsies performed 3 and 6 days after implant. The fact that such implants are possible may have interesting applications in medicine and surgery. 

Category: digestive system diseases
Intradural spinal cord tumor presenting as a subarachnoid hemorrhage: magnetic resonance imaging diagnosis. Negative findings on four-vessel angiography after a subarachnoid hemorrhage are seen in 5 to 30% of patients. A previously silent lesion in the spinal canal may be responsible for the ictus in a small percentage of this group. The etiological factors include tumors and arteriovenous malformations; however, investigations of such lesions have been limited to patients with signs and symptoms of spinal cord or nerve root pathological processes. This report describes the management of a 56-year-old woman with clinical findings typical of an aneurysmal subarachnoid hemorrhage and negative findings on cerebral angiography, in whom magnetic resonance imaging with gadolinium enhancement revealed an intradural extramedullary cervical schwannoma. For this reason, cervicothoracic magnetic resonance imaging with gadolinium enhancement should be considered as an adjunctive scanning examination in all patients with a subarachnoid hemorrhage and negative findings on angiography. 

Category: cardiovascular diseases
A hepatocellular carcinoma of massive arterioportal shunts without tumor stain treated with CDDP two-route chemotherapy--a case report. Massive arterioportal shunts without tumor vessels or tumor stain are sometimes encountered in advanced cases of liver cirrhosis. Massive arterioportal shunts without tumor stain that responded well to intensive chemotherapy with cis-diamminedichloroplatinum II are reported. 

Category: general pathological conditions
Translumbar arch aortography: a retrospective controlled study of usefulness, technique, and safety. Subclavian and axillary artery stenoses may lead to axillofemoral bypass graft failure. These arteries were assessed preoperatively with arch aortography performed after conventional high translumbar peripheral aortography by exchanging the initial 16-gauge sheath for a 5-F pigtail catheter. Thirty-two diagnostic translumbar runoff and arch (TLR-arch) aortograms were obtained in 30 patients with advanced lower extremity ischemia. In six patients (20%), the results of the arch study influenced the choice of an inflow site. These patients were compared with 70 control subjects who underwent conventional translumbar aortography without arch studies. In the TLR-arch group, two major complications occurred in one patient, while in the control group 11 major complications occurred in 10 patients. One retroperitoneal hematoma occurred in the TLR-arch group; two occurred in the control group. The mean change in hematocrit for the TLR-arch group was -3.81% (-0.0381), and for the control group it was -4.17% (-0.0417). This difference was not statistically significant. Arch aortography is a valuable adjunct to the translumbar aortofemoral study. It can be simply performed without increasing the morbidity of the peripheral study. 

Category: cardiovascular diseases
Prognostic factors in the treatment of alopecia areata with diphenylcyclopropenone. One hundred thirty-nine patients with alopecia areata were treated with diphenylcyclopropenone. Before treatment, 85 patients had subtotal or total hair loss (greater than 90% bald area) and in the remaining patients scalp involvement was between 40% and 90%. The following three factors were found to be of prognostic significance: type of alopecia areata as documented before treatment, duration of the disease before therapy, and presence of nail changes. Other factors such as age at onset, sex, presence of atopic features, the extent of variation in the range of diphenylcyclopropenone concentrations during treatment, and sleep disturbances caused by pruritus did not influence the prognosis significantly. 

Category: nervous system diseases
Death notification. Family notification in sudden, unexpected, and violent death is a major responsibility of law enforcement, medical examiner, and coroner offices. This report reviews and discusses the process and procedures utilized in death notification and provides suggestions to accomplish this difficult task more effectively. 

Category: general pathological conditions
Quadriceps myopathy: forme fruste of Becker muscular dystrophy. We examined dystrophin, the protein product of the Duchenne muscular dystrophy gene, in muscle biopsy specimens from 4 male patients with quadriceps myopathy, all of whom showed a mild and slowly progressive myopathy confined to the quadriceps muscles. All 4 patients had clear abnormalities of dystrophin, and were diagnosed as having Becker muscular dystrophy by both immunofluorescence and immunoblot examinations; that is, dystrophin of an abnormal molecular mass was visualized in muscle cryosections as "patchy" or discontinuous immunostaining at the surface membrane of the muscle fibers. One patient had a brother who showed widespread myopathic changes consistent with typical Becker muscular dystrophy. We conclude that the syndrome called quadriceps myopathy includes a group of forme fruste Becker muscular dystrophy. 

Category: general pathological conditions
Antibiotic compared with antiseptic prophylaxis for prostatic surgery. Two different regimens of cephalosporin antibiotic prophylaxis were compared with antiseptic lubricating jelly to try to prevent infection and complications in 196 men after prostatic surgery. Pre-operative urine was cultured and prostatic chips (170 cases) were also cultured to define the source of any infection. The use of antibiotics was associated with a reduced risk of postoperative bacteriuria. No serious complications occurred, although 1 patient in the antiseptic treated group developed rigors; 79 of 170 patients (46%) had positive prostatic chip cultures, of whom 74 had sterile pre-operative urine. There was no association between the result of chip culture and the presence of a pre-operative catheter. Culture positive patients had an increased risk of post-operative urine infection, although the same organism was found in the prostate and urine in only 36% of cases of post-operative bacteriuria and in 43 (54%) the organism cultured from the prostate was Staphylococcus albus. This study provides further evidence of the benefit of true prophylactic antibiotic therapy for transurethral prostatic surgery and the prostatic chip data suggest that some of the risk is due to pre-operative contamination of the prostate in the absence of per-operative urinary infection or catheterisation. 

Category: general pathological conditions
'Two-stage turbinectomy': sequestration of the inferior turbinate following submucosal diathermy. Submucous diathermy of the inferior turbinates is a widely practised procedure. Three cases are presented in which surgery was complicated by avascular necrosis of the turbinate bone. Each patient required a debridement procedure before healing and recovery of normal mucociliary function could take place. 

Category: general pathological conditions
Expression of leukocyte alkaline phosphatase gene in normal and leukemic cells: regulation of the transcript by granulocyte colony-stimulating factor. The levels of leukocyte alkaline phosphatase (LAP) messenger RNA (mRNA) are evaluated in B and T lymphocytes, monocytes, and polymorphonuclear cells (PMNs), and this transcript is found to be present only in PMNs. Precursors of the myelomonocytic pathway, represented by leukemic cells isolated from several cases of chronic myelogenous leukemia (CML) in its stable and blastic phase and acute myelogenous leukemia (AML), are devoid of LAP transcript. These data support the notion that LAP is a marker of the granulocyte terminal differentiation. Despite the absence of LAP mRNA in both the myeloid and the lymphoid precursors, nuclear run-on experiments show constitutive transcription of the LAP gene in leukemic cells obtained from AML, CML, as well as acute lymphoblastic leukemia (ALL) and B-cell chronic lymphocytic leukemia (B-CLL). In CML and in chronic myelo-monocytic leukemia (CMML) PMNs, granulocyte colony-stimulating factor (G-CSF) specifically accumulates LAP mRNA without showing a substantial increase in the rate of transcription of the LAP gene. Once increased by G-CSF, LAP mRNA is very stable, showing a half-life of more than 4 hours in the presence of actinomycin-D. G-CSF is suggested to play a pivotal role in the modulation of LAP transcript in PMNs. 

Category: neoplasms
Tumefactive fibroinflammatory lesion of the extremity. Report of a case and review of the literature. Tumefactive fibroinflammatory lesion is an idiopathic fibroinflammatory process of the head and neck region. Although benign histopathologically, it is invasive, destructive, and locally recurrent, leading to uncertainty regarding its proper management; as the disease is rare, determining optimal treatment is difficult, given the anecdotal nature of reports. We report the first case of a tumefactive fibroinflammatory lesion occurring outside the head and neck region. Our patient was treated with corticosteroids and had a favorable response, supporting this approach as initial treatment. Immunohistochemical studies performed on a pretreatment specimen were consistent with a secondary inflammatory component because no monoclonal nor aberrant phenotypes were detected. The tumefactive fibroinflammatory lesion appears to be indistinguishable from the other known idiopathic fibroinflammatory processes; patients presenting with any one of these should be evaluated for the others. 

Category: general pathological conditions
Magnetic resonance imaging and computer tomography of acute spinal cord trauma. Spinal cord lesions are not detectable on roentgenograms and computed tomography (CT) scans. Magnetic resonance images (MRIs) are able to make soft-tissue lesions visible. Interpretations of MRIs, CT scans, and roentgenograms were compared in 25 patients and three postmortem specimens with spinal cord injuries. In 14 patients and one specimen with normal roentgenograms and CT scans, the MRI demonstrated ten soft-tissue injuries as minimal displacement of the vertebral bodies or as a high signal intensity in the disc space, indicating a hematoma. Seven of the ten patients demonstrating soft-tissue injuries also had an intramedullary lesion, while in five of the 15 patients with normal CT scans, only a medullary lesion was present on MRI. In 11 patients and two postmortem specimens, fractures were seen on roentgenograms and CT scans. In these patients, the CT was superior to the MRI in detecting small bony fragments, but the medullary lesions were visible only on the MRIs. An intramedullary low signal intensity corresponded to macroscopically visible hemorrhages in the three postmortem specimens. The MRI provided important information in patients with neurologic deficits. No obvious pathologic changes were evident on the roentgenograms and CT scans. The MRI also demonstrated intramedullary and extramedullary soft-tissue lesions and was useful in establishing a diagnosis and in choosing appropriate therapy. CT, on the other hand, was superior in detecting small bony fragments and fracture lines. 

Category: general pathological conditions
Monocytoid B-cell lymphoma arising in extranodal organs. Six cases of monocytoid B-cell lymphoma (MBCL) developing in extranodal sites (thyroid, three; stomach, two; rectum, one) are described. Patients were all women aged 46 to 65 years (median, 53 years). Three patients with thyroid lymphoma presented with an increasing goiter, two with positive serum antithyroid antibodies, and one patient had chronic lymphocytic thyroiditis (CLTH). The histologic type of surgically resected specimens was a diffuse proliferation of atypical lymphoid cells with monocytoid appearance, i.e., abundant pale cytoplasm with distinct cell border and small reniform nucleus. These cells were CD20+, 22+, 24-, 9- showing their B-cell origin. The monoclonal nature of the proliferating cells was confirmed by restricted expression of immunoglobulin (Ig) light chain and/or gene rearrangement study in three cases. Two cases of thyroid lymphoma in which the monoclonality could not be confirmed had histologic appearances characteristic of malignant lymphoma. All three patients with gastric or rectal lymphoma had reactive lymphoid hyperplasia (RLH) near the tumors. These findings showed presence of MBCL in the extranodal sites with invariable coexistence with lymphoid follicles formed by CLTH in thyroid or RLH in stomach and rectum. 

Category: neoplasms
Vertebral hemangiomas: fat content as a sign of aggressiveness. Thirty-two vertebral hemangiomas (VHs) were evaluated with nonenhanced computed tomography (CT), T1-weighted magnetic resonance (MR) imaging, CT enhanced with contrast material, and selective spinal arteriography. The stroma between the osseous trabeculae was found to correspond to either fatty tissue or soft tissue or both. All 11 asymptomatic VHs showed complete fatty stroma at CT and increased signal intensity at MR imaging. In contrast, all four compressive VHs had soft-tissue attenuation at CT. Three compressive VHs showed low signal intensity on MR images. Predominantly fatty stroma at CT and increased signal intensity at MR imaging were associated with normal or only slightly increased vascularization at selective spinal arteriography or contrast-enhanced CT, while soft-tissue stroma at CT and low signal intensity at MR imaging were associated with distinct hypervascularization. The authors' experience suggests that fatty VHs may represent inactive forms of VH, while soft-tissue content at CT and low signal intensity at MR imaging may indicate a more active vascular lesion with potential to compress the spinal cord. CT and MR imaging may be especially valuable for evaluating patients with clinical signs or symptoms of uncertain origin and findings compatible with VH at plain radiography. 

Category: neoplasms
The role of carotid screening before coronary artery bypass. Five hundred thirty-nine patients with no symptoms of cerebral ischemia undergoing coronary artery bypass were preoperatively evaluated for presence of carotid stenosis by noninvasive methods (duplex scanning and ocular pneumoplethysmography-Gee). Overall prevalence of carotid stenosis greater than 75% was higher (8.7%) than that generally reported. Age greater than 60 years was significantly related to presence of carotid stenosis greater than 75% (11.3% vs 3.8%, p = 0.003). Risk factors such as hypercholesterolemia, hypertension, diabetes mellitus, and smoking were not predictive for carotid stenosis, postoperative stroke, or death. Carotid stenosis greater than 75% (odds ratio 9.87, p less than 0.005) and coronary artery bypass redo (odds ratio 5.26, p less than 0.05) were both independent predictors of stroke risk. Patients were divided into four groups: group 1, minimal or mild degree of carotid stenosis (less than 50%), not submitted to prophylactic carotid endarterectomy (432 patients, 80.1%); group 2, moderate degree of stenosis (50% to 75%), no prophylactic carotid endarterectomy (60 patients, 11.2%); group 3, severe carotid stenosis; (greater than 75%), submitted to prophylactic carotid endarterectomy (19 patients, 3.5%), group 4, severe carotid stenosis (greater than 75%) no prophylactic carotid endarterectomy (28 patients, 5.2%). Patients in group 4 had significantly higher stroke rate (14.3%) compared to the other three groups (1.1%) (p = 0.0019). The finding of carotid stenosis greater than 75% in patients over 60 years of age was associated with occurrence of stroke in 15% of cases. Carotid screening is helpful to determine patients at increased risk of stroke and should be performed in patients greater than 60 years. 

Category: cardiovascular diseases