Melricflash/CW_MedAbstractsAlt huggingface dataset:
An immunofluorescence study of cerebral malaria. A correlation with histopathology. Histopathologic and immunopathologic features of cerebral malaria have been defined in a study of six autopsy cases with severe Plasmodium falciparum infection. In five cases, immunofluorescent studies demonstrated intense deposition of P falciparum antigen, IgG, and fibrin in cerebral vessels associated with the histopathologic finding of hemorrhage in the white matter of cerebrum and cerebellum regardless of the presence of parasitized erythrocytes in the cerebral vessels. Immunofluorescent study also demonstrated the extravascular deposits of P falciparum granular antigen associated with acute inflammatory lesion in cerebral tissue in one case. These findings suggested that the immunopathogenic mechanism may in some way play a role in the pathogenesis of cerebral malaria. 

Category: nervous system diseases
GI symptoms, function, and psychophysiological arousal in dysmenorrheic women. In a previous study, gastrointestinal (GI) symptoms and stool characteristics were found to be influenced by menstrual cycle phase. The current study was designed to replicate initial work regarding GI symptoms and stool characteristics and to explore the relationships between GI symptoms, stool characteristics, ovarian hormone levels, and indicators of psychophysiological arousal. Fifty women (dysmenorrheic, N = 22; nondysmenorrheic, N = 28) maintained a daily dairy for recording stool characteristics, GI symptoms, and daily anxiety level. First morning void urine specimens for catecholamine assays and serum samples for ovarian hormone and cortisol determinations were obtained at menses, follicular, and luteal phases. Results showed menstrual cycle-related differences in stool characteristics and report of GI symptoms, with the greatest changes occurring at menses in the total sample. Dysmenorrheic women reported higher levels of all GI symptoms at menses as compared to nondysmenorrheic women. In addition, cycle-related differences in serum cortisol, urine catecholamines, and report of anxiety were also noted, particularly in dysmenorrheic women. However, looser stools and GI symptoms at menses were not correlated with absolute levels of ovarian hormones or indicators of psychophysiological arousal. 

Category: digestive system diseases
Modification of stroke susceptibility by genotype-dependent maternal influences. The influence of the prenatal and postnatal maternal environment on stroke susceptibility was evaluated by reciprocally crossing the spontaneously hypertensive (SHR) and the Dahl salt-sensitive (SS/Jr) inbred rat strains to produce reciprocal F1 hybrids that were nurtured, respectively, during prenatal and postnatal life by SHR or SS/Jr mothers. Following placement on a high-salt diet containing 8% NaCl at 35 days of age, F1 rats reared by SHR mothers had shorter survival times and were more likely to die with cerebral hemorrhage than F1s reared by SS/Jrs. Across reciprocal F1 female groups, enhanced susceptibility to stroke was associated with greater elevations of systolic blood pressure, but this association was not seen across reciprocal F1 male groups. There was also an association between blood pressure and stroke within each F1/gender subgroup: Rats eventually suffering strokes developed higher blood pressure after placement on the high-salt diet than rats that did not suffer stroke. Lower day 35 body weights (before exposure to the high-salt diet) were associated with greater likelihood of stroke both across the reciprocal F1 groups, and within three of the four F1/gender subgroups. The differences in stroke susceptibility between the reciprocal F1 groupings may be due to systematic differences in the prenatal and/or postnatal environments of SHR and SS/Jr mothers and may be mediated by variations in the nutritive capacity of the two inbred mothers. 

Category: cardiovascular diseases
Hot-tip laser. Results and complications. The hot tip laser system for atheroablation has been used since mid-1984 as a device for broadening the indications for and extending the applicability of angioplasty in the management of lower-extremity atherosclerosis. It has been a controversial device. Although the system demonstrates that it can occasionally be useful for the management of occlusive as opposed to stenotic disease of the infrainguinal arteries, a close examination of the published data fails to demonstrate a consistent improvement in either the primary success or long-term patency rates for thermal energy applied to atheroma for recanalization of the lower extremity arteries. 

Category: cardiovascular diseases
The De Vega tricuspid annuloplasty. Perioperative mortality and long term follow-up. One hundred and fifty-three patients undergoing De Vega tricuspid annuloplasty, with or without other associated cardiac procedures between January, 1979, and June, 1987, were evaluated. There were 136 hospital survivors. The follow-up was 98.1% complete for a mean of 3.7 years/patient. Operative mortality was 11.1%; preoperative NYHA class and length of CPB were significant risk factors of perioperative mortality. The actuarial survival of operative survivors at 9 years was 73.5 +/- 11.8%. There were 7 late cardiac deaths among a total of 12 late deaths. Eleven patients required reoperation (2.1 +/- 0.6% patient-year). In seven patients it was necessary for recurrence of tricuspid regurgitation; six of these had also a mitral prosthesis malfunction or a periprosthetic leak. Residual tricuspid regurgitation was judged as mild, moderate or severe in 29.9%, 11.9% and 4.3% of the patients respectively. De Vega tricuspid annuloplasty is the method of choice for mild and moderate tricuspid insufficiency; in selected cases, with a more severe degree of regurgitation, better results could be achieved with a different surgical approach. 

Category: general pathological conditions
Pharmacologic stress imaging. Pharmacologic stress imaging has increasingly been employed as an alternative to exercise imaging for detection of coronary artery disease and risk stratification particularly in patients who are unable to perform adequate exercise. Sensitivity and specificity of thallium 201 scintigraphy using intravenous dipyridamole infusion as a stress for coronary artery disease detection average 85% and 91%, respectively. Dipyridamole imaging is also useful for differentiating between ischemia and scar and identifying patients who have an increased risk for subsequent cardiac events. Dipyridamole imaging is particularly useful for preoperative risk stratification in patients undergoing surgery for peripheral vascular or aortic disease. Dipyridamole imaging is also useful for identifying residual myocardial ischemia after myocardial infarction and detecting restenosis after coronary angioplasty. Adverse side effects of dipyridamole are promptly reversed by aminophylline. Dipyridamole stress can also be employed in association with echocardiography for detection of ischemia-induced regional wall motion abnormalities. 

Category: general pathological conditions
Improved silver staining of nucleolar organiser regions in paraffin wax sections using an inverted incubation technique [published erratum appears in J Clin Pathol 1991 Jun;44(6):528] A new simple modification to the silver staining of nucleolar organiser regions (AgNORs) was devised which, by performing the incubation with the slide inverted, results in minimal undesirable background staining, a persistent problem. Inverted incubation is facilitated by the use of a commercially available plastic coverplate. This technique has several additional advantages over other published staining protocols. In particular, the method is straightforward, fast, and maintains a high degree of contrast between the background and the AgNORs. 

Category: neoplasms
Corneal sensitivity and correlations between decreased sensitivity and anterior segment pathology in ocular leprosy. Leprosy is one of the leading causes of corneal hyposensitivity. In this article the corneal sensitivity of 143 leprosy patients was examined, and correlations between corneal hyposensitivity and anterior segment pathology were detected. Twenty four healthy volunteers were examined as controls. Various degrees of corneal loss of sensitivity were found in 46.2% of leprosy patients. Lagophthalmos, chronic lepromatous granulomatous uveitis, iris atrophy, and social blindness were found 4.5-16.6 times more frequently in eyes which developed severe corneal hyposensitivity. 

Category: nervous system diseases
Does carotid restenosis predict an increased risk of late symptoms, stroke, or death? The identification of carotid restenosis as an unexpected late complication of carotid endarterectomy has prompted concerns regarding its importance as a source of new cerebral symptoms, stroke, and death. To investigate these concerns, we analyzed a consecutive series of 507 patients undergoing 566 carotid endarterectomies, each documented as technically satisfactory. Post-operative duplex Doppler examination data at 3 days, 1, 3, 6, 12 months, and annually thereafter in 484 arteries (85.5%) permitted classification of these arteries according to the most severe degree of postoperative stenosis: normal (n = 306); 1% to 19% (n = 89); 20% to 50% (n = 40); more than 50% (n = 49, including 8 occluded). The incidence of more than 50% restenosis was 14.5% in female and 7.7% in male patients (p = 0.003). Life table analyses to 10 years revealed a significantly greater life expectancy among those with restenosis (p = 0.05). Stroke was also less likely in patients with restenosis, although this difference did not reach statistical significance. When survival and stroke were both endpoints, the likelihood of patients with more than 50% restenosis remaining alive and stroke free was also greater than the less than 20% stenotic group (p = 0.03). Thus patients with carotid restenosis were less likely than patients with normal postoperative scans to have late symptoms, stroke, or early death. 

Category: cardiovascular diseases
Results of a multicenter trial comparing imipenem/cilastatin to tobramycin/clindamycin for intra-abdominal infections. We designed a multicenter study to compare tobramycin/clindamycin to imipenem/cilastatin for intra-abdominal infections. We included the Acute Physiology and Chronic Health Evaluation (APACHE II) index of severity and excluded patients without established infection. Two hundred ninety patients were enrolled, of whom 162 were evaluable. Using logistic regression to analyze both outcome at the abdominal site of infection and outcome as mortality, we found a significant correlation for both with APACHE II score (p less than 0.0001 for both). Next we analyzed the residual effect of treatment assignment and found a significant improvement in outcome for imipenem/cilastatin-treated patients (p = 0.043). The differences in outcome were explained by a higher failure rate for patients with gram-negative organisms for tobramycin/clindamycin-treated patients (p = 0.018). This was reflected in a significantly higher incidence of fasciitis requiring reoperation and prosthetic fascial replacement. Maximum peak tobramycin levels were analyzed for 63 tobramycin/clindamycin patients harboring gram-negative organisms. For failures the maximum peak was 6.4 +/- 1.9 micrograms/mL, and time to maximum peak was 4.6 +/- 5.2 days. For successes the maximum peak was 6.1 +/- 1.7 micrograms/mL, occurring at 3.8 +/- 2.6 days. This study supports inclusion of severity scoring in statistical analyses of outcome results and supports the notion that imipenem/cilastatin therapy improves outcome at the intra-abdominal site of infection as compared to a conventionally prescribed amino-glycoside-based regimen. 

Category: digestive system diseases
Oral zidovudine, continuous-infusion fluorouracil, and oral leucovorin calcium: a phase I study. A phase I clinical, pharmacologic, and biochemical evaluation of escalating oral zidovudine (AZT) given over 2 days with a fixed dose of continuous-infusion fluorouracil (800 mg/m2 per day X 3 days) and oral leucovorin calcium was performed. Eighteen patients were treated with doses of AZT ranging from 1.0 to 9.0 g/m2 per day. Nausea and vomiting were dose limiting, with a maximally tolerated dose of 7.5 g/m2 per day. Rash and mucositis occurred but were not dose limiting. A dose-related increase in peak plasma levels of AZT was observed, and the alpha half-life of AZT in plasma (75 min) was unaffected by these high doses. At doses above 4.0 g/m2 per day, trough levels significantly increased, perhaps reflecting prolonged absorption from the gut. No responses were observed; however, a significant increase in DNA single-strand breaks was observed in peripheral blood cells after a threshold dose of 4.0 g/m2 per day, confirming a biological effect of AZT in this regimen. Further trials with an intravenous formulation capable of maintaining plasma levels and circumventing dose-limiting toxicity are warranted. 

Category: neoplasms
A videofluoroscopy chair for the evaluation of dysphagia in patients with severe neuromotor disease. Due to the difficulties encountered in positioning severely neurologically impaired individuals for videofluoroscopic studies, the Rehab Tech Video FluoroChair was developed. The purpose of the chair is to provide the severely disabled patient with safe, stable postural support in an upright position for videofluoroscopic studies, with anterior-posterior, lateral, and rotational views easily performed. The chair features a removable headrest, a full back support, armrests, lateral truncal supports, and a patented base which is clamped to the footboard of the radiology table and allows for 200 degrees rotation of the patient. Two case studies illustrate the practical use and versatility of the Rehab Tech Video FluoroChair. 

Category: nervous system diseases
Local-regional breast cancer recurrence following mastectomy. Local-regional recurrence patterns were investigated in 1392 patients with breast cancer. Primary treatment for all patients included a mastectomy. Nine hundred seventeen patients had negative nodes and did not receive systemic therapy. Four hundred seventy-five patients had node metastases and were randomized to receive different combinations of chemoendocrine therapy. Follow-up ranged between 5 and 16 years. Two hundred thirty (25.8%) node-negative patients have had recurrences, with the initial recurrence being local-regional in 9.2%. Two hundred forty-two (50.9%) node-positive patients have had recurrences, with the initial recurrence being local-regional in 17.1%. Larger tumors and more extensive node involvement were associated with more first local-regional recurrences. The relative percent of first local-regional recurrence among patients in whom cancer recurred was similar for node-negative and node-positive patients (35.4% and 33.5%, respectively). In 63.6% of patients in whom cancer recurred, first local-regional recurrence were distant. Larger tumors, more extensive node involvement, and a shorter disease-free interval after mastectomy were associated with more rapid appearance of distant recurrence among these patients. 

Category: general pathological conditions
Brucella endocarditis: the role of combined medical and surgical treatment. Brucella endocarditis, although a rare complication of brucellosis, is the main cause of death related to this disease. This report describes a case of aortic endocarditis due to Brucella abortus in an elderly farmer with known aortic stenosis. Urgent valve replacement was performed because of progressive heart failure despite appropriate antimicrobial treatment. The infection was cured with trimethoprim-sulfamethoxazole and rifampin given for 3 months after surgery. A review of the literature reports on the 38 other cases of cured brucella endocarditis made clear the need for combined antimicrobial treatment and surgical valve replacement. 

Category: cardiovascular diseases
The validity of canine platelet aggregometry in predicting vascular graft patency. Several laboratories have found canine platelet aggregometry predictive of thrombotic potential in vascular grafts. Adenosine diphosphate (ADP) is a frequently used agonist, often at unspecified or differing concentrations. This study was designed to evaluate the predictive value of ADP-induced platelet aggregometry and the validity of the methodology. Platelet aggregometry in response to 2 x 10(-5) M ADP was assayed in 70 dogs. Twenty-six percent were aggregators, 51% were non-aggregators, and 20% were indeterminant. All dogs were then treated with aspirin and dipyridamole. Vascular prostheses were implanted bilaterally (aorto-iliac) and anti-platelet therapy continued for two weeks. Dose-response to ADP was studied at three concentrations in 20 dogs. At 2 x 10(-5) 1/20 aggregated, at 4 x 10(-5) 3/19 aggregated and at 2 x 10(-4) 15/20 aggregated. Time between samples and study was evaluated in 11 dogs, with 2/11 changing from non-aggregator to aggregator at two or three hours. Daily reproducibility was studied in 70 dogs, 14 of which changed aggregation status between days. Patency was 58/68 (85%) for non-aggregators, 23/34 (68%) for aggregators (p = 0.038). Platelet aggregometry has significant predictive value for graft patency but methodology must be specified and standardized. 

Category: general pathological conditions
Osteoma of the middle ear. Report of a case. Osteomas of the middle ear are rare. We report a case of a 7-year-old boy with osteoma originating from the pyramidal eminence, combined with congenital cholesteatoma. The osteoma and cholesteatoma were successfully removed by tympanomastoidectomy. The long process of the incus and the superstructure of the stapes disappeared. The body of the incus was sculpted and used as a columella. Histopathologically, the osteoma was much the same as an external auditory canal osteoma. The possibility of a primary congenital origin of this neoplasm is suggested. 

Category: neoplasms
Orthotopic liver transplantation for patients with hepatitis B virus-related liver disease Fifty-nine patients with prior hepatitis B virus infection underwent orthotopic liver transplantation. During the first 2 mo, mortality was not significantly different in the hepatitis B virus-infected group (25.5%) vs. a hepatitis B virus-immune control group (21%). Beyond 2 mo, the mortality, rate of graft loss, need for retransplantation and incidence of abnormal liver function were significantly higher in the hepatitis B virus-infected group. Treatment of the hepatitis B virus infection was attempted with passive immunization, combined active and passive immunization, alpha-interferon or nothing. The clinical outcome was not significantly influenced by any of these therapies. However, of the patients who lived more than 60 days, 6 of 22 treated with active plus passive immunization were cleared of HBsAg, something achieved once in 16 patients treated with alpha-interferon, never in 3 patients with passive immunization only and once in 4 patients with no therapy. In patients with recurrent hepatitis B virus infection, the pace of hepatitis development in the graft appeared to be accelerated, and this was particularly striking in patients who underwent multiple retransplantations at progressively shorter intervals. None of the patients who became HBsAg-negative had HBeAg preoperatively. 

Category: digestive system diseases
Positive selection of candidate tumor-suppressor genes by subtractive hybridization. A positive selection system designed to identify and recover candidate tumor-suppressor genes is described. The system compares mRNA expression of genes from normal and tumor-derived human mammary epithelial cells grown in a special medium that supports similar growth rates of the two cell types. mRNAs uniquely expressed in normal cells are recovered as cDNAs after subtraction with mRNA from tumor cells. Seven different clones, from 0.6 to 4.8 kilobases in transcript size and including both rare and abundunt transcripts, were recovered in the first 23 clones analyzed. Among the isolated clones were genes encoding the gap-junction protein connexin 26, two different keratins, and glutathione-S-transferase pi, as well as an unknown gene in the S100 family of small calcium-binding proteins. In principle, tumor-suppressor genes include two classes: class I, in which loss of function results from mutation or deletion of DNA and class II, in which loss of function is from a regulatory block to expression. A class II suppressor gene is assumed to be regulated by a different suppressor gene that lost its function by mutation or deletion. Both classes of tumor-suppressor genes may provide valuable proteins with clinical applications in cancer diagnosis or therapy. Class II suppressors may be especially useful because the normal genes are present and their reexpression may be inducible by drugs or other treatments. 

Category: neoplasms
Recurrent pain, illness intrusiveness, and quality of life in end-stage renal disease. Repeated episodes of headache and muscle cramp were hypothesized to contribute to increased patient perceptions of illness intrusiveness and to compromised quality of life. Standard measures of pain, illness intrusiveness, and quality of life were obtained on 2 occasions, each 6 weeks apart, from 100 end-stage renal disease patients. The impact of recurrent muscle cramps on perceptions of illness intrusiveness was conditional upon the occurrence of headache symptoms. Perceptions of illness intrusiveness were significantly higher when both muscle cramp and headache symptoms occurred during one or more assessment intervals as compared to when muscle cramps or headaches, only, occurred. Illness-related concerns and general feelings of pessimism were also significantly higher among patients who experienced recurrent episodes of muscle cramp. Although no direct relations were observed between pain and other quality of life indicators, previous research has documented a relation between illness intrusiveness and quality of life. Recurrent pain problems, thus, appear to contribute to increased illness intrusiveness and to reduced quality of life in end-stage renal disease patients. 

Category: general pathological conditions
Transcranial Doppler determination of cerebral perfusion in patients undergoing CPR: methodology and preliminary findings. STUDY OBJECTIVES: To correlate cerebral arterial blood velocity measurements as determined by transcranial Doppler ultrasound with various resuscitation maneuvers performed in an uncontrolled manner in a series of cardiac arrest patients undergoing standard resuscitation. TYPE OF PARTICIPANTS: Any patient undergoing resuscitation for a nontraumatic cardiac arrest was eligible for the study. INTERVENTIONS: Resuscitation was carried out while flow velocities were monitored in various intracranial arteries by transcranial Doppler ultrasound. Vessel identification was based on the angle and depth of insonation. MEASUREMENTS AND MAIN RESULTS: The internal carotid artery was located more consistently than either middle cerebral or ophthalmic arteries and provided superior waveforms for analysis. Alterations in flow velocity were noted and correlated to various therapeutic interventions. Flow velocities were 70% of normal during the early phase of resuscitation but deteriorated over time until there was no evidence of net forward flow. Even early in CPR, flow was demonstrated only during systole. CONCLUSION: Transcranial Doppler ultrasound appears to be a potentially promising means of determining cerebral flow in patients undergoing CPR. 

Category: cardiovascular diseases