shukoor65/lab-rag-model huggingface dataset:
Can transcutaneous recordings detect gastric electrical abnormalities? The ability of transcutaneous recordings of gastric electrical activity to detect gastric electrical abnormalities was determined by simultaneous measurements of gastric electrical activity with surgically implanted serosal electrodes and cutaneous electrodes in six patients undergoing abdominal operations. Transient abnormalities in gastric electrical activity were seen in five of the six patients during the postoperative period. Recognition of normal gastric electrical activity by visual analysis was possible 67% of the time and with computer analysis 95% of the time. Ninety four per cent of abnormalities in frequency were detected by visual analysis and 93.7% by computer analysis. Abnormalities involving a loss of coupling, however, were not recognised by transcutaneous recordings. Transcutaneous recordings of gastric electrical activity assessed by computer analysis can usually recognise normal gastric electrical activity and tachygastria. Current techniques, however, are unable to detect abnormalities in electrical coupling.
Cocultures: a new lead in embryo quality improvement for assisted reproduction. One of the contributory causes to poor PRs in assisted reproduction has been the decreased viability of transferred embryos and the transfer of four-cell embryos into an environment that naturally would be receptive only to 5-day-old blastocysts. In this paper, we have reviewed our own work and that of others on the role of tubal ampullary cells (cocultures) to mimic the in vivo environment to bring about improved embryo quality and an increased number of blastocysts for replacement in IVF patients. The establishment, maintenance, and behavior of human tubal cell lines is first presented, followed by their use as cocultures for fertilization and cleavage of embryos. The mode of action, specificity, and cryopreservation of ampullary cells are also discussed. The currently available results of pregnancies after cocultures are presented together with future aspects of research that are necessary to refine the coculture system. The ultimate aim is to mimic in vivo conditions in vitro, so that at least the PRs of assisted conception can be parallel to normal fecundity in the human. Therefore, a very attractive future includes the freezing of blastocysts generated from coculture, thawing, and replacing them in natural cycles.
Mathematical modeling of antigen and immune complex kinetics during extracorporeal removal of autoantibody. The extracorporeal removal of circulating auto-antibodies by repeated plasma exchange or continuous lymph drainage is modeled by single-pool kinetics. Total amounts of antigenic determinants, k-valent antibodies and immune complexes are variables of the model. Factors influencing the course of therapy are included: production rate of antigen and antibody and their natural catabolism. This model can give useful formulae for clinical practice. The effect of treatment can be predicted from the relative depletion of antibody and the actual severity of the disease. Another formula shows how the changed catabolism of antigen after antibody binding can influence the amount of immune complexes. As an example, lymph drainage in myasthenia gravis is calculated using averaged data from three patients.
The natural history of HELLP syndrome: patterns of disease progression and regression. Despite much recent interest in HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count), there is little published information about the natural history of this unique form of severe preeclampsia-eclampsia. The time course and pattern of laboratory abnormalities for 158 patients with HELLP syndrome managed in a single tertiary referral center between 1980 and 1989 were studied retrospectively. Despite considerable patient variation, most gravid women with HELLP syndrome had decreasing platelet counts until 24 to 48 hours after delivery. Conversely, lactate dehydrogenase concentrations usually peaked 24 to 48 hours post partum. In all patients who recovered, a platelet count greater than 1,000,000/mm3 was spontaneously achieved by the sixth postpartum day or within 72 hours of platelet nadir. An upward trend in platelet count and a downward trend in lactate dehydrogenase concentrations should be apparent in patients without complications by the fourth postpartum day. These data provide baseline information against which the course of individual patients can be compared and the infrequent, atypical case identified for interventive therapy.
Immunohematologic characteristics of infection-associated cerebral infarction. We evaluated 50 consecutive patients with acute ischemic stroke to assess the prevalence of systemic infection preceding the neurological event. We analyzed the immunohematologic characteristics of patients with and without signs and/or symptoms of a preceding infectious process. Patients were examined less than or equal to 7 days after cerebral infarction and evaluated for fibrinogen, anticardiolipin antibodies, fibrin D-dimer (a fragment of cross-linked fibrin), plasminogen activator inhibitor-1, and protein S. Of the 50 patients, 17 had symptoms of infection beginning less than or equal to 1 month before the stroke (11 had upper respiratory tract infections, three urinary tract infections, two subacute bacterial endocarditis, and one pneumonia). Compared with patients without infection, patients with infection had significant increases in fibrin D-dimer concentration (5.3 +/- 1.1 versus 4.7 +/- 0.9 log-transformed ng/ml, p less than 0.05) and cardiolipin immunoreactivity, IgG isotype (1.8 +/- 1.3 versus 1.1 +/- 0.9 log-transformed phospholipid units, p less than 0.04), and, when studied less than or equal to 2 days after the stroke, increased fibrinogen levels (459 +/- 126 versus 360 +/- 94 mg/dl, p less than 0.05). In conclusion, infection-associated cerebral infarction is common and is associated with substantial immunohematologic abnormalities.
Postphlebitic syndrome and general surgery: an epidemiologic investigation. Of a random sample comprising 4581 subjects from The Copenhagen County, 3608 (79%) attended an interview and a general health examination. The subjects were defined as suffering from subjective postphlebitic syndrome if they claimed of lower extremity pain or cramps at rest and from objective postphlebitic syndrome if varicose veins, edema, lower extremity ulcers, or skin changes were present. By means of logistic regression analysis, subjective postphlebitic syndrome was found independently associated with previous thromboembolism, obesity, increasing age, female sex, hormonal therapy, varicose veins, and previous major abdominal surgery. Objective postphlebitic syndrome was associated with previous thromboembolism, obesity, former birthgiving, and high social status. The findings support the view that subclinical deep venous thrombosis in connection with previous surgery may give rise to symptoms in the lower extremities.
Acute antihypertensive and renal effects of isradipine in hypertensive patients with normal and reduced renal function. The renal effects of a single oral dose of placebo v a new dihydropyridine calcium antagonist, isradipine, were investigated in 12 patients with mild-to-moderate essential hypertension. Six patients (group A) had normal creatinine concentrations greater than 1.6 mg/dL. Patients maintained a constant daily intake of approximately 120 mmol of sodium and 50 mmol of potassium. Measurements were taken at 30, 60, and 90 min after drug administration. Results indicated that isradipine at a dose of 5 mg once daily produced significant antihypertensive and renal responses. In conclusion, there is therapeutic benefit with isradipine independent of the status of renal function.
Pathophysiology of renovascular hypertension. Renovascular hypertension has its experimental counterpart in the two-kidney, one clip model (Goldblatt hypertension). From the study of this model, a general pathophysiological scheme has evolved suggesting that temporal stages in the development and maintenance of hypertension are regulated by complicated hormonal and neural interrelations. The central roles played by the renin-angiotensin system and the renal nerves is discussed as they relate to other hormones. In addition, the possible contribution of converting enzyme inhibitors to understanding the pathophysiology of this condition is discussed.
Observation of the external aperture of the vestibular aqueduct using three-dimensional surface reconstruction imaging. Observation of the external aperture of the vestibular aqueduct was hitherto possible only in cadavers or dry temporal bones; however, by applying three-dimensional surface reconstruction imaging, it is now possible to observe solid-looking images of this structure in living humans. When the width of the external aperture of the vestibular aqueduct was measured in 58 people, it was found to be significantly narrower in the affected ears of patients with Meniere's disease than in normal ears.
Bright pleural effusion and ascites on gradient-echo MR images: a potential source of confusion in vascular MR studies. Motion of fluids other than blood can cause flow-related signal enhancement on MR images, including MR angiograms. In order to study this problem, the appearance of ascites (20 patients) and pleural effusions (five patients) was assessed on MR images made during suspended respiration with flow-compensated gradient-echo sequences as well as T1- and T2-weighted sequences. Signal intensities of vessels, fluid collections, and muscle were measured and vessel/muscle and vessel/fluid contrast were calculated. Fluid motion was measured with a bolus tracking technique that tags a selected volume of fluid with an RF presaturation. Fluid collections had a bright signal in four of five patients with pleural effusion and in 15 of 20 patients with ascites. The average contrast ratio between bright components of the fluid collections and vessels was only 0.03 +/- 0.09. Bright fluid collections were seen on MR angiograms and could obscure blood vessels. Bolus tracking measurements of ascites revealed multidirectional flow, suggesting that its bright signal is related to motion that continues during suspended respiration. Fluid collections appeared dark on T1-weighted images in all patients, indicating that a short T1 relaxation time was not a cause of the high signal intensity. The results indicate that, despite breath-holding, ascites and pleural effusions can show bright signal intensity on gradient-echo images. Awareness of this phenomenon will avoid confusion between moving fluid collections and flowing blood and identify a source of image degradation on both gradient-echo and T2-weighted spin-echo MR acquisitions.
Alpha 2-macroglobulin is not an acute-phase protein in the rat testis. Earlier studies from this laboratory have shown that Sertoli cells actively synthesize and secrete a nonspecific protease inhibitor in vitro; N-terminal sequence analysis, subunit structural analysis, and other biological studies revealed that this protein is the homolog of serum alpha 2-macroglobulin. We have now quantified the relative distribution of alpha 2-macroglobulin in the reproductive compartments and their comparison with nonreproductive organs. In serum and all nonreproductive tissues examined, the concentration of alpha 2-macroglobulin progressively decreased with advancing age. However, in both the testis and epididymis, the levels of this protein increased with the age of the animals. Serum alpha 2-macroglobulin levels were consistently higher than those in any other tissues until 60 days when the concentrations of this protein were the highest in the epididymis. The distribution of alpha 2-macroglobulin in various nonreproductive tissues from female rats was similar to that observed for male rats in that its levels tended to decrease with age. However, uterine levels of alpha 2-macroglobulin increased progressively with advancing age, whereas ovarian levels of alpha 2-macroglobulin remained relatively stable with an increase in animal age. As serum alpha 2-macroglobulin is an acute-phase protein in the rat, the response of this protein in the testis to induced inflammation was examined. The concentration of alpha 2-macroglobulin in serum rose about 150-fold after injection of fermented yeast. By contrast, the levels of this protein in rete testis fluid, which is derived exclusively from seminiferous fluid, did not change in response to inflammation. These results suggest that there might be distinctive mechanisms that regulate this protein in the systemic circulation vs. the microenvironment behind the blood-testis barrier in the seminiferous epithelium.
Echocardiographic demonstration of decreased left ventricular dimensions and vigorous myocardial contraction during syncope induced by head-up tilt. Two-dimensional echocardiography was performed during a head-up tilt test in 11 control subjects (group I) and 18 patients with recurrent unexplained syncope. In four patients (group II), the head-up tilt test was negative at baseline and after isoproterenol infusion. Syncope was induced during baseline head-up tilt in nine patients (group III) and after isoproterenol challenge in five (group IV). The echocardiographic variables assessed were left ventricular end-systolic and end-diastolic areas and percent fractional shortening. At the end of head-up tilt, end-systolic area decreased by 4.5 +/- 1.3 and 3.0 +/- 1.2 cm2 in groups III and IV, respectively, compared with 0.5 +/- 0.7 and 0.2 +/- 0.1 cm2 in groups I and II, respectively (p less than 0.04). Similarly, end-diastolic area decreased by 5.5 +/- 2.6 cm2 in group III compared with 2.7 +/- 1.9 and 1.75 +/- 0.4 cm2 in group I and II, respectively (p less than 0.04). Additionally, at the end of the baseline study, fractional shortening was significantly greater in group III and group IV (43 +/- 5%) than in groups I and II (p less than 0.01). In conclusion, syncope induced by head-up tilt is associated with vigorous myocardial contraction and a significant decrease in left ventricular end-systolic dimensions. This left ventricular hypercontractility may play an important role in the pathogenesis of syncope induced by head-up tilt.
Hepatitis B and C viruses and their interaction in the origin of hepatocellular carcinoma. Serum taken from patients in a case-control study in Athens, Greece, was used to examine the interactive roles of hepatitis B virus (HBV) and hepatitis C virus (HCV) in the origin of hepatocellular carcinoma (HCC). An enzyme immunoassay for anti-HCV was used to test serum taken from 185 cases with HCC, 35 cases with metastatic liver cancer (MLC), and 432 hospital controls. Weakly positive anti-HCV results were more strongly related to MLC than to HCC, implying that these anti-HCV results are false positive. By contrast, strongly positive anti-HCV results were significantly related to HCC (relative risk [RR], 6.3), whereas no significant association was evident for MLC (RR, 0.6). The association of anti-HCV with HCC was substantially higher among subjects whose radioimmunoassay was positive for hepatitis B surface antigen (RR, 20.0) than among those whose radioimmunoassay was negative for this marker (RR, 4.8). These findings indicate that HCV infection has an interactive role in the origin of HCC.
Multiple myeloma: increased circulating lymphocytes carrying plasma cell-associated antigens as an indicator of poor survival. In multiple myeloma (MM) an increase in circulating lymphocytes expressing plasma cell-associated antigens (PCAA) has been described. Its prognostic significance was evaluated in this study. The immunologic phenotype of peripheral blood lymphocytes was analyzed with a panel of monoclonal antibodies specific for B, T, natural killer lymphocytes, and PCAA (CD38, PCA1) in 52 MM patients at diagnosis, remission, and during relapse, 18 monoclonal gammopathy of undetermined significance (MGUS), and 25 normal controls. No significant phenotypic alteration was observed in MGUS. In MM, the number of B lymphocytes was in the normal range at diagnosis and during the subsequent phases. A CD4/CD8 ratio decrease, during relapse, was due to both a CD4+ reduction and to an expansion of a subset of CD8+ activated suppressor lymphocytes. CD38+ and PCA1+ lymphocytes at diagnosis were significantly higher than in MGUS, and a further increase was observed during relapse, suggesting a correlation between PCAA expression and disease activity. The prognostic significance of increased PCAA was confirmed by a survival analysis of 32 patients evaluated at diagnosis using a CD38 cutoff of 0.45 x 10(9)/L positive lymphocytes. Median survival for patients with high values was only 14 months, whereas it was not reached at 32 months by those with low values (P less than .0007).
Giant cell arteritis presenting as limb claudication. Report and review of the literature. Upper limb claudication and pulselessness is an uncommon presentation of giant cell arteritis (GCA), often resulting in delayed diagnosis. We describe such a case diagnosed by angiography, in which a temporal artery biopsy showed classic GCA, despite the absence of local signs or symptoms. A review of 26 similar cases revealed that in 81% of patients where the only manifestation of GCA was upper limb findings, temporal artery biopsy yielded positive findings. Steroid therapy clinically improved 24/26 patients. These findings suggest that a consideration of temporal artery biopsy early in the investigation will hasten diagnosis and appropriate therapy.
Lack of C-erbB-2 protein expression in pulmonary carcinoid tumours. To determine if amplification of the C-erb-B2 proto-oncogene could be correlated with prognosis in carcinoid tumours, 49 pulmonary carcinoid tumours (26 typical, 23 atypical) were examined using a polyclonal antibody to the C-terminal peptide of the C-erb-B2 protein sequence. No C-erb-B2 gene product could be shown: the demonstration of C-erb-B2 does not seem to help, therefore, in determining diagnosis or prognosis in pulmonary carcinoid tumours.
Femoral-distal bypass with in situ greater saphenous vein. Long-term results using the Mills valvulotome. During a 7-year period, 440 consecutive in situ saphenous vein grafts originating in the groin were performed in 371 patients, exposing the entire vein for valvulotomy with a modified Mills valvulotome. critical ischemia was the indication for bypass in 68%, and the distal anastomosis was to an infrapopliteal artery in 46%. Thirty-day operative mortality was 2.0%. Postoperative surveillance identified 18 stenotic grafts (4.1%), which were revised while still patent (primary revised patency); 36 grafts (8.2%) underwent revision after graft occlusion (secondary patency). Five-year life-table analysis showed overall primary revised patency of 78%, secondary patency of 83%, limb salvage of 88%, and patient survival of 66%. Femoroperoneal and inframalleolar bypasses fared well. The presence of diabetes did not diminish late graft patency. In contrast to reversed vein grafts, long infrapopliteal in situ grafts had long-term secondary patency similar to shorter femoropopliteal bypass grafts (p greater than 0.05). These results, coupled with the versatility and simplicity of the technique as used in the present series, suggest that in situ vein grafting is the procedure of choice for long infrapopliteal bypass.
Identifying risk factors in development of clinically significant post-shock-wave lithotripsy subcapsular hematomas. A retrospective study of 1,012 shock-wave lithotripsy treatments was performed to identify and analyze the risk factors for the development of six clinically significant post-extracorporeal shock-wave lithotripsy (ESWL) subcapsular hematomas. The patients studied had clinical signs and symptoms that on evaluation were confirmed as originating from a subcapsular hematoma. Common factors identified which we believe may put patients at increased risk for the development of subcapsular hematoma included hypertension, diabetes mellitus, coronary artery disease, and obesity.
A universal ossicular replacement prosthesis: clinical trials of 152 cases. An ossicular replacement prosthesis is described that advances implant design in several respects. The head is a flattened egg shape, which eliminates pressure points against the pars tensa and provided balance on the stapes. Dense hydroxylapatite ceramic provides maximal biocompatibility. The shaft, of either Teflon or Plastipore, is easily cut to size and is replaceable to minimize wastage. Interchangeable partial or total shaft variants are provided. Trials in more than 200 patients have produced optimal results. Among 152 mature patients in 85% of the good-risk cases, the air-bone gap closed to within 20 dB and in 65% to within 10 dB; in 69% of all cases the gap closed to within 20 dB. Extrusion rates were 5% in good-risk cases and 7% overall. Long-term extrusions have not occurred. Inasmuch as cartilage interpositioning is unnecessary, the prosthesis is rapidly prepared and implanted by an easily mastered technique.
Exercise training after cardiac transplantation. During the last decade, cardiac transplantation has become the accepted form of treatment for selected patients with end-stage heart disease, which usually results from dilated cardiomyopathy or coronary artery disease. Although 5-yr survival is currently 85%, patients have complicated courses after surgery, with an ever present risk of infection and graft rejection. Because of physical inactivity and severe limitation of cardiac output preoperatively, these deconditioned patients are excellent candidates for medically supervised rehabilitative exercise training programs. Denervation of the myocardium, which occurs with cardiac transplantation, results in a loss of autonomic nervous system modulation of cardiac output, with reliance on circulating catecholamines and with a delayed heart rate and cardiac output response to the onset of exercise. Oxygen uptake kinetics are prolonged, and maximal oxygen uptake is reduced. Additional abnormalities in cardiac and pulmonary artery pressures and in ventilation during exercise have been described. The literature contains seven studies concerning the effects of exercise training in cardiac transplant recipients. Benefits resulting from training include increases in maximal oxygen uptake, peak exercise power output, anaerobic threshold, and lean body mass, reduced perceived exertion, heart rate, and blood pressure during submaximal exercise, and a lowered resting heart rate and blood pressure. There are no data to suggest that exercise training alters the incidence of infection or rejection or improves longevity or return to pre-illness lifestyle.